A two-stage but time-saving reconstructive scheme to treat severe lower limb length discrepancy:Two case reports

Limb length discrepancy(LLD)is a common orthopedic condition that can result in significant functional impairment,pain,and cosmetic deformities.Current reconstructive techniques for severe LLD are primarily based on callus distraction,which is a time-consuming process that can lead to complications,such as significant infection,joint stiffness,and stress fractures.To reduce the therapeutic time and minimize the risk of complications,we investigated the use of vascularized bone flaps as a technical supplement to callus distraction in the reconstruction of short limbs.We present two cases of severe LLD in the upper and lower legs,in which a twostage reconstruction approach was used.In the first stage,external fixation was applied to the affected limb to correct the soft tissue length and convert the short deformity into a bone defect.In the second stage,the bone defect was reconstructed using bilateral(patient A)or unilateral(patient B)free vascularized fibula bone grafts.Both patients had complete survival of the fibular grafts without stress fractures,and bone consolidation took 8 months(patient A)and 4 months(patient B).Compared to the traditional callus distraction,the two-stage approach was found to be more time-saving and reliable.The entire reconstructive scheme required 18 and 4 months for patients A and B,respectively,whereas the traditional callus distraction required 41 and 17 months,respectively.These findings suggest that the use of vascularized bone flaps as a technical supplement for callus distraction may provide an effective and efficient alternative for the treatment of severe LLD.Further studies are needed to validate these results and assess the long-term outcomes of this approach.

Influence of two-stage harvesting on the properties of cold-pressed rapeseed(Brassica napus L.)oils

Rapeseed(Brassica napus L.)harvesting method is critical since it significantly determines the seed yield,oil quality,and industrial efficiency.This study investigated the influences of harvesting methods on the quality of cold-pressed rapeseed oil of two varieties.Oil color,peroxide value(POV),tocopherol content,fatty acid composition,and polarity of total polyphenols(PTP)contents of two rapeseed varieties in Huanggang and Xiangyang were compared through artificially simulated combined harvesting and two-stage harvesting.Results showed significant differences in the quality of rapeseed oil between the two harvesting methods.The red value(R-value),POV,total tocopherol contents,linoleic and linolenic acid content,and PTP content of the pressed rapeseed oil prepared by the combined harvesting method were about 27.6,5.7,15.8,2.0,0.5,and 28.6%lower than those of the oil produced from the two-stage harvesting method,respectively.Xiangyang and Huayouza62 performed better in the two regions and two varieties,respectively.To sum up,the rapeseed oil obtained 41–44 days after final flowering of combined harvesting,35 days after final flowering,and six days of post-ripening of the two-stage harvesting had the best quality.

Two-Stage Optimal Scheduling of Community Integrated Energy System

From the perspective of a community energy operator,a two-stage optimal scheduling model of a community integrated energy system is proposed by integrating information on controllable loads.The day-ahead scheduling analyzes whether various controllable loads participate in the optimization and investigates the impact of their responses on the operating economy of the community integrated energy system(IES)before and after;the intra-day scheduling proposes a two-stage rolling optimization model based on the day-ahead scheduling scheme,taking into account the fluctuation of wind turbine output and load within a short period of time and according to the different response rates of heat and cooling power,and solves the adjusted output of each controllable device.The simulation results show that the optimal scheduling of controllable loads effectively reduces the comprehensive operating costs of community IES;the two-stage optimal scheduling model can meet the energy demand of customers while effectively and timely suppressing the random fluctuations on both sides of the source and load during the intra-day stage,realizing the economic and smooth operation of IES.

Two-stage transcrestal sinus floor elevation-insight into replantation: Six case reports

BACKGROUND Transcrestal sinus floor elevation(TSFE)has been widely used in the oral clinic when the residual bone height(RBH)exceeds 5 mm.However,when there is insufficient RBH in the posterior maxilla,two-stage TSFE may be an option.CASE SUMMARY This article introduces the concept of two-stage TSFE.Six patients had osseointegration failure after TSFE.For the first-stage surgery,we restricted the vertical bone augmentation as much as possible.At the second-stage surgery,the increased RBH was 3.28±1.55 mm,which was beneficial for surgery.Five implants functioned successfully on schedule,but one implant failed again during the healing period.A third surgery was performed,and the implant functioned successfully.CONCLUSION When RBH was less than 5 mm,two or more procedures of TSFE might result in a higher RBH.

蓝舌病新疆分离株VP7蛋白编码基因序列分析及一步法RT-PCR方法的建立

【目的】分析蓝舌病新疆分离株编码VP7蛋白S7基因保守序列,建立蓝舌病新疆分离株一步法RT-PCR方法,为新疆BTV分子流行病学调查及防控提供技术支持。【方法】采用二代测序技术获得新疆分离株S7基因序列,登陆GenBank对序列进行同源性Blast比对,用软件MEGA 5.0分析序列差异,根据蓝舌病新疆分离株编码VP7蛋白S7基因保守序列,运用软件Oligo6.0设计引物,对蓝舌病新疆分离株S7基因进行RT-PCR扩增,并验证该方法的特异性及敏感性。【结果】蓝舌病中国新疆分离株编码VP7蛋白S7基因序列与哈尔滨报道BTV分离株S7基因片段相似度较高为89.64%,与中国云南报道BTV-29型分离株、蒙古国BTV分离株S7基因片段相似度分别为87.49%和87.39%;与德国BTV分离株S7基因片段相似度为80.70%,其余均无同源性序列。中国新疆分离株S7基因片段序列与4条同源序列间存在26处核苷酸差异,9处氨基酸差异。【结论】建立的蓝舌病中国新疆分离株S7基因片段一步法RT-PCR方法具有良好的特异性,仅BTV中国新疆分离株扩增获得目的条带,该方法的敏感性为4.0×10^(3)copies/mL。

闪光放射治疗(Flash-RT)技术的研究进展

经过多年发展,精准放射治疗技术已广泛应用,但现有技术仍受限于正常组织耐受剂量的限制,无法实现肿瘤治疗的最佳目标。闪光放射治疗(Flash-RT)是一种以超高剂量率射束(UHDR)进行照射的放射治疗技术,能够在显著降低正常组织辐射损伤的同时,最大限度地治疗肿瘤。但直到目前,Flash-RT的生物学机制、关键物理参数及触发机制等尚不明确,其原理及临床转化应用仍处于研究阶段。本综述通过归纳Flash-RT相关研究,阐明Flash-RT研究的技术进展及临床转化应用。

基于RT-Thread的液压支架监控分站的设计

为提高煤矿生产的安全性和效率,降低生产成本,设计了基于嵌入式实时操作系统RT-Thread的液压支架监控分站。该分站通过CAN总线将综采工作面液压支架的工作数据上传到主站并接收主站下达的指令;此外,通过支架控制器可以实现对液压支架的远程控制。软件设计利用信号量和事件集进行线程间通信同步;同时采用多线程优先级抢占调度机制,实现任务的并发运行。实验证明,该分站具有精度高、可靠性强和实时响应等特点,达到工程实际应用需求。

建立检测猕猴三磷酸腺苷结合盒转运蛋白G2的mRNA相对表达水平的RT-qPCR方法

目的本研究旨在建立一种实时荧光定量PCR方法,用于检测猕猴三磷酸腺苷结合盒转运蛋白G2(adenosine triphosphate-binding cassette transporter protein G2,ABCG2)mRNA的基因转录水平。方法使用NCBI上GenBank数据库猕猴(Macaca mulatta)的ABCG2核苷酸序列号NM_001032919.1及内参GAPDH核苷酸序列号NM_001195426.1,借助Primer premier 5.0软件设计PCR引物。提取猕猴新鲜肾组织的总RNA,并反转录合成cDNA。接着,利用PCR引物进行实时荧光定量PCR扩增,并根据反应体系中荧光的变化情况定量分析ABCG2的mRNA相对表达水平。结果PCR产物测序结果显示,扩增的ABCG2和GAPDH核苷酸序列与NCBI上猕猴的序列同源性分别为90.91%和91.14%。ABCG2和GAPDH的扩增效率均达到80%~120%,实时荧光定量PCR标准曲线的熔解曲线为单峰,R2接近1。结论本研究建立的检测猕猴ABCG2 mRNA实时荧光定量检测方法,为研究高尿酸血症的发病机制以及新药开发奠定基础。

Tourism Route Recommendation Based on A Multi-Objective Evolutionary Algorithm Using Two-Stage Decomposition and Pareto Layering

Tourism route planning is widely applied in the smart tourism field.The Pareto-optimal front obtained by the traditional multi-objective evolutionary algorithm exhibits long tails,sharp peaks and disconnected regions problems,which leads to uneven distribution and weak diversity of optimization solutions of tourism routes.Inspired by these limitations,we propose a multi-objective evolutionary algorithm for tourism route recommendation(MOTRR)with two-stage and Pareto layering based on decomposition.The method decomposes the multiobjective problem into several subproblems,and improves the distribution of solutions through a two-stage method.The crowding degree mechanism between extreme and intermediate populations is used in the two-stage method.The neighborhood is determined according to the weight of the subproblem for crossover mutation.Finally,Pareto layering is used to improve the updating efficiency and population diversity of the solution.The two-stage method is combined with the Pareto layering structure,which not only maintains the distribution and diversity of the algorithm,but also avoids the same solutions.Compared with several classical benchmark algorithms,the experimental results demonstrate competitive advantages on five test functions,hypervolume(HV)and inverted generational distance(IGD)metrics.Using the experimental results of real scenic spot datasets from two famous tourism social networking sites with vast amounts of users and large-scale online comments in Beijing,our proposed algorithm shows better distribution.It proves that the tourism routes recommended by our proposed algorithm have better distribution and diversity,so that the recommended routes can better meet the personalized needs of tourists.

GRACE Level-2数据的RTS状态平滑

GRACE Level-2球谐系数反演得到的全球地表质量变化存在明显的南北条带噪声,严重影响区域地表质量异常估计的精度。DDK滤波引入信号协方差矩阵和正则化因子,能较好地削弱条带误差,同时保留更多的真实信号。采用状态空间模型表示球谐系数在相邻月份之间的联系,进而通过卡尔曼滤波实现去条带,即为状态空间DDK滤波方法(SS-DDK)。本文提出的SS-DDK方法状态向量只包含球谐系数,反映条带误差统计信息的协方差矩阵被用作状态空间模型中观测噪声协方差矩阵,采用幂律模型设计过程噪声协方差矩阵,通过迭代法求解方差分量因子,最后输出RTS平滑解代替卡尔曼滤波解作为最终数据处理结果。结果表明,在全球范围内,SS-DDK结果不存在明显的条带误差;计算各约束解与mascon解质量异常差异的均方根(RMSD),SS-DDK的RMSD为10.36 cm,小于任意一种DDK滤波。对比五大区域135个月所有约束解的等效水柱高、年振幅及RMSD发现,在格陵兰岛,SS-DDK所导致的信号失真更少,仅为49.8 cm;在其他区域,SS-DDK的去条带和保留信号的能力与DDK3—5滤波有不同程度的相似,在某些时段优于所有DDK滤波。对估计结果进行不确定性分析,SS-DDK解全球的不确定性大小为2.20 cm,其在所选区域的不确定性大小介于DDK2和DDK3之间。对比大地水准面阶误差的结果说明,SS-DDK解的噪声水平低于DDK4—8,保留信号能力与DDK2—3相当。增添仿真试验进一步说明SS-DDK在去条带和保留信号方面具有较好的性能。

Current status of associating liver partition with portal vein ligation for staged hepatectomy: Comparison with two-stage hepatectomy and strategies for better outcomes

Since its introduction in 2012,associating liver partition with portal vein ligation for staged hepatectomy(ALPPS)has significantly expanded the pool of candidates for liver resection.It offers patients with insufficient liver function a chance of a cure.ALPPS is most controversial when its high morbidity and mortality is concerned.Operative mortality is usually a result of posthepatectomy liver failure and can be minimized with careful patient selection.Elderly patients have limited reserve for tolerating the demanding operation.Patients with colorectal liver metastasis have normal liver and are ideal candidates.ALPPS for cholangiocarcinoma is technically challenging and associated with fair outcomes.Patients with hepatocellular carcinoma have chronic liver disease and limited parenchymal hypertrophy.However,in selected patients with limited hepatic fibrosis satisfactory outcomes have been produced.During the inter-stage period,serum bilirubin and creatinine level and presence of surgical complication predict mortality after stage II.Kinetic growth rate and hepatobiliary scintigraphy also guide the decision whether to postpone or omit stage II surgery.The outcomes of ALPPS have been improved by a combination of technical modifications.In patients with challenging anatomy,partial ALPPS potentially reduces morbidity,but remnant hypertrophy may compare unfavorably to a complete split.When compared to conventional two-stage hepatectomy with portal vein embolization or portal vein ligation,ALPPS offers a higher resection rate for colorectal liver metastasis without increased morbidity or mortality.While ALPPS has obvious theoretical oncological advantages over two-stage hepatectomy,the long-term outcomes are yet to be determined.

Period-doubling bifurcation in two-stage power factor correction converters using the method of incremental harmonic balance and Floquet theory

In this paper, period-doubling bifurcation in a two-stage power factor correction converter is analyzed by using the method of incremental harmonic balance （IHB） and Floquet theory. A two-stage power factor correction converter typically employs a cascade configuration of a pre-regulator boost power factor correction converter with average current mode control to achieve a near unity power factor and a tightly regulated post-regulator DC-DC Buck converter with voltage feedback control to regulate the output voltage. Based on the assumption that the tightly regulated postregulator DC-DC Buck converter is represented as a constant power sink and some other assumptions, the simplified model of the two-stage power factor correction converter is derived and its approximate periodic solution is calculated by the method of IHB. And then, the stability of the system is investigated by using Floquet theory and the stable boundaries are presented on the selected parameter spaces. Finally, some experimental results are given to confirm the effectiveness of the theoretical analysis.

Multi-source coordinated stochastic restoration for SOP in distribution networks with a two-stage algorithm

After suffering from a grid blackout, distributed energy resources(DERs), such as local renewable energy and controllable distributed generators and energy storage can be used to restore loads enhancing the system’s resilience. In this study, a multi-source coordinated load restoration strategy was investigated for a distribution network with soft open points(SOPs). Here, the flexible regulation ability of the SOPs is fully utilized to improve the load restoration level while mitigating voltage deviations. Owing to the uncertainty, a scenario-based stochastic optimization approach was employed,and the load restoration problem was formulated as a mixed-integer nonlinear programming model. A computationally efficient solution algorithm was developed for the model using convex relaxation and linearization methods. The algorithm is organized into a two-stage structure, in which the energy storage system is dispatched in the first stage by solving a relaxed convex problem. In the second stage, an integer programming problem is calculated to acquire the outputs of both SOPs and power resources. A numerical test was conducted on both IEEE 33-bus and IEEE 123-bus systems to validate the effectiveness of the proposed strategy.

Acceptance,availability and feasibility of RTS,S/AS01 malaria vaccine:A review of literature

Malaria remains the most serious infectious disease and is one of the leading causes of death among children in malaria endemic areas.The development of malaria vaccines has been underway since 1960s.Significant progress in the development of vaccine has been made in the last decade.On 6 October 2021,World Health Organization recommended widespread use of the RTS,S/AS01 malaria vaccine.The level of acceptance of RTS,S/AS01 malaria vaccine is relatively low in middle-income countries.This might be because of lack of information regarding vaccine implementation in such countries.The proper and efficient execution of the malaria vaccination program necessitates careful consideration of each community's socio-cultural setting.The most prominent RTS,S/AS01 vaccine trial was conducted from 2009 to 2011 in which eleven sites in seven African countries participated.Results of the trial,published in 2015,provided a promising advance in the development of a malaria vaccine for African children.As of 2019,large-scale pilot studies of the vaccine have been conducted in Ghana,Kenya,and Malawi,involving several hundreds of thousands of infants.The RTS,S/AS01 vaccine shows modest efficacy against malaria and has a feasible mode of administration.Although there is increased risk of meningitis,cerebral malaria,pneumonia,anemia,febrile convulsions and gastroenteritis,the vaccine still has a feasible mode of administration and high cost effectiveness and can be easily implemented in resource-limited settings.

RT-fqPCR检测腐乳耐药基因方法的建立及应用

该研究根据腐乳中微生物全基因组测序结果中耐药基因的丰度筛选出3种耐药基因(Baca、Emra、Imrp)设计引物,建立一种非培养方式—实时荧光定量聚合酶链式反应(RT-fqPCR)方法检测不同腐乳样品中微生物可能存在的耐药基因,并对该方法的灵敏度、抗干扰能力及重复性进行检测,最后应用于市售腐乳样品中耐药基因的检测。结果表明,建立的RT-fqPCR方法对3种耐药基因检测的灵敏度较高,均达到5.4 pg;添加黄豆基因对检测结果影响不显著,抗干扰能力较好;重复性试验结果的相对标准偏差(RSD)均<1.8%,重复性较好。采用该方法对市售的47批次腐乳样品进行检测发现,3种耐药基因Baca、Emra、Imrp在腐乳中的检出率较高,分别为96.5%、92.2%和97.2%;青方腐乳、白方腐乳、红方腐乳3类腐乳含有的耐药基因分别为84.4%、83.3%和89.6%。综上,建立的RT-fqPCR方法可快速检测不同腐乳中的3种耐药基因。

A New Two-Stage Tunable Space-Time Adaptive Detector

In order to improve the rejection capability of mismatched interferer signals,a new two-stage detector is proposed under homogeneous scenarios with unknown covariance matrix,which is obtained by cascading the adaptive matched filter(AMF)detector and the enhanced RAO(EnRAO)detector.The new detector has constant false alarm performance,and the closed-form expression of probability of false alarm and probability of detection is derived.The performance of the new detector is assessed,and analyzed in comparison with other detectors.The results show that,the proposed detector can provide enhanced rejection capability in the case of mismatch,but the performance of the detector is slightly lost under the condition of matching.

猪Linda病毒巢式RT-PCR检测方法的建立

猪Linda病毒能引起仔猪先天性震颤,严重危害养猪业的发展,目前在我国暂未发现感染病例。本研究根据猪Linda病毒Core-E~(ms)基因序列,设计并合成巢式RT-PCR引物,通过对退火温度、引物浓度等进行优化,建立了猪Linda病毒巢式RT-PCR检测方法。结果显示,该方法具有良好的特异性,与非洲猪瘟病毒、猪瘟病毒、猪繁殖与呼吸综合征病毒、猪伪狂犬病病毒、猪圆环病毒2型均无交叉反应;敏感性好,对慢病毒阳性对照品的最低检出限为10~1 copies/μL,比普通RT-PCR灵敏10倍。使用该方法检测模拟病毒样品,发现最低检出限为10~1 TU/mL,与荧光定量RT-PCR方法一致。本研究首次建立了可检测猪Linda病毒的巢式RT-PCR方法,其特异性强、灵敏度高,为在口岸以及条件有限的场地对猪Linda病毒进行精准且快速的检测提供了有效技术手段,也为防范Linda病毒传入提供了有力技术支撑。

Two-stage revision arthroplasty for coagulase-negative staphylococcal periprosthetic joint infection of the hip and knee

BACKGROUND Periprosthetic joint infections(PJIs)are frequently caused by coagulase-negative Staphylococci(CoNS),which is known to be a hard-to-treat microorganism.Antibiotic resistance among causative pathogens of PJI is increasing.Two-stage revision is the favoured treatment for chronic CoNS infection of a hip or knee prosthesis.We hypothesised that the infection eradication rate of our treatment protocol for two-stage revision surgery for CoNS PJI of the hip and knee would be comparable to eradication rates described in the literature.AIM To evaluate the infection eradication rate of two-stage revision arthroplasty for PJI caused by CoNS.METHODS All patients treated with two-stage revision of a hip or knee prosthesis were retrospectively included.Patients with CoNS infection were included in the study,including polymicrobial cases.Primary outcome was infection eradication at final follow-up.RESULTS Forty-four patients were included in the study.Twenty-nine patients were treated for PJI of the hip and fifteen for PJI of the knee.At final follow-up after a mean of 37 mo,recurrent or persistent infection was present in eleven patients.CONCLUSION PJI with CoNS can be a difficult to treat infection due to increasing antibiotic resistance.Infection eradication rate of 70%-80%may be achieved.

基于GNSS-RTK水田平地机的设计与试验

设计了一种基于GNSS-RTK的水田平地机,并根据水田平整作业要求,设计了水田平地机的机械结构、液压及控制系统。控制系统基于GNSS-RTK卫星定位技术,采用Cortex M3系列控制器及RT-Thread嵌入式实时操作系统完成了平地铲高程的高精度检测,实现了平地铲高度的自动调节。田间试验结果表明:平地机机构设计合理,控制系统运行稳定可靠,平整精度满足要求。研究结果对水田平地机的设计具有一定的参考价值。

Improved patient reported outcomes with functional articulating spacers in two-stage revision of the infected hip

BACKGROUND Two-stage revision arthroplasty with an antibiotic-loaded spacer is the treatment of choice in chronically infected total hip arthroplasties.Interval spacers can be functional articulating or prefabricated.Functional results of these spacers have scarcely been reported.AIM To compare retrospectively the patient reported outcome and infection eradication rate after two-stage revision arthroplasty of the hip with the use of a functional articulating or prefabricated spacer.METHODS All patients with two-stage revision of a hip prosthesis at our hospital between 2003 and 2016 were included in this retrospective cohort study.Patients were divided into two groups;patients treated with a functional articulating spacer or with a prefabricated spacer.Patients completed the Hip Osteoarthritis Outcome Score and the EQ-5D-3L(EQ-5D)and the EQ-5D quality of life thermometer(EQVAS)scores.Primary outcomes were patient reported outcome and infection eradication after two-stage revision.The results of both groups were compared to the patient acceptable symptom state for primary arthroplasty of the hip.Secondary outcomes were complications during spacer treatment and at final follow-up.Descriptive statistics,mean and range are used to represent the demographics of the patients.For numerical variables,students’t-tests were used to assess the level of significance for differences between the groups,with 95%confidence intervals;for binary outcome,we used Fisher’s exact test.RESULTS We consecutively treated 55 patients with a prefabricated spacer and 15 patients with a functional articulating spacer of the hip.The infection eradication rates for functional articulating and prefabricated spacers were 93%and 78%,respectively(P>0.05).With respect to the functional outcome,the Hip Osteoarthritis Outcome Score(HOOS)and its subscores(all P<0.01),the EQ-5D(P<0.01)and the EQVAS scores(P<0.05)were all significantly better for patients successfully treated with a functional articulating spacer.More patients in the functional articulating spacer group reached the patient acceptable symptom state for the HOOS pain,HOOS quality of life and EQ-VAS.The number of patients with a spacer dislocation was not significantly different for the functional articulating or prefabricated spacer group(P>0.05).However,the number of dislocations per patient experiencing a dislocation was significantly higher for patients with a prefabricated spacer(P<0.01).CONCLUSION Functional articulating spacers lead to improved patient reported functional outcome and less perioperative complications after two-stage revision arthroplasty of an infected total hip prosthesis,while maintaining a similar infection eradication rate compared to prefabricated spacers.