Objective To determine the usefulness of tricuspid annular displacement(TAD),based on twodimensional speckle tracking imaging, for assessment of right ventricular(RV)systolic function.Methods Eighteen patientswith dilated cardiomyopathy and 20 age-matched healthy volunteers were in volved. Twodimensional and real-time three-dimensional(RT3D)imaging were obtained in all patients at apical four-chamber view.The parameters of TAD were derived from off-line QLAB software.RT3D-RV ejection fraction(RVEF)was calculated by using 4D RV function software.Results TAD data were acquired in all 38 cases, while RT3D-RVEF was done in 30 out of 38.The parameters of TAD correlated well with RVEF(P<0.01).The parameters of TAD in dilated cardiomyopathy group were significantly lower than the corresponding values in healthy subjects (P<0.01).The intra-and interobserver variabilities for measurement of TAD were(0.49±2.69)mm and(0.21± 0.60)mm, respectively.Conclusions TAD,based on two-dimensional speckle tracking imaging,proved to be a rapid and reproducible method in determining RV global systolic function.

Objective To investigate the preliminary value of mitral annular displacement (MAD) with two-dimensional speckle tracking in evaluating left ventricular systolic function. Methods Forty-nine patients with dilated cardiomyopathy, aged 51±14 years (DCM group), and 43 age-matched (46±14 years) normal subjects (control group) were enrolled in this study. Two-dimensional and real-time three-dimensional (RT3D) imaging were obtained all at the apical four-chamber view. The parameters of MAD and RT3D-LVEF were obtained using off-line QLAB software. Results Compared with control group, MAD reduced significantly in DCM group (P＜0.01). The parameters of MAD correlated positively with LVEF (P＜0.01). The intra- and inter-observer variabilities for measurement of MAD were low. When one point was placed at the chest wall, the ratio of long axis shortening correlated best with LVEF among all the data of MAD. Conclusion Based on two-dimensional speckle tracking imaging, MAD is a rapid and reproducible method of determining LV global systolic function, may even replace LVEF in the future.

Objective:To explore the effect of intraoperative local application of thrombin on postoperative blood loss in internal fixation of femoral intertrochanteric fracture with proximal femoral nail antirotation (PFNA).Methods:A retrospective study was conducted to analyze the 50 patients with intertrochanteric femur fracture who had been treated at Department of Orthopaedics, The First Ningbo Hospital & Longshan Hospital Medical Health Group between January 2021 and December 2023. The patients were divided into 2 groups according to whether local thrombin was applied intraoperatively or not. In the treatment group of 25 cases [9 males and 16 females aged (76.5±10.1) years], after PFNA implantation, 6 pieces of thrombin freeze-dried powder were dissolved in 60 mL of sterile physiological saline, 30 mL of which was sprayed inside the main nail incision, 20 mL of which inside the spiral blade incision, and 10 mL of which inside the distal locking nail incision. In the control group of 25 cases [11 males and 14 females aged (71.1±10.1) years], after PFNA implantation, the incisions were rinsed only with the same doses of physiological saline. The hemoglobin (Hb) and hematocrit (Hct) on the 1st, 3rd, and 7th days after surgery, total blood loss, occult blood loss, transfusion rate, and deep vein thrombosis (DVT) were compared between the 2 groups.Results:There were no significant differences in the preoperative general data or operation time between the 2 groups, indicating comparability ( P>0.05). On the 1st, 3rd, and 7th days after surgery, respectively, the Hb was (101.48±12.15) g/L, (102.96±12.76) g/L, and (107.24±13.47) g/L, and the Hct 0.31±0.03, 0.32±0.03, and 0.33±0.04 in the treatment group, significantly higher than those in the control group [(92.72±10.95) g/L, (86.52±7.43) g/L, and (91.56±10.24) g/L; 0.28±0.03, 0.26±0.03, and 0.27±0.03] ( P<0.05). In the treatment group, the total postoperative blood loss was (364.60±134.27) mL, and the occult blood loss was (258.04±112.59) mL, both significantly lower than those in the control group [(481.72±218.69) mL and (355.84±176.97) mL] ( P<0.05). In the treatment group and the control group, respectively, 2 patients and 1 patient developed DVT after surgery, showing no statistically significant difference in the incidence ( P>0.05). Conclusion:Intraoperative local application of thrombin can significantly reduce postoperative blood loss but may not increase postoperative thrombosis or other complications in PFNA internal fixation of femoral intertrochanteric fracture.

Objective:To explore the surgical procedure and clinical efficacy of free chimeric tendon mini-flap pedicled with superficial palmar branch with flexor carpi radialis of radial artery in reconstruction of the dorsal finger composite tissue defects.Methods:From January 2020 to December 2022, 6 fingers (6 patients) with combined dorsal soft tissue and extensor tendon defects were treated in the Department of Plastic and Reconstructive Surgery, the First Affiliated Hospital of Ningbo University. The ipsilateral free chimeric flexor carpi radialis tendon mini-flap pedicled with superficial palmar branch of radial artery was used to reconstruct the soft tissue defects that sized 1.5 cm×1.8 cm - 2.5 cm×3.0 cm and the extensor tendon defects ranged 1.5 - 2.5 cm in length. The flap donor sites were directly sutured. Blood supply and survival of the flaps were observed after surgery. Postoperative follow-ups were scheduled at the 1, 3, 6, 12, 18 and 24 months after surgery and mainly conducted at the outpatient clinic and by home visits. Patients who were inconvenient to visit the hospital were reviewed through WeChat or telephone interviews. The follow-up included the colour, texture, appearance, sensation of the flap and functional status of the affected fingers.Results:After surgery, all 6 flaps survived without any incidence. All flap donor sites achieved stage I healing. The postoperative follow-up lasted 6-22 (mean 11.3) months. The colour and texture of the flaps were similar to those of the skin of dorsal finger, without bulky appearance. For the 3 flaps that had nerve anastomoses, the sensation recovery of the flap achieved to S 3+, with TPD at 7.6 mm, 7.9 mm and 8.3 mm, respectively, and 7.93 mm in average. For the 3 flaps without nerve anastomosis, the sensation recovery of the flap achieved S 3. No complication occurred at the donor sites. According to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, 4 patients were in excellent and 2 in good. Conclusion:Transfer of free chimeric flexor carpi radialis tendon mini-flap pedicled with superficial palmar branch of radial artery in reconstruction of the soft tissue defect in dorsal finger offers the advantages of reliable blood supply, sufficient blood reflux, bridging blood vessels, nerves and tendons, a minimal damage to the donor site and satisfactory postoperative outcome. It is an ideal surgical procedure for reconstruction of the composite tissue defects in dorsal finger.