简介：Coronaryarterychronictotalocclusion(CTO)isdefinedasanoccludedcoronaryarterysegmentwithoutanterogradeflowforatleastthreemonths.Itcanbeclassifiedasa“true”or“functional”CTObasedonflowcharacteristics.In“true”CTO,thereisnoanterogradeflow.In“functional”CTO,thereisminimalanterogradeflowthroughtheoccludedsegmentofthecoronaryartery.CTOisacommonfindingduringcoronaryangiographyanditsprevalencemayvarydependingonthereportedliterature.Amongpatientswithoutpreviouscoronaryarterybypassgrafting(CABG),CTOisfoundinabout20–30%ofthepatients.CTOmaydevelopinsidiouslyoveraperiodoftimeandinvolveacomplexinterplaybetweenintracellularandextracellularfactors,smoothmuscleandfoamcells,calcification,andneovascularization.ThereisagrowingbodyofevidencetosupportthatCTOrevascularizationmayimproveclinicaloutcomewhencomparedtomedicalmanagement.BoththeEuropeanandAmericancardiovascularsocietiessupportCTOrevascularizationwithaclass2arecommendation(levelofevidenceB).Historically,duetolowproceduralsuccessrate,apparentinefficientresourceutilization,potentialincreaseincomplicationratesanduncertainclinicalbenefits,onlyabout10–20%ofpatientswithCTOaretreatedwithpercutaneouscoronaryintervention(PCI).RecentadvancesusingnovelandinnovativetechniqueswithdedicatedequipmenthavesignificantlyimprovedtheproceduralsuccessrateforCTOPCItoabout90%inthehandsofexperiencedoperators.WithincreasinginterestinCTOPCIcoupledwithincreasededucationaleffort,CTOPCIlikelywillbecomemoreaccessibletopatientsinneedofCTOrevascularization.OngoingadvancementininnovativetechniquesandequipmentwillcontinuetoimproveproceduralsuccessratesandreduceproceduralcomplicationrateforCTOPCI.Furthermore,thereareanumberofprospectiveclinicaltrialsonthehorizonwhichshouldhelpdefinetheclinicalbenefitsandlimitationsofCTOPCIinthenear

简介：Occlusaldisordercausedbysevereworndentitionisoneofthemostcommondiseasesintheocclusion.Occlusalreconstructionisanimportantrepairmethod,referringtomodifyandrebuildtheexistingocclusionstatus,thentorestoretheocclusion.Duringocclusalreconstruction,thedigitalocclusionanalysissystemcanaccuratelyacquiretheocclusionstatus,inordertoguidethereconstructionocclusionaccuratelyandrestorethenormalfunctionoftheoralmaxillarysystem.Thispaperreviewstheconceptofocclusalreconstruction,sequencetherapy,traditionalocclusionanalysismethodsandthedevelopmentstatusandprospectofdigitalocclusionanalysis.

简介：Followingclassicaltheory,atwo-layerfrontalmodelisdesigned.Itassumesthatfrontalsurfaceisthezero-orderdiscontinuityofdensity.Inthispaper,themodelisusedtostudyorographicallydistortedandoccludedfronts.Itisindi-catedthatthedistortionandocclusionofcoldfrontsaredifferentunderdifferentconditionsoforography.Frontalin-tensityalsoinfluencesthedistortionandocclusion.Somerulesarerevealedandcomparedwithobservations.Inaddition,wehaveanalysedtheverticalstructureofcoldfrontabovemountainsandfoundthatfrontalsurfacemaybebulgedundertheinfluenceoforographywhenitclimesthemountain.ThebulgeoffrontalsurfaceisjustliketheboreaspointedoutbyLong(1972)whenheanalysedfluidoverobstacles.

简介：视觉追踪是在计算机视觉的一个重要区域。怎么处理照明和吸藏问题是一个挑战性的问题。这份报纸论述一篇小说和有效追踪算法处理如此的问题。一方面，一起始的外观总是有的目标清除轮廓，它对照明变化光不变、柔韧。在另一方面，特征在追踪起一个重要作用，在哪个之中convolutional特征显示出有利性能。因此，我们采用卷的轮廓特征代表目标外观。一般来说，一阶的衍生物边坡度操作员在由卷检测轮廓是有效的他们与图象。特别，Prewitt操作员对水平、垂直的边更敏感，当Sobel操作员对斜边更敏感时。内在地，Prewitt和Sobel与对方一起是补足的。技术上说，这份报纸设计二组Prewitt和Sobel边察觉者提取一套完全的convolutional特征，它包括水平、垂直、斜的边特征。在第一个框架，轮廓特征从目标被提取构造起始的外观模型。在有这些轮廓特征的试验性的图象的分析以后，明亮的部分经常提供更有用的信息描述目标特征，这能被发现。因此，我们建议一个方法比较候选人样品和我们仅仅使用明亮的象素的训练模型的类似，它使我们的追踪者有能力处理部分吸藏问题。在得到新目标以后，变化以便改编外观，我们建议相应联机策略逐渐地更新我们的模型。convolutional特征由井综合的Prewitt和Sobel边察觉者提取了的实验表演能是足够有效的学习柔韧的外观模型。九个挑战性的序列上的众多的试验性的结果证明我们的建议途径与最先进的追踪者比较很有效、柔韧。

简介：AbstractBackground:Massive bleeding is the main concern for the management of placenta percreta (PP). Intra-abdominal aortic balloon occlusion (IABO) is one method for pelvic devascularization, but the efficacy of IABO is uncertain. This study aims to investigate the outcomes of IABO in PP patients.Methods:We retrospectively reviewed the clinical data of PP cases from six tertiary centers in China between January 2011 and December 2015. PP cases with/without the use of IABO were analyzed. Propensity score matching analysis was performed to reduce the effect of selection bias. Postpartum hemorrhage (PPH) and the rate of hysterectomy, as well as neonatal outcomes, were analyzed.Results:One hundred and thirty-two matched pairs of patients were included in the final analysis. Compared with the control group, maternal outcomes, including PPH (68.9% vs. 87.9%, χ2= 13.984, P < 0.001), hysterectomy (8.3% vs. 65.2%, χ2= 91.672, P < 0.001), and repeated surgery (1.5% vs. 12.1%, χ2 = 11.686, P= 0.001) were significantly reduced in the IABO group. For neonatal outcomes, Apgar scores at 1 minute (8.67 ± 1.79 vs. 8.53 ± 1.68, t=-0.638, P= 0.947) and 5 minutes (9.43 ± 1.55 vs. 9.53 ± 1.26, t = 0.566, P = 0.293) were not significantly different between the two groups.Conclusions:IABO can significantly reduce blood loss, hysterectomies, and repeated surgeries. This procedure has not shown harmful effects on neonatal outcomes.

简介：Cerebralischemianotonlycausespathologicalchangesintheischemicareasbutalsoinducesaseriesofsecondarychangesinmoredistalbrainregions(suchasthecontralateralcerebralhemisphere).Theimpactofsupratentoriallesions,whicharethemostcommontypeoflesion,onthecontralateralcerebellumhasbeenstudiedinpatientsbypositronemissiontomography,singlephotonemissioncomputedtomography,magneticresonanceimaginganddiffusiontensorimaging.Inthepresentstudy,weinvestigatedmetabolitechangesinthecontralateralcerebralhemisphereaftersupratentorialunilateralischemiausingnuclearmagneticresonancespectroscopy-basedmetabonomics.Thepermanentmiddlecerebralarteryocclusionmodelofischemicstrokewasestablishedinrats.Ratswererandomlydividedintothemiddlecerebralarteryocclusion1-,3-,9-and24-hourgroupsandtheshamgroup.~1Hnuclearmagneticresonancespectroscopywasusedtodetectmetabolitesintheleftandrightcerebralhemispheres.Comparedwiththeshamgroup,theconcentrationsoflactate,alanine,γ-aminobutyricacid,cholineandglycineintheischemiccerebralhemispherewereincreasedintheacutestage,whiletheconcentrationsofN-acetylaspartate,creatinine,glutamateandaspartateweredecreased.Thisdemonstratesthatthereisanupregulationofanaerobicglycolysis(shownbytheincreaseinlactate),aperturbationofcholinemetabolism(suggestedbytheincreaseincholine),neuronalcelldamage(shownbythedecreaseinN-acetylaspartate)andneurotransmitterimbalance(evidencedbytheincreaseinγ-aminobutyricacidandglycineandbythedecreaseinglutamateandaspartate)intheacutestageofcerebralischemia.Inthecontralateralhemisphere,theconcentrationsoflactate,alanine,glycine,cholineandaspartatewereincreased,whiletheconcentrationsofγ-aminobutyricacid,glutamateandcreatinineweredecreased.Thissuggeststhatthereisadifferenceinthemetabolitechangesinducedbyischemicinjuryinthecontral

简介：Aim:Todetermineifandrogensdirectlyregulateveno-occlusionorifandrogensactindirectlytomaintainthepenilestrutureswhichcontroloutflow.Methods:UsingCASTRATEandTESTOrots,measurementwasmadeofmeanarterialpressure(MAP),intracavemosalpressure(CCP),andintracavemosalflow(CCF)duringerectionresultingfromstimulationoftheautonomicinnervationofthepenis.CCPandCCFwerealsomeasuredduringsalineinfusionintothecavemosalsinusesbeforeandaftertreatmentwithsodiumnitropmsside(SNP,anitricoxidedonordrug)tofullyrelaxcavemosalsmoothmuscle.Peniletissuewasalsocollectedtomeasurethecontentofaactinandproliueandhydroxyprolinetodetermineifbriefwithdrawalofandrogenicsupportledtochangesinthenumberofsmoothmusclecellsorthecollagencontentofthetissue.Resttlts:Infusionofsalineintothecavemosalsinusesdemonstratedthatveno-occlusionwasdefectiveinCASTRATEratswhileveno-occlusionwasfullyfunctionalinTESTOanimals.Funtmmore,veno-occlusioncouldbeinducedinCASTRATEratsiftheywerefirstnearedwithSNP.Thisobservationsuggeststhatfailureofveno-occlusionintheCASTRATEratsisduetoadeficiencyintheproductionofNOresultinginareductioninthedegreeofrelaxationofthepenilesmoothmuscle.Themeasurementsofsmoothmuscleaactinandprolineandhydroxyprolinecontentofcollagenshowedthatbothwereunaffectedbycastrationandthatthebasicstructureofthepenisdidnotdegenerateafteroneweekwithoutandrogenicsupport.Conclusion:Theseresultscanbeinteipretedtomeanthatandrogenscontroltheveno-occlusivemechanismindirectlyviaaNOdependentmechanismandnotbymaintainingthestructuresofthepeniswhichareessentialtoveno-ocelusion.(AsianJAndrol1999Jun;1:53-59)

简介：ObjectivesToinvestigatethecauses,theraputicandpreventivemethodsofcomplicationsassociatedwithtranscatheterocclusionofatrialseptaldefect(ASD)usingtheAmplatzerseptaloccluder(ASO)inchildren.Methods289casesunderwenttranscatheterclosureofASDwithASO.Complicationsoccurredin9cases.Thecomplicationsinprocedureincludedsystemiccirculatorysystemicairembolismin2,pulmonaryairembolismin1,pericardialtamponadein1,ASOmalpositionrequiringemergencysurgicalremovalin1,transientatrialextrasystolesin1andsizingballoonrupturein1case.2caseswithpostoperativecomplicationswerefoundinthefollow-upstudies.TheseincludedperforationofmitralvalveandASOpartiallydislodged.Inthisstudy,5childrenwithintraoperativecomplicationreceivedemergencytherapyincludingsurgicalintervention,andothersneededonlyfollow-up,asthecomplicationsweretransientorasymptomatic.ResultsTherewerenochildrendeathinthisstudy.The5caseswhoreceivedtreatmentwerecompletelyhealing,andtheotherswithintra-procedurecomplicationswerealsohadnosequelaexisted.CaseswithmitralvalveandASOpartiallydislodgedwerestillinfollow-upstudies,asthe2patientshavingnosymptoms.ConclutionsAirembolismwereoccurredeasilyinatrialseptaldefectcaseswhoreceivedASOtherapy.Complicationsmainlycausedbyinappropriateoperativeprocedureandsomecomplicationsneededemergencytreatments.Follow-upstudieswereimportanttocaseswithtranscatheterocclusiontherapy.

简介：AbstractIntracranial atherosclerosis (ICAS)-related large vascular occlusion (LVO) was an intractable subtype of acute ischemic stroke (AIS), which always needed rescue angioplasty and stenting and complicated the procedure of endovascular recanalization. Diagnosing ICAS-LVO accurately and early was helpful for both clinical treatment and trials. Digital subtraction angiography (DSA) was unable to provide an early and rapid diagnosis of ICAS-LVO based on current studies. A variety of pre-DSA methods had been used to distinguish ICAS-LVO with other subtypes of ischemic stroke, such as medical histories, clinical presentations, computed tomography or angiography (CT/CTA), and magnetic resonance imaging (MRI/MRA). This article briefly reviewed the status quo of the diagnosis and treatment of ICAS-LVO and summarized early diagnostic methods of ICAS-LVO from different aspects.

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简介：AbstractBackground:The development of the technique has improved the success rate of percutaneous coronary intervention (PCI) for instent chronic total occlusion (IS-CTO). However, long-term outcomes remain unclear. The present study sought to investigate long-term outcomes of PCI for IS-CTO.Methods:A total of 474 IS-CTO patients were enrolled at two cardiac centers from 2015 to 2018 retrospectively. These patients were allocated into either successful or failed IS-CTO PCI groups. The primary endpoint (major adverse cardiac events [MACE]) consisted of recurrent angina pectoris (RAP), target-vessel myocardial infarction (MI), heart failure, cardiac death, or ischemia-driven target-vessel revascularization (TVR) at follow-up. Multivariable Cox regression analysis was used to investigate the association between treatment appropriateness and clinical outcomes.Results:A total of 367 patients were successfully treated with IS-CTO PCI while 107 patients had failed recanalization. After a median follow-up of 30 months (interquartile range: 17-42 months), no significant difference was observed between the two groups for the following parameters: cardiac death (successful PCI vs. failed PCI: 0.9% vs. 2.7%; adjusted hazard ratio [HR]: 1.442; 95% confidence interval [CI]: 0.21-9.887; P = 0.709), RAP (successful PCI vs. failed PCI: 40.8% vs. 40.0%; adjusted HR: 1.025; 95% CI: 0.683-1.538; P = 0.905), heart failure (successful PCI vs. failed PCI: 6.1% vs. 2.7%; adjusted HR: 0.281; 95% CI: 0.065-1.206; P = 0.088), target-vessel related MI (successful PCI vs. failed PCI: 1.5% vs. 2.7%; adjusted HR: 1.150; 95% CI: 0.221-5.995; P = 0.868), MACE (successful PCI vs. failed PCI: 44.2% vs. 45.3%; adjusted HR: 1.052; 95% CI: 0.717-1.543; P = 0.797). More patients were free of angina in the successful IS-CTO PCI group compared with failed PCI in the first (80.4% vs. 60%, P < 0.01) and second years (73.3% vs. 60.0%, P = 0.02) following up. Successful IS-CTO PCI had a lower incidence of MACE in the first and second years (20.2% vs. 40.0%, P < 0.01; 27.9% vs. 41.3%, P = 0.023) compared with failed PCI. After a median follow-up of 30 months, the reocclusion rate was 28.5% and TVR was 26.1% in the successful IS-CTO PCI group. Receiving >18 months of dual antiplatelet therapy (DAPT) was an independent predictor of decreased risk of TVR (HR: 2.682; 95% CI: 1.295-5.578; P = 0.008) or MACE (without TVR) (HR: 1.898; 95% CI: 1.036-3.479; P = 0.038) in successful IS-CTO PCI.Conclusions:After a median follow-up of 30 months, the successful IS-CTO PCI group had MACE similar to that of the failed PCI group. However, the successful IS-CTO PCI group had improved angina symptoms and were free from requiring coronary artery bypass grafting in the first or second years. To decrease MACE, DAPT was found to be essential and recommended for at least 18 months for IS-CTO PCI.

简介：DearEditor,Wearewritingthislettertoreportanunexpectedrarecaseofcentralretinalarteryocclusion(CRAO)happenedafterstent-assistedcoilingforinternalcarotidartery(ICA)aneurysminafemalepatient.CRAOisadevastatingocularemergencywithpoorvisualprognosisandnouniversalacceptedtreatmentatpresent.CRAOisusuallyassociatedwitharterialhypertension,diabetesmellitus,renaldisease.

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简介：在这篇论文，多分辨率批评点的过滤器(CPF)被采用想象为框架率起来变换(FRUC)匹配。由CPF匹配，稠密的运动地能为精确地代表目标运动被获得。然而，有弹性的运动模型不控制吸藏的区域，因此在插入内推的框架导致污迹人工制品。处理这个问题，我们建议用吸藏的一个新FRUC计划精制了匹配插值(ORCMI)的CPF。在建议途径，吸藏精炼基于印射的双向CPF。并且中间的框架被双向插值为象素为吸藏象素与单向性的设计相结合的非吸藏产生。试验性的结果证明ORCMI改进插入内推的框架的视觉质量，特别在吸藏区域。比作匹配基于的FRUC算法的块，ORCMI能完成dBPSNR为标准录像序列获得的1∼2。

简介：AbstractBackground:Chronic total occlusion (CTO) is a critical and unique subgroup of coronary lesions. This study aimed to investigate the correlation between the Selvester QRS score and late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMRI) in quantifying myocardial scarring to provide a simple and feasible method for treating CTO.Methods:The medical records of 134 patients with absolute CTO who underwent coronary angiography between May 1, 2014 and December 30, 2017 were retrospectively reviewed. All patients were grouped according to the CTO location (right coronary artery [RCA] CTO, left artery descending [LAD] CTO, left circumflex [LCX] CTO, and multivessel CTO groups). The degree of myocardial scarring was determined according to the Selvester QRS score and using the LGE-CMRI. All patients were followed up for at least 12 months.Results:Among the 62 CTO patients, 55 had occlusion of a single vessel and seven had occlusion of multiple vessels, of which 27 (43.55%) were in the RCA CTO group, 16 (25.81%) in the LAD CTO group, 12 (19.35%) in the LCX CTO group, and 7 (11.29%) in the multivessel CTO group. The area under the receiver operating characteristic curve for the QRS score that was used to determine the degree of myocardial scarring was 0.806, with a sensitivity and specificity of 94.7% and 42.1%, respectively. The Selvester QRS score and LGE-CMRI measures of scar size were correlated in the RCA CTO, LCX CTO, and multivessel CTO groups (r = 0.466, 0.593, and 0.775, respectively).Conclusion:The Selvester QRS score was feasible for detecting myocardial scarring in patients with CTO.

简介：瞄准：评估与hemihepatic经历hepatectomy的病人的临床的结果脉管的吸藏(HHO)与全部的肝的流入吸藏(THO)相比。方法：比较hemihepatic的使随机化的控制试用(RCT)脉管的吸藏和全部的肝的流入吸藏被系统的文学搜索包括。二个作者独立地为包括估计了试用并且提取了数据。元分析被进行基于aspartateaminotransferase(著名计算机生产厂商)和丙氨酸aminotransferase(中高音)的层次估计血损失，输送要求，和肝损害。固定效果模型或随机的效果模型被使用。结果：包括338个病人的四RCT满足了predened包括标准。167个病人的一个总数与THO被对待并且171与HHO。著名计算机生产厂商的元分析与加权的吝啬的差别(WMD)在THO组在手术后的白天铺平1显示的高水平342.27；95%信心间隔(CI)217.28-467.26；P=0.00001；I2=16%。元分析没在血损失上显示出THO组和HHO组之间的重要差别，输送要求，死亡，病态，操作时间，ischemic持续时间，医院停留，在手术后的白天的中高音层次1，3和7并且在手术后的白天的著名计算机生产厂商层次3和7。结论：Hemihepatic脉管的吸藏不把令人满意的利益提供给经历肝的切除术的病人。然而，他们在肝切除术以后有更少的肝损害。

简介：AbstractBackground:Surgical left atrial appendage occlusion (SLAAO) may be associated with a lower risk of thromboembolism in patients with atrial fibrillation undergoing cardiac surgery. However, evidence regarding the effectiveness of SLAAO in patients undergoing mechanical heart valve replacement (MHVR) is lacking. Therefore, we aimed to evaluate the association between SLAAO and the cardiovascular outcomes in patients with atrial fibrillation undergoing MHVR.Methods:We retrospectively analyzed data for 497 patients with atrial fibrillation; 27.6% of the patients underwent SLAAO, and the remainder of the patients did not (No-SLAAO group). The primary outcome was a composite of ischemic stroke, systemic embolism, and all-cause mortality. Cumulative event-free survival rates were estimated using Kaplan-Meier curves, and we performed multivariate Cox analyses to evaluate the association between SLAAO and outcomes. We used one-to-one propensity score matching to balance patients’ baseline characteristics, and analyzed 120 matching pairs.Results:Five patients died within 30 days postoperatively, and there were no significant differences between the two groups regarding in-hospital complications (all P > 0.05). After a median follow-up of 14 months, 14 primary events occurred. Kaplan-Meier curves showed no difference in the cumulative incidence of freedom from the primary outcome (log-rank P = 0.830), hemorrhagic events (log-rank P = 0.870), and the secondary outcome (log-rank P = 0.730), between the two groups. Multivariable Cox proportional hazards regression analysis showed no association between SLAAO and any outcome (all P > 0.05). After propensity score matching, cardiopulmonary bypass time and aortic cross-clamp time, and the postoperative length of stay were significantly longer in the SLAAO group (all P < 0.05); results were similar to the unadjusted analyses.Conclusions:Concomitant SLAAO and MHVR was associated with longer length of stay, and cardiopulmonary bypass time and aortic cross-clamp time, but was not associated with additional protective effects against thromboembolic events and mortality during the 14-month follow-up.

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简介：AIMTo探索在网膜的血容器的氧浸透怎么在ischemic和non-ischemic分支被改变网膜的静脉吸藏(BRVO).METHODSFiftyBRVO眼睛被划分成ischemic(n=26)和non-ischemic(n=24)组，基于宫底荧光黄angiography。健康个人(n=52和n=48，分别地)也为二个组作为控制被招募。堵塞容器和中央容器的吝啬的氧浸透被oximetry在BRVO和控制groups.RESULTSIn测量ischemicBRVO组，堵塞小动脉氧浸透(SaO2-一，106.0%±；14.3%)，而不是堵塞小静脉氧浸透(SaO2-V,60.8%±；9.4%)，看了增加什么时候与那些相比在一样的象限容器(SaO2-A,86.1%±；16.5%)在contralateral眼睛(P<；0.05)。中央容器的氧浸透堵塞容器与那些显示出类似的趋势。在non-ischemicBRVO组，堵塞，中央SaO2-V和SaO2-A没显示出重要变化。在ischemic和non-ischemicBRVO，当时，中央SaO2-A显著地被增加与健康individuals.CONCLUSIONObvious变化在相比堵塞，中央SaO2-A在ischemicBRVO组被发现，显示在小动脉的氧新陈代谢的混乱可以参予ischemicBRVO的致病。