AIM:To investigate the short-term effects of commercially available eyelid-cleaning wipes on film parameters.METHODS:This study enrolled 48 healthy participants aged 20-35y(both males and females).Clinical assessment ...AIM:To investigate the short-term effects of commercially available eyelid-cleaning wipes on film parameters.METHODS:This study enrolled 48 healthy participants aged 20-35y(both males and females).Clinical assessment included the Ocular Surface Disease Index(OSDI)questionnaire,non-invasive tear break-up time(NITBUT),tear meniscus height(TMH),and lipid layer pattern(LLP).Based on these initial results,participants were categorized as either non-dry eye or dry eye.Participants in each group were randomly allocated to either Blephaclean■or Systane■treatments.Changes in NITBUT,TMH,and LLP levels before and after lid wipe treatment were assessed.RESULTS:The dry eye group exhibited significantly higher OSDI scores and lower NITBUT and TMH levels than in the non-dry eye group(P<0.001).Following the application of eyelid wipes(Systane■wipes),dry eye subjects experienced a significant improvement in NITBUT levels(P=0.0014)compared to the non-dry eye individuals.Although the remaining participants showed a marginal increase in TMH and NITBUT levels,these changes did not achieve statistical significance(P>0.05).Similarly,the LLP levels were significantly improved with Systane■(P<0.001)post-treatment compared to individuals in the non-dry eye group.However,the dry eye subjects showed higher posttreatment LLP levels than the untreated group(P<0.02).CONCLUSION:The short-term effects of Systane®eyelid wipes on tear film parameters suggest their effectiveness in dry eye disease.Nonetheless,further exploration of their long-term impact is essential to justify their cost effectiveness and efficacy in treating both aqueous deficiency and evaporative dryness.展开更多
Tear film,the outermost layer of the eye,is a complex and dynamic structure responsible for tear production.The tear film lipid layer is a vital component of the tear film that provides a smooth optical surface for th...Tear film,the outermost layer of the eye,is a complex and dynamic structure responsible for tear production.The tear film lipid layer is a vital component of the tear film that provides a smooth optical surface for the cornea and wetting the ocular surface.Dry eye syndrome(DES)is a symptomatic disease caused by reduced tear production,poor tear quality,or excessive evaporation.Its diagnosis is a difficult task due to its multifactorial etiology.Out of several clinical tests available,the evaluation of the interference patterns of the tear film lipid layer forms a potential tool for DES diagnosis.An instrument known as Tearscope Plus allows the rapid assessment of the lipid layer.A grading scale composed of five categories is used to classify lipid layer patterns.The reported work proposes the design of an automatic system employing light weight convolutional neural networks(CNN)and nature inspired optimization techniques to assess the tear film lipid layer patterns by interpreting the images acquired with the Tearscope Plus.The designed framework achieves promising results compared with the existing state-of-the-art techniques.展开更多
Effects of plasma radiation on the nonlinear evolution of neo-classical double tearing modes(NDTMs)in tokamak plasmas with reversed magnetic shear are numerically investigated based on a set of reduced magnetohydrodyn...Effects of plasma radiation on the nonlinear evolution of neo-classical double tearing modes(NDTMs)in tokamak plasmas with reversed magnetic shear are numerically investigated based on a set of reduced magnetohydrodynamics(MHD)equations.Cases with different separations △_(rs)=|r_(s2)-r_(s1)|between the two same rational surfaces are considered.In the small △_(rs)cases,the plasma radiation destabilizes the NDTMs and makes the kinetic energy still grow gradually in the late nonlinear phase.Moreover,the NDTM harmonics with high mode numbers reach a high level in the presence of plasma radiation,forming a broad spectrum of MHD perturbations that induces a radially broadened region of MHD turbulence.As a result,the profiles of safety factors also enter a nonlinear oscillation phase.In the intermediate △_(rs)case,the plasma radiation can advance the explosive burst of kinetic energy that results from the fast driven reconnection between the two rational surfaces,because it can further promote the destabilizing effects of bootstrap current perturbation on the magnetic island near the outer rational surfaces.In the large △_(rs)case,through destabilizing the outer islands significantly,the plasma radiation can even induce the explosive burst in the reversed magnetic shear configuration where the burst cannot be induced in the absence of plasma radiation.展开更多
Objective:This study aimed to explore the clinical efficiency of an improved transosseous pullout suture technique for arthroscopic repair of a meniscus root tear.Methods:From January 2017 to January 2021,53 patients ...Objective:This study aimed to explore the clinical efficiency of an improved transosseous pullout suture technique for arthroscopic repair of a meniscus root tear.Methods:From January 2017 to January 2021,53 patients with posterior meniscus root tears combined with anterior cruciate ligament(ACL)and/or posterior cruciate ligament(PCL)tears were collected.Totally,in 29 patients(group A),the 2.0 mm modified pullout tunnel method was used to suture the posterior meniscus root,while 24 patients(group B)were treated with the traditional 4.5 mm pullout tunnel method.In group A,20 patients had lateral meniscus posterior root(LMPR)combined with ACL tears,5 patients had LMPR combined with ACL and PCL tears,and 4 patients had medial meniscus posterior root(MMPR)combined with ACL tears.In group B,19 patients had LMPR combined with ACL tears,3 patients had LMPR combined with ACL and PCL tears,and 2 patients had MMPR combined with ACL tears.The improvement of the Lysholm and VAS scores and the incidence of complications in group A and group B before the operation,1 month and 3 months after the operation,and after the final follow-up were compared.Results:Preoperative Lysholm score was 26.0±5.6 in group A and 26.7±5.8 in group B(P>0.05).One-month postoperative Lysholm score was 66.5±5.7 in group A and 54.3±2.4 in group B(P<0.001).Three-month postoperative Lysholm score was 81.1±7.2 in group A and 73.2±9.7 in group B(P<0.05).Lysholm scores after the final follow-up was 90.3±5.6 in group A and 90.0±5.0 in group B(P>0.05).Preoperative VAS score was 6.3±1.4 in group A and 6.3±1.2 in group B(P>0.05).One-month postoperative VAS score was 1.8±0.7 in group A and 2.4±0.9 in group B(P<0.05).Three-month postoperative VAS score was 0.7±0.6 in group A and 0.8±0.6 in group B(P>0.05).VAS score after the final follow-up was 0.2±0.4 in group A and 0.3±0.5 in group B(P>0.05).Conclusion:The improved transosseous pullout suture technique using a smaller 2.0 mm bone tunnel can virtually eliminate the risk of conflict with other bone tunnels and facilitate the management of bone tunnels in multiple ligament injuries,while also diminishing suture abrasion caused by the windshield wiper effect.The technique achieves good clinical efficacy.展开更多
·AIM: To detect proteomic differences in tears between adenoid cystic carcinoma(ACC) and pleomorphic adenoma(PA).·METHODS: Tear samples were collected from 4 patients with ACC, 5 with PA, and 4 control cases...·AIM: To detect proteomic differences in tears between adenoid cystic carcinoma(ACC) and pleomorphic adenoma(PA).·METHODS: Tear samples were collected from 4 patients with ACC, 5 with PA, and 4 control cases. Label-free analysis and parallel reaction monitoring(PRM) were used to screen and validate the tear proteome. Gene Ontology(GO) annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG) were conducted for bioinformatics analysis.·RESULTS: In total, 1059 proteins in tear samples were identified by label-free analysis. Between ACC and PA, 415 differentially expressed proteins were detected. Based on the GO annotation, enzyme regulator activity and serinetype endopeptidase inhibitor activity in the molecular function category, blood microparticle and extracellular matrix in the cellular component category, and response to nutrient levels in the biological process category were most predominant. By KEGG pathway annotation, the different proteins between ACC and PA mainly par ticipated in complement and coagulation cascades, amoebiasis, African trypanosomiasis and cholesterol metabolism. Eight proteins with mostly significant differences were verified by PRM, and five proteins with more than 10-fold increases in ACC compared with PA, including integrin β, α-2-macroglobulin, epididymal secretory sperm binding protein Li 78p, RAB5C, and complement C5, were identified.·CONCLUSION: The combined tools of label-free analysis and PRM are very effective and efficient, especially for samples such as tears. Some proteomic dif ferences in tears between ACC and PA are identified and these protein candidates may be specific biomarkers for future exploration.展开更多
AIM:To investigate the relationship between dynamic tear meniscus parameters and dry eye using an automated tear meniscus segmentation method.METHODS:The analysis of tear meniscus videos captured within 5s after a com...AIM:To investigate the relationship between dynamic tear meniscus parameters and dry eye using an automated tear meniscus segmentation method.METHODS:The analysis of tear meniscus videos captured within 5s after a complete blink includes data from 38 participates.By processing video data,several key parameters including the average height of the tear meniscus at different lengths,the curvature of the tear meniscus’s upper boundary,and the total area of the tear meniscus in each frame were calculated.The effective values of these dynamic parameters were then linearly fitted to explore the relationship between their changing trends and dry eye disease.RESULTS:In 94.74%of the samples,the average height of central tear meniscus increased over time.Moreover,97.37%of the samples exhibited an increase in the overall tear meniscus height(TMH)and area from the nasal to temporal side.Notably,the central TMH increased at a faster rate compared to the nasal side with the temporal side showing the slowest ascent.Statistical analysis indicates that the upper boundary curvature of the whole tear meniscus as well as the tear meniscus of the nasal side(2,3,and 4 mm)aid in identifying the presence of dry eye and assessing its severity.CONCLUSION:This study contributes to the understanding of tear meniscus dynamics as potential markers for dry eye,utilizing an automated and non-invasive approach that has implications for clinical assessment.展开更多
The effects of addition of minor amount of(0.5 wt.%) antimony(Sb) or gadolinium(Gd) and combined addition of Sb and Gd(0.5 wt.%,respectively) on the hot tearing susceptibility(HTS) of Mg-5Al-3Ca alloy were investigate...The effects of addition of minor amount of(0.5 wt.%) antimony(Sb) or gadolinium(Gd) and combined addition of Sb and Gd(0.5 wt.%,respectively) on the hot tearing susceptibility(HTS) of Mg-5Al-3Ca alloy were investigated experimentally using a “T-shaped” hot tearing measuring system. Various solidification parameters of the alloys were measured and calculated through thermal analysis experiments. The microstructure, grain size, and morphology of the crack zone were characterized by scanning electron microscopy and electron backscatter diffraction, and the crystal phases of the alloys were analyzed by X-ray diffraction and energy-dispersive X-ray spectroscopy. The results showed that the addition of 0.5 wt.% Gd resulted in the increase in the vulnerable temperature range(Tv) and reduced the eutectic structure content that could participate in feeding, thereby improving the HTS of the alloy. However, addition of 0.5 wt.% Sb or combined addition of Gd and Sb(0.5 wt.%, respectively) to the Mg-5Al-3Ca alloy shortened the Tvand improved the skeleton strength of the alloy, thereby reducing HTS. Moreover, significantly refined structure of Mg-5Al-3Ca-0.5Gd-0.5Sb alloy improved the feeding ability of the eutectic structure, thus the alloy exhibited the lowest HTS.展开更多
Dry eye disease(DED),primarily classified as multifactorial ocular surface disorder,afflicts tens of millions of individuals worldwide,adversely impacting their quality of life.Extensive research has been conducted on...Dry eye disease(DED),primarily classified as multifactorial ocular surface disorder,afflicts tens of millions of individuals worldwide,adversely impacting their quality of life.Extensive research has been conducted on tear film analysis over the past decades,offering a range of tests to evaluate its volume,health,and integrity.Yet,early diagnosis and effective treatment for DED continue to pose significant challenges in clinical settings.Nevertheless,by recognizing key phenomena in DED such as ocular surface inflammation,hyperosmolarity,and tear film instability,this article provides a comprehensive overview of both traditional and recently developed methods for diagnosing and monitoring DED.The information serves as a valuable resource not only for clinical diagnosis but also for further research into DED.展开更多
Both current and pressure coupling schemes have been adopted in the hybrid kinetic–magnetohydrodynamic code CLT-K recently.Numerical equivalences between these two coupling schemes are strictly verified under differe...Both current and pressure coupling schemes have been adopted in the hybrid kinetic–magnetohydrodynamic code CLT-K recently.Numerical equivalences between these two coupling schemes are strictly verified under different approximations.First,when considering only the perturbed distribution function of energetic particles(EPs),the equivalence can be proved analytically.Second,when both the variations of the magnetic field and the EP distribution function are included,the current and pressure coupling schemes numerically produce the same result in the nonlinear simulations.On this basis,the influences of co-/counter-passing and trapped EPs on the linear stabilities of the m/n=2/1 tearing mode(TM)have been investigated(where m and n represent the poloidal and toroidal mode numbers,respectively).The results of scanningβh of EPs show that the co-passing and trapped EPs are found to stabilize the TM,while the counter-passing EPs tend to destabilize the TM.The behind(de)stabilization mechanisms of the TM by EPs are carefully analyzed.Furthermore,after exceeding critical EP betas,the same branch of the high-frequency mode is excited by co-/counterpassing and trapped EPs,which is identified as the m/n=2/1 energetic particle mode.展开更多
BACKGROUND Quantitative studies on the changes in inflammation-related content in tears,especially the effect of diabetes,are lacking.In this study,we measured the preoperative and postoperative tear inflammatory medi...BACKGROUND Quantitative studies on the changes in inflammation-related content in tears,especially the effect of diabetes,are lacking.In this study,we measured the preoperative and postoperative tear inflammatory mediator levels in cataract patients,focusing on the expression of inflammatory factors in postoperative cataracts in the diabetic,and investigated the effect of drugs on the control of postoperative inflammation.AIM To study the expression of inflammatory factors in elderly people with type 2 diabetes after cataract surgery.METHODS Patients with a mean age of 70.3±6.3 years were divided into group A(composed of elderly patients with cataracts and type 2 diabetes,n=20 eyes)and group B(patients with age-related cataract,n=20 eyes).Their tears were collected before each operation and on days 1 and 3,and weeks 1,2,3,and 4 post-surgery.Saline(150μL)was dropped into the conjunctival sac of the surgical eye,followed by oculogyration in four directions.The fluid in the conjunctival sac was extracted using a sterile syringe and stored in Eppendorf tubes at-80°C until measurement.The expression levels of matrix metalloproteinase-2(MMP-2),MMP-9,tissue inhibitor of metalloproteinase-1(TIMP-1),TIMP-2,interleukin-6(IL-6),and IL-20 in tear fluid were measured using enzyme-linked immunosorbent assays.RESULTS The postoperative expression levels of MMP-2,MMP-9,TIMP-2,IL-6,and IL-20 in group A were significantly higher than those in group B,whereas the concentration of TIMP-1 in group A remained lower than that in group B.The levels of MMP-2 and IL-6 in both groups continuously increased until the peak in the first postoperative week,and then gradually decreased over the next three weeks.Ultimately,MMP-2 declined to a lower level than that preoperatively at week 4,but IL-6 decreased to the same level as that preoperatively.The level of MMP-9 peaked in the first two weeks postoperative and then returned to the same level as 1-day post-operation.The concentration of TIMP-1 post-operation remained constant at a lower level than before surgery,and TIMP-2 Levels remained stable in both groups.IL-20 content started to increase in the third week after surgery.CONCLUSION Inflammatory factor levels in tears fluctuated before and post-operation,which indicated more severe postoperative inflammation in the first two weeks.展开更多
BACKGROUND The late presentation of dural tears(LPDT)has a low incidence rate and hidden symptoms and is easily ignored in clinical practice.If the disease is not treated in time,a series of complications may occur,in...BACKGROUND The late presentation of dural tears(LPDT)has a low incidence rate and hidden symptoms and is easily ignored in clinical practice.If the disease is not treated in time,a series of complications may occur,including low intracranial pressure headache,infection,pseudodural cyst formation,and sinus formation.Here,we describe two cases of LPDT.CASE SUMMARY Two patients had sudden fever 1 wk after lumbar surgery.Physical examination showed obvious tenderness in the operation area.The patients were confirmed as having LPDT by lumbar magnetic resonance imaging and surgical exploration.One case was caused by continuous negative pressure suction and malnutrition,and the other was caused by decreased dural ductility and low postoperative nutritional status.The first symptom of both patients was fever,with occasional headache.Both patients underwent secondary surgery to treat the LPDT.Dural defects were observed and dural sealants were used to seal the dural defects,then drainage tubes were retained for drainage.After the operation,the patients were treated with antibiotics and the patients’surgical incisions healed well,without fever or incision tenderness.Both recovered and were discharged 1 wk after the operation.CONCLUSION LPDT is a rare complication of spinal surgery or neurosurgery that has hidden symptoms and can easily be overlooked.Since it may cause a series of complic-ations,LPDT needs to be actively addressed in clinical practice.展开更多
Over the years,several studies demonstrated the crucial role of knee menisci in joint biomechanics.As a result,save the meniscus has become the new imperative nowadays,and more and more studies addressed this topic.Th...Over the years,several studies demonstrated the crucial role of knee menisci in joint biomechanics.As a result,save the meniscus has become the new imperative nowadays,and more and more studies addressed this topic.The huge amount of data on this topic may create confusion in those who want to approach this surgery.The aim of this review is to provide a practical guide for treatment of meniscus tears,including an overview of technical aspects,outcomes in the literature and personal tips.Taking inspiration from a famous movie directed by Sergio Leone in 1966,the authors classified meniscus tears in three categories:The good,the bad and the ugly lesions.The inclusion in each group was determined by the lesion pattern,its biomechanical effects on knee joint,the technical challenge,and prognosis.This classification is not intended to substitute the currently proposed classifications on meniscus tears but aims at offering a readerfriendly narrative review of an otherwise difficult topic.Furthermore,the authors provide a concise premise to deal with some aspects of menisci phylogeny,anatomy and biomechanics.展开更多
BACKGROUND Superior capsular reconstruction(SCR)with long head of biceps tendon(LHBT)transposition was developed to massive and irreparable rotator cuff tears(MIRCTs);however,the outcomes of this technique remain uncl...BACKGROUND Superior capsular reconstruction(SCR)with long head of biceps tendon(LHBT)transposition was developed to massive and irreparable rotator cuff tears(MIRCTs);however,the outcomes of this technique remain unclear.AIM To perform a systematic review of biomechanical outcomes and a meta-analysis of clinical outcomes after LHBT transposition for MIRCTs.METHODS We performed a systematic electronic database search on PubMed,EMBASE,and Cochrane Library.Studies of SCR with LHBT transposition were included according to the inclusion and exclusion criteria.Biomechanical studies were assessed for main results and conclusions.Included clinical studies were evaluated for quality of methodology.Data including study characteristics,cohort demographics,and outcomes were extracted.A meta-analysis was conducted of the clinical outcomes.RESULTS According to our inclusion and exclusion criteria,a total of six biomechanical studies were identified and reported an overall improvement in subacromial contact pressures and prevention of superior humeral migration without limiting range of motion(ROM)after LHBT transposition for MIRCTs.A total of five clinical studies were included in the meta-analysis of LHBT transposition outcomes,consisting of 253 patients.The results indicated that compared to other surgical methods for MIRCTs,LHBT transposition had advantages of more significant improvement in ROM(forward flexion mean difference[MD]=6.54,95%confidence interval[CI]:3.07-10.01;external rotation[MD=5.15,95%CI:1.59-8.17];the acromiohumeral distance[AHD][MD=0.90,95%CI:0.21-1.59])and reducing retear rate(odds ratio=0.27,95%CI:0.15-0.48).No significant difference in American Shoulder and Elbow Surgeons score,visual analogue scale score,and University of California at Los Angles score was demonstrated between these two groups for MIRCTs.CONCLUSION In general,SCR with LHBT transposition was a reliable and economical technique for treating MIRCTs,both in terms of biomechanical and clinical outcomes,with comparable clinical outcomes,improved ROM,AHD,and reduced the retear rates compared to conventional SCR and other established techniques.More high-quality randomized controlled studies on the long-term outcomes of SCR with LHBT transposition are required to further assess.展开更多
Background:Neuroinflammation is an essential event in Parkinson’s disease(PD).Identifying affordable and less invasive biomarkers to make an early diagnosis and monitor therapeutic strategies should be a priority amo...Background:Neuroinflammation is an essential event in Parkinson’s disease(PD).Identifying affordable and less invasive biomarkers to make an early diagnosis and monitor therapeutic strategies should be a priority among researchers.The study’s objective was to measure tear levels of cytokines in subjects with PD and their association with motor features and the presence of dry eye symptoms.Methods:A total of 16 subjects with PD and 16 age-and sex-matched controls were included.Movement Disorders Society-Unified Parkinson’s Disease Rating Scale(MDS-UPDRS),Hoehn and Yahr(HY)stage scale,Montreal Cognitive Assessment(MoCA),tear break-up time(TBUT),blink rate(BR),Dry Eye Questionnaire 5(DEQ-5)were examined,and pro-inflammatory cytokines[interleukin(IL)-1β,IL-6,IL-8,IL-10,IL-12p70 and tumor necrosis factor-alpha(TNF-α)]were quantified in tears using the BD Cytometric Bead Array Human Inflammatory Cytokine Kit.Results:Higher tear TNF-αwere quantified in PD compared to controls(2.94±3.95 vs.0.33±0.49 pg/mL,P=0.008).According to DEQ-5,50.0%(n=8)of PD subjects and 12.5%(n=2)controls had dry eye disease(DED).No differences were found in cytokines concentrations between PD patients with DED compared to those without DED.IL-8 was associated with the HY stage,TBUT,DEQ-5,and a better MoCA score.A higher BR correlated moderately with a lower HY stage(r=−0.645,P=0.007),and DED patients have lower BR in PD(12.14±2.54 vs.9.0±2.06 blinks/minute,P=0.031).Conclusions:PD patients have higher levels of TNF-αin tears than age-and sex-matched HC.IL-8 in tears may be both involved in the severity of the disease and in the development of DED in PD.In addition,our findings suggest that as HY stage increases,indicating a more advanced stage,BR decreases,indicating greater motor impairment.Conversely,the presence of DED is associated with higher levels of bradykinesia in PD patients,suggesting a potential relationship between DED and motor impairment severity.展开更多
Hot tearing is often a major casting defect in magnesium alloys and has a significant impact on the quality of their casting products.Hot tearing of magnesium alloys is a complex solidification phenomenon which is sti...Hot tearing is often a major casting defect in magnesium alloys and has a significant impact on the quality of their casting products.Hot tearing of magnesium alloys is a complex solidification phenomenon which is still not fully understood,it is of great importance to investigate the hot tearing behaviour of magnesium alloys.This review attempts to summarize the investigations on hot tearing of magnesium alloys over the past decades.The hot tearing criteria including recently developed Kou’s criterion are summarized and compared.The numeric simulation and assessing methods of hot tearing,factors influencing hot tearing,and hot tearing susceptibility(HTS)of magnesium alloys are discussed.展开更多
BACKGROUND Arthroscopic procedures are commonly performed for rotator cuff pathology.Repair of rotator cuff tears is a commonly performed procedure.The intraoperative evaluation of the tear size and pattern contribute...BACKGROUND Arthroscopic procedures are commonly performed for rotator cuff pathology.Repair of rotator cuff tears is a commonly performed procedure.The intraoperative evaluation of the tear size and pattern contributes to the choice and completion of the technique and the prognosis of the repair.AIM To compare the arthroscopic and open measurements with the real dimensions of three different patterns of simulated rotator cuff tears of known size using a plastic shoulder model.METHODS We created three sizes and patterns of simulated supraspinatus tears on a plastic shoulder model(small and large U-shaped,oval-shaped).Six orthopaedic surgeons with three levels of experience measured the dimensions of the tears arthroscopically,using a 5 mm probe,repeating the procedure three times,and then using a ruler(open technique).Arthroscopic,open and computerized measurements were compared.RESULTS A constant underestimation of specific dimensions of the tears was found when measured with an arthroscope,compared to both the open and computerized measurements(mean differences up to-7.5±5.8 mm,P<0.001).No differences were observed between the open and computerized measurements(mean difference-0.4±1.6 mm).The accuracy of arthroscopic and open measurements was 90.5%and 98.5%,respectively.When comparing between levels of experience,senior residents reported smaller tear dimensions when compared both to staff surgeons and fellows.CONCLUSION This study suggests that arthroscopic measurements of full-thickness rotator cuff tears constantly underestimate the dimensions of the tears.Development of more precise arthroscopic techniques or tools for the evaluation of the size and type of rotator cuff tears are necessary.展开更多
Lesions of the rotator cuff(RC) are a common occurrence affecting millions of people across all parts of the globe. RC tears are also rampantly prevalent with an agedependent increase in numbers. Other associated fact...Lesions of the rotator cuff(RC) are a common occurrence affecting millions of people across all parts of the globe. RC tears are also rampantly prevalent with an agedependent increase in numbers. Other associated factors include a history of trauma, limb dominance, contralateral shoulder, smoking-status, hypercholesterolemia, posture and occupational dispositions. The challenge lies in early diagnosis since a high proportion of patients are asymptomatic. Pain and decreasing shoulder power and function should alert the heedful practitioner in recognizing promptly the onset or aggravation of existing RC tears. Partial-thickness tears(PTT) can be bursalsided or articular-sided tears. Over the course of time, PTT enlarge and propagate into full-thickness tears(FTT) and develop distinct chronic pathological changes due to muscle retraction, fatty infiltration and muscle atrophy. These lead to a reduction in tendon elasticity and viability. Eventually, the glenohumeral joint experiences a series of degenerative alterations- cuff tear arthropathy. To avert this, a vigilant clinician must utilize and corroborate clinical skill and radiological findings to identify tear progression. Modern radio-diagnostic means of ultrasonography and magnetic resonance imaging provide excellent visualization of structural details and are crucial in determining further course of action for these patients. Physical therapy along with activity modifications, antiinflammatory and analgesic medications form the pillars of nonoperative treatment. Elderly patients with minimal functional demands can be managed conservatively and reassessed at frequent intervals. Regular monitoring helps in isolating patients who require surgical interventions. Early surgery should be considered in younger, active and symptomatic, healthy patients. In addition to being costeffective, this helps in providing a functional shoulder witha stable cuff. An easily reproducible technique of maximal strength and sturdiness should by chosen among the armamentarium of the shoulder surgeon. Grade 1 PTTs do well with debridement while more severe lesions mandate repair either by trans-tendon technique or repair following conversion into FTT. Early repair of repairable FTT can avoid appearance and progression of disability and weakness. The choice of surgery varies from surgeon-to-surgeon with arthroscopy taking the lead in the current scenario. The double-row repairs have an edge over the single-row technique in some patients especially those with massive tears. Stronger, costeffective and improved functional scores can be obtained by the former. Both early and delayed postoperative rehabilitation programmes have led to comparable outcomes. Guarded results may be anticipated in patients in extremes of age, presence of comorbidities and severe tear patters. Overall, satisfactory results are obtained with timely diagnosis and execution of the appropriate treatment modality.展开更多
In this paper,an equation expressing relationship between trapezoid tear strength and fabrictensile properties,weave texture and geomitry of specimen was studied.It could be used to predicttrapezoid tear strength for ...In this paper,an equation expressing relationship between trapezoid tear strength and fabrictensile properties,weave texture and geomitry of specimen was studied.It could be used to predicttrapezoid tear strength for uncoated fabrics well,and also for coated fabrics if multipling a stressconcentration coefficient.The four tear test standard methods(single-rip,double-rip,wing-ripand trapezoid tear)have been adopted to measure the tear strength of fifteen coated fabrics whichwere used for architecture and gencral industrial purposes and the nine corresponding uncoatedfabrics respectively.Analysis and comparison of experimental results showed that there are an ex-cellent correlation between each two methods with the four tear parameters respectively and a goodconsistency of the order of the tear strength for different samples.In addition,the experimental results showed that a good correlation exists between the tenslieproperties and tear strength of coated and uncoated fabrics.展开更多
Objective: To evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) for the detection of partial-thickness rotator cuff tears (PTT) and full-thickness rotator cuff tears(FTT) by comparing its findings w...Objective: To evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) for the detection of partial-thickness rotator cuff tears (PTT) and full-thickness rotator cuff tears(FTT) by comparing its findings with surgical findings as the gold standard and to improve the previous MRI accuracy in diagnosing rotator cuff tears (RCT) considering more variables. Methods: In 45 months, 804 patients underwent MRI shoulder joint. Among them, only 95 cases had undergone both MRI imaging and surgery accordingly. The patient records were evaluated retrospectively if MRI and surgery were performed within 40 days of MRI. MRI findings were categorized into PTT, FTT and no tears which were further divided into different types according to four main nominal data as variables viz. site, size, shape and muscle involvement in RCT and were correlated with surgical findings for statistical calculation by using Kappa coefficient and McNemar Bowker test. Results: 81 patients (86 RCTs) underwent surgery within 40 days. On the basis of site as variable, MRI correctly depicted 100% of full thickness tears(FTT), 85% of bursal partial thickness tears(PTT), 80.4% of articular partial thickness tears(PTT). The consistency in diagnosis of RCT between MRI and surgery was moderate (Kappa coefficient 0.645). Overall sensitivity, specificity and accuracy of MRI for diagnosing PTT was 87.3%, 53.3% and 81.3%;and that for FTT was 100%, 98.7% and 98.8% respectively. Likewise on the basis of size, shape and muscles involved, the consistency between MRI and surgery was poor for size and shape and moderate for muscles involved;and the difference in diagnosing RCT by MRI and surgery was significant for shape (P = 0.002) only, but not significant for size (P = 0.16) and for muscles involved (P = 0.206) respectively. The agreement between MRI and surgery in diagnosing calcific tendinitis and shoulder joint hematoma with Kappa coefficient is (0.577) and (0.556) respectively. Conclusion: MRI has better accuracy for detecting FTT and has high sensitivity and positive predictive value in diagnosing both PTT and FTT. Combining more others variables in addition to RCT, MRI offers a great value in diagnosing RCT.展开更多
文摘AIM:To investigate the short-term effects of commercially available eyelid-cleaning wipes on film parameters.METHODS:This study enrolled 48 healthy participants aged 20-35y(both males and females).Clinical assessment included the Ocular Surface Disease Index(OSDI)questionnaire,non-invasive tear break-up time(NITBUT),tear meniscus height(TMH),and lipid layer pattern(LLP).Based on these initial results,participants were categorized as either non-dry eye or dry eye.Participants in each group were randomly allocated to either Blephaclean■or Systane■treatments.Changes in NITBUT,TMH,and LLP levels before and after lid wipe treatment were assessed.RESULTS:The dry eye group exhibited significantly higher OSDI scores and lower NITBUT and TMH levels than in the non-dry eye group(P<0.001).Following the application of eyelid wipes(Systane■wipes),dry eye subjects experienced a significant improvement in NITBUT levels(P=0.0014)compared to the non-dry eye individuals.Although the remaining participants showed a marginal increase in TMH and NITBUT levels,these changes did not achieve statistical significance(P>0.05).Similarly,the LLP levels were significantly improved with Systane■(P<0.001)post-treatment compared to individuals in the non-dry eye group.However,the dry eye subjects showed higher posttreatment LLP levels than the untreated group(P<0.02).CONCLUSION:The short-term effects of Systane®eyelid wipes on tear film parameters suggest their effectiveness in dry eye disease.Nonetheless,further exploration of their long-term impact is essential to justify their cost effectiveness and efficacy in treating both aqueous deficiency and evaporative dryness.
文摘Tear film,the outermost layer of the eye,is a complex and dynamic structure responsible for tear production.The tear film lipid layer is a vital component of the tear film that provides a smooth optical surface for the cornea and wetting the ocular surface.Dry eye syndrome(DES)is a symptomatic disease caused by reduced tear production,poor tear quality,or excessive evaporation.Its diagnosis is a difficult task due to its multifactorial etiology.Out of several clinical tests available,the evaluation of the interference patterns of the tear film lipid layer forms a potential tool for DES diagnosis.An instrument known as Tearscope Plus allows the rapid assessment of the lipid layer.A grading scale composed of five categories is used to classify lipid layer patterns.The reported work proposes the design of an automatic system employing light weight convolutional neural networks(CNN)and nature inspired optimization techniques to assess the tear film lipid layer patterns by interpreting the images acquired with the Tearscope Plus.The designed framework achieves promising results compared with the existing state-of-the-art techniques.
基金Project supported by the National Key R&D Program of China(Grant No.2022YFE03090000)the National Natural Science Foundation of China(Grant No.11925501)the Fundament Research Funds for the Central Universities(Grant No.DUT22ZD215)。
文摘Effects of plasma radiation on the nonlinear evolution of neo-classical double tearing modes(NDTMs)in tokamak plasmas with reversed magnetic shear are numerically investigated based on a set of reduced magnetohydrodynamics(MHD)equations.Cases with different separations △_(rs)=|r_(s2)-r_(s1)|between the two same rational surfaces are considered.In the small △_(rs)cases,the plasma radiation destabilizes the NDTMs and makes the kinetic energy still grow gradually in the late nonlinear phase.Moreover,the NDTM harmonics with high mode numbers reach a high level in the presence of plasma radiation,forming a broad spectrum of MHD perturbations that induces a radially broadened region of MHD turbulence.As a result,the profiles of safety factors also enter a nonlinear oscillation phase.In the intermediate △_(rs)case,the plasma radiation can advance the explosive burst of kinetic energy that results from the fast driven reconnection between the two rational surfaces,because it can further promote the destabilizing effects of bootstrap current perturbation on the magnetic island near the outer rational surfaces.In the large △_(rs)case,through destabilizing the outer islands significantly,the plasma radiation can even induce the explosive burst in the reversed magnetic shear configuration where the burst cannot be induced in the absence of plasma radiation.
基金supported by the Natural Science Foundation of Hubei Province(No.2018CFC832).
文摘Objective:This study aimed to explore the clinical efficiency of an improved transosseous pullout suture technique for arthroscopic repair of a meniscus root tear.Methods:From January 2017 to January 2021,53 patients with posterior meniscus root tears combined with anterior cruciate ligament(ACL)and/or posterior cruciate ligament(PCL)tears were collected.Totally,in 29 patients(group A),the 2.0 mm modified pullout tunnel method was used to suture the posterior meniscus root,while 24 patients(group B)were treated with the traditional 4.5 mm pullout tunnel method.In group A,20 patients had lateral meniscus posterior root(LMPR)combined with ACL tears,5 patients had LMPR combined with ACL and PCL tears,and 4 patients had medial meniscus posterior root(MMPR)combined with ACL tears.In group B,19 patients had LMPR combined with ACL tears,3 patients had LMPR combined with ACL and PCL tears,and 2 patients had MMPR combined with ACL tears.The improvement of the Lysholm and VAS scores and the incidence of complications in group A and group B before the operation,1 month and 3 months after the operation,and after the final follow-up were compared.Results:Preoperative Lysholm score was 26.0±5.6 in group A and 26.7±5.8 in group B(P>0.05).One-month postoperative Lysholm score was 66.5±5.7 in group A and 54.3±2.4 in group B(P<0.001).Three-month postoperative Lysholm score was 81.1±7.2 in group A and 73.2±9.7 in group B(P<0.05).Lysholm scores after the final follow-up was 90.3±5.6 in group A and 90.0±5.0 in group B(P>0.05).Preoperative VAS score was 6.3±1.4 in group A and 6.3±1.2 in group B(P>0.05).One-month postoperative VAS score was 1.8±0.7 in group A and 2.4±0.9 in group B(P<0.05).Three-month postoperative VAS score was 0.7±0.6 in group A and 0.8±0.6 in group B(P>0.05).VAS score after the final follow-up was 0.2±0.4 in group A and 0.3±0.5 in group B(P>0.05).Conclusion:The improved transosseous pullout suture technique using a smaller 2.0 mm bone tunnel can virtually eliminate the risk of conflict with other bone tunnels and facilitate the management of bone tunnels in multiple ligament injuries,while also diminishing suture abrasion caused by the windshield wiper effect.The technique achieves good clinical efficacy.
文摘·AIM: To detect proteomic differences in tears between adenoid cystic carcinoma(ACC) and pleomorphic adenoma(PA).·METHODS: Tear samples were collected from 4 patients with ACC, 5 with PA, and 4 control cases. Label-free analysis and parallel reaction monitoring(PRM) were used to screen and validate the tear proteome. Gene Ontology(GO) annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG) were conducted for bioinformatics analysis.·RESULTS: In total, 1059 proteins in tear samples were identified by label-free analysis. Between ACC and PA, 415 differentially expressed proteins were detected. Based on the GO annotation, enzyme regulator activity and serinetype endopeptidase inhibitor activity in the molecular function category, blood microparticle and extracellular matrix in the cellular component category, and response to nutrient levels in the biological process category were most predominant. By KEGG pathway annotation, the different proteins between ACC and PA mainly par ticipated in complement and coagulation cascades, amoebiasis, African trypanosomiasis and cholesterol metabolism. Eight proteins with mostly significant differences were verified by PRM, and five proteins with more than 10-fold increases in ACC compared with PA, including integrin β, α-2-macroglobulin, epididymal secretory sperm binding protein Li 78p, RAB5C, and complement C5, were identified.·CONCLUSION: The combined tools of label-free analysis and PRM are very effective and efficient, especially for samples such as tears. Some proteomic dif ferences in tears between ACC and PA are identified and these protein candidates may be specific biomarkers for future exploration.
基金Supported by Medical-Engineering Interdisciplinary Research Foundation of Shenzhen University and Research Development Fund of Beijing Municipal Health Commission(No.2019-4).
文摘AIM:To investigate the relationship between dynamic tear meniscus parameters and dry eye using an automated tear meniscus segmentation method.METHODS:The analysis of tear meniscus videos captured within 5s after a complete blink includes data from 38 participates.By processing video data,several key parameters including the average height of the tear meniscus at different lengths,the curvature of the tear meniscus’s upper boundary,and the total area of the tear meniscus in each frame were calculated.The effective values of these dynamic parameters were then linearly fitted to explore the relationship between their changing trends and dry eye disease.RESULTS:In 94.74%of the samples,the average height of central tear meniscus increased over time.Moreover,97.37%of the samples exhibited an increase in the overall tear meniscus height(TMH)and area from the nasal to temporal side.Notably,the central TMH increased at a faster rate compared to the nasal side with the temporal side showing the slowest ascent.Statistical analysis indicates that the upper boundary curvature of the whole tear meniscus as well as the tear meniscus of the nasal side(2,3,and 4 mm)aid in identifying the presence of dry eye and assessing its severity.CONCLUSION:This study contributes to the understanding of tear meniscus dynamics as potential markers for dry eye,utilizing an automated and non-invasive approach that has implications for clinical assessment.
基金financial support from Joint Research Fund Liaoning-Shenyang National Laboratory for Materials Science (2019JH3/30100014)Liaoning Bai Qian Wan Talents Program. Liaoning Revitalization Talents Program (Nos. XLYC1807021 and 1907007)+2 种基金High Level Innovation Team of Liaoning Province(XLYC1908006)Project of Liaoning Education Department(Nos. LQGD2019002, and LJGD2020008)Liaoning Nature Fund Guidance Plan (No. 2019-ZD-0210)。
文摘The effects of addition of minor amount of(0.5 wt.%) antimony(Sb) or gadolinium(Gd) and combined addition of Sb and Gd(0.5 wt.%,respectively) on the hot tearing susceptibility(HTS) of Mg-5Al-3Ca alloy were investigated experimentally using a “T-shaped” hot tearing measuring system. Various solidification parameters of the alloys were measured and calculated through thermal analysis experiments. The microstructure, grain size, and morphology of the crack zone were characterized by scanning electron microscopy and electron backscatter diffraction, and the crystal phases of the alloys were analyzed by X-ray diffraction and energy-dispersive X-ray spectroscopy. The results showed that the addition of 0.5 wt.% Gd resulted in the increase in the vulnerable temperature range(Tv) and reduced the eutectic structure content that could participate in feeding, thereby improving the HTS of the alloy. However, addition of 0.5 wt.% Sb or combined addition of Gd and Sb(0.5 wt.%, respectively) to the Mg-5Al-3Ca alloy shortened the Tvand improved the skeleton strength of the alloy, thereby reducing HTS. Moreover, significantly refined structure of Mg-5Al-3Ca-0.5Gd-0.5Sb alloy improved the feeding ability of the eutectic structure, thus the alloy exhibited the lowest HTS.
文摘Dry eye disease(DED),primarily classified as multifactorial ocular surface disorder,afflicts tens of millions of individuals worldwide,adversely impacting their quality of life.Extensive research has been conducted on tear film analysis over the past decades,offering a range of tests to evaluate its volume,health,and integrity.Yet,early diagnosis and effective treatment for DED continue to pose significant challenges in clinical settings.Nevertheless,by recognizing key phenomena in DED such as ocular surface inflammation,hyperosmolarity,and tear film instability,this article provides a comprehensive overview of both traditional and recently developed methods for diagnosing and monitoring DED.The information serves as a valuable resource not only for clinical diagnosis but also for further research into DED.
基金supported by National Natural Science Foundation of China(No.11835010)by the National Key Research and Development Program of China(Nos.2019YFE03030004 and 2022YFE031000001)。
文摘Both current and pressure coupling schemes have been adopted in the hybrid kinetic–magnetohydrodynamic code CLT-K recently.Numerical equivalences between these two coupling schemes are strictly verified under different approximations.First,when considering only the perturbed distribution function of energetic particles(EPs),the equivalence can be proved analytically.Second,when both the variations of the magnetic field and the EP distribution function are included,the current and pressure coupling schemes numerically produce the same result in the nonlinear simulations.On this basis,the influences of co-/counter-passing and trapped EPs on the linear stabilities of the m/n=2/1 tearing mode(TM)have been investigated(where m and n represent the poloidal and toroidal mode numbers,respectively).The results of scanningβh of EPs show that the co-passing and trapped EPs are found to stabilize the TM,while the counter-passing EPs tend to destabilize the TM.The behind(de)stabilization mechanisms of the TM by EPs are carefully analyzed.Furthermore,after exceeding critical EP betas,the same branch of the high-frequency mode is excited by co-/counterpassing and trapped EPs,which is identified as the m/n=2/1 energetic particle mode.
基金Supported by Cataract Prevention and Control Appropriate Technology Base of Sichuan Provincial Health Commission(Regional Demonstration),No.2022JDXM012。
文摘BACKGROUND Quantitative studies on the changes in inflammation-related content in tears,especially the effect of diabetes,are lacking.In this study,we measured the preoperative and postoperative tear inflammatory mediator levels in cataract patients,focusing on the expression of inflammatory factors in postoperative cataracts in the diabetic,and investigated the effect of drugs on the control of postoperative inflammation.AIM To study the expression of inflammatory factors in elderly people with type 2 diabetes after cataract surgery.METHODS Patients with a mean age of 70.3±6.3 years were divided into group A(composed of elderly patients with cataracts and type 2 diabetes,n=20 eyes)and group B(patients with age-related cataract,n=20 eyes).Their tears were collected before each operation and on days 1 and 3,and weeks 1,2,3,and 4 post-surgery.Saline(150μL)was dropped into the conjunctival sac of the surgical eye,followed by oculogyration in four directions.The fluid in the conjunctival sac was extracted using a sterile syringe and stored in Eppendorf tubes at-80°C until measurement.The expression levels of matrix metalloproteinase-2(MMP-2),MMP-9,tissue inhibitor of metalloproteinase-1(TIMP-1),TIMP-2,interleukin-6(IL-6),and IL-20 in tear fluid were measured using enzyme-linked immunosorbent assays.RESULTS The postoperative expression levels of MMP-2,MMP-9,TIMP-2,IL-6,and IL-20 in group A were significantly higher than those in group B,whereas the concentration of TIMP-1 in group A remained lower than that in group B.The levels of MMP-2 and IL-6 in both groups continuously increased until the peak in the first postoperative week,and then gradually decreased over the next three weeks.Ultimately,MMP-2 declined to a lower level than that preoperatively at week 4,but IL-6 decreased to the same level as that preoperatively.The level of MMP-9 peaked in the first two weeks postoperative and then returned to the same level as 1-day post-operation.The concentration of TIMP-1 post-operation remained constant at a lower level than before surgery,and TIMP-2 Levels remained stable in both groups.IL-20 content started to increase in the third week after surgery.CONCLUSION Inflammatory factor levels in tears fluctuated before and post-operation,which indicated more severe postoperative inflammation in the first two weeks.
基金Supported by Jilin Health Science and Technology Capability Improvement Project,No.2022C107.
文摘BACKGROUND The late presentation of dural tears(LPDT)has a low incidence rate and hidden symptoms and is easily ignored in clinical practice.If the disease is not treated in time,a series of complications may occur,including low intracranial pressure headache,infection,pseudodural cyst formation,and sinus formation.Here,we describe two cases of LPDT.CASE SUMMARY Two patients had sudden fever 1 wk after lumbar surgery.Physical examination showed obvious tenderness in the operation area.The patients were confirmed as having LPDT by lumbar magnetic resonance imaging and surgical exploration.One case was caused by continuous negative pressure suction and malnutrition,and the other was caused by decreased dural ductility and low postoperative nutritional status.The first symptom of both patients was fever,with occasional headache.Both patients underwent secondary surgery to treat the LPDT.Dural defects were observed and dural sealants were used to seal the dural defects,then drainage tubes were retained for drainage.After the operation,the patients were treated with antibiotics and the patients’surgical incisions healed well,without fever or incision tenderness.Both recovered and were discharged 1 wk after the operation.CONCLUSION LPDT is a rare complication of spinal surgery or neurosurgery that has hidden symptoms and can easily be overlooked.Since it may cause a series of complic-ations,LPDT needs to be actively addressed in clinical practice.
文摘Over the years,several studies demonstrated the crucial role of knee menisci in joint biomechanics.As a result,save the meniscus has become the new imperative nowadays,and more and more studies addressed this topic.The huge amount of data on this topic may create confusion in those who want to approach this surgery.The aim of this review is to provide a practical guide for treatment of meniscus tears,including an overview of technical aspects,outcomes in the literature and personal tips.Taking inspiration from a famous movie directed by Sergio Leone in 1966,the authors classified meniscus tears in three categories:The good,the bad and the ugly lesions.The inclusion in each group was determined by the lesion pattern,its biomechanical effects on knee joint,the technical challenge,and prognosis.This classification is not intended to substitute the currently proposed classifications on meniscus tears but aims at offering a readerfriendly narrative review of an otherwise difficult topic.Furthermore,the authors provide a concise premise to deal with some aspects of menisci phylogeny,anatomy and biomechanics.
基金the National Natural Science Foundation of China,No.81972125 and No.82172510.
文摘BACKGROUND Superior capsular reconstruction(SCR)with long head of biceps tendon(LHBT)transposition was developed to massive and irreparable rotator cuff tears(MIRCTs);however,the outcomes of this technique remain unclear.AIM To perform a systematic review of biomechanical outcomes and a meta-analysis of clinical outcomes after LHBT transposition for MIRCTs.METHODS We performed a systematic electronic database search on PubMed,EMBASE,and Cochrane Library.Studies of SCR with LHBT transposition were included according to the inclusion and exclusion criteria.Biomechanical studies were assessed for main results and conclusions.Included clinical studies were evaluated for quality of methodology.Data including study characteristics,cohort demographics,and outcomes were extracted.A meta-analysis was conducted of the clinical outcomes.RESULTS According to our inclusion and exclusion criteria,a total of six biomechanical studies were identified and reported an overall improvement in subacromial contact pressures and prevention of superior humeral migration without limiting range of motion(ROM)after LHBT transposition for MIRCTs.A total of five clinical studies were included in the meta-analysis of LHBT transposition outcomes,consisting of 253 patients.The results indicated that compared to other surgical methods for MIRCTs,LHBT transposition had advantages of more significant improvement in ROM(forward flexion mean difference[MD]=6.54,95%confidence interval[CI]:3.07-10.01;external rotation[MD=5.15,95%CI:1.59-8.17];the acromiohumeral distance[AHD][MD=0.90,95%CI:0.21-1.59])and reducing retear rate(odds ratio=0.27,95%CI:0.15-0.48).No significant difference in American Shoulder and Elbow Surgeons score,visual analogue scale score,and University of California at Los Angles score was demonstrated between these two groups for MIRCTs.CONCLUSION In general,SCR with LHBT transposition was a reliable and economical technique for treating MIRCTs,both in terms of biomechanical and clinical outcomes,with comparable clinical outcomes,improved ROM,AHD,and reduced the retear rates compared to conventional SCR and other established techniques.More high-quality randomized controlled studies on the long-term outcomes of SCR with LHBT transposition are required to further assess.
基金supported by Hospital Fundacion Nuestra Senora de la Luz,Private Assistance Institution.
文摘Background:Neuroinflammation is an essential event in Parkinson’s disease(PD).Identifying affordable and less invasive biomarkers to make an early diagnosis and monitor therapeutic strategies should be a priority among researchers.The study’s objective was to measure tear levels of cytokines in subjects with PD and their association with motor features and the presence of dry eye symptoms.Methods:A total of 16 subjects with PD and 16 age-and sex-matched controls were included.Movement Disorders Society-Unified Parkinson’s Disease Rating Scale(MDS-UPDRS),Hoehn and Yahr(HY)stage scale,Montreal Cognitive Assessment(MoCA),tear break-up time(TBUT),blink rate(BR),Dry Eye Questionnaire 5(DEQ-5)were examined,and pro-inflammatory cytokines[interleukin(IL)-1β,IL-6,IL-8,IL-10,IL-12p70 and tumor necrosis factor-alpha(TNF-α)]were quantified in tears using the BD Cytometric Bead Array Human Inflammatory Cytokine Kit.Results:Higher tear TNF-αwere quantified in PD compared to controls(2.94±3.95 vs.0.33±0.49 pg/mL,P=0.008).According to DEQ-5,50.0%(n=8)of PD subjects and 12.5%(n=2)controls had dry eye disease(DED).No differences were found in cytokines concentrations between PD patients with DED compared to those without DED.IL-8 was associated with the HY stage,TBUT,DEQ-5,and a better MoCA score.A higher BR correlated moderately with a lower HY stage(r=−0.645,P=0.007),and DED patients have lower BR in PD(12.14±2.54 vs.9.0±2.06 blinks/minute,P=0.031).Conclusions:PD patients have higher levels of TNF-αin tears than age-and sex-matched HC.IL-8 in tears may be both involved in the severity of the disease and in the development of DED in PD.In addition,our findings suggest that as HY stage increases,indicating a more advanced stage,BR decreases,indicating greater motor impairment.Conversely,the presence of DED is associated with higher levels of bradykinesia in PD patients,suggesting a potential relationship between DED and motor impairment severity.
基金the National Natural Science Foundation of China(Project 51531002,51474043)the Ministry of Science&Technology of China(2013DFA71070)+1 种基金the Ministry of Education of China(SRFDR 20130191110018)Chongqing Municipal Government(CSTC2013JCYJC60001,CEC project,Two River Scholar Project and The Chief Scientist Studio Project).
文摘Hot tearing is often a major casting defect in magnesium alloys and has a significant impact on the quality of their casting products.Hot tearing of magnesium alloys is a complex solidification phenomenon which is still not fully understood,it is of great importance to investigate the hot tearing behaviour of magnesium alloys.This review attempts to summarize the investigations on hot tearing of magnesium alloys over the past decades.The hot tearing criteria including recently developed Kou’s criterion are summarized and compared.The numeric simulation and assessing methods of hot tearing,factors influencing hot tearing,and hot tearing susceptibility(HTS)of magnesium alloys are discussed.
文摘BACKGROUND Arthroscopic procedures are commonly performed for rotator cuff pathology.Repair of rotator cuff tears is a commonly performed procedure.The intraoperative evaluation of the tear size and pattern contributes to the choice and completion of the technique and the prognosis of the repair.AIM To compare the arthroscopic and open measurements with the real dimensions of three different patterns of simulated rotator cuff tears of known size using a plastic shoulder model.METHODS We created three sizes and patterns of simulated supraspinatus tears on a plastic shoulder model(small and large U-shaped,oval-shaped).Six orthopaedic surgeons with three levels of experience measured the dimensions of the tears arthroscopically,using a 5 mm probe,repeating the procedure three times,and then using a ruler(open technique).Arthroscopic,open and computerized measurements were compared.RESULTS A constant underestimation of specific dimensions of the tears was found when measured with an arthroscope,compared to both the open and computerized measurements(mean differences up to-7.5±5.8 mm,P<0.001).No differences were observed between the open and computerized measurements(mean difference-0.4±1.6 mm).The accuracy of arthroscopic and open measurements was 90.5%and 98.5%,respectively.When comparing between levels of experience,senior residents reported smaller tear dimensions when compared both to staff surgeons and fellows.CONCLUSION This study suggests that arthroscopic measurements of full-thickness rotator cuff tears constantly underestimate the dimensions of the tears.Development of more precise arthroscopic techniques or tools for the evaluation of the size and type of rotator cuff tears are necessary.
文摘Lesions of the rotator cuff(RC) are a common occurrence affecting millions of people across all parts of the globe. RC tears are also rampantly prevalent with an agedependent increase in numbers. Other associated factors include a history of trauma, limb dominance, contralateral shoulder, smoking-status, hypercholesterolemia, posture and occupational dispositions. The challenge lies in early diagnosis since a high proportion of patients are asymptomatic. Pain and decreasing shoulder power and function should alert the heedful practitioner in recognizing promptly the onset or aggravation of existing RC tears. Partial-thickness tears(PTT) can be bursalsided or articular-sided tears. Over the course of time, PTT enlarge and propagate into full-thickness tears(FTT) and develop distinct chronic pathological changes due to muscle retraction, fatty infiltration and muscle atrophy. These lead to a reduction in tendon elasticity and viability. Eventually, the glenohumeral joint experiences a series of degenerative alterations- cuff tear arthropathy. To avert this, a vigilant clinician must utilize and corroborate clinical skill and radiological findings to identify tear progression. Modern radio-diagnostic means of ultrasonography and magnetic resonance imaging provide excellent visualization of structural details and are crucial in determining further course of action for these patients. Physical therapy along with activity modifications, antiinflammatory and analgesic medications form the pillars of nonoperative treatment. Elderly patients with minimal functional demands can be managed conservatively and reassessed at frequent intervals. Regular monitoring helps in isolating patients who require surgical interventions. Early surgery should be considered in younger, active and symptomatic, healthy patients. In addition to being costeffective, this helps in providing a functional shoulder witha stable cuff. An easily reproducible technique of maximal strength and sturdiness should by chosen among the armamentarium of the shoulder surgeon. Grade 1 PTTs do well with debridement while more severe lesions mandate repair either by trans-tendon technique or repair following conversion into FTT. Early repair of repairable FTT can avoid appearance and progression of disability and weakness. The choice of surgery varies from surgeon-to-surgeon with arthroscopy taking the lead in the current scenario. The double-row repairs have an edge over the single-row technique in some patients especially those with massive tears. Stronger, costeffective and improved functional scores can be obtained by the former. Both early and delayed postoperative rehabilitation programmes have led to comparable outcomes. Guarded results may be anticipated in patients in extremes of age, presence of comorbidities and severe tear patters. Overall, satisfactory results are obtained with timely diagnosis and execution of the appropriate treatment modality.
文摘In this paper,an equation expressing relationship between trapezoid tear strength and fabrictensile properties,weave texture and geomitry of specimen was studied.It could be used to predicttrapezoid tear strength for uncoated fabrics well,and also for coated fabrics if multipling a stressconcentration coefficient.The four tear test standard methods(single-rip,double-rip,wing-ripand trapezoid tear)have been adopted to measure the tear strength of fifteen coated fabrics whichwere used for architecture and gencral industrial purposes and the nine corresponding uncoatedfabrics respectively.Analysis and comparison of experimental results showed that there are an ex-cellent correlation between each two methods with the four tear parameters respectively and a goodconsistency of the order of the tear strength for different samples.In addition,the experimental results showed that a good correlation exists between the tenslieproperties and tear strength of coated and uncoated fabrics.
文摘Objective: To evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) for the detection of partial-thickness rotator cuff tears (PTT) and full-thickness rotator cuff tears(FTT) by comparing its findings with surgical findings as the gold standard and to improve the previous MRI accuracy in diagnosing rotator cuff tears (RCT) considering more variables. Methods: In 45 months, 804 patients underwent MRI shoulder joint. Among them, only 95 cases had undergone both MRI imaging and surgery accordingly. The patient records were evaluated retrospectively if MRI and surgery were performed within 40 days of MRI. MRI findings were categorized into PTT, FTT and no tears which were further divided into different types according to four main nominal data as variables viz. site, size, shape and muscle involvement in RCT and were correlated with surgical findings for statistical calculation by using Kappa coefficient and McNemar Bowker test. Results: 81 patients (86 RCTs) underwent surgery within 40 days. On the basis of site as variable, MRI correctly depicted 100% of full thickness tears(FTT), 85% of bursal partial thickness tears(PTT), 80.4% of articular partial thickness tears(PTT). The consistency in diagnosis of RCT between MRI and surgery was moderate (Kappa coefficient 0.645). Overall sensitivity, specificity and accuracy of MRI for diagnosing PTT was 87.3%, 53.3% and 81.3%;and that for FTT was 100%, 98.7% and 98.8% respectively. Likewise on the basis of size, shape and muscles involved, the consistency between MRI and surgery was poor for size and shape and moderate for muscles involved;and the difference in diagnosing RCT by MRI and surgery was significant for shape (P = 0.002) only, but not significant for size (P = 0.16) and for muscles involved (P = 0.206) respectively. The agreement between MRI and surgery in diagnosing calcific tendinitis and shoulder joint hematoma with Kappa coefficient is (0.577) and (0.556) respectively. Conclusion: MRI has better accuracy for detecting FTT and has high sensitivity and positive predictive value in diagnosing both PTT and FTT. Combining more others variables in addition to RCT, MRI offers a great value in diagnosing RCT.
