Clinical application of Kirschner wires combined with 5-Ethibond fixation for patella fractures

BackgroundPatella fractures that require surgery are conventionally treated using Kirschner wires (K-wires) and stainless steel wires. In recent years, the nonabsorbable polyester has been reported to have excellent outcomes clinically. Therefore, the goal of our study was to evaluate the effects of Kirschner wires combined with 5-Ethibond on treating patellar fractures.MethodsFrom July 2018 to January 2022, 22 patella fracture patients were treated with Kirschner wires combined with 5-Ethibond. Radiographs of the knees were used to evaluate fracture healing and hardware complications. The clinical results were evaluated through the functional score, knee joint range of motion (ROM), and Bostman patella fracture functional score.ResultsThe average age of patients was 57.4 ± 11.9 (range 33–74) years. The mean follow-up time was 15.2 ± 7.6 (range 4–36) months. The mean operation time was 56.8 ± 8.7 (range 45–80) min. The entire patients had bony union at an average of 10.5 ± 1.9 (range 8–14) weeks. At the final follow-up, the mean range of postoperative ROM was 123.4° ± 14.6° (range 95°–140°), and the functional score was 28.7 ± 1.2 (range 26–30) points. No patient exhibited internal fixation failure, and no symptomatic implants or skin complications were recorded.ConclusionsThe fixation approach using K-wires combined with 5-Ethibond has a lower complication rate and delivers superior clinical results. This research reveals that such technology is a safe and prospective substitute for conventional metal fixation approaches

miR-216b Post-Transcriptionally Downregulates Oncogene KRAS and Inhibits Cell Proliferation and Invasion in Clear Cell Renal Cell Carcinoma

Background/Aims: Increasing evidence has shown that miR-216b plays an important role in human cancer progression. However, little is known about the function of miR-216b in renal cell carcinoma. Methods: The expression levels of miR-216b in renal cell carcinoma tissues and cell lines were examined by qRT-PCR. The biological role of miR-216b in renal cell carcinoma proliferation and/or metastasis was examined in vitro and in vivo. The target of miR-216b was identified by a dual-luciferase reporter assay. The expression level of KRAS protein was measured by western blotting. Results: The expression of miR-216b was downregulated in clear cell renal cell carcinoma (ccRCC) cell lines and specimens compared to the adjacent normal tissues. Furthermore, miR-216b can bind to the 3’untranslated region (UTR) of KRAS and inhibit the expression of KRAS through translational repression. The in vitro study revealed that miR-216b attenuated ccRCC cell proliferation and invasion. Furthermore, in vivo study also showed that miR-216b suppressed tumor growth. MiR-216b exerted its tumor suppressor function through inhibiting the KRAS-related MAPK/ERK and PI3K/AKT pathways. Conclusion: Our findings provide, for the first time, significant clues regarding the role of miR-216b as a tumor suppressor by targeting KRAS in ccRCC

A User-Oriented Intelligent Access Selection Algorithm in Heterogeneous Wireless Networks

A heterogeneous wireless network (HWN) contains many kinds of wireless networks with overlapping areas of signal coverage. One of the research topics on HWNs is how to make users choose the most suitable network. This paper designs a user-oriented intelligent access selection algorithm in HWNs with five modules (input, user preference calculation, candidate network score calculation, output, and learning). Essentially, the input module uses a utility function to calculate the utility value of the judgment parameter; the user preference calculation module calculates the weight of the judgment parameter using the fuzzy analysis hierarchy process (FAHP) approach; the candidate network score calculation module calculates the network score through a fuzzy neural network; the output module calculates the error between the actual output value and the expected output value; and the learning module corrects the parameter of the membership function in the fuzzy neural network structure according to the error. Simulation results show that the algorithm proposed in this paper can enable users to select the most suitable network according to service characteristics and can enable users to obtain higher gains

Evaluation of the comprehensive efficiency of the interception pipeline in the urban rainwater pipe network for the initial rainwater collection and storage

Urban runoff pollution has become one of the important limiting factors hindering the continuous improvement of water environment. In the process of drainage system reconstruction, the evaluation of interception pipeline for the collection and storage efficiency of initial rainwater is an important work. Therefore, this study uses the analytic hierarchy process to establish an evaluation system and method containing 4 first-level indicators and 10 second-level indicators to evaluate the comprehensive efficiency of the interception pipeline for initial rainwater collection and storage. Taking the interception pipeline in a drainage system in Shanghai as a case study, the established evaluation method was adopted to evaluate it, and the comprehensive indexes under the rainfall return periods of 0.5 year, 1 year, 3 years and 5 years were calculated. The results indicated that the evaluation method could be well applied to the effectiveness evaluation of intercepting pipelines in drainage systems, and could provide technical support for the planning and design of urban runoff pollution control projects in the future

Optimized Analysis Method for Evaluating the Shear Strength Parameters of Rock Joint Surfaces

The results obtained from the mechanical test of rock samples inevitably suffer dispersion owing to discrepancies between test specimens. In view of these deficiencies, the present study proposes a method based on the empirical equation of shear strength developed by Barton to determine the shear strength parameters of joint surfaces using a single test specimen. This approach is then applied to optimize the analysis of multiple specimens. An analysis of experimental results verifies that the shear strength parameters of joint surfaces obtained by the proposed method can more accurately reflect the shear mechanics of multiple specimens than conventional multiple sample analyses; meanwhile, the results are reasonable and reliable. More importantly, the optimized method ensures the shear strength parameters are no longer affected by the sequence of specimens employed during shear test. The optimized analysis method eliminates the effect of differences between specimens and the influence of subjective factors on test results and therefore provides more realistic evaluations of shear strength parameters

An Access Selection Algorithm for Heterogeneous Wireless Networks Based on Optimal Resource Allocation

Wireless networks form heterogeneous wireless networks (HWNs) with overlapping signal coverage, and access selection is one of the key technologies of HWNs. Today, most access selection algorithms select appropriate networks mainly from the perspective of users while failing to consider resource allocation and optimize the overall transmission performance of HWNs. This paper proposes an access selection algorithm for HWNs based on optimal resource allocation by analyzing the wireless link transmission rate model, focusing on maximizing the HWN transmission rate, using the dynamic programming theory to derive the optimal value of bandwidth allocated to users. Experimental results show that the algorithm proposed in this paper can effectively improve network throughput and resource utilization and can connect users to the appropriate network according to QoS rate requirements

A systematic review of suture-button versus syndesmotic screw in the treatment of distal tibiofibular syndesmosis injury

Abstract Background Now, using a suture-button device to treat distal tibiofibular syndesmotic injuries is overwhelming due to its advantages over screw fixation. Current systematic review was conducted to make a comparison between suture-button fixation and traditionally screw fixation in the treatment of syndesmotic injuries. The outcomes included functional outcomes, implant removal, implant failure, malreduction, post-operative complications (except implant failure and malreduction), and cost-effectiveness aspects. Method A literature search in the electronic databases of Medline, Embase, the Cochrane Library, Web of Science was conducted to identify studies until March 2017. The references of the included articles were also checked for potentially relevant studies. Only English articles were included. We followed the Preferred Reporting Items for Systematics reviews and Meta-Analysis (PRISMA) guidelines in this review. Results Finally, 10 studies were identified, encompassing a total of 390 patients. The mean American Orthopaedic Foot and Ankle Society ankle score (AOFAS) score of 150 patients treated with the suture-button device was 91.06 points, with an average follow-up of 17.58 months, and the mean AOFAS score of 150 patients treated with syndesmotic screws was 87.78 points, with an average follow-up of 17.73 months. Implant removal was reported in 5 of 134 (3.7%) patients treated with the suture-button device, and in 54 of 134 (40.2%) patients treated with the syndesmotic screw. No patient in the suture-button fixation group had implant failure, however the rate of implant failure in the screw fixation group was 30.9%. Malreduction was reported in 1 of 93 (1.0%) patients treated with the suture-button device, and in 12 of 95 (12.6%) patients treated with the syndesmotic screw. The rate of post-operative complications in the suture-button fixation group was 12.0% and 16.4% in the screw fixation group. There was only one publication demonstrated about cost-effectiveness aspects, it showed that patients treated with the suture-button device spent on average $1482 less and had a higher quality of life by 0.058 quality-adjusted life-year compared with patients who received fixation with 2 syndesmotic screws in supination-external rotation type 4 injuries. Conclusion Based on our research, though the suture-button fixation group had similar functional outcome (measured on the AOFAS score) and post-operative complication rate compared with the syndesmotic screw fixation group, the suture-button device could lead to better objective range of motion (ROM) measurements and earlier return to work. Besides, the suture-button fixation group had lower rate of implant removal, implant failure, and malreduction. However, high-quality randomized controlled trials with more uniformity in outcome reporting are desirable to determine the long-term effects and cost-effectiveness of the suture-button device

Joint Optimization of Control Strategy and Energy Consumption for Energy Harvesting WSAN

With the rapid development of wireless sensor technology, recent progress in wireless sensor and actuator networks (WSANs) with energy harvesting provide the possibility for various real-time applications. Meanwhile, extensive research activities are carried out in the fields of efficient energy allocation and control strategy design. However, the joint design considering physical plant control, energy harvesting, and consumption is rarely concerned in existing works. In this paper, in order to enhance system control stability and promote quality of service for the WSAN energy efficiency, a novel three-step joint optimization algorithm is proposed through control strategy and energy management analysis. First, the optimal sampling interval can be obtained based on energy harvesting, consumption, and remaining conditions. Then, the control gain for each sampling interval is derived by using a backward iteration. Finally, the optimal control strategy is determined as a linear function of the current plant states and previous control strategies. The application of UAV formation flight system demonstrates that better system performance and control stability can be achieved by the proposed joint optimization design for all poor, sufficient, and general energy harvesting scenarios

Analysis of Changes in the Micromorphology of Sandstone Joint Surface under Dry-Wet Cycling

Changes in the micromorphology of joint surface under dry-wet cycling have a direct effect on the mechanical properties of the jointed rock masses, which in turn affects the deformation stability of the bank slope of a reservoir. In this study, we design and carry out a test that aims to quantity the effects of repeated rise and fall of a reservoir on the properties of a jointed rock masses. The results are as follows: first, the roughness, local gradient, and undulation of the joint surface gradually decreased under repeated dry-wet cycling. In addition, the height parameters and texture parameters showed a steep decrease followed by a slow decline. The deterioration was particularly obvious over the first 5 dry-wet cycles. Second, the roughness coefficient of the joint surface, the compressive strength of the face wall, and the basic friction angle were gradually reduced under dry-wet cycling. The shear strength of the jointed rock masses (obtained both quantitatively and experimentally) showed a deteriorating trend controlled by the deterioration of the micromorphology, the strength of the face wall, and the frictional properties of the joint surface. Finally, the dry-wet cycling process determined trends of changes in the microstructure parameters and mechanical properties of the joint surface. Our research results provide a good basis for the analysis of the deterioration and failure of rock masses within the hydrofluctuation belt of a bank slope

Understanding variations and influencing factors on length of stay for T2DM patients based on a multilevel model.

AimShortening the length of stay (LOS) is a potential and sustainable way to relieve the pressure that type 2 diabetes mellitus (T2DM) patients placed on the public health system.MethodMulti-stage random sampling was used to obtain qualified hospitals and electronic medical records for patients discharged with T2DM in 2018. A box-cox transformation was adopted to normalize LOS. Multilevel model was used to verify hospital cluster effect on LOS variations and screen potential factors for LOS variations from both individual and hospital levels.Result50 hospitals and a total of 12,888 T2DM patients were included. Significant differences in LOS variations between hospitals, and a hospital cluster effect on LOS variations (t = 92.188, PConclusionsThe evidence proved that hospital cluster effect on LOS variation did exist. Complications and patients features at individual level, as well as organization and resource characteristics at hospital level, had impacted LOS variations to varying degrees. To shorten LOS and better meet the medical demand for T2DM patients, limited health resources must be allocated and utilized rationally at hospital level, and the patients with the characteristics of longer LOS risk must be identified in time. More influencing factors on LOS variations at different levels are still worth of comprehensive exploration in the future