Whole grains of proso and barnyard millets were sequentially extracted using different solvents(hexane,chloroform,ethyl acetate,and methanol).Phytochemical analysis was performed qualitatively,and the total phenolic c...Whole grains of proso and barnyard millets were sequentially extracted using different solvents(hexane,chloroform,ethyl acetate,and methanol).Phytochemical analysis was performed qualitatively,and the total phenolic content in the extracts of proso and barnyard millets was quantified.Alkaloids and cardiac glycosides were identified in all solvent extracts of both millets.Anthraquinone and glycosides yielded negative results in all solvent extracts of both millets.Among all the solvent extracts,methanol extracts of proso and barnyard millets showed the presence of major compounds such as flavonoids,terpenoids,amino acids,tannins,and phenolics compounds.The maximum amount of phenols was found in methanolic extracts of proso and barnyard millets(0.669±0.003 and 0.625±0.003),followed by the chloroform extract of proso and barnyard millets(0.284±0.002 and 0.257±0.003).The minimum amount of phenolics was found in the acetone extract of proso and barnyard millets.The methanol extract of both millets showed the presence of major compounds with high phenolic content.展开更多
Objective:To systematically evaluate and compare the safety and effectiveness of esophagojejunostomy and traditional esophagojejunostomy in total laparoscopic total gastrectomy in the treatment of gastric cancer,provi...Objective:To systematically evaluate and compare the safety and effectiveness of esophagojejunostomy and traditional esophagojejunostomy in total laparoscopic total gastrectomy in the treatment of gastric cancer,providing evidence-based medical evidence for clinical practice.Methods:PubMed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang and VIP databases were searched by computer,and the retrieval time was up to December 2021.Relevant literatures were obtained,and eligible studies were gradually screened and included.Cochrane ROB bias risk assessment tool and NOS scale were used to evaluate the quality of the articles,and required data were extracted from high-quality literatures.Finally,meta-analysis was performed using Review Manager 5.3 software.Results:Eleven studies were finally included,including 1398 patients,including 566 patients receiving overlap anastomosis and 832 patients receiving traditional anastomosis.The results show that overlap anastomosis and traditional anastomosis had the advantages of operation time(MD=0.63,95%CI=7.22,8.48,P=0.88),postoperative first exhaust time(MD=-0.13,95%CI=0.43,0.18,P=0.42),postoperative first feeding time(MD=0.02,95%CI=0.33,0.37,P=0.91),anastomotic leakage(OR=1.38,95%CI=0.73,2.63,P=0.32),and postoperative hospital stay(MD=-0.16,95%CI=0.82,0.51,P=0.64)had no significant differences(all P>0.05).Compared with traditional anastomosis,overlap anastomosis had longer anastomosis time(MD=5.60,95%CI=0.59,10.62,P=0.03),higher incidence of anastomotic bleeding(OR=2.48,95%CI=1.08,5.69,P=0.03),less intraoperative bleeding(MD=-6.42,MD=-6.42,OR=2.48,95%CI=1.08,P=0.03).95%CI=10.28,-2.56,P=0.001)and anastomotic stenosis(OR=0.17,95%CI=0.06,0.46,P=0.0006).Conclusion:Overlap esophagojejunostomy is a safe,effective and prognostic surgical method,and is expected to become the standard esophagojejunostomy in total laparoscopic total gastrectomy.展开更多
AIM:To determine and evaluate the features of highly cited articles(HCAs)in the ophthalmology category in the Science Citation Index Expanded(SCI-EXPANDED)from 1991 to 2020.METHODS:The Web of Science Core Collection d...AIM:To determine and evaluate the features of highly cited articles(HCAs)in the ophthalmology category in the Science Citation Index Expanded(SCI-EXPANDED)from 1991 to 2020.METHODS:The Web of Science Core Collection documents with at least 100 citations from their publication year until December 31,2020,were evaluated as highly cited.The examined features were the distribution of yearly output and its average number of per publication,HCAs,authors,institutions,journals,and nations.The publication performance of nations and organizations was assessed using six publication indicators.The Y-index was employed to compare the research outputs of various authors.RESULTS:Publications that had cited the most references were highly published in high-impact factor journals.The United States of America came out on top across all six publication indicators,and it was home to eight of the top 10 most productive institutions.The articles written by Breivik et al(2006)and Farrar et al(2001)were highly cited and had a significant impact in 2020.The authors had a higher number of highly cited articles published as corresponding authors than as first authors.CONCLUSION:The findings of the present study highlight the current scope of global research in ophthalmology.The findings can help policy-makers and advisory groups of research centers to develop future policies.In addition,the findings can guide researchers in this field.展开更多
[Objectives]To systematically evaluate the total clinical effective rate of acupuncture treatment of depression,and provide clinical reference for the scheme design and selection of acupuncture treatment of depression...[Objectives]To systematically evaluate the total clinical effective rate of acupuncture treatment of depression,and provide clinical reference for the scheme design and selection of acupuncture treatment of depression.[Methods]By searching CNKI,Wanfang Data,CBM,VIP,Cochrane Library,Cochrane Central,Springer and other databases,randomized controlled experiment(RCT)on acupuncture and moxibustion treatment of depression from January 1,2019 to August 31,2022 was collected,to extract relevant data of total clinical effective rate and conduct methodological quality evaluation.ReviewManager 5.4.1 software was used for Meta analysis.[Results]22 RCTs were included,1602 patients in total.Among them,there were 804 cases in treatment group and 798 cases in control group.Meta analysis results displayed that acupuncture and moxibustion treatment of depression may be better than the control group in improving the total clinical effective rate,and the difference was statistically significant[MD=1.16,95%CI(1.11,1.21)].[Conclusions]Acupuncture and moxibustion can achieve a higher total clinical effective rate in the treatment of depression,which is worthy of clinical application.However,due to fewer studies included in this systematic evaluation,small sample size,and low quality,there was a high possibility of bias.Therefore,the above conclusions needed to be verified by high-quality,large-sample,and multi-center RCTs.展开更多
The main objective of this research was to examine the suitability of aluminium alloy to design a piston of an internal combustion engine for improvement in weight and cost reduction. The piston was modelled using Aut...The main objective of this research was to examine the suitability of aluminium alloy to design a piston of an internal combustion engine for improvement in weight and cost reduction. The piston was modelled using Autodesk Inventor 2017 software. The modelled piston was then imported into Ansys for further analysis. Static structural and thermal analysis were carried out on the pistons of the four different materials namely: Al 413 alloy, Al 384 alloy, Al 390 alloy and Al332 alloy to determine the total deformation, equivalent Von Mises stress, maximum shear stress, and the safety factor. The results of the study revealed that, aluminium 332 alloy piston deformed less compared to the deformations of aluminium 390 alloy piston, aluminium 384 alloy piston and aluminium 413 alloy piston. The induced Von Mises stresses in the pistons of the four different materials were found to be far lower than the yield strengths of all the materials. Hence, all the selected materials including the implementing material have equal properties to withstand the maximum gas load. All the selected materials were observed to have high thermal conductivity enough to be able to withstand the operating temperature in the engine cylinders.展开更多
Porous structure in orthopedic prosthesis may reduce micromotion and increase the service life of implants.The purposes of this study were to compare the influence of the tibial stems with solid and porous structures ...Porous structure in orthopedic prosthesis may reduce micromotion and increase the service life of implants.The purposes of this study were to compare the influence of the tibial stems with solid and porous structures in Total Knee Arthroplasty(TKA)on knee joint and prostheses,and to improve the mechanical stability of the host bone by seeking favorable structure for the tibial stem.The Finite Element(FE)models of TKA knee with four different structures in the middle segment of the tibial stem(i.e.,solid,cubic,truncated cubic,and octahedral structures)were constructed.The distributions of von Mises stress in the knee joint,tibial prosthesis and proximal tibia,and the compressive stresses of the tibial prosthesis and ultra-high-molecular-weight polyethylene for the four FE models were analyzed.The results showed that the tibial stem filled with the octahedral structure has the best mechanical performance among the above four types of tibial stems.It could effectively reduce the stress concentration and stress shielding effects,and provide an improved mechanical environment for knee joint after TKA.This study would shed some lights on the design and fabrication of porous implants targeted to biomedical applications.展开更多
AIM:To conduct a meta-analysis comparing laparoscopic total gastrectomy(LTG)with open total gastrectomy(OTG)for the treatment of gastric cancer.METHODS:Major databases such as Medline(PubMed),Embase,Academic Search Pr...AIM:To conduct a meta-analysis comparing laparoscopic total gastrectomy(LTG)with open total gastrectomy(OTG)for the treatment of gastric cancer.METHODS:Major databases such as Medline(PubMed),Embase,Academic Search Premier(EBSCO),Science Citation Index Expanded and the Cochrane Central Register of Controlled Trials(CENTRAL)in The Cochrane Library were searched for studies comparing LTG and OTG from January 1994 to May 2013.Evaluated endpoints were operative,postoperative and oncological outcomes.Operative outcomes included operative time and intraoperative blood loss.Postoperative recovery included time to first fatus,time to first oral intake,hospital stay and analgesics use.Postoperative complications comprised morbidity,anastomotic leakage,anastomotic stenosis,ileus,bleeding,abdominal abscess,wound problems and mortality.Oncological outcomes included positive resection margins,number of retrieved lymph nodes,and proximal and distal resection margins.The pooled effect was calculated using either a fixed effects or a random effects model.RESULTS:Fifteen non-randomized comparative studies with 2022 patients were included(LTG-811,OTG-1211).Both groups had similar short-term oncological outcomes,analgesic use(WMD-0.09;95%CI:-2.39-2.20;P=0.94)and mortality(OR=0.74;95%CI:0.24-2.31;P=0.61).However,LTG was associated with a lower intraoperative blood loss(WMD-201.19 mL;95%CI:-296.50--105.87 mL;P<0.0001)and overall complication rate(OR=0.73;95%CI:0.57-0.92;P=0.009);fewer wound-related complications(OR=0.39;95%CI:0.21-0.72;P=0.002);a quicker recovery of gastrointestinal motility with shorter time to frst fatus(WMD-0.82;95%CI:-1.18--0.45;P<0.0001)and oral intake(WMD-1.30;95%CI:-1.84--0.75;P<0.00001);and a shorter hospital stay(WMD-3.55;95%CI:-5.13--1.96;P<0.0001),albeit with a longer operation time(WMD 48.25 min;95%CI:31.15-65.35;P<0.00001),as compared with OTG.CONCLUSION:LTG is safe and effective,and may offer some advantages over OTG in the treatment of gastric cancer.展开更多
Failure during total hip arthroplasty may lead to bedridden of the elderly. Since the acetabulum cup fix in an anatomically deep region, failures, such as loosening and fracture, occur three times more frequently comp...Failure during total hip arthroplasty may lead to bedridden of the elderly. Since the acetabulum cup fix in an anatomically deep region, failures, such as loosening and fracture, occur three times more frequently compared with failures of the stem fix in the femur. We investigated the possibility of evaluating whether fixation was acquired by frequency analysis of the hammering sound of implanting a cup into the acetabulum. The subjects were 11 patients (11 joints) who underwent total hip arthroplasty, biomechanical test materials, and orthopedic models. Surgeries and experiments were performed by orthopedists specialized in the hip. A system was constructed with a tablet PC and directional microphone, the peak frequency at which the amplitude reached the maximum was determined, and judgment processing (stable, unstable) of cup fixability was performed in real time. The stable maximum peak frequency observed in the clinical trials was 4.42 ± 4.02 kHz. The mean stable maximum peak frequency in the biomechanical tests was 4.46 ± 1.19 kHz in biomechanical test materials and 4.56 ± 2.02 kHz in orthopaedicmodels. When hammering was continued, the frequency leading to fracture decreased in both biomechanical test materials and orthopaedicmodels. In conclusion, in clinical trials and biomechanical studies, variation of the maximum peak frequency decreased when fixation was acquired and the frequency stabilized. It was suggested that this method can serve as a fixability evaluation method of acetabular cups because analysis can be performed in real time during surgery, for which prevention of intraoperative fracture can be expected.展开更多
When a stem is inserted into the femur during total hip arthroplasty, sufficient fixation depends on the surgeon’s experience. An objective method of evaluating whether the stem has been correctly fixed may aid clini...When a stem is inserted into the femur during total hip arthroplasty, sufficient fixation depends on the surgeon’s experience. An objective method of evaluating whether the stem has been correctly fixed may aid clinicians in their decision. We examined the relationship between the sound frequency caused by hammering the stem and the internal stress in artificial femurs, and evaluated the utility of sound frequency analysis to prevent intraoperative fracture. Surgeons inserted one of two types of cementless stems (SL-PLUS and modified CLS) using routine operational procedures into 13 artificial femurs. These are the standard Zweymüllers used in Europe. The difference is the lateral shape;SL-PLUS has holes for removal and the modified CLS has fins to prevent rotation. We estimated stress in the femur via finite element analysis, measured the hammering force, and recorded the sound of hammering for frequency analysis. Finite element analysis revealed that the hammering sound frequency decreased as the maximum stress increased. A decrease in frequency suggested that fixation was sufficient and that continued hammering would increase the risk of fracture. Thus, evaluation of the change in sound frequency during stem insertion may indicate when the hammering force should be reduced, thereby preventing intraoperative periprosthetic fractures. Further frequency change may also predict fractures prior to visual confirmation. We concluded that sound frequency analysis has potential as an objective evaluation method to help prevent intraoperative periprosthetic fractures during stem insertion.展开更多
AIM:To evaluate the safety and efficacy of laparoscopy-assisted total gastrectomy(LATG)and open total gastrectomy(OTG)for gastric cancer.METHODS:A comprehensive search of PubMed,Cochrane Library,Web of Science and BIO...AIM:To evaluate the safety and efficacy of laparoscopy-assisted total gastrectomy(LATG)and open total gastrectomy(OTG)for gastric cancer.METHODS:A comprehensive search of PubMed,Cochrane Library,Web of Science and BIOSIS Previews was performed to identify studies that compared LATG and OTG.The following factors were checked:operating time,blood loss,harvested lymph nodes,flatus time,hospital stay,mortality and morbidity.Data synthesis and statistical analysis were carried out using RevMan 5.1 software.RESULTS:Nine studies with 1221 participants were included(436 LATG and 785 OTG).Compared to OTG,LATG involved a longer operating time[weighted mean difference(WMD)=57.68 min,95%CI:30.48-84.88;P<0.001];less blood loss[standard mean difference(SMD)=-1.71;95%CI:-2.48--0.49;P<0.001];earlier time to flatus(WMD=-0.76 d;95%CI:-1.22--0.30;P<0.001);shorter hospital stay(WMD=-2.67d;95%CI:-3.96--1.38,P<0.001);and a decrease in medical complications(RR=0.41,95%CI:0.19-0.90,P=0.03).The number of harvested lymph nodes,mortality,surgical complications,cancer recurrence rate and long-term survival rate of patients undergoing LATG were similar to those in patients undergoing OTG.CONCLUSION:Despite a longer operation,LATG can be performed safely in experienced surgical centers with a shorter hospital stay and fewer complications than open surgery.展开更多
BACKGROUND Laparoscopy has been widely used in general surgical procedures,but total laparoscopic pancreaticoduodenectomy(TLPD)is still a complex and challenging surgery that is only performed in a small number of pat...BACKGROUND Laparoscopy has been widely used in general surgical procedures,but total laparoscopic pancreaticoduodenectomy(TLPD)is still a complex and challenging surgery that is only performed in a small number of patients at a few large academic medical centers.Although the safety and feasibility of TLPD have been established,few studies have compared it with open pancreaticoduodenectomy(OPD)with regard to perioperative and oncological outcomes.Therefore,we carried out a meta-analysis to evaluate whether TLPD is superior to OPD.AIM To compare the treatment outcomes of TLPD and OPD in order to assess the safety and feasibility of TLPD.METHODS We conducted a systematic search of studies comparing TLPD with OPD that were published in the PubMed,EMBASE,and Cochrane Library databases through December 31,2018.The studies comparing TLPD and OPD with at least one of the outcomes we were interested in and with more than 10 cases in each group were included in this analysis.The Newcastle-Ottawa scale was used to assess the quality of the nonrandomized controlled trials and the Jadad scale was used to assess the randomized controlled trials.Intraoperative data,postoperative complications,and oncologic outcomes were evaluated.The metaanalysis was performed using Review Manager Software version 5.3.Random or fixed-effects meta-analyses were undertaken to measure the pooled estimates.RESULTS A total of 4790 articles were initially identified for our study.After screening,4762 articles were excluded and 28 studies representing 39771 patients(3543 undergoing TLPD and 36228 undergoing OPD)were eventually included.Patients who underwent TLPD had less intraoperative blood loss[weighted mean difference(WMD)=-260.08 mL,95%confidence interval(CI):(-336.02,-184.14)mL,P<0.00001],a lower blood transfusion rate[odds ratio(OR)=0.51,95%CI:0.36-0.72,P=0.0001],a lower perioperative overall morbidity(OR=0.82,95%CI:0.73-0.92,P=0.0008),a lower wound infection rate(OR=0.48,95%CI:0.34-0.67,P<0.0001),a lower pneumonia rate(OR=0.72,95%CI:0.60-0.85,P=0.0002),a shorter duration of intensive care unit(ICU)stay[WMD=-0.28 d,95%CI(-2.88,-1.29)d,P<0.00001]and a shorter length of hospital stay[WMD=-3.05 d,95%CI(-3.93,-2.17),P<0.00001],a lower rate of discharge to a new facility(OR=0.55,95%CI:0.39-0.78,P=0.0008),and a lower 30-d readmission rate(OR=0.81,95%CI:0.68-0.95,P=0.10)than those who underwent OPD.In addition,the TLPD group had a higher R0 rate(OR=1.28,95%CI:1.13-1.44,P=0.0001)and more lymph nodes harvested(WMD=1.32,95%CI:0.57-2.06,P=0.0005)than the OPD group.However,the patients who underwent TLPD experienced a significantly longer operative time(WMD=77.92 min,95%CI:40.89-114.95,P<0.0001)and had a smaller tumor size than those who underwent OPD[WMD=-0.32 cm,95%CI:(-0.58,-0.07)cm,P=0.01].There were no significant differences between the two groups in the major morbidity,postoperative pancreatic fistula,delayed gastric emptying,postpancreatectomy hemorrhage,bile leak,gastroenteric anastomosis fistula,intra-abdominal abscess,bowel obstruction,fluid collection,reoperation,ICU admission,or 30-d and 90-d mortality rates.For malignant tumors,the 1-,2-,3-,4-and 5-year overall survival rates were not significantly different between the two groups.CONCLUSION This meta-analysis indicates that TLPD is safe and feasible,and may be a desirable alternative to OPD,although a longer operative time is needed and only smaller tumors can be treated.展开更多
BACKGROUND Laparoscopic radical gastrectomy is currently the most common surgical approach for gastric cancer.The main difference between totally laparoscopic total gastrectomy(TLTG)and laparoscopic-assisted total gas...BACKGROUND Laparoscopic radical gastrectomy is currently the most common surgical approach for gastric cancer.The main difference between totally laparoscopic total gastrectomy(TLTG)and laparoscopic-assisted total gastrectomy(LATG)is the route of digestive tract reconstruction.However,TLTG is currently not widespread as the safety and feasibility of intracorporeal esophagojejunostomy is uncertain.AIM To compare the short-term efficacy of TLTG and LATG for radical gastrectomy of gastric cancer,and to determine the safety and feasibility of intracorporeal esophagojejunostomy.METHODS PubMed,EMBASE,and Web of Science databases were searched for all relevant articles regarding TLTG vs LATG for gastric cancer published up to October 1,2019.Inclusion and exclusion criteria were established.All the basic conditions of patients and important clinical data related to surgery were extracted,and a meta-analysis was performed with RevMan 5.3 software.RESULTS Eight studies involving a total of 1883 cases(869 cases in the TLTG group and 1014 cases in the LATG group)were included.Compared with the LATG group,reduced intraoperative blood loss(weighted mean difference=-35.37,95%CI:-61.69--9.06,P=0.008)and a larger number of retrieved lymph nodes(weighted mean difference=3.11,95%CI:-2.60-12.00,P=0.01)were found in the TLTG group.There were no significant differences in operating time,anastomotic time,tumor size,proximal resection margin length,postoperative pain score,time to first flatus,time to first oral intake,postoperative hospital stay,postoperative anastomosis-related complication rate and overall complication rate between the two groups(P>0.05).CONCLUSION Intracorporeal esophagojejunostomy is safe and feasible.TLTG has the advantages of being minimally invasive,reduced intraoperative blood loss and easier access to lymph nodes compared with LATG.Totally laparoscopic gastrectomy is likely to be the surgical trend for gastric cancer in the future.展开更多
After a total resection of the stomach,the continuity of the gastrointestinal tract can be restored either by Rouxen-Y esophagojejunostomy with or without a pouch.There is still no consensus on the best reconstruction...After a total resection of the stomach,the continuity of the gastrointestinal tract can be restored either by Rouxen-Y esophagojejunostomy with or without a pouch.There is still no consensus on the best reconstruction technique.The aim of this report was to derive a more precise estimation of Roux-en-Y esophagojejunostomy with a pouch compared with Roux-en-Y esophagojejunostomy without a pouch.Studies were identified by PubMed and Embase searches,and the inclusion criteria were randomized controlled trials (RCTs) comparing reconstruction techniques between Roux-en-Y with and without a pouch.A total of 12 studies including 1,018 patients were included.The meta-analysis shows that pouch Roux-en-Y does not significantly increase total postoperative complications,anastomotic leakage or mortality.Importantly,there is no significant difference in 5-year survival rates between the two groups.Patients with Roux-en-Y esophagojejunostomy complained significantly less of reflux symptoms and dumping syndrome,and had significantly less severe reflux esophagitis.Quality of life was significantly improved in patients with Roux-en-Y esophagojejunostomy with a pouch compared with patients who received Roux-en-Y reconstruction without a pouch.The results indicate the need for Roux-en-Y esophagojejunostomy with a pouch is a gastric substitute after total gastrectomy by comparison with Roux-en-Y esophagojejunostomy without a pouch.展开更多
AIM To determine whether cemented, cementless, or hybrid implant was superior to the other in terms of survival rate.METHODS Systematic searches across MEDLINE, CINAHL, and Cochrane that compared cemented, cementless ...AIM To determine whether cemented, cementless, or hybrid implant was superior to the other in terms of survival rate.METHODS Systematic searches across MEDLINE, CINAHL, and Cochrane that compared cemented, cementless and hybrid total hip replacement(THR) were performed. Two independent reviewers evaluated the risk ratios of revision due to any cause, aseptic loosening, infection, and dislocation rate of each implants with a pre-determined form. The risk ratios were pooled separately for clinical trials, cohorts and registers before pooled altogether using fixed-effect model. Meta-regressions were performed to identify the source of heterogeneity. Funnel plots were analyzed. RESULTS Twenty-seven studies comprising 5 clinical trials, 9 cohorts, and 13 registers fulfilled the research criteria and analyzed. Compared to cementless THR, cemented THR have pooled RR of 0.47(95%CI: 0.45-0.48), 0.9(0.84-0.95), 1.29(1.06-1.57) and 0.69(0.6-0.79) for revision due to any reason, revision due to aseptic loosening, revision due to infection, and dislocation respectively. Compared to hybrid THR, the pooled RRs of cemented THR were 0.82(0.76-0.89), 2.65(1.14-6.17), 0.98(0.7-1.38), and 0.67(0.57-0.79) respectively. Compared to hybrid THR, cementless THR had RRs of 0.7(0.65-0.75), 0.85(0.49-1.5), 1.47(0.93-2.34) and 1.13(0.98-1.3).CONCLUSION Despite the limitations in this study, there was some tendency that cemented fixation was still superior than other types of fixation in terms of implant survival.展开更多
Objective:To perform phytochemical screening,estimate total phenolics,flavonoids and to evaluate antioxidant potential of Moringa peregrina(M.peregrina) leaves.Methods:The dried powdered leaves of M.peregrina(150 g) w...Objective:To perform phytochemical screening,estimate total phenolics,flavonoids and to evaluate antioxidant potential of Moringa peregrina(M.peregrina) leaves.Methods:The dried powdered leaves of M.peregrina(150 g) were extracted exhaustively by Soxhlet with ethanol and then fractionated into hexane,chloroform,ethy alacetate and methanol.All the prepared extracts were also analyzed by gas chromatography-mass spectrometry to identify and characterize the chemical compounds present in the crude extracts.Folin- Ciocalteu reagent and aluminium chloride colorimetric methods were used to estimate total phenolic and flavonoid content of extracts.Hydrogen peroxide and 1,1 diphenyl-2-picrylhydrazyl were used to determine in vitro antioxidant activity.Results:Phytochemical analysis of ethanol extract showed presence of major classes of phytochemicals.Gas chromatography-mass spectrometry results revealed presence of 19 phytoconstituents in hexane extract,6 in ethyl acetate and 7 compounds in methanolic extract.Methanol extract was found to contain the highest phenolic content and flavonoids.In vitro antioxidant activities of all crude extracts were significant and comparable with the standard ascorbic acid.Conclusions:Results of this study show that the leaves of M.peregrina are the rich source of phenolic compounds that can play an important role in preventing the progression of many diseases.展开更多
The use of parameterization in assessing gait waveforms has been widely accepted, although it is recognized that this approach excludes the majority of information contained in the waveform. Waveform analysis techniqu...The use of parameterization in assessing gait waveforms has been widely accepted, although it is recognized that this approach excludes the majority of information contained in the waveform. Waveform analysis techniques, such as principal component analysis (PCA), have gained popularity in recent years as a more effective approach to extracting important information from human movement waveforms, but are more challenging to interpret. Few studies have compared these two different approaches to determine which yields the most relevant information. This study compared the kinematic patterns during gait of six total knee arthroplasty (TKA) subjects (10 TKA knees), to a group of 10 age-matched asymptomatic control subjects (19 control knees). An eight-camera Vicon M-cam system was used to track movement and compute joint angles. Group differences in parameterization (max and min peaks) values and principal component scores were tested using one-way ANOVA and Kruskal-Wallis tests. Using parameterization, the TKA group was characterized by reduced hip extension, increased hip flexion, increased anterior pelvic tilt, increased trunk tilt, and reduced sagittal ankle angles compared to the control group. Waveform analysis, by means of PCA, showed-magnitude shifts in sagittal ankle waveforms between groups, rather than solely reporting differences in peaks. Waveform analysis also indicated a significant shift in the magnitude of the entire waveform for hip angles, pelvic tilt, and trunk tilt, indicating no change in range of motion between groups, but rather a change in the way in which range of motion is achieved at the hip. This study has identified several gait variables that were significantly different between the TKA and control groups. Our results suggest that waveform analysis is effective at identifying magnitude shifts as sources of variability between groups, which would not necessarily be analyzed using conventional parameterization techniques unless one knew a priori where the variability would exist.展开更多
Introduction: gait analysis of a subject with total hip replacement is described. Objective: instrumental gait analysis of a subject 12 years after the total hip arthroplasty. Materials and Methods: in a movement anal...Introduction: gait analysis of a subject with total hip replacement is described. Objective: instrumental gait analysis of a subject 12 years after the total hip arthroplasty. Materials and Methods: in a movement analysis laboratory, locomotion studies were carried out at freely chosen walking speed by a 64-year-old subject, obtaining kinematic, kinetic and surface electromyographic data in time and space. All measurements were assessments by applying walking protocols on a straight surface of 8 m long. Results: abnormal slight activations of semitendinosus and tibialis anterior muscles, of the left limb, were observed throughout the gait cycle, no spatiotemporal parameters far from normal values were detected. Conclusions: it was possible to obtain an exhaustive analysis of the parameters associated with the gait of a subject after 12 years of total hip arthroplasty.展开更多
The purpose of this research is to evaluate clinical and cost effectiveness of total knee replacement surgery (TKA) for adults hospitalized in the United States between 2010 and 2013. We tried to answer the question t...The purpose of this research is to evaluate clinical and cost effectiveness of total knee replacement surgery (TKA) for adults hospitalized in the United States between 2010 and 2013. We tried to answer the question that whether lower length of stay and higher utilization of post-op facilities would be helpful to control the overall costs. Using the National Hospital Discharge Survey (NHDS) database and cost data from Blue Cross Blue shield, this study seeks to identify which U.S. region renders the highest quality patient care during a three-year span of 2008-2010. Using length of stay and discharge disposition (2010) as input factors, and regional TKA costs (2013) as output factors, Data Envelopment Analysis (DEA), a non-parametric method, illustrated the efficiency ranking of four regions in the US on TKA expenditures. The result shows the West is the most efficient region on controlling the overall cost by shrinking the length of stay and increasing the utilization of short-term/long-term care facilities.展开更多
Several methods for analysis of dissolved total phosphorus in seawater were reviewed. Discussions were focused on UV irradiation and persulphate oxidation methods which are the most popular dissolved organic phosphoru...Several methods for analysis of dissolved total phosphorus in seawater were reviewed. Discussions were focused on UV irradiation and persulphate oxidation methods which are the most popular dissolved organic phosphorus determination methods presently. The compounds used for the phosphorus recovery test were categorized into three groups according to their chemical structure. It was found that low power UV irradiation can decompose P-O-C or P-C bonds efficiently but may be inefficient for P-O-P bonds. Heating-bath in acid condition is useful for decomposing P-O-P bonds. Using the continuous flow analysis system (Auto-analyzer Ⅱ), UV digestion and heating-bath, series experiments were carried out based on the above analysis. Eleven model compounds were employed for the phosphorus recovery test and the factors influencing the decomposition efficiency of dissolved compounds containing phosphorus were clarified. Finally,the optimal design for determination of dissolved total phosphorus in seawater based on the routine continuous flow analysis system was presented. For the organic mono-phosphate, the recovery is more than 90% and a recovery of 33%～51% was obtained for inorganic or organic polyphosphates. Up to now, this is the highest decomposition efficiency for dissolved phosphorus based on the continuous flow analysis system.展开更多
In order to analyze the influencing factors of TFP (the abbreviation of Total Factor Productivity) deeply, this paper calculates and decomposes the TFP of the main grain producing provinces in China from 2006 to 2015 ...In order to analyze the influencing factors of TFP (the abbreviation of Total Factor Productivity) deeply, this paper calculates and decomposes the TFP of the main grain producing provinces in China from 2006 to 2015 by the DEA-Malmquist index model. On the basis of this, the grey correlation analysis model based on super-efficiency DEA is used to quantitatively analyze the influencing factors of total factor productivity, technological progress and technical efficiency. The results show that the proportion of grain sowing, the level of food economic development, the level of grain mechanization, the average scale of operations and the level of fertilizer using have the most influence on grain total factor productivity. Finally, according to the results of the analysis, some suggestions are put forward to improve the TFP of different provinces in the main grain producing areas.展开更多
文摘Whole grains of proso and barnyard millets were sequentially extracted using different solvents(hexane,chloroform,ethyl acetate,and methanol).Phytochemical analysis was performed qualitatively,and the total phenolic content in the extracts of proso and barnyard millets was quantified.Alkaloids and cardiac glycosides were identified in all solvent extracts of both millets.Anthraquinone and glycosides yielded negative results in all solvent extracts of both millets.Among all the solvent extracts,methanol extracts of proso and barnyard millets showed the presence of major compounds such as flavonoids,terpenoids,amino acids,tannins,and phenolics compounds.The maximum amount of phenols was found in methanolic extracts of proso and barnyard millets(0.669±0.003 and 0.625±0.003),followed by the chloroform extract of proso and barnyard millets(0.284±0.002 and 0.257±0.003).The minimum amount of phenolics was found in the acetone extract of proso and barnyard millets.The methanol extract of both millets showed the presence of major compounds with high phenolic content.
文摘Objective:To systematically evaluate and compare the safety and effectiveness of esophagojejunostomy and traditional esophagojejunostomy in total laparoscopic total gastrectomy in the treatment of gastric cancer,providing evidence-based medical evidence for clinical practice.Methods:PubMed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang and VIP databases were searched by computer,and the retrieval time was up to December 2021.Relevant literatures were obtained,and eligible studies were gradually screened and included.Cochrane ROB bias risk assessment tool and NOS scale were used to evaluate the quality of the articles,and required data were extracted from high-quality literatures.Finally,meta-analysis was performed using Review Manager 5.3 software.Results:Eleven studies were finally included,including 1398 patients,including 566 patients receiving overlap anastomosis and 832 patients receiving traditional anastomosis.The results show that overlap anastomosis and traditional anastomosis had the advantages of operation time(MD=0.63,95%CI=7.22,8.48,P=0.88),postoperative first exhaust time(MD=-0.13,95%CI=0.43,0.18,P=0.42),postoperative first feeding time(MD=0.02,95%CI=0.33,0.37,P=0.91),anastomotic leakage(OR=1.38,95%CI=0.73,2.63,P=0.32),and postoperative hospital stay(MD=-0.16,95%CI=0.82,0.51,P=0.64)had no significant differences(all P>0.05).Compared with traditional anastomosis,overlap anastomosis had longer anastomosis time(MD=5.60,95%CI=0.59,10.62,P=0.03),higher incidence of anastomotic bleeding(OR=2.48,95%CI=1.08,5.69,P=0.03),less intraoperative bleeding(MD=-6.42,MD=-6.42,OR=2.48,95%CI=1.08,P=0.03).95%CI=10.28,-2.56,P=0.001)and anastomotic stenosis(OR=0.17,95%CI=0.06,0.46,P=0.0006).Conclusion:Overlap esophagojejunostomy is a safe,effective and prognostic surgical method,and is expected to become the standard esophagojejunostomy in total laparoscopic total gastrectomy.
文摘AIM:To determine and evaluate the features of highly cited articles(HCAs)in the ophthalmology category in the Science Citation Index Expanded(SCI-EXPANDED)from 1991 to 2020.METHODS:The Web of Science Core Collection documents with at least 100 citations from their publication year until December 31,2020,were evaluated as highly cited.The examined features were the distribution of yearly output and its average number of per publication,HCAs,authors,institutions,journals,and nations.The publication performance of nations and organizations was assessed using six publication indicators.The Y-index was employed to compare the research outputs of various authors.RESULTS:Publications that had cited the most references were highly published in high-impact factor journals.The United States of America came out on top across all six publication indicators,and it was home to eight of the top 10 most productive institutions.The articles written by Breivik et al(2006)and Farrar et al(2001)were highly cited and had a significant impact in 2020.The authors had a higher number of highly cited articles published as corresponding authors than as first authors.CONCLUSION:The findings of the present study highlight the current scope of global research in ophthalmology.The findings can help policy-makers and advisory groups of research centers to develop future policies.In addition,the findings can guide researchers in this field.
基金Supported by Shiyan Guiding Project in 2021(21Y33).
文摘[Objectives]To systematically evaluate the total clinical effective rate of acupuncture treatment of depression,and provide clinical reference for the scheme design and selection of acupuncture treatment of depression.[Methods]By searching CNKI,Wanfang Data,CBM,VIP,Cochrane Library,Cochrane Central,Springer and other databases,randomized controlled experiment(RCT)on acupuncture and moxibustion treatment of depression from January 1,2019 to August 31,2022 was collected,to extract relevant data of total clinical effective rate and conduct methodological quality evaluation.ReviewManager 5.4.1 software was used for Meta analysis.[Results]22 RCTs were included,1602 patients in total.Among them,there were 804 cases in treatment group and 798 cases in control group.Meta analysis results displayed that acupuncture and moxibustion treatment of depression may be better than the control group in improving the total clinical effective rate,and the difference was statistically significant[MD=1.16,95%CI(1.11,1.21)].[Conclusions]Acupuncture and moxibustion can achieve a higher total clinical effective rate in the treatment of depression,which is worthy of clinical application.However,due to fewer studies included in this systematic evaluation,small sample size,and low quality,there was a high possibility of bias.Therefore,the above conclusions needed to be verified by high-quality,large-sample,and multi-center RCTs.
文摘The main objective of this research was to examine the suitability of aluminium alloy to design a piston of an internal combustion engine for improvement in weight and cost reduction. The piston was modelled using Autodesk Inventor 2017 software. The modelled piston was then imported into Ansys for further analysis. Static structural and thermal analysis were carried out on the pistons of the four different materials namely: Al 413 alloy, Al 384 alloy, Al 390 alloy and Al332 alloy to determine the total deformation, equivalent Von Mises stress, maximum shear stress, and the safety factor. The results of the study revealed that, aluminium 332 alloy piston deformed less compared to the deformations of aluminium 390 alloy piston, aluminium 384 alloy piston and aluminium 413 alloy piston. The induced Von Mises stresses in the pistons of the four different materials were found to be far lower than the yield strengths of all the materials. Hence, all the selected materials including the implementing material have equal properties to withstand the maximum gas load. All the selected materials were observed to have high thermal conductivity enough to be able to withstand the operating temperature in the engine cylinders.
基金the National Natural Science Foundation of China(Nos.11872095,11702110)the Natural Science Foundation of Jilin Province(No.20200201260JC)the Graduate Innovation Fund of Jilin University(No.101832018C194)for financial support.
文摘Porous structure in orthopedic prosthesis may reduce micromotion and increase the service life of implants.The purposes of this study were to compare the influence of the tibial stems with solid and porous structures in Total Knee Arthroplasty(TKA)on knee joint and prostheses,and to improve the mechanical stability of the host bone by seeking favorable structure for the tibial stem.The Finite Element(FE)models of TKA knee with four different structures in the middle segment of the tibial stem(i.e.,solid,cubic,truncated cubic,and octahedral structures)were constructed.The distributions of von Mises stress in the knee joint,tibial prosthesis and proximal tibia,and the compressive stresses of the tibial prosthesis and ultra-high-molecular-weight polyethylene for the four FE models were analyzed.The results showed that the tibial stem filled with the octahedral structure has the best mechanical performance among the above four types of tibial stems.It could effectively reduce the stress concentration and stress shielding effects,and provide an improved mechanical environment for knee joint after TKA.This study would shed some lights on the design and fabrication of porous implants targeted to biomedical applications.
基金Supported by UK/China Postgraduate Scholarships for Excellence,an NIHR Translational Research Fellowship and a Royal College of Surgeons of England-Ethicon Research Fellowship grant
文摘AIM:To conduct a meta-analysis comparing laparoscopic total gastrectomy(LTG)with open total gastrectomy(OTG)for the treatment of gastric cancer.METHODS:Major databases such as Medline(PubMed),Embase,Academic Search Premier(EBSCO),Science Citation Index Expanded and the Cochrane Central Register of Controlled Trials(CENTRAL)in The Cochrane Library were searched for studies comparing LTG and OTG from January 1994 to May 2013.Evaluated endpoints were operative,postoperative and oncological outcomes.Operative outcomes included operative time and intraoperative blood loss.Postoperative recovery included time to first fatus,time to first oral intake,hospital stay and analgesics use.Postoperative complications comprised morbidity,anastomotic leakage,anastomotic stenosis,ileus,bleeding,abdominal abscess,wound problems and mortality.Oncological outcomes included positive resection margins,number of retrieved lymph nodes,and proximal and distal resection margins.The pooled effect was calculated using either a fixed effects or a random effects model.RESULTS:Fifteen non-randomized comparative studies with 2022 patients were included(LTG-811,OTG-1211).Both groups had similar short-term oncological outcomes,analgesic use(WMD-0.09;95%CI:-2.39-2.20;P=0.94)and mortality(OR=0.74;95%CI:0.24-2.31;P=0.61).However,LTG was associated with a lower intraoperative blood loss(WMD-201.19 mL;95%CI:-296.50--105.87 mL;P<0.0001)and overall complication rate(OR=0.73;95%CI:0.57-0.92;P=0.009);fewer wound-related complications(OR=0.39;95%CI:0.21-0.72;P=0.002);a quicker recovery of gastrointestinal motility with shorter time to frst fatus(WMD-0.82;95%CI:-1.18--0.45;P<0.0001)and oral intake(WMD-1.30;95%CI:-1.84--0.75;P<0.00001);and a shorter hospital stay(WMD-3.55;95%CI:-5.13--1.96;P<0.0001),albeit with a longer operation time(WMD 48.25 min;95%CI:31.15-65.35;P<0.00001),as compared with OTG.CONCLUSION:LTG is safe and effective,and may offer some advantages over OTG in the treatment of gastric cancer.
文摘Failure during total hip arthroplasty may lead to bedridden of the elderly. Since the acetabulum cup fix in an anatomically deep region, failures, such as loosening and fracture, occur three times more frequently compared with failures of the stem fix in the femur. We investigated the possibility of evaluating whether fixation was acquired by frequency analysis of the hammering sound of implanting a cup into the acetabulum. The subjects were 11 patients (11 joints) who underwent total hip arthroplasty, biomechanical test materials, and orthopedic models. Surgeries and experiments were performed by orthopedists specialized in the hip. A system was constructed with a tablet PC and directional microphone, the peak frequency at which the amplitude reached the maximum was determined, and judgment processing (stable, unstable) of cup fixability was performed in real time. The stable maximum peak frequency observed in the clinical trials was 4.42 ± 4.02 kHz. The mean stable maximum peak frequency in the biomechanical tests was 4.46 ± 1.19 kHz in biomechanical test materials and 4.56 ± 2.02 kHz in orthopaedicmodels. When hammering was continued, the frequency leading to fracture decreased in both biomechanical test materials and orthopaedicmodels. In conclusion, in clinical trials and biomechanical studies, variation of the maximum peak frequency decreased when fixation was acquired and the frequency stabilized. It was suggested that this method can serve as a fixability evaluation method of acetabular cups because analysis can be performed in real time during surgery, for which prevention of intraoperative fracture can be expected.
文摘When a stem is inserted into the femur during total hip arthroplasty, sufficient fixation depends on the surgeon’s experience. An objective method of evaluating whether the stem has been correctly fixed may aid clinicians in their decision. We examined the relationship between the sound frequency caused by hammering the stem and the internal stress in artificial femurs, and evaluated the utility of sound frequency analysis to prevent intraoperative fracture. Surgeons inserted one of two types of cementless stems (SL-PLUS and modified CLS) using routine operational procedures into 13 artificial femurs. These are the standard Zweymüllers used in Europe. The difference is the lateral shape;SL-PLUS has holes for removal and the modified CLS has fins to prevent rotation. We estimated stress in the femur via finite element analysis, measured the hammering force, and recorded the sound of hammering for frequency analysis. Finite element analysis revealed that the hammering sound frequency decreased as the maximum stress increased. A decrease in frequency suggested that fixation was sufficient and that continued hammering would increase the risk of fracture. Thus, evaluation of the change in sound frequency during stem insertion may indicate when the hammering force should be reduced, thereby preventing intraoperative periprosthetic fractures. Further frequency change may also predict fractures prior to visual confirmation. We concluded that sound frequency analysis has potential as an objective evaluation method to help prevent intraoperative periprosthetic fractures during stem insertion.
基金Supported by The key project grant from the Science and Technology Department of Zhejiang ProvinceChinaNo.2011C3036-2
文摘AIM:To evaluate the safety and efficacy of laparoscopy-assisted total gastrectomy(LATG)and open total gastrectomy(OTG)for gastric cancer.METHODS:A comprehensive search of PubMed,Cochrane Library,Web of Science and BIOSIS Previews was performed to identify studies that compared LATG and OTG.The following factors were checked:operating time,blood loss,harvested lymph nodes,flatus time,hospital stay,mortality and morbidity.Data synthesis and statistical analysis were carried out using RevMan 5.1 software.RESULTS:Nine studies with 1221 participants were included(436 LATG and 785 OTG).Compared to OTG,LATG involved a longer operating time[weighted mean difference(WMD)=57.68 min,95%CI:30.48-84.88;P<0.001];less blood loss[standard mean difference(SMD)=-1.71;95%CI:-2.48--0.49;P<0.001];earlier time to flatus(WMD=-0.76 d;95%CI:-1.22--0.30;P<0.001);shorter hospital stay(WMD=-2.67d;95%CI:-3.96--1.38,P<0.001);and a decrease in medical complications(RR=0.41,95%CI:0.19-0.90,P=0.03).The number of harvested lymph nodes,mortality,surgical complications,cancer recurrence rate and long-term survival rate of patients undergoing LATG were similar to those in patients undergoing OTG.CONCLUSION:Despite a longer operation,LATG can be performed safely in experienced surgical centers with a shorter hospital stay and fewer complications than open surgery.
文摘BACKGROUND Laparoscopy has been widely used in general surgical procedures,but total laparoscopic pancreaticoduodenectomy(TLPD)is still a complex and challenging surgery that is only performed in a small number of patients at a few large academic medical centers.Although the safety and feasibility of TLPD have been established,few studies have compared it with open pancreaticoduodenectomy(OPD)with regard to perioperative and oncological outcomes.Therefore,we carried out a meta-analysis to evaluate whether TLPD is superior to OPD.AIM To compare the treatment outcomes of TLPD and OPD in order to assess the safety and feasibility of TLPD.METHODS We conducted a systematic search of studies comparing TLPD with OPD that were published in the PubMed,EMBASE,and Cochrane Library databases through December 31,2018.The studies comparing TLPD and OPD with at least one of the outcomes we were interested in and with more than 10 cases in each group were included in this analysis.The Newcastle-Ottawa scale was used to assess the quality of the nonrandomized controlled trials and the Jadad scale was used to assess the randomized controlled trials.Intraoperative data,postoperative complications,and oncologic outcomes were evaluated.The metaanalysis was performed using Review Manager Software version 5.3.Random or fixed-effects meta-analyses were undertaken to measure the pooled estimates.RESULTS A total of 4790 articles were initially identified for our study.After screening,4762 articles were excluded and 28 studies representing 39771 patients(3543 undergoing TLPD and 36228 undergoing OPD)were eventually included.Patients who underwent TLPD had less intraoperative blood loss[weighted mean difference(WMD)=-260.08 mL,95%confidence interval(CI):(-336.02,-184.14)mL,P<0.00001],a lower blood transfusion rate[odds ratio(OR)=0.51,95%CI:0.36-0.72,P=0.0001],a lower perioperative overall morbidity(OR=0.82,95%CI:0.73-0.92,P=0.0008),a lower wound infection rate(OR=0.48,95%CI:0.34-0.67,P<0.0001),a lower pneumonia rate(OR=0.72,95%CI:0.60-0.85,P=0.0002),a shorter duration of intensive care unit(ICU)stay[WMD=-0.28 d,95%CI(-2.88,-1.29)d,P<0.00001]and a shorter length of hospital stay[WMD=-3.05 d,95%CI(-3.93,-2.17),P<0.00001],a lower rate of discharge to a new facility(OR=0.55,95%CI:0.39-0.78,P=0.0008),and a lower 30-d readmission rate(OR=0.81,95%CI:0.68-0.95,P=0.10)than those who underwent OPD.In addition,the TLPD group had a higher R0 rate(OR=1.28,95%CI:1.13-1.44,P=0.0001)and more lymph nodes harvested(WMD=1.32,95%CI:0.57-2.06,P=0.0005)than the OPD group.However,the patients who underwent TLPD experienced a significantly longer operative time(WMD=77.92 min,95%CI:40.89-114.95,P<0.0001)and had a smaller tumor size than those who underwent OPD[WMD=-0.32 cm,95%CI:(-0.58,-0.07)cm,P=0.01].There were no significant differences between the two groups in the major morbidity,postoperative pancreatic fistula,delayed gastric emptying,postpancreatectomy hemorrhage,bile leak,gastroenteric anastomosis fistula,intra-abdominal abscess,bowel obstruction,fluid collection,reoperation,ICU admission,or 30-d and 90-d mortality rates.For malignant tumors,the 1-,2-,3-,4-and 5-year overall survival rates were not significantly different between the two groups.CONCLUSION This meta-analysis indicates that TLPD is safe and feasible,and may be a desirable alternative to OPD,although a longer operative time is needed and only smaller tumors can be treated.
基金Supported by the Ethics Committee of Chongqing Three Gorges Central Hospitalthe Guiding Project of Science and Technology Plan for Social Development in Wanzhou District Chongqing,No.wzstc-z 201707
文摘BACKGROUND Laparoscopic radical gastrectomy is currently the most common surgical approach for gastric cancer.The main difference between totally laparoscopic total gastrectomy(TLTG)and laparoscopic-assisted total gastrectomy(LATG)is the route of digestive tract reconstruction.However,TLTG is currently not widespread as the safety and feasibility of intracorporeal esophagojejunostomy is uncertain.AIM To compare the short-term efficacy of TLTG and LATG for radical gastrectomy of gastric cancer,and to determine the safety and feasibility of intracorporeal esophagojejunostomy.METHODS PubMed,EMBASE,and Web of Science databases were searched for all relevant articles regarding TLTG vs LATG for gastric cancer published up to October 1,2019.Inclusion and exclusion criteria were established.All the basic conditions of patients and important clinical data related to surgery were extracted,and a meta-analysis was performed with RevMan 5.3 software.RESULTS Eight studies involving a total of 1883 cases(869 cases in the TLTG group and 1014 cases in the LATG group)were included.Compared with the LATG group,reduced intraoperative blood loss(weighted mean difference=-35.37,95%CI:-61.69--9.06,P=0.008)and a larger number of retrieved lymph nodes(weighted mean difference=3.11,95%CI:-2.60-12.00,P=0.01)were found in the TLTG group.There were no significant differences in operating time,anastomotic time,tumor size,proximal resection margin length,postoperative pain score,time to first flatus,time to first oral intake,postoperative hospital stay,postoperative anastomosis-related complication rate and overall complication rate between the two groups(P>0.05).CONCLUSION Intracorporeal esophagojejunostomy is safe and feasible.TLTG has the advantages of being minimally invasive,reduced intraoperative blood loss and easier access to lymph nodes compared with LATG.Totally laparoscopic gastrectomy is likely to be the surgical trend for gastric cancer in the future.
文摘After a total resection of the stomach,the continuity of the gastrointestinal tract can be restored either by Rouxen-Y esophagojejunostomy with or without a pouch.There is still no consensus on the best reconstruction technique.The aim of this report was to derive a more precise estimation of Roux-en-Y esophagojejunostomy with a pouch compared with Roux-en-Y esophagojejunostomy without a pouch.Studies were identified by PubMed and Embase searches,and the inclusion criteria were randomized controlled trials (RCTs) comparing reconstruction techniques between Roux-en-Y with and without a pouch.A total of 12 studies including 1,018 patients were included.The meta-analysis shows that pouch Roux-en-Y does not significantly increase total postoperative complications,anastomotic leakage or mortality.Importantly,there is no significant difference in 5-year survival rates between the two groups.Patients with Roux-en-Y esophagojejunostomy complained significantly less of reflux symptoms and dumping syndrome,and had significantly less severe reflux esophagitis.Quality of life was significantly improved in patients with Roux-en-Y esophagojejunostomy with a pouch compared with patients who received Roux-en-Y reconstruction without a pouch.The results indicate the need for Roux-en-Y esophagojejunostomy with a pouch is a gastric substitute after total gastrectomy by comparison with Roux-en-Y esophagojejunostomy without a pouch.
文摘AIM To determine whether cemented, cementless, or hybrid implant was superior to the other in terms of survival rate.METHODS Systematic searches across MEDLINE, CINAHL, and Cochrane that compared cemented, cementless and hybrid total hip replacement(THR) were performed. Two independent reviewers evaluated the risk ratios of revision due to any cause, aseptic loosening, infection, and dislocation rate of each implants with a pre-determined form. The risk ratios were pooled separately for clinical trials, cohorts and registers before pooled altogether using fixed-effect model. Meta-regressions were performed to identify the source of heterogeneity. Funnel plots were analyzed. RESULTS Twenty-seven studies comprising 5 clinical trials, 9 cohorts, and 13 registers fulfilled the research criteria and analyzed. Compared to cementless THR, cemented THR have pooled RR of 0.47(95%CI: 0.45-0.48), 0.9(0.84-0.95), 1.29(1.06-1.57) and 0.69(0.6-0.79) for revision due to any reason, revision due to aseptic loosening, revision due to infection, and dislocation respectively. Compared to hybrid THR, the pooled RRs of cemented THR were 0.82(0.76-0.89), 2.65(1.14-6.17), 0.98(0.7-1.38), and 0.67(0.57-0.79) respectively. Compared to hybrid THR, cementless THR had RRs of 0.7(0.65-0.75), 0.85(0.49-1.5), 1.47(0.93-2.34) and 1.13(0.98-1.3).CONCLUSION Despite the limitations in this study, there was some tendency that cemented fixation was still superior than other types of fixation in terms of implant survival.
基金Supported by the Department of Pharmacy.Oman MedicalCollege.Muscat,Oman(Grant No.OMC-PHAR/425-05/13)
文摘Objective:To perform phytochemical screening,estimate total phenolics,flavonoids and to evaluate antioxidant potential of Moringa peregrina(M.peregrina) leaves.Methods:The dried powdered leaves of M.peregrina(150 g) were extracted exhaustively by Soxhlet with ethanol and then fractionated into hexane,chloroform,ethy alacetate and methanol.All the prepared extracts were also analyzed by gas chromatography-mass spectrometry to identify and characterize the chemical compounds present in the crude extracts.Folin- Ciocalteu reagent and aluminium chloride colorimetric methods were used to estimate total phenolic and flavonoid content of extracts.Hydrogen peroxide and 1,1 diphenyl-2-picrylhydrazyl were used to determine in vitro antioxidant activity.Results:Phytochemical analysis of ethanol extract showed presence of major classes of phytochemicals.Gas chromatography-mass spectrometry results revealed presence of 19 phytoconstituents in hexane extract,6 in ethyl acetate and 7 compounds in methanolic extract.Methanol extract was found to contain the highest phenolic content and flavonoids.In vitro antioxidant activities of all crude extracts were significant and comparable with the standard ascorbic acid.Conclusions:Results of this study show that the leaves of M.peregrina are the rich source of phenolic compounds that can play an important role in preventing the progression of many diseases.
文摘The use of parameterization in assessing gait waveforms has been widely accepted, although it is recognized that this approach excludes the majority of information contained in the waveform. Waveform analysis techniques, such as principal component analysis (PCA), have gained popularity in recent years as a more effective approach to extracting important information from human movement waveforms, but are more challenging to interpret. Few studies have compared these two different approaches to determine which yields the most relevant information. This study compared the kinematic patterns during gait of six total knee arthroplasty (TKA) subjects (10 TKA knees), to a group of 10 age-matched asymptomatic control subjects (19 control knees). An eight-camera Vicon M-cam system was used to track movement and compute joint angles. Group differences in parameterization (max and min peaks) values and principal component scores were tested using one-way ANOVA and Kruskal-Wallis tests. Using parameterization, the TKA group was characterized by reduced hip extension, increased hip flexion, increased anterior pelvic tilt, increased trunk tilt, and reduced sagittal ankle angles compared to the control group. Waveform analysis, by means of PCA, showed-magnitude shifts in sagittal ankle waveforms between groups, rather than solely reporting differences in peaks. Waveform analysis also indicated a significant shift in the magnitude of the entire waveform for hip angles, pelvic tilt, and trunk tilt, indicating no change in range of motion between groups, but rather a change in the way in which range of motion is achieved at the hip. This study has identified several gait variables that were significantly different between the TKA and control groups. Our results suggest that waveform analysis is effective at identifying magnitude shifts as sources of variability between groups, which would not necessarily be analyzed using conventional parameterization techniques unless one knew a priori where the variability would exist.
文摘Introduction: gait analysis of a subject with total hip replacement is described. Objective: instrumental gait analysis of a subject 12 years after the total hip arthroplasty. Materials and Methods: in a movement analysis laboratory, locomotion studies were carried out at freely chosen walking speed by a 64-year-old subject, obtaining kinematic, kinetic and surface electromyographic data in time and space. All measurements were assessments by applying walking protocols on a straight surface of 8 m long. Results: abnormal slight activations of semitendinosus and tibialis anterior muscles, of the left limb, were observed throughout the gait cycle, no spatiotemporal parameters far from normal values were detected. Conclusions: it was possible to obtain an exhaustive analysis of the parameters associated with the gait of a subject after 12 years of total hip arthroplasty.
文摘The purpose of this research is to evaluate clinical and cost effectiveness of total knee replacement surgery (TKA) for adults hospitalized in the United States between 2010 and 2013. We tried to answer the question that whether lower length of stay and higher utilization of post-op facilities would be helpful to control the overall costs. Using the National Hospital Discharge Survey (NHDS) database and cost data from Blue Cross Blue shield, this study seeks to identify which U.S. region renders the highest quality patient care during a three-year span of 2008-2010. Using length of stay and discharge disposition (2010) as input factors, and regional TKA costs (2013) as output factors, Data Envelopment Analysis (DEA), a non-parametric method, illustrated the efficiency ranking of four regions in the US on TKA expenditures. The result shows the West is the most efficient region on controlling the overall cost by shrinking the length of stay and increasing the utilization of short-term/long-term care facilities.
基金The research was supported by the National Basic Research Program(“973”Program)of China under contract No.2002CB412405the Key Science and Technology Plan of the Ministry of Education of China under contract No.[2000]156-00079the Joint Sino-German Project under contract No.03F0189A.
文摘Several methods for analysis of dissolved total phosphorus in seawater were reviewed. Discussions were focused on UV irradiation and persulphate oxidation methods which are the most popular dissolved organic phosphorus determination methods presently. The compounds used for the phosphorus recovery test were categorized into three groups according to their chemical structure. It was found that low power UV irradiation can decompose P-O-C or P-C bonds efficiently but may be inefficient for P-O-P bonds. Heating-bath in acid condition is useful for decomposing P-O-P bonds. Using the continuous flow analysis system (Auto-analyzer Ⅱ), UV digestion and heating-bath, series experiments were carried out based on the above analysis. Eleven model compounds were employed for the phosphorus recovery test and the factors influencing the decomposition efficiency of dissolved compounds containing phosphorus were clarified. Finally,the optimal design for determination of dissolved total phosphorus in seawater based on the routine continuous flow analysis system was presented. For the organic mono-phosphate, the recovery is more than 90% and a recovery of 33%～51% was obtained for inorganic or organic polyphosphates. Up to now, this is the highest decomposition efficiency for dissolved phosphorus based on the continuous flow analysis system.
文摘In order to analyze the influencing factors of TFP (the abbreviation of Total Factor Productivity) deeply, this paper calculates and decomposes the TFP of the main grain producing provinces in China from 2006 to 2015 by the DEA-Malmquist index model. On the basis of this, the grey correlation analysis model based on super-efficiency DEA is used to quantitatively analyze the influencing factors of total factor productivity, technological progress and technical efficiency. The results show that the proportion of grain sowing, the level of food economic development, the level of grain mechanization, the average scale of operations and the level of fertilizer using have the most influence on grain total factor productivity. Finally, according to the results of the analysis, some suggestions are put forward to improve the TFP of different provinces in the main grain producing areas.
