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A central principle of synaptic transmission is that action potential-induced presynaptic neurotransmitter release occurs exclusively via Ca

Currently, due to the lack of long-term postoperative follow-up outcomes of the congenital divided eyelid nevus, we described our surgical approaches and presented the functional and cosmetic results of 13 patients with an average of 5-year follow-up. Based on the surgical treatments and the follow-ups, the selection of total or subtotal excision depends on the lesion location and the use of blepharoplasty approaches is determined by defect size. The CO2 laser may be a useful second-stage procedure to ablate remnant lesions, but long-term monitoring is required.

After ingestion of toxin-contaminated food, the brain initiates a series of defensive responses (e.g., nausea, retching, and vomiting). How the brain detects ingested toxin and coordinates diverse defensive responses remains poorly understood. Here, we developed a mouse-based paradigm to study defensive responses induced by bacterial toxins. Using this paradigm, we identified a set of molecularly defined gut-to-brain and brain circuits that jointly mediate toxin-induced defensive responses. The gut-to-brain circuit consists of a subset of Htr3a+ vagal sensory neurons that transmit toxin-related signals from intestinal enterochromaffin cells to Tac1+ neurons in the dorsal vagal complex (DVC). Tac1+ DVC neurons drive retching-like behavior and conditioned flavor avoidance via divergent projections to the rostral ventral respiratory group and lateral parabrachial nucleus, respectively. Manipulating these circuits also interferes with defensive responses induced by the chemotherapeutic drug doxorubicin. These results suggest that food poisoning and chemotherapy recruit similar circuit modules to initiate defensive responses.

The candidate gene AhLBA1 controlling lateral branch angel of peanut was fine-mapped to a 136.65-kb physical region on chromosome 15 using the BSA-seq and QTL mapping. Lateral branch angel (LBA) is an important plant architecture trait of peanut, which plays key role in lodging, peg soil penetration and pod yield. However, there are few reports of fine mapping and quantitative trait loci (QTLs)/cloned genes for LBA in peanut. In this project, a mapping population was constructed using a spreading variety Tifrunner and the erect variety Fuhuasheng. Through bulked segregant analysis sequencing (BSA-seq), a major gene related to LBA, named as AhLBA1, was preliminarily mapped at the region of Chr.15: 150-160 Mb. Then, using traditional QTL approach, AhLBA1 was narrowed to a 1.12 cM region, corresponding to a 136.65-kb physical interval of the reference genome. Of the nine genes housed in this region, three of them were involved in hormone metabolism and regulation, including one "F-box protein" and two "2-oxoglutarate (2OG) and Fe(II)-dependent oxygenase (2OG oxygenase)" encoding genes. In addition, we found that the level of some classes of cytokinin (CK), auxin and ethylene showed significant differences between spreading and erect peanuts at the junction of main stem and lateral branch. These findings will aid further elucidation of the genetic mechanism of LBA in peanut and facilitating marker-assisted selection (MAS) in the future breeding program.

A central principle of synaptic transmission is that action potential-induced presynaptic neurotransmitter release occurs exclusively via Ca2+-dependent secretion (CDS). The discovery and mechanistic investigations of Ca2+-independent but voltage-dependent secretion (CiVDS) have demonstrated that the action potential per se is sufficient to trigger neurotransmission in the somata of primary sensory and sympathetic neurons in mammals. One key question remains, however, whether CiVDS contributes to central synaptic transmission. Here we report, in the central transmission from presynaptic (dorsal root ganglion) to postsynaptic (spinal dorsal horn) neurons, (1) excitatory postsynaptic currents (EPSCs) are mediated by glutamate transmission through both CiVDS (up to 87%) and CDS; (2) CiVDS-EPSCs are independent of extracellular and intracellular Ca2+; (3) CiVDS is >100 times faster than CDS in vesicle recycling with much less short-term depression; (4) the fusion machinery of CiVDS includes Cav2.2 (voltage sensor) and SNARE (fusion pore). Together, an essential component of activity-induced EPSCs is mediated by CiVDS in a central synapse.

Conventional railway track is supported by a layer of crushed stones known as ballast. In recent years concrete slab tracks have been introduced which have been used widely in the construction of high-speed lines. However, a particular concern is that slab track is considered to be noisier than ballasted track. In order to investigate the differences in the noise radiation characteristics of ballasted and slab tracks, the TWINS model for rolling noise has been updated. Differences are included in the sound radiation of the rails and sleepers due to the presence of absorptive or reflective ground and the effect of the ballast vibration on the sound radiation of the sleepers is taken into account. The effects of the ballast absorption under the train on the sound propagation are also considered. To calculate the sound radiation from the slab itself, a waveguide finite element/boundary element method is used, which includes the supporting ground. The slab vibration is shown to be the dominant noise source only up to around 100 Hz, whereas it is negligible at higher frequencies. Results are presented for two ballasted tracks (one with stiff rail pads and the other with soft pads) and one slab track, and compared with measured data. Finally, the sound radiation from the various tracks are compared for equivalent situations. The results are found to depend on the assumptions made, particularly in relation to the track decay rates and roughness spectra; the ground conditions adjacent to the track also affect the sound pressure spectra below 1 kHz.

According to ISO 3095, railway pass-by noise should be measured at 7.5 m from the track and at 1.2 m or 3.5 m above the rail head or at 25 m from the track and 3.5 m height. The level of the ground surface should be between 0 m and –2 m relative to the top of the rail. The level of the ground and nature of the ground surface can affect the spectral content of the measured sound. In this paper the TWINS model is used for a range of situations to illustrate the effect of ground height and equivalent flow resistivity on the sound pressure spectrum. The location of the ground dip is shown to depend on the ground properties. Measurement results support these results. For the particular cases illustrated it is shown that the differences between the overall A-weighted noise levels at 7.5 m and 25 m can vary between 4.6 and 7.4 dB for the cases considered. Moreover, the noise level differences between different track types can also vary by several dB. In particular, the level differences between two ballasted tracks and a slab track are found to vary in a range of about ± 2 dB.

In a conventional railway track, the rails are laid on sleepers, usually made of concrete, which are supported by a layer of coarse stones known as ballast. This paper focuses on quantifying the influence that the ballast has on the noise produced by the vibration of the track, particularly on the rail and sleeper radiation ratios. A one-fifth scale model of a railway track has been used to conduct acoustic and vibration measurements. This includes reduced-scale ballast that has been produced with stone sizes in the correct proportions. Two different scaling factors (1:√5 and 1:5) have been adopted for the stone sizes in an attempt to reproduce approximately the acoustic properties of full-scale ballast. It is shown that, although a scale factor of 1:√5 gives a better scaling of the acoustic properties, the stones scaled at 1:5 also give acceptable results. The flow resistivity and porosity of this ballast sample have been measured. These have been used in a local reaction model based on the Johnson-Allard formulation to predict the ballast absorption, showing good agreement with measurements of the absorption coefficient. The effects of the presence of the ballast on the noise radiation from a reduced-scale steel rail and concrete sleeper have been investigated experimentally with the ballast located on a rigid foundation. Comparisons are made with the corresponding numerical predictions obtained by using the boundary element method, in which the ballast is represented by a surface impedance. Additionally the finite element method has been used in which the porous medium is considered as an equivalent fluid. From these results it is shown that the extended reaction model gives better agreement with the measurements. Finally, the effects of the ballast vibration on the sleeper radiation have also been investigated for a case of three sleepers embedded in ballast. The ballast vibration is shown to increase the sound radiation by between 1 and 4.5 dB for frequencies between 20 and 300 Hz at full scale whereas at higher frequencies the effect is negligible.

Models for predicting railway rolling noise such as TWINS are well-established and have been validated against field measurements. However, there are still some areas where improvements are required. In particular, the radiation from the rail is based on a model of a rail in free space whereas in reality the rail is located close to the ground; there are also limitations in the existing model for the sound radiation from the sleepers. Besides, the influence of the ballast absorption on the sound power radiated by the track is neglected. This paper draws on recent research into the effects of the proximity of the rail and sleeper to an absorptive ground on their sound radiation, based on the boundary element method. In reality, the rail is located above the ballast over part of its length, and attached periodically to the concrete sleepers elsewhere. The sound radiation of the rail for those two situations can be predicted using the 2D boundary element method. In order to obtain a realistic rail radiation model for engineering applications, a method to combine those two results is proposed and the resulting average rail radiation is verified by using a 3D boundary element model. An improved sleeper radiation model is also proposed and verified using the 3D boundary element model. These new engineering models for the rail and sleeper radiation have been used together with TWINS to predict the sound radiation from operational tracks and the results have been compared with field measurements. Compared with the TWINS model, the rail radiation is found to be increased below 300 Hz, but decreased above 1 kHz; the sound radiation from the sleeper is reduced compared with the TWINS model below 600 Hz.

Slab track is generally noisier than conventional ballasted track, so noise control measures that can be applied to a slab track are of great importance. Several noise control treatments have been studied under controlled conditions through experiments on a 1:5 scale model slab track with and without the presence of a train body. These treatments consist of absorptive rubber mats applied to the surface of the slab and a low noise barrier introduced close to the track. The noise reduction is evaluated experimentally by using a reciprocal method and compared with the results of numerical simulations. The insertion loss spectra of these treatments have been combined with predicted train pass-by spectra to determine the potential overall noise reductions. It has been found that the absorptive treatment alone has only a small effect on the radiated noise from the track. This is increased by the presence of the train body leading to a reduction of up to 2–3 dB at a standard receiver height of 1.2 m, which suggests that the absorptive layer controls reflections between the car body and the track. All the treatments considered have a greater effect on the noise radiated by the lateral vibration of the rail than on that from the vertical vibration. Their effectiveness mostly increases, by between roughly 0.5 and 1.5 dB, as the train speed is increased from 80 to 300 km/h. As expected, the noise barrier is more effective at lower receiver positions than at higher ones but its effectiveness is reduced by 1–2 dB by the presence of the train body. However, in combination with the absorptive treatment, its effectiveness increases when the train body is present. This shows the importance of including of the presence of the train body in evaluating the effects of acoustic treatments in the track.

It is generally considered that a Timoshenko beam is superior to an Euler-Bernoulli beam for determining the dynamic response of beams at higher frequencies but that they are equivalent at low frequencies. Here, the case is considered of the parametric excitation caused by spatial variations in stiffness on a periodically supported beam such as a railway track excited by a moving load. It is shown that large differences exist between the results obtained using Timoshenko and Euler-Bernoulli beams for a railway track with typical parameters; the Euler-Bernoulli beam model underestimates this parametric excitation by around a factor of 3. This difference is shown to be due to shear deformation in the rail, which is significant for span lengths less than about 2 m. A 2.5D finite element model of the rail is used as a reference. This gives a deflection that is closer to the Timoshenko beam model. However, the displacement profile obtained from the Timoshenko beam model has a discontinuity of gradient at the support points, whereas neither the Euler-Bernoulli beam nor the 2.5D finite element model contains the discontinuity of gradient. Finally, the moving load is introduced explicitly in the various periodically supported models. The results for a moving constant load, expressed as an equivalent roughness, are not strongly affected by the load speed until the sleeper passing frequency approaches the vertical track resonance at which the track mass bounces on the support stiffness. Consequently, a quasi-static model gives satisfactory results for moderate load speeds.

Background: Nurse competence is a combination of knowledge, performance, skills, and attitudes that are required in fulfilling one's role as a nurse. So far, few comprehensive studies have explored the influencing factors of nurse competence. Method: The competence levels of 160 RNs in a Chinese hospital were evaluated using a questionnaire method, and the relationship between competence results and nursing characteristics was analyzed. Results: The competence of participating nurses was at a medium level. Among all the characteristics, education and staffing levels were two main factors influencing nurse competence. Conclusion: Quantity of nurses and quality of nursing service are two main issues facing the modern nursing system. The findings from this study provide useful information and suggestions on how to improve nurse competence to nurse industry personnel, including nurses, nursing employers, educators, and students. [ J Contin Educ Nurs . 2019;50(12):572–580.]

The dynamic properties of a railway track are important for both the generation of rolling noise and the development of rail corrugation. A conventional track consists of long rails mounted periodically on transverse sleepers and supported in ballast. In order to improve the predictions of the noise and vibration of the track, a model of a discretely supported track is proposed based on the so-called 2.5 dimensional (2.5D) finite element approach, which is used to model an infinite free rail. This is coupled to a finite number of sleepers, by means of an array of springs representing each rail pad, using a receptance coupling method. The sleepers are represented by flexible beams, supported on an elastic foundation. Results are presented in terms of the point mobility and track decay rate and these are compared with the corresponding field measurements for two tracks, one with soft rail pads and one with stiff rail pads. Very good agreement is found between the predictions and the measurement results, especially for the track with soft rail pads. The flexible sleeper model is shown to give improved results compared with a rigid mass model, especially for the track with stiff rail pads.

Stearoyl lysophosphatidylcholine (LPC) exerts protective effect during endotoxemia and in experimental sepsis, but the underlying mechanism is unclear. Here, we demonstrated that stearoyl LPC could block caspase-11-mediated macrophage pyroptosis. In vitro, stearoyl LPC significantly decreased caspase-11 activation and pyroptosis induced by lipopolysaccharide (LPS) plus cholera toxin subunit B independent of the receptor G2A. Stearoyl LPC did not affect LPS uptake by mouse peritoneal macrophages but did significantly inhibit the interaction between LPS and caspase-11. Moreover, stearoyl LPC treatment conferred significant protection against lethal endotoxemia and significantly reduced the release of IL-1α and IL-1β. These findings identify stearoyl LPC as an inhibitor of LPS-mediated caspase-11 activation. This mechanism could explain the protective action of stearoyl LPC in experimental sepsis and endotoxemia.

To study the effectiveness of facial meticulous fat grafting by fat granules injection asistor.Between January and August 2015, 46 patients received facial autologous fat grafting for rejuvenation. There were 7 males and 39 females, aged 21-65 years (mean, 34 years). Firstly, the faces were divided into 10 cosmetic zonations according to facial aesthetic criteria, then autologous fat grafting was carried out by fat granules injection asistor. The autologous fat was filled into 1, 2, 3, 4, 5, 6, 7, 8, and 9 cosmetic zonations in 3, 7, 5, 3, 8, 4, 2, 10, and 4 cases respectively; the injected fat amount was 2-110 mL (mean, 47 mL).The swelling period was from 5 to 15 days after operation (mean, 7 days), and there were no complications of infection, cyst, introvascular thrombogenesis, and so on. They were followed up 1-7 months (mean, 3 months). The effect of face rejuvenation was satisfactory.Cosmetic zonation of face is helpful for preoperative evaluation of autologous fat grafting, and the fat granules injection asistor is beneficial to reach better effect of face rejuvenation.探讨恒压恒量微创匀速助推器（以下简称“助推器”）辅助下面部精细脂肪移植术的临床应用效果。.2015年1月-8月，根据面部网格化美学分区进行评估，采用助推器辅助下实施面部自体脂肪注射精细移植46例。男7例，女39例；年龄21～65岁，平均34岁。填充1个美学单位者3例，2个者7例，3个者5 例，4个者3例，5个者8例，6个者4例，7个者2例，8个者10例，9个者4例。注射脂肪量为2～110 mL，平均47 mL。.受术者术后面部肿胀5～15 d，平均7 d。无1例发生感染、囊肿、血管栓塞等不良反应。受术者均获随访，随访时间1～7个月，平均3个月。均取得了良好的面部年轻化效果，受术者均自觉满意。.面部网格化美学分区有助于自体脂肪注射术前评估，助推器有助于实现面部精细自体脂肪移植，获得更理想的面部年轻化效果。.

The sound radiation of a railway in close to proximity to a ground (both rigid and absorptive) is predicted by the boundary element method (BEM) in two dimensions (2D). Results are given in terms of the radiation ratio for both vertical and lateral motion of the rail, when the effects of the acoustic boundary conditions due to the sleepers and ballast are taken into account in the numerical models. Allowance is made for the effect of wave propagation along the rail by applying a correction in the 2D modelling. It is shown that the 2D correction is necessary at low frequency, for both vertical and lateral motion of an unsupported rail, especially in the vicinity of the corresponding critical frequency. However, this correction is not applicable for a supported rail; for vertical motion no correction is needed to the 2D result while for lateral motion the corresponding correction would depend on the pad stiffness. Finally, the corresponding numerical predictions of the sound radiation from a rail are verified by comparison with experimental results obtained using a 1/5 scale rail model in different configurations.

The TWINS model is a widely used and well-established model for rolling noise which has been validated against field measurements in terms of overall noise spectra and levels. However, there are still some areas that can be improved. In particular, the radiation from the rail is based on a model of a rail in free space and there are also limitations in the model for the sound radiation from the sleepers. This paper draws on recent research into the effects of the proximity of the rail and sleeper to an absorbing ground on their sound radiation. Moreover, the ballast is acoustically absorbing to some extent because of the gaps between the ballast particles and this can affect the noise radiation by the rail and sleeper. The ballast absorption is represented here using the Johnson-Allard model with measured values of flow resistivity and porosity. Additionally, the Delany and Bazley model is introduced with a higher value of flow resistivity for comparison. These are used to produce the normal impedance of the ballast layer which is introduced in boundary element calculations of the radiation from the rail and sleepers. Comparisons are made first with the sound radiation from a 1:5 scale track model which has been measured reciprocally in the reverberation chamber. It is shown that the impedance using the measured flow resistivity is inadequate for use in the numerical models; probably an extended reaction model would be more appropriate. However, the Delany and Bazley model with the higher flow resistivity gives better agreement with the measurements and is a practical solution. The new models have also been used together with TWINS to predict the sound radiation from an operational track and the results have been compared with an example field measurement. The new models are found to give an improvement at low frequencies, where the sleeper is the dominant noise source.

The reciprocity principle is well-known and has many applications in acoustics and vibro-acoustics. This paper discusses a reciprocity measurement method to determine the radiation efficiency of a vibrating structure. The method comprises two steps: (i) measurements of the acceleration response of the structure induced by a sound field in a reverberation chamber and (ii) measurements of the spatially-averaged squared transfer mobility of the structure. The approach is more flexible than a direct method and has the advantage that no shaker is required to excite the structure in the acoustic measurements. To demonstrate the applicability of this method, experiments were conducted on rectangular flat plates, on two components of a railway track test-rig and on three different built-up structures. For the plates and the railway rig components, comparisons are also made with theoretical models. It is shown that the measured results for each arrangement obtained using this reciprocity method provide good agreement with conventional direct measurements and with theoretical modelling. However, in most of the examples presented, the direct method has been found to be less practical and sometimes even less accurate than the reciprocal one, mostly due to the structure-shaker connection and to the inherent uncertainty of acoustic intensity measurements.

Conventional railway tracks are laid in a layer of crushed stone known as ballast which contributes to the resilience of the track support. Beneath it is the subgrade which also has a considerable influence on the track support stiffness. Although quasi-static measurements of track stiffness are reasonably common, the dynamic stiffness at higher frequencies is required for noise and vibration modelling. Here, a distinction is made between the dynamic stiffness of the ballast layer itself and the dynamic support stiffness which includes the underlying ground. The dynamic transfer stiffness of a ballast layer is required for ground vibration and bridge noise predictions. Two different methods for measuring this are presented, one in the laboratory and the other in the field. The laboratory method is limited to a maximum frequency of about 600 Hz due to limitations of the test rig. The field measurement, which relies on identifying the wavespeed within the medium, gives results up to 2 kHz. These methods give broadly consistent results, with a stiffness per rail seat for a 300 mm thick ballast layer of approximately 300–500 MN/m, increasing in proportion to the square root of the preload, and a damping loss factor in the range 0.15–0.3. The corresponding Young's modulus is between 200 and 700 MPa, depending on the preload. The dynamic stiffness increases above about 300 Hz with a first peak due to standing wave effects occurring at about 700 Hz. The dynamic support stiffness beneath the sleeper, on the other hand, is required for rolling noise modelling. This has been measured using two methods: a direct method for frequencies 50–500 Hz and an indirect method based on a modal analysis of a sleeper embedded in the ballast. A clear shift in natural frequencies is seen which is associated with the support stiffness. This support stiffness is strongly frequency-dependent, with the value per rail seat increasing from about 100 to 200 MN/m at 100 Hz to 2000 MN/m at 1 kHz. The support damping corresponds to a loss factor of around 1 for frequencies above 200 Hz, or a damping coefficient of 100–200 kN/m per rail seat. This damping is due to the radiation of energy into the ground rather than internal losses in the ballast. It strongly affects the modal damping of the sleeper and thus its radiated noise. The dynamic support stiffness increases roughly in proportion to the cube root of the preload. Comparison with a finite element model indicates that the underlying ground is responsible for the support stiffness and damping at low frequencies. However, above about 500 Hz it is independent of the ground and is only affected by the ballast layer. The results from the finite element model imply behaviour similar to a viscous damper. The sleeper vibration obtained using either a viscous damping or a constant loss factor is similar.

The sleepers supporting the rails of a railway track are an important source of noise at low frequencies. The sound radiation from the sleepers has been calculated using a three-dimensional boundary element model including the effect of both reflective and partially absorptive ground. When the sleeper flexibility and support stiffness are taken into account, it is found that the radiation ratio of the sleeper can be approximated by that of a rigid half-sleeper. When multiple sleepers are excited through the rail, their sound radiation is increased. This effect has been calculated for cases where the sleeper is embedded in a rigid or partially absorptive ground. It is shown that it is sufficient to consider only three sleepers in determining their radiation ratio when installed in track. At low frequencies the vibration of the track is localised to the three sleepers nearest the excitation point whereas at higher frequencies the distance between the sleepers is large enough for them to be treated independently. Consequently the sound radiation increases by up to 5 dB below 100 Hz compared with the result for a single sleeper whereas above 300 Hz the result can be approximated by that for a single sleeper. Measurements on a 1/5 scale model railway track are used to verify the numerical predictions with good agreement being found for all configurations.

Caspase-11, a cytosolic endotoxin (lipopolysaccharide: LPS) receptor, mediates pyroptosis, a lytic form of cell death. Caspase-11-dependent pyroptosis mediates lethality in endotoxemia, but it is unclear how LPS is delivered into the cytosol for the activation of caspase-11. Here we discovered that hepatocyte-released high mobility group box 1 (HMGB1) was required for caspase-11-dependent pyroptosis and lethality in endotoxemia and bacterial sepsis. Mechanistically, hepatocyte-released HMGB1 bound LPS and targeted its internalization into the lysosomes of macrophages and endothelial cells via the receptor for advanced glycation end-products (RAGE). Subsequently, HMGB1 permeabilized the phospholipid bilayer in the acidic environment of lysosomes. This resulted in LPS leakage into the cytosol and caspase-11 activation. Depletion of hepatocyte HMGB1, inhibition of hepatocyte HMGB1 release, neutralizing extracellular HMGB1, or RAGE deficiency prevented caspase-11-dependent pyroptosis and death in endotoxemia and bacterial sepsis. These findings indicate that HMGB1 interacts with LPS to mediate caspase-11-dependent pyroptosis in lethal sepsis.

Centrosome amplification is frequent in cancer, but the underlying mechanisms remain unclear. Here we report that disruption of the Kruppel-like factor 14 (KLF14) gene in mice causes centrosome amplification, aneuploidy and spontaneous tumorigenesis. Molecularly, KLF14 functions as a transcriptional repressor of Plk4, a polo-like kinase whose overexpression induces centrosome overduplication. Transient knockdown of KLF14 is sufficient to induce Plk4-directed centrosome amplification. Clinically, KLF14 transcription is significantly downregulated, whereas Plk4 transcription is upregulated in multiple types of cancers, and there exists an inverse correlation between KLF14 and Plk4 protein expression in human breast and colon cancers. Moreover, KLF14 depletion promotes AOM/DSS-induced colon tumorigenesis. Our findings reveal that KLF14 reduction serves as a mechanism leading to centrosome amplification and tumorigenesis. On the other hand, forced expression of KLF14 leads to mitotic catastrophe. Collectively, our findings identify KLF14 as a tumour suppressor and highlight its potential as biomarker and therapeutic target for cancer., Centrosome amplification is common in cancer, but the mechanism is not clear. Here the authors uncover a role for Kruppel-like factor 14 (KLF14) as a transcriptional repressor of polo-like kinase 4 (PLK4); KLF14 depletion correlates with increased PLK4 in human samples and leads to centrosome amplification and tumorigenesis in mice.

To explore the timing and suitable method of reconstructing penile defects caused by devastating electrical burn.Thirteen patients with penile defects after devastating electrical burn, hospitalized from September 1998 to August 2013, were included in this study. After the necrotic tissues in the wounds were removed by dressing changes, a local or a hinge-like flap constructed from scrotum or abdominal wall, a prelaminated hinge-like flap from forearm, or a free forearm flap was selected, according to the injury degree of the penis, for the repair of the defect or reconstruction of penis respectively.The flaps survived and the wounds healed well in 2 patients repaired with local flaps from scrotum or abdominal wall. Urethritis occurred in 2 patients 6 to 9 months after the transplantation of hinge-like flaps from scrotum, and they were cured by appropriate drugs. Functions of urination and erection of penis were recovered in these 4 patients. All flaps survived in the 5 patients repaired with hinge-like flaps from abdominal wall or prelaminated flaps from forearm. The wounds in 2 patients healed; wound dehiscence occurred in the other 3 patients in different degrees, and they healed after suturing for 2 or 3 times. The function of erection of penis recovered in these 5 patients, but with discontinuity of urinary stream during urination. Among them, 3 married patients enjoyed satisfactory sexual life. All free forearm flaps survived and the wounds healed well in 4 patients. Urinary fistula occurred in 1 patient, and it was repaired by a secondary operation. These 4 patients experienced normal urination function, but only 2 patients in whom corpus spongiosum partially remained retained the function of erection of penis to certain degree. All these 4 patients could not perform normal sexual intercourse. All patients were followed up for 6 to 13 months after surgery. Under ordinary state, the length of penis was 5.9-9.3 cm, and the circumference of penis was 8.4-10.0 cm. Wound scar was not obvious in all cases. Nine patients reported a restricted erection.Penile defect caused by devastating electrical burn should be repaired with a suitable flap after necrotic tissues are removed with dressing change. To repair affected penis with necrosis of a small part of cavernous body and/or corpus spongiosum, or combined with urethra defects, local flaps from scrotum or abdominal wall or hinge-like flap from scrotum should be employed. To repair those with necrosis of a large part or the whole of corpus spongiosum combined with urethra defects, hinge-like skin flaps from abdominal wall or prelaminated flaps from forearm should be employed. In patients with necrosis of a large part of cavernous body and corpus spongiosum combined with urethra defect, or total loss of penis, free forearm flaps should be employed to reconstruct penis.

To sum up the clinical characteristics, surgical management, and effectiveness of pressure sore of sinus type.Between January 2009 and April 2013, 17 patients with 19 pressure sores of sinus type after traumatic paraplegia were treated, and the clinical data were analyzed retrospectively. There were 11 males and 6 females with an average age of 27.4 years (range, 17-49 years). The median disease duration was 1.5 years (range, 6 months to 7 years). Of 17 cases, there were 14 primary cases and 3 recurrent cases; 10 focuses of 8 cases were classified as simple sinus type, and 9 focuses of 9 cases as complex sinus type, which had a false synovial sheath complicated with one to four "second sinus". The pressure sore of sinus type majorly located at the ischial tuberosity. The size of pressure sore ranged from 1.5 cm x 1.0 cm to 3.0 cm X 2.0 cm, and the length of "second sinus" ranged from 8 to 32 cm with an average of 17 cm. After the false synovial sheath was totally excised, the wound was repaired by local sliding or rhombus flaps at the first or second stage in patients with simple sinus type pressure sore. On the basis of excising the false synovial sheath, the "second sinus" was totally removed in the patients with complex sinus type pressure sore.Wound dehiscence occurred in 1 case of simple sinus type pressure sore at 4 days, which was cured after it was sutured again. Wound infection occurred at 9, 17, and 23 days respectively in 3 cases of complex sinus type pressure sore, which was cured after second debridement and necrosis tissues removal. The other wounds healed by first intention, and the flaps totally survived. All patients were followed up 6-12 months (mean, 9.3 months). No recurrence was observed.According to the clinical characteristics, pressure sore of sinus type could be divided into simple sinus type and complex sinus type. The key of successful treatment is to thoroughly excise false synovial sheath and "second sinus".

A railway track consists of rails attached to sleepers (cross ties) which are laid in ballast. The sleeper provides support for the rail and transfer loads to the ballast and subgrade. Due to the wheel/rail interaction the rail is induced to vibrate and this vibration is transmitted to the sleepers; both the rail and the sleepers radiate sound. Existing models used to predict the sound radiation from the sleeper consider this to be completely embedded in a rigid ground; in reality, however, the sleeper is surrounded by, or embedded to some extent, in the ballast. It is therefore necessary to take these conditions into account in order to obtain a more realistic model. This paper investigates the influence of the ground in close proximity to the sleeper on its sound radiation. A 1/5 scale concrete sleeper is analyzed by using the boundary element method in 3-D. Ground absorption is introduced in terms of its acoustic impedance using the Delany-Bazley model and its effects on the sleeper radiation are predicted. Finally, the numerical results are validated by experimental results using a 1/5 scale model.