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@#Objective To study the safety of right vertical infra-axillary thoracotomy (RVIAT) in the repair of ventricular septal defect (VSD) and the optimal age for RVIAT. Methods Between June 2014 and June 2018, 441 children underwent VSD repair via RVIAT in our hospital. According to the age, they were divided into four groups: a 4 months to 1 year old group (R1 group, n=123), a 1-2 years old group (R2 group, n=106), a 2-5 years old group (R3 group, n=166), a >5 years old group (R4 group, n=46). The clinical effects of the patients were compared. Results All the operations were successfully performed and no serious complication was found in all groups. No statistical difference was observed in the operation time, blood loss during operation, thoracic drainage 24 h after operation among groups (P>0.05). The cardiopulmonary bypass time, aortic cross-blocking time and ICU stay time in the R1 and R2 groups were longer than those in the R3 and R4 groups (P<0.05). In the R1 group, the postoperative ventilating time and postoperative hospital stay time were longer, and the blood transfusion volume was more than those in the R3 and R4 groups (P<0.05). The incidence of postoperative complications was higher in the R4 group than that in the R1 and R3 groups (P<0.05). Conclusion VSD repair via RVIAT may be more effective in children >2 years old, and 2-5 years old may be the optimal age.
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Purpose To investigate the CT gemstone spectral imaging features of gastric stromal tumors (GST), so as to discuss the value of CT gemstone spectral imaging in the diagnosis and differential diagnosis of GST. Materials and Methods Thirty patients with GST proved pathologically were scanned by gemstone spectral imaging. Their GSI scanning image data and the related clinical data were retrospectively analyzed, and the quantitative analysis based on iodine content of the lesions in both arterial phase and portal phase was carried out. Results The GSI findings showed that the lesions were intra-luminal, extra-luminal or both intra-and extra-luminal soft tissue mass, the sizes were various, and they protruded either toward the inner side of stomach or the opposite or both. Among them, the diameter of 4 tumors in the low risk group ranged from 1 to 5 cm; in the intermediate risk group, 3 tumors had diameters from 1 to 5 cm, and 3 others were from 6 to 19 cm; in high-risk group, 18 tumors' diameter were between 6 to 9 cm, 2 were between 1 to 5 cm, and the rest 1 had multiple lesions in various sizes. Fifteen tumors occurred in gastric body, 10 occurred in gastric antrum, 4 were at the bottom of the stomach, and 1 had multifocal growth. Sixteen patients had internal and external growth of lesions, among whom 14 patients were at high risk; 10 patients' lesions were outside the cavity, including 6 patients at high risk and 1 patient at low risk; and 4 patients had lesions inside the cavity, including 3 patients at low risk. At the arterial phase the foci mildly strengthened, and they strengthened increasingly at the portal phase. The material value based water and iodine figure showed that material value based iodine of the lesions at both arterial phase and portal phase was higher than that in the normal gastric wall tissue, and the material value based iodine of the lesions at portal phase was higher than that at arterial phase (F=378.6 and 296.6, P<0.05). At arterial phase, the iodine content of the lesions in the mucosa was slightly higher than that in the submucosa and muscular layer (t= - 2.245, P<0.05). Conclusion CT gemstone spectral imaging can accurately show the external forms and internal changes of GST lesions and iodine content measurement can provide quantitative diagnostic information, therefore they can provide more effective information for clinical diagnosis.