BACKGROUND Traditional esophagogastroduodenoscopy(EGD),an invasive examination method,can cause discomfort and pain in patients.In contrast,magnetically controlled capsule endoscopy(MCE),a noninvasive method,is being ...BACKGROUND Traditional esophagogastroduodenoscopy(EGD),an invasive examination method,can cause discomfort and pain in patients.In contrast,magnetically controlled capsule endoscopy(MCE),a noninvasive method,is being applied for the detection of stomach and small intestinal diseases,but its application in treating esophageal diseases is not widespread.AIM To evaluate the safety and efficacy of detachable string MCE(ds-MCE)for the diagnosis of esophageal diseases.METHODS Fifty patients who had been diagnosed with esophageal diseases were pros-pectively recruited for this clinical study and underwent ds-MCE and conven-tional EGD.The primary endpoints included the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for patients with esophageal diseases.The secondary endpoints consisted of visualizing the esophageal and dentate lines,as well as the subjects'tolerance of the procedure.RESULTS Using EGD as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for esophageal disease detection were 85.71%,86.21%,81.82%,89.29%,and 86%,respectively.ds-MCE was more comfortable and convenient than EGD was,with 80%of patients feeling that ds-MCE examination was very comfortable or comfortable and 50%of patients believing that detachable string v examination was very convenient.CONCLUSION This study revealed that ds-MCE has the same diagnostic effects as traditional EGD for esophageal diseases and is more comfortable and convenient than EGD,providing a novel noninvasive method for treating esophageal diseases.展开更多
BACKGROUND The goal of therapy for traumatic carotid-cavernous fistula(TCCF)is the elimination of fistula while maintaining patency of the parent artery.The treatment for TCCF has evolved from surgery to endovascular ...BACKGROUND The goal of therapy for traumatic carotid-cavernous fistula(TCCF)is the elimination of fistula while maintaining patency of the parent artery.The treatment for TCCF has evolved from surgery to endovascular management using detachable balloons,coils,liquid embolic agents,covered stents,or flow-diverter stent through arterial or venous approaches.Despite the withdrawal of detachable balloons from the market in the United States since 2004,transarterial embolization with detachable balloons has currently remained the best initial treatment for TCCF in several countries.However,the pseudoaneurysm formation following transarterial detachable balloon embolization has rarely been observed in long-term follow-up.AIM To determine the occurrence and long-term follow-up of pseudoaneurysm after transarterial detachable balloon for TCCF.METHODS Between January 2009 and December 2019,79 patients diagnosed with TCCF were treated using detachable latex balloons(GOLDBAL)of four sizes.Pseudoaneurysm sizes were stratified into five grades for analysis.Initial and follow-up assessments involved computed tomography angiography at 1 month,6 month,1 year,and longer intervals for significant cases.Clinical follow-ups occurred semi-annually for 2 years,then annually.Factors analyzed included sex,age,fistula size and location,and balloon size.RESULTS In our cohort of 79 patients treated for TCCF,pseudoaneurysms formed in 67.1%,with classifications ranging from grade 0 to grade 3;no grade 4 or giant pseudoaneurysms were observed.The majority of pseudoaneurysms did not progress in size,and some regressed spontaneously.Calcifications developed in most large pseudoaneurysms over 5-10 years.Parent artery occlusion occurred in 7.6%and recurrent fistulas in 16.5%.The primary risk factors for pseudoaneurysm formation were identified as the use of specific balloon sizes,with balloon SP and No.6 significantly associated with its occurrence(P=0.005 and P=0.002,respectively),whereas sex,age,fistula size,location,and the number of balloons used were not significant predictors.CONCLUSION Pseudoaneurysm formation following detachable balloon embolization for TCCF is common,primarily influenced by the size of the balloon used.Despite this,all patients with pseudoaneurysms remained asymptomatic during long-term follow-up.展开更多
Background Coronary artery fistula (CAF) is a rare anomaly.Transcatheter CAF closure has been introduced using various materials,but only few data are available on the Guglielmi detachable coil (GDC).The advantage...Background Coronary artery fistula (CAF) is a rare anomaly.Transcatheter CAF closure has been introduced using various materials,but only few data are available on the Guglielmi detachable coil (GDC).The advantage of using GDC for transcatheter CAF closure is more controllable,therefore much safer when compared to other coils.This report is about our experience in transcatheter closure of CAF using fibered GDC in our hospital.Methods & Results From 2002 to 2007,there were 10 patients with CAFs (age range:28 to 56 year-old,7 males) who underwent transcatheter CAF closure.There were a total of 19 CAFs which originated from right coronary (n =5),left circumflex (n =3),left anterior descending artery (n =10) and left main trunk (n =1).Median number of coil deployment for each fistula was 3 (range:1 to 6).The pulmonary artery was the most common site of the distal communication of CAFs (n =14),followed by right atrium (n =3),left atrium (n =1) and left ventricle (n =1).Immediate coronary angiography after GDC deployment revealed no residual shunt in 12 (63.2%) CAFs,significant reduction of the flow in 5 (26.3%),while 2 (10.5%) could not be closed due to small size.Nine (90%) patients underwent a repeated angiography within 3 to 8 months.Among 12 CAFs that were occluded immediately post-deployment,there were 2 CAFs with insignificant residual flow.Among 6 CAFs with significantly decreased flow immediately post-deployment,2 were occluded totally in the follow-up angiography.In total,12 (70.5%) CAFs were occluded completely and 5 (29.5%) CAFs still had insignificant residual flow,which did not need any additional coil deployment.During a mean follow up of 4.3 ± 0.7 year,all patients remained symptom and complication free.Conclusions The fibered GDC is a safe and effective method for percutaneous closure of the CAFs.展开更多
Embolization of collateral veins is often treated with rigid coils(Gianturco and interlocking detachable coils type).However,when dealing with tortuous and dilated collateral veins,there is a high risk for technical f...Embolization of collateral veins is often treated with rigid coils(Gianturco and interlocking detachable coils type).However,when dealing with tortuous and dilated collateral veins,there is a high risk for technical failure and coil migration due to inflexibility of the coils.To safely and successfully solve this problem,Guglielmi detachable coils(GDC) can be used for embolization.Their flexibility allows for easy navigation in tortuous veins,low risk of unintended coil release or coil migration,and safe deployment.A 12-year-old girl with a single ventricle had severe cyanosis and a low exercise tolerance 5 years after Fontan procedure.The symp-toms were caused by a tortuous and dilated collateral from the left phrenic vein into the left pulmonary vein,forming a right-to-left shunt.The collateral,which had a large diameter and high flow,and therefore a high risk of coil migration,was successfully embolized with 8 GDC.There were no complications such as coil migration or cerebral infarction.Transcatheter embolization increased her systemic oxygen saturation from 81%-84% to 94%-95%,and increased her ability to exercise.The embolization procedure using flexible GDC was low risk compared with other rigid coil embolization techniques when performing embolization of tortuous and dilated collateral veins.展开更多
Objective. To compare the embolization effects of intracranial aneurysms with mechanical detachable spirals (MDS) and with Guglielmi detachable coils (GDC).Methods. One hundred and twenty cases with 125 intracranial a...Objective. To compare the embolization effects of intracranial aneurysms with mechanical detachable spirals (MDS) and with Guglielmi detachable coils (GDC).Methods. One hundred and twenty cases with 125 intracranial aneurysms were embolized in Beijing Hospital from March 1995 to July 1999. Sixty - six aneurysms in 64 cases were embolized with MDS, 51 in 48 with GDC, and 8 in 8 with both MDS and GDC. Clinical data including sex, age, subarachnoid hemorrhage (SAH), Hunt & Hess grading, diameter and neck width of aneurysms, number and length of coils used per aneurysm, occlusive ratio, and complications were compared between MDS and GDC groups.Results. MDS and GDC groups were comparable (t-test or x2 -test, all P value > 0. 10) in terms of age, sex, diameter of aneurysms [ (8. 46 ± 3. 42) mm vs. (7. 38 ± 3. 45) mm], neck width [ (3. 49 ± 1. 50) mm vs. (3. 26 ± 1. 52) mm], coils number[ (4. 65 ± 3. 01) vs. (4. 24 ± 2. 65) ] and their length[ (460. 2 ± 398. 5) mm vs. (422. 9 ±387. 1) mm] used per aneurysm, occlusive ratio in aneurysms embolized ≥80% [ (95. 00% ± 6. 32% ) vs. (94. 19% ± 7. 63% ) ], mortality and permanent complications (7. 8% vs. 4. 2% ).Conclusions. MDS and GDC are all materials for embolization of intracranial aneurysms. MDS is less expensive, but more difficult to control and of propensity to complications while GDC is more compliant, easier to be used, safer, and have many alternative types for use as well as more extensive indications.展开更多
Electrolytic detachable coils (EDC) have been the main embolic materi als for intracranial aneurysms. Liquid aneurysmal embolic materials represented by cellulose acetate polymer (CAP) are still in controversy. In thi...Electrolytic detachable coils (EDC) have been the main embolic materi als for intracranial aneurysms. Liquid aneurysmal embolic materials represented by cellulose acetate polymer (CAP) are still in controversy. In this research, t he embolization results and pathological reactions after embolization of canine aneurysmal models with EDC or CAP were observed and compared. Methods. The canine aneurysmal models constructed by anastomosis of venous pouch es were randomly grouped. The aneurysms were respectively occluded with CAP and electrolytic detachable coils that was named by Wu electrolytic detachable coil (WEDC) and made by us. Angiogram follow ups were performed at 24 hour, 2 week , and 2 month after embolization. The occluded aneurysms were dissected in each stage for light microscopic, electron microscopic, and histochemical research. Results. The effect of embolization was significantly better with WEDC than that with CAP . Post embolized complications such as aneurysm rupture and stenosis of parent arteries could only be found in CAP group. Pathol ogical research showed that CAP mass could packed the aneurysms more densely tha n coils. Acute chemical damage of aneurysmal wall and inflammatory cell infiltra tion was prominently found in early stage after CAP embolization. Organization of thrombus inside aneurysms and formation of endothelial tissue over the orific es of aneurysmal necks could be found in both groups 2 months after embolization . But parts of coils might be exposed outside endothelial layer. Conclusions. EDC are still the most safe, efficient, and reliable instruments to embolize aneurysm. CAP should be improved further to solve the problem of stron g chemical corrosion and difficulty in control before it is widely used.展开更多
Achieving the detachment of divertor can help to alleviate excessive heat load and sputtering problems on the target plates,thereby extending the lifetime of divertor components for fusion devices.In order to provide ...Achieving the detachment of divertor can help to alleviate excessive heat load and sputtering problems on the target plates,thereby extending the lifetime of divertor components for fusion devices.In order to provide a fast but relatively reliable prediction of plasma parameters along the flux tube for future device design,a one-dimensional(1D)modeling code for the operating point of impurity seeded detached divertor is developed based on Python language,which is a fluid model based on previous work(Plasma Phys.Control.Fusion 58045013(2016)).The experimental observation of the onset of divertor detachment by neon(Ne)and argon(Ar)seeding in EAST is well reproduced by using the 1D modeling code.The comparison between the 1D modeling and two-dimensional(2D)simulation by the SOLPS-ITER code for CFETR detachment operation with Ne and Ar seeding also shows that they are in good agreement.We also predict the radiative power loss and corresponding impurity concentration requirement for achieving divertor detachment via different impurity seeding under high heating power conditions in EAST and CFETR phase II by using the 1D model.Based on the predictions,the optimized parameter space for divertor detachment operation on EAST and CFETR is also determined.Such a simple but reliable 1D model can provide a reasonable parameter input for a detailed and accurate analysis by 2D or three-dimensional(3D)modeling tools through rapid parameter scanning.展开更多
The Sonid Zuoqi ductile detachment zone is located at the southeastern margin of the Central Asian orogenic belt(CAOB),striking EW and dipping to the S.The major rock type of the Sonid Zuoqi ductile detachment zone is...The Sonid Zuoqi ductile detachment zone is located at the southeastern margin of the Central Asian orogenic belt(CAOB),striking EW and dipping to the S.The major rock type of the Sonid Zuoqi ductile detachment zone is mylonite derived from granite.The sequence of mylonite features is:(1)S and C foliations of mylonite,and(2)extensional crenulation cleavage(ecc)or C′and the kinematic vorticity(Wk)value changed from 0.70 to 0.95 and from 0.37 to 0.69,respectively;the strain type of the mylonites within the Sonid Zuoqi ductile detachment zone is compressional to planar strain.The strong deformation mylonite and Halatu plutons yielded a zircon U-Pb age of 244 Ma and a zircon(U-Th)/He age of 214 Ma,respectively.Based on the strain and kinematic vorticity analysis,together with the zircon U-Pb and zircon(U-Th)/He ages and the regional tectonic background,the study area experienced three stage evolution:tangential simpleshear(244 Ma),simple-shear-dominated general shear represented by upper crustal extension(224 Ma)and pure-shear-dominated general shear represented by the Halatu pluton doming(214 Ma),which constrained the early Mesozoic NE-SW crustal extension at the southeastern margin of the CAOB.This NE-SW extension probably originated from the postorogenic extensional collapse of the CAOB,subsequent exhumation being controlled by the far afield effects of the closure of the Mongol-Okhotsk belt.展开更多
AIM:To evaluate the efficacy and safety of perfluoro-n-octane(PFO)for ophthalmic surgery versus F-Octane as an intraoperative tamponade in pars plana vitrectomy(PPV)in management of retinal detachment.METHODS:This mul...AIM:To evaluate the efficacy and safety of perfluoro-n-octane(PFO)for ophthalmic surgery versus F-Octane as an intraoperative tamponade in pars plana vitrectomy(PPV)in management of retinal detachment.METHODS:This multicenter,prospective,randomized,double-masked,parallel-controlled,non-inferiority trial was conducted in three ophthalmology clinical centers in China.Patients with retinal detachment,who were eligible for PPV were consecutively enrolled.Participants were assigned to PFO for ophthalmic surgery or F-Octane for intraocular tamponade in a 1:1 ratio.Best-corrected visual acuity(BCVA),intraocular pressure(IOP)measurement,and dilated fundus examination were performed preoperatively and at 1,7±1,28±3d postoperatively.The primary outcome was complete retinal reattachment rate at postoperative day one.The non-inferiority margin was set at 9.8%.The secondary outcomes included intraoperative retinal reattachment rate,and mean changes in IOP and BCVA from baseline to 1,7±1,28±3d postoperatively,respectively.Safety analyses were presented for all randomly assigned participates in this study.RESULTS:Totally 124 eligible patients completed the study between Mar.14,2016 and Jun.7,2017.Sixty of them were randomly assigned to the PFO for ophthalmic surgery group,and 64 were assigned to the F-Octane group.Baseline characteristics were comparable between the two groups.Both groups achieved 100%retinal reattachment at postoperative day one(difference 0,95%CI:-6.21%to 5.75%,P=1).The pre-defined noninferiority criterion was met.No significant difference was observed in intraoperative retinal reattachment rate(difference 1.77%,P=0.61),mean changes in IOP(difference 0.36,-0.09,2.22 mm Hg at 1,7±1,28±3d postoperatively,with all P>0.05)and BCVA(difference 0.04,-0.02,0.06 logMAR at 1,7±1,28±3d postoperatively,all P>0.05)between the two groups.No apparent adverse events related to the utilization of PFO were reported.CONCLUSION:In patients with retinal detachment undergoing PPV,PFO for ophthalmic surgery is non-inferior to F-Octane as an intraocular tamponade,and both are safe and well-tolerated.展开更多
AIM:To evaluate scleral buckling(SB)surgery using a noncontact wide-field viewing system and 23-gauge intraocular illumination for the treatment of rhegmatogenous retinal detachment in silicone oil(SO)-filled eyes.MET...AIM:To evaluate scleral buckling(SB)surgery using a noncontact wide-field viewing system and 23-gauge intraocular illumination for the treatment of rhegmatogenous retinal detachment in silicone oil(SO)-filled eyes.METHODS:Totally 9 patients(9 eyes)with retinal detachment in SO-filled eyes were retrospectively analyzed.All patients underwent non-contact wide-field viewing system-assisted buckling surgery with 23-gauge intraocular illumination.SO was removed at an appropriate time based on recovery.The patients were followed up for at least 3mo after SO removal.Retinal reattachment,complications,visual acuity and intraocular pressure(IOP)before and after surgery were observed.RESULTS:Patients were followed up for a mean of 8.22mo(3-22mo)after SO removal.All patients had retinal reattachment.At the final follow-up,visual acuity showed improvement for 8 patients,and no change for 1 patient.The IOP was high in 3 patients before surgery,but it stabilized after treatment;it was not affected in the other patients.None of the patients had infections,hemorrhage,anterior ischemia,or any other complication.CONCLUSION:This new non-contact wide-field viewing system-assisted SB surgery with 23-gauge intraocular illumination is effective and safe for retinal detachment in SO-filled eyes.展开更多
●AIM:To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment(RRD)using a novel foldable capsular buckle(FCB).●METHODS:This was a series of case observation...●AIM:To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment(RRD)using a novel foldable capsular buckle(FCB).●METHODS:This was a series of case observation studies.Eighteen patients(18 eyes)who visited our ophthalmology department between August 2020 and August 2022 and were treated for RRD with scleral buckling using FCB were included.The procedure was similar to conventional scleral buckling,while a balloon-like FCB was placed onto the retinal break with balanced salt solution filling for a broad,external indentation instead of the silicone buckle.The retinal reattachment rate,best corrected visual acuity(BCVA),intraocular pressure(IOP),refractive dioptre and astigmatism degree,and complications were evaluated and recorded.●RESULTS:There were 7 males and 11 females aged 19-58y.The average time course of RRD was 12d,ranging from 7-20d.The retinal break was located in the superior quadrants in 8 eyes and in the inferior quadrants in 10 eyes,with macula-off detachments in 12 eyes.The patients were followed-up for at least 6mo.The final retinal reattachment rate was 100%.The BCVA was significantly improved compared with the baseline(P<0.05).There was no significant change in refractive dioptre or astigmatism degree at each follow-up(all P>0.05).Three patients had transiently high IOPs within one week after surgery.Mild diplopia occurred in 5 patients after surgery and then disappeared after the balloon fluid was removed.●CONCLUSION:The success rate of FCB scleral buckling for RRD is satisfactory.This procedure can be expected to be applied in new,uncomplicated cases of RRD.展开更多
AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who receiv...AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who received treatment for nontraumatic RRD after ICL implantation surgery at the Retinal Department of Zhongshan Ophthalmic Center from Jan 2018 to Dec 2022 were reviewed.Comprehensive ophthalmologic examinations including visual acuity measurement and digital fundus photography were performed in each patient.RESULTS:A total of nine RRD eyes from nine patients who received V4c-ICL implantation were included.The mean time from ICL implantation surgery to the diagnosis of RRD was 32.44±22.56mo(range,1-60mo).At the initial visit for RRD,giant retinal tear(GRT),horseshoe tear,simple round hole,and horseshoe tear combined with round hole were detected in 3,3,2,and 1 eye(s),respectively,with maculaoff in eyes.Eight patients received surgical treatment,and one patient was treated by retinal laser photocoagulation alone.The ICL was preserved in 7 eyes.At the last followup,the mean best corrected visual acuity(BCVA)improved significantly from 1.76±1.06 logMAR at presentation to 0.81±1.01 logMAR(P=0.035),and no case of recurrent retinal detachment was found.CONCLUSION:The morphological presentation of retinal breaks is diverse in this study.The ICL can be preserved in most cases during the course of retinal detachment repair surgery in our data,companied with acceptable visual and anatomical outcomes.展开更多
BACKGROUND There are very few cases of cardiac occluder detachment,and it is rare to completely remove the occluder using interventional methods without undergoing thoracotomy surgery after detachment.This case innova...BACKGROUND There are very few cases of cardiac occluder detachment,and it is rare to completely remove the occluder using interventional methods without undergoing thoracotomy surgery after detachment.This case innovatively used ultrasound guidance combined with digital subtraction angiography(DSA)to completely remove the occluder,accumulating some experience.CASE SUMMARY The patient underwent left atrial appendage occlusion surgery in our hospital due to atrial fibrillation.After the surgery,the occluder fell off and became free in the left ventricle,which is very dangerous.We innovatively used ultrasound guidance,combined with DSA,and interventional surgery to successfully capture the free occluder using a catcher,completely remove it,and then re implant a new left atrial appendage occluder.After the surgery,the patient recovered very well.CONCLUSION The size selection of the occluder is slightly conservative,and the shape of the left atrial appendage opening is irregular.展开更多
A series of three-dimensional numerical computations were conducted to understand the effects of different static magnetic fields on thermal fluctuation and melt flow during the detached solidification of CdZnTe. Nume...A series of three-dimensional numerical computations were conducted to understand the effects of different static magnetic fields on thermal fluctuation and melt flow during the detached solidification of CdZnTe. Numerical calculations were carried out by three different configurations of magnetic field: without magnetic field, with an axial magnetic field (AMF) and with a cusp-shaped magnetic field (CMF). The results reveal that the magnetic fields can effectively suppress the melt flow and thermal fluctuation and the suppression effect of the AMF is stronger than that of the CMF. Besides, the physical mechanism of thermocapillary?buoyancy convection instability was discussed and the effects of magnetic field on the critical Marangoni number were also obtained.展开更多
In the paper, the effects of linear expansion coefficient and basic index of melting slag on the detachability of self shielded flux cored electrode (SSFCE) are investigated. An equation is obtained on the principles ...In the paper, the effects of linear expansion coefficient and basic index of melting slag on the detachability of self shielded flux cored electrode (SSFCE) are investigated. An equation is obtained on the principles of ceramics and mineralography which predict the detachability of basic SSFCE. In addition, stick slag mechanism of SSFCE is analyzed.展开更多
The wavelength dependence of photoelectron angular distributions (PADs) of two-photon detachment of Cu^- has been directly studied by using the photoelectron map imaging. Results show that for the laser field intens...The wavelength dependence of photoelectron angular distributions (PADs) of two-photon detachment of Cu^- has been directly studied by using the photoelectron map imaging. Results show that for the laser field intensity of 6.0×10^10W/cm^2, PADs exhibit dramatic change with the external field wavelength. Comparison between the experimental observation and the lowest-order perturbation theory prediction indicates that the pattern of PADs can be explained by the interference of the s and d partial waves in the final state. Relative contri- butions of s and d partial waves in the two-photon detachment at different laser wavelengths are obtained.展开更多
In order to understand the effect of geometric parameters and axial magnetic field on buoyant-thermocapillary convection during detached solidification, a series of threedimensional numerical simulations were conducte...In order to understand the effect of geometric parameters and axial magnetic field on buoyant-thermocapillary convection during detached solidification, a series of threedimensional numerical simulations were conducted by the finite-difference method. The results indicate that the stable flow is observed when the Marangoni number (Ma) is small; however, when the value of Ma increases and exceeds a threshold value, the stable steady flow transits to be unstable flow. As the height of the melt increases, the flow is enhanced at first and then gets weakened. As the width of gap decreases gradually, the strength of flow is enhanced. The approach of using axial magnetic field is an effective way to suppress the buoyant-thermocapillary convection. As the magnetic field strength increases, the inhibition is enhanced. The critical Marangoni number increases slightly with a greater melt height, a narrower width of gap, and a more strength of magnetic field.展开更多
基金the Science and Technology Commission of Shanghai,No.18DZ1930309.
文摘BACKGROUND Traditional esophagogastroduodenoscopy(EGD),an invasive examination method,can cause discomfort and pain in patients.In contrast,magnetically controlled capsule endoscopy(MCE),a noninvasive method,is being applied for the detection of stomach and small intestinal diseases,but its application in treating esophageal diseases is not widespread.AIM To evaluate the safety and efficacy of detachable string MCE(ds-MCE)for the diagnosis of esophageal diseases.METHODS Fifty patients who had been diagnosed with esophageal diseases were pros-pectively recruited for this clinical study and underwent ds-MCE and conven-tional EGD.The primary endpoints included the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for patients with esophageal diseases.The secondary endpoints consisted of visualizing the esophageal and dentate lines,as well as the subjects'tolerance of the procedure.RESULTS Using EGD as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for esophageal disease detection were 85.71%,86.21%,81.82%,89.29%,and 86%,respectively.ds-MCE was more comfortable and convenient than EGD was,with 80%of patients feeling that ds-MCE examination was very comfortable or comfortable and 50%of patients believing that detachable string v examination was very convenient.CONCLUSION This study revealed that ds-MCE has the same diagnostic effects as traditional EGD for esophageal diseases and is more comfortable and convenient than EGD,providing a novel noninvasive method for treating esophageal diseases.
文摘BACKGROUND The goal of therapy for traumatic carotid-cavernous fistula(TCCF)is the elimination of fistula while maintaining patency of the parent artery.The treatment for TCCF has evolved from surgery to endovascular management using detachable balloons,coils,liquid embolic agents,covered stents,or flow-diverter stent through arterial or venous approaches.Despite the withdrawal of detachable balloons from the market in the United States since 2004,transarterial embolization with detachable balloons has currently remained the best initial treatment for TCCF in several countries.However,the pseudoaneurysm formation following transarterial detachable balloon embolization has rarely been observed in long-term follow-up.AIM To determine the occurrence and long-term follow-up of pseudoaneurysm after transarterial detachable balloon for TCCF.METHODS Between January 2009 and December 2019,79 patients diagnosed with TCCF were treated using detachable latex balloons(GOLDBAL)of four sizes.Pseudoaneurysm sizes were stratified into five grades for analysis.Initial and follow-up assessments involved computed tomography angiography at 1 month,6 month,1 year,and longer intervals for significant cases.Clinical follow-ups occurred semi-annually for 2 years,then annually.Factors analyzed included sex,age,fistula size and location,and balloon size.RESULTS In our cohort of 79 patients treated for TCCF,pseudoaneurysms formed in 67.1%,with classifications ranging from grade 0 to grade 3;no grade 4 or giant pseudoaneurysms were observed.The majority of pseudoaneurysms did not progress in size,and some regressed spontaneously.Calcifications developed in most large pseudoaneurysms over 5-10 years.Parent artery occlusion occurred in 7.6%and recurrent fistulas in 16.5%.The primary risk factors for pseudoaneurysm formation were identified as the use of specific balloon sizes,with balloon SP and No.6 significantly associated with its occurrence(P=0.005 and P=0.002,respectively),whereas sex,age,fistula size,location,and the number of balloons used were not significant predictors.CONCLUSION Pseudoaneurysm formation following detachable balloon embolization for TCCF is common,primarily influenced by the size of the balloon used.Despite this,all patients with pseudoaneurysms remained asymptomatic during long-term follow-up.
文摘Background Coronary artery fistula (CAF) is a rare anomaly.Transcatheter CAF closure has been introduced using various materials,but only few data are available on the Guglielmi detachable coil (GDC).The advantage of using GDC for transcatheter CAF closure is more controllable,therefore much safer when compared to other coils.This report is about our experience in transcatheter closure of CAF using fibered GDC in our hospital.Methods & Results From 2002 to 2007,there were 10 patients with CAFs (age range:28 to 56 year-old,7 males) who underwent transcatheter CAF closure.There were a total of 19 CAFs which originated from right coronary (n =5),left circumflex (n =3),left anterior descending artery (n =10) and left main trunk (n =1).Median number of coil deployment for each fistula was 3 (range:1 to 6).The pulmonary artery was the most common site of the distal communication of CAFs (n =14),followed by right atrium (n =3),left atrium (n =1) and left ventricle (n =1).Immediate coronary angiography after GDC deployment revealed no residual shunt in 12 (63.2%) CAFs,significant reduction of the flow in 5 (26.3%),while 2 (10.5%) could not be closed due to small size.Nine (90%) patients underwent a repeated angiography within 3 to 8 months.Among 12 CAFs that were occluded immediately post-deployment,there were 2 CAFs with insignificant residual flow.Among 6 CAFs with significantly decreased flow immediately post-deployment,2 were occluded totally in the follow-up angiography.In total,12 (70.5%) CAFs were occluded completely and 5 (29.5%) CAFs still had insignificant residual flow,which did not need any additional coil deployment.During a mean follow up of 4.3 ± 0.7 year,all patients remained symptom and complication free.Conclusions The fibered GDC is a safe and effective method for percutaneous closure of the CAFs.
文摘Embolization of collateral veins is often treated with rigid coils(Gianturco and interlocking detachable coils type).However,when dealing with tortuous and dilated collateral veins,there is a high risk for technical failure and coil migration due to inflexibility of the coils.To safely and successfully solve this problem,Guglielmi detachable coils(GDC) can be used for embolization.Their flexibility allows for easy navigation in tortuous veins,low risk of unintended coil release or coil migration,and safe deployment.A 12-year-old girl with a single ventricle had severe cyanosis and a low exercise tolerance 5 years after Fontan procedure.The symp-toms were caused by a tortuous and dilated collateral from the left phrenic vein into the left pulmonary vein,forming a right-to-left shunt.The collateral,which had a large diameter and high flow,and therefore a high risk of coil migration,was successfully embolized with 8 GDC.There were no complications such as coil migration or cerebral infarction.Transcatheter embolization increased her systemic oxygen saturation from 81%-84% to 94%-95%,and increased her ability to exercise.The embolization procedure using flexible GDC was low risk compared with other rigid coil embolization techniques when performing embolization of tortuous and dilated collateral veins.
基金This work was originally published in the Chinese Journal of Neuro-surgery (2001 17(2): 87-90) in Chinese.
文摘Objective. To compare the embolization effects of intracranial aneurysms with mechanical detachable spirals (MDS) and with Guglielmi detachable coils (GDC).Methods. One hundred and twenty cases with 125 intracranial aneurysms were embolized in Beijing Hospital from March 1995 to July 1999. Sixty - six aneurysms in 64 cases were embolized with MDS, 51 in 48 with GDC, and 8 in 8 with both MDS and GDC. Clinical data including sex, age, subarachnoid hemorrhage (SAH), Hunt & Hess grading, diameter and neck width of aneurysms, number and length of coils used per aneurysm, occlusive ratio, and complications were compared between MDS and GDC groups.Results. MDS and GDC groups were comparable (t-test or x2 -test, all P value > 0. 10) in terms of age, sex, diameter of aneurysms [ (8. 46 ± 3. 42) mm vs. (7. 38 ± 3. 45) mm], neck width [ (3. 49 ± 1. 50) mm vs. (3. 26 ± 1. 52) mm], coils number[ (4. 65 ± 3. 01) vs. (4. 24 ± 2. 65) ] and their length[ (460. 2 ± 398. 5) mm vs. (422. 9 ±387. 1) mm] used per aneurysm, occlusive ratio in aneurysms embolized ≥80% [ (95. 00% ± 6. 32% ) vs. (94. 19% ± 7. 63% ) ], mortality and permanent complications (7. 8% vs. 4. 2% ).Conclusions. MDS and GDC are all materials for embolization of intracranial aneurysms. MDS is less expensive, but more difficult to control and of propensity to complications while GDC is more compliant, easier to be used, safer, and have many alternative types for use as well as more extensive indications.
文摘Electrolytic detachable coils (EDC) have been the main embolic materi als for intracranial aneurysms. Liquid aneurysmal embolic materials represented by cellulose acetate polymer (CAP) are still in controversy. In this research, t he embolization results and pathological reactions after embolization of canine aneurysmal models with EDC or CAP were observed and compared. Methods. The canine aneurysmal models constructed by anastomosis of venous pouch es were randomly grouped. The aneurysms were respectively occluded with CAP and electrolytic detachable coils that was named by Wu electrolytic detachable coil (WEDC) and made by us. Angiogram follow ups were performed at 24 hour, 2 week , and 2 month after embolization. The occluded aneurysms were dissected in each stage for light microscopic, electron microscopic, and histochemical research. Results. The effect of embolization was significantly better with WEDC than that with CAP . Post embolized complications such as aneurysm rupture and stenosis of parent arteries could only be found in CAP group. Pathol ogical research showed that CAP mass could packed the aneurysms more densely tha n coils. Acute chemical damage of aneurysmal wall and inflammatory cell infiltra tion was prominently found in early stage after CAP embolization. Organization of thrombus inside aneurysms and formation of endothelial tissue over the orific es of aneurysmal necks could be found in both groups 2 months after embolization . But parts of coils might be exposed outside endothelial layer. Conclusions. EDC are still the most safe, efficient, and reliable instruments to embolize aneurysm. CAP should be improved further to solve the problem of stron g chemical corrosion and difficulty in control before it is widely used.
基金Project supported by the National Key Research and Development Program of China (Grant No.2022YFE03030001)the National Natural Science Foundation of China (Grant No.12075283)。
文摘Achieving the detachment of divertor can help to alleviate excessive heat load and sputtering problems on the target plates,thereby extending the lifetime of divertor components for fusion devices.In order to provide a fast but relatively reliable prediction of plasma parameters along the flux tube for future device design,a one-dimensional(1D)modeling code for the operating point of impurity seeded detached divertor is developed based on Python language,which is a fluid model based on previous work(Plasma Phys.Control.Fusion 58045013(2016)).The experimental observation of the onset of divertor detachment by neon(Ne)and argon(Ar)seeding in EAST is well reproduced by using the 1D modeling code.The comparison between the 1D modeling and two-dimensional(2D)simulation by the SOLPS-ITER code for CFETR detachment operation with Ne and Ar seeding also shows that they are in good agreement.We also predict the radiative power loss and corresponding impurity concentration requirement for achieving divertor detachment via different impurity seeding under high heating power conditions in EAST and CFETR phase II by using the 1D model.Based on the predictions,the optimized parameter space for divertor detachment operation on EAST and CFETR is also determined.Such a simple but reliable 1D model can provide a reasonable parameter input for a detailed and accurate analysis by 2D or three-dimensional(3D)modeling tools through rapid parameter scanning.
基金supported by the National Natural Science Foundation of China(Grant No.41662014)。
文摘The Sonid Zuoqi ductile detachment zone is located at the southeastern margin of the Central Asian orogenic belt(CAOB),striking EW and dipping to the S.The major rock type of the Sonid Zuoqi ductile detachment zone is mylonite derived from granite.The sequence of mylonite features is:(1)S and C foliations of mylonite,and(2)extensional crenulation cleavage(ecc)or C′and the kinematic vorticity(Wk)value changed from 0.70 to 0.95 and from 0.37 to 0.69,respectively;the strain type of the mylonites within the Sonid Zuoqi ductile detachment zone is compressional to planar strain.The strong deformation mylonite and Halatu plutons yielded a zircon U-Pb age of 244 Ma and a zircon(U-Th)/He age of 214 Ma,respectively.Based on the strain and kinematic vorticity analysis,together with the zircon U-Pb and zircon(U-Th)/He ages and the regional tectonic background,the study area experienced three stage evolution:tangential simpleshear(244 Ma),simple-shear-dominated general shear represented by upper crustal extension(224 Ma)and pure-shear-dominated general shear represented by the Halatu pluton doming(214 Ma),which constrained the early Mesozoic NE-SW crustal extension at the southeastern margin of the CAOB.This NE-SW extension probably originated from the postorogenic extensional collapse of the CAOB,subsequent exhumation being controlled by the far afield effects of the closure of the Mongol-Okhotsk belt.
基金Supported by the Program of Shanghai Academic/Technology Research Leader(No.21XD1402700)the Clinical Research Plan of Shenkang Hospital Development Center of Shanghai(No.SHDC2022CRD001).
文摘AIM:To evaluate the efficacy and safety of perfluoro-n-octane(PFO)for ophthalmic surgery versus F-Octane as an intraoperative tamponade in pars plana vitrectomy(PPV)in management of retinal detachment.METHODS:This multicenter,prospective,randomized,double-masked,parallel-controlled,non-inferiority trial was conducted in three ophthalmology clinical centers in China.Patients with retinal detachment,who were eligible for PPV were consecutively enrolled.Participants were assigned to PFO for ophthalmic surgery or F-Octane for intraocular tamponade in a 1:1 ratio.Best-corrected visual acuity(BCVA),intraocular pressure(IOP)measurement,and dilated fundus examination were performed preoperatively and at 1,7±1,28±3d postoperatively.The primary outcome was complete retinal reattachment rate at postoperative day one.The non-inferiority margin was set at 9.8%.The secondary outcomes included intraoperative retinal reattachment rate,and mean changes in IOP and BCVA from baseline to 1,7±1,28±3d postoperatively,respectively.Safety analyses were presented for all randomly assigned participates in this study.RESULTS:Totally 124 eligible patients completed the study between Mar.14,2016 and Jun.7,2017.Sixty of them were randomly assigned to the PFO for ophthalmic surgery group,and 64 were assigned to the F-Octane group.Baseline characteristics were comparable between the two groups.Both groups achieved 100%retinal reattachment at postoperative day one(difference 0,95%CI:-6.21%to 5.75%,P=1).The pre-defined noninferiority criterion was met.No significant difference was observed in intraoperative retinal reattachment rate(difference 1.77%,P=0.61),mean changes in IOP(difference 0.36,-0.09,2.22 mm Hg at 1,7±1,28±3d postoperatively,with all P>0.05)and BCVA(difference 0.04,-0.02,0.06 logMAR at 1,7±1,28±3d postoperatively,all P>0.05)between the two groups.No apparent adverse events related to the utilization of PFO were reported.CONCLUSION:In patients with retinal detachment undergoing PPV,PFO for ophthalmic surgery is non-inferior to F-Octane as an intraocular tamponade,and both are safe and well-tolerated.
基金Supported by National Natural Science Foundation of China(No.81700884)Scientific Research Foundation of National Health and Health Commission(No.WKJ-ZJ-2037)+1 种基金Zhejiang Public Welfare Technology Application Project(No.LGF21H120005)Science and Technology Project of Wenzhou(No.Y20190649).
文摘AIM:To evaluate scleral buckling(SB)surgery using a noncontact wide-field viewing system and 23-gauge intraocular illumination for the treatment of rhegmatogenous retinal detachment in silicone oil(SO)-filled eyes.METHODS:Totally 9 patients(9 eyes)with retinal detachment in SO-filled eyes were retrospectively analyzed.All patients underwent non-contact wide-field viewing system-assisted buckling surgery with 23-gauge intraocular illumination.SO was removed at an appropriate time based on recovery.The patients were followed up for at least 3mo after SO removal.Retinal reattachment,complications,visual acuity and intraocular pressure(IOP)before and after surgery were observed.RESULTS:Patients were followed up for a mean of 8.22mo(3-22mo)after SO removal.All patients had retinal reattachment.At the final follow-up,visual acuity showed improvement for 8 patients,and no change for 1 patient.The IOP was high in 3 patients before surgery,but it stabilized after treatment;it was not affected in the other patients.None of the patients had infections,hemorrhage,anterior ischemia,or any other complication.CONCLUSION:This new non-contact wide-field viewing system-assisted SB surgery with 23-gauge intraocular illumination is effective and safe for retinal detachment in SO-filled eyes.
基金Supported by Xuzhou Health Outstanding Talents Project(No.XWJC001)Critical Special Project for Social Development of Xuzhou(No.KC21153)+1 种基金Science and Technology Innovation Project of Xuzhou Municipal Health Commission(No.XWKYHT20230039)Applied Basic Research Project of Xuzhou(No.KC23016).
文摘●AIM:To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment(RRD)using a novel foldable capsular buckle(FCB).●METHODS:This was a series of case observation studies.Eighteen patients(18 eyes)who visited our ophthalmology department between August 2020 and August 2022 and were treated for RRD with scleral buckling using FCB were included.The procedure was similar to conventional scleral buckling,while a balloon-like FCB was placed onto the retinal break with balanced salt solution filling for a broad,external indentation instead of the silicone buckle.The retinal reattachment rate,best corrected visual acuity(BCVA),intraocular pressure(IOP),refractive dioptre and astigmatism degree,and complications were evaluated and recorded.●RESULTS:There were 7 males and 11 females aged 19-58y.The average time course of RRD was 12d,ranging from 7-20d.The retinal break was located in the superior quadrants in 8 eyes and in the inferior quadrants in 10 eyes,with macula-off detachments in 12 eyes.The patients were followed-up for at least 6mo.The final retinal reattachment rate was 100%.The BCVA was significantly improved compared with the baseline(P<0.05).There was no significant change in refractive dioptre or astigmatism degree at each follow-up(all P>0.05).Three patients had transiently high IOPs within one week after surgery.Mild diplopia occurred in 5 patients after surgery and then disappeared after the balloon fluid was removed.●CONCLUSION:The success rate of FCB scleral buckling for RRD is satisfactory.This procedure can be expected to be applied in new,uncomplicated cases of RRD.
基金Supported by the Fundamental Research Funds of the State Key Laboratory of Ophthalmology(No.303060202400201203).
文摘AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who received treatment for nontraumatic RRD after ICL implantation surgery at the Retinal Department of Zhongshan Ophthalmic Center from Jan 2018 to Dec 2022 were reviewed.Comprehensive ophthalmologic examinations including visual acuity measurement and digital fundus photography were performed in each patient.RESULTS:A total of nine RRD eyes from nine patients who received V4c-ICL implantation were included.The mean time from ICL implantation surgery to the diagnosis of RRD was 32.44±22.56mo(range,1-60mo).At the initial visit for RRD,giant retinal tear(GRT),horseshoe tear,simple round hole,and horseshoe tear combined with round hole were detected in 3,3,2,and 1 eye(s),respectively,with maculaoff in eyes.Eight patients received surgical treatment,and one patient was treated by retinal laser photocoagulation alone.The ICL was preserved in 7 eyes.At the last followup,the mean best corrected visual acuity(BCVA)improved significantly from 1.76±1.06 logMAR at presentation to 0.81±1.01 logMAR(P=0.035),and no case of recurrent retinal detachment was found.CONCLUSION:The morphological presentation of retinal breaks is diverse in this study.The ICL can be preserved in most cases during the course of retinal detachment repair surgery in our data,companied with acceptable visual and anatomical outcomes.
文摘BACKGROUND There are very few cases of cardiac occluder detachment,and it is rare to completely remove the occluder using interventional methods without undergoing thoracotomy surgery after detachment.This case innovatively used ultrasound guidance combined with digital subtraction angiography(DSA)to completely remove the occluder,accumulating some experience.CASE SUMMARY The patient underwent left atrial appendage occlusion surgery in our hospital due to atrial fibrillation.After the surgery,the occluder fell off and became free in the left ventricle,which is very dangerous.We innovatively used ultrasound guidance,combined with DSA,and interventional surgery to successfully capture the free occluder using a catcher,completely remove it,and then re implant a new left atrial appendage occluder.After the surgery,the patient recovered very well.CONCLUSION The size selection of the occluder is slightly conservative,and the shape of the left atrial appendage opening is irregular.
基金Project(51276203)supported by the National Natural Science Foundation of China
文摘A series of three-dimensional numerical computations were conducted to understand the effects of different static magnetic fields on thermal fluctuation and melt flow during the detached solidification of CdZnTe. Numerical calculations were carried out by three different configurations of magnetic field: without magnetic field, with an axial magnetic field (AMF) and with a cusp-shaped magnetic field (CMF). The results reveal that the magnetic fields can effectively suppress the melt flow and thermal fluctuation and the suppression effect of the AMF is stronger than that of the CMF. Besides, the physical mechanism of thermocapillary?buoyancy convection instability was discussed and the effects of magnetic field on the critical Marangoni number were also obtained.
文摘In the paper, the effects of linear expansion coefficient and basic index of melting slag on the detachability of self shielded flux cored electrode (SSFCE) are investigated. An equation is obtained on the principles of ceramics and mineralography which predict the detachability of basic SSFCE. In addition, stick slag mechanism of SSFCE is analyzed.
基金ACKNOWLEDGMENTS This work was supported by the National Natural Science Foundation of China (No.21073188).
文摘The wavelength dependence of photoelectron angular distributions (PADs) of two-photon detachment of Cu^- has been directly studied by using the photoelectron map imaging. Results show that for the laser field intensity of 6.0×10^10W/cm^2, PADs exhibit dramatic change with the external field wavelength. Comparison between the experimental observation and the lowest-order perturbation theory prediction indicates that the pattern of PADs can be explained by the interference of the s and d partial waves in the final state. Relative contri- butions of s and d partial waves in the two-photon detachment at different laser wavelengths are obtained.
基金Project(51076173)supported by the National Natural Science Foundation of China
文摘In order to understand the effect of geometric parameters and axial magnetic field on buoyant-thermocapillary convection during detached solidification, a series of threedimensional numerical simulations were conducted by the finite-difference method. The results indicate that the stable flow is observed when the Marangoni number (Ma) is small; however, when the value of Ma increases and exceeds a threshold value, the stable steady flow transits to be unstable flow. As the height of the melt increases, the flow is enhanced at first and then gets weakened. As the width of gap decreases gradually, the strength of flow is enhanced. The approach of using axial magnetic field is an effective way to suppress the buoyant-thermocapillary convection. As the magnetic field strength increases, the inhibition is enhanced. The critical Marangoni number increases slightly with a greater melt height, a narrower width of gap, and a more strength of magnetic field.