Impedance-Manometry w Viscous Increases Test Sensitivity-Blonski-2007

.论著.盐酸多奈哌齐联合重复经颅磁刺激治疗老年痴呆的效果及对患者认知功能的影响^刘瑞王雪詹丽娟方立郑州人民医院神经内科,河南省郑州市450000【摘要】目的探讨盐酸多奈哌齐联合重复经颅磁刺激(rTMS)治疗老年痴呆的效果及对患者认知功能的影响。

方法选取2017年6月至2019年6月我院收治的老年痴呆患者86例，采用随机数字法分为观察组和对照组，每组43例，两组患者均给予常规治疗及盐酸多奈哌齐片治疗。

在此基础上，观察组患者给予rTMS治疗，对照组患者给予rTMS伪治疗，持续治疗3个月。

比较两组患者的临床疗效；比较两组患者治疗前后的认知功能(MoCA)和独立生活能力(ADL)；比较两组患者的不良反应发生情况。

结果观察组患者的临床疗效明显优于对照组，治疗总有效率(90.7%)显著高于对照组(72.1%),差异有统计学意义(P<0.05)o治疗前，两组患者的MoCA和ADL评分比较，差异无统计学意义(P>0.05)；治疗3个月后，两组患者的MoCA和ADL评分均明显升高，观察组患者的评分显著高于对照组，差异有统计学意义(P<0.05)o治疗期间，观察组患者的不良反应发生率(20.9%)低于对照组(27.9%),但差异无统计学意义(P>0.05)o结论盐酸多奈哌齐联合rTMS治疗老年痴呆患者临床效果显著，可显著提高患者的认知功能和独立生活能力，但不增加患者的不良反应。

【关键词】老年痴呆；盐酸多奈哌齐；颅磁刺激;认知功能【中图分类号】R592；R742【文献标识码】A【文章编号】1673-7768(2021)01aXH£4DOI：10.16121/45-1347/r.2021.01.01Effect of donepezil hydrochloride combined with repetitive transcranial magnetic stimulation in the treatment of senile dementia and their effects on cognitive functionUURui,WANG Xue,ZHAN Lijuan,FANG LiDepartment of Neurology,Zhengzhou Peopled Hospital,Zhengzhou450000,Henan Province,China[Abstract]Objective To explore the effects of donepezil hydrochloride combined with repetitive transcranial magnetic stimulation(rTMS)in the treatment of senile dementia and their influences on cognitive function.Methods A total of86patients with senile dementia admitted to our hospital from June2017to June2019were divided into observation group and control group by the random number method,with43cases in each group.Both groups were received conventional treatment and administrated donepezil hydrochloride tablets,based on which patients in the observation group were given rTMS for treatment,whereas patients in the control group were given rTMS pseudo treatment,for a continuously three-month treatment.The clinical efficacy was compared between the two groups.The Montreal cognitive assessment(MoCA)and the activities of daily living(ADL)before and after treatment were compared between the two groups,the occurrence of adverse reactions between the two groups was compared as well.Results The clinical efficacy of the observation group was significantly superior to that of the control group,and the total effective rate of the observation group(90.7%)was significantly higher than that of the control group(72.1%),and the differences were statistically significant(P<0.05). There were no statistically significant differences in pre-treatment MoCA and ADL scores between the two groups(P>0.05). After3months of treatment,the MoCA and ADL scores of the two groups significandy increased,and the scores of the observation group were significantly higher than those of the control group,with statistically significant differences(P<0.05). During the treatment period,the incidence of adverse reactions in the observation group(20.9%)was lower than that in the control group(27.9%),but the difference was not statistically significant(P>0.05).Conclusion Donepezil hydrochloride combined with rTMS has a significandy clinical effect in the treatment of patients with senile dementia,which can significantly improve the cognitive function and independent living ability in patients,but it does not increase the adverse reactions in patients.[Key words]Senile dementia；Donepezil hydrochloride；Cranial magnetic stimulation；Cognitive function▲基金项目:国家重点研发计划中医现代化研究重点专项(2018YFC1705801)老年痴呆是老年人常见的神经功能障碍性病变,主要包括阿尔茨海默病(Alzheimer，s disease,AD)和血管性痴呆(vascular dementia,VD)两种类型，其中AD是一种起病隐匿的退行性脑病,VD为一种因脑血管病变导致的脑功能损害,AD、VD患者均以认知功能损害和记忆力减退为主要临床表现，同时可能存在性格、判断力及定向力等方面的异常，日常生活能力明显下降UT。

类号分级密国际进类号十分（UDC ）第四军医大学学位论文模拟失重对大鼠海马齿状回神经发生的影响题题（名和副名）郑丽娟（作者姓名） 导教师指姓名刘立 教授导教师单指位第四军医大学航空航天医学系临床医学教研室 请学级别申位硕士专业称名航空航天与航海医学 论文提交日期2008.04 辩答日期2008.05 论时间文起止2006 年 09月至2008 年 05月学单位授予位第四军医大学独创性声明秉承学校严谨的学风与优良的科学道德，本人声明所呈交的论文是我个人在导师指导下进行的研究工作及取得的研究成果。

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论文作者签名： 导师签名： 日期：模拟失重对大鼠海马齿状回神经发生的影响研 究 生：郑丽娟学科专业：航空航天与航海医学所在单位：第四军医大学航空航天医学系导师：刘立教授关键词：模拟失重；神经发生；大鼠；海马；齿状回；免疫组织化学；5－溴化脱氧尿核苷；神经元；微血管中国人民解放军第四军医大学2008年 05 月目录缩略语表 (1)中文摘要 (3)英文摘要 (6)前 言 (10)文献回顾 (14)正 文 (36)实验一模拟失重对大鼠海马齿状回细胞增殖的影响 (36)1 引言 (36)2 材料 (36)3 方法 (37)4 结果 (38)5 讨论 (40)实验二模拟失重对大鼠海马齿状回神经干细胞分化的影响 (42)1 引言 (42)2 材料 (43)3 方法 (43)4 结果 (45)5 讨论 (51)实验三模拟失重后大鼠海马齿状回血管发生与神经发生的变化 (53)1 引言 (53)2 材料 (54)3 方法 (55)4 结果 (56)5 讨论 (60)小 结 (63)参考文献 (65)个人简历和研究成果 (80)致 谢 (81)缩略语表缩略词英文全称中文全称ABC avidinbiotin-peroxidasecomplex 卵白素－生物素－辣根过氧化物酶BDNF brain-derivedneurotrophic factor 脑源性神经营养因子bFGF basic fibroblast growth factor 碱性成纤维细胞生长因子BrdU bromodeoxyuridine 5－溴化脱氧尿核苷CNS central nervous system 中枢神经系统DAB 3,3’diaminobenzidine 二氨基联苯胺d day 天DCX doublecortin 微管相关蛋白DG dentategyrus 齿状回EC endothelialcell 内皮细胞EPO erythropoietin 促红细胞生长素g gram 克IGF-1 insulin like growth factor-1 胰岛素样生长因子-1 GCL granule cell layer 颗粒细胞层GDNF glial cell line-derivedneurotrophic factor胶质源性生长因子GFAP glial fibrillary acidic protein胶质纤维酸性蛋白LTP long－term potentiation 长时程增强-1-mm milimeter 毫米NeuN neuron-specific protein neural nuclet 神经元核心抗原NGF nerve growth factor 神经生长因子NMDA N－methyl－D-aspartate N－甲基－D－天门冬氨酸NSC neural stem cells 神经干细胞PBS phosphate buffered saline 磷酸盐缓冲生理盐水 RECA rat endothelial cell antigen大鼠内皮细胞抗原RMS rostral migration stream 喙侧迁移流SD Sprague-Dawleyrats SD大鼠SGZ subgranularzone 亚颗粒区SSC standardsalinecitrate 标准柠檬酸盐－氯化钠液SVZ subventricularzone 脑室下区VEC vascular endothelial cell 血管内皮细胞VEGF vascular endothelial growth factor 血管内皮生长因子-2-模拟失重对大鼠海马齿状回神经发生的影响硕士研究生：郑丽娟导 师：刘 立 教授第四军医大学航空航天医学系航空航天临床医学教研室，西安 710032中文摘要近年来研究发现, 成年中枢神经系统(central nervous system ,CNS) 仍能不断地产生新的神经元,即在成年CNS 仍有神经发生(neurogenesis)，神经干细胞存在于包括人在内的所有哺乳动物的成熟的神经系统内，海马是一个重要的神经发生区域，也是与学习和记忆有关的重要脑区。

The Neutral Grounding Resistor Sizing Using an Analytical Method Based on Nonlinear Transformer Model for Inrush Current MitigationGholamabas M.H.Hajivar Shahid Chamran University,Ahvaz, Iranhajivar@S.S.MortazaviShahid Chamran University,Ahvaz, IranMortazavi_s@scu.ac.irMohsen SanieiShahid Chamran University,Ahvaz, IranMohsen.saniei@Abstract-It was found that a neutral resistor together with 'simultaneous' switching didn't have any effect on either the magnitudes or the time constant of inrush currents. The pre-insertion resistors were recommended as the most effective means of controlling inrush currents. Through simulations, it was found that the neutral resistor had little effect on reducing the inrush current peak or even the rate of decay as compared to the cases without a neutral resistor. The use of neutral impedances was concluded to be ineffective compared to the use of pre-insertion resistors. This finding was explained by the low neutral current value as compared to that of high phase currents during inrush. The inrush currents could be mitigated by using a neutral resistor when sequential switching is implemented. From the sequential energizing scheme performance, the neutral resistor size plays the significant role in the scheme effectiveness. Through simulation, it was found that a few ohms neutral grounding resistor can effectively achieve inrush currents reduction. If the neutral resistor is directly selected to minimize the peak of the actual inrush current, a much lower resistor value could be found.This paper presents an analytical method to select optimal neutral grounding resistor for mitigation of inrush current. In this method nonlinearity and core loss of the transformer has been modeled and derived analytical equations.Index Terms--Inrush current, neutral grounding resistor, transformerI.I NTRODUCTIONThe energizing of transformers produces high inrush currents. The nature of inrush currents have rich in harmonics coupled with relatively a long duration, leads to adverse effects on the residual life of the transformer, malfunction of the protection system [1] and power quality [2]. In the power-system industry, two different strategies have been implemented to tackle the problem of transformer inrush currents. The first strategy focuses on adapting to the effects of inrush currents by desensitizing the protection elements. Other approaches go further by 'over-sizing' the magnetic core to achieve higher saturation flux levels. These partial countermeasures impose downgrades on the system's operational reliability, considerable increases unit cost, high mechanical stresses on the transformer and lead to a lower power quality. The second strategy focuses on reducing the inrush current magnitude itself during the energizing process. Minimizing the inrush current will extend the transformer's lifetime and increase the reliability of operation and lower maintenance and down-time costs. Meanwhile, the problem of protection-system malfunction is eliminated during transformer energizing. The available inrush current mitigation consist "closing resistor"[3], "control closing of circuit breaker"[4],[5], "reduction of residual flux"[6], "neutral resistor with sequential switching"[7],[8],[9].The sequential energizing technique presents inrush-reduction scheme due to transformer energizing. This scheme involves the sequential energizing of the three phases transformer together with the insertion of a properly sized resistor at the neutral point of the transformer energizing side [7] ,[8],[9] (Fig. 1).The neutral resistor based scheme acts to minimize the induced voltage across the energized windings during sequential switching of each phase and, hence, minimizes the integral of the applied voltage across the windings.The scheme has the main advantage of being a simpler, more reliable and more cost effective than the synchronous switching and pre-insertion resistor schemes. The scheme has no requirements for the speed of the circuit breaker or the determination of the residual flux. Sequential switching of the three phases can be implemented through either introducing a mechanical delay between each pole in the case of three phase breakers or simply through adjusting the breaker trip-coil time delay for single pole breakers.A further study of the scheme revealed that a much lower resistor size is equally effective. The steady-state theory developed for neutral resistor sizing [8] is unable to explain this phenomenon. This phenomenon must be understood using transient analysis.Fig. 1. The sequential phase energizing schemeUPEC201031st Aug - 3rd Sept 2010The rise of neutral voltage is the main limitation of the scheme. Two methods present to control the neutral voltage rise: the use of surge arrestors and saturated reactors connected to the neutral point. The use of surge arresters was found to be more effective in overcoming the neutral voltage rise limitation [9].The main objective of this paper is to derive an analytical relationship between the peak of the inrush current and the size of the resistor. This paper presents a robust analytical study of the transformer energizing phenomenon. The results reveal a good deal of information on inrush currents and the characteristics of the sequential energizing scheme.II. SCHEME PERFORMANCESince the scheme adopts sequential switching, each switching stage can be investigated separately. For first-phase switching, the scheme's performance is straightforward. The neutral resistor is in series with the energized phase and this resistor's effect is similar to a pre-insertion resistor.The second- phase energizing is one of the most difficult to analyze. Fortunately, from simulation studies, it was found that the inrush current due to second-phase energizing is lower than that due to first-phase energizing for the same value of n R [9]. This result is true for the region where the inrush current of the first-phase is decreasing rapidly as n R increases. As a result, when developing a neutral-resistor-sizing criterion, the focus should be directed towards the analysis of the first-phase energizing.III. A NALYSIS OF F IRST -P HASE E NERGIZING The following analysis focuses on deriving an inrush current waveform expression covering both the unsaturatedand saturated modes of operation respectively. The presented analysis is based on a single saturated core element, but is suitable for analytical modelling of the single-phase transformers and for the single-phase switching of three-phase transformers. As shown in Fig. 2, the transformer's energized phase was modeled as a two segmented saturated magnetizing inductance in series with the transformer's winding resistance, leakage inductance and neutral resistance. The iron core non-l inear inductance as function of the operating flux linkages is represented as a linear inductor inunsaturated ‘‘m l ’’ and saturated ‘‘s l ’’ modes of operation respectively. (a)(b)Fig. 2. (a) Transformer electrical equivalent circuit (per-phase) referred to the primary side. (b) Simplified, two slope saturation curve.For the first-phase switching stage, the equivalent circuit represented in Fig. 2(a) can accurately represent behaviour of the transformer for any connection or core type by using only the positive sequence Flux-Current characteristics. Based on the transformer connection and core structure type, the phases are coupled either through the electrical circuit (3 single phase units in Yg-D connection) or through the Magnetic circuit (Core type transformers with Yg-Y connection) or through both, (the condition of Yg-D connection in an E-Core or a multi limb transformer). The coupling introduced between the windings will result in flux flowing through the limbs or magnetic circuits of un-energized phases. For the sequential switching application, the magnetic coupling will result in an increased reluctance (decreased reactance) for zero sequence flux path if present. The approach presented here is based on deriving an analytical expression relating the amount of inrush current reduction directly to the neutral resistor size. Investigation in this field has been done and some formulas were given to predict the general wave shape or the maximum peak current.A. Expression for magnitude of inrush currentIn Fig. 2(a), p r and p l present the total primary side resistance and leakage reactance. c R shows the total transformer core loss. Secondary side resistance sp r and leakage reactance sp l as referred to primary side are also shown. P V and s V represent the primary and secondary phase to ground terminal voltages, respectively.During first phase energizing, the differential equation describing behaviour of the transformer with saturated ironcore can be written as follows:()())sin((2) (1)φω+⋅⋅=⋅+⋅+⋅+=+⋅+⋅+=t V (t)V dtdi di d λdt di l (t)i R r (t)V dt d λdt di l (t)i R r (t)V m P ll p pp n p P p p p n p PAs the rate of change of the flux linkages with magnetizing current dt d /λcan be represented as an inductance equal to the slope of the i −λcurve, (2) can be re-written as follows;()(3) )()()(dtdi L dt di l t i R r t V lcore p p P n p P ⋅+⋅+⋅+=λ (4) )()(L core l p c l i i R dtdi−⋅=⋅λ⎩⎨⎧==sml core L L di d L λλ)(s s λλλλ>≤The general solution of the differential equations (3),(4) has the following form;⎪⎩⎪⎨⎧>−⋅⋅+−⋅+−−⋅+≤−⋅⋅+−⋅+−⋅=(5) )sin(//)()( )sin(//)(s s 22222221211112121111λλψωττλλψωττt B t e A t t e i A t B t e A t e A t i s s pSubscripts 11,12 and 21,22 denote un-saturated and saturated operation respectively. The parameters given in the equation (5) are given by;() )(/12221σ⋅++⎟⎟⎠⎞⎜⎜⎝⎛⋅−++⋅=m p c p m n p c m m x x R x x R r R x V B()2222)(/1σ⋅++⎟⎟⎠⎞⎜⎜⎝⎛⋅−++⋅=s p c p s n p c s m x x R x x R r R x V B⎟⎟⎟⎟⎟⎠⎞⎜⎜⎜⎜⎜⎝⎛⋅−+++=⋅−−⎟⎟⎟⎠⎞⎜⎜⎜⎝⎛−c p m n p m p c m R x x R r x x R x σφψ111tan tan ⎟⎟⎟⎟⎟⎠⎞⎜⎜⎜⎜⎜⎝⎛⋅−+++=⋅−−⎟⎟⎟⎠⎞⎜⎜⎜⎝⎛−c p s n p s p c m R R r x x R x σφψ112tan tan )sin(111211ψ⋅=+B A A )sin(222221s t B A A ⋅−⋅=+ωψ mp n p m p m p m p c xx R r x x x x x x R ⋅⋅+⋅−⋅+−⋅+⋅⋅⋅=)(4)()(21211σστm p n p m p m p m p c xx R r x x x x x x R ⋅⋅+⋅−⋅++⋅+⋅⋅⋅=)(4)()(21212σστ s p n p s p s p s p xx R r x x x x x x c R ⋅⋅+⋅−⋅+−⋅+⋅⋅⋅=)(4)()(21221σστ sp n p s p s p sp c xx R r x x x x x x R ⋅⋅+⋅−⋅++⋅+⋅⋅⋅=)(4)()(21222σστ ⎟⎟⎠⎞⎜⎜⎝⎛−⋅==s rs s ri i λλλ10 cnp R R r ++=1σ21221112 , ττττ>>>>⇒>>c R , 012≈A , 022≈A According to equation (5), the required inrush waveform assuming two-part segmented i −λcurve can be calculated for two separate un-saturated and saturated regions. For thefirst unsaturated mode, the current can be directly calculated from the first equation for all flux linkage values below the saturation level. After saturation is reached, the current waveform will follow the second given expression for fluxlinkage values above the saturation level. The saturation time s t can be found at the time when the current reaches the saturation current level s i .Where m λ,r λ,m V and ωare the nominal peak flux linkage, residual flux linkage, peak supply voltage and angular frequency, respectivelyThe inrush current waveform peak will essentially exist during saturation mode of operation. The focus should be concentrated on the second current waveform equation describing saturated operation mode, equation (5). The expression of inrush current peak could be directly evaluated when both saturation time s t and peak time of the inrush current waveform peak t t =are known [9].(10))( (9) )(2/)(222222121//)()(2B eA t e i A peak peak t s t s n peak n n peak R I R R t +−⋅+−−⋅+=+=ττωψπThe peak time peak t at which the inrush current will reachits peak can be numerically found through setting the derivative of equation (10) with respect to time equal to zero at peak t t =.()(11) )sin(/)(022222221212221/ψωωττττ−⋅⋅⋅−−−⋅+−=+−⋅peak t s t B A t te A i peak s peakeThe inrush waveform consists of exponentially decaying'DC' term and a sinusoidal 'AC' term. Both DC and AC amplitudes are significantly reduced with the increase of the available series impedance. The inrush waveform, neglecting the relatively small saturating current s i ,12A and 22A when extremely high could be normalized with respect to theamplitude of the sinusoidal term as follows; (12) )sin(/)()(2221221⎥⎦⎤⎢⎣⎡−⋅+−−⋅⋅=ψωτt t t e B A B t i s p(13) )sin(/)()sin()( 22221⎥⎦⎤⎢⎣⎡−⋅+−−⋅⋅−⋅=ψωτωψt t t e t B t i s s p ))(sin()( 2s n n t R R K ⋅−=ωψ (14) ωλλλφλφωλλφωmm m r s s t r m s mV t dt t V dtd t V V s=⎪⎭⎪⎬⎫⎪⎩⎪⎨⎧⎥⎥⎦⎤⎢⎢⎣⎡⎟⎟⎠⎞⎜⎜⎝⎛−−+−⋅=+⋅+⋅⋅==+⋅⋅=−∫(8) 1cos 1(7))sin((6))sin(10The factor )(n R K depends on transformer saturation characteristics (s λand r λ) and other parameters during saturation.Typical saturation and residual flux magnitudes for power transformers are in the range[9]; .).(35.1.).(2.1u p u p s <<λ and .).(9.0.).(7.0u p r u p <<λIt can be easily shown that with increased damping 'resistance' in the circuit, where the circuit phase angle 2ψhas lower values than the saturation angle s t ⋅ω, the exponential term is negative resulting in an inrush magnitude that is lowerthan the sinusoidal term amplitude.B. Neutral Grounding Resistor SizingBased on (10), the inrush current peak expression, it is now possible to select a neutral resistor size that can achieve a specific inrush current reduction ratio )(n R α given by:(15) )0(/)()(==n peak n peak n R I R I R α For the maximum inrush current condition (0=n R ), the total energized phase system impedance ratio X/R is high and accordingly, the damping of the exponential term in equation (10) during the first cycle can be neglected; [][](16))0(1)0()0(2212=⋅++⎥⎦⎤⎢⎣⎡⋅−+===⎟⎟⎠⎞⎜⎜⎝⎛+⋅⋅n s p c p s pR x n m n peak R x x R x x r R K V R I c s σ High n R values leading to considerable inrush current reduction will result in low X / R ratios. It is clear from (14) that X / R ratios equal to or less than 1 ensure negative DC component factor ')(n R K ' and hence the exponential term shown in (10) can be conservatively neglected. Accordingly, (10) can be re-written as follows;()[](17) )()(22122n s p c p s n p R x m n n peak R x x R x x R r V R B R I c s σ⋅++⎥⎦⎤⎢⎣⎡⋅−+=≈⎟⎟⎠⎞⎜⎜⎝⎛+⋅Using (16) and (17) to evaluate (15), the neutral resistorsize which corresponds to a specific reduction ratio can be given by;[][][](18) )0()(1)0( 12222=⋅++⋅−⋅++⋅−+⋅+=⎥⎥⎦⎤⎢⎢⎣⎡⎥⎥⎦⎤⎢⎢⎣⎡=n s p c p s p n s p c p s n p n R x x R x x r R x x R x x R r R K σσα Very high c R values leading to low transformer core loss, it can be re-written equation (18) as follows [9]; [][][][](19) 1)0(12222s p p s p n p n x x r x x R r R K +++++⋅+==α Equations (18) and (19) reveal that transformers require higher neutral resistor value to achieve the desired inrush current reduction rate. IV. A NALYSIS OF SECOND-P HASE E NERGIZING It is obvious that the analysis of the electric and magnetic circuit behavior during second phase switching will be sufficiently more complex than that for first phase switching.Transformer behaviour during second phase switching was served to vary with respect to connection and core structure type. However, a general behaviour trend exists within lowneutral resistor values where the scheme can effectively limitinrush current magnitude. For cases with delta winding or multi-limb core structure, the second phase inrush current is lower than that during first phase switching. Single phase units connected in star/star have a different performance as both first and second stage inrush currents has almost the same magnitude until a maximum reduction rate of about80% is achieved. V. NEUTRAL VOLTAGE RISEThe peak neutral voltage will reach values up to peak phasevoltage where the neutral resistor value is increased. Typicalneutral voltage peak profile against neutral resistor size is shown in Fig. 6- Fig. 8, for the 225 KVA transformer during 1st and 2nd phase switching. A del ay of 40 (ms) between each switching stage has been considered. VI. S IMULATION A 225 KVA, 2400V/600V, 50 Hz three phase transformer connected in star-star are used for the simulation study. The number of turns per phase primary (2400V) winding is 128=P N and )(01.0pu R R s P ==, )(05.0pu X X s P ==,active power losses in iron core=4.5 KW, average length and section of core limbs (L1=1.3462(m), A1=0.01155192)(2m ), average length and section of yokes (L2=0.5334(m),A2=0.01155192)(2m ), average length and section of air pathfor zero sequence flux return (L0=0.0127(m),A0=0.01155192)(2m ), three phase voltage for fluxinitialization=1 (pu) and B-H characteristic of iron core is inaccordance with Fig.3. A MATLAB program was prepared for the simulation study. Simulation results are shown in Fig.4-Fig.8.Fig. 3.B-H characteristic iron coreFig.4. Inrush current )(0Ω=n RFig.5. Inrush current )(5Ω=n RFig.6. Inrush current )(50Ω=n RFig.7. Maximum neutral voltage )(50Ω=n RFig.8. Maximum neutral voltage ).(5Ω=n RFig.9. Maximum inrush current in (pu), Maximum neutral voltage in (pu), Duration of the inrush current in (s)VII. ConclusionsIn this paper, Based on the sequential switching, presents an analytical method to select optimal neutral grounding resistor for transformer inrush current mitigation. In this method, complete transformer model, including core loss and nonlinearity core specification, has been used. It was shown that high reduction in inrush currents among the three phases can be achieved by using a neutral resistor .Other work presented in this paper also addressed the scheme's main practical limitation: the permissible rise of neutral voltage.VIII.R EFERENCES[1] Hanli Weng, Xiangning Lin "Studies on the UnusualMaloperation of Transformer Differential Protection During the Nonlinear Load Switch-In",IEEE Transaction on Power Delivery, vol. 24, no.4, october 2009.[2] Westinghouse Electric Corporation, Electric Transmissionand Distribution Reference Book, 4th ed. East Pittsburgh, PA, 1964.[3] K.P.Basu, Stella Morris"Reduction of Magnetizing inrushcurrent in traction transformer", DRPT2008 6-9 April 2008 Nanjing China.[4] J.H.Brunke, K.J.Frohlich “Elimination of TransformerInrush Currents by Controlled Switching-Part I: Theoretical Considerations” IEEE Trans. On Power Delivery, Vol.16,No.2,2001. [5] R. Apolonio,J.C.de Oliveira,H.S.Bronzeado,A.B.deVasconcellos,"Transformer Controlled Switching:a strategy proposal and laboratory validation",IEEE 2004, 11th International Conference on Harmonics and Quality of Power.[6] E. Andersen, S. Bereneryd and S. Lindahl, "SynchronousEnergizing of Shunt Reactors and Shunt Capacitors," OGRE paper 13-12, pp 1-6, September 1988.[7] Y. Cui, S. G. Abdulsalam, S. Chen, and W. Xu, “Asequential phase energizing method for transformer inrush current reduction—part I: Simulation and experimental results,” IEEE Trans. Power Del., vol. 20, no. 2, pt. 1, pp. 943–949, Apr. 2005.[8] W. Xu, S. G. Abdulsalam, Y. Cui, S. Liu, and X. Liu, “Asequential phase energizing method for transformer inrush current reduction—part II: Theoretical analysis and design guide,” IEEE Trans. Power Del., vol. 20, no. 2, pt. 1, pp. 950–957, Apr. 2005.[9] S.G. Abdulsalam and W. Xu "A Sequential PhaseEnergization Method for Transformer Inrush current Reduction-Transient Performance and Practical considerations", IEEE Transactions on Power Delivery,vol. 22, No.1, pp. 208-216,Jan. 2007.。

A Facial Aging Simulation Method Using flaccidity deformation criteriaAlexandre Cruz Berg Lutheran University of Brazil.Dept Computer ScienceRua Miguel Tostes, 101. 92420-280 Canoas, RS, Brazil berg@ulbra.tche.br Francisco José Perales LopezUniversitat les Illes Balears.Dept Mathmatics InformaticsCtra Valldemossa, km 7,5E-07071 Palma MallorcaSpainpaco.perales@uib.esManuel GonzálezUniversitat les Illes Balears.Dept Mathmatics InformaticsCtra Valldemossa, km 7,5E-07071 Palma MallorcaSpainmanuel.gonzales@uib.esAbstractDue to the fact that the aging human face encompasses skull bones, facial muscles, and tissues, we render it using the effects of flaccidity through the observation of family groups categorized by sex, race and age. Considering that patterns of aging are consistent, facial ptosis becomes manifest toward the end of the fourth decade. In order to simulate facial aging according to these patterns, we used surfaces with control points so that it was possible to represent the effect of aging through flaccidity. The main use of these surfaces is to simulate flaccidity and aging consequently.1.IntroductionThe synthesis of realistic virtual views remains one of the central research topics in computer graphics. The range of applications encompasses many fields, including: visual interfaces for communications, integrated environments of virtual reality, as well as visual effects commonly used in film production.The ultimate goal of the research on realistic rendering is to display a scene on a screen so that it appears as if the object exists behind the screen. This description, however, is somewhat ambiguous and doesn't provide a quality measure for synthesized images. Certain areas, such as plastic surgery, need this quality evaluation on synthesized faces to make sure how the patient look like and more often how the patient will look like in the future. Instead, in computer graphics and computer vision communities, considerable effort has been put forthto synthesize the virtual view of real or imaginary scenes so that they look like the real scenes.Much work that plastic surgeons put in this fieldis to retard aging process but aging is an inevitable process. Age changes cause major variations in the appearance of human faces [1]. Some aspects of aging are uncontrollable and are based on hereditary factors; others are somewhat controllable, resulting from many social factors including lifestyle, among others [2].1.1.Related WorkMany works about aging human faces have been done. We can list some related work in the simulation of facial skin deformation [3].One approach is based on geometric models, physically based models and biomechanical models using either a particle system or a continuous system.Many geometrical models have been developed, such as parametric model [4] and geometric operators [5]. The finite element method is also employed for more accurate calculation of skin deformation, especially for potential medical applications such as plastic surgery [6]. Overall, those works simulate wrinkles but none of them have used flaccidity as causing creases and aging consequently.In this work is presented this effort in aging virtual human faces, by addressing the synthesis of new facial images of subjects for a given target age.We present a scheme that uses aging function to perform this synthesis thru flaccidity. This scheme enforces perceptually realistic images by preserving the identity of the subject. The main difference between our model and the previous ones is that we simulate increase of fat and muscular mass diminish causing flaccidity as one responsible element for the sprouting of lines and aging human face.In the next section will plan to present the methodology. Also in section 3, we introduce the measurements procedure, defining structural alterations of the face. In section 4, we present a visual facial model. We describe age simulation thrua deformation approach in section 5. In the last section we conclude the main results and future work.2.MethodologyA methodology to model the aging of human face allows us to recover the face aging process. This methodology consists of: 1) defining the variations of certain face regions, where the aging process is perceptible; 2) measuring the variations of those regions for a period of time in a group of people and finally 3) making up a model through the measurements based on personal features.That could be used as a standard to a whole group in order to design aging curves to the facial regions defined.¦njjjpVM2.1Mathematical Background and AnalysisHuman society values beauty and youth. It is well known that the aging process is influenced by several parameters such: feeding, weight, stress level, race, religious factors, genetics, etc. Finding a standard set of characteristics that could possibly emulate and represent the aging process is a difficult proposition.This standard set was obtained through a mathematical analysis of some face measurements in a specific group of people, whose photographs in different ages were available [7]. To each person in the group, there were, at least, four digitized photographs. The oldest of them was taken as a standard to the most recent one. Hence, some face alterations were attained through the passing of time for the same person.The diversity of the generated data has led to the designing of a mathematical model, which enabled the acquiring of a behavior pattern to all persons of the same group, as the form of a curve defined over the domain [0,1] in general, in order to define over any interval [0,Į] for an individual face. The unknown points Įi are found using the blossoming principle [8] to form the control polygon of that face.The first step consisted in the selection of the group to be studied. Proposing the assessment of the face aging characteristics it will be necessary to have a photographic follow-up along time for a group of people, in which their face alterations were measurable.The database used in this work consisted of files of patients who were submitted to plastic surgery at Medical Center Praia do Guaíba, located in Porto Alegre, Brazil.3.MeasurementsAccording to anatomic principles [9] the vectors of aging can be described aswhich alter the position and appearance of key anatomic structures of the face as can be shown in figure 1 which compares a Caucasian mother age 66 (left side) with her Caucasian daughters, ages 37 (right above) and 33 (right below) respectively.Figure 1 - Observation of family groupsTherefore, basic anatomic and surgical principles must be applied when planning rejuvenative facial surgery and treating specific problems concomitantwith the aging process.4.Visual Facial ModelThe fact that human face has an especially irregular format and interior components (bones, muscles and fabrics) to possess a complex structure and deformations of different face characteristics of person to person, becomes the modeling of the face a difficult task. The modeling carried through in the present work was based on the model, where the mesh of polygons corresponds to an elastic mesh, simulating the dermis of the face. The deformations in this mesh, necessary to simulate the aging curves, are obtained through the displacement of the vertexes, considering x(t) as a planar curve, which is located within the (u,v ) unit square. So, we can cover the square with a regular grid of points b i,j =[i/m,j/n]T ; i=0,...,m; j=0,...,n. leading to every point (u,v ) asfrom the linear precision property of Bernstein polynomials. Using comparisons with parents we can distort the grid of b i,j into a grid b'i,j , the point (u,v )will be mapped to a point (u',v') asIn order to construct our 3D mesh we introduce the patch byAs the displacements of the vertexes conform to the certain measures gotten through curves of aging and no type of movement in the face is carried through, the parameters of this modeling had been based on the conformation parameter.4.1Textures mappingIn most cases the result gotten in the modeling of the face becomes a little artificial. Using textures mapping can solve this problem. This technique allows an extraordinary increase in the realism of the shaped images and consists of applying on the shaped object, existing textures of the real images of the object.In this case, to do the mapping of an extracted texture of a real image, it is necessary that the textureaccurately correspond to the model 3D of that is made use [9].The detected feature points are used for automatic texture mapping. The main idea of texture mapping is that we get an image by combining two orthogonal pictures in a proper way and then give correct texture coordinates of every point on a head.To give a proper coordinate on a combined image for every point on a head, we first project an individualized 3D head onto three planes, the front (x, y), the left (y, z) and the right (y, z) planes. With the information of feature lines, which are used for image merging, we decide on which plane a 3D-head point on is projected.The projected points on one of three planes arethen transferred to one of feature points spaces suchas the front and the side in 2D. Then they are transferred to the image space and finally to the combined image space.The result of the texture mapping (figure 2) is excellent when it is desired to simulate some alteration of the face that does not involve a type of expression, as neutral. The picture pose must be the same that the 3D scanned data.¦¦¦ mi nj lk n j m i lk k j i w B v B u B b w v u 000,,)()()(')',','(¦¦ m i nj n jmij i v B u B b v u 00,)()(),(¦¦ m i nj n j m i j i v B u B b v u 00,)()(')','(¦¦¦ mi nj lk n j m i lk k j i w B v B u B b w v u 000,,)()()(')',','(Figure 2 - Image shaped with texturemapping5.Age SimulationThis method involves the deformation of a face starting with control segments that define the edges of the faces, as¦¦¦ mi nj lk n j m i lk k j i w B v B u B b w v u 000,,)()()(')',','(Those segments are defined in the original face and their positions are changed to a target face. From those new positions the new position of each vertex in the face is determined.The definition of edges in the face is a fundamental step, since in that phase the applied aging curves are selected. Hence, the face is divided in influencing regions according to their principal edges and characteristics.Considering the face morphology and the modeling of the face aging developed [10], the face was divided in six basic regions (figure 3).The frontal region (1) is limited by the eyelids and the forehead control lines. The distance between these limits enlarges with forward aging.The orbitary region (2) is one of the most important aging parameters because a great number of wrinkles appears and the palpebral pouch increases [11]. In nasal region (3) is observed an enlargement of its contour.The orolabial region (4) is defined by 2 horizontal control segments bounding the upper and lower lips and other 2 segments that define the nasogenian fold. Figure 3 - Regions considering the agingparametersThe lips become thinner and the nasogenian fold deeper and larger. The mental region (5) have 8 control segments that define the low limit of the face and descend with aging. In ear curve (6) is observed an enlargement of its size. The choice of feature lines was based in the characteristic age points in figure 6.The target face is obtained from the aging curves applied to the source face, i.e., with the new control segment position, each vertex of the new image has its position defined by the corresponding vertex in the target face. This final face corresponds to the face in the new age, which was obtained through the application of the numerical modeling of the frontal face aging.The definition of the straight-line segment will control the aging process, leading to a series of tests until the visual result was adequate to the results obtained from the aging curves. The extremes of the segments are interpolated according to the previously defined curves, obtained by piecewise bilinear interpolation [12].Horizontal and vertical orienting auxiliary lines were defined to characterize the extreme points of the control segments (figure 4). Some points, that delimit the control segments, are marked from the intersection of the auxiliary lines with the contour of the face, eyebrow, superior part of the head and the eyes. Others are directly defined without the use of auxiliary lines, such as: eyelid hollow, eyebrow edges, subnasion, mouth, nasolabial wrinkle andnose sides.Figure 4 - Points of the control segmentsOnce the control segments characterize the target image, the following step of the aging process can be undertaken, corresponding to the transformations of the original points to the new positions in the target image. The transformations applied to the segments are given by the aging curves, presented in section 4.In the present work the target segments are calculated by polynomial interpolations, based on parametric curves [12].5.1Deformation approachThe common goal of deformation models is to regulate deformations of a geometric model by providing smoothness constraints. In our age simulation approach, a mesh-independent deformation model is proposed. First, connected piece-wise 3D parametric volumes are generated automatically from a given face mesh according to facial feature points.These volumes cover most regions of a face that can be deformed. Then, by moving the control pointsof each volume, face mesh is deformed. By using non-parallel volumes [13], irregular 3D manifolds are formed. As a result, smaller number of deformvolumes are necessary and the number of freedom incontrol points are reduced. Moreover, based on facialfeature points, this model is mesh independent,which means that it can be easily adopted to deformany face model.After this mesh is constructed, for each vertex on the mesh, it needs to be determined which particularparametric volume it belongs to and what valueparameters are. Then, moving control points ofparametric volumes in 3D will cause smooth facialdeformations, generating facial aging throughflaccidity, automatically through the use of the agingparameters. This deformation is written in matricesas , where V is the nodal displacements offace mesh, B is the mapping matrix composed ofBernstein polynomials, and E is the displacementvector of parametric volume control nodes.BE V Given a quadrilateral mesh of points m i,j ,, we define acontinuous aged surface via a parametricinterpolation of the discretely sampled similaritiespoints. The aged position is defined via abicubic polynomial interpolation of the form with d m,n chosen to satisfy the known normal and continuity conditions at the sample points x i,j .>@>M N j i ,...,1,...,1),(u @@>@>1,,1,),,( j j v i i u v u x ¦3,,),(n m n m n m v u d v u x An interactive tool is programmed to manipulate control points E to achieve aged expressions making possible to simulate aging through age ranges. Basic aged expression units are orbicularis oculi, cheek, eyebrow, eyelid, region of chin, and neck [14]. In general, for each segment, there is an associated transformation, whose behavior can be observed by curves. The only segments that do not suffer any transformation are the contour of the eyes and the superior side of the head.5.2Deformation approachThe developed program also performs shape transformations according to the created aging curves, not including any quantification over the alterations made in texture and skin and hair color. Firstly, in the input model the subjects are required to perform different ages, as previouslymentioned, the first frame needs to be approximately frontal view and with no expression.Secondly, in the facial model initialization, from the first frame, facial features points are extracted manually. The 3D fitting algorithm [15] is then applied to warp the generic model for the person whose face is used. The warping process and from facial feature points and their norms, parametric volumes are automatically generated.Finally, aging field works to relieve the drifting problem in template matching algorithm, templates from the previous frame and templates from the initial frame are applied in order to combine the aging sequence. Our experiments show that this approach is very effective. Despite interest has been put in presenting a friendly user interface, we have to keep in mind that the software system is research oriented. In this kind of applications an important point is the flexibility to add and remove test facilities. 6.Results The presented results in the following figuresrefer to the emulations made on the frontalphotographs, principal focus of this paper, with theobjective to apply the developed program to otherpersons outside the analyzed group. The comparisonswith other photographs of the tested persons dependon their quality and on the position in which theywere taken. An assessment was made of the new positions, of the control segments. It consisted in: after aging a face, from the first age to the second one, through the use of polynomial interpolation of the control segments in the models in the young age, the new positions are then compared with the ones in the model of a relative of older age (figure 5). The processed faces were qualitatively compared with theperson’s photograph at the same age. Figure 5 - Synthetic young age model,region-marked model and aged modelAlso the eyelid hollow, very subtle falling of the eyebrow, thinning of the lips with the enlarging of the nasion and the superior part of the lip, enlargingof the front and changing in the nasolabial wrinkle.7.ConclusionsModelling biological phenomena is a great deal of work, especially when the biggest part of the information about the subject involves only qualitative data. Thus, this research developed had has a challenge in the designing of a model to represent the face aging from qualitative data.Due to its multi-disciplinary character, the developed methodology to model and emulate the face aging involved the study of several other related fields, such as medicine, computing, statistics and mathematics.The possibilities opened by the presented method and some further research on this field can lead to new proposals of enhancing the current techniques of plastic face surgery. It is possible to suggest the ideal age to perform face lifting. Once the most affected aging regions are known and how this process occurs over time. Also missing persons can be recognized based on old photographs using this technique. AcknowledgementsThe project TIN2004-07926 of Spanish Government have subsidized this work.8. References[1] Burt, D. M. et al., Perc. age in adult Caucasianmale faces, in Proc. R. Soc., 259, pp 137-143,1995.[2] Berg, A C. Aging of Orbicularis Muscle inVirtual Human Faces. IEEE 7th InternationalConference on Information Visualization, London, UK, 2003a.[3] Beier , T., S. Neely, Feature-based imagemetamorphosis, In Computer Graphics (Proc.SIGGRAPH), pp. 35-42, 1992.[4] Parke, F. I. P arametrized Models for FacialAnimation, IEEE Computer & Graphics Applications, Nov. 1982.[5] Waters, K.; A Muscle Model for Animating ThreeDimensional Facial Expression. Proc SIGGRAPH'87,Computer Graphics, Vol. 21, Nº4, United States, 1987. [6] Koch, R.M. et alia.. Simulation Facial SurgeryUsing Finite Element Models, Proceedings of SIGGRAPH'96, Computer Graphics, 1996.[7] Kurihara, Tsuneya; Kiyoshi Arai, ATransformation Method for Modeling and Animation of the Human Face from Photographs, Computer Animatio n, Springer-Verlag Tokyo, pp.45-58, 1991.[8] Kent, J., W. Carlson , R. Parent, ShapeTransformation for Polygon Objects, In Computer Graphics (Proc. SIGGRAPH), pp. 47-54, 1992. [9] Sorensen, P., Morphing Magic, in ComputerGraphics World, January 1992.[10]Pitanguy, I., Quintaes, G. de A., Cavalcanti, M.A., Leite, L. A. de S., Anatomia doEnvelhecimento da Face, in Revista Brasileira deCirurgia, Vol 67, 1977.[11]Pitanguy, I., F. R. Leta, D. Pamplona, H. I.Weber, Defining and measuring ageing parameters, in Applied Mathematics and Computation , 1996.[12]Fisher, J.; Lowther, J.; Ching-Kuang S. Curveand Surface Interpolation and Approximation: Knowledge Unit and Software Tool. ITiCSE’04,Leeds, UK June 28–30, 2004.[13]Lerios, A. et al., Feature-Based VolumeMetamorphosis, in SIGGRAPH 95 - Proceedings,pp 449-456, ACM Press, N.Y, 1995.[14]Berg, A C. Facial Aging in a VirtualEnvironment. Memória de Investigación, UIB, Spain, 2003b.[15]Hall, V., Morphing in 2-D and 3-D, in Dr.Dobb's Journal, July 1993.。

医学考博英语：影像X射线常用词汇医学考博词汇不仅在医学考博英语中会用到，平时大家写论文时也经常需要熟悉其含义，新东方在线考博频道将各类医学考博英语常用词汇进行分类，希望考生们平日多累积记忆。

一、肺Lung清晰clear肺门阴影增大enlargement of hilar shadows肺纹理增粗increase of lung markings钙化灶calcified空洞cavitation球形病灶circular lesion (coin lesion)小块阴影区a minimal area of density散状的点(片)状阴影scattered spot (plaque-like) shadows边界不清的片状阴影a poorly defined patchy density圆形致密影a round density胸膜增厚pleural thickening肋膈角模糊(变钝、消失)haziness (blunting, obliteration) of the costophrenic angle横膈抬高、活动受限elevation of diaphragm with limitation of movement包裹性胸腔积液encapsulated pleural effusion液气胸hydropneumothorax纵膈移位mediastinal displacement肺门模糊hilar haze肺门密度增高increase of pulmonary hilar density肺淤血(栓塞) pulmonary venous stasis (infarction)阴影性状shadow淡的haziness云雾状clouding线装streaky絮状patcky结节状nodular块状massive粟粒状miliary融合状confluent均匀的homogeneous二、心脏Heart左(右)房(室)增大left (right) atrial (ventricular) enlargement 主动脉屈曲延长 a tortuous and prolonged aorta主动脉型(二尖瓣型)心脏“aortic type”(“mitral valve”) heart 肺动脉段突出bulging pulmonary artery segment肺动脉扩张a dilatation of the pulmonary artery心影普遍增大general enlargement of the heart shadow左(右)心室增大left(right) ventricular enlargement左(右)心房增大left(right) atrial dilatation靴形心脏boot-shaped heart主动脉钙化calcification of aorta心腰部waist of heart垂位(狭长形;无力形;横位;斜位)心vertical (slender; asthenic; horizontal; oblique) heart三、腹部平片KUB film结石calculus钙化影calcified shadow阶梯型液平fluid levels with stepladder pattern液气平面gas-fluid level膈下游离气体subphrenic free air四、胃肠道钡剂检查barium enema examination胃肠造影gastroenterography双重对比造影double contrast radiography食管蠕动征esophageal peristalsis sign十二指肠曲(压迹)duodenal flexure(impression)小肠黏膜皱襞影mucosal fold shadow of small intestine结肠蠕动与排空征peristalsis and empting signs of colon胃排空时间延长delayed gastric emptying time胃空腹潴留液fasting retention of stomach充盈缺损filling defect黏膜皱襞消失disappearance of the mucosal folds张力减低(增高)hypotonicity (hypertonicity)球部激惹现象irritable cap蠕动增强vigorous peristaltic activity (hyperperistalsis)蠕动减弱bradydiastalsis蠕动消失aperistalsis排空加快(减缓) accelerated(reduced) evacuation跳跃现象skipping phenomenon黏膜增宽和迂曲broadened and tortuous mucosal fold黏膜皱襞平坦flat mucosal fold五、胆道bile tract口服胆囊造影oral cholecystography静脉胆管胆囊造影intravenous cholecysto-cholangiography经T形管胆囊造影trans-T-tube cholecystography经皮肝穿刺胆管造影percutaneous transhepatic cholangiography (PTC)胆总管扩张dilated common duct胆囊浓缩功能良好gallbladder concentrated satisfactorily 胆囊显影不好，浓缩功能差gallbladder with faint shadow, concentrated inadequately收缩功能contractibility六、骨骼skeleton骨皮质增厚cortical thickening of bone洋葱皮样改变“onion skin” appearance骨膜反应periosteal reaction骨质疏松osteoporosis (rarefaction)骨化ossification畸形deformity缩短shortening移位displacement脱位luxation半脱位subluxation连接不正malunion青枝骨折greenstick fracture多发性骨折multiple fracture病理性骨折pathological fracture关节间隙joint space椎间隙intervertebral space肋软骨钙化影calcification shadow of costal cartilage骨质软化osteomalacia (osteomalacosis)骨质增生硬化hyperostosis osteosclerosis死骨sequestrum骨质坏死bone necrosis关节肿胀(破坏;退行)swelling (destruction; degeneration) of joint 关节强直ankyloses骨骺分离epiphyseal separation对线良好good alignment对位良好good apposition七、泌尿系统urological system静脉肾盂造影intravenous pyelography (IVP)逆行肾盂造影retrograde pyelography萎缩atrophy移位deformity扭曲distortion充盈缺损filling defect狭窄stricture不透光的(透光的)结石opaque(translucent) stone八、X线检查位置前后位anteroposterior projection后前位postero-anterior(PA) projection侧位lateral projection立位upright position斜位oblique projection右(左)前斜位right(left) anterior oblique(RAO/LAO) projection 前后斜位anteroposterior oblique projection前凸位lordotic position projection轴位axial position头位cranial projection尾位caudal projection。

Sandhill Scientific, Inc9150 Commerce Center Circle; Suite 500 Highlands Ranch, Colorado 80129 USASunday; May 2 PostersTopic Presenter ID TitleColonic Manometry Rao S1305 How Useful Is Colonic Manometry in the Evaluation of Sensorimotor Dysfunction in Slow Transit Constipation? Z-pH Monitoring Savarino S1623 Proximal Migration of Reflux Episodes Is a Relevant Factor in Determining Intestinal Metaplasia Extension andReflux Perception Between Patients With Short and Long-Segment Barrett's EsophagusSunday; May 2 Oral PresentationsTopic Presenter ID Title Location TimeReflux-Cough Monitoring Smith 60 Acoustic Cough-Reflux Associations in Chronic Cough: Potential Triggers andMechanisms291 8:45-9:00Chicago Classifications Kindt 64 Diagnostic (DIS)agreement Between Conventional Manometry Criteria and theChicago Classification of Esophageal Motility Disorders in Tertiary Care Patients291 9:45-10:00HRAM Nguyen 169 Investigation of High-Definition Anorectal Pressure Topography (HDM) inPatients With Constipation and Fecal Incontinence397 3:00-3:15HRAM Cheeney 170 Topographic and Manometric Characterization of the Recto-Anal InhibitoryReflex (RAIR)397 3:15-3:30Transient Elastography Salzi 158 Comparison of Liver Stiffness Assessment by FibroScan® and Acoustic RadiationForce Impulse Imaging® for the Evaluation of Liver Fibrosis and Cirrhosis352 3:15-3:30Sandhill Scientific, Inc9150 Commerce Center Circle; Suite 500 Highlands Ranch, Colorado 80129 USAMonday; May 3 PostersTopic Presenter ID TitleZ-pH Monitoring Bredenoord M1143 Quality of Life in Patients With Excessive Supragastric Belching HRIM Leslie M1145 Predicting Bolus Transit Using Esophageal Pressure Topography (Ept) Measures: A Study Using SimultaneousHigh-Resolution Impedance and Manometry HRIM Ghosh M1152 Integrity of Esophageal Emptying in Spasm Patients: A High-Resolution Impedance Manometry Study EFT Pohl M1153 Distal Esophageal Spasm Revisited - Which Spasm Is a Spasm?HRIM Pohl M1154 High Resolution Impedance Manometry Recording During Multiple Rapid Swallows (MRS): A Study in HealthyVolunteersHRM Kumar M1156 Segmental Measurement of Contractile Front Velocity (Cfv) on High-Resolution Manometry (HRM) HRM Abreu M1157 Chicago (CC) Versus Traditional (Tc) Classifications in the Diagnosis of Esophageal Motility Disorders HRM Bansal M1158 Detailed Evaluation of Hiatus Hernia Morphology by High-Resolution ManometryEFT Jung M1162 The Clinical Correlation of Nutcracker Esophagus Motility PatternsEFT Krieger-Grübel M1163 Which Test Should Be Used to Investigate Patients After Treatment for Achalasia?HRM Yazaki M1164 Multiple Rapid Swallowing (MRS) As a Complementary Test During High Resolution Manometry HRM Jadcherla M1200 Effect of Pharyngeal Stimulus on Upper Esophageal Sphincter (UES) and Lower Esophageal Sphincter (LES)During Development in Human Pre-Term Infants HRAM Chumpitazi M1205 Single Center Experience Using High Resolution Anorectal Manometry in ChildrenZ-pH Monitoring Loots M1211 Multichannel Intraluminal Impedance Baseline Values in Infants Before and During Proton Pump InhibitorTherapyZ-pH Monitoring Garza M1212 Nasogastric Feeds Do Not Increase Gastroesophageal Reflux Events in InfantsZ-pH Monitoring Rosen M1213 Does Non-Acid Reflux Affect Quality of Life?HRM Dinning M2038 Simultaneous Multi-Point Measurement of Circumferential and Longitudinal Activity Recorded in IsolatedMammalian Lumen Using a Multimodal Fibre Optic Catheter HRIM Hong M2055 Multiple Intraluminal Impedance (MII) Can Detect Flow Across the Esophago Gastric Junction (EGJ): Validationin Normal SubjectsSandhill Scientific, Inc9150 Commerce Center Circle; Suite 500 Highlands Ranch, Colorado 80129 USAMonday; May 3 Oral PresentationsTopic Presenter ID TitleLocation Time Plenary Hecht Sp307 Presentation of Friedenwald Medal to Donald O. Castell Aud A-B 10:05-10:09 Plenary Furuta Sp311 Eosinophilic Esophagitis: Challenges and Horizons Aud A-B 10:39-10:49 PlenaryInadomiSp316Era of Healthcare Reform: What Is the Impact on GI?Aud A-B11:29-11:39Tuesday; May 4 PostersTopicPresenterIDTitleZ-pH Monitoring Slaughter T1097 Neither SI or SAP Are Reliable Tools for Assessing Symptoms and Reflux EventsZ-pH Monitoring Galindo T1098 Multi-Modality Evaluation of Patients With GERD Symptoms Who Have Failed Empiric PPI TherapyZ-pH Monitoring Hemmink T1100 Computer Analysis of 24-h Esophageal Impedance SignalsZ-pH Monitoring Heard T1101 Wireless “Mini” Multichannel Intraluminal Impedance - pH (MII-pH): What and Where?Z-pH Monitoring Heard T1102 Characterization of Patients With Low Baseline Impedance on Multichannel Intraluminal Impedance - pH (MII-pH) Reflux TestingZ-pH Monitoring Jeon T1105 Comparison of Esophageal pH, Impedance, and High Resolution Manometry in Detecting Reflux After a Meal Z-pH Monitoring Ali T1106 Duration of Reflux Events Is an Important Factor in Induction of Reflux Symptoms in Patients on PPI TherapyZ-pH Monitoring Aravapalli T1107 Influence of Symptom Index Time Windows on Association to Reflux EpisodesZ-pH Monitoring Bayrakci T1108 The Feasibility of 24 Hour Ambulatory Multichannel Intraluminal Impedance in Patients With ProgressiveSystemic SclerosisZ-pH Monitoring Emerenziani T1110 Relationship Between Esophageal Acid Exposure and Symptom Association Probability (SAP) Index in Erosiveand Non-Erosive Reflux Disease PatientsZ-pH Monitoring Arevalo T1111 Nocturnal Heartburn Is Not Common in Patients With GERDZ-pH Monitoring Gunderson T1112 Diagnostic Impact of Impedance-pH Testing in Management of GERD and Laryngopharyngeal Reflux PatientsNot Controlled by Acid SuppressionZ-pH Monitoring Salim T1113 Diagnostic Contribution of 24h Impedance Compared to 24h Oesophageal pH Monitoring: Study on 220Consecutive pH-Impedance in a Tertiary CenterZ-pH Monitoring Savarino T1116 Functional Heartburn and Non-Erosive Reflux Disease: The Added Value of Impedance-pH Monitoring to ROMEIII CriteriaZ-pH Monitoring Savarino T1117 Differences in Reflux Characteristics Can Be Diagnostic in NERD Patients When Symptoms Do Not Occur DuringMII-pH TestingZ-pH MonitoringJungT1119The Comparison of the Discomfort Between Catheter and Catheterless pH TestSandhill Scientific, Inc9150 Commerce Center Circle; Suite 500 Highlands Ranch, Colorado 80129 USAZ-pH Monitoring Gunderson T1121 Impedance-pH Characteristics of 47 Pre-Lung Transplantation PatientsZ-pH Monitoring Ang T1127 A Comparison of Acid and Non-Acid Reflux in the Evaluation of Patients With Typical Versus AtypicalManifestations of Gastroesophageal Reflux Disease: Results From an Asian CohortZ-pH Monitoring Karamanolis T1131 Therapeutic Success in Patients With Non-Cardiac Chest Pain Could Be Predicted Using GERD Parameters onImpedance-pH MonitoringZ-pH Monitoring Vardar T1132 The Impact of the Speed of Food Intake on Intraesophageal Reflux Events in Obese Female PatientsZ-pH Monitoring Leslie T1135 The Complementary Role of Impedance Color Contours for Analysis of Impedance-pH Tracings DuringEsophageal Reflux MonitoringTransient Elastography Mueller T1201 Improved Diagnostic Accuracy of TRANSIENT ELASTOGRAPHY for Cirrhosis Using Histology Plus Clinics As GoldStandardTransientElastographyAdolf T1202 Valsalva and Orthostatic Maneuvers Increase Liver Stiffness (FibroScan®) in Healthy VolunteersTransientElastographySporea T1204 Which Is the Best Noninvasive Ultrasound Method for the Evaluation of Liver Fibrosis?HRAM Anh T1347 High-Definition Manometry Can Predict Damage to External Anal Sphincter & Puborectalis MuscleHRAM Lee T1352 Comparison of High Resolution Anorectal Manometry With Conventional Anorectal Manometry in the Diagnosisof Defecatory Disorder Caused by Pelvic Floor Dysfunction Topic Presenter ID TitleAnorectal Manometry Moreau T1353 Fecal Incontinence in Males: Anal Sphincter Pressure Is Not the AnswerAnorectal Manometry Lam T1356 Anorectal Function Evaluation in Patients With Fecal Incontinence Compared to Patients Without FecalIncontinence: Determination of Predictive Factors for Fecal IncontinenceAnorectal Manometry Papathanasopoulos T1359 Anal Sphincter Responses to Different Patterns of Rectal Distension in Inflammatory Bowel Disease: A Role inFecal IncontinenceZ-pH Monitoring Uyanikoglu T1403 Does Cholecystectomy Increase the Esophageal Alkaline Reflux? Evaluation by Impedance-pH TechniqueZ-pH Monitoring Farré T1678 Evaluation of Esophageal Mucosa Integ rity “In Vivo”. Validation of Basal Intraluminal ImpedanceMeasurements to Assess Non-Erosive Changes Induced by Esophageal Acid Exposure in Rabbit and HealthyHuman SubjectsZ-pH Monitoring Ribolsi T1680 Functional Heartburn Patients Are Characterized by Increased Frequency and Perception of Liquid-Gas andProximal RefluxZ-pH Monitoring Ribolsi T1681 Relevance of the Dynamic Pattern of Reflux Episodes in Non-Erosive Reflux Disease (NERD) Patients With Non-Cardiac Chest PainZ-pH Monitoring Blondeau T1682 Increasing Body Weight Is Associated With a Higher Incidence and Proximal Extent of Reflux in Patients WithGERD Both 'on' and 'off' PPI TherapyZ-pH Monitoring Blondeau T1683 An Increase in Intra-Gastric Pressure Is Associated With a Higher Proximal Extent of Gastroesophageal Refluxin Healthy VolunteersZ-pH Monitoring Woodley T1692 The Association Between Acid Reflux and Cough in Patients With Cystic Fibrosis Is Not Dependent on the Typeof Acid RefluxZ-pH Monitoring Savarino T1695 Reflux Patterns in Patients With Short and Long Segment Barrett's Esophagus, Erosive Esophagitis andControls: A Study Using Impedance-pH MonitoringZ-pH Monitoring Savarino T1696 Reflux Patterns Differ Among Patients With Non-Erosive Reflux Disease (NERD), Hypersensitive Esophagus(HE) and Functional Heartburn (Fh)Z-pH Monitoring Savarino T1701 Is Nonacid Reflux Increased in Cholecystectomized Patients With Typical Reflux Symptoms? a Study UsingImpedance-pH MonitoringSandhill Scientific, Inc9150 Commerce Center Circle; Suite 500 Highlands Ranch, Colorado 80129 USAZ-pH Monitoring Emerenziani T1705 Findings of pH-Impedance Monitoring Improve Prediction of PPI Response in Non Erosive Reflux Disease(NERD) Patients With Typical Symptoms HRIM Hong T1880 Esophageal Emptying and Longitudinal Muscle Contraction in Patients With Achalasia As Defined by HighResolution Manometry, High Frequency Ultrasound (Hfus) and Impedance HRIM Roman T1883 Upper Esophageal Sphincter Relaxation As a Determinant of Reflux and Symptoms During Transient LowerEsophageal Sphincter Relaxation (TLESR)?HRM Roman T1884 High Resolution Manometry Improves Transient Lower Esophageal Relaxations (TLESRs) Detection in HealthyVolunteersHRM McCarthy T1886 The Effect of Body Posture on Esophageal Pressure Topography Subtypes in AchalasiaHRM Rohof T1887 High Resolution Esophageal Topography Is Superior to Conventional Sleeve Manometry for the Detection ofTLESRs Associated With RefluxHRM Bogte T1888 Reproducibility of Esophageal High-Resolution ManometryHRM Sweis T1889 Inclusion of Solid Swallows and a Test Meal Increase the Clinical Utility of High Resolution Manometry inPatients With DysphagiaHRM Sweis T1890 The Effect of 'Physiologic Challenge' on Coordination Between Proximal and Distal Esophageal Contractions inHealthy VolunteersHRM Sweis T1891 Solid Swallows and a Test Meal Increase the Clinical Utility of High Resolution Manometry in PatientsPresenting With Reflux SymptomsTopic Presenter ID TitleHRIM Jung T1901 The Discrepancy Between 2 and 3-Dimensional Impedance Recording Regarding Bolus Clearance: A StudyUsing High-Resolution Impedance ManometryHRM Burdick T1903 High Resolution Manometry (HRM) Reveals Worsening Esophageal Motor Function in Patients With Barrett'sEsophagusEFT Almansa T1905 Manometric Course of Patients With Esophageal SpasmHRIM Fareeduddin T1908 Reflux-Symptom Association and Determinants of Symptom Perception in an Investigator-Monitored Post-Prandial Study Utilizing High Resolution Impedance Manometry (HRIM) and pH Recording HRM Kahrilas T1910 Normalized High Resolution Esophageal Pressure Topography (HREPT) Data: Characterizing Peristalsis inTerms of Neuromuscular PhysiologyHRM Shukla T1911 Ingestion of Carbonated Drinks Decreases Lower Esophageal Sphincter (LES) Pressure and Increases TransientLES RelaxationsEFT Burza T1913 Esophageal Peristaltic Dysfunction in Obese and Overweight Subjects: A Prospective StudyHRM Rommel T1914 Manometric Characteristics of Deglutitive Upper Esophageal Sphincter Relaxation of in Patients WithDysphagia.Tuesday; May 4 Oral PresentationsTopic Presenter ID Title Location TimeZ-pH Monitoring Savarino 550 Microscopic Esophagitis Is More Frequent in Patients With pH-Positive Non-383-385 8:45-9:00Sandhill Scientific, Inc9150 Commerce Center Circle; Suite 500 Highlands Ranch, Colorado 80129 USAErosive Reflux Disease and Hypersensitive Esophagus Than in Those WithFunctional Heartburn: A Study Using Impedance-pH and Optical MicroscopyZ-pH Monitoring Luger 552 Inter-Observer and Inter-Analysis Agreement for Impedance Tracing and ColorContours Analysis of Esophageal Impedance Reflux Data383-385 9:15-9:30Z-pH Monitoring Weigt553 Small Volume Acid Reflux in GERD Patients With Hiatal Hernia Is Only Detectableby pH-Metry but Not by Multichannel Intraluminal Impedance383-385 9:30-9:45 Z-pH Monitoring Smout Sp546 State-of-the-Art Lecture: How Can We Improve the Diagnosis of Reflux Disease? 383-385 9:45-10:00Z-pH Monitoring Arevalo 880 Recumbent Impedance-pH Detected Swallows Predict Awakenings in GERDPatients295/296 5:00-5:15Wednesday; May 5 PostersTopic Presenter ID TitleZ-pH Monitoring Pauwels W1061 Duodeno-Gastro-Esophageal Reflux and Bile Acids in Saliva in Adult Patients With Cystic FibrosisZ-pH Monitoring Mertens W1065 the Effect of Gastro-Duodenal Contents on Functional Integrity of Tracheal Mucosa: There Is More to It ThanAcid.Z-pH Monitoring Rosen W1070 Non-Acid Reflux Burden Is a Predictor of Bacterial Lung InfectionsZ-pH Monitoring Ang W1072 A Pilot Study Evaluating the Role of Combined Impedance-pH Monitoring in the Evaluation of Asian PatientsWith Suspected Supra-Esophageal Manifestations of Gastro-Esophageal Reflux Disease (GERD): Establishingthe Presence of Acid and Non-Acid Reflux (NAR)Z-pH Monitoring Woodley W1107 Reduced Acid Reflux Frequency and Total Acid Exposure Following Proton Pump Inhibitor Treatment in CysticFibrosis Patients Is Largely Due to an Effect on pH Only and Classic Two-Phase Acid Reflux Episodes EFT Odaka W1125 Characteristics of Esophageal Motility in Patients With NERD Refractory for PPIs and a Treatment StrategyUsing Rikkunshito - A Study Using Combined Multichannel Intraluminal Impedance and Manometry (MII-EM) Z-pH Monitoring Battula W1186 A Portable Wireless System for Integrated Batteryless Impedance- and pH-Sensor Implants to Detect GERDEpisodesHRIM Kessing W1414 Impedance Recording and High Resolution Manometry Help to Better Define Rumination EpisodesZ-pH Monitoring Starpoli W1426 Characteristics of Multichannel Intraluminal Impedance-pH Reflux (MII-pH) Testing Before and After TransoralIncisionless Fundoplication (TIF)Sandhill Scientific, Inc9150 Commerce Center Circle; Suite 500 Highlands Ranch, Colorado 80129 USAZ-pH Monitoring Arnold W1662 Postoperative Impedance Testing Unreliable in Detecting Nissen Fundoplication FailureWednesday; May 5 Oral PresentationsTopic Presenter ID Title Location Time HRM Pandolfino Sp818 Lessons Learned From Research Studies Using High-ResolutionManometry/Esophageal Pressure Topography286/287 8:30-8:52HRM Kahrilas Sp819 Use of High-Resolution Manometry/Esophageal Pressure Topography in theDiagnosis of Esophageal Motility Disorders286/287 8:52-9:14HRIM Sifrim Sp820 Is There Value to Adding Impedance to High-Resolution Manometry/EsophagealPressure Topography?286/287 9:14-9:36 Colonic HRM Dinning Sp821 Colonic High-Resolution Manometry 286/287 9:36-9:58 GERD Castell Sp828 State-of-the-Art Lecture: Improving Treatment Outcomes in GERD Patients 265-268 9:45-10:00 Z-pH & HRIM Crowell Sp837 Manometry, Impedance, pH Testing 255-257 11:14-11:36 HRM Boeckxstaens Sp866 State-of-the-Art Lecture: Diagnosis and Treatment of Achalasia 2010 298-299 11:45-12:00。

循证医学名词术语中英文对照安全性Safety半随机对照试验quasi— randomized control trial,qRCT背景问题background questions比值比odds ratio,OR标准化均数差standardized mean difference, SMD病例报告case report病例分析case analysis病人价值观patient value病人预期事件发生率patient’s expected event rate，PEER补充替代医学complementary and alternative medicine，CAM 不良事件adverse event不确定性uncertaintyCochrane图书馆Cochrane Library, CLCochrane系统评价Cochrane systematic review，CSR Cochrane协作网Cochrane Collaboration，CCCox比例风险模型Cox' proportional hazard model参考试验偏倚References test bias肠激惹综合征irritable bowel syndrome，IRB测量变异measurement variation成本-效果cost-effectiveness成本-效果分析cost—effectiveness analysis成本-效益分析cost—benefit analysis成本-效用分析cost-utility analysis成本最小化分析（最小成本分析）cost—minimization analysis重复发表偏倚Multiple publication bias传统医学Traditional Medicine，TMD—L法DerSimonian & Laird methodthe number needed to harm one more patients from the therapy，NNH 对抗疗法allopathic medicine,AM对照组中某事件的发生率control event rate，CER多重发表偏倚multiple publication bias二次研究secondary studies二次研究证据secondary research evidence发表偏倚publication biasnumber needed to treat，NNT非随机同期对照试验non—randomized concurrent control trial分层随机化stratified randomization分类变量categorical variable风险（危险度) risk干扰co—intervention工作偏倚Workup bias固定效应模型fixed effect model国际临床流行病学网International Clinical Epidemiology Network，INCLEN 灰色文献grey literature后效评价reevaluation获益benefit机会结chance node疾病谱偏倚Spectrum bias技术特性Technical properties加权均数差weighted mean difference，WMD假阳性率（误诊率）false positive rate假阴性率（漏诊率) false negative rate简单随机化simple randomization检索策略search strategy交叉对照研究（交叉设计）crossover design经济学分析economic analysis经济学特性Economic attributes or impacts经验医学empirical medicine精确性precision决策结decision node决策树分析decision tree analysis绝对获益增加率absolute benefit increase, ABI绝对危险度降低率absolute risk reduction，ARR 绝对危险度增加率absolute risk increase，ARI 可重复性repeatability,reproducibility可靠性（信度）reliability可信区间confidence interval ,CI可信限confidence limit ，CLLogistic回归模型Logistic regression model 历史性对照研究historical control trial利弊比likelihood of being helped vs harmed, LHH 连续性变量continuous variable临床对照试验controlled clinical trial，CCT临床结局clinical outcome临床经济学clinical economics临床决策分析clinical decision analysis临床流行病学clinical epidemiology, CE临床实践指南clinical practice guidelines，CPG临床试验clinical trial临床研究证据clinical research evidence临床证据clinical evidence临床证据手册handbook of clinical evidence零点Zero time灵活性flexibility临界点Cut off points漏斗图funnel plots率差(或危险差）rate difference,risk difference,RD Meta—分析Meta—analysis敏感度sensitivity敏感性分析sensitivity analysis墨克手册Merck manual脑卒中病房Stroke Unit内在真实性internal validity偏倚bias起始队列inception cohort前—后对照研究before—after study前景问题foreground questions区组随机化block randomization散点图scatter plots森林图forest plots伤残调整寿命年disability adjusted life year，DALY生存曲线survival curves生存时间survival time生存质量（生活质量）quality of life世界卫生组织World Health Organization, WHO失安全数fail-Safe Number试验组某事件发生率experimental event rate，EER似然比likelihood Ratio, LR适用性applicability受试者工作特征曲线(ROC曲线）receiver operator characteristic curve随机对照临床试验randomized clinical trials, RCT 随机对照试验randomized control trial，RCT随机化隐藏randomization concealment随机效应模型random effect model特异度specificity同行评价colleague evaluation统计效能（把握度）power同质性检验tests for homogeneity外在真实性external validity完成治疗分析per protocol，PP腕管综合征carpal tunnel syndrome，CTS卫生技术health technology卫生技术评估health technology assessment, HTA 系统评价systematic review，SR相对获益增加率relative benefit increase, RBI相对危险度relative risk，RR相对危险度降低率relative risk reduction, RRR相对危险度增加率relative risk increase，RRI 效果effectiveness效力efficacy效应尺度effect magnitude效应量effect size序贯试验sequential trial选择性偏倚selection bias循证儿科学evidence—based pediatrics循证妇产科学evidence-based gynecology ＆obstetrics 循证购买evidence—based purchasing循证护理evidence-based nursing循证决策evidence-based decision-making循证内科学evidence-based internal medicine循证筛选evidence—based selection循证外科学evidence-based surgery循证卫生保健evidence—based health care循证诊断evidence-based diagnosis循证医学evidence-based medicine, EBM亚组分析subgroup analysis严格评价critical appraisal验后比post—test odds验后概率post-test probability验前比pre-test odds验前概率pre—test probability阳性预测值positive predictive value原始研究primary studies异质性检验tests for heterogeneity意向治疗分析intention—to-treat，ITT阴性预测值negative predictive value引用偏倚citation bias尤登指数Youden’s index语言偏倚language bias预后prognosis预后因素prognostic factor预后指数prognostic index原始研究证据primary research evidence原始研究证据来源primary resources沾染contamination真实性（效度）validity诊断参照标准reference standard of diagnosis。