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Objective:To evaluate correlation between left ventricular mechanical contraction synchrony and left ventricular systolic function by gated myocardial perfusion imaging(GMPI) using Cadmium-Zine-Telluride (CZT) SPECT.Methods:Three hundred and forty three consecutive patients( 232 males, 111 females, age (60.08±12.88) years) who underwent CZT SPECT GMPI in Shanxi Cardiovascular Hospital between January and August 2019 were retrospectively analyzed. The Emory cardiac toolbox was used to process the imaging data, and the left ventricular systolic synchrony parameters and systolic function parameters were acquired, including peak phase(PP), phase standard deviation (PSD), phase histogram bandwidth(PHB), histogram skewness(HS), histogram kurtosis(HK), and end-diastolic volume( EDV), end-systolic volume (ESV), left ventrieular ejection fraction (LVEF). All patients were divided into 4 groups: the normal group (147 cases), ischemic cardiomyopathy group (114 cases), nonischemic cardiomyopathy without left bundle branch block (LBBB) group(50 cases)and nonischemic cardiomyopathy with LBBB group(32 cases). The relationship between systolic synchrony parameters and systolic function parameters were analyzed with Pearson correlation analysis.Results:Statistic results for all patients showed that PSD and PHB were well correlated with LVEF( r values: -0.790, -0.799, both P<0.01), but PP was poorly correlated with LVEF( r=-0.194, P<0.01); HS, HK were positively correlated with LVEF( r values: 0.767, 0.676, both P<0.01); PSD, PHB were positively correlated with ESV( r values: 0.778, 0.795, both P<0.01) and EDV ( r values: 0.722, 0.732, both P<0.01); but PP was poorly correlated with ESV( r=0.145, P<0.01) and not correlated with EDV ( r=0.095, P>0.01). HS, HK were negatively correlated with EDV and ESV ( r values: -0.700 to -0.580, all P<0.01). PSD and PHB showed negatively correlation with LVEF ( r values: -0.834 to -0.492, all P<0.01), while HS, HK showed positive correlation with LVEF ( r values: 0.243-0.792, all P<0.01) in normal group, the ischemic cardiomyopathy group, the nonischemic cardiomyopathy without LBBB group and the nonischemic cardiomyopathy with LBBB group. Conclusions:The left ventricular systolic synchrony parameters provided by CZT SPECT GMPI correlate well with the left ventricular systolic function parameters, and the worse systolic function, the worse systolic synchrony. Both ischemic cardiomyopathy and non-ischemic cardiomyopathy can affect left ventricular mechanical contraction synchrony, and the effect on contraction synchrony in non-ischemic cardiomyopathy patients with LBBB is greater.
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Objective To investigate the clinical value of snapshot assist (SSA) of the gemstone CT in prospective ECG-gated coronary artery angiography in reducing radiation dose.Methods A total of 59 patients with prospective ECG-gated coronary angiography were enrolled,who were divided into SSA group and routine group.The SSA group was scanned with SSA technique.The difference were compared between SSA group and conventional group in image quality,dose length product (DLP) and effective dose (ED).Results There was no significant difference of image quality scores between the two groups (x2 =2.362,P=0.307).There was also no significant difference in the mean CT value of the aorta root between the two groups (Z=-0.061,P 0.951).While the differences of noise,CNR and SNR were statistically significant (all P＜0.05).The DLP and ED of SSA group were (135.44±37.41)mGy · cm and (1.89±0.52)mSv.And the DLP and ED of routine group were (275.57 ±36.59)mGy · cm and (3.85 ±0.51)mSy.There were significant differences between the two groups (t=14.504,P＜0.01).The ED reduced about 50.85％ in SSA group compared with that in routine group.Conclusion The SSA technology can reduce the effective radiation dose of patients in prospective ECG gated coronary angiography,and has a high clinical value.
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Objective The clinical effect of the lateral femoral cutaneous artery flap for soft tissue defects of leg wounds. Methods From October 2007 to January 2016, VSD was firstly used to promote the growth of granulation tissue. When the growth of granulation tissue became satisfactory, flaps were designed based on the anatomical characteristics of the lateral femoral cutaneous artery. We repaired 20 cases of wound defects by cutting flaps that coincide with the recipient vessels. Result 20 cases were followed up for 6 to 24 months, 12 months on average. All flaps were survived and only one case had small area of necrosis flap which was healed by replacing medicines. In all cases, wounds were healed and flaps showed good color and good texture. The strength of quadriceps muscle was good and the extension of knee flexion was 0° to 150°. Conclusion To The lateral femoral cutaneous artery flap is used for soft tissue defects of refractory wounds on leg , flap donor sites are sutured directly, the treatment period is shorten and the method is safe and effective. The lateral femoral cutaneous artery flap is one of ideal choices for wound tissue defects.
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BACKGROUND:Open fracture of lower limb with severe soft tissue and bone defects also accompanies anterior tibial soft tissue defects and exposure of sclerotin and steel plate, which can be crucial y treated with strong fixation and use of skin flap to block the wound. OBJECTIVE:To explore the clinical efficacy of a large area of soft tissue defects in the anterior tibia using vacuum sealing drainage combined with groin free flap. METHODS:A total of 24 patients with a large area of soft tissue defects in the anterior tibia were included in this study and then divided into two groups, with 12 cases in each group. In vacuum sealing drainage group, the scope of soft tissue defects was ranged from 10 cm×15 cm to 15 cm×20 cm. After the debridement, the fracture was fixed with external fixation scaffold and the wound was covered with the vacuum sealing drainage dressing. The blood clot was rinsed with normal saline via T-tube, and 7-10 days later the vacuum sealing drainage was given. According to the growth of granulation tissue, the wound was secondarily sutured, fol owed by groin free skin flap of superficial iliac circumflex artery with medial knee arteriovenous anastomosis transplantation. In the non-vacuum sealing drainage group, the wound size was ranged from 10 cm×5 cm to 30 cm×20 cm, the period from injury to admission was 1-24 hours. They were given conventional debridement and secondary fixation or skin flap transplantation. RESULTS AND CONCLUSION:The length of preoperative hospital stay and the skin flap are in vacuum sealing drainage group were significantly better than those in non-vacuum sealing drainage group (P0.05). The wound infection rate was 0 in vacuum sealing drainage group and 75%in non-vacuum sealing drainage group at 8-14 days after treatment. The wound and donor area incision were healed at I stage, the skin grafts survived. Al the involved patients in two groups were fol owed up, for 6-36 months. During the fol ow-up process, the fracture healing time in non-vacuum sealing drainage group was significantly longer than that in vacuum sealing drainage group. The skin flap in two groups was similar to surrounding skin in color and texture, the flap exhibited no vessels, no ulceration, and no clumsy. The vacuum sealing drainage combined with groin free flap can timely control a large area of soft tissue defects post-trauma, improve wound blood supply, shorten preoperative preparation time, early close the wound, significantly promote the healing of wound and fracture. The skin flap is soft, flexible, wel-looking, and active functional, it significantly shortens the course of treatment and maximizes the recovery of limb function.
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10.3969/j.issn.2095-4344.2013.26.023