Objective:To explore influence of different guide wire on transradial coronary angiography (CAG). Methods:A total of 238 patients,who received successful transradial CAG in our hospital from Nov 2009 to Jan 2013,were selected.According to kinds of guide wire,they were divided into group A (n=119,used ordinary J type exchange guide wire)and group B (n=119,used loach exchange guide wire.Trafficability,supporting force and incidence rate of complications were compared between above two groups.Results:The trafficability of loach exchange guide wire was significantly better than that of ordinary J type exchange guide wire,the pass rates of elbow joint (98.3% vs.87.4%)and brachiocephalic trunk (100% vs.96.2%)were significantly higher than those of or-dinary J type exchange guide wire (P<0.01 or <0.05).For guide wire support to rotate catheter,ordinary J type exchange guide wire had obvious advantages,its success rate of left CAG (98.3%)was significantly higher than that of loach exchange guide wire (89.1%),P<0.01.There were no significant differences in incidence rate of compli-cations between two groups.Conclusion:Ordinary J type exchange guide wire could be preferred in coronary angiog-raphy,and loach exchange guide wire can be considered if the former can't pass.

ObjectiveTo review the efficacy and safety in secondary prevention of ischemic stroke with cilostazol or aspirin.Methodswe searched Cochrane Library(the 4th issue, 2009 ), PubMed(1980.1～2009.11), EMBASE(1980.1～2009.11), CBM(1978.1～2009.11), CNKI(1979.1～2009.11) and some other databases, then collected all of the studies describing the outcomes in curing the ischemic stroke after taking cilostazol or aspirin. According to the strict inclusion and exclusion criteria, two reviewers independently selected trials, extracted datas, made cross-checking and methodological quality assessment of the homogeneity studies by using the Cochrane systematic review methods, then made Meta analysis using RevMan 5.0 software.ResultsThis systematic review study included two randomized controlled trials and a cross-over trial, which contained a total of 838 participants. The evidence quality of one of the randomized controlled trials was high, however, the evidence quality of another randomized controlled trial and the cross-over trial was poor. Meta analysis results suggested that the effectiveness of cilostazol and aspirin in the secondary prevention of ischemic stroke performed no significantly statistical difference: primary endpoint(30 d［RR=3.00, 95%CI(0.31,28.70)］; 90 d［RR=1.67, 95%CI(0.40,6.92)］; 180 d［RR=1.25, 95%CI(0.50, 3.13)］; 360 d［RR=0.65, 95%CI(0.33, 1.29)］; 540 d［RR=0.80,95%CI(0.54, 1.18)］); combined endpoint(30 d［RR=4.00, 95%CI(0.45,35.61)］; 90 d ［RR=1.75,95%CI(0.52,5.93)］; 180 d［RR=1.00, 95%CI(0.48, 2.07)］; 360 d ［RR=0.77, 95%CI(0.45, 1.29)］; 540 d［RR=0.66,95%CI(0.40,1.09)］); the recurrence of ischemic stroke: cilostazol group: RR=0.64, 95%CI(0.31,1.30)，aspirin group: RR=0.21, 95%CI(0.04,1.06); PDMP［RR=1.00, 95%CI(0.39, 2.58)］. But in terms of the probability of intracranial hemorrhage (［RR=7.14, 95%CI(0.7,58.33)］) and other safety standards, taking cilostazol performed lower than taking aspirin.ConclusionThe side effects of cilostazol and aspirin in the treatment for ischemic stroke were similar to each other, but in terms of the probability of dizziness, headache, tachycardia and palpitation, taking cilostazol performed higher than taking aspirin, however, taking cilostazol performed lower in the probability of intracranial hemorrhage and other organ hemorrhage than taking aspirin. Since this study included a small amount of studies, in which the evidence quality of one of the randomized controlled trials and the cross-over study was poor, therefore, it would be necessary to make a further validation with lots of high-quality clinical trials.

Objective:To evaluate the value of a three-dimensional inversion-recovery with real reconstruction (3D-real IR) sequence with an ultralong repetition time (TR) for the endolymphatic hydrops (EH) of Meniere disease (MD) after intravenous gadolinium administration, and compare it with a heavily T 2-weighted three-dimensional fluid-attenuated inversion recovery (hT 2-3D-FLAIR) sequence. Methods:From July 2021 to July 2022, 52 definite MD patients (58 ears) were retrospectively enrolled at Zhongshan Hospital, Fudan University. The 3D-real IR with an ultralong TR (16 000 ms) and hT 2-3D-FLAIR sequences were performed four hours after intravenous single-dose gadolinium administration. The image quality of the two sequences was rated. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured in the two sequence. The EH of cochlear and vestibular was graded, and EH detection rates were calculated. Scores of the two sequences were compared using the paired Wilcoxon signed rank test. Paired t test was used to compare the differences of the SNR and CNR. McNemar test was performed to compare the EH detection rate between the two sequences. Results:The score of the 3D-real IR [3 (3, 4)] was significantly higher than that of the hT 2-3D-FLAIR [2.5 (2, 3), Z=-6.06, P<0.001]. No significant difference was found in SNR of 3D-real IR and hT 2-3D-FLAIR (11.4±6.5 and 12.3±3.7, t=-1.38, P=0.175). CNR of the 3D-real IR (21.7±9.3) was significantly higher than that of the hT 2-3D-FLAIR (9.7±3.8, t=10.67, P<0.001). Using 3D-real IR sequence, the EH detection rate of cochlear (89.7%, 52/58) was higher than using hT 2-3D-FLAIR (67.2%, 39/58, χ 2=11.10, P<0.001). No significant difference was found in the EH detection rate of vestibular between 3D-real IR (77.6%, 45/58) and hT 2-3D-FLAIR (74.1%, 43/58, χ 2=0.50, P=0.500). Conclusion:Compared with hT 2-3D-FLAIR sequence, the 3D-real IR with an ultralong TR can improve the depiction of EH in MD patients after intravenous single-dose gadolinium administration. It can provide higher image quality and detection rate of EH.

Objective To investigate the clinical application of scalp skin grafts in reconstruction of external auditory meatus in congenital aural atresia.Methods We conducted a retrospective study on 85 patients of congenital aural atresia,all of whom were unilateral,operated from March of 2008 to December of 2010 in ENT department of the Sun Yat-Sen Memorial Hospital.The patients enrolled in the study were between 6 to 37 years old (median age 12 years),55 male and 30 female.Scalp surface graft in ipsilateral temporal region was harvested to cover the bony external auditory meatus.Results All of these scalp split-thickness skin grafts survived without necrosis,no restenosis was found in these external auditory meatus.Neither scar nor alopecia was found in the skin-harvesting region,and hairs grew well.Granulations occurred in 27 cases in the first to sixth month posteroperatively,20 cases recovered after local treatment.In the first year,30 cases obtained hearing improvement more than 15 dB,36 cases gained more than 25 dB and 19 cases gained more than 35 dB.Totally 8 patients were lost in the 4 to 5 years of follow-up,70 cases (70/77,90.9％) developed new external auditory meatus,7 cases (7/77,9.1％) suffered from stenosis in different degrees,but no atresia was found in these patients.Conclusion Scalp split-thickness skin grafts has significant clinical advantage in meatoplasty of congenital aural atresia.