Left atrial aneurysm is an exceptionally rare condition,particularly in the pediatric population,and even more so as a sequela of bacterial pericarditis.We present the case of a 16-month-old girl who developed a left ...Left atrial aneurysm is an exceptionally rare condition,particularly in the pediatric population,and even more so as a sequela of bacterial pericarditis.We present the case of a 16-month-old girl who developed a left atrial aneurysm following isolated Staphylococcus aureus pericarditis.She initially presented in decompensated shock and was later diagnosed with constrictive pericarditis.Despite undergoing pericardiectomy,she subsequently developed a left atrial aneurysm,necessitating surgical closure.This case highlights the aggressive nature of bacterial pericarditis and its potential to cause rare structural cardiac complications.展开更多
Non-typhoid Salmonella is a common foodborne infection.[1]In the setting of immunosuppression,the classical symptom of diarrhea,that is an immune defense mechanism,may be absent,[2,3]allowing the bacteria to hematogen...Non-typhoid Salmonella is a common foodborne infection.[1]In the setting of immunosuppression,the classical symptom of diarrhea,that is an immune defense mechanism,may be absent,[2,3]allowing the bacteria to hematogenous spread and settle in other organs.[4,5]As a result,in the setting of acute pericarditis in immunosuppressed patients,a bacterial etiology must always be considered,which requires pericardiocentesis to complete drainage and pathogen identification.展开更多
BACKGROUND Neuralgic amyotrophy(NA)is a rare disease with sudden upper limb pain followed by affected muscle weakness.The most commonly affected area in NA is the upper part of the brachial plexus,and the paraspinal m...BACKGROUND Neuralgic amyotrophy(NA)is a rare disease with sudden upper limb pain followed by affected muscle weakness.The most commonly affected area in NA is the upper part of the brachial plexus,and the paraspinal muscles are rarely affected(1.5%),making these cases difficult to distinguish from cervical radiculopathy.CASE SUMMARY A 76-year-old male presented to the emergency department with left hip pain post-fall.After undergoing left femoral neck fracture surgery,he experienced sudden left shoulder pain for 10 days with subsequent left arm weakness.Cervical spine computed tomography revealed mild right asymmetric intervertebral disc bulging with a decreased C5-6disc space.Three weeks later,an electrodiagnostic study confirmed brachial plexopathy findings involving the cervical root.Magnetic resonance neurography was performed for a differential diagnosis.Contrast enhancement was identified at the upper trunk of the brachial plexus,including the C5 nerve root.A suprascapular nerve hourglass-like focal constriction(HLFC)was also identified,confirming NA.After being diagnosed with NA,the patient received 15 mg prednisolone,twice daily,for 3 weeks.Physical therapy was initiated,including left arm strengthening exercises and electrical stimulation therapy.Left shoulder muscle strength significantly improved one CONCLUSION NA's unique features like HLFC and paraspinal involvement are crucial for accurate diagnosis,avoiding confusion with cervical radiculopathy.展开更多
Rationale:Synthetic cannabinoids are increasingly used as recreational drugs and have been associated with adverse cardiovascular effects.However,reports of synthetic cannabinoids accompanied by constrictive pericardi...Rationale:Synthetic cannabinoids are increasingly used as recreational drugs and have been associated with adverse cardiovascular effects.However,reports of synthetic cannabinoids accompanied by constrictive pericarditis are limited.Patient’s concern:A 28-year-old male with a history of synthetic cannabinoid(Bonzai)abuse presented with chest discomfort,dyspnea,and lower extremity edema.Investigations revealed reduced left ventricular ejection fraction,elevated inflammatory markers,low electrocardiogram voltages,and atrial fibrillation.Diagnosis:Chest spiral computerized tomography scan and chest X-ray demonstrated pericardial calcification.Cardiac magnetic resonance imaging and right heart catheterization were done to confirm the possibility of constrictive pericarditis.Based on the patient’s addiction history and exclusion of rheumatologic and infectious causes,it was supposed that constrictive pericarditis and cardiomyopathy may be accompanied by synthetic cannabinoid use.Interventions:The patient received standard medical therapy,including loop diuretics for cardiomyopathy and constrictive pericarditis.Catheter ablation was recommended for his rhythm control,and he was planned for close monitoring of clinical and echocardiographic response and evaluation of the need for surgical pericardiectomy in the future.Outcomes:After 6 months follow-up,echocardiographic exam revealed no significant improvement in ventricular function.However,due to the high surgical risk,the patient’s poor compliance,and the continuation of drug abuse,he was not a good candidate for surgery according to our heart team’s decision.Lessons:Synthetic cannabinoids can trigger constrictive pericarditis,and clinicians should consider them when evaluating patients with compatible symptoms and exposure history.Further research on the cardiovascular effects of synthetic cannabinoids is needed and public education on potential harms is warranted.展开更多
Centered or striped wick structures have been used to develop ultrathin heat pipes.Differing from traditional heat pipes,the centered or striped wick structures leave noncontact container surfaces with the wick struct...Centered or striped wick structures have been used to develop ultrathin heat pipes.Differing from traditional heat pipes,the centered or striped wick structures leave noncontact container surfaces with the wick structure.In this study,experiments andnumerical analyseswere conductedtoinvestigate the influenceof thesenoncontact surfaces.In the experiments,a strip-shaped wick structure was placed vertically,the top was sandwiched between wider rods and the bottom was immersed in a working fluid.The rod width was greater than the wick width;thus,noncontact surfaces were left between the rod and the wick structure.The heat was applied from the rod to the wick structure,and the evaporation heat transfer characteristics of the working fluid from the wick structure were evaluated.Water was used as the working fluid.The experiments were conducted by varying the rod and wick widths.The experimental results were obtained when the wick structures were placed separately.In the numerical analyses,the temperature and heat flux distributions in the rod were obtained.From the experimental and numerical results,it was confirmed that the noncontact surfaces caused the heat flux in the rod near both surfaces of the wick structure to concentrate,which increased the evaporation thermal resistance of the wick structure.A reduction in the noncontact surface area by increasing the wick width was found to be effective in decreasing the evaporation thermal resistance and increasing themaximumheat transfer rate of the wick structure.The separation of the wick structure increased the evaporation surface area.However,its effectiveness was limited when the heat transfer rate was small.展开更多
BACKGROUND Endoscopic management is the first-line therapy for post-liver-transplant anas-tomotic strictures.Although the optimal duration of treatment with plastic stents has been reported to be 8-12 months,data on s...BACKGROUND Endoscopic management is the first-line therapy for post-liver-transplant anas-tomotic strictures.Although the optimal duration of treatment with plastic stents has been reported to be 8-12 months,data on safety and duration for metal stents in this setting is scarce.Due to limited access to endoscopic retrograde cholan-giopancreatography(ERCP)during the coronavirus disease 2019 pandemic in our centre,there was a change in practice towards increased usage and length-of-stay of the Kaffes biliary intraductal self-expanding stent in patients with suitable anatomy.This was mainly due to the theoretical benefit of Kaffes stents allowing for longer indwelling periods compared to the traditional plastic stents.METHODS Adult liver transplant recipients aged 18 years and above who underwent ERCP were retrospectively identified during a 10-year period through a database query.Unplanned admissions post-Kaffes stent insertion were identified manually through electronic and scanned medical records.The main outcome was the incidence of complications when stents were left indwelling for 3 months vs 6 months.Stent efficacy was calculated via rates of stricture recurrence between patients that had stenting courses for≤120 d or>120 d.RESULTS During the study period,a total of 66 ERCPs with Kaffes insertion were performed in 54 patients throughout their stenting course.In 33 ERCPs,the stent was removed or exchanged on a 3-month interval.No pancreatitis,perfor-ations or deaths occurred.Minor post-ERCP complications were similar between the 3-month(abdominal pain and intraductal migration)and 6-month(abdominal pain,septic shower and embedded stent)groups-6.1%vs 9.1%respectively,P=0.40.All strictures resolved at the end of the stenting course,but the stenting course was variable from 3 to 22 months.The recurrence rate for stenting courses lasting for up to 120 d was 71.4%and 21.4%for stenting courses of 121 d or over(P=0.03).There were 28 patients that were treated with a single ERCP with Kaffes,21 with removal after 120 d and 7 within 120 d.There was a significant improvement in stricture recurrence when the Kaffes was removed after 120 d when a single ERCP was used for the entire stenting course(71.0%vs 10.0%,P=0.01).CONCLUSION Utilising a single Kaffes intraductal fully-covered metal stent for at least 4 months is safe and efficacious for the management of post-transplant anastomotic strictures.展开更多
Based on effective media theory, a predictive model, relating chloride diffusivity to the capillary pores, gel pores, tortuosity factor, and pore size distribution of hardened cement, is proposed. To verify the propos...Based on effective media theory, a predictive model, relating chloride diffusivity to the capillary pores, gel pores, tortuosity factor, and pore size distribution of hardened cement, is proposed. To verify the proposed model, the diffusion coefficient of chloride ions, the degree of hydration, and peak radius of capillary pores of cement paste specimens were measured. The predicted results for chloride diffusivity were compared with published data. The results showed that the predicted chloride diffusivity of hardened cement paste was in good agreement with the experimental results. The effect of the evolution of pore structures in cement paste on chloride diffusivity could be deduced simultaneously using the proposed model.展开更多
The constriction factor method (CFM) is a new variation of the basic particle swarm optimization (PSO), which has relatively better convergent nature. The effects of the major parameters on CFM were systematically inv...The constriction factor method (CFM) is a new variation of the basic particle swarm optimization (PSO), which has relatively better convergent nature. The effects of the major parameters on CFM were systematically investigated based on some benchmark functions. The constriction factor, velocity constraint, and population size all have significant impact on the per- formance of CFM for PSO. The constriction factor and velocity constraint have optimal values in practical application, and im- proper choice of these factors will lead to bad results. Increasing population size can improve the solution quality, although the computing time will be longer. The characteristics of CFM parameters are described and guidelines for determining parameter values are given in this paper.展开更多
Acupuncture has been used to treat neuropathic pain for a long time, but its mechanisms of action remain unknown. In this study, we observed the effects of electroacupuncture and manual acu- puncture on neuropathic pa...Acupuncture has been used to treat neuropathic pain for a long time, but its mechanisms of action remain unknown. In this study, we observed the effects of electroacupuncture and manual acu- puncture on neuropathic pain and on ephrin-B/EphB signaling in rats models of chronic constriction injury-induced neuropathic pain. The results showed that manual acupuncture and electroacu- puncture significantly reduced mechanical hypersensitivity following chronic constriction injury, es- pecially electroacupuncture treatment. Real-time PCR results revealed that ephrin-B1/B3 and EphB1/B2 mRNA expression levels were significantly increased in the spinal dorsal horns of chronic constriction injury rats. Electroacupuncture and manual acupuncture suppressed the high expres- sion of ephrin-B1 mRNA, and elevated EphB3/B4 mRNA expression. Electroacupuncture signifi- cantly enhanced the mRNA expression of ephrin-B3 and EphB3/B6 in the dorsal horns of neuro- pathic pain rats. Western blot results revealed that electroacupuncture in particular, and manual acupuncture, significantly up-regulated ephrin-B3 protein levels in rat spinal dorsal horns. The re- sults of this study suggest that acupuncture could activate ephrin-B/EphB signaling in neuropathic pain rats and improve neurological function.展开更多
This article describes a case we experienced in which good postsurgical facial profiles were obtained for a patient with jaw deformities associated with facial asymmetry,by implementing surgical planning with SimPlant...This article describes a case we experienced in which good postsurgical facial profiles were obtained for a patient with jaw deformities associated with facial asymmetry,by implementing surgical planning with SimPlant OMS.Using this method,we conducted LF1 osteotomy,intraoral vertical ramus osteotomy（IVRO）,sagittal split ramus osteotomy（SSRO）,mandibular constriction and mandibular border genioplasty.Not only did we obtain a class I occlusal relationship,but the complicated surgery also improved the asymmetry of the frontal view,as well as of the profile view,of the patient.The virtual operation using three-dimensional computed tomography（3D-CT）could be especially useful for the treatment of patients with jaw deformities associated with facial asymmetry.展开更多
Aimed at more than 60 shaft linings damaged in Huaibei, Datun, Xuzhou and Yanzhou mine areas, this paper presents a new type of sliding shaft lining with asphalt blocks sliding layer. By model test, it is obtained tha...Aimed at more than 60 shaft linings damaged in Huaibei, Datun, Xuzhou and Yanzhou mine areas, this paper presents a new type of sliding shaft lining with asphalt blocks sliding layer. By model test, it is obtained that the deformation characteristics and the mechanical mechanisms of the sliding shaft lining under the condition of ground subsidence. The research results provide a testing basis for the sliding shaft lining design. By now, this kind of sliding shaft lining had been applied in 9 shafts in China and Bangladesh.展开更多
Experimental models have allowed inquiry into the pathophysiology of varicocele （VC） beyond that possible with human patients. A randomized controlled study in rats was designed to clarify the influence of the degre...Experimental models have allowed inquiry into the pathophysiology of varicocele （VC） beyond that possible with human patients. A randomized controlled study in rats was designed to clarify the influence of the degree of left renal vein constriction on the development of adolescent VC. Fifty adolescent male Sprague-Dawley rats （Rattus norvegicus） were randomly assigned to five groups of 10： the experimental groups （I-IV） underwent partial ligation of left renal veins with 0.5-, 0.6-, 0.7-, and 0.8-mm diameter needles, respectively. The control group （V） underwent a sham operation. The diameter of the left spermatic vein （LSV） was measured at baseline and 30 days postoperatively. In addition, the lesion of the left kidney was examined with the naked eye and assessed by Masson＇s trichrome staining. VC was successfully induced in 2 （20%）, 4 （40%）, 7 （70%）, and 10 （100%） rats in groups I-IV, respectively. The other rats failed to develop VCs primarily due to left renal atrophy. No VC was observed in group V. The postsurgical LSV diameters in VC rats in groups III and IV were 1.54 ± 0. 16 and 1.49 ± 0.13 mm, respectively （P〉 0.05）, and their increments were 1.36±0. 10 and 1.31±0. 10 ram, respectively （P 〉 0.05）. These results suggest that suitable constriction of the left renal vein is critical for adolescent VC development. In addition, the 0.8-mm diameter needle may be more suitable for inducing left renal vein constriction in adolescent rat models.展开更多
BACKGROUND： In the perspective of traditional Chinese medicine, few studies have focused on the compound preparations though there are many investigations. The present study was undertaken to investigate the effect o...BACKGROUND： In the perspective of traditional Chinese medicine, few studies have focused on the compound preparations though there are many investigations. The present study was undertaken to investigate the effect of Zhenwu Tang Granule on chronic pressure-overloaded left ventricular hypertrophy in rats.METHODS： The study was performed at the laboratory of Guangzhou Institute of Respiratory Disease. Male SD rats were divided randomly into 3 groups： sham operation group （n=8）, operation group （n=15） and traditional Chinese medicine （TCM） group （n=15）.The model of myocardial hypertrophy was made by gradually constricting the abdominal aorta. Sixteen weeks later, cardiac ultrasonography was performed in all groups in order to ascertain post-operational left ventricular （LV） hypertrophy. And Zhenwu Tang Granule was added at a dose of 12 g/kg in the mixed feedstuff for 8 weeks in the TCM group. In the 24th week, weight, structure as well as function of the heart in each group were measured by high-frequency ultrasonography, and Masson＇s staining was performed on the cardiac muscles. Meanwhile, total collagen volume fraction （CVF-T） and non-coronary vessel collagen volume fraction （CVF-NV） were analyzed.RESULTS： There was an increase in the weight of the heart in the operation group, with the left ventricule dominated （P〈0.05）. The heart was enlarged, with diastolic interventricular septal distance （IVSd） and left ventricular posterior wall distance （LVPWd） dominated （P〈0.01）.There was a significant decrease in the cardiac function （P〈0.05）. The weight （P〈0.01） and volume of the heart decreased in the TCM group compared with the operation group, with IVSd and systolic left ventricular posterior wall dominated （P〈0.01）. And the cardiac function was improved （P〈0.05）. Significant interstitial and collagen hyperplasia was shown in the operation group based on pathological analysis, and various improvements were proved in the TCM group, i.e. there was a significant decrease in CVF-T and CVF-NV （P〈0.01） compared with the operation group; but no difference （P〉0.05） was found when compared with the pseudo-operation group.CONCLUSION： Zhenwu Tang Granule could reduce the weight and volume of the heart, improve the cardiac function, inhibit hyperplasia of collagen, and reverse myocardial hypertrophy in rats with pressure-overloaded left ventricular hypertrophy.展开更多
Neuropathic pain(NP)has become a serious global health issue and a huge clinical challenge without available effective treatment.P2 receptors family is involved in pain transmission and represents a promising target f...Neuropathic pain(NP)has become a serious global health issue and a huge clinical challenge without available effective treatment.P2 receptors family is involved in pain transmission and represents a promising target for pharmacological intervention.Traditional Chinese medicine(TCM)contains multiple components which are effective in targeting different pathological mechanisms involved in NP.Different from traditional analgesics,which target a single pathway,TCMs take the advantage of multiple components and multiple targets,and can significantly improve the efficacy of treatment and contribute to the prediction of the risks of NP.Compounds of TCM acting at nucleotide P2 receptors in neurons and glial cells could be considered as a potential research direction for moderating neuropathic pain.This review summarized the recently published data and highlighted several TCMs that relieved NP by acting at P2 receptors.展开更多
Ultra-narrow gap welding （UNGW） process with high stabilization, reliability and without spatter can be achieved with constricted arc by molten slag wall, which is made from melted flux. The experiments are carried ...Ultra-narrow gap welding （UNGW） process with high stabilization, reliability and without spatter can be achieved with constricted arc by molten slag wall, which is made from melted flux. The experiments are carried out by changing voltage under different currents. The results indicate voltage range being fit for UNGW is about 22 -31 V under the current range of 200 -320 A. With the increasing of voltage, weld formation of UNGW has the law of lack of fusion on sidewall, good weld and undercut in turn under a certain current. In addition, the action relationships among arc, molten slag wall and sidewalls can be improved by properly adjusting voltage and current of arc, which makes cathode spot properly distribute in ultra-narrow gap. Therefore, the effective control of weld formation of UNGW has been achieved.展开更多
The main objective of this investigation is to study the influence of arc constriction current frequency(ACCF)on tensile properties and microstructural evolution of aerospace Alloy 718 sheets(2 mm in thickness)joined ...The main objective of this investigation is to study the influence of arc constriction current frequency(ACCF)on tensile properties and microstructural evolution of aerospace Alloy 718 sheets(2 mm in thickness)joined by constricted arc TIG(CA-TIG)welding process.One variable at a time approach of design of experiments(DOE)was used,in which ACCF was varied from 4 to 20 kHz at an interval of 5 levels while other parameters were kept constant.The joints welded using ACCF of 4 kHz exhibited superior tensile properties extending joint efficiency up to 99.20%.It is attributed to the grain refinement in fusion zone leading to the evolution of finer,discrete Laves phase in interdendritic areas.An increase of ACCF above 12 kHz caused severe grain growth and evolution of coarser Laves phase in fusion zone.Alloy 718 welds showed more obvious tendency for Nb segregation and Laves phase formation at higher levels of ACCF due to the slower cooling rate.The volume fraction of Laves phase was increased by 62.31%at ACCF of 20 kHz compared to that at 4 kHz,thereby reducing the tensile properties of joints.This is mainly due to the stacking of heat input in weld thermal cycles at increased levels of ACCF.展开更多
Transmembrane member 16 A(TMEM16 A) is involved in many physiological functions, such as epithelial secretion, sensory conduction, nociception, control of neuronal excitability, and regulation of smooth muscle contrac...Transmembrane member 16 A(TMEM16 A) is involved in many physiological functions, such as epithelial secretion, sensory conduction, nociception, control of neuronal excitability, and regulation of smooth muscle contraction, and may be important in peripheral pain transmission. To explore the role of TMEM16 A in the persistent hyperalgesia that results from chronic constriction injury-induced neuropathic pain, a rat model of the condition was established by ligating the left sciatic nerve. A TMEM16 A selective antagonist(10 μg T16 Ainh-A01) was intrathecally injected at L5–6. For measurement of thermal hyperalgesia, the drug was administered once at 14 days and thermal withdrawal latency was recorded with an analgesia meter. For measurement of other indexes, the drug was administered at 12 days,once every 6 hours, totally five times. The measurements were performed at 14 days. Western blot assay was conducted to analyze TMEM16 A expression in the L4–6 dorsal root ganglion. Immunofluorescence staining was used to detect the immunoreactivity of TMEM16 A in the L4–6 dorsal root ganglion on the injured side. Patch clamp was used to detect electrophysiological changes in the neurons in the L4–6 dorsal root ganglion. Our results demonstrated that thermal withdrawal latency was shortened in the model rats compared with control rats.Additionally, TMEM16 A expression and the number of TMEM16 A positive cells in the L4–6 dorsal root ganglion were higher in the model rats, which induced excitation of the neurons in the L4–6 dorsal root ganglion. These findings were inhibited by T16 Ainh-A01 and confirm that TMEM16 A plays a key role in persistent chronic constriction injury-induced hyperalgesia. Thus, inhibiting TMEM16 A might be a novel pharmacological intervention for neuropathic pain. All experimental protocols were approved by the Animal Ethics Committee at the First Affiliated Hospital of Shihezi University School of Medicine, China(approval No. A2017-170-01) on February 27, 2017.展开更多
AIM: To present a new technique of cervical esophagogastric anastomosis to reduce the frequency of fistula formation. METHODS: A group of 31 patients with thoracic and abdominal esophageal cancer underwent cervical es...AIM: To present a new technique of cervical esophagogastric anastomosis to reduce the frequency of fistula formation. METHODS: A group of 31 patients with thoracic and abdominal esophageal cancer underwent cervical esophagogastric anastomosis with invagination of the proximal esophageal stump into the stomach tube. In the region elected for anastomosis, a transverse myotomy of the esophagus was carried out around the entire circumference of the esophagus. Afterwards, a 4-cm long segment of esophagus was invaginated into the stomach and anastomosed to the anterior and the posterior walls. RESULTS: Postoperative minor complications occurred in 22 (70.9%) patients. Four (12.9%) patients had serious complications that led to death. The discharge of saliva was at a lower region, while attempting to leave the anastomosis site out of the alimentary transit. Three (9.7%) patients had fistula at the esophagogastric anastomosis, with minimal leakage of air or saliva and with mild clinical repercussions. No patients had esophago- gastric fistula with intense saliva leakage from either the cervical incision or the thoracic drain. Fibrotic stenosis of anastomoses occurred in seven (22.6%) patients. All these patients obtained relief from their dysphagia with endoscopic dilatation of the anastomosis.CONCLUSION: Cervical esophagogastric anastomosis with invagination of the proximal esophageal stump into the stomach tube presented a low rate of esophagogastric fistula with mild clinical repercussions.展开更多
文摘Left atrial aneurysm is an exceptionally rare condition,particularly in the pediatric population,and even more so as a sequela of bacterial pericarditis.We present the case of a 16-month-old girl who developed a left atrial aneurysm following isolated Staphylococcus aureus pericarditis.She initially presented in decompensated shock and was later diagnosed with constrictive pericarditis.Despite undergoing pericardiectomy,she subsequently developed a left atrial aneurysm,necessitating surgical closure.This case highlights the aggressive nature of bacterial pericarditis and its potential to cause rare structural cardiac complications.
文摘Non-typhoid Salmonella is a common foodborne infection.[1]In the setting of immunosuppression,the classical symptom of diarrhea,that is an immune defense mechanism,may be absent,[2,3]allowing the bacteria to hematogenous spread and settle in other organs.[4,5]As a result,in the setting of acute pericarditis in immunosuppressed patients,a bacterial etiology must always be considered,which requires pericardiocentesis to complete drainage and pathogen identification.
文摘BACKGROUND Neuralgic amyotrophy(NA)is a rare disease with sudden upper limb pain followed by affected muscle weakness.The most commonly affected area in NA is the upper part of the brachial plexus,and the paraspinal muscles are rarely affected(1.5%),making these cases difficult to distinguish from cervical radiculopathy.CASE SUMMARY A 76-year-old male presented to the emergency department with left hip pain post-fall.After undergoing left femoral neck fracture surgery,he experienced sudden left shoulder pain for 10 days with subsequent left arm weakness.Cervical spine computed tomography revealed mild right asymmetric intervertebral disc bulging with a decreased C5-6disc space.Three weeks later,an electrodiagnostic study confirmed brachial plexopathy findings involving the cervical root.Magnetic resonance neurography was performed for a differential diagnosis.Contrast enhancement was identified at the upper trunk of the brachial plexus,including the C5 nerve root.A suprascapular nerve hourglass-like focal constriction(HLFC)was also identified,confirming NA.After being diagnosed with NA,the patient received 15 mg prednisolone,twice daily,for 3 weeks.Physical therapy was initiated,including left arm strengthening exercises and electrical stimulation therapy.Left shoulder muscle strength significantly improved one CONCLUSION NA's unique features like HLFC and paraspinal involvement are crucial for accurate diagnosis,avoiding confusion with cervical radiculopathy.
文摘Rationale:Synthetic cannabinoids are increasingly used as recreational drugs and have been associated with adverse cardiovascular effects.However,reports of synthetic cannabinoids accompanied by constrictive pericarditis are limited.Patient’s concern:A 28-year-old male with a history of synthetic cannabinoid(Bonzai)abuse presented with chest discomfort,dyspnea,and lower extremity edema.Investigations revealed reduced left ventricular ejection fraction,elevated inflammatory markers,low electrocardiogram voltages,and atrial fibrillation.Diagnosis:Chest spiral computerized tomography scan and chest X-ray demonstrated pericardial calcification.Cardiac magnetic resonance imaging and right heart catheterization were done to confirm the possibility of constrictive pericarditis.Based on the patient’s addiction history and exclusion of rheumatologic and infectious causes,it was supposed that constrictive pericarditis and cardiomyopathy may be accompanied by synthetic cannabinoid use.Interventions:The patient received standard medical therapy,including loop diuretics for cardiomyopathy and constrictive pericarditis.Catheter ablation was recommended for his rhythm control,and he was planned for close monitoring of clinical and echocardiographic response and evaluation of the need for surgical pericardiectomy in the future.Outcomes:After 6 months follow-up,echocardiographic exam revealed no significant improvement in ventricular function.However,due to the high surgical risk,the patient’s poor compliance,and the continuation of drug abuse,he was not a good candidate for surgery according to our heart team’s decision.Lessons:Synthetic cannabinoids can trigger constrictive pericarditis,and clinicians should consider them when evaluating patients with compatible symptoms and exposure history.Further research on the cardiovascular effects of synthetic cannabinoids is needed and public education on potential harms is warranted.
文摘Centered or striped wick structures have been used to develop ultrathin heat pipes.Differing from traditional heat pipes,the centered or striped wick structures leave noncontact container surfaces with the wick structure.In this study,experiments andnumerical analyseswere conductedtoinvestigate the influenceof thesenoncontact surfaces.In the experiments,a strip-shaped wick structure was placed vertically,the top was sandwiched between wider rods and the bottom was immersed in a working fluid.The rod width was greater than the wick width;thus,noncontact surfaces were left between the rod and the wick structure.The heat was applied from the rod to the wick structure,and the evaporation heat transfer characteristics of the working fluid from the wick structure were evaluated.Water was used as the working fluid.The experiments were conducted by varying the rod and wick widths.The experimental results were obtained when the wick structures were placed separately.In the numerical analyses,the temperature and heat flux distributions in the rod were obtained.From the experimental and numerical results,it was confirmed that the noncontact surfaces caused the heat flux in the rod near both surfaces of the wick structure to concentrate,which increased the evaporation thermal resistance of the wick structure.A reduction in the noncontact surface area by increasing the wick width was found to be effective in decreasing the evaporation thermal resistance and increasing themaximumheat transfer rate of the wick structure.The separation of the wick structure increased the evaporation surface area.However,its effectiveness was limited when the heat transfer rate was small.
文摘BACKGROUND Endoscopic management is the first-line therapy for post-liver-transplant anas-tomotic strictures.Although the optimal duration of treatment with plastic stents has been reported to be 8-12 months,data on safety and duration for metal stents in this setting is scarce.Due to limited access to endoscopic retrograde cholan-giopancreatography(ERCP)during the coronavirus disease 2019 pandemic in our centre,there was a change in practice towards increased usage and length-of-stay of the Kaffes biliary intraductal self-expanding stent in patients with suitable anatomy.This was mainly due to the theoretical benefit of Kaffes stents allowing for longer indwelling periods compared to the traditional plastic stents.METHODS Adult liver transplant recipients aged 18 years and above who underwent ERCP were retrospectively identified during a 10-year period through a database query.Unplanned admissions post-Kaffes stent insertion were identified manually through electronic and scanned medical records.The main outcome was the incidence of complications when stents were left indwelling for 3 months vs 6 months.Stent efficacy was calculated via rates of stricture recurrence between patients that had stenting courses for≤120 d or>120 d.RESULTS During the study period,a total of 66 ERCPs with Kaffes insertion were performed in 54 patients throughout their stenting course.In 33 ERCPs,the stent was removed or exchanged on a 3-month interval.No pancreatitis,perfor-ations or deaths occurred.Minor post-ERCP complications were similar between the 3-month(abdominal pain and intraductal migration)and 6-month(abdominal pain,septic shower and embedded stent)groups-6.1%vs 9.1%respectively,P=0.40.All strictures resolved at the end of the stenting course,but the stenting course was variable from 3 to 22 months.The recurrence rate for stenting courses lasting for up to 120 d was 71.4%and 21.4%for stenting courses of 121 d or over(P=0.03).There were 28 patients that were treated with a single ERCP with Kaffes,21 with removal after 120 d and 7 within 120 d.There was a significant improvement in stricture recurrence when the Kaffes was removed after 120 d when a single ERCP was used for the entire stenting course(71.0%vs 10.0%,P=0.01).CONCLUSION Utilising a single Kaffes intraductal fully-covered metal stent for at least 4 months is safe and efficacious for the management of post-transplant anastomotic strictures.
基金Project supported by the National Basic Research Program (973) of China (No. 2009CB623200)the National High-Tech R&D Program (863) of China (No. 2008AA030794)the Postgraduates Research Innovation in University of Jiangsu Province, China (No. CX10B-064Z)
文摘Based on effective media theory, a predictive model, relating chloride diffusivity to the capillary pores, gel pores, tortuosity factor, and pore size distribution of hardened cement, is proposed. To verify the proposed model, the diffusion coefficient of chloride ions, the degree of hydration, and peak radius of capillary pores of cement paste specimens were measured. The predicted results for chloride diffusivity were compared with published data. The results showed that the predicted chloride diffusivity of hardened cement paste was in good agreement with the experimental results. The effect of the evolution of pore structures in cement paste on chloride diffusivity could be deduced simultaneously using the proposed model.
基金Project (No. 20276063) supported by the National Natural Sci-ence Foundation of China
文摘The constriction factor method (CFM) is a new variation of the basic particle swarm optimization (PSO), which has relatively better convergent nature. The effects of the major parameters on CFM were systematically investigated based on some benchmark functions. The constriction factor, velocity constraint, and population size all have significant impact on the per- formance of CFM for PSO. The constriction factor and velocity constraint have optimal values in practical application, and im- proper choice of these factors will lead to bad results. Increasing population size can improve the solution quality, although the computing time will be longer. The characteristics of CFM parameters are described and guidelines for determining parameter values are given in this paper.
基金supported by the China Postdoctoral Science Foundation,No.20100480643the Program of Shanghai Municipal Education Commission,No.2011JW13
文摘Acupuncture has been used to treat neuropathic pain for a long time, but its mechanisms of action remain unknown. In this study, we observed the effects of electroacupuncture and manual acu- puncture on neuropathic pain and on ephrin-B/EphB signaling in rats models of chronic constriction injury-induced neuropathic pain. The results showed that manual acupuncture and electroacu- puncture significantly reduced mechanical hypersensitivity following chronic constriction injury, es- pecially electroacupuncture treatment. Real-time PCR results revealed that ephrin-B1/B3 and EphB1/B2 mRNA expression levels were significantly increased in the spinal dorsal horns of chronic constriction injury rats. Electroacupuncture and manual acupuncture suppressed the high expres- sion of ephrin-B1 mRNA, and elevated EphB3/B4 mRNA expression. Electroacupuncture signifi- cantly enhanced the mRNA expression of ephrin-B3 and EphB3/B6 in the dorsal horns of neuro- pathic pain rats. Western blot results revealed that electroacupuncture in particular, and manual acupuncture, significantly up-regulated ephrin-B3 protein levels in rat spinal dorsal horns. The re- sults of this study suggest that acupuncture could activate ephrin-B/EphB signaling in neuropathic pain rats and improve neurological function.
文摘This article describes a case we experienced in which good postsurgical facial profiles were obtained for a patient with jaw deformities associated with facial asymmetry,by implementing surgical planning with SimPlant OMS.Using this method,we conducted LF1 osteotomy,intraoral vertical ramus osteotomy（IVRO）,sagittal split ramus osteotomy（SSRO）,mandibular constriction and mandibular border genioplasty.Not only did we obtain a class I occlusal relationship,but the complicated surgery also improved the asymmetry of the frontal view,as well as of the profile view,of the patient.The virtual operation using three-dimensional computed tomography（3D-CT）could be especially useful for the treatment of patients with jaw deformities associated with facial asymmetry.
文摘Aimed at more than 60 shaft linings damaged in Huaibei, Datun, Xuzhou and Yanzhou mine areas, this paper presents a new type of sliding shaft lining with asphalt blocks sliding layer. By model test, it is obtained that the deformation characteristics and the mechanical mechanisms of the sliding shaft lining under the condition of ground subsidence. The research results provide a testing basis for the sliding shaft lining design. By now, this kind of sliding shaft lining had been applied in 9 shafts in China and Bangladesh.
文摘Experimental models have allowed inquiry into the pathophysiology of varicocele （VC） beyond that possible with human patients. A randomized controlled study in rats was designed to clarify the influence of the degree of left renal vein constriction on the development of adolescent VC. Fifty adolescent male Sprague-Dawley rats （Rattus norvegicus） were randomly assigned to five groups of 10： the experimental groups （I-IV） underwent partial ligation of left renal veins with 0.5-, 0.6-, 0.7-, and 0.8-mm diameter needles, respectively. The control group （V） underwent a sham operation. The diameter of the left spermatic vein （LSV） was measured at baseline and 30 days postoperatively. In addition, the lesion of the left kidney was examined with the naked eye and assessed by Masson＇s trichrome staining. VC was successfully induced in 2 （20%）, 4 （40%）, 7 （70%）, and 10 （100%） rats in groups I-IV, respectively. The other rats failed to develop VCs primarily due to left renal atrophy. No VC was observed in group V. The postsurgical LSV diameters in VC rats in groups III and IV were 1.54 ± 0. 16 and 1.49 ± 0.13 mm, respectively （P〉 0.05）, and their increments were 1.36±0. 10 and 1.31±0. 10 ram, respectively （P 〉 0.05）. These results suggest that suitable constriction of the left renal vein is critical for adolescent VC development. In addition, the 0.8-mm diameter needle may be more suitable for inducing left renal vein constriction in adolescent rat models.
文摘BACKGROUND： In the perspective of traditional Chinese medicine, few studies have focused on the compound preparations though there are many investigations. The present study was undertaken to investigate the effect of Zhenwu Tang Granule on chronic pressure-overloaded left ventricular hypertrophy in rats.METHODS： The study was performed at the laboratory of Guangzhou Institute of Respiratory Disease. Male SD rats were divided randomly into 3 groups： sham operation group （n=8）, operation group （n=15） and traditional Chinese medicine （TCM） group （n=15）.The model of myocardial hypertrophy was made by gradually constricting the abdominal aorta. Sixteen weeks later, cardiac ultrasonography was performed in all groups in order to ascertain post-operational left ventricular （LV） hypertrophy. And Zhenwu Tang Granule was added at a dose of 12 g/kg in the mixed feedstuff for 8 weeks in the TCM group. In the 24th week, weight, structure as well as function of the heart in each group were measured by high-frequency ultrasonography, and Masson＇s staining was performed on the cardiac muscles. Meanwhile, total collagen volume fraction （CVF-T） and non-coronary vessel collagen volume fraction （CVF-NV） were analyzed.RESULTS： There was an increase in the weight of the heart in the operation group, with the left ventricule dominated （P〈0.05）. The heart was enlarged, with diastolic interventricular septal distance （IVSd） and left ventricular posterior wall distance （LVPWd） dominated （P〈0.01）.There was a significant decrease in the cardiac function （P〈0.05）. The weight （P〈0.01） and volume of the heart decreased in the TCM group compared with the operation group, with IVSd and systolic left ventricular posterior wall dominated （P〈0.01）. And the cardiac function was improved （P〈0.05）. Significant interstitial and collagen hyperplasia was shown in the operation group based on pathological analysis, and various improvements were proved in the TCM group, i.e. there was a significant decrease in CVF-T and CVF-NV （P〈0.01） compared with the operation group; but no difference （P〉0.05） was found when compared with the pseudo-operation group.CONCLUSION： Zhenwu Tang Granule could reduce the weight and volume of the heart, improve the cardiac function, inhibit hyperplasia of collagen, and reverse myocardial hypertrophy in rats with pressure-overloaded left ventricular hypertrophy.
基金supported by the National Natural Science Foundation of China(Nos.81570735,8181101216,31560276,81970749,and 81870574)
文摘Neuropathic pain(NP)has become a serious global health issue and a huge clinical challenge without available effective treatment.P2 receptors family is involved in pain transmission and represents a promising target for pharmacological intervention.Traditional Chinese medicine(TCM)contains multiple components which are effective in targeting different pathological mechanisms involved in NP.Different from traditional analgesics,which target a single pathway,TCMs take the advantage of multiple components and multiple targets,and can significantly improve the efficacy of treatment and contribute to the prediction of the risks of NP.Compounds of TCM acting at nucleotide P2 receptors in neurons and glial cells could be considered as a potential research direction for moderating neuropathic pain.This review summarized the recently published data and highlighted several TCMs that relieved NP by acting at P2 receptors.
基金The work was supported by National Natural Science Foundation of China （51105185） and Advanced Project Foundation of Jinchuan Company（420032）.
文摘Ultra-narrow gap welding （UNGW） process with high stabilization, reliability and without spatter can be achieved with constricted arc by molten slag wall, which is made from melted flux. The experiments are carried out by changing voltage under different currents. The results indicate voltage range being fit for UNGW is about 22 -31 V under the current range of 200 -320 A. With the increasing of voltage, weld formation of UNGW has the law of lack of fusion on sidewall, good weld and undercut in turn under a certain current. In addition, the action relationships among arc, molten slag wall and sidewalls can be improved by properly adjusting voltage and current of arc, which makes cathode spot properly distribute in ultra-narrow gap. Therefore, the effective control of weld formation of UNGW has been achieved.
基金This work was supported by the Indian Space Research Organization(ISRO),Department of Space,India,under ISRO RESPOND scheme(Project No.ISRO/RES/3/728/16-17).
文摘The main objective of this investigation is to study the influence of arc constriction current frequency(ACCF)on tensile properties and microstructural evolution of aerospace Alloy 718 sheets(2 mm in thickness)joined by constricted arc TIG(CA-TIG)welding process.One variable at a time approach of design of experiments(DOE)was used,in which ACCF was varied from 4 to 20 kHz at an interval of 5 levels while other parameters were kept constant.The joints welded using ACCF of 4 kHz exhibited superior tensile properties extending joint efficiency up to 99.20%.It is attributed to the grain refinement in fusion zone leading to the evolution of finer,discrete Laves phase in interdendritic areas.An increase of ACCF above 12 kHz caused severe grain growth and evolution of coarser Laves phase in fusion zone.Alloy 718 welds showed more obvious tendency for Nb segregation and Laves phase formation at higher levels of ACCF due to the slower cooling rate.The volume fraction of Laves phase was increased by 62.31%at ACCF of 20 kHz compared to that at 4 kHz,thereby reducing the tensile properties of joints.This is mainly due to the stacking of heat input in weld thermal cycles at increased levels of ACCF.
基金supported by the National Natural Science Foundation of China,No.30160026(to JQS)the High Level Talent Research Project of Shihezi University of China,No.RCSX201705(to YW)
文摘Transmembrane member 16 A(TMEM16 A) is involved in many physiological functions, such as epithelial secretion, sensory conduction, nociception, control of neuronal excitability, and regulation of smooth muscle contraction, and may be important in peripheral pain transmission. To explore the role of TMEM16 A in the persistent hyperalgesia that results from chronic constriction injury-induced neuropathic pain, a rat model of the condition was established by ligating the left sciatic nerve. A TMEM16 A selective antagonist(10 μg T16 Ainh-A01) was intrathecally injected at L5–6. For measurement of thermal hyperalgesia, the drug was administered once at 14 days and thermal withdrawal latency was recorded with an analgesia meter. For measurement of other indexes, the drug was administered at 12 days,once every 6 hours, totally five times. The measurements were performed at 14 days. Western blot assay was conducted to analyze TMEM16 A expression in the L4–6 dorsal root ganglion. Immunofluorescence staining was used to detect the immunoreactivity of TMEM16 A in the L4–6 dorsal root ganglion on the injured side. Patch clamp was used to detect electrophysiological changes in the neurons in the L4–6 dorsal root ganglion. Our results demonstrated that thermal withdrawal latency was shortened in the model rats compared with control rats.Additionally, TMEM16 A expression and the number of TMEM16 A positive cells in the L4–6 dorsal root ganglion were higher in the model rats, which induced excitation of the neurons in the L4–6 dorsal root ganglion. These findings were inhibited by T16 Ainh-A01 and confirm that TMEM16 A plays a key role in persistent chronic constriction injury-induced hyperalgesia. Thus, inhibiting TMEM16 A might be a novel pharmacological intervention for neuropathic pain. All experimental protocols were approved by the Animal Ethics Committee at the First Affiliated Hospital of Shihezi University School of Medicine, China(approval No. A2017-170-01) on February 27, 2017.
基金Supported by ABC Medical School Scientific Project Grant
文摘AIM: To present a new technique of cervical esophagogastric anastomosis to reduce the frequency of fistula formation. METHODS: A group of 31 patients with thoracic and abdominal esophageal cancer underwent cervical esophagogastric anastomosis with invagination of the proximal esophageal stump into the stomach tube. In the region elected for anastomosis, a transverse myotomy of the esophagus was carried out around the entire circumference of the esophagus. Afterwards, a 4-cm long segment of esophagus was invaginated into the stomach and anastomosed to the anterior and the posterior walls. RESULTS: Postoperative minor complications occurred in 22 (70.9%) patients. Four (12.9%) patients had serious complications that led to death. The discharge of saliva was at a lower region, while attempting to leave the anastomosis site out of the alimentary transit. Three (9.7%) patients had fistula at the esophagogastric anastomosis, with minimal leakage of air or saliva and with mild clinical repercussions. No patients had esophago- gastric fistula with intense saliva leakage from either the cervical incision or the thoracic drain. Fibrotic stenosis of anastomoses occurred in seven (22.6%) patients. All these patients obtained relief from their dysphagia with endoscopic dilatation of the anastomosis.CONCLUSION: Cervical esophagogastric anastomosis with invagination of the proximal esophageal stump into the stomach tube presented a low rate of esophagogastric fistula with mild clinical repercussions.
