AIM： To introduce and evaluate a new method to re- pair bile duct defect with a degradable stent and au- tologous tissues. METHODS： Eight Ba-Ma mini-pigs were used in this study, Experimental models with common bile...AIM： To introduce and evaluate a new method to re- pair bile duct defect with a degradable stent and au- tologous tissues. METHODS： Eight Ba-Ma mini-pigs were used in this study, Experimental models with common bile duct （CBD） defect （0,5-1,0 cm segment of CBD resected） were established and then CBD was reconstructed by duct to duct anastomosis with a novel degradable stent made of poly [sebacic acid-co-（1,3-propanediol）-co- （1,2-propanediol）]. In addition, a vascularized greater omentum was placed around the stent and both ends of CBD. Cholangiography via gall bladder was per- formed for each pig at postoperative months 1 and 3 to rule out stent translocation and bile duct stricture. Complete blood count was examined pre- and post- operatively to estimate the inflammatory reaction. Liver enzymes and serum bilirubin were examined pre- and post-operatively to evaluate the liver function. Five pigs were sacrificed at month 3 to evaluate the healing of anastomosis. The other three pigs were raised for one year for long-term observation. RESULTS： All the animals underwent surgery success- fully. There was no intraoperative mortality and no bile leakage during the observation period, The white blood cell counts were only slightly increased on day 14 and month 3 postoperatively compared with that before operation, the difference was not statistically significant （P = 0.652）. The plasma level of alanine aminotrans- ferase on day 14 and month 3 postoperatively was also not significantly elevated compared with that before operation （P = 0.810）. Nevertheless, the plasma level of y-glutamyl transferase was increased after opera- tion in both groups （P = 0.004）, especially 2 wk after operation. The level of serum total bilirubin after opera- tion was not significantly elevated compared with that before operation （P = 0.227）, so did the serum direct bilirubin （P = 0.759）. By cholangiography yia gall blad- der, we found that the stent maintained its integrity of shape and was stillin situ at month 1, and it disap- peared completely at month 3. No severe CBD dilation and stricture were observed at both months 1 and 3. No pig died during the 3-too postoperative observation period. No sign of necrosis, bile duct stricture, bile leak- age or abdominal abscess was found at reoperation at month 3 postoperatively. Pigs had neither fragments of stent nor stones formed in the CBD. Collagen deposit was observed in the anastomosis by hematoxylin and eosin （HE） and Masson＇s trichrome stains. No severe cholestasis was observed in liver parenchyma by HE staining. Intestinal obstruction was found in a pig 4 mo after operation, and no bile leakage, bile duct stricture or biliary obstruction were observed in laparotomy. No sign of bile duct stricture or bile leakage was observed in the other two pigs. CONCLUSION： The novel method for repairing bile duct defect yielded a good short-term effect without postoperative bile duct stricture. However, the long- term effect should be further studied.展开更多
The purpose of the study was to use the Problem-Centered Double-Cycles Instructional Model （PCDC-IM） （1995, Chang） to help the teacher （Lin） implement model-eliciting activity （MEA） in her mathematics classes....The purpose of the study was to use the Problem-Centered Double-Cycles Instructional Model （PCDC-IM） （1995, Chang） to help the teacher （Lin） implement model-eliciting activity （MEA） in her mathematics classes. In this study, there were 31 students divided in 10 groups and engaged in the MEA ＂Who saved the oriental cherry trees＂. Data collections included the learning sheets, journals and debriefing forms of students, teaching and reflection journals, observation reports, and field notes of teachers, reflection journals and interview reports of researchers, video tapes and records of the classes and meetings. There were four parts of the teaching cycle in PCDC-IM, namely task, guidance, environment and analysis. We summarized developing and implementing the MEA in ＂Task＂ aspect, 5 principles and 5 kinds of teachers＇ roles in ＂Guidance＂ aspect, 2 elements and 5 features in ＂Environment＂ aspect and data in ＂Analysis＂ aspect. The findings showed that PCDC-IM was helpful for mathematics teachers who want to change their instruction from lecture into modeling teaching.展开更多
Objective： The liver hanging maneuver （LHM） is rarely applied in laparoscopic right hepatectomy （LRH） because of the difficulty encountered in retrohepatic tunnel （RT） dissection and tape positioning. Thus far ...Objective： The liver hanging maneuver （LHM） is rarely applied in laparoscopic right hepatectomy （LRH） because of the difficulty encountered in retrohepatic tunnel （RT） dissection and tape positioning. Thus far no report has detailed how to quickly and easily establish RT for laparoscopic LHM in LRH, nor has employment of the Goldfinger dissector to create a total RT been reported. This study＇s aim was to evaluate the safety and feasibility of establishing RT for laparoscopic LHM using the Goldfinger dissector in LRH. Methods： Between March 2015 and July 2015, five consecutive patients underwent LRH via the caudal approach with laparoscopic LHM. A five-step strategy using the Goldfinger dissector to establish RT for laparoscopic LHM was adopted. Perioperative data were analyzed. Results： The median age of patients was 58 （range, 51-65） years. Surgery was performed for one intrahepatic lithiasis and four hepatocellular carcinomas with a median size of 90 （40-150） mm. The median operative time was 320 （282-358） min with a median blood loss of 200 （200-600） ml. Laparoscopic LHM was achieved in a median of 31 （21-62） min, and the median postoperative hospital stay was 14 （9-16） d. No transfusion or conversion was required, and no severe liver-related morbidity or death was observed. Conclusions： The Goldfinger dissector is a useful instrument for the establishment of RT. A five-step strategy using the Goldfinger dissector can quickly and easily facilitate an RT for a laparoscopic LHM in LRH.展开更多
The long-range interaction between Rydberg-excited atoms endows a medium with large optical nonlinearity.Here,we demonstrate an optical switch to operate on a single photon from an entangled photon pair under a Rydber...The long-range interaction between Rydberg-excited atoms endows a medium with large optical nonlinearity.Here,we demonstrate an optical switch to operate on a single photon from an entangled photon pair under a Rydberg electromagnetically induced transparency configuration.With the presence of the Rydberg blockade effect,we switch on a gate field to make the atomic medium nontransparent thereby absorbing the single photon emitted from another atomic ensemble via the spontaneous fourwave mixing process.In contrast to the case without a gate field,more than 50%of the photons sent to the switch are blocked,and finally achieve an effective single-photon switch.There are on average 1-2 gate photons per effective blockade sphere in one gate pulse.This switching effect on a single entangled photon depends on the principal quantum number and the photon number of the gate field.Our experimental progress is significant in the quantum information process especially in controlling the interaction between Rydberg atoms and entangled photon pairs.展开更多
基金Supported by Grants from Science and Technology Department of Zhejiang Province, No. 2009C33027 and No. 2009R50040
文摘AIM： To introduce and evaluate a new method to re- pair bile duct defect with a degradable stent and au- tologous tissues. METHODS： Eight Ba-Ma mini-pigs were used in this study, Experimental models with common bile duct （CBD） defect （0,5-1,0 cm segment of CBD resected） were established and then CBD was reconstructed by duct to duct anastomosis with a novel degradable stent made of poly [sebacic acid-co-（1,3-propanediol）-co- （1,2-propanediol）]. In addition, a vascularized greater omentum was placed around the stent and both ends of CBD. Cholangiography via gall bladder was per- formed for each pig at postoperative months 1 and 3 to rule out stent translocation and bile duct stricture. Complete blood count was examined pre- and post- operatively to estimate the inflammatory reaction. Liver enzymes and serum bilirubin were examined pre- and post-operatively to evaluate the liver function. Five pigs were sacrificed at month 3 to evaluate the healing of anastomosis. The other three pigs were raised for one year for long-term observation. RESULTS： All the animals underwent surgery success- fully. There was no intraoperative mortality and no bile leakage during the observation period, The white blood cell counts were only slightly increased on day 14 and month 3 postoperatively compared with that before operation, the difference was not statistically significant （P = 0.652）. The plasma level of alanine aminotrans- ferase on day 14 and month 3 postoperatively was also not significantly elevated compared with that before operation （P = 0.810）. Nevertheless, the plasma level of y-glutamyl transferase was increased after opera- tion in both groups （P = 0.004）, especially 2 wk after operation. The level of serum total bilirubin after opera- tion was not significantly elevated compared with that before operation （P = 0.227）, so did the serum direct bilirubin （P = 0.759）. By cholangiography yia gall blad- der, we found that the stent maintained its integrity of shape and was stillin situ at month 1, and it disap- peared completely at month 3. No severe CBD dilation and stricture were observed at both months 1 and 3. No pig died during the 3-too postoperative observation period. No sign of necrosis, bile duct stricture, bile leak- age or abdominal abscess was found at reoperation at month 3 postoperatively. Pigs had neither fragments of stent nor stones formed in the CBD. Collagen deposit was observed in the anastomosis by hematoxylin and eosin （HE） and Masson＇s trichrome stains. No severe cholestasis was observed in liver parenchyma by HE staining. Intestinal obstruction was found in a pig 4 mo after operation, and no bile leakage, bile duct stricture or biliary obstruction were observed in laparotomy. No sign of bile duct stricture or bile leakage was observed in the other two pigs. CONCLUSION： The novel method for repairing bile duct defect yielded a good short-term effect without postoperative bile duct stricture. However, the long- term effect should be further studied.
文摘The purpose of the study was to use the Problem-Centered Double-Cycles Instructional Model （PCDC-IM） （1995, Chang） to help the teacher （Lin） implement model-eliciting activity （MEA） in her mathematics classes. In this study, there were 31 students divided in 10 groups and engaged in the MEA ＂Who saved the oriental cherry trees＂. Data collections included the learning sheets, journals and debriefing forms of students, teaching and reflection journals, observation reports, and field notes of teachers, reflection journals and interview reports of researchers, video tapes and records of the classes and meetings. There were four parts of the teaching cycle in PCDC-IM, namely task, guidance, environment and analysis. We summarized developing and implementing the MEA in ＂Task＂ aspect, 5 principles and 5 kinds of teachers＇ roles in ＂Guidance＂ aspect, 2 elements and 5 features in ＂Environment＂ aspect and data in ＂Analysis＂ aspect. The findings showed that PCDC-IM was helpful for mathematics teachers who want to change their instruction from lecture into modeling teaching.
基金Project supported by the General Research Project of Medicine and Science of Zhejiang Province(Nos.2014KYB119 and 2015KYB221),China
文摘Objective： The liver hanging maneuver （LHM） is rarely applied in laparoscopic right hepatectomy （LRH） because of the difficulty encountered in retrohepatic tunnel （RT） dissection and tape positioning. Thus far no report has detailed how to quickly and easily establish RT for laparoscopic LHM in LRH, nor has employment of the Goldfinger dissector to create a total RT been reported. This study＇s aim was to evaluate the safety and feasibility of establishing RT for laparoscopic LHM using the Goldfinger dissector in LRH. Methods： Between March 2015 and July 2015, five consecutive patients underwent LRH via the caudal approach with laparoscopic LHM. A five-step strategy using the Goldfinger dissector to establish RT for laparoscopic LHM was adopted. Perioperative data were analyzed. Results： The median age of patients was 58 （range, 51-65） years. Surgery was performed for one intrahepatic lithiasis and four hepatocellular carcinomas with a median size of 90 （40-150） mm. The median operative time was 320 （282-358） min with a median blood loss of 200 （200-600） ml. Laparoscopic LHM was achieved in a median of 31 （21-62） min, and the median postoperative hospital stay was 14 （9-16） d. No transfusion or conversion was required, and no severe liver-related morbidity or death was observed. Conclusions： The Goldfinger dissector is a useful instrument for the establishment of RT. A five-step strategy using the Goldfinger dissector can quickly and easily facilitate an RT for a laparoscopic LHM in LRH.
基金supported by the National Key Research and Development Program of China(Grant No.2017YFA0304800)the National Natural Science Foundation of China(Grant Nos.61525504,61722510,61435011,11174271,61275115,and 11604322)+1 种基金the Anhui Initiative in Quantum Information Technologies(Grant No.AHY020200)the Youth Innovation Pro motion Association of Chinese Academy of Sciences(Grant No.2018490)。
文摘The long-range interaction between Rydberg-excited atoms endows a medium with large optical nonlinearity.Here,we demonstrate an optical switch to operate on a single photon from an entangled photon pair under a Rydberg electromagnetically induced transparency configuration.With the presence of the Rydberg blockade effect,we switch on a gate field to make the atomic medium nontransparent thereby absorbing the single photon emitted from another atomic ensemble via the spontaneous fourwave mixing process.In contrast to the case without a gate field,more than 50%of the photons sent to the switch are blocked,and finally achieve an effective single-photon switch.There are on average 1-2 gate photons per effective blockade sphere in one gate pulse.This switching effect on a single entangled photon depends on the principal quantum number and the photon number of the gate field.Our experimental progress is significant in the quantum information process especially in controlling the interaction between Rydberg atoms and entangled photon pairs.
