Renal dysfunction is a prognostic marker in patients with cardiovascular disease. However, no long-term follow-up studies on the influence of mild renal dysfunction on mortality in patients undergoing coronary bypass ...Renal dysfunction is a prognostic marker in patients with cardiovascular disease. However, no long-term follow-up studies on the influence of mild renal dysfunction on mortality in patients undergoing coronary bypass grafting have been reported. Therefore, we aimed to identify the significance of preoperative(mild) renal dysfunction as a long-term predictor of clinical outcome after coronary bypass surgery. In 358 patients who underwent isolated saphenous vein aorta-coronary artery bypass grafting, estimated glomerular filtration rates were calculated with the Cockroft-Gault equation(GFRc). Patients were categorized into 2 groups(group 1, GFRc >71.1 mL·min·1.73 m-2; group 2, GFRc< 71.1 mL·min·1.73 m-2). Multivariate Cox proportional hazard analyses were performed to determine the independent prognostic value of GFRc. During a median follow-up of 18.2 years, 233 patients(65.1%) died. Patients who died had lower GFRc and were older. Multivariate analysis demonstrated that total mortality in patients with lower GFRc was significantly increased(lower GFRc group vs normal GFRc group: hazard ratio, 1.44; P=. 019). Lower GFRc was also an independent predictor of cardiac mortality(hazard ratio, 1.51; P=. 032). No significant differences were observed between groups in the occurrence of myocardial infarction and the need for reintervention. Our study demonstrates that after long-term follow-up, preoperative mild renal dysfunction is an independent predictor of long-term(cardiac) mortality in patients who undergo coronary artery bypass grafting.展开更多
Objective To observe the value of deep learning echocardiographic intelligent model for evaluation on left ventricular(LV)regional wall motion abnormalities(RWMA).Methods Apical two-chamber,three-chamber and four-cham...Objective To observe the value of deep learning echocardiographic intelligent model for evaluation on left ventricular(LV)regional wall motion abnormalities(RWMA).Methods Apical two-chamber,three-chamber and four-chamber views two-dimensional echocardiograms were obtained prospectively in 205 patients with coronary heart disease.The model for evaluating LV regional contractile function was constructed using a five-fold cross-validation method to automatically identify the presence of RWMA or not,and the performance of this model was assessed taken manual interpretation of RWMA as standards.Results Among 205 patients,RWMA was detected in totally 650 segments in 83 cases.LV myocardial segmentation model demonstrated good efficacy for delineation of LV myocardium.The average Dice similarity coefficient for LV myocardial segmentation results in the apical two-chamber,three-chamber and four-chamber views was 0.85,0.82 and 0.88,respectively.LV myocardial segmentation model accurately segmented LV myocardium in apical two-chamber,three-chamber and four-chamber views.The mean area under the curve(AUC)of RWMA identification model was 0.843±0.071,with sensitivity of(64.19±14.85)%,specificity of(89.44±7.31)%and accuracy of(85.22±4.37)%.Conclusion Deep learning echocardiographic intelligent model could be used to automatically evaluate LV regional contractile function,hence rapidly and accurately identifying RWMA.展开更多
A new low power quasi adiabatic logic,complementary pass transistor adiabatic logic (CPAL),is presented.The CPAL circuit is driven by a new three phase power clock,and its non adiabatic loss on output loads can b...A new low power quasi adiabatic logic,complementary pass transistor adiabatic logic (CPAL),is presented.The CPAL circuit is driven by a new three phase power clock,and its non adiabatic loss on output loads can be effectively reduced by using complementary pass transistor logic and transmission gates.Furthermore,the minimization of the energy consumption can be obtained by choosing the optimal size of bootstrapped nMOS transistors,thus it has more efficient energy transfer and recovery.A three phase power supply generator with a small control logic circuit and a single inductor is proposed.An 8 bit adder based on CPAL is designed and verified.With MOSIS 0 25μm CMOS technology,the CPAL adder consumes only 35% of the dissipated energy of a 2N 2N2P adder and is about 50% of the dissipated energy of a PFAL adder for clock rates ranging from 50 to 200MHz.展开更多
文摘Renal dysfunction is a prognostic marker in patients with cardiovascular disease. However, no long-term follow-up studies on the influence of mild renal dysfunction on mortality in patients undergoing coronary bypass grafting have been reported. Therefore, we aimed to identify the significance of preoperative(mild) renal dysfunction as a long-term predictor of clinical outcome after coronary bypass surgery. In 358 patients who underwent isolated saphenous vein aorta-coronary artery bypass grafting, estimated glomerular filtration rates were calculated with the Cockroft-Gault equation(GFRc). Patients were categorized into 2 groups(group 1, GFRc >71.1 mL·min·1.73 m-2; group 2, GFRc< 71.1 mL·min·1.73 m-2). Multivariate Cox proportional hazard analyses were performed to determine the independent prognostic value of GFRc. During a median follow-up of 18.2 years, 233 patients(65.1%) died. Patients who died had lower GFRc and were older. Multivariate analysis demonstrated that total mortality in patients with lower GFRc was significantly increased(lower GFRc group vs normal GFRc group: hazard ratio, 1.44; P=. 019). Lower GFRc was also an independent predictor of cardiac mortality(hazard ratio, 1.51; P=. 032). No significant differences were observed between groups in the occurrence of myocardial infarction and the need for reintervention. Our study demonstrates that after long-term follow-up, preoperative mild renal dysfunction is an independent predictor of long-term(cardiac) mortality in patients who undergo coronary artery bypass grafting.
文摘Objective To observe the value of deep learning echocardiographic intelligent model for evaluation on left ventricular(LV)regional wall motion abnormalities(RWMA).Methods Apical two-chamber,three-chamber and four-chamber views two-dimensional echocardiograms were obtained prospectively in 205 patients with coronary heart disease.The model for evaluating LV regional contractile function was constructed using a five-fold cross-validation method to automatically identify the presence of RWMA or not,and the performance of this model was assessed taken manual interpretation of RWMA as standards.Results Among 205 patients,RWMA was detected in totally 650 segments in 83 cases.LV myocardial segmentation model demonstrated good efficacy for delineation of LV myocardium.The average Dice similarity coefficient for LV myocardial segmentation results in the apical two-chamber,three-chamber and four-chamber views was 0.85,0.82 and 0.88,respectively.LV myocardial segmentation model accurately segmented LV myocardium in apical two-chamber,three-chamber and four-chamber views.The mean area under the curve(AUC)of RWMA identification model was 0.843±0.071,with sensitivity of(64.19±14.85)%,specificity of(89.44±7.31)%and accuracy of(85.22±4.37)%.Conclusion Deep learning echocardiographic intelligent model could be used to automatically evaluate LV regional contractile function,hence rapidly and accurately identifying RWMA.
文摘A new low power quasi adiabatic logic,complementary pass transistor adiabatic logic (CPAL),is presented.The CPAL circuit is driven by a new three phase power clock,and its non adiabatic loss on output loads can be effectively reduced by using complementary pass transistor logic and transmission gates.Furthermore,the minimization of the energy consumption can be obtained by choosing the optimal size of bootstrapped nMOS transistors,thus it has more efficient energy transfer and recovery.A three phase power supply generator with a small control logic circuit and a single inductor is proposed.An 8 bit adder based on CPAL is designed and verified.With MOSIS 0 25μm CMOS technology,the CPAL adder consumes only 35% of the dissipated energy of a 2N 2N2P adder and is about 50% of the dissipated energy of a PFAL adder for clock rates ranging from 50 to 200MHz.
