Dengue fever may mislead the surgeons when it presents as an acute abdomen

Objective: To review the management experience of a consecutive series of patients presenting as acute surgical abdomen whom were ultimately diagnosed to have DF(Dengue fever)/ DHF(Dengue heamorrhagic fever),Methods: Clinical data of all cases of apparent acute abdomen(AA) which were later confirmed as having DF/DHF reviewed by two surgical units from December 2012 to December 2013 were analyzed,Initially confirmed patients with DF/DHF who developed abdominal symptoms were not considered,Results: Out of the seventeen cases(7 males,age range 10-71 years) presented with fever and AA; appendicitis,cholecystitis,pancreatitis and non-specific peritonitis were suspected initially in 8,5,1 and 3 cases,respectively,Neutropenia or thrombocytopenia signifying DF/DHF occurred only in 11 patients at first evaluation thus six remained as surgical candidates beyond 24 h,One patient underwent appendicectomy with a prolonged hospital stay,DF was confirmed by serology in all patients,latest by fourth day of admission,One required blood product transfusion,4 needed critical care treatment and there was 1 death,Conclusions: DF/DHF misleads the clinicians when it presents as AA,Initial heamatological and ultrasonographic findings may be equivocal creating a diagnostic and management dilemma,Vigilant clinical suspicion and early dengue serological assessment is advisable in equivocal cases of AAs with fever in dengue endemic areas,to confirm/exclude the infection in order to avoid unnecessary surgical morbidity in the presence of DF.

Polyarteritis nodosa diagnosed by surgically resected jejunal necrosis following acute abdomen

The differential diagnosis of acute abdomen is typically extremely broad in range, with vasculitis posing a rare but potentially life-threatening cause of acute abdomen. Here, we report a case of acute abdomen with bowel wall thickening limited to jejunum, accompanied by unexplained renal dysfunction. Later, the patient was diagnosed as having polyarteritis nodosa based on surgically resected jejunal necrosis. Despite aggressive treatment, including the use of steroid pulse therapy and continuous hemodiafiltration, the patient died. Although polyarteritis nodosa is extremely rare in patients with acute abdomen, acute abdomen is relatively common manifestation of that. And it is reported that involvement of small intestine suggests poorer prognosis. Our case highlights the importance of vasculitis as a differential diagnosis of patients with atypical acute abdomen. In this report, we not only review possible clues that might have led to an earlier diagnosis in this case, but also attempt to draw some lessons for treating similar cases in the future.

Epidemiological, Etiological, Therapeutic and Evolutionary Aspects of Acute Surgical Abdomens Operated at the University Hospital of Bobo-Dioulasso

Surgical acute abdomens represent a significant proportion of surgical emergencies in terms of frequency, morbidity and mortality. The aim of our study was to describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of acute surgical abdomens operated in the surgical emergency department of the Centre Hospitalier Universitaire Souro Sanou (CHUSS). This was a retrospective descriptive study of 426 cases of surgical acute abdomens operated in the CHUSS surgical emergency department from 1 January to 31 December 2015. These 426 cases accounted for 24.14% of the emergency interventions carried out in the CHUSS surgical emergency department. These were 314 (73.7%) men and 112 (26.3%) women with an average age of 30 years. Among the causes, there were 187 (43.9%) cases of acute generalized peritonitis, 71 (16.7%) cases of acute intestinal occlusions, 49 (11.5%) cases of acute appendicitis, 38 (9.4%) cases of strangulated parietal hernias, 16 (3.8%) cases of abdominal contusions, and 15 (3.5%) cases of penetrating wounds of the abdomen. The appendectomy was the most performed gesture with 112 (26.3%) cases. The time to surgery was greater than 48 hours in 29 (6.8%) cases. Complications were observed in 68 (16%) cases with 35 (8.2%) cases of parietal infections, 18 (4.2%) cases of postoperative peritonitis. The death occurred in 37 (8.7%) patients. The average hospital stay was 8.7 days. Improving the prognosis of acute surgical abdomens requires early diagnosis and treatment, as well as better postoperative follow-up.

Establishment and evaluation of an improved rat model of open abdomen

Introduction:This study aimed to establish an animal model of open abdomen(OA)through temporary abdominal closure via different techniques.Methods:Adult male Sprague-Dawley rats were randomly divided into three groups:group A(OA with polypropylene mesh alone);group B(OA with polypro-pylene mesh combined with a patch);and group C(OA with polypropylene mesh and a sutured patch).Vital signs,pathophysiological changes,and survival rates were closely monitored in the rats for 7 days after surgery.Abdominal X-rays and histopathological examinations were performed to assess abdominal organ changes and wound healing.Results:The results showed no significant difference in mortality rates among the three groups(p>0.05).However,rats in group B exhibited superior overall condi-tion,cleaner wounds,and a higher rate of wound healing compared to the other groups(p<0.05).Abdominal X-rays indicated that varying degrees of distal intestinal obstruction in all groups.Histopathological examinations revealed fibrous hyperpla-sia,inflammatory cell infiltration,neovascularization,and collagen deposition in all groups.Group B demonstrated enhanced granulation tissue generation,neovasculari-zation,and collagen deposition compared to the other groups(p<0.05).Conclusions:Polypropylene mesh combined with patches is the most suitable method for establishing an animal model of OA.This model successfully replicated the patho-logical and physiological changes in postoperative patients with OA,specifically the progress of abdominal skin wound healing.It provides a practical and reliable animal model for OA research.

Future Changes in Various Cold Surges over China in CMIP6 Projections

Cold surges(CSs)often occur in the mid-latitude regions of the Northern Hemisphere and have enormous effects on socioeconomic development.We report that the occurrences of CSs and persistent CSs(PCSs)have rebounded since the 1990s,but the trends related to the frequencies of strong CSs(SCSs)and extreme CSs(ECSs)changed from increasing to decreasing after 2000.The highest-ranked model ensemble approach was used to project the occurrences of various CSs under the SSP1-2.6,SSP2-4.5,and SSP5-8.5 scenarios.The frequencies of the total CSs show overall decreasing trends.However,under the SSP1-2.6 scenario,slight increasing trends are noted for SCSs and ECSs in China.Atmospheric circulations that are characterized by an anomalous anticyclonic circulation with a significantly positive 500-hPa geopotential height(Z500)anomaly at high latitudes along with significant negative anomalies in China were favorable for cold air intrusions into China.In addition,the frequencies of all CS types under the SPP5-8.5 scenario greatly decreased in the long term(2071-2100),a finding which is thought to be related to negative SST anomalies in the central and western North Pacific,differences in sea level pressure(SLP)between high-and mid-latitude regions,and a weaker East Asian trough.In terms of ECSs,the decreasing trends observed during the historical period were maintained until 2024 under the SSP1-2.6 scenario.Compared to the SSP1-2.6 scenario,the Z500 pattern showed a trend of strengthened ridges over the Ural region and northern East Asia and weakened troughs over Siberia(60°-90°E)under the SSP2-4.5 and SSP5-8.5 scenarios,contributing to the shift to increasing trends of ECSs after 2014.

Trend of Storm Surge Induced by Typical Landfall Super Typhoons During 1975–2021 in the Eastern China Sea

Climate change affects the activity of global and regional tropical cyclones(TCs).Among all TCs,typical super typhoons(STYs)are particularly devastating because they maintain their intensity when landing on the coast and thus cause casualties,economic losses,and environmental damage.Using a 3D tidal model,we reconstructed the typhoon(TY)wind field to simulate the storm surge induced by typical STYs.The TY activity was then analyzed using historical data.Results showed a downtrend of varying degrees in the annual frequency of STYs and TCs in the Western North Pacific(WNP)Basin,with a significant trend change observed for TCs from 1949 to 2021.A large difference in the interannual change in frequency was found between STYs and TCs in the WNP and Eastern China Sea(ECS).Along the coast of EC,the frequency of landfall TCs showed a weak downtrend,and the typical STYs showed reverse micro growth with peak activity in August.Zhejiang,Fujian,and Taiwan were highly vulnerable to the frontal hits of typical STYs.Affected by climate change,the average lifetime maximum intensity(LMI)locations and landfall locations of typical STYs in the ECS basin showed a significant poleward migration trend.In addition,the annual average LMI and accumulated cyclone energy showed an uptrend,indicating the increasing severity of the disaster risk.Affected by the typical STY activity in the ECS,the maximum storm surge area also showed poleward migration,and the coast of North China faced potential growth in high storm surge risks.

Exploration of standard dosage for GnRH antagonist protocol and dosage adjustments after premature luteinizing hormone surge

The gonadotropin-releasing hormone (GnRH) antagonist protocol has emerged as an efficacious alternative to the GnRH agonist protocol for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF) cycles, and has been demonstrated applicability in infertile female patients with diverse ovarian responses. While the clinical implementation of the antagonist COH protocol has achieved widespread consensus, opportunities for refinement persist. Therefore, this review article focuses on the advantages and disadvantages of GnRH antagonist protocol, the selection of optimal standard doses, and the strategies for adjusting antagonist doses after the premature luteinizing hormone (LH) surge, aiming to provide more reasonable and scientific recommendations for the application of this scheme.

A typhoon-induced storm surge numerical model with GPU acceleration based on an unstructured spherical centroidal Voronoi tessellation grid

Storm surge is often the marine disaster that poses the greatest threat to life and property in coastal areas.Accurate and timely issuance of storm surge warnings to take appropriate countermeasures is an important means to reduce storm surge-related losses.Storm surge numerical models are important for storm surge forecasting.To further improve the performance of the storm surge forecast models,we developed a numerical storm surge forecast model based on an unstructured spherical centroidal Voronoi tessellation(SCVT)grid.The model is based on shallow water equations in vector-invariant form,and is discretized by Arakawa C grid.The SCVT grid can not only better describe the coastline information but also avoid rigid transitions,and it has a better global consistency by generating high-resolution grids in the key areas through transition refinement.In addition,the simulation speed of the model is accelerated by using the openACC-based GPU acceleration technology to meet the timeliness requirements of operational ensemble forecast.It only takes 37 s to simulate a day in the coastal waters of China.The newly developed storm surge model was applied to simulate typhoon-induced storm surges in the coastal waters of China.The hindcast experiments on the selected representative typhoon-induced storm surge processes indicate that the model can reasonably simulate the distribution characteristics of storm surges.The simulated maximum storm surges and their occurrence times are consistent with the observed data at the representative tide gauge stations,and the mean absolute errors are 3.5 cm and 0.6 h respectively,showing high accuracy and application prospects.

Metaverse Upsurge Drives Virtual Human Industry to Upgrade

The concept of a virtual human is rapidly fermenting with the boom of the metaverse in 2020.In March 2021,Roblox,a game company focusing on the socialization of teenagers’games and the free realization of UGC,went public.In its prospectus,Roblox is defined as the concept of the metaverse.Under this background,as the direct embodiment of“virtual identity”and“virtual reality coexisting”under the concept of the metaverse,the emerging definition of virtual human and its representative virtual image has gradually caught the attention of the public.

Risk assessment of coastal flooding disaster by storm surge based on Elevation-Area method and hydrodynamic models:Taking Bohai Bay as an example

The future inundation by storm surge on coastal areas are currently ill-defined.With increasing global sealevel due to climate change,the coastal flooding by storm surge is more and more frequently,especially in coastal lowland with land subsidence.Therefore,the risk assessment of such inundation for these areas is of great significance for the sustainable socio-economic development.In this paper,the authors use Elevation-Area method and Regional Ocean Model System(ROMS)model to assess the risk of the inundation of Bohai Bay by storm surge.The simulation results of Elevation-Area method show that either a 50-year or 100-year storm surge can inundate coastal areas exceeding 8000 km^(2);the numerical simulation results based on hydrodynamics,considering ground friction and duration of the storm surge high water,show that a 50-year or 100-year storm surge can only inundate an area of over 2000 km^(2),which is far less than 8000 km^(2);while,when taking into account the land subsidence and sea level rise,the very inundation range will rapidly increase by 2050 and 2100.The storm surge will greatly impact the coastal area within about 10-30 km of the Bohai Bay,in where almost all major coastal projects are located.The prompt response to flood disaster due to storm surge is urgently needed,for which five suggestions have been proposed based on the geological background of Bohai Bay.This study may offer insight into the development of the response and adaptive plans for flooding disasters caused by storm surge.

Critical considerations for the management of acute abdomen in transplant patients

The number of solid organ transplantations performed annually is increasing and are increasing in the following order:Kidney,liver,heart,lung,pancreas,small bowel,and uterine transplants.However,the outcomes of transplants are impro-ving(organ survival>90%after the 1st year).Therefore,there is a high probability that a general surgeon will be faced with the management of a transplant patient with acute abdomen.Surgical problems in immunocompromised patients may not only include graft-related problems but also nongraft-related problems.The perioperative regulation of immunosuppression,the treatment of accompanying problems of immunosuppression,the administration of cortisol and,above all,the realization of a rapidly deteriorating situation and the accurate evaluation and interpretation of clinical manifestations are particularly important in these patients.The perioperative assessment and preparation includes evaluation of the patient’s cardiovascular system and determining if the patient has hypertension or suppression of the hypothalamic-pituitary-adrenal axis,or if the patient has had any coagulation mechanism abnormalities or thromboembolic episodes.Immunosuppression in transplant patients is associated with the use of calci-neurin inhibitors,corticosteroids,and antiproliferation agents.Many times,the clinical picture is atypical,resulting in delays in diagnosis and treatment and leading to increased morbidity and mortality.Multidetector computed tomo-graphy is of utmost importance for early diagnosis and management.Transplant recipients are prone to infections,especially specific infections caused by cytomegalovirus and Clostridium difficile,and they are predisposed to intraop-erative or postoperative complications that require great care and vigilance.It is necessary to follow evidence-based therapeutic protocols.Thus,it is required that the clinician choose the correct therapeutic plan for the patient(conservative,emergency open surgery or minimally invasive surgery,including laparoscopic or even robotic surgery).

A Boost to Inbound Tourism China sees surge in foreign travellers following introduction of visa-free transit measures

One of the viral terms on Chinese social media these days-“city bu city”–was actually created by a foreign tourist.The tourist,a blogger,used the term,which literally means city or not city,in a short video he filmed while visiting the Great Wall,wondering whether the place is like a fashionable big city.

Evaluation of The Effectiveness of Abdominal and Vaginal B-Ultrasound in The Diagnosis of Acute Abdomen in Obstetrics and Gynecology

Objective: To explore the clinical effect of the combined application of abdominal and vaginal B-ultrasound in the diagnosis of acute abdomen in obstetrics and gynecology. Methods: Eighty patients admitted to our hospital from March 2023 to March 2024 were selected, all of whom were acute abdomen patients admitted to the Department of Obstetrics and Gynecology. In this study, the patients were divided into two groups. One group of 40 patients was given a simple abdominal B-ultrasound diagnosis (control group). The other group of 40 patients was given both abdominal and vaginal B-ultrasound examinations (experimental group). The diagnostic accuracy between the two groups was compared. Results: Patients in the experimental group had higher consistency rates with pathological diagnosis results in ectopic pregnancy rupture, embryonic arrest, acute pelvic inflammation, corpus luteum rupture, and intrauterine adhesions as compared to the control group. At the same time, the inspection accuracy rate of the experimental group (92.50%) was higher than that of the control group (70.00%) (P < 0.05). Conclusion: The combined application of abdominal and vaginal B-ultrasound in the diagnosis of acute abdomen was of great significance in improving the accuracy of clinical diagnosis and guiding doctors to provide effective treatment.

Research on Current Situation,Symptoms and Protection Technological Measures of Ancient Trees in Surging Waves Pavilion,China

The paper had studied growth situation and disease symptoms of ancient trees in Surging Waves Pavilion.There were 14 ancient trees belonging to 10 genera of 9 families,with tree age of 120-260 years.These trees had been well protected generally.There were 9 ancient trees growing well,occupying 64.29%,which were Ginkgo biloba,Cupressus funebris Endl.,Podocarpus macrophyllus,Zelkova schneideriana Hand.-Mazz,Cinnamomum camphora(L.)Presl,Buxus sinica,and Wisteria sinensis(Sims)Sweet.There were 5 ancient trees needing to be protected preferentially,occupying 35.71%,including Ligustrum lucidum,Osmanthus fragrans and Pterocarya stenoptera.The disease symptoms were trunk rot and hollow structure.Based on these symptoms,the paper had proposed protective measures for Ligustrum lucidum and Osmanthus fragrans:① enclosing eroding holes on the trunk;② clearing up eroded woodiness on the surface of trunk,disinfecting and applying anti-corrosion protectants;③ filling eroded holes of the trunk.Protective measures for Pterocarya stenoptera included:① clearing up the inner part and interior walls;② disinfecting the inside and interior walls of holes;③ applying anti-corrosion protectants.

Numerical Simulation of the Influence of Mean Sea Level Rise on Typhoon Storm Surge in the East China Sea

In this paper, ECOMSED （Estuarine Coastal Ocean Model with sediment transport） model is employed to simulate storm surge process caused by typhoon passing across East China Sea in nearly years. Capability of ECOMSED to simulate storm surge is validated by comparing model result with observed data. Sensitivity experiments are designed to study the influence of sea level rise on typhoon storm surge. Numerical experiment shows that influence of mean sea level rise on typhoon storm surge is non-uniform spatially and changes as typhoon process differs. Maybe fixed boundary method would weaken the influence of mean sea level rise on storm surge, and free boundary method is suggested for the succeeding study.

Numerical simulation of typhoon- induced storm surge on the coast of Jiangsu Province,China,based on coupled hydrodynamic and wave models

In order to facilitate engineering design and coastal flooding protection, the potential storm surge induced by a typhoon is studied.Using an unstructured mesh, a coupled model which combines the advanced circulation （ ADCIRC ） hydrodynamic model and simulating waves nearshore （ SWAN ） model is applied to analyze the storm surge and waves on the coast of Jiangsu Province.The verifications of wind velocity, tidal levels and wave height show that this coupling model performs well to reflect the characteristics of the water levels and waves in the studied region.Results show that the effect of radiation stress on storm surge is significant, especially in shallow areas such as the coast of Jiangsu Province and the Yangtze estuary.By running the coupled model, the simulated potential flooding results can be employed in coastal engineering applications in the Jiangsu coastal area, such as storm surge warnings and extreme water level predictions.

Statistical and causes analysis of storm surges along Tianjin coast during the past 20 years

Based on tidal data statistical analysis for 20 years of Tanggu Marine Environmental Monitoring Station from 1991 to 2010, we concluded that an average of nearly 10 days of 100 cm above water increase took place at Tianjin coast every year. The maximum high tide and average tide of Tianjin coast occurred in summer and autumn, and the maximum water increase also occurred in summer and autumn. Days with water increase more than 100 cm mostly occurred in spring, autumn and winter. Then we summarized the causes of coastal storm surge disaster in Tianjin based on astronomical tide factors, meteorological factors, sea level rise, land subsidence, and geographic factors, et al. Finally, we proposed storm surge disaster prevention measures.

促进绿色经济的城市绿色基础设施生态系统服务——欧盟GREEN SURGE研究项目解析

从整体到分项,对基于欧盟城市可持续与绿色发展的GREEN SURGE项目进行深入分析与总结。GREEN SURGE是第7个欧盟研究与技术发展框架计划中的一个研究项目。研究从整体、理念到实践的创新对GREEN SURGE项目进行了解读。其目的主要是促进绿色基础设施和城市生物多样性对城市可持续发展和绿色经济建设的积极作用。理念上,创新性地提出城市生物文化多样性的概念,并对城市绿色基础设施生态系统服务进行评估,对绿色经济提出新的认识与理解;实践上,通过对欧洲城市地区的研究调查,凝练出5大绿色基础设施战略规划方法以及6大绿色基础设施创新治理安排。这些经验对于我国绿色空间研究、规划及治理均具有较为重要的启示作用。

A new combined therapy to 15 patients with multiple organ failure in abdominal surgery

AIMS We report 15 cases of abdominal-surgical multiple organ failure(MOF)treated successfully by a new combined therapy four high doses in volume and one support“FHDOS”short period high doses in large volume anJsodaminum;short period high doses in large volume dexamethasonum;high doses in large volume of dis- infectant antibiotics;high doses in large volume of abdominal cav- ity washing liquor and support of nutrition metabolism.The mortal- ity rate and cost of MOF were decreased.It is simple,practical and effective. METHODS The study group consisted of 15 patients(10 wom- en,5 men;average age,42.7)who were hospitalized in our hospital.All patients were given“FHDOS”:short period high in large volume Anisodaminum:intravenous injection 40 mg once; another 40rag may be added 30 minutes later according to condition.The total amount may reach 120-240 mg a day,or,in- travenous injection 40 mg every 15 minutes until condition being under control.Short period high doses in large volume Dexamethasonum:intravenous injection 100-200 mg once;this remedy may be continued for 1-3 days;the amount also may de- crease according to condition.High doses in large volume of dis- infectant Antibiotics:select and use antibiotics according to clini- cal condition,inference of Gram's stain;it is necessary to re- peatedly culture bacteria in many parts,and then,to make ad- justment according to culture result and drug-resistance,and to prevent carefully the dual infections from occurring.High doses in large volume of abdominal cavity washing liquor:generally adopt- ing physiological saline 6000o8000ml in washing abdominal cavity. “One support”means full support of nutrition metabolism. RESULTS All the patients in this group survive well after the rescue without any complication. CONCLUSIONS MOF should be prevented,if possible,by stopping or controlling the injury,removing as much necrotic tis- sue as possible,improving blood flow and oxygen consumption, supporting metabolism,and preventing infection or treating it ear- ly and adequately.“FHDOS”is a combined therapy and plays a key role in treating MOF.

Numerical simulations and comparative analysis for two types of storm surges in the Bohai Sea using a coupled atmosphere-ocean model

The Bohai Sea is extremely susceptible to storm surges induced by extratropical storms and tropical cyclones in nearly every season. In order to relieve the impacts of storm surge disasters on structures and human lives in coastal regions, it is very important to understand the occurring of the severe storm surges. The previous research is mostly restricted to a single type of storm surge caused by extratropical storm or tropical cyclone. In present paper, a coupled atmosphere-ocean model is developed to study the storm surges induced by two types of extreme weather conditions. Two special cases happened in the Bohai Sea are simulated successively. The wind intensity and minimum sea-level pressure derived from the Weather Research and Forecasting (WRF) model agree well with the observed data. The computed time series of water level obtained from the Regional Ocean Modeling System (ROMS) also are in good agreement with the tide gauge observations. The structures of the wind fields and average currents for two types of storm surges are analyzed and compared. The results of coupled model are compared with those from the uncoupled model. The case studies indicate that the wind field and structure of the ocean surface current have great differences between extratropical storm surge and typhoon storm surge. The magnitude of storm surge in the Bohai Sea is shown mainly determined by the ocean surface driving force, but greatly affected by the coastal geometry and bathymetry.