BACKGROUND Uniportal full-endoscopy(UFE)technique has been continuously developed and applied for treating lumbar spinal stenosis.However,achieving effective decompression outcome of using the UFE technique remains te...BACKGROUND Uniportal full-endoscopy(UFE)technique has been continuously developed and applied for treating lumbar spinal stenosis.However,achieving effective decompression outcome of using the UFE technique remains technically demanding and uncertain.Previously,we have proposed the biportal full-endoscopy(BFE)technique to integrate the respective advantages of both UFE and unilateral biportal endoscopy technique.There is limited published data on the comparison of clinical outcomes between biportal and UFE techniques in lumbar spinal stenosis with bilateral symptoms.AIM To contrast the clinical outcomes between biportal and UFE techniques for treating lumbar spinal stenosis with bilateral symptoms.METHODS This study retrospectively examined 100 patients diagnosed with lumbar spinal stenosis and bilateral symptoms.Among them,52 cases were part of group A(BFE technique group),and 48 cases belonged to group B(UFE technique group).The visual analogue scale(VAS),Oswestry Disability Index(ODI),and modified Macnab criteria were used to evaluate the clinical outcomes.RESULTS Group A had significantly shorter operation time than group B.Both groups experienced substantial relief in lower back and lower extremity pain on the severe side at postoperative 3 days,3 months,and 12 months.Group A had notably lower VAS scores for mild side lower extremity pain at postoperative 3 months and 12 months compared to group B.Group A's ODI scores were significantly lower at postoperative 3 months and 12 months,whereas group B's scores did not significantly differ from preoperative values.Group A's ODI scores were significantly lower than group B's at postoperative 3 months and 12 months.Group A had a significantly higher excellent and good response rate(94.23%)compared to group B(81.25%)at postoperative 12 months based on the modified Macnab scale outcomes.CONCLUSION The BFE technique offers multiple benefits,including reduced trauma and quicker recovery as a minimally invasive surgery,and enhanced decompression efficiency over the UFE technique when treating lumbar spinal stenosis with bilateral symptoms.展开更多
BACKGROUND This is a retrospective study on endoscopic treatment of cervical spinal radiculopathy(CSR)conducted at a single academic institution.Conventional full-spine endoscopy is performed in a single portal which ...BACKGROUND This is a retrospective study on endoscopic treatment of cervical spinal radiculopathy(CSR)conducted at a single academic institution.Conventional full-spine endoscopy is performed in a single portal which has certain limitations of high technical requirements,steep learning curve,and narrow indications.Although unilateral biportal endoscopy(UBE)technique has a gentle learning curve and is gradually applied to treat CSR,all procedures were performed in the uniportal working channel that potentially increase the surgical risk and time in the treatment of complex cases.It is worthy to delve novel technique for more working channels in the treatment of complex CSR.AIM To propose a hybrid technique(HT)that utilizes spine endoscopy in UBE to treatment of CSR.METHODS A total of 81 patients with single-segment CSR who underwent uniportal endoscopic surgery(UES),UBE,or HT at a single institution between September 2019 and August 2021 were retrospectively studied.Perioperative patient data were compared between the groups.The pre-operative and post-operative images were compared to confirm adequate decompression of the nerve root canal.Patients'visual analogue scale(VAS)scores and neck disability index(NDI)were recorded before surgery,and three days,three months and six months after surgery.RESULTS The UBE and HT groups had a significantly shorter operation duration than the UES group.Data for bleeding and length of hospital stay were significantly higher in the UBE group than in the UES and HT groups.The hospitalization cost was lowest in the UES group and highest in the HT group.Soft tissue edema reaction bands on postoperative day 3 were larger in the UBE and HT groups than in the UES group.Post-operative VAS and NDI scores were significantly lower in all three groups than the pre-operative levels.On post-operative day 3,the VAS score for neck pain was significantly higher in the UBE and HT groups than that in the UES group.However,there were no significant differences in the VAS scores for arm pain or NDI between the three groups.The post-operative 3-month and 6-month neck pain VAS,arm pain VAS,NDI,and modified Macnab success rates did not differ statistically between the three groups.CONCLUSION The HT for CSR treatment has the advantage of double working channels to facilitate decompression and hemostasis,improving the surgical efficiency and clinical outcomes of CSR.展开更多
China is rich in abundant lithium resources characterized by considerable reserves and a concentrated distribution of metallogenic zones or belts,with proven reserves of 4046.8×10^(3) t(calculated based on Li_(2)...China is rich in abundant lithium resources characterized by considerable reserves and a concentrated distribution of metallogenic zones or belts,with proven reserves of 4046.8×10^(3) t(calculated based on Li_(2)O)by 2021.China is also a big consumer of lithium.By 2019,China’s lithium consumption in the battery sector alone had reached 99×10^(3) t,with an average annual growth rate of nearly 26%.China has become the world’s largest importer of lithium resources,showing a severely unbalanced relationship between supply and demand for lithium resources.Therefore,there is an urgent need for the prospecting,exploitation,and study of lithium resources in China.This study collected,organized,and summarized the data on the major lithium deposits in China,analyzed and compared the spatial-temporal distribution patterns,geological characteristics,and metallogenic regularity of these lithium deposits,and summarized the prospecting and research achievements over the last decade.The major lithium deposits in China are distributed in provinces and regions such as Qinghai,Jiangxi,Sichuan,Tibet,and Xinjiang.These deposits are mostly small in scale.According to different genetic types,this study divided lithium deposits into granitic pegmatite type,granite type,saline lake brine type,underground brine type,and sedimentary type,as well as new types including hot spring type and magmatic-hydrothermal type,and summarized the characteristics and key metallogenic factors of these different types of deposits.Sixteen metallogenic prospect areas of lithium deposits were delineated according to the deposit types and the distribution patterns of metallogenic belts.The paper introduced the research progress in major metallogenic models and lithium extraction techniques made over the past decade.Based on the comprehensive analysis of the prospecting potential of lithium deposits,the authors concluded that the future prospecting of lithium resources in China should focus on lithium metallogenic belts,the deep and peripheral areas of currently determined large-scale pegmatite-type lithium deposits,geophysical-geochemical anomalous areas with mineralization clues,and areas with developed large-scale low-grade associated granite-type and sedimentary lithium resources.The study aims to serve as a guide for the future prospecting of lithium deposits in China.展开更多
AIM： To elucidate the clinical, radiological and laboratory pro？les of renal abscess （RA） and perinephric abscess （PNA）, along with related treatment and outcome.METHODS： Ninety-eight patients diagnosed with RA...AIM： To elucidate the clinical, radiological and laboratory pro？les of renal abscess （RA） and perinephric abscess （PNA）, along with related treatment and outcome.METHODS： Ninety-eight patients diagnosed with RA or PNA using the primary discharge diagnoses identi？ed from the International Statistical Classification of Diseases and Related Health Problems Tenth Edition （ICD-10） codes （RA： N15.101, PNA： N15.102） between September 2004 and December 2014 in West China Hospital were selected. Medical records including patients’ characteristics, symptoms and signs, high-risk factors, radiological features, causative microorganisms and antibiotic-resistance pro？les, treatment approaches, and clinical outcomes were collected and analyzed.RESULTS： The mean age of the patients was 46.49 years with a male to female ratio of 41：57. Lumbar pain （76.5%） and fever （53.1%） were the most common symptoms. Other symptoms and signs included chills （28.6%）, anorexia and vomiting （25.5%）, lethargy （10.2%）, abdominal pain （11.2%）, fank mass （12.2%）, fank ？stula （2.0%）, gross hematuria （7.1%）, frequency （14.3%）, dysuria （9.2%）, pyuria （5.1%） and weight loss （1.0%）. Painful percussion of the costovertebral angle （87.8%） was the most common physical ？nding. The main predisposing factors were lithiasis （48.0%）, diabetes mellitus （33.7%） followed by history of urological surgery （16.3%）, urinary tract infections （14.3%）, renal function impairment （13.3%）, liver cirrhosis （2.0%）, neurogenic bladder （1.0%）, renal cyst （1.0%）, hydronephrosis （1.0%）, chronic hepatitis B （1.0%）, post-discectomy （1.0%） and post-colectomy （1.0%）. Ultrasound （US） and computed tomography were the most valuable diagnostic tools and US was recommended as the initial diagnostic imaging choice.Escherichia coli （51.4%）, Staphylococcus aureus （10.0%） and Klebsiella pneumoniae （8.6%） were the main causative microorganisms. Intravenous antibiotic therapy was necessary while intervention including surgical and nonsurgical approaches were reserved for larger abscesses, multiple abscesses, PNAs and non-responders. CONCLUSION： Heightened alertness, prompt diagnosis, and especially proper antibiotics in conjunction with interventional approaches allow a promising clinical outcome of renal and perinephric abscesses.展开更多
The transient performance and optimization of a passive residual heat removal heat exchanger(PRHR HX)were investigated.First,a calculation method was developed for predicting the heat transfer of the PRHR HX.The calcu...The transient performance and optimization of a passive residual heat removal heat exchanger(PRHR HX)were investigated.First,a calculation method was developed for predicting the heat transfer of the PRHR HX.The calculation results were validated through comparisons with ROSA experimental data.The heat-transfer performance of the AP1000 PRHR HX in the initial period was predicted,and it satisfied the design requirements.Second,the distributions of the heat flux,tube-inside/outside heattransfer coefficients,and heat load for the AP1000 PRHR HX over 2000 s were examined.Third,an optimization study was conducted by adjusting the horizontal length and tube diameter.Their effects on the four main heat-transfer parameters and the heat-transfer area were analyzed.Furthermore,the influence of the initial in-containment refueling water storage tank(IRWST)temperature was investigated using an established simulation procedure.The results indicated that it significantly affected the trends of the IRWST temperature and reactor outlet temperature.Finally,the minimum required flow rates over time to maintain the reactor outlet temperature at the safety line were determined for different start-up times.The trends of the minimum required flow rate and the peak flow rate were analyzed.展开更多
基金Supported by National Natural Science Foundation of China,No.82202694Clinical Research Innovation Plan of Shanghai General Hospital,No.CTCCR-2021C10.
文摘BACKGROUND Uniportal full-endoscopy(UFE)technique has been continuously developed and applied for treating lumbar spinal stenosis.However,achieving effective decompression outcome of using the UFE technique remains technically demanding and uncertain.Previously,we have proposed the biportal full-endoscopy(BFE)technique to integrate the respective advantages of both UFE and unilateral biportal endoscopy technique.There is limited published data on the comparison of clinical outcomes between biportal and UFE techniques in lumbar spinal stenosis with bilateral symptoms.AIM To contrast the clinical outcomes between biportal and UFE techniques for treating lumbar spinal stenosis with bilateral symptoms.METHODS This study retrospectively examined 100 patients diagnosed with lumbar spinal stenosis and bilateral symptoms.Among them,52 cases were part of group A(BFE technique group),and 48 cases belonged to group B(UFE technique group).The visual analogue scale(VAS),Oswestry Disability Index(ODI),and modified Macnab criteria were used to evaluate the clinical outcomes.RESULTS Group A had significantly shorter operation time than group B.Both groups experienced substantial relief in lower back and lower extremity pain on the severe side at postoperative 3 days,3 months,and 12 months.Group A had notably lower VAS scores for mild side lower extremity pain at postoperative 3 months and 12 months compared to group B.Group A's ODI scores were significantly lower at postoperative 3 months and 12 months,whereas group B's scores did not significantly differ from preoperative values.Group A's ODI scores were significantly lower than group B's at postoperative 3 months and 12 months.Group A had a significantly higher excellent and good response rate(94.23%)compared to group B(81.25%)at postoperative 12 months based on the modified Macnab scale outcomes.CONCLUSION The BFE technique offers multiple benefits,including reduced trauma and quicker recovery as a minimally invasive surgery,and enhanced decompression efficiency over the UFE technique when treating lumbar spinal stenosis with bilateral symptoms.
基金Supported by the Provincial Natural Science Foundation of Gansu,No.24JRRF008Science and Technology Research Project of Songjiang District,No.2024SJKJGG105+1 种基金National Natural Science Foundation of China,No.82202694Clinical Research Innovation Plan of Shanghai General Hospital,No.CTCCR-2021C10.
文摘BACKGROUND This is a retrospective study on endoscopic treatment of cervical spinal radiculopathy(CSR)conducted at a single academic institution.Conventional full-spine endoscopy is performed in a single portal which has certain limitations of high technical requirements,steep learning curve,and narrow indications.Although unilateral biportal endoscopy(UBE)technique has a gentle learning curve and is gradually applied to treat CSR,all procedures were performed in the uniportal working channel that potentially increase the surgical risk and time in the treatment of complex cases.It is worthy to delve novel technique for more working channels in the treatment of complex CSR.AIM To propose a hybrid technique(HT)that utilizes spine endoscopy in UBE to treatment of CSR.METHODS A total of 81 patients with single-segment CSR who underwent uniportal endoscopic surgery(UES),UBE,or HT at a single institution between September 2019 and August 2021 were retrospectively studied.Perioperative patient data were compared between the groups.The pre-operative and post-operative images were compared to confirm adequate decompression of the nerve root canal.Patients'visual analogue scale(VAS)scores and neck disability index(NDI)were recorded before surgery,and three days,three months and six months after surgery.RESULTS The UBE and HT groups had a significantly shorter operation duration than the UES group.Data for bleeding and length of hospital stay were significantly higher in the UBE group than in the UES and HT groups.The hospitalization cost was lowest in the UES group and highest in the HT group.Soft tissue edema reaction bands on postoperative day 3 were larger in the UBE and HT groups than in the UES group.Post-operative VAS and NDI scores were significantly lower in all three groups than the pre-operative levels.On post-operative day 3,the VAS score for neck pain was significantly higher in the UBE and HT groups than that in the UES group.However,there were no significant differences in the VAS scores for arm pain or NDI between the three groups.The post-operative 3-month and 6-month neck pain VAS,arm pain VAS,NDI,and modified Macnab success rates did not differ statistically between the three groups.CONCLUSION The HT for CSR treatment has the advantage of double working channels to facilitate decompression and hemostasis,improving the surgical efficiency and clinical outcomes of CSR.
基金funded by the Major Research Plan of the National Natural Science Foundation of China(Grant No.92062217)the project of China Geological Survey(DD20190405).
文摘China is rich in abundant lithium resources characterized by considerable reserves and a concentrated distribution of metallogenic zones or belts,with proven reserves of 4046.8×10^(3) t(calculated based on Li_(2)O)by 2021.China is also a big consumer of lithium.By 2019,China’s lithium consumption in the battery sector alone had reached 99×10^(3) t,with an average annual growth rate of nearly 26%.China has become the world’s largest importer of lithium resources,showing a severely unbalanced relationship between supply and demand for lithium resources.Therefore,there is an urgent need for the prospecting,exploitation,and study of lithium resources in China.This study collected,organized,and summarized the data on the major lithium deposits in China,analyzed and compared the spatial-temporal distribution patterns,geological characteristics,and metallogenic regularity of these lithium deposits,and summarized the prospecting and research achievements over the last decade.The major lithium deposits in China are distributed in provinces and regions such as Qinghai,Jiangxi,Sichuan,Tibet,and Xinjiang.These deposits are mostly small in scale.According to different genetic types,this study divided lithium deposits into granitic pegmatite type,granite type,saline lake brine type,underground brine type,and sedimentary type,as well as new types including hot spring type and magmatic-hydrothermal type,and summarized the characteristics and key metallogenic factors of these different types of deposits.Sixteen metallogenic prospect areas of lithium deposits were delineated according to the deposit types and the distribution patterns of metallogenic belts.The paper introduced the research progress in major metallogenic models and lithium extraction techniques made over the past decade.Based on the comprehensive analysis of the prospecting potential of lithium deposits,the authors concluded that the future prospecting of lithium resources in China should focus on lithium metallogenic belts,the deep and peripheral areas of currently determined large-scale pegmatite-type lithium deposits,geophysical-geochemical anomalous areas with mineralization clues,and areas with developed large-scale low-grade associated granite-type and sedimentary lithium resources.The study aims to serve as a guide for the future prospecting of lithium deposits in China.
基金Project supported by the National Natural Science Foundation of China(No.11572149)the Nanjing University of Aeronautics and Astronautics Ph D Short-term Visiting Scholar Project(No.180912DF15)+2 种基金the Funding of Jiangsu Innovation Program for Graduate Education,China(No.KYLX15_0318)the Fundamental Research Funds for the Central Universities of Chinathe Open Funding Project of State Key Laboratory of Virtual Reality Technology and Systems,China(No.VRLAB2018C04)
文摘AIM： To elucidate the clinical, radiological and laboratory pro？les of renal abscess （RA） and perinephric abscess （PNA）, along with related treatment and outcome.METHODS： Ninety-eight patients diagnosed with RA or PNA using the primary discharge diagnoses identi？ed from the International Statistical Classification of Diseases and Related Health Problems Tenth Edition （ICD-10） codes （RA： N15.101, PNA： N15.102） between September 2004 and December 2014 in West China Hospital were selected. Medical records including patients’ characteristics, symptoms and signs, high-risk factors, radiological features, causative microorganisms and antibiotic-resistance pro？les, treatment approaches, and clinical outcomes were collected and analyzed.RESULTS： The mean age of the patients was 46.49 years with a male to female ratio of 41：57. Lumbar pain （76.5%） and fever （53.1%） were the most common symptoms. Other symptoms and signs included chills （28.6%）, anorexia and vomiting （25.5%）, lethargy （10.2%）, abdominal pain （11.2%）, fank mass （12.2%）, fank ？stula （2.0%）, gross hematuria （7.1%）, frequency （14.3%）, dysuria （9.2%）, pyuria （5.1%） and weight loss （1.0%）. Painful percussion of the costovertebral angle （87.8%） was the most common physical ？nding. The main predisposing factors were lithiasis （48.0%）, diabetes mellitus （33.7%） followed by history of urological surgery （16.3%）, urinary tract infections （14.3%）, renal function impairment （13.3%）, liver cirrhosis （2.0%）, neurogenic bladder （1.0%）, renal cyst （1.0%）, hydronephrosis （1.0%）, chronic hepatitis B （1.0%）, post-discectomy （1.0%） and post-colectomy （1.0%）. Ultrasound （US） and computed tomography were the most valuable diagnostic tools and US was recommended as the initial diagnostic imaging choice.Escherichia coli （51.4%）, Staphylococcus aureus （10.0%） and Klebsiella pneumoniae （8.6%） were the main causative microorganisms. Intravenous antibiotic therapy was necessary while intervention including surgical and nonsurgical approaches were reserved for larger abscesses, multiple abscesses, PNAs and non-responders. CONCLUSION： Heightened alertness, prompt diagnosis, and especially proper antibiotics in conjunction with interventional approaches allow a promising clinical outcome of renal and perinephric abscesses.
基金supported by the Shanghai Nuclear Engineering Research and Design Institute,State Power Investment Corporation
文摘The transient performance and optimization of a passive residual heat removal heat exchanger(PRHR HX)were investigated.First,a calculation method was developed for predicting the heat transfer of the PRHR HX.The calculation results were validated through comparisons with ROSA experimental data.The heat-transfer performance of the AP1000 PRHR HX in the initial period was predicted,and it satisfied the design requirements.Second,the distributions of the heat flux,tube-inside/outside heattransfer coefficients,and heat load for the AP1000 PRHR HX over 2000 s were examined.Third,an optimization study was conducted by adjusting the horizontal length and tube diameter.Their effects on the four main heat-transfer parameters and the heat-transfer area were analyzed.Furthermore,the influence of the initial in-containment refueling water storage tank(IRWST)temperature was investigated using an established simulation procedure.The results indicated that it significantly affected the trends of the IRWST temperature and reactor outlet temperature.Finally,the minimum required flow rates over time to maintain the reactor outlet temperature at the safety line were determined for different start-up times.The trends of the minimum required flow rate and the peak flow rate were analyzed.
