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On One Possibility of Closuring the Chain of Equations for Statistical Moments in Turbulence Theory
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作者 Edward V. Teodorovich 《Journal of Modern Physics》 2013年第1期56-63,共8页
The paper concerns the problem on statistical description of the turbulent velocity pulsations by using the method of characteristic functional. The equations for velocity covariance and Green’s function, which descr... The paper concerns the problem on statistical description of the turbulent velocity pulsations by using the method of characteristic functional. The equations for velocity covariance and Green’s function, which describes an average velocity response to external force action, have been obtained. For the nonlinear term in the equation for velocity covariance, it has been obtained an exact representation in the form of two terms, which can be treated as describing a momentum transport due to turbulent viscosity and action of effective random forces (within the framework of traditional phenomenological description, the turbulent viscosity is only accounted for). Using a low perturbation theory approximation for high statistical moments, a scheme of closuring the chain of equations for statistical moments is proposed. As the result, we come to a closed set of equations for velocity covariance and Green’s function, the solution to which corresponds to summing up a certain infinite subsequence of total perturbation series. 展开更多
关键词 Random Velocity Field STATISTICAL DESCRIPTION Characteristic Functional CHAIN of EQUATIONS for MOMENTS Problem of closuring
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Production induced fracture closure of deep shale gas well under thermo-hydro-mechanical conditions 被引量:1
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作者 Shi-Ming Wei Yang Xia +4 位作者 Yan Jin Xu-Yang Guo Jing-Yu Zi Kai-Xuan Qiu Si-Yuan Chen 《Petroleum Science》 SCIE EI CAS CSCD 2024年第3期1796-1813,共18页
Deep shale gas reservoirs have geological characteristics of high temperature,high pressure,high stress,and inferior ability to pass through fluids.The multi-stage fractured horizontal well is the key to exploiting th... Deep shale gas reservoirs have geological characteristics of high temperature,high pressure,high stress,and inferior ability to pass through fluids.The multi-stage fractured horizontal well is the key to exploiting the deep shale gas reservoir.However,during the production process,the effectiveness of the hydraulic fracture network decreases with the closure of fractures,which accelerates the decline of shale gas production.In this paper,we addressed the problems of unclear fracture closure mechanisms and low accuracy of shale gas production prediction during deep shale gas production.Then we established the fluid—solid—heat coupled model coupling the deformation and fluid flow among the fracture surface,proppant and the shale matrix.When the fluid—solid—heat coupled model was applied to the fracture network,it was well solved by our numerical method named discontinuous discrete fracture method.Compared with the conventional discrete fracture method,the discontinuous discrete fracture method can describe the three-dimensional morphology of the fracture while considering the effect of the change of fracture surface permeation coefficient on the coupled fracture—matrix flow and describing the displacement discontinuity across the fracture.Numerical simulations revealed that the degree of fracture closure increases as the production time proceeds,and the degree of closure of the secondary fractures is higher than that of the primary fractures.Shale creep and proppant embedment both increase the degree of fracture closure.The reduction in fracture surface permeability due to proppant embedment reduces the rate of fluid transfer between matrix and fracture,which has often been overlooked in the past.However,it significantly impacts shale gas production,with calculations showing a 24.7%cumulative three-year yield reduction.This study is helpful to understand the mechanism of hydraulic fracture closure.Therefore,it provides the theoretical guidance for maintaining the long-term effectiveness of hydraulic fractures. 展开更多
关键词 Shalegas Fracture closure Fluid-solid-heat coupling Discontinuous discrete fracture
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Evaluating the stability and volumetric flowback rate of proppant packs in hydraulic fractures using the lattice Boltzmann-discrete element coupling method 被引量:1
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作者 Duo Wang Sanbai Li +2 位作者 Rui Wang Binhui Li Zhejun Pan 《Journal of Rock Mechanics and Geotechnical Engineering》 SCIE CSCD 2024年第6期2052-2063,共12页
The stability and mobility of proppant packs in hydraulic fractures during hydrocarbon production are numerically investigated by the lattice Boltzmann-discrete element coupling method(LB-DEM).This study starts with a... The stability and mobility of proppant packs in hydraulic fractures during hydrocarbon production are numerically investigated by the lattice Boltzmann-discrete element coupling method(LB-DEM).This study starts with a preliminary proppant settling test,from which a solid volume fraction of 0.575 is calibrated for the proppant pack in the fracture.In the established workflow to investigate proppant flowback,a displacement is applied to the fracture surfaces to compact the generated proppant pack as well as further mimicking proppant embedment under closure stress.When a pressure gradient is applied to drive the fluid-particle flow,a critical aperture-to-diameter ratio of 4 is observed,above which the proppant pack would collapse.The results also show that the volumetric proppant flowback rate increases quadratically with the fracture aperture,while a linear variation between the particle flux and the pressure gradient is exhibited for a fixed fracture aperture.The research outcome contributes towards an improved understanding of proppant flowback in hydraulic fractures,which also supports an optimised proppant size selection for hydraulic fracturing operations. 展开更多
关键词 Numerical simulation Hydraulic fracturing Proppant flowback Closure stress Particulate flow
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Anisotropic FCGR behaviour in hot-rolled Mg-3Al-0.5Ce alloy 被引量:1
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作者 Prakash C.Gautam Somjeet Biswas 《Journal of Magnesium and Alloys》 SCIE EI CAS CSCD 2024年第7期2985-3002,共18页
In this work,anisotropic fatigue crack growth rate(FCGR)behaviour in a hot-rolled Mg-3wt%Al-0.5wt%Ce alloy was investigated using compact tension(CT)specimens with notch(an)parallel to the rolling direction(RD)and tra... In this work,anisotropic fatigue crack growth rate(FCGR)behaviour in a hot-rolled Mg-3wt%Al-0.5wt%Ce alloy was investigated using compact tension(CT)specimens with notch(an)parallel to the rolling direction(RD)and transverse direction(TD).The FCGR tests were conducted at a constant load ratio(R=0.1)and maximum stress intensity factor(KMax=15.6 MPa√m)to investigate the crack closure effect.For both constant R and KMax conditions:(i)the load-displacement curves for every loading cycle were linear for a_(n)∥ to RD and TD,indicating no crack closure;(ii)the FCGR was found to be lower for an∥RD than an∥TD over the entire stress intensity factor range(△K).The hot-rolled sample contained long-aligned Al11Ce3 intermetallic phase within grain boundaries that are elongated along RD.During the FCGR test,{10.12}<10.11>extension twins(ET)with lamellae∼⊥and c-axis∼∥to these elongated intermetallics along RD developed irrespective of the notch orientation.During the loading cycle,these intermetallics along RD generate back-stresses,reducing the in-plane tensile stress∼||and∼⊥to crack-tip to∼0 for a_(n)∥to RD and TD,respectively.Hence,lenticular ET∼||⊥and∼||,with c-axis∼||and∼⊥to crack path activates,leading to trans and inter lamellar crack for anto RD and TD,respectively,and anisotropic FCGR.Translamellar crack in a_(n)∥RD reduces the FCGR due to plastic energy dissipation as perceived by comparatively more geometrically necessary boundaries(GNBs).On the other hand,faster FCGR was obtained for a_(n)∥TD due to interlamellar cracking.Thus,the crack growth through the matrix-ET interfaces was favoured due to strain incompatibility.The Fractography for a_(n)∥RD shows smaller elongated grooves along crack propagation,which indicates crack arrest.However,larger elongated grooves for a_(n)||TD indicated easy crack propagation due to favourable interlamellar crack. 展开更多
关键词 Fatigue crack growth rate(FCGR) Magnesium(Mg) INTERMETALLICS Extension twins Crack closure
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Closure Effect ofⅠ+ⅡMixed-mode Crack for EA4T Axle Steel
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作者 Shuancheng Wang Bing Yang +2 位作者 Shuwei Zhou Jian Li Shoune Xiao 《Chinese Journal of Mechanical Engineering》 SCIE EI CAS CSCD 2024年第4期327-341,共15页
The crack-closure effect is a crucial factor that affects the crack growth rate and should be considered in simulation analysis and testing.A mixed-mode I+II loading fatigue crack growth test was performed using EA4T ... The crack-closure effect is a crucial factor that affects the crack growth rate and should be considered in simulation analysis and testing.A mixed-mode I+II loading fatigue crack growth test was performed using EA4T axle steel specimens.The variation of the plastic-induced crack closure(PICC)effect and the roughness-induced crack closure(RICC)effect during crack deflection in the mixed-mode is examined in this study.The results show that the load perpendicular to the crack propagation direction hinders the slip effect caused by the load parallel to the crack propagation direction under mixed-mode loading,and the crack deflection is an intuitive manifestation of the interaction between the PICC and RICC.The proportion of the RA value change on the crack side caused by contact friction was reduced by the interaction between PICC and RICC.The roughness of the crack surface before and after the crack deflection is different,and the spatial torsion crack surface is formed during the crack propagation process.With the increase of the crack length,the roughness of the fracture surface increases.During the crack deflection process,the PICC value fluctuates around 0.2,and the RICC value is increased to 0.15. 展开更多
关键词 Crack closure Crack deflection Plasticity-induced closure Roughness-induced closure Interaction mechanism
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Preface:Development and utilization of pumped storage in closed/abandoned mines
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作者 WEN Zhi-jie JIANG Yu-jing +3 位作者 ZHAO Guang-ming LI Li-ping PU Hai YANG Sheng-li 《Journal of Central South University》 SCIE EI CAS CSCD 2024年第8期2545-2548,共4页
China has embarked on an extensive and sustained endeavor to harness its coal resources for a substantial period.However,the depletion of coal reserves in mining regions has necessitated the closure or abandonment of ... China has embarked on an extensive and sustained endeavor to harness its coal resources for a substantial period.However,the depletion of coal reserves in mining regions has necessitated the closure or abandonment of numerous mines,resulting in a marked increase in the number of such facilities.Parallel to this,China is vigorously advancing the development of a novel energy power system,aimed at transitioning the power sector from a high-carbon,fossil fuel-dependent paradigm to a low-carbon,clean energy footing. 展开更多
关键词 PUMPED SUSTAINED CLOSURE
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Workflow for treating inadvertent arterial placement of the central venous catheter
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作者 Joho Tokumine Keisuke Fujimaki +1 位作者 Kiyoshi Moriyama Tomoko Yorozu 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2024年第11期1096-1098,共3页
We read the article“How to manage the malposition of deep vein catheterization into the artery”[1]with keen interest.However,we have several concerns with the proposed algorithm.First,the site of catheter misplaceme... We read the article“How to manage the malposition of deep vein catheterization into the artery”[1]with keen interest.However,we have several concerns with the proposed algorithm.First,the site of catheter misplacement is assumed to be the subclavian artery,the most frequent site of misplacement during internal jugular vein catheterization.[2]However,catheter misplacement can occur in the common carotid and vertebral arteries during internal jugular vein catheterization.[2,3]If a catheter is misplaced in one of these arteries,preventing cerebral ischemia is a priority.[2,4,5]For example,if a thrombus forms around the catheter,a method is chosen to resolve it while preventing dispersion and closing the perforation.[2,6]Therefore,open surgical closure must be selected.Second,the algorithm may not handle instances of realistic catheter misplacement in the arteries.We assume a case where an internal jugular venous catheter(5Fr double-lumen catheter)is inserted but accidentally penetrates the subclavian artery and is placed in the thoracic cavity.Suppose that the injured site is about 5 mm from the confluence of the right common carotid or vertebral arteries. 展开更多
关键词 CATHETER CLOSURE instance
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On Multi-Granulation Rough Sets with Its Applications
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作者 Radwan Abu-Gdairi R.Mareay M.Badr 《Computers, Materials & Continua》 SCIE EI 2024年第4期1025-1038,共14页
Recently,much interest has been given tomulti-granulation rough sets (MGRS), and various types ofMGRSmodelshave been developed from different viewpoints. In this paper, we introduce two techniques for the classificati... Recently,much interest has been given tomulti-granulation rough sets (MGRS), and various types ofMGRSmodelshave been developed from different viewpoints. In this paper, we introduce two techniques for the classificationof MGRS. Firstly, we generate multi-topologies from multi-relations defined in the universe. Hence, a novelapproximation space is established by leveraging the underlying topological structure. The characteristics of thenewly proposed approximation space are discussed.We introduce an algorithmfor the reduction ofmulti-relations.Secondly, a new approach for the classification ofMGRS based on neighborhood concepts is introduced. Finally, areal-life application from medical records is introduced via our approach to the classification of MGRS. 展开更多
关键词 Multi-granulation rough sets data classifications information systems interior operators closure operators approximation structures
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Iridoschisis misdiagnosed as acute angle-closure glaucoma:a case report and literature review
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作者 Huan Wan Yao Zhang Li Tang 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第1期201-205,共5页
We present the case of a patient with iridoschisis complicated with cataract,peripheral anterior synechiae(PAS),secondary glaucoma,and corneal endothelial damage.The patient was initially misdiagnosed with acute angle... We present the case of a patient with iridoschisis complicated with cataract,peripheral anterior synechiae(PAS),secondary glaucoma,and corneal endothelial damage.The patient was initially misdiagnosed with acute angle-closure glaucoma.Iridoschisis is a rare condition characterized by the splitting of the iris into two layers:the anterior layer breaks down into fibers,floating freely in the anterior chamber with a“shredded wheat”appearance. 展开更多
关键词 GLAUCOMA ACUTE CLOSURE
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Micropulse transscleral laser therapy for secondary angle-closure glaucoma in nanophthalmos: a case report
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作者 Ping Yu Bai-Yu Hu +4 位作者 Yu He Lin Jing Han-Ying Fan Jing Shu Liu-Zhi Zeng 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第7期1381-1384,共4页
Dear Editor,The choice of surgical intervention for nanophthalmos patients with secondary angle-closure glaucoma poses a challenging decision for ophthalmologists.Because nanophthalmos patients who have undergone filt... Dear Editor,The choice of surgical intervention for nanophthalmos patients with secondary angle-closure glaucoma poses a challenging decision for ophthalmologists.Because nanophthalmos patients who have undergone filtration surgery or other intraocular procedures are more susceptible to severe complications,including choroidal effusion,malignant glaucoma,and explosive choroidal hemorrhage,all of which can lead to vision loss[1].This dilemma is particularly pronounced in patients with shorter axial lengths.Micropulse transscleral laser therapy(M-TLT),also known as micropulse transscleral cyclophotocoagulation(MP-TSCPC),is a nonincisional laser therapy surgery for glaucoma[2].In 2015,Golan and Kurtz[3]were the first to report four patients with secondary angle-closure glaucoma in nanophthalmos with axial lengths ranging between 17 and 19 mm(mean 18 mm)who were successfully treated with M-TLT,and choroidal detachment was observed in all patients(recovery spontaneously in two patients and recovery after systemic steroid treatment in the other two),of which two had a slight decrease in visual acuity. 展开更多
关键词 GLAUCOMA SURGERY CLOSURE
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Transcatheter Closure of Postoperative Residual Atrial or Ventricular Septal Shunts in Patients with Congenital Heart Disease
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作者 Jiawang Xiao Jianming Wang +3 位作者 Zhongchao Wang Lili Meng Ming Zhao Qiguang Wang 《Congenital Heart Disease》 SCIE 2024年第3期293-303,共11页
Background:Transcatheter closure(TCC)has emerged as the preferred treatment for selected congenital heart disease(CHD).While TCC offers benefits for patients with postoperative residual shunts,understanding its mid-an... Background:Transcatheter closure(TCC)has emerged as the preferred treatment for selected congenital heart disease(CHD).While TCC offers benefits for patients with postoperative residual shunts,understanding its mid-and long-term efficacy and safety remains crucial.Objective:This study aims to assess the mid-and long-term safety and efficacy of TCC for patients with residual atrial or ventricular septal shunts following CHD correction.Methods:In this consecutive retrospective study,we enrolled 35 patients with residual shunt who underwent TCC or surgical repair of CHD between June 2011 to October 2022.TCC candidacy was determined based on established criteria.Echocardiography and electrocardiogram were conducted during the perioperative period and continued as part of long-term follow-up.Results:Among the patients,5(14.3%)exhibited interatrial shunt-ing,while 30(85.7%)had interventricular shunting.TCC was successfully implemented in 33 of 35 patients,with exceptions in two cases of post-ventricular septal defect repair due to anatomical challenges involving the shape and aortic angulation.This resulted in a TCC success rate of 94.3%.Trace residual shunt was detected in two interventricular shunting cases and a mild residual shunt in one interventricular shunting case;all resolved by the three-month follow-up after TCC.Minor complications included one hematoma at the puncture site and one transient junctional rhythm during the perioperative period.During a median follow-up of 73 months,there were no instances of residual shunt,device embolization,occluder displacement,valve insufficiency,malignant arrhythmia,infective endocarditis,death,or other serious complications.Conclusion:TCC is an effective and safe therapy for patients with residual atrial or ventricular septal shunts following CHD correction.Thesefindings support the consideration of TCC as the preferred treatment option for appropriate patient populations. 展开更多
关键词 Congenital heart disease residual shunt transcatheter closure surgical repair
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Acute primary angle closure during the Omicron outbreak
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作者 Dong Fang Wang-Ting Li +9 位作者 Jia Liang Lu Chen Ning-Xin Dou Hui-Yan Zheng Can-Feng Huang Ting Xie Yi-Jing Zhuang Peng-Feng Li Xing-Xing Mao Shao-Chong Zhang 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第7期1337-1343,共7页
AIM:To investigate Omicron’s impact on clinical presentation of acute primary angle closure(APAC)in China.METHODS:A consecutive case series with historical controls was conducted at Shenzhen Eye Hospital,the largest ... AIM:To investigate Omicron’s impact on clinical presentation of acute primary angle closure(APAC)in China.METHODS:A consecutive case series with historical controls was conducted at Shenzhen Eye Hospital,the largest specialized hospital in Shenzhen,China.Medical records from a two-month period during the Omicron pandemic(December 1,2022,to January 31,2023)were compared with records from two control groups(12/2018–1/2019 and 12/2021–1/2022)before pandemic.Patients with APAC were included,and the prevalence of APAC and demographic characteristics in Omicron-infected and noninfected patients were compared.RESULTS:Seventy-one(23.43%)out of 303 patients were diagnosed with APAC in the pandemic cohort,which was 2.98 and 2.61 times higher than that in control cohorts(7.87%in 2019,8.96%in 2022,P<0.001).The pandemic cohort has significantly higher Omicron-infected rate(78.87%vs 0 vs 0;P<0.001),lower proportion of glaucoma history(16.90%vs 42.86%vs 41.67%,P=0.005),higher surgical rate(95.77%vs 83.33%vs 78.57%,P=0.024),higher total medical costs and larger pupil diameter(5.63±0.15 vs 4.68±0.15 vs 4.69±0.22 mm,P<0.01).In 83%Omicron-infected patients,ocular symptoms appeared within 3d after systemic symptoms onset.In multivariate analysis,Omicron infection(P<0.001)was the only independent predictor of pupil diameter.CONCLUSION:In the Omicron epidemic in China,there is an increase of prevalence and severity of APAC,particularly focusing on the first 3d following infection. 展开更多
关键词 Omicron acute primary angle closure ocular symptoms
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Impact of Atrial Septal Defect Closure on Mortality in Older Patients
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作者 Sipawath Khamplod Yodying Kaolawanich +1 位作者 Khemajira Karaketklang Nithima Ratanasit 《Congenital Heart Disease》 SCIE 2024年第1期93-105,共13页
Background:Atrial septal defect(ASD)is a common form of adult congenital heart disease that can lead to long-term adverse outcomes if left untreated.Early closure of ASD has been associated with excellent outcomes and... Background:Atrial septal defect(ASD)is a common form of adult congenital heart disease that can lead to long-term adverse outcomes if left untreated.Early closure of ASD has been associated with excellent outcomes and lower complication rates.However,there is limited evidence regarding the prognosis of ASD closure in older adults.This study aims to evaluate the mortality rates in older ASD patients with and without closure.Methods:A retrospective cohort study was conducted on patients aged 40 years or older with ASD between 2001 and 2017.Patients were followed up to assess all-cause mortality.Univariable and multivariable analyses were performed to identify the predictors of mortality.A p-value of<0.05 was considered statistically significant.Results:The cohort consisted of 450 patients(mean age 56.6±10.4 years,77.3%female),with 66%aged between 40 and 60 years,and 34%over 60 years.Within the cohort,299 underwent ASD closure(201 with transcatheter and 98 with surgical closure).During the median follow-up duration of 7.9 years,51 patients died.The unadjusted cumulative 10-year rate of mortality was 3%in patients with ASD closure,and 28%in patients without ASD closure(log-rank p<0.001).Multivariable analysis revealed that age(hazard ratio[HR]1.04,95%confidence interval[CI]1.006–1.06,p=0.01),NYHA class(HR 2.75,95%CI 1.63–4.62,p<0.001),blood urea nitrogen(BUN)(HR 1.07,95%CI 1.03–1.12,p<0.001),right ventricular systolic pressure(RVSP)(HR 1.07,95%CI 1.003–1.04,p=0.01),and lack of ASD closure(HR 15.12,95%CI 5.63–40.59,p<0.001)were independently associated with mortality.Conclusion:ASD closure demonstrated favorable outcomes in older patients.Age,NYHA class,BUN,RVSP,and lack of ASD closure were identified as independent factors linked to mortality in this population. 展开更多
关键词 Atrial septal defect congenital heart disease defect closure long-term survival MORTALITY
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Intraocular pressure and gonioscopic findings in primary angle-closure disease in India—a big data study
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作者 Srikantaiah Ramyashri Anthony Vipin Das Sirisha Senthil 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第8期1495-1500,共6页
AIM:To describe the gonioscopic profile and intraocular pressure(IOP)in primary angle-closure(PAC)disease in patients presenting to a tertiary eye care network in India.METHODS:A cross-sectional hospital-based study t... AIM:To describe the gonioscopic profile and intraocular pressure(IOP)in primary angle-closure(PAC)disease in patients presenting to a tertiary eye care network in India.METHODS:A cross-sectional hospital-based study that included 31484 new patients presenting between 2011 and 2021.Patients with a clinical diagnosis of PAC/suspect/glaucoma were included.The data was collected from an electronic medical record system.RESULTS:PAC glaucoma(PACG)(47.55%)was the most common diagnosis followed by PAC(39.49%)and PAC suspect(PACS;12.96%).Female preponderance(54.6%)was noted with higher mean age at presentation among males(P<0.0001).PACS and PAC showed the highest prevalence in 6th decade but PACG was higher at 7th decade.The probability of angle opening was 95.93%,90.32%and 63.36%in PACS,PAC and PACG eyes respectively post peripheral iridotomy(PI).Plateau iris syndrome(PIS)was noted in 252 eyes and all showed post dilated rise of IOP.A post dilated IOP rise was also noted with 8.86%,33.95%and 57.19%eyes with PACS,PAC and PACG respectively with IOP rise between 6-8 mm Hg across the disease spectrum.CONCLUSION:The superior quadrant is the narrowest angle and difficult to open with indentation and post PI.The probability of angle opening is less in PIS especially the complete variety along with post dilated IOP rise.The post dilated IOP rise in angle closure eyes warrants a careful dilatation,especially with PIS. 展开更多
关键词 angle closure disease peripheral iridectomy GONIOSCOPY post dilated intraocular pressure rise plateau iris syndrome
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Clinical efficacy of endovascular revascularization combined with vacuum-assisted closure for the treatment of diabetic foot
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作者 Feng-Rui Lei Xiao-Fei Shen +3 位作者 Chuang Zhang Xin-Qing Li Hao Zhuang Hong-Fei Sang 《World Journal of Diabetes》 SCIE 2024年第7期1499-1508,共10页
BACKGROUND The diabetic foot is a common cause of disability and death,and comorbid foot infections usually lead to prolonged hospitalization,high healthcare costs,and a significant increase in amputation rates.And mo... BACKGROUND The diabetic foot is a common cause of disability and death,and comorbid foot infections usually lead to prolonged hospitalization,high healthcare costs,and a significant increase in amputation rates.And most diabetic foot trauma is complicated by lower extremity arteriopathy,which becomes an independent risk factor for major amputation in diabetic foot patients.AIM To establish the efficacy and safety of endovascular revascularization(ER)combined with vacuum-assisted closure(VAC)for the treatment of diabetic foot.METHODS Clinical data were collected from 40 patients with diabetic foot admitted to the Second Affiliated Hospital of Soochow University from April 2018 to April 2022.Diabetic foot lesions were graded according to Wagner’s classification,and blood flow to the lower extremity was evaluated using the ankle-brachial index test and computerized tomography angiography of the lower extremity arteries.Continuous subcutaneous insulin infusion pumps were used to achieve glycemic control.Lower limb revascularization was facilitated by percutaneous transluminal balloon angioplasty(BA)or stenting.Wounds were cleaned by nibbling debridement.Wound granulation tissue growth was induced by VAC,and wound repair was performed by skin grafting or skin flap transplantation.RESULTS Of the 35 cases treated with lower limb revascularization,34 were successful with a revascularization success rate of 97%.Of these,6 cases underwent stenting after BA of the superficial femoral artery,and 1 received popliteal artery stent implantation.In the 25 cases treated with infrapopliteal artery revascularization,39 arteries were reconstructed,7 of which were treated by drug-coated BA and the remaining 32 with plain old BA.VAC was performed in 32 wounds.Twenty-four cases of skin grafting and 2 cases of skin flap transplantation were performed.Two patients underwent major amputations,whereas 17 had minor amputations,accounting for a success limb salvage rate of 95%.CONCLUSION ER in combination with VAC is a safe and effective treatment for diabetic foot that can significantly improve limb salvage rates.The use of VAC after ER simplifies and facilitates wound repair. 展开更多
关键词 Diabetic foot REVASCULARIZATION Vacuum-assisted closure Balloon angioplasty Wound repair
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Management of cerebral amyloid angiopathy and atrial fibrillation:We are still far from precision medicine
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作者 Liuba Fusco Zefferino Palamà +5 位作者 Antonio Scarà Alessio Borrelli Antonio Gianluca Robles Gabriele De Masi DeLuca Silvio Romano Luigi Sciarra 《World Journal of Cardiology》 2024年第5期231-239,共9页
The use of anticoagulation therapy could prove to be controversial when trying to balance ischemic stroke and intracranial bleeding risks in patients with concurrent cerebral amyloid angiopathy(CAA)and atrial fibrilla... The use of anticoagulation therapy could prove to be controversial when trying to balance ischemic stroke and intracranial bleeding risks in patients with concurrent cerebral amyloid angiopathy(CAA)and atrial fibrillation(AF).In fact,CAA is an age-related cerebral vasculopathy that predisposes patients to intracerebral hemorrhage.Nevertheless,many AF patients require oral systemic dose-adjusted warfarin,direct oral anticoagulants(such as factor Xa inhibitors)or direct thrombin inhibitors to control often associated with cardioembolic stroke risk.The prevalence of both CAA and AF is expected to rise,due to the aging of the population.This clinical dilemma is becoming increasingly common.In patients with coexisting AF and CAA,the risks/benefits profile of anticoagulant therapy must be assessed for each patient individually due to the lack of a clear-cut consensus with regard to its risks in scientific literature.This review aims to provide an overview of the management of patients with concomitant AF and CAA and proposes the implementation of a risk-based decision-making algorithm. 展开更多
关键词 ANTICOAGULATION Atrial fibrillation Cerebral amyloid angiopathy Intracerebral hemorrhage STROKE Watchman Secondary prevention Left atrial appendage closure
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Colon perforation with severe peritonitis caused by erotic toy insertion and treated using vacuum-assisted closure:A case report
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作者 Cheng-You Lin Ta-Wei Pu 《World Journal of Clinical Cases》 SCIE 2024年第18期3548-3554,共7页
BACKGROUND Colorectal foreign bodies are commonly encountered during surgery.They are frequently observed in men 20 to 90 years of age and have bimodal age distribution.Surgical management is necessary for cases of re... BACKGROUND Colorectal foreign bodies are commonly encountered during surgery.They are frequently observed in men 20 to 90 years of age and have bimodal age distribution.Surgical management is necessary for cases of rectal perforation.However,surgical site infections are the most common complications after colorectal surgery.CASE SUMMARY We discuss a case of rectal perforation in a patient who presented to our hospital 2 d after its occurrence.The perforation occurred as a result of the patient inserting a sex toy in his rectum.Severe peritonitis was attributable to delayed presentation.CONCLUSION Vacuum-assisted closure was performed to treat the wound,which healed well after therapy.No complications were noted. 展开更多
关键词 Colorectal surgery Foreign bodies Intestinal perforation Surgical site infection Wound closure techniques Case report
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Effectiveness of negative pressure wound therapy in complex surgical treatment of necrotizing fasciitis of the upper limb
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作者 Konstantin V Lipatov Arthur Asatryan +5 位作者 George Melkonyan Aleksandr D Kazantcev Ekaterina I Solov’eva Denis V Krivikhin Irina V Gorbacheva Urii E Cherkasov 《World Journal of Orthopedics》 2024年第11期1015-1022,共8页
BACKGROUND Necrotizing fasciitis(NF)of the upper extremities is a severe surgical pathology,and the incidence of this disease has been steadily increasing in recent decades.Surgical treatment is accompanied by the for... BACKGROUND Necrotizing fasciitis(NF)of the upper extremities is a severe surgical pathology,and the incidence of this disease has been steadily increasing in recent decades.Surgical treatment is accompanied by the formation of extensive wounds,which can be treated with significant difficulties.In recent years,negative pressure wound therapy(NPWT)has proven to be highly effective.It is also promising for the treatment of NF.AIM To explore the effectiveness of NPWT in the treatment of NF of the upper extremities.METHODS The results of the treatment of 36 patients with NF of the upper extremities in two groups(NPWT group and control group;2022−2023)were retrospectively analyzed.In the NPWT group,the NPWT method(120 mmHg;constant mode)was used after surgical treatment.The number of vacuum-assisted dressings in patients ranged from 1 to 3,depending on the dynamics of the wound process.The duration of fixation of one bandage was up to 2−3 d.In the control group,conventional methods of local wound treatment were used.The following indicators were analyzed:The treatment delay,the prevalence of inflammation,the microbial landscape,the number of debridements,the duration of wound preparation for surgical closure,and the nature of skin plastic surgery.RESULTS Most patients experienced a significant treatment delay[4 d,interquartile range(IQR):2–7 d],which led to the spread of the pathological process to the forearm and shoulder.The most common pathogens were Staphylococcus aureus(14;38.9%)and Streptococcus pyogenes(22;61.1%).The average number of debridements per patient was 5(IQR:3–7),with no difference between groups.The average time to prepare wounds for surgical closure was 11±4 d in the NPWT group and 29±10 d(P=0.00001)in the control group.In the NPWT group,the wounds were more often closed with local tissues(15;83.3%),and in the control group,split-thickness skin grafts were more often used(4;50%).CONCLUSION The predominant isolation of Staphylococcus aureus and/or Streptococcus pyogenes from the lesions allowed us to classify these patients as NF type II.Multiple debridement procedures have become a feature of this disease treatment.The use of NPWT has significantly reduced the time required to prepare wounds for surgical closure.Early closure of wounds allows for more frequent use of local tissue repair,which ensures better results.NPWT is a highly effective way to prepare wounds for early surgical closure in patients with upper extremity NF. 展开更多
关键词 Necrotizing fasciitis Upper limb Negative pressure wound therapy Vacuum-assisted closure Surgical treatment
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Early postoperative complications after transverse colostomy closure,a retrospective study
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作者 Fei Liu Xiao-Juan Luo +6 位作者 Zi-Wei Li Xiao-Yu Liu Xu-Rui Liu Quan Lv Xin-Peng Shu Wei Zhang Dong Peng 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第3期807-815,共9页
BACKGROUND Ostomy is a common surgery usually performed to protect patients from clinical symptoms caused by distal anastomotic leakage after colorectal cancer(CRC)surgery and perforation or to relieve intestinal obst... BACKGROUND Ostomy is a common surgery usually performed to protect patients from clinical symptoms caused by distal anastomotic leakage after colorectal cancer(CRC)surgery and perforation or to relieve intestinal obstruction.AIM To analyze the complications after transverse colostomy closure.METHODS Patients who underwent transverse colostomy closure from Jan 2015 to Jan 2022 were retrospectively enrolled in a single clinical center.The differences between the complication group and the no complication group were compared.Logistic regression analyses were conducted to find independent factors for overall complications or incision infection.RESULTS A total of 102 patients who underwent transverse colostomy closure were enrolled in the current study.Seventy(68.6%)patients underwent transverse colostomy because of CRC related causes.Postoperative complications occurred in 30(29.4%)patients and the most frequent complication occurring after transverse colostomy closure was incision infection(46.7%).The complication group had longer hospital stays(P<0.01).However,no potential risk factors were identified for overall complications and incision infection.CONCLUSION The most frequent complication occurring after transverse colostomy closure surgery in our center was incision infection.The operation time,interval from transverse colostomy to reversal,and method of anastomosis might have no impact on the postoperative complications.Surgeons should pay more attention to aseptic techniques. 展开更多
关键词 Transverse colostomy closure Surgery COMPLICATIONS A single clinical centre Risk factors
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Micro-power negative pressure wound technique reduces risk of incision infection following loop ileostomy closure
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作者 Deng-Yong Xu Bing-Jun Bai +4 位作者 Lina Shan Hui-Yan Wei Deng-Feng Lin Ya Wang Da Wang 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第1期186-195,共10页
BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complic... BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal cancer.Incisional surgical site infection(SSI)is a common complication after ileostomy closure.AIM To evaluate the efficacy and safety of the micro-power negative pressure wound technique(MPNPWT)in preventing incisional SSI.METHODS This was a prospective,randomized controlled clinical trial conducted at a single center.A total of 101 consecutive patients who underwent ileostomy closure after rectal cancer surgery with a prophylactic ileostomy were enrolled from January 2019 to December 2021.Patients were randomly allocated into an MPNPWT group and a control group.The MPNPWT group underwent intermittent suturing of the surgical incision with 2-0 Prolene and was covered with a micro-power negative pressure dressing.The surgical outcomes were compared between the MPNPWT(n=50)and control(n=51)groups.Risk factors for incisional SSI were identified using logistic regression.RESULTS There were no differences in baseline characteristics between the MPNPWT(n=50)and control groups(n=51).The incisional SSI rate was significantly higher in the control group than in the MPNPWT group(15.7%vs 2.0%,P=0.031).However,MPNPWT did not affect other surgical outcomes,including intra-abdominal complications,operative time,and blood loss.Postoperative hospital stay length and hospitalization costs did not differ significantly between the two groups(P=0.069 and 0.843,respectively).None of the patients experienced adverse effects of MPNPWT,including skin allergy,dermatitis,and pain.MPNPWT also helped heal the infected incision.Our study indicated that MPNPWT was an independent protective factor[odds ratio(OR)=0.005,P=0.025)]and diabetes was a risk factor(OR=26.575,P=0.029)for incisional SSI.CONCLUSION MPNPWT is an effective and safe way to prevent incisional SSI after loop ileostomy closure. 展开更多
关键词 Micro-power negative pressure technique Ileostomy closure Incisional surgical site infection Infection prevention Postoperative incision
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