目的总结73例脑死亡器官捐献供体评估和供心选择的临床经验。方法回顾73对脑死亡器官捐献心脏移植供受者临床资料,评估供体,选择供心,分析心脏移植受者生存情况和边缘供心使用情况。结果发现潜在供体,在判定脑死亡状态后,明确供体家属...目的总结73例脑死亡器官捐献供体评估和供心选择的临床经验。方法回顾73对脑死亡器官捐献心脏移植供受者临床资料,评估供体,选择供心,分析心脏移植受者生存情况和边缘供心使用情况。结果发现潜在供体,在判定脑死亡状态后,明确供体家属同意器官捐献后,评估供体,选择供心,使供受体最大限度匹配。73例心脏移植受者手术成功率为94.5%(69/73),围手术期死亡4例,术后随访1年死亡4例。边缘供心使用情况:供体年龄≥45岁17例,供受体体质量不匹配2例,供体中毒1例,供心冷缺血时间≥4 h 43例,大部分心脏移植受者予主动脉内球囊反搏和(或)体外膜肺氧合辅助,最终顺利出院。结论供受体最大限度匹配可使心脏移植患者获益最大;同时,适当放宽供心选择标准,增加供心数量,将为众多等待心脏移植患者带来希望。展开更多
Objective: To study the changes between cerebral oxygen (O 2) delivery and uptake in dogs resuscitated under normotension or hypertension for 4 h. Methods: The model of ventricular fibrillation of 8 min in 12 dogs was...Objective: To study the changes between cerebral oxygen (O 2) delivery and uptake in dogs resuscitated under normotension or hypertension for 4 h. Methods: The model of ventricular fibrillation of 8 min in 12 dogs was made, followed by open cardiopulmonary resuscitation, reperfusion with normal or high mean arterial pressure (MAP), and controlled ventilation to 4 h. Animals were randomly assigned into Group NT (normotensive reperfusion, n=6) and Group HT (hypertensive reperfusion, n=6). Cerebral arteriovenous (sagittal sinus) O 2 content difference (Ca-ssO 2) and venous (sagittal sinus) PO 2 (PssO 2) were determined before cardiac arrest (CA) and 30, 60, 120, and 240 min after CA. Results: In Group NT, Ca-ssO 2 was lower at 30 min (P<0.05) but higher at 240 min (P<0.01) after CA than that before CA. In Group HT, Ca-ssO 2 was not significantly different from that in Group NT before CA but was lower than that in Group NT at 30 min after CA (P<0.01). Ca-ssO 2 was not significantly different in Group NT and HT thereafter. In both groups, PssO 2 was both higher at 30 min after reperfusion (P<0.01) and at 240 min after reperfusion lower (P<0.05) than those before CA .At 30 min after reperfusion, PssO 2 was higher (P<0.01) in Group HT than that in Group NT, with insignificant difference between two groups. Conclusion: Cerebral O 2 delivery and uptake are mismatched after CA and resuscitation. Hypertensive reperfusion improves oxygen delivery to the brain early after CA.展开更多
Cloud computing and storage services allow clients to move their data center and applications to centralized large data centers and thus avoid the burden of local data storage and maintenance.However,this poses new ch...Cloud computing and storage services allow clients to move their data center and applications to centralized large data centers and thus avoid the burden of local data storage and maintenance.However,this poses new challenges related to creating secure and reliable data storage over unreliable service providers.In this study,we address the problem of ensuring the integrity of data storage in cloud computing.In particular,we consider methods for reducing the burden of generating a constant amount of metadata at the client side.By exploiting some good attributes of the bilinear group,we can devise a simple and efficient audit service for public verification of untrusted and outsourced storage,which can be important for achieving widespread deployment of cloud computing.Whereas many prior studies on ensuring remote data integrity did not consider the burden of generating verification metadata at the client side,the objective of this study is to resolve this issue.Moreover,our scheme also supports data dynamics and public verifiability.Extensive security and performance analysis shows that the proposed scheme is highly efficient and provably secure.展开更多
文摘目的总结73例脑死亡器官捐献供体评估和供心选择的临床经验。方法回顾73对脑死亡器官捐献心脏移植供受者临床资料,评估供体,选择供心,分析心脏移植受者生存情况和边缘供心使用情况。结果发现潜在供体,在判定脑死亡状态后,明确供体家属同意器官捐献后,评估供体,选择供心,使供受体最大限度匹配。73例心脏移植受者手术成功率为94.5%(69/73),围手术期死亡4例,术后随访1年死亡4例。边缘供心使用情况:供体年龄≥45岁17例,供受体体质量不匹配2例,供体中毒1例,供心冷缺血时间≥4 h 43例,大部分心脏移植受者予主动脉内球囊反搏和(或)体外膜肺氧合辅助,最终顺利出院。结论供受体最大限度匹配可使心脏移植患者获益最大;同时,适当放宽供心选择标准,增加供心数量,将为众多等待心脏移植患者带来希望。
文摘Objective: To study the changes between cerebral oxygen (O 2) delivery and uptake in dogs resuscitated under normotension or hypertension for 4 h. Methods: The model of ventricular fibrillation of 8 min in 12 dogs was made, followed by open cardiopulmonary resuscitation, reperfusion with normal or high mean arterial pressure (MAP), and controlled ventilation to 4 h. Animals were randomly assigned into Group NT (normotensive reperfusion, n=6) and Group HT (hypertensive reperfusion, n=6). Cerebral arteriovenous (sagittal sinus) O 2 content difference (Ca-ssO 2) and venous (sagittal sinus) PO 2 (PssO 2) were determined before cardiac arrest (CA) and 30, 60, 120, and 240 min after CA. Results: In Group NT, Ca-ssO 2 was lower at 30 min (P<0.05) but higher at 240 min (P<0.01) after CA than that before CA. In Group HT, Ca-ssO 2 was not significantly different from that in Group NT before CA but was lower than that in Group NT at 30 min after CA (P<0.01). Ca-ssO 2 was not significantly different in Group NT and HT thereafter. In both groups, PssO 2 was both higher at 30 min after reperfusion (P<0.01) and at 240 min after reperfusion lower (P<0.05) than those before CA .At 30 min after reperfusion, PssO 2 was higher (P<0.01) in Group HT than that in Group NT, with insignificant difference between two groups. Conclusion: Cerebral O 2 delivery and uptake are mismatched after CA and resuscitation. Hypertensive reperfusion improves oxygen delivery to the brain early after CA.
基金the National Natural Science Foundation of China，the National Basic Research Program of China ("973" Program) the National High Technology Research and Development Program of China ("863" Program)
文摘Cloud computing and storage services allow clients to move their data center and applications to centralized large data centers and thus avoid the burden of local data storage and maintenance.However,this poses new challenges related to creating secure and reliable data storage over unreliable service providers.In this study,we address the problem of ensuring the integrity of data storage in cloud computing.In particular,we consider methods for reducing the burden of generating a constant amount of metadata at the client side.By exploiting some good attributes of the bilinear group,we can devise a simple and efficient audit service for public verification of untrusted and outsourced storage,which can be important for achieving widespread deployment of cloud computing.Whereas many prior studies on ensuring remote data integrity did not consider the burden of generating verification metadata at the client side,the objective of this study is to resolve this issue.Moreover,our scheme also supports data dynamics and public verifiability.Extensive security and performance analysis shows that the proposed scheme is highly efficient and provably secure.
