The present study investigated diagnostically the seasonal variation of the bypassing flows caused by the splitting effect of the Tibetan Plateau （TP）. The relationships among the splitting bypassing flows around th...The present study investigated diagnostically the seasonal variation of the bypassing flows caused by the splitting effect of the Tibetan Plateau （TP）. The relationships among the splitting bypassing flows around the TP to precipitation in China, the westerly jet stream, and the thermal status over the TP are revealed. The bypassing flows occur from the 1st to the 22nd pentad and from the 59th to the 73rd pentad, respectively, and they disappear from the 29th to the 58th pentad. They are strongest in winter from the 1st to the 22nd pentad and from the 59th to the 73rd pentad, respectively. During the rebuilding of the bypassing flows from mid-October to mid-February, they are the main cause of precipitation over southeastern China. The enhancement of the bypassing flow intensity in March can cause the precipitation to increase in the early stage of the persistent spring rain over southeastern China. From winter to summer, the seasonal transition of the bypassing flows in the lower troposphere precedes that of the westerly jet stream axis in the upper troposphere to the west of the TP by -4 pentads, while from summer to winter lags by -4 pentads. The seasonal variation of the thermal status over the TP plays an important role in the bypassing flows around the TP. The strengthening of the heating over the cooling over the TP is related to the rebuilding and TP weakens the bypassing flows, and the increase in strengthening of the bypassing flows.展开更多
Objective： To Comparatively study grafts flow between on-pump and off-pump coronary bypass surgery for patients with triple coronary artery disease. Methods ： The grafts flow was studied in 100 patients of OPCAB and...Objective： To Comparatively study grafts flow between on-pump and off-pump coronary bypass surgery for patients with triple coronary artery disease. Methods ： The grafts flow was studied in 100 patients of OPCAB and compared with 100 cases of CCABG by means of Medi-Stim Butterfly Flowmeter measurement intraoperatively. Results： The mean number of the distal anastomosis was 3.78＋ 1.11 in CCABG group, and 3.83 ＋ 0.93 in OPCAB group. The index of completeness of revascularization in CCABG group was 1.01 ＋ 0.08, and 1.10＋ 0.09 in OPCAB group. The flow of grafts was satisfied in all patients. The PI values were all under 5. There was no significant difference in the mean graft flow and PI value between two groups. Conclusion： OPCAB can provide the same grafts flow and similar completeness of revascularization when compared with CCABG which indicates the similar anastomosis quality of grafts in OPCAB and CCABG groups.展开更多
Flood is occurring more frequently in Kuching nowadays due to the impact of climate change and rapid urbanization. The only discharge outlet for Sarawak River Basin currently is at Kuching Barrage and Shiplock. Sarawa...Flood is occurring more frequently in Kuching nowadays due to the impact of climate change and rapid urbanization. The only discharge outlet for Sarawak River Basin currently is at Kuching Barrage and Shiplock. Sarawak State Government had decided to build Matang Bypass Channel from Sarawak River’s “Oxbow” to Batang Salak River for mitigating the flooding issues within Sarawak River Basin. Matang Bypass Channel had a bottom width of 250 m, 500 m reserve width and 8 Km in length. Flow behaviour with two discharge outlets during low tides are unknown yet. Therefore, this research is carried out to study Sarawak River flow behaviour after construction of Matang Bypass Channel using InfoWorks River Simulation (RS). Rainfall data used is January 2018. Four scenarios investigated are 1) Open two gates at Matang Bypass Channel opens and all gates at Kuching Barrage, 2) Open all gates at Matang Bypass Channel and Kuching Barrage, 3) Open gates at Matang Bypass Channel, but close all gates at Kuching Barrage, 4) Close all gates at Matang Bypass Channel, but open all gates at Kuching Barrage. Results revealed that when water gates are opened, sea water has the potential to backflow into Sarawak River basin through Kuching Barrage since sea level at Kuching Barrage discharge outlet is always 0.5 m higher than Matang Bypass Channel discharge outlet. When the gates at Matang Bypass Channel are fully opened and Kuching Barrage are closed, Kuching Barrage will retain the excess water and the river water will only be discharged into ocean through Matang Bypass Channel. In contrast, as the gates at Matang Bypass Channel are closed and at Kuching Barrage are fully opened, Matang Bypass Channel will store the excess water and river water will be discharged through Kuching Barrage alone.展开更多
Objective\ The relationship between graft blood flow, epicardial microflow, mean arterial pressure and hemorheologic changes was studied during intraoperative heart failure. Methods\ These parameters were done to ...Objective\ The relationship between graft blood flow, epicardial microflow, mean arterial pressure and hemorheologic changes was studied during intraoperative heart failure. Methods\ These parameters were done to evaluate the use of repeated cardiopulmonary bypass support for the intraoperative heart failure following aorto coronary bypass surgery. Included in this study were 10 patients with a mean age of 70 and unstable angina undergoing coronary bypass grafting and suffering from intraoperative heart failure. The epicardiai microflow, graft flow, mean arterial pressure and blood cell filterability were measured. Resluts\ During heart failure, the mean arterial pressure fell by 41%(P<0.01), graft flow by 67%(P<0.01) and epicardialmicroflow by 64%(P<0.01). After 15 to 56 min of assisted cardiopulmonary bypass support, the epicardial microflow and graft flow were partially restored, while red cell and white cell filterability was reduced by 31% and 64% respectively (P<0.01). There were significant correlations between graft flow, epicardial microflow, blood cell filterability and cardiopulmonary bypass time. All patients recovered and were discharged from the hospital.Conclusion\ It is concluded that the use of temporary assisted CPB support to treat intrapoperative heart failure allows the recovery of the myocardium and thereby restores the mean arterial pressure. The recovery of graft flow and epicardial flow occurred to a lesser extent. The CPB support seemed to be suitable for about 60 min probably because of increasing disturbance to the blood cell filterability, graft flow and the epicardial microcirculation.\;展开更多
In this paper, the subject of mathematical model is a series of math expressions, which is used to calculate different regions＇ volume fraction and analyze flow characterization in multi-strand tundish. But research ...In this paper, the subject of mathematical model is a series of math expressions, which is used to calculate different regions＇ volume fraction and analyze flow characterization in multi-strand tundish. But research about mathematical model for multi-strand tundish is few, and so far, there has been no acknowledged math model for multi- strand tundish to describe its flow characteristic. If Sahai＇s model, which is originally proposed for the case of single-strand tundish （proposed in reference, and this model is widely used in the world）, is applied to describe flow feature in multi-strand tundish, the calculation results would be unreasonable. Based on the data of watermodel experiment results, the sum of each strand＇s dead region＇s volume fraction is bigger than 100%, and this obviously doesn＇T agree with reality; and the value of dead region＇s volume fraction is calculated to be minus according to mathematical simulation results data in another case. What＇s more, Sahai＇s model does not propose the standard of plotting the RTD-curve, and this makes scholars around the world can＇t achieve consensus of views about plotting RTD-curve. And the model doesn＇t consider the bypass flow and can＇t calculate its volume fraction, but bypass flow is critical to tundish metallurgy. And through Sahai＇s model, the calculation result of plug flow region＇s volume fraction is also not reasonable, because the model doesn＇t well describe the essence of plug flow. So these suggest that it is not reliable to apply Sahai＇s single-strand tundish model to multi-strand tundish case. Then a new model is attempted to propose in this paper for your discussion. In the new model, the standard of plotting RTD curve is definitely proposed, and relative calculation method is also proposed; and the feature of dead region is carefully studied and the model proposes a new method to calculate its volume fraction, and the calculation formula about its volume fraction can be adjustable according the actual demand; what＇s more, the new model considers the bypass flow and proposes a method to calculate its volume fraction for the first time, and then volume fraction of plug flow region, backmix flow region, dead region and bypass flow can be calculated and obtained at the same time; and this new model can better capture the deviation of reality flow pattern from ideal plug flow pattern, and reflects the feature of plug flow.展开更多
Flow fractional reserve(FFR) allows to evaluate the functional significance of coronary artery lesions, through the ratio of the mean coronary artery pressure after the stenosis to the mean aortic pressure duringmaxim...Flow fractional reserve(FFR) allows to evaluate the functional significance of coronary artery lesions, through the ratio of the mean coronary artery pressure after the stenosis to the mean aortic pressure duringmaximum hyperemia. The actual widely accepted cutoff value is 0.80. Below this value a coronary lesion is considered significant and therefore it requires invasive revascularization. Several studies [in particular Fractional Flow Reserve vs Angiography for Multivessel Evaluation 1(FAME-1) and FAME-2] have shown the relationship between FFR measurement and hard end-points(death, myocardial infarction, and urgent revascularization). Consequently, FFR evaluation represents the cornerstone in the decision-making in intermediate coronary lesions. Recent studies paved the way for further applications of FFR evaluation in complex and tricky clinical settings. In this paper, we perform an overview of the data regarding contemporary application of FFR. In particular, we review the use of FFR in: left main intermediate stenoses, serial stenoses, evaluation after stenting, guidance in coronary artery bypass surgery, and acute coronary syndrome. All the data presented in our overview confirm the essential role of FFR assessment in the daily clinical practice. The shift from "operator-dependent" to "FFR-dependent" evaluation in intermediate coronary artery stenosis is of paramount importance in order to improve the prognosis of our patients, through the discrimination of the functional role of every single coronary stenosis.展开更多
The data about FFR-guided revascularization in isolated proximal LAD disease are limited and studies comparing long-term outcomes of FFR-guided PCI versus FFR-guided CABG in single-vessel proximal LAD disease are lack...The data about FFR-guided revascularization in isolated proximal LAD disease are limited and studies comparing long-term outcomes of FFR-guided PCI versus FFR-guided CABG in single-vessel proximal LAD disease are lacking. We aimed to assess the 4-year long-term safety and effectiveness of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) and FFR-guided coronary artery bypass graft surgery (CABG) for the treatment of proximal left anterior descending (LAD) lesions. The study included 129 patients with functionally significant (FFR ≤ 0.80) isolated proximal LAD stenosis (PCI, 88 patients vs. CABG, 41). Clinical endpoints were assessed by Kaplan-Meier method and compared by the log-rank test. At a mean follow-up time of 47 ± 12 months, a higher incidence of myocardial infarction in the PCI group (PCI: 32% vs. CABG: 15%;p = 0.003) and a higher incidence of stroke in the CABG group (CABG: 3 (7%) vs. PCI 0 (0%);p = 0.031) were observed. However, there were no significant differences in the primary composite endpoint, death and target vessel revascularization between PCI and CABG groups. The PCI and CABG in isolated proximal LAD lesions yielded similar long-term outcomes regarding the primary composite clinical endpoints. However, stroke was more frequent in the CABG group than in the PCI group.展开更多
Transit-time flow technology is considered as a quality of care in bypass surgery especially in off pump revascularization. Transit time flow measurement is a real time, direct, easy and handy tool for assessment qual...Transit-time flow technology is considered as a quality of care in bypass surgery especially in off pump revascularization. Transit time flow measurement is a real time, direct, easy and handy tool for assessment quality of anastomosis and graft blood flow.展开更多
The authors are reporting on a study drawn from unpublished dissertation done by the corresponding author when he completed his neurosurgical training in Paris, France in 2004, few years before the advent of flow dive...The authors are reporting on a study drawn from unpublished dissertation done by the corresponding author when he completed his neurosurgical training in Paris, France in 2004, few years before the advent of flow diverters. The study was a retrospective review of giant intracranial aneurysms treated by superficial temporal artery to middle cerebral artery bypass combined with endovascular occlusion of the parent artery. From 1990 to 2003, 29 consecutive cases of giant cerebral aneurysms, not suitable to selective treatment were managed in that way. Twenty-one medical records had enough data to allow objective evaluation. Sixteen female and five male patients bearing 21 giant aneurysms were involved. Their mean age was 46 years. The aneurysm was revealed by mass effect in 13 cases and subarachnoid hemorrhage in one case. On admission 19 patients presented with unruptured aneurysms and two have sustained a subarachnoid hemorrhage. The balloon occlusion test before the bypass operation was not tolerated in 18 patients. The treatment was completed in 19 patients and 17 of them had parent artery occlusion with latex detachable balloons. The only death of the series occurred before the endovascular treatment. The mean follow-up period was 30 months. After completion of the treatment, 16 (84%) patients had no symptom. Aneurysm recanalization or rupture was not observed after the parent artery occlusion. With the combination of superficial temporal artery to middle cerebral artery bypass + endovascular parent artery occlusion, 90% of giant intracranial aneurysms untreatable selectively were permanently excluded with a good outcome in 95%.展开更多
基金supported by the National Natural Science Foundation of China (Grant No.40921003)the International S&T Cooperation Project of the Ministry of Science and Technology of China under Grant No. 2009DFA21430
文摘The present study investigated diagnostically the seasonal variation of the bypassing flows caused by the splitting effect of the Tibetan Plateau （TP）. The relationships among the splitting bypassing flows around the TP to precipitation in China, the westerly jet stream, and the thermal status over the TP are revealed. The bypassing flows occur from the 1st to the 22nd pentad and from the 59th to the 73rd pentad, respectively, and they disappear from the 29th to the 58th pentad. They are strongest in winter from the 1st to the 22nd pentad and from the 59th to the 73rd pentad, respectively. During the rebuilding of the bypassing flows from mid-October to mid-February, they are the main cause of precipitation over southeastern China. The enhancement of the bypassing flow intensity in March can cause the precipitation to increase in the early stage of the persistent spring rain over southeastern China. From winter to summer, the seasonal transition of the bypassing flows in the lower troposphere precedes that of the westerly jet stream axis in the upper troposphere to the west of the TP by -4 pentads, while from summer to winter lags by -4 pentads. The seasonal variation of the thermal status over the TP plays an important role in the bypassing flows around the TP. The strengthening of the heating over the cooling over the TP is related to the rebuilding and TP weakens the bypassing flows, and the increase in strengthening of the bypassing flows.
文摘Objective： To Comparatively study grafts flow between on-pump and off-pump coronary bypass surgery for patients with triple coronary artery disease. Methods ： The grafts flow was studied in 100 patients of OPCAB and compared with 100 cases of CCABG by means of Medi-Stim Butterfly Flowmeter measurement intraoperatively. Results： The mean number of the distal anastomosis was 3.78＋ 1.11 in CCABG group, and 3.83 ＋ 0.93 in OPCAB group. The index of completeness of revascularization in CCABG group was 1.01 ＋ 0.08, and 1.10＋ 0.09 in OPCAB group. The flow of grafts was satisfied in all patients. The PI values were all under 5. There was no significant difference in the mean graft flow and PI value between two groups. Conclusion： OPCAB can provide the same grafts flow and similar completeness of revascularization when compared with CCABG which indicates the similar anastomosis quality of grafts in OPCAB and CCABG groups.
文摘Flood is occurring more frequently in Kuching nowadays due to the impact of climate change and rapid urbanization. The only discharge outlet for Sarawak River Basin currently is at Kuching Barrage and Shiplock. Sarawak State Government had decided to build Matang Bypass Channel from Sarawak River’s “Oxbow” to Batang Salak River for mitigating the flooding issues within Sarawak River Basin. Matang Bypass Channel had a bottom width of 250 m, 500 m reserve width and 8 Km in length. Flow behaviour with two discharge outlets during low tides are unknown yet. Therefore, this research is carried out to study Sarawak River flow behaviour after construction of Matang Bypass Channel using InfoWorks River Simulation (RS). Rainfall data used is January 2018. Four scenarios investigated are 1) Open two gates at Matang Bypass Channel opens and all gates at Kuching Barrage, 2) Open all gates at Matang Bypass Channel and Kuching Barrage, 3) Open gates at Matang Bypass Channel, but close all gates at Kuching Barrage, 4) Close all gates at Matang Bypass Channel, but open all gates at Kuching Barrage. Results revealed that when water gates are opened, sea water has the potential to backflow into Sarawak River basin through Kuching Barrage since sea level at Kuching Barrage discharge outlet is always 0.5 m higher than Matang Bypass Channel discharge outlet. When the gates at Matang Bypass Channel are fully opened and Kuching Barrage are closed, Kuching Barrage will retain the excess water and the river water will only be discharged into ocean through Matang Bypass Channel. In contrast, as the gates at Matang Bypass Channel are closed and at Kuching Barrage are fully opened, Matang Bypass Channel will store the excess water and river water will be discharged through Kuching Barrage alone.
文摘Objective\ The relationship between graft blood flow, epicardial microflow, mean arterial pressure and hemorheologic changes was studied during intraoperative heart failure. Methods\ These parameters were done to evaluate the use of repeated cardiopulmonary bypass support for the intraoperative heart failure following aorto coronary bypass surgery. Included in this study were 10 patients with a mean age of 70 and unstable angina undergoing coronary bypass grafting and suffering from intraoperative heart failure. The epicardiai microflow, graft flow, mean arterial pressure and blood cell filterability were measured. Resluts\ During heart failure, the mean arterial pressure fell by 41%(P<0.01), graft flow by 67%(P<0.01) and epicardialmicroflow by 64%(P<0.01). After 15 to 56 min of assisted cardiopulmonary bypass support, the epicardial microflow and graft flow were partially restored, while red cell and white cell filterability was reduced by 31% and 64% respectively (P<0.01). There were significant correlations between graft flow, epicardial microflow, blood cell filterability and cardiopulmonary bypass time. All patients recovered and were discharged from the hospital.Conclusion\ It is concluded that the use of temporary assisted CPB support to treat intrapoperative heart failure allows the recovery of the myocardium and thereby restores the mean arterial pressure. The recovery of graft flow and epicardial flow occurred to a lesser extent. The CPB support seemed to be suitable for about 60 min probably because of increasing disturbance to the blood cell filterability, graft flow and the epicardial microcirculation.\;
基金supported by the National Natural Science Foundation of China(No.60672145)
文摘In this paper, the subject of mathematical model is a series of math expressions, which is used to calculate different regions＇ volume fraction and analyze flow characterization in multi-strand tundish. But research about mathematical model for multi-strand tundish is few, and so far, there has been no acknowledged math model for multi- strand tundish to describe its flow characteristic. If Sahai＇s model, which is originally proposed for the case of single-strand tundish （proposed in reference, and this model is widely used in the world）, is applied to describe flow feature in multi-strand tundish, the calculation results would be unreasonable. Based on the data of watermodel experiment results, the sum of each strand＇s dead region＇s volume fraction is bigger than 100%, and this obviously doesn＇T agree with reality; and the value of dead region＇s volume fraction is calculated to be minus according to mathematical simulation results data in another case. What＇s more, Sahai＇s model does not propose the standard of plotting the RTD-curve, and this makes scholars around the world can＇t achieve consensus of views about plotting RTD-curve. And the model doesn＇t consider the bypass flow and can＇t calculate its volume fraction, but bypass flow is critical to tundish metallurgy. And through Sahai＇s model, the calculation result of plug flow region＇s volume fraction is also not reasonable, because the model doesn＇t well describe the essence of plug flow. So these suggest that it is not reliable to apply Sahai＇s single-strand tundish model to multi-strand tundish case. Then a new model is attempted to propose in this paper for your discussion. In the new model, the standard of plotting RTD curve is definitely proposed, and relative calculation method is also proposed; and the feature of dead region is carefully studied and the model proposes a new method to calculate its volume fraction, and the calculation formula about its volume fraction can be adjustable according the actual demand; what＇s more, the new model considers the bypass flow and proposes a method to calculate its volume fraction for the first time, and then volume fraction of plug flow region, backmix flow region, dead region and bypass flow can be calculated and obtained at the same time; and this new model can better capture the deviation of reality flow pattern from ideal plug flow pattern, and reflects the feature of plug flow.
文摘Flow fractional reserve(FFR) allows to evaluate the functional significance of coronary artery lesions, through the ratio of the mean coronary artery pressure after the stenosis to the mean aortic pressure duringmaximum hyperemia. The actual widely accepted cutoff value is 0.80. Below this value a coronary lesion is considered significant and therefore it requires invasive revascularization. Several studies [in particular Fractional Flow Reserve vs Angiography for Multivessel Evaluation 1(FAME-1) and FAME-2] have shown the relationship between FFR measurement and hard end-points(death, myocardial infarction, and urgent revascularization). Consequently, FFR evaluation represents the cornerstone in the decision-making in intermediate coronary lesions. Recent studies paved the way for further applications of FFR evaluation in complex and tricky clinical settings. In this paper, we perform an overview of the data regarding contemporary application of FFR. In particular, we review the use of FFR in: left main intermediate stenoses, serial stenoses, evaluation after stenting, guidance in coronary artery bypass surgery, and acute coronary syndrome. All the data presented in our overview confirm the essential role of FFR assessment in the daily clinical practice. The shift from "operator-dependent" to "FFR-dependent" evaluation in intermediate coronary artery stenosis is of paramount importance in order to improve the prognosis of our patients, through the discrimination of the functional role of every single coronary stenosis.
文摘The data about FFR-guided revascularization in isolated proximal LAD disease are limited and studies comparing long-term outcomes of FFR-guided PCI versus FFR-guided CABG in single-vessel proximal LAD disease are lacking. We aimed to assess the 4-year long-term safety and effectiveness of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) and FFR-guided coronary artery bypass graft surgery (CABG) for the treatment of proximal left anterior descending (LAD) lesions. The study included 129 patients with functionally significant (FFR ≤ 0.80) isolated proximal LAD stenosis (PCI, 88 patients vs. CABG, 41). Clinical endpoints were assessed by Kaplan-Meier method and compared by the log-rank test. At a mean follow-up time of 47 ± 12 months, a higher incidence of myocardial infarction in the PCI group (PCI: 32% vs. CABG: 15%;p = 0.003) and a higher incidence of stroke in the CABG group (CABG: 3 (7%) vs. PCI 0 (0%);p = 0.031) were observed. However, there were no significant differences in the primary composite endpoint, death and target vessel revascularization between PCI and CABG groups. The PCI and CABG in isolated proximal LAD lesions yielded similar long-term outcomes regarding the primary composite clinical endpoints. However, stroke was more frequent in the CABG group than in the PCI group.
文摘Transit-time flow technology is considered as a quality of care in bypass surgery especially in off pump revascularization. Transit time flow measurement is a real time, direct, easy and handy tool for assessment quality of anastomosis and graft blood flow.
文摘The authors are reporting on a study drawn from unpublished dissertation done by the corresponding author when he completed his neurosurgical training in Paris, France in 2004, few years before the advent of flow diverters. The study was a retrospective review of giant intracranial aneurysms treated by superficial temporal artery to middle cerebral artery bypass combined with endovascular occlusion of the parent artery. From 1990 to 2003, 29 consecutive cases of giant cerebral aneurysms, not suitable to selective treatment were managed in that way. Twenty-one medical records had enough data to allow objective evaluation. Sixteen female and five male patients bearing 21 giant aneurysms were involved. Their mean age was 46 years. The aneurysm was revealed by mass effect in 13 cases and subarachnoid hemorrhage in one case. On admission 19 patients presented with unruptured aneurysms and two have sustained a subarachnoid hemorrhage. The balloon occlusion test before the bypass operation was not tolerated in 18 patients. The treatment was completed in 19 patients and 17 of them had parent artery occlusion with latex detachable balloons. The only death of the series occurred before the endovascular treatment. The mean follow-up period was 30 months. After completion of the treatment, 16 (84%) patients had no symptom. Aneurysm recanalization or rupture was not observed after the parent artery occlusion. With the combination of superficial temporal artery to middle cerebral artery bypass + endovascular parent artery occlusion, 90% of giant intracranial aneurysms untreatable selectively were permanently excluded with a good outcome in 95%.
