The study aimed to investigate the clinical efficacy of duodenoscopy combined with laparoscopy in the treatment of patients with severe acute pancreatitis (SAP) and pancreatic pseudocyst (PP), and its effects on serum inflammatory factors. Altogether 94 patients complicated with SAP and PP who were admitted to Weifang People's Hospital (Weifang, China) from September 2015 to December 2018 were included. Based on the different operation methods, 49 patients who underwent traditional laparotomy under laparoscopic surgery were included in group A, and 45 patients who underwent duodenoscopy and laparoscopy under duodenoscope to treat the drainage of nipple and pancreatic pseudocysts were included in group B. The expression levels of related serum indexes and serum stress indexes before and at 48 h after surgery, the postoperative nausea, vomiting and abdominal pain scores, as well as the clinical efficacy, perioperative related indexes, recovery and complications were compared between the two groups. The prognostic factors in both groups were assessed via Logistic univariate and multivariate analyses. C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-β (IL-β), endotoxin and nuclear factor κB (NF-κB) were significantly lower in group B than those in group A (P<0.001). Upregulating cortisol and norepinephrine in group B was lower than that in group A (P<0.001). The total effective rate in group B was higher than that in group A (P<0.05). The perioperative related indexes, recovery, and postoperative complications in group B were better than those in group A (P<0.05). Scores of abdominal pain, nausea and vomiting in group B were markedly lower than those in group A (P<0.001). Multivariate Logistic regression analysis showed that CRP, TNF-α, IL-6, IL-β and surgical methods were independent risk factors for the prognosis of patients with SAP and PP. In conclusion, the combined treatment with duodenoscopy and laparoscopic surgery has little inflammatory and stress reaction, and it is highly safe, worthy to be popularized.
In order to improve the reliability and continuous navigation of ship propulsion, a dieselelectric hybrid field modulation motor with bread-loaf eccentric magnetic poles is proposed in this paper. The permanent magnet of the inner rotor of the motor adopts a bread-loaf eccentric magnetic pole structure and is embedded and fixed on the iron yoke of the inner rotor. The structure can obtain a sinusoidal air gap magnetic field, to reduce the torque ripple of the motor. In this study, some key parameters of the motor are optimized by using the optimization strategy of the combination of genetic algorithm and finite element method. In addition, compared with the conventional magnetic field modulation motor with surface mounted permanent magnet, the motor has a stronger rotor structure. The back-EMF, torque, and loss of the motor are calculated. The proposed motor has good sinusoidal back-EMF, less loss and better stability. Finally, the working modes of the motor in the diesel-electric hybrid ship propulsion system are mainly diesel internal combustion engine driving mode, electric propulsion mode, and hybrid propulsion mode. The system can improve the reliability and continuous navigation of the ship propulsion system.
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