Tulip bundle technique and fibrin glue injection:Unusual treatment of colonic perforation

We report a case of a 63-year-old male who experienced an iatrogenic sigmoid perforation repaired combining three endoscopic techniques.The lesion was large and irregular with three discrete perforations,therefore,we decided to close it by placing one clip per perforation,and then connecting all the clips with two endoloops.Finally we chose to use a fibrin glue injection to obtain a complete sealing.Four days after the colonoscopy the patient underwent a laparoscopic right hemicolectomy due to evidence of a large polyp of the caecum with high grade dysplasia and focal carcinoma in situ.Inspection of the sigma showed complete repair of the perforation.This report underlines how a conservative approach,together with a combination of various endoscopic techniques,can resolve complicated iatrogenic perforations of the colon.

Modified unilateral periureteral injection technique in the treatment of patients with high-grade vesicoureteral reflux: A study of primary findings

Objective:Although endoscopic treatment has been used by many pediatric urologists for the treatment of vesicoureteral reflux(VUR),it has no considerable success in high-grade VUR.We aimed to describe the primary outcomes of unilateral periureteral injection technique(PIT),as well as bilateral PIT in high-grade VUR.Methods:In this prospective study,we examined 92 ureters in 45 boys and 40 girls from February 2010 to May 2018.Bilateral PIT and unilateral PIT were applied in 67 and 25 refluxing units,respectively.In the unilateral PIT,the subureteral injection site was only at the 5-or 7-o’clock position.However,in the bilateral PIT,the subureteral injection sites were at 5-and 7-o’clock position.Pre-and post-operative reflux grades were evaluated by voiding cystourethrography 6 months after surgery.Results:Seven patients had bilateral reflux.Overall,75(81.5%)ureters showed Grade IV VUR,while 17(18.5%)had primary Grade V VUR.The mean age of the subjects was 39.2 months.In unilateral PIT ureters,VUR was resolved in 23(92.0%)refluxing units.It was downgraded to Grade III in one ureter(4.0%)and to Grade II in another ureter(4.0%).In addition,in bilateral PIT cases,VUR was resolved in 60(89.6%)ureters;it downgraded to Grades II and III in 3(4.5%)and 4(6.0%)refluxing units,respectively.Conclusion:Unilateral PIT can be highly effective in the treatment of selected ureters of high-grade VUR.However,further studies are needed to confirm our results.

Efficacy and Safety in Intramuscular Injection Techniques Using Ultrasonographic Data

Delivered by intramuscular (IM) injections, Long Acting Injections (LAI), offering comparatively long term medicinal effects from several weeks to several months, are gaining much attention. The aim of this article was to indicate a safe and effective IM injection technique based on evidenced data derived from ultrasonographic data. Accurate anatomical knowledge is necessary in order to administer IM injections. It is possible to gain an adequate understanding of injection site anatomical structures by using ultrasound diagnostic devices. In particular, ultrasonography offers real-time diagnostic data allowing for observation of injection site, subcutaneous tissues, fat layers, muscle membrane, muscles and bones. To deliver the drug accurately into the muscle is essential, to achieve maximum drug efficacy and prevent injection site reactions. Therefore, when administering IM injections to the buttocks area, a suitable injection needle between 23G 25 mm to 21G or 22G 38 mm must be chosen depending on physique and drug characteristics. Needles determined as safe and effective through ultrasonographic evidence are needed such as in the case of a deltoid injection site, in which a 23G 25 mm injection needle is used in the absence of notable obesity. Not only the needle type is essential, but also the IM procedure itself. It is important to stretch the skin, inserting the needle at 90 degree angle to ensure depth of needle insertion to the muscle. Until new con-firmed evidence becomes available, it is necessary to increase the understanding of injection site selection methods, needle insertion depth, needle angle, and established IM injection techniques. The application of ultrasound devices in the development of next-generation techniques for IM injection is promising. Importantly, these techniques provide critical information from a risk management perspective.

Intramuscular vaccine administrations including the adoption of"Zeta-track technique"&"without aspiration slow injection technique"(ZTT&WASiT):a prospective review

Objective:To review the current literature on the practice of intramuscular injections(IMIs),focusing on immunizations.Methods:The present study comprises 2 reviews,characterized by high-quality evidence,per taining to the deployment of the slow injection technique without aspiration(referred to in this paper as the without-aspiration slow injection technique[WASi T])and combined with the Zeta-track technique(ZTT).The literature review is oriented toward the analysis of 2 features associated with IMIs techniques:safety and pain,integrating new evidence on vaccinee positioning for each muscle site and general relaxation techniques in the multi-parametric analysis.Results:The rigorous and in-depth reviews in the current study reveal the usefulness of including,among the international guidelines for via intramuscular immunizations,the adoption of WASi T only for compliant vaccinees,and in combination with all validated techniques for IMIs,and the use of ZTT limitedly if specific well-developed muscles are indicated.All the technique's limitations are exposed.Conclusions:Future research directions are presented by including the author's study designs to provide indirect evidence for the validity of the rationale of the slow injection technique using scientific methods,and for the conduction of future randomized controlled trials(RCTs)focused on revisiting the adoption of ZTT in a dynamic and integrated immunizations protocol in anterolateral thigh(ALT),ventrogluteal(VG),and also in the deltoid muscle,in the specific cases analyzed.

LDAP Injection Techniques

The increase in the number of databases accessed only by some applications has made code injection attacks an important threat to almost any current system. If one of these applications accepts inputs from a client and executes these inputs without first validating them, the attackers are free to execute their own queries and therefore, to extract, modify or delete the content of the database associated to the application. In this paper a deep analysis of the LDAP injection techniques is presented. Furthermore, a clear distinction between classic and blind injection techniques is made.

Construction of a model of autologous blood intracerebral hemorrhage in rats with a double injection and double needle withdrawal and the characteristics of the operative technique

BACKGROUND ： Experimental animal models of intracerebral hemorrhag （ICH） are greatly needed, so the process of establishment should be ideal in hematoma formation and easy to operate. OBJECTIVE ： To construct model of ICH in rats with double injection of autologous blood taken from the cut tail cut and double withdrawal of the needle （shortened as two-step injection model）, and compare with those induced by single and double injections. DESIGN ： A randomized controlled tria SETTING： Department of Neurology, General Hospital of Military Area Command of Chinese PLA. MATERIALS： Thirty male Wistar rats of 10 to 12 months, weighing （400±25） g, provided by the Experimental Center of Medical Animals, General Hospital of Shenyang Military Area Command of Chinese PLA, were divided randomly into 3 groups with 10 rats in each group： two-step injection group, single injection group, double injection group. METHODS ： The experiment was carried out in the Department of Neurology, General Hospital of Military Area Command of Chinese PLA from March to June in 2004. Autologous blood ICH model in rats were established as follows： In the two-step injection group, 50 μL unclotted autologous blood was taken from the rat tail cut, then injected with microsyringe into the caudate nucleus, 10 μL injected at first, paused for 2 minutes, and then the rest 40 μL injected slowly and continuously within 2 minutes. After the injection, the needle was kept immovable for about 4 minutes, withdrawn 2.0 mm, again kept immovable for about 4 minute, and then removed wholly at a slow speed. In the single injection group, 50 μL unclotted tail blood was injected slowly and continuously all within 2 minutes and the needle was slowly removed;（4） In the double injection group, 10 mL blood was injected at first, paused for 2 minutes, the rest 40 μL injected evenly within 2 minutes, and then the needle was withdrawn slowly and uninterruptedly. Neurologic findings were scored in accordance with Longa＇s five-point scale （0-4 scores, the higher the score, the severer the neurological dysfunction）. The rats were killed to remove and sections were prepared, the morphological features of hematomas were grossly observed, the maximal diameter and size of hematomas in each slice were measured with the imaging analytical system, and the volume was calculated. Meanwhile, the conveniences of the techniques were compared. MAIN OUTCOME MEASURES： The morphological features and volume of hematomas, neurologic deficit score （NDS）, and the convenience of the techniques were compared. RESULTS： All the 30 rats were involved in the analysis of results without deletion. （1） Results of the morphological observation of volume of hematoma： In the two-step injection group, hematomas located in the right caudate nucleus area regularly in circular or analogously circular shape in each slice. The formation rate of hematomas in the single injection group and double injection group were lower than those in the two-step injection group [60% （6/10）, 80% （8/10）, 100% （10/10）, P〈 0.01, 0.05]. The volume of hematomas in the single injection group and double injection group were smaller than those in the two-step injection group [（28.5±14.8）, （33.4±7.4）, （41.6±3.9） mm3, P〈 0.01, 0.05]. （2） NDS results： The NDS scores in the single injection group and double injection group were smaller than that in the two-step injection group （0.90±0.83, 1.30±0.78, 1.90±0.57, P〈 0.05）. （3）Comparison of the convenience of the techniques： The double injection method allowed generating reproducible hematomas in rats with shortcomings that it needed autologous arterial blood from femoral artery, and precision instruments such as microinfusion pump. The two-step injection injected fresh unclotting blood taken directly from the tail cut with microsyringe into the rat brain, and it has the advantages of easy operation, no influence on the activity of thrombase, shorter duration for model establishment, and higher rate of hematoma formation, which could generate ideal and economical models of ICH. The two-step injection induced hemotoma regularly in circular or analogously circular shape in each slice, but those induced by single and double injections were mostly in strip or fusiform shapes and extending along the needle tracks or into the ventricle or subarachnoid space. CONCLUSION ： The autologous blood ICH model induced by the two-step injection method is a reproducible and reliable one in regular shape, which is better than those induced by double and single injections.

Combination of Plugging and Acidization Improves Injection Profile

Plugging agent treatment and acid stimulation have completely different mechanisms for improving injection profiles. In this paper, a hybrid procedure is introduced to reduce the damage of the plugging agent to low and medium permeability zones and the penetration radius of acid into high permeability zones. The procedure is: First inject plugging agent to block high permeability zones, and then inject acid to remove plugging agent damage from the low and medium permeability zones and stimulate them. To perform this procedure successfully, three kinds of plugging agents, namely strong strength plugging agent for the wells with fractures or high permeability streaks, weak gel for those with thick layer in which serious heterogeneity exists, temporary plugging agent for those in which the absorption ability of high permeability zones needs maintaining, were screened out for use in different reservoirs. Several acid systems were evaluated to be compatible with the three kinds of plugging agents. The objectives of this paper are:(1)To show the screen results about the compatible plugging agent and acid; 2 To show how to optimize the operation process;(3)To tell some experience gained ( ) from the oilfield applications of this technique. From Jan. 2001 to Dec. 2002, 46 operations using this procedure were carried out in Weicheng and Mazhai Oilfields of SINOPEC. Results show that the average benefit/cost ratio is over 3.5. Experience acquired from these applications was summarized in the paper.

Determination of Trace Non Rare Earth Elements in High Purity Rare Earth Oxides by ICP－AES with Microcolumn Preconcentration in a Flow Injection System

A new method for the determination of trace non-rare earth elements in high purity rare earth oxides by ICP-AES with preconcentration on an active carbon-silica gel microcolumn in a flow injection system is described in this paper. Experimental parameters such as pH, flow rate,reagent concentration,length of reaction coil,eluent acidity,etc. were optimized. In the buffer solution of NH3. H2O/NH4Cl at pH 4. 6,Al,Cr,Cu,Fe, Pb, V and Zn can be preconcentrated and then eluted with 4. 5 mol/L nitric acid utilizing stop-flow technique. The enrichment factors were in range of 8. 1￣12. 6 with detection limits of μg/m level ,and the RSD with metals at μg/g level were 2. 3￣5. 0% (n= 7). The method proposed can reduce the matrix interference effectively , and has been applied to the determination of non-rare earth metals atμg/g level in high purity Eu2O3 with satisfactory results.

Optimization of Process Parameters for Injection Moulding of Nylon6/SiC and Nylon6/B_(4)C Polymer Matrix Composites

In this research study,the mechanical properties of several Polymer matrix composites are investigated.These composites are multi-phase materials in which reinforcing materials are properly mixed with a polymer matrix.More precisely,Nylon 6 reinforced with 5,15 and 25 wt.%of silicon carbide(SiC)and Nylon 6 reinforced with 5,15 and 25 wt.%of boron carbide(B_(4)C),prepared by means of an injection moulding process at three different injection pressures are considered.Specific attention is paid to the tensile and impact strength of these composites.The Taguchi technique is used to optimize the process parameters such as reinforcement material,its percentage and the injection pressure.It is observed that the specimens 5%SiC with 80 MPa injection pressure display a better tensile strength and similarly the specimen 5%B_(4)C with 90 MPa injection pressure have a superior impact strength.

A Low Phase Noise Ring-VCO Based PLL Using Injection Locking for ZigBee Applications

A low power low phase noise frequency synthesizer with subharmonic injection locking is proposed for ZigBee applications. The PLL is based on a ring VCO to decrease area and production cost. In order to improve phase noise performance, a high frequency injection signal of which frequency varies with channel number is used. The circuit is designed in TSMC 0.18 μm CMOS technology and simulated in ADS (Advanced Design System). The phase noise at 3.5 and 10 MHz offsets is -116 and -118 dBc/Hz, respectively, and total circuit consumes 2.2 mA current.

Modelling Key Population Attrition in the HIV and AIDS Programme in Kenya Using Random Survival Forests with Synthetic Minority Oversampling Technique-Nominal Continuous

HIV and AIDS has continued to be a major public health concern, and hence one of the epidemics that the world resolved to end by 2030 as highlighted in sustainable development goals (SDGs). A colossal amount of effort has been taken to reduce new HIV infections, but there are still a significant number of new infections reported. HIV prevalence is more skewed towards the key population who include female sex workers (FSW), men who have sex with men (MSM), and people who inject drugs (PWID). The study design was retrospective and focused on key population enrolled in a comprehensive HIV and AIDS programme by the Kenya Red Cross Society from July 2019 to June 2021. Individuals who were either lost to follow up, defaulted (dropped out, transferred out, or relocated) or died were classified as attrition;while those who were active and alive by the end of the study were classified as retention. The study used density analysis to determine the spatial differences of key population attrition in the 19 targeted counties, and used Kilifi county as an example to map attrition cases in smaller administrative areas (sub-county level). The study used synthetic minority oversampling technique-nominal continuous (SMOTE-NC) to balance the datasets since the cases of attrition were much less than retention. The random survival forests model was then fitted to the balanced dataset. The model correctly identified attrition cases using the predicted ensemble mortality and their survival time using the estimated Kaplan-Meier survival function. The predictive performance of the model was strong and way better than random chance with concordance indices greater than 0.75.

Injection and Extraction Techniques in Circular Accelerators

Injection and extraction are usually the key systems in circular accelerators.They play important roles in transferring the beam from one stage acceleration to the other or to experimental stations.It is also in the injection and extraction regions where beam losses happen mostly.Due to the tight space and to reduce the perturbation to the circulating orbit,the devices are usually designed to meet special requirements such as compactness,small stray field,fast rise time or fall time,etc.Usual injection and extraction devices include septum magnets,kicker magnets, electrostatic deflectors,slow bump magnets and strippers.In spite of different accelerators and specification for the injection and extraction devices,many techniques are shared in the design and manufacturing.This paper gives a general review on the techniques employed in the major circular accelerators in China.

REINJECTOR注胶结合碳纤维粘贴技术在开裂桥梁加固中的应用

本文介绍了采用REINJECTOR注浆技术及粘贴碳纤维布对裂缝进行综合加固,施工便利,效果可靠。

Effective generation of optical quadruple frequency millimeter-wave based on fiber laser using injection rational harmonic mode-locked technique

A method to generate the optical quadruple frequency millimeter-wave with high power efficiency is pro- posed and demonstrated based on the combination of the injection 2nd-order rational harmonic mode- locked fiber ring laser technique and the fiber grating notch filter. In this approach, the fiber Bragg grating notch filter is inserted into the laser cavity to prevent the undesired optical carrier, so that the pump power can be converted to 2nd-order harmonic wave more efficiently. In our experiment, the power efficiency of optical quadruple frequency millimeter-wave （40 GHz） generation is ten folds of that of our previous method based only on the rational harmonic mode-locked technique.

股前外侧穿支皮瓣术前CT血管成像扫描及重建方案研究

目的:股前外侧皮瓣是一种用于头颈部缺损重建的多功能骨干皮瓣,其穿支血管的位置、走向和来源评估对制定合理的手术计划中至关重要。小视野(Small FOV)技术可以缩小重建视野,增加图像分辨率,提升对穿支血管显示的空间分辨率;双阶段造影剂注射法增强末梢血管的充盈压力;多平面重建(MPR)对感兴趣区域进行冠状位重组,观察旋股外动脉远端各皮支血管分布;曲面重建(CPR)生成穿支血管的曲面图像,将穿支血管曲面路径与旋股外动脉主干容积成像图像融合,确定穿支血管的位置及其走行。本研究旨在通过各种计算机断层血管造影(CTA)扫描和后处理技术提高皮瓣穿支血管的可视化。方法:研究组为我院耳鼻喉头颈外科于2018年1月至2021年8月对13例头颈部肿瘤术后缺损患者行皮瓣术前CTA改进扫描方案。对照组选取首都医科大学附属北京友谊医院放射科2020年9月至2023年4月,为进行双下肢动脉CT非能谱血管成像检查的13例患者,股动脉及其分支血管无明显病变。对两组血管成像质量进行主观评价,并对旋股外动脉的对比噪声比(CNR)和信噪比(SNR)进行客观评价。结果:研究组SNR较对照组稍高,但两组差别无统计学意义。研究组CNR均值为18.25±7.38,对照组CNR均值为7.26±2.64,研究组CNR明显高于对照组,两组差别有统计学意义。研究组与对照组图像质量主观评价无差异。研究组术前在CTA上检测到的穿支血管100%在手术中得到证实。结论:多种技术综合应用增加皮支血管与周围组织的对比,获得满意的CT图像质量,提高图像分析的准确性,给临床医生分析供血血管的位置、走行和来源提供了更好的技术支持。

基于加权逼近理想解排序法对儿科应用喜炎平注射液的药物利用评价

目的:探讨喜炎平注射液药物利用评价(DUE)标准的建立与应用,为喜炎平注射液在儿童患者中的合理使用提供参考。方法:以喜炎平注射液说明书为基础,参考相关共识及指南建立新乡市第一人民医院喜炎平注射液DUE标准,并采用加权逼近理想解排序(TOPSIS)法对我院2023年3-6月使用喜炎平注射液的130份患儿归档病历进行评价及分析。结果:制订的喜炎平注射液DUE标准包括用药指征、用药过程、用药结果3个方面,11项评价指标。经评价我医院患儿在喜炎平注射液使用过程中存在的主要问题为用法用量不适宜24例(18.46%)、无适应证用药15例(11.54%)、用药疗程不适宜12例(9.23%)、给药速度不适宜6例(4.62%)。结论:基于加权TOPSIS法的儿科应用喜炎平注射液DUE方法可综合多个评价指标,操作性强,评价方法简便灵活,但我院儿科喜炎平注射液的临床应用存在不合理使用现象,应加强点评和干预。

流动树脂注射充填技术的临床应用

随着流动树脂性能的提高,导板技术和数字化技术的不断发展,流动树脂注射充填新技术在临床有了更广阔的应用场景。流动树脂的操作简便性和高度可塑性使其临床技术敏感性降低,结合导板技术和数字化技术可优质、高效地完成复杂和疑难直接粘接修复病例。本文对流动树脂材料的进展、注射充填技术的内涵和发展以及注射充填技术的临床应用和注意事项进行阐述和讨论,为流动树脂注射充填技术在临床的应用提供参考。

A型肉毒毒素注射治疗痉挛性斜颈的引导技术研究进展

痉挛性斜颈(CD)是临床常见的一种局灶性肌张力障碍疾病,主要由于颈部肌肉不自主收缩引起的异常姿势或运动,大多数为特发性。CD的治疗方法有口服药物、A型肉毒毒素(BoNT-A)注射、手术等方法。BoNT-A注射起效快、持续时间长、副作用小、重复性好,是目前首选的治疗方法。然而不同研究中BoNT-A注射的疗效差异较大,为提高BoNT-A注射疗效,临床上各类引导技术应运而生,本文就各类BoNT-A注射引导技术的优势和不足进行综述。

基于SOGI高频方波电压注入的永磁直线同步电机无感控制

针对永磁直线同步电机的无感控制技术,为了解决传统高频方波注入法无法准确定位转子位置和转速的问题,提出了基于SOGI高频方波电压注入的无感方法。与传统的高频方波电压注入法不同,为了得到更好的高频电流信号,采用二阶广义积分器提取响应高频电流信号,采用正交锁相环解决反正切函数没有反馈直接放大噪声的影响。为证明无感控制技术的有效性,用Simulink进行了仿真验证。结果表明,基于SOGI高频方波电压注入的无感方法大大降低了误差,缩短了调节时间,提升了响应时间。