At present,the emerging solid-phase friction-based additive manufacturing technology,including friction rolling additive man-ufacturing(FRAM),can only manufacture simple single-pass components.In this study,multi-laye...At present,the emerging solid-phase friction-based additive manufacturing technology,including friction rolling additive man-ufacturing(FRAM),can only manufacture simple single-pass components.In this study,multi-layer multi-pass FRAM-deposited alumin-um alloy samples were successfully prepared using a non-shoulder tool head.The material flow behavior and microstructure of the over-lapped zone between adjacent layers and passes during multi-layer multi-pass FRAM deposition were studied using the hybrid 6061 and 5052 aluminum alloys.The results showed that a mechanical interlocking structure was formed between the adjacent layers and the adja-cent passes in the overlapped center area.Repeated friction and rolling of the tool head led to different degrees of lateral flow and plastic deformation of the materials in the overlapped zone,which made the recrystallization degree in the left and right edge zones of the over-lapped zone the highest,followed by the overlapped center zone and the non-overlapped zone.The tensile strength of the overlapped zone exceeded 90%of that of the single-pass deposition sample.It is proved that although there are uneven grooves on the surface of the over-lapping area during multi-layer and multi-pass deposition,they can be filled by the flow of materials during the deposition of the next lay-er,thus ensuring the dense microstructure and excellent mechanical properties of the overlapping area.The multi-layer multi-pass FRAM deposition overcomes the limitation of deposition width and lays the foundation for the future deposition of large-scale high-performance components.展开更多
Bcakground: Pancreatic pseudocyst (PPC) is a common complication arising from acute or chronic pancreatitis, trauma, or pancreatic duct obstruction. When acute fluid collection persists for 4 - 6 weeks and is encapsul...Bcakground: Pancreatic pseudocyst (PPC) is a common complication arising from acute or chronic pancreatitis, trauma, or pancreatic duct obstruction. When acute fluid collection persists for 4 - 6 weeks and is encapsulated by a fibrous wall, it is classified as a pancreatic pseudocyst. While PPC is generally asymptomatic in many patients, it can manifest with persistent abdominal pain, dyspepsia, intra-cystic infection, and potentially lead to gastrointestinal obstruction in some cases. Although smaller PPCs may resolve spontaneously, larger PPCs tend to be refractory to absorption and often necessitate surgical intervention to prevent complications such as intracystic hemorrhage. Objective: To explore the efficacy of percutaneous catheterization with negative pressure in the treatment of large pancreatic pseudocysts. Methods: The cases of large pancreatic pseudocysts treated in our hospital from 2004 to 2022 were retrospectively collected, and the general condition, operation time, drainage time, feeding time, postoperative complications, hospital stay, cost and follow-up of the patients were analyzed. Results: A total of 132 patients with large pancreatic pseudocysts were collected. The average operation time was 32.4 ± 2.1 min;The retention time of the drainage tube was 30 ± 1.8 days in the percutaneous negative pressure drainage group;The postoperative feeding time was no fasting after local anesthesia drainage;Postoperative complications (bleeding, infection, pancreatic leakage, recurrence, anastomotic leakage, etc.): Two of the 132 patients had recurrent cysts, which were cured by re-puncture and negative pressure drainage. The length of hospital stay was 6 ± 1.1 days;The cost was 11,200 ± 1300 yuan;Follow-up: The follow-up time ranged from 1 to 3 years, and the patients had no discomfort. Conclusion: Percutaneous catheterization and negative pressure drainage can effectively treat large pancreatic pseudocysts. Compared with other treatment methods, it is simple and effective, the postoperative recovery of patients is faster, the physical damage is less, the hospital stay is shorter, and the cost is lower.展开更多
Although time-dependent deformation of geomaterials underpins slope-failure prediction models,the influence of strain rate on shearing strength and deformation behavior of loess remains unclear.The consolidated undrai...Although time-dependent deformation of geomaterials underpins slope-failure prediction models,the influence of strain rate on shearing strength and deformation behavior of loess remains unclear.The consolidated undrained(CU)and drained(CD)triaxial testing elucidated the impact of strain rate(0.005–0.3 mm/min)on strength envelopes,deformation moduli,pore pressures,and dilatancy characteristics of unsaturated and quasi-saturated loess.Under drained conditions with a controlled matric suction of 50 kPa,increasing strain rates from 0.005 mm/min to 0.011 mm/min induced decreases in failure deviatoric stress(qf),initial deformation modulus(Ei),and cohesion(c),while friction angles remained unaffected.Specimens displayed initial contractive volumetric strains transitioning to dilation across varying confining pressures.Higher rates diminished contractive volumetric strains and drainage volumes,indicating reduced densification and strength in the shear zone.Under undrained conditions,both unsaturated and quasi-saturated(pore pressure coefficient B=0.75)loess exhibited deteriorating mechanical properties with increasing rates from 0.03 mm/min to 0.3 mm/min.For unsaturated loess,reduced contractive volumetric strains at higher rates manifested relatively looser structures in the pre-peak stress phase.The strength decrement in quasi-saturated loess arose from elevated excess porewater pressures diminishing effective stresses.Negative porewater pressures emerged in quasi-saturated loess at lower confining pressures and strain rates.Compared to previous studies,the qf and Ei exhibited rate sensitivity below threshold values before attaining minima with marginal subsequent influence.The underlying mechanism mirrors the transition from creep to accelerated deformation phase of landslides.展开更多
BACKGROUND Common bile duct stones pose a high risk of recurrence or disease progression if not promptly treated.However,there is still no optimal treatment approach.AIM To investigate the clinical efficacy of modifie...BACKGROUND Common bile duct stones pose a high risk of recurrence or disease progression if not promptly treated.However,there is still no optimal treatment approach.AIM To investigate the clinical efficacy of modified pancreatic duct stent drainage in endoscopic retrograde cholangiopancreatography(ERCP)for treating common bile duct stones.METHODS This retrospective study included 175 patients with common bile duct stones treated at Taizhou Fourth People’s Hospital between January 1,2021,and November 30,2023.The patients were divided into three groups-the modified pancreatic duct stent drainage group(59 cases),the nasobiliary drainage group(58 cases),and the standard biliary drainage group(58 cases).Preoperative general clinical data,laboratory indicators,and the visual analog scale(VAS)at two time points(24 hours before and after surgery)were compared,along with postoperative complications across the three groups.RESULTS Serum levels of aspartate aminotransferase,alanine aminotransferase,alkaline phosphatase,gamma-glutamyltransferase,total bilirubin,direct bilirubin,Creactive protein,and amylase were significantly lower in the modified pancreatic duct stent drainage group and the standard biliary drainage group than those in the nasobiliary drainage group(P<0.05).However,no statistically significant differences were observed in white blood cells,hemoglobin,or neutrophil levels among the three groups(P>0.05).The standard biliary drainage group had significantly lower VAS scores[(4.36±1.18)points]than those for the modified pancreatic duct stent drainage group[(4.92±1.68)points](P=0.033),and the nasobiliary drainage group[(5.54±1.24)points](P=0.017).There were no statistically significant differences in complication rates across the three groups(P>0.05).CONCLUSION Compared to standard biliary drainage and nasobiliary drainage,the modified pancreatic duct stent used during ERCP for patients with bile duct stones significantly reduced hepatocyte injury,improved liver function parameters,alleviated inflammation and pain,enhanced patient comfort,and demonstrated superior safety.展开更多
Endoscopic retrograde cholangiopancreatography is considered the gold standard for treating benign and malignant biliary obstructions.However,its use in complex biliary obstructions is limited.Over the past decades,th...Endoscopic retrograde cholangiopancreatography is considered the gold standard for treating benign and malignant biliary obstructions.However,its use in complex biliary obstructions is limited.Over the past decades,therapeutic endosonography(EUS)and emerging technologies such as lumen-apposing metal stents have enabled endoscopic treatment of conditions previously requiring nonendoscopic or surgical approaches.Studies show that EUS-guided choledochoduodenostomy is a reliable alternative to endoscopic retrograde cholangiopancreatography in the treatment of distal malignant biliary obstructions and can be considered a primary drainage modality in centers with adequate expertise.For malignant hilar biliary obstructions,draining at least 50%of viable liver tissue often requires combining different modalities.The treatment strategy in these patients should be individualized,depending on the Bismuth classification,patient physical status,and intended systemic therapy.Due to the lack of evidence,general recommendations cannot be made for EUS-guided hepaticoduodenostomy or combined procedures with transhepatic bridging stents.These novel techniques should be limited to selected palliative cases where conventional methods have failed and conducted within clinical trials to generate evidence before broader application.展开更多
BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a ...BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.展开更多
BACKGROUND Severe acute cholangitis is a potentially life-threatening disease in low-middle income countries(LMIC).Due to limited endoscopic services,these patients mostly undergo percutaneous transhepatic biliary dra...BACKGROUND Severe acute cholangitis is a potentially life-threatening disease in low-middle income countries(LMIC).Due to limited endoscopic services,these patients mostly undergo percutaneous transhepatic biliary drainage(PTBD).Studies from developed countries reported more complications with PTBD as compared with endoscopic retrograde cholangiopancreatography(ERCP).AIM To compare safety,therapeutic success,and survival among the PTBD and ERCP procedure in severe cholangitis in LMIC.METHODS A retrospective study was conducted in the Aga Khan University Hospital from January 2017 to December 2023.All patients who had severe acute cholangitis and underwent ERCP or PTBD were included.Patients were followed for complications,procedure success,and mortality.Data was gathered through an electronic medical record system and analyzed usingχ²and two sample t-tests.RESULTS A total of 33 patients were recruited,consisting of 12 females and 21 males with a mean age of 61 years.Among these participants,12 patients underwent ERCP,and the remaining 21 patients underwent PTBD.Therapeutic success was seen more in the ERCP group[11/12(97.1%)]than in the PTBD group[12/21 patients(57.1%)].Post-procedure complications were seen in both groups;however,more were observed in the PTBD cohort with a significant P value of 0.02.There were no mortalities among the patients who underwent ERCP while 5(23.8%)mortalities were seen in the PTBD group.CONCLUSION Fewer post-procedure complications and deaths were observed after ERCP than after PTBD,laying the foundation for large prospective studies and shifting the local paradigm of acute cholangitis treatment in LMICs.展开更多
Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperativ...Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperative pain, hospital stay, and other factors between the negative pressure group and the control group. Methods: This study is a prospective controlled trial that selected patients undergoing two-port thoracoscopic valve surgery at a certain hospital from January 2019 to December 2024. Patients were randomly assigned to the control group and the negative pressure group using a random number table method. The control group consisted of 30 patients (20 males, 10 females, mean age 42.03 ± 12.89 years), and the negative pressure group consisted of 35 patients (26 males, 9 females, mean age 41.84 ± 11.83 years). The control group received traditional chest drainage, while the negative pressure group received negative pressure chest drainage. Postoperative pain scores, hospital stay, drainage time, number of tube blockages, and incidences of pneumothorax or subcutaneous emphysema were recorded and statistically analyzed. Results: The negative pressure group had a significantly shorter postoperative drainage time compared to the control group (49.09 ± 11.99 hours vs. 79.10 ± 7.32 hours, P < 0.001). The postoperative pain score was lower in the negative pressure group (4.49 ± 1.27 vs. 7.03 ± 0.85, P < 0.001), and the hospital stay was significantly shorter (9.83 ± 1.69 days vs. 14.73 ± 2.32 days, P < 0.001). The incidence of pneumothorax or subcutaneous emphysema was significantly lower in the negative pressure group than in the control group (14.29% vs. 56.67%, P = 0.0003). Conclusion: The application of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery can effectively reduce postoperative pain, shorten hospital stay, and lower the incidence of tube blockage and pneumothorax, demonstrating good clinical outcomes.展开更多
BACKGROUND Historically intraoperative drains were employed after pancreatic surgery but over the last decade,there has been debate over the routine usage of drains.AIM To assess the necessity of intra-abdominal drain...BACKGROUND Historically intraoperative drains were employed after pancreatic surgery but over the last decade,there has been debate over the routine usage of drains.AIM To assess the necessity of intra-abdominal drain placement,identify the most effective drain type,and determine the optimal timing for drain removal.METHODS A systematic review of electronic databases,including PubMed,MEDLINE,PubMed Central,and Google Scholar,was conducted using Medical Subject Headings and keywords until December 2023.From an initial pool of 1910 articles,48 were included after exclusion and screening.The primary outcomes analyzed were clinically relevant postoperative pancreatic fistula(CR-POPF),delayed gastric emptying(DGE),overall morbidity,and mortality.Subgroup analyses were performed for pancreaticoduodenectomy and distal pancreatectomy.RESULTS Routine use of drains is associated with a statistically significant increase in the risk of CR-POPF and DGE.Conversely,patients who did not have drains placed experienced a significant reduction in morbidity,readmission rates,and reoperations.No significant differences were observed between active and passive drain types.Early drain removal(<3 days)yielded favorable outcomes compared to delayed removal.CONCLUSION Analysis of randomized controlled trials and cohort studies did not demonstrate an advantage of routine drain placement following pancreatic resection,potentially contributing to increased morbidity and mortality.The decision to use drains should be left to the discretion of the operating surgeon.However,early drain removal can substantially reduce morbidity.展开更多
BACKGROUND Bile duct leaks(BDLs)are serious postsurgical adverse events.Typically,conservative management with ab-dominal drainage is the initial treatment option.However,prolonged abdominal drainage without improveme...BACKGROUND Bile duct leaks(BDLs)are serious postsurgical adverse events.Typically,conservative management with ab-dominal drainage is the initial treatment option.However,prolonged abdominal drainage without improvement can lead to biliary stricture and delay the optimal timing of endoscopic retrograde cholangiopancreatography(ERCP).AIM To identify the optimal timing for ERCP and the period during which clinical observation with conservative management is acceptable,balancing ERCP success and the risk of biliary strictures.METHODS We conducted a multicenter retrospective study involving 448 patients with BDLs between November 2002 and November 2022.The patients were divided into four groups based on the timing of ERCP:3 days,7 days,14 days,and 21 days.The primary outcome was clinical success,defined as the resolution of BDL and related symptoms within 6 months without additional percutaneous drainage,surgery,or death.The secondary outcome was incidence of biliary strictures.Univariate and multivariate logistic regression analyses were performed to identify factors associated with ERCP success and biliary stricture occurrence.RESULTS In a cohort of 448 consecutive patients diagnosed with BDLs,354 were excluded,leaving 94 patients who underwent ERCP.Clinical success was achieved in 84%of cases(79/94),with a median ERCP timing of 20 days(9.5-35.3 days).Biliary strictures were identified in 29(30.9%)patients.Performing ERCP within 3 weeks,compared to after 3 weeks,was associated with higher success rates[92.0%(46/50)vs 75.0%(33/44),P=0.032]and a lower incidence of biliary stricture incidence[18.0%(9/50)vs 45.5%(20/44),P=0.005].Subsequent multivariate analysis confirmed the association with higher success rates(odds ratio=4.168,P=0.045)and lower biliary stricture rates(odds ratio=0.256,P=0.007).CONCLUSION Performing ERCP for BDLs within 3 weeks may be associated with a higher success rate and a lower biliary stricture rate.If patients with BDLs do not respond to conservative treatment,ERCP is suggested to be performed within 3 weeks.展开更多
Hydrogel has developed into a very important platform in solar interface evaporator.However,the current hydrogel evaporators are usually three-dimensional evaporators,which will consume a lot of raw materials.Thus,a n...Hydrogel has developed into a very important platform in solar interface evaporator.However,the current hydrogel evaporators are usually three-dimensional evaporators,which will consume a lot of raw materials.Thus,a new two-dimensional hydrogel evaporator is urgently needed to alleviate this problem.Here,a double layer hydrogel evaporator was designed by twice vacuum filtration.Furthermore,through the arched design and the introduction of concentrated brine drainage system,the hydrogel evaporator has enhanced water transportation and tailored water transportation path.Such a unique drainage evaporation system greatly improves the stability of the evaporator.Thereby,a good balance is established between photothermal conversion and water supply,and solar energy is utilized efficiently.It can remain stable in continuous evaporation for up to 12 h with an excellent evaporation rate of 2.70 kg m^(-2)h^(-1)under 1 sun irradiation.Meanwhile,the drainage system realized the 1.8×10^(-10)mol m^(-2)s^(-1)diffusion flux of concentrated brine.Through one-time freeze-drying preparation,an arch-shaped drainage evaporator was used to prepare an evaporation area of more than 20 cm^(2).With the self-made condensate collecting device in outdoor environment,the fresh water yield reaches 7.5 L m^(-2)d^(-1).This provides a new scheme for building a new hydrogel evaporator and solving the fresh water crisis.展开更多
This study evaluates the effectiveness of microwave technology in producing activated carbon from lemongrass waste,an underutilized agricultural byproduct.Microwave-assisted production offers faster heating,lower ener...This study evaluates the effectiveness of microwave technology in producing activated carbon from lemongrass waste,an underutilized agricultural byproduct.Microwave-assisted production offers faster heating,lower energy consumption,and better process control compared to conventionalmethods.It also enhances pore development,resulting in larger,cleaner,and more uniform pores,making the activated carbon more effective for adsorption.The microwave-assisted process significantly accelerates production,reducing the required time to just 10 min at a power of 400 W.Activated carbon derived from lemongrass waste at 400 W exhibits a water absorption capacity of 7.88%,ash content of 5.51%,volatile matter of 6.96%,fixed carbon of 75.79%,and an iodine number of 790.97 g iodine/100 g.Scanning Electron Microscopy(SEM)analysis confirms the formation of larger,cleaner,and smoother pores,contributing to increased porosity and pore size.Additionally,Energy Dispersive X-ray(EDX)analysis identifies key elements in the lemongrass waste,with carbon being the dominant component at 75.57%.The Brunauer-Emmett-Teller(BET)surface area is measured at 818 m^(2)/g,with an average pore diameter of 1.91 nm,classifying the material as microporous.The activated carbon,meeting quality standards,is applied as an adsorbent in acid mine drainage(AMD)treatment,with varying mass concentrations introduced intowastewater samples.Adsorption tests confirmthat the microparticle carbon adsorption profile follows the Langmuir model,indicating a monolayer adsorption process.Furthermore,adsorption kineticswere analyzed over different time intervals,revealing that the process alignswith both pseudo-first-order(PFO)and pseudo-second-order(PSO)models,with all cases predominantly following the PFO rate equation.展开更多
Coastal cities in Vietnam face increasing urban flooding vulnerability due to climate change-induced extreme pre-cipitation.This study evaluates the response capacity of urban drainage systems,using Vung Tau City as a...Coastal cities in Vietnam face increasing urban flooding vulnerability due to climate change-induced extreme pre-cipitation.This study evaluates the response capacity of urban drainage systems,using Vung Tau City as a case study.We employed a comprehensive approach,combining Intensity-Duration-Frequency(IDF)curve analysis with hydrodynamic modeling,to assess drainage performance under current and projected rainfall intensities.A significant rainfall event on June 19,2020(54.4 mm in 3 h,peaking at 42 mm/h),which exceeded the 5-year return period design(TCVN 7957:2008),caused widespread flooding(25-50 cm depths).Design rainfall hyetographs for 2,5,and 10-year return periods(TCVN 7957:2008)were developed.Results show that under more extreme scenarios,flooded areas increase significantly,with depths up to 1.05 m in the 10-year scenario and prolonged durations due to stormwater routing through regulatory lakes.The analysis reveals the current infrastructure meets only 64%of the 5-year return period demands and merely 41% for a 10-year period.This research highlights the urgent need for enhanced flood management in Vung Tau and similar coastal cities,suggesting upgrades to drainage capacity,implementation of sustainable urban drainage systems,and improved early warning.These insights are valuable for developing climate-resilient infrastructure.展开更多
The huge impact kinetic energy cannot be quickly dissipated by the energy-absorbing structure and transferred to the other vehicle through the car body structure,which will cause structural damage and threaten the liv...The huge impact kinetic energy cannot be quickly dissipated by the energy-absorbing structure and transferred to the other vehicle through the car body structure,which will cause structural damage and threaten the lives of the occupants.Therefore,it is necessary to understand the laws of energy conversion,dissipation and transfer during train collisions.This study proposes a multi-layer progressive analysis method of energy flow during train collisions,considering the characteristics of the train.In this method,the train collision system is divided into conversion,dissipation,and transfer layers from the perspective of the train,collision interface,and car body structure to analyze the energy conversion,dissipation and transfer characteristics.Taking the collision process of a rail train as an example,a train collision energy transfer path analysis model was established based on power flow theory.The results show that when the maximum mean acceleration of the vehicle meets the standard requirements,the jerk may exceed the allowable limit of the human body,and there is a risk of injury to the occupants of a secondary collision.The decay rate of the collision energy along the direction of train operation reaches 79%.As the collision progresses,the collision energy gradually converges in the structure with holes,and the structure deforms when the gathered energy is greater than the maximum energy the structure can withstand.The proposed method helps to understand the train collision energy flow law and provides theoretical support for the train crashworthiness design in the future.展开更多
BACKGROUND Liver abscess is a serious hepatic infectious disease for which percutaneous drainage has become the preferred treatment method due to its minimally invasive advantages.With the rising prevalence of non-alc...BACKGROUND Liver abscess is a serious hepatic infectious disease for which percutaneous drainage has become the preferred treatment method due to its minimally invasive advantages.With the rising prevalence of non-alcoholic fatty liver disease reaching 29.2%in Chinese adults,the number of patients with liver abscess combined with fatty liver has shown a significant increasing trend clinically.AIM To analyze risk factors affecting prognosis after percutaneous drainage in liver abscess patients with fatty liver.METHODS A retrospective analysis of 165 liver abscess patients with fatty liver who underwent percutaneous drainage from January 2020 to April 2024.Patients were divided into good prognosis(n=121,73.3%)and poor prognosis groups(n=44,26.7%)based on 30-day outcomes.Univariate and multivariate logistic regression analyses were performed to identify independent risk factors.RESULTS The poor prognosis group had older age(65.2±11.8 years vs 56.1±11.9 years,P<0.001),higher diabetes prevalence(70.5%vs 47.2%,P=0.008),elevated inflammatory markers,and lower serum albumin(26.8±4.2 g/L vs 32.1±5.6 g/L,P<0.001).Moderate-to-severe fatty liver was more prevalent in the poor prognosis group(68.2%vs 38.0%,P=0.001).Multivariate analysis identified five independent risk factors:Age≥65 years(OR=2.847,P=0.007),diabetes history(OR=3.124,P=0.003),abscess diameter≥8 cm(OR=2.591,P=0.015),serum albumin<30 g/L(OR=3.456,P=0.001),and moderate-to-severe fatty liver(OR=2.213,P=CONCLUSION)Advanced age,diabetes history,large abscess,hypoalbuminemia,and moderate-to-severe fatty liver are independent risk factors for poor prognosis after percutaneous drainage in liver abscess patients with fatty liver.展开更多
The growing incidence of cyberattacks necessitates a robust and effective Intrusion Detection Systems(IDS)for enhanced network security.While conventional IDSs can be unsuitable for detecting different and emerging at...The growing incidence of cyberattacks necessitates a robust and effective Intrusion Detection Systems(IDS)for enhanced network security.While conventional IDSs can be unsuitable for detecting different and emerging attacks,there is a demand for better techniques to improve detection reliability.This study introduces a new method,the Deep Adaptive Multi-Layer Attention Network(DAMLAN),to boost the result of intrusion detection on network data.Due to its multi-scale attention mechanisms and graph features,DAMLAN aims to address both known and unknown intrusions.The real-world NSL-KDD dataset,a popular choice among IDS researchers,is used to assess the proposed model.There are 67,343 normal samples and 58,630 intrusion attacks in the training set,12,833 normal samples,and 9711 intrusion attacks in the test set.Thus,the proposed DAMLAN method is more effective than the standard models due to the consideration of patterns by the attention layers.The experimental performance of the proposed model demonstrates that it achieves 99.26%training accuracy and 90.68%testing accuracy,with precision reaching 98.54%on the training set and 96.64%on the testing set.The recall and F1 scores again support the model with training set values of 99.90%and 99.21%and testing set values of 86.65%and 91.37%.These results provide a strong basis for the claims made regarding the model’s potential to identify intrusion attacks and affirm its relatively strong overall performance,irrespective of type.Future work would employ more attempts to extend the scalability and applicability of DAMLAN for real-time use in intrusion detection systems.展开更多
BACKGROUND Choledochal cyst is a rare biliary tract disorder with five subtypes categorized based on the anatomical location of cystic dilatation.Type IV(which affects the intrahepatic and extrahepatic ducts)is the mo...BACKGROUND Choledochal cyst is a rare biliary tract disorder with five subtypes categorized based on the anatomical location of cystic dilatation.Type IV(which affects the intrahepatic and extrahepatic ducts)is the most common subtype in adults.Its clinical manifestations are diverse and the disease can potentially become malignant.Currently,the mainstay treatment is surgical excision which is used as a definitive treatment to prevent complications and avoid carcinogenesis.However,the surgical operation for giant choledochal cysts is technically challenging.CASE SUMMARY Here,we present a case of a giant choledochal cyst in an 18-year-old female.The diagnosis of patient was confirmed through magnetic resonance cholangiopancreatography.The patient developed acute cholangitis,and was treated with percutaneous transhepatic cholangial drainage to alleviate symptoms.The final treatment approach was cyst excision followed by Roux-en-Y hepaticojejunostomy,which successfully achieved excellent postoperative recovery.CONCLUSION Ultrasonography and magnetic resonance cholangiopancreatography can effectively diagnose choledochal cysts.Combined percutaneous transhepatic cholangial drainage surgery for giant choledochal cysts is safe and effective.展开更多
BACKGROUND The current method of cleaning and changing dressings for non-healing lumbar incisions post-radiotherapy is time-consuming and laborious,with very poor results.We here report a patient with radiation dermat...BACKGROUND The current method of cleaning and changing dressings for non-healing lumbar incisions post-radiotherapy is time-consuming and laborious,with very poor results.We here report a patient with radiation dermatitis who developed a nonhealing wound after lumbar spinal surgery.The wound was successfully treated with vacuum sealing drainage therapy,confirming its feasibility in complex wound healing.CASE SUMMARY The patient was a 76-year-old female with lung cancer,positron emission tomography/computed tomography showed bone metastasis in L2 and L3 vertebrae.After 2 months of local radiotherapy to the lumbar spine,symptoms did not improve and pain worsened.She had lumbar lesion clearance and internal fixation surgery,but developed a nonhealing wound of approximately 15 cm postoperatively.After 12 rounds of clearing necrotic and unhealthy tissue,78 days of negative pressure therapy promoted granulation tissue growth and wound healing,resulting in wound healing.CONCLUSION Vacuum sealing drainage therapy has shown efficacy in treating nonhealing wounds after radiotherapy,promoting wound healing and reducing infection risk.展开更多
BACKGROUND Pyogenic liver abscess(PLA)is a prevalent liver infection with gradual onset and severe symptoms,including fever,abdominal pain,jaundice,and vomiting.Complications like sepsis or toxic shock can also occur....BACKGROUND Pyogenic liver abscess(PLA)is a prevalent liver infection with gradual onset and severe symptoms,including fever,abdominal pain,jaundice,and vomiting.Complications like sepsis or toxic shock can also occur.AIM To investigate the clinical value of early ultrasound-guided percutaneous drainage(PCD)in PLA patients,specifically those with non-liquefied abscesses,and evaluate the feasibility of early intervention.METHODS This retrospective analysis included 143 patients with PLA who were admitted to the Department of General Surgery between January 2018 and March 2023.All patients underwent ultrasound-guided PCD.Based on the liquefaction status of the abscess,patients were divided into two groups:Liquefied group and nonliquefied group.Clinical outcomes,including puncture success rate,puncture duration,length of hospital stay,time to fever resolution,abscess shrinkage rate,and complication rates,were compared between the two groups.RESULTS The puncture success rate for all patients was 99.3%,with a postoperative complication rate of 5.59%,and no intraoperative deaths occurred.Compared to the liquefied group,the non-liquefied group had significantly shorter hospital stays(3.9±1.8 days vs 5.1±2.7 days),faster fever resolution(2.4±1.1 days vs 4.9±2.2 days),and quicker abscess shrinkage(>50%)(4.7±1.5 days vs 8.6±3.3 days)(P<0.05).There were no significant differences in puncture success rates or complication rates between the two groups.CONCLUSION Early ultrasound-guided PCD can be safely and effectively performed in PLA,even when the abscess is not fully liquefied or is non-liquefied,supporting the clinical feasibility of early intervention.展开更多
BACKGROUND Type Ⅲ choledochal cysts(CCs)are extremely rare,and they present as dilatations and herniations of the end of the common bile duct into the duodenum.Moreover,type Ⅱ CCs may be easily misdiagnosed as intra...BACKGROUND Type Ⅲ choledochal cysts(CCs)are extremely rare,and they present as dilatations and herniations of the end of the common bile duct into the duodenum.Moreover,type Ⅱ CCs may be easily misdiagnosed as intraduodenal polyps or tumors.Thus,adequate differential diagnosis and selection of appropriate treatment are important.CASE SUMMARY A young man with a duodenal mass presented with 3-year intermittent abdominal pain and acute pancreatitis 3 days before hospitalization.After evaluation by magnetic resonance imaging and endoscopic ultrasonography,the duodenal papilla was pressed,and the bile flowed out slowly,which was speculated to be the cause of his symptoms.The lesion was punctured with a submucosal injection needle,and golden clear fluid was aspirated.Laboratory tests of the aspirate after 50-fold dilution revealed significantly elevated total bilirubin,direct bilirubin,amylase and lipase.Taken together,these findings confirmed that the lesion was a type Ⅲ CC.The patient underwent fused surgical procedures.Fenestration plus internal drainage of the lesion was subsequently performed with a DualKnife.After drainage,the incision was sealed with tissue clips.During follow-up,the patient recovered well,and no abdominal pain symptoms or acute pancreatitis recurred.CONCLUSION Laboratory tests of cyst aspirates are beneficial for diagnosis,and endoscopic fenestration plus internal drainage works well to mitigate cysts.展开更多
基金supported by the National Key Research and Development Program of China(No.2022YFB3404700)the National Natural Science Foundation of China(Nos.52105313 and 52275299)+2 种基金the Research and Development Program of Beijing Municipal Education Commission,China(No.KM202210005036)the Natural Science Foundation of Chongqing,China(No.CSTB2023NSCQ-MSX0701)the National Defense Basic Research Projects of China(No.JCKY2022405C002).
文摘At present,the emerging solid-phase friction-based additive manufacturing technology,including friction rolling additive man-ufacturing(FRAM),can only manufacture simple single-pass components.In this study,multi-layer multi-pass FRAM-deposited alumin-um alloy samples were successfully prepared using a non-shoulder tool head.The material flow behavior and microstructure of the over-lapped zone between adjacent layers and passes during multi-layer multi-pass FRAM deposition were studied using the hybrid 6061 and 5052 aluminum alloys.The results showed that a mechanical interlocking structure was formed between the adjacent layers and the adja-cent passes in the overlapped center area.Repeated friction and rolling of the tool head led to different degrees of lateral flow and plastic deformation of the materials in the overlapped zone,which made the recrystallization degree in the left and right edge zones of the over-lapped zone the highest,followed by the overlapped center zone and the non-overlapped zone.The tensile strength of the overlapped zone exceeded 90%of that of the single-pass deposition sample.It is proved that although there are uneven grooves on the surface of the over-lapping area during multi-layer and multi-pass deposition,they can be filled by the flow of materials during the deposition of the next lay-er,thus ensuring the dense microstructure and excellent mechanical properties of the overlapping area.The multi-layer multi-pass FRAM deposition overcomes the limitation of deposition width and lays the foundation for the future deposition of large-scale high-performance components.
文摘Bcakground: Pancreatic pseudocyst (PPC) is a common complication arising from acute or chronic pancreatitis, trauma, or pancreatic duct obstruction. When acute fluid collection persists for 4 - 6 weeks and is encapsulated by a fibrous wall, it is classified as a pancreatic pseudocyst. While PPC is generally asymptomatic in many patients, it can manifest with persistent abdominal pain, dyspepsia, intra-cystic infection, and potentially lead to gastrointestinal obstruction in some cases. Although smaller PPCs may resolve spontaneously, larger PPCs tend to be refractory to absorption and often necessitate surgical intervention to prevent complications such as intracystic hemorrhage. Objective: To explore the efficacy of percutaneous catheterization with negative pressure in the treatment of large pancreatic pseudocysts. Methods: The cases of large pancreatic pseudocysts treated in our hospital from 2004 to 2022 were retrospectively collected, and the general condition, operation time, drainage time, feeding time, postoperative complications, hospital stay, cost and follow-up of the patients were analyzed. Results: A total of 132 patients with large pancreatic pseudocysts were collected. The average operation time was 32.4 ± 2.1 min;The retention time of the drainage tube was 30 ± 1.8 days in the percutaneous negative pressure drainage group;The postoperative feeding time was no fasting after local anesthesia drainage;Postoperative complications (bleeding, infection, pancreatic leakage, recurrence, anastomotic leakage, etc.): Two of the 132 patients had recurrent cysts, which were cured by re-puncture and negative pressure drainage. The length of hospital stay was 6 ± 1.1 days;The cost was 11,200 ± 1300 yuan;Follow-up: The follow-up time ranged from 1 to 3 years, and the patients had no discomfort. Conclusion: Percutaneous catheterization and negative pressure drainage can effectively treat large pancreatic pseudocysts. Compared with other treatment methods, it is simple and effective, the postoperative recovery of patients is faster, the physical damage is less, the hospital stay is shorter, and the cost is lower.
文摘Although time-dependent deformation of geomaterials underpins slope-failure prediction models,the influence of strain rate on shearing strength and deformation behavior of loess remains unclear.The consolidated undrained(CU)and drained(CD)triaxial testing elucidated the impact of strain rate(0.005–0.3 mm/min)on strength envelopes,deformation moduli,pore pressures,and dilatancy characteristics of unsaturated and quasi-saturated loess.Under drained conditions with a controlled matric suction of 50 kPa,increasing strain rates from 0.005 mm/min to 0.011 mm/min induced decreases in failure deviatoric stress(qf),initial deformation modulus(Ei),and cohesion(c),while friction angles remained unaffected.Specimens displayed initial contractive volumetric strains transitioning to dilation across varying confining pressures.Higher rates diminished contractive volumetric strains and drainage volumes,indicating reduced densification and strength in the shear zone.Under undrained conditions,both unsaturated and quasi-saturated(pore pressure coefficient B=0.75)loess exhibited deteriorating mechanical properties with increasing rates from 0.03 mm/min to 0.3 mm/min.For unsaturated loess,reduced contractive volumetric strains at higher rates manifested relatively looser structures in the pre-peak stress phase.The strength decrement in quasi-saturated loess arose from elevated excess porewater pressures diminishing effective stresses.Negative porewater pressures emerged in quasi-saturated loess at lower confining pressures and strain rates.Compared to previous studies,the qf and Ei exhibited rate sensitivity below threshold values before attaining minima with marginal subsequent influence.The underlying mechanism mirrors the transition from creep to accelerated deformation phase of landslides.
文摘BACKGROUND Common bile duct stones pose a high risk of recurrence or disease progression if not promptly treated.However,there is still no optimal treatment approach.AIM To investigate the clinical efficacy of modified pancreatic duct stent drainage in endoscopic retrograde cholangiopancreatography(ERCP)for treating common bile duct stones.METHODS This retrospective study included 175 patients with common bile duct stones treated at Taizhou Fourth People’s Hospital between January 1,2021,and November 30,2023.The patients were divided into three groups-the modified pancreatic duct stent drainage group(59 cases),the nasobiliary drainage group(58 cases),and the standard biliary drainage group(58 cases).Preoperative general clinical data,laboratory indicators,and the visual analog scale(VAS)at two time points(24 hours before and after surgery)were compared,along with postoperative complications across the three groups.RESULTS Serum levels of aspartate aminotransferase,alanine aminotransferase,alkaline phosphatase,gamma-glutamyltransferase,total bilirubin,direct bilirubin,Creactive protein,and amylase were significantly lower in the modified pancreatic duct stent drainage group and the standard biliary drainage group than those in the nasobiliary drainage group(P<0.05).However,no statistically significant differences were observed in white blood cells,hemoglobin,or neutrophil levels among the three groups(P>0.05).The standard biliary drainage group had significantly lower VAS scores[(4.36±1.18)points]than those for the modified pancreatic duct stent drainage group[(4.92±1.68)points](P=0.033),and the nasobiliary drainage group[(5.54±1.24)points](P=0.017).There were no statistically significant differences in complication rates across the three groups(P>0.05).CONCLUSION Compared to standard biliary drainage and nasobiliary drainage,the modified pancreatic duct stent used during ERCP for patients with bile duct stones significantly reduced hepatocyte injury,improved liver function parameters,alleviated inflammation and pain,enhanced patient comfort,and demonstrated superior safety.
文摘Endoscopic retrograde cholangiopancreatography is considered the gold standard for treating benign and malignant biliary obstructions.However,its use in complex biliary obstructions is limited.Over the past decades,therapeutic endosonography(EUS)and emerging technologies such as lumen-apposing metal stents have enabled endoscopic treatment of conditions previously requiring nonendoscopic or surgical approaches.Studies show that EUS-guided choledochoduodenostomy is a reliable alternative to endoscopic retrograde cholangiopancreatography in the treatment of distal malignant biliary obstructions and can be considered a primary drainage modality in centers with adequate expertise.For malignant hilar biliary obstructions,draining at least 50%of viable liver tissue often requires combining different modalities.The treatment strategy in these patients should be individualized,depending on the Bismuth classification,patient physical status,and intended systemic therapy.Due to the lack of evidence,general recommendations cannot be made for EUS-guided hepaticoduodenostomy or combined procedures with transhepatic bridging stents.These novel techniques should be limited to selected palliative cases where conventional methods have failed and conducted within clinical trials to generate evidence before broader application.
基金Supported by Natural Science Foundation of Shandong Province,No.ZR2023MH331.
文摘BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.
文摘BACKGROUND Severe acute cholangitis is a potentially life-threatening disease in low-middle income countries(LMIC).Due to limited endoscopic services,these patients mostly undergo percutaneous transhepatic biliary drainage(PTBD).Studies from developed countries reported more complications with PTBD as compared with endoscopic retrograde cholangiopancreatography(ERCP).AIM To compare safety,therapeutic success,and survival among the PTBD and ERCP procedure in severe cholangitis in LMIC.METHODS A retrospective study was conducted in the Aga Khan University Hospital from January 2017 to December 2023.All patients who had severe acute cholangitis and underwent ERCP or PTBD were included.Patients were followed for complications,procedure success,and mortality.Data was gathered through an electronic medical record system and analyzed usingχ²and two sample t-tests.RESULTS A total of 33 patients were recruited,consisting of 12 females and 21 males with a mean age of 61 years.Among these participants,12 patients underwent ERCP,and the remaining 21 patients underwent PTBD.Therapeutic success was seen more in the ERCP group[11/12(97.1%)]than in the PTBD group[12/21 patients(57.1%)].Post-procedure complications were seen in both groups;however,more were observed in the PTBD cohort with a significant P value of 0.02.There were no mortalities among the patients who underwent ERCP while 5(23.8%)mortalities were seen in the PTBD group.CONCLUSION Fewer post-procedure complications and deaths were observed after ERCP than after PTBD,laying the foundation for large prospective studies and shifting the local paradigm of acute cholangitis treatment in LMICs.
文摘Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperative pain, hospital stay, and other factors between the negative pressure group and the control group. Methods: This study is a prospective controlled trial that selected patients undergoing two-port thoracoscopic valve surgery at a certain hospital from January 2019 to December 2024. Patients were randomly assigned to the control group and the negative pressure group using a random number table method. The control group consisted of 30 patients (20 males, 10 females, mean age 42.03 ± 12.89 years), and the negative pressure group consisted of 35 patients (26 males, 9 females, mean age 41.84 ± 11.83 years). The control group received traditional chest drainage, while the negative pressure group received negative pressure chest drainage. Postoperative pain scores, hospital stay, drainage time, number of tube blockages, and incidences of pneumothorax or subcutaneous emphysema were recorded and statistically analyzed. Results: The negative pressure group had a significantly shorter postoperative drainage time compared to the control group (49.09 ± 11.99 hours vs. 79.10 ± 7.32 hours, P < 0.001). The postoperative pain score was lower in the negative pressure group (4.49 ± 1.27 vs. 7.03 ± 0.85, P < 0.001), and the hospital stay was significantly shorter (9.83 ± 1.69 days vs. 14.73 ± 2.32 days, P < 0.001). The incidence of pneumothorax or subcutaneous emphysema was significantly lower in the negative pressure group than in the control group (14.29% vs. 56.67%, P = 0.0003). Conclusion: The application of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery can effectively reduce postoperative pain, shorten hospital stay, and lower the incidence of tube blockage and pneumothorax, demonstrating good clinical outcomes.
文摘BACKGROUND Historically intraoperative drains were employed after pancreatic surgery but over the last decade,there has been debate over the routine usage of drains.AIM To assess the necessity of intra-abdominal drain placement,identify the most effective drain type,and determine the optimal timing for drain removal.METHODS A systematic review of electronic databases,including PubMed,MEDLINE,PubMed Central,and Google Scholar,was conducted using Medical Subject Headings and keywords until December 2023.From an initial pool of 1910 articles,48 were included after exclusion and screening.The primary outcomes analyzed were clinically relevant postoperative pancreatic fistula(CR-POPF),delayed gastric emptying(DGE),overall morbidity,and mortality.Subgroup analyses were performed for pancreaticoduodenectomy and distal pancreatectomy.RESULTS Routine use of drains is associated with a statistically significant increase in the risk of CR-POPF and DGE.Conversely,patients who did not have drains placed experienced a significant reduction in morbidity,readmission rates,and reoperations.No significant differences were observed between active and passive drain types.Early drain removal(<3 days)yielded favorable outcomes compared to delayed removal.CONCLUSION Analysis of randomized controlled trials and cohort studies did not demonstrate an advantage of routine drain placement following pancreatic resection,potentially contributing to increased morbidity and mortality.The decision to use drains should be left to the discretion of the operating surgeon.However,early drain removal can substantially reduce morbidity.
基金Supported by the National Key Research and Development Program,China,No.2022YFC2503603.
文摘BACKGROUND Bile duct leaks(BDLs)are serious postsurgical adverse events.Typically,conservative management with ab-dominal drainage is the initial treatment option.However,prolonged abdominal drainage without improvement can lead to biliary stricture and delay the optimal timing of endoscopic retrograde cholangiopancreatography(ERCP).AIM To identify the optimal timing for ERCP and the period during which clinical observation with conservative management is acceptable,balancing ERCP success and the risk of biliary strictures.METHODS We conducted a multicenter retrospective study involving 448 patients with BDLs between November 2002 and November 2022.The patients were divided into four groups based on the timing of ERCP:3 days,7 days,14 days,and 21 days.The primary outcome was clinical success,defined as the resolution of BDL and related symptoms within 6 months without additional percutaneous drainage,surgery,or death.The secondary outcome was incidence of biliary strictures.Univariate and multivariate logistic regression analyses were performed to identify factors associated with ERCP success and biliary stricture occurrence.RESULTS In a cohort of 448 consecutive patients diagnosed with BDLs,354 were excluded,leaving 94 patients who underwent ERCP.Clinical success was achieved in 84%of cases(79/94),with a median ERCP timing of 20 days(9.5-35.3 days).Biliary strictures were identified in 29(30.9%)patients.Performing ERCP within 3 weeks,compared to after 3 weeks,was associated with higher success rates[92.0%(46/50)vs 75.0%(33/44),P=0.032]and a lower incidence of biliary stricture incidence[18.0%(9/50)vs 45.5%(20/44),P=0.005].Subsequent multivariate analysis confirmed the association with higher success rates(odds ratio=4.168,P=0.045)and lower biliary stricture rates(odds ratio=0.256,P=0.007).CONCLUSION Performing ERCP for BDLs within 3 weeks may be associated with a higher success rate and a lower biliary stricture rate.If patients with BDLs do not respond to conservative treatment,ERCP is suggested to be performed within 3 weeks.
基金the financial support of the National Natural Science Foundation of China(No.52075309)the Youth Innovation Team of Shaanxi Universities(21JP021)。
文摘Hydrogel has developed into a very important platform in solar interface evaporator.However,the current hydrogel evaporators are usually three-dimensional evaporators,which will consume a lot of raw materials.Thus,a new two-dimensional hydrogel evaporator is urgently needed to alleviate this problem.Here,a double layer hydrogel evaporator was designed by twice vacuum filtration.Furthermore,through the arched design and the introduction of concentrated brine drainage system,the hydrogel evaporator has enhanced water transportation and tailored water transportation path.Such a unique drainage evaporation system greatly improves the stability of the evaporator.Thereby,a good balance is established between photothermal conversion and water supply,and solar energy is utilized efficiently.It can remain stable in continuous evaporation for up to 12 h with an excellent evaporation rate of 2.70 kg m^(-2)h^(-1)under 1 sun irradiation.Meanwhile,the drainage system realized the 1.8×10^(-10)mol m^(-2)s^(-1)diffusion flux of concentrated brine.Through one-time freeze-drying preparation,an arch-shaped drainage evaporator was used to prepare an evaporation area of more than 20 cm^(2).With the self-made condensate collecting device in outdoor environment,the fresh water yield reaches 7.5 L m^(-2)d^(-1).This provides a new scheme for building a new hydrogel evaporator and solving the fresh water crisis.
基金funded by the Ministry of Research,Technology,and Higher Education under Grant Number B/67/D.D3/KD.02.00/2019as part of the BPPDN(Beasiswa Pendidikan Pascasarjana Dalam Negeri—Domestic Postgraduate Education Scholarship)program.
文摘This study evaluates the effectiveness of microwave technology in producing activated carbon from lemongrass waste,an underutilized agricultural byproduct.Microwave-assisted production offers faster heating,lower energy consumption,and better process control compared to conventionalmethods.It also enhances pore development,resulting in larger,cleaner,and more uniform pores,making the activated carbon more effective for adsorption.The microwave-assisted process significantly accelerates production,reducing the required time to just 10 min at a power of 400 W.Activated carbon derived from lemongrass waste at 400 W exhibits a water absorption capacity of 7.88%,ash content of 5.51%,volatile matter of 6.96%,fixed carbon of 75.79%,and an iodine number of 790.97 g iodine/100 g.Scanning Electron Microscopy(SEM)analysis confirms the formation of larger,cleaner,and smoother pores,contributing to increased porosity and pore size.Additionally,Energy Dispersive X-ray(EDX)analysis identifies key elements in the lemongrass waste,with carbon being the dominant component at 75.57%.The Brunauer-Emmett-Teller(BET)surface area is measured at 818 m^(2)/g,with an average pore diameter of 1.91 nm,classifying the material as microporous.The activated carbon,meeting quality standards,is applied as an adsorbent in acid mine drainage(AMD)treatment,with varying mass concentrations introduced intowastewater samples.Adsorption tests confirmthat the microparticle carbon adsorption profile follows the Langmuir model,indicating a monolayer adsorption process.Furthermore,adsorption kineticswere analyzed over different time intervals,revealing that the process alignswith both pseudo-first-order(PFO)and pseudo-second-order(PSO)models,with all cases predominantly following the PFO rate equation.
基金supported by the Ministry of Natural Resources and Environment project 2024.06.04,“Research on the application of artificial intelligence combined with remote sensing in warning of flood risks due to heavy rain and high tides for coastal cities”,grant number 2024.06.04.
文摘Coastal cities in Vietnam face increasing urban flooding vulnerability due to climate change-induced extreme pre-cipitation.This study evaluates the response capacity of urban drainage systems,using Vung Tau City as a case study.We employed a comprehensive approach,combining Intensity-Duration-Frequency(IDF)curve analysis with hydrodynamic modeling,to assess drainage performance under current and projected rainfall intensities.A significant rainfall event on June 19,2020(54.4 mm in 3 h,peaking at 42 mm/h),which exceeded the 5-year return period design(TCVN 7957:2008),caused widespread flooding(25-50 cm depths).Design rainfall hyetographs for 2,5,and 10-year return periods(TCVN 7957:2008)were developed.Results show that under more extreme scenarios,flooded areas increase significantly,with depths up to 1.05 m in the 10-year scenario and prolonged durations due to stormwater routing through regulatory lakes.The analysis reveals the current infrastructure meets only 64%of the 5-year return period demands and merely 41% for a 10-year period.This research highlights the urgent need for enhanced flood management in Vung Tau and similar coastal cities,suggesting upgrades to drainage capacity,implementation of sustainable urban drainage systems,and improved early warning.These insights are valuable for developing climate-resilient infrastructure.
基金Supported by the National Natural Science Foundation of China(Grant No.52172409)Postdoctoral Innovation Talents Support Program(Grant No.BX20240298)+1 种基金the Fundamental Research Funds for the Central Universities(Grant No.2682024GF023)Heilongjiang Province Postdoctoral Foundation Project(Grant No.LBH-Z23041).
文摘The huge impact kinetic energy cannot be quickly dissipated by the energy-absorbing structure and transferred to the other vehicle through the car body structure,which will cause structural damage and threaten the lives of the occupants.Therefore,it is necessary to understand the laws of energy conversion,dissipation and transfer during train collisions.This study proposes a multi-layer progressive analysis method of energy flow during train collisions,considering the characteristics of the train.In this method,the train collision system is divided into conversion,dissipation,and transfer layers from the perspective of the train,collision interface,and car body structure to analyze the energy conversion,dissipation and transfer characteristics.Taking the collision process of a rail train as an example,a train collision energy transfer path analysis model was established based on power flow theory.The results show that when the maximum mean acceleration of the vehicle meets the standard requirements,the jerk may exceed the allowable limit of the human body,and there is a risk of injury to the occupants of a secondary collision.The decay rate of the collision energy along the direction of train operation reaches 79%.As the collision progresses,the collision energy gradually converges in the structure with holes,and the structure deforms when the gathered energy is greater than the maximum energy the structure can withstand.The proposed method helps to understand the train collision energy flow law and provides theoretical support for the train crashworthiness design in the future.
基金Supported by Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project,No.2024ZL039.
文摘BACKGROUND Liver abscess is a serious hepatic infectious disease for which percutaneous drainage has become the preferred treatment method due to its minimally invasive advantages.With the rising prevalence of non-alcoholic fatty liver disease reaching 29.2%in Chinese adults,the number of patients with liver abscess combined with fatty liver has shown a significant increasing trend clinically.AIM To analyze risk factors affecting prognosis after percutaneous drainage in liver abscess patients with fatty liver.METHODS A retrospective analysis of 165 liver abscess patients with fatty liver who underwent percutaneous drainage from January 2020 to April 2024.Patients were divided into good prognosis(n=121,73.3%)and poor prognosis groups(n=44,26.7%)based on 30-day outcomes.Univariate and multivariate logistic regression analyses were performed to identify independent risk factors.RESULTS The poor prognosis group had older age(65.2±11.8 years vs 56.1±11.9 years,P<0.001),higher diabetes prevalence(70.5%vs 47.2%,P=0.008),elevated inflammatory markers,and lower serum albumin(26.8±4.2 g/L vs 32.1±5.6 g/L,P<0.001).Moderate-to-severe fatty liver was more prevalent in the poor prognosis group(68.2%vs 38.0%,P=0.001).Multivariate analysis identified five independent risk factors:Age≥65 years(OR=2.847,P=0.007),diabetes history(OR=3.124,P=0.003),abscess diameter≥8 cm(OR=2.591,P=0.015),serum albumin<30 g/L(OR=3.456,P=0.001),and moderate-to-severe fatty liver(OR=2.213,P=CONCLUSION)Advanced age,diabetes history,large abscess,hypoalbuminemia,and moderate-to-severe fatty liver are independent risk factors for poor prognosis after percutaneous drainage in liver abscess patients with fatty liver.
基金Nourah bint Abdulrahman University for funding this project through the Researchers Supporting Project(PNURSP2025R319)Riyadh,Saudi Arabia and Prince Sultan University for covering the article processing charges(APC)associated with this publication.Special acknowledgement to Automated Systems&Soft Computing Lab(ASSCL),Prince Sultan University,Riyadh,Saudi Arabia.
文摘The growing incidence of cyberattacks necessitates a robust and effective Intrusion Detection Systems(IDS)for enhanced network security.While conventional IDSs can be unsuitable for detecting different and emerging attacks,there is a demand for better techniques to improve detection reliability.This study introduces a new method,the Deep Adaptive Multi-Layer Attention Network(DAMLAN),to boost the result of intrusion detection on network data.Due to its multi-scale attention mechanisms and graph features,DAMLAN aims to address both known and unknown intrusions.The real-world NSL-KDD dataset,a popular choice among IDS researchers,is used to assess the proposed model.There are 67,343 normal samples and 58,630 intrusion attacks in the training set,12,833 normal samples,and 9711 intrusion attacks in the test set.Thus,the proposed DAMLAN method is more effective than the standard models due to the consideration of patterns by the attention layers.The experimental performance of the proposed model demonstrates that it achieves 99.26%training accuracy and 90.68%testing accuracy,with precision reaching 98.54%on the training set and 96.64%on the testing set.The recall and F1 scores again support the model with training set values of 99.90%and 99.21%and testing set values of 86.65%and 91.37%.These results provide a strong basis for the claims made regarding the model’s potential to identify intrusion attacks and affirm its relatively strong overall performance,irrespective of type.Future work would employ more attempts to extend the scalability and applicability of DAMLAN for real-time use in intrusion detection systems.
基金Supported by Cuiying Scientific and Technological Innovation Program of Lanzhou University Second Hospital,No.CY2024-MS-B04Gansu Provincial Natural Science Foundation Project,No.24JRRA331the Traditional Chinese Medicine Research Project of Gansu Province,No.GZKZ-2024-26.
文摘BACKGROUND Choledochal cyst is a rare biliary tract disorder with five subtypes categorized based on the anatomical location of cystic dilatation.Type IV(which affects the intrahepatic and extrahepatic ducts)is the most common subtype in adults.Its clinical manifestations are diverse and the disease can potentially become malignant.Currently,the mainstay treatment is surgical excision which is used as a definitive treatment to prevent complications and avoid carcinogenesis.However,the surgical operation for giant choledochal cysts is technically challenging.CASE SUMMARY Here,we present a case of a giant choledochal cyst in an 18-year-old female.The diagnosis of patient was confirmed through magnetic resonance cholangiopancreatography.The patient developed acute cholangitis,and was treated with percutaneous transhepatic cholangial drainage to alleviate symptoms.The final treatment approach was cyst excision followed by Roux-en-Y hepaticojejunostomy,which successfully achieved excellent postoperative recovery.CONCLUSION Ultrasonography and magnetic resonance cholangiopancreatography can effectively diagnose choledochal cysts.Combined percutaneous transhepatic cholangial drainage surgery for giant choledochal cysts is safe and effective.
文摘BACKGROUND The current method of cleaning and changing dressings for non-healing lumbar incisions post-radiotherapy is time-consuming and laborious,with very poor results.We here report a patient with radiation dermatitis who developed a nonhealing wound after lumbar spinal surgery.The wound was successfully treated with vacuum sealing drainage therapy,confirming its feasibility in complex wound healing.CASE SUMMARY The patient was a 76-year-old female with lung cancer,positron emission tomography/computed tomography showed bone metastasis in L2 and L3 vertebrae.After 2 months of local radiotherapy to the lumbar spine,symptoms did not improve and pain worsened.She had lumbar lesion clearance and internal fixation surgery,but developed a nonhealing wound of approximately 15 cm postoperatively.After 12 rounds of clearing necrotic and unhealthy tissue,78 days of negative pressure therapy promoted granulation tissue growth and wound healing,resulting in wound healing.CONCLUSION Vacuum sealing drainage therapy has shown efficacy in treating nonhealing wounds after radiotherapy,promoting wound healing and reducing infection risk.
文摘BACKGROUND Pyogenic liver abscess(PLA)is a prevalent liver infection with gradual onset and severe symptoms,including fever,abdominal pain,jaundice,and vomiting.Complications like sepsis or toxic shock can also occur.AIM To investigate the clinical value of early ultrasound-guided percutaneous drainage(PCD)in PLA patients,specifically those with non-liquefied abscesses,and evaluate the feasibility of early intervention.METHODS This retrospective analysis included 143 patients with PLA who were admitted to the Department of General Surgery between January 2018 and March 2023.All patients underwent ultrasound-guided PCD.Based on the liquefaction status of the abscess,patients were divided into two groups:Liquefied group and nonliquefied group.Clinical outcomes,including puncture success rate,puncture duration,length of hospital stay,time to fever resolution,abscess shrinkage rate,and complication rates,were compared between the two groups.RESULTS The puncture success rate for all patients was 99.3%,with a postoperative complication rate of 5.59%,and no intraoperative deaths occurred.Compared to the liquefied group,the non-liquefied group had significantly shorter hospital stays(3.9±1.8 days vs 5.1±2.7 days),faster fever resolution(2.4±1.1 days vs 4.9±2.2 days),and quicker abscess shrinkage(>50%)(4.7±1.5 days vs 8.6±3.3 days)(P<0.05).There were no significant differences in puncture success rates or complication rates between the two groups.CONCLUSION Early ultrasound-guided PCD can be safely and effectively performed in PLA,even when the abscess is not fully liquefied or is non-liquefied,supporting the clinical feasibility of early intervention.
文摘BACKGROUND Type Ⅲ choledochal cysts(CCs)are extremely rare,and they present as dilatations and herniations of the end of the common bile duct into the duodenum.Moreover,type Ⅱ CCs may be easily misdiagnosed as intraduodenal polyps or tumors.Thus,adequate differential diagnosis and selection of appropriate treatment are important.CASE SUMMARY A young man with a duodenal mass presented with 3-year intermittent abdominal pain and acute pancreatitis 3 days before hospitalization.After evaluation by magnetic resonance imaging and endoscopic ultrasonography,the duodenal papilla was pressed,and the bile flowed out slowly,which was speculated to be the cause of his symptoms.The lesion was punctured with a submucosal injection needle,and golden clear fluid was aspirated.Laboratory tests of the aspirate after 50-fold dilution revealed significantly elevated total bilirubin,direct bilirubin,amylase and lipase.Taken together,these findings confirmed that the lesion was a type Ⅲ CC.The patient underwent fused surgical procedures.Fenestration plus internal drainage of the lesion was subsequently performed with a DualKnife.After drainage,the incision was sealed with tissue clips.During follow-up,the patient recovered well,and no abdominal pain symptoms or acute pancreatitis recurred.CONCLUSION Laboratory tests of cyst aspirates are beneficial for diagnosis,and endoscopic fenestration plus internal drainage works well to mitigate cysts.
