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| 1 | 在有在现代时代的经皮的冠的干预的安全范例的变化: 课从 ASCERT 登记学习了显示文摘 In the past,comparative effectiveness trials evaluating percutaneous coronary interventions(PCI),using either balloon angioplasty or bare metal stent(BMS) implantation,versus coronary artery bypass surgery(CABG) found similar survival rates at long-term follow-up with both revascularization strategies.Two major meta-analyses of these trials reported 5-and 6-year comparative effectiveness between PCI and CABG:one included only four trials that compared PCI with BMS implantation versus CABG whereas the largest one also included trials using balloon angioplasty.In these studies,the authors observed no survival differences between groups although a significant survival advantage was seen in diabetics treated with CABG and this benefit was also perceived in elderly patients.In both reports,number of involved vessels,presence of left anterior descending artery stenosis or poor left ventricular ejection fraction were no predictors of poor survival with PCI.Therefore,extent of the coronary artery disease(CAD) was not associated with poor outcome after PCI in the pre-drug eluting stent(DES) era.Recently,the ASCERT(Database Collaboration on the Comparative Effectiveness of Revascularization Strategies) registry found higher mortality rate with PCI in patients ≥ 65 years old in comparison with CABG,and advantages of surgery were seen in all subgroups including those at low risk.In this registry,PCI was accomplished by implantation of the first type of DES designs in 78% of cases.The intriguing observation of high mortality rate with PCI,including for non-diabetics and patients with two-vessel CAD,meaning a lack of clinical benefit with DES implantation,had not been seen previously.The study was not randomized,although its results are largely strengthened by its sample size.In this manuscript,the authors describe other registries and randomized trials reporting similar results supporting the findings of the aforementioned study and explore the reasons for these results,while also searching for potential solutions. | Alfredo E Rodríguez Carlos Fernández-Pereira Alfredo M Rodríguez-Granillo | 2012 | World Journal of Cardiology2012，4，8： | 1 |
| 2 | 磨刀门河口枯季波生流场数值模拟研究显示文摘本文建立曲线坐标系下的双曲型缓坡方程波浪模型和考虑波浪辐射应力影响的深度平均2D潮流数学模型,首次研究了磨刀门河口2011年地形条件下的枯季波生流场。受波浪作用影响,落潮阶段,波浪作用方向与流向相反,在波浪顶托效应下拦门沙沙脊及外坡处流速普遍减小,形成两个主要回流区,口门外东西两侧浅滩处流速也减小,东西两汊及横洲深槽流速增大;涨潮阶段,波浪作用方向与流向相同,拦门沙沙脊及外坡处流速增大,沙脊处出现冲越流,口门两侧浅滩处流速增大,横洲深槽流速减小。 | 刘诚 梁燕 彭石 侯堋 | 2017 | 海洋学报2017，39，1： | 1 |
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