High complex anal fistula managed by the modified transanal opening of the intersphincteric space via the inter-sphincteric approach:A case report

BACKGROUND High complex anal fistulas are epithelialized tunnels,with the main fistula piercing above the deep external sphincter and the internal opening approaching the dentate line.Conventional surgical procedures for high complex anal fistulas remove most of the external sphincter and damage the anorectal ring.Postoperative loss of anal function can cause physical and mental damage.Transanal opening of the intersphincteric space(TROPIS)is an effective procedure that completely preserves the external anal sphincter.However,its clinical application is limited by challenges in the localization of the internal opening of a fistula and the high risk of complications.On the basis of our clinical experience,we modified the TROPIS procedure for the treatment of treating high complex anal fistulas.CASE SUMMARY A patient with a high complex anal fistula located above the anorectal ring underwent modified TROPIS,which involved sepsis drainage and identification of the internal opening in the intersphincteric space.The patient with the high complex anal fistula recovered well postoperatively,without any postoperative complications or anal dysfunction.Anal function returned to normal after 17 months of follow-up.CONCLUSION The modified TROPIS procedure is the most minimally invasive surgery for anal fistulas that minimally impairs anal function.It allows the complete removal of infected anal glands and reduces the risk of postoperative complications.Modified TROPIS via the intersphincteric approach is an alternative sphincter-preserving treatment for high complex anal fistulas.

我国高质量教育资源供给机制创新与路径研究——来自美国“#GoOpen”计划的启示

数字化是当下教育改革的重点,也是未来教育发展的趋势。无论是作为“十四五”规划中的战略举措,还是党的二十大中提出的必然要求,构建数字化教育资源为主体的高质量教育资源体系在当下具有必要性与迫切性。美国#GoOpen计划自实施以来,在教育资源数字化、个性化、均等化三个方面均取得了一定成果。通过对该计划官方文件与政策进行解读,对其内涵与特点进行分析,我国在进行高质量教育资源建设及其供给路径探究过程中应当重视统筹规划,循序渐进,同时完善多重考核与评估机制,结合社会多方力量,保证每个学习者的享有权利,最终走向教育公平,共同发展。

Process for improving the ladle free- opening rate for high aluminum steel in continuous casting

Steel 20Mn23AlV is a type of high aluminum steel with a very low ladle free-opening rate. The aluminum composition of 20Mn23AlV ranges from 1.6% to 2.45% ,which is significantly higher than other types of steel. According to the real condition of 40 t ladle in steel-making plant of Baosteel Special Steel Company, previous works show that the key factors affecting the ladle free-opening rate of high aluminum steel in continuous casting are：sand material, accessories baking, ladle nozzle cleaning, the process and amount of adding sand, and the rate of argon stirring during refining. Therefore, improving the ladle filler sand quality, baking all of the raw materials, controlling the addition of ladle filler sand, cleaning the ladle nozzle, and optimizing argon stirring during the refining process can resolve the problem of a low ladle free-opening rate of high aluminum steel caused by the long ladle time of liquid steel.

基于CAPE-OPEN标准的乙苯脱氢反应器模块开发与全流程模拟

基于某乙苯负压绝热脱氢制苯乙烯装置转化率低于设计值的现状,建立了包括小分子水蒸气转化反应在内的乙苯绝热脱氢制苯乙烯反应动力学模型和反应器模型,基于工业数据,估计了模型动力学参数,模型具有较高的精度;采用C++语言和COM技术开发了符合CAPE-OPEN标准的乙苯脱氢制苯乙烯反应器单元模块;在Aspen Plus平台构建了内嵌反应器模块的乙苯脱氢制苯乙烯全流程模型,反应器与精馏塔的模拟结果与实际相吻合;进一步考察了工艺参数对装置运行中期反应的影响,提出了适宜的工艺参数,为乙苯脱氢制苯乙烯的工艺设计、生产优化提供有益的支持。

An Empirical Study of the Effect of Inquiry Teaching on the Development of High School Students'Critical Thinking Under the New Curriculum Standards

The Ministry of Education of the People’s Republic of China has issued three guideline documents to encourage inquiry teaching to help students develop their ability to question,which is a defining feature of critical thinking.Two of the documents have clearly stated that English subject teaching should focus on building students’thinking capacity.Critical thinking is an essential feature of building thinking capacity and a key element of the core competencies the English subject seeks to cultivate.This research measures the performance of students of two high school classes in the exams conducted at the beginning,in the middle,and at the end of the experiment period during which inquiry teaching was applied to enhance students’critical thinking ability.The experiment results show that inquiry teaching can improve students’academic performance in English study and help them better develop their language skills.The implementation of the inquiry design in teaching listening,reading,and writing conforms to the law that governs the development of critical thinking,and the adoption of inquiry teaching can promote the development of critical thinking.

Surface Water Quality Profiling Using Physicochemical Parameters in Open Defecation Free and Non-Open Defecation Free Local Government Areas in Benue State, Nigeria

Physicochemical parameters of surface water sources in the study of local government areas (LGAs) were assessed using standard procedures. The mean physicochemical parameters for pH (5.49), NO2 (0.23 mg/L), SO4 (0.77 mg/L), Na (28.72 mg/L), Ca (28.94 mg/L), Mg (17.50 mg/L), Cl (11.65 mg/L), TSS (6.27 mg/L), TDS (104.23 mg/L), BOD (2.83 mg/L) and F (0.87 mg/L) were below WHO standards irrespective of their defecation status. The values for electrical conductivity (EC) (2770.50 µs/cm, turbidity (481.24 NTU), dissolved oxygen (DO) (5.32 mg/L), chemical oxygen demand (COD) (445.50 mg/L), K (125.06 mg/L), PO4 (0.78 mg/L) and Fe (0.57 mg/L) were above the WHO limits for safe water. Higher EC and COD values obtained in the study is evidence of pollution of the water sources by organic matter.

Challenges of the Performance Standards of the International Finance Corporation in Financing the African Integrated High-Speed Railway Network and the Way Forward: The Case of Standard Gauge Railway in Tanzania

Financing of the African Integrated High-Speed Railway Network (AIHSRN) through Standard Gauge Railway (SGR) Projects is very expensive. As a result, most of the African countries seek financial supports from the International Financial Institutions (IFIs). However, conditions provided by the IFIs through the Performance Standards (PS) of the International Financial Corporation (IFC) increase cost of the projects and thus, it becomes a burden to most of the African countries. This study aimed to explore the causes of IFC-PS through the SGR Projects that escalate costs and how to address them. The Tanzania SGR Lot 1 Project that covered 205 km from Dar es Salaam to Morogoro was selected as a case study. The methods used for data collection involved literature review, focus group discussions and interviews. The results and findings show a gap between the IFC-PS and the National Laws and Regulations that escalates costs of the projects if funds from the IFIs were to be secured. To bridge the gap, it is recommended that the African countries should engage into negotiations with the IFIs to agree to waive IFC-PS conditions that escalate costs provided they are adequately covered in the national laws and regulations;engagement of locally established national and regional financial institutions;and the responsible government institutions in the African countries should sit together for assessment and review of the IFC-PS against the national laws and regulations.

Construction of the standardized efficiency evaluation system for the opening and sharing of valuable instruments and equipment

In terms of the problem of the evaluation of the utilization efficiency of the opening and sharing of the expensive instruments and equipment in colleges and universities, combined with the Internet plus management mode of the whole process of the valuable instruments, based on the idea of ＂full opening and sharing＂, the author of this paper established the opening and sharing mechanisms of the instruments and equipment, to promote their effective allocation and improve their utilization efficiency. In this paper, the author carries out the thinking and discussion of the construction of a standardized evaluation system of the performance evaluation the valuable instruments and equipment.

The Opening Ceremony for the Restructured China Standardization Press

The opening ceremony for the restructured China Standardization Press was grandly held in Beijing on December 1st, Mr. Pu Changcheng, the vice minister of the General Administration of Quality Supervision, Inspection and Quarantine （AQSIQ）, Mr. Ji Zhengkun, the administrator of the Standardization Administration of China （SAC）, Li Zhonghai, the chairman of China Association for Standardization （CAS） and the president of the China National Institute of Standardization （CNIS） attended and addressed at the ceremony.

Grand Opening of the Plenary Meeting on Publicity of the 2005 World Standard Day

Organized by the Standard Administration of China (SAC), the plenary meeting on publicity of the 2005 World Standards Day was held on October 14, 2005 at the Great Hall of People. Surrounding the theme of this year's World Standards Day - "Standards for a Safer World", the meeting made publicized the status of construction and implementation of the food safety and production safety standard system of our country,the result of clearance on national standards and the announcement of formal operation of the system for online free-of-charge access to the full text of national compulsory standards, and the system for online distribution and service of national standards. Attending the meeting were Li Changjiang, Director of AQSIQ, Li Chuanqing,Party Group Secretary of AQSIQ, Li Zhonghai, Director of SAC, high-ranking officers of relevant departments of the State Council, Chen Xiaohong, Vice-minister of Ministry of Health, Wang Xianzheng, Vice-director of the National General Bureau of Supervision and Administration on Production Safety, and representatives and experts from enterprises of various sectors with a total of over 300 people. The meeting was presided over by Zhang Yanhua, Standing Vice-director of SAC.

Acute Correction of Varus Knee by Biplanar Medial Opening-Wedge High Tibial Osteotomy and Fixation with TomoFix Plate

Background: Biplanar medial opening wedge high tibial osteotomy (MOWHTO) is a treatment method that allows adequate correction of symptomatic varus knee deformity. However, MOWHTO tends to decrease patellar height and increase the posterior tibial slope, which can affect the knee joint stability. Objective: The aim of this study was to describe the technique of biplanar MOWHTO and fixation by TomoFix plate, as well as to evaluate the accuracy of the planned correction and the postoperative tibial slope. Patients and Methods: This prospective cohort study was conducted on patients who presented with varus knee deformity and underwent biplanar MOWHTO and fixation by TomoFix plate during the period from March 2016 to March 2017. Assessment of patients included pre- and postoperative Knee and function scores, mechanical femorotibial angle (mFTA), posterior tibial slope angle (pTSA), range of motion (ROM) and radiological evaluation of the healing of the osteotomy site. Results: The recruited patients were 13 (8 men and 5 women), with average age 31.7 years old. The knee and functional scores improved from the preoperative mean of 45 and 41 to the postoperative mean of 85 and 72 points, respectively. The average knee flexion was 115 degrees, which at the final follow-up remained unchanged except for one case. The mean preoperative mFTA was 13.5°varus and decreased post-operatively to a mean of 3°valgus. The average postoperative follow-up period was 12 months (10 - 18 M). Conclusion: The biplanar MOWHTO allows preservation of posterior tibial slope while correcting the varus knee adequately.

High myopia as a risk factor in primary open angle glaucoma

Glaucoma, one of the leading causes of irreversible blindness in the adult population worldwide, is a progressive optic neuropathy. Primary open angle glaucoma (POAG) is the most commonly reported type of glaucoma in population based prevalence studies worldwide. Elevated intraocular pressure is a well-known major risk factor for POAG. In addition, there is growing evidence that other risk factors like age, gender, race, refractive error, heredity and systemic factors may play a role in glaucoma pathogenesis. Many studies found that high myopia has been associated with POAG, however, direct and convincing evidences are still lacking. The aim of this review is to summarize the evidences implicating high myopia as a risk factor in the pathogenesis of POAG.

High-Dimensional Spatial Standardization Algorithm for Diffusion Tensor Image Registration

Three high dimensional spatial standardization algorithms are used for diffusion tensor image(DTI)registration,and seven kinds of methods are used to evaluate their performances.Firstly,the template used in this paper was obtained by spatial transformation of 16 subjects by means of tensor-based standardization.Then,high dimensional standardization algorithms for diffusion tensor images,including fractional anisotropy(FA)based diffeomorphic registration algorithm,FA based elastic registration algorithm and tensor-based registration algorithm,were performed.Finally,7 kinds of evaluation methods,including normalized standard deviation,dyadic coherence,diffusion cross-correlation,overlap of eigenvalue-eigenvector pairs,Euclidean distance of diffusion tensor,and Euclidean distance of the deviatoric tensor and deviatoric of tensors,were used to qualitatively compare and summarize the above standardization algorithms.Experimental results revealed that the high-dimensional tensor-based standardization algorithms perform well and can maintain the consistency of anatomical structures.

基于Open XML和有限自动机的试卷自动生成系统

考试出题讲究高保密性和高时效性,不允许将题目事先导入数据库再自动生成试卷,需要现场从大量的WORD文档中直接抽取题目并排版生成试卷,这是一项耗时耗力的工作。本研究利用Open XML文档的开源性,直接对DOCX和XLSX文档的内容进行分析读取,并利用有限状态自动机原理对文档的内容进行分类处理,自动生成试卷、答案卷和答题卡文档。实验表明这种方法能够正确按照要求生成试卷,既解决了考试中的保密性要求又提高了工作效率,节省了人力成本。

High Standard Capital Farmland Construction Based on Grain Security

In the context that global grain security is still in very severe situation,the grain security situation in China is not optimistic as well. The " Red Line of Farmland Area" cannot completely solve the grain security problems in China. We still need to seek new breakthroughs in the quality and yield of farmland. The construction of high standard capital farmland is the important premise to guarantee national grain security. On this basis,this paper has summarized the difficulties we are facing in the construction of high standard capital farmland,and has proposed the methods and measures to construct high standard capital farmland and lay a solid foundation for grain security in China.

Zoning Approach of Key Construction Areas of High Standard Capital Farmland in Guangdong Province

On the basis of actual situations of Guangdong Province, using Factor Analysis Approach and Quantitative Analysis Method, we built index system by four factors, namely, extent of farmland connectivity, local financial support, grain production capacity and farmland consolidation potential. Finally, we obtained that the areas with total scores of evaluation higher than 50 points are key construction areas of high-standard capital farmland in Guangdong Province. In total, there are 40 key construction areas, including 16 in plain areas of the Pearl River Delta, 9 in coastal regions of east of Guangdong, 10 in coastal regions of west of Guangdong, and 5 in northwest mountainous regions of Guangdong. Besides, we put forward construction direction of these 4 capital farmland areas.

基于CAPE-OPEN标准的SINOALKY烷基化反应器模块开发与全流程模拟

基于SINOALKY烷基化工艺,建立了二十集总反应动力学模型和反应器模型,并在此基础上开发了符合CAPE-OPEN标准的SINOALKY烷基化反应器模块,模块包含符合CAPE-OPEN标准的6个物流接口、数值求解器以及可视化的交互界面。将该反应器模块加载于Aspen Plus平台中,搭建了某0.2 Mt a的SINOALKY烷基化装置全流程模型,模型的模拟效果较好;进而,考察了反应工艺参数对烷基化产品组成和性质的影响,结果表明,模型模拟值与实际烷基化工艺相符,获得了适宜的烷基化反应工艺参数。表明包含SINOALKY烷基化反应器模块的烷基化全流程模型可为SINOALKY烷基化装置的模拟优化提供重要参考。

Arrangement of High-standard Basic Farmland Construction Based on Village-region Cultivated Land Quality Uniformity

As an important constitute of land consolidation, high-standard basic farmland construction is an important means to protect the quantity, quality and ecological environment of cultivated land. Its target not only lies in the increase of cultivated land quantity, but also the improvement of cultivated land quality, agricultural production conditions and ecosystem environments. In the present study, the quality evaluation method and construction arrangement of cultivated land were explored to facilitate the process of decision-making and implementation for high-standard basic farmland construction(HSBFC) with administrative village as the unit. Taking the land comprehensive improvement project area in Quzhou County, Handan City, Hebei Province as a case study, the whole process of the study comprised of three steps: 1) establishment of the evaluation model of cultivated land quality uniformity based on regional optimum cultivated land quality, and construction of the uniformity evaluation index system from the aspects of soil fertility quality, engineering quality, spatial quality and eco-environment quality, according to the new concept of cultivated land quality; 2) calculation of cultivated land quality uniformity by grading indicators, assigning scores and weighting sums, exploring the local homogenization characteristics of regional cultivated land quality through spatial autocorrelation analysis, and analyzing the constraints and transformative potential of barrier factors; 3) arrangement of HSBFC according to the principle of concentration, continuity and priority to the easy operation. The results revealed that the value of farmland quality uniformity for the administrative villages in the study area was between 7.76 and 21.96, and there was a difference between various administrative villages. The regional spatial autocorrelation patterns included High-High(HH), Low-Low(LL), High-Low(HL) and Low-High(LH). These indicate that regional cultivated land quality has local homogenization characteristics. The most restrictive factors in the study area were the medium and low transformation difficulty indexes, including soil organic matter content, farmland shelterbelt network density, field regularity and scale of the field. In addition, there were also high transformation difficulty indicators in some areas, such as sectional configuration. The project area was divided into four partitions: major construction area, secondary construction area, general construction area, and conditional construction area. The cultivated land area of each subarea was 1538.85 ha, 1224.27 ha, 555.93 ha, and 1666.63 ha, respectively. This comprised of 30.87%, 24.56%, 11.15% and 33.42% of the total project area, respectively. The evaluation model and index system could satisfy the evaluation of farmland quality and diagnosis of obstacle factors to facilitate the subsequent construction decision. The present study provides reference for the practice of regional HSBFC, and a new feasible idea and method for related studies.

Opening Angle Rules of the Aerodynamic Brake Panel

In order to get the relationship between aerodynamic brake effect and the opening angle,based on a high-speed train model in CFD software FLUENT,the aerodynamic force properties from brake panels with different opening angles were analyzed as well as the flow field's variation laws. Six cases were researched,taking opening angles 45°,60°,75°,80°,85° and 90° respectively.Three-dimensional Reynolds-average Navier-Stokes equation combined with k-ε turbulence model was utilized. The control equation was discretized and solved by finite volume method.SIMPLE method was also considered to couple the pressure and velocity fields and search the numeric solutions. Conclusions can be achieved from the results which are shown as follows. When the opening angle increases from 45° to 75°,the aerodynamic forces and the central area with larger pressure increase fast,and the flow field distribution changes greatly; when the opening angle increases from75° to 90°,the aerodynamic forces and the central area with larger pressure increase slowly, and the flow field distribution changes slightly; considering train boundary and opening performance of the wind resistance brake mechanism,the opening angle should be 75°.