Wettability,reactivity,and interface structure in Mg/Ni system

The sessile drop method was applied to the experimental investigation of the wetting and spreading behaviors of liquid Mg drops on pure Ni substrates.For comparison,the experiments were performed in two variants:(1)using the Capillary Purification(CP)procedure,which allows the non-contact heating and squeezing of a pure oxide-free Mg drop;(2)by classical Contact Heating(CH)procedure.The high-temperature tests were performed under isothermal conditions(CP:760℃for 30 s;CH:715℃for 300 s)using Ar+5 wt%H_(2) atmosphere.During the sessile drop tests,images of the Mg/Ni couples were recorded by CCD cameras(57 fps),which were then applied to calculate the contact angles of metal/substrate couples.Scanning and transmission electron microscopy analyses,both coupled with energy-dispersive X-ray spectroscopy,were used for detailed structural characterization of the solidified couples.It was found that an oxide-free Mg drop obtained by the CP procedure showed a wetting phenomenon on the Ni substrate(an average contact angleθ<90°in<1 s),followed by fast spreading and good wetting over the Ni substrate(θ_((CP))~20°in 5 s)to form a final contact angle ofθ_(f(CP))~18°.In contrast,a different wetting behavior was observed for the CH procedure,where the unavoidable primary oxide film on the Mg surface blocked the spreading of liquid Mg showing apparently non-wetting behavior after 300 s contact at the test temperature.However,in both cases,the deep craters formed in the Ni substrates under the Mg drops and significant change in the structure of initially pure Mg drops to Mg-Ni alloys suggest a strong dissolution of Ni in liquid Mg and apparent values of the final contact angles measured for the Mg/Ni system.

Introduction of PIC/S Accession Procedure and Suggestions for Establishing a Unified Quality Management System in China

Objective To introduce the accession procedure and evaluation of PIC/S,and help relevant departments in China to understand the requirements of PIC/S in detail,and to promote the process of China’s entry into PIC/S.Methods The procedures and steps of joining PIC/S,the evaluation process of PIC/S,and the experience of several countries in joining PIC/S were introduced and analyzed,which could help the relevant personnel in China understand the specific contents.Results and Conclusion According to the requirements of PIC/S,it is necessary to establish a unified GMP quality management system.

Optimization of Open-cast Mining Procedure Based on RSR Method

To explore the optimal evaluation mechanism of open-cast mining procedure,this paper takes the actual operation status of Huolinhe No.1 Open-cast Mine as the research basis,and makes a deep analysis of the four representative mining procedures proposed by this mine.A detailed and comprehensive evaluation system is constructed using rank-sum ratio(RSR)method.The system covers 17 key indicators and aims to evaluate the advantages and disadvantages of each scheme in an all-round and multi-angle manner.Through the calculation and analysis by RSR method,the comprehensive evaluation of the four types of mining procedure schemes is carried out,and finally the secondary river improvement project is determined as the optimal mining implementation scheme,and the joint mining scheme of the south and north areas is the alternative strategy.The research results of this paper are objective,clear and definite,can not only reveal the effectiveness and feasibility of RSR method in solving the problem of open-cast mining procedure optimization,but also provide a strong technical support and decision-making basis for the future production development of Huolinhe No.1 Open-cast Mine.Thus,this study is expected to further promote the scientific and refined process of mining operations.

Coordinated Mining Procedures of Open Pit Mines Based on River Management

This paper primarily concerns the effective coordination of the procedures and methods employed in open pit mining operations under the background of river management.The central objective of this study is to identify a viable approach for ensuring rational and efficient development of open pit mineral resources while simultaneously protecting and restoring the ecological environment of the river.This approach should facilitate the realization of a harmonious symbiosis between mining and river management.The intricate mutual influence relationship between river management and open pit mining is first analyzed in depth,which provides a solid foundation for the subsequent coordination strategy development.In light of the aforementioned considerations,a set of coordination procedures for open pit mining based on river management conditions is proposed.These procedures emphasize the integration of river protection into the overall layout of mining at the planning stage.The implementation of scientific mining schemes,accompanied by rigorous control of the scope and depth of mining operations,has proven to be an effective means of reducing the impact of mining activities on river environments.This approach has also facilitated the achievement of a balance and coordination between mining and river management.

Education Programs for Invasive Procedures Involving Nurses: A Scoping Review

Background: Implementing invasive procedures is an important part of patient management by clinical nurses;however, there are gaps between nurses’ actual knowledge and skills and expected professional care capacity. Purpose: This scoping review aimed to map the existing literature related to recent institution-provided educational programs for invasive procedures involving clinical nurses. This study seeks to understand the contents of educational programs and the methods for assessing educational effects. Methods: This scoping review was completed using the following four databases: PubMed (MEDLINE), Embase, Cochrane Library, and Emcare for the period 2000-2022. We included studies that used all forms of educational approaches (e.g., didactic lectures, hands-on training, or on-the-job training). This scoping review considered peer-reviewed publications published in English using quantitative, qualitative, or mixed approaches. A total of 83 studies underwent in the final analysis. Results and Conclusion: A combination of didactic lectures and hands-on training was provided as an educational program in most studies. Contrary to our prediction, educational interventions with advanced technologies such as VR are extremely rare, suggesting that the effectiveness of advanced technologies in learning invasive procedures should be examined to facilitate and retain educational effects more efficiently in future studies. Regarding the assessment of educational effects, nurses’ cognitive (i.e., theoretical knowledge about procedures), psychomotor (i.e., implementing procedures), and psychological aspects (e.g., confidence and self-efficacy in procedures) were evaluated using questionnaires and observational methods. While most studies used a one-group pretest-posttest design, the ratio of randomized controlled trials (RCT) was relatively low. Thus, an RCT design should be introduced in future studies to test the validity of the developed educational program more accurately.

Comparison of Surgical Techniques Used in Treating Acromioclavicular Dislocation in Patients Participating in Sports: A Systematic Review

Introduction: The acromioclavicular joint is a superficial diarthrodial joint that surrounds the medial articular facet of the acromion and the distal portion of the clavicle. Due to its anatomy and biomechanics, it is highly susceptible to trauma and in young men who play contact sports, acromioclavicular dislocation is common. This article aimed to systematically review the literature and compare the surgical techniques used in the treatment of acromioclavicular dislocation in patients who practice sports. Methods: This systematic review was conducted according to the International Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Eligible studies for this systematic review included articles in English or Spanish published between 2013 and 2023, which mention the occurrence of acromioclavicular dislocation during sports practices. Additionally, only studies that addressed the surgical treatment of acromion-clavicular dislocation and contained original data on the topic were included. Results: We found 144 eligible studies after searching the LILACS and PubMed databases. Based on the inclusion and exclusion criteria and the reviewers’ consensus, we selected four studies for the systematic review. 133 patients with AC joint displacement were evaluated. Mean Age: approximately 31.90 years. 81.92 of these injuries occurred during sports practice. Surgical Procedures Used: titanium plates fixation (49 patients), arthroscopy (24), single tunnel technique (30) and coracoid sling technique (30). The results of the visual analog scale and Constant-Murley scores varied between the techniques used. Twenty-two complications after surgical treatment were identified. Conclusion: A significant variability of operative techniques can be used in the surgical approach of acromioclavicular dislocation, such as arthroscopy, single tunnel, coracoid sling and titanium plates. Although it presented excellent functional results compared to the other three techniques evaluated by this review, using titanium plates is not the gold standard since other techniques not assessed by this work may be more effective.

Adverse Pregnancy Outcomes Following Cryotherapy, Thermal Ablation and Loop Electrosurgical Excision Procedure for Cervical Intraepithelial Neoplasia Treatment: A Pilot Study among Zambian Women

Background: Cervical Intraepithelial neoplasia treatments have become essential interventions to manage cervical lesions. Majority of the recipients of these treatments are women within the reproductive age group, who according to literature may be at risk of adverse pregnancy outcomes. This pilot study is part of a study investigating adverse pregnancy outcomes among women who received Cryotherapy, Thermal ablation and Loop Electrosurgical Excision Procedure compared to the untreated women in Zambia. Materials and Methods: This descriptive study analyzed records of 886 (n = 443 treated and n = 443 untreated) women aged 15 - 49 years. The women were either screened with Visual Inspection with Acetic Acid or treated for Cervical Intraepithelial neoplasia at the Adult Infectious Disease Centre between January 2010 and December 2020. Women meeting the criteria were identified using the Visual Inspection with Acetic Acid screening records and telephone interviews to obtain the adverse pregnancy outcome experienced. Data were analysed using STATA version 16 to determine the prevalence and obtain frequency distribution of outcomes of interest. Univariate and multivariable binary logistic regression estimated odds of adverse pregnancy outcomes across the three treatments. Results: The respondents were aged 15 to 49 years. Adverse pregnancy outcomes were observed to be more prevalent in the treatment group (18.5%) compared to the untreated group (5.4%). Normal pregnancy outcomes were lower in the treated (46.3%;n = 443) than the untreated (53.7%;n = 443). The treated group accounted for the majority of abortions (85.2%), prolonged labour (85.7%) and low birth weight (80%), whereas, the untreated accounted for the majority of still births (72.7%). Women treated with cryotherapy (aOR = 2.43, 95% CI = 1.32 - 4.49, p = 0.004), thermal ablation (aOR = 6.37, 95% CI = 0.99 - 41.2, p = 0.052) and Loop Electrosurgical Excision Procedure (aOR = 9.67, 95% CI = 2.17 - 43.1, p = 0.003) had two-, six- and ten-times higher odds of adverse pregnancy outcomes respectively, relative to women who required no treatment. Conclusion: Adverse pregnancy outcomes are prevalent among women who have received treatment in Zambia. The findings indicate that treating Cervical Intraepithelial Neoplasia has been linked to higher chances of experiencing abortion, delivering low birth weight babies and enduring prolonged labor that may result in a caesarean section delivery. Cervical neoplasia treatments, particularly Loop Electrosurgical Excision Procedure, are associated with significantly increased odds of adverse pregnancy outcomes. It is essential to include information about prior Cervical Intraepithelial neoplasia treatment outcomes in obstetric care.

Clinical Study on the Treatment of Low Anal Fistula in Infants and Young Children by Anal Gland Excision and Virtual Hanging Procedure

Objective:To compare the efficacy of anal adenectomy with virtual hanging wire and anal fistulotomy in the treatment of low anal fistula in infants and children.Methods:60 children with low anal fistula who were admitted to our hospital from October 2021 to March 2022 and met the inclusion criteria were randomly divided into two groups of 30 cases each;the treatment group was treated with anal adenectomy and virtual hanging wire surgery,and the control group was treated with anal fistula resection.The clinical efficacy after treatment was compared.Results:The total effective rate of both groups was 96.67%and the difference between the two groups was not statistically significant(P>0.05).The postoperative pain score of the treatment group was lower than that of the control group(P<0.05).The length of hospitalization and healing time of the treatment group was lower than that of the control group(P<0.05).The anal function of the patients in both groups was normal,and there was no adverse reaction.Conclusion:Anal gland excision and virtual hanging surgery for the treatment of low anal fistula in infants and children have the advantages of mild pain,reduced length of hospitalization,short healing time,and better patient experience as compared to anal fistula excision.

Knowledge expression and reasoning process in an expert system for welding procedure qualification

After analyzing the welding procedure knowledge in Chinese national standards for welding procedure qualification of steel pressure vessel from the point of establishing expert system, it can be divided into five types of knowledge, i. e. practice, definition, regularity, process and description knowledge. The knowledge expression methods are established according to the different type of welding procedure knowledge. The reasoning process based on rule is adopted. And the reasoning engine is embedded among objects integrated with the knowledge base.

Orthodontic simulation system with force feedback for training complete bracket placement procedures

Background A virtual system that simulates the complete process of orthodontic bracket placement can be used for pre-clinical skill training to help students gain confidence by performing the required tasks on a virtual patient.Methods The hardware for the virtual simulation system is built using two force feedback devices to support bi-manual force feedback operation.A 3D mouse is used to adjust the position of the virtual patient.A multi-threaded computational methodology is adopted to satisfy the requirements of the frame rate.The computation threads mainly consist of the haptic thread running at a frequency of>1000Hz and the graphic thread at>30Hz.The graphic thread allows the graphics engine to effectively display the visual effects of biofilm removal and acid erosion through texture mapping.Using the haptic thread,the physics engine adopts the hierarchy octree collision-detection algorithm to simulate the multi-point and multi-region interaction between the tools and the virtual environment.Its high efficiency guarantees that the time cost can be controlled within 1 ms.The physics engine also performs collision detection between the tools and particles,making it possible to simulate paint and removal of colloids.The surface-contact constraints are defined in the system;this ensures that the bracket will not divorce from or embed into the tooth during the adjustment of the bracket.Therefore,the simulated adjustment is more realistic and natural.Results A virtual system to simulate the complete process of orthodontic bracket bonding was developed.In addition to bracket bonding and adjustment,the system simulates the necessary auxiliary steps such as smearing,acid etching,and washing.Furthermore,the system supports personalized case training.Conclusions The system provides a new method for students to practice orthodontic skills.

Procedure Design to Fulfill Quality Management System

With the application of the principle of PDCA, and dr awing on the experience of the process methods of the ISO9000 and the system met hods of management, the author analyses the basic requirement to fulfill quality management system in enterprises. Then the author inquires into the procedure t o establish the efficiency quality management system. Finally four stages (plan, do, check, action) and eight steps (decision, plan, analyze, design, do, check, improve, fulfill) are put forward to fulfill quality management system.

Reporting of longitudinal pancreatojejunostomy with partial pancreatic head resection(the Frey procedure) for chronic pancreatitis: A systematic review

Background:Longitudinal pancreatojejunostomy with partial pancreatic head resection(the Frey procedure)is accepted for surgical treatment of painful chronic pancreatitis.However,conduct and reporting are not standardized and thus,making comparisons difficult.This study assesses the reporting standards of this procedure.Data sources:A systematic literature review was performed between January 1987 and January 2020.The keyword and Medical Subject Heading"chronic pancreatitis"was used together with the individual operation term"Frey pancreatojejunostomy".Reports were included if they provided original information on conduct and outcome.Thirty-three papers providing information on 1205 patients constituted the study population.Risk of bias in included reports was assessed.Results:Etiology of chronic pancreatitis(alcohol)was reported in 26 of 28(93%)studies,duration of symptoms prior to surgery in 19(58%)studies and pre-operative opiate use in 12(36%)studies.In terms of morphology,pancreatic duct diameter was reported in 17(52%)studies and diameter of the pancreatic head in 13(39%)studies.In terms of technique,three(9%)studies reported weight of excised parenchyma.There were 9(0.7%)procedure-related deaths.Post-operative follow-up ranged from 6 to 82.5 months.No studies reported post-operative portal hypertension.Conclusions:There is substantial heterogeneity between studies in reporting of clinical baseline,morphology of the diseased pancreas,operative detail and outcome after longitudinal pancreatojejunostomy with partial pancreatic head resection.This critically compromises the comparison between centers and between surgeons.Structured reporting is necessary for clinicians to assess choice of procedure and for patients to make informed choices when seeking treatment for painful chronic pancreatitis.

Pushover analysis procedure for systems considering SSI effects based on capacity spectrum method

This paper presents a new procedure to transform an SSI system into an equivalent SDOF system using twice equivalence. A pushover analysis procedure based on the capacity spectrum method for buildings with SSI effects （PASSI） is then established based on the equivalent SDOF system, and the modified response spectrum and equivalent capacity spectrum are obtained. Furthermore, the approximate formulas to obtain the dynamic stiffness of foundations are suggested. Three steel buildings with different story heights （3, 9 and 20） including SSI effects are analyzed under two far-field and two near-field historical records and an artificial seismic time history using the two PASSI procedures and the nonlinear response history analysis （NLhRHA） method. The results are compared and discussed. Finally, combined with seismic design response spectrum, the nonlinear seismic response of a 9-story building with SSI effects is analyzed using the PASSI procedures, and its seismic performance is evaluated according to the Chinese ＇Code for Seismic Design of Buildings. The feasibility of the proposed procedure is verified.

Initial experience of laparoendoscopic single-site radical prostatectomy with a novel purpose-built robotic system

Objective This prospective single-arm clinical trial aimed to evaluated the feasibility and safety of the application of the SHURUI system(Beijing Surgerii Technology Co.,Ltd.,Beijing,China),a novel purpose-built robotic system,in single-port robotic radical prostatectomy.Methods Sixteen patients diagnosed with prostate cancer were prospectively enrolled in and underwent robotic radical prostatectomy from October 2021 to August 2022 by the SHURUI single-port robotic surgical system.The demographic and baseline data,surgical,oncological,and functional outcomes as well as follow-up data were recorded.Results The mean operative time was 226.3(standard deviation[SD]52.0)min,and the mean console time was 183.4(SD 48.3)min,with the mean estimated blood loss of 116.3(SD 90.0)mL.The mean length of postoperative hospital stay was 4.50(SD 0.97)days.Two patients had postoperative complications(Clavien-Dindo Grade II),and both patients improved after conservative treatment.All patients’postoperative prostate-specific antigen levels decreased to below 0.2 ng/mL 1 month after discharge.The mean prostate-specific antigen level further decreased to a mean of 0.0219(SD 0.0641)ng/mL 6 months after surgery.Thirty days postoperatively,12 out of 16 patients reported using no more than one urinary pad per day,and all patients reported satisfactory urinary control without the need for pads 6 months after surgery.Conclusion The SHURUI system is safe and feasible in performing radical prostatectomy via both transperitoneal and extraperitoneal approaches.Tumor control and urinary continence were satisfying for patients enrolled in.The next phase involves conducting a large-scale,multicenter randomized controlled trial to thoroughly assess the effectiveness and safety of the new technology in a broader population.

Analysis and Optimization of Validation Procedure in Blockchain-Enhanced Wireless Resource Sharing and Transactions

To ensure the security of resource and intelligence sharing in 6G,blockchain has been widely adopted in wireless communications and applications.Although blockchain can ensure the traceability and non-tamperability of data in the concatenated blocks,it cannot guarantee the honest behaviors of users in the application before the generation of transactions.Thus,additional technologies are required to ensure that the source of blockchain data is reliable.In this paper,the detailed procedure is designed for the application-oriented task validation in the blockchainenhanced computing resource sharing and transactions in ultra dense networks(UDN).The corresponding queuing model is built and analyzed with the consideration of the wireless re-transmission and the probability of malicious deception by users.Based on the analysis results,the UDN deployment is optimized to save network cost while ensuring latency performance.Numerical results verify our analysis,and the optimized system deployment including the number and service capacities of both base stations and mobile edge computing(MEC)servers are also given with various system settings.

Rotationplasty type BIIIb as an effective alternative to limb salvage procedure in adults:Two case reports

BACKGROUND Rotationplasty is often performed for malignant tumors,but type BIIIb rotationplasty is rarely reported,and there needs to be more evidence of the procedure and treatment.The purpose of this case study was to report a new direction in the use of type BIIIb rotationplasty in treating patients with limb salvage and longterm non-healing infections.CASE SUMMARY Case 1:A 47-year-old man underwent radiotherapy for hemangioendothelioma in his left thigh,resulting in a femoral fracture.Despite the use of plates,intramedullary nailing,and external fixators,the femoral bone failed to unite due to infectious nonunion.Multiple operations were unable to control the infection,leaving the patient immobile.We performed a modified tibia-pelvic-constrained hip rotationplasty,utilizing a constrained prosthetic hip between the tibia and pelvis following a femur resection.Two years post-surgery,the patient was able to walk with the prosthetic device without any signs of recurring infection.The corresponding functional scores were 72 points for the Musculoskeletal Tumor Society(MSTS),53 for the Functional Mobility Assessment(FMA),93 for the Toronto Extremity Salvage Score(TESS),and 56 for the MOS 36-item short form health survey(SF-36).Case 2:A 59-year-old woman presented with liposarcoma in her left thigh.Magnetic resonance imaging revealed tumors in the medial,anterior,and posterior femur muscles,encircling the femoral vessels and nerves.Fortunately,there were no symptoms of sciatic dysfunction,and the tumor had not invaded the sciatic nucleus.After one year of follow-up,the patient expressed satisfaction with limb preservation post-type BIIIb rotationplasty.The corresponding functional scores were 63 points for the MSTS,47 for the FMA,88 for the TESS,and 52 for the SF-36.CONCLUSION Our study suggests that type BIIIb rotationplasty may be an alternative to amputation in patients with incurable infections.For malignant tumors of the lower extremities without invasion of the sciatic nerve,type BIIIb rotationplasty remains an excellent alternative to amputation.This surgical method may prevent amputation,improve functional outcomes,and facilitate biological reconstruction.

Balloon-occluded retrograde transvenous obliteration for treatment of congenital intrahepatic portosystemic venous shunt:A case report

Congenital intrahepatic portosystemic venous shunt(CPSVS), a rare vascular malformation, has been described in both children and adults and can lead to severe neurophysiological complications. However, a standard therapeutic protocol for CPSVS has not been elucidated. With the advantage of minimally invasive techniques,transcatheter embolization has been used to treat CPSVS. The condition is challenging to manage, especially in patients with large or multiple shunts, through which rapid blood flow can cause ectopic embolism. Here, we describe a case of CPSVS with a large shunt that was successfully treated with balloon-occluded retrograde transvenous obliteration with interlocking detachable coils.

Spinal fusion is an aerosol generating procedure

BACKGROUND Transmission of severe acute respiratory syndrome coronavirus 2 can occur during aerosol generating procedures.Several steps in spinal fusion may aerosolize blood but little data exists to quantify the risk this may confer upon surgeons.Aerosolized particles containing infectious coronavirus are typically 0.5-8.0μm.AIM To measure the generation of aerosols during spinal fusion using a handheld optical particle sizer(OPS).METHODS We quantified airborne particle counts during five posterior spinal instrumentation and fusions(9/22/2020-10/15/2020)using an OPS near the surgical field.Data were analyzed by 3 particle size groups:0.3-0.5μm/m^(3),1.0-5.0μm/m^(3),and 10.0μm/m^(3).We used hierarchical logistic regression to model the odds of a spike in aerosolized particle counts based on the step in progress.A spike was defined as a>3 standard deviation increase from average baseline levels.RESULTS Upon univariate analysis,bovie(P<0.0001),high speed pneumatic burring(P=0.009),and ultrasonic bone scalpel(P=0.002)were associated with increased 0.3-0.5μm/m^(3)particle counts relative to baseline.Bovie(P<0.0001)and burring(P<0.0001)were also associated with increased 1-5μm/m^(3)and 10μm/m^(3)particle counts.Pedicle drilling was not associated with increased particle counts in any of the size ranges measured.Our logistic regression model demonstrated that bovie(OR=10.2,P<0.001),burring(OR=10.9,P<0.001),and bone scalpel(OR=5.9,P<0.001)had higher odds of a spike in 0.3-0.5μm/m^(3)particle counts.Bovie(OR=2.6,P<0.001),burring(OR=5.8,P<0.001),and bone scalpel(OR=4.3,P=0.005)had higher odds of a spike in 1-5μm/m^(3)particle counts.Bovie(OR=0.3,P<0.001)and drilling(OR=0.2,P=0.011)had significantly lower odds of a spike in 10μm/m^(3)particle counts relative to baseline.CONCLUSION Several steps in spinal fusion are associated with increased airborne particle counts in the aerosol size range.Further research is warranted to determine if such particles have the potential to contain infectious viruses.Previous research has shown that electrocautery smoke may be an inhalation hazard for surgeons but here we show that usage of the bone scalpel and high-speed burr also have the potential to aerosolize blood.

Operating procedures of traditional Chinese medicine breast massage

Traditional Chinese medicine breast massage,also known as breast Tuina or manual expression of breast milk,is a technique of using certain manipulations to act on specific positions or acupoints of the breast to promote blood and lymphatic circulation of breast and facilitate the discharge of stagnant milk.This technique is widely used in China to treat breastfeeding problems such as breast engorgement,mastitis,and postpartum hypogalactia.In this article,we introduce the definition and standardization process of breast massage,elaborate the operating procedures of breast massage in detail,and summarize and discuss the current situation of its clinical application,so as to provide a reference for its wide application and in‑depth research.

Current approach for Boerhaaves syndrome:A systematic review of case reports

There is no consensus on the appropriate therapeutic strategy for Boerhaave syndrome due to its rarity and changing therapeutic approaches.We conducted a systematic review of case reports documenting Boerhaave syndrome.AIM To assess the therapeutic methods and clinical outcomes and discuss the current trends in the management of Boerhaave syndrome.METHODS We searched PubMed,Google scholar,MEDLINE,and The Cochrane Library for studies concerning Boerhaave syndrome published between 2017 and 2022.RESULTS Of the included studies,49 were case reports,including a total of 56 cases.The mean age was 55.8±16 years old.Initial conservative treatment was performed in 25 cases,while operation was performed in 31 cases.The rate of conservative treatment was significantly higher than that of operation in cases of shock vital on admission(9.7%vs 44.0%;P=0.005).Seventeen out of 25 conservative cases(68.0%)were initially treated endoscopic esophageal stenting;2 of those 17 cases subsequently underwent operation due to poor infection control.Twelve cases developed postoperative leakage(38.7%),and 4 of those 12 cases underwent endoscopic esophageal stenting to stop the leakage.The length of the hospital stay was not significantly different between the conservative treatment and operation cases(operation vs conservation:33.52±22.69 vs 38.81±35.28 days;P=0.553).CONCLUSION In the treatment of Boerhaave syndrome,it is most important to diagnose the issue immediately.Primary repair with reinforcement is the gold-standard procedure.The indication of endoscopic esophageal stenting or endoluminal vacuum-assisted therapy should always be considered for patients in a poor general condition and who continue to have leakage after repair.