Background: The optimal time to closure of a newborn with a myelomeningocele has been the focus of a number of evaluations. The Timing of primary surgery has received significant attention due to its relationship to r...Background: The optimal time to closure of a newborn with a myelomeningocele has been the focus of a number of evaluations. The Timing of primary surgery has received significant attention due to its relationship to repair-site infection that can lead to increased morbidity and prolonged hospital stays. It is on this basis that recommendations have utilized 48 - 72 hours post birth as ideal time of closure. This is not only prevent infection at the site but also prevent ventriculitis and neural structure damage. We therefore, hypothesized an increase in wound infection rates in those patients with delays in myelomeningocele repair. Methods: We retrospectively reviewed the records of 103 children with myelomeningocele treated between 2016 and 2023. At discharge the patients were followed up at the post-operative clinic visit 2 weeks later. Children were assigned to 1 of 2 groups, those who underwent primary neurosurgical repair within 72 hours of delivery (Group 1) and those undergoing repair after 72 hours (Group 2). We compared the infection rates. Results: 103 children who underwent myelomeningocele repair were identified, with a median time from birth to treatment of 1 day. Eight (7.8 %) patients were noted to have post-repair surgical site complications. There was no significant difference in rates of infection between Group 1 and Group 2 repair times. The presence of infection was associated increased length of stay when compared to neonates without infection. Conclusion: In children with myelomeningocele, the timing of primary neurosurgical repair appears not to have a significant impact on surgical site infection. Closure of the spinal lesion within the first 72 hours of life may be more favorable for neural damage prevention. These results suggest that early myelomeningocele repair may not impart significantly on the rate of wound-site infection.展开更多
Background and objective Pre-operative assessment of mitral valve (MV) anatomy is essential to surgical design in patients undergoing MV repair.Although 2-dimensional (2D) echocardiography provides precise information...Background and objective Pre-operative assessment of mitral valve (MV) anatomy is essential to surgical design in patients undergoing MV repair.Although 2-dimensional (2D) echocardiography provides precise information regarding MV anatomy,RT-3D TEE could increase the understanding of MV apparatus and individual scallop identification.We aimed to investigate the value of RT- 3DTEE in MV repair.Methods RT-3DTEE was performed in six patients with mitral valve prolapse (MVP) by using Philips 1E33 with X7-2t probe.Preoperative RT-3DTEE studies were compared with surgical findings in patients undergoing surgical mitral valve repair,and quantitative evaluation was performed by QLab 6.0 software before and after surgical mitral valve repair.Results RT- 3DTEE could display dynamic morphology of MV,the location of prolapse,and spatial relation to the surrounding tissue.It could provide surgical views of the valves and the valvular apparatus.These results were consistent with surgical findings.The quantitative evaluation before and after surgical MV repair indicated that anterolateral to posteromedial diameter of annulus,anterior to posterior diameter of annulus,perimeter of annulus,and area of annulus in projection plane were significantly smaller after operation compared with those before operation (P【0.05).The length of posterior leaflet,the area of anterior and posterior leaflet,the maximal prolapse height,the volume of leaflet prolapse and the length of coaptation in projection plane were significantly reduced after operation (P【0. 05).Conclusion RT-3DTEE is a unique new modality for rapid and accurate evaluation ofmitral valve prolapse and mitral valve repair.展开更多
The strategy on repair and strengthening of existing bridges based on time-dependent reliability was analyzed with the maximum expected benefit as the objective function. A sample of risk-ranking decision was illustra...The strategy on repair and strengthening of existing bridges based on time-dependent reliability was analyzed with the maximum expected benefit as the objective function. A sample of risk-ranking decision was illustrated based on updated inspection information with 35 survival age. The effect of improvement of live loads and difference of repair methods on time-dependent reliability of existing bridges are considered. The results show that the decision method can be used in real project, with the cost of failure consequence and the risk of failure considered.展开更多
To solve a real problem:how to calculate the reliability of a system with time-varying failure rates in industry systems,this paper studies a model for the load-sharing parallel system with time-varying failure rates,...To solve a real problem:how to calculate the reliability of a system with time-varying failure rates in industry systems,this paper studies a model for the load-sharing parallel system with time-varying failure rates,and obtains calculating formulas of reliability and availability of the system by solving differential equations.In this paper,the failure rates are expressed in polynomial configuration.The constant,linear and Weibull failure rate are in their special form.The polynomial failure rates provide flexibility in modeling the practical time-varying failure rates.展开更多
To study the seismic resilience of a concrete-framed hospital building with viscous dampers,the elastoplastic time history analysis of a three-story concrete-framed hospital building under moderate and rare earthquake...To study the seismic resilience of a concrete-framed hospital building with viscous dampers,the elastoplastic time history analysis of a three-story concrete-framed hospital building under moderate and rare earthquakes was carried out by finite element analysis software.The structure’s overall response was studied,meanwhile,the seismic resilience of the building was evaluated from three aspects:repair cost,repair time,and casualties.The results show that viscous dampers can effectively reduce the repair cost,repair time,and casualties under earthquakes.Compared with the structure without dampers,the repair cost and repair time of the structure with dampers have been reduced by 67%and 69%respectively under moderate earthquakes,42%and 39%respectively under rare earthquakes,and the seismic resilience grade has been increased from zero to one star.展开更多
目的探讨标准化皮肤管理在乳腺癌放疗所致皮肤损害中的应用效果。方法选取2022年1月—2023年6月在泉州市第一医院放疗科行放疗的乳腺癌患者108例,采用抽签法分为对照组与研究组,各54例。对照组患者行常规皮肤护理,研究组在此基础上增加...目的探讨标准化皮肤管理在乳腺癌放疗所致皮肤损害中的应用效果。方法选取2022年1月—2023年6月在泉州市第一医院放疗科行放疗的乳腺癌患者108例,采用抽签法分为对照组与研究组,各54例。对照组患者行常规皮肤护理,研究组在此基础上增加标准化皮肤管理干预。对比2组的患者皮肤损伤程度、护理效果、皮肤损伤出现时间及修复时间,使用肿瘤患者生活质量测定量表(quality of life questionnaire:core 30,QLQ-C30)比较2组患者护理前后生活质量情况,对比2组护理满意度情况。结果研究组患者急性放射性损伤皮肤分级显著低于对照组(P<0.05)。研究组皮肤护理有效率显著高于对照组(P<0.05)。研究组皮肤损伤出现时间晚于对照组,修复时间早于对照组,差异有统计学意义(P<0.05)。护理前,2组QLQ-C30各维度评分比较,差异无统计学意义(P>0.05);护理后,研究组QLQ-C30心理、生理、社会及总体健康评分均显著高于对照组(P<0.05)。研究组护理满意度显著高于对照组(98.15%vs.81.48%)(P<0.05)。结论在乳腺癌放疗患者皮肤护理中增加标准化皮肤管理,具有改善皮肤损伤、延缓损伤进程、促进皮肤修复、提高患者生活质量的效果,且患者护理满意度高。展开更多
文摘Background: The optimal time to closure of a newborn with a myelomeningocele has been the focus of a number of evaluations. The Timing of primary surgery has received significant attention due to its relationship to repair-site infection that can lead to increased morbidity and prolonged hospital stays. It is on this basis that recommendations have utilized 48 - 72 hours post birth as ideal time of closure. This is not only prevent infection at the site but also prevent ventriculitis and neural structure damage. We therefore, hypothesized an increase in wound infection rates in those patients with delays in myelomeningocele repair. Methods: We retrospectively reviewed the records of 103 children with myelomeningocele treated between 2016 and 2023. At discharge the patients were followed up at the post-operative clinic visit 2 weeks later. Children were assigned to 1 of 2 groups, those who underwent primary neurosurgical repair within 72 hours of delivery (Group 1) and those undergoing repair after 72 hours (Group 2). We compared the infection rates. Results: 103 children who underwent myelomeningocele repair were identified, with a median time from birth to treatment of 1 day. Eight (7.8 %) patients were noted to have post-repair surgical site complications. There was no significant difference in rates of infection between Group 1 and Group 2 repair times. The presence of infection was associated increased length of stay when compared to neonates without infection. Conclusion: In children with myelomeningocele, the timing of primary neurosurgical repair appears not to have a significant impact on surgical site infection. Closure of the spinal lesion within the first 72 hours of life may be more favorable for neural damage prevention. These results suggest that early myelomeningocele repair may not impart significantly on the rate of wound-site infection.
文摘Background and objective Pre-operative assessment of mitral valve (MV) anatomy is essential to surgical design in patients undergoing MV repair.Although 2-dimensional (2D) echocardiography provides precise information regarding MV anatomy,RT-3D TEE could increase the understanding of MV apparatus and individual scallop identification.We aimed to investigate the value of RT- 3DTEE in MV repair.Methods RT-3DTEE was performed in six patients with mitral valve prolapse (MVP) by using Philips 1E33 with X7-2t probe.Preoperative RT-3DTEE studies were compared with surgical findings in patients undergoing surgical mitral valve repair,and quantitative evaluation was performed by QLab 6.0 software before and after surgical mitral valve repair.Results RT- 3DTEE could display dynamic morphology of MV,the location of prolapse,and spatial relation to the surrounding tissue.It could provide surgical views of the valves and the valvular apparatus.These results were consistent with surgical findings.The quantitative evaluation before and after surgical MV repair indicated that anterolateral to posteromedial diameter of annulus,anterior to posterior diameter of annulus,perimeter of annulus,and area of annulus in projection plane were significantly smaller after operation compared with those before operation (P【0.05).The length of posterior leaflet,the area of anterior and posterior leaflet,the maximal prolapse height,the volume of leaflet prolapse and the length of coaptation in projection plane were significantly reduced after operation (P【0. 05).Conclusion RT-3DTEE is a unique new modality for rapid and accurate evaluation ofmitral valve prolapse and mitral valve repair.
基金TheLiaoningProviceCommunicationDe partmentKeyScienceFoundation (No .0 10 1)
文摘The strategy on repair and strengthening of existing bridges based on time-dependent reliability was analyzed with the maximum expected benefit as the objective function. A sample of risk-ranking decision was illustrated based on updated inspection information with 35 survival age. The effect of improvement of live loads and difference of repair methods on time-dependent reliability of existing bridges are considered. The results show that the decision method can be used in real project, with the cost of failure consequence and the risk of failure considered.
文摘To solve a real problem:how to calculate the reliability of a system with time-varying failure rates in industry systems,this paper studies a model for the load-sharing parallel system with time-varying failure rates,and obtains calculating formulas of reliability and availability of the system by solving differential equations.In this paper,the failure rates are expressed in polynomial configuration.The constant,linear and Weibull failure rate are in their special form.The polynomial failure rates provide flexibility in modeling the practical time-varying failure rates.
基金Financial support for this work was provided by the Science and Technology Commission of Shanghai Municipality(Project No.22YF1409500).
文摘To study the seismic resilience of a concrete-framed hospital building with viscous dampers,the elastoplastic time history analysis of a three-story concrete-framed hospital building under moderate and rare earthquakes was carried out by finite element analysis software.The structure’s overall response was studied,meanwhile,the seismic resilience of the building was evaluated from three aspects:repair cost,repair time,and casualties.The results show that viscous dampers can effectively reduce the repair cost,repair time,and casualties under earthquakes.Compared with the structure without dampers,the repair cost and repair time of the structure with dampers have been reduced by 67%and 69%respectively under moderate earthquakes,42%and 39%respectively under rare earthquakes,and the seismic resilience grade has been increased from zero to one star.
文摘目的探讨标准化皮肤管理在乳腺癌放疗所致皮肤损害中的应用效果。方法选取2022年1月—2023年6月在泉州市第一医院放疗科行放疗的乳腺癌患者108例,采用抽签法分为对照组与研究组,各54例。对照组患者行常规皮肤护理,研究组在此基础上增加标准化皮肤管理干预。对比2组的患者皮肤损伤程度、护理效果、皮肤损伤出现时间及修复时间,使用肿瘤患者生活质量测定量表(quality of life questionnaire:core 30,QLQ-C30)比较2组患者护理前后生活质量情况,对比2组护理满意度情况。结果研究组患者急性放射性损伤皮肤分级显著低于对照组(P<0.05)。研究组皮肤护理有效率显著高于对照组(P<0.05)。研究组皮肤损伤出现时间晚于对照组,修复时间早于对照组,差异有统计学意义(P<0.05)。护理前,2组QLQ-C30各维度评分比较,差异无统计学意义(P>0.05);护理后,研究组QLQ-C30心理、生理、社会及总体健康评分均显著高于对照组(P<0.05)。研究组护理满意度显著高于对照组(98.15%vs.81.48%)(P<0.05)。结论在乳腺癌放疗患者皮肤护理中增加标准化皮肤管理,具有改善皮肤损伤、延缓损伤进程、促进皮肤修复、提高患者生活质量的效果,且患者护理满意度高。
