简介：瞄准：评估对在有动脉的可勃起的机能障碍(编辑)的病人的sildenafil管理的反应是否与他们的山峰有关收缩速度(PSV)，外部动脉粥样硬化，心血管的风险因素(RF)或在低心血管的风险的comorbidities。方法：我们与12RF和comorbidities注册了97个病人，独自与动脉的编辑结合了(组A，n=27)，编辑正动脉粥样硬化患者颈动脉动脉(组B，n=23)，编辑正更低的手足动脉畸形(组C，n=25)，并且编辑正颈动脉和更低的手足动脉畸形(组D，n=22)。Sildenafil功效(100mg两次为12个星期的一个星期)也与≥在病人被检验3RF，外部动脉粥样硬化和没有心血管的comorbidities(组E，n=20)。结果：中部的PSV分别地是在组A，B，C，D和E的24.1，21.0，19.3，14.5和17.5cm/s。Sildenafil反应在组A是更高的病人(77.8%)，在组B和C(65.2%和56%)中间、在组最低D(45.4%)和E(50%)，和在后者二组的反应比在另外的三个组显著地低。另外，sildenafil反应否定地旁边被影响：≥3RF，外部动脉粥样硬化和没有全身的comorbidity，或与扩大动脉粥样硬化和comorbidities联系的12RF的存在。comorbidities的数字是断然与动脉粥样硬化本地化或扩展有关(25，35，38和47在组A，B，C和D，分别地)。结论：在有动脉的编辑的病人的低sildenafil功效与扩大动脉粥样硬化被联系。这些病人应该经历广泛的ultrasonography和完整的心血管的考试。

简介：AbstractPurpose:To discuss and share the experience of treatment of traumatic innominate arterial injury.Methods:A retrospective analysis was performed on patients with innominate arterial injuries admitted from January 2016 to July 2018 at the department of vascular surgery, Beijing Jishuitan Hospital, China. All the arterial injuries were confirmed by arteriography. Clinical data including mechanism of injury, type of injury, demographics, concomitant injuries, time interval from trauma to blood flow reconstruction, and operation methods were collected. Follow-up program included outpatient visit and duplex-ultrasonography. SPSS version 23.0 was adopted for data analysis. Categorical variables are presented as number and/or frequency and continuous variables as mean ± standard deviation.Result:Altogether 7 patients were included and 6 (85.7%) were male. The mean age of patients was (29.43 ± 7.98) years, range 19-43 years. Six patients had isolated innominate arterial injuries and the rest 1 combined innominate arterial and vein injuries. The injury causes were road accidents in 3 patients, stab wound in 2, gunshot wound in 1, and crush injury in 1. All the 7 patients presented hemorrhagic shock at admission, which was timely and effectively corrected. No perioperative death or technical complications occurred. Intimal injury (n = 2) and partial transaction (n = 2) of the innominate artery were treated with covered stents. Two patients with complete transection of artery received vascular reconstruction by artificial grafts. One patient with partial transaction received balloon dilation and open surgical repair (hybrid operation). The mean time interval from trauma to blood flow reconstruction was (4.27 ± 0.18) h, range 4.0-4.5 h; while the operation time was (48.57 ± 19.94) min, range 25-75 min. Cerebral infarction occurred in one patient with brain injury due to anticoagulation contraindication. The average follow-up was (13.29 ± 5.65) months, range 6-24 months. No severe stenosis, occlusion, and thrombosis of covered stents or artificial vessels were found by color Doppler ultrasound.Conclusion:Urgent control of hemorrhage and restoration of blood supply are critical for the treatment of traumatic innominate arterial injury. Endovascular therapy is a feasible and effective method with short operation time and less trauma.

简介：DearEditor,Retinalarterialmacroaneurysm(RAM),whichusuallyoccurswithinthefirstthreeordersofarterialbifurcation,isacquiredfusiformorsacculardilatationsofretinalarterioles~([1-2]).Aging,thefemalegender,andsystemicvascularpa-

简介：Varioussteadymodelsforinteractionbetweenheartandarterialsystemhavebeengiveninliter-ature,Inourrecentstudy,adynamicprinciple,i.e.theprincipleofleastcardiacworkisproposed,andady-namicmodelforinteractionofheartandarterialsystemisestablished.Preliminaryresultsofourexperimentsshowthatboththeprincipleandthemodelareconsistentwiththephysiologicalphenomena.Itrevealsthatthepres-entanalysismayofferanewmeasureforthestudyofdynamicprocessofinteractionbetweenheartandarterialsystem.

简介：Rightventricularfailure(RVF)remainstheprimarycauseofdeathinpatientswithpulmonaryarterialhypertension.WereviewthepathophysiologyofRVF,includingtheremodelingandventriculoarterialuncouplingthatoccurswhenthefailingrightsideoftheheartisunabletocompensateforarisingafterload.Secondly,thenoninvasiveimagingtechniquesusedintheassessmentofRVFareexplored,includingechocardiography,cardiacmagneticresonanceimaging,computedtomography,andpositronemissiontomography.Third,wedescribehowtheseimagingtechniquesandapatient’sclinicalcharacteristicsmaybeusedtodetermineprognosis.Lastly,weexplorethemedicalandsurgical/interventionaltreatmentoptionsforRVF.Despitethesetreatmentoptions,morbidityandmortalityremainhighinthispatientpopulation.Thediscoveryofnewprognosticindicators,useofhybridimagingforearlydetectionofRVF,andstrategiestopreventthedevelopmentofRVFwillbeimportantifoutcomesinthispatientpopulationaretoimprove.

简介：Objective:Toanalyzeretrospectivelythesurgicaltreatmentof21casesofinfectedarterialinjuriesofthemajorlimbhospitalizedfrom1989to2003inourdepartment.Methods:Afteraradicaldebridementanddrainage,anautologousvesselbypassreconstruction,simplevesselligationoramputationwerecarriedoutrespectivelyaccordingtoeachpatient'scondition.Inordertomakeabettermilieuforthegrafts,localmusculo-cutaneousflapsweretranslocatedtocoverthewoundsin9cases.Results:1case(4.8%)diedduringthetreatment.5cases(5/21,23.8%)underwentamputations.Bloodsupplyreconstructionwassuccessfulin15cases(15/21,71.4%).93.3%(14/15)ofthecasesweresuccessfulingettinganunobstructedvesselatearlystage.Thrombosisoccurredin1case(1/15,6.7%)andasoundresultwasobtainedafterasecondoperation.Conclusions:Radicaldebridementcombinedwithbypassvesselreconstructionwithautologousveinandwithmusculo-cutaneousflaptranslocationisaneffectivetreatmentforinfectivelimbvascularinjuries.

简介：AbstractTwin reversed arterial perfusion sequence, a severe and unique complication of monochorionic multiple pregnancy, is characterized by vascular anastomosis and abnormal or absent cardiac development in the twins. This article reviewed its pathogenesis, prenatal ultrasound diagnosis, and management. The pump twin’s chances for survival can be maximized by proper management. The optimal timing of the interventions remains a debate, although the latest studies encourage early intervention, i.e., in the first trimester. The most preferred approach is to interrupt the vascular supply to the acardius, such as through ultrasound-guided laser coagulation and radiofrequency ablation of the intrafetal vessels.

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简介：Thispaperconsiderstheoptimaltrafficsignalsettingforanurbanarterialroad.Byintroducingtheconceptsofsynchronizationrateandnon-synchronizationdegree,amathematicalmodelisconstructedandanoptimizationproblemisposed.Then,anewiterativealgorithmisdevelopedtosolvethisoptimaltrafficcontrolsignalsettingproblem.Convergencepropertiesforthisiterativealgorithmareestablished.Finally,anumericalexampleissolvedtoillustratetheeffectivenessofthemethod.

简介：BackgroundPregnancycomplicatingpulmonaryarterialhypertension(PAH)isalife-threateningobstetricalcomplication.FewstudieshavereportedtheclinicalcharacteristicsandoutcomesofpregnantwomenwithPAH.MethodsRetrospectivelyanalysiswasconductedon86casesofpregnantwomenwithPAHattheDepartmentofObstetricinGuangdongGeneralHospitalbetween2009and2014.Dataincludedpatients'age,theetiologiesofPAH,clinicalclassificationoftheNewYorkHeartAssociation(NYHA),gestationalweeks,deliverymode,maternalandfetaloutcomes.Results1Therewere2casesofidiopathicpulmonaryarterialhypertension(IPAH)and84casesofsecondarypulmonaryarterialhypertension.Thelatterwascomposedby40(47.61%)casesofcongenitalheartdisease(CHD),38(45.23%)casesofrheumaticheartdisease(RHD),3(3.57%)casesofsystemiclupuserythematosus(SLE)and1(1.19%)caseofpartialhydatidiformmole.ThenumberofpatientsclassifiedinNYHAI~IVwere8(9.30%),41(47.67%),26(30.23%)and11(12.7%),respectively.Andthemortalitywas3.48%(3/86).2Amongthe86patients,31(36.04%)womengavebirthattermand36(41.86%)hadprematuredelivery.Inaddition,16(18.6%)womenhadanabortionlessthan28weeks.Therewereatotalof65(75.58%)livebirths,61(93.84%)ofwhomweredeliveredviacesareansection,whiletheother4(6.15%)werevaginaldeliveries.3Patientsweredividedinto3groups,12ofmild(<40mmHg),35ofmoderate(40~70mmHg)and39ofsevere(≥70mmHg)regardingthepulmonaryarterysystolicpressure(sPAP)measuredbyultrasound.WedefinedtheformertwoasgroupAandthelatterasgroupB.Thesignificancewasseenstatisticallyingestationalweeks(32.86±8.86gvs28.76±9.84),therateoftransferringtoICU(19.14%vs53.84%),neonatalbirth-weight(2725.69±467.43vs2044.82±665.75g),APGARscoring(9.97±0.16vs8.68±2.08),maternalstatusofheartfunctionandadversepregnantoutcomes,whencomparedgroupAwithB.AlltheP-valuesmentionedabovew

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简介：Congenitalheartdisease(CHD)-associatedpulmonaryarterialhypertension(PAH)includesaheterogeneouspatientpopulationthatcanbecharacterizedbytheunderlyingcardiacmalformation.CHD-associatedPAHhasanestimatedprevalenceof5–10%inadultpatients,withanincreasingnumberofpatientssurvivingtoadulthoodbecauseofadvancesinthesurgicalmanagementandthedevelopmentofpulmonaryarterialhypertension(PAH)-targetedpharmacotherapy.Althoughlimiteddataexist,targetedPAHpharmacotherapyhasproventobebeneficialinpatientswithCHD-associatedPAH,withobservedimprovementinfunctionalclass,increaseinexercisecapacity,andimprovementinqualityoflifeandcardiopulmonaryhemodynamics.Additionally,therehasbeenincreasinginterestinthe“treat-to-close”strategy.PAH-targetedpharmacotherapymaybeusedtooptimizecardiopulmonaryhemodynamicssoastoimprovepatients’operabilityinrepairingthecardiacdefect.Althoughtherehavebeensignificantadvancesinthemanagementofthisdiseasestateinthepast2decades,mortalityremainshigh,andongoingclinicaltrialsareneededtobetterunderstandthetreat-to-closestrategy.

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简介：优化协调控制的过程被划分成二个阶段。在第一个阶段，学习改进单个点的交叉的一个柔韧的最佳的控制模型优化周期和裂口。在第二个阶段，学习作为一个完全的系统把所有连接与动脉的道路的交叉相结合，并且使用房间传播模型在城市的庆祝动脉的道路上模仿交通流动。我们基于站台建议一个协调控制模型优化在邻近的交叉之间的偏移量。基因算法被MATLAB执行解决模型。性能评估表演模型有效地，还原剂一般水准延期和动脉的道路上并且大部分的车辆的停止的率不仅提高动脉的道路的交通能力，而且为流动变化降低信号控制的敏感。

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简介：Tomakecleartheprecisehemodynamicmechanismunderlyingtheanti-atherogenesisbenefitofenhancedexternalcouterpulsation(EECP)treatment,andtoinvestigatetheproperroleofsomeimportanthemodynamicfactorsduringtheatheroscleroticprogress,acomprehensivestudycombininglong-termanimalexperimentandnumericalsolvingwasconductedinthispaper.AnexperimentallyinducedhypercholesterolemicporcinemodelwasdevelopedandthechronicEECPinterventionwassubjected.Basichemodynamicmeasurementwasperformedinvivo,aswellasthearterialendothelialsampleswereextractedforphysiologicalexamination.Meanwhile,anumericalmodelwasintroducedtosolvethecomplexhemodynamicfactorssuchasWSSandOSI.TheresultsshowthatEECPtreatmentresultedinsignificantincreaseoftheinstantlevelsofarterialWSS,bloodpressure,andOSI.DuringEECPtreatment,theinstantOSIlevelofthecommoncarotidarteriesovercardiaccyclesraisedtoameanvalueof8.58×10-2±2.13×10-2.Meanwhile,thechronicinterventionofEECPtreatmentsignificantlyreducedtheatheroscleroticlesionsinabdominalaortasandtheendothelialcellularadherence.ThepresentstudysuggeststhattheuniquebloodflowpatterninducedbyEECPtreatmentandtheaugmentationofWSSlevelincardiaccyclesmaybethemostimportanthemodynamicmechanismthatcontributetoitsanti-atherogenesiseffect.Andasoneoftheindicesthatcausegreatconcernincurrenthemodynamicstudy,OSImaynotplayakeyroleduringtheinitiationofatherosclerosis.更多还原

简介：AbstractBackground:Chronic total occlusion (CTO) is a critical and unique subgroup of coronary lesions. This study aimed to investigate the correlation between the Selvester QRS score and late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMRI) in quantifying myocardial scarring to provide a simple and feasible method for treating CTO.Methods:The medical records of 134 patients with absolute CTO who underwent coronary angiography between May 1, 2014 and December 30, 2017 were retrospectively reviewed. All patients were grouped according to the CTO location (right coronary artery [RCA] CTO, left artery descending [LAD] CTO, left circumflex [LCX] CTO, and multivessel CTO groups). The degree of myocardial scarring was determined according to the Selvester QRS score and using the LGE-CMRI. All patients were followed up for at least 12 months.Results:Among the 62 CTO patients, 55 had occlusion of a single vessel and seven had occlusion of multiple vessels, of which 27 (43.55%) were in the RCA CTO group, 16 (25.81%) in the LAD CTO group, 12 (19.35%) in the LCX CTO group, and 7 (11.29%) in the multivessel CTO group. The area under the receiver operating characteristic curve for the QRS score that was used to determine the degree of myocardial scarring was 0.806, with a sensitivity and specificity of 94.7% and 42.1%, respectively. The Selvester QRS score and LGE-CMRI measures of scar size were correlated in the RCA CTO, LCX CTO, and multivessel CTO groups (r = 0.466, 0.593, and 0.775, respectively).Conclusion:The Selvester QRS score was feasible for detecting myocardial scarring in patients with CTO.

简介：ObjectiveToevaluatereliabilityandsafetyofAngio-sealhemostasisdeviceappliedtothefemoralarterialpuncturesiteafterpercutaneouscoronaryintervention(PCI).MethodsIn40patientsafterPCIinourinstituteduringtheperiodbetweenMay2002andDecember2003,Angio-sealdevicewereusedtosealthefemoralarterialpuncturesite.ResultsAlltheAngiosealdevicesweresuccessfullydeployedin40patients(successfulrate;100%);themeantimetohemostasiswas45±12sec;themeantimetoambulateafterangiosealclosurewas1.9?.5hours.Nomajorgroinandsystemiccomplicationwasobserved.Therewasminorgroinoozingin2casesandsmallhemotomain1patient.ConclusionsAngio-sealclosuredeviceofthefemoralarterypuncturesiteafterapercutaneouscoronaryprocedureissafe.Itcanshortenthetimetohemostasis,leadstoearlymobilization,andreducegroincomplication.Thedisadvantageisrelativelyexpensive.