The rational canonical form theorem is very essential basic result of matrix theory, which has been proved by different methods in the literature. In this note, we provide an effcient direct proof, from which the mini...The rational canonical form theorem is very essential basic result of matrix theory, which has been proved by different methods in the literature. In this note, we provide an effcient direct proof, from which the minimality for the decomposition of the rational canonical form can be found.展开更多
A necessary and sufficient condition is obtained for the incompleteness of a complex exponential system E(A, M) in Cα, where Cα is the weighted Banach space consisting of all complex continuous functions f on the re...A necessary and sufficient condition is obtained for the incompleteness of a complex exponential system E(A, M) in Cα, where Cα is the weighted Banach space consisting of all complex continuous functions f on the real axis R with f(t)exp(-α(t)) vanishing at infinity, in the uniform norm ‖f‖α = sup{|f(t)e-α(t)|: t ∈ R} with respect to the weight α(t). If the incompleteness holds, then the complex exponential system E(∧, M) is minimal and each function in the closure of the linear span of complex exponential system E(∧, M) can be extended to an entire function represented by a Taylor-Dirichlet series.展开更多
In the practice of healthcare,patient-reported outcomes(PROs)and PRO measures(PROMs)are used as an attempt to observe the changes in complex clinical situations.They guide us in making decisions based on the evidence ...In the practice of healthcare,patient-reported outcomes(PROs)and PRO measures(PROMs)are used as an attempt to observe the changes in complex clinical situations.They guide us in making decisions based on the evidence regarding patient care by recording the change in outcomes for a particular treatment to a given condition and finally to understand whether a patient will benefit from a particular treatment and to quantify the treatment effect.For any PROM to be usable in health care,we need it to be reliable,encapsulating the points of interest with the potential to detect any real change.Using structured outcome measures routinely in clinical practice helps the physician to understand the functional limitation of a patient that would otherwise not be clear in an office interview,and this allows the physician and patient to have a meaningful conver-sation as well as a customized plan for each patient.Having mentioned the rationale and the benefits of PROMs,understanding the quantification process is crucial before embarking on management decisions.A better interpretation of change needs to identify the treatment effect based on clinical relevance for a given condition.There are a multiple set of measurement indices to serve this effect and most of them are used interchangeably without clear demarcation on their differences.This article details the various quantification metrics used to evaluate the treatment effect using PROMs,their limitations and the scope of usage and implementation in clinical practice.展开更多
The dynamical system on T^2 which is a group extension over an irrational rotation on T^1 is investigated. The criterion when the extension is minimal, a system of order 2 and when the maximal equicontinuous factor is...The dynamical system on T^2 which is a group extension over an irrational rotation on T^1 is investigated. The criterion when the extension is minimal, a system of order 2 and when the maximal equicontinuous factor is the irrational rotation is given. The topological complexity of the extension is computed, and a negative answer to the latter part of an open question raised by Host et al.(2014) is obtained.展开更多
BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for ...BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.AIM To investigate the analgesic effect and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.METHODS In this retrospective study,94 patients scheduled for laparoscopic minimally invasive surgery for inguinal hernia,admitted to Yiwu Central Hospital between May 2022 and May 2023,were divided into a control group(inhalation combined general anesthesia)and a treatment group(dexmedetomidine-assisted intrave-nous-inhalation combined general anesthesia).Perioperative indicators,analgesic effect,preoperative and postoperative 24-hours blood pressure(BP)and heart rate(HR),stress indicators,immune function levels,and adverse reactions were com-pared between the two groups.RESULTS Baseline data,including age,hernia location,place of residence,weight,monthly income,education level,and underlying diseases,were not significantly different between the two groups,indicating comparability(P>0.05).No significant difference was found in operation time and anesthesia time between the two groups(P>0.05).However,the treatment group exhibited a shorter postoperative urinary catheter removal time and hospital stay than the control group(P<0.05).Preoperatively,no significant differences were found in the visual analog scale(VAS)scores between the two groups(P>0.05).However,at 12,18,and 24 hours postoper-atively,the treatment group had significantly lower VAS scores than the control group(P<0.05).Although no significant differences in preoperative hemodynamic indicators were found between the two groups(P>0.05),both groups experienced some extent of changes in postoperative HR,diastolic BP(DBP),and systolic BP(SBP).Nevertheless,the treatment group showed smaller changes in HR,DBP,and SBP than the control group(P<0.05).Preoperative immune function indicators showed no significant differences between the two groups(P>0.05).However,postoperatively,the treatment group demonstrated higher levels of CD3+,CD4+,and CD4+/CD8+and lower levels of CD8+than the control group(P<0.05).The rates of adverse reactions were 6.38%and 23.40%in the treatment and control groups,respectively,revealing a significant difference(χ2=5.371,P=0.020).CONCLUSION Dexmedetomidine-assisted intravenous-inhalation combined general anesthesia can promote early recovery of patients undergoing laparoscopic minimally invasive surgery for inguinal hernia.It ensures stable blood flow,improves postoperative analgesic effects,reduces postoperative pain intensity,alleviates stress response,improves immune function,facilitates anesthesia recovery,and enhances safety.展开更多
Pulpotomy,which belongs to vital pulp therapy,has become a strategy for managing pulpitis in recent decades.This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing l...Pulpotomy,which belongs to vital pulp therapy,has become a strategy for managing pulpitis in recent decades.This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing long-term patient-centered outcomes.Pulpotomy is categorized into partial pulpotomy(PP),the removal of a partial segment of the coronal pulp tissue,and full pulpotomy(FP),the removal of whole coronal pulp,which is followed by applying the biomaterials onto the remaining pulp tissue and ultimately restoring the tooth.Procedural decisions for the amount of pulp tissue removal or retention depend on the diagnostic of pulp vitality,the overall treatment plan,the patient’s general health status,and pulp inflammation reassessment during operation.This statement represents the consensus of an expert committee convened by the Society of Cariology and Endodontics,Chinese Stomatological Association.It addresses the current evidence to support the application of pulpotomy as a potential alternative to root canal treatment(RCT)on mature permanent teeth with pulpitis from a biological basis,the development of capping biomaterial,and the diagnostic considerations to evidence-based medicine.This expert statement intends to provide a clinical protocol of pulpotomy,which facilitates practitioners in choosing the optimal procedure and increasing their confidence in this rapidly evolving field.展开更多
BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery ...BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.展开更多
Given two ideals I and J of a commutative ring R,there are two extreme connections between I and J:I+J=R and I∩J={0}.For the former case,graphs whose vertices are defined as the proper ideals of R and that two vertic...Given two ideals I and J of a commutative ring R,there are two extreme connections between I and J:I+J=R and I∩J={0}.For the former case,graphs whose vertices are defined as the proper ideals of R and that two vertices are adjacent if and only if their sum is the whole ring R are known as co-maximal ideal graphs.In this paper,we introduce a new kind of graph structure on R,called co-minimal ideal graph,according to the second case:Its vertices are the nonzero ideals of R and two vertices are adjacent if and only if their intersection is zero.Some important graph parameters(including girth,diameter,clique number and chromatic number)and graph structures(including tree and bipartite graph)of co-minimal ideal graphs over finite commutative rings are studied.In particular,we show that the co-maximal ideal graph and the co-minimal ideal graph over R are isomorphic if and only if the number of maximal ideals of R and the number of minimal ideals of R coincide.展开更多
In this paper,we use the solution of the even functional Minkowski problem to show that there is a minimizing affine Minkowski total variation of the function of bounded variation.Moreover,for the Minkowski total vari...In this paper,we use the solution of the even functional Minkowski problem to show that there is a minimizing affine Minkowski total variation of the function of bounded variation.Moreover,for the Minkowski total variation,we use the method of convexation to establish the same conclusion as the convex body space.展开更多
A nowhere-zero k-flow on a graph G=(V(G),E(G))is a pair(D,f),where D is an orientation on E(G)and f:E(G)→{±1,±2,,±(k-1)}is a function such that the total outflow equals to the total inflow at each vert...A nowhere-zero k-flow on a graph G=(V(G),E(G))is a pair(D,f),where D is an orientation on E(G)and f:E(G)→{±1,±2,,±(k-1)}is a function such that the total outflow equals to the total inflow at each vertex.This concept was introduced by Tutte as an extension of face colorings,and Tutte in 1954 conjectured that every bridgeless graph admits a nowhere-zero 5-flow,known as the 5-Flow Conjecture.This conjecture is verified for some graph classes and remains unresolved as of today.In this paper,we show that every bridgeless graph of Euler genus at most 20 admits a nowhere-zero 5-flow,which improves several known results.展开更多
The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the p...The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the patient's perspective.This comprehensive review analyzes the evolution,applications,and challenges of MCID across medical specialties,emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and needs.We discuss the evolution of MCID since its inception in the 1980s,its current applications across various medical specialties,and the methodologies used in its calculation,highlighting both anchor-based and distribution-based approaches.Furthermore,the paper delves into the challenges associated with the application of MCID,such as methodological variability and the interpretation difficulties that arise in clinical settings.Recommendations for the future include standardizing MCID calculation methods,enhancing patient involvement in setting MCID thresholds,and extending research to incorporate diverse global perspectives.These steps are critical to refining the role of MCID in patient-centered healthcare,addressing existing gaps in methodology and interpretation,and ensuring that medical interventions lead to significant,patient-perceived improvements.展开更多
We study the following minimization problem d_(p)(M_(p)=∫_(R^(n))|▽u|^(2)-c|u|^(2)/|x|^(2)+V(x)|u|^(2)dx-2/p+2∫_(R^(N))|u|^p+2dx.when=p=p^(*):=4/N,,the precise concentration behavior of minimizers is analyzed as M_...We study the following minimization problem d_(p)(M_(p)=∫_(R^(n))|▽u|^(2)-c|u|^(2)/|x|^(2)+V(x)|u|^(2)dx-2/p+2∫_(R^(N))|u|^p+2dx.when=p=p^(*):=4/N,,the precise concentration behavior of minimizers is analyzed as M_(p^(*))↗‖Q_(p^(*))‖_(L^(2)),where Q_(p^(*))is the unique radially positive solution of-Δφ-cφ/|x|^(2-|φ|^(p^(*)+1)φ=0.When 0<p<p^(*)we prove that all minimizers must blow up if lim p→p^(*)M_(p)≥‖Q_(p^(*))‖L^(2).On his argument,the detailed concentration behavior of minimizers is established as p↗p^(*).展开更多
A Bayesian network reconstruction method based on norm minimization is proposed to address the sparsity and iterative divergence issues in network reconstruction caused by noise and missing values.This method achieves...A Bayesian network reconstruction method based on norm minimization is proposed to address the sparsity and iterative divergence issues in network reconstruction caused by noise and missing values.This method achieves precise adjustment of the network structure by constructing a preliminary random network model and introducing small-world network characteristics and combines L1 norm minimization regularization techniques to control model complexity and optimize the inference process of variable dependencies.In the experiment of game network reconstruction,when the success rate of the L1 norm minimization model’s existence connection reconstruction reaches 100%,the minimum data required is about 40%,while the minimum data required for a sparse Bayesian learning network is about 45%.In terms of operational efficiency,the running time for minimizing the L1 normis basically maintained at 1.0 s,while the success rate of connection reconstruction increases significantly with an increase in data volume,reaching a maximum of 13.2 s.Meanwhile,in the case of a signal-to-noise ratio of 10 dB,the L1 model achieves a 100% success rate in the reconstruction of existing connections,while the sparse Bayesian network had the highest success rate of 90% in the reconstruction of non-existent connections.In the analysis of actual cases,the maximum lift and drop track of the research method is 0.08 m.The mean square error is 5.74 cm^(2).The results indicate that this norm minimization-based method has good performance in data efficiency and model stability,effectively reducing the impact of outliers on the reconstruction results to more accurately reflect the actual situation.展开更多
BACKGROUND Minimally invasive lumbar interbody fusion(LIF)procedures have evolved rapidly in recent years,with robot-assisted(RA)techniques increasingly integrated into clinical practice.However,questions remain regar...BACKGROUND Minimally invasive lumbar interbody fusion(LIF)procedures have evolved rapidly in recent years,with robot-assisted(RA)techniques increasingly integrated into clinical practice.However,questions remain regarding the relative advantages of RA over traditional fluoroscopy-guided and navigation-assisted methods in terms of perioperative,radiographic,and clinical outcomes.This systematic review synthesizes current evidence on these comparisons,focusing on the accuracy of screw placement,perioperative efficiency,radiographic and clinical outcomes,and complications.AIM To investigate the comparative effectiveness of RA vs conventional LIF techniques.METHODS A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 and Cochrane guidelines.Databases searched included PubMed,EMBASE,Web of Science,Scopus,and the Cochrane Library(through May 2025).Eligible studies were randomized controlled trials and observational studies comparing RA with fluoroscopy-or navigation-guided LIF(transforaminal lumbar interbody fusion,lateral lumbar interbody fusion,oblique lumbar interbody fusion)in adults.Two reviewers independently extracted data and assessed risk of bias.The Grading of Recommendations Assessment,Development and Evaluation framework was used to evaluate certainty of evidence.Meta-analyses were performed where data were sufficiently homogeneous.RESULTS Twenty-two studies were included,encompassing a total of 2313 patients-1046 who underwent RA-guided procedures and 1267 who received comparator techniques.Meta-analyses showed that RA significantly improved perfect pedicle screw placement[pooled odds ratio=2.93;95%confidence interval(CI):1.40-6.14;I2=78.2%]and reduced intraoperative blood loss(pooled standardized mean difference=-0.28;95%CI:-0.47 to-0.08;I2=0%).Operative time did not significantly differ between groups(pooled standardized mean difference=0.01;95%CI:-0.30 to 0.31;I2=66%).Radiation dose could not be synthesized quantitatively due to heterogeneous definitions and measurement units.Narratively,RA demonstrated consistent advantages in reducing surgical exposure and adjacent segment degeneration.Clinical and radiographic outcomes,fusion success,and complication rates were generally comparable across groups.CONCLUSION RA LIF improves pedicle screw placement accuracy and reduces blood loss and surgeon radiation exposure while maintaining similar clinical outcomes and safety profiles to conventional techniques.These findings support the integration of RA into spine surgery but highlight the need for high-quality multicenter randomized controlled trials and cost-effectiveness studies to guide broader implementation.展开更多
The underlying molecular changes that result in minimal change disease(ne-phrotic syndrome)require an in-depth analysis.Current molecular studies have shown the involvement of zinc fingers and homeobox transcriptional...The underlying molecular changes that result in minimal change disease(ne-phrotic syndrome)require an in-depth analysis.Current molecular studies have shown the involvement of zinc fingers and homeobox transcriptional factors in its pathogenesis.The application of therapeutic drugs relies on understanding the cascade of molecular events to determine their efficacy in managing the clinical condition.展开更多
Bone injuries induced by accidents or bone-related disease have dramatically increased in the past decades.The application of biomaterials has become an inextricable part of treatment for new bone formation and regene...Bone injuries induced by accidents or bone-related disease have dramatically increased in the past decades.The application of biomaterials has become an inextricable part of treatment for new bone formation and regeneration.Different from traditional bone-regeneration materials,injectable biomaterials—ranging from bioceramics to polymers—have been applied as a means of promoting surgery with a minimal intervention approach.In this review,we summarize the most recent developments in minimally invasive implantable biomaterials for bone reconstruction and different ways to achieve osteogenesis,with a focus on injectable biomaterials for various applications in the orthopedic field.More specifically,bioceramics and polymeric materials,together with their applications in bone fracture healing,vertebral body augmentation,bone implant fixation,bone tumor therapy,and bone-defect-related infection treatment are reviewed in detail.Recent progress in injectable biomaterials with multiple functionalities and bioresponsive properties is also reviewed.Finally,we summarize the challenges in this field and future directions for clinical treatment.展开更多
Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularl...Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularly lumbosacral plexus.The introduction of minimally invasive surgical approaches,such as the lateral rectus approach,not only contributes to preserving lumbar plexus integrity in operated patients but also positively impacts their psychological well-being.Patients treated by surgical reduction of pelvic fractures with lumbosacral plexus injury often experience states of anxiety and depression.The lateral rectus approach is associated with lower levels of anxiety and depression compared to more invasive surgical techniques used for similar fractures.展开更多
Hemorrhoidal disease is a prevalent anorectal condition causing significant morbidity,affecting approximately 4%of the general population with incidence increasing with age and sedentary lifestyle.While conventional e...Hemorrhoidal disease is a prevalent anorectal condition causing significant morbidity,affecting approximately 4%of the general population with incidence increasing with age and sedentary lifestyle.While conventional excisional hemorrhoidectomy techniques such as Milligan-Morgan and Ferguson remain standard for long-term efficacy,they are often associated with substantial postoperative pain and prolonged recovery.This narrative review evaluates the comparative clinical outcomes of laser hemorrhoidoplasty(LHP)versus conventional surgical interventions in the treatment of grade II and III symptomatic hemorrhoids.A comprehensive analysis of comparative studies,randomized controlled trials,and meta-analyses published between 2020 and 2025 was conducted,with primary outcomes including postoperative pain,recovery time,operative duration,complication rates,and recurrence.Key findings from studies by Maloku et al and Hassan et al.were analyzed to contextualize real-world LHP use.Across multiple high-quality studies,LHP was consistently associated with significantly lower postoperative pain scores,reduced analgesic requirements,and faster return to daily activities.Maloku et al demonstrated a shorter mean operative time(15.9 minutes)and reduced pain compared to open techniques(26.8 minutes;P<0.01).Hassan et al confirmed these benefits in a cohort of 40 patients treated under local anesthesia.Operative time was generally comparable or shorter,and vessel ligation was suggested as an adjunct to improve outcomes in select cases.Complication rates were low and similar between groups,with LHP demonstrating minimal risk for major complications such as anal stenosis or incontinence.However,recurrence rates were higher with LHP in some studies,particularly in grade III disease.LHP offers a minimally invasive,low-morbidity alternative to excisional hemorrhoidectomy for appropriately selected patients.Despite superior short-term recovery profiles,potential for higher recurrence underscores the importance of patient selection and long-term follow-up.The role of local anesthesia and adjunctive vessel ligation merits further prospective evaluation.展开更多
文摘The rational canonical form theorem is very essential basic result of matrix theory, which has been proved by different methods in the literature. In this note, we provide an effcient direct proof, from which the minimality for the decomposition of the rational canonical form can be found.
基金This work was partially supported by the Research Foundation for Doctor Programme(Grant No.20060027023)the National Natural Science Foundation of China(Grant No.10671022)
文摘A necessary and sufficient condition is obtained for the incompleteness of a complex exponential system E(A, M) in Cα, where Cα is the weighted Banach space consisting of all complex continuous functions f on the real axis R with f(t)exp(-α(t)) vanishing at infinity, in the uniform norm ‖f‖α = sup{|f(t)e-α(t)|: t ∈ R} with respect to the weight α(t). If the incompleteness holds, then the complex exponential system E(∧, M) is minimal and each function in the closure of the linear span of complex exponential system E(∧, M) can be extended to an entire function represented by a Taylor-Dirichlet series.
文摘In the practice of healthcare,patient-reported outcomes(PROs)and PRO measures(PROMs)are used as an attempt to observe the changes in complex clinical situations.They guide us in making decisions based on the evidence regarding patient care by recording the change in outcomes for a particular treatment to a given condition and finally to understand whether a patient will benefit from a particular treatment and to quantify the treatment effect.For any PROM to be usable in health care,we need it to be reliable,encapsulating the points of interest with the potential to detect any real change.Using structured outcome measures routinely in clinical practice helps the physician to understand the functional limitation of a patient that would otherwise not be clear in an office interview,and this allows the physician and patient to have a meaningful conver-sation as well as a customized plan for each patient.Having mentioned the rationale and the benefits of PROMs,understanding the quantification process is crucial before embarking on management decisions.A better interpretation of change needs to identify the treatment effect based on clinical relevance for a given condition.There are a multiple set of measurement indices to serve this effect and most of them are used interchangeably without clear demarcation on their differences.This article details the various quantification metrics used to evaluate the treatment effect using PROMs,their limitations and the scope of usage and implementation in clinical practice.
基金National Natural Science Foundation of China (Grant Nos. 11225105 and 11371339)
文摘The dynamical system on T^2 which is a group extension over an irrational rotation on T^1 is investigated. The criterion when the extension is minimal, a system of order 2 and when the maximal equicontinuous factor is the irrational rotation is given. The topological complexity of the extension is computed, and a negative answer to the latter part of an open question raised by Host et al.(2014) is obtained.
文摘BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.AIM To investigate the analgesic effect and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.METHODS In this retrospective study,94 patients scheduled for laparoscopic minimally invasive surgery for inguinal hernia,admitted to Yiwu Central Hospital between May 2022 and May 2023,were divided into a control group(inhalation combined general anesthesia)and a treatment group(dexmedetomidine-assisted intrave-nous-inhalation combined general anesthesia).Perioperative indicators,analgesic effect,preoperative and postoperative 24-hours blood pressure(BP)and heart rate(HR),stress indicators,immune function levels,and adverse reactions were com-pared between the two groups.RESULTS Baseline data,including age,hernia location,place of residence,weight,monthly income,education level,and underlying diseases,were not significantly different between the two groups,indicating comparability(P>0.05).No significant difference was found in operation time and anesthesia time between the two groups(P>0.05).However,the treatment group exhibited a shorter postoperative urinary catheter removal time and hospital stay than the control group(P<0.05).Preoperatively,no significant differences were found in the visual analog scale(VAS)scores between the two groups(P>0.05).However,at 12,18,and 24 hours postoper-atively,the treatment group had significantly lower VAS scores than the control group(P<0.05).Although no significant differences in preoperative hemodynamic indicators were found between the two groups(P>0.05),both groups experienced some extent of changes in postoperative HR,diastolic BP(DBP),and systolic BP(SBP).Nevertheless,the treatment group showed smaller changes in HR,DBP,and SBP than the control group(P<0.05).Preoperative immune function indicators showed no significant differences between the two groups(P>0.05).However,postoperatively,the treatment group demonstrated higher levels of CD3+,CD4+,and CD4+/CD8+and lower levels of CD8+than the control group(P<0.05).The rates of adverse reactions were 6.38%and 23.40%in the treatment and control groups,respectively,revealing a significant difference(χ2=5.371,P=0.020).CONCLUSION Dexmedetomidine-assisted intravenous-inhalation combined general anesthesia can promote early recovery of patients undergoing laparoscopic minimally invasive surgery for inguinal hernia.It ensures stable blood flow,improves postoperative analgesic effects,reduces postoperative pain intensity,alleviates stress response,improves immune function,facilitates anesthesia recovery,and enhances safety.
基金supported by the National Natural Science Foundation of China(82170941 and 82370948 to Lu Zhang,82071110 and 82230029 to Zhi Chen)the National Key R&D Program of China(2018YFC1105100)。
文摘Pulpotomy,which belongs to vital pulp therapy,has become a strategy for managing pulpitis in recent decades.This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing long-term patient-centered outcomes.Pulpotomy is categorized into partial pulpotomy(PP),the removal of a partial segment of the coronal pulp tissue,and full pulpotomy(FP),the removal of whole coronal pulp,which is followed by applying the biomaterials onto the remaining pulp tissue and ultimately restoring the tooth.Procedural decisions for the amount of pulp tissue removal or retention depend on the diagnostic of pulp vitality,the overall treatment plan,the patient’s general health status,and pulp inflammation reassessment during operation.This statement represents the consensus of an expert committee convened by the Society of Cariology and Endodontics,Chinese Stomatological Association.It addresses the current evidence to support the application of pulpotomy as a potential alternative to root canal treatment(RCT)on mature permanent teeth with pulpitis from a biological basis,the development of capping biomaterial,and the diagnostic considerations to evidence-based medicine.This expert statement intends to provide a clinical protocol of pulpotomy,which facilitates practitioners in choosing the optimal procedure and increasing their confidence in this rapidly evolving field.
基金Supported by Joint Funds for the Innovation of Science and Technology,Fujian Province,No.2023Y9187 and No.2021Y9057.
文摘BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.
基金partially supported by the Open Research Fund of Key Laboratory of Nonlinear Analysis&Applications(Central China Normal University),Ministry of Education,P.R.Chinathe Guiding Science and Technology Plan Project of Suqian City in 2023(No.Z2023130)partially supported by NSFC(No.12271234)。
文摘Given two ideals I and J of a commutative ring R,there are two extreme connections between I and J:I+J=R and I∩J={0}.For the former case,graphs whose vertices are defined as the proper ideals of R and that two vertices are adjacent if and only if their sum is the whole ring R are known as co-maximal ideal graphs.In this paper,we introduce a new kind of graph structure on R,called co-minimal ideal graph,according to the second case:Its vertices are the nonzero ideals of R and two vertices are adjacent if and only if their intersection is zero.Some important graph parameters(including girth,diameter,clique number and chromatic number)and graph structures(including tree and bipartite graph)of co-minimal ideal graphs over finite commutative rings are studied.In particular,we show that the co-maximal ideal graph and the co-minimal ideal graph over R are isomorphic if and only if the number of maximal ideals of R and the number of minimal ideals of R coincide.
基金Supported in part by NSFC(No.11971005)the Fundamental Research Funds for the Central Universities(Nos.GK202101008,GK202102012)。
文摘In this paper,we use the solution of the even functional Minkowski problem to show that there is a minimizing affine Minkowski total variation of the function of bounded variation.Moreover,for the Minkowski total variation,we use the method of convexation to establish the same conclusion as the convex body space.
文摘A nowhere-zero k-flow on a graph G=(V(G),E(G))is a pair(D,f),where D is an orientation on E(G)and f:E(G)→{±1,±2,,±(k-1)}is a function such that the total outflow equals to the total inflow at each vertex.This concept was introduced by Tutte as an extension of face colorings,and Tutte in 1954 conjectured that every bridgeless graph admits a nowhere-zero 5-flow,known as the 5-Flow Conjecture.This conjecture is verified for some graph classes and remains unresolved as of today.In this paper,we show that every bridgeless graph of Euler genus at most 20 admits a nowhere-zero 5-flow,which improves several known results.
文摘The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the patient's perspective.This comprehensive review analyzes the evolution,applications,and challenges of MCID across medical specialties,emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and needs.We discuss the evolution of MCID since its inception in the 1980s,its current applications across various medical specialties,and the methodologies used in its calculation,highlighting both anchor-based and distribution-based approaches.Furthermore,the paper delves into the challenges associated with the application of MCID,such as methodological variability and the interpretation difficulties that arise in clinical settings.Recommendations for the future include standardizing MCID calculation methods,enhancing patient involvement in setting MCID thresholds,and extending research to incorporate diverse global perspectives.These steps are critical to refining the role of MCID in patient-centered healthcare,addressing existing gaps in methodology and interpretation,and ensuring that medical interventions lead to significant,patient-perceived improvements.
基金supported by the National Natural Science Foundation of China(11771314,12071323).
文摘We study the following minimization problem d_(p)(M_(p)=∫_(R^(n))|▽u|^(2)-c|u|^(2)/|x|^(2)+V(x)|u|^(2)dx-2/p+2∫_(R^(N))|u|^p+2dx.when=p=p^(*):=4/N,,the precise concentration behavior of minimizers is analyzed as M_(p^(*))↗‖Q_(p^(*))‖_(L^(2)),where Q_(p^(*))is the unique radially positive solution of-Δφ-cφ/|x|^(2-|φ|^(p^(*)+1)φ=0.When 0<p<p^(*)we prove that all minimizers must blow up if lim p→p^(*)M_(p)≥‖Q_(p^(*))‖L^(2).On his argument,the detailed concentration behavior of minimizers is established as p↗p^(*).
基金supported by the Scientific and Technological Developing Scheme of Jilin Province,China(No.20240101371JC)the National Natural Science Foundation of China(No.62107008).
文摘A Bayesian network reconstruction method based on norm minimization is proposed to address the sparsity and iterative divergence issues in network reconstruction caused by noise and missing values.This method achieves precise adjustment of the network structure by constructing a preliminary random network model and introducing small-world network characteristics and combines L1 norm minimization regularization techniques to control model complexity and optimize the inference process of variable dependencies.In the experiment of game network reconstruction,when the success rate of the L1 norm minimization model’s existence connection reconstruction reaches 100%,the minimum data required is about 40%,while the minimum data required for a sparse Bayesian learning network is about 45%.In terms of operational efficiency,the running time for minimizing the L1 normis basically maintained at 1.0 s,while the success rate of connection reconstruction increases significantly with an increase in data volume,reaching a maximum of 13.2 s.Meanwhile,in the case of a signal-to-noise ratio of 10 dB,the L1 model achieves a 100% success rate in the reconstruction of existing connections,while the sparse Bayesian network had the highest success rate of 90% in the reconstruction of non-existent connections.In the analysis of actual cases,the maximum lift and drop track of the research method is 0.08 m.The mean square error is 5.74 cm^(2).The results indicate that this norm minimization-based method has good performance in data efficiency and model stability,effectively reducing the impact of outliers on the reconstruction results to more accurately reflect the actual situation.
文摘BACKGROUND Minimally invasive lumbar interbody fusion(LIF)procedures have evolved rapidly in recent years,with robot-assisted(RA)techniques increasingly integrated into clinical practice.However,questions remain regarding the relative advantages of RA over traditional fluoroscopy-guided and navigation-assisted methods in terms of perioperative,radiographic,and clinical outcomes.This systematic review synthesizes current evidence on these comparisons,focusing on the accuracy of screw placement,perioperative efficiency,radiographic and clinical outcomes,and complications.AIM To investigate the comparative effectiveness of RA vs conventional LIF techniques.METHODS A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 and Cochrane guidelines.Databases searched included PubMed,EMBASE,Web of Science,Scopus,and the Cochrane Library(through May 2025).Eligible studies were randomized controlled trials and observational studies comparing RA with fluoroscopy-or navigation-guided LIF(transforaminal lumbar interbody fusion,lateral lumbar interbody fusion,oblique lumbar interbody fusion)in adults.Two reviewers independently extracted data and assessed risk of bias.The Grading of Recommendations Assessment,Development and Evaluation framework was used to evaluate certainty of evidence.Meta-analyses were performed where data were sufficiently homogeneous.RESULTS Twenty-two studies were included,encompassing a total of 2313 patients-1046 who underwent RA-guided procedures and 1267 who received comparator techniques.Meta-analyses showed that RA significantly improved perfect pedicle screw placement[pooled odds ratio=2.93;95%confidence interval(CI):1.40-6.14;I2=78.2%]and reduced intraoperative blood loss(pooled standardized mean difference=-0.28;95%CI:-0.47 to-0.08;I2=0%).Operative time did not significantly differ between groups(pooled standardized mean difference=0.01;95%CI:-0.30 to 0.31;I2=66%).Radiation dose could not be synthesized quantitatively due to heterogeneous definitions and measurement units.Narratively,RA demonstrated consistent advantages in reducing surgical exposure and adjacent segment degeneration.Clinical and radiographic outcomes,fusion success,and complication rates were generally comparable across groups.CONCLUSION RA LIF improves pedicle screw placement accuracy and reduces blood loss and surgeon radiation exposure while maintaining similar clinical outcomes and safety profiles to conventional techniques.These findings support the integration of RA into spine surgery but highlight the need for high-quality multicenter randomized controlled trials and cost-effectiveness studies to guide broader implementation.
文摘The underlying molecular changes that result in minimal change disease(ne-phrotic syndrome)require an in-depth analysis.Current molecular studies have shown the involvement of zinc fingers and homeobox transcriptional factors in its pathogenesis.The application of therapeutic drugs relies on understanding the cascade of molecular events to determine their efficacy in managing the clinical condition.
基金supported by the National Natural Science Foundation of China(81925027,82002275,and 32271421)the Priority Academic Program Development of Jiangsu Higher Education Institutions.
文摘Bone injuries induced by accidents or bone-related disease have dramatically increased in the past decades.The application of biomaterials has become an inextricable part of treatment for new bone formation and regeneration.Different from traditional bone-regeneration materials,injectable biomaterials—ranging from bioceramics to polymers—have been applied as a means of promoting surgery with a minimal intervention approach.In this review,we summarize the most recent developments in minimally invasive implantable biomaterials for bone reconstruction and different ways to achieve osteogenesis,with a focus on injectable biomaterials for various applications in the orthopedic field.More specifically,bioceramics and polymeric materials,together with their applications in bone fracture healing,vertebral body augmentation,bone implant fixation,bone tumor therapy,and bone-defect-related infection treatment are reviewed in detail.Recent progress in injectable biomaterials with multiple functionalities and bioresponsive properties is also reviewed.Finally,we summarize the challenges in this field and future directions for clinical treatment.
文摘Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularly lumbosacral plexus.The introduction of minimally invasive surgical approaches,such as the lateral rectus approach,not only contributes to preserving lumbar plexus integrity in operated patients but also positively impacts their psychological well-being.Patients treated by surgical reduction of pelvic fractures with lumbosacral plexus injury often experience states of anxiety and depression.The lateral rectus approach is associated with lower levels of anxiety and depression compared to more invasive surgical techniques used for similar fractures.
文摘Hemorrhoidal disease is a prevalent anorectal condition causing significant morbidity,affecting approximately 4%of the general population with incidence increasing with age and sedentary lifestyle.While conventional excisional hemorrhoidectomy techniques such as Milligan-Morgan and Ferguson remain standard for long-term efficacy,they are often associated with substantial postoperative pain and prolonged recovery.This narrative review evaluates the comparative clinical outcomes of laser hemorrhoidoplasty(LHP)versus conventional surgical interventions in the treatment of grade II and III symptomatic hemorrhoids.A comprehensive analysis of comparative studies,randomized controlled trials,and meta-analyses published between 2020 and 2025 was conducted,with primary outcomes including postoperative pain,recovery time,operative duration,complication rates,and recurrence.Key findings from studies by Maloku et al and Hassan et al.were analyzed to contextualize real-world LHP use.Across multiple high-quality studies,LHP was consistently associated with significantly lower postoperative pain scores,reduced analgesic requirements,and faster return to daily activities.Maloku et al demonstrated a shorter mean operative time(15.9 minutes)and reduced pain compared to open techniques(26.8 minutes;P<0.01).Hassan et al confirmed these benefits in a cohort of 40 patients treated under local anesthesia.Operative time was generally comparable or shorter,and vessel ligation was suggested as an adjunct to improve outcomes in select cases.Complication rates were low and similar between groups,with LHP demonstrating minimal risk for major complications such as anal stenosis or incontinence.However,recurrence rates were higher with LHP in some studies,particularly in grade III disease.LHP offers a minimally invasive,low-morbidity alternative to excisional hemorrhoidectomy for appropriately selected patients.Despite superior short-term recovery profiles,potential for higher recurrence underscores the importance of patient selection and long-term follow-up.The role of local anesthesia and adjunctive vessel ligation merits further prospective evaluation.
