BACKGROUND A male urethral disruption injury is a urological emergency.Primary endoscopic realignment(PER)refers to reestablishment of urethral alignment via indwelling urethral catheter by cystoscope,which is recomme...BACKGROUND A male urethral disruption injury is a urological emergency.Primary endoscopic realignment(PER)refers to reestablishment of urethral alignment via indwelling urethral catheter by cystoscope,which is recommended as the optimal emergent treatment approach for reducing the likelihood of complications following injury.However,the prior literature suggests the success rate of PER to be relatively low due to complicated urethral disruption.We report a modified PER approach that serves to improve both the success rate and safety of the treatment.CASE SUMMARY A 19-year-old male patient presented with multiple pelvic fractures and complete urethral disruption following a high-velocity traffic accident.The patient’s abdominal computed tomography and retrograde urethrography results revealed complete urethral disruption at the bulbar urethra,with hematoma and contrast medium extravasation that extended into the extraperitoneal space.The conventional retrograde PER by cystoscope failed due to severe disruption and considerable hematoma.Modified simultaneous antegrade and retrograde PER was performed by means of semi-rigid ureteroscopy via a suprapubic Foley catheter and cystoscopy via the external urethra.An antegrade guidewire was passed through the bladder neck and then pulled out through the external urethral meatus with a cystoscope.Urethral continuity was achieved after a 16-Fr silicone Foley catheter was indwelled into the bladder along the guidewire.The patient recovered well,achieving voiding continence and avoiding further operation for urethral stricture.CONCLUSION Modified PER via suprapubic Foley catheter represents a promising and safe treatment approach in patients with posterior urethral injuries.展开更多
Background: Posterior urethral injury usually occurs in male patients with pelvic fractures. Posterior urethral injuries are associated with considerable morbidity including urinary incontinence, erectile dysfunction ...Background: Posterior urethral injury usually occurs in male patients with pelvic fractures. Posterior urethral injuries are associated with considerable morbidity including urinary incontinence, erectile dysfunction and urethral stricture. Objective: To compare the outcomes between early primary endoscopic realignment and delayed reconstruction in the management of male patients of posterior urethral injury. Methodology: This prospective study was conducted in the department of urology and department of casualty, Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2015 to June 2017 among 50 male patients with posterior urethral injury. Fifty patients were randomly allocated into two groups;the group A consisted of 24 patients underwent early primary endoscopic realignment within 10 days after posterior urethral injury and the group B consisted of 26 patients underwent delayed reconstruction in form of anastomotic urethroplasty after 3 months. All patients were followed up at 3rd, 6th and 9th month after the procedure. Outcome variables were post-operative urethral stricture, urinary incontinence and erectile dysfunction. Data were analyzed and compared by statistical tests. Results: The mean (±SD) age of the study patients was almost similar between the groups (28.8 ± 8.4 vs. 27.4 ± 7.2 years, p = 0.486). In group A, 83.33% patients developed postoperative urethral stricture, none of them developed urinary incontinence and 20.83% developed erectile dysfunction;On the other hand, in group B, these rates were 38.46%, 23.07% and 38.46% respectively. Postoperative urethral stricture formation was significantly higher in Group A (p = 0.0012) but urinary incontinence and erectile dysfunction rates were significantly higher in Group B (p = 0.018 and p = 0.042 respectively). Conclusion: Early primary endoscopic realignment is better than delayed reconstruction in the management of male patients with posterior urethral injury. It provides less postoperative complications like urinary incontinence and erectile dysfunction, though postoperative urethral stricture formation is higher but amenable to be corrected endoscopically.展开更多
Wang: Speaking of Sino-U. S. relations, actually it touches upon great power relationship. The current Iraqi crisis became a focus in UN. There is a clear demarcation line between those countries supporting a war and ...Wang: Speaking of Sino-U. S. relations, actually it touches upon great power relationship. The current Iraqi crisis became a focus in UN. There is a clear demarcation line between those countries supporting a war and those countries in favor of weapons inspections within展开更多
Based on a questionnaire survey,the paper made a comparative study on the changes of traditional library positions within the context of the emerging professional positions and functional units at some large academic ...Based on a questionnaire survey,the paper made a comparative study on the changes of traditional library positions within the context of the emerging professional positions and functional units at some large academic libraries in China and in the United States from 1998 to 2007.It describes how some of the library professional positions and functional units have gone through a time period of intensified and proactive position allocation realignment in terms of their rise,decline,fission and/or fusion within the administrative context of their library's evolving changes in missions,objectives and service delivery structure under the impact of the rapid development of information technologies.Such changes are graphically demonstrated in several charts in this paper to highlight the evolutionary development of academic librarianship in general and the waves of changes for library position reallocations in specific in the ten-year period under study.It is believed that such a study can be useful for discerning the overall developing trend of academic librarianship,especially in the area of the rising professional and social status of academic librarianship during this period.The movement of library position allocation realignment was a corresponding response at the time to the influx of applicable information technologies to the library scene.It not only made the library operation to become'leaner and meaner,' but also gave added impetus to the rise of the professional and social status of their practitioners in the society due to the latter's enhanced service delivery innovations and capabilities for meeting their constituencies' timely information needs more satisfactorily.展开更多
China has fortified its relationships with trade partners around the globe as US President Donald Trump makes new tariff threats On the sidelines of the ASE-AN Plus foreign ministers'Lumpur,Malaysia on July meetin...China has fortified its relationships with trade partners around the globe as US President Donald Trump makes new tariff threats On the sidelines of the ASE-AN Plus foreign ministers'Lumpur,Malaysia on July meetings held in Kuala 11,Chinese Foreign Minister Wang Yi met with US Secretary of State Marco Rubio.Both Wang and Rubio described their first meeting in person as"con-structive,"emphasizing the importance of managing their differences and expanding cooperation in relevant fields.展开更多
As the world navigates through a period of profound geopolitical and economic realignment,the recently unveiled Recommendations for China’s 15th Five-Year Plan(2026-2030)offer a timely and resolute vision.At its core...As the world navigates through a period of profound geopolitical and economic realignment,the recently unveiled Recommendations for China’s 15th Five-Year Plan(2026-2030)offer a timely and resolute vision.At its core lies a commitment to promote high-standard opening up and break new ground in pursuing win-win outcomes,and to advance the building of a community with a shared future for humanity.展开更多
Transformations of the world unseen in a century are unfolding at a faster pace.Changes of the world,of our times,and of the historical trajectory are taking place in ways like never before.As the new round of technol...Transformations of the world unseen in a century are unfolding at a faster pace.Changes of the world,of our times,and of the historical trajectory are taking place in ways like never before.As the new round of technological revolution and industrial transformation advances,the international power structure and world order are undergoing tectonic realignments and constantly being reshaped.The protracted Ukraine crisis and the escalating Palestinian-Israeli conflict exemplify the intensification of major-power strategic rivalries and geopolitical conflicts.At the same time,non-traditional security issues are getting severe and more deeply intertwined with traditional security.Challenges such as climate change,cybersecurity,energy security,and food security are becoming critical global issues which confront humanity with unprecedented threats and herald a new era of instability and transformation for the world’s development.展开更多
Managed realignment(MR)schemes are being implemented to compensate for the degradation of coastal habitats.However,evidence suggests that MR sites have lower biodiversity than anticipated,which has been linked to poor...Managed realignment(MR)schemes are being implemented to compensate for the degradation of coastal habitats.However,evidence suggests that MR sites have lower biodiversity than anticipated,which has been linked to poor drainage.Despite creek networks playing an important role in enhancing site drainage in natural intertidal environments,there remains a shortage of data on the formation and evolution of creeks within MR sites.This study evaluates creek development at the Medmerry Managed Realignment Site,UK.Creek development is investigated using differential global positioning system(dGPS)data,supported by sedimentological analyses and a high-resolution digital surface model(DSM)derived from images taken using a small unmanned aerial vehicle.Measurements indicated that creeks will develop relatively quickly,but are influenced by differences in the sub-surface sedimentological conditions.A suitable level of agreement was found between the DSM and dGPS measurements,demonstrating the appropriateness of this method to study creek development within intertidal environments at a higher resolution than traditional surveying techniques.These results are used to propose the collapse of sub-surface piping as the primary creek formation mechanism.Findings are discussed in terms of increasing the success of MR schemes and enhancing site design to maximise the ecosystem services provided.展开更多
文摘BACKGROUND A male urethral disruption injury is a urological emergency.Primary endoscopic realignment(PER)refers to reestablishment of urethral alignment via indwelling urethral catheter by cystoscope,which is recommended as the optimal emergent treatment approach for reducing the likelihood of complications following injury.However,the prior literature suggests the success rate of PER to be relatively low due to complicated urethral disruption.We report a modified PER approach that serves to improve both the success rate and safety of the treatment.CASE SUMMARY A 19-year-old male patient presented with multiple pelvic fractures and complete urethral disruption following a high-velocity traffic accident.The patient’s abdominal computed tomography and retrograde urethrography results revealed complete urethral disruption at the bulbar urethra,with hematoma and contrast medium extravasation that extended into the extraperitoneal space.The conventional retrograde PER by cystoscope failed due to severe disruption and considerable hematoma.Modified simultaneous antegrade and retrograde PER was performed by means of semi-rigid ureteroscopy via a suprapubic Foley catheter and cystoscopy via the external urethra.An antegrade guidewire was passed through the bladder neck and then pulled out through the external urethral meatus with a cystoscope.Urethral continuity was achieved after a 16-Fr silicone Foley catheter was indwelled into the bladder along the guidewire.The patient recovered well,achieving voiding continence and avoiding further operation for urethral stricture.CONCLUSION Modified PER via suprapubic Foley catheter represents a promising and safe treatment approach in patients with posterior urethral injuries.
文摘Background: Posterior urethral injury usually occurs in male patients with pelvic fractures. Posterior urethral injuries are associated with considerable morbidity including urinary incontinence, erectile dysfunction and urethral stricture. Objective: To compare the outcomes between early primary endoscopic realignment and delayed reconstruction in the management of male patients of posterior urethral injury. Methodology: This prospective study was conducted in the department of urology and department of casualty, Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2015 to June 2017 among 50 male patients with posterior urethral injury. Fifty patients were randomly allocated into two groups;the group A consisted of 24 patients underwent early primary endoscopic realignment within 10 days after posterior urethral injury and the group B consisted of 26 patients underwent delayed reconstruction in form of anastomotic urethroplasty after 3 months. All patients were followed up at 3rd, 6th and 9th month after the procedure. Outcome variables were post-operative urethral stricture, urinary incontinence and erectile dysfunction. Data were analyzed and compared by statistical tests. Results: The mean (±SD) age of the study patients was almost similar between the groups (28.8 ± 8.4 vs. 27.4 ± 7.2 years, p = 0.486). In group A, 83.33% patients developed postoperative urethral stricture, none of them developed urinary incontinence and 20.83% developed erectile dysfunction;On the other hand, in group B, these rates were 38.46%, 23.07% and 38.46% respectively. Postoperative urethral stricture formation was significantly higher in Group A (p = 0.0012) but urinary incontinence and erectile dysfunction rates were significantly higher in Group B (p = 0.018 and p = 0.042 respectively). Conclusion: Early primary endoscopic realignment is better than delayed reconstruction in the management of male patients with posterior urethral injury. It provides less postoperative complications like urinary incontinence and erectile dysfunction, though postoperative urethral stricture formation is higher but amenable to be corrected endoscopically.
文摘Wang: Speaking of Sino-U. S. relations, actually it touches upon great power relationship. The current Iraqi crisis became a focus in UN. There is a clear demarcation line between those countries supporting a war and those countries in favor of weapons inspections within
文摘Based on a questionnaire survey,the paper made a comparative study on the changes of traditional library positions within the context of the emerging professional positions and functional units at some large academic libraries in China and in the United States from 1998 to 2007.It describes how some of the library professional positions and functional units have gone through a time period of intensified and proactive position allocation realignment in terms of their rise,decline,fission and/or fusion within the administrative context of their library's evolving changes in missions,objectives and service delivery structure under the impact of the rapid development of information technologies.Such changes are graphically demonstrated in several charts in this paper to highlight the evolutionary development of academic librarianship in general and the waves of changes for library position reallocations in specific in the ten-year period under study.It is believed that such a study can be useful for discerning the overall developing trend of academic librarianship,especially in the area of the rising professional and social status of academic librarianship during this period.The movement of library position allocation realignment was a corresponding response at the time to the influx of applicable information technologies to the library scene.It not only made the library operation to become'leaner and meaner,' but also gave added impetus to the rise of the professional and social status of their practitioners in the society due to the latter's enhanced service delivery innovations and capabilities for meeting their constituencies' timely information needs more satisfactorily.
文摘China has fortified its relationships with trade partners around the globe as US President Donald Trump makes new tariff threats On the sidelines of the ASE-AN Plus foreign ministers'Lumpur,Malaysia on July meetings held in Kuala 11,Chinese Foreign Minister Wang Yi met with US Secretary of State Marco Rubio.Both Wang and Rubio described their first meeting in person as"con-structive,"emphasizing the importance of managing their differences and expanding cooperation in relevant fields.
文摘As the world navigates through a period of profound geopolitical and economic realignment,the recently unveiled Recommendations for China’s 15th Five-Year Plan(2026-2030)offer a timely and resolute vision.At its core lies a commitment to promote high-standard opening up and break new ground in pursuing win-win outcomes,and to advance the building of a community with a shared future for humanity.
文摘Transformations of the world unseen in a century are unfolding at a faster pace.Changes of the world,of our times,and of the historical trajectory are taking place in ways like never before.As the new round of technological revolution and industrial transformation advances,the international power structure and world order are undergoing tectonic realignments and constantly being reshaped.The protracted Ukraine crisis and the escalating Palestinian-Israeli conflict exemplify the intensification of major-power strategic rivalries and geopolitical conflicts.At the same time,non-traditional security issues are getting severe and more deeply intertwined with traditional security.Challenges such as climate change,cybersecurity,energy security,and food security are becoming critical global issues which confront humanity with unprecedented threats and herald a new era of instability and transformation for the world’s development.
文摘Managed realignment(MR)schemes are being implemented to compensate for the degradation of coastal habitats.However,evidence suggests that MR sites have lower biodiversity than anticipated,which has been linked to poor drainage.Despite creek networks playing an important role in enhancing site drainage in natural intertidal environments,there remains a shortage of data on the formation and evolution of creeks within MR sites.This study evaluates creek development at the Medmerry Managed Realignment Site,UK.Creek development is investigated using differential global positioning system(dGPS)data,supported by sedimentological analyses and a high-resolution digital surface model(DSM)derived from images taken using a small unmanned aerial vehicle.Measurements indicated that creeks will develop relatively quickly,but are influenced by differences in the sub-surface sedimentological conditions.A suitable level of agreement was found between the DSM and dGPS measurements,demonstrating the appropriateness of this method to study creek development within intertidal environments at a higher resolution than traditional surveying techniques.These results are used to propose the collapse of sub-surface piping as the primary creek formation mechanism.Findings are discussed in terms of increasing the success of MR schemes and enhancing site design to maximise the ecosystem services provided.
