手钳

The uncovered tracts and the liver wound surface were managed by some of the methods combined such as high frequency electrocoagulation, titanium clamp, suture, hemostatic gauze oppression, argon-beam coagulation, protein glue adherence, and Endo-GIA switcher. The total operative outcome, operating time, blood loss, postoperative complications and postoperative hospital stay were summarized in order to assess feasibility and safety of the clinical laparoscopic liver resection.Results: 1. Laparoscopic liver resection with clamp dissection method needs only the ordinary laparoscopic equipment. It has a low cost but causes a little more bleeding. 2. Laparoscopic liver resection operated by microwave tissue coagulation method had very little bleeding when dissecting hepatic parenchyma. The operative field is clear and the cost is low. It is a safe, convenient and effective method. 3. Ultrasound dissector is a relatively ideal appliance for laparoscopic liver resection at present because ofless bleeding during operation. But the speed is slow thus prolongs the operation time. Its separating intensity is not strong enough, and it can only be applied to patients without hepatic cirrhosis. 4. Ligsure has clamp dissection and electrocoagulation functions. It can carbonize hepatic tissue including the tracts whose diameters are less than 7mm. It has some advantage in dissecting. However, it has the shortcomings of the clamp dissector during coagulating. 5. Hand-assisted laparoscopic liver resection can make use of the flexibility and feeling of the operators left hand.

结果：1、钳夹分离切肝法不需特殊仪器设备，只要具备常规的腹腔镜器械即可实施，成本低，肝断面较易渗血；2、微波固化切肝法肝实质出血很少，视野清晰，成本低，操作简单，是一种安全、简便、有效的方法；3、超声刀是目前较为理想的切肝器械，术中出血少，但是，切割速度慢，手术时间长，而且，切割强度有限，适用于无肝硬化的肝切除；4、Ligsure具有挤压粉碎及高频电凝止血两大功能，可使包括7~以下管道的肝组织碳化、形成焦痴，具有一定的优势，但是，也存在分离钳电凝止血的缺点；5、手辅助腹腔镜肝切除可以利用术者左手的灵活性及手感，便于术中显露、分离、控制出血等，可随意协助右手及助手的主要操作，缩短了手术时间，大大提高了腹腔镜肝切除的安全性，李朝龙等的改良方法，同样达到了手辅助目的，又节省了费用；6、小切口腹腔镜辅助切肝法可以使用剖腹肝切除常规器械及剖腹肝切除技术，操作简单、可靠，适用于肝左外叶切除及右肝第V段切除；7、Endo一GIA切肝法在离断肝组织的同时闭合管道结构，多用于肝左静脉、门静脉分支、管径较大胆管的切割，缺点是不能用于较厚肝组织的切割，而且价格昂贵；8、临床巧例腹腔镜肝切除均获得成功，手术时间最短1.5h，最长sh，平均125 min，多数在100 min左右，手术出血量最少50 ml，最多500 ml，平均1 78 ml，除2例合并严重肝硬化的原发性肝癌患者术后出现少量腹水，1例术后发生胆漏外，其余无并发症，发生胆漏的1例患者术后住院40d，多数在术后一周左右出院，术后住院时间5一40d，平均gd。

First, according to the model chart ruler, opens cutting the gate hole two, the decision opens the door the direction, changes the slanting tongue direction three, inside and outside the adjustment the hand direction (if: The symmetry holds the hand, does not need to exchange holds about the hand adjustment then), holds the hand like left and right AND gate to open the direction asymmetrically to be opposite, invites you: A, takes down the circlip and the edges and corners with the special-purpose circlip pliers.

一、按样板图尺，开凿门孔二、决定开门方向，改为斜舌方向三、调整内外把手方向（若：对称执手，无需调换执手调整左右即可），非对称执手如左、右与门开启方向相反，请您： A、用专用卡簧钳取下卡簧和棱角。

Methods: 1. Experimental laparoscopic liver resection: We selected pigs as experimental models aiming to approach human beings physiological and anatomical condition. After CO2 pneumoperitoneum was established, the ligaments around liver were dissociated. Livers were cut off by the methods such as clamp dissection, microwave tissue coagulator, ultrasound dissector, Ligsure dissection, hand-assisted, short abdominal incision laparoscopy-assisted, and Endo-GIA switcher. The operation time and bleeding volume were compared between different methods of laparoscopic liver resection. The advantages and limitations of different methods were summarized. 2. Clinical laparoscopic liver resection: 15 cases with tumors in segment V of anterior right lobe or segments II, III of left lateral lobe or segment IV of left internal lobe were selected in this study. The liver diseases included hepatocellular cancer, hepatic cavernous hemangioma and hepatic focal nodular hyperplasia. The ligaments around liver were dissociated after CO2 pneumoperitoneum established. Laparoscopic liver resection were carried out by some of the methods combined such as clamp dissection, microwave tissue coagulator, hand-assisted, short abdominal incision laparoscopy-assisted, ultrasound dissector, rotation and suction dissector.

1、实验性腹腔镜肝切除：以猪为实验动物，旨在接近人体的生理、解剖环境下进行实验，建立操作空间后游离肝脏周围韧带，采用钳夹分离切肝法、微波刀切肝法、超声刀切肝法、Ligsure切肝法、手辅助腹腔镜肝切除法、小切口腹腔镜辅助切肝法、Endo-GIA切肝法等方法实施腹腔镜下肝切除，比较不同切肝方法的手术时间、出血量，总结各种方法的优越性及其局限性。2、临床腹腔镜肝切除：选择肿瘤位于肝右前叶第Ⅴ段、肝左外叶第Ⅱ、Ⅲ段及左内叶第Ⅳ段的15例患者，病种包括原发性肝癌、肝海绵状血管瘤、肝脏局灶性增生，建立气腹后游离肝脏周围韧带，采用钳夹分离断肝、微波刀固化后断肝、手辅助腹腔镜肝切除、小切口腹腔镜辅助肝切除、超声刀断肝、旋吸断肝等多种方法分离切线肝组织，暴露管道结构，再采用高频电凝、钛夹夹闭、缝扎止血、止血纱布覆盖、氩气刀止血、生物胶止血、Endo-GIA处理等多种方法相结合处理肝断面，统计手术完成情况、手术时间、手术出血量、术后并发症及术后住院时间等，评价腹腔镜肝切除的可行性及安全性。

I held out my hand, and the horrible, soft-spoken, eyeless creature gripped it in a moment like a vice.

我伸过手去，那面目狰狞、说话客气的瞎眼怪物立刻牢牢抓住了我的手，就像虎头钳一样。

I held out my hand, and the terrible, soft-speaking ,eyeless man took hold of it like a dog biting a bone .He pulled me vio－lently towards him.

我伸出一只手，立刻被那个说话温和的瞎子紧紧钳住，他把我粗暴地拉到他身边。

A series of novel aromatic amide molecular tweezers with different chiral centers and cavities were designed and synthesized by using isophthalic acid as the spacer to bridge the different L-amino acid methyl esters under microwave irradiation.

以间苯二甲酸为隔离基，酰胺键桥联L-氨基酸甲酯构成手臂，在微波辐射下合成了具有不同手性中心和裂穴的新型手性芳酰胺类分子钳。

In this dissertation, the efforts were focused on design and synthesis of chiral tmsymmetrical urea, cholic acid and heteroaromatic molecular tweezers and their molecular recognition as well as enantioselective recognition. A series of useful and creative results have been obtained.Three new types of chiral molecular tweezers containing unsymmetrically disubstituted urea unit, four new types of chiral molecular tweezers based on steroid cholic acid and one type of heteroaromatic molecular tweezers involving multiple hydrogen-bonding site have been designed and synthesized.

本文致力于新型手性不对称脲、胆甾和芳杂环类分子钳受体的设计合成及其对阴离子、中性分子和手性分子的识别及对映选择性识别性能研究，取得了一系列具有重要学术意义与应用前景的创新性结果。

He hears a sound behind some creepy red-lit pipes and sees a clawlike hand moving around one of the pipes. He gingerly reaches out with a wrench to touch it, but suddenly the hand reaches out and grabs HOMER's hand. HOMER begins screaming as the camera pans back down the hall.

他听到一些声音从被灯光照得红红的恐怖管子那儿传来，看到爪子般的手抱著根管子，他小心翼翼地拿出螺旋钳去碰他，但忽然间那只手伸出来抓住荷马的手，荷马开始尖叫，摄影机移开到走廊上。

Produced recently developed dual-line clamp, pipe clamp, such as hand tools.

最近双开发出产了断线钳，管子钳等手工具。

In this dissertation, the efforts were focused on design and synthesis of new types of chiral and achiral azoamide hosts,bowl-shaped steroid cholic acid methyl esters with one chiral arm under microwave irradiation and heteroaromatic molecular tweezers under microwave irradiation in solid state and their molecular recognition as well as enantioselective recognition.

本文致力于新型手性不对称脲、胆甾和芳杂环类分子钳受体的设计合成及其对阴离子、中性分子和手性分子的识别及对映选择性识别性能研究，取得了一系列具有重要学术意义与应用前景的创新性结果。

Neither the killing of Mr Zarqawi nor any breakthrough on the political front will stop the insurgency and the fratricidal murders in their tracks.

在对危险的南部地区访问时，他斥责什叶派民兵领导人对中央集权的挑衅行为。

In fact,I've got him on the satellite mobile right now.

实际上 我们已接通卫星可视电话了