A new power divider, composed of a novel composite right/left-handed (CRLH) transmission line (TL) unit, is proposed. The properties of the power divider based on four CRLH TL unit cells are investigated theoretically...A new power divider, composed of a novel composite right/left-handed (CRLH) transmission line (TL) unit, is proposed. The properties of the power divider based on four CRLH TL unit cells are investigated theoretically. By adjusting the parameters of the capacitors and the inductors, the power divider shows perfectly symmetric power division at 5.13 GHz, return loss up to ?24 dB, with the transmitted power being close to ?3.1 dB. The phenomena are demonstrated by simulation results. Being compact in size and low-cost, the proposed power divider is very suitable for microwave and millimeter wave integrated circuits.展开更多
A new approach was introduced to analyze composite right/left-handed transmission lines （CRLH TLs）. The Bloch impedance and the dispersion relations are directly obtained from the S parameters of the unit cells. The...A new approach was introduced to analyze composite right/left-handed transmission lines （CRLH TLs）. The Bloch impedance and the dispersion relations are directly obtained from the S parameters of the unit cells. The LH and RH frequency bands are then identified by the real parts of the Bloch impedance and the phase delay of the unit cells. The new approach has some advantages over the LC parameters extraction method introduced by Caloz et a1.（2004）. Based on the new approach, a novel resonator is designed using CRLH TLs. The simulation and experimental results accorded well with the theoretical analysis. The novel resonator may have potential applications in filters with high harmonic suppression and compact structures,展开更多
In this paper a metamaterial-inspired antenna with high gain and good directivity is designed. Based on the concept of composite right/left-handed transmission line (CRLH-TL), the proposed antenna is realized based on...In this paper a metamaterial-inspired antenna with high gain and good directivity is designed. Based on the concept of composite right/left-handed transmission line (CRLH-TL), the proposed antenna is realized based on three leakage wave unit cell and a left handed circular ring slot incorporated on the surface. The maximum achievable gain at the resonant frequency of 5.6GHz is 6.933 dBi, and the return loss at 5.6 GHz can be –20 db. This proposed design has a simple structure and a compact dimension of 35 mm*40 mm*1 mm, which is suitable for particular wireless communication application such as WiFi and WLAN.展开更多
Background Previous studies have shown that an echocardiographic right/left ventricular end-diastolic diameter ratio(RV/LV ratio)≥0.9 is an independent predictor of poor prognosis in patients with acute pulmonary emb...Background Previous studies have shown that an echocardiographic right/left ventricular end-diastolic diameter ratio(RV/LV ratio)≥0.9 is an independent predictor of poor prognosis in patients with acute pulmonary embolism. The prognostic value of the RV/LV ratio in patients with idiopathic pulmonary arterial hypertension(IPAH) is still unknown. Methods We retrospectively enrolled 95 consecutive patients with newly diagnosed IPAH and 16 of them were reevaluated by echocardiography at 3-12 months following targeted therapy.Follow-up data were obtained by telephone interviews and review of the patients’ records.Results The RV/LV ratio was in parallel with the severity of World Health Orgnization(WHO) functional class and mean right atrial pressure.The RV/LV ratio was positively correlated with total pulmonary resistance(P P P 2 saturation(P P = 0.001),weight and absence of targeted therapy were independent predictors of death.No significant changes in the RV/LV ratio before and after targeted therapy were observed. A baseline RV/LV ratio≥0.84 or a further increase in the RV/LV ratio during targeted therapy indicated a poor prognosis. Conclusions The RV/LV ratio helps to assess the severity of IPAH and serves as an independent predictor of prognosis in patients with IPAH.展开更多
In this paper, a new miniaturized wide-pass-band filter at U band based on composite right/left- handed transmission line (CRLH TL) is implemented. The CRLH TL contributed to a broadband filter is a balanced structure...In this paper, a new miniaturized wide-pass-band filter at U band based on composite right/left- handed transmission line (CRLH TL) is implemented. The CRLH TL contributed to a broadband filter is a balanced structure with a small size of only 1.428 mm*0.5530 mm. The frequency characteristics are simulated and the results show that the 3 dB band width of the proposed filter is about 13.5 GHz from 45.8 GHz to 59.3 GHz. The insertion loss is quite flat through the pass-band and the return loss is relatively low.展开更多
A tunable dual-broad-band branch-line coupler (BLC) utilizing composite right/left-handed (CRLH) transmission lines is presented. Two λ/4 segments consisting of CRLH transmission lines are added to each port to broad...A tunable dual-broad-band branch-line coupler (BLC) utilizing composite right/left-handed (CRLH) transmission lines is presented. Two λ/4 segments consisting of CRLH transmission lines are added to each port to broaden the dual bands of the branch-line coupler. Numerical simulation and optimal design of the novel coupler are presented. The dual bands of the novel coupler are tunable and broad. The 1-dB bandwidth of each pass band is more than 16% of the central frequency.展开更多
A dual structure of composite right/left handed (CRLH) transmission line (TL) is analyzed in which an inductance LR is in parallel with a capacitance CL and a shunt capacitance CR is in series with an inductance LL. B...A dual structure of composite right/left handed (CRLH) transmission line (TL) is analyzed in which an inductance LR is in parallel with a capacitance CL and a shunt capacitance CR is in series with an inductance LL. Both the distributed and lumped cases are considered. The dispersion diagram and transmission properties of the dual CRLH TL are given and compared with those of a standard CRLH TL. Contrary to the frequency response of a standard CRLH TL, a dual CRLH TL has a left-handed (negative phase shift) band at higher frequencies and a right-handed (positive phase shift) band at lower frequencies. A novel dual-band balun is presented as an application.展开更多
BACKGROUND Transplant teams often hesitate to use the right kidney(RK)in living donor(LD)transplants due to the complexities of anastomosing the short,thin-walled right renal veins,which can potentially lead to graft ...BACKGROUND Transplant teams often hesitate to use the right kidney(RK)in living donor(LD)transplants due to the complexities of anastomosing the short,thin-walled right renal veins,which can potentially lead to graft loss or graft dysfunction.Nevertheless,circumstances may arise where selecting the RK over the left kidney(LK)is unavoidable.Consequently,it is crucial to thoroughly examine the implications of such a choice on the overall transplant outcome.AIM To compare transplant outcomes between recipients of RK and LK while examining the factors that influence these outcomes.METHODS We retrospectively analyzed data from adult patients who received LD kidney transplants involving meticulous patient selection and surgical techniques at our center from January 2020 to December 2023.We included all kidney donors who were over 18,fit to donate,and had undergone diethylenetriamine pentaacetic acid split function and/or computed tomography based volumetry.The variables examined comprised donor and recipient demographics,and outcome measures included technical graft loss(TGL),delayed or slow graft function(SGF),and post-transplant serum creatinine(SC)trends.We used a logistic regression model to assess the likelihood of adverse outcomes considering the donor kidney side.RESULTS Of the 250 transplants performed during the period,56(22%)were RKs.The recipient demographics and transplant factors were comparable for the right and LKs,except that the donor warm and cold ischemia time were shorter for RKs.TGL and SGF each occurred in 2%(n=1)of RKs and 0.5%(n=1)of LKs,the difference being insignificant.These complications,however,were not related to the venous anastomosis.One RK(2%)developed delayed graft function after 48 hours,which was attributable to postoperative hypoxia rather than the surgical technique.The post-transplant SC trend and mean SC at the last follow-up were similar across both kidney sides.CONCLUSION The donor kidney side has little impact on post-transplant adverse events and graft function in LD transplants,provided that careful patient selection and precise surgical techniques are employed.展开更多
Diabetic cardiomyopathy(DCM)has long been considered as a left ventricular(LV)disease with diastolic dysfunction preceding systolic dysfunction in diabetes.However,it is increasingly recognized that the right ventricl...Diabetic cardiomyopathy(DCM)has long been considered as a left ventricular(LV)disease with diastolic dysfunction preceding systolic dysfunction in diabetes.However,it is increasingly recognized that the right ventricle(RV)is also affected by diabetes and may be independently responsible for adverse outcomes in diabetic patients with or without LV failure.Yu et al conducted a 30-week longitudinal evaluation of biventricular function and pathology in OVE26 diabetic mice and revealed early diastolic dysfunction preceding systolic decline,suggesting that early LV diastolic impairment precedes the later onset of systolic dysfunction.With age,the animals developed fibrosis,hypertrophy,and pulmonary arterial hypertension in the RV.The purpose of this editorial is to contextualize these findings within the existing literature by highlighting the interplay between cardiac chambers and the vasculature.We also seek to reiterate that DCM is a condition extending beyond left ventricular dysfunction.As the authors note,the right side of the heart may remain"the forgotten ventricle"in diabetic patients.We hope that the mechanisms discussed in this paper will help researchers to understand the pathogenesis of cardiovascular disease in this context and encourage clinicians to be more attentive to the associated clinical symptoms.展开更多
To the Editor:Theoretically,autologous liver transplantation is posited as a treatment for patients experiencing traumatic liver rupture.How-ever,the procedural complexity and its infrequent application by the medical...To the Editor:Theoretically,autologous liver transplantation is posited as a treatment for patients experiencing traumatic liver rupture.How-ever,the procedural complexity and its infrequent application by the medical community have resulted in a lack of documented suc-cesses.This report presented the efficacious intervention in a pa-tient presenting with polytraumatic injuries involving the thoracic and abdominal regions,namely right-sided hemothorax,contusion and hematoma of the right lung,splenic rupture,lateral damage to the common bile duct,disruption of the left portal vein branch and left hepatic duct,incisions in the hepatic segments IV,V,VI,VII,and VIII,laceration of the right adrenal gland,rupture of the right hepatic venous trunk and retro-hepatic inferior vena cava(RHIVC),and pancreatic hematoma.展开更多
In this paper,novel dual-band (DB) branch-line couplers (BLCs) employing a composite right/left handed transmission line (CRLH TL) and fractal geometry are presented for the first time.The CRLH TL,with specified chara...In this paper,novel dual-band (DB) branch-line couplers (BLCs) employing a composite right/left handed transmission line (CRLH TL) and fractal geometry are presented for the first time.The CRLH TL,with specified characteristic impedance and phase shift,consists of lumped elements for the left handed (LH) part and fractal-shaped microstrip lines (MLs) for the right handed (RH) part,which can be designed separately.Two designed BLCs are involved in size reduction,one using a 3/2 fractal curve of first iteration,the other constructed based on a hybrid shape of fractal and meandered lines.A miniaturized principle for CRLH TL realization is derived and an exact design method for fractal implementation is developed.For verification,an example coupler was fabricated and measured.Consistent numerical and experimental results confirmed the design concept,showing that the BLCs obtain DB behavior centered at 0.9 GHz and 1.8 GHz respectively with good in-band performance,except for slightly larger coupled insertion loss for the hybrid-shaped BLC case.In addition,the proposed fractal-and hybrid-shaped BLCs obtained a 49.7% and 64.1% size reduction respectively relative to their conventional counterparts working in the lower band.The most important contributions of this article are the demonstration of compatibility between the fractal and CRLH TL techniques and the provision of an alternative approach and a new concept for designing devices.展开更多
A wideband composite right/left handed transmission line (CRLH TL) in conjunction with its corresponding equivalent circuit model is studied based on a cascaded complementary single split ring resonator (CCSSRR).The c...A wideband composite right/left handed transmission line (CRLH TL) in conjunction with its corresponding equivalent circuit model is studied based on a cascaded complementary single split ring resonator (CCSSRR).The characterization is performed by theory analysis,circuit simulation,and full-wave electromagnetic (EM) simulation.The negative refractive index (NRI) and backward wave propagation performance of the CRLH TL are demonstrated.For application,a bandpass filter (BPF) with enhanced out-of-band selectivity and harmonic suppression operating at the wireless local area network (WLAN) band is designed,fabricated,and measured by combining the CRLH TL with a complementary electric inductive-capacitive resonator (CELC).Three CELC cells with wideband stopband performance in the conductor strip and ground plane,respectively,are utilized in terms of single negative permeability.The design concept has been verified by the measurement data.展开更多
Objective To search for effective methods of acupuncture therapy in treating chronic diarrhea. Methods Treatments were carried out on 52 patients with chronic diarrhea by using the left ascending and right descending ...Objective To search for effective methods of acupuncture therapy in treating chronic diarrhea. Methods Treatments were carried out on 52 patients with chronic diarrhea by using the left ascending and right descending method. Three acupoints at the left side, namely Xiàng （陷谷 ST 43）, Zúsānl （足三 里 ST 36） and Qūchí （曲池 LI 11）, and Lièqūe （列缺 LU 7） at the right side were selected, moxibustion was also carried out according to syndrome differentiation. The operation of left ascending and right descending method were firstly left and then right, first down and then up, firstly four limbs and then abdomen; the thumb moved backward and the index finger moved forward during needle twisting for the acupoints at the left side, and it was on the contrary for the right side. The needles were retained for 1 h for deficiency, and the pinholes were pressed when the needles were withdrawn; the needles were retained for 0.5 h for excess syndrome and newly-contracted disease, and the pinholes were enlarged by shaking the needles when they were withdrawn. Except that the needling was carried out twice a day for the patients with desertion following chronic diarrhea, the needling was carried out once a day, five days as a treatment course, the patients were given an interval for two days after every two treatment courses, and the therapeutic effect was observed after five treatment courses. Results totally 36 patients were cured, among which 11 patients were cured after one treatment course, 19 patients were cured after two to three treatment courses and 6 patients were cured after four to five treatment courses; eight patients were improved; six patients were not cured; the total effective rate was 88.0%. Conclusion the acupuncture with left ascending and right descending method has satisfactory therapeutic effect in treating chronic diarrhea.展开更多
The colon is derived from the embryological midgut and hindgut separately,with the right colon and left colon having different features with regards to both anatomical and physiological characteristics.Cancers located...The colon is derived from the embryological midgut and hindgut separately,with the right colon and left colon having different features with regards to both anatomical and physiological characteristics.Cancers located in the right and left colon are referred to as right colon cancer(RCC) and left colon cancer(LCC),respectively,based on their apparent anatomical positions.Increasing evidence supports the notion that not only are there differences in treatment strategies when dealing with RCC and LCC,but molecular features also vary between them,not to mention the distinguishing clinical manifestations.Disease-free survival after radical surgery of both RCC and LCC are similar.In the treatment of RCC,the benefit gained from adjuvant FOLFIRI chemotherapy is superior,or at least similar,to LCC,but inferior to LCC if FOLFOX regimen is applied.On the other hand,metastatic LCC exhibits longer survival than that of RCC in a palliative chemotherapy setting.For KRAS wild-type cancers,LCC benefits more from cetuximab treatment than RCC.Moreover,advanced LCC shows a higher sensitivity to bevacizumab treatment in comparison with advanced RCC.Significant varieties exist at the molecular level between RCC and LCC,which may serve as the cause of all apparent differences.With respect to carcinogenesis mechanisms,RCC is associated with known gene types,such as MMR,KRAS,BRAF,and mi RNA-31,while LCC is associated with CIN,p53,NRAS,mi RNA-146 a,mi RNA-147 b,and mi RNA-1288.Regarding protein expression,RCC is related to GNAS,NQO1,telomerase activity,P-PDH,and annexin A10,while LCC is related to Topo I,TS,and EGFR.In addition,separated pathways dominate progressionto relapse in RCC and LCC.Therefore,RCC and LCC should be regarded as two heterogeneous entities,with this heterogeneity being used to stratify patients in order for them to have the optimal,current,and novel therapeutic strategies in clinical practice.Additional research is needed to uncover further differences between RCC and LCC.展开更多
Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enc...Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enclosing conduit graft was used as a sac bypassed to right atrium to form a extracardial left-toright shunt in order to control bleeding and the results turned out to be satisfactory. The bypass and hemodynamically ignorable shunt can close spontaneously without complications with recovery of coagulation system. The technique may find wide application in clinical practice.展开更多
Background An echocardiographic right/left ventricular end-diastolic diameter ratio （RV/LV ratio） 〉0.9 is an independent predictor of poor prognosis in patients with acute pulmonary embolism. Right ventricular dila...Background An echocardiographic right/left ventricular end-diastolic diameter ratio （RV/LV ratio） 〉0.9 is an independent predictor of poor prognosis in patients with acute pulmonary embolism. Right ventricular dilation is a common characteristic of both acute pulmonary embolism and idiopathic pulmonary arterial hypertension （IPAH）. However, the prognostic value of the RV/LV ratio in patients with IPAH is unknown. Methods Ninety-five consecutive patients with newly diagnosed IPAH were included, 17 were re-evaluated by echocardiography after 3-12 months of targeted therapy, Follow-up data were obtained by telephone interviews and review of the patients＇ records.展开更多
AIM To explore the differences in the responses of left-sided colorectal cancer(LSCRC) and right-sided colon cancer(RSCC) to traditional Chinese medicine(TCM).METHODS Patients with postoperative stage I-III colorectal...AIM To explore the differences in the responses of left-sided colorectal cancer(LSCRC) and right-sided colon cancer(RSCC) to traditional Chinese medicine(TCM).METHODS Patients with postoperative stage I-III colorectal cancer(CRC) were enrolled and divided into the LSCRC with or without TCM and RSCC with or without TCM groups depending on the primary tumor side and TCM administration. Patients in the TCM group were given TCM for at least 6 mo. Our research adopted diseasefree survival(DFS) as the primary endpoint. We applied a Cox proportional hazards regression model for the multivariate factor analysis using Stata 12.0 and SPSS 22.0 software for data analysis.RESULTS Of the 817 patients included in our study, 617 had LSCRC(TCM group, n = 404; Non-TCM group, n = 213), and 200 had RSCC(TCM group, n = 132; NonTCM group, n = 68). The 6-year DFS for patients with LSCRC was 56.95% in the TCM group and 41.50% in the Non-TCM group(P = 0.000). For patients with RSCC, the 6-year DFS was 52.92% in the TCM group and 37.19% in the Non-TCM group(P = 0.003). Differences between LSCRC and RSCC were not statistically significant regardless of TCM ingestion.CONCLUSION Patients with either LSCRC or RSCC and who took TCM experienced longer DFS; furthermore, patients with RSCC benefited more from TCM in DFS.展开更多
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
基金Project supported by the National Natural Science Foundation of China (Nos. 60577023 and 60378037), the National Basic Research Program (973) of China (No. 2004CB719802), China Postdoctoral Science Foundation, and Education Ministry Key Laboratory of Photoelectric Information Technology Science Foundation (No. 2005-20), China
文摘A new power divider, composed of a novel composite right/left-handed (CRLH) transmission line (TL) unit, is proposed. The properties of the power divider based on four CRLH TL unit cells are investigated theoretically. By adjusting the parameters of the capacitors and the inductors, the power divider shows perfectly symmetric power division at 5.13 GHz, return loss up to ?24 dB, with the transmitted power being close to ?3.1 dB. The phenomena are demonstrated by simulation results. Being compact in size and low-cost, the proposed power divider is very suitable for microwave and millimeter wave integrated circuits.
基金Project supported by the National Basic Research Program (973) of China (No. 2004CB719800) and the National Natural Science Foundation of China (Nos. 60271027 and 60501018)
文摘A new approach was introduced to analyze composite right/left-handed transmission lines （CRLH TLs）. The Bloch impedance and the dispersion relations are directly obtained from the S parameters of the unit cells. The LH and RH frequency bands are then identified by the real parts of the Bloch impedance and the phase delay of the unit cells. The new approach has some advantages over the LC parameters extraction method introduced by Caloz et a1.（2004）. Based on the new approach, a novel resonator is designed using CRLH TLs. The simulation and experimental results accorded well with the theoretical analysis. The novel resonator may have potential applications in filters with high harmonic suppression and compact structures,
文摘In this paper a metamaterial-inspired antenna with high gain and good directivity is designed. Based on the concept of composite right/left-handed transmission line (CRLH-TL), the proposed antenna is realized based on three leakage wave unit cell and a left handed circular ring slot incorporated on the surface. The maximum achievable gain at the resonant frequency of 5.6GHz is 6.933 dBi, and the return loss at 5.6 GHz can be –20 db. This proposed design has a simple structure and a compact dimension of 35 mm*40 mm*1 mm, which is suitable for particular wireless communication application such as WiFi and WLAN.
文摘Background Previous studies have shown that an echocardiographic right/left ventricular end-diastolic diameter ratio(RV/LV ratio)≥0.9 is an independent predictor of poor prognosis in patients with acute pulmonary embolism. The prognostic value of the RV/LV ratio in patients with idiopathic pulmonary arterial hypertension(IPAH) is still unknown. Methods We retrospectively enrolled 95 consecutive patients with newly diagnosed IPAH and 16 of them were reevaluated by echocardiography at 3-12 months following targeted therapy.Follow-up data were obtained by telephone interviews and review of the patients’ records.Results The RV/LV ratio was in parallel with the severity of World Health Orgnization(WHO) functional class and mean right atrial pressure.The RV/LV ratio was positively correlated with total pulmonary resistance(P P P 2 saturation(P P = 0.001),weight and absence of targeted therapy were independent predictors of death.No significant changes in the RV/LV ratio before and after targeted therapy were observed. A baseline RV/LV ratio≥0.84 or a further increase in the RV/LV ratio during targeted therapy indicated a poor prognosis. Conclusions The RV/LV ratio helps to assess the severity of IPAH and serves as an independent predictor of prognosis in patients with IPAH.
文摘In this paper, a new miniaturized wide-pass-band filter at U band based on composite right/left- handed transmission line (CRLH TL) is implemented. The CRLH TL contributed to a broadband filter is a balanced structure with a small size of only 1.428 mm*0.5530 mm. The frequency characteristics are simulated and the results show that the 3 dB band width of the proposed filter is about 13.5 GHz from 45.8 GHz to 59.3 GHz. The insertion loss is quite flat through the pass-band and the return loss is relatively low.
基金Project (No. 2004CB719802) supported by the National Basic Re-search Program (973) of China
文摘A tunable dual-broad-band branch-line coupler (BLC) utilizing composite right/left-handed (CRLH) transmission lines is presented. Two λ/4 segments consisting of CRLH transmission lines are added to each port to broaden the dual bands of the branch-line coupler. Numerical simulation and optimal design of the novel coupler are presented. The dual bands of the novel coupler are tunable and broad. The 1-dB bandwidth of each pass band is more than 16% of the central frequency.
基金Project supported by the National Basic Research Program (973) of China (No. 2004CB719802), and the Science and Technology De-partment of Zhejiang Province (No. 2005C31004), China
文摘A dual structure of composite right/left handed (CRLH) transmission line (TL) is analyzed in which an inductance LR is in parallel with a capacitance CL and a shunt capacitance CR is in series with an inductance LL. Both the distributed and lumped cases are considered. The dispersion diagram and transmission properties of the dual CRLH TL are given and compared with those of a standard CRLH TL. Contrary to the frequency response of a standard CRLH TL, a dual CRLH TL has a left-handed (negative phase shift) band at higher frequencies and a right-handed (positive phase shift) band at lower frequencies. A novel dual-band balun is presented as an application.
文摘BACKGROUND Transplant teams often hesitate to use the right kidney(RK)in living donor(LD)transplants due to the complexities of anastomosing the short,thin-walled right renal veins,which can potentially lead to graft loss or graft dysfunction.Nevertheless,circumstances may arise where selecting the RK over the left kidney(LK)is unavoidable.Consequently,it is crucial to thoroughly examine the implications of such a choice on the overall transplant outcome.AIM To compare transplant outcomes between recipients of RK and LK while examining the factors that influence these outcomes.METHODS We retrospectively analyzed data from adult patients who received LD kidney transplants involving meticulous patient selection and surgical techniques at our center from January 2020 to December 2023.We included all kidney donors who were over 18,fit to donate,and had undergone diethylenetriamine pentaacetic acid split function and/or computed tomography based volumetry.The variables examined comprised donor and recipient demographics,and outcome measures included technical graft loss(TGL),delayed or slow graft function(SGF),and post-transplant serum creatinine(SC)trends.We used a logistic regression model to assess the likelihood of adverse outcomes considering the donor kidney side.RESULTS Of the 250 transplants performed during the period,56(22%)were RKs.The recipient demographics and transplant factors were comparable for the right and LKs,except that the donor warm and cold ischemia time were shorter for RKs.TGL and SGF each occurred in 2%(n=1)of RKs and 0.5%(n=1)of LKs,the difference being insignificant.These complications,however,were not related to the venous anastomosis.One RK(2%)developed delayed graft function after 48 hours,which was attributable to postoperative hypoxia rather than the surgical technique.The post-transplant SC trend and mean SC at the last follow-up were similar across both kidney sides.CONCLUSION The donor kidney side has little impact on post-transplant adverse events and graft function in LD transplants,provided that careful patient selection and precise surgical techniques are employed.
文摘Diabetic cardiomyopathy(DCM)has long been considered as a left ventricular(LV)disease with diastolic dysfunction preceding systolic dysfunction in diabetes.However,it is increasingly recognized that the right ventricle(RV)is also affected by diabetes and may be independently responsible for adverse outcomes in diabetic patients with or without LV failure.Yu et al conducted a 30-week longitudinal evaluation of biventricular function and pathology in OVE26 diabetic mice and revealed early diastolic dysfunction preceding systolic decline,suggesting that early LV diastolic impairment precedes the later onset of systolic dysfunction.With age,the animals developed fibrosis,hypertrophy,and pulmonary arterial hypertension in the RV.The purpose of this editorial is to contextualize these findings within the existing literature by highlighting the interplay between cardiac chambers and the vasculature.We also seek to reiterate that DCM is a condition extending beyond left ventricular dysfunction.As the authors note,the right side of the heart may remain"the forgotten ventricle"in diabetic patients.We hope that the mechanisms discussed in this paper will help researchers to understand the pathogenesis of cardiovascular disease in this context and encourage clinicians to be more attentive to the associated clinical symptoms.
基金supported by a grant from the Climbing Project for Medical Talent of Zhongnan Hospital,Wuhan University(PDJH202215).
文摘To the Editor:Theoretically,autologous liver transplantation is posited as a treatment for patients experiencing traumatic liver rupture.How-ever,the procedural complexity and its infrequent application by the medical community have resulted in a lack of documented suc-cesses.This report presented the efficacious intervention in a pa-tient presenting with polytraumatic injuries involving the thoracic and abdominal regions,namely right-sided hemothorax,contusion and hematoma of the right lung,splenic rupture,lateral damage to the common bile duct,disruption of the left portal vein branch and left hepatic duct,incisions in the hepatic segments IV,V,VI,VII,and VIII,laceration of the right adrenal gland,rupture of the right hepatic venous trunk and retro-hepatic inferior vena cava(RHIVC),and pancreatic hematoma.
基金supported by the National Natural Science Foundation of China(Nos.60871027and 60971118)the National Basic Research Program(973) of China(No.2009CB613306)
文摘In this paper,novel dual-band (DB) branch-line couplers (BLCs) employing a composite right/left handed transmission line (CRLH TL) and fractal geometry are presented for the first time.The CRLH TL,with specified characteristic impedance and phase shift,consists of lumped elements for the left handed (LH) part and fractal-shaped microstrip lines (MLs) for the right handed (RH) part,which can be designed separately.Two designed BLCs are involved in size reduction,one using a 3/2 fractal curve of first iteration,the other constructed based on a hybrid shape of fractal and meandered lines.A miniaturized principle for CRLH TL realization is derived and an exact design method for fractal implementation is developed.For verification,an example coupler was fabricated and measured.Consistent numerical and experimental results confirmed the design concept,showing that the BLCs obtain DB behavior centered at 0.9 GHz and 1.8 GHz respectively with good in-band performance,except for slightly larger coupled insertion loss for the hybrid-shaped BLC case.In addition,the proposed fractal-and hybrid-shaped BLCs obtained a 49.7% and 64.1% size reduction respectively relative to their conventional counterparts working in the lower band.The most important contributions of this article are the demonstration of compatibility between the fractal and CRLH TL techniques and the provision of an alternative approach and a new concept for designing devices.
基金Project (Nos.60871027 and 60971118) supported by the National Natural Science Foundation of China
文摘A wideband composite right/left handed transmission line (CRLH TL) in conjunction with its corresponding equivalent circuit model is studied based on a cascaded complementary single split ring resonator (CCSSRR).The characterization is performed by theory analysis,circuit simulation,and full-wave electromagnetic (EM) simulation.The negative refractive index (NRI) and backward wave propagation performance of the CRLH TL are demonstrated.For application,a bandpass filter (BPF) with enhanced out-of-band selectivity and harmonic suppression operating at the wireless local area network (WLAN) band is designed,fabricated,and measured by combining the CRLH TL with a complementary electric inductive-capacitive resonator (CELC).Three CELC cells with wideband stopband performance in the conductor strip and ground plane,respectively,are utilized in terms of single negative permeability.The design concept has been verified by the measurement data.
文摘Objective To search for effective methods of acupuncture therapy in treating chronic diarrhea. Methods Treatments were carried out on 52 patients with chronic diarrhea by using the left ascending and right descending method. Three acupoints at the left side, namely Xiàng （陷谷 ST 43）, Zúsānl （足三 里 ST 36） and Qūchí （曲池 LI 11）, and Lièqūe （列缺 LU 7） at the right side were selected, moxibustion was also carried out according to syndrome differentiation. The operation of left ascending and right descending method were firstly left and then right, first down and then up, firstly four limbs and then abdomen; the thumb moved backward and the index finger moved forward during needle twisting for the acupoints at the left side, and it was on the contrary for the right side. The needles were retained for 1 h for deficiency, and the pinholes were pressed when the needles were withdrawn; the needles were retained for 0.5 h for excess syndrome and newly-contracted disease, and the pinholes were enlarged by shaking the needles when they were withdrawn. Except that the needling was carried out twice a day for the patients with desertion following chronic diarrhea, the needling was carried out once a day, five days as a treatment course, the patients were given an interval for two days after every two treatment courses, and the therapeutic effect was observed after five treatment courses. Results totally 36 patients were cured, among which 11 patients were cured after one treatment course, 19 patients were cured after two to three treatment courses and 6 patients were cured after four to five treatment courses; eight patients were improved; six patients were not cured; the total effective rate was 88.0%. Conclusion the acupuncture with left ascending and right descending method has satisfactory therapeutic effect in treating chronic diarrhea.
基金Supported by Grants from Key Projects in the National Science and Technology Pillar Program during the Twelfth Five-year Plan Period,No.2014BAI09B07grants from the National Natural Science Foundation of China,No.81101580 and No.81201640
文摘The colon is derived from the embryological midgut and hindgut separately,with the right colon and left colon having different features with regards to both anatomical and physiological characteristics.Cancers located in the right and left colon are referred to as right colon cancer(RCC) and left colon cancer(LCC),respectively,based on their apparent anatomical positions.Increasing evidence supports the notion that not only are there differences in treatment strategies when dealing with RCC and LCC,but molecular features also vary between them,not to mention the distinguishing clinical manifestations.Disease-free survival after radical surgery of both RCC and LCC are similar.In the treatment of RCC,the benefit gained from adjuvant FOLFIRI chemotherapy is superior,or at least similar,to LCC,but inferior to LCC if FOLFOX regimen is applied.On the other hand,metastatic LCC exhibits longer survival than that of RCC in a palliative chemotherapy setting.For KRAS wild-type cancers,LCC benefits more from cetuximab treatment than RCC.Moreover,advanced LCC shows a higher sensitivity to bevacizumab treatment in comparison with advanced RCC.Significant varieties exist at the molecular level between RCC and LCC,which may serve as the cause of all apparent differences.With respect to carcinogenesis mechanisms,RCC is associated with known gene types,such as MMR,KRAS,BRAF,and mi RNA-31,while LCC is associated with CIN,p53,NRAS,mi RNA-146 a,mi RNA-147 b,and mi RNA-1288.Regarding protein expression,RCC is related to GNAS,NQO1,telomerase activity,P-PDH,and annexin A10,while LCC is related to Topo I,TS,and EGFR.In addition,separated pathways dominate progressionto relapse in RCC and LCC.Therefore,RCC and LCC should be regarded as two heterogeneous entities,with this heterogeneity being used to stratify patients in order for them to have the optimal,current,and novel therapeutic strategies in clinical practice.Additional research is needed to uncover further differences between RCC and LCC.
文摘Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enclosing conduit graft was used as a sac bypassed to right atrium to form a extracardial left-toright shunt in order to control bleeding and the results turned out to be satisfactory. The bypass and hemodynamically ignorable shunt can close spontaneously without complications with recovery of coagulation system. The technique may find wide application in clinical practice.
文摘Background An echocardiographic right/left ventricular end-diastolic diameter ratio （RV/LV ratio） 〉0.9 is an independent predictor of poor prognosis in patients with acute pulmonary embolism. Right ventricular dilation is a common characteristic of both acute pulmonary embolism and idiopathic pulmonary arterial hypertension （IPAH）. However, the prognostic value of the RV/LV ratio in patients with IPAH is unknown. Methods Ninety-five consecutive patients with newly diagnosed IPAH were included, 17 were re-evaluated by echocardiography after 3-12 months of targeted therapy, Follow-up data were obtained by telephone interviews and review of the patients＇ records.
基金Supported by the Scientific Research Foundation of Traditional Chinese Medicine of the Shanghai Health Bureau,No.2014LZ079Athe Scientific Research Plan Project of the Shanghai Science and Technology Committee,No.14401930800the Program of Shanghai Municipal Technology and Education Commission,No.16401970500
文摘AIM To explore the differences in the responses of left-sided colorectal cancer(LSCRC) and right-sided colon cancer(RSCC) to traditional Chinese medicine(TCM).METHODS Patients with postoperative stage I-III colorectal cancer(CRC) were enrolled and divided into the LSCRC with or without TCM and RSCC with or without TCM groups depending on the primary tumor side and TCM administration. Patients in the TCM group were given TCM for at least 6 mo. Our research adopted diseasefree survival(DFS) as the primary endpoint. We applied a Cox proportional hazards regression model for the multivariate factor analysis using Stata 12.0 and SPSS 22.0 software for data analysis.RESULTS Of the 817 patients included in our study, 617 had LSCRC(TCM group, n = 404; Non-TCM group, n = 213), and 200 had RSCC(TCM group, n = 132; NonTCM group, n = 68). The 6-year DFS for patients with LSCRC was 56.95% in the TCM group and 41.50% in the Non-TCM group(P = 0.000). For patients with RSCC, the 6-year DFS was 52.92% in the TCM group and 37.19% in the Non-TCM group(P = 0.003). Differences between LSCRC and RSCC were not statistically significant regardless of TCM ingestion.CONCLUSION Patients with either LSCRC or RSCC and who took TCM experienced longer DFS; furthermore, patients with RSCC benefited more from TCM in DFS.
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.
