Nine female patients underwent resection of the middle and distal urethra and the urethra was reconstructed with labia majora fasciocutaneous flap.During the operation the bilateral inner side partial flap of labia majora was taken,and penetrated through the tunnel under the labia minora to the urethral incision,then the flap was sutured as tube-shaped and anastomosed with the urethral incision to reconstruct the urethra.Patients were followed-up for up to 11 years,all patients had normal urination,except 1 patient with adenocarcinoma who developed urinary incontinence 1 month after operation and recovered by pelvic floor muscle training.The application of labia majora fasciocutaneous flap is a safe and effective procedure with less trauma and fewer complications in reconstruction of female middle and distal urethra.

Objective To explore the clinical value of prospective electrocardiography-triggering high-pitch spiral acquisition by dual-source CT (HP mode ) in children with congenital heart diseases (CHD).MethodsThirty-six patients ( mean age:0.67 years,range:1 month to 2 years and 6 months; 25 males;mean weight:7.7 kg)underwent prospective ECG-triggering high-pitch spiral acquisition.The dose length product (DLP) was recorded to calculate effective dose ( ED ).Two experienced radiologists made diagnosis and assessed the overall image quality by a five-point scale independently.The consistency of their judgment was determined by Kappa statistics.Surgeries were performed in 29 patients,and conventional cardiac angiography(CCA) was performed in 7 patients.The accuracy,sensitivity and specificity of HP mode were calculated based on the surgical or CCA findings.ResultsThe DLP was (5.12 ± 1.64) mGy.cm with a range of 2.4 mGy · cm to 9.2 mGy · cm and ED was (0.125 ± 0.027 ) mSv ranging from 0.078 mSv to 0.179 mSv.The average subjective image quality score was 4.2 ± 0.7.All images were diagnosable.Two radiologists made good agreement ( K =0.774,P ＜ 0.05 ).The accuracy,sensitivity and specificity of HP mode were 98.9％,94.2％ and 99.8％,respectively.ConclusionLow radiation dose with the accurate diagnosis of anomalies makes HP mode a new choice for children with CHD.

ObjectiveTo investigate the value of prospective ECG-gated dual-source CT (DSCT)in the diagnosis of coarctation of aorta ( CoA ).MethodsSixteen patients clinically suspected of CoA underwent prospective ECG-gated DSCT angiography and color Doppler flow imaging (CDFI). The diagnostic accuracy of DSCT and CDFI were compared according to the results of operation or DSA.The nonparametric chi-square test was used for the statistics.ResultsSixteen patients were diagnosed as CoA by DSCT,4 were complicated with artial septal defect (ASD),9 with ventricular septal defect (VSD),1 with transposition of the great arteries,3 with dysplasia of aortic arch,7 with patent ductus arteriosus (PDA),1 with abnormal origin of the coronary artery, 1 with bronchus artery dilation. Fifteen patients were diagnosed as CoA by CDFI,1 was diagnosed as interruption of aortic arch. Four were complicated with ASD,9 with VSD,2 with bicuspid aortic valve (BAV),1 with transposition of the great arteries,2 with dysplasia of aortic arch,7 with PDA,1 with bronchus artery dilation.Abnormal origin of the coronary artery was not found.The diagnostic accuracy of DSCT and CDFI were 97.2％ ( 140/144)and 97.9％ (141/144)respectively,there was no significant difference (x2 =0.00,P ＞ 0.05 ).The sensitivity of DSCT and CDFI were both 93.2％ ( 41/44 ),the specificity were 99.0％ (99/100) and 100.0％ (100/100).The mean effective radiation dose was 0.42 mSv. Conclusion Prospective ECG-gated DSCT is a good imaging technique for the diagnosis of aortic coarctation in children.

Objective To investigate the value of electrocardiographic parameters in assessing severe coronary artery lesions in patients with coronary artery disease.Methods A total of 364 patients with coronary heart disease admitted to the Second Affiliated Hospital,Zhengzhou University from January 2022 to September 2023 were selected as the subjects.The patients were divided into severe lesion group(n=123)and non-severe lesion group(n=241)based on the Gensini score.The two groups were compared in terms of baseline data and electrocardiographic parameters.Logistic regression was used to analyze the factors affecting severe lesions and the efficacy of ECG parameters assessment.A column-line plot of ECG parameters to assess severe lesions was created.The joint incremental value of ECG parameters and the area under the ROC curve for assessing severe lesions were calculated.Results The patients in the severe lesion group were elder in age and they showed significantly higher rates in creatine kinase isoenzyme,amino-terminal brain natriuretic peptide precursor,QRS time frame,frontal QRS-T pinch angle,smoking,hypertension,diabetes mellitus,pathologic Q waves,left ventricular hyper voltage,fragmented QRS waves,and significantly lower rates in low HDL cholesterol and ejection fraction,as compared to the non-severe lesion group(all P<0.05).Logistic regression analysis showed that pathological Q waves(OR=3.71,95%CI:1.93～7.15,P<0.001),left ventricular hyper voltage(OR=5.05,95%CI:1.66～15.41,P=0.004),fragmented QRS waves(OR=2.17,95%CI:1.14～4.11,P=0.018),and frontal QRS-T pinch angle(OR=1.01,95%CI:1.00～1.02,P=0.023)were the factors for assessing severe lesions.The incremental value of combined ECG parameters for severe lesions:C-statistic 0.09(95%CI:0.02～0.16,P=0.009),NRI 0.37(95%CI:0.20～0.55,P<0.001),and IDI 0.12(95%CI:0.08～0.17,P<0.001).The ROC curves showed an AUC of 0.79(95%CI:0.74～0.84,P<0.001),a sensitivity of 63.41%,and a specificity of 85.89%for the combined assessment of severe lesions by ECG parameters.Conclusion The combined observations of electrocardiographic parameters such as pathologic Q waves,left ventricular hyper voltage,fragmented QRS waves,and frontal QRS-T pinch angle have an affirmativeclinical value in the assessment of severe lesions.