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ObjectiveThis study aimed to evaluate the effectiveness and safety of auricular acupuncture (AA) on postoperative analgesia, the degree of postoperative nausea, and the effect of inflammation after total knee arthroplasty (TKA).MethodsThis was a single-center, placebo-controlled, randomized clinical trial. In total, 96 patients were randomly divided into an AA group with an indwelling intradermal needle (n = 48) and a sham auricular acupuncture (SAA) group with a non-penetrating placebo needle (n = 48). Intra-spinal anesthesia was adopted in both groups during surgery, and an epidural analgesic pump was implanted after surgery for 48 h. The primary outcome was the post-surgery visual analog score (VAS) of resting and movement states (at 6, 12 h and 1, 2, 3, 5, and 7 days). The secondary outcomes included additional doses of analgesic injection during the treatment, C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count on the 1st, 3rd, and 7th day after the operation, nausea on the 1st, 2nd, and 3rd day after the operation, the Hospital for Special Surgery Knee Score (HSS) on the 2nd and 12th week after the operation, and adverse events.ResultsThe VAS in the AA group at 6 h, 12 h, 2, 3, and 5 days after surgery were lower than those of the SAA group (p 0.05).ConclusionIn this study, AA was shown to be an effective and safe complementary and alternative therapy for pain relief after TKA, which was able to reduce the total postoperative dose of additional painkillers, decrease serum CRP 1 day after surgery, and improve the degree of postoperative nausea.Clinical trial registrationwww.chictr.org.cn, ChiCTR2100054403.

ObjectiveThis study aimed to investigate the association between new inflammatory indicators at admission and the occurrence of preoperative deep vein thrombosis (DVT) in patients with patella fractures.MethodsA retrospective analysis of the medical records of patients aged 18 years or older who underwent surgical treatment for unilateral closed patella fractures at our hospital between August 2016 and August 2020. The incidence of preoperative DVT was detected by Duplex ultrasound (DUS). Partial blood routine and biochemical indexes were collected at admission, and the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) of inflammatory indexes were also calculated. ROC was used to analyze the cut-off value NLR, MLR, and PLR for predicting preoperative DVT, and univariate and multivariate analyses of the risk factors for preoperative DVT of patella fractures, and to verify whether other risk factors affecting the relationship between validation indexes and preoperative DVT.ResultsA total of 500 patients were included, of which 39 patients (7.8%) developed preoperative DVT. After univariate and multivariate analysis, preoperative time (in each day delay), male (vs. female), D-dimer > 0.6 mg/L, total cholesterol (TC) > 5.6 mmol/L, and PLR > 189.8 were the risk factors for preoperative DVT in patients with patella fracture. Inflammation index PLR combined with the other four risk factors significantly improved the predictive efficacy of preoperative DVT compared with PLR (P = 0.009).ConclusionInflammatory index PLR is a risk factor for preoperative DVT in patients with patella fracture, and the efficacy of PLR in predicting DVT can be significantly improved when other risk factors (male, D-dimer > 0.6 mg/L, TC > 5.6 mmol/L, and PLR > 189.8 of preoperative time in each day delay) are combined. These data are useful for the clinical identification of patients at high risk of preoperative DVT in patella fractures.

In this research, two distinct designs of protective structures were developed to address structural damage caused by ships impacting the internal structures of floating docks during maintenance operations. The designed protective structures consist of support sections and load-bearing sections, with the load-bearing section comprising three frame sections. For ease of description, the front frame section, middle frame section, and rear frame section are referred to as Frame A, Frame B, and Frame C, respectively. A drop-weight test was conducted with a stern-shaped indenter impacting the structures at 3.89 m/s. This study also assessed varying impact speeds and positions. The results showed that Specimen 2 had localized indentations on Frame B, while Specimen 1 exhibited overall deformation of Frame B and additional deformations in Frame A. The simulations agreed with the experimental results, confirming the model’s accuracy. At speeds from 2.34 m/s to 5.45 m/s, Specimen 2 consistently showed localized deformations, while Specimen 1 showed comprehensive deformation of Frame B at 3.89 m/s due to lower rigidity. When the indenter impacted the specimens at different locations with a speed of 5.45 m/s, the two specimens exhibited varying degrees of damage. As the impact location shifted from the central area to the end, the maximum indentation depth of Specimen 1 decreased from 52.26 mm to 41.71 mm, while that of Specimen 2 decreased from 43.26 mm to 38.50 mm. The reduction in indentation depth and extent as the impact location approached the support frame can be attributed to the increasing involvement of the web plate beneath the frame in resisting the impact. Additionally, compared to Specimen 1, Specimen 2 exhibited a relatively smaller overall indentation depth, and the impact of location variation on indentation depth was also relatively minor.

In practical conditions, near-field acoustic holography (NAH) requires the measurement environment to be a free sound field. If vibrating objects are located above the reflective ground, the sound field becomes non-free in the presence of a reflecting surface, and conventional NAH may not identify the sound source. In this work, two types of half-space NAH techniques based on the Helmholtz equation least-squares (HELS) method are developed to reconstruct the sound field above a reflecting plane. The techniques are devised by introducing the concept of equivalent source in HELS-method-based NAH. Two equivalent sources are tested. In one technique, spherical waves are used as the equivalent source, and the sound reflected from the reflecting surface is regarded as a linear superposition of orthogonal spherical wave functions of different orders located below the reflecting surface. In the other technique, some monopoles are considered equivalent sources, and the reflected sound is considered a series of sounds generated by simple sources distributed under the reflecting surface. The sound field is reconstructed by matching the pressure measured on the holographic surface with the orthogonal spherical wave source in the vibrating object and replacing the reflected sound with an equivalent source. Therefore, neither technique is related to the surface impedance of the reflected plane. Compared with the HELS method, both methods show higher reconstruction accuracy for a half-space sound field and are expected to broaden the application range of HELS-method-based NAH techniques.