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World Journal of Clinical Cases 2019年第21期7卷 3639-3648页

作者： Yuan-Yuan Sun Guo-Ming Zhang You-Bin Zhang Xin Du Mao-Long Su Department of Ultrasound Xiamen Cardiovascular Hospital Xiamen UniversityXiamen 361000Fujian ProvinceChina Department of Cardiology Xiamen Cardiovascular Hospital Xiamen UniversityXiamen 361000Fujian ProvinceChina Department of Radiology Zhongshan Hospital Xiamen UniversityXiamen 361000Fujian ProvinceChina

BACKGROUND We report a rare case of numbness in the right hand,finally diagnosed as bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome and explain the cause of these diseases.CASE SUMMARY The patient was a 65-year-old woman.She complained of dizziness,numbness and weakness of the right hand for 6 mo.She was diagnosed with bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome by ultrasound,enhanced computed tomography,computed tomography angiography and other examinations.Considering the surgical risks,the patient refused the aberrant right subclavian artery stent implantation and was discharged.We hypothesize that these two kinds of deformity and right subclavian steal syndrome may not occur by accident and result from multiple malformations.CONCLUSION Bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome is rare.This case reminds interventional radiologists of the possibility of these abnormalities before surgery.

关键词： Bilateral common carotid artery common trunk Aberrant right subclavianartery right subclavian steal syndrome Case report

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小儿遗尿症指南和专家共识质量评价

中国全科医学 2023年第2期26卷 134-141页

作者：孙香娟肖祥吴宣諭张丰华成都中医药大学附属医院四川省成都市610072 成都中医药大学方剂教研室四川省成都市610075

背景小儿遗尿症是儿科常见病之一,有效的小儿遗尿症诊疗指南有助于症状的规范化控制和缓解,而制定高质量的临床实践指南是提高小儿遗尿症诊疗水平的重要方式。目的基于AGREEⅡ和right工具,评价2010年以来国内外发布的小儿遗尿症指南和... 详细信息

背景小儿遗尿症是儿科常见病之一,有效的小儿遗尿症诊疗指南有助于症状的规范化控制和缓解,而制定高质量的临床实践指南是提高小儿遗尿症诊疗水平的重要方式。目的基于AGREEⅡ和right工具,评价2010年以来国内外发布的小儿遗尿症指南和专家共识的质量,以期为临床实践及后续指南的制订提供参考。方法检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库和PubMed(补充检索医脉通、世界卫生组织以及英国国家临床示范研究所等数据库)2010-01-01至2022-01-31公开发表的小儿遗尿症相关的诊疗指南和专家共识。采用AGREEⅡ和right工具评价纳入文献的方法学和报告质量。根据AGREEⅡ工具评价结果,将各指南/共识推荐等级评定为“推荐(A级)”“更新后推荐(B级)”和“不推荐(C级)”。使用组内相关系数(ICC)进行一致性评价。结果纳入8部指南和5部专家共识。共形成推荐意见185条,其中44条为诊断评估方面的意见,140条为治疗方面的推荐意见,1条为随访推荐意见。AGREEⅡ工具评价结果显示,范围和目的、参与人员、严谨性、清晰性、应用性和独立性6个领域的总得分(报告率)分别为(66.99%±16.73%)、(46.26%±21.56%)、(34.42%±26.73%)、(60.36%±32.13%)、(39.82%±20.14%)、(45.35%±37.93%),纳入的13篇文献中,无推荐等级为A的文献,推荐等级为B和C的文献分别为8篇和5篇。right工具评价结果显示,基本信息、背景、证据、推荐意见、评审和质量保证、资助与利益冲突声明和管理、其他方面7个领域的总得分(报告率)分别为(60.58%±12.19%)、(50.72%±20.18%)、(30.77%±26.88%)、(32.97%±27.53%)、25.00%(40.63%)、(25.96%±24.00%)、16.67%(33.33%)。AGREEⅡ工具评估结果中指南的范围和目的领域得分高于专家共识得分(Pright工具评估中指南各领域得分与专家共识得分比较,差异均无统计学意义(P>0.05)。AGREEⅡ工具各领域一致性评价ICC均大于0.750,一致性较高;right工具各领域一致性评价ICC为0.736,一致性较好。结论本研究纳入的指南和专家共识总体方法学和报告质量均有待提高,纳入文献的推荐等级为B级和C级,缺少A级的文献,建议临床决策中优先参考高质量诊疗指南。目前尚无面向我国基层医师制定的小儿遗尿症诊疗指南,且现有的小儿遗尿症中医药管理指南证据质量有待提高,建议参照AGREEⅡ和right标准制定相关指南以指导小儿遗尿症的临床管理。

关键词：夜间遗尿症儿童指南专家共识 AGREEⅡ right 评价研究研究报告

Microvolt T-wave alternans complemented with electrophysiologic study for prediction of ventricular tachyarrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy: a long-term follow-up study

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Chinese Medical Journal 2019年第12期132卷 1406-1413页

作者： She-Liang Xue Xiao-Feng Hou Kang-Yun Sun Yao Wang Zhi-Yong Qian Quan-Peng Wang Si-Peng Shen Hong-Li Yin Rong Zhang Hai-Ping Yin Jian-Gang Zou Department of Cardiology The First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China Department of Cardiology The Affiliated Wujin Hospital of Jiangsu UniversityChangzhouJiangsu 213002China Department of Cardiology The Affiliated Suzhou Hospital of Nanjing Medical UniversitySuzhouJiangsu 215008China Department of Biostatistics School of Public HealthNanjing Medical UniversityNanjingJiangsu 211166China Key Laboratory of Targeted Intervention in Cardiovascular Disease Collaborative Inn ovation Center for Cardiovascular Disease Translational MedicineNanjing Medical University NanjingJiangsu 211166China

Background: The long-term predicted value of microvolt T-wave alternans (MTWA) for ventricular tachyarrhythmia in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) remains unclear. Our study explored the characteristics of MTWA and its prognostic value when combined with an electrophysiologic study (EPS) in patients with ARVC. Methods: All patients underwent non-invasive MTWA examination with modified moving average (MMA) analysis and an EPS. A positive event was defined as the first occurrence of sudden cardiac death, documented sustained ventricular tachycardia (VT), ventricular fibrillation, or the administration of appropriate implantable cardioverter defibrillator therapy including shock or antitachycardia pacing. Results: Thirty-five patients with ARVC (age 38.6 ± 11.0 years;28 males) with preserved left ventricular (LV) function were recruited. The maximal TWA value (MaxValt) was 17.0 (11.0–27.0)μV. Sustained VT was induced in 22 patients by the EPS. During a median follow-up of 99.9 ± 7.7 months, 15 patients had positive clinical events. When inducible VT was combined with the MaxValt, the area under the curve improved from 0.739 to 0.797. The receiver operating characteristic curve showed that a MaxValt of 23.5 μV was the optimal cutoff value to identify positive events. The multivariate Cox regression model for survival showed that MTWA (MaxValt, hazard ratio [HR], 1.06;95% confidence interval [CI], 1.01–1.11;P = 0.01) and inducible VT (HR, 5.98;95% CI, 1.33–26.8;P = 0.01) independently predicted positive events in patients with ARVC. Conclusions: MTWA assessment with MMA analysis complemented by an EPS might provide improved prognostic ability in patients with ARVC with preserved LV function during long-term follow-up.

关键词： Modified moving average analysis Microvolt T-wave alternans Electrophysiologic study Ventricular tachyarrhythmia Arrhythmogenic right ventricular cardiomyopathy

The Semantic Equivalence Between the Good and the right:Its Support for and Challenge to Consequentialism

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Fudan Journal of the Humanities and Social Sciences 2022年第4期15卷 463-473页

作者： Qingping Liu Fudan Institute for Advanced Study in Social Sciences Fudan UniversityShanghaiChina

Viewed from the perspective of meta-ethics,there is some semantic equivalence between the good as desirability and the right as acceptability,so that we can claim that whatever is desirable for a person is also acceptable to and thus right for her or him in terms of its very goodness.In the debate with deontology,then,this equivalence gives consequentialism an advantage,because it could prove that the good on its own is always right,and the evil on its own is always wrong.Meanwhile,it also puts consequentialism at a disadvantage,because consequentialism could hardly answer a tough question:why do we seriously need another criterion of right and wrong besides the one of good and evil in evaluation?

关键词： Good right Semantics Consequentialism Deontology

Robust Control for Uncertain Nonlinear Feedback Systems Using Operator-based right Coprime Factorization

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IEEE/CAA Journal of Automatica Sinica 2019年第3期6卷 824-829页

作者： Ni Bu Wei Chen Longguo Jin Yandong Zhao IEEE the College of Automation and Electronic Engineering Qingdao University of Science and Technology Haier School of Qingdao Technical College

The robust control issue for uncertain nonlinear system is discussed by using the method of right coprime factorization. As it is difficult to obtain the inverse of the right factor due to the high nonlinearity, the proving of the Bezout identity becomes troublesome. Therefore, two sufficient conditions are derived to manage this problem with the nonlinear feedback system as well as that with the uncertain nonlinear feedback system under the definition of Lipschitz norm. A simulation of temperature control is given to demonstrate the validity of the proposed method.

关键词： Bezout identity nonlinearity right coprime factorization (RCF) robust control

Donor ductal anomaly is not a contraindication to right liver lobe donation

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Hepatobiliary & Pancreatic Diseases International 2019年第4期18卷 343-347页

作者： Kenneth SH Chok James YY Fung Wing Chiu Dai Sui Ling Sin Ka Wing Ma Albert CY Chan Tan To Cheung Chung Mau Lo Department of Surgery The University of Hong Kong102 Pok Fu Lam RoadHong KongChina State Key Laboratory for Liver Research The University of Hong Kong102 Pok Fu Lam RoadHong KongChina Department of Medicine The University of Hong Kong102 Pok Fu Lam RoadHong KongChina

Background:Data of living-donor liver transplantation(LDLT)suggested that donor ductal anomaly may contribute to postoperative biliary complications in recipients and in donors.This retrospective study aimed to determine if the occurrence of postoperative biliary stricture in donors or recipients in rightlobe LDLT(RLDLT)is related to donor biliary anatomy type.Methods:We analyzed our RLDLT recipients’clinical data and those of their graft donors.The recipients were divided into 2 groups:with and without postoperative biliary stricture.The 2 groups were compared.The primary endpoints were donor biliary anatomy type and postoperative biliary complication incidence;the secondary endpoints were 1-,3-and 5-year graft and patient survival rates.Results:Totally 127 patients were included in the study;25(19.7%)of them developed biliary anastomotic stricture.In these 25 patients,16 had type A biliary anatomy,3 had type B,2 had type C,3 had type D,and 1 had type E.In the 127 donors,96(75.6%)had type A biliary anatomy,13(10.2%)had type B,6(4.7%)had type C,10(7.9%)had type D,and 2(1.6%)had type E.Biliary stricture was seen in 2 donors,who had type A biliary anatomy.None of the recipients or donors developed bile leakage.No association between the occurrence of postoperative biliary stricture and donor biliary anatomy type was found(P=0.527).Conclusions:The incidence of biliary stricture in donors or recipients after RLDLT was not related to donor biliary anatomy type.As postoperative complications were similar in whatever type of donor bile duct anatomy,donor ductal anomaly should not be considered a contraindication to donation of right liver lobe.

关键词： Living donor liver transplantation right liver donation Biliary complications Cholangiograms Ductal anomaly

Clinical differentiation of acute appendicitis and right colonic diverticulitis: A case-control study

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World Journal of Clinical Cases 2019年第12期7卷 1393-1402页

作者： Yosuke Sasaki Fumiya Komatsu Naoyasu Kashima Takahiro Sato Ikutaka Takemoto Sho Kijima Tadashi Maeda Takamasa Ishii Taito Miyazaki Yoshiko Honda Nagato Shimada Yoshihisa Urita Department of General Medicine and Emergency Care Toho University School of Medicine

BACKGROUND Acute right colonic diverticulitis (ARCD) is an important differential diagnosis of acute appendicitis (AA) in Asian countries because of the unusually high prevalence of right colonic diverticula. Due to qualitative improvement and the high penetration rate of computed tomography (CT) scanning in Japan, differentiation of ARCD and AA mainly depends on this modality. But cost, limited availability, and concern for radiation exposure make CT scanning problematic. Differential findings of ARCD from AA are based on several small studies that used univariate comparisons from Korea and Taiwan. Previous studies on clinical and laboratory differences between AA and ARCD are limited. AIM To determine clinical differences between AA and ARCD for differentiation of these two diagnoses by creating a logistic regression model. METHODS We performed an exploratory single-center retrospective case-control study evaluating 369 Japanese patients (age ≥ 16 years), 236 (64.0%) with AA and 133 (36.0%) with ARCD, who were hospitalized between 2012 and 2016. Diagnoses were confirmed by CT images. We compared age, sex, onset-to-visit interval, epigastric/periumbilical pain, right lower quadrant (RLQ) pain, nausea/vomiting, diarrhea, anorexia, medical history, body temperature, blood pressure, heart rate, RLQ tenderness, peritoneal signs, leukocyte count, and levels of serum creatinine, serum C-reactive protein (CRP), and serum alanine aminotrans-ferase. We subsequently performed logistic regression analysis for differentiating AA from ARCD based on the results of the univariate analyses.RESULTS In the AA and ARCD groups, median ages were 35.5 and 41.0 years, respectively (p=0.011);median onset-to-visit intervals were 1 [interquartile range (IQR): 0-1] and 2 (IQR: 1-3) days, respectively (P < 0.001);median leukocyte counts were 12600 and 11500/mm3, respectively (P = 0.002);and median CRP levels were 1.1 (IQR: 0.2-4.1) and 4.9 (IQR: 2.9-8.5) mg/dL, respectively (P < 0.001). In the logistic regression model, odds ratios (ORs) w

关键词： Abdominal pain Acute abdomen Appendicitis Clinical difference Creactive protein Diverticulitis right lower quadrant pain

Stationary response of stochastic viscoelastic system with the right unilateral nonzero offset barrier impacts

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Chinese Physics B 2019年第1期28卷 195-204页

作者：王德莉徐伟谷旭东 Department of Applied Mathematics Northwestern Polytechnical UniversityXi’an 710072China Department of Engineering Mechanics Northwestern Polytechnical UniversityXi’an 710072China

The stationary response of viscoelastic dynamical system with the right unilateral nonzero offset barrier impacts subjected to stochastic excitations is investigated. First, the viscoelastic force is approximately treated as equivalent terms associated with effects. Then, the free vibro-impact(VI) system is absorbed to describe the periodic motion without impacts and quasi-periodic motion with impacts based upon the level of system energy. The stochastic averaging of energy envelope(SAEE) is adopted to seek the stationary probability density functions(PDFs). The detailed theoretical results for Van der Pol viscoelastic VI system with the right unilateral nonzero offset barrier are solved to demonstrate the important effects of the viscoelastic damping and nonzero rigid barrier impacts condition. Monte Carlo(MC) simulation is also performed to verify the reliability of the suggested approach. The stochastic P-bifurcation caused by certain system parameters is further explored. The variation of elastic modulus from negative to zero and then to positive witnesses the evolution process of stochastic P-bifurcation. From the vicinity of the common value to a wider range, the relaxation time induces the stochastic P-bifurcation in the two interval schemes.

关键词： viscoelastic system right unilateral nonzero offset barrier impacts stochastic averaging of energy envelope(SAEE) stochastic P-bifurcation

Assessment of right ventricular strain in children with repaired tetralogy of Fallot using speckle tracking imaging

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Chinese Medical Journal 2019年第6期132卷 744-748页

作者： Jing-Ya Li Rong-Juan Li Ning Ma Fang-Yun Wang Xiao-Lin Zhang Jin-Jie Xie Jing Yang Ya Yang Department of Echocardiography Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China Department of Echocardiography Beijing Children's Hospital Capital Medical University National Center for Children's Health Beijing 100045. China

To the Editor: Tetralogy of Fallot (TOF) was first surgically repaired in 1955. Initial TOF repairs were performed using a trans-annular right ventricular outflow tract patch to relieve the obstruction. However, this procedure resulted in long-standing pulmonary valve regurgitation and increased right ventricular (RV) volume, causing arrhythmias and sudden death.[1] Thus, pulmonary annulus preservation became the most prevalent surgical strategy for TOF repair, possibly causing a mix of pulmonary stenosis and pulmonary valve regurgitation. Currently, clinicians concerned with RV function decrease during the long-term follow-up use of cardiac magnetic resonance imaging (CMR) to predict the appropriate timing of interventions for valve sparing. Although CMR techniques have evolved as the reference standard for assessing RV volumes and function during the last two decades, routinely monitoring the progression of repaired tetralogy of Fallot (rTOF) RV dysfunction remains difficult.

关键词： Assessment right ventricular repaired tetralogy

Middle hepatic vein reconstruction in adult right lobe living donor liver transplantation improves recipient survival

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Hepatobiliary & Pancreatic Diseases International 2019年第2期18卷 125-131页

作者： Hai-Jun Guo Kun Wang Kang-Chen Chen Zhi-Kun Liu Abdulahad Al-Ameri Yan Shen Xiao Xu Shu-Sen Zheng Division of Hepatobiliary and Pancreatic Surgery First Affiliated Hospital Zhejiang University School of Medicine Key Laboratory of Combined Multi-organ Transplantation Ministry of Public Health First Affiliated Hospital Zhejiang University School of Medicine

Background: The efficacy and necessity of middle hepatic vein(MHV) reconstruction in adult-to-adult right lobe living donor liver transplantation(LDLT) remain controversial. The present study aimed to evaluate the survival beneficiary of MHV reconstructions in LDLT. Methods: We compared the clinical outcomes of liver recipients with MHV reconstruction( n = 101) and without MHV reconstruction( n = 43) who underwent LDLT using right lobe grafts at our institution from January 2006 to May 2017. Results: The overall survival(OS) rate of recipients with MHV reconstruction was significantly higher than that of those without MHV reconstruction in liver transplantation( P = 0.022; 5-yr OS: 76.2% vs 58.1%). The survival of two segments(segments 5 and 8) hepatic vein reconstruction was better than that of the only one segment(segment 5 or segment 8) hepatic vein reconstruction( P = 0.034; 5-yr OS: 83.6% vs 67.4%). The survival of using two straight vascular reconstructions was better than that using Y-shaped vascular reconstruction in liver transplantation with two segments hepatic vein reconstruction( P = 0.020; 5-yr OS: 100% vs 75.0%). The multivariate analysis demonstrated that MHV tributary reconstructions were an independent beneficiary prognostic factor for OS(hazard ratio = 0.519, 95% CI: 0.282–0.954, P = 0.035). Biliary complications were significantly increased in recipients with MHV reconstruction(28.7% vs 11.6%, P = 0.027). Conclusions: MHV reconstruction ensured excellent outflow drainage and favored recipient outcome. The MHV tributaries(segments 5 and 8) should be reconstructed as much as possible to enlarge the hepatic vein anastomosis and reduce congestion.

关键词： Living donor liver transplantation right lobe graft MHV reconstruction Survival Complications