Objective To quantitatively assess left ventricular systolic function in rabbits with dilated cardiomyopathy(DCM) by quantitative tissue velocity imaging (QTVI). Methods Thirty rabbits were divided into two groups: group A(adriamycin group) and group B(sodium chloride group). Group A( n = 20) were given adriamycin 2 mg/kg intravenously once a week for eight weeks (total dose, 16 mg/kg) to induce DCM model, group B were given with the same dose of sodium chloride injection solution. Two dimensional echocardiography and QTVI examination were performed in all rabbits before and three weeks after the administration,respectively. Peak systolic velocity(Vs), peak displacement(D) and other common parameters were analyzed. Results Common parameters assessed after administration in group B did not show significant changes. The QTVI curves of left ventricle myocardium were regular and the value of Vs and D decreased gradually from the basal segments to the apical segments after the administration. The diameters of atrium and ventricle of group A increased,while the ejection fraction and fractional shortening of left ventricle decreased significantly ( P <0. 05 or P < 0.01). The pattern of the curves still had the regularity. But Vs and D value decreased significantly ( P <0. 05 or P <0. 01). Pathology of myocardium samples of group A showed the cardiomyocyte changes like dilated cardiomyopathy, while samples of group B had no significant change. Conclusions QTVI can accurately evaluate regional systolic function of left ventricle in rabbits with dilated cardiomyopathy, therefore provides experimental foundation for clinical observation and treatment.

Objective To analyze the clinical features, recurrent characters in patients with recurrent Tolosa-Hunt syndrome (THS). Methods The clinical data of 24 hospitalized patients with recurrent THS from January 2006 to May 2016 were collected The general features, clinical manifestations, disease courses, recurrent features, lab and imaging studies, treatment measures and outcoming of recurrent THS patients was investigated , and compared with 69 patients with first attack THS in corresponding period. Results Recurrent THS patients were 25.8%(24/93) of total THS. The male rate in recurrent group was significantly higher than that in first attack group: 66.7%(16/24) vs. 42.0%(29/69), P<0.05. The involved rate of trigeminal nerves in recurrent group was significantly lower than that in first attack group:16.7%(4/24) vs. 33.0%(23/69), P<0.05. The disease courses were from 3 months to 20 years. The total recurrent frequencies were from 2 to 10 times. The recurrence occurred in the same side in 18 patients, and in contralateral in other 6 patients. The intervals were from 3 months to 6 years, and average intervals were 1.9 years. Two patients recurred in hormone reduction, and 22 patients recurred in hormone withdrawal. All cases received MRI examination. Nineteen patients (79.2%) of them had lesions in cavernous sinus. 16 patients had one side lesions and 3 patients had bilateral lesions. The recurrent patients still had good responds to corticosteroids treatment. Conclusions Recurrences in THS are common, taking place in about 26%total patients, and usually at an interval of months or years from the initial attack. These recurrences may be ipsilateral, contralateral, or rarely, bilateral. Corticosteroids are still effective to recurrent cases.

BACKGROUND: Nanotechnology has widely used in tissue engineered reconstruction in recent years. Most reports are concerning carbon nanomaterials in bone reparation, but the study of peripheral nerve regeneration is poorly understood.OBJECTIVE: To improve the physical, chemical and biological properties of chitosan/collagen composite nerve conduit with functionalized carbon nanotubes, in addition, to investigate the therapeutic effect of this novel material.DESIGN, TIME AND SETTING: The same body controlled experiment of animals was performed at the Tissue Engineering Laboratory and The Key Laboratory of Thin Film and Microfabrication Technology, Shanghai Jiao Tong University from February 2005 to November 2006.MATERIALS: The carbon nanotubes were mixed with 2% chitosan solution, coated on the die to prepare chitosan/collagen composite nerve conduit with functionalized carbon nanotubes. The chitosan/collagen tubes were served as controls.METHODS: A total of 80 male adult-rats were prepared a 4 mm accessory nerve defects models, and repaired by nerve conduit in the experimental material and control material groups. In the auto nerve grafts group, the removed nerve was connected to the broken end. In the blank control group, there was no other treatment except removing 2 mm nerves. The left sides were served as experimental sides and the right sides as within-subject controls.MAIN OUTCOME MEASURES: The repairing outcomes were measured by electrophysiological, myophysiological, and histological measurements.RESULTS: The accessory nerve defects were repaired in a rat model using carbon nanotubes in chitosan/collagen-based composite nerve conduit. As time passed after the surgery, good results of the electrophysiological, myophysiological and histological measurements were achieved, which were similar or superior to those of the nerve autografts.CONCLUSION: The carbon nanotubes in chitosan/collagen-based composite can be an ideal candidate for peripheral nerve regeneration.

Objective To select sonogram features for the differential diagnosis of benign and malignant thyroid small nodules by Logistics regression analysis,and to contribute the binary Logistic regression model of sonogram features as independent variable and evaluate the value of conventional ultrasonography and ultrasound elastography (UE) in the differential diagnosis of benign and malignant thyroid small nodules.Methods 166 thyroid nodules (≤ 10 mm) in 140 patients were reviewed and analyzed by 2D ultrasound,color Doppler flow imaging and UE.A Logistic model was obtained based on pathology as golden diagnosis criteria.The odds ratio of variables in the equation were compared to assess various variables,especially the efficacy of elastography in the diagnosis.Results Four statistically significant features were finally entering the Logistic stepwise regression model,including shape,calcification,the internal component of nodules and elasticity score.And the odds ratio of the elasticity score was higher than other features.Conclusions The analysis of binary Logistic regression can select the valuable variables for the diagnosis of pathological nature of thyroid small nodules.UE has much more dominances than other features.The combinated application of UE and 2D ultrasonic features plays a great clinical role in the final diagnosis of thyroid small nodules.

Objective To summarize the characters of the elastograms of different pathological nodules, and to observe the value of elastography in differentiating benign from malignant thyroid solid nodules. Methods One hundred and sixteen patients with thyroid nodules were enrolled in the study and 122 nodules were detected in total. All of them were examined by elastography and conventional ultrasound. Five sonographers were invited to evaluate the nodules double blinded basing on the images and the four-point system proposed by Fukunari. The interobserver agreement was evaluated by Kappa coefficient. Diagnostic performances of the five readers were compared by the ROC curves. Distributions of elastography scores of different pathological nodules were compared by one-way ANOVA. Results Interobserver agreements on scoring the nodules were moderate. Mean value of benign nodules was obvious lower than that of the malignant ones. The mean score of nodular goiters was 2.67 ± 0.89, range from 1 to 3. Most of the adenomas got score of 2, but the score of thyroiditis was quite high. No significant differences were found between the comparison of thyroiditis and thyroid cancers. Areas under the ROC curve (AUC) of the five readers were 0.82,0.81,0.79,0.73 and 0.83 respectively. When 3.5 was choosen as the cut-off point, the sensitivity of elastography was 82.4%, and specificity was 71.6%. Conclusions Elastography was really a useful technique for it can provide a new index for the differential diagnosis of thyroid nodules. However, the 4-point score system is not comprehensive enough.

Objective To introduce a new computer-aided technique applicable for myocardial contrast echocardiography(MCE)to quantitate automatically calibrated myocardial contrast intensity(CI)and to test the value of color-coded images of calibrated CI in assessing myocardial perfusion.Methods There were two experimental groups of anesthetized rabbits,which underwent 30 min(group I)and 120 min(groupⅡ)coronary occlusion followed by 60 min reperfusion.MCE was performed on all rabbits during occlusion and after reperfusion,and its images were analyzed by a new computer-aided technique.Myocardial calibrated CI of each segment was measured and a color-coded map was produced automatically by software.The risk areas and infarct sizes obtained by myocardial perfusional defect(MPD)and color-coded map were compared with those by fluorescent microsphere and triphenyl-tetrazolium chloride(TTC)staining.Results Compared with non-risk segments,myocardial CI values were significantly decreased in risk segments in group Ⅰ and Ⅱ before calibration (P＜0.01),however,myocardial calibrated CI values were significantly decreased in risk segments in group Ⅱ(P＜0.01)and not different in group Ⅰ after calibration.Calibrated CI in-70 pix was an optimal cutoff point to identify infarcted segments and to yield the sensitivity of 95% and specificity 87%.The correlation between the risk area by MPD and fluorescent staining was 0.84(P=0.003)whereas color-coded map and staining was 0.91 (P＜0.001).The correlation between the infarct size by MPD and TTC was 0.75(P＜0.001),and between color-coded image and TTC was 0.89(P＜0.001).Conclusions MCE with a new computer-aided technique canassess quantitatively myocardial perfusion and identify automatically risk area and infarct region.

Objective To study the cryoprecipitate effect of local external treatment of anal fistula surgical wound repair.Methods A total of 95 cases of low simple anal fistula patients was chosen, and was divided into three groups according to random number table method.The cryoprecipitate group (n =32 cases) began with cryoprecipitate dressing (2 layer) even to fill in a wound, once per day.The Kangfuxin group (n =32 cases) used Kangfuxin solution.The exposed burn ointment (MEBO) group (n =31 cases) used MEBO to cover the wound.The healing time, postoperative wound healing rate, the granulation tissue growth, new epithelial coverage, and adverse reactions were observed.Results The cryoprecipitate group in 14 d and 21 d had postoperative wound healing rate (60.97 ±4.20)％ and (97.69 ± 1.79)％ ,wound healing time (21.31 ±2.08)days;it had higher healing rate and shorter healing times compared to other two groups (P ＜0.05).Wound repaired more neatly;and 14d and 21d after the operation, wound granulation tissue growth rate [(61.06 ± 13.29) ％ and (97.63 ± 2.81) ％] and new epithelial coverage [(33.03 ±4.15)％ and (94.97 ±4.36)％] were more than the control groups (P ＜0.05) with less adverse reactions relative to control groups.Conclusions The cryoprecipitate contained in the composition has a strong biological activity.It can promote the wound tissue cell growth, and promote the wound repair.

Cardiac Surgical Procedures ; Heart Valves ; surgery ; Humans ; Models, Theoretical ; Risk Assessment

Objective To evaluate the effect of pharmacological postconditioning on longitudinal myocardial function in rabbits' model of myocardial inshemia-reperfusion using layer-specific strain of ultrasound speckle tracking imaging.Methods Forty healthy rabbits were randomly divided into two groups:ischemia-reperfusion group (IR) and pharmacological postconditioning group (ATP-PPost). Echocardiography examinations were performed at baseline,45 min after ligation and 30 min,60 min,120 min after reperfusion.Pathological examinations were applied in two rabbits randomly selected from each group at 45 min after ligation and 30 min,60 min after reperfusion and at the end of experiment.Results①After coronary artery ligation,left ventricular ejection fraction (LVEF) decreased in two groups(P <0.05) and longitudinal systolic strain(SLsys) of 3 myocardial layers decreased in two groups (P <0.01). And the SLsys in the endocardium had greater variation than that in the epicardium.②Compared with that after ligation,the SLsys of all myocardial layers increased at 30 min after reperfusion in ATP-PPost group (P <0.01),and the SLsys in endocardial layer kept increasing with the time of reperfusion(P <0.05). And the SLsys of 3 myocardial layers were significantly higher in ATP-PPost group than those in IR group (P <0.01).③ In two groups,the values of SLsys were decreasing from endocardial layer to epicardial layer.They were higher in the endocardium than those in the epicardium at any time(P <0.01 and P <0.05).Conclusions Layer-specific strain of STI can evaluate exactly the regional myocardial function of rabbit myocardial pharmacological-postconditioning model.SLsys of endocardial layer is more sensitive to myocardial ischemia than that of epicardial layer.

Objective To retrospectively review the history and development of radiotherapy quality assurance ( QA) in the Affiliated Cancer Hospital of Fudan University, and to report the primary experience and evolvement of an entire QA workflow management. Methods The multidisciplinary QA team has implemented an entire QA workflow management process in the Radiotherapy Center using the failure modes and effects analysis ( FMEA) and plan?do?check?act ( PDCA) tool since April 2015. Treatment data of approximately 6000 patients before and after implementation were compared. Results The error rate was reduced from 17% to 09% after using the entire QA workflow management. Conclusions Entire QA workflow management effectively improves the accuracy and safety of radiotherapy.