下三尖

A novel endocyclic enamine cyclopentenone annulation was discovered and rationalized as an unusual Nazarov-type electrocyclization, which would have broad applications in the synthesis of natural alkaloids and other heterocycles.

我们在合成路线一、路线二中用的6-6元环系到7-5元环系的还原重排反应，在温和的酸性还原条件下即能发生，这说明在三尖杉碱的生物合成中6-6元环到7-5元环的还原重排步骤是非常有可能发生的；因此，我们的合成路线二中可认为是生物合成过程。

A closure of bicuspid and tricuspid valves first heart sound "lub".

心声： 二尖瓣和三尖瓣关闭第一下心声；(b 半月瓣关闭第二下心声。

Methods:32 patients of TCPC were reviewed: the average age was 10 years,ranged from 5 to 24 years and the average weight was 28 kilogramme,ranged from 13 to 55 kilogramme.18 patients underwent lateral tunnel and 1 patient underwent extracardiac conduit TCPC with hypothermic cardiopulmonary bypass and heart arrest,and 10 patients were treated by extracardiac conduit technique with normothermic CPB and without heart arrest and 2 patients without CPB,and 1 patients underwent two-step operation.

回顾性分析32例全腔静脉肺动脉连接术患者的临床资料：年龄5～24岁，平均（10±5）岁，体重13～55 kg，平均（28±11） kg，病种包括单心室16例，右心室双出口并完全性心内膜垫缺损6例，完全性大动脉转位并完全性心内膜垫缺损3例，三尖瓣闭锁6例，二尖瓣闭锁1例。其中，在低温体外循环心脏停跳下18例行右房内侧隧道法，1例行心外管道法，常温体外循环心脏跳动下10例行心外管道法，非体外循环下2例行心外管道法，1例行分次全腔静脉肺动脉连接术。

Starting from piperonal, the initial total synthesis of CET involved BischlerNapieralski reaction, 3, 2-sigmatropic rearrangement, unusual Nazarov-type electrocyclization, and autoxidative dehydrogenation of desmethylcephalotaxine to desmethylcephalotaxinone etc.

第一条路线我们以胡椒醛为起始原料，经Bischler-Napieralski反应，[3，2]-σ重排，6-6环系到7-5环系的还原重排，Nazarov氧化环化；碱性条件下脱甲基三尖杉碱到脱甲基三尖杉酮碱的氧化脱氢等20步反应，完成了三尖杉碱的全合成。

Furthermore, a biogenesis-based synthesis of CET was developed, which realized the plausible biogenetic transformation by a transannular reductive skeletal rearrangement of cyclic amino enone 45 to key ring skeleton of CET under mild condition directly.

化合物17经Wacker氧化、环化得到重排前体不饱和酮45，45在温和的还原条件下重排得到三尖杉碱五环骨架化合物34，从而实现了三尖杉碱的全合成。第二条路线较前一条步骤更短，合成更方便，收率更高（从二酯化合物8计合成三尖杉碱的总收率可达10％）。

No Ⅲ° atrioventricular conduction block happened, 9 patients developed right bundle branch block, and 2 patients showed junctional rhythm. Two patients with perimembranous extending outlet were repaired because of residual shunt(0.4cm,0.3cm) on the anterosuperior rim of defect. One patient with trivial residual shunt(0.15cm) on the posteroinferior rim of defect was found closed spontaneously six months later. Tricuspid valve was incised in 10 patients of VSD sextending outlet,8 patients vertical to the valve ring,2 patients parallel to the valve ring. Moderate tricuspid valve regurgitation was found in 1 patient, mild in 5 patients, trivial in 4 patients. No one aggravated. One patient complicated with pericardial effusion.

无Ⅲ°房室传导阻滞发生，9例发生右束支传导阻滞，2例结性心律。2例膜周偏流出道型VSD患者因前上缘残余分流分别为0.4cm和0.3cm，再次手术修补；1例后下缘残留细束样分流，直径0.15cm，随访6个月后自愈；10例膜周偏流出道型VSD患者剪开三尖瓣，8例垂直瓣环，2例平行瓣环；1例三尖瓣中度反流，随访无加重；5例轻度反流，4例轻微反流，随访均无加重；1例心包积液；1例再次进入手术室止血。

Methods The mitral (M1) and tricuspid (T1) valves componented of the first heart sound (S1), the aortic (A2) and pulmonary (P2) valves componented of the second heart sound (S2) were detected by short-time Fourier transformation spectrogram and Shannon engergy, in the high frequency resolution circumstance.

在频率分辨率较高的情况下，利用短时傅立叶变换声谱图和香农能量，提取出第1心音(S1)的主要成分二尖瓣关闭音(M1)、三尖瓣关闭音(T1)及第2心音(S2)的主要成分主动脉瓣关闭音(A2)、肺动脉瓣关闭音(P2)。

In the presence of sodium as catalyst, the ester exchange reaction between methyl dimethoxy acetate and cephalotaxine produced cephalotaxine dimethoxy acetate, which was then hydrolyzed in dilute hydrochloric acid. Spectrum analysis showed one of hydrolytic products was cephalotaxinone.

本文报导己二甲氧基乙酸甲酮和三尖杉碱在金属钠催化下，直接进行酯交换反应生成二甲氧基乙酸三尖杉酯，后者在稀盐酸中水解，水解产物之一经光谱分析碳定为三尖杉酮碱。

After follow-up of 4 to 18 months,atrial flutter recurred in one patient and ablated successfully by another procedure.

左前斜45度影像定位下，在三尖瓣环5～6点处划线消融三尖瓣环与下腔静脉开口之峡部。

In all,10 patients were cured after mean follow-up 15.3±12.8 months.The causes of RFCA failure were demonstrated in surgical operation.In 3 patients without structural heart disease,ablation catheters were not located in distinct target sites during ablation of 2 left posteroseptal pathways and 1 right posterior wall pathway.In 2 cases of Ebstein?s anomaly,ablations were failed by serious tricuspid regurgitation and AP at epicardium.In one case with rhumatic valvular disease,ablation catheter did not achieve mitral annulus because of pathologic changes.Other 4 cases with congenital heart disease were associated with anotomical anomaly and serious hemodynamic disturbance.

s畸形合并房间隔缺损，1例为重度三尖瓣返流使消融电极不能稳定贴靠靶点，另1例为AP靠近心外膜面而致RFCA失败；1例风湿性心脏病联合瓣膜病因瓣膜及瓣下结构病理改变致RFCA失败；1例重度二尖瓣返流RFCA失败与病人不能耐受RFCA与AP定位于24区消融导管难以抵达有关；先天性心脏病大房间隔缺损、重度主动脉关闭不全及矫正性大动脉转位右旋心伴三尖瓣返流各1例，RFCA失败与解剖畸形、心内大分流等血液动力学障碍有关。

I didn't watch TV last night, because it .

昨晚我没有看电视，因为电视机坏了。

Since this year, in a lot of villages of Beijing, TV of elevator liquid crystal was removed.

今年以来，在北京的很多小区里，电梯液晶电视被撤了下来。