This study investigated the effects of upper-level descending inflow(ULDI)associated with inner-eyewall convection on the formation of the moat in tropical cyclones(TCs)with secondary eyewall formation(SEF).In our num...This study investigated the effects of upper-level descending inflow(ULDI)associated with inner-eyewall convection on the formation of the moat in tropical cyclones(TCs)with secondary eyewall formation(SEF).In our numerical experiments,a clear moat with SEF occurred in TCs with a significant ULDI,while no SEF occurred in TCs without a significant ULDI.The eyewall convection developed more vigorously in the control run.A ULDI occurred outside the inner-eyewall convection,where it was symmetrically unstable.The ULDI was initially triggered by the diabatic warming released by the inner eyewall and later enhanced by the cooling below the anvil cloud.The ULDI penetrated the outer edge of the inner eyewall with relatively dry air and prevented excessive solid-phase hydrometeors from being advected further outward.It produced extensive sublimation cooling of falling hydrometeors between the eyewall and the outer convection.The sublimation cooling resulted in negative buoyancy and further induced strong subsidence between the eyewall and the outer convection.As a result,a clear moat was generated.Development of the moat in the ongoing SEF prevented the outer rainband from moving farther inward,helping the outer rainband to symmetrize into an outer eyewall.In the sensitivity experiment,no significant ULDI formed since the eyewall convection was weaker,and the eyewall anvil developed relatively lower,meaning the formation of a moat and thus an outer eyewall was less likely.This study suggests that a better-represented simulation of inner-eyewall convective structures and distribution of the solid-phase hydrometeors is important to the prediction of SEF.展开更多
BACKGROUND Arterial cannulation sites for the surgical repair of type A aortic dissection(AAD)have evolved from right axillary artery(AA)cannulation to bilateral carotid artery(CA)based of femoral artery(FA)cannulatio...BACKGROUND Arterial cannulation sites for the surgical repair of type A aortic dissection(AAD)have evolved from right axillary artery(AA)cannulation to bilateral carotid artery(CA)based of femoral artery(FA)cannulation.Postoperative descending aorta remodeling is closely linked to the false lumen area ratio(FLAR),defined as false lumen area/aortic area,as well as to the incidence of renal replacement therapy(RRT).AIM To investigate the effect of the updated arterial cannulation strategy on descending aortic remodeling.METHODS A total of 443 AAD patients who received FA combined cannulation between March 2015 and March 2023 were included in the study.Of these,209 received right AA cannulation and 234 received bilateral CA cannulation.The primary outcome was the change in FLAR,as calculated from computed tomography angiography in three segments of the descending aorta:Thoracic(S1),upper abdominal(S2),and lower abdominal(S3).Secondary outcomes were the incidence of RRT and the serum inflammation response,as observed by the levels of high sensitivity C reaction protein(hs-CRP)and Interleukin-6(IL-6).RESULTS The postoperative/preoperative ratio of FLAR in S2 and S3 was higher in the AA group compared to the CA group(S2:0.80±0.08 vs 0.75±0.07,P<0.001;S3:0.57±0.12 vs 0.50±0.12,P<0.001,respectively).The AA group also had a significantly higher incidence of RRT(19.1%vs 8.5%,P=0.001;odds ratio:2.533,95%CI:1.427-4.493)and higher levels of inflammation cytokines 24 h after the procedure[hr-CRP:117±17 vs 104±15 mg/L;IL-6:129(103,166)vs 83(69,101)pg/mL;both P<0.001]compared to the CA group.CONCLUSION The CA cannulation strategy was associated with better abdominal aorta remodeling after AAD repair compared to AA cannulation,as observed by a greater change in FLAR and lower incidence of RRT.展开更多
Orpheus Descending is written by American famous playwright Tennessee Williams. According to the portrayal of a series marginalized people, this drama presents the solitude in human beings' heart and the estrangem...Orpheus Descending is written by American famous playwright Tennessee Williams. According to the portrayal of a series marginalized people, this drama presents the solitude in human beings' heart and the estrangement in interpersonal relations. This paper tries to analyze the solitude theme in this drama from philosophic aspect and realistic aspect, combining alienation theory and existentialism theory to analyze the reason and the manifestation of solitude.展开更多
Purpose: Descending necrotizing mediastinitis(DNM) is a lethal and acute suppurative disease. This report aimed to summarize our experience in the treatment of DNM with continuous negative pressure catheter drainage a...Purpose: Descending necrotizing mediastinitis(DNM) is a lethal and acute suppurative disease. This report aimed to summarize our experience in the treatment of DNM with continuous negative pressure catheter drainage and transnasal jejunal feeding by interventional techniques. Materials and Methods: We retrospectively analyzed relevant clinical data of patients with DNM who underwent continuous negative pressure catheter drainage and transnasal jejunal feeding. All drainage catheters and jejunal feeding tubes were inserte d by interventional techniques. Results: In total, 21 patients were diagnosed with DNM by esophagography and computed tomography(CT). Catheters for the drainage of mediastinal abscesses as well as transnasal jejunal feeding tubes were successfully placed in all patients, indicating a 100% success rate. Of all patients, 13 underwent insertion of abscess drainage catheters through percutaneous puncture under DynaCT guidance, while eight had drainage catheter insertion through fistula orifices in the posterior nasopharyngeal wall or esophagus under fluoroscopic guidance. In total, 26 drainage tubes were inserted. One patient with diabetes died of sepsis and diabetic ketoacidosis 5 days postoperatively, while the remaining 20 patients showed good recovery with successful removal of the drainage catheters. Durations of catheterization were 45.2±50.44 days. The overall clinical success rate was 95.2%. Conclusion: The above described methods are non-surgical, minimally invasive and efficacious, and may be alternative therapeutic tools for patients who are not eligible for surgical operation, have a high postoperative risk, or are more likely to choose minimally invasive techniques.展开更多
Based on the working principle of satellite radars, the earthquake deformation field measured by interferometric synthetic aperture（InSAR） is the projection of ground displacement associated with the seismogenic fau...Based on the working principle of satellite radars, the earthquake deformation field measured by interferometric synthetic aperture（InSAR） is the projection of ground displacement associated with the seismogenic fault in the line of sight（LOS） of the satellite. However, LOS projections are complex, and are not only related to the ascending/descending modes and incidence angles of SAR data, but also related to the strike and motion senses of the fault. Even for the same earthquake, the LOS deformation derived from different ascending/descending data can be almost identical in one case, but quite different in another case, which makes the interpretation of InSAR seismic deformation and its comparison with field observations difficult. In this study, we undertook a quantitative analysis of the relationships between LOS observation sensitivity of InSAR and fault strike, fault motion sense, and ascending/descending modes, as well as 3D deformation fields. We studied the features and differences of the LOS deformation fields in different types of earthquakes using ascending/descending modes, with a particularly detailed analysis of the relations for a strikeslip type of earthquake. We also summarized the characteristics of LOS deformation fields of faults with different strikes and optimal observational data modes. Taking the strike-slip Yushu earthquake and the normal Gaize event as examples, we used SAR data of the ascending/descending modes to verify the results of quantitative calculations. These analyses will not only provide a more reasonable interpretation of InSAR seismic deformation fields and but also help understand the differences of seismic deformation fields revealed by data with different observational modes, therefore promoting the application of InSAR technology in seismology.展开更多
An adaptive chaotic gradient descending optimization algorithm for single objective optimization was presented. A local minimum judged by two rules was obtained by an improved mutative-step gradient descending method....An adaptive chaotic gradient descending optimization algorithm for single objective optimization was presented. A local minimum judged by two rules was obtained by an improved mutative-step gradient descending method. A new optimal minimum was obtained to replace the local minimum by mutative-scale chaotic search algorithm whose scales are magnified gradually from a small scale in order to escape local minima. The global optimal value was attained by repeatedly iterating. At last, a BP (back-propagation) neural network model for forecasting slag output in matte converting was established. The algorithm was used to train the weights of the BP neural network model. The simulation results with a training data set of 400 samples show that the training process can be finished within 300 steps to obtain the global optimal value, and escape local minima effectively. An optimization system for operation parameters, which includes the forecasting model, is achieved, in which the output of converter increases by 6.0%, and the amount of the treated cool materials rises by 7.8% in the matte converting process.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
Objective: To determine diagnostic utility of Doppler measurements in fetal descending aorta and umbilical arteries in predicting intrauterine growth retarded (IUGR) fetuses at risk in pregnancies complicated by preec...Objective: To determine diagnostic utility of Doppler measurements in fetal descending aorta and umbilical arteries in predicting intrauterine growth retarded (IUGR) fetuses at risk in pregnancies complicated by preeclampsia and/or HELLP syndrome. Methods: Doppler measurements were taken in fetal descending aorta and umbilical arteries of 53 patients with pre-eclampsia, 10 of whom had HELLP syndrome using fetometry (ACUSON 128XP/10, 3.5 MHz probe). These values were compared with those of 44 appropriate-for-gestational age singleton pregnancies (AGA). Doppler Indices (Resistance Index (RI), Systolic/Diastolic (S/D) ratio) and end-diastolic flows were related to fetal heart rate (FHR) during contraction stress test, to cord blood parameters (pH, Base Excess) and to Apgar Scores. Results: In contrast to AGA fetuses, IUGR fetuses had decreased end-diastolic flow and an increase of Doppler Indices significantly earlier in the descending aorta (p < 0.05), compared to umbilical artery. Increased RI’s, S/D ratios and a decrease of end-diastolic flow in fetal aorta were significantly correlated to frequency of FHR decelerations during contraction stress tests, pH, Base Excess (p < 0.01) and Apgar Scores in IUGR fetuses. Conclusion: A decrease in end-diastolic flow paralleled with an increase in Doppler indices in fetal descending aorta reflect oxygen deprivation in IUGR fetuses during pre-eclamptic pregnancies with or without HELLP syndrome. While ductus venosus and umbilical artery are more frequently used nowadays to determine fetal oxygen deprivation, Doppler measurements in fetal descending aorta provide additional information for early detection of fetuses at risk for IUGR in pregnancies complicated with pre-eclampsia and/or HELLP展开更多
Sensory inputs stimulated by Zusanli（ST36） acupuncture in the abdomen are known to converge in the upper cervical cord. However, it is unclear whether these inputs are subsequently conveyed to the hypothalamic parav...Sensory inputs stimulated by Zusanli（ST36） acupuncture in the abdomen are known to converge in the upper cervical cord. However, it is unclear whether these inputs are subsequently conveyed to the hypothalamic paraventricular nucleus and what kind of afferent fibers are involved. We focused on the upper cervical cord, where afferent inputs converge, and detected c-fos expression in oxytocinergic neurons. We found that Zusanli acupuncture therapy effectively elevated intragastric pressure, but inhibited expression of c-fos in oxytocinergic neurons of the paraventricular nucleus in upper cervical cord injured rats. These Zusanli acupuncture effects remained even after complete dorsal cord transection. However, after complete transection of the spinal cord or dorsolateral funiculus, the effects were significantly attenuated and even disappeared. These findings suggest that the paraventricular nucleus is responsible for pooling and integrating signals from the Zusanli acupuncture and sensory information from the intragastric pressure variation, thereby contributing to the regulation of intragastric pressure. The upper cervical cord serves as the key link between ascending and descending pathways, which conveys afferent inputs to the paraventricular nucleus through the dorsolateral funiculus.展开更多
One-sided ascending or descending Synthetic Aperture Radar（SAR） stereoradargrammetry has limited accuracy of topographic mapping due to the short spatial baseline（-100 km） and small intersection angle. In order to...One-sided ascending or descending Synthetic Aperture Radar（SAR） stereoradargrammetry has limited accuracy of topographic mapping due to the short spatial baseline（-100 km） and small intersection angle. In order to improve the performance and reliability of generating digital elevation model（DEM） from spaceborne SAR radargrammetry, an exploration of two-sided stereoradargrammetry from the combination of ascending and descending orbits with geometric configuration of long spatial baseline（-1000 km） was conducted in this study. The slant-range geometry between SAR sensors to the earth surface and the Doppler positioning equations were employed to establish the stereoscopic intersection model. The measurement uncertainty of two-sided radargrammetric elevation was estimated on the basis of radar parallax of homogeneous points between input SAR images. Two stereo-pairs of ALOS/PALSAR（Advanced Land Observing Satellite/Phased Array type L-band Synthetic Aperture Radar） acquisitions with the orbital separation almost 1080 km over the west Sichuan foreland basin with rolling topography in southwestern China were employed in the study to obtain the up-to-date terrain data after the 2008 Wenchuan earthquake that hit this area. Thequantitative accuracy assessment of two-sided radargrammetric DEM was performed with reference to field GPS observations. The experimental results show that the elevation accuracy reaches 5.5 m without ground control points（GCPs） used, and the accuracy is further improved to 1.5 m with only one GPS GCP used as the least constraint. The theoretical analysis and testing results demonstrate that the twosided long baseline SAR radargrammetry from the ascending and descending orbits can be a very promising technical alternative for large-area and high accuracy topographic mapping.展开更多
<strong>Objectives:</strong> To describe our technique for the implantation of the Thoraflex Hybrid prosthesis for replacement of the aortic arch in a safe and reproducible way. <strong>Materials:<...<strong>Objectives:</strong> To describe our technique for the implantation of the Thoraflex Hybrid prosthesis for replacement of the aortic arch in a safe and reproducible way. <strong>Materials:</strong> Thoraflex<span style="font-size:12.0pt;line-height:107%;font-family:;" "="">™</span> Hybrid Plexus Device (Terumo Aortic).<strong> Design:</strong> Drawing on our own experience over the past 4 years in the management of acute type A aortic dissection, we have distilled the essentials of our “Frozen Elephant Trunk” technique which have led us through our own learning curve to the improved management of this taxing condition. <strong>Method/ Results:</strong> Small extension of the median sternotomy incision along the medial border of sternocleidomastoid muscle. End to side graft anastomosis near the origin of the left subclavian artery during cooling on bypass towards 20 degrees. Attention to cardiac protection and maintenance of cerebral perfusion during the shortened corporeal arrest period. Excellent results in 24 consecutive AAAD patients with just one hospital mortality. <strong>Conclusions:</strong> We believe we are entering a new phase in the treatment of AAAD, facilitated by the availability of a hybrid prosthesis which combines expanding stent technology with familiar surgical graft material. Our particular management of the left subclavian artery and of the cerebral circulation during implantation has contributed to an expeditious and reproducible method of treating dissection within the arch of the aorta and beyond.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
A 49-year-old female patient consulted us for a cardiac evaluation before undergoing colon adenocarcinoma surgery. Three years prior, the patient underwent coronary angiography for dyspnea. The coronary angiography ex...A 49-year-old female patient consulted us for a cardiac evaluation before undergoing colon adenocarcinoma surgery. Three years prior, the patient underwent coronary angiography for dyspnea. The coronary angiography examination revealed a fistula originating from the left anterior descending artery and left main coronary artery, which had soft aneurysmal sacs and most likely drained into the pulmonary artery. Parasternal short axis echocardiography revealed a color flow that could be related to the fistula, but the other echocardiographic findings were normal. The patient did not accept the proposed examination and invasive treatment.展开更多
Descending aortic aneurysms (DAAs), including dissecting aneurysms (DA) have a multifactorial etiology and pathogenesis, therefore raising questions about the leading role of operative treatment to repair the lesion. ...Descending aortic aneurysms (DAAs), including dissecting aneurysms (DA) have a multifactorial etiology and pathogenesis, therefore raising questions about the leading role of operative treatment to repair the lesion. Objective: To investigate remote (7 and more years) results of treatment in patients with DAAs in operative treatment only if there is a danger of aneurysm rupture. A total of 82 patients with atherosclerotic DAA identified between 2008 and 2011, and 22 patients with type 1 or 3 DeBakey dissecting aneurysms (DA) who had not been operated in the acute period due to a number of reasons were examined. The follow-up period of these groups was 7 or more years. When using a sparing treatment to treat DAA, we saw survival of 90.1 at 2 years, 76.8% at 4 years, 59.4% at 6 years, and 57.5% at 7 years with the uniform increase in mortality rate, mainly due to a comorbidity. Survival in DA group (77.3%) was better due to a younger age and was 68.4% in operated and 54% in non-operated patients at 7 years. It is symptomatic that the aneurysm rupture rate was not always affected by operative treatment. Therefore, it seems like medical treatment is more consistent with etiopathogenesis of the disease compared to surgery during the stabilization period.展开更多
Within the last few years, there has been a strong trend to rethink the issue of management of atherosclerotic descending thoracic and abdominal aortic aneurysms (AAAs). When etiopathogenetic associations among change...Within the last few years, there has been a strong trend to rethink the issue of management of atherosclerotic descending thoracic and abdominal aortic aneurysms (AAAs). When etiopathogenetic associations among changes observed during the progression of the disease were not fully described, surgeons had successfully applied, although traumatic, but a rather radical method to rescue from the rupture threat. As we gained experience and knowledge about long-term outcomes, mostly concerned mortality, we realized that surgery could not be the main tactical approach to AAAs treatment due to its frequent inefficiency and failure to guarantee that the disease would be suppressed including co-morbidities, polymorphic processes and clinical manifestations. It all required more sparing treatment strategies. The situation gave rise to a more argumentative and sparing medical-and-surgical approach to treatment based on a more in-depth understanding of the etiopathogenesis of the disease whereas surgery would remain of prime importance when appropriate. The following has been developed to improve treatment outcomes for AAA: 1) Multifactorial determination of indications for surgical correction with outlining the area of relative and absolute risk of aneurysm rupture;2) Method of conservative treatment aimed to attain and maintain optimal blood pressure, target levels of cholesterol and low-density lipoproteins, as well as reduce oxidative and inflammatory processes in aorta, strengthen its wall, stabilize the disease and control co-morbidities. A four-year follow-up of patients using this developed technology has yielded more preferred results suggesting the need for narrowing indications for surgery to treat AAAs. Another advantage of the sparing approach to treat AAA is economic, due to fewer operations and implantations of stent-grafts, considering the fact that medical treatment should be used in operated subjects, too.展开更多
Objective:To observe the clinical efficacy of compound of owarming yang,descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome.Meth...Objective:To observe the clinical efficacy of compound of owarming yang,descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome.Methods:Seventy-six patients of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome were randomly divided into observation group and control group,thirty-eight cases in each group.The control group was given conventional western medicine treatment,while the observation group took compound of owarming yang,descending turbidity and dredging collaterals orally on the basis of conventional western medicine treatment.The course of treatment covered for one month.Before and after treatment,we observed the scores of traditional Chinese medicine symptoms,indicators of renal function[serum creatinine(Scr),blood urea nitrogen(BUN),microalbuminuria(MALB)],indicators of glucose metabolism[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],indicators of hemorheology[plasma viscosity(PV),platelet aggregation rate(PAR),fibrinogen(FIB)],Cystatin-C(Cys-C),C-reactive protein(CRP)in the two groups.Results:After treatment,the clinical effect of the observation group was significantly better than the control group(P<0.05).The scores of traditional Chinese medicine symptoms,indicators of renal function(Scr、BUN、UAER),indicators of glucose metabolism(FPG、2hPG、HbAlc),indicators of hemorheology(PV、PAR、FIB),Cys-C and CRP in the two groups were decreased significantly compared with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.05).Conclusion:Compound of warming yang,descending turbidity and dredging collaterals has remarkable efficacy in treating of diabetic kidney disease patients with yin-yang deficiency and blood stasis syndrome by alleviating clinical symptoms,glucose metabolism,renal function and microcirculatory disturbance,and the mechanism related to alleviation of microinflammation.展开更多
The purpose of this study was to analyze motion of the left anterior descending coronary artery (LAD) and left ventricle during normal breathing and deep inspiration breath hold (DIBH). This is a dosimetric study util...The purpose of this study was to analyze motion of the left anterior descending coronary artery (LAD) and left ventricle during normal breathing and deep inspiration breath hold (DIBH). This is a dosimetric study utilizing free-breathing and static DIBH scans from eleven patients treated with radiotherapy for breast cancer. The anterior-posterior displacement along the length of the LAD was measured in each respiratory phase. Standard treatment plans targeting the whole breast without treatment of the internal mammary lymph nodes were generated and dose to the LAD and LV calculated. Non-uniform movement of the LAD during respiratory maneuvers with the proximal third exhibiting the greatest displacement was observed. In DIBH compared to end-expiration (EP), the mean posterior displacement of the proximal 1/3 of the LAD was 8.99 mm, the middle 1/3 of the artery was 6.37 mm, and the distal 1/3 was 3.27 mm. In end-inspiration (IP) compared to end-expiration the mean posterior displacements of the proximal 1/3 of the LAD was 2.08 mm, the middle 1/3 of the artery was 0.91 mm, and the distal 1/3 was 0.97 mm. Mean doses to the LAD using tangential treatment fields and a prescribed dose of 50.4 Gy were 11.32 Gy in EP, 8.98 Gy in IP, and 3.50 Gy in DIBH. Mean doses to the LV were 2.38 Gy in EP, 2.31 Gy in IP, and 1.24 Gy in DIBH. In conclusion, inspiration and especially DIBH, cause a displacement of the origin and proximal 2/3 of the LAD away from the chest wall, resulting in sparing of the most critical segment of the artery during tangential radiotherapy.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
The limit and the problem of modern religion and science are due to the materialistic, mechanistic, and dichotomous thought that separates humanity from God, spirit from body and I from you. Indicating that the method...The limit and the problem of modern religion and science are due to the materialistic, mechanistic, and dichotomous thought that separates humanity from God, spirit from body and I from you. Indicating that the methodology is wrong, the author will suggest an alternative to solve its problem. In the body, the author will introduce the paranormal phenomena focusing on the descending of the Holy Spirit by the Victor on NRMs in Korea. The author will speak of the differences between Aura and the light of the Holy Spirit using some new methodologies of participant observation by film photo-graphing and interviewing testimonies from fieldwork. Furthermore the author attempted to research scientifically how the light of life emitted from the Victor influences humanity and all things. The author will tell the theory of bio scientific and biblical salvation and immortality based on somatic. This paper will contribute in revealing the invisible God and the Holy Spirit to be physically seen.展开更多
The prevalence of myocardial bridging in hypertrophic cardiomyopathy （HCM） is relatively higher, and it usually occurs in the middle and distal portions of the left anterior descending artery. It is rarely reported ...The prevalence of myocardial bridging in hypertrophic cardiomyopathy （HCM） is relatively higher, and it usually occurs in the middle and distal portions of the left anterior descending artery. It is rarely reported that multiple lesions of myocardial bridging affecting not only the left anterior descending artery but also right coronary artery. We reported a 56-year-old man suffering from chest discomfort on exertion. Echocardiography and ventriculography showed hypertrophy of the apex involving the anterior and lateral wall. Coronary angiograph revealed multiple myocardial bridges affecting the left anterior descending artery and the right posterior descending artery.展开更多
基金supported by the National Natural Science Foundation of China(Grant Nos.42192552,42192551,42150710531,42175016,and 42075072)the Shanghai Typhoon Research Fund(Grant No.TFJJ202207)the Basic Research Fund of CAMS(Grant No.2023Y010)。
文摘This study investigated the effects of upper-level descending inflow(ULDI)associated with inner-eyewall convection on the formation of the moat in tropical cyclones(TCs)with secondary eyewall formation(SEF).In our numerical experiments,a clear moat with SEF occurred in TCs with a significant ULDI,while no SEF occurred in TCs without a significant ULDI.The eyewall convection developed more vigorously in the control run.A ULDI occurred outside the inner-eyewall convection,where it was symmetrically unstable.The ULDI was initially triggered by the diabatic warming released by the inner eyewall and later enhanced by the cooling below the anvil cloud.The ULDI penetrated the outer edge of the inner eyewall with relatively dry air and prevented excessive solid-phase hydrometeors from being advected further outward.It produced extensive sublimation cooling of falling hydrometeors between the eyewall and the outer convection.The sublimation cooling resulted in negative buoyancy and further induced strong subsidence between the eyewall and the outer convection.As a result,a clear moat was generated.Development of the moat in the ongoing SEF prevented the outer rainband from moving farther inward,helping the outer rainband to symmetrize into an outer eyewall.In the sensitivity experiment,no significant ULDI formed since the eyewall convection was weaker,and the eyewall anvil developed relatively lower,meaning the formation of a moat and thus an outer eyewall was less likely.This study suggests that a better-represented simulation of inner-eyewall convective structures and distribution of the solid-phase hydrometeors is important to the prediction of SEF.
基金Supported by Huanhua Talent for Discipline Backbone of Sichuan Provincial People’s Hospital,No.SY2022017Science Fund for Distinguished Young Scholars of Sichuan Province,No.2021JDJQ0041+1 种基金Sichuan Science and Technology Program,No.2020YFQ0060National Natural Science and Technology Foundation of China,No.81800274.
文摘BACKGROUND Arterial cannulation sites for the surgical repair of type A aortic dissection(AAD)have evolved from right axillary artery(AA)cannulation to bilateral carotid artery(CA)based of femoral artery(FA)cannulation.Postoperative descending aorta remodeling is closely linked to the false lumen area ratio(FLAR),defined as false lumen area/aortic area,as well as to the incidence of renal replacement therapy(RRT).AIM To investigate the effect of the updated arterial cannulation strategy on descending aortic remodeling.METHODS A total of 443 AAD patients who received FA combined cannulation between March 2015 and March 2023 were included in the study.Of these,209 received right AA cannulation and 234 received bilateral CA cannulation.The primary outcome was the change in FLAR,as calculated from computed tomography angiography in three segments of the descending aorta:Thoracic(S1),upper abdominal(S2),and lower abdominal(S3).Secondary outcomes were the incidence of RRT and the serum inflammation response,as observed by the levels of high sensitivity C reaction protein(hs-CRP)and Interleukin-6(IL-6).RESULTS The postoperative/preoperative ratio of FLAR in S2 and S3 was higher in the AA group compared to the CA group(S2:0.80±0.08 vs 0.75±0.07,P<0.001;S3:0.57±0.12 vs 0.50±0.12,P<0.001,respectively).The AA group also had a significantly higher incidence of RRT(19.1%vs 8.5%,P=0.001;odds ratio:2.533,95%CI:1.427-4.493)and higher levels of inflammation cytokines 24 h after the procedure[hr-CRP:117±17 vs 104±15 mg/L;IL-6:129(103,166)vs 83(69,101)pg/mL;both P<0.001]compared to the CA group.CONCLUSION The CA cannulation strategy was associated with better abdominal aorta remodeling after AAD repair compared to AA cannulation,as observed by a greater change in FLAR and lower incidence of RRT.
文摘Orpheus Descending is written by American famous playwright Tennessee Williams. According to the portrayal of a series marginalized people, this drama presents the solitude in human beings' heart and the estrangement in interpersonal relations. This paper tries to analyze the solitude theme in this drama from philosophic aspect and realistic aspect, combining alienation theory and existentialism theory to analyze the reason and the manifestation of solitude.
文摘Purpose: Descending necrotizing mediastinitis(DNM) is a lethal and acute suppurative disease. This report aimed to summarize our experience in the treatment of DNM with continuous negative pressure catheter drainage and transnasal jejunal feeding by interventional techniques. Materials and Methods: We retrospectively analyzed relevant clinical data of patients with DNM who underwent continuous negative pressure catheter drainage and transnasal jejunal feeding. All drainage catheters and jejunal feeding tubes were inserte d by interventional techniques. Results: In total, 21 patients were diagnosed with DNM by esophagography and computed tomography(CT). Catheters for the drainage of mediastinal abscesses as well as transnasal jejunal feeding tubes were successfully placed in all patients, indicating a 100% success rate. Of all patients, 13 underwent insertion of abscess drainage catheters through percutaneous puncture under DynaCT guidance, while eight had drainage catheter insertion through fistula orifices in the posterior nasopharyngeal wall or esophagus under fluoroscopic guidance. In total, 26 drainage tubes were inserted. One patient with diabetes died of sepsis and diabetic ketoacidosis 5 days postoperatively, while the remaining 20 patients showed good recovery with successful removal of the drainage catheters. Durations of catheterization were 45.2±50.44 days. The overall clinical success rate was 95.2%. Conclusion: The above described methods are non-surgical, minimally invasive and efficacious, and may be alternative therapeutic tools for patients who are not eligible for surgical operation, have a high postoperative risk, or are more likely to choose minimally invasive techniques.
基金jointly supported by projects of the National Key Laboratory for Earthquake Dynamics (LED2013A02,LED2015A03)the National Natural Science foundation of China (41374105)
文摘Based on the working principle of satellite radars, the earthquake deformation field measured by interferometric synthetic aperture（InSAR） is the projection of ground displacement associated with the seismogenic fault in the line of sight（LOS） of the satellite. However, LOS projections are complex, and are not only related to the ascending/descending modes and incidence angles of SAR data, but also related to the strike and motion senses of the fault. Even for the same earthquake, the LOS deformation derived from different ascending/descending data can be almost identical in one case, but quite different in another case, which makes the interpretation of InSAR seismic deformation and its comparison with field observations difficult. In this study, we undertook a quantitative analysis of the relationships between LOS observation sensitivity of InSAR and fault strike, fault motion sense, and ascending/descending modes, as well as 3D deformation fields. We studied the features and differences of the LOS deformation fields in different types of earthquakes using ascending/descending modes, with a particularly detailed analysis of the relations for a strikeslip type of earthquake. We also summarized the characteristics of LOS deformation fields of faults with different strikes and optimal observational data modes. Taking the strike-slip Yushu earthquake and the normal Gaize event as examples, we used SAR data of the ascending/descending modes to verify the results of quantitative calculations. These analyses will not only provide a more reasonable interpretation of InSAR seismic deformation fields and but also help understand the differences of seismic deformation fields revealed by data with different observational modes, therefore promoting the application of InSAR technology in seismology.
文摘An adaptive chaotic gradient descending optimization algorithm for single objective optimization was presented. A local minimum judged by two rules was obtained by an improved mutative-step gradient descending method. A new optimal minimum was obtained to replace the local minimum by mutative-scale chaotic search algorithm whose scales are magnified gradually from a small scale in order to escape local minima. The global optimal value was attained by repeatedly iterating. At last, a BP (back-propagation) neural network model for forecasting slag output in matte converting was established. The algorithm was used to train the weights of the BP neural network model. The simulation results with a training data set of 400 samples show that the training process can be finished within 300 steps to obtain the global optimal value, and escape local minima effectively. An optimization system for operation parameters, which includes the forecasting model, is achieved, in which the output of converter increases by 6.0%, and the amount of the treated cool materials rises by 7.8% in the matte converting process.
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Objective: To determine diagnostic utility of Doppler measurements in fetal descending aorta and umbilical arteries in predicting intrauterine growth retarded (IUGR) fetuses at risk in pregnancies complicated by preeclampsia and/or HELLP syndrome. Methods: Doppler measurements were taken in fetal descending aorta and umbilical arteries of 53 patients with pre-eclampsia, 10 of whom had HELLP syndrome using fetometry (ACUSON 128XP/10, 3.5 MHz probe). These values were compared with those of 44 appropriate-for-gestational age singleton pregnancies (AGA). Doppler Indices (Resistance Index (RI), Systolic/Diastolic (S/D) ratio) and end-diastolic flows were related to fetal heart rate (FHR) during contraction stress test, to cord blood parameters (pH, Base Excess) and to Apgar Scores. Results: In contrast to AGA fetuses, IUGR fetuses had decreased end-diastolic flow and an increase of Doppler Indices significantly earlier in the descending aorta (p < 0.05), compared to umbilical artery. Increased RI’s, S/D ratios and a decrease of end-diastolic flow in fetal aorta were significantly correlated to frequency of FHR decelerations during contraction stress tests, pH, Base Excess (p < 0.01) and Apgar Scores in IUGR fetuses. Conclusion: A decrease in end-diastolic flow paralleled with an increase in Doppler indices in fetal descending aorta reflect oxygen deprivation in IUGR fetuses during pre-eclamptic pregnancies with or without HELLP syndrome. While ductus venosus and umbilical artery are more frequently used nowadays to determine fetal oxygen deprivation, Doppler measurements in fetal descending aorta provide additional information for early detection of fetuses at risk for IUGR in pregnancies complicated with pre-eclampsia and/or HELLP
基金supported by the National Natural Science Foundation of China,No.81273677a grant from the Postgraduate Innovation Topics of Hunan University of Chinese Medicine in China in 2014,No.2014CX01
文摘Sensory inputs stimulated by Zusanli（ST36） acupuncture in the abdomen are known to converge in the upper cervical cord. However, it is unclear whether these inputs are subsequently conveyed to the hypothalamic paraventricular nucleus and what kind of afferent fibers are involved. We focused on the upper cervical cord, where afferent inputs converge, and detected c-fos expression in oxytocinergic neurons. We found that Zusanli acupuncture therapy effectively elevated intragastric pressure, but inhibited expression of c-fos in oxytocinergic neurons of the paraventricular nucleus in upper cervical cord injured rats. These Zusanli acupuncture effects remained even after complete dorsal cord transection. However, after complete transection of the spinal cord or dorsolateral funiculus, the effects were significantly attenuated and even disappeared. These findings suggest that the paraventricular nucleus is responsible for pooling and integrating signals from the Zusanli acupuncture and sensory information from the intragastric pressure variation, thereby contributing to the regulation of intragastric pressure. The upper cervical cord serves as the key link between ascending and descending pathways, which conveys afferent inputs to the paraventricular nucleus through the dorsolateral funiculus.
基金supported by the National Natural Science Foundation of China(Grant Nos.41472255,51178404)Open Research Fund by Sichuan Engineering Research Center for Emergency Mapping & Disaster Reduction(Program K2014B006)Fundamental Research Funds for the Central Universities(Grant Nos.SWJTU12ZT07,2682014BR014)
文摘One-sided ascending or descending Synthetic Aperture Radar（SAR） stereoradargrammetry has limited accuracy of topographic mapping due to the short spatial baseline（-100 km） and small intersection angle. In order to improve the performance and reliability of generating digital elevation model（DEM） from spaceborne SAR radargrammetry, an exploration of two-sided stereoradargrammetry from the combination of ascending and descending orbits with geometric configuration of long spatial baseline（-1000 km） was conducted in this study. The slant-range geometry between SAR sensors to the earth surface and the Doppler positioning equations were employed to establish the stereoscopic intersection model. The measurement uncertainty of two-sided radargrammetric elevation was estimated on the basis of radar parallax of homogeneous points between input SAR images. Two stereo-pairs of ALOS/PALSAR（Advanced Land Observing Satellite/Phased Array type L-band Synthetic Aperture Radar） acquisitions with the orbital separation almost 1080 km over the west Sichuan foreland basin with rolling topography in southwestern China were employed in the study to obtain the up-to-date terrain data after the 2008 Wenchuan earthquake that hit this area. Thequantitative accuracy assessment of two-sided radargrammetric DEM was performed with reference to field GPS observations. The experimental results show that the elevation accuracy reaches 5.5 m without ground control points（GCPs） used, and the accuracy is further improved to 1.5 m with only one GPS GCP used as the least constraint. The theoretical analysis and testing results demonstrate that the twosided long baseline SAR radargrammetry from the ascending and descending orbits can be a very promising technical alternative for large-area and high accuracy topographic mapping.
文摘<strong>Objectives:</strong> To describe our technique for the implantation of the Thoraflex Hybrid prosthesis for replacement of the aortic arch in a safe and reproducible way. <strong>Materials:</strong> Thoraflex<span style="font-size:12.0pt;line-height:107%;font-family:;" "="">™</span> Hybrid Plexus Device (Terumo Aortic).<strong> Design:</strong> Drawing on our own experience over the past 4 years in the management of acute type A aortic dissection, we have distilled the essentials of our “Frozen Elephant Trunk” technique which have led us through our own learning curve to the improved management of this taxing condition. <strong>Method/ Results:</strong> Small extension of the median sternotomy incision along the medial border of sternocleidomastoid muscle. End to side graft anastomosis near the origin of the left subclavian artery during cooling on bypass towards 20 degrees. Attention to cardiac protection and maintenance of cerebral perfusion during the shortened corporeal arrest period. Excellent results in 24 consecutive AAAD patients with just one hospital mortality. <strong>Conclusions:</strong> We believe we are entering a new phase in the treatment of AAAD, facilitated by the availability of a hybrid prosthesis which combines expanding stent technology with familiar surgical graft material. Our particular management of the left subclavian artery and of the cerebral circulation during implantation has contributed to an expeditious and reproducible method of treating dissection within the arch of the aorta and beyond.
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A 49-year-old female patient consulted us for a cardiac evaluation before undergoing colon adenocarcinoma surgery. Three years prior, the patient underwent coronary angiography for dyspnea. The coronary angiography examination revealed a fistula originating from the left anterior descending artery and left main coronary artery, which had soft aneurysmal sacs and most likely drained into the pulmonary artery. Parasternal short axis echocardiography revealed a color flow that could be related to the fistula, but the other echocardiographic findings were normal. The patient did not accept the proposed examination and invasive treatment.
文摘Descending aortic aneurysms (DAAs), including dissecting aneurysms (DA) have a multifactorial etiology and pathogenesis, therefore raising questions about the leading role of operative treatment to repair the lesion. Objective: To investigate remote (7 and more years) results of treatment in patients with DAAs in operative treatment only if there is a danger of aneurysm rupture. A total of 82 patients with atherosclerotic DAA identified between 2008 and 2011, and 22 patients with type 1 or 3 DeBakey dissecting aneurysms (DA) who had not been operated in the acute period due to a number of reasons were examined. The follow-up period of these groups was 7 or more years. When using a sparing treatment to treat DAA, we saw survival of 90.1 at 2 years, 76.8% at 4 years, 59.4% at 6 years, and 57.5% at 7 years with the uniform increase in mortality rate, mainly due to a comorbidity. Survival in DA group (77.3%) was better due to a younger age and was 68.4% in operated and 54% in non-operated patients at 7 years. It is symptomatic that the aneurysm rupture rate was not always affected by operative treatment. Therefore, it seems like medical treatment is more consistent with etiopathogenesis of the disease compared to surgery during the stabilization period.
文摘Within the last few years, there has been a strong trend to rethink the issue of management of atherosclerotic descending thoracic and abdominal aortic aneurysms (AAAs). When etiopathogenetic associations among changes observed during the progression of the disease were not fully described, surgeons had successfully applied, although traumatic, but a rather radical method to rescue from the rupture threat. As we gained experience and knowledge about long-term outcomes, mostly concerned mortality, we realized that surgery could not be the main tactical approach to AAAs treatment due to its frequent inefficiency and failure to guarantee that the disease would be suppressed including co-morbidities, polymorphic processes and clinical manifestations. It all required more sparing treatment strategies. The situation gave rise to a more argumentative and sparing medical-and-surgical approach to treatment based on a more in-depth understanding of the etiopathogenesis of the disease whereas surgery would remain of prime importance when appropriate. The following has been developed to improve treatment outcomes for AAA: 1) Multifactorial determination of indications for surgical correction with outlining the area of relative and absolute risk of aneurysm rupture;2) Method of conservative treatment aimed to attain and maintain optimal blood pressure, target levels of cholesterol and low-density lipoproteins, as well as reduce oxidative and inflammatory processes in aorta, strengthen its wall, stabilize the disease and control co-morbidities. A four-year follow-up of patients using this developed technology has yielded more preferred results suggesting the need for narrowing indications for surgery to treat AAAs. Another advantage of the sparing approach to treat AAA is economic, due to fewer operations and implantations of stent-grafts, considering the fact that medical treatment should be used in operated subjects, too.
基金Key R&D Project of Liaoning Provincial Science and Technology Department(No.2018225042)
文摘Objective:To observe the clinical efficacy of compound of owarming yang,descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome.Methods:Seventy-six patients of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome were randomly divided into observation group and control group,thirty-eight cases in each group.The control group was given conventional western medicine treatment,while the observation group took compound of owarming yang,descending turbidity and dredging collaterals orally on the basis of conventional western medicine treatment.The course of treatment covered for one month.Before and after treatment,we observed the scores of traditional Chinese medicine symptoms,indicators of renal function[serum creatinine(Scr),blood urea nitrogen(BUN),microalbuminuria(MALB)],indicators of glucose metabolism[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],indicators of hemorheology[plasma viscosity(PV),platelet aggregation rate(PAR),fibrinogen(FIB)],Cystatin-C(Cys-C),C-reactive protein(CRP)in the two groups.Results:After treatment,the clinical effect of the observation group was significantly better than the control group(P<0.05).The scores of traditional Chinese medicine symptoms,indicators of renal function(Scr、BUN、UAER),indicators of glucose metabolism(FPG、2hPG、HbAlc),indicators of hemorheology(PV、PAR、FIB),Cys-C and CRP in the two groups were decreased significantly compared with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.05).Conclusion:Compound of warming yang,descending turbidity and dredging collaterals has remarkable efficacy in treating of diabetic kidney disease patients with yin-yang deficiency and blood stasis syndrome by alleviating clinical symptoms,glucose metabolism,renal function and microcirculatory disturbance,and the mechanism related to alleviation of microinflammation.
文摘The purpose of this study was to analyze motion of the left anterior descending coronary artery (LAD) and left ventricle during normal breathing and deep inspiration breath hold (DIBH). This is a dosimetric study utilizing free-breathing and static DIBH scans from eleven patients treated with radiotherapy for breast cancer. The anterior-posterior displacement along the length of the LAD was measured in each respiratory phase. Standard treatment plans targeting the whole breast without treatment of the internal mammary lymph nodes were generated and dose to the LAD and LV calculated. Non-uniform movement of the LAD during respiratory maneuvers with the proximal third exhibiting the greatest displacement was observed. In DIBH compared to end-expiration (EP), the mean posterior displacement of the proximal 1/3 of the LAD was 8.99 mm, the middle 1/3 of the artery was 6.37 mm, and the distal 1/3 was 3.27 mm. In end-inspiration (IP) compared to end-expiration the mean posterior displacements of the proximal 1/3 of the LAD was 2.08 mm, the middle 1/3 of the artery was 0.91 mm, and the distal 1/3 was 0.97 mm. Mean doses to the LAD using tangential treatment fields and a prescribed dose of 50.4 Gy were 11.32 Gy in EP, 8.98 Gy in IP, and 3.50 Gy in DIBH. Mean doses to the LV were 2.38 Gy in EP, 2.31 Gy in IP, and 1.24 Gy in DIBH. In conclusion, inspiration and especially DIBH, cause a displacement of the origin and proximal 2/3 of the LAD away from the chest wall, resulting in sparing of the most critical segment of the artery during tangential radiotherapy.
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.
文摘The limit and the problem of modern religion and science are due to the materialistic, mechanistic, and dichotomous thought that separates humanity from God, spirit from body and I from you. Indicating that the methodology is wrong, the author will suggest an alternative to solve its problem. In the body, the author will introduce the paranormal phenomena focusing on the descending of the Holy Spirit by the Victor on NRMs in Korea. The author will speak of the differences between Aura and the light of the Holy Spirit using some new methodologies of participant observation by film photo-graphing and interviewing testimonies from fieldwork. Furthermore the author attempted to research scientifically how the light of life emitted from the Victor influences humanity and all things. The author will tell the theory of bio scientific and biblical salvation and immortality based on somatic. This paper will contribute in revealing the invisible God and the Holy Spirit to be physically seen.
文摘The prevalence of myocardial bridging in hypertrophic cardiomyopathy （HCM） is relatively higher, and it usually occurs in the middle and distal portions of the left anterior descending artery. It is rarely reported that multiple lesions of myocardial bridging affecting not only the left anterior descending artery but also right coronary artery. We reported a 56-year-old man suffering from chest discomfort on exertion. Echocardiography and ventriculography showed hypertrophy of the apex involving the anterior and lateral wall. Coronary angiograph revealed multiple myocardial bridges affecting the left anterior descending artery and the right posterior descending artery.
