Which approach of total hip arthroplasty is the best efficacy and least complication?

BACKGROUND Total hip arthroplasty is as an effective intervention to relieve pain and improve hip function.Approaches of the hip have been exhaustively explored about pros and cons.The efficacy and the complications of hip approaches remains inconclusive.This study conducted an umbrella review to systematically appraise previous meta-analysis(MAs)including conventional posterior approach(PA),and minimally invasive surgeries as the lateral approach(LA),direct anterior approach(DAA),2-incisions method,mini-lateral approach and the newest technique direct superior approach(DSA)or supercapsular percutaneouslyassisted total hip(SuperPath).AIM To compare the efficacy and complications of hip approaches that have been published in all MAs and randomized controlled trials(RCTs).METHODS MAs were identified from MEDLINE and Scopus from inception until 2023.RCTs were then updated from the latest MA to September 2023.This study included studies which compared hip approaches and reported at least one outcome such as Harris Hip Score(HHS),dislocation,intra-operative fracture,wound compliData were independently selected,extracted and assessed by two reviewers.Network MA and cluster rank and surface under the cumulative ranking curve(SUCRA)were estimated for treatment efficacy and safety.RESULTS Finally,twenty-eight MAs(40 RCTs),and 13 RCTs were retrieved.In total 47 RCTs were included for reanalysis.The results of corrected covered area showed high degree(13.80%).Among 47 RCTs,most of the studies were low risk of bias in part of random process and outcome reporting,while other domains were medium to high risk of bias.DAA significantly provided higher HHS at three months than PA[pooled unstandardized mean difference(USMD):3.49,95%confidence interval(CI):0.98,6.00 with SUCRA:85.9],followed by DSA/SuperPath(USMD:1.57,95%CI:-1.55,4.69 with SUCRA:57.6).All approaches had indifferent dislocation and intraoperative fracture rates.SUCRA comparing early functional outcome and composite complications(dislocation,intra-operative fracture,wound complication,and nerve injury)found DAA was the best approach followed by DSA/SuperPath.CONCLUSION DSA/SuperPath had better earlier functional outcome than PA,but still could not overcome the result of DAA.This technique might be the other preferred option with acceptable complications.

Total flavonoids of Astragalus membranaceus protect against 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced neurotoxicity in mice by inhibiting ferroptosis through SLC7A11/GPX-4 signaling pathway

Parkinson’s disease(PD)is a common neurodegenerative disorder with no cure.Astragalus membranaceus is used in Chinese culture as a food supplement to boost immunity.The present study aimed to explore the neuroprotective effects of total flavonoids extracted from A.membranaceus(TFA)and their protective mechanisms.TFA offered neuroprotection against 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)in the mouse model of Parkinsonism,by improving behavior performance in the gait analysis and pole test,and inhibiting the decline of tyrosine hydroxylase(TH)positive neurons and TH protein expression in substantia nigra of mice.TFA also prevented 1-methyl-4-phenylpyridinium(MPP+)induced neurotoxicity in SHSY5Y cells,by increasing GSH and GSH/GSSG ratio,and reducing reactive oxygen species.In addition,the neuroprotective effects of TFA were associated with its ability to restore MPTP/MPP+induced downregulation of SLC7A11 and glutathione peroxidase 4(GPX-4).In conclusion,we demonstrated that TFA exerted significant neuroprotection against MPTP/MPP+induced neurodegeneration by inhibiting ferroptosis through the regulation of SLC7A11/GPX-4 axis,suggesting the use of TFA as a possible food supplement in the prevention of PD.

Assessment of International GNSS Service Global Ionosphere Map products over China region based on measurements from the Crustal Movement Observation Network of China

The global ionosphere maps(GIM)provided by the International GNSS Service(IGS)are extensively utilized for ionospheric morphology monitoring,scientific research,and practical application.Assessing the credibility of GIM products in data-sparse regions is of paramount importance.In this study,measurements from the Crustal Movement Observation Network of China(CMONOC)are leveraged to evaluate the suitability of IGS-GIM products over China region in 2013-2014.The indices of mean error(ME),root mean square error(RMSE),and normalized RMSE(NRMSE)are then utilized to quantify the accuracy of IGS-GIM products.Results revealed distinct local time and latitudinal dependencies in IGS-GIM errors,with substantially high errors at nighttime(NRMSE:39%)and above 40°latitude(NRMSE:49%).Seasonal differences also emerged,with larger equinoctial deviations(NRMSE:33.5%)compared with summer(20%).A preliminary analysis implied that the irregular assimilation of sparse IGS observations,compounded by China’s distinct geomagnetic topology,may manifest as error variations.These results suggest that modeling based solely on IGS-GIM observations engenders inadequate representations across China and that a thorough examination would proffer the necessary foundation for advancing regional total electron content(TEC)constructions.

Nitrogen mineralization in the oldest climax communities in the eastern Mediterranean region

In this study,we investigated how tree species affect N mineralization in connection to some soil properties and seconder metabolite levels of litter,in the soil of the old-est native forest communities.In the oldest pure communi-ties of Pinus nigra(PN),Fagus orientalis(FO),and Abies bornmuelleriana(AB)in the mountain range of Mount Uludağ,Bursa,Turkey,annual net yield and N mineraliza-tion in the 0-5-and 5-20-cm soil layers were determined in a field incubation study over 1 year.Sampling locations were chosen from 1300 to 1600 m a.s.l.,and moisture content(%),pH,water-holding capacity(%),organic C,total N,and C/N ratio,and annual net mineral N yield of the soil and hydro-lyzed tannic acid and total phenolic compounds in litter were compared for these forest communities.F.orientalis had the highest annual net Nmin yield(43.9±4.8 kg ha^(-1) a^(-1)),P.nigra the lowest(30.5±4.2 kg ha^(-1) a^(-1)).Our findings show that in the oldest forest ecosystems,the seasonal soil moisture content and tree species play an essential role in N cycling and that hydrolyzed tannic acids and total phenolic compounds effectively control N turnover.Tannic acid and total phenolics in the litter were found to inhibit nitrification,but total phenolics were found to stimulate ammonification.

Algorithms and statistical analysis for linear structured weighted total least squares problem

Weighted total least squares(WTLS)have been regarded as the standard tool for the errors-in-variables(EIV)model in which all the elements in the observation vector and the coefficient matrix are contaminated with random errors.However,in many geodetic applications,some elements are error-free and some random observations appear repeatedly in different positions in the augmented coefficient matrix.It is called the linear structured EIV(LSEIV)model.Two kinds of methods are proposed for the LSEIV model from functional and stochastic modifications.On the one hand,the functional part of the LSEIV model is modified into the errors-in-observations(EIO)model.On the other hand,the stochastic model is modified by applying the Moore-Penrose inverse of the cofactor matrix.The algorithms are derived through the Lagrange multipliers method and linear approximation.The estimation principles and iterative formula of the parameters are proven to be consistent.The first-order approximate variance-covariance matrix(VCM)of the parameters is also derived.A numerical example is given to compare the performances of our proposed three algorithms with the STLS approach.Afterwards,the least squares(LS),total least squares(TLS)and linear structured weighted total least squares(LSWTLS)solutions are compared and the accuracy evaluation formula is proven to be feasible and effective.Finally,the LSWTLS is applied to the field of deformation analysis,which yields a better result than the traditional LS and TLS estimations.

Understanding the combustion behavior of electric bicycle batteries and unveiling its relationship with fire extinguishing

In this study,a detailed analysis of the combustion behaviors of the lithium iron phosphate(LFP)and lithium manganese oxide(LMO)batteries used in electric bicycles was conducted.This research included quantitative measurements of the combustion duration,flame height,combustion temperature,heat release rate,and total heat release.The results indicated that LMO batteries exhibited higher combustion temperatures of 600–700°C,flame heights of 70–75 cm,a significantly higher heat release rate of40.1 k W(12 Ah),and a total heat release of 1.04 MJ(12 Ah)compared to LFP batteries with the same capacity.Based on these experimental results,a normalized total heat release(NORTHR)parameter was proposed,demonstrating good universality for batteries with different capacities.Utilizing this parameter,quantitative calculations and optimization of the extinguishing agent dosage were conducted for fires involving these two types of batteries,and the method was validated by extinguishing fires for these two types of battery packs with water-based extinguishing fluids.

The efficacy of vitamin E in preventing arthrofibrosis after joint replacement

Background:Arthrofibrosis is a joint disorder characterized by excessive scar formation in the joint tissues.Vitamin E is an antioxidant with potential anti-fibroblastic effect.The aim of this study was to establish an arthrofibrosis rat model after joint replacement and assess the effects of vitamin E supplementation on joint fibrosis.Methods:We simulated knee replacement in 16 male Sprague–Dawley rats.We immobilized the surgical leg with a suture in full flexion.The control groups were killed at 2 and 12 weeks(n=5 per group),and the test group was supplemented daily with vitamin E(0.2 mg/mL)in their drinking water for 12 weeks(n=6).We performed histological staining to investigate the presence and severity of arthrofibrosis.Immunofluorescent staining andα2-macroglobulin(α2M)enzyme-linked immunosorbent assay(ELISA)were used to assess local and systemic inflammation.Static weight bearing(total internal reflection)and range of motion(ROM)were collected for functional assessment.Results:The ROM and weight-bearing symmetry decreased after the procedure and recovered slowly with still significant deficit at the end of the study for both groups.Histological analysis confirmed fibrosis in both lateral and posterior periarticular tissue.Vitamin E supplementation showed a moderate anti-inflammatory effect on the local and systemic levels.The vitamin E group exhibited significant improvement in ROM and weight-bearing symmetry at day 84 compared to the control group.Conclusions:This model is viable for simulating arthrofibrosis after joint replacement.Vitamin E may benefit postsurgical arthrofibrosis,and further studies are needed for dosing requirements.

MicroRNAs as potential biomarkers for diagnosis of attention deficit hyperactivity disorder

Inappropriate levels of hyperactivity,impulsivity,and inattention characterize attention deficit hyperactivity disorder,a common childhood-onset neuropsychiatric disorder.The cognitive function and learning ability of children with attention deficit hyperactivity disorder are affected,and these symptoms may persist to adulthood if they are not treated.The diagnosis of attention deficit hyperactivity disorder is only based on symptoms and objective tests for attention deficit hyperactivity disorder are missing.Treatments for attention deficit hyperactivity disorder in children include medications,behavior therapy,counseling,and education services which can relieve many of the symptoms of attention deficit hyperactivity disorder but cannot cure it.There is a need for a molecular biomarker to distinguish attention deficit hyperactivity disorder from healthy subjects and other neurological conditions,which would allow for an earlier and more accurate diagnosis and appropriate treatment to be initiated.Abnormal expression of microRNAs is connected to brain development and disease and could provide novel biomarkers for the diagnosis and prognosis of attention deficit hyperactivity disorder.The recent studies reviewed had performed microRNA profiling in whole blood,white blood cells,blood plasma,and blood serum of children with attention deficit hyperactivity disorder.A large number of microRNAs were dysregulated when compared to healthy controls and with some overlap between individual studies.From the studies that had included a validation set of patients and controls,potential candidate biomarkers for attention deficit hyperactivity disorder in children could be miR-140-3p,let-7g-5p,-30e-5p,-223-3p,-142-5p,-486-5p,-151a-3p,-151a-5p,and-126-5p in total white blood cells,and miR-4516,-6090,-4763-3p,-4281,-4466,-101-3p,-130a-3p,-138-5p,-195-5p,and-106b-5p in blood serum.Further studies are warranted with children and adults with attention deficit hyperactivity disorder,and consideration should be given to utilizing rat models of attention deficit hyperactivity disorder.Animal studies could be used to confirm microRNA findings in human patients and to test the effects of targeting specific microRNAs on disease progression and behavior.

Total ionizing dose effect modeling method for CMOS digital-integrated circuit

Simulating the total ionizing dose(TID)of an electrical system using transistor-level models can be difficult and expensive,particularly for digital-integrated circuits(ICs).In this study,a method for modeling TID effects in complementary metaloxide semiconductor(CMOS)digital ICs based on the input/output buffer information specification(IBIS)was proposed.The digital IC was first divided into three parts based on its internal structure:the input buffer,output buffer,and functional area.Each of these three parts was separately modeled.Using the IBIS model,the transistor V-I characteristic curves of the buffers were processed,and the physical parameters were extracted and modeled using VHDL-AMS.In the functional area,logic functions were modeled in VHDL according to the data sheet.A golden digital IC model was developed by combining the input buffer,output buffer,and functional area models.Furthermore,the golden ratio was reconstructed based on TID experimental data,enabling the assessment of TID effects on the threshold voltage,carrier mobility,and time series of the digital IC.TID experiments were conducted using a CMOS non-inverting multiplexer,NC7SZ157,and the results were compared with the simulation results,which showed that the relative errors were less than 2%at each dose point.This confirms the practicality and accuracy of the proposed modeling method.The TID effect model for digital ICs developed using this modeling technique includes both the logical function of the IC and changes in electrical properties and functional degradation impacted by TID,which has potential applications in the design of radiation-hardening tolerance in digital ICs.

船舶进气畸变模拟板结构设计与参数分析

Significant aerodynamic engine instability can occur during the operation of marine gas turbines as airflow enters the compressor through a 90°turning and causes inlet distortion.This study adopts the method of simulating board equivalence to provide the target distortion flow field for ship compressors.The characteristics of the flow field behind the simulated board are obtained through experiments and numerical simulations,through which the relationship between the height of the simulated board and the total pressure distortion is elucidated.Subsequently,the study summarizes the prediction formula to achieve a distortion prediction of 0.8%–7.8%.In addition,this work analyzes the effects of drilling methods and diameters on flow nonuniformity by drilling holes into the simulation board.The results indicate that drilling holes on the board can weaken the nonuniformity of the flow field within a certain range and change the distribution pattern of total pressure in the cross-section.Furthermore,the total pressure distortion no longer changes significantly when the number of holes is too large.The proposed double simulation board structure is capable of obtaining the following two types of distorted flow fields:symmetrical dual lowpressure zones and low-pressure zones with high distortion intensity at the compressor inlet.The distortion equivalent simulation method proposed in this work can obtain various types of distortion spectra,thereby meeting the distortion parameter requirements for the antidistortion testing of marine engines.

Measurement of the neutron-induced total cross sections of ^(nat)Pb from 0.3 eV to 20 MeV on the Back-n at CSNS

The neutron-induced total cross sections of natural lead have been measured in a wide energy range(0.3 eV-20 MeV)on the back-streaming white neutron beamline(Back-n)at the China Spallation Neutron Source.Neutron energy was determined by the neutron total cross-section spectrometer using the time-of-flight technique.A fast multi-cell fission chamber was used as the neutron detector,and a 10-mm-thick high-purity natural lead sample was employed for the neutron transmission measurements.The on-beam background was determined using Co,In,Ag,and Cd filters.The excitation function of ^(nat)Pb(n,tot)reaction below 20 MeV was calculated using the TALYS-1.96 nuclear-reaction modeling program.The present results were compared with previous results,the evaluated data available in the five major evaluated nuclear data libraries(i.e.,ENDF/B-VIII.0,JEFF-3.3,JENDL-5,CENDL-3.2,and BROND-3.1),and the theoretical calculation curve.Good agreement was found between the new results and those of previous experiments and with the theoretical curves in the corresponding region.This measurement obtained the neutron total cross section of natural lead with good accuracy over a wide energy range and added experimental data in the resonance energy range.This provides more reliable experimental data for nuclear engineering design and nuclear data evaluation of lead.

Machine learning identifies the risk of complications after laparoscopic radical gastrectomy for gastric cancer

BACKGROUND Laparoscopic radical gastrectomy is widely used,and perioperative complications have become a highly concerned issue.AIM To develop a predictive model for complications in laparoscopic radical gastrectomy for gastric cancer to better predict the likelihood of complications in gastric cancer patients within 30 days after surgery,guide perioperative treatment strategies for gastric cancer patients,and prevent serious complications.METHODS In total,998 patients who underwent laparoscopic radical gastrectomy for gastric cancer at 16 Chinese medical centers were included in the training group for the complication model,and 398 patients were included in the validation group.The clinicopathological data and 30-d postoperative complications of gastric cancer patients were collected.Three machine learning methods,lasso regression,random forest,and artificial neural networks,were used to construct postoperative complication prediction models for laparoscopic distal gastrectomy and laparoscopic total gastrectomy,and their prediction efficacy and accuracy were evaluated.RESULTS The constructed complication model,particularly the random forest model,could better predict serious complications in gastric cancer patients undergoing laparoscopic radical gastrectomy.It exhibited stable performance in external validation and is worthy of further promotion in more centers.CONCLUSION Using the risk factors identified in multicenter datasets,highly sensitive risk prediction models for complications following laparoscopic radical gastrectomy were established.We hope to facilitate the diagnosis and treatment of preoperative and postoperative decision-making by using these models.

Subsequent total joint arthroplasty: Are we learning from the first stage?

BACKGROUND With the increasing incidence of total joint arthroplasty(TJA),there is a desire to reduce peri-operative complications and resource utilization.As degenerative conditions progress in multiple joints,many patients undergo multiple proce-dures.AIM To determine if both physicians and patients learn from the patient’s initial arth-roplasty,resulting in improved outcomes following the second procedure.METHODS The institutional database was retrospectively queried for primary total hip arth-roplasty(THA)and total knee arthroplasty(TKA).Patients with only unilateral THA or TKA,and patients undergoing same-day bilateral TJA,were excluded.Patient demographics,comorbidities,and implant sizes were collected at the time of each procedure and patients were stratified by first vs second surgery.Outcome metrics evaluated included operative time,length of stay(LOS),disposition,90-d readmissions and emergency department(ED)visits.RESULTS A total of 642 patients,including 364 undergoing staged bilateral TKA and 278 undergoing bilateral THA,were analyzed.There was no significant difference in demographics or comorbidities between the first and second procedure,which were separated by a mean of 285 d.For THA and TKA,LOS was significantly less for the second surgery,with 66%of patients having a shorter hospitalization(P<0.001).THA patients had significantly decreased operative time only when the same sized implant was utilized(P=0.025).The vast majority(93.3%)of patients were discharged to the same type of location following their second surgery.However,when a change in disposition was present from the first surgery,patients were significantly more likely to be discharged to home after the second procedure(P=0.033).There was no difference between procedures for post-operative readmissions(P=0.438)or ED visits(P=0.915).CONCLUSION After gaining valuable experience recovering from the initial surgery,a patient’s perioperative outcomes are improved for their second TJA.This may be the result of increased confidence and decreased anxiety,and it supports the theory that enhanced patient education pre-operatively may improve outcomes.For the surgical team,the second procedure of a staged THA is more efficient,although this finding did not hold for TKA.

Quality of life after pancreatic surgery

BACKGROUND Pancreatic surgery is challenging owing to the anatomical characteristics of the pancreas.Increasing attention has been paid to changes in quality of life(QOL)after pancreatic surgery.AIM To summarize and analyze current research results on QOL after pancreatic surgery.METHODS A systematic search of the literature available on PubMed and EMBASE was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Relevant studies were identified by screening the references of retrieved articles.Studies on patients’QOL after pancreatic surgery published after January 1,2012,were included.These included prospective and retrospective studies on patients'QOL after several types of pancreatic surgeries.The results of these primary studies were summarized inductively.RESULTS A total of 45 articles were included in the study,of which 13 were related to pancreaticoduodenectomy(PD),seven to duodenum-preserving pancreatic head resection(DPPHR),nine to distal pancreatectomy(DP),two to central pancre-atectomy(CP),and 14 to total pancreatectomy(TP).Some studies showed that 3-6 months were needed for QOL recovery after PD,whereas others showed that 6-12 months was more accurate.Although TP and PD had similar influences on QOL,patients needed longer to recover to preoperative or baseline levels after TP.The QOL was better after DPPHR than PD.However,the superiority of the QOL between patients who underwent CP and PD remains controversial.The decrease in exocrine and endocrine functions postoperatively was the main factor affecting the QOL.Minimally invasive surgery could improve patients’QOL in the early Core Tip:This review summarizes and analyzes current research results on quality of life(QOL)after pancreatic surgery.The article covers the discussion and analysis of the QOL of various pancreatic surgeries.Which kind of surgical procedure has better QOL is controversial.The long-term benefits on QOL of minimally invasive surgery over open surgery are contro-INTRODUCTION The pancreas,located in the retroperitoneum,is a glandular organ with endocrine and exocrine functions.It can be divided into four main parts:Head,neck,body,and tail.Pancreatic surgery can be divided into pancreaticoduoden-ectomy(PD),duodenum-preserving pancreatic head resection(DPPHR),distal pancreatectomy(DP),central pancre-atectomy(CP),and total pancreatectomy(TP).Pancreatic surgery is challenging due to the organ’s complex anatomical structure,peripheral vascularity,and intractable postoperative complications.Following the standardization of surgical steps and improvements in relevant medical techniques and surgical instruments,the safety of pancreatic surgery has significantly improved.Perioperative morbidity,mortality,and other related indicators have become more acceptable.However,owing to the organ’s essential role in digestion,absorption,and blood glucose regulation,changes in the quality of life(QOL)of patients after pancreatic surgery have attracted the attention of surgeons.More patients with non-malignant pancreatic diseases are willing to undergo surgical treatment because of the acceptable safety.In this case,from the perspective of the patient postoperatively,the significance of rehabilitation reflects the traditional perioperative outcome and QOL[1].The QOL is a new concept that extends beyond health.Although there is no consensus on its conception[2],we can consider it a multi-dimensional architecture that incorporates objective and individual subjective views of aspects of one’s physical,psychological,and social well-being[3-5].It includes evaluating physical health,and many subscales,such as emotion,job,culture,family,sociability,economy,cognition,happiness,sex,and some symptoms[6].Since people have realized the importance of QOL,many QOL scales have emerged,including the European Organization for Research and Treatment of Cancer QLQ-C30,European Quality of Life 5-dimension,36-item Short,etc.However,it is challenging to follow up on patients’QOL once they are discharged from the hospital.Consequently,most relevant studies had small sample sizes or lacked long-term follow-up results.Moreover,a summary of studies on QOL after pancreatic surgery is lacking.This study assessed the QOL in patients who underwent PD,DPPHR,DP,CP and TP.We conducted this study to describe the existing findings on the QOL after pancreatic surgery to make it easier for surgeons and patients to decide on a surgical approach.In addition,we attempted to identify controversial results to encourage further targeted research.

Analyze the Performance of Electroactive Anticorrosion Coating of Medical Magnesium Alloy Using Deep Learning

Electroactive anticorrosion coatings are specialized surface treatments that prevent or minimize corrosion. Thestudy employs strategic thermodynamic equilibriumcalculations to pioneer a novel factor in corrosion protection.A first-time proposal, the total acidity (TA) potential of the hydrogen (pH) concept significantly shapes medicalmagnesium alloys. These coatings are meticulously designed for robust corrosion resistance, blending theoreticalinsights and practical applications to enhance our grasp of corrosion prevention mechanisms and establisha systematic approach to coating design. The groundbreaking significance of this study lies in its innovativeintegration of the TA/pH concept,which encompasses the TA/pH ratio of the chemical environment. This approachsurpasses convention by acknowledging the intricate interplay between the acidity and pH levels within thecoating formulation, thereby optimizing metal-phosphate-based conversion coatings and transforming corrosionmitigation strategies. To authenticate the TA/pH concept, the study comprehensively compares its findings withexisting research, rigorously validating the theoretical framework and reinforcing the correlates among TA/pHvalues and observed corrosion resistance in the coatings. The influence of mutations that occur naturally inthe detergent solution on persistent phosphorus changes is shown by empirical confirmation, which improvescorrosion resistance. This realization advances the field ofmaterials and the field’s knowledge of coated generation,particularly anticorrosion converter layers.

Potential applications of single-incision laparoscopic totally preperitoneal hernioplasty

BACKGROUND The totally preperitoneal(TPP)approach is a new concept that was recently introduced.Although the TPP approach combined with single-incision laparoscopic hernia repair has its own advantages,there is little evidence reflecting the characteristics and feasibility of either approach.AIM To analyze the potential applications of single-incision laparoscopic TPP(SILTPP)inguinal hernia hernioplasty for the treatment of inguinal hernias.METHODS A total of 152 SIL-TPP surgeries were performed at the First Affiliated Hospital of Ningbo University from February 2019 to November 2022.A single-port,named Iconport,and standard laparoscopic instruments were used during the operation.Demographic data,intraoperative parameters and short-term postoperative outcomes were collected and retrospectively analyzed.RESULTS The demographic data of 152 patients underwent SIL-TPP were shown in Table 1.The average age was 49.5 years(range from 21 to 81 years).The average body mass index was 27.7 kg/m^(2)(range from 17.7 kg/m^(2) to 35.6 kg/m^(2)).SIL-TPP were conducted successfully in 147 patients.Three patients were converted to the SILtransabdominal preperitoneal laparoscopic herniorrhaphy at the initial stage of the study due to a lack of experience.In 2 patients with incisional hernias,an auxiliary operation hole was added during the SIL-TPP procedure,as required for surgery.The mean operative time was 64.5 minutes(range:36.0-110.0 minutes)for unilateral direct and femoral hernias and 81.6 minutes for indirect hernias(range:40.0-150.0 minutes).The mean postoperative hospital stay was 3.4 days.CONCLUSION SIL-TPP is feasible and has advantages for inguinal hernia repair.SIL-TPP has potential benefits for patients with various abdominal wall hernias.Consequently,doctors should be encouraged to actively apply the TPP approach combined with a single incision in their daily work.

Mortality rate after total knee arthroplasty or total hip arthroplasty in patients with a history of liver transplant

In this editorial I comment on the article by Ahmed et al published in a recent issue of the World J Orthop 2023;14:784-790.It is well known that patients who have undergone a liver transplant(LT)may need to have a total hip arthroplasty(THA)or total knee arthroplasty(TKA)implanted.Ahmed et al stated that the mortality rate in these patients was similar to the one of the general population.However,there are three articles previously published that found higher mortality in LT patients who experienced THA/TKA than in the general population(individuals without LT).Therefore,in this Editorial I would like to point out that there is controversy in the literature regarding whether LT patients undergoing THA/TKA have higher mortality than the general population.Therefore,future research should attempt to resolve this controversy.

A High Order Accurate Bound-Preserving Compact Finite Difference Scheme for Two-Dimensional Incompressible Flow

For solving two-dimensional incompressible flow in the vorticity form by the fourth-order compact finite difference scheme and explicit strong stability preserving temporal discretizations,we show that the simple bound-preserving limiter in Li et al.(SIAM J Numer Anal 56:3308–3345,2018)can enforce the strict bounds of the vorticity,if the velocity field satisfies a discrete divergence free constraint.For reducing oscillations,a modified TVB limiter adapted from Cockburn and Shu(SIAM J Numer Anal 31:607–627,1994)is constructed without affecting the bound-preserving property.This bound-preserving finite difference method can be used for any passive convection equation with a divergence free velocity field.

Successful management of severe hypoglycemia induced by total parenteral nutrition in patients with hepatocellular injury: Three cases reports

BACKGROUND Glucose imbalance is common in total parenteral nutrition(TPN).Hypoglycemia seems to be less frequent than hyperglycemia,but it influences the clinical outcome to a greater extent.Therefore,it should be effectively prevented and treated.However,there is no relevant report on how to treat hypoglycemia caused by TPN in patients with liver cell injury.CASE SUMMARY We present three patients with liver cell injury who developed severe hypo-glycemia during or after TPN infusion.The causes of severe hypoglycemia and glucose-raising strategies were discussed.According to the physiological charac-teristics of the hepatocellular injury,the ratio of nutrition components prescribed in TPN was appropriately adjusted for the three cases.We simultaneously reduced the dose of insulin and fat emulsion,and increased the dose of glucose in TPN.The blood glucose level was restored to normal range and clinical symptoms were eliminated.CONCLUSION When hypoglycemia occurs during or after TPN in patients with hepatocellular injury,physicians need to simultaneously reduce insulin and fat emulsion,and increase glucose,and correct severe hypoglycemia in time to reduce its adverse consequences.

The Effect of Soil Enzymes and Polysaccharides Secreted by the Roots of Salvia miltiorrhiza Bunge under Drought,High Temperature,and Nitrogen and Phosphorus Deficits

Root exudates serve as crucial mediators for information exchange between plants and soil,and are an important evolutionary mechanism for plants’adaptation to environmental changes.In this study,15 different abiotic stress models were established using various stress factors,including drought(D),high temperature(T),nitrogen deficiency(N),phosphorus deficiency(P),and their combinations.We investigated their effects on the seedling growth of Salvia miltiorrhiza Bunge and the activities of Solid-Urease(S-UE),Solid-Nitrite Reductase(S-NiR),Solid-Nitrate Reductase(S-NR),Solid-Phosphotransferase(S-PT),and Solid-Catalase(S-CAT),as well as the contents of polysaccharides in the culture medium.The results showed that the growth of S.miltiorrhiza was inhibited under 15 stress conditions.Among them,13 stress conditions increased the root-shoot ratio.These 15 stress conditions significantly reduced the activity of S-NR,two combinations significantly improved the activity of S-NIR,they were synergistic stresses of high temperature and nitrogen deficiency(TN),and synergistic stresses of drought and nitrogen deficiency(DN)(p<0.05).The activity of S-UE was significantly improved under N,D,T,synergistic stresses of drought and high temperature(DT),DN,synergistic stresses of drought and phosphorus deficiency(DP),and synergistic stresses of high temperature,nitrogen,and phosphorus deficiency(TNP)stress conditions(p<0.05).Most stress combinations reduced the activity of S-PT,but D and T significantly improved it.(p<0.05).The N,DN,and TN stress conditions significantly reduced S-CAT activity.The P,DT,and synergistic stresses of drought,high temperature,and phosphorus deficiency(DTP)significantly decreased the total polysaccharide content of the soil(p<0.05).The research suggested that abiotic stress hindered the growth of S.miltiorrhiza and altered the behavior of root secretion.Roots regulated the secretion of several substances in response to various abiotic stresses,including soil nitrogen cycle enzymes,phosphorus transport-related enzymes,and antioxidant enzymes.In conclusion,plants regulate the utilization of rhizosphere substances in response to abiotic stresses by modulating the exudation of soil enzymes and polysaccharides by the root system.At the same time,soil carbon sequestration was affected by the adverse environment,which restricted the input of organic matter into the soil.