BACKGROUND Candidal periprosthetic joint infection is a rare and difficult to diagnose complication of total knee arthroplasty.The treatment of such complications is inconclusive and may include prosthesis removal,deb...BACKGROUND Candidal periprosthetic joint infection is a rare and difficult to diagnose complication of total knee arthroplasty.The treatment of such complications is inconclusive and may include prosthesis removal,debridement,arthrodesis,and extensive antifungal therapy to control the infection.CASE SUMMARY A 62-year-old male with a history of total knee arthroplasty(TKA)in his left knee presented with ipsilateral knee pain and a sinus discharge 20 mo after TKA.The patient was previously evaluated for left knee pain,swelling,and a transient fever one month postoperatively.Prothesis removal and insertion of a cement spacer were performed in a local hospital six months prior to the current presentation.Medical therapy included rifampicin and amphotericin which were administered for 4 wk following prosthesis removal.A second debridement was performed in our hospital and Candida parapsilosis was detected in the knee joint.Fourteen weeks following the latter debridement,the patient suffered a left intertrochanteric fracture and received closed reduction and internal fixation with proximal femoral nail anterotation.Two weeks after fracture surgery,a knee arthrodesis with autograft was performed using a double-plate fixation.The patient recovered adequately and was subsequently discharged.At the two-year follow-up,the patient has a stable gait with a pain-free,fused knee.CONCLUSION Fungal periprosthetic joint infection following TKA may be successfully and safely treated with prosthesis removal,exhaustive debridement,and arthrodesis after effective antifungal therapy.Ipsilateral intertrochanteric fractures of the affected knee can be safely fixated with internal fixation if the existing infection is clinically excluded and aided by the investigation of serum inflammatory markers.展开更多
We examine the deep learning technique referred to as the physics-informed neural network method for approximating the nonlinear Schr¨odinger equation under considered parity-time symmetric potentials and for obt...We examine the deep learning technique referred to as the physics-informed neural network method for approximating the nonlinear Schr¨odinger equation under considered parity-time symmetric potentials and for obtaining multifarious soliton solutions.Neural networks to found principally physical information are adopted to figure out the solution to the examined nonlinear partial differential equation and to generate six different types of soliton solutions,which are basic,dipole,tripole,quadruple,pentapole,and sextupole solitons we consider.We make comparisons between the predicted and actual soliton solutions to see whether deep learning is capable of seeking the solution to the partial differential equation described before.We may assess whether physicsinformed neural network is capable of effectively providing approximate soliton solutions through the evaluation of squared error between the predicted and numerical results.Moreover,we scrutinize how different activation mechanisms and network architectures impact the capability of selected deep learning technique works.Through the findings we can prove that the neural networks model we established can be utilized to accurately and effectively approximate the nonlinear Schr¨odinger equation under consideration and to predict the dynamics of soliton solution.展开更多
With the widespread adoption of advanced tourniquets,the mortality rate of limb wound hemorrhage has decreased significantly,and non-compressible torso hemorrhage has gradually occupied the leading position of potenti...With the widespread adoption of advanced tourniquets,the mortality rate of limb wound hemorrhage has decreased significantly,and non-compressible torso hemorrhage has gradually occupied the leading position of potentially preventable death,both in military and civilian circumstances.With the emergence of novel hemostatic devices and materials,strategies for the management of non-compressible torso hemorrhage have changed significantly.This review summarizes the current treatment strategies and types of equipment for non-compressible torso hemorrhage and suggests future research directions,hoping to provide a comprehensive review for the medical personnel and researchers engaging in this field.展开更多
Introduction Lymphatic malformations (LMs) are composed of dilated, abnormal lymphatic channels of varying size that can result in significant physical and esthetic impairment due to relentless growth(1)LMs represent ...Introduction Lymphatic malformations (LMs) are composed of dilated, abnormal lymphatic channels of varying size that can result in significant physical and esthetic impairment due to relentless growth(1)LMs represent a group of heterogeneous diseases, and are classi if ed into three types: microcystic/superficial LM, which was named as lymphangioma circumscriptum[2], macro-cystic LM, and mixed LMs(2-4)In clinical practice, it is dif if cult to classify LMs because some cases have been found to differ from the well- characterized entities. Cutaneous LMs are uncommon, and usually present as microcystic/superficial LM. This condition represents congenitally determined or developmental malformations of the superficial lymphatics rather than true neoplasms. Although developmental dys-plasia, these lesions do not appear genetic, as familial cases do not seem to occur. Typically, LM in infancy usually has the highest incidence of onset, but the lesions can spontaneously appear in adolescence or adulthood, and mostly by the age of 30 years(1- 2,4)Herein we report a case of late-onset superficial LM, which is relatively infrequent.展开更多
基金Supported by Clinical Technology Innovation Cultivation Program of Army Medical University of PLA,No.CX2019JS109Independent Project of State Key Laboratory of Trauma,Burns and Combined Injuries,No.SKLZZ201603Chongqing Appropriate Technology Promotion Project No.2018jstg019。
文摘BACKGROUND Candidal periprosthetic joint infection is a rare and difficult to diagnose complication of total knee arthroplasty.The treatment of such complications is inconclusive and may include prosthesis removal,debridement,arthrodesis,and extensive antifungal therapy to control the infection.CASE SUMMARY A 62-year-old male with a history of total knee arthroplasty(TKA)in his left knee presented with ipsilateral knee pain and a sinus discharge 20 mo after TKA.The patient was previously evaluated for left knee pain,swelling,and a transient fever one month postoperatively.Prothesis removal and insertion of a cement spacer were performed in a local hospital six months prior to the current presentation.Medical therapy included rifampicin and amphotericin which were administered for 4 wk following prosthesis removal.A second debridement was performed in our hospital and Candida parapsilosis was detected in the knee joint.Fourteen weeks following the latter debridement,the patient suffered a left intertrochanteric fracture and received closed reduction and internal fixation with proximal femoral nail anterotation.Two weeks after fracture surgery,a knee arthrodesis with autograft was performed using a double-plate fixation.The patient recovered adequately and was subsequently discharged.At the two-year follow-up,the patient has a stable gait with a pain-free,fused knee.CONCLUSION Fungal periprosthetic joint infection following TKA may be successfully and safely treated with prosthesis removal,exhaustive debridement,and arthrodesis after effective antifungal therapy.Ipsilateral intertrochanteric fractures of the affected knee can be safely fixated with internal fixation if the existing infection is clinically excluded and aided by the investigation of serum inflammatory markers.
基金supported by the National Natural Science Foundation of China(Grant No.12075034)。
文摘We examine the deep learning technique referred to as the physics-informed neural network method for approximating the nonlinear Schr¨odinger equation under considered parity-time symmetric potentials and for obtaining multifarious soliton solutions.Neural networks to found principally physical information are adopted to figure out the solution to the examined nonlinear partial differential equation and to generate six different types of soliton solutions,which are basic,dipole,tripole,quadruple,pentapole,and sextupole solitons we consider.We make comparisons between the predicted and actual soliton solutions to see whether deep learning is capable of seeking the solution to the partial differential equation described before.We may assess whether physicsinformed neural network is capable of effectively providing approximate soliton solutions through the evaluation of squared error between the predicted and numerical results.Moreover,we scrutinize how different activation mechanisms and network architectures impact the capability of selected deep learning technique works.Through the findings we can prove that the neural networks model we established can be utilized to accurately and effectively approximate the nonlinear Schr¨odinger equation under consideration and to predict the dynamics of soliton solution.
基金This work was supported by research funding of Clinical Technology Innovation Cultivation Program of Army Medical University(CX2019JS109)Innovation Developing Program of Army Medical Center(2019CXJX018).
文摘With the widespread adoption of advanced tourniquets,the mortality rate of limb wound hemorrhage has decreased significantly,and non-compressible torso hemorrhage has gradually occupied the leading position of potentially preventable death,both in military and civilian circumstances.With the emergence of novel hemostatic devices and materials,strategies for the management of non-compressible torso hemorrhage have changed significantly.This review summarizes the current treatment strategies and types of equipment for non-compressible torso hemorrhage and suggests future research directions,hoping to provide a comprehensive review for the medical personnel and researchers engaging in this field.
文摘Introduction Lymphatic malformations (LMs) are composed of dilated, abnormal lymphatic channels of varying size that can result in significant physical and esthetic impairment due to relentless growth(1)LMs represent a group of heterogeneous diseases, and are classi if ed into three types: microcystic/superficial LM, which was named as lymphangioma circumscriptum[2], macro-cystic LM, and mixed LMs(2-4)In clinical practice, it is dif if cult to classify LMs because some cases have been found to differ from the well- characterized entities. Cutaneous LMs are uncommon, and usually present as microcystic/superficial LM. This condition represents congenitally determined or developmental malformations of the superficial lymphatics rather than true neoplasms. Although developmental dys-plasia, these lesions do not appear genetic, as familial cases do not seem to occur. Typically, LM in infancy usually has the highest incidence of onset, but the lesions can spontaneously appear in adolescence or adulthood, and mostly by the age of 30 years(1- 2,4)Herein we report a case of late-onset superficial LM, which is relatively infrequent.
