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 con...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.展开更多
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 fo...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.展开更多
Percutaneous Patent Foramen Ovate PFO/Atrial Septal Defect (ASD) closure has become an increasingly simplified procedure over the past decade. The main advantages of a percutaneous approach include avoidance of surger...Percutaneous Patent Foramen Ovate PFO/Atrial Septal Defect (ASD) closure has become an increasingly simplified procedure over the past decade. The main advantages of a percutaneous approach include avoidance of surgery, short procedure time and hospital stay. Device embolization is seen rarely but it can be fatal. We report this complication following a percutaneous PFO closure in a 44-year-old man. The device was embolized into the distal part of the right pulmonary artery. We removed the device surgically and closed the PFO/ASD.展开更多
BACKGROUND As an established,simple,inexpensive,and surprisingly effective diagnostic tool,right-heart contrast echocardiography(RHCE)might help in solving a vexing diagnostic problem.If performed appropriately and in...BACKGROUND As an established,simple,inexpensive,and surprisingly effective diagnostic tool,right-heart contrast echocardiography(RHCE)might help in solving a vexing diagnostic problem.If performed appropriately and interpreted logically,RHCE allows for differentiation of various usual and unusual right-to-left shunts based on the site of injection and the sequence of microbubble appearance in the heart.CASE SUMMARY A 31-year-old woman was readmitted to hospital with a 2-mo history of worsening palpitation and chest distress.Two years prior,she had been diagnosed with postpartum pulmonary embolism by conventional echocardiography and computed tomography angiography.While the latter showed no sign of pulmonary artery embolism,the former showed pulmonary artery hypertension,moderate insufficiency,and mild stenosis of the aortic valve.RHCE showed microbubbles appearing in the left ventricle,slightly delayed after rightheart filling with microbubbles;no microbubbles appeared in the left atrium and microbubbles’appearance in the descending aorta occurred nearly simultaneous to right pulmonary artery filling with microbubbles.Conventional echocardiography was re-performed,and an arterial horizontal bidirectional shunt was found according to Doppler enhancement effects caused by microbubbles.The original computed tomography angiography findings were reviewed and found to show a patent ductus arteriosus.CONCLUSION RHCE shows a special imaging sequence for unexplained pulmonary artery hypertension with aortic valve insufficiency and simultaneous patent ductus arteriosus.展开更多
Through over a decade of painstakingeffort, the Fujian AgricultureUniversity has witnessed abreakthrough in its research and applicationof bacterioflora technology, and has obtaineda series of results at the internati...Through over a decade of painstakingeffort, the Fujian AgricultureUniversity has witnessed abreakthrough in its research and applicationof bacterioflora technology, and has obtaineda series of results at the international advancedlevel. Since 1983, under the leadership of LiZhanxi, a senior agronomist, the universityhas successively and successfully developed16 technical items, including "edible funguscultivation using bacterioflora to replace woodand grain" and "bacterioflora fermentationmethod for the cultivation of mushroom andauricularia auriculajudae". The bacteriofloratechnology has basically solved the"contradiction between fungus and forestry",that is, the contradiction between edible fungusproduction and the ecological balance inforestry. This technology has captured展开更多
AIM To test the potential association between atrial septal aneurysm(ASA) and migraine in patent foramen ovale(PFO) closure patients through an observational, singlecenter, case-controlled study.METHODS We studied a t...AIM To test the potential association between atrial septal aneurysm(ASA) and migraine in patent foramen ovale(PFO) closure patients through an observational, singlecenter, case-controlled study.METHODS We studied a total of 450 migraineurs who had rightto-left shunts and underwent PFO closure in a retrospective single-center non-randomized registry from February 2012 to October 2016 on the condition that they were aged 18-45 years old. Migraine was diagnosed according to the International Classification of Headache Disorders, 3^(rd) edition and evaluated using the Headache Impact Test-6(HIT-6). All patients underwent preoperative transesophageal echocardiography, contrast transthoracic echocardiography, and computed tomography or magnetic resonance imaging examinations, with subsequent fluoroscopy-guided PFO closure. Based on whether they have ASA or not, the patients were divided into two groups: A(PFO with ASA, n = 80) and B(PFO without ASA, n = 370). Baseline characteristics and procedural and follow-up data were reviewed. RESULTS Compared to group B, group A had an increased frequency of ischemic lesions(11.3% vs 6.2%, P = 0.038) and migraine with aura(32.5% vs 21.1%, P = 0.040). The PFO size was significantly larger in group A(P = 0.007). There was no significant difference in HIT-6 scores between the two groups before and at the oneyear follow-up after the PFO closure [61(9) vs 63(9), P = 0.227; 36(13) vs 36(10), P = 0.706].CONCLUSION Despite its small sample size, our study suggests that the prevalence of ASA in PFO with migraine patients is associated with ischemic stroke, larger PFO size, and migraine with aura.展开更多
This study examined Japanese patents in terms of the quantitative characteristics of application documents that resulted in the acquisition of rights in order to clarify the relationship between the features and paten...This study examined Japanese patents in terms of the quantitative characteristics of application documents that resulted in the acquisition of rights in order to clarify the relationship between the features and patentability of applications. The groups of approved applications and those that had not been approved were compared for 12 variables： publication time lag; numbers of inventors, classifications, pages, figures, tables, claims, priority claims, countries for priority claims, cited patents, and cited non-patent documents; and median of citation age. Furthermore, the authors carried out the experiments in which patent applications were automatically classified into two groups by the machine learning method, random forests. As a result, statistically significant differences between the two groups were observed for the following variables （p 〈 .001）： the numbers of inventors, pages, figures, claims, priority claims, and countries for priority claims were significantly larger in the group of approved applications, while the time lag until publication was smaller. In particular, the publication time lag and the numbers of inventors, pages, and figures were variables representing the features that largely contribute to discriminating approved applications in the classification using random forests, which implies that these have relatively strong relationships with patentability.展开更多
On the basis of definition of agricultural plant genetic resources,this paper takes the two most important forms of intellectual property protection regarding agricultural plant genetic resources-patent rights and new...On the basis of definition of agricultural plant genetic resources,this paper takes the two most important forms of intellectual property protection regarding agricultural plant genetic resources-patent rights and new plant variety rights as an example,to expound the current situation of intellectual property protection of agricultural plant genetic resources in China.It reveals the problems of intellectual property protection as follows:the awareness of intellectual property protection of agricultural plant genetic resources is weak;the system of laws and regulations is not sound;the protection system is not perfect;the management system lacks standardization.It further puts forward corresponding countermeasures and suggestions as follows:promote the protection awareness of agricultural plant genetic resources in whole society;enact special law system to protect agricultural plant genetic resources;improve the management system of agricultural plant genetic resources;strengthen the international protection of agricultural plant genetic resources in China.展开更多
The Netac Technology Co., Ltd brought suit against Beijing Huaqi Information Digital Technology Co., Ltd for infringing Netac＇s patent. This case was the preclude to the intellectual property rights （IPR） war of th...The Netac Technology Co., Ltd brought suit against Beijing Huaqi Information Digital Technology Co., Ltd for infringing Netac＇s patent. This case was the preclude to the intellectual property rights （IPR） war of the internal enterprises. The process of this case was followed with great interest because it would influence the development of the hundreds of Mobile Storage enterprises in China. This paper is based on the brief review of the details of the case, the authors analyze the main legal issues covered by this case from the two aspects of the substantive and the procedural law, and reach the conclusions that the IPR strategy has gradually become the key to the IT enterprises in their intense market competition and that the concerned laws and regulations in China should be rectified and improved accordingly.展开更多
文摘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.
文摘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.
文摘Percutaneous Patent Foramen Ovate PFO/Atrial Septal Defect (ASD) closure has become an increasingly simplified procedure over the past decade. The main advantages of a percutaneous approach include avoidance of surgery, short procedure time and hospital stay. Device embolization is seen rarely but it can be fatal. We report this complication following a percutaneous PFO closure in a 44-year-old man. The device was embolized into the distal part of the right pulmonary artery. We removed the device surgically and closed the PFO/ASD.
文摘BACKGROUND As an established,simple,inexpensive,and surprisingly effective diagnostic tool,right-heart contrast echocardiography(RHCE)might help in solving a vexing diagnostic problem.If performed appropriately and interpreted logically,RHCE allows for differentiation of various usual and unusual right-to-left shunts based on the site of injection and the sequence of microbubble appearance in the heart.CASE SUMMARY A 31-year-old woman was readmitted to hospital with a 2-mo history of worsening palpitation and chest distress.Two years prior,she had been diagnosed with postpartum pulmonary embolism by conventional echocardiography and computed tomography angiography.While the latter showed no sign of pulmonary artery embolism,the former showed pulmonary artery hypertension,moderate insufficiency,and mild stenosis of the aortic valve.RHCE showed microbubbles appearing in the left ventricle,slightly delayed after rightheart filling with microbubbles;no microbubbles appeared in the left atrium and microbubbles’appearance in the descending aorta occurred nearly simultaneous to right pulmonary artery filling with microbubbles.Conventional echocardiography was re-performed,and an arterial horizontal bidirectional shunt was found according to Doppler enhancement effects caused by microbubbles.The original computed tomography angiography findings were reviewed and found to show a patent ductus arteriosus.CONCLUSION RHCE shows a special imaging sequence for unexplained pulmonary artery hypertension with aortic valve insufficiency and simultaneous patent ductus arteriosus.
文摘Through over a decade of painstakingeffort, the Fujian AgricultureUniversity has witnessed abreakthrough in its research and applicationof bacterioflora technology, and has obtaineda series of results at the international advancedlevel. Since 1983, under the leadership of LiZhanxi, a senior agronomist, the universityhas successively and successfully developed16 technical items, including "edible funguscultivation using bacterioflora to replace woodand grain" and "bacterioflora fermentationmethod for the cultivation of mushroom andauricularia auriculajudae". The bacteriofloratechnology has basically solved the"contradiction between fungus and forestry",that is, the contradiction between edible fungusproduction and the ecological balance inforestry. This technology has captured
文摘AIM To test the potential association between atrial septal aneurysm(ASA) and migraine in patent foramen ovale(PFO) closure patients through an observational, singlecenter, case-controlled study.METHODS We studied a total of 450 migraineurs who had rightto-left shunts and underwent PFO closure in a retrospective single-center non-randomized registry from February 2012 to October 2016 on the condition that they were aged 18-45 years old. Migraine was diagnosed according to the International Classification of Headache Disorders, 3^(rd) edition and evaluated using the Headache Impact Test-6(HIT-6). All patients underwent preoperative transesophageal echocardiography, contrast transthoracic echocardiography, and computed tomography or magnetic resonance imaging examinations, with subsequent fluoroscopy-guided PFO closure. Based on whether they have ASA or not, the patients were divided into two groups: A(PFO with ASA, n = 80) and B(PFO without ASA, n = 370). Baseline characteristics and procedural and follow-up data were reviewed. RESULTS Compared to group B, group A had an increased frequency of ischemic lesions(11.3% vs 6.2%, P = 0.038) and migraine with aura(32.5% vs 21.1%, P = 0.040). The PFO size was significantly larger in group A(P = 0.007). There was no significant difference in HIT-6 scores between the two groups before and at the oneyear follow-up after the PFO closure [61(9) vs 63(9), P = 0.227; 36(13) vs 36(10), P = 0.706].CONCLUSION Despite its small sample size, our study suggests that the prevalence of ASA in PFO with migraine patients is associated with ischemic stroke, larger PFO size, and migraine with aura.
文摘This study examined Japanese patents in terms of the quantitative characteristics of application documents that resulted in the acquisition of rights in order to clarify the relationship between the features and patentability of applications. The groups of approved applications and those that had not been approved were compared for 12 variables： publication time lag; numbers of inventors, classifications, pages, figures, tables, claims, priority claims, countries for priority claims, cited patents, and cited non-patent documents; and median of citation age. Furthermore, the authors carried out the experiments in which patent applications were automatically classified into two groups by the machine learning method, random forests. As a result, statistically significant differences between the two groups were observed for the following variables （p 〈 .001）： the numbers of inventors, pages, figures, claims, priority claims, and countries for priority claims were significantly larger in the group of approved applications, while the time lag until publication was smaller. In particular, the publication time lag and the numbers of inventors, pages, and figures were variables representing the features that largely contribute to discriminating approved applications in the classification using random forests, which implies that these have relatively strong relationships with patentability.
文摘On the basis of definition of agricultural plant genetic resources,this paper takes the two most important forms of intellectual property protection regarding agricultural plant genetic resources-patent rights and new plant variety rights as an example,to expound the current situation of intellectual property protection of agricultural plant genetic resources in China.It reveals the problems of intellectual property protection as follows:the awareness of intellectual property protection of agricultural plant genetic resources is weak;the system of laws and regulations is not sound;the protection system is not perfect;the management system lacks standardization.It further puts forward corresponding countermeasures and suggestions as follows:promote the protection awareness of agricultural plant genetic resources in whole society;enact special law system to protect agricultural plant genetic resources;improve the management system of agricultural plant genetic resources;strengthen the international protection of agricultural plant genetic resources in China.
文摘The Netac Technology Co., Ltd brought suit against Beijing Huaqi Information Digital Technology Co., Ltd for infringing Netac＇s patent. This case was the preclude to the intellectual property rights （IPR） war of the internal enterprises. The process of this case was followed with great interest because it would influence the development of the hundreds of Mobile Storage enterprises in China. This paper is based on the brief review of the details of the case, the authors analyze the main legal issues covered by this case from the two aspects of the substantive and the procedural law, and reach the conclusions that the IPR strategy has gradually become the key to the IT enterprises in their intense market competition and that the concerned laws and regulations in China should be rectified and improved accordingly.
