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81.
Susanne G Warner Adnan A Alseidi Johnny Hong Timothy M Pawlik Rebecca M Minter 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2015,17(9):785-790
BackgroundHepatopancreatobiliary (HPB) surgery fellowship training has multiple paths. Prospective trainees and employers must understand the differences between training pathways. This study examines self-reported fellowship experiences and current scope of practice across three pathways.MethodsAn online survey was disseminated to 654 surgeons. These included active Americas Hepato-Pancreato-Biliary Association (AHPBA) members and recent graduates of HPB, transplant–HPB and HPB–heavy surgical oncology fellowships.ResultsA total of 416 (64%) surgeons responded. Most respondents were male (89%) and most were practising in an academic setting (83%). 290 (70%) respondents underwent formal fellowship training. Although fellowship experiences varied, current practice was largely similar. Minimally invasive surgery (MIS) and ultrasound were the most commonly identified areas of training deficiencies and were, respectively, cited as such by 47% and 34% of HPB-, 49% and 50% of transplant-, and 52% and 25% of surgical oncology-trained respondents. Non-HPB cases performed in current practice included gastrointestinal (GI) and general surgery cases (56% and 49%, respectively) for HPB-trained respondents, transplant and general surgery cases (87% and 21%, respectively) for transplant-trained respondents, and GI surgery and non-HPB surgical oncology cases (70% and 28%, respectively) for surgical oncology-trained respondents.ConclusionsFellowship training in HPB surgery varies by training pathway. Training in MIS and ultrasound is deficient in each pathway. The ultimate scope of non-transplant HPB practice appears similar across training pathways. Thus, training pathway choice is best guided by the training experience desired and non-HPB components of anticipated practice. 相似文献
82.
Shisong Zhang Juan Li Yurui Wu Yuanjun Hu Chunhong Duan Meiyun Wang Zhongtao Gai 《Medicine》2015,94(39)
The purpose of this meta-analysis is to compare the relative merits among laparoscopic-assisted operations and laparotomy operations for patients with Hirschsprung disease.PubMed, Web of Science, and Wanfang databases were searched for the related articles. We analyzed dichotomous variables by estimating odds ratios (ORs) with their 95% confidence intervals (CIs) and continuous variables using the weighted mean difference (WMD) with the 95% CI. The random-effects model (REM) was used to combine the results. The outcome measures included operating time (OT), estimated blood loss (EBL), length of hospital stay (LOHS), mean first bowel movement (MFBM), and number of complications.Sixteen articles were included in the meta-analysis. These studies involved a total of 774 patients, 396 of whom underwent laparoscopic-assisted operations and 378 of whom underwent laparotomy operations. The EBL (WMD = −1.48, 95% CI = −1.82, −1.13), LOHS (WMD = −0.67, 95% CI = −0.86, −0.49), MFBM (WMD = −0.83, 95% CI = −1.05, −0.61), and number of complications (OR = 0.60, 95% CI = 0.40, 0.89) were significantly lower in laparoscopic-assisted operations than in laparotomy operations. The OT (WMD = 0.12, 95% CI = −0.05, 0.28) showed no significant differences between laparoscopic-assisted operations and laparotomy operations.Compared with laparotomy operations, laparoscopic-assisted operations are generally safer and more reliable for patients with Hirschsprung disease. 相似文献
83.
84.
目的 分析H型高血压患者的舌面诊图像颜色参数特征,探讨H型高血压患者的舌诊、面诊变化规律。方法 运用上海中医药大学自行研制的Smart TCM-1型中医舌面一体仪,采集高血压患者舌面诊图像,提取特征参数,分析健康对照组、H型高血压组与非H型高血压组患者舌面颜色参数特征。结果 ①在舌色各项参数中,H型高血压组舌尖部R值、B值、V值均显著小于健康对照组(P < 0.01);非H型高血压组舌尖部B值显著小于健康对照组(P < 0.01),S值较健康对照组显著增大(P < 0.05);H型高血压组舌尖部R、V值均明显小于非H型高血压组(P < 0.05)。在舌苔各项参数中,H型高血压组舌中H值、V值均明显小于健康对照组(P < 0.05);非H型高血压组舌中V值、舌右V值均显著小于健康对照组(P < 0.01);H型高血压组舌中H值明显小于非H型高血压组(P < 0.05),右侧舌苔S值明显大于非H型高血压组(P < 0.05)。②H型高血压组面色参数鼻G值、下颌G值、口唇R值、口唇V值均明显小于健康对照组(P < 0.05);非H型高血压组前额H值、目眶H值、脸颊H值、鼻H值、下颌H值、整体H值均明显大于健康对照组(P < 0.05);H型高血压组前额H值、目眶G值、目眶H值、脸颊H值、鼻G值、鼻H值、下颌R值、下颌G值、下颌H值、下颌V值、口唇R值、口唇G值、口唇V值、整体R值、整体G值、整体H值、整体V值均明显小于非H型高血压组(P < 0.05)。结论 H型高血压患者苔色偏黄,以舌中部为主,且舌右侧黄苔积聚较明显;H型高血压患者面色为黄中带红,口唇、下颌部更为晦暗。H型高血压患者的舌、面诊特征参数的变化,与高血压病阳亢湿盛病机相符。 相似文献
85.
86.
This study utilizes a psychophysical approach to examine the effects on
carrying capacity for bi-manual carrying tasks involving different handle positions and
carrying ranges. A total of 16 female subjects participated in the experiment in groups of
two people, and each group of subjects performed the tasks in a random order with 12
different combinations of carrying task. The independent variables are handle position
(upper, middle, lower) and carrying range (F–F: floor height carried to floor height, F–W:
floor height carried to waist height, W–W: waist height carried to waist height, W–F:
waist height carried to floor height), the dependent variable is the maximum acceptable
carried weight (MAWC), heart rate (HR), and the rating of perceived exertion (RPE). The
results show that the handle position has a significant effect on MAWC and overall RPE but
no significant effect on HR. Carrying range has a significant effect on the MAWC and HR,
but no significant effect on overall HR. The handle position and carrying range have a
significant interaction on the MAWC and HR. The RPE for different body parts shows
significant differences, and the hands feel the most tired. Overall, this study confirms
that the lower handle position with the W–W carrying range is the best combination for a
two-person carrying task. 相似文献
87.
88.
The ban of lead in many electronic products and the expectation that, sooner or later, this ban will include the currently exempt piezoelectric ceramics based on Lead-Zirconate-Titanate has motivated many research groups to look for lead-free substitutes. After a short overview on different classes of lead-free piezoelectric ceramics with large strain, this review will focus on Bismuth-Sodium-Titanate and its solid solutions. These compounds exhibit extraordinarily high strain, due to a field induced phase transition, which makes them attractive for actuator applications. The structural features of these materials and the origin of the field-induced strain will be revised. Technologies for texturing, which increases the useable strain, will be introduced. Finally, the features that are relevant for the application of these materials in a multilayer design will be summarized. 相似文献
89.
This meta-analysis examined whether early decompressive craniectomy (DC) can improve control of intracranial pressure (ICP) and mortality in patients with traumatic brain injury (TBI).Medline, Cochrane, EMBASE, and Google Scholar databases were searched until May 14, 2015, using the following terms: traumatic brain injury, refractory intracranial hypertension, high intracranial pressure, craniectomy, standard care, and medical management. Randomized controlled trials in which patients with TBI received DC and non-DC medical treatments were included.Of the 84 articles identified, 8 studies were selected for review, with 3 randomized controlled trials s having a total of 256 patients (123 DCs, 133 non-DCs) included in the meta-analysis. Patients receiving DC had a significantly greater reduction of ICP and shorter hospital stay. They also seemed to have lower odds of death than patients receiving only medical management, but the P value did not reach significance (pooled odds ratio 0.531, 95% confidence interval 0.209–1.350, Z = 1.95, P = 0.183) with respect to the effect on overall mortality; a separate analysis of 3 retrospective studies yielded a similar result.Whereas DC might effectively reduce ICP and shorten hospital stay in patients with TBI, its effect in decreasing mortality has not reached statistical significance. 相似文献
90.