Clinical value of wide body CT in chest scanning of patients under free breathing state / 中国医学装备

Objective:To explore the application value of compute tomography(CT)scan with 16cm wide body detector in chest examination of patients who could not cooperate with breath-holding.Methods:A total of 100 patients who could not cooperate with breath-holding during chest examination in the second affiliated hospital of Shenyang Medical College from May to August in 2022 were selected,and they were randomly divided into observation group and control group,with 50 patients in each group.The collimation width of CT scan with 16cm wide body detector was 256 mm×0.625 mm in the observation group,and that with 8 cm wide body detector was 128 mm×0.625 mm in the control group,and other parameters of two groups were same.A series of indicators included age,height,weight and body mass index(BMI)of patients were recorded,and the CT dose index(CTDIvol),dose length product(DLP),effective dose(ED)were measured and calculated.And then,the Contrast to Noise ratio(CNR),signal to noise(SNR)and Standard Deviation(SD)between two groups were compared,and the image quality was evaluated objectively and subjectively.Results:The average age and the average weight of the patients in the observation group were respectively(78.81±6.84)years old and(64.46±9.86)kg,and the mean values of BMI,CTDIvol,DLP,ED and exposure time were respectively(22.89±3.09)kg/m2,(4.61±1.00)mGy,(1 471.02±345.25)mGy·cm,(20.59±4.83)mSv,(1.01±0.61)s.The average age and the average weight of the patients in the control group were respectively(77.70±6.76)years old and(62.84±4.75)kg.The mean values of BMI,CTDIvol,DLP,Ed and exposure time were respectively(22.89±2.29)kg/m2,(14.5±0.00)mGy,(4 561.70±346.32)mGy·cm,(63.86±4.85)mSv and(4.07±0.12)s.The differences of subjective evaluations of main pulmonary artery,right inferior pulmonary vein trunk and aortic arch between the observation group and the control group were not significant(P>0.05).The subjective scores of image qualities both two groups were larger than 4,and the image qualities of two groups could meet the diagnostic requirements.The CTDIvol,DLP,ED and exposure time of observation group were significantly lower than those in control group(t=-69.42,-44.231,-44.234,-107.10,P<0.05),respectively.Conclusion:Compared with the CT scan with conventional 8 cm detector,the CT scan with 16 cm wide body detector can greatly shorten the scanning time and reduce the radiation dose in the chest CT scan of patients with free breathing,and the image quality of that can meet the requirement of clinical diagnosis,which has very high application value in the fast diagnosis of clinical emergency.

Application of reductional M-shaped plasty in upper lip aesthetic improvement / 中华医学美学美容杂志

Objective:To observe and evaluate reductional M-shaped plasty method in patients with thick lips and dissatisfied lip appearance.Methods:From 2013 to 2019, 415 Chinese cases of thick upperlip without clear vermilion curve and tubercle were included. A reduction method for upper lip M-shaped plasty was performed. Objective data of lip morphology before and after operation were measured, and subjective satisfaction survey and long-term follow-up were conducted.Results:According to the statistics of 415 patients, the time of detumescence was 3-21 (11.8±2.6) days; the time of incision scar softening was 1-24 (2.6±0.8) months; the time of expression recovery was 1-24 (3.1±1.4) months; the time of numbness disappearance was 1-2 years. Three months after the operation, there was no significant change in the height of the central part of the upper red lip compared with that before the operation, the height of the red lip at the peak of the lip was significantly reduced, the height of the red lip was (13.3±2.2) mm before the operation, and (11.4±1.7) mm after the operation; the relative height of the dome point was significantly increased, the height was (0.4±1.0) mm before the operation, and the height was (2.1±0.5) mm after the operation. After more than 6 months of follow-up, patients' satisfaction rate of one operation was 72.0%, the satisfactory rate of upper lip shape was 75.4%, the long-term complications included obvious scars or discomfort (3.6%), local numbness (1.7%), and unnatural expression (0.7%).Conclusions:The reduction method for upper lip M-shaped plasty displays a significant effect in improving the shape of upper vermilion with thick and normal lips. The complications are slight and repairable. This lip cosmetology and rejuvenation procedure is recommended for further clinical application.

Advances in immunological mechanism of dry age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

@#Dry age-related macular degeneration(ARMD)is a degenerative fundus disease whose pathogenesis is not yet fully clear. Dry ARMD with macular pigmentation disorder, drusen and geographic atrophy as main manifestations can lead to irreversible loss of central vision. It's reported that immune and inflammatory reactions play a key role in the development of dry ARMD, in which complement system, pattern recognition receptors, inflammasomes, and various cytokines in immune molecules are closely related to the occurrence of dry ARMD. In this paper, the latest researches on these immune molecules and dry ARMD will be reviewed.

Characteristics of Visual Evoked Potential in Different Parts of Visual Impairment / 法医学杂志

OBJECTIVES@#To study the quantitative and qualitative differences of visual evoked potential (VEP) in monocular visual impairment after different parts of visual pathway injury.@*METHODS@#A total of 91 subjects with monocular visual impairment caused by trauma were selected and divided into intraocular refractive media-injury group (eyeball injury group for short), optic nerve injury group, central nervous system injury and intracranial combined injury group according to the injury cause and anatomical segment. Pattern Reversal visual evoked potential (PR-VEP) P100 peak time and amplitude, Flash visual evoked potential (F-VEP) P2 peak time and amplitude were recorded respectively. SPSS 26.0 software was used to analyze the differences of quantitative (peak time and amplitude) and qualitative indexes (spatial frequency sweep-VEP acuity threshold, and abnormal waveform category and frequency) of the four groups.@*RESULTS@#Compared with healthy eyes, the PR-VEP P100 waveforms of the intraocular eyeball injury group and the F-VEP P2 waveforms of the optic nerve group showed significant differences in prolonged peak time and decreased amplitude in injured eyes (P<0.05). The PR-VEP amplitudes of healthy eyes were lower than those of injured eyes at multiple spatial frequencies in central nervous system injury group and intracranial combined injury group (P<0.05).The amplitude of PR-VEP in patients with visual impairment involving central injury was lower than that in patients with eye injury at multiple spatial frequencies. The frequency of VEP P waveforms reaching the threshold of the intraocular injury group and the optic nerve injury group were siginificantly different from the intracranial combined injury group, respectively(P<0.008 3), and the frequency of abnormal reduction of VEP amplitude of threshold were significantly different from the central nervous system injury group, respectively(P<0.008 3).@*CONCLUSIONS@#VEP can distinguish central injury from peripheral injury, eyeball injury from nerve injury in peripheral injury, but cannot distinguish simple intracranial injury from complex injury, which provides basic data and basis for further research on the location of visual impairment injury.

Clinical Value of Minimally Invasive Bridging for the Lateral Malleolar Fractures in the Open Comminuted Ankle Fractures with Dislocation / 中国医学科学院学报

To evaluate the effectiveness of minimally invasive bridging for the lateral malleolar fractures in the open comminuted ankle fractures with dislocation. Methods The clinical data of 24 patients [19 males and 5 females aged 40 to 65 years,mean(47.5±8.6)years] with open comminuted ankle fractures with dislocation who were treated in the Second Hospital of Tangshan from September 2015 to June 2017 were retrospectively analyzed.All patients were treated with minimally invasive bridging for the lateral malleolar fractures.The ankle function after treatment was assessed with the Olerud Molander Ankle(OMA)score. Results All the 24 patients were followed up from 12-26 months [mean:(14.5±2.6)months].Good fracture union was achieved in all patients after 2 - 5 months(mean:3 months).No deep infection,skin necrosis,or bone nonunion occurred after 12 months of follow-up.Only one patient suffered from partial skin necrosis at lateral malleolus,which was cured after changing wound dressings.The OMA score was 93.5(range:85-100)after 12 months(excellent in 19 cases and good in 5 cases). Conclusions Minimally invasive bridging for the lateral malleolar fractures is effective in treating the open comminuted ankle fractures with dislocation.It can obtain good reduction and fixation,reduce complications,and achieve high union rate.

Finite element comparative study of S2 alar-iliac screw and sacroiliac joint screw in treatment of type C sacroiliac joint dislocation / 中华创伤杂志

Objective To compare the biomechanical characteristics between S2 alar-iliac (S2AI) screw and sacroiliac joint screw in treating unilateral type C sacroiliac joint dislocation. Methods A 25 year-old healthy male adult agreed to take computed tomography scan of the pelvis. The pelvic floor thickness was 1 mm and the image data were saved in DCOM format. A three dimensional finite element model of intact pelvis was reconstructed by Mimics, Geomagic, SolidWorks, and Abaqus softwares. A finite element model of type C unilateral sacroiliac dislocation was established. One S1 vertebral sacroiliac screw of 6.5 mm in diameter (S1 group), one S2AI screw (S2AI group) and one Si vertebra sacroiliac screw + one S2 vertebra sacroiliac screw (S1+S2 group) were placed in the model, respectively. The500 N vertical load on the upper surface of the sacrum was simulated. The displacement value of sacroiliac joint, the displacement of sacrum, the stress value of the internal fixation and surrounding bone, and the stress distribution cloud map were recorded and analyzed. Results The displacement data showed that displacement distribution in the three groups had a consistent trend. In terms of the absolute value of displacement the result was S, group＞S 2AI group＞S1+ S2 group, of which the maximum displacement of sacroiliac joint in S1 groups was 0.87 mm and that of sacrum was 1.6 mm; the maximum displacement of sacroiliac joint in S2 AI group was 0.22 mm, and that of sacrum was 0.24 mm; the maximum displacement of the sacroiliac joint in S1 + S2 group was 0.06 mm, and that of sacrum was0.16 mm. Stress data showed that the stress in the internal fixation was mainly distributed at the sacroiliac joint, and the stress result was S2AI group＞S, group＞S, + S2 group, of which the maximum stress value was 52.8 MPa in S1 group, 62.1 MPa in S2AI group, and 38.2 MPa in S1 + S2 group. The stress around the screws was also concentrated at the sacroiliac joint, and the stress result was S1 group＞S2AI group＞S1 + S2 group, of which the maximum stress value was 56.8 MPa in S1 group, 11.2 MPa in S2AI group, and 5.8 MPa in S1 + S2 group. Conclusions Single S1 screw, single S2 AI screw and S, screws combined S2 screws can be used for the treatment of unilateral C type sacroiliac joint dislocation. Early weight bearing of single S1 screw might lead to the risks of increased sacroiliac joint displacement and internal fixation failure. S2 AI screw fixation and S1 + S2 screw fixation have similar biomechanical strength, allowing early weight-bearing and contributing to better postoperative rehabilitation.

Research progress in treatment of dorsal pelvic ring injury by transiliac internal fixator ( TIFI ) / 中华创伤骨科杂志

Minimally invasive surgical techniques reduce the damages to skin and soft tissue due to a high rate of complications following open reduction and internal fixation for dorsal pelvic ring injuries. However, they can still cause iatrogenic injuries to nerves, vessels and even organs because of reduced surgical exposure. Transiliac Internal Fixator ( TIFI ) , which was first designed by Füchtmeier, has been widely used in clinics because it successfully reduces iatrogenic injuries and ensures stability of internal fixation. This paper focuses on the principles, clinical outcomes, biomechanical studies and probable improvements of TIFI.

Neuropeptide Y Y1 receptor antagonist PD160170 promotes osteogenic differentiation of rat bone marrow mesenchymal stem cells in vitro and femoral defect repair in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of neuropeptide Y (NPY) Y1 receptor antagonist PD160170 in promoting osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and accelerating healing of femoral defect in rats.</p><p><b>METHODS</b>The third generation of rat BMSCs were treated with PBS (control) or 10, 10, or 10 mol/L NPY Y1 receptor antagonist PD160170. After 7 and 14 days of treatment, the cells were examined for osteogenic differentiation with alkaline phosphatase (ALP) and alizarin red staining. At 7 and 21 days of treatment, the mRNA and protein expressions of collagen type I (COLI), osteocalcin (OCN) and Runt-related transcription factor 2 (Runx2) in the cells were detected using q-PCR and Westem Blotting. In a male SD rat model (body weight 300∓20 g) of bilateral femoral condyle defects (2.5 mm in diameter), the effect of daily local injection of 0.2 mL PD160170 (10 and 10 mol/L, for 28 consecutive days) in promoting bone defect repair was evaluated with micro-CT scans.</p><p><b>RESULTS</b>ALP and alizarin red staining showed that the BMSCs treated with PD160170, at the optimal concentration of 10 mol/L, contained more intracellular cytoplasmic brown particles and mineralized nodules in extracellular matrix than PBS-treated cells. PD160170 (10 mol/L) significantly up-regulated the mRNA and protein expressions of COLI at day 7 and those of OCN and Runx2 at day 21 (P<0.05). In the rat models of femoral bone defect, the volume/tissue volume ratio, bone mineral density and the number of bone trabeculae were significantly greater in 10 mol/L PD160170 group than in the control group (P<0.05), but the bone trabecular thickness (P=0.07) and bone volume (P=0.35) were similar between the two groups.</p><p><b>CONCLUSION</b>NPY Y1 receptor antagonist PD160170 can promote osteogenic differentiation of BMSCs and healing of femoral defects in rats, suggesting the potential of therapeutic strategies targeting NPY Y1 receptor signaling in the prevention and treatment of bone fracture and osteoporosis.</p>

Forensic Application of Objective Assessment on Visual Acuity by ERP / 法医学杂志

OBJECTIVES@#To explore the composition characteristic of event related potential （ERP） in different visual acuity levels, and to provide theoretical basis for the objective assessment of visual acuity.@*METHODS@#Monocular stimulus was performed on 16 selected subjects. The subjects were required to look straight at the screen ahead and count the amount of stimuli from different directions. The pictures of optotype stimulus which corresponding to three different visual acuity levels were showed in the center of the screen. The ERP results were recorded separately.@*RESULTS@#（1） The P₁ amplitudes of match stimuli recorded under the supra-threshold visual acuity level were higher than that of match stimuli recorded under the threshold and sub-threshold visual acuity levels. There was no significant difference between the P₁ amplitudes of match stimuli recorded under the threshold and sub-threshold visual acuity levels. The tendency of conflict stimuli was similar to that of match stimuli under three visual acuity levels. （2） In the 340-500 ms post-stimulus range, P₃₀₀ component was found under supra-threshold and threshold visual acuity levels; no P₃₀₀ component was found in corresponding time window under sub-threshold visual acuity. The differences of P₃₀₀ amplitudes among three visual acuity levels were statistically significant. The amplitudes from high to low were the supra-threshold, threshold and sub-threshold visual acuity levels.@*CONCLUSIONS@#ERP can be a potential new method for the objective assessment of visual acuity in forensic medicine.

Effect of Different Attentional Conditions on ERP Detection of Visual Acuity / 法医学杂志

OBJECTIVES@#To study the effect of different attentional conditions on the event-related potential （ERP） components generated by the visual information stimuli related to visual acuity, and provide a theoretical reference for clinical forensic visual objective evaluation.@*METHODS@#With visual acuity optotypes as normal form of visual information stimuli, 15 volunteers as study subjects were supposed to account the visual acuity optotypes under the attentional condition of visual stimuli. Furthermore, the subjects were required to listen to the storytelling carefully under the non-attentional condition of visual stimuli, and after the examination, they needed to answer the story-related questions. All the EEG results of two different attentional conditions from the subjects were recorded by 32 channel ERP system.@*RESULTS@#Under two attentional conditions, P₁ and P₃₀₀ components were evoked by the visual acuity optotypes on supra-threshold and threshold visual acuity levels, while only P₁ component were evoked by the visual acuity optotypes on sub-threshold levels. In the ERP waveforms evoked by the visual acuity optotypes on supra-threshold, P₁ and P₃₀₀ amplitudes under attentional condition were larger than that under non-attentional condition.@*CONCLUSIONS@#Attentional conditions can influence the detection of visual acuity. P₃₀₀ component can be used to distinguish the visual acuity levels with supra-threshold and sub-threshold under non-attentional condition.

Variable angle locking plate for treatment of the pediatric subtrochanteric femoral fractures / 中华创伤骨科杂志

Objective To explore the clinical effects of variable angle locking plate ( VLP ) in the treatment of pediatric subtrochanteric femoral fractures. Methods Between January 2012 and November 2014, 9 pre-school children were treated at our department for subtrochanteric femoral fractures. They were 6 boys and 3 girls, with an average age of 4. 8 years ( from 4 to 6 years ) . By the Seinsheimer classification, 5 cases were of typeⅡB and 2 of typeⅡC and 2 of typeⅢA. The intervals between injury and surgery averaged 3 days ( from 2 to 5 days ) . All of them were treated with open reduction and VLP internal fixation. Results All the wounds healed well without any infection. All the stitches were removed within 12 days. They were followed up for 8 to 26 months ( average, 16 months ) . All the fractures united within 3 months after operation. Follow-ups revealed no plate or screw loosening, or refracture at the same site. According to the Beaty imaging criteria, the early outcomes were all satisfactory. At the final follow-ups, all the children gained normal gait after full-weight rehabilitation. The affected and normal hips are nearly identical in range of motion and muscle strength. All the children recovered their pre-injury status. By the Sanders scoring for function of the affected hip, 7 cases were rated as excellent and 2 as good. Conclusion VLP can be an effective option for treatment of subtrochanteric femoral fractures in preschool children patients.

Formation mechanism of hypercoagulable state after radiofrequency ablation for atrial fibrillation / 心血管康复医学杂志

Pulmonary vein isolation (PVI) is a new ,effective and radical method to cure atrial fibrillation .Within a period after radiofrequency ablation (RFA) ,coagulation system is activated in patients ,then thrombus incident such as cerebral embolism may happen .The present article made a review on its mechanism .

MR imaging of the atherosclerosis and the expression of tenascin-C and CD68 in ApoE-/- mouse model / 实用放射学杂志

Objective To explore the feasibility of 7.0T MR scanner in mouse aorta atherosclerosis models.Visualising the TN-C in atherosclerotic plaque by immunohistochemistry and its correlation with CD68 to provide experimental basis for the feasibility of TN-C in targeted MRI.Methods ApoE-/- mice and wild type C57 mice were fed on high fat diet to establish aorta atherosclerosis model (n=10),the aorta were observed by MRI after 14 weeks.The aorta specimens were taken to stain with HE to observe the pathological changes.The plaque was stained with oil red O,anti-TNC and TN-C antibody respectively to observe the fat,CD68 and TN-C in plaque.Results 7.0 MRI showed the aortic wall of the experimental group was thicker,high signal on T1 WI and PDWI,and low signal on T2 WI after 14 weeks.The histopathlogic examination showed the intima was obviously thicker,and the lumen was ir-regulary narrow.Both of CD68 and TN-C were highly expressed in plaque,and the distribution of TN-C correlated with CD68.In the control group,no case showed hyper-signal in the vessel wall of aorta or narrow lumen by MRI,and the histopathlogy showed no for-mation of atherosclerotic plaque in the aorta.Conclusion Aorta atherosclerotic plaque can be established through high fat diet on ApoE-/- mouse,and 7.0 MR can successfully detect it.TN-C is high expressed in AS plaque and the expression is correlated with CD68,which may suggest that they may collaborate in the development of AS.Detecting TN-C could be useful for the further study of atherosclerotic plaque.

Research Progress of Event-related Potential in Mild Cognitive Impairment / 法医学杂志

Mild cognitive impairment caused by craniocerebral trauma is the key points and difficulties in judicial authentication. This article has comparative analysis of each mode of event-related potential (classical Oddball, Eriksen flanker task and so on), which can provide a more objective method for such craniocerebral trauma cases in clinical forensic judicial authentication.

Mentation of the Female in Mammography Examination / 中国康复理论与实践

@#ObjectiveTo investigate the mentation of the female in mammography examination. Methods292 female patients (over 35 years old) from the out-patient department accepted the psychological questionnaire survey.ResultsMost female patients showed some mental problems, include angst, discomposure, tension or funk for examination. They worried about examination result and the damage being exposed to the X-ray irradiation.ConclusionTechnicians should pay attention to the mentation of the female in mammography examination to win their trust and cooperation.

Improving Medical Care Quality and Strengthening Hospital Infection Management / 中华医院感染学杂志

OBJECTIVE To understand the current situation in management of nosocomial infections in hospitals,and provide rational preventive measures in order to improve the medical care quality.METHODS An observatory study was conducted and reasonable suggestions were preferred referring to foreign nosocomial infections modes.RESULTS Problems were found to a different extent in administration of nosocomial infections.Most alarming problems were shortages of rules and regulations,and deficiency of infection propaganda and administration coordination.CONCLUSIONS Strengthening management of nosocomial infections is one of the key issues for improvement of the medical care quality and should be paid special attention.