Based on the working principle of satellite radars, the earthquake deformation field measured by interferometric synthetic aperture(InSAR) is the projection of ground displacement associated with the seismogenic fau...Based on the working principle of satellite radars, the earthquake deformation field measured by interferometric synthetic aperture(InSAR) is the projection of ground displacement associated with the seismogenic fault in the line of sight(LOS) of the satellite. However, LOS projections are complex, and are not only related to the ascending/descending modes and incidence angles of SAR data, but also related to the strike and motion senses of the fault. Even for the same earthquake, the LOS deformation derived from different ascending/descending data can be almost identical in one case, but quite different in another case, which makes the interpretation of InSAR seismic deformation and its comparison with field observations difficult. In this study, we undertook a quantitative analysis of the relationships between LOS observation sensitivity of InSAR and fault strike, fault motion sense, and ascending/descending modes, as well as 3D deformation fields. We studied the features and differences of the LOS deformation fields in different types of earthquakes using ascending/descending modes, with a particularly detailed analysis of the relations for a strikeslip type of earthquake. We also summarized the characteristics of LOS deformation fields of faults with different strikes and optimal observational data modes. Taking the strike-slip Yushu earthquake and the normal Gaize event as examples, we used SAR data of the ascending/descending modes to verify the results of quantitative calculations. These analyses will not only provide a more reasonable interpretation of InSAR seismic deformation fields and but also help understand the differences of seismic deformation fields revealed by data with different observational modes, therefore promoting the application of InSAR technology in seismology.展开更多
This study investigated the effects of upper-level descending inflow(ULDI)associated with inner-eyewall convection on the formation of the moat in tropical cyclones(TCs)with secondary eyewall formation(SEF).In our num...This study investigated the effects of upper-level descending inflow(ULDI)associated with inner-eyewall convection on the formation of the moat in tropical cyclones(TCs)with secondary eyewall formation(SEF).In our numerical experiments,a clear moat with SEF occurred in TCs with a significant ULDI,while no SEF occurred in TCs without a significant ULDI.The eyewall convection developed more vigorously in the control run.A ULDI occurred outside the inner-eyewall convection,where it was symmetrically unstable.The ULDI was initially triggered by the diabatic warming released by the inner eyewall and later enhanced by the cooling below the anvil cloud.The ULDI penetrated the outer edge of the inner eyewall with relatively dry air and prevented excessive solid-phase hydrometeors from being advected further outward.It produced extensive sublimation cooling of falling hydrometeors between the eyewall and the outer convection.The sublimation cooling resulted in negative buoyancy and further induced strong subsidence between the eyewall and the outer convection.As a result,a clear moat was generated.Development of the moat in the ongoing SEF prevented the outer rainband from moving farther inward,helping the outer rainband to symmetrize into an outer eyewall.In the sensitivity experiment,no significant ULDI formed since the eyewall convection was weaker,and the eyewall anvil developed relatively lower,meaning the formation of a moat and thus an outer eyewall was less likely.This study suggests that a better-represented simulation of inner-eyewall convective structures and distribution of the solid-phase hydrometeors is important to the prediction of SEF.展开更多
The right ascending lumbar vein is difficult to detect on anteroposterior abdominalradiographs because it overlaps with the inferior vena cava on anteroposteriorradiographs.Intensive observation by medical providers m...The right ascending lumbar vein is difficult to detect on anteroposterior abdominalradiographs because it overlaps with the inferior vena cava on anteroposteriorradiographs.Intensive observation by medical providers may be a cue fordiagnosis.However,knowledge of catheter misplacement of the right ascendinglumbar vein is also necessary,because misplacement cannot be suspected withoutthat awareness.展开更多
BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients...BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients with superior vena cava syndrome(SVCS).We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein,to indicate and verify PICC catheterisation in the lower extremity is safe and feasible.And hope to provide different per-spectives for clinical PICC venipuncture to get the attention of peers.CASE SUMMARY On 24 August 2022,a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month,which worsened 10 d prior.Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS.Chemotherapy was not an absolute contraindication in this patient.Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head,neck,and upper extremities.The patient and his family were informed about the procedure,and informed consent was obtained.After successful puncture and prompt treatment,the patient was discharged,experiencing some relief from symptoms.CONCLUSION Inferior vena cava catheterisation is rare and important for cancer patients with SVCS,particularly in complex situations involving ectopic placement.展开更多
BACKGROUND Obesity is a risk factor for colorectal cancer,yet metabolic distinctions between healthy right and left colon tissue,before cancer is diagnosed,remains largely unknown.This study compared right-ascending a...BACKGROUND Obesity is a risk factor for colorectal cancer,yet metabolic distinctions between healthy right and left colon tissue,before cancer is diagnosed,remains largely unknown.This study compared right-ascending and left-descending colon tissue metabolomes to identify differences from the stool metabolome in normal weight,overweight,and obese adults.AIM To examine right and left colon tissue metabolites according to body mass index that may serve as mechanistic targets for interventions and biomarkers for colon cancer risk.METHODS Global,non-targeted metabolomics was applied to assess right-ascending and left-descending colon tissue collected from healthy adults undergoing screening colonoscopies to test the hypothesis that BMI differentially impacts colon tissue metabolite profiles.The colon tissue and stool metabolome of healthy adults(n=24)was analyzed for metabolite signatures and metabolic pathway networks implicated in progression of colorectal cancer.RESULTS Ascending and descending colon contained 504 host,food,and microbiotaderived metabolites from normal weight,overweight and obese adults grouped according to body mass index.Amino acids,lipids,and nucleotides were among the chemical types that further differentiated from the stool metabolite profiles.Normal weight adults had 46 significantly different metabolites between ascending and descending colon tissue locations,whereas there were 37 metabolite differences in overweight and 28 metabolite differences for obese adults(P<0.05).Obese adults had trimethylamine N-oxide,endocannabinoids and monoacylglycerols with different relative abundances identified between ascending and descending colon.Primary and secondary bile acids,vitamins,and fatty acids also showed marked relative abundance differences in colon tissue from overweight/obese adults.CONCLUSION There were metabolite profile differences between right-ascending and leftdescending colon tissue in healthy adults.Colon lipids and other metabolites in obese and overweight adults were distinguished from normal weight participants and associated with gut inflammation,nutrient absorption,and products of microbiota metabolism.展开更多
Sensory inputs stimulated by Zusanli(ST36) acupuncture in the abdomen are known to converge in the upper cervical cord. However, it is unclear whether these inputs are subsequently conveyed to the hypothalamic parav...Sensory inputs stimulated by Zusanli(ST36) acupuncture in the abdomen are known to converge in the upper cervical cord. However, it is unclear whether these inputs are subsequently conveyed to the hypothalamic paraventricular nucleus and what kind of afferent fibers are involved. We focused on the upper cervical cord, where afferent inputs converge, and detected c-fos expression in oxytocinergic neurons. We found that Zusanli acupuncture therapy effectively elevated intragastric pressure, but inhibited expression of c-fos in oxytocinergic neurons of the paraventricular nucleus in upper cervical cord injured rats. These Zusanli acupuncture effects remained even after complete dorsal cord transection. However, after complete transection of the spinal cord or dorsolateral funiculus, the effects were significantly attenuated and even disappeared. These findings suggest that the paraventricular nucleus is responsible for pooling and integrating signals from the Zusanli acupuncture and sensory information from the intragastric pressure variation, thereby contributing to the regulation of intragastric pressure. The upper cervical cord serves as the key link between ascending and descending pathways, which conveys afferent inputs to the paraventricular nucleus through the dorsolateral funiculus.展开更多
<strong>Objectives:</strong> To describe our technique for the implantation of the Thoraflex Hybrid prosthesis for replacement of the aortic arch in a safe and reproducible way. <strong>Materials:<...<strong>Objectives:</strong> To describe our technique for the implantation of the Thoraflex Hybrid prosthesis for replacement of the aortic arch in a safe and reproducible way. <strong>Materials:</strong> Thoraflex<span style="font-size:12.0pt;line-height:107%;font-family:;" "="">™</span> Hybrid Plexus Device (Terumo Aortic).<strong> Design:</strong> Drawing on our own experience over the past 4 years in the management of acute type A aortic dissection, we have distilled the essentials of our “Frozen Elephant Trunk” technique which have led us through our own learning curve to the improved management of this taxing condition. <strong>Method/ Results:</strong> Small extension of the median sternotomy incision along the medial border of sternocleidomastoid muscle. End to side graft anastomosis near the origin of the left subclavian artery during cooling on bypass towards 20 degrees. Attention to cardiac protection and maintenance of cerebral perfusion during the shortened corporeal arrest period. Excellent results in 24 consecutive AAAD patients with just one hospital mortality. <strong>Conclusions:</strong> We believe we are entering a new phase in the treatment of AAAD, facilitated by the availability of a hybrid prosthesis which combines expanding stent technology with familiar surgical graft material. Our particular management of the left subclavian artery and of the cerebral circulation during implantation has contributed to an expeditious and reproducible method of treating dissection within the arch of the aorta and beyond.展开更多
To extract the high-quality DEM in complicated mountain areas,a DEM fusion method for ascending and descending orbit StereoSAR DEMs considering Synthetic Aperture Radar(SAR)echo intensity is proposed.After the analysi...To extract the high-quality DEM in complicated mountain areas,a DEM fusion method for ascending and descending orbit StereoSAR DEMs considering Synthetic Aperture Radar(SAR)echo intensity is proposed.After the analysis for the influence of terrain features and SAR side-looking imaging characteristics on radar echo intensity and DEM accuracy,four Terras AR-X images with the stripmap mode and the 3 m spatial resolution covering a certain area of Maoxian County,Sichuan Province,China,was selected as the experimental area.StereoSAR technology was used to extract the ascending orbit StereoSAR DEM and the descending orbit StereoSAR DEM,respectively,and the corresponding radar echo intensity map was calculated.Then,while comparing the radar echo intensity corresponding to the same point position,DEM fusion was carried out,and the accuracy of DEM before and after the fusion was analyzed with the ground points measured by GNSS-RTK as reference data.Finally,a high-quality DEM with a 3 m spatial resolution in the experimental area was obtained.The DEM accuracy was improved on all slopes,and the mean absolute deviation(MAD)improved to 4.798 m,the standard deviation(SD)improved to 6.087 m and the LE90 improved to 40.48 m.The experimental results indicate that the fusion method of highresolution ascending and descending orbit StereoSAR DEMs considering SAR echo intensity can effectively extract DEM with high accuracy and reliability,which can provide technical support for obtaining highquality terrain information in similar areas.展开更多
Through the method of literature mining,the classics of traditional Chinese medicine,materia medica works,medical cases and documents are studied.Based on common prescriptions for the treatment of diseases such as abn...Through the method of literature mining,the classics of traditional Chinese medicine,materia medica works,medical cases and documents are studied.Based on common prescriptions for the treatment of diseases such as abnormal Zang-fu viscera and qi movement,dysfunction,etc.,and combined with the theory of ascending and descending property of traditional Chinese medicine,the application of ascending and descending property of traditional Chinese medicine in clinical prescription compatibility and the factors affecting the application are summarized.The ascending and descending properties of traditional Chinese medicine have been widely used in prescription compatibility for the clinical treatment of impairment of purifying and descending function of the lung,spleen and stomach's ascending and descending disorders and heart-kidney noninteractionpatte.展开更多
Pseudoaneurysms of the ascending aorta are a rare complication of aortic and cardiac surgery. In this article, we present a clinical case of a 56-year-old patient with a fortuitous diagnosis of a pseudoaneurysm of asc...Pseudoaneurysms of the ascending aorta are a rare complication of aortic and cardiac surgery. In this article, we present a clinical case of a 56-year-old patient with a fortuitous diagnosis of a pseudoaneurysm of ascending aorta that was treated by an endovascular stent-graft. We discuss in this article the diagnostic and therapeutic aspect of the case and the place of endovascular treatment for the ascending aorta.展开更多
Orpheus Descending is written by American famous playwright Tennessee Williams. According to the portrayal of a series marginalized people, this drama presents the solitude in human beings' heart and the estrangem...Orpheus Descending is written by American famous playwright Tennessee Williams. According to the portrayal of a series marginalized people, this drama presents the solitude in human beings' heart and the estrangement in interpersonal relations. This paper tries to analyze the solitude theme in this drama from philosophic aspect and realistic aspect, combining alienation theory and existentialism theory to analyze the reason and the manifestation of solitude.展开更多
A 38-year-old female with a history of alcoholic liver cirrhosis visited our hospital with a massive hematochezia.An esophagogastroduodenoscopy did not demonstrate any bleeding source,and a colonoscopy showed a massiv...A 38-year-old female with a history of alcoholic liver cirrhosis visited our hospital with a massive hematochezia.An esophagogastroduodenoscopy did not demonstrate any bleeding source,and a colonoscopy showed a massive hemorrhage in the ascending colon but without an obvious focus.The source of the bleeding could not be found with a mesenteric artery angiography.We performed an enhanced abdominal computed tomography,which revealed a distal ascending colonic varix,and assumed that the varix was the source of the bleeding.We performed a venous coil embolization and histoacryl injection to obliterate the colon varix.The intervention appeared to be successful because the vital signs and hemoglobin laboratory data remained stable and because the hematochezia was no longer observed.We report here on a rare case of colonic variceal bleeding that was treated with venous coil embolization.展开更多
Purpose: Descending necrotizing mediastinitis(DNM) is a lethal and acute suppurative disease. This report aimed to summarize our experience in the treatment of DNM with continuous negative pressure catheter drainage a...Purpose: Descending necrotizing mediastinitis(DNM) is a lethal and acute suppurative disease. This report aimed to summarize our experience in the treatment of DNM with continuous negative pressure catheter drainage and transnasal jejunal feeding by interventional techniques. Materials and Methods: We retrospectively analyzed relevant clinical data of patients with DNM who underwent continuous negative pressure catheter drainage and transnasal jejunal feeding. All drainage catheters and jejunal feeding tubes were inserte d by interventional techniques. Results: In total, 21 patients were diagnosed with DNM by esophagography and computed tomography(CT). Catheters for the drainage of mediastinal abscesses as well as transnasal jejunal feeding tubes were successfully placed in all patients, indicating a 100% success rate. Of all patients, 13 underwent insertion of abscess drainage catheters through percutaneous puncture under DynaCT guidance, while eight had drainage catheter insertion through fistula orifices in the posterior nasopharyngeal wall or esophagus under fluoroscopic guidance. In total, 26 drainage tubes were inserted. One patient with diabetes died of sepsis and diabetic ketoacidosis 5 days postoperatively, while the remaining 20 patients showed good recovery with successful removal of the drainage catheters. Durations of catheterization were 45.2±50.44 days. The overall clinical success rate was 95.2%. Conclusion: The above described methods are non-surgical, minimally invasive and efficacious, and may be alternative therapeutic tools for patients who are not eligible for surgical operation, have a high postoperative risk, or are more likely to choose minimally invasive techniques.展开更多
Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enc...Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enclosing conduit graft was used as a sac bypassed to right atrium to form a extracardial left-toright shunt in order to control bleeding and the results turned out to be satisfactory. The bypass and hemodynamically ignorable shunt can close spontaneously without complications with recovery of coagulation system. The technique may find wide application in clinical practice.展开更多
Purpose: This study aimed to investigate the morphological characteristics of ascending aortic dissection in detail. Materials and Methods: The ascending aorta was morphologically assessed in a consecutive series of p...Purpose: This study aimed to investigate the morphological characteristics of ascending aortic dissection in detail. Materials and Methods: The ascending aorta was morphologically assessed in a consecutive series of patients between January 2009 and October 2014. A new assessment and evaluation method was used to describe 114 patients with ascending aortic dissection. Results: A large difference was found in the degree of curvature between the ascending aorta with and without dissection. The shape of the former was straighter and steeper(control group R, 47.46 ± 6.40 mm; experimental group R, 59.70 ± 10.27 mm, P < 0.001). In the case of aortic dissection involving the valves, the proximal edge of the first entry was obviously close to the aortic sinus. The orientation of the entries was mainly around the 10 o'clock and 1–2 o'clock positions, and most of their shapes were fusiform(111; 70.02%). The distance of the distal extending dissection was associated with cases involving the branch arteries(involving three branches 441.40 ± 101.13 mm vs 159.85 ± 131.86 mm in others, P < 0.001). Conclusion: The morphological features of the ascending aorta after dissection and the correlations among dissections, entries, and related factors were found.展开更多
We studied the wall motion characteristics of the ascending aorta by velocity vector imaging (VVI) in primary hypertension patients. The ascending aortas both in 30 patients with primary hypertension and 30 normal c...We studied the wall motion characteristics of the ascending aorta by velocity vector imaging (VVI) in primary hypertension patients. The ascending aortas both in 30 patients with primary hypertension and 30 normal controls were examined by Acuson sequoia 512 equiped with VVI. The maximum velocity (Vs, Ve) of every point on the anterior wall of ascending aorta both in systole and diastole was measured. The aortic diameter was wider in the hypertension patients than that in the healthy subjects (P〈0.05). The movement amplitude of the anterior wall of the ascending aorta in long axis view in the hypertension patients was lower than that in the healthy subjects (P〈0.05). The motion and time to peak in systole of each point of the ascending aorta in the healthy subjects had no significant difference (P〉0.05). The velocity curves of the anterior wall of ascending aorta both in the hypertension and healthy subjects were regular, and the curve in systole was named S wave and that in diastole named E wave. The velocity of S wave and E wave was slower in the hypertension patients than that in the healthy subjects (P〈0.05). The time to peak of S wave on the anterior wall of ascending aorta in systole was shorter in the hypertension patients than in the healthy subjects (P〈0.05). VVI could be used to accurately and directly observe the movement character of the ascending aorta walls, which would help us understand the elasticity of great arteries in patients with hypertension.展开更多
Persistent ascending or descending mesocolon is an embryological anomaly that occurs during the final process of intestinal development in organogenesis.Specifically,the primitive dorsal mesocolon fails to fuse with t...Persistent ascending or descending mesocolon is an embryological anomaly that occurs during the final process of intestinal development in organogenesis.Specifically,the primitive dorsal mesocolon fails to fuse with the parietal peritoneum in the fifth month of gestation.Herein,we describe a case of ascending colon cancer with persistent ascending and descending mesocolon treated by laparoscopic right hemicolectomy.Preoperative computed tomography imaging of the abdomen demonstrated that the descending colon shifted at the midline of the abdomen and the sigmoid colon was located under the ascending colon.The detailed preoperative imaging examination revealed malpositioning of the large intestine and aided in the procedural planning.Because persistent mesocolon may result in the formation of abnormal adhesions,an accurate preoperative diagnosis is essential.We propose that it is important to consider this anomaly when making the preoperative imaging diagnosis to ensure a safe operation.展开更多
The aim of this work was to prepare ascending release compression-coated(CC) tablets with paliperidone(PAL) using a simple manufacturing technique and short manufacturing process.The release behavior and mechanisms in...The aim of this work was to prepare ascending release compression-coated(CC) tablets with paliperidone(PAL) using a simple manufacturing technique and short manufacturing process.The release behavior and mechanisms in vitro of the final tablets was investigated and evaluated. The PAL CC tablets were comprised of a core layer of high viscosity hydroxypropyl cellulose(HPC-H) and a coating layer of high viscosity hydroxypropyl methylcellulose(HPMCK100 M). Several factors such as materials and core tablet compositions were studied for their influence in the formulation procedure. The drug release mechanism was studied using gravimetric analysis. The data could be fitted to the Peppas model. The ascending drug release results were expressed in terms of the slope of the release curve at different time points.Results showed that the formulation could achieve a good ascending drug release when the weight ratio of PAL was 5:1(core:layer). The fraction of HPC and HPMC was 33 %, and the combination of Eudragit RL-PO was 10%. The ascending release mechanism was due to solvent penetration into the PAL CC tablets, and subsequent drug dissolution from the gelatinous HPC and HPMC matrix erosion. The release mechanism was therefore a combination of diffusion and erosion. This work demonstrated that the compression-coated tablets could achieve controlled ascending release over 24 h for the oral administration systems.展开更多
Objective: To determine diagnostic utility of Doppler measurements in fetal descending aorta and umbilical arteries in predicting intrauterine growth retarded (IUGR) fetuses at risk in pregnancies complicated by preec...Objective: To determine diagnostic utility of Doppler measurements in fetal descending aorta and umbilical arteries in predicting intrauterine growth retarded (IUGR) fetuses at risk in pregnancies complicated by preeclampsia and/or HELLP syndrome. Methods: Doppler measurements were taken in fetal descending aorta and umbilical arteries of 53 patients with pre-eclampsia, 10 of whom had HELLP syndrome using fetometry (ACUSON 128XP/10, 3.5 MHz probe). These values were compared with those of 44 appropriate-for-gestational age singleton pregnancies (AGA). Doppler Indices (Resistance Index (RI), Systolic/Diastolic (S/D) ratio) and end-diastolic flows were related to fetal heart rate (FHR) during contraction stress test, to cord blood parameters (pH, Base Excess) and to Apgar Scores. Results: In contrast to AGA fetuses, IUGR fetuses had decreased end-diastolic flow and an increase of Doppler Indices significantly earlier in the descending aorta (p < 0.05), compared to umbilical artery. Increased RI’s, S/D ratios and a decrease of end-diastolic flow in fetal aorta were significantly correlated to frequency of FHR decelerations during contraction stress tests, pH, Base Excess (p < 0.01) and Apgar Scores in IUGR fetuses. Conclusion: A decrease in end-diastolic flow paralleled with an increase in Doppler indices in fetal descending aorta reflect oxygen deprivation in IUGR fetuses during pre-eclamptic pregnancies with or without HELLP syndrome. While ductus venosus and umbilical artery are more frequently used nowadays to determine fetal oxygen deprivation, Doppler measurements in fetal descending aorta provide additional information for early detection of fetuses at risk for IUGR in pregnancies complicated with pre-eclampsia and/or HELLP展开更多
基金jointly supported by projects of the National Key Laboratory for Earthquake Dynamics (LED2013A02,LED2015A03)the National Natural Science foundation of China (41374105)
文摘Based on the working principle of satellite radars, the earthquake deformation field measured by interferometric synthetic aperture(InSAR) is the projection of ground displacement associated with the seismogenic fault in the line of sight(LOS) of the satellite. However, LOS projections are complex, and are not only related to the ascending/descending modes and incidence angles of SAR data, but also related to the strike and motion senses of the fault. Even for the same earthquake, the LOS deformation derived from different ascending/descending data can be almost identical in one case, but quite different in another case, which makes the interpretation of InSAR seismic deformation and its comparison with field observations difficult. In this study, we undertook a quantitative analysis of the relationships between LOS observation sensitivity of InSAR and fault strike, fault motion sense, and ascending/descending modes, as well as 3D deformation fields. We studied the features and differences of the LOS deformation fields in different types of earthquakes using ascending/descending modes, with a particularly detailed analysis of the relations for a strikeslip type of earthquake. We also summarized the characteristics of LOS deformation fields of faults with different strikes and optimal observational data modes. Taking the strike-slip Yushu earthquake and the normal Gaize event as examples, we used SAR data of the ascending/descending modes to verify the results of quantitative calculations. These analyses will not only provide a more reasonable interpretation of InSAR seismic deformation fields and but also help understand the differences of seismic deformation fields revealed by data with different observational modes, therefore promoting the application of InSAR technology in seismology.
基金supported by the National Natural Science Foundation of China(Grant Nos.42192552,42192551,42150710531,42175016,and 42075072)the Shanghai Typhoon Research Fund(Grant No.TFJJ202207)the Basic Research Fund of CAMS(Grant No.2023Y010)。
文摘This study investigated the effects of upper-level descending inflow(ULDI)associated with inner-eyewall convection on the formation of the moat in tropical cyclones(TCs)with secondary eyewall formation(SEF).In our numerical experiments,a clear moat with SEF occurred in TCs with a significant ULDI,while no SEF occurred in TCs without a significant ULDI.The eyewall convection developed more vigorously in the control run.A ULDI occurred outside the inner-eyewall convection,where it was symmetrically unstable.The ULDI was initially triggered by the diabatic warming released by the inner eyewall and later enhanced by the cooling below the anvil cloud.The ULDI penetrated the outer edge of the inner eyewall with relatively dry air and prevented excessive solid-phase hydrometeors from being advected further outward.It produced extensive sublimation cooling of falling hydrometeors between the eyewall and the outer convection.The sublimation cooling resulted in negative buoyancy and further induced strong subsidence between the eyewall and the outer convection.As a result,a clear moat was generated.Development of the moat in the ongoing SEF prevented the outer rainband from moving farther inward,helping the outer rainband to symmetrize into an outer eyewall.In the sensitivity experiment,no significant ULDI formed since the eyewall convection was weaker,and the eyewall anvil developed relatively lower,meaning the formation of a moat and thus an outer eyewall was less likely.This study suggests that a better-represented simulation of inner-eyewall convective structures and distribution of the solid-phase hydrometeors is important to the prediction of SEF.
文摘The right ascending lumbar vein is difficult to detect on anteroposterior abdominalradiographs because it overlaps with the inferior vena cava on anteroposteriorradiographs.Intensive observation by medical providers may be a cue fordiagnosis.However,knowledge of catheter misplacement of the right ascendinglumbar vein is also necessary,because misplacement cannot be suspected withoutthat awareness.
基金the Chongqing Medical Scientific Research Project(a joint project of the Chongqing Health Commission and Science and Technology Bureau),No.2020FYYX046。
文摘BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients with superior vena cava syndrome(SVCS).We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein,to indicate and verify PICC catheterisation in the lower extremity is safe and feasible.And hope to provide different per-spectives for clinical PICC venipuncture to get the attention of peers.CASE SUMMARY On 24 August 2022,a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month,which worsened 10 d prior.Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS.Chemotherapy was not an absolute contraindication in this patient.Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head,neck,and upper extremities.The patient and his family were informed about the procedure,and informed consent was obtained.After successful puncture and prompt treatment,the patient was discharged,experiencing some relief from symptoms.CONCLUSION Inferior vena cava catheterisation is rare and important for cancer patients with SVCS,particularly in complex situations involving ectopic placement.
基金Supported by the Cancer Cure Foundation and the University of Colorado Cancer Center Support Grant,Division of Cancer Control and Prevention(Aurora,CO),No.P30CA046934
文摘BACKGROUND Obesity is a risk factor for colorectal cancer,yet metabolic distinctions between healthy right and left colon tissue,before cancer is diagnosed,remains largely unknown.This study compared right-ascending and left-descending colon tissue metabolomes to identify differences from the stool metabolome in normal weight,overweight,and obese adults.AIM To examine right and left colon tissue metabolites according to body mass index that may serve as mechanistic targets for interventions and biomarkers for colon cancer risk.METHODS Global,non-targeted metabolomics was applied to assess right-ascending and left-descending colon tissue collected from healthy adults undergoing screening colonoscopies to test the hypothesis that BMI differentially impacts colon tissue metabolite profiles.The colon tissue and stool metabolome of healthy adults(n=24)was analyzed for metabolite signatures and metabolic pathway networks implicated in progression of colorectal cancer.RESULTS Ascending and descending colon contained 504 host,food,and microbiotaderived metabolites from normal weight,overweight and obese adults grouped according to body mass index.Amino acids,lipids,and nucleotides were among the chemical types that further differentiated from the stool metabolite profiles.Normal weight adults had 46 significantly different metabolites between ascending and descending colon tissue locations,whereas there were 37 metabolite differences in overweight and 28 metabolite differences for obese adults(P<0.05).Obese adults had trimethylamine N-oxide,endocannabinoids and monoacylglycerols with different relative abundances identified between ascending and descending colon.Primary and secondary bile acids,vitamins,and fatty acids also showed marked relative abundance differences in colon tissue from overweight/obese adults.CONCLUSION There were metabolite profile differences between right-ascending and leftdescending colon tissue in healthy adults.Colon lipids and other metabolites in obese and overweight adults were distinguished from normal weight participants and associated with gut inflammation,nutrient absorption,and products of microbiota metabolism.
基金supported by the National Natural Science Foundation of China,No.81273677a grant from the Postgraduate Innovation Topics of Hunan University of Chinese Medicine in China in 2014,No.2014CX01
文摘Sensory inputs stimulated by Zusanli(ST36) acupuncture in the abdomen are known to converge in the upper cervical cord. However, it is unclear whether these inputs are subsequently conveyed to the hypothalamic paraventricular nucleus and what kind of afferent fibers are involved. We focused on the upper cervical cord, where afferent inputs converge, and detected c-fos expression in oxytocinergic neurons. We found that Zusanli acupuncture therapy effectively elevated intragastric pressure, but inhibited expression of c-fos in oxytocinergic neurons of the paraventricular nucleus in upper cervical cord injured rats. These Zusanli acupuncture effects remained even after complete dorsal cord transection. However, after complete transection of the spinal cord or dorsolateral funiculus, the effects were significantly attenuated and even disappeared. These findings suggest that the paraventricular nucleus is responsible for pooling and integrating signals from the Zusanli acupuncture and sensory information from the intragastric pressure variation, thereby contributing to the regulation of intragastric pressure. The upper cervical cord serves as the key link between ascending and descending pathways, which conveys afferent inputs to the paraventricular nucleus through the dorsolateral funiculus.
基金supported by the National Natural Science Foundation of China(Grant Nos.41472255,51178404)Open Research Fund by Sichuan Engineering Research Center for Emergency Mapping & Disaster Reduction(Program K2014B006)Fundamental Research Funds for the Central Universities(Grant Nos.SWJTU12ZT07,2682014BR014)
文摘合成的孔雷达(SAR ) stereo-radargrammetry 的片面上升或下降限制了由于短空间基线(100 km ) 和小交叉角度的地志的印射的精确性。以便改进从卫星转菠的 SAR radargrammetry 产生数字举起模型(DEM ) 的表演和可靠性,从与长空间的基线(1000 km ) 的几何配置登上并且下降轨道的联合的两方面的 stereo-radargrammetry 的探索在这研究被进行。在到放方程的地球表面和 Doppler 的 SAR 传感器之间的观点范围几何学被采用建立实体镜的交叉模型。两方面的 radargrammetric 举起的测量无常根据在输入 SAR 图象之间的同类的点的雷达视差被估计。ALOS/PALSAR (先进土地观察卫星 / 阶段数组类型 L 乐队合成的孔雷达) 的二立体声对有轨道的分离的获得在有在西南的中国卷地形学的西方四川低岬盆上的几乎 1080 km 在学习被采用在撞击了这个区域的 2008 Wenchuan 地震以后获得新地面数据。对两方面的 radargrammetric DEM 的量的精确性评价与参考被执行回答 GPS 观察。试验性的结果证明没有使用的地面控制点(GCP ) ,举起精确性到达 5.5 m,并且精确性是进一步的改善了到 1.5 m,一仅仅 GPS GCP 用作最少的限制。理论分析和严峻的结果证明从上升并且下降的轨道的两方面的长基线 SAR radargrammetry 能是为大区域、高的精确性的一种很有希望的技术选择地志的印射。
文摘<strong>Objectives:</strong> To describe our technique for the implantation of the Thoraflex Hybrid prosthesis for replacement of the aortic arch in a safe and reproducible way. <strong>Materials:</strong> Thoraflex<span style="font-size:12.0pt;line-height:107%;font-family:;" "="">™</span> Hybrid Plexus Device (Terumo Aortic).<strong> Design:</strong> Drawing on our own experience over the past 4 years in the management of acute type A aortic dissection, we have distilled the essentials of our “Frozen Elephant Trunk” technique which have led us through our own learning curve to the improved management of this taxing condition. <strong>Method/ Results:</strong> Small extension of the median sternotomy incision along the medial border of sternocleidomastoid muscle. End to side graft anastomosis near the origin of the left subclavian artery during cooling on bypass towards 20 degrees. Attention to cardiac protection and maintenance of cerebral perfusion during the shortened corporeal arrest period. Excellent results in 24 consecutive AAAD patients with just one hospital mortality. <strong>Conclusions:</strong> We believe we are entering a new phase in the treatment of AAAD, facilitated by the availability of a hybrid prosthesis which combines expanding stent technology with familiar surgical graft material. Our particular management of the left subclavian artery and of the cerebral circulation during implantation has contributed to an expeditious and reproducible method of treating dissection within the arch of the aorta and beyond.
基金supported by Study on Early Identification of Landslide Hazards based on Highresolution SAR Image[KJ-2018-13]。
文摘To extract the high-quality DEM in complicated mountain areas,a DEM fusion method for ascending and descending orbit StereoSAR DEMs considering Synthetic Aperture Radar(SAR)echo intensity is proposed.After the analysis for the influence of terrain features and SAR side-looking imaging characteristics on radar echo intensity and DEM accuracy,four Terras AR-X images with the stripmap mode and the 3 m spatial resolution covering a certain area of Maoxian County,Sichuan Province,China,was selected as the experimental area.StereoSAR technology was used to extract the ascending orbit StereoSAR DEM and the descending orbit StereoSAR DEM,respectively,and the corresponding radar echo intensity map was calculated.Then,while comparing the radar echo intensity corresponding to the same point position,DEM fusion was carried out,and the accuracy of DEM before and after the fusion was analyzed with the ground points measured by GNSS-RTK as reference data.Finally,a high-quality DEM with a 3 m spatial resolution in the experimental area was obtained.The DEM accuracy was improved on all slopes,and the mean absolute deviation(MAD)improved to 4.798 m,the standard deviation(SD)improved to 6.087 m and the LE90 improved to 40.48 m.The experimental results indicate that the fusion method of highresolution ascending and descending orbit StereoSAR DEMs considering SAR echo intensity can effectively extract DEM with high accuracy and reliability,which can provide technical support for obtaining highquality terrain information in similar areas.
基金University-level Scientific Research Project of Guangxi University of Chinese Medicine(2015MS011)Guangxi Key Laboratory of Zhuang Yao Medicine(20-065-14)Key Laboratory of Basic and Applied Research of Zhuang Traditional Medicine in Collages and Universities in Guangxi(GJKY[2017]23 zyfy201707).
文摘Through the method of literature mining,the classics of traditional Chinese medicine,materia medica works,medical cases and documents are studied.Based on common prescriptions for the treatment of diseases such as abnormal Zang-fu viscera and qi movement,dysfunction,etc.,and combined with the theory of ascending and descending property of traditional Chinese medicine,the application of ascending and descending property of traditional Chinese medicine in clinical prescription compatibility and the factors affecting the application are summarized.The ascending and descending properties of traditional Chinese medicine have been widely used in prescription compatibility for the clinical treatment of impairment of purifying and descending function of the lung,spleen and stomach's ascending and descending disorders and heart-kidney noninteractionpatte.
文摘Pseudoaneurysms of the ascending aorta are a rare complication of aortic and cardiac surgery. In this article, we present a clinical case of a 56-year-old patient with a fortuitous diagnosis of a pseudoaneurysm of ascending aorta that was treated by an endovascular stent-graft. We discuss in this article the diagnostic and therapeutic aspect of the case and the place of endovascular treatment for the ascending aorta.
文摘Orpheus Descending is written by American famous playwright Tennessee Williams. According to the portrayal of a series marginalized people, this drama presents the solitude in human beings' heart and the estrangement in interpersonal relations. This paper tries to analyze the solitude theme in this drama from philosophic aspect and realistic aspect, combining alienation theory and existentialism theory to analyze the reason and the manifestation of solitude.
文摘A 38-year-old female with a history of alcoholic liver cirrhosis visited our hospital with a massive hematochezia.An esophagogastroduodenoscopy did not demonstrate any bleeding source,and a colonoscopy showed a massive hemorrhage in the ascending colon but without an obvious focus.The source of the bleeding could not be found with a mesenteric artery angiography.We performed an enhanced abdominal computed tomography,which revealed a distal ascending colonic varix,and assumed that the varix was the source of the bleeding.We performed a venous coil embolization and histoacryl injection to obliterate the colon varix.The intervention appeared to be successful because the vital signs and hemoglobin laboratory data remained stable and because the hematochezia was no longer observed.We report here on a rare case of colonic variceal bleeding that was treated with venous coil embolization.
文摘Purpose: Descending necrotizing mediastinitis(DNM) is a lethal and acute suppurative disease. This report aimed to summarize our experience in the treatment of DNM with continuous negative pressure catheter drainage and transnasal jejunal feeding by interventional techniques. Materials and Methods: We retrospectively analyzed relevant clinical data of patients with DNM who underwent continuous negative pressure catheter drainage and transnasal jejunal feeding. All drainage catheters and jejunal feeding tubes were inserte d by interventional techniques. Results: In total, 21 patients were diagnosed with DNM by esophagography and computed tomography(CT). Catheters for the drainage of mediastinal abscesses as well as transnasal jejunal feeding tubes were successfully placed in all patients, indicating a 100% success rate. Of all patients, 13 underwent insertion of abscess drainage catheters through percutaneous puncture under DynaCT guidance, while eight had drainage catheter insertion through fistula orifices in the posterior nasopharyngeal wall or esophagus under fluoroscopic guidance. In total, 26 drainage tubes were inserted. One patient with diabetes died of sepsis and diabetic ketoacidosis 5 days postoperatively, while the remaining 20 patients showed good recovery with successful removal of the drainage catheters. Durations of catheterization were 45.2±50.44 days. The overall clinical success rate was 95.2%. Conclusion: The above described methods are non-surgical, minimally invasive and efficacious, and may be alternative therapeutic tools for patients who are not eligible for surgical operation, have a high postoperative risk, or are more likely to choose minimally invasive techniques.
文摘Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enclosing conduit graft was used as a sac bypassed to right atrium to form a extracardial left-toright shunt in order to control bleeding and the results turned out to be satisfactory. The bypass and hemodynamically ignorable shunt can close spontaneously without complications with recovery of coagulation system. The technique may find wide application in clinical practice.
文摘Purpose: This study aimed to investigate the morphological characteristics of ascending aortic dissection in detail. Materials and Methods: The ascending aorta was morphologically assessed in a consecutive series of patients between January 2009 and October 2014. A new assessment and evaluation method was used to describe 114 patients with ascending aortic dissection. Results: A large difference was found in the degree of curvature between the ascending aorta with and without dissection. The shape of the former was straighter and steeper(control group R, 47.46 ± 6.40 mm; experimental group R, 59.70 ± 10.27 mm, P < 0.001). In the case of aortic dissection involving the valves, the proximal edge of the first entry was obviously close to the aortic sinus. The orientation of the entries was mainly around the 10 o'clock and 1–2 o'clock positions, and most of their shapes were fusiform(111; 70.02%). The distance of the distal extending dissection was associated with cases involving the branch arteries(involving three branches 441.40 ± 101.13 mm vs 159.85 ± 131.86 mm in others, P < 0.001). Conclusion: The morphological features of the ascending aorta after dissection and the correlations among dissections, entries, and related factors were found.
文摘We studied the wall motion characteristics of the ascending aorta by velocity vector imaging (VVI) in primary hypertension patients. The ascending aortas both in 30 patients with primary hypertension and 30 normal controls were examined by Acuson sequoia 512 equiped with VVI. The maximum velocity (Vs, Ve) of every point on the anterior wall of ascending aorta both in systole and diastole was measured. The aortic diameter was wider in the hypertension patients than that in the healthy subjects (P〈0.05). The movement amplitude of the anterior wall of the ascending aorta in long axis view in the hypertension patients was lower than that in the healthy subjects (P〈0.05). The motion and time to peak in systole of each point of the ascending aorta in the healthy subjects had no significant difference (P〉0.05). The velocity curves of the anterior wall of ascending aorta both in the hypertension and healthy subjects were regular, and the curve in systole was named S wave and that in diastole named E wave. The velocity of S wave and E wave was slower in the hypertension patients than that in the healthy subjects (P〈0.05). The time to peak of S wave on the anterior wall of ascending aorta in systole was shorter in the hypertension patients than in the healthy subjects (P〈0.05). VVI could be used to accurately and directly observe the movement character of the ascending aorta walls, which would help us understand the elasticity of great arteries in patients with hypertension.
文摘Persistent ascending or descending mesocolon is an embryological anomaly that occurs during the final process of intestinal development in organogenesis.Specifically,the primitive dorsal mesocolon fails to fuse with the parietal peritoneum in the fifth month of gestation.Herein,we describe a case of ascending colon cancer with persistent ascending and descending mesocolon treated by laparoscopic right hemicolectomy.Preoperative computed tomography imaging of the abdomen demonstrated that the descending colon shifted at the midline of the abdomen and the sigmoid colon was located under the ascending colon.The detailed preoperative imaging examination revealed malpositioning of the large intestine and aided in the procedural planning.Because persistent mesocolon may result in the formation of abnormal adhesions,an accurate preoperative diagnosis is essential.We propose that it is important to consider this anomaly when making the preoperative imaging diagnosis to ensure a safe operation.
基金funded by National Natural Science Foundation of China (No.81673378)
文摘The aim of this work was to prepare ascending release compression-coated(CC) tablets with paliperidone(PAL) using a simple manufacturing technique and short manufacturing process.The release behavior and mechanisms in vitro of the final tablets was investigated and evaluated. The PAL CC tablets were comprised of a core layer of high viscosity hydroxypropyl cellulose(HPC-H) and a coating layer of high viscosity hydroxypropyl methylcellulose(HPMCK100 M). Several factors such as materials and core tablet compositions were studied for their influence in the formulation procedure. The drug release mechanism was studied using gravimetric analysis. The data could be fitted to the Peppas model. The ascending drug release results were expressed in terms of the slope of the release curve at different time points.Results showed that the formulation could achieve a good ascending drug release when the weight ratio of PAL was 5:1(core:layer). The fraction of HPC and HPMC was 33 %, and the combination of Eudragit RL-PO was 10%. The ascending release mechanism was due to solvent penetration into the PAL CC tablets, and subsequent drug dissolution from the gelatinous HPC and HPMC matrix erosion. The release mechanism was therefore a combination of diffusion and erosion. This work demonstrated that the compression-coated tablets could achieve controlled ascending release over 24 h for the oral administration systems.
文摘Objective: To determine diagnostic utility of Doppler measurements in fetal descending aorta and umbilical arteries in predicting intrauterine growth retarded (IUGR) fetuses at risk in pregnancies complicated by preeclampsia and/or HELLP syndrome. Methods: Doppler measurements were taken in fetal descending aorta and umbilical arteries of 53 patients with pre-eclampsia, 10 of whom had HELLP syndrome using fetometry (ACUSON 128XP/10, 3.5 MHz probe). These values were compared with those of 44 appropriate-for-gestational age singleton pregnancies (AGA). Doppler Indices (Resistance Index (RI), Systolic/Diastolic (S/D) ratio) and end-diastolic flows were related to fetal heart rate (FHR) during contraction stress test, to cord blood parameters (pH, Base Excess) and to Apgar Scores. Results: In contrast to AGA fetuses, IUGR fetuses had decreased end-diastolic flow and an increase of Doppler Indices significantly earlier in the descending aorta (p < 0.05), compared to umbilical artery. Increased RI’s, S/D ratios and a decrease of end-diastolic flow in fetal aorta were significantly correlated to frequency of FHR decelerations during contraction stress tests, pH, Base Excess (p < 0.01) and Apgar Scores in IUGR fetuses. Conclusion: A decrease in end-diastolic flow paralleled with an increase in Doppler indices in fetal descending aorta reflect oxygen deprivation in IUGR fetuses during pre-eclamptic pregnancies with or without HELLP syndrome. While ductus venosus and umbilical artery are more frequently used nowadays to determine fetal oxygen deprivation, Doppler measurements in fetal descending aorta provide additional information for early detection of fetuses at risk for IUGR in pregnancies complicated with pre-eclampsia and/or HELLP