BACKGROUND Hook of hamate fractures occur either due to repetitive stress from gripping sports(e.g.,golf,tennis,and baseball),leading to fatigue fracture,or as a result of trauma from falls or other injuries.The recom...BACKGROUND Hook of hamate fractures occur either due to repetitive stress from gripping sports(e.g.,golf,tennis,and baseball),leading to fatigue fracture,or as a result of trauma from falls or other injuries.The recommended treatment involves the excision of bone fragments to facilitate athletes’early return to sports;excision surgery is also performed in trauma cases.However,some patients prefer nonsurgical treatment options,and conservative treatment should be considered.AIM To present a case series of 16 patients conservatively treated for hook of hamate fractures.METHODS This study included 16(11 males and 5 females;right side,6 cases;left side,10)patients who desired conservative treatment and could be followed-up until bone union was achieved.The average age of the patients was 49.6(range:24-72)years.The average time from injury to consultation was 4.3(range:0.2-21.4)weeks.The treatment involved 4 weeks of casting from the forearm to the metacarpophalangeal joint,followed by 8 weeks of splint fixation of the wrist.Follow-up computed tomography scans were performed every 4 weeks.RESULTS Bone union was achieved in all patients.The average duration of casting was 3.7(range:0-5)weeks and that of splint fixation thereafter was 8.6(range:0-28)weeks.The patients did not exhibit joint contractures or range of motion restrictions due to prolonged immobilization.CONCLUSION Conservative treatment with external fixation may be an option for hook of hamate fractures.展开更多
This commentary evaluates the case report by Mohammed et al on conservative management of ischiofemoral impingement through a multimodal physical therapy program integrating in-person sessions,telerehabilitation,dry n...This commentary evaluates the case report by Mohammed et al on conservative management of ischiofemoral impingement through a multimodal physical therapy program integrating in-person sessions,telerehabilitation,dry needling,and kinesiology taping.The study demonstrated significant pain reduction and functional improvement,highlighting the feasibility of hybrid care models.However,limitations include short-term follow-up,lack of post-treatment imaging,and single-case design restricting generalizability.Future research should prioritize longitudinal studies,anatomical correlation via imaging,and randomized trials to validate efficacy across diverse populations.While the framework offers promising clinical utility,further investigation is critical to optimize protocols and elucidate biomechanical mechanisms underlying symptom resolution.展开更多
This editorial critically evaluates the landmark study by Tanaka and Yoshii,which demonstrated a 100%union rate with conservative management of hamate hook fractures,challenging the historical preference for surgical ...This editorial critically evaluates the landmark study by Tanaka and Yoshii,which demonstrated a 100%union rate with conservative management of hamate hook fractures,challenging the historical preference for surgical intervention.In contrast to Scheufle et al’s report of 90%-100%failure rates with early surgical approaches,Tanaka and Yoshii’s protocol achieved universal healing despite delayed diagnoses in 25%of cases.Central to this success is the systematic inte-gration of high-resolution computed tomography for early diagnosis and dynamic monitoring of trabecular bone regeneration,significantly reducing missed dia-gnoses and guiding personalized immobilization timelines.The patient-centered strategy—allowing temporary splint removal during low-risk activities—balanced fracture stability with joint mobility preservation,avoiding post-treatment stiff-ness.However,limitations such as small sample size(n=16),selection bias,and insufficient long-term functional data(e.g.,grip strength,return-to-sport metrics)underscore the need for comparative trials.Emerging trends,including adjunct therapies like low-intensity pulsed ultrasound and biologics(e.g.,teriparatide),are proposed to accelerate healing while minimizing immobilization risks.This work redefines conservative fracture management paradigms,emphasizing in-novation without compromising efficacy.Overall,this assessment deepens our understanding of the conservative management of hook fractures and provides evidence-based insights for improved clinical decision-making.展开更多
BACKGROUND Enterocutaneous(EC)fistula incidence has been increasing in China,along with increases in the volume and complexity of surgeries.The conservative treatment strategy has been analyzed to improve the treatmen...BACKGROUND Enterocutaneous(EC)fistula incidence has been increasing in China,along with increases in the volume and complexity of surgeries.The conservative treatment strategy has been analyzed to improve the treatment outcomes for patients with EC fistulas and reduce the need for reoperation.AIM To analyze the clinical data of patients undergoing conservative treatment for EC fistulas and identify the factors that promote self-healing.These findings provide a reference for improving the clinical cure rate of EC fistulas with conservative treatment.METHODS The clinical data of 91 patients with EC fistulas who underwent conservative treatment were collected.The relationships between the cure rate and characteristics such as age,sex,body mass index,albumin level,primary disease,cause of the fistula,location of the fistula,number of fistulas,nature of the fistula,infection status,diagnostic methods,nutritional support methods,somatostatin therapy,growth hormone therapy,and fibrin glue therapy were analyzed.RESULTS A comparison of the basic patient characteristics between the two groups revealed statistically significant differences in primary disease(P=0.044),location of the fistula(P=0.006),number of fistulas(P=0.007),and use of adhesive sealing(χ2=12.194,P<0.001)between the uncured and cured groups.The use of fibrin glue was a significant factor associated with a cure for fistulas(odds ratio=5.459,95%CI:1.958-15.219,P=0.01).CONCLUSION The cure rate of patients with a single EC fistula can be effectively improved via conservative treatment combined with the use of biological fibrin glue to seal the fistula.展开更多
BACKGROUND Emphysematous gastritis(EG)is a rare and serious condition that has fatal consequences.Although its clinical presentation is not specific,radiological imaging is characterized by intramural gastric gas.Defe...BACKGROUND Emphysematous gastritis(EG)is a rare and serious condition that has fatal consequences.Although its clinical presentation is not specific,radiological imaging is characterized by intramural gastric gas.Defects in the stomach mucosal barrier and invasion of gas-producing organisms are believed to be the cause.CASE SUMMARY An 88-year-old male with multiple comorbidities presented to our center with abdominal pain and increased stoma output as chief complaints.Upon further investigation he was found to have EG.Despite the high mortality risk without intervention,the patient and family declined operative intervention.CONCLUSION This case report underscored the challenges of managing a critically ill elderly patient with a history of multiple comorbidities and extensive abdominal surgeries and highlighted the successful use of conservative measures in treating EG.展开更多
In this paper,we develop a fourth-order conservative wavelet-based shock-capturing scheme.The scheme is constructed by combining a wavelet collocation upwind method with the monotonic tangent of hyperbola for interfac...In this paper,we develop a fourth-order conservative wavelet-based shock-capturing scheme.The scheme is constructed by combining a wavelet collocation upwind method with the monotonic tangent of hyperbola for interface capturing(THINC)technique.We employ boundary variation diminishing(BVD)reconstruction to enhance the scheme’s effectiveness in handling shocks.First,we prove that wavelet collocation upwind schemes based on interpolating wavelets can be reformulated into a conservative form within the framework of wavelet theory,forming the foundation of the proposed scheme.The new fourthorder accurate scheme possesses significantly better spectral resolution than the fifth-and even seventh-order WENO-Z(weighted essentially non-oscillatory)schemes over the entire wave-number range.Moreover,the inherent low-pass filtering property of the wavelet bases allows them to filter high-frequency numerical oscillations,endowing the wavelet upwind scheme with robustness and accuracy in solving problems under extreme conditions.Notably,due to the wavelet multiresolution approximation,the proposed scheme possesses a distinctive shape-preserving property absent in the WENO-Z schemes and the fifth-order schemes with BVD reconstruction based on polynomials.Furthermore,compared to the fifth-order scheme with BVD reconstruction based on polynomials—which is significantly superior to the WENO schemes—the proposed scheme further enhances the ability to capture discontinuities.展开更多
This paper presents both analytical and numerical studies of the conservative Sawada-Kotera equation and its dissipative generalization,equations known for their soliton solutions and rich chaotic dynamics.These model...This paper presents both analytical and numerical studies of the conservative Sawada-Kotera equation and its dissipative generalization,equations known for their soliton solutions and rich chaotic dynamics.These models offer valuable insights into nonlinear wave propagation,with applications in fluid dynamics and materials science,including systems such as liquid crystals and ferrofluids.It is shown that the conservative Sawada-Kotera equation supports traveling wave solutions corresponding to elliptic limit cycles,as well as two-and three-dimensional invariant tori surrounding these cycles in the associated ordinary differential equation(ODE)system.For the dissipative generalized Sawada-Kotera equation,chaotic wave behavior is observed.The transition to chaos in the corresponding ODE systemfollows a universal bifurcation scenario consistent with the framework established by FShM(Feigenbaum-Sharkovsky-Magnitskii)theory.Notably,this study demonstrates for the first time that the conservative Sawada-Kotera equation can exhibit complex quasi-periodic wave solutions,while its dissipative counterpart admits an infinite number of stable periodic and chaotic waveforms.展开更多
Conservative chaotic systems have unique advantages over dissipative chaotic systems in the fields of secure communication and pseudo-random number generator because they do not have attractors but possess good traver...Conservative chaotic systems have unique advantages over dissipative chaotic systems in the fields of secure communication and pseudo-random number generator because they do not have attractors but possess good traversal and pseudorandomness. In this work, a novel five-dimensional(5D) Hamiltonian conservative hyperchaotic system is proposed based on the 5D Euler equation. The proposed system can have different types of coordinate transformations and time reversal symmetries. In this work, Hamilton energy and Casimir energy are analyzed firstly, and it is proved that the new system satisfies Hamilton energy conservation and can generate chaos. Then, the complex dynamic characteristics of the system are demonstrated and the conservatism and chaos characteristics of the system are verified through the correlation analysis methods such as phase diagram, equilibrium point, Lyapunov exponent, bifurcation diagram, and SE complexity. In addition, a detailed analysis of the multistable characteristics of the system reveals that many energy-related coexisting orbits exist. Based on the infinite number of center-type and saddle-type equilibrium points, the dynamic characteristics of the hidden multistability of the system are revealed. Then, the National Institute of Standards and Technology(NIST)test of the new system shows that the chaotic sequence generated by the system has strong pseudo-random. Finally, the circuit simulation and hardware circuit experiment of the system are carried out with Multisim simulation software and digital signal processor(DSP) respectively. The experimental results confirm that the new system has good ergodicity and realizability.展开更多
In this paper,we propose a novel Local Macroscopic Conservative(LoMaC)low rank tensor method with discontinuous Galerkin(DG)discretization for the physical and phase spaces for simulating the Vlasov-Poisson(VP)system....In this paper,we propose a novel Local Macroscopic Conservative(LoMaC)low rank tensor method with discontinuous Galerkin(DG)discretization for the physical and phase spaces for simulating the Vlasov-Poisson(VP)system.The LoMaC property refers to the exact local conservation of macroscopic mass,momentum,and energy at the discrete level.The recently developed LoMaC low rank tensor algorithm(arXiv:2207.00518)simultaneously evolves the macroscopic conservation laws of mass,momentum,and energy using the kinetic flux vector splitting;then the LoMaC property is realized by projecting the low rank kinetic solution onto a subspace that shares the same macroscopic observables.This paper is a generalization of our previous work,but with DG discretization to take advantage of its compactness and flexibility in handling boundary conditions and its superior accuracy in the long term.The algorithm is developed in a similar fashion as that for a finite difference scheme,by observing that the DG method can be viewed equivalently in a nodal fashion.With the nodal DG method,assuming a tensorized computational grid,one will be able to(i)derive differentiation matrices for different nodal points based on a DG upwind discretization of transport terms,and(ii)define a weighted inner product space based on the nodal DG grid points.The algorithm can be extended to the high dimensional problems by hierarchical Tucker(HT)decomposition of solution tensors and a corresponding conservative projection algorithm.In a similar spirit,the algorithm can be extended to DG methods on nodal points of an unstructured mesh,or to other types of discretization,e.g.,the spectral method in velocity direction.Extensive numerical results are performed to showcase the efficacy of the method.展开更多
BACKGROUND Acute appendicitis is one of the most common emergency abdominal disease,and recent studies have evaluated conservative treatment using antibiotics for uncomplicated appendicitis.Although the efficacy of co...BACKGROUND Acute appendicitis is one of the most common emergency abdominal disease,and recent studies have evaluated conservative treatment using antibiotics for uncomplicated appendicitis.Although the efficacy of conservative treatment for uncomplicated appendicitis is known,its efficacy for complicated appendicitis remains unknown,so are risk factors for the conservative treatment of appendi-citis.In our institution,conservative treatment has long been the first choice for most appendicitis cases,except for perforation.Therefore,this novel study inves-tigated the outcomes of conservative treatment for uncomplicated and compli-cated acute appendicitis and the risk factors associated with conservative treat-ment.treatment.The significant and independent predictors of resistance to conservative treatment were body temperature≥37.3℃,appendicolith and Douglas sinus fluid visible on computed tomography(CT).The rate of resistance to conservative treatment was 66.7%(6/9)for patients with the above three factors,22.9%(8/35)for patients with two factors(appendicolith and body temperature≥37.3℃),16.7%(2/12)for patients with two factors(Douglas sinus fluid and appendicolith)and 11.1%(1/9)for patients with two factors(Douglas sinus fluid and body temperature≥37.3℃).CONCLUSION A temperature≥37.3℃,appendicolith and Douglas sinus fluid on CT might be clinical risk factors of resistance to conservative treatment for acute appendicitis.展开更多
Secondary hyperparathyroidism (HPT) is frequent in dialysis patients. Parathyroidectomy (PTX) is indicated for patients who failed medical therapy. We reviewed the data from 184 dialysis patients who underwent PTX bet...Secondary hyperparathyroidism (HPT) is frequent in dialysis patients. Parathyroidectomy (PTX) is indicated for patients who failed medical therapy. We reviewed the data from 184 dialysis patients who underwent PTX between January 2015 and January 2023. We aimed to evaluate the short and long term outcomes of PTX in dialysis patients, comparing the conservative 3/4 versus 7/8 techniques in this population.166 dialysis patients with secondary HPT were included. A conservative subtotal PTX (sPTX) 7/8 was performed in 72% of patients and sPTX 3/4 in 28% of them. Severe postoperative hypocalcaemiaocurred in 45 patients (27%). Hypocalcaemia was significantly more frequent in the sPTX 7/8 group (p = 0.012). One case of persistent HPT (0.6%) and 20 cases of recurrence (12%) were diagnosed. Recurrence was more frequent in the sPTX 3/4 group (15%). No deaths were reported during the perioperative period.展开更多
Congenital eversion of the upper eyelids is a rare condition, the exact cause of which remains unknown. It is more frequently associated with Down’s syndrome and black babies. If diagnosed early and treated properly,...Congenital eversion of the upper eyelids is a rare condition, the exact cause of which remains unknown. It is more frequently associated with Down’s syndrome and black babies. If diagnosed early and treated properly, the condition can be managed without surgery. We report a case of non syndromic congenital bilateral severe upper eyelid eversion in otherwise normal 3 days old neonate of African descent (Tanzanian), born by vaginal delivery. The case was conservatively managed by lubricants, antibiotics and eyelid patching. We report this case because from the best of our knowledge it has never been documented here at our hospital and Tanzania before.展开更多
Lumbar disc herniation(LDH)is a common orthopedic disease in clinical practice,with main symptoms of varying degrees of pain and functional impairment,seriously affecting the quality of work and life of patients,and a...Lumbar disc herniation(LDH)is a common orthopedic disease in clinical practice,with main symptoms of varying degrees of pain and functional impairment,seriously affecting the quality of work and life of patients,and also causing a certain degree of economic burden to the patient's family and society.At present,there are various conservative treatment methods for LDH in clinical practice.Conservative treatment has the characteristics of small trauma and high safety,which can achieve symptom relief and cure for most patients in clinical practice.This article aims to provide a scientific reference for the selection of treatment plans for LDH patients by reviewing relevant literature on conservative treatment of LDH that has been publicly reported both domestically and internationally in recent years.展开更多
In this paper Mei symmetry is introduced for a nonconservative system. The necessary and sufficient condition for a Mei symmetry to be also a Lie symmetry is derived. It is proved that the Mei symmetry leads to a non-...In this paper Mei symmetry is introduced for a nonconservative system. The necessary and sufficient condition for a Mei symmetry to be also a Lie symmetry is derived. It is proved that the Mei symmetry leads to a non-Noether conservative quantity via a Lie symmetry, and deduces a Lutzky conservative quantity via a Lie point symmetry.展开更多
In this paper,we develop an entropy-conservative discontinuous Galerkin(DG)method for the shallow water(SW)equation with random inputs.One of the most popular methods for uncertainty quantifcation is the generalized P...In this paper,we develop an entropy-conservative discontinuous Galerkin(DG)method for the shallow water(SW)equation with random inputs.One of the most popular methods for uncertainty quantifcation is the generalized Polynomial Chaos(gPC)approach which we consider in the following manuscript.We apply the stochastic Galerkin(SG)method to the stochastic SW equations.Using the SG approach in the stochastic hyperbolic SW system yields a purely deterministic system that is not necessarily hyperbolic anymore.The lack of the hyperbolicity leads to ill-posedness and stability issues in numerical simulations.By transforming the system using Roe variables,the hyperbolicity can be ensured and an entropy-entropy fux pair is known from a recent investigation by Gerster and Herty(Commun.Comput.Phys.27(3):639–671,2020).We use this pair and determine a corresponding entropy fux potential.Then,we construct entropy conservative numerical twopoint fuxes for this augmented system.By applying these new numerical fuxes in a nodal DG spectral element method(DGSEM)with fux diferencing ansatz,we obtain a provable entropy conservative(dissipative)scheme.In numerical experiments,we validate our theoretical fndings.展开更多
Aim To extend several fundamental theorems of conventional elasticity theory to quasicrystalelasticity theory. Methods The basic governing equations of quasicrystal elasticity theory and Gauss's theorem were appli...Aim To extend several fundamental theorems of conventional elasticity theory to quasicrystalelasticity theory. Methods The basic governing equations of quasicrystal elasticity theory and Gauss's theorem were applied in the derivation. Results and Conclusion The principle of virtual work, Betti's reciprocal theorem and the uniqueness theorem of quasicrystal elasticity theory are proud, and some conservative integrals in quasicrystal elasticty theory are obtained.展开更多
The conservative form and singular perturbed ordinary differential equation with periodic boundary value problem were studied, and a conservative difference scheme was constructed. Using the method of decomposing the ...The conservative form and singular perturbed ordinary differential equation with periodic boundary value problem were studied, and a conservative difference scheme was constructed. Using the method of decomposing the singular term from its solution and combining an asymptotic expansion of the equation, it is proved that the scheme converges uniformly to the solution of differential equation with order one.展开更多
For the conservative and non-conservative schemes of nonlinear evolution equations, by taking the two-dimensional shallow water wave equations as an example, a comparative analysis on computational stability is carrie...For the conservative and non-conservative schemes of nonlinear evolution equations, by taking the two-dimensional shallow water wave equations as an example, a comparative analysis on computational stability is carried out. The relationship between the nonlinear computational stability, the structure of the difference schemes, and the form of initial values is also discussed.展开更多
Objective To investigate whether the very elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) will benefit from an invasive strategy versus a conservative strategy. Methods 190 consecutive pa...Objective To investigate whether the very elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) will benefit from an invasive strategy versus a conservative strategy. Methods 190 consecutive patients aged 80 years or older with NSTEMI were included in the retrospective study from September 2014 to August 2017, of which 69 patients received conservative strategy and 121 patients received invasive strategy. The primary outcome was death. Multivariate Cox regression models were used to assess the statistical association between strategies and mortality. The survival probability was further analyzed. Results The primary outcome occurred in 17.4% patients in the invasive group and in 42.0% patients in the conservative group (P = 0.0002). The readmission rate in the invasive group (14.9%) was higher than that in the conservative group (7.2%). Creatinine level (OR = 1.01, 95% CI: 0.10–1.03, P = 0.05) and use of diuretic (OR = 3.65, 95% CI: 1.56–8.53, P = 0.003) were independent influential factors for invasive strategy. HRs for multivariate Cox regression models were 3.45 (95% CI: 1.77–6.75, P = 0.0003), 3.02 (95% CI: 1.52–6.01, P = 0.0017), 2.93 (95% CI: 1. 46–5.86, P = 0.0024) and 2.47 (95% CI: 1.20–5.07, P = 0.0137). Compared with the patients received invasive strategy, the conservative group had remarkably reduced survival probability with time since treatment (P < 0.001). Conclusions An invasive strategy is superior to a conservative strategy in reducing mortality of patients aged 80 years or older with NSTEMI. Our results suggest that an invasive strategy is more suitable for the very elderly patients with NSTEMI in China.展开更多
A new conservative finite difference scheme is presented based on the numerical analysis for an initialboundary value problem of a class of Schroedinger equation with the wave operator. The scheme can be linear and im...A new conservative finite difference scheme is presented based on the numerical analysis for an initialboundary value problem of a class of Schroedinger equation with the wave operator. The scheme can be linear and implicit or explicit based on the parameter choice. The initial value after discretization has second-order accuracy that is consistent with the scheme accuracy. The existence and the uniqueness of the difference solution are proved. Based on the priori estimates and an inequality about norms, the stability and the convergence of difference solutions with the second-order are proved in the energy norm. Experimental results demonstrate the efficiency of the new scheme.展开更多
文摘BACKGROUND Hook of hamate fractures occur either due to repetitive stress from gripping sports(e.g.,golf,tennis,and baseball),leading to fatigue fracture,or as a result of trauma from falls or other injuries.The recommended treatment involves the excision of bone fragments to facilitate athletes’early return to sports;excision surgery is also performed in trauma cases.However,some patients prefer nonsurgical treatment options,and conservative treatment should be considered.AIM To present a case series of 16 patients conservatively treated for hook of hamate fractures.METHODS This study included 16(11 males and 5 females;right side,6 cases;left side,10)patients who desired conservative treatment and could be followed-up until bone union was achieved.The average age of the patients was 49.6(range:24-72)years.The average time from injury to consultation was 4.3(range:0.2-21.4)weeks.The treatment involved 4 weeks of casting from the forearm to the metacarpophalangeal joint,followed by 8 weeks of splint fixation of the wrist.Follow-up computed tomography scans were performed every 4 weeks.RESULTS Bone union was achieved in all patients.The average duration of casting was 3.7(range:0-5)weeks and that of splint fixation thereafter was 8.6(range:0-28)weeks.The patients did not exhibit joint contractures or range of motion restrictions due to prolonged immobilization.CONCLUSION Conservative treatment with external fixation may be an option for hook of hamate fractures.
文摘This commentary evaluates the case report by Mohammed et al on conservative management of ischiofemoral impingement through a multimodal physical therapy program integrating in-person sessions,telerehabilitation,dry needling,and kinesiology taping.The study demonstrated significant pain reduction and functional improvement,highlighting the feasibility of hybrid care models.However,limitations include short-term follow-up,lack of post-treatment imaging,and single-case design restricting generalizability.Future research should prioritize longitudinal studies,anatomical correlation via imaging,and randomized trials to validate efficacy across diverse populations.While the framework offers promising clinical utility,further investigation is critical to optimize protocols and elucidate biomechanical mechanisms underlying symptom resolution.
文摘This editorial critically evaluates the landmark study by Tanaka and Yoshii,which demonstrated a 100%union rate with conservative management of hamate hook fractures,challenging the historical preference for surgical intervention.In contrast to Scheufle et al’s report of 90%-100%failure rates with early surgical approaches,Tanaka and Yoshii’s protocol achieved universal healing despite delayed diagnoses in 25%of cases.Central to this success is the systematic inte-gration of high-resolution computed tomography for early diagnosis and dynamic monitoring of trabecular bone regeneration,significantly reducing missed dia-gnoses and guiding personalized immobilization timelines.The patient-centered strategy—allowing temporary splint removal during low-risk activities—balanced fracture stability with joint mobility preservation,avoiding post-treatment stiff-ness.However,limitations such as small sample size(n=16),selection bias,and insufficient long-term functional data(e.g.,grip strength,return-to-sport metrics)underscore the need for comparative trials.Emerging trends,including adjunct therapies like low-intensity pulsed ultrasound and biologics(e.g.,teriparatide),are proposed to accelerate healing while minimizing immobilization risks.This work redefines conservative fracture management paradigms,emphasizing in-novation without compromising efficacy.Overall,this assessment deepens our understanding of the conservative management of hook fractures and provides evidence-based insights for improved clinical decision-making.
文摘BACKGROUND Enterocutaneous(EC)fistula incidence has been increasing in China,along with increases in the volume and complexity of surgeries.The conservative treatment strategy has been analyzed to improve the treatment outcomes for patients with EC fistulas and reduce the need for reoperation.AIM To analyze the clinical data of patients undergoing conservative treatment for EC fistulas and identify the factors that promote self-healing.These findings provide a reference for improving the clinical cure rate of EC fistulas with conservative treatment.METHODS The clinical data of 91 patients with EC fistulas who underwent conservative treatment were collected.The relationships between the cure rate and characteristics such as age,sex,body mass index,albumin level,primary disease,cause of the fistula,location of the fistula,number of fistulas,nature of the fistula,infection status,diagnostic methods,nutritional support methods,somatostatin therapy,growth hormone therapy,and fibrin glue therapy were analyzed.RESULTS A comparison of the basic patient characteristics between the two groups revealed statistically significant differences in primary disease(P=0.044),location of the fistula(P=0.006),number of fistulas(P=0.007),and use of adhesive sealing(χ2=12.194,P<0.001)between the uncured and cured groups.The use of fibrin glue was a significant factor associated with a cure for fistulas(odds ratio=5.459,95%CI:1.958-15.219,P=0.01).CONCLUSION The cure rate of patients with a single EC fistula can be effectively improved via conservative treatment combined with the use of biological fibrin glue to seal the fistula.
文摘BACKGROUND Emphysematous gastritis(EG)is a rare and serious condition that has fatal consequences.Although its clinical presentation is not specific,radiological imaging is characterized by intramural gastric gas.Defects in the stomach mucosal barrier and invasion of gas-producing organisms are believed to be the cause.CASE SUMMARY An 88-year-old male with multiple comorbidities presented to our center with abdominal pain and increased stoma output as chief complaints.Upon further investigation he was found to have EG.Despite the high mortality risk without intervention,the patient and family declined operative intervention.CONCLUSION This case report underscored the challenges of managing a critically ill elderly patient with a history of multiple comorbidities and extensive abdominal surgeries and highlighted the successful use of conservative measures in treating EG.
基金supported by the National Natural Science Foundation of China(Grant No.11925204).
文摘In this paper,we develop a fourth-order conservative wavelet-based shock-capturing scheme.The scheme is constructed by combining a wavelet collocation upwind method with the monotonic tangent of hyperbola for interface capturing(THINC)technique.We employ boundary variation diminishing(BVD)reconstruction to enhance the scheme’s effectiveness in handling shocks.First,we prove that wavelet collocation upwind schemes based on interpolating wavelets can be reformulated into a conservative form within the framework of wavelet theory,forming the foundation of the proposed scheme.The new fourthorder accurate scheme possesses significantly better spectral resolution than the fifth-and even seventh-order WENO-Z(weighted essentially non-oscillatory)schemes over the entire wave-number range.Moreover,the inherent low-pass filtering property of the wavelet bases allows them to filter high-frequency numerical oscillations,endowing the wavelet upwind scheme with robustness and accuracy in solving problems under extreme conditions.Notably,due to the wavelet multiresolution approximation,the proposed scheme possesses a distinctive shape-preserving property absent in the WENO-Z schemes and the fifth-order schemes with BVD reconstruction based on polynomials.Furthermore,compared to the fifth-order scheme with BVD reconstruction based on polynomials—which is significantly superior to the WENO schemes—the proposed scheme further enhances the ability to capture discontinuities.
文摘This paper presents both analytical and numerical studies of the conservative Sawada-Kotera equation and its dissipative generalization,equations known for their soliton solutions and rich chaotic dynamics.These models offer valuable insights into nonlinear wave propagation,with applications in fluid dynamics and materials science,including systems such as liquid crystals and ferrofluids.It is shown that the conservative Sawada-Kotera equation supports traveling wave solutions corresponding to elliptic limit cycles,as well as two-and three-dimensional invariant tori surrounding these cycles in the associated ordinary differential equation(ODE)system.For the dissipative generalized Sawada-Kotera equation,chaotic wave behavior is observed.The transition to chaos in the corresponding ODE systemfollows a universal bifurcation scenario consistent with the framework established by FShM(Feigenbaum-Sharkovsky-Magnitskii)theory.Notably,this study demonstrates for the first time that the conservative Sawada-Kotera equation can exhibit complex quasi-periodic wave solutions,while its dissipative counterpart admits an infinite number of stable periodic and chaotic waveforms.
基金Project supported by the Heilongjiang Province Natural Science Foundation Joint Guidance Project,China (Grant No.LH2020F022)the Fundamental Research Funds for the Central Universities,China (Grant No.3072022CF0801)。
文摘Conservative chaotic systems have unique advantages over dissipative chaotic systems in the fields of secure communication and pseudo-random number generator because they do not have attractors but possess good traversal and pseudorandomness. In this work, a novel five-dimensional(5D) Hamiltonian conservative hyperchaotic system is proposed based on the 5D Euler equation. The proposed system can have different types of coordinate transformations and time reversal symmetries. In this work, Hamilton energy and Casimir energy are analyzed firstly, and it is proved that the new system satisfies Hamilton energy conservation and can generate chaos. Then, the complex dynamic characteristics of the system are demonstrated and the conservatism and chaos characteristics of the system are verified through the correlation analysis methods such as phase diagram, equilibrium point, Lyapunov exponent, bifurcation diagram, and SE complexity. In addition, a detailed analysis of the multistable characteristics of the system reveals that many energy-related coexisting orbits exist. Based on the infinite number of center-type and saddle-type equilibrium points, the dynamic characteristics of the hidden multistability of the system are revealed. Then, the National Institute of Standards and Technology(NIST)test of the new system shows that the chaotic sequence generated by the system has strong pseudo-random. Finally, the circuit simulation and hardware circuit experiment of the system are carried out with Multisim simulation software and digital signal processor(DSP) respectively. The experimental results confirm that the new system has good ergodicity and realizability.
基金supported by the NSF(Grant Nos.the NSF-DMS-1818924 and 2111253)the Air Force Office of Scientific Research FA9550-22-1-0390 and Department of Energy DE-SC0023164+1 种基金supported by the NSF(Grant Nos.NSF-DMS-1830838 and NSF-DMS-2111383)the Air Force Office of Scientific Research FA9550-22-1-0390.
文摘In this paper,we propose a novel Local Macroscopic Conservative(LoMaC)low rank tensor method with discontinuous Galerkin(DG)discretization for the physical and phase spaces for simulating the Vlasov-Poisson(VP)system.The LoMaC property refers to the exact local conservation of macroscopic mass,momentum,and energy at the discrete level.The recently developed LoMaC low rank tensor algorithm(arXiv:2207.00518)simultaneously evolves the macroscopic conservation laws of mass,momentum,and energy using the kinetic flux vector splitting;then the LoMaC property is realized by projecting the low rank kinetic solution onto a subspace that shares the same macroscopic observables.This paper is a generalization of our previous work,but with DG discretization to take advantage of its compactness and flexibility in handling boundary conditions and its superior accuracy in the long term.The algorithm is developed in a similar fashion as that for a finite difference scheme,by observing that the DG method can be viewed equivalently in a nodal fashion.With the nodal DG method,assuming a tensorized computational grid,one will be able to(i)derive differentiation matrices for different nodal points based on a DG upwind discretization of transport terms,and(ii)define a weighted inner product space based on the nodal DG grid points.The algorithm can be extended to the high dimensional problems by hierarchical Tucker(HT)decomposition of solution tensors and a corresponding conservative projection algorithm.In a similar spirit,the algorithm can be extended to DG methods on nodal points of an unstructured mesh,or to other types of discretization,e.g.,the spectral method in velocity direction.Extensive numerical results are performed to showcase the efficacy of the method.
文摘BACKGROUND Acute appendicitis is one of the most common emergency abdominal disease,and recent studies have evaluated conservative treatment using antibiotics for uncomplicated appendicitis.Although the efficacy of conservative treatment for uncomplicated appendicitis is known,its efficacy for complicated appendicitis remains unknown,so are risk factors for the conservative treatment of appendi-citis.In our institution,conservative treatment has long been the first choice for most appendicitis cases,except for perforation.Therefore,this novel study inves-tigated the outcomes of conservative treatment for uncomplicated and compli-cated acute appendicitis and the risk factors associated with conservative treat-ment.treatment.The significant and independent predictors of resistance to conservative treatment were body temperature≥37.3℃,appendicolith and Douglas sinus fluid visible on computed tomography(CT).The rate of resistance to conservative treatment was 66.7%(6/9)for patients with the above three factors,22.9%(8/35)for patients with two factors(appendicolith and body temperature≥37.3℃),16.7%(2/12)for patients with two factors(Douglas sinus fluid and appendicolith)and 11.1%(1/9)for patients with two factors(Douglas sinus fluid and body temperature≥37.3℃).CONCLUSION A temperature≥37.3℃,appendicolith and Douglas sinus fluid on CT might be clinical risk factors of resistance to conservative treatment for acute appendicitis.
文摘Secondary hyperparathyroidism (HPT) is frequent in dialysis patients. Parathyroidectomy (PTX) is indicated for patients who failed medical therapy. We reviewed the data from 184 dialysis patients who underwent PTX between January 2015 and January 2023. We aimed to evaluate the short and long term outcomes of PTX in dialysis patients, comparing the conservative 3/4 versus 7/8 techniques in this population.166 dialysis patients with secondary HPT were included. A conservative subtotal PTX (sPTX) 7/8 was performed in 72% of patients and sPTX 3/4 in 28% of them. Severe postoperative hypocalcaemiaocurred in 45 patients (27%). Hypocalcaemia was significantly more frequent in the sPTX 7/8 group (p = 0.012). One case of persistent HPT (0.6%) and 20 cases of recurrence (12%) were diagnosed. Recurrence was more frequent in the sPTX 3/4 group (15%). No deaths were reported during the perioperative period.
文摘Congenital eversion of the upper eyelids is a rare condition, the exact cause of which remains unknown. It is more frequently associated with Down’s syndrome and black babies. If diagnosed early and treated properly, the condition can be managed without surgery. We report a case of non syndromic congenital bilateral severe upper eyelid eversion in otherwise normal 3 days old neonate of African descent (Tanzanian), born by vaginal delivery. The case was conservatively managed by lubricants, antibiotics and eyelid patching. We report this case because from the best of our knowledge it has never been documented here at our hospital and Tanzania before.
文摘Lumbar disc herniation(LDH)is a common orthopedic disease in clinical practice,with main symptoms of varying degrees of pain and functional impairment,seriously affecting the quality of work and life of patients,and also causing a certain degree of economic burden to the patient's family and society.At present,there are various conservative treatment methods for LDH in clinical practice.Conservative treatment has the characteristics of small trauma and high safety,which can achieve symptom relief and cure for most patients in clinical practice.This article aims to provide a scientific reference for the selection of treatment plans for LDH patients by reviewing relevant literature on conservative treatment of LDH that has been publicly reported both domestically and internationally in recent years.
基金Project supported by the State Key Laboratory of Scientific and Engineering Computing, Chinese Academy of Sciences and the National Natural Science Foundation of China （Grant Nos 10672143, 10471145 and 10372053） and the Natural Science Foundation of Henan Province Government of China（Grant Nos 0511022200 and 0311011400）.
文摘In this paper Mei symmetry is introduced for a nonconservative system. The necessary and sufficient condition for a Mei symmetry to be also a Lie symmetry is derived. It is proved that the Mei symmetry leads to a non-Noether conservative quantity via a Lie symmetry, and deduces a Lutzky conservative quantity via a Lie point symmetry.
文摘In this paper,we develop an entropy-conservative discontinuous Galerkin(DG)method for the shallow water(SW)equation with random inputs.One of the most popular methods for uncertainty quantifcation is the generalized Polynomial Chaos(gPC)approach which we consider in the following manuscript.We apply the stochastic Galerkin(SG)method to the stochastic SW equations.Using the SG approach in the stochastic hyperbolic SW system yields a purely deterministic system that is not necessarily hyperbolic anymore.The lack of the hyperbolicity leads to ill-posedness and stability issues in numerical simulations.By transforming the system using Roe variables,the hyperbolicity can be ensured and an entropy-entropy fux pair is known from a recent investigation by Gerster and Herty(Commun.Comput.Phys.27(3):639–671,2020).We use this pair and determine a corresponding entropy fux potential.Then,we construct entropy conservative numerical twopoint fuxes for this augmented system.By applying these new numerical fuxes in a nodal DG spectral element method(DGSEM)with fux diferencing ansatz,we obtain a provable entropy conservative(dissipative)scheme.In numerical experiments,we validate our theoretical fndings.
文摘Aim To extend several fundamental theorems of conventional elasticity theory to quasicrystalelasticity theory. Methods The basic governing equations of quasicrystal elasticity theory and Gauss's theorem were applied in the derivation. Results and Conclusion The principle of virtual work, Betti's reciprocal theorem and the uniqueness theorem of quasicrystal elasticity theory are proud, and some conservative integrals in quasicrystal elasticty theory are obtained.
文摘The conservative form and singular perturbed ordinary differential equation with periodic boundary value problem were studied, and a conservative difference scheme was constructed. Using the method of decomposing the singular term from its solution and combining an asymptotic expansion of the equation, it is proved that the scheme converges uniformly to the solution of differential equation with order one.
文摘For the conservative and non-conservative schemes of nonlinear evolution equations, by taking the two-dimensional shallow water wave equations as an example, a comparative analysis on computational stability is carried out. The relationship between the nonlinear computational stability, the structure of the difference schemes, and the form of initial values is also discussed.
文摘Objective To investigate whether the very elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) will benefit from an invasive strategy versus a conservative strategy. Methods 190 consecutive patients aged 80 years or older with NSTEMI were included in the retrospective study from September 2014 to August 2017, of which 69 patients received conservative strategy and 121 patients received invasive strategy. The primary outcome was death. Multivariate Cox regression models were used to assess the statistical association between strategies and mortality. The survival probability was further analyzed. Results The primary outcome occurred in 17.4% patients in the invasive group and in 42.0% patients in the conservative group (P = 0.0002). The readmission rate in the invasive group (14.9%) was higher than that in the conservative group (7.2%). Creatinine level (OR = 1.01, 95% CI: 0.10–1.03, P = 0.05) and use of diuretic (OR = 3.65, 95% CI: 1.56–8.53, P = 0.003) were independent influential factors for invasive strategy. HRs for multivariate Cox regression models were 3.45 (95% CI: 1.77–6.75, P = 0.0003), 3.02 (95% CI: 1.52–6.01, P = 0.0017), 2.93 (95% CI: 1. 46–5.86, P = 0.0024) and 2.47 (95% CI: 1.20–5.07, P = 0.0137). Compared with the patients received invasive strategy, the conservative group had remarkably reduced survival probability with time since treatment (P < 0.001). Conclusions An invasive strategy is superior to a conservative strategy in reducing mortality of patients aged 80 years or older with NSTEMI. Our results suggest that an invasive strategy is more suitable for the very elderly patients with NSTEMI in China.
文摘A new conservative finite difference scheme is presented based on the numerical analysis for an initialboundary value problem of a class of Schroedinger equation with the wave operator. The scheme can be linear and implicit or explicit based on the parameter choice. The initial value after discretization has second-order accuracy that is consistent with the scheme accuracy. The existence and the uniqueness of the difference solution are proved. Based on the priori estimates and an inequality about norms, the stability and the convergence of difference solutions with the second-order are proved in the energy norm. Experimental results demonstrate the efficiency of the new scheme.
