Objective To explore the influence on isthmic spondylolisthesis (IS) from lumbar vertebras facet joint orientation (FJO) variation. Methods The lumbar vertebras of 60 patients scanned by 16-slices spiral CT were collected, 30 cases with IS was defined as isthmic group;30 cases with normal lumbar vertebras was defined as control group, the FJO at L3-4, L4-5 and L5-S1 were measured in two groups. The difference between two groups were compared at three levels, the difference between both sides of the facet joint orientation also was compared;the measured data and the data of 60 patients from foreign literature were compared at three levels. Results The FJO in isthmic group were (47.9±6.3)° ,(37.5±7.3)° , (37.9±7.7)° at the right of L3-4, L4-5, L5-S1 levels respectively,the FJO in control group were (53.1 ± 7.3)° , (40.5±6.3)° , (38.5±7.3)° respectively, the FJO in isthmic group were (48.1±6.0)° , (37.9 ± 7.4)° , (37.6 ± 7.6)° at the left of L3-4, L4-5, L5-S1 levels respectively, the FJO in control group were (52.3 ± 7.6)° , (41.6 ± 6.0)° , (38.2 ± 7.2)° respectively. The significant difference was found at L3-4 and L4-5 levels (P < 0.05), the orientation was similar at L5-S1 level (P > 0.05). The difference between the both sides FJO of lumbar vertebras was not found at L3-4,L4-5 and L5-S1 levels (P >0.05). The same as the measured data and the corresponding data from foreign literature(P > 0.05 ). Conclusions It seems possible that the coronal FJO may be the phenotypic representation of the familial etiology of IS. It is helpful for the measurement of lumbar vertebras FJO to find IS early,it is important to reduce and release the IS.

Objective:To investigate the principle and measures of prevention and treatment on pancreatic fistula due to pancreatic injury.Method:The clinical data of 131 pancreatic injury patients were analyzed retrospectively.Operation and combined therapy during perioperative were performed.Results:Among 35 cases(26.7%,35/131) with pancreatic fistula,3 cases shaped internal fistula showed by visualization and cured spontaneously after operations,9 cases with pancreatic pseudocyst after operations were treated by Roux-en-Y pancreatic cystojejunostomy,2 cases(5.7%,2/35) died of MODS and abdominal infections.The rest were recovered.The follow-up from 3 months to 5 years showed that there were no cases died of complications related to pancreatic fistula.Conclusions:Operation combined with multiple therapies was effective in the prevention and treatment of pancreatic fistula.

Objective To explore the association between PI3K polymorphisms in insulin signal transduction pathway and Alzheimer's disease (AD)risk.Methods There were three groups,including 112 cases for AD +T2D group,231 cases for only AD group,and 231 cases for healthy controls group.The polymorphisms in PI3K gene was sequenced by PCR and the concentration of PI3K in serum was tested by enzyme -linked immunosorbent assay (ELISA).Results Overall,there was significantly statistical difference in PI3K rs3730087 polymorphism among three groups (χ2 =20.99,P =0.000 3).The CC frequency of PI3K rs3730087 polymorphism in AD with T2D group and AD control group was significantly higher than that in the healthy control group.The PI3K protein level of differ-ent genotype was statistically significant (F =27.450,P <0.000 1).As for CC genotypes of PI3K rs3730087 poly-morphism,the PI3K protein level was statistically different among these three groups (F =8.096,P =0.000 6).Moreover,the PI3K protein level of the three groups was different (F =9.034,P =0.000 1),which in both AD group was lower as compared with healthy control group.Conclusion The study suggested that CC genotype of PI3K rs3730087 polymorphism in insulin signaling transduction pathway might be a risk factor for AD with T2D and it also affects the expression level of PI3K protein.However,the polymorphism is not shown to be exclusive in AD patients with T2D.

Objective To explore the value of dual energy CT displaying knee joint torn posterior cruciate ligament (PCL). Methods Ten cases with single knee joint torn PCL were scanned by 1.5 TMR and dual energy CT. By the use of postprocessing technique of muhiplanar reformation (MPR) and volume rendering technique (VRT), the CT value,length,thickness of PCL were assessed by paired t test respectively. Results MPR and VRT clearly displayed the PCL. The CT value of the patient sides and normal sides were(60.10±3.21), (72.98±7.35) HU(t=4.33,P=0.006), the length were(4.42±0.56),(4.14±0.49) cm (t=-1.20,P=0.285), the thickness of the attachment site and middle sire were (0.88±0.19), (0.58±0.10), (0.38±0.12) cm and (0.43±0.07), (0.39±0.03), (0.43±0.12) cm (t=-6.89,P=0.001;t=-4.38,P=0.007;t=0.85,P=0.587) respectively. Conclusion Dual energy CT can demonstrate clearly the ligament with three-dimension display,and may provide important information for diagnosis and per-surgical evaluation.

Objective    To summarize the early outcomes of totally thoracoscopic minimally invasive aortic valve replacement (AVR) and double valve replacement (DVR). Methods    The clinical data of patients who underwent totally thoracoscopic minimally invasive AVR or DVR in Guangdong Provincial People’s Hospital from April 2020 to January 2021 were retrospectively analyzed. The patients were divided into an AVR group and a DVR group according to the surgical method, and the clinical data of the two groups were compared. Results    Finally 22 patients were enrolled, including 14 males and 8 females with an average age of 50.0±11.2 years at operation. Eight patients were degenerative disease, 8 were rheumatic heart disease combined with valvular disease, and 6 were bicuspid aortic valve. Out of the 22 patients, 16 underwent AVR alone, and 6 underwent DVR. All patients completed the operation successfully, and there was no death. Perivalvular leakage during surgery occurred in 2 patients. The average cardiopulmonary bypass time was 187.0±39.9 minutes, and aortic cross-clamping time was 117.0 (99.0, 158.0) minutes. Duration of mechanical ventilation and intensive care unit stay was 9.5 (4.8, 18.3) hours and 41.0 (34.0, 64.0) hours, respectively. The volume of chest drainage at the first 24 hours after surgery was 214.0±124.6 mL, and the postoperative hospital stay was 5.5 (4.0, 8.3) days. The cardiopulmonary bypass time and aortic cross-clamping time in the DVR group were longer than those in the AVR group, and the volume of chest drainage at 24 hours after surgery was more than that in the AVR group, with a statistical difference (P<0.05). Echocardiography before hospital discharge showed paravalvular leakage in 1 patient. There was no death during follow-up of 5.9±3.0 months. Conclusion    The early outcome of totally thoracoscopic minimally invasive AVR and DVR is satisfactory, and the approach of surgery is worth exploring.