Fractal characters and fractal dimension of time series created by repeller in complicated system were studied and the time series were reconstructed by applying the theory of phase space reconstruction for chaotic ti...Fractal characters and fractal dimension of time series created by repeller in complicated system were studied and the time series were reconstructed by applying the theory of phase space reconstruction for chaotic time series. The influence of zero_mean treatment, Fourier filter on prediction for time series were studied. The choice of prediction sample affects the relative error and the prediction length which were also under good concern. The results show that the model provided here are practical for the modeling and prediction of time series created by chaotic repellers. Zero_mean treatment has changed prediction result quantitatively for chaotic repeller sample data. But using Fourier filter may decrease the prediction precision. This is theoretical and practical for study on chaotic repeller in complicated system.展开更多
The paper analyzed characters of complicated system and discussed the reason of comprehensive evaluation, realization of flexible comprehensive evaluation was researched from prospect of dynamic measure selection of e...The paper analyzed characters of complicated system and discussed the reason of comprehensive evaluation, realization of flexible comprehensive evaluation was researched from prospect of dynamic measure selection of evaluation, balance of functionality and harmony, uncertainty factor. In the end, multistage flexible comprehensive evaluation of complicated system was applied to performance evaluation of firm.展开更多
BACKGROUND Complicated crown–root fracture (CRF) involves severe injury to the crown, root,and pulp, and may be accompanied by multiple root fractures. The loss of a toothhas lifelong consequences for children and te...BACKGROUND Complicated crown–root fracture (CRF) involves severe injury to the crown, root,and pulp, and may be accompanied by multiple root fractures. The loss of a toothhas lifelong consequences for children and teenagers, but the maintenance of pulphealth and the calcific healing of multiple root fractures are rarely reported in theliterature.CASE SUMMARY This case reports healing of a permanent tooth with complicated crown–root andadditional root fractures, in which pulp health was maintained. A 10-year-old girlfell and fractured the root of her maxillary left central incisor at the cervical level.After the coronal fragment was repositioned, the tooth was splinted until thetooth was no longer mobile, 2 years later. Eight years after treatment, the toothhas remained asymptomatic with vital pulp and localized gingival overgrowth.Cone-beam computed tomography revealed not only calcified healing of the CRFbut also spontaneous healing in an additional undiagnosed root fracture. Thefracture line on the enamel could not be healed by hard tissue and formed agroove in the cervical crown. It was speculated that the groove was related to thelocalized gingival overgrowth.CONCLUSION This case provides a clinical perspective of the treatment of a tooth with acomplicated CRF and an additional root fracture.展开更多
BACKGROUND Ventriculoperitoneal shunt(VPS)catheter insertion is one of the most widely accepted surgical procedures for hydrocephalus.Migration of the end of the distal VPS catheter into the scrotum is one of the rare...BACKGROUND Ventriculoperitoneal shunt(VPS)catheter insertion is one of the most widely accepted surgical procedures for hydrocephalus.Migration of the end of the distal VPS catheter into the scrotum is one of the rare complications of VPS catheter insertion.METHODS This is a systematic review of the published cases,and the literature search was performed from 1974 to June 30,2024,to retrieve the relevant manuscripts.The cases were grouped into two.Group A included cases of migration of the distal VPS catheter into the scrotum,detected in children.Group B included the cases of migration of the distal VPS catheter into the scrotum,which was detected in adults and older people.RESULTS One hundred-twenty cases of migration of the distal end of VPS catheter into the scrotum were included in this study,a systematic literature review.Group A included n=112 cases,and group B included n=8 cases only.Three-fourths of the cases involved the right scrotum.Bilateral involvement was rare.The indication for initial VPS insertion was congenital hydrocephalus in four-fifths of the group A cases.The majority were infants at the time of initial shunt insertion.Four-fifths of the group A cases were 24 months-old or younger at the time of clinical diagnosis and treatment was provided for migration of the distal VPS catheter into the scrotum.In children,the interval from VPS insertion or shunt revision if any,to the diagnosis of the complication mentioned above was 12 months or less in four-fifths of the cases.The repositioning of migrated distal VPS catheter into the peritoneal cavity and herniotomy was preferred for the surgical procedure,and it was performed for two-thirds of group A cases.CONCLUSION Migration of the distal part of the VPS catheter into the scrotum is a rare complication of cerebrospinal fluid diversion via VPS catheter insertion.It was most frequent in children,and the right side of the scrotum was most often involved.展开更多
BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related co...BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related complications in colorectal cancer patients who underwent stoma creation.METHODS Patients with stoma was prospectively recorded in the established stoma system.Data was collected from this stoma management system from November 2021 through May 2024.The rates of stoma-related complications were assessed,and potential risk factors were analyzed using univariate and multivariate logistic regression models.RESULTS A total of 734 patients were included in the analysis.The results showed that 12.3%of patients experienced stoma-related complications,with mucocutaneous separation,edema,and skin excoriation being the most common complications.The majority(90%)of complications were classified as grade 2 according to the Clavien-Dindo classification.Surgical factors,such as blood loss volume greater than 500 mL and open surgery,were significantly associated with stoma complications.Additionally,stoma features like location,shape,color,height,and edema were important factors in the association with complications.Body mass index over 30 kg/m²was also found to be a significant risk factor.CONCLUSION These findings highlight the need for a holistic approach to preventing and managing stoma complications,considering both patient-related and surgical factors.展开更多
Objective:To evaluate the efficacy and safety of traditional Chinese exercises(TCE)in patients with diabetic peripheral neuropathy(DPN)and to recommend best practices for using TCE to improve neurological function,gly...Objective:To evaluate the efficacy and safety of traditional Chinese exercises(TCE)in patients with diabetic peripheral neuropathy(DPN)and to recommend best practices for using TCE to improve neurological function,glycemic control,and psychological well-being.Methods:Nine databases were searched from the inception to October 2024.Effect relationships were assessed using meta-analysis with Stata 17,and the methodological quality and certainty of the evidence were evaluated using standard tools.Results:Twelve studies comprising three study designs(nine randomized controlled,one quasi-exper-imental controlled,and two single-arm clinical trials),were identified.Compared with usual care,TCE improved various indicators and enhanced the nerve conduction velocities of the peroneal motor(mean difference[MD]=3.86 m/s,95%confidence interval[CI]:0.38 to 7.34,P=0.03),sural sensory(MD=4.15 m/s,95%CI:0.68 to 7.63,P=0.02),median motor(MD=3.84 m/s,95%CI:2.14 to 5.54,P<.001),and median sensory nerves(MD=6.14 m/s,95%CI:4.54 to 7.74,P<.001).TCE practices also reduced glycosylated hemoglobin level(MD=-0.59%,95%CI:-0.91 to-0.27,P<.001)and fasting blood glucose(standardized mean difference[SMD]=-1.08,95%CI:-1.79 to-0.37,P<.001).The overall quality of evidence was very low.Conclusion:The results indicate that TCE therapy improves certain outcomes in patients with DPN.Although the optimal type,intensity,frequency,and duration of TCE interventions are uncertain,these preliminary findings suggest that TCE should be further studied as a potentially affordable and effective treatment for DPN.展开更多
BACKGROUND Colon cancer is one of the most common malignancies of the digestive tract,often complicated by intestinal obstruction,which can significantly impact patient outcomes.While traditional laparotomy is the sta...BACKGROUND Colon cancer is one of the most common malignancies of the digestive tract,often complicated by intestinal obstruction,which can significantly impact patient outcomes.While traditional laparotomy is the standard treatment,it is associated with large wounds,slower recovery,and higher complication rates.Laparoscopic surgery,a minimally invasive approach,may offer better outcomes for these patients.AIM To evaluate the clinical effects and prognosis of laparoscopic surgery in patients with colon cancer complicated by intestinal obstruction compared to traditional laparotomy.METHODS A retrospective analysis was conducted on 100 patients diagnosed with colon cancer and intestinal obstruction who underwent surgical treatment between January 2020 and December 2022.Patients were divided into two groups:The control group(CG),treated with traditional laparotomy,and the observation group(OG),treated with laparoscopic surgery.Clinical effects,surgical indicators,postoperative pain,inflammatory response,complication rates,quality of life,and prognosis were assessed and compared between the two groups.RESULTS The OG showed superior clinical outcomes compared to the CG(P<0.05).Patients in the OG had shorter operation times,reduced intraoperative blood loss,faster recovery of intestinal function,earlier mobilization,and shorter hospital stays(P<0.05).Postoperative pain(numerical rating scale scores)and inflam-matory markers[tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]were lower in the OG(P<0.05).The incidence of complic-ations was significantly reduced in the OG(6.00%vs 22.00%,P<0.05).Quality of life scores,including physical function,psychological state,social communication,and self-care ability,were significantly higher in the OG(P<0.05).There were no significant differences between groups in abdominal drainage volume,1-year tumor recurrence or metastasis rates,or 1-and 3-year survival rates(P>0.05).CONCLUSION The OG showed superior clinical outcomes compared to the CG(P<0.05).Patients in the OG had shorter operation times,reduced intraoperative blood loss,faster recovery of intestinal function,earlier mobilization,and shorter hospital stays(P<0.05).Postoperative pain(NRS scores)and inflammatory markers(TNF-α,IL-6,CRP)were lower in the OG(P<0.05).The incidence of complications was significantly reduced in the OG(6.00%vs 22.00%,P<0.05).Quality of life scores,including physical function,psychological state,social communication,and self-care ability,were significantly higher in the OG(P<0.05).There were no significant differences between groups in abdominal drainage volume,1-year tumor recurrence or metastasis rates,or 1-and 3-year survival rates(P>0.05).展开更多
BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is a highly effective treat-ment for complications associated with portal hypertension.However,stent fracture,although extremely rare,represents a potentia...BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is a highly effective treat-ment for complications associated with portal hypertension.However,stent fracture,although extremely rare,represents a potentially serious complication following TIPS creation.Timely identification and management are crucial for preventing further adverse events.CASE SUMMARY We report a 56-year-old male patient who underwent a TIPS procedure for re-current melena caused by portal hypertension secondary to hepatitis B and experienced a stent fracture 15 months post-procedure.He was readmitted 30 months after the initial TIPS due to recurrent esophagogastric variceal bleeding and ascites.An attempt to revise the dysfunctional shunt via a stent-in-stent approach was unsuccessful.Consequently,a parallel TIPS procedure was success-fully performed via the proximal end of the fractured stent to decompress the portal venous system.At the 1-month follow-up,the patient exhibited no recur-rent variceal bleeding,and his ascites had significantly decreased.Twelve-month postoperative monitoring revealed no hepatic encephalopathy and no recurrence of bleeding or ascites.Additionally,we review the existing literature on post-TIPS stent fractures to explore the underlying mechanisms contributing to this com-plication.CONCLUSION Early recognition and prompt intervention are essential in managing stent fractures after TIPS creation to mitigate potential risks and ensure optimal patient outcomes.展开更多
Liver cancer presents unique challenges due to its systemic impact and complex treatment modalities.Patients often experience a range of complications,including cardiovascular,renal,hematological,and metabolic abnorma...Liver cancer presents unique challenges due to its systemic impact and complex treatment modalities.Patients often experience a range of complications,including cardiovascular,renal,hematological,and metabolic abnormalities,which can significantly affect treatment outcomes and quality of life.This article emphasizes the integration of multidisciplinary strategies and artificial intelligence-driven diagnostics,which have the potential to improve patient outcomes by optimizing early detection and targeted management of these complications.A recent study on 60 liver cancer patients undergoing interventional therapy highlighted the importance of recognizing and managing these complications.This article offers an overview of systemic complications in liver cancer,focusing on pathophysiological mechanisms,risk factors,and strategies to improve care.By addressing gaps in the existing literature and proposing future research directions,it underscores the importance of comprehensive,patient-centered approaches to refine therapeutic strategies.展开更多
Dear Editor,For the past few decades,mosquito-borne orthoflaviviruses,such as dengue virus,Zika virus,and West Nile virus(WNV),have posed significant threats to global public health.The Orthoflavivirus genus comprises...Dear Editor,For the past few decades,mosquito-borne orthoflaviviruses,such as dengue virus,Zika virus,and West Nile virus(WNV),have posed significant threats to global public health.The Orthoflavivirus genus comprises more than 70 viruses,many of which are responsible for a wide range of diseases in humans and animals,including febrile illnesses,encephalitis,and hemorrhagic febrile illness.These viruses are associated with approximately 400 million infections and 100 million symptomatic cases worldwide each year(Van Leur et al.,2021).Among them,Usutu virus(USUV)is an emerging pathogen classified alongside WNV within the Japanese encephalitis virus(JEV)serogroup of the Orthoflavivirus genus,the Flaviviridae family.USUV has spread from Africa to Europe since the late 20th century.It primarily causes central nervous system disorders in birds,with several large-scale mortality events recorded in Europe.USUV can also infect humans,it typically leads to neurological complications in rare cases(Roesch et al.,2019).展开更多
BACKGROUND Stomal complications though small in early postoperative period,but poses significant morbidity,therapeutic challenge,delay in adjuvant treatment and sometimes even leads to mortality.Predictive model for e...BACKGROUND Stomal complications though small in early postoperative period,but poses significant morbidity,therapeutic challenge,delay in adjuvant treatment and sometimes even leads to mortality.Predictive model for early detection of stomal complications is important to improve the outcome.A model including patients and disease related factors,intraoperative surgical techniques and biochemical markers would be a better determinant to anticipate early stomal complications.Incorporation of emerging tools and technology such as artificial intelligence(AI),will further improve the prediction.AIM To identify various risk factors and models for prediction of early post operative stomal complications in colorectal cancer(CRC)surgery.METHODS Published literatures on early postoperative stomal complications in CRC surgery were systematically reviewed between 1995 and 2024 from online search engines PubMed and MEDLINE.RESULTS Twenty-four observational studies focused on identifying various risk factors for early post operative stomal complications in CRC surgery were analyzed.Stomal complications in CRC are influenced by several factors such as disease factors,patient-specific characteristics,and surgical techniques.There are some biomarkers and tools loke AI which may play significant roles in early detection.CONCLUSION Careful analysis of these factors,changes in biochemical parameters,and application of AI,a predictive model for stomal complications can be generated,to help in early detection,prompt action to achieve better outcomes.展开更多
BACKGROUND Hepatitis B virus(HBV)infection can lead to renal involvement,commonly manifested as HBV-associated glomerulonephritis(HBV-GN),which typically presents as nephrotic or nephritic syndrome.Antineutrophil cyto...BACKGROUND Hepatitis B virus(HBV)infection can lead to renal involvement,commonly manifested as HBV-associated glomerulonephritis(HBV-GN),which typically presents as nephrotic or nephritic syndrome.Antineutrophil cytoplasmic antibody-associated vasculitis(AAV)is a systemic disease characterized by immune necrotizing inflammation of small blood vessels involving multiple organs with complex and severe clinical implications.The coexistence of HBV-GN and AAV is sporadic,with limited data existing regarding its diagnosis,management,clinical outcomes,and prognosis,especially in patients with AAV.CASE SUMMARY This manuscript presents the case of an older male patient who presented with persistent foamy urine lasting over two weeks.Initial clinical findings included nephrotic syndrome and renal insufficiency,which subsequently progressed to involve the lungs,immune system,hematologic system,and other organ systems.The patient was diagnosed with HBV-GN complicated by AAV,a rare and complex condition.Despite receiving comprehensive treatment,including corticosteroids,cyclophosphamide for immune regulation,plasma exchange,and immunoadsorption targeting antineutrophil cytoplasmic antibody-associated antibodies,the patient required long-term dialysis and demonstrated a poor prognosis.CONCLUSION HBV infection may trigger nephropathy with AAV.Early recognition and intervention are crucial for improving patient prognosis.展开更多
Background: Surgical treatment of lumbar disc herniation is a widely debated topic, with several techniques available. Percutaneous endoscopic discectomy (PELD) has gained popularity due to its lower invasiveness comp...Background: Surgical treatment of lumbar disc herniation is a widely debated topic, with several techniques available. Percutaneous endoscopic discectomy (PELD) has gained popularity due to its lower invasiveness compared to conventional techniques such as microdiscectomy/open lumbar microdiscectomy (OLMD)/tubular microdiscectomy (TMD). However, evidence on the effectiveness, recovery time and complications of these techniques is not yet clearly established. This systematic review aims to compare the preoperative and postoperative outcomes of both techniques. Methods: A comprehensive search was performed in databases including PubMed and Cochrane, following strict inclusion and exclusion criteria. Comparative studies and narrative reviews on PELD and OLMD/TMD published between 2019 and 2024 were included. Key outcomes considered were pre- and postoperative Visual Analogue Scale (VAS), hospitalization time, time to return to work, and postoperative complications. Results: The reviewed studies indicated that PELD is associated with a greater reduction in postoperative pain compared to OLMD/TMD, with a significant decrease in VAS, according to the study by Priola et al. (2019). The hospital stay was also shorter for patients undergoing PELD, averaging 2 days compared to OLMD/TMD. Furthermore, PELD favored a faster return to work and had a lower rate of postoperative complications, such as dural tears and reoperations, compared to OLMD/TMD. Conclusions: PELD demonstrates clear advantages over OLMD/TMD in terms of pain reduction, shorter hospital stay, faster return to work, and fewer postoperative complications. However, the implementation of this technique requires a significant learning curve, suggesting that its effectiveness may vary depending on the surgeon’s experience. PELD should be considered a preferred option in the resection of lumbar disc herniations, especially in patients seeking a quick and less invasive recovery.展开更多
Based on the work discussed on the former study, this article first starts from the mathematical model of a kind of complicated financial system, and analyses all possible things that the model shows in the operation ...Based on the work discussed on the former study, this article first starts from the mathematical model of a kind of complicated financial system, and analyses all possible things that the model shows in the operation of our country's macro_financial system: balance, stable periodic, fractal, Hopf_bifurcation, the relationship between parameters and Hopf_bifurcation, and chaotic motion etc. By the changes of parameters of all economic meanings, the conditions on which the complicated behaviors occur in such a financial system, and the influence of the adjustment of the macro_economic policies and adjustment of some parameter on the whole financial system behavior have been analyzed. This study will deepen people's understanding of the lever function of all kinds of financial policies.展开更多
Based on the work discussed on the former study, this article first starts from the mathematical model of a kind of complicated financial system, and analyses all possible things that the model shows in the operation ...Based on the work discussed on the former study, this article first starts from the mathematical model of a kind of complicated financial system, and analyses all possible things that the model shows in the operation of our country's macro_financial system: balance, stable periodic, fractal, Hopf_bifurcation, the relationship between parameters and Hopf_bifurcation, and chaotic motion etc. By the changes of parameters of all economic meanings, the conditions on which the complicated behaviors occur in such a financial system, and the influence of the adjustment of the macro_economic policies and adjustment of some parameter on the whole financial system behavior have been analyzed. This study will deepen people's understanding of the lever function of all kinds of financial policies.展开更多
This paper is a further study of reference [1]. In this paper, we mainly discuss the complicated dynamical behaviors resulting from a simple one-dimensional model of nonlinear ecosystems: fixed point motion, periodic ...This paper is a further study of reference [1]. In this paper, we mainly discuss the complicated dynamical behaviors resulting from a simple one-dimensional model of nonlinear ecosystems: fixed point motion, periodic motion and chaotic motion etc., and briefly discuss the universality of the complicated dynamical behaviors, which can be described by the first and the second M. Feigenbaun. constants. At last, we discuss the 'one-side lowering phenomenon' due to near unstabilization when the nonlinear ecosystem approaches bifurcation points from unbifurcation side. It is of important theoretical and practical meanings both in the development and utilization of ecological resources ar.d in the design and management of artifilial ecosystems.展开更多
BACKGROUND Gastric cancer has a high incidence and fatality rate,and surgery is the preferred course of treatment.Nonetheless,patient survival rates are still low,and the incidence of major postoperative complications...BACKGROUND Gastric cancer has a high incidence and fatality rate,and surgery is the preferred course of treatment.Nonetheless,patient survival rates are still low,and the incidence of major postoperative complications cannot be disregarded.The systemic inflammatory response,nutritional level,and coagulation status are key factors affecting the postoperative recovery and prognosis of gastric cancer patients.The systemic inflammatory response index(SIRI)and the albumin fibrinogen ratio(AFR)are two valuable comprehensive indicators of the severity and prognosis of systemic inflammation in various medical conditions.AIM To assess the clinical importance and prognostic significance of the SIRI scores and the AFR on early postoperative outcomes in patients undergoing radical gastric cancer surgery.METHODS We conducted a retrospective analysis of the clinicopathological characteristics and relevant laboratory indices of 568 gastric cancer patients from January 2018 to December 2019.We calculated and compared two indicators of inflammation and then examined the diagnostic ability of combined SIRI and AFR values for serious early postoperative complications.We scored the patients and categorized them into three groups based on their SIRI and AFR levels.COX analysis was used to compare the three groups of patients the prognostic value of various preoperative SIRI-AFR scores for 5-year overall survival(OS)and disease-free survival(DFS).RESULTS SIRI-AFR scores were an independent risk factor for prognosis[OS:P=0.004;hazards ratio(HR)=3.134;DFS:P<0.001;HR=3.543]and had the highest diagnostic power(area under the curve:0.779;95%confidence interval:0.737-0.820)for early serious complications in patients with gastric cancer.The tumor-node-metastasis stage(P=0.001),perioperative transfusion(P=0.044),positive carcinoembryonic antigen(P=0.014)findings,and major postoperative complications(P=0.011)were factors associated with prognosis.CONCLUSION Preoperative SIRI and AFR values were significantly associated with early postoperative survival and the occurrence of severe complications in gastric cancer patients.展开更多
Natural slopes usually display complicated exposed rock surfaces that are characterized by complex and substantial terrain undulation and ubiquitous undesirable phenomena such as vegetation cover and rockfalls.This st...Natural slopes usually display complicated exposed rock surfaces that are characterized by complex and substantial terrain undulation and ubiquitous undesirable phenomena such as vegetation cover and rockfalls.This study presents a systematic outcrop research of fracture pattern variations in a complicated rock slope,and the qualitative and quantitative study of the complex phenomena impact on threedimensional(3D)discrete fracture network(DFN)modeling.As the studies of the outcrop fracture pattern have been so far focused on local variations,thus,we put forward a statistical analysis of global variations.The entire outcrop is partitioned into several subzones,and the subzone-scale variability of fracture geometric properties is analyzed(including the orientation,the density,and the trace length).The results reveal significant variations in fracture characteristics(such as the concentrative degree,the average orientation,the density,and the trace length)among different subzones.Moreover,the density of fracture sets,which is approximately parallel to the slope surface,exhibits a notably higher value compared to other fracture sets across all subzones.To improve the accuracy of the DFN modeling,the effects of three common phenomena resulting from vegetation and rockfalls are qualitatively analyzed and the corresponding quantitative data processing solutions are proposed.Subsequently,the 3D fracture geometric parameters are determined for different areas of the high-steep rock slope in terms of the subzone dimensions.The results show significant variations in the same set of 3D fracture parameters across different regions with density differing by up to tenfold and mean trace length exhibiting differences of 3e4 times.The study results present precise geological structural information,improve modeling accuracy,and provide practical solutions for addressing complex outcrop issues.展开更多
BACKGROUND Colorectal cancer is a major global health challenge that predominantly affects older people.Surgical management,despite advancements,requires careful consideration of preoperative patient status for optima...BACKGROUND Colorectal cancer is a major global health challenge that predominantly affects older people.Surgical management,despite advancements,requires careful consideration of preoperative patient status for optimal outcomes.AIM To summarize existing evidence on the association of frailty with short-term postoperative outcomes in patients undergoing colorectal cancer surgery.METHODS A literature search was conducted using PubMed,EMBASE and Scopus databases for observational studies in adult patients aged≥18 years undergoing planned or elective colorectal surgery for primary carcinoma and/or secondary metastasis.Only studies that conducted frailty assessment using recognized frailty assess-ment tools and had a comparator group,comprising nonfrail patients,were included.Pooled effect sizes were reported as weighted mean difference or relative risk(RR)with 95%confidence intervals(CIs).RESULTS A total of 24 studies were included.Compared with nonfrail patients,frailty was associated with an increased risk of mortality at 30 d(RR:1.99,95%CI:1.47-2.69),at 90 d(RR:4.76,95%CI:1.56-14.6)and at 1 year(RR:5.73,95%CI:2.74-12.0)of follow up.Frail patients had an increased risk of any complications(RR:1.81,95%CI:1.57-2.10)as well as major complications(Clavien-Dindo classification grade≥III)(RR:2.87,95%CI:1.65-4.99)compared with the control group.The risk of reoperation(RR:1.18,95%CI:1.07-1.31),readmission(RR:1.70,95%CI:1.36-2.12),need for blood transfusion(RR:1.67,95%CI:1.52-1.85),wound complications(RR:1.49,95%CI:1.11-1.99),delirium(RR:4.60,95%CI:2.31-9.16),risk of prolonged hospitalization(RR:2.09,95%CI:1.22-3.60)and discharge to a skilled nursing facility or rehabilitation center(RR:3.19,95%CI:2.0-5.08)was all higher in frail patients.CONCLUSION Frailty in colorectal cancer surgery patients was associated with more complications,longer hospital stays,higher reoperation risk,and increased mortality.Integrating frailty assessment appears crucial for tailored surgical management.展开更多
BACKGROUND The optimal approach for managing hepatic hemangioma is controversial.AIM To evaluate a clinical grading system for management of hepatic hemangioma based on our 17-year of single institution experience.MET...BACKGROUND The optimal approach for managing hepatic hemangioma is controversial.AIM To evaluate a clinical grading system for management of hepatic hemangioma based on our 17-year of single institution experience.METHODS A clinical grading system was retrospectively applied to 1171 patients with hepatic hemangioma from January 2002 to December 2018.Patients were classified into four groups based on the clinical grading system and treatment:(1)Observation group with score<4(Obs score<4);(2)Surgical group with score<4(Sur score<4);(3)Observation group with score≥4(Obs score≥4);and(4)Surgical group with score≥4(Sur score≥4).The clinico-pathological index and outcomes were evaluated.RESULTS There were significantly fewer symptomatic patients in surgical groups(Sur score≥4 vs Obs score≥4,P<0.001;Sur score<4 vs Obs score<4,χ^(2)=8.60,P=0.004;Sur score≥4 vs Obs score<4,P<0.001).The patients in Sur score≥4 had a lower rate of in need for intervention and total patients with adverse event than in Obs score≥4(P<0.001;P<0.001).Nevertheless,there was no significant difference in need for intervention and total patients with adverse event between the Sur score<4 and Obs score<4(P>0.05;χ^(2)=1.68,P>0.05).CONCLUSION This clinical grading system appeared as a practical tool for hepatic hemangioma.Surgery can be suggested for patients with a score≥4.For those with<4,follow-up should be proposed.展开更多
文摘Fractal characters and fractal dimension of time series created by repeller in complicated system were studied and the time series were reconstructed by applying the theory of phase space reconstruction for chaotic time series. The influence of zero_mean treatment, Fourier filter on prediction for time series were studied. The choice of prediction sample affects the relative error and the prediction length which were also under good concern. The results show that the model provided here are practical for the modeling and prediction of time series created by chaotic repellers. Zero_mean treatment has changed prediction result quantitatively for chaotic repeller sample data. But using Fourier filter may decrease the prediction precision. This is theoretical and practical for study on chaotic repeller in complicated system.
文摘The paper analyzed characters of complicated system and discussed the reason of comprehensive evaluation, realization of flexible comprehensive evaluation was researched from prospect of dynamic measure selection of evaluation, balance of functionality and harmony, uncertainty factor. In the end, multistage flexible comprehensive evaluation of complicated system was applied to performance evaluation of firm.
基金Supported by 2021 Disciplinary Construction Project in School of Dentistry,Anhui Medical University,No.2021kqxkFY05.
文摘BACKGROUND Complicated crown–root fracture (CRF) involves severe injury to the crown, root,and pulp, and may be accompanied by multiple root fractures. The loss of a toothhas lifelong consequences for children and teenagers, but the maintenance of pulphealth and the calcific healing of multiple root fractures are rarely reported in theliterature.CASE SUMMARY This case reports healing of a permanent tooth with complicated crown–root andadditional root fractures, in which pulp health was maintained. A 10-year-old girlfell and fractured the root of her maxillary left central incisor at the cervical level.After the coronal fragment was repositioned, the tooth was splinted until thetooth was no longer mobile, 2 years later. Eight years after treatment, the toothhas remained asymptomatic with vital pulp and localized gingival overgrowth.Cone-beam computed tomography revealed not only calcified healing of the CRFbut also spontaneous healing in an additional undiagnosed root fracture. Thefracture line on the enamel could not be healed by hard tissue and formed agroove in the cervical crown. It was speculated that the groove was related to thelocalized gingival overgrowth.CONCLUSION This case provides a clinical perspective of the treatment of a tooth with acomplicated CRF and an additional root fracture.
文摘BACKGROUND Ventriculoperitoneal shunt(VPS)catheter insertion is one of the most widely accepted surgical procedures for hydrocephalus.Migration of the end of the distal VPS catheter into the scrotum is one of the rare complications of VPS catheter insertion.METHODS This is a systematic review of the published cases,and the literature search was performed from 1974 to June 30,2024,to retrieve the relevant manuscripts.The cases were grouped into two.Group A included cases of migration of the distal VPS catheter into the scrotum,detected in children.Group B included the cases of migration of the distal VPS catheter into the scrotum,which was detected in adults and older people.RESULTS One hundred-twenty cases of migration of the distal end of VPS catheter into the scrotum were included in this study,a systematic literature review.Group A included n=112 cases,and group B included n=8 cases only.Three-fourths of the cases involved the right scrotum.Bilateral involvement was rare.The indication for initial VPS insertion was congenital hydrocephalus in four-fifths of the group A cases.The majority were infants at the time of initial shunt insertion.Four-fifths of the group A cases were 24 months-old or younger at the time of clinical diagnosis and treatment was provided for migration of the distal VPS catheter into the scrotum.In children,the interval from VPS insertion or shunt revision if any,to the diagnosis of the complication mentioned above was 12 months or less in four-fifths of the cases.The repositioning of migrated distal VPS catheter into the peritoneal cavity and herniotomy was preferred for the surgical procedure,and it was performed for two-thirds of group A cases.CONCLUSION Migration of the distal part of the VPS catheter into the scrotum is a rare complication of cerebrospinal fluid diversion via VPS catheter insertion.It was most frequent in children,and the right side of the scrotum was most often involved.
基金Beijing Municipal Administration of Hospitals Incubating Program,No.PZ20200272018 Beijing Talent Incubating Funding,No.2018-4+3 种基金National Natural Science Foundation of China,No.81773214Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support,No.ZYLX202116the National Key R&D Program of China,No.2021YFF1201104Science Foundation of Peking University Cancer Hospital-2023,No.JC202310.
文摘BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related complications in colorectal cancer patients who underwent stoma creation.METHODS Patients with stoma was prospectively recorded in the established stoma system.Data was collected from this stoma management system from November 2021 through May 2024.The rates of stoma-related complications were assessed,and potential risk factors were analyzed using univariate and multivariate logistic regression models.RESULTS A total of 734 patients were included in the analysis.The results showed that 12.3%of patients experienced stoma-related complications,with mucocutaneous separation,edema,and skin excoriation being the most common complications.The majority(90%)of complications were classified as grade 2 according to the Clavien-Dindo classification.Surgical factors,such as blood loss volume greater than 500 mL and open surgery,were significantly associated with stoma complications.Additionally,stoma features like location,shape,color,height,and edema were important factors in the association with complications.Body mass index over 30 kg/m²was also found to be a significant risk factor.CONCLUSION These findings highlight the need for a holistic approach to preventing and managing stoma complications,considering both patient-related and surgical factors.
基金funded by the Seed Funding of the Beijing University of Chinese Medicine(90011451310034).
文摘Objective:To evaluate the efficacy and safety of traditional Chinese exercises(TCE)in patients with diabetic peripheral neuropathy(DPN)and to recommend best practices for using TCE to improve neurological function,glycemic control,and psychological well-being.Methods:Nine databases were searched from the inception to October 2024.Effect relationships were assessed using meta-analysis with Stata 17,and the methodological quality and certainty of the evidence were evaluated using standard tools.Results:Twelve studies comprising three study designs(nine randomized controlled,one quasi-exper-imental controlled,and two single-arm clinical trials),were identified.Compared with usual care,TCE improved various indicators and enhanced the nerve conduction velocities of the peroneal motor(mean difference[MD]=3.86 m/s,95%confidence interval[CI]:0.38 to 7.34,P=0.03),sural sensory(MD=4.15 m/s,95%CI:0.68 to 7.63,P=0.02),median motor(MD=3.84 m/s,95%CI:2.14 to 5.54,P<.001),and median sensory nerves(MD=6.14 m/s,95%CI:4.54 to 7.74,P<.001).TCE practices also reduced glycosylated hemoglobin level(MD=-0.59%,95%CI:-0.91 to-0.27,P<.001)and fasting blood glucose(standardized mean difference[SMD]=-1.08,95%CI:-1.79 to-0.37,P<.001).The overall quality of evidence was very low.Conclusion:The results indicate that TCE therapy improves certain outcomes in patients with DPN.Although the optimal type,intensity,frequency,and duration of TCE interventions are uncertain,these preliminary findings suggest that TCE should be further studied as a potentially affordable and effective treatment for DPN.
文摘BACKGROUND Colon cancer is one of the most common malignancies of the digestive tract,often complicated by intestinal obstruction,which can significantly impact patient outcomes.While traditional laparotomy is the standard treatment,it is associated with large wounds,slower recovery,and higher complication rates.Laparoscopic surgery,a minimally invasive approach,may offer better outcomes for these patients.AIM To evaluate the clinical effects and prognosis of laparoscopic surgery in patients with colon cancer complicated by intestinal obstruction compared to traditional laparotomy.METHODS A retrospective analysis was conducted on 100 patients diagnosed with colon cancer and intestinal obstruction who underwent surgical treatment between January 2020 and December 2022.Patients were divided into two groups:The control group(CG),treated with traditional laparotomy,and the observation group(OG),treated with laparoscopic surgery.Clinical effects,surgical indicators,postoperative pain,inflammatory response,complication rates,quality of life,and prognosis were assessed and compared between the two groups.RESULTS The OG showed superior clinical outcomes compared to the CG(P<0.05).Patients in the OG had shorter operation times,reduced intraoperative blood loss,faster recovery of intestinal function,earlier mobilization,and shorter hospital stays(P<0.05).Postoperative pain(numerical rating scale scores)and inflam-matory markers[tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]were lower in the OG(P<0.05).The incidence of complic-ations was significantly reduced in the OG(6.00%vs 22.00%,P<0.05).Quality of life scores,including physical function,psychological state,social communication,and self-care ability,were significantly higher in the OG(P<0.05).There were no significant differences between groups in abdominal drainage volume,1-year tumor recurrence or metastasis rates,or 1-and 3-year survival rates(P>0.05).CONCLUSION The OG showed superior clinical outcomes compared to the CG(P<0.05).Patients in the OG had shorter operation times,reduced intraoperative blood loss,faster recovery of intestinal function,earlier mobilization,and shorter hospital stays(P<0.05).Postoperative pain(NRS scores)and inflammatory markers(TNF-α,IL-6,CRP)were lower in the OG(P<0.05).The incidence of complications was significantly reduced in the OG(6.00%vs 22.00%,P<0.05).Quality of life scores,including physical function,psychological state,social communication,and self-care ability,were significantly higher in the OG(P<0.05).There were no significant differences between groups in abdominal drainage volume,1-year tumor recurrence or metastasis rates,or 1-and 3-year survival rates(P>0.05).
文摘BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is a highly effective treat-ment for complications associated with portal hypertension.However,stent fracture,although extremely rare,represents a potentially serious complication following TIPS creation.Timely identification and management are crucial for preventing further adverse events.CASE SUMMARY We report a 56-year-old male patient who underwent a TIPS procedure for re-current melena caused by portal hypertension secondary to hepatitis B and experienced a stent fracture 15 months post-procedure.He was readmitted 30 months after the initial TIPS due to recurrent esophagogastric variceal bleeding and ascites.An attempt to revise the dysfunctional shunt via a stent-in-stent approach was unsuccessful.Consequently,a parallel TIPS procedure was success-fully performed via the proximal end of the fractured stent to decompress the portal venous system.At the 1-month follow-up,the patient exhibited no recur-rent variceal bleeding,and his ascites had significantly decreased.Twelve-month postoperative monitoring revealed no hepatic encephalopathy and no recurrence of bleeding or ascites.Additionally,we review the existing literature on post-TIPS stent fractures to explore the underlying mechanisms contributing to this com-plication.CONCLUSION Early recognition and prompt intervention are essential in managing stent fractures after TIPS creation to mitigate potential risks and ensure optimal patient outcomes.
文摘Liver cancer presents unique challenges due to its systemic impact and complex treatment modalities.Patients often experience a range of complications,including cardiovascular,renal,hematological,and metabolic abnormalities,which can significantly affect treatment outcomes and quality of life.This article emphasizes the integration of multidisciplinary strategies and artificial intelligence-driven diagnostics,which have the potential to improve patient outcomes by optimizing early detection and targeted management of these complications.A recent study on 60 liver cancer patients undergoing interventional therapy highlighted the importance of recognizing and managing these complications.This article offers an overview of systemic complications in liver cancer,focusing on pathophysiological mechanisms,risk factors,and strategies to improve care.By addressing gaps in the existing literature and proposing future research directions,it underscores the importance of comprehensive,patient-centered approaches to refine therapeutic strategies.
基金funded by grants from the National Key Research and Development Program of China(2022YFD1801900)National Natural Science Foundation of China(32272976&32302848)+3 种基金Sichuan Provincial Department of Science and Technology international scientific and technological innovation cooperation(2022YFH0026)the earmarked fund for China Agricultural Research System(CARS-42-17)Program Sichuan Veterinary Medicine and Drug Innovation Group of China Agricultural Research System(SCCXTD-2021-18)the Innovation and Demonstration of Industry and Education Integration in Feed Industrial Chain Transformation and Upgradation,Sichuan Province,China.
文摘Dear Editor,For the past few decades,mosquito-borne orthoflaviviruses,such as dengue virus,Zika virus,and West Nile virus(WNV),have posed significant threats to global public health.The Orthoflavivirus genus comprises more than 70 viruses,many of which are responsible for a wide range of diseases in humans and animals,including febrile illnesses,encephalitis,and hemorrhagic febrile illness.These viruses are associated with approximately 400 million infections and 100 million symptomatic cases worldwide each year(Van Leur et al.,2021).Among them,Usutu virus(USUV)is an emerging pathogen classified alongside WNV within the Japanese encephalitis virus(JEV)serogroup of the Orthoflavivirus genus,the Flaviviridae family.USUV has spread from Africa to Europe since the late 20th century.It primarily causes central nervous system disorders in birds,with several large-scale mortality events recorded in Europe.USUV can also infect humans,it typically leads to neurological complications in rare cases(Roesch et al.,2019).
文摘BACKGROUND Stomal complications though small in early postoperative period,but poses significant morbidity,therapeutic challenge,delay in adjuvant treatment and sometimes even leads to mortality.Predictive model for early detection of stomal complications is important to improve the outcome.A model including patients and disease related factors,intraoperative surgical techniques and biochemical markers would be a better determinant to anticipate early stomal complications.Incorporation of emerging tools and technology such as artificial intelligence(AI),will further improve the prediction.AIM To identify various risk factors and models for prediction of early post operative stomal complications in colorectal cancer(CRC)surgery.METHODS Published literatures on early postoperative stomal complications in CRC surgery were systematically reviewed between 1995 and 2024 from online search engines PubMed and MEDLINE.RESULTS Twenty-four observational studies focused on identifying various risk factors for early post operative stomal complications in CRC surgery were analyzed.Stomal complications in CRC are influenced by several factors such as disease factors,patient-specific characteristics,and surgical techniques.There are some biomarkers and tools loke AI which may play significant roles in early detection.CONCLUSION Careful analysis of these factors,changes in biochemical parameters,and application of AI,a predictive model for stomal complications can be generated,to help in early detection,prompt action to achieve better outcomes.
基金Supported by the Natural Science Foundation of Hunan Province,China,No.2023JJ30842.
文摘BACKGROUND Hepatitis B virus(HBV)infection can lead to renal involvement,commonly manifested as HBV-associated glomerulonephritis(HBV-GN),which typically presents as nephrotic or nephritic syndrome.Antineutrophil cytoplasmic antibody-associated vasculitis(AAV)is a systemic disease characterized by immune necrotizing inflammation of small blood vessels involving multiple organs with complex and severe clinical implications.The coexistence of HBV-GN and AAV is sporadic,with limited data existing regarding its diagnosis,management,clinical outcomes,and prognosis,especially in patients with AAV.CASE SUMMARY This manuscript presents the case of an older male patient who presented with persistent foamy urine lasting over two weeks.Initial clinical findings included nephrotic syndrome and renal insufficiency,which subsequently progressed to involve the lungs,immune system,hematologic system,and other organ systems.The patient was diagnosed with HBV-GN complicated by AAV,a rare and complex condition.Despite receiving comprehensive treatment,including corticosteroids,cyclophosphamide for immune regulation,plasma exchange,and immunoadsorption targeting antineutrophil cytoplasmic antibody-associated antibodies,the patient required long-term dialysis and demonstrated a poor prognosis.CONCLUSION HBV infection may trigger nephropathy with AAV.Early recognition and intervention are crucial for improving patient prognosis.
文摘Background: Surgical treatment of lumbar disc herniation is a widely debated topic, with several techniques available. Percutaneous endoscopic discectomy (PELD) has gained popularity due to its lower invasiveness compared to conventional techniques such as microdiscectomy/open lumbar microdiscectomy (OLMD)/tubular microdiscectomy (TMD). However, evidence on the effectiveness, recovery time and complications of these techniques is not yet clearly established. This systematic review aims to compare the preoperative and postoperative outcomes of both techniques. Methods: A comprehensive search was performed in databases including PubMed and Cochrane, following strict inclusion and exclusion criteria. Comparative studies and narrative reviews on PELD and OLMD/TMD published between 2019 and 2024 were included. Key outcomes considered were pre- and postoperative Visual Analogue Scale (VAS), hospitalization time, time to return to work, and postoperative complications. Results: The reviewed studies indicated that PELD is associated with a greater reduction in postoperative pain compared to OLMD/TMD, with a significant decrease in VAS, according to the study by Priola et al. (2019). The hospital stay was also shorter for patients undergoing PELD, averaging 2 days compared to OLMD/TMD. Furthermore, PELD favored a faster return to work and had a lower rate of postoperative complications, such as dural tears and reoperations, compared to OLMD/TMD. Conclusions: PELD demonstrates clear advantages over OLMD/TMD in terms of pain reduction, shorter hospital stay, faster return to work, and fewer postoperative complications. However, the implementation of this technique requires a significant learning curve, suggesting that its effectiveness may vary depending on the surgeon’s experience. PELD should be considered a preferred option in the resection of lumbar disc herniations, especially in patients seeking a quick and less invasive recovery.
文摘Based on the work discussed on the former study, this article first starts from the mathematical model of a kind of complicated financial system, and analyses all possible things that the model shows in the operation of our country's macro_financial system: balance, stable periodic, fractal, Hopf_bifurcation, the relationship between parameters and Hopf_bifurcation, and chaotic motion etc. By the changes of parameters of all economic meanings, the conditions on which the complicated behaviors occur in such a financial system, and the influence of the adjustment of the macro_economic policies and adjustment of some parameter on the whole financial system behavior have been analyzed. This study will deepen people's understanding of the lever function of all kinds of financial policies.
文摘Based on the work discussed on the former study, this article first starts from the mathematical model of a kind of complicated financial system, and analyses all possible things that the model shows in the operation of our country's macro_financial system: balance, stable periodic, fractal, Hopf_bifurcation, the relationship between parameters and Hopf_bifurcation, and chaotic motion etc. By the changes of parameters of all economic meanings, the conditions on which the complicated behaviors occur in such a financial system, and the influence of the adjustment of the macro_economic policies and adjustment of some parameter on the whole financial system behavior have been analyzed. This study will deepen people's understanding of the lever function of all kinds of financial policies.
基金Supported by the Youth Science Fundation of Chinese Academia SinicaYouth Fundation of Lanzhou Unviersity
文摘This paper is a further study of reference [1]. In this paper, we mainly discuss the complicated dynamical behaviors resulting from a simple one-dimensional model of nonlinear ecosystems: fixed point motion, periodic motion and chaotic motion etc., and briefly discuss the universality of the complicated dynamical behaviors, which can be described by the first and the second M. Feigenbaun. constants. At last, we discuss the 'one-side lowering phenomenon' due to near unstabilization when the nonlinear ecosystem approaches bifurcation points from unbifurcation side. It is of important theoretical and practical meanings both in the development and utilization of ecological resources ar.d in the design and management of artifilial ecosystems.
基金the National Natural Science Foundation of China,No.8236110677Central to guide local scientific and Technological Development,No.ZYYDDFFZZJ-1+1 种基金Natural Science Foundation of Gansu Province,China,No.18JR2RA033Gansu Da Vinci Robot High-End Diagnosis and Treatment Team Construction Project,National Key Research and Development Program,No.2020RCXM076.
文摘BACKGROUND Gastric cancer has a high incidence and fatality rate,and surgery is the preferred course of treatment.Nonetheless,patient survival rates are still low,and the incidence of major postoperative complications cannot be disregarded.The systemic inflammatory response,nutritional level,and coagulation status are key factors affecting the postoperative recovery and prognosis of gastric cancer patients.The systemic inflammatory response index(SIRI)and the albumin fibrinogen ratio(AFR)are two valuable comprehensive indicators of the severity and prognosis of systemic inflammation in various medical conditions.AIM To assess the clinical importance and prognostic significance of the SIRI scores and the AFR on early postoperative outcomes in patients undergoing radical gastric cancer surgery.METHODS We conducted a retrospective analysis of the clinicopathological characteristics and relevant laboratory indices of 568 gastric cancer patients from January 2018 to December 2019.We calculated and compared two indicators of inflammation and then examined the diagnostic ability of combined SIRI and AFR values for serious early postoperative complications.We scored the patients and categorized them into three groups based on their SIRI and AFR levels.COX analysis was used to compare the three groups of patients the prognostic value of various preoperative SIRI-AFR scores for 5-year overall survival(OS)and disease-free survival(DFS).RESULTS SIRI-AFR scores were an independent risk factor for prognosis[OS:P=0.004;hazards ratio(HR)=3.134;DFS:P<0.001;HR=3.543]and had the highest diagnostic power(area under the curve:0.779;95%confidence interval:0.737-0.820)for early serious complications in patients with gastric cancer.The tumor-node-metastasis stage(P=0.001),perioperative transfusion(P=0.044),positive carcinoembryonic antigen(P=0.014)findings,and major postoperative complications(P=0.011)were factors associated with prognosis.CONCLUSION Preoperative SIRI and AFR values were significantly associated with early postoperative survival and the occurrence of severe complications in gastric cancer patients.
基金supported by the National Key Research and Development Program of China(Grant No.2022YFC3080200)the National Natural Science Foundation of China(Grant No.42022053)the China Postdoctoral Science Foundation(Grant No.2023M731264).
文摘Natural slopes usually display complicated exposed rock surfaces that are characterized by complex and substantial terrain undulation and ubiquitous undesirable phenomena such as vegetation cover and rockfalls.This study presents a systematic outcrop research of fracture pattern variations in a complicated rock slope,and the qualitative and quantitative study of the complex phenomena impact on threedimensional(3D)discrete fracture network(DFN)modeling.As the studies of the outcrop fracture pattern have been so far focused on local variations,thus,we put forward a statistical analysis of global variations.The entire outcrop is partitioned into several subzones,and the subzone-scale variability of fracture geometric properties is analyzed(including the orientation,the density,and the trace length).The results reveal significant variations in fracture characteristics(such as the concentrative degree,the average orientation,the density,and the trace length)among different subzones.Moreover,the density of fracture sets,which is approximately parallel to the slope surface,exhibits a notably higher value compared to other fracture sets across all subzones.To improve the accuracy of the DFN modeling,the effects of three common phenomena resulting from vegetation and rockfalls are qualitatively analyzed and the corresponding quantitative data processing solutions are proposed.Subsequently,the 3D fracture geometric parameters are determined for different areas of the high-steep rock slope in terms of the subzone dimensions.The results show significant variations in the same set of 3D fracture parameters across different regions with density differing by up to tenfold and mean trace length exhibiting differences of 3e4 times.The study results present precise geological structural information,improve modeling accuracy,and provide practical solutions for addressing complex outcrop issues.
基金The authors have read the PRISMA 2009 Checklist,and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
文摘BACKGROUND Colorectal cancer is a major global health challenge that predominantly affects older people.Surgical management,despite advancements,requires careful consideration of preoperative patient status for optimal outcomes.AIM To summarize existing evidence on the association of frailty with short-term postoperative outcomes in patients undergoing colorectal cancer surgery.METHODS A literature search was conducted using PubMed,EMBASE and Scopus databases for observational studies in adult patients aged≥18 years undergoing planned or elective colorectal surgery for primary carcinoma and/or secondary metastasis.Only studies that conducted frailty assessment using recognized frailty assess-ment tools and had a comparator group,comprising nonfrail patients,were included.Pooled effect sizes were reported as weighted mean difference or relative risk(RR)with 95%confidence intervals(CIs).RESULTS A total of 24 studies were included.Compared with nonfrail patients,frailty was associated with an increased risk of mortality at 30 d(RR:1.99,95%CI:1.47-2.69),at 90 d(RR:4.76,95%CI:1.56-14.6)and at 1 year(RR:5.73,95%CI:2.74-12.0)of follow up.Frail patients had an increased risk of any complications(RR:1.81,95%CI:1.57-2.10)as well as major complications(Clavien-Dindo classification grade≥III)(RR:2.87,95%CI:1.65-4.99)compared with the control group.The risk of reoperation(RR:1.18,95%CI:1.07-1.31),readmission(RR:1.70,95%CI:1.36-2.12),need for blood transfusion(RR:1.67,95%CI:1.52-1.85),wound complications(RR:1.49,95%CI:1.11-1.99),delirium(RR:4.60,95%CI:2.31-9.16),risk of prolonged hospitalization(RR:2.09,95%CI:1.22-3.60)and discharge to a skilled nursing facility or rehabilitation center(RR:3.19,95%CI:2.0-5.08)was all higher in frail patients.CONCLUSION Frailty in colorectal cancer surgery patients was associated with more complications,longer hospital stays,higher reoperation risk,and increased mortality.Integrating frailty assessment appears crucial for tailored surgical management.
文摘BACKGROUND The optimal approach for managing hepatic hemangioma is controversial.AIM To evaluate a clinical grading system for management of hepatic hemangioma based on our 17-year of single institution experience.METHODS A clinical grading system was retrospectively applied to 1171 patients with hepatic hemangioma from January 2002 to December 2018.Patients were classified into four groups based on the clinical grading system and treatment:(1)Observation group with score<4(Obs score<4);(2)Surgical group with score<4(Sur score<4);(3)Observation group with score≥4(Obs score≥4);and(4)Surgical group with score≥4(Sur score≥4).The clinico-pathological index and outcomes were evaluated.RESULTS There were significantly fewer symptomatic patients in surgical groups(Sur score≥4 vs Obs score≥4,P<0.001;Sur score<4 vs Obs score<4,χ^(2)=8.60,P=0.004;Sur score≥4 vs Obs score<4,P<0.001).The patients in Sur score≥4 had a lower rate of in need for intervention and total patients with adverse event than in Obs score≥4(P<0.001;P<0.001).Nevertheless,there was no significant difference in need for intervention and total patients with adverse event between the Sur score<4 and Obs score<4(P>0.05;χ^(2)=1.68,P>0.05).CONCLUSION This clinical grading system appeared as a practical tool for hepatic hemangioma.Surgery can be suggested for patients with a score≥4.For those with<4,follow-up should be proposed.
