BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients...BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients with superior vena cava syndrome(SVCS).We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein,to indicate and verify PICC catheterisation in the lower extremity is safe and feasible.And hope to provide different per-spectives for clinical PICC venipuncture to get the attention of peers.CASE SUMMARY On 24 August 2022,a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month,which worsened 10 d prior.Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS.Chemotherapy was not an absolute contraindication in this patient.Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head,neck,and upper extremities.The patient and his family were informed about the procedure,and informed consent was obtained.After successful puncture and prompt treatment,the patient was discharged,experiencing some relief from symptoms.CONCLUSION Inferior vena cava catheterisation is rare and important for cancer patients with SVCS,particularly in complex situations involving ectopic placement.展开更多
Pseudoaneurysms of the ascending aorta are a rare complication of aortic and cardiac surgery. In this article, we present a clinical case of a 56-year-old patient with a fortuitous diagnosis of a pseudoaneurysm of asc...Pseudoaneurysms of the ascending aorta are a rare complication of aortic and cardiac surgery. In this article, we present a clinical case of a 56-year-old patient with a fortuitous diagnosis of a pseudoaneurysm of ascending aorta that was treated by an endovascular stent-graft. We discuss in this article the diagnostic and therapeutic aspect of the case and the place of endovascular treatment for the ascending aorta.展开更多
The aortic aneurysm is the 13th leading cause of death in Western countries. The incidence of thoracic aortic aneurysms is estimated at 4.5 cases per 100,000. The diagnosis is often made on a chest x-ray or other imag...The aortic aneurysm is the 13th leading cause of death in Western countries. The incidence of thoracic aortic aneurysms is estimated at 4.5 cases per 100,000. The diagnosis is often made on a chest x-ray or other imaging tests, such as an echocardiogram done for other heart diseases. Echocardiography is the first test to assess the diameter of the ascending aorta and its progression over time. Most patients are first assessed and followed up with spiral thoracic computed tomography with injection of contrast medium, supplemented by 3-dimensional reconstruction of the aneurysm in order to improve the accuracy of measurements, identification of its proximal part and distal. When dilation of the ascending aorta reaches the critical diameter of 50 mm, there is a risk of aortic dissection or rupture. Supravalvular aneurysms are treated by replacing the ectatic portion with a Dacron<span style="white-space:nowrap;">®</span> tube in the supracoronary position. Aortic root aneurysms, including coronary ostia, require tube replacement, reimplantation of coronary ostia, as well as surgery on the aortic valve. In this article, we report a case of aneurysm of the aortic root and the ascending aorta treated by aortic valve replacement and the ascending aorta associated with the Cabrol hemi-mustache technique and we review the literature.展开更多
A 38-year-old female with a history of alcoholic liver cirrhosis visited our hospital with a massive hematochezia.An esophagogastroduodenoscopy did not demonstrate any bleeding source,and a colonoscopy showed a massiv...A 38-year-old female with a history of alcoholic liver cirrhosis visited our hospital with a massive hematochezia.An esophagogastroduodenoscopy did not demonstrate any bleeding source,and a colonoscopy showed a massive hemorrhage in the ascending colon but without an obvious focus.The source of the bleeding could not be found with a mesenteric artery angiography.We performed an enhanced abdominal computed tomography,which revealed a distal ascending colonic varix,and assumed that the varix was the source of the bleeding.We performed a venous coil embolization and histoacryl injection to obliterate the colon varix.The intervention appeared to be successful because the vital signs and hemoglobin laboratory data remained stable and because the hematochezia was no longer observed.We report here on a rare case of colonic variceal bleeding that was treated with venous coil embolization.展开更多
Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enc...Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enclosing conduit graft was used as a sac bypassed to right atrium to form a extracardial left-toright shunt in order to control bleeding and the results turned out to be satisfactory. The bypass and hemodynamically ignorable shunt can close spontaneously without complications with recovery of coagulation system. The technique may find wide application in clinical practice.展开更多
One purpose of this study was to develop a paliperidone(PAL)tri-layer ascending release pushepull osmotic pump(TA-PPOP)tablet which could meet the needs of clinical applications.And another purpose was to investigate ...One purpose of this study was to develop a paliperidone(PAL)tri-layer ascending release pushepull osmotic pump(TA-PPOP)tablet which could meet the needs of clinical applications.And another purpose was to investigate whether different coating materials influenced in vivo performance of TA-PPOP.The ascending release mechanism of this trilayer delivery system on theory was elaborated.TA-PPOP was prepared by means of coating with cellulose acetate(CA)or ethyl cellulose(EC).Several important influence factors such as different core tablet compositions and different coating solution ingredients involved in the formulation procedure were investigated.The optimization of formulation and process was conducted by comparing different in vitro release behaviors of PAL.In vitro dissolution studies indicated that both the two formulations of different coating materials were able to deliver PAL at an ascending release rate during the whole 24 h test.The in vivo pharmacokinetics study showed that both self-made PPOP tablets with different coating had a good in vitro-in vivo correlation(IVIVC)and were bioequivalent with the brand product,which demonstrated no significant influence of the coating materials on the in vivo release acceleration of TA-PPOP.展开更多
BACKGROUND Obesity is a risk factor for colorectal cancer,yet metabolic distinctions between healthy right and left colon tissue,before cancer is diagnosed,remains largely unknown.This study compared right-ascending a...BACKGROUND Obesity is a risk factor for colorectal cancer,yet metabolic distinctions between healthy right and left colon tissue,before cancer is diagnosed,remains largely unknown.This study compared right-ascending and left-descending colon tissue metabolomes to identify differences from the stool metabolome in normal weight,overweight,and obese adults.AIM To examine right and left colon tissue metabolites according to body mass index that may serve as mechanistic targets for interventions and biomarkers for colon cancer risk.METHODS Global,non-targeted metabolomics was applied to assess right-ascending and left-descending colon tissue collected from healthy adults undergoing screening colonoscopies to test the hypothesis that BMI differentially impacts colon tissue metabolite profiles.The colon tissue and stool metabolome of healthy adults(n=24)was analyzed for metabolite signatures and metabolic pathway networks implicated in progression of colorectal cancer.RESULTS Ascending and descending colon contained 504 host,food,and microbiotaderived metabolites from normal weight,overweight and obese adults grouped according to body mass index.Amino acids,lipids,and nucleotides were among the chemical types that further differentiated from the stool metabolite profiles.Normal weight adults had 46 significantly different metabolites between ascending and descending colon tissue locations,whereas there were 37 metabolite differences in overweight and 28 metabolite differences for obese adults(P<0.05).Obese adults had trimethylamine N-oxide,endocannabinoids and monoacylglycerols with different relative abundances identified between ascending and descending colon.Primary and secondary bile acids,vitamins,and fatty acids also showed marked relative abundance differences in colon tissue from overweight/obese adults.CONCLUSION There were metabolite profile differences between right-ascending and leftdescending colon tissue in healthy adults.Colon lipids and other metabolites in obese and overweight adults were distinguished from normal weight participants and associated with gut inflammation,nutrient absorption,and products of microbiota metabolism.展开更多
Purpose: This study aimed to investigate the morphological characteristics of ascending aortic dissection in detail. Materials and Methods: The ascending aorta was morphologically assessed in a consecutive series of p...Purpose: This study aimed to investigate the morphological characteristics of ascending aortic dissection in detail. Materials and Methods: The ascending aorta was morphologically assessed in a consecutive series of patients between January 2009 and October 2014. A new assessment and evaluation method was used to describe 114 patients with ascending aortic dissection. Results: A large difference was found in the degree of curvature between the ascending aorta with and without dissection. The shape of the former was straighter and steeper(control group R, 47.46 ± 6.40 mm; experimental group R, 59.70 ± 10.27 mm, P < 0.001). In the case of aortic dissection involving the valves, the proximal edge of the first entry was obviously close to the aortic sinus. The orientation of the entries was mainly around the 10 o'clock and 1–2 o'clock positions, and most of their shapes were fusiform(111; 70.02%). The distance of the distal extending dissection was associated with cases involving the branch arteries(involving three branches 441.40 ± 101.13 mm vs 159.85 ± 131.86 mm in others, P < 0.001). Conclusion: The morphological features of the ascending aorta after dissection and the correlations among dissections, entries, and related factors were found.展开更多
Consciousness is controlled by activation of the ascending reticular activating system(ARAS).The ARAS consists mainly of the lower and upper parts between the thalamus and cerebral cortex(Edlow et al.,2012;Yeo et al.,...Consciousness is controlled by activation of the ascending reticular activating system(ARAS).The ARAS consists mainly of the lower and upper parts between the thalamus and cerebral cortex(Edlow et al.,2012;Yeo et al.,2013;Jang et al.,2014).Because the ARAS is composed of several neuronal circuits connecting the brainstem to the cortex.These neuronal connections begin from the reticular formation(RF)of the brainstem and the in-展开更多
The aim of this work was to prepare ascending release compression-coated(CC) tablets with paliperidone(PAL) using a simple manufacturing technique and short manufacturing process.The release behavior and mechanisms in...The aim of this work was to prepare ascending release compression-coated(CC) tablets with paliperidone(PAL) using a simple manufacturing technique and short manufacturing process.The release behavior and mechanisms in vitro of the final tablets was investigated and evaluated. The PAL CC tablets were comprised of a core layer of high viscosity hydroxypropyl cellulose(HPC-H) and a coating layer of high viscosity hydroxypropyl methylcellulose(HPMCK100 M). Several factors such as materials and core tablet compositions were studied for their influence in the formulation procedure. The drug release mechanism was studied using gravimetric analysis. The data could be fitted to the Peppas model. The ascending drug release results were expressed in terms of the slope of the release curve at different time points.Results showed that the formulation could achieve a good ascending drug release when the weight ratio of PAL was 5:1(core:layer). The fraction of HPC and HPMC was 33 %, and the combination of Eudragit RL-PO was 10%. The ascending release mechanism was due to solvent penetration into the PAL CC tablets, and subsequent drug dissolution from the gelatinous HPC and HPMC matrix erosion. The release mechanism was therefore a combination of diffusion and erosion. This work demonstrated that the compression-coated tablets could achieve controlled ascending release over 24 h for the oral administration systems.展开更多
Ascending mining is one of the most effective ways to solve problems of water inrush, gas outburst and rock burst in coal seams mining. In order to reveal the law of motion and spatiotemporal relationship of overlayin...Ascending mining is one of the most effective ways to solve problems of water inrush, gas outburst and rock burst in coal seams mining. In order to reveal the law of motion and spatiotemporal relationship of overlaying strata, field measurement has been done in a mine. Long distance drillings were constructed from 4# coal seam to 6# coal seam at several certain typical positions, and movement and failure law of overlying strata after mining was analyzed by drilling video and observing the fluid leakage. Besides, we also analyzed the spatiotemporal development law of overlying strata failure with different mining heights and time intervals in the lower coal seam. The results show that: ascending mining is significantly affected by time-domain characteristics of overlaying strata failure after the lower coal seam's mining, height equations of caving zone and fractured zone are given in this paper, and the feasibility of ascending mining was compartmentalized concretely according to the spatiotemporal relationship. Research methods and conclusions of this paper have certain referential significance for the study of ascending mining, mining under water, mining under building, mining under railway and stress-relief mining.展开更多
Methods: Sixteen patients with American Society of Anesthesiologists status (ASA) II-III, age ≤ 70 yr, male or female, preoperatively NYHA II-III and EF ≥ 45%, scheduled for mitral valve replacement (MVR) were studi...Methods: Sixteen patients with American Society of Anesthesiologists status (ASA) II-III, age ≤ 70 yr, male or female, preoperatively NYHA II-III and EF ≥ 45%, scheduled for mitral valve replacement (MVR) were studied. Complete intravenous general anesthesia was used for induction and anesthesia maintenance. After anesthesia induction we put the TEE probe into the esophagus. The cardiac index was determined at three periods following MVR: T1 30 minutes later following cessation of bypass, T2 60 minutes after cessation of bypass, T3 90 minutes after cessation of bypass. Statistical analysis was made with the Bland and Altman method. Results: Ninety-six measurements were compared. The cardiac index values at the level of prosthesis mitral valve (CIMV) ranged from 1.3 to 5.5 L·min-1·m-2 (mean 2.6 ± 0.9). The Values of cardiac index at aortic valve (CIAA) ranged from 2.7 to8.8 L·min-1·m-2 (mean 4.9 ± 1.7). Bias was -2.3 L·min-1·m-2 and limits of agreement -5.6 to 1.0 L·min-1·m-2. Conclusion: During mitral valve replacement, doubtful correlations were observed between values of cardiac index at the mitral valve and the ascending aorta using TEE.展开更多
This paper proposed a T- Y tube model to simulate foe input impedance of arterial system. It improves and extends the asymmetric T-tube model which was firstproposed by O’ Rourke[1] and developed laier by Liu et al.[...This paper proposed a T- Y tube model to simulate foe input impedance of arterial system. It improves and extends the asymmetric T-tube model which was firstproposed by O’ Rourke[1] and developed laier by Liu et al.[2]. Based on foe asymmetricT-tube model. a T-Y tube model was proposed by adding branching tubes whichrepresem the iliac arteries.All the tubes are considered to be uniform,viscoelasticlongitudinally tethered cylindrical tubes.The upper tube terminates with a windkesselmodel, while the terminal arterioles of the lowr tube are expressed as a resistance.After proper eraluation of the parameters.the impedance of the arterial system iscalculated under normal physiological and hypertensive condition.The model canpredict impedance in good agreement with the experimentally obtained data no matterin normal physiological condition or in pathological condition In comparison with theasymmeric T-tube model,T- Y tube model is closer to anatomy structure of the human arlerial system and at the sametime much simpler than the extremely complex multiplebranching tube model Therefore it will be a valuable model in studying the influencesof various parameters on aorta impedance and ventricular-vascular coupling.展开更多
To extract the high-quality DEM in complicated mountain areas,a DEM fusion method for ascending and descending orbit StereoSAR DEMs considering Synthetic Aperture Radar(SAR)echo intensity is proposed.After the analysi...To extract the high-quality DEM in complicated mountain areas,a DEM fusion method for ascending and descending orbit StereoSAR DEMs considering Synthetic Aperture Radar(SAR)echo intensity is proposed.After the analysis for the influence of terrain features and SAR side-looking imaging characteristics on radar echo intensity and DEM accuracy,four Terras AR-X images with the stripmap mode and the 3 m spatial resolution covering a certain area of Maoxian County,Sichuan Province,China,was selected as the experimental area.StereoSAR technology was used to extract the ascending orbit StereoSAR DEM and the descending orbit StereoSAR DEM,respectively,and the corresponding radar echo intensity map was calculated.Then,while comparing the radar echo intensity corresponding to the same point position,DEM fusion was carried out,and the accuracy of DEM before and after the fusion was analyzed with the ground points measured by GNSS-RTK as reference data.Finally,a high-quality DEM with a 3 m spatial resolution in the experimental area was obtained.The DEM accuracy was improved on all slopes,and the mean absolute deviation(MAD)improved to 4.798 m,the standard deviation(SD)improved to 6.087 m and the LE90 improved to 40.48 m.The experimental results indicate that the fusion method of highresolution ascending and descending orbit StereoSAR DEMs considering SAR echo intensity can effectively extract DEM with high accuracy and reliability,which can provide technical support for obtaining highquality terrain information in similar areas.展开更多
BACKGROUND Acute type A aortic dissection(ATAAD)is a life-threatening disease associated with high morbidity and mortality.AIM To evaluate the diameter of dissected ascending aorta in patients diagnosed with ATAAD and...BACKGROUND Acute type A aortic dissection(ATAAD)is a life-threatening disease associated with high morbidity and mortality.AIM To evaluate the diameter of dissected ascending aorta in patients diagnosed with ATAAD and whether the aortic diameter is associated with preoperative adverse events.METHODS A total of 108 patients diagnosed with ATAAD who underwent emergency operation under hypothermic circulatory arrest were enrolled in this study.Demographic characteristics and perioperative data were recorded.In all patients,preoperative chest and abdomen computed tomography(CT)scans were performed.RESULTS Median age of the patients was 61.5(52.5-70.5)years and median body mass index(BMI)was 28.2(25.1-32.6)cm^(2).The number of female patients was 37(25%).Median diameter of the ascending aorta was 5.0(4.5-6)cm and 53.8%of the patients had an aortic diameter<5.0 cm,while 32.3%of the patients had an aortic diameter of 4.5cm and 72.0%had an ascending aorta diameter<5.5 cm.The diameter of the ascending aorta did not differ in patients with vs without preoperative adverse events:Preoperative neurological dysfunction(P=0.53)and hemodynamic instability(P=0.43).Median age of patients with preoperative hemodynamic instability was 65(57.5-74)years,while it was 60(51-68)years in patients without(P=0.04)CONCLUSION Although current guidelines suggest replacing the ascending aorta with a diameter>5.5 cm,most of the patients with ATAAD had an aortic diameter of less than 5.5 cm.The diameter of the ascending aorta in patients diagnose with ATAAD is not associated with preoperative adverse events.展开更多
In pediatric age group, Intussusception is the most common cause of acute intestinal obstruction. They present with the classic clinical triad of colicky abdominal pain, vomiting and bloody stools. But clinically very...In pediatric age group, Intussusception is the most common cause of acute intestinal obstruction. They present with the classic clinical triad of colicky abdominal pain, vomiting and bloody stools. But clinically very few patients (20%) present with this classical symptoms. This article highlights an importance of suspecting intussusception by physician and rare presentations of intussusception lump in abdomen in a child with abdominal pain, gastrointestinal symptoms. Here a case reported of 16-year-old male child who presented with migrating lump in abdomen on and off with varied clinical presentation every time in single admission. Patient underwent laparotomy and manual reduction of intussusception was done. It is advisable to have high suspicion of intussusception while dealing with such cases.展开更多
Stressful stimuli induced by immobilization are perceived as acute stress in rats. This acute stress activates corticotropin-releasing hormone (CRH) neurons in the hypothalamic paraventricular nucleus (PVN), resulting...Stressful stimuli induced by immobilization are perceived as acute stress in rats. This acute stress activates corticotropin-releasing hormone (CRH) neurons in the hypothalamic paraventricular nucleus (PVN), resulting in stimulation of the hypothalamic-pituitary-adrenal (HPA) axis. The ventral ascending noradrenergic bundles (V-NAB) from the brainstem innervate the PVN. To investigate the relationship between the response of the HPA axis and the V-NAB, we examined changes in plasma corticosterone, the final output of the HPA axis, and extracellular noradrenaline (NA) in the PVN following immobilization stress in rats that received bilateral 6-hydroxydopamine (6-OHDA) lesions of the V-NAB. 6-OHDA microinjection into the V-NAB reduced the magnitude of the responses of plasma corticosterone and extracellular NA in the PVN following immobilization stress. Our results suggest that V-NAB innervation of the PVN is involved in immobilization stress-induced activation of the HPA axis.展开更多
Aim: To highlight the imaging features and the peculiarities associated with a giant ascending aortic aneurysm in a typical developing world setting. Presentation of Case: A 78-year-old known hypertensive and asthmati...Aim: To highlight the imaging features and the peculiarities associated with a giant ascending aortic aneurysm in a typical developing world setting. Presentation of Case: A 78-year-old known hypertensive and asthmatic woman of 25 and 10 years duration respectively. She had an untreated degenerative aortic valve lesion and moderate aortic regurgitation. This case study showed the complex interplay of background untreated aortic valve disease, aortic insufficiency, chronic hypertension, chronic airway obstructive disease and ageing in a case of giant aneurysm of the entire ascending aorta. It also emphasizes the role of imaging in diagnosis and follows up of ascending aortic aneurysm particularly where prevention is key to prevent the high mortality associated with Thoracic aneurysymal rupture. Conclusion: Timely institution of appropriate treatment of aortic valve disease, prevention and adequate control of hypertension is key to prevent the development and the grave prognosis of ascending aortic aneurysm, particularly in the developing world where appropriate medical facilities, expertise and treatment are scarce.展开更多
Through the method of literature mining,the classics of traditional Chinese medicine,materia medica works,medical cases and documents are studied.Based on common prescriptions for the treatment of diseases such as abn...Through the method of literature mining,the classics of traditional Chinese medicine,materia medica works,medical cases and documents are studied.Based on common prescriptions for the treatment of diseases such as abnormal Zang-fu viscera and qi movement,dysfunction,etc.,and combined with the theory of ascending and descending property of traditional Chinese medicine,the application of ascending and descending property of traditional Chinese medicine in clinical prescription compatibility and the factors affecting the application are summarized.The ascending and descending properties of traditional Chinese medicine have been widely used in prescription compatibility for the clinical treatment of impairment of purifying and descending function of the lung,spleen and stomach's ascending and descending disorders and heart-kidney noninteractionpatte.展开更多
基金the Chongqing Medical Scientific Research Project(a joint project of the Chongqing Health Commission and Science and Technology Bureau),No.2020FYYX046。
文摘BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients with superior vena cava syndrome(SVCS).We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein,to indicate and verify PICC catheterisation in the lower extremity is safe and feasible.And hope to provide different per-spectives for clinical PICC venipuncture to get the attention of peers.CASE SUMMARY On 24 August 2022,a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month,which worsened 10 d prior.Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS.Chemotherapy was not an absolute contraindication in this patient.Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head,neck,and upper extremities.The patient and his family were informed about the procedure,and informed consent was obtained.After successful puncture and prompt treatment,the patient was discharged,experiencing some relief from symptoms.CONCLUSION Inferior vena cava catheterisation is rare and important for cancer patients with SVCS,particularly in complex situations involving ectopic placement.
文摘Pseudoaneurysms of the ascending aorta are a rare complication of aortic and cardiac surgery. In this article, we present a clinical case of a 56-year-old patient with a fortuitous diagnosis of a pseudoaneurysm of ascending aorta that was treated by an endovascular stent-graft. We discuss in this article the diagnostic and therapeutic aspect of the case and the place of endovascular treatment for the ascending aorta.
文摘The aortic aneurysm is the 13th leading cause of death in Western countries. The incidence of thoracic aortic aneurysms is estimated at 4.5 cases per 100,000. The diagnosis is often made on a chest x-ray or other imaging tests, such as an echocardiogram done for other heart diseases. Echocardiography is the first test to assess the diameter of the ascending aorta and its progression over time. Most patients are first assessed and followed up with spiral thoracic computed tomography with injection of contrast medium, supplemented by 3-dimensional reconstruction of the aneurysm in order to improve the accuracy of measurements, identification of its proximal part and distal. When dilation of the ascending aorta reaches the critical diameter of 50 mm, there is a risk of aortic dissection or rupture. Supravalvular aneurysms are treated by replacing the ectatic portion with a Dacron<span style="white-space:nowrap;">®</span> tube in the supracoronary position. Aortic root aneurysms, including coronary ostia, require tube replacement, reimplantation of coronary ostia, as well as surgery on the aortic valve. In this article, we report a case of aneurysm of the aortic root and the ascending aorta treated by aortic valve replacement and the ascending aorta associated with the Cabrol hemi-mustache technique and we review the literature.
文摘A 38-year-old female with a history of alcoholic liver cirrhosis visited our hospital with a massive hematochezia.An esophagogastroduodenoscopy did not demonstrate any bleeding source,and a colonoscopy showed a massive hemorrhage in the ascending colon but without an obvious focus.The source of the bleeding could not be found with a mesenteric artery angiography.We performed an enhanced abdominal computed tomography,which revealed a distal ascending colonic varix,and assumed that the varix was the source of the bleeding.We performed a venous coil embolization and histoacryl injection to obliterate the colon varix.The intervention appeared to be successful because the vital signs and hemoglobin laboratory data remained stable and because the hematochezia was no longer observed.We report here on a rare case of colonic variceal bleeding that was treated with venous coil embolization.
文摘Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enclosing conduit graft was used as a sac bypassed to right atrium to form a extracardial left-toright shunt in order to control bleeding and the results turned out to be satisfactory. The bypass and hemodynamically ignorable shunt can close spontaneously without complications with recovery of coagulation system. The technique may find wide application in clinical practice.
文摘One purpose of this study was to develop a paliperidone(PAL)tri-layer ascending release pushepull osmotic pump(TA-PPOP)tablet which could meet the needs of clinical applications.And another purpose was to investigate whether different coating materials influenced in vivo performance of TA-PPOP.The ascending release mechanism of this trilayer delivery system on theory was elaborated.TA-PPOP was prepared by means of coating with cellulose acetate(CA)or ethyl cellulose(EC).Several important influence factors such as different core tablet compositions and different coating solution ingredients involved in the formulation procedure were investigated.The optimization of formulation and process was conducted by comparing different in vitro release behaviors of PAL.In vitro dissolution studies indicated that both the two formulations of different coating materials were able to deliver PAL at an ascending release rate during the whole 24 h test.The in vivo pharmacokinetics study showed that both self-made PPOP tablets with different coating had a good in vitro-in vivo correlation(IVIVC)and were bioequivalent with the brand product,which demonstrated no significant influence of the coating materials on the in vivo release acceleration of TA-PPOP.
基金Supported by the Cancer Cure Foundation and the University of Colorado Cancer Center Support Grant,Division of Cancer Control and Prevention(Aurora,CO),No.P30CA046934
文摘BACKGROUND Obesity is a risk factor for colorectal cancer,yet metabolic distinctions between healthy right and left colon tissue,before cancer is diagnosed,remains largely unknown.This study compared right-ascending and left-descending colon tissue metabolomes to identify differences from the stool metabolome in normal weight,overweight,and obese adults.AIM To examine right and left colon tissue metabolites according to body mass index that may serve as mechanistic targets for interventions and biomarkers for colon cancer risk.METHODS Global,non-targeted metabolomics was applied to assess right-ascending and left-descending colon tissue collected from healthy adults undergoing screening colonoscopies to test the hypothesis that BMI differentially impacts colon tissue metabolite profiles.The colon tissue and stool metabolome of healthy adults(n=24)was analyzed for metabolite signatures and metabolic pathway networks implicated in progression of colorectal cancer.RESULTS Ascending and descending colon contained 504 host,food,and microbiotaderived metabolites from normal weight,overweight and obese adults grouped according to body mass index.Amino acids,lipids,and nucleotides were among the chemical types that further differentiated from the stool metabolite profiles.Normal weight adults had 46 significantly different metabolites between ascending and descending colon tissue locations,whereas there were 37 metabolite differences in overweight and 28 metabolite differences for obese adults(P<0.05).Obese adults had trimethylamine N-oxide,endocannabinoids and monoacylglycerols with different relative abundances identified between ascending and descending colon.Primary and secondary bile acids,vitamins,and fatty acids also showed marked relative abundance differences in colon tissue from overweight/obese adults.CONCLUSION There were metabolite profile differences between right-ascending and leftdescending colon tissue in healthy adults.Colon lipids and other metabolites in obese and overweight adults were distinguished from normal weight participants and associated with gut inflammation,nutrient absorption,and products of microbiota metabolism.
文摘Purpose: This study aimed to investigate the morphological characteristics of ascending aortic dissection in detail. Materials and Methods: The ascending aorta was morphologically assessed in a consecutive series of patients between January 2009 and October 2014. A new assessment and evaluation method was used to describe 114 patients with ascending aortic dissection. Results: A large difference was found in the degree of curvature between the ascending aorta with and without dissection. The shape of the former was straighter and steeper(control group R, 47.46 ± 6.40 mm; experimental group R, 59.70 ± 10.27 mm, P < 0.001). In the case of aortic dissection involving the valves, the proximal edge of the first entry was obviously close to the aortic sinus. The orientation of the entries was mainly around the 10 o'clock and 1–2 o'clock positions, and most of their shapes were fusiform(111; 70.02%). The distance of the distal extending dissection was associated with cases involving the branch arteries(involving three branches 441.40 ± 101.13 mm vs 159.85 ± 131.86 mm in others, P < 0.001). Conclusion: The morphological features of the ascending aorta after dissection and the correlations among dissections, entries, and related factors were found.
基金supported by the National Research Foundation (NRF) of Korea Grant funded by the Korean Government (MSIP) No. 2015R1A2A2A01004073
文摘Consciousness is controlled by activation of the ascending reticular activating system(ARAS).The ARAS consists mainly of the lower and upper parts between the thalamus and cerebral cortex(Edlow et al.,2012;Yeo et al.,2013;Jang et al.,2014).Because the ARAS is composed of several neuronal circuits connecting the brainstem to the cortex.These neuronal connections begin from the reticular formation(RF)of the brainstem and the in-
基金funded by National Natural Science Foundation of China (No.81673378)
文摘The aim of this work was to prepare ascending release compression-coated(CC) tablets with paliperidone(PAL) using a simple manufacturing technique and short manufacturing process.The release behavior and mechanisms in vitro of the final tablets was investigated and evaluated. The PAL CC tablets were comprised of a core layer of high viscosity hydroxypropyl cellulose(HPC-H) and a coating layer of high viscosity hydroxypropyl methylcellulose(HPMCK100 M). Several factors such as materials and core tablet compositions were studied for their influence in the formulation procedure. The drug release mechanism was studied using gravimetric analysis. The data could be fitted to the Peppas model. The ascending drug release results were expressed in terms of the slope of the release curve at different time points.Results showed that the formulation could achieve a good ascending drug release when the weight ratio of PAL was 5:1(core:layer). The fraction of HPC and HPMC was 33 %, and the combination of Eudragit RL-PO was 10%. The ascending release mechanism was due to solvent penetration into the PAL CC tablets, and subsequent drug dissolution from the gelatinous HPC and HPMC matrix erosion. The release mechanism was therefore a combination of diffusion and erosion. This work demonstrated that the compression-coated tablets could achieve controlled ascending release over 24 h for the oral administration systems.
基金provided by the National Natural Science Foundation of China (No. 50974118)the New Century Talents Supporting Program from Ministry of Education (No.NCET-09-0727)the Program for Postgraduates Research Innovation in Universities of Jiangsu Province of China (No.CXZZ12_0951)
文摘Ascending mining is one of the most effective ways to solve problems of water inrush, gas outburst and rock burst in coal seams mining. In order to reveal the law of motion and spatiotemporal relationship of overlaying strata, field measurement has been done in a mine. Long distance drillings were constructed from 4# coal seam to 6# coal seam at several certain typical positions, and movement and failure law of overlying strata after mining was analyzed by drilling video and observing the fluid leakage. Besides, we also analyzed the spatiotemporal development law of overlying strata failure with different mining heights and time intervals in the lower coal seam. The results show that: ascending mining is significantly affected by time-domain characteristics of overlaying strata failure after the lower coal seam's mining, height equations of caving zone and fractured zone are given in this paper, and the feasibility of ascending mining was compartmentalized concretely according to the spatiotemporal relationship. Research methods and conclusions of this paper have certain referential significance for the study of ascending mining, mining under water, mining under building, mining under railway and stress-relief mining.
文摘Methods: Sixteen patients with American Society of Anesthesiologists status (ASA) II-III, age ≤ 70 yr, male or female, preoperatively NYHA II-III and EF ≥ 45%, scheduled for mitral valve replacement (MVR) were studied. Complete intravenous general anesthesia was used for induction and anesthesia maintenance. After anesthesia induction we put the TEE probe into the esophagus. The cardiac index was determined at three periods following MVR: T1 30 minutes later following cessation of bypass, T2 60 minutes after cessation of bypass, T3 90 minutes after cessation of bypass. Statistical analysis was made with the Bland and Altman method. Results: Ninety-six measurements were compared. The cardiac index values at the level of prosthesis mitral valve (CIMV) ranged from 1.3 to 5.5 L·min-1·m-2 (mean 2.6 ± 0.9). The Values of cardiac index at aortic valve (CIAA) ranged from 2.7 to8.8 L·min-1·m-2 (mean 4.9 ± 1.7). Bias was -2.3 L·min-1·m-2 and limits of agreement -5.6 to 1.0 L·min-1·m-2. Conclusion: During mitral valve replacement, doubtful correlations were observed between values of cardiac index at the mitral valve and the ascending aorta using TEE.
文摘This paper proposed a T- Y tube model to simulate foe input impedance of arterial system. It improves and extends the asymmetric T-tube model which was firstproposed by O’ Rourke[1] and developed laier by Liu et al.[2]. Based on foe asymmetricT-tube model. a T-Y tube model was proposed by adding branching tubes whichrepresem the iliac arteries.All the tubes are considered to be uniform,viscoelasticlongitudinally tethered cylindrical tubes.The upper tube terminates with a windkesselmodel, while the terminal arterioles of the lowr tube are expressed as a resistance.After proper eraluation of the parameters.the impedance of the arterial system iscalculated under normal physiological and hypertensive condition.The model canpredict impedance in good agreement with the experimentally obtained data no matterin normal physiological condition or in pathological condition In comparison with theasymmeric T-tube model,T- Y tube model is closer to anatomy structure of the human arlerial system and at the sametime much simpler than the extremely complex multiplebranching tube model Therefore it will be a valuable model in studying the influencesof various parameters on aorta impedance and ventricular-vascular coupling.
基金supported by Study on Early Identification of Landslide Hazards based on Highresolution SAR Image[KJ-2018-13]。
文摘To extract the high-quality DEM in complicated mountain areas,a DEM fusion method for ascending and descending orbit StereoSAR DEMs considering Synthetic Aperture Radar(SAR)echo intensity is proposed.After the analysis for the influence of terrain features and SAR side-looking imaging characteristics on radar echo intensity and DEM accuracy,four Terras AR-X images with the stripmap mode and the 3 m spatial resolution covering a certain area of Maoxian County,Sichuan Province,China,was selected as the experimental area.StereoSAR technology was used to extract the ascending orbit StereoSAR DEM and the descending orbit StereoSAR DEM,respectively,and the corresponding radar echo intensity map was calculated.Then,while comparing the radar echo intensity corresponding to the same point position,DEM fusion was carried out,and the accuracy of DEM before and after the fusion was analyzed with the ground points measured by GNSS-RTK as reference data.Finally,a high-quality DEM with a 3 m spatial resolution in the experimental area was obtained.The DEM accuracy was improved on all slopes,and the mean absolute deviation(MAD)improved to 4.798 m,the standard deviation(SD)improved to 6.087 m and the LE90 improved to 40.48 m.The experimental results indicate that the fusion method of highresolution ascending and descending orbit StereoSAR DEMs considering SAR echo intensity can effectively extract DEM with high accuracy and reliability,which can provide technical support for obtaining highquality terrain information in similar areas.
文摘BACKGROUND Acute type A aortic dissection(ATAAD)is a life-threatening disease associated with high morbidity and mortality.AIM To evaluate the diameter of dissected ascending aorta in patients diagnosed with ATAAD and whether the aortic diameter is associated with preoperative adverse events.METHODS A total of 108 patients diagnosed with ATAAD who underwent emergency operation under hypothermic circulatory arrest were enrolled in this study.Demographic characteristics and perioperative data were recorded.In all patients,preoperative chest and abdomen computed tomography(CT)scans were performed.RESULTS Median age of the patients was 61.5(52.5-70.5)years and median body mass index(BMI)was 28.2(25.1-32.6)cm^(2).The number of female patients was 37(25%).Median diameter of the ascending aorta was 5.0(4.5-6)cm and 53.8%of the patients had an aortic diameter<5.0 cm,while 32.3%of the patients had an aortic diameter of 4.5cm and 72.0%had an ascending aorta diameter<5.5 cm.The diameter of the ascending aorta did not differ in patients with vs without preoperative adverse events:Preoperative neurological dysfunction(P=0.53)and hemodynamic instability(P=0.43).Median age of patients with preoperative hemodynamic instability was 65(57.5-74)years,while it was 60(51-68)years in patients without(P=0.04)CONCLUSION Although current guidelines suggest replacing the ascending aorta with a diameter>5.5 cm,most of the patients with ATAAD had an aortic diameter of less than 5.5 cm.The diameter of the ascending aorta in patients diagnose with ATAAD is not associated with preoperative adverse events.
文摘In pediatric age group, Intussusception is the most common cause of acute intestinal obstruction. They present with the classic clinical triad of colicky abdominal pain, vomiting and bloody stools. But clinically very few patients (20%) present with this classical symptoms. This article highlights an importance of suspecting intussusception by physician and rare presentations of intussusception lump in abdomen in a child with abdominal pain, gastrointestinal symptoms. Here a case reported of 16-year-old male child who presented with migrating lump in abdomen on and off with varied clinical presentation every time in single admission. Patient underwent laparotomy and manual reduction of intussusception was done. It is advisable to have high suspicion of intussusception while dealing with such cases.
文摘Stressful stimuli induced by immobilization are perceived as acute stress in rats. This acute stress activates corticotropin-releasing hormone (CRH) neurons in the hypothalamic paraventricular nucleus (PVN), resulting in stimulation of the hypothalamic-pituitary-adrenal (HPA) axis. The ventral ascending noradrenergic bundles (V-NAB) from the brainstem innervate the PVN. To investigate the relationship between the response of the HPA axis and the V-NAB, we examined changes in plasma corticosterone, the final output of the HPA axis, and extracellular noradrenaline (NA) in the PVN following immobilization stress in rats that received bilateral 6-hydroxydopamine (6-OHDA) lesions of the V-NAB. 6-OHDA microinjection into the V-NAB reduced the magnitude of the responses of plasma corticosterone and extracellular NA in the PVN following immobilization stress. Our results suggest that V-NAB innervation of the PVN is involved in immobilization stress-induced activation of the HPA axis.
文摘Aim: To highlight the imaging features and the peculiarities associated with a giant ascending aortic aneurysm in a typical developing world setting. Presentation of Case: A 78-year-old known hypertensive and asthmatic woman of 25 and 10 years duration respectively. She had an untreated degenerative aortic valve lesion and moderate aortic regurgitation. This case study showed the complex interplay of background untreated aortic valve disease, aortic insufficiency, chronic hypertension, chronic airway obstructive disease and ageing in a case of giant aneurysm of the entire ascending aorta. It also emphasizes the role of imaging in diagnosis and follows up of ascending aortic aneurysm particularly where prevention is key to prevent the high mortality associated with Thoracic aneurysymal rupture. Conclusion: Timely institution of appropriate treatment of aortic valve disease, prevention and adequate control of hypertension is key to prevent the development and the grave prognosis of ascending aortic aneurysm, particularly in the developing world where appropriate medical facilities, expertise and treatment are scarce.
基金University-level Scientific Research Project of Guangxi University of Chinese Medicine(2015MS011)Guangxi Key Laboratory of Zhuang Yao Medicine(20-065-14)Key Laboratory of Basic and Applied Research of Zhuang Traditional Medicine in Collages and Universities in Guangxi(GJKY[2017]23 zyfy201707).
文摘Through the method of literature mining,the classics of traditional Chinese medicine,materia medica works,medical cases and documents are studied.Based on common prescriptions for the treatment of diseases such as abnormal Zang-fu viscera and qi movement,dysfunction,etc.,and combined with the theory of ascending and descending property of traditional Chinese medicine,the application of ascending and descending property of traditional Chinese medicine in clinical prescription compatibility and the factors affecting the application are summarized.The ascending and descending properties of traditional Chinese medicine have been widely used in prescription compatibility for the clinical treatment of impairment of purifying and descending function of the lung,spleen and stomach's ascending and descending disorders and heart-kidney noninteractionpatte.
