Overview and prospects of an in vitro cell model for studying liver fibrosis / 中华肝脏病杂志

Liver fibrosis incidence and adverse outcomes are high; however, there are no known chemical drugs or biological agents that are specific and effective for treatment. The paucity of a robust and realistic in vitro model for liver fibrosis is one of the major causes hindering anti-liver fibrosis drug development. This article summarizes the latest progress in the development of in vitro cell models for liver fibrosis, with a focus based on the analysis of induction and activation of hepatic stellate cells, cell co-culture, and 3D model co-construction, as well as concurrent potential methods based on hepatic sinusoidal endothelial cell establishment.

Reference values for carotid artery intima-media thickness among community adult dwellers in Shenzhen City / 中华预防医学杂志

Objective: To establish reference values for carotid intima-media thickness (CIMT) of adult dwellers in Shenzhen City. Methods: The study was conducted based on the Shenzhen heart failure epidemiological survey from 2021 to 2022. In this survey, residents aged 18 years and above in Shenzhen were selected by using a multi-stage stratified random sampling method. General information, cardiovascular disease (CVD) related behavior and carotid ultrasound examination and etc. were collected from the participants. People with CVD factors, a history of atherosclerotic cardiovascular disease, carotid plaque or having no carotid ultrasound examination results were excluded. The parameter regression model based on fractional polynomial was used to establish the reference values of CIMT by age and sex. Results: A total of 2 163 healthy individuals were enrolled in the final analysis, including 576 males (26.6%) and 1 587 females (73.4%). The fractional polynomial regression of the CIMT mean and standard deviation was obtained. For men, the regression was meanCIMT=0.324 7+0.006 9×age and SDCIMT=0.076 9+0.001 2×age. For women, the regression was meanCIMT=0.354 9+0.005 4×age and SDCIMT=0.041 6+0.002 0×age. Conclusion: The age and sex reference values for CIMT of adult people in Shenzhen established in this study could provide the latest reference standards for early screening of subclinical CVD.

The effects of robotic-assisted versus laparoscopic-assisted radical right hemicolectomy on short-term outcome and long-term prognosis based on propensity score matching / 中华外科杂志

Objective: To compare the short-term and long-term outcomes between robotic-assisted and laparoscopic-assisted radical right hemicolectomy in patients with adenocarcinoma of the right colon. Methods: Retrospective review of a prospectively collected database identified 288 right colon cancer patients who underwent either robotic-assisted (n=57) or laparoscopic-assisted right hemicolectomy (n=231) between October 2014 and October 2020 at Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University. There were 161 males and 127 females, aging (60.3±12.8) years (range: 17 to 86 years). After propensity score matching as 1∶4 between robotic-assisted and laparoscopic-assisted right hemicolectomy, there were 56 cases in robotic group and 176 cases in laparoscipic group. Perioperative outcomes and overall survival were compared between the two groups using t test, Wilcoxon rank sum test, χ2 test, Fisher exact test, Kaplan-Meier method and Log-rank test, respectively. Results: The total operative time was similar between the robotic and laparoscopic group ((206.9±60.7) minutes vs. (219.9±56.3) minutes, t=-1.477, P=0.141). Intraoperative bleeding was less in the robotic group (50 (20) ml vs. 50 (50) ml, Z=-4.591, P<0.01), while the number of lymph nodes retrieved was significantly higher (36.0±10.0 vs. 29.0±10.1, t=4.491, P<0.01). Patients in robotic group experienced significantly shorter hospital stay, shorter time to first flatus, and defecation (t: -2.888, -2.946, -2.328, all P<0.05). Moreover, the overall peri-operative complication rate was similar between robotic and laparoscopic group (17.9% vs. 22.7%, χ²=0.596,P=0.465). The 3-year overall survival were 92.9% and 87.9% respectively and the 3-year disease-free survival rates were 83.1% and 82.6% with no statistical significance between the robotic and laparoscopic group (P>0.05). Conclusions: Compared to laparoscopic-assisted right hemicolectomy, robot-assisted right hemicolectomy could improve some short-term clinical outcomes. The two procedures are both achieving comparable survival.

A feasibility study on calculating individualized scheme of dose of iodine contrast medium in enhanced abdominal CT imaging based on liver volume measurement / 中华放射学杂志

Objective:To explore the feasibility and value of individualized scheme of dose of iodine contrast medium in enhanced abdominal CT imaging based on liver volume (LV) measurement.Methods:The examination data and technical parameters of 64 patients, who underwent multi-phase dynamic enhanced abdominal CT imaging from February to September 2019 at First People's Hospital of Yunnan Province were retrospectively analyzed. The density of liver on CT pre-contrast images and post-contrast images, LV and average iodine content in the liver (AII) of all subjects were measured. The difference of liver density (ΔHU), total iodine dose of contrast agent injected (IM) and total intrahepatic iodine (TII) were calculated. Pearson correlation analysis was performed to evaluate the association between AII and ΔHU, as well as IM and TII. The difference between the injection volume of contrast agent predicted by the formula and the actual injection volume of contrast agent was tested by paired t test. Results:The ΔHU and AII showed highly positive correlation ( r=0.926, P<0.05). The regression equation was Y AII=0.034X ΔHU+0.296. The TII showed significantly positive correlation with the IM ( r=0.759, P<0.05), and the regression equation was Y IM=3.649X TII+16 486.754. With the liver enhancement ΔHU=50 HU as a reference, the individually dose of contrast medium injection could be deducted based on LV, with Y IM=7.225X LV+ 16 486.754. This formula was introduced into all the subjects to calculate the predicted value of contrast agent application, and the calculated injection volume of contrast agent was (64.27± 4.92) ml. Paired t test was conducted to compare the predicted injection volume of contrast agent with the actual injection volume of contrast agent, and the difference was statistically significant ( t= 6.009, P<0.05). Conclusion:The feasibility of calculating individualized scheme of contrast agent based on LV in enhanced abdominal imaging is verified. This method can be used to predict the enhancement level of liver and to reduce the dosage of iodine contrast agent.

Comparison of visual quality between bifocal and trifocal intraocular lens implantation / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the visual quality of bifocal(AT LISA 809MP)and trifocal(AT LISA tri 839MP)IOLs after implantation.<p>METHODS: Retrospective study. A total of 49 eyes of 28 patients with cataract who underwent phacoemulsification combined with multifocal IOL implantation from March 2018 to February 2019 were collected. There were 30 eyes of 18 patients in the bifocal group, aged 40-85(mean 67.08±10.80)years. The trifocal group consisted of 19 eyes of 10 patients, aged 38-79(mean 62.21±14.50)years. All patients underwent visual quality analysis system(OQAS), defocus curve and other examinations.<p>RESULTS: The near BCVA of the two focus groups was better than that of the three focus groups, and the medium UCVA and far BCVA of the three focus groups were better than those of the two focus groups(all <i>P</i><0.05). The trifocal group had better visual acuity at +1.5, -1.0, -1.5, -2, -2.5D and -3.0D defocus than the bifocal group. OQAS visual quality parameters were better in the two-focus group than in the three-focus group in OV 20%, OV 9%, and SR(all <i>P</i><0.05).<p>CONCLUSION: Both bifocal and trifocal IOL implantation can achieve good uncorrected and near visual acuity and high visual quality, while trifocal IOL can achieve better intermediate visual acuity.

Comprehensive performance evaluation of immunocolloidal gold qualitative rapid detection kits based on AHP-FCE method / 上海预防医学

Objective To establish a scientific and objective evaluation model of the comprehensive performance of immunocolloidal gold qualitative rapid detection kits, and to provide a reference for the overall evaluation of similar products. Methods Based on the various factors affecting the performance of qualitative rapid detection kits, a comprehensive performance evaluation index system consisting of 4 first-level indicators and 18 second-level indicators was constructed.The analytic hierarchy process (AHP) and the fuzzy comprehensive evaluation (FCE) method were combined to determine the weights for the evaluation indicators and graded thresholds.The model was then used to evaluate the performance level of 6 brands of furazolidone metabolite rapid test kits. Results According to maximum membership degree principle, the evaluation of brand A, B, C, D, E and F were graded as good, excellent, middle, excellent, middle and excellent, respectively.Then the scores of 6 brands were calculated according to the hundred-mark system, and brand B had the highest score.This was consistent with the actual use experience. Conclusion The application of this model can make the evaluation results more comprehensive and accurate, providing reference for rational evaluation and selection of qualitative rapid detection kits.

Anatomical relationship between fascia propria of the rectum and visceral pelvic fascia in the view of continuity of fasciae / 中华胃肠外科杂志

Objective@#To perform an anatomical observation on the extension of the mesocolon to the mesorectum and the continuity of the fasciae lining the abdomen and pelvis, in order to clarify the appropriate surgical plane of total mesorectal excision.@*Methods@#This is an descriptive study. The operation videos of 61 cases (28 males, 33 females, median age of 61) were collected. All the patients underwent laparoscopic colorectal surgery from January 2018 to December 2018 in Yangpu Hospital, including low anterior resection for rectal cancer in 25 cases, left hemicolectomy for descending colon cancer in 15 cases, and subtotal resection of the colon for intractable constipation in 21 cases. Among these 21 constipation patients, 8 received additional modified Duhamel surgeries. Gross anatomy was performed on 24 adult cadavers provided by Department of Anatomy, Shanghai Jiaotong University School of Medicine, including 23 formalin-fixed and 1 fresh cadaver (12 males, 12 females). Sixty-one patients and 24 cadavers had no previous abdominal or pelvic surgical history. The anatomy and extension of fasciae related to descending colon, sigmoid colon and rectum, especially the morphology of Toldt fascia, and the continuities of mesocolon and mesorectum were observed carefully. The distribution characteristics of the fasciae and anatomical landmarks during laparoscopic surgery were recorded and described.@*Results@#The anatomical study on 24 cadavers showed that visceral fascia was the densest connective tissue in the pelvic, posterolateral to the rectum, and stretched as a hammock to lift all pelvic organs. Among 61 patients undergoing laparoscopic surgery, 36 (59.0%) needed to free the left colon during operation, and Toldt fascia in the descending colon segment presented as potential, avascular and extensible loose connective tissue plane between the mesocolon and posterior Gerota fascia; 33 (54.1%) needed to free the rectum during operation, and Toldt fascia extended downward to pelvis as loose connective tissue between the fascia propria of the rectum and visceral fascia; the fascia propria of the rectum exposed completely in 32 (32/33, 97.0%) cases, which ran downward and fused with visceral fascia at the level of the fourth sacral vertebra. The anatomy of 24 cadavers also showed that fascia propria of the rectum fused with visceral fascia at the level of Waldeyer fascia. The fusion line of these two fasciae was supposed to be the extension of Waldeyer fascia. There were two avascular planes behind the rectum: one between the fascia propria of the rectum and visceral fascia, and the other between the visceral fascia and parietal fascia. In 8 constipation cases undergoing laparoscopic subtotal colon resection plus modified Duhamel operation, both mesocolon and mesorectum needed to be mobilized. It was obvious that the mesocolon of descending colon extended and became the mesocolon of sigmoid colon, and ran further into the pelvic and became the mesorectum. The colon fascia of descending colon served as the natural boundary of mesocolon extended downward as the fascia of sigmoid colon and the fascia propria of the rectum, respectively. Toldt fascia locating between mesocolon of descending colon and Gerota fascia extended to pelvis as the 'presacral space’ between the fascia propria of the rectum and visceral fascia. Gerota fascia in descending colon segment extended as urogenital fascia in sigmoid colon segment and visceral fascia in the pelvis, respectively. In the cadaver anatomy study, the visceral fascia served as a corridor carrying the hypogastric nerve, and ureter was observed in 23 (23/24, 95.8%) cases. The visceral fascia passed from posterior to anterior lateral of rectum, fusing with Denonvilliers fascia in a fan shape. The pelvic plexus located exactly external to the junction of visceral fascia and Denonvilliers fascia. Pelvic splanchnic nerves went through the parietal fascia toward to the inferolateral of the pelvic plexus.@*Conclusion@#Fascia propria of the rectum and the visceral pelvic fascia are two independent layers of fascia, and the TME surgical plane is between the fascia propria of the rectum and visceral pelvic fascia instead of between the visceral and the parietal pelvic fascia.

Hot issues in diagnosis and treatment of thoracolumbar fractures / 中华创伤杂志

In recent years,the surgical treatment of thoracolumbar fractures has made great progress.The thoracolumbar injury classification and severity score (TLICS) of thoracolumbar injuries and the new AO classification,as the most widely used classification score in clinical application,have a clear guiding significance for clinical treatment and scientific research.With the extensive application of CT and MRI,the divergence in the diagnosis of posterior ligament complex (PLC) injury in scoring systems has been narrowed.With the wide application of pedicle screw and the deeper understanding of the anatomical and mechanical characteristics of spine,posterior pedicle screw fixation has been gradually adopted as the major method,while anterior or posterior pedicle screw fixation is only used in special cases.Because of the in-depth study of pedicle screw mechanics,more and more attention has been paid to the fixation of injured vertebrae.Moreover,with the intensive study of sagittal balance of the spine,the reconstruction of injured vertebrae has been proposed as a new concept and further investigated.The author discusses thoracolumbar fracture scoring system,surgical approach,surgical fixation segment,bone graft reconstruction and minimally invasive treatment so as to provide some reference.

Clinicopathological characteristics and prognosis analysis of 217 patients with carcinoma in the remnant stomach / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinicopathological features and prognostic factors of carcinoma in the remnant stomach (CRS).</p><p><b>METHODS</b>Clinicopathological data of 217 consecutive CRS patients from January 2000 to March 2017 at Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University were retrospectively analyzed. CRS was defined as the primary cancer arising from the remnant stomach following gastrectomy, regardless of the initial disease or operation, and at no special time interval. The clinicopathological features and treatment were compared between CRS after benign disease operation (CRS-B) group and CRS after gastric cancer operation (CRS-C) group, and factors influencing prognosis were analyzed using Cox regression model analysis.</p><p><b>RESULTS</b>Of 217 patients, 189 were male and 28 were female with mean age of (60.9±11.2) years. The interval between the first and the second operations was (18.3±15.1) years. The CRS-B group comprised 108 patients and the CRS-C group comprised 109 patients. Compared to CRS-C group, CRS=B group had higher ratio of male [92.6% (100/108) vs. 81.7% (89/109), χ=5.779, P=0.016], longer interval [30(25-40) years vs. 4(1.5-8.0) years, Z=-1.685, P=0.000], longer tumor diameter [(5.9±3.2) cm vs. (3.9±2.4) cm, t=3.390, P=0.000] and later tumor stage [patients in stage I(, II(, III(, and IIII(: 6 (8.0%), 14 (18.7%), 41 (54.7%), and 14 (18.7%) vs. 16 (25.4%), 14 (22.2%), 21(33.3%), and 12(19.0%), respectively, Z=-2.018, P=0.044]. A total of 138 patients underwent surgery, including 118(85.5%) patients of curative resection and 20(14.5%) patients of palliative resection. The other 79 patients did not receive surgery due to extensive metastasis or miscellaneous reasons. Among 138 patients receiving surgery, 3 patients underwent endoscopic resection, 6 patients underwent minimally invasive surgery (laparoscopy or robot), and 129 patients underwent laparotomy. Forty-eight patients underwent surgery involving combined resection. The median postoperative hospital stay was 10(8-14) days. The incidence of postoperative complication was 23.2%(32/138). A total of 91 patients were followed up for 7-120 months, including 51 patients in CRS-B group and 40 in CRS-C group. The overall 1-, 3-, and 5-year survival rates of the 75 patients receiving curative resection were 80.7%, 55.1%, and 41.6%, respectively. The overall 1-, 3-, and 5-year survival rates were 73.5%, 48.3%, and 29.0% respectively in CRS-B group and 83.1%, 51.2%, and 32.5% respectively in CRS-C group. There was no significant difference between two groups (P=0.527). Multivariate analysis showed that age (RR=1.879, 95%CI: 1.015-3.479, P=0.045), radical procedure (RR=2.956, 95%CI: 1.421-6.150, P=0.004) and TNM stage (RR=1.570, 95%CI: 1.047-2.354, P=0.029) were independent prognostic factors for CRS.</p><p><b>CONCLUSIONS</b>As compared to the CRS-C group, the CRS-B group has higher percentage of male, longer interval, larger tumor diameter and later TNM stage. Radical resection indicates better prognosis.</p>

Application of MRI in diagnosis of transient dislocation of patella / 中国骨伤

<p><b>OBJECTIVE</b>To explore the diagnostic value of MRI in the transient dislocation of the patella.</p><p><b>METHODS</b>The DR and MRI data of 35 patients with acute patellar transient dislocation from January 2015 to December 2017 were retrospectively analyzed, including 12 males and 23 females, ranging in age from 10 to 23 years old, with an average of 17 years old. The differences between DR and MRI diagnosis and surgical or discharge diagnosis were compared, and the difference between them in diagnosis of knee anatomical position, bone injury, signs and soft tissue injury were compared. The R statistical software WiLcoxon signed rank test (WiLcoxon signed rank test) was used for statistical analysis.</p><p><b>RESULTS</b>All 35 MRI findings were completely consistent with postoperative or discharge diagnosis. According to MRI, 7 cases of high patella and 7 cases of patella subluxation were diagnosed. According to DR, 7 cases of high patella and 0 cases of patella subluxation were diagnosed. Fourteen dislocations were diagnosed by MRI and 7 dislocations were diagnosed by DR. There was statistically significant difference between the two methods in the diagnosis of abnormal position of patella(=10, <0.05). Total 112 cases of bone injuries were diagnosed by MRI, and 0 was diagnosed by DR. There was statistically significant difference between the two methods in the diagnosis of bone injuries(=16, <0.05). Total 43 cases of soft tissue injuries were diagnosed by MRI, and 0 was diagnosed by DR. There was statistically significant difference between the two methods in the diagnosis of soft tissue injuries (=21, <0.05). Total 35 cases of hydrops of the knee joint were diagnosed by MRI, and 30 were diagnosed by DR. There was statistically significant difference between the two methods in the diagnosis of hydrops of the knee joint(=32, >0.05).</p><p><b>CONCLUSIONS</b>MRI is superior to DR in the diagnosis of acute temporal bone dislocation. MRI should be used as the first choice for imaging diagnosis of acute temporal bone dislocation. It can avoid missed diagnosis and misdiagnosis.</p>

Effect of IFN-α on Cytokines in Serum of Patients with Chronic Myeloid Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of IFN-α on cytokines in serum of patients with chronic myeloid leukemia(CML).</p><p><b>METHODS</b>Fifty patients with CML from March 2012 to December 2015 in our hospital were randomly divided into routine treatment group (n=25) and combined treatment group (n=25), 30 healthy persons were selected as control (control group). The CML patients in routine treatment group were given orally hydroxyurea, the CML patients in combined treatment group were treated with recombinant human interferon α2b injection based on routine treatment (hydroxyurea plus IFN-α group). The levels of ALP, IL-6, PGE-2, MMP-2, and bFGF in serum were detected by ELISA. The cytogenetic, molecular and hematologic responses of patients in routine treatment group and combined treatment group, including patients in chronic and accelerated blastic phases were compared after 6 weeks of treatment.</p><p><b>RESULTS</b>The servum levels of ALP, IL-6, PGE-2, MMP-2 and bFGF in CML patients with chronic and accelerated blastic phases all were higher than those in control group(P<0.05). The levels of MMP-2 and bFGF in CML patients with chronic phase were highr than those of CML patients with accelerated blastic phase (P<0.05), the levels of ALP, PGE-2 and IL-6 of patients with chronic phase were significantly lower than those of patients in accelerated blastic phase (P<0.05). The ALP, IL-6, PGE-2, MMP-2 and bFGF levels in combined treatment group were significantly lower than those in the routine treatment group after 2 weeks and 6 weeks of treatment(P<0.05); After the end of treatment, the CHR of routine treatment group was 56%, which was lower than that of combined treatment group 84%(χ=18.667, P<0.001); the CCyR of routine treatment group was 32% which was significantly higher than 12% in combined treatment group(χ=11.655, P<0.001); the CMR of routine treatment group was 12% that was significantly higher than 4% in combined treatment group (χ=4.347, P=0.037). The median survival time of routine treatment group was significantly shorter than that of the combined treatment group, but there was no significant difference during follow-up (P>0.05).</p><p><b>CONCLUSION</b>IFN-α can alleviate the symptoms of patients with CML and inhibit the process of disease with CML patients, effectively inhibit the expression of disease-related cytokines.</p>

Overexpression of SIRT1 is a poor prognostic factor for advanced colorectal cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Sirtuin 1 (SIRT1) has been reported to have diverse roles in various biological processes through deacetylation of histone and nonhistone proteins. However, the correlations among SIRT1 protein expression, clinicopathological parameters, and survival of colorectal cancer patients remain unclear.</p><p><b>METHODS</b>SIRT1 protein expression was measured by immunohistochemistry in a paraffin-embedded tissue microarray, including 120 paired colorectal cancer and normal mucosa tissues. The correlations among SIRT1 protein expression, clinicopathological features, and prognosis were analyzed.</p><p><b>RESULTS</b>All samples (100%) were positive for SIRT1, with variable staining in the cytoplasm rather than in the nucleus. There was significant difference in SIRT1 overexpression between adenocarcinomas and normal mucosal tissue (P < 0.01, χ(2) test). SIRT1 overexpression was more frequently observed in advanced-stage tumors (P = 0.046, 0.002, χ(2) test). SIRT1 overexpression was significantly correlated with poor overall survival (P = 0.013, log-rank test) and diseasefree survival (P = 0.012, log-rank test).</p><p><b>CONCLUSIONS</b>SIRT1 overexpression correlated with advanced stage and poor prognosis. SIRT1 may play an important role in the progression of colorectal cancer.</p>

Efficacy of intravascular ultrasound guided rotational atherectomy for heavily calcified coronary lesions / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of intravascular ultrasound guided tranradial rotational atherectomy (RA) followed by drug eluting stent (DES) implantation in treating patients with heavily calcified coronary lesions.</p><p><b>METHODS</b>Clinical characteristics, coronary angiogram, intravascular ultrasound images, peri-procedure and follow-up data (including death , myocardial infarction and target lesion revascularization) of 44 patients treated with RA and DES implantation under the guidance of IVUS in our department from March 2011 to March 2013 were retrospectively analyzed. IVUS examination was carried out before RA, after RA and stent implantation to guide whether further RA or post dilatation was needed. According to the arc of calcification, the patients were divided into group A (90°-270°, 18 cases) and group B (271°-360°, 26 cases).</p><p><b>RESULTS</b>In A and B group, the arc of calcification was (195 ± 71)° in group A and (345 ± 23)° in group B (P < 0.01) , length of calcification was (34.4 ± 11.8) mm in group A and (20.0 ± 6.6) mm in group B (P < 0.05). Number of burrs used and size of largest burr used were similar between 2 groups (both P > 0.05). Acute cross sectional area gain after RA was (0.43 ± 0.32) mm in group A and (0.53 ± 0.38) mm² in group B (P > 0.05). After RA, there was significant decrease in the arc of calcification in group B compared with baseline ((324 ± 52)° vs. (345 ± 23)°, P < 0.05). The minimal lumen area and diameter were significantly increased after RA resulting in significant decrease in the plaque burden in both groups (all P < 0.05). The final minimal lumen area after stenting were similar between 2 groups (P > 0.05). Procedure success rate was 100% (44/44) without any major complications such as death, acute myocardial infarction and coronary perforation. During the (16.6 ± 6.3) months follow-up, there was 1 death in group A, 1 target lesion revascularization in group B and there was no acute myocardial infarction in the 2 groups.</p><p><b>CONCLUSION</b>Heavily calcified coronary lesions can be effectively and safely treated by transradial RA under the guidance of IVUS.</p>

Assessment of aortic stenosis with dual-source CT / 中华放射学杂志

Objective To discuss the feasibility and accuracy of dual-source CT ( DSCT) in the evaluation of aortic stenosis ( AS) with transthoracic echocardiography ( TTE) as reference.Methods A total of 53 patients who underwent both DSCT and TTE were prospectively evaluated.All of them were assessed by TTE for aortic stenosis.Maximum aortic valve area ( AVA) in systolic phase was measured with DSCT , and was compared to that index obtained from the continuity equation on TTE.The severity of AS was graded as mild , moderate , or severe according to the AVA.Linear regression analysis and Bland-Altman plots were used to compare the AVA measured by using CT and TTE.Agreement on semi-quantitative grades of AS severity between the two methods was tested by using Kappa statistics.Results The mean AVA using DSCT was (1.45 ±0.35 ) cm2 compared to the mean AVA of ( 1.33 ±0.36 ) cm2 using TTE, with a significant correlation between them (r=0.92,P<0.01).Bland-Altman analysis demonstrated good inter-modality consistency between DSCT and TTE.However , DSCT demonstrated a slight overestimation of the AVA compared to TTE.As identified by TTE, there were 53 patients with AS, 13 with mild AS, 21 with moderate AS , and 19 with severe AS.In 3 patients DSCT showed no AS , TTE detected mild AS.In 6 cases, TTE had graded the stenosis as moderate , but the stenosis degree was graded as mild using DSCT.Kappa analysis showed a good agreement between the two methods on semi -quantitative grades of aortic stenosis severity (Kappa=0.75,P<0.01).Conclusion AVA measurements using DSCT is feasible and reasonably accurate for those patients with moderate to severe aortic stenosis.

Observation of clinical efficacy of intertrochanteric fracture of aging patients treated with hip replacement / 中国基层医药

Objective To investigate effects of cemented hip arthroplasty applied to treat intertrochanteric fracture of aging patients.Methods 21 cases of clinical data of patients with intertrochanteric fracture treated with cemented hip arthroplasty were retrospectively analyzed,and hip functions were evaluated according to Harris grading.Results The mean time of surgery was (42.2 ± 8.6) main,mean blood loss was (597 ± 83) ml,mean time of hospital stay(specialist hospital stay not included) was (16.5 ± 1.7) days,all cuts were primary healing,and mean time of healing was (15.7 ± 0.2)days.After operation 5 parents had respiratory tract infection and improved by symptomatic anti-inspection therapy.3 cases had deep vein thrombosis and improved by inferior vena cava filter input and thrombolysis therapy.1 case had dislocation after cemented hip hemiarthroplasty and improved by legs brace booth outside fixed for 3month.21 cases had following up for 6 months after operation.All fractures were cured,without any osteolysis,loosening of the prosthesis or heterotopic ossification.65 ～ 89 scores by Harris hip function grading,and the mean score was 74.1.13 cases were good,7 cases less than ideal and 1 case poor.Conclusion Cemented hip arthroplasty is an effective method to treat intertrochanteric fracture of aged patients.After operation,the patients can do early activity and have long-term good function recovery.