Rational planning of spares configuration project is an effective approach to improve equipment availability as well as reduce life cycle cost （LCC）. With an analysis of various impacts on support system, the spares...Rational planning of spares configuration project is an effective approach to improve equipment availability as well as reduce life cycle cost （LCC）. With an analysis of various impacts on support system, the spares demand rate forecast model is constructed. According to systemic analysis method, spares support effectiveness evaluation indicators system is built, and then, initial spares configuration and optimization method is researched. To the issue of discarding and con-sumption for incomplete repairable items, its expected backorders function is approximated by Laplace demand distribution. Combining the （s-1, s） and （R, Q） inventory policy, the spares resup-ply model is established under the batch ordering policy based on inventory state, and the optimi-zation analysis flow for spares configuration is proposed. Through application on shipborne equipment spares configuration, the given scenarios are analyzed under two constraint targets：one is the support effectiveness, and the other is the spares cost. Analysis reveals that the result is consistent with practical regulation;therefore, the model＇s correctness, method＇s validity as well as optimization project＇s rationality are proved to a certain extent.展开更多
Level of repair analysis（LORA） is an important method of maintenance decision for establishing systems of operation and maintenance in the equipment development period. Currently, the research on equipment of repair...Level of repair analysis（LORA） is an important method of maintenance decision for establishing systems of operation and maintenance in the equipment development period. Currently, the research on equipment of repair level focuses on economic analysis models which are used to optimize costs and rarely considers the maintenance time required by the implementation of the maintenance program. In fact, as to the system requiring high mission complete success, the maintenance time is an important factor which has a great influence on the availability of equipment systems. Considering the relationship between the maintenance time and the spares stocks level, it is obvious that there are contradictions between the maintenance time and the cost. In order to balance these two factors, it is necessary to build an optimization LORA model. To this end, the maintenance time representing performance characteristic is introduced, and on the basis of spares stocks which is traditionally regarded as a decision variable, a decision variable of repair level is added, and a multi-echelon multiindenture（MEMI） optimization LORA model is built which takes the best cost-effectiveness ratio as the criterion, the expected number of backorder（EBO） as the objective function and the cost as the constraint. Besides, the paper designs a convex programming algorithm of multi-variable for the optimization model, provides solutions to the non-convex objective function and methods for improving the efficiency of the algorithm. The method provided in this paper is proved to be credible and effective according to the numerical example and the simulation result.展开更多
Redundancy is a common structure for warship system,and it is an effective way to improve the reliability of the system.In this paper, warship system is taken as the object of study,based on the system reliability equ...Redundancy is a common structure for warship system,and it is an effective way to improve the reliability of the system.In this paper, warship system is taken as the object of study,based on the system reliability equivalence principle, a spares demand rate calculation method for redundant system is proposed through structure transformation. According to the system analysis method, the general modeling data structure of spares support echelon and system indenture is established, and the mission success probability is taken as the optimization target to build the dynamic optimization model of carrying spares during the process of multi-phase. By introducing the Lagrange multiplier, the spares weight, volume and cost are transformed to the single target of the spares total scale, and the initial Lagrange factors and its dynamic adjustment policy is proposed. In a given example, the main influence factors of the carrying spares project are analyzed, and the study results are in accordance with the reality, which can provide a new approach to mission-oriented carrying spares optimization for the redundant system.展开更多
Spare parts are critical to scheduled maintenance and fault repair, and can directly affect the readiness and combat capability of equipment. Equipmentrs capacity of carrying spares is influenced by its storage space ...Spare parts are critical to scheduled maintenance and fault repair, and can directly affect the readiness and combat capability of equipment. Equipmentrs capacity of carrying spares is influenced by its storage space and scales, so it is necessary to consider economic factors, e.g. spares cost, as well as non-economic ones, such as spares volume, mass and scale, when optimizing spares configuration. Aiming at this problem, the optimization model based on multi-constraints for carrying spares is built by METRIC theory and system analysis. Through the introduction of Lagrange factors, the spares cost is transformed to shadow price, and the optimization method for carrying spares and the dynamic adjustment policy of Lagrange factors are proposed. The result of a given example is analyzed, and demonstrates that the proposed model can be optimized with all constraints, and the research can provide a new way for carrying spares optimization.展开更多
Air spares support is general term of using and repairing of aircrafts which is the material foundation of aero technical support, its effectiveness influences operational effectiveness and equipments of aircrafts dir...Air spares support is general term of using and repairing of aircrafts which is the material foundation of aero technical support, its effectiveness influences operational effectiveness and equipments of aircrafts directly. Based on particle swarm optimization algorithm, a new model is proposed to optimize the distribution of the cost of air spares, it take the funds as resource and the improvement of performance efficiency as objective and deduces the expressions to get the best distribution plan. The results of experiments indicate that this model can make full use of the limited funds and obtain the highest efficiency of air spares support.展开更多
This paper studies the solution technique to solve the DRAMA spares allocation optimization problem. DRAMA model is an analytic spare optimization model of a multi-item, multi-location, and two-echelon inventory syste...This paper studies the solution technique to solve the DRAMA spares allocation optimization problem. DRAMA model is an analytic spare optimization model of a multi-item, multi-location, and two-echelon inventory system. The computation of its system spares availability is much complicated. The objective function and constraint functions of DRAMA model could be written as the separable forms. A new bound heuristic algorithm has been presented by improving the bound heuristic algorithm for solving the reliability redundancy optimization problem (BHA in short). With the results, the proposed algorithm has been found to be more economical and effective than BHA to obtain the solutions of large DRAMA model. The new algorithm could be used to solve reliability redundancy optimization problems with the separable forms.展开更多
To obtain a higher readiness for a complex system, the common method is to store some spares. Confidence level of system spares is an important parameter to control the probability of the spares required. By introduci...To obtain a higher readiness for a complex system, the common method is to store some spares. Confidence level of system spares is an important parameter to control the probability of the spares required. By introducing fuzzy theory, this paper allocates the confidence level of system spares to its subsystems, thus to achieve a rational management of system spares,展开更多
This paper develops a new replacement policy for a system with multiple spare units.An optimal replacement period is determined by maximizing the mean time to failure of the system.We show that there exists a finite a...This paper develops a new replacement policy for a system with multiple spare units.An optimal replacement period is determined by maximizing the mean time to failure of the system.We show that there exists a finite and unique optimal replacement period T for units with strictly increasing failure rates. We also proof that the optimal repIacement period for a system with spares is decreasing in k. Furthermore, an algorithm is presented to get the optimal replacement period and a numerical example is given to illustrate the result. with strictly展开更多
Cold spare is the most common configuration amongst the three types of configuration for systems used on board and for power generation systems. A new approach to calculate the unavailability of systems composed of id...Cold spare is the most common configuration amongst the three types of configuration for systems used on board and for power generation systems. A new approach to calculate the unavailability of systems composed of identical spares in cold spare configuration was proposed in this study. Instead of using the spare gate of dynamic fault tree( DFT) and the Markov analysis,AND gate of static fault tree used for calculating the unavailability of cold spare systems was proposed in this paper. By using this approach,unavailability of identical cold spare systems composed of nonrepairable spare components can be calculated exactly and systems composed of both repairable and nonreparable identical spare components can be estimated without building large Markov state diagram.展开更多
Spares inventory configuration optimization is an effective way to improve readiness and reduce life cycle cost of equipment.Through analyzing two-echelon spares support system,the METRIC model basic theory was used.A...Spares inventory configuration optimization is an effective way to improve readiness and reduce life cycle cost of equipment.Through analyzing two-echelon spares support system,the METRIC model basic theory was used.An inventory configuration optimization model of two-echelon spares support system was proposed which took the spares expected shortfall as the object and made the minimum repairable parts expected shortfall instead of the maximum spares supportability as the objective function.Marginal efficiency analysis algorithm was applied to optimizing the spares configuration and generating a rational spares inventory configuration.Finally,several examples are given to verify the model.展开更多
Tumor recurrence, the Gordian knot of liver transplantation for malignancies, may be attributed to many parameters. The technique of the “classical” recipient hepatectomy is believed to be one of the potential reaso...Tumor recurrence, the Gordian knot of liver transplantation for malignancies, may be attributed to many parameters. The technique of the “classical” recipient hepatectomy is believed to be one of the potential reasons to cause tumor evasion because of the possible increase of circulating tumor cells, thus leading to an increased recurrent rate. On this background, the no-touch oncological recipient hepatectomy technique has been developed. A comprehensive review of the development and the key surgical steps of the no-touch recipient hepatectomy is presented. This technique might improve clinical outcomes, especially for those recipients who are at a high risk for tumor recurrence. Multicenter prospective studies should be set up to further validate the prognostic role of this technique in patients with liver cancer treated with liver transplantation.展开更多
The prelimbic cortex(PL)plays a critical role in processing both the sensory and affective components of pain.However,the underlying molecular mechanisms remain poorly understood.In this study,we observed a reduction ...The prelimbic cortex(PL)plays a critical role in processing both the sensory and affective components of pain.However,the underlying molecular mechanisms remain poorly understood.In this study,we observed a reduction in hyperpolarization-activated cation current(Ih)in layer V pyramidal neurons of the contralateral PL in a mouse model of spared nerve injury(SNI).The expression of hyperpolarization-activated cyclic nucleotide-gated 2(HCN2)channels was also decreased in the contralateral PL.Conversely,microinjection of fisetin,a partial agonist of HCN2,produced both analgesic and anxiolytic effects.Additionally,we found that cyclin-dependent kinase 5(CDK5)was activated in the contralateral PL,where it formed a complex with HCN2 and phosphorylated its C-terminus.Knockdown of CDK5 restored HCN2 expression and alleviated both pain hypersensitivity and anxiety-like behaviors.Collectively,these results indicate that CDK5-mediated dysfunction of HCN2 in the PL underlies nerve injury-induced mechanical hypersensitivity and anxiety.展开更多
BACKGROUND Laparoscopic nephrectomy is a preferred surgical approach due to its minimally invasive nature and faster recovery times.However,effective management of postoperative pain remains a significant challenge.Se...BACKGROUND Laparoscopic nephrectomy is a preferred surgical approach due to its minimally invasive nature and faster recovery times.However,effective management of postoperative pain remains a significant challenge.Several traditional methods,including opioid-based analgesia,are commonly used but are associated with side effects such as nausea,vomiting,sedation,and delayed recovery.In recent years,the erector spinae plane block(ESPB)has gained attention as an ultrasoundguided regional anesthesia technique offering promising results in various surgical procedures by reducing opioid requirements and enhancing patient comfort.AIM To evaluate the efficacy and safety of ESPB in comparison to conventional pain management strategies in patients undergoing laparoscopic nephrectomy.METHODS Following PRISMA guidelines,we searched PubMed,EMBASE,Web of Science,and the Cochrane Register for randomized controlled trials(RCTs)comparing ESPB with control for laparoscopic nephrectomy.The Cochrane Risk of Bias tool was employed for quality assessment.The primary outcome was total patient-controlled analgesia(PCA)consumption.Secondary outcomes included hospital discharge time and the incidence of postoperative nausea and vomiting.A random-effects meta-analysis was conducted to calculate pooled mean differences(MD)and odds ratios(OR)with 95%CIs.RESULTS Nine RCTs involving a total of 643 patients(ESPB group=320;control group=323)were included in the analysis.ESPB significantly reduced PCA opioid consumption compared to controls(MD:-14.24,95%CI:-20.66 to-7.83,P<0.0001).Subgroup analysis showed reduced PCA use with ESPB vs morphine(MD:-8.78,95%CI:-15.34 to-2.22,P=0.009),and a non-significant effect compared to other analgesics(MD:-48.26,95%CI:-143.60 to 47.09).No statistically significant differences were observed in discharge time or the incidence of nausea and vomiting.CONCLUSION ESPB demonstrates the potential of reducing PCA in laparoscopic nephrectomy patients;however,its impact on secondary outcomes remains inconclusive.Large-scale RCTs are needed to confirm ESPB's benefits and explore long-term effects.展开更多
BACKGROUND The volar approach with plate fixation is the gold standard for treating distal radius fractures,often requiring incision of the pronator quadratus(PQ)muscle.Preserving the PQ during surgery may facilitate ...BACKGROUND The volar approach with plate fixation is the gold standard for treating distal radius fractures,often requiring incision of the pronator quadratus(PQ)muscle.Preserving the PQ during surgery may facilitate early postoperative recovery.However,conventional minimally invasive plate osteosynthesis(MIPO)techniques frequently necessitate multiple(3-4)intraoperative fluoroscopic adjustments to achieve optimal plate positioning,which can inadvertently damage the PQ muscle.Based on our clinical observations,we developed a novel 3-point positioning technique to minimize PQ injury while ensuring accurate plate placement.Preliminary results demonstrate promising early clinical outcomes.AIM To retrospectively analyze distal radius fractures treated using the 3-point positioning-assisted MIPO technique with preservation of the PQ.METHODS The 3-point positioning technique was applied:The Kirschner wire was inserted after fluoroscopy and was correctly adjusted the position of the plate above the PQ.With the aid of Kirschner wires positioning the PQ stripping was performed only once,and the plate then placed in a correct and satisfactory position.Operation time,incision length,wrist pain score,upper extremity function disabilities of the arm,shoulder and hand(DASH)score,wrist Gartland-Werley score,wrist grip strength,and range of motion were among the quantitative variables recorded.Qualitative variables including AO fracture classification,intraoperative and postoperative complications were evaluated.RESULTS At a mean follow-up of 6.9±0.8 months,the mean scar length was 25.4±1.5 mm,the pain score was 0.7±0.6,the DASH score for the upper limb was 4.7±1.3,and the Gartland-Werley score for wrist function was 4.1±1.1 at the last follow-up.Mean flexion was 97.3%,extension was 97.0%,pronation was 98.9%,supination was 98.9%,and grip strength was 86.6%compared to contralateral values.No unfavorable intraoperative or postoperative complications occurred.CONCLUSION The 3-point positioning technique may reduce the damage to the PQ muscle and is a safe and effective method for MIPO for distal radius fractures.展开更多
On July 17,2024,Chinese electric vehicle manufacturer GAC International opened a smart factory in Rayong Province,Thailand.The next day,then Prime Minister of Thailand Saita Thawaixin met with a delegation led by Zeng...On July 17,2024,Chinese electric vehicle manufacturer GAC International opened a smart factory in Rayong Province,Thailand.The next day,then Prime Minister of Thailand Saita Thawaixin met with a delegation led by Zeng Qinghong,chairman of GAC Group.He encouraged GAC to purchase various spare parts in Thailand to enhance Thailand’s position in the global electric vehicle industry supply chain.“Thailand has a favorable business environment,”Zeng responded.“As the location of GAC’s first wholly-owned overseas facility,it was our premier choice.”展开更多
Dear Editor,Primary bladder neck obstruction(PBNO)affects approximately 28%–54%of men[1].Its etiology remains unclear.Symptoms of PBNO present as voiding(e.g.,decreased force of stream,hesitancy,intermittent stream,a...Dear Editor,Primary bladder neck obstruction(PBNO)affects approximately 28%–54%of men[1].Its etiology remains unclear.Symptoms of PBNO present as voiding(e.g.,decreased force of stream,hesitancy,intermittent stream,and incomplete emptying),storage(e.g.,frequency,urgency,urge incontinence,and nocturia),or a combination of both[2].Untreated PBNO can lead to bladder dysfunction,bladder diverticula,hydronephrosis,and impaired renal function[3].展开更多
Objective: To study the feasibility of radionuclide colloid 32P used for the treatment of stage II lung cancer by video enhanced minimal access muscle sparing thoracotomy (VEMAST). Methods: Video assisted thoracosc...Objective: To study the feasibility of radionuclide colloid 32P used for the treatment of stage II lung cancer by video enhanced minimal access muscle sparing thoracotomy (VEMAST). Methods: Video assisted thoracoscopic surgery (VATS) was carried out under general anesthesia. A double lumen endobronchial tube was intubated into trachea. One lung ventilation of the healthy side was done during operation. An incision of 8–10 cm long was made along the 4th or 5th intercostals. The lobectomy could be performed under VATS. Radionuclide colloid 32P was injected locally into the area where surgical cleaning of lymph node around was considered to be unsatisfactory or desection of the tumor was not completed. Results: The operation with VEMAST was successful in 29 patients. A conventional lobectomy by thoracotomy had to be done due to unusual bleeding from the pulmonary artery involved during VEMAST in one case and the procedure was interrupted because the pulmonary artery cloud not be separated from the tumor in another patient. There was no dead case or the patient who had any severe complication or adverse response to the radiant. Conclusion: Radionuclide therapy was performed to the treatment of stage II lung cancer with VEMAST in case that surgical resection was considered not to be satisfactory. Minithoractomy assisted with VATS lobectomy and radionuclide colloid 32P therapy is a safe and e?ective technique for some selected stage II lung cancer.展开更多
基金co-supported by the General Armament Department Pre-research Foundation of China (Nos. 51304010206, 51327 020105)
文摘Rational planning of spares configuration project is an effective approach to improve equipment availability as well as reduce life cycle cost （LCC）. With an analysis of various impacts on support system, the spares demand rate forecast model is constructed. According to systemic analysis method, spares support effectiveness evaluation indicators system is built, and then, initial spares configuration and optimization method is researched. To the issue of discarding and con-sumption for incomplete repairable items, its expected backorders function is approximated by Laplace demand distribution. Combining the （s-1, s） and （R, Q） inventory policy, the spares resup-ply model is established under the batch ordering policy based on inventory state, and the optimi-zation analysis flow for spares configuration is proposed. Through application on shipborne equipment spares configuration, the given scenarios are analyzed under two constraint targets：one is the support effectiveness, and the other is the spares cost. Analysis reveals that the result is consistent with practical regulation;therefore, the model＇s correctness, method＇s validity as well as optimization project＇s rationality are proved to a certain extent.
基金supported by the National Natural Science Foundation of China(6110413261304148)
文摘Level of repair analysis（LORA） is an important method of maintenance decision for establishing systems of operation and maintenance in the equipment development period. Currently, the research on equipment of repair level focuses on economic analysis models which are used to optimize costs and rarely considers the maintenance time required by the implementation of the maintenance program. In fact, as to the system requiring high mission complete success, the maintenance time is an important factor which has a great influence on the availability of equipment systems. Considering the relationship between the maintenance time and the spares stocks level, it is obvious that there are contradictions between the maintenance time and the cost. In order to balance these two factors, it is necessary to build an optimization LORA model. To this end, the maintenance time representing performance characteristic is introduced, and on the basis of spares stocks which is traditionally regarded as a decision variable, a decision variable of repair level is added, and a multi-echelon multiindenture（MEMI） optimization LORA model is built which takes the best cost-effectiveness ratio as the criterion, the expected number of backorder（EBO） as the objective function and the cost as the constraint. Besides, the paper designs a convex programming algorithm of multi-variable for the optimization model, provides solutions to the non-convex objective function and methods for improving the efficiency of the algorithm. The method provided in this paper is proved to be credible and effective according to the numerical example and the simulation result.
基金supported by the National Defense Pre-research Project in the 13th Five-Year(41404050502)the National Defense Science and Technology Fund of the Central Military Commission(2101140)
文摘Redundancy is a common structure for warship system,and it is an effective way to improve the reliability of the system.In this paper, warship system is taken as the object of study,based on the system reliability equivalence principle, a spares demand rate calculation method for redundant system is proposed through structure transformation. According to the system analysis method, the general modeling data structure of spares support echelon and system indenture is established, and the mission success probability is taken as the optimization target to build the dynamic optimization model of carrying spares during the process of multi-phase. By introducing the Lagrange multiplier, the spares weight, volume and cost are transformed to the single target of the spares total scale, and the initial Lagrange factors and its dynamic adjustment policy is proposed. In a given example, the main influence factors of the carrying spares project are analyzed, and the study results are in accordance with the reality, which can provide a new approach to mission-oriented carrying spares optimization for the redundant system.
基金supported in part by the General Armament Department Pre-research Foundation in 12th FiveYear(No.51304010206)the National Defense Pre-research Project in 13th Five-Year (No.41404050502)
文摘Spare parts are critical to scheduled maintenance and fault repair, and can directly affect the readiness and combat capability of equipment. Equipmentrs capacity of carrying spares is influenced by its storage space and scales, so it is necessary to consider economic factors, e.g. spares cost, as well as non-economic ones, such as spares volume, mass and scale, when optimizing spares configuration. Aiming at this problem, the optimization model based on multi-constraints for carrying spares is built by METRIC theory and system analysis. Through the introduction of Lagrange factors, the spares cost is transformed to shadow price, and the optimization method for carrying spares and the dynamic adjustment policy of Lagrange factors are proposed. The result of a given example is analyzed, and demonstrates that the proposed model can be optimized with all constraints, and the research can provide a new way for carrying spares optimization.
文摘Air spares support is general term of using and repairing of aircrafts which is the material foundation of aero technical support, its effectiveness influences operational effectiveness and equipments of aircrafts directly. Based on particle swarm optimization algorithm, a new model is proposed to optimize the distribution of the cost of air spares, it take the funds as resource and the improvement of performance efficiency as objective and deduces the expressions to get the best distribution plan. The results of experiments indicate that this model can make full use of the limited funds and obtain the highest efficiency of air spares support.
文摘This paper studies the solution technique to solve the DRAMA spares allocation optimization problem. DRAMA model is an analytic spare optimization model of a multi-item, multi-location, and two-echelon inventory system. The computation of its system spares availability is much complicated. The objective function and constraint functions of DRAMA model could be written as the separable forms. A new bound heuristic algorithm has been presented by improving the bound heuristic algorithm for solving the reliability redundancy optimization problem (BHA in short). With the results, the proposed algorithm has been found to be more economical and effective than BHA to obtain the solutions of large DRAMA model. The new algorithm could be used to solve reliability redundancy optimization problems with the separable forms.
文摘To obtain a higher readiness for a complex system, the common method is to store some spares. Confidence level of system spares is an important parameter to control the probability of the spares required. By introducing fuzzy theory, this paper allocates the confidence level of system spares to its subsystems, thus to achieve a rational management of system spares,
文摘This paper develops a new replacement policy for a system with multiple spare units.An optimal replacement period is determined by maximizing the mean time to failure of the system.We show that there exists a finite and unique optimal replacement period T for units with strictly increasing failure rates. We also proof that the optimal repIacement period for a system with spares is decreasing in k. Furthermore, an algorithm is presented to get the optimal replacement period and a numerical example is given to illustrate the result. with strictly
基金National High-Technology Research and Development Program of China(863 Program)(No.2013AA040203)
文摘Cold spare is the most common configuration amongst the three types of configuration for systems used on board and for power generation systems. A new approach to calculate the unavailability of systems composed of identical spares in cold spare configuration was proposed in this study. Instead of using the spare gate of dynamic fault tree( DFT) and the Markov analysis,AND gate of static fault tree used for calculating the unavailability of cold spare systems was proposed in this paper. By using this approach,unavailability of identical cold spare systems composed of nonrepairable spare components can be calculated exactly and systems composed of both repairable and nonreparable identical spare components can be estimated without building large Markov state diagram.
文摘Spares inventory configuration optimization is an effective way to improve readiness and reduce life cycle cost of equipment.Through analyzing two-echelon spares support system,the METRIC model basic theory was used.An inventory configuration optimization model of two-echelon spares support system was proposed which took the spares expected shortfall as the object and made the minimum repairable parts expected shortfall instead of the maximum spares supportability as the objective function.Marginal efficiency analysis algorithm was applied to optimizing the spares configuration and generating a rational spares inventory configuration.Finally,several examples are given to verify the model.
基金supported in part by grants from National Nat-ural Science Foundation of China (82200726 and U23A20451)Key Program of the National Natural Science Foundation of China (81930016)National Key Research and Development Program of China (2021YFA1100500)。
文摘Tumor recurrence, the Gordian knot of liver transplantation for malignancies, may be attributed to many parameters. The technique of the “classical” recipient hepatectomy is believed to be one of the potential reasons to cause tumor evasion because of the possible increase of circulating tumor cells, thus leading to an increased recurrent rate. On this background, the no-touch oncological recipient hepatectomy technique has been developed. A comprehensive review of the development and the key surgical steps of the no-touch recipient hepatectomy is presented. This technique might improve clinical outcomes, especially for those recipients who are at a high risk for tumor recurrence. Multicenter prospective studies should be set up to further validate the prognostic role of this technique in patients with liver cancer treated with liver transplantation.
基金supported by the National Natural Science Foundation of China(32030052,W2411014 to Yun Wang,32271190 and 31972905 to Ying Zhang)the STI 2030 Major Project of the Ministry of Science and Technology of China(2021ZD0203204)the Beijing Natural Science Foundation(QY23067).
文摘The prelimbic cortex(PL)plays a critical role in processing both the sensory and affective components of pain.However,the underlying molecular mechanisms remain poorly understood.In this study,we observed a reduction in hyperpolarization-activated cation current(Ih)in layer V pyramidal neurons of the contralateral PL in a mouse model of spared nerve injury(SNI).The expression of hyperpolarization-activated cyclic nucleotide-gated 2(HCN2)channels was also decreased in the contralateral PL.Conversely,microinjection of fisetin,a partial agonist of HCN2,produced both analgesic and anxiolytic effects.Additionally,we found that cyclin-dependent kinase 5(CDK5)was activated in the contralateral PL,where it formed a complex with HCN2 and phosphorylated its C-terminus.Knockdown of CDK5 restored HCN2 expression and alleviated both pain hypersensitivity and anxiety-like behaviors.Collectively,these results indicate that CDK5-mediated dysfunction of HCN2 in the PL underlies nerve injury-induced mechanical hypersensitivity and anxiety.
文摘BACKGROUND Laparoscopic nephrectomy is a preferred surgical approach due to its minimally invasive nature and faster recovery times.However,effective management of postoperative pain remains a significant challenge.Several traditional methods,including opioid-based analgesia,are commonly used but are associated with side effects such as nausea,vomiting,sedation,and delayed recovery.In recent years,the erector spinae plane block(ESPB)has gained attention as an ultrasoundguided regional anesthesia technique offering promising results in various surgical procedures by reducing opioid requirements and enhancing patient comfort.AIM To evaluate the efficacy and safety of ESPB in comparison to conventional pain management strategies in patients undergoing laparoscopic nephrectomy.METHODS Following PRISMA guidelines,we searched PubMed,EMBASE,Web of Science,and the Cochrane Register for randomized controlled trials(RCTs)comparing ESPB with control for laparoscopic nephrectomy.The Cochrane Risk of Bias tool was employed for quality assessment.The primary outcome was total patient-controlled analgesia(PCA)consumption.Secondary outcomes included hospital discharge time and the incidence of postoperative nausea and vomiting.A random-effects meta-analysis was conducted to calculate pooled mean differences(MD)and odds ratios(OR)with 95%CIs.RESULTS Nine RCTs involving a total of 643 patients(ESPB group=320;control group=323)were included in the analysis.ESPB significantly reduced PCA opioid consumption compared to controls(MD:-14.24,95%CI:-20.66 to-7.83,P<0.0001).Subgroup analysis showed reduced PCA use with ESPB vs morphine(MD:-8.78,95%CI:-15.34 to-2.22,P=0.009),and a non-significant effect compared to other analgesics(MD:-48.26,95%CI:-143.60 to 47.09).No statistically significant differences were observed in discharge time or the incidence of nausea and vomiting.CONCLUSION ESPB demonstrates the potential of reducing PCA in laparoscopic nephrectomy patients;however,its impact on secondary outcomes remains inconclusive.Large-scale RCTs are needed to confirm ESPB's benefits and explore long-term effects.
基金Supported by Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopaedic Trauma,No.2020Y2014Fuzhou Health Technology Innovation Platform Construction Project,No.2019-S-wp2.
文摘BACKGROUND The volar approach with plate fixation is the gold standard for treating distal radius fractures,often requiring incision of the pronator quadratus(PQ)muscle.Preserving the PQ during surgery may facilitate early postoperative recovery.However,conventional minimally invasive plate osteosynthesis(MIPO)techniques frequently necessitate multiple(3-4)intraoperative fluoroscopic adjustments to achieve optimal plate positioning,which can inadvertently damage the PQ muscle.Based on our clinical observations,we developed a novel 3-point positioning technique to minimize PQ injury while ensuring accurate plate placement.Preliminary results demonstrate promising early clinical outcomes.AIM To retrospectively analyze distal radius fractures treated using the 3-point positioning-assisted MIPO technique with preservation of the PQ.METHODS The 3-point positioning technique was applied:The Kirschner wire was inserted after fluoroscopy and was correctly adjusted the position of the plate above the PQ.With the aid of Kirschner wires positioning the PQ stripping was performed only once,and the plate then placed in a correct and satisfactory position.Operation time,incision length,wrist pain score,upper extremity function disabilities of the arm,shoulder and hand(DASH)score,wrist Gartland-Werley score,wrist grip strength,and range of motion were among the quantitative variables recorded.Qualitative variables including AO fracture classification,intraoperative and postoperative complications were evaluated.RESULTS At a mean follow-up of 6.9±0.8 months,the mean scar length was 25.4±1.5 mm,the pain score was 0.7±0.6,the DASH score for the upper limb was 4.7±1.3,and the Gartland-Werley score for wrist function was 4.1±1.1 at the last follow-up.Mean flexion was 97.3%,extension was 97.0%,pronation was 98.9%,supination was 98.9%,and grip strength was 86.6%compared to contralateral values.No unfavorable intraoperative or postoperative complications occurred.CONCLUSION The 3-point positioning technique may reduce the damage to the PQ muscle and is a safe and effective method for MIPO for distal radius fractures.
文摘On July 17,2024,Chinese electric vehicle manufacturer GAC International opened a smart factory in Rayong Province,Thailand.The next day,then Prime Minister of Thailand Saita Thawaixin met with a delegation led by Zeng Qinghong,chairman of GAC Group.He encouraged GAC to purchase various spare parts in Thailand to enhance Thailand’s position in the global electric vehicle industry supply chain.“Thailand has a favorable business environment,”Zeng responded.“As the location of GAC’s first wholly-owned overseas facility,it was our premier choice.”
文摘Dear Editor,Primary bladder neck obstruction(PBNO)affects approximately 28%–54%of men[1].Its etiology remains unclear.Symptoms of PBNO present as voiding(e.g.,decreased force of stream,hesitancy,intermittent stream,and incomplete emptying),storage(e.g.,frequency,urgency,urge incontinence,and nocturia),or a combination of both[2].Untreated PBNO can lead to bladder dysfunction,bladder diverticula,hydronephrosis,and impaired renal function[3].
文摘Objective: To study the feasibility of radionuclide colloid 32P used for the treatment of stage II lung cancer by video enhanced minimal access muscle sparing thoracotomy (VEMAST). Methods: Video assisted thoracoscopic surgery (VATS) was carried out under general anesthesia. A double lumen endobronchial tube was intubated into trachea. One lung ventilation of the healthy side was done during operation. An incision of 8–10 cm long was made along the 4th or 5th intercostals. The lobectomy could be performed under VATS. Radionuclide colloid 32P was injected locally into the area where surgical cleaning of lymph node around was considered to be unsatisfactory or desection of the tumor was not completed. Results: The operation with VEMAST was successful in 29 patients. A conventional lobectomy by thoracotomy had to be done due to unusual bleeding from the pulmonary artery involved during VEMAST in one case and the procedure was interrupted because the pulmonary artery cloud not be separated from the tumor in another patient. There was no dead case or the patient who had any severe complication or adverse response to the radiant. Conclusion: Radionuclide therapy was performed to the treatment of stage II lung cancer with VEMAST in case that surgical resection was considered not to be satisfactory. Minithoractomy assisted with VATS lobectomy and radionuclide colloid 32P therapy is a safe and e?ective technique for some selected stage II lung cancer.
