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Short-term efficacy of natural orifice specimen extraction surgery for low rectal cancer

World Journal of Clinical Cases 2019年第2期7卷 122-129页

作者： Jun-Hong Hu Xing-Wang Li Chen-Yu Wang Jun-Jie Zhang Zheng Ge Bing-Hui Li Xu-Hong Lin Department of Anorectal Surgery Huaihe Hospital Affiliated to Henan University Evidence-Based Medicine Center Huaihe Hospital Affiliated to Henan University Department of Clinical Laboratory Translational Medicine Center Huaihe Hospital Affiliated to Henan University

BACKGROUND This case-control study compared the short-term clinical efficacy of natural orifice specimen extraction surgery(NOSES) using a prolapsing technique and the conventional laparoscopic-assisted approach for low rectal cancer.AIM To further explore the application value of the transanal placement of the anvil and to evaluate the short-term efficacy of NOSES for resecting specimens of low rectal cancer, as well as to provide a theoretical basis for its extensive clinical application.METHODS From June 2015 to June 2018, 108 consecutive laparoscopic-assisted low rectal cancer resections were performed at our center. Among them, 26 specimens were resected transanally using a prolapsing technique(NOSES), and 82 specimens were resected through a conventional abdominal wall small incision(LAP). A propensity score matching method was used to select 26 pairs of matched patients, and their perioperative data were analyzed.RESULTS The baseline data were comparable between the two matched groups. All 52 patients underwent the surgery successfully. The operative time, blood loss,number of harvested lymph nodes, postoperative complication rate,circumferential margin involvement, postoperative follow-up data, and postoperative anal function were not statistically significant. The NOSES group had shorter time to gastrointestinal function recovery(2.6 ± 1.0 d vs 3.4 ± 0.9 d, P= 0.006), shorter postoperative hospital stay(7.1 ± 1.7 d vs 8.3 ± 1.1 d, P = 0.003),lower pain score(day 1: 2.7 ± 1.8 vs 4.6 ± 1.9, day 3: 2.0 ± 1.1 vs 4.1 ± 1.2, day 5: 1.7± 0.9 vs 3.3 ± 1.0, P < 0.001), a lower rate of additional analgesic use(11.5% vs61.5%, P = 0.001), and a higher satisfaction rate in terms of the aesthetic appearance of the abdominal wall after surgery(100% vs 23.1%, P < 0.001).CONCLUSION NOSES for low rectal cancer can achieve satisfactory short-term efficacy and has advantages in reducing postoperative pain, shortening the length of postoperative hospital stay, and improving patients' satisfaction in terms of a more aesthetic

关键词： Natural orifice specimen extraction surgery Low rectal cancer Laparoscopy Prolapsing technique No auxiliary incision

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Evaluation for Adhesion Strength of Coating and Substrateby Burying Beforehand specimen

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Journal of Wuhan University of Technology(Materials Science) 2003年第1期18卷 31-32,36页

作者：廖义德 WuhanInstituteofChemicalTechnology

Adhesion strength is an important target in evaluating the quality of coating layers.The traditional way of adhesion strength test is bonding pull off method for thick layers and scratch test for thin films.The drawbacks of these two methods are discussed in this paper,and an evaluating method for adhesion strength of coating by burying beforehand specimen is proposed.The adhesion strength of samples is measured with two methods.The dispersity of testing data is lower than that in the ASTM C663 79 Standard.

关键词： coating adhesion strength specimen measure

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Ratcheting Behavior of Weld Joints Under Uniaxial Cyclic Loading Using Miniature specimen

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Transactions of Tianjin University 2019年第3期25卷 283-292页

作者： Jiankai Tang Zhe Zhang Hongsheng Lu Xu Chen School of Chemical Engineering and Technology Tianjin University

Because of the size limitation of weld joints in different regions, the traditional standard bar specimen is not suitable to investigate the mechanical properties of weld joints. In this study, miniature specimens were extracted from specific regions(base metal, weld metal, and three heat-affected zones) of API X80 and X70 weld joints. Uniaxial tensile tests were conducted to obtain the mechanical properties of different regions, and then uniaxial ratcheting tests were conducted to investigate the ratcheting behaviors of the different regions under the same peak and nominal stresses. Under both the tensile tests and ratcheting tests, the weld joints exhibit heterogeneous results, such as different mechanical properties and ratcheting behaviors, which were region dependent. Furthermore, the yield strength and yield-to-tensile strength ratio contribute differently to the ratcheting response.

关键词： Ratcheting Weld joints Heat-affected zone Miniature specimen Heterogeneity

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Measuring dynamic fracture toughness of cement rock using a short rod specimen

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Journal of Harbin Institute of Technology(New Series) 2002年第2期9卷 188-192页

作者：黄义春王滨王祥林徐国涵 Sch. of Sci. Harbin Inst. of Technol. Harbin 150090 China

As Daqing Oilfield is developing oil layer with a big potential, the requirement for the quality of well cementation is higher than ever before. Cement rock is a brittle material containing a great number of microcracks and defects. In order to reduce the damage to cement ring and improve sealed cementing property at the interface, it is necessary to conduct research on the modification of the cement rock available. According to the principle of super mixed composite materials, various fillers are added to the ingredients of cement rock. Dynamic fracture toughness of cement rock will be changed under the influence of filler. In this paper, short rod specimens of cement rock are employed in the experiments to investigate the dynamic fracture toughness of cement rocks with different ingredients using split Hopkinson Pressure Bar, and partial experimental results are given. The results indicate that fiber reinforcement is an effective way to improve the impact resistance of cement rock.

关键词： well cementation cement rock short rod specimen fracture toughness

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Modeling and numerical analysis of granite rock specimen under mechanical loading and fire

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岩石力学与工程学报 2015年第1期34卷 101-108页

作者： Luc Leroy Ngueyep.Mambou Joseph Ndop Jean-Marie Bienvenu Ndjaka Laboratory of Sciences Material Department of PhysicsFaculty of ScienceUniversity of Yaoundé Department of Mine Mineral Processing and EnvironmentSchool of Geology and Mining EngineeringUniversity of Ngaoundéré Douala Institute of Technology

The effect of ISO 834 fire on the mechanical properties of granite rock specimen submitted to uniaxial loading is numerically investigated. Based on Newton's second law, the rate-equation model of granite rock specimen under mechanical load and fire is established. The effect of heat treatment on the mechanical performance of granite is analyzed at the center and the ends of specimen. At the free end of granite rock specimen, it is shown that from 20 C to 500 C, the internal stress and internal strain are weak; whereas above 500 C, they start to increase rapidly, announcing the imminent collapse. At the center of specimen, the analysis of the internal stress and internal strain reveals that the fi re reduces the mechanical performance of granite signi fi cantly. Moreover, it is found that after 3 min of exposure to fi re,the mechanical energy necessary to fragment the granite can be reduced up to 80%.

关键词： Granite rock specimen High temperature Internal stress Internal strain ISO 834 fire

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Robotic gastrectomy with transvaginal specimen extraction for female gastric cancer patients

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World Journal of Gastroenterology 2015年第47期21卷 13332-13338页

作者： Shu Zhang Zhi-Wei Jiang Gang Wang Xiao-Bo Feng Jiang Liu Jian Zhao Jie-Shou Li Department of General Surgery Jinling Hospital Medical School Nanjing University

AIM: To describe the application of complete robotic gastrectomy with transvaginal specimen extraction(TVSE) for gastric cancer patients.METHODS: Between July and November 2014, eight female patients who were diagnosed with gastric adenocarcinoma underwent a TVSE following a full robot-sewn gastrectomy. According to the tumor location, the patients were allocated to two different groups; two patients received robotic total gastrectomy with TVSE and the other six received robotic distal gastrectomy with TVSE.RESULTS: Surgical procedures were successfully performed in all eight cases without conversion. The mean age was 55.3(range, 42-69) years, and the mean body mass index was 23.2(range, 21.6-26.0) kg/m2. The mean total operative time and blood loss were 224(range, 200-298) min and 62.5(range, 50-150) m L, respectively. The mean postoperative hospital stay was 3.6(range, 3-5) d. The mean number of lymph nodes resected was 23.6(range, 17-27). None was readmitted within 30 d of postoperation. During the follow-up, no stricture developed nor was any anastomotic leakage detected.CONCLUSION: It is possible to perform a TVSE following a full robot-sewn gastrectomy with standard D2 lymph node resection for female gastric cancer patients.

关键词： Gastric cancer Robotic surgery Transvaginal Natural orifice specimen extraction

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Quality of Sputum specimen Samples Submitted for Culture and Drug Susceptibility Testing at the National Tuberculosis Reference Laboratory-Uganda, July-October 2013

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Journal of Tuberculosis Research 2015年第3期3卷 97-106页

作者： Lilian Bulage Joseph Imoko Bruce J. Kirenga Terry Lo Henry Byabajungu Keneth Musisi Moses Joloba Emily Bloss National Tuberculosis and Leprosy Programme Kampala Uganda National Tuberculosis Reference Laboratory Kampala Uganda World Health Organization Kampala Uganda Division of Pulmonary Medicine Department of Medicine Makerere University College of Health Sciences Kampala Uganda Centers for Disease Control and Prevention Atlanta USA

Setting: The Uganda National Tuberculosis Reference Laboratory (NTRL) in Kampala. Objective: The proportion of poor quality specimens received for drug susceptibility testing (DST) at the NTRL and factors contributing to poor specimen quality were assessed. Design: A cross-sectional study was conducted of sputum samples received at the NTRL from patients at high risk for multi-drug-resistant tuberculosis (MDR TB) during July-October 2013. Demographic, clinical, and bacte-riological data were abstracted from laboratory records. A poor quality sample failed to meet any one of four criteria: ≥3 milliliter (ml) volume, delivered within 72 hours, triple packaged, and non-salivary appearance. Results: Overall, 365 (64%) of 556 samples were of poor quality;89 (16%) were not triple packaged, 44 (8%) were specimens were more likely to be collected during the eighth month of TB treatment (OR = 2.5, CI = 1.2 - 5.1), from the East or Northeast zones (OR = 2.2, CI = 1.1 - 4.8), and from patients who previously defaulted from treatment (OR = 1.9, CI = 1.1 - 3.2). Conclusion: The majority of sputum samples had poor quality. Additional efforts are needed to improve quality of samples collected at the end of treatment, from East and Northeast zones, and from patients who had previously defaulted.

关键词： Tuberculosis Sputum specimen Quality Uganda

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Transanal natural orifice specimen extraction for laparoscopic anterior resection in rectal cancer

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World Journal of Gastroenterology 2013年第43期19卷 7751-7757页

作者： Fang-Hai Han Li-Xin Hua Zhi Zhao Jian-Hai Wu Wen-Hua Zhan Department of Gastrointestinal Surgery The First Affiliated Hospital of Sun Yat-Sen University

AIM:To investigate whether transanal natural orifice specimen extraction(NOSE)is a better technique for rectal cancer resection.METHODS:A prospectively designed database of a consecutive series of patients undergoing laparoscopic low anterior resection for rectal cancer with various tumor-node-metastasis classifcations from March 2011to February 2012 at the First Affliated Hospital of Sun Yat-Sen University was analyzed.Patient selection for transanal specimen extraction and intracorporeal anastomosis was made on the basis of tumor size and distance of rectal lesions from the anal verge.Demographic data,operative parameters,and postoperative outcomes were assessed.RESULTS:None of the patients was converted to laparotomy.Respectively,there were 16 cases in the low anastomosis and fve in the ultralow anastomosis groups.Mean age of the patients was 45.4 years,and mean body mass index was 23.1 kg/m2.Mean distance of the lower edge of the lesion from the anal verge was 8.3 cm.Mean operating time was 132 min,and mean intraoperative blood loss was 84 mL.According to the principle of rectal cancer surgery,we performed D2 lymph node dissection in 13 cases and D3 in eight.Mean lymph nodes harvest was 17.8,and the number of positive lymph nodes was 3.4.Median hospital stay was 6.7 d.No serious postoperative complication occurred except for one anastomotic leakage.All patients remained disease free.Mean Wexner score was 3.7 at11 mo after the operation.CONCLUSION:Transanal NOSE for total laparoscopic low/ultralow anterior resection is feasible,safe and oncologically sound.Further studies with long-term outcomes are needed to explore its potential advantages.

关键词： Transanal specimen extraction Natural orifce specimen extraction Laparoscopic anterior resection Low/ultra-low anastomosis Total mesorectal excision

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Laparoscopic total mesorectal excision with natural orifice specimen extraction

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World Journal of Gastroenterology 2013年第5期19卷 750-754页

作者： Quan Wang Chao Wang Dong-Hui Sun Punyaram Kharbuja Xue-Yuan Cao Department of Gastric and Colorectal Surgery Jilin University First Hospital

AIM:To introduce transvaginal or transanal specimen extraction in laparoscopic total mesorectal excision surgery to avoid an abdominal incision. METHODS:Between January 2009 and December 2011,21 patients with rectal cancer underwent laparoscopic radical resection and the specimen was retrieved by two different ways:transvaginal or transanal rectal removal.Transvaginal specimen extraction approach was strictly limited to elderly post-menopausal women who need hysterectomy.Patients aged between 30 and 80 years,with a body mass index of less than 30 kg/m2, underwent elective surgery.The surgical technique and the outcomes related to the specimen extraction,such as duration of surgery,length of hospital stay,and the complications were retrospectively reviewed. RESULTS:Laparoscopic resection using a natural orifice removal approach was successful in all of the 21 patients.Median operating time was 185 min(range,122-260 min)and the estimated blood loss was 48 mL. The mean length of hospital stay was 7.5 d(range,2-11 d).One patient developed postoperative ileus and had an extended hospital stay.The patient complained of minimal pain.There were no postoperative complications or surgery-associated death.The mean size of the lesion was 2.8 cm(range,1.8-6.0 cm),and the mean number of lymph nodes harvested was 18.7(range, 8-27).At a mean follow-up of 20.6 mo(range,10-37 mo),there were no functional disorders associated with the transvaginal and transanal specimen extraction. CONCLUSION:Transvaginal or transanal extraction in L-TME is a safe and effective procedure.Natural orifice specimen extraction can avoid the abdominal wall incision and its potential complications.

关键词： Laparoscopic total mesorectal excision Natural orifice specimen extraction Rectum cancer Transvaginal Transanal

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Improved specimen adequacy using jumbo biopsy forceps in patients with Barrett's esophagus

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World Journal of Gastroenterology 2015年第17期21卷 5328-5335页

作者： Jan Martinek Jana Maluskova Magdalena Stefanova Inna Tuckova Stepan Suchanek Zuzana Vackova Jana Krajciova Marek Kollar Miroslav Zavoral Julius Spicak Department of Hepatogastroenterology Institute for Clinical and Experimental Medicine14021 PragueCzech Republic Faculty of Medicine University of Ostrava70103 OstravaCzech Republic Department of Pathology IKEM14021 PragueCzech Republic Department of Internal Medicine Hospital "Na Frantisku"11000 PragueCzech Republic Department of Pathology Central Military Hospital16902 PragueCzech Republic Department of Medicine Charles UniversityMilitary University Hospital16902 PragueCzech Republic

AIM:To assess the sampling quality of four different forceps(three large capacity and one jumbo) in patients with Barrett's esophagus.METHODS:This was a prospective,single-blind study.A total of 37 patients with Barrett's esophagus were enrolled.Targeted or random biopsies with all four forceps were obtained from each patient using a diagnostic endoscope during a single endoscopy.The following forceps were tested:A:FB-220 K disposable large capacity;B:BI01-D3-23 reusable large capacity;C:GBF-02-23-180 disposable large capacity;and jumbo:disposable Radial Jaw 4 jumbo.The primary outcome measurement was specimen adequacy,defined as a well-oriented biopsy sample 2 mm or greater with the presence of muscularis mucosa.RESULTS:A total of 436 biopsy samples were analyzed.We found a significantly higher proportion of adequate biopsy samples with jumbo forceps(71%)(P specimen sampling were observed with any of the four tested forceps.CONCLUSION:Jumbo biopsy forceps,when used with a diagnostic endoscope,provide more adequate specimens as compared to large-capacity forceps in patients with Barrett's esophagus.

关键词： Barrett's esophagus Barrett's esophagusrelatedneoplasia Biopsy forceps Jumbo forceps specimen adequacy

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