Modelling of the elastoplastic behaviour of the bio-cemented soils using an extended Modified Cam Clay model

An elastoplastic constitutive model based on the Modified Cam Clay(MCC)model is developed to describe the mechanical behaviour of soils cemented via microbially induced calcite precipitation(MICP).It considers the increase of the elastic stiffness,the change of the yield surface due to MICP cementation and the degradation of calcium carbonate bonds during shearing.Specifically,to capture the typical contraction-dilation transition in MICP soils,the original volumetric hardening rule in the MCC model is modified to a combined deviatoric and volumetric hardening rule.The model could reproduce a series of drained triaxial tests on MICP-treated soils with different calcium carbonate contents.Further,we carry out a parametric study and observe numerical instability in some cases.In combination with an analytical analysis,our numerical modelling has identified the benefits and limitations of using MCCbased models in the simulation of MICP-cemented soils,leading to suggestions for further model development.

A dual-RPA based lateral flow strip for sensitive,on-site detection of CP4-EPSPS and Cry1Ab/Ac genes in genetically modified crops

Traditional transgenic detection methods require high test conditions and struggle to be both sensitive and efficient.In this study,a one-tube dual recombinase polymerase amplification(RPA)reaction system for CP4-EPSPS and Cry1Ab/Ac was proposed and combined with a lateral flow immunochromatographic assay,named“Dual-RPA-LFD”,to visualize the dual detection of genetically modified(GM)crops.In which,the herbicide tolerance gene CP4-EPSPS and the insect resistance gene Cry1Ab/Ac were selected as targets taking into account the current status of the most widespread application of insect resistance and herbicide tolerance traits and their stacked traits.Gradient diluted plasmids,transgenic standards,and actual samples were used as templates to conduct sensitivity,specificity,and practicality assays,respectively.The constructed method achieved the visual detection of plasmid at levels as low as 100 copies,demonstrating its high sensitivity.In addition,good applicability to transgenic samples was observed,with no cross-interference between two test lines and no influence from other genes.In conclusion,this strategy achieved the expected purpose of simultaneous detection of the two popular targets in GM crops within 20 min at 37°C in a rapid,equipmentfree field manner,providing a new alternative for rapid screening for transgenic assays in the field.

Nucleoside modified mRNA-lipid nanoparticles as a new delivery platform for the repair of the injured spinal cord

Spinal cord injury and treatment opportunities:The adult mammalian spinal cord has a very limited capacity for spontaneous regeneration due to various intrinsic molecular and cellular factors.Although the spinal cord neurons have the capacity to regenerate their axons,the expression of growth inhibitory factors,lack or suppression of proper guidance cues,and profound inflammatory responses do not permit successful regeneration(Khyeam et al.,2021).

Effect of Modified Biochar with Organic Fertiliser on the Growth and Development of Chinese Rose

In order to reduce the waste of resources and environmental pollution caused by excessive application of chemical fertilizers, improve the utilization rate of fertilizers, and promote the large-scale and high-quality development of the Chinese rose industry. In this experiment, corn stover biochar, phosphoric acid modified biochar and organic fertilizer were used as test materials, and the effects of mixed application of modified biochar and organic fertilizer on the growth and development of Chinese rose as well as soil physicochemical properties were investigated by using the method of pot planting test. The results showed that modified biochar with organic fertilizer had the most significant effect on the enhancement of soil pH, organic matter content and soil carbon-to-nitrogen ratio. After 120 d of planting, modified biochar with organic fertilizer had the most significant effect on the enhancement of plant height and crown width of Chinese rose;both organic fertilizer and modified biochar with organic fertilizer significantly increased the chlorophyll content of Chinese rose. The number of flowers and the number of branches were the highest in the modified biochar with organic fertilizer treatment. In conclusion, the application of modified biochar with organic fertilizer can better improve the soil pH, and increase the soil organic matter content and carbon-to-nitrogen ratio to change the biological traits of Chinese rose. The results of this study provide a theoretical basis for the reduction of chemical fertilizers and the resource utilization of agricultural wastes and guarantee the sustainable development of the cut flower industry.

Multi-soliton solutions, breather-like and bound-state solitons for complex modified Korteweg–de Vries equation in optical fibers

Under investigation in this paper is a complex modified Korteweg–de Vries(KdV) equation, which describes the propagation of short pulses in optical fibers. Bilinear forms and multi-soliton solutions are obtained through the Hirota method and symbolic computation. Breather-like and bound-state solitons are constructed in which the signs of the imaginary parts of the complex wave numbers and the initial separations of the two parallel solitons are important factors for the interaction patterns. The periodic structures and position-induced phase shift of some solutions are introduced.

Investigation of granite failure precursor under axial load using modified LSTM framework

Granite is usually composed of quartz,biotite,feldspar,and cracks,and the variation characteristics of these components could reflect the deformation and failure process of rock well.Taking granite as an example,the video camera was used to record the deformation and failure process of rock.The distribution of meso-components in video images was then identified.The meso-components of rock failure precursors were also discussed.Moreover,a modified LSTM(long short-term memory method)based on SSA(sparrow search algorithm)was proposed to estimate the change of meso-components of rock failure precursor.It shows that the initiation and expansion of cracks are mainly caused by feldspar and quartz fracture,and when the quartz and feldspar exit the stress framework,rock failure occurs;the second large increase of crack area and the second large decrease of quartz or feldspar area may be used as a precursor of rock failure;the precursor time of rock failure based on meso-scopic components is about 4 s earlier than that observed by the naked eye;the modified LSTM network has the strongest estimation ability for quartz area change,followed by feldspar and biotite,and has the worst estimation ability for cracks;when using the modified LSTM network to predict the precursors of rock instability and failure,quartz and feldspar could be given priority.The results presented herein may provide reference in the investigation of rock failure mechanism.

Fatigue Resistance of RCA Modified Asphalt Based on Dielectric Properties

In order to study the anti-fatigue performance of RCA modified asphalt (RMA),the performance of RMA and 90#matrix asphalt with different modifier content were measured by asphalt penetration,ductility,softening point,Brookfield viscosity,rheological index,infrared spectrum and dielectric constant test.This paper discusses the changes of asphalt basic indexes,fatigue properties and asphalt components based on dielectric properties under different modifier contents,and analyzes the grey correlation degree between components and asphalt pavement performance indexes.The results show that the optimum content of RCA modifier is 16.7%of the asphalt quality according to the penetration,ductility,softening point,Brockfield viscosity,viscosity temperature curve and fatigue life.In the phase angle-strain curve,there is disorder in the latter part of the curve.According to the strain (ε_(d)) corresponding to the disorder point,a new fatigue failure criterion is proposed and proved.Based on the new asphalt fatigue failure criterion,the fatigue prediction model of asphalt mixture is improved,and the fatigue life predicted by the improved fatigue model is compared with the fatigue life obtained by four-point bending fatigue test.The results show that the proposed new asphalt fatigue failure criterion is reasonable,and the fatigue life predicted by the improved asphalt mixture fatigue prediction model is accurate.The research method of classifying asphalt components based on dielectric properties is simple and effective,and the components have a high correlation with the road performance of base asphalt and modified asphalt.

Modified Xiaoyao powder for postpartum depression:A systematic review and meta-analysis

Objective:To evaluate the effectiveness and safety of modified Xiaoyao powder for postpartum depression(PPD)by conducting a systematic review of randomized controlled trials(RCTs).Methods:The Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,Google Scholar,the SinoMed,Embase,Cochrane Library,and PubMed databases were searched from their inception to April 25,2023.The Cochrane Risk of Bias tool was used to assess the quality of the trials.We applied the risk ratio to present dichotomous data and the mean difference to present continuous data.Data with similar characteristics were pooled for meta-analysis and heterogeneity was assessed using I2.Results:This review included 35 trials involving 2848 participants.The quality of the included studies was low(unclear randomization processes and insufficient reporting of blinding).Participants treated with modified Xiaoyao powder plus Western medicine showed lower Hamilton Depression Scale(HAMD)depression score than those who used Western medicine alone(mean difference=-2.15;95%confidence interval:-2.52 to 1.78;P<.00001),and higher effective rate(relative risk=1.19;95%confidence interval:1.15 to 1.24;P<.00001),When comparing modified Xiaoyao alone with Western medicine,the HAMD depression score remained low,however,the efficacy rate was higher in the modified Xiaoyao group.Regarding adverse events,the modified Xiaoyao group reported weight gain,nausea,and diarrhea,but no severe adverse events were reported.Conclusion:Modified Xiaoyao may help relieve depression in PPD when used alone or in combination with Western medicine,with minor side effects.Therefore,future high-quality,large-sample size RCTs are warranted.

Preparation of Modified UiO-66 Catalyst and Its Catalytic Performance for NH_(3)-SCR Denitration

Zirconium-based metal-organic framework UiO-66 was successfully prepared by solvothermal method,and UiO-66 was modified by adding regulators such as formic acid,acetic acid,and hydrochloric acid.The NH_(3)-SCR reactivity of the samples was evaluated by the denitration activity evaluation system,and the UiO-66 and the regulator-modified UiO-66 were characterized by XRD,SEM,BET,FTIR,TG,NH_(3)-TPD,etc.,the effects of regulator types on the structure and properties of UiO-66 were investigated.The experimental results show that,after adding the modifier,the morphology of UiO-66 changes from irregular quadrilateral with serious agglomeration to particles with regular crystal shape and good dispersibility,and the crystal morphology of the catalyst is improved.In addition,after adding the modifier,UiO-66 has a larger specific surface area and stronger surface acidity,which optimizes the catalytic performance of UiO-66.The catalytic performance test results of NH_(3)-SCR show that the low-temperature activity of UiO-66 is poor,and it only shows a certain catalytic activity at higher temperatures.The catalytic activity of UiO-66 was significantly improved after adding the regulator.Among them,the UiO-66-HCl modified with hydrochloric acid had the best catalytic activity,and the denitration rate reached 70%when the denitration temperature was 380℃.

A Modified Iterative Learning Control Approach for the Active Suppression of Rotor Vibration Induced by Coupled Unbalance and Misalignment

This paper proposes a modified iterative learning control(MILC)periodical feedback-feedforward algorithm to reduce the vibration of a rotor caused by coupled unbalance and parallel misalignment.The control of the vibration of the rotor is provided by an active magnetic actuator(AMA).The iterative gain of the MILC algorithm here presented has a self-adjustment based on the magnitude of the vibration.Notch filters are adopted to extract the synchronous(1×Ω)and twice rotational frequency(2×Ω)components of the rotor vibration.Both the notch frequency of the filter and the size of feedforward storage used during the experiment have a real-time adaptation to the rotational speed.The method proposed in this work can provide effective suppression of the vibration of the rotor in case of sudden changes or fluctuations of the rotor speed.Simulations and experiments using the MILC algorithm proposed here are carried out and give evidence to the feasibility and robustness of the technique proposed.

Modified intratympanic steroid therapy for sudden sensorineural hearing loss via tympanic tube and gelfoam as a salvage treatment

Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatment for SSNHL after the failure of systemic steroid therapy(SST).Objective: This study aimed to analyze the efficacy of modified IST involving the insertion of a tympanic tube and gelfoam as a salvage treatment for patients with SSNHL, and to explore its associated factors.Methods: Totally, 74 patients who were aged 22–81 years with SSNHL were enrolled and allocated to either the control group(n = 25) or the treatment group(n = 49) based on their treatment modalities. All patients received SST lasting for at least 7 days. Subsequently, patients in the treatment group, after SST failure, underwent IST twice a week for 2–6 weeks, while the control group did not. Efficacy was assessed by the improvement in pure tone average at the affected frequency at the beginning and end of IST.Results: Hearing improvement in all patients after IST in the treatment group was 9.71 ± 14.84 dB, with significant improvement at affected frequencies(250-8000 Hz) compared with the control group(P < 0.05). The findings indicated the duration from the onset of SSNHL to the beginning of IST as an independent factor for pure tone average improvement after treatment(P = 0.002), whereas age, duration of SST, and time of IST were not(P > 0.05).Conclusion: The modified IST was demonstrated to be a safe and effective method as a salvage treatment for SSNHL. This study explored the efficacy of a modified IST approach, incorporating the utilization of tympanic tubes and gelfoam as key components. The findings underscore the advantages of gelfoam as a strategic drug carrier placed in the round window niche. By minimizing drug loss, extending action time, and increasing perilymph concentration, gelfoam enhances the therapeutic impact of IST, contributing to improved hearing outcomes in patients with SSNHL.

Clinical efficacy of modified Kamikawa anastomosis in patients with laparoscopic proximal gastrectomy

BACKGROUND With the increasing incidence of proximal gastric cancer,laparoscopic proximal gastrectomy has been applied.However,reflux esophagitis often occurs after traditional esophagogastric anastomosis.In order to solve this problem,several methods of digestive tract reconstruction have emerged,but the most satisfying method remains to be discussed.Therefore,we modified traditional Kamikawa anastomosis to investigate the appropriate digestive tract reconstruction in laparo-scopic proximal gastrectomy.All the patients were successfully operated on without conversion to laparotomy.The duration of operation and digestive tract reconstruction were 203.500(150-224)min and 87.500(73-111)min,respectively.The intraoperative amount of bleeding was 20.500 mL±0.696 mL.The time of postoperative first flatus,the first postoperative fluid intake,and the postoperative length of stay were 2(1-3)d,4(3-5)d,and 9(8-10)d,respectively.All the patients were followed up for 12-23 months.The body mass index at 6 and 12 months after surgery were 22.577 kg/m2±3.098 kg/m2 and 22.594 kg/m2±3.207 kg/m2,respectively.The nutrition risk screening 2002 score,the patient-generated subjective global assessment score,and the gastroesophageal reflux disease scale score were good at 6 and 12 months after surgery.Reflux esophagitis and anastomotic stenosis were not observed in any of the patients during their 12-month postoperative gastroscopy or upper gastrointestinal tract visits.All the patients exhibited no tumor recurrence or metastasis.CONCLUSION The modified Kamikawa anastomosis is safe and feasible for laparoscopic proximal gastrectomy and has good antireflux effects and nutritional status.

A Glassy Carbon Electrode Modified with Cellulose Nanofibrils from Ammophila arenaria for the Sensitive Detection of L-Trytophan

L-tryptophan is an essential amino acid for human health. Nanofibrillated cellulose (NFC) from marram grass (Ammophila arenaria) extracted from plants harvested in the center of Tunisia was used for the first time for the modification of a glassy carbon electrode (GCE), for the sensitive detection of L-tryptophan (Trp). After spectroscopic and morphological characterization of the extracted NFC, the GC electrode modification was monitored through cyclic voltammetry. The NFC-modified electrode exhibited good analytical performance in detecting Trp with a wide linear range between 7.5 × 10−4 mM and 10−2 mM, a detection limit of 0.2 µM, and a high sensitivity of 140.0 µA∙mM−1. Additionally, the NFC/GCE showed a good reproducibility, good selectivity versus other amino acids, uric acid, ascorbic acid, and good applicability to the detection of Trp in urine samples.

Novel wood-plastic composite fabricated via modified steel slag:Preparation,mechanical and flammability properties

A novel method was developed to enhance the utilization rate of steel slag(SS).Through treatment of SS with phosphoric acid and aminopropyl triethoxysilane(KH550),we obtained modified SS(MSS),which was used to prepare MSS/wood-plastic composites(MSS/WPCs)by replacing talcum powder(TP).The composites were fabricated through melting blending and hot pressing.Their mechanical and combustion properties,which comprise heat release,smoke release,and thermal stability,were systematically investigated.MSS can improve the mechanical strength of the composites through grafting reactions between wood powder and thermoplastics.Notably,MSS/WPC#50(16wt%MSS)with an MSS-to-TP mass ratio of 1:1 exhibited optimal comprehensive performance.Compared with those of WPC#0 without MSS,the tensile,flexural,and impact strengths of MSS/WPC#50 were increased by 18.5%,12.8%,and 18.0%,respectively.Moreover,the MSS/WPC#50 sample achieved the highest limited oxygen index of 22.5%,the highest vertical burning rating at the V-1 level,and the lowest horizontal burning rate at 44.2 mm/min.The formation of a dense and stable char layer led to improved thermal stability and a considerable reduction in heat and smoke releases of MSS/WPC#50.However,the partial replacement of TP with MSS slightly compromised the mechanical and flame-retardant properties,possibly due to the weak grafting caused by SS powder agglomeration.These findings suggest the suitability of MSS/WPCs for high-value-added applications as decorative panels indoors or outdoors.

Arterial Duct Stenting Versus Modified Blalock-Taussig Shunt in Patient with Ductal-Dependent Pulmonary Circulation: Systematic Review & Meta-Analysis

Objective:Patients with ductal-dependent pulmonary circulation require alternative bloodflow to provide and maintain adequate oxygenation.Modified Blalock-Taussig Shunt(MBTS)has been the standard for providing such a result.Currently,less invasive methods such as Arterial Duct(AD)stenting have been performed as alter-natives.This study aims to compare the outcome of AD stenting and MBTS.Method:Systematic research was performed in online databases using the PRISMA protocol.The outcomes measured were 30-day mortality,com-plication,unplanned intervention,oxygen saturation,duration of hospital,and ICU length of stay.Any compara-tive study provided with full text is included.The outcome of each study was analyzed using a trandom effects model with relative risk and mean difference as the effect size.Bias risk assessment was conducted using the New-castle-Ottawa Scale.All analyses were performed using Review Manager 5.4.1.Result:A total of 11 studies with 3154 samples included in this study.There is no significant difference in 30-day mortality between the two groups(p-value=0.10).However,there is significantly less complication(RR 0.53[0.35,0.82];p-value=0.004)and unplanned intervention(RR 0.59[0.38,0.92];p-value=0.02)in the AD stent group.Comparison of the Nakata index showed no significant difference(p-value=0.88).Post-operative oxygen saturation was measured signifi-cantly higher in the AD stenting(MD 1.80[0.85,2.74];p-value=0.0002).However,AD stent group shows sig-nificantly lower long-term oxygen saturation(MD-8.43[-14.38,-2.48];p-value=0.005).Both hospital and ICU length of stay was significantly shorter in the AD stent group(MD-8.30[-11.13,-5.48];p-value<0.00001;MD-5.09[-7.79,-2.38];p-value=0.0002).Conclusion:AD stenting provides comparable outcomes relative to MBTS as it provides less complication and unplanned intervention and higher post-procedural O2 saturation.However,MBTS proved its superiority in maintaining higher long-term oxygen saturation and still became the preferred option to manage complex cases where stenting is either challenging or unsuccessful.

Distribution of modified Circumpolar Deep Water and its threat in Vincennes Bay,East Antarctica

The Antarctic Bottom Water formation site Vincennes Bay,East Antarctica is experiencing a substantial intrusion of modified Circumpolar Deep Water(mCDW),which may inhibit the formation of Dense Shelf Water(DSW)and drive basal melting of the ice shelves.Based on hydrographic data obtained from March to November in 2012,we evaluated the spatial spread of mCDW over the continental shelf region of Vincennes Bay and the associated temporal evolution of water properties,as well as the sea ice formation effect on water column in the coastal polynya.Results show that two branches of mCDW occupied the deep layers of the continental shelf,distinguished by the potential density(smaller than 27.8 kg/m^(3) or not)when potential temperatureθ=0.5°C in theθ-salinity space.The warmer and less dense branch observed on the east plateau,accessed the eastern ice shelves in the coastal polynya to drive basal melting of ice shelves.In contrast,the other colder and denser branch in the mid-depression reached the western Underwood Ice Shelf.DSW formation was detectable in the coastal polynya during September-November,proving the occurrence of deep convection.Surface heat loss and brine rejection during the intensive sea ice formation contributed to the destratification of the water column in the coastal polynya.It was estimated that at least 1.11±0.79 TW heat carried by mCDW into the inner part of the polynya.

Hydrogen-bonded organic framework modified separator for simultaneously enhancing the safety and electrochemical performance of Ni-rich lithium-ion battery

Nickel-rich layered oxide cathode(LiNi_(x)Co_(y)Mn_(1−x−y)O_(2),x>0.5,NCM)shows substantial potential for applications in longer-range electrical vehicles.However,the rapid capacity decay and serious safety concerns impede its practical viability.This work provides a hydrogen-bonded organic framework(HOF)modification strategy to simultaneously improve the electrochemical performance,thermal stability and incombustibility of separator.Melamine cyanurate(MCA),as a low-cost and reliable flame-retardant HOF,was implemented in the separator modification layer,which can prevent the battery short circuit even at a high temperature.In addition,the supermolecule properties of MCA provide unique physical and chemical microenvironment for regulating ion-transport behavior in electrolyte.The MCA coating layer enabled the nickel-rich layered oxide cathode with a high-capacity retention of 90.3%after 300 cycles at 1.0 C.Collectively,the usage of MCA in lithium-ion batteries(LIBs)affords a simple,low-cost and efficient strategy to improve the security and service life of nickel-rich layered cathodes.

Establishment of acquired tracheoesophageal fistula using a modified magnetic compression technique in rabbits and its postmodeling evaluation

BACKGROUND Previous studies have validated the efficacy of both magnetic compression and surgical techniques in creating rabbit tracheoesophageal fistula(TEF)models.Magnetic compression achieves a 100%success rate but requires more time,while surgery,though less frequently successful,offers rapid model establishment and technical maturity in larger animal models.AIM To determine the optimal approach for rabbit disease modeling and refine the process.METHODS TEF models were created in 12 rabbits using both the modified magnetic compression technique and surgery.Comparisons of the time to model establishment,success rate,food and water intake,weight changes,activity levels,bronchoscopy findings,white blood cell counts,and biopsies were performed.In response to the failures encountered during modified magnetic compression modeling,we increased the sample size to 15 rabbit models and assessed the repeatability and stability of the models,comparing them with the original magnetic compression technique.RESULTS The modified magnetic compression technique achieved a 66.7%success rate,whereas the success rate of the surgery technique was 33.3%.Surviving surgical rabbits might not meet subsequent experimental requirements due to TEF-related inflammation.In the modified magnetic compression group,one rabbit died,possibly due to magnet corrosion,and another died from tracheal magnet obstruction.Similar events occurred during the second round of modified magnetic compression modeling,with one rabbit possibly succumbing to aggravated lung infection.The operation time of the first round of modified magnetic compression was 3.2±0.6 min,which was significantly reduced to 2.1±0.4 min in the second round,compared to both the first round and that of the original technique.CONCLUSION The modified magnetic compression technique exhibits lower stress responses,a simple procedure,a high success rate,and lower modeling costs,making it a more appropriate choice for constructing TEF models in rabbits.

Modified Black Widow Optimization-Based Enhanced Threshold Energy Detection Technique for Spectrum Sensing in Cognitive Radio Networks

This study develops an Enhanced Threshold Based Energy Detection approach(ETBED)for spectrum sensing in a cognitive radio network.The threshold identification method is implemented in the received signal at the secondary user based on the square law.The proposed method is implemented with the signal transmission of multiple outputs-orthogonal frequency division multiplexing.Additionally,the proposed method is considered the dynamic detection threshold adjustments and energy identification spectrum sensing technique in cognitive radio systems.In the dynamic threshold,the signal ratio-based threshold is fixed.The threshold is computed by considering the Modified Black Widow Optimization Algorithm(MBWO).So,the proposed methodology is a combination of dynamic threshold detection and MBWO.The general threshold-based detection technique has different limitations such as the inability optimal signal threshold for determining the presence of the primary user signal.These limitations undermine the sensing accuracy of the energy identification technique.Hence,the ETBED technique is developed to enhance the energy efficiency of cognitive radio networks.The projected approach is executed and analyzed with performance and comparison analysis.The proposed method is contrasted with the conventional techniques of theWhale Optimization Algorithm(WOA)and GreyWolf Optimization(GWO).It indicated superior results,achieving a high average throughput of 2.2 Mbps and an energy efficiency of 3.8,outperforming conventional techniques.

Modified stapled hemorrhoidopexy for lower postoperative stenosis: A five-year experience

BACKGROUND Stapled hemorrhoidopexy(SH)is currently a widely accepted method for treating the prolapse of internal hemorrhoids.Postoperative anal stenosis is a critical complication of SH.A remedy for this involves the removal of the circumferential staples of the anastomosis,followed by the creation of a hand-sewn anastomosis.Numerous studies have reported modified SH procedures to improve outcomes.We hypothesized that our modified SH technique may help reduce complications of anal stenosis after SH.AIM To compare outcomes of staple removal at the 3-and 9-o’clock positions during modified SH in patients with mixed hemorrhoids.METHODS This was a single-center,retrospective,observational study.Patients with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1,2015,and January 1,2020,were included.The operation time,blood loss,length of hospital stay,and incidence of minor or major complic-ations were recorded.RESULTS Patients with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1,2015 and January 1,2020,were included.Operation time,blood loss,length of hospital stay,and incidence of minor or major complications were recorded.We investigated 187 patients(mean age,50.9 years)who had undergone our modified SH and 313 patients(mean age,53.0 years)who had undergone standard SH.In the modified SH group,54%of patients had previously undergone surgical intervention for hemorrhoids,compared with the 40.3%of patients in the standard SH group.The modified SH group included five(2.7%)patients with anal stenosis,while 21(6.7%)patients in the standard SH group had complications of anal stenosis.There was a significant relationship between the rate of postoperative anal stenosis and the modified SH:0.251(0.085-0.741)and 0.211(0.069-0.641)in multiple regression analysis.The modified SH technique is a safe surgical method for advanced grade hemorrhoids and might result in a lower rate of postoperative anal stenosis than standard SH.CONCLUSION The modified SH technique is a safe surgical method for advanced grade hemorrhoids and might result in a lower rate of postoperative anal stenosis than standard SH.