Prospective randomized study to evaluate and compare the post-procedural sexual function in patients undergoing semi-rigid ureterorenoscopy for distal ureteric stones in three different operating room settings

Objective:To evaluate and compare the effect of semi-rigid ureterorenoscopy on post-procedural sexual function with three different operating room settings.Methods:In this prospective randomized study,consecutive sexually active patients with normal pre-operative sexual function undergoing uncomplicated semi-rigid ureterorenoscopy for distal ureteric stones were randomized into three groups,with three different operating room settings.Procedure-related anxiety and sexual function were assessed pre-operatively using Amsterdam Preoperative Anxiety and Information Scale and Brief Sexual Function Inventory(in males)and Female Sexual Function Index-6(in females),respectively.All the participants were stented following the procedure,and the stent was removed after 3 weeks.Post-procedural sexual function and general discomfort were assessed and compared between three groups at 1 week,3 weeks,and 12 weeks.The effect of surgery-related anxiety,preoperative sexual function,age,and general discomfort(including stent-related discomfort)on post-procedural sexual function were analyzed using multiple regression analysis.A p-value of less than 0.05 was considered statistically significant.Results:Totally,327 eligible patients were randomized into three groups.The group of patients who underwent the procedural with a screen separating the operating area from the patient vision,while the patient could watch the endoscopy through a separate monitor,had better post-procedural sexual function compared to those who had total vision of the operating area as well as to those whose eyes were blocked.This difference was statistically significant.This post-procedural reduction in sexual function could not be attributed to in situ stent alone.Conclusions:Our study showed that semi-rigid ureterorenoscopy can have significant negative effect on sexual function,which can be reduced with proper preoperative counseling and an ideal operating room settings.

Ureteroscopy with Holmium: YAG Laser—A Initial Study in the Urology Department of the Pr Bocar Sidy Sall University Hospital of Kati

Introduction: Ureteroscopy is a minimally invasive endoscopic surgery which provides access to the ureter, pyelon and calyceal cavities via the urethra and the bladder. Laser ureteroscopy uses the laser as an energy source to treat the stone and eliminate it naturally. Minimally invasive endoscopic methods are struggling to become popular in sub-Saharan African countries, especially for the upper urinary tract. The objective of our work was to report the results of our first laser ureteroscopy experience in the department. Materials and Methods: This was a prospective and descriptive study running from December 1, 2023 to February 19, 2024. Included in our study was any case of upper urinary tract stone operated by Laser ureteroscopy. The characteristics of the lithiasis were determined by CT scan. Sterilization of urine was verified by carrying out a cytobacteriological examination of urine. Ureteral lithiasis was approached by semi-rigid ureteroscopy. Renal lithiasis was immediately addressed by flexible ureteroscopy. Ureteroscopy was coupled with a Holmium YAG laser. A double J ureteral catheter was placed after the operation. A 230 µm laser fiber was used in each case with a generator with a power of 35 watts (Storz Calculase III type). An access sheath was used in all cases of flexible ureteroscopy. The parameters studied were: sociodemographic characteristics, lithiasis (site, size, number, density, topography), type of anesthesia, duration of laser use, duration of intervention, postoperative outcomes. Data entry and analysis were carried out using the software (Word 2016 and SPSS). Result: We collected 30 cases of laser ureteroscopy. The average age was 37 years with extremes of 9 and 79 years. The male gender was more represented. The most common age group was 24-39 years old. Renal colic was the most frequent reason for admission, 12 patients (40%). On physical examination, lumbar tenderness was present in 47% (14 patients). ECBU was positive in 4 patients (13%). CT scan was performed in all our patients before the intervention. The average stone size was 12 mm and the largest was 23 mm. The majority of stones, i.e. 59% (18 patients), had a density greater than 1000 HU. The stone was unique in 19 patients (63%). The location of the stone was pyelic in 8 patients or 27%. An impact on the upper urinary tract was found in 16 of our patients or 53%. General anesthesia was used in 25 patients (83%). A digital flexible ureteroscopy was used in 24 patients and a semi-rigid ureteroscopy (URS) in 6 patients. Full-course fragmentation was the most used therapeutic method, 9 patients or 32%. The average duration of interventions was 61 minutes. Drainage by double J catheter at the end of the procedure was performed in all our patients. The length of hospitalization was 24 hours. Only one case of failure in the USSR was recorded, and one case of failure was in the semi-rigid URS. Conclusion: Laser ureteroscopy is an effective minimally invasive surgery in the management of lithiasis of the upper urinary tract. It significantly reduces the length of hospitalization. Mastery of this technique and the acquisition of the equipment necessary for its implementation is an undeniable asset in the management of renal and ureteral lithiasis.

Compressive strength and frost heave resistance of different types of semi-rigid base materials after freeze-thaw cycles

Freeze-thaw damage is the most common disease of semi-rigid bases in cold regions, which may greatly affect the dura- bility of roadways. In this study, the compressive strength and frost resistance of four different types of semi-rigid bases （lime-fly ash-stabilized sand, cement-stabilized sand, lime-fly ash-stabilized gravel, and cement-stabilized gravel） are assessed by varying the materials content. Based on freeze-thaw and compressive strength tests, this paper presents the performance of the different materials, each having different physical properties, and the optimal amounts of materials contents are proposed.

Use of a modified ureteral access sheath in semi-rigid ureteroscopy to treat large upper ureteral stones is associated with high stone free rates

Objective:To examine differences in outcomes of semi-rigid ureteroscopy(URS)with or without a modified-ureteral-access-sheath(mUAS)to treat large upper ureteral stones.Methods:Patients with single,radio-opaque large upper ureteral stone(≥10 mm)treated using semi-rigid URS between August 2013 and October 2016 were retrospectively evaluated.The stone-free status was determined from Kidney-ureter-bladder(KUB)X-ray films taken on postoperative Day 1 and after 1 month.Results:Of 103 patients meeting inclusion criteria,43(41.75%)and 60(58.25%)were treated with semi-rigid URS with and without mUAS,respectively.The immediate stone-free rate(SFR)for the mUAS group was significantly higher than the non-mUAS group(40[93.0%]vs.46[76.7%];p=0.033).The SFR at 1 month was also high for patients treated using mUAS,but not statistically different from patients not treated with mUAS(41[95.3%]mUAS vs.51[85.0%]non-mUAS;p=0.115).Auxiliary procedure rates were significantly lower for mUAS patients compared to non-mUAS patients(2[4.7%]vs.14[23.3%];p=0.01).There were no significant differences in surgical duration and hospital stays,and the overall complication rates were statistically similar for mUAS patients compared to non-mUAS patients(1[2.3%]vs.3[5.0%];p=0.638).

STATISTICAL MODELS FOR SEMI-RIGID NEMATIC POLYMERS

Semi-rigid liquid crystal polymer is a class of liquid crystal polymers different from long rigid rod liquid crystal polymer to which the well-known Onsager and Flory theories are applied. In this paper, three statistical models for the semi-rigid nematic polymer were addressed. They are the elastically jointed rod model, worm-like chain model, and non-homogeneous chain model. The nematic-isotropic transition temperature was examined. The pseudo-second transition temperature is expressed analytically. Comparisons with the experiments were made and the agreements were found.

Static behavior of semi-rigid thin-walled steel-concrete composite beam-to-column joints with bolted partial-depth flush end plate:experimental study

A new type of semi-rigid thin-walled steel-concrete composite beam-to-column joint has been proposed in this paper.Five semi-rigid composite beam-to-column joint specimens subjected to hogging moments under monotonic loading were tested to study the static behavior of this new type of joint.The main variable parameters for the five joint specimens were the longitudinal reinforcement ratio and the joint type.The experimental results designated that the magnitude of extension of the longitudinal reinforcement is the most important factor that influenced the moment-rotation characteristic of the new type of joint.The concrete slabs could resist 3.8%-19.1% of the total shear load applied to the cross-sections near the beam-to-column connection.The edge stiffened elements,such as the flange of the lipped I-section thin-walled steel beam,were capable of having considerable inelastic deformation capacity although they had comparatively large width-to-thickness ratios.The shear failure of the concrete cantilever edge strip must be taken into account in practical design because it has significant influence on the anchorage of the longitudinal reinforcement in the new type of external joints.

Infrapubic versus Penoscrotal Approaches for Implantation of Semi-Rigid Penile Prosthesis

Background: Modification of surgical techniques to minimize wound infections in penile implant surgery using malleable prosthesis which is easy to use, of very low risk of mechanical failure and is financially suitable to improve outcome and ensures less complications. The aim of the study is to compare infrapubic approach and Penoscrotal approach in penile semi-rigid prosthesis implantation surgery. Patients and methods: Fifty patients were randomly divided into two groups and each group underwent one approach. Results: No statically significant differences were found between both groups in terms of operative time. Corporeal cross over was the most common intraoperative complications, 3 cases in IP approach and 6 cases in PS but not statistically significant. Peyronie’s disease patients underwent penile implant through infrapubic approach in 3 cases and PS in 4 cases with one recorded complication of keloid formations with IP. Urethral false passage reported only in one case with PS approach without affecting the procedure. Only minor complications including superficial wound infection which was significantly more with PS, 6/25 (24%) and IP 1/25 (4%), p value = 0.041. Penile and scrotal edema was common with IP approach (92%) in comparison with PS approach (60%). The urethral catheter can be abandoned with IP to avoid the risk of catheterizations. No significant relation between diabetes and infections and no erosions were encountered. Conclusion: Through this research work, infrapubic approach is better than Penoscrotal approach even if it is not commonly used by surgeon.

Study on Test Methods for Mechanical Properties of Semi-rigid Base Cores of In-service Pavements

Compressive strength and compressive resilience modulus are two important parameters to measure the mechanical properties of semi-rigid base.The test methods of semi-rigid base cores are different from those of the laboratory samples in terms of sample acquisition,sample selection and humidity requirements.Core-drilling location,size of core sample,smoothness and humidity conditions were analyzed.The test methods of compressive strength and compressive resilience modulus were proposed.The research results show that compressive strength of lime fly-ash stabilized gravels base has a tendency of increasing during a long period.The compressive resilience modulus increases significantly with compressive strength of semi-rigid base.The compressive resilience modulus generally is 3-4 times than the recommended range of asphalt pavement design specifications.The fluctuation range of compressive resilience modulus is obviously higher than the compressive strength.The compressive resilience modulus is more sensitive to the construction variability.The overall trend between the compressive resilience modulus and the back-calculation modulus is consistent.FWD(falling weight deflectometer)back-calculation modulus can reflect the stiffness and bearing capacity of asphalt pavement.

Semi-Rigid Registration of 3D Points

In this paper, we proposed a method for semi-rigid changed 3D point clouds registration. We first segment the point clouds into individual segments and then the alignment energy costs of each segment are calculated. The rough initial transformation is estimated by minimizing the energy cost using integer programming. The final registration results are obtained by rigid alignments of separated corresponded segments. Experimental result with simulated point clouds demonstrate that the concept of semi-rigid registration works well.

Analytical Model of Nonlinear Semi-rigid Frames Using Finite Element Method

Performance-based design for a constructional steel frame in nonlinear-plastic region requires an improvement in order to achieve a reliable structural analysis.The need to explicitly consider the nonlinear behaviour of structures makes the numerical modelling approach much more favourable than expensive and potentially dangerous experimental work.The parameters considered in the analysis are not limited to the linear change of geometry and material yielding,but also include the effect of large deformations,geometrical imperfections,load eccentricities,residual stresses,strain-unloading,and the nonlinear boundary conditions.Such analysis requires the use of accurate mathematical modelling and effective numerical procedures for solving equations of equilibrium.With that in mind,this paper presents the mathematical formulations and finite element procedures of nonlinear inelastic steel frame analysis with quasi-static semi-rigid connections.Verification and validation of the developed analytical procedures are conducted and good agreements are obtained.It is an approach that enables the structural behaviour of constructional steel frames to be traced throughout the entire range of loading until failure.It also provides information on the derivation of the structural analysis by using finite element method.

Semi-rigid腰椎后路动态钉棒固定系统治疗单节段腰椎不稳的疗效观察

目的探讨Semi-rigid腰椎后路动态钉棒固定系统治疗单节段腰椎不稳的临床疗效。方法对该院2009年6月—2011年1月间采用Semi-rigid腰椎后路动态钉棒固定系统手术治疗34例单节段腰椎不稳症病例进行回顾性分析。结果随访10～24个月,优31例(91.2%),良2例(5.9%),差1例(2.9%),优良率97.1%。结论 Semi-rigid腰椎后路动态钉棒固定系统可有效治疗单节段腰椎不稳,值得临床推广。

钢渣混合土基层材料干缩及抗冻性能研究

为了解钢渣混合土基层材料在环境作用下的响应特性,分别以失水率、干缩应变、干缩系数和冻融质量损失率、冻融残留强度比为指标,开展了干缩和冻融循环试验研究。研究发现,随着钢渣占比的增加,钢渣混合土28 d干缩系数、冻融质量损失率均有所减小,冻融残留强度比先增后减,在钢渣占比50%(质量分数)时达到峰值96.1%,说明合适的钢渣占比既能抑制钢渣混合土的干缩,又赋予其较好的抗冻性能;随着水泥掺量的增加,28 d干缩系数、冻融残留强度比增加,冻融质量损失率减小,表明水泥掺量的增加不利于钢渣混合土的干缩性能但有利于其抗冻性能;土壤固化剂的掺入能改善钢渣混合土的干缩和抗冻性能。SEM分析表明,钢渣占比为50%、水泥掺量为5%配合比的钢渣混合土结构更紧密,8次冻融循环后整体性更好。通过对比不同基层材料的干缩系数和冻融残留强度比发现,钢渣混合土的干缩性能劣于水泥稳定碎石但优于水泥石灰稳定土,抗冻性达到甚至超过水泥稳定碎石。

赤泥做道路基层材料的试验研究

在分析山东铝业赤泥理化性质的基础上,进行了赤泥做道路基层材料的配制和试验研究。试验研究表明:选用适当的配比,赤泥道路基层强度可满足高等级公路的要求,7d抗压强度可达到2 0MPa以上,28d强度3 0MPa以上,赤泥基层与传统的半刚性基层材料相比具有强度高、回弹值大等优点。这不仅可拓宽道路基层材料的应用范围,而且可使赤泥变废为宝。

注浆法在黄土地区公路路基洞穴处理中的应用

研究了注浆法在黄土地区公路路基洞穴处理中的加固机理及技术指标。黄土地区公路中的洞穴对公路的安全运营常造成严重危害,同时对于这类洞穴的处理尚缺乏有效的方法。在大量调查和参考前人研究成果的基础上,将注浆法用于路基中洞穴的处理,提出了注浆法加固的主要设计参数,通过对施工现场黄土洞穴注浆处理效果分析,认为该方法具有良好的处理效果。

西湖疏浚淤泥的固化试验

采用工业废料、水泥及添加剂对西湖疏浚淤泥进行固化.结果表明,淤泥固化土的强度能够达到公路基层填料的要求,但是淤泥的含水量对固化效果的影响很大,若将含水量降至100%以下,淤泥固化土的强度随固化材料掺入比和龄期的提高均有较大的增长,可获得理想的固化效果;钢渣和粉煤灰两种工业废料中,钢渣对淤泥固化土强度的提高幅度显著高于粉煤灰,当钢渣掺入比大于30%时,淤泥固化土Ⅰ和Ⅱ分别可作为公路基层和底基层的填料,但掺粉煤灰的淤泥固化土不能满足公路基层填料的强度要求;掺入少量的QL-1添加剂能显著提高淤泥固化土的强度,从成本和效果综合考虑,QL-1添加剂的掺入比不宜超过1.5‰;水泥掺入比大于10%才能有效地固化西湖淤泥;经估算,采用淤泥固化土作为公路基层填料与级配粒料造价相当,但其环保和社会效益却无法比拟.

疏浚淤泥的固化试验研究

采用一种成分可调的水泥系土壤固化剂对太湖清淤工程的3种代表性淤泥质土(HH-4、HH-10、LM-2)进行了固化试验,以研究太湖淤泥固化后用于路基填筑的可行性,确定固化剂各组分的质量分数,掺入固化剂的最佳质量分数以及固化土的强度变化特性。结果表明:当固化剂质量分数为6%时,3种固化土均能满足路堤填料的规范要求,但加固HH-10土样时,需要提高固化剂中A、D、F组分的质量分数。由于土样颗粒级配和化学成分的不同,HH-4固化土具有较高的早期强度,LM-2固化土具有较高的后期强度。疏浚淤泥固化并用于路基填筑,避免了淤泥的长期占地堆放,既减少了环境污染,又保护了土地资源,经济和社会效益显著。

水泥粉煤灰稳定碎石在高速公路上的应用

针对目前我国广泛采用的水泥稳定类材料与二灰稳定类材料在高等级公路基层建设中存在的问题,提出采用水泥粉煤灰稳定碎石修筑路面基层。对水泥粉煤灰稳定碎石材料作为路面基层材料的配合比设计及其性能进行了研究,设计底基层的配合比为水泥∶粉煤灰∶碎石=3∶10∶90,基层配合比为水泥∶粉煤灰∶碎石=4.5∶10∶90,较水泥稳定碎石降低水泥剂量1%左右,并节省混合料用量5%。此外,还进一步探讨了孝襄高速公路试验路用水泥粉煤灰稳定碎石材料的施工工艺与应用效果,通过观察发现该种基层材料的裂缝较水泥稳定碎石材料大大减少,具有很好的路用性能。

海排灰在道路水泥稳定类碎石材料基层中的应用

目的通过对海排灰原材料的物理力学性能试验和基于海排灰的二灰混合料的配合比设计的研究,为海排灰应用于道路基层提供可靠的理论和实践依据.方法进行配合比设计以及最佳配合比条件下不同含盐量对抗压强度的影响分析.结果在进行的6组试件中只有一组早期强度为1.27 MPa不能满足规范7 d强度大于1.5 MPa的要求,其他各组都能满足强度大于1.5 MPa的要求.海排灰中不同的氯盐含量对水泥海排灰碎石强度有影响:当二灰混合料中海排灰的氯盐含量在1.3%左右时,混合料28 d强度最高.当海排灰中氯离子含量大于1.3%时,二灰试件浸水后,氯离子融解到水中而使试件变疏松,强度会有所下降,但还能满足规范要求.结论海排灰中的氯盐含量对二灰混合料路用性能有一定影响,但能满足规范要求,可安全用于营口沿海产业基地路面基层.

铁尾矿在公路工程中的应用

通过对铁尾矿物理力学性质、颗粒组成、化学成分分析、理论推断和必要的实验室及小规模工业试验,证明铁尾矿在路面材料、替代河砂混凝土和路基回填料等方面应用的可靠性和技术要求。

道路基层贫混凝土抗冻性能的研究

为研究贫混凝土的抗冻性能,通过室内试验,分析了几种贫混凝土的抗冻性能及其规律。试验表明,各种贫混凝土的抗冻性能优于二灰碎石和水泥稳定碎石;贫混凝土中掺原状湿排灰时,其抗冻性能变差,而掺优质粉煤灰贫混凝土的抗冻性能与不掺粉煤灰的接近。