Intraluminal migration of a surgical drain near an anastomosis site after total gastrectomy:A case report

BACKGROUND Esophagojejunal anastomotic leakage(EJAL)is a severe complication following gastrectomy for gastric cancer,typically treated with drainage and nutritional support.We report a case of intraluminal drain migration near the esophagojejunal anastomosis(EJA),resulting in persistent drainage and mimicking EJAL after total gastrectomy.CASE SUMMARY A 64-year-old male underwent open total gastrectomy with Roux-en-Y reconstruction for gastric adenocarcinoma,with two silicone drains placed near the EJA.On postoperative day(POD)4,the patient developed signs of peritonitis and sepsis,necessitating surgical re-exploration abscess drainage,peritoneal lavage,and drain repositioning.A contrast swallow study on POD 18 revealed rapid filling of the abdominal drain without extraluminal contrast collection.Persistent drainage prompted an upper gastrointestinal endoscopy on POD 59,which revealed approximately 5 cm of the drain within the esophagus,with the perforation site located 2 cm distal to the intact EJA.The drain was repositioned under endoscopic guidance.A repeat contrast radiograph on POD 67 demonstrated no evidence of extraluminal contrast extravasation or filling of the abdominal drain.The patient was subsequently discharged without further incident.CONCLUSION Intraluminal drain migration is a rare complication following gastric surgery but should be considered when persistent drainage occurs.

Semi-analytical solution for drained expansion analysis of a hollow cylinder of critical state soils

The expansion of a thick-walled hollow cylinder in soil is of non-self-similar nature that the stress/deformation paths are not the same for different soil material points.As a result,this problem cannot be solved by the common self-similar-based similarity techniques.This paper proposes a novel,exact solution for rigorous drained expansion analysis of a hollow cylinder of critical state soils.Considering stress-dependent elastic moduli of soils,new analytical stress and displacement solutions for the nonself-similar problem are developed taking the small strain assumption in the elastic zone.In the plastic zone,the cavity expansion response is formulated into a set of first-order partial differential equations(PDEs)with the combination use of Eulerian and Lagrangian descriptions,and a novel solution algorithm is developed to efficiently solve this complex boundary value problem.The solution is presented in a general form and thus can be useful for a wide range of soils.With the new solution,the non-self-similar nature induced by the finite outer boundary is clearly demonstrated and highlighted,which is found to be greatly different to the behaviour of cavity expansion in infinite soil mass.The present solution may serve as a benchmark for verifying the performance of advanced numerical techniques with critical state soil models and be used to capture the finite boundary effect for pressuremeter tests in small-sized calibration chambers.

Palliative long-term abdominal drains vs large volume paracenteses for the management of refractory ascites in end-stage liver disease

BACKGROUND Long-term abdominal drains(LTAD)are a cost-effective palliative measure to manage malignant ascites in the community,but their use in patients with end-stage chronic liver disease and refractory ascites is not routine practice.The safety and cost-effectiveness of LTAD are currently being studied in this setting,with preliminary positive results.We hypothesised that palliative LTAD are as effective and safe as repeat palliative large volume paracentesis(LVP)in patients with cirrhosis and refractory ascites and may offer advantages in patients’quality of life.AIM To compare the effectiveness and safety of palliative LTAD and LVP in refractory ascites secondary to end-stage chronic liver disease.METHODS A retrospective,observational cohort study comparing the effectiveness and safety outcomes of palliative LTAD and regular palliative LVP as a treatment for refractory ascites in consecutive patients with end-stage chronic liver disease followed-up at our United Kingdom tertiary centre between 2018 and 2022 was conducted.Fisher’s exact tests and the Mann-Whitney U test were used to compare qualitative and quantitative variables,respectively.Kaplan-Meier survival estimates were generated to stratify time-related outcomes according to the type of drain.RESULTS Thirty patients had a total of 35 indwelling abdominal drains and nineteen patients underwent regular LVP.The baseline characteristics were similar between the groups.Prophylactic antibiotics were more frequently prescribed in patients with LTAD(P=0.012),while the incidence of peritonitis did not differ between the two groups(P=0.46).The incidence of acute kidney injury(P=0.014)and ascites/drain-related hospital admissions(P=0.004)were significantly higher in the LVP group.The overall survival was similar in the two groups(log-rank P=0.26),but the endpoint-free survival was significantly shorter in the LVP group(P=0.003,P<0.001,P=0.018 for first ascites/drain-related admission,acute kidney injury and drain-related complications,respectively).CONCLUSION The use of LTAD in the management of refractory ascites in palliated end-stage liver disease is effective,safe,and may reduce hospital admissions and utilisation of healthcare resources compared to LVP.

Long-Term Exposure to Low-Level Ambient Air Pollution and Mortality among 0.3 Million Chinese Older Adults

Objective Evidence that long-term exposure to ambient air pollution increases mortality among older adults,particularly those residing in low-level air pollution locations,remains scarce.This study investigated the potential links between long-term low-level air pollution exposure and mortality among Chinese older adults.Methods A population-based study with 317,464 individuals aged≥65 years was conducted in Shenzhen,China during 2018 and 2020.Logistic regression models were used to analyze the associations between long-term exposure to air pollution and all-cause mortality,as the primary outcome,as well as non-accidental,cancer and cardiovascular mortality.Results Significant associations of PM1,PM_(2.5),PM_(10),SO_(2),CO,and O3 exposures with a higher risk of all-cause mortality were found.Adjusted odds ratio(OR)for each 1μg/m^(3) increment was 1.49[95%confidence interval(CI):1.46,1.53]for PM1,1.30(1.27,1.32)for PM_(2.5),1.05(1.04,1.06)for PM_(10),5.84(5.39,6.32)for SO_(2),1.04(1.04,1.05)for CO,and 1.02(1.00,1.03)for O3,respectively.Long-term PM1,PM_(2.5),PM_(10),SO_(2),and CO exposures also elevated the risks of non-accidental,cancer and cardiovascular mortality.Conclusion Long-term low-level air pollution exposure was associated with an increased mortality risk among Chinese older adults.

Characteristics and Formation Mechanisms of Low-Level Jets in Northeastern China

This study examines low-level jets(LLJs)across Northeastern China during both warm(June-September)and cold seasons(December-March)from 1957 to 2021,using fifth generation of the European Centre for Medium-Range Weather Forecasts reanalysis data with 25-km resolution.LLJs manifest in two prominent regions,one along the leeward flank of the Da Hinggan Ling Mountains in the cold season and another at the center of Northeastern China in the warm season.The intricate interplay between ambient circulation and terrain shapes LLJ distribution,altitudes,wind directions,diurnal cycles,and seasonal diversities.During the warm season,prevailing southwesterly LLJs are found at 925 hPa,while the cold season features stronger and more frequent northwesterly LLJs at 875 hPa.Analysis of the diurnal patterns reveals distinctive behaviors of LLJs in the cold and warm seasons.During the warm season,the single peak in LLJ occurrence emerges around midnight;conversely,in the cold season,LLJs are most frequent shortly before midnight,with an additional sub-peak in the morning.A momentum budget analysis establishes mechanisms underlying these two distinct diurnal variations.In both seasons,the diurnal variation of LLJs is predominately driven by an inertial oscillation and mountain-valley circulations.However,the sub-peak observed in the cold-season morning arises from the thermodynamic and dynamic interaction between the low-level atmosphere and complex terrain.

Modelling smear effect of vertical drains using a diameter reduction method

Vertical drains are used to accelerate consolidation of clays in ground improvement projects.Smear zones exist around these drains,where permeability is reduced due to soil disturbance caused by the installation process.Hansbo solution is widely used in practice to consider the effects of drain discharge capacity and smear on the consolidation process.In this study,a computationally efficient diameter reduction method(DRM)obtained from the Hansbo solution is proposed to consider the smear effect without the need to model the smear zone physically.Validated by analytical and numerical results,a diameter reduction factor is analytically derived to reduce the diameter of the drain,while achieving similar solutions of pore pressure dissipation profile as the classical full model of the smear zone and drain.With the DRM,the excess pore pressure u obtained from the reduced drain in the original un-disturbed soil zone is accurate enough for practical applications in numerical models.Such performance of DRM is independent of soil material property.Results also show equally accurate performance of DRM under conditions of multi-layered soils and coupled radial-vertical groundwater flow.

Observation of Low-Level Jets in the Eastern Tropical Indian Ocean Based on Shipborne Coherent Doppler Lidar

In contrast to the Pacific and Atlantic Oceans,the Indian Ocean has lacked in-situ observations of wind profiles over open sea areas for decades.In 2021,a shipborne coherent Doppler lidar(CDL)was used to observe in-situ wind profiles in the eastern tropical Indian Ocean.This equipment successfully captured low-level jets(LLJs)in the region,and their characteristics were thoroughly analyzed.Results reveal that the observed wind speed of LLJs in the eastern Indian Ocean ranges from 6 m s^(-1) to 10 m s^(-1) during the boreal winter and spring seasons,showing a height range of 0.6 to 1 km and two peak times at 0800 and 2000 UTC.This wind shear is weaker than that in land or offshore areas,ranging from 0 s^(-1) to 0.006 s^(-1).Moreover,the accuracy of the CDL data is compared to that of ERA5 data in the study area.The results indicate that the zonal wind from ERA5 data significantly deviated from the CDL measurement data,and the overall ERA5 data are substantially weaker than the in-situ observations.Notably,ERA5 underestimates northwestward LLJs.

Special stent for draining the abdominal abscess respectively from colon and duodenum:A case report

BACKGROUND Postoperative abdominal infections are an important and heterogeneous health challenge.Many samll abdominal abscesses are resolved with antibiotics,but larger or symptomatic abscesses may require procedural management.CASE SUMMARY A 65-year-old male patient who suffered operation for the left hepatocellular carcinoma eight months ago,came to our hospital with recurrent abdominal pain,vomit,and fever for one month.Abdominal computed tomography showed that a big low-density dumbbell-shaped mass among the liver and intestine.Colonoscopy showed a submucosal mass with a fistula at colon of liver region.Gastroscopy showed a big rupture on the submucosal mass at the descending duodenum and a fistula at the duodenal bulb.Under colonoscopy,the brown liquid and pus were drained from the mass with“special stent device”.Under gastroscopy,we closed the rupture of the mass with a loop and six clips for purse stitching at the descending duodenum,and the same method as colonoscopy was used to drain the brown liquid and pus from the mass.The symptom of abdominal pain,vomit and fever were relieved after the treatment.CONCLUSION The special stent device could be effectively for draining the abdominal abscess respectively from colon and duodenum.

Study of the Efficiency of Vertical Drains by an FEM Method in Soil Treatment for Road Projects: Case of the Development and Bitumination Works of the ROCADE Porto-Novo in Benin

This article aims to study the efficiency of coupled vertical drains for the treatment of long-lasting compressible clay soils for the road project platform of the ring road of Porto Novo, capital of Benin. The experimental data allowed us to estimate a consolidation of 29% in 9 months, justifying the drainage of the soil. In order to study the efficiency of drainage, a FEM model was proposed simulating different scenarios. These include a drainless road, pavements equipped with vertical drains with meshes of 0.5 m 0.5 m, 1 m 1 m and 1.5 m 1.5 m respectively and horizontal drains. The results expressed in terms of variations in vertical stresses, effective stresses and shear deformations revealed significant variations in pavement performance depending on the mesh size of the vertical drains. The configuration with a mesh of 0.5 m 0.5 m showed the least deformations, thus indicating a reduction in deformations and better stress distribution. However, the other mesh configurations showed variable results, underlining the importance of choosing the right mesh for the specific project conditions.

基于Drain3与Loganomaly的网络安全日志分析与事件响应

随着信息技术的发展,网络安全问题日益凸显,为了保障网络系统的稳定运行,对HDFS-v1日志进行研究。首先,利用Drain3算法对日志进行解析,有效避免了构造深度较大、不平衡的树,实验结果显示其精确率、召回率、F1度量及准确度均高达100%;其次,基于Loganomaly算法进行异常检测,训练结果训练集、验证集损失值分别为0.21、0.18,预测结果精确度为96.889%,召回率为93.604%,F1度量为95.218%;接着,再用Drain3算法对异常日志分类;最后,通过远程控制实现异常事件响应,发送报警邮件,确保在HDFS发生紧急情况时能够快速、有效地处理故障,保障大数据处理任务的稳定进行。

Coupling Aquaculture—Crop Productions and Using of Water Drained from Ponds Rearing Clarias gariepinus as Fertilizer for Okra Production (Abelmoschus esculentus var. Clemson spineless, L. Moench)

The present study concerns the revalorization of drained water from aquaculture ponds rearing Clarias gariepinus on okra crops. The rearing was carried out at the farm of Gaston Berger University in 100 m2 ponds. In each pond, the individuals of C. garipinus with an average weight of 6 ± 0.3 g were stocked at a density of 11 per m2. The water temperature and pH were measured during the experiment. The control fishing is carried out every month to monitor variations in the weight and size of reared individuals. The plant production is carried out in elementary plots measuring 3 m × 1.5 m. Each plot was fertilized with either: drained water from C. gariepinus rearing (DWC), poultry droppings (PD), cow dung (CD) and mineral fertilizer (NPK). Treatments are carried out in tripliqua with either river water (RW), RW + the recommended dose of NPK (RD-NPK), RW + RD-PD, RW + RD-CD, DWC, DWC + 25% RD-NPK, DWC + 50% RD-NPK, DWC + 75% RD-NPK, DWC + 25% RD-PD, DWC + 50% RD-PD, DWC + 75% RD-PD, DWC + 25% RD-CD, DWC + 50% RD-CD, DWC + 75% RD-CD. Growth parameters and yield of okra were determined. The average temperature in the rearing environment was 27.6 ± 1.5˚C and pH 7.9 ± 1.1. After six (06) months of rearing, C. gariepinus individuals reached an average weight of 850.12 ± 1.3 g and an average height of 52.44 ± 1.1 cm. The daily weight gain and specific growth rates over this period were 3.9 g per day and 2.8% per day, respectively. The treatment T1 (RW + DR-NPK) gave the highest mean collar diameter and mean plant height with 2.3 ± 0.9 cm and 61.6 ± 32 cm, respectively. In T4 (DWC), the mean height of plants was 38.8 ± 23.5 cm and mean collar diameter 1.4 ± 0.8 cm. The growth performance in T4 was comparable to that of RD-CD (T3), but different from RD-NPK (T1) and RD-PD (T2). The highest average number, average weight, average length and average diameter of fruits were noted in treatments T13 (RW + RD-75%CD) and T7 (DWC + 75% RD-NPK). The best yields were noted in T1 (RW + RD-NPK) = 10.8 ± 5.4 t·ha−1, T5 (DWC + 25% RD-NPK) = 9.2 ± 4.6 t·ha−1 and T4 (DWC) = 8.6 ± 4.3 t·ha−1 which are comparable and higher than those obtained in T2 = 5.7 ± 2.8 t·ha−1 and T3 = 7.5 ± 3.8 t·ha−1.

隧道涌水量基于MODFLOW中DRAIN模块水力传导系数取值探析

目前Visual Modflow已广泛地应用于隧道涌水的模拟,Drain模块中的水力传导系数是一个综合系数,但没有可参考的取值范围。从排水沟水力传导系数对隧洞涌水量引起的变化入手,通过C值的不同取值范围,利用模型计算出的涌水量与真实涌水量进行对比,发现当水力传导系数取值在一定范围内时计算出的涌水量最接近施工时隧道的真实涌水量,以此为Drain模块中水力传导系数的取值作一个经验参考。

农田排水沟沟水灌溉对土壤盐碱及稻谷重金属的影响

为缓解宁夏银北地区农业水资源短缺问题,根据农田排水沟水资源丰富的情况,在宁夏平罗县银北盐碱土改良试验站水稻试验田,采用田间监测与室内检测相结合的方法,研究农田排水沟的水灌溉对土壤盐碱性质及稻谷重金属的影响。结果表明:水稻生育期内试验田排水沟的水矿化度低于1.2 g/L、pH值小于8.54,属于弱矿化水和淡水;采用农田排水沟的水灌溉不会导致土壤盐碱加重及土壤、稻谷重金属含量超标;与黄河水灌溉相比,农田排水沟的水直接灌溉会减产19.7%,农田排水沟的水和黄河水掺灌、交替灌溉对水稻产量的影响差别不大。因此,在黄河水资源短缺的情况下,可以适当利用农田排水沟的水与黄河水进行掺灌或交替灌溉,以保障粮食安全。

龙胆泻肝汤治疗慢性前列腺炎Meta分析

目的:系统评价龙胆泻肝汤治疗慢性前列腺炎的临床疗效和安全性。方法:检索Pubmed、EMBASE、Cochrane Library、中国生物医学文献数据库(CBMdisc)、中国知网、万方数据库和维普数据库中龙胆泻肝汤治疗慢性前列腺炎的相关文献,对符合纳入标准的文献进行Meta分析。结果:(1)龙胆泻肝汤无论是单独使用还是与抗生素或α受体阻滞剂联合使用,均可使有效率[RR=1.31,95%CI(1.18,1.45),P<0.00001]和临床治愈率[RR=1.79,95%CI(1.52,2.12),P<0.00001]显著升高;(2)龙胆泻肝汤无论是单独使用还是与抗生素或α受体阻滞剂联合使用,均可降低慢性前列腺炎症状总分[MD=-2.15,95%CI(-3.32,-0.97),P<0.0003]、疼痛领域评分[MD=-3.45,95%CI(-4.26,-2.63),P<0.00001]、排尿领域评分[MD=-2.7,95%CI(-4.73,-0.66),P<0.00001]和生活质量领域评分[MD=-1.94,95%CI(-2.42,-1.46),P<0.00001];(3)龙胆泻肝汤无论是单独使用还是与抗生素或α受体阻滞剂联合使用,可降低患者前列腺液中白细胞计数[MD=-9.88,95%CI(-14.34,-5.42),P<0.0001]。结论:龙胆泻肝汤治疗慢性前列腺炎可以提高患者的临床治愈率和有效率,降低慢性前列腺炎症状总分和白细胞计数,但仍需大规模、多中心、高质量的随机对照试验进一步验证。

“宣、降、清、利、养”五法治疗急性咳嗽

急性咳嗽基本病机为表邪外束内兼里热,表气不通里气上雍,肺失宣降上逆,治应首辨表里,次辨寒热,再辨虚实,终辨阴阳,主以祛邪为要,辅以畅达气机,采用宣法、降法、利法、清法、养法等治法。外邪初犯人体,病位在表,治以宣发为主,使用轻透之品以散邪,表寒者辛温宣散,方用麻杏石甘汤,表热者辛凉宣透,方用桑菊饮;肺为娇脏,其气以清肃下降为顺,肺气上逆则选用能降气逆的苦味药物如旋覆花、代赭石、杏仁、桑白皮等。内有郁热,当以寒凉药物清热,清热之法,首用轻清药物如石膏,继用苦寒之品如黄芩、栀子等;里有水饮邪气痼结者,当泻肺利水,通调水道,方用葶苈大枣泻肺汤。咳嗽日久,热邪实邪劫伤肺阴,用沙参、麦冬、石斛等甘寒药物补液救阴,以水制火。急性咳嗽治愈后,当培土生金,养护脾胃,以防复发,方用参苓白术散。

新型Drain Box设计与应用

本文首先介绍了目前国内海上油气田设施开排系统设计的工艺设计流程的原理及应用特点,随后通过对比分析介绍了一种新型DrainBox的设计与运用,最后对该新型DrainBox的创新点进行了分析和介绍,并对其推广与应用前景进行了展望。

刚果民主共和国利卡西黏土质砾的岩土工程特性

为获得刚果民主共和国Likasi黏土质砾的岩土工程特性,系统开展了Likasi黏土质砾物理性质指标测试、化学性质指标与矿物成分测试、击实试验、承载比试验、回弹模量试验、无侧限抗压强度试验、各向等压固结试验、固结排水剪三轴压缩试验、变水头渗透试验研究。获得了系统全面的Likasi黏土质砾物理、化学、力学特性与指标。结果表明:Likasi黏土质砾标准吸湿含水率低、级配良好、土颗粒形状大体呈次棱角状、不具膨胀性、比表面积小、阳离子交换量小,亲水性弱,具有良好的强度、刚度、渗透、压实等力学性质,可作为良好的路基填料。

Prophylactic intra-peritoneal drain placement following pancreaticoduodenectomy:A systematic review and metaanalysis

AIM:To conduct a meta-analysis comparing outcomes after pancreaticoduodenectomy(PD)with or without prophylactic drainage.METHODS:Relevant comparative randomized and nonrandomized studies were systemically searched based on specific inclusion and exclusion criteria.Postoperative outcomes were compared between patients with and those without routine drainage.Pooled odds ratios(OR)with 95%CI were calculated using either fixed effects or random effects models.RESULTS:One randomized controlled trial and four non-randomized comparative studies recruiting 1728patients were analyzed.Patients without prophylactic drainage after PD had significantly higher mortality(OR=2.32,95%CI:1.11-4.85;P=0.02),despite the fact that they were associated with fewer overall complications(OR=0.62,95%CI:0.48-0.82;P=0.00),major complications(OR=0.75,95%CI:0.60-0.93;P=0.01)and readmissions(OR=0.77,95%CI:0.60-0.98;P=0.04).There were no significant differences in the rates of pancreatic fistula,intraabdominal abscesses,postpancreatectomy hemorrhage,biliary fistula,delayed gastric emptying,reoperation or radiologic-guided drains between the two groups.CONCLUSION:Indiscriminate abandonment of intraabdominal drainage following PD is associated with greater mortality,but lower complication rates.Future randomized trials should compare routine vs selective drainage.

A new concept of backfll design—Application of wick drains in backflled stopes

Backflling represents an environmentally friendly mining waste disposal technique.It is increasingly used in underground mines all over the world.However,its primary purpose remains to improve ground stability and to reduce ore dilution.Previous investigations have shown that fll drainage plays a key role in backfll and barricade design.With a poor drainage system in the backflled stope,the required dimension of barricade,which is constructed at the base of the stope near the drift entrance,has to be increased.A poor backfll drainage system can also lead to a signifcant increase in drainage waiting time and further reduction in mining productivity.In this paper,the drainage of conventional backfll design in backflled stopes is briefly reviewed.For the frst time,the application of the wick drain is introduced in the backfll within mine stopes.The drainage improvement from the introduction of the wick drain is illustrated using numerical modeling.

FREEZE PROFILE AND HEAT BALANCE CALCULATION OF THE 160kA DRAINED CELL

A 2D full cell thermo-electric model of 160kA drained cell was set up using finiteelement code to calculate its freeze profile, then the drained cell model was modifiedaccording to the freeze profile computed and its heat balance was calculated. Comparedwith that of a 160kA conventional Hall-Heroult cell (H-H cell), though the melts vol-ume of the drained cell reduced greatly, the whole heat loss from it didn't drop downapparently, and an analysis was presented in the paper. On the other hand, the anode-cathode distance (ACD) of a drained cell was much less than that of a H-H cell, sothe voltage drop on it and heat produced decreased too, steps should be taken to keepa workable heat balance on a drained cell.