Transcatheter to Close the Patent Duetus Arteriosus and Atrial Septal Defects in Children

Objective: To evaluate the therapeutic effect, safety and complications oftranscathetering Amplatzer device in the closure of patent ductus arteriosus (PDA) and atrial septaldefects (ASD) in children. Methods: Patients with PDA (n = 25) and ASD ( n = 16), confirmed byechocardiography, were treated by transcatheterization. Amplatzer occluder device was placed by thetranscatheterization with the image support of X-ray and transthoracic echocardiography ( TTE) . TheTTE, ECG and X-ray examination were engaged to evaluate the therapeutic results on the time pointsof 24 h , 1, 3 , 6, 12 months after the operation, and all these cases were engaged to the follow-upexamination. Results: The cardioangiographic diameter was 13.0-28.0 mm ([19.3+-4.9] mm) in ASD and2.0-7.7 mm ([3.9+-1.5] mm) in PDA . The diameter of the Amplatzer occluder selected were 13.0-30.0mm ( [20.6+-5.1] mm) in ASD and 4.0-12.0 mm ([6.6+-1.9] mm) in PDA , respectively. All the Amplatzeroccluders were placed successfully. There were no complications during and after the operation.Very small residual shunt was still found soon after the operation in 10 cases , and there were noresidual or recanalization after three months of the operation. The pulmonary artery pressure andheart size were significantly decreased in follow-up examination . Conclusion: Transcatheteringclosure with Amplatzer device is an effective, simple and safe technique in the treatment of ASD andPDA in children.

Leveraging Digital Entrepreneurship Through Collaboration Between Incumbent Firms and Entrepreneurial Ventures： An Inbound Open Innovation Perspective

Considering that traditional research and development （R＆D） models cannot keep up with the disruptive advances, the incumbent firms should consider external sources for obtaining and commercializing digital innovations. By contrast, entrepreneurial ventures have the necessary tech development skills and agility to create digital innovations. There has never been a better time for incumbent firms and entrepreneurial ventures to collaborate One paradigm that establishes such mutual beneficial partnership is called ＂inbound open innovation＂. Based on a multiple-cases design, this research provides evidence of the benefits, the degree of co-creation required, and the various collaboration schemes that emerge through an open innovation initiative

ANALYSIS OF CLINICAL CHARACTERISTICS AND DEATH RELATED FACTORS OF SEVERE MECONIUM ASPIRATION SYNDROME

Objective To investigate the factors in relation with the case fatality in severe meconium aspiration syndrome (MAS). Methods Eighty-one severe MAS cases intervened by the mechanical ventilation from 9 childrens hospitals were retrospectively analyzed for the risk factors of fatality with SAS software for non-parametric rank sum test and chi-square test. Results In the 81 cases, 49 were survived (death rate 39%). The gestational age (GA), Apgars score at 1min and other complications with MAS were significantly related to the death (P <0.05). There was no difference of death rate between the patients with or without receiving endotracheal intubation and airway suctioning (P>0.05). Conclusion A higher death rate (close to 40%) of severe MAS in the middle of 1990s in major cities of China suggests that it is important to detect the intrauterine hypoxemia as it may indicated by meconium staining amniotic fluid which should be intervened early by adequate termination of pregnancy before 42 weeks. The effects of delivery room suction and conventional ventilation also need to be reevaluated.

The Dates of the Reign of Vakhtang Gorgasali

Georgian historiography dates the reign of King Vakhtang Gorgasali （Gorg-a-sar--＇wolf-head＇ in Persian） to the 2nd half of 5th century. The king is considered to have died in 502 in a fight with Persians. Cyril Toumanoff has expressed an opinion about the identification of Vakhtang Gorgasali with the King of Kartli Gurgen, mentioned by Procopius of Caesarea in 523. Accordingly, he believed that in case of such an identification, Vakhtang Gorgasali should have died in 527 during the big Persian invasion of Georgia. We have noticed that the author of the martyrdom of David and Constantine, who were based on the ancient chronicle （＂Dzveli Utskebani＂---Old Story） and who created his hagiographic work in the middle of 1 lth century, made a big mistake： erroneously, due to the similarity of names, he identified the sons of Georgian King Vakhtang Gorgasali Darchil and Mihrdat and the invasion of Persians in their reign with the sons of the ruler of Georgia （Kartli） Stephanoz III Mihrdat and Archil and invasions of Arabs and Marwan ibn Muhammad （Murvan Qru--＂Marwan the Deaf＇） that took place two centuries later, in the 30s of 8th century. Consequently, the author related the martyrdom on the background of Arab invasions. The fact that according to the author of the martyrdom, the sons of Vakhtang Gorgasali were in West Georgia, namely Anakopia, and fought the so-called Arabs there, makes it clear that the historical developments were taking place in the period of the Great Persian-Byzantine War of 542-562. In the title of the work it is mentioned that the invasion, during which the martyrdom of David and Constantine took place, happened in the vicinity of the death of Vakhtang Gorgasali. Thus, it becomes clear that King Vakhtang Gorgasali could not have died during the Persian-Byzantine War of 502-505 and that the Great Invasion of Persians described in the ＂Georgian Chronicles＂, in which Vakhtang Gorgasali was wounded, could only have happened in 527. The king must have died during a war between Persia and Byzantium in 527-532, more specifically in 527 when Persians invaded Georgia. Proceeding from the above, the surmise of Cyril Toumanoff regarding the death of Vakhtang Gorgasali in 527 becomes more convincing and well-grounded. Since it is known that King Vakhtang Gorgasali lived 60 years, the date of his birth can be presumed to be 466-467. This gives us an opportunity to establish a more precise date of reign ofVakhtang＇s father-Mihrdat and his grandfather-Archil. The dates of reign we have put forward for kings Mihrdat and Archil （Archil ,130-463, Mihrdat--463-473） correspond to the information of the Assyrian version of the Life of Peter the Iberian.

汉魏时期来氏家族考论

在中国中古时代门阀政治或宗族制度等问题的研究中,'崔卢李郑''王谢袁萧'诸族历来颇受关注,一些知名度相对较低、影响力局限于特定区域的家族,则不免受到冷落。隋唐时期的江都来氏,就属于这一类地方性家族。作为隋唐时期在扬州地区有较大影响的地方性家族,江都来氏一直没有引起学术界应有的关注,其中一个重要原因可能与史学叙述有关,隋唐时期江都来氏人物入于正史,且有较为详细记录者,仅有来护儿入《隋书》。

Clinical observation of pediatric Tuina plus oral Chinese medication for pediatric anorexia due to spleen failing in transportation

Objective To observe the clinical efficacy of pediatric Tuina(Chinese therapeutic massage)plus oral administration of Chinese medication for pediatric anorexia due to spleen failing in transportation.Methods A total of 94 children with anorexia due to spleen failing in transportation were randomized into an observation group and a control group by the random number table method at a ratio of 1:1,with 47 cases in each group.The control group was treated with modified Bu Huan Jin Zheng Qi San,and the observation group was treated with additional Tuina manipulation of Yun Shui Ru Tu based on the treatment in the control group.After 4 weeks of treatment,the clinical efficacy of the two groups was observed,and the traditional Chinese medicine(TCM)symptom score,serum leptin,neuropeptide Y,and serum zinc and calcium levels were compared.Results After 4 weeks of treatment,the total effective rate of the observation group was 87.2%,and that of the control group was 74.5%.The difference between the two groups was statistically significant( P<0.05).After treatment,the TCM symptom scores in both groups decreased significantly(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).After treatment,the serum leptin level in both groups decreased,and the level in the observation group was lower than that in the control group(P<0.05).The serum neuropeptide Y,zinc,and calcium levels in both groups increased after treatment,and the levels in the observation group were higher than those in the control group(P<0.05).Conclusion Tuina manipulation of Yun Shui Ru Tu plus oral administration of Chinese medication is significantly effective in treating pediatric anorexia due to spleen failing in transportation,which can improve the appetite of children and improve the symptoms of anorexia,and the curative effect is better than that of oral administration of Chinese medication alone.

Modeling impulsive resource inputs in host-parasitoid interactions with time delays

For the interaction of parasitoids and their insect hosts in the laboratory environment, a novel mathematical model with impulsive resource inputs, stage-structure, maturation delays and negative binomial distribution is proposed. Based on the adaptability of the insect host to the environment, we study the permanence of the system in two cases and gain conditions under which the host and parasitoid species can coexist with impulsive resource inputs. We also discuss the existence of the positive periodic solution when the system is permanent by applying a fixed point theory. Besides, we perform numerical simulations which not only confirm but also further enhance our theoretical results. The simulations show that when total input of resource is fixed, smaller input amounts with shorter periods of impulsive delivery produce smaller oscillation amplitudes for both the host and parasitoid populations at the juvenile stage. However, both the densities of adult host and adult parasitoid are not affected by the resource management strategy. Furthermore, we also reconfirm that larger maturation delays, either the host or the parasitoid＇s delay, lead to any more individuals staying at the inmature stage of the species, while the adult populations decline dramatically at the same time. On the other hand, larger host maturation delays promote the parasitoid＇s population growth at both stages, and the impact of parasitoid maturation delay on the host population is almost the same but not as dramatic. These findings give us a deeper understanding about the host parasitoid interaction in laboratory environment.

Natural selection on flower size in invasive Cytisus scoparius along an elevation gradient

Aims Established invasive plant species have more diverse gene pools than single populations in their home range.This genetic and often phenotypic variation allows for natural selection to act and produce rapid adaptations as an invasive species interacts with other members of the community.For an invasive flowering plant,interactions with pollinators may lead to adaptations to a heterogeneous pollinator community.The variation in the pollinator community in the invaded range is similar to variation in the native range,suggesting that adaptations may mirror patterns seen in the home range.In this study,we investigated variation in flower size in Cytisus scoparius,an invasive leguminous shrub,along an elevation gradient.Methods This study took place in the Capitol State Forest in Washington State.We measured flower widths and the proportion of visited flowers,using 10 plants per field site.Sites were located along an elevation gradient and were visited three times to measure phenological variation on a per-plant basis.Important Findings We saw positive selection for flower size,albeit without a distinct pattern of higher selection at higher elevations.The pattern of natural selection could be seen both in terms of pollinator visitation rates and in seed production.We also found that the largest contributor to changes in seed production was not elevation or flower size but management practices.