The dimension of the levator hiatus is a possible predictor of pelvic organ prolapse （POP）. Thisretrospective study investigated 360 women who went to urogynecological clinic for pelvic floor discomfort.Levator hiat...The dimension of the levator hiatus is a possible predictor of pelvic organ prolapse （POP）. Thisretrospective study investigated 360 women who went to urogynecological clinic for pelvic floor discomfort.Levator hiatus dimensions were obtained by three-dimensional transperineal ultrasound and results werecompared between women with and without significantly objective prolapse （International Continence SocietyPOP quantification, grade 2 or higher）. Receiver operating characteristic （ROC） curve analyses were performed todetermine valid screening index for detecting abnormal levator hiatus distensibility. Women with significantlyobjective prolapse had significantly higher levator hiatus dimensions than those without （all P 〈 0.001）. ROCcurve analyses confirmed that hiatal area （HA） of 19.5 cm2 during Valsalva maneuver can be used as single-screening index for abnormal levator hiatus distensibility with sensitivity of 0.80 and specificity of 0.70. In thisstudy, we used a two-step method and achieved higher sensibility （0.80 vs. 0.87） without reducing specificity （0.70vs. 0.71） compared with a single-screening index method. As a result, we suggest that HA ≥ 19.5 cm2 duringValsalva maneuver is an indicator of abnormal levator hiatus distensibility in Chinese women and that the two-step method has higher sensitivity in detecting abnormal distensibility.展开更多
The ability of 3D ultrasound volume contrast imaging in C-plane (VCI-C) in the assessment of female levator hiatus was analyzed in eighty normal nulliparas. Interoperator variability in levator hiatus measurements was...The ability of 3D ultrasound volume contrast imaging in C-plane (VCI-C) in the assessment of female levator hiatus was analyzed in eighty normal nulliparas. Interoperator variability in levator hiatus measurements was analyzed. The comparison of the axial image of magnetic resonance imaging (MRI) and C-plane image of volume contrast imaging (VCI) in thirty normal nulliparas was also done. It shows that VCI-C can clearly demonstrate the structure and accurately quantitates the size of the levator hiatus. It is reliable, convenient and without contraindication in assessment of female levator hiatus. The technology opens up entirely new modality for assessing female pelvic floor.展开更多
Background:To correct mild and moderate congenital ptosis,traditional surgical techniques usually include dissection of the Müller’s muscle.Meanwhile,both the levator palpebrae superioris and the Müller’s ...Background:To correct mild and moderate congenital ptosis,traditional surgical techniques usually include dissection of the Müller’s muscle.Meanwhile,both the levator palpebrae superioris and the Müller’s muscle play a synergistic role to elevate the upper eyelid.Thus,to protect the Müller muscle and minimize injury,we developed and applied a levator imbrication technique in patients with mild and moderate congenital ptosis and followed it up to evaluate its clinical efficacy.Methods:This retrospective case series included 53 patients with mild and moderate congenital ptosis,all of whom had undergone ptosis correction using the levator imbrication technique at the Plastic and Aesthetic Department of the Second Affiliated Hospital of Zhengzhou University between June 2018 and June 2020.The outcomes of correction,upper eyelid appearance,and operative complications were observed and analyzed.The postoperative follow-up was 3–12 months.Results:Fifty cases of ptosis were fully corrected,and the bilateral double eyelids were smooth and natural.The eyelids of 20 patients were incompletely closed immediately after the operation but were able to close spontaneously within 2 weeks.No serious complications such as exposure keratitis were reported.Three patients with undercorrection underwent reoperation 3 months after the first operation,and ptosis was corrected.Conclusion:The levator imbrication technique for mild and moderate congenital ptosis is simple to perform and shortens the operation time with less damage,stable postoperative outcomes,and no long-term complications.展开更多
目的探讨肛提肌未发生撕脱时,盆腔脏器脱垂(pelvic organ prolapse,POP)的初产妇肛提肌裂孔形态是否发生异常改变。方法收集经阴道分娩且肛提肌未发生撕脱的初产妇107例,出现POP的65例为POP组,未出现POP的42例为对照组。应用经会阴4D盆...目的探讨肛提肌未发生撕脱时,盆腔脏器脱垂(pelvic organ prolapse,POP)的初产妇肛提肌裂孔形态是否发生异常改变。方法收集经阴道分娩且肛提肌未发生撕脱的初产妇107例,出现POP的65例为POP组,未出现POP的42例为对照组。应用经会阴4D盆底超声采集在静息、最大瓦氏状态下两组初产妇肛提肌裂孔形态参数:肛提肌裂孔前后径(LHAP)、肛提肌裂孔左右径(LHLD)、肛提肌裂孔周径(LHC)、肛提肌裂孔面积(LHA)。结果静息状态下POP组及对照组LHAP、LHLD、LHC、LHA比较,差异无统计学意义(P>0.05);最大瓦氏状态下POP组的LHAP、LHLD、LHC、LHA较对照组均增大,差异有统计学意义(P<0.05),当最大瓦氏状态下LHA>18.84 cm^(2),诊断初产妇发生POP的敏感度为73.8%,特异度95.2%,AUC为0.912。结论肛提肌未撕脱的初次经阴道分娩的POP产妇也会发生肛提肌损伤。4D盆底超声下肛提肌裂孔形态的改变可反映肛提肌有无损伤及损伤程度,尤其最大瓦氏状态下肛提肌裂孔的面积与POP相关性很好。展开更多
AIM: To determine if the severity of gastroesophageal reflux disease is dependent on the size of a hiatus hernia. METHODS: Seventy-five patients with either a small(n = 25), medium(n = 25) or large(n = 25) hiatus hern...AIM: To determine if the severity of gastroesophageal reflux disease is dependent on the size of a hiatus hernia. METHODS: Seventy-five patients with either a small(n = 25), medium(n = 25) or large(n = 25) hiatus hernia(assessed by high resolution esophageal manometry) were investigated using 24-h esophageal monitoring and a self-assessed symptom questionnaire. The questionnaire comprised the following items, each graded from 0 to 3 according to severity: heartburn; pharyngeal burning sensation; acid regurgitation; and chest pain. RESULTS: The percentage total reflux time was significantly longer in the group with hernia of 5 cm or more compared with the group with a hernia of < 3 cm(P < 0.002), and the group with a hernia of 3 to < 5 cm(P < 0.04). Pharyngeal burning sensation, heartburn and acid regurgitation were more common with large hernias than small hernias, but the frequency of chest pain was similar in all three hernia groups. CONCLUSION: Patients with a large hiatus hernia are more prone to have pathological gastroesophageal reflux and to have more acid symptoms than patients with a small hiatus hernia. However, it is unlikely that patients with an absence of acid symptoms will have pathological reflux regardless of hernia size.展开更多
An abrupt temperature change and a warming hiatus have strongly influenced the global climate.This study focused on these changes in Inner Mongolia, China. This study used the central clustering method, Mann-Kendall m...An abrupt temperature change and a warming hiatus have strongly influenced the global climate.This study focused on these changes in Inner Mongolia, China. This study used the central clustering method, Mann-Kendall mutation test and other methods to explore the abrupt temperature change and warming hiatus in three different temperature zones of the study region based on average annual data series.Among the temperature metrics investigated, average minimum temperature(Tnav) shifted the earliest,followed by average temperature(Tnv) and average maximum temperature(Txav). The latest change was observed in summer(1990 s), whereas the earliest was observed in winter(1970 s). Before and after the abrupt temperature change, Tnav fluctuated considerably, whereas there was only a slight change in Txav.Before and after the abrupt temperature change, the winter temperature changed more dramatically than the summer temperature. Before the abrupt temperature change, Tnav in the central region(0.322°C/10 a)and west region(0.48°C/10 a) contributed the most to the increasing temperatures. After the abrupt temperature change, Tnav in winter in the central region(0.519°C/10 a) and in autumn in the west region(0.729°C/10 a) contributed the most to the temperature increases. Overall, in the years in which temperature shifts occurred early, a warming hiatus also appeared early. The three temperature metrics in spring(1991)in the east region were the first to exhibit a warming hiatus. In the east region, Txav displayed the lowest rate of increase(0.412°C/a) in the period after the abrupt temperature change and before the warming hiatus,and the highest rate of increase after the warming hiatus.展开更多
Taken as an example the Upper Permian reef section on the carbonate platformmargin at Ziyun, Guizhou, the paper discusses the missing time of a hiatus surface, an impor-tant problem in chemical sequence stratigraphy, ...Taken as an example the Upper Permian reef section on the carbonate platformmargin at Ziyun, Guizhou, the paper discusses the missing time of a hiatus surface, an impor-tant problem in chemical sequence stratigraphy, with the concept of cosmic chemistry. Then thepaper proposes a series of new concepts for chemical sequence stratigraphy, including the con-densation surface, relative compaction factor and time missing factor. Finally a quantitativecurve of Late Permian relative sea-level change in the Ziyun area is presented with timecoordinates.展开更多
AIM:To compare frontalis sling and tarsoconjunctival mullerectomy plus levator resection(TCMLR)in subjects with severe unilateral congenital ptosis with poor levator function(LF).METHODS:A prospective non-randomized n...AIM:To compare frontalis sling and tarsoconjunctival mullerectomy plus levator resection(TCMLR)in subjects with severe unilateral congenital ptosis with poor levator function(LF).METHODS:A prospective non-randomized nonblinded single center clinical trial.Fifty patients with severe unilateral congenital ptosis with poor LF were recruited.The frontalis sling and TCMLR were performed and the functional,cosmetic outcomes,complications,and success rate were evaluated at 1,3,and 6mo postoperatively.The t-test,Chi-square,Fishers exact,and nonparametric MannWhitney tests were used by SPSS software.RESULTS:Frontalis sling and TCMLR procedures were performed on 26 and 24 patients respectively.The mean age was 10.97±10.67y.LF was significantly better in the TCMLR group at months 1,3,and 6(P=0.002).Lagophthalmos was more common in the TCMLR group(no significant difference).At month 3,mild punctate epithelial erosions were observed more in the frontalis sling group(P=0.002).Significant complete success rate of 1st and 6th month for the frontalis sling vs TCMLR groups were 50%vs 20.8%(P=0.02),and 38.4%vs 50%(P=0.03)respectively.CONCLUSION:Complete success rate of TCMLR is higher in long-term follow-up in contrast with the frontalis sling in the short-term.Transient complications are more detected in mid-term follow-ups in both groups.展开更多
"Warming hiatus" occurred in the AltaySayan Mountain Region, Siberia in c. 1997–2014. We analyzed evergreen conifer(EGC) stands area(satellite data) and trees(Siberian pine, Pinus sibirica Du Tour, Siberian..."Warming hiatus" occurred in the AltaySayan Mountain Region, Siberia in c. 1997–2014. We analyzed evergreen conifer(EGC) stands area(satellite data) and trees(Siberian pine, Pinus sibirica Du Tour, Siberian fir, Abies sibirica Ledeb.) growth increment(dendrochronology data) response to climate variables before and during the hiatus. During the hiatus, EGC area increased in the highlands(>1000 m)(+30%), whereas at low and middle elevations(<1000 m. a.s.l.) the EGC area decreased(-7%). The EGC area increase was observed on the rain-ward northwest slopes mainly. In highlands, EGC area increase mainly correlated with summer air temperature, whereas at low and middle elevations EGC area decrease correlated with drought index SPEI and vapor pressure deficit(VPD). EGC mortality(fir and Siberian pine) in lowland was caused by the synergy of water stress(inciting factor) and barkbeetle attacks(contributing factor). Tree growth increment(GI) dynamics differs with respect to elevation. At high elevation(1700 m) GI permanently increased since warming onset, whereas at the middle(900 m) and low elevations(450 m) GI increased until c. 1983 yr. with followed depression. That GI "breakpoint" occurred about a decade before hiatus onset. In spite of growth depression, during hiatus GI was higher than that in pre-warming period. At high elevation, GI positively responded to elevated June temperatures and negatively to moisture increase(precipitation, root zone moisture content, VPD, and SPEI). At low elevation GI negatively responded to June temperatures and positively to moisture increase. For both, low and high elevation, these patterns persisted throughout the study period(1967–2014). On the contrary, at middle elevations GI dependence on climate variables switch after breakpoint year(1983). Before breakpoint, June air temperature(positive correlation) and moisture(negative correlations) controlled GI. Further temperature increase leads GI depression and switched correlation signs to opposite(from positive to negative with temperature, and from negative to positive with moisture variables).展开更多
Purpose:.To evaluate the surgical effect of levator muscle shortening and levator aponeurosis tucking in treating minimal and moderate congenital blepharoptosis.Methods:.Clinical data of 28 patients(40 eyes) diagnosed...Purpose:.To evaluate the surgical effect of levator muscle shortening and levator aponeurosis tucking in treating minimal and moderate congenital blepharoptosis.Methods:.Clinical data of 28 patients(40 eyes) diagnosed with mide and moderate congenital blepharoptosis at our institution were retrospectively analyzed. Postoperative efficacy was evaluated and statistically compared between these two techniques.Results:.During 14 months follow-up,.16 eyes with ptosis undergoing levator muscle shortening were treated,.3 with undercorrection of ptosis and 1 with overcorrection of ptosis.In patients receiving levator aponeurosis tucking,.16 eyes were cured and 4 with undercorrection of ptosis.Conclusion:.Both levator muscle shortening and levator aponeurosis tucking are safe and efficacious for correcting minimal and moderate congenital blepharoptosis.展开更多
Temperature is a crucial factor that affects in flue nza tran smissi on. Therefore, several studies have correlated various aspects of in flue nza with temperature from the global warming period during which temperatu...Temperature is a crucial factor that affects in flue nza tran smissi on. Therefore, several studies have correlated various aspects of in flue nza with temperature from the global warming period during which temperature exhibits a clear trend. The global warming hiatus has been existing since the year 1998. This provides an opportunity to investigate the effect of temperature on the transmission of influenza from the viewpoint that temperature is trendless.展开更多
Introduction: The ptosis is a fall of the upper eyelid in relation to a deficit of the levator device of this one. In practice, it poses two major problems, the first one is the eminent risk of amblyopia during severe...Introduction: The ptosis is a fall of the upper eyelid in relation to a deficit of the levator device of this one. In practice, it poses two major problems, the first one is the eminent risk of amblyopia during severe congenital ptosis, and the second is of an aesthetic nature, representing the main reason for consultation. The aim of this work is to evaluate the interest of the levator palpebrae superioris muscle plication in the ptosis surgery. Materials and Methods: We collected 12 patients who received a correction of their ptosis by plication of the levator palpebrae superioris muscle over a period of 3 years from January 2012 to December 2014. Result: The mean age at treatment was 22 years;the ptosis was congenital in 8 cases, and acquired in 4. The ptosis was major in 67% and moderate in 33% of the cases. Muscle plication was the basic surgical technique in all patients in our series. The function and aesthetic results were satisfying in 6 cases (50%), good in 4 cases (34%), acceptable in 1 case and bad in 1 case (8%). Discussion: The comparative study has shown that the plication of the levator palpebrae superioris muscle is a possible alternative for the correction of ptosis whatever the type of ptosis with results comparable to the reference technique compared to the degree of correction, whereas the operative follow-up is simpler and more minor complications. Conclusion: The surgical treatment of ptosis should be done after a systematic clinical examination and after very precise indications. However, the plication of the levator muscle of the upper eyelid has shown its functional and aesthetic efficiency in congenital ptosis and in the ptosis of the adult.展开更多
The Eocene succession of the El Basatin Section in Gebel Mokattam, east of Cairo, consists, from base to top, of two main units; the Mokattam and Maadi Formations. The Mokattam Formation consists of two Members, the B...The Eocene succession of the El Basatin Section in Gebel Mokattam, east of Cairo, consists, from base to top, of two main units; the Mokattam and Maadi Formations. The Mokattam Formation consists of two Members, the Building Stone Member and the Giushi Member. The Upper Building Stone Member yielded six species of Nummulites belonging to the Upper Lutetian. These species are: Nummulites farisi Hussein et al., 2004; Nummulites cf. praegizehensis Boukhary and Hussein-Kamel, 1993; Nummulites cf. gizehensis(Forsk?l, 1775); Nummulites discorbinus(Schlotheim 1820) and Arxina schwageri(Silvestri, 1928) emended by Boukhary et al. 2012 and Nummulites crassichordatus Boukhary et al., 2010. The Giushi Member yielded three species that indicate a Bartonian age. These species, which continued from their first appearance in the Upper Building Stone Members, are N. discorbinus, A. schwageri and N. crassichordatus. The Maadi Formation, which has been previously considered to be of Bartonian–Priabonian age, is devoid of fossils in the study section. The two members of the Mokattam Formation represent a carbonate platform facies. The deposition of the Upper Building Stone Member was disturbed during the Lutetian by slumping and a convolute-bedding interval, indicating a short hiatus. The subsequent regression resulted in a very shallow marine to near-shore facies in the above Maadi Formation.展开更多
The perineal membrane (PM) is a thick, elastic fiber-rich, smooth muscle-poor membrane extending along the vestibule and lower vaginal wall and embedding the urethrovaginal sphincter and compressor urethrae muscles. T...The perineal membrane (PM) is a thick, elastic fiber-rich, smooth muscle-poor membrane extending along the vestibule and lower vaginal wall and embedding the urethrovaginal sphincter and compressor urethrae muscles. To provide a better understanding of the topographical relationship between the PM and the levator ani muscle, we examined histological sections from 15 female cadavers. The composite fibers of the PM were usually continuous with that of a fascia covering the inferior or lateral surface of the levator ani (fascia diaphragmatis pelvis inferior) rather than the endopelvic fascia covering the superior or medial surface of the latter muscle. However, this fascial connection was sometimes interrupted by a venous plexus. The deep transverse perineal muscle was consistently adjacent to the posterolateral aspect of the PM, but whether it extended superficially or deeply to the PM depended on size of the muscle. In contrast to the endopelvic fascia embedding abundant middle-sized nerves (cavernous and sphincter nerves;0.05 - 0.1 mm in thickness), the PM contained very thin nerves: many in 10 cadavers but few in 5 cadavers. Most of the nerves seemed to be sensory on the basis of immunohistochemistry. The levator ani muscle was considered likely to provide traction force to the PM, but active elevation appeared to be difficult because of the highly elastic nature of the PM and the interrupting venous plexus. Loss of nerves in the PM might be one of a number of factors that can accelerate pelvic organ prolapse.展开更多
基金The National Science Foundation of China is acknowledged for providing financial support to this work （No. 81571699）.
文摘The dimension of the levator hiatus is a possible predictor of pelvic organ prolapse （POP）. Thisretrospective study investigated 360 women who went to urogynecological clinic for pelvic floor discomfort.Levator hiatus dimensions were obtained by three-dimensional transperineal ultrasound and results werecompared between women with and without significantly objective prolapse （International Continence SocietyPOP quantification, grade 2 or higher）. Receiver operating characteristic （ROC） curve analyses were performed todetermine valid screening index for detecting abnormal levator hiatus distensibility. Women with significantlyobjective prolapse had significantly higher levator hiatus dimensions than those without （all P 〈 0.001）. ROCcurve analyses confirmed that hiatal area （HA） of 19.5 cm2 during Valsalva maneuver can be used as single-screening index for abnormal levator hiatus distensibility with sensitivity of 0.80 and specificity of 0.70. In thisstudy, we used a two-step method and achieved higher sensibility （0.80 vs. 0.87） without reducing specificity （0.70vs. 0.71） compared with a single-screening index method. As a result, we suggest that HA ≥ 19.5 cm2 duringValsalva maneuver is an indicator of abnormal levator hiatus distensibility in Chinese women and that the two-step method has higher sensitivity in detecting abnormal distensibility.
基金the Scientific Research Project of Shanghai Municipal Health Bureau (No. 2008083)
文摘The ability of 3D ultrasound volume contrast imaging in C-plane (VCI-C) in the assessment of female levator hiatus was analyzed in eighty normal nulliparas. Interoperator variability in levator hiatus measurements was analyzed. The comparison of the axial image of magnetic resonance imaging (MRI) and C-plane image of volume contrast imaging (VCI) in thirty normal nulliparas was also done. It shows that VCI-C can clearly demonstrate the structure and accurately quantitates the size of the levator hiatus. It is reliable, convenient and without contraindication in assessment of female levator hiatus. The technology opens up entirely new modality for assessing female pelvic floor.
文摘Background:To correct mild and moderate congenital ptosis,traditional surgical techniques usually include dissection of the Müller’s muscle.Meanwhile,both the levator palpebrae superioris and the Müller’s muscle play a synergistic role to elevate the upper eyelid.Thus,to protect the Müller muscle and minimize injury,we developed and applied a levator imbrication technique in patients with mild and moderate congenital ptosis and followed it up to evaluate its clinical efficacy.Methods:This retrospective case series included 53 patients with mild and moderate congenital ptosis,all of whom had undergone ptosis correction using the levator imbrication technique at the Plastic and Aesthetic Department of the Second Affiliated Hospital of Zhengzhou University between June 2018 and June 2020.The outcomes of correction,upper eyelid appearance,and operative complications were observed and analyzed.The postoperative follow-up was 3–12 months.Results:Fifty cases of ptosis were fully corrected,and the bilateral double eyelids were smooth and natural.The eyelids of 20 patients were incompletely closed immediately after the operation but were able to close spontaneously within 2 weeks.No serious complications such as exposure keratitis were reported.Three patients with undercorrection underwent reoperation 3 months after the first operation,and ptosis was corrected.Conclusion:The levator imbrication technique for mild and moderate congenital ptosis is simple to perform and shortens the operation time with less damage,stable postoperative outcomes,and no long-term complications.
文摘目的探讨肛提肌未发生撕脱时,盆腔脏器脱垂(pelvic organ prolapse,POP)的初产妇肛提肌裂孔形态是否发生异常改变。方法收集经阴道分娩且肛提肌未发生撕脱的初产妇107例,出现POP的65例为POP组,未出现POP的42例为对照组。应用经会阴4D盆底超声采集在静息、最大瓦氏状态下两组初产妇肛提肌裂孔形态参数:肛提肌裂孔前后径(LHAP)、肛提肌裂孔左右径(LHLD)、肛提肌裂孔周径(LHC)、肛提肌裂孔面积(LHA)。结果静息状态下POP组及对照组LHAP、LHLD、LHC、LHA比较,差异无统计学意义(P>0.05);最大瓦氏状态下POP组的LHAP、LHLD、LHC、LHA较对照组均增大,差异有统计学意义(P<0.05),当最大瓦氏状态下LHA>18.84 cm^(2),诊断初产妇发生POP的敏感度为73.8%,特异度95.2%,AUC为0.912。结论肛提肌未撕脱的初次经阴道分娩的POP产妇也会发生肛提肌损伤。4D盆底超声下肛提肌裂孔形态的改变可反映肛提肌有无损伤及损伤程度,尤其最大瓦氏状态下肛提肌裂孔的面积与POP相关性很好。
文摘AIM: To determine if the severity of gastroesophageal reflux disease is dependent on the size of a hiatus hernia. METHODS: Seventy-five patients with either a small(n = 25), medium(n = 25) or large(n = 25) hiatus hernia(assessed by high resolution esophageal manometry) were investigated using 24-h esophageal monitoring and a self-assessed symptom questionnaire. The questionnaire comprised the following items, each graded from 0 to 3 according to severity: heartburn; pharyngeal burning sensation; acid regurgitation; and chest pain. RESULTS: The percentage total reflux time was significantly longer in the group with hernia of 5 cm or more compared with the group with a hernia of < 3 cm(P < 0.002), and the group with a hernia of 3 to < 5 cm(P < 0.04). Pharyngeal burning sensation, heartburn and acid regurgitation were more common with large hernias than small hernias, but the frequency of chest pain was similar in all three hernia groups. CONCLUSION: Patients with a large hiatus hernia are more prone to have pathological gastroesophageal reflux and to have more acid symptoms than patients with a small hiatus hernia. However, it is unlikely that patients with an absence of acid symptoms will have pathological reflux regardless of hernia size.
基金supported by the Program for Young Talents of Science and Technology in Universities of the Inner Mongolia Autonomous Regionthe National Key Research and Development Plan (2017YFC0404305)the National Natural Science Foundation of China (51669016)
文摘An abrupt temperature change and a warming hiatus have strongly influenced the global climate.This study focused on these changes in Inner Mongolia, China. This study used the central clustering method, Mann-Kendall mutation test and other methods to explore the abrupt temperature change and warming hiatus in three different temperature zones of the study region based on average annual data series.Among the temperature metrics investigated, average minimum temperature(Tnav) shifted the earliest,followed by average temperature(Tnv) and average maximum temperature(Txav). The latest change was observed in summer(1990 s), whereas the earliest was observed in winter(1970 s). Before and after the abrupt temperature change, Tnav fluctuated considerably, whereas there was only a slight change in Txav.Before and after the abrupt temperature change, the winter temperature changed more dramatically than the summer temperature. Before the abrupt temperature change, Tnav in the central region(0.322°C/10 a)and west region(0.48°C/10 a) contributed the most to the increasing temperatures. After the abrupt temperature change, Tnav in winter in the central region(0.519°C/10 a) and in autumn in the west region(0.729°C/10 a) contributed the most to the temperature increases. Overall, in the years in which temperature shifts occurred early, a warming hiatus also appeared early. The three temperature metrics in spring(1991)in the east region were the first to exhibit a warming hiatus. In the east region, Txav displayed the lowest rate of increase(0.412°C/a) in the period after the abrupt temperature change and before the warming hiatus,and the highest rate of increase after the warming hiatus.
基金This study was supported by the National Climbing Project "Sequence Stratigraphy and Sea-level Eustasy on the Margins of the Chinese Palaeocontinent"(No.8502208)and the China Postdoctoral Foundation.
文摘Taken as an example the Upper Permian reef section on the carbonate platformmargin at Ziyun, Guizhou, the paper discusses the missing time of a hiatus surface, an impor-tant problem in chemical sequence stratigraphy, with the concept of cosmic chemistry. Then thepaper proposes a series of new concepts for chemical sequence stratigraphy, including the con-densation surface, relative compaction factor and time missing factor. Finally a quantitativecurve of Late Permian relative sea-level change in the Ziyun area is presented with timecoordinates.
基金Supported by Tehran University of Medical Sciences(No.9511257008)。
文摘AIM:To compare frontalis sling and tarsoconjunctival mullerectomy plus levator resection(TCMLR)in subjects with severe unilateral congenital ptosis with poor levator function(LF).METHODS:A prospective non-randomized nonblinded single center clinical trial.Fifty patients with severe unilateral congenital ptosis with poor LF were recruited.The frontalis sling and TCMLR were performed and the functional,cosmetic outcomes,complications,and success rate were evaluated at 1,3,and 6mo postoperatively.The t-test,Chi-square,Fishers exact,and nonparametric MannWhitney tests were used by SPSS software.RESULTS:Frontalis sling and TCMLR procedures were performed on 26 and 24 patients respectively.The mean age was 10.97±10.67y.LF was significantly better in the TCMLR group at months 1,3,and 6(P=0.002).Lagophthalmos was more common in the TCMLR group(no significant difference).At month 3,mild punctate epithelial erosions were observed more in the frontalis sling group(P=0.002).Significant complete success rate of 1st and 6th month for the frontalis sling vs TCMLR groups were 50%vs 20.8%(P=0.02),and 38.4%vs 50%(P=0.03)respectively.CONCLUSION:Complete success rate of TCMLR is higher in long-term follow-up in contrast with the frontalis sling in the short-term.Transient complications are more detected in mid-term follow-ups in both groups.
基金supported by the Russian Foundation for Basic Research (grants #18-0500432)supported by the Russian Science Foundation (1774-10113)
文摘"Warming hiatus" occurred in the AltaySayan Mountain Region, Siberia in c. 1997–2014. We analyzed evergreen conifer(EGC) stands area(satellite data) and trees(Siberian pine, Pinus sibirica Du Tour, Siberian fir, Abies sibirica Ledeb.) growth increment(dendrochronology data) response to climate variables before and during the hiatus. During the hiatus, EGC area increased in the highlands(>1000 m)(+30%), whereas at low and middle elevations(<1000 m. a.s.l.) the EGC area decreased(-7%). The EGC area increase was observed on the rain-ward northwest slopes mainly. In highlands, EGC area increase mainly correlated with summer air temperature, whereas at low and middle elevations EGC area decrease correlated with drought index SPEI and vapor pressure deficit(VPD). EGC mortality(fir and Siberian pine) in lowland was caused by the synergy of water stress(inciting factor) and barkbeetle attacks(contributing factor). Tree growth increment(GI) dynamics differs with respect to elevation. At high elevation(1700 m) GI permanently increased since warming onset, whereas at the middle(900 m) and low elevations(450 m) GI increased until c. 1983 yr. with followed depression. That GI "breakpoint" occurred about a decade before hiatus onset. In spite of growth depression, during hiatus GI was higher than that in pre-warming period. At high elevation, GI positively responded to elevated June temperatures and negatively to moisture increase(precipitation, root zone moisture content, VPD, and SPEI). At low elevation GI negatively responded to June temperatures and positively to moisture increase. For both, low and high elevation, these patterns persisted throughout the study period(1967–2014). On the contrary, at middle elevations GI dependence on climate variables switch after breakpoint year(1983). Before breakpoint, June air temperature(positive correlation) and moisture(negative correlations) controlled GI. Further temperature increase leads GI depression and switched correlation signs to opposite(from positive to negative with temperature, and from negative to positive with moisture variables).
文摘Purpose:.To evaluate the surgical effect of levator muscle shortening and levator aponeurosis tucking in treating minimal and moderate congenital blepharoptosis.Methods:.Clinical data of 28 patients(40 eyes) diagnosed with mide and moderate congenital blepharoptosis at our institution were retrospectively analyzed. Postoperative efficacy was evaluated and statistically compared between these two techniques.Results:.During 14 months follow-up,.16 eyes with ptosis undergoing levator muscle shortening were treated,.3 with undercorrection of ptosis and 1 with overcorrection of ptosis.In patients receiving levator aponeurosis tucking,.16 eyes were cured and 4 with undercorrection of ptosis.Conclusion:.Both levator muscle shortening and levator aponeurosis tucking are safe and efficacious for correcting minimal and moderate congenital blepharoptosis.
基金funded by the National Natural Science Foundation of China [No.31460296 and 31560315]the Key Project of Guangxi Scientific Research and Technology Development Plan [AB17190534]the central government directed special funds for local science and technology development project [AZ1949015]
文摘Temperature is a crucial factor that affects in flue nza tran smissi on. Therefore, several studies have correlated various aspects of in flue nza with temperature from the global warming period during which temperature exhibits a clear trend. The global warming hiatus has been existing since the year 1998. This provides an opportunity to investigate the effect of temperature on the transmission of influenza from the viewpoint that temperature is trendless.
文摘Introduction: The ptosis is a fall of the upper eyelid in relation to a deficit of the levator device of this one. In practice, it poses two major problems, the first one is the eminent risk of amblyopia during severe congenital ptosis, and the second is of an aesthetic nature, representing the main reason for consultation. The aim of this work is to evaluate the interest of the levator palpebrae superioris muscle plication in the ptosis surgery. Materials and Methods: We collected 12 patients who received a correction of their ptosis by plication of the levator palpebrae superioris muscle over a period of 3 years from January 2012 to December 2014. Result: The mean age at treatment was 22 years;the ptosis was congenital in 8 cases, and acquired in 4. The ptosis was major in 67% and moderate in 33% of the cases. Muscle plication was the basic surgical technique in all patients in our series. The function and aesthetic results were satisfying in 6 cases (50%), good in 4 cases (34%), acceptable in 1 case and bad in 1 case (8%). Discussion: The comparative study has shown that the plication of the levator palpebrae superioris muscle is a possible alternative for the correction of ptosis whatever the type of ptosis with results comparable to the reference technique compared to the degree of correction, whereas the operative follow-up is simpler and more minor complications. Conclusion: The surgical treatment of ptosis should be done after a systematic clinical examination and after very precise indications. However, the plication of the levator muscle of the upper eyelid has shown its functional and aesthetic efficiency in congenital ptosis and in the ptosis of the adult.
文摘The Eocene succession of the El Basatin Section in Gebel Mokattam, east of Cairo, consists, from base to top, of two main units; the Mokattam and Maadi Formations. The Mokattam Formation consists of two Members, the Building Stone Member and the Giushi Member. The Upper Building Stone Member yielded six species of Nummulites belonging to the Upper Lutetian. These species are: Nummulites farisi Hussein et al., 2004; Nummulites cf. praegizehensis Boukhary and Hussein-Kamel, 1993; Nummulites cf. gizehensis(Forsk?l, 1775); Nummulites discorbinus(Schlotheim 1820) and Arxina schwageri(Silvestri, 1928) emended by Boukhary et al. 2012 and Nummulites crassichordatus Boukhary et al., 2010. The Giushi Member yielded three species that indicate a Bartonian age. These species, which continued from their first appearance in the Upper Building Stone Members, are N. discorbinus, A. schwageri and N. crassichordatus. The Maadi Formation, which has been previously considered to be of Bartonian–Priabonian age, is devoid of fossils in the study section. The two members of the Mokattam Formation represent a carbonate platform facies. The deposition of the Upper Building Stone Member was disturbed during the Lutetian by slumping and a convolute-bedding interval, indicating a short hiatus. The subsequent regression resulted in a very shallow marine to near-shore facies in the above Maadi Formation.
文摘The perineal membrane (PM) is a thick, elastic fiber-rich, smooth muscle-poor membrane extending along the vestibule and lower vaginal wall and embedding the urethrovaginal sphincter and compressor urethrae muscles. To provide a better understanding of the topographical relationship between the PM and the levator ani muscle, we examined histological sections from 15 female cadavers. The composite fibers of the PM were usually continuous with that of a fascia covering the inferior or lateral surface of the levator ani (fascia diaphragmatis pelvis inferior) rather than the endopelvic fascia covering the superior or medial surface of the latter muscle. However, this fascial connection was sometimes interrupted by a venous plexus. The deep transverse perineal muscle was consistently adjacent to the posterolateral aspect of the PM, but whether it extended superficially or deeply to the PM depended on size of the muscle. In contrast to the endopelvic fascia embedding abundant middle-sized nerves (cavernous and sphincter nerves;0.05 - 0.1 mm in thickness), the PM contained very thin nerves: many in 10 cadavers but few in 5 cadavers. Most of the nerves seemed to be sensory on the basis of immunohistochemistry. The levator ani muscle was considered likely to provide traction force to the PM, but active elevation appeared to be difficult because of the highly elastic nature of the PM and the interrupting venous plexus. Loss of nerves in the PM might be one of a number of factors that can accelerate pelvic organ prolapse.
