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经颅彩色多普勒超声联合经颅超声造影与磁共振血管成像在颅内动脉狭窄诊断中的相关性及应用价值 被引量:1
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作者 夏岩 王嵘 +3 位作者 张蕾 林发 刘子琪 王晓岩 《首都医科大学学报》 北大核心 2025年第4期694-701,共8页
目的探究经颅彩色多普勒超声(transcranial color-coded Duplex ultrasound,TCCD)联合超声造影(contrast-enhanced ultrasound,CEUS)检测颅内主要动脉狭窄的灵敏度、特异度及其与磁共振血管成像(magnetic resonance angiography,MRA)检... 目的探究经颅彩色多普勒超声(transcranial color-coded Duplex ultrasound,TCCD)联合超声造影(contrast-enhanced ultrasound,CEUS)检测颅内主要动脉狭窄的灵敏度、特异度及其与磁共振血管成像(magnetic resonance angiography,MRA)检查结果的一致性和应用价值。方法选取2023年4月至2024年8月首都医科大学附属北京天坛医院医院55例疑似颅内动脉狭窄或闭塞患者,分别应用TCCD联合CEUS和MRA,检查颈内动脉终末段、大脑中动脉M1和M2段,大脑前动脉A1和A2段、大脑后动脉P1和P2段以及椎动脉V4段等血管狭窄程度。将颅内动脉狭窄程度分为正常/轻度、中度、重度/闭塞3组,计算两种检查方法的灵敏度、特异度及一致性。采用Wilcoxon符号秩检验比较两种检查费用及诊断时长的差异。结果本研究纳入55例(共110例大脑半球)高危脑血管狭窄患者(中位年龄46岁,男性占69.0%),同步行TCCD联合CEUS与MRA检测。TCCD联合CEUS与MRA在颅内动脉狭窄诊断的灵敏度和特异度较高。TCCD联合CEUS与MRA在诊断颅内动脉狭窄具有一致性,其中M2段(加权Kappa值=0.704)、A2段(加权Kappa值=0.650)诊断一致性较高;M1段(加权Kappa值=0.569)一致性中等。同时,TCCD联合CEUS检查的平均费用为240元,诊断时长21 min,而MRA为722元和287 min(P<0.001,效应量r=0.89~0.91)。结论与MRA相比,TCCD联合CEUS在颅内大脑中动脉M2段和大脑前动脉A2段的血管狭窄筛查中具有较高一致性。TCCD联合CEUS更具成本效益。MRA对颅内深部血管狭窄程度的评估更具有优势。选择二者协同应用可优化颅内血管狭窄诊疗资源配置,建议基层医疗机构以TCCD初筛和经过规范培训技术升级联合CEUS,对复杂病例转诊MRA精细化评估。 展开更多
关键词 经颅彩色多普勒超声 超声造影 磁共振血管成像 颅内动脉 卫生经济学 诊疗模式
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脑心共患疾病共治与分治模式的卫生经济学比较研究 被引量:1
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作者 夏岩 王晓岩 +2 位作者 林发 梁艳超 张佳妮 《中国卒中杂志》 北大核心 2024年第8期866-872,共7页
目的评估脑心共患疾病在共治与分治两种模式下的卫生经济学效益,以确定更优的医疗策略,提高治疗效率与经济效益。方法本研究采用回顾性分析方法,收集2019年1月—2023年12月在首都医科大学附属北京天坛医院心血管内科、神经内科、神经外... 目的评估脑心共患疾病在共治与分治两种模式下的卫生经济学效益,以确定更优的医疗策略,提高治疗效率与经济效益。方法本研究采用回顾性分析方法,收集2019年1月—2023年12月在首都医科大学附属北京天坛医院心血管内科、神经内科、神经外科、心血管外科和介入放射科等治疗的,符合中国疾病诊断相关分组(Chinese diagnosis related groups,CN-DRG)中神经系统疾病及功能障碍合并循环系统疾病及功能障碍患者的病历资料,记录患者的人口学特征、总住院天数、各类医疗费用以及病例组合指数(case mix index,CMI)和权重(relative weight,RW)。将患者分为共治组(一次住院期间对患者的脑心共患疾病进行统筹规划和综合治疗)与分治组(不同住院期间分别进行神经系统和心血管系统疾病的治疗),比较两组的基线特点及总住院天数、费用等经济学指标。结果共纳入442例患者数据。共治组总住院天数低于分治组(6 d vs.14 d,P<0.001)。经济学效益分析显示,共治组住院总费用低于分治组(65967元vs.106673元,P<0.001)。此外,共治组的RW高于分治组(2.24 vs.1.61,P<0.001)。结论相较于分治模式,共治模式下脑心共患疾病患者的住院时间更短,住院费用更低。共治模式有利于优化脑心共患疾病的医疗资源配置和诊疗流程。 展开更多
关键词 脑心共患疾病 共治 卫生经济学 资源配置 诊疗流程
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Seismic Signal and Data Analysis of Rock Media with Vertical Anisotropy 被引量:3
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作者 Yuan Zhao Nan Zhao +1 位作者 lin fa Meishan Zhao 《Journal of Modern Physics》 2013年第1期11-18,共8页
This paper is concerned with anisotropic effects on seismic data and signal analysis for transversely isotropic rock media with vertical anisotropy. It is understood that these effects are significant in many practica... This paper is concerned with anisotropic effects on seismic data and signal analysis for transversely isotropic rock media with vertical anisotropy. It is understood that these effects are significant in many practical applications, e.g. earthquake forecasting, materials exploration inside the Earth’s crust, as well as various practical works in oil industry. Under the framework of the most accepted anisotropic media model (i.e. VTI media, transverse isotropy with a vertical axis symmetry), with applications of a set of available anisotropic rock parameters for sandstone and shale, we have performed numerical calculations of the anisotropic effects. We show that for rocks with strong anisotropy, the induced relative depth error can be significantly large. Nevertheless, with an improved understanding of the seismic-signal propagation and proper data processing, the error can be reduced, which in turn may enhance the probability of forecasting accurately the various wave propagations inside the Earth’s crust, e.g. correctly forecasting the incoming earthquakes from the center of the Earth. 展开更多
关键词 ANISOTROPY ROCK MEDIA SEISMIC SIGNAL Data and Analysis
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中国破裂颅内动脉瘤临床管理指南(2024版)解读 被引量:3
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作者 江裕华 李润亭 +2 位作者 林发 陈玉 陈晓霖 《中华医学杂志》 CAS CSCD 北大核心 2024年第21期1907-1910,共4页
动脉瘤性蛛网膜下腔出血(aSAH)是一种高致死率的神经外科急症,即使患者接受了最佳的医疗护理,仍有可能出现长期残疾,严重影响患者生活质量,给社会和家庭增加了沉重的医疗负担。为提供全面的临床管理意见,中华医学会神经外科学分会、中... 动脉瘤性蛛网膜下腔出血(aSAH)是一种高致死率的神经外科急症,即使患者接受了最佳的医疗护理,仍有可能出现长期残疾,严重影响患者生活质量,给社会和家庭增加了沉重的医疗负担。为提供全面的临床管理意见,中华医学会神经外科学分会、中国卒中学会脑血管外科分会、国家神经系统疾病医学中心与国家神经系统疾病临床研究中心联合制订《中国破裂颅内动脉瘤临床管理指南(2024版)》,将证据来源分为中国人群和其他人群,并采用模块化形式,对aSAH的流行病学、临床影像诊断、预后评价、治疗策略及选择、麻醉管理、围手术期护理和特殊人群aSAH管理建议等问题提供推荐意见、相关意见概述及未来研究方向,为医师及相关专业人员提供了实用的临床指导建议。 展开更多
关键词 蛛网膜下腔出血 动脉瘤 指南 临床管理
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Reflection and refraction of elastic wave at VTI-TTI media interface 被引量:1
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作者 lin fa Jiaojiao Tang +4 位作者 Qi Zhang Minjin Zhang Yandong Zhang Meng Liang Meishan Zhao 《Frontiers of physics》 SCIE CSCD 2020年第2期39-55,共17页
We explore the physical phenomenon of acoustic waves induced at the interface between two different anisotropic rock media.Specifically,one medium is a transversely isotropic medium with a vertical axis of symmetry(VT... We explore the physical phenomenon of acoustic waves induced at the interface between two different anisotropic rock media.Specifically,one medium is a transversely isotropic medium with a vertical axis of symmetry(VTI medium)and the other one is a transversely isotropic medium with a tilt axis of symmetry(TTI medium).By solving the Kelvin-Christoffel equation,an eighth-order polynomial is established for reflection and refraction angles,which is confirmed from SnelFs law.Three types of analytical expressions of the polarization coefficients of the induced waves are obtained corresponding to different incident angle regions.An effective algorithm has been developed for numerical analysis of the polarization coefficients.Applying characteristic anisotropic parameters reported in the literature,the influencing factors on reflection and refraction coefficients are analyzed,e.g.,the anisotropy,the tilt-angle of rock-layer,and the incident-angle.The calculated reflection and refraction coefficients have been rechecked for energy conservation. 展开更多
关键词 VTI-TTI INTERFACE REFLECTION REFRACTION rock ANISOTROPY tilt-angle
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一站式复合手术对后循环参与供血的脑动静脉畸形手术风险和预后的影响 被引量:2
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作者 林发 王明泽 +3 位作者 仇汉诚 曹勇 王硕 赵继宗 《中华医学杂志》 CAS CSCD 北大核心 2022年第21期1614-1620,共7页
目的探索在一站式复合手术应用场景下,栓塞后循环供血动脉辅助显微切除手术对后循环参与供血的脑动静脉畸形手术风险和预后的影响。方法从2016年1月至2019年12月前瞻性、多中心脑动静脉畸形的复合手术外科队列(NCT03209804)的患者中选... 目的探索在一站式复合手术应用场景下,栓塞后循环供血动脉辅助显微切除手术对后循环参与供血的脑动静脉畸形手术风险和预后的影响。方法从2016年1月至2019年12月前瞻性、多中心脑动静脉畸形的复合手术外科队列(NCT03209804)的患者中选择存在后循环供血的脑动静脉畸形患者为研究对象。根据是否栓塞后循环供血动脉将患者分为后循环栓塞组和后循环未栓塞组。根据两组患者的一般情况、脑动静脉畸形形态学、血管构筑学特征和病灶Spetzler-Martin分级进行1∶1倾向性评分匹配(PSM)。以神经功能障碍加重为主要终点事件,围手术期相关指标为次要终点事件,比较两组间手术风险和临床预后的差异。结果共计545例患者加入研究,后循环动脉参与供血者占38.3%(n=209例),后循环栓塞组42例,后循环未栓塞组167例,对两组行PSM,栓塞组纳入39例、未栓塞组纳入39例,其中男50例,女28例;年龄5~58(30±13)岁。后循环栓塞组患者术后3个月神经功能障碍加重比例高于未栓塞组,但两组间比较差异无统计学意义[15.4%(6/39)比2.6%(1/39),P=0.107]。组间比较示栓塞组的术中出血量显著少于未栓塞组[M(Q1,Q3),650(500,1500)ml比1200(800,2000)ml,P=0.002]。后循环栓塞组与后循环未栓塞组显微手术时间比较差异无统计学意义[437(374,521)min比424(359,601)min,P=0.865]。术后脑动静脉畸形残留[(5.1%(2/39)比7.7%(3/39),P=1.000],出血性并发症[5.1%(2/39)比0(0),P=0.494],术后缺血性并发症[10.3%(4/39)比5.1%(2/39),P=0.675],出院神经功能障碍[17.9%(7/39)比15.4%(6/39),P=0.755],1年神经功能障碍[5.1%(2/39)比2.6%(1/39),P=1.000]等各类术后并发症发生率及神经功能障碍加重发生率比较差异均无统计学意义(均P>0.05)。结论一站式复合手术术中栓塞脑动静脉畸形的后循环供血动脉能够有效减少术中出血,降低手术风险。栓塞后循环供血动脉未对复合手术的围手术期并发症和神经功能预后产生显著影响。 展开更多
关键词 动静脉畸形 手术 治疗结局 队列研究
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An innovative model for the transient response of a spherical thin-shell transducer and an experimental confirmation 被引量:3
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作者 lin fa Xin Zhou +9 位作者 YuXiao fa YanDong Zhang JinPeng Mou Meng Liang MaoMao Wang Qi Zhang PengFei Ding WeiTing Feng Hong Yang MeiShan Zhao 《Science China(Physics,Mechanics & Astronomy)》 SCIE EI CAS CSCD 2018年第11期103-106,共4页
A unique characteristic of piezoelectric materials is their ability of electric-mechanical transduction and converting mechanical energy to electrical energy or vice versa. This remarkable property, embedded in piezoe... A unique characteristic of piezoelectric materials is their ability of electric-mechanical transduction and converting mechanical energy to electrical energy or vice versa. This remarkable property, embedded in piezoelectric materials, has been exploited to construct a wide variety of acoustic transducers for industrial applications. These include acoustic experimental measurements [1-3], mobile and internet communications [4,5], intravascular ultrasound [6], medical imaging [7], rangefinders [8], fingerprint sensors, implantable micro-devices, nondestructive detection, mea-surement of the in-situ stresses of underground rock formation, and early warning systems for dam damage and natural hazards, among others. 展开更多
关键词 试验性 变换器 球形 模型 创新 反应 薄壳 指纹传感器
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Acoustic Goos-H?nchen effect 被引量:3
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作者 lin fa ling Xue +10 位作者 YuXiao fa YongLan Han YanDong Zhang HongShen Cheng PengFei Ding GuoHui Li ShaoJie Tang Chunling Bai BingJie Xi Xiaolin Zhang MeiShan Zhao 《Science China(Physics,Mechanics & Astronomy)》 SCIE EI CAS CSCD 2017年第10期15-26,共12页
We report two models of the lateral displacement of acoustic-wave scattering on a fluid-solid interface that reveal an acoustic analog of the Goos-Hainchen effect in optics. This acoustic analog is called the acoustic... We report two models of the lateral displacement of acoustic-wave scattering on a fluid-solid interface that reveal an acoustic analog of the Goos-Hainchen effect in optics. This acoustic analog is called the acoustic Goos-Hainchen effect. Using newly proposed models, we made numerical calculations for the system ofa water-Perspex interface. Specifically, in the post-critical-angle region, we observed a lateral displacement (and transition time) of the reflected P-wave with respect to the incident P-wave. The first arrival of the acoustic signal from the interface is found to be a reflected P-wave rather than the sliding-refraction P-wave usually described in traditional acoustic-logging sliding P-wave theory. For both proposed models, the effective propagation speed of the reflected P-wave along the interface depends on not only the physical properties of the interracial media but also the incident angle. These observations are intriguing and warrant further investigation. 展开更多
关键词 lateral displacement transition time fluid-solid interface reflection/refraction
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The influence of rock anisotropy on elliptical-polarization state of inhomogenously refracted P-wave 被引量:5
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作者 lin fa Jie Zhao +3 位作者 YongLan Han GuoHui Li PengFei Ding MeiShan Zhao 《Science China(Physics,Mechanics & Astronomy)》 SCIE EI CAS CSCD 2016年第4期71-77,共7页
This paper discusses the influence of the anisotropy parameters on elliptical-polarization of the inhomogenously refracted P-wave induced at VTI-media interface.For this refracted P-wave,we have derived,the equations ... This paper discusses the influence of the anisotropy parameters on elliptical-polarization of the inhomogenously refracted P-wave induced at VTI-media interface.For this refracted P-wave,we have derived,the equations of the elliptical-polarization trajectory.Following the elliptical-polarization trajectory,we calculated the effects of the rock anisotropic-parameters on the polarization state,with a Poincare-sphere-like representation,for several varying media parameters.It is noted that the size,shape and initial phase angle of the elliptical-polarization trajectory are all depending the anisotropy media,as well as on the incident-angle.We expect that the findings from this paper would be applied to practical applications of seismic exploration. 展开更多
关键词 anisotropy elliptical-polarization inhomogenous wave VTI medium
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