AIM:To evaluate the clinical outcomes of a new minimally invasive technique using horizontal mattress sutures and Hoffman pockets for four-point refixation of dislocated fourhaptic intraocular lenses(IOLs).METHODS:Thi...AIM:To evaluate the clinical outcomes of a new minimally invasive technique using horizontal mattress sutures and Hoffman pockets for four-point refixation of dislocated fourhaptic intraocular lenses(IOLs).METHODS:This retrospective consecutive case series included eyes with dislocated Akreos AO60 IOLs underwent scleral refixation using a horizontal mattress doubleneedle suture technique with intralamellar knot burial via Hoffman pockets.Clinical outcomes assessed included pre-and postoperative best-corrected visual acuity(BCVA),intraocular pressure(IOP),spherical equivalent(SE),suture duration,IOL centration,and perioperative complications.RESULTS:A total of 10 eyes from 10 patients(6 males)were included.The mean age at the time of IOL refixation was 53.10±13.07y(range:28-68y).The mean interval between initial IOL implantation and dislocation was 8.44±3.54y.The mean postoperative follow-up duration was 11.45±10.30mo.Surgical time averaged 15.3±1.77min,with no intraoperative complications.The mean axial length was 27.16±4.35 mm,with high myopia(HM)as the leading comorbidity(4/10 eyes).Postoperative BCVA significantly improved compared to preoperative values(P=0.025).Postoperative SE was significantly improved compared with preoperative(P=0.01).All IOLs remained centered throughout follow-up.CONCLUSION:This minimally invasive four-point scleral fixation technique offers a safe and effective refixation strategy for dislocated four-haptic IOLs.The horizontal mattress suture configuration combined with Hoffman pockets facilitates durable centration,avoids conjunctival dissection,and could be adopted into routine surgical practice.展开更多
Automatic identificationof discontinuities is a key focus in rock slope research.Conventional methods typically target small areas,which limits efficiencyand applicability for complex discontinuities in large-scale ro...Automatic identificationof discontinuities is a key focus in rock slope research.Conventional methods typically target small areas,which limits efficiencyand applicability for complex discontinuities in large-scale rock slopes.This study uses multi-angle unmanned aerial vehicle(UAV)nap-of-the-object photogrammetry to construct a high-definitionthree-dimensional(3D)point cloud model of the slope.The edge-firstconnection algorithm identifiesall edge points of discontinuities in the point cloud and completes recognition through simple connection analysis.This method avoids the complex calculations required for sequentially identifying discontinuity edges in conventional methods and achieves significantacceleration through algorithm optimization and parallel computation support.Based on this algorithm,the RockDiscontinuity Identification(RD ID)software is developed and applied to identify numerous highly disordered discontinuities on the Xulong slope in the Jinsha River suture zone.Processing tens of millions of point clouds within approximately 2 h demonstrates exceptional computational efficiency.The automatic algorithm accurately identifiesnearly 80%of planar discontinuities,with orientations and trace lengths closely matching manual results,highlighting its potential for large-scale rock outcrop applications.Comparisons with region growing algorithms further emphasize its effectiveness and accuracy.However,the algorithm struggles to identify linear discontinuities,which are a major source of error.Additionally,high roughness and smooth edges of discontinuities affect recognition accuracy,indicating areas for further improvement.展开更多
Currently, animal and clinical research on biomaterials, such as surgical sutures, are mainly performed by removing them from the experiment targets and observing them by microscopy. However, traditional microscopy is...Currently, animal and clinical research on biomaterials, such as surgical sutures, are mainly performed by removing them from the experiment targets and observing them by microscopy. However, traditional microscopy is not able to observe the internal structure, and there is a risk of sacrificing animals to remove the suture and damaging the materials. Therefore, we introduced optical coherence tomography (OCT) to observe and evaluate four different kinds of surgical sutures in vivo (monofilament absorbable and nonabsorbable sutures and braided absorbable and nonabsorbable sutures). As a result, while the monofilament nonabsorbable sutures showed almost no change over time, the absorbable sutures had color fading and it was also confirmed that the internal structure became chaotic due to decomposition, which improved the OCT signal intensity. For the braided sutures, both absorbable and nonabsorbable, we found that the reflection signal improved from week 0 because blood got among the filaments of sutures and dried during recovery which increased OCT signal from week 0 to week 1. We also confirmed that the braided sutures untwisted over time. All four kinds of sutures were pulled due to the movement of rats during recovery. It is expected that OCT technology will be of great help in in vivo experiments on biomaterials such as sutures.展开更多
BACKGROUND Anastomotic leakage(AL)is a challenging complication following rectal cancer surgery,often leading to increased morbidity and healthcare costs.The use of reinforcement sutures is expected to reduce the rate...BACKGROUND Anastomotic leakage(AL)is a challenging complication following rectal cancer surgery,often leading to increased morbidity and healthcare costs.The use of reinforcement sutures is expected to reduce the rate of AL,their preventive effects are controversial.AIM To determine the efficacy of reinforcing sutures in preventing AL in rectal cancer.METHODS A systematic search of major medical databases was conducted to identify studies up to June 2024.Intraoperative and postoperative outcomes were assessed;the primary outcome assessed was the incidence of AL.Pooled odds ratios(ORs)and mean differences(MDs)with a 95%confidence interval(CI)were calculated using fixed-effect or random-effect models under heterogeneity.RESULTS This meta-analysis incorporated 20 studies involving 3726 patients.Pooled results demonstrated a statistically significant reduction AL incidence in the reinforced suture group(OR:0.26,95%CI:0.19-0.35,P<0.001)than the unreinforced suture group.The reinforced suture group also exhibited a shorter hospital stay(MD:-1.17,95%CI:-1.78 to-0.57,P<0.001),earlier anal exhaust(MD:-0.13,95%CI:-0.22 to-0.05,P=0.002),longer operative time(MD:15.25,95%CI:10.71-19.80,P<0.001),lower infection rate(OR:0.54,95%CI:0.29-1.00,P=0.05)and lower reoperation rate(OR:0.19,95%CI:0.08-0.45,P<0.001).CONCLUSION The results substantiate the clinical value of anastomotic reinforcement sutures in reducing AL incidence postrectal cancer surgery.Nevertheless,these conclusions warrant verification through additional high-quality randomized controlled trials.展开更多
The effectiveness of cranial suture expansion therapy hinges on the timely and adequate regeneration of bone tissue in response to mechanical stimuli.To optimize clinical outcomes and prevent post-expansion relapse,we...The effectiveness of cranial suture expansion therapy hinges on the timely and adequate regeneration of bone tissue in response to mechanical stimuli.To optimize clinical outcomes and prevent post-expansion relapse,we delved into the underlying mechanisms governing bone remodeling during the processes of suture expansion and relapse.Our findings revealed that in vitro stretching bolstered mesenchymal stem cells'antioxidative and osteogenic capacity by orchestrating mitochondrial activities,which governed by force-induced endoplasmic reticulum(ER)stress.Nonetheless,this signal transduction occurred through the activation of protein kinase R-like ER kinase(PERK)at the ER-mitochondria interface,rather than ER-mitochondria calcium flow as previously reported.Subsequently,PERK activation triggered TFEB translocation to the nucleus,thus regulating mitochondrial dynamics transcriptionally.Assessment of the mitochondrial pool during expansion and relapse unveiled a sequential,two-phase regulation governed by the ER stress/p-PERK/TFEB signaling cascade.Initially,PERK activation facilitated TFEB nuclear localization,stimulating mitochondrial biogenesis through PGC1-α,thereby addressing energy demands during the initial phase.Subsequently,TFEB shifted focus towards ensuring adequate mitophagy for mitochondrial quality maintenance during the remodeling process.Premature withdrawal of expanding force disrupted this sequential regulation,leading to compromised mitophagy and the accumulation of dysfunctional mitochondria,culminating in suboptimal bone regeneration and relapse.Notably,pharmacological activation of mitophagy effectively mitigated relapse and attenuated bone loss,while its inhibition impeded anticipated bone growth in remodeling progress.Conclusively,we elucidated the ER stress/p-PERK/TFEB signaling orchestrated sequential mitochondria biogenesis and mitophagy under mechanical stretch,thus ensuring antioxidative capacity and osteogenic potential of cranial suture tissues.展开更多
Regarding the current materials used for suture anchors for rotator cuff repair,there are still limitations in terms of degradability,mechanical properties,and bioactivities in clinical applications.Magnesium alloys h...Regarding the current materials used for suture anchors for rotator cuff repair,there are still limitations in terms of degradability,mechanical properties,and bioactivities in clinical applications.Magnesium alloys have preliminarily been shown to promote tendon-bone healing with good prospects for application as anchor materials.However,the design of anchor structures for the degradation characteristics of magnesium alloy materials has not been considered,which is critical for the practical application of magnesium alloy anchors.The mechanism by which magnesium promotes tendon bone healing remains to be clarified.Here,we proposed a novel split hollowed magnesium alloy suture anchors for the repair of rabbit rotator cuff injury.We found that novel split hollowed magnesium alloy anchors structure effectively solved the problem of failure due to degradation of traditional eyelet structure,providing reliable suture fixation.The open architecture facilitates the metabolic resorption of the degradation products of and promotes the ingrowth of bone tissue.Histological staining showed that magnesium anchors have better ability to promote regeneration at the fibrocartilage interface compared to PLLA anchors.The higher expression of fibrocartilage markers(Aggrecan,COL2A1,and Sox9)at the tendon-bone interface in magnesium anchors,which promotes chondrocyte differentiation at the tendon-bone interface and matrix formation,which is more conducive to achieving regeneration and maturation of fibrocartilage enthesis.Hence,this study provides a basis for further research on the clinical application of degradable magnesium alloy suture anchors.展开更多
This study aimed to evaluate the feasibility,safety,and efficacy of a noveltranscatheter suture closure system(HaloStitch^(®))for patent foramen ovale(PFO)closure in a swine model.Methods:Thirteen swine underwent...This study aimed to evaluate the feasibility,safety,and efficacy of a noveltranscatheter suture closure system(HaloStitch^(®))for patent foramen ovale(PFO)closure in a swine model.Methods:Thirteen swine underwentexperimental PF0 model creation.All animals received implantationof the transcatheter suture closure system to evaluate procedural success.Comprehensive follow-up over sixmonths included serial ultrasound imaging,histopathological analysis,and gross anatomical exaninationof cardiac specimens.Results:Successful HaloStitch^(®)device implantation was adhieved in 11 of 13 swine.Gross anatomical examination confirrned secure positioning of all sutures in the atrial septum,with noredundancy or thrombus formation.Postoperative ultrasound demonstrated stable suture and staplepositions throughout follow-up,with no evidence of suture breakage,displacement,or thrombus.Stapleswere clearly visualized under ultrasound imaging,Both the atrial septal defect orifice diameter and residualseptal shunt flow velocity decreased significantly during the observation period.Histopathological analysisrevealed partially organized thrombi at the implant head and fibrous connective tissue encapsulation withlocalized inflammatory cell infiltration surrounding the polymer material.Conclsions:The transcathetersuture closure system(HaloStitch^(®))demonstrated feasibility,safety,and biocompatib ility for PFO closure ina swine model,supporting its potential for clinical translation.展开更多
BACKGROUND In recent years,endoscopic resection(ER)has been employed for the excision of submucosal tumors(SMTs).Nonetheless,ER in the duodenum is linked to ele-vated risks of both immediate and delayed hemorrhagic co...BACKGROUND In recent years,endoscopic resection(ER)has been employed for the excision of submucosal tumors(SMTs).Nonetheless,ER in the duodenum is linked to ele-vated risks of both immediate and delayed hemorrhagic complications and perforations.Satisfactory suturing is crucial for reducing the occurrence of complications.AIM To establish a clinical score model for supporting suture decision-making of duodenal SMTs.METHODS This study included 137 individuals diagnosed with duodenal SMTs who under-went ER.Participants were evenly divided into two groups:A training cohort(TC)comprising 95 cases and an internal validation cohort(VC)with 42 cases.Subsequently,a scoring system was formulated utilizing multivariate logistic regression analysis within the TC,which was then subjected to evaluation in the VC.RESULTS The clinical scoring system incorporated two key factors:Extraluminal growth,which was assigned 2 points,and endoscopic full-thickness resection,which was given 3 points.This model demonstrated strong predictive accuracy,as evidenced by the area under the receiver operating characteristic curve of 0.900(95%confidence interval:0.823-0.976).Additionally,the model’s goodness-of-fit was validated by the Hosmer-Lemeshow test(P=0.404).The probability of purse-string suturing in low(score 0-2)and high(score>3)categories were 3.0%and 64.3%in the TC,and 6.1%and 88.9%in the VC,respectively.CONCLUSION This scoring system may function as a beneficial instrumentality for medical practitioners,facilitating the decision-making process concerning suture techniques in the context of duodenal SMTs.展开更多
BACKGROUND The purpose of this systematic review was to evaluate the clinical and radiological outcomes at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries.AIM ...BACKGROUND The purpose of this systematic review was to evaluate the clinical and radiological outcomes at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries.AIM To assess the effectiveness of suture button fixation in managing ligamentous Lisfranc injuries through a systematic evaluation of short-term clinical and radiological outcomes.METHODS During March 2024,the PubMed,EMBASE,and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following suture button fixation for the management of ligamentous Lisfranc injuries.Data regarding patient demographics,pathological characteristics,subjective clinical outcomes,radiological outcomes,complications,and failure rates were extracted and analyzed.RESULTS Eight studies were included.In total,94 patients(94 feet)underwent suture button fixation for the management of ligamentous Lisfranc injuries at a weighted mean follow-up of 27.2±10.2 months.The American Orthopaedic Foot and Ankle Society score improved from a weighted mean pre-operative score of 39.2±11.8 preoperatively to a post-operative score of 82.8±5.4.The weighted mean visual analogue scale score improved from a weighted mean pre-operative score of 7.7±0.6 preoperatively to a post-operative score of 2.0±0.4.In total,100%of patients returned to sport at a mean time of 16.8 weeks.The complication rate was 5%,the most common complication of which was residual midfoot stiffness(3.0%).No failures nor secondary surgical procedures were recorded.CONCLUSION This systematic review demonstrated that suture button fixation for ligamentous Lisfranc injuries produced improved clinical outcomes at short-term follow-up.In addition,there was an excellent return-to-sport rate(100%)at a weighted mean time of 16.8 weeks.This review highlights that suture button fixation is a potent surgical treatment strategy for ligamentous Lisfranc injuries;however,caution should be taken when evaluating this data in light of the lack of high quality,comparative studies,and short-term follow-up.展开更多
BACKGROUND Low-grade appendiceal mucinous neoplasms(LAMNs)are a class of histolo-gically well-differentiated adenomas that can proliferate outside the appendix in the form of malignant tumours,resulting in the accumul...BACKGROUND Low-grade appendiceal mucinous neoplasms(LAMNs)are a class of histolo-gically well-differentiated adenomas that can proliferate outside the appendix in the form of malignant tumours,resulting in the accumulation of external appen-diceal mucus.They may present as an extra-appendiceal mass-like bulge,mucus or polypoid tissue at the appendiceal orifice,or even with abdominal dissem-ination.The surgical approach is usually appendectomy,ileocecal resection or right hemicolectomy.It is essential to raise awareness of LAMNs and choose an appropriate treatment.CASE SUMMARY A 68-year-old man underwent a routine physical examination at our hospital on May 17,2022.The patient had no symptoms of abdominal pain,bloating,or weight loss,and his tumour marker levels were normal.The faecal occult blood test was negative,and no abnormalities were identified on physical examination.Colonoscopy revealed a submucosal protrusion at the appendiceal orifice.During endoscopic ultrasound,uneven echoes were observed in the appendix cavity.A contrast-enhanced computed tomography scan of the abdomen revealed a nodular thickening at the base of the appendix,with a diameter of approximately 1 cm.When all the examination results were considered,we suspected the lesion to be an appendiceal mucinous tumour.Laparoscopic surgery was performed using the double purse-string suture method.Postoperative pathology suggested a low-grade mucinous cystadenoma of the appendix with no involvement of the margins.A repeat colonoscopy 18 months after surgery revealed no significant abnormality at the appendiceal orifice.A contrast-enhanced computed tomography scan of the abdomen suggested only postoperative changes.CONCLUSION This study describes a case of LAMN that was treated by resecting the mass at the appendiceal orifice via the double purse-string suture technique and provides new insights on the diagnosis and treatment of LAMNs.展开更多
The connection efficiency of composite pre-tightened multi-tooth joint is low because of uneven load distribution and single load transmission path.In this paper,based on the principle of bio-tooth(suture)structure,co...The connection efficiency of composite pre-tightened multi-tooth joint is low because of uneven load distribution and single load transmission path.In this paper,based on the principle of bio-tooth(suture)structure,combining soft material with fractal,a composite pre-tightened multi-hierarchy tooth joint is proposed,and the bearing performance and failure process of the joint through experiments and finite element method under tensile load.First,the ultimate bearing capacity,load distribution ratio,and failure process of different hierarchies of teeth joints are studied through experiments.Then,the progressive damage models of different hierarchies of tooth joints are established,and experiments verify the validity of the finite element model.Finally,the effects of soft material and increasing tooth hierarchy on the failure process and bearing capacity of composite pre-tightened tooth joints are analyzed by the finite element method.The following conclusions can be drawn:(1)The embedding of soft materials changed the failure process of the joint.Increasing the tooth hierarchy can give the joint more load transfer paths,but the failure process of the joint is complicated.(2)Embedding soft materials and increasing the tooth hierarchy simultaneously can effectively improve the bearing capacity of composite pre-tightened tooth joints,which is 87.8%higher than that of traditional three-tooth joints.展开更多
Objective To investigate the clinical efficacy of acupuncture combined with medicine for AIzheimer＇s disease. Methods Fifty-five patients of Alzheimer＇s disease were randomly divided into two groups in accordance wi...Objective To investigate the clinical efficacy of acupuncture combined with medicine for AIzheimer＇s disease. Methods Fifty-five patients of Alzheimer＇s disease were randomly divided into two groups in accordance with random number table： the drug group （n=28） was treated with oral donepezil hydrochloride tablets, once a day for 5-10 mg with 10 days as a course of treatment; the combined acupuncture and drug group （n=27） was treated with cranial suture acupuncture combined with donepezil hydrochloride tablets in the above-mentioned way. The cranial suture acupuncture was given once a day for 30 min with 10 days as a course of treatment. Both groups were given treatment for two courses. Mini-mental state examination （MMSE）, Alzheimer＇s disease assessment scale （ADAS-Cog）, activities of daily living scale （Barthel） and electroencephalogram （EEG） were checked before and after treatment, to evaluate the efficacy of each group via integral changes of Barthel. Results MMSE score increased, Barthel index score increased, and ADAS-Cog score decreased in the two groups after treatment （P〈0.05, P〈0.01）, and the efficacy of the combined acupuncture and drug group was more significant （P〈0.01）. The α wave frequency and amplitude and θ wave frequency of EEG increased after treatment in both groups （P〈0.05）, θ wave amplitude decreased （P〈0.01）, and the efficacy of the combined acupuncture and drug group was superior to that of the drug group in terms of EEG improvement （P〈0.05）. The total effective rate of the combined acupuncture and drug group （88.9%, 24/27） was superior to that of drug group （67.9%, 18/28, P〈0.05）. Conclusion The effect of cranial suture acupuncture combined with donepezil hydrochloride tablets for Alzheimer＇s disease is more significant than only medicine therapy.展开更多
The recently identified Huashan ophiolitic mélange was considered as the eastern part of the Mianlüe suture in the Qinling orogenic belt. SHRIMP zircon U-Pb geochronology on gabbro from the Huashan ophiolite...The recently identified Huashan ophiolitic mélange was considered as the eastern part of the Mianlüe suture in the Qinling orogenic belt. SHRIMP zircon U-Pb geochronology on gabbro from the Huashan ophiolite and granite intruding basic volcanic rocks indicates crystallization ages of 947±14 Ma and 876±17 Ma respectively. These ages do not support a recently proposed Hercynian Huashan Ocean, but rather favor that a Neoproterozoic suture assemblage （ophiolite） is incorporated into the younger （Phanerozoic） Qinling orogenic belt.展开更多
How ophiolitic mèlanges can be defined as sutures is controversial with regard to accretionary orogenesis and continental growth.The Chinese Altay,East junggar,Tianshan,and Beishan belts of the southern Central A...How ophiolitic mèlanges can be defined as sutures is controversial with regard to accretionary orogenesis and continental growth.The Chinese Altay,East junggar,Tianshan,and Beishan belts of the southern Central Asian Orogenic Belt（CAOB） in Northwest China,offer a special natural laboratory to resolve this puzzle.In the Chinese Altay,the Erqis unit consists of ophiolitic melanges and coherent assemblages,forming a Paleozoic accretionary complex.At least two ophiolitic melanges（Armantai,and Kelameili） in East Junggar,characterized by imbricated ophiolitic melanges,Nb-enriched basalts,adakitic rocks and volcanic rocks,belong to a Devonian-Carboniferous intra-oceanic island arc with some Paleozoic ophiolites,superimposed by Permian arc volcanism.In the Tianshan,ophiolitic melanges like Kanggurtag,North Tianshan,and South Tianshan occur as part of some Paleozoic accretionary complexes related to amalgamation of arc terranes.In the Beishan there are also several ophiolitic melanges,including the Hongshishan,Xingxingxia-Shibangjing,Hongliuhe-Xichangjing,and Liuyuan ophiolitic units.Most ophiolitic melanges in the study area are characterized by ultramafic,mafic and other components,which are juxtaposed,or even emplaced as lenses and knockers in a matrix of some coherent units.The tectonic settings of various components are different,and some adjacent units in the same melange show contrasting different tectonic settings.The formation ages of these various components are in a wide spectrum,varying from Neoproterozoic to Permian.Therefore we cannot assume that these ophiolitic melanges always form in linear sutures as a result of the closure of specific oceans.Often the ophiolitic components formed either as the substrate of intra-oceanic arcs,or were accreted as lenses or knockers in subduction-accretion complexes.Using published age and paleogeographic constraints,we propose the presence of （1） a major early Paleozoic tectonic boundary that separates the Chinese Altay-East Junggar multiple subduction systems of the southern Siberian active margin from those of the northern Tarim;and （2） a major Permian suture zone that separates the Tianshan-Beishan from the northern active margin of the Tarim Craton.These new observations and interpretations have broad implications for the architecture and crustal growth of central Asia and other ancient orogens as well.展开更多
文摘AIM:To evaluate the clinical outcomes of a new minimally invasive technique using horizontal mattress sutures and Hoffman pockets for four-point refixation of dislocated fourhaptic intraocular lenses(IOLs).METHODS:This retrospective consecutive case series included eyes with dislocated Akreos AO60 IOLs underwent scleral refixation using a horizontal mattress doubleneedle suture technique with intralamellar knot burial via Hoffman pockets.Clinical outcomes assessed included pre-and postoperative best-corrected visual acuity(BCVA),intraocular pressure(IOP),spherical equivalent(SE),suture duration,IOL centration,and perioperative complications.RESULTS:A total of 10 eyes from 10 patients(6 males)were included.The mean age at the time of IOL refixation was 53.10±13.07y(range:28-68y).The mean interval between initial IOL implantation and dislocation was 8.44±3.54y.The mean postoperative follow-up duration was 11.45±10.30mo.Surgical time averaged 15.3±1.77min,with no intraoperative complications.The mean axial length was 27.16±4.35 mm,with high myopia(HM)as the leading comorbidity(4/10 eyes).Postoperative BCVA significantly improved compared to preoperative values(P=0.025).Postoperative SE was significantly improved compared with preoperative(P=0.01).All IOLs remained centered throughout follow-up.CONCLUSION:This minimally invasive four-point scleral fixation technique offers a safe and effective refixation strategy for dislocated four-haptic IOLs.The horizontal mattress suture configuration combined with Hoffman pockets facilitates durable centration,avoids conjunctival dissection,and could be adopted into routine surgical practice.
基金supported by the National Key R&D Program of China(Grant No.2022YFC3080200)the China Postdoctoral Science Foundation(Grant No.2023M731264)the Science and Technology Development Plan Project of Jilin Province,China(Grant No.20250602007RC).
文摘Automatic identificationof discontinuities is a key focus in rock slope research.Conventional methods typically target small areas,which limits efficiencyand applicability for complex discontinuities in large-scale rock slopes.This study uses multi-angle unmanned aerial vehicle(UAV)nap-of-the-object photogrammetry to construct a high-definitionthree-dimensional(3D)point cloud model of the slope.The edge-firstconnection algorithm identifiesall edge points of discontinuities in the point cloud and completes recognition through simple connection analysis.This method avoids the complex calculations required for sequentially identifying discontinuity edges in conventional methods and achieves significantacceleration through algorithm optimization and parallel computation support.Based on this algorithm,the RockDiscontinuity Identification(RD ID)software is developed and applied to identify numerous highly disordered discontinuities on the Xulong slope in the Jinsha River suture zone.Processing tens of millions of point clouds within approximately 2 h demonstrates exceptional computational efficiency.The automatic algorithm accurately identifiesnearly 80%of planar discontinuities,with orientations and trace lengths closely matching manual results,highlighting its potential for large-scale rock outcrop applications.Comparisons with region growing algorithms further emphasize its effectiveness and accuracy.However,the algorithm struggles to identify linear discontinuities,which are a major source of error.Additionally,high roughness and smooth edges of discontinuities affect recognition accuracy,indicating areas for further improvement.
文摘Currently, animal and clinical research on biomaterials, such as surgical sutures, are mainly performed by removing them from the experiment targets and observing them by microscopy. However, traditional microscopy is not able to observe the internal structure, and there is a risk of sacrificing animals to remove the suture and damaging the materials. Therefore, we introduced optical coherence tomography (OCT) to observe and evaluate four different kinds of surgical sutures in vivo (monofilament absorbable and nonabsorbable sutures and braided absorbable and nonabsorbable sutures). As a result, while the monofilament nonabsorbable sutures showed almost no change over time, the absorbable sutures had color fading and it was also confirmed that the internal structure became chaotic due to decomposition, which improved the OCT signal intensity. For the braided sutures, both absorbable and nonabsorbable, we found that the reflection signal improved from week 0 because blood got among the filaments of sutures and dried during recovery which increased OCT signal from week 0 to week 1. We also confirmed that the braided sutures untwisted over time. All four kinds of sutures were pulled due to the movement of rats during recovery. It is expected that OCT technology will be of great help in in vivo experiments on biomaterials such as sutures.
文摘BACKGROUND Anastomotic leakage(AL)is a challenging complication following rectal cancer surgery,often leading to increased morbidity and healthcare costs.The use of reinforcement sutures is expected to reduce the rate of AL,their preventive effects are controversial.AIM To determine the efficacy of reinforcing sutures in preventing AL in rectal cancer.METHODS A systematic search of major medical databases was conducted to identify studies up to June 2024.Intraoperative and postoperative outcomes were assessed;the primary outcome assessed was the incidence of AL.Pooled odds ratios(ORs)and mean differences(MDs)with a 95%confidence interval(CI)were calculated using fixed-effect or random-effect models under heterogeneity.RESULTS This meta-analysis incorporated 20 studies involving 3726 patients.Pooled results demonstrated a statistically significant reduction AL incidence in the reinforced suture group(OR:0.26,95%CI:0.19-0.35,P<0.001)than the unreinforced suture group.The reinforced suture group also exhibited a shorter hospital stay(MD:-1.17,95%CI:-1.78 to-0.57,P<0.001),earlier anal exhaust(MD:-0.13,95%CI:-0.22 to-0.05,P=0.002),longer operative time(MD:15.25,95%CI:10.71-19.80,P<0.001),lower infection rate(OR:0.54,95%CI:0.29-1.00,P=0.05)and lower reoperation rate(OR:0.19,95%CI:0.08-0.45,P<0.001).CONCLUSION The results substantiate the clinical value of anastomotic reinforcement sutures in reducing AL incidence postrectal cancer surgery.Nevertheless,these conclusions warrant verification through additional high-quality randomized controlled trials.
基金supported by National Natural Science Foundation of China(No.82370988,32271416,81870743,82170934)Sichuan Province Science and Technology Support Program(2024YFHZ0043)。
文摘The effectiveness of cranial suture expansion therapy hinges on the timely and adequate regeneration of bone tissue in response to mechanical stimuli.To optimize clinical outcomes and prevent post-expansion relapse,we delved into the underlying mechanisms governing bone remodeling during the processes of suture expansion and relapse.Our findings revealed that in vitro stretching bolstered mesenchymal stem cells'antioxidative and osteogenic capacity by orchestrating mitochondrial activities,which governed by force-induced endoplasmic reticulum(ER)stress.Nonetheless,this signal transduction occurred through the activation of protein kinase R-like ER kinase(PERK)at the ER-mitochondria interface,rather than ER-mitochondria calcium flow as previously reported.Subsequently,PERK activation triggered TFEB translocation to the nucleus,thus regulating mitochondrial dynamics transcriptionally.Assessment of the mitochondrial pool during expansion and relapse unveiled a sequential,two-phase regulation governed by the ER stress/p-PERK/TFEB signaling cascade.Initially,PERK activation facilitated TFEB nuclear localization,stimulating mitochondrial biogenesis through PGC1-α,thereby addressing energy demands during the initial phase.Subsequently,TFEB shifted focus towards ensuring adequate mitophagy for mitochondrial quality maintenance during the remodeling process.Premature withdrawal of expanding force disrupted this sequential regulation,leading to compromised mitophagy and the accumulation of dysfunctional mitochondria,culminating in suboptimal bone regeneration and relapse.Notably,pharmacological activation of mitophagy effectively mitigated relapse and attenuated bone loss,while its inhibition impeded anticipated bone growth in remodeling progress.Conclusively,we elucidated the ER stress/p-PERK/TFEB signaling orchestrated sequential mitochondria biogenesis and mitophagy under mechanical stretch,thus ensuring antioxidative capacity and osteogenic potential of cranial suture tissues.
基金supported by Capital Health Development Research Special Project(2022-2-5051)DongGuan Innovative Research Team Program.Basic applied research program of Liaoning Province of China(No.2022020347-JH2/1013)。
文摘Regarding the current materials used for suture anchors for rotator cuff repair,there are still limitations in terms of degradability,mechanical properties,and bioactivities in clinical applications.Magnesium alloys have preliminarily been shown to promote tendon-bone healing with good prospects for application as anchor materials.However,the design of anchor structures for the degradation characteristics of magnesium alloy materials has not been considered,which is critical for the practical application of magnesium alloy anchors.The mechanism by which magnesium promotes tendon bone healing remains to be clarified.Here,we proposed a novel split hollowed magnesium alloy suture anchors for the repair of rabbit rotator cuff injury.We found that novel split hollowed magnesium alloy anchors structure effectively solved the problem of failure due to degradation of traditional eyelet structure,providing reliable suture fixation.The open architecture facilitates the metabolic resorption of the degradation products of and promotes the ingrowth of bone tissue.Histological staining showed that magnesium anchors have better ability to promote regeneration at the fibrocartilage interface compared to PLLA anchors.The higher expression of fibrocartilage markers(Aggrecan,COL2A1,and Sox9)at the tendon-bone interface in magnesium anchors,which promotes chondrocyte differentiation at the tendon-bone interface and matrix formation,which is more conducive to achieving regeneration and maturation of fibrocartilage enthesis.Hence,this study provides a basis for further research on the clinical application of degradable magnesium alloy suture anchors.
基金supported by grants from National High-Level Hospital Clinical Research Funding(2023-GSP-RC-04).
文摘This study aimed to evaluate the feasibility,safety,and efficacy of a noveltranscatheter suture closure system(HaloStitch^(®))for patent foramen ovale(PFO)closure in a swine model.Methods:Thirteen swine underwentexperimental PF0 model creation.All animals received implantationof the transcatheter suture closure system to evaluate procedural success.Comprehensive follow-up over sixmonths included serial ultrasound imaging,histopathological analysis,and gross anatomical exaninationof cardiac specimens.Results:Successful HaloStitch^(®)device implantation was adhieved in 11 of 13 swine.Gross anatomical examination confirrned secure positioning of all sutures in the atrial septum,with noredundancy or thrombus formation.Postoperative ultrasound demonstrated stable suture and staplepositions throughout follow-up,with no evidence of suture breakage,displacement,or thrombus.Stapleswere clearly visualized under ultrasound imaging,Both the atrial septal defect orifice diameter and residualseptal shunt flow velocity decreased significantly during the observation period.Histopathological analysisrevealed partially organized thrombi at the implant head and fibrous connective tissue encapsulation withlocalized inflammatory cell infiltration surrounding the polymer material.Conclsions:The transcathetersuture closure system(HaloStitch^(®))demonstrated feasibility,safety,and biocompatib ility for PFO closure ina swine model,supporting its potential for clinical translation.
基金Supported by National Natural Science Foundation of China,No.82170555Shanghai Academic/Technology Research Leader,No.22XD1422400+2 种基金Shanghai“Rising Stars of Medical Talent”Youth Development Program,No.20224Z0005the 74th General Support of China Postdoctoral Science Foundation,No.2023M740675Outstanding Resident Clinical Postdoctoral Program of Zhongshan Hospital Affiliated to Fudan University.
文摘BACKGROUND In recent years,endoscopic resection(ER)has been employed for the excision of submucosal tumors(SMTs).Nonetheless,ER in the duodenum is linked to ele-vated risks of both immediate and delayed hemorrhagic complications and perforations.Satisfactory suturing is crucial for reducing the occurrence of complications.AIM To establish a clinical score model for supporting suture decision-making of duodenal SMTs.METHODS This study included 137 individuals diagnosed with duodenal SMTs who under-went ER.Participants were evenly divided into two groups:A training cohort(TC)comprising 95 cases and an internal validation cohort(VC)with 42 cases.Subsequently,a scoring system was formulated utilizing multivariate logistic regression analysis within the TC,which was then subjected to evaluation in the VC.RESULTS The clinical scoring system incorporated two key factors:Extraluminal growth,which was assigned 2 points,and endoscopic full-thickness resection,which was given 3 points.This model demonstrated strong predictive accuracy,as evidenced by the area under the receiver operating characteristic curve of 0.900(95%confidence interval:0.823-0.976).Additionally,the model’s goodness-of-fit was validated by the Hosmer-Lemeshow test(P=0.404).The probability of purse-string suturing in low(score 0-2)and high(score>3)categories were 3.0%and 64.3%in the TC,and 6.1%and 88.9%in the VC,respectively.CONCLUSION This scoring system may function as a beneficial instrumentality for medical practitioners,facilitating the decision-making process concerning suture techniques in the context of duodenal SMTs.
文摘BACKGROUND The purpose of this systematic review was to evaluate the clinical and radiological outcomes at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries.AIM To assess the effectiveness of suture button fixation in managing ligamentous Lisfranc injuries through a systematic evaluation of short-term clinical and radiological outcomes.METHODS During March 2024,the PubMed,EMBASE,and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following suture button fixation for the management of ligamentous Lisfranc injuries.Data regarding patient demographics,pathological characteristics,subjective clinical outcomes,radiological outcomes,complications,and failure rates were extracted and analyzed.RESULTS Eight studies were included.In total,94 patients(94 feet)underwent suture button fixation for the management of ligamentous Lisfranc injuries at a weighted mean follow-up of 27.2±10.2 months.The American Orthopaedic Foot and Ankle Society score improved from a weighted mean pre-operative score of 39.2±11.8 preoperatively to a post-operative score of 82.8±5.4.The weighted mean visual analogue scale score improved from a weighted mean pre-operative score of 7.7±0.6 preoperatively to a post-operative score of 2.0±0.4.In total,100%of patients returned to sport at a mean time of 16.8 weeks.The complication rate was 5%,the most common complication of which was residual midfoot stiffness(3.0%).No failures nor secondary surgical procedures were recorded.CONCLUSION This systematic review demonstrated that suture button fixation for ligamentous Lisfranc injuries produced improved clinical outcomes at short-term follow-up.In addition,there was an excellent return-to-sport rate(100%)at a weighted mean time of 16.8 weeks.This review highlights that suture button fixation is a potent surgical treatment strategy for ligamentous Lisfranc injuries;however,caution should be taken when evaluating this data in light of the lack of high quality,comparative studies,and short-term follow-up.
基金Supported by Jinhua City Science and Technology Plan Projects“Improve the Polarization of Cancer-related Fatigue:Clinical Efficacy Study”,No.2018-4-049.
文摘BACKGROUND Low-grade appendiceal mucinous neoplasms(LAMNs)are a class of histolo-gically well-differentiated adenomas that can proliferate outside the appendix in the form of malignant tumours,resulting in the accumulation of external appen-diceal mucus.They may present as an extra-appendiceal mass-like bulge,mucus or polypoid tissue at the appendiceal orifice,or even with abdominal dissem-ination.The surgical approach is usually appendectomy,ileocecal resection or right hemicolectomy.It is essential to raise awareness of LAMNs and choose an appropriate treatment.CASE SUMMARY A 68-year-old man underwent a routine physical examination at our hospital on May 17,2022.The patient had no symptoms of abdominal pain,bloating,or weight loss,and his tumour marker levels were normal.The faecal occult blood test was negative,and no abnormalities were identified on physical examination.Colonoscopy revealed a submucosal protrusion at the appendiceal orifice.During endoscopic ultrasound,uneven echoes were observed in the appendix cavity.A contrast-enhanced computed tomography scan of the abdomen revealed a nodular thickening at the base of the appendix,with a diameter of approximately 1 cm.When all the examination results were considered,we suspected the lesion to be an appendiceal mucinous tumour.Laparoscopic surgery was performed using the double purse-string suture method.Postoperative pathology suggested a low-grade mucinous cystadenoma of the appendix with no involvement of the margins.A repeat colonoscopy 18 months after surgery revealed no significant abnormality at the appendiceal orifice.A contrast-enhanced computed tomography scan of the abdomen suggested only postoperative changes.CONCLUSION This study describes a case of LAMN that was treated by resecting the mass at the appendiceal orifice via the double purse-string suture technique and provides new insights on the diagnosis and treatment of LAMNs.
基金funded by the National Natural Science Foundation of China(52478138).
文摘The connection efficiency of composite pre-tightened multi-tooth joint is low because of uneven load distribution and single load transmission path.In this paper,based on the principle of bio-tooth(suture)structure,combining soft material with fractal,a composite pre-tightened multi-hierarchy tooth joint is proposed,and the bearing performance and failure process of the joint through experiments and finite element method under tensile load.First,the ultimate bearing capacity,load distribution ratio,and failure process of different hierarchies of teeth joints are studied through experiments.Then,the progressive damage models of different hierarchies of tooth joints are established,and experiments verify the validity of the finite element model.Finally,the effects of soft material and increasing tooth hierarchy on the failure process and bearing capacity of composite pre-tightened tooth joints are analyzed by the finite element method.The following conclusions can be drawn:(1)The embedding of soft materials changed the failure process of the joint.Increasing the tooth hierarchy can give the joint more load transfer paths,but the failure process of the joint is complicated.(2)Embedding soft materials and increasing the tooth hierarchy simultaneously can effectively improve the bearing capacity of composite pre-tightened tooth joints,which is 87.8%higher than that of traditional three-tooth joints.
文摘Objective To investigate the clinical efficacy of acupuncture combined with medicine for AIzheimer＇s disease. Methods Fifty-five patients of Alzheimer＇s disease were randomly divided into two groups in accordance with random number table： the drug group （n=28） was treated with oral donepezil hydrochloride tablets, once a day for 5-10 mg with 10 days as a course of treatment; the combined acupuncture and drug group （n=27） was treated with cranial suture acupuncture combined with donepezil hydrochloride tablets in the above-mentioned way. The cranial suture acupuncture was given once a day for 30 min with 10 days as a course of treatment. Both groups were given treatment for two courses. Mini-mental state examination （MMSE）, Alzheimer＇s disease assessment scale （ADAS-Cog）, activities of daily living scale （Barthel） and electroencephalogram （EEG） were checked before and after treatment, to evaluate the efficacy of each group via integral changes of Barthel. Results MMSE score increased, Barthel index score increased, and ADAS-Cog score decreased in the two groups after treatment （P〈0.05, P〈0.01）, and the efficacy of the combined acupuncture and drug group was more significant （P〈0.01）. The α wave frequency and amplitude and θ wave frequency of EEG increased after treatment in both groups （P〈0.05）, θ wave amplitude decreased （P〈0.01）, and the efficacy of the combined acupuncture and drug group was superior to that of the drug group in terms of EEG improvement （P〈0.05）. The total effective rate of the combined acupuncture and drug group （88.9%, 24/27） was superior to that of drug group （67.9%, 18/28, P〈0.05）. Conclusion The effect of cranial suture acupuncture combined with donepezil hydrochloride tablets for Alzheimer＇s disease is more significant than only medicine therapy.
基金the National Natural Science Foundation of China （Grant No. 40234045, 40473030）.
文摘The recently identified Huashan ophiolitic mélange was considered as the eastern part of the Mianlüe suture in the Qinling orogenic belt. SHRIMP zircon U-Pb geochronology on gabbro from the Huashan ophiolite and granite intruding basic volcanic rocks indicates crystallization ages of 947±14 Ma and 876±17 Ma respectively. These ages do not support a recently proposed Hercynian Huashan Ocean, but rather favor that a Neoproterozoic suture assemblage （ophiolite） is incorporated into the younger （Phanerozoic） Qinling orogenic belt.
基金financially supported by the Chinese National Basic Research 973 Program(2012CB416604,2007CB411307)the National Natural Science Foundation of China(41230207,41390441,41190075)the One Hundred Talent Program B of the Chinese Academy of Sciences
文摘How ophiolitic mèlanges can be defined as sutures is controversial with regard to accretionary orogenesis and continental growth.The Chinese Altay,East junggar,Tianshan,and Beishan belts of the southern Central Asian Orogenic Belt（CAOB） in Northwest China,offer a special natural laboratory to resolve this puzzle.In the Chinese Altay,the Erqis unit consists of ophiolitic melanges and coherent assemblages,forming a Paleozoic accretionary complex.At least two ophiolitic melanges（Armantai,and Kelameili） in East Junggar,characterized by imbricated ophiolitic melanges,Nb-enriched basalts,adakitic rocks and volcanic rocks,belong to a Devonian-Carboniferous intra-oceanic island arc with some Paleozoic ophiolites,superimposed by Permian arc volcanism.In the Tianshan,ophiolitic melanges like Kanggurtag,North Tianshan,and South Tianshan occur as part of some Paleozoic accretionary complexes related to amalgamation of arc terranes.In the Beishan there are also several ophiolitic melanges,including the Hongshishan,Xingxingxia-Shibangjing,Hongliuhe-Xichangjing,and Liuyuan ophiolitic units.Most ophiolitic melanges in the study area are characterized by ultramafic,mafic and other components,which are juxtaposed,or even emplaced as lenses and knockers in a matrix of some coherent units.The tectonic settings of various components are different,and some adjacent units in the same melange show contrasting different tectonic settings.The formation ages of these various components are in a wide spectrum,varying from Neoproterozoic to Permian.Therefore we cannot assume that these ophiolitic melanges always form in linear sutures as a result of the closure of specific oceans.Often the ophiolitic components formed either as the substrate of intra-oceanic arcs,or were accreted as lenses or knockers in subduction-accretion complexes.Using published age and paleogeographic constraints,we propose the presence of （1） a major early Paleozoic tectonic boundary that separates the Chinese Altay-East Junggar multiple subduction systems of the southern Siberian active margin from those of the northern Tarim;and （2） a major Permian suture zone that separates the Tianshan-Beishan from the northern active margin of the Tarim Craton.These new observations and interpretations have broad implications for the architecture and crustal growth of central Asia and other ancient orogens as well.
