Objective:To explore the scientific and feasible plan of early ambulation after pancreaticoduodenectomy.Methods:A research group was established in February 2020, and a plan for early ambulation was initially formulated according to evidence-based literature and expert group discussions. From June to October 2020, a total of 11 experts from three Class Ⅲ Grade A hospitals in Beijing were selected for two rounds of consultation by using the Delphi method. By calculating the expert positive coefficient, expert authority coefficient, and the Kendall coordination coefficient, an early ambulation plan was constructed according to the expert's revised opinions.Results:Among two rounds of expert consultation, and the questionnaire recovery rates were all 100.00%, and the expert authority coefficient was 0.92, and the Kendall coordination coefficient were 0.337 and 0.257, respectively. The finalized early ambulation plan after pancreaticoduodenectomy included two parts, namely, the early safe ambulation evaluation standard and the early ambulation program, with a total of 14 first-level indicators and 36 second-level indicators.Conclusions:The early ambulation plan after pancreaticoduodenectomy is scientific and feasible, and can be further tested and applied in clinical practice.

Lycophytes and seed plants constitute the typical vascular plants. Lycophytes have been thought to have no paleo-polyploidization although the event is known to be critical for the fast expansion of seed plants. Here, genomic analyses including the homologous gene dot plot analysis detected multiple paleo-polyploidization events, with one occurring approximately 13-15 million years ago (MYA) and another about 125-142 MYA, during the evolution of the genome of Selaginella moellendorffii, a model lycophyte. In addition, comparative analysis of reconstructed ancestral genomes of lycophytes and angiosperms suggested that lycophytes were affected by more paleo-polyploidization events than seed plants. Results from the present genomic analyses indicate that paleo-polyploidization has contributed to the successful establishment of both lineages-lycophytes and seed plants-of vascular plants.
Evolution, Molecular ; Genome, Plant ; Genomics ; Phylogeny ; Polyploidy ; Selaginellaceae/genetics*