英汉方位隐喻的文化蕴涵比较——以up/down(上/下)、left/right(左/右)为例

隐喻不仅是一种语言现象,更是一种认知现象。借助方位隐喻能更好地实现抽象概念的表达。英语和汉语中的up/down(上/下)、left/right(左/右)两组方位词,在时间、地位、数量等方面形成的方位隐喻概念所蕴含的抽象文化意义体现出文化特色。

Different treatment strategies and molecular features between right-sided and left-sided colon cancers

The colon is derived from the embryological midgut and hindgut separately,with the right colon and left colon having different features with regards to both anatomical and physiological characteristics.Cancers located in the right and left colon are referred to as right colon cancer(RCC) and left colon cancer(LCC),respectively,based on their apparent anatomical positions.Increasing evidence supports the notion that not only are there differences in treatment strategies when dealing with RCC and LCC,but molecular features also vary between them,not to mention the distinguishing clinical manifestations.Disease-free survival after radical surgery of both RCC and LCC are similar.In the treatment of RCC,the benefit gained from adjuvant FOLFIRI chemotherapy is superior,or at least similar,to LCC,but inferior to LCC if FOLFOX regimen is applied.On the other hand,metastatic LCC exhibits longer survival than that of RCC in a palliative chemotherapy setting.For KRAS wild-type cancers,LCC benefits more from cetuximab treatment than RCC.Moreover,advanced LCC shows a higher sensitivity to bevacizumab treatment in comparison with advanced RCC.Significant varieties exist at the molecular level between RCC and LCC,which may serve as the cause of all apparent differences.With respect to carcinogenesis mechanisms,RCC is associated with known gene types,such as MMR,KRAS,BRAF,and mi RNA-31,while LCC is associated with CIN,p53,NRAS,mi RNA-146 a,mi RNA-147 b,and mi RNA-1288.Regarding protein expression,RCC is related to GNAS,NQO1,telomerase activity,P-PDH,and annexin A10,while LCC is related to Topo I,TS,and EGFR.In addition,separated pathways dominate progressionto relapse in RCC and LCC.Therefore,RCC and LCC should be regarded as two heterogeneous entities,with this heterogeneity being used to stratify patients in order for them to have the optimal,current,and novel therapeutic strategies in clinical practice.Additional research is needed to uncover further differences between RCC and LCC.

Outcomes of right-lobe and left-lobe living-donor liver transplantations using small-for-size grafts

AIM To analyze the outcomes of living-donor liver transplantation(LDLT) using left-lobe(LL) or right-lobe(RL) small-for-size(SFS) grafts.METHODS Prospectively collected data of adult patients who underwent LDLT at our hospital in the period from January 2003 to December 2013 were reviewed. The patients were divided into the RL-LDLT group and the LL-LDLT group. The two groups were compared in terms of short-and long-term outcomes, including incidence of postoperative complication, graft function, graft survival, and patient survival. A SFS graft was defined as a graft with a ratio of graft weight(GW) to recipient standard liver volume(RSLV)(GW/RSLV) of < 50%. The Urata formula was used to estimate RSLV.RESULTS Totally 218 patients were included for analysis, with 199 patients in the RL-LDLT group and 19 patients in the LL-LDLT group. The two groups were similar in terms of age(median, 53 years in the RL-LDLT group and 52 years in the LL-LDLT group, P = 0.997) but had significantly different ratios of men to women(165:34 in the RL-LDLT group and 8:11 in the LL-LDLT group, P < 0.0001). The two groups were also significantly different in GW(P < 0.0001), GW/RSLV(P < 0.0001), and graft cold ischemic time(P = 0.007). When it comes to postoperative complication, the groups were comparable(P = 0.105). Five patients died in hospital,4(2%) in the RL-LDLT group and 1(5.3%) in the LLLDLT group(P = 0.918). There were 38 graft losses, 33(16.6%) in the RL-LDLT group and 5(26.3%) in the LL-LDLT group(P = 0.452). The 5-year graft survival rate was significantly better in the RL-LDLT group(95.2% vs 89.5%, P = 0.049). The two groups had similar 5-year patient survival rates(RL-LDLT: 86.8%, LL-LDLT: 89.5%, P = 0.476).CONCLUSION The use of SFS graft in LDLT requires careful tailormade surgical planning and meticulous operation. LLLDLT can be a good alternative to RL-LDLT with similar recipient outcomes but a lower donor risk. Further research into different patient conditions is needed in order to validate the use of LL graft.

Influence of High-Velocity Blood Flow on Right-to-Left Shunt in Patients with Patent Foramen Ovale during the Valsalva Maneuver

In this study, we investigated the changes in the right-to-left shunt (RLS) of the patent foramen ovale (PFO) at different phases of the Valsalva maneuver and analyzed the possible mechanisms. The study population consisted of 57 patients with symptoms highly suggestive of a PFO. These patients had been diagnosed with apsychia, migraine with aura, cerebral infarction, transient ischemic attack (TIA), and cerebral ischemia with unknown cause. Routine echocardiography was performed in all patients to rule out a cardiac malformation. Contrast-transcranial Doppler (c-TCD) and contrast-enhanced transthoracic echocardiography (c-TTE) were used to visualize and quantify the RLS. The standard apical four chamber view was used to observe the changes of E peak, A peak, and velocity-time integral (VTI) ratio of tricuspid blood flow during the strain phase and release phase of the Valsalva maneuver. Paired t-test was used to compare E peak, A peak, and VTI ratio of tricuspid blood flow during the different phases. The right-to-left shunt across the PFO (PFO-RLS) was graded in the two phases and compared by Kruskal-Wallis test. Compared with the strain phase of the Valsalva maneuver, the parameters of E, A, and VTI in diastolic period in patients with PFO-RLS at the release phase were significantly increased [54.30 ± 13.65 cm/s vs 100.35 ± 21.11 cm/s, 42.21 ± 12.32 cm/s vs 57.30 ± 18.88 cm/s, 10.34 ± 3.27 cm/s vs 19.58 ± 4.56 cm/s, respectively], and the difference was statistically significant. The positive consequence of PFO-RLS, as diagnosed by c-TTE with the Valsalva maneuver at the release phase of the Valsalva maneuver, was significantly higher than that at the strain phase of the Valsalva maneuver. At the beginning of release phase of the Valsalva maneuver, decreased intrathoracic pressure led to increased venous backflow into the right atrium. Thus, high-velocity blood flow rapidly pushed the PFO open, which resulted in a significant increase in the PFO-RLS. Therefore, the increase of the PFO-RLS during the Valsalva maneuver is caused by the impact of high-velocity blood flow the PFO.

Does Right Coronary Artery Stenosis Increase Morbi-Mortality in Patients Undergoing Coronary Artery Bypass Graft for Left Main Coronary Artery Disease?

Background: The association of right coronary artery (RCA) stenosis in patients undergoing myocardial revascularization for left main coronary artery (LMCA) stenosis affects the prognosis. This study aimed to compare immediate results of patients with isolated LMCA stenosis and those with combined RCA stenosis. Patients and methods: We retrospectively evaluated 107 consecutive patients with LMCA disease who underwent coronary artery bypass grafts. The patients were divided into two groups: isolated LMCA stenosis (n = 36) and LMCA stenosis + RCA stenosis (n = 71). Different variables (preoperative, intra operative and post operative) were compared. Results: Patients with LMCA stenosis + RCA stenosis experienced higher prevalence of diabetes mellitus (p = 0.024) and smoker (p = 0.032). Also left ventricular EF was reduced (p = 0.004). Myocardial revascularization was more complete in patients with LMCA stenosis + RCA stenosis (p = 0.033), but in-hospital mortality rate was higher (12.6% vs 5.5%) in isolated LLMCA stenosis, but it did not reach statistical significance (p = 0.32). Except low output syndrome (LOS) that was frequent in presence of RCA stenosis (p = 0.026), no significant difference was found between groups for other complications. Conclusion: The presence of RCA stenosis in patients undergoing CABG for LMCA disease increases 30 day mortality but without significant impact on overall morbidities.

Left to Right Extracardial Shunt to Control Hemorrhage of Ascending Aorta and Left Ventricle: A Report of 3 Cases

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.

Intertwined leukocyte balances in tumours and peripheral blood as robust predictors of right and left colorectal cancer survival

BACKGROUND Colorectal cancer(CRC)accounts for 9.4%of overall cancer deaths,ranking second after lung cancer.Despite the large number of factors tested to predict their outcome,most patients with similar variables show big differences in survival.Moreover,right-sided CRC(RCRC)and left-sided CRC(LCRC)patients exhibit large differences in outcome after surgical intervention as assessed by preoperative blood leukocyte status.We hypothesised that stronger indexes than circulating(blood)leukocyte ratios to predict RCRC and LCRC patient outcomes will result from combining both circulating and infiltrated(tumour/peritumour fixed tissues)concentrations of leukocytes.AIM To seek variables involving leukocyte balances in peripheral blood and tumour tissues and to predict the outcome of CRC patients.METHODS Sixty-five patients diagnosed with colon adenocarcinoma by the Digestive Surgery Service of the La Paz University Hospital(Madrid,Spain)were enrolled in this study:43 with RCRC and 22 with LCRC.Patients were followed-up from January 2017 to March 2021 to record overall survival(OS)and recurrence-free survival(RFS)after surgical interventions.Leukocyte concentrations in peripheral blood were determined by routine laboratory protocols.Paraffin-fixed samples of tumour and peritumoural tissues were assessed for leukocyte concentrations by immunohistochemical detection of CD4,CD8,and CD14 marker expression.Ratios of leukocyte concentration in blood and tissues were calculated and evaluated for their predictor values for OS and RFS with Spearman correlations and Cox univariate and multivariate proportional hazards regression,followed by the calculation of the receiver-operating characteristic and area under the curve(AUC)and the determination of Youden’s optimal cutoff values for those variables that significantly correlated with either RCRC or LCRC patient outcomes.RCRC patients from the cohort were randomly assigned to modelling and validation sets,and clinician-friendly nomograms were developed to predict OS and RFS from the respective significant indexes.The accuracy of the model was evaluated using calibration and validation plots.RESULTS The relationship of leukocyte ratios in blood and peritumour resulted in six robust predictors of worse OS in RCRC:CD8+lymphocyte content in peritumour(CD8pt,AUC=0.585,cutoff<8.250,P=0.0077);total lymphocyte content in peritumour(CD4CD8pt,AUC=0.550,cutoff<10.160,P=0.0188);lymphocyte-to-monocyte ratio in peritumour(LMRpt,AUC=0.807,cutoff<3.185,P=0.0028);CD8+LMR in peritumour(CD8MRpt,AUC=0.757,cutoff<1.650,P=0.0007);the ratio of blood LMR to LMR in peritumour(LMRb/LMRpt,AUC=0.672,cutoff>0.985,P=0.0244);and the ratio of blood LMR to CD8+LMR in peritumour(LMRb/CD8MRpt,AUC=0.601,cutoff>1.485,P=0.0101).In addition,three robust predictors of worse RFS in RCRC were found:LMRpt(AUC=0.737,cutoff<3.185,P=0.0046);LMRb/LMRpt(AUC=0.678,cutoff>0.985,P=0.0155)and LMRb/CD8MRpt(AUC=0.615,cutoff>1.485,P=0.0141).Furthermore,the ratio of blood LMR to CD4+LMR in peritumour(LMRb/CD4MRpt,AUC=0.786,cutoff>10.570,P=0.0416)was found to robustly predict poorer OS in LCRC patients.The nomograms showed moderate accuracy in predicting OS and RFS in RCRC patients,with concordance index of 0.600 and 0.605,respectively.CONCLUSION Easily obtainable variables at preoperative consultation,defining the status of leukocyte balances between peripheral blood and peritumoural tissues,are robust predictors for OS and RFS of both RCRC and LCRC patients.

Propagation of Airy beams from right-handed material to left-handed material

Based on the ABCD matrix formalism,the propagation property of an Airy beam from right-handed material（RHM） to left-handed material（LHM） is investigated.The result shows that when the Airy beam propagates in the LHM,the intensity self-bending due to its propagation in the RHM can be compensated.In particular,if the propagation distance in the RHM is equal to that in the LHM and the refractive index of the LHM is n L =-1,the transverse intensity distribution of the Airy beam can return to its original state.

Left Radial Approach versus Right Radial Approach of Coronary Angiography in the Diagnosis of Coronary Heart Disease

Background: Transradial coronary angiography has established itself as safe alternative to transfemoral approach. Today, the artery of approach lies completely on the operator’s choice. The Right Radial Approach (RRA) has been a favorite for most of the interventional cardiologists due to the convenience in operating from the right side. The Left Radial Approach (LRA) has always been a neglected route. LRA does have many advantages over the right, the vascular anatomy being one of them. The aim of our study was to compare the right radial approach of diagnostic coronary angiography with left radial approach. Method: A total of 70 cases of Coronary Angiography (CAG) with normal Allen test and satisfying the inclusion criteria were prospectively observed and studied after randomly assigning them into two equal groups, LRA (Left Radial Approach) n = 35 and RRA (Right Radial Approach) n = 35. Multipurpose TIG (Tiger) catheter was used in both the approaches to catheterize the right as well as left coronary artery. Results: The access time, catheter manipulation time, procedure time, amount of contrast used, hospital stay, intensity of pain experienced, cost of the procedure and quality of coronary angiogram observed were statistically insignificant while the fluoroscopy time was slightly statistically significant which was independent to catheter manipulation time. Conclusions: The neglected Left Radial Approach to coronary angiography is as efficacious, safe and cost effective with reduction in arterial spasm complications when compared to the Right Radial Approach performed by multipurpose Tiger catheter.

Right-and left-sided colorectal cancers respond differently to traditional Chinese medicine

AIM To explore the differences in the responses of left-sided colorectal cancer(LSCRC) and right-sided colon cancer(RSCC) to traditional Chinese medicine(TCM).METHODS Patients with postoperative stage I-III colorectal cancer(CRC) were enrolled and divided into the LSCRC with or without TCM and RSCC with or without TCM groups depending on the primary tumor side and TCM administration. Patients in the TCM group were given TCM for at least 6 mo. Our research adopted diseasefree survival(DFS) as the primary endpoint. We applied a Cox proportional hazards regression model for the multivariate factor analysis using Stata 12.0 and SPSS 22.0 software for data analysis.RESULTS Of the 817 patients included in our study, 617 had LSCRC(TCM group, n = 404; Non-TCM group, n = 213), and 200 had RSCC(TCM group, n = 132; NonTCM group, n = 68). The 6-year DFS for patients with LSCRC was 56.95% in the TCM group and 41.50% in the Non-TCM group(P = 0.000). For patients with RSCC, the 6-year DFS was 52.92% in the TCM group and 37.19% in the Non-TCM group(P = 0.003). Differences between LSCRC and RSCC were not statistically significant regardless of TCM ingestion.CONCLUSION Patients with either LSCRC or RSCC and who took TCM experienced longer DFS; furthermore, patients with RSCC benefited more from TCM in DFS.

“Taking the Left for the Upper” or “Taking the Right for the Upper”

Currently, there are two rituals coexist in the world:"taking the left for the upper"and"taking the right for the up?per". The former is usually taken in domestic affairs such as meetings, dinners, etc. while the latter enjoys an overwhelmingly fa?vor in the west and so that it becomes the international practice in every conceivable social activities. The paper intends to offer a deep explanation of the differences of two rituals with adequate evidence and examples in some specific situations, say different kinds of seat arrangement in various large and small meetings, respectively in China and the west. Then it follows to provide the underlying reasons for the differences from the perspective of cultural difference. It finds that different denotation of"left"and"right"in English and Chinese may shed some light on the understanding of the two different rituals.

LEFT-RIGHT BROWDER LINEAR RELATIONS AND RIESZ PERTURBATIONS

A closed linear relation T in a Banach space X is called left(resp. right) Fredholm if it is upper(resp. lower) semi Fredholm and its range(resp. null space) is topologically complemented in X. We say that T is left(resp. right) Browder if it is left(resp. right)Fredholm and has a finite ascent(resp. descent). In this paper, we analyze the stability of the left(resp. right) Fredholm and the left(resp. right) Browder linear relations under commuting Riesz operator perturbations. Recent results of Zivkovic et al. to the case of bounded operators are covered.

Structure analysis of levitation chassis of medium-to-low speed maglev vehicles based on left-right decoupling

Levitation chassis, as an extremely important component of maglev vehicles, provides functions of transmitting levitation force and steering force, and directly affects the safety performance of the vehicle. Based on the vertical dynamics model of the levitation chassis, kinetic equations of the model are established, and a simulation program is designed to analyze the structural decoupling function of the chassis, especially under the influence of elastic constraints between the left and right modules, which are exclusively owned by maglev vehicles. A finite element model of the levitation chassis based on left-right decoupling is constructed. Analysis results of the model show that the mechanical properties of the chassis tailored for the vehicle meet the design requirements, and the stiffness and strength is adequate to bear the weight of the whole vehicle.

MDCT of right aortic arch with aberrant left subclavian artery associated with kommerell diverticulum and calcified ligamentum arteriosum

We present a case of the right aortic arch with kommerell diverticulum (KD) and aberrant left subclavian artery in a symptomatic 50-year-old patient with a calcification in the presumed attachment site of the ligamentum arteriosum (LA) to the KD. In another 30-year-old male patient, the entire course of a calcified LA was demonstrated using multidetector row computed tomography.

Hypoxemia without persistent right-to-left pressure gradient across a patent foramen ovale:A clinical challenge

Patent foramen ovale (PFO) closure for systemic hypoxemia is controversial. The first systematic, albeit retrospective, study was recently presented which showed good procedural and clinical success for PFO closure for this indication. We present a case of acute right to left intra-cardiac shunt across PFO where the shunting is not persistent. Hence making a decision on PFO closure based on the aforementioned promising trial may not have been the right decision for the patient. This case highlights that the decision on PFO closure for such indication needs to be individualized. We also review the sparse literature on PFO closure for this indication and discuss how the decision making for such indication needs to be individualized.

Left and Right Inverse Eigenpairs Problem of Orthogonal Matrices

In this paper, the left and right inverse eigenpairs problem of orthogonal matrices and its optimal approximation solution are considered. Based on the special properties of eigenvalue and the special relations of left and right eigenpairs for orthogonal matrices, we find the equivalent problem, and derive the necessary and sufficient conditions for the solvability of the problem and its general solutions. With the properties of continuous function in bounded closed set, the optimal approximate solution is obtained. In addition, an algorithm to obtain the optimal approximation and numerical example are provided.

Left Ventricular Pseudoaneurysm Caused by a Left Ventricular Venting Catheter via the Right Superior Pulmonary Vein during Thoracic Aortic Surgery: A Case Report

A left ventricular (LV) pseudoaneurysm is one of the complications of acute myocardial infarction. It is also reported after chest trauma, cardiac surgery, and endocarditis. We report a rare case of an LV pseudoaneurysm induced by an LV venting catheter through the right superior pulmonary vein during thoracic aortic surgery. A 77-year-old man was referred for surgical repair of a distal aortic arch aneurysm. He underwent total aortic arch reconstruction with the frozen elephant trunk technique. The early postoperative period was uneventful. Postoperative contrast computed tomography and transthoracic echocardiography (TTE) revealed a pseudoaneurysm with a narrow neck at the apex of the LV that had sub-clinically progressed. Because of the risk of spontaneous rupture, an urgent aneurysmectomy was performed via a repeat sternotomy. Under cardioplegic arrest, the pseudoaneurysm was opened and the small orifice, which communicated with the LV, was confirmed. No myocardial ischemic changes were observed around the orifice. The pseudoaneurysm was thought to be induced by endocardial laceration by the tip of the venting catheter. The pseudoaneurysm was closed by linear repair reinforced with felt strips. The patient recovered well and was discharged 18 days after the second surgery. TTE showed no recurrence of LV aneurysm at the last follow-up.

Right and Left Colon Cancer: Clinico-Pathological Features and Treatment Results (South Egypt Cancer Institute Experience)

Background: Colon cancer (CC) ranks as the third most common cancer worldwide and is considered the second leading cause of cancer death. Recently, many international studies have made the observation that right and left colon cancer have many significant differences regarding clinico-pathological characteristics and primary tumor location has a crucial impact on treatment outcomes and overall survival. Our study was conducted to verify the presence of significant differences between right and left colon cancer. Patients and Methods: This study is a retrospective cohort study which aimed at comparing right and left colon cancer as regards clinico-pathological data and treatment results among patients with colon cancer receiving treatment at South Egypt Cancer Institute (SECI) during the period from 1/2008 to 12/2018. A sample size of 160 cases of colon cancer patients (80 diagnosed as right colon cancer and 80 diagnosed as left colon cancer) was randomly selected from our South Egypt Cancer Institute (SECI)’s tumor registry. Statistical analysis was done using SPSS program version 20. Difference was considered statistically significant at P-value < 0.05. Survival curves were conducted using the Kaplan-Meier methods and were compared with the log-rank test. Results: Right colon cancer occurred at an older age and was more commonly presented with abdominal pain while left colon cancer was more commonly presented with bleeding manifestations. More cases of the right side underwent curative surgeries whereas more palliative surgeries were performed to left-sided cases. Left sided cases were associated with a more advanced stage at diagnosis while right-sided cases were associated with a better response to first-line chemotherapy. More cases of the left side died due to metastatic disease. On the other hand, our findings demonstrated no differences between both sides regarding gender predilection, risk factors, sites of metastases, number of metastatic organs, histo-pathological examination and grading, response to second- or third-line chemotherapy, chemotherapy toxicity (hematological or non-hematological), overall survival, progression-free survival, or disease-free survival. Conclusion: Primary tumor location of colon cancer has a significant effect on clinico-pathological characteristics and treatment outcomes.

Consideration of the Necessity of Prophylactic Bypass Grafting for Anomalous Origin of the Right Coronary Artery—Based on a Case with Concomitant Left Main Trunk Disease Resuscitated from Cardiopulmonary Arrest

Anomalous origin of the right coronary artery is a rare congenital anomaly, but is associated with sudden death. Originating from the opposite sinus of Valsalva, an interarterial?course and an intramural course are especially considered as the risk factor for fatal cardiac events. Surgical indication remains controversial because many patients are asymptomatic. A 52-year-old man with anomalous origin of the right coronary artery with an interarterial?course concomitant with the left main trunk disease was resuscitated from cardiopulmonary arrest. It was likely to be attributed to the left main trunk disease, but anatomical structure of the right coronary artery suggests its possible involvement. Prophylactic bypass grafting for the right coronary artery was performed using saphenous vein graft without ligating native vessel to prevent future cardiac events, as well as revascularization of the left main trunk disease. All grafts were patent in one-year follow-up coronary angiography. Any cardiac event has not occurred.