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Robotic versus laparoscopic surgery for sporadic benign insulinoma:Short-and long-term outcomes

Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 399-405页

作者： Zhu-Zeng Yin Yuan-Xing Gao Zhi-ming Zhao ming-gen hu Wen-Bo Tang Rong Liu Faculty of Hepato-Pancreato-Biliary Surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China Institute of Hepatobiliary Surgery of Chinese PLA Beijing 100853China Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA Beijing 100853China

Background:Minimally invasive surgery is the optimal treatment for insulinoma.The present study aimed to compare short-and long-term outcomes of laparoscopic and robotic surgery for sporadic benign insulinoma.Methods:A retrospective analysis of patients who underwent laparoscopic or robotic surgery for insulinoma at our center between September 2007 and December 2019 was conducted.The demographic,perioperative and postoperative follow-up results were compared between the laparoscopic and robotic groups.Results:A total of 85 patients were enrolled,including 36 with laparoscopic approach and 49 with robotic approach.Enucleation was the preferred surgical procedure.Fifty-nine patients(69.4%)underwent enucleation;among them,26 and 33 patients underwent laparoscopic and robotic surgery,respectively.Robotic enucleation had a lower conversion rate to laparotomy(0 vs.19.2%,P=0.013),shorter operative time(102.0 vs.145.5 min,P=0.008)and shorter postoperative hospital stay(6.0 vs.8.5 d,P=0.002)than laparoscopic enucleation.There were no differences between the groups in terms of intraoperative blood loss,the rates of postoperative pancreatic fistula and complications.After a median follow-up of 65 months,two patients in the laparoscopic group developed a functional recurrence and none of the patients in the robotic group had a recurrence.Conclusions:Robotic enucleation can reduce the conversion rate to laparotomy and shorten operative time,which might lead to a reduction in postoperative hospital stay.

关键词： Robotic surgical procedures Laparoscopy Insulinoma Enucleation Pancreatectomy

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Superior compound coatings prepared by low-temperature vanadium-nitrocarburizing duplex treatment

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Rare Metals 2024年第4期43卷 1828-1835页

作者： gen Jin Fang-Fang Xu Xun-Xun hu Yue Xu School of Chemistry Beihang University Guobiao (Beijing) Testing and Certification Co. Ltd School of Materials Science and Engineering Beihang University

Superior compound coatings were prepared on CK45 steel surface by vanadium-nitrocarburizing duplex treatment in low-temperature salt bath.In this study,the microhardness,the phase constitution and the compositional distribution in the coatings prepared under different conditions were systematically characterized.The results indicated that the reactions among activated vanadium,carbon and nitrogen atoms occurred on the steel surface,leading to the formation of compound coatings composed of outermost and compound layers.The mechanism for the formation of compound layer as well as the growth kinetics of the layer was also discussed.Upon the duplex treatment,the wear and corrosion resistances of steel surface were significantly improved.It was found that the growth kinetics of compound layer obeyed the parabolic law,with the activation energy of 122.82 kJ·mol-1.

关键词： Vanadium-nitrocarburizing duplex treatment Compound coatings Microstructure Formation mechanism Growth kinetics

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Grain size effect on the assembly quality of micro-scaled barrel formed by microforming

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Advances in Manufacturing 2024年第1期12卷 19-32页

作者： Dien hu Jieyichen Fang Feng Zeng ming-Wang Fu Department of Mechanical Engineering Research Institute of Advanced ManufacturingThe Hong Kong Polytechnic UniversityHung HomKowloonHong KongPeople’s Republic of China Xiamen Yulong Machinery Co.Ltd. Xiamen361023FujianPeople’s Republic of China

In this research,a method employing micro-extrusion was designed to produce the micro-scaled barrel-shaped parts with complex geometrical features to study the feasibility of the proposed microforming method and its grain size effect on the formability of the complicated internal features in terms of deformation behavior,material evolution,accuracy of dimensions and final components quality.The results reveal that the deformation behavior is highly affected by grain size and becomes unpredictable with increased grain size.In addition,assembly parameters including feature dimension,tolerance and coaxiality also vary with grain size,and the variation of grain size needs to be accommodated by different assembly types,viz.,clearance fit or transition fit.From the microstructural evolution aspect,it was identified there were two dead zones and four shear bands,and the formation of these deformation zones was barely affected by the variation in grain size.Though bulges,cracks,and fracture induced voids were observed on the surface of the final components,tailoring the microstructure of the working material with finer grains could significantly avoid these defects.This study advances the understanding of forming microparts by extrusion processes and provides guidance for microforming of similar microparts.

关键词： Microformed part Size effect Extrusion Microstructural evolution Dimensions Assembly accuracy

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Assessment of Wet Season Precipitation in the Central United States by the Regional Climate Simulation of the WRFG Member in NARCCAP and Its Relationship with Large-Scale Circulation Biases

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Advances in Atmospheric Sciences 2024年第4期41卷 619-638页

作者： Yating ZHAO ming XUE Jing JIANG Xiao-ming hu Anning huANG School of Atmospheric Sciences Nanjing UniversityNanjing 210023China Center for Analysis and Prediction of Storms and School of Meteorology The University of OklahomaNorman 73072U.S.A

Assessment of past-climate simulations of regional climate models(RCMs)is important for understanding the reliability of RCMs when used to project future regional climate.Here,we assess the performance and discuss possible causes of biases in a WRF-based RCM with a grid spacing of 50 km,named WRFG,from the North American Regional Climate Change Assessment Program(NARCCAP)in simulating wet season precipitation over the Central United States for a period when observational data are available.The RCM reproduces key features of the precipitation distribution characteristics during late spring to early summer,although it tends to underestimate the magnitude of precipitation.This dry bias is partially due to the model’s lack of skill in simulating nocturnal precipitation related to the lack of eastward propagating convective systems in the simulation.Inaccuracy in reproducing large-scale circulation and environmental conditions is another contributing factor.The too weak simulated pressure gradient between the Rocky Mountains and the Gulf of Mexico results in weaker southerly winds in between,leading to a reduction of warm moist air transport from the Gulf to the Central Great Plains.The simulated low-level horizontal convergence fields are less favorable for upward motion than in the NARR and hence,for the development of moist convection as well.Therefore,a careful examination of an RCM’s deficiencies and the identification of the source of errors are important when using the RCM to project precipitation changes in future climate scenarios.

关键词： NARCCAP Central United States precipitation low-level jet large-scale environment diurnal variation

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Ferrite features in simulated transition zone of EH36 shipbuilding steel submerged arc welded by CaF_(2)-SiO_(2)-MnO fluxes

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Journal of Iron and Steel Research(International) 2024年第4期31卷 790-796页

作者： ming Zhong Dong hu Da-ming Guo Somnath Basu Cong Wang Key Laboratory for Ecological Metallurgy of Multimetallic Mineral(Ministry of Education) Northeastern UniversityShenyang 110819LiaoningChina School of Metallurgy Northeastern UniversityShenyang 110819LiaoningChina The State Key Laboratory of Refractories and Metallurgy Wuhan University of Science and TechnologyWuhan 430081HubeiChina Department of Metallurgical Engineering and Materials Science Indian Institute of Technology BombayMumbai 400076MaharashtraIndia

Ferrite features in the simulated transition zone welded with CaF_(2)-SiO_(2)-MnO fluxes containing various MnO contents have been investigated.Confocal laser scanning microscopy has been applied to simulate the thermal cycling of the transition zone and the phase transformations during cooling have been in-situ observed.It has been found that the appearance temperature for ferrite side plate decreases with increasing Mn content in the weld metals caused by MnO content increasing.Meanwhile,growth rates for both ferrite side plate and acicular ferrite are significantly enhanced with a higher Mn content of weld metal.Furthermore,from the statistical fractions of salient microstructures,for all samples,the acicular ferrite,grain boundary ferrite,and polygonal ferrite take over more than 90%.It has also been demonstrated that with the increase in Mn content,the ferrite side plate fraction increases slightly from 5%to 10%and the acicular ferrite fraction shows a tendency of first increasing and then decreasing,which experiences the maximum with the flux containing 30 wt.%MnO.This phenomenon is believed to be controlled by the O and Mn contents in weld metals synergistically.

关键词： Submerged arc welding Transition zone Phase transformation Microstructure

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Derivation and validation of a preoperative prognostic model for resectable pancreatic ductal adenocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2023年第2期22卷 160-168页

作者： Shuai Xu Xiu-Ping Zhang Guo-Dong Zhao Wen-Bo Zou Zhi-ming Zhao Qu Liu ming-gen hu Rong Liu Faculty of Hepato-Biliary-Pancreatic Surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China Department of Liver Transplantation and Hepatobiliary Surgery Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021China

Background: The prognosis of patients with pancreatic ductal adenocarcinoma(PDAC) remains poor even after radical pancreaticoduodenectomy(PD). The study aimed to develop and validate a novel preoperative prognostic model to accurately predict the long-term survival of patients with PDAC.Methods: Patients with PDAC of pancreatic head from Chinese PLA general Hospital were included. The preoperative PDAC model with contour plots was developed using a non-linear model in the training cohort and then tested in the validation cohort.Results: Of 421 patients who met the inclusion criteria, 280 were in the training cohort and 141 in the validation cohort. Contour plots for preoperative PDAC model were established to visually predict the survival probabilities of these patients, based on preoperative carbohydrate antigen 19-9, preoperative fibrinogen to albumin ratio and pain symptoms. This model stratified patients into low-and high-risk groups with distinctly different long-term survival in the training cohort [median overall survival(OS)32.1 vs. 17.5 months;median recurrence-free survival(RFS) 19.3 vs. 10.0 months, both P < 0.001] and the validation cohort(median OS 28.3 vs. 19.0 months;median RFS 17.5 vs. 11.2 months, both P < 0.001).Time-dependent receiver operating characteristic and decision curve analyses revealed that the model provided higher diagnostic accuracy and superior net benefit compared to other staging systems.Conclusions: This study constructed and validated a novel preoperative prognostic model that can accurately and conveniently predict the long-term survival of patients with resectable PDAC of pancreatic head. Besides, the model can screen high-risk patients with poor prognosis, which may provide references for personal treatment strategies in the future.

关键词： Pancreatic ductal adenocarcinoma Pancreaticoduodenectomy Contour plot Overall survival Recurrence-free survival

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Robotic pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: Analysis of surgical outcomes and long-term prognosis in a high-volume center

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Hepatobiliary & Pancreatic Diseases International 2023年第2期22卷 140-146页

作者： Xiu-Ping Zhang Shuai Xu Zhi-ming Zhao Qu Liu Guo-Dong Zhao ming-gen hu Xiang-Long Tan Rong Liu Faculty of Hepato-Biliary-Pancreatic Surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China Department of Liver Transplantation and Hepatobiliary Surgery Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021China

Background: Robotic pancreaticoduodenectomy(RPD) has been reported to be safe and feasible for patients with pancreatic ductal adenocarcinoma(PDAC) of the pancreatic head. This study aimed to analyze the surgical outcomes and risk factors for poor long-term prognosis of these patients. Methods: Data from patients who underwent RPD for PDAC of pancreatic head were retrospectively analyzed. Multivariate Cox regression analysis was used to seek the independent prognostic factors for overall survival(OS), and an online nomogram calculator was developed based on the independent prognostic factors. Results: Of the 273 patients who met the inclusion criteria, the median operative time was 280.0 minutes, the estimated blood loss was 100.0 m L, the median OS was 23.6 months, and the median recurrence-free survival(RFS) was 14.4 months. Multivariate analysis showed that preoperative carbohydrate antigen 19-9(CA19-9) [hazard ratio(HR) = 2.607, 95% confidence interval(CI): 1.560-4.354, P < 0.001], lymph node metastasis(HR = 1.429, 95% CI: 1.005-2.034, P = 0.047), tumor moderately(HR = 3.190, 95% CI: 1.813-5.614, P < 0.001) or poorly differentiated(HR = 5.114, 95% CI: 2.839-9.212, P < 0.001), and Clavien-Dindo grade ≥ Ⅲ(HR = 1.657, 95% CI: 1.079-2.546, P = 0.021) were independent prognostic factors for OS. The concordance index(C-index) of the nomogram constructed based on the above four independent prognostic factors was 0.685(95% CI: 0.640-0.729), which was significantly higher than that of the AJCC staging(8th edition): 0.541(95% CI: 0.493-0.589)( P < 0.001). Conclusions: This large-scale study indicated that RPD was feasible for PDAC of pancreatic head. Preoperative CA19-9, lymph node metastasis, tumor poorly differentiated, and Clavien-Dindo grade ≥ Ⅲ were independent prognostic factors for OS. The online nomogram calculator could predict the OS of these patients in a simple and convenient manner.

关键词： Robotic pancreaticoduodenectomy Nomogram Long-term prognosis Pancreatic ductal adenocarcinoma

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A Quasi-Linear Relationship between Planetary Outgoing Longwave Radiation and Surface Temperature in a Radiative-Convective-Transportive Climate Model of a Gray Atmosphere

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Advances in Atmospheric Sciences 2024年第1期41卷 8-18页

作者： Jie SUN Michael SECOR ming CAI Xiaoming hu Department of Earth Oceanand Atmospheric ScienceFlorida State UniversityTallahasseeFlorida 32304USA School of Atmospheric Sciences Sun Yat-sen University and Southern Marine Science and Engineering Guangdong Laboratory(Zhuhai)Zhuhai 519082China Guangdong Province Key Laboratory for Climate Change and Natural Disaster Studies Zhuhai 519082China

In this study,we put forward a radiative-convective-transportive energy balance model of a gray atmosphere to examine individual roles of the greenhouse effect of water vapor,vertical convection,and atmospheric poleward energy transport as well as their combined effects for a quasi-linear relationship between the outgoing longwave radiation(OLR)and surface temperature(T_(S)).The greenhouse effect of water vapor enhances the meridional gradient of surface temperature,thereby directly contributing to a quasi-linear OLR-T_(S) relationship.The atmospheric poleward energy transport decreases the meridional gradient of surface temperature.As a result of the poleward energy transport,tropical(high-latitude)atmosphere-surface columns emit less(more)OLR than the solar energy input at their respective locations,causing a substantial reduction of the meridional gradient of the OLR.The combined effect of reducing the meridional gradients of both OLR and surface temperature by the poleward energy transport also contributes to the quasi-linear OLR-T_(S) relationship.Vertical convective energy transport reduces the meridional gradient of surface temperature without affecting the meridional gradient of OLR,thereby suppressing part of the reduction to the increasing rate of OLR with surface temperature by the greenhouse effect of water vapor and poleward energy transport.Because of the nature of the energy balance in the climate system,such a quasi-linear relationship is also a good approximation for the relationship between the annual-mean net downward solar energy flux at the top of the atmosphere and surface temperature.

关键词： outgoing longwave radiation greenhouse effect poleward energy transport

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Twisted Integration of Complex Oxide Magnetoelectric Heterostructures via Water‑Etching and Transfer Process

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Nano-Micro Letters 2024年第1期16卷 360-369页

作者： Guannan Yang Guohua Dong Butong Zhang Xu Xu Yanan Zhao Zhongqiang hu ming Liu State Key Laboratory for Manufacturing Systems Engineering Electronic Materials Research LaboratoryKey Laboratory of the Ministry of EducationEngineering Research Center of Spin Quantum Sensor ChipsUniversities of Shaanxi ProvinceSchool of Electronic Science and EngineeringXi’an Jiaotong UniversityXi’an 710049People’s Republic of China

Manipulating strain mode and degree that can be applied to epitaxial complex oxide thin films have been a cornerstone of strain engineering.In recent years,lift-off and transfer technology of the epitaxial oxide thin films have been developed that enabled the integration of heterostructures without the limitation of material types and crystal orientations.Moreover,twisted integration would provide a more interesting strategy in artificial magnetoelectric heterostructures.A specific twist angle between the ferroelectric and ferromagnetic oxide layers corresponds to the distinct strain regulation modes in the magnetoelectric coupling process,which could provide some insight in to the physical phenomena.In this work,the La_(0.67)Sr_(0.33)MnO_(3)(001)/0.7Pb(Mg_(1/3)Nb_(2/3))O_(3)-0.3PbTiO_(3)(011)(LSMO/PMN-PT)heterostructures with 45.and 0.twist angles were assembled via water-etching and transfer process.The transferred LSMO films exhibit a fourfold magnetic anisotropy with easy axis along LSMO.A coexistence of uniaxial and fourfold magnetic anisotropy with LSMO[110]easy axis is observed for the 45°Sample by applying a 7.2 kV cm^(−1)electrical field,significantly different from a uniaxial anisotropy with LSMO[100]easy axis for the 0°Sample.The fitting of the ferromagnetic resonance field reveals that the strain coupling generated by the 45°twist angle causes different lattice distortion of LSMO,thereby enhancing both the fourfold and uniaxial anisotropy.This work confirms the twisting degrees of freedom for magnetoelectric coupling and opens opportunities for fabricating artificial magnetoelectric heterostructures.

关键词： Magnetoelectric heterostructures Twist angle Epitaxial lift-off Magnetic anisotropy Ferromagnetic resonance

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Causal associations between gastroesophageal reflux disease and essential hypertension: A bidirectional Mendelian randomization study

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World Journal of Clinical Cases 2024年第5期12卷 880-890页

作者： Ning Wei ming-hui Liu Yu-hu Song Department of Gastroenterology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022Hubei ProvinceChina

BACKGROUND Clinical studies have reported that patients with gastroesophageal reflux disease(GERD)have a higher prevalence of hypertension.AIM To performed a bidirectional Mendelian randomization(MR)analysis to investi-gate the causal link between GERD and essential hypertension.METHODS Eligible single nucleotide polymorphisms(SNPs)were selected,and weighted median,inverse variance weighted(IVW)as well as MR egger(MR-Egger)re-gression were used to examine the potential causal association between GERD and hypertension.The MR-Pleiotropy RESidual Sum and Outlier analysis was used to detect and attempt to reduce horizontal pleiotropy by removing outliers SNPs.The MR-Egger intercept test,Cochran’s Q test and“leave-one-out”sen-sitivity analysis were performed to evaluate the horizontal pleiotropy,heterogen-eities,and stability of single instrumental variable.RESULTS IVW analysis exhibited an increased risk of hypertension(OR=1.46,95%CI:1.33-1.59,P=2.14E-16)in GERD patients.And the same result was obtained in replication practice(OR=1.002,95%CI:1.0008-1.003,P=0.000498).Meanwhile,the IVW analysis showed an increased risk of systolic blood pressure(β=0.78,95%CI:0.11-1.44,P=0.021)and hypertensive heart disease(OR=1.68,95%CI:1.36-2.08,P=0.0000016)in GERD patients.Moreover,we found an decreased risk of Barrett's esophagus(OR=0.91,95%CI:0.83-0.99,P=0.043)in essential hypertension patients.CONCLUSION We found that GERD would increase the risk of essential hypertension,which provided a novel prevent and therapeutic perspectives of essential hypertension.

关键词： Gastroesophageal reflux disease Essential hypertension Hypertensive heart disease Mendelian randomization study

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