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简介：瞄准：估计联合transcatheter的效果动脉的chemoembolization(不作声)并且在有大hepatocellular癌(HCC)的病人的经皮的乙醇脱离(豌豆)。方法：有unresectable的63个病人的一个总数大HCC被对待与不作声由豌豆列在后面。肿瘤的最大的尺寸从5.3厘米到17.8厘米。幸存率，尖锐效果，毒性和预示的因素被分析。结果：在1，3和5年的累积幸存率是59.4%，28.4%和15.8%，分别地(27.7瞬间的中部的幸存)。肿瘤区域被超过50%在30减少(47.6%)盒子。在有增加的-fetoprotein(法新社)的56种情况中珍视，法新社水平被超过75%拒绝。联合治疗很好通常被容忍。仅仅二个病人从variceal流血死了与治疗联系了。比例的危险建模的艇长证明肿瘤，肿瘤边缘和乙醇剂量的数字是独立预示的因素。结论：联合不作声并且豌豆治疗是为unresectable的一条有希望的途径大HCC。

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简介：AbstractBackground:Mallet fracture is avulsion of the terminal extensor tendon from the base of the distal phalangeal bone with a bony fragment. This study was performed to evaluate the anatomical characteristics of mallet fractures, investigate a new mallet fracture classification system using anatomical and imaging methods, and discuss the treatment schemes for different types of mallet fracture.Methods:Sixty-four fresh cadaveric fingers were divided into four groups, and models of different types of mallet fracture with distal interphalangeal joint instability were established by dissecting 25%, 50%, 75%, and 100% of the bilateral collateral ligaments. The effect of mallet fractures on the stability of the distal interphalangeal joint was then observed. The lateral radiographs of mallet fractures in 168 patients were analyzed and classified according to the involvement of the joint surface in the fracture, the thickness of fracture, the untreated time after injury, and the complication of distal interphalangeal joint palmar subluxation. Forty-seven patients were surgically treated by reconstruction of extensor tendon insertion, the Ishiguro method, or single Kirschner wire fixation.Results:The established mallet fracture model showed that the distal interphalangeal joint was stable when the bilateral collateral ligaments were cut off by 25% (t= -0.415, P = 0.684) and significantly unstable when this range was ≥50% (50% transection: t= -6.363, P < 0.001; 75% transection: t= -17.036, P < 0.001; 100% transection: t = -30.977, P < 0.001, respectively). The mallet fractures were divided into Types I, II, and III (fracture involving <20%, 20%-50%, and >50% of the joint surface, respectively). Type II was further divided into Types IIa and IIb according to whether the course of injury was < or ≥2 weeks, respectively. The mean post-operative flexion of the distal interphalangeal joint was 63.4° ± 7.9°, and the mean extension lag was 6.7°± 4.6°.Conclusions:The lateral collateral ligament is the main factor that maintains the stability of the distal interphalangeal joint. Classification that combines the involvement of the joint surface in the fracture, the thickness of the fracture, and the untreated time after injury is reasonable and will help to choose an appropriate operational method.

简介：与ipsilateral联系的臀部的创伤的以后的脱臼代替了大腿骨的颈骨折是稀罕损害。而且，如此的病人的管理唤起考虑主要代替或保存大腿骨的头的强壮的看法。我们与如此的损害介绍了年轻成年人的一个盒子。他被操作在之上与大腿骨的颈的脱臼和固定的减小，在cancellous的帮助下的骨折拧紧。二年以后，破裂联合起来，病人是无征状的。我们进一步为如此的破裂建议了损害的机制并且在发展中的世界的变化损伤情形讨论了管理。

简介：这个工作检验包含平行表面的板击碎，轮流出现的长度使遭到了到热震动的机能上地分级的材料(FGM)的破裂行为。在长、短的裂缝的尖端的热压力紧张因素(TSIF)用一种单个不可分的方程技术被计算。引起快克开始的批评热吃惊螖Tc用一个压力紧张因素标准被计算。为一个Al2O3/Si3N4FGM盘子的TSIF和螖Tc的数字例子被举在TSIF和螖Tc上说明热性质阶段，裂缝间距和裂缝长度比率的效果。为给定的裂缝长度比率，在长、短的裂缝的尖端的TSIF能显著地被减少，螖Tc能被介绍适当材料阶段提高，这被发现。TSIF也在裂缝间距与减少戏剧性地减少。在短裂缝的尖端的TSIF可能为在某些裂缝几何学条件下面的长裂缝比那高。因此，短裂缝可以开始首先在装载的热吃惊下面成长而不是长裂缝。

简介：Objective:Toinvestigatetheapproachofemergencymanagementforseverepelvicfractureassociatedwithinjuriesofadjacentvisceraandevaluatethetherapeuticeffect.Methods:Thedataof79patientswithseverepelvicfractureassociatedwithinjuriesofadjacentviscerawereretrospectivelystudied,andthestudycoveredaperiodof14years.Results:Toceasemassivebleedingduetopelvicfracture,ligationofinternaliliacarterieswasperformedon33cases,andangioembolizationon8.Of42patientswithcysticor/andurethralinjury,35underwentcystostomyanddelayedreconstruction,and7receivedaprimaryrealignment.Allof17patientswithinjuryofretroperitonealrectumunderwentdivertingcolostomyoftheproximalendofsigmoidwithpresacraldrainage,but4receivedprimaryrepairwithoutcolostomy.In22patientswithintraperitonealcolorectalinjury,19weremanagedwithprimaryrepairoranastomosiswhile3receivedacolostomy.Theoverallmortalityratewas8.86%(7/79);themaincauseswerehemorrhagicshockandassociatedinjury.Thecomplicationsincludedurethro-rectalfistulain4cases,thrombosisofrightcommoniliacarteryin1,ARDSfollowingchesttraumain1,andparaplegiain1.Exceptthepatientwithparaplegia,allofthemwerecured.Conclusions:Promptdiagnosisandpropertreatmentarethekeytosuccess.Devascularizationofinternaliliacarterieswithexternalfixationcageofthepelvis,cystostomyandproximalsigmoidostomyareeffectiveproceduresinemergencytreatmentofthecriticalpatients.

简介：PLAispresentlyconsideredasthemostattractivecompoundfortemporarytherapeuticapplicationinthebiomedicalfield.Inthispaperwegiveanoverviewofthepresentknowledgeonthedegradationbehavior,processingtechnologyofPLAanditsapplicationinthefixationofbonefracture.

简介：ThefracturetoughnessandfractureworkofAl2O3/SiCprismaticceramiccompositeswasevaluatedinthispaper,whichshowedthefractureenergywasimprovedgreatly.Basedontheobservationforcrackpropagationandfracturemorphology,thefracturebehavioroftheprismaticcompositeswasanalyzed.Inthebendingtest,thecompositesdisplayedanon-catastrophicbehaviorandagracefulfailurewithreasonableload-carryingcapability.

简介：lObjectiveTalar身体破裂是稀罕的并且有差的处理结果。学习是报导关上的talardomefractures.MethodsEight的长期的外科的治疗结果的这的目的关上了talar身体破裂，在我们的水平与小碎片cancellous螺丝钉或Herbert螺丝钉由开的减小和内部固定对待我损伤中心回顾地被分析。脚(antero以后、侧面、倾斜的看法)和脚关节的外科手术前、手术后的拍(antero以后，侧面并且榫眼看法)被获得。病人被跟随在上面放射学地并且机能上地(脚功能索引，FFI)在3以后，星期，6个星期，3个月，6个月然后annually.ResultsThere是五压碎破裂并且三砍破裂(二sagittal砍并且一个花冠砍)，与5年的平均后续。没有早复杂并发症在这些病人被注意。迟了的复杂并发症在四个病人在talar身体的六个病人和osteonecrosis包括了subtalar/ankle关节的osteoarthrosis。在功能的评价以后，在5年以后的吝啬的FFI是104.63个点，更坏的结果在压碎损害和花冠被注意砍破裂。Sagittal砍破裂有对通过手术对待的talar身体破裂随后的复杂并发症是的好功能、放射学的outcome.ConclusionsLate不可避免尽管准确减小和僵硬固定被完成，因此，病人们应当关于不利结果被建议。尽管压碎和花冠砍，破裂有差的结果，sagittal损害在长期的评估上有好预后。

简介：Thefracturetoughnessofhardbiomaterials,suchasnacre,bovinehoofwallandbeetlecuticle,isassociatedwithfibrousorlamellarstructuresthatdeflectorstopgrowingcracks.Theirhardnessandreducedmodulusweremeasuredbyusingananoindenterinthispaper.Micro/nanoscalecracksweregeneratedbynanoindentationusingaBerkovichtip.Nanoindentationofnacreandbovinehoofwallresultedinpile-uparoundtheindent.Itwasfoundthatthefracturetoughness(KC)ofbovinehoofwallisthemaximum,thesecondisnacre,andtheelytracuticleofdungbeetleistheleastone.

简介：一个有力的数字模型的发展长有模仿具体材料的破裂行为是在地震工程的主导的研究区域之一。一个可靠模型应该能足够地代表裂缝的不连续的特征并且在复杂装载条件下面模仿各种各样的失败行为。在这篇论文，数字明确的表达，它合并一个复杂僵硬塑料的接口联合弄软的结合的组成的模型，接触，磨擦并且砍膨胀进XFEM，被建议描述具体材料的各种各样的裂缝行为。为精确地在断绝的双方上装配贡献到弱形式的一个有效数字集成计划被介绍。建议方法的有效性被模仿几著名试验性的测试估计了。数字方法罐头成功地捕获裂缝路径并且精确地预言具体结构的破裂行为，这被结束。混合模式破裂行为上的mode-II参数的影响进一步被调查更好决定这些参数。

简介：ThispaperstudiesRabinovitch'scompressionexperimentsongraniteandchalkandproposesanoscillatingdipolemodeltoanalyseandsimulatetheelectromagneticradiationphenomenoncausedbyfractureofrocks.Ourmodelassumesthattheelectromagneticradiationpulsesareinitiatedbyvibrationsofthechargedrockgrainsonthetipsofthecrack.Thevibrationsoftherockgrainsarestimulatedbythepulsesofthecracks.OursimulationsshowcomparableresultswithRabinovitch'scompressionexperiments.Fromthesimulationresults,itverifiesanassumptionthatthecrackwidthisinverselyproportionaltothecircularfrequencyelectromagneticradiation,whichispresentedbyRabinovitchetal.Thesimulationresultsalsoimplythat,byusingouroscillatingdipolemodeltogetherwithRabinovitch'stwoequationsaboutthecracklengthandcrackwidth,wecanquantitativelyanalyseandsimulatetheelectromagneticradiationphenomenon,whichisinducedfromthefractureoftherocks.

简介：AbstractIntroduction:Basal cell carcinoma (BCC) is the most common skin cancer which mainly affects the population over 50 years of age. In addition to surgical treatment, nonsurgical treatment is also an attractive option for some patients.We herein report a case of an 82-year-old man with BCC successfully treated with acitretin.Case presentation:An 82-year-old man presented with BCC on his left nose wing more than 2 years ago. Due to his unwillingness to accept treatment that may lead to pain, discomfort, or trauma, the patient was prescribed oral acitretin 25 mg twice daily [0.8 mg/(kg·d)] and was instructed to apply 2% fusidic acid cream topically once daily for trauma protection. The lesion progressively shrank in size after 4 weeks of treatment, and was almost completely resolved after 28 weeks of follow-up. The patient reported mild adverse effects, such as mild skin fragility and cheilitis, and apparent scaling skin, which caused minor discomfort but did not affect the continuation of treatment.Discussion:The pathogenesis of BCC is still unclear, but it has been demonstrated to be linked to overactive hedgehog signaling and its crosstalk with other pathways such as phosphoinositide 3-kinase and mammalian target of rapamycin. Acitretin could obviously inhibit cell growth and proliferation and down-regulate AMP-dependent protein kinases that plays critical role in the blocking of malignant progression of several tumors including BCC.Conclusion:We provide an effective alternative for the patients with BCC who are unwilling to receive surgical therapy.

简介：AbstractSevere fever with thrombocytopenia syndrome (SFTS), caused by a novel identified bunyavirus SFTS virus (SFTSV), was an emerging viral infectious disease that was firstly reported in China. There are no licensed vaccines and therapeutics against SFTSV currently. B-Propiolactone (BPL) inactivated whole virions of SFTSV strain AH12 were prepared as experimental vaccine in different antigen dose with or without Al(OH)3 adjuvant. The experimental SFTS vaccine was a satisfying immunogen, which could efficiently trigger the development of high levels of SFTSV NP-specific IgG antibodies and neutralizing antibodies against SFTSV Strain HB29 in BALB/c and C57/BL6 mice, and could induce SFTS virus-specific cellular immune responses to a certain extent. A single dose of vaccine was immunogenically insufficient in BALB/c mice; the second and third dose resulted in significant boost in antibody response. The use of Al(OH)3 adjuvant resulted in higher antibody titers. The mediate-dose of vaccine could induce as high and equivalent level of antibody titer as that of high-dose. The experimental SFTS vaccine in mediate-and high antigen dose with adjuvant resulted in solid protection of C57/BL6 mice against wild-type SFTSV challenge with markedly accelerated virus clearance from blood and spleen compared with controls. The experimental SFTS vaccine prepared in this study could efficiently elicit virus specific humoral and cellular immune responses in both BALB/c and C57/BL6 mice, and could protect C57/BL6 mice against SFTS virus challenge. These results supplied evidence that inactivated vaccine was a promising vaccine candidate for the prevention of SFTSV infection.

简介：BackgroundBasedonpreviousstudies,afragmentedQRS(fQRS)complex,asapredictivebiomarkerofmyocardialscarringcondition,couldbeusedtopredicttheoutcomesofcardiacresynchronizedtherapy(CRT).However,thisconclusionisstilldebatable.MethodsFiftyischemicornon-ischemiccardiomyopathypatientsfailure(aged65±10yrs,34males,16females)withrefractoryheart,diagnosedbythecriteriaofNewYorkHeartAssociationreceivedCRT.TheECGsof18patientswithafQRScomplex(dividedbyDas)werecomparedwiththoseof32patientswithoutafQRScomplex,whowereevaluatedby12-leadECGbeforeCRT.Thepatientswerefollowedupforsixmonths,and12-leadECGandechocardiographywerereviewed.Atleast15%reductionintheleftventricularend-systolicvolume(LVESV)wasdefinedasrespondersaccordingtothedataobtainedforbetween-groupandintra-groupanalysis.ResultsSixpatients(33.3%)inthefQRSgroupand24patients(75%)inthenon-fQRSgrouprespondedwell.Inaddition,comparisonsofindicatorsfromsurfaceECGandechocardiography6monthsafterCRTshowedthatthenon-fQRSgroupbenefitedfromCRTsignificantlymorethanthefQRSgroup.ConclusionsThefQRScomplexhasgoodpredictivevalueforresponsivenesstoCRT.Non-fQRScomplexpatientswithrefractoryheartfailuremaybenefitmorefromCRT,andthesepatientsneedtoreceivethistreatmentasearlyaspossible.

简介：QigongisapartoftraditionalChinesemedicine.Accordingtotheantiquetreaties,thefoundationsoftraditionalChinesemedicinearebasedinmaintainingtheharmonybetweenQi(energy),Jing(essence)andShen(spirit).Alterationsinthisharmonycandevelopanddeterminetheappearanceofdisease.TherapeuticeffectsofQigongarehelpfulinthepreventionandtreatmentofseveraldiseases.It'smainroleinrestoringbodyfunctionsisduetothecommunicationbetweeninternalorgans,tissuesandcells.ThemaingoalofthisworkistoshowtheefficacyofQigonginthetreatmentofadermatologicaldiseasecharacterizedbytheappearanceofcircularorovalpatchesofmissinghair,knownasalopeciauniversalis.Forwesternmedicinetheexactcauseofthisillnessisnottotallyrevealed,however,it'sattributedtopsycological,geneticsandmetabolicalterations.FromthetraditionalChinesemedicineperspective,hairalterationsareframedintheareaofthewaterenergy,representedbythekidneyorgan.TheresultsofQigongtreatmentsuggestedthatthecranialhairfollicleshadbeenactivatedsincethefirsttreatment.Astreatmentprogressed,thecranialhairfolliclescontinuedtogrow,what'smore,thebrightnessandpigmentationofthehairalsoincreased.Therefore,intheclinicalconditionsevaluated,Qigongcouldbeaneffectivealternativetreatmentinconsiderationofthevisibleevidenceaboutrapidandlonglastingresults.Besides,wedidnotobserveanysideeffectsofQigonginthiscase.

简介：摘要The COVID-19 pandemic affects a large number of patients with a rapid progression of respiratory failure often requiring hospitalization or intensive care unit treatment in some patients. Survivors of severe COVID-19 suffer from persistent weakness and cardiorespiratory failure. Feasibility and potential benefit of cardiopulmonary rehabilitation (CR) after COVID-19 remains unclear. Therefore, we retrospectively analyzed a cohort of COVID-19 patients in a single center inpatient rehabilitation clinic and describe performance and outcome during CR.Patients were referred from acute care hospitals for rehabilitation after severe COVID-19. The cohort (n＝28) was divided in ventilated or not ventilated patients for further analysis. 50% were female, mean age was 66 years and patients stayed in the acute hospital for 19.3±10.7 days before referral for CR. 17 patients (61%) needed previous ICU treatment in the acute care hospital. Risk factors, assessments and questionnaires on admission were comparable in both groups. Significant enhancements were observed in 6-minute walking test and Feeling Thermometer which were independent of previous ventilation status.In conclusion, comprehensive CR following COVID-19 is safe, feasible and effective. Improvements in physical performance and subjective health status were independent of previous ventilation.

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