Dynamic ultrasonography for optimizing treatment position in superior mesenteric artery syndrome:Two case reports and review of literature

BACKGROUND Superior mesenteric artery(SMA)syndrome is a rare cause of duodenal obstruction by extrinsic compression between the SMA and the aorta(SMA-Ao).Although the left lateral recumbent position is considered effective in the treatment of SMA syndrome,individual variations in the optimal patient position have been noted.In this report,we present two elderly cases of SMA syndrome that exhibited rapid recovery due to ultrasonographic dynamic evaluation of the optimal position for each patient.CASE SUMMARY Case 1:A 90-year-old man with nausea and vomiting.Following diagnosis of SMA syndrome by computed tomography(CT),ultrasonography(US)revealed the SMA-Ao distance in the supine position(4 mm),which slightly improved in the lateral position(5.7–7.0 mm)without the passage of duodenal contents.However,in the sitting position,the SMA-Ao distance was increased to 15 mm accompanied by improved content passage.Additionally,US indicated enhanced passage upon abdominal massage on the right side.By day 2,the patient could eat comfortably with the optimal position and massage.Case 2:An 87-year-old woman with vomiting.After the diagnosis of SMA syndrome and aspiration pneumonia by CT,dynamic US confirmed the optimal position(SMA-Ao distance was improved to 7 mm in forward-bent position,whereas it remained at 5 mm in the supine position).By day 7 when her pneumonia recovered,she could eat with the optimal position.CONCLUSION The optimal position for SMA syndrome varies among individuals.Dynamic US appears to be a valuable tool in improving patient outcomes.

Superior mesenteric artery syndrome:Diagnosis and management

Superior mesenteric artery(SMA)syndrome(also known as Wilkie's syndrome,cast syndrome,or aorto-mesenteric compass syndrome)is an obstruction of the duodenum caused by extrinsic compression between the SMA and the aorta.The median age of patients is 23 years old(range 0-91 years old)and predominant in females over males with a ratio of 3:2.The symptoms are variable,consisting of postprandial abdominal pain,nausea and vomiting,early satiety,anorexia,and weight loss and can mimic anorexia nervosa or functional dyspepsia.Because recurrent vomiting leads to aspiration pneumonia or respiratory depression via metabolic alkalosis,early diagnosis is required.The useful diagnostic modalities are computed tomography as a standard tool and ultrasonography,which has advantages in safety and capability of real-time assessments of SMA mobility and duodenum passage.The initial treatment is usually conservative,including postural change,gastroduodenal decompression,and nutrient management(success rates:70%-80%).If conservative therapy fails,surgical treatment(i.e.,laparoscopic duodenojejunostomy)is recommended(success rates:80%-100%).

Multifractal analysis of white matter structural changes on 3D magnetic resonance imaging between normal aging and early Alzheimer's disease

Applications of multifractal analysis to white matter structure changes on magnetic resonance imaging（MRI） have recently received increasing attentions. Although some progresses have been made, there is no evident study on applying multifractal analysis to evaluate the white matter structural changes on MRI for Alzheimer＇s disease（AD） research. In this paper, to explore multifractal analysis of white matter structural changes on 3D MRI volumes between normal aging and early AD, we not only extend the traditional box-counting multifractal analysis（BCMA） into the 3D case, but also propose a modified integer ratio based BCMA（IRBCMA） algorithm to compensate for the rigid division rule in BCMA. We verify multifractal characteristics in 3D white matter MRI volumes. In addition to the previously well studied multifractal feature,△α, we also demonstrated △ f as an alternative and effective multifractal feature to distinguish NC from AD subjects.Both △α and △ f are found to have strong positive correlation with the clinical MMSE scores with statistical significance.Moreover, the proposed IRBCMA can be an alternative and more accurate algorithm for 3D volume analysis. Our findings highlight the potential usefulness of multifractal analysis, which may contribute to clarify some aspects of the etiology of AD through detection of structural changes in white matter.

A Comparative Analysis of Culture Media for Optimizing the Mycelial Growth and Sporulation of Stemphylium vesicarium Cause of White Blotch of Onion

This study was conducted to identify a cheap and suitable culture medium for the mycelial growth and sporulation of Sternphylium vesicarium and to determine the cultural and morphological variability of this pathogen. A total of 24 isolates of S. vesicarium collected from eight different onion growing areas were characterized in terms of cultural and morphological aspects. Front colony colors were greenish brown to dirty white, deep grey to whitish, light grey to whitish, deep greenish white, light grey and dirty white to greenish. Reverse colony colors were brown, deep brown and light brown. Colony shapes were circular and irregular with umbonate, raised and flat type colony elevation. Colony textures were cottony, fluffy and velvety with entire, undulate and filiform type colony margin. Among the culture media, V-7 juice agar found to be the most suitable culture media for mycclial growth of S. vesicarium. The sporulation of the fungus was remarkably influenced by V-7 juice mixed with potato dextrose agar （PDA） media, this media exhibited the highest sporulation （87.76-169.0/mm^2） of S. vesicariumin comparison with other media. The minimum days （28 d to 31 d） for conidial production were observed on V-7 juice agar medium. The length of conidia varied from 14.6 μm to 30.6 μm. The maximum mean length of conidia was 29.97 μm found in isolate DSSA, while the minimum mean length 17.36 μm was found in isolate MSMM 02. The breadth of conidia ranged from 4.7 μm to 15.7μm. The maximum mean breadth of conidia was 12.55 μm found in the isolate DSSA, while the minimum mean breadth 9.760 μm was found in the isolate CCKH 02. The horizontal septation varied from l to 3 and the longitudinal septation varied from 0 to 4.

Superior mesenteric artery syndrome in a patient with Charcot Marie Tooth disease

The extrinsic compression of the third part of the duodenum as it passes through the aorto-mesenteric angle is known as the superior mesenteric artery syndrome(SMAS).This syndrome is a rare mechanical cause of upper intestinal obstruction,with a reported incidence of between 0.2% and 0.78%.Clinical manifestations of SMAS may be chronic or acute;chronic symptoms include intermittent gastric pain,fullness and occasional episodes of postprandial vomiting,while acute symptoms include incoercible vomiting,oral intolerance,mainly epigastric abdominal distension and abdominal pain.Surgery is recommended only when initial conservative treatment fails.Here,we report what appears to be the third published case of SMAS associated with hereditary motor and sensory neuropathy or Charcot Marie Tooth disease.

The State of White Supremacy in America:It Is Time to Stand Together

The United States has numerous social-cultural issues affecting its population.One of these problems is white supremacy.This concept refers to a racist perception that white persons are naturally superior to individuals of other races and should thus dominate them.While white supremacy in previous centuries galvanized a lot of support among white people,the concept is now regarded vicious by white,African American,Latino as well as other races.The modern American society is structured under cultural sensitiveness,racial equality,and religious tolerance.Unlike the years of slavery or reconstruction,all citizens in the United States are afforded equal rights irrespective of their cultural identities.Nevertheless,white supremacist notions persist in a nation that prides itself for its democratic model,cultural diversity,religious tolerance and socioeconomic transcendence.The state of white supremacy is that America can be manifested by violence,imperialistic tendencies,discrimination in the society,unfair immigration policies,poor political leadership,and the deplorable role of the media.With the growing number of atrocities being committed around the United States by both members of identified and non-identified white supremacist group,it is time to address this issue together.This paper,is a constructive discussion venting the many ills of racial discrimination in every aspect that affects minorities at all spheres of the society and the deplorable state of white supremacy in America.

The Land Question and Catholic-Anglican Relations in Buha, Western Tanzania： The White Fathers and C.M.S. Experience, 1934-1959

Land was important--in the course of spreading and seeking new converts--for both Missionaries of Africa （White Fathers） and Church Missionary Society （C.M.S.） in Buha, Western Tanzania. This paper examines the land question as one of the challenges that the White Fathers encountered in their attempt to evangelize communities in Western Tanzania. I argue that the land question remained throughout the late-colonial period one of the unresolved issues, and at some mission stations, impeded the activities of the White Fathers and C.M.S. missionaries. This paper relies on archival documents first, to examine the land question and White Fathers-C.M.S. relations in Buha from 1934 to 1959. Second, I intend to demonstrate the fact that land issues remained at the heart of the missionary enterprise in Buha. Both Catholic and Anglican missionaries were determined to have more mission plots for medical, education and religious purposes.

Classic of Mountains and Seas and the Origin of White Jade Worship： On the Myths of the Yellow Emperor＇s Eating Jade and Queen Mother of the West＇s Presenting the White Jade Ring

The white jade worship, born in the Shang and Zhou Dynasties, brought about a ＂Protestant Revolution＂ in the development history of Chinese jade mythology, which had deep influence on the nation＇s ideology and material production in the following 3,000 years. The myths of the Yellow Emperor＇s eating the white jade cream and the Queen Mother of the West living in Kunlun Jade Mountain, as recorded in Classic of Mountains and Seas, are mythological imaginations of the historical reality that the jades were spread from the West to the East and recreated by people living in the early state of the Central Plains. All such motifs, no matter the white jade cream that produced black jades, the Yellow Emperor＇s planting the jade flowers, the Kunlun Jade Mountains （the Mountain of Jades） where the Queen Mother of the West lives or the Jade Lake, clearly show Chinese indigenous worship for the white jades. Scholars like Su Xuelin and Ling Chunsheng think that Queen Mother of the West is the goddess of the moon that originated from the old West Asian civilization. However, such idea is full of contradictions and flaws after the discovery of Chinese unique worship for white jades and the holy mountain of Kunlun. The book Classic of Mountains and Seas, with records of 140 mountains that produce jades and 16 mountains that produce white jades, can be the white jade worshippers＇ bible to explore the holy material resources.

Symbols In HEMINGWAY'S “Hills Like White Elephants” Story commentary

HEMINGWAY’s story,“Hills Like White Elephants”,is about lovingrelationships between an American man and a girl.As lovers,they are in-timate,with the girl in the state of pregnancy.The story is told from the objective point of view.It takes place duringa 40-minute wait between trains.What lies behind them is indicated by thelabels on their bags.What lies ahead of them implies entire force and dir-ection of the story.It is at the station that a decision will be made

Magnetic Structure of the Earth’s Crust in the White Sea Region

The geological structure of the White Sea area and the surrounding land areas has been well studied in the framework of individual case studies. There are a number of local models of the deep structure of the Earth’s crust available. We propose a uniform assessment of deep crustal bodies responsible for long-period (regional) magnetic anomalies and consider their correlation with surface structures. The aim of the study is to build a three-dimensional magnetic model of the Earth’s crust in the White Sea region using aeromagnetic data and modeling technologies of the Integro software package. The model is formed on the basis of a digital map of the anomalous magnetic field reduced to the pole. The sources of magnetic anomalies are considered to be located in the Earth’s crust. The 3D distribution of the relative magnetic susceptibility of rocks was obtained by solving the inverse problem of the magnetic survey. To separate the magnetic sources by frequency and depth, it was necessary to continue the magnetic field of the model upward and to calculate the TDR derivatives, which determine the lateral boundaries of the sources of positive magnetic field anomalies. 2D distributions of magnetic sources of the model for vertical and horizontal sections with depths of 10, 15 and 20 km are analyzed. The correlation between the surface and deep structures of magnetic sources of the Earth’s crust in the region is shown.

Characteristic Analysis of White Gaussian Noise in S-Transformation Domain

The characteristic property of white Gaussian noise (WGN) is derived in S-transformation domain. The results show that the distribution of normalized S-spectrum of WGN follows X2?distribution with two degrees of freedom. The conclusion has been confirmed through both theoretical derivations and numerical simulations. Combined with different criteria, an effective signal detection in S-transformation can be realized.

Superior mesenteric artery syndrome in a patient with esophageal stenosis: A case report

BACKGROUND Superior mesenteric artery syndrome(SMAS)is a rare condition,characterized by duodenal obstruction caused by compression of its third part by the superior mesenteric artery(SMA).Most cases of SMAS are associated with weight loss,and the most frequent clinical manifestations are nausea,vomiting,postprandial fullness,and abdominal pain.Treatment of SMAS is usually conservative,consisting mainly of adequate nutritional support,but in refractory cases surgery may be necessary,with gastrojejunostomy and duodenojejunostomy being the most commonly performed procedures.CASE SUMMARY We describe the case of a man in his forties with a pre-existing diagnosis of esophageal stricture due to sodium hydroxide ingestion,who suffered significant weight loss after replacement of his jejunostomy tube.He was admitted to the hospital due to pain and abdominal distension.A computerized tomography scan showed significant distension of the stomach and duodenum with narrowing of the duodenum at the point at which it is crossed by the superior mesenteric artery,thus establishing the diagnosis of SMAS.Due to the presence of the esophageal stricture,the patient was incapable of emesis;however,passage of a nasogastric tube for decompression was not possible.Considering the risk of gastric perforation due to distention,we opted for surgical treatment in the form of a surgical gastrojejunostomy after which he showed complete resolution of all symptoms and was discharged from the hospital 5 d after the procedure.CONCLUSION Diagnosis of SMAS can be challenging in patients with esophageal stenosis,and risk of gastric perforation may preclude conservative treatment.

White Paper:China’s Policies toward Ethnic Minorities Well Fit National Conditions and Win Support from All Nationalities

The State Council Information Office published on September 27, 2009, a white paper entitled China＇ s Policies toward Minorities and Common Prosperity and Development of All Nationalities. The white paper says that the policies well fit the national conditions and are correct. They are instrumental to promoting harmonious coexistence of all nationalities that work with one heart and one mind and in mutual cooperation; they have helped open up a good national situation characterized by economic development, political stability,

Publicizing China's Human Rights——A Case Study on Human Rights White Papers

Human rights issues are practical political issues in the realm of international relations. Publicizing hu man rights to the rest of the wold i： one key means of spreading the tru image of a rising and responsibl large country. Effective publicit3 regarding human rights developmen can help China win undersandin and respect from the internationa community for China＇s human rightt policies, show the image of a demo cratic, progressive, civilized ant open large country, and create favor. able global public opinion for China Since the Communist Party of Chin （CPC） attaches great importance tc publicity regarding key human right, issues of economic and social signifi. cance in China and of international concern as well, it has organizec relevant press conferences and corn. piled white papers on human rights. White papers are important means fol China to publicize its human right, progress to the rest of the world anc are important windows by which foreign countries can understanc China＇s policies, principled stand, and achievements related to humar rights. Based on a review of Chinese government white papers, this article discusses the work, function and modes of human rights publicity.

Human Rights Protection for Prisoners:Its Features and Evolution——In commemoration of the 20th anniversary of the Publication of the White Paper on China’s Criminal Reform Situation

China put forward the concept of human rights protection for prisoners as part of the modernization of its prison system. On Nov. 1, 1991; the Chinese government published the white pa- per ＂Human Rights in China＂ and it showed that human rights theories and practices in China fully embody the basic spirit and requirements set forth in the Universal Declaration of Human Rights. On August 11, 1992,

基于广义S变换模时频矩阵的局部放电特高频信号去噪方法

为有效抑制局部放电特高频信号中的噪声干扰,提出一种基于广义S变换模时频矩阵的去噪方法。基于二维模时频矩阵,采用区域最大能量法提取周期性窄带干扰的特征量,并通过矩阵逆向分离将其去除;采用奇异值分解去噪方法抑制信号中的高斯白噪声。使用该方法对仿真信号和实验室实测信号进行去噪处理,并与传统方法去噪结果进行对比。结果表明,所提方法能有效抑制局部放电信号特高频信号中的噪声,同时更好地保留了原始局部放电信号特征。对现场实测信号进行去噪处理,与传统方法相比,该方法具有较高的噪声抑制比和较低的幅值衰减比,可以有效提取局部放电超高频信号。

中国白梨PbSFBB 13-gamma基因的分子克隆与序列特征(英文)

以5个已知S基因型的中国白梨品种为试材,设计分别对应于梨SFBB-alpha,SFBB-beta和SFBB-gamma基因的3对引物对这5个品种进行基因组PCR扩增。结果仅引物组合PSFBG-F/PSFBG-R从‘金花’（S13S18）,‘金花四号’（S13S18）和‘鹅梨’（S13S34）中扩增出一约1300bp的条带,经回收、克隆、测序后,鉴定其为SFBB-gamma基因,命名为PbSFBB13-gamma（Pyrus bretschneideri SFBB13-gamma）,GenBank登录号为EU081892。逆转录PCR结果表明PbSFBB13-gamma仅在花粉中特异表达;序列分析表明该基因不含内含子,编码区含1191个核苷酸,编码396个氨基酸,预测分子质量与等电点分别为45.4ku、4.63。PbSFBB13-gamma表现出典型的花粉SFB/SLF基因的基本结构特征,即1个F-box结构域及4个可变区;在推导氨基酸水平上,其与蔷薇科SFB/SLF基因的相似性为17.8%-97.7%。试验结果充分表明PbSFBB13-gamma应为花粉S基因的候选基因。选取蔷薇科34个SFB/SLF基因的全长氨基酸序列,构建进化树研究基因间的进化关系。结果表明,34个SFB/SLF基因形成2个亚科特异的类群,但不形成种特异的类群,其进化规律与蔷薇科S-RNase基因一致,即花粉SFB/SLF基因的形成也是在亚科形成之后、种形成之前。研究结果有助于从分子水平上揭示中国白梨的自交不亲和性机制。

TOPSIS价值函数模型

综合研究了TOPSIS函数的结构和性质.在构建单向规范化向量空间的基础上,定义并归纳了6种TOP SIS函数,证明了这6种函数都是价值函数.最后经过分析比较,推荐其中两种函数作为正统的TOPSIS价值函数模型.