A number of clinical trials have demonstrated that the laparoscopic approach for colorectal cancer resection provides the same oncologic results as open surgery along with all clinical benefits of minimally invasive s...A number of clinical trials have demonstrated that the laparoscopic approach for colorectal cancer resection provides the same oncologic results as open surgery along with all clinical benefits of minimally invasive surgery. During the last years, a great effort has been made to research for minimizing parietal trauma, yet for cosmetic reasons and in order to further reduce surgery-related pain and morbidity. New techniques, such as natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopy (SIL) have been developed in order to reach the goal of “scarless” surgery. Although NOTES may seem not fully suitable or safe for advanced procedures, such as colectomies, SIL is currently regarded as the next major advance in the progress of minimally invasive surgical approaches to colorectal disease that is more feasible in generalized use. The small incision through the umbilicus allows surgeons to use familiar standard laparoscopic instruments and thus, perform even complex procedures which require extraction of large surgical specimens or intestinal anastomosis. The cosmetic result from SIL is also better because the only incision is made through the umbilicus which can hide the wound effectively after operation. However, SIL raises a number of specific new challenges compared with the laparoscopic conventional approach. A reduced capacity for triangulation, the repeated conflicts between the shafts of the instruments and the difficulties to achieve a correct exposure of the operative field are the most claimed issues. The use therefore of this new approach for complex colorectal procedures might understandingly be viewed as difficult to implement, especially for oncologic cases.展开更多
BAPV Building Attached Photovoltaic系统一般采用自发自用、余电上网的方式接入用户侧电网。文章针对BAPV单点接入系统的设计,从接入电压、主要设备的选择、保护装置的配置、通信装置的配置和接入方案设计5个方面进行了论述,并分析了...BAPV Building Attached Photovoltaic系统一般采用自发自用、余电上网的方式接入用户侧电网。文章针对BAPV单点接入系统的设计,从接入电压、主要设备的选择、保护装置的配置、通信装置的配置和接入方案设计5个方面进行了论述,并分析了接入系统对电网电压的扰动和短路条件下对电网稳定性的影响,验证了设计方案的合理性与可行性。展开更多
Purpose: To report a novel technique of laparoscopic 10 mm Single Port Access IntraPeritoneal Onlay Mesh (SPA-IPOM) using bioresorbable composite mesh fixed with Endoclose suture (percutaneous subcutaneous suture) in ...Purpose: To report a novel technique of laparoscopic 10 mm Single Port Access IntraPeritoneal Onlay Mesh (SPA-IPOM) using bioresorbable composite mesh fixed with Endoclose suture (percutaneous subcutaneous suture) in 3 cases of bilateral inguinal hernia. Methods: Laparoscopic SPA-IPOM is done through a 10 mm trocar with one 10 mm instrument that has 5 mm optical lens and 5 mm channel for grasper. After inserting 10 mm trocar at umbilicus using semi-open technique, intraperitoneal anatomical landmark of inguinal her-nia is identified. A 10 × 15 cm pre-tied bioresorbable composite mesh is then placed to cover hernia defect and all three potential area of indirect, direct and femoral hernia. Using Endoclose? needle, each pair of pre-tied sutures is retrieved percutaneously through a needle wound and extracorporeal tied with knot in subcutaneous space. After the upper half of mesh is sutured to the posterior surface of abdominal wall, the lower half of mesh is fixed by hernia tacker to Symphysis Pubis, Cooper Ligament and Iliopubic tract. Re-sults: Three men, average 48 year olds were operated by laparoscopic 10 mm SPA-IPOM for bilateral in-guinal hernia repair using bioresorbable composite mesh. Average operative time was 36 minutes. No imme-diate complication. All patients were discharge on the 2nd post-operative day and average 6 months follow up has no recurrence. Conclusions: Laparoscopic SPA-IPOM is an optional operation and is much easier to be performed. Benefits include operative time saving, cosmesis, early discharge and early return to work. Bio-resorbable composite mesh prevents bowel adhesion, however, is much more expensive. Long term follow up study for complications and recurrence is needed.展开更多
针对认知无线电网络(Cognitive Radio Network,CRN)中认知无线电(Cognitive Radio,CR)用户单信道伺机频谱接入问题,从既满足CR用户各异的QoS需求又不对主用户(Primary Radio,PR)产生干扰的角度,定义新的度量指标CRN有效吞吐量,并以CRN...针对认知无线电网络(Cognitive Radio Network,CRN)中认知无线电(Cognitive Radio,CR)用户单信道伺机频谱接入问题,从既满足CR用户各异的QoS需求又不对主用户(Primary Radio,PR)产生干扰的角度,定义新的度量指标CRN有效吞吐量,并以CRN有效吞吐量最大为目标建立单信道伺机频谱接入模型。提出基于最小速率差额的接入策略,给出相应的信道和功率分配算法(Minimum Rate Gap-based Channel and Power Allocation,MRG-CPA),并设计MAC协议以实现分布式接入。仿真结果表明,与现有的降序最佳适应算法、降序首次适应算法和基于最小速率需求的功率分配算法相比,MRG-CPA不仅提供较大的CRN有效吞吐量,并且提高CR用户QoS保证率。展开更多
文摘A number of clinical trials have demonstrated that the laparoscopic approach for colorectal cancer resection provides the same oncologic results as open surgery along with all clinical benefits of minimally invasive surgery. During the last years, a great effort has been made to research for minimizing parietal trauma, yet for cosmetic reasons and in order to further reduce surgery-related pain and morbidity. New techniques, such as natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopy (SIL) have been developed in order to reach the goal of “scarless” surgery. Although NOTES may seem not fully suitable or safe for advanced procedures, such as colectomies, SIL is currently regarded as the next major advance in the progress of minimally invasive surgical approaches to colorectal disease that is more feasible in generalized use. The small incision through the umbilicus allows surgeons to use familiar standard laparoscopic instruments and thus, perform even complex procedures which require extraction of large surgical specimens or intestinal anastomosis. The cosmetic result from SIL is also better because the only incision is made through the umbilicus which can hide the wound effectively after operation. However, SIL raises a number of specific new challenges compared with the laparoscopic conventional approach. A reduced capacity for triangulation, the repeated conflicts between the shafts of the instruments and the difficulties to achieve a correct exposure of the operative field are the most claimed issues. The use therefore of this new approach for complex colorectal procedures might understandingly be viewed as difficult to implement, especially for oncologic cases.
文摘BAPV Building Attached Photovoltaic系统一般采用自发自用、余电上网的方式接入用户侧电网。文章针对BAPV单点接入系统的设计,从接入电压、主要设备的选择、保护装置的配置、通信装置的配置和接入方案设计5个方面进行了论述,并分析了接入系统对电网电压的扰动和短路条件下对电网稳定性的影响,验证了设计方案的合理性与可行性。
文摘Purpose: To report a novel technique of laparoscopic 10 mm Single Port Access IntraPeritoneal Onlay Mesh (SPA-IPOM) using bioresorbable composite mesh fixed with Endoclose suture (percutaneous subcutaneous suture) in 3 cases of bilateral inguinal hernia. Methods: Laparoscopic SPA-IPOM is done through a 10 mm trocar with one 10 mm instrument that has 5 mm optical lens and 5 mm channel for grasper. After inserting 10 mm trocar at umbilicus using semi-open technique, intraperitoneal anatomical landmark of inguinal her-nia is identified. A 10 × 15 cm pre-tied bioresorbable composite mesh is then placed to cover hernia defect and all three potential area of indirect, direct and femoral hernia. Using Endoclose? needle, each pair of pre-tied sutures is retrieved percutaneously through a needle wound and extracorporeal tied with knot in subcutaneous space. After the upper half of mesh is sutured to the posterior surface of abdominal wall, the lower half of mesh is fixed by hernia tacker to Symphysis Pubis, Cooper Ligament and Iliopubic tract. Re-sults: Three men, average 48 year olds were operated by laparoscopic 10 mm SPA-IPOM for bilateral in-guinal hernia repair using bioresorbable composite mesh. Average operative time was 36 minutes. No imme-diate complication. All patients were discharge on the 2nd post-operative day and average 6 months follow up has no recurrence. Conclusions: Laparoscopic SPA-IPOM is an optional operation and is much easier to be performed. Benefits include operative time saving, cosmesis, early discharge and early return to work. Bio-resorbable composite mesh prevents bowel adhesion, however, is much more expensive. Long term follow up study for complications and recurrence is needed.
文摘针对认知无线电网络(Cognitive Radio Network,CRN)中认知无线电(Cognitive Radio,CR)用户单信道伺机频谱接入问题,从既满足CR用户各异的QoS需求又不对主用户(Primary Radio,PR)产生干扰的角度,定义新的度量指标CRN有效吞吐量,并以CRN有效吞吐量最大为目标建立单信道伺机频谱接入模型。提出基于最小速率差额的接入策略,给出相应的信道和功率分配算法(Minimum Rate Gap-based Channel and Power Allocation,MRG-CPA),并设计MAC协议以实现分布式接入。仿真结果表明,与现有的降序最佳适应算法、降序首次适应算法和基于最小速率需求的功率分配算法相比,MRG-CPA不仅提供较大的CRN有效吞吐量,并且提高CR用户QoS保证率。
