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Differences in symptoms and pre-hospital delay among acute myocardial infarction patients according to ST-segment elevation on electrocardiogram: an analysis of China Acute Myocardial Infarction (CAMI) registry

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Chinese Medical Journal 2019年第5期132卷 519-524页

作者： Rui Fu Chen-Xi Song Ke-Fei Dou Jin-Gang Yang Hai-Yan Xu Xiao-Jin Gao Qian-Qian Liu Han Xu Yue-Jin Yang Department of Cardiology Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

Background: Approximately 70% patients with acute myocardial infarction (AMI) presented without ST-segment elevation on electrocardiogram. Patients with non-ST segment elevation myocardial infarction (NSTEMI) often presented with atypical symptoms, which may be related to pre-hospital delay and increased risk of mortality. However, up to date few studies reported detailed symptomatology of NSTEMI, particularly among Asian patients. The objective of this study was to describe and compare symptoms and presenting characteristics of NSTEMI vs. STEMI patients. Methods: We enrolled 21,994 patients diagnosed with AMI from China Acute Myocardial Infarction (CAMI) Registry between January 2013 and September 2014. Patients were divided into 2 groups according to ST-segment elevation: ST-segment elevation (STEMI) group and NSTEMI group. We extracted data on patients' characteristics and detailed symptomatology and compared these variables between two groups. Results: Compared with patients with STEMI (N=16,315), those with NSTEMI (N=5679) were older, more often females and more often have comorbidities. Patients with NSTEMI were less likely to present with persistent chest pain (54.3% vs.71.4%), diaphoresis (48.6% vs.70.0%), radiation pain (26.4% vs.33.8%), and more likely to have chest distress (42.4% vs.38.3%) than STEMI patients (all P<0.0001). Patients with NSTEMI were also had longer time to hospital. In multivariable analysis, NSTEMI was independent predictor of presentation without chest pain (odds ratio: 1.974, 95% confidence interval:1.849-2.107). Conclusions: Patients with NSTEMI were more likely to present with chest distress and pre-hospital patient delay compared with patients with STEMI. It is necessary for both clinicians and patients to learn more about atypical symptoms of NSTEMI in order to rapidly recognize myocardial infarction.

关键词： Non-ST segment elevation myocardial infarction Symptom assessment Time to treatment

segment-Centric Geo-Competitive Environment of a Tourism Destination (A Case of Georgia)

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Journal of Tourism and Hospitality Management 2023年第1期11卷 19-30页

作者： Ioseb Khelashvili Ivane Javakhishvili Tbilisi State University TbilisiGeorgia

This work aims to introduce a conceptual approach to determining the competitive environment for a particular tourist destination by considering popular outbound destinations of its leading segments.This approach we name as a concept of a segment-centered geo-competitive environment of a tourism destination(SGE-TD).The applied methodology includes consideration of the popularity of tourist destinations for each selected segment and the indicators of leading segments of the studied destination.The practical application of the proposed concept is examined in the case of Georgia as a tourist destination by selecting its leading segments and identifying their popular travel destinations.The integrated consideration and application of the mentioned indicators define the competitive position of a destination(in this case Georgia)among the specified tourism destinations,considered as the geo-competitive environment.This research suggests an innovative version of the universal conceptual approach to identify the leading competing destinations for a specific studied one.It fills the gap in similar studies where competing destinations for the analysis are selected based on specific research objectives,missing the universal conceptual approach in this regard.

关键词： tourism destination segment competitive environment Georgia segment-centric geo-competitive environment(SGE-TD)

The influence of hand hole on the ultimate strength and crack pattern of shield tunnel segment joints by scaled model test

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Frontiers of Structural and Civil Engineering 2019年第5期13卷 1200-1213页

作者： Shaochun WANG Xi JIANG Yun BAI Department of Geotechnical Engineering College of Civil EngineeringTongji UniversityShanghai 200092China

With the shield tunnel going deeper and deeper, the circumferential axial force becomes the governing factor rather than the bending moment. The hand hole acts as a weak point and initial damage in the segment joint especially when the circumferential axial force is extremely high. Despite the wide application of steel fiber or synthetic fiber in t|ie tunneling, limited researches focus on the structural responses of segment joint with macro structural synthetic fiber (MSSF). In this paper, a 1:2 reduced-scale experiment was conducted to study the structural perfonnance of the segment joint with different types of hand holes under ultra-high axial force. Special attention is paid to failure mode and structural performance (bearing capacity, deformation, cracking, and toughness). Moreover, segment joints with MSSF are also tested to evaluate the effects of MSSF on the failure mode and structural performance of the segment joints. The experiment results show that the hand hole becomes the weakest point of the segment joint under ultra-high axial force. A\/-type crack pattern is always observed before the final failure of the segment joints. Different types and sizes of the hand hole have different degree of influences on the structural behavior of segment joints. The segment joint with MSSF shows higher ultimate bearing capacity and toughness compared to segment joint with common concrete. Besides, the MSSF improves the initial cracking load and anti-spallling resistance of the segment joint.

关键词： shield tunneling structural synthetic fiber concrete hand hole segment joint ultimate bearing capacity crack pattern

Geochemical characteristics of the metapelites from the Xingxingxia group in the Eastern segment of the Central Tianshan:Implications for the provenance and paleoweathering

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Science China Earth Sciences 2005年第10期48卷 1637-1648页

作者： LI Qiugen LIU Shuwen HAN Baofu WANG Yueran DANG Qingning The Key Laboratory of Orogenic Belts and Crustal Evolution Ministry of Education School of Earth and Space Sciences Peking University Beijing 100871 China The Key Laboratory of Orogenic Belts and Crustal Evolution Ministry of Education School of Earth and Space Sciences Peking University Beijing 100871 China The Key Laboratory of Orogenic Belts and Crustal Evolution Ministry of Education School of Earth and Space Sciences Peking University Beijing 100871 China The Key Laboratory of Orogenic Belts and Crustal Evolution Ministry of Education School of Earth and Space Sciences Peking University Beijing 100871 China The Key Laboratory of Orogenic Belts and Crustal Evolution Ministry of Education School of Earth and Space Sciences Peking University Beijing 100871 China

Metapelites from the Mesoproterozoic Xingxingxia group in the Eastern segment of the Central Tianshan, Northwestern China, were analyzed for major and trace elements, includ-ing rare earth elements. Compared with post-Archean shales, the metapelites are enriched in Sr, Hf and Zr. The other elements are similar to the compositions of the Phanerozoic North American Shale Composite and the Post-Archean Australian average Shale (PAAS). The characteristics of Al2O3/TiO2, Cr/Zr, Cr/Th, Th/Sc and high Zr concentration suggest that these pelites could be derived from a significant proportion of felsic and a few proportion of participation of mafic mate-rials in nature. These rocks display highly fractionated REE patterns, and average (La/Yb)n = 18.6. Several samples have slightly negative Eu anomalies (Eu/Eu* = 0.7―0.84) in comparison with PAAS (Eu/Eu* = 0.65), indicating contribution from young immature materials. The low K2O/Al2O3 values of these metapelites suggest that their source materials could contain minimal alkali feldspar. In the A-CN-K triangular diagram, the sample data array intersects the feldspar join, indicating that the source had a plagioclase: K-feldspar ratio of approximately 5:1, repre-senting weathered products from components that could approximately correspond to granodio-rites and tonalites. The low Chemical Index of Alteration (CIA) and high Index of Compositional Variability (ICV) values suggest low degrees of weathering of the source and low compositional maturity of the sediments, respectively. The geochemical characteristics of the metapelites from the Xingxingxia group also demonstrate that these sediments were deposited in a back-arc background within a continental-arc system.

关键词： Eastern segment of the Central Tianshan, metapelites from the Xingxingxia group, geochemistry, provenance, paleoweathering, tectonic setting.

Identification of QTL for kernel number-related traits in a rice chromosome segment substitution line and fine mapping of qSP1

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The Crop Journal 2019年第4期7卷 494-503页

作者： Fuying Ma Xiaoyan Zhu Hui Wang Shiming Wang Guoqing Cui Ting Zhang Zhenglin Yang Guanghua He Yinghua Ling Nan Wang Fangming Zhao Rice Research Institute Academy of Agricultural Sciences Southwest University

A chromosome segment substitution line (CSSL) is a powerful tool for combining quantitative trait locus (QTL) mapping with the pyramiding of desirable alleles. The rice CSSL Z1364 with increased kernel number was identified in a BC3F8 population derived from a cross of Nipponbare as the recipient with Xihui 18 as the donor parent. Z1364 carried three substitution segments distributed on chromosomes 1, 6, and 8. The mean substitution length was 1.19 Mb. Of 17 QTL identified on the substitution segments, qSP1 for spikelets per panicle, qSSD1 for seed-set density, and qNSB1 for number of secondary branches explained respectively 57.34%, 87.7%, and 49.44% of the corresponding phenotypic variance and were all linked to RM6777. Chi-square analysis showed that the increased kernel number in Z1364 was inherited recessively by a single gene. By fine mapping, qSP1 was delimited to a 50-kb region on the short arm of chromosome 1. Based on DNA sequence, a previously uncharacterized rice homolog of Arabidopsis thaliana AT4G32551 was identified as a candidate gene for qSP1 in which mutation increases the number of spikelets and kernels in Z1364. qSP1 was expressed in all tissues, but particularly in 1-cm panicles. The expression levels of OsMADS22, GN1A, and DST were upregulated and those of LAX2, GNP1, and GHD7 were downregulated in Nipponbare. These results provide a foundation for functional research on qSP1.

关键词： Rice Chromosome segment substitution line Increased number of kernels qSP1 QTL mapping for yield traits

Alternative technique to save ischemic bowel segment in management of neonatal short bowel syndrome: A case report

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World Journal of Clinical Cases 2019年第20期7卷 3353-3357页

作者： Lei Geng Lei Zhou Guo-Jian Ding Xiao-Liang Xu Yu-Mei Wu Ji-Jun Liu Ting-Liang Fu Department of Pediatric Surgery Binzhou Medical University HospitalBinzhou 256603Shandong ProvinceChina Department of Hepatobiliary Surgery Binzhou Medical University HospitalBinzhou 256603Shandong ProvinceChina Department of Neonatology Binzhou Medical University HospitalBinzhou 256603Shandong ProvinceChina Department of Anorectal Surgery Binzhou Medical University HospitalBinzhou 256603Shandong ProvinceChina

BACKGROUND Congenital short bowel syndrome(SBS)associated with malrotation,gut volvulus and jejuno-ileal atresia is a very rare condition.It is a severe challenge for surgeons to preserve residual ischemic bowel segment in the management of short bowel syndrome,especially in neonates.CASE SUMMARY We report a newborn baby with gut malrotation associated with jejuno-ileal atresia,congenital SBS and jejunal volvulus.Hematemesis and abdominal distention were noted.At laparotomy,malrotation associated with jejuno-ileal atresia,congenital SBS and jenunal volvulus was confirmed.The total length of the small bowel was 63 cm with proximal jejunal bowel segment measuring 38 cm,including 18 cm necrotic segment below the Treitz’s ligament and 20 cm severe ischemic segment.The distal part of the small bowel was 25 cm in length and only about 0.8 cm in diameter.Ladd’s procedure,necrotic segment resection and end-to-back duodeno-ileal anastomosis were performed.The residual severe ischemic jejunum was preserved with single proximal stoma and distal end closure.Three months later,to restore the continuity of the isolated gut segment,end-to-end duodeno-jejunal and jejuno-ileal anastomosis was performed.The entire functional small bowel length increased to 80 cm.Intravenous fluid therapy and parenteral nutrition were discontinued on the 10th day postoperatively.Twelve months later,her body weight was 9.5 kg.CONCLUSION Isolation of severe ischemic bowel segment and staged anastomosis to restore the gut continuity for infants with SBS are safe and feasible.

关键词： Ischemic bowel segment Short bowel syndrome Bowel isolation technique Staged salvaging procedure Case report

Identification of long-grain chromosome segment substitution line Z744 and QTL analysis for agronomic traits in rice

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Journal of Integrative Agriculture 2020年第5期19卷 1163-1169页

作者： MA Fu-ying DU Jie WANG Da-chuan WANG Hui ZHAO Bing-bing HE Guang-hua YANG Zheng-lin ZHANG Ting WU Ren-hong ZHAO Fang-ming Rice Research Institute Academy of Agricultural SciencesSouthwest UniversityChongqing 400715P.R.China

Length of grain affects the appearance, quality, and yield of rice. A rice long-grain chromosome segment substitution line Z744, with Nipponbare as the recipient parent and Xihui 18 as the donor parent, was identified. Z744 contains a total of six substitution segments distributed on chromosomes(Chrs.) 1, 2, 6, 7, and 12, with an average substitution length of 2.72 Mb. The grain length, ratio of length to width, and 1 000-grain weight of Z744 were significantly higher than those in Nipponbare. The plant height, panicle number, and seed-set ratio in Z744 were significantly lower than those in Nipponbare, but they were still 78.7 cm, 13.5 per plant, and 86.49%, respectively. Furthermore, eight QTLs of different traits were identified in the secondary F2 population, constructed by Nipponbare and Z744 hybridization. The grain weight of Z744 was controlled by two synergistic QTLs(qGWT1 and q GWT7) and two subtractive QTLs(qGWT2 and qGWT6), respectively. The increase in the grain weight of Z744 was caused mainly by the increase in grain length. Two QTLs were detected, qGL1 and qGL7-3, which accounted for 25.54 and 15.58% of phenotypic variation, respectively. A Chi-square test showed that the long-grain number and the short-grain number were in accordance with the 3:1 separation ratio, which indicates that the long grain is dominant over the short-grain and Z744 was controlled mainly by the principal effect qGL1. These results offered a good basis for further fine mapping of qGL1 and further dissection of other QTLs into single-segment substitution lines.

关键词： rice chromosome segment substitution line grain length QTL

Pseudophakic Malignant Glaucoma Treatment Assisted with Anterior segment Optical Coherence Tomography: A Case Report

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Chinese Medical Sciences Journal 2015年第4期30卷 266-269页

作者： Huan Chen Shun-hua Zhang Department of Ophthalmology Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical College

PSEUDOPHAKIC malignant glaucoma is diagnosedbased on the presence of a shallow or flat centraland peripheral anterior chamber in the presenceof patent iridectomy, with intraocular pressure（IOP） of 22 mm Hg or more after lens extraction andintraocular lens implantation.1 Pseudophakic malignantglaucoma is one of the most challenging complicationsfaced by surgeons. Initial medication includes topicalcycloplegics, osmotic agents.

关键词： malignant glaucoma anterior segment optical coherence tomography pseudophakia

Risk factors of distal segment aortic enlargement after complicated type B aortic dissection

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Journal of Interventional Medicine 2019年第4期2卷 154-159页

作者： Yu Shen Simeng Zhang Guanglang Zhu Yanqing Chen Zheng Chen Zaiping Jing Qingsheng Lu Department of Vascular Surgery Changhai HospitalSecond Military Medical University17 Building168 Changhai RoadShanghaiChina Department of Congenital Heart Disease Fuwai HospitalNational Center of Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Objectives:Distal segment aortic enlargement(DSAE)is a common complication that influences the long-term prognosis of type B aortic dissection(TBAD)after thoracic endovascular aortic repair(TEVAR).In this study,a multivariate analysis was performed to find potential factors predictive of DSAE.Methods:A single-center retrospective study was performed from 1999 to 2016.Included in the study were complicated TBAD patients who underwent TEVAR with uncovered residual tears.Based on the diameter of the distal segment of the uncovered aorta,we assigned patients to an enlargement group and a non-enlargement group.Data extracted from the medical records included demographic and clinical characteristics and followup computed tomography angiography data.The primary endpoints were the all-cause mortality and the presumably aortic-related events that required reintervention during the follow-up period.Results:For the 333 patients,all-cause mortality was 38(11.41%),and 76(22.82%)patients underwent reintervention.A total of 70(21.02%)patients experienced DSAE,among them were 2 patients who died of aortic rupture and 58 patients who accepted reintervention.Multivariate analysis reviewed independent risk factors of postoperative DSAE,including current smoking,the residual length of the patent false lumen,the postoperative number of dissection tears in the thoracic aorta and type III aortic arch;as well as protective factors,including the application of a restrictive bare stent(RBS),the length of covered stent in the descending thoracic aorta,and the distance from the residual first tear to the left subclavian artery(LSA).Conclusion:DSAE after TEVAR for patients with a complicated TBAD can be influenced by their current smoking habit,the residual length of patent false lumen,the postoperative number of dissection tears in the thoracic aorta and the aortic arch type.Meanwhile,RBS usage,the length of the covered stent in the descending thoracic aorta and the distance from the residual first tear to the LSA could have positive effect

关键词： Type B aortic dissection Thoracic endovascular aortic repair Distal segment aortic enlargement Risk factor