BACKGROUND Kommerell’s diverticulum(KD)with aberrant left subclavian artery is a rare congenital deformity and also has very little research literature about it(35%of case study).There are three types of aortic arch ...BACKGROUND Kommerell’s diverticulum(KD)with aberrant left subclavian artery is a rare congenital deformity and also has very little research literature about it(35%of case study).There are three types of aortic arch diverticulum.Even literature concerning the treatment options are limited.CASE SUMMARY We present a case report of a 50-year-old male with KD in the right aortic arch with aberrant left subclavian artery.We conducted a total endovascular repair procedure,which is innovative and will spread more light in the medical world.Our patient has no past medical history and is a non-smoker and non-alcoholic.Patient presented with shortness of breath,chest pain and dizziness for six months.Blood tests were done and computerized tomography(CT)angiogram of the chest confirmed the diagnosis,illustrating showed a 3.9 cm KD.On Day 1,the CT angiogram showed mild dilatation of the thoracic aorta,adjacent esophagus,trachea was compressed and displaced.Surgery was planned as the treatment modality.Carotid-Subclavian artery bypass and endovascular aortic repair was conducted.We used prolene 5-0 C1 sutures to precisely anastomose a 6-mm Dacron graft to the left subclavian artery.Haemostasis was secured and wounds were closed.Protamine was administered and patient was shifted to intensive care unit.Post-operative,patient responded favorably and was discharged.Regular follow-up is done.CONCLUSION The procedure we performed is novel.This will help the cardio-thoracic surgeons a better insight about the full procedures we conducted,thereby bringing more light and better treatment options in managing KD with aberrant subclavian artery.展开更多
Background: Invasive mechanical ventilation worsens prognosis in patients with severe chronic obstructive pulmonary disease (COPD). To avoid complications in these patients, anesthesia should be carefully considered. ...Background: Invasive mechanical ventilation worsens prognosis in patients with severe chronic obstructive pulmonary disease (COPD). To avoid complications in these patients, anesthesia should be carefully considered. Case presentation: A 78-year-old man with COPD presented with dyspnea and pain from the epigastric to the umbilical regions. He was diagnosed with left incarcerated inguinal hernia and underwent radical inguinal hernia repair and surgical ileus treatment. To avoid general anesthesia with tracheal intubation, epidural anesthesia was combined with peripheral nerve blocks. An epidural catheter was inserted from T12/L1, and ilioinguinal-iliohypogastric and genitofemoral nerve blocks were performed under ultrasound guidance. No post-surgery complications or pain symptoms were noted. Conclusions: General anesthesia would likely have been challenging due to the patient’s COPD;however, management of peritoneal traction pain is difficult using peripheral nerve block alone. By combining epidural anesthesia with peripheral nerve blocks, we safely performed a procedure in a patient with severe COPD while avoiding invasive positive pressure ventilation.展开更多
Objective:To explore the value of ultrasound-guided ilioinguinal and iliohypogastric nerve block(IINB)in tension-free inguinal hernia repair in elderly patients.Methods:A total of 70 elderly patients with tension-free...Objective:To explore the value of ultrasound-guided ilioinguinal and iliohypogastric nerve block(IINB)in tension-free inguinal hernia repair in elderly patients.Methods:A total of 70 elderly patients with tension-free inguinal hernia repair who treated in the hospital from April 2018 to November 2019 were selected and divided into two groups according to the random number table method,with 35 cases each.The control group underwent infiltration of local anesthesia(LA),and the study group added with IINB.The visual analogue scale(VAS)scores of the two groups of patients were compared.Results:The VAS score of the study group when pulling the hernia sac was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:IINB has good analgesic effect in tensionfree inguinal hernia repair in elderly patients,and it is worth promoting.展开更多
Background: Peyronie’s disease is characterized by fibrous plaque formation in the tunica albuginea, leading to penile curvature and sexual dysfunction. Surgical correction is often required in cases of severe deform...Background: Peyronie’s disease is characterized by fibrous plaque formation in the tunica albuginea, leading to penile curvature and sexual dysfunction. Surgical correction is often required in cases of severe deformity or significant functional impairment. Aim: To present the case of a patient with severe Peyronie’s disease who underwent surgical correction using an autologous fascia lata graft. Case Presentation: We report the case of a 77-year-old Black-African gentleman with Peyronie’s disease, presenting with a self-reported penile curvature of 70 degrees and significant sexual frustration. He was managed surgically with plaque excision followed by a tunica albuginea patch using a subcutaneously harvested autologous fascia lata graft, all performed in a single surgical session. Conclusion: This case highlights the importance of individualized surgical planning and patient-specific considerations in achieving optimal outcomes in the management of Peyronie’s disease, particularly in cases requiring grafting for severe curvature.展开更多
On the description of the landscapes of historical blocks in China,this paper proposes the approaches to renovating the historical blocks,including their repairing and reconstruction. It aims at presenting suggestions...On the description of the landscapes of historical blocks in China,this paper proposes the approaches to renovating the historical blocks,including their repairing and reconstruction. It aims at presenting suggestions for the protection and development of historical blocks through analyzing the methods and procedures for repairing and rebuilding the infrastructures and green landscapes in the blocks.展开更多
1研究背景将卫星遥感红外资料应用于地震监测,起始于20世纪80年代前苏联科学家。后续国内外学者陆续开展了这方面的研究,提出了涡度、RST、ZS、距平和功率谱等异常提取方法,取得了大量震例和机理方面的研究成果(张元生等,2002;Tramutoli...1研究背景将卫星遥感红外资料应用于地震监测,起始于20世纪80年代前苏联科学家。后续国内外学者陆续开展了这方面的研究,提出了涡度、RST、ZS、距平和功率谱等异常提取方法,取得了大量震例和机理方面的研究成果(张元生等,2002;Tramutoli et al,2005;Ouzounov et al,2007;Freund,2011;Jing et al,2022)。张铁宝等(2016)研究表明,川滇块体东边界带强震前,川滇块体存在显著的超阈值辐射增强异常。利用该地区通过震例总结得到的红外辐射异常特征,持续对川滇块体红外辐射进行了多年跟踪,在2022年9月5日四川泸定M_(S)6.8地震前,川滇块体又再次出现了类似的异常变化。泸定地震发生在川滇块体东边界的鲜水河断裂带磨西段。本研究主要分析泸定地震前红外辐射的异常变化。展开更多
The Ca 2+-binding protein of the EF-hand type,S100B,exerts both intracellular and extracellular regulatory activities.As an intracellular regulator,S100B is involved in the regulation of energy metabolism,transcriptio...The Ca 2+-binding protein of the EF-hand type,S100B,exerts both intracellular and extracellular regulatory activities.As an intracellular regulator,S100B is involved in the regulation of energy metabolism,transcription,protein phosphorylation,cell proliferation,survival,differentiation and motility,and Ca 2+ homeostasis,by interacting with a wide array of proteins(i.e.,enzymes,enzyme substrates,cytoskeletal subunits,scaffold/adaptor proteins,transcription factors,ubiquitin E3 ligases,ion channels) in a restricted number of cell types.As an extracellular signal,S100B engages the pattern recognition receptor,receptor for advanced glycation end-products(RAGE),on immune cells as well as on neuronal,astrocytic and microglial cells,vascular smooth muscle cells,skeletal myoblasts and cardiomyocytes.However,RAGE may not be the sole receptor activated by S100B,the protein being able to enhance bFGF-FGFR1 signaling by interacting with FGFR1-bound bFGF in particular cell types.Moreover,extracellular effects of S100B vary depending on its local concentration.Increasing evidence suggests that at the concentration found in extracellular fluids in normal physiological conditions and locally upon acute tissue injury,which is up to a few nM levels,S100B exerts trophic effects in the central and peripheral nervous system and in skeletal muscle tissue thus participating in tissue homeostasis.The present commentary summarizes results implicating intracellular and extracellular S100B in tissue development,repair and regeneration.展开更多
BACKGROUND When herpes zoster is complicated with paralytic ileus,this mostly involves acute intestinal pseudo-obstruction of Ogilvie’s syndrome manifesting as obvious dilatation of the cecum and right colon;small in...BACKGROUND When herpes zoster is complicated with paralytic ileus,this mostly involves acute intestinal pseudo-obstruction of Ogilvie’s syndrome manifesting as obvious dilatation of the cecum and right colon;small intestinal obstruction is rare.Here,we present a patient with a very rare case of small bowel pseudo-obstruction.CASE SUMMARY A 76-year-old female patient complained of right upper quadrant pain.Two days later,a blistering,right-sided rash of the thoracoabdominal dermatome(T5-T10) emerged in conjunction with small intestinal dilatation and the inability to defecate.Computed tomography of the abdomen confirmed small bowel pseudoobstruction.Antiviral therapy,gastrointestinal decompression,and enemas proved unproductive.After 4 d of stagnation,an epidural block was performed for pain relief and prompted the passage of gas and stool,resolving the obstructive problem.Three days later,the rash appeared dry and crusted,and the pain diminished.After 5 d,no abnormality was visible by gastroenteroscopy,and the patient was discharged on day 7.CONCLUSION This case shows that herpes zoster may induce small bowel pseudo-obstruction in addition to colonic pseudo-obstruction.Epidural block can not only treat intercostal neuralgia but also resolve small bowel pseudo-obstruction caused by herpes zoster.展开更多
It was not until 1979 that Bayes de Ltma described atrial conduction blocks and classified them as interatrial and intra- atrial.Interatrial blocks refer to conduction disorders lo- cated between the atria, while intr...It was not until 1979 that Bayes de Ltma described atrial conduction blocks and classified them as interatrial and intra- atrial.Interatrial blocks refer to conduction disorders lo- cated between the atria, while intraalxial blocks occur within the same atrium. This work motivated several authors, in- cluding Bayes himself, to further investigate atrial conduc- tion and interatrial block （IAB）.展开更多
The most commonly used method for assessing the hydraulic erodibility of rock is Annandale's method.This method is based on a correlation between the erosive force of flowing water and the capacity of rock resista...The most commonly used method for assessing the hydraulic erodibility of rock is Annandale's method.This method is based on a correlation between the erosive force of flowing water and the capacity of rock resistance. This capacity is evaluated using Kirsten's index, which was initially developed to evaluate the excavatability of earth materials. For rocky material, this index is determined according to certain geomechanical factors related to intact rock and rock mass, such as compressive strength of intact rock, rock block size, discontinuity shear strength and relative block structure. To quantify the relative block structure, Kirsten(1982) developed a mathematical expression that accounts for the shape and orientation of the blocks relative to the direction of flow. Kirsten's initial concept for assessing the relative block structure considers that the geological formation is mainly fractured by two joint sets forming an orthogonally fractured system. An adjusted concept is proposed to determine the relative block structure when the fractured system is non-orthogonal where the angle between the planes of the two joint sets is greater or less than 90°. An analysis of the proposed relative block structure rating shows that considering a non-orthogonally fractured system has a significant effect on Kirsten's index and, as a consequence, on the assessment of the hydraulic erodibility of rock.展开更多
Using pure S wave fitting method, we studied the shear wave velocity structures under the Ordos block and its eastern and southern marginal areas. The results show that the velocity structure beneath Yulin station in ...Using pure S wave fitting method, we studied the shear wave velocity structures under the Ordos block and its eastern and southern marginal areas. The results show that the velocity structure beneath Yulin station in the interior of Ordos block is relatively stable, where no apparent change between high and low velocity layers exists and the shear wave velocity increases steadily with the depth. There is a 12km thick layer at the depth of 25km under this station, with an S wave velocity (V S=3.90km/s) lower than that at the same depth in its eastern and southern areas (V S≥4.00km/s). The crust under the eastern margin of Ordos block is thicker than that of the Yulin station, and the velocity structures alternate between the high and low velocity layers, with more low velocity layers. It has the same characteristic as having a 10km-thick low velocity layer (V S=3.80km/s) in the lower crust but buried at a depth of about 35km. Moreover, we studied the V P/V S ratio under each station in combination with the result of P wave velocity inversion. The results show that, the average velocity ratio of the Yulin station at the interior of Ordos block is only 1.68, with a very low ratio (about 1.60) in the upper crust and a stable ratio of about 1.73 in the mid and lower crust, which indicates the media under this station is homogenous and stable, being in a state of rigidity. But at the stations in the eastern and southern margins of the Ordos block, several layers of high velocity ratio (about 1.80) have been found, in which the average velocity ratio under Kelan and Lishi stations at the eastern margin is systemically higher than that of the general elastical body waves (1.732). This reflects that the crust under the marginal areas is more active relatively, and other materials may exist in these layers. Finally, we discussed the relationship among earthquakes, velocity structures beneath stations and faults.展开更多
文摘BACKGROUND Kommerell’s diverticulum(KD)with aberrant left subclavian artery is a rare congenital deformity and also has very little research literature about it(35%of case study).There are three types of aortic arch diverticulum.Even literature concerning the treatment options are limited.CASE SUMMARY We present a case report of a 50-year-old male with KD in the right aortic arch with aberrant left subclavian artery.We conducted a total endovascular repair procedure,which is innovative and will spread more light in the medical world.Our patient has no past medical history and is a non-smoker and non-alcoholic.Patient presented with shortness of breath,chest pain and dizziness for six months.Blood tests were done and computerized tomography(CT)angiogram of the chest confirmed the diagnosis,illustrating showed a 3.9 cm KD.On Day 1,the CT angiogram showed mild dilatation of the thoracic aorta,adjacent esophagus,trachea was compressed and displaced.Surgery was planned as the treatment modality.Carotid-Subclavian artery bypass and endovascular aortic repair was conducted.We used prolene 5-0 C1 sutures to precisely anastomose a 6-mm Dacron graft to the left subclavian artery.Haemostasis was secured and wounds were closed.Protamine was administered and patient was shifted to intensive care unit.Post-operative,patient responded favorably and was discharged.Regular follow-up is done.CONCLUSION The procedure we performed is novel.This will help the cardio-thoracic surgeons a better insight about the full procedures we conducted,thereby bringing more light and better treatment options in managing KD with aberrant subclavian artery.
文摘Background: Invasive mechanical ventilation worsens prognosis in patients with severe chronic obstructive pulmonary disease (COPD). To avoid complications in these patients, anesthesia should be carefully considered. Case presentation: A 78-year-old man with COPD presented with dyspnea and pain from the epigastric to the umbilical regions. He was diagnosed with left incarcerated inguinal hernia and underwent radical inguinal hernia repair and surgical ileus treatment. To avoid general anesthesia with tracheal intubation, epidural anesthesia was combined with peripheral nerve blocks. An epidural catheter was inserted from T12/L1, and ilioinguinal-iliohypogastric and genitofemoral nerve blocks were performed under ultrasound guidance. No post-surgery complications or pain symptoms were noted. Conclusions: General anesthesia would likely have been challenging due to the patient’s COPD;however, management of peritoneal traction pain is difficult using peripheral nerve block alone. By combining epidural anesthesia with peripheral nerve blocks, we safely performed a procedure in a patient with severe COPD while avoiding invasive positive pressure ventilation.
文摘Objective:To explore the value of ultrasound-guided ilioinguinal and iliohypogastric nerve block(IINB)in tension-free inguinal hernia repair in elderly patients.Methods:A total of 70 elderly patients with tension-free inguinal hernia repair who treated in the hospital from April 2018 to November 2019 were selected and divided into two groups according to the random number table method,with 35 cases each.The control group underwent infiltration of local anesthesia(LA),and the study group added with IINB.The visual analogue scale(VAS)scores of the two groups of patients were compared.Results:The VAS score of the study group when pulling the hernia sac was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:IINB has good analgesic effect in tensionfree inguinal hernia repair in elderly patients,and it is worth promoting.
文摘Background: Peyronie’s disease is characterized by fibrous plaque formation in the tunica albuginea, leading to penile curvature and sexual dysfunction. Surgical correction is often required in cases of severe deformity or significant functional impairment. Aim: To present the case of a patient with severe Peyronie’s disease who underwent surgical correction using an autologous fascia lata graft. Case Presentation: We report the case of a 77-year-old Black-African gentleman with Peyronie’s disease, presenting with a self-reported penile curvature of 70 degrees and significant sexual frustration. He was managed surgically with plaque excision followed by a tunica albuginea patch using a subcutaneously harvested autologous fascia lata graft, all performed in a single surgical session. Conclusion: This case highlights the importance of individualized surgical planning and patient-specific considerations in achieving optimal outcomes in the management of Peyronie’s disease, particularly in cases requiring grafting for severe curvature.
基金Funded by the Scientific Support Project of the State Eleventh Five-Year Plan (2007BAQ01089)~~
文摘On the description of the landscapes of historical blocks in China,this paper proposes the approaches to renovating the historical blocks,including their repairing and reconstruction. It aims at presenting suggestions for the protection and development of historical blocks through analyzing the methods and procedures for repairing and rebuilding the infrastructures and green landscapes in the blocks.
文摘1研究背景将卫星遥感红外资料应用于地震监测,起始于20世纪80年代前苏联科学家。后续国内外学者陆续开展了这方面的研究,提出了涡度、RST、ZS、距平和功率谱等异常提取方法,取得了大量震例和机理方面的研究成果(张元生等,2002;Tramutoli et al,2005;Ouzounov et al,2007;Freund,2011;Jing et al,2022)。张铁宝等(2016)研究表明,川滇块体东边界带强震前,川滇块体存在显著的超阈值辐射增强异常。利用该地区通过震例总结得到的红外辐射异常特征,持续对川滇块体红外辐射进行了多年跟踪,在2022年9月5日四川泸定M_(S)6.8地震前,川滇块体又再次出现了类似的异常变化。泸定地震发生在川滇块体东边界的鲜水河断裂带磨西段。本研究主要分析泸定地震前红外辐射的异常变化。
基金Supported by Ministero dell'Università e della Ricerca,No. PRIN 2007LNKSYS,No.2007AWZTHH_004 and No.2009WBFZYM_002Association Fran aise contre les Myopathies,No. Project 12992+1 种基金Associazione Italiana per la Ricerca sul Cancro,No. Project 6021Fondazione Cassa di Risparmio di Perugia,No. 2007.0218.020,No.2009.020.0021 and No.2012.0241.021
文摘The Ca 2+-binding protein of the EF-hand type,S100B,exerts both intracellular and extracellular regulatory activities.As an intracellular regulator,S100B is involved in the regulation of energy metabolism,transcription,protein phosphorylation,cell proliferation,survival,differentiation and motility,and Ca 2+ homeostasis,by interacting with a wide array of proteins(i.e.,enzymes,enzyme substrates,cytoskeletal subunits,scaffold/adaptor proteins,transcription factors,ubiquitin E3 ligases,ion channels) in a restricted number of cell types.As an extracellular signal,S100B engages the pattern recognition receptor,receptor for advanced glycation end-products(RAGE),on immune cells as well as on neuronal,astrocytic and microglial cells,vascular smooth muscle cells,skeletal myoblasts and cardiomyocytes.However,RAGE may not be the sole receptor activated by S100B,the protein being able to enhance bFGF-FGFR1 signaling by interacting with FGFR1-bound bFGF in particular cell types.Moreover,extracellular effects of S100B vary depending on its local concentration.Increasing evidence suggests that at the concentration found in extracellular fluids in normal physiological conditions and locally upon acute tissue injury,which is up to a few nM levels,S100B exerts trophic effects in the central and peripheral nervous system and in skeletal muscle tissue thus participating in tissue homeostasis.The present commentary summarizes results implicating intracellular and extracellular S100B in tissue development,repair and regeneration.
文摘BACKGROUND When herpes zoster is complicated with paralytic ileus,this mostly involves acute intestinal pseudo-obstruction of Ogilvie’s syndrome manifesting as obvious dilatation of the cecum and right colon;small intestinal obstruction is rare.Here,we present a patient with a very rare case of small bowel pseudo-obstruction.CASE SUMMARY A 76-year-old female patient complained of right upper quadrant pain.Two days later,a blistering,right-sided rash of the thoracoabdominal dermatome(T5-T10) emerged in conjunction with small intestinal dilatation and the inability to defecate.Computed tomography of the abdomen confirmed small bowel pseudoobstruction.Antiviral therapy,gastrointestinal decompression,and enemas proved unproductive.After 4 d of stagnation,an epidural block was performed for pain relief and prompted the passage of gas and stool,resolving the obstructive problem.Three days later,the rash appeared dry and crusted,and the pain diminished.After 5 d,no abnormality was visible by gastroenteroscopy,and the patient was discharged on day 7.CONCLUSION This case shows that herpes zoster may induce small bowel pseudo-obstruction in addition to colonic pseudo-obstruction.Epidural block can not only treat intercostal neuralgia but also resolve small bowel pseudo-obstruction caused by herpes zoster.
文摘It was not until 1979 that Bayes de Ltma described atrial conduction blocks and classified them as interatrial and intra- atrial.Interatrial blocks refer to conduction disorders lo- cated between the atria, while intraalxial blocks occur within the same atrium. This work motivated several authors, in- cluding Bayes himself, to further investigate atrial conduc- tion and interatrial block （IAB）.
基金the organizations that have funded this project:the Natural Sciences and Engineering Research Council of Canada(Grant No.498020-16)Hydro-Quebec(NC-525700)Mitacs Accelerate Program(Grant Ref.IT10008)
文摘The most commonly used method for assessing the hydraulic erodibility of rock is Annandale's method.This method is based on a correlation between the erosive force of flowing water and the capacity of rock resistance. This capacity is evaluated using Kirsten's index, which was initially developed to evaluate the excavatability of earth materials. For rocky material, this index is determined according to certain geomechanical factors related to intact rock and rock mass, such as compressive strength of intact rock, rock block size, discontinuity shear strength and relative block structure. To quantify the relative block structure, Kirsten(1982) developed a mathematical expression that accounts for the shape and orientation of the blocks relative to the direction of flow. Kirsten's initial concept for assessing the relative block structure considers that the geological formation is mainly fractured by two joint sets forming an orthogonally fractured system. An adjusted concept is proposed to determine the relative block structure when the fractured system is non-orthogonal where the angle between the planes of the two joint sets is greater or less than 90°. An analysis of the proposed relative block structure rating shows that considering a non-orthogonally fractured system has a significant effect on Kirsten's index and, as a consequence, on the assessment of the hydraulic erodibility of rock.
文摘Using pure S wave fitting method, we studied the shear wave velocity structures under the Ordos block and its eastern and southern marginal areas. The results show that the velocity structure beneath Yulin station in the interior of Ordos block is relatively stable, where no apparent change between high and low velocity layers exists and the shear wave velocity increases steadily with the depth. There is a 12km thick layer at the depth of 25km under this station, with an S wave velocity (V S=3.90km/s) lower than that at the same depth in its eastern and southern areas (V S≥4.00km/s). The crust under the eastern margin of Ordos block is thicker than that of the Yulin station, and the velocity structures alternate between the high and low velocity layers, with more low velocity layers. It has the same characteristic as having a 10km-thick low velocity layer (V S=3.80km/s) in the lower crust but buried at a depth of about 35km. Moreover, we studied the V P/V S ratio under each station in combination with the result of P wave velocity inversion. The results show that, the average velocity ratio of the Yulin station at the interior of Ordos block is only 1.68, with a very low ratio (about 1.60) in the upper crust and a stable ratio of about 1.73 in the mid and lower crust, which indicates the media under this station is homogenous and stable, being in a state of rigidity. But at the stations in the eastern and southern margins of the Ordos block, several layers of high velocity ratio (about 1.80) have been found, in which the average velocity ratio under Kelan and Lishi stations at the eastern margin is systemically higher than that of the general elastical body waves (1.732). This reflects that the crust under the marginal areas is more active relatively, and other materials may exist in these layers. Finally, we discussed the relationship among earthquakes, velocity structures beneath stations and faults.
