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Efficacy and safety of transvaginal mesh repair in a cohort with a minimum of 10-year follow-up

Science China(Life Sciences) 2024年第5期67卷 1061-1068页

作者： Zhibo Zhang Jianbin Guo Weijie Tian Ye Zhang Yuelun Zhang Tianshu Sun jiali duan Xinmiao Bao Yuan Wang Yang Ye Qianqian Gao Honghui Shi Abraham Nick Morse Juan Chen Lan Zhu Departmentof Obstetrics and Gynecology Peking Union MedicalCollege HospitalChinese Academyof Medical Sciences&Peking Union MedicalCollegeNational Clinical Research Center for Obstetricand Gynecologic DiseasesBeijing 100730China Department of Gynecology Guizhou Provincial People’s HospitalMedical College of Guizhou UniversityGuiyang 550002China Department of Obstetrics and Gynecology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450000China Medical Research Center Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Medical Doctor Program Chinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Department of Pathology Peking Union Medical College HospitalBeijing 100730China Tufts University School of Medicine Boston MA 02111USA

Although transvaginal mesh(TVM)repair is no longer used in some countries,long-term outcomes after TVM surgery are of great importance ***,reports with follow-up>10 years are ***,this study aimed to report outcomes in a prospective cohort with at least 10 years of *** with stageⅢ–Ⅳsymptomatic prolapse were approached consecutively from 2008 to 2013 at one tertiary *** main outcome measure was symptomatic *** outcomes included anatomic failure,recurrence,patient satisfaction,complications,and *** Kaplan-Meier curve was used to estimate the cumulative failure *** the 121 patients enrolled in the study,103(85.1%)completed a median follow-up of 11 *** estimated probability rates of symptomatic and anatomic failure were 17.6%and 8.8%in 11 years,*** estimated incidence of symptomatic failure increased by 8.2%between 5 and 11 years;however,the corresponding rate for anatomic failure was 3.7%.The most common complication was vaginal mesh exposure,and its estimated probability increased from 19.3%to 28.4%from 5 to 11 years,*** trimming resolved 80.0%of vaginal *** patients did not report decreased overall *** with vaginal mesh exposure requiring>3 office procedures or mesh removal in the operating room(5.8%by 11 years)had lower satisfaction rates(P<0.01)and were defined as having severe mesh *** rates of postoperative pain,reoperation,and Patient Global Impression of Improvement≥2 were 2.5%,3.3%,and 94.2%,*** results of this study implied that TVM treatment gradually increased the symptomatic failure rate but provided durable anatomical support of the vaginal *** mesh exposure was common in women who were largely not sexually active;however,80%of the cases could be managed in the outpatient clinic,which did not affect patient satisfaction.

关键词： complication efficacy long-term follow-up pelvic organ prolapse safety transvaginal mesh

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城市中压配电网雪花格式网架结构初探

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电力系统及其自动化学报 2024年第9期36卷 51-60页

作者：王哲段佳莉何平王伟臣徐晶张章国网天津市电力公司天津300010 国网天津市电力公司城南供电分公司天津300201 国网天津市电力公司经济技术研究院天津300171

为适应新型电力系统建设需求,提出一种适合国情的雪花格式网架结构。首先,总结国内外典型城市中压配电网结构的特征与优缺点;然后,结合天津已有网架结构,提出雪花格式网架结构及其构建方法;其次,分析测算雪花网结构的负荷转移能力、可... 详细信息

为适应新型电力系统建设需求,提出一种适合国情的雪花格式网架结构。首先,总结国内外典型城市中压配电网结构的特征与优缺点;然后,结合天津已有网架结构,提出雪花格式网架结构及其构建方法;其次,分析测算雪花网结构的负荷转移能力、可靠性与效率效益水平;最后,从结构形式、适合场景等方面给出雪花网结构与花瓣结构等的综合对比情况。结果表明,雪花格式网架结构具有一定综合比较优势,可为中压配电网远景目标网架规划提供指导。

关键词：城市电网中压配电网雪花格式网架结构负荷转移能力

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A Virtual Puncture Surgery System Based on Multi-Layer Soft Tissue and Force Mesh

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Computers, Materials & Continua 2018年第12期57卷 505-519页

作者： Xiaorui Zhang jiali duan Lifeng Zhu Ladislav Kavan Jiangsu Engineering Center of Network Monitoring Nanjing University of Information Science&TechnologyNanjing210044China School of Instrument Science and Engineering Southeast UniversityNanjing210096China School of Computing University of UtahSalt Lake CityUT 84112-9205USA

Puncture is a common operation in surgery,which involves all kinds of tissue materials with different geometry and mechanical *** a new cross-disciplinary research area,Virtual Surgery(VS)makes simulation of soft tissue in puncture operation possible in virtual *** this paper,we introduce a VS-based puncture system composed by three-layer soft tissue,simulated with spherical harmonic function(SHF),which is covered with a force mesh,constructed by mass spring model(MSM).The two models are combined together with a parameter of SHF named surface radius,which provides MSM with real-time deformation data needed in force ***,force calculation,divided into the surface spring force and the puncture damping force,makes the force presentation better accord to the corresponding tissue ***,a deformation resumption algorithm is leveraged to simulate the resumption phenomenon of the broken tissue *** evaluation experiment,several residents are invited to grades our model along with other four mainstream soft tissue models in terms of 7 different *** the evaluation,the scores are analyzed by a comprehensive weighted grading *** results show that the proposed model has better performance during puncture operation than other models,and can well simulate surface resumption phenomenon when tissue surface is broken.

关键词： Puncture simulation spherical harmonic function mass spring model tissue surface resumption weighted grading evaluation

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Measuring Financial Systemic Risk:Net Liability Clearing Mechanism and Contagion Effect

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Journal of Systems Science & Complexity 2024年第3期37卷 1114-1146页

作者： MA jiali ZHU Shushang LI duan College of Big Data Statistics Guizhou University of Finance and EconomicsGuiyang 550025China School of Business Sun Yat-Sen UniversityGuangzhou 510275China School of Data Science City University of Hong KongHong Kong 999077China

Following the framework of E-N model(Eisenberg and Noe,2001),the authors consider a new clearing mechanism based on net liabilities among financial institutions since the liabilities between the counterparties should be deducted accordingly when clearing in *** the basis for systemic risk measurement,similar to the original E-N model,the authors first establish some good properties for the clearing payment vector according to a more general ***,the authors investigate how risk spreads among institutions through the liability network forming the risk contagion ***,the authors illustrate with a specific example that the original E-N clearing mechanism may misidentify the systemic important institutions,and theoretically show that it may also overestimate the risk compared with the netting clearing mechanism.

关键词： Clearing mechanism contagion net liability network systemic risk

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A Three-Stage Cutting Simulation System Based on Mass-Spring Model

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Computer Modeling in Engineering & Sciences 2021年第4期127卷 117-133页

作者： Xiaorui Zhang jiali duan Wei Sun Tong Xu Sunil Kumar Jha Jiangsu Engineering Center of Network Monitoring Engineering Research Center of Digital ForensicsMinistry of EducationSchool of Computer and SoftwareNanjing University of Information Science&TechnologyNanjing210044China Jiangsu Collaborative Innovation Center of Atmospheric Environment and Equipment Technology(CICAEET) Nanjing University of Information Science&TechnologyNanjing210044China Faculty of Information Technology University of Information Technology and ManagementRzeszow35-225Poland

The cutting simulation of soft tissue is important in virtual *** includes three major challenges in computation:Soft tissue simulation,collision detection,and handling,as well as soft tissue *** order to address the earlier challenges,we propose a virtual cutting system based on the mass-spring *** this system,MSM is utilized to simulate the soft tissue *** stress is introduced to the model for simulating the shrinking effect of soft tissue in ***,a cylinder-based collision detection method is used to supervise the collision between surgical tools and soft ***,we simulate the cutting operation with a three-stage cutting method with swept volume,B´ezier curve,and an algorithm named shortest distance nodes matching *** order to verify the system performance,we carry out three validation experiments on the proposed system:Cutting accuracy experiment,collision detection validation,and practical cutting *** indicate that our system can well perform the shrinking effect of soft tissue in *** system has fast and accurate collision ***,the system can reconstruct smooth incisions vividly.

关键词： Mass-spring model collision algorithm virtual surgery soft tissue simulation

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生物补片法阴道成形术在MRKH综合征患者中的临床应用研究

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生物医学转化 2024年第3期5卷 13-19页

作者：顾翔宇陈娜段佳丽朱兰中国医学科学院北京协和医学院北京协和医院国家妇产疾病临床医学研究中心疑难重症及罕见病国家重点实验室北京100730 中国医学科学院北京协和医学院北京100730

目的本研究旨在评估采用生物补片法阴道成形术治疗的苗勒管发育不全(MRKH)综合征患者的心理健康、生活质量及性功能。方法本研究为一项单中心前瞻性研究,纳入2018年1月-2023年6月,北京协和医院诊断为MRKH综合征并行生物补片法人工阴道... 详细信息

目的本研究旨在评估采用生物补片法阴道成形术治疗的苗勒管发育不全(MRKH)综合征患者的心理健康、生活质量及性功能。方法本研究为一项单中心前瞻性研究,纳入2018年1月-2023年6月,北京协和医院诊断为MRKH综合征并行生物补片法人工阴道成形术的103例患者。分析患者术前门诊的全面表型评估信息、住院手术的围手术期相关信息、术后3个月及术后1年患者门诊复查的相关信息及术后1年复查时所填写的相关问卷信息。其中,83例患者完成术后1年的门诊随诊,签署知情同意并完成相关问卷,具体包括:患者健康状况问卷-9(PHQ-9)及广泛性焦虑量表(GAD-7)问卷评估患者术后的心理健康,健康调查量表-12(SF-12)问卷评价患者术后的生活质量。问卷结果与文献记载中一般人群数据比较。术后的性功能评价方面,术后1年门诊复查时,4周内有性生活并填写女性性功能问卷(FSFI)的患者49例,选用同期该院体检的年龄匹配、性活跃的健康女性对照49例进行对照分析。结果患者接受手术的平均年龄为23.39±6.03岁,术后平均随访时间为14.42±3.38个月。末次门诊就诊时,患者的平均阴道长度为7.89±1.28 cm,阴道宽度为2.95±1.06 cm。术后1年,患者的PHQ-9评分显著高于一般人群(P=0.03),而GAD-7评分差异无统计学意义(P=0.5)。SF-12的身体健康综合得分(PCS)显著低于一般人群(P=0.002),而心理健康综合得分(MCS)显著高于一般人群(P<0.001)。性功能评估显示,患者与对照组的FSFI总评分和达到性功能正常定义的人群比例差异无统计学意义,但在性高潮(P=0.01)和疼痛(P=0.01)评分上显著低于健康人群对照组。性功能障碍的发生率有所不同,患者中满足阴道润滑障碍定义的比例显著低于对照组(P<0.001),而性高潮障碍显著高于对照组(P=0.009)。Pearson相关性分析显示,术后时间与FSFI之间呈显著正相关关系。结论生物补片法人工阴道成形术后,MRKH综合征患者的心理健康、生活质量及性生活质量均较为满意。

关键词： MRKH综合征生物补片法阴道成形术焦虑抑郁生活质量性功能

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MRKH综合征患者顶压法人工阴道成形术的性功能评价一项前瞻性队列研究

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中华妇产科杂志 2024年第7期59卷 540-547页

作者：段佳丽陈娜高倩倩黄柔婕宋爽康佳刘霞顾翔宇邓姗朱兰中国医学科学院北京协和医学院北京协和医院妇产科、国家妇产疾病临床医学研究中心、疑难重症及罕见病国家重点实验室北京100730

目的评估顶压法人工阴道成形术的Mayer-Rokitansky-Küster-Hauser(MRKH)综合征患者的性功能、功能学成功率及并发症。方法本研究为前瞻性队列研究,选取2020年3月至2023年2月于北京协和医院行顶压法人工阴道成形术的MRKH综合征患者共97... 详细信息

目的评估顶压法人工阴道成形术的Mayer-Rokitansky-Küster-Hauser(MRKH)综合征患者的性功能、功能学成功率及并发症。方法本研究为前瞻性队列研究,选取2020年3月至2023年2月于北京协和医院行顶压法人工阴道成形术的MRKH综合征患者共97例,其中45例顶压治疗开始后有阴茎插入式性生活被纳入本研究(即观察组)。采用经中文验证的女性性功能指数量表(FSFI)对患者性功能进行评估,采用FSFI总分>23.45分为功能学成功标准;同时选择40例年龄匹配的正常妇女作为对照组。采用Kaplan-Meier法计算顶压开始至成功所需的时长。采用Pearson相关性分析计算阴道长度与FSFI评分之间的关系。通过随访问卷记录患者顶压过程中出现的并发症。结果89%(40/45)的观察组MRKH综合征患者顶压后达到功能学成功标准,成功所需的中位时长为4.3个月(95%CI为3.0~6.1个月)。与对照组相比,虽然观察组的性高潮评分[分别为(4.72±1.01)、(4.09±1.20)分;P=0.013]和疼痛程度评分[分别为(5.03±0.96)、(4.26±0.83)分;P0.999]、性高潮障碍[分别为40%(16/40)、20%(8/40);P=0.051]、性交痛[分别为30%(12/40)、15%(6/40);P=0.108]的发生率无显著差异。顶压过程中出现的并发症主要包括轻中度阴道疼痛(67%,30/45)、阴道点滴出血(33%,15/45)和尿路刺激征(9%,4/45)。结论无创的顶压法人工阴道成形术成功率高,并发症轻微,患者性生活满意度高。应当推广顶压法作为MRKH综合征患者阴道重建的一线治疗方案,减少不必要的手术。

关键词： 46,XX性发育障碍先天畸形子宫阴道修复外科手术前瞻性研究

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Assessing the morphology and ovarian reserve of the ovaries from Mayer-Rokitansky-Küster-Hauser syndrome patients

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Science China(Life Sciences) 2023年第5期66卷 1204-1207页

作者： Ze Liang jiali duan Duoduo Zhang Yan You Lan Zhu Department of Obstetrics and Gynecology National Clinical Research Center for Obstetric&Gynecologic DiseasesState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China 4+4 Medical Doctor Program Chinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Department of Pathology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China

Dear Editor,Mayer-Rokitansky-Küster-Hauser(MRKH)syndrome is a rare congenital disease characterized by the hypoplastic uterus and vagina in women with a normal female karyotype(46,XX)and *** some genes and mutations,... 详细信息

关键词： Hauser uterus congenital

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夏季运营环境下西宁市某型号架空导线温度场变化规律

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青海大学学报 2024年第4期42卷 86-93页

作者：段佳丽刘永斗张越韩志磊刘胜坤青海大学土木水利学院青海西宁810016 青海省建筑节能材料与工程安全重点实验室青海西宁810016

特殊、多变的高寒区气候条件导致架空导线的温度场变化较大,影响导线丝温度变形和分层应力波动,进而引发疲劳断股问题。因此,开展在高原寒区运营环境下架空导线温度场变化规律研究具有重要意义。本文基于二维稳态热平衡控制方程,考虑输... 详细信息

特殊、多变的高寒区气候条件导致架空导线的温度场变化较大,影响导线丝温度变形和分层应力波动,进而引发疲劳断股问题。因此,开展在高原寒区运营环境下架空导线温度场变化规律研究具有重要意义。本文基于二维稳态热平衡控制方程,考虑输电导线内部钢芯和铝导线丝的接触构造及孔隙,建立一套架空导线径向温度场数值求解方法。将该方法应用于JL/G1A-630/55-48/7型钢芯铝绞线,研究其径向温度分布规律和在不同环境下架空导线的温度场变化规律。结果表明:导线内存在不容忽略的径向温度差,风速、光照强度及环境温度对架空导线温度场有较大的影响。

关键词：架空导线径向温度场二维稳态热平衡有限元法数值模拟

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Research on the Developmental Trend of Education Economy and Management Major under the Perspectives of Policy Reform and Subject Game

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International Journal of Technology Management 2016年第7期 48-50页

作者： jiali duan Changsha Medical University ChangshaHunan410219

In this paper, we conduct research on the developmental trend of education economy and management major under theperspectives of policy reform and subject game. Education economics and management are two tied for the secondary education management andthe education economics discipline in 1997 to adjust the merger of a cross subject. The development of higher education is refers to the cause ofhigher education by man’s subjective activity to achieve the purpose of process as often characterized by the higher education gross enrollmentratio and the main working age population average received increasing the proportion of the higher education, it is a certain period of a countryof the higher education enterprise overall refl ection of the change process and results. This paper combines the state-of-the-art methodologies topropose the new perspective of the education economy and management subject development that will be meaningful.

关键词： Developmental Trend Education Economy Policy Reform Subject Game.

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