Objective: This study aims to evaluate the efficacy and safety of using a strip-shaped cymba conchae orthosis for the nonsurgical correction of complex auricular deformities. Methods: Clinical data were collected from...Objective: This study aims to evaluate the efficacy and safety of using a strip-shaped cymba conchae orthosis for the nonsurgical correction of complex auricular deformities. Methods: Clinical data were collected from 2020 to 2021 for 6 patients who underwent correction using a stripshaped cymba conchae orthosis. The indications, corrective effects, and complications associated with use of the orthosis were analyzed. Results: There were four indications for treatment: cryptotia with helix adhesion;cryptotia with grade I microtia;cryptotia with excessive helix thickness;and auricular deformity beyond the treatment time window(≥6 months). Excellent corrective effects were observed in all 6 patients. Complications occurred in one patient, who recovered after symptomatic treatment. Conclusion: The use of a strip-shaped cymba conchae orthosis alone or combined with a U-shaped helix orthosis presents a feasible approach for correcting complex auricular deformities or deformities beyond the treatment time window in pediatric patients.展开更多
BACKGROUND It has been confirmed that the increased posterior tibial slope over 12 degrees is a risk factor for anterior cruciate ligament injury,and varus deformity can aggravate the progression of medial osteoarthri...BACKGROUND It has been confirmed that the increased posterior tibial slope over 12 degrees is a risk factor for anterior cruciate ligament injury,and varus deformity can aggravate the progression of medial osteoarthritis.AIM To evaluate the efficacy of modified high tibial osteotomy(HTO)and anterior cruciate ligament reconstruction(ACLR)in the treatment of anterior cruciate ligament(ACL)injuries with varus deformities and increased posterior tibial slope(PTS)based on clinical and imaging data.METHODS The patient data in this retrospective study were collected from 2019 to 2021.A total of 6 patients were diagnosed with ACL injury combined with varus deformities and increased PTS.All patients underwent modified open wedge HTO and ACLR.The degree of correction of varus deformity and the PTS was evaluated by radiography and magnetic resonance imaging.RESULTS All 6 patients(6 knee joints)were followed up for an average of 20.8±3.7 months.The average age at surgery was 29.5±3.8 years.At the last follow-up,all patients resumed competitive sports.The International Knee Documentation Committee score increased from 50.3±3.1 to 87.0±2.8,the Lysholm score increased from 43.8±4.9 to 86±3.1,and the Tegner activity level increased from 2.2±0.7 to 7.0±0.6.The average movement distance of the tibia anterior translation was 4.8±1.1 mm,medial proximal tibial angle(MPTA)was 88.9±1.3°at the last follow-up,and the PTS was 8.4±1.4°,both of which were significantly higher than those before surgery(P<0.05).CONCLUSION Modified open wedge HTO combined with ACLR can effectively treat patients with ACL ruptures with an associated increased PTS and varus deformity.The short-term effect is significant,but the long-term effect requires further follow-up.展开更多
Objective The Vickers ligament is thought to hinder the growth of palmar ulnar radius by tethering the lunate to the radius,leading to Madelung deformity.The purpose of this study was to clarify the nature of the Vick...Objective The Vickers ligament is thought to hinder the growth of palmar ulnar radius by tethering the lunate to the radius,leading to Madelung deformity.The purpose of this study was to clarify the nature of the Vickers ligament and investigate its pathogenesis in Madelung deformities based on our observation of the Vickers ligament.Methods All 22 patients(33 wrists)with Madelung deformities treated surgically between 2018 and 2022 were included.The diagnosis was confirmed radiographically in all patients.The three-dimensional computed tomography(3D-CT)data of 16 patients(19 wrists)were available.Magnetic resonance imaging(MRI)data were available for 9 patients(14 wrists).Wrist arthroscopy was used in 4 patients.The Vickers ligament was resected and submitted for histopathological examination in 8 patients.Radiographic outcomes,3D-CT,MRI,arthroscopy,surgical findings,and histopathology of the Vickers ligament were evaluated.Results The 3D-CT revealed that the Vickers ligament originated in the metaphysis and formed a metaphyseal defect at the palmar ulnar radius.In the sequential MR coronal images,the Vickers ligament could be divided into 3 branches,extending to the lunate,triquetrum and ulnar styloid.Arthroscopy and surgical findings revealed that the nature of the Vickers ligament was the stretched palmar ligament of the wrist.The histopathology results revealed ligamentous tissue and fibrocartilaginous metaplasia with a structure similar to that of the triangular fibrocartilage complex(TFCC).Conclusions The Vickers ligament is not a separate aberrant ligament.The nature of the Vickers ligament is a combination of the stretched TFCC ligament(palmar radioulnar ligament,ulnotriquetral ligament and ulnolunate ligament)and radiolunate ligament.The possible pathogenesis of Madelung deformity might be focal early epiphyseal closure at the middle part of the sigmoid notch,which leads to focal growth retardation of the radius and pulls palmar ligaments proximally to form the Vickers ligament.展开更多
Hallux valgus is a relatively common and multifaceted complex deformity of the front part of the foot. It is the result of multiple effects of innate (endogenous) and exogenous etiological factors with different degre...Hallux valgus is a relatively common and multifaceted complex deformity of the front part of the foot. It is the result of multiple effects of innate (endogenous) and exogenous etiological factors with different degrees of influence. The degree of hallux valgus deformity is usually assessed by radiological values of hallux valgus (HV) and intermetatarsal (IM) angles. The aim of the paper is to justify the definition of hallux valgus deformity as a function of one angle, (HVA or IMA), and then to determine the functional connection and the most suitable function equalizing the values of the angles IMA and HVA. As hallux valgus is a double angulation deformity, the analytically determined connection between the HVA and IMA angles reduces the study of the deformity to the study of function with one argument, and makes the analysis of deformity changes before and after operative treatment simpler. For the determined connections between the angles, the values of linear proportionality coefficients and regression coefficients of corresponding linear functions of analytical equalization of the value of the IM angle and the degree of deformity for a given value of the HV angle were experimentally determined. The obtained results were checked on a sample of 396 operatively treated hallux valgus deformities. The presented analytical approach and the obtained functional links of IMA and HVA enable quantitative observation of the change in the degree of deformity based on the radiologically determined value of these angles, and the established nonlinear function will be useful for evaluating the expected value of the IM angle and the degree of deformity based only on the measured value of the HV angle. .展开更多
In engineering practice,it is often necessary to determine functional relationships between dependent and independent variables.These relationships can be highly nonlinear,and classical regression approaches cannot al...In engineering practice,it is often necessary to determine functional relationships between dependent and independent variables.These relationships can be highly nonlinear,and classical regression approaches cannot always provide sufficiently reliable solutions.Nevertheless,Machine Learning(ML)techniques,which offer advanced regression tools to address complicated engineering issues,have been developed and widely explored.This study investigates the selected ML techniques to evaluate their suitability for application in the hot deformation behavior of metallic materials.The ML-based regression methods of Artificial Neural Networks(ANNs),Support Vector Machine(SVM),Decision Tree Regression(DTR),and Gaussian Process Regression(GPR)are applied to mathematically describe hot flow stress curve datasets acquired experimentally for a medium-carbon steel.Although the GPR method has not been used for such a regression task before,the results showed that its performance is the most favorable and practically unrivaled;neither the ANN method nor the other studied ML techniques provide such precise results of the solved regression analysis.展开更多
BACKGROUND Osteoporosis is the leading cause of vertebral fractures.Dual-energy X-ray absor-ptiometry(DXA)and radiographs are traditionally used to detect osteoporosis and vertebral fractures/deformities.Magnetic reso...BACKGROUND Osteoporosis is the leading cause of vertebral fractures.Dual-energy X-ray absor-ptiometry(DXA)and radiographs are traditionally used to detect osteoporosis and vertebral fractures/deformities.Magnetic resonance imaging(MRI)can be utilized to detect the relative severity of vertebral deformities using three-dimen-sional information not available in traditional DXA and lateral two-dimensional radiography imaging techniques.AIM To generate normative vertebral parameters in women using MRI and DXA scans,determine the correlations between MRI-calculated vertebral deformities and age,DXA T-scores,and DXA Z-scores,and compare MRI vertebral deformity values with radiography values previously published in the literature.METHODS This study is a retrospective vertebral morphometric analysis conducted at our institution.The patient sample included MR images from 1638 female patients who underwent both MR and DXA imaging between 2005 and 2014.Biconcavity,wedge,crush,anterior height(Ha)/posterior height(Hp),and middle height(Hm)/posterior height values were calculated from the MR images of the patient’s vertebrae.Associations between vertebral deformity values,patient age,and DXA T-scores were analyzed using Spearman correlation.The MRI-derived measure-ments were compared with radiograph-based calculations from population-based data compiled from multiple studies.RESULTS Age was positively correlated with lumbar Hm/Hp(P=0.04)and thoracic wedge(P=0.03)and biconcavity(P=0.001)and negatively correlated with thoracic Ha/Hp(P=0.002)and Hm/Hp(P=0.001)values.DXA T-scores correlated positively with lumbar Hm/Hp(P<0.0001)and negatively with lumbar wedge(P=0.046),biconcavity(P<0.0001),and Ha/Hp(P=0.046)values.Qualitative analysis revealed that Ha/Hp differed between MRI and radiography population-based data by no more than 0.3 and Hm/Hp by a maximum of 1.2.CONCLUSION Compared with traditional imaging techniques,MRI detects vertebral deformities with high accuracy and re-liability.It may be a sensitive,ionizing,radiation-free tool for use in clinical settings.展开更多
Geological deformations are generally attributed to compressional, extensional and strike-slip processes. Since the breakup of Gondwana, torque deformation has been responsible for the current configuration of the wes...Geological deformations are generally attributed to compressional, extensional and strike-slip processes. Since the breakup of Gondwana, torque deformation has been responsible for the current configuration of the western coasts of Africa and the eastern shore of South America and the morphotectonic geometry of the rift basins of South America, conditioning the morphostructure of the Andean chain and the current geoforms of the foreland.展开更多
This paper presents a nonlinear micropolar nonclassical continuum theory (MPNCCT) for finite deformation, finite strain deformation physics of thermosviscoelastic solid medium with memory (polymeric micropolar solids)...This paper presents a nonlinear micropolar nonclassical continuum theory (MPNCCT) for finite deformation, finite strain deformation physics of thermosviscoelastic solid medium with memory (polymeric micropolar solids) based on classical rotations cΘand their rates. Contravariant second Piola-Kirchhoff stress and moment tensors, in conjunction with finite deformation measures derived by the authors in recent paper, are utilized in deriving the conservation and balance laws and the constitutive theories based on conjugate pairs in entropy inequality and the representation theorem. This nonlinear MPNCCT for TVES with rheology: 1) incorporates nonlinear ordered rate dissipation mechanism based on Green’s strain rates up to order n;2) also incorporates an additional ordered rate dissipation mechanism due to microconstituents, the viscosity of the medium and the rates of the symmetric part of the rotation gradient (of cΘ) tensor up to order n, referred to as micropolar dissipation or micropolar viscous dissipation mechanism;3) incorporates the primary mechanism of memory or rheology due to long chain molecules of the polymer and the viscosity of the medium by using the contravaraint second Piola-Kirchhoff stress tensor and its rates up to order m, resulting in a relaxation spectrum;4) incorporates second mechanism of memory or rheology due to nonclassical physics, interaction of microconstituents with the viscous medium and long chain molecules by considering rates of the contravariant second Piola-Kirchhoff moment tensor up to order m, resulting in relaxation of second Piola-Kirchhoff moment tensor. This results in another relaxation spectrum for the second Piola-Kirchhoff moment tensor due to microconstituents, referred to as micropolar relaxation spectrum consisting of micropolar relaxation time constants of the material. This nonlinear MPNCCT for TVES with memory is thermodynamically and mathematically consistent, and the mathematical model consisting of conservation and balance laws and the constitutive theories has closure and naturally reduces to linear MPNCCT based on infinitesimal deformation assumption. BMM is the essential balance law for all MPNCCT and is used in the present work as well. In the absence of this balance law, a valid thermodynamically and mathematically consistent nonlinear MPNCCT is not possible. The nonlinear MPNCCT based on rotations (cΘ+αΘ) and αΘ(ignoring cΘ) is not considered due to the fact that even the linear MPNCCT based on these rotations is invalid and is thermodynamically and mathematically inconsistent MPNCCT.展开更多
To address the issue of extensive deformation in the Tabaiyi Tunnel caused by the fault zone,nuclear magnetic resonance(NMR)technology was employed to analyze the physical and mechanical properties of waterabsorbing m...To address the issue of extensive deformation in the Tabaiyi Tunnel caused by the fault zone,nuclear magnetic resonance(NMR)technology was employed to analyze the physical and mechanical properties of waterabsorbing mudstone.This analysis aimed to understand the mechanism behind the significant deformations.Drawing from the principle of excavation stress compensation,a support scheme featuring NPR anchorcables and an asymmetric truss support system was devised.To validate the scheme,numerical analysis using a combination of the Discrete Element Method(DEM)-Finite Element Method(FEM)was conducted.Additionally,similar material model tests and engineering measurements were carried out.Field experiments were also performed to evaluate the NPR anchor-cable and truss support system,focusing on anchor cable forces,pressures between the truss and surrounding rock,pressures between the initial support and secondary lining,as well as the magnitude of settlement and convergence deformation in the surrounding rock.The results indicate that the waterinduced expansion of clay minerals,resulting from damage caused by fissure water,accelerated the softening of the mudstone's internal structure,leading to significant deformations in the Tabaiyi Tunnel under high tectonic stress.The original support design fell short as the length of the anchor rods was smaller than the expansion depth of the plastic zone.As a result,the initial support structure bore the entire load from the surrounding rock,and a non-coupled deformation contact was observed between the double-arch truss and the surrounding rock.The adoption of NPR asymmetric anchor-cable support effectively restrained the expansion and asymmetric distribution characteristics of the plastic zone.Considering the mechanical degradation caused by water absorption in mudstone,the rigid constraint provided by the truss proved crucial for controlling the stability of the surrounding rock.These research findings hold significant implications for managing large deformations in soft rock tunnels situated within fractured zones under high tectonic stress conditions.展开更多
The dynamic fracture behavior of the three-point bending beam with double deformity inclusions under impact loading is studied by using digital high-speed photography in combination with the transmission-type dynamic ...The dynamic fracture behavior of the three-point bending beam with double deformity inclusions under impact loading is studied by using digital high-speed photography in combination with the transmission-type dynamic caustic method. The experimental results indicate that the fluctuation of crack propagation velocity v first increases and then decreases in the crack propagation process. During the process of crack propagating into the inclusion area, the fracture resistance effect of the circular inclusion is the most significant and the effects of triangular and square inclusions are less obvious. The stress intensity factor near the crack tip increases during the propagation process and reaches its maximum value when the crack tip is close to the inclusions. The crack tip’s dynamic stress intensity factor （ DSIF） decreases when the crack exceeds the middle area of the double inclusions. These results provide an experimental basis and scientific foundation to strengthen the evaluation and fracture analysis of the structure containing deformity inclusions.展开更多
The approach combining the dynamic caustics method with high-speed photography technology is used to study the interaction between propagating cracks and three kinds of deformity inclusions（ cylinder inclusion, quadr...The approach combining the dynamic caustics method with high-speed photography technology is used to study the interaction between propagating cracks and three kinds of deformity inclusions（ cylinder inclusion, quadruple inclusion and triangular inclusion） under lowvelocity impact loading. By recording the caustic spots of crack tips at different moments during the crack propagation, the variation regulations of dynamic stress intensity factors（ DSIF） and crack growth velocity with respect to time are obtained. The experimental results showthat the resistance effects to crack growth are varied with different shapes of inclusions in specimens, and the quadruple inclusion＇s effect is more apparent. The distortion degree of caustic spots is affected by the shapes of inclusions as well, and the situation is more serious for cylinder and quadruple inclusions. The overall values of DSIFs of triangular inclusion specimen are greater than the others, and the crack growth velocities, characteristic sizes and DSIFs showprocesses of fluctuations because of the disturbance of reflection waves in specimens. The results provide an experimental basis for the analysis of strength and impact-resistance ability in structures with deformity inclusions.展开更多
AIM: To evaluate the effect of releasing the orbicularis retaining ligament(ORL) complex of the tear trough combined with the transconjunctival blepharoplasty in the surgical management of tear trough deformity compar...AIM: To evaluate the effect of releasing the orbicularis retaining ligament(ORL) complex of the tear trough combined with the transconjunctival blepharoplasty in the surgical management of tear trough deformity compared with the effect of blepharoplasty alone. METHODS: A prospective, randomized(by closed envelope technique), controlled surgical trial which included 50 patients(100 eyes) with bilateral visible tear trough deformity and lower eyelid fat bulging, was divided into two groups where 25 patients(50 eyes) had tear trough-ORL release with blepharoplasty and 25 patients(50 eyes) didn't. Qualitative and quantitative assessments of tear trough deformity were done at 6 mo postoperatively, achieving grade 0 or 1 of Barton's classification was considered a success. Standardized photographic documentation of each patient was done pre and postoperatively, also assessment of the patients' satisfaction postoperatively was done and ranked as excellent, very good, good or fair. RESULTS: There was statistically significant difference between the two groups in the overall aesthetic results postoperatively regarding the qualitative and quantitative analysis of the tear trough deformity, where patients who had tear trough-ORL complex release had more successful outcomes than those of the second group. CONCLUSION: ORL release should be done in patients with tear trough deformity in order to release the tethering effect of this ligament which causes the prominence of the naso jugal groove.展开更多
Aim:To investigate the impact of abnormal sperm morphology using the sperm deformity index (SDI) on reactive oxygen species (ROS) production and its correlation with sperm DNA damage.Methods:Semen samples were collect...Aim:To investigate the impact of abnormal sperm morphology using the sperm deformity index (SDI) on reactive oxygen species (ROS) production and its correlation with sperm DNA damage.Methods:Semen samples were collected from men undergoing infertility screening (n=7) and healthy donors (n=6).Mature spermatozoa were isolated and incubated with 5 mmol/L β-nicotinamide adenine dinucleotide phosphate (NADPH) for up to 24 h to induce ROS.Sperm morphology was evaluated using strict Tygerberg's criteria and the SDI.ROS levels and DNA damage were assessed using chemiluminescence and terminal deoxynucleotidyl transferase-mediated fluorescein- dUTP nick end labeling (TUNEL) assays,respectively.Results:SDI values (median [interquartiles]) were higher in patients than donors (2 [1.8,2.1] vs.1.53 [1.52,1.58],P=0.008).Aliquots treated with NADPH showed higher ROS levels (1.22 [0.30,1.87] vs.0.39 [0.10,0.57],P=0.03) and higher incidence of DNA damage than those not treated (10 [4.69,24.85] vs.3.85 [2.58,5.10],P=0.008).Higher DNA damage was also seen following 24 h of incubation in patients compared to donors.SDI correlated with the percentage increase in sperm DNA damage following incubation for 24 h in samples treated with NADPH (r=0.7,P=0.008) and controls (r=0.58,P=0.04). Conclusion:SDI may be a useful tool in identifying potential infertile males with abnormal prevalence of oxidative stress (OS)-induced DNA damage.NADPH plays a role in ROS-mediated sperm DNA damage,which appears to be more evident in infertile patients with semen samples containing a high incidence of morphologically abnormal spermatozoa.展开更多
AIM: To evaluate published data on the predictors of progressive adolescent idiopathic scoliosis(AIS) in order to evaluate their efficacy and level of evidence. METHODS: Selection criteria:(1) study design: randomized...AIM: To evaluate published data on the predictors of progressive adolescent idiopathic scoliosis(AIS) in order to evaluate their efficacy and level of evidence. METHODS: Selection criteria:(1) study design: randomized controlled clinical trials, prospective cohort studies and case series, retrospective comparative and none comparative studies;(2) participants: adolescents with AIS aged from 10 to 20 years; and(3) treatment: observation, bracing, and other. Search method: Ovid MEDLINE, Embase, the Cochrane Library, Pub Medand patent data bases. All years through August 2014 were included. Data were collected that showed an association between the studied characteristics and the progression of AIS or the severity of the spine deformity. Odds ratio(OR), sensitivity, specificity, positive and negative predictive values were also collected. A metaanalysis was performed to evaluate the pooled OR and predictive values, if more than 1 study presented a result. The GRADE approach was applied to evaluate the level of evidence.RESULTS: The review included 25 studies. All studies showed statistically significant or borderline association between severity or progression of AIS with the following characteristics:(1) An increase of the Cobb angle or axial rotation during brace treatment;(2) decrease of the rib-vertebral angle at the apical level of the convex side during brace treatment;(3) initial Cobb angle severity(> 25o);(4) osteopenia;(5) patient age < 13 years at diagnosis;(6) premenarche status;(7) skeletal immaturity;(8) thoracic deformity;(9) brain stem vestibular dysfunction; and(10) multiple indices combining radiographic, demographic, and physiologic characteristics. Single nucleotide polymorphisms of the following genes:(1) calmodulin 1;(2) estrogen receptor 1;(3) tryptophan hydroxylase 1;(3) insulin-like growth factor 1;(5) neurotrophin 3;(6) interleukin-17 receptor C;(7) melatonin receptor 1B, and(8) Scoli Score test. Other predictors included:(1) impairment of melatonin signaling in osteoblasts and peripheral blood mononuclear cells(PBMC);(2) G-protein signaling dysfunction in PBMC; and(3) the level of platelet calmodulin. However, predictive values of all these findings were limited, and the levels of evidence were low. The pooled result of brace treatment outcomes demonstrated that around 27% of patents with AIS experienced exacerbation of the spine deformity during or after brace treatment, and 15% required surgical correction. However, the level of evidence is also low due to the limitations of the included studies.CONCLUSION: This review did not reveal any methods for the prediction of progression in AIS that could be recommended for clinical use as diagnostic criteria.展开更多
Objective: A common cavity deformity(CCD) is a deformed inner ear in which the cochlea and vestibule are confluent forming a common rudimentary cystic cavity that results in profound hearing loss. There are few studie...Objective: A common cavity deformity(CCD) is a deformed inner ear in which the cochlea and vestibule are confluent forming a common rudimentary cystic cavity that results in profound hearing loss. There are few studies paying attention to common cavity. Our group is engrossed in observing the improvement of auditory and verbal abilities in children who have received cochlear implantation(CI), and comparing these targets between children with common cavity and normal inner ear structure.Material and methods: A retrospective study was conducted in 12 patients with profound hearing loss that were divided into a common cavity group and a control group, six in each group matched in sex, age and time of implantation, based on inner ear structure. Categories of Auditory Performance(CAP) and speech intelligibility rating(SIR) scores and aided hearing thresholds were collected and compared between the two groups. All patients wore CI for more than 1 year at the Cochlear Center of Anhui Medical University from 2011 to 2015.Results: Postoperative CAP and SIR scores were higher than before operation in both groups(p < 0.05), although the scores were lower in the CCD group than in the control group(p < 0.05). The aided threshold was also lower in the control group than in the CCD group(p < 0.05).Conclusion: Even though audiological improvement in children with CCD was not as good as in those without CCD, CI provides benefits in auditory perception and communication skills in these children.展开更多
文摘Objective: This study aims to evaluate the efficacy and safety of using a strip-shaped cymba conchae orthosis for the nonsurgical correction of complex auricular deformities. Methods: Clinical data were collected from 2020 to 2021 for 6 patients who underwent correction using a stripshaped cymba conchae orthosis. The indications, corrective effects, and complications associated with use of the orthosis were analyzed. Results: There were four indications for treatment: cryptotia with helix adhesion;cryptotia with grade I microtia;cryptotia with excessive helix thickness;and auricular deformity beyond the treatment time window(≥6 months). Excellent corrective effects were observed in all 6 patients. Complications occurred in one patient, who recovered after symptomatic treatment. Conclusion: The use of a strip-shaped cymba conchae orthosis alone or combined with a U-shaped helix orthosis presents a feasible approach for correcting complex auricular deformities or deformities beyond the treatment time window in pediatric patients.
文摘BACKGROUND It has been confirmed that the increased posterior tibial slope over 12 degrees is a risk factor for anterior cruciate ligament injury,and varus deformity can aggravate the progression of medial osteoarthritis.AIM To evaluate the efficacy of modified high tibial osteotomy(HTO)and anterior cruciate ligament reconstruction(ACLR)in the treatment of anterior cruciate ligament(ACL)injuries with varus deformities and increased posterior tibial slope(PTS)based on clinical and imaging data.METHODS The patient data in this retrospective study were collected from 2019 to 2021.A total of 6 patients were diagnosed with ACL injury combined with varus deformities and increased PTS.All patients underwent modified open wedge HTO and ACLR.The degree of correction of varus deformity and the PTS was evaluated by radiography and magnetic resonance imaging.RESULTS All 6 patients(6 knee joints)were followed up for an average of 20.8±3.7 months.The average age at surgery was 29.5±3.8 years.At the last follow-up,all patients resumed competitive sports.The International Knee Documentation Committee score increased from 50.3±3.1 to 87.0±2.8,the Lysholm score increased from 43.8±4.9 to 86±3.1,and the Tegner activity level increased from 2.2±0.7 to 7.0±0.6.The average movement distance of the tibia anterior translation was 4.8±1.1 mm,medial proximal tibial angle(MPTA)was 88.9±1.3°at the last follow-up,and the PTS was 8.4±1.4°,both of which were significantly higher than those before surgery(P<0.05).CONCLUSION Modified open wedge HTO combined with ACLR can effectively treat patients with ACL ruptures with an associated increased PTS and varus deformity.The short-term effect is significant,but the long-term effect requires further follow-up.
基金supported by the Natural Science Foundation of Beijing Municipality(No.7222087)Beijing JST Research Funding(No.ZR-202217).
文摘Objective The Vickers ligament is thought to hinder the growth of palmar ulnar radius by tethering the lunate to the radius,leading to Madelung deformity.The purpose of this study was to clarify the nature of the Vickers ligament and investigate its pathogenesis in Madelung deformities based on our observation of the Vickers ligament.Methods All 22 patients(33 wrists)with Madelung deformities treated surgically between 2018 and 2022 were included.The diagnosis was confirmed radiographically in all patients.The three-dimensional computed tomography(3D-CT)data of 16 patients(19 wrists)were available.Magnetic resonance imaging(MRI)data were available for 9 patients(14 wrists).Wrist arthroscopy was used in 4 patients.The Vickers ligament was resected and submitted for histopathological examination in 8 patients.Radiographic outcomes,3D-CT,MRI,arthroscopy,surgical findings,and histopathology of the Vickers ligament were evaluated.Results The 3D-CT revealed that the Vickers ligament originated in the metaphysis and formed a metaphyseal defect at the palmar ulnar radius.In the sequential MR coronal images,the Vickers ligament could be divided into 3 branches,extending to the lunate,triquetrum and ulnar styloid.Arthroscopy and surgical findings revealed that the nature of the Vickers ligament was the stretched palmar ligament of the wrist.The histopathology results revealed ligamentous tissue and fibrocartilaginous metaplasia with a structure similar to that of the triangular fibrocartilage complex(TFCC).Conclusions The Vickers ligament is not a separate aberrant ligament.The nature of the Vickers ligament is a combination of the stretched TFCC ligament(palmar radioulnar ligament,ulnotriquetral ligament and ulnolunate ligament)and radiolunate ligament.The possible pathogenesis of Madelung deformity might be focal early epiphyseal closure at the middle part of the sigmoid notch,which leads to focal growth retardation of the radius and pulls palmar ligaments proximally to form the Vickers ligament.
文摘Hallux valgus is a relatively common and multifaceted complex deformity of the front part of the foot. It is the result of multiple effects of innate (endogenous) and exogenous etiological factors with different degrees of influence. The degree of hallux valgus deformity is usually assessed by radiological values of hallux valgus (HV) and intermetatarsal (IM) angles. The aim of the paper is to justify the definition of hallux valgus deformity as a function of one angle, (HVA or IMA), and then to determine the functional connection and the most suitable function equalizing the values of the angles IMA and HVA. As hallux valgus is a double angulation deformity, the analytically determined connection between the HVA and IMA angles reduces the study of the deformity to the study of function with one argument, and makes the analysis of deformity changes before and after operative treatment simpler. For the determined connections between the angles, the values of linear proportionality coefficients and regression coefficients of corresponding linear functions of analytical equalization of the value of the IM angle and the degree of deformity for a given value of the HV angle were experimentally determined. The obtained results were checked on a sample of 396 operatively treated hallux valgus deformities. The presented analytical approach and the obtained functional links of IMA and HVA enable quantitative observation of the change in the degree of deformity based on the radiologically determined value of these angles, and the established nonlinear function will be useful for evaluating the expected value of the IM angle and the degree of deformity based only on the measured value of the HV angle. .
基金supported by the SP2024/089 Project by the Faculty of Materials Science and Technology,VˇSB-Technical University of Ostrava.
文摘In engineering practice,it is often necessary to determine functional relationships between dependent and independent variables.These relationships can be highly nonlinear,and classical regression approaches cannot always provide sufficiently reliable solutions.Nevertheless,Machine Learning(ML)techniques,which offer advanced regression tools to address complicated engineering issues,have been developed and widely explored.This study investigates the selected ML techniques to evaluate their suitability for application in the hot deformation behavior of metallic materials.The ML-based regression methods of Artificial Neural Networks(ANNs),Support Vector Machine(SVM),Decision Tree Regression(DTR),and Gaussian Process Regression(GPR)are applied to mathematically describe hot flow stress curve datasets acquired experimentally for a medium-carbon steel.Although the GPR method has not been used for such a regression task before,the results showed that its performance is the most favorable and practically unrivaled;neither the ANN method nor the other studied ML techniques provide such precise results of the solved regression analysis.
基金the Institutional Review Board at the University of Pennsylvania (Approval No.824040).
文摘BACKGROUND Osteoporosis is the leading cause of vertebral fractures.Dual-energy X-ray absor-ptiometry(DXA)and radiographs are traditionally used to detect osteoporosis and vertebral fractures/deformities.Magnetic resonance imaging(MRI)can be utilized to detect the relative severity of vertebral deformities using three-dimen-sional information not available in traditional DXA and lateral two-dimensional radiography imaging techniques.AIM To generate normative vertebral parameters in women using MRI and DXA scans,determine the correlations between MRI-calculated vertebral deformities and age,DXA T-scores,and DXA Z-scores,and compare MRI vertebral deformity values with radiography values previously published in the literature.METHODS This study is a retrospective vertebral morphometric analysis conducted at our institution.The patient sample included MR images from 1638 female patients who underwent both MR and DXA imaging between 2005 and 2014.Biconcavity,wedge,crush,anterior height(Ha)/posterior height(Hp),and middle height(Hm)/posterior height values were calculated from the MR images of the patient’s vertebrae.Associations between vertebral deformity values,patient age,and DXA T-scores were analyzed using Spearman correlation.The MRI-derived measure-ments were compared with radiograph-based calculations from population-based data compiled from multiple studies.RESULTS Age was positively correlated with lumbar Hm/Hp(P=0.04)and thoracic wedge(P=0.03)and biconcavity(P=0.001)and negatively correlated with thoracic Ha/Hp(P=0.002)and Hm/Hp(P=0.001)values.DXA T-scores correlated positively with lumbar Hm/Hp(P<0.0001)and negatively with lumbar wedge(P=0.046),biconcavity(P<0.0001),and Ha/Hp(P=0.046)values.Qualitative analysis revealed that Ha/Hp differed between MRI and radiography population-based data by no more than 0.3 and Hm/Hp by a maximum of 1.2.CONCLUSION Compared with traditional imaging techniques,MRI detects vertebral deformities with high accuracy and re-liability.It may be a sensitive,ionizing,radiation-free tool for use in clinical settings.
文摘Geological deformations are generally attributed to compressional, extensional and strike-slip processes. Since the breakup of Gondwana, torque deformation has been responsible for the current configuration of the western coasts of Africa and the eastern shore of South America and the morphotectonic geometry of the rift basins of South America, conditioning the morphostructure of the Andean chain and the current geoforms of the foreland.
文摘This paper presents a nonlinear micropolar nonclassical continuum theory (MPNCCT) for finite deformation, finite strain deformation physics of thermosviscoelastic solid medium with memory (polymeric micropolar solids) based on classical rotations cΘand their rates. Contravariant second Piola-Kirchhoff stress and moment tensors, in conjunction with finite deformation measures derived by the authors in recent paper, are utilized in deriving the conservation and balance laws and the constitutive theories based on conjugate pairs in entropy inequality and the representation theorem. This nonlinear MPNCCT for TVES with rheology: 1) incorporates nonlinear ordered rate dissipation mechanism based on Green’s strain rates up to order n;2) also incorporates an additional ordered rate dissipation mechanism due to microconstituents, the viscosity of the medium and the rates of the symmetric part of the rotation gradient (of cΘ) tensor up to order n, referred to as micropolar dissipation or micropolar viscous dissipation mechanism;3) incorporates the primary mechanism of memory or rheology due to long chain molecules of the polymer and the viscosity of the medium by using the contravaraint second Piola-Kirchhoff stress tensor and its rates up to order m, resulting in a relaxation spectrum;4) incorporates second mechanism of memory or rheology due to nonclassical physics, interaction of microconstituents with the viscous medium and long chain molecules by considering rates of the contravariant second Piola-Kirchhoff moment tensor up to order m, resulting in relaxation of second Piola-Kirchhoff moment tensor. This results in another relaxation spectrum for the second Piola-Kirchhoff moment tensor due to microconstituents, referred to as micropolar relaxation spectrum consisting of micropolar relaxation time constants of the material. This nonlinear MPNCCT for TVES with memory is thermodynamically and mathematically consistent, and the mathematical model consisting of conservation and balance laws and the constitutive theories has closure and naturally reduces to linear MPNCCT based on infinitesimal deformation assumption. BMM is the essential balance law for all MPNCCT and is used in the present work as well. In the absence of this balance law, a valid thermodynamically and mathematically consistent nonlinear MPNCCT is not possible. The nonlinear MPNCCT based on rotations (cΘ+αΘ) and αΘ(ignoring cΘ) is not considered due to the fact that even the linear MPNCCT based on these rotations is invalid and is thermodynamically and mathematically inconsistent MPNCCT.
基金financially supported by the Innovation Fund Research Project of State Key Laboratory for Geomechanics and Deep Underground Engineering,China University of Mining and Technology(Grant No.SKLGDUEK202201)。
文摘To address the issue of extensive deformation in the Tabaiyi Tunnel caused by the fault zone,nuclear magnetic resonance(NMR)technology was employed to analyze the physical and mechanical properties of waterabsorbing mudstone.This analysis aimed to understand the mechanism behind the significant deformations.Drawing from the principle of excavation stress compensation,a support scheme featuring NPR anchorcables and an asymmetric truss support system was devised.To validate the scheme,numerical analysis using a combination of the Discrete Element Method(DEM)-Finite Element Method(FEM)was conducted.Additionally,similar material model tests and engineering measurements were carried out.Field experiments were also performed to evaluate the NPR anchor-cable and truss support system,focusing on anchor cable forces,pressures between the truss and surrounding rock,pressures between the initial support and secondary lining,as well as the magnitude of settlement and convergence deformation in the surrounding rock.The results indicate that the waterinduced expansion of clay minerals,resulting from damage caused by fissure water,accelerated the softening of the mudstone's internal structure,leading to significant deformations in the Tabaiyi Tunnel under high tectonic stress.The original support design fell short as the length of the anchor rods was smaller than the expansion depth of the plastic zone.As a result,the initial support structure bore the entire load from the surrounding rock,and a non-coupled deformation contact was observed between the double-arch truss and the surrounding rock.The adoption of NPR asymmetric anchor-cable support effectively restrained the expansion and asymmetric distribution characteristics of the plastic zone.Considering the mechanical degradation caused by water absorption in mudstone,the rigid constraint provided by the truss proved crucial for controlling the stability of the surrounding rock.These research findings hold significant implications for managing large deformations in soft rock tunnels situated within fractured zones under high tectonic stress conditions.
基金The National Basic Research Program of China(973 Program)(No.2011CB606105)the National Natural Science Foundation of China(No.51374210,51134025)
文摘The dynamic fracture behavior of the three-point bending beam with double deformity inclusions under impact loading is studied by using digital high-speed photography in combination with the transmission-type dynamic caustic method. The experimental results indicate that the fluctuation of crack propagation velocity v first increases and then decreases in the crack propagation process. During the process of crack propagating into the inclusion area, the fracture resistance effect of the circular inclusion is the most significant and the effects of triangular and square inclusions are less obvious. The stress intensity factor near the crack tip increases during the propagation process and reaches its maximum value when the crack tip is close to the inclusions. The crack tip’s dynamic stress intensity factor （ DSIF） decreases when the crack exceeds the middle area of the double inclusions. These results provide an experimental basis and scientific foundation to strengthen the evaluation and fracture analysis of the structure containing deformity inclusions.
基金The National Natural Science Foundation of China(No.51374210,51134025)the 111 Project(No.B14006)
文摘The approach combining the dynamic caustics method with high-speed photography technology is used to study the interaction between propagating cracks and three kinds of deformity inclusions（ cylinder inclusion, quadruple inclusion and triangular inclusion） under lowvelocity impact loading. By recording the caustic spots of crack tips at different moments during the crack propagation, the variation regulations of dynamic stress intensity factors（ DSIF） and crack growth velocity with respect to time are obtained. The experimental results showthat the resistance effects to crack growth are varied with different shapes of inclusions in specimens, and the quadruple inclusion＇s effect is more apparent. The distortion degree of caustic spots is affected by the shapes of inclusions as well, and the situation is more serious for cylinder and quadruple inclusions. The overall values of DSIFs of triangular inclusion specimen are greater than the others, and the crack growth velocities, characteristic sizes and DSIFs showprocesses of fluctuations because of the disturbance of reflection waves in specimens. The results provide an experimental basis for the analysis of strength and impact-resistance ability in structures with deformity inclusions.
文摘AIM: To evaluate the effect of releasing the orbicularis retaining ligament(ORL) complex of the tear trough combined with the transconjunctival blepharoplasty in the surgical management of tear trough deformity compared with the effect of blepharoplasty alone. METHODS: A prospective, randomized(by closed envelope technique), controlled surgical trial which included 50 patients(100 eyes) with bilateral visible tear trough deformity and lower eyelid fat bulging, was divided into two groups where 25 patients(50 eyes) had tear trough-ORL release with blepharoplasty and 25 patients(50 eyes) didn't. Qualitative and quantitative assessments of tear trough deformity were done at 6 mo postoperatively, achieving grade 0 or 1 of Barton's classification was considered a success. Standardized photographic documentation of each patient was done pre and postoperatively, also assessment of the patients' satisfaction postoperatively was done and ranked as excellent, very good, good or fair. RESULTS: There was statistically significant difference between the two groups in the overall aesthetic results postoperatively regarding the qualitative and quantitative analysis of the tear trough deformity, where patients who had tear trough-ORL complex release had more successful outcomes than those of the second group. CONCLUSION: ORL release should be done in patients with tear trough deformity in order to release the tethering effect of this ligament which causes the prominence of the naso jugal groove.
文摘Aim:To investigate the impact of abnormal sperm morphology using the sperm deformity index (SDI) on reactive oxygen species (ROS) production and its correlation with sperm DNA damage.Methods:Semen samples were collected from men undergoing infertility screening (n=7) and healthy donors (n=6).Mature spermatozoa were isolated and incubated with 5 mmol/L β-nicotinamide adenine dinucleotide phosphate (NADPH) for up to 24 h to induce ROS.Sperm morphology was evaluated using strict Tygerberg's criteria and the SDI.ROS levels and DNA damage were assessed using chemiluminescence and terminal deoxynucleotidyl transferase-mediated fluorescein- dUTP nick end labeling (TUNEL) assays,respectively.Results:SDI values (median [interquartiles]) were higher in patients than donors (2 [1.8,2.1] vs.1.53 [1.52,1.58],P=0.008).Aliquots treated with NADPH showed higher ROS levels (1.22 [0.30,1.87] vs.0.39 [0.10,0.57],P=0.03) and higher incidence of DNA damage than those not treated (10 [4.69,24.85] vs.3.85 [2.58,5.10],P=0.008).Higher DNA damage was also seen following 24 h of incubation in patients compared to donors.SDI correlated with the percentage increase in sperm DNA damage following incubation for 24 h in samples treated with NADPH (r=0.7,P=0.008) and controls (r=0.58,P=0.04). Conclusion:SDI may be a useful tool in identifying potential infertile males with abnormal prevalence of oxidative stress (OS)-induced DNA damage.NADPH plays a role in ROS-mediated sperm DNA damage,which appears to be more evident in infertile patients with semen samples containing a high incidence of morphologically abnormal spermatozoa.
文摘AIM: To evaluate published data on the predictors of progressive adolescent idiopathic scoliosis(AIS) in order to evaluate their efficacy and level of evidence. METHODS: Selection criteria:(1) study design: randomized controlled clinical trials, prospective cohort studies and case series, retrospective comparative and none comparative studies;(2) participants: adolescents with AIS aged from 10 to 20 years; and(3) treatment: observation, bracing, and other. Search method: Ovid MEDLINE, Embase, the Cochrane Library, Pub Medand patent data bases. All years through August 2014 were included. Data were collected that showed an association between the studied characteristics and the progression of AIS or the severity of the spine deformity. Odds ratio(OR), sensitivity, specificity, positive and negative predictive values were also collected. A metaanalysis was performed to evaluate the pooled OR and predictive values, if more than 1 study presented a result. The GRADE approach was applied to evaluate the level of evidence.RESULTS: The review included 25 studies. All studies showed statistically significant or borderline association between severity or progression of AIS with the following characteristics:(1) An increase of the Cobb angle or axial rotation during brace treatment;(2) decrease of the rib-vertebral angle at the apical level of the convex side during brace treatment;(3) initial Cobb angle severity(> 25o);(4) osteopenia;(5) patient age < 13 years at diagnosis;(6) premenarche status;(7) skeletal immaturity;(8) thoracic deformity;(9) brain stem vestibular dysfunction; and(10) multiple indices combining radiographic, demographic, and physiologic characteristics. Single nucleotide polymorphisms of the following genes:(1) calmodulin 1;(2) estrogen receptor 1;(3) tryptophan hydroxylase 1;(3) insulin-like growth factor 1;(5) neurotrophin 3;(6) interleukin-17 receptor C;(7) melatonin receptor 1B, and(8) Scoli Score test. Other predictors included:(1) impairment of melatonin signaling in osteoblasts and peripheral blood mononuclear cells(PBMC);(2) G-protein signaling dysfunction in PBMC; and(3) the level of platelet calmodulin. However, predictive values of all these findings were limited, and the levels of evidence were low. The pooled result of brace treatment outcomes demonstrated that around 27% of patents with AIS experienced exacerbation of the spine deformity during or after brace treatment, and 15% required surgical correction. However, the level of evidence is also low due to the limitations of the included studies.CONCLUSION: This review did not reveal any methods for the prediction of progression in AIS that could be recommended for clinical use as diagnostic criteria.
文摘Objective: A common cavity deformity(CCD) is a deformed inner ear in which the cochlea and vestibule are confluent forming a common rudimentary cystic cavity that results in profound hearing loss. There are few studies paying attention to common cavity. Our group is engrossed in observing the improvement of auditory and verbal abilities in children who have received cochlear implantation(CI), and comparing these targets between children with common cavity and normal inner ear structure.Material and methods: A retrospective study was conducted in 12 patients with profound hearing loss that were divided into a common cavity group and a control group, six in each group matched in sex, age and time of implantation, based on inner ear structure. Categories of Auditory Performance(CAP) and speech intelligibility rating(SIR) scores and aided hearing thresholds were collected and compared between the two groups. All patients wore CI for more than 1 year at the Cochlear Center of Anhui Medical University from 2011 to 2015.Results: Postoperative CAP and SIR scores were higher than before operation in both groups(p < 0.05), although the scores were lower in the CCD group than in the control group(p < 0.05). The aided threshold was also lower in the control group than in the CCD group(p < 0.05).Conclusion: Even though audiological improvement in children with CCD was not as good as in those without CCD, CI provides benefits in auditory perception and communication skills in these children.
