BACKGROUND Hook of hamate fractures occur either due to repetitive stress from gripping sports(e.g.,golf,tennis,and baseball),leading to fatigue fracture,or as a result of trauma from falls or other injuries.The recom...BACKGROUND Hook of hamate fractures occur either due to repetitive stress from gripping sports(e.g.,golf,tennis,and baseball),leading to fatigue fracture,or as a result of trauma from falls or other injuries.The recommended treatment involves the excision of bone fragments to facilitate athletes’early return to sports;excision surgery is also performed in trauma cases.However,some patients prefer nonsurgical treatment options,and conservative treatment should be considered.AIM To present a case series of 16 patients conservatively treated for hook of hamate fractures.METHODS This study included 16(11 males and 5 females;right side,6 cases;left side,10)patients who desired conservative treatment and could be followed-up until bone union was achieved.The average age of the patients was 49.6(range:24-72)years.The average time from injury to consultation was 4.3(range:0.2-21.4)weeks.The treatment involved 4 weeks of casting from the forearm to the metacarpophalangeal joint,followed by 8 weeks of splint fixation of the wrist.Follow-up computed tomography scans were performed every 4 weeks.RESULTS Bone union was achieved in all patients.The average duration of casting was 3.7(range:0-5)weeks and that of splint fixation thereafter was 8.6(range:0-28)weeks.The patients did not exhibit joint contractures or range of motion restrictions due to prolonged immobilization.CONCLUSION Conservative treatment with external fixation may be an option for hook of hamate fractures.展开更多
This commentary evaluates the case report by Mohammed et al on conservative management of ischiofemoral impingement through a multimodal physical therapy program integrating in-person sessions,telerehabilitation,dry n...This commentary evaluates the case report by Mohammed et al on conservative management of ischiofemoral impingement through a multimodal physical therapy program integrating in-person sessions,telerehabilitation,dry needling,and kinesiology taping.The study demonstrated significant pain reduction and functional improvement,highlighting the feasibility of hybrid care models.However,limitations include short-term follow-up,lack of post-treatment imaging,and single-case design restricting generalizability.Future research should prioritize longitudinal studies,anatomical correlation via imaging,and randomized trials to validate efficacy across diverse populations.While the framework offers promising clinical utility,further investigation is critical to optimize protocols and elucidate biomechanical mechanisms underlying symptom resolution.展开更多
This editorial critically evaluates the landmark study by Tanaka and Yoshii,which demonstrated a 100%union rate with conservative management of hamate hook fractures,challenging the historical preference for surgical ...This editorial critically evaluates the landmark study by Tanaka and Yoshii,which demonstrated a 100%union rate with conservative management of hamate hook fractures,challenging the historical preference for surgical intervention.In contrast to Scheufle et al’s report of 90%-100%failure rates with early surgical approaches,Tanaka and Yoshii’s protocol achieved universal healing despite delayed diagnoses in 25%of cases.Central to this success is the systematic inte-gration of high-resolution computed tomography for early diagnosis and dynamic monitoring of trabecular bone regeneration,significantly reducing missed dia-gnoses and guiding personalized immobilization timelines.The patient-centered strategy—allowing temporary splint removal during low-risk activities—balanced fracture stability with joint mobility preservation,avoiding post-treatment stiff-ness.However,limitations such as small sample size(n=16),selection bias,and insufficient long-term functional data(e.g.,grip strength,return-to-sport metrics)underscore the need for comparative trials.Emerging trends,including adjunct therapies like low-intensity pulsed ultrasound and biologics(e.g.,teriparatide),are proposed to accelerate healing while minimizing immobilization risks.This work redefines conservative fracture management paradigms,emphasizing in-novation without compromising efficacy.Overall,this assessment deepens our understanding of the conservative management of hook fractures and provides evidence-based insights for improved clinical decision-making.展开更多
BACKGROUND Enterocutaneous(EC)fistula incidence has been increasing in China,along with increases in the volume and complexity of surgeries.The conservative treatment strategy has been analyzed to improve the treatmen...BACKGROUND Enterocutaneous(EC)fistula incidence has been increasing in China,along with increases in the volume and complexity of surgeries.The conservative treatment strategy has been analyzed to improve the treatment outcomes for patients with EC fistulas and reduce the need for reoperation.AIM To analyze the clinical data of patients undergoing conservative treatment for EC fistulas and identify the factors that promote self-healing.These findings provide a reference for improving the clinical cure rate of EC fistulas with conservative treatment.METHODS The clinical data of 91 patients with EC fistulas who underwent conservative treatment were collected.The relationships between the cure rate and characteristics such as age,sex,body mass index,albumin level,primary disease,cause of the fistula,location of the fistula,number of fistulas,nature of the fistula,infection status,diagnostic methods,nutritional support methods,somatostatin therapy,growth hormone therapy,and fibrin glue therapy were analyzed.RESULTS A comparison of the basic patient characteristics between the two groups revealed statistically significant differences in primary disease(P=0.044),location of the fistula(P=0.006),number of fistulas(P=0.007),and use of adhesive sealing(χ2=12.194,P<0.001)between the uncured and cured groups.The use of fibrin glue was a significant factor associated with a cure for fistulas(odds ratio=5.459,95%CI:1.958-15.219,P=0.01).CONCLUSION The cure rate of patients with a single EC fistula can be effectively improved via conservative treatment combined with the use of biological fibrin glue to seal the fistula.展开更多
BACKGROUND Emphysematous gastritis(EG)is a rare and serious condition that has fatal consequences.Although its clinical presentation is not specific,radiological imaging is characterized by intramural gastric gas.Defe...BACKGROUND Emphysematous gastritis(EG)is a rare and serious condition that has fatal consequences.Although its clinical presentation is not specific,radiological imaging is characterized by intramural gastric gas.Defects in the stomach mucosal barrier and invasion of gas-producing organisms are believed to be the cause.CASE SUMMARY An 88-year-old male with multiple comorbidities presented to our center with abdominal pain and increased stoma output as chief complaints.Upon further investigation he was found to have EG.Despite the high mortality risk without intervention,the patient and family declined operative intervention.CONCLUSION This case report underscored the challenges of managing a critically ill elderly patient with a history of multiple comorbidities and extensive abdominal surgeries and highlighted the successful use of conservative measures in treating EG.展开更多
Objective:Acute appendicitis,as a common clinical acute abdominal condition,has a significant impact on patient prognosis depending on the choice of treatment strategy.This study aims to systematically compare the cli...Objective:Acute appendicitis,as a common clinical acute abdominal condition,has a significant impact on patient prognosis depending on the choice of treatment strategy.This study aims to systematically compare the clinical efficacy and safety of surgical versus conservative treatment in patients with acute appendicitis.Methods:A total of 60 patients with acute appendicitis admitted to our hospital from August 2024 to July 2025 were selected as the study subjects and divided into a surgical group(n=30)and a conservative group(n=30)based on the treatment approach.The surgical group underwent abdominal incision appendectomy,while the conservative group received antibiotic therapy combined with symptomatic supportive treatment.Evaluation indicators included the treatment effective rate,symptom relief time,and complication incidence.Results:The treatment effective rate in the surgical group was 96.67%,significantly higher than that in the conservative group(76.67%)(p<0.05).In terms of symptom relief,the time to relief of abdominal pain(1.25±0.36 days)and fever(1.08±0.29 days)in the surgical group was significantly shorter than that in the conservative group(3.12±0.57 days and 2.89±0.61 days,respectively,p<0.001).The complication rates in the two groups were 10.00%and 13.33%,respectively(p>0.05).Conclusion:Surgical treatment for acute appendicitis demonstrates significant advantages in improving treatment efficacy and shortening the time to symptom relief,with a comparable risk of complications to conservative treatment.It is therefore worthy of clinical priority recommendation,particularly for patients without surgical contraindications.展开更多
In this paper,we develop a fourth-order conservative wavelet-based shock-capturing scheme.The scheme is constructed by combining a wavelet collocation upwind method with the monotonic tangent of hyperbola for interfac...In this paper,we develop a fourth-order conservative wavelet-based shock-capturing scheme.The scheme is constructed by combining a wavelet collocation upwind method with the monotonic tangent of hyperbola for interface capturing(THINC)technique.We employ boundary variation diminishing(BVD)reconstruction to enhance the scheme’s effectiveness in handling shocks.First,we prove that wavelet collocation upwind schemes based on interpolating wavelets can be reformulated into a conservative form within the framework of wavelet theory,forming the foundation of the proposed scheme.The new fourthorder accurate scheme possesses significantly better spectral resolution than the fifth-and even seventh-order WENO-Z(weighted essentially non-oscillatory)schemes over the entire wave-number range.Moreover,the inherent low-pass filtering property of the wavelet bases allows them to filter high-frequency numerical oscillations,endowing the wavelet upwind scheme with robustness and accuracy in solving problems under extreme conditions.Notably,due to the wavelet multiresolution approximation,the proposed scheme possesses a distinctive shape-preserving property absent in the WENO-Z schemes and the fifth-order schemes with BVD reconstruction based on polynomials.Furthermore,compared to the fifth-order scheme with BVD reconstruction based on polynomials—which is significantly superior to the WENO schemes—the proposed scheme further enhances the ability to capture discontinuities.展开更多
BACKGROUND Osteonecrosis of the femoral head(ONFH)is a prevalent clinical condition,and as the affected population becomes younger and more widespread,an increasing number of patients prefer to retain their own hip jo...BACKGROUND Osteonecrosis of the femoral head(ONFH)is a prevalent clinical condition,and as the affected population becomes younger and more widespread,an increasing number of patients prefer to retain their own hip joints.In comparison to joint replacement and hip-preserving surgeries,conservative hip preservation treatment is gaining more recognition from both clinicians and patients.AIM To observe the clinical efficacy and influencing factors of conservative hip preservation treatment for patients with ONFH.METHODS A total of 73 patients(119 hips)were included,and patients were grouped based on Association Research Circulation Osseous(ARCO)stage,Japanese Investigation Committee(JIC)classification,lesion size,and collapse degree.The clinical efficacy of conservative hip preservation treatment was evaluated from two aspects:Radiological progression and clinical functional scores[Harris Hip Score,Western Ontario and McMaster Universities Arthritis Index(WOMAC),international Hip Outcome Tool 12(iHOT-12),and visual analogue scale(VAS)].Analyzing the success rate of conservative hip preservation based on conversion to total hip arthroplasty or hip preservation surgery.RESULTS In this retrospective cohort study,we retrospectively analyzed 73 patients(119 hips)with an average follow-up time of 53.58±26.80(18-129)months.The overall success rate of hip preservation is 90.76%.The success rates of hip preservation in ARCO I-II,IIIa,and IIIb were 97.67%,91.53%,and 70.59%,respectively(P<0.05).The success rates of hip preservation for JIC A-B,C1,and C2 were 93.37%,92.59%,and 77.78%,respectively(P<0.05).The success rates of hip preservation with collapse degree≤2 mm and>2 mm were 94.12%and 70.59%,respectively(P<0.05).There was no significant difference in the success rate of hip preservation between different lesion sizes.In terms of clinical function,the Harris Hip Score,WOMAC,iHOT-12,and VAS scores at the last follow-up were significantly better than before treatment(P<0.05).The VAS scores of ARCO IIIa and IIIb were significantly worse than those of ARCO I and II(P<0.05).The iHOT-12,WOMAC,and VAS scores were significantly better with the lesion size<15%(P<0.05).In terms of radiological results,there was significant progress in ARCO staging and collapse degree after conservative hip preservation treatment,but there was no significant difference in JIC classification and lesion size.CONCLUSION Conservative hip preservation treatment can effectively treat ONFH,prevent the progression of the necrosis,and significantly improve the clinical function of patients.The radiological staging and lesion size at the initial visit may help determine the prognosis of conservative hip preservation treatment.展开更多
This paper presents both analytical and numerical studies of the conservative Sawada-Kotera equation and its dissipative generalization,equations known for their soliton solutions and rich chaotic dynamics.These model...This paper presents both analytical and numerical studies of the conservative Sawada-Kotera equation and its dissipative generalization,equations known for their soliton solutions and rich chaotic dynamics.These models offer valuable insights into nonlinear wave propagation,with applications in fluid dynamics and materials science,including systems such as liquid crystals and ferrofluids.It is shown that the conservative Sawada-Kotera equation supports traveling wave solutions corresponding to elliptic limit cycles,as well as two-and three-dimensional invariant tori surrounding these cycles in the associated ordinary differential equation(ODE)system.For the dissipative generalized Sawada-Kotera equation,chaotic wave behavior is observed.The transition to chaos in the corresponding ODE systemfollows a universal bifurcation scenario consistent with the framework established by FShM(Feigenbaum-Sharkovsky-Magnitskii)theory.Notably,this study demonstrates for the first time that the conservative Sawada-Kotera equation can exhibit complex quasi-periodic wave solutions,while its dissipative counterpart admits an infinite number of stable periodic and chaotic waveforms.展开更多
The work presents new methods for selecting adaptive artificial viscosity(AAV)in iterative algorithms of completely conservative difference schemes(CCDS)used to solve gas dynamics equations in Euler variables.These me...The work presents new methods for selecting adaptive artificial viscosity(AAV)in iterative algorithms of completely conservative difference schemes(CCDS)used to solve gas dynamics equations in Euler variables.These methods allow to effectively suppress oscillations,including in velocity profiles,as well as computational instabilities in modeling gas-dynamic processes described by hyperbolic equations.The methods can be applied both in explicit and implicit(method of separate sweeps)iterative processes in numerical modeling of gas dynamics in the presence of heat and mass transfer,as well as in solving problems of magnetohydrodynamics and computational astrophysics.In order to avoid loss of solution accuracy on spatially non-uniform grids,in this work an algorithm of grid embeddings is developed,which is applied near transition points between cells of different sizes.The developed algorithms of CCDS using the methods for AAV selection and the algorithm of grid embeddings are implemented for various iterative processes.Calculations are performed for the classical problem of decay of an arbitrary discontinuity(Sod’s problem)and the problem of propagation of two symmetric rarefaction waves in opposite directions(Einfeldt’s problem).In the case of using different methods for selecting the AAV,a comparison of the solutions of the Sod’s problem on uniform and non-uniform grids and a comparison of the solutions of the Einfeldt’s problem on a uniform grid are performed.As a result of the comparative analysis,the applicability of these methods is shown in the spatially one-dimensional case(explicit and implicit iterative processes).The obtained results are compared with the data from the literature.The results coincide with analytical solutions with high accuracy,where the relative error does not exceed 0.1%,which demonstrates the effectiveness of the developed algorithms and methods.展开更多
In this paper Mei symmetry is introduced for a nonconservative system. The necessary and sufficient condition for a Mei symmetry to be also a Lie symmetry is derived. It is proved that the Mei symmetry leads to a non-...In this paper Mei symmetry is introduced for a nonconservative system. The necessary and sufficient condition for a Mei symmetry to be also a Lie symmetry is derived. It is proved that the Mei symmetry leads to a non-Noether conservative quantity via a Lie symmetry, and deduces a Lutzky conservative quantity via a Lie point symmetry.展开更多
Aim To extend several fundamental theorems of conventional elasticity theory to quasicrystalelasticity theory. Methods The basic governing equations of quasicrystal elasticity theory and Gauss's theorem were appli...Aim To extend several fundamental theorems of conventional elasticity theory to quasicrystalelasticity theory. Methods The basic governing equations of quasicrystal elasticity theory and Gauss's theorem were applied in the derivation. Results and Conclusion The principle of virtual work, Betti's reciprocal theorem and the uniqueness theorem of quasicrystal elasticity theory are proud, and some conservative integrals in quasicrystal elasticty theory are obtained.展开更多
The conservative form and singular perturbed ordinary differential equation with periodic boundary value problem were studied, and a conservative difference scheme was constructed. Using the method of decomposing the ...The conservative form and singular perturbed ordinary differential equation with periodic boundary value problem were studied, and a conservative difference scheme was constructed. Using the method of decomposing the singular term from its solution and combining an asymptotic expansion of the equation, it is proved that the scheme converges uniformly to the solution of differential equation with order one.展开更多
For the conservative and non-conservative schemes of nonlinear evolution equations, by taking the two-dimensional shallow water wave equations as an example, a comparative analysis on computational stability is carrie...For the conservative and non-conservative schemes of nonlinear evolution equations, by taking the two-dimensional shallow water wave equations as an example, a comparative analysis on computational stability is carried out. The relationship between the nonlinear computational stability, the structure of the difference schemes, and the form of initial values is also discussed.展开更多
Objective To investigate whether the very elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) will benefit from an invasive strategy versus a conservative strategy. Methods 190 consecutive pa...Objective To investigate whether the very elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) will benefit from an invasive strategy versus a conservative strategy. Methods 190 consecutive patients aged 80 years or older with NSTEMI were included in the retrospective study from September 2014 to August 2017, of which 69 patients received conservative strategy and 121 patients received invasive strategy. The primary outcome was death. Multivariate Cox regression models were used to assess the statistical association between strategies and mortality. The survival probability was further analyzed. Results The primary outcome occurred in 17.4% patients in the invasive group and in 42.0% patients in the conservative group (P = 0.0002). The readmission rate in the invasive group (14.9%) was higher than that in the conservative group (7.2%). Creatinine level (OR = 1.01, 95% CI: 0.10–1.03, P = 0.05) and use of diuretic (OR = 3.65, 95% CI: 1.56–8.53, P = 0.003) were independent influential factors for invasive strategy. HRs for multivariate Cox regression models were 3.45 (95% CI: 1.77–6.75, P = 0.0003), 3.02 (95% CI: 1.52–6.01, P = 0.0017), 2.93 (95% CI: 1. 46–5.86, P = 0.0024) and 2.47 (95% CI: 1.20–5.07, P = 0.0137). Compared with the patients received invasive strategy, the conservative group had remarkably reduced survival probability with time since treatment (P < 0.001). Conclusions An invasive strategy is superior to a conservative strategy in reducing mortality of patients aged 80 years or older with NSTEMI. Our results suggest that an invasive strategy is more suitable for the very elderly patients with NSTEMI in China.展开更多
A new conservative finite difference scheme is presented based on the numerical analysis for an initialboundary value problem of a class of Schroedinger equation with the wave operator. The scheme can be linear and im...A new conservative finite difference scheme is presented based on the numerical analysis for an initialboundary value problem of a class of Schroedinger equation with the wave operator. The scheme can be linear and implicit or explicit based on the parameter choice. The initial value after discretization has second-order accuracy that is consistent with the scheme accuracy. The existence and the uniqueness of the difference solution are proved. Based on the priori estimates and an inequality about norms, the stability and the convergence of difference solutions with the second-order are proved in the energy norm. Experimental results demonstrate the efficiency of the new scheme.展开更多
BACKGROUND Arthroscopic debridement is a mature treatment for knee osteoarthritis(KOA).Due to the differences in the research subjects,methods,and efficacy evaluation indexes,there are great differences in the surgica...BACKGROUND Arthroscopic debridement is a mature treatment for knee osteoarthritis(KOA).Due to the differences in the research subjects,methods,and efficacy evaluation indexes,there are great differences in the surgical efficacy reported in the literature.AIM To compare the medium-term efficacy of arthroscopic debridement and conservative treatment for KOA of Kellgren-Lawrence grades I-III.METHODS Patients with KOA of Kellgren-Lawrence grades I-III who were admitted to the orthopedic clinic of our hospital from July 2018 to December 2018 and agreed to undergo arthroscopic surgery were included in an arthroscopic debridement group,and those who refused surgical treatment were included in a conservative treatment group.Gender,age,body mass index(BMI),side of KOA,American hospital for special surgery knee score(HSS score)before treatment,visual analogue scale(VAS)score during walking and rest before treatment,conservative treatment content,and surgical procedure were recorded.Outpatient visits were conducted at the 1st,3rd,6th,12th,and 24th mo after treatment in the two groups.The changes of HSS score and VAS score in each group before and after treatment were statistically analyzed,and the differences of HSS score and VAS score in different treatment stages between the two groups were also compared.RESULTS In the conservative treatment group,there were 80 patients with complete followup data,including 20 males and 60 females,aged 58.75±14.66 years old.And in the knee arthroscopic debridement group,there were 98 patients with complete follow-up data,including 24 males and 74 females,aged 59.27±14.48 years old.There was no statistically significant difference in the general data(gender,age,BMI,side of KOA,Kellgren-Lawrence grade distribution,HSS score,and VAS score)between the two groups before treatment.The HSS scores of the conservative treatment group at the 1st,3rd,6th,12th,and 24th mo after treatment were significantly higher than that before treatment(P<0.05).There was no statistical difference in HSS score of the conservative treatment group among the 1st,3rd,6th,12th,and 24th mo(P>0.05).The HSS score of the knee arthroscopic debridement group at the 1st mo after surgery was significantly higher than that before surgery(P<0.05).HSS scores of the knee arthroscopic debridement group at the 3rd,6th,12th,and 24th mo were significantly higher than those before surgery and at the 1st mo after surgery(P<0.05).There were no statistically significant differences in HSS scores at the 3rd,6th,12th,and 24th mo after surgery(P>0.05).HSS scores at the 3rd,6th,12th,and 24th mo were significantly higher in the arthroscopic debridement group than in the conservative treatment group(P<0.05).There was no statistical difference in HSS scores between the two groups before treatment and at the 1st mo of follow-up(P>0.05).VAS scores during walking and rest were significantly decreased in both groups,and the VAS score during rest was significantly lower in the arthroscopic debridement group than in the conservative treatment group,but there was no significant difference in the VAS score during walking between the two groups after treatment.CONCLUSION Compared with conservative treatment,arthroscopic debridement can significantly improve the knee resting pain and knee functional status of patients with KOA of Kellgren-Lawrence grades I-III within 2 years after treatment.展开更多
This study investigated possible effective treatments for cervical pregnancy, a rare form of ectopic pregnancy. The clinical records of 11 cases of ectopic pregnancy admitted to the Third Affiliated Hospital of Sun Ya...This study investigated possible effective treatments for cervical pregnancy, a rare form of ectopic pregnancy. The clinical records of 11 cases of ectopic pregnancy admitted to the Third Affiliated Hospital of Sun Yat-sen University from 1998 to 2010 were analyzed. All patients were treated with intermuscular injection of methotrexate （MTX, 50 mg）, and oral mifepristone （25 mg, bid）. All cases were successfully cured by conservative treatments using methotrexate plus mifepristone. Cervical pregnancy is a contributive factor to mutiple abortions and curettages. Methotrexate plus mifepristone, curettage through hysteroscopy and intracervical obturation with gauze are effective treatments of cervical pregnancy without the need for surgical intervention.展开更多
BACKGROUND Diverse presentations of dens invaginatus (DI) and root canal treatment with an immature open apex often pose challenges to dentists. Adequate treatment planning for DI is the main reason for successful app...BACKGROUND Diverse presentations of dens invaginatus (DI) and root canal treatment with an immature open apex often pose challenges to dentists. Adequate treatment planning for DI is the main reason for successful approach, i.e., we should consider the shape and depth of the concave folding, the condition of the original pulp, and the growth stage of the root formation. CASE SUMMARY A 9-year-old girl complained of severe pain of the right maxillary incisor (tooth 12) when chewing for two weeks. Following clinical and radiographic examinations, Oehlers type III DI of tooth 12, with an immature open apical foramen and a symptomatic periapical pathosis, was diagnosed. Cone-beam computed tomography verified the specific spatial and stereoscopic data regarding the communication between the main root canal and pseudo root canal of the involved tooth. After removing the source of infection, a mineral trioxide aggregate was selected to fill and seal the pseudo root canal;additionally, pulp capping of the main canal was performed through the interconnections between the root canals in the middle segment to preserve pulp vitality and enable continual root formation and eventual root apex closure. CONCLUSION We propose to conduct main root canal pulp capping for DI with communication between the main and pseudo root canals.展开更多
Knee osteoarthritis(KOA)is a common chronic debilitating disease with an estimated prevalence of 23.9%in the general adult population.The condition is characterised by joint pain,functional impairment and significant ...Knee osteoarthritis(KOA)is a common chronic debilitating disease with an estimated prevalence of 23.9%in the general adult population.The condition is characterised by joint pain,functional impairment and significant reduction in quality of life.Management for KOA can generally be divided into conservative(non-operative)and surgical(operative)measures.Conservative management broadly compromises pharmacological and non-pharmacological options and is conventionally the first line treatment to avoid or delay the need for surgical management.The aim of this study is to provide an overview of the current recommendations,efficacy and safety profile of different conservative treatments through a review of the literature.展开更多
文摘BACKGROUND Hook of hamate fractures occur either due to repetitive stress from gripping sports(e.g.,golf,tennis,and baseball),leading to fatigue fracture,or as a result of trauma from falls or other injuries.The recommended treatment involves the excision of bone fragments to facilitate athletes’early return to sports;excision surgery is also performed in trauma cases.However,some patients prefer nonsurgical treatment options,and conservative treatment should be considered.AIM To present a case series of 16 patients conservatively treated for hook of hamate fractures.METHODS This study included 16(11 males and 5 females;right side,6 cases;left side,10)patients who desired conservative treatment and could be followed-up until bone union was achieved.The average age of the patients was 49.6(range:24-72)years.The average time from injury to consultation was 4.3(range:0.2-21.4)weeks.The treatment involved 4 weeks of casting from the forearm to the metacarpophalangeal joint,followed by 8 weeks of splint fixation of the wrist.Follow-up computed tomography scans were performed every 4 weeks.RESULTS Bone union was achieved in all patients.The average duration of casting was 3.7(range:0-5)weeks and that of splint fixation thereafter was 8.6(range:0-28)weeks.The patients did not exhibit joint contractures or range of motion restrictions due to prolonged immobilization.CONCLUSION Conservative treatment with external fixation may be an option for hook of hamate fractures.
文摘This commentary evaluates the case report by Mohammed et al on conservative management of ischiofemoral impingement through a multimodal physical therapy program integrating in-person sessions,telerehabilitation,dry needling,and kinesiology taping.The study demonstrated significant pain reduction and functional improvement,highlighting the feasibility of hybrid care models.However,limitations include short-term follow-up,lack of post-treatment imaging,and single-case design restricting generalizability.Future research should prioritize longitudinal studies,anatomical correlation via imaging,and randomized trials to validate efficacy across diverse populations.While the framework offers promising clinical utility,further investigation is critical to optimize protocols and elucidate biomechanical mechanisms underlying symptom resolution.
文摘This editorial critically evaluates the landmark study by Tanaka and Yoshii,which demonstrated a 100%union rate with conservative management of hamate hook fractures,challenging the historical preference for surgical intervention.In contrast to Scheufle et al’s report of 90%-100%failure rates with early surgical approaches,Tanaka and Yoshii’s protocol achieved universal healing despite delayed diagnoses in 25%of cases.Central to this success is the systematic inte-gration of high-resolution computed tomography for early diagnosis and dynamic monitoring of trabecular bone regeneration,significantly reducing missed dia-gnoses and guiding personalized immobilization timelines.The patient-centered strategy—allowing temporary splint removal during low-risk activities—balanced fracture stability with joint mobility preservation,avoiding post-treatment stiff-ness.However,limitations such as small sample size(n=16),selection bias,and insufficient long-term functional data(e.g.,grip strength,return-to-sport metrics)underscore the need for comparative trials.Emerging trends,including adjunct therapies like low-intensity pulsed ultrasound and biologics(e.g.,teriparatide),are proposed to accelerate healing while minimizing immobilization risks.This work redefines conservative fracture management paradigms,emphasizing in-novation without compromising efficacy.Overall,this assessment deepens our understanding of the conservative management of hook fractures and provides evidence-based insights for improved clinical decision-making.
文摘BACKGROUND Enterocutaneous(EC)fistula incidence has been increasing in China,along with increases in the volume and complexity of surgeries.The conservative treatment strategy has been analyzed to improve the treatment outcomes for patients with EC fistulas and reduce the need for reoperation.AIM To analyze the clinical data of patients undergoing conservative treatment for EC fistulas and identify the factors that promote self-healing.These findings provide a reference for improving the clinical cure rate of EC fistulas with conservative treatment.METHODS The clinical data of 91 patients with EC fistulas who underwent conservative treatment were collected.The relationships between the cure rate and characteristics such as age,sex,body mass index,albumin level,primary disease,cause of the fistula,location of the fistula,number of fistulas,nature of the fistula,infection status,diagnostic methods,nutritional support methods,somatostatin therapy,growth hormone therapy,and fibrin glue therapy were analyzed.RESULTS A comparison of the basic patient characteristics between the two groups revealed statistically significant differences in primary disease(P=0.044),location of the fistula(P=0.006),number of fistulas(P=0.007),and use of adhesive sealing(χ2=12.194,P<0.001)between the uncured and cured groups.The use of fibrin glue was a significant factor associated with a cure for fistulas(odds ratio=5.459,95%CI:1.958-15.219,P=0.01).CONCLUSION The cure rate of patients with a single EC fistula can be effectively improved via conservative treatment combined with the use of biological fibrin glue to seal the fistula.
文摘BACKGROUND Emphysematous gastritis(EG)is a rare and serious condition that has fatal consequences.Although its clinical presentation is not specific,radiological imaging is characterized by intramural gastric gas.Defects in the stomach mucosal barrier and invasion of gas-producing organisms are believed to be the cause.CASE SUMMARY An 88-year-old male with multiple comorbidities presented to our center with abdominal pain and increased stoma output as chief complaints.Upon further investigation he was found to have EG.Despite the high mortality risk without intervention,the patient and family declined operative intervention.CONCLUSION This case report underscored the challenges of managing a critically ill elderly patient with a history of multiple comorbidities and extensive abdominal surgeries and highlighted the successful use of conservative measures in treating EG.
文摘Objective:Acute appendicitis,as a common clinical acute abdominal condition,has a significant impact on patient prognosis depending on the choice of treatment strategy.This study aims to systematically compare the clinical efficacy and safety of surgical versus conservative treatment in patients with acute appendicitis.Methods:A total of 60 patients with acute appendicitis admitted to our hospital from August 2024 to July 2025 were selected as the study subjects and divided into a surgical group(n=30)and a conservative group(n=30)based on the treatment approach.The surgical group underwent abdominal incision appendectomy,while the conservative group received antibiotic therapy combined with symptomatic supportive treatment.Evaluation indicators included the treatment effective rate,symptom relief time,and complication incidence.Results:The treatment effective rate in the surgical group was 96.67%,significantly higher than that in the conservative group(76.67%)(p<0.05).In terms of symptom relief,the time to relief of abdominal pain(1.25±0.36 days)and fever(1.08±0.29 days)in the surgical group was significantly shorter than that in the conservative group(3.12±0.57 days and 2.89±0.61 days,respectively,p<0.001).The complication rates in the two groups were 10.00%and 13.33%,respectively(p>0.05).Conclusion:Surgical treatment for acute appendicitis demonstrates significant advantages in improving treatment efficacy and shortening the time to symptom relief,with a comparable risk of complications to conservative treatment.It is therefore worthy of clinical priority recommendation,particularly for patients without surgical contraindications.
基金supported by the National Natural Science Foundation of China(Grant No.11925204).
文摘In this paper,we develop a fourth-order conservative wavelet-based shock-capturing scheme.The scheme is constructed by combining a wavelet collocation upwind method with the monotonic tangent of hyperbola for interface capturing(THINC)technique.We employ boundary variation diminishing(BVD)reconstruction to enhance the scheme’s effectiveness in handling shocks.First,we prove that wavelet collocation upwind schemes based on interpolating wavelets can be reformulated into a conservative form within the framework of wavelet theory,forming the foundation of the proposed scheme.The new fourthorder accurate scheme possesses significantly better spectral resolution than the fifth-and even seventh-order WENO-Z(weighted essentially non-oscillatory)schemes over the entire wave-number range.Moreover,the inherent low-pass filtering property of the wavelet bases allows them to filter high-frequency numerical oscillations,endowing the wavelet upwind scheme with robustness and accuracy in solving problems under extreme conditions.Notably,due to the wavelet multiresolution approximation,the proposed scheme possesses a distinctive shape-preserving property absent in the WENO-Z schemes and the fifth-order schemes with BVD reconstruction based on polynomials.Furthermore,compared to the fifth-order scheme with BVD reconstruction based on polynomials—which is significantly superior to the WENO schemes—the proposed scheme further enhances the ability to capture discontinuities.
基金Supported by Zhejiang Medical and Health Science and Technology Project,No.2024KY133Zhejiang Provincial Plan for Traditional Chinese Medicine Science and Technology Project,No.2025ZR111 and No.2023ZL038.
文摘BACKGROUND Osteonecrosis of the femoral head(ONFH)is a prevalent clinical condition,and as the affected population becomes younger and more widespread,an increasing number of patients prefer to retain their own hip joints.In comparison to joint replacement and hip-preserving surgeries,conservative hip preservation treatment is gaining more recognition from both clinicians and patients.AIM To observe the clinical efficacy and influencing factors of conservative hip preservation treatment for patients with ONFH.METHODS A total of 73 patients(119 hips)were included,and patients were grouped based on Association Research Circulation Osseous(ARCO)stage,Japanese Investigation Committee(JIC)classification,lesion size,and collapse degree.The clinical efficacy of conservative hip preservation treatment was evaluated from two aspects:Radiological progression and clinical functional scores[Harris Hip Score,Western Ontario and McMaster Universities Arthritis Index(WOMAC),international Hip Outcome Tool 12(iHOT-12),and visual analogue scale(VAS)].Analyzing the success rate of conservative hip preservation based on conversion to total hip arthroplasty or hip preservation surgery.RESULTS In this retrospective cohort study,we retrospectively analyzed 73 patients(119 hips)with an average follow-up time of 53.58±26.80(18-129)months.The overall success rate of hip preservation is 90.76%.The success rates of hip preservation in ARCO I-II,IIIa,and IIIb were 97.67%,91.53%,and 70.59%,respectively(P<0.05).The success rates of hip preservation for JIC A-B,C1,and C2 were 93.37%,92.59%,and 77.78%,respectively(P<0.05).The success rates of hip preservation with collapse degree≤2 mm and>2 mm were 94.12%and 70.59%,respectively(P<0.05).There was no significant difference in the success rate of hip preservation between different lesion sizes.In terms of clinical function,the Harris Hip Score,WOMAC,iHOT-12,and VAS scores at the last follow-up were significantly better than before treatment(P<0.05).The VAS scores of ARCO IIIa and IIIb were significantly worse than those of ARCO I and II(P<0.05).The iHOT-12,WOMAC,and VAS scores were significantly better with the lesion size<15%(P<0.05).In terms of radiological results,there was significant progress in ARCO staging and collapse degree after conservative hip preservation treatment,but there was no significant difference in JIC classification and lesion size.CONCLUSION Conservative hip preservation treatment can effectively treat ONFH,prevent the progression of the necrosis,and significantly improve the clinical function of patients.The radiological staging and lesion size at the initial visit may help determine the prognosis of conservative hip preservation treatment.
文摘This paper presents both analytical and numerical studies of the conservative Sawada-Kotera equation and its dissipative generalization,equations known for their soliton solutions and rich chaotic dynamics.These models offer valuable insights into nonlinear wave propagation,with applications in fluid dynamics and materials science,including systems such as liquid crystals and ferrofluids.It is shown that the conservative Sawada-Kotera equation supports traveling wave solutions corresponding to elliptic limit cycles,as well as two-and three-dimensional invariant tori surrounding these cycles in the associated ordinary differential equation(ODE)system.For the dissipative generalized Sawada-Kotera equation,chaotic wave behavior is observed.The transition to chaos in the corresponding ODE systemfollows a universal bifurcation scenario consistent with the framework established by FShM(Feigenbaum-Sharkovsky-Magnitskii)theory.Notably,this study demonstrates for the first time that the conservative Sawada-Kotera equation can exhibit complex quasi-periodic wave solutions,while its dissipative counterpart admits an infinite number of stable periodic and chaotic waveforms.
基金carried out within the framework of the state assignment of KIAM RAS(No.125020701776-0).
文摘The work presents new methods for selecting adaptive artificial viscosity(AAV)in iterative algorithms of completely conservative difference schemes(CCDS)used to solve gas dynamics equations in Euler variables.These methods allow to effectively suppress oscillations,including in velocity profiles,as well as computational instabilities in modeling gas-dynamic processes described by hyperbolic equations.The methods can be applied both in explicit and implicit(method of separate sweeps)iterative processes in numerical modeling of gas dynamics in the presence of heat and mass transfer,as well as in solving problems of magnetohydrodynamics and computational astrophysics.In order to avoid loss of solution accuracy on spatially non-uniform grids,in this work an algorithm of grid embeddings is developed,which is applied near transition points between cells of different sizes.The developed algorithms of CCDS using the methods for AAV selection and the algorithm of grid embeddings are implemented for various iterative processes.Calculations are performed for the classical problem of decay of an arbitrary discontinuity(Sod’s problem)and the problem of propagation of two symmetric rarefaction waves in opposite directions(Einfeldt’s problem).In the case of using different methods for selecting the AAV,a comparison of the solutions of the Sod’s problem on uniform and non-uniform grids and a comparison of the solutions of the Einfeldt’s problem on a uniform grid are performed.As a result of the comparative analysis,the applicability of these methods is shown in the spatially one-dimensional case(explicit and implicit iterative processes).The obtained results are compared with the data from the literature.The results coincide with analytical solutions with high accuracy,where the relative error does not exceed 0.1%,which demonstrates the effectiveness of the developed algorithms and methods.
基金Project supported by the State Key Laboratory of Scientific and Engineering Computing, Chinese Academy of Sciences and the National Natural Science Foundation of China （Grant Nos 10672143, 10471145 and 10372053） and the Natural Science Foundation of Henan Province Government of China（Grant Nos 0511022200 and 0311011400）.
文摘In this paper Mei symmetry is introduced for a nonconservative system. The necessary and sufficient condition for a Mei symmetry to be also a Lie symmetry is derived. It is proved that the Mei symmetry leads to a non-Noether conservative quantity via a Lie symmetry, and deduces a Lutzky conservative quantity via a Lie point symmetry.
文摘Aim To extend several fundamental theorems of conventional elasticity theory to quasicrystalelasticity theory. Methods The basic governing equations of quasicrystal elasticity theory and Gauss's theorem were applied in the derivation. Results and Conclusion The principle of virtual work, Betti's reciprocal theorem and the uniqueness theorem of quasicrystal elasticity theory are proud, and some conservative integrals in quasicrystal elasticty theory are obtained.
文摘The conservative form and singular perturbed ordinary differential equation with periodic boundary value problem were studied, and a conservative difference scheme was constructed. Using the method of decomposing the singular term from its solution and combining an asymptotic expansion of the equation, it is proved that the scheme converges uniformly to the solution of differential equation with order one.
文摘For the conservative and non-conservative schemes of nonlinear evolution equations, by taking the two-dimensional shallow water wave equations as an example, a comparative analysis on computational stability is carried out. The relationship between the nonlinear computational stability, the structure of the difference schemes, and the form of initial values is also discussed.
文摘Objective To investigate whether the very elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) will benefit from an invasive strategy versus a conservative strategy. Methods 190 consecutive patients aged 80 years or older with NSTEMI were included in the retrospective study from September 2014 to August 2017, of which 69 patients received conservative strategy and 121 patients received invasive strategy. The primary outcome was death. Multivariate Cox regression models were used to assess the statistical association between strategies and mortality. The survival probability was further analyzed. Results The primary outcome occurred in 17.4% patients in the invasive group and in 42.0% patients in the conservative group (P = 0.0002). The readmission rate in the invasive group (14.9%) was higher than that in the conservative group (7.2%). Creatinine level (OR = 1.01, 95% CI: 0.10–1.03, P = 0.05) and use of diuretic (OR = 3.65, 95% CI: 1.56–8.53, P = 0.003) were independent influential factors for invasive strategy. HRs for multivariate Cox regression models were 3.45 (95% CI: 1.77–6.75, P = 0.0003), 3.02 (95% CI: 1.52–6.01, P = 0.0017), 2.93 (95% CI: 1. 46–5.86, P = 0.0024) and 2.47 (95% CI: 1.20–5.07, P = 0.0137). Compared with the patients received invasive strategy, the conservative group had remarkably reduced survival probability with time since treatment (P < 0.001). Conclusions An invasive strategy is superior to a conservative strategy in reducing mortality of patients aged 80 years or older with NSTEMI. Our results suggest that an invasive strategy is more suitable for the very elderly patients with NSTEMI in China.
文摘A new conservative finite difference scheme is presented based on the numerical analysis for an initialboundary value problem of a class of Schroedinger equation with the wave operator. The scheme can be linear and implicit or explicit based on the parameter choice. The initial value after discretization has second-order accuracy that is consistent with the scheme accuracy. The existence and the uniqueness of the difference solution are proved. Based on the priori estimates and an inequality about norms, the stability and the convergence of difference solutions with the second-order are proved in the energy norm. Experimental results demonstrate the efficiency of the new scheme.
基金Shanghai Jing'an District Health Research Project,China,No.2018MS09.
文摘BACKGROUND Arthroscopic debridement is a mature treatment for knee osteoarthritis(KOA).Due to the differences in the research subjects,methods,and efficacy evaluation indexes,there are great differences in the surgical efficacy reported in the literature.AIM To compare the medium-term efficacy of arthroscopic debridement and conservative treatment for KOA of Kellgren-Lawrence grades I-III.METHODS Patients with KOA of Kellgren-Lawrence grades I-III who were admitted to the orthopedic clinic of our hospital from July 2018 to December 2018 and agreed to undergo arthroscopic surgery were included in an arthroscopic debridement group,and those who refused surgical treatment were included in a conservative treatment group.Gender,age,body mass index(BMI),side of KOA,American hospital for special surgery knee score(HSS score)before treatment,visual analogue scale(VAS)score during walking and rest before treatment,conservative treatment content,and surgical procedure were recorded.Outpatient visits were conducted at the 1st,3rd,6th,12th,and 24th mo after treatment in the two groups.The changes of HSS score and VAS score in each group before and after treatment were statistically analyzed,and the differences of HSS score and VAS score in different treatment stages between the two groups were also compared.RESULTS In the conservative treatment group,there were 80 patients with complete followup data,including 20 males and 60 females,aged 58.75±14.66 years old.And in the knee arthroscopic debridement group,there were 98 patients with complete follow-up data,including 24 males and 74 females,aged 59.27±14.48 years old.There was no statistically significant difference in the general data(gender,age,BMI,side of KOA,Kellgren-Lawrence grade distribution,HSS score,and VAS score)between the two groups before treatment.The HSS scores of the conservative treatment group at the 1st,3rd,6th,12th,and 24th mo after treatment were significantly higher than that before treatment(P<0.05).There was no statistical difference in HSS score of the conservative treatment group among the 1st,3rd,6th,12th,and 24th mo(P>0.05).The HSS score of the knee arthroscopic debridement group at the 1st mo after surgery was significantly higher than that before surgery(P<0.05).HSS scores of the knee arthroscopic debridement group at the 3rd,6th,12th,and 24th mo were significantly higher than those before surgery and at the 1st mo after surgery(P<0.05).There were no statistically significant differences in HSS scores at the 3rd,6th,12th,and 24th mo after surgery(P>0.05).HSS scores at the 3rd,6th,12th,and 24th mo were significantly higher in the arthroscopic debridement group than in the conservative treatment group(P<0.05).There was no statistical difference in HSS scores between the two groups before treatment and at the 1st mo of follow-up(P>0.05).VAS scores during walking and rest were significantly decreased in both groups,and the VAS score during rest was significantly lower in the arthroscopic debridement group than in the conservative treatment group,but there was no significant difference in the VAS score during walking between the two groups after treatment.CONCLUSION Compared with conservative treatment,arthroscopic debridement can significantly improve the knee resting pain and knee functional status of patients with KOA of Kellgren-Lawrence grades I-III within 2 years after treatment.
文摘This study investigated possible effective treatments for cervical pregnancy, a rare form of ectopic pregnancy. The clinical records of 11 cases of ectopic pregnancy admitted to the Third Affiliated Hospital of Sun Yat-sen University from 1998 to 2010 were analyzed. All patients were treated with intermuscular injection of methotrexate （MTX, 50 mg）, and oral mifepristone （25 mg, bid）. All cases were successfully cured by conservative treatments using methotrexate plus mifepristone. Cervical pregnancy is a contributive factor to mutiple abortions and curettages. Methotrexate plus mifepristone, curettage through hysteroscopy and intracervical obturation with gauze are effective treatments of cervical pregnancy without the need for surgical intervention.
基金Supported by a grant from the Kaohsiung Medical University,No.KMUH106-6M52
文摘BACKGROUND Diverse presentations of dens invaginatus (DI) and root canal treatment with an immature open apex often pose challenges to dentists. Adequate treatment planning for DI is the main reason for successful approach, i.e., we should consider the shape and depth of the concave folding, the condition of the original pulp, and the growth stage of the root formation. CASE SUMMARY A 9-year-old girl complained of severe pain of the right maxillary incisor (tooth 12) when chewing for two weeks. Following clinical and radiographic examinations, Oehlers type III DI of tooth 12, with an immature open apical foramen and a symptomatic periapical pathosis, was diagnosed. Cone-beam computed tomography verified the specific spatial and stereoscopic data regarding the communication between the main root canal and pseudo root canal of the involved tooth. After removing the source of infection, a mineral trioxide aggregate was selected to fill and seal the pseudo root canal;additionally, pulp capping of the main canal was performed through the interconnections between the root canals in the middle segment to preserve pulp vitality and enable continual root formation and eventual root apex closure. CONCLUSION We propose to conduct main root canal pulp capping for DI with communication between the main and pseudo root canals.
文摘Knee osteoarthritis(KOA)is a common chronic debilitating disease with an estimated prevalence of 23.9%in the general adult population.The condition is characterised by joint pain,functional impairment and significant reduction in quality of life.Management for KOA can generally be divided into conservative(non-operative)and surgical(operative)measures.Conservative management broadly compromises pharmacological and non-pharmacological options and is conventionally the first line treatment to avoid or delay the need for surgical management.The aim of this study is to provide an overview of the current recommendations,efficacy and safety profile of different conservative treatments through a review of the literature.
