Echocardiography is the most common diagnostic method for assessing atrial function but the technique has some limitations. Traditionally, assessment of left atrial function has been performed by measuring volumes wit...Echocardiography is the most common diagnostic method for assessing atrial function but the technique has some limitations. Traditionally, assessment of left atrial function has been performed by measuring volumes with 2D echocardiography. Additionally, it can be assessed with transmitral Doppler and pulmonary vein Doppler. Recently, an alternative method has been incorporated, namely, measurement of myocardial deformation with color tissue Doppler-derived strain. However, this method has several limitations, such as suboptimal reproducibility, angle-dependence, signal artifacts and the fact that it only measures regional strain and does not obtain information about the curved portion of the atrial roof. To overcome these limitations in the quantification of atrial function, the use of speckle tracking echocardiography (STE) strain has been proposed. This technique is not derived from Doppler but rather from 2D echocardiography; it is angle-independent and allows one to measure global as well as regional atrial strain. In this editorial, we describe the physical and pathophysiological concepts of STE and underline the clinical usefulness of this new technique.展开更多
Using the relative vorticity averaged over a certain area, a new index for measuring the longitudinal position of the subtropical high (SH) in the western Pacific is proposed to avoid the increasing trend of heights i...Using the relative vorticity averaged over a certain area, a new index for measuring the longitudinal position of the subtropical high (SH) in the western Pacific is proposed to avoid the increasing trend of heights in the previous indices based on geopotential height. The years of extreme westward and eastward extension of SH using the new index are in good agreement with those defined by height index. There exists a distinct difference in large-scale circulation between the eastward and westward extension of SH under the new definition, which includes not only the circulation in the middle latitudes but also the flow in the lower latitudes. It seems that when the SH extends far to the east (west), the summer monsoon in the South China Sea is stronger (weaker) and established earlier (later). In addition, there exists a good relationship between the longitudinal position of SH and the summer rainfall in China. A remarkable negative correlation area appears in the Changjiang River valley, indicating that when the SH extends westward (eastward), the precipitation in that region increases (decreases). A positive correlation region is found in South China, showing the decrease of rainfall when the SH extends westward. On the other hand, the rainfall is heavier when the SH retreats eastward. However, the anomalous longitudinal position of SH is not significantly related to the precipitation in North China. The calculation of correlation coefficients between the index of longitudinal position of SH and surface temperature in China shows that a large area of positive values, higher than 0.6 in the center, covers the whole of North China, even extending eastward to the Korean Peninsula and Japan Islands when using NCEP/NCAR reanalysis data to do the correlation calculation. This means that when the longitudinal position of the SH withdraws eastward in summer, the temperature over North China is higher. On the other hand, when it moves westward, the temperature there is lower. This could explain the phenomenon of the ser展开更多
The vibration problem of a pile of arbitrary segments withvariable modulus modules under ex- citing force is established, inwhich the influence of the soil under pile toe and the surroundingsis tak- en into account. W...The vibration problem of a pile of arbitrary segments withvariable modulus modules under ex- citing force is established, inwhich the influence of the soil under pile toe and the surroundingsis tak- en into account. With Laplace transforms, the transmitfunctions for velocity and displacement of pile are derived.Furthermore, in terms of the convolution theorem and inversed Laplacetransform, an analytical solution for the time domain response of apile subjected to semi-sine impulse is developed, which is thetheoretical basis of the sonic method in pile integrity testing. Basedon the solution, the vibration properties of pile with sharp orcontinuous modulus are studied. The validity of this approach isverified through field dynamic tests on some engineering piles. Itshows that the theoretical predic- tion ad the response of the pileare in good agreement.展开更多
Variable gauge rolling （VGR） is a new technology to produce flat products with different thicknesses （FDT）, which could be used to replace conventional fiat products in order to save metals and reduce structure ma...Variable gauge rolling （VGR） is a new technology to produce flat products with different thicknesses （FDT）, which could be used to replace conventional fiat products in order to save metals and reduce structure mass. The method of VGR was introduced for investigating new problems in rolling theory of VGR, and the new formulas for calculating parameters of VGR were proposed. Besides, some results of numerical simulation by finite elemen~ method were described. As an example, the products applications of FDT in bridge construction, ship building and auto manufacturing were presented. Finally, the prospects for VGR and FDT were discussed.展开更多
Background Ossification of the posterior longitudinal ligament （OPLL） has a strong genetic background. Previous studies have shown that bone morphogenetic protein-2 （BMP2） and BMP2 mRNA are expressed in ossifying ...Background Ossification of the posterior longitudinal ligament （OPLL） has a strong genetic background. Previous studies have shown that bone morphogenetic protein-2 （BMP2） and BMP2 mRNA are expressed in ossifying matrix and chondrocytes adjacent to cartilaginous areas of OPLL tissues and mesenchymal cells with fibroblastic features in the immediate vicinity of the cartilaginous areas. It is suggested that BMP2 plays different roles in the different stages of development of OPLL. However, it remains unknown which factors induce ligament cells to produce BMP2. Methods OPLL patients （n=-192） and non-OPLL controls （n=304） were studied. Radiographs of the cervical spine were analyzed for extent of OPLL. We investigated whether single nucleotide polymorphisms of exons 3（-726） T/C and 3（-583） NG in the BMP2 gene are statistically associated with genetic susceptibility to OPLL in Chinese Han subjects. Results There was no statistical difference between the occurrence of exons 3（-726） T/C and 3（-583） NG and the occurrence of OPLL in the cervical spine. However, there was a significant association between occurrence of exon 3（-726） T/C polymorphism and occurrence of OPLL in males of cases and controls in the cervical spine. In addition, no significant association was found between the exons 3（-726） T/C and 3（-583） A/G with number of ossified cervical vertebrae in OPLL patients. Conclusions Exon 3（-583） A/G polymorphism in BMP2 gene is not associated with the occurrence and the extent of OPLL in the cervical spine. Chinese Han male patients with TC and CC genotypes in exon 3（-726） T/C have genetic susceptibility to OPLL but not to more extensive OPLL in the cervical spine.展开更多
Obstructive azoospermia secondary to epididymal obstruction can be corrected by microsurgical reconstruction with vasoepididymostomy （VE）. Although alternative management such as epididymal or testicular sperm aspir...Obstructive azoospermia secondary to epididymal obstruction can be corrected by microsurgical reconstruction with vasoepididymostomy （VE）. Although alternative management such as epididymal or testicular sperm aspiration in conjunction with intracytoplasmic sperm injection is feasible, various studies have established the superior cost-effectiveness of VE as a treatment of choice. Microsurgical VE is considered one of the most technically challenging microsurgeries. Its success rate is highly dependent on the skills and experience of the surgeons. Various techniques have been described in the literature for VE. We have pioneered a technique known as longitudinal intussusception VE （LIVE） in which the epididymal tubule is opened longitudinally to obtain a larger opening to allow its tubular content to pass through the anastomosis. Our preliminary data demonstrated a patency rate of over 90%. This technique has been widely referenced in the recent literature including robotic-assisted microsurgery. The history of the development of different VE approaches, the oreoDerative evaluation along with the techniaues of various VE will be described in this article.展开更多
Using the NCEP/NCAR reanalysis data, the China rainfall data of the China Meteorological Administration, and the sea surface temperature (SST) data of NOAA from 1951-2000, the features of the anomalous longitudinal po...Using the NCEP/NCAR reanalysis data, the China rainfall data of the China Meteorological Administration, and the sea surface temperature (SST) data of NOAA from 1951-2000, the features of the anomalous longitudinal position of the subtropical high in the western Pacific (SHWP) in the pre-rainy season in South China and associated circulation and precipitation are studied. Furthermore, the relationship between SHWP and SST and the eastern Asian winter monsoon is also investigated. Associated with the anomalous longitudinal position of SHWP in the pre-rainy season in South China, the flow patterns in both the middle and lower latitudes are different. The circulation anomalies greatly influence the precipitation in the pre-rainy season in South China. When the SHWP is in a west position (WP), the South China quasi-stationary front is stronger with more abundant precipitation there. However, when the SHWP is in an east position (EP), a weaker front appears with a shortage of precipitation there. There exists a good relationship between the longitudinal position of SHWP and SST in the tropical region. A negative correlation can be found both in the central and eastern tropical Pacific and the Indian Ocean. This means that the higher (lower) SST there corresponds to a west (east) position of SHWP. This close relationship can be found even in the preceding autumn and winter. A positive correlation appears in the western and northern Pacific and large correlation coefficient values also occur in the preceding autumn and winter. A stronger eastern Asian winter monsoon will give rise to cooler SSTs in the Kuroshio and the South China Sea regions and it corresponds to negative SST anomaly (SSTA) in the central and eastern Pacific and positive SSTA in the western Pacific in winter and the following spring. The whole tropical SSTA pattern, that is, positive (negative) SSTA in the central and eastern Pacific and negative (positive) SSTA in the western Pacific, is favorable to the WP (EP) of SHWP.展开更多
Ballastless tracks have been widely applied in high-speed railway (HSR). The adaptability research between continuous welded rails (CWR) and long-span bridges of HSR is of great practical engineering significance. Bas...Ballastless tracks have been widely applied in high-speed railway (HSR). The adaptability research between continuous welded rails (CWR) and long-span bridges of HSR is of great practical engineering significance. Based on the HSR long-span continuous bridges, the integrative spatial finite element model of track-bridge-pier-foundation system was established with the nonlinear spring element simulating the longitudinal resistance between track and bridge. Comparative study on the various additional longitudinal forces of CWR using the common fasteners and small resistance fasteners was carried out. Analysis results indicate that the additional expansion forces and additional rail-breaking forces in long-span ballastless continuous girders can be reduced evidently by 40% 50% after adopting small resistance fasteners, but lead to greater rail broken gap. The small resistance fasteners have little influence on the additional force only caused by vertical load, but can reduce the additional force caused by vertical load combined with braking load by over 10%. Besides, transient analysis method is proved to be more accurate and safe in calculating additional longitudinal forces when the train running or braking on the bridge, compared with the traditional static method.展开更多
Based on the construction bridge of Xiamen-Shenzhen high-speed railway(9-32 m simply-supported beam + 6×32 m continuous beam),the pier-beam-track finite element model,where the continuous beam of the ballast trac...Based on the construction bridge of Xiamen-Shenzhen high-speed railway(9-32 m simply-supported beam + 6×32 m continuous beam),the pier-beam-track finite element model,where the continuous beam of the ballast track and simply-supported beam are combined with each other,was established.The laws of the track stress,the pier longitudinal stress and the beam-track relative displacement were analyzed.The results show that reducing the longitudinal resistance can effectively reduce the track stress and the pier stress of the continuous beam,and increase the beam-track relative displacement.Increasing the rigid pier stiffness of continuous beam can reduce the track braking stress,increase the pier longitudinal stress and reduce the beam-track relative displacement,Increasing the rigid pier stiffness of simply-supported beam can reduce the track braking stress,the rigid pier longitudinal stress and the beam-track relative displacement.展开更多
The surgical outcomes of decompression for thoracic spinal stenosis （TSS） are unfavorable. The purpose of this study was to determine the efficacy of intraoperative ultrasonography during ＂cave-in＂ 360~ circumfere...The surgical outcomes of decompression for thoracic spinal stenosis （TSS） are unfavorable. The purpose of this study was to determine the efficacy of intraoperative ultrasonography during ＂cave-in＂ 360~ circumferential decompression surgery in patients with TSS. Methods Thirteen patients with TSS underwent ＂cave-in＂ 360° circumferential decompression surgery between May 2010 and November 2010. Intraoperative ultrasonography was used after removal of the posterior wall of thoracic spinal canal to assess the morphologic restoration of the spinal cord and the anterior surface of the spinal canal. In seven patients, ultrasonography was used again after circumferential decompression to compare the cross-sectional area of the spinal cord before and after circumferential decompression. Results The average period of follow-up was （12±2） months （range 9-15 months）. The Japanese Orthopedic Association score was significantly higher at the final follow-up （8.5±2.1, range 3-10） than preoperatively （5.2±1.1, range 3-7; P 〈0.01）. The cross-sectional area of the spinal cord was （30.8±6.6） mm2 before and （53.6±19.1） mm2 after circumferential decompression （P 〈0.01）. For five patients with TSS caused by thoracic disc herniation, the levels of circumferential decompression performed corresponded to those expected preoperatively. In contrast, for eight patients with TSS caused by ossification of the posterior longitudinal ligament, on average 1.6±0.9 fewer levels of circumferential decompression were performed than expected preoperatively. Conclusions ＂Cave-in＂ 360° circumferential decompression is an effective therapeutic option for TSS. Intraoperative ultrasonographic evaluation may reduce the levels of circumferential decompression and ensure sufficient decomoression, and increase the efficacy of this surqical technique.展开更多
Accurate determination of the presence and degree of fibrosis in liver is of great importance, because the prognosis and management strategies for chronic liver disease depend mainly on these factors. To date, liver b...Accurate determination of the presence and degree of fibrosis in liver is of great importance, because the prognosis and management strategies for chronic liver disease depend mainly on these factors. To date, liver biopsy (LB) remains the "gold standard" for assessing the severity of liver fibrosis; however, LB is often limited by its invasiveness, sampling error, and intra/ inter-observer variability in histological interpretation. Furthermore, repeated LB examinations within a short time interval are indeed ineligible in a real clinical practice. Thus, due to the pressing need for non-invasive surrogates for liver fibrosis, transient elastography (TE),as a novel ultrasound based technology, has allowed a noninvasive measurement of liver stiffness and has gained in popularity over recent years. In the past few years, additional roles for transient TE beyond the initial purpose of a non-invasive surrogate for LB have included the prediction of the most two critical consequences of fibrosis progression: the development of portal hypertension-related complications and hepatocellular carcinoma. This indicates that the role of transient TE is not merely limited to reducing the need for LB, but transient TE can enable the establishment of tailored management strategies by providing more detailed prognostic information. In particular, under the concept in which the clinical course of liver fibrosis is dynamic and bidirectional, especially when appropriate intervention is commenced, transient TE can be used to track the dynamic changes in fibrotic burden during antiviral or antifibrotic treatment. This review discussed extended applications of transient TE in prediction of the development of real clinical endpoints from a longitudinal perspective.展开更多
Combining the adaptive shrinkage genetic algorithm in the feasible region with the imaging of apparent vertical conductance differential, we have inverted the TEM conductive thin layer. The result of the inversion dem...Combining the adaptive shrinkage genetic algorithm in the feasible region with the imaging of apparent vertical conductance differential, we have inverted the TEM conductive thin layer. The result of the inversion demonstrates that by adaptive shrinkage in the feasible region, the calculation speed accelerates and the calculation precision improves. To a certain extent, in this method we surmount the transient electromagnetic sounding equivalence and reduced equivalence scope. Comparison of the inverted result with the forward curve clearly shows that we can image the conductive thin layer.展开更多
文摘Echocardiography is the most common diagnostic method for assessing atrial function but the technique has some limitations. Traditionally, assessment of left atrial function has been performed by measuring volumes with 2D echocardiography. Additionally, it can be assessed with transmitral Doppler and pulmonary vein Doppler. Recently, an alternative method has been incorporated, namely, measurement of myocardial deformation with color tissue Doppler-derived strain. However, this method has several limitations, such as suboptimal reproducibility, angle-dependence, signal artifacts and the fact that it only measures regional strain and does not obtain information about the curved portion of the atrial roof. To overcome these limitations in the quantification of atrial function, the use of speckle tracking echocardiography (STE) strain has been proposed. This technique is not derived from Doppler but rather from 2D echocardiography; it is angle-independent and allows one to measure global as well as regional atrial strain. In this editorial, we describe the physical and pathophysiological concepts of STE and underline the clinical usefulness of this new technique.
基金supported by the Innovation Key Prograrn of the Chinese Academy of Sciences ZKCX2-SW-210the National Natural Science Foundation of China under Grant Nol40135020,and 40233033.
文摘Using the relative vorticity averaged over a certain area, a new index for measuring the longitudinal position of the subtropical high (SH) in the western Pacific is proposed to avoid the increasing trend of heights in the previous indices based on geopotential height. The years of extreme westward and eastward extension of SH using the new index are in good agreement with those defined by height index. There exists a distinct difference in large-scale circulation between the eastward and westward extension of SH under the new definition, which includes not only the circulation in the middle latitudes but also the flow in the lower latitudes. It seems that when the SH extends far to the east (west), the summer monsoon in the South China Sea is stronger (weaker) and established earlier (later). In addition, there exists a good relationship between the longitudinal position of SH and the summer rainfall in China. A remarkable negative correlation area appears in the Changjiang River valley, indicating that when the SH extends westward (eastward), the precipitation in that region increases (decreases). A positive correlation region is found in South China, showing the decrease of rainfall when the SH extends westward. On the other hand, the rainfall is heavier when the SH retreats eastward. However, the anomalous longitudinal position of SH is not significantly related to the precipitation in North China. The calculation of correlation coefficients between the index of longitudinal position of SH and surface temperature in China shows that a large area of positive values, higher than 0.6 in the center, covers the whole of North China, even extending eastward to the Korean Peninsula and Japan Islands when using NCEP/NCAR reanalysis data to do the correlation calculation. This means that when the longitudinal position of the SH withdraws eastward in summer, the temperature over North China is higher. On the other hand, when it moves westward, the temperature there is lower. This could explain the phenomenon of the ser
文摘The vibration problem of a pile of arbitrary segments withvariable modulus modules under ex- citing force is established, inwhich the influence of the soil under pile toe and the surroundingsis tak- en into account. With Laplace transforms, the transmitfunctions for velocity and displacement of pile are derived.Furthermore, in terms of the convolution theorem and inversed Laplacetransform, an analytical solution for the time domain response of apile subjected to semi-sine impulse is developed, which is thetheoretical basis of the sonic method in pile integrity testing. Basedon the solution, the vibration properties of pile with sharp orcontinuous modulus are studied. The validity of this approach isverified through field dynamic tests on some engineering piles. Itshows that the theoretical predic- tion ad the response of the pileare in good agreement.
基金Item Sponsored by National Natural Science Foundation of China(50634030,50974039)
文摘Variable gauge rolling （VGR） is a new technology to produce flat products with different thicknesses （FDT）, which could be used to replace conventional fiat products in order to save metals and reduce structure mass. The method of VGR was introduced for investigating new problems in rolling theory of VGR, and the new formulas for calculating parameters of VGR were proposed. Besides, some results of numerical simulation by finite elemen~ method were described. As an example, the products applications of FDT in bridge construction, ship building and auto manufacturing were presented. Finally, the prospects for VGR and FDT were discussed.
文摘Background Ossification of the posterior longitudinal ligament （OPLL） has a strong genetic background. Previous studies have shown that bone morphogenetic protein-2 （BMP2） and BMP2 mRNA are expressed in ossifying matrix and chondrocytes adjacent to cartilaginous areas of OPLL tissues and mesenchymal cells with fibroblastic features in the immediate vicinity of the cartilaginous areas. It is suggested that BMP2 plays different roles in the different stages of development of OPLL. However, it remains unknown which factors induce ligament cells to produce BMP2. Methods OPLL patients （n=-192） and non-OPLL controls （n=304） were studied. Radiographs of the cervical spine were analyzed for extent of OPLL. We investigated whether single nucleotide polymorphisms of exons 3（-726） T/C and 3（-583） NG in the BMP2 gene are statistically associated with genetic susceptibility to OPLL in Chinese Han subjects. Results There was no statistical difference between the occurrence of exons 3（-726） T/C and 3（-583） NG and the occurrence of OPLL in the cervical spine. However, there was a significant association between occurrence of exon 3（-726） T/C polymorphism and occurrence of OPLL in males of cases and controls in the cervical spine. In addition, no significant association was found between the exons 3（-726） T/C and 3（-583） A/G with number of ossified cervical vertebrae in OPLL patients. Conclusions Exon 3（-583） A/G polymorphism in BMP2 gene is not associated with the occurrence and the extent of OPLL in the cervical spine. Chinese Han male patients with TC and CC genotypes in exon 3（-726） T/C have genetic susceptibility to OPLL but not to more extensive OPLL in the cervical spine.
文摘Obstructive azoospermia secondary to epididymal obstruction can be corrected by microsurgical reconstruction with vasoepididymostomy （VE）. Although alternative management such as epididymal or testicular sperm aspiration in conjunction with intracytoplasmic sperm injection is feasible, various studies have established the superior cost-effectiveness of VE as a treatment of choice. Microsurgical VE is considered one of the most technically challenging microsurgeries. Its success rate is highly dependent on the skills and experience of the surgeons. Various techniques have been described in the literature for VE. We have pioneered a technique known as longitudinal intussusception VE （LIVE） in which the epididymal tubule is opened longitudinally to obtain a larger opening to allow its tubular content to pass through the anastomosis. Our preliminary data demonstrated a patency rate of over 90%. This technique has been widely referenced in the recent literature including robotic-assisted microsurgery. The history of the development of different VE approaches, the oreoDerative evaluation along with the techniaues of various VE will be described in this article.
基金This work was supported by the National Key Basic Research and Development Project of China 2004CB18300the Key Knowledge Innovation Project of Chinese Academy of Sciences(Grand No.KZCX3-SW-226)the National Natural Science Foundation of China under Grant Nos.40135020 and 40325015.
文摘Using the NCEP/NCAR reanalysis data, the China rainfall data of the China Meteorological Administration, and the sea surface temperature (SST) data of NOAA from 1951-2000, the features of the anomalous longitudinal position of the subtropical high in the western Pacific (SHWP) in the pre-rainy season in South China and associated circulation and precipitation are studied. Furthermore, the relationship between SHWP and SST and the eastern Asian winter monsoon is also investigated. Associated with the anomalous longitudinal position of SHWP in the pre-rainy season in South China, the flow patterns in both the middle and lower latitudes are different. The circulation anomalies greatly influence the precipitation in the pre-rainy season in South China. When the SHWP is in a west position (WP), the South China quasi-stationary front is stronger with more abundant precipitation there. However, when the SHWP is in an east position (EP), a weaker front appears with a shortage of precipitation there. There exists a good relationship between the longitudinal position of SHWP and SST in the tropical region. A negative correlation can be found both in the central and eastern tropical Pacific and the Indian Ocean. This means that the higher (lower) SST there corresponds to a west (east) position of SHWP. This close relationship can be found even in the preceding autumn and winter. A positive correlation appears in the western and northern Pacific and large correlation coefficient values also occur in the preceding autumn and winter. A stronger eastern Asian winter monsoon will give rise to cooler SSTs in the Kuroshio and the South China Sea regions and it corresponds to negative SST anomaly (SSTA) in the central and eastern Pacific and positive SSTA in the western Pacific in winter and the following spring. The whole tropical SSTA pattern, that is, positive (negative) SSTA in the central and eastern Pacific and negative (positive) SSTA in the western Pacific, is favorable to the WP (EP) of SHWP.
基金Projects(50908232, 51108460) supported by the National Natural Science Foundation of China
文摘Ballastless tracks have been widely applied in high-speed railway (HSR). The adaptability research between continuous welded rails (CWR) and long-span bridges of HSR is of great practical engineering significance. Based on the HSR long-span continuous bridges, the integrative spatial finite element model of track-bridge-pier-foundation system was established with the nonlinear spring element simulating the longitudinal resistance between track and bridge. Comparative study on the various additional longitudinal forces of CWR using the common fasteners and small resistance fasteners was carried out. Analysis results indicate that the additional expansion forces and additional rail-breaking forces in long-span ballastless continuous girders can be reduced evidently by 40% 50% after adopting small resistance fasteners, but lead to greater rail broken gap. The small resistance fasteners have little influence on the additional force only caused by vertical load, but can reduce the additional force caused by vertical load combined with braking load by over 10%. Besides, transient analysis method is proved to be more accurate and safe in calculating additional longitudinal forces when the train running or braking on the bridge, compared with the traditional static method.
基金Project(50678176) supported by the National Natural Science Foundation of China
文摘Based on the construction bridge of Xiamen-Shenzhen high-speed railway(9-32 m simply-supported beam + 6×32 m continuous beam),the pier-beam-track finite element model,where the continuous beam of the ballast track and simply-supported beam are combined with each other,was established.The laws of the track stress,the pier longitudinal stress and the beam-track relative displacement were analyzed.The results show that reducing the longitudinal resistance can effectively reduce the track stress and the pier stress of the continuous beam,and increase the beam-track relative displacement.Increasing the rigid pier stiffness of continuous beam can reduce the track braking stress,increase the pier longitudinal stress and reduce the beam-track relative displacement,Increasing the rigid pier stiffness of simply-supported beam can reduce the track braking stress,the rigid pier longitudinal stress and the beam-track relative displacement.
文摘The surgical outcomes of decompression for thoracic spinal stenosis （TSS） are unfavorable. The purpose of this study was to determine the efficacy of intraoperative ultrasonography during ＂cave-in＂ 360~ circumferential decompression surgery in patients with TSS. Methods Thirteen patients with TSS underwent ＂cave-in＂ 360° circumferential decompression surgery between May 2010 and November 2010. Intraoperative ultrasonography was used after removal of the posterior wall of thoracic spinal canal to assess the morphologic restoration of the spinal cord and the anterior surface of the spinal canal. In seven patients, ultrasonography was used again after circumferential decompression to compare the cross-sectional area of the spinal cord before and after circumferential decompression. Results The average period of follow-up was （12±2） months （range 9-15 months）. The Japanese Orthopedic Association score was significantly higher at the final follow-up （8.5±2.1, range 3-10） than preoperatively （5.2±1.1, range 3-7; P 〈0.01）. The cross-sectional area of the spinal cord was （30.8±6.6） mm2 before and （53.6±19.1） mm2 after circumferential decompression （P 〈0.01）. For five patients with TSS caused by thoracic disc herniation, the levels of circumferential decompression performed corresponded to those expected preoperatively. In contrast, for eight patients with TSS caused by ossification of the posterior longitudinal ligament, on average 1.6±0.9 fewer levels of circumferential decompression were performed than expected preoperatively. Conclusions ＂Cave-in＂ 360° circumferential decompression is an effective therapeutic option for TSS. Intraoperative ultrasonographic evaluation may reduce the levels of circumferential decompression and ensure sufficient decomoression, and increase the efficacy of this surqical technique.
基金Supported by Liver Cirrhosis Clinical Research Center, in part by a grant from the Korea Health care technology R and D project, Ministry of Health and Welfare, Republic of Korea, NoA102065the Yonsei Liver Blood Bank, in part by a grantfrom sanofi-aventis Korea
文摘Accurate determination of the presence and degree of fibrosis in liver is of great importance, because the prognosis and management strategies for chronic liver disease depend mainly on these factors. To date, liver biopsy (LB) remains the "gold standard" for assessing the severity of liver fibrosis; however, LB is often limited by its invasiveness, sampling error, and intra/ inter-observer variability in histological interpretation. Furthermore, repeated LB examinations within a short time interval are indeed ineligible in a real clinical practice. Thus, due to the pressing need for non-invasive surrogates for liver fibrosis, transient elastography (TE),as a novel ultrasound based technology, has allowed a noninvasive measurement of liver stiffness and has gained in popularity over recent years. In the past few years, additional roles for transient TE beyond the initial purpose of a non-invasive surrogate for LB have included the prediction of the most two critical consequences of fibrosis progression: the development of portal hypertension-related complications and hepatocellular carcinoma. This indicates that the role of transient TE is not merely limited to reducing the need for LB, but transient TE can enable the establishment of tailored management strategies by providing more detailed prognostic information. In particular, under the concept in which the clinical course of liver fibrosis is dynamic and bidirectional, especially when appropriate intervention is commenced, transient TE can be used to track the dynamic changes in fibrotic burden during antiviral or antifibrotic treatment. This review discussed extended applications of transient TE in prediction of the development of real clinical endpoints from a longitudinal perspective.
文摘Combining the adaptive shrinkage genetic algorithm in the feasible region with the imaging of apparent vertical conductance differential, we have inverted the TEM conductive thin layer. The result of the inversion demonstrates that by adaptive shrinkage in the feasible region, the calculation speed accelerates and the calculation precision improves. To a certain extent, in this method we surmount the transient electromagnetic sounding equivalence and reduced equivalence scope. Comparison of the inverted result with the forward curve clearly shows that we can image the conductive thin layer.
