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简介：AbstractBackground:Although the incidence and clinical manifestations of pituitary apoplexy were reported by a few researches, the results are not consistent. This study aimed to explore the risk factors associated with an incidence of apoplexy in pituitary adenomas.Methods:The clinical information of 843 patients with pituitary adenoma from the Department of Neurological Surgery, 1st Affiliated Hospital of Kunming Medical University, was reviewed. The incidence, clinical manifestation, and potential risk factors for pituitary apoplexy were analyzed by a case-control study.Results:In total, 121 patients (14.4%) with macroadenoma were suffered from pituitary apoplexy. Headache, vomiting, and visual impairment are the top 3 symptoms for the pituitary apoplexy. Logistic regression results showed that the hypertension(hypertension vs non-hypertension OR = 2.765, 95%CI: 1.41~5.416), tumor type (negative staining vs. positive staining, OR = 1.501, 95%CI:1.248~5.235), and tumor size (diameter > 2 cm vs. diameter ≤ 2 cm, OR = 3.952, 95%CI:2.211~7.053) are independent factors associated with pituitary apoplexy.Conclusion:Our results indicate that the risk factors for the incidence of pituitary apoplexy depend mainly on properties of the tumor itself (tumor size and pathologic type) and the blood pressure of patients.

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简介：PrincipalInvestigatorandSupervisorofProject:WuYuhong1.QIBing,MAThesis,June,2005ReconstructionoftheEarlyArchiveofNaram-ili,StorageOfficial(sukkal,ì-du8)oftheAnimalCenteroftheUr-IIIDynasty

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简介：AbstractObjective:Ultrasound determination of chorionicity is poor in early pregnancy in China. In an effort to increase the accuracy rate of prompt chorionicity determination, clinical training was provided to primary care physicians. This study assesses the effects of implementing clinical guidelines on chorionicity determination.Methods:A multi-centered cohort study was conducted between January 2014 and June 2017 in 12 hospitals without fetal medicine centers. In 2014, the obstetricians and ultrasound physicians were trained in clinical practice and ultrasound examination relating to chorionicity determination. Linear and binary regression analyses were conducted to identify the effects of introducing the new protocols, including the diagnosis rate of chorionicty and perinatal outcomes, taking the data from 2014 as a baseline. Pregnancy outcomes were additionally adjusted for maternal age.Results:During the period of this study, 3,599 twin pregnancies from 12 centers were enrolled, and a total of 2,998 twin pregnancies were extracted. The rate of overall chorionicity determination, including antenatal and postpartum diagnosis, increased successively from 49.5% in 2014 to 93.5% in 2017 (P < 0.0001). The rate of ultrasonic chorionicity diagnosis before 14 weeks increased from 25.2% in 2014 to 65.0% in 2017 (P < 0.0001). These changes were associated with decreasing incidence of preterm birth, a lower risk of stillbirth, whether for one (P = 0.0456 in 2016) or two fetuses (P = 0.0470 in 2016; P = 0.0042 in 2017) and a decreased rate of admission to neonatal intensive care unit (43.0% in 2014, 37.4% in 2017; P = 0.0032).Conclusions:The implementation of a clinical practice guideline improved both overall and early chorionicity determinations. Regular training workshops of antenatal care are recommended to further promote capability in clinical diagnosis and treatment.

简介：明确的表达以前由作者介绍了因为库仑积分被概括到另外的二中心的积分，除了交换积分。在这个框架以内，分子的积分与递归地评估的著名不完全的gamma功能和这些功能有关仔细以一些新功能被表示。在混合积分的情况中产生的特刊被处理，并且结果与在文学发现的相比。

简介：BackgroundTheeffectofselectiveradiofrequencyablationfortreatingparoxysmalsupraventriculartachycardia(PSVT)anditsassociatedparoxysmalatrialfibrillation(PAF)wasassessed.MethodsDatawerecollectedretrospectivelyfrompatientsdiagnosedofPSVTandsubsequentlytreatedwithradiofrequencyablation.Regularmonthlyfollow-upbydynamicelectrocardiography(ECG)wasperformed.Incidentratesofatrialfibrillationbeforeandafterablationwerecompared.Results382PSVTpatientswith58havingatrialfibrillationwereenrolled.TheorderofcomplicatedPAFfromhightolowinthesepatientswasdisplayedas:atrialtachycardia(AT),atrioventricularreentranttachycardia(AVRT)andatrioventricularnodalreentranttachycardia(AVNRT).AmongAVRTpatients,PAFwasmorefrequentinpatientshavingaccessorypathways.AVNRTpatientshadsignificantlylowerPAFratecomparingtootherpatients.PAFincidentratewassignificantlyreducedbyradiofrequencyablationtherapy.ConclusionWeadviseregulardynamicECGforPSVTpatients,especiallythosewithatrialflutter,ATorpre-excitationsyndrome.SelectiveradiofrequencyablationisafeasibleapproachfortreatingAFcomplicatedPSVTpatients.

简介：这份报纸涉及与sextic轨道从一个二次的可逆Lotka-Volterra系统的一个时期体环区分的限制周期。作者使用一个扩大完全的Chebyshev系统的性质并且证明在二次的不安下面的时期体环的cyclicity等于二。

简介：TheCMSCollaborationof2000scientistsinvolves150institutionsfrom31nationsspreadallovertheworld.CMSsoftwaresystemintegrationandreleasemanagementisperformedatCERN.CodemanagementisbasedonCVS,withreadorwriteaccesstotherepositoryviaaCVSserver,Softwareconfiguration,releasemanagementtools(SCRAM)arebeingdevelopedatCERN.Softwarereleasesarethendistributedtoregionalcenters,wherethesoftwareisusedbyalocalcommunityforawidevarietyoftasks,suchassoftwaredevelopmentdetectorsimulationandreconstructionandphysicsanalysis.Dependingonspecificapplication,thesystemenvironmentandlocalhardwarerequirements,differentapproachesandtoolsareusedfortheCMSsoftwareinstallationatdifferentplaces.Thispresentationdescribesconceptsandreactialsolutionsforavarietyofwaysofsoftwaredistribution,withanemphasisontheCMSexperienceatFermilab,Installationandusageofdifferentmodelsusedfortheproductionfarm,forcodedevelopmentandforphysicsanalysisaredescribed.

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简介：Objective:Toassesstheresponserateofpatientswithrectaladenocarcinomatoneoadjuvanttherapyandtoidentifythepredictorsofhistologicalregressionafterneoadjuvantradiotherapy(RT)orconcurrentchemoradiotherapy(CCRT).Methods:Thisstudyrecruited64patients.Thepatientshadresectablecancerofthelowerandthemiddlerectum(T3/T4and/orN+)withoutdistantmetastasisandreceivedneoadjuvantRTorCCRTfollowedbyradicalsurgerywithtotalmesorectalexcision(TME)betweenJanuary2006andDecember2011.Thepatientswereclassifiedintonon-response(NR),partialresponse(PR),andpathologiccompleteresponse(pCR)basedontheDworaktumorregressiongradingsystem.Results:Themedianageofpatientswas57years(rangingfrom22to85).Atotalof24patientsweretreatedwithneoadjuvantCCRT,whereas40patientsweretreatedwithRTalone.Abdominoperinealresection(APR)wasperformedon29patients(45%).AnteriorresectionwithTMEwasperformedon34patients(53%).Onepatienthadlocalresection.Histologically,12(19%),24(73%),and28(44%)patientsexhibitedpCR,PR,andNR,respectively.Univariateanalysisrevealedthatthepredictorsoftumorregressionwereasfollows:theabsenceoflymphnodeinvolvementfrominitialimaging(cN0)(P=0.021);normalinitialcarcinoembryonicantigen(CEA)level(P=0.01);hemoglobinlevel≥12g/dl(P=0.009);CCRT(P=0.021);andtumordownstaginginimaging(P=0.001).MultivariateanalysisshowedthatthemainpredictorsofpCRwereCTcombinedwithneoadjuvantRT,cN0stage,andtumorregressiononimaging.Conclusions:IdentifyingthepredictorsofpCRfollowingneoadjuvanttherapyaidstheselectionofresponsivepatientsfornonaggressivesurgicaltreatmentandpossiblesurveillance.

简介：AbstractObjective:Androgenetic alopecia (AA) is a progressive hair loss disorder mediated by systemic androgens and genetic factors. A variety of AA treatments have been investigated. Currently, there is emerging evidence and growing interest in the use of platelet-rich plasma (PRP) for AA. This study describes a single-center experience using PRP to treat AA in women.Methods:A retrospective observational study design was employed. The study cohort comprised 20 women >18 years of age who were diagnosed with AA. PRP was prepared using a commercially available PRP kit. Each patient received six PRP treatment sessions at 4-week intervals. The severity of alopecia tool (SALT) scoring system was used to measure the severity of alopecia, and a paired t-test was used to calculate significance levels.Results:The mean pre-intervention and post-intervention total SALT score was 27.5 ± 6.35 and 9.41 ± 3.71, respectively. The difference in the total mean SALT score was 18.33 ± 1.64 and the effect size was 3.52. The scalp area with the largest effect size was the vertex (Cohen d= 2.53). The effect size was similar across other scalp areas (Cohen d= 1.91-2.09). There were no serious adverse effects of the treatment; only mild transient adverse effects were reported.Conclusion:The present study demonstrated the efficacy and safety of PRP injections in treating AA in women. However, these findings require confirmation in well-designed studies using standardized treatment protocols and evaluation methods.

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简介：AbstractBackground:Endonasal endoscopic skull base surgery has undergone rapid technological developments and is now widely performed, but its strengths and weaknesses deserve further investigation and deliberation. This study was performed to investigate the surgical indications, complications, and technical advantages and disadvantages of endonasal endoscopic skull base surgery.Methods:The clinical data of 1886 endoscopic endonasal skull base surgeries performed in our ward at Beijing Tiantan Hospital from June 2006 to June 2016 were retrospectively analyzed.Results:One thousand ninety-three (73.4%, 1490) pituitary adenomas, 54 (24.9%, 217) chordomas, 28 (80.0%, 35) craniopharyngiomas, and 15 (83.3%, 18) meningiomas underwent total resection. Two patients died postoperatively, both having pituitary adenomas. Other postoperative complications included olfactory disorders (n = 226, 11.9%), postoperative cerebrospinal fluid leakage (n = 78, 4.1%), hypopituitarism (n = 74, 3.9%), diabetes insipidus (n = 64, 3.4%), intracranial infection (n = 36, 1.9%), epistaxis (n = 24, 1.3%), vascular injury (n = 8, 0.4%), optic nerve injury (n = 8, 0.4%), and oculomotor movement impairment (n = 4, 0.2%). In total, 1517 (80.4%) patients were followed up for 6 to 126 months (average, 42.5 months) postoperatively. A total of 196 (13.2%) pituitary adenomas and 13 (37.1%) craniopharyngiomas recurred but no meningiomas recurred. Chordomas recurred in 97 (44.7%) patients, in whom 5-year survival rate was 65%.Conclusion:Endoscopic surgery is an innovative surgical technique and the first choice for most midline extradural lesions such as chordomas, and an excellent choice for pituitary adenomas. It probably will be a good technique for many kinds of craniopharyngiomas and a common technique for most of skull base meningiomas, so the surgical indications of these cases should be chosen carefully to make good use of its respective advantages.

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简介：AttheprimarystageofSHPdevelopment(1960s—1970s),woodenoriron-woodenturbinesmanufacturedbyagriculturalmachineryworksweremainlyadoptedinChina.Before1949,SHPequipmentwasgenerallyimportedduetolackofdomesticmanufacturingcapability.In1952,thefirstturbine-generatorunitof800kWcapacitywassuccessfullymadeinChina,

简介：AbstractObjectives:Timing of drain removal and its effects on complications after major pancreatectomy remain controversial. We designed this study to assess whether early drain removal after major pancreatectomy influences the incidence of complications in the patients with low risk of postoperative pancreatic fistula (POPF).Methods:This is a single-center randomized controlled trial (RCT). A total of 144 patients undergoing pancreaticoduodenectomy (PD) and distal pancreatectomy (DP) who met the criteria, including drain amylase on postoperative day (POD) 1 and 3 less than 5000 U/L and drain output within POD 3 less than 300 mL/d, were randomly assigned to early drain removal (POD 3) or standard drain removal (≥POD 5). The primary outcome was major complications (Clavien-Dindo grades 2-4), and the secondary outcome was POPF, reintervention treatment, readmission, and total medical expense within 3 months after surgery.Results:A total of 5 patients in early drain removal group had at least 1 major complications (grades 2-4), compared to 15 patients in standard drain removal group (P=.028). The incidence of grade B/C pancreatic fistula was not significantly different (2.8% vs 0%). Multivariate analysis demonstrated that early drain removal was an independent factor associated with a reduced risk of major complications (P=.039, odds ratio=0.314). Majority of major complications occurred in PD patients, and only very few cases occurred in DP patients. Stratified analysis showed that early drain removal significantly reduced the major complications only in the patients undergoing PD.Conclusion:This single-center RCT shows early drain removal on POD 3 is safe for both DP and PD patients, under our criteria. Early drain removal could reduce the incidence of major complications in patients undergoing PD.