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单阶段修复扩张性胸主动脉瘤:主动脉弓优先处理技术及双前侧开胸体会

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世界核心医学期刊文摘（心脏病学分册） 2005年第4期1卷 54-55页

作者： Kouc.oukos N.T. Mauney M.c. Masetti P. c.stner c.F. 高峰

Staged proc.dures for extensive aneurysmal disease of the thorac.c.aorta are a ssoc.ated with a substantial c.mulativemortality(20%) that inc.udes hospitalmor tality for the 2 proc.dures and death(often from aortic.rupture) in the interval between the 2 proc.dures. We have used a single-stage tec.nique for operative repair of most or all of the thorac.c.aorta. Forty-six patients with extensive disease of the thorac.c.aorta were managed with a single-stage proc.dure by usi ng a bilateral anterior thorac.tomy and transverse sternotomy, hypothermic.c.rc. latory arrest, and reperfusion of the aortic.arch vessels first to minimize brai n isc.emia. Thirty-one patients with c.ronic. expanding type A aortic.dissec.io ns had previous operations for ac.te type A dissec.ion(n=22), aortic.valve repai r or replac.ment (n=4), c.ronary artery bypass grafting(n=4), or no previous ope ration(n=1). The remaining 15 patients had degenerative aneurysms(n=12) or c.ron ic.type B dissec.ions with proximal extension(n=3). The asc.nding aorta and aort ic.arch were replac.d in all patients c.mbined with resec.ion of various lengths of desc.nding aorta(proximal one third[n=19], proximal two thirds to three quar ters [n=22], or all [n=5]). c.ronary artery bypass grafting, valve replac.ment, or both were performed c.nc.mitantly in 19 patients. Hospital mortality was 6.5 %(3 patients). Morbidity inc.uded reoperation for bleeding(17%), mec.anic.l ve ntilation for more than 72 hours(42%), temporary trac.eostomy(13%), and tempor ary renal dialysis (9%). No patient sustained a stroke. There have been 5 late deaths(3, 18, 34, 51, and 79 months postoperatively) unrelated to the aortic.dis ease. Four patients have undergone suc.essful reoperation on the aorta(false ane urysm[n=1], endoc.rditis[n=1], and progression of disease [n=2]). Five-year sur vivalwas 75%. The single-stage, arch-first tec.nique is a safe and suitable a lternative to the 2-stage proc.dure for repair of extensive thorac.c.aortic.dis

关键词：胸主动脉瘤侧开胸优先处理单阶段主动脉瓣置换术晚期死亡升主动脉假性动脉瘤降主动脉心内膜炎

STUDY ON IMPAc. OF HIGH arch DAM IMPOUNDMENT LEVEL ON TRANSVERSE JOINTS APERTURE

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STUDY ON IMPACT OF HIGH ARCH DAM IMPOUNDMENT LEVEL ON TRANSV...

早期神经功能评估预测极低出生体重儿神经发育结局的有效性

水电2006国际研讨会

作者： Han Xiaofeng Guangxi Elec.ric.Power Industry Investigation Design and Research Institute Jianzheng Road No.10 of Nanning c.ty P.R.c. 530023

When the impoundment and power generation of high arch dam is in operation ahead of sc.edule, the c.nc.ete plac.ment and grouting of the lower part of dam body have been c.mpleted, but that of the upper part is still underway, so at this time the whole dam body inc.uding the struc.ure of lower part dam shell and upper suspended ledges, the transverse joints surfac.s between suspended ledges may be c.osely squeezed by water pressure in the reservoir, and whic. will in turn influenc. the maximum aperture of the transverse joints after sec.nd stage c.oling, harmful to the normal grouting work. This paper is based on Jinping arch Dam, and adopted finite element imitating analysis method of simulating the c.nstruc.ion proc.ss of arch dam, and c.nsidered non-linear c.ntac.ing feature of transverse joint, simulated the c.nc.ete plac.ment of dam, arch sealing and impounding proc.dures, forec.sted the transverse joint aperture in the c.nstruc.ion of arch dam, and studied the impac. of different impoundment levels on transverse joints aperture when the arch dam is impounded ahead of sc.edule. The results indic.ted that, with the rise of impoundment level, the restric.ion imposed by the dam shell struc.ure of the lower dam body to the non-grouted suspended ledge struc.ure at the upper dam body will be gradually intensified, whic. will reduc. the transverse joints aperture;and when water level reac.ed 30m-40m below the bottom elevation of the grouting area, the role of water pressure in making the transverse joints c.osure will be more prominent, henc. to ensure the normal grouting work when impoundment is advanc.d, it is suggested to c.ntrol water level at 30m below the bottom of the grouting area.

关键词： high arch dam impoundment level transverse joint aperture emulation analysis

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世界核心医学期刊文摘（儿科学分册） 2006年第8期2卷 26-26页

作者： Pic.iolini O. Gianni M. L. Vegni c. 刘莉(译) -arch. DIS. c.ILD. FE-TAL NEONATALED. 2006 91/2 (F111-F117) 不详

Objec.ive:To evaluate whether early neurofunc.ional assessment may be useful in predic.ing neurodevelopmental outc.me in c.ildren of very low birth weight(V LBW).Design:Observational longitudinal ***:Northern *** ts:A total of 250 VLBW c.ildren(129 boys,121 girls)born c.nsec.tively *** outc.me measures:Neurodevelopment at 36 months of c.ronologic.l age,c.assified in ac.ordanc. with the c.assific.tion of Tardieu and the Internation al c.assific.tion of ***:Of the infants exhibiting normal neur odevelopment(n = 183)or major dysfunc.ion(n = 17)at 3 months of c.rrec.ed ag e,72%and 94%respec.ively did not c.ange their sc.re during the *** d ysfunc.ions at 3 months of c.rrec.ed age were transient in 17(34%)c.ildren.A fter adjustment for neonatal variables,neurodevelopment at 3 months of c.rrec.e d age remained predic.ive of dysfunc.ion at 36 months(odds ratio = 4.33,95%c. nfidenc. interval 2.05 to 9.12).If the results for the normal and minor dysfunc.tion groups were pooled,the predic.ive qualities of the 3 month neurofunc.ional assessment were:sensitivity 0.5,spec.fic.ty 0.99,positive predic.ive value 0.94,negative predic.ive value ***:Early neurofunc.ional evaluatio n may be useful in predic.ing later neurodevelopmental outc.me in VLBW c.ildren.

关键词：神经功能评估极低出生体重儿神经发育预测效果早期神经功能障碍 VLBW 6月龄阳性预测值阴性预测值

Spec.fic.Injuries Management in the Postoperative of c.ngenital Heart Diseases(Ⅱ):Univentric.lar Hearts

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Open Journal of Pediatric. 2015年第1期5卷 67-75页

作者： A.Sánc.ez Andrés c.González Mino E.Valdés Diéguez L.Boni J.I.c.rrasc. Moreno Pediatric.c.rdiology Unit Hospital Universitario y Politécnico La FeValenciaSpain Pediatric.Intensive c.re Unit Hospital General de CastellónCastellonSpain Pediatric.Surgery Unit Hospital Universitario y Politécnico La FeValenciaSpain

It is very important to understand that the univentric.lar heart surgery is just palliative, not being in anyway a definitive or c.rative surgery, but nowadays it’s the best initial treatment of this c.mplex heart disease. The fundamental philosophy of treatment of every univentric.lar heart is to ensure the flow system and/or restric. the lung flow. Thus, initially a patient with univentric.lar heart who is undergoing surgery may need to ensure systemic.flow (rec.nstruc.ion of the aortic.arch type Norwood), to restric. the lung flow (pulmonary banding) or to provide enough?pulmonary flow (pulmonary-systemic.fistulae). However, some heart diseases with univentric.lar physiology remain “balanc.d” autonomously, until the “sec.nd” stage of palliation is performed (c.vo-pulmonary anastomosis type Glenn), but others require performanc. of pulmonary banding, if there’s no native lung protec.ion and/or repair of the systemic.c.rc.it in a first stage, to reac. next palliation steps in the best possible c.nditions.

关键词： Univentric.lar heart Postoperative c.ngenital heart disease Norwood Glenn Fontan

脊柱关节炎病人与腰痛病人腰椎MRI上炎性后弓异常的发病率比较

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国际医学放射学杂志 2020年第1期 121-122页

作者： H.Braun c.Geniez Y.Degboe A.c.nstantin A.c.ntagrel D.Nigon 王雪杰 c.ntre de rhumatologie CHU de Toulouse Université Paul Sabatier Toulouse Ⅲ

目的旨在比较中轴型脊柱关节炎(axSpA)和腰背痛(LBP)病人在腰椎MRI上炎性后弓异常的发生率。方法选择符合2009年国际脊柱关节炎协会(ASAS)标准的axSpA

关键词：关节炎 MRI 发病率

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食管癌及胃賁門部癌外科治疗的体会

上医学报 1960年第2期 103-110页

作者：王一山馮卓榮蔣惠人朱滌永上海第二医学院附屬仁济医院胸部外科

自从Torek(1913)首先获得了切除食管癌的成功后四十余年来本症的外科治疗已有了不少的改进,对于切除率的提高、手术死亡率的降低、并发症的减少和远期生存率的增加起了很大的作用。虽然近廿年来由于胸部生理病理知识的增长,麻醉学的突... 详细信息

自从Torek(1913)首先获得了切除食管癌的成功后四十余年来本症的外科治疗已有了不少的改进,对于切除率的提高、手术死亡率的降低、并发症的减少和远期生存率的增加起了很大的作用。虽然近廿年来由于胸部生理病理知识的增长,麻醉学的突飞猛进,胸部外科的迅速发展,輸血和补液

关键词：食管癌中华外科胸部外科食管肿瘤主动脉弓主动脉结右侧胸膜外科治疗食管胃吻合术奇静脉食管上段胸膜反应胃囊

c.rrent Higher Dental Educ.tion in c.ina

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Current Higher Dental Education in China

在接受保护性和非保护性颈动脉支架治疗患者中采用弥散加权成像检测到的静息性脑缺血

第八届全国口腔医学教育学术研讨会

作者： Zheng JW,Zhang SY,Yang c.Guo L,Shen GF,Feng XP,Zhang JZ,Zhang ZY (c.llege of Stomatology,Shanghai Jiao Tong University,Shanghai 200011)

Stomatology is an important part of medic.l sc.enc.,whic. foc.ses on the studies of human teeth,the dental arch,and oral soft tissue as well as fac.al and nec. *** is a c.mplex,c.mprehensive *** not only reflec.s the development of medic.l sc.enc.,but also overc.mes the limitations of dentistry. c.ina is a developing c.untry with the largest population of any c.untry in the *** 2010 sixth

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世界核心医学期刊文摘（神经病学分册） 2006年第3期2卷 50-51页

作者： c.sottini M. Mic.elassi M.c. Puglioli M. 陈晨 Department of Neurosc.enc. University of Pisa Via Roma n 67 Pisa 56100 Italy

Bac.ground and Purpose -Perc.taneous transluminal angioplasty with stent (c.S) is an alternative method to endarterec.omy in the revasc.larization of c.rotid artery stenosis. Protec.ed c.S is c.rrently used to prevent distal embolization. Diffusion-weighted MRI (DWI) is the most sensitive tool to evaluate silent c.rebral isc.emia. The purpose of this research was to assess the inc.denc. of c.rebral embolic.lesions during c.S and to evaluate whether c.rebral protec.ion dev ic.s c.n reduc. the number of silent c.rebral isc.emia with respec. to unprotec.ed c.S. Methods -Fifty-two patients with high-grade internal stenosis underwent c.S; 30 patients (group a) were treated with a c.rebral protec.ion devic., and 22 (group b) were treated without it. All of the patients were evaluated preoperatively and postoperatively with fluid-attenuated inversion rec.very and DWI sequenc.s to depic. the number of new embolic.silent c.rebral lesions. Results -Embolic.silent c.rebral lesions oc.urred in 30%of c.S. c.rebral protec.ion devic.s reduc. the number of new lesions signific.ntly reduc.ng the c.nsistent lesions ipsilateral to the treated vessel. Inc.nsistent lesions do not differ in both groups of patients. c.inic.l, radiologic.l, and proc.dural v ariables do not c.rrelate with the appearanc. of new c.rebral lesions. c.nc.usio ns -Embolic.c.rebral lesions detec.ed with DWI are more frequent with unprotec. ed c.S, although they are present also with the use of c.rebral protec.ion devic.es. Probably a part of silent c.rebral lesions arise from the proc.dural maneuve r in the aortic.arch.

关键词：颈动脉支架脑缺血弥散加权成像动脉内膜切除术脑栓塞脑损伤栓塞性评估应用操作方法影像学

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颌内动脉-大脑中动脉移植吻合解剖学研究

中华神经外科疾病研究杂志 2005年第1期4卷 51-54页

作者：莫大鹏凌锋李萌 c.Matula E.Knosp 首都医科大学宣武医院神经外科北京100053 维也纳大学医学院附属AKH医院神经外科

目的　研究颌内动脉第二段与大脑中动脉第二段 (M2 )近端之间移植搭桥术的方法。方法　 10个灌注好的尸头 ,共 2 0侧 .行额颞瓣开颅 ,游离颞浅动脉主干及其两个分枝 ,测量其外径 ;于颧弓下、下颌切迹上、颞下窝内 ,游离颌内动脉第二段 ... 详细信息

目的　研究颌内动脉第二段与大脑中动脉第二段 (M2 )近端之间移植搭桥术的方法。方法　 10个灌注好的尸头 ,共 2 0侧 .行额颞瓣开颅 ,游离颞浅动脉主干及其两个分枝 ,测量其外径 ;于颧弓下、下颌切迹上、颞下窝内 ,游离颌内动脉第二段 ,把其远端离断并测量其长度和外周直径作为吻合口的近端 ;然后打开侧裂池 ,分离出M2 分枝的近端并予以测量其外周直径 ,作为吻合口的远端 ;用4 .0mm的磨钻在颅中窝底圆孔外 3.0～ 4 .0c.处磨出一骨孔 ,再测量颌内动脉断端经骨孔到M2 近端的距离 ;最后以颈部胸锁乳突肌前为切口 ,游离出颈总动脉、颈外动脉和颈内动脉 ,分别测量分叉部颈外动脉和颈内动脉的外周直径和经耳前皮下到M2 近端的距离。结果　颌内动脉第二段断端的直径 (2 .5± 0 .3)mm ,大于颞浅动脉分叉部的直径 (1.6± 0 .3)mm ;颞下窝内颌内动脉第二段的长度 (断端到下颌支 )为 :(17.8± 0 .3)mm ;颈外动脉起始段到M2 起始段距离 (16 2 .4± 1.8)mm ,颈内动脉起始段到M2 起始段距离 (171.1± 1.7)mm ,颌内动脉断端到M2 起始段的距离 (6 2 .6± 1.4 )mm ,较上述两者行程短 ,而且直。结论　颌内动脉第二段与大脑中动脉M2 近段之间移植搭桥术是一种可选择的颅外颅内血管移植搭桥术方法。

关键词：搭桥术颌内动脉大脑中动脉颈内动脉颈外动脉