Evaluation of Right Ventricular Volume and Systolic Function by Real-time Three-dimensional Echocardiography

The optimal plane for measurement of the right ventricular (RV) volumes by real-time three-dimensional echocardiography (RT3DE) was determined and the feasibility and accuracy of RT3DE in studying RV systolic function was assessed. RV “Full volume” images were acquired by RT3DE in 22 healthy subjects. RV end-diastolic volumes (RVEDV) and end-systolic volumes (RVESV) were outlined using apical biplane, 4-plane, 8-plane, 16-plane offline separately. RVSV and RVEF were calculated. Meanwhile tricuspid annual systolic excursion (TASE) was measured by M-mode echo. LVSV was outlined by 2-D echo according to the biplane Simpson's rule. The results showed: (1) There was a good correlation between RVSV measured from series planes and LVSV from 2-D echo (r=0.73; r=0.69; r=0.63; r=0.66, P<0.25—0.0025); (2) There were significant differences between RVEDV in biplane and those in 4-, 8-, 16-plane (P<0.001). There was also difference between RV volume in 4-plane and that in 8-plane (P<0.05), but there was no significant difference between RV volume in 8-plane and that in 16-plane (P>0.05); (3) Inter-observers and intro-observers variability analysis showed that there were close agreements and relations for RV volumes (r=0.986, P<0.001; r=0.93, P<0.001); (4) There was a significantly positive correlation of TASE to RVSV and RVEF from RT3DE (r=0.83; r=0.90). So RV volume measures with RT3DE are rapid, accurate and reproducible. In view of RV's complex shape, apical 8-plane method is better in clinical use. It may allow early detection of RV systolic function.

Dynamic Characteristic Mechanism of Atrial Septal Defect Using Real-Time Three-Dimensional Echocardiography and Evaluation of Right Ventricular Functions

The dynamic characteristics of the area of the atrial septal defect（ASD） were evaluated using the technique of real-time three-dimensional echocardiography（RT 3DE）, the potential factors responsible for the dynamic characteristics of the area of ASD were observed, and the overall and local volume and functions of the patients with ASD were measured. RT 3DE was performed on the 27 normal controls and 28 patients with ASD. Based on the three-dimensional data workstations, the area of ASD was measured at P wave vertex, R wave vertex, T wave starting point, and T wave terminal point and in the T-P section. The right atrial volume in the same time phase of the cardiac cycle and the motion displacement distance of the tricuspid annulus in the corresponding period were measured. The measured value of the area of ASD was analyzed. The changes in the right atrial volume and the motion displacement distance of the tricuspid annulus in the normal control group and the ASD group were compared. The right ventricular ejection fractions in the normal control group and the ASD group were compared using the RT 3DE long-axis eight-plane（LA 8-plane） method. Real-time three-dimensional volume imaging was performed in the normal control group and ASD group（n=30）. The right ventricular inflow tract, outflow tract, cardiac apex muscular trabecula dilatation, end-systolic volume, overall dilatation, end-systolic volume, and appropriate local and overall ejection fractions in both two groups were measured with the four-dimensional right ventricular quantitative analysis method（4D RVQ） and compared. The overall right ventricular volume and the ejection fraction measured by the LA 8-plane method and 4D RVQ were subjected to a related analysis. Dynamic changes occurred to the area of ASD in the cardiac cycle. The rules for dynamic changes in the area of ASD and the rules for changes in the right atrial volume in the cardiac cycle were consistent. The maximum value of the changes in the right atrial volume occurred in the end-systolic period when the peak of the curve appeared. The minimum value of the changes occurred in the end-systolic period and was located at the lowest point of the volume variation curve. The area variation curve for ASD and the motion variation curve for the tricuspid annulus in the cardiac cycle were the same. The displacement of the tricuspid annulus exhibited directionality. The measured values of the area of ASD at P wave vertex, R wave vertex, T wave starting point, T wave terminal point and in the T-P section were properly correlated with the right atrial volume（P〈0.001）. The area of ASD and the motion displacement distance of the tricuspid annulus were negatively correlated（P〈0.05）. The right atrial volumes in the ASD group in the cardiac cycle in various time phases increased significantly as compared with those in the normal control group（P=0.0001）. The motion displacement distance of the tricuspid annulus decreased significantly in the ASD group as compared with that in the normal control group（P=0.043）. The right ventricular ejection fraction in the ASD group was lower than that in the normal control group（P=0.032）. The ejection fraction of the cardiac apex trabecula of the ASD patients was significantly lower than the ejection fractions of the right ventricular outflow tract and inflow tract and overall ejection fraction. The difference was statistically significant（P=0.005）. The right ventricular local and overall dilatation and end-systolic volumes in the ASD group increased significantly as compared with those in the normal control group（P=0.031）. The a RVEF and the overall ejection fraction decreased in the ASD group as compared with those in the normal control group（P=0.0005）. The dynamic changes in the area of ASD and the motion curves for the right atrial volume and tricuspid annulus have the same dynamic characteristics. RT 3DE can be used to accurately evaluate the local and overall volume and functions of the right ventricle. The local and overall volume loads of the right ventricle in the ASD patients increase significantly as compared with those of the normal people. The right ventricular cardiac apex and the overall systolic function decrease.

The Infeasibility of Establishing Land Development Rights in China Based on the Path of Real Rights

Using comparative analysis and documentation method,this paper reveals infeasibility of establishing land development rights in China based on the path of real rights,in the hope of providing recommendations for improving the research route on localization of land development rights. Results indicate that at the level of legislative techniques,the land development rights rooted from property right paradigm do not contain possess the elements of object of real rights and conflict with the principle of statutory real rights and single ownership. At the level of legal logic,individual case of TDR conflicts with real right in rem. In conclusion,it is infeasible to introduce land development rights based on the path of real rights. In future,it is required to discard the concept of mechanical transplantation and explore feasible path and seek feasible way for establishing land development rights along with the direction of quasi-property and improving regulation efficiency.

Study on the Theory and Method of Real Estate Property Right Appraisal

This paper first introduces the overview of real estate appraisal theory,the basic situation of real estate appraisal,the basic principles and characteristics of real estate appraisal,and three main appraisal methods.On this basis,the specific use scope of each method,the meaning of each parameter,and the influencing factors are analyzed.Then,based on the in-depth study of various existing appraisal theories and methods,a new appraisal method is proposed:the appraisal analysis method based on fuzzy analytic hierarchy process.

Solutions to Right Conflicts and Integrated Protection of Diverse Interests in Real EstateDevelopment and Operation

In the development and operation of real estate, real estate development enterprises as the principal subject would often establish contractual relationships with subjects of diverse interests including removed households, banks, construction project contractors, and buyers. At times, conflicts of interests might occur among these contractual subjects requesting civil and commercial claims of the same subject matter based on agreements or legal rights. As for the causes of these conflicts and their solutions, a majority of existing researches still stay at the superficial causes from the perspective of civil and commercial law, and the solution of determining the order of priority of compensation of related rights. Due to the lack of research into deep-seated reasons and solutions from the perspective of economic law, the current legislative and judicial approaches to this kind of problems tend to give more protection to the rights of one subject while lack sufficient attention to other subjects. This paper attempts to carry out analyses and research on the causes and solutions to this kind of conflicts from the perspective of economic law, to achieve integrated protection of diverse interests in real estate development and operation so as to better safeguard the order in real estate development and operation and facilitate the healthy and ordered development of the real estate industry.

论NFT数字作品的权属特点与规则适用

NFT是一种技术,它通过对数字客体进行标识、登记和固定,使其具有可支配性和特定性。数字作品经过NFT处理后,其“物”的特性得到了强化,从而在一定程度上超出了债权客体的范畴,更接近于物权客体的特征。虽然NFT数字作品的铸造和交易应该适用物权规则,但在占有和处分这些作品的过程中,其登记性和非同质性特点却十分鲜明。因此,传统物权规则在应用于该种新型物时需要进行内部调整,同时还需要与外部规则相适配。NFT与区块链登记公示的高度绑定有别于传统的动产物权登记和著作权自愿登记,它应该比照不动产而非动产物权登记机制进行规范,并明确该登记行为在著作权规则中的地位。NFT通过独特识别符形成的非同质性,与同质化代币相比存在巨大差异,因此在适用货币化、证券化规则时应该更加谨慎。

价值均衡视角下宅基地使用权继承纠纷的裁判规则构建

现阶段宅基地使用权继承纠纷解决存在司法处理态度不一、缺少统一立法规范的实践困境。根本原因在于宅基地使用权兼具身份价值和财产价值,而现有纠纷处理模式不能达成两种价值取向的均衡。鉴于此,建议适用“身份资格—房地关系”双重标准的限制继承规则作为司法裁判指引,同时明确“三权分置”背景下宅基地使用权的成员权内涵,以填补双重标准裁判规则的理论漏洞,消解新规则的内在矛盾。

登记对抗主义下相对性物权说之批判

登记对抗主义物权变动规则由设立要件与对抗要件构成,其适用难点在于如何解释对抗要件所产生的登记对抗效力。相对性物权说在承认未登记物权仍为物权属性可对抗一般债权的前提下,主张未登记物权不能对抗特殊债权乃对抗要件发挥其登记对抗效力的必然结果,进而认为,在登记对抗主义下,依据合同设立的未登记物权具有相对性。然而,该学说偏离了物权界定规则与登记对抗规则的位阶关系,对域外法的借鉴未能作出契合本土的诠释,导致设立要件与对抗要件的功能错位。实质上,相对性物权说是以物权的相对性替换债权物权化。特殊债权优先受偿与登记对抗效力不存在必然联系,因而不应纳入登记对抗效力的调整范围。

商品房买卖消费者物权期待权适用困境与纾解

为解决商品房买卖中消费者生存利益与房地产企业其他债权人财产利益保护失衡问题,最高人民法院将物权期待权理论融入司法解释。然而该理论不仅有悖于民法典规定的物权变动规则,而且受制于物权公示制度。囿于主体认定标准、生存权界定标准、后续保护措施欠缺等,该理论在司法实践中并没有形成统一的适用逻辑。对此应当对《执行异议复议规定》第二十九条规定的构成要件予以实质化解释,以此完善“用于居住”“名下无其他用于居住住房”和“支付价款比例”的判定标准,并对消费者科以合理审查义务,同时法律还应完善排除强制执行后的所有权确权与登记程序。

不动产抵押登记被撤销后相关法律问题探究

已经登记的抵押权被撤销或注销后,抵押权是否有效以及各当事人之间如何承担责任的问题,在我国理论界探讨不足,立法上尚属空白。在司法实践中,由于不动产抵押登记行为具有行民交叉的特征,存在着诉讼路径与诉讼结果的冲突,增加了司法诉累,影响了司法公信力。抵押登记是一种行政行为,不是一种持续的状态。即使抵押权登记被撤销或被注销,抵押权人的信赖利益仍然受到法律的保护,抵押权应继续有效。应当采取抵押权登记纠纷的行民合并审理模式,以保护交易安全,节约司法成本。如果抵押登记在行政诉讼中被撤销或被行政机关主动注销,说明行政机关在当初登记时就有错误,受到损失的利害关系人可以要求登记机关承担赔偿责任。

房企破产中购房合同的处理方式

购房合同的处理无疑是房企破产的焦点之一。从系统性风险和法治化双重视角看,管理人原则上应当选择继续履行现房合同并认可已支付房款的优先权地位和对房企违约金的劣后债权地位;从房屋续建可能产生的价值提升以及消费者住房生存权益的保障角度看,管理人原则上也应当选择继续履行期房合同。与普通待履行合同的处置模式不同,购房合同的处置应转变为购房者的多层次自决:基于债务人追加担保及共益债保障的障碍,购房优先权人有权逐一决定是否接受现金清偿或是等待交房,且全体购房债权人基于对重整风险的分摊和自身权益的让步,均有权对重整计划、续建方案等事项进行表决,并根据其付出的时间与金钱成本分享房企继续履行购房合同的成果。在其他融资途径均行不通的情况下,可以由选择交房的购房者出资续建,且其出资额形成共益债务。同时还应充分利用数理思维来维护购房者之间的同质性及相应的权利救济。

物权登记错误行政赔偿裁判规则争议问题之再认识

需要受害人穷尽其他法律救济途径才能判令行政机关承担因登记错误致损赔偿责任的司法实践于法无据;物权登记错误行政赔偿与民事赔偿或者刑事附带民事赔偿等救济途径具有同等独立法律价值,人民法院应当根据当事人诉请依法裁判;司法实践和司法规范将以房屋登记为代表的物权登记行政赔偿归责原则确立为过错归责原则缺少法律依据。确立结果归责原则理据在于:具有法律规范依据,更加符合《国家赔偿法》《民法典》立法宗旨;与国家赔偿责任构成要件相匹配;结果归责原则并不要求物权登记机构承担绝对责任。将登记错误行政赔偿责任作为一种补充责任涉嫌违反《行政诉讼法》和《国家赔偿法》规定,也会造成新的不公平。根据物权交易民事侵权人与登记机构(工作人员)是否具有实施故意侵权意思联络为标准,登记错误行政赔偿责任可以分为份额责任和连带责任。

论借名购房纠纷房屋物权的归属

司法实践中经常遇见所谓借名购房问题,这种房产物权名实不符的现象给相关司法裁判带来困惑,而《中华人民共和国民法典》(以下简称《民法典》)以及相关的司法解释中均没有对此类行为作出明确规定,各地法院在审理过程中的处理结果也不尽相同。对此,司法裁判应从意思自治的民法理念出发,结合《民法典》的基本法理及相关司法解释精神,在对借名购房纠纷中房屋物权归属进行系统法理分析基础上作出妥当处理。

房地一体不动产确权登记数据管理系统的研究与实现

从房地一体化采购项目数字化、标准化、科学化和智能化管理面临的问题着手,结合房地一体不动产确权登记数据管理实际需求,给出了房地一体不动产确权登记数据管理系统的功能设计和实现,并对房地一体不动产确权登记数据管理系统建设的关键技术和系统特色进行了论述。

物权变动规则是一个解释选择吗?

我国物权变动规则对债权合同与履行行为从一体把握到相互区分,最终采纳了物权形式主义。物权变动规则不是一个“解释选择”问题。物权形式主义贯彻了意思自治原则,既是物债二分的必然结果,也是非即时交易的必然规则,还是登记审查的必然要求。我国目前无论在立法还是在司法方面都确立了物权形式主义。支持债权形式主义的许多理由不能成立,诸如所有权保留等规则均能也均应通过物权行为理论解释。应当协调物权形式主义与法律行为无效制度、善意取得制度的关系,共同维护当事人的利益平衡和保障交易安全。

多模态超声心动图对肺动脉高压患者右心功能的诊断价值分析

目的探讨多模态超声心动图对肺动脉高压患者右心功能的诊断效能。方法选取2022年1月至2023年8月于金华市中心医院就诊的80例肺动脉高压患者纳入观察组,根据患者的肺动脉收缩压将其分为轻度组[40~50mmHg(1mmHg=0.133kPa),36例]、中度组(51~70mmHg,20例)和重度组(>70mmHg,24例);选取同期健康体检者80名纳入对照组,所有受试者均进行多模态超声心动图检测,对比其超声检查相关数据,评估多模态超声心动图对肺动脉高压患者右室收缩功能的诊断效能。结果观察组患者的右室舒张末期容积(right ventricular end diastolic volume,RVEDV)、右室收缩末期容积(right ventricular end systolic volume,RVESV)、右室整体无效做功(right ventricular global waste work,RVGWW)均显著高于对照组,右室每搏输出量(right ventricular stroke volume,RVSV)、右室射血分数(right ventrical ejection fraction,RVEF)、三尖瓣环收缩期位移(tricuspid annular plane systolic excusion,TAPSE)、整体纵向应变(global longitudinal strain,GLS)、右室整体做功效率(right ventricular global work efficiency,RVGWE)、右室整体做功指数(right ventricular global work index,RVGWI)、右室整体有效做功(right ventricular global constructive work,RVGCW)均显著低于对照组(P<0.05)。重度组患者的RVEDV、RVESV及RVGWW均显著高于中度组、轻度组,RVSV、RVEF、RVGWE、RVGWI、RVGCW均显著低于中度组、轻度组(P<0.05)。TAPSE、GLS、RVSV、RVEF、RVGWI五项联合诊断肺动脉高压患者右心功能的曲线下面积为0.911,敏感度为92.23%,特异性为96.45%。结论多模态超声心动图能有效评价肺动脉高压患者的右室收缩功能,值得临床推广应用。

“三权分置”背景下土地经营权登记的路径选择

农地“三权分置”背景下,土地经营权性质的界定关系到土地经营权的权利构造及其权利行使方式,对于后续改革与权利的完善具有重大意义。学界针对土地经营权登记问题的研究形成了债权和物权登记两种理论观点。就其权利属性而言,土地经营权债权登记欠缺理论基础且在实践中不具有可操作性,无法为权利人提供实质性保障。土地资源要素市场化的构建需要效力强大的物权为其提供制度支撑,土地经营权的物权属性为其纳入不动产登记体系提供了理论基础。物权登记路径的确立有着坚实的制度基础和法律保障,既符合农地改革的内在要求,也与我国正在建立实施的不动产统一登记制度相契合。

体育赛事直播画面法律保护的适用困境与纾解路径——基于31个案例的实证分析

体育赛事直播已成为我国体育产业的重要组成部分,但其现有的法律保护路径仍不完善。综合运用文献资料、案例分析等方法,梳理2012-2023年31起体育赛事直播画面侵权案例后发现:由于相关权益性质不明,现有法律框架下著作权法、反不正当竞争法以及体育法等相关法律法规对体育赛事直播画面保护出现距离性,受害人通常难以实现权利救济。研究总结了当前体育赛事直播画面纠纷处理过程中在体育赛事直播画面定性、权利主体认定、权益保护法律适用三方面的现存困境。据此提出纾解路径,即立法将体育赛事直播画面定义为“实时数据集合”,并将其纳入“新型知识产权”客体范畴;扩大广播组织的定义,使其涵盖网络广播组织;在《体育法》中创设“体育赛事视听信息权”。

实时三维超声联合二维斑点追踪技术评估肝硬化患者右心室功能的价值

目的 探讨实时三维超声检查(RT-3DE)联合二维斑点追踪(2D-STI)技术评估肝硬化患者右心室功能的应用价值。方法 选取91例临床确诊的肝硬化患者,根据Child-Pugh分级标准分为A组、B组、C组,另外选取30例健康体检者作为对照组,应用RT-3DE获得右心室射血分数(RVEF)、右心室舒张末期容积(RVEDV)、右心室收缩末期容积(RVESV)及右心室每搏输出量(RVSV),应用2D-STI获得右心室游离壁应变(RVFWSL)、右心室整体纵向应变(RV4CSL)。结果 与对照组、A组及B组相比,C组RVEDV、RVESV升高,RVEF及RVFWSL、RV4CSL减低,差异有统计学意义(P<0.05);与对照组、A组相比,B组RVEDV、RVESV升高,RVEF及RVFWSL减低,差异有统计学意义(P<0.05);与对照组相比,A组RVESV升高,RVEF及RVFWSL、RV4CSL减低,差异有统计学意义(P<0.05)。相关性分析显示RVEDV、RVESV与肝功能分级呈正相关,RVEF、RVFWSL及RV4CSL与肝功能分级呈负相关。结论 RT-3DE和2DSTI能够定量评估肝硬化患者右心室的功能改变,具有显著的临床意义。

多模态超声对右心结构和功能的评估研究

目的运用多模态超声检查技术进行右心室结构和功能的综合评估,为右心相关的疾病诊治提供更客观、高效的超声检测工具。方法前瞻性收集2022年2月至2023年2月义乌市中心医院诊治右心相关疾病的患者88例(观察组)和健康志愿者80名(对照组),采用常规二维超声测量三尖瓣环收缩期位移(TAPSE)、三尖瓣环收缩期速度(S')和右心室面积变化分数(FAC)、三尖瓣口舒张早期与晚期血流峰值速度的比值(E/A)、右心房内径(RAD)、下腔静脉内径及吸气末内径塌陷率,二维斑点追踪技术(2D-STE)测量右心室游离壁心肌整体纵向应变(RVGLS),实时三维超声(RT-3DE)测量右心室射血分数(RVEF)。结果观察组TAPSE、S'、FAC、E/A和RVEF明显低于对照组,RVGLS高于对照组(均P<0.05)。Spearman秩相关显示,RVGLS与TAPSE、S'、FAC、E/A和RVEF均呈负相关,RVEF与TAPSE、S'、FAC和E/A均呈正相关(均P<0.05)。最后,TAPSE、S'、FAC、E/A、RVEF和RVGLS的观察者内和观察者间的组内相关系数均≥0.899(均P<0.05),提示多模态超声的重复性较好。结论综合应用多模态超声技术能够提供更多有关右心室结构和功能的信息,在客观、准确诊治右心相关疾病方面具有重要的应用价值。