检索结果-南通市图书馆

Influence of breathing movements and Valsalva maneuver on vena caval dynamics

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Radiology 2014年第10期6卷 833-839页

作者： Alicia Laborda sergio Sierre Mauro Malvè Ignacio De Blas Ignatios Ioakeim William T Kuo Miguel Angel De Gregorio Minimally Invasive Techniques Research Group Universidad de Zaragoza 50013 Zaragoza Spain Department of Mechanical Engineering Energetics and Materials Universidad Pública de Navarra. Aragon Institute of Engineering Research31006 Pamplona Spain Department of Animal Pathology Faculty of Veterinary Universidad de Zaragoza 50013 Zaragoza Spain Division of Vascular and Interventional Radiology Stanford University Medical CenterCA 94305 United States

AIM: To study changes produced within the inferior vena cava(IVC) during respiratory movements and identify their possible clinical ***: This study included 100 patients(46 women; 54 men) over 18 years of age who required an abdominal computed tomography(CT) and central venous access. IVC cross-sectional areas were measured on CT scans at three levels, suprarenal(SR), juxtarenal(JR) and infrarenal(IR), during neutral breathing and again during the Valsalva maneuver. All patientswere instructed on how to perform a correct Valsalva maneuver. In order to reduce the total radiation dose in our patients, low-dose CT protocols were used in all patients. The venous blood pressure(systolic, diastolic and mean) was invasively measured at the same three levels with neutral breathing and the Valsalva maneuver during venous port implantation. From CT scans, threedimensional models of the IVC were constructed and a collapsibility index was calculated for each patient. These data were then correlated with venous pressures and cross-sectional ***: The mean patient age was 51.64 ± 12.01 years. The areas of the ellipse in neutral breathing were 394.49 ± 85.83(SR), 380.10 ± 74.55(JR), and 342.72 ± 49.77 mm2(IR), and 87.46 ± 18.35(SR), 92.64 ± 15.36(JR) and 70.05 ± 9.64 mm2(IR) during the Valsalva(P s < 0.001). There was a correlation between areas in neutral breathing and in the Valsalva maneuver(P < 0.05 in all areas). Large areas decreased more than smaller areas. The collapsibility indices were 0.49 ± 0.06(SR), 0.50 ± 0.04(JR) and 0.50 ± 0.04(IR), with no significant differences in any region. Reconstructed three-dimensional models showed a flattening of the IVC during Valsalva, adopting an ellipsoid cross-sectional shape. The mean pressures with neutral breathing were 9.44 ± 1.78(SR), 9.40 ± 1.44(JR) and 8.84 ± 1.03 mmHg(IR), and 81.08 ± 21.82(SR), 79.88 ± 19.01(JR) and 74.04 ± 16.56 mmHg(IR) during Valsalva(P s < 0.001). There was a negative correlatio

关键词： Inferior vena cava Morphology Respiratory movements Size Valsalva Venous hemodynamics

Business Architecture： A Case Study of a Medium Enterprise in Mexico

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

通讯和计算机（中英文版） 2014年第1期11卷 22-29页

作者： Alicia Valdez Menchaca sergio Castaneda Alvarado Gloria Campos Posada Alma Domfnguez Lugo Alicia Silva Avila Samuel Hernandez Donjuan Research Center Faculty of Engineering Mechanical and Electrical University Autonomous of Coahuila Coahuila Mexico Academic Unit Computer Systems Faculty of Engineering Mechanical and Electrical University Autonomous of CoahuilaCoahuila Mexico

Enterprise architecture is a subject that has increased its importance in the small and medium enterprises in the manufacturing sector of the industry in Mexico. The global competitiveness of the markets has influenced the adoption of methodologies that support the strategic alignment of the processes with the goals and strategic objectives of the firms. The components of the business architecture like mission, vision, strategic objectives, products, organizational structure, business processes, clients and geographic region, were collected from the firm of the case study for the design of the architecture. As a result of the practical application, an implementation model has been created and four strategic objectives were established for to improve productivity and competitiveness. This paper is a result of the research project of analysis, design and implementing business architecture in a medium size manufacturing company like partial architecture of an enterprise using ontologies for representing the core elements of the business architecture; the study presents clearly the importance of the strategic planning for the analysis and the detection of the main faults for the success of the achievement of goals and objectives.

关键词：业务架构中型企业墨西哥全球竞争力建筑设计中小型企业组织结构组成部分

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

街头的孤独之歌

摄影之友 2019年第10期 122-125页

作者：塞吉奥·加西亚·加瓦尔德李思瑾不详

城市之于每个人都有着不一样的魅力,这个游荡在巴塞罗那街头的摄影师将自己对周围的感知与希望糅合到了他极致的光影当中。街头摄影也包含了很多种类型。所有类型的照片都同样能吸引你的眼球,但我认为每张照片都必须有一个问题要回答,... 详细信息

城市之于每个人都有着不一样的魅力,这个游荡在巴塞罗那街头的摄影师将自己对周围的感知与希望糅合到了他极致的光影当中。街头摄影也包含了很多种类型。所有类型的照片都同样能吸引你的眼球,但我认为每张照片都必须有一个问题要回答,你在拍下这张照片时,是一些什么东西吸引着你,要问你自己这个问题。

关键词：巴塞罗那加瓦尔变焦镜头摄影师加西亚

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

针灸治疗网球肘疗效的系统评价

针灸治疗网球肘疗效的系统评价

第七届中医/中西医结合循证医学方法研讨会

作者： Marcus Gadau Wing-Fai Yeung 柳华 Chris Zaslawski Yuan-Sheng Tan Fu-Chun Wang sergio Bangrazia Ka-Fai Chung Zhao-Xiang Bian 张世平香港浸会大学中医药学院香港大学精神科川北医学院第二临床医学院南充市中心医院神经科 College of Traditional Chinese Medicine University of Technology Sydney World Federation of Acupuncture and Moxibustion Societies Changchun University of Traditional Chinese Medicine

针灸广泛应用于网球肘(肱骨外上髁炎,LEP)的治疗,然而,不同的研究结论差异较大。本研究旨在运用循证医学方法,对有关针灸治疗LEP的随机对照试验进行了系统评价,以探讨针灸对LEP的疗效和副作用。本研究广泛检索中英文数据库以获取合格文... 详细信息

针灸广泛应用于网球肘(肱骨外上髁炎,LEP)的治疗,然而,不同的研究结论差异较大。本研究旨在运用循证医学方法,对有关针灸治疗LEP的随机对照试验进行了系统评价,以探讨针灸对LEP的疗效和副作用。本研究广泛检索中英文数据库以获取合格文献,针刺临床试验干预措施报告的标准(STRICTA)被用来衡量针灸临床实施质量,Jadad评分修订版用来评估纳入研究的方法学质量。总共19个比较针灸和假针刺或者传统治疗对LEP的RCT研究纳入本系统评价,仅有5个研究Jadad评分在3分或以上,其余14个研究具有较低的方法学质量。分析结果表明,相对于假针刺或者超声治疗,针灸疗效更好;然而,由于纳入研究的方法学质量低,目前证据不足以支持针灸在治疗LEP中,疗效比局麻药注射、局部糖皮质激素注射和非甾体类消炎药更好,虽然分析发现针刺加灸法似乎比单用针刺疗效好,然而这些研究低的方法学质量减弱了证据的可靠性。在未来的研究中,需要改进研究方法学质量,以便得出针灸对LEP疗效的真实可靠结论。

关键词：针灸网球肘肱骨外上髁炎系统评价 Meta分析

来源： cnki会议评论

在线全文

cnki会议

学校读者我要写书评

暂无评论

城市虚空汇编

城市设计 2020年第5期 24-31页

作者：塞尔吉奥·洛佩斯-皮内罗蔡淦东(译) 哈佛大学 Sasaki事务所

《城市虚空汇编》是对包括模糊地块、缓冲区等超过200个用于命名城市虚空的术语所进行的批判性编集。景观设计师詹姆斯·科纳认为此类空间无法被命名,因为"命名即赋予其含义"。本书通过对已有术语的罗列,尝试给无法命名的空间命名,为缺... 详细信息

《城市虚空汇编》是对包括模糊地块、缓冲区等超过200个用于命名城市虚空的术语所进行的批判性编集。景观设计师詹姆斯·科纳认为此类空间无法被命名,因为"命名即赋予其含义"。本书通过对已有术语的罗列,尝试给无法命名的空间命名,为缺乏准确定义的场所添加定义。书中记录的名称曾用于特指因城市化历程而废弃的场所,这些空间因种种原因被城市所淘汰或遗忘。废弃进程在带来显而易见的负面影响的同时,也把空间从金融、资本或文化层面的固有意识形态中解放出来,使不同的空间性得以产生,并最终为一种新的公共空间类型的构想与概念化提供机会。本书把汇编当作一种理论工具,展示并讨论了有关城市虚空及其作为公共空间潜在角色的核心问题。

关键词：城市虚空公共空间术语集模糊地块城市废弃地

P2Y12受体抑制剂联合质子泵抑制剂对急性冠脉综合征患者缺血事件影响的临床分析

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

中华医学杂志 2016年第33期96卷 2611-2615页

作者：冯斯婷严妍范婧尧王晓郑文聂绍平 sergio Raposeiras-Roubin Emad Abu-Assi Jose P Simao Henriques Fabrizio D' Ascenzo Jorge Saucedo Jose R Conzalez-Juanatey Stephen B Wilton Wouter J Kikkert Ivan Nunez-Gil Albert Ariza-Sole Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Moretti Zenon Huczek Toshiharu Fujii Luis C Correia Masa-aki Kawashiri Sasko Kedev 首都医科大学附属北京安贞医院急诊危重症中心 100029 University Hospital Alvaro Cunqueiro Vigo Spain Academic Medical Center Amsterdam the Netherlands Dipartimento di Scienze Mediche Divisione di Cardiologia Citta della Salute e della Scienza Turin Italy North Shore University Hospital Chicago USA University Clinical Hospital of Santiago de Compostela Santiago de compostela Spain Libin Cardiovascular Institute of Alberta Calgary Canada San Carlos Hospital Madrid Spain Bellvitge University Hospital Barcelona Spain University Patras Hospital Athens Greece Kerckhoff Heart and Thorax Center Frankfurt Germany Graduate School of Medicine Kyoto University Kyoto Japan University Clinical Hospital Warsaw Poland Hospital Sao Rafael Salvador Brazil Kanazawa University Graduate School of Medicine Kanazawa Japan University Clinic of Cardiology Skopje Macedonia

目的本研究旨在分析P2Y12受体抑制剂联合质子泵抑制剂（PPI）治疗对经皮冠状动脉介入（PCI）术后的急性冠脉综合征患者缺血事件的影响。方法基于国际多中心回顾性注册登记研究，纳入2003至2014年因急性冠脉综合征人院行PCI术的患者，分... 详细信息

目的本研究旨在分析P2Y12受体抑制剂联合质子泵抑制剂（PPI）治疗对经皮冠状动脉介入（PCI）术后的急性冠脉综合征患者缺血事件的影响。方法基于国际多中心回顾性注册登记研究，纳入2003至2014年因急性冠脉综合征人院行PCI术的患者，分为PPI组及非PPI组并随访1年，主要临床终点为全因死亡／再发心肌梗死的复合终点。根据P2Y12受体抑制剂种类，将入组患者分为氯吡格雷组及替格瑞洛组，并比较不同药物与PPI联用发生临床终点事件的风险。结果研究入选9429例患者，PPI组占54．8％，具有更多高危因素。Cox回归结果提示PPI组较非PPI组全因死亡／再发心肌梗死复合事件的发生差异无统计学意义（HR1．00，95％CI 0．86—1．18）。根据P2Y12抑制剂种类不同分为氯吡格雷组和替格瑞洛组，不同P2Y12受体抑制剂联用PPI较未联用PPI患者的临床终点无差异，联用PPI的氯吡格雷组与替格瑞洛组的临床终点差异也无统计学意义。结论急性冠脉综合征患者PPI与P2Y12受体抑制剂联用不增加全因死亡和再发心肌梗死风险，尤其PPI联用氯吡格雷在患者的缺血事件上与替格瑞洛比较差异无统计学意义。

关键词：急性冠脉综合征氯吡格雷质子泵抑制剂患者结局评价替格瑞洛

Conventional insulin vs insulin infusion therapy in acute coronary syndrome diabetic patients

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of Diabetes 2014年第4期5卷 562-568页

作者： Caterina Arvia Valeria Siciliano Kyriazoula Chatzianagnostou Gillian Laws Alfredo Quinones Galvan Chiara Mammini sergio Berti Sabrina Molinaro Giorgio Iervasi Fondazione CNR/Regione Toscana G Monaste-rio 56124 Pisa Italy CNR In-stitute of Clinical Physiology 56124 Pisa Italy

AIM:To evaluate the impact on glucose variability(GLUCV)of an nurse-implemented insulin infusion protocol when compared with a conventional insulin treatment during the day-to-day clinical ***:We enrolled 44 type 2 diabetic patients(n=32 males;n=12 females)with acute coronary syndrome(ACS)and randomy assigned to standard a subcutaneous insulin treatment(n=23)or a nurse-implemented continuous intravenous insulin infusion protocol(n=21).We utilized some parameters of GLUCV representing well-known surrogate markers of prognosis,i.e.,glucose standard deviation(SD),the mean dailyδglucose(mean of daily difference between maximum and minimum glucose),and the coefficient of variation(CV)of glucose,expressed as percent glucose(SD)/glu-cose(mean).RESULTS:At the admission,first fasting blood glucose,pharmacological treatments(insulin and/or anti-diabetic drugs)prior to entering the study and basal glycated hemoglobin(HbA1c)were observed in the two groups treated with subcutaneous or intravenous insulin infusion,*** compared with patients submitted to standard therapy,insulin-infused patients showed both increased first 24-h(median 6.9 mmol/L vs 5.7mmol/L P<0.045)and overall hospitalizationδglucose(median 10.9 mmol/L vs 9.3 mmol/L,P<0.028),with a tendency to a significant increase in first 24-h glycaemic CV(23.1%vs 19.6%,P<0.053).Severe hypoglycaemia was rare(14.3%),and it was observed only in 3 patients receiving insulin infusion ***1c values measured during hospitalization and 3 mo after discharge did not differ in the two groups of ***:Our pilot data suggest that no real benefit in terms of GLUCV is observed when routinely managing blood glucose by insulin infusion therapy in type 2 diabetic ACS hospitalized patients in respect to conventional insulin

关键词： Glycaemic management Intensive insulin therapy Conventional insulin treatment Acute coronay syndrome Glucose variability

Electrical storm in systemic sclerosis: Inside the electroanatomic substrate

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Cardiology 2014年第10期6卷 1127-1130页

作者： Michela Casella Corrado Carbucicchio Eleonora Russo Francesca Pizzamiglio Paolo Golia sergio Conti Fabrizio Costa Antonio Dello Russo Claudio Tondo Francesca Pizzamiglio Sergio Conti Antonio Dello Russo Claudio Tondo Cardiac Arrhythmia Research Centre Centro Cardiologico Monzino IRCCS 20138 Milan Italy Department of Cardiovascular Disease Morgagni-Pierantoni Hospital 27121 Forlì Italy Biosense-Webster 00040 Pomezia Italy

We report the case of a 63-year-old woman affected by a severe form of systemic scleroderma with pul-monary involvement(interstitial fibrosis diagnosed by biopsy and moderate pulmonary hypertension) and cardiac involvement(paroxysmal atrial fibrillation, right atrial flutter treated by catheter ablation, ventricular tachyarrhythmias, previous dual chamber implantable cardioverter defibrillator implant). Because of recurrent electrical storms refractory to iv antiarrhythmic drugs the patient was referred to our institution to undergo catheter ablation. During electrophysiological proce-dure a 3D shell of cardiac anatomy was created with intracardiac echocardiography pointing out a significant right ventricular dilatation with a complex aneurysmal lesion characterized by thin walls and irregular multiple trabeculae. A substrate-guided strategy of catheter ab-lation was accomplished leading to a complete electri-cal isolation of the aneurism and to the abolishment of all abnormal electrical activities. The use of advanced strategies of imaging together with electroanatomical mapping added important information to the complex arrhythmogenic substrate and improved efficacy and safety.

关键词： Ventricular tachycardia Electrical storm Radiofrequency catheter ablation Systemic sclerosis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

釜山电影中心/釜山国际电影节

城市环境设计 2020年第4期126卷 186-199页

作者：沃尔夫·狄·普瑞克斯 Markus Baumann Jan Brosch Jasmin Dieterle sergio Gonzalez Hallstein Guthu Rob Henderson Veronica Janovska Ivana Jug Matt Kirkham Jana Kucerova Dieter Segerer Anja Sorger Duccio Malagamba COOP HIMMELB(L)AU

项目大事记/CHRONOLOGY竞赛（一等奖）/Competition （1st Prize）:11/2005规划设计/Start of Planning:01/2007动工/Start of Construction:10/2008开放/Opening:29/09/2011项目参数/PROJECT DATA用地面积/Site Area:32 100m2建筑毛面积（室内）/Gross Floor Area （interior spaces）:57 981m2建筑净面积（室内）/Net Floor Area （interior spaces）:51 067m2建成区面积/Built-up Area:10 005m2（不包含屋顶/without roofs）

关键词：