AIM:To determine the merits of magnetic resonance cholangiopancreatography(MRCP) as the primary diagnostic test for choledochal cysts(CC’s).METHODS:Between 2009 and 2012,patients who underwent MRCP for perioperative... AIM:To determine the merits of magnetic resonance cholangiopancreatography(MRCP) as the primary diagnostic test for choledochal cysts(CC’s).METHODS:Between 2009 and 2012,patients who underwent MRCP for perioperative diagnosis were identified.Demographic information,clinical characteristics,and radiographic findings were recorded.MRCP results were compared with intraoperative findings.A PubMed search identified studies published between 1996-2012,employing MRCP as the primary preoperative imaging and comparing results with either endoscopic retrograde cholangiopancreatography(ERCP) or operative findings.Detection rates for CC’s and abnormal pancreaticobiliary junction(APBJ) were calculated.In addition detection rates for clinically related biliary pathology like choledocholithiasis and cholangiocarcinomas in patients diagnosed with CC’s were also evaluated.RESULTS:Eight patients were identified with CC’s.Six patients out of them had typeⅣCC’s,1 had type I and 1 had a new variant of choledochal cyst with confluent dilatation of the common bile duct(CBD) and cystic duct.Seven patients had an APBJ and 3 of those had a long common-channel.Gallstones were found in 2 patients,1 had a CBD stone,and 1 pancreatic-duct stone was also detected.In all cases,MRCP successfully identified the type of CC’s,as well as APBJ with ductal stones.From analyzing the literature,we found that MRCP has 96%-100% detection rate for CC’s.Additionally,we found that the range for sensitivity,specificity,and diagnostic accuracy was 53%-100%,90%-100% and 56%-100% in diagnosing APBJ.MRCP’s detection rate was 100% for choledocholithiasis and 87% for cholangiocarcinomas with concurrent CC’s.CONCLUSION:After initial ultrasound and computed tomography scan,MRCP should be the next diagnostic test in both adult and pediatric patients.ERCP should be reserved for patients where therapeutic intervention is needed.展开更多
Stroke is the leading cause of death and long-term disability worldwide,and cognitive impairment and dementia are major complications of ischemic stroke.Cystatin C (CysC) has been found to be a neuroprotective factor ...Stroke is the leading cause of death and long-term disability worldwide,and cognitive impairment and dementia are major complications of ischemic stroke.Cystatin C (CysC) has been found to be a neuroprotective factor in animal studies.However,the relationship between CysC levels and cognitive dysfunction in previous studies has revealed different results.This prospective observational study investigated the correlation between serum CysC levels and post-stroke cognitive dysfunction at 3 months.Data from 638 patients were obtained from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS).Cognitive dysfunction was assessed using the Mini-Mental State Examination (MMSE) at 3 months after stroke.According to the MMSE score,308 patients (52.9%) had post-stroke cognitive dysfunction.After adjusting for potential confounding factors,the odds ratio (95% CI) of post-stroke cognitive dysfunction for the highest quartile of serum CysC levels was 0.54 (0.30–0.98),compared with the lowest quartile.The correlation between serum CysC and cognitive dysfunction was modified by renal function status.We observed a negative linear dose-response correlation between CysC and cognitive dysfunction in patients with normal renal function (Plinearity = 0.044),but not in those with abnormal renal function.Elevated serum CysC levels were correlated with a low risk of 3-month cognitive dysfunction in patients with acute ischemic stroke,especially in those with normal renal function.The current results suggest that CysC is a protective factor for post-stroke cognitive dysfunction,and could be used to treat post-stroke cognitive dysfunction.The CATIS study was approved by the Institutional Review Boards at Soochow University from China (approval No.2012-02) on December 30,2012,and was registered at ClinicalTrials.gov (identifier No.NCT01840072) on April 25,2013.展开更多
In steel squeeze casting process, the working condition of a punch was very rigorous. The abnormal failure models of an H13 punch, such as plastic rubbed damnification, could not be avoided easily. Based on the analys...In steel squeeze casting process, the working condition of a punch was very rigorous. The abnormal failure models of an H13 punch, such as plastic rubbed damnification, could not be avoided easily. Based on the analysis of the flow stress and the friction-shearing stress of an H13 punch in steel squeeze casting process, the following results were obtained： if the flow stress of an H13 punch was smaller than its friction-shearing stress, these abnormal failures could not be avoided; and if there were some protection measures that enable the flow stress to have a greater value than its friction-shearing one, the abnormal failures would not occur. In the production of 45^# steel valves and catenary system components, the flow stress of a lateral H13 punch without any protection measure was about 29 MPa and its friction-shearing stress was about 51 MPa, then, the abnormal failures occurred; however, when the protection measures of the punch enabled its working temperature to have a value below 682 ℃ its flow stress was greater than its friction-shearing stress, and the abnormal failures were avoided.展开更多
Root cause analysis （RCA） of abnormal aluminum electrolysis cell condition has long been a challenging industrial issue due to its inherent complexity in analyzing based on multi-source knowledge. In addition, accur...Root cause analysis （RCA） of abnormal aluminum electrolysis cell condition has long been a challenging industrial issue due to its inherent complexity in analyzing based on multi-source knowledge. In addition, accurate RCA of abnormal aluminum electrolysis cell condition is the precondition of improving current efficiency. RCA of abnormal condition is a complex work of multi-source knowledge fusion, which is difficult to ensure the RCA accuracy of abnormal cell condition because of dwindling and frequent flow of experienced technicians. In view of this, a method based on Fuzzy- Bayesian network to construct multi-source knowledge solidification reasoning model is proposed. The method can effectively fuse and solidify the knowledge, which is used to analyze the cause of abnormal condition by technicians providing a clear and intuitive framework to this complex task, and also achieve the result of root cause automatically. The proposed method was verified under 20 sets of abnormal cell conditions, and implements root cause analysis by finding the abnormal state of root node, which has a maximum posterior probability by Bayesian diagnosis reasoning. The accuracy of the test results is up to 95%, which shows that the knowledge reasoning feasibility for RCA of aluminum electrolysis cell.展开更多
OBJECTIVE: To analyze the association between tongue manifestations and the levels of glucose (GLU), total cholesterol(TCH), and high-density lipoprotein cholesterol(HDL-C) in subjects with acute cerebral infarction.M...OBJECTIVE: To analyze the association between tongue manifestations and the levels of glucose (GLU), total cholesterol(TCH), and high-density lipoprotein cholesterol(HDL-C) in subjects with acute cerebral infarction.METHODS: Hospitalized patients with first unilateral cerebral infarction in the Neurological Department of Xuanwu Hospital were included and the correlation between tongue fur color, fur nature,and the levels of GLU,TCH, HDL-C were analyzed.RESULTS: HDL level in the thin fur group was higher than that in the thick fur group(P=0.02). The difference in the levels of GLU,TCH, and HDL-C among the groups was significant(P<0.05), classified in terms of slippery, moist, and dry fur. Further comparison between the groups by Student-Newman-Keuls test showed that GLU level in the dry fur group was the highest. Moreover, the TCH level in the slippery fur group was higher than the other two groups.CONCLUSION: A correlation between tongue manifestations and GLU, TCH, HDL-C was identified in the patients with acute cerebral infarction.展开更多
文摘 AIM:To determine the merits of magnetic resonance cholangiopancreatography(MRCP) as the primary diagnostic test for choledochal cysts(CC’s).METHODS:Between 2009 and 2012,patients who underwent MRCP for perioperative diagnosis were identified.Demographic information,clinical characteristics,and radiographic findings were recorded.MRCP results were compared with intraoperative findings.A PubMed search identified studies published between 1996-2012,employing MRCP as the primary preoperative imaging and comparing results with either endoscopic retrograde cholangiopancreatography(ERCP) or operative findings.Detection rates for CC’s and abnormal pancreaticobiliary junction(APBJ) were calculated.In addition detection rates for clinically related biliary pathology like choledocholithiasis and cholangiocarcinomas in patients diagnosed with CC’s were also evaluated.RESULTS:Eight patients were identified with CC’s.Six patients out of them had typeⅣCC’s,1 had type I and 1 had a new variant of choledochal cyst with confluent dilatation of the common bile duct(CBD) and cystic duct.Seven patients had an APBJ and 3 of those had a long common-channel.Gallstones were found in 2 patients,1 had a CBD stone,and 1 pancreatic-duct stone was also detected.In all cases,MRCP successfully identified the type of CC’s,as well as APBJ with ductal stones.From analyzing the literature,we found that MRCP has 96%-100% detection rate for CC’s.Additionally,we found that the range for sensitivity,specificity,and diagnostic accuracy was 53%-100%,90%-100% and 56%-100% in diagnosing APBJ.MRCP’s detection rate was 100% for choledocholithiasis and 87% for cholangiocarcinomas with concurrent CC’s.CONCLUSION:After initial ultrasound and computed tomography scan,MRCP should be the next diagnostic test in both adult and pediatric patients.ERCP should be reserved for patients where therapeutic intervention is needed.
基金supported by the National Natural Science Foundation of China,No.81673263(to YHZ)Ministry of Science and Technology of China,No.2016YFC1307300(to YHZ)a Project of the Priority Academic Program Development of Jiangsu Higher Education Institutions,China(to YHZ)
文摘Stroke is the leading cause of death and long-term disability worldwide,and cognitive impairment and dementia are major complications of ischemic stroke.Cystatin C (CysC) has been found to be a neuroprotective factor in animal studies.However,the relationship between CysC levels and cognitive dysfunction in previous studies has revealed different results.This prospective observational study investigated the correlation between serum CysC levels and post-stroke cognitive dysfunction at 3 months.Data from 638 patients were obtained from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS).Cognitive dysfunction was assessed using the Mini-Mental State Examination (MMSE) at 3 months after stroke.According to the MMSE score,308 patients (52.9%) had post-stroke cognitive dysfunction.After adjusting for potential confounding factors,the odds ratio (95% CI) of post-stroke cognitive dysfunction for the highest quartile of serum CysC levels was 0.54 (0.30–0.98),compared with the lowest quartile.The correlation between serum CysC and cognitive dysfunction was modified by renal function status.We observed a negative linear dose-response correlation between CysC and cognitive dysfunction in patients with normal renal function (Plinearity = 0.044),but not in those with abnormal renal function.Elevated serum CysC levels were correlated with a low risk of 3-month cognitive dysfunction in patients with acute ischemic stroke,especially in those with normal renal function.The current results suggest that CysC is a protective factor for post-stroke cognitive dysfunction,and could be used to treat post-stroke cognitive dysfunction.The CATIS study was approved by the Institutional Review Boards at Soochow University from China (approval No.2012-02) on December 30,2012,and was registered at ClinicalTrials.gov (identifier No.NCT01840072) on April 25,2013.
文摘In steel squeeze casting process, the working condition of a punch was very rigorous. The abnormal failure models of an H13 punch, such as plastic rubbed damnification, could not be avoided easily. Based on the analysis of the flow stress and the friction-shearing stress of an H13 punch in steel squeeze casting process, the following results were obtained： if the flow stress of an H13 punch was smaller than its friction-shearing stress, these abnormal failures could not be avoided; and if there were some protection measures that enable the flow stress to have a greater value than its friction-shearing one, the abnormal failures would not occur. In the production of 45^# steel valves and catenary system components, the flow stress of a lateral H13 punch without any protection measure was about 29 MPa and its friction-shearing stress was about 51 MPa, then, the abnormal failures occurred; however, when the protection measures of the punch enabled its working temperature to have a value below 682 ℃ its flow stress was greater than its friction-shearing stress, and the abnormal failures were avoided.
文摘Root cause analysis （RCA） of abnormal aluminum electrolysis cell condition has long been a challenging industrial issue due to its inherent complexity in analyzing based on multi-source knowledge. In addition, accurate RCA of abnormal aluminum electrolysis cell condition is the precondition of improving current efficiency. RCA of abnormal condition is a complex work of multi-source knowledge fusion, which is difficult to ensure the RCA accuracy of abnormal cell condition because of dwindling and frequent flow of experienced technicians. In view of this, a method based on Fuzzy- Bayesian network to construct multi-source knowledge solidification reasoning model is proposed. The method can effectively fuse and solidify the knowledge, which is used to analyze the cause of abnormal condition by technicians providing a clear and intuitive framework to this complex task, and also achieve the result of root cause automatically. The proposed method was verified under 20 sets of abnormal cell conditions, and implements root cause analysis by finding the abnormal state of root node, which has a maximum posterior probability by Bayesian diagnosis reasoning. The accuracy of the test results is up to 95%, which shows that the knowledge reasoning feasibility for RCA of aluminum electrolysis cell.
基金Supported by the Projects of Capital Medical Technology Development Foundation (No.2005-SF-Ⅱ-038)the Projects of Beijing Administration of Traditional Chinese Medicine (No.JJ2007-035 and No.JZZ-VI26)
文摘OBJECTIVE: To analyze the association between tongue manifestations and the levels of glucose (GLU), total cholesterol(TCH), and high-density lipoprotein cholesterol(HDL-C) in subjects with acute cerebral infarction.METHODS: Hospitalized patients with first unilateral cerebral infarction in the Neurological Department of Xuanwu Hospital were included and the correlation between tongue fur color, fur nature,and the levels of GLU,TCH, HDL-C were analyzed.RESULTS: HDL level in the thin fur group was higher than that in the thick fur group(P=0.02). The difference in the levels of GLU,TCH, and HDL-C among the groups was significant(P<0.05), classified in terms of slippery, moist, and dry fur. Further comparison between the groups by Student-Newman-Keuls test showed that GLU level in the dry fur group was the highest. Moreover, the TCH level in the slippery fur group was higher than the other two groups.CONCLUSION: A correlation between tongue manifestations and GLU, TCH, HDL-C was identified in the patients with acute cerebral infarction.
