旋转数字减影脑血管造影每幅图像投照角度确定的临床研究

目的　探讨确定脑血管旋转DSA任意 1帧图像投照角度的可行性。方法　通过模型试验获得旋转血管造影数次旋转的有关数据 ,采用数据拟合方法得到描述X线机旋转规律近似的数学表达式。使用可编程手持器实现对 2 3例脑血管旋转DSA任意 1帧图像投照角度的实时计算。结果　所有 2 3例脑血管旋转DSA中 ,可编程手持计算器均可立即计算出每一个感兴趣图像的投照角度。其中颅内动脉瘤 14例 ,左前颅凹脑膜瘤 1例 ,颅内大脑动静脉畸形 8例。对比由计算器获得的图像与旋转DSA相对应的图像 ,两者在显示异常动脉的起源、形态、走行、分布以及病变的供血动脉和引流静脉等诸方面 ,具有较好的相似性。结论　实时确定脑血管旋转DSA任意图像的投照角度 ,对准确诊断与治疗颅内脑血管异常具有重要作用     

Minimum fuel powered dynamic soaring of unmanned aerial vehicles utilizing wind gradients

This paper studies optimal powered dynamic soaring flights of unmanned aerial vehicles (UAVs) that utilize low‐altitude wind gradients for reducing fuel consumptions. Three‐dimensional point‐mass UAV equations of motion are used, and linear wind gradients are assumed. Fundamental UAV performance parameters are identified through the normalization of the equations of motion. In particular, a single wind condition parameter is defined that represents the combined effect of air density, UAV wing loading, and wind gradient slope on UAV flight. An optimal control problem is first used to determine bounds on wind conditions over which optimal powered dynamic soaring is meaningful. Then, powered UAV dynamic soaring flights through wind gradients are formulated as non‐linear optimal control problems. For a jet‐engined UAV, performance indices are selected to minimize the average thrust required per cycle of powered dynamic soaring that employs either variable or constant thrust. For a propeller‐driven UAV, in comparison, performance indices are selected to minimize the average power required per cycle of powered dynamic soaring with either variable or constant power. All problem formulations are subject to UAV equations of motion, UAV operational constraints, proper initial conditions, and terminal conditions that enforce a periodic flight. These optimal control problems are converted into parameter optimization with a collocation method and solved numerically using the parameter optimization software NPSOL. Analytical gradient expressions are derived for the numerical solution process. Extensive numerical solutions are obtained for a wide range of wind conditions and UAV performance parameters. Results reveal basic features of powered dynamic soaring flights through linear wind gradients. Copyright © 2004 John Wiley & Sons, Ltd.     

旋转肾动脉DSA的临床应用

目的　探讨旋转肾动脉DSA临床应用的可行性。方法　回顾性分析 48例肾肿瘤患者腹主动脉DSA检查中肾动脉的解剖情况。测量 5 0例腹部CT增强扫描肾动脉开口的位置、方向。观察 16例旋转肾动脉DSA的效果。结果　 48例常规腹主动脉DSA中 ,右肾动脉开口、主干及分支显示不清分别为 12例、5例及 10例。左肾动脉开口、主干及分支显示不清分别为 8例、4例及 6例。 5 0例腹部CT增强扫描显示 :右肾动脉开口位于腹主动脉侧壁、侧前壁以及侧后壁分别为 4例、2 4例及 3例。左肾动脉开口位于腹主动脉侧壁、侧前壁以及侧后壁分别为 13例、2例及 13例。两肾动脉开口位于腹主动脉同一水平面 11例。 16例旋转肾动脉DSA中 ,两侧肾动脉旋转 6例 ,单侧肾动脉旋转 10例。肾动脉开口狭窄 3例 ,主干狭窄 2例 ,肾肿瘤供血动脉 7例 ,排除肾动脉狭窄 4例。结论　旋转肾动脉DSA有助于详细显示肾动脉的解剖细节。     

Three-dimensional rotational angiography of the left atrium and esophagus—A virtual computed tomography scan in the electrophysiology lab?

BACKGROUND: Three-dimensional (3D) reconstruction of the heart and surrounding structures has been supplementing traditional two-dimensional imaging to guide diagnostic and therapeutic electrophysiologic procedures. Current methods using computed tomography (CT)/magnetic resonance imaging (MRI) reconstruction have certain limitations. OBJECTIVE: We investigated the feasibility of rotational angiography (RA) combined with simultaneous esophagogram to create an intraprocedural 3D reconstruction of the left atrium (LA) and the esophagus. METHODS: Rotational angiography was performed. Contrast was injected via a pigtail catheter positioned in the left or right pulmonary artery to achieve a levophase venous cycle opacification of the ipsilateral pulmonary veins and adjacent LA. Simultaneous administration of oral contrast allowed a 3D reconstruction of the esophagus in the same image. Qualitative and quantitative comparison between the intraprocedural 3D RA and a remote CT scan was performed in 11 consecutive patients undergoing ablation for atrial fibrillation. RESULTS: Adequate visualization of the pulmonary veins, adjacent posterior LA, and esophagus was achieved in 10 patients. Determination of pulmonary transit time to guide the initiation of RA resulted in better-quality imaging. A close correlation between 3D RA and CT was found. Based on close proximity between the LA and esophagus, the ablation procedure was modified in three patients. CONCLUSIONS: Three-dimensional RA of the LA and esophagus is a promising new method allowing intraprocedural 3D reconstruction of these structures comparable in quality to a CT scan. Further studies refining the method are justified because it could eliminate the need for CT/MRI scans before ablation.     

按压医风穴配合针刺治疗顽固性呃逆62例

呃逆，现代医学称为膈肌痉挛，以气逆上冲，喉间呃呃连声，声短而频，令人不能自制为主证。呃逆一证，有时可以单独出现，有时常在其它疾病中以兼证出现。本证轻重差别极为明显，如偶然发作，大都轻浅，常可自行消失，或以取嚏、惊恐、闭气皆可取效；若持续不断昼夜不停，或间歇发作，迁延数日至数月不愈，或给予药物治疗也难以控制。针灸治疗，对于病程短的实证疗效较好，对于病程长的虚证疗效较差。     

祛风宣肺颗粒治疗感染后咳嗽60例临床观察

目的观察祛风宣肺颗粒治疗感染后咳嗽的疗效,并探讨其作用机制。方法对60例感染后咳嗽的患者,采用配对设计的方法,分为中药治疗组40例和西药对照组(茶碱联合开瑞坦)20例,观察治疗前后咳嗽、咽痒等症状的变化情况,对两组疗效、病程及起效时间进行比较。结果中药治疗组愈显率75.50%,总有效率92.50%;西药组愈显率35.00%,总有效率70.00%。结论祛风宣肺颗粒治疗感染后咳嗽疗效显著,治疗机制可能与减轻呼吸道炎症、修复上皮细胞损伤以及降低气道反应性有关。     

Coronary rotational atherectomy in current practice: acute and mid-term results in high- and low-volume centers.

We conducted a prospective observational study to evaluate the indications, technique, in-hospital and 9-month results of consecutive patients treated with rotational atherectomy (RA) in 12 centers during 1 year, as well as their relationship with volume of RA activity. The study included 345 lesions in 289 patients treated (4.4% +/- 2.6% of procedures at the participating centers). The lesions were mostly calcified (63%) and type B2 or C (74%). Procedural success was obtained in 94% of patients, with a major adverse cardiac event (MACE) rate of 4.5%. At 9 months, MACE occurred in 17.3%. Multivariate analysis identified multivessel disease and slow flow as negative predictors of procedural success, whereas balloon pressure 相似文献   

吸烟与中风病中医证候的相关性研究

目的探讨吸烟与中风病中医证候的相关性。方法制定调查表,由临床中医师采集中风病患者的临床资料并辨证,然后双人、双盲录入到数据库,导出数据后统计分析。将中风病患者分为吸烟组和非吸烟组,分别对两组的中医证候进行统计分析。结果吸烟组中风病患者年龄(64.7±0.7)岁,小于非吸烟组(69.5±0.5)岁,吸烟组中风病患者风痰阻络证的比例(61.4%),高于非吸烟组(51.9%)。结论吸烟使中风病的发病年龄提前,与中风病风痰阻络证的形成有关。     

一种新的混合矢量磁滞模型磁滞算子定义方法

提出了一种新的磁滞算子定义方法,从能量角度定性分析了单畴单轴各向异性椭圆形磁性粒子的特性及其磁化方向的判定法则,借助于磁性粒子矢量场等势线分别给出了各向异性和各向同性材料的磁滞算子临界面方程,把磁滞算子定义为等势线包围的封闭区域,给出了磁滞算子的磁化方向判定方法。定义的磁滞算子满足第二热力学定律,具有能够描述磁滞现象的损耗特性和擦除特性,符合描述磁滞特性的Mandelung定则。     

紫丹银屑颗粒联合窄谱中波紫外线治疗血虚风燥证寻常型银屑病的临床分析

目的:观察紫丹银屑颗粒联合窄谱中波紫外线治疗血虚风燥证寻常型银屑病的临床疗效及对血清白介素-17(IL-17),IL-22和IL-23的影响。方法:将符合条件的116例患者采用随机按数字表法分成对照组和观察组各58例。对照组采用窄谱中波紫外线(NB-UVB)治疗。观察组在对照组治疗的基础上加用紫丹银屑颗粒,4 g/次,3次/d。两组疗程均为8周。所有患者进行3个月随访,记录复发情况。于治疗前、治疗后和治疗结束后1,2,3个月进行皮损面积和严重程度指数(PASI)评分;记录复发时间。进行治疗前后皮肤病生活质量指数(DLQI)和瘙痒程度视觉模拟(VAS)评分,检测治疗前后IL-17,IL-22,IL-23水平。结果:治疗后观察组PASI,DLQI和VAS评分均低于对照组(P0.05,P0.01);观察组临床有效率为93.1%,对照组为84.48%,观察组高于对照组,但差异无统计学意义;在治疗后3个月的随访期间,观察组复发率为40.74%,低于对照组的63.26%(P0.05);观察组平均复发时间长于对照组(P0.05);治疗后观察组血清IL-17,IL-22,IL-23水平均低于对照组(P0.01)。结论:紫丹银屑颗粒联合窄谱中波紫外线治疗血虚风燥证寻常型银屑病,能减轻皮损和瘙痒,提高患者的生活质量,并能稳定病情,降低复发率,同时可调节血清IL-17,IL-22,IL-23等辅助性T细胞17(TH17)细胞因子。