Pretreatment Effects of Cutting Balloon on Coronary Artery Calcification Based on Finite Element Analysis / 医用生物力学

Objective To investigates the applicability of cutting balloon in the pretreatment of superficial coronary artery calcified lesions, so as to decrease the occurrence of serious consequences in the treatment of calcified lesions. Methods The effect of cutting balloon on calcified plaques with different curvatures, thickness, and length was analyzed using the finite element method, with normal balloon as a control. The thickness of calcified plaque was set to 0.3 mm and 0.4 mm, and the length was set to 2 mm and 4 mm. The calcification degree was set to 120°, 180°, 270°and 360° according to the intravenous ultrasound (IVUS) calcification severity grading, with a total of 16 types of calcified plaques. The brittle fracture module was used to simulate calcification fracture of calcified plaques, and virtual stent implantation was carried out based on pretreatment simulation. The effect of pretreatment was evaluated by calcification fracture condition and stent roundness. Results For superficial calcification lesions, in lesions less than 120°, the balloon could not remove the calcification plaque obstruction, and the stent roundness rate was 82.75%. In 180° calcified lesions with thickness of less than 0.3 mm, the calcification was broken by cutting balloon under 1 215.9 kPa expansion pressure, and the post-stent roundness rate was 74.42%; normal balloon could not cause calcification fracture under safe expansion pressure (1 418.55 kPa). In 270°calcified lesions with thickness less than 0.3 mm, the normal balloon produced 3 fractures under 1 013.25 kPa expansion pressure. The cutting balloon produced 2 fractures under 1 013.25 kPa expansion pressure, and the balloon could not fracture the circular calcified lesions with thickness of 0.3 mm. Conclusions Cutting balloon is recommended for 180°calcified lesions with thickness less than 0.3 mm, the normal balloon is recommended for 270°calcified lesions, and balloon pretreatment is not recommended for annular lesions with thickness greater than 0.3 mm.

Cardiac Surgery through Upper Hemi Sternotomy and Pulmonary Trunk Incision for Calcified Amorphous Tumor in Right Ventricular Outflow Tract / 日本心臓血管外科学会雑誌

A 35-year-old man was followed up for systemic lupus erythematous with antiphospholipid antibody-positive. He underwent an echocardiogram for a closer examination of his heart murmur. Transthoracic echocardiography revealed a calcified mass of 30 mm in diameter in the right ventricular outflow tract. Surgery was performed through an upper hemi-sternotomy. After establishment of beating-heart cardiopulmonary bypass, the pulmonary trunk was opened with a longitudinal incision. The highly calcified mass was located immediately below the pulmonary valve. We exfoliated the mass from the right ventricle, and resected it en bloc during short-term cardiac arrest. The postoperative pathological diagnosis was a calcified amorphous tumor. The patient was discharged from our hospital on postoperative day 12．No tumor recurrence was observed 9 months after the surgery.

Histological study of platelet-rich fibrin combined with MTA for direct pulp capping of rabbit teeth / 口腔疾病防治

Objective @# To investigate the outcomes of a novel direct pulp capping agent containing platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA). @*Methods @# A total of 32 New Zealand rabbits were randomly divided into 4 groups, namely, the PRF+MTA group (P+M group), PRF group (P group), MTA group (M group) and blank control group (BC group), with 8 rabbits per group. Dental pulp exposure and direct pulp capping were performed, and complete crown square sealing was performed on 2 mandibular central incisor teeth of each rabbit. Four rabbits from each group were euthanized after each observation period (7 and 28 days). The experimental teeth were subjected to HE staining. Inflammatory cell infiltration, calcified bridge formation and pulp tissue disorganization were observed and graded. @*Results@#Inflammatory cell infiltration: on the 7th day, group P+M and group M were lighter than group BC (P<0.05); on the 28th day, group P+M was lighter than group P and group BC (P<0.05); group P+M and group M did not significantly differ (P>0.05). Calcified bridge formation: on the 7th and 28th days, group P+M was lighter than group P, group M and group BC (P<0.05); on the 28th day, group M was higher than group BC (P<0.05). Under microscope, the calcified bridge contained cellular components and was surrounded by odontoblast-like cells, sharing a structure resembled osteodentin; dentin tubule-like structure could not be observed in calcified bridge, and the calcified bridge resembled certain points of osteodentin. Pulp tissue disorganization: on the 7th day, group P+M and group M were lighter than group BC (P<0.05); on the 28th day, group P+M was lighter than group P and group BC (P<0.05). group P+M and group M did not significantly differ (P>0.05). @*Conclusion @# The combination of PRF and MTA for direct pulp capping provided light inflammatory cell infiltration, stable pulp status and a strong ability of pulp tissue to form calcified bridge, and the calcified bridge resembled certain points of osteodentin.

Effect of Calcified Lymph Nodes on Thoracoscopic Lobectomy in Chronic Obstructive Pulmonary Disease Patients with Lung Cancer / 中国医学科学院学报

Objective To observe the effect of calcified lymph nodes on video-assisted thoracoscopic surgery (VATS) lobectomy in the chronic obstructive pulmonary disease (COPD) patients with lung cancer. Methods A retrospective analysis was conducted on the COPD patients with lung cancer who underwent VATS lobectomy in the Department of Thoracic Surgery in the First Affiliated Hospital of Hebei North University from May 2014 to May 2018.The patients were assigned into a calcified lymph node group and a control group according to the presence or absence of calcified lymph nodes in CT,and the size,morphology,and calcification degree of the lymph nodes were recorded.The operation duration,intraoperative blood loss,chest tube retention time,hospitalization days,and overall complication rate were compared between the two groups. Results The 30 patients in the calcified lymph node group included 17 patients with one calcified lymph node and 13 patients with two or more calcified lymph nodes,and a total of 65 calcified lymph nodes were recorded.The calcified lymph nodes with the size ≤5 mm were the most common (53.8%),and complete calcification was the most common form (55.4%) in lymph node calcification.The mean operation duration had no significant difference between the calcified lymph node group and the control group (t=-1.357,P=0.180).The intraoperative blood loss (t=-2.646,P=0.010),chest tube retention time (t=-2.302,P=0.025),and hospitalization days (t=-2.274,P=0.027) in the calcified lymph node group were higher than those in the control group. Conclusion Calcified lymph nodes increase the difficulty and risk of VATS lobectomy in the COPD patients with lung cancer.The findings of this study are conducive to predicting the perioperative process of VATS lobectomy.

Guided endodontic access of severe calcified tooth without incisal edge ­ case report / Acesso endodôntico guiado de dente calcificado severamente sem borda incisal ­ relato de caso

Pulp tissue may suffer calcification because of trauma, operative procedures or carious lesions. This paper aimed to report and discuss the guided endodontic access as an alternative treatment. A 52 years old female patient had severe root canal calcification of tooth #11 associated with a radiolucent periapical lesion. Firstly, the crown and metal post and core were removed. A digital impression and cone-beam computed tomography "CBCT" scans were performed and imported to implant planning software (SimPlant Version 11; Materialise Dental, Leuven, Belgium).The guided endodontic access template was designed to allow the drill to reach a distance of 2 mm short of the apical foramen, once printed, it was tested in the mouth to evaluate its insertion and stability in the dental arch. The calcified root canal was penetrated using the access drill rotating by a low-speed hand-piece (10,000 rpm) under saline solution irrigation through advancing movements. Then, the apical foramen was negotiated with C-Pilot files #10 and #15. The working length was measured using the iPex-II apex locator. The instrumentation was carried out with Reciproc R50 and 2.5% sodium hypochlorite. One week later, a full-ceramic crown preparation was performed, and polyvinyl siloxane impression was carried out. A total of three follow-up sessions were performed after one week, one and twelve months. Bone neoformation was observed in the site of the periapical lesion and the patient had no signs or symptoms of any discomfort. Therefore, guided endodontics is indicated for severe calcified root canals.(AU)

O tecido pulpar pode sofrer calcificação por trauma, procedimentos cirúrgicos ou como resposta a lesões cariosas. Este trabalho teve como objetivo relatar e discutir o acesso endodôntico guiado como opção de tratamento. Paciente do sexo feminino, 52 anos, com calcificação severa do canal radicular do dente 11 associada a lesão periapical radiolucida. Na primeira intervenção clínica, a coroa e o pino de metal foram removidos. Uma impressão digital e imagens de CBCT foram realizadas e importadas para o software de planejamento de implante (SimPlant Versão 11; Materialize Dental, Leuven, Bélgica) tentando projetar um modelo de acesso endodôntico guiado para permitir que a broca alcance uma distância de 2 mm antes do forame apical, uma vez impresso, foi testado na boca para avaliar sua inserção e estabilidade na arcada dentária. O canal radicular calcificado foi penetrado com broca de acesso girando por peça de mão de baixa velocidade (10.000 rpm) sob irrigação com solução salina por meio de movimentos de avanço. Em seguida, o forame apical foi negociado com as limas C-Pilot nº 10 e nº 15. O comprimento de trabalho foi determinado usando o localizador de ápice iPex-II. A instrumentação foi realizada com Reciproc R50 e hipoclorito de sódio 2,5%. Uma semana depois, foi realizado o preparo da coroa total em cerâmica e a moldagem com polivinilsiloxano. Um total de três sessões de acompanhamento foram realizadas após uma semana, um e doze meses. A neoformação óssea foi observada no local da lesão periapical e a paciente não apresentava sinais ou sintomas de qualquer desconforto. Portanto, o acesso endodôntico guiado é indicado para canais radiculares calcificados severamente.(AU)

Efficacy of Aortic Valve Replacement with Ascending Aorta Grafting under Hypothermic Circulatory Arrest for the Patients with Shaggy/Calcified Aorta / 日本心臓血管外科学会雑誌

Purpose : The aim of this study is to evaluate the outcome of aortic valve replacement (AVR) with ascending aorta grafting under hypothermic circulatory arrest for patients with shaggy/calcified ascending aorta based on preoperative and intraoperative assessment of ascending aorta. Methods : From April 2010 to July 2019, 133 patients with aortic stenosis underwent AVR. Based on preoperative computed tomography and intraoperative epi aortic ultrasound, 121 patients were able to have their aorta clamped (C-AVR), while clamping was not possible for 12 patients due to shaggy/calcified in the ascending aorta (Asc-AVR). In Asc-AVR, ascending aorta was replaced to the vascular graft under hypothermic circulatory arrest with retrograde cerebral perfusion followed by AVR. Results : Although operative time and cardiopulmonary bypass time were prolonged and blood transfusion volume was significantly high in Asc-AVR, there were no significant differences in postoperative complications. Although postoperative MRI revealed two silent strokes, no symptomatic neurologic complications occurred in Asc-AVR. Five-year survival rates between groups were comparable (64.2% in Asc-AVR vs. 79.9% in C-AVR, p=0.420). Replacement of ascending aorta was not a risk factor of late death. Conclusion : AVR with ascending aorta grafting under hypothermic circulatory arrest based on preoperative and intraoperative assessment of ascending aorta is an acceptable method for patients with shaggy/calcified aorta.

Application of drug-coated balloons in percutaneous coronary intervention / 中国基层医药

Percutaneous coronary intervention is the main treatment of coronary heart disease. Both the original bare metal stent and drug-coated stent have the possibility of developing in-stent restenosis, and have poor therapeutic effect on small vessel lesions and bifurcation lesions, which limit their clinical application. In recent years, drug-coated balloons have made considerable progress. They provide a new treatment method for in-stent restenosis, chronic total occlusion, bifurcation lesions and small vessel lesions, and can shorten the duration of dual antiplatelet therapy and reduce the risk of bleeding. This paper reviews the clinical research progress of drug-coated balloon.

Mesenchymal stem cell calcification induced by protoscolex of two species of Echinococcus: A differential analysis / 中国组织工程研究

BACKGROUND: The growth pattern of Echinococcus granulosus is different from that of Echinococcus alveolaris. Hepatic echinococcosis can form a complete fibrous calcified cyst wall, while hepatic alveolar echinococcosis can grow infiltratively and cannot form a complete fibrous calcified cyst wall. Bone marrow mesenchymal stem cells (BMSCs) are involved in the formation of calcified wall of hydatidosis, but the calcification characteristics of Echinococcus granulosus and Echinococcus alveolaris are different and the role of BMSCs is still unclear. OBJECTIVE: To compare the effects of Echinococcus granulosus and Echinococcus alveolaris on the calcification of BMSCs and to preliminarily investigate the formation mechanism of echinococcosis calcifications. METHODS: BMSCs of C57BL/6 mice were extracted, cultured and identified, followed by co-culture with the protoscolex of Echinococcus granulosus (BMSC+CE group) and Echinococcus alveolaris (BMSC+AE group), respectively. BMSCs cultured alone were used as control group. After 1, 4, and 7 days of co-culture, alkaline phosphatase activity was detected by a microplate reader, the expression of BMP2 and RUNX2 mRNA was detected by RT-q PCR, and the expression of BMP2, RUNX2 and phosphorylated Smad1/5/8 (P-Smad1/5/8) proteins was detected by western blot assay. RESULTS AND CONCLUSION: (1) The alkaline phosphatase activity of the BMSC+CE group and BMSC+AE group was significantly higher than that of the control group at 1 and 4 days after culture (P < 0.05), and the alkaline phosphatase activity of the BMSC+CE group was significantly higher than that of BMSC+AE group (P < 0.05). (2) Western blot results showed that the expression of BMP2, RUNX2, and P-Smad1/5/8 protein in the BMSC+CE group and BMSC+AE group was significantly higher than that in the control group at 1 and 4 days after culture (P < 0.05), while the expression of BMP2, RUNX2, and P-Smad1/5/8 protein in the BMSC+CE group was significantly higher than that in the BMSC+AE group (P < 0.05). (3) RT-qPCR results showed that the expression of BMP2 and RUNX2 mRNA in the BMSC+CE group was significantly higher than that in the control group at 1, 4 and 7 days after culture (P < 0.05), and was significantly higher than that in the BMSC+AE group at 4 and 7 days after culture (P < 0.05). The expression of RUNX2 mRNA in the BMSC+AE group was significantly higher than that in the control group at 1, 4, and 7 days after culture (P < 0.05). (4) To conclude, co-culture of the protoscolex of Echinococcus alveolaris and BMSCs promotes the expression of alkaline phosphatase and RUNX2 in BMSCs by up-regulating BMP-Smad1/5/8 pathway. At the later stage of co-culture, the effect of Echinococcus alveolaris on BMSCs calcification is significantly weakened, while the effect of Echinococcus granulosus on BMSCs calcification remains unchanged, suggesting that this mechanism may be related to the different growth patterns of two kinds of hydatids.

Abordaje lateral retropleural mínimamente invasivo para hernia de disco torácica gigante calcificada: reporte de caso / Minimally Invasive Lateral Retropleural Approach for Calcified Giant Thoracic Disc Herniation: Case Report

Introducción: Las hernias de disco torácicas (HDT) representan solo el 0.15-1.8% de las hernias de disco tratadas quirúrgicamente. Se han descrito distintos tipos de abordajes que reportan diferentes índices de éxito y complicaciones. El objetivo es presentar el caso quirúrgico de una HDT resuelta por un abordaje lateral retropleural mínimamente invasivo y exponer las ventajas del mismo. Descripción: Se presenta el caso de una paciente de 29 años, que consultó por dorsalgia y paresia crural izquierda 4/5. La TC y RM mostraron una HDT gigante calcificada T8-9. Bajo monitoreo neurofisiológico y visión microscópica, se realizó un abordaje lateral retropleural izquierdo mínimamente invasivo, con resección parcial de la costilla para luego utilizar un sistema de dilatadores y retractores tubulares. Se confirmó el nivel bajo radioscopía, y se completó con el drilado de la cabeza costal para exponer el espacio y la HDT calcificada de manera precoz. Se realizó la discectomía del fragmento herniado, incluyendo drilado intracanal de la porción calcificada y se completó la descompresión incluyendo la porción posterior de los platillos vertebrales y el pedículo inferior. Parte del fragmento herniado se encontraba íntimamente adherido al saco dural, por lo que creímos conveniente dejar este remanente para evitar complicaciones. La paciente evolucionó favorablemente, recuperando de manera completa el déficit motor y el dolor que motivaron la consulta. Consideramos que no fue necesario realizar ningún tipo de fusión intersomática. Discusión: Los distintos abordajes propuestos tienen sus ventajas y desventajas. El desarrollo de las técnicas mínimamente invasivas sumado a la posibilidad de exponer precozmente la lesión resultan ventajas importantes en estos casos. La necesidad de fusión es un tema controversial, donde la mayoría de los trabajos sugieren que no es mandatoria. Conclusión: el abordaje lateral retropleural mínimamente invasivo es una técnica segura, que permitió una visualización precoz de la HDT sin desplazar el estuche dural y logrando una adecuada descompresión. Además, evita la morbilidad que podría representar la toracotomía transtorácica y la necesidad de fusión

Introduction: Thoracics disc herniations (TDH) represent just 0.15-1.8% of all surgically treated herniated discs. Many approaches had been described with different amount of success and complications. The objective is to present a TDH surgical case using a minimally invasive lateral retropleural approach and describe the advantages of this approach. Case description: we present a 29 years old female who presented with dorsal pain and right leg weakness 4/5. CT and MRi showed a calcified giant TDH T8-9. The surgery was performed under neurophysiological monitoring and using a surgical microscope. A minimally invasive left lateral retropleural approach was performed, with partial resection of a rib. Finally, we used dilators and tubular retractors. After radioscopic confirmation of T8-9, we completed the approach by drilling rib ́s head in order to early expose the spinal canal with the TDH. We resected the herniated fragment of the TDH, drilled the calcified intraspinal canal portion and completed the decompression including the posterior portion of the endplates and the inferior pedicle. The most anterior portion of the TDH was intimately attached to the dural sac, so we decided to leave this remanent in order to avoid complications. The patient had a good postoperative recovery, the leg weakness and pain improved significantly. From our perspective, we consider that no intersomatic fusion was necessary. Discusion: each approach has it advantages and disadvantages. The evolution of minimally invasive techniques together with the early visualization of TDH became important advantages in these cases. The need of fusion remains controversial, and most of the literature suggest that is not mandatory. Conclusión: the minimally invasive lateral retropleural approach is a safe technique that offers an early visualization of the TDH without manipulation of the dural sac and allows an adequate decompression. Furthermore, this approach avoids the morbidity of a transthoracic approach and the requirement of fusion.

Transaneurysmal R=repair of a giant calcified submitral left ventricular aneurysm

Abstract Submitral left ventricular aneurysm is a rare cardiac pathology with very few cases reported in the literature. These are nonischemic aneurysms mostly reported from Africa. Patients with submitral aneurysm exhibit varied clinical manifestations. We report a case of calcified submitral aneurysm and its successful surgical management through a transaneurysmal approach.

Mechanism of autophagy on the formation of kidney stones caused by calcified nanoparticles / 医学研究生学报

Objective　The relationship between calcified nanoparticles (CNPs) and the formation of urinary stones is drawing increasing attention and the specific mechanisms involved. This study aims to investigate the mechanisms of the formation of kidney stone caused by CNPs.　Methods　A total of 48 rats were randomly and equally divided into a CNPs group (each rat was injected with 2 mL CNPs through the tail vein to establish a rat kidney stone model of CNPs), and a control group (injected the same amount of sterile isotonic saline instead of CNPs). We compared the expression levels of autophagy-related proteins, such as Beclin-1 and LC-3, the formation of autophagosomes and calcium salt crystals in renal tissues at time points of 3h, 6h, 12h, 24h, 1w, 2w, 4w and 8w in two groups.　Results　The relative expression levels and positive cells of Beclin-1 and LC-3 in CNPs group at 3h,6h,12h,24h, 1w, 2w, 4w, 8w were significantly higher than those in the control group (P< 0.05), and reached the highest value at 24 (P< 0.05). The number of autophagosomes at 24h, 1w, 2w, 4w, and 8w in the CNPs group ((2.83±0.32), (3.00±0.26), (3.70±0.44), (3.90±0.98), (4.70±0.51)/HP, respectively) were significantly higher than those in the control group (0.73±0.15)/HP (P <0.05). The scores of calcium salt crystals in the CNPs group at 2w, 4w, and 8w significantly increased compared to the control group (P <0.05). The calcium salt crystal formation score ((0.92 ± 0.98) points) was positively correlated with the expression intensities of Beclin-1 and LC-3 ((6.78 ± 4.25), (2.61 ± 2.57), respectively) (r = 0.843, 0.628, P <0.05), which was positively correlated with the number of autophagosomes (2.53 ± 1.41) (r = 0.923, P <0.001).　Conclusion　CNPs may damage renal tubular epithelial cells, and induce immediate autophagic activity, also increase expression of autophagy-related proteins and autophagosome formation, which will promote the formation and aggregation of calcium salt crystals in renal tubules to some extent.

A Calcified Amorphous Tumor from the Aortic Valve to the Tricuspid Valve with Aortic Valve Stenosis / 日本心臓血管外科学会雑誌

We report a rare case of a hemodialysis patient with calcified amorphous tumor (CAT) originating from aortic valve cusp that continues to tricuspid valve, which may be related to aortic annular calcification and aortic valve stenosis. A 79-year-old female with chronic kidney disease on hemodialysis for 16 years was transferred to our hospital with loss of consciousness. Echocardiography revealed aortic valve stenosis and presence of tumor on the aortic valve and tricuspid valve. We suspected the presence of a cardiac tumor or vegetation. We underwent tumor resection of tricuspid valve and aortic valve replacement and coronary artery bypass grafting (SVG-RCA). Pathological findings of the tumor was CAT.

Cardiac Calcified Amorphous Tumor Presenting as Cerebral Infarction / 日本心臓血管外科学会雑誌

We report the case of a 62-year-old man who was admitted for acute cerebral infarction linked to a cardiac calcified amorphous tumor (CAT). The patient, who had been on hemodialysis for about 10 years, was referred to our hospital with dysarthria, and left hemiplegia. Brain magnetic resonance imaging (MRI) showed acute cerebral infarction in right parietal lobe of the cortex, and transthoracic echocardiography revealed moderate aortic valve stenosis and a mobile mass measuring 8 mm×5 mm in diameter attached to the aortic valve. The mobile structure was thought to be related to the cerebral infarction. Aortic valve replacement was performed. On the basis of the pathological examination, a cardiac calcified amorphous tumor was diagnosed. The patient was discharged from our hospital without any complication.

A Case of Tender Calcinosis Cutis of an Infant Following a Single Heel Stick / 대한피부과학회지

No abstract available.

Endodontic Management of a Mature Mandibular First Permanent Molar That Survived for 20 Years after Complete Pulpotomy: A Case Report

@#Complete pulpotomy as a treatment option for caries exposure in mature permanent teeth with complete root formation still remains controversial due to lack of evidence on the long-term success. This article highlights a rare complete pulpotomy case done on a mature permanent tooth that survived for 20 years. A 34-year-old female presented with dull spontaneous pain on her right mandibular first molar and showed positive response to both cold test and electrical pulp test. The tooth was previously restored with tooth coloured restoration at the disto-occlusal surface and pre-operative periapical radiograph revealed large radiopacity covering the entire pulp chamber with calcified canals. The tooth was diagnosed as previously initiated therapy with symptomatic apical periodontitis. Endodontic treatment was initiated. All canals were located and corrected working length achieved followed by cleaning and shaping using HyFlex CM rotary files with copious irrigation of 2.5% sodium hypochlorite solution. Intracanal medication (non-setting calcium hydroxide) was placed and the tooth was restored with temporary restoration. After two weeks, obturation was done using single cone technique with EndoRez sealer. Universal composite resin was placed as permanent restoration and follow-up was done after one month and three months respectively without symptoms and evidence of periapical lesion. This minimally invasive pulpotomy procedure may be an alternative treatment option for mature permanent teeth whenever carious exposure to the pulp occurs.

A Calcified Amorphous Tumor Causing Mitral Valve Perforation and Ruptured Chordae Tendineae / 日本心臓血管外科学会雑誌

Calcified amorphous tumor (CAT) is a non-neoplastic mass characterized by calcified nodules that was first reported in 1997. It is often associated with dialysis or mitral annular calcification (MAC). CAT is considered a risk factor for systemic embolism, but there has been no report of CAT damaging the native valve tissue and leading to valvular disease. An 81-year-old woman had shortness of breath on exertion starting 1 year previously, and was referred to our hospital with cardiac murmur detected on physical examination. Echocardiography showed evidence of severe mitral valve regurgitation with ruptured chordae tendineae of the posterior leaflet and a poorly mobile club-shaped structure protruding into the left ventricle and appearing to be continuous with MAC. She underwent elective mitral valve repair. A club-shaped calcification originating from MAC was found under the P2 segment, with ruptured P2 chordae tendineae immediately above it and mitral perforation in the contralateral A2 segment, which were likely to have resulted from direct damage by the hard structure. Mitral valve repair was successful with mass resection, triangular resection of the posterior leaflet P2 segment, and closure of the perforation. Histopathological findings of the mass were consistent with CAT, with no evidence of infection or malignancy. CAT may not only cause embolism but also grow while damaging the native valve tissue. It is important to closely follow-up and perform surgery in proper timing.

CTA observation on relationship of right collateral ischemic colitis and calcified plaque of superior mesenteric artery / 中国医学影像技术

Objective: To explore the relationship of right collateral ischemic colitis (IC) and calcified plaque of superior mesenteric artery (SMA). Methods Totally 605 patients who underwent CTA of SMA were enrolled and analyzed retrospectively, including 81 patients in IC group and 524 patients in the non-IC group. The detection rate of SMA calcified plaque was compared between the 2 groups. The number, morphology and location of SMA calcified plaque, as well as the degree of stenosis of the opening and the narrowest part of SMA in IC group and the non-IC group were analyzed and compared, and the ROC curve was used to evaluate the efficacy of SMA stenosis degree in diagnosis of IC. Results The incidence of SMA calcified plaques in IC group (13/81, 16.05%) was higher than that in non-IC group (33/524, 6.30%; P=0.002). The number of SMA calcified plaques in IC group was more than that in the non-IC group (P=0.043). Significant difference in the location of calcified plaque was found between the 2 groups (P<0.001). SMA calcified plaques mostly located in the distal segment in IC group, while in the proximal or middle segment in non-IC group. There was no significant difference of plaque morphology between the 2 groups (P=0.421). Statistically significant difference of the narrowest stenosis degree was detected between the 2 groups (P<0.001). The AUC of the narrowest stenosis degree in diagnosis of IC was 0.838 (P<0.001), the sensitivity was 76.92% (10/13), and the specificity was 87.88% (29/33). Conclusion When there are more calcified plaques located in the distal segment of SMA and stenosis degree of the narrowest segment of SMA ≥25%, IC should be considered.

Diagnostic value of digital breast tomosynthesis technique for breast suspicious calcified lesions / 中华普通外科杂志

Objective To explore the diagnostic value of digital breast tomosynthesis technique (DBT) in breast suspicious calcified lesions.Methods Clinical data of 135 patients using DBT and FFDM (Full field digital mammography) was respectively analyzed.Results Of the 135 cases,43 cases were malignant,and 92 cases were benign.The diagnostic sensitivity DBT and FFDM were 93.0％ (40/43)and 88.4％ (38/43),specificity were 88.0％ (81/92) and 75.0％ (69/92),accuracy were 89.6％ (121/135) and 79.3％ (107/135),the differences were statistically significant (P ＜0.05).The ROC curve area (AUC) of DBT and FFDM were 0.905 ± 0.026 and 0.817 ± 0.034 (P =0.000 2).In premenopausal,postmenopausal and breast density ACR3-4 cases,DBT accuracy is higher than FFDM (P ＜ 0.05).The BI-RADS classification difference of the benign calcified lesions was statistically significant (x2 =11.740,P =0.038 5).Conclusions Compared with the traditional FFDM,DBT has a higher value in the diagnosis of breast suspicious calcified lesions,especially for benign calcified lesions.

Clinical analysis on arthroscopic incomplete removal of calcifications of supraspinatus tendinitis / 局解手术学杂志

Objective To evaluate the treatment effect of the arthroscopic incomplete removal of calcifications of the supraspinatus tendinitis without acromioplasty.Methods The clinical data of 20 patients of calcified supraspinatus tendinitis with Ellman Ⅰ or Ⅱ in general hospital of Shenyang military area command from January 2014 to February 2016 were retrospectively analyzed.Of the 20 patients,4 males and 16 females,the age ranged from 45 to 62 years old,with average age (50.2 ± 6.3) years old.All the patients received removal incomplete of calcification without acromioplasty.Pre-and postoperative 3,6,9 months general situation were evaluated by the VAS score,Constant-Murley score,University of California Los Angeles (UCLA) score,X-Radiographs and CT.Results The shoulder function was evidently improved in all 20 patients.The average VAS pain score was (8.2 ± 1.4) preoperatively and (0.8 ± 0.6) at the 6 months follow-up.The average Constant-Murley score was (44.6 ± 7.4) preoperatively and (95.4± 3.4) at the 6 months follow-up.The average UCLA score was (12.2 ± 3.6) preoperatively and (33.1 ± 1.4) at the 6 months follow-up.Conclusion The arthroscopic incomplete removal of calcifications of the supraspinatus tendon without acromioplasty can lead to good results with less iatrogenic injury.