This paper presents a novel modelling method to study the thrust generation mechanism of biplane flapping wings made of thin and highly deformable membrane.Based on the principle of strain energy equivalence,the membr...This paper presents a novel modelling method to study the thrust generation mechanism of biplane flapping wings made of thin and highly deformable membrane.Based on the principle of strain energy equivalence,the membrane structures were modelled by mass-spring systems.The aerodynamic loads were calculated by a simplified quasi-steady aerodynamic model with consideration of the clap-and-fling mechanism.The impact force was introduced into the system when two wing surfaces were in contact.For wing-dynamics simulation problems,convergence analyses were conducted to obtain suitable mesh resolution.To validate the present modelling method,the predicted thrust and required power of a biplane flapping-wing air vehicle were compared with the experimental data.The effect of the forward speed was also analyzed in this paper.It was shown that as the forward speed increases the thrust production efficiency becomes lower together with smaller wing deformation.展开更多
The Adaptive Dropped Hinge Flap(ADHF) is a novel trailing edge high-lift device characterized by the integration of downward deflection spoiler and simple hinge flap, with excellent aerodynamic and mechanism performan...The Adaptive Dropped Hinge Flap(ADHF) is a novel trailing edge high-lift device characterized by the integration of downward deflection spoiler and simple hinge flap, with excellent aerodynamic and mechanism performance. In this paper, aerodynamic optimization design of an ADHF high-lift system is conducted considering the mechanism performance. Shape and settings of both takeoff and landing configurations are optimized and analyzed, with considering the kinematic constraints of ADHF mechanism, and the desired optimization results were obtained after optimization. Sensitivity analysis proves the robustness of the optimal design. Comparison shows that the ADHF design has better comprehensive performance of both mechanism and aerodynamics than the conventional Fowler flap and simple hinge flap design.展开更多
Linked tetra shaft and double cantilever flat flap gate is a new type of structure in water conservancy projects,but the traditional method is now adopted in its design.In order to the application and dissemination ...Linked tetra shaft and double cantilever flat flap gate is a new type of structure in water conservancy projects,but the traditional method is now adopted in its design.In order to the application and dissemination of the type of sluice,this paper researches the difficult points of design advance,through researching the motion locus & stress coundition of linked tetra shaft system.The writer will build up the mathmatical model and handle it with the computer.Thus,we can achieve the modern desing on the basis of the software of linked tetra shaft system development.展开更多
Background: Although the surgical outcomes of free flap reconstruction have improved over time, vascular compromise remains a devastating complication. Near-infrared spectroscopy(NIRS) is a promising new free flap mon...Background: Although the surgical outcomes of free flap reconstruction have improved over time, vascular compromise remains a devastating complication. Near-infrared spectroscopy(NIRS) is a promising new free flap monitoring technique with the potential for better outcomes than clinical monitoring(CM). This systematic review aims to provide a comprehensive review of the current evidence regarding the use of NIRS for free flap monitoring.Methods: A systematic literature review was performed, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, on existing NRIS studies, including the clinical outcomes of NIRS monitoring, speed of detection, diagnostic accuracy, variables affecting NIRS accuracy, and cost-effectiveness.Results: A total of 24 articles were included in this analysis. In most instances of flap compromise, NIRS enabled earlier detection of compromise than did CM, by an average of 8.1(0.5±32.0) h. The flap salvage rate of flaps monitored with CM and NIRS(87.2%) was significantly higher than that of flaps monitored with CM alone(50.0%)(P<0.01). The overall survival rate for flaps monitored with CM and NIRS(98.1%) was also significantly higher than that for flaps monitored with CM alone(96.3%)(P=0.02). Blood oxygen saturation was the only variable with a significant effect on NIRS results.Conclusion: NIRS is an objective and reliable flap monitoring technique that provides superior flap salvage and survival rates compared with CM, which translates to cost savings and a reduction in workload for healthcare staff. Further large-scale studies are needed to standardize flap compromise criterion values and efficacy for different flap types.展开更多
BACKGROUND Flap reconstruction after resection of a superficial malignant soft tissue tumor extends the surgical field and is an indicator for potential recurrence sites.AIM To describe a grading system for surgical f...BACKGROUND Flap reconstruction after resection of a superficial malignant soft tissue tumor extends the surgical field and is an indicator for potential recurrence sites.AIM To describe a grading system for surgical field extension of soft tissue sarcomas.METHODS Grading system:CD-grading is a description system consisting of C and D values in the surgical field extension,which are related to the compartmental position of the flap beyond the nearby large joint and deeper extension for the pedicle,respectively.C1/D1 are positive values and C0/D0 are negative.With a known location,1/0 values can be"p"(proximal),"d"(distal),and"b"(in the tumor bed),and the description method is as follows:flap type,CxDx[x=0,1,p,d or b].RESULTS Four representative patients with subcutaneous sarcomas who underwent reconstruction using fasciocutaneous flaps are presented.The cases involved a distal upper arm(elbow)synovial sarcoma reconstructed using a pedicled latissimus dorsi(pedicled flap:CpDp);a distal upper arm(elbow)pleomorphic rhabdomyosarcoma reconstructed using a transpositional flap from the forearm(transpositional flap:CdD0);an undifferentiated pleomorphic sarcoma in the buttocks reconstructed using a transpositional flap(transpositional flap:C0D0);and a myxofibrosarcoma in the buttocks reconstructed using a propeller flap from the thigh(pedicled flap:CdDd).CONCLUSION The reconstruction method is chosen by the surgeon based on size,location,and other tumor characteristics;however,the final surgical field cannot be determined based on preoperative images alone.CD-grading is a description system consisting of C and D values in the surgical field extension that are related to the compartmental position of the flap beyond the nearby large joint and deeper extension for the pedicle,respectively.The CD-grading system gives a new perspective to the flap reconstruction classification.The CD-grading system also provides important information for follow-up imaging of a possible recurrence.展开更多
Lower eyelid retraction describes the inferior displacement of the lower eyelid with or without inversion or ectropion.Based on the causes of lower eyelid retraction,we divided the forming factors of lower eyelid retr...Lower eyelid retraction describes the inferior displacement of the lower eyelid with or without inversion or ectropion.Based on the causes of lower eyelid retraction,we divided the forming factors of lower eyelid retraction into three categories:(1)change in the balance of forces associated with the lower eyelid margin;(2)excessive loss of lower eyelid volume;(3)changes in the relative position of the eyeball and lower lid margin.In this review,the corresponding treatment methods are elaborated on individually for the above three forming factors.We also reported,for the first time,a new treatment for lower eyelid retraction.We created a dermal-orbicularis oculi suspension flap on the lateral side of the canthus and suspended it upward and inward on the dense connective tissue over the lateral bony surface of the orbital rim.The longest follow-up time was one year,and the results were satisfactory.展开更多
Modeling the dynamics of flapping wing aerial vehicle is challenging due to the complexity of aerodynamic effects and mechanical structures.The aim of this work is to develop an accurate dynamics model of flapping win...Modeling the dynamics of flapping wing aerial vehicle is challenging due to the complexity of aerodynamic effects and mechanical structures.The aim of this work is to develop an accurate dynamics model of flapping wing aerial vehicle based on real flight data.We propose a modeling framework that combines rigid body dynamics with a neural network to predict aerodynamic effects.By incorporating the concept of flapping phase,we significantly enhance the network’s ability to analyze transient aerodynamic behavior.We design and utilize a phase-functioned neural network structure for aerodynamic predictions and train the network using real flight data.Evaluation results show that the network can predict aerodynamic effects and demonstrate clear physical significance.We verify that the framework can be used for dynamic propagation and is expected to be utilized for building simulators for flapping wing aerial vehicles.展开更多
Cicatricial ectropion of the eyelid is an eversion of its edge, which has moved away from the globe. It is frequently the result of cicatricial retraction after trauma. The main risk is the occurrence of a corneal ulc...Cicatricial ectropion of the eyelid is an eversion of its edge, which has moved away from the globe. It is frequently the result of cicatricial retraction after trauma. The main risk is the occurrence of a corneal ulcer or chronic conjunctivitis. Their treatment is often difficult, especially when the ectropion is old and significant. There are several classic techniques for correcting cicatricial ectropions, but the technique of the myocutaneous flap combined with external tarsorrhaphy without damage to the canthal ligament is minimally invasive, not very widespread, yet responds very well to the rules of plastic surgery. We report two cases of post-traumatic cicatricial ectropions of the left lower eyelid, respectively in a 33-year-old and an 87-year-old, treated using this technique. The surgical procedure was performed in two stages, after evaluation of the skin of the flap to be harvested: harvesting of the flap and closure plasty including external tarsorrhaphy. Patient follow-up did not note any complications. This combined technique offers a minimally invasive alternative for the often-delicate treatment of ectropions.展开更多
A robust Reynolds-Averaged Navier-Stokes(RANS)based solver is established to predict the complex unsteady aerodynamic characteristics of the Active Flap Control(AFC)rotor.The complex motion with multiple degrees of fr...A robust Reynolds-Averaged Navier-Stokes(RANS)based solver is established to predict the complex unsteady aerodynamic characteristics of the Active Flap Control(AFC)rotor.The complex motion with multiple degrees of freedom of the Trailing Edge Flap(TEF)is analyzed by employing an inverse nested overset grid method.Simulation of non-rotational and rotational modes of blade motion are carried out to investigate the formation and development of TEF shedding vortex with high-frequency deflection of TEF.Moreover,the mechanism of TEF deflection interference with blade tip vortex and overall rotor aerodynamics is also explored.In nonrotational mode,two bundles of vortices form at the gap ends of TEF and the main blade and merge into a single TEF vortex.Dynamic deflection of the TEF significantly interferes with the blade tip vortex.The position of the blade tip vortex consistently changes,and its frequency is directly related to the frequency of TEF deflection.In rotational mode,the tip vortex forms a helical structure.The end vortices at the gap sides co-swirl and subsequently merge into the concentrated beam of tip vortices,causing fluctuations in the vorticity and axial position of the tip vortex under the rotor.This research concludes with the investigation on suppression of Blade Vortex Interaction(BVI),showing an increase in miss distance and reduction in the vorticity of tip vortex through TEF phase control at a particular control frequency.Through this mechanism,a designed TEF deflection law increases the miss distance by 34.7%and reduces vorticity by 11.9%at the target position,demonstrating the effectiveness of AFC in mitigating BVI.展开更多
Osteoradionecrosis of the temporal bone(ORN-TB)is usually controlled with conservative measures.However,a temporal bone resection may be required in unresponsive cases.The reconstruction of the resulting defects may b...Osteoradionecrosis of the temporal bone(ORN-TB)is usually controlled with conservative measures.However,a temporal bone resection may be required in unresponsive cases.The reconstruction of the resulting defects may be challenging because of the radiation damage to regional tissues.As a result,distant free flaps may be an optimal choice.For instance,the gracilis muscular free flap(GMFF)has consistent vascular anatomy and can be used to reconstruct small defects.We report three cases of uncontrolled ORN-TB requiring an extensive temporal bone resection followed by vascularized obliteration with a GMFF.The patients reported complete control of the main otologic symptoms(otorrhea,otalgia,and aural fullness)and optimal functional and aesthetic outcomes.Finally,the patients reported significant improvement in quality of life despite early postoperative complications.To our knowledge,the GMFF had not been used to obliterate temporal bone defects in patients with ORN-TB.展开更多
The online version of the original article can be found at:https://www.sciopen.com/article/10.26599/JOTO.2025.9540018 Erratum to Journal of Otology,2025,20(2):123-126.https://doi.org/10.26599/JOTO.2025.9540018 The sur...The online version of the original article can be found at:https://www.sciopen.com/article/10.26599/JOTO.2025.9540018 Erratum to Journal of Otology,2025,20(2):123-126.https://doi.org/10.26599/JOTO.2025.9540018 The surnames and given names of these authors are reversed:Saro-Buendía Miguel,Andresen-Lorca Belén,Pérez-García Alberto,Llópez Carratala Nacho,Carreres Polo Joan,Armengot Carceller Miguel,Perolada Valmaña Jose María.It should be Miguel Saro-Buendía,Belén Andresen-Lorca,Alberto Pérez-García,Nacho Llópez Carratala,Joan Carreres Polo,Miguel Armengot Carceller,Jose María Perolada Valmaña.展开更多
Current breast reconstruction evaluations mostly focus on static cosmetic analysis as a measure of the clinical outcomes.Moreover,it is essential to consider the dynamic changes in the reconstructed breast alongside a...Current breast reconstruction evaluations mostly focus on static cosmetic analysis as a measure of the clinical outcomes.Moreover,it is essential to consider the dynamic changes in the reconstructed breast alongside assessments of aesthetic symmetry,functional restoration,complication rates,and long-term stability of the reconstruction.This study aimed to assess the mobility of the reconstructed breast following various breast reconstruction techniques,specifically by comparing deep inferior epigastric perforator(DIEP) flaps and pedicled transverse rectus abdominis musculocutaneous(TRAM) flaps.We conducted a longitudinal case study to investigate the changes in breast movement resulting from different surgical interventions.The comparison showed that DIEP flap reconstruction was more likely to achieve superior breast mobility outcomes than TRAM flap reconstruction.For a better breast aesthetic outcome,it is fundamental to improve the awareness of the dynamic evaluation of the reconstructed breast at the surgical strategy level.展开更多
Objectives:To assess outcomes of rectourethral fistula repair utilizing a gracilis flap in a largely radiated cohort.Patients and Methods:We performed a retrospective review of all gracilis interposition flap reconstr...Objectives:To assess outcomes of rectourethral fistula repair utilizing a gracilis flap in a largely radiated cohort.Patients and Methods:We performed a retrospective review of all gracilis interposition flap reconstruction surgeries performed for RUF at a university hospital in South Carolina between January 2010 and June 2023.All repairs utilized a multidisciplinary approach with urology,colorectal,and plastic surgery teams.Postoperatively,patients were maximally drained with foley catheter and suprapubic tube(SPT).Initial voiding cystourethrogram(VCUG)was performed at 4 weeks post-repair.If there was a persistent leak,catheter drainage was maintained for 4 additional weeks and VCUG was repeated.Success was defined as absence of leak on VCUG within 3 months after surgery.Results:22 patients met inclusion criteria.68%of patients had history of external beam radiation therapy(EBRT),13.6%had brachytherapy,and 40.9%had cryotherapy.Initial post-operative VCUG was negative in 10 patients(45.5%).Of the 12 patients with a persistent fistula,5(42%)had no evidence of fistula on subsequent VCUG after 4 weeks.Overall,68%of patients were successfully treated with gracilis interposition flap.There was a significant difference of repair success based on EBRT status(p<0.05).Conclusions:We report a success rate of 68%for gracilis flap repair of RUF.Our cohort had a higher rate of prior radiation therapy compared to other studies.A clinically significant portion of patients with an initial positive VCUG will seal their fistula with prolonged catheter drainage.Gracilis interposition flap is a reasonable surgical treatment for RUF.展开更多
Background: The lumbar artery perforator(LAP) flap is an important autologous option in breast reconstruction.As the lumbar perforator flap is relatively new in this field,several questions remain regarding preoperati...Background: The lumbar artery perforator(LAP) flap is an important autologous option in breast reconstruction.As the lumbar perforator flap is relatively new in this field,several questions remain regarding preoperative preparation,especially concerning computed tomography(CT) and magnetic resonance imaging of the donor site.The objective of this study was to aid the surgical approach to the LAP flap in female patients by precisely determining the characteristics of the lumbar perforators.Methods: We retrospectively reviewed the computed tomographic angiography images of 20 patients who underwent evaluation of the perforator positions from the four lumbar arteries.Four characteristics were studied:length,diameter,path of the lumbar pedicle,and thickness of the tissues available for transfer.Results: We analyzed 20 CT images,identifying 149 perforating vessels of the lumbar artery.The most suitable perforator for flap harvesting was the L4 perforator,which exhibited a larger diameter,a greater number of perforasomes,and a higher percentage of the cutaneous-septal tract.Conclusion: The LAP flap is a viable option for breast reconstruction and as a free flap in women.The L4 perforator artery is the most suitable for harvesting,owing to its superior perfusion capacity,diameter,and course;however,an interposition graft may be required to lengthen the vascular pedicle.展开更多
The flow control at low Reynolds numbers is one of the most promising technologies in the field of aerodynamics,and it is also an important source of the innovation for novel aircraft.In this study,a new way of nonlin...The flow control at low Reynolds numbers is one of the most promising technologies in the field of aerodynamics,and it is also an important source of the innovation for novel aircraft.In this study,a new way of nonlinear flow control by interaction between two flexible flaps is proposed,and their flow control mechanism is studied employing the self-constructed immersed boundary-lattice Boltzmann-finite element method(IB-LB-FEM).The effects of the difference in material properties and flap length between the two flexible flaps on the nonlinear flow control of the airfoil are discussed.It is suggested that the relationship between the deformation of the two flexible flaps and the evolution of the vortex under the fluid-structure interaction(FSI).It is shown that the upstream flexible flap plays a key role in the flow control of the two flexible flaps.The FSI effect of the upstream flexible flap will change the unsteady flow behind it and affect the deformation of the downstream flexible flap.Two flexible flaps with different material properties and different lengths will change their own FSI characteristics by the induced vortex,effectively suppressing the flow separation on the airfoil’s upper surface.The interaction of two flexible flaps plays an extremely important role in improving the autonomy and adjustability of flow control.The numerical results will provide a theoretical basis and technical guidance for the development and application of a new flap passive control technology.展开更多
Soft tissue reconstruction of the radial thumb tip remains surgically challenging,particularly when standard options such as kite or Brünelli flaps are less suitable due to anatomical constraints.This technical n...Soft tissue reconstruction of the radial thumb tip remains surgically challenging,particularly when standard options such as kite or Brünelli flaps are less suitable due to anatomical constraints.This technical note presents the case of a 37-year-old male with a radial-sided distal thumb defect reconstructed using a reverse homodigital dorsoradial flap.Two key refinements were applied:preservation of approximately 5 mm of subcutaneous tissue to support venous outflow and a 3-5 mm proximal safety margin at the pivot point based on Doppler assessment to reduce pedicle tension during 180◦rotation.The flap was inset without tunneling and healed without complications.Functional recovery was confirmed by progressive improvements in the disabilities of the arm,shoulder and hand score(from 25 at 1 month to 4.2 at 1 year),normal range of motion,and two-point discrimination(from 5 mm to 4 mm).This case highlights the practical advantages of flap design refinement for radial thumb reconstruction and supports its reproducibility in similar clinical scenarios.However,as this is a single case report,further validation with studies involving multiple cases is necessary to confirm the reliability and broad applicability of these refinements.展开更多
To propel the application of a bottom-hinged flap breakwater in real sea conditions,a two-dimensional computational fluid dynamics numerical model was conducted to investigate the pitching motion response and wave att...To propel the application of a bottom-hinged flap breakwater in real sea conditions,a two-dimensional computational fluid dynamics numerical model was conducted to investigate the pitching motion response and wave attenuation in random waves.First,the flow velocity distribution characteristic of the pitching flap at typical times was summarized.Then,the effects of random wave and flap parameters on the flap’s significant pitching angle amplitude θ_(s) and hydrodynamic coefficients were investigated.The results reveal that θ_(s) and wave reflection coefficient K_(r) values increase with increasing significant wave height Hs,random wave steepnessλs,and flap relative height.As Hs andλs increase,the wave transmission coefficient K_(t) increases while the wave dissipation coefficient K_(d) decreases.Additionally,K_(t) decreases with increasing flap relative height.With increasing equivalent damping coefficient ratio,θ_(s) and K_(t) decrease,while K_(r) and K_(d) increase.The relationships betweenλs and flap relative height on the one hand andθ_(s),K_(r),K_(t),and K_(d) in random waves on the other hand are compared to those in regular waves.Based on the equal incident wave energy and the equal incident wave energy flux,the pitching flap performs better in the wave attenuation capability under random waves than in regular waves.Finally,the dimensionless parameters with respect to random wave and flap were used to derive the K_(r) and K_(t) for-mulae,which were validated with the related data.展开更多
基金funded by Vietnam National Foundation for Science and Technology Development(NAFOSTED)(Grant No.107.01-2021.39).
文摘This paper presents a novel modelling method to study the thrust generation mechanism of biplane flapping wings made of thin and highly deformable membrane.Based on the principle of strain energy equivalence,the membrane structures were modelled by mass-spring systems.The aerodynamic loads were calculated by a simplified quasi-steady aerodynamic model with consideration of the clap-and-fling mechanism.The impact force was introduced into the system when two wing surfaces were in contact.For wing-dynamics simulation problems,convergence analyses were conducted to obtain suitable mesh resolution.To validate the present modelling method,the predicted thrust and required power of a biplane flapping-wing air vehicle were compared with the experimental data.The effect of the forward speed was also analyzed in this paper.It was shown that as the forward speed increases the thrust production efficiency becomes lower together with smaller wing deformation.
基金supported by the National Natural Science Foundation of China(Nos.11872230,91852108,91952302,92052203)the Aeronautical Science Foundation of China(No.2020Z006058002)。
文摘The Adaptive Dropped Hinge Flap(ADHF) is a novel trailing edge high-lift device characterized by the integration of downward deflection spoiler and simple hinge flap, with excellent aerodynamic and mechanism performance. In this paper, aerodynamic optimization design of an ADHF high-lift system is conducted considering the mechanism performance. Shape and settings of both takeoff and landing configurations are optimized and analyzed, with considering the kinematic constraints of ADHF mechanism, and the desired optimization results were obtained after optimization. Sensitivity analysis proves the robustness of the optimal design. Comparison shows that the ADHF design has better comprehensive performance of both mechanism and aerodynamics than the conventional Fowler flap and simple hinge flap design.
文摘Linked tetra shaft and double cantilever flat flap gate is a new type of structure in water conservancy projects,but the traditional method is now adopted in its design.In order to the application and dissemination of the type of sluice,this paper researches the difficult points of design advance,through researching the motion locus & stress coundition of linked tetra shaft system.The writer will build up the mathmatical model and handle it with the computer.Thus,we can achieve the modern desing on the basis of the software of linked tetra shaft system development.
文摘Background: Although the surgical outcomes of free flap reconstruction have improved over time, vascular compromise remains a devastating complication. Near-infrared spectroscopy(NIRS) is a promising new free flap monitoring technique with the potential for better outcomes than clinical monitoring(CM). This systematic review aims to provide a comprehensive review of the current evidence regarding the use of NIRS for free flap monitoring.Methods: A systematic literature review was performed, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, on existing NRIS studies, including the clinical outcomes of NIRS monitoring, speed of detection, diagnostic accuracy, variables affecting NIRS accuracy, and cost-effectiveness.Results: A total of 24 articles were included in this analysis. In most instances of flap compromise, NIRS enabled earlier detection of compromise than did CM, by an average of 8.1(0.5±32.0) h. The flap salvage rate of flaps monitored with CM and NIRS(87.2%) was significantly higher than that of flaps monitored with CM alone(50.0%)(P<0.01). The overall survival rate for flaps monitored with CM and NIRS(98.1%) was also significantly higher than that for flaps monitored with CM alone(96.3%)(P=0.02). Blood oxygen saturation was the only variable with a significant effect on NIRS results.Conclusion: NIRS is an objective and reliable flap monitoring technique that provides superior flap salvage and survival rates compared with CM, which translates to cost savings and a reduction in workload for healthcare staff. Further large-scale studies are needed to standardize flap compromise criterion values and efficacy for different flap types.
文摘BACKGROUND Flap reconstruction after resection of a superficial malignant soft tissue tumor extends the surgical field and is an indicator for potential recurrence sites.AIM To describe a grading system for surgical field extension of soft tissue sarcomas.METHODS Grading system:CD-grading is a description system consisting of C and D values in the surgical field extension,which are related to the compartmental position of the flap beyond the nearby large joint and deeper extension for the pedicle,respectively.C1/D1 are positive values and C0/D0 are negative.With a known location,1/0 values can be"p"(proximal),"d"(distal),and"b"(in the tumor bed),and the description method is as follows:flap type,CxDx[x=0,1,p,d or b].RESULTS Four representative patients with subcutaneous sarcomas who underwent reconstruction using fasciocutaneous flaps are presented.The cases involved a distal upper arm(elbow)synovial sarcoma reconstructed using a pedicled latissimus dorsi(pedicled flap:CpDp);a distal upper arm(elbow)pleomorphic rhabdomyosarcoma reconstructed using a transpositional flap from the forearm(transpositional flap:CdD0);an undifferentiated pleomorphic sarcoma in the buttocks reconstructed using a transpositional flap(transpositional flap:C0D0);and a myxofibrosarcoma in the buttocks reconstructed using a propeller flap from the thigh(pedicled flap:CdDd).CONCLUSION The reconstruction method is chosen by the surgeon based on size,location,and other tumor characteristics;however,the final surgical field cannot be determined based on preoperative images alone.CD-grading is a description system consisting of C and D values in the surgical field extension that are related to the compartmental position of the flap beyond the nearby large joint and deeper extension for the pedicle,respectively.The CD-grading system gives a new perspective to the flap reconstruction classification.The CD-grading system also provides important information for follow-up imaging of a possible recurrence.
基金The study was sponsored by the Natural Science Foundation of Shanghai(grant no.19ZR1430100)the National Natural Science Foundation of China(grant no.81871576).
文摘Lower eyelid retraction describes the inferior displacement of the lower eyelid with or without inversion or ectropion.Based on the causes of lower eyelid retraction,we divided the forming factors of lower eyelid retraction into three categories:(1)change in the balance of forces associated with the lower eyelid margin;(2)excessive loss of lower eyelid volume;(3)changes in the relative position of the eyeball and lower lid margin.In this review,the corresponding treatment methods are elaborated on individually for the above three forming factors.We also reported,for the first time,a new treatment for lower eyelid retraction.We created a dermal-orbicularis oculi suspension flap on the lateral side of the canthus and suspended it upward and inward on the dense connective tissue over the lateral bony surface of the orbital rim.The longest follow-up time was one year,and the results were satisfactory.
基金supported by National Natural Science Foundation of China under Grant No.62236007the specialized research projects of Huanjiang Laboratory.
文摘Modeling the dynamics of flapping wing aerial vehicle is challenging due to the complexity of aerodynamic effects and mechanical structures.The aim of this work is to develop an accurate dynamics model of flapping wing aerial vehicle based on real flight data.We propose a modeling framework that combines rigid body dynamics with a neural network to predict aerodynamic effects.By incorporating the concept of flapping phase,we significantly enhance the network’s ability to analyze transient aerodynamic behavior.We design and utilize a phase-functioned neural network structure for aerodynamic predictions and train the network using real flight data.Evaluation results show that the network can predict aerodynamic effects and demonstrate clear physical significance.We verify that the framework can be used for dynamic propagation and is expected to be utilized for building simulators for flapping wing aerial vehicles.
文摘Cicatricial ectropion of the eyelid is an eversion of its edge, which has moved away from the globe. It is frequently the result of cicatricial retraction after trauma. The main risk is the occurrence of a corneal ulcer or chronic conjunctivitis. Their treatment is often difficult, especially when the ectropion is old and significant. There are several classic techniques for correcting cicatricial ectropions, but the technique of the myocutaneous flap combined with external tarsorrhaphy without damage to the canthal ligament is minimally invasive, not very widespread, yet responds very well to the rules of plastic surgery. We report two cases of post-traumatic cicatricial ectropions of the left lower eyelid, respectively in a 33-year-old and an 87-year-old, treated using this technique. The surgical procedure was performed in two stages, after evaluation of the skin of the flap to be harvested: harvesting of the flap and closure plasty including external tarsorrhaphy. Patient follow-up did not note any complications. This combined technique offers a minimally invasive alternative for the often-delicate treatment of ectropions.
基金supported by the National Natural Science Foundation of China(No.11972190)。
文摘A robust Reynolds-Averaged Navier-Stokes(RANS)based solver is established to predict the complex unsteady aerodynamic characteristics of the Active Flap Control(AFC)rotor.The complex motion with multiple degrees of freedom of the Trailing Edge Flap(TEF)is analyzed by employing an inverse nested overset grid method.Simulation of non-rotational and rotational modes of blade motion are carried out to investigate the formation and development of TEF shedding vortex with high-frequency deflection of TEF.Moreover,the mechanism of TEF deflection interference with blade tip vortex and overall rotor aerodynamics is also explored.In nonrotational mode,two bundles of vortices form at the gap ends of TEF and the main blade and merge into a single TEF vortex.Dynamic deflection of the TEF significantly interferes with the blade tip vortex.The position of the blade tip vortex consistently changes,and its frequency is directly related to the frequency of TEF deflection.In rotational mode,the tip vortex forms a helical structure.The end vortices at the gap sides co-swirl and subsequently merge into the concentrated beam of tip vortices,causing fluctuations in the vorticity and axial position of the tip vortex under the rotor.This research concludes with the investigation on suppression of Blade Vortex Interaction(BVI),showing an increase in miss distance and reduction in the vorticity of tip vortex through TEF phase control at a particular control frequency.Through this mechanism,a designed TEF deflection law increases the miss distance by 34.7%and reduces vorticity by 11.9%at the target position,demonstrating the effectiveness of AFC in mitigating BVI.
文摘Osteoradionecrosis of the temporal bone(ORN-TB)is usually controlled with conservative measures.However,a temporal bone resection may be required in unresponsive cases.The reconstruction of the resulting defects may be challenging because of the radiation damage to regional tissues.As a result,distant free flaps may be an optimal choice.For instance,the gracilis muscular free flap(GMFF)has consistent vascular anatomy and can be used to reconstruct small defects.We report three cases of uncontrolled ORN-TB requiring an extensive temporal bone resection followed by vascularized obliteration with a GMFF.The patients reported complete control of the main otologic symptoms(otorrhea,otalgia,and aural fullness)and optimal functional and aesthetic outcomes.Finally,the patients reported significant improvement in quality of life despite early postoperative complications.To our knowledge,the GMFF had not been used to obliterate temporal bone defects in patients with ORN-TB.
文摘The online version of the original article can be found at:https://www.sciopen.com/article/10.26599/JOTO.2025.9540018 Erratum to Journal of Otology,2025,20(2):123-126.https://doi.org/10.26599/JOTO.2025.9540018 The surnames and given names of these authors are reversed:Saro-Buendía Miguel,Andresen-Lorca Belén,Pérez-García Alberto,Llópez Carratala Nacho,Carreres Polo Joan,Armengot Carceller Miguel,Perolada Valmaña Jose María.It should be Miguel Saro-Buendía,Belén Andresen-Lorca,Alberto Pérez-García,Nacho Llópez Carratala,Joan Carreres Polo,Miguel Armengot Carceller,Jose María Perolada Valmaña.
文摘Current breast reconstruction evaluations mostly focus on static cosmetic analysis as a measure of the clinical outcomes.Moreover,it is essential to consider the dynamic changes in the reconstructed breast alongside assessments of aesthetic symmetry,functional restoration,complication rates,and long-term stability of the reconstruction.This study aimed to assess the mobility of the reconstructed breast following various breast reconstruction techniques,specifically by comparing deep inferior epigastric perforator(DIEP) flaps and pedicled transverse rectus abdominis musculocutaneous(TRAM) flaps.We conducted a longitudinal case study to investigate the changes in breast movement resulting from different surgical interventions.The comparison showed that DIEP flap reconstruction was more likely to achieve superior breast mobility outcomes than TRAM flap reconstruction.For a better breast aesthetic outcome,it is fundamental to improve the awareness of the dynamic evaluation of the reconstructed breast at the surgical strategy level.
文摘Objectives:To assess outcomes of rectourethral fistula repair utilizing a gracilis flap in a largely radiated cohort.Patients and Methods:We performed a retrospective review of all gracilis interposition flap reconstruction surgeries performed for RUF at a university hospital in South Carolina between January 2010 and June 2023.All repairs utilized a multidisciplinary approach with urology,colorectal,and plastic surgery teams.Postoperatively,patients were maximally drained with foley catheter and suprapubic tube(SPT).Initial voiding cystourethrogram(VCUG)was performed at 4 weeks post-repair.If there was a persistent leak,catheter drainage was maintained for 4 additional weeks and VCUG was repeated.Success was defined as absence of leak on VCUG within 3 months after surgery.Results:22 patients met inclusion criteria.68%of patients had history of external beam radiation therapy(EBRT),13.6%had brachytherapy,and 40.9%had cryotherapy.Initial post-operative VCUG was negative in 10 patients(45.5%).Of the 12 patients with a persistent fistula,5(42%)had no evidence of fistula on subsequent VCUG after 4 weeks.Overall,68%of patients were successfully treated with gracilis interposition flap.There was a significant difference of repair success based on EBRT status(p<0.05).Conclusions:We report a success rate of 68%for gracilis flap repair of RUF.Our cohort had a higher rate of prior radiation therapy compared to other studies.A clinically significant portion of patients with an initial positive VCUG will seal their fistula with prolonged catheter drainage.Gracilis interposition flap is a reasonable surgical treatment for RUF.
文摘Background: The lumbar artery perforator(LAP) flap is an important autologous option in breast reconstruction.As the lumbar perforator flap is relatively new in this field,several questions remain regarding preoperative preparation,especially concerning computed tomography(CT) and magnetic resonance imaging of the donor site.The objective of this study was to aid the surgical approach to the LAP flap in female patients by precisely determining the characteristics of the lumbar perforators.Methods: We retrospectively reviewed the computed tomographic angiography images of 20 patients who underwent evaluation of the perforator positions from the four lumbar arteries.Four characteristics were studied:length,diameter,path of the lumbar pedicle,and thickness of the tissues available for transfer.Results: We analyzed 20 CT images,identifying 149 perforating vessels of the lumbar artery.The most suitable perforator for flap harvesting was the L4 perforator,which exhibited a larger diameter,a greater number of perforasomes,and a higher percentage of the cutaneous-septal tract.Conclusion: The LAP flap is a viable option for breast reconstruction and as a free flap in women.The L4 perforator artery is the most suitable for harvesting,owing to its superior perfusion capacity,diameter,and course;however,an interposition graft may be required to lengthen the vascular pedicle.
基金This work was supported by the National Natural Science Foundation of China(Grant Nos.92371201,52192633,11872293,and 92152301)the Natural Science Basic Research Program of Shaanxi(Grant Nos.2024JC-YBQN-0008,and 2022JC-03)+1 种基金Shaanxi Key Research and Development Program(Grant No.2022ZDLGY02-07)the Joint Natural Science Foundation of China with Guangdong Province for TianHe-II Supercomputer Resources,and the Research Start-up Foundation of Xi’an University of Science and Technology for the High-Level Talent.
文摘The flow control at low Reynolds numbers is one of the most promising technologies in the field of aerodynamics,and it is also an important source of the innovation for novel aircraft.In this study,a new way of nonlinear flow control by interaction between two flexible flaps is proposed,and their flow control mechanism is studied employing the self-constructed immersed boundary-lattice Boltzmann-finite element method(IB-LB-FEM).The effects of the difference in material properties and flap length between the two flexible flaps on the nonlinear flow control of the airfoil are discussed.It is suggested that the relationship between the deformation of the two flexible flaps and the evolution of the vortex under the fluid-structure interaction(FSI).It is shown that the upstream flexible flap plays a key role in the flow control of the two flexible flaps.The FSI effect of the upstream flexible flap will change the unsteady flow behind it and affect the deformation of the downstream flexible flap.Two flexible flaps with different material properties and different lengths will change their own FSI characteristics by the induced vortex,effectively suppressing the flow separation on the airfoil’s upper surface.The interaction of two flexible flaps plays an extremely important role in improving the autonomy and adjustability of flow control.The numerical results will provide a theoretical basis and technical guidance for the development and application of a new flap passive control technology.
文摘Soft tissue reconstruction of the radial thumb tip remains surgically challenging,particularly when standard options such as kite or Brünelli flaps are less suitable due to anatomical constraints.This technical note presents the case of a 37-year-old male with a radial-sided distal thumb defect reconstructed using a reverse homodigital dorsoradial flap.Two key refinements were applied:preservation of approximately 5 mm of subcutaneous tissue to support venous outflow and a 3-5 mm proximal safety margin at the pivot point based on Doppler assessment to reduce pedicle tension during 180◦rotation.The flap was inset without tunneling and healed without complications.Functional recovery was confirmed by progressive improvements in the disabilities of the arm,shoulder and hand score(from 25 at 1 month to 4.2 at 1 year),normal range of motion,and two-point discrimination(from 5 mm to 4 mm).This case highlights the practical advantages of flap design refinement for radial thumb reconstruction and supports its reproducibility in similar clinical scenarios.However,as this is a single case report,further validation with studies involving multiple cases is necessary to confirm the reliability and broad applicability of these refinements.
基金supported by the National Natural Science Foundation of China(Nos.52271295,52088102).
文摘To propel the application of a bottom-hinged flap breakwater in real sea conditions,a two-dimensional computational fluid dynamics numerical model was conducted to investigate the pitching motion response and wave attenuation in random waves.First,the flow velocity distribution characteristic of the pitching flap at typical times was summarized.Then,the effects of random wave and flap parameters on the flap’s significant pitching angle amplitude θ_(s) and hydrodynamic coefficients were investigated.The results reveal that θ_(s) and wave reflection coefficient K_(r) values increase with increasing significant wave height Hs,random wave steepnessλs,and flap relative height.As Hs andλs increase,the wave transmission coefficient K_(t) increases while the wave dissipation coefficient K_(d) decreases.Additionally,K_(t) decreases with increasing flap relative height.With increasing equivalent damping coefficient ratio,θ_(s) and K_(t) decrease,while K_(r) and K_(d) increase.The relationships betweenλs and flap relative height on the one hand andθ_(s),K_(r),K_(t),and K_(d) in random waves on the other hand are compared to those in regular waves.Based on the equal incident wave energy and the equal incident wave energy flux,the pitching flap performs better in the wave attenuation capability under random waves than in regular waves.Finally,the dimensionless parameters with respect to random wave and flap were used to derive the K_(r) and K_(t) for-mulae,which were validated with the related data.
