Acinar cell carcinoma(ACC)is a rare malignant epithelial neoplasm accounting for 1%-2%of all pancreatic exocrine neoplasm,affecting more frequently man with an age between 50 and 70 years.Most patients present with no...Acinar cell carcinoma(ACC)is a rare malignant epithelial neoplasm accounting for 1%-2%of all pancreatic exocrine neoplasm,affecting more frequently man with an age between 50 and 70 years.Most patients present with nonspecific symptoms,which may give rise to difficulties in clinical diagnosis[1].ACC can manifest with diarrhea,weight loss,abdominal pain and,in up to 10%-15%,with lipase hypersecretion syndrome,characterized by elevated lipase production,diffuse subcutaneous fat necrosis and polyarthralgia[1,2].Biliary obstruction and jaundice are infre-quent clinical manifestations,unlike ductal adenocarcinoma,due to pushing rather than infiltrating growth of ACC.展开更多
Objective: To evaluate the effects of abdominal massage on gastrointestinal function in the intensive care unit(ICU) patients.Methods: Randomized controlled trials about the effects of abdominal massage on gastrointes...Objective: To evaluate the effects of abdominal massage on gastrointestinal function in the intensive care unit(ICU) patients.Methods: Randomized controlled trials about the effects of abdominal massage on gastrointestinal function in ICU patients were included from multiple electronic databases: PubMed, Web of Science, the Cochrane Library, Embase, CINAHL, China Academic Journals Full-Text Database(CNKI), Wanfang Database, and CQVIP, until November 2018. Studies were selected according to inclusion and exclusion criteria, extracting data and assessing. Data were analyzed by RevMan 5.3.Results: Nine studies with 720 patients were included. The results of meta-analysis in the intervention group were as follows: abdomen circumference: mean difference(MD)=-4.22, 95% confidence interval(CI)=(-6.20,-2.24), P<0.00001;abdominal distension: MD=0.34, 95% CI=(0.22, 0.52), P<0.00001;gastric residual: MD=-41.51, 95% CI=(-55.86,-29.15), P=0.001;gastric retention: MD=-0.23, 95% CI(-0.30,-0.15), P<0.00001;and vomiting: MD=0.12, 95% CI=(0.04, 0.35), P=0.0001.Conclusions: Abdominal massage is effective in reducing abdominal distension, gastric residual, and vomiting. When the intervention period was <7 days, abdominal massage could not reduce the abdominal circumference in ICU patients, and when the intervention period was equal to 7 days, abdominal massage could reduce the abdominal circumference in ICU patients.展开更多
BACKGROUND Regular abdominal massage can be used to treat digestive symptoms such as bloating and constipation and is reported to reduce abdominal discomfort,improve digestive function,and increase the quality of life...BACKGROUND Regular abdominal massage can be used to treat digestive symptoms such as bloating and constipation and is reported to reduce abdominal discomfort,improve digestive function,and increase the quality of life,without serious adverse effects.Isolated pancreatic injury is rare,and most often occurs during severe trauma such as steering wheel impact injury.To our knowledge,pancreatic injury caused by massage has not yet been reported in the literature.CASE SUMMARY A 57-year-old woman was referred to our hospital for acute abdominal pain and transient syncope.On examination,she had low hemoglobin concentration and a high white blood cell count and neutrophil percentage.Plain computed tomography of the abdomen revealed a substantial hemorrhage in the abdominal cavity.A large amount of exudate in the pancreatic area was considered a hematoma.Preoperative diagnosis was difficult.Her hemoglobin and blood pressure did not rise even after blood.We suspected progressive bleeding in the abdominal cavity and urgently performed exploratory laparotomy.During the operation,the pancreas was confirmed to be ruptured;hence,spleen-preserving pancreatic body and tail resection were performed.A pancreatic fistula was found on the 15th d after the operation,and the patient was discharged with a drainage tube on the 24th d after active treatment.Subsequently,it was discovered that the patient had undergone a vigorous abdominal massage the day before the abdominal pain began.To our knowledge,this is the first report of isolated pancreatic injury and massive abdominal hemorrhage caused by abdominal massage.CONCLUSION Our findings indicate that any action that increases intra-abdominal pressure may cause internal organ damage.We also review similar cases reported in the literature.展开更多
Objective:To investigate the clinical effect of abdominal massage combined with fomentation of traditional Chinese medicine in the treatment of constipation-predominantirritable bowel syndrome.Methods:A total of 90 pa...Objective:To investigate the clinical effect of abdominal massage combined with fomentation of traditional Chinese medicine in the treatment of constipation-predominantirritable bowel syndrome.Methods:A total of 90 patients with irritable bowel syndrome were selected and randomly divided into a control group and an observation group,with 45 cases in each group.The control group received abdominal massage therapy,and the observation group received abdominal massage combined with traditional Chinese medicine fomentation.The clinical efficacy of the two groups of patients on constipation-predominantirritable bowel syndrome was compared.Results:The total effective rate of the observation group in the treatment of constipation-predominantirritable bowel syndrome was 95.6%(43/45),which was higher than the control group by 80%(36/45),and the difference was statistically significant(P<0.05).Conclusion:Abdominal massage combined with fomentation of traditional Chinese medicine is effective in treating constipation-predominantirritable bowel syndrome.Its environmental protection,green,non-invasive treatment advantages are convenient for clinical promotion and application.展开更多
Introduction: Majority of mesenchymal tumors of gastrointestinal tract are Gastrointestinal Stromal Tumor (GIST). It is, however, a rare tumor, accounting for less than 1% of primary gastrointestinal (GI) neoplasms. T...Introduction: Majority of mesenchymal tumors of gastrointestinal tract are Gastrointestinal Stromal Tumor (GIST). It is, however, a rare tumor, accounting for less than 1% of primary gastrointestinal (GI) neoplasms. Though, these tumors are refractory to conventional chemotherapy or radiotherapy but show a good response to targeted adjuvant chemotherapy with tyrosine kinase inhibitors following surgical resection. Case Report: we report here a case of primary Extra-GIST tumor arising from mesentry of small bowel near duodeno-jejunal junction in a 69 years old male patient. The patient presented with a palpable mass in upper abdomen for past 15 days. On examination, a non-tender mobile lump of size around 17 × 10 cm, with bosselated surface and firm in consistency was palpable involving epigastric, left hypochondrium and umbilical region. Contrast enhanced computed tomography of abdomen revealed a heterogenous mesentric mass. On surgical intervention a mass was found involving mesentery near dudenojejunal junction without involvement of gastrointestinal tract. Complete surgical resection of the tumor was done and adjuvant chemotherapy with Imatinib mesylate was started as HPE revealing GIST with mitotic index of >10/50 HPF and 17 × 10 cm size placed the patient in high risk category. Patient was discharged on 12th of post-operative day with advice of regular follow-up. Conclusion: GIST occurrence is not restricted to bowel but can involve unusual sites also. The mainstay of treatment remains surgical resection with adequate margin. In cases where tumour has malignant potential (high mitotic figures on histopathology) adjuvent treatment with tyrosine kinase may prevent or delay relapse.展开更多
Gastrointestinal stromal tumours(GISTs) are the most common mesenchymal tumour of gastro-intestinal tract. Annual incidence of GIST in United States is approximately 3000-4000. Clinical presentation of GIST varies wit...Gastrointestinal stromal tumours(GISTs) are the most common mesenchymal tumour of gastro-intestinal tract. Annual incidence of GIST in United States is approximately 3000-4000. Clinical presentation of GIST varies with location and size of tumour but GIST presenting with palpable abdominal mass is rare. We report a case of 38 years old male who presented with large abdominal lump. Computed tomography(CT) scan showed a large solid-cystic lesion encasing second part of duodenum and distal common bile duct. On CT differential diagnosis of Leiomyoma, Leiomyosarcoma and GIST were made. The diagnosis of GIST was confirmed by immune-histochemical study of the biopsy material. Patient underwent pancreaticodudenectomy. Post-operative course was uneventful. Patient was started on Imatinib therapy post-operatively. No recurrence noted at six months follow up.展开更多
AIM To compare the aspiration needle(AN) and core biopsy needle(PC) in endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) of abdominal masses.METHODS Consecutive patients referred for EUS-FNA were included i...AIM To compare the aspiration needle(AN) and core biopsy needle(PC) in endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) of abdominal masses.METHODS Consecutive patients referred for EUS-FNA were included in this prospective single-center trial. Each patient underwent a puncture of the lesion with both standard 22-gauge(G) AN(Echo Tip Ultra; Cook Medical, Bloomington, Indiana, United States) and the novel 22 G PC(Echo Tip Pro Core; Cook Medical, Bloomington, Indiana, United States) in a randomized fashion; histology was attempted in the PC group only. The main study endpoint was the overall diagnostic accuracy, including the contribution of histology to the final diagnosis. Secondary outcome measures included material adequacy, number of needle passes, and complications.RESULTS Fifty six consecutive patients(29 men; mean age 68 years) with pancreatic lesions(n = 38), lymphadenopathy(n = 13), submucosal tumors(n = 4), or others lesions(n = 1) underwent EUS-FNA using both of the needles in a randomized order. AN and PC reached similar overall results for diagnostic accuracy(AN: 88.9 vs PC: 96.1, P = 0.25), specimen adequacy(AN: 96.4% vs PC: 91.1%, P = 0.38), mean number of passes(AN: 1.5 vs PC: 1.7, P = 0.14), mean cellularity score(AN: 1.7 vs PC: 1.1, P = 0.058), and complications(none). A diagnosis on the basis of histology was achieved in the PC group in 36(64.3%) patients, and in 2 of those as the sole modality. In patients with available histology the mean cellularity score was higher for AN(AN: 1.7 vs PC: 1.0, P = 0.034); no other differences were of statistical significance.CONCLUSION Both needles achieved high overall diagnostic yields and similar performance characteristics for cytological diagnosis; histological analysis was only possible in 2/3 of cases with the new needle.展开更多
Background and Aims: The study aims to explore the association between body composition and depression in adolescents and young adults. Methods: A random cluster sampling method was used to select 41 age-matched indi-...Background and Aims: The study aims to explore the association between body composition and depression in adolescents and young adults. Methods: A random cluster sampling method was used to select 41 age-matched indi-viduals (aged 11 - 30) as a non-depressive control group. The Department of Psychology at the Affiliated Hospital of Youjiang Medical University for Na-tionalities recruited 27 depressive patients within the same age range. Bioelec-trical impedance analysis measured body composition, while SCL-90, SAS, and SDS were employed for depression diagnosis. Logistic regression analysis was conducted to assess the relationship between body composition and de-pression scores. Results: The Depression Group exhibited higher levels of fat mass (p Conclusion: Depression is associated with age, gender, and muscle mass in adolescents and young people. Proper exercise and a healthy diet can increase muscle mass, thereby reducing fat mass and, as a result, reducing the prevalence of depression.展开更多
Introduction: On the 5<sup>th</sup> of June 2022, an incident of a mass attack following multiple gunshots and explosions occurred in a community in Ondo State Nigeria. This study aims to assess the mental...Introduction: On the 5<sup>th</sup> of June 2022, an incident of a mass attack following multiple gunshots and explosions occurred in a community in Ondo State Nigeria. This study aims to assess the mental health status of victims of the mass attack to guide further interventions among them. Methods: A cross-sectional study was conducted among victims of a mass attack in Owo community, Ondo State. A total of 209 affected victims were interviewed on socio-demographic characteristics, symptoms of anxiety (AD) and post-traumatic stress disorder (PTSD), threat experienced, and mental health support received. A 7-item Generalized Anxiety Disorder (GAD-7) and 9-item Post Traumatic Stress Disorder (PTSD) scale were used to assess the mental health status of the victims. A point was assigned to respondents who reported the symptoms of GAD, with a maximum score of 7 attained. For GAD, scores were categorized as follows: 1 - 2 as mild, 2 - 3 as minimal, 4 - 5 as moderate and 6 - 7 as severe. The PTSD symptoms were rated using a 5-point Likert scale response, and assigned the following points;4 = extremely, 3 = quite a bit, 2 = moderate, 1 = a little bit and 0 = not at all. From a maximum score of 36, participants with scores 18 and above were categorized as those with provisional PTSD. The independent samples t-test and correlational analysis were used to determine the association between PTSD score and other independent variables, with an alpha level of significance set at 0.05. Results: Generally, 38 (18.2%) of the respondents had severe AD. About half (89;42.6%) were categorized as those with provisional PTSD. The mean level of both AD (3.40 ± 2.26) and PTSD (16.51 ± 7.63) score is higher among those who were married compared to those not married (anxiety disorder;2.52 ± 2.20, P = 0.005 and PTSD;13.20 ± 8.86, P = 0.004). Respondents who have been counseled by a healthcare worker had a higher mean level (15.89 ± 7.58) of provisional PTSD compared to those not counseled by a healthcare worker (13.56 ± 9.22, P = 0.046). The level of PTSD score increased with a higher age group (r = 0.21, P = 0.003). Conclusions: The results show that the mass attack had psychological consequences among a high proportion of the victims, particularly, those married and in the older age groups. This suggests the need for continuous supportive counseling targeting these affected groups, and considering other factors moderating the effectiveness of counseling among them in future interventions.展开更多
BACKGROUND Malignant triton tumors(MTTs)comprise a subgroup of malignant peripheral nerve sheath tumors(MPNSTs)that exhibits rhabdomyosarcomatous differen-tiation and follow an aggressive course.MTTs are primarily loc...BACKGROUND Malignant triton tumors(MTTs)comprise a subgroup of malignant peripheral nerve sheath tumors(MPNSTs)that exhibits rhabdomyosarcomatous differen-tiation and follow an aggressive course.MTTs are primarily located along peripheral nerves.Cases of MTTs in the abdominal wall have not been reported.MTT has a poorer prognosis than classic MPNSTs,and accurate diagnosis necessitates a keen understanding of the clinical history and knowledge of its differential diagnosis intricacies.Treatment for MTTs mirrors that for MPNSTs and is predominantly surgical.CASE SUMMARY A 49-year-old woman presented with a subcutaneous mass in her lower abdo-minal wall and a pre-existing surgical scar that had grown slowly over 3-4 months before the consultation.She had previously undergone radical hysterectomy and concurrent chemo-radiotherapy for cervical cancer approximately 5 years prior to the consultation.Abdominal computed tomography(CT)showed a 1.3 cm midline mass in the lower abdomen with infiltration into the rectus abdominis muscle.There was no sign of metastasis(T1N0M0).An incisional biopsy identified sporadic MTT of the lower abdomen.A comprehensive surgical excision with a 3 cm margin inclusive of the peritoneum was executed.Subse-quently,the general surgeon utilized an approach akin to the open peritoneal onlay mesh technique.The patient underwent additional treatment with an excision shaped as a mini-abdominoplasty for the skin defect.No complications arose,and annual follow-up CTs did not show signs of recurrence or metastasis.CONCLUSION An abdominal MTT was efficaciously treated with extensive excision and abdominal wall reconstruction,eliminating the need for postoperative radiotherapy.展开更多
This paper investigates the hydrodynamic characteristics of floating truncated cylinders undergoing horizontal and vertical motions due to earthquake excitations in the finite water depth.The governing equation of the...This paper investigates the hydrodynamic characteristics of floating truncated cylinders undergoing horizontal and vertical motions due to earthquake excitations in the finite water depth.The governing equation of the hydrodynamic pressure acting on the cylinder is derived based on the radiation theory with the inviscid and incompressible assumptions.The governing equation is solved by using the method of separating variables and analytical solutions are obtained by assigning reasonable boundary conditions.The analytical result is validated by a numerical model using the exact artificial boundary simulation of the infinite water.The main variation and distribution characteristics of the hydrodynamic pressure acting on the side and bottom of the cylinder are analyzed for different combinations of wide-height and immersion ratios.The added mass coefficient of the cylinder is calculated by integrating the hydrodynamic pressure and simplified formulas are proposed for engineering applications.The calculation results show that the simplified formulas are in good agreement with the analytical solutions.展开更多
Controlling mass transportation using intrinsic mechanisms is a challenging topic in nanotechnology.Herein,we employ molecular dynamics simulations to investigate the mass transport inside carbon nanotubes(CNT)with te...Controlling mass transportation using intrinsic mechanisms is a challenging topic in nanotechnology.Herein,we employ molecular dynamics simulations to investigate the mass transport inside carbon nanotubes(CNT)with temperature gradients,specifically the effects of adding a static carbon hoop to the outside of a CNT on the transport of a nanomotor inside the CNT.We reveal that the underlying mechanism is the uneven potential energy created by the hoops,i.e.,the hoop outside the CNT forms potential energy barriers or wells that affect mass transport inside the CNT.This fundamental control of directional mass transportation may lead to promising routes for nanoscale actuation and energy conversion.展开更多
In this paper, the submicroscopic deterministic concept developed by the author is applied to the problem of the neutrino mass. A particle appears from space considered as a mathematical lattice of primary topological...In this paper, the submicroscopic deterministic concept developed by the author is applied to the problem of the neutrino mass. A particle appears from space considered as a mathematical lattice of primary topological balls, and induces a deformation coat in its surrounding. The principles of the interaction of particles with space and through space between themselves are considered in detail. The approach states that real quarks possess only an integer charge (±e) and when moving they periodically change to the monopole state (⇄g) and hence, canonical particles are dynamic dyons. A neutrino emerges as a squeezed quark when it is in a monopole state, or in other words, the quark monopole state (a bubble in the tessellattice) is transferred to the appropriate lepton monopole state (a speck in the tessellattice). The self-mass (a “rest” mass) for each neutrino flavour is calculated. The calculated value of the self-mass for the electron anti-neutrino is 1.22873978 × 10<sup>-36</sup> kg = 0.68927247 eV/c<sup>2</sup>. The concept of neutrino oscillations is revised, and another postulation is proposed, namely, that the transition from lighter to heavier flavors is due to the inelastic scattering of neutrinos on oncoming scatterers. As a result, the neutrino captures the mass defect, becomes heavier, and therefore the transitions V<sub>e</sub>⟶V<sub>μ</sub> and V<sub>μ</sub>⟶V<sub>τ</sub> occur;thus, the number of light neutrinos decreases in the neutrino flux studied.展开更多
BACKGROUND Guidewire slippage into the peritoneal cavity during clinical operations is extremely rare.Therefore,this paper aims to report a successful case of guidewire removal using transgastric natural orifice trans...BACKGROUND Guidewire slippage into the peritoneal cavity during clinical operations is extremely rare.Therefore,this paper aims to report a successful case of guidewire removal using transgastric natural orifice transluminal endoscopic surgery(NOTES).The goal is to enhance physicians'understanding of the management plan for this unique scenario and provide a valuable reference for clinical practice.CASE SUMMARY A 64-year-old man presented with abdominal distension and was diagnosed with cirrhosis combined with massive ascites.To proceed with treatment,the patient underwent ultrasound-guided peritoneal puncture and underwent catheterization and drainage.Unfortunately,a 0.035-inch guidewire slipped into the abdominal cavity during the procedure.Following a comprehensive evaluation and consultation by a multidisciplinary team,the guidewire was successfully removed using NOTES.CONCLUSION This case highlights the potential consideration of transgastric NOTES removal when encountering a foreign body,such as a guidewire,within the abdominal cavity.展开更多
Mathematical physics equations are often utilized to describe physical phenomena in various fields of science and engineering.One such equation is the Fourier equation,which is a commonly used and effective method for...Mathematical physics equations are often utilized to describe physical phenomena in various fields of science and engineering.One such equation is the Fourier equation,which is a commonly used and effective method for evaluating the effectiveness of temperature control measures for mass concrete.One important measure for temperature control in mass concrete is the use of cooling water pipes.However,the mismatch of grids between large-scale concrete models and small-scale cooling pipe models can result in a significant waste of calculation time when using the finite element method.Moreover,the temperature of the water in the cooling pipe needs to be iteratively calculated during the thermal transfer process.The substructure method can effectively solve this problem,and it has been validated by scholars.The Abaqus/Python secondary development technology provides engineers with enough flexibility to combine the substructure method with an iteration algorithm,which enables the creation of a parametric modeling calculation for cooling water pipes.This paper proposes such a method,which involves iterating the water pipe boundary and establishing the water pipe unit substructure to numerically simulate the concrete temperature field that contains a cooling water pipe.To verify the feasibility and accuracy of the proposed method,two classic numerical examples were analyzed.The results showed that this method has good applicability in cooling pipe calculations.When the value of the iteration parameterαis 0.4,the boundary temperature of the cooling water pipes can meet the accuracy requirements after 4∼5 iterations,effectively improving the computational efficiency.Overall,this approach provides a useful tool for engineers to analyze the temperature control measures accurately and efficiently for mass concrete,such as cooling water pipes,using Abaqus/Python secondary development.展开更多
Vertical mass isolation(VMI)is one of the novel methods for the seismic control of structures.In this method,the entire structure is assumed to consist of two mass and stiffness subsystems,and an isolated layer is loc...Vertical mass isolation(VMI)is one of the novel methods for the seismic control of structures.In this method,the entire structure is assumed to consist of two mass and stiffness subsystems,and an isolated layer is located among them.In this study,the magnetorheological damper in three modes:passive-off,passive-on,and semi-active mode with variable voltage between zero and 9 volts was used as an isolated layer between two subsystems.Multi-degrees-of-freedom structures with 5,10,and 15 floors in two dimensions were examined under 11 pairs of near field earthquakes.On each level,the displacement of MR dampers was taken into account.The responses of maximum displacement,maximum inter-story drift,and maximum base shear in controlled and uncontrolled buildings were compared to assess the suggested approach for seismic control of the structures.According to the results,the semi-active control method can reduce the response by more than 12%compared to the uncontrolled mode in terms of maximum displacement of the mass subsystem of the structures.This method can reduce more than 16%and 20%of the responses compared to the uncontrolled mode in terms of maximum inter-story drift and base shear of the structure,respectively.展开更多
Introduction: Carbai tunnel syndrome [CTS] is compression of the median nerve at the wrist , this causes tingling in the hands, pain, numbness, tingling in the fingers particularly the thumb, index and middle fingers,...Introduction: Carbai tunnel syndrome [CTS] is compression of the median nerve at the wrist , this causes tingling in the hands, pain, numbness, tingling in the fingers particularly the thumb, index and middle fingers, loss of sensation in the hands and fingers, also weakness in the hands. The aim of the present study was to study a possible association which could be found between electrophysiological data in CTS, BMI, hyperlipidemia, and vitamin D [Vit D] levels. Methods: We used a sample of 40 females of the same age group, who were divided into Group 1 as a control consists of 18 healthy females and Group II consisted of 22 age matched females with clinical and electrophysiological evidence of CTS. We measured atherogenic index [AI] as a marker of hyperlipidemia, body mass index [BMI], Vit D status and electrophysiological tests of CTS. Results: Subjects with CTS had deficient Vit D status, they had significantly high atherogenic index (AI), and significant high BMI all compared to control Group I. Median sensory conduction velocity was significantly correlated negatively with BMI and atherogenic index, and positively correlated significantly with Vit D status. But median sensory and motor action potential latency were significantly correlated positively with BMI and atherogenic index, and negatively correlated significantly with Vit D status The analysis revealed BMI, atherogenic index and Vit D status as predictors of median nerve sensory and motor action potential latency and sensory nerve conduction velocity in CTS. Conclusion: The results of this study suggest that obesity and hyperlipidemia are potent CTS risk factors and declared the direct association between Vit D status and CTS occurrence. Our study supports the notion of the compensatory neuroprotective role of Vit D which could have a direct impact on the nerves integrity as it has an anti-inflammatory property which acts in relieving nervous insults and stress. .展开更多
BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abd...BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abdominal paracentesis catheter place-ment and drainage.AIM To explore the influence of different timing for abdominal paracentesis catheter placement and drainage in SAP complicated by intra-abdominal fluid accumu-lation.METHODS Using a retrospective approach,184 cases of SAP complicated by intra-abdominal fluid accumulation were enrolled and categorized into three groups based on the timing of catheter placement:group A(catheter placement within 2 d of symptom onset,n=89),group B(catheter placement between days 3 and 5 after symptom onset,n=55),and group C(catheter placement between days 6 and 7 after symptom onset,n=40).The differences in progression rate,mortality rate,and the number of cases with organ dysfunction were compared among the three groups.RESULTS The progression rate of group A was significantly lower than those in groups B and groups C(2.25%vs 21.82%and 32.50%,P<0.05).Further,the proportion of patients with at least one organ dysfunction in group A was significantly lower than those in groups B and groups C(41.57%vs 70.91%and 75.00%,P<0.05).The mortality rates in group A,group B,and group C were similar(P>0.05).At postoperative day 3,the levels of C-reactive protein(55.41±19.32 mg/L vs 82.25±20.41 mg/L and 88.65±19.14 mg/L,P<0.05),procalcitonin(1.36±0.51 ng/mL vs 3.20±0.97 ng/mL and 3.41±0.98 ng/mL,P<0.05),tumor necrosis factor-alpha(15.12±6.63 pg/L vs 22.26±9.96 pg/L and 23.39±9.12 pg/L,P<0.05),interleukin-6(332.14±90.16 ng/L vs 412.20±88.50 ng/L and 420.08±87.65ng/L,P<0.05),interleukin-8(415.54±68.43 ng/L vs 505.80±66.90 ng/L and 510.43±68.23ng/L,P<0.05)and serum amyloid A(270.06±78.49 mg/L vs 344.41±81.96 mg/L and 350.60±80.42 mg/L,P<0.05)were significantly lower in group A compared to those in groups B and group C.The length of hospital stay in group A was significantly lower than those in groups B and group C(24.50±4.16 d vs 35.54±6.62 d and 38.89±7.10 d,P<0.05).The hospitalization expenses in group A were also significantly lower than those in groups B and groups C[2.70(1.20,3.55)ten-thousand-yuan vs 5.50(2.98,7.12)ten-thousand-yuan and 6.00(3.10,8.05)ten-thousand-yuan,P<0.05).The incidence of complications in group A was markedly lower than that in group C(5.62%vs 25.00%,P<0.05),and similar to group B(P>0.05).CONCLUSION Percutaneous catheter drainage for the treatment of SAP complicated by intra-abdominal fluid accumulation is most effective when performed within 2 d of onset.展开更多
With the rapid development of large megawatt wind turbines,the operation environment of wind turbine towers(WTTs)has become increasingly complex.In particular,seismic excitation can create a resonance response and cau...With the rapid development of large megawatt wind turbines,the operation environment of wind turbine towers(WTTs)has become increasingly complex.In particular,seismic excitation can create a resonance response and cause excessive vibration of the WTT.To investigate the vibration attenuation performance of the WTT under seismic excitations,a novel passive vibration control device,called a prestressed tuned mass damper(PS-TMD),is presented in this study.First,a mathematical model is established based on structural dynamics under seismic excitation.Then,the mathematical analytical expression of the dynamic coefficient is deduced,and the parameter design method is obtained by system tuning optimization.Next,based on a theoretical analysis and parameter design,the numerical results showed that the PS-TMD was able to effectively mitigate the resonance under the harmonic basal acceleration.Finally,the time-history analysis method is used to verify the effectiveness of the traditional pendulum tuned mass damper(PTMD)and the novel PS-TMD device,and the results indicate that the vibration attenuation performance of the PS-TMD is better than the PTMD.In addition,the PS-TMD avoids the nonlinear effect due to the large oscillation angle,and has the potential to dissipate hysteretic energy under seismic excitation.展开更多
Background:Recurrent acute cholecystitis(RAC)can occur after non-surgical treatment for acute cholecystitis(AC),and can be more severe in comparison to the first episode of AC.Low skeletal muscle mass or adiposity hav...Background:Recurrent acute cholecystitis(RAC)can occur after non-surgical treatment for acute cholecystitis(AC),and can be more severe in comparison to the first episode of AC.Low skeletal muscle mass or adiposity have various effects in several diseases.We aimed to clarify the relationship between RAC and body parameters.Methods:Patients with AC who were treated at our hospital between January 2011 and March 2022 were enrolled.The psoas muscle mass and adipose tissue area at the third lumbar level were measured using computed tomography at the first episode of AC.The areas were divided by height to obtain the psoas muscle mass index(PMI)and subcutaneous/visceral adipose tissue index(SATI/VATI).According to median VATI,SATI and PMI values by sex,patients were divided into the high and low PMI groups.We performed propensity score matching to eliminate the baseline differences between the high PMI and low PMI groups and analyzed the cumulative incidence and predictors of RAC.Results:The entire cohort was divided into the high PMI(n=81)and low PMI(n=80)groups.In the propensity score-matched cohort there were 57 patients in each group.In Kaplan-Meier analysis,the low PMI group and the high VATI group had a significantly higher cumulative incidence of RAC than their counterparts(log-rank P=0.001 and 0.015,respectively).In a multivariate Cox regression analysis,the hazard ratios of low PMI and low VATI for RAC were 5.250(95%confidence interval 1.083-25.450,P=0.039)and 0.158(95%confidence interval:0.026-0.937,P=0.042),respectively.Conclusions:Low skeletal muscle mass and high visceral adiposity were independent risk factors for RAC.展开更多
文摘Acinar cell carcinoma(ACC)is a rare malignant epithelial neoplasm accounting for 1%-2%of all pancreatic exocrine neoplasm,affecting more frequently man with an age between 50 and 70 years.Most patients present with nonspecific symptoms,which may give rise to difficulties in clinical diagnosis[1].ACC can manifest with diarrhea,weight loss,abdominal pain and,in up to 10%-15%,with lipase hypersecretion syndrome,characterized by elevated lipase production,diffuse subcutaneous fat necrosis and polyarthralgia[1,2].Biliary obstruction and jaundice are infre-quent clinical manifestations,unlike ductal adenocarcinoma,due to pushing rather than infiltrating growth of ACC.
文摘Objective: To evaluate the effects of abdominal massage on gastrointestinal function in the intensive care unit(ICU) patients.Methods: Randomized controlled trials about the effects of abdominal massage on gastrointestinal function in ICU patients were included from multiple electronic databases: PubMed, Web of Science, the Cochrane Library, Embase, CINAHL, China Academic Journals Full-Text Database(CNKI), Wanfang Database, and CQVIP, until November 2018. Studies were selected according to inclusion and exclusion criteria, extracting data and assessing. Data were analyzed by RevMan 5.3.Results: Nine studies with 720 patients were included. The results of meta-analysis in the intervention group were as follows: abdomen circumference: mean difference(MD)=-4.22, 95% confidence interval(CI)=(-6.20,-2.24), P<0.00001;abdominal distension: MD=0.34, 95% CI=(0.22, 0.52), P<0.00001;gastric residual: MD=-41.51, 95% CI=(-55.86,-29.15), P=0.001;gastric retention: MD=-0.23, 95% CI(-0.30,-0.15), P<0.00001;and vomiting: MD=0.12, 95% CI=(0.04, 0.35), P=0.0001.Conclusions: Abdominal massage is effective in reducing abdominal distension, gastric residual, and vomiting. When the intervention period was <7 days, abdominal massage could not reduce the abdominal circumference in ICU patients, and when the intervention period was equal to 7 days, abdominal massage could reduce the abdominal circumference in ICU patients.
文摘BACKGROUND Regular abdominal massage can be used to treat digestive symptoms such as bloating and constipation and is reported to reduce abdominal discomfort,improve digestive function,and increase the quality of life,without serious adverse effects.Isolated pancreatic injury is rare,and most often occurs during severe trauma such as steering wheel impact injury.To our knowledge,pancreatic injury caused by massage has not yet been reported in the literature.CASE SUMMARY A 57-year-old woman was referred to our hospital for acute abdominal pain and transient syncope.On examination,she had low hemoglobin concentration and a high white blood cell count and neutrophil percentage.Plain computed tomography of the abdomen revealed a substantial hemorrhage in the abdominal cavity.A large amount of exudate in the pancreatic area was considered a hematoma.Preoperative diagnosis was difficult.Her hemoglobin and blood pressure did not rise even after blood.We suspected progressive bleeding in the abdominal cavity and urgently performed exploratory laparotomy.During the operation,the pancreas was confirmed to be ruptured;hence,spleen-preserving pancreatic body and tail resection were performed.A pancreatic fistula was found on the 15th d after the operation,and the patient was discharged with a drainage tube on the 24th d after active treatment.Subsequently,it was discovered that the patient had undergone a vigorous abdominal massage the day before the abdominal pain began.To our knowledge,this is the first report of isolated pancreatic injury and massive abdominal hemorrhage caused by abdominal massage.CONCLUSION Our findings indicate that any action that increases intra-abdominal pressure may cause internal organ damage.We also review similar cases reported in the literature.
文摘Objective:To investigate the clinical effect of abdominal massage combined with fomentation of traditional Chinese medicine in the treatment of constipation-predominantirritable bowel syndrome.Methods:A total of 90 patients with irritable bowel syndrome were selected and randomly divided into a control group and an observation group,with 45 cases in each group.The control group received abdominal massage therapy,and the observation group received abdominal massage combined with traditional Chinese medicine fomentation.The clinical efficacy of the two groups of patients on constipation-predominantirritable bowel syndrome was compared.Results:The total effective rate of the observation group in the treatment of constipation-predominantirritable bowel syndrome was 95.6%(43/45),which was higher than the control group by 80%(36/45),and the difference was statistically significant(P<0.05).Conclusion:Abdominal massage combined with fomentation of traditional Chinese medicine is effective in treating constipation-predominantirritable bowel syndrome.Its environmental protection,green,non-invasive treatment advantages are convenient for clinical promotion and application.
文摘Introduction: Majority of mesenchymal tumors of gastrointestinal tract are Gastrointestinal Stromal Tumor (GIST). It is, however, a rare tumor, accounting for less than 1% of primary gastrointestinal (GI) neoplasms. Though, these tumors are refractory to conventional chemotherapy or radiotherapy but show a good response to targeted adjuvant chemotherapy with tyrosine kinase inhibitors following surgical resection. Case Report: we report here a case of primary Extra-GIST tumor arising from mesentry of small bowel near duodeno-jejunal junction in a 69 years old male patient. The patient presented with a palpable mass in upper abdomen for past 15 days. On examination, a non-tender mobile lump of size around 17 × 10 cm, with bosselated surface and firm in consistency was palpable involving epigastric, left hypochondrium and umbilical region. Contrast enhanced computed tomography of abdomen revealed a heterogenous mesentric mass. On surgical intervention a mass was found involving mesentery near dudenojejunal junction without involvement of gastrointestinal tract. Complete surgical resection of the tumor was done and adjuvant chemotherapy with Imatinib mesylate was started as HPE revealing GIST with mitotic index of >10/50 HPF and 17 × 10 cm size placed the patient in high risk category. Patient was discharged on 12th of post-operative day with advice of regular follow-up. Conclusion: GIST occurrence is not restricted to bowel but can involve unusual sites also. The mainstay of treatment remains surgical resection with adequate margin. In cases where tumour has malignant potential (high mitotic figures on histopathology) adjuvent treatment with tyrosine kinase may prevent or delay relapse.
文摘Gastrointestinal stromal tumours(GISTs) are the most common mesenchymal tumour of gastro-intestinal tract. Annual incidence of GIST in United States is approximately 3000-4000. Clinical presentation of GIST varies with location and size of tumour but GIST presenting with palpable abdominal mass is rare. We report a case of 38 years old male who presented with large abdominal lump. Computed tomography(CT) scan showed a large solid-cystic lesion encasing second part of duodenum and distal common bile duct. On CT differential diagnosis of Leiomyoma, Leiomyosarcoma and GIST were made. The diagnosis of GIST was confirmed by immune-histochemical study of the biopsy material. Patient underwent pancreaticodudenectomy. Post-operative course was uneventful. Patient was started on Imatinib therapy post-operatively. No recurrence noted at six months follow up.
文摘AIM To compare the aspiration needle(AN) and core biopsy needle(PC) in endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) of abdominal masses.METHODS Consecutive patients referred for EUS-FNA were included in this prospective single-center trial. Each patient underwent a puncture of the lesion with both standard 22-gauge(G) AN(Echo Tip Ultra; Cook Medical, Bloomington, Indiana, United States) and the novel 22 G PC(Echo Tip Pro Core; Cook Medical, Bloomington, Indiana, United States) in a randomized fashion; histology was attempted in the PC group only. The main study endpoint was the overall diagnostic accuracy, including the contribution of histology to the final diagnosis. Secondary outcome measures included material adequacy, number of needle passes, and complications.RESULTS Fifty six consecutive patients(29 men; mean age 68 years) with pancreatic lesions(n = 38), lymphadenopathy(n = 13), submucosal tumors(n = 4), or others lesions(n = 1) underwent EUS-FNA using both of the needles in a randomized order. AN and PC reached similar overall results for diagnostic accuracy(AN: 88.9 vs PC: 96.1, P = 0.25), specimen adequacy(AN: 96.4% vs PC: 91.1%, P = 0.38), mean number of passes(AN: 1.5 vs PC: 1.7, P = 0.14), mean cellularity score(AN: 1.7 vs PC: 1.1, P = 0.058), and complications(none). A diagnosis on the basis of histology was achieved in the PC group in 36(64.3%) patients, and in 2 of those as the sole modality. In patients with available histology the mean cellularity score was higher for AN(AN: 1.7 vs PC: 1.0, P = 0.034); no other differences were of statistical significance.CONCLUSION Both needles achieved high overall diagnostic yields and similar performance characteristics for cytological diagnosis; histological analysis was only possible in 2/3 of cases with the new needle.
文摘Background and Aims: The study aims to explore the association between body composition and depression in adolescents and young adults. Methods: A random cluster sampling method was used to select 41 age-matched indi-viduals (aged 11 - 30) as a non-depressive control group. The Department of Psychology at the Affiliated Hospital of Youjiang Medical University for Na-tionalities recruited 27 depressive patients within the same age range. Bioelec-trical impedance analysis measured body composition, while SCL-90, SAS, and SDS were employed for depression diagnosis. Logistic regression analysis was conducted to assess the relationship between body composition and de-pression scores. Results: The Depression Group exhibited higher levels of fat mass (p Conclusion: Depression is associated with age, gender, and muscle mass in adolescents and young people. Proper exercise and a healthy diet can increase muscle mass, thereby reducing fat mass and, as a result, reducing the prevalence of depression.
文摘Introduction: On the 5<sup>th</sup> of June 2022, an incident of a mass attack following multiple gunshots and explosions occurred in a community in Ondo State Nigeria. This study aims to assess the mental health status of victims of the mass attack to guide further interventions among them. Methods: A cross-sectional study was conducted among victims of a mass attack in Owo community, Ondo State. A total of 209 affected victims were interviewed on socio-demographic characteristics, symptoms of anxiety (AD) and post-traumatic stress disorder (PTSD), threat experienced, and mental health support received. A 7-item Generalized Anxiety Disorder (GAD-7) and 9-item Post Traumatic Stress Disorder (PTSD) scale were used to assess the mental health status of the victims. A point was assigned to respondents who reported the symptoms of GAD, with a maximum score of 7 attained. For GAD, scores were categorized as follows: 1 - 2 as mild, 2 - 3 as minimal, 4 - 5 as moderate and 6 - 7 as severe. The PTSD symptoms were rated using a 5-point Likert scale response, and assigned the following points;4 = extremely, 3 = quite a bit, 2 = moderate, 1 = a little bit and 0 = not at all. From a maximum score of 36, participants with scores 18 and above were categorized as those with provisional PTSD. The independent samples t-test and correlational analysis were used to determine the association between PTSD score and other independent variables, with an alpha level of significance set at 0.05. Results: Generally, 38 (18.2%) of the respondents had severe AD. About half (89;42.6%) were categorized as those with provisional PTSD. The mean level of both AD (3.40 ± 2.26) and PTSD (16.51 ± 7.63) score is higher among those who were married compared to those not married (anxiety disorder;2.52 ± 2.20, P = 0.005 and PTSD;13.20 ± 8.86, P = 0.004). Respondents who have been counseled by a healthcare worker had a higher mean level (15.89 ± 7.58) of provisional PTSD compared to those not counseled by a healthcare worker (13.56 ± 9.22, P = 0.046). The level of PTSD score increased with a higher age group (r = 0.21, P = 0.003). Conclusions: The results show that the mass attack had psychological consequences among a high proportion of the victims, particularly, those married and in the older age groups. This suggests the need for continuous supportive counseling targeting these affected groups, and considering other factors moderating the effectiveness of counseling among them in future interventions.
文摘BACKGROUND Malignant triton tumors(MTTs)comprise a subgroup of malignant peripheral nerve sheath tumors(MPNSTs)that exhibits rhabdomyosarcomatous differen-tiation and follow an aggressive course.MTTs are primarily located along peripheral nerves.Cases of MTTs in the abdominal wall have not been reported.MTT has a poorer prognosis than classic MPNSTs,and accurate diagnosis necessitates a keen understanding of the clinical history and knowledge of its differential diagnosis intricacies.Treatment for MTTs mirrors that for MPNSTs and is predominantly surgical.CASE SUMMARY A 49-year-old woman presented with a subcutaneous mass in her lower abdo-minal wall and a pre-existing surgical scar that had grown slowly over 3-4 months before the consultation.She had previously undergone radical hysterectomy and concurrent chemo-radiotherapy for cervical cancer approximately 5 years prior to the consultation.Abdominal computed tomography(CT)showed a 1.3 cm midline mass in the lower abdomen with infiltration into the rectus abdominis muscle.There was no sign of metastasis(T1N0M0).An incisional biopsy identified sporadic MTT of the lower abdomen.A comprehensive surgical excision with a 3 cm margin inclusive of the peritoneum was executed.Subse-quently,the general surgeon utilized an approach akin to the open peritoneal onlay mesh technique.The patient underwent additional treatment with an excision shaped as a mini-abdominoplasty for the skin defect.No complications arose,and annual follow-up CTs did not show signs of recurrence or metastasis.CONCLUSION An abdominal MTT was efficaciously treated with extensive excision and abdominal wall reconstruction,eliminating the need for postoperative radiotherapy.
基金financially supported by the National Natural Science Foundation of China(Grant Nos.52078010 and 52101321)the National Key Research and Development Program of China(Grant No.2022YFC3004300).
文摘This paper investigates the hydrodynamic characteristics of floating truncated cylinders undergoing horizontal and vertical motions due to earthquake excitations in the finite water depth.The governing equation of the hydrodynamic pressure acting on the cylinder is derived based on the radiation theory with the inviscid and incompressible assumptions.The governing equation is solved by using the method of separating variables and analytical solutions are obtained by assigning reasonable boundary conditions.The analytical result is validated by a numerical model using the exact artificial boundary simulation of the infinite water.The main variation and distribution characteristics of the hydrodynamic pressure acting on the side and bottom of the cylinder are analyzed for different combinations of wide-height and immersion ratios.The added mass coefficient of the cylinder is calculated by integrating the hydrodynamic pressure and simplified formulas are proposed for engineering applications.The calculation results show that the simplified formulas are in good agreement with the analytical solutions.
基金Project supported by the Doctoral Fund of Yanshan University (Grant No.B919)the Program of Independent Research for Young Teachers of Yanshan University (Grant No.020000534)the S&T Program of Hebei Province of China (Grant No.QN2016123)。
文摘Controlling mass transportation using intrinsic mechanisms is a challenging topic in nanotechnology.Herein,we employ molecular dynamics simulations to investigate the mass transport inside carbon nanotubes(CNT)with temperature gradients,specifically the effects of adding a static carbon hoop to the outside of a CNT on the transport of a nanomotor inside the CNT.We reveal that the underlying mechanism is the uneven potential energy created by the hoops,i.e.,the hoop outside the CNT forms potential energy barriers or wells that affect mass transport inside the CNT.This fundamental control of directional mass transportation may lead to promising routes for nanoscale actuation and energy conversion.
文摘In this paper, the submicroscopic deterministic concept developed by the author is applied to the problem of the neutrino mass. A particle appears from space considered as a mathematical lattice of primary topological balls, and induces a deformation coat in its surrounding. The principles of the interaction of particles with space and through space between themselves are considered in detail. The approach states that real quarks possess only an integer charge (±e) and when moving they periodically change to the monopole state (⇄g) and hence, canonical particles are dynamic dyons. A neutrino emerges as a squeezed quark when it is in a monopole state, or in other words, the quark monopole state (a bubble in the tessellattice) is transferred to the appropriate lepton monopole state (a speck in the tessellattice). The self-mass (a “rest” mass) for each neutrino flavour is calculated. The calculated value of the self-mass for the electron anti-neutrino is 1.22873978 × 10<sup>-36</sup> kg = 0.68927247 eV/c<sup>2</sup>. The concept of neutrino oscillations is revised, and another postulation is proposed, namely, that the transition from lighter to heavier flavors is due to the inelastic scattering of neutrinos on oncoming scatterers. As a result, the neutrino captures the mass defect, becomes heavier, and therefore the transitions V<sub>e</sub>⟶V<sub>μ</sub> and V<sub>μ</sub>⟶V<sub>τ</sub> occur;thus, the number of light neutrinos decreases in the neutrino flux studied.
基金Supported by the Specific Research Fund of The Innovation Platform for Academicians of Hainan Province,No.YSPTZX202313Hainan Province Clinical Medical Center,No.2021818+1 种基金Hainan Provincial Health Industry Research Project,No.22A200078and Hainan Provincial Postgraduate Innovation Research Project,No.Qhyb2022-133.
文摘BACKGROUND Guidewire slippage into the peritoneal cavity during clinical operations is extremely rare.Therefore,this paper aims to report a successful case of guidewire removal using transgastric natural orifice transluminal endoscopic surgery(NOTES).The goal is to enhance physicians'understanding of the management plan for this unique scenario and provide a valuable reference for clinical practice.CASE SUMMARY A 64-year-old man presented with abdominal distension and was diagnosed with cirrhosis combined with massive ascites.To proceed with treatment,the patient underwent ultrasound-guided peritoneal puncture and underwent catheterization and drainage.Unfortunately,a 0.035-inch guidewire slipped into the abdominal cavity during the procedure.Following a comprehensive evaluation and consultation by a multidisciplinary team,the guidewire was successfully removed using NOTES.CONCLUSION This case highlights the potential consideration of transgastric NOTES removal when encountering a foreign body,such as a guidewire,within the abdominal cavity.
文摘Mathematical physics equations are often utilized to describe physical phenomena in various fields of science and engineering.One such equation is the Fourier equation,which is a commonly used and effective method for evaluating the effectiveness of temperature control measures for mass concrete.One important measure for temperature control in mass concrete is the use of cooling water pipes.However,the mismatch of grids between large-scale concrete models and small-scale cooling pipe models can result in a significant waste of calculation time when using the finite element method.Moreover,the temperature of the water in the cooling pipe needs to be iteratively calculated during the thermal transfer process.The substructure method can effectively solve this problem,and it has been validated by scholars.The Abaqus/Python secondary development technology provides engineers with enough flexibility to combine the substructure method with an iteration algorithm,which enables the creation of a parametric modeling calculation for cooling water pipes.This paper proposes such a method,which involves iterating the water pipe boundary and establishing the water pipe unit substructure to numerically simulate the concrete temperature field that contains a cooling water pipe.To verify the feasibility and accuracy of the proposed method,two classic numerical examples were analyzed.The results showed that this method has good applicability in cooling pipe calculations.When the value of the iteration parameterαis 0.4,the boundary temperature of the cooling water pipes can meet the accuracy requirements after 4∼5 iterations,effectively improving the computational efficiency.Overall,this approach provides a useful tool for engineers to analyze the temperature control measures accurately and efficiently for mass concrete,such as cooling water pipes,using Abaqus/Python secondary development.
文摘Vertical mass isolation(VMI)is one of the novel methods for the seismic control of structures.In this method,the entire structure is assumed to consist of two mass and stiffness subsystems,and an isolated layer is located among them.In this study,the magnetorheological damper in three modes:passive-off,passive-on,and semi-active mode with variable voltage between zero and 9 volts was used as an isolated layer between two subsystems.Multi-degrees-of-freedom structures with 5,10,and 15 floors in two dimensions were examined under 11 pairs of near field earthquakes.On each level,the displacement of MR dampers was taken into account.The responses of maximum displacement,maximum inter-story drift,and maximum base shear in controlled and uncontrolled buildings were compared to assess the suggested approach for seismic control of the structures.According to the results,the semi-active control method can reduce the response by more than 12%compared to the uncontrolled mode in terms of maximum displacement of the mass subsystem of the structures.This method can reduce more than 16%and 20%of the responses compared to the uncontrolled mode in terms of maximum inter-story drift and base shear of the structure,respectively.
文摘Introduction: Carbai tunnel syndrome [CTS] is compression of the median nerve at the wrist , this causes tingling in the hands, pain, numbness, tingling in the fingers particularly the thumb, index and middle fingers, loss of sensation in the hands and fingers, also weakness in the hands. The aim of the present study was to study a possible association which could be found between electrophysiological data in CTS, BMI, hyperlipidemia, and vitamin D [Vit D] levels. Methods: We used a sample of 40 females of the same age group, who were divided into Group 1 as a control consists of 18 healthy females and Group II consisted of 22 age matched females with clinical and electrophysiological evidence of CTS. We measured atherogenic index [AI] as a marker of hyperlipidemia, body mass index [BMI], Vit D status and electrophysiological tests of CTS. Results: Subjects with CTS had deficient Vit D status, they had significantly high atherogenic index (AI), and significant high BMI all compared to control Group I. Median sensory conduction velocity was significantly correlated negatively with BMI and atherogenic index, and positively correlated significantly with Vit D status. But median sensory and motor action potential latency were significantly correlated positively with BMI and atherogenic index, and negatively correlated significantly with Vit D status The analysis revealed BMI, atherogenic index and Vit D status as predictors of median nerve sensory and motor action potential latency and sensory nerve conduction velocity in CTS. Conclusion: The results of this study suggest that obesity and hyperlipidemia are potent CTS risk factors and declared the direct association between Vit D status and CTS occurrence. Our study supports the notion of the compensatory neuroprotective role of Vit D which could have a direct impact on the nerves integrity as it has an anti-inflammatory property which acts in relieving nervous insults and stress. .
文摘BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abdominal paracentesis catheter place-ment and drainage.AIM To explore the influence of different timing for abdominal paracentesis catheter placement and drainage in SAP complicated by intra-abdominal fluid accumu-lation.METHODS Using a retrospective approach,184 cases of SAP complicated by intra-abdominal fluid accumulation were enrolled and categorized into three groups based on the timing of catheter placement:group A(catheter placement within 2 d of symptom onset,n=89),group B(catheter placement between days 3 and 5 after symptom onset,n=55),and group C(catheter placement between days 6 and 7 after symptom onset,n=40).The differences in progression rate,mortality rate,and the number of cases with organ dysfunction were compared among the three groups.RESULTS The progression rate of group A was significantly lower than those in groups B and groups C(2.25%vs 21.82%and 32.50%,P<0.05).Further,the proportion of patients with at least one organ dysfunction in group A was significantly lower than those in groups B and groups C(41.57%vs 70.91%and 75.00%,P<0.05).The mortality rates in group A,group B,and group C were similar(P>0.05).At postoperative day 3,the levels of C-reactive protein(55.41±19.32 mg/L vs 82.25±20.41 mg/L and 88.65±19.14 mg/L,P<0.05),procalcitonin(1.36±0.51 ng/mL vs 3.20±0.97 ng/mL and 3.41±0.98 ng/mL,P<0.05),tumor necrosis factor-alpha(15.12±6.63 pg/L vs 22.26±9.96 pg/L and 23.39±9.12 pg/L,P<0.05),interleukin-6(332.14±90.16 ng/L vs 412.20±88.50 ng/L and 420.08±87.65ng/L,P<0.05),interleukin-8(415.54±68.43 ng/L vs 505.80±66.90 ng/L and 510.43±68.23ng/L,P<0.05)and serum amyloid A(270.06±78.49 mg/L vs 344.41±81.96 mg/L and 350.60±80.42 mg/L,P<0.05)were significantly lower in group A compared to those in groups B and group C.The length of hospital stay in group A was significantly lower than those in groups B and group C(24.50±4.16 d vs 35.54±6.62 d and 38.89±7.10 d,P<0.05).The hospitalization expenses in group A were also significantly lower than those in groups B and groups C[2.70(1.20,3.55)ten-thousand-yuan vs 5.50(2.98,7.12)ten-thousand-yuan and 6.00(3.10,8.05)ten-thousand-yuan,P<0.05).The incidence of complications in group A was markedly lower than that in group C(5.62%vs 25.00%,P<0.05),and similar to group B(P>0.05).CONCLUSION Percutaneous catheter drainage for the treatment of SAP complicated by intra-abdominal fluid accumulation is most effective when performed within 2 d of onset.
基金Fundamental Research Funds for the National Natural Science Foundation of China under Grant No.52078084the Natural Science Foundation of Chongqing (cstc2021jcyj-msxmX0623)+2 种基金the 111 project of the Ministry of Educationthe Bureau of Foreign Experts of China under Grant No.B18062China Postdoctoral Science Foundation under Grant No.2021M690838。
文摘With the rapid development of large megawatt wind turbines,the operation environment of wind turbine towers(WTTs)has become increasingly complex.In particular,seismic excitation can create a resonance response and cause excessive vibration of the WTT.To investigate the vibration attenuation performance of the WTT under seismic excitations,a novel passive vibration control device,called a prestressed tuned mass damper(PS-TMD),is presented in this study.First,a mathematical model is established based on structural dynamics under seismic excitation.Then,the mathematical analytical expression of the dynamic coefficient is deduced,and the parameter design method is obtained by system tuning optimization.Next,based on a theoretical analysis and parameter design,the numerical results showed that the PS-TMD was able to effectively mitigate the resonance under the harmonic basal acceleration.Finally,the time-history analysis method is used to verify the effectiveness of the traditional pendulum tuned mass damper(PTMD)and the novel PS-TMD device,and the results indicate that the vibration attenuation performance of the PS-TMD is better than the PTMD.In addition,the PS-TMD avoids the nonlinear effect due to the large oscillation angle,and has the potential to dissipate hysteretic energy under seismic excitation.
基金This study was approved by the Ethics Committee of Kyushu Rosai Hospital Moji Medical Center(No:04-01,date of approval:June 2,2022).This study was conducted in compliance with the principles of the Declaration of Helsinki.
文摘Background:Recurrent acute cholecystitis(RAC)can occur after non-surgical treatment for acute cholecystitis(AC),and can be more severe in comparison to the first episode of AC.Low skeletal muscle mass or adiposity have various effects in several diseases.We aimed to clarify the relationship between RAC and body parameters.Methods:Patients with AC who were treated at our hospital between January 2011 and March 2022 were enrolled.The psoas muscle mass and adipose tissue area at the third lumbar level were measured using computed tomography at the first episode of AC.The areas were divided by height to obtain the psoas muscle mass index(PMI)and subcutaneous/visceral adipose tissue index(SATI/VATI).According to median VATI,SATI and PMI values by sex,patients were divided into the high and low PMI groups.We performed propensity score matching to eliminate the baseline differences between the high PMI and low PMI groups and analyzed the cumulative incidence and predictors of RAC.Results:The entire cohort was divided into the high PMI(n=81)and low PMI(n=80)groups.In the propensity score-matched cohort there were 57 patients in each group.In Kaplan-Meier analysis,the low PMI group and the high VATI group had a significantly higher cumulative incidence of RAC than their counterparts(log-rank P=0.001 and 0.015,respectively).In a multivariate Cox regression analysis,the hazard ratios of low PMI and low VATI for RAC were 5.250(95%confidence interval 1.083-25.450,P=0.039)and 0.158(95%confidence interval:0.026-0.937,P=0.042),respectively.Conclusions:Low skeletal muscle mass and high visceral adiposity were independent risk factors for RAC.
