Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chin ese Trauma Surge on Associati on orga nized a committee composed of 28 experts across China in July ...Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chin ese Trauma Surge on Associati on orga nized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries.Eleven questions regarding the use of VSD in abdominal surgeries were addressed:(1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions?(2) Can VSD be preventively used for a high-risk abdominal incision w让h primary suture?(3) Can VSD be used in severely contaminated/infected abdominal surgical sites?(4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome?(5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage?(6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula?(7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess?(8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects?(9) Does VSD in crease the risk of bleeding?(10) Does VSD increase the risk of intestinal wail injury?(11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.展开更多
Operational reliability evaluation theory reflects real-time reliability level of power system. The component failure rate varies with operating conditions. The impact of real-time operating conditions such as ambient...Operational reliability evaluation theory reflects real-time reliability level of power system. The component failure rate varies with operating conditions. The impact of real-time operating conditions such as ambient temperature and transformer MVA (megavolt-ampere) loading on transformer insulation life is studied in this paper. The formula of transformer failure rate based on the winding hottest-spot temperature (HST) is given. Thus the real-time reliability model of transformer based on oper- ating conditions is presented. The work is illustrated using the 1979 IEEE Reliability Test System. The changes of operating conditions are simulated by using hourly load curve and temperature curve, so the curves of real-time reliability indices are ob- tained by using operational reliability evaluation.展开更多
Penetrating injury to the rectum, verte- bral body and spinal cord by a steel rod is a rare condition. Treatment of this kind of injury is very challenging. Rectal injury requires repair and fecal diversion, while deb...Penetrating injury to the rectum, verte- bral body and spinal cord by a steel rod is a rare condition. Treatment of this kind of injury is very challenging. Rectal injury requires repair and fecal diversion, while debride- ment of the spine is difficult, especially when the injury site is very long. Here we report a case of penetrating injury of rectum and sacral vertebra by a steel rod after falling onto the ground from 1 m height. The abscess cav- ity was irrigated with 3% hydrogen peroxide and physio- logical saline repeatedly. The bony canal was carefully debrided, curetted and bony fragments were removed. Spinal irrigation and drainage lasted for 2 months and sen- sitive antibiotic （amikacin sulfate） was given 7 days after surgery, but abscess was still formed in the vertebral canal. At 6-month follow-up, the patient was paralyzed without any neurological improvement, and the pain in low back and lower limb still continued.展开更多
<strong>Objective:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> To explore the effects of goal-directed fluid therapy (GDFT) o...<strong>Objective:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> To explore the effects of goal-directed fluid therapy (GDFT) on lung function, cognitive function and inflammatory response in patients undergoing radical esophageal cancer surgery under one-lung ventilation. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Sixty-seven patients undergoing radical esophageal cancer surgery were divided into GDFT group</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(GDFT therapy) and control group</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(conventional liquid therapy). The changes in patients</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;"> pulmonary function,</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">cognitive function and inflammatory response were evaluated. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Both alveolar-arterial oxygen partial pressure difference</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">[P(A-a)O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">] and respiratory index</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">(RI) increased at one-lung ventilation for 30 minutes (T</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">) and decreased at one-lung ventilation for 60 minutes</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">(T</span><sub><span style="font-family:Verdana;">3</span></sub><span style="font-family:Verdana;">), and after surgery (T</span><sub><span style="f展开更多
文摘Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chin ese Trauma Surge on Associati on orga nized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries.Eleven questions regarding the use of VSD in abdominal surgeries were addressed:(1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions?(2) Can VSD be preventively used for a high-risk abdominal incision w让h primary suture?(3) Can VSD be used in severely contaminated/infected abdominal surgical sites?(4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome?(5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage?(6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula?(7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess?(8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects?(9) Does VSD in crease the risk of bleeding?(10) Does VSD increase the risk of intestinal wail injury?(11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.
基金Project (No. 2004CB217901) supported by the National Basic Re-search Program (973) of China
文摘Operational reliability evaluation theory reflects real-time reliability level of power system. The component failure rate varies with operating conditions. The impact of real-time operating conditions such as ambient temperature and transformer MVA (megavolt-ampere) loading on transformer insulation life is studied in this paper. The formula of transformer failure rate based on the winding hottest-spot temperature (HST) is given. Thus the real-time reliability model of transformer based on oper- ating conditions is presented. The work is illustrated using the 1979 IEEE Reliability Test System. The changes of operating conditions are simulated by using hourly load curve and temperature curve, so the curves of real-time reliability indices are ob- tained by using operational reliability evaluation.
文摘Penetrating injury to the rectum, verte- bral body and spinal cord by a steel rod is a rare condition. Treatment of this kind of injury is very challenging. Rectal injury requires repair and fecal diversion, while debride- ment of the spine is difficult, especially when the injury site is very long. Here we report a case of penetrating injury of rectum and sacral vertebra by a steel rod after falling onto the ground from 1 m height. The abscess cav- ity was irrigated with 3% hydrogen peroxide and physio- logical saline repeatedly. The bony canal was carefully debrided, curetted and bony fragments were removed. Spinal irrigation and drainage lasted for 2 months and sen- sitive antibiotic （amikacin sulfate） was given 7 days after surgery, but abscess was still formed in the vertebral canal. At 6-month follow-up, the patient was paralyzed without any neurological improvement, and the pain in low back and lower limb still continued.
文摘<strong>Objective:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> To explore the effects of goal-directed fluid therapy (GDFT) on lung function, cognitive function and inflammatory response in patients undergoing radical esophageal cancer surgery under one-lung ventilation. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Sixty-seven patients undergoing radical esophageal cancer surgery were divided into GDFT group</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(GDFT therapy) and control group</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(conventional liquid therapy). The changes in patients</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;"> pulmonary function,</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">cognitive function and inflammatory response were evaluated. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Both alveolar-arterial oxygen partial pressure difference</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">[P(A-a)O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">] and respiratory index</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">(RI) increased at one-lung ventilation for 30 minutes (T</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">) and decreased at one-lung ventilation for 60 minutes</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">(T</span><sub><span style="font-family:Verdana;">3</span></sub><span style="font-family:Verdana;">), and after surgery (T</span><sub><span style="f
