This paper proposes a type of double-layer charge liner fabricated using chemical vapor deposition(CVD)that has tungsten as its inner liner.The feasibility of this design was evaluated through penetration tests.Double...This paper proposes a type of double-layer charge liner fabricated using chemical vapor deposition(CVD)that has tungsten as its inner liner.The feasibility of this design was evaluated through penetration tests.Double-layer charge liners were fabricated by using CVD to deposit tungsten layers on the inner surfaces of pure T2 copper liners.The microstructures of the tungsten layers were analyzed using a scanning electron microscope(SEM).The feasibility analysis was carried out by pulsed X-rays,slug-retrieval test and static penetration tests.The shaped charge jet forming and penetration law of inner tungsten-coated double-layer liner were studied by numerical simulation method.The results showed that the double-layer liners could form well-shaped jets.The errors between the X-ray test results and the numerical results were within 11.07%.A slug-retrieval test was found that the retrieved slug was similar to a numerically simulated slug.Compared with the traditional pure copper shaped charge jet,the penetration depth of the double-layer shaped charge liner increased by 11.4% and>10.8% respectively.In summary,the test results are good,and the numerical simulation is in good agreement with the test,which verified the feasibility of using the CVD method to fabricate double-layer charge liners with a high-density and high-strength refractory metal as the inner liner.展开更多
In this study,zircon U-Pb dating of volcanic rocks from the Zhongba ophiolite of the Yarlung Zangbo Suture Zone(YZSZ)in southern Xizang(Tibet)yielded an age of 247±3 Ma.According to whole rock geochemical and Sr-...In this study,zircon U-Pb dating of volcanic rocks from the Zhongba ophiolite of the Yarlung Zangbo Suture Zone(YZSZ)in southern Xizang(Tibet)yielded an age of 247±3 Ma.According to whole rock geochemical and Sr-NdPb isotopic data,the Early Triassic samples could be divided into two groups:Group 1 with P-MORB affinity,showing initial^(87)Sr/^(86)Sr ratios of 0.70253–0.70602,ε_(Nd)(t)values of 4.2–5.3,(^(206)Pb/^(204)Pb)_(t)ratios of 16.353–18.222,(^(207)Pb/^(204)Pb)_(t)ratios of 15.454–15.564,and(^(208)Pb/^(204)Pb)_(t)ratios of 35.665–38.136;Group 2 with OIB affinity,showing initial^(87)Sr/^(86)Sr ratios of 0.70249–0.70513,ε_(Nd)(t)values of 4.4–4.9,(^(206)Pb/^(204)Pb)_(t)ratios of 17.140–18.328,(^(207)Pb/^(204)Pb)_(t)ratios of 15.491–15.575,and(^(208)Pb/^(204)Pb)_(t)ratios of 36.051–38.247.Group 2 rocks formed by partial melting of the mantle source enriched by a former plume,and assimilated continental crustal material during melt ascension.The formation of Group 1 rocks corresponds to the mixing of OIB melts,with the same components as Group 2 and N-MORBs.The Zhongba Early Triassic rocks belong to the continental margin type ophiolite and formed in the continental–oceanic transition zone during the initial opening of the Neo-Tethys in southern Xizang(Tibet).展开更多
BACKGROUND Endoscopic full-thickness resection(EFTR)of gastric submucosal tumors(SMTs)is safe and effective;however,postoperative wound management is equally important.Literature on suturing following EFTR for large(...BACKGROUND Endoscopic full-thickness resection(EFTR)of gastric submucosal tumors(SMTs)is safe and effective;however,postoperative wound management is equally important.Literature on suturing following EFTR for large(≥3 cm)SMTs is scarce and limited.AIM To evaluate the efficacy and clinical value of double-nylon purse-string suture in closing postoperative wounds following EFTR of large(≥3 cm)SMTs.METHODS We retrospectively analyzed the data of 85 patients with gastric SMTs in the fundus of the stomach or in the lesser curvature of the gastric body whose wounds were treated with double-nylon purse-string sutures after successful tumor resection at the Endoscopy Center of Renmin Hospital of Wuhan University.The operative,postoperative,and follow-up conditions of the patients were evaluated.RESULTS All tumors were completely resected using EFTR.36(42.35%)patients had tumors located in the fundus of the stomach,and 49(57.65%)had tumors located in the body of the stomach.All patients underwent suturing with double-nylon sutures after EFTR without laparoscopic assistance or further surgical treatment.Postoperative fever and stomach pain were reported in 13(15.29%)and 14(16.47%)patients,respectively.No serious adverse events occurred during the intraoperative or postoperative periods.A postoperative review of all patients revealed no residual or recurrent lesions.CONCLUSION Double-nylon purse-string sutures can be used to successfully close wounds that cannot be completely closed with a single nylon suture,especially for large(≥3 cm)EFTR wounds in SMTs.展开更多
AIM:To report a technique used with intermittent slidinglock-knot(ISLK)fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent(RI)fixation.METHODS:Consecutive p...AIM:To report a technique used with intermittent slidinglock-knot(ISLK)fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent(RI)fixation.METHODS:Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed.Primary outcome measures were mean duration of surgery and suture removal,degree of conjunctival hyperemia on postoperative day 1,pain score at suture removal,postoperative symptoms at 6mo,including conjunctival hyperemia,foreign body sensation,and graft stability.RESULTS:Ninety-eight patients underwent monocular surgery and were divided into ISLK(51 eyes)and RI(47 eyes)groups according to the type of conjunctiva autograft fixation method planned.There was no significant difference in mean duration of surgery between the two groups(18.59±2.39min vs 18.15±2.20min,P=0.417);however,compared to the RI group,shorter suture removal times were observed in the ISLK group[0.58min(0.42-0.87)vs 3.00min(2.21-4.15),P<0.001].The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group(P<0.001).Pain scores at suture removal were lower in the ISLK group than in RI group[1(0-3)vs 2(1-4),P<0.001].Postoperative symptoms at 6mo were comparable between the groups(P=0.487),with no recurrence.CONCLUSION:ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision.Compared to RI fixation,ISLK facilitates suture removal and reduces discomfort,with comparable surgery duration and less conjunctival hyperemia.展开更多
Objective:Double-J(DJ)ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal surgery.It is believed that lesser stent material within the bladder mitigates stent-related symp...Objective:Double-J(DJ)ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal surgery.It is believed that lesser stent material within the bladder mitigates stent-related symptoms.This study aimed to evaluate the J-Fil ureteral stent,a single pigtail suture stent compared with conventional DJ stent in relation to stent symptoms in an Asian population undergoing ureterorenal intervention.Methods:Based on internal audit committee recommendation approval,the records of 50 patients retrieved,available data of 41 patients who were prospectively enrolled into two groups(Group 1[J-Fil stent group],n=21 and Group 2[DJ stent group],n=20)between August 2020 to January 2021,were analysed.Parameters compared were nature of procedure,stone location and size,ease of deployment or removal,and complications.A modified universal stent symptom questionnaire was used to assess morbidity of stent symptoms within 48 h of insertion and at removal.Results:Both groups had similar median age,distribution in male to female ratio,and stone size.The overall median universal stent symptom questionnaire score at insertion was similar for bladder pain,flank or loin pain,and quality of life between Group 1 and 2;however,at removal Group 1 fared significantly better than Group 2,especially for flank or loin pain and pain at voiding.Both groups had similar ease in insertion with no hospital readmissions.Conclusion:Our audit favoured the single pigtail suture stent in Asian ureters in mitigating stent-related issues.It showed a good safety profile with easy deployment and removal.It promises a new standard in stenting.展开更多
Among surgical procedures,suturing is considered simple.However,in some situations,suturing is not easy or feasible.Here,we present proof of concept of a new self-tightening needle-less suture made of a NiTi alloy.The...Among surgical procedures,suturing is considered simple.However,in some situations,suturing is not easy or feasible.Here,we present proof of concept of a new self-tightening needle-less suture made of a NiTi alloy.The new device is designed to overcome two demanding steps of traditional suturing:needle introduction and manual knotting.Our novel suture is composed only of a short NiTi wire that is able to change shape by exploiting a thermoelastic phase transition.This shape change is achieved by increasing the temperature from that of the operating room(e.g.,20-22℃)to 32℃using warm water.Suturing consists of two steps:suture introduction,in which the suture is in an open configuration,and shape recovery(i.e.,closed configuration).The closed configuration is maintained at human body temperature thanks to peculiar pseudoelastic properties of the NiTi material.Finally,thermal and functional characterization verified the simplicity and effectiveness of the proposed device.展开更多
BACKGROUND There are many available treatment options for keloid;however,single treatments are usually less effective.Therefore,more scientifically rational and effective com-bined treatment methods should be sought t...BACKGROUND There are many available treatment options for keloid;however,single treatments are usually less effective.Therefore,more scientifically rational and effective com-bined treatment methods should be sought to solve the pain associated with keloids.AIM To explore the efficacy and safety of surgical resection and ultra-reduced tension suture combined with superficial radiation as keloid treatment.METHODS Fifteen keloid patients admitted to Qingdao Eighth People's Hospital from June 2020 to January 2022 were enrolled in this retrospective analysis.All patients underwent a comprehensive treatment approach comprising surgical resection,ultra-reduced tension suture incision,and superficial radiation therapy within 24 h postoperatively.The modified Vancouver Scar Scale(mVSS)and Patient and Observer Scar Assessment Scale(POSAS)were used to evaluate the treatment effect,whereas the efficacy,adverse effects,and recurrence rate were observed according to the 12-mo follow-up after treatment.RESULTS The mVSS and POSAS scores at 1 and 6 mo after combination treatment decreased compared to before treatment(P<0.001),and the overall response rate was 93.3%.Only one case recurred,yielding a 6.7%recurrence rate.The incidence of local chromour sedimentation rate in 1–3 mo after radiotherapy was 33.3%(5 patients),all subsiding after 6–9 mo,without complications,such as delayed wound healing or dermatitis.CONCLUSION Surgical resection,super subtraction sutures,and superficial radiotherapy are treatment methods with short courses,low recurrence rates,and good safety profiles.展开更多
The time-sequenced damage behavior of the reactive projectile impacting double-layer plates is discussed.The analytical model considering the combined effect of kinetic and chemical energy is developed to reveal the d...The time-sequenced damage behavior of the reactive projectile impacting double-layer plates is discussed.The analytical model considering the combined effect of kinetic and chemical energy is developed to reveal the damage mechanism.The influences of impact velocity and reactive projectile chemical characteristics on the damage effect are decoupled analyzed based on this model.These analyses indicate that the high energy releasing efficiency and fast reaction propagation velocity of the reactive projectile are conducive to enhancing the damage effect.The experiments with various reactive projectiles impact velocity increasing from 702 to 1385 m/s were conducted to verify this model.The experimental results presented that,the damage hole radius of the rear-plate increases with the increase of impact velocity.At the impact velocity of 1350 m/s,the radius of damage hole formed by PTFE/Al/Bi_(2)O_(3),PTFE/Al/MoO_(3),PTFE/Al/Fe_(2)O_(3)projectile on the rear-plate become smaller in sequence.These results are consistent with the analytical model prediction,demonstrating that this model can predict the damage effect quantitatively.This work is of constructive significance to the application of reactive projectiles.展开更多
Gas-driven permeation(GDP)and plasma-driven permeation(PDP)of hydrogen gas through Ga In Sn/Fe are systematically investigated in this work.The permeation parameters of hydrogen through Ga In Sn/Fe,including diffusivi...Gas-driven permeation(GDP)and plasma-driven permeation(PDP)of hydrogen gas through Ga In Sn/Fe are systematically investigated in this work.The permeation parameters of hydrogen through Ga In Sn/Fe,including diffusivity,Sieverts'constant,permeability,and surface recombination coefficient are obtained.The permeation flux of hydrogen through Ga In Sn/Fe shows great dependence on external conditions such as temperature,hydrogen pressure,and thickness of liquid Ga In Sn.Furthermore,the hydrogen permeation behavior through Ga In Sn/Fe is well consistent with the multilayer permeation theory.In PDP and GDP experiments,hydrogen through Ga In Sn/Fe satisfies the diffusion-limited regime.In addition,the permeation flux of PDP is greater than that of GDP.The increase of hydrogen plasma density hardly causes the hydrogen PDP flux to change within the test scope of this work,which is due to the dissolution saturation.These findings provide guidance for a comprehensive and systematic understanding of hydrogen isotope recycling,permeation,and retention in plasma-facing components under actual conditions.展开更多
Dear Editor,We report a case of severe hemorrhagic Descemet’s membrane detachment(HDD)following ab external360-degree suture trabeculotomy with trabeculectomy that was successfully managed with the guidance of bedsid...Dear Editor,We report a case of severe hemorrhagic Descemet’s membrane detachment(HDD)following ab external360-degree suture trabeculotomy with trabeculectomy that was successfully managed with the guidance of bedside anterior segment optical coherence tomography(ASOCT).Descemet’s membrane detachment(DMD)is a complication that impairs vision and is commonly observed after cataract surgery.It’s reported a high incidence(25%-82%)of focal DMD that were mostly subclinical and detected only with gonioscopy[1].展开更多
To develop the microwave absorbing(MA)properties of cementitious material mixed with mine solid waste,the iron tailings cementitious microwave absorbing materials were prepared.The iron tailings was treated into diffe...To develop the microwave absorbing(MA)properties of cementitious material mixed with mine solid waste,the iron tailings cementitious microwave absorbing materials were prepared.The iron tailings was treated into different particle sizes by planetary ball mill,and the physicochemical properties of iron tailings were tested by laser particle size analyzer and scanning electron microscope(SEM).The electromagnetic parameters of iron tailings cementitious materials were characterized by a vector network analyzer and simulated MA properties,and the MA properties of iron tailings-cement composite system with steel fiber as absorber was studied.Based on the design of the single-layer structure,optimum mix ratio and thickness configuration method of double-layer structure were further studied,meanwhile,the mechanical properties and engineering application were analyzed and discussed.The results show that the particle size of iron tailings can afiect its electromagnetic behavior in cementitious materials,and the smaller particles lead the increase of demagnetisation efiect induced by domain wall motion and achieve better microwave absorbing properties in cementitious materials.When the thickness of matching layer and absorbing layer is 5 mm,the optimized microwave absorbing properties of C1/C3 double-layer cementitious material can obtain optimal RL value of-27.61 dB and efiective absorbing bandwidth of 0.97 GHz,which attributes to the synergistic efiect of impedance matching and attenuation characteristics.The double-layer microwave absorbing materials obtain excellent absorbing properties and show great design flexibility and diversity,which can be used as a suitable candidate for the preparation of favorable microwave absorbing cementitious materials.展开更多
The transplantation of full-thickness skin grafts(FTSGs)is important for reconstructing skin barrier and promoting wound healing.Sufficient oxygen supply is closely related to the success of skin grafting.However,full...The transplantation of full-thickness skin grafts(FTSGs)is important for reconstructing skin barrier and promoting wound healing.Sufficient oxygen supply is closely related to the success of skin grafting.However,full-thickness oxygen delivery is limited by the poor oxygen permeability of skin.Oxygen-releasing sutures(O_(2)sutures)were developed to facilitate oxygen penetration through full-thickness skin.The O_(2)sutures delivered 100 times more oxygen than topical gaseous oxygen therapy at a 15 mm depth in the skin model.Under extreme hypoxia(<0.5%O_(2),v/v),O_(2)sutures could also promote endothelial cell proliferation.After the transplantation of FTSGs in mice,O_(2)sutures accelerated blood re-perfusion and increased the survival area of the skin graft.It is expected that O_(2)sutures will be adopted in clinical applications to increase the success rate of full-thickness skin transplantation.展开更多
To reduce the comprehensive costs of the construction and operation of microgrids and to minimize the power fluctuations caused by randomness and intermittency in distributed generation,a double-layer optimizing confi...To reduce the comprehensive costs of the construction and operation of microgrids and to minimize the power fluctuations caused by randomness and intermittency in distributed generation,a double-layer optimizing configuration method of hybrid energy storage microgrid based on improved grey wolf optimization(IGWO)is proposed.Firstly,building a microgrid system containing a wind-solar power station and electric-hydrogen coupling hybrid energy storage system.Secondly,the minimum comprehensive cost of the construction and operation of the microgrid is taken as the outer objective function,and the minimum peak-to-valley of the microgrid’s daily output is taken as the inner objective function.By iterating through the outer and inner layers,the system improves operational stability while achieving economic configuration.Then,using the energy-self-smoothness of the microgrid as the evaluation index,a double-layer optimizing configuration method of the microgrid is constructed.Finally,to improve the disadvantages of grey wolf optimization(GWO),such as slow convergence in the later period and easy falling into local optima,by introducing the convergence factor nonlinear adjustment strategy and Cauchy mutation operator,an IGWO with excellent global performance is proposed.After testing with the typical test functions,the superiority of IGWO is verified.Next,using IGWO to solve the double-layer model.The case analysis shows that compared to GWO and particle swarm optimization(PSO),the IGWO reduced the comprehensive cost by 15.6%and 18.8%,respectively.Therefore,the proposed double-layer optimizationmethod of capacity configuration ofmicrogrid with wind-solar-hybrid energy storage based on IGWO could effectively improve the independence and stability of the microgrid and significantly reduce the comprehensive cost.展开更多
BACKGROUND Large or transmural defects induced by gastrointestinal endoscopic manipulations are difficult to close,although complete closure is recommended for better recovery.Endoscopic purse-string assisted suturing...BACKGROUND Large or transmural defects induced by gastrointestinal endoscopic manipulations are difficult to close,although complete closure is recommended for better recovery.Endoscopic purse-string assisted suturing(EPSS)has been used in clinical practice and has proven to be an effective and safe technique for the closure of large mucosal defects.However,details regarding the efficacy of endoscopic pre-purse-string suture(P-EPSS)are unknown,especially that it offers several advantages over conventional EPSS(C-EPSS).AIM To elucidate the outcomes of EPSS-assisted closure in different clinical situations,and evaluate the efficacy of P-EPSS.METHODS This retrospective observational study included a total of 180 patients who underwent closure assisted by P-EPSS(n=63)or C-EPSS(n=117)between July 2014 and June 2020.The P-EPSS and C-EPSS groups were compared and the intergroup differences in aspects such as the lesion size,location,and morphology,incidence of complete closure,intraoperative perforation,and delayed adverse events were evaluated.Data on the features and clinical course of cases with adverse events were collected for further analysis.RESULTS Patients with lesion size larger than 3 cm,lesions located at the fundus of stomach,or submucosal tumors originating from the deep mucosa were more likely to undergo P-EPSS-assisted closure.The P-EPSS group showed a significantly higher proportion of intraoperative perforation(56%vs 17%)and a much shorter procedure time(9.06±6.14 min vs 14.84±7.25 min).Among adverse events,the incidence of delayed perforation(5%vs 4%;P=0.82)and delayed bleeding(3%vs 4%;P=0.96)did not differ significantly between the groups.Multivariate analysis revealed that lesions with incomplete closure[odds ratio(OR)=21.33;95%confidence interval(CI):5.45-83.45;P<0.01]or size greater than 3 cm(OR=3.14;95%CI:1.08-9.18;P=0.039)showed a statistical tendency to result in an increase in delayed adverse events.CONCLUSION The present study revealed that EPSS could achieve secure complete closure of mucosal defect.PEPSS could shorten the procedure and yield complete closure of mucosal defects.Rather than closure-type selection,incomplete closure or lesion size larger than 3 cm were associated with worse outcomes.展开更多
BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors.However,the ...BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors.However,the traditional interrupted suturing technique used in enterostomy closure surgery has several issues,including longer surgical incisions and higher incision tension,which can increase the risk of postoperative complications.To address these issues,scholars have proposed the use of a“gunsight suture”technique.This technique involves using a gunsight incision instead of a traditional linear incision,leaving a gap in the center for the drainage of blood and fluid to reduce the risk of infection.Building on this technique,we propose an improved gunsight suture technique.A drainage tube is placed at the lowest point of the incision and close the gap in the center of the gunsight suture,which theoretically facilitates early postoperative mobility and reduces the burden of dressing changes,thereby reducing the risk of postoperative complications.AIM To compare the effectiveness of improved gunsight suture technique with traditional interrupted suture in closing intestinal stomas.METHODS In this study,a retrospective,single-center case analysis was conducted on 270 patients who underwent prophylactic ileostomy closure surgery at the Department of Colorectal Surgery of Qilu Hospital from April 2017 to December 2021.The patients were divided into two groups:135 patients received sutures using the improved gunsight method,while the remaining 135 patients were sutured with the traditional interrupted suture method.We collected data on a variety of parameters,such as operation time,postoperative pain score,body temperature,length of hospital stays,laboratory indicators,incidence of incisional complications,number of wound dressing changes,and hospitalization costs.Non-parametric tests and chi-square tests were utilized for data analysis.RESULTS There were no statistically significant differences in general patient information between the two groups,including the interval between the first surgery and the stoma closure[132(105,184)d vs 134(109,181)d,P=0.63],gender ratio(0.64 vs 0.69,P=0.44),age[62(52,68)years vs 60(52,68)years,P=0.33],preoperative body mass index(BMI)[23.83(21.60,25.95)kg/m²vs 23.12(20.94,25.06)kg/m²,P=0.17].The incidence of incision infection in the improved gunsight suture group tended to be lower than that in the traditional interrupted suture group[(n=2/135,1.4%)vs(n=10/135,7.4%),P<0.05],and the postoperative hospital stay in the improved gunsight suture group was significantly shorter than that in the traditional interrupted suture group[5(4,7)d vs 7(6,8)d,P<0.05].Additionally,the surgical cost in the modified gunsight suture group was slightly lower than that in the traditional suture group[4840(4330,5138)yuan vs 4980(4726,5221)yuan,P>0.05],but there was no significant difference in the total hospitalization cost between the two groups.CONCLUSION In stoma closure surgery,the improved gunsight technique can reduce the incision infection rate,shorten the postoperative hospital stay,reduce wound tension,and provide better wound cosmetic effects compared to traditional interrupted suture.展开更多
South Tianshan–Solonker suture,is the largest and southernmost suture within the Central Asian orogenic belt(CAOB).It records the ultimate collision between Tarim–North China cratons and Siberia craton,and is common...South Tianshan–Solonker suture,is the largest and southernmost suture within the Central Asian orogenic belt(CAOB).It records the ultimate collision between Tarim–North China cratons and Siberia craton,and is commonly interpreted as marking the eventual closure of Paleo-Asian Ocean.South Tianshan suture belongs to the western segment of the suture zone,and its evolutionary features are important for defining the formation age of the South Tianshan–Solonker suture.In this paper,the authors review the geochronological,geochemical,petrographic,and paleontological evidence within South Tianshan suture to delineate its formation era and closure characteristics,and thus further revealing the ultimate evolutionary pattern of the western segment of Paleo-Asian Ocean.This suture records strong plate collision before Late Carboniferous,forming a series of high-pressure metamorphic rocks,characterized by the presence of blue schist,eclogite and mica schist.In Permian,the whole area was under a relatively stable post-orogenic setting,with the formation of bimodal volcanic rocks,post-collisional granites,and terrestrial molasses.Sedimentary facies gradually changed from marine to either lacustrine or fluvial during this period.An Early Permian granite dike crosscuts the HP metamorphic belt,and the HP metamorphic rocks also underwent retrograde metamorphism at this time,indicating the formation of the South Tianshan suture was earlier than Permian.Hence,the western section of Paleo-Asian Ocean closed during Late Carboniferous,and Tarim Craton moved northward to collide with Kazakhstan–Yili Block,leading to the formation of the South Tianshan suture.展开更多
Objective:This paper aims to compare the effect of skin staple suture and traditional silk suture in scalp suture surgery.Methods:A total of 80 craniocerebral surgery patients were included in this study,and the patie...Objective:This paper aims to compare the effect of skin staple suture and traditional silk suture in scalp suture surgery.Methods:A total of 80 craniocerebral surgery patients were included in this study,and the patients were randomly divided into observation group and control group,with 40 cases in each group.The observation group used disposable skin stapler to suture the scalp incision,and the control group used conventional silk suture to suture the incision.Statistical analysis was carried out on 6 indicators including suturing speed,healing under-scab,incision necrosis,incision cerebrospinal fluid(CSF)leakage,incision infection,and postoperative“centipede-shaped”scar incidence rate of the two suture methods.Results:There was no significant difference between the groups in terms of postoperative healing under-scab,incision necrosis,incision CSF leakage,and intracranial infection(P>0.05).The suturing speed in the observation group was 15.2±0.7 cm/min,which was significantly faster than 7.4±0.3 cm/min in the control group(P<0.05).The incidence of“centipede-shaped”scars in the observation group was significantly lower than that in the control group at 1 to 6 months after operation(P<0.05).Conclusion:Compared with traditional silk suture,skin staple suture has obvious advantages in suture speed and cosmetic effect.展开更多
Background:Surgical site infection(SSI)is the most common complication after stoma closure and is particularly common in obese patients.To reduce the incidence of SSI,various skin closure techniques have been proposed...Background:Surgical site infection(SSI)is the most common complication after stoma closure and is particularly common in obese patients.To reduce the incidence of SSI,various skin closure techniques have been proposed;however,the best technique is still under debate.The purpose of this study was to explore the effectiveness of subcutaneous vacuum drains(SVDs)after two surgical suture techniques following stoma reversal in obese patients. Methods:Data from 190 obese patients with rectal cancer who underwent stoma reversal for enterostomy between February 2012 and April 2023 at Jinxiang Hospital Affiliated to Jining Medical University were retrospectively analyzed.These patients were divided into two groups:gunsight suture(GS)with SVD and primary linear suture(PLS)with SVD.The GS group and PLS group included 90 and 100 patients,respectively.The clinical characteristics and short-term outcomes were compared between the two groups.Postoperative pain scores were analyzed using a generalized estimation equation. Results:Surgery was successfully performed in both groups.The rate of SSI in the GS group was significantly lower than that in the PLS group(2.2%vs 9.0%,P=0.046).Patients in the GS group had a significantly shorter wound healing time than did patients in the PLS group,as well as a significantly shorter postoperative fasting time(P<0.05).No significant differences were found between the groups in terms of the postoperative hospital stay,operative time,and estimated blood loss(P>0.05).The results of the generalized estimation equation analysis showed that the GS group had significantly lower pain scores at 12,24,48,and 72 h after surgery than the PLS group(P<0.05).Moreover,the GS group showed significantly better alleviation of wound pain between 12 and 72 h after surgery(P<0.05). Conclusions:The GS technique with SVD may be recommended for wound closure of a nonfunctioning stoma in obese patients.展开更多
基金funded by the China Postdoctoral Science Foundation(Grant No.2022M721614)the opening project of State Key Laboratory of Explosion Science and Technology,Beijing Institute of Technology(Grant No.KFJJ23-07M)。
文摘This paper proposes a type of double-layer charge liner fabricated using chemical vapor deposition(CVD)that has tungsten as its inner liner.The feasibility of this design was evaluated through penetration tests.Double-layer charge liners were fabricated by using CVD to deposit tungsten layers on the inner surfaces of pure T2 copper liners.The microstructures of the tungsten layers were analyzed using a scanning electron microscope(SEM).The feasibility analysis was carried out by pulsed X-rays,slug-retrieval test and static penetration tests.The shaped charge jet forming and penetration law of inner tungsten-coated double-layer liner were studied by numerical simulation method.The results showed that the double-layer liners could form well-shaped jets.The errors between the X-ray test results and the numerical results were within 11.07%.A slug-retrieval test was found that the retrieved slug was similar to a numerically simulated slug.Compared with the traditional pure copper shaped charge jet,the penetration depth of the double-layer shaped charge liner increased by 11.4% and>10.8% respectively.In summary,the test results are good,and the numerical simulation is in good agreement with the test,which verified the feasibility of using the CVD method to fabricate double-layer charge liners with a high-density and high-strength refractory metal as the inner liner.
基金the National Natural Science Foundation of China(Grant Nos.91955206,41603038)Second Tibetan Plateau Scientific Expedition and Research program(Grant No.2019QZKK0803)+2 种基金Scientific Research Foundation for Advanced ScholarsWest Yunnan University of Applied Sciences(Grant No.2022RCKY0004)Yunnan Fundamental Research Projects(Grant No.202301AT070012).
文摘In this study,zircon U-Pb dating of volcanic rocks from the Zhongba ophiolite of the Yarlung Zangbo Suture Zone(YZSZ)in southern Xizang(Tibet)yielded an age of 247±3 Ma.According to whole rock geochemical and Sr-NdPb isotopic data,the Early Triassic samples could be divided into two groups:Group 1 with P-MORB affinity,showing initial^(87)Sr/^(86)Sr ratios of 0.70253–0.70602,ε_(Nd)(t)values of 4.2–5.3,(^(206)Pb/^(204)Pb)_(t)ratios of 16.353–18.222,(^(207)Pb/^(204)Pb)_(t)ratios of 15.454–15.564,and(^(208)Pb/^(204)Pb)_(t)ratios of 35.665–38.136;Group 2 with OIB affinity,showing initial^(87)Sr/^(86)Sr ratios of 0.70249–0.70513,ε_(Nd)(t)values of 4.4–4.9,(^(206)Pb/^(204)Pb)_(t)ratios of 17.140–18.328,(^(207)Pb/^(204)Pb)_(t)ratios of 15.491–15.575,and(^(208)Pb/^(204)Pb)_(t)ratios of 36.051–38.247.Group 2 rocks formed by partial melting of the mantle source enriched by a former plume,and assimilated continental crustal material during melt ascension.The formation of Group 1 rocks corresponds to the mixing of OIB melts,with the same components as Group 2 and N-MORBs.The Zhongba Early Triassic rocks belong to the continental margin type ophiolite and formed in the continental–oceanic transition zone during the initial opening of the Neo-Tethys in southern Xizang(Tibet).
基金This observational study was approved by the Ethics Committee of Renmin Hospital of Wuhan University.
文摘BACKGROUND Endoscopic full-thickness resection(EFTR)of gastric submucosal tumors(SMTs)is safe and effective;however,postoperative wound management is equally important.Literature on suturing following EFTR for large(≥3 cm)SMTs is scarce and limited.AIM To evaluate the efficacy and clinical value of double-nylon purse-string suture in closing postoperative wounds following EFTR of large(≥3 cm)SMTs.METHODS We retrospectively analyzed the data of 85 patients with gastric SMTs in the fundus of the stomach or in the lesser curvature of the gastric body whose wounds were treated with double-nylon purse-string sutures after successful tumor resection at the Endoscopy Center of Renmin Hospital of Wuhan University.The operative,postoperative,and follow-up conditions of the patients were evaluated.RESULTS All tumors were completely resected using EFTR.36(42.35%)patients had tumors located in the fundus of the stomach,and 49(57.65%)had tumors located in the body of the stomach.All patients underwent suturing with double-nylon sutures after EFTR without laparoscopic assistance or further surgical treatment.Postoperative fever and stomach pain were reported in 13(15.29%)and 14(16.47%)patients,respectively.No serious adverse events occurred during the intraoperative or postoperative periods.A postoperative review of all patients revealed no residual or recurrent lesions.CONCLUSION Double-nylon purse-string sutures can be used to successfully close wounds that cannot be completely closed with a single nylon suture,especially for large(≥3 cm)EFTR wounds in SMTs.
基金the Nature and Science of Science Technology Department of Fujian Province(No.2020J01233).
文摘AIM:To report a technique used with intermittent slidinglock-knot(ISLK)fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent(RI)fixation.METHODS:Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed.Primary outcome measures were mean duration of surgery and suture removal,degree of conjunctival hyperemia on postoperative day 1,pain score at suture removal,postoperative symptoms at 6mo,including conjunctival hyperemia,foreign body sensation,and graft stability.RESULTS:Ninety-eight patients underwent monocular surgery and were divided into ISLK(51 eyes)and RI(47 eyes)groups according to the type of conjunctiva autograft fixation method planned.There was no significant difference in mean duration of surgery between the two groups(18.59±2.39min vs 18.15±2.20min,P=0.417);however,compared to the RI group,shorter suture removal times were observed in the ISLK group[0.58min(0.42-0.87)vs 3.00min(2.21-4.15),P<0.001].The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group(P<0.001).Pain scores at suture removal were lower in the ISLK group than in RI group[1(0-3)vs 2(1-4),P<0.001].Postoperative symptoms at 6mo were comparable between the groups(P=0.487),with no recurrence.CONCLUSION:ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision.Compared to RI fixation,ISLK facilitates suture removal and reduces discomfort,with comparable surgery duration and less conjunctival hyperemia.
文摘Objective:Double-J(DJ)ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal surgery.It is believed that lesser stent material within the bladder mitigates stent-related symptoms.This study aimed to evaluate the J-Fil ureteral stent,a single pigtail suture stent compared with conventional DJ stent in relation to stent symptoms in an Asian population undergoing ureterorenal intervention.Methods:Based on internal audit committee recommendation approval,the records of 50 patients retrieved,available data of 41 patients who were prospectively enrolled into two groups(Group 1[J-Fil stent group],n=21 and Group 2[DJ stent group],n=20)between August 2020 to January 2021,were analysed.Parameters compared were nature of procedure,stone location and size,ease of deployment or removal,and complications.A modified universal stent symptom questionnaire was used to assess morbidity of stent symptoms within 48 h of insertion and at removal.Results:Both groups had similar median age,distribution in male to female ratio,and stone size.The overall median universal stent symptom questionnaire score at insertion was similar for bladder pain,flank or loin pain,and quality of life between Group 1 and 2;however,at removal Group 1 fared significantly better than Group 2,especially for flank or loin pain and pain at voiding.Both groups had similar ease in insertion with no hospital readmissions.Conclusion:Our audit favoured the single pigtail suture stent in Asian ureters in mitigating stent-related issues.It showed a good safety profile with easy deployment and removal.It promises a new standard in stenting.
基金Funding was provided by Regione Lombardia(Grant No.BANDO MISE Brevetti+N.BRE0000721).
文摘Among surgical procedures,suturing is considered simple.However,in some situations,suturing is not easy or feasible.Here,we present proof of concept of a new self-tightening needle-less suture made of a NiTi alloy.The new device is designed to overcome two demanding steps of traditional suturing:needle introduction and manual knotting.Our novel suture is composed only of a short NiTi wire that is able to change shape by exploiting a thermoelastic phase transition.This shape change is achieved by increasing the temperature from that of the operating room(e.g.,20-22℃)to 32℃using warm water.Suturing consists of two steps:suture introduction,in which the suture is in an open configuration,and shape recovery(i.e.,closed configuration).The closed configuration is maintained at human body temperature thanks to peculiar pseudoelastic properties of the NiTi material.Finally,thermal and functional characterization verified the simplicity and effectiveness of the proposed device.
基金This study was reviewed and approved by the Ethics Committee of Qingdao Eighth People’s Hospital(Approval no.:QBYLL-KY-2023-013).
文摘BACKGROUND There are many available treatment options for keloid;however,single treatments are usually less effective.Therefore,more scientifically rational and effective com-bined treatment methods should be sought to solve the pain associated with keloids.AIM To explore the efficacy and safety of surgical resection and ultra-reduced tension suture combined with superficial radiation as keloid treatment.METHODS Fifteen keloid patients admitted to Qingdao Eighth People's Hospital from June 2020 to January 2022 were enrolled in this retrospective analysis.All patients underwent a comprehensive treatment approach comprising surgical resection,ultra-reduced tension suture incision,and superficial radiation therapy within 24 h postoperatively.The modified Vancouver Scar Scale(mVSS)and Patient and Observer Scar Assessment Scale(POSAS)were used to evaluate the treatment effect,whereas the efficacy,adverse effects,and recurrence rate were observed according to the 12-mo follow-up after treatment.RESULTS The mVSS and POSAS scores at 1 and 6 mo after combination treatment decreased compared to before treatment(P<0.001),and the overall response rate was 93.3%.Only one case recurred,yielding a 6.7%recurrence rate.The incidence of local chromour sedimentation rate in 1–3 mo after radiotherapy was 33.3%(5 patients),all subsiding after 6–9 mo,without complications,such as delayed wound healing or dermatitis.CONCLUSION Surgical resection,super subtraction sutures,and superficial radiotherapy are treatment methods with short courses,low recurrence rates,and good safety profiles.
基金supported by the State Key Program of National Natural Science Foundation of China(Grant No.12132003)State Key Laboratory of Explosion Science and Technology(Grant No.QNKT20-07)。
文摘The time-sequenced damage behavior of the reactive projectile impacting double-layer plates is discussed.The analytical model considering the combined effect of kinetic and chemical energy is developed to reveal the damage mechanism.The influences of impact velocity and reactive projectile chemical characteristics on the damage effect are decoupled analyzed based on this model.These analyses indicate that the high energy releasing efficiency and fast reaction propagation velocity of the reactive projectile are conducive to enhancing the damage effect.The experiments with various reactive projectiles impact velocity increasing from 702 to 1385 m/s were conducted to verify this model.The experimental results presented that,the damage hole radius of the rear-plate increases with the increase of impact velocity.At the impact velocity of 1350 m/s,the radius of damage hole formed by PTFE/Al/Bi_(2)O_(3),PTFE/Al/MoO_(3),PTFE/Al/Fe_(2)O_(3)projectile on the rear-plate become smaller in sequence.These results are consistent with the analytical model prediction,demonstrating that this model can predict the damage effect quantitatively.This work is of constructive significance to the application of reactive projectiles.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.11905151 and 11875198)the National Key Research and Development Program of China(Grant No.2022YFE03130000)。
文摘Gas-driven permeation(GDP)and plasma-driven permeation(PDP)of hydrogen gas through Ga In Sn/Fe are systematically investigated in this work.The permeation parameters of hydrogen through Ga In Sn/Fe,including diffusivity,Sieverts'constant,permeability,and surface recombination coefficient are obtained.The permeation flux of hydrogen through Ga In Sn/Fe shows great dependence on external conditions such as temperature,hydrogen pressure,and thickness of liquid Ga In Sn.Furthermore,the hydrogen permeation behavior through Ga In Sn/Fe is well consistent with the multilayer permeation theory.In PDP and GDP experiments,hydrogen through Ga In Sn/Fe satisfies the diffusion-limited regime.In addition,the permeation flux of PDP is greater than that of GDP.The increase of hydrogen plasma density hardly causes the hydrogen PDP flux to change within the test scope of this work,which is due to the dissolution saturation.These findings provide guidance for a comprehensive and systematic understanding of hydrogen isotope recycling,permeation,and retention in plasma-facing components under actual conditions.
文摘Dear Editor,We report a case of severe hemorrhagic Descemet’s membrane detachment(HDD)following ab external360-degree suture trabeculotomy with trabeculectomy that was successfully managed with the guidance of bedside anterior segment optical coherence tomography(ASOCT).Descemet’s membrane detachment(DMD)is a complication that impairs vision and is commonly observed after cataract surgery.It’s reported a high incidence(25%-82%)of focal DMD that were mostly subclinical and detected only with gonioscopy[1].
基金Funded by the Natural Science Foundation of Nanping of China(No.N2021J002)Guangdong Basic and Applied Basic Research Foundation(No.2020A1515110304)+3 种基金Guangzhou Science and Technology Plan(No.202102020224)Natural Science Foundation of Fujian Province(No.2020Y0092)Natural Science Foundation of Fujian Province(No.2023J011044)Resource Chemical Industry and Technology Foundation of Nanping(No.N2020Z003)。
文摘To develop the microwave absorbing(MA)properties of cementitious material mixed with mine solid waste,the iron tailings cementitious microwave absorbing materials were prepared.The iron tailings was treated into different particle sizes by planetary ball mill,and the physicochemical properties of iron tailings were tested by laser particle size analyzer and scanning electron microscope(SEM).The electromagnetic parameters of iron tailings cementitious materials were characterized by a vector network analyzer and simulated MA properties,and the MA properties of iron tailings-cement composite system with steel fiber as absorber was studied.Based on the design of the single-layer structure,optimum mix ratio and thickness configuration method of double-layer structure were further studied,meanwhile,the mechanical properties and engineering application were analyzed and discussed.The results show that the particle size of iron tailings can afiect its electromagnetic behavior in cementitious materials,and the smaller particles lead the increase of demagnetisation efiect induced by domain wall motion and achieve better microwave absorbing properties in cementitious materials.When the thickness of matching layer and absorbing layer is 5 mm,the optimized microwave absorbing properties of C1/C3 double-layer cementitious material can obtain optimal RL value of-27.61 dB and efiective absorbing bandwidth of 0.97 GHz,which attributes to the synergistic efiect of impedance matching and attenuation characteristics.The double-layer microwave absorbing materials obtain excellent absorbing properties and show great design flexibility and diversity,which can be used as a suitable candidate for the preparation of favorable microwave absorbing cementitious materials.
基金supported by the National Key Research and Development Program of China(2022YFC3401600)the National Natural Science Foundation of China(32171372)+2 种基金the Program A for Outstanding PhD Candidate of Nanjing University(202102A004)the Logistics Research Projects(BWS20J017)the University of Sydney–China Scholarship Council(USYD-CSC)scholarship(202008320366)。
文摘The transplantation of full-thickness skin grafts(FTSGs)is important for reconstructing skin barrier and promoting wound healing.Sufficient oxygen supply is closely related to the success of skin grafting.However,full-thickness oxygen delivery is limited by the poor oxygen permeability of skin.Oxygen-releasing sutures(O_(2)sutures)were developed to facilitate oxygen penetration through full-thickness skin.The O_(2)sutures delivered 100 times more oxygen than topical gaseous oxygen therapy at a 15 mm depth in the skin model.Under extreme hypoxia(<0.5%O_(2),v/v),O_(2)sutures could also promote endothelial cell proliferation.After the transplantation of FTSGs in mice,O_(2)sutures accelerated blood re-perfusion and increased the survival area of the skin graft.It is expected that O_(2)sutures will be adopted in clinical applications to increase the success rate of full-thickness skin transplantation.
基金supported by the NationalNatural Science Foundation of China Under Grant 61961017Key R&D Plan Projects in Hubei Province 2022BAA060.
文摘To reduce the comprehensive costs of the construction and operation of microgrids and to minimize the power fluctuations caused by randomness and intermittency in distributed generation,a double-layer optimizing configuration method of hybrid energy storage microgrid based on improved grey wolf optimization(IGWO)is proposed.Firstly,building a microgrid system containing a wind-solar power station and electric-hydrogen coupling hybrid energy storage system.Secondly,the minimum comprehensive cost of the construction and operation of the microgrid is taken as the outer objective function,and the minimum peak-to-valley of the microgrid’s daily output is taken as the inner objective function.By iterating through the outer and inner layers,the system improves operational stability while achieving economic configuration.Then,using the energy-self-smoothness of the microgrid as the evaluation index,a double-layer optimizing configuration method of the microgrid is constructed.Finally,to improve the disadvantages of grey wolf optimization(GWO),such as slow convergence in the later period and easy falling into local optima,by introducing the convergence factor nonlinear adjustment strategy and Cauchy mutation operator,an IGWO with excellent global performance is proposed.After testing with the typical test functions,the superiority of IGWO is verified.Next,using IGWO to solve the double-layer model.The case analysis shows that compared to GWO and particle swarm optimization(PSO),the IGWO reduced the comprehensive cost by 15.6%and 18.8%,respectively.Therefore,the proposed double-layer optimizationmethod of capacity configuration ofmicrogrid with wind-solar-hybrid energy storage based on IGWO could effectively improve the independence and stability of the microgrid and significantly reduce the comprehensive cost.
基金the National Natural Science Foundation of China,No.82172737 and 82003277Shanghai Municipal Education Commission,No.16411950403 and 19411951605。
文摘BACKGROUND Large or transmural defects induced by gastrointestinal endoscopic manipulations are difficult to close,although complete closure is recommended for better recovery.Endoscopic purse-string assisted suturing(EPSS)has been used in clinical practice and has proven to be an effective and safe technique for the closure of large mucosal defects.However,details regarding the efficacy of endoscopic pre-purse-string suture(P-EPSS)are unknown,especially that it offers several advantages over conventional EPSS(C-EPSS).AIM To elucidate the outcomes of EPSS-assisted closure in different clinical situations,and evaluate the efficacy of P-EPSS.METHODS This retrospective observational study included a total of 180 patients who underwent closure assisted by P-EPSS(n=63)or C-EPSS(n=117)between July 2014 and June 2020.The P-EPSS and C-EPSS groups were compared and the intergroup differences in aspects such as the lesion size,location,and morphology,incidence of complete closure,intraoperative perforation,and delayed adverse events were evaluated.Data on the features and clinical course of cases with adverse events were collected for further analysis.RESULTS Patients with lesion size larger than 3 cm,lesions located at the fundus of stomach,or submucosal tumors originating from the deep mucosa were more likely to undergo P-EPSS-assisted closure.The P-EPSS group showed a significantly higher proportion of intraoperative perforation(56%vs 17%)and a much shorter procedure time(9.06±6.14 min vs 14.84±7.25 min).Among adverse events,the incidence of delayed perforation(5%vs 4%;P=0.82)and delayed bleeding(3%vs 4%;P=0.96)did not differ significantly between the groups.Multivariate analysis revealed that lesions with incomplete closure[odds ratio(OR)=21.33;95%confidence interval(CI):5.45-83.45;P<0.01]or size greater than 3 cm(OR=3.14;95%CI:1.08-9.18;P=0.039)showed a statistical tendency to result in an increase in delayed adverse events.CONCLUSION The present study revealed that EPSS could achieve secure complete closure of mucosal defect.PEPSS could shorten the procedure and yield complete closure of mucosal defects.Rather than closure-type selection,incomplete closure or lesion size larger than 3 cm were associated with worse outcomes.
基金the Natural Science Foundation of Shandong Province,No.ZR2020MH257。
文摘BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors.However,the traditional interrupted suturing technique used in enterostomy closure surgery has several issues,including longer surgical incisions and higher incision tension,which can increase the risk of postoperative complications.To address these issues,scholars have proposed the use of a“gunsight suture”technique.This technique involves using a gunsight incision instead of a traditional linear incision,leaving a gap in the center for the drainage of blood and fluid to reduce the risk of infection.Building on this technique,we propose an improved gunsight suture technique.A drainage tube is placed at the lowest point of the incision and close the gap in the center of the gunsight suture,which theoretically facilitates early postoperative mobility and reduces the burden of dressing changes,thereby reducing the risk of postoperative complications.AIM To compare the effectiveness of improved gunsight suture technique with traditional interrupted suture in closing intestinal stomas.METHODS In this study,a retrospective,single-center case analysis was conducted on 270 patients who underwent prophylactic ileostomy closure surgery at the Department of Colorectal Surgery of Qilu Hospital from April 2017 to December 2021.The patients were divided into two groups:135 patients received sutures using the improved gunsight method,while the remaining 135 patients were sutured with the traditional interrupted suture method.We collected data on a variety of parameters,such as operation time,postoperative pain score,body temperature,length of hospital stays,laboratory indicators,incidence of incisional complications,number of wound dressing changes,and hospitalization costs.Non-parametric tests and chi-square tests were utilized for data analysis.RESULTS There were no statistically significant differences in general patient information between the two groups,including the interval between the first surgery and the stoma closure[132(105,184)d vs 134(109,181)d,P=0.63],gender ratio(0.64 vs 0.69,P=0.44),age[62(52,68)years vs 60(52,68)years,P=0.33],preoperative body mass index(BMI)[23.83(21.60,25.95)kg/m²vs 23.12(20.94,25.06)kg/m²,P=0.17].The incidence of incision infection in the improved gunsight suture group tended to be lower than that in the traditional interrupted suture group[(n=2/135,1.4%)vs(n=10/135,7.4%),P<0.05],and the postoperative hospital stay in the improved gunsight suture group was significantly shorter than that in the traditional interrupted suture group[5(4,7)d vs 7(6,8)d,P<0.05].Additionally,the surgical cost in the modified gunsight suture group was slightly lower than that in the traditional suture group[4840(4330,5138)yuan vs 4980(4726,5221)yuan,P>0.05],but there was no significant difference in the total hospitalization cost between the two groups.CONCLUSION In stoma closure surgery,the improved gunsight technique can reduce the incision infection rate,shorten the postoperative hospital stay,reduce wound tension,and provide better wound cosmetic effects compared to traditional interrupted suture.
基金the National Natural Science Foundation of China(Nos.41730210,41888101).
文摘South Tianshan–Solonker suture,is the largest and southernmost suture within the Central Asian orogenic belt(CAOB).It records the ultimate collision between Tarim–North China cratons and Siberia craton,and is commonly interpreted as marking the eventual closure of Paleo-Asian Ocean.South Tianshan suture belongs to the western segment of the suture zone,and its evolutionary features are important for defining the formation age of the South Tianshan–Solonker suture.In this paper,the authors review the geochronological,geochemical,petrographic,and paleontological evidence within South Tianshan suture to delineate its formation era and closure characteristics,and thus further revealing the ultimate evolutionary pattern of the western segment of Paleo-Asian Ocean.This suture records strong plate collision before Late Carboniferous,forming a series of high-pressure metamorphic rocks,characterized by the presence of blue schist,eclogite and mica schist.In Permian,the whole area was under a relatively stable post-orogenic setting,with the formation of bimodal volcanic rocks,post-collisional granites,and terrestrial molasses.Sedimentary facies gradually changed from marine to either lacustrine or fluvial during this period.An Early Permian granite dike crosscuts the HP metamorphic belt,and the HP metamorphic rocks also underwent retrograde metamorphism at this time,indicating the formation of the South Tianshan suture was earlier than Permian.Hence,the western section of Paleo-Asian Ocean closed during Late Carboniferous,and Tarim Craton moved northward to collide with Kazakhstan–Yili Block,leading to the formation of the South Tianshan suture.
文摘Objective:This paper aims to compare the effect of skin staple suture and traditional silk suture in scalp suture surgery.Methods:A total of 80 craniocerebral surgery patients were included in this study,and the patients were randomly divided into observation group and control group,with 40 cases in each group.The observation group used disposable skin stapler to suture the scalp incision,and the control group used conventional silk suture to suture the incision.Statistical analysis was carried out on 6 indicators including suturing speed,healing under-scab,incision necrosis,incision cerebrospinal fluid(CSF)leakage,incision infection,and postoperative“centipede-shaped”scar incidence rate of the two suture methods.Results:There was no significant difference between the groups in terms of postoperative healing under-scab,incision necrosis,incision CSF leakage,and intracranial infection(P>0.05).The suturing speed in the observation group was 15.2±0.7 cm/min,which was significantly faster than 7.4±0.3 cm/min in the control group(P<0.05).The incidence of“centipede-shaped”scars in the observation group was significantly lower than that in the control group at 1 to 6 months after operation(P<0.05).Conclusion:Compared with traditional silk suture,skin staple suture has obvious advantages in suture speed and cosmetic effect.
基金supported by the New Technology and New Project of Jinxiang Hospital Affiliated to Jining Medical University(No.JY2021022).
文摘Background:Surgical site infection(SSI)is the most common complication after stoma closure and is particularly common in obese patients.To reduce the incidence of SSI,various skin closure techniques have been proposed;however,the best technique is still under debate.The purpose of this study was to explore the effectiveness of subcutaneous vacuum drains(SVDs)after two surgical suture techniques following stoma reversal in obese patients. Methods:Data from 190 obese patients with rectal cancer who underwent stoma reversal for enterostomy between February 2012 and April 2023 at Jinxiang Hospital Affiliated to Jining Medical University were retrospectively analyzed.These patients were divided into two groups:gunsight suture(GS)with SVD and primary linear suture(PLS)with SVD.The GS group and PLS group included 90 and 100 patients,respectively.The clinical characteristics and short-term outcomes were compared between the two groups.Postoperative pain scores were analyzed using a generalized estimation equation. Results:Surgery was successfully performed in both groups.The rate of SSI in the GS group was significantly lower than that in the PLS group(2.2%vs 9.0%,P=0.046).Patients in the GS group had a significantly shorter wound healing time than did patients in the PLS group,as well as a significantly shorter postoperative fasting time(P<0.05).No significant differences were found between the groups in terms of the postoperative hospital stay,operative time,and estimated blood loss(P>0.05).The results of the generalized estimation equation analysis showed that the GS group had significantly lower pain scores at 12,24,48,and 72 h after surgery than the PLS group(P<0.05).Moreover,the GS group showed significantly better alleviation of wound pain between 12 and 72 h after surgery(P<0.05). Conclusions:The GS technique with SVD may be recommended for wound closure of a nonfunctioning stoma in obese patients.