One-Step Multichannel Percutaneous Transhepatic Cholangioscopic Lithotripsy Applied in Bilateral Hepatolithiasis

Background

The aim of this study was to compare the outcomes of one-step multichannel percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) with traditional PTCSL in the treatment of bilateral hepatolithiasis.

Methods

From February 2011 to June 2015, 156 patients with bilateral hepatolithiasis received surgical treatment in our department. Among these patients, 81 received one-step multichannel PTCSL (group A), and the remaining 75 received traditional PTCSL (group B).

Results

Compared with group B, group A was characterized by a significantly shorter operation time (83.7 ± 28.5 min vs 118.1 ± 41.5 min; P = 0.000), hospital stay (11.1 ± 3.4 d vs 17.8 ± 5.6 d; P = 0.034), and postoperative hospital stay (6.9 ± 3.1 d vs 9.6 ± 4.5 d; P = 0.026). In addition, the immediate clearance (62.9% vs 45.3%, P = 0.027) and final clearance (90.1% vs 78.7%, P = 0.048) rates were higher in group A than in group B. During the follow-up period, stone recurrence was significantly less common in group A than in group B (13.6% vs 26.7%, P = 0.041). Multivariate Cox analysis showed that the PTCSL method (HR = 2.32, 95% confidence interval [CI] = 1.09–4.90, P = 0.028), bilateral biliary stricture (HR = 4.17, 95% CI = 1.73–10.03, P = 0.001), and stones located in segments I (HR = 7.75, 95% CI = 3.67–16.38, P = 0.000) were independent predictors of recurrence.

Conclusions

Compared with traditional PTCSL, one-step multichannel PTCSL was more efficient and effective in the treatment of bilateral hepatolithiasis.

     

留置针溶栓处理人工血管动静脉内瘘血栓形成的临床疗效

目的探讨采用留置针溶栓治疗AVG血栓形成的临床疗效。方法回顾性分析佛山市第一人民医院血管外科2018年3~12月行留置针溶栓治疗31例AVG血栓形成患者的临床资料,统计AVG复通的成功率、溶栓时间及并发症等情况。结果 31例患者平均溶栓次数1.5次(1~3次),23例溶栓成功,8例溶栓失败,溶栓成功率74.2%。需置入临时透析管12例,免于置入临时透析管19例(61.3%)。7例患者(22.6%)出血,未见肺栓塞病例。术中球囊扩张处理28例患者,其中支架植入4例。结论留置针溶栓处理急性AVG血栓成功率较高,可减少置管造成的血管损伤,值得在基层医院推广。     

运用网络资源进行《护理学基础》课堂教学效果分析

目的探究网络环境下资源利用教学模式以及学生信息素养形成、自主学习能力培养和小组协作学习的方式。方法将2002级护理本科生48人按随机数字表法随机分为网络组和课堂组,每组24人。网络组采用网络环境教学,课堂组采用传统方法课堂教学,学习内容:《护理学基础》中舒适与卧位、静脉输血、褥疮护理。以考试成绩和问卷调查进行各组教学前后及组间的比较。结果考试成绩网络组高于课堂组(P<0.05)。在网络组问卷调查中,24人课前对网络查寻了解为18人,课后为19人,经实验教学后19人认为提高了自主学习的能力;22人认为提高了信息获取能力;22人认为小组学习有利于合作能力的培养,提倡小组协作学习形式。结论网络环境下采用按教学目标自主学习-围绕问题协助学习的模式,可达到培养学生获取信息能力;促进学习者自主学习习惯养成;有利团队协作精神培养的目的。存在问题:网络组教学时间比课堂组教学所需时间长,课后网络作业对没有计算机的学生增加了经济负担。     

Quasiparticle dynamics in reshaped helical Dirac cone of topological insulators

Topological insulators and graphene present two unique classes of materials, which are characterized by spin-polarized (helical) and nonpolarized Dirac cone band structures, respectively. The importance of many-body interactions that renormalize the linear bands near Dirac point in graphene has been well recognized and attracted much recent attention. However, renormalization of the helical Dirac point has not been observed in topological insulators. Here, we report the experimental observation of the renormalized quasiparticle spectrum with a skewed Dirac cone in a single Bi bilayer grown on Bi₂Te₃ substrate from angle-resolved photoemission spectroscopy. First-principles band calculations indicate that the quasiparticle spectra are likely associated with the hybridization between the extrinsic substrate-induced Dirac states of Bi bilayer and the intrinsic surface Dirac states of Bi₂Te₃ film at close energy proximity. Without such hybridization, only single-particle Dirac spectra are observed in a single Bi bilayer grown on Bi₂Se₃, where the extrinsic Dirac states Bi bilayer and the intrinsic Dirac states of Bi₂Se₃ are well separated in energy. The possible origins of many-body interactions are discussed. Our findings provide a means to manipulate topological surface states.     

现场摄像多媒体教学对基护技能课影响的研究

目的 为缓解学生人数急产加引起的《基础护理学》技能课教学环境不能满足教学需要的矛盾。方法 在2000年《基础护理学》教学中，将大的阶梯型教室改建为多媒体教室，并采用现场摄像，大屏幕播放为主的多媒体教学方式。结果 本年学生的技能操作平均成绩与前一年学生的平均成绩的差异无显著意义。结论 该方法能满足大教室学生的技能操作教学要求，具有表现力强，受控性好，参与性高的特点。