Two-dimensional time-resolved particle image velocimetry(TR-PIV)and stereographic particle image velocimetry(SPIV)techniques were used to investigate the effect of leading-edge tubercles on the flow over low-aspect-ra...Two-dimensional time-resolved particle image velocimetry(TR-PIV)and stereographic particle image velocimetry(SPIV)techniques were used to investigate the effect of leading-edge tubercles on the flow over low-aspect-ratio wing models.The angle of attack is fixed at 10°,and the Reynolds number based on chord length is 5.8×10^(3).It is shown that the leading-edge tubercles can effectively mitigate flow separation in the model and also reduce the contribution of wake vortex to the fluctuating energy of flow.Counter-rotating vortex pairs(CVPs)initiated from the peak of leading-edge tubercles can promote nearby momentum exchange,enhance mixing of the flow and increase the energy contained in the boundary layer,which results in resisting the larger adverse pressure gradient.Therefore,it is concluded that CVPs play an important role in mitigating the flow separation for wings with leading-edge tubercles.展开更多
BACKGROUND The spleen is the most commonly injured solid organ in blunt abdominal trauma,and splenic pseudoaneurysm rupture is associated with a high risk of mortality.Nonoperative management has become the standard t...BACKGROUND The spleen is the most commonly injured solid organ in blunt abdominal trauma,and splenic pseudoaneurysm rupture is associated with a high risk of mortality.Nonoperative management has become the standard treatment for hemodynam-ically stable patients with splenic injuries.On the other hand,delayed splenic pseudoaneurysms can develop in any patient,and at present,there are no known risk factors that may reliably predict their occurrence.Furthermore,there is a lack of consensus regarding the most appropriate strategies for monitoring and mana-ging splenic injuries,especially lower-grade(I-III).AIM To determine the predictors of pseudo-aneurysm formation following splenic injury and develop follow-up strategies for early detection of pseudoaneurysms.METHODS We retrospectively analyzed patients who visited the Level I Trauma Center bet-ween January 2013 and December 2022 and were diagnosed with spleen injuries after blunt abdominal trauma.RESULTS Using the American Association for the Surgery of Trauma spleen injury scale,the splenic injuries were categorized into the following order based on severity:Grade I(n=57,17.6%),grade II(n=114,35.3%),grade III(n=89,27.6%),grade IV(n=50,15.5%),and grade V(n=13,4.0%).Of a total of 323 patients,35 underwent splenectomy and 126 underwent angioembolization.19 underwent delayed angioembolization,and 5 under-went both initial and delayed angioem-bolization.In 14 patients who had undergone delayed angioembolization,no extravasation or pseudoaneurysm was observed on the initial computed tomography scan.There are no particular patient-related risk factors for the formation of a delayed splenic pseudoaneurysm,which can occur even in a grade I spleen injury or even 21 days after the injury.The mean detection time for a delayed pseudoaneurysm was 6.26±5.4(1-21,median:6,inter-quartile range:2-9)days.CONCLUSION We recommend regular follow-up computed tomography scans,including an arterial and portal venous phase,at least 1 week and 1 month after injury in any grade of blunt traumatic spleen injury for the timely detection of delayed pseudoaneurysms.展开更多
BACKGROUND Pelvic fractures(PF)with concomitant injuries are on the rise due to an increase of high-energy trauma.Increase of the elderly population with age related comorbidities further complicates the management.Ab...BACKGROUND Pelvic fractures(PF)with concomitant injuries are on the rise due to an increase of high-energy trauma.Increase of the elderly population with age related comorbidities further complicates the management.Abdominal organ injuries are kindred with PF due to the proximity to pelvic bones.Presence of contrast blush(CB)on computed tomography in patients with PF is considered a sign of active bleeding,however,its clinical significance and association with outcomes is debatable.AIM To analyze polytrauma patients with PF with a focus on the geriatric population,co-injuries and the value of contrast blush.METHODS This retrospective cohort study included 558 patients with PF admitted to level 1 trauma center(01/2017-01/2023).Analyzed variables included:Age,sex,mechanism of injury(MOI),injury severity score(ISS),Glasgow coma scale(GCS),abbreviated injury scale(AIS),co-injuries,transfusion requirements,pelvic angiography,embolization,laparotomy,orthopedic pelvic surgery,intensive care unit and hospital lengths of stay,discharge disposition and mortality.The study compared geriatric and non-geriatric patients,patients with and without CB and abdominal co-injuries.Propensity score matching was implemented in comparison groups.RESULTS PF comprised 4%of all trauma admissions.89 patients had CB.286(52%)patients had concomitant injuries including 93(17%)patients with abdominal co-injuries.Geriatric patients compared to non-geriatric had more falls as MOI,lower ISS and AIS pelvis,higher GCS,less abdominal co-injuries,similar CB and angio-embolization rates,less orthopedic pelvic surgeries,shorter lengths of stay and higher mortality.After propensity matching,orthopedic pelvic surgery rates remained lower(8%vs 19%,P<0.001),hospital length of stay shorter,and mortality higher(13%vs 4%,P<0.001)in geriatric patients.Out of 89 patients with CB,45(51%)were embolized.After propensity matching,patients with CB compared to without CB had more pelvic angiography(71%vs 12%,P<0.001),higher embolization rates(64%vs 22%,P=0.02)and comparable mortality.CONCLUSION Half of the patients with PF had concomitant co-injuries,including abdominal co-injuries in 17%.Similarly injured geriatric patients had higher mortality.Half of the patients with CB required an embolization.展开更多
Stability and transition prediction of hypersonic boundary layer on a blunt cone with small nose bluntness at zero angle of attack was investigated. The nose radius of the cone is 0.5 mm; the cone half-angle is 5°...Stability and transition prediction of hypersonic boundary layer on a blunt cone with small nose bluntness at zero angle of attack was investigated. The nose radius of the cone is 0.5 mm; the cone half-angle is 5°, and the Mach number of the oncoming flow is 6. The base flow of the blunt cone was obtained by direct numerical simulation. The linear stability theory was applied for the analysis of the first mode and the second mode unstable waves under both isothermal and adiabatic wall condition, and e^N method was used for the prediction of transition location. The N factor was tentatively taken as 10, as no experimentally confirmed value was available. It is found that the wall temperature condition has a great effect on the transition location. For adiabatic wall, transition would take place more rearward than those for isothermal wall. And despite that for high Mach number flows, the maximum amplification rate of the second mode wave is far bigger than the maximum amplification rate of the first mode wave, the transition location of the boundary layer with adiabatic wall is controlled by the growth of first mode unstable waves. The methods employed in this paper are expected to be also applicable to the transition prediction for the three dimensional boundary layers on cones with angle of attack.展开更多
The laminar-turbulent transition has always been a hot topic of fluid mechanics. Receptivity is the initial stage and plays a crucial role in the entire transition process. The previous studies of receptivity focus on...The laminar-turbulent transition has always been a hot topic of fluid mechanics. Receptivity is the initial stage and plays a crucial role in the entire transition process. The previous studies of receptivity focus on external disturbances such as sound waves and vortices in the free stream, whereas those on the leading-edge receptivity to the three-dimensional free-stream turbulence (FST), which is more general in the nature, are rarely reported. In consideration of this, this work is devoted to investigating the receptivity process of three-dimensional Tollmien-Schlichting (T-S) wave packets excited by the three-dimensional FST in a flat-plate boundary layer numerically. The relations between the leading-edge receptivity and the turbulence intensity are established, and the influence of the FST directions on the propagation directions and group velocities of the excited T-S wave packets is studied. Moreover, the leading-edge receptivity to the anisotropic FST is also studied. This parametric investigation can contribute to the prediction of laminar-turbulent transition.展开更多
A physical mechanism by which nose bluntness suppresses second-mode instability is proposed.Considered are 7 degree half-angle straight cones with nose bluntness radii of 0.15 mm, 3.556 mm,5 mm, 9.525 mm, 12.7 mm and ...A physical mechanism by which nose bluntness suppresses second-mode instability is proposed.Considered are 7 degree half-angle straight cones with nose bluntness radii of 0.15 mm, 3.556 mm,5 mm, 9.525 mm, 12.7 mm and 25.4 mm at tunnel conditions relevant to the AFOSR-Notre Dame Large Mach 6 Quiet Tunnel. It is shown that second-mode suppression is achieved via entropy layer modulation of the basic state density gradient. A weakening of the density gradient disrupts the acoustic resonance necessary to sustain second-mode growth. These results are consistent with the thermoacoustic interpretation which posits that second-mode instability can be modeled as thermoacoustic resonance of acoustic energy trapped within an acoustic impedance well.Furthermore, the generalized inflection point criterion of Lees and Lin is applied to develop a criterion for the existence of second-mode instability based on the strength of the basic state density gradient.展开更多
We reported an 8-year-old boy with panscleritis in left eye and right epididymitis after falling on the ground.Etiologic diagnosis played a key role in this case.Systemic examinations ruled out systemic autoimmune dis...We reported an 8-year-old boy with panscleritis in left eye and right epididymitis after falling on the ground.Etiologic diagnosis played a key role in this case.Systemic examinations ruled out systemic autoimmune diseases,tumors,and infections as the cause of scleritis and suggested that the disease was caused by a local delayedtype hypersensitivity(DTH)induced by ocular trauma and was non-infectious.Still,the right epididymitis was infectious.Both conditions were treated successfully using steroids and antibiotics,respectively.Thus,early etiologic diagnosis and reasonable treatment are crucial to prevent visual loss.展开更多
Retinal injury after blunt ocular trauma may directly affect prognosis and lead to vision loss.To investigate the pathological changes and molecular mechanisms involved in retinal injury after blunt ocular trauma,we e...Retinal injury after blunt ocular trauma may directly affect prognosis and lead to vision loss.To investigate the pathological changes and molecular mechanisms involved in retinal injury after blunt ocular trauma,we established a weight drop injury model of blunt ocular trauma in male Beagle dogs.Hematoxylin-eosin staining,immunofluorescence staining,western blotting,and TUNEL assays were performed to investigate retinal injury within 14 days after blunt ocular trauma.Compared with the control group,the thicknesses of the inner and outer nuclear layers,as well as the number of retinal ganglion cells,gradually decreased within 14 days after injury.The number of bipolar cells in the inner nuclear layer began to decrease 1 day after injury,while the numbers of cholinergic and amacrine cells in the inner nuclear layer did not decrease until 7 days after injury.Moreover,retinal cell necroptosis increased with time after injury;it progressed from the ganglion cell layer to the outer nuclear layer.Visual electrophysiological findings indicated that visual impairment began on the first day after injury and worsened over time.Additionally,blunt ocular trauma induced nerve regeneration and Müller glial hyperplasia;it also resulted in the recruitment of microglia to the retina and polarization of those microglia to the M1 phenotype.These findings suggest that necroptosis plays an important role in exacerbating retinal injury after blunt ocular trauma via gliosis and neuroinflammation.Such a role has important implications for the development of therapeutic strategies.展开更多
BACKGROUND Traumatic internal carotid artery(ICA)occlusion is a rare complication of skull base fractures,characterized by high mortality and disability rates,and poor prognosis.Therefore,timely discovery and correct ...BACKGROUND Traumatic internal carotid artery(ICA)occlusion is a rare complication of skull base fractures,characterized by high mortality and disability rates,and poor prognosis.Therefore,timely discovery and correct management are crucial for saving the lives of such patients and improving their prognosis.This article retrospectively analyzed the imaging and clinical data of three patients,to explore the imaging characteristics and treatment strategies for carotid artery occlusion,combined with severe skull base fractures.CASE SUMMARY This case included three patients,all male,aged 21,63,and 16 years.They underwent plain film skull computed tomography(CT)examination at the onset of their illnesses,which revealed fractures at the bases of their skulls.Ultimately,these cases were definitively diagnosed through CT angiography(CTA)examinations.The first patient did not receive surgical treatment,only anticoagulation therapy,and recovered smoothly with no residual limb dysfunction(Case 1).The other two patients both developed intracranial hypertension and underwent decompressive craniectomy.One of these patients had high intracranial pressure and significant brain swelling postoperatively,leading the family to choose to take him home(Case 2).The other patient also underwent decompressive craniectomy and recovered well postoperatively with only mild limb motor dysfunction(Case 3).We retrieved literature from PubMed on skull base fractures causing ICA occlusion to determine the imaging characteristics and treatment strategies for this type of disease.CONCLUSION For patients with cranial trauma combined with skull base fractures,it is essential to complete a CTA examination as soon as possible,to screen for blunt cerebrovascular injury.展开更多
基金financial support from the National Natural Science Foundation of China under grand No.11721202。
文摘Two-dimensional time-resolved particle image velocimetry(TR-PIV)and stereographic particle image velocimetry(SPIV)techniques were used to investigate the effect of leading-edge tubercles on the flow over low-aspect-ratio wing models.The angle of attack is fixed at 10°,and the Reynolds number based on chord length is 5.8×10^(3).It is shown that the leading-edge tubercles can effectively mitigate flow separation in the model and also reduce the contribution of wake vortex to the fluctuating energy of flow.Counter-rotating vortex pairs(CVPs)initiated from the peak of leading-edge tubercles can promote nearby momentum exchange,enhance mixing of the flow and increase the energy contained in the boundary layer,which results in resisting the larger adverse pressure gradient.Therefore,it is concluded that CVPs play an important role in mitigating the flow separation for wings with leading-edge tubercles.
文摘BACKGROUND The spleen is the most commonly injured solid organ in blunt abdominal trauma,and splenic pseudoaneurysm rupture is associated with a high risk of mortality.Nonoperative management has become the standard treatment for hemodynam-ically stable patients with splenic injuries.On the other hand,delayed splenic pseudoaneurysms can develop in any patient,and at present,there are no known risk factors that may reliably predict their occurrence.Furthermore,there is a lack of consensus regarding the most appropriate strategies for monitoring and mana-ging splenic injuries,especially lower-grade(I-III).AIM To determine the predictors of pseudo-aneurysm formation following splenic injury and develop follow-up strategies for early detection of pseudoaneurysms.METHODS We retrospectively analyzed patients who visited the Level I Trauma Center bet-ween January 2013 and December 2022 and were diagnosed with spleen injuries after blunt abdominal trauma.RESULTS Using the American Association for the Surgery of Trauma spleen injury scale,the splenic injuries were categorized into the following order based on severity:Grade I(n=57,17.6%),grade II(n=114,35.3%),grade III(n=89,27.6%),grade IV(n=50,15.5%),and grade V(n=13,4.0%).Of a total of 323 patients,35 underwent splenectomy and 126 underwent angioembolization.19 underwent delayed angioembolization,and 5 under-went both initial and delayed angioem-bolization.In 14 patients who had undergone delayed angioembolization,no extravasation or pseudoaneurysm was observed on the initial computed tomography scan.There are no particular patient-related risk factors for the formation of a delayed splenic pseudoaneurysm,which can occur even in a grade I spleen injury or even 21 days after the injury.The mean detection time for a delayed pseudoaneurysm was 6.26±5.4(1-21,median:6,inter-quartile range:2-9)days.CONCLUSION We recommend regular follow-up computed tomography scans,including an arterial and portal venous phase,at least 1 week and 1 month after injury in any grade of blunt traumatic spleen injury for the timely detection of delayed pseudoaneurysms.
文摘BACKGROUND Pelvic fractures(PF)with concomitant injuries are on the rise due to an increase of high-energy trauma.Increase of the elderly population with age related comorbidities further complicates the management.Abdominal organ injuries are kindred with PF due to the proximity to pelvic bones.Presence of contrast blush(CB)on computed tomography in patients with PF is considered a sign of active bleeding,however,its clinical significance and association with outcomes is debatable.AIM To analyze polytrauma patients with PF with a focus on the geriatric population,co-injuries and the value of contrast blush.METHODS This retrospective cohort study included 558 patients with PF admitted to level 1 trauma center(01/2017-01/2023).Analyzed variables included:Age,sex,mechanism of injury(MOI),injury severity score(ISS),Glasgow coma scale(GCS),abbreviated injury scale(AIS),co-injuries,transfusion requirements,pelvic angiography,embolization,laparotomy,orthopedic pelvic surgery,intensive care unit and hospital lengths of stay,discharge disposition and mortality.The study compared geriatric and non-geriatric patients,patients with and without CB and abdominal co-injuries.Propensity score matching was implemented in comparison groups.RESULTS PF comprised 4%of all trauma admissions.89 patients had CB.286(52%)patients had concomitant injuries including 93(17%)patients with abdominal co-injuries.Geriatric patients compared to non-geriatric had more falls as MOI,lower ISS and AIS pelvis,higher GCS,less abdominal co-injuries,similar CB and angio-embolization rates,less orthopedic pelvic surgeries,shorter lengths of stay and higher mortality.After propensity matching,orthopedic pelvic surgery rates remained lower(8%vs 19%,P<0.001),hospital length of stay shorter,and mortality higher(13%vs 4%,P<0.001)in geriatric patients.Out of 89 patients with CB,45(51%)were embolized.After propensity matching,patients with CB compared to without CB had more pelvic angiography(71%vs 12%,P<0.001),higher embolization rates(64%vs 22%,P=0.02)and comparable mortality.CONCLUSION Half of the patients with PF had concomitant co-injuries,including abdominal co-injuries in 17%.Similarly injured geriatric patients had higher mortality.Half of the patients with CB required an embolization.
基金Project supported by the National Natural Science Foundation of China (No.10632050)the Science Foundation of Liu-Hui Center of Applied Mathematics of Nankai University and Tianjin University.
文摘Stability and transition prediction of hypersonic boundary layer on a blunt cone with small nose bluntness at zero angle of attack was investigated. The nose radius of the cone is 0.5 mm; the cone half-angle is 5°, and the Mach number of the oncoming flow is 6. The base flow of the blunt cone was obtained by direct numerical simulation. The linear stability theory was applied for the analysis of the first mode and the second mode unstable waves under both isothermal and adiabatic wall condition, and e^N method was used for the prediction of transition location. The N factor was tentatively taken as 10, as no experimentally confirmed value was available. It is found that the wall temperature condition has a great effect on the transition location. For adiabatic wall, transition would take place more rearward than those for isothermal wall. And despite that for high Mach number flows, the maximum amplification rate of the second mode wave is far bigger than the maximum amplification rate of the first mode wave, the transition location of the boundary layer with adiabatic wall is controlled by the growth of first mode unstable waves. The methods employed in this paper are expected to be also applicable to the transition prediction for the three dimensional boundary layers on cones with angle of attack.
基金supported by the National Natural Science Foundation of China(Nos.11472139 and11802143)the Natural Science Foundation of Jiangsu Province of China(No.BK20180781)
文摘The laminar-turbulent transition has always been a hot topic of fluid mechanics. Receptivity is the initial stage and plays a crucial role in the entire transition process. The previous studies of receptivity focus on external disturbances such as sound waves and vortices in the free stream, whereas those on the leading-edge receptivity to the three-dimensional free-stream turbulence (FST), which is more general in the nature, are rarely reported. In consideration of this, this work is devoted to investigating the receptivity process of three-dimensional Tollmien-Schlichting (T-S) wave packets excited by the three-dimensional FST in a flat-plate boundary layer numerically. The relations between the leading-edge receptivity and the turbulence intensity are established, and the influence of the FST directions on the propagation directions and group velocities of the excited T-S wave packets is studied. Moreover, the leading-edge receptivity to the anisotropic FST is also studied. This parametric investigation can contribute to the prediction of laminar-turbulent transition.
基金support from the Air Force Office of Scientific Research(AFOSR)(Grant FA9550-20-10047)。
文摘A physical mechanism by which nose bluntness suppresses second-mode instability is proposed.Considered are 7 degree half-angle straight cones with nose bluntness radii of 0.15 mm, 3.556 mm,5 mm, 9.525 mm, 12.7 mm and 25.4 mm at tunnel conditions relevant to the AFOSR-Notre Dame Large Mach 6 Quiet Tunnel. It is shown that second-mode suppression is achieved via entropy layer modulation of the basic state density gradient. A weakening of the density gradient disrupts the acoustic resonance necessary to sustain second-mode growth. These results are consistent with the thermoacoustic interpretation which posits that second-mode instability can be modeled as thermoacoustic resonance of acoustic energy trapped within an acoustic impedance well.Furthermore, the generalized inflection point criterion of Lees and Lin is applied to develop a criterion for the existence of second-mode instability based on the strength of the basic state density gradient.
基金Supported by Beijing Natural Science Foundation(7202229).
文摘We reported an 8-year-old boy with panscleritis in left eye and right epididymitis after falling on the ground.Etiologic diagnosis played a key role in this case.Systemic examinations ruled out systemic autoimmune diseases,tumors,and infections as the cause of scleritis and suggested that the disease was caused by a local delayedtype hypersensitivity(DTH)induced by ocular trauma and was non-infectious.Still,the right epididymitis was infectious.Both conditions were treated successfully using steroids and antibiotics,respectively.Thus,early etiologic diagnosis and reasonable treatment are crucial to prevent visual loss.
基金supported by the National Natural Science Foundation of China,No.81600738the Youth Development Project of Air Force Medical University,No.21QNPY072(both to FF)。
文摘Retinal injury after blunt ocular trauma may directly affect prognosis and lead to vision loss.To investigate the pathological changes and molecular mechanisms involved in retinal injury after blunt ocular trauma,we established a weight drop injury model of blunt ocular trauma in male Beagle dogs.Hematoxylin-eosin staining,immunofluorescence staining,western blotting,and TUNEL assays were performed to investigate retinal injury within 14 days after blunt ocular trauma.Compared with the control group,the thicknesses of the inner and outer nuclear layers,as well as the number of retinal ganglion cells,gradually decreased within 14 days after injury.The number of bipolar cells in the inner nuclear layer began to decrease 1 day after injury,while the numbers of cholinergic and amacrine cells in the inner nuclear layer did not decrease until 7 days after injury.Moreover,retinal cell necroptosis increased with time after injury;it progressed from the ganglion cell layer to the outer nuclear layer.Visual electrophysiological findings indicated that visual impairment began on the first day after injury and worsened over time.Additionally,blunt ocular trauma induced nerve regeneration and Müller glial hyperplasia;it also resulted in the recruitment of microglia to the retina and polarization of those microglia to the M1 phenotype.These findings suggest that necroptosis plays an important role in exacerbating retinal injury after blunt ocular trauma via gliosis and neuroinflammation.Such a role has important implications for the development of therapeutic strategies.
文摘BACKGROUND Traumatic internal carotid artery(ICA)occlusion is a rare complication of skull base fractures,characterized by high mortality and disability rates,and poor prognosis.Therefore,timely discovery and correct management are crucial for saving the lives of such patients and improving their prognosis.This article retrospectively analyzed the imaging and clinical data of three patients,to explore the imaging characteristics and treatment strategies for carotid artery occlusion,combined with severe skull base fractures.CASE SUMMARY This case included three patients,all male,aged 21,63,and 16 years.They underwent plain film skull computed tomography(CT)examination at the onset of their illnesses,which revealed fractures at the bases of their skulls.Ultimately,these cases were definitively diagnosed through CT angiography(CTA)examinations.The first patient did not receive surgical treatment,only anticoagulation therapy,and recovered smoothly with no residual limb dysfunction(Case 1).The other two patients both developed intracranial hypertension and underwent decompressive craniectomy.One of these patients had high intracranial pressure and significant brain swelling postoperatively,leading the family to choose to take him home(Case 2).The other patient also underwent decompressive craniectomy and recovered well postoperatively with only mild limb motor dysfunction(Case 3).We retrieved literature from PubMed on skull base fractures causing ICA occlusion to determine the imaging characteristics and treatment strategies for this type of disease.CONCLUSION For patients with cranial trauma combined with skull base fractures,it is essential to complete a CTA examination as soon as possible,to screen for blunt cerebrovascular injury.