Clinical and cardiac MR characteristics of heart involvement in patients with Fabry disease / 中华放射学杂志

Objective:To investigate the clinical and cardiac magnetic resonance (CMR) characteristics of heart involvement in patients with Fabry disease (AFD).Methods:From January 2018 to March 2021, eight AFD patients [3 males and 5 females, mean age (50±11) years old, range 26-60 years old] confirmed by genetic testing or pathology in Fuwai Hospital were retrospectively included in this study. At the same time, sixteen patients with hypertrophic cardiomyopathy (HCM) [6 males and 10 females, mean age (46±15) years old] and 16 healthy individuals [6 males and 10 females, mean age (51±11) years old] were included as controls. The clinical baseline data and CMR data of the patients were collected and analyzed. The CMR data were analyzed using the software CVI42, with the corresponding parameters automatically generated. One-way ANOVA or Kruskal-Wallis test was used to compare the differences in the parameters among the three groups. Independent-samples t test, Fisher precise test or Mann-Whitney U test were used for the comparison between each two groups. Results:Statistically significant difference was found in renal insufficiency between the HCM group and the AFD group; No other significant difference was found in other clinical factors and ECG results (all P>0.05). CMR results showed that in the AFD group, there were 5 cases with symmetric or roughly symmetric hypertrophy, and 3 with asymmetric hypertrophy. The late gadolinium enhancement (LGE) showed myocardial enhancement in 5 patients, mainly presenting as multiple intermural enhancement, and partially as local subendocardial enhancement. In the HCM group, fourteen cases suffered mainly asymmetric ventricular septal thickening, with or without thickening of other parts of left ventricular wall; and 2 cases had thickening of middle and distal part of the left ventricle. The LGE showed myocardial enhancement in 14 patients, which manifested as focal or patchy enhancement in hypertrophic myocardium, including focal enhancement in the right ventricular insertion of ventricular septum (more common) and subendocardial enhancement in the middle and far segments of left ventricle. Statistically significant difference was found in the differences between the left atrial anterior posterior diameter, the maximum wall thickness of left ventricular, the left ventricular myocardial mass index (LVMI) and the native T 1 value among the three groups (all P<0.001). However, there was no statistically significant difference in the left atrial anterior posterior diameter and the maximum wall thickness of left ventricular between AFD group and HCM group ( P>0.05). The LVMI in AFD group was higher than that in healthy group and HCM group (all P<0.05). Significant difference was found in the native T 1 value among the three groups, with the native T 1 value of the AFD group [(1 177.4±46.0) ms] was significantly lower than that of the healthy group [(1 244.5±34.3) ms] and the HCM group [(1 278.8±41.6) ms], with ( F=13.10, P<0.001). Conclusions:The clinical characteristics of AFD and HCM are quite similar. When AFD is suspected, CMR imaging should be the first choice for imaging examination. Especially, T 1 mapping imaging can provide important information for the diagnosis of AFD.

The clinical value of procalcitonin in predicting the death of patients with acute biliary pancreatitis / 中华胰腺病杂志

Objective:To explore the clinical value of procalcitonin (PCT) in predicting mortality of patients with acute biliary pancreatitis (ABP).Methods:The clinical data of 196 ABP patients admitted in the emergency department of Ruijin Hospital Affiliated to Shanghai Jiaotong University Medical College from January 2013 to June 2017 were analyzed retrospectively. The enrolled patients were divided into survival group ( n=176) and death group ( n=20) according to clinical outcome, and their clinical characteristics, laboratory results(including WBC, CRP, PCT), APACHEⅡ score, BISAP score, modified Marshall score, SOFA score and CTSI at admission were compared between two groups. The ROC curve and AUC were used to evaluate the effectiveness of PCT and multiple scoring systems in predicting mortality in ABP patients, and the Delong test was used to compare the predictive efficacy of various methods at 1-2 d, 3-4 d, and 5-7 d days after onset. Results:The PCT level, APACHEⅡ score, BISAP score, modified Marshall score, SOFA score, and CTSI of patients in the death group were significantly higher than those in the survival group [6.98(3.12, 13.64) μg/L vs 0.55(0.17, 1.74) μg/L, 12.00(6.00, 18.75) vs 6.00(3.00, 9.00), 3.20±1.47 vs 1.59±1.05, 2.85±0.37 vs 1.96±0.64, 5.50(4.00, 9.50) vs 2.00(1.00, 4.25), 5.05±2.33 vs 3.39±1.74], and all the differences were statistically significant (all P values <0.05). The AUC of PCT for predicting death was 0.881 (95% CI 0.820-0.938)and the cut-off value was 2.44. The predictive value of PCT was similar to that of the modified Marshall score, BISAP score and SOFA score, but higher than that of APACHEⅡ score and CTSI (all P values <0.05). The predictive AUC of PCT at 3-4 days after onset was higher than that of modified Marshall score, BISAP score and SOFA score, and were significantly higher than those at 1-2 days after onset. Conclusions:PCT can be used to predict the mortality of ABP within 7 days of onset. The predictive value of PCT was comparable to the modified Marshall score, BISAP score and SOFA score, and the best predictive time was 3-4 days after onset.

Study progress of diagnosis for asthma in preschool-aged children / 中华实用儿科临床杂志

Children under 6 years old are high-risk group for wheezing,and it is difficult but essential for these particular group to be diagnosed with asthma. In the past 30 years,researches based on asthma prediction models have been raised,but with no specific diagnostic criteria. Experts of childhood asthma in China had established empiri-cal diagnostic criteria since 1998 and optimized it continuously,but it was denied due to lack of further research of evi-dence-based medicine. Independent and operative diagnostic criteria was out of range since 2008,therefore diagnosis might be a great challenge for clinical physicians. Now,it is necessary to explore and establish diagnostic criteria based on evidence-based medicine as well as experience of experts. Scholars of childhood asthma in China have obtained 38 asthma-related parameters after massive search of related literatures,and obtained 5 parameters ultimately through Delphi method,single factor analysis and multi-factor regression analysis,and have valued them according to relevant intensity. The diagnostic criteria for cumulative integration of children under 6 years of age has been established initia-lly,which is still in the verification stage,but is expected to provide timely and accurate diagnosis for early childhood asthma.

The predictive effect of myocardial injury markers on the severity of acute pancreatitis / 中华急诊医学杂志

Objective To assess the predictive effect of myocardial injury biomarkers (proBNP, CK-MB, and cTnI) on the severity of acute pancreatitis (AP). Methods The records of 246 patients diagnosed with acute pancreatitis who were treated at Ruijin Hospital Emergency Department from January 2015 to December 2016 were retrospectively analyzed. According to the revised 2012 Atlanta guidelines, these patients were divided into the mild acute pancreatitis (MAP, n=47), moderately severe acute pancreatitis (MSAP, n=151) and severe acute pancreatitis (SAP, n=48) groups. The highest plasma levels of troponin I (cTnI), creatine kinase (CK)-MB, N-terminal B-type brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), and procalcitonin (PCT) were recorded for comparison within 72 h after admission. The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score, sequential organ failure assessment (SOFA), bedside index for severity in acute pancreatitis (BISAP) and Balthazar computed tomography severity index (CTSI) were calculated at admission within 72 h. Whether there is an occurrence of organ dysfunction, and the organ types and persist time of organ dysfunction were recorded. The analysis of variance, SNK-q test and paired samples t test were used for the statistical analysis. Results The levels of proBNP, CK-MB, and cTnI were significantly higher in the SAP group than in the non-SAP group. The receiver operating characteristic (ROC) curve demonstrated cTnI had the maximum predictive power (AUC=0.872), while proBNP had the least predictive ability (AUC=0.763). The established model, which is to explore whether the myocardial injury markers had the predictive value, showed that the combination of myocardial injury indicators (CK-MB, cTnI) and traditional indicators had higher predictive value for SAP than traditional indicators alone (AUC=0.966 vs. AUC=0.945, P=0.04). Conclusions The elevated markers of myocardial injury had certain predictive value for severe acute pancreatitis.

Diagnostic criteria and predictive tools for asthma in preschool-aged children / 国际儿科学杂志

Preschool-aged children are more likely to be diagnosed with asthma compared with elder children or adolescents.Diagnosis might be a great challenge for clinical physicians due to its specialties in symptom patterns, phenotype classifications and difficulties to apply measurements.For decades researches based on the diagnosis and prediction of asthma in preschool-aged children have never been stopped, meanwhile efforts should be made on the development of the diagnostic criteria for Chinese preschool-aged children.This article places spotlight on the development of diagnosis and prediction of asthma in early childhood throughout the world, thus provide references for the establishment of the diagnostic criteria for Chinese preschool-aged chilren.

Preliminary study of iFlow application in lower extremity vascular disease / 中华胸心血管外科杂志

Objective The purpose of this study was to evaluate the practicability and efficiency of iFlow assistant function in lower extremity vascular disease angioplasty.Methods Retrospective analysis to 22 patients with lower extremity vascular disease in our single center from Septmber 2013 to November 2013, 19 males and 3 females with mean age(66.31 ± 7.46)years, iFlow technology was utilized to analyze the Region Of Interest(ROI) Peak Time(PeakTime) in pre-and post-angioplasty of lower extremity artery and assessed the state of vessel stenosis and blood flow perfusion, as well Doppler ultrasound in postoperative was used to double identify iFlow results.The results of vessel lesion, such as state of stenosis and occlusion were diagnosed by two senior doctors individually, as well as ROI Peak Time was recorded by technician.Results The iFlow technique performed that the ROI PeakTime in the region of interest was significantly decreased in postoperative in comparison to pre-angioplasty [(0.48 ± 0.39) s vs.(1.32 ± 0.60) s, t =8.836, P ＜ 0.001].The Doppler ultrasound in postoperative showed that the ankle-brachial index was significantly increased compared within preoperative (0.97 ± 0.16 vs.0.49 ± 0.11, t =-10.205, P ＜ 0.001).The results of iFlow technique in intraoperative were consistent with those of Doppler ultrasound in postoperative.Conclusion iFlow technique is effective to evaluate hemodynamic change of blood flow in vessel lesion in pre-and postangioplasty, which is assistive technique to assess the efficiency and prognosis in angioplasty.

Radiation dose rate received by patients with coronary heart disease during interventional management:comparison between fluoroscopy and movies / 介入放射学杂志

Objective To determine the real time radiation dose rate displayed on DSA equipment in interventional management for patients with coronary heart disease in order to provide medical staff with useful basis to reasonably control the radiation dose. Methods A total of 30 patients with coronary heart disease, who received interventional treatment at authors’ hospital in September 2014 with a GE DSA unit, were randomly selected. Intraoperative radiation dose rates when fluoroscopy was converted to movies , which were displayed on DSA at respective sequence, were determined, and the results were analyzed and compared. Results The fluoroscopy radiation dose rate ranged from 18.5 to 212.0 mGy/min, the mean value was (114.7±42.1) mGy/min;while the radiation dose rate of movies varied from 216 to 1 691 mGy/min, with a mean value of(970.1±298.4) mGy/min. The overall mean fluoroscopy-to-movies radiation dose ratio was 1 ∶8.5. The larger the digital flat panel detector area was , the bigger the mean radiation dose rate would be and the more obvious increase in the mean radiation dose rate of movies than that of the fluoroscopy would be observed; the mean radiation dose rate of fluoroscopy was lower than that of movies , and the difference was significantly. Conclusion During the performance of coronary intervention , the medical staff should make reasonable choice of the equipment and closely observe the dynamic real-time display of the radiation dose rate, promptly adjust the inspection mode and the controllable parameters when it is needed , make immediate evaluation of dose level that might cause radiation injury to the patient , and reasonably control the radiation dose to reduce the effects of ionizing radiation on human health.

Web-based support system for medical device maintenance / 中国医疗器械杂志

A Web-based technology system was put forward aiming at the actual problems of the long maintenance cycle and the difficulties of the maintenance and repairing of medical equipments. Based on analysis of platform system structure and function, using the key technologies such as search engine, BBS, knowledge base and etc, a platform for medical equipment service technician to use by online or offline was designed. The platform provides users with knowledge services and interactive services, enabling users to get a more ideal solution.

A new kind of drying cabinet for surgical instrument / 局解手术学杂志

Objective To create a new drying surgical instruments drying cabinet for the drying equipment with some technical short-comings and without widely used. Methods The air cleanliness,temperature and speed of special properties in the process of drying surgical instruments were study to create a new technology of drying cabinet for surgical instruments with a low cost,advanced features and the maneu-verability. Results A new type of dry prototype for surgical instruments was successfully developed and tested with heating and drying,the average heating time and the shortest processing time under 70 ℃ were 5. 1 min and 15. 6 min,respectively,the average heating time and the shortest processing time under 90℃ were 7. 8 min and 14. 2 min,respectively,which has more advantages than traditional drying equipment. Conclusion The new surgical instruments drying cabinet has a high application value and good prospect of industrialization,which can be the basic equipment for CSSD and operating departments of hospital.

Heart Rate Variability and Carotid Intima Media Thickness in Patients with Type 2 Diabetes Mellitus / 中华高血压杂志

Objective To investigate the relationship between heart rate variability(HRV) and the carotid intima media thickness in type 2 diabetic patients.Methods One hundred thirty-two type 2 diabetic patients were categorized into groups by carotid intima-media thickness(IMT):group T1(36 cases,IMT

Analysis on the Supervision System of Retail Pharmacies in the Developed Countries like America and Great Britain / 中国药房

OBJECTIVE:To provide references for the perfecting of Chinese administration system on retail pharmacies.METHODS:The related laws and regulations of the supervising institutions of retail pharmacies in the developed countries like America and Great Britain were collected,compared and analyzed.RESULTS:The supervision systems of retail pharmacies in the developed countries like America and Great Britain have noticeable merits and rationalities.CONCLUSION:The construction of supervising system and the arrangement of its authorities on retail pharmacy in countries like America,Great Britain have some reference value for the supervision of Chinese retail pharmacies in its way towards more rationality and humanity.

Standardization and supervision of medical consumables management by ISO9001 / 医疗卫生装备

Medical consumables is the indispensible material foundation for diagnosis and treatment in hospital.The management of medical consumables is rather complicated for the multiplicity of its manufacture factories,suppliers and marketing ways.ISO9001 certification is extensively applied to the management of medical consumables,which can effectively ensure the consumables quality,prevent medical accident and protect consumer's privilege.

Development of multi-functional cleaning-out device for medical apparatus / 医疗卫生装备

Objective To develop a kind of multi-functional cleaning-out device for medical apparatus.Methods Drawing on experience of traditional medical apparatus cleaning techniques by human or machine,a new cleaning-out device was designed.The prototype was made and proofed by series of tests.Results This device has outstanding advantages in producing cost,cleaning quality and cleaning cost.Conclusion This device worth popularizing for its easy-operation and low cost.

Design and development of mapping model among medical images with different modes in virtual reality / 医疗卫生装备

This paper is to establish a mathematical mapping m odel of different medical images for the same human tissue or organ.According to the mathematical mapping model of gray level,the merging and matching methods of medical image information,including CT and MRI,are studied.The coordinate sy stems of different medical images are normalized to be at the same three-dime nsional position,and then the new-mode images are showed to the users.This study establishes the basis of three-dimensional visibility of the information merge of medical images with different mode.

Analysis and verification of positive B-D experiment result for pulsation vacuum sterilization machine / 医疗卫生装备

B-D experiment is the main way to determine the safety of pulsation vacuum sterilization machine, but the positive result by B-D experiment doesn't always result from the error of the machine for too many influencing factors. In this paper, Analysis and verification of positive B-D experiment result are performed, and thus the sterilization machine can be used properly.