Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 20...Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 2025,selecting 90 patients who underwent hydrofluoric acid-related treatments in the outpatient dental department of this hospital during this period as subjects.Forty-five patients treated between June 2023 and June 2024 received conventional protective care(pre-intervention group),while 45 patients treated between June 2024 and June 2025 underwent the standardized protective care protocol(post-intervention group).Thirteen healthcare personnel participated in both pre-and post-intervention treatment phases.Based on the different nursing models,indicators such as the incidence of adverse events in patients and the exposure rate of healthcare personnel before and after implementation were compared to evaluate the effectiveness of the nursing intervention.Results:The incidence of oral mucosal irritation reactions in patients was lower after implementation,p<0.05.Compared with the pre-implementation period,the incidence of procedure-related adverse events decreased after implementation,p<0.05.There was a significant difference in the occupational exposure rate of healthcare personnel before and after implementation,with a higher rate observed before implementation(p<0.05).Post-implementation,healthcare personnel achieved higher compliance scores for pre-procedure preparation,intra-procedure protection,and post-procedure handling(p<0.05).Patient satisfaction with treatment was lower pre-implementation than post-implementation(p<0.05).Conclusion:Adherence to standardized protective care procedures during hydrofluoric acid operations by dental department staff in outpatient settings standardizes practitioner techniques,effectively prevents oral mucosal irritation in patients,reduces occupational exposure risks for staff,minimizes adverse procedural events,and consequently enhances patient treatment satisfaction.This demonstrates significant practical value.展开更多
Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and t...Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and that most physicians would choose to adopt software that provides real-time image guidance if accessible.Methods:A voluntary,cross-sectional survey of physicians at a single site was conducted using a five-point Likert scale.Data analysis included both descriptive and inferential statistical analyses and stratified by categorical descriptors,including variables of formal training,years of experience,and specialty of practice.Results:One hundred sixteen physicians responded to the survey.The majority disagreed that there was a steep learning curve(57.5%)and that they need more time to identify structures under ultrasound(85.0%).Overall attitudes were mixed about the use of additional software to improve ease of use,but most(55.4%)had positive opinions toward the addition of real-time 3D reconstruction.Respondents without formal training were significantly more likely to agree that additional software would improve ease of ultrasound-guided procedures(p=0.0389).Radiologists were significantly more likely to perceive a steeper learning curve and less likely to advocate for supplemental software compared to emergency medicine physicians,surgeons,or anesthesiologists.Conclusions:Surveyed physicians demonstrated comfort with ultrasound-guided procedures and a mixed stance toward the use of additional software to assist with procedures.Those without formal training had significantly more positive attitudes toward the use of additional technology to augment ultrasound-guided procedures,suggesting a knowledge gap that may benefit from such technology.展开更多
This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadi...This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadias admitted to the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between October 2012 and October 2022.In total,31 patients underwent the conventional Byars procedure(conventional group),and 45 patients underwent the modified Byars staged procedure(modified group).Our modified strategy was built upon the standard Byars procedure by incorporating glansplasty during the first stage and employing a Y-shaped flap in conjunction with a glandular tunnel for urethroplasty during the second stage.Notably,there were no statistically significant differences in the preoperative baseline characteristics,duration of surgery,amount of blood loss,or occurrence of postoperative complications,including urethral fistula,stricture and diverticulum,or penile curvature,between the conventional and modified groups.However,there was a significantly lower incidence of coronal sulcus fistula(0 vs 16.1%,P=0.02)and glans dehiscence(0 vs 12.9%,P=0.02)in the surgical group than that in the conventional group.In addition,the modified group exhibited a notably greater rate of normotopic urethral opening(100.0%vs 83.9%,P=0.01)and a higher mean score on the Hypospadias Objective Penile Evaluation(HOPE;mean±standard error of mean:8.6±0.2 vs 7.9±0.3,P=0.02)than did the conventional group.In conclusion,the modified Byars staged procedure significantly reduced the risks of glans dehiscence and coronal sulcus fistula.Consequently,it offers a promising approach for achieving favorable penile esthetics,thereby providing a reliable therapeutic option for severe hypospadias.展开更多
Dear Editor,We report a relatively safe and effective triple procedure for traumatic aphakia,glaucoma,and mydriasis.Blunt eye trauma can lead to various anterior-and posterior-segment conditions[1],that often occur si...Dear Editor,We report a relatively safe and effective triple procedure for traumatic aphakia,glaucoma,and mydriasis.Blunt eye trauma can lead to various anterior-and posterior-segment conditions[1],that often occur simultaneously.Closed-globe injuries can damage one or more ocular structures.展开更多
BACKGROUND In open heart surgery requiring cardiopulmonary bypass(CPB),ventricular fibrillation(VF)is common,but refractory recurrent VF is uncommon but perilous.CASE SUMMARY This article reports a 58-year-old male pa...BACKGROUND In open heart surgery requiring cardiopulmonary bypass(CPB),ventricular fibrillation(VF)is common,but refractory recurrent VF is uncommon but perilous.CASE SUMMARY This article reports a 58-year-old male patient with an ascending aortic aneurysm who presented for a Bentall procedure and subsequently experienced multiple occurrences of unexplained VF after weaning from CPB.The recurrent episodes of VF in this case were felt to be related to coronary insufficiency after reconstruction of the aortic root.Coronary artery bypass grafting(CABG)of the proximal right coronary artery and the left anterior descending artery successfully resolved VF.Finally,this patient was safely transferred to the postoperative intensive care unit,and was discharged successfully after subsequent supportive treatment.CONCLUSION In aortic root replacement,coronary insufficiency is a potential cause of VF episodes and should be considered in the differential diagnosis.CABG is the sole effective treatment for VF caused by coronary insufficiency.展开更多
The transverse incision with longitudinal ligation(TILL)procedure is a new method for treating circumferential prolapsed hemorrhoids.A study by Song et al found TILL to be better than the traditional Milligan-Morgan h...The transverse incision with longitudinal ligation(TILL)procedure is a new method for treating circumferential prolapsed hemorrhoids.A study by Song et al found TILL to be better than the traditional Milligan-Morgan hemorrhoidectomy for short-term results,showing less pain,quicker healing,and lower risk of anal stenosis.TILL reduces tissue tension and controls blood supply,allowing effective removal of diseased tissue while maintaining anal function and structure.However,the study's limitations,including its retrospective,single-center design,small sample size,and short follow-up,restrict the findings'generalizability and ability to assess long-term outcomes like recurrence.Larger,multicenter trials are needed for a thorough evaluation and wider clinical adoption of TILL.展开更多
BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with signifi...BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with significant post-operative pain,edema,and delayed healing in severe CPH cases.To address these limitations,our research team innovatively proposed the transverse incision with longitudinal ligation procedure(TILL).This novel technique utilizes targeted transverse incisions and longitudinal pedicle ligation to optimize complete resection while preserving anal anatomy and function.METHODS A total of 180 patients were retrospectively reviewed in China.The patients were divided into two groups of 90 based on the surgical methods.The treatment group underwent the TILL procedure,while the control group underwent MMH.The main observation index was the evaluation of clinical efficacy after wound healing.Secondary outcomes included the recurrence rate and wound healing time.Safety measurements were also evaluated.RESULTS The TILL group showed a significant difference compared to the MMH group(P=0.022),indicating better overall treatment effects.The time for wound healing in the TILL group was shorter than that in the MMH group(P=0.001).Compared to those who underwent MMH,those who underwent TILL experienced significantly reduced postoperative pain,with lower average scores for anal edema and anal stenosis(both P<0.05).CONCLUSION TILL demonstrates superior efficacy to MMH for advanced CPH,reducing recovery times and postoperative pain,edema,and stenosis while preserving anal function.展开更多
In this study,we searched for dispersed repeats(DRs)in the rice(Oryza sativa)genome using the iterative procedure(IP)method.The results revealed that the O.sativa genome contained 79 DR families,comprising 992739 DNA ...In this study,we searched for dispersed repeats(DRs)in the rice(Oryza sativa)genome using the iterative procedure(IP)method.The results revealed that the O.sativa genome contained 79 DR families,comprising 992739 DNA repeats,of which 496762 and 495977 were identified on the forward and reverse DNA strands,respectively.The detected DRs were,on average,374 bp in length and occupied 66.4%of the O.sativa genome.Totally 61%of DRs,identified by the IP method,overlapped with previously annotated dispersed repeats(ADRs)detected using the Extensive De Novo TE Annotator(EDTA)pipeline.展开更多
BACKGROUND Recently,the identification of cell apoptosis induced by natural products has become research hotspot and frontier in the biopharmaceutical and food industries under the umbrella of global green development...BACKGROUND Recently,the identification of cell apoptosis induced by natural products has become research hotspot and frontier in the biopharmaceutical and food industries under the umbrella of global green development worldwide.Traditionally,cell apoptosis is identified using morphological,biochemical,and cell cycle experiments,which is time consuming,and experimental materials are not from the same group,and it is very hard to ensure the identity and veracity of results of former and latter experiments.AIM To establish a selective,instant,and practical protocol to identify cell apoptosis induced by natural products.METHODS A one transient cell processing procedure(OTCPP)was used to detect human colorectal cancer LoVo cell apoptosis after treatment with Pinus massoniana bark extract(PMBE)at the morphological,biochemical,and cell cycle levels.The methods used included treatment with DNA gel electrophoresis,fluorescence microscopy,and flow cytometry.RESULTS In PMBE-treated LoVo cells,we observed a DNA ladder on gel electrophoresis and fluorescence microscopy revealed"nuclear shrinkage,chromatin condensation or fragmentation".In addition,flow cytometry showed an"obvious apoptosis curve".Thus OTCPP achieved synchronous detection of the morphology,biochemistry,cell cycle,and the DNA content of the cells.CONCLUSION OTCPP can quickly identify apoptosis and measure the apoptosis rate,thereby unifying qualitative and quantitative analysis.展开更多
Practical jurisprudence is a completely new proposition in legal education and research.The introduction of the concept of“practical jurisprudence”in the teaching of the Civil Procedure Law of the People’s Republic...Practical jurisprudence is a completely new proposition in legal education and research.The introduction of the concept of“practical jurisprudence”in the teaching of the Civil Procedure Law of the People’s Republic of China(the“Civil Procedure Law”)is a major innovation in terms of values and methodology.Practical jurisprudence focuses more on practical issues,Chinese characteristics,and major needs,while strengthening the practical nature of the Civil Procedure Law.China’s traditional education system for juris masters(for non-law graduates)(“non-law JMs”)emphasizes the development of foundational legal theoretical knowledge.However,it has not fully achieved its goal of cultivating interdisciplinary and practical legal professionals.Therefore,the traditional education system for the Civil Procedure Law needs reconstruction and supplementation through the practical jurisprudence teaching system in the following areas:(a)System composition:The focus should be on the eight tertiary subsystems under the two secondary subsystems—“the knowledge teaching system and the practical teaching system”of practical jurisprudence in the Civil Procedure Law,as well as the management of their interrelationships.(b)Credit structure:The proportion of credits for“practical teaching and training”should be increased.(c)Practical ability requirements:Legal professionals should be cultivated according to the standards for juris masters(for law graduates)as stipulated by the Law of the People’s Republic of China on Academic Degrees.(d)Practice evaluation:“Formalization of the evaluations,”“homogeneity of the evaluators,”and“reliance on written formats”should be avoided.展开更多
As one of the key components of a UHV converter transformer,the suitable switching condition of the vacuum onload tap changer(OLTC)is essential for the stability of the power system.It is highly desirable to interpret...As one of the key components of a UHV converter transformer,the suitable switching condition of the vacuum onload tap changer(OLTC)is essential for the stability of the power system.It is highly desirable to interpret OLTC’s switching procedure to assess OLTC’s switching condition.However,such work can’t be solved by vibration analysis alone.Therefore,this paper proposes an innovative electromechanical comprehensive analysis method.First,a joint motor drive current,vibration,and electromagnetic signals online monitoring system is established and deployed in a VRG type OLTC in±800 kV converter station.Second,independent component analysis(ICA),dynamic time warping(DTW),and wavelet transform(WT)are used for processing motor current,UHFCT,and vibration signals,respectively,to extract electromechanical pulses corresponding to OLTC’s contact actions.Third,the switching procedure of OLTC is revealed by comprehensively analyzing the corresponding time relationship between these extracted pulses,combined with OLTC’s timing sequence.The methodologies developed in this paper can help to interpret OLTC’s switching procedure for deeper and finer online condition assessment.展开更多
BACKGROUND Postoperative pulmonary complications(PPCs)are the most common complications following major upper abdominal surgeries,particularly hepatobiliary procedures,and significantly compromise surgical outcomes an...BACKGROUND Postoperative pulmonary complications(PPCs)are the most common complications following major upper abdominal surgeries,particularly hepatobiliary procedures,and significantly compromise surgical outcomes and patients’quality of life.Although the adoption of laparoscopy has lowered their incidence,PPCs remain a frequent and serious concern after hepatobiliary surgery.Existing research on risk factors specific to hepatobiliary surgeries is limited,particularly regarding the epidemiology and risk factors of PPCs in liver and gallbladder surgeries in China.Therefore,this study aimed to investigate the risk factors for PPCs in a large hepatobiliary center.AIM To identify the incidence and risk factors for PPCs following hepatobiliary surgery based on perioperative variables.METHODS Retrospective data were collected from patients who underwent liver,gallbladder,or pancreatic surgery at a hepatobiliary center in China between May 2023 and December 2023.We retrospectively reviewed comprehensive medical records to extract demographic and hospital admission information for determining PPC incidence.Statistically significant variables were initially screened through univariate analysis,followed by binary logistic regression modeling to identify independent predictors of PPCs.Hospitalization expenditures and duration of stay were further contrasted across the study cohorts.RESULTS This study included 1941 patients who underwent liver,gallbladder,or pancreatic surgery,of whom 78 developed PPCs,resulting in an incidence rate of 4.02%.Logistic regression analysis revealed two independent predictors of PPCs in hepatobiliary surgery patients:Age≥75 year(odds ratio=8.350,95%CI:3.521-19.798,P<0.001)and prolonged anesthesia(odds ratio=1.052,95%CI:1.015-1.091,P=0.006).Patients with PPCs had significantly elevated healthcare resource utilization,including higher total hospitalization costs,increased medication expenses,longer hospital stays,and extended postoperative admissions(all P<0.001).CONCLUSION Age≥75 years and prolonged anesthesia emerged as independent predictors of PPCs following hepatobiliary surgery.These complications were correlated with protracted hospitalization and increased healthcare costs.展开更多
Peroral endoscopic myotomy(POEM)has revolutionized the treatment of upper gastrointestinal tract motility disorders,particularly achalasia.This editorial explores the efficacy,safety,and challenges of POEM,emphasizing...Peroral endoscopic myotomy(POEM)has revolutionized the treatment of upper gastrointestinal tract motility disorders,particularly achalasia.This editorial explores the efficacy,safety,and challenges of POEM,emphasizing its role as a primary treatment with excellent long-term outcomes and minimal adverse events.The evolution of POEM underscores the need for precision in myotomy techniques and the importance of interdisciplinary collaboration,especially regar-ding anesthetic considerations.Despite significant advances,challenges remain in standardizing safety protocols and managing complications.As POEM appli-cations expand,precision endoscopy continues to enhance therapeutic outcomes,promising a transformative impact on gastrointestinal motility disorder manage-ment.展开更多
This standard operating procedure stipulated the natural condition of pro- ducing area, cultivation technique, disease and pest control, harvest, quality stan- dard, packaging, transportation and storage of H. cordata...This standard operating procedure stipulated the natural condition of pro- ducing area, cultivation technique, disease and pest control, harvest, quality stan- dard, packaging, transportation and storage of H. cordata, in order to provide a ba- sis for the standard cultivation of H. cordata.展开更多
BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints...BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.展开更多
1.Introduction.Pancreaticoduodenectomy is an essential surgical procedure for the treatment of malignant tumors in the pancreatic head,distal common bile duct,and duodenal papilla,and is widely used in clinical practi...1.Introduction.Pancreaticoduodenectomy is an essential surgical procedure for the treatment of malignant tumors in the pancreatic head,distal common bile duct,and duodenal papilla,and is widely used in clinical practice.One of the primary determinants of surgical success is the durability of the pancreaticojejunal anastomosis.展开更多
Self-Centering Piston-Based Braced Frames(SC-PBBFs)are designed to curtail structural damage under severe ground motions.The self-centering mechanism in this bracing mitigates structural damage during an earthquake,th...Self-Centering Piston-Based Braced Frames(SC-PBBFs)are designed to curtail structural damage under severe ground motions.The self-centering mechanism in this bracing mitigates structural damage during an earthquake,thereby reducing post-earthquake repair costs and contributing to seismic resilience.However,non-structural components,particularly those sensitive to floor acceleration,remain vulnerable,resulting in prolonged func-tional recovery times.This paper aims to address this limitation by introducing a novel structural archetype,the Self-Centering Viscous-Based Braced Frame(SC-VBBF),which integrates superelastic shape memory alloy(SMA)bars,viscous dampers(VDs),and friction springs(FSs).A streamlined analytical approach relies on the strength decoupling of VD from other components using aλfactor to design SC-VBBFs.To evaluate the effectiveness of the hybrid brace,a set of 4-,8-,and 12-story archetypes equipped with SC-PBBs and SC-VBBFs are simulated in OpenSees and analyzed under various earthquake types,including crustal,subcrustal,and subduction events.The results demonstrate the superior performance of the SC-VBBF withλ≤0.5 system compared to SC-PBBFs in mitigating floor accelerations under design-level earthquakes and improving seismic resilience.展开更多
The original online version of this article was revised:Several errors occurred in the published version of the article.These have now been corrected as follows:Page 2,section"2.2 Laser Texturing Procedure of Sur...The original online version of this article was revised:Several errors occurred in the published version of the article.These have now been corrected as follows:Page 2,section"2.2 Laser Texturing Procedure of Surfaces",line 2:The device name was corrected from"YDFLP-E-50-M8"to"YDFLP-50-M8."Page 3,Section 2.4:The phrase"95%confidence interval"has been corrected to"95%confidence level."Page 3,Figure 1 caption:The phrase"fandg"has been corrected to"f and g."The order"C4 and C12"has been reversed to"C12 and C4,"in accordance with the display order in the figure.Page 4,Figure reference:The phrase"Figs.4c and d"has been corrected to"Figs.5b and c."Page 5,paragraph starting with"The ANOVA results are presented...":The phrase"95%confidence interval"has been corrected to"95%confidence level."展开更多
Deep cervical lymph-venous anastomosis(LVA)is a surgical procedure initially developed to treat cervical lymphatic obstruction,such as lymphedema,a condition caused by the accumulation of lymphatic fluid due to blocke...Deep cervical lymph-venous anastomosis(LVA)is a surgical procedure initially developed to treat cervical lymphatic obstruction,such as lymphedema,a condition caused by the accumulation of lymphatic fluid due to blocked or damaged lymphatic vessels.In early 2024,Dr.Qingping Xie from Hangzhou Qiushi Hospital,China,and Dr.Wei F.Chen from the Cleveland Clinic,USA,adapted LVA for the treatment of patients with Alzheimer’s disease(AD).As a VIEWPOINT,they presented a video showcasing the post-surgery cognitive recovery of an 84-year-old AD patient(Xie et al.,2024).展开更多
基金Construction of Standardized Protective Nursing Plan for Hydrofluoric Acid Operation in Stomatology and Re search on Injury Prevention Effect(Project No.:FZ2025101)。
文摘Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 2025,selecting 90 patients who underwent hydrofluoric acid-related treatments in the outpatient dental department of this hospital during this period as subjects.Forty-five patients treated between June 2023 and June 2024 received conventional protective care(pre-intervention group),while 45 patients treated between June 2024 and June 2025 underwent the standardized protective care protocol(post-intervention group).Thirteen healthcare personnel participated in both pre-and post-intervention treatment phases.Based on the different nursing models,indicators such as the incidence of adverse events in patients and the exposure rate of healthcare personnel before and after implementation were compared to evaluate the effectiveness of the nursing intervention.Results:The incidence of oral mucosal irritation reactions in patients was lower after implementation,p<0.05.Compared with the pre-implementation period,the incidence of procedure-related adverse events decreased after implementation,p<0.05.There was a significant difference in the occupational exposure rate of healthcare personnel before and after implementation,with a higher rate observed before implementation(p<0.05).Post-implementation,healthcare personnel achieved higher compliance scores for pre-procedure preparation,intra-procedure protection,and post-procedure handling(p<0.05).Patient satisfaction with treatment was lower pre-implementation than post-implementation(p<0.05).Conclusion:Adherence to standardized protective care procedures during hydrofluoric acid operations by dental department staff in outpatient settings standardizes practitioner techniques,effectively prevents oral mucosal irritation in patients,reduces occupational exposure risks for staff,minimizes adverse procedural events,and consequently enhances patient treatment satisfaction.This demonstrates significant practical value.
文摘Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and that most physicians would choose to adopt software that provides real-time image guidance if accessible.Methods:A voluntary,cross-sectional survey of physicians at a single site was conducted using a five-point Likert scale.Data analysis included both descriptive and inferential statistical analyses and stratified by categorical descriptors,including variables of formal training,years of experience,and specialty of practice.Results:One hundred sixteen physicians responded to the survey.The majority disagreed that there was a steep learning curve(57.5%)and that they need more time to identify structures under ultrasound(85.0%).Overall attitudes were mixed about the use of additional software to improve ease of use,but most(55.4%)had positive opinions toward the addition of real-time 3D reconstruction.Respondents without formal training were significantly more likely to agree that additional software would improve ease of ultrasound-guided procedures(p=0.0389).Radiologists were significantly more likely to perceive a steeper learning curve and less likely to advocate for supplemental software compared to emergency medicine physicians,surgeons,or anesthesiologists.Conclusions:Surveyed physicians demonstrated comfort with ultrasound-guided procedures and a mixed stance toward the use of additional software to assist with procedures.Those without formal training had significantly more positive attitudes toward the use of additional technology to augment ultrasound-guided procedures,suggesting a knowledge gap that may benefit from such technology.
基金supported by funding from the Medical Research Funding of Guangdong(No.A2022499 to QGX)the National Natural Science Foundation of China(No.82301796 to PL)the Guangdong Province Regional Joint Fund-Youth Fund Project of China(No.2022A1515111201 to PL).
文摘This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadias admitted to the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between October 2012 and October 2022.In total,31 patients underwent the conventional Byars procedure(conventional group),and 45 patients underwent the modified Byars staged procedure(modified group).Our modified strategy was built upon the standard Byars procedure by incorporating glansplasty during the first stage and employing a Y-shaped flap in conjunction with a glandular tunnel for urethroplasty during the second stage.Notably,there were no statistically significant differences in the preoperative baseline characteristics,duration of surgery,amount of blood loss,or occurrence of postoperative complications,including urethral fistula,stricture and diverticulum,or penile curvature,between the conventional and modified groups.However,there was a significantly lower incidence of coronal sulcus fistula(0 vs 16.1%,P=0.02)and glans dehiscence(0 vs 12.9%,P=0.02)in the surgical group than that in the conventional group.In addition,the modified group exhibited a notably greater rate of normotopic urethral opening(100.0%vs 83.9%,P=0.01)and a higher mean score on the Hypospadias Objective Penile Evaluation(HOPE;mean±standard error of mean:8.6±0.2 vs 7.9±0.3,P=0.02)than did the conventional group.In conclusion,the modified Byars staged procedure significantly reduced the risks of glans dehiscence and coronal sulcus fistula.Consequently,it offers a promising approach for achieving favorable penile esthetics,thereby providing a reliable therapeutic option for severe hypospadias.
文摘Dear Editor,We report a relatively safe and effective triple procedure for traumatic aphakia,glaucoma,and mydriasis.Blunt eye trauma can lead to various anterior-and posterior-segment conditions[1],that often occur simultaneously.Closed-globe injuries can damage one or more ocular structures.
文摘BACKGROUND In open heart surgery requiring cardiopulmonary bypass(CPB),ventricular fibrillation(VF)is common,but refractory recurrent VF is uncommon but perilous.CASE SUMMARY This article reports a 58-year-old male patient with an ascending aortic aneurysm who presented for a Bentall procedure and subsequently experienced multiple occurrences of unexplained VF after weaning from CPB.The recurrent episodes of VF in this case were felt to be related to coronary insufficiency after reconstruction of the aortic root.Coronary artery bypass grafting(CABG)of the proximal right coronary artery and the left anterior descending artery successfully resolved VF.Finally,this patient was safely transferred to the postoperative intensive care unit,and was discharged successfully after subsequent supportive treatment.CONCLUSION In aortic root replacement,coronary insufficiency is a potential cause of VF episodes and should be considered in the differential diagnosis.CABG is the sole effective treatment for VF caused by coronary insufficiency.
文摘The transverse incision with longitudinal ligation(TILL)procedure is a new method for treating circumferential prolapsed hemorrhoids.A study by Song et al found TILL to be better than the traditional Milligan-Morgan hemorrhoidectomy for short-term results,showing less pain,quicker healing,and lower risk of anal stenosis.TILL reduces tissue tension and controls blood supply,allowing effective removal of diseased tissue while maintaining anal function and structure.However,the study's limitations,including its retrospective,single-center design,small sample size,and short follow-up,restrict the findings'generalizability and ability to assess long-term outcomes like recurrence.Larger,multicenter trials are needed for a thorough evaluation and wider clinical adoption of TILL.
基金Supported by Scientific Research Fund of China-Japan Friendship Hospital,No.2019-1-QN-53.
文摘BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with significant post-operative pain,edema,and delayed healing in severe CPH cases.To address these limitations,our research team innovatively proposed the transverse incision with longitudinal ligation procedure(TILL).This novel technique utilizes targeted transverse incisions and longitudinal pedicle ligation to optimize complete resection while preserving anal anatomy and function.METHODS A total of 180 patients were retrospectively reviewed in China.The patients were divided into two groups of 90 based on the surgical methods.The treatment group underwent the TILL procedure,while the control group underwent MMH.The main observation index was the evaluation of clinical efficacy after wound healing.Secondary outcomes included the recurrence rate and wound healing time.Safety measurements were also evaluated.RESULTS The TILL group showed a significant difference compared to the MMH group(P=0.022),indicating better overall treatment effects.The time for wound healing in the TILL group was shorter than that in the MMH group(P=0.001).Compared to those who underwent MMH,those who underwent TILL experienced significantly reduced postoperative pain,with lower average scores for anal edema and anal stenosis(both P<0.05).CONCLUSION TILL demonstrates superior efficacy to MMH for advanced CPH,reducing recovery times and postoperative pain,edema,and stenosis while preserving anal function.
基金supported by the Russian Science Foundation,Russia(Grant No.24-24-00031).
文摘In this study,we searched for dispersed repeats(DRs)in the rice(Oryza sativa)genome using the iterative procedure(IP)method.The results revealed that the O.sativa genome contained 79 DR families,comprising 992739 DNA repeats,of which 496762 and 495977 were identified on the forward and reverse DNA strands,respectively.The detected DRs were,on average,374 bp in length and occupied 66.4%of the O.sativa genome.Totally 61%of DRs,identified by the IP method,overlapped with previously annotated dispersed repeats(ADRs)detected using the Extensive De Novo TE Annotator(EDTA)pipeline.
基金Supported by 2023 Key R&D Projects of Tongji University,No.150029607160-24323Industrial Key Program Foundation of Guangdong Province:R&D of Natural Novel Anticancer Drugs,No.2004B10401033。
文摘BACKGROUND Recently,the identification of cell apoptosis induced by natural products has become research hotspot and frontier in the biopharmaceutical and food industries under the umbrella of global green development worldwide.Traditionally,cell apoptosis is identified using morphological,biochemical,and cell cycle experiments,which is time consuming,and experimental materials are not from the same group,and it is very hard to ensure the identity and veracity of results of former and latter experiments.AIM To establish a selective,instant,and practical protocol to identify cell apoptosis induced by natural products.METHODS A one transient cell processing procedure(OTCPP)was used to detect human colorectal cancer LoVo cell apoptosis after treatment with Pinus massoniana bark extract(PMBE)at the morphological,biochemical,and cell cycle levels.The methods used included treatment with DNA gel electrophoresis,fluorescence microscopy,and flow cytometry.RESULTS In PMBE-treated LoVo cells,we observed a DNA ladder on gel electrophoresis and fluorescence microscopy revealed"nuclear shrinkage,chromatin condensation or fragmentation".In addition,flow cytometry showed an"obvious apoptosis curve".Thus OTCPP achieved synchronous detection of the morphology,biochemistry,cell cycle,and the DNA content of the cells.CONCLUSION OTCPP can quickly identify apoptosis and measure the apoptosis rate,thereby unifying qualitative and quantitative analysis.
文摘Practical jurisprudence is a completely new proposition in legal education and research.The introduction of the concept of“practical jurisprudence”in the teaching of the Civil Procedure Law of the People’s Republic of China(the“Civil Procedure Law”)is a major innovation in terms of values and methodology.Practical jurisprudence focuses more on practical issues,Chinese characteristics,and major needs,while strengthening the practical nature of the Civil Procedure Law.China’s traditional education system for juris masters(for non-law graduates)(“non-law JMs”)emphasizes the development of foundational legal theoretical knowledge.However,it has not fully achieved its goal of cultivating interdisciplinary and practical legal professionals.Therefore,the traditional education system for the Civil Procedure Law needs reconstruction and supplementation through the practical jurisprudence teaching system in the following areas:(a)System composition:The focus should be on the eight tertiary subsystems under the two secondary subsystems—“the knowledge teaching system and the practical teaching system”of practical jurisprudence in the Civil Procedure Law,as well as the management of their interrelationships.(b)Credit structure:The proportion of credits for“practical teaching and training”should be increased.(c)Practical ability requirements:Legal professionals should be cultivated according to the standards for juris masters(for law graduates)as stipulated by the Law of the People’s Republic of China on Academic Degrees.(d)Practice evaluation:“Formalization of the evaluations,”“homogeneity of the evaluators,”and“reliance on written formats”should be avoided.
基金supported by the Science and Technology Project of State Grid Corporation of China(NO.5500-202016076A-0-0-00).
文摘As one of the key components of a UHV converter transformer,the suitable switching condition of the vacuum onload tap changer(OLTC)is essential for the stability of the power system.It is highly desirable to interpret OLTC’s switching procedure to assess OLTC’s switching condition.However,such work can’t be solved by vibration analysis alone.Therefore,this paper proposes an innovative electromechanical comprehensive analysis method.First,a joint motor drive current,vibration,and electromagnetic signals online monitoring system is established and deployed in a VRG type OLTC in±800 kV converter station.Second,independent component analysis(ICA),dynamic time warping(DTW),and wavelet transform(WT)are used for processing motor current,UHFCT,and vibration signals,respectively,to extract electromechanical pulses corresponding to OLTC’s contact actions.Third,the switching procedure of OLTC is revealed by comprehensively analyzing the corresponding time relationship between these extracted pulses,combined with OLTC’s timing sequence.The methodologies developed in this paper can help to interpret OLTC’s switching procedure for deeper and finer online condition assessment.
基金Supported by the Beijing Tsinghua Changgung Hospital Fund,China,No.12023C01005.
文摘BACKGROUND Postoperative pulmonary complications(PPCs)are the most common complications following major upper abdominal surgeries,particularly hepatobiliary procedures,and significantly compromise surgical outcomes and patients’quality of life.Although the adoption of laparoscopy has lowered their incidence,PPCs remain a frequent and serious concern after hepatobiliary surgery.Existing research on risk factors specific to hepatobiliary surgeries is limited,particularly regarding the epidemiology and risk factors of PPCs in liver and gallbladder surgeries in China.Therefore,this study aimed to investigate the risk factors for PPCs in a large hepatobiliary center.AIM To identify the incidence and risk factors for PPCs following hepatobiliary surgery based on perioperative variables.METHODS Retrospective data were collected from patients who underwent liver,gallbladder,or pancreatic surgery at a hepatobiliary center in China between May 2023 and December 2023.We retrospectively reviewed comprehensive medical records to extract demographic and hospital admission information for determining PPC incidence.Statistically significant variables were initially screened through univariate analysis,followed by binary logistic regression modeling to identify independent predictors of PPCs.Hospitalization expenditures and duration of stay were further contrasted across the study cohorts.RESULTS This study included 1941 patients who underwent liver,gallbladder,or pancreatic surgery,of whom 78 developed PPCs,resulting in an incidence rate of 4.02%.Logistic regression analysis revealed two independent predictors of PPCs in hepatobiliary surgery patients:Age≥75 year(odds ratio=8.350,95%CI:3.521-19.798,P<0.001)and prolonged anesthesia(odds ratio=1.052,95%CI:1.015-1.091,P=0.006).Patients with PPCs had significantly elevated healthcare resource utilization,including higher total hospitalization costs,increased medication expenses,longer hospital stays,and extended postoperative admissions(all P<0.001).CONCLUSION Age≥75 years and prolonged anesthesia emerged as independent predictors of PPCs following hepatobiliary surgery.These complications were correlated with protracted hospitalization and increased healthcare costs.
文摘Peroral endoscopic myotomy(POEM)has revolutionized the treatment of upper gastrointestinal tract motility disorders,particularly achalasia.This editorial explores the efficacy,safety,and challenges of POEM,emphasizing its role as a primary treatment with excellent long-term outcomes and minimal adverse events.The evolution of POEM underscores the need for precision in myotomy techniques and the importance of interdisciplinary collaboration,especially regar-ding anesthetic considerations.Despite significant advances,challenges remain in standardizing safety protocols and managing complications.As POEM appli-cations expand,precision endoscopy continues to enhance therapeutic outcomes,promising a transformative impact on gastrointestinal motility disorder manage-ment.
基金Supported by Key Research and Development Plan(Agricultural Support Field)of Hunan Province in 2015(2015NK3016)
文摘This standard operating procedure stipulated the natural condition of pro- ducing area, cultivation technique, disease and pest control, harvest, quality stan- dard, packaging, transportation and storage of H. cordata, in order to provide a ba- sis for the standard cultivation of H. cordata.
文摘BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.
文摘1.Introduction.Pancreaticoduodenectomy is an essential surgical procedure for the treatment of malignant tumors in the pancreatic head,distal common bile duct,and duodenal papilla,and is widely used in clinical practice.One of the primary determinants of surgical success is the durability of the pancreaticojejunal anastomosis.
文摘Self-Centering Piston-Based Braced Frames(SC-PBBFs)are designed to curtail structural damage under severe ground motions.The self-centering mechanism in this bracing mitigates structural damage during an earthquake,thereby reducing post-earthquake repair costs and contributing to seismic resilience.However,non-structural components,particularly those sensitive to floor acceleration,remain vulnerable,resulting in prolonged func-tional recovery times.This paper aims to address this limitation by introducing a novel structural archetype,the Self-Centering Viscous-Based Braced Frame(SC-VBBF),which integrates superelastic shape memory alloy(SMA)bars,viscous dampers(VDs),and friction springs(FSs).A streamlined analytical approach relies on the strength decoupling of VD from other components using aλfactor to design SC-VBBFs.To evaluate the effectiveness of the hybrid brace,a set of 4-,8-,and 12-story archetypes equipped with SC-PBBs and SC-VBBFs are simulated in OpenSees and analyzed under various earthquake types,including crustal,subcrustal,and subduction events.The results demonstrate the superior performance of the SC-VBBF withλ≤0.5 system compared to SC-PBBFs in mitigating floor accelerations under design-level earthquakes and improving seismic resilience.
文摘The original online version of this article was revised:Several errors occurred in the published version of the article.These have now been corrected as follows:Page 2,section"2.2 Laser Texturing Procedure of Surfaces",line 2:The device name was corrected from"YDFLP-E-50-M8"to"YDFLP-50-M8."Page 3,Section 2.4:The phrase"95%confidence interval"has been corrected to"95%confidence level."Page 3,Figure 1 caption:The phrase"fandg"has been corrected to"f and g."The order"C4 and C12"has been reversed to"C12 and C4,"in accordance with the display order in the figure.Page 4,Figure reference:The phrase"Figs.4c and d"has been corrected to"Figs.5b and c."Page 5,paragraph starting with"The ANOVA results are presented...":The phrase"95%confidence interval"has been corrected to"95%confidence level."
基金supported by AG057842 from the National Institutes of Health,TRIBA/Physiology Faculty Startup Fund from Augusta University (to FF)the National Natural Science Foundation of China (82173384)(to MG)
文摘Deep cervical lymph-venous anastomosis(LVA)is a surgical procedure initially developed to treat cervical lymphatic obstruction,such as lymphedema,a condition caused by the accumulation of lymphatic fluid due to blocked or damaged lymphatic vessels.In early 2024,Dr.Qingping Xie from Hangzhou Qiushi Hospital,China,and Dr.Wei F.Chen from the Cleveland Clinic,USA,adapted LVA for the treatment of patients with Alzheimer’s disease(AD).As a VIEWPOINT,they presented a video showcasing the post-surgery cognitive recovery of an 84-year-old AD patient(Xie et al.,2024).
