Bioinspired Ultrasensitive Flexible Strain Sensors for Real‑Time Wireless Detection of Liquid Leakage

Liquid leakage of pipeline networks not only results in considerableresource wastage but also leads to environmental pollution and ecological imbalance.In response to this global issue, a bioinspired superhydrophobic thermoplastic polyurethane/carbon nanotubes/graphene nanosheets flexible strain sensor (TCGS) hasbeen developed using a combination of micro-extrusion compression molding andsurface modification for real-time wireless detection of liquid leakage. The TCGSutilizes the synergistic effects of Archimedean spiral crack arrays and micropores,which are inspired by the remarkable sensory capabilities of scorpions. This designachieves a sensitivity of 218.13 at a strain of 2%, which is an increase of 4300%. Additionally, it demonstrates exceptional durability bywithstanding over 5000 usage cycles. The robust superhydrophobicity of the TCGS significantly enhances sensitivity and stability indetecting small-scale liquid leakage, enabling precise monitoring of liquid leakage across a wide range of sizes, velocities, and compositionswhile issuing prompt alerts. This provides critical early warnings for both industrial pipelines and potential liquid leakage scenariosin everyday life. The development and utilization of bioinspired ultrasensitive flexible strain sensors offer an innovative and effectivesolution for the early wireless detection of liquid leakage.

The features of soil erosion and soil leakage in karst peak-cluster areas of Southwest China

Through utilizing water flow monitoring, rock scratching, soil wood piles and radionuclide ^(137)Cs tracing in the Longhe karst ecological experimental site(hereinafter referred to"Longhe site"), Pingguo County, Guangxi Province, the features and values of soil erosion and soil leakage in different geomorphologic locations and land uses in the karst peak-cluster depressions are showed clearly. There are four kinds of geomorphologic locations in the karst peak-cluster depression, namely peaks, strip, slopes and depression. The soil leakage modulus in the peaks and strips respectively occupy 92.43% and 96.24% of the total mean soil erosion modulus at experimental sites. On the slope, soil leakage accounted for about 75%. At the bottom of depression, surface water was the main factor of soil erosion, and at last most soil leaked into underground rivers from sinkholes. The total soil erosion modulus and the contribution rates of relative surface soil erosion in regard of peaks, slopes and depressions gradually increased. There are also five major types of land use in the karst peak-cluster depressions, farmland, Kudingcha tea plantations, young Lignum Sappan fields, shrub-grassland and pastures. The soil erosion modulus of slope farmland has the highest value with an increasing trend year by year. But soil erosion modulus of other four land use types decreased by year, which shows the "grain for green" will result in better soil protection. By handling with rocky desertification and ecological rehabilitation in Longhe site, the mean soil erosion modulus of the karst peak-cluster depression has decreased about 80% from 2003 to 2015.

Effect of stress-dependent microannulus aperture on well leakage

Debonding at the cement-casing interface is recognized as a principal failure mechanism leading to CO_(2) leakage in wells.This detachment gives rise to a microannulus,which notably possesses greater permeability than undamaged cement,undermining its sealing efficacy.Conventionally,the permeability of the microannulus is regarded as a uniform value throughout the well.However,fundamentally,a microannulus is one type of fracture,and its gap or aperture size is affected by the effective stress.In this work,we developed a unique experimental apparatus.This equipment facilitates the curing of cement inside a steel casing,the formation of a microannulus between the casing and the cement,and the investigation of the fluid flow dynamics along the microannulus under laboratory-replicated in situ conditions.The microannulus was formed by injecting fluid from one end of the setup,and receiving similar amount of fluid on the other end signified the development of the leakage channel.Additionally,strain gauges affixed to the casing’s external surface yielded key information on the microannulus’s opening and closure.We observed a noticeable decline in microannulus hydraulic aperture(or permeability)in relation to effective stress and an exponential equation fits their relationship.Our findings also indicate a distinct behavior when comparing liquid CO_(2) with water.Specifically,it is easier for liquid CO_(2) to create the microannulus.However,the hydraulic aperture range for this microannulus(0.7-6 mm)is considerably smaller than that created by water flow(2-17 mm).Finally,we integrated the stressdependent microannulus aperture size into the combined analysis of well mechanical integrity and well leakage.The outcomes consistently demonstrated that when factoring in the stress-dependent aperture sizes,the leakage rates are 3e5 times compared to a fixed aperture model.The traditional assumption of a constant aperture significantly underestimates fluid leakage risks.

Evaluating Privacy Leakage and Memorization Attacks on Large Language Models (LLMs) in Generative AI Applications

The recent interest in the deployment of Generative AI applications that use large language models (LLMs) has brought to the forefront significant privacy concerns, notably the leakage of Personally Identifiable Information (PII) and other confidential or protected information that may have been memorized during training, specifically during a fine-tuning or customization process. We describe different black-box attacks from potential adversaries and study their impact on the amount and type of information that may be recovered from commonly used and deployed LLMs. Our research investigates the relationship between PII leakage, memorization, and factors such as model size, architecture, and the nature of attacks employed. The study utilizes two broad categories of attacks: PII leakage-focused attacks (auto-completion and extraction attacks) and memorization-focused attacks (various membership inference attacks). The findings from these investigations are quantified using an array of evaluative metrics, providing a detailed understanding of LLM vulnerabilities and the effectiveness of different attacks.

Evaluating the characteristics of geological structures in karst groundwater inflow, Nowsud Tunnel

Highly permeable geological structures such as dissolution channels, open fractures, and faults create environmental challenges regard to hydrological and hydrogeological aspects of underground construction, often causing significant groundwater inflow during drilling due to the limitations of empirical and analytical methods. This study aims to identify the geological factors influencing water flow into the tunnel. High-flow zones' geological features have been identified and examined for this purpose. According to the geological complexity of the Nowsud tunnel, presence of different formations with different permeability and karstification have led to a high volume of underground inflow water (up to 4700 L/s) to the tunnel. The Nowsud tunnel faces significant geological and hydrogeological challenges due to its passage through the Ilam formation's LI2 unit, characterized by dissolution channels, faults, and fractures. The highest inflow rate (4700 L/s) occurred in the Hz-9 zone within the Zimkan anticline. The relationship between geological features and groundwater inflow indicates that anticlines are more susceptible to inflow than synclines. Additionally, different types of faults exhibit varying hydraulic effects, with strike-slip faults having the most significant impact on groundwater inflow, thrust faults conducting less water into the tunnel, and inflow through normal faults being negligible compared to the other two types of faults. The novelty of this paper lies in its detailed analysis of geological features influencing groundwater inflow into the Nowsud tunnel, providing empirical data on high-flow zones and differentiating the hydraulic effects of various fault types, which enhances the understanding and prediction of groundwater inflow in underground constructions.

Stable reverse J-shaped diameter distribution occurs in an old-growth karst forest

The reverse J-shaped diameter distribution is considered an inherent attribute of natural forests,cru-cial for forest resource utilization and community stability.However,in karst regions,intense habitat heterogeneity might alter species composition,spatial distribution,growth,biomass allocation,and mortality processes,yet its impact on diameter structure remains unclear.A fixed plot of 200 m×110 m was established in the Nanpan River Basin,Southwest China,within an old-growth oak forest(>300 years old),and the influence of site substrates(i.e.,rock and soil),topographic factors,sample area,and orientation on diameter distribution was analyzed.Trees on both rock and soil exhibited a reverse-J shape,quantifiable Project funding:This work was supported by the National Natural Science Foundation of China(32060340 and 31400542),the Scientific Research Capacity Building Project for Laibin Jinxiu Dayaoshan Forest Ecosystem Observation and Research Station of Guangxi(22-035-130-01).through the Weibull function.The substrates had a similar density,approximately 2100 plants/ha.However,the average and range of diameter of trees on rock were smaller than those on soil,suggesting that rock constrains tree growth.The diameter distribution of trees across microtopography also displayed a reverse-J shape.Yet,higher elevations and sunny slopes showed a greater curvature of diameter classes compared to lower elevations and shady slopes,indicating habitat preferences in karst trees.Sample area and orientation had minimal effects on diameter class curve that reached stability when the plot size was 6000 m2.These results suggest that the reverse J-shaped diameter distribution prevails at small scales in karst old-growth forests,encompassing multiple curvatures and spanning forest ecosystems.

Exploring social-ecological system resilience in South China Karst:Quantification,interaction and policy implication

China’s Grain to Green Program(GTGP),which is one of the largest payments for ecosystem services(PES)in the world,has made significant ecological improvements to the environment.However,current understanding of its outcomes on the social-ecological system(SES)remains limited.Therefore,taking the South China Karst as an example,a SES resilience evaluation index system was constructed followed by an exploratory spatial analysis,root mean square error,and Self-Organizing Feature Map to clarify the spatiotemporal changes and relationship of SES resilience,achieve the zoning of SES resilience and provide restoration measures.The results showed an upward trend in social resilience from 2000 to 2020,especially its subsystem of social development.Regional ecological resilience was stable,owing to a slightly declined ecosystem services and increased landscape pattern.Spatially,nearly half of the counties exhibited a distribution mismatch in SES resilience.There was an obvious inverted U-shaped relationship of SES resilience,indicating a clear threshold effect,and the constraint relation-ship of SES resilience eased over time,demonstrating the effectiveness of the ecological restoration program.GTGP played a positive role in reducing regional SES trade-off,but this positive effect was limited,reflecting the limitations of overemphasizing the conversion from farmland to forest and grassland.Regional SES resilience can be divided into four clusters,which were the key optimization zone for social system,the SES resilience safety zone,the key restoration zone for SES resilience,and the key optimization zone for ecological system.Adaptive adjustments for the GTGP in these zones should be taken to achieve maximum SES benefits in the future.

Peritoneal fluid indocyanine green test for diagnosis of gut leakage in anastomotic leakage rats and colorectal surgery patients

BACKGROUND Application of indocyanine green(ICG)fluorescence has led to new developments in gastrointestinal surgery.However,little is known about the use of ICG for the diagnosis of postoperative gut leakage(GL).In addition,there is a lack of rapid and intuitive methods to definitively diagnose postoperative GL.AIM To investigate the effect of ICG in the diagnosis of anastomotic leakage in a surgical rat GL model and evaluate its diagnostic value in colorectal surgery patients.METHODS Sixteen rats were divided into two groups:GL group(n=8)and sham group(n=8).Approximately 0.5 mL of ICG(2.5 mg/mL)was intravenously injected postoperatively.The peritoneal fluid was collected for the fluorescence test at 24 and 48 h.Six patients with rectal cancer who had undergone laparoscopic rectal cancer resection plus enterostomies were injected with 10 mL of ICG(2.5 mg/mL)on postoperative day 1.Their ostomy fluids were collected 24 h after ICG injection to identify the possibility of the ICG excreting from the peripheral veins to the enterostomy stoma.Participants who had undergone colectomy or rectal cancer resection were enrolled in the diagnostic test.The peritoneal fluids from drainage were collected 24 h after ICG injection.The ICG fluorescence test was conducted using OptoMedic endoscopy along with a near-infrared fluorescent imaging system.RESULTS The peritoneal fluids from the GL group showed ICG-dependent green fluorescence in contrast to the sham group.Six samples of ostomy fluids showed green fluorescence,indicating the possibility of ICG excreting from the peripheral veins to the enterostomy stoma in patients.The peritoneal fluid ICG test exhibited a sensitivity of 100%and a specificity of 83.3%for the diagnosis of GL.The positive predictive value was 71.4%,while the negative predictive value was 100%.The likelihood ratios were 6.0 for a positive test result and 0 for a negative result.CONCLUSION The postoperative ICG test in a drainage tube is a valuable and simple technique for the diagnosis of GL.Hence,it should be employed in clinical settings in patients with suspected GL.

Air pressure law of a reservoir constructed in karst sinkholes

Karst sinkholes with natural negative landform provide favorable conditions for the pumped storage reservoir construction for less excavation work.However,the construction of the reservoir would plug the natural karst channels for water and air,which would cause remarkable air pressure in karst channels when the groundwater level fluctuates.A large laboratory simulation test was carried out to study the air pressure variation of a reservoir built on the karst sinkhole.The air pressure in the karst channel and inside the model was monitored during the groundwater rising and falling process.Result showed that the variation of air pressure in the karst channel and the surrounding rock exhibited a high degree of similarity.The air pressure increased rapidly at the initial stage of water level rising,followed by a slight decrease,then the air pressure increased sharply when the water level approached the top of the karst cave.The initial peak of air pressure and the final peak of air pressure were defined,and both air pressure peaks were linearly increasing with the water level rising rate.The negative air pressure was also analyzed during the drainage process,which was linearly correlated with the water level falling rate.The causes of air pressure variation in karst channels of a pumped storage reservoir built on the karst sinkhole were discussed.The initial rapid increase,then slight decrease and final sudden increase of air pressure were controlled by the combined effects of air compression in karst channel and air seepage into the surrounding rock.For the drainage process,the instant negative air pressure and gradual recovering of air pressure were controlled by the combined effects of negative air pressure induced by water level falling and air supply from surrounding rock.This work could provide valuable reference for the reservoir construction in karst area.

Physio-ecological adaptability and service function in karst rocky desertification control of Premna puberula

Increased soil erosion as a consequence of karst rocky desertification(KRD)reduces soil quality and plant diversity.Premna puberula Pamp.is a perennial understory shrub that can adapt to the harsh environment of KRD and has potential value for KRD environmental restoration.We measure morphological and photosynthetic characteristics,nutrient accumulation,and soil physical and chemical properties of two-year-old P.puberula planted in KRD habitat and non-rocky desertification areas,and investigate how it adapts to this habitat.In KRD areas,P.puberula reduces aboveground water loss by decreasing leaf area,stomatal conductance,and transpiration rate,while increasing leaf thickness,root length and number,and increases belowground biomass to absorb more water and nutrients.In KRD areas,drought leads to decreased leaf water content,stomatal conductance,intercellular CO_(2) concentration,and chlorophyll content,and decreased photosynthetic rate.Soluble sugar and protein contents increase in KRD areas in response to water stress,but pectin and flavonoid contents decrease.Correlation analysis reveals that leaf area and thickness are important functional traits that affect leaf water content and photosynthesis.Totals of leaf carbon,nitrogen,and phosphorus,along with C:N,C:P,and N:P ratios,are coupled with leaf photosynthetic characteristics and root development.Redundancy analysis reveals that available K and P,and total P,K,and N in soil mainly influence the differences in plant functional traits,explaining 95.8%,95.5%,91.1%,85.8%,and 74%of variation,respectively.We hypothesize that P.puberula reduces aboveground productivity to maintain its water balance,and acquires more water and nutrients by increasing belowground biomass.It indicates that this species adapts to arid KRD environments.

Enhanced ferroelectric and improved leakage of BFO-based thin films through increasing entropy strategy

BiFeO_(3)(BFO)has received considerable attention as a lead-free ferroelectric film due to its large theoretical remnant polariza-tion.However,BFO suffers from a large leakage current,resulting in poor ferroelectric properties.Herein,the sol-gel method was used to deposit a series of BFO-based thin films on fluorine-doped tin oxide substrates,and the effects of the substitution of the elements Co,Cu,Mn(B-site)and Sm,Eu,La(A-site)on the crystal structure,ferroelectricity,and leakage current of the BFO-based thin films were invest-igated.Results confirmed that lattice distortion by X-ray diffraction can be attributed to the substitution of individual elements in the BFO-based films.Sm and Eu substitutions contribute to the lattice distortion in a pseudo-cubic structure,while La is biased toward pseudo-tet-ragonal.Piezoelectric force microscopy confirmed that reversible switching of ferroelectric domains by nearly 180°can be realized through the prepared films.The ferroelectric hysteresis loops showed that the order for the polarization contribution is as follows:Cu>Co>Mn(B-site),Sm>La>Eu(A-site).The current density voltage curves indicated that the order for leakage contribution is as follows:Mn<Cu<Co(B-site),La<Eu<Sm(A-site).Scanning electron microscopy showed that the introduction of Cu elements facilitates the formation of dense grains,and the grain size distribution statistics proved that La element promotes the reduction of grain size,leading to the increase of grain boundaries and the reduction of leakage.Finally,a Bi_(0.985)Sm_(0.045)La_(0.03)Fe_(0.96)Co_(0.02)Cu_(0.02)O_(3)(SmLa-CoCu)thin film with a qualitative leap in the remnant polarization from 25.5(Bi_(0.985)Sm_(0.075)FeO_(3))to 98.8µC/cm^(2)(SmLa-CoCu)was prepared through the syner-gistic action of Sm,La,Co,and Cu elements.The leakage current is also drastically reduced from 160 to 8.4 mA/cm^(2)at a field strength of 150 kV/cm.Thus,based on the increasing entropy strategy of chemical engineering,this study focuses on enhancing ferroelectricity and decreasing leakage current,providing a promising path for the advancement of ferroelectric devices.

Dominance of rock exposure and soil depth in leaf trait networks outweighs soil quality in karst limestone and dolomite habitats

Leaf trait networks(LTNs)visualize the intricate linkages reflecting plant trait-functional coordination.Typical karst vegetation,developed from lithological dolomite and limestone,generally exhibits differential communities,possibly due to habitat rock exposure,soil depth,and soil physicochemical properties variations,leading to a shift from plant trait variation to functional linkages.However,how soil and habitat quality affect the differentiation of leaf trait networks remains unclear.LTNs were constructed for typical dolomite and limestone habitats by analyzing twenty-one woody plant leaf traits across fifty-six forest subplots in karst mountains.The differences between dolomite and limestone LTNs were compared using network parameters.The network association of soil and habitat quality was analyzed using redundancy analysis(RDA),Mantle's test,and a random forest model.The limestone LTN exhibited significantly higher edge density with lower diameter and average path length when compared to the dolomite LTN.It indicates LTN differentiation,with the limestone network displaying a more compact architecture and higher connectivity than the dolomite network.The specific leaf phosphorus and leaf nitrogen contents of dolomite LTN,as well as the leaf mass and leaf carbon contents of limestone LTN,significantly contributed to network degree and closeness,serving as crucial node traits regulating LTN connectedness.Additionally,both habitat LTNs significantly correlated with soil nitrogen and phosphorus,stoichiometric ratios,pH,and organic carbon,as well as soil depth and rock exposure rates,with soil depth and rock exposure showing greater relative importance.Soil depth and rock exposure dominate trait network differentiation,with the limestone habitat exhibiting a more compact network architecture than the dolomite habitat.

Genomic divergence and mutation load in the Begonia masoniana complex from limestone karsts

Understanding genome-wide diversity,inbreeding,and the burden of accumulated deleterious mutations in small and isolated populations is essential for predicting and enhancing population persistence and resilience.However,these effects are rarely studied in limestone karst plants.Here,we re-sequenced the nuclear genomes of 62 individuals of the Begonia masoniana complex(B.liuyanii,B.longgangensis,B.masoniana and B.variegata)and investigated genomic divergence and genetic load for these four species.Our analyses revealed four distinct clusters corresponding to each species within the complex.Notably,there was only limited admixture between B.liuyanii and B.longgangensis occurring in overlapping geographic regions.All species experienced historical bottlenecks during the Pleistocene,which were likely caused by glacial climate fluctuations.We detected an asymmetric historical gene flow between group pairs within this timeframe,highlighting a distinctive pattern of interspecific divergence attributable to karst geographic isolation.We found that isolated populations of B.masoniana have limited gene flow,the smallest recent population size,the highest inbreeding coefficients,and the greatest accumulation of recessive deleterious mutations.These findings underscore the urgency to prioritize conservation efforts for these isolated population.This study is among the first to disentangle the genetic differentiation and specific demographic history of karst Begonia plants at the whole-genome level,shedding light on the potential risks associated with the accumulation of deleterious mutations over generations of inbreeding.Moreover,our findings may facilitate conservation planning by providing critical baseline genetic data and a better understanding of the historical events that have shaped current population structure of rare and endangered karst plants.

Visualization and characterization of experimental hydraulic fractures interacting with karst fracture-cavity distributions

Karst fracture-cavity carbonate reservoirs,in which natural cavities are connected by natural fractures to form cavity clusters in many circumstances,have become significant fields of oil and gas exploration and exploitation.Proppant fracturing is considered as the best method for exploiting carbonate reservoirs;however,previous studies primarily focused on the effects of individual types of geological formations,such as natural fractures or cavities,on fracture propagation.In this study,true-triaxial physical simulation experiments were systematically performed under four types of stress difference conditions after the accurate prefabrication of four types of different fracture-cavity distributions in artificial samples.Subsequently,the interaction mechanism between the hydraulic fractures and fracture-cavity structures was systematically analyzed in combination with the stress distribution,cross-sectional morphology of the main propagation path,and three-dimensional visualization of the overall fracture network.It was found that the propagation of hydraulic fractures near the cavity was inhibited by the stress concentration surrounding the cavity.In contrast,a natural fracture with a smaller approach angle(0°and 30°)around the cavity can alleviate the stress concentration and significantly facilitate the connection with the cavity.In addition,the hydraulic fracture crossed the natural fracture at the 45°approach angle and bypassed the cavity under higher stress difference conditions.A new stimulation effectiveness evaluation index was established based on the stimulated reservoir area(SRA),tortuosity of the hydraulic fractures(T),and connectivity index(CI)of the cavities.These findings provide new insights into the fracturing design of carbonate reservoirs.

Side-Channel Leakage Analysis of Inner Product Masking

The Inner Product Masking(IPM)scheme has been shown to provide higher theoretical security guarantees than the BooleanMasking(BM).This scheme aims to increase the algebraic complexity of the coding to achieve a higher level of security.Some previous work unfolds when certain(adversarial and implementation)conditions are met,and we seek to complement these investigations by understanding what happens when these conditions deviate from their expected behaviour.In this paper,we investigate the security characteristics of IPM under different conditions.In adversarial condition,the security properties of first-order IPMs obtained through parametric characterization are preserved in the face of univariate and bivariate attacks.In implementation condition,we construct two new polynomial leakage functions to observe the nonlinear leakage of the IPM and connect the security order amplification to the nonlinear function.We observe that the security of IPMis affected by the degree and the linear component in the leakage function.In addition,the comparison experiments from the coefficients,signal-to-noise ratio(SNR)and the public parameter show that the security properties of the IPM are highly implementation-dependent.

Formation process of cover collapse sinkholes related to groundwater level decline in karst areas

The decline in groundwater level is a key factor contributing to cover collapse in karst areas.In this study,the model tests and numerical simulations are conducted to reveal the breeding process and formation mechanism of cover collapse sinkholes caused by the decline of groundwater level in karst area.Firstly,the model tests confirm that the decline of groundwater level generates negative pressure at the lower edge of overlying soil.The negative pressure experiences four distinct phases during the groundwater drawdown process:rapid rise,slow decline,rapid decline,and gradual dissipation.The maximum negative pressure is influenced by the particle size distribution of the overlying soil.Then,the numerical simulations are carried out to investigate the change process of negative pressure caused by the loss of fillers in karst pipe.The simulated results indicate that the rate of groundwater decline and the thickness and initial void ratio of the overlying soil can affect the maximum negative pressure.As groundwater level drops,a negative pressure zone forms underground,causing tensile failure in the surrounding soil and creating an arched soil hole,which weakens the support for the overlying soil.This phenomenon can also lead to the collapse of the overlying soil under its self-weight.Groundwater table decline in karst areas can result in both internal and surface collapses.When the overlying soil is thin,internal and surface collapses occur simultaneously.In contrast,for thick overlying soil,internal collapse happens first,followed by a layer-by-layer collapse,ultimately forming sinkholes.Finally,the breeding process and formation mechanism of the Yujiawan Reservoir sinkholes are discussed.Geological conditions and groundwater level decline significantly affect internal collapse in karst areas,requiring careful consideration from on-site engineers.

Conditions for the enrichment of karst hydrothermal resources in Bohai Bay Basin

Drilling for karst hydrothermal resources in eastern China has posed challenges,including disparities between the temperature and yield of geothermal water.It is evident that relying solely on geothermal anomalies or indications of karst reservoirs is inadequate for the exploration of karst hydrothermal resources.This study seeks to elucidate the cause of geothermal sweet spots by analyzing the interplay between geothermal anomalies and karst reservoirs and the underlying geological conditions for karst hydrothermal enrichment.Key findings include:(1)the Bohai Bay Basin has been geologically favorable for the development of karst hydrothermal resources since the Mesozoic era;(2)the karst hydrothermal enrichment varies significantly between the basin’s margin and its interior.On the basin margin,the enrichment is largely driven by groundwater activity and faults,particularly where faults facilitate the upwelling of geothermal water.In contrast,within the basin’s interior,karst hydrothermal resources are predominantly influenced by buried hills and are especially enriched in areas facilitating the discharge of deep geothermal waters.

A Case Report and Literature Review: A Case of Delayed Bile Leakage Following Laparoscopic Cholecystectomy

Background: Delayed bile leakage after laparoscopic cholecystectomy, defined as occurring more than 72 hours after surgery, is a rare and serious complication of laparoscopic cholecystectomy, with an incidence rate of 0.060%. Case Declaration: This case report details a patient diagnosed with delayed bile leakage 43 days after laparoscopic cholecystectomy. The patient was discharged from our hospital after undergoing CT-guided puncture treatment, with no obvious complications identified. The patient was monitored for one year following the procedure, during which time no significant discomfort was reported. Objective: This case report is to analyse and review the clinical manifestations, diagnosis, treatment and prevention of delayed bile leakage after cholecystectomy, with reference to the relevant literature. Results: Delayed bile leakage after laparoscopic cholecystectomy can be prevented, although not eliminated. It is recommended that the operator treat the operation with caution, avoid taking risks, and adhere to careful procedures and strict separation according to the requirements. This approach is key to preventing late bile leakage in the postoperative period.

Serum nutritional predictive biomarkers and risk assessment for anastomotic leakage after laparoscopic surgery in rectal cancer patients

BACKGROUND Anastomotic leakage(AL)is one of the severest complications after laparoscopic surgery for middle/low rectal cancer,significantly impacting patient outcomes.Identifying reliable predictive factors for AL remains a clinical challenge.Serum nutritional biomarkers have been implicated in surgical outcomes but are un-derexplored as predictive tools for AL in this setting.Our study hypothesizes that preoperative serum levels of prealbumin(PA),albumin(ALB),and transferrin(TRF),along with surgical factors,can accurately predict AL risk.AIM To determine the predictive value of preoperative serum nutritional biomarkers for rectal cancer AL following laparoscopic surgery.METHODS In the retrospective cohort study carried out at a tertiary cancer center,we examined 560 individuals who underwent laparoscopic procedures for rectal cancer from 2018 to 2022.Preoperative serum levels of PA,ALB,and TRF were measured.We employed multivariate logistic regression to determine the independent risk factors for AL,and a predictive model was constructed and evaluated using receiver operating characteristic curve analysis.RESULTS AL occurred in 11.96%of cases,affecting 67 out of 560 patients.Multivariate analysis identified PA,ALB,and TRF as the independent risk factor,each with an odds ratio of 2.621[95%confidence interval(CI):1.582-3.812,P=0.012],3.982(95%CI:1.927-4.887,P=0.024),and 2.109(95%CI:1.162-2.981,P=0.031),respectively.Tumor location(<7 cm from anal verge)and intraoperative bleeding≥300 mL also increased AL risk.The predictive model demonstrated an excellent accuracy,achieving an area under the receiver operating characteristic curve of 0.942,a sensitivity of 0.844,and a specificity of 0.922,demonstrating an excellent ability to discriminate.CONCLUSION Preoperative serum nutritional biomarkers,combined with surgical factors,reliably predict anastomotic leakage risk after rectal cancer surgery,highlighting their importance in preoperative assessment.

Thoracic spinal cord injury and paraplegia caused by intradural cement leakage after percutaneous kyphoplasty: A case report

BACKGROUND Percutaneous kyphoplasty(PKP)is a pivotal intervention for osteoporotic fractures,pathological vertebral compression fractures,and vertebral bone tumors.Despite its efficacy,the procedure presents challenges,notably complications arising from intradural cement leakage.Timely and accurate diagnosis,coupled with emergent intervention is imperative to improve patient prognosis.This case report illuminates the intricacies and potential complications associated with PKP,emphasizing the critical need for vigilant monitoring,prompt diagnosis,and immediate intervention to mitigate adverse outcomes.CASE SUMMARY A 58-year-old male patient,experiencing a T7 osteoporosis-related pathological compression fracture,underwent PKP at a local hospital.Two weeks postprocedure,the patient developed paraplegic and dysuric symptoms,necessitating emergency decompression surgery.Gradual improvement was achieved,marked by the restoration of muscle strength,sensation,and mobility.CONCLUSION PKP Intradural cement leakage following PKP is unusual and potentially fatal.Prompt imaging examinations,urgent evaluation,and the decompression surgery are essential,which help alleviate symptoms associated with spinal damage,markedly improving the overall prognosis.