For 18 months, a newly developed low alloy weathering steel has been exposed in two coastal sites （Qingdao in the north China, Wanning in the south China）. The different corrosion behaviors of the exposed side and t...For 18 months, a newly developed low alloy weathering steel has been exposed in two coastal sites （Qingdao in the north China, Wanning in the south China）. The different corrosion behaviors of the exposed side and the underside of the samples were characterized by X-ray diffraetion （XRD）, polarization curve, electrochemical impedance spectroscopy （EIS）, scanning electron microscopy （SEM）, and N2 adsorption approach. It was found that the samples exhibited higher corrosion rate in Wanning than that in Qingdao. The underside of the samples corrodes more seriously than the exposed side in Qingdao, whereas the result in Wanning is just the reverse. The protection performance of rust layers mainly depends on its compactness and the enrichment of Cu and Cr is a secondary causation. The different compactness of rust layers in the exposed side and the underside originates from different corrosion conditions of the two sides.展开更多
BACKGROUND To prevent mother to child transmission(MTCT)of human immunodeficiency virus(HIV),sustained maternal viral load suppression(VLS)and early HIV testing among HIV exposed infants(HEI)is critical.AIM To investi...BACKGROUND To prevent mother to child transmission(MTCT)of human immunodeficiency virus(HIV),sustained maternal viral load suppression(VLS)and early HIV testing among HIV exposed infants(HEI)is critical.AIM To investigate maternal viral load results and infant HIV testing uptake at 6-weeks,and 9-months and 18-months in Rwanda.METHODS Between 2015 and 2022,VLS(<200 copies/mL)was measured among pregnant women living with HIV(WLHIV)from 38-healthcare facilities.Viral loads(VL)were measured at 6-months,12-months and 24-months,respectively.For maternal VL,the unit of analysis was visit-pair,and the pairs were created to define those with VL<200 copies/mL at two consecutive visits as having sustained VLS,persistent viremia(VL≥200 copies/mL at two consecutive visits),viral rebound(VL<200 copies/mL at prior visit only)and newly suppressed(VL<200 copies/mL at subsequent visit only).HEI were considered to have persistent HIV testing if they had all three HIV tests.Poisson regression models with generalized estimating equations were used to estimate the adjusted incidence rate ratio(aIRR)and 95%CI for factors associated with sustained VLS and persistent HIV testing.RESULTS A total of 1145 mother-infant pairs were analyzed.Infant HIV testing uptake at 6-weeks,9-months and 18-months was 1145(100.0%),1089(95.1%),1006(87.9%)respectively.Nine hundred ninety-nine HEI(87.3%)tested for HIV persistently.At 18-months,the incidence of HIV among HEI was 8(0.7%).Of 1145 mothers,1076(94.0%)had≥2 VL results making a total of 2010 visit-pairs(142-single;934-double visit-pairs).The incidence rate of sustained VLS,persistent viremia,viral rebound and new suppression were 91.0%,1.3%,3.6%and 4.0%respectively.Maternal disclosure of HIV status(aIRR=1.08,95%CI:1.02-1.14)was associated with increased likelihood of sustained VLS.Having peer support(aIRR=1.0595%CI:1.01-1.10)was associated with persistent HIV testing among HEI.CONCLUSION Sustained VLS is high among pregnant WLHIV in Rwanda.The low incidence of HIV among HEI may be attributed to high VLS levels.Targeted interventions,including enhanced HIV disclosure and peer support,are crucial for improving sustained VLS and increasing infant HIV testing uptake to reduce MTCT.展开更多
Natural slopes usually display complicated exposed rock surfaces that are characterized by complex and substantial terrain undulation and ubiquitous undesirable phenomena such as vegetation cover and rockfalls.This st...Natural slopes usually display complicated exposed rock surfaces that are characterized by complex and substantial terrain undulation and ubiquitous undesirable phenomena such as vegetation cover and rockfalls.This study presents a systematic outcrop research of fracture pattern variations in a complicated rock slope,and the qualitative and quantitative study of the complex phenomena impact on threedimensional(3D)discrete fracture network(DFN)modeling.As the studies of the outcrop fracture pattern have been so far focused on local variations,thus,we put forward a statistical analysis of global variations.The entire outcrop is partitioned into several subzones,and the subzone-scale variability of fracture geometric properties is analyzed(including the orientation,the density,and the trace length).The results reveal significant variations in fracture characteristics(such as the concentrative degree,the average orientation,the density,and the trace length)among different subzones.Moreover,the density of fracture sets,which is approximately parallel to the slope surface,exhibits a notably higher value compared to other fracture sets across all subzones.To improve the accuracy of the DFN modeling,the effects of three common phenomena resulting from vegetation and rockfalls are qualitatively analyzed and the corresponding quantitative data processing solutions are proposed.Subsequently,the 3D fracture geometric parameters are determined for different areas of the high-steep rock slope in terms of the subzone dimensions.The results show significant variations in the same set of 3D fracture parameters across different regions with density differing by up to tenfold and mean trace length exhibiting differences of 3e4 times.The study results present precise geological structural information,improve modeling accuracy,and provide practical solutions for addressing complex outcrop issues.展开更多
Background: Retention in clinical trials is critical for the accumulation of data over time and retaining enough power for comprehensive analysis. We document for the first time the retention rates and factors associa...Background: Retention in clinical trials is critical for the accumulation of data over time and retaining enough power for comprehensive analysis. We document for the first time the retention rates and factors associated with retention among a cohort of HIV exposed seronegative (HESN) person in a discordant relationship. Understanding these factors will provide valuable cues for maintaining high retention rates in future HIV biomedical prevention studies in this cohort. Aim: We aimed to document retention rates and associated factors relevant in conducting future HIV prevention studies using a cohort of HIV exposed sero-negative individuals. Method: We conducted a prospective cohort study to enroll HESN persons in discordant relationship based on established inclusion criteria that includes: Established sero-discordance with at least 3 months in the relationship;above 18 years and willingness to be followed up. Relevant ethical approvals were obtained. Following informed consent at enrollment, standardized questionnaires on risk behavior and factors that may affect retention were administered at enrollment and during the 2 years follow-up. This was spread over 10 follow-up visits to mimic phase a 2b HIV vaccine clinical trial follow up and duration. In addition, clinical examinations were done and samples collected for safety lab during the follow up visits. Estimation of CD4 and viral load was also done for the HIV+ partners of HESN study participants. Results: Six hundred and sixty HESN persons were screened and 534 (81%) enrolled (i.e. month 0) and followed up. There was a decline in retention from 96% at month 1 (visit 1) to 78% at month 24 (Visit 10). Sharpest drop out from the study occurred at month 1 (20%) and month 15 (14%) follow-up visits. Inability to reach study participants, unwillingness of study participants to continue study, and mortality of the HIV+ partners of HESN participants were the commonest reasons for participant study termination. Furthermore, no or low level of formal education, (AOR 2.79;95% CI 1.29 - 6.02, p = 0.06), being unemployed (AOR 1.96;95% CI 1.18 - 3.29, p < 0.01) and inconsistent use of condoms (AOR 1.83;95% CI 1.16 - 2.91, p Conclusion: Retention rates decline especially during month 1 (visit 1) and month 15 (visit 7) mainly due to participants’ inability to locate study participants and death of HIV+ partners of HESN enrollees. One unexpected finding from our study is that those who were more consistent in their use of condom were more likely to stay in the study. This is a possible indication of commitment or an incentive for giving free condoms at study visits. This is encouraging for combined biomedical prevention strategies where consistent condoms use is desired. On the other hand, factors such as unemployment, poor formal education and never/occasional condom use were predictors of study drop out. Retention strategies should consider these barriers and predictors of drop out as exclusion criteria in preparation for future HIV biomedical prevention trial.展开更多
Orthorhombic Nb_(2)O_(5)(T-Nb_(2)O_(5))is attractive for fast-charging Li-ion batteries,but it is still hard to realize rapid charge transfer kinetics for Li-ion storage.Herein,F-doped T-Nb_(2)O_(5) microflowers(F-Nb_(...Orthorhombic Nb_(2)O_(5)(T-Nb_(2)O_(5))is attractive for fast-charging Li-ion batteries,but it is still hard to realize rapid charge transfer kinetics for Li-ion storage.Herein,F-doped T-Nb_(2)O_(5) microflowers(F-Nb_(2)O_(5))are rationally synthesized through topotactic conversion.Specifically,F-Nb_(2)O_(5) are assembled by single-crystal nanoflakes with nearly 97%exposed(100)facet,which maximizes the exposure of the feasible Li^(+)transport pathways along loosely packed 4g atomic layers to the electrolytes,thus effectively enhancing the Li^(+)-intercalation performance.Besides,the band gap of F-Nb_(2)O_(5) is reduced to 2.87 eV due to the doping of F atoms,leading to enhanced electrical conductivity.The synergetic effects between tailored exposed crystal facets,F-doping,and ultrathin building blocks,speed up the Li^(+)/electron transfer kinetics and improve the pseudocapacitive properties of F-Nb_(2)O_(5).Therefore,F-Nb_(2)O_(5) exhibit superior rate capability(210.8 and 164.9 mAh g^(-1) at 1 and 10 C,respectively)and good long-term 10 C cycling performance(132.7 mAh g^(-1) after 1500 cycles).展开更多
BACKGROUND Gastric stromal tumors,originating from mesenchymal tissues,are one of the most common tumors of the digestive tract.For stromal tumors originating from the muscularis propria,compared with conventional end...BACKGROUND Gastric stromal tumors,originating from mesenchymal tissues,are one of the most common tumors of the digestive tract.For stromal tumors originating from the muscularis propria,compared with conventional endoscopic submucosal dissection(ESD),endoscopic full-thickness resection(EFTR)can remove deep lesions and digestive tract wall tumors completely.However,this technique has major limitations such as perforation,postoperative bleeding,and post-polypectomy syndrome.Herein,we report a case of postoperative serous surface bleeding which formed an encapsulated hemoperitoneum in a patient with gastric stromal tumor that was treated with exposed EFTR.Feasible treatment options to address this complication are described.CASE SUMMARY A 47-year-old male patient had a hemispherical protrusion found during gastric endoscopic ultrasonography,located at the upper gastric curvature adjacent to the stomach fundus,with a smooth surface mucosa and poor mobility.The lesion was 19.3 mm×16.1 mm in size and originated from the fourth ultrasound layer.Computed tomography(CT)revealed no significant evidence of lymph node enlargement or distant metastasis.Using conventional ESD technology for mucosal pre-resection,exposed EFTR was performed to resect the intact tumor in order to achieve a definitive histopathological diagnosis.Based on its morphology and immunohistochemical expression of CD117 and DOG-1,the lesion was proven to be consistent with a gastric stromal tumor.Six days after exposed EFTR,CT showed a large amount of encapsulated fluid and gas accumulation around the stomach.In addition,gastroscopy suggested intracavitary bleeding and abdominal puncture drainage indicated serosal bleeding.Based on these findings,the patient was diagnosed with serosal bleeding resulting in encapsulated abdominal hemorrhage after exposed EFTR for a gastric stromal tumor.The patient received combined treatments,such as hemostasis under gastroscopy,gastrointestinal decompression,and abdominal drainage.All examinations were normal within six months of follow-up.CONCLUSION This patient developed serous surface bleeding in the gastric cavity following exposed EFTR.Serosal bleeding resulting in an encapsulated hemoperitoneum is rare in clinical practice.The combined treatment may replace certain surgical techniques.展开更多
This article presents a new multichannel medium access control (MAC) protocol to solve the exposed-terminal (ET) problem for efficient channel sharing in multi-hop wireless networks. It uses request-to-send and clear-...This article presents a new multichannel medium access control (MAC) protocol to solve the exposed-terminal (ET) problem for efficient channel sharing in multi-hop wireless networks. It uses request-to-send and clear-to-send (RTS/CTS) dialogue on a common channel and flexibly opts for conflict-free traffic channels to carry out the data packet transmission on the basis of a new channel selection scheme. The acknowledgment (ACK) packet for the data packet transmission is sent back to the sender over another ...展开更多
Rational tuning of crystallographic surface and metal doping were effective to enhance the catalytic performance of metal organic frameworks,but limited work has been explored for achieving modulation of crystal facet...Rational tuning of crystallographic surface and metal doping were effective to enhance the catalytic performance of metal organic frameworks,but limited work has been explored for achieving modulation of crystal facets and metal doping in a single system.MIL-68(In)was promising for photocatalytic applications due to its low toxicity and excellent photoresponsivity.However,its catalytic activity was constrained by severe carrier recombination and a lack of active sites.Herein,increased(001)facet ratio and active sites exposure were simultaneously realized by cobalt doping in MIL-68(In)through a one-pot solvothermal strategy.Optimized MIL-68(In/Co)-2.5 exhibited remarkable catalytic performance in comparison with pristine MIL-68(In)and other MIL-68(In/Co).The reaction kinetic constant and degradation efficiency of MIL-68(In/Co)were approximately twice and 17%higher than the pristine MIL-68(In)in 36 min reaction,respectively.Density functional theory calculations revealed that Co dopant could modulate the orientation of MIL-68(In)facets,facilitate the exchange of electrons and reduce the adsorption energy of peroxymonosulfate(PMS).This work provides a novel pathway for improvement of In-based MOFs in PMS/vis system,it also promotes the profound comprehension of the correlation between crystal facet regulation and catalytic activation in the PMS/vis system.展开更多
The China Pavilion has consistently been the primary vehicle for China's participation in World Expos over the years.From the first China Pavilion at the 1876 Philadelphia Expo to the 2025 China Pavilion at the on...The China Pavilion has consistently been the primary vehicle for China's participation in World Expos over the years.From the first China Pavilion at the 1876 Philadelphia Expo to the 2025 China Pavilion at the ongoing Osaka Expo,nearly 150 years have passed.During this span,the China Pavilion at the Expos.展开更多
In current underground mining, the stability of the exposed backfill face is a basic issue associated with mining design and has been the subject of considerable research in mining safety and efficiency. In this study...In current underground mining, the stability of the exposed backfill face is a basic issue associated with mining design and has been the subject of considerable research in mining safety and efficiency. In this study, an improved analytical solution for evaluating the safety of vertically exposed faces in backfilling was proposed. Based on a differential slice method, the proposed solution emphasizes the arching effect as having the advantages of more rigor and wider scalability. Feasibility of the proposed solution was validated with classic centrifuge results. Good agreement between compared results indicated that the proposed solution skillfully predicts the behavior of the paste centrifuge model. Additionally, calculation of exposed face safety in sequential filling was presented. The proposed solution has practical significance in mine backfill design.展开更多
The present report evaluates the effects of formaldehyde (FA) exposure on peripheral lymphocytes by using heth genetic and immunological parameters. Twenty-three non-smoking students in the study had inhalation exposu...The present report evaluates the effects of formaldehyde (FA) exposure on peripheral lymphocytes by using heth genetic and immunological parameters. Twenty-three non-smoking students in the study had inhalation exposure to 0.508 ±0. 299 mg/m3 of FA for a Period of 8 weeks (3h × 3 times each week) during anatomy classes. As for composition of lymphocyte subsets after FA exposare,significant increase was found in the percentage of CD19(B cells), while sighficant decrease was observed in CD3(total T cells), CD4(T helper-inducer cells), and CD8(T cytotoxic-suppressior cells) with a P<0 .01. Increase in the ratio of T-helper-inducer cells to T-cytotoxic-suppressor cells (T4 / T8) was also observed with statistical sighcance after exposure (P < 0.001). In the meanwhile,no significant difference (P > 0 .05) was reported between lymphocyte prolifendion rate and sisterchromatid exchange (SCE) at the exposure level and duration. It is suggested that the lymphocyte subsets may be most susceptible to the effects of FA, though a single immunological endpoint is rarely related with pathophysiological interpretation.展开更多
The ultimately exposed roof area(UERA)of goaf is crucial to the safety and economics of underground mining.The prediction models do not consider the mechanical weakness of rock mass and ignore the influence of the joi...The ultimately exposed roof area(UERA)of goaf is crucial to the safety and economics of underground mining.The prediction models do not consider the mechanical weakness of rock mass and ignore the influence of the joint damage factor,causing a large predicted exposure area with a high roof falling risk.This work adopted joint damage factor to derive a new UERA prediction model.The relationships between the UERA(S)and the span ratio(m),the density(k)and the diameter of fracture(d)were analysed by the new prediction model.The results showed that the exposed area S and the span ratio m have a U-shaped curve relationship.The S decreases with the increase of m and then increases when m is beyond 2.The exposed roof area S is in an inversely proportional power-law relationship with the fracture surface density k,and the curvature of the S-k relationship curve decreases when d=0.5 and k>7,and S is close to 0.There is a negative correlation between S and the fracture surface diameter d,the curvature of the S-d curve decreases with the increase of d and k,and the variation rate increases first and then decreases with the increase of d;when k=0.5 and d>9,S is close to 0.The predicted values of the UERA prediction model are 119.3,112.8,and 114.6 m2 with different joint damage parameters,which are slightly smaller than the actual critical exposure area of a roof(S=120 m2).The case study shows that the alternative prediction model is reasonable and acceptable and provides new theoretical support for the underground mining safety of sedimentary bauxite ore.展开更多
Photocatalytic degradation of gaseous pollutants on Bi-based semiconductors under solar lightirradiation has attracted significant attention.However,their application in gaseous straight-chainalkane purification is st...Photocatalytic degradation of gaseous pollutants on Bi-based semiconductors under solar lightirradiation has attracted significant attention.However,their application in gaseous straight-chainalkane purification is still rare.Here,a series of Bi/BiOBr composites were solvothermally synthe-sized and applied in solar-light-driven photocatalytic degradation of gaseous n-hexane.The charac-terization results revealed that both increasing number of functional groups of alcohol solvent(from methanol and ethylene glycol to glycerol)and solvothermal temperature(from 160 and 180to 200℃)facilitated the in-situ formation of metallic Bi nanospheres on BiOBr nanoplates withexposed(110)facets.Meanwhile,chemical bonding between Bi and BiOBr was observed on theseexposed facets that resulted in the formation of surface oxygen vacancy.Furthermore,the synergis-tic effect of optimum surface oxygen vacancy on exposed(110)facets led to a high visible light re-sponse,narrow band gap,great photocurrent,low recombination rate of the charge carriers,andstrong·O2-and h*formation,all of which resulted in the highest removal efficiency of 97.4%within120 min of 15 ppmv of n-hexane on Bi/BiOBr.Our findings efficiently broaden the application ofBi-based photocatalysis technology in the purification of gaseous straight-chain pollutants emittedby the petrochemical industry.展开更多
The frequency of micronuclei (MN) in cells of the nasal mucosa, oral mucosa and in lym-phocytes was evaluated for 25 students in anatomy classes exposed to formaldehyde (FA) overan 8-week period. Each student served a...The frequency of micronuclei (MN) in cells of the nasal mucosa, oral mucosa and in lym-phocytes was evaluated for 25 students in anatomy classes exposed to formaldehyde (FA) overan 8-week period. Each student served as his or her own control. The time-weighted averageconcentration (TWA) of fOrmaldehyde in anatomical laboratories and in students' dormitorieswas 0. 508 ± 0. 299 mg/m3 and 0. 012 ± 0. 0025mg/m3, respectively. A higher frequency ofmicronuclei was observed in nasal and oral exfoliative cells after formaldehyde exposure (3. 85± 1. 48 vs 1 .20± 0. 676 and 0. 857 ± 0. 558 vs 0. 568 ± 0. 317, paired-t test: P< 0. 001and P < 0. 01, respectively). No significant increase in the frequency of lymphocyte micronu-clei was found after formaldehyde exposure (P >0. 05 ). The present study shows that nasalmucosa cel1s exposed through respiration are the chief target of FA-induced genotoxic effects展开更多
BACKGROUND Aplasia cutis congenita (ACC) in newborns is a condition in which congenital defects or hypoplasia is present in part of the epidermis,dermis and even subcutaneous tissue (including muscle and bones).First ...BACKGROUND Aplasia cutis congenita (ACC) in newborns is a condition in which congenital defects or hypoplasia is present in part of the epidermis,dermis and even subcutaneous tissue (including muscle and bones).First reported by Cordon in 1767,ACC is a rare disease with a low incidence of 1/100000 to 3/10000.Currently,there are 500 cases reported worldwide.ACC can be accompanied by other malformations.The onset mechanism of the disease remains unknown but is thought to be correlated to factors such as genetics,narrow uterus,foetal skin and amniotic membrane adhesion,use of teratogenic drugs in early pregnancy and viral infection.CASE SUMMARY In August 2018,we treated a newborn with ACC on the left lower limbs using a combination of ionic silver dressing and moist exposed burn ointment (MEBO) and achieved a satisfactory treatment outcome.The skin defects were observed on the external genitals and on areas from the left foot to 3/4 of the upper left side.Subcutaneous tissue and blood vessels were observed in the regions with skin defects.The following treatments were provided.First,the wound was rinsed with 0.9% sodium chloride solution followed by disinfection with povidone-iodine twice.And then MEBO was applied to the wound at a thickness of approximately 1 mm.After applying ionic silver dressing,the wound was covered with sterile gauze.The wound dressing was replaced every 2-3 d.At the 4-mo follow-up,the treatment outcome was satisfactory.There was minimal scar tissue formation,and limb function was not impaired.CONCLUSION The combination of ionic silver dressing and MEBO to ACC is helpful.展开更多
Exposed endoscopic full-thickness resection(EFTR)without laparoscopic assistance is a minimally invasive natural orifice transluminal endoscopic surgery technique that is emerging as a promising effective and safe alt...Exposed endoscopic full-thickness resection(EFTR)without laparoscopic assistance is a minimally invasive natural orifice transluminal endoscopic surgery technique that is emerging as a promising effective and safe alternative to surgery for the treatment of muscularis propria-originating gastric submucosal tumors.To date,various techniques have been used for the closure of the transmural postEFTR defect,mainly consisting in clip-and endoloop-assisted closure methods.However,the recent advent of dedicated tools capable of providing full-thickness defect suture could further improve the efficacy and safety of the exposed EFTR procedure.The aim of our review was to evaluate the efficacy and safety of the different closure methods adopted in gastric-exposed EFTR without laparoscopic assistance,also considering the recent advent of flexible endoscopic suturing.展开更多
Cytokinesis-blocked micronucleus assay was applied as a biological dosimeter to detect abnormalities in human peripheral lymphocytes of thirteen students exposed to formaldehyde (FA) during a 12-week (10 h per week) a...Cytokinesis-blocked micronucleus assay was applied as a biological dosimeter to detect abnormalities in human peripheral lymphocytes of thirteen students exposed to formaldehyde (FA) during a 12-week (10 h per week) anatomy class. Breathing-zone air samples colleeted during dissection procedures showed a mean concentration of 2. 37 ppm (3. 17mg/m3 ). Ten students from the same school but without FA exposure served as controls. Chromosome aberrations (CA) and sister chromatid exchanges (SCE) were detected in both groups. The micronuclei (MN) rate (6. 38 ± 2. 50‰ ) and CA rate (5. 92 ±2. 40‰ ) in the FA-exposed group showed a significant increase (P< 0. 01 ) when compared with those of the controls (3. 15 ±1. 46‰and 3. 40 ± 1. 57 % respectively). A correlation between MN and CA in individuals was observed. SCE in the exmpd group were also increased (P< 0. 05), but not so greatly as MN or CA. The results indicated that FA might damage the chromosomes of human lymphocytes.展开更多
The specific distribution characteristics of inclusions along with the sliver defect were analyzed in detail to explain the formation mechanism of the sliver defect on the automobile exposed panel surface.A quantitati...The specific distribution characteristics of inclusions along with the sliver defect were analyzed in detail to explain the formation mechanism of the sliver defect on the automobile exposed panel surface.A quantitative electrolysis method was used to compare and evaluate the three-dimensional morphology,size,composition,quantity,and distribution of inclusions in the defect and non-defect zone of automobile exposed panel.The Al2O3 inclusions were observed to be aggregated or chain-like shape along with the sliver defect of about 3–10μm.The aggregation sections of the Al2O3 inclusions are distributed discretely along the rolling direction,with a spacing of 3–7 mm,a length of 6–7 mm,and a width of about 3 mm.The inclusion area part is 0.04%–0.16%with an average value of 0.08%,the inclusion number density is 40 mm−2 and the inclusion average spacing is 25.13μm.The inclusion spacing is approximately 40–160μm,with an average value of 68.76μm in chain-like inclusion parts.The average area fraction and number density of inclusions in the non-defect region were reduced to about 0.002%and 1–2 mm^−2,respectively,with the inclusion spacing of 400μm and the size of Al2O3 being 1–3μm.展开更多
BACKGROUND Body parts such as the face and hands are highly exposed during daily life and burns may accumulate in these areas.In addition,residual wounds,scar hyperplasia and contracture often exist in the late stage ...BACKGROUND Body parts such as the face and hands are highly exposed during daily life and burns may accumulate in these areas.In addition,residual wounds,scar hyperplasia and contracture often exist in the late stage of a deep burn in these areas,which may affect patients’appearance,movements,and mental health.However,inadequate attention has been paid to this issue which can result in problems,such as difficulty in healing,possibility of carcinoma,chronic pain and a heavy mental burden.AIM To investigate the long-term medical treatment of patients with severe burns at exposed sites following a mass burn casualty event.METHODS A retrospective analysis of 13 patients with severe burns at exposed sites was performed to determine their respective long-term medical treatment.A combined wound dressing scheme consisting of traditional Chinese and Western medicine was introduced to repair residual wounds.Active and passive functional exercises with massage,Chinese herbal baths and compression fixation were proposed to ameliorate the condition of the hands.A combination of physical,chemical and photoelectrical measures was adopted for anti-scar treatment.A psychological intervention and recovery guide was provided which corresponded to the patients’psychological status.RESULTS Compared to patients who did not simultaneously receive the same treatment,patients who underwent systematic treatment recovered with a lower woundinfection rate(P<0.05),a shorter healing time(13.6±3.2 d)compared with(19.1±3.5 d)and more bearable pain during wound dressing at three days,one week and two weeks after a Chinese herbal bath(P<0.05).Satisfactory results were achieved with regard to restored function of patients’joints and blood supply to nerve endings,closure of the eyelids and the size of mouth opening tended to be normal,and only 7.1%of patients were diagnosed with severe scar hyperplasia and contracture deformity compared with 30.7%in the control group.In addition,the color,thickness,vascular distribution and softness score of the scars improved(P<0.01),and the effects of the psychological intervention was remarkable as shown by the Self-Rating Anxiety Scale and Self-Rating Depression Scale.CONCLUSION A better prognosis can be achieved in patients in the late stage of a burn with active residual wound repair,limb functional exercise,anti-scar and psychological rehabilitation.展开更多
基金supported by National Key Basic Research and Development Programof China (No.2004CB619102).
文摘For 18 months, a newly developed low alloy weathering steel has been exposed in two coastal sites （Qingdao in the north China, Wanning in the south China）. The different corrosion behaviors of the exposed side and the underside of the samples were characterized by X-ray diffraetion （XRD）, polarization curve, electrochemical impedance spectroscopy （EIS）, scanning electron microscopy （SEM）, and N2 adsorption approach. It was found that the samples exhibited higher corrosion rate in Wanning than that in Qingdao. The underside of the samples corrodes more seriously than the exposed side in Qingdao, whereas the result in Wanning is just the reverse. The protection performance of rust layers mainly depends on its compactness and the enrichment of Cu and Cr is a secondary causation. The different compactness of rust layers in the exposed side and the underside originates from different corrosion conditions of the two sides.
文摘BACKGROUND To prevent mother to child transmission(MTCT)of human immunodeficiency virus(HIV),sustained maternal viral load suppression(VLS)and early HIV testing among HIV exposed infants(HEI)is critical.AIM To investigate maternal viral load results and infant HIV testing uptake at 6-weeks,and 9-months and 18-months in Rwanda.METHODS Between 2015 and 2022,VLS(<200 copies/mL)was measured among pregnant women living with HIV(WLHIV)from 38-healthcare facilities.Viral loads(VL)were measured at 6-months,12-months and 24-months,respectively.For maternal VL,the unit of analysis was visit-pair,and the pairs were created to define those with VL<200 copies/mL at two consecutive visits as having sustained VLS,persistent viremia(VL≥200 copies/mL at two consecutive visits),viral rebound(VL<200 copies/mL at prior visit only)and newly suppressed(VL<200 copies/mL at subsequent visit only).HEI were considered to have persistent HIV testing if they had all three HIV tests.Poisson regression models with generalized estimating equations were used to estimate the adjusted incidence rate ratio(aIRR)and 95%CI for factors associated with sustained VLS and persistent HIV testing.RESULTS A total of 1145 mother-infant pairs were analyzed.Infant HIV testing uptake at 6-weeks,9-months and 18-months was 1145(100.0%),1089(95.1%),1006(87.9%)respectively.Nine hundred ninety-nine HEI(87.3%)tested for HIV persistently.At 18-months,the incidence of HIV among HEI was 8(0.7%).Of 1145 mothers,1076(94.0%)had≥2 VL results making a total of 2010 visit-pairs(142-single;934-double visit-pairs).The incidence rate of sustained VLS,persistent viremia,viral rebound and new suppression were 91.0%,1.3%,3.6%and 4.0%respectively.Maternal disclosure of HIV status(aIRR=1.08,95%CI:1.02-1.14)was associated with increased likelihood of sustained VLS.Having peer support(aIRR=1.0595%CI:1.01-1.10)was associated with persistent HIV testing among HEI.CONCLUSION Sustained VLS is high among pregnant WLHIV in Rwanda.The low incidence of HIV among HEI may be attributed to high VLS levels.Targeted interventions,including enhanced HIV disclosure and peer support,are crucial for improving sustained VLS and increasing infant HIV testing uptake to reduce MTCT.
基金supported by the National Key Research and Development Program of China(Grant No.2022YFC3080200)the National Natural Science Foundation of China(Grant No.42022053)the China Postdoctoral Science Foundation(Grant No.2023M731264).
文摘Natural slopes usually display complicated exposed rock surfaces that are characterized by complex and substantial terrain undulation and ubiquitous undesirable phenomena such as vegetation cover and rockfalls.This study presents a systematic outcrop research of fracture pattern variations in a complicated rock slope,and the qualitative and quantitative study of the complex phenomena impact on threedimensional(3D)discrete fracture network(DFN)modeling.As the studies of the outcrop fracture pattern have been so far focused on local variations,thus,we put forward a statistical analysis of global variations.The entire outcrop is partitioned into several subzones,and the subzone-scale variability of fracture geometric properties is analyzed(including the orientation,the density,and the trace length).The results reveal significant variations in fracture characteristics(such as the concentrative degree,the average orientation,the density,and the trace length)among different subzones.Moreover,the density of fracture sets,which is approximately parallel to the slope surface,exhibits a notably higher value compared to other fracture sets across all subzones.To improve the accuracy of the DFN modeling,the effects of three common phenomena resulting from vegetation and rockfalls are qualitatively analyzed and the corresponding quantitative data processing solutions are proposed.Subsequently,the 3D fracture geometric parameters are determined for different areas of the high-steep rock slope in terms of the subzone dimensions.The results show significant variations in the same set of 3D fracture parameters across different regions with density differing by up to tenfold and mean trace length exhibiting differences of 3e4 times.The study results present precise geological structural information,improve modeling accuracy,and provide practical solutions for addressing complex outcrop issues.
文摘Background: Retention in clinical trials is critical for the accumulation of data over time and retaining enough power for comprehensive analysis. We document for the first time the retention rates and factors associated with retention among a cohort of HIV exposed seronegative (HESN) person in a discordant relationship. Understanding these factors will provide valuable cues for maintaining high retention rates in future HIV biomedical prevention studies in this cohort. Aim: We aimed to document retention rates and associated factors relevant in conducting future HIV prevention studies using a cohort of HIV exposed sero-negative individuals. Method: We conducted a prospective cohort study to enroll HESN persons in discordant relationship based on established inclusion criteria that includes: Established sero-discordance with at least 3 months in the relationship;above 18 years and willingness to be followed up. Relevant ethical approvals were obtained. Following informed consent at enrollment, standardized questionnaires on risk behavior and factors that may affect retention were administered at enrollment and during the 2 years follow-up. This was spread over 10 follow-up visits to mimic phase a 2b HIV vaccine clinical trial follow up and duration. In addition, clinical examinations were done and samples collected for safety lab during the follow up visits. Estimation of CD4 and viral load was also done for the HIV+ partners of HESN study participants. Results: Six hundred and sixty HESN persons were screened and 534 (81%) enrolled (i.e. month 0) and followed up. There was a decline in retention from 96% at month 1 (visit 1) to 78% at month 24 (Visit 10). Sharpest drop out from the study occurred at month 1 (20%) and month 15 (14%) follow-up visits. Inability to reach study participants, unwillingness of study participants to continue study, and mortality of the HIV+ partners of HESN participants were the commonest reasons for participant study termination. Furthermore, no or low level of formal education, (AOR 2.79;95% CI 1.29 - 6.02, p = 0.06), being unemployed (AOR 1.96;95% CI 1.18 - 3.29, p < 0.01) and inconsistent use of condoms (AOR 1.83;95% CI 1.16 - 2.91, p Conclusion: Retention rates decline especially during month 1 (visit 1) and month 15 (visit 7) mainly due to participants’ inability to locate study participants and death of HIV+ partners of HESN enrollees. One unexpected finding from our study is that those who were more consistent in their use of condom were more likely to stay in the study. This is a possible indication of commitment or an incentive for giving free condoms at study visits. This is encouraging for combined biomedical prevention strategies where consistent condoms use is desired. On the other hand, factors such as unemployment, poor formal education and never/occasional condom use were predictors of study drop out. Retention strategies should consider these barriers and predictors of drop out as exclusion criteria in preparation for future HIV biomedical prevention trial.
基金supported by the National Natural Science Foundation of China(No.51802163)the Natural Science Foundation of Henan Province of China(No.222300420252)the Natural Science Foundation of Henan Department of Education(No.20A480004).
文摘Orthorhombic Nb_(2)O_(5)(T-Nb_(2)O_(5))is attractive for fast-charging Li-ion batteries,but it is still hard to realize rapid charge transfer kinetics for Li-ion storage.Herein,F-doped T-Nb_(2)O_(5) microflowers(F-Nb_(2)O_(5))are rationally synthesized through topotactic conversion.Specifically,F-Nb_(2)O_(5) are assembled by single-crystal nanoflakes with nearly 97%exposed(100)facet,which maximizes the exposure of the feasible Li^(+)transport pathways along loosely packed 4g atomic layers to the electrolytes,thus effectively enhancing the Li^(+)-intercalation performance.Besides,the band gap of F-Nb_(2)O_(5) is reduced to 2.87 eV due to the doping of F atoms,leading to enhanced electrical conductivity.The synergetic effects between tailored exposed crystal facets,F-doping,and ultrathin building blocks,speed up the Li^(+)/electron transfer kinetics and improve the pseudocapacitive properties of F-Nb_(2)O_(5).Therefore,F-Nb_(2)O_(5) exhibit superior rate capability(210.8 and 164.9 mAh g^(-1) at 1 and 10 C,respectively)and good long-term 10 C cycling performance(132.7 mAh g^(-1) after 1500 cycles).
文摘BACKGROUND Gastric stromal tumors,originating from mesenchymal tissues,are one of the most common tumors of the digestive tract.For stromal tumors originating from the muscularis propria,compared with conventional endoscopic submucosal dissection(ESD),endoscopic full-thickness resection(EFTR)can remove deep lesions and digestive tract wall tumors completely.However,this technique has major limitations such as perforation,postoperative bleeding,and post-polypectomy syndrome.Herein,we report a case of postoperative serous surface bleeding which formed an encapsulated hemoperitoneum in a patient with gastric stromal tumor that was treated with exposed EFTR.Feasible treatment options to address this complication are described.CASE SUMMARY A 47-year-old male patient had a hemispherical protrusion found during gastric endoscopic ultrasonography,located at the upper gastric curvature adjacent to the stomach fundus,with a smooth surface mucosa and poor mobility.The lesion was 19.3 mm×16.1 mm in size and originated from the fourth ultrasound layer.Computed tomography(CT)revealed no significant evidence of lymph node enlargement or distant metastasis.Using conventional ESD technology for mucosal pre-resection,exposed EFTR was performed to resect the intact tumor in order to achieve a definitive histopathological diagnosis.Based on its morphology and immunohistochemical expression of CD117 and DOG-1,the lesion was proven to be consistent with a gastric stromal tumor.Six days after exposed EFTR,CT showed a large amount of encapsulated fluid and gas accumulation around the stomach.In addition,gastroscopy suggested intracavitary bleeding and abdominal puncture drainage indicated serosal bleeding.Based on these findings,the patient was diagnosed with serosal bleeding resulting in encapsulated abdominal hemorrhage after exposed EFTR for a gastric stromal tumor.The patient received combined treatments,such as hemostasis under gastroscopy,gastrointestinal decompression,and abdominal drainage.All examinations were normal within six months of follow-up.CONCLUSION This patient developed serous surface bleeding in the gastric cavity following exposed EFTR.Serosal bleeding resulting in an encapsulated hemoperitoneum is rare in clinical practice.The combined treatment may replace certain surgical techniques.
基金National Natural Science Foundation of China (10577005, 60532030)National Outstanding Youth Science Foundation of China (60625102)NSBS Program of Beijing University of Aeronau-tics and Astronautics, China (221235)
文摘This article presents a new multichannel medium access control (MAC) protocol to solve the exposed-terminal (ET) problem for efficient channel sharing in multi-hop wireless networks. It uses request-to-send and clear-to-send (RTS/CTS) dialogue on a common channel and flexibly opts for conflict-free traffic channels to carry out the data packet transmission on the basis of a new channel selection scheme. The acknowledgment (ACK) packet for the data packet transmission is sent back to the sender over another ...
基金supported by the National Natural Science Foundation of China(Nos.52100087,52170079,U20A20322)Science and Technology Development Program of Jilin Province,China(Nos.20220508100RC,20230402035GH).
文摘Rational tuning of crystallographic surface and metal doping were effective to enhance the catalytic performance of metal organic frameworks,but limited work has been explored for achieving modulation of crystal facets and metal doping in a single system.MIL-68(In)was promising for photocatalytic applications due to its low toxicity and excellent photoresponsivity.However,its catalytic activity was constrained by severe carrier recombination and a lack of active sites.Herein,increased(001)facet ratio and active sites exposure were simultaneously realized by cobalt doping in MIL-68(In)through a one-pot solvothermal strategy.Optimized MIL-68(In/Co)-2.5 exhibited remarkable catalytic performance in comparison with pristine MIL-68(In)and other MIL-68(In/Co).The reaction kinetic constant and degradation efficiency of MIL-68(In/Co)were approximately twice and 17%higher than the pristine MIL-68(In)in 36 min reaction,respectively.Density functional theory calculations revealed that Co dopant could modulate the orientation of MIL-68(In)facets,facilitate the exchange of electrons and reduce the adsorption energy of peroxymonosulfate(PMS).This work provides a novel pathway for improvement of In-based MOFs in PMS/vis system,it also promotes the profound comprehension of the correlation between crystal facet regulation and catalytic activation in the PMS/vis system.
文摘The China Pavilion has consistently been the primary vehicle for China's participation in World Expos over the years.From the first China Pavilion at the 1876 Philadelphia Expo to the 2025 China Pavilion at the ongoing Osaka Expo,nearly 150 years have passed.During this span,the China Pavilion at the Expos.
基金financially supported by the China Scholarship Council (No. 201506420049)
文摘In current underground mining, the stability of the exposed backfill face is a basic issue associated with mining design and has been the subject of considerable research in mining safety and efficiency. In this study, an improved analytical solution for evaluating the safety of vertically exposed faces in backfilling was proposed. Based on a differential slice method, the proposed solution emphasizes the arching effect as having the advantages of more rigor and wider scalability. Feasibility of the proposed solution was validated with classic centrifuge results. Good agreement between compared results indicated that the proposed solution skillfully predicts the behavior of the paste centrifuge model. Additionally, calculation of exposed face safety in sequential filling was presented. The proposed solution has practical significance in mine backfill design.
文摘The present report evaluates the effects of formaldehyde (FA) exposure on peripheral lymphocytes by using heth genetic and immunological parameters. Twenty-three non-smoking students in the study had inhalation exposure to 0.508 ±0. 299 mg/m3 of FA for a Period of 8 weeks (3h × 3 times each week) during anatomy classes. As for composition of lymphocyte subsets after FA exposare,significant increase was found in the percentage of CD19(B cells), while sighficant decrease was observed in CD3(total T cells), CD4(T helper-inducer cells), and CD8(T cytotoxic-suppressior cells) with a P<0 .01. Increase in the ratio of T-helper-inducer cells to T-cytotoxic-suppressor cells (T4 / T8) was also observed with statistical sighcance after exposure (P < 0.001). In the meanwhile,no significant difference (P > 0 .05) was reported between lymphocyte prolifendion rate and sisterchromatid exchange (SCE) at the exposure level and duration. It is suggested that the lymphocyte subsets may be most susceptible to the effects of FA, though a single immunological endpoint is rarely related with pathophysiological interpretation.
基金This work is supported by the National Natural Science Foundation of China(51974135,51704094)the National Key Research and Development Program of China(2016YFC0600802).
文摘The ultimately exposed roof area(UERA)of goaf is crucial to the safety and economics of underground mining.The prediction models do not consider the mechanical weakness of rock mass and ignore the influence of the joint damage factor,causing a large predicted exposure area with a high roof falling risk.This work adopted joint damage factor to derive a new UERA prediction model.The relationships between the UERA(S)and the span ratio(m),the density(k)and the diameter of fracture(d)were analysed by the new prediction model.The results showed that the exposed area S and the span ratio m have a U-shaped curve relationship.The S decreases with the increase of m and then increases when m is beyond 2.The exposed roof area S is in an inversely proportional power-law relationship with the fracture surface density k,and the curvature of the S-k relationship curve decreases when d=0.5 and k>7,and S is close to 0.There is a negative correlation between S and the fracture surface diameter d,the curvature of the S-d curve decreases with the increase of d and k,and the variation rate increases first and then decreases with the increase of d;when k=0.5 and d>9,S is close to 0.The predicted values of the UERA prediction model are 119.3,112.8,and 114.6 m2 with different joint damage parameters,which are slightly smaller than the actual critical exposure area of a roof(S=120 m2).The case study shows that the alternative prediction model is reasonable and acceptable and provides new theoretical support for the underground mining safety of sedimentary bauxite ore.
文摘Photocatalytic degradation of gaseous pollutants on Bi-based semiconductors under solar lightirradiation has attracted significant attention.However,their application in gaseous straight-chainalkane purification is still rare.Here,a series of Bi/BiOBr composites were solvothermally synthe-sized and applied in solar-light-driven photocatalytic degradation of gaseous n-hexane.The charac-terization results revealed that both increasing number of functional groups of alcohol solvent(from methanol and ethylene glycol to glycerol)and solvothermal temperature(from 160 and 180to 200℃)facilitated the in-situ formation of metallic Bi nanospheres on BiOBr nanoplates withexposed(110)facets.Meanwhile,chemical bonding between Bi and BiOBr was observed on theseexposed facets that resulted in the formation of surface oxygen vacancy.Furthermore,the synergis-tic effect of optimum surface oxygen vacancy on exposed(110)facets led to a high visible light re-sponse,narrow band gap,great photocurrent,low recombination rate of the charge carriers,andstrong·O2-and h*formation,all of which resulted in the highest removal efficiency of 97.4%within120 min of 15 ppmv of n-hexane on Bi/BiOBr.Our findings efficiently broaden the application ofBi-based photocatalysis technology in the purification of gaseous straight-chain pollutants emittedby the petrochemical industry.
文摘The frequency of micronuclei (MN) in cells of the nasal mucosa, oral mucosa and in lym-phocytes was evaluated for 25 students in anatomy classes exposed to formaldehyde (FA) overan 8-week period. Each student served as his or her own control. The time-weighted averageconcentration (TWA) of fOrmaldehyde in anatomical laboratories and in students' dormitorieswas 0. 508 ± 0. 299 mg/m3 and 0. 012 ± 0. 0025mg/m3, respectively. A higher frequency ofmicronuclei was observed in nasal and oral exfoliative cells after formaldehyde exposure (3. 85± 1. 48 vs 1 .20± 0. 676 and 0. 857 ± 0. 558 vs 0. 568 ± 0. 317, paired-t test: P< 0. 001and P < 0. 01, respectively). No significant increase in the frequency of lymphocyte micronu-clei was found after formaldehyde exposure (P >0. 05 ). The present study shows that nasalmucosa cel1s exposed through respiration are the chief target of FA-induced genotoxic effects
文摘BACKGROUND Aplasia cutis congenita (ACC) in newborns is a condition in which congenital defects or hypoplasia is present in part of the epidermis,dermis and even subcutaneous tissue (including muscle and bones).First reported by Cordon in 1767,ACC is a rare disease with a low incidence of 1/100000 to 3/10000.Currently,there are 500 cases reported worldwide.ACC can be accompanied by other malformations.The onset mechanism of the disease remains unknown but is thought to be correlated to factors such as genetics,narrow uterus,foetal skin and amniotic membrane adhesion,use of teratogenic drugs in early pregnancy and viral infection.CASE SUMMARY In August 2018,we treated a newborn with ACC on the left lower limbs using a combination of ionic silver dressing and moist exposed burn ointment (MEBO) and achieved a satisfactory treatment outcome.The skin defects were observed on the external genitals and on areas from the left foot to 3/4 of the upper left side.Subcutaneous tissue and blood vessels were observed in the regions with skin defects.The following treatments were provided.First,the wound was rinsed with 0.9% sodium chloride solution followed by disinfection with povidone-iodine twice.And then MEBO was applied to the wound at a thickness of approximately 1 mm.After applying ionic silver dressing,the wound was covered with sterile gauze.The wound dressing was replaced every 2-3 d.At the 4-mo follow-up,the treatment outcome was satisfactory.There was minimal scar tissue formation,and limb function was not impaired.CONCLUSION The combination of ionic silver dressing and MEBO to ACC is helpful.
文摘Exposed endoscopic full-thickness resection(EFTR)without laparoscopic assistance is a minimally invasive natural orifice transluminal endoscopic surgery technique that is emerging as a promising effective and safe alternative to surgery for the treatment of muscularis propria-originating gastric submucosal tumors.To date,various techniques have been used for the closure of the transmural postEFTR defect,mainly consisting in clip-and endoloop-assisted closure methods.However,the recent advent of dedicated tools capable of providing full-thickness defect suture could further improve the efficacy and safety of the exposed EFTR procedure.The aim of our review was to evaluate the efficacy and safety of the different closure methods adopted in gastric-exposed EFTR without laparoscopic assistance,also considering the recent advent of flexible endoscopic suturing.
文摘Cytokinesis-blocked micronucleus assay was applied as a biological dosimeter to detect abnormalities in human peripheral lymphocytes of thirteen students exposed to formaldehyde (FA) during a 12-week (10 h per week) anatomy class. Breathing-zone air samples colleeted during dissection procedures showed a mean concentration of 2. 37 ppm (3. 17mg/m3 ). Ten students from the same school but without FA exposure served as controls. Chromosome aberrations (CA) and sister chromatid exchanges (SCE) were detected in both groups. The micronuclei (MN) rate (6. 38 ± 2. 50‰ ) and CA rate (5. 92 ±2. 40‰ ) in the FA-exposed group showed a significant increase (P< 0. 01 ) when compared with those of the controls (3. 15 ±1. 46‰and 3. 40 ± 1. 57 % respectively). A correlation between MN and CA in individuals was observed. SCE in the exmpd group were also increased (P< 0. 05), but not so greatly as MN or CA. The results indicated that FA might damage the chromosomes of human lymphocytes.
基金This work was financially supported by the National Natural Science Foundation of China(No.U1960202).
文摘The specific distribution characteristics of inclusions along with the sliver defect were analyzed in detail to explain the formation mechanism of the sliver defect on the automobile exposed panel surface.A quantitative electrolysis method was used to compare and evaluate the three-dimensional morphology,size,composition,quantity,and distribution of inclusions in the defect and non-defect zone of automobile exposed panel.The Al2O3 inclusions were observed to be aggregated or chain-like shape along with the sliver defect of about 3–10μm.The aggregation sections of the Al2O3 inclusions are distributed discretely along the rolling direction,with a spacing of 3–7 mm,a length of 6–7 mm,and a width of about 3 mm.The inclusion area part is 0.04%–0.16%with an average value of 0.08%,the inclusion number density is 40 mm−2 and the inclusion average spacing is 25.13μm.The inclusion spacing is approximately 40–160μm,with an average value of 68.76μm in chain-like inclusion parts.The average area fraction and number density of inclusions in the non-defect region were reduced to about 0.002%and 1–2 mm^−2,respectively,with the inclusion spacing of 400μm and the size of Al2O3 being 1–3μm.
基金Supported by Key Research and Development Project of Jiangsu Province,No.BE2018626。
文摘BACKGROUND Body parts such as the face and hands are highly exposed during daily life and burns may accumulate in these areas.In addition,residual wounds,scar hyperplasia and contracture often exist in the late stage of a deep burn in these areas,which may affect patients’appearance,movements,and mental health.However,inadequate attention has been paid to this issue which can result in problems,such as difficulty in healing,possibility of carcinoma,chronic pain and a heavy mental burden.AIM To investigate the long-term medical treatment of patients with severe burns at exposed sites following a mass burn casualty event.METHODS A retrospective analysis of 13 patients with severe burns at exposed sites was performed to determine their respective long-term medical treatment.A combined wound dressing scheme consisting of traditional Chinese and Western medicine was introduced to repair residual wounds.Active and passive functional exercises with massage,Chinese herbal baths and compression fixation were proposed to ameliorate the condition of the hands.A combination of physical,chemical and photoelectrical measures was adopted for anti-scar treatment.A psychological intervention and recovery guide was provided which corresponded to the patients’psychological status.RESULTS Compared to patients who did not simultaneously receive the same treatment,patients who underwent systematic treatment recovered with a lower woundinfection rate(P<0.05),a shorter healing time(13.6±3.2 d)compared with(19.1±3.5 d)and more bearable pain during wound dressing at three days,one week and two weeks after a Chinese herbal bath(P<0.05).Satisfactory results were achieved with regard to restored function of patients’joints and blood supply to nerve endings,closure of the eyelids and the size of mouth opening tended to be normal,and only 7.1%of patients were diagnosed with severe scar hyperplasia and contracture deformity compared with 30.7%in the control group.In addition,the color,thickness,vascular distribution and softness score of the scars improved(P<0.01),and the effects of the psychological intervention was remarkable as shown by the Self-Rating Anxiety Scale and Self-Rating Depression Scale.CONCLUSION A better prognosis can be achieved in patients in the late stage of a burn with active residual wound repair,limb functional exercise,anti-scar and psychological rehabilitation.
