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@#Objective To explore the feasibility of 5G remote robot-assisted pulmonary lobectomy through animal experiments. Methods In this research, the Toumai® surgical robot was manipulated remotely by the surgeon in the Control Center of the MedBot Company through the 5G network established by China Telecom, and the experimental pig underwent lobectomy in simulated operating room. Results The animal experiment surgery was successfully completed. The surgeon remotely manipulated the surgical robot to complete the lobectomy of right apical lobe and mediastinal lymph node dissection. The entire animal experiment took about 60 minutes, with an average round-trip network delay of 125 (110-155) ms, and no network interruption or robot malfunction occurred. Conclusion This animal experiment is the first attempt of 5G remote thoracic surgery, which preliminarily proves the feasibility of completing remote lobectomy through the Toumai® surgical robot 5G wireless network connection. The systematic surgical procedure is summarized, which lays a foundation for the subsequent experiments and clinical applications of 5G remote robot-assisted thoracic surgery.
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Remote pharmaceutical care refers to the process that pharmacists provide pharmaceutical care to patients remotely through information technology. Remote pharmaceutical care in China starts late and develops slowly. Therefore ，this paper discusses the pharmaceutical care modes that pharmacists at home and abroad can provide under the remote mode by collecting literature. The results show that foreign remote pharmaceutical care starts early and is relatively mature. The service mainly included remote follow-up and intervention ，24-hour online prescription and order review ，24-hour online drug reorganization ，and guidance on rational drug use in remote areas or community hospitals. The service population covers patients with cardiovascular disease ， diabetes，asthma，AIDS and so on. Some hospitals have established an integrated pharmaceutical care system of “Internet+Medical Consortium”in China ，with which pharmacists can provide patients with pharmaceutical care such as remote follow-up and intervention，drug consultation and so on. With the promotion of telemedicine ，domestic pharmacists can gradually expand the scope of services ，expand pharmaceutical services such as remote consultation and remote popular science push ，and realize the sharing of high-quality pharmaceutical care for the whole people.
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@#Objective To analyze the efficacy and safety of Toumai® endoscopic surgery robot in right upper lobe resection. Methods The clinical data of 2 patients with non-small cell lung cancer who received right upper lobe resection with Toumai® endoscopic surgery robot in Shanghai Chest Hospital, Shanghai Jiao Tong University in November 2021 were retrospectively analyzed. Both patients were male, aged 66 years and 44 years, respectively. Results The operation was successful in both patients with no conversion to thoracotomy, surgical complication or death. The operation time was 65 min and 48 min, and the amount of intraoperative bleeding was 80 mL and 50 mL, respectively. The postoperative hospital stay was 3 days. There was no blood transfusion during the perioperative period. Conclusion The application of Toumai® endoscopic surgery robot in lobectomy is preliminarily proved to be safe and effective. Compared with Da Vinci robotic surgery system, it has similar clear 3D vision and flexible and stable operation, which can become one of the important choices for the new generation of minimally invasive chest surgery.
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Objective:To explore the predictive value of artificial intelligence algorithm model for venous thromboembolism（VTE）in lower extremities of trauma patients.Methods:The data of 15，856 orthopedic inpatients were retrospectively collected from the information system database in Chinese PLA General Hospital from December 1992 to November 2017. The patients were divided according to whether they had thrombosis or not. Data pretreatment and feature extraction were carried out. Four artificial intelligence algorithms including Random Forest（RF），Bayes（Bayes），Decision Tree（DTC）and Gradient Boosting Tree（GBDT）were constructed to evaluate their clinical diagnostic efficacy in VTE. The original data were divided into training set and test set according to the ratio of 8∶2 by random stratified sampling method. By comparing the area under receiver operating characteristic curve（ROC）（AUC），true positive rate（TPR）and accuracy in the above methods，the efficiency of different models in clinical diagnosis of VTE was evaluated. According to the contribution degree of the features in the model，the important features were ranked to screen the independent risk factors of VTE.Results:For RF，Bayes，DTC and GBDT algorithm models，the AUC was 0.89，0.86，0.68，0.71，with the TPR for 0.29，0.44，0.38，0.66 and the accuracy for 0.97，0.94，0.95，0.76，respectively. The RF algorithm model had the highest accuracy and the largest AUC. Analysis of important features of artificial intelligence prediction models for VTE showed that the history of thrombosis was the primary predictor of adverse outcomes. The ranking of important clinical features represented by the RF model showed that the history of thrombosis，enoxaparin sodium injection dose，last glucose measurement and first glucose measurement after surgery were important predictive characteristics of VTE.Conclusions:The RF model has the highest accuracy in risk prediction of VTE in trauma patients，which can provide a reference for the formulation of VTE prevention strategies.
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Objective:To investigate the curative effect of triangular mechanical reconstruction in revision of failed fixation of intertrochanteric factures.Methods:A retrospective case series study was conducted for data of 11 patients with failed treatment of intertrochanteric fractures treated at First Medical Centre, Chinese PLA General Hospital from January 2017 to December 2019, including 7 males and 4 females, aged 41-75 years [(57.9±11.4)years]. The patients underwent revision surgery to achieve mechanical reconstruction of the proximal femoral triangular structure by two different implants. Among them, 6 patients were fixed using the dynamic condylar screw (DCS) combined with anteromedial plate and 5 patients were fixed using the cephalomedullary nail combined with anteromedial plate. The fracture healing rate and time, neck-shaft angle, neck anteversion angle and complications were detected. The lower extremity functional scale (LEFS), short form 12 health survey questionnaire (SF-12) and pain visual analogue scale (VAS) were measured at postoperative 6 and 12 months to evaluate functional recovery and quality of life.Results:All patients were followed up for 12-45 months [(19.1±10.8)months]. The fracture healing rate was 100%, with the healing time of 3-8 months [(4.7±1.8)months]. Compared with the unaffected limb, the neck-shaft angle and neck anteversion angle of the affected side were reduced ( P>0.05), and no secondary fracture reduction loss occurred before healing ( P>0.05). There were no postoperative complications such as femoral head avascular necrosis and implant failure. The LEFS score was (44.7±8.2)points at postoperative 12 months, significantly improved compared with that at postoperative 6 months [(61.6±10.4)points] ( P<0.05). The VAS was 1.5 (0, 2)points at postoperative 12 months, significantly decreased compared with that at postoperative 6 months [3.5(2, 4)points] ( P<0.05). The SF-12 score in physical state [(42.5±9.0)points] and mental state [(55.7±5.7)points] were also significantly improved compared with those at postoperative 6 months [(30.0±6.4)points, (43.6±6.2)points] ( P<0.05). Conclusions:Based on the characteristics of structural mechanics of the proximal femur, the DCS or cephalomedullary nail combined with anteromedial plate used to construct a triangular stable structure can achieve stable fracture reduction and maintenance reduction, relieve pain and improve function recovery as well as quality of life. This may provide an optimized revision strategy for failed fixation of intertrochanteric fractures.
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Intertrochanteric fracture is the most common hip fracture. Due to severe osteoporosis and high degree of fracture comminution, initial implant failure or nonunion occasionally occurs. It is still controversial how to formulate a more effective strategy for revision and fixation after failed primary operation for patients who have high functional needs and/or long-life expectancy. Common surgical procedures include angle-stabilized extramedullary plate systems (dynamic condylar screw or dynamic hip screw), cephalomedullary nail systems (proximal femoral nail antirotation, InterTAN, and trochanteric fixation nail advanced) with/without medial augmentation plate. For patients with intertrochanteric fracture who have suffered from primary operation failure, the basic principle for revision is to mechanically reconstruct the stable triangular structure of the proximal femur in order to improve the mechanical stability of the fracture ends as much as possible so that fracture healing and early functional exercise can be ensured. This paper reviews the clinical and biomechanical studies published, analyzes the mechanical factors responsible for failure of initial surgery, summarizes revision strategy and clinical prognosis, and provides our clinical experience and technical innovations, hoping to help clinicians in choosing an optimal revision strategy.
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Objective:To compare the anti-rotation stability between different modes of augmentative plating for femoral shaft nonunion after intramedullary nailing.Methods:Fifteen artificial synthetic femurs were used to create models of femoral shaft nonunion with rotational instability after intramedullary nailing. They were randomly divided into 3 groups ( n=5). Control group 1 was fixated with lateral locking compression plate (LCP), control group 2 with anterior LCP, and the experimental group with anterior multi-dimensional cross locking plate (MDC-LP). After fixation, all the groups were subjected to a torsional loading test, with the torsional loading starting from 0 N·m till 10 N·m and a loading speed of 6°/min. The 3 model groups were compared in terms of torsional angle and stiffness. Results:Under the torsion loading, the torsional angles for control group 1, control group 2 and the experimental group were 9.69°±0.34°, 7.15°±0.20° and 1.59°±0.02°, respectively, showing significant differences ( P=0.002); the torsional angle for the experi mental group was significantly smaller than that for control group 1 ( P<0.05). The torsion stiffness for control group 1, control group 2 and the experimental group was respectively 1.02 N·m/° ±0.04 N·m/°, 1.39 N·m/° ± 0.04 N·m/° and 6.16 N·m/° ± 0.06 N·m/°, showing significant differences ( P=14 886.140, P<0.001); there was a significant difference between any 2 groups ( P< 0.05). Conclusions:In the management of femoral shaft nonunion after intramedullary nailing, anterior augmentative plating can provide better anti-torsional stability than lateral augmentative plating, and MDC-LP can also provide better anti-torsional stability than a conventional LCP because it leads to bicortical fixation of the screws.
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Objective:To determine the gender and age differences in anatomical parameters of proximal femur in middle-aged and elderly patients with femoral intertrochanteric fracture so as to provide theoretical evidence for development of internal fixation devices.Methods:The clinical and CT data of 375 patients with intertrochanteric fracture were analyzed retrospectively who had been treated at Department of Orthopedics, The First Medical Center, General Hospital of Chinese PLA from September 2009 to March 2017. The patients were divided into 4 age groups. The middle-aged group (from 45 to 59 years old) had 22 cases, 16 males and 6 females; the early elderly group (from 60 to 74 years old) had 87 cases, 37 males and 50 females; the elderly group (from 75 to 89 years old) had 238 cases, 76 males and 162 females; the late elderly group (≥90 years old) had 28 cases, 6 males and 22 females. The anteversion angle of femoral neck, femoral neck-shaft angle, femoral head diameter, femoral neck length, femoral neck offset and femoral neck width were measured on their images. The anatomical parameters of proximal femur were compared between genders in the same age group and between groups of the same gender.Results:There were no significant differences between male and female patients with femoral intertrochanteric fracture in body mass index or AO classification, showing comparability( P>0.05). The anteversion angle of femoral neck (8.33°±5.00°) of the male middle-aged and elderly patients with intertrochanteric fracture was significantly smaller than that of the female ones (11.28°±6.15°), but their femoral head diameter, femoral neck length, femoral neck offset and femoral neck width (49.10 mm±2.48 mm, 99.70 mm±5.22 mm, 7.18 mm±2.20 mm and 39.10 mm±4.92 mm) were significantly larger than those of the female ones (43.46 mm±2.79 mm, 90.00 mm ± 4.75 mm, 6.29 mm±2.07 mm and 33.49 mm±4.87 mm) (all P<0.05). The femoral head diameter, femoral neck length and femoral neck width of the male patients in all the 4 age groups were significantly larger than those of the female ones ( P< 0.05). The anteversion angles of femoral neck of the male patients in the early elderly, elderly and late elderly groups were significantly smaller than those of the female ones ( P< 0.05). The femoral neck offset of male patients in the elderly group was significantly greater than that of female ones ( P< 0.05). There were no statistically significant differences in anteversion angle of femoral neck, femoral neck-shaft angle, femoral head diameter, femoral neck length, femoral neck offset or femoral neck width between groups of the same gender ( P>0.05). Conclusions:Compared with the middle-aged and elderly male patients with femoral intertrochanteric fracture, the middle-aged and elderly female ones have a larger anteversion angle of femoral neck, smaller offset, width and length of femoral neck, and a smaller femoral head diameter. There are no significant age differences in anatomical parameters of the proximal femur in middle-aged and elderly patients with femoral intertrochanteric fracture.
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@#Objective To summarize the perioperative outcome of patients undergoing robot-assisted thoracic surgery (RATS) or four-port single-direction video-assisted thoracic surgery (VATS) right upper lobectomy (RUL), and to discuss the safety and the essentials of the surgery. Methods The clinical data of 579 patients with non-small cell lung cancer (NSCLC) undergoing minimally invasive RUL in Dr. Luo Qingquan’s team of our center from 2015 to 2018 were retrospectively analyzed. There were 246 males and 333 females aged 33-78 years. The 579 patients were divided into a RATS group (n=283) and a VATS group (n=296) according to surgical methods. Baseline characteristics and perioperative outcomes including dissected lymph nodes, postoperative duration of drainage, postoperative hospital stay, postoperative complications and surgery cost were compared between the two groups. Results There was no significant difference in baseline data between the two groups (P>0.05), and no postoperative 30 d mortality or intraoperative blood transfusion was observed. Compared with VATS, RATS had shorter operation time (90.22±12.16 min vs. 92.68±12.26 min, P=0.016), postoperative hospital stay (4.67±1.43 d vs. 5.31±1.59 d, P<0.001) and time of drainage (3.55±1.38 d vs. 4.16±1.58 d, P<0.001). No significant difference was observed between the two groups in the lymph nodes dissection, blood loss volume, conversion rate or complications. The cost of RATS was much higher than that of VATS (93 275.46±13 276.69 yuan vs. 67 082.58±12 978.17 yuan, P<0.001). Conclusion The safety and effectiveness of robot-assisted and video-assisted RUL are satisfactory, and they have similar perioperative outcomes. However, RATS costs relatively shorter operation time and postoperative hospital stay.
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Objective:To explore the effect of invalid reconstruction of proximal triangular structure on clinical failure of proximal femoral fractures treatment.Methods:A retrospective study of patients with femoral neck or intertrochanteric fractures postoperative failures from January 2013 to December 2018 was performed. Fifty-three patients including 26 males and 27 females (31 intertrochanteric fractures and 22 femoral neck fractures) met the inclusion criteria. The mean age of included patients was 55.13 years (range, 18-94 years). Fixation strategies included plate screws (18 cases), cannulated screws (13 cases) and intramedullary nails (22 cases). Medial side, the lateral side and the upper side were defined according to the law of mechanics based on the proximal femoral structure and statistical analysis of the failure factors of reconstruction of different sides were performed based on the imaging data of postoperative failure cases.Results:Nineteen of 53 patients were without medial side reconstruction, 4 cases without lateral side reconstruction, 21 cases without upper side reconstruction, 2 cases without medial or lateral side reconstruction and 7 cases were without medial or upper side reconstruction. Sixteen cases experienced loss of reduction, and 23 cases suffered from nonunion; excessive movement of fixation occurred in 12 cases, and fixation breakage occurred in 2 cases. Indicated by statistical analysis, it was invalid reconstruction of different sides that lead to surgical failure ( P=0.098). Revision strategy: 5 cases were treated with plate-screw fixation, 1 with steel cable binding, 11 with hip replacement, 3 with internal fixation removal, 6 with intramedullary nail replacement, 21 with triangular reconstruction fixation, and 6 cases had not been followed up successfully. Conclusion:Invalid reconstruction of any side of the proximal triangular structure will cause instability of the proximal structure which can lead to the failure of fracture fixation during the treatment of proximal femoral fractures.
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With the development of modern science and information technology,surgery has begun to enter the 4.0 era.The connotation of Surgery 4.0 is to use technology to redefine the relationship between people and information and to reshape the way people communicate.Artificial intelligence,holographic visualization,medical robotics,precision manufacturing,network transmission and cloud technology lay the technical ground for the surgical 4.0 era.Characterized by data,intelligence,precision,high-depersonalization,automation and cloud,surgery 4.0 has opened the era of technology empowering surgeons,certainly bringing fundamental changes to sciences of human health.This article is to look into to the future trends of surgery,hoping to provide references and stimulate more thinking for medical exploration in the age of surgery 4.0.
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Objective: To summarize the evolving concept in treatment of intertrochanteric fractures and the development of internal fixation devices. Methods: Related literature concerning the implant devices to treat intertrochanteric fractures was reviewed and analyzed in terms of the biomechanical characteristics, clinical application, and complications. Results: The treatment of intertrochanteric fractures has undergone an evolving concept from conservative treatment to surgical treatment. Surgery strategies include extramedullary fixation and intramedullary fixation. Intramedullary fixation has gradually become the main treatment of intertrochanteric fractures due to its minimally invasive and biomechanical advantages. However, the current intramedullary fixation system still can not reconstruct the medial cortical support of the proximal femur, which leads to some failures in the treatment of unstable fractures. Conclusion: The development of internal fixation of intertrochanteric fractures is based on the deep understanding and biomechanical theory of intertrochanteric fractures in clinical practice. In the future, the updated design of internal fixation devices will depend on the treatment principle of reconstruction of medial support and secondary stabilization of intertrochanteric fractures, and finally the purpose of improving success rate and reducing postoperative complications of intertrochanteric fracture will achieved.
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Objective To retrospectively analyze the implementation of the antimicrobial agents prescription monthly review at the emergency and outpatient departments for the past five years, for evaluation of its action in promoting rational application of antimicrobial drugs. Methods At the baseline investigation stage, 1780 prescriptions on antibiotics in emergency and outpatient department from June 2012 to November 2012 were randomly selected for centralized evaluation. The period of correction and observation falls into two stages. The first stage ranged from December 2012 to February 2015, when the prescription of antibiotics was sampled manually for monthly review. The second stage ranged from March 2015 to June 2017, when a prescription review software for prescription comment was introduced for the sample purpose. The data so acquired were subject to chi-square test and linear regression analysis using Excel 2010 and SPSS 16. 0. Results The rational rate of prescription for antibiotics at the emergency department increased from 80. 56％ of the baseline stage to 99. 47％ of the second stage (166506/167400), scoring a difference of statistical significance (P<0. 001). With intervention of the prescription review software, the percentage of irrational use of antimicrobial agents dropped by 5. 18％ compared to the baseline stage. Conclusions Monthly prescription review on antimicrobial agents at the outpatient and emergency departments could promote the rational use of antimicrobial agents and play an important role in clinical drug safety. Information system and performance assessment contributed to the effect of prescription review.
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Objective Analyzed surgical outcome following Flex-3D thoracoscopy among 429 cases with lobectomy and segmentectomy in this paper to define its safety and efficacy.Methods From the completion of the Olympus Flex-3D integrated operation room in Shanghai Chest Hospital in June 2015 up to December 2016,a single surgeons team carried out 429 cases of Flex-3D anatomic video-assisted thoracic surgery.Demography,preoperative condition,perioperative period complications and pathology for these patients were analyzed and discussed.Results There was a total of 429 patients including 258 males and 171 females.The age at diagnosis was ranged 21-81 yds.Lobectomy was performed in 313 cases,segmentectomy in 116 cases.Among those with 389 primary malignant tumors,39 benign tumors and 1 MALT were anatomically resected.The mean number of lymph nodes resected was 11.10 ±4.58(1-30) and mean sampled lymph node stations 6.10 ± 1.34(1-10).1patient was converted to thoracotomy because of vessel injury.The average operation time was 98.00 ±24.61 min(range,35-274 min) and the average blood loss was(97.9 ±24.6)ml(range,50-400 ml).The postoperative hospital stay was(5.6 ± 1.3) days on average.There was no operative death,and operative complications occurred in 18 patients(4.1％).The 1-year overall survival and 1-year disease-free survival for the lung cancer group were 100％ and 99.8％,respectively.Conclusion Flex-3D video-assisted thoracic surgery is a safe and effective surgical procedure featured by its added depth perception to facilitate operation and short learning curve.
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OBJECTIVE:To investigate the situation of hospital pharmaceutical administration in China,and provide basis for developing measures in improving the quality and safety of medication in hospitals. METHODS:According to the organization of National Health and Family Planning Commission,National Quality Control Center of Pharmaceutical Administration drafted the re-search indicators,and adopted internet survey to screen,confirm and statistically analyze the data about pharmacy staffing and drug use management of hospitals in 2014 that was completed and reported as requested by the secondary general hospitals and above in each area selected by Health and Family Planning Commission in provinces (cities,districts). RESULTS:The rates of pharmacy technicians in secondary and tertiary general hospitals were 5.2% and 4.4%,the numbers of clinical pharmacists per hundred-bed were 0.42 and 0.44 person,the numbers of dispensing prescription per person in a day were 119 and 173 in pharmacist in outpa-tient;the monitoring rates for key patients were 1.8% and 6.9%,the rates of intravenous infusion in outpatients were 12.8% and 10.1%,and inpatient were 93.1% and 90.4%;the rates of intravenous infusion of antibiotics in inpatients were 51.8% and 44.3%,and the rates of intravenous infusion of TCM were 34.7% and 29.0%,respectively. CONCLUSIONS:The problems exist-ing in pharmaceutical quality administration in China include lacking of pharmacy technicians,large workload,lacking of clinical pharmacists,imperfect pharmaceutical care model,non-standardized choice and use of intravenous infusion,etc. For these prob-lems,it is suggested to increase the propaganda of health education and management efforts of intravenous drugs,equipped with ad-equate pharmacy technicians and clinical pharmacists,continuously improve the quality evaluation system of hospital pharmaceuti-cal administration in China.
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Objective To analyze the views and perceptions of practicing physicians on the practicing environment in the province,in order to provide policy reference for improvement.Methods By means of equi-probability and multi-stage sampling, 3 570 valid questionnaires were collected and analyzed from site survey which consist of the subj ective evaluation,and measures to identify and prevent medical professional risk.Results Overall assessment of the practice environment of physicians in Shanxi province is low,as those holding the environment asniceandacceptableaccounting for 4.8% and 21.7%,only 47.0% of physicians in tertiary hospitals hold the environment as very bad,while only 6.1% of those in level-1 hospitals share this view.92.4% of the physicians surveyed hold compliance of laws and regulations and technical specifications as key to prevention of medical dispute,yet most of them do not expect the media to be obj ective,fair and accurate in their coverage of events.Conclusions It is recommended to strengthen communication with the media for obj ective coverage of the limits of medicine,and explore the mechanism to take care of medical disputes by physicians,and improve their medical risk control capabilities,for a better practicing environment.
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BACKGROUND:Transverse acetabular fracture often involves the damage of anterior and posterior columns of acetabulum. The most popular fixation of the anterior and posterior columns needs the combined anterior and posterior approach. Big trauma is not conducive to patient’s recovery after surgery. Limited incision or percutaneous minimaly invasive lag screw placement can reduce soft tissue injuries, but the strength of the fixation lacks of biomechanical verification. OBJECTIVE: To compare different types of fixations for transverse acetabular fracture, explore the appropriate fixation options that can achieve effective fixation and reduce tissue injury by combing with repair approach and the condition of soft tissue. METHODS: The fourth generation of synthetic semi-pelvic sawbones was set as a template to establish a model of acetabular transverse fracture using finite element analysis. Five different fixation options were used to fix the transverse acetabular fracture. The magnitudes of anterior and posterior displacement of transverse fracture were compared to assess the stability of different options under a simulated condition of incomplete weight bearing stand. RESULTS AND CONCLUSION:The motion at anterior column was minimal when fixed by anterior column locking plate + posterior column screw and the minimum displacement at posterior column was the fixation of anterior column screw + posterior column locking plate. Both of the motions of these two fixations were less than the reconstruction plate fixation respectively. The worst fixation was the anterior column and posterior column lag screw fixation with the largest displacement. The anterior column locking plate + posterior column screw, accomplished by single approach, could not only reduce surgical trauma, but also has a stronger stability. Moreover, this fixation option is effective method to place posterior column lag screw under direct vision and reduce the difficulty of screw implantation.
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Purpose To explore the image quality, radiation dose and diagnostic accuracy of double flash scanning mode in patients with coronary artery stent. Materials and Methods Sixty-three patients with coronary stents underwent CT coronary artery imaging using conventional coronary artery angiography as the gold standard. Double flash mode was used in patients with heart rate ≤ 70 beats per minute. Spiral scanning was used in patients with heart rate between 70-100 beats per minute. The image quality, vascular CT value, noise, SNR and CNR were compared. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were determined, and the radiation dose was calculated. Results There were 59 stents in Double flash group (57 were diagnostic) and 58 stents in spiral group (all diagnostic). There was no statistically significant difference in image quality, CT value, noise, SNR or CNR for the first scan between two groups (P>0.05). Image quality for the second scan in Double flash group showed statistical difference with the first scan and spiral group (P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Double flash and spiral group were 90.0%, 89.8%, 64.3%, 97.8%, 89.8% and 83.3%, 95.7%, 83.3%, 95.7% 93.1%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for stents with diameter ≥ 3.0 mm were significantly higher than stents with diameter <3.0 mm. The radiation doses of Double flash group were significantly lower than the spiral group (P<0.05). Conclusion Double Flash mode scanning provides good image quality and diagnostic accuracy with lower radiation dose in patients with coronary artery stents. Imaging of stents with diameter ≥ 3.0 mm is superior to stents with diameter <3.0 mm.
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10.3969/j.issn.1007-3969.2013.05.006
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Objective To compare the effects of kidney calcium oxalate calculus resistant acidophilus milk (KCOCRAM) versus commercially available acidophilus milk (CAAM) on urinary oxalate excretion in rats. Methods Fifty SD rats were randomly divided into 5 groups (n=10), and were bred with KCOCRAM (KCOCRAM group), CAAM (CAAM group), sterilized KCOCRAM (sterilized KCOCRAM group), sterilized CAAM (sterilized CAAM group) and water (blank control group), respectively for a consecutive 20 d, with 4 mL/d for each rat. The data of body weight and 24 h urinary oxalate excretion volume were obtained 1 d before breeding and every 4 d during breeding. Results During breeding, body weight and 24 h urinary oxalate excretion volume of each group increased with time. There was no significant difference in urinary oxalate excretion volume among sterilized KCOCRAM group, sterilized CAAM group and blank control group (P>0.05). The increase tendency of KCOCRAM group and CAAM group was weaker than that of the other three groups. The urinary oxalate excretion volume was significantly lower in KCOCRAM group than that in sterilized KCOCRAM group from 8 d after breeding, and that was significantly lower in CAAM group than that in sterilized CAAM group from 12 d after breeding (P<0.05). The urinary oxalate excretion volume was significantly lower in KCOCRAM group than that in CAAM group from 16 d after breeding (P<0.05). There was a positive correlationship between body weight and 24 h urinary oxalate excretion volume in each group (r＝0.97-0.99, P<0.01). Conclusion Both KCOCRAM and CAAM can reduce urinary oxalate excretion in rats, and the former has a more favourable effect.