BACKGROUND Laparoscopic distal pancreatectomy(LDP)has emerged as the preferred approach for both benign and malignant lesions located in the pancreatic body and tail.Nevertheless,a notable deficiency persists in the a...BACKGROUND Laparoscopic distal pancreatectomy(LDP)has emerged as the preferred approach for both benign and malignant lesions located in the pancreatic body and tail.Nevertheless,a notable deficiency persists in the absence of a standardized,procedure-specific metric for evaluating and comparing surgical quality.A composite measure termed“textbook outcome(TO)”,which encompasses key short-term endpoints,has been validated in laparoscopic pancreatoduodenectomy but has not yet been established in dedicated LDP cohorts.The definition and prediction of TO in this context could aid in facilitating cross-institutional benchmarking and fostering advancements in quality improvement.AIM To establish procedure-specific criteria for TO and identify independent predictors of TO failure in patients undergoing LDP.METHODS Consecutive patients who underwent LDP at a single high-volume pancreatic center between January 2015 and August 2022 were retrospectively analyzed.TO was defined as the absence of clinically relevant postoperative pancreatic fistula(grade B/C),post-pancreatectomy hemorrhage(grade B/C),severe complications(Clavien-Dindo≥III),readmission within 30 days,and in-hospital or 30-day mortality.Multivariable logistic regression was employed to identify independent predictors of TO failure,and a nomogram was constructed and internally validated.RESULTS Among 405 eligible patients,286(70.6%)attained TO.Multivariable analysis revealed that female sex[odds ratio(OR)=0.62,95%confidence interval(CI):0.39-0.99]conferred a protective effect,while preoperative endoscopic ultrasound-guided fine-needle aspiration(OR=2.66,95%CI:1.05-6.73),pancreatic portal hypertension(OR=2.81,95%CI:1.06-7.45),and cystic-solid(OR=2.51,95%CI:1.34-4.69)or solid lesions(OR=1.91,95%CI:1.06-3.44)were independently associated with TO failure(all P<0.05).The derived nomogram exhibited modest discrimination and calibration when assessed in both the training and validation datasets.CONCLUSION The proposed LDP-specific definition of TO is feasible and discriminative,and the developed nomogram provides an objective tool for individualized risk assessment.展开更多
BACKGROUND To investigate the preoperative factors influencing textbook outcomes(TO)in Intrahepatic cholangiocarcinoma(ICC)patients and evaluate the feasibility of an interpretable machine learning model for preoperat...BACKGROUND To investigate the preoperative factors influencing textbook outcomes(TO)in Intrahepatic cholangiocarcinoma(ICC)patients and evaluate the feasibility of an interpretable machine learning model for preoperative prediction of TO,we developed a machine learning model for preoperative prediction of TO and used the SHapley Additive exPlanations(SHAP)technique to illustrate the prediction process.AIM To analyze the factors influencing textbook outcomes before surgery and to establish interpretable machine learning models for preoperative prediction.METHODS A total of 376 patients diagnosed with ICC were retrospectively collected from four major medical institutions in China,covering the period from 2011 to 2017.Logistic regression analysis was conducted to identify preoperative variables associated with achieving TO.Based on these variables,an EXtreme Gradient Boosting(XGBoost)machine learning prediction model was constructed using the XGBoost package.The SHAP(package:Shapviz)algorithm was employed to visualize each variable's contribution to the model's predictions.Kaplan-Meier survival analysis was performed to compare the prognostic differences between the TO-achieving and non-TO-achieving groups.RESULTS Among 376 patients,287 were included in the training group and 89 in the validation group.Logistic regression identified the following preoperative variables influencing TO:Child-Pugh classification,Eastern Cooperative Oncology Group(ECOG)score,hepatitis B,and tumor size.The XGBoost prediction model demonstrated high accuracy in internal validation(AUC=0.8825)and external validation(AUC=0.8346).Survival analysis revealed that the disease-free survival rates for patients achieving TO at 1,2,and 3 years were 64.2%,56.8%,and 43.4%,respectively.CONCLUSION Child-Pugh classification,ECOG score,hepatitis B,and tumor size are preoperative predictors of TO.In both the training group and the validation group,the machine learning model had certain effectiveness in predicting TO before surgery.The SHAP algorithm provided intuitive visualization of the machine learning prediction process,enhancing its interpretability.展开更多
The report of the Chinese 20th National Congress put forward“strengthening the construction and management of textbooks”for the first time,which indicates the importance of textbook construction and highlights the v...The report of the Chinese 20th National Congress put forward“strengthening the construction and management of textbooks”for the first time,which indicates the importance of textbook construction and highlights the vital position of textbooks in the overall development of the country.From the perspective of textbook quality,and based on the research and analysis of the policy requirements and current evaluation indicators of higher education textbooks,this paper establishes the textbook quality evaluation index system composed of basic indicators and evaluation indicators.This system is based on the principles of science,comprehensiveness,operability,and target-oriented approach.It provides a relatively scientific,objective,and fair reference system for the management and evaluation of textbooks.展开更多
This study first analyzes four distinct forms of Fujian folk dance,highlighting the notable differences in their cultural characteristics and dance qualities.It then categorizes these dance forms to align with textboo...This study first analyzes four distinct forms of Fujian folk dance,highlighting the notable differences in their cultural characteristics and dance qualities.It then categorizes these dance forms to align with textbook construction,discussing in depth the principles guiding the development of textbooks that correspond to these classifications.展开更多
BACKGROUND Textbook outcome(TO),an emerging composite metric for surgical quality assessment,has recently gained recognition for evaluating perioperative results.Laparoscopic transcystic common bile duct exploration(L...BACKGROUND Textbook outcome(TO),an emerging composite metric for surgical quality assessment,has recently gained recognition for evaluating perioperative results.Laparoscopic transcystic common bile duct exploration(LTCBDE)has become a widely adopted minimally invasive technique for treating cholecystolithiasis with choledocholithiasis.Despite its growing clinical application,TO has not yet been formally defined for LTCBDE,nor have its failure-associated risk factors been systematically examined.AIM To define TO for LTCBDE,establish standardized criteria,and identify risk factors for TO failure via logistic regression.METHODS A retrospective cohort of 388 patients who underwent LTCBDE in combination with laparoscopic cholecystectomy at the Department of Biliopancreatic Surgery,Tongji Hospital,from January 2018 to October 2024,was analyzed.The study delineated TO criteria for LTCBDE,calculated the rate of TO achievement,and employed logistic regression to determine independent predictors of TO failure.RESULTS TO was defined as the absence of the following seven criteria:Conversion to open surgery,postoperative complications(Clavien-Dindo grade≥2),biliary leakage(International Study Group of Pancreatic Surgery/International Study Group of Liver Surgery grade B/C),delayed removal of drainage tube(>4 days),postoperative interventions,prolonged length of stay(>7 days),and 30-day readmission or mortality.Among 388 patients,276(71.1%)achieved TO.The primary causes of TO failure included delayed removal of drainage tube(94 cases,83.9%),prolonged length of stay(50 cases,44.6%).Multivariate analysis revealed four independent risk factors for TO failure:Preoperative endoscopic retrograde cholangiopancreatography(P=0.022),advanced age(P=0.010),prolonged anesthesia time(P<0.001),and elevated preoperative alkaline phosphatase levels(P=0.048).These findings suggest that applying the concept of TO to LTCBDE enhances surgical quality evaluation and supports early identification of high-risk patients,facilitating personalized clinical decisions and optimizing individual management.展开更多
“Five education”is pivotal for students’all-round development.However,primary English teaching currently faces challenges including the superficial implementation of“Five education”.This study employed action res...“Five education”is pivotal for students’all-round development.However,primary English teaching currently faces challenges including the superficial implementation of“Five education”.This study employed action research to explore practical methods for integrating English picture book with textbook to implement“Five education”.Through two rounds of iterative action research,a three-stage activity-based teaching path was developed and refined,enabling the progressive infusion of“Five education”objectives across the learning cycle.Findings demonstrated that this integrated approach-particularly when supported by strategies such as picture book background videos and audio-edited narrative connections-effectively deepened the implementation of“Five education”,mitigated student reading fatigue,and significantly improved students’reading fluency and labor initiative,thus provided a replicable practical paradigm for realizing“Five education simultaneously”.展开更多
Based on the ADDIE model,we explored the integration path between Understanding Contemporary China:An English Reading and Writing Textbook and the main textbook of college English reading.Firstly,the basis of textbook...Based on the ADDIE model,we explored the integration path between Understanding Contemporary China:An English Reading and Writing Textbook and the main textbook of college English reading.Firstly,the basis of textbook integration was analyzed,followed by an explanation of the overall design scheme of textbook integration,and then a series of teaching resources were initially developed and used in teaching practice.Through testing,it was found that the integrative teaching of the two sets of textbooks under the ADDIE model achieved good teaching results,and promoted the three aspects of reading literacy,disciplinary literacy,and value leadership.展开更多
The paper discusses the application of three-dimensional textbook in English teaching. The three-dimensional textbook plays an incomparable function than the traditional textbook and thus has an extensive application ...The paper discusses the application of three-dimensional textbook in English teaching. The three-dimensional textbook plays an incomparable function than the traditional textbook and thus has an extensive application in the college English education. It demonstrates the application through the usage of the three-dimensional textbook in the real teaching and shows that excessive usage of sound and pictures or drawings may distract the attention of students. It raises several suggestions at the end.展开更多
笔者以医学英语学习者为主要服务设计对象,以医学内科界的权威书籍Cecil Textbook of Medicine为语料库,以自主开发的词频统计软件获取的单词词频为依据,参考了GSL&AWL词汇表,构建了两个医学英语词汇表,分别是General Word List of ...笔者以医学英语学习者为主要服务设计对象,以医学内科界的权威书籍Cecil Textbook of Medicine为语料库,以自主开发的词频统计软件获取的单词词频为依据,参考了GSL&AWL词汇表,构建了两个医学英语词汇表,分别是General Word List of Internal Medicine和Internal Medicine Terminology List,旨在提高医学英语学习者单词记忆有效性,也为医学英语的教材编写、教学大纲的确定以及在此基础上衍生的医学英语学习者语料库的完善和计算机辅助教学的展开提供一定的学术参考。展开更多
The survey of textbook 'Garden Plant Protection' was introduced in this study,and the necessity of textbook 'Garden Plant Protection' construction in agricultural and forestry universities or higher vo...The survey of textbook 'Garden Plant Protection' was introduced in this study,and the necessity of textbook 'Garden Plant Protection' construction in agricultural and forestry universities or higher vocational colleges was also analyzed.Aimed at the status of textbook 'Garden Plant Protection' construction in agricultural and forestry universities or higher vocational colleges,the corresponding ideas for its construction were put forward.展开更多
More and more researchers realized that what happened in classrooms was deeply influenced by the social and culturalcontexts outside and various articles and researches have been written or done to address this proble...More and more researchers realized that what happened in classrooms was deeply influenced by the social and culturalcontexts outside and various articles and researches have been written or done to address this problem.The essay evaluates a teach-ing material from the perspectives of culture,society and politics by suggesting a few adaptations to the teaching material to make itmore culturally appropriate for Chinese learners.展开更多
文摘BACKGROUND Laparoscopic distal pancreatectomy(LDP)has emerged as the preferred approach for both benign and malignant lesions located in the pancreatic body and tail.Nevertheless,a notable deficiency persists in the absence of a standardized,procedure-specific metric for evaluating and comparing surgical quality.A composite measure termed“textbook outcome(TO)”,which encompasses key short-term endpoints,has been validated in laparoscopic pancreatoduodenectomy but has not yet been established in dedicated LDP cohorts.The definition and prediction of TO in this context could aid in facilitating cross-institutional benchmarking and fostering advancements in quality improvement.AIM To establish procedure-specific criteria for TO and identify independent predictors of TO failure in patients undergoing LDP.METHODS Consecutive patients who underwent LDP at a single high-volume pancreatic center between January 2015 and August 2022 were retrospectively analyzed.TO was defined as the absence of clinically relevant postoperative pancreatic fistula(grade B/C),post-pancreatectomy hemorrhage(grade B/C),severe complications(Clavien-Dindo≥III),readmission within 30 days,and in-hospital or 30-day mortality.Multivariable logistic regression was employed to identify independent predictors of TO failure,and a nomogram was constructed and internally validated.RESULTS Among 405 eligible patients,286(70.6%)attained TO.Multivariable analysis revealed that female sex[odds ratio(OR)=0.62,95%confidence interval(CI):0.39-0.99]conferred a protective effect,while preoperative endoscopic ultrasound-guided fine-needle aspiration(OR=2.66,95%CI:1.05-6.73),pancreatic portal hypertension(OR=2.81,95%CI:1.06-7.45),and cystic-solid(OR=2.51,95%CI:1.34-4.69)or solid lesions(OR=1.91,95%CI:1.06-3.44)were independently associated with TO failure(all P<0.05).The derived nomogram exhibited modest discrimination and calibration when assessed in both the training and validation datasets.CONCLUSION The proposed LDP-specific definition of TO is feasible and discriminative,and the developed nomogram provides an objective tool for individualized risk assessment.
基金Supported by National Key Research and Development Program,No.2022YFC2407304Major Research Project for Middle-Aged and Young Scientists of Fujian Provincial Health Commission,No.2021ZQNZD013+2 种基金The National Natural Science Foundation of China,No.62275050Fujian Province Science and Technology Innovation Joint Fund Project,No.2019Y9108Major Science and Technology Projects of Fujian Province,No.2021YZ036017.
文摘BACKGROUND To investigate the preoperative factors influencing textbook outcomes(TO)in Intrahepatic cholangiocarcinoma(ICC)patients and evaluate the feasibility of an interpretable machine learning model for preoperative prediction of TO,we developed a machine learning model for preoperative prediction of TO and used the SHapley Additive exPlanations(SHAP)technique to illustrate the prediction process.AIM To analyze the factors influencing textbook outcomes before surgery and to establish interpretable machine learning models for preoperative prediction.METHODS A total of 376 patients diagnosed with ICC were retrospectively collected from four major medical institutions in China,covering the period from 2011 to 2017.Logistic regression analysis was conducted to identify preoperative variables associated with achieving TO.Based on these variables,an EXtreme Gradient Boosting(XGBoost)machine learning prediction model was constructed using the XGBoost package.The SHAP(package:Shapviz)algorithm was employed to visualize each variable's contribution to the model's predictions.Kaplan-Meier survival analysis was performed to compare the prognostic differences between the TO-achieving and non-TO-achieving groups.RESULTS Among 376 patients,287 were included in the training group and 89 in the validation group.Logistic regression identified the following preoperative variables influencing TO:Child-Pugh classification,Eastern Cooperative Oncology Group(ECOG)score,hepatitis B,and tumor size.The XGBoost prediction model demonstrated high accuracy in internal validation(AUC=0.8825)and external validation(AUC=0.8346).Survival analysis revealed that the disease-free survival rates for patients achieving TO at 1,2,and 3 years were 64.2%,56.8%,and 43.4%,respectively.CONCLUSION Child-Pugh classification,ECOG score,hepatitis B,and tumor size are preoperative predictors of TO.In both the training group and the validation group,the machine learning model had certain effectiveness in predicting TO before surgery.The SHAP algorithm provided intuitive visualization of the machine learning prediction process,enhancing its interpretability.
文摘The report of the Chinese 20th National Congress put forward“strengthening the construction and management of textbooks”for the first time,which indicates the importance of textbook construction and highlights the vital position of textbooks in the overall development of the country.From the perspective of textbook quality,and based on the research and analysis of the policy requirements and current evaluation indicators of higher education textbooks,this paper establishes the textbook quality evaluation index system composed of basic indicators and evaluation indicators.This system is based on the principles of science,comprehensiveness,operability,and target-oriented approach.It provides a relatively scientific,objective,and fair reference system for the management and evaluation of textbooks.
文摘This study first analyzes four distinct forms of Fujian folk dance,highlighting the notable differences in their cultural characteristics and dance qualities.It then categorizes these dance forms to align with textbook construction,discussing in depth the principles guiding the development of textbooks that correspond to these classifications.
文摘BACKGROUND Textbook outcome(TO),an emerging composite metric for surgical quality assessment,has recently gained recognition for evaluating perioperative results.Laparoscopic transcystic common bile duct exploration(LTCBDE)has become a widely adopted minimally invasive technique for treating cholecystolithiasis with choledocholithiasis.Despite its growing clinical application,TO has not yet been formally defined for LTCBDE,nor have its failure-associated risk factors been systematically examined.AIM To define TO for LTCBDE,establish standardized criteria,and identify risk factors for TO failure via logistic regression.METHODS A retrospective cohort of 388 patients who underwent LTCBDE in combination with laparoscopic cholecystectomy at the Department of Biliopancreatic Surgery,Tongji Hospital,from January 2018 to October 2024,was analyzed.The study delineated TO criteria for LTCBDE,calculated the rate of TO achievement,and employed logistic regression to determine independent predictors of TO failure.RESULTS TO was defined as the absence of the following seven criteria:Conversion to open surgery,postoperative complications(Clavien-Dindo grade≥2),biliary leakage(International Study Group of Pancreatic Surgery/International Study Group of Liver Surgery grade B/C),delayed removal of drainage tube(>4 days),postoperative interventions,prolonged length of stay(>7 days),and 30-day readmission or mortality.Among 388 patients,276(71.1%)achieved TO.The primary causes of TO failure included delayed removal of drainage tube(94 cases,83.9%),prolonged length of stay(50 cases,44.6%).Multivariate analysis revealed four independent risk factors for TO failure:Preoperative endoscopic retrograde cholangiopancreatography(P=0.022),advanced age(P=0.010),prolonged anesthesia time(P<0.001),and elevated preoperative alkaline phosphatase levels(P=0.048).These findings suggest that applying the concept of TO to LTCBDE enhances surgical quality evaluation and supports early identification of high-risk patients,facilitating personalized clinical decisions and optimizing individual management.
基金this paper is funded by Project Information:2023 Guangdong Undergraduate Colleges and Universities Teaching Quality and Teaching Reform Project Construction Project,Project Name:Action Research on Whole-area Nurturing of English Reading Teaching in Universities,Secondary and Primary Schools under the Perspective of Discipline Nurturing.Project serial number:895.
文摘“Five education”is pivotal for students’all-round development.However,primary English teaching currently faces challenges including the superficial implementation of“Five education”.This study employed action research to explore practical methods for integrating English picture book with textbook to implement“Five education”.Through two rounds of iterative action research,a three-stage activity-based teaching path was developed and refined,enabling the progressive infusion of“Five education”objectives across the learning cycle.Findings demonstrated that this integrated approach-particularly when supported by strategies such as picture book background videos and audio-edited narrative connections-effectively deepened the implementation of“Five education”,mitigated student reading fatigue,and significantly improved students’reading fluency and labor initiative,thus provided a replicable practical paradigm for realizing“Five education simultaneously”.
基金funded by Project Information:2022 Guangzhou Municipal Higher Education Teaching Research and Reform Key Research Project:“Innovation and Practice of English Reading Curriculum Ideological and Political in Colleges and Universities:A Study on the Integration of Understanding Contemporary China:An English Reading and Writing Textbook and English Reading Teaching”(2023JGZDXM001).
文摘Based on the ADDIE model,we explored the integration path between Understanding Contemporary China:An English Reading and Writing Textbook and the main textbook of college English reading.Firstly,the basis of textbook integration was analyzed,followed by an explanation of the overall design scheme of textbook integration,and then a series of teaching resources were initially developed and used in teaching practice.Through testing,it was found that the integrative teaching of the two sets of textbooks under the ADDIE model achieved good teaching results,and promoted the three aspects of reading literacy,disciplinary literacy,and value leadership.
文摘The paper discusses the application of three-dimensional textbook in English teaching. The three-dimensional textbook plays an incomparable function than the traditional textbook and thus has an extensive application in the college English education. It demonstrates the application through the usage of the three-dimensional textbook in the real teaching and shows that excessive usage of sound and pictures or drawings may distract the attention of students. It raises several suggestions at the end.
基金西安思源学院2016年横向课题"基于Cecil Textbook of Medicine的医学英语词表构建"
文摘笔者以医学英语学习者为主要服务设计对象,以医学内科界的权威书籍Cecil Textbook of Medicine为语料库,以自主开发的词频统计软件获取的单词词频为依据,参考了GSL&AWL词汇表,构建了两个医学英语词汇表,分别是General Word List of Internal Medicine和Internal Medicine Terminology List,旨在提高医学英语学习者单词记忆有效性,也为医学英语的教材编写、教学大纲的确定以及在此基础上衍生的医学英语学习者语料库的完善和计算机辅助教学的展开提供一定的学术参考。
文摘The survey of textbook 'Garden Plant Protection' was introduced in this study,and the necessity of textbook 'Garden Plant Protection' construction in agricultural and forestry universities or higher vocational colleges was also analyzed.Aimed at the status of textbook 'Garden Plant Protection' construction in agricultural and forestry universities or higher vocational colleges,the corresponding ideas for its construction were put forward.
文摘More and more researchers realized that what happened in classrooms was deeply influenced by the social and culturalcontexts outside and various articles and researches have been written or done to address this problem.The essay evaluates a teach-ing material from the perspectives of culture,society and politics by suggesting a few adaptations to the teaching material to make itmore culturally appropriate for Chinese learners.
