Establishment of a prognostic nomogram model for predicting acute renal injury in patients with moderate and severe burns / 中华危重病急救医学

OBJECTIVE@#To establish a prediction model of acute kidney injury (AKI) in moderate and severe burn patients, so as to provide basic research evidence for early identification of burn-related AKI.@*METHODS@#Patients who were admitted to the department of plastic burn surgery of the Affiliated Hospital of Southwest Medical University from November 2018 to January 2021 were selected, and their clinical characteristics, laboratory examinations and other indicators were recorded. Multivariate Logistic regression analysis was used to screen out the risk factors of AKI related to moderate and severe burns, and R software was used to establish the nomogram of moderate and severe burn patients complicated with AKI. The Bootstrap method model was used for internal verification by repeating sample for 1 000 times. Consistency index and calibration curve were used to evaluate the accuracy of the model, and the receiver operator characteristic curve (ROC curve) and the area under the curve (AUC) were used to evaluate the prediction efficiency, decision curve analysis (DCA) was used to evaluate the clinical utility of the model.@*RESULTS@#A total of 186 patients with moderate and severe burn were included, among which 54 patients suffered from AKI, and the incidence rate was 29.03%. Multivariate Logistic regression analysis showed that the total burn surface area [TBSA; odds ratio (OR) = 1.072, 95% confidence interval (95%CI) was 1.031-1.115, P = 0.001], estimated glomerular filtration rate (eGFR; OR = 0.960, 95%CI was 0.931-0.990, P = 0.010), neutrophil (NEU; OR = 1.190, 95%CI was 1.021-1.386, P = 0.026), neutrophil/lymphocyte ratio (NLR; OR = 0.867, 95%CI was 0.770-0.977, P = 0.019), D-dimer (OR = 4.603, 95%CI was 1.792-11.822, P = 0.002) were the risk factors for patients with moderate and severe burn complicated with AKI. Taking the above indexes as predictive factors, a nomogram prediction model was established, the ROC curve was plotted with AUC of 0.998 (95%CI was 0.988-1.000). Optimum threshold of ROC curve was -0.862, the sensitivity was 98.0% and the specificity was 98.2%, and the consistency index was 0.998 (95%CI was 0.988-1.000). The calibration curve showed that the prognostic nomogram model was accurate, DCA showed that most patients can benefit from this model.@*CONCLUSIONS@#The burned patients with higher TBSA, NEU, NLR, D-dimer and lower eGFR tend to suffer from AKI. The nomogram based on the above five risk factors has high accuracy and clinical value, which can be used as a predictive tool to evaluate the risk of AKI in moderate and severe burn patients.

Protein expression, purification and mouse antiserum preparation of monkeypox virus A23R / 细胞与分子免疫学杂志

Objective To express the monkeypox virus (MPXV) A23R protein in Escherichia coli and purify by Ni-NTA affinity column, and to prepare mouse antiserum against MPXV A23R. Methods The recombinant plasmid pET-28a-MPXV-A23R was constructed and transformed into Escherichia coli BL21 to induce the expression of A23R protein. After optimizing the conditions of expression, A23R protein was highly expressed. Recombinant A23R protein was purified by Ni-NTA affinity column and identified by Western blot analysis. The purified protein was used to immunize mice for preparing the A23R polyclonal antibody, and the antibody titer was detected by ELISA. Results The expression of A23R recombinant protein reached the peak under the induced conditions of 0.6 mmol/L isopropyl-β-D-thiogalactoside (IPTG), 37 DegreesCelsius and 20 hours. The purity of the protein was about 96.07% and was identified by Western blot analysis. The mice were immunized with recombinant protein, and the titer of antibody reached 1:102 400 at the 6th week after immunization. Conclusion MPXV A23R is expressed highly and purified with a high purity and its antiserum from mouse is obtained with a high titre.

Effect of miR-5787 on breast cancer cell invasion and proliferation by targeting HSPG2 gene / 中国医师杂志

Objective:To observe the expression of microRNA (miRNA, miR)-5787 in breast cancer tissues and various cell lines, analyze the effect of overexpression of miR-5787 on breast cancer cell invasion and proliferation, and explore its possible molecular mechanism.Methods:Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) method was used to detect the expression of miR-5787 in 47 breast cancer tissues and adjacent tissues, 4 breast cancer cell lines and normal breast epithelial cells. Breast cancer cell lines with the lowest miR-5787 expression were selected and transfected with miR-5787 mimics (experimental group) and control NC mimics (control group), respectively. qRT-PCR was used to detect the expression of miR-5787 in cells of the two groups. Transwell invasion experiment and cell counting kit-8 (CCK-8) were used to detect the effect of miR-5787 overexpression on breast cancer cell invasion and proliferation. Bioinformatics software and dual luciferase reporter gene experiments were used to predict and verify the target genes that miR-5787 could complementally bind. qRT-PCR and Western blot were used to detect the expression of target gene mRNA and protein.Results:Compared with adjacent tissues (5.05±0.82), the expression of miR-5787 in breast cancer tissues (1.32±0.33) was significantly reduced ( P<0.01). Compared with normal breast epithelial cells, the expression of miR-5787 in the four breast cancer cell lines was reduced ( P<0.05), and the expression in HCC1937 cells was the lowest ( P<0.01). After transfection of miR-5787 mimics, the expression of miR-5787 in HCC1937 cells in the experimental group was significantly higher than that in the control group ( P<0.01). Overexpression of miR-5787 could inhibit the invasion ( P<0.05) and proliferation ( P<0.05) of breast cancer HCC1937 cells. Bioinformatics software showed that the target gene of miR-5787 might be heparan sulfate proteoglycan 2 (HSPG2), and miR-5787 could complement HSPG2 mRNA ( P<0.01). qRT-PCR and Western blot indicated that overexpression of miR-5787 could significantly inhibit the expression of HSPG2 gene ( P<0.01), with the decreased expression of Vimentin, N-cadherin, Ki67 and PCNA. Conclusions:miR-5787 expression was low in breast cancer tissues and cell lines. Overexpression of miR-5787 could inhibit the invasion and proliferation of breast cancer HCC1937 cells by interfering with the expression of HSPG2 gene.

Value and Clinical Application of Orthopedic Metal Artifact Reduction Algorithm in CT Scans after Orthopedic Metal Implantation

OBJECTIVE: To evaluate orthopedic metal artifact reduction algorithm (O-MAR) in CT orthopedic metal artifact reduction at different tube voltages, identify an appropriate low tube voltage for clinical practice, and investigate its clinical application. MATERIALS AND METHODS: The institutional ethical committee approved all the animal procedures. A stainless-steel plate and four screws were implanted into the femurs of three Japanese white rabbits. Preoperative CT was performed at 120 kVp without O-MAR reconstruction, and postoperative CT was performed at 80–140 kVp with O-MAR. Muscular CT attenuation, artifact index (AI) and signal-to-noise ratio (SNR) were compared between preoperative and postoperative images (unpaired t test), between paired O-MAR and non-O-MAR images (paired Student t test) and among different kVp settings (repeated measures ANOVA). Artifacts' severity, muscular homogeneity, visibility of inter-muscular space and definition of bony structures were subjectively evaluated and compared (Wilcoxon rank-sum test). In the clinical study, 20 patients undertook CT scan at low kVp with O-MAR with informed consent. The diagnostic satisfaction of clinical images was subjectively assessed. RESULTS: Animal experiments showed that the use of O-MAR resulted in accurate CT attenuation, lower AI, better SNR, and higher subjective scores (p < 0.010) at all tube voltages. O-MAR images at 100 kVp had almost the same AI and SNR as non-O-MAR images at 140 kVp. All O-MAR images were scored ≥ 3. In addition, 95% of clinical CT images performed at 100 kVp were considered satisfactory. CONCLUSION: O-MAR can effectively reduce orthopedic metal artifacts at different tube voltages, and facilitates low-tube-voltage CT for patients with orthopedic metal implants.

Effects of different surgical procedures on clinical outcomes and quality of life in patients with breast cancer / 中国基层医药

Objective To investigate the effects of different surgical procedures on clinical outcomes and quality of life(QOL)in patients with breast cancer.Methods The clinical data of 93 patients with breast cancer were retrospectively reviewed.According to the different surgical methods,they were divided into two groups:breast conserving surgery(BCS)group(n =42)and modified radical mastectomy(MRM)group(n =51).Clinical outcomes and QOL score between the two groups were compared.Results Compared with MRM group,the incidence rate of complication in BCS group was significantly lower in subcutaneous exudate[7.1%(3 /42)vs.25.5%(13 /51),χ2 =5.443,P =0.020]and upper limb swelling[14.3%(6 /42)vs.37.3%(19 /51),χ2 =5.443,P =0.020].In the aspect of QOL score,BCS group showed significantly higher score in emotional well -being [(23.14 ±2.71)points vs.(19.98 ±2.69)points,t =5.606,P =0.000],functional well -being[(24.61 ±2.72)points vs.(23.18 ± 2.99)points,t =2.372,P =0.020]and total score of QOL[(116.42 ±12.439)points vs.(111.18 ±10.75)points, t =2.147,P =0.034].BCS group showed significantly lower score in self -rating anxiety scale test[(47.89 ±8.32) points vs.(52.46 ±7.38)points,t =2.767,P =0.007].Conclusion Compared with MRM,BCS can effectively decrease the incidence rate of complications and increase the QOL in breast cancer patients.

Effect of trichostatin A on the chemotherapy sensibility to 5-Fu of colorectal cancer cell line Lovo and the possible mechanisms / 肿瘤研究与临床

Objective To investigate the effect of histone deacetylase inhibitor trichostatin A (TSA) on the chemotherapy sensibility of 5-fluorouracil (5-Fu) in colorectal cancer cell line Lovo, and to explore the possible mechanisms.Methods According to the treatment methods, the cells were divided into control group, 5-Fu group, TSA group, TSA preconditioning group and combination group (TSA+5-Fu).MTT assay was used to detect cell proliferation at 24 h, 48 h and 72 h after drugs treatment.Transwell assay was used to test cell invasion after 24 h drugs treatment.Flow cytometer was applied to observe the apoptosis after 24 h drugs treatment.The expressions of thymidylate synthase (TS) were detected by Western blot after 24 h drugs treatment.Results Compared with control group, the 5-Fu group, TSA preconditioning group and combination group had a growth inhibition to Lovo cell at 24 h, 48 h and 72 h (P ＜ 0.05), and compared with 5-Fu group, the growth inhibition of TSA preconditioning group and combination group were distinctive at 48 h and 72 h (P ＜ 0.05).However, the inhibition between TSA preconditioning group and combination group were no significant (P ＞ 0.05).Interfered after 24 h, the number of cells penetrating the matrigel in control group, 5-Fu group, TSA group,TSA preconditioning group and combination group were (25.0±4.2), (16.8±2.8), (19.6± 2.5), (8.2±3.2) and (6.5±2.6), respectively (P ＜ 0.05), and the apoptosis rates were (4.26±1.36) ％, (11.66± 3.18) ％, (8.57±2.69) ％, (39.79±8.53) ％ and (45.18±10.07) ％, respectively (P ＜ 0.05).Compared with control group, the number of cells penetrating the matrigel in the experimental groups was significantly decreased, and the apoptosis rate was significantly increased (P ＜ 0.05).Compared with 5-Fu group, the numbers of cells penetrating the matrigel in TSA preconditioning group and combination group were markedly decreased, and the apoptosis rates were markedly increased (P ＜ 0.05), but the number of cells penetrating the matrigel and the apoptosis rate between TSA preconditioning group and combination group were not different (P ＞ 0.05).The difference of TS expression between control group and 5-Fu group was not significant (P ＞ 0.05).Compared with that in control group and 5-Fu group, TS expressions in TSA group, TSA preconditioning group and combination group were markedly decreased (P ＜ 0.05), but TS expressions among the last three groups were not different (P ＞ 0.05).Conclusion TSA can increase the chemotherapy sensibility of 5-Fu in Lovo cells, which may be dependent on reducing the TS expression.

MK-2206, an inhibitor of Akt, induced cell apoptosis and autophagy in U2 OS cells / 中国病理生理杂志

AIM:To observe the effect of MK-2206, an inhibitor of Akt, on the cell apoptosis and autophagy of U2OS cells.METHODS:The cell viability was detected by MTT assay .The cell apoptosis was analyzed by TdT-media-ted dUTP nick end labeling assay .The expression of LC3-II was examined by Western blotting .RESULTS:MK-2206 in-hibited the cell viability in a dose-dependent manner .MK-2206 induced the cell apoptosis via activation of caspase-3, caspase-9 and PARP.MK-2206 treatment substantially induced the U 2OS cell autophagy by increasing in the levels of LC 3-II.Blockage of autophagy using chloroquine magnified MK-2206-induced cell death in U2OS cells.CONCLUSION:The Akt inhibitor MK-2206 induces cell apoptosis and autophagy .Blocking autophagy magnifies MK-2206-induced the inhibi-tion of the viability in U2OS cells.

The clinical observation of neoadjuvant chemotherapy with TAC scheme in breast cancer / 中国基层医药

Objective To investigate clinical effects of neoadjuvant chemotherapy of TAC scheme in breast cancer.Methods 82 patients with locally advanced breast cancer receiving neoadjuvant TAC chemotherapy program were retrospectively analyzed.The total efficiency,toxicity,and recent surgical cases were evaluated.Results There were 21 cases of CR in 82 cases with breast cancer,accounting for 25.6％,47 PR(57.3 ％),14 SD(17.1％),so the clinical total effective rate was 82.9％.The major toxic reactions was bone marrow suppression and neutropenia occurrence rate was 81.7％.Other adverse effects include gastrointestinal symptoms and liver dysfunction,and alopecia.All patients after symptomatic treatment can be tolerated.Conclusion TAC program neoadjuvant chemotherapy for locally advanced breast cancer patients can improve the cure rate,increase breast-conserving opportunities.

Dynamic changes of capillary bed blood volume in acute ischemic denervated hindlimb of rabbits: an evaluation on 256-slice CT perfusion imaging / 中华放射学杂志

Objective To investigate the capillary blood volume (BV) changes in acute ischemic denervated hindlimb of rabbits and the value of 256-slice detector computed tomography (CT) perfusion imaging in evaluation.Methods A total of 40 healthy, adult white rabbits underwent either right hindlimb femoral artery excision combined femoral nerve denervation (combined modeling group, n = 10), simple femoral artery excision (iachemia group, n = 10), simple femoral nerve denervation (denervation group,n = 10), or simple femoral artery separation (sham-surgery group, n = 10).At 1,7, 14, 21, and 28 days following surgery, CT perfusion scanning (Philips Brilliance 256-row) was performed and CT perfusion images were processed using maximum-slope method with Function CT software on EBW workstation.The ratio of BV (rBV) in muscle tissue between right and left hindlimbs was calculated in each group.At 14 and 28 days, following sacrifice, rabbit bilateral adductor was harvested for immunohistochemical staining.The ratio of microvessei density (rMVD) in muscle tissue between right and left hindlimbs was calculated.The significance of the difference of rBV at each time point was assessed using analysis of variance of factorial design (2 ×2).Pearson correlation analysis was used to study the relationship between rBV and rMVD.Results After surgery, the 1st day rBV of combined modeling group, combined modeling group,denervation group and sham-surgery group is 0.31 ± 0.15 ( n = 6), 0.29 ± 0.12 (n = 6), 0.98 ± 0.08 ( n =6), 0.98 ± 0.07 ( n = 6) respectively.The 7th day following surgery rBV is 1.69 ± 0.45 ( n = 5 ), 1.63 ±0.43(n=6), 0.99 ±0.07(n =6), 1.00 ±0.08(n =6).The 14th day is respectively 1.58 ±0.18(n=5), 1.49 ±0.25(n =6), 0.94 ±0.08(n =6), 1.01 ±0.05(n =6).The 21th day is 1.42 ±0.41 (n=4),1.43 ±0.31(n=4), 0.94 ±0.05(n =5), 1.02 ±0.05(n =5),and the 28th day is 1.00 ±0.25(n=4),0.99 ±0.08(n=4), 0.92 ±0.09(n =5), 1.02 ±0.13(n=5).At each time point with exception of postoperative 28 days(F(A) =0.214,P>0.05), ischemia produced main effects on rBV(F(A) =274.268,30.044,65.787,18.886 ,P < 0.01 ), while simple denervation did not show main effects on each time point.Ischemia and denervation did not yield interaction effects on each time point, rMVD from each group supported above-mentioned changes.The correlation coefficient of rBV to rMVD was r = 0.862 ( P < 0.01 ).Conclusions BV in acute ischemic denervated hindlimb of rabbits shows a dynamic change, and denervation does not obviously influence this process.256-slice detector CT perfusion imaging can be used to noninvasively and semi-quantitatively evaluate the dynamic changes of capillary bed in acute ischemie denervated hindlimb of rabbits.

Assessment of image quality and radiation dose with prospective versus retrospective electrocardiography gated 256-slice coronary CT angiography / 中华放射学杂志

Objective To retrospectively compare the image quality and radiation dose for coronary CT angiography obtained with a prospectively gated transverse (PGT) CT technique and a retrospectively gated helical (RGH) CT technique. Methods Coronary CT angiography obtained with 256-slice CT were retrospectively evaluated in 177 patients. The main branches of coronary arteries were divided into 9 segments. The image quality was evaluated with a four-point grading scale. The assessability of coronary artery segment, image quality score and radiation dose for prospective and retrospective CT angiography were compared with student t test. Results The PGT technique was used in 86 patients. The routine RGT technique was used in 91 patients. The percentage of assessable coronary artery segments was 98. 8% (765 of 774)with PGT technique versus 99. 6% (816 of 819) with RGH technique (t = 2. 51, P = 0. 01 ). In patients with heart rates under 75 beats per minute, the image quality of coronary artery branches was similar between PGT and RGH techniques (99. 8% versus 99. 7%, t = 1.90, P > 0. 05 ) . In patients with heart rates above 75 beats per minute, the image quality with RGH technique was better than that with PGT technique (99.0% versus 93. 6%, t = 3.57, P < 0. 05 ). Effective dose with prospective CT angiography was 60. 0% lower than that with retrospective CT angiography [ (4. 4 ± 0. 5 ) vs ( 10. 3 ± 1.5 ) mSv, t = 33.4,P <0. 05 ]. Conclusions Prospective CT angiography can reduce effective radiation dose obviously. The PGT technique offers the similar image quality with RGH technique in patients with heart rates under 75 beats per minute and RGH technique has better image quality in patients with heart rates above 75 beats per minute.

Optimal window width and center level settings in 256-slice spiral CT diagnosis of costal cartilage fracture / 中国医学影像技术

Objective To investigate the optimal window level and center level settings in the diagnosis of costal cartilage fracture with 256-slice spiral CT through ROC analysis. Methods Thirty patients with suspected costal cartilage fractures underwent 256-slices chest spirals CT scaning. CT value of costal cartilage was measured by three experienced radiologists. The soft copy images of three kinds of window level and window width (-100 HU/1120 HU, 100 HU/1120 HU, 300 HU/1120 HU) were analyzed independently in PACS with dual-blind method, and the diagnosis results were taken ROC analysis with SPSS 16.0 software. The diagnostic accuracy of three physicians were evaluated and compared according to the area under the ROC curve (Az). Results A total of 8 patients of costal cartilage fractures were confirmed by CT diagnosis combined with clinical follow-up. The mean CT value of 30 patients was (98.78±32.86) HU. The area under the ROC curve with the window level and center level settings of (100 HU/1120 HU) were bigger than that of other window level and window width (P=0.045,P=0.002). Kappa identity test showed that there was a powerful conformability between the diagnostic results of three physicians. Conclusion 256-slice spiral CT is a good way for the diagnosis of costal cartilage fractures with suitable window level and center level settings.

Comparison of body artery imaging between dual-energy CT angiography and traditional 3D CT angiography / 中国医学影像技术

Objective To evaluate the effect of automatic bone and plaque removal on image quality and grading of steno-occlusive lesions in patients undergoing dual energy CT angiography (DE-CTA) of body artery. Methods DE-CTA was performed in 23 patients with suspected body vascular disease. Separate datasets were calculated for each of the two tubes and used to generate automatically bone-subtracted images (ABS) as well as additional manual bone removes after plaque subtracted images (ABPS). In addition, a weighted average dataset from both dual energy acquisitions resembling routine 3D CT acquisition was used for automatic bone remove (ABR). Residual bone in the ABR dataset was removed manually (ABR-M). Operator time for bone removal was measured, while effectiveness of bone subtraction and the time needed of ABPS and ABR-M was assessed. Compared with MPR, ABR images and stenosis grading in plaque subtracted were assessed with two radiologists. Results The imaging quality of ABR was superior to that of ABS (P<0.05). The time needed of ABPS was (7.8±4.3) min, significantly lower than that of ABR-M (11.4 min±2.5 min, P<0.05). A total of 325 steno-occlusive lesions were assessed. The sensitivity, specificity of DE-CTA and traditional 3D CTA was 95.74%, 96.19% and 92.93%, 97.87%, respectively. Conclusion The imaging quality is good after automatic bone and plaque subtraction of DE-CTA. Automatic plaque subtraction for the first time provides a true CTA imaging which is easy to interpret and reduces the need for further post-processing. The diagnosis of vascular stenosis with DE-CTA is also accurate, and the time spent in post-processing is less than that of traditional 3D angiography.

Clinicopathologic characteristics of triple-negative breast cancer / 中华普通外科杂志

Objective To study the clinicopathologic characteristics of triple-negative breast cancer (TNBC) and its value in the prediction of prognosis. Method In this study,500 cases of female breast cancers were examined immunohistochcmically for the TNBC. The clinicopathologic characteristics of the 243 TNBC cases were inspected. Results TNBC accounted for 17.6% (88/500) of the 500 breast cancers. The histological types of the TNBC included mainly infihrative ductal carcinoma, metaplastic carcinoma and medullar carcinoma. Among those, histological grade Ⅲ accounted for 72.7% (64/88) of all the TNBC and was more common than that in hormone receptor positive breast cancers (HR+ group ) and Her-2 overexpression breast cancers (Her-2 group)(P=0.000). The positive rates of CK5/6 and EGFR in the TNBC were 30.7% (27/88) and 34.1% (30/88), respectively. The positive rates of ERCC1 and KIT in the TNBC were 28.4% (25/88) and 34.1% (30/88), respectively, Both of which were higher than those in the HR + group and Her-2 group, respectively (P=0.032 and P=0.026). 3-year survival rate of the TNBC was 71.5% and it was lower than that of HR group (P=0.021) and not significantly different from that of Her-2 group (P=0.474). Conclusions TNBC is the breast cancer with high aggressive pathologic futures and poor prognosis. EGFR and ERCC1 expression were positive in a portion of TNBC cases.

Application of energy subtract angiography of dual source CT in diagnosis of arterial diseases of the lower extremities / 中国医学影像技术

Objective To observe the value of dual source CT (DSCT) dual energy subtract method in diagnosis of lower extremity arterial occlusion. Methods Thirty-two patients with lower extremity arterial occlusive diseases underwent DSCT direct bone removal CT angiography (DE-BR-CTA) and digital subtraction angiography (DSA) within 2 weeks. Raw data were reconstructed with techniques including MIP and VR. Arterial visibility of DE-BR-CTA was analyzed by two experienced radiologists taking DSA as the standard. Results A total of 328 arterial segments were selected in 32 patients with lower extremity arterial occlusive diseases. The correlation between DSA and DE-BR-CTA was good. There was no significant difference in arterial visibility between DE-BR-CTA and DSA (P＞0.05). Compared with DSA, 12 of the segmental stenosis were overestimated and 6 were underestimated with DE-BR-CTA. When stenosis was over 10%, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of DE-BR-CTA was 94.51%, 96.15%, 93.02%, 92.59% and 96.39%, respectively. Conclusion DSCT energy subtraction angiography is an accurate diagnostic method and non-invasive imaging technology in the assessment of lower extremity arterial occlusive diseases. It may provide precious information for pre-surgery evaluation and screening the arterial diseases of the lower extremities.

Noninvasive coronary venous system imaging using 64-slice CT angiography / 中华放射学杂志

Objective To evaluate the 64-slice CT angiography in characterizing the coronary venous anatomy and the arterio-venous relationship.Methods Sixty-four slice CT coronary veins angiography images of 300 patients(187 men and 113 women,)were analyzed.The visibility of the coronary veins and arterio-venous spatial relationship were assessed qualitatively on two-and three-dimensional displays.The diameter of the coronary sinus ostium(CSO),middle cardiac vein ostium(MCVO)and posterior vein of left ventricle ostium(PVLVO)were measured.All data was statistically processed with SPSS for Windows.Results The CS,great cardiac vein(GCV)and MCV could be clearly visualized in all of the images.1-3 branches of PVLV could be observed in 273 patients(91.0%).Small cardiac vein(SCV)and Marshall vein were found in 56(18.7%)and 24(8.0%)cases respectively.Three patients had permanent vena cava superior on the left and one patient had a CS diverticulum.Posterior descending artery(PDA)was concomitant with MCV in 189 cases(63.0%)and intersected with MCV in 96 cases(32.0%).Left circumflex artery(LCX)was concomitant with CS in 122 cases(40.7%),intersected with MCV in 15 cases(5.0%),and intersected with PVLV in 104 cases(34.7%).There were no significant differences in age,sex and CHD groups among CSO,MCV,PVLV value.The supero-inferior diameter of CSO had a significant difference between male and female(F=6.67,P＜0.05).Conclusion Sixty-four slice CT venous angiography is able to be used for guiding electrophysiological procedures,which is especially useful due to the considerable variations in venous anatomy.