AIM: To identify factors that were related to the short term effectiveness of percutaneous transhepatic biliary drainage in cholangiocarcinoma patients and to evaluate the impact of palliative drainage on their surviv...AIM: To identify factors that were related to the short term effectiveness of percutaneous transhepatic biliary drainage in cholangiocarcinoma patients and to evaluate the impact of palliative drainage on their survival. METHODS: Seventy-four patients with hilar cholangiocarcinoma who underwent percutaneous biliary drainage were enrolled in the study. The demographic and laboratory data as well as the imaging characteristics were retrospectively analyzed to correlate with the bile output and reduction rate of serum bilirubin 1 wk after drainage.RESULTS: Patients with more bile duct visualized on percutaneous transhepatic cholangiography or absence of multiple liver metastases on imaging studies had more bile output after biliary drainage [odds ratio (OR): 8.471, P = 0.010 and OR: 1.959, P = 0.022, respectively]. Patients with prolonged prothrombin time had a slow decrease in serum bilirubin (OR: 0.437, P = 0.005). The median survival time was not signif icantly different in patients with low or high bile output (75 d vs 125 d, P = 0.573) or in patients with slow or rapid reduction of serum bilirubin (88 d vs 94 d, P = 0.576). CONCLUSION: The short term effectiveness of percutaneous biliary drainage was related to patient's prothrombin time or the extent of tumor involvement. It, however, had no impact on survival.展开更多
Understanding the relationship between hillslope soil loss with ephemeral gully and rainfall regime is important for soil loss prediction and erosion control. Based on 12-year field observation data, this paper quanti...Understanding the relationship between hillslope soil loss with ephemeral gully and rainfall regime is important for soil loss prediction and erosion control. Based on 12-year field observation data, this paper quantified the rainfall regime impacts on soil loss at loessial hillslope with ephemeral gully. According to three rainfall parameters including precipitation （P）, rainfall duration （t）, and maximum 30-minute rainfall intensity （I30）, 115 rainfall events were classified by using K-mean clustering method and Discriminant Analysis. The results showed that 115 rainfall events could be divided into three rainfall regimes. Rainfall Regime 1 （RR1） had large I30 values with low precipitation and short duration, while the three rainfall parameters of Rainfall Regime 3 （RR3） were inversely different compared with those of RR1; for Rainfall Regime 2 （RR2）, the precipitation, duration and Iso values were all between those of RR1 and RR3. Compared with RR2 and RR3, RR1 was the dominant rainfall regime for causing soil loss at the loessial hillslope with ephemeral gully, especially for causing extreme soil loss events. PI30 （Product of P and Izo） was selected as the key index of rainfall characteristics to fit soil loss equations. Two sets of linear regression equations between soil loss and Plzo with and without rainfall regime classification were fitted. Compared with the equation without rainfall regime classification, the cross validation results of the equations with rainfall regime classification was satisfactory. These results indicated that rainfall regime classification could not only depict rainfall characteristics precisely, but also improve soil loss equation prediction accuracy at loessial hillslope with ephemeral gully.展开更多
AIM:To investigate the spleen vascular involvement and the presence of liver fibrosis in a population of subjects with established systemic sclerosis(SSc).METHODS:In a cross-sectional fashion,17 patients with SSc were...AIM:To investigate the spleen vascular involvement and the presence of liver fibrosis in a population of subjects with established systemic sclerosis(SSc).METHODS:In a cross-sectional fashion,17 patients with SSc were compared with 18 patients suffering from hepatitis C virus(HCV) -related liver cirrhosis,grade A and B Child-Pugh classification.Eighteen non elderly subjects,apparently healthy,were used as the control group.Splenic artery resistivity index(SARI) at doppler ultraSound,transient elastography of liver and nailfold capillaroscopy were the main outcomes.RESULTS:Transient elastography values of SSc patients were similar to those of controls;5.2±1.1 vs 4.5 ±1,(P=0.07).Median Alanine amino transferase(ALT) concentrations of cirrhotic patients were greater than those of controls and SSc patients,i.e.66.5(36-89) U/L vs 29(22-34) U/L and 31(22-41) U/L,respectively,(P =0.005).SARI determinations in cirrhotic patients,although significantly higher than those found in controls and SSc patients,showed some degree of overlap with SSc patients,i.e.0.59 vs 0.52 and 0.57,respectively,(P =0.04).Mean systolic blood pressure was significantly higher in SSc patients than in cirrhotics and controls,i.e.142 mmHg vs 128.2 mmHg and 127 mmHg,respectively,(P=0.005).Mean diastolic blood pressure behaved in a similar fashion,i.e.84 mmHg vs 72.2 mmHg and 76.9 mmHg(P=0.005).Nailfold Capillaroscopy grades and diastolic blood pressure values correlated well with SARI results.CONCLUSION:An enhanced resistivity of the splenic artery was found in patients suffering from SSc;they did not have evidence of splenomegaly as well as no liver fibrosis or any other form of liver damage.展开更多
Internal energy of real warm bodies can change their kinetic-potential energy balance on Keplerian orbits and relativistic geodesic. Chiral nature of the mass results in chirality of gravitons and their energy confine...Internal energy of real warm bodies can change their kinetic-potential energy balance on Keplerian orbits and relativistic geodesic. Chiral nature of the mass results in chirality of gravitons and their energy confinement within the constant energy charge of a moving thermodynamical body. Zero energy-momentum gravitons provide dissipative self-heating and spiral fall of massive stars on gravitating centers. Computed self-heating of the pulsar PSR B1913＋16 quantitatively describes its period decay without an outward emission of metric waves in question. Deviation of warm bodies from geodesic trajectories of cold point matter complies with Einstein＇s directives toward pure field physics of material space plenum without metric singularities.展开更多
Bugs have long embodied that from which we seek protection. Whether a mild irritant （a ＂fly in the ointment＂）, a costly pest to gardeners （＂bug of W＂）, or a destructive force of Biblical proportions （a swarm ...Bugs have long embodied that from which we seek protection. Whether a mild irritant （a ＂fly in the ointment＂）, a costly pest to gardeners （＂bug of W＂）, or a destructive force of Biblical proportions （a swarm of locusts）, bugs are nature＇s warning of approaching death. This paper investigates the natura morta canvas during the Golden Age of Dutch art, focusing on how these symbols of natural evil work to enliven the visual rhetoric of the still-life as they invite spiritual contemplation. In religious-themed art, we intuitively recognize these morbid creatures as symbols of decay encroaching on domestic scenes filled with food and cut flowers. Emphasizing the short life of these perishables, bugs embody a classic tension and its dichotomous variations： the corporeal vs. the spiritual, earth vs. heaven, and sin vs. redemption. Though ostensibly a peripheral feature of the natura morta, bugs are a decidedly central motif that reflects the viewer＇s struggle with sin： Is it repellent, attractive, or repellently attractive？ This study will concern the visual rhetoric of flies, dragonflies, and bees in the works of Osias Beert, Ambrosius Bosschaert, and Georg Flegel, with an emphasis on the beasts of the devil as icons of Dutch art.展开更多
Measurement of portal pressure is pivotal in the evaluation of patients with liver cirrhosis. The measurement of the hepatic venous pressure gradient represents the reference method by which portal pressure is estimat...Measurement of portal pressure is pivotal in the evaluation of patients with liver cirrhosis. The measurement of the hepatic venous pressure gradient represents the reference method by which portal pressure is estimated. However, it is an invasive procedure that requires significant hospital resources, including experienced staff, and is associated with considerable cost. Non-invasive methods that can be reliably used to estimate the presence and the degree of portal hypertension are urgently needed in clinical practice. Biochemical and morphological parameters have been proposed for this purpose, but have shown disappointing results overall. Splanchnic Doppler ultrasonography and the analysis of microbubble contrast agent kinetics with contrast-enhanced ultrasonography have shown better accuracy for the evaluation of patients with portal hypertension. A key advancement in the non-invasive evaluation of portal hypertension has been the introduction in clinical practice of methods able to measure stiffness in the liver, as well as stiffness/congestion in the spleen. According to the data published to date, it appears to be possible to rule out clinically significant portal hypertension in patients with cirrhosis (i.e., hepatic venous pressure gradient ≥ 10 mmHg) with a level of clinically-acceptable accuracy by combining measurements of liver stiffness and spleen stiffness along with Doppler ultrasound evaluation. It is probable that the combination of these methods may also allow for the identification of patients with the most serious degree of portal hypertension, and ongoing research is helping to ensure progress in this field.展开更多
The global attractor problem of the long-short wave equations with periodic boundary condition was studied. The existence of global attractor of this problem was proved by means of a uniform a priori estimate for time.
文摘AIM: To identify factors that were related to the short term effectiveness of percutaneous transhepatic biliary drainage in cholangiocarcinoma patients and to evaluate the impact of palliative drainage on their survival. METHODS: Seventy-four patients with hilar cholangiocarcinoma who underwent percutaneous biliary drainage were enrolled in the study. The demographic and laboratory data as well as the imaging characteristics were retrospectively analyzed to correlate with the bile output and reduction rate of serum bilirubin 1 wk after drainage.RESULTS: Patients with more bile duct visualized on percutaneous transhepatic cholangiography or absence of multiple liver metastases on imaging studies had more bile output after biliary drainage [odds ratio (OR): 8.471, P = 0.010 and OR: 1.959, P = 0.022, respectively]. Patients with prolonged prothrombin time had a slow decrease in serum bilirubin (OR: 0.437, P = 0.005). The median survival time was not signif icantly different in patients with low or high bile output (75 d vs 125 d, P = 0.573) or in patients with slow or rapid reduction of serum bilirubin (88 d vs 94 d, P = 0.576). CONCLUSION: The short term effectiveness of percutaneous biliary drainage was related to patient's prothrombin time or the extent of tumor involvement. It, however, had no impact on survival.
基金supported by the National Natural Science Foundation of China(Grant No.41271299)by the Opening Fund of MWR Laboratory of Soil and Water Loss Process and Control in the Loess Plateau of China(Grant NO.2017001)
文摘Understanding the relationship between hillslope soil loss with ephemeral gully and rainfall regime is important for soil loss prediction and erosion control. Based on 12-year field observation data, this paper quantified the rainfall regime impacts on soil loss at loessial hillslope with ephemeral gully. According to three rainfall parameters including precipitation （P）, rainfall duration （t）, and maximum 30-minute rainfall intensity （I30）, 115 rainfall events were classified by using K-mean clustering method and Discriminant Analysis. The results showed that 115 rainfall events could be divided into three rainfall regimes. Rainfall Regime 1 （RR1） had large I30 values with low precipitation and short duration, while the three rainfall parameters of Rainfall Regime 3 （RR3） were inversely different compared with those of RR1; for Rainfall Regime 2 （RR2）, the precipitation, duration and Iso values were all between those of RR1 and RR3. Compared with RR2 and RR3, RR1 was the dominant rainfall regime for causing soil loss at the loessial hillslope with ephemeral gully, especially for causing extreme soil loss events. PI30 （Product of P and Izo） was selected as the key index of rainfall characteristics to fit soil loss equations. Two sets of linear regression equations between soil loss and Plzo with and without rainfall regime classification were fitted. Compared with the equation without rainfall regime classification, the cross validation results of the equations with rainfall regime classification was satisfactory. These results indicated that rainfall regime classification could not only depict rainfall characteristics precisely, but also improve soil loss equation prediction accuracy at loessial hillslope with ephemeral gully.
基金Supported by Funds of the Department of Clinical and Experimental Medicine of the Federico II University
文摘AIM:To investigate the spleen vascular involvement and the presence of liver fibrosis in a population of subjects with established systemic sclerosis(SSc).METHODS:In a cross-sectional fashion,17 patients with SSc were compared with 18 patients suffering from hepatitis C virus(HCV) -related liver cirrhosis,grade A and B Child-Pugh classification.Eighteen non elderly subjects,apparently healthy,were used as the control group.Splenic artery resistivity index(SARI) at doppler ultraSound,transient elastography of liver and nailfold capillaroscopy were the main outcomes.RESULTS:Transient elastography values of SSc patients were similar to those of controls;5.2±1.1 vs 4.5 ±1,(P=0.07).Median Alanine amino transferase(ALT) concentrations of cirrhotic patients were greater than those of controls and SSc patients,i.e.66.5(36-89) U/L vs 29(22-34) U/L and 31(22-41) U/L,respectively,(P =0.005).SARI determinations in cirrhotic patients,although significantly higher than those found in controls and SSc patients,showed some degree of overlap with SSc patients,i.e.0.59 vs 0.52 and 0.57,respectively,(P =0.04).Mean systolic blood pressure was significantly higher in SSc patients than in cirrhotics and controls,i.e.142 mmHg vs 128.2 mmHg and 127 mmHg,respectively,(P=0.005).Mean diastolic blood pressure behaved in a similar fashion,i.e.84 mmHg vs 72.2 mmHg and 76.9 mmHg(P=0.005).Nailfold Capillaroscopy grades and diastolic blood pressure values correlated well with SARI results.CONCLUSION:An enhanced resistivity of the splenic artery was found in patients suffering from SSc;they did not have evidence of splenomegaly as well as no liver fibrosis or any other form of liver damage.
文摘Internal energy of real warm bodies can change their kinetic-potential energy balance on Keplerian orbits and relativistic geodesic. Chiral nature of the mass results in chirality of gravitons and their energy confinement within the constant energy charge of a moving thermodynamical body. Zero energy-momentum gravitons provide dissipative self-heating and spiral fall of massive stars on gravitating centers. Computed self-heating of the pulsar PSR B1913＋16 quantitatively describes its period decay without an outward emission of metric waves in question. Deviation of warm bodies from geodesic trajectories of cold point matter complies with Einstein＇s directives toward pure field physics of material space plenum without metric singularities.
文摘Bugs have long embodied that from which we seek protection. Whether a mild irritant （a ＂fly in the ointment＂）, a costly pest to gardeners （＂bug of W＂）, or a destructive force of Biblical proportions （a swarm of locusts）, bugs are nature＇s warning of approaching death. This paper investigates the natura morta canvas during the Golden Age of Dutch art, focusing on how these symbols of natural evil work to enliven the visual rhetoric of the still-life as they invite spiritual contemplation. In religious-themed art, we intuitively recognize these morbid creatures as symbols of decay encroaching on domestic scenes filled with food and cut flowers. Emphasizing the short life of these perishables, bugs embody a classic tension and its dichotomous variations： the corporeal vs. the spiritual, earth vs. heaven, and sin vs. redemption. Though ostensibly a peripheral feature of the natura morta, bugs are a decidedly central motif that reflects the viewer＇s struggle with sin： Is it repellent, attractive, or repellently attractive？ This study will concern the visual rhetoric of flies, dragonflies, and bees in the works of Osias Beert, Ambrosius Bosschaert, and Georg Flegel, with an emphasis on the beasts of the devil as icons of Dutch art.
文摘Measurement of portal pressure is pivotal in the evaluation of patients with liver cirrhosis. The measurement of the hepatic venous pressure gradient represents the reference method by which portal pressure is estimated. However, it is an invasive procedure that requires significant hospital resources, including experienced staff, and is associated with considerable cost. Non-invasive methods that can be reliably used to estimate the presence and the degree of portal hypertension are urgently needed in clinical practice. Biochemical and morphological parameters have been proposed for this purpose, but have shown disappointing results overall. Splanchnic Doppler ultrasonography and the analysis of microbubble contrast agent kinetics with contrast-enhanced ultrasonography have shown better accuracy for the evaluation of patients with portal hypertension. A key advancement in the non-invasive evaluation of portal hypertension has been the introduction in clinical practice of methods able to measure stiffness in the liver, as well as stiffness/congestion in the spleen. According to the data published to date, it appears to be possible to rule out clinically significant portal hypertension in patients with cirrhosis (i.e., hepatic venous pressure gradient ≥ 10 mmHg) with a level of clinically-acceptable accuracy by combining measurements of liver stiffness and spleen stiffness along with Doppler ultrasound evaluation. It is probable that the combination of these methods may also allow for the identification of patients with the most serious degree of portal hypertension, and ongoing research is helping to ensure progress in this field.
基金the Natural Science Foundation of Henan Educational Committee(2003110005)
文摘The global attractor problem of the long-short wave equations with periodic boundary condition was studied. The existence of global attractor of this problem was proved by means of a uniform a priori estimate for time.
