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Challenges and opportunities in improving left ventricular remodelling and clinical outcome following surgical and trans-catheter aortic valve replacement

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Frontiers of Medicine 2021年第3期15卷 416-437页

作者： Xu Yu Jin Mario Petrou Jiang Ting Hu Ed D nicol john R Pepper Surgical Echo-Cardiology Services Oxford Heart CentreJohn Radcliffe HospitalOxford University Hospitals NHS Foundation TrustOxford OX39DUUK Cardiac Surgical Physiology and Genomics Group Nuffield Division of Clinical Laboratory SciencesRadcliffe Department of MedicineUniversity of OxfordOxford OX39DUUK Department of Cardiac Surgery Royal Brompton HospitalLondon SW36NPUK National Heart and Lung Institute Imperial College LondonLondon SW36LYUK NIHR Imperial Biomedical Research Centre London W21NYUK Department of Cardiology Royal Brompton HospitalLondon SW36NPUK

Over the last half century,surgical aortic valve replacement(SAVR)has evolved to offer a durable and efficient valve haemodynamically,with low procedural complications that allows favourable remodelling of left ventricular(LV)structure and *** latter has become more challenging among elderly patients,particularly following trans-catheter aortic valve implantation(TAVI).Precise understanding of myocardial adaptation to pressure and volume overloading and its responses to valve surgery requires comprehensive assessments from aortic valve energy loss,valvular-vascular impedance to myocardial activation,force-velocity relationship,and myocardial *** hypertrophy and myocardial fibrosis remains as the structural and morphological focus in this *** intervention in asymptomatic aortic stenosis or regurgitation along with individualised management of hypertension and atrial fibrillation is likely to improve patient *** pacing via the His-Purkinje system for conduction abnormalities,further reduction in para-valvular aortic regurgitation along with therapy of angiotensin receptor blockade will improve patient outcome by facilitating hypertrophy regression,LV coordinate contraction,and global vascular *** leaflet thromboses require anticoagulation while impaired access to coronary ostia risks future TAVI-in-TAVI or coronary *** comparable long-term durability and the resolution of TAVI related complications become available,SAVR remains the first choice for lower risk younger patients.

关键词： surgical aortic valve replacement trans-catheter aortic valve implantation left ventricular hypertrophy and fibrosis myocardial force-velocity relationship His-Purkinje pacing renin-angiotensin system inhibitors coronary access impairment

Resection of complex pancreatic injuries: Benchmarking postoperative complications using the Accordion classification

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World Journal of Gastrointestinal Surgery 2017年第3期9卷 82-91页

作者： Jake E Krige Eduard Jonas Sandie R Thomson Urda K Kotze Mashiko Setshedi Pradeep H Navsaria andrew J nicol Surgical Gastroenterology Unit Department of Surgery University of Cape Town Health Sciences Faculty Observatory Groote Schuur Hospital Observatory Department of Medicine University of Cape Town Health Sciences Faculty Department of Surgery Trauma Centre University of Cape Town Health Sciences Faculty Observatory

AIM To benchmark severity of complications using the Accordion Severity Grading System(ASGS) in patients undergoing operation for severe pancreatic injuries. METHODS A prospective institutional database of 461 patients with pancreatic injuries treated from 1990 to 2015 was reviewed. One hundred and thirty patients with AAST grade 3, 4 or 5 pancreatic injuries underwent resection(pancreatoduodenectomy, n = 20, distal pancreatectomy, n = 110), including 30 who had an initial damage controllaparotomy(DCL) and later definitive surgery. AAST injury grades, type of pancreatic resection, need for DCL and incidence and ASGS severity of complications were assessed. Uni-and multivariate logistic regression analysis was applied. RESULTS Overall 238 complications occurred in 95(73%) patients of which 73% were ASGS grades 3-6. Nineteen patients(14.6%) died. Patients more likely to have complications after pancreatic resection were older, had a revised trauma score(RTS) < 7.8, were shocked on admission, had grade 5 injuries of the head and neck of the pancreas with associated vascular and duodenal injuries, required a DCL, received a larger blood transfusion, had a pancreatoduodenectomy(PD) and repeat laparotomies. Applying univariate logistic regression analysis, mechanism of injury, RTS < 7.8, shock on admission, DCL, increasing AAST grade and type of pancreatic resection were significant variables for complications. Multivariate logistic regression analysis however showed that only age and type of pancreatic resection(PD) were significant. CONCLUSION This ASGS-based study benchmarked postoperative morbidity after pancreatic resection for trauma. The detailed outcome analysis provided may serve as a reference for future institutional comparisons.

关键词： Pancreas Injury Complications Accordion classification

水下喷发火山碎屑岩储层特征及主控因素:以新西兰Taranaki盆地中新世Kora火山为例

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地学前缘 2021年第1期28卷 375-387页

作者：唐华风王寒非 Ben KENNEDY 张芯语 Marcos ROSSETTI Alan Patrick BISCHOFF andrew nicol 自然资源部东北亚矿产资源评价重点实验室吉林长春130061 坎特伯雷大学地球与环境学院新西兰坎特伯雷基督城8140 教育部东北亚生命与环境演化重点实验室(吉林大学) 吉林长春130061 吉林大学地球科学学院吉林长春130061

新西兰Taranaki盆地中新世Kora火山是海底喷发形成的碎屑岩型火山,可代表浅埋藏火山岩的储层特征。本文根据5口钻井的孔隙度、渗透率、孔隙孔径和铸体薄片开展Kora火山的储层特征、储集空间组成、缝宽以及原生和次生孔隙之间关系的分析... 详细信息

新西兰Taranaki盆地中新世Kora火山是海底喷发形成的碎屑岩型火山,可代表浅埋藏火山岩的储层特征。本文根据5口钻井的孔隙度、渗透率、孔隙孔径和铸体薄片开展Kora火山的储层特征、储集空间组成、缝宽以及原生和次生孔隙之间关系的分析。研究结果如下:(1)储集空间主要为次生孔隙,然后是裂缝和原生孔隙;Kora火山具有高孔隙度和高渗透率特征,孔径具有双峰到单峰的分布特征。(2)炸裂缝、淬火缝和粒间孔形成于岩浆破碎和/或喷发期间;在晚Tortonian期间产生了网状构造裂缝,在Tortonian晚期至Messinian早期产生规则构造裂缝,二者形成时间均早于原油充注;筛状孔和铸模孔应由风化阶段和/或埋藏阶段的溶蚀作用形成,晶间微孔应由埋藏阶段的蚀变和/或重结晶作用形成。(3)原生孔隙控制次生孔隙的分布,特别是原生的裂缝;在Kora火山中控制筛状孔和铸模孔形成的缝宽的阈值约为9μm,较宽的裂缝可优先促成筛状孔和铸模孔的形成。(4)再搬运火山颗粒含量的增加会显著降低高孔隙度岩石的总孔隙度;近源相带的孔隙度和渗透率高于远源相带,海底喷发火山远源相带发生的强烈钙质胶结可显著减少孔隙度和渗透率。相关认识可为火山岩储层形成、演化和分布规律研究提供依据。

关键词： Taranaki盆地中新世火山岩储层裂缝形成机理主控因素

新西兰Taranaki盆地中新世Kora火山高精度地层格架

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地球科学 2022年第7期47卷 2631-2645页

作者：唐华风陶鹏 Alan Patrick Bischoff 王寒非 Marcos Rossetti andrew nicol Ben Kennedy 郭天婵吉林大学自然资源部东北亚矿产资源评价重点实验室吉林长春130061 吉林大学地球科学学院吉林长春130061 坎特伯雷大学地球与环境学院基督城8140

建立埋藏火山的高精度地层格架对了解火山系统的演化、储层成因和资源潜力等具有重要意义.以新西兰Taranaki盆地中新世Kora火山为例,利用小波变换和井震联合对比等方法,开展火山地层高精度格架分析.在Kora火山识别出20个堆积单元,主要... 详细信息

建立埋藏火山的高精度地层格架对了解火山系统的演化、储层成因和资源潜力等具有重要意义.以新西兰Taranaki盆地中新世Kora火山为例,利用小波变换和井震联合对比等方法,开展火山地层高精度格架分析.在Kora火山识别出20个堆积单元,主要为火山碎屑堆积单元以及再搬运碎屑堆积单元,可合并为5个部分(相当于5个火山机构);整体上火山地层的建造与喷发中心的形成和迁移有关.利用井和常规三维地震数据可以较为准确地识别出喷发间断不整合界面系统、可建立堆积单元尺度的高精度地层格架,利用常规三维地震数据只能识别出部分喷发间断不整合界面、只能建立火山机构尺度的地层格架.相对年代的高精度地层格架是埋藏火山的更好选择.

关键词：火山地层格架火山岩地层界面地层单元火山机构石油地质学

Selenium and Iodine Deficiencies and Selenoprotein Function

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Biomedical and Environmental Sciences 1997年第2期10卷 129-135页

作者： john R. ARTHUR FERGUS nicol JULIE H. MITCHELL AND GEOFFREY J. BECKETT(Division Of Biochemical Sciences, Rowett Research Institute, Bucksburn, Aberdeen AB21 9SB, UK Cellular Endocrinology Unit,University Department of Clinical Biochemistry, The Royal In Division of Biochemical Sciences Rowett Research Institute Aberdeen UK.

This paper reviews some recent findings on the interactions between selenium deficiency and iodine deficency. Both micronutrients can control the levels of selenoprotein mRNAs, particularly in the thyroid and brain. When selenium and iodine supplies are limiting the compensatory mechanisms work to minimise adverse effects on thyroid hormone metabolsm and thus neurological developtnent. The mechanisms for regulation of selenoproteins in selenium and iodine deficiency are however very tissue-specific. For example, unlike the brain and thyroid,brown adipose tissue is unable to retain selenoproteins in selenium and iodine deficiency and is therefore at greater risk from injurious effects of the deficiencies.

关键词： gene Selenium and Iodine Deficiencies and Selenoprotein Function

Transthoracic echocardiography assists appropriate pulmonary artery catheter placement: An observational study

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World Journal of Anesthesiology 2015年第2期4卷 30-38页

作者： Chong Oon Tan Laurence Weinberg David andrew Story Larry Mc nicol Department of Anaesthesia the Austin Hospital Department of Surgery Melbourne Medical School the University of Melbourne

AIM: To investigate the utility of transthoracic echocardiography in confirming appropriate pulmonary artery catheter(PAC) placement. METHODS: Three commonly used transthoracic echocardiography(TTE) views were used to confirm PAC position in 103 patients undergoing elective cardiac surgery- the parasternal short axis right ventricular inflow-outflow view; the subcostal short axis right ventricular inflow-outflow view; and the parasternal short axis ascending aortic view. All PACs were inserted by the managing anesthesiologist under pressure waveform guidance alone, who was blinded to all sonographic information. A sonographer blinded to all pressure waveform information confirmed visualisation of an "empty" PA before PAC insertion, and visualisation of the PAC balloon in the main PA(MPA) or right PA(RPA) after attempts at placement were complete. Agreement, sensitivity and specificity of TTE in confirming appropriate PAC placement was compared against pressure waveformguidance as the "gold standard". The successful view used was compared against patients' anthropomorphic indices, presence of lung hyperinflation, and insertion of PAC during positive pressure ventilation. Agreement between TTE and pressure waveform guidance was analysed using Cohen's Kappa statistic. The relative proportion of total RPA seen by subcostal vs parasternal TTE views was also compared with a further 20 patients' computed tomography(CT) pulmonary angiograms(CTPA), to determine efficacy in detection of distal RPA PAC placement. RESULTS: Appropriate positioning of the PAC balloon, and its to-and-fro movement consistent with a nonwedged state, within the MPA or RPA was confirmed by TTE in 98 of the 103 patients [sensitivity 95%(95%CI: 89%-98%)], and absence of the PAC balloon before insertion correctly established in 100 patients [specificity 97%(92%-99%)]. This was in very good agreement with pressure waveform guidance [Cohen's Kappa 0.92,(0.87-0.98)]. The subcostal view was the best view to

关键词： Transthoracic echocardiography Pulmonary artery catheter Main pulmonary artery Right pulmonary artery Pulmonary artery rupture Intensive care unit