Transcapsular scleral fixation of the standard capsular tension ring and in-the-bag intraocular lens implantation for severely subluxated lenses

AIM:To present a technique of transcapsular scleral fixation of the standard capsular tension ring(CTR)through equatorial capsulotomy and in-the-bag intraocular lens(IOL)implantation in subluxated lenses.METHODS:This retrospective consecutive case series included patients with subluxated lenses by more than 180 degrees who underwent lens extraction,transcapsular scleral fixation of the standard CTR through equatorial capsulotomy,in-the-bag IOL implantation and with at least 6mo follow-up.Preoperative and postoperative best corrected visual acuity(BCVA),intraocular pressure(IOP),complications,and postoperative IOL tilt and decentration were recorded.RESULTS:Nine eyes of 7 patients with a mean followup of 11.0±3.7mo were included in this study.The BCVA was significantly improved from 0.64±0.22 logMAR preoperatively to 0.21±0.19 logMAR postoperatively(P<0.001).The IOP was within the normal range postoperatively.The mean tilt of the IOL was 4.30°±2.31°(range,1.0°to 8.9°)and the mean decentration of the IOL was 0.37±0.12 mm(range,0.14 to 0.50 mm).No visually threatened intraoperative and postoperative complications were detected during the follow-up period.CONCLUSION:This is a safe and effective surgical technique for managing patients with severely subluxated lenses.It has achieved favorable outcomes with fewer surgical manipulations and less need for advanced capsular support devices.

Impact of Alcian blue and periodic acid Schiff expression on the prognosis of gastric signet ring cell carcinoma

BACKGROUND The Alcian blue(AB)and periodic acid Schiff(PAS)stains are representative mucus markers in gastric signet ring cell carcinoma(SRCC).They are low-cost special staining methods used to detect acidic mucus and neutral mucus,respectively.However,the clinical importance of the special combined AB and PAS stain is unclear.AIM To investigate AB expression,PAS expression and the AB-to-PAS(A/P)ratio in gastric SRCC patients and to assess patient prognosis.METHODS Paraffin-embedded sections from 83 patients with gastric SRCC were stained with AB and PAS,and signet ring cell positivity was assessed quantitatively.Immuno-histochemical staining for Ki67,protein 53(P53)and human epidermal growth factor receptor 2(HER2)was performed simultaneously.The cancer-specific survival(CSS)rate was estimated via Kaplan-Meier analysis.Cox proportional hazards models were used for univariate and multivariate survival analyses.RESULTS Kaplan-Meier survival analysis revealed that the 3-year CSS rate was significantly greater in the high-PAS-expression subgroup than in the low-PAS-expression subgroup(P<0.001).The 3-year CSS rate in the A/P≤0.5 group was significantly greater than that in the A/P>0.5 group(P=0.042).Univariate Cox regression analysis revealed that the factors affecting prognosis included tumor diameter,lymph node metastasis,vessel carcinoma embolus,tumor stage,the A/P ratio and the expression of Ki67,P53 and the PAS.Cox multivariate regression analysis confirmed that low PAS expression[hazard ratio(HR)=3.809,95%confidence interval(CI):1.563-9.283,P=0.003]and large tumor diameter(HR=2.761,95%CI:1.086-7.020,P=0.033)were independent risk factors for poor prognosis.CONCLUSION A/P>0.5 is potentially a risk factor for prognosis,and low PAS expression is an independent risk factor in the prognosis of gastric SRCC.PAS expression and the A/P ratio could help in predicting the clinical prognosis of patients with SRCC.

On the Judgement of Full-Period Sequences and a Novel Congruential Map with Double Modulus on Z(p^n)

This paper studies the judgement problem of full-period maps on Z(p^n) and proposes a novel congruential map with double modulus on Z(p^n). The full-period properties of the sequences generated by the novel map are studied completely. We prove some theorems including full-period judgement theorem on Z(p^n) and validate them by some numerical experiments. In the experiments, full-period sequences are generated by a full-period map on Z(p^n). By the binarization, full-period sequences are transformed into binary sequences. Then, we test the binary sequences with the NIST SP 800-22 software package and make the poker test. The passing rates of the statistical tests are high in NIST test and the sequences pass the poker test. So the randomness and statistic characteristics of the binary sequences are good. The analysis and experiments show that these full-period maps can be applied in the pseudo-random number generation(PRNG), cryptography, spread spectrum communications and so on.

On Period of Fibonacci Sequence in Finite Rings with Identity of Order P^2

In this paper, we obtain the period of generalized Fibonacci sequence in finite rings with identity of order p2 by using equality recursively defined by Fn＋2 = A1Fn＋1 ＋ A0Fn, for n ≥ 0, where F0 = 0 （ the zero of the ring）, F1 = 1 （the identity of the ring） and A0 , A1 are generators elements of finite rings with identity of order p2. Also, we get some results between the period of generalized Fibonacci sequence in the finite rings oforderp2 and characteristic of these rings.

Combined anterior and posterior ring fixation versus posterior ring fixation alone in the management of unstable Tile B and C pelvic ring injuries:A randomized controlled trial

Purpose: Combined anterior and posterior ring (APR) fixation is classically performed in Tile B2 and C1 injuries to achieve superior biomechanical stability.However,the posterior ring (PR) is the main weight bearing portion that is responsible for weight transmission from the upper parts of the body to the lower limbs through the sacrum and the linea terminalis.It is hypothesized that isolated PR fixation can achieve comparable radiological and clinical outcomes to APR fixation.Therefore,we conducted this study to compare the two fixation principles in managing Tile B2 and C1 injuries.Methods: Our study included 20 patients with Tile B2 injuries and 20 patients with Tile C1 injuries.This study was a randomized control single-blinded study via computerized random numbers with a 1:1 allocation by using random block method.The study was performed at a level one trauma center.A total of 40 patients with Tile B2 and C1 injuries underwent combined APR or isolated PR fixation (Group A and B,respectively).Matta & Tornetta radiological principles and Majeed pelvic scoring system were used for the assessment of primary outcomes and postoperative complications.Secondary outcomes included operative time,amount of blood loss,intraoperative assessment of reduction,need of another operation,length of hospital stay,ability to weight bear postoperatively and pain control metrics.We used studentt-test to compare the difference in means between two groups,and Chi-square test to compare proportions between two qualitative parameters.We set the confidence interval to 95% and the margin of error accepted to 5%.So,p ≤ 0.05 was considered statistically significant.Results: The mean follow-up duration was 18 months.The operative time (mean difference 0.575 h) and the intraoperative blood loss (mean difference 97.5 mL) were lower in Group B.Also,despite the higher frequency of rami displacement before union in the same group,there were no significant differences in terms of radiological outcome (excellent outcome withOR = 2.357),clinical outcome (excellent outcome withOR = 2.852) and postoperative complications assessment (OR = 1.556) at last follow-up.Conclusion: The authors concluded that isolated PR fixation could favorably manage Tile B2 and C1 pelvic ring injuries with Nakatani zone II pubic rami fractures and intact inguinal ligament.Its final radiological and clinical outcomes and postoperative complications were comparable to combined APR fixation,but with less morbidity (shorter operation time,lower amount of blood,and no records of postoperative wound infection).

前环皮下内固定治疗骨盆前环损伤的研究进展

前环皮下内置外固定架(internal fixation,INFIX)作为目前骨盆前环损伤微创固定的代表之一,该技术的置钉点位于髂前下棘螺钉,以向外30°、向后20°的角度拧入,并且注意螺钉头应位于深筋膜上方与骨面保持20~25 mm的安全距离。其改良版本有增加耻骨结节螺钉的3钉或4钉INFIX、单侧INFIX、短杆INFIX以及双INFIX,这些改良使其稳定性进一步增强。解剖上股外侧皮神经(lateral femoral cutaneous nerve,LFCN)相对容易受损,术中要格外注意。生物力学稳定性相较于外固定架有着优势,并且应用之灵活,不局限于耻骨支骨折、联合分离等,在前后环联合固定中也扮演着重要角色可联合后路骶髂螺钉、髂腰固定等。在儿童、妊娠期妇女、存在皮下连接杆禁忌等人群中也有报道并取得了不错的临床效果。加之目前机器人、复位架等技术的应用,极大降低了复位难度,提高了闭合复位质量,令其在复杂骨盆骨折中也能够进行固定。该技术复位质量高,有着与传统钢板等相当的疗效,常见并发症是LFCN损伤,术中仔细暴露、调整内固定的位置和深度,可有效避免该并发症。

青海湖裸鲤仔稚鱼耳石结构特征与早期生长相关性分析

为了解青海湖裸鲤(Gymnocypris przewalskii)仔稚鱼耳石结构特征与其早期生长的相关性,通过采集典型洄游产卵河道的青海湖裸鲤野生仔稚鱼和同期人工培育的仔稚鱼,观察仔稚鱼耳石微结构特征,确认第一轮纹出现时间和耳石轮纹沉积规律,并拟合耳石轮纹数、轮纹间距与日龄间的关系。结果表明:青海湖裸鲤仔稚鱼耳石生长呈日周期性,日龄以轮纹数(N)+1进行推算;根据日龄和采样日期推算,2020年从青海湖支流沙柳河采集的野生仔稚鱼孵化期为6月5日—8月14日,主要集中于7月中旬和8月初,从泉吉河采集的野生仔稚鱼孵化期为6月27日—8月3日,孵化高峰期在7月中旬,与早期野外资源现场调查发现鱼卵的孵化期时间基本吻合;野生与人工培育仔稚鱼全长(LT)与日龄(t)均呈极显著线性相关(P<0.001),耳石长度与仔稚鱼全长呈显著线性相关(P<0.05),其中,15℃条件下人工培育的仔稚鱼相关系数最高,此条件下的人工培育仔稚鱼全长拟合方程为L_(T)=0.1672t+10.377(R^(2)=0.6890,P<0.001)。研究表明,青海湖裸鲤仔稚鱼耳石生长受环境因子影响较大,且耳石的沉积变化与仔稚鱼生长发育关系密切。

微创经皮空心螺钉内固定治疗骨盆前环骨折的效果分析

目的:分析微创经皮空心螺钉内固定治疗骨盆前环骨折的临床效果。方法:选取2020年3月—2022年3月北京市上地医院和北京大望路急诊抢救医院收治的骨盆前环骨折患者66例作为研究对象,根据随机数字表法分为对照组与观察组,各33例。对照组实施开放复位内固定术,观察组实施微创经皮空心螺钉内固定术。比较两组治疗效果。结果:观察组骨折复位总优良率高于对照组,差异有统计学意义(P=0.039)。观察组术中出血量少于对照组,术后下床活动时间、骨痂形成时间早于对照组,差异有统计学意义(P<0.001)。术后3、6、8个月,两组骨盆功能评分逐渐升高,且观察组高于对照组,差异有统计学意义(P<0.001)。观察组并发症总发生率低于对照组,差异有统计学意义(P=0.046)。结论:微创经皮空心螺钉内固定治疗骨盆前环骨折的效果显著,可减少术中出血量,加速康复,提高骨折复位优良率,降低并发症发生率。

基于SM2的周期性可否认环签名方案

周期性可否认环签名通过引入时间周期的概念,允许环成员在每个时间周期结束后选择性地否认自己在环中的签名者身份。这种周期性的变换提供了一种自主可控的机制,使得环成员能够更好地保护自己的隐私,同时还能与监管机构进行合法协作。一般数字签名具有不可否认性,可用于确保签名的来源、内容的完整性和认证性,而可否认签名具有可否认性,环成员能够在无可信第三方的情况下确认或者否认自己是否为该签名的签署者。文章在包子健等人提出的基于SM2的可否认环签名方案的基础上提出一种基于SM2的周期性可否认环签名方案,能够实现对签名的周期性确认与否认功能,有效保护自己的隐私信息。文章通过形式化证明方式证明了方案满足正确性、不可伪造性、匿名性、可追踪性和不可诽谤性。

钢丝环扎结合带孔钛针钛缆张力带治疗髌骨骨折

目的 探讨钢丝环扎结合带孔钛针钛缆张力带治疗髌骨骨折的疗效。方法 采用钢丝环扎结合带孔钛针钛缆张力带治疗27例髌骨骨折患者。记录骨折愈合及并发症发生情况,采用Bostman评分标准评价疗效。结果 患者均获得随访,时间12~15个月。切口均一期愈合,无切口感染、钢丝断裂、钛针松动移位、创伤性关节炎等情况发生。骨折均愈合,时间3~4个月。术后6个月按照Bostman评分标准评价疗效:优20例,良6例,差1例,优良率26/27。结论 钢丝环扎结合带孔钛针钛缆张力带治疗髌骨骨折并发症少,患者可早期功能锻炼,膝关节功能恢复好,疗效确切。

微创钢板内固定术与切开复位内固定术治疗肋骨骨折患者的效果分析

目的:探究微创钢板内固定术与切开复位内固定术治疗肋骨骨折患者的效果。方法:选择2022年3月—2024年2月枣庄市峄城区人民医院收治的82例肋骨骨折患者为研究对象,按随机数字法将其分为对照组和研究组,各41例。对照组采用切开复位内固定术治疗,研究组采用微创钢板内固定术治疗。对比两组围手术期临床指标、疼痛程度、肺功能指标及并发症发生情况。结果:与对照组相比,研究组手术时间、呼吸机使用时间均短于对照组,术后出血量、胸腔引流量均低于对照组,切口长度短于对照组,差异均有统计学意义(P<0.05)。术后14 d,两组第1秒用力呼气容积、用力肺活量、最大呼气峰流速均较术前升高,且研究组高于对照组,差异均有统计学意义(P<0.05)。术后3、7、14 d,研究组疼痛视觉模拟评分均低于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率为2.44%,低于对照组的19.51%,差异有统计学意义(P<0.05)。结论:微创钢板内固定术相较于切开复位内固定术,能提升手术质量,缩短肋骨骨折患者的术后康复周期,改善其肺功能状态,降低并发症发生率。

颅盆环牵引及后路内固定技术治疗重度脊柱侧弯的效果

目的:分析颅盆环牵引及后路内固定技术治疗重度脊柱侧弯的效果。方法:选取2021年1月—2023年10月北京优联医院收治的重度脊柱侧弯患者100例作为研究对象,采用随机数字表法分为对照组与观察组,各50例。对照组采用常规脊柱矫形手术方案治疗,观察组采用颅盆环牵引及后路内固定技术治疗。比较两组脊柱侧弯度、腰椎功能、疼痛程度、并发症发生情况。结果:治疗60d后,两组侧凸Cobb角及后凸Cobb角小于治疗前,且观察组小于对照组,差异有统计学意义(P<0.05)。治疗60 d后,两组Oswestry功能障碍指数、视觉模拟评分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P=0.046)。结论:颅盆环牵引及后路内固定技术治疗重度脊柱侧弯的效果显著,可降低脊柱侧弯度,增强腰椎功能,减轻疼痛,减少并发症发生风险。

围手术期预见性护理在石膏固定术治疗下肢骨折患儿中的应用

目的探讨围手术期预见性护理在石膏固定术治疗下肢骨折患儿中的应用效果。方法选取滨州医学院附属医院儿外科2021年5月至2023年5月收治的78例下肢骨折患儿作为研究对象,按照随机数字表法分为对照组和观察组,每组各39例。对照组采用常规护理干预,观察组采用围手术期预见性护理干预,比较两组疼痛程度、骨折愈合时间和生活质量。结果护理后,观察组视觉模拟评分法评分低于对照组(P<0.05);观察组骨折愈合时间短于对照组(P<0.05);观察组各项健康调查量表36评分高于对照组(P<0.05)。结论围手术期预见性护理干预在石膏固定术治疗下肢骨折患儿中的应用效果较好,可有效改善疼痛程度,缩短骨折愈合时间,提高生活质量。

关节镜下经皮空心螺钉内固定治疗SchatzkertⅠ~Ⅲ型胫骨平台骨折术后恢复与预后分析

目的分析对比关节镜下经皮空心螺钉内固定和传统切开复位内固定治疗SchatzkertⅠ~Ⅲ型胫骨平台骨折的术后恢复以及不同时间预后效果差异。方法选择2021年1月至2023年12月南阳医学高等专科学校第一附属医院收治的114例胫骨平台骨折患者,根据治疗方法分为两组,对照组55例开展传统切开复位内固定术,观察组59例开展关节镜辅助下经皮空心螺钉内固定术。比较两组患者围手术期指标、术后恢复情况,以及出院前、术后1个月和术后6个月疼痛程度、下肢功能、膝关节功能和日常生活能力水平变化。结果观察组患者术中出血量和术后引流量均明显少于对照组,差异有统计学意义(P<0.05)。观察组手术时间、下地时间、总住院时间、术后负重下地所用时间和骨折愈合时间均于对照组,差异有统计学意义(P<0.05)。出院前、术后1个月和术后6个月观察组患者视觉模拟评分法(VAS)评分均低于对照组,差异有统计学意义(P<0.05);两组出院前LEFS评分比较差异无统计学意义(P>0.05);术后1个月、术后6个月,观察组LEFS评分高于对照组,差异有统计学意义(P<0.05)。观察组出院前、术后1个月和术后6个月KSS评分均高于对照组,差异有统计学意义(P<0.05)。结论在关节镜辅助下开展经皮空心螺钉内固定术治疗胫骨平台骨折较传统切开复位内固定术更理想,不仅体现在前者围手术期指标更具优越性,前者术后恢复程度也相对更快,疼痛感减轻明显,并且术后运动功能和日常生活能力改善更明显。

细节干预及分层护理在外固定联合骨赘清理治疗创伤性踝关节炎的应用效果

目的:接受外固定联合骨赘清理治疗的创伤性踝关节炎患者,于其围术期护理工作中开展细节干预及分层护理,对缓解患者术后肿胀程度及疼痛程度、改善其负面情绪和睡眠质量的价值探究.方法:选取我院2021年3月—2023年3月收治的80例创伤性踝关节炎患者为研究对象,随机将其分为对照组与观察组,各40例.患者入组均接受外固定联合骨赘清理治疗,对照组采用常规围术期护理,观察组开展细节干预及分层护理.比较2组患者的护理效果差异.结果:术后1、2 d,2组肿胀程度评分比较,组间差异无统计学意义(P>0.05);术后3~6 d,观察组肿胀程度评分均低于对照组,组间差异有统计学意义(P<0.05).术后1、2 d,2组疼痛评分比较,组间差异无统计学意义(P>0.05),术后3~6 d,观察组疼痛评分均低于对照组,组间差异有统计学意义(P<0.05).护理后,观察组负性情绪评分均低于对照组,组间差异有统计学意义(P<0.05).护理后,观察组睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能障碍评分及总分均低于对照组,组间差异有统计学意义(P<0.05).结论:接受外固定联合骨赘清理治疗的创伤性踝关节炎患者,于其围术期护理工作中开展细节干预及分层护理,对缓解患者术后肿胀程度及疼痛程度,改善其负面情绪和睡眠质量的效果显著.

Sediment Movement in Periodic Alternating Current

The present paper summarizes the results of previous studies, including the structure and principle of the rotary ring flume for researching the fine sediment movement, the mechanism of the flume, method of eliminating the influence of the centrifugal force and sediment movement experiments with periodic alternating current. Also included are the experiment-based relationship among sediment concentration, bed shear stress and silt carrying capacity, a proposed erosion-deposition function and bed erosion-deposition calculation together with the results of verification.

口咽入路小钛板固定治疗不稳定寰椎骨折的可行性分析

目的 研究口咽入路小钛板固定治疗不稳定寰椎骨折的可行性分析。方法 选取64例不稳定寰椎骨折患者,其中30例采用口咽入路小钛板固定治疗为观察组,34例采用后路寰枢椎椎弓根钉内固定治疗为对照组。比较2组术中指标:手术时间、出血量;术后指标:住院时间、并发症(颈部慢性疼痛、切口感染、吞咽困难)发生情况,术前、术后1个月、末次随访的疼痛视觉模拟(VAS)评分、日本骨科协会(JOA)评分以及颈椎后伸、前屈、左旋、右旋活动度。结果 观察组手术时间、出血量均显著低于对照组(P<0.05),住院时间差异无统计学意义;2组颈部慢性疼痛、切口感染和吞咽困难发生率差异无统计学意义;2组术后1个月、末次随访VAS评分低于术前,JOA评分高于术前(P<0.05),组间比较差异均无统计学意义;2组术后1个月、末次随访后伸、前屈、左旋、右旋活动度均较术前增加(P<0.05);观察组术后1个月、末次随访后伸、前屈、左旋、右旋活动度均高于对照组(P<0.05)。结论 口咽入路小钛板固定治疗不稳定寰椎骨折创伤小,手术时间短,且较传统后路寰枢椎椎弓根钉内固定治疗能够最大程度上保留颈椎活动度。

辽宁省千山生态旅游气候特征研究

基于千山1987年-2020年气象资料、卫星遥感资料和环境空气质量资料,分析了千山的气候背景、气候舒适度、适游期、氧环境和空气质量状况,结果表明:千山具备避暑旅游和春、秋季养生旅游的气候特征;千山4月-6月和9月-10月为旅游适宜期,5月和9月是旅游最佳时节;千山负氧离子全年均值达到4229个/cm 3,空气质量非常清新;过去的20年间,千山植被通过光合作用固碳释氧量稳中有升,2020年植被总固碳释氧功能较2001年提高了22.7%;千山空气主要污染物含量呈下降趋势,2017年千山景区空气质量优良天数高达91.6%,与2016年相比上升4.0%。

钴铜混合离子-DC^(-)凝胶体系有序结构的FTIR研究

在体外模拟胆结石形成机制的体系,选取混合金属离子Co^(2+)和Cu^(2+)研究其相互耦合,考察Co^(2+)/Cu^(2+)-DC^(-)凝胶体系有序结构的特征,分别用扫描仪及体式显微镜记录体系产生的沉淀的时空图案;傅里叶变换红外谱从凝胶中剥离的沉淀的微观结构。结果显示:Co^(2+)和Cu^(2+)存在相互影响,其混合离子-DC^(-)凝胶体系的沉淀物的时空图案与其单一离子-DC^(-)凝胶体系不同,Co^(2+)-DC^(-)凝胶体系沉淀形貌特征为以粉色花状分形形成周期环;Cu^(2+)-DC^(-)凝胶体系沉淀形貌特征为以蓝色球形颗粒形成周期环;混合金属离子Co^(2+)/Cu^(2+)-DC^(-)凝胶体系沉淀形貌更具复杂性:浅蓝色颗粒组成花状分形再以周期环分布、浅粉色花状分形的枝杈存在颗粒形态分布。FTIR光谱显示,混合离子Co^(2+)/Cu^(2+)-DC^(-)凝胶体系多种沉淀物为Co^(2+),Cu^(2+)-DC^(-)双核配合物,具有非化学计量特征。

非均布质量对偏心旋转环状周期结构自由振动的影响

工程实际中的各类旋转机械广泛应用旋转环状周期结构.为了提升动力学性能,该类结构通常采用对称构型设计.但是,由于存在制造和安装误差,对称设计的周期结构通常呈现偏心形式的非对称状态,从而降低旋转机械性能.本文研究了该类结构的质量周期分布特征对固有频率分裂和动力稳定性的影响.为此,首先建立了惯性坐标系和结构随动坐标系,计算了该结构在自转和公转情形下的能量,利用Hamilton原理得到解析形式的动力学方程;然后,采用Galerkin方法和经典振动理论获得特征方程以及特征值,根据特征值预测了质量个数以及振动波数等不同基本参数组合对动力学特性的影响,揭示了基本参数与固有频率分裂及动力稳定性之间的映射关系;最后,给出了附加质量拓扑结构对固有频率分裂影响的数值算例,然后分别在稳定域和不稳定域中选取计算参考点,利用数值计算求解了时域响应,根据响应的特征验证了稳定性预测结果特别是解析结果的正确性.结果表明:当采用不同附加质量拓扑结构时,固有频率分裂和稳定性规律发生明显的变化;当质量分布参数与振动波数满足所提解析关系时,可有效抑制固有频率分裂,且调整基本参数组合可有效改善系统的动力稳定性.研究结果为该类旋转环状周期结构的振动控制提供了一定的借鉴.