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Purpose To determine the safety and efficacy of microsphere embolization plus transarterial infusion chemotherapy for the treatment of gastroesophageal junction cancer with hepatic metastasis. Methods Sixty patients with gastroesophageal junction cancer and hepatic metastasis were randomly divided into two groups: group A (treatment group), which was treated with transarterial infusion chemotherapy plus microsphere embolization for gastroesophageal cancer, and with transarterial chemoembolization for hepatic metastasis; and group B (control group), which was treated with transarterial infusion chemotherapy for gastroesophageal cancer, and with transarterial chemoembolization for hepatic metastasis. The chemotherapy regimen used consisted of oxaliplatin plus FUDR. The embolization agent used for gastroesophageal cancer and the hepatic metastasis were Embosphere and ultra-liquefied lipiodol, respectively. Results The median survival time of patients in group A was 19 months, with survival rates at 12, 18, and 24 months of 93.3%, 60.0%, and 23.3%, respectively. The median survival time of patients in group B was 13 months, with survival rates at 12, 18, and 24 months of 60.0%, 30.0%, and 3.3%, respectively. There was a significant difference in survival between the two groups (P = 0.00). One month after treatment, the severity of dysphagia was significantly less in group A, as compared to that in group B (p Conclusion Treatment of gastroesophageal junction cancer with hepatic metastasis by transarterial infusion chemotherapy plus microsphere embolization can rapidly reduce tumor size near the gastroesophageal junction. This treatment is an effective therapeutic option for these patients as it can relieve dysphagia and improve long-term survival rate.

Background. The plantar soft tissue plays a critical role in absorbing shocks and attenuating excessive stresses during walking. Plantar soft tissue property and plantar pressure are critical information for footwear design and clinical assessment. The aim of this study was to investigate the relationship between plantar soft tissue hardness and plantar pressure during walking. Methods. 59 healthy volunteers (27 males and 32 females, aged 20 to 82) participated in this study. The plantar surface was divided into five regions: lateral rearfoot, medial rearfoot, lateral midfoot, lateral forefoot, and medial forefoot, and the plantar tissue hardness was tested using Shore durometer in each region. Average dynamic pressures in each region were analyzed for the five regions corresponding to the hardness tests. The relationship between hardness and average dynamic pressure was analyzed in each region. Results. The average hardness of the plantar soft tissue in the above five regions is as follows: lateral rearfoot ( 34.49 ± 6.77 ), medial rearfoot ( 34.47 ± 6.64 ), lateral midfoot ( 27.95 ± 6.13 ), lateral forefoot ( 29.72 ± 5.47 ), and medial forefoot ( 28.58 ± 4.41 ). Differences of hardness were observed between age groups, and hardness of plantar soft tissues in forefoot regions increased with age ( P < 0.05 ). A negative relationship was found between plantar soft tissue hardness and pressure reduction at lateral rearfoot, medial rearfoot, and lateral midfoot ( P < 0.05 ). Conclusion. The hardness of plantar soft tissues changes with age in healthy individuals, and there is a trend of increasing hardness of the plantar soft tissue with age. The plantar soft tissue hardness increases with plantar pressure.

Background : : Radiographic guided percutaneous gastrostomy has become a safe and effective enteral nutrition method for patients who can not eat by mouth. Fluoroscopy, computed tomography (CT) and cone-beam CT have been routinely used clinically. The aim of this study was to compare the advantages and disadvantages of percutaneous gastrostomy using different radiographic guided methods. Methods : : We retrospectively analyzed the clinical data of 538 patients undergoing percutaneous gastrostomy in our department. According to the image guidance method used in gastrostomy, the patients were divided into groups A by fluoroscopy guidance, group B by fluoroscopy combined with C-arm CT guidance, and group C with the whole process CT guidance. The gastrostomy success rate, complication rate, procedure time, and patient radiation dose were analyzed in the three groups. Results : : Among 538 patients, 534 were successful and the success rates are 94.3%, 99.3%, and 100% in group A, B, and C, respectively (P > 0.05). There were 3 cases occurred postoperative bleeding as serious adverse events and transferred to surgical gastrostomy. The minor complications include local infection, hyperplasia of granulation tissue, tube obstruction or prolapse, and local pain of the ostomy. The minor complication rates were 10.5%, 10.4%, and 7.7% in group A, B, and C, respectively (P > 0.05). The average procedure time was 25.57 ± 5.99 minutes, 29.01 ± 6.63 minutes, and 45.47 ± 8.98 minutes, respectively (χ2 = 87.98, P < 0.001). The average radiation dosage was 27.30 ± 19.27 mGy, 145.07 ± 106.08 mGy, and 2,590.26 ± 1,088.22 mGy, respectively (χ2 = 204.44, P < 0.001). Conclusion : : There were no significant differences in the success rates and complication rates of gastrostomy under the three guiding methods. For difficult cases, CT-guided gastrostomy may be a very useful supplemental method.

A simple electrochemical sensing platform based on a low-cost disposable laser-induced porous graphene (LIPG) flexible electrode for the intelligent analysis of maleic hydrazide (MH) in potatoes and peanuts coupled with machine learning (ML) was successfully designed. The LIPG electrode was patterned by a simple one-step laser-induced procedure on commercial polyimide film using a computer-controlled direct laser writing micromachining system and displayed excellent flexibility, 3D porous structure, large specific surface area, and preferable conductivity. A data partitioning technique was proposed for the optimal MH concentration ranges by selecting the size of datasets, including the size of the training set and the size of the test set combined with the performance metrics of ML models. Different algorithms such as artificial neural networks (ANN), random forest (RF), and least squares support vector machine (LS-SVM) were selected to build the ML models. Three ML models were evaluated, and the LS-SVM model displayed unique superiority. Both the recoveries and RSD of practical application were further measured to assess the feasibility of the selected LS-SVM model. This will have important theoretical and practical significance for the intelligent analysis of harmful residuals in agro-product safety using an electrochemical sensing platform.

Objective Arthroscopic ankle arthrodesis (AAA) is a standard surgical method for the treatment of advanced traumatic ankle arthritis and has become more popular due to its advantages. To fix the tibiotalar joint, the use of three percutaneous screws is considered to have better mechanical stability than the use of two screws. However, it is sometimes difficult to insert three screws because they might block each other due to the small area of the tibiotalar joint surface and the large diameter of the screws; few articles illustrate how to insert three screws without the screws disturbing each other. The purpose of this study is to explore possible screw configurations of tripod fixation in arthroscopic ankle arthrodesis that avoid the collision of screws and yield better biomechanical performance. Methods We used the finite element method to examine the impact of different screw positions and orientations on the biomechanical characteristics of a three-dimensional (3D) ankle model. Maximum and average micromotion, pressure on the articular surface, and von Mises stress values of the tibia and the talus were used to evaluate the initial stability of the ankle. Results Five kinds of three-screw configurations were identified, and finite element analysis results suggested that configurations with the posteromedial home-run screw presented lower micromotion (maximum, 17.96 ± 7.49 μm versus 22.52 ± 12.8 μm; mean, 4.88 ± 1.89 μm versus 5.19 ± 1.92 μm) (especially configuration 3) and better screw distributions on the articular surface than those with the posterolateral home-run screw. Conclusion Screw configurations with the posteromedial home-run screw avoid collision and are more biomechanically stable than those with the posterolateral home-run screw. Thus, inserting the home-run screw through the posteromedial approach is recommended for clinical practice.

Background. Previously, scholars have concluded that the Achilles tendon and the plantar fascia were closely biomechanically related, although there is little clinical evidence of the relationship between the two. To investigate the biomechanical relationship between the Achilles tendon and the plantar fascia, the author used standing lateral ankle radiographs of patients with insertional Achilles tendonitis to determine the biomechanical relationship between the Achilles tendon and plantar fascia. Methods. The author collected standing lateral ankle radiographs from patients with insertional Achilles tendonitis who accepted surgical treatment in the author’s hospital from March 2009 to July 2018. According to whether there were bone spurs on the posterior side of the calcaneus, patients were divided into group A (spur present on the posterior side) and group B (spur not present on the posterior side). The positive rates of spurs on the plantar side of the calcaneus were determined in group A and group B. The chi-square test was used to compare the measurement results between the two groups. Results. In group A, 13 heels were positive for calcaneal bone spurs, and the positive rate was 65.0%. In group B, 3 heels were positive for plantar calcaneal spurs, and the positive rate was 12%. Among all 16 patients with positive plantar calcaneal spurs, 13 had posterior calcaneal spurs (accounting for 81.3%), and 3 had negative results, accounting for 18.7%. There was a significant difference between the results in groups A and B (P<0.05). Conclusion. There is a relationship between posterior calcaneal spurs and plantar calcaneal spurs in patients with insertional Achilles tendonitis, which can be inferred as resulting from the increasing tension in the biomechanically complex relationship between the Achilles tendon and the plantar fascia.

Patients with mechanic ankle instability experience increased tibiotalar and subtalar joint laxity. However, in vivo joint kinematics in functional ankle instability (FAI) patients and lateral ankle sprain (LAS) copers, especially during dynamic activities, are poorly understood. Ten FAI patients, 10 LAS copers, and 10 healthy controls were included in this study. A dual fluoroscopic imaging system was used to analyze the tibiotalar and subtalar joint kinematics during stair descent. Five key poses of stair descent were analyzed. Kinematic data from six degrees of freedom were calculated utilizing a solid modeling software. The range of motion and joint positions in each degree of freedom were compared among the three groups. The tibiotalar joints of FAI patients and LAS copers were significantly more inverted than those of healthy controls during the foot strike (p = 0.016, η p 2 = 0.264). The subtalar joints of FAI patients were significantly more anteriorly translated (pose 2, p = 0.003, η p 2 = 0.352; pose 3, p η p 2 = 0.454; pose 4, p = 0.004, η p 2 = 0.334), inverted (pose 4, p = 0.027, η p 2 = 0.234; pose 5,p = 0.034, η p 2 = 0.221), and externally rotated (pose 4, p = 0.037, η p 2 = 0.217; pose 5; p = 0.004, η p 2 = 0.331) than those of healthy controls during the mid-stance and the heel off. The FAI patients showed excessive tibiotalar inversion and subtalar joint hypermobility during stair descent. Meanwhile, the LAS copers maintained subtalar joint stability, and only showed excessive tibiotalar inversion in foot strike. These data provide insight into the mechanisms behind the development of FAI after initial LAS. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1860-1867, 2019.

The use of finite element models has gained popularity in the field of foot and footwear biomechanics to predict the stress–strain distribution and the treatment effectiveness of therapeutic insoles for pathological foot conditions. However, a comprehensive evaluation of mesh quality is often ignored, meanwhile no golden standard exists for the mesh density and selection of element size at an acceptable accuracy. Here, we make a convergence test and established anatomically-realistic foot models at different mesh densities. The study compared the discrepancy in output variables to the changes of element type and mesh density under barefoot and footwear conditions with compressive and shear loads, which are commonly encountered in foot and footwear biomechanics simulations. For a range of loading conditions simulated in 125 finite element models, the peak plantar pressure consistently converged with optimal mesh size determined at 2.5[Formula: see text]mm. The convergence variable of principal strains and stress tensors, however, varies significantly. The max von-Mises stress showed strong sensitive behavior to the changes of the mesh density. The pattern for contact pressure distribution became less accurate when the element sizes increase to 6.0[Formula: see text]mm; in particular, the locations of the pressure peak do not show remarkable changes, but the size of the area of contact still changes. The current study could offer a general guideline when generating a reasonable accurate finite element models for the analysis of plantar pressure distributions and stress/strain states employed for foot and footwear biomechanics evaluations.

The exploration of noise performance for a laser system is one of the most charming topics in optics community. Photo-receivers designed to be stable, low-noise, and high-dynamic-range for a specified laser device are of vital significance to the noise characterization systems. In this paper, principle criteria for customizing photo-receivers used in amplitude- and phase-noise measurements of mode-locked laser systems were presented, and real examples were given for a 100-MHz repetition-rate Ti:Sapphire mode-locked laser. High-dynamic-range output voltage noise spectral density of 5.2 nV/√Hz and 35.6 nV/√Hz for amplitude- and phase-noise photo-receiver, and stability of 70.8° phase margin at loop-gain closure point up to 207 MHz for phase-noise photo-receiver were implemented.

In this paper, asymmetric biconical fiber tapers (ABFTs) for in-fiber Mach-Zehnder interferometers (IFMZIs) are proposed and analyzed to enhance the interference effect. The proposed ABFT-IFMZIs are fabricated, tested, and demonstrated in applications of single-frequency (SF) emissions when incorporated into an all-fiber laser cavity as the frequency selecting component. In comparison with the traditional IFMZIs composed of all symmetric biconical fiber tapers (SBFTs), higher average transmittance and fringe contrast have been demonstrated with the ABFT-based IFMZIs. When applied to the SF fiber laser emission, lower pump threshold and higher slope efficiency have also been confirmed with the ABFT-IFMZI device. The theoretical and experimental results have indicated that the interference effect of IFMZIs can indeed be improved by the designated asymmetry of conical taper angles in ABFTs that can offer an extra flexibility in fiber taper design, fabrication, and applications.

BACKGROUND: To identify the factors related to the effectiveness of retrograde removal of double J ureteral stents using a simple snare technique in female patients. METHODS: It was a retrospective observational study. From 2012 to 2017, 128 female patients underwent fluoroscopy-guided, retrograde double J stent removal with or without replacement using a simple snare technique. The position of the tip of the double J stent in the urinary bladder was classified according to position types A, B, C, and D, corresponding to the ipsilateral lateral, ipsilateral medial, contralateral medial, and contralateral lateral quadrants of the urinary bladder, respectively. The factors influencing the fluoroscopy time upon removal of the double J stent were analyzed. RESULTS: Technical success rate of 312 procedures performed was 97.44% (304/312) with the mean fluoroscopy time of 12.68±7.34 minutes. Eight double J stent removal procedures failed, and all of these occurred in the position type D patients. The position type and the number of curls of the double J stent had a significant influence on the fluoroscopy time (P

Antibiotics, a common strategy used for neonatal infection, show consistent effect on the gut microbiota of neonates. Supplementation with probiotics has become increasingly popular in mitigating the loss of the gut microbiota. However, no clear consensus recommending the use of probiotics in the infection of neonates currently exists. This study examined the effects of probiotics on the gut microbiota of infectious neonates when used concurrently with or during the recovery period following antibiotic therapy. Fifty-five full-term neonates diagnosed with neonatal infections were divided into the following groups: NI (no intervention, antibiotic therapy only), PCA (probiotics used concurrently with antibiotics), and PAA (probiotics used after antibiotics). The NI group received antibiotic treatment (piperacillin–tazobactam) for 1 week and the PCA group received antibiotic treatment together with probiotics (Bifidobacterium longum, Lactobacillus acidophilus, and Enterococcus faecalis) for 1 week. The PAA group received antibiotic treatment for 1 week followed by probiotics for 1 week. Fecal samples were collected at four time nodes: newborn, 1 week, 2 weeks, and 42 days after birth. The composition of the gut microbiota was determined by the high-throughput sequencing of 16S rRNA amplicons. Antibiotic exposure was found to dramatically alter gut microbiota, with a significant decrease of Bifidobacterium and Lactobacillus. The use of probiotics did not restore the overall diversity of the gut microbiota. However, using probiotics simultaneously with the antibiotics was found to be beneficial for the gut microbiota as compared to delaying the use of probiotics to follow treatment with antibiotics, particularly in promoting the abundance of Bifidobacterium. These results suggest that the early use of probiotics may have a potential ability to remodel the gut microbiota during recovery from antibiotic treatment. However, further study is required to fully understand the long-term effects including the clinical benefits.

BACKGROUND This study was to investigate the effect of high-flux hemodialysis (HD) combined with levocarnitine on vascular calcification, microinflammation, hepcidin, and malnutrition in elderly patients on maintenance HD (MHD). METHODS 75 MHD elderly patients admitted to hospital between 1st September 2017 and 31st August 2019 were selected as the study subjects. They were randomly divided by digital table into three groups: low-flux group (n=25), high-flux group (n=25) and joint group (n=25). In the low-flux group, dialyzer had an ultrafiltration coefficient 12 mL/(h·mmHg) and effective surface area of 1.4 m2 compared with 59 mL/(h·mmHg) and 1.8 m2 in the high-flux group. After treatment, the calcification of blood vessels was examined by lateral X-ray, pelvic plain film and bilateral positive position. For patients in all groups, the concentrations of parathyroid hormone (PTH) and β 2-microglobulin (β 2-MG) in serum were measured by automatic chemiluminescence; levels of interleukin-6, C-reactive protein (CRP), and tumor necrosis factor alpha (TNF-α) were measured by ELISA before and after treatment; and the level of hepcidin was measured by ELISA. Before and 12 weeks after the treatment, the nutritional status of the patients was evaluated by modified quantitative subjective global assessment (MQSGA), hemoglobin (Hb) and red blood cell count (RBC). Complications in the three groups were recorded, including nausea, chest pain, hypotension, hypertension, pruritus, dry heat, muscle spasm, arrhythmia, and restless legs. RESULTS Vascular calcification in the joint group was better than the low-flux and high-flux groups (P

The in vivo kinematic characteristics of the tarsal joints during gait stance phase were still unclear in adult-acquired foot deformity (AAFD). This study included seven healthy subjects (14 feet) and 12 stage II AAFD patients (14 feet). The 3D models of tarsal bones were reconstructed based on CT scan. Each subject took standard gait on the single fluoroscopy system. Continuous lateral fluoroscopic images were collected. The key postures during the stance phase were selected. The 2D-3D registration technique was applied to explore the spatial motions of the tarsal joints in 6 degrees of freedom (DOF). During the whole stance phase, the AAFD talo-navicular joint (TNJ) exhibited ROM of 13 ± 6° in the sagittal plane while the normal subjects showed ROM of 7 ± 3° (p = 0.004). In AAFD, the subtalar joint (STJ) demonstrated 19 ± 8° and 7 ± 3° of motion in coronal and horizontal plane, respectively, while the normal subjects showed 14 ± 4°(p = 0.031) and 11 ± 3° (p = 0.014) of motion, respectively. Additionally STJ of AAFD patients showed significantly less dorsiflexion during the weight acceptance and showed significantly less external rotation both during the weight acceptance and single limb support of stance phase. In conclusion, for stage II AAFD patients, the talonavicular joint and the subtalar joint showed hypermobility in dorsi/planterflexion and inversion/eversion, respectively, during the gait stance phase while the internal/external rotation of the subtalar joint was reduced. The current study improves our understanding of the pathological kinematics of the tarsal complex in AAFD patients. Notice should be taken about these tarsal joints mobility in AAFD during clinical practice. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:477-482, 2019.

Functional ankle instability (FAI) and anterior ankle impingement (AAI) are likely to occur simultaneously. Nevertheless, how AAI affects ankle instability remains largely unknown. This study aimed to assess patients with FAI + AAI and those having FAI without AAI after arthroscopic synovectomy combined with the modified Broström procedure. Patients with chronic ankle instability who underwent surgery at the Huashan Hospital of Fudan University (China) from January 2010 to December 2015 were reviewed. Propensity score matching was performed (FAI + AAI: n = 86; FAI without AAI: n = 43). Ankle function was assessed by the American Orthopedic Foot and Ankle Society (AOFAS) and the Meislin criteria at 3 months, 1 year, and final follow-up. In the FAI + AAI group, AOFAS scores increased from 52.6 ± 7.2 to 78.6 ± 8.2, 84.2 ± 6.4, and 83.6 ± 11.3 at 3 months, 1 year, and last follow-up, respectively (p.001). In the FAI without AAI group, AOFAS scores increased from 64.3 ± 10.5 to 85.2 ± 8.6, 91.4 ± 7.9, and 90.2 ± 9.8 at 3 months, 1 year, and last follow-up, respectively (p.001; all p.05 for differences between the 2 groups at each time point). The 2 groups showed similar scores based on the Meislin criteria (p = .38). Hypertrophic distal fascicle of the anteroinferior tibiofibular ligament showed lower AOFAS scores (all p.05). Patients with FAI with or without AAI had improved outcomes with arthroscopic synovectomy combined with the modified Broström procedure; however, patients with combined FAI and AAI showed a relatively poorer outcome in comparison with those suffering from FAI alone, probably because of hypertrophic distal fascicle of the anteroinferior tibiofibular ligament.

The role of fibulin-1 or FBLN1 in chondrocyte proliferation has not been reported so far. In this study, we aimed to verify whether FBLN1 promotes chondrocyte proliferation in elderly patients with knee osteoarthritis by phosphorylating Smad2.Chondrocytes were isolated from cartilage samples collected from elderly patients with osteoarthritis (n = 6) and young patients (n = 6). The isolated chondrocytes were divided into the following three groups: control (medium only); cells transfected with adenovirus expressing green fluorescent protein (Ad-GFP); and those transfected with adenovirus expressing green fluorescent protein and FBLN1 (Ad-GFP-FBLN1). Furthermore, chondrocytes were divided into the following three groups in the mechanistic analysis: group 1, medium only; group 2, Ad-FBLN1; and group 3, Ad-FBLN1+pSmad2 inhibitor. The cells were analyzed for the relevant indicators after culturing for 48 h.There were more EdU-positive cells in the Ad-GFP-FBLN1 group than in the other two groups (both P 0.05). Compared with the other two groups, the level of pSmad2 and Col2 in the Ad-GFP-FBLN1 group was significantly increased (P 0.05). The gene expression level of each indicator was consistent with the protein expression level. There was no significant difference in the indicators between groups 1 and 3. The percentage of EdU-positive cells in group 2 was higher than that in the other two groups (P 0.05). The expression of pSmad2 and Col2 in group 2 was higher than that in the other two groups (both P 0.05).FBLN1 can promote chondrocyte proliferation in the knee cartilage in elderly patients by phosphorylating Smad2.

Background Between 39% and 69% of women wear high-heeled shoes. Previous studies have shown that high heels can induce adverse biomechanical effects, but variables, such as walking speed, structure, style, and material of the shoes, have not been strictly controlled. The purpose of this study is to investigate the influences of high-heeled shoe parameters on gait cycle, center of pressure trajectory, and plantar pressure in young females. Methods Twenty healthy adult females were recruited to participate in this study. Subjects walked on a treadmill at a fixed speed (1 m/s). Overall, six pairs of high-heeled shoes were evaluated, which consisted of two heel types (thin and thick) and three different heel heights (low (3 cm), medium (6 cm), and high (8.2 cm)). Subjects also wore one pair of flat shoes (with 0.6 cm heel height) as the control group, while they walked on the treadmill at the same speed. Results and their significance were evaluated using a Heel Height × Heel Type Two way repeated ANOVA Test. Results The main parameters measured were the gait cycle, center of pressure parameters, peak pressure (PP), maximum force, contact area (CA), and the force time integral (impulse). The comparison of these parameters, conducted when the volunteers wore thick heel and flat shoes at different walking conditions, indicated that thin heels caused significant increases in the preswing parameter, CA, and PP exerted on the first toe and first metatarsus. Increased heel heights yielded smaller gait line lengths, single support lines, and smaller hindfoot areas. By contrast, increased anterior–posterior positions and plantar pressure parameter values were noted in the case of the forefoot. Conclusions Data analyses showed significant differences in plantar pressure distribution associated with the heel height and heel type at increased pressure in the central forefoot region and decreased pressure in the midfoot and heel sections, which consisted of the increased anterior shift. The implication of this study is to provide scientific advice to women for their choices of high heel shoes.

Coagulation is an important process to remove organics from water. The molecular composition and structure of organic matter influence water quality in many ways, and the lack of information regarding the organics removed by different coagulants makes it challenging to optimize coagulation processes and ensure reclaimed water safety. In this paper, we investigated coagulation of secondary biological effluent from a municipal sewage treatment plant with different coagulants. We emphasized investigation of organics removal characteristics at the molecular level using Fourier transform-ion cyclotron resonance mass spectrometry (FT-ICR MS) coupled with electrospray ionization (ESI). We found that conventional coagulants can only partially remove condensed polycyclic aromatics and polyphenols with low H/C (H/C0.7) and highly unsaturated and phenolic compounds and aliphatic compounds with high O/C (O/C0.6). A new coagulant, CBHyC, had better removal efficiencies for all organics with different element compositions and molecular structures, especially organics that are resistant to conventional coagulants such as highly unsaturated and phenolic compounds and aliphatic compounds located in 0.3O/C0.8 and 1.0H/C2.0 regions and sulfur-containing compounds with higher O/C (e.g., anionic surfactants and their metabolites or coproducts). This study provides molecular insights into the organics removed by different coagulants and provides data supporting the possible optimization of advanced wastewater treatment processes.

Fixation of posterior malleolar fractures with plates or screws is under debate. A fatigue loading system and a spatial motion capture system were used in this study to evaluate a posterior malleolar fracture model.Thirty-six below-knee specimens with a single posterolateral fragment (Haraguchi I) type posterior malleolar fracture models were randomly divided into 2 groups. Two parallel-placed 3.5-mm partially threaded titanium alloy screws were used in Group A to fix the fractures, while anatomical plates were used in Group B. According to the ratio (S) of the area between the fracture and the total articular surface, each group was subdivided into 3 subgroups. In group A1 and B1, S=1/4; in A2 and B2, S=1/3; and in A3 and B3, S=1/2. To simulate the gait cycle, each specimen was subjected to mechanical loading in 4 different ankle positions. A fatigue loading system was used for repeated loading. A spatial motion capture system was used to measure the displacement in the final loading stage.Despite the limited sample size and relatively low power, no significant difference was observed between A1 and B1, A2 and B2, and A3 and B3 in all 4 ankle positions after repeated loading.For a Haraguchi type I posterior malleolar fracture with an average height of 19 mm, fixation with a posterior malleolar anatomical plate failed to demonstrate a stronger strength than 2 parallel-placed 3.5-mm partially threaded screws, which indicates that plates may not be absolutely necessary for standard rehabilitation after posterior malleolar internal fixation.These findings may help guide surgeons with regard to fixation requirements for posterior malleolar fractures.

Background The sustentacular screw is essential to maintain the stability of the subtalar joint during ORIF (open reduction with internal fixation) of calcaneal fractures. Currently, the screw is still inserted based on surgeons’ anatomical experiences and nearly 40% of screws are misplaced from the sustentaculum. Previous studies demonstrated some methods of sustentacular screw placement through anatomical measurements or navigation system. The purposes of this study are to design an assistant guidance device that can effectively improve the accuracy of sustentacular screw placement and to compare the accuracy of this technique with traditional screw placement based on experience. Methods A customized guidance device is designed, aiming to improve the accuracy of sustentacular screw placement. Twenty cadaveric specimens are used in the present study. Ten specimens are allocated into the guidance-assisted group, and others are included in the traditional screw insertion group. A total of 40 sustentacular screw placements are performed in each group. Fluoroscopic images are obtained after each screw placement. Only the screw that captures the sustentaculum both on the lateral and axial X-ray views was regarded as an accurate placement. Results The accuracy rate in the guidance-assisted group is 87.5% (35 out of 40 times of insertions) while in the traditional screw insertion group, the accuracy rate is 65% (26 out of 40 times of insertions). A significant difference is found between the two groups (p = 0.018). Conclusions The guidance-assisted technique is a convenient approach that can effectively improve the accuracy of sustentacular screw placement during the ORIF of calcaneal fractures. This study provides a novel technique that significantly facilitates sustentacular screw insertion and improves its accuracy.

// Hong Tao Hu 1 , Jun Peng Luo 1 , Hai-Liang Li 1 , Chen Yang Guo 1 , Quan Jun Yao 1 , Xiang Geng 1 , Li Jiang 1 1 Department of Radiology and Research Institute of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan Province 450003, P. R. China Correspondence to: Hai-Liang Li, email: irlihailiang@163.com Keywords: hepatocellular carcinoma, portal vein tumor thrombus, transarterial chemoembolization, 125 iodine implantation, computed tomography-guided Received: October 11, 2016 Accepted: February 14, 2017 Published: March 23, 2017 ABSTRACT We conducted a retrospective study to evaluate the safety and efficacy of transarterial chemoembolization (TACE) combined with computed tomography-guided 125 iodine implantation (TACE- 125 iodine) in hepatocellular carcinoma (HCC) patients with type B portal vein tumor thrombus (PVTT). From medical records, we determined that 50 patients who received 125 iodine implantation 4-7 days after the first TACE session showed better survival than 50 patients who received only TACE (median survival, 13.1 vs. 6.0 months; P

Objective. The aim of this study was to investigate the respective correlation between the height (H) of a posterior malleolar fracture (PMF) and the involved area (S) of an articular surface and the presence of “die-punch.” Methods. Patients with closed posterior malleolar fractures admitted to our hospital from January 2015 to December 2017 were selected, with complete X-ray and 3D reconstruction CT imaging data. The gender, age, injured side, and surgical fixation methods of the patients were recorded. A preoperative ankle CT scan was performed, and the images were viewed through the PACS (Picture Archiving and Communication Systems). Simultaneously, the involved joint surface area (S) by the posterior malleolar fracture was measured, as well as the proportion of the fracture area to the total ankle joint area. On the sagittal reconstruction CT images, the height (H) of the posterior malleolar fracture was measured to compare the correlation between the height of the fracture and the area of the fracture, as well as the area ratio. Besides, according to the presence or absence of “die-punch,” patients were divided into two groups: A and B. And each group was further divided into three subgroups according to age (16-39 years old, 40-59 years old, and ≥60 years old). The statistical differences in the height of fracture between the subgroups were compared. Results. A total of 48 patients, aged 16-82 years, with an average age of 48.9 years, were included in this study, including 13 males and 35 females. There were 20 cases of left ankle injury and 28 cases of right ankle injury. The average height of the posterior malleolar fractures was 18.19 mm, the average area of the fracture was 202.28 mm2, and the average ratio of the fracture area to the total articular surface area was 17.84%. Besides, die-punch was seen in 27 cases and not in 21 cases. The average height of fractures was 21.33±5.38 mm in group A1, 14.38±9.01 mm in group B1, 18.30±7.95 mm in group A2, 14.48±5.37 mm in group B2, 26.26±6.73 mm in group A3, and 12.77±3.07 mm in group B3. Conclusion. The height (H) of the posterior malleolar fractures is positively correlated with the fracture area (S) and the fracture area ratio (FAR). The posterior malleolar fractures with “die-punch” tend to have a greater average height than that without “die-punch.” In clinical work, orthopedic surgeons should not only pay attention to the size of the posterior malleolus fracture but also value its height, which hopefully could provide insight into the treatment and prognosis of PMF patients.

Quality Estimation is a task to predict the quality of translations without relying on any references. QE systems are based on neural features but suffer from the limited size of QE data. The best models nowadays transfer bilingual knowledge from parallel data to QE tasks. However, the distribution between parallel data and QE data may lead to the value of parallel data not being used for best. More specifically, there are no errors in parallel translations while there may be more than one error in the translations of QE data. To alleviate this problem, we propose a model that will mask some tokens at the target side on parallel data but still need to predict every target token. And based on this model, we propose a variant model that uses a masked language model at the target side to obtain deep bi-directional information. Besides, we also try different ensemble methods to get better performance of the CCMT20 Quality Estimation Task. Our system finally won second place in the ZH-EN language pair and third place in the EN-ZH language pair.

Background Quantifying detailed kinematics of the intrinsic foot bone during gait is crucial for understanding biomechanical functions of the foot complex musculoskeletal structure and making appropriate surgery decisions. Research question The purpose of this experiment is to measure bone kinematic of the normal foot in a gait cycle via a custom-made cadaveric gait simulator. Methods In this experiment, we used a custom-made 6 degrees of freedom (DOF) of robotic gait simulator simulating normal human gait to measure the 3-dimensional (3D) kinematics of tibia, calcaneus, cuboid, navicular, medial cuneiform, first metatarsal, and fifth metatarsal through six cadaveric feet. Results The results showed that the kinematic of the intrinsic foot bones in the stance phase of the gait was successfully quantified using a custom-made robotic gait simulator. During walking stance, the joints in the medial column of foot had less movement than those in the lateral column. And during the later portion of stance, no rotational cease was observed in the movement between navicular and cuboid, calcaneocuboid joint, or cuneonavicular joint. Conclusion This study described foot bone motion using a biomechanically near-physiological gait simulator with 6 DOF of the tibia. The kinematic data helps to clarify previous descriptions of several joint kinematics that are difficult to study in vivo. The methodology also provides a platform for researchers to explore more invasive foot biomechanics under dynamic and near-physiologic conditions.

Backgrounds There has long been a consensus that shortening of the first metatarsal during hallux valgus reconstruction could lead to postoperative transfer metatarsalgia. However, appropriate shortening is sometimes beneficial for correcting severe deformities or relieving stiff joints. This study is to investigate, from the biomechanical perspective, whether and how much shortening of the first metatarsal could be allowed. Methods A finite element model of the human foot simulating the push-off phase of the gait was established. Progressive shortening of the first metatarsal from 2 to 8 mm at an increment of 2 mm were sequentially applied to the model, and the corresponding changes in forefoot loading pattern during push-off phase, especially the loading ratio at the central rays, was calculated. The effect of depressing the first metatarsal head was also investigated. Results With increasing shortening level of the first metatarsal, the plantar pressure of the first ray decreased, while that of the lateral rays continued to rise. When the shortening reaches 6 mm, the load ratio of the central rays exceeds a critical threshold of 55%, which was considered risky; but it could still be manipulated to normal if the distal end of the first metatarsal displaced to the plantar side by 3 mm. Conclusions During the first metatarsal osteotomy, a maximum of 6 mm shortening length is considered to be within the safe range. Whenever a higher level of shortening is necessary, pushing down the distal metatarsal segment could be a compensatory procedure to maintain normal plantar force distributions.

Thyroid follicular carcinoma is a malignant tumor from thyroid follicular epithelium, which is prone to involve capsular and vascular invasion. The present study was conducted in order to detect the expression of microRNA-155-5p (miR-155-5p) in thyroid follicular carcinoma with an attempt to analyze its involvement in apoptosis-related factors.Forty-five patients with thyroid follicular carcinoma made up the observation group and 45 patients with thyroid follicular adenoma were included into the control group. Tissues of thyroid follicular carcinoma and thyroid follicular adenoma were obtained from the patients, and analysed for expression of miR-155-5p by real-time fluorescence quantitative PCR (qPCR). The expression of cysteine-containing aspartic acid protein hydrolase-3 (Caspase-3) in thyroid follicular carcinoma was detected with the use of Western Blot analyses. Immunohistochemical method was used to detect the expression of B-cell lymphoma protein-2 (Bcl-2) in thyroid follicular carcinoma.There was significant difference in the expression of miR-155-5p between the two groups (Observation vs Control: 1.46 ± 0.42 vs 0.98 ± 0.33 P .05). The expression of miR-155-5p was significantly different in the maximum diameter of tumor, vascular invasion and neural invasion (maximum diameter of tumor4 cm vs ≥4 cm: 1.36 ± 0.40 vs 1.68 ± 0.32, vascular invasion N vs Y: 1.35 ± 0.42 vs 1.69 ± 0.39, Neural invasion N vs Y: 1.35 ± 0.38 vs 1.70 ± 0.31 P .05). However, there was no significant difference in the expression of miR-155-5p in terms of different gender, age and group with or without lymph node metastasis (P .05). Based on survival analysis, patients with high expression of miR-155-5p experienced short survival time (median survival time was 45 months, P .05). There was a negative correlation between miR-155-5p and Caspase-3 (r = -.50, P .05). In addition, positive correlation was observed between miR-155-5p and Bcl-2 (r = .55, P .05).There was increased expression of miR-155-5p in thyroid follicular carcinoma. The abnormal expression of miR-155-5p may be an independent prognostic factor for thyroid follicular carcinoma associated with cell apoptosis.

Objective Bone marrow-derived mesenchymal stem cells (BMSCs) are effective in the treatment of severe acute pancreatitis (SAP), but their therapeutic effects could still be improved. In order to optimize the clinical application of BMSCs, we adopted the strategy of resveratrol (Res) pretreatment of BMSCs (Res-BMSCs) and applied it to a rat model of sodium taurocholate (NaT)-induced acute pancreatitis. Methods SAP was induced by injection of 3% NaT into the pancreatic duct and successful induction of SAP occurred after 12 h. Rats were treated with BMSCs, Res or BMSCs primed with Res at 40 mmol/L, Vandetanib (ZD6474) daily oral dosages of 50 mg/kg vandetanib. Results Res stimulated BMSCs to secrete vascular endothelial growth factor A (VEGFA), activated the downstream phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway, and inhibited pancreatic cell apoptosis. In addition, conditioned medium (CM) from Res-BMSCs enhanced the proliferation of human umbilical vein endothelial cells (HUVECs) in vitro, increased resistance to apoptosis and promoted the expression of angiogenesis-related proteins CD31, VEGF and VEGFR2 in pancreatic tissue, but Vandetanib partly abolished these effects by blocking the VEGFA- mediated pathway. Conclusion Resveratrol-preprocessed BMSCs can activate the PI3K/AKT signaling pathway in pancreatic cells and HUVECs through paracrine release of VEGFA; thus, achieving the therapeutic effect of resisting apoptosis of pancreatic cells and promoting regeneration of damaged blood vessels. Res pretreatment may be a new strategy to improve the therapeutic effect of BMSCs on SAP.

Objective To evaluate the safety, clinical efficacy, and long-term outcome of arsenic trioxide (As2 O3 ) intravenous infusion for pulmonary metastases in patients with HCC. Materials and methods Sixty consecutive patients who were diagnosed with advanced hepatocellular carcinoma (HCC) with pulmonary metastasis were randomized 1:1 into the treatment and control groups. Treatment group underwent transcatheter arterial chemoembolization (TACE) for the primary liver tumor and then underwent As2 O3 treatment, whereas control group underwent TACE alone. The treatment group underwent a continuous 5-h intravenous infusion of 10 mg/day As2 O3 . The course of As2 O3 treatment was initiated 3-5 days after TACE (to allow liver and gastrointestinal function to recover) and continued for 14 consecutive days. All patients in the treatment group underwent at least four treatment courses. Response to treatment was evaluated after four treatment courses. Result In treatment group, two patients had a complete response (CR), six had a partial response (PR), 10 had stable disease (SD), and 12 had progressive disease. A clinically effective rate (CR + PR) was achieved in 26.7%, and the clinical benefit rate (CR + PR + SD) was 60%. In the control group, no patients had a CR or PR, five had SD, and 25 had progressive disease. The clinically effective rate was 0%, and the clinical benefit rate was 16.7%. The overall 1-year survival was 56.7% in treatment group and 36.7% in control group. The overall 2-year survival was 16.7% in treatment group and 3.3% in control group. Conclusion Transcatheter arterial chemoembolization plus an intravenous infusion of As2 O3 effectively controlled pulmonary metastasis and prolonged overall survival in patients with HCC compared with TACE alone.

Objective: To explore the accurate in vivo kinematic changes in the ankle complex when wearing low- and high-heel shoes (LHS and HHS, respectively). Materials and methods: Twelve young women were tested unilaterally. Three-dimensional models of the tibia, talus, and calcaneus were first created based on CT scan results. The subjects walked at a self-controlled speed in barefoot, LHS (4cm), and HHS (10cm) conditions. A fluoroscopy system captured the lateral fluoroscopic images of the ankle complex. The images of seven key positions in the stance phase were selected, and 3D to 2D bone model registrations were performed to determine the joint positions. The mean of 6 degree of freedom (DOF) range of motions (ROM), joint positions, and angular displacements of the ankle complex during the gait were then obtained. Results: For the talocrural joint, the rotational ROMs of the subjects either in LHS or HHS condition displayed no significant difference from those in barefoot condition. For the subtalar joint, all the rotational ROMs in the HHS condition and the internal/external rotations in the LHS condition significantly decreased compared with those in the barefoot condition. The talocrural joint was positioned significantly more plantarflexed, inverted, internally rotated, and posteriorly seated in all seven poses in HHS condition, compared with those in barefoot condition. Conclusion: HHS mainly affected the rotational motion of the ankle complex during walking. The talocrural joint position was abnormal, and the subtalar joint ROM decreased during the gait in HHS condition. Only a few kinematic changes occurred in LHS condition relative to the barefoot condition.

Osteochondroma occurs most frequently in the long bones such as the proximal humerus, tibia, and distal femur. It is rare for it to originate in the talar neck. In the present case report, we describe a case of osteochondroma arising from the talar neck. Furthermore, a review of the published studies of talar osteochondroma was performed to obtain a better understanding of the symptoms, diagnosis, and treatment of this unusual entity.

Stochastic resonance vibrations are known to enhance balance in the elderly and patients with impaired plantar sensation. However, the underlying mechanisms of plantar vibrations on balance capacity are not well resolved. This study investigated the impact of stochastic resonance vibrations on activities of major extrinsic foot muscles and center of pressure sway in tactile inhibited subjects.Using a customized vibration insole, single-leg stance tests were performed in fourteen healthy subjects at control, ice-intervention-only (inhibited foot sensation) and ice-intervention plus vibration conditions. The sway parameters and the root mean square of electromyography of medial gastrocnemius, tibialis anterior, peroneus longus, and extensor digitorum longus were examined.The sway area in the ice-intervention-only condition was significantly increased compared with the control (P .001). Following vibrations, the sway area, however, was significantly decreased. Regression analysis showed the activity levels of all extrinsic foot muscles were positively correlated with sway area when foot sensation was inhibited. In contrast, following vibrations, only that of the tibialis anterior muscle was positively correlated with sway area, indicative of a muscle control strategy similar to the control condition.The study showed that stochastic resonance vibrations could effectively reduce body sway in the healthy subjects with inhibited foot sensation. The effects seemed to be associated with improved muscle activities in particular to the tibialis anterior muscle. It suggested that vibration insole may be used as a means to affect neuromuscular strategies to enhance balance control in people with diminished plantar sensations.

Summary AIM: The aim of this study was to investigate whether an aged systemic environment could impair young cartilage tissue in mice. METHODS: Mice differing in age were randomly divided into three groups. Group 1 was the experimental group (Y/O group) consisting of the heterochronic parabiosis model (2-month-old/12-month-old, young/old). Group 2 was the surgical control group (Y/Y group) with the isochronic parabiosis model (2-month-old/2-month-old, young/young). Group 3 consisted of the ageing control mice (2-month-old alone, Y group). Young knee cartilages collected from all three groups at 4 months after surgery were compared. Fluorescence molecular tomography (FMT) was used to confirm whether the two mice in parabiosis shared a common blood circulation at 2 weeks after surgery. The knee joints of young mice were examined radiologically at 4 months after surgery. Histological scoring was assigned to grade the severity of osteoarthritis (OA). Immunohistochemistry and quantitative reverse transcription polymerase chain reaction were used to evaluate OA-related protein expression and gene expression, and chondrocyte proliferation was determined with EdU staining. RESULTS: FMT imaging confirmed cross-circulation in the parabiotic pairs. The percentage of EdU-positive chondrocytes in young mice from the Y/O group was significantly lower compared with those of the Y/Y and Y groups (p 0.05), but expression of sex-determining region Y box 9 (Sox9) mRNA in young cartilage from the Y/O group was markedly attenuated compared to those in the Y/Y and Y groups (p

The national flag culture contains the scientific connotation and noble symbol significance, which is the full expression of national spirit and national integrity that can arouse people's patriotic enthusiasm and strengthen its cultural consciousness of the people. By using the four dimensional approaches such as carrying forward the national spirit and culture of the flag, enriching the flag’s material culture, perfecting the flag system culture and animating the national flag’s behavior culture, college workers can comprehensively promote the national flag culture into college campus, strengthen college students' national consciousness and national emotion in theory and practice. They play a leading role in the development of colleges and universities as well as personnel training so as to achieve the purpose of national flag culture into college campus.

This study aims to evaluate the rotation and translation of each joint in the hindfoot and compare the differences in healthy foot with that in stage II PTTD flatfoot by analyzing the reconstructive three-dimensional (3D) computed tomography (CT) image data during several extreme positions.CT scans of 20 healthy feet and 20 feet with stage II PTTD flatfoot were taken in maximal positions of plantarflexion, dorsiflexion, inversion, eversion, external rotation and internal rotation conditions. The images of the hindfoot bones were reconstructed into 3D models. The "twice registration" method was used to calculate the spatial changes of the talus relative to the calcaneus in the talocalcaneal joint, the navicular relative to the talus in talonavicular joint, and the cuboid relative to the calcaneus in the calcaneocuboid joint.Compared with normal participants, with the calcaneus relative to the talus, participants with stage II PTTD flatfoot presented more dorsiflexion (p 0.05), adduction (p 0.05), and eversion (p 0.05) in rotation, and more anterior (p 0.05) and distal translation (p 0.05) from maximal plantarflexion to maximal dorsiflexion; more dorsiflexion (p 0.05), eversion (p 0.05), and abduction (p 0.05) in rotation and more lateral translation (p 0.05) from maximal inversion to maximal eversion; and a greater degree of adduction (p 0.05) in rotation, and more lateral (p 0.05) and posterior translation (p 0.05) from maximal internal rotation to maximal external rotation condition. For navicular relative to the talus, they demonstrated more eversion (p 0.05) and adduction (p 0.05) in rotation, and more lateral (p 0.05), anterior (p 0.05), and distal translation (p 0.05) from maximal plantarflexion to maximal dorsiflexion; more eversion (p 0.05) and adduction (p 0.05) in rotation, and more lateral (p 0.05) and proximal (p 0.05) translation from maximal inversion to maximal eversion; more eversion (p 0.05) and abduction (p 0.05) in rotation and more lateral (p 0.05) translation from maximal internal to maximal external rotation condition. The cuboid position relative to the calcaneus in the calcaneocuboid joint did not change significantly in rotation and translation in different positions (p 0.05).As previous studies shown, regarding both of the cadaveric foot and the live foot, hindfoot joint instability occurred in patients with stage II PTTD flatfoot.

Background The purpose of this study was to use serial magnetic resonance imaging (MRI) examinations to observe changes in malignant lung tumors over time post-cryoablation. Methods The study protocol was approved by Institutional Review Board, and written informed consent was obtained from each participant in accordance with the Declaration of Helsinki. Patients with primary or metastatic lung tumors eligible for cryoablation were included in this prospective study. Cryoablation was performed according to standard procedures. Unenhanced and dynamic contrast-enhanced MRI scans were performed pre-cryoablation and at 1 day, 1 week, and 3-, 6-, and 12 months after cryoablation. At each time point, the signal intensity of the ablated zone on both T1WI and T2WI images, and volume and characteristics of the ablation zone were examined, and changes over time analyzed. Results A total of 26 nodules in 23 patients were included in the study. The mean patient age was 53.7 ± 13.6 years, and 57.7% were males. Ablation zone volume increased to 1 week after the procedure, and then returned to baseline by 3 months. Cavitation post-cryoablation was found in 34.6% (9/26) of the nodules 1 month after treatment. Two types of time-signal intensity curves post-cryoablation were found: a straight line representing no definite enhancement from 1-day to 1-month, and an inflow curve representing mild delayed enhancement from month 3 to month 12. Local progression was associated with an incomplete hypointense rim around the ablation zone and absence of cavitation post-treatment. Conclusions Characteristic changes are present on MRI after cryoablation of lung tumors. A complete hypointense rim and cavitation may be signs of adequate treatment and that local tumor progression is less likely. Electronic supplementary material The online version of this article (doi:10.1186/s40644-017-0131-7) contains supplementary material, which is available to authorized users.

Background Postoperative transfer metatarsalgia is a common complication after hallux valgus surgeries. Shortening of the first metatarsal is traditionally thought to be the primary cause of it. However, we speculate the abnormal loading pattern during gait is the real reason. This study is to determine specific differences in the loading patterns between reconstructive hallux valgus (HV) feet with and without postoperative transfer metatarsalgia, so as to find risky loading characteristics of this complication. Methods Thirty feet with postoperative transfer metatarsalgia were recruited as pain group, while another 30 postoperative feet without pain as controls. All participants were asked to walk barefoot at self-selected speed through a plantar force measuring plate (Rs-Scan Inc.) for three times. Certain plantar load variables were recorded or calculated, and their differences between two groups were compared. Results For pain group, the maximum plantar force and force time integral of the first metatarsal decrease significantly; the force time integral of the central rays (second plus third metatarsal) does not significantly differ with that in the controls, but their cumulative load percentage to the whole foot is higher. In pain group, the time point when central rays reached their peak force during the push-off is significantly later than that in controls. And the regional instant load percentage at this moment presented significantly higher for central rays, while significantly lower for the first metatarsal and the hallux compared to the controls. Conclusions For hallux valgus feet with postoperative metatarsalgia, the load function of the first metatarsal is obviously impaired. But for central rays, indicative difference is not reflected in either peak or cumulative load during the gait cycle, but in the instant load distribution when central rays reach their peak load. So we can conclude that whether the remaining regions can adequately share certain load during walking, especially around the time metatarsalgia often occurs, plays an unnegligible role. So surgeons should pay more attention to reconstruct a foot where load can be evenly distributed.

Gluteal muscle contracture is not very common, but cases are still seen in China. Open surgical treatment is considered as an efficient method to treat this disease. However, the type of incision that can provide best results is yet to be determined. The authors therefore compared various incisions to determine the better one. In this retrospective study, patients who underwent surgery with a traverse straight incision, a curved incision, a longitudinal straight incision, or an 'S'-shaped incision above the greater trochanter were enrolled and divided into four groups: A, B, C, and D. In each group, the patients were divided into different levels according to a specific standard. The four groups were compared in terms of incision length, postoperative drainage amounts, wound healing rates, visual analog scale scores, and improvement in the degree of range of motion (ROM). During the follow-up period, the validity of the results, complications, and recurrent cases were evaluated. In our study, incision length and visual analog scale score of the four groups showed no significant differences (P>0.05). Wound healing rates, drainage amount, improvement in ROM, validity of the results, and recurrences in group D were significantly the best (P

The paper presents an assessment methodology for comparable evaluation of a Spar and a Barge support with multi-megawatt OWT. Stability and hydrodynamic performance of both two floaters are checked by SESAM software. Taking consideration of rotational excitation frequencies of the OWT and primary wave excitations, reasonable engineering attributes of the structures are derived. The attributes are applied in multi-criteria decision making method-TOPSIS combining with environmental and economic attributes for benchmarking relatively better solution. The outcome of the study would contribute towards a more informed decision making process for the most suitable configuration of a new floating support structure for large wind turbine at deeper water.

To establish an expert diagnosis system for cerebrovascular diseases (CVDs) and assess accuracy of the diagnosis system.An expert diagnosis system for CVDs was established and evaluated using actual clinical cases.An expert diagnosis system for CVDs was established and tested in 319 clinical patients. Diagnosis accordance was obtained in 307 patients (the diagnosis accordance rate was 96.2%). Involved were 223, 7, 23, 54 and 12 patients with cerebral thrombosis, cerebral embolism, transient ischemic attack, cerebral hemorrhage and subarachnoid hemorrhage, respectively; and diagnosis accordance was obtained in 219 (98.2%), 6 (85.7%), 23 (100%), 48 (88.9%) and 11 (91.7%), respectively.Overall, the case analysis results support and demonstrate the diagnostic reasoning accuracy of the expert diagnosis system for CVDs. With the expert diagnosis system, medical experts' diagnosis of CVDs can be effectively mimicked and auxiliary diagnosis of CVDs has been preliminarily realized, laying a foundation for increasing the diagnostic accuracy of clinical diagnoses as it pertains to CVDs.

In this paper, we propose a speech enhancement technique in terms of subspace methods to reduce the white or colored noise in strong background noise environment. This subspace approach based on Karhunen-Loève transform (KLT) and implemented via Principal Component Analysis (PCA). The subspace selection provided by the minimum description length (MDL) criterion. An offset factor generated from the white noise was used to modify the variance to adapt to the specified colored noise. The objective speech quality measures SegSNR have been introduced to evaluate the performance of the proposed method in time domain. A large amount of data and figures testify that our algorithm provides high performance for a large scale of input signal-to-noise ratio (-5~10dB). The performance of our algorithm is assessed in white and colored noise.

The choice of a reasonable excavation sequence and contour blasting method is one of the key techniques for the construction of underground powerhouses. Firstly, the excavation sequences and contour blasting methods commonly adopted for main large-scale underground powerhouse under construction or completed in PR China is introduced and analyzed. Secondly, on the basis of an analysis of the propagation of cracks driven by explosion gases during contour blasting, and taking into account the combined effects of initial in situ stress of surrounding rock mass and the explosion pressure of adjacent blast boreholes, the process of propagation of crack formed along excavation contour under action of laterally high in situ stress is analyzed and demonstrated. The results show that the in situ stress of surrounding rock mass is one of the main factors affecting the crack propagation for contour blasting, and when the in situ stress is higher than 10–12 MPa, it is improper to adopt an excavation sequence of pre-split first followed by the main rock mass excavation, alternatively, the excavation sequence with middle cut blasting carried out first, followed by pre-split or smoothing blasting is recommended.

Metal-CO2 propulsion is less known than in-situ resource utilization (ISRU) technologies. This concept, based on using Martian carbon dioxide as an oxidizer in jet or rocket engines, offers the advantage of no chemical processing for CO2 and thus requires less power consumption than ISRU alternatives. In this paper, we study the burning behavior of the Mg in a CO2 atmosphere to assess the feasibility of using Mg/CO2 reactions as an in situ resource utilization technology for rocket propulsion and energy generation on other planets. From the experimental results, we can see that the critical ignition temperature increases with increasing the particle size and decreases with increasing the ambient pressure. In the CO2 atmosphere, we found the complicated sequence of interaction modes including pulsating combustion in a wide range of ambient temperatures. The pulsation frequency is determined by the sample temperature at the phases of slow heterogeneous combustion between the flashes. The combustion mechanisms are discussed with consideration of processes in both a surface film and gas phase.

The ablative performance of the C/SiC ceramic matrix composite material is studied experimentally using a experimental system based on solid rocket motor and liquid rocket engine in this paper. It is mainly studied how the ablative performance is influenced by ablation time, particle and temperature. It is indicated that the ablative performance decays with longer ablation time. The ablation becomes acute when the temperature is higher than 2973K, and the higher temperature, the more significant ablation. In addition, a large amount of vapor increases the thermochemical ablation of the material.

Introduction The motion of the distal syndesmosis correlates highly with the instability, while an accurate kinematic description of the distal tibiofibular joint during normal gait has not previously been presented. Material and methods Sixteen healthy syndesmoses of sixteen living subjects (8 male and 8 female) were studied during stance phase of the normal gait. Data of CT scanning were collected first and used to create the 3D models of the distal tibia and fibula. The lateral X-ray images of the syndesmosis were captured by fluoroscopy when the subject was walking. Seven key-pose images were selected for subsequent 3D to 2D bone model registration and six degrees-of-freedom (DOF) motions of syndesmosis were then calculated. A validation experiment was also conducted to confirm the accuracy of the 3D/2D technique for the syndesmosis. Results During the stance phase, the distal tibiofibular joint exhibited with 2.98 ± 1.10° of dorsi/plantarflexion, 5.94 ± 1.52° of inversion/eversion, and 5.99 ± 2.00° of internal/external rotation; 2.63 ± 1.05 mm on medial/lateral, 3.86 ± 1.65 mm on anterior/posterior, and 4.12 ± 1.53 mm on superior/inferior translation. From heel strike to mid-stance, the syndesmosis demonstrated 1.69° of dorsiflexion, 3.61° of eversion, and 3.95° of external rotation. Likewise, from mid-stance to heel-off, the syndesmosis presented 1.04° of plantarflexion, 4.95° of inversion, and 5.13° of internal rotation. Conclusion During the stance phase of normal gait, internal/external rotation and vertical motion play dominant roles in terms of rotation and translation, respectively.

The injection scheme of an RBCC(Rocket-based combined cycle) engine at scramjetmode using the strut base as a flameholder is carried out by commercial software CFD++ code. Three dimensional steady Reynolds time-averaged Navier-Stokes (N-S) equations were chosen as the control equations. Turbulence closure was achieved using a model that combines the 2 equation cubic k-e model. The turbulent Schmidt (Sct) and Prandtl (Prt) numbers were set to 0.3 and 0.89 respectively. Cases of reacting and nonreacting were considered. Besides the effects of the jet postition, the effect of the variation of equivalence ratio on the engine’s flow structure was investgated.The results shows that :(1) the strut base could act as a flameholder,a high pressure can be found at scramjet-mode due to the counter-rotating vortex’s rolling back movement; (2) better combustion efficiency and engine performance can be achieved when fuel was injected upstream of the area between the strut and cavity; (3) an equivalence ratio above 0.4 could move the high temperature area downstream.

In this paper, a new measuring method of ablation rate was proposed based on X-ray three-dimensional (3D) reconstruction. The ablation of 4-direction carbon/carbon composite nozzles was investigated in the combustion environment of a solid rocket motor, and the macroscopic ablation and linear recession rate were studied through the X-ray 3D reconstruction method. The results showed that the maximum relative error of the X-ray 3D reconstruction was 0.0576%, which met the minimum accuracy of the ablation analysis; along the nozzle axial direction, from convergence segment, throat to expansion segment, the ablation gradually weakened; in terms of defect ablation, the middle ablation was weak, while the ablation in both sides was more serious. In a word, the proposed reconstruction method based on X-ray about C/C nozzle ablation can construct a clear model of ablative nozzle which characterizes the details about micro-cracks, deposition, pores and surface to analyze ablation, so that this method can create the ablation curve in any surface clearly.

We sought to determine whether hallux valgus displaces the sesamoid bones laterally away from a stationary first metatarsal or whether the first metatarsal head is displaced medially from the stationary sesamoids, which remain in position relative to the rest of the forefoot. We reviewed weightbearing radiographs in the dorsal plantar view of 128 consecutive patients (149 feet) seen over 2 months in 2014. Of these, 82 feet (55%) had a hallux valgus angle of >15° (hallux valgus group) and 67 feet (45%) had an angle of no more than 15° (control group). We measured the absolute distances from the center of the lateral sesamoid and the first metatarsal head to the long axis of the second metatarsal. Next, the relative distances, defined as the ratio of these 2 absolute distances to the length of the second metatarsal, were calculated to adjust for foot size. Both the absolute and the relative distances from the center of the first metatarsal head to the second metatarsal differed significantly between the 2 groups and correlated positively with the hallux valgus angle and first intermetatarsal angle. However, neither the absolute nor the relative distance to the lateral sesamoid bone differed significantly between the groups, nor did they correlate with either of the 2 angles. Thus, despite medial shifting of the first metatarsal in hallux valgus, the lateral sesamoid retains its relationship to the second metatarsal in transverse plane. Its apparent lateral movement is a radiographic misinterpretation. Awareness of this misinterpretation should improve the success of corrective surgery.