Introduction: Superior mesenteric artery syndrome (SMAS), a rare diagnosis due to compression of the third duodenum between the superior mesenteric artery (SMA) and the aorta resulting in bowel obstruction, may lead t...Introduction: Superior mesenteric artery syndrome (SMAS), a rare diagnosis due to compression of the third duodenum between the superior mesenteric artery (SMA) and the aorta resulting in bowel obstruction, may lead to severe malnutrition. We report two cases of patients hospitalised in the Internal Medicine, Endocrinology, Diabetology, and Nutrition Department of the National Hospital Center (NHC) of Pikine. Observations: Patient 1: A 35-year-old female was referred for an aetiological diagnosis due to a rapid weight loss of 15 kilograms in one month, accompanied by persistent vomiting, following an appendectomy performed a month before admission. Upon clinical examination, she presented severe malnutrition (Buzby index of 76%), early post-prandial chronic vomiting, and a poor general condition. An abdominal CT scan revealed aortomesenteric clamp syndrome (AMCS) with an angulation between the aorta and the SMA of 13˚. The underlying cause in this patient was severe malnutrition. Fortunately, her condition improved with medical treatment. Patient 2: We report the case of a 30-year-old female hospitalized due to unusual weight-bearing post-prandial epigastric pain and intermittent vomiting over the past six months. Upon physical examination at admission, she exhibited severe malnutrition with a body mass index (BMI) of 14 kg/m<sup>2</sup>, a Buzby index of 71%, trophic disorders, and a stage IV general condition assessment according to the World Health Organization (WHO). An abdominal CT scan revealed AMCS with an angle between the aorta and the SMA of 22˚ and an aortomesenteric space of 4 mm. The outcome was poor with medical treatment failure and, unfortunately, the patient died before surgery. Conclusion: SMAS is rarely evoked in clinical practice despite the presence of contributing factors and suggestive clinical signs. The prognosis depends on management time.展开更多
BACKGROUND Superior mesenteric artery(SMA)syndrome is a rare cause of duodenal obstruction by extrinsic compression between the SMA and the aorta(SMA-Ao).Although the left lateral recumbent position is considered effe...BACKGROUND Superior mesenteric artery(SMA)syndrome is a rare cause of duodenal obstruction by extrinsic compression between the SMA and the aorta(SMA-Ao).Although the left lateral recumbent position is considered effective in the treatment of SMA syndrome,individual variations in the optimal patient position have been noted.In this report,we present two elderly cases of SMA syndrome that exhibited rapid recovery due to ultrasonographic dynamic evaluation of the optimal position for each patient.CASE SUMMARY Case 1:A 90-year-old man with nausea and vomiting.Following diagnosis of SMA syndrome by computed tomography(CT),ultrasonography(US)revealed the SMA-Ao distance in the supine position(4 mm),which slightly improved in the lateral position(5.7–7.0 mm)without the passage of duodenal contents.However,in the sitting position,the SMA-Ao distance was increased to 15 mm accompanied by improved content passage.Additionally,US indicated enhanced passage upon abdominal massage on the right side.By day 2,the patient could eat comfortably with the optimal position and massage.Case 2:An 87-year-old woman with vomiting.After the diagnosis of SMA syndrome and aspiration pneumonia by CT,dynamic US confirmed the optimal position(SMA-Ao distance was improved to 7 mm in forward-bent position,whereas it remained at 5 mm in the supine position).By day 7 when her pneumonia recovered,she could eat with the optimal position.CONCLUSION The optimal position for SMA syndrome varies among individuals.Dynamic US appears to be a valuable tool in improving patient outcomes.展开更多
BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with sev...BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with severe pneumonia success-fully treated by V-V ECMO,but during treatment,the retrovenous catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.The ECMO was safely withdrawn after multidiscip-linary consultation.Our experience with this case is expected to provide a reference for colleagues who will encounter similar situations.CASE SUMMARY A 64-year-old man had severe pulmonary infection and respiratory failure.He was admitted to our hospital and was given ventilation support(fraction of inspired oxygen 100%).The respiratory failure was not improved and he was treated by V-V ECMO,during which the venous return catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.There was a risk of massive mediastinal bleeding if the catheter was removed directly when the ECMO was withdrawn.Finally,the patient underwent vena cava angiography+balloon attachment+ECMO with-drawal in the operating room(prepared for conversion to thoracotomy for vascular exploration and repair at any time during surgery)after multidiscip-linary consultation.ECMO was safely withdrawn,and the patient recovered and was discharged.CONCLUSION Patients may have different vascular conditions.Multidisciplinary cooperation can ensure patient safety.Our experience will provide a reference for similar cases.展开更多
Electrolytic aqueous zinc-manganese(Zn–Mn) batteries have the advantage of high discharge voltage and high capacity due to two-electron reactions. However, the pitfall of electrolytic Zn–Mn batteries is the sluggish...Electrolytic aqueous zinc-manganese(Zn–Mn) batteries have the advantage of high discharge voltage and high capacity due to two-electron reactions. However, the pitfall of electrolytic Zn–Mn batteries is the sluggish deposition reaction kinetics of manganese oxide during the charge process and short cycle life. We show that, incorporating ZnO electrolyte additive can form a neutral and highly viscous gel-like electrolyte and render a new form of electrolytic Zn–Mn batteries with significantly improved charging capabilities. Specifically, the ZnO gel-like electrolyte activates the zinc sulfate hydroxide hydrate assisted Mn^(2+) deposition reaction and induces phase and structure change of the deposited manganese oxide(Zn_(2)Mn_(3)O_8·H_(2)O nanorods array), resulting in a significant enhancement of the charge capability and discharge efficiency. The charge capacity increases to 2.5 mAh cm^(-2) after 1 h constant-voltage charging at 2.0 V vs. Zn/Zn^(2+), and the capacity can retain for up to 2000 cycles with negligible attenuation. This research lays the foundation for the advancement of electrolytic Zn–Mn batteries with enhanced charging capability.展开更多
BACKGROUND Regarding the incidence of malignant tumors in China,the incidence of liver cancer ranks fourth,second only to lung,gastric,and esophageal cancers.The case fatality rate ranks third after lung and cervical ...BACKGROUND Regarding the incidence of malignant tumors in China,the incidence of liver cancer ranks fourth,second only to lung,gastric,and esophageal cancers.The case fatality rate ranks third after lung and cervical cancer.In a previous study,the whole-process management model was applied to patients with breast cancer,which effectively reduced their negative emotions and improved treatment adherence and nursing satisfaction.METHODS In this single-center,randomized,controlled study,60 randomly selected patients with liver cancer who had been admitted to our hospital from January 2021 to January 2022 were randomly divided into an observation group(n=30),who received whole-process case management on the basis of routine nursing mea-sures,and a control group(n=30),who were given routine nursing measures.We compared differences between the two groups in terms of anxiety,depression,the level of hope,self-care ability,symptom distress,sleep quality,and quality of life.RESULTS Post-intervention,Hamilton anxiety scale,Hamilton depression scale,memory symptom assessment scale,and Pittsburgh sleep quality index scores in both groups were lower than those pre-intervention,and the observation group had lower scores than the control group(P<0.05).Herth hope index,self-care ability assessment scale-revision in Chinese,and quality of life measurement scale for patients with liver cancer scores in both groups were higher than those pre-intervention,with higher scores in the observation group compared with the control group(P<0.05).CONCLUSION Whole-process case management can effectively reduce anxiety and depression in patients with liver cancer,alleviate symptoms and problems,and improve the level of hope,self-care ability,sleep quality,and quality of life,as well as provide feasible nursing alternatives for patients with liver cancer.展开更多
Aims: The present study aims to compare the assessment of work ability based on the use of the Work Ability Index (WAI) with another questionnaire base only on the use of WAI’s first item, termed as the “Work Abilit...Aims: The present study aims to compare the assessment of work ability based on the use of the Work Ability Index (WAI) with another questionnaire base only on the use of WAI’s first item, termed as the “Work Ability Score” (WAS). Study design: A cohort of 384 Spanish workers included in a Post COVID-19 condition or persistent COVID-19 multicenter research was utilized. Place and Duration of Study: This cohort was enlisted in four hospitals (Hospital Universitario 12 de Octubre, Madrid;Hospital Universitario Virgen Macarena, Sevilla, Andalucía;Hospital Universitario Gregorio Marañón, Madrid and Complejo Asistencial Universitario de Salamanca, Castilla y León), since 2021 until 2022. Methodology: 384 Spanish workers (176 men and 208 women;aged 20 to 70 years) with Post COVID-19 condition or persistent COVID-19 were included. Descriptive analysis of primary scores was conducted. Given the non-normal distribution of data, the Mann-Whitney and Kruskal-Wallis tests were employed. Spearman and Kendall correlations were employed to assess the relationship between WAI and WAS, also used weighted Kappa to estimate the degree agreement between WAI and WAS. Logistic regression models were utilized to study determinants influencing WAI and WAS, categorized as poor or moderate. Results: WAI had an average score of 32.98 (SD = 10.28), whereas WAS had an average of 5.95 (SD = 2.77). Significant differences were observed in both WAI and WAS across the same variables. Strong and statistically significant correlations were evident between WAI and WAS (rs = 0.83, p < 0.001). All the variables used in the logistic regression model (gender, the sector employment, and previous chronic diseases) were statistically significant in both questionnaires. Conclusion: WAS questionnaire could be used as a tool for reliable assessment of work ability among Spanish workers with Post COVID-19 condition or Persistent CO-VID-19.展开更多
This paper takes college students as research subjects to investigate the factors affecting L2 Reading ability and their regulation strategies through scale surveys.The findings are as follows:(1)Linguistic factors ha...This paper takes college students as research subjects to investigate the factors affecting L2 Reading ability and their regulation strategies through scale surveys.The findings are as follows:(1)Linguistic factors have significant impacts on L2 Reading ability,and the influence of non-linguistic factors,such as non-intellectual factors and cultural background knowledge,is also important;and(2)flexible use of reading regulation strategies according to the learning conditions(such as the information extraction strategy,the metacognitive reading regulation strategy,and the interactive reading strategy)can effectively improve learners’L2 Reading ability.The findings of this study have important theoretical and practical value for improving L2 learners’Reading ability.展开更多
BACKGROUND Postoperative complications remain a paramount concern for surgeons and healthcare practitioners.AIM To present a comprehensive analysis of the Estimation of Physiologic Ability and Surgical Stress(E-PASS)s...BACKGROUND Postoperative complications remain a paramount concern for surgeons and healthcare practitioners.AIM To present a comprehensive analysis of the Estimation of Physiologic Ability and Surgical Stress(E-PASS)scoring system’s efficacy in predicting postoperative complications following abdominal surgery.METHODS A systematic search of published studies was conducted,yielding 17 studies with pertinent data.Parameters such as preoperative risk score(PRS),surgical stress score(SSS),comprehensive risk score(CRS),postoperative complications,post-operative mortality,and other clinical data were collected for meta-analysis.Forest plots were employed for continuous and binary variables,withχ2 tests assessing heterogeneity(P value).RESULTS Patients experiencing complications after abdominal surgery exhibited significantly higher E-PASS scores compared to those without complications[mean difference and 95%confidence interval(CI)of PRS:0.10(0.05-0.15);SSS:0.04(0.001-0.08);CRS:0.19(0.07-0.31)].Following the exclusion of low-quality studies,results remained valid with no discernible heterogeneity.Subgroup analysis indicated that variations in sample size and age may contribute to hetero-geneity in CRS analysis.Binary variable meta-analysis demonstrated a correlation between high CRS and increased postoperative complication rates[odds ratio(OR)(95%CI):3.01(1.83-4.95)],with a significant association observed between high CRS and postoperative mortality[OR(95%CI):15.49(3.75-64.01)].CONCLUSION In summary,postoperative complications in abdominal surgery,as assessed by the E-PASS scoring system,are consistently linked to elevated PRS,SSS,and CRS scores.High CRS scores emerge as risk factors for heightened morbidity and mortality.This study establishes the accuracy of the E-PASS scoring system in predicting postoperative morbidity and mortality in abdominal surgery,underscoring its potential for widespread adoption in effective risk assessment.展开更多
By constructing a model,this study seeks to provide suggestions for strengthening pre-service teachers’informatization teaching ability.It aims to answer the following research questions:(1)What do the pre-service te...By constructing a model,this study seeks to provide suggestions for strengthening pre-service teachers’informatization teaching ability.It aims to answer the following research questions:(1)What do the pre-service teachers know about informatization instruction?What is their level of informatization teaching ability?(2)What factors influence pre-service teachers’ability to deliver informatization instruction?How to overcome the obstacles?The inquiry focuses on the theoretical exploration of informatization teaching ability,questionnaire,and interview analysis on the current condition and improvement of pre-service teachers’informatization teaching ability.The data from the questionnaire and interview of the pre-service teachers were evaluated from three dimensions:awareness and attitude towards informatization teaching,knowledge of informatization teaching,and the ability to apply informatization teaching skills innovatively and comprehensively.The 3S-7D(Three Subjects and Seven Duties)model consisting of three subjects and the seven duties that go with them is established.The three subjects include pre-service teachers,teacher educators,and higher education schools.The seven duties involve pre-service teachers demonstrating learning motivation,cross-discipline thinking,and information and communications technology mastery;teacher educators actively constructing informatization teaching practice and formative assessment;and higher education schools providing adequate hardware and software equipment while offering cooperative opportunities with primary and junior schools through institutionalization.展开更多
Innovation ability is the ability to continuously provide new ideas,theories,methods,and inventions with economic,social,and ecological values in the fields of technology and various practical activities.The ideologic...Innovation ability is the ability to continuously provide new ideas,theories,methods,and inventions with economic,social,and ecological values in the fields of technology and various practical activities.The ideological and political education of vocational school students should be student-oriented and close to reality and life.It is necessary to improve the pertinence,effectiveness,attractiveness,and infectiousness of ideological and political education,and cultivate socialist builders and successors with all-round development of morality,intelligence,physique,and beauty.In this paper,we investigate and understand the practice of innovation ability education in colleges and universities at home and abroad,especially the current situation of professional practice teaching in Xinjiang Vocational Colleges.The construction of a professional practice base in vocational colleges is systematically studied.展开更多
Objective: It remains unknown whether calcium metabolism has any effect on the clinical presentation of superior semicircular canal dehiscence(SSCD). Our aim was to analyse the adjusted calcium and vitamin D levels in...Objective: It remains unknown whether calcium metabolism has any effect on the clinical presentation of superior semicircular canal dehiscence(SSCD). Our aim was to analyse the adjusted calcium and vitamin D levels in SSCD patients compared to a control group.Methods: This was a prospective case-control study performed in a tertiary referral center, university teaching hospital in the UK. It included all new patients with SSCD seen in a dedicated skull base clinic over a 5-year period(2015-2019) compared to a gender and age matched control group. The main outcome of the study was adjusted calcium and Vitamin D levels between the two groups.Results: A total of 31 SSCD patients were recruited with a matched number of control patients. The mean Vitamin D level on the SSCD group was 44.8 nmoL/l(SD: 20.8) compared to 47.5 nmoL/l(SD: 27.4) on the control group(p = 0.702). Mean Adjusted calcium level was 2.34 mmoL/l(SD: 0.7) for SSCD compared to2.41 mmoL/l(SD: 0.11) for controls(p = 0.01), being within normal limits for both the SSCD and the control group.Conclusion: Our study did not identify a link between Vitamin D levels and presence of SSCD. Normal adjusted calcium values were found in both groups. Despite that a statistically significant lower calcium level was found in the SSCD group which could indicate that suboptimal levels of calcium may affect the micro-environment of the otic capsule at the SSC region.展开更多
Superior mesenteric artery(SMA)syndrome(also known as Wilkie's syndrome,cast syndrome,or aorto-mesenteric compass syndrome)is an obstruction of the duodenum caused by extrinsic compression between the SMA and the ...Superior mesenteric artery(SMA)syndrome(also known as Wilkie's syndrome,cast syndrome,or aorto-mesenteric compass syndrome)is an obstruction of the duodenum caused by extrinsic compression between the SMA and the aorta.The median age of patients is 23 years old(range 0-91 years old)and predominant in females over males with a ratio of 3:2.The symptoms are variable,consisting of postprandial abdominal pain,nausea and vomiting,early satiety,anorexia,and weight loss and can mimic anorexia nervosa or functional dyspepsia.Because recurrent vomiting leads to aspiration pneumonia or respiratory depression via metabolic alkalosis,early diagnosis is required.The useful diagnostic modalities are computed tomography as a standard tool and ultrasonography,which has advantages in safety and capability of real-time assessments of SMA mobility and duodenum passage.The initial treatment is usually conservative,including postural change,gastroduodenal decompression,and nutrient management(success rates:70%-80%).If conservative therapy fails,surgical treatment(i.e.,laparoscopic duodenojejunostomy)is recommended(success rates:80%-100%).展开更多
Background High temperature stress at peak flowering stage of cotton is a major hindrance for crop potential.This study aimed to increase genetic divergence regarding heat tolerance in newly developed cultivars and hy...Background High temperature stress at peak flowering stage of cotton is a major hindrance for crop potential.This study aimed to increase genetic divergence regarding heat tolerance in newly developed cultivars and hybrids.Fifty cotton genotypes and 40 F1(hybrids)were tested under field conditions following the treatments,viz.,high temperature stress and control at peak flowering stage in August and October under April and June sowing,respectively.Results The mean squares revealed significant differences among genotypes,treatments,genotype×treatment for relative cell injury,chlorophyll contents,canopy temperature,boll retention and seed cotton yield per plant.The genetic diversity among 50 genotypes was analyzed through cluster analysis and heat susceptibility index(HSI).The heat tolerant genotypes including FH-Noor,NIAB-545,FH-466,FH-Lalazar,FH-458,NIAB-878,IR-NIBGE-8,Weal-AGShahkar,and heat sensitive,i.e.,CIM-602,Silky-3,FH-326,SLH-12 and FH-442 were hybridized in line×tester fashion to produce F1 populations.The breeding materials’populations(40 F1)revealed higher specific combining ability variances along with dominance variances,decided the non-additive type gene action for all the traits.The best general combining ability effects for most of the traits were displayed by the lines,i.e.,FH-Lalazar,NIAB-878 along with testers FH-326 and Silky-3.Specific combining ability effects and better-parent heterosis were showed by the crosses,viz.,FH-Lalazar×Silky-3,FH-Lalazar×FH-326,NIAB-878×Silky-3,and NIAB-878×FH-326 for seed cotton yield and yield contributing traits under high temperature stress.Conclusion Heterosis breeding should be carried out in the presence of non-additive type gene action for all the studied traits.The best combiner parents with better-parent heterosis may be used in crossing program to develop high yielding cultivars,and hybrids for high temperature stress tolerance.展开更多
A series of CeO_(2)-TiO_(2)mixed oxides supports with various Ce/Ti molar ratio were synthesized by modified coprecipitation method. The corresponding Pt loaded(0.5 wt% Pt) catalysts were prepared by electronless depo...A series of CeO_(2)-TiO_(2)mixed oxides supports with various Ce/Ti molar ratio were synthesized by modified coprecipitation method. The corresponding Pt loaded(0.5 wt% Pt) catalysts were prepared by electronless deposition method and evaluated for the deep oxidation of n-hexane as a model VOCs. The results show that the CeO_(2)and TiOxnanoparticles can highly disperse into each other and form Ce_(2)Ti_(2)O_(7)solid solution with appropriate Ce/Ti molar ratio, which significantly improves their redox ability by enhancing the interaction between CeO_(2)and TiO_(x). The dispersibility of Pt species can also be adjusted by altering the Ce/Ti molar ratio, and Pt/CeTi-2/1 catalyst with Ce/Ti molar ratio of 2:1 exhibits the best Pt dispersibility that Pt species mainly exist as Pt single atoms. The high dispersion of Pt species in the Pt/CeO_(2)-TiO_(2)catalysts would promote the catalytic activity of VOCs oxidation with low T90% values(1000 ppm, GHSV = 15,000 h^(-1)), such as for n-hexane degradation with T90% of 139℃. The characterizations reveal that the superior activity is mainly related to possessing the more Pt2+species,adsorbed oxygen species and higher low-temperature reducibility owing to the strong interaction between highly dispersed Pt species and CeO_(2)-TiO_(2)as well as the promoted migration of lattice oxygen by the formation of more Ce_(2)Ti_(2)O_(7)species. Furthermore, the Pt/CeTi-2/1 catalyst also exhibits excellent stability for chlorinated and other non-chlorinated VOCs oxidation, making it very promising for real application under various operating conditions.展开更多
Background: Anatomical variations in the liver arterial supply are quite common and can affect the surgical strategy when performing a minimally invasive pancreaticoduodenectomy(MIPD). Their presence must be preemptiv...Background: Anatomical variations in the liver arterial supply are quite common and can affect the surgical strategy when performing a minimally invasive pancreaticoduodenectomy(MIPD). Their presence must be preemptively detected to avoid postoperative liver and biliary complications. Data sources: Following the PRISMA guidelines and the Cochrane protocol we conducted a systematic review on the management of an accessory or replaced right hepatic artery(RHA) arising from the superior mesenteric artery when performing an MIPD. Results: Five studies involving 118 patients were included. The most common reported management of the aberrant RHA was conservative(97.0%);however, patients undergoing aberrant RHA division without reconstruction did not develop liver or biliary complications. No differences in postoperative morbidity or long-term oncological related overall survival were reported in all the included studies when comparing MIPD in patients with standard anatomy to those with aberrant RHA. Conclusions: MIPD in patients with aberrant RHA is feasible without increase in morbidity and mortality. As preoperative strategy is crucial, we suggested planning an MIPD with an anomalous RHA focusing on preoperative vascular aberrancy assessment and different strategies to reduce the risk of liver ischemia.展开更多
Purpose:To construct a symptoms-based prediction tool to assess the likelihood of superior canal dehiscence(SSCD)on high-resolution CT.Materials and methods:Mathematical modeling was employed to predict radiologic evi...Purpose:To construct a symptoms-based prediction tool to assess the likelihood of superior canal dehiscence(SSCD)on high-resolution CT.Materials and methods:Mathematical modeling was employed to predict radiologic evidence of SSCD at a tertiary neurotology referral center.Results:A total of 168 patients were included,of which 118 had imaging-confirmed SSCD.On univariate analysis significant predictors of SSCD presence were:sound/pressure-induced vertigo(p?0.006),disequilibrium(p?0.008),hyperacusis(p?0.008),and autophony(p?0.034).Multivariate analysis enabled a 14-point symptom-weighted tool to be developed,wherein a score of6 raised the suspicion of SSCD(70%likelihood of being present),R2?0.853.Conclusions:The likelihood of SSCD on CT scan can be determined with a high degree of certainty based on symptoms recorded at presentation.Using the evidenced-based diagnostic tool validated herein,a score6 with any symptom combination justifies ordering a CT scan.展开更多
Isolated superior mesenteric artery dissection(ISMAD)is a rare but potentially life-threatening cause of acute abdominal pain.Owing to the availability of computed tomography angiography,more cases have been detected ...Isolated superior mesenteric artery dissection(ISMAD)is a rare but potentially life-threatening cause of acute abdominal pain.Owing to the availability of computed tomography angiography,more cases have been detected during screening for acute abdomen in recent years.With increasing knowledge of ISMAD,a better management strategy is being developed.To enhance our understanding and improve treatment outcomes of ISMAD,a systematic literature review was conducted with a focus on diagnosis and management strategies based on existing evidence.展开更多
Glass-forming ability(GFA) and mechanical properties of(Zr_(0.58)Nb_(0.03)Cu_(0.16)Ni_(0.13)Al_(0.10))_(100-x)Lu_x(x= 0-3 at%) alloys have been investigated.The GFA of Zr_(58)Nb_3Cu_(16)Ni_(13)Al_(10) alloy is dramati...Glass-forming ability(GFA) and mechanical properties of(Zr_(0.58)Nb_(0.03)Cu_(0.16)Ni_(0.13)Al_(0.10))_(100-x)Lu_x(x= 0-3 at%) alloys have been investigated.The GFA of Zr_(58)Nb_3Cu_(16)Ni_(13)Al_(10) alloy is dramatically enhanced by adding Lu.The(Zr_(0.58)Nb_(0.03)Cu_(0.16)Ni_(0.13)Al_(0.10))_(98)Lu_2 alloy possesses the highest GFA in the studied Zr-Nb-Cu-Ni-Al-Lu alloys,with its critical diameter for glass formation reaching 20 mm by copper-mould casting method,while that of the Lu-free Zr_(58)Nb_3Cu_(16)Ni_(13)Al_(10) alloy is 7 mm.The critical diameters of(Zr_(0.58)Nb_(0.03)Cu_(0.16)Ni_(0.13)Al_(0.10))_(100-x)Lu_x(x =1 at%and 3 at%) alloys are 15 mm and 12 mm,respectively.The Lu addition to Zr_(58)Nb_3Cu_(16)Ni_(13)Al_(10) alloy induces the change of initial crystallization phases from face-centred-cubic Zr_2Ni and tetragonal Zr_2Ni phases for the Lu-free Zr_(58)Nb_3Cu_(16)Ni_(13)Al_(10) alloy to an icosahedral quasi-crystalline phase for the Lu-doped alloys,which may be the origin for the enhanced GFA of the Lu-doped alloys.The compressive fracture strength and plastic strain of the bulk glassy(Zr_(0.58)Nb_(0.03)Cu_(0.16)Ni_(0.13)Al_(0.10))_(98)Lu_2 alloy are1 610 MPa and 1.5%,respectively.展开更多
BACKGROUND Although superior vena cava(SVC)syndrome has also been reported as a late complication of pacemaker(PM)implantation,acute onset of SVC syndrome caused by disdialysis syndrome in patients with PM implantatio...BACKGROUND Although superior vena cava(SVC)syndrome has also been reported as a late complication of pacemaker(PM)implantation,acute onset of SVC syndrome caused by disdialysis syndrome in patients with PM implantation is very rare.There are no specific therapies or guidelines.CASE SUMMARY A 96-year-old woman receiving dialysis was implanted with a PM due to sick sinus syndrome.She was referred to our facility for chest discomfort experienced during dialysis.Upon examination,unilateral pleural effusion on the right side was cloudy with a foul odour.The patient was diagnosed with pyothorax and treated with antibiotics.After the effusion was reduced,it gradually reaggravated and remained cloudy.In this case,SVC syndrome,which is generally considered a late complication after PM implantation,rapidly developed following the bacteraemia,resulting in impaired venous return,chylothorax,and disdialysis syndrome.After catheter intervention for SVC stenosis,the patient’s symptoms promptly improved.The patient has been recurrence-free for a year.CONCLUSION Acute SVC syndrome can cause dysdialysis in PM-implanted patients.Catheter intervention alone has improved this condition for a traceable period.展开更多
BACKGROUND Superior mesenteric artery syndrome(SMAS)is a rare condition causing functional obstruction of the third portion of the duodenum.Postoperative SMAS following laparoscopic-assisted radical right hemicolectom...BACKGROUND Superior mesenteric artery syndrome(SMAS)is a rare condition causing functional obstruction of the third portion of the duodenum.Postoperative SMAS following laparoscopic-assisted radical right hemicolectomy is even less prevalent and can often be unrecognized by radiologists and clinicians.AIM To analyze the clinical features,risk factors,and prevention of SMAS after laparoscopic-assisted radical right hemicolectomy.METHODS We retrospectively analyzed clinical data of 256 patients undergoing laparoscopicassisted radical right hemicolectomy in the Affiliated Hospital of Southwest Medical University from January 2019 to May 2022.The occurrence of SMAS and its countermeasures were evaluated.Among the 256 patients,SMAS was confirmed in six patients(2.3%)by postoperative clinical presentation and imaging features.All six patients were examined by enhanced computed tomography(CT)before and after surgery.Patients who developed SMAS after surgery were used as the experimental group.A simple random sampling method was used to select 20 patients who underwent surgery at the same time but did not develop SMAS and received preoperative abdominal enhanced CT as the control group.The angle and distance between the superior mesenteric artery and abdominal aorta were measured before and after surgery in the experimental group and before surgery in the control group.The preoperative body mass index(BMI)of the experimental group and the control group was calculated.The type of lymphadenectomy and surgical approach in the experimental and control groups were recorded.The differences in angle and distance were compared preoperatively and postoperatively in the experimental group compared.The differences in angle,distance,BMI,type of lymphadenectomy and surgical approach between the experimental and control groups were compared,and the diagnostic efficacy of the significant parameters was assessed using receiver operating characteristic curves.RESULTS In the experimental group,the aortomesenteric angle and distance after surgery were significantly decreased than those before surgery(P<0.05).The aortomesenteric angle,distance and BMI were significantly higher in the control group than in the experimental(P<0.05).There was no significant difference in the type of lymphadenectomy and surgical approach between the two groups(P>0.05).CONCLUSION The small preoperative aortomesenteric angle and distance and low BMI may be important factors for the complication.Over-cleaning of lymph fatty tissues may also be associated with this complication.展开更多
文摘Introduction: Superior mesenteric artery syndrome (SMAS), a rare diagnosis due to compression of the third duodenum between the superior mesenteric artery (SMA) and the aorta resulting in bowel obstruction, may lead to severe malnutrition. We report two cases of patients hospitalised in the Internal Medicine, Endocrinology, Diabetology, and Nutrition Department of the National Hospital Center (NHC) of Pikine. Observations: Patient 1: A 35-year-old female was referred for an aetiological diagnosis due to a rapid weight loss of 15 kilograms in one month, accompanied by persistent vomiting, following an appendectomy performed a month before admission. Upon clinical examination, she presented severe malnutrition (Buzby index of 76%), early post-prandial chronic vomiting, and a poor general condition. An abdominal CT scan revealed aortomesenteric clamp syndrome (AMCS) with an angulation between the aorta and the SMA of 13˚. The underlying cause in this patient was severe malnutrition. Fortunately, her condition improved with medical treatment. Patient 2: We report the case of a 30-year-old female hospitalized due to unusual weight-bearing post-prandial epigastric pain and intermittent vomiting over the past six months. Upon physical examination at admission, she exhibited severe malnutrition with a body mass index (BMI) of 14 kg/m<sup>2</sup>, a Buzby index of 71%, trophic disorders, and a stage IV general condition assessment according to the World Health Organization (WHO). An abdominal CT scan revealed AMCS with an angle between the aorta and the SMA of 22˚ and an aortomesenteric space of 4 mm. The outcome was poor with medical treatment failure and, unfortunately, the patient died before surgery. Conclusion: SMAS is rarely evoked in clinical practice despite the presence of contributing factors and suggestive clinical signs. The prognosis depends on management time.
文摘BACKGROUND Superior mesenteric artery(SMA)syndrome is a rare cause of duodenal obstruction by extrinsic compression between the SMA and the aorta(SMA-Ao).Although the left lateral recumbent position is considered effective in the treatment of SMA syndrome,individual variations in the optimal patient position have been noted.In this report,we present two elderly cases of SMA syndrome that exhibited rapid recovery due to ultrasonographic dynamic evaluation of the optimal position for each patient.CASE SUMMARY Case 1:A 90-year-old man with nausea and vomiting.Following diagnosis of SMA syndrome by computed tomography(CT),ultrasonography(US)revealed the SMA-Ao distance in the supine position(4 mm),which slightly improved in the lateral position(5.7–7.0 mm)without the passage of duodenal contents.However,in the sitting position,the SMA-Ao distance was increased to 15 mm accompanied by improved content passage.Additionally,US indicated enhanced passage upon abdominal massage on the right side.By day 2,the patient could eat comfortably with the optimal position and massage.Case 2:An 87-year-old woman with vomiting.After the diagnosis of SMA syndrome and aspiration pneumonia by CT,dynamic US confirmed the optimal position(SMA-Ao distance was improved to 7 mm in forward-bent position,whereas it remained at 5 mm in the supine position).By day 7 when her pneumonia recovered,she could eat with the optimal position.CONCLUSION The optimal position for SMA syndrome varies among individuals.Dynamic US appears to be a valuable tool in improving patient outcomes.
文摘BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with severe pneumonia success-fully treated by V-V ECMO,but during treatment,the retrovenous catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.The ECMO was safely withdrawn after multidiscip-linary consultation.Our experience with this case is expected to provide a reference for colleagues who will encounter similar situations.CASE SUMMARY A 64-year-old man had severe pulmonary infection and respiratory failure.He was admitted to our hospital and was given ventilation support(fraction of inspired oxygen 100%).The respiratory failure was not improved and he was treated by V-V ECMO,during which the venous return catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.There was a risk of massive mediastinal bleeding if the catheter was removed directly when the ECMO was withdrawn.Finally,the patient underwent vena cava angiography+balloon attachment+ECMO with-drawal in the operating room(prepared for conversion to thoracotomy for vascular exploration and repair at any time during surgery)after multidiscip-linary consultation.ECMO was safely withdrawn,and the patient recovered and was discharged.CONCLUSION Patients may have different vascular conditions.Multidisciplinary cooperation can ensure patient safety.Our experience will provide a reference for similar cases.
基金financially supported by National Natural Science Foundation of China (22209133, 22272131, 21972111, 22211540712)Natural Science Foundation of Chongqing (CSTB2022NSCQ-MSX1411)+1 种基金Chongqing Engineering Research Center for Micro-Nano Biomedical Materials and DevicesChongqing Key Laboratory for Advanced Materials and Technologies。
文摘Electrolytic aqueous zinc-manganese(Zn–Mn) batteries have the advantage of high discharge voltage and high capacity due to two-electron reactions. However, the pitfall of electrolytic Zn–Mn batteries is the sluggish deposition reaction kinetics of manganese oxide during the charge process and short cycle life. We show that, incorporating ZnO electrolyte additive can form a neutral and highly viscous gel-like electrolyte and render a new form of electrolytic Zn–Mn batteries with significantly improved charging capabilities. Specifically, the ZnO gel-like electrolyte activates the zinc sulfate hydroxide hydrate assisted Mn^(2+) deposition reaction and induces phase and structure change of the deposited manganese oxide(Zn_(2)Mn_(3)O_8·H_(2)O nanorods array), resulting in a significant enhancement of the charge capability and discharge efficiency. The charge capacity increases to 2.5 mAh cm^(-2) after 1 h constant-voltage charging at 2.0 V vs. Zn/Zn^(2+), and the capacity can retain for up to 2000 cycles with negligible attenuation. This research lays the foundation for the advancement of electrolytic Zn–Mn batteries with enhanced charging capability.
基金This study protocol was approved by the General Hospital of the Yangtze River Shipping,and all the families have voluntarily participated in the study and have signed informed consent forms.
文摘BACKGROUND Regarding the incidence of malignant tumors in China,the incidence of liver cancer ranks fourth,second only to lung,gastric,and esophageal cancers.The case fatality rate ranks third after lung and cervical cancer.In a previous study,the whole-process management model was applied to patients with breast cancer,which effectively reduced their negative emotions and improved treatment adherence and nursing satisfaction.METHODS In this single-center,randomized,controlled study,60 randomly selected patients with liver cancer who had been admitted to our hospital from January 2021 to January 2022 were randomly divided into an observation group(n=30),who received whole-process case management on the basis of routine nursing mea-sures,and a control group(n=30),who were given routine nursing measures.We compared differences between the two groups in terms of anxiety,depression,the level of hope,self-care ability,symptom distress,sleep quality,and quality of life.RESULTS Post-intervention,Hamilton anxiety scale,Hamilton depression scale,memory symptom assessment scale,and Pittsburgh sleep quality index scores in both groups were lower than those pre-intervention,and the observation group had lower scores than the control group(P<0.05).Herth hope index,self-care ability assessment scale-revision in Chinese,and quality of life measurement scale for patients with liver cancer scores in both groups were higher than those pre-intervention,with higher scores in the observation group compared with the control group(P<0.05).CONCLUSION Whole-process case management can effectively reduce anxiety and depression in patients with liver cancer,alleviate symptoms and problems,and improve the level of hope,self-care ability,sleep quality,and quality of life,as well as provide feasible nursing alternatives for patients with liver cancer.
文摘Aims: The present study aims to compare the assessment of work ability based on the use of the Work Ability Index (WAI) with another questionnaire base only on the use of WAI’s first item, termed as the “Work Ability Score” (WAS). Study design: A cohort of 384 Spanish workers included in a Post COVID-19 condition or persistent COVID-19 multicenter research was utilized. Place and Duration of Study: This cohort was enlisted in four hospitals (Hospital Universitario 12 de Octubre, Madrid;Hospital Universitario Virgen Macarena, Sevilla, Andalucía;Hospital Universitario Gregorio Marañón, Madrid and Complejo Asistencial Universitario de Salamanca, Castilla y León), since 2021 until 2022. Methodology: 384 Spanish workers (176 men and 208 women;aged 20 to 70 years) with Post COVID-19 condition or persistent COVID-19 were included. Descriptive analysis of primary scores was conducted. Given the non-normal distribution of data, the Mann-Whitney and Kruskal-Wallis tests were employed. Spearman and Kendall correlations were employed to assess the relationship between WAI and WAS, also used weighted Kappa to estimate the degree agreement between WAI and WAS. Logistic regression models were utilized to study determinants influencing WAI and WAS, categorized as poor or moderate. Results: WAI had an average score of 32.98 (SD = 10.28), whereas WAS had an average of 5.95 (SD = 2.77). Significant differences were observed in both WAI and WAS across the same variables. Strong and statistically significant correlations were evident between WAI and WAS (rs = 0.83, p < 0.001). All the variables used in the logistic regression model (gender, the sector employment, and previous chronic diseases) were statistically significant in both questionnaires. Conclusion: WAS questionnaire could be used as a tool for reliable assessment of work ability among Spanish workers with Post COVID-19 condition or Persistent CO-VID-19.
基金funded by the Social Sciences Annual Research Project of Shanghai“A Study on the Interactive Processing Mechanism of English L2 Text Reading”(Grant No.2021BYY008).
文摘This paper takes college students as research subjects to investigate the factors affecting L2 Reading ability and their regulation strategies through scale surveys.The findings are as follows:(1)Linguistic factors have significant impacts on L2 Reading ability,and the influence of non-linguistic factors,such as non-intellectual factors and cultural background knowledge,is also important;and(2)flexible use of reading regulation strategies according to the learning conditions(such as the information extraction strategy,the metacognitive reading regulation strategy,and the interactive reading strategy)can effectively improve learners’L2 Reading ability.The findings of this study have important theoretical and practical value for improving L2 learners’Reading ability.
基金Supported by Medical Science and Technology Project of Zhejiang Province of China,No.2020PY053.
文摘BACKGROUND Postoperative complications remain a paramount concern for surgeons and healthcare practitioners.AIM To present a comprehensive analysis of the Estimation of Physiologic Ability and Surgical Stress(E-PASS)scoring system’s efficacy in predicting postoperative complications following abdominal surgery.METHODS A systematic search of published studies was conducted,yielding 17 studies with pertinent data.Parameters such as preoperative risk score(PRS),surgical stress score(SSS),comprehensive risk score(CRS),postoperative complications,post-operative mortality,and other clinical data were collected for meta-analysis.Forest plots were employed for continuous and binary variables,withχ2 tests assessing heterogeneity(P value).RESULTS Patients experiencing complications after abdominal surgery exhibited significantly higher E-PASS scores compared to those without complications[mean difference and 95%confidence interval(CI)of PRS:0.10(0.05-0.15);SSS:0.04(0.001-0.08);CRS:0.19(0.07-0.31)].Following the exclusion of low-quality studies,results remained valid with no discernible heterogeneity.Subgroup analysis indicated that variations in sample size and age may contribute to hetero-geneity in CRS analysis.Binary variable meta-analysis demonstrated a correlation between high CRS and increased postoperative complication rates[odds ratio(OR)(95%CI):3.01(1.83-4.95)],with a significant association observed between high CRS and postoperative mortality[OR(95%CI):15.49(3.75-64.01)].CONCLUSION In summary,postoperative complications in abdominal surgery,as assessed by the E-PASS scoring system,are consistently linked to elevated PRS,SSS,and CRS scores.High CRS scores emerge as risk factors for heightened morbidity and mortality.This study establishes the accuracy of the E-PASS scoring system in predicting postoperative morbidity and mortality in abdominal surgery,underscoring its potential for widespread adoption in effective risk assessment.
文摘By constructing a model,this study seeks to provide suggestions for strengthening pre-service teachers’informatization teaching ability.It aims to answer the following research questions:(1)What do the pre-service teachers know about informatization instruction?What is their level of informatization teaching ability?(2)What factors influence pre-service teachers’ability to deliver informatization instruction?How to overcome the obstacles?The inquiry focuses on the theoretical exploration of informatization teaching ability,questionnaire,and interview analysis on the current condition and improvement of pre-service teachers’informatization teaching ability.The data from the questionnaire and interview of the pre-service teachers were evaluated from three dimensions:awareness and attitude towards informatization teaching,knowledge of informatization teaching,and the ability to apply informatization teaching skills innovatively and comprehensively.The 3S-7D(Three Subjects and Seven Duties)model consisting of three subjects and the seven duties that go with them is established.The three subjects include pre-service teachers,teacher educators,and higher education schools.The seven duties involve pre-service teachers demonstrating learning motivation,cross-discipline thinking,and information and communications technology mastery;teacher educators actively constructing informatization teaching practice and formative assessment;and higher education schools providing adequate hardware and software equipment while offering cooperative opportunities with primary and junior schools through institutionalization.
基金2023 Education Assistance to Xinjiang Special Project of Jiangsu Vocational and Technical Education Science Research Centre(SZ2023041)。
文摘Innovation ability is the ability to continuously provide new ideas,theories,methods,and inventions with economic,social,and ecological values in the fields of technology and various practical activities.The ideological and political education of vocational school students should be student-oriented and close to reality and life.It is necessary to improve the pertinence,effectiveness,attractiveness,and infectiousness of ideological and political education,and cultivate socialist builders and successors with all-round development of morality,intelligence,physique,and beauty.In this paper,we investigate and understand the practice of innovation ability education in colleges and universities at home and abroad,especially the current situation of professional practice teaching in Xinjiang Vocational Colleges.The construction of a professional practice base in vocational colleges is systematically studied.
文摘Objective: It remains unknown whether calcium metabolism has any effect on the clinical presentation of superior semicircular canal dehiscence(SSCD). Our aim was to analyse the adjusted calcium and vitamin D levels in SSCD patients compared to a control group.Methods: This was a prospective case-control study performed in a tertiary referral center, university teaching hospital in the UK. It included all new patients with SSCD seen in a dedicated skull base clinic over a 5-year period(2015-2019) compared to a gender and age matched control group. The main outcome of the study was adjusted calcium and Vitamin D levels between the two groups.Results: A total of 31 SSCD patients were recruited with a matched number of control patients. The mean Vitamin D level on the SSCD group was 44.8 nmoL/l(SD: 20.8) compared to 47.5 nmoL/l(SD: 27.4) on the control group(p = 0.702). Mean Adjusted calcium level was 2.34 mmoL/l(SD: 0.7) for SSCD compared to2.41 mmoL/l(SD: 0.11) for controls(p = 0.01), being within normal limits for both the SSCD and the control group.Conclusion: Our study did not identify a link between Vitamin D levels and presence of SSCD. Normal adjusted calcium values were found in both groups. Despite that a statistically significant lower calcium level was found in the SSCD group which could indicate that suboptimal levels of calcium may affect the micro-environment of the otic capsule at the SSC region.
文摘Superior mesenteric artery(SMA)syndrome(also known as Wilkie's syndrome,cast syndrome,or aorto-mesenteric compass syndrome)is an obstruction of the duodenum caused by extrinsic compression between the SMA and the aorta.The median age of patients is 23 years old(range 0-91 years old)and predominant in females over males with a ratio of 3:2.The symptoms are variable,consisting of postprandial abdominal pain,nausea and vomiting,early satiety,anorexia,and weight loss and can mimic anorexia nervosa or functional dyspepsia.Because recurrent vomiting leads to aspiration pneumonia or respiratory depression via metabolic alkalosis,early diagnosis is required.The useful diagnostic modalities are computed tomography as a standard tool and ultrasonography,which has advantages in safety and capability of real-time assessments of SMA mobility and duodenum passage.The initial treatment is usually conservative,including postural change,gastroduodenal decompression,and nutrient management(success rates:70%-80%).If conservative therapy fails,surgical treatment(i.e.,laparoscopic duodenojejunostomy)is recommended(success rates:80%-100%).
基金Higher Education Commission of Pakistan for funding the experiments
文摘Background High temperature stress at peak flowering stage of cotton is a major hindrance for crop potential.This study aimed to increase genetic divergence regarding heat tolerance in newly developed cultivars and hybrids.Fifty cotton genotypes and 40 F1(hybrids)were tested under field conditions following the treatments,viz.,high temperature stress and control at peak flowering stage in August and October under April and June sowing,respectively.Results The mean squares revealed significant differences among genotypes,treatments,genotype×treatment for relative cell injury,chlorophyll contents,canopy temperature,boll retention and seed cotton yield per plant.The genetic diversity among 50 genotypes was analyzed through cluster analysis and heat susceptibility index(HSI).The heat tolerant genotypes including FH-Noor,NIAB-545,FH-466,FH-Lalazar,FH-458,NIAB-878,IR-NIBGE-8,Weal-AGShahkar,and heat sensitive,i.e.,CIM-602,Silky-3,FH-326,SLH-12 and FH-442 were hybridized in line×tester fashion to produce F1 populations.The breeding materials’populations(40 F1)revealed higher specific combining ability variances along with dominance variances,decided the non-additive type gene action for all the traits.The best general combining ability effects for most of the traits were displayed by the lines,i.e.,FH-Lalazar,NIAB-878 along with testers FH-326 and Silky-3.Specific combining ability effects and better-parent heterosis were showed by the crosses,viz.,FH-Lalazar×Silky-3,FH-Lalazar×FH-326,NIAB-878×Silky-3,and NIAB-878×FH-326 for seed cotton yield and yield contributing traits under high temperature stress.Conclusion Heterosis breeding should be carried out in the presence of non-additive type gene action for all the studied traits.The best combiner parents with better-parent heterosis may be used in crossing program to develop high yielding cultivars,and hybrids for high temperature stress tolerance.
基金supported by a grant from the National Key Research and Development Program of China (2016YFC0204300)the National Nature Science Foundation of China (21477109)。
文摘A series of CeO_(2)-TiO_(2)mixed oxides supports with various Ce/Ti molar ratio were synthesized by modified coprecipitation method. The corresponding Pt loaded(0.5 wt% Pt) catalysts were prepared by electronless deposition method and evaluated for the deep oxidation of n-hexane as a model VOCs. The results show that the CeO_(2)and TiOxnanoparticles can highly disperse into each other and form Ce_(2)Ti_(2)O_(7)solid solution with appropriate Ce/Ti molar ratio, which significantly improves their redox ability by enhancing the interaction between CeO_(2)and TiO_(x). The dispersibility of Pt species can also be adjusted by altering the Ce/Ti molar ratio, and Pt/CeTi-2/1 catalyst with Ce/Ti molar ratio of 2:1 exhibits the best Pt dispersibility that Pt species mainly exist as Pt single atoms. The high dispersion of Pt species in the Pt/CeO_(2)-TiO_(2)catalysts would promote the catalytic activity of VOCs oxidation with low T90% values(1000 ppm, GHSV = 15,000 h^(-1)), such as for n-hexane degradation with T90% of 139℃. The characterizations reveal that the superior activity is mainly related to possessing the more Pt2+species,adsorbed oxygen species and higher low-temperature reducibility owing to the strong interaction between highly dispersed Pt species and CeO_(2)-TiO_(2)as well as the promoted migration of lattice oxygen by the formation of more Ce_(2)Ti_(2)O_(7)species. Furthermore, the Pt/CeTi-2/1 catalyst also exhibits excellent stability for chlorinated and other non-chlorinated VOCs oxidation, making it very promising for real application under various operating conditions.
文摘Background: Anatomical variations in the liver arterial supply are quite common and can affect the surgical strategy when performing a minimally invasive pancreaticoduodenectomy(MIPD). Their presence must be preemptively detected to avoid postoperative liver and biliary complications. Data sources: Following the PRISMA guidelines and the Cochrane protocol we conducted a systematic review on the management of an accessory or replaced right hepatic artery(RHA) arising from the superior mesenteric artery when performing an MIPD. Results: Five studies involving 118 patients were included. The most common reported management of the aberrant RHA was conservative(97.0%);however, patients undergoing aberrant RHA division without reconstruction did not develop liver or biliary complications. No differences in postoperative morbidity or long-term oncological related overall survival were reported in all the included studies when comparing MIPD in patients with standard anatomy to those with aberrant RHA. Conclusions: MIPD in patients with aberrant RHA is feasible without increase in morbidity and mortality. As preoperative strategy is crucial, we suggested planning an MIPD with an anomalous RHA focusing on preoperative vascular aberrancy assessment and different strategies to reduce the risk of liver ischemia.
文摘Purpose:To construct a symptoms-based prediction tool to assess the likelihood of superior canal dehiscence(SSCD)on high-resolution CT.Materials and methods:Mathematical modeling was employed to predict radiologic evidence of SSCD at a tertiary neurotology referral center.Results:A total of 168 patients were included,of which 118 had imaging-confirmed SSCD.On univariate analysis significant predictors of SSCD presence were:sound/pressure-induced vertigo(p?0.006),disequilibrium(p?0.008),hyperacusis(p?0.008),and autophony(p?0.034).Multivariate analysis enabled a 14-point symptom-weighted tool to be developed,wherein a score of6 raised the suspicion of SSCD(70%likelihood of being present),R2?0.853.Conclusions:The likelihood of SSCD on CT scan can be determined with a high degree of certainty based on symptoms recorded at presentation.Using the evidenced-based diagnostic tool validated herein,a score6 with any symptom combination justifies ordering a CT scan.
基金supported by the Changzhou Sci&Tech Program(CZ20220029 and CJ20210108)the Clinical Research Project of Changzhou Medical Center of Nanjing Medical University(CMCC202206)
文摘Isolated superior mesenteric artery dissection(ISMAD)is a rare but potentially life-threatening cause of acute abdominal pain.Owing to the availability of computed tomography angiography,more cases have been detected during screening for acute abdomen in recent years.With increasing knowledge of ISMAD,a better management strategy is being developed.To enhance our understanding and improve treatment outcomes of ISMAD,a systematic literature review was conducted with a focus on diagnosis and management strategies based on existing evidence.
基金Funded by the National Natural Science Foundation of China(Nos.51101133,51101134)the Encouraging Foundation for Outstanding Youth Scientists of Shandong Province,China(No.BS2012CL036)the Natural Science Foundation of Shandong Province,China(No.ZR2011EL025)
文摘Glass-forming ability(GFA) and mechanical properties of(Zr_(0.58)Nb_(0.03)Cu_(0.16)Ni_(0.13)Al_(0.10))_(100-x)Lu_x(x= 0-3 at%) alloys have been investigated.The GFA of Zr_(58)Nb_3Cu_(16)Ni_(13)Al_(10) alloy is dramatically enhanced by adding Lu.The(Zr_(0.58)Nb_(0.03)Cu_(0.16)Ni_(0.13)Al_(0.10))_(98)Lu_2 alloy possesses the highest GFA in the studied Zr-Nb-Cu-Ni-Al-Lu alloys,with its critical diameter for glass formation reaching 20 mm by copper-mould casting method,while that of the Lu-free Zr_(58)Nb_3Cu_(16)Ni_(13)Al_(10) alloy is 7 mm.The critical diameters of(Zr_(0.58)Nb_(0.03)Cu_(0.16)Ni_(0.13)Al_(0.10))_(100-x)Lu_x(x =1 at%and 3 at%) alloys are 15 mm and 12 mm,respectively.The Lu addition to Zr_(58)Nb_3Cu_(16)Ni_(13)Al_(10) alloy induces the change of initial crystallization phases from face-centred-cubic Zr_2Ni and tetragonal Zr_2Ni phases for the Lu-free Zr_(58)Nb_3Cu_(16)Ni_(13)Al_(10) alloy to an icosahedral quasi-crystalline phase for the Lu-doped alloys,which may be the origin for the enhanced GFA of the Lu-doped alloys.The compressive fracture strength and plastic strain of the bulk glassy(Zr_(0.58)Nb_(0.03)Cu_(0.16)Ni_(0.13)Al_(0.10))_(98)Lu_2 alloy are1 610 MPa and 1.5%,respectively.
文摘BACKGROUND Although superior vena cava(SVC)syndrome has also been reported as a late complication of pacemaker(PM)implantation,acute onset of SVC syndrome caused by disdialysis syndrome in patients with PM implantation is very rare.There are no specific therapies or guidelines.CASE SUMMARY A 96-year-old woman receiving dialysis was implanted with a PM due to sick sinus syndrome.She was referred to our facility for chest discomfort experienced during dialysis.Upon examination,unilateral pleural effusion on the right side was cloudy with a foul odour.The patient was diagnosed with pyothorax and treated with antibiotics.After the effusion was reduced,it gradually reaggravated and remained cloudy.In this case,SVC syndrome,which is generally considered a late complication after PM implantation,rapidly developed following the bacteraemia,resulting in impaired venous return,chylothorax,and disdialysis syndrome.After catheter intervention for SVC stenosis,the patient’s symptoms promptly improved.The patient has been recurrence-free for a year.CONCLUSION Acute SVC syndrome can cause dysdialysis in PM-implanted patients.Catheter intervention alone has improved this condition for a traceable period.
文摘BACKGROUND Superior mesenteric artery syndrome(SMAS)is a rare condition causing functional obstruction of the third portion of the duodenum.Postoperative SMAS following laparoscopic-assisted radical right hemicolectomy is even less prevalent and can often be unrecognized by radiologists and clinicians.AIM To analyze the clinical features,risk factors,and prevention of SMAS after laparoscopic-assisted radical right hemicolectomy.METHODS We retrospectively analyzed clinical data of 256 patients undergoing laparoscopicassisted radical right hemicolectomy in the Affiliated Hospital of Southwest Medical University from January 2019 to May 2022.The occurrence of SMAS and its countermeasures were evaluated.Among the 256 patients,SMAS was confirmed in six patients(2.3%)by postoperative clinical presentation and imaging features.All six patients were examined by enhanced computed tomography(CT)before and after surgery.Patients who developed SMAS after surgery were used as the experimental group.A simple random sampling method was used to select 20 patients who underwent surgery at the same time but did not develop SMAS and received preoperative abdominal enhanced CT as the control group.The angle and distance between the superior mesenteric artery and abdominal aorta were measured before and after surgery in the experimental group and before surgery in the control group.The preoperative body mass index(BMI)of the experimental group and the control group was calculated.The type of lymphadenectomy and surgical approach in the experimental and control groups were recorded.The differences in angle and distance were compared preoperatively and postoperatively in the experimental group compared.The differences in angle,distance,BMI,type of lymphadenectomy and surgical approach between the experimental and control groups were compared,and the diagnostic efficacy of the significant parameters was assessed using receiver operating characteristic curves.RESULTS In the experimental group,the aortomesenteric angle and distance after surgery were significantly decreased than those before surgery(P<0.05).The aortomesenteric angle,distance and BMI were significantly higher in the control group than in the experimental(P<0.05).There was no significant difference in the type of lymphadenectomy and surgical approach between the two groups(P>0.05).CONCLUSION The small preoperative aortomesenteric angle and distance and low BMI may be important factors for the complication.Over-cleaning of lymph fatty tissues may also be associated with this complication.
