目的探讨颅内外直接、间接联合搭桥术治疗成人烟雾病的技术要点,评价其临床意义。方法回顾性分析25例成人烟雾病患者应用直接、间接联合搭桥术治疗效果,术中分别解剖游离出颞浅动脉额支、顶支,采用较粗一支行颞浅动脉—大脑中动脉M4段...目的探讨颅内外直接、间接联合搭桥术治疗成人烟雾病的技术要点,评价其临床意义。方法回顾性分析25例成人烟雾病患者应用直接、间接联合搭桥术治疗效果,术中分别解剖游离出颞浅动脉额支、顶支,采用较粗一支行颞浅动脉—大脑中动脉M4段直接搭桥;另一支行脑硬脑膜动脉血管融通间接搭桥术。应用改良RANKIN量表(m Rs评分)和美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分评估患者手术前1天、术后1周及术后3个月的神经系统功能状态。结果 25例患者,行30侧联合搭桥术,23例术后1周内复查CT血管成像或DSA显示吻合口通畅,头部CT灌注成像显示脑血流量较术前增加,缺血症状改善。无死亡病例,患者的中位m RS评分由术前的3(1,3)分恢复到术后1周的2(1,3)分及术后3个月的1(0,3)分,差异有统计学意义(Z=15.14,P<0.01)。患者的中位NIHSS评分由术前的5(4,8)分恢复到术后1周的4(2,7)分及术后3个月的3(1,4)分,差异有统计学意义(Z=11.36,P<0.01)。1例患者术后合并对侧半球梗死,另1例合并术侧半球出血,均遗留偏瘫症状。结论颞浅动脉-大脑中动脉直接搭桥联合脑-硬脑膜-动脉血管融通间接搭桥术,可显著增加患者近期、远期脑血流量;围手术期血流动力学稳定是手术成功的关键。展开更多
Based on the field measurements in Barrow, Alaska within the period of April-May 2015, we investigate the sources and variations of elemental carbon(EC) and organic carbon(OC) in the surface layer of snowpack on sea i...Based on the field measurements in Barrow, Alaska within the period of April-May 2015, we investigate the sources and variations of elemental carbon(EC) and organic carbon(OC) in the surface layer of snowpack on sea ice, and estimate their effects on the sea ice albedo. Results show that the snow OC in Barrow are from natural sources(e.g. terrestrial higher plants and micro-organisms) mainly, as well as biomass burning(e.g. forest fires and straw combustion) as an important part. Both EC and OC can accumulate at the snow surface with snow melt. The variations in EC and OC and liquid water content in the snow layer are well consistent during the snow-melting period. A higher rate of snow melt implied a more efficient enrichment of EC and OC. In the last phase of snow melt, the concentration increased to a maximum of 16.2 ng/g for EC and 128 ng/g for OC, which is ~10 times larger than those before snow melt onset. Except for the dominant influence of melt amplification mechanism, the variation in concentrations of EC and OC could be disturbed by the air temperature fluctuation and snowfall. Our study indicates that the lightabsorbing impurities contributed 1.6%-5.1% to the reduction in sea ice albedo with melt during the measurement period. The significant period oflight-absorbing impurities influencing on sea ice albedo begins with the rapid melting of overlying snow and ends before the melt ponds formed widely, which lasted for about 10 days in Barrow, 2015.展开更多
文摘目的探讨颅内外直接、间接联合搭桥术治疗成人烟雾病的技术要点,评价其临床意义。方法回顾性分析25例成人烟雾病患者应用直接、间接联合搭桥术治疗效果,术中分别解剖游离出颞浅动脉额支、顶支,采用较粗一支行颞浅动脉—大脑中动脉M4段直接搭桥;另一支行脑硬脑膜动脉血管融通间接搭桥术。应用改良RANKIN量表(m Rs评分)和美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分评估患者手术前1天、术后1周及术后3个月的神经系统功能状态。结果 25例患者,行30侧联合搭桥术,23例术后1周内复查CT血管成像或DSA显示吻合口通畅,头部CT灌注成像显示脑血流量较术前增加,缺血症状改善。无死亡病例,患者的中位m RS评分由术前的3(1,3)分恢复到术后1周的2(1,3)分及术后3个月的1(0,3)分,差异有统计学意义(Z=15.14,P<0.01)。患者的中位NIHSS评分由术前的5(4,8)分恢复到术后1周的4(2,7)分及术后3个月的3(1,4)分,差异有统计学意义(Z=11.36,P<0.01)。1例患者术后合并对侧半球梗死,另1例合并术侧半球出血,均遗留偏瘫症状。结论颞浅动脉-大脑中动脉直接搭桥联合脑-硬脑膜-动脉血管融通间接搭桥术,可显著增加患者近期、远期脑血流量;围手术期血流动力学稳定是手术成功的关键。
基金supported by the Ministry of Science and Technology of China(MOST, 2013CBA01804)the National Nature Science Foundation of China (41425003,41401079, 41476164 and 41625014)+2 种基金the key project of CAMS:Research on the Key Processes of Cryospheric Rapid Changes (KJZD-EW-G03)the Opening Founding of State Key Laboratory of Cryospheric Sciences(SKLCSOP-2016-03)the State Key Laboratory of Cryospheric Sciences (SKLCS-ZZ-2017)
文摘Based on the field measurements in Barrow, Alaska within the period of April-May 2015, we investigate the sources and variations of elemental carbon(EC) and organic carbon(OC) in the surface layer of snowpack on sea ice, and estimate their effects on the sea ice albedo. Results show that the snow OC in Barrow are from natural sources(e.g. terrestrial higher plants and micro-organisms) mainly, as well as biomass burning(e.g. forest fires and straw combustion) as an important part. Both EC and OC can accumulate at the snow surface with snow melt. The variations in EC and OC and liquid water content in the snow layer are well consistent during the snow-melting period. A higher rate of snow melt implied a more efficient enrichment of EC and OC. In the last phase of snow melt, the concentration increased to a maximum of 16.2 ng/g for EC and 128 ng/g for OC, which is ~10 times larger than those before snow melt onset. Except for the dominant influence of melt amplification mechanism, the variation in concentrations of EC and OC could be disturbed by the air temperature fluctuation and snowfall. Our study indicates that the lightabsorbing impurities contributed 1.6%-5.1% to the reduction in sea ice albedo with melt during the measurement period. The significant period oflight-absorbing impurities influencing on sea ice albedo begins with the rapid melting of overlying snow and ends before the melt ponds formed widely, which lasted for about 10 days in Barrow, 2015.
