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Delayed ischemic gangrene change of distal limb despite optimal decompressed colostomy constructed in obstructedsigmoid colon cancer:A case report

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World Journal of Gastroenterology 2006年第6期12卷 993-995页

作者： wen-shih huang Kuang-wen Liu Paul Y Lin Ching-Chuan Hsieh Jeng-Yi Wang Division of Colon and Rectal Surgery Department of SurgeryChang Gung Memorial Hospital ChiayiTaiwan Graduate Institute of Clinical Medicine Chang Gung UniversityTaoyuanTaiwanChina Department of Surgery E-Da Hospital/Ⅰ-Shou University KaohsiungTaiwanChina Division of Anatomical Pathology Department of Pathology Chang Gung Memorial HospitalChiayiTaiwanChina Division of General Surgery Department of Surgery Chang Gung Memorial HospitalChiayiTaiwanChina Division of Colon and Rectal Surgery Department of Surgery Chang Gung Memorial HospitalChiayiTaiwanChina

Creating blow-hole colostomy for decompression could provide a time-saving and efficient surgical procedure for a severely debilitated case with a completely obstructed colorectal cancer. Complications are reported as prolapse, retraction, and paracolostomal abscess. However, complication with an ischemic distal limb has not been reported. We report a case of critical intra-abdominal disease after decompressed colostomy for relieving malignant sigmoid colon obstruction; a potential fatal condition should be alerted. A 76-year-old male visited our emergency department for symptoms related to obstructed sigmoid colon tumor with foul-odor vomitus containing fecal-like materials. An emergent blow-hole colostomy proximal to an obstructed sigmoid lesion was created, and resolution of complete colon obstruction was pursued. Unfortunately, extensive abdominal painful distention with board-like abdomen and sudden onset of high fever with leukocytopenia developed subsequently. Such surgical abdomen rendered a secondary laparotomy with resection of the sigmoid tumor along with an ischemic colon segment located proximally up to the previously created colostomy. Eventually, the patient had an uneventful postoperative hospital stay. In the present article, we have described an emergent condition of sudden onset of distal limb ischemia after blow-hole colostomy and concluded that despite the decompressed colostomy would resolve acute malignant colon obstruction efficiently; impending ischemic bowel may progress with a possible irreversible peritonitis. Any patient, who undergoes a decompressed colostomy without resection of the obstructed lesion, should be monitored with leukocyte count and abdominal condition survey frequently.

关键词： Colorectal cancer obstruction Colostomy IschemJc colitis Laparotomy

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Analysis of risk factors for central venous port failure in cancer patients

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World Journal of Gastroenterology 2009年第37期15卷 4709-4714页

作者： Ching-Chuan Hsieh Hsu-Huei weng wen-shih huang wen-Ke Wang Chiung-Lun Kao Ming-Shian Lu Chia-Siu Wang Division of General Surgery Department of Surgery ChangGung Memorial Hospital Chiayi 613 Taiwan China GraduateInstitute of Clinical Medical Science College of MedicineChang Gung University Taoyuan 333 Taiwan China Department of Diagnostic Radiology ChangGung Memorial Hospital Chiayi 613 Taiwan China Division of Colon and Rectal Surgery Department of Surgery Chang Gung Memorial Hospital Chiayi613 Taiwan China Division of Thoracic andCardiovascular Surgery Department of Surgery Chang GungMemorial Hospital Chiayi 613 Taiwan China Division of General Surgery Department ofSurgery Chang Gung Memorial Hospital Chiayi 613 TaiwanChina

AIM: To analyze the risk factors for central port failure in cancer patients administered chemotherapy, using univariate and multivariate analyses. METHODS: A total of 1348 totally implantable venous access devices (TIVADs) were implanted into 1280 cancer patients in this cohort study. A Cox proportional hazard model was applied to analyze risk factors for failure of TIVADs. Log-rank test was used to compare actuarial survival rates. Infection, thrombosis, and surgical complication rates (χ2 test or Fisher's exact test) were compared in relation to the risk factors. RESULTS: Increasing age, male gender and openended catheter use were signifi cant risk factors reducing survival of TIVADs as determined by univariate and multivariate analyses. Hematogenous malignancy decreased the survival time of TIVADs; this reduction was not statistically signifi cant by univariate analysis [hazard ratio (HR) = 1.336, 95% CI: 0.966-1.849, P = 0.080)]. However, it became a signifi cant risk factor by multivariate analysis (HR = 1.499, 95% CI: 1.079-2.083, P = 0.016) when correlated with variables of age, sex and catheter type. Close-ended (Groshong) catheters had a lower thrombosis rate than open-ended catheters (2.5% vs 5%, P = 0.015). Hematogenous malignancy had higher infection rates than solid malignancy (10.5% vs 2.5%, P < 0.001). CONCLUSION: Increasing age, male gender, openended catheters and hematogenous malignancy were risk factors for TIVAD failure. Close-ended catheters had lower thrombosis rates and hematogenous malignancy had higher infection rates.

关键词： Central venous port Chemotherapy Risk factor Cancer patient Multivariate analysis

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Management of patients with stercoral perforation of the sigmoid colon:Report of five cases

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World Journal of Gastroenterology 2006年第3期12卷 500-503页

作者： wen-shih huang Chia-Siu Wang Ching-Chuan Hsieh Paul Y Lin Chih-Chien Chin Jeng-Yi Wang Divisionof Colon and Rectal Surgery Chang Gung Memorial Hospital Putzu 613 Taiwan China Division of GeneralSurgery Chang Gung Memorial Hospital Pu-tzu 613 TaiwanChina Division of Anatomical Pathology Chang GungMemorial Hospital Pu-tzu 613 Taiwan China Graduate Institute of Clinical Medicine Chang Gung University Kwei-Shan Taiwan China

To our knowledge, stercoral perforation of the colon is rarely seen with fewer than 90 cases reported in the literature till date. We explored the principles of management to prevent impending mortality in five patients with this condition. Five patients, two males and three females, whose median age was 64 years, had sustained stercoral perforation of the sigmoid colon. Chronic constipation was the common symptom among these patients. Three patients underwent a Hartmann＇s procedure and another two were treated with segmental colectomy with anastomosis and diverting colostomy. There was one surgical mortality and the other patients had an uneventful hospital stay. Timely intervention to prevent and/or treat any associated sepsis along with extensive peritoneal lavage and surgical intervention to remove diseased colonic tissue at the primary stercoral ulceration site coupled with aggressive therapy for peritonitis are key treatment modalities in salvaging patients presenting with stercoral perforation of the colon.

关键词： Stercoral perforation Colon Management

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Quality of life and symptom distress after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

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World Journal of Clinical Cases 2022年第32期10卷 11775-11788页

作者： Ya-Fen Wang Ting-Yao Wang Tzu-Ting Liao Meng-Hung Lin Tzu-Hao huang Meng-Chiao Hsieh Vincent Chin-Hung Chen Li-wen Lee wen-shih huang Chao-Yu Chen Cancer Center Chang Gung Memorial HospitalChiayiTaiwan Division of Hematology and Oncology Department of Internal MedicineChang Gung Memorial HospitalChiayiTaiwan Division of Case Management Cancer CenterChang Gung Memorial HospitalChiayiTaiwan Health Information and Epidemiology Laboratory Chang Gung Memorial HospitalChiayiTaiwan Division of General Surgery Department of SurgeryChang Gung Memorial HospitalChiayiTaiwan Division of Colorectal Surgery Department of SurgeryChang Gung Memorial HospitalChiayiTaiwan Department of Psychiatry Chang Gung Memorial HospitalChiayi and Chang Gung UniversityTaoyuanTaiwan Department of Diagnostic Radiology Chang Gung Memorial HospitalChiayiTaiwanCollege of MedicineChang Gung UniversityTaoyuanTaiwan Department of Obstetrics and Gynecology Chang Gung Memorial HospitalChiayiTaiwan Department of Early Childhood Care and Education Shu-Zen Junior College of Medicine and ManagementKaohsiungTaiwanDepartment of Early Childhood Care and EducationShu-Zen Junior College of Medicine and ManagementKaohsiungTaiwan

BACKGROUND Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy(CRS/HIPEC)for peritoneal surface malignancy can effectively control the disease,however it is also associated with adverse effects which may affect quality of life(QoL).AIM To investigate early perioperative QoL after CRS/HIPEC,which has not been discussed in *** This single institution,observational cohort study enrolled patients who received CRS/*** assessed QoL using the Taiwan residents version of the MD Anderson Symptom Inventory(MDASI-T)and European Organization Research and Treatment of Cancer Core Quality of Life Questionnaire(EORTC QLQ-C30).Participants completed the questionnaires before CRS/HIPEC(S1),at the first outpatient follow-up(S2),and 3 mo after CRS/HIPEC(S3).RESULTS Fifty-eight patients were *** was no significant perioperative difference in global health *** changes in physical and role functioning scores decreased at S2,and fatigue and pain scores increased at S2 but returned to baseline at *** regression analysis showed that age and performance status were significantly correlated with *** the MDASI-T questionnaire,distress/feeling upset and lack of appetite had the highest scores at S1,compared to fatigue and distress/feeling upset at S2,and fatigue and lack of appetite at *** leading interference items were working at S1 and S2 and activity at ***-T scores were significantly negatively correlated with the EORTC QLQ-C30 *** QoL and symptom severity improved or returned to baseline in most categories within 3 mo after CRS/*** findings can help with preoperative consultation and perioperative care.

关键词： Cytoreductive surgery Hyperthermic intraperitoneal chemotherapy Peritoneal carcinomatosis Quality of life Symptom distress Perioperative care

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Role of body mass index in colon cancer patients in Taiwan

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World Journal of Gastroenterology 2012年第31期18卷 4191-4198页

作者： Chih-Chien Chin Yi-Hung Kuo Chien-Yuh Yeh Jinn-Shiun Chen Reiping Tang Chung-Rong Changchien Jeng-Yi Wang wen-shih huang Division of Colon and Rectal Surgery Department of SurgeryChang Gung Memorial HospitalChiayi 613Taiwan Graduate Institute of Clinical Medical Science College of MedicineChang Gung UniversityTaoyuan 333Taiwan Division of Colon and Rectal Surgery Department of SurgeryChang Gung Memorial HospitalLinko 333Taiwan

AIM： To determine the effect of body mass index （BMI） on the characteristics and overall outcome of colon cancer in Taiwan. METHODS： From January 1995 to July 2003, 2138 patients with colon cancer were enrolled in this study. BMI categories （in kg/m2） were established according to the classification of the Department of Health of Tai- wan. Postoperative morbidities and mortality, and survival analysis including overall survival （OS）, disease- free survival （DFS）, and cancer-specific survival （CSS） were compared across the BMI categories.27 kg/m2） patients. Being female, apparently anemic, hypoalbuminemic, and having body weight loss was more likely among underweight patients than among the other patients （P 〈 0.001）. Underweight patients had higher mortality rate （P = 0.00.7） and lower OS （P 〈 0.001） and DFS （P = 0.002） than the other pa- tients. OS and DFS did not differ significantly between normal-weight, overweight, and obese patients, while CSS did not differ significantly with the BMI category. CONCLUSION： In Taiwan, BMI does not significantly affect colon-CSS. Underweight patients had a higher rate of surgical mortality and a worse OS and DFS than the other patients. Obesity does not predict a worse survival.

关键词： Body mass index Colon cancer Survival IVlorbidity Outcome

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Noninvasive beam diagnosis based on the TM_(010)mode

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Nuclear Science and Techniques 2024年第7期35卷 115-125页

作者： Chuang-Ye Song wen-Hui huang Department of Engineering Physics Tsinghua University BeijingBeijing100084China of Education Beijing100084China

A resonant cavity based on the TM_(010)mode is an effective tool for noninvasive beam characterization. This technique has the advantages of a high signal-to-noise ratio, compact structure, and is related to multiple parameters compared with other beam monitors. In this study, high-precision measurements of the bunch charge, arrival time, bunch length, and energy parameters based on the TM_(010)mode are discussed. A cavity beam arrival time monitor(BAM) utilizing a phase cavity has been widely used in many facilities. Regarding bunch-length measurements, the influence of the beam energy, beam offset,and longitudinal spectrum on the TM_(010)mode are carefully considered to reduce errors, and the theoretical resolution of two cavities with different frequencies is analyzed. Owing to the dependence of the beam velocity of the beam loss factor, this method can also be used for the detection low beam energy using two cavities with the same frequency but different cavity lengths. A set of three cavities with different lengths and frequencies of 1.902 and 11.424 GHz is presented for measuring the four aforementioned parameters.

关键词： TM_(010)mode Noninvasive diagnosis Beam length Low energy

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Hole cleaning evaluation and installation spacing optimization of cuttings bed remover in extended-reach drilling

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Petroleum Science 2024年第3期21卷 2005-2022页

作者： Shuo Peng wen-Jun huang De-Li Gao MOE Key Laboratory of Petroleum Engineering China University of Petroleum-BeijingBeijing102249China State Key Laboratory of Petroleum Resources and Engineering China University of Petroleum-BeijingBeijing102249China

In extended-reach or long-horizontal drilling,cuttings usually deposit at the bottom of the *** cuttings accumulate to a certain thickness,complex problems such as excessive torque and drag,tubing buckling,and pipe stuck probably occur,which results in a lot of non-productive time and remedial *** bed remover can efficiently destroy deposited cuttings in time through hydraulic and mechanical stirring *** paper aims to build a method for hole cleaning evaluation and installation spacing optimization of cuttings bed remover to improve the wellbore cleaning ***,a Computational Fluid Dynamics approach with Eulerian—Eulerian multiphase model was utilized to investigate the mechanism of cuttings transportation,and a new type of cuttings bed remover was ***,an evaluation method of hole cleaning effect of remover was *** that,the effects of several drilling parameters on hole cleaning including flow rate of drilling fluid,rotational speed of drillpipe,rate of penetration,wellbore size,rheological property of drilling fluid,and remover eccentricity on the performance of cuttings bed remover were *** results demonstrate that the new type of remover with streamline blade performs better than conventional *** efficiency of hole cleaning is greatly improved by increasing the rotational speed of drillpipe,flow rate of drilling fluid,remover eccentricity,and 6 rpm Fann dial reading for drilling *** higher rate of penetration and large wellbore size result in worse hole *** findings can serve as an important guide for the structure optimization design of cuttings bed remover and installation spacing of removers.

关键词： Extended-reach drlling Drilling hydraulics Cuttings transport Hole cleaning Cuttings bed remover

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Shock-induced energy localization and reaction growth considering chemical-inclusions effects for crystalline explosives

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Defence Technology（防务技术） 2024年第3期33卷 278-294页

作者： Ruqin Liu Yanqing Wu Xinjie Wang Fenglei huang Xiaona huang Yushi wen State Key Laboratory of Explosion Science and Technology Beijing Institute of TechnologyBeijing100081China School of Power and Mechanical Engineering Wuhan UniversityWuhan430072HubeiChina Institute of Chemical Materials China Academy of Engineering Physics(CAEP)Mianyang621999SichuanChina

Chemical inclusions significantly alter shock responses of crystalline explosives in macroscale gap experiments but their microscale dynamics origin remains *** shock-induced energy localization,overall physical responses,and reactions in a-1,3,5-trinitro-1,3,5-triazinane(a-RDX)crystal entrained various chemical inclusions were investigated by the multi-scale shock technique implemented in the reactive molecular dynamics *** indicated that energy localization and shock reaction were affected by the intrinsic factors within chemical inclusions,i.e.,phase states,chemical compositions,and *** atomic origin of chemical-inclusions effects on energy localization is dependent on the dynamics mechanism of interfacial molecules with free space volume,which includes homogeneous intermolecular compression,interfacial impact and shear,and void collapse and *** introducing various chemical inclusions,the initiation of those dynamics mechanisms triggers diverse decay rates of bulk RDX molecules and hereby impacts on growth speeds of final *** chemical inclusions can reduce the effectiveness of the void during the shock *** the shockwave velocity of 9 km/s,the parent RDX decay rate in RDX entrained amorphous carbon decreases the most and is about one fourth of that in RDX with a vacuum void,and solid HMX and TATB inclusions are more reactive than amorphous carbon but less reactive than dry air or acetone *** lessdense shocking system denotes the greater increases in local temperature and stress,the faster energy liberation,and the earlier final reaction into equilibrium,revealing more pronounced responses to the present intense *** quantitative models associated with the relative system density(RD_(sys))were proposed for indicating energy-localization mechanisms and evaluating initiation safety in the shocked crystalline ***_(sys)is defined by the density ratio of defective RDX to perfec

关键词： Shock responses Energy localization Crystalline explosives Chemical inclusions Reactive molecular dynamics

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Porous nanofibrous dressing enables mesenchymal stem cell spheroid formation and delivery to promote diabetic wound healing

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Chinese Journal of Chemical Engineering 2024年第4期68卷 156-164页

作者： Kexin Zhang wenmin Zhang Heng An Zhe huang Yanzhen wen Xiangyu Jiao Yongqiang wen College of Chemical Engineering and Technology Taiyuan University of Science and TechnologyTaiyuan 030024China Beijing Key Laboratory for Bioengineering and Sensing Technology Daxing Research InstituteSchool of Chemistry&Biological EngineeringUniversity of Science&Technology BeijingBeijing 100083China

Delayed and nonhealing of diabetic wounds imposes substantial economic burdens and physical pain on *** stem cells(MSCs)promote diabetic wound *** when MSCs aggregate into multicellular spheroids,their therapeutic effect is ***,traditional culture platforms are inadequate for the efficient preparation and delivery of MSC spheroids,resulting in inefficiencies and inconveniences in MSC spheroid *** this study,a three-dimensional porous nanofibrous dressing(NFD)is prepared using a combination of electrospinning and homogeneous *** thermal crosslinking,the NFD not only achieves satisfactory elasticity but also maintains notable *** the design of its structure and chemical composition,the NFD allows MSCs to spontaneously form MSC spheroids with controllable sizes,serving as MSC spheroid delivery systems for diabetic wound *** importantly,MSC spheroids cultured on the NFD exhibit improved secretion of vascular endothelial growth factor,basic fibroblast growth factor,and hepatocyte growth factor,thereby accelerating diabetic wound *** NFD provides a competitive strategy for MSC spheroid formation and delivery to promote diabetic wound healing.

关键词： Electrospinning Homogenization Biomedical engineering Nanomaterials Stem cell spheroids Diabetic wound healing

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Prediction models of burst strength degradation for casing with considerations of both wear and corrosion

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Petroleum Science 2024年第1期21卷 458-474页

作者： Jie-Li Wang wen-Jun huang De-Li Gao MOE Key Laboratory of Petroleum Engineering China University of PetroleumBeijing102249China State Key Laboratory of Petroleum Resources and Prospecting China University of PetroleumBeijing102249China

Casing wear and casing corrosion are serious problems affecting casing integrity failure in deep and ultra-deep *** paper aims to predict the casing burst strength with considerations of both wear and ***,the crescent wear shape is simplified into three categories according to common mathematical ***,based on the mechano-electrochemical(M-E)interaction,the prediction model of corrosion depth is built with worn depth as the initial condition,and the prediction models of burst strength of the worn casing and corroded casing are ***,the accuracy of different prediction models is validated by numerical simulation,and the main influence factors on casing strength are *** last,the theoretical models are applied to an ultra-deep well in Northwest China,and the dangerous well sections caused by wear and corrosion are predicted,and the corrosion rate threshold to ensure the safety of casing is *** results show that the existence of wear defects results in a stress concentration and enhanced M-E interaction on corrosion depth *** accuracy of different mathematical models is different:the slot ring model is most accurate for predicting corrosion depth,and the eccentric model is most accurate for predicting the burst strength of corroded *** burst strength of the casing will be overestimated by more than one-third if the M-E interaction is neglected,so the coupling effect of wear and corrosion should be sufficiently considered in casing integrity evaluation.

关键词： Deep well Casing integrity Casing wear Casing corrosion Burst strength

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