Effect of stress-dependent microannulus aperture on well leakage

Debonding at the cement-casing interface is recognized as a principal failure mechanism leading to CO_(2) leakage in wells.This detachment gives rise to a microannulus,which notably possesses greater permeability than undamaged cement,undermining its sealing efficacy.Conventionally,the permeability of the microannulus is regarded as a uniform value throughout the well.However,fundamentally,a microannulus is one type of fracture,and its gap or aperture size is affected by the effective stress.In this work,we developed a unique experimental apparatus.This equipment facilitates the curing of cement inside a steel casing,the formation of a microannulus between the casing and the cement,and the investigation of the fluid flow dynamics along the microannulus under laboratory-replicated in situ conditions.The microannulus was formed by injecting fluid from one end of the setup,and receiving similar amount of fluid on the other end signified the development of the leakage channel.Additionally,strain gauges affixed to the casing’s external surface yielded key information on the microannulus’s opening and closure.We observed a noticeable decline in microannulus hydraulic aperture(or permeability)in relation to effective stress and an exponential equation fits their relationship.Our findings also indicate a distinct behavior when comparing liquid CO_(2) with water.Specifically,it is easier for liquid CO_(2) to create the microannulus.However,the hydraulic aperture range for this microannulus(0.7-6 mm)is considerably smaller than that created by water flow(2-17 mm).Finally,we integrated the stressdependent microannulus aperture size into the combined analysis of well mechanical integrity and well leakage.The outcomes consistently demonstrated that when factoring in the stress-dependent aperture sizes,the leakage rates are 3e5 times compared to a fixed aperture model.The traditional assumption of a constant aperture significantly underestimates fluid leakage risks.

Enhanced ferroelectric and improved leakage of BFO-based thin films through increasing entropy strategy

BiFeO_(3)(BFO)has received considerable attention as a lead-free ferroelectric film due to its large theoretical remnant polariza-tion.However,BFO suffers from a large leakage current,resulting in poor ferroelectric properties.Herein,the sol-gel method was used to deposit a series of BFO-based thin films on fluorine-doped tin oxide substrates,and the effects of the substitution of the elements Co,Cu,Mn(B-site)and Sm,Eu,La(A-site)on the crystal structure,ferroelectricity,and leakage current of the BFO-based thin films were invest-igated.Results confirmed that lattice distortion by X-ray diffraction can be attributed to the substitution of individual elements in the BFO-based films.Sm and Eu substitutions contribute to the lattice distortion in a pseudo-cubic structure,while La is biased toward pseudo-tet-ragonal.Piezoelectric force microscopy confirmed that reversible switching of ferroelectric domains by nearly 180°can be realized through the prepared films.The ferroelectric hysteresis loops showed that the order for the polarization contribution is as follows:Cu>Co>Mn(B-site),Sm>La>Eu(A-site).The current density voltage curves indicated that the order for leakage contribution is as follows:Mn<Cu<Co(B-site),La<Eu<Sm(A-site).Scanning electron microscopy showed that the introduction of Cu elements facilitates the formation of dense grains,and the grain size distribution statistics proved that La element promotes the reduction of grain size,leading to the increase of grain boundaries and the reduction of leakage.Finally,a Bi_(0.985)Sm_(0.045)La_(0.03)Fe_(0.96)Co_(0.02)Cu_(0.02)O_(3)(SmLa-CoCu)thin film with a qualitative leap in the remnant polarization from 25.5(Bi_(0.985)Sm_(0.075)FeO_(3))to 98.8µC/cm^(2)(SmLa-CoCu)was prepared through the syner-gistic action of Sm,La,Co,and Cu elements.The leakage current is also drastically reduced from 160 to 8.4 mA/cm^(2)at a field strength of 150 kV/cm.Thus,based on the increasing entropy strategy of chemical engineering,this study focuses on enhancing ferroelectricity and decreasing leakage current,providing a promising path for the advancement of ferroelectric devices.

Side-Channel Leakage Analysis of Inner Product Masking

The Inner Product Masking(IPM)scheme has been shown to provide higher theoretical security guarantees than the BooleanMasking(BM).This scheme aims to increase the algebraic complexity of the coding to achieve a higher level of security.Some previous work unfolds when certain(adversarial and implementation)conditions are met,and we seek to complement these investigations by understanding what happens when these conditions deviate from their expected behaviour.In this paper,we investigate the security characteristics of IPM under different conditions.In adversarial condition,the security properties of first-order IPMs obtained through parametric characterization are preserved in the face of univariate and bivariate attacks.In implementation condition,we construct two new polynomial leakage functions to observe the nonlinear leakage of the IPM and connect the security order amplification to the nonlinear function.We observe that the security of IPMis affected by the degree and the linear component in the leakage function.In addition,the comparison experiments from the coefficients,signal-to-noise ratio(SNR)and the public parameter show that the security properties of the IPM are highly implementation-dependent.

Study of leakage current degradation based on stacking faults expansion in irradiated SiC junction barrier Schottky diodes

A comprehensive investigation was conducted to explore the degradation mechanism of leakage current in SiC junction barrier Schottky(JBS)diodes under heavy ion irradiation.We propose and verify that the generation of stacking faults(SFs)induced by the recombination of massive electron-hole pairs during irradiation is the cause of reverse leakage current degradation based on experiments results.The irradiation experiment was carried out based on Ta ions with high linear energy transfer(LET)of 90.5 MeV/(mg/cm^(2)).It is observed that the leakage current of the diode undergoes the permanent increase during irradiation when biased at 20%of the rated reverse voltage.Micro-PL spectroscopy and PL micro-imaging were utilized to detect the presence of SFs in the irradiated SiC JBS diodes.We combined the degraded performance of irradiated samples with SFs introduced by heavy ion irradiation.Finally,three-dimensional(3D)TCAD simulation was employed to evaluate the excessive electron-hole pairs(EHPs)concentration excited by heavy ion irradiation.It was observed that the excessive hole concentration under irradiation exceeded significantly the threshold hole concentration necessary for the expansion of SFs in the substrate.The proposed mechanism suggests that the process and material characteristics of the silicon carbide should be considered in order to reinforcing against the single event effect of SiC power devices.

Peritoneal fluid indocyanine green test for diagnosis of gut leakage in anastomotic leakage rats and colorectal surgery patients

BACKGROUND Application of indocyanine green(ICG)fluorescence has led to new developments in gastrointestinal surgery.However,little is known about the use of ICG for the diagnosis of postoperative gut leakage(GL).In addition,there is a lack of rapid and intuitive methods to definitively diagnose postoperative GL.AIM To investigate the effect of ICG in the diagnosis of anastomotic leakage in a surgical rat GL model and evaluate its diagnostic value in colorectal surgery patients.METHODS Sixteen rats were divided into two groups:GL group(n=8)and sham group(n=8).Approximately 0.5 mL of ICG(2.5 mg/mL)was intravenously injected postoperatively.The peritoneal fluid was collected for the fluorescence test at 24 and 48 h.Six patients with rectal cancer who had undergone laparoscopic rectal cancer resection plus enterostomies were injected with 10 mL of ICG(2.5 mg/mL)on postoperative day 1.Their ostomy fluids were collected 24 h after ICG injection to identify the possibility of the ICG excreting from the peripheral veins to the enterostomy stoma.Participants who had undergone colectomy or rectal cancer resection were enrolled in the diagnostic test.The peritoneal fluids from drainage were collected 24 h after ICG injection.The ICG fluorescence test was conducted using OptoMedic endoscopy along with a near-infrared fluorescent imaging system.RESULTS The peritoneal fluids from the GL group showed ICG-dependent green fluorescence in contrast to the sham group.Six samples of ostomy fluids showed green fluorescence,indicating the possibility of ICG excreting from the peripheral veins to the enterostomy stoma in patients.The peritoneal fluid ICG test exhibited a sensitivity of 100%and a specificity of 83.3%for the diagnosis of GL.The positive predictive value was 71.4%,while the negative predictive value was 100%.The likelihood ratios were 6.0 for a positive test result and 0 for a negative result.CONCLUSION The postoperative ICG test in a drainage tube is a valuable and simple technique for the diagnosis of GL.Hence,it should be employed in clinical settings in patients with suspected GL.

Suppressing Leakage Currents and Improving Performance of Indoor Organic Photovoltaic Devices

Organic photovoltaic(OPV) devices hold great promise for indoor light harvesting,offering a theoretical upper limit of power conversion efficiency that surpasses that of other photovoltaic technologies.However,the presence of high leakage currents in OPV devices commonly constrains their effective performance under indoor conditions.In this study,we identified that the origin of the high leakage currents in OPV devices lay in pinhole defects present within the active layer(AL).By integrating an automated spin-coating strategy with sequential deposition processes,we achieved the compactness of the AL and minimized the occurrence of pinhole defects therein.Experimental findings demonstrated that with an increase in the number of deposition cycles,the density of pinhole defects in the AL underwent a marked reduction.Consequently,the leakage current experienced a substantial decrease by several orders of magnitude which achieved through well-calibrated AL deposition procedures.This enabled a twofold enhancement in the power conversion efficiency(PCE) of the OPV devices under conditions of indoor illumination.

Endoscopic clipping of gastrojejunostomy leakage following Whipple procedure: A case report

BACKGROUND Currently,perioperative complications of classic Whipple surgery occur at a rate of approximately 40%.Common complications include delayed gastric emptying,pancreatic fistula,and bile leakage,whereas gastrojejunostomy(GJ)leakage is rare.CASE SUMMARY This case report will assess the management of a GJ leak in a 71-year-old male patient following the Whipple procedure.After surgery,the patient was trans-ferred to the clinic after four days of intensive care,where vacuum therapy was used to handle a developing subcutaneous collection.The patient,who had bile in the drains and incision during follow-up,underwent endoscopic examination on the 21st day after the operation.An opening of approximately 4 mm was observed in the GJ anastomosis during endoscopy.Five titanium clips were used to close the openings.The drainage of bile decreased to less than 50 mL on the first day after the procedure,and the patient's oral intake was opened.CONCLUSION Current literature reports a GJ leakage rate of 0.54%following Whipple surgery,with clinical findings lasting on average between 4-34 days.Surgery was the main form of therapy for this case,with a success rate of 84%,and percutaneous drai-nage was also utilized as a treatment option.This case report is the first to docu-ment endoscopic treatment of GJ leaks following the classic Whipple procedure.

Characteristics of gut microbiota in anastomotic leakage patients in cold zones post-colorectal cancer surgery: A high-throughput sequencing and propensity-score matching study

Objective:The study aimed to explore the association between gut microbiota and anastomotic leakage(AL)after surgery in colorectal cancer(CRC)patients from a frigid zone,based on high-throughput sequencing.Methods:A total of 98 CRC patients admitted to the Second Affiliated Hospital of Harbin Medical University from July 2018 to February 2019,who met the inclusion criteria,were included.Among these,10 patients were diagnosed as AL.After propensity-score matching of baseline characteristics,10 patients from the anastomotic leakage group(AG)and 10 patients from the normal group(NG)were finally included in this study.Fecal samples were collected,and total DNA was extracted for high-throughput sequencing and bioinformatic analysis.Results:Alpha diversity analysis showed no significant difference between the two groups,while beta diversity analysis revealed significant differences in principal components.Differential microbiota were classified as Proteobacteria at the phylum level(P=0.021).At the genus level,the abundances of Streptococcus(P=0.045),Citrobacter(P=0.008)and Klebsiella(P=0.002)were significantly different between the two groups.LEfSe analysis indicated that these genera contributed most to the differences between the groups.Conclusion:The characteristics of the gut microbiota in the AG and NG were significantly different,and these differences might be associated with AL in CRC patients from frigid zones.

A Case Report and Literature Review: A Case of Delayed Bile Leakage Following Laparoscopic Cholecystectomy

Background: Delayed bile leakage after laparoscopic cholecystectomy, defined as occurring more than 72 hours after surgery, is a rare and serious complication of laparoscopic cholecystectomy, with an incidence rate of 0.060%. Case Declaration: This case report details a patient diagnosed with delayed bile leakage 43 days after laparoscopic cholecystectomy. The patient was discharged from our hospital after undergoing CT-guided puncture treatment, with no obvious complications identified. The patient was monitored for one year following the procedure, during which time no significant discomfort was reported. Objective: This case report is to analyse and review the clinical manifestations, diagnosis, treatment and prevention of delayed bile leakage after cholecystectomy, with reference to the relevant literature. Results: Delayed bile leakage after laparoscopic cholecystectomy can be prevented, although not eliminated. It is recommended that the operator treat the operation with caution, avoid taking risks, and adhere to careful procedures and strict separation according to the requirements. This approach is key to preventing late bile leakage in the postoperative period.

Development of a Low-Cost Prototype System for Pipeline Operational and Vandalism Spillage Detection and Validation Framework

Crude oil spillage is a major challenge in Nigeria. It affects the environment, health, life, and livelihood of residents of the Niger Delta region, where oil is explored, processed, and transported via a network of pipelines. Oil spillage is primarily caused by vandalization/sabotage and operational issues such as corrosion, equipment failure, operation, and maintenance errors. Thus, prompt response is required to mitigate the impact of oil spills. In this study, we deployed low-cost Arduino systems, including sensors (vibration and flow), modules (GPS and Wifi) and an IoT platform (ThingSpeak) to detect spillage caused by vandalism and operational inefficiencies proactively. The results demonstrate that low-cost sensors can detect changes in the flow volume between the inflow and outflow attributable to spillage, and vibration shocks caused by vandalism can be detected and linked to the cause of the spillage and communicated in real time to inform response action. Moreover, we proposed a framework for field validation utilizing KoboToolBox (a crowdsourcing/citizen science platform). The prototype system designed and programmed showed promising results, as it could detect spillage for vandalism and operational scenarios in real-time, quantify the volume of spillage, and identify the location and time of spillage occurrence;indicators relevant for response planning to minimize the impact of oil spillage. A video demonstration of the prototype system developed is accessible via: https://youtu.be/wKa9MZvYf1w. .

Modeling of Hydrogen Blending on the Leakage and Diffusion of Urban Buried Hydrogen-Enriched Natural Gas Pipeline

With the introduction of various carbon reduction policies around the world,hydrogen energy,as a kind of clean energy with zero carbon emission,has attracted much attention.The safe and economical transportation of hydrogen is of great significance to the development of hydrogen energy industries.Utilizing natural gas pipelines to transport hydrogen is considered to be an efficient and economical way.However,hydrogen has a higher risk of leakage due to its strong diffusion capacity and lower explosive limit than conventional natural gas.Therefore,it is of great significance to study the leakage and diffusion law of hydrogen-enriched natural gas(HENG)pipelines for the safe transportation of hydrogen energy.In this study,the leakage and diffusion characteristics of urban buried HENG pipelines are investigated numerically,and the dangerous degree of leakage is analyzed based on the time and area when the gas concentration reaches the lower explosive limit.The influences of hydrogen blending ratio(HBR),operating pressure,leakage hole size and direction,as well as soil type on the leakage and diffusion law of HENG are analyzed.Results show that the hydrogen mixing is not the key factor in increasing the degree of risk after gas leakage for urban buried HENG pipelines.When the HBR is 5%,10%,15% and 20%,the corresponding first dangerous time is 1053,1041,1019 and 998 s,respectively.Thiswork is expected to provide a valuable reference for the safe operation and risk prevention of HENG pipelines in the future.

Establishment and application of three predictive models of anastomotic leakage after rectal cancer sphincter-preserving surgery

BACKGROUND Anastomotic leakage(AL)occurs frequently after sphincter-preserving surgery for rectal cancer and has a significant mortality rate.There are many factors that influence the incidence of AL,and each patient’s unique circumstances add to this diversity.The early identification and prediction of AL after sphincter-preserving surgery are of great significance for the application of clinically targeted preventive measures.Developing an AL predictive model coincides with the aim of personalised healthcare,enhances clinical management techniques,and advances the medical industry along a more precise and intelligent path.AIM To develop nomogram,decision tree,and random forest prediction models for AL following sphincter-preserving surgery for rectal cancer and to evaluate the predictive efficacy of the three models.METHODS The clinical information of 497 patients with rectal cancer who underwent sphincter-preserving surgery at Jincheng People’s Hospital of Shanxi Province between January 2017 and September 2022 was analyzed in this study.Patients were divided into two groups:AL and no AL.Using univariate and multivariate analyses,we identified factors influencing postoperative AL.These factors were used to establish nomogram,decision tree,and random forest models.The sensitivity,specificity,recall,accuracy,and area under the receiver operating characteristic curve(AUC)were compared between the three models.RESULTS AL occurred in 10.26%of the 497 patients with rectal cancer.The nomogram model had an AUC of 0.922,sensitivity of 0.745,specificity of 0.966,accuracy of 0.936,recall of 0.987,and accuracy of 0.946.The above indices in the decision tree model were 0.919,0.833,0.862,0.951,0.994,and 0.955,respectively and in the random forest model were 1.000,1.000,1.000,0.951,0.994,and 0.955,respectively.The DeLong test revealed that the AUC value of the decision-tree model was lower than that of the random forest model(P<0.05).CONCLUSION The random forest model may be used to identify patients at high risk of AL after sphincter-preserving surgery for rectal cancer owing to its strong predictive effect and stability.

Impact of anastomotic leakage on long-term prognosis after colorectal cancer surgery

Colorectal cancer(CRC)is one of the most common malignancies in the world.Despite significant improvements in surgical technique,postoperative complications still occur in a fair percentage of patients undergoing colorectal surgery.The most feared complication is anastomotic leakage.It negatively affects shortterm prognosis,with increased post-operative morbidity and mortality,higher hospitalization time and costs.Moreover,it may require further surgery with the creation of a permanent or temporary stoma.While there is no doubt about the negative impact of anastomotic dehiscence on the short-term prognosis of patients operated on for CRC,still under discussion is its impact on the long-term prognosis.Some authors have described an association between leakage and reduced overall survival,disease-free survival,and increased recurrence,while other Authors have found no real impact of dehiscence on long term prognosis.The purpose of this paper is to review all the literature about the impact of anastomotic dehiscence on long-term prognosis after CRC surgery.The main risk factors of leakage and early detection markers are also summarized.

Prediction and diagnosis of colorectal anastomotic leakage: A systematic review of literature

Although many studies have focused on the preoperative risk factors of anastomotic leakage after colorectal surgery(CAL), postoperative delay in diagnosis is common and harmful. This review provides a systematic overview of all available literature on diagnostic tools used for CAL. A systematic search of literature was undertaken using Medline, Embase, Cochrane and Webof-Science libraries. Articles were selected when a diagnostic or prediction tool for CAL was described and tested. Two reviewers separately assessed the eligibility and level of evidence of the papers. Sixty-nine articles were selected(clinical methods: 11, laboratory tests: 12, drain fluid analysis: 12, intraoperative techniques:22, radiology: 16). Clinical scoring leads to early awareness of probability of CAL and reduces delay of diagnosis. C-reactive protein measurement at postoperative day 3-4 is helpful. CAL patients are characterized by elevated cytokine levels in drain fluid in the very early postoperative phase in CAL patients. Intraoperative testing using the air leak test allows intraoperative repair of the anastomosis. Routine contrast enema is not recommended. If CAL is clinically suspected, rectal contrast-computer tomography is recommended by a few studies. In many studies a "no-test" control group was lacking, furthermore no golden standard for CAL is available. These two factors contributed to a relatively low level of evidence in the majority of the papers. This paper provides a systematic overview of literature on the available tools for diagnosing CAL. The study shows that colorectal surgery patients could benefit from some diagnostic interventions that can easily be performed in daily postoperative care.

Benchmark experiment on slab^(238)U with D-T neutrons for validation of evaluated nuclear data

A benchmark experiment on^(238)U slab samples was conducted using a deuterium-tritium neutron source at the China Institute of Atomic Energy.The leakage neutron spectra within energy levels of 0.8-16 MeV at 60°and 120°were measured using the time-of-flight method.The samples were prepared as rectangular slabs with a 30 cm square base and thicknesses of 3,6,and 9 cm.The leakage neutron spectra were also calculated using the MCNP-4C program based on the latest evaluated files of^(238)U evaluated neutron data from CENDL-3.2,ENDF/B-Ⅷ.0,JENDL-5.0,and JEFF-3.3.Based on the comparison,the deficiencies and improvements in^(238)U evaluated nuclear data were analyzed.The results showed the following.(1)The calculated results for CENDL-3.2 significantly overestimated the measurements in the energy interval of elastic scattering at 60°and 120°.(2)The calculated results of CENDL-3.2 overestimated the measurements in the energy interval of inelastic scattering at 120°.(3)The calculated results for CENDL-3.2 significantly overestimated the measurements in the 3-8.5 MeV energy interval at 60°and 120°.(4)The calculated results with JENDL-5.0 were generally consistent with the measurement results.

Optimization of sensor deployment sequences for hazardous gas leakage monitoring and source term estimation

Nowadays, chemical safety has attracted considerable attention, and chemical gas leakage monitoring and source term estimation(STE) have become hot spots. However, few studies have focused on sensor layouts in scenarios with multiple potential leakage sources and wind conditions, and studies on the risk information(RI) detection and prioritization order of sensors have not been performed. In this work, the monitoring area of a chemical factory is divided into multiple rectangles with a uniform mesh. The RI value of each grid node is calculated on the basis of the occurrence probability and normalized concentrations of each leakage scenario. A high RI value indicates that a sensor at a grid node has a high chance of detecting gas concentrations in different leakage scenarios. This situation is beneficial for leakage monitoring and STE. The methods of similarity redundancy detection and the maximization of sensor RI detection are applied to determine the sequence of sensor locations. This study reveals that the RI detection of the optimal sensor layout with eight sensors exceeds that of the typical layout with 12 sensors. In addition, STE with the optimized placement sequence of the sensor layout is numerically simulated. The statistical results of each scenario with various numbers of sensors reveal that STE is affected by sensor number and scenarios(leakage locations and winds). In most scenarios, appropriate STE results can be retained under the optimal sensor layout even with four sensors. Eight or more sensors are advised to improve the performance of STE in all scenarios. Moreover, the reliability of the STE results in each scenario can be known in advance with a specific number of sensors. Such information thus provides a reference for emergency rescue.

Dynamic Simulation and Test Verifcation of Hydraulic Automatic Tensioner for an Engine Timing Chain Drive System

As a fundamental component of an automobile engine’s timing chain drive system, the hydraulic automatic tensioner signifcantly enhances fuel economy while minimizing system vibrations and noise. However, there is a noticeable lack of research on automatic hydraulic tensioners. This study presents a comprehensive calculation approach for the principal parameters of a hydraulic automatic tensioner. An efective method, grounded in hydraulics and multibody dynamics, was introduced for estimating the dynamic response of such a tensioner. The simulation model developed for the hydraulic tensioner is characterized by its rapid dynamic response, consistent operation, and high accuracy. The dynamic behavior of the tensioner was analyzed under varying boundary conditions, using sinusoidal signal excitation. It was observed that the maximum damping force increases with a decreasing leakage gap. Conversely, an increase in oil temperature or air content leads to a decrease in the maximum damping force. The reaction forces derived from these calculations align well with experimental results. This calculation and simulation approach ofers considerable value for the design of innovative hydraulic tensioners. It not only streamlines the design phase, minimizes the number of trials, and reduces product costs, but also provides robust insights for evaluating the performance of hydraulic tensioners.

Analysis of fluidized zone in transparent soil under jet induced by pipe leakage

Jets caused by burst tubes erode the surrounding soil, eventually leading to issues such as ground collapse. It is therefore highly important to study the mechanisms of soil erosion caused by jets after pipeline leakage. To investigate the water-soil interaction mechanisms of pipe leakage, this study used transparent soil and developed a three-dimensional experimental device to observe the fluidization process. Changes in the boundary of the fluidization transition area were investigated, and a formula for calculating the soil damage area was derived. The results showed three different shapes of the fluidized cavity appearing in the fluidization process. The particles initially moved upward and then gradually transitioned into a state of backflow. The effects of particle size, upper load, and porosity on fluidization were also analyzed. It was found that soil with a large particle size and a lower porosity under a heavy upper load can effectively restrain fluidization. Therefore, large-diameter and dense soil can be used as pipe-covering material.

Establishment of a Rat Model of Capillary Leakage Syndrome Induced by Cardiopulmonary Resuscitation After Cardiac Arrest

Objective:Cardiopulmonary resuscitation(CPR)after cardiac arrest(CA)is one of the main causes of capillary leakage syndrome(CLS).This study aimed to establish a stable CLS model following the CA and cardiopulmonary resuscitation(CA-CPR)model in Sprague-Dawley(SD)rats.Methods:We conducted a prospective,randomized,animal model study.All adult male SD rats were randomly divided into a normal group(group N),a sham operation group(group S),and a cardiopulmonary resuscitation group(group T).The SD rats of the three groups were all inserted with 24-G needles through their left femoral arteries and right femoral veins.In group S and group T,the endotracheal tube was intubated.In group T,CA induced by asphyxia(AACA)was caused by vecuronium bromide with the endotracheal tube obstructed for 8 min,and the rats were resuscitated with manual chest compression and mechanical ventilation.Preresuscitation and postresuscitation measurements,including basic vital signs(BVS),blood gas analysis(BG),routine complete blood count(CBC),wet-to-dry ratio of tissues(W/D),and the HE staining results after 6 h were evaluated.Results:In group T,the success rate of the CA-CPR model was 60%(18/30),and CLS occurred in 26.6%(8/30)of the rats.There were no significant differences in the baseline characteristics,including BVS,BG,and CBC,among the three groups(P>0.05).Compared with pre-asphyxia,there were significant differences in BVS,CBC,and BG,including temperature,oxygen saturation(SpO_(2)),mean arterial pressure(MAP),central venous pressure(CVP),white blood cell count(WBC),hemoglobin,hematocrit,pH,pCO_(2),pO_(2),SO_(2),lactate(Lac),base excess(BE),and Na+(P<0.05)after the return of spontaneous circulation(ROSC)in group T.At 6 h after ROSC in group T and at 6 h after surgery in groups N and S,there were significant differences in temperature,heart rate(HR),respiratory rate(RR),SpO_(2),MAP,CVP,WBC,pH,pCO_(2),Na+,and K+among the three groups(P<0.05).Compared with the other two groups,the rats in group T showed a significantly increased W/D weight ratio(P<0.05).The HE-stained sections showed consistent severe lesions in the lung,small intestine,and brain tissues of the rats at 6 h after ROSC following AACA.Conclusion:The CA-CPR model in SD rats induced by asphyxia could reproduce CLS with good stability and reproducibility.

Systematic review of cystic duct closure techniques in relation to prevention of bile duct leakage after laparoscopic cholecystectomy

AIM To study the effect of different techniques of cystic duct closure on bile leakage after laparoscopic cholecystectomy(LC) for biliary disease.METHODS A systematic search of MEDLINE, Cochrane and EMBASE was performed. Rate of cystic duct leakage(CDL) was the primary outcome. Risk of bias was evaluated. Odds ratios were analyzed for comparison of techniques and pooled event rates for non-comparative analyses. Pooled event rates were compared for each of included techniques.RESULTS Out of 1491 articles, 38 studies were included. A total of 47491 patients were included, of which 38683(81.5%)underwent cystic duct closure with non-locking(metal)clips. All studies were of low-moderate methodological quality. Only two studies reported separate data on uncomplicated and complicated gallbladder disease. For overall CDL, an odds ratio of 0.4(95%CI: 0.06-2.48)was found for harmonic energy vs clip closure and an odds ratio of 0.17(95%CI: 0.03-0.93) for locking vs non-locking clips. Pooled CDL rate was around 1% for harmonic energy and metal clips, and 0% for locking clips and ligatures. CONCLUSION Based on available evidence it is not possible to either recommend or discourage any of the techniques for cystic duct closure during LC with respects to CDL,although data point out a slight preference for locking clips and ligatures vs other techniques. No separate recommendation can be made for complicated gallbladder disease.