Background: Patients on hemodialysis are at high risk of adverse cardiac events after coronary artery bypass grafting (CABG). The aim of this study is to know whether CABG with complete revascularization and similar g...Background: Patients on hemodialysis are at high risk of adverse cardiac events after coronary artery bypass grafting (CABG). The aim of this study is to know whether CABG with complete revascularization and similar graft selection can provide equivalent long-term benefits for patients on and not on hemodialysis. Methods: Between 2004 and 2018, 746 patients underwent isolated CABG, of which 106 were on hemodialysis. Propensity matching on baseline characteristics, graft types and on/off-pump CABG was performed to compare clinical outcomes between patients on (n = 102) and not on (n = 102) hemodialysis. Results: Complete revascularization was achieved in all patients. The mean follow-up was 112.5 ± 46.6 months. Off-pump rates (hemodialysis vs non-hemodialysis, 93/102 vs 94/102, p > 0.999) and graft selections (distal anastomoses: 3.7 ± 1.4 vs 3.8 ± 1.5, p = 0.377, ITA grafts: 1.4 ± 0.6 vs 1.5 ± 0.6, p = 0.560, arterial grafts: 1.9 ± 0.9 vs 2.0 ± 0.8, p = 0.658, vein grafts: 0.69 ± 0.63 vs 0.65 ± 0.70, p = 0.513) were well balanced between the groups. Hospital mortality was higher in patients on hemodialysis than in those not on hemodialysis (5/102 vs 1/102, p = 0.212). The Kaplan-Meier analysis revealed that cardiac death (without non-cardiac causes) was significantly more common in patients on hemodialysis than in those not on hemodialysis (p = 0.018). However, there were no significant differences in deaths due to ischemic heart disease (p = 0.327), repeated revascularization (p = 0.542), myocardial infarction (p = 0.783), and heart failure requiring admission (p = 0.371). Conclusion: CABG with complete revascularization and similar graft selection provides equivalent long-term benefits with regard to the prevention of adverse cardiac events due to ischemic heart disease in patients on and not on hemodialysis.展开更多
有效的信号特征提取是高精度雷达辐射源识别的基础,以脉冲描述字为代表的传统特征已无法满足复杂电磁环境的需要。本文提出一种基于自适应噪声完备集合经验模态分解(CEEMDAN)的有效雷达辐射源脉内细微特征提取算法。雷达信号由对非平稳...有效的信号特征提取是高精度雷达辐射源识别的基础,以脉冲描述字为代表的传统特征已无法满足复杂电磁环境的需要。本文提出一种基于自适应噪声完备集合经验模态分解(CEEMDAN)的有效雷达辐射源脉内细微特征提取算法。雷达信号由对非平稳、非线性信号尤为有效的CEEMDAN分解产生的个别分量重构,抑噪效果通过1 000次蒙特卡罗实验得到验证,同时设计基于该重构的一种脉内特征空间。本文方法与主流特征提取方法的识别精度在6部雷达辐射源产生的3000个不同脉内调制的加噪信号样本上进行了实验对比,结果表明不同种类信号样本在本文特征空间中清晰可分,本文方法较之主流方法更加精确,尤其在0 d B信噪比(SNR)下仍保持90%以上的高精度。展开更多
颌位关系丧失会严重影响患者的面容和咀嚼功能,而准确地恢复咬合垂直距离(vertical dimension of occlusion,OVD)是无牙颌患者咬合重建的关键。无牙颌患者OVD的测量方法有很多种,本文通过对常用OVD记录法的工作原理、适用范围、优缺点...颌位关系丧失会严重影响患者的面容和咀嚼功能,而准确地恢复咬合垂直距离(vertical dimension of occlusion,OVD)是无牙颌患者咬合重建的关键。无牙颌患者OVD的测量方法有很多种,本文通过对常用OVD记录法的工作原理、适用范围、优缺点、测量方法以及操作要点进行综述,以期对临床治疗提供一定的参考作用。研究表明,拔牙前记录法较为客观且准确度高,但要求拔牙前的诊断模型能够准确地反映患者原有的OVD;息止颌位参照法易受主观因素的影响,颌位关系不稳定的无牙颌患者禁用;吞咽法的主观性较强,特别适用于情绪紧张,配合较差的患者;面部标志测量法的客观性较强,但也受一定程度的主观测量因素的影响,颌面部畸形患者禁用;语音法的主观性较强,其测量结果的准确性与医师的临床经验密切相关,失语、失聪患者禁用。X线头影测量法与手指测量法的客观性强,是近年来新兴起的测量方法,发展前景好,其中手指测量法特别适用于颌面部畸形或肿瘤术后畸形的患者。展开更多
文摘Background: Patients on hemodialysis are at high risk of adverse cardiac events after coronary artery bypass grafting (CABG). The aim of this study is to know whether CABG with complete revascularization and similar graft selection can provide equivalent long-term benefits for patients on and not on hemodialysis. Methods: Between 2004 and 2018, 746 patients underwent isolated CABG, of which 106 were on hemodialysis. Propensity matching on baseline characteristics, graft types and on/off-pump CABG was performed to compare clinical outcomes between patients on (n = 102) and not on (n = 102) hemodialysis. Results: Complete revascularization was achieved in all patients. The mean follow-up was 112.5 ± 46.6 months. Off-pump rates (hemodialysis vs non-hemodialysis, 93/102 vs 94/102, p > 0.999) and graft selections (distal anastomoses: 3.7 ± 1.4 vs 3.8 ± 1.5, p = 0.377, ITA grafts: 1.4 ± 0.6 vs 1.5 ± 0.6, p = 0.560, arterial grafts: 1.9 ± 0.9 vs 2.0 ± 0.8, p = 0.658, vein grafts: 0.69 ± 0.63 vs 0.65 ± 0.70, p = 0.513) were well balanced between the groups. Hospital mortality was higher in patients on hemodialysis than in those not on hemodialysis (5/102 vs 1/102, p = 0.212). The Kaplan-Meier analysis revealed that cardiac death (without non-cardiac causes) was significantly more common in patients on hemodialysis than in those not on hemodialysis (p = 0.018). However, there were no significant differences in deaths due to ischemic heart disease (p = 0.327), repeated revascularization (p = 0.542), myocardial infarction (p = 0.783), and heart failure requiring admission (p = 0.371). Conclusion: CABG with complete revascularization and similar graft selection provides equivalent long-term benefits with regard to the prevention of adverse cardiac events due to ischemic heart disease in patients on and not on hemodialysis.
文摘有效的信号特征提取是高精度雷达辐射源识别的基础,以脉冲描述字为代表的传统特征已无法满足复杂电磁环境的需要。本文提出一种基于自适应噪声完备集合经验模态分解(CEEMDAN)的有效雷达辐射源脉内细微特征提取算法。雷达信号由对非平稳、非线性信号尤为有效的CEEMDAN分解产生的个别分量重构,抑噪效果通过1 000次蒙特卡罗实验得到验证,同时设计基于该重构的一种脉内特征空间。本文方法与主流特征提取方法的识别精度在6部雷达辐射源产生的3000个不同脉内调制的加噪信号样本上进行了实验对比,结果表明不同种类信号样本在本文特征空间中清晰可分,本文方法较之主流方法更加精确,尤其在0 d B信噪比(SNR)下仍保持90%以上的高精度。
基金Supported by the National Natural Science Foundation of China(10962004,11061019)the Specialized Research Fund for the Doctoral Program of Higher Education of China(20111501110001)the SPHIMU(Z20100116,125120)
文摘颌位关系丧失会严重影响患者的面容和咀嚼功能,而准确地恢复咬合垂直距离(vertical dimension of occlusion,OVD)是无牙颌患者咬合重建的关键。无牙颌患者OVD的测量方法有很多种,本文通过对常用OVD记录法的工作原理、适用范围、优缺点、测量方法以及操作要点进行综述,以期对临床治疗提供一定的参考作用。研究表明,拔牙前记录法较为客观且准确度高,但要求拔牙前的诊断模型能够准确地反映患者原有的OVD;息止颌位参照法易受主观因素的影响,颌位关系不稳定的无牙颌患者禁用;吞咽法的主观性较强,特别适用于情绪紧张,配合较差的患者;面部标志测量法的客观性较强,但也受一定程度的主观测量因素的影响,颌面部畸形患者禁用;语音法的主观性较强,其测量结果的准确性与医师的临床经验密切相关,失语、失聪患者禁用。X线头影测量法与手指测量法的客观性强,是近年来新兴起的测量方法,发展前景好,其中手指测量法特别适用于颌面部畸形或肿瘤术后畸形的患者。
