Objective To explore the clinical effect of posterior pedicle screw internal fixation in the treatment of multiple level noncontiguous thoracolumbar fractures.Methods Thirteen patients with multiple level noncontiguous thoracolumbar fractures were treated by posterior pedicle screw internal fixation.The Frankel score,percentage of vertebral compression and Cobb angle of the injured vertebral segment were analyzed to evaluate the surgery efficacy.Results All patients were followed up from 12 to 24 months ( averaged 15 months ).All cases achieved bone fusion with no implant failure.The Cobb angle of the injured vertebral segment was corrected from preoperative(22.2 ±5.3) degree to postoperative(5.3 ±3.5) degree and(6.2 ±3.6) degree at the last follow up.The percentage of vertebral compression was corrected from preoperative (45.7 ± 14.1 )％ to postoperative ( 6.1 ± 3.8 ) ％ and ( 7.2 ± 3.9 ) ％ at the last follow up.All improvements showed significant differences when compared statistically( t =15.03,t =12.05,Ps ＜0.05 ).The spinal cord function was improved 1 to 2 degree in all patients except 2 patients of grade A.Conclusion The posterior fixation with pedicle screw is a secure,safe and effective method in treating multiple level noncontiguous thoracolumbar fracture.

Objective To compare the the effect of PCI on short term (3 months) left ventricular diastolic function in the old patients with acute myocardial infarction (AMI) (≥ 65 years old). Methods 40 old AMI patients were divided into PCI group and non-operation group (pure medicine treatment group). The changes of left ventricular diastolic function were observed 3 months after operation which were compared with that before treatment so to define the effect of PCI. The major indexes were LA, LV, LVEF, E/A, and S/D. Results LA and LV in PCI group were not significandy changes but they were increased in non-operation group (P < 0.05). Although the left ventricular diastolic function in both group was continually impaird,it was better in PCI group than in non-operation greup(P <0.05). Conclusion PCI can prolong the progress of left heart remodeling and the excerbation of left ventricular diastolic function in old AMI patients.

Objective To construct a scientific and practical core literacy training system for nurses working in bleeding centers so as to provide reference for the training and curriculum design of nurses working in bleeding centers.Methods A computerized retrieval of academic papers concerning the core literacy training system for nurses working in bleeding centers from the databases of PubMed,Web of Science,China Biomedical Literature Service(CBM),China Knowledge Network(CNKI),Wanfang and other databases was conducted.Combined with the results of interviews with patients,family members and medical staff,and through organizing the group discussion,a training system for nurses working in bleeding centers was preliminary formulated.Finally,the Delphi method was used to make two rounds of inquiries to 21 experts from 12 provinces,and a three-level index system was determined.Results The first round of expert inquiry questionnaires effectively collected 21/21 consultation letters,and the second round of expert inquiry questionnaires effectively collected 19/21 consultation letters.The expert consultation and judgment coefficient of the core literacy training system for nurses working in bleeding centers was 0.99,the authority coefficient was 0.89;the Miller pyramid theory expert consultation and judgment coefficient was 0.72,the authority coefficient is 0.85,and the familiarity level was 0.80.Finally,the training system for bleeding center nurses covered four levels,including theory,application,skills and practical performance ability,and consisted of three parts,including training content,training management,and exam assessment.The training content included 22 first-level indicators,96 second-level indicators and 78 third-level indicators;the training management included 4 first-level indicators,8 second-level indicators and 12 third-level indicators;and the exam assessment included 5 first-level indicators and 16 second-level indicators.Conclusion The Miller pyramid theory-based core literacy training system for nurses working in hemorrhage centers fully adopts the expert opinions and suggestions,and it carries a high degree of credibility,therefore,it can provide reference for the training of the nurses working in bleeding centers.(J Intervent Radiol,2024,33:664-673)

Objective To investigate the clinical characteristics and risk factors of mixed connective tissue disease associated with pulmonary arterial hypertension(MCTD-PAH).Methods Twelve MCTD-PAH patients diagnosed by right heart catheterization(RHC)at Tianjin Medical University General Hospital were retrospectively included,and 36 MCTD patients without pulmonary arterial hypertension(MCTD-non-PAH)were randomly selected from the same period of hospitalization based on gender and age.The clinical features and auxiliary examination of the two groups were compared,and the survival status of the two groups was compared.Results The proportion of dyspnea after activity,myositis and pericardial effusion were higher in the MCTD-PAH group than those of the control group.Serum sedimentation rate and immunoglobulin G(IgG)levels were higher in the MCTD-PAH group.Multivariate Logistic regression analysis showed that dyspnea after activity and high level of IgG were risk factors for predicting the occurrence of PAH in MCTD.Three patients(16.7%)died in the MCTD-PAH group,and no patients died in the control group.Conclusion Pulmonary arterial hypertension is one of the serious complications of MCTD.MCTD patients have shortness of breath after activity and high level of IgG should be wary of concomitant PAH.