Objective To evaluate the reliability of transversus abdominis muscles measure with ultrasonography. Methods The thickness of bilateral transversus abdominis muscles of 20 volunteers at rest and during different postures for training was measured with ultrasonography by 2 examiners. The rate of contraction was calculated. Results The measurement was correlated strongly between examiners (r>0.7). There was significant difference in variety of thickness among postures except head rise to contralateral leg rise (P<0.01). Conclusion Ultrasonography is reliable in measuring transversus abdominis muscles.

Objective To investigate the risk factors of post-operative cardiovascular or pulmonary complications in patients with gastrointestinal tumor. MethodsThe data of 352 cases with gastrointestinal tumor were analyzed retrospectively. These patients were divided into the two groups based on with or without cardiovascular or pulmonary complications. Seven relative factors including the patients' age, sex, smoking, duration of surgery, pulmonary function, ECG, UCG, and relationship between these factors and the incidence of post-operative cardiovascular or pulmonary complications were analyzed.ResultsForty-two cases occourred cardiovascular or pulmonary complications in 352 patients. The mean age and surgery duration were (61.2±7.9) years and (3.0±0.9) hours in patients with cardiovascular or pulmonary complications, and (53.5±4.6) years and (2.7±0.7) hours in patients without cardiovascular or pulmonary complications respectively. There was a significant difference between the two groups ( P<0.05). The patients with abnormal FEV1%, FEV1/FVC%, MVV% and cardiac function before operation had higher risk for post-operative cardiopulmonary complications ( P<0.05).ConclusionAge, duration of surgery and cardiac and pulmonary dysfunction may be risk factors of cardiovascular or pulmonary complications after gastrointestinal surgery.

Objective To explore the clinical and MRI features of spontaneous osteonecrosis of the knee(SONK).Methods 15 patients with SONK diagnosed by clinic and imaging were collected.All of cases were examined by MRI,of them 5 cases underwent CT scan and 3 cases underwent radiographic examinations.Results The subchondral lesions were seen in all cases on MRI and the lesions located in the femoral condyle weight-bearing zone in 14 cases.The subchondral "fracture cleft"sign was found in 2 cases;the subchondral long T1 and short T2 linear abnormal signal intensity surrounding with bone marrow edema were shown by MRI in 3 cases of them.The subchondral focal lesions were slight long T1 and long T2 signal intensity in 10 cases.The subchondral lesion were showed clearly only in 2 cases of 5 cases with CT scan,and only 1 case of 3 cases with plain X-ray examinations.Conclusion MRI is more sensitive than CT and radiography in showing the lesions of SONK.The SONK can be diagnosed based on the clinical and MRI features.

ObjectiveTo evaluate the usefulness of an ultrasonography-based method to examine quadriceps femoris contracting. MethodsThe thickness of bilateral rectus femoris (RF) and vastus intermedius (VI) and the cross-sectional area (CSA) of RF was measured in 10 healthy subjects （n=20） in a relaxed position and 3 isometric contraction states using ultrasonography by two examiners. The date was compared with paired t test. Half of these subjects （n=10） were also measured with MRI at rest. The date was also compared with paired t test. ResultsThere was no significant difference between MRI and static compound ultrasonography, nor between two examiners. There was a significant difference (P<0.05) in thickness of RF and VI between relaxed and isometric contraction conditions. There was no significant difference among isometric contraction conditions. There was no significant difference among measurements of RF-CSA. Conclusionultrasonography shows good validity and reliability in measuring quadriceps shape.

Objective To evaluate the effect of lumbar multifidus muscle training on muscle thickness.Methods The morphological changes in volunteers' lumbar multifidus muscles were observed in response to 11 kinds of training.Muscle thickness was measured at rest and during contraction using ultrasonography and two examiners.The rate of change in muscle thickness and the contraction rate were calculated.Results There was no significant difference in the contraction rates determined by the two examiners using ultrasound imaging.There was no significant difference in average contraction rate between the males and females.Pairwise,there was no significant difference among contralateral leg-raising,ipsilateral leg-raising,contralateral hand-raising,ipsilateral hand-raising and contralateral leg-lifting.Pairwise,there was no significant difference among ipsilateral leg-lifting and ipsilateral arm-lifting compared with contralateral leg-lifting,contralateral arm-lifting or contralaleral lower limb-lifting.There was no significant difference between contralateral arm-lifting and ipsilateral arm-lifting.There was no significant difference between ipsilateral arm-lifting with contralateral leg-lifting and contralateral arm-lifting with ipsilateral leg-lifting.Pairwise,there was a significant difference in lumbar multifidus muscle contraction rates among these actions.Conclusion Lumbar multifidus muscle training has various effects.Muscle thickness as measured using ultrasonography can provide a basis for formulating a rehabilitation training plan.

Objective To sum up experience and lessons learnt from liver separation in two thoracoventropagus twins. Method By preoperative imaging it was verified that the two twins of thoracoventropagus named as AB and CD respectively having independent portal hepatic system and the digestive tract.Intraoperatively a separation line was delineated between the porta hepatis,the second porta hepatis.Liver parenchyma of the AB conjoined twin was separated under local blood control with both sides of the seperation line.Intraoperative bleeding was about 10ml,liver rough surface was suctured together,after ligation or suturing of blood vessels and bile ducts.The livers of CD conjoined twin were separated with blocking the first hepatic hilum firstly,and partial hepatic vascular exclusion secondly by part of the liver pressed with finger.There was intraoperative bleeding of about 200 ml. Results The two cases of conjoined twins were separated successfully,and there was no bile leakage,liver failure and infection.A and B are alive and well.D died of lung infection 78 days later.C died of lung and cavitas thoracis infection 9 months later. Conclusion Liver separation is feasible in a thoracoventropagus with independent porta hepatis system.Partial blocking of hepatic vasculature occlusion,in stead of portal triad clamping is preferred.During the separation of hepatic parenchyma finger press for the control of local hepatic blood flow is not always reliable.

Objective: To investigate the changes of cardiac sympathetic nerve function and susceptibility of ventricular arrhythmia at chronic stress condition in experimental rats.
Methods: A total of 30 SD rats were randomly assigned into two groups: Control group, the rats were fed with normal condition and Chronic stress group, the rats were fed with unpredictable chronic stimulus program.n=15 in each group and all animals were treated for 4 weeks. The behavior of rats was assessed by open ifeld test and sucrose intake test, the susceptibility of ventricular arrhythmia was measured by Burst stimulus program under narcosis condition, and the sign of cardiac sympathetic nerve reconstruction, tyrosine hydroxylase content was examined by immunohistochemistry.
Results: Compared with Control group, Chronic stress group had decreased ratio of sucrose favorite/open field test, P<0.05 and increased susceptibility of ventricular arrhythmia,P<0.05. Masson staining showed that the ventricular collagen score was similar between 2 groups,P>0.05. Immunohistochemistry presented that Chronic stress group had much higher tyrosine hydroxylase content (1397.8 ± 268.8) um2/mm2 than Control group (995 ± 232.3) um2/mm2,P<0.05.
Conclusion: Chronic stress may increase the susceptibility of ventricular arrhythmia in experimental rats, and the cardiac sympathetic nerve reconstruction might be an important mechanism.

Objective: To evaluate the value of clinical application of Heart of the City type TJH-03A remote electrocardiogram recorder (remote ECG). Methods: A total of 1 014 community residents from Wuhan received ECG examination by Heart of the City type TJH-03A remote ECG recorder. Clinical and ECG data of all subjects were collected and analyzed. Results: There were 359 (35.40%) cases with normal ECG and 655 (64.60%) cases with abnormal ECG, after remote ECG examination . There were 581 cases had a variety of arrhythmia in 655 cases with abnormal ECG, so there were 828 cases times with abnormal ECG, in which there were （1）320 cases times (38.65%) with repolarization abnormality,（2）98 cases times(11.84%) with sinus bradycardia, （3）98 cases times (11.84%)with myocardial ischemia,（4）78 cases times (9.42%)with conduction block,（5）56 cases times(6.76%) with ventricular hypertrophy and high voltage,（6）43 cases times(5.19%) with atrial premature beats（7）37 cases times (4.47%)with atrial fibrillation,（8）35 cases times (4.23%)with sinus tachycardia,（9）24 cases times (2.90%)with ventricular premature beats, （10）19 cases times (2.29%)with suspected myocardial infarction according to ECG abnormality rate order. In addition, there were 5 cases times with QT interval prolongation, and abnormal ECG with abnormality rate ≤3 cases times: atrial tachycardia, atrial flutter, supraventricular tachycardia, ventricular tachycardia, Brugada wave, dextrocardia. Conclusion: Heart of the City type TJH-03A remote electrocardiogram recorder is convenient to use, it can perform remote electrocardiogram record, and find a variety of arrhythmias. It’s important for ECG diagnosis, especially for diagnosis of arrhythmias.

Objective: To investigate influence of Wenxin particle on cardiac electrophysiology in rats complicated with depression after myocardial infarction (MI). Methods: A total of 50 SD rats were randomly and equally divided into normal group, MI group, depression group, MI complicated with depression group (model group) and Wenxin particle group (Wenxin particle were given to model rats by gavage, 2 g/d, 28d). Model（MI complicated with depression）rats were made by acute ligation of left coronary artery and supply chronic unpredictable mild stress in order. The influences of Wenxin particle on cardiac electrophysiological indexes, such as monophasic action potential (MAP90), left ventricular effective refractory period (ERP) and ventricular fibrillation threshold (VFT) were evaluated in Wenxin particle group. Results: (1) Compared with normal group, there were significant decrease in behavior scores (P<0.05) in model group, after four-week treatment with Wenxin particle, their behavior scores significantly increased (P<0.01); (2) Compared with normal group, there were significant increase in MAPD90 and ERP, and significant decrease in VFT in model group (P<0.05); compared with model group, there were significant decrease in MAPD90 [(89.33±7.12) ms vs. (72.29±8.37) ms] and ERP [(84.00±6.57) ms vs. (68.00±7.43) ms], and significant increase in VFT [(7±3.11)V vs. (29±5.60)V] in Wenxin particle group, P<0.05. Conclusion: Wenxin particle can improve cardiac electrical remodeling in rats complicated with depression after myocardial infarction, including decrease monophasic action potential duration and effective refractory period, and raise ventricular fibrillation threshold.

Objective To investigate the efficacy and safety of gastric peroral endoscopic myotomy ( G-POEM) for postsurgical gastroparesis. Methods A retrospective analysis was performed on data of 47 patients with gastroparesis after subtotal gastrectomy, who underwent G-POEM at Zhongda Hospital Southeast University form August 2016 to June 2018. G-POEM procedure, complications related to G-POEM, and improvement of symptoms and gastric emptying function were observed. Results All patients underwent G-POEM successfully. No serious G-POEM-related complications were observed. During a follow-up period of 9. 8±5. 8 months (range 3-18 months), the scores of gastroparesis cardinal symptoms index (GCSI) were 1. 6±0. 5, 1. 2±0. 4, 1. 1±0. 6, 1. 4±0. 3 and 1. 7±0. 3 respectively at the 1st, 3rd, 6th, 12th, and 18th months after G-POEM, and all scores were lower than that before G-POEM (3. 8±1. 1, all P<0. 01). The results showed the symptoms of gastroparesis were improved significantly. Gastric emptying imaging showed the hemi-emptying time was 23. 8±8. 8 min, 21. 2±9. 5 min, 20. 9±8. 3 min and 26. 4±7. 8 min at the 1st, 6th, 12th and 18th months after G-POEM, respectively, significantly shorter than that before G-POEM (67. 8±12. 5 min, all P<0. 01). Three-dimensional ultrasonography results of gastric antrum volume showed that the hemi-emptying time was 26. 4 (21. 8, 40. 3) min, 22. 6 (13. 9, 32. 7) min, 24. 3 (18. 2, 36. 5) min and 26. 8 (16. 4, 38. 5) min at the 1st, 6th, 12th and 18th months after G-POEM, respectively, which were all significantly shorter than that before G-POEM [ 72. 5 ( 48. 3, 108. 6 ) min, all P<0. 01 ] . Conclusion G-POEM has a satisfactory long-term efficacy on the treatment of gastroparesis after subtotal gastrectomy with good safety.