简介：<正>REPLACEMENTPATTERNSOFGEOTECTONICUNITSLiYuping(Dept.ofChemicalScienceandEngineering,HunanUniv.,Changsha,China,410082)replacementpattern,geotectonicunit,DiwatheoryBaseupontheDiwatheoryandthestudiesofevolutionprocessofgeotectonicunits,thispaperhasadvancedthattherearemanyreplacementpatternsofthegeotectonicu-nitsintheirevolutionprocess.Therearethreereplacementpatterns(eg.suddenchange(nor-mal)pattern,gradualchangeandprogressivepattern)duringtheplatformregionsubstitutesthegeosynclinalregionandthreereplacementpatterns(eg.normalpattern,surpassivepatternandprogressivepattern)whentheDiwaregiondevelopsfrompre-Diwaregions.Theknowl-edgeoftheseregularityisofimportantsignificanceforustodeeplystudytheevolutionofgeo-tectonicunitandthedevelopmentofthecrust.

简介：这篇论文考虑最佳的预防维护的一个问题和奉献给从已知的存款提取资源的设备的代替时间表。典型例子是油练习，矿铲，等等。至多，在新的存在机械的一代替被允许。这个问题作为一个最佳的控制问题题目被提出到在任何给定的时间的留下的存款是非否定的州的限制。我们证明如果要求，最佳的预防维护，生产率，和存在机械和新机械的代替和抢救时间能被顺序解决一系列free-end-point获得最佳的控制问题。而且，一个算法基于这结果被开发并且过去常解决二个解说性的例子。

简介：BackgroundThisarticlesummarizedtheexperienceofatrioventricularvalvereplacementoperationforfunctionalsingleventriclepatientswhoseatrioventricularvalvewasinsufficiency.Thefollow-uptimeofoperationwasarrangedfromearly-tomedium-term.MethodsFromJuly2009toJuly2015,therewere40patientsoffunctionalsingleventriclereceivingtheoperationofatrioventricularvalvereplacement,including23maleand17femalepatients.TheageatA-Vvalvereplacementwasrangedfrom6daysto32years(themediumageof9years),andthebodyweightrangedfrom2.7to57kg(themediumbodyweightof21.5kg).Moreover,theatrioventricularvalvereplacementwasperformedonallpatientsunderextracorporealcirculation.ResultsAtrioventricularvalvereplacementwasperformedon40patientswithfunctionsingleventricleinhospital,ofwhicheight(20.0%)diedinhospitalincludingtwoneonateandinfant(agerange:6days-2yearsold)accountingfor25%(2/8),Amongthem,sevenpatientsdiedoflowcardiacoutputsyndrometwopatientswithrepeatedhypoxemiaconcurrentinfectionafteroperation,andonewithbilateraldiaphragmaticparalysisandmalignantarrhythmia.Forthepatientssufferingthesevereperivalvularleakage,therewasareoperation,andthecardiacfunctionbeforethefirstoperationwasclassⅣ.OnepatientreceivedhearttransplantationfinallyforsevereheartfailureafterAVvalvereplacement.Fortherestofpatients,theircardiacfunctionrecoveredtoclassⅠ-Ⅱafteroperation.ConclusionsForfunctionsingleventriclepatientswithatrioventricularvalveregurgitation,themortalityrateofatrioventricularvalvereplacementcanbeacceptediftheoperationwasindicated.Forpatientswithsevereatrioventricularvalueregurgitation,theresultoftheoperationintheearlyandmediumtermwassatisfying.Thus,theatrioventricularvalvereplacementservedasausefultreatmentforpatientsdiagnosedofA-Vvalveregurgitationandfunctionalsingleventricle.

简介：Mostofthespareorderingpoliciestreateduptonowhaveassumedthatpreventiveandcorrectivereplacementcostsareequal,whichimpliesinessentialthatthereisnosignificantneedforpreventivereplacement.Thispaperpresentsanorderingpolicyforpreventiveagereplacementwithminimalrepair.Introducingthereplacement,repair,inventoryholdingandshortagecosts,theexpectedcostrateisderived.Aproceduretodeterminejointlytheorderingtimeforaspareandthepreventivereplacementtimefortheoperatingunitsoastominimizetheexpectedcostrateisproposed.Toexplaintheorderingpolicyandtheoptimizationprocedure,anumericalexampleisalsoincluded.

简介：In2001and2002,publicationoftheresultsofthreelargerandomizedcontrolledtriais(RCTs)changedourunderstandingoftherisksandbenefitsofhormonereplacementtherapy(HRT),leadingtonewguidancefromnationaladvisorybodiesonitsuse.Manyclinicaliyrelevantquestionsremainunanswered,butparadoxicallythereultsofrecenttrialsmayhavemadeitmoredifficulttodesignthestudiesnecessarytoanswerthesequestions.TheUKWISDOMtrial(oestrogen-progestogenvsplaceboinhealthywomen),forexample,hasbeendiscontinued.

简介：Objective:tostudytheclinicalinfluenceoffemoralqualityoncementlesshipreplacementandtoevaluatecorticalindex(CI)forfemoralqualityinordertoguideprosthesischoiceandrehabilitation.Methods:forth-ninecasesofcementlesshipreplacementwerefollowedupforaverage3.5years,42ofwhonhadX-rayfilmsonpreoperationoroperationday.Results:Harrisscoresandpatients'satisfactionwerelowbutpainwassignificantandprolongedwhencorticalindiceswerelow.Conclusions:CIisareliablesemi-quantityparameterforclinicalevaluationoffemoralquality.Osteoporosispatientspredisposetothighpain.Lagforfull-weightloadingandavoidancefortorsionmotioncancontributetolesspainwhenCI≤2.2.

简介：AbstractBackground:The past decade has witnessed an ever-increasing momentum of transcatheter aortic valve replacement (TAVR) and a subsequent paradigm shift in the contemporary management of severe aortic stenosis (AS). We conducted a multi-centric TAVR registry based on Chinese patients (the China Aortic valve tRanscatheter Replacement registrY [CARRY]) to delineate the clinical characteristics and outcomes of Chinese patients who underwent TAVR and compare the results between different valve types in different Chinese regions.Methods:CARRY is an all-comer registry of aortic valve disease patients undergoing TAVR across China and was designed as an observational study that retrospectively included all TAVR patients at each participating site. Seven hospitals in China participated in the CARRY, and 1204 patients from April 2012 to November 2020 were included. Categorical variables were compared using the chi-squared test, and continuous variables were analyzed using a t test or analysis of variance (ANOVA) test. The Kaplan-Meier curve was used to estimate the risk of adverse events during follow-up.Results:The mean age of the patients was 73.8 ± 6.5 years and 57.2% were male. The median Society of Thoracic Surgeon-Predicted Risk of Mortality score was 6.0 (3.7-8.9). Regarding the aortic valve, the proportion of bicuspid aortic valve (BAV) was 48.5%. During the hospital stay, the stroke rate was 0.7%, and the incidence of high-degree atrioventricular block indicating permanent pacemaker implantation was 11.0%. The in-hospital all-cause mortality rate was 2.2%. After 1 year, the overall mortality rate was 4.5%. Compared to patients with tricuspid aortic valve (TAV), those with BAV had similar in-hospital complication rates, but a lower incidence of in-hospital mortality (1.4% vs. 3.3%) and 1 year mortality (2.3% vs. 5.8%).Conclusions:TAVR candidates in China were younger, higher proportion of BAV, and had lower rates of post-procedural complications and mortality than other international all-comer registries. Given the use of early generation valves in the majority of the population, patients with BAV had similar rates of complications, but lower mortality than those with TAV. These findings further propel the extension of TAVR in low-risk patients.Trial Registration:https://www.chictr.org.cn/(No. ChiCTR2000038526).

简介：Abstract,Asystemreceivesshocksatsuccessiverandompointsofdiscretefime,

简介：Objective:Toevaluatetheresultsoftotalkneearthroplasty(TKA)inpatientswithposttraumaticdegenerativearthritisduetoapreviousfracturearoundtheknee.Methods:Weanalyzedtheresultsof15TKAs,performedfrom1997to2003,in15patientswithpost-traumaticdegenerativearthritisduetoapreviousfracturearoundknee.Therewere3womenand12menwithanaverageageof58years(range,31-76years).Thetimefromfracturetoarthroplastyaveraged8.2years(range,2-27years).Internalfixationhadpreviouslybeenperformedin8patientsresultinginretainedhardware.Atthetimeofarthroplastyafemoralfracturemalunionwaspresentintwoknees.Lateralretinacularrelease(4knees),extensormechanismrealignment(1knee)ormedialcollateralligamentreconstruction(1knee)wereneededatthetimeofarthroplasty.Results:Follow-upaveraged35months(range,12-73months).Nopatientwaslostforfollow-up.AccordingtotheKneeSocietyScorescale,themeanpreoperativekneescorewas37(range,10-70)andfunctionalscorewas41(range,0-60).Theywereimprovedsignificantlytoameanof84(range,10-100)and76(range,20-100)points,respectivelyatthelatestfollow-up.Themeankneearcofmotionwereimprovedfrom84°preoperationto94°atthelatestfollow-up.Postoperativemanipulationunderanesthesiaforpoormotionwascarriedoutin4knees.Nokneehadasepticlooseningthatrequiredsubsequentrevision.Twokneesdevelopedsuperficialinfectionandweretreatedwithdebridement.Itsubsequentlyrecoveredwiththeretentionofcomponents.Conclusions:SignificantimprovementinfunctionandreliefofpainhasbeenachievedinpatientswithpreviousfracturesundergoingsubsequentTKA.However,thisprocedureistechnicallydemandingandpatientsareatincreasedriskforrestrictedmotionandneedmorecarefollowingTKA.ThisstudysuggeststhattheoutcomeofTKAmaybeimprovedfurtherbymakingspecialeffortstorestorelimbalignment,toensurecorrectcomponent

简介：Inthispaper,theoptimalmaintenancepolicyisinvestigatedforasystemwithstochasticleadtimeandtwotypesoffailures.Thesystemhastwotypesoffailures,onetypeisrepairable,whentherepairablefailureoccurs,thesystemwillberepairedbyrepairman,andthesystemafterrepairisnot“asgoodasnew".Theothertypeoffailureisunrepairable,andwhentheunrepairablefailureoccursthesystemmustbereplacedbyanewandidenticalone.Thesparesystemforreplacementisavailableonlybyorder,andtheleadtimefordeliveringthesparesystemisstochastic.Thesuccessivesurvivaltimesofthesystemformastochasticallydecreasinggeometricprocess,theconsecutiverepairtimesafterfailuresofthesystemformarenewalprocess.Byusingtherenewalprocesstheoryandgeometricprocesstheory,theexplicitexpressionofthelong-runaveragecostperunittimeunderorderingpolicy(N-1)isderived,andthecorrespondingoptimalcanbefoundanalytically.Finally,thenumericalanalysesaregiven.

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简介：Tetralogyoffallot(TOF)occursinapproximately1in5000livebirthsandaccountsfor12%-14%ofcon-genitalheartdisease.Surgicalrepairwasfirstintroducedinthe1950sandthereisnowalargepopulationofadultswithrepairedTOF.

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简介：BackgroundEnd阶段脚关节关节炎损害联合功能和病人活动性。全部的脚关节代替是一个外科的过程对待严重脚关节关节炎。SaltoTalaris解剖脚关节TM(STAA)被设计模仿正常脚关节解剖和脚关节运动的屈曲/扩展。这研究的目的是与结束阶段在gait.MethodsFive病人期间在脚关节关节功能和力学上检验STAA脚关节代替的效果单方的脚关节关节炎被招募。病人们执行了水平在2个场合上走在一个实验室背景，在以前并且在STAA脚关节手术以后的3个月。美国矫形的脚和脚关节社会(AOFAS)hindfoot分数被获得。A12照相机运动俘获系统被用来执行走的分析。步法temporo空间的参数和脚关节关节力学被评估。配对的学生t测试和非参量的Wilcoxon匹配测试被执行在在外科前和外科以后的走conditions.ResultsCompared之间的biomechanical变量检验差别到pre外科的条件，在3月post-STAA外科，病人们在AOFAShindfoot经历了更大的改进分数(p=0.0001)；STAA脚关节证明31%在脚关节关节旅行(p=0.045)增加，22%在脚关节plantarflexor时刻(p=0.075)增加，60%尽最大努力增加吸收(p=0.023)，并且68%尽最大努力增加生产(p=0.039)。病人们也证明26%在走速度(p=0.005)增加，迈进长度(p=0.013)的20%增加，在两倍支持时间(p=0.043)的15%减少，和在全部的位置的5%减少预定(p=0.055)在手术以后的.ConclusionThree月，STAA病人在脚关节功能和步法参数经历了改进。STAA脚关节在象走那样的每日的活动期间表明了改进脚关节力学。

简介：BackgroundProstheticmitralvalvereplacementisacommonsurgicaltreatmentofmitralvalvedisease.Completevideo-assistedmitralvalvereplacementrepresentsthecontemporaryminimallyinvasivecardiacsurgeryinvalvediseasesurgicaltherapy.Inthefieldofminimallyinvasivecardiacsurgery,thesuccessoftheoperationislargelydependingonsurgicalincision,italsoreflectsthesurgeon'stechniquelevel.MethodFromFebruary2010toFebruary2013,80casesofcardiacpatientswithmitralvalvepathologicalchangesinourdepartmentwhohadreceivedsurgicaltreatmentofcompletevideo-assistedmitralvalvereplacementwererecruited,theyweredividedintotwogroupsaccordingtothesurgicalincision:midclaviculargroup(Mgroup,n=50)andparasternalgroup(Pgroup,n=30).Theclinicaldatawererecordedincluding:cardiopulmonarybypasstime,aorticclampingtime,volumeofthoracicdrainageafteroperation,ICUtrachealintubationtime,postoperativedaysofhospitalstayandtimeforobservingthepostoperativecomplications.Thecomparisonbetweentwogroupswasperformedusingt-testanalysis.ResultBothMGroupandPGrouphadfavorablesurgicalview,therewerenoemergencysituationofredomediansternotomyduringinitialoperativeperiodorintraoperativedeath,nopericardialtamponade,noinfection,andnootherseriouspostoperativecomplications.Whereas,therewere2casesofredooperationforstanchbleedinginMGroupand1caseofperivalvularleakageinPGroup.Nevertheless,3monthslater,theresultofreexamineshowedthattheperivalvularleakagehadvanished.Theclinicaldatawasshownasfollow(MGroupvs.PGroup):cardiopulmonarybypasstime(90.2±28.7vs.87.3±24.5min,P>0.05),aorticclampingtime(65.2±17.4vs.68.6±21.9min,P>0.05),1stdayvolumeofthoracicdrainageafteroperation1(75.8±35.6vs.53.2±25.6mL,P>0.05),ICUtrachealintubationtime(9.6±3.4vs.8.4±4.5hours,P>0.05),postoperativedaysofhospitalstay(7.3±2.2v

简介：Hormonereplacementtherapy(HRT)isinuseformorethanahalfofcentury,butthequestionofindicationsandidealcandidatesforHRTremainsunclear.Postmenopausalwomenareapopulationwiththeincreasingrisksforcardiovasculardiseaseswhicharethemaincauseofdeathinthisgroup.Declineinoestrogenconcentrations

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简介：Transcatheteraorticvalvereplacement(TAVR)isincreasinglyusedforthetreatmentofhighorveryhighsurgicalriskpatientswithsevereaorticstenosis(AS)orfailingsurgicalbioprosthesis(valve-in-valve,VIV-TAVR).InTAVR,thecollapsedtranscatheterheartvalve(THV)isintroducedusingthedeliverysysteminsertedfromthefemoralartery(preferred)orotheralternativeaccesses(transapical,transaortic,transcarotid,subclavian/transinnominateortranscaval).Thedeliverysystemisthenadvanceduntilcoaxiallyalignedwiththeaorticannulus,wheretheTHVisdeployed.Thisprocedurecanbeassociatedwithcomplicationssuchasaccesssiteinjury(vascularcomplication),paravalvarleak,cerebrovasculareventsandconductiondisturbances.However,therapidacceptanceandsuccessesobservedwithTAVRhavebeenmadepossiblethroughcarefulpatientselection,preproceduralplanning(i.e.MDCTannularsizing),THVtechnology(i.e.newgenerationvalves),andproceduraltechniques(i.e.minimalistTF-TAVRandalternativepercutaneousaccessoptions),aswellasadecreaseincomplicationsasTAVRexperiencegrows.ThoughtheresultsorongoingclinicaltrialsevaluatingTAVRinintermediatesurgicalriskpatientsarepending,itislikelythatTAVRwillsoonbeapprovedforlowerriskpatientsaswell.