BACKGROUND The diabetic foot is a common cause of disability and death,and comorbid foot infections usually lead to prolonged hospitalization,high healthcare costs,and a significant increase in amputation rates.And mo...BACKGROUND The diabetic foot is a common cause of disability and death,and comorbid foot infections usually lead to prolonged hospitalization,high healthcare costs,and a significant increase in amputation rates.And most diabetic foot trauma is complicated by lower extremity arteriopathy,which becomes an independent risk factor for major amputation in diabetic foot patients.AIM To establish the efficacy and safety of endovascular revascularization(ER)combined with vacuum-assisted closure(VAC)for the treatment of diabetic foot.METHODS Clinical data were collected from 40 patients with diabetic foot admitted to the Second Affiliated Hospital of Soochow University from April 2018 to April 2022.Diabetic foot lesions were graded according to Wagner’s classification,and blood flow to the lower extremity was evaluated using the ankle-brachial index test and computerized tomography angiography of the lower extremity arteries.Continuous subcutaneous insulin infusion pumps were used to achieve glycemic control.Lower limb revascularization was facilitated by percutaneous transluminal balloon angioplasty(BA)or stenting.Wounds were cleaned by nibbling debridement.Wound granulation tissue growth was induced by VAC,and wound repair was performed by skin grafting or skin flap transplantation.RESULTS Of the 35 cases treated with lower limb revascularization,34 were successful with a revascularization success rate of 97%.Of these,6 cases underwent stenting after BA of the superficial femoral artery,and 1 received popliteal artery stent implantation.In the 25 cases treated with infrapopliteal artery revascularization,39 arteries were reconstructed,7 of which were treated by drug-coated BA and the remaining 32 with plain old BA.VAC was performed in 32 wounds.Twenty-four cases of skin grafting and 2 cases of skin flap transplantation were performed.Two patients underwent major amputations,whereas 17 had minor amputations,accounting for a success limb salvage rate of 95%.CONCLUSION ER in combination with VAC is a safe and effective treatment for diabetic foot that can significantly improve limb salvage rates.The use of VAC after ER simplifies and facilitates wound repair.展开更多
Sea ice hinders the navigability of the Arctic,especially in winter and spring.However,three Arc7 ice-class Liquefied Natural Gas carrying vessels safely transited the Northern Sea Route(NSR)without icebreaker assista...Sea ice hinders the navigability of the Arctic,especially in winter and spring.However,three Arc7 ice-class Liquefied Natural Gas carrying vessels safely transited the Northern Sea Route(NSR)without icebreaker assistance in January 2021.More and more Arc7 ice-class vessels are putting into the transit services in the NSR.Therefore,it is necessary to analyze sea-ice conditions and their impact on navigation during wintertime,and the future navigability of Arc7 ice-class vessels along the NSR during winter and spring.Based on sea ice datasets from satellite observations and a model using data assimilation,we explored the sea-ice conditions and their impact during the first three successful commercial voyages through the NSR in winter.In addition,we analyzed the sea ice variation and estimated navigability for Arc7 ice-class vessels in the NSR from January to June of the years 2021–2050 using future projections of the sea-ice cover by the Coupled Model Inter-comparison Project Phase 6(CMIP6)models under two emission scenarios(SSP2-4.5 and SSP5-8.5).The results reveal lower sea ice thickness and similar sea ice concentration during these three transits relative to the past 42 years(from 1979 to 2020).We found the thickness has a larger impact on the vessels’speeds than sea ice concentration.Very likely sea ice thickness played a larger role than the sea ice concentration for the successful transit of the NSR in winter 2021.Future projections suggest sea ice thickness will decrease further in most regions of the NSR from January to June under all scenarios enabling increased navigability of the NSR for Arc7 ice-class vessels.Such vessels could transit through the NSR from January to June under all scenarios by 2050,while some areas near the coast of East Siberian Sea remain inaccessible for Arc7 ice-class vessels in spring(April and May).These findings can support the strategic planning of shipping along the NSR in winter and spring.展开更多
Landfast ice plays an important role in atmosphere‒ocean interactions and ecosystems in the near coast area of Antarctica.Understanding the characteristics and variations of landfast ice is crucial to the study of cli...Landfast ice plays an important role in atmosphere‒ocean interactions and ecosystems in the near coast area of Antarctica.Understanding the characteristics and variations of landfast ice is crucial to the study of climates and field activities in Antarctic.In this study,a high-resolution thermodynamic snow-ice(HIGHTSI)model was applied to simulate the seasonal changes of landfast ice along the Mawson Coast,East Antarctica,through ERA-Interim reanalysis data.Four ocean heat-flux(Fw)values(10,15,20 and 25 W m−2)were used in sensitivity experiments.The results showed that it is reasonable to simulate landfast ice using the HIGHTSI model,and the simulation of landfast ice thickness matched best well with field measurements when Fw was 20 W m^(−2).Then,2-D distributions of landfast ice from 2006 to 2018 were modeled by HIGHTSI with 2-D ERA-Interim reanalysis data in a 0.125°×0.125°cell grid as external forcing.The results showed that fast ice was thicker along the coast and thinner near open water,and usually reaches its maximal thickness in October,varying from 1.2 to 2.0 m through the study area.There was no statistical trend for the thickness during the study period.展开更多
In 2023,Antarctica experienced its lowest sea ice extent in the satellite era,with extreme polar events gaining widespread attention.Prydz Bay,where the Chinese Zhongshan Station is located,is the third largest embaym...In 2023,Antarctica experienced its lowest sea ice extent in the satellite era,with extreme polar events gaining widespread attention.Prydz Bay,where the Chinese Zhongshan Station is located,is the third largest embayment in Antarctica.Changes in sea ice,fast ice and polynyas directly affect local heat and mass exchanges between the ocean and atmosphere,as well as ecosystems and research activities.In 2023,substantial fast ice anomalies were observed in Prydz Bay:the extent of fast ice off Zhongshan Station(ZSFI)was anomalously low,while that within Barrier Bay(BaFI)was anomalously high.This study analysed the seasonal evolution and underlying main causes for the extreme conditions using ice charts,satellites and reanalysis data.From 2014 to 2022,the extent of zSFI typically increased during the cold season,reaching a maximum of(9.41±2.47)×10^(3) km^(2),whilst the Barrier Bay Polynya(BaP)persisted throughout this period.However,in 2023,ZSFI did not increase from June onwards,peaking at a maximum extent of only 5.49×10^(3) km^(2),and the BaP closed in mid-winter,leading to the formation of extensive BaFI.Air temperature and wind speed continuously dropped in July,and these conditions persisted for approximately 1 month,leading to the closure of BaP.However,zSFI did not expand further under these extreme meteorological conditions,indicating its independence from these factors.The limited expansion of ZSFI could be attributed to high ocean temperatures.Overall,this study provides valuable insights into the mechanisms driving extreme fast ice conditions.展开更多
文摘BACKGROUND The diabetic foot is a common cause of disability and death,and comorbid foot infections usually lead to prolonged hospitalization,high healthcare costs,and a significant increase in amputation rates.And most diabetic foot trauma is complicated by lower extremity arteriopathy,which becomes an independent risk factor for major amputation in diabetic foot patients.AIM To establish the efficacy and safety of endovascular revascularization(ER)combined with vacuum-assisted closure(VAC)for the treatment of diabetic foot.METHODS Clinical data were collected from 40 patients with diabetic foot admitted to the Second Affiliated Hospital of Soochow University from April 2018 to April 2022.Diabetic foot lesions were graded according to Wagner’s classification,and blood flow to the lower extremity was evaluated using the ankle-brachial index test and computerized tomography angiography of the lower extremity arteries.Continuous subcutaneous insulin infusion pumps were used to achieve glycemic control.Lower limb revascularization was facilitated by percutaneous transluminal balloon angioplasty(BA)or stenting.Wounds were cleaned by nibbling debridement.Wound granulation tissue growth was induced by VAC,and wound repair was performed by skin grafting or skin flap transplantation.RESULTS Of the 35 cases treated with lower limb revascularization,34 were successful with a revascularization success rate of 97%.Of these,6 cases underwent stenting after BA of the superficial femoral artery,and 1 received popliteal artery stent implantation.In the 25 cases treated with infrapopliteal artery revascularization,39 arteries were reconstructed,7 of which were treated by drug-coated BA and the remaining 32 with plain old BA.VAC was performed in 32 wounds.Twenty-four cases of skin grafting and 2 cases of skin flap transplantation were performed.Two patients underwent major amputations,whereas 17 had minor amputations,accounting for a success limb salvage rate of 95%.CONCLUSION ER in combination with VAC is a safe and effective treatment for diabetic foot that can significantly improve limb salvage rates.The use of VAC after ER simplifies and facilitates wound repair.
基金supported by the National Natural Science Foundation of China(41976214)Innovation Group Project of Southern Marine Science and Engineering Guangdong Laboratory(Zhuhai)(311021008).
文摘Sea ice hinders the navigability of the Arctic,especially in winter and spring.However,three Arc7 ice-class Liquefied Natural Gas carrying vessels safely transited the Northern Sea Route(NSR)without icebreaker assistance in January 2021.More and more Arc7 ice-class vessels are putting into the transit services in the NSR.Therefore,it is necessary to analyze sea-ice conditions and their impact on navigation during wintertime,and the future navigability of Arc7 ice-class vessels along the NSR during winter and spring.Based on sea ice datasets from satellite observations and a model using data assimilation,we explored the sea-ice conditions and their impact during the first three successful commercial voyages through the NSR in winter.In addition,we analyzed the sea ice variation and estimated navigability for Arc7 ice-class vessels in the NSR from January to June of the years 2021–2050 using future projections of the sea-ice cover by the Coupled Model Inter-comparison Project Phase 6(CMIP6)models under two emission scenarios(SSP2-4.5 and SSP5-8.5).The results reveal lower sea ice thickness and similar sea ice concentration during these three transits relative to the past 42 years(from 1979 to 2020).We found the thickness has a larger impact on the vessels’speeds than sea ice concentration.Very likely sea ice thickness played a larger role than the sea ice concentration for the successful transit of the NSR in winter 2021.Future projections suggest sea ice thickness will decrease further in most regions of the NSR from January to June under all scenarios enabling increased navigability of the NSR for Arc7 ice-class vessels.Such vessels could transit through the NSR from January to June under all scenarios by 2050,while some areas near the coast of East Siberian Sea remain inaccessible for Arc7 ice-class vessels in spring(April and May).These findings can support the strategic planning of shipping along the NSR in winter and spring.
基金funded by the National Natural Science Foundation of China(41925027,41676176)the Innovation Group Project of Southern Marine Science and Engineering Guangdong Laboratory(Zhuhai)(311021008).
文摘Landfast ice plays an important role in atmosphere‒ocean interactions and ecosystems in the near coast area of Antarctica.Understanding the characteristics and variations of landfast ice is crucial to the study of climates and field activities in Antarctic.In this study,a high-resolution thermodynamic snow-ice(HIGHTSI)model was applied to simulate the seasonal changes of landfast ice along the Mawson Coast,East Antarctica,through ERA-Interim reanalysis data.Four ocean heat-flux(Fw)values(10,15,20 and 25 W m−2)were used in sensitivity experiments.The results showed that it is reasonable to simulate landfast ice using the HIGHTSI model,and the simulation of landfast ice thickness matched best well with field measurements when Fw was 20 W m^(−2).Then,2-D distributions of landfast ice from 2006 to 2018 were modeled by HIGHTSI with 2-D ERA-Interim reanalysis data in a 0.125°×0.125°cell grid as external forcing.The results showed that fast ice was thicker along the coast and thinner near open water,and usually reaches its maximal thickness in October,varying from 1.2 to 2.0 m through the study area.There was no statistical trend for the thickness during the study period.
基金supported by the National Natural Science Foundation of China(41925027,42206248).
文摘In 2023,Antarctica experienced its lowest sea ice extent in the satellite era,with extreme polar events gaining widespread attention.Prydz Bay,where the Chinese Zhongshan Station is located,is the third largest embayment in Antarctica.Changes in sea ice,fast ice and polynyas directly affect local heat and mass exchanges between the ocean and atmosphere,as well as ecosystems and research activities.In 2023,substantial fast ice anomalies were observed in Prydz Bay:the extent of fast ice off Zhongshan Station(ZSFI)was anomalously low,while that within Barrier Bay(BaFI)was anomalously high.This study analysed the seasonal evolution and underlying main causes for the extreme conditions using ice charts,satellites and reanalysis data.From 2014 to 2022,the extent of zSFI typically increased during the cold season,reaching a maximum of(9.41±2.47)×10^(3) km^(2),whilst the Barrier Bay Polynya(BaP)persisted throughout this period.However,in 2023,ZSFI did not increase from June onwards,peaking at a maximum extent of only 5.49×10^(3) km^(2),and the BaP closed in mid-winter,leading to the formation of extensive BaFI.Air temperature and wind speed continuously dropped in July,and these conditions persisted for approximately 1 month,leading to the closure of BaP.However,zSFI did not expand further under these extreme meteorological conditions,indicating its independence from these factors.The limited expansion of ZSFI could be attributed to high ocean temperatures.Overall,this study provides valuable insights into the mechanisms driving extreme fast ice conditions.
