简介：Objective:Toevaluatetheshort-termoutcomesofvideo-assistedthoracicsurgery(VATS)forthoracictumors.Methods:Thedataof1,790consecutivepatientswereretrospectivelyreviewed.ThesepatientsunderwentVATSpulmonaryresections,VATSesophagectomies,andVATSresectionsofmediastinaltumorsorbiopsiesattheCancerInstitute&Hospital,ChineseAcademyofMedicalSciencesbetweenJanuary2009andJanuary2012.Results:Therewere33patientsconvertedtoopenthoracotomy(OT,1.84%).Theoverallmorbidityandmortalityratewas2.79%(50/1790)and0.28%(5/1790),respectively.TheoverallhospitalizationandchesttubedurationwereshorterintheVATSlobectomygroup(n=949)thanintheopenthoracotomy(OT)lobectomygroup(n=753).Therewerenosignificantdifferencesinmorbidityrate,mortalityrateandoperationtimebetweenthetwogroups.Intheesophagealcancerpatients,nosignificantdifferencewasfoundinthenumberofnodaldissection,chesttubeduration,morbidityrate,mortalityrate,andhospitallengthofstaybetweentheVATSesophagectomygroup(n=81)andopenesophagectomygroup(n=81).However,theoperationtimewaslongerintheVATSesophagectomygroup.Inthethymomapatients,therewasnosignificantdifferenceinthechesttubeduration,morbidityrate,mortalityrate,andhospitallengthofstaybetweentheVATSthymectomygroup(n=41)andopenthymectomygroup(n=41).However,theoperationtimewaslongerintheVATSgroup.ThemediantumorsizeintheVATSthymectomygroupwascomparablewiththatintheOTgroup.Conclusions:Inearly-stage(I/II)non-smallcelllungcancerpatientswhounderwentlobectomies,VATSiscomparablewiththeOTapproachwithsimilarshort-termoutcomes.Inpatientswithresectableesophagealcancer,VATSesophagectomyiscomparablewithOTesophagectomywithsimilarmorbidityandmortality.VATSthymectomyforMasaokastageIandIIthymomaisfeasibleandsafe,andtumorsizeisnotcontraindicated.Longerfollow-upsareneededtodete

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简介：Objective:Theobjectiveofthecurrentstudywastoevaluatethefeasibilityandsafetyofnonintubateduniportalvideo-assistedthoracoscopicsurgery（VATS）forthemanagementofprimaryspontaneouspneumothorax（PSP）.Methods:FromNovember2011toJune2013,32consecutivepatientswithPSPweretreatedbynonintubateduniportalthoracoscopicbullectomyusingepiduralanaesthesiaandsedationwithoutendotrachealintubation.Anincision2cminlengthwasmadeatthe6thintercostalspaceinthemedianaxillaryline.Thepleuralspacewasenteredbybluntdissectionforplacementofasoftincisionprotector.Instrumentsweretheninsertedthroughtheincisionprotectortoperformthoracoscopicbullectomy.Datawerecollectedwithinaminimumfollow-upperiodof10months.Results:Theaveragetimeofsurgerywas49.0min（range,33-65min）.Nocomplicationswererecorded.Thepostoperativefeedingtimewas6h.Themeanpostoperativechesttubedrainageandhospitalstaywere19.3hand41.6h,respectively.Thepostoperativepainwasmildfor30patients（93.75%）andmoderatefortwopatients（6.25%）.Norecurrencesofpneumothoraxwereobservedatfollow-up.Conclusions:Theinitialresultsindicatedthatnonintubateduniportalvideo-assistedthoracoscopicoperationsarenotonlytechnicallyfeasible,butmayalsobeasafeandlessinvasivealternativeforselectpatientsinthemanagementofPSP.ThisisthefirstreporttoincludetheuseofanonintubateduniportaltechniqueinVATSforsuchalargenumberofPSPcases.Furtherworkanddevelopmentofinstrumentsareneededtodefinetheapplicationsandadvantagesofthistechnique.

简介：AbstractBackground:The first-line treatment for lung cancer is surgical resection, and one-lung ventilation (OLV) is the most basic anesthetic management method in lung surgery. During OLV, inflammatory cytokines are released in response to the lung tissue damage and promote local and contralateral lung damage through the systemic circulation. We designed a randomized, prospective study to evaluate the effect of the urinary trypsin inhibitor (UTI) ulinastatin on the inflammatory response after video-assisted thoracic lobectomy in patients with lung cancer.Methods:Adult patients aged 19 to 70 years, who were scheduled for video-assisted thoracic lobectomy surgery to treat lung cancer between May 2020 and August 2020, were enrolled in this randomized, prospective study. UTI (300,000 units) mixed with 100 mL of normal saline in the ulinastatin group and 100 mL of normal saline in the control group was administered over 1 h after inducing anesthesia.Results:The baseline (T0) interferon-γ (IFN-γ)/interleukin-4 (IL-4) ratio was not different between the groups (6941.3 ± 2778.7 vs. 6954.3 ± 2752.4 pg/mL, respectively; P > 0.05). The IFN-γ/IL-4 ratio was significantly higher in ulinastatin group at 30 min after entering the recovery room than control group (20,148.2 ± 5054.3 vs. 6674.0 ± 2963.6, respectively; adjusted P < 0.017). Conclusion: Administering UTI attenuated the anti-inflammatory response, in terms of INF-γ expression and the IFN-γ/IL-4 ratio, after video-assisted thoracic surgery in lung cancer patients.Trial registration:Clinical Research Information Service of Korea National Institute of Health (CRIS), KCT0005533.

简介：BackgroundProstheticmitralvalvereplacementisacommonsurgicaltreatmentofmitralvalvedisease.Completevideo-assistedmitralvalvereplacementrepresentsthecontemporaryminimallyinvasivecardiacsurgeryinvalvediseasesurgicaltherapy.Inthefieldofminimallyinvasivecardiacsurgery,thesuccessoftheoperationislargelydependingonsurgicalincision,italsoreflectsthesurgeon'stechniquelevel.MethodFromFebruary2010toFebruary2013,80casesofcardiacpatientswithmitralvalvepathologicalchangesinourdepartmentwhohadreceivedsurgicaltreatmentofcompletevideo-assistedmitralvalvereplacementwererecruited,theyweredividedintotwogroupsaccordingtothesurgicalincision:midclaviculargroup(Mgroup,n=50)andparasternalgroup(Pgroup,n=30).Theclinicaldatawererecordedincluding:cardiopulmonarybypasstime,aorticclampingtime,volumeofthoracicdrainageafteroperation,ICUtrachealintubationtime,postoperativedaysofhospitalstayandtimeforobservingthepostoperativecomplications.Thecomparisonbetweentwogroupswasperformedusingt-testanalysis.ResultBothMGroupandPGrouphadfavorablesurgicalview,therewerenoemergencysituationofredomediansternotomyduringinitialoperativeperiodorintraoperativedeath,nopericardialtamponade,noinfection,andnootherseriouspostoperativecomplications.Whereas,therewere2casesofredooperationforstanchbleedinginMGroupand1caseofperivalvularleakageinPGroup.Nevertheless,3monthslater,theresultofreexamineshowedthattheperivalvularleakagehadvanished.Theclinicaldatawasshownasfollow(MGroupvs.PGroup):cardiopulmonarybypasstime(90.2±28.7vs.87.3±24.5min,P>0.05),aorticclampingtime(65.2±17.4vs.68.6±21.9min,P>0.05),1stdayvolumeofthoracicdrainageafteroperation1(75.8±35.6vs.53.2±25.6mL,P>0.05),ICUtrachealintubationtime(9.6±3.4vs.8.4±4.5hours,P>0.05),postoperativedaysofhospitalstay(7.3±2.2v

简介：ObjectiveToreportexperienceswithuseofotoendoscopyincerebellopontineangle(CPA)surgeries.MethodsTwentyfivecasesofCPAsurgeriesperformedbetweenNovember2002andDecember2008inwhichmicroscopeenabledotoendoscopywasusedwerereviewed.The25casesincluded19casesofacousticneuroma,3casesofCPAfacialnervetumors,1caseoftrigeminalneurinoma,acaseofglossopharyngealneuralgiaand1caseofhemifacialspasm.Endoscopywasusedinallcasestogetherwithmonitoringofbrainstemauditoryresponsesandfacialelectromyography.Postoperativehearingandfacialnervefunctionwereevaluatedandcomparedtopre-operativelevels.ResultsEndoscopyprovidedimprovedvisualizationoflocalanatomy,revealedhiddenlesionsandreducedunnecessaryanatomicaldistortions.Totalresectionwasachievedin18ofthe19acousticneuromacases,Facialnerveanatomicalintegritywaspreservedinall19cases.OneweekpostoperativeHouse-BrackmanngradingwasIin3cases,Ⅱin10casesandⅢin6cases.Facialnervefunctioncontinuedtoimproveinsomecasesat3months.Totaltumorresectionwasachievedinall3patientswithfacialneurinoma.Thefacialnervewassacrificedin2ofthe3caseswithprimaryfaciohypoglossalnerveanastomosis.FacialnervefunctionwasGradeⅡandGradeIIIoneyearaftersurgery,respectively.Inthecasewithanatomicallypreservedfacialnerve,postoperativefacialnervefunctionwasinitiallyGradeⅢandimprovedtoⅡat3months.ThetumorwascompletelyresectedinthetrigeminalneurinomapatientwithaGradeⅢpostoperativefacialnervefunctionwhichimprovedGradeIIthreemonthslater.Seventeenofthe19patientswithacousticneuromaretainedhearingpostoperatively,ofthese12maintainedpreoperativelevelsofhearing.Preoperativehearingcapacitywaspreservedin2ofthe3patientswithfacialnervetumors,butlostinpatientswithothertumortypes.Glossopharyngealneurotomy(n=1)andmicrovasculardecompression(n=1)resultedinsatisfactorysymptomrelie

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简介：与WiFi和3G/4G的快速的发展，人们趋于在移动设备上看录像。这些设备是无所不在的，但是有小存储器缓冲录像。作为结果，与传统的计算机相对照，这些设备加重内容供应商的网络压力。以前的研究使用CDN解决这个问题。但是它出租空间不能动态地在被调整的静态的租借机制让运作的费用高飞并且与不兼容动态地录像交货。在我们的学习，基于从Tencent录像的用户行为的彻底的分析，一个流行中国联机录像份额平台，我们识别二关键用户行为。第一，在一样的区域的大量用户趋于看一样的录像。第二，录像的流行分发符合Pareto原则，即，20%流行录像拥有的顶80%所有录像交通。把这些观察变成银子弹，我们在需求系统(CPA-VoD)上建议并且实现一个新奇帮助云、帮助同伴的录像。在系统，我们在象同伴群的一样的区域，并且在一样的同伴群组织用户，用户们能由分享他们的缓冲录像提供录像给另外的用户。而且，我们在云服务器缓冲10%很流行的录像进一步减轻网络压力。我们选择云服务者因为出租空间能动态地被调整，缓冲录像。根据从Tencent录像的真实数据集上的评估，CPA-VoD最优地减轻网络压力和操作费用，当仅仅20.9%交通被内容供应商满足时。

简介：AIMTo评估变化在phacoemulsification(PC)和femtosecond激光(FSL)期间帮助了的血压(BP)奔流surgery.METHODSA回顾的图表评论为从2013年7月收到了传统的phacoemulsification外科(PC组)和帮助FSL的奔流外科(FS组)到2014年12月的所有病人被执行。完全，从收到过程的二种类型的133个病人的206只眼睛被包括。耐心的特征(年龄，性，和高血压历史)，外科手术前、手术后的位／秒是收缩的collected.RESULTSThe支持operative，心脏舒张的位／秒(公里Hg)是124.89摥琠?桴?楳楬潣敮瀠畬？

简介：AIMTo在一年后续上分析并且比较五个不同变量(1wk，1，3，6并且12mo)：线性测密度术珍视的前面的囊(交流)，和以后的囊(PC)区域测密度术值，交流和PC，和交流洞在femtosecond以后的区域减小比率帮助激光的奔流surgery.METHODSThis是未来的比较级学习。71个病人经历了femtosecond在2014年6月和2015年12月之间的单个眼睛上的帮助激光的奔流外科。5.0公里直径激光帮助了前面的capsulotomy在所有眼睛上被执行。在每外科以后的评估，交流opacificaction(ACO)和密度铺平的PCopacification(PCO)被OculusPentacam?HR使用区域和线性测密度术方法。数字图象与一个裂缝灯Topcon摄影照相机和IMAGEnet?被捕获5软件。数字图象上的交流洞区域用Sketchandcalc区域计算器被测量并且变换成减小比率levels.RESULTSUsing皮尔森关联系数(PCC)，我们没发现关联(r=-0.091，P=0.46)在在ACO的进化之间的第12个月评价，区域测密度术珍视，PCO区域测密度术珍视看作了独立变量。我们没发现关联，用PCC(r=-0.096，P=0.43)在ACO线性测密度术价值和PCO的进化之间，线性测密度术珍视在第12月访问，作为独立变量两个都工作。交流线性测密度术层次和交流区域测密度术层次继续从第六强烈成长到第12个月。交流空缺区域减小比率的价值的分析(1wk，1，3，6，12mo)揭示了连续考试的价值之间的统计上重要的差别，但是变化的大小减少了。在在六和12之间监视月的最后的时期，变化的大小是结果显示出的low.CONCLUSIONOur当capsulorhexis区域减小比率铺平时，ACO测密度术从第六珍视到第12个月的Scheimpflug的猛烈增加显示了可观的减少。我们没发现在ACO区域和PCO区域和线性测密度术价值之间的关联，在第12月考试，作为独立变量工作。

简介：AIMTo评估人的透镜上皮房间apoptosis并且对femtosecond激光在有到N3的N2的帮助奔流外科(FLACS).METHODSSixty奔流病人根据LOCSIII上演的femtosecond激光导致的间充质的转变(EMT)上皮在这研究被注册并且随机把组划分了成三：FLACS1组(由有LenSx的FLACS的奔流外科)，FLACS2组(由有LensAR的FLACS的奔流外科)和用手的组(由phacoemulsification的奔流外科)。在二个FLACS组的病人由LenSx或LensAR激光系统执行了前面的capsulotomy。在用手的组的病人被执行连续曲线的capsulorrhexis(CCC)手工地。恰好在从眼睛移动了以后，前面的囊被修理。在奔流surgery.RESULTSThe囊优势被病理学的染色在用手的capsulotomy在二个FLACS组和光滑的边看不规则和粗糙以后，染色的Hematoxylin-eosine，immunofluorescence染色和即时PCR被执行以便观察人的透镜上皮房间变化。有部分肿、破坏的原子核的房间配置的不规则在二个FLACS组被观察。Femtosecond激光能比手工地执行的CCC在人的透镜上皮房间导致显著地更高的房间apoptosis(P<0.05)。透镜上皮房间apoptosis根据皮尔森关联分析与femtosecond激光持续时间被相关。在二个FLACS组的减少的N-cadherin表示，alpha-SMA和FSP-1水平证明房间EMT.CONCLUSIONFemtosecond激光的抑制可以影响在剥的中央透镜囊下面的透镜上皮房间的apoptosis和EMT。

简介：AbstractBackground:Indocyanine green video angiography (ICG-VA) is a safe and effective instrument to assess changes in cerebral blood flow during cerebrovascular surgery. After ICG-VA, FLOW 800 provides a color-coded map to directly observe the dynamic distribution of blood flow and to calculate semiquantitative blood flow parameters later. The purpose of our study is to assess whether FLOW 800 is useful for surgery of complex intracranial aneurysms and to provide reliable evidence for intraoperative decision-making.Methods:We retrospectively reviewed patients with complex aneurysms that underwent microsurgical and intraoperative evaluation of ICG-VA and FLOW 800 color-coded maps from February 2019 to May 2020. FLOW 800 data were correlated with patient characteristics, clinical outcomes, and intraoperative decision-making.Results:The study included 32 patients with 42 complex aneurysms. All patients underwent ICG-VA FLOW 800 data provided semiquantitative data regarding localization, flow status in major feeding arteries; color maps confirmed relative adequate flow in parent, branching, and bypass vessels.Conclusions:FLOW 800 is a useful supplement to ICG-VA for intraoperative cerebral blood flow assessment. ICG-VA and FLOW 800 can help to determine the blood flow status of the parent artery after aneurysm clipping and the bypass vessels after aneurysm bypass surgery.

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简介：随着互联网的快速发展，网络游戏为越来越多的人所接受。青少年是一个特殊的网络游戏玩家群体，成为网络游戏玩家的“主力军”，他们的父母又是持怎样的态度呢？

简介：电视上看到一则某种牌子的电器之广告,内中有audio和video两个字,借贵刊一角谈一谈。不用说,这两个字都是和电器有关的。audio与“音”有关系,video则和“影”有关。audio是指由声音、机械、或电力所造成的频率(audiofrs-quency),具有这种频率的声波每秒钟振动十五至二万次,也就是所谓低周波,是人类所能听得见的。在电器制品中,andio特指电唱机、收音机或电视机的发音部分,平常人们所说的音响设备就叫audioequipment。因此,audio现用来泛指一般与音响有关的东西。

简介：[1]Ci,S.,Sharif,H.,2002.AVariableDataRateSchemetoEnhanceThroughputPerformanceofWirelessLANs.IEEECSNDSP.[2]Doufexi,A.,Armour,S.,Butler,M.,Nix,A.,Bull,D.,2001.AstudyoftheperformanceofHiperlan/2andIEEE802.11aphysicallayers.IEEEVTC,1:668-672.[doi:10.1109/VETECS.2001.944927][3]Doufexi,A.,Armour,S.,Karlsson,P.,Butler,M.,Nix,A.,Bull,D.,2002.AcomparisonoftheHiperlan/2andIEEE802.11aWirelessLANstandards.IEEECommunicationsMagazine,40(5):172-180.[doi:10.1109/35.1000232][4]Ferré,P.,Doufexi,A.,Chung-How,J.,Nix,A.,Bull,D.,2003.LinkAdaptationforVideoTransmissionoverCOFDMBasedWLANs.IEEESCVT.Eindhoven.[5]Girod,B.,Kalman,M.,Liang,Y.,Zhang,R.,2002.Advancesinchannel-adaptivevideostreaming.JournalofWirelessCommunicationsandMobileComputing,2(6):573-584.[doi:10.1002/wcm.87][6]Haratcherev,I.,Langendoen,K.,2004.HybridRateControlforIEEE802.11.ACMInternationalWorkshoponMobilityManagementandWirelessAccess(MobiWac),Philadelphia.[7]Haratcherev,I.,Langendoen,K.,Lagendijk,I.,Sips,H.,2002.D3.16:Application-directedAutomatic802.11RateControl.GigaMobileProject,TUDelf,Tech.Rep.[8]Haratcherev,I.,Langendoen,K.,Lagendijk,R.,Sips,H.,2004.SNR-basedRateControlinWaveLAN.ASCI2004Conference.PortZelande.[9]Haratcherev,I.,Taal,J.,Langendoen,K.,Lagendijk,R.,Sips,H.,2005.AutomaticIEEE802.11ratecontrolforstreamingapplications.WirelessCommunicationsandMobileComputing,5(4):421-437.[doi:10.1002/wcm.301][10]Hoffman,C.,Manshaie,M.H.,Turletti,T.,2005.CLARA:Closed-LoopAdaptiveRateAllocationforIEEE802.11WirelessLANs.IEEEWirelessCom'.Hawaii.[11]Holland,G.,Vaidya,N.,Bahl,P.,2001.ARate-AdaptiveMACProtocolforMulti-HopWirelessNetworks.Mobicom.Rome.[12]H264software,2005.H.264/AVCSoftwareCoordination.http://bs.hhi.de/～suehring/tml/.[13]IEEE802.11,1999.Part11:WirelessLANMediumAccessControl(MAC)andPhysicalLayer(PHY)Specifications.[14]IEEE802.11a,1999.Part11:WirelessLANMediumAccessControl(MAC)andPhysicalLayer(PHY)Specific

简介：AbstractPurpose:To analyze the efficacy and outcome of percutaneous thoracic endovascular aortic repair (TEVAR) in patients with traumatic blunt aortic injury in our single-center.Methods:From January 2014 to December 2018, a total of 89 patients with traumatic blunt aortic injuries were treated with emergency TEVAR in our center. Their clinical data such as demographics, operative details and postprocedure outcomes were analyzed retrospectively in this study using SPSS 20 software. Continuous variables were expressed as mean and standard deviation or median and interquartile range. Categorical variables are expressed as the numbers and percentages of patients.Results:The median age of the patients was 37 years, and 76 (85.4%) were males. All the patients were involved in violent accidents and combined with associated injuries. Two patients died while awaiting the operations and 87 patients underwent emergency percutaneous TEVAR, with a 100% technique success. The mean time interval from admission to operating room was (90.1 ± 18.7) min, and the mean procedure time was (54.6 ± 11.9) min. Eighty (92.0%) patients were operated on under local anesthesia, while other 7 (8.0%) patients were under general anesthesia. Two cases underwent open repair of the femoral arteries because of the pseudoaneurysm formation of the access vessels. A total of 98 aortic covered stent grafts were deployed, of which 11 patients used two stent grafts (all in dissection cases). The length of the stent was (177.5 ± 24.6) mm. The horizontal diameter of aorta arch at the proximal left subclavian artery ostium was (24.9 ± 2.4) mm, the proximal diameter of the covered stent was (30.5 ± 2.6) mm, and the oversize rate of proximal site was (22.7 ± 4.0)%. The proximal landing zone length was (14.1 ± 5.5) mm. The left subclavian artery ostium was completely covered in 5 patients and partially covered in 32 patients. No blood flow reconstruction was performed. The overall aortic-related mortality was 2.25% (2/89). Among 87 patients, the median follow-up time was 24 months. Postoperative computed tomography angiography scans demonstrated no residual pseudoaneurysm, hematoma or endoleak. One patient complained of mild left upper limb weakness during follow-up due to left subclavian artery occlusion. Neither late death, nor neurological or other complications occurred.Conclusion:Emergency percutaneous endovascular repair is a less invasive and effective approach for the treatment of traumatic blunt aortic injuries. Long-term results remain to be further followed.

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