Background： Migraine without aura （MWoA）, the most common type of migraine, has great impacts on quality of life for migraineurs. Acupuncture is used in the treatment and prevention of migraine for its analgesic ef...Background： Migraine without aura （MWoA）, the most common type of migraine, has great impacts on quality of life for migraineurs. Acupuncture is used in the treatment and prevention of migraine for its analgesic effects. Objective： The aim of this systematic review and meta-analysis is to systematically assess the therapeutic and preventive effect of acupuncture treatment and its safety for MWoA,Search strategy： Nine electronic databases （PubMed, MEDLINE, Cochrane Library, Lilacs, Embase, China National Knowledge Infrastructure （CNKI）, Chongqing VIP （CQV1P）, Wanfang Data and Chinese Clinical Trial Registry （ChiCTR）） were systematically searched from their beginning through June 2017 using MeSH terms such as ＂acupuncture, acupuncture therapy, electro-acupuncture, ear acupuncture, acupuncture points, acupuncture analgesia,＂ and ＂migraine disorders, cluster headache.＂ Manual searching included other conference abstracts and reference lists. Inclusion criteria： Randomized controlled trials （RCTs） with a clinical diagnosis of MWoA, which were treated with acupuncture versus oral medication or sham acupuncture treatment. Data extraction and analysis： Two evaluators screened and collected literature independently; they extracted information on participants, study design, interventions, follow-up, withdrawal and adverse events and assessed risk of bias and quality of the acupuncture intervention. The primary outcomes were frequency of migraine （FM） and number of migraine days （NM）. Secondary outcomes included the visual analogue scale （VAS） score, effective rate （ER） and adverse events. Pooled estimates were calculated as mean difference （MD） with 95% confidence interval （CI） for continuous data and relative risk （RR） with 95% CI for dichotomous data. Results： Overall, 14 RCTs including 1155 participants were identified. The analysis found that acupunc- ture had a significant advantage over medication in reducing FM （MD）=-1.50; 95% CI： -2.32 to -0.68; P〈 0.001） and VAS score （MD =0.97; 95% CI： 0.63-1.31; P〈 0.00001） and had a higher ER （RR = 1.30; 95Z Cl： 1.16-1.45; P 〈 0.00001）. Acupuncture also had a significant advantage over sham acupuncture in the decrease of FM （MD = -1.05; 95% CI： -1.75 to -0.34; P=0.004） and VAS score （MD = -1.19; 95g CI： -1.75 to -0.63; P〈 0.0001）. Meanwhile, acupuncture was more tolerated than medication because of less side effect reports （RR= 0.29; 95% CI： 0.17-0.51; P〈 0.0001）. However, the quality of evidence in the included studies was mainly low （to very low）, making confidence in the FM and VAS score results low. Conclusion： Our meta-analysis shows that the effectiveness of acupuncture is still uncertain, but it might be relatively safer than medication therapy in the treatment and prophylaxis of MWoA. Further proof is needed.展开更多
In this paper, we prove the existence of at least one positive solution pair （u, v）∈ H1（RN） × H1（RN） to the following semilinear elliptic system {-△u＋u=f（x,v）,x∈RN,-△u＋u=g（x,v）,x∈RN （0.1）,by us...In this paper, we prove the existence of at least one positive solution pair （u, v）∈ H1（RN） × H1（RN） to the following semilinear elliptic system {-△u＋u=f（x,v）,x∈RN,-△u＋u=g（x,v）,x∈RN （0.1）,by using a linking theorem and the concentration-compactness principle. The main conditions we imposed on the nonnegative functions f, g ∈C0（RN× R1） are that, f（x, t） and g（x, t） are superlinear at t = 0 as well as at t =＋∞, that f and g are subcritical in t and satisfy a kind of monotonic conditions. We mention that we do not assume that f or g satisfies the Ambrosetti-Rabinowitz condition as usual. Our main result can be viewed as an extension to a recent result of Miyagaki and Souto [J. Diff. Equ. 245（2008）, 3628-3638] concerning the existence of a positive solution to the semilinear elliptic boundary value problem {-△u＋u=f（x,u）,x∈Ω,u∈H0^1（Ω） where Ω ∩→RN is bounded and a result of Li and Yang [G. Li and J. Yang： Communications in P.D.E. Vol. 29（2004） Nos.5＆ 6.pp.925-954, 2004] concerning （0.1） when f and g are asymptotically linear.展开更多
BACKGROUND： Esophagogastric variceal hemorrhage is a life-threatening complication of portal hypertension. In this study, we compared the therapeutic effect of a novel surgi- cal procedure, esophagogastric devascular...BACKGROUND： Esophagogastric variceal hemorrhage is a life-threatening complication of portal hypertension. In this study, we compared the therapeutic effect of a novel surgi- cal procedure, esophagogastric devascularization without splenectomy （EDWS）, with the widely used modified esopha- gogastric devascularization （MED） with splenectomy for the treatment of portal hypertension.展开更多
AIM:To investigate the clinical significance of hepatic blood inflow occlusion without hemihepatic artery control (BIOwHAC) in the treatment of hepatocellular carcinoma (HCC).METHODS:Fifty-nine patients with HCC were ...AIM:To investigate the clinical significance of hepatic blood inflow occlusion without hemihepatic artery control (BIOwHAC) in the treatment of hepatocellular carcinoma (HCC).METHODS:Fifty-nine patients with HCC were divided into 3 groups based on the technique used for achieving hepatic vascular occlusion:group 1,vascular occlusion was achieved by the Pringle maneuver (n=20);group 2,by hemihepatic vascular occlusion (HVO) (n=20);and group 3,by BIOwHAC (n=19).We compared the procedures among the three groups in term of operation time,intraoperative bleeding,postoperative liver function,postoperative complications,and length of hospital stay.RESULTS:There were no statistically significant differences (P > 0.05) in age,sex,pathological diagnosis,preoperative Child's disease grade,hepatic function,and tumor size among the three groups.No intraoperative complications or deaths occurrred,and there were no significant intergroup differences (P > 0.05) in intraoperative bleeding,hepatic function change 3 and 7 d after operation,the incidence of complications,and length of hospital stay.BIOwHAC and Pringle maneuver required a significantly shorter operation time than HVO;the difference in the serum alanine aminotransferase or aspartate aminotransferase levels before and 1 d after operation was more significant in the BIOwHAC and HVO groups than in the Pringle maneuver group (P < 0.05).CONCLUSION:BIOwHAC is convenient and safe;this technique causes slight hepatic ischemia-reperfusion injury similar to HVO.展开更多
Several Al2O3 samples were prepared by a precipitation method coupled with ultrasonic treatment,and NF3 decomposition without water over Al2O3 reagents is carried out.The effect of preparation parameters of Al2O3 reag...Several Al2O3 samples were prepared by a precipitation method coupled with ultrasonic treatment,and NF3 decomposition without water over Al2O3 reagents is carried out.The effect of preparation parameters of Al2O3 reagents,such as precipitating agents,structure directing agents,and calcining temperatures on their reactivity for NF3 decomposition has been investigated.The results show that NF3 can be decomposed completely at 400-C,and full conversion of NF3 maintains 580 min over the best Al2O3 reagent,calcined at 600-C which was prepared using both PEG-2000 and Tween-60 as structure directing agents,ammonia as a precipitating agent.展开更多
AIM To compare the operation time, blood loss, and early outcomes of acetabular components with and without the screw.METHODS Thirty patients who underwent cementless acetabular component with or without screw and who...AIM To compare the operation time, blood loss, and early outcomes of acetabular components with and without the screw.METHODS Thirty patients who underwent cementless acetabular component with or without screw and whose follow-up exceeded one year period in total hip arthroplasty were evaluated. A posterior approach was used in all surgical procedures by one experienced surgeon. Demographic data, operation time, intra-and postoperative blood loss volume, follow-up clinical score, cup migration, and osteolysis were recorded. The Kolmogorov-Smirnov test was performed for testing the normality of study data. Mann-Whitney U test was used to analyze the intergroup differences. A P-value of ≤ 0.05 was considered statistically significant.RESULTS Acetabular components were used in 16(53.3%) patients with screw and 14(46.7%) without screw. After one year of follow-up, an osteolytic lesion of 3 mm was found in only one patient in the screw group. No cup migrationwas encountered. Intra-group mean Harris hip score significantly increased, but there was no significant intergroup difference. While the mean operation time of the screw group was 121.8 min(range; 95-140), it was 102.7 min(range; 80-120) in the no-screw group, and this difference was statistically significant(P = 0.002). The mean intraoperative/postoperative, and total blood loss were 556.6 mL(range: 350-800)/423.3 mL(range: 250-600), and 983.3 mL(range: 600-1350), respectively in the screw group; and 527 mL(range: 400-700)/456 mL(range: 230-600), and 983 mL(range: 630-1250), respectively in the no-screw group. The blood loss difference between the two groups was not significant. In the screw group, the operation time was 19.1 min longer than the no-screw group, and this difference was statistically significant.CONCLUSION Acetabular components with or without screw have similar results, but the use of screw increases the operation time significantly, while not changing the blood loss volume.展开更多
Objectives To identify the loci involved in nonsyndromic cleft lip with or without cleft palate （NSCL/P） in Northern Chinese people in Shenyang by using genomewide and interaction linkage scan.Methods Two multiplex ...Objectives To identify the loci involved in nonsyndromic cleft lip with or without cleft palate （NSCL/P） in Northern Chinese people in Shenyang by using genomewide and interaction linkage scan.Methods Two multiplex families in Shenyang from North China were ascertained through probands with NSCL/P.Blood of every member was drawn for DNA extraction and analysis.Genotypes were available for 382 autosomal short tandem repeat （STR） markers from the ABI Prism Linkage Mapping Set version 2.5.Linkage between markers and NSCL/P was assessed by 2-point parametric LOD scores,multipoint heterogeneity parametric LOD scores （HLODs）,and multipoint nonparametric linkage score （NPL）.Results The initial scan suggested linkage on Chromosomes 1,2,and 15.In subsequent fine mapping,1q32-q42 showed a maximum multipoint LOD score of 1.9（empirical P=0.013） and an NPL score of 2.35 （empirical P=0.053）.For 2p24-p25,the multipoint NPL increased to 2.94 （empirical P=0.007）.2-locus interaction analysis obtained a maximum NPL score of 3.73 （P=0.00078） and a maximum LOD score of 3 for Chromosome 1 （at 221 cM） and Chromosome 2 （at 29 cM）.Conclusion Both parametric and nonparametric linkage scores greatly increased over the initial linkage scores on 1q32-q42,suggesting a susceptibility locus in this region.Nonparametric linkage gave a strong evidence for a candidate region on chromosome 2p24-p25.The superiority of 2-locus linkage scores compared to single-locus scores gave additional evidence for linkage on 1q32-q42 and 2p24-p25,and suggested that certain genes in the two regions may contribute to NCSL/P risks with interaction.展开更多
In this paper, the propagation of guided thermoelastic waves in laminated orthotropic plates subjected to stress-free, isothermal boundary conditions is investigated in the context of the Green-Naghdi （GN） generaliz...In this paper, the propagation of guided thermoelastic waves in laminated orthotropic plates subjected to stress-free, isothermal boundary conditions is investigated in the context of the Green-Naghdi （GN） generalized thermoelastic theory （without energy dissipation）. The coupled wave equations and heat conduction equation are solved by the Legendre orthogonal polynomial series expansion approach. The validity of the method is confirmed through a comparison. The dispersion curves of thermal modes and elastic modes are illustrated simultaneously. Dispersion curves of the corresponding pure elastic plate are also shown to analyze the influence of the thermoelasticity on elastic modes. The displacement and temperature distributions are shown to discuss the differences between the elastic modes and thermal modes.展开更多
To remedy the defects of the existing research achievements,the dynamic vague region relations without kernel and the non-same-plane vague region relations without kernel based on the conception of the vague sets were...To remedy the defects of the existing research achievements,the dynamic vague region relations without kernel and the non-same-plane vague region relations without kernel based on the conception of the vague sets were studied systematically.The formalized definitions of the vague intersection set,the vague cut sets and vague region partition etc were given.Based on the vague sets,the eight vague region relations in the same plane and the ten vague region relations in the different plane were given.Furthermore,the coessential intersection and the heterogeneous intersection were proposed to simplify the representation for the dynamic vague region relations without kernel and the rotation-corresponding relations between the two kinds of the relations were also studied.The production in this paper laid the foundation for the applications and research of the vague region relations without kernel in the spatial database.展开更多
For friction stir welding （FSW）, a new idea is put forward in this paper to weld the thin plate of Al alloy by using the rotational tool without pin. The experiments of FSW are carried out by using the tools with in...For friction stir welding （FSW）, a new idea is put forward in this paper to weld the thin plate of Al alloy by using the rotational tool without pin. The experiments of FSW are carried out by using the tools with inner-concave-flute shoulder, concentric-circles-flute shoulder and three-spiral-flute shoulder, respectively. The experimental results show that the grain size in weld nugget zone attained by the tool with three-spiral-flute shoulder is nearly the same while the grain sizes decrease with the decrease of welding velocity. The displacement of material flow in the heat-mechanical affected zone by the tool with three-spiral-flute shoulder is much larger than that by the tool with inner-concave-flute shoulder or concentric-circles–flute shoulder. The above-mentioned results are verified by numerical simulation. For the tool with three-spiral-flute shoulder, the tensile strength of FSW joint increases with the decrease of welding velocity while the value of tensile strength attained by the welding velocity of 20 mm/min and the rotation speed of 1800 r/min is about 398 MPa, which is 80% more than that of parent mental tensile strength. Those verify that the tool with three-spiral-flute shoulder can be used to join the thin plate of Al alloy.展开更多
BACKGROUND: The clearance of propofol is very rapid, and its transformation takes place mainly in the liver. Some reports indicated extrahepatic clearance of the drug and that the lungs are the likely place where the ...BACKGROUND: The clearance of propofol is very rapid, and its transformation takes place mainly in the liver. Some reports indicated extrahepatic clearance of the drug and that the lungs are the likely place where the process occurs. This study was undertaken to compare the plasma concentrations of propofol both in the pulmonary and radial arteries after constant infusion during the dissection, anhepatic and reperfusion phases of orthotopic liver transplantation (OLT) without veno-venous bypass, attempting to investigate extrahepatic clearance and to determine whether the human lungs take part in the elimination of propofol. METHODS: Fifteen patients undergoing OLT without veno-venous bypass were enrolled in the study, and propofol was infused via a forearm vein at a rate of 2 mg· kg-1·h-1. Blood samples were simultaneously collected from pulmonary and radial arteries at the end of the first hepatic portal dissection (T0), at the clamping of the portal vein (T1), 30, and 60 minutes after the beginning of the anhepatic phase (T2, T3), and 30, 60, and 120 minutes after the unclamping of the new liver (T4, T5, T6). Plasma propofol concentrations were measured using a reversed- phase, high-performance liquid chromatographic method with fluorescence detection. RESULTS: The concentrations of plasma propofol in the pulmonary and radial arteries at T2 and T3 rose significantly compared with T0 and T1 (P<0.01) respectively. After reperfusion, the drug concentrations at T4, T5 and T6 decreased significantly compared with T2, T3 (P<0.01)respectively. There were no significant differences in plasma propofol concentrations between the pulmonary and radial arteries at any time points. CONCLUSIONS: Propofol is eliminated mainly by the liver, and also by extrahepatic organs. The lungs seem to be not a major site contributing to the extrahepatic metabolism of propofol in humans.展开更多
Introduction:?Worldwide increasing cesarean section rates are expected to have a parallel increase in the number of cases of Placenta Previa with all the expected complications, including pathologically adherent place...Introduction:?Worldwide increasing cesarean section rates are expected to have a parallel increase in the number of cases of Placenta Previa with all the expected complications, including pathologically adherent placenta. This morbidly adherent placenta constitutes a serious and possibly a life threatening complication. An efficient team capable for managing possible complicated situations will be able to reduce mortality and morbidity. Objectives: The aim of our study was to evaluate maternal outcome in cases of Placenta Previa with and without morbidly adherent placenta. Methods: Analysis of all pregnancies complicated by antepartum hemorrhage during the period from January 2013 to September 2017 at King Abdul-Aziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia (KSA) was done. Cases of Placenta Previa with gestational age > 28 weeks were included. They were classified into 2 groups;Group (A) included Placenta Previa cases without morbidly adherent placenta and Group (B) included cases with morbidly adherent placenta. Maternal outcomes were recorded. Results: Placenta Previa was the leading cause of antepartum hemorrhage constituting 76.8%, out of them 52% were unbooked. Morbidly adherent placenta constituted 13.5% of total Placenta Previa cases and was diagnosed prenatally in only 1 case. Morbidity rate in placenta previa patients with adherent placenta (Group B) was higher than in placenta previa without adherent placenta (Group A). We considered the occurrence of intrapartum hypovolemic shock, Intensive care unit admission, surgical complications and peripartum hysterectomy as parameters for morbidity. P value for hypovolemic shock was insignificant (P = 0.580), significant for Intensive care unit admission (P = 0.008), significant for surgical complications (P = 0.009) and significant for peripartum展开更多
It has been shown that a volume discharge is forming in non-uniform electric-field rough cathode and even anode without pre-ionization in SF6 and C2H6 mixtures. The discharge is presented with many diffuse channels at...It has been shown that a volume discharge is forming in non-uniform electric-field rough cathode and even anode without pre-ionization in SF6 and C2H6 mixtures. The discharge is presented with many diffuse channels attached to bright circular cathode spots that diverge towards the anode, with the channels overlapping, form a spatially uniform glow discharge. Self-Initiated Volume Discharge(SIVD) has been performed at a total mixture pressure up to 8 kPa and energy deposition up to 200 J/L. The experimental results indicate that Self-Sustained Volume Discharge(SSVD) in SF6 and C2H6 mixtures develops in the form of SIVD, which is promising for creation of high energy and pulse-periodic HF laser.展开更多
Active power filter (APF) using novel virtual line-flux-linkage oriented control strategy can not only realizes no phase-locked-loop (PLL) control, but also achieves a good inhibitory effect to interfere. However, the...Active power filter (APF) using novel virtual line-flux-linkage oriented control strategy can not only realizes no phase-locked-loop (PLL) control, but also achieves a good inhibitory effect to interfere. However, there are some problems in the conventional method, such as the error of amplitude, the shift of phase angle and the non-determinacy of initial oriented angle. In this paper, two one-order low-pass filters are adopted instead of the pure integrator in the virtual line-flux-linkage observer, which can steady the phase and amplitude. Furthermore, an original scheme of harmonics detection under the rotating coordinate is advanced based on the simplified space vector pulse width modulation (SVPWM) strategy. Meanwhile, by using the new SVPWM algorithm, the voltage space vector diagram of the three-level inverter can be simplified and applied into that of two-level inverter, and this makes the control for Neutral Point potential easier.展开更多
BACKGROUND Retroperitoneal lymph node dissection(RPLND)plays a diagnostic,therapeutic,and prognostic role in myriad urologic malignancies,including testicular carcinoma,renal cell carcinoma(RCC),and upper urinary trac...BACKGROUND Retroperitoneal lymph node dissection(RPLND)plays a diagnostic,therapeutic,and prognostic role in myriad urologic malignancies,including testicular carcinoma,renal cell carcinoma(RCC),and upper urinary tract urothelial carcinoma.RCC represents 2%of all cancers with approximately 25%of patients presenting with advanced disease.Clear cell RCC(CCRCC)is the most common RCC,accounting for 75%-80%of all RCC.CASE SUMMARY A 71-year-old man presented with a history of benign prostatic hypertrophy.He was asymptomatic without any hematuria,pain,or other urinary symptoms.A computed tomography(CT)scan of the abdomen and pelvis showed a 1.8 cm left retroperitoneal lymph node.There was no evidence of renal pathology.A core biopsy was performed of the left para-aortic lymph node.Although the primary tumor site was unknown,the morphological and immunohistochemical features were most consistent with CCRCC.A RPLND was performed which revealed a single mass 5.5 cm in greatest dimension with extensive necrosis.The retroperitoneal lymph node was most compatible with CCRCC.A nephrectomy was not conducted as a renal mass had not been detected on any prior imaging studies.The patient did not receive any type of adjuvant therapy.The patient underwent surveillance with serial CT scans with contrast of the chest,abdomen,and pelvis for the next 5 years,all of which demonstrated no recurrent or metastatic disease and no evidence of retroperitoneal adenopathy.CONCLUSION Our unique case emphasizes the therapeutic role of metastasectomy in metastatic CCRCC even in the absence of primary tumor in the kidneys.展开更多
The Man Without a Temperament,one of Katherine Mansfield's classic short stories,is written in the modernist mode,without a set structure,and with many shifts in the narrative.
This paper numerically demonstrates synchronization and bidirectional communication without delay line by using two semiconductor lasers with strong mutual injection in a face-to-face configuration. These results show...This paper numerically demonstrates synchronization and bidirectional communication without delay line by using two semiconductor lasers with strong mutual injection in a face-to-face configuration. These results show that both of the two lasers＇ outputs synchronize with their input chaotic carriers. In addition, simulations demonstrate that this kind of synchronization can be used to realize bidirectional communications without delay line. Further studies indicate that within a small deviation in message amplitudes of two sides （±6%）, the message can be extracted with signal-noise-ratio more than 10 dB; and the signal-noise-ratio is extremely sensitive to the message rates mismatch of two sides, which may be used as a key of bidirectional communication.展开更多
A solid ternary mixture consisting of NaF, silicon and one of the metal oxides such as Al2O3, MgO, CaO, SrO, BaO was prepared and used as a defluorinated reagent for CF4 decomposition. The results show that the initia...A solid ternary mixture consisting of NaF, silicon and one of the metal oxides such as Al2O3, MgO, CaO, SrO, BaO was prepared and used as a defluorinated reagent for CF4 decomposition. The results show that the initial conversion of CF4 reached 100% over NaF-Si-MgO and NaF-Si-CaO at 850°C, and the reagent with NaF/Si/MgO molar ratio of 33/34/33 exhibited a high reactivity with a full conversion of CF4 lasting for 57 min. The plausible paths of CF4 decomposition over NaF-Si-Al2O3, NaF-Si-MgO, NaF-Si-CaO, NaF-Si-SrO and NaF-Si-BaO are proposed.展开更多
So far, most of the proposed group key exchange （GKE） protocols do not consider the attack when the adversary reveals the parties＇ ephemeral private keys without their long-term private keys, so these GKE protocols...So far, most of the proposed group key exchange （GKE） protocols do not consider the attack when the adversary reveals the parties＇ ephemeral private keys without their long-term private keys, so these GKE protocols are insecure on this attack. In this paper, for resisting above attack, we propose a dynamic authenticated group key exchange （AGKE） protocol in the ID-based setting. Different from previous ID-based protocols, our protocol does not utilize bilinear pairings, which makes it more efficient. At last, we analyze the security of the protocol in the cCK （enhanced Canetti-Krawczyk） security model.展开更多
基金supported by grants from the National Natural Science Foundation of China(No.81603697)key disciplines of the special project from the Chinese State Administration of TCM(No.GJZYJZJ-2010)+2 种基金key projects of the Shanghai Committee of Science and Technology of China(Nos.14401971300,16401970300)the characteristic acupuncture therapy project of the Shanghai Municipal Commission of Health and Family Planning of China(No.ZJ2016001)the TCM genre programme of the Shanghai Health Bureau(No.ZY3-CCCX-1-1007)
文摘Background： Migraine without aura （MWoA）, the most common type of migraine, has great impacts on quality of life for migraineurs. Acupuncture is used in the treatment and prevention of migraine for its analgesic effects. Objective： The aim of this systematic review and meta-analysis is to systematically assess the therapeutic and preventive effect of acupuncture treatment and its safety for MWoA,Search strategy： Nine electronic databases （PubMed, MEDLINE, Cochrane Library, Lilacs, Embase, China National Knowledge Infrastructure （CNKI）, Chongqing VIP （CQV1P）, Wanfang Data and Chinese Clinical Trial Registry （ChiCTR）） were systematically searched from their beginning through June 2017 using MeSH terms such as ＂acupuncture, acupuncture therapy, electro-acupuncture, ear acupuncture, acupuncture points, acupuncture analgesia,＂ and ＂migraine disorders, cluster headache.＂ Manual searching included other conference abstracts and reference lists. Inclusion criteria： Randomized controlled trials （RCTs） with a clinical diagnosis of MWoA, which were treated with acupuncture versus oral medication or sham acupuncture treatment. Data extraction and analysis： Two evaluators screened and collected literature independently; they extracted information on participants, study design, interventions, follow-up, withdrawal and adverse events and assessed risk of bias and quality of the acupuncture intervention. The primary outcomes were frequency of migraine （FM） and number of migraine days （NM）. Secondary outcomes included the visual analogue scale （VAS） score, effective rate （ER） and adverse events. Pooled estimates were calculated as mean difference （MD） with 95% confidence interval （CI） for continuous data and relative risk （RR） with 95% CI for dichotomous data. Results： Overall, 14 RCTs including 1155 participants were identified. The analysis found that acupunc- ture had a significant advantage over medication in reducing FM （MD）=-1.50; 95% CI： -2.32 to -0.68; P〈 0.001） and VAS score （MD =0.97; 95% CI： 0.63-1.31; P〈 0.00001） and had a higher ER （RR = 1.30; 95Z Cl： 1.16-1.45; P 〈 0.00001）. Acupuncture also had a significant advantage over sham acupuncture in the decrease of FM （MD = -1.05; 95% CI： -1.75 to -0.34; P=0.004） and VAS score （MD = -1.19; 95g CI： -1.75 to -0.63; P〈 0.0001）. Meanwhile, acupuncture was more tolerated than medication because of less side effect reports （RR= 0.29; 95% CI： 0.17-0.51; P〈 0.0001）. However, the quality of evidence in the included studies was mainly low （to very low）, making confidence in the FM and VAS score results low. Conclusion： Our meta-analysis shows that the effectiveness of acupuncture is still uncertain, but it might be relatively safer than medication therapy in the treatment and prophylaxis of MWoA. Further proof is needed.
基金supported by NSFC (10571069, 10631030) and Hubei Key Laboratory of Mathematical Sciencessupported by the fund of CCNU for PHD students(2009019)
文摘In this paper, we prove the existence of at least one positive solution pair （u, v）∈ H1（RN） × H1（RN） to the following semilinear elliptic system {-△u＋u=f（x,v）,x∈RN,-△u＋u=g（x,v）,x∈RN （0.1）,by using a linking theorem and the concentration-compactness principle. The main conditions we imposed on the nonnegative functions f, g ∈C0（RN× R1） are that, f（x, t） and g（x, t） are superlinear at t = 0 as well as at t =＋∞, that f and g are subcritical in t and satisfy a kind of monotonic conditions. We mention that we do not assume that f or g satisfies the Ambrosetti-Rabinowitz condition as usual. Our main result can be viewed as an extension to a recent result of Miyagaki and Souto [J. Diff. Equ. 245（2008）, 3628-3638] concerning the existence of a positive solution to the semilinear elliptic boundary value problem {-△u＋u=f（x,u）,x∈Ω,u∈H0^1（Ω） where Ω ∩→RN is bounded and a result of Li and Yang [G. Li and J. Yang： Communications in P.D.E. Vol. 29（2004） Nos.5＆ 6.pp.925-954, 2004] concerning （0.1） when f and g are asymptotically linear.
基金supported by grants from the Health Industry Scientific Research Fund (201002015)Beijing Medicine Research and Development Fund (2009-2029)
文摘BACKGROUND： Esophagogastric variceal hemorrhage is a life-threatening complication of portal hypertension. In this study, we compared the therapeutic effect of a novel surgi- cal procedure, esophagogastric devascularization without splenectomy （EDWS）, with the widely used modified esopha- gogastric devascularization （MED） with splenectomy for the treatment of portal hypertension.
基金Supported by The Inner Mongolia Science Foundation,Grant No.2009BS1103
文摘AIM:To investigate the clinical significance of hepatic blood inflow occlusion without hemihepatic artery control (BIOwHAC) in the treatment of hepatocellular carcinoma (HCC).METHODS:Fifty-nine patients with HCC were divided into 3 groups based on the technique used for achieving hepatic vascular occlusion:group 1,vascular occlusion was achieved by the Pringle maneuver (n=20);group 2,by hemihepatic vascular occlusion (HVO) (n=20);and group 3,by BIOwHAC (n=19).We compared the procedures among the three groups in term of operation time,intraoperative bleeding,postoperative liver function,postoperative complications,and length of hospital stay.RESULTS:There were no statistically significant differences (P > 0.05) in age,sex,pathological diagnosis,preoperative Child's disease grade,hepatic function,and tumor size among the three groups.No intraoperative complications or deaths occurrred,and there were no significant intergroup differences (P > 0.05) in intraoperative bleeding,hepatic function change 3 and 7 d after operation,the incidence of complications,and length of hospital stay.BIOwHAC and Pringle maneuver required a significantly shorter operation time than HVO;the difference in the serum alanine aminotransferase or aspartate aminotransferase levels before and 1 d after operation was more significant in the BIOwHAC and HVO groups than in the Pringle maneuver group (P < 0.05).CONCLUSION:BIOwHAC is convenient and safe;this technique causes slight hepatic ischemia-reperfusion injury similar to HVO.
基金financially supported by the National Natural Science Foundation of China(No.20976149)
文摘Several Al2O3 samples were prepared by a precipitation method coupled with ultrasonic treatment,and NF3 decomposition without water over Al2O3 reagents is carried out.The effect of preparation parameters of Al2O3 reagents,such as precipitating agents,structure directing agents,and calcining temperatures on their reactivity for NF3 decomposition has been investigated.The results show that NF3 can be decomposed completely at 400-C,and full conversion of NF3 maintains 580 min over the best Al2O3 reagent,calcined at 600-C which was prepared using both PEG-2000 and Tween-60 as structure directing agents,ammonia as a precipitating agent.
文摘AIM To compare the operation time, blood loss, and early outcomes of acetabular components with and without the screw.METHODS Thirty patients who underwent cementless acetabular component with or without screw and whose follow-up exceeded one year period in total hip arthroplasty were evaluated. A posterior approach was used in all surgical procedures by one experienced surgeon. Demographic data, operation time, intra-and postoperative blood loss volume, follow-up clinical score, cup migration, and osteolysis were recorded. The Kolmogorov-Smirnov test was performed for testing the normality of study data. Mann-Whitney U test was used to analyze the intergroup differences. A P-value of ≤ 0.05 was considered statistically significant.RESULTS Acetabular components were used in 16(53.3%) patients with screw and 14(46.7%) without screw. After one year of follow-up, an osteolytic lesion of 3 mm was found in only one patient in the screw group. No cup migrationwas encountered. Intra-group mean Harris hip score significantly increased, but there was no significant intergroup difference. While the mean operation time of the screw group was 121.8 min(range; 95-140), it was 102.7 min(range; 80-120) in the no-screw group, and this difference was statistically significant(P = 0.002). The mean intraoperative/postoperative, and total blood loss were 556.6 mL(range: 350-800)/423.3 mL(range: 250-600), and 983.3 mL(range: 600-1350), respectively in the screw group; and 527 mL(range: 400-700)/456 mL(range: 230-600), and 983 mL(range: 630-1250), respectively in the no-screw group. The blood loss difference between the two groups was not significant. In the screw group, the operation time was 19.1 min longer than the no-screw group, and this difference was statistically significant.CONCLUSION Acetabular components with or without screw have similar results, but the use of screw increases the operation time significantly, while not changing the blood loss volume.
基金supported by National Natural Science Foundation of China (the research to identify susceptibility genes of nonsyndromic cleft lip and/or palates, 30600676)Program for New Century Excellent Talents of the Ministry of Education of China (NCET-07-0034)
文摘Objectives To identify the loci involved in nonsyndromic cleft lip with or without cleft palate （NSCL/P） in Northern Chinese people in Shenyang by using genomewide and interaction linkage scan.Methods Two multiplex families in Shenyang from North China were ascertained through probands with NSCL/P.Blood of every member was drawn for DNA extraction and analysis.Genotypes were available for 382 autosomal short tandem repeat （STR） markers from the ABI Prism Linkage Mapping Set version 2.5.Linkage between markers and NSCL/P was assessed by 2-point parametric LOD scores,multipoint heterogeneity parametric LOD scores （HLODs）,and multipoint nonparametric linkage score （NPL）.Results The initial scan suggested linkage on Chromosomes 1,2,and 15.In subsequent fine mapping,1q32-q42 showed a maximum multipoint LOD score of 1.9（empirical P=0.013） and an NPL score of 2.35 （empirical P=0.053）.For 2p24-p25,the multipoint NPL increased to 2.94 （empirical P=0.007）.2-locus interaction analysis obtained a maximum NPL score of 3.73 （P=0.00078） and a maximum LOD score of 3 for Chromosome 1 （at 221 cM） and Chromosome 2 （at 29 cM）.Conclusion Both parametric and nonparametric linkage scores greatly increased over the initial linkage scores on 1q32-q42,suggesting a susceptibility locus in this region.Nonparametric linkage gave a strong evidence for a candidate region on chromosome 2p24-p25.The superiority of 2-locus linkage scores compared to single-locus scores gave additional evidence for linkage on 1q32-q42 and 2p24-p25,and suggested that certain genes in the two regions may contribute to NCSL/P risks with interaction.
基金supported by the National Natural Science Foundation of China (No. 10802027)
文摘In this paper, the propagation of guided thermoelastic waves in laminated orthotropic plates subjected to stress-free, isothermal boundary conditions is investigated in the context of the Green-Naghdi （GN） generalized thermoelastic theory （without energy dissipation）. The coupled wave equations and heat conduction equation are solved by the Legendre orthogonal polynomial series expansion approach. The validity of the method is confirmed through a comparison. The dispersion curves of thermal modes and elastic modes are illustrated simultaneously. Dispersion curves of the corresponding pure elastic plate are also shown to analyze the influence of the thermoelasticity on elastic modes. The displacement and temperature distributions are shown to discuss the differences between the elastic modes and thermal modes.
基金Sponsored by the Science and Tecnology Research Project of Education Department Heilongjiang Province(Grant No.11551084)
文摘To remedy the defects of the existing research achievements,the dynamic vague region relations without kernel and the non-same-plane vague region relations without kernel based on the conception of the vague sets were studied systematically.The formalized definitions of the vague intersection set,the vague cut sets and vague region partition etc were given.Based on the vague sets,the eight vague region relations in the same plane and the ten vague region relations in the different plane were given.Furthermore,the coessential intersection and the heterogeneous intersection were proposed to simplify the representation for the dynamic vague region relations without kernel and the rotation-corresponding relations between the two kinds of the relations were also studied.The production in this paper laid the foundation for the applications and research of the vague region relations without kernel in the spatial database.
文摘For friction stir welding （FSW）, a new idea is put forward in this paper to weld the thin plate of Al alloy by using the rotational tool without pin. The experiments of FSW are carried out by using the tools with inner-concave-flute shoulder, concentric-circles-flute shoulder and three-spiral-flute shoulder, respectively. The experimental results show that the grain size in weld nugget zone attained by the tool with three-spiral-flute shoulder is nearly the same while the grain sizes decrease with the decrease of welding velocity. The displacement of material flow in the heat-mechanical affected zone by the tool with three-spiral-flute shoulder is much larger than that by the tool with inner-concave-flute shoulder or concentric-circles–flute shoulder. The above-mentioned results are verified by numerical simulation. For the tool with three-spiral-flute shoulder, the tensile strength of FSW joint increases with the decrease of welding velocity while the value of tensile strength attained by the welding velocity of 20 mm/min and the rotation speed of 1800 r/min is about 398 MPa, which is 80% more than that of parent mental tensile strength. Those verify that the tool with three-spiral-flute shoulder can be used to join the thin plate of Al alloy.
文摘BACKGROUND: The clearance of propofol is very rapid, and its transformation takes place mainly in the liver. Some reports indicated extrahepatic clearance of the drug and that the lungs are the likely place where the process occurs. This study was undertaken to compare the plasma concentrations of propofol both in the pulmonary and radial arteries after constant infusion during the dissection, anhepatic and reperfusion phases of orthotopic liver transplantation (OLT) without veno-venous bypass, attempting to investigate extrahepatic clearance and to determine whether the human lungs take part in the elimination of propofol. METHODS: Fifteen patients undergoing OLT without veno-venous bypass were enrolled in the study, and propofol was infused via a forearm vein at a rate of 2 mg· kg-1·h-1. Blood samples were simultaneously collected from pulmonary and radial arteries at the end of the first hepatic portal dissection (T0), at the clamping of the portal vein (T1), 30, and 60 minutes after the beginning of the anhepatic phase (T2, T3), and 30, 60, and 120 minutes after the unclamping of the new liver (T4, T5, T6). Plasma propofol concentrations were measured using a reversed- phase, high-performance liquid chromatographic method with fluorescence detection. RESULTS: The concentrations of plasma propofol in the pulmonary and radial arteries at T2 and T3 rose significantly compared with T0 and T1 (P<0.01) respectively. After reperfusion, the drug concentrations at T4, T5 and T6 decreased significantly compared with T2, T3 (P<0.01)respectively. There were no significant differences in plasma propofol concentrations between the pulmonary and radial arteries at any time points. CONCLUSIONS: Propofol is eliminated mainly by the liver, and also by extrahepatic organs. The lungs seem to be not a major site contributing to the extrahepatic metabolism of propofol in humans.
文摘Introduction:?Worldwide increasing cesarean section rates are expected to have a parallel increase in the number of cases of Placenta Previa with all the expected complications, including pathologically adherent placenta. This morbidly adherent placenta constitutes a serious and possibly a life threatening complication. An efficient team capable for managing possible complicated situations will be able to reduce mortality and morbidity. Objectives: The aim of our study was to evaluate maternal outcome in cases of Placenta Previa with and without morbidly adherent placenta. Methods: Analysis of all pregnancies complicated by antepartum hemorrhage during the period from January 2013 to September 2017 at King Abdul-Aziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia (KSA) was done. Cases of Placenta Previa with gestational age > 28 weeks were included. They were classified into 2 groups;Group (A) included Placenta Previa cases without morbidly adherent placenta and Group (B) included cases with morbidly adherent placenta. Maternal outcomes were recorded. Results: Placenta Previa was the leading cause of antepartum hemorrhage constituting 76.8%, out of them 52% were unbooked. Morbidly adherent placenta constituted 13.5% of total Placenta Previa cases and was diagnosed prenatally in only 1 case. Morbidity rate in placenta previa patients with adherent placenta (Group B) was higher than in placenta previa without adherent placenta (Group A). We considered the occurrence of intrapartum hypovolemic shock, Intensive care unit admission, surgical complications and peripartum hysterectomy as parameters for morbidity. P value for hypovolemic shock was insignificant (P = 0.580), significant for Intensive care unit admission (P = 0.008), significant for surgical complications (P = 0.009) and significant for peripartum
基金Supported by the National Natural Science Fundation of China(Nos.60708005,1178029)
文摘It has been shown that a volume discharge is forming in non-uniform electric-field rough cathode and even anode without pre-ionization in SF6 and C2H6 mixtures. The discharge is presented with many diffuse channels attached to bright circular cathode spots that diverge towards the anode, with the channels overlapping, form a spatially uniform glow discharge. Self-Initiated Volume Discharge(SIVD) has been performed at a total mixture pressure up to 8 kPa and energy deposition up to 200 J/L. The experimental results indicate that Self-Sustained Volume Discharge(SSVD) in SF6 and C2H6 mixtures develops in the form of SIVD, which is promising for creation of high energy and pulse-periodic HF laser.
文摘Active power filter (APF) using novel virtual line-flux-linkage oriented control strategy can not only realizes no phase-locked-loop (PLL) control, but also achieves a good inhibitory effect to interfere. However, there are some problems in the conventional method, such as the error of amplitude, the shift of phase angle and the non-determinacy of initial oriented angle. In this paper, two one-order low-pass filters are adopted instead of the pure integrator in the virtual line-flux-linkage observer, which can steady the phase and amplitude. Furthermore, an original scheme of harmonics detection under the rotating coordinate is advanced based on the simplified space vector pulse width modulation (SVPWM) strategy. Meanwhile, by using the new SVPWM algorithm, the voltage space vector diagram of the three-level inverter can be simplified and applied into that of two-level inverter, and this makes the control for Neutral Point potential easier.
文摘BACKGROUND Retroperitoneal lymph node dissection(RPLND)plays a diagnostic,therapeutic,and prognostic role in myriad urologic malignancies,including testicular carcinoma,renal cell carcinoma(RCC),and upper urinary tract urothelial carcinoma.RCC represents 2%of all cancers with approximately 25%of patients presenting with advanced disease.Clear cell RCC(CCRCC)is the most common RCC,accounting for 75%-80%of all RCC.CASE SUMMARY A 71-year-old man presented with a history of benign prostatic hypertrophy.He was asymptomatic without any hematuria,pain,or other urinary symptoms.A computed tomography(CT)scan of the abdomen and pelvis showed a 1.8 cm left retroperitoneal lymph node.There was no evidence of renal pathology.A core biopsy was performed of the left para-aortic lymph node.Although the primary tumor site was unknown,the morphological and immunohistochemical features were most consistent with CCRCC.A RPLND was performed which revealed a single mass 5.5 cm in greatest dimension with extensive necrosis.The retroperitoneal lymph node was most compatible with CCRCC.A nephrectomy was not conducted as a renal mass had not been detected on any prior imaging studies.The patient did not receive any type of adjuvant therapy.The patient underwent surveillance with serial CT scans with contrast of the chest,abdomen,and pelvis for the next 5 years,all of which demonstrated no recurrent or metastatic disease and no evidence of retroperitoneal adenopathy.CONCLUSION Our unique case emphasizes the therapeutic role of metastasectomy in metastatic CCRCC even in the absence of primary tumor in the kidneys.
文摘The Man Without a Temperament,one of Katherine Mansfield's classic short stories,is written in the modernist mode,without a set structure,and with many shifts in the narrative.
基金supported by the National Natural Science Foundation of China (Grant Nos. 60577019 and 60777041)the International Cooperation Project of Shanxi Province,China (Grant No. 2007081019)
文摘This paper numerically demonstrates synchronization and bidirectional communication without delay line by using two semiconductor lasers with strong mutual injection in a face-to-face configuration. These results show that both of the two lasers＇ outputs synchronize with their input chaotic carriers. In addition, simulations demonstrate that this kind of synchronization can be used to realize bidirectional communications without delay line. Further studies indicate that within a small deviation in message amplitudes of two sides （±6%）, the message can be extracted with signal-noise-ratio more than 10 dB; and the signal-noise-ratio is extremely sensitive to the message rates mismatch of two sides, which may be used as a key of bidirectional communication.
基金financially supported by the National Natural Science Foundation of China(No.20976149)
文摘A solid ternary mixture consisting of NaF, silicon and one of the metal oxides such as Al2O3, MgO, CaO, SrO, BaO was prepared and used as a defluorinated reagent for CF4 decomposition. The results show that the initial conversion of CF4 reached 100% over NaF-Si-MgO and NaF-Si-CaO at 850°C, and the reagent with NaF/Si/MgO molar ratio of 33/34/33 exhibited a high reactivity with a full conversion of CF4 lasting for 57 min. The plausible paths of CF4 decomposition over NaF-Si-Al2O3, NaF-Si-MgO, NaF-Si-CaO, NaF-Si-SrO and NaF-Si-BaO are proposed.
基金Supported by the National Natural Science Foundation ofChina (60773035)
文摘So far, most of the proposed group key exchange （GKE） protocols do not consider the attack when the adversary reveals the parties＇ ephemeral private keys without their long-term private keys, so these GKE protocols are insecure on this attack. In this paper, for resisting above attack, we propose a dynamic authenticated group key exchange （AGKE） protocol in the ID-based setting. Different from previous ID-based protocols, our protocol does not utilize bilinear pairings, which makes it more efficient. At last, we analyze the security of the protocol in the cCK （enhanced Canetti-Krawczyk） security model.
