Salt marshes are widespread in estuarine coastal areas and are one of the most productive natural ecosystems in the world. More importantly, the role of salt marshes in coastal protection is of increasing interest, as salt marshes significantly reduce wave height and stabilize substrates. However, the application of hydrodynamic models for coastal salt marsh management is still uncommon. In this study, TELEMAC is used to set up a hydro-morphodynamic model to simulate the dynamic process in the study area. After that, the influence of hydrodynamic stress on the salt marshes under natural conditions was analysed and the feasibility of applying artificial structures to restore salt marshes was discussed. Finally, the long-term evolution of salt marsh platform is modelled. The results show that salt marsh vegetation is strongly influenced by coastal dynamics. The artificial restoration measures such as submerged dikes have the potential to restore or rehabilitate salt marshes by attenuating the currents on tidal flats. The long-term marsh evolution contains both platform raising and channel incision, which forms the unique landscape of tidal salt marsh. The research results of the study can provide theoretical support for the management and restoration of coastal salt marsh wetlands and contribute to disaster prevention and mitigation in the coastal areas.
Objective: To evaluate the efficacy and safety of botulinum toxin type A (BTX-A) in treating patients with low bladder compliance (BC) secondary to spinal cord injury (SCI). Methods: From 2011 to 2016, we retrospected patients who received BTX-A injections for LBC secondary to SCI. The primary outcomes were urodynamic parameters including maximum detrusor pressure (Pdetmax), bladder compliance (BC). Related adverse events were recorded. Results: 72 SCI patients were selected (62 males, 10 females, age range 18 -52 years; mean age 28.5 years). 12 weeks after BTX-A injection, Pdetmax decreased from 51.02 cmH 2 O to 28.31 cmH 2 O. BC increased from 3.64 ml/cmH 2 O to 10.08 ml/cmH 2 O. 12 patients had mild transient haematuria for 1 -2 days. Conclusion: Intradetrusor BTX-A injection was effective and safe for patients with low BC secondary to SCI.
Objective: To assess the safety and efficacy of bladder irrigation for reducing the morbidity of bladder stones in patients with neurological lower urinary tract dysfunction (NLUTD). Methods: From June 2012 to July 2013, patients with NLUTD were prospectively randomized and assigned to either a bladder irrigation group or a no bladder irrigation group. Bladder irrigations were performed twice a week by urologists. Patients were followed up at 6 months respectively. Primary outcomes were Incontinence-Specific Quality-of-Life Instrument (I-QoL), the rate incidences of bladder stone. All adverse events were also noted. Results: A total of 80 eligible patients participated and 78 (97.5%) patients (bladder irrigation, n = 39; no bladder irrigation, n = 39) completed 24 weeks of follow-up. Out of the 78 patients, 19 (24.3%) developed bladder stones. All occurred in no bladder irrigation group. In 8 of the 19 patients (42.1%), stones were only detected by cystoscopy. The bladder stones were mostly thin with an eggshell appearance (78.95% for diameter of stone < 5 mm, 84.21% for volume of bladder stone < 0.2 cm 3 ). Bladder stones were removed by vigorous bladder irrigation guided by ultrasound (73.68%) or endoscopic lithotripsy (26.32%). The I-QOL was significantly better in the bladder irrigation group than in no bladder irrigation group at weeks 6, 12, 18, and 24 of follow-up. Conclusion: Bladder irrigation may be more effective and safer than no bladder irrigation for reducing the morbidity of bladder stone in spinal cord injury patients.
Objective: To compare the short-time complications associated with time-opening suprapubic catheter (SPT) versus intermittent catheter (IC) in male patients with spinal cord injury (above level C5). Methods: A prospective review of records was carried out to identify SCI patients managed with SPT or IC between 2011 and 2016. The complications included renal function (Serum creatinine), urinary tract infection (UTI), bladder stones, urethral complications, scrotal, and gross hematuria. Patients were followed at week 4, 3 and 6 months; the urodynamic assessment was repeated at 6 months. Results: A total of 30 patients (11 SPT, 19 IC) were recruited in this trial. There is no significant difference between the two catheter groups for the entire outcome. Scrotal abscesses and urethral stricture were only seen in patients with IC. Conclusions: SPT has similar urological complication with IC for SCI patients (above level C5) except the incidence of scrotal abscesses and urethral stricture.
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