Objective:To explore the relationship between the lipid accumulation product index (LAP) and the risk of carotid atherosclerosis in different gender groups.Methods:The data of 2 740 employees of Dalian municipal government and institutions, including 1 583 males and 1 157 females, who had underwent physical examination in Dalian Municipal Central Hospital Affiliated of Dalian Medical University from January to June 2018 were analyzed retrospectively. The general data, laboratory indexes and carotid ultrasound data of the population were collected, and the body mass index (BMI) and LAP value were calculated. According to carotid intima-media thickness (IMT), the subjects were divided into carotid atherosclerosis group (IMT ≥ 1.0 mm) and carotid normal group (IMT<1.0 mm). The clinical indicators between the two groups were compared. Independent risk factors for carotid atherosclerosis were analyzed by binary Logistic regression, and the cutoff point for predicting carotid atherosclerosis by LAP was calculated by receiver operating characteristic (ROC) curve.Results:The age, waist circumference (WC), hip circumference (HC), LAP, BMI, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), systemic blood pressure (SBP), diastolic blood pressure (DBP) and the prevalence of hypertension and diabetes in the male and female population carotid atherosclerosis groups were significantly higher than those in the normal group ( P<0.05). The results of binary Logistic regression analysis showed that after adjusting age, BMI, HC, WC, smoking, drinking, hypertension, diabetes, TC and LDL-C, the risk of carotid arteriosclerosis still increased 1.316 times with each quartile interval of LAP in women ( OR= 1.316, 95% CI 1.063 to 1.629, P = 0.012). In men, after adjusting for these factors, the independent effect of LAP on the risk of carotid atherosclerosis disappeared. In women, the area under curve (AUC) of LAP in predicting carotid atherosclerosis was 0.713, significantly higher than that of BMI (AUC 0.614) and WC (AUC 0.654), and the differences were statistically significant ( P<0.05). But there was no significant difference among the three indexes in the male population in predicting carotid atherosclerosis. According to ROC curve, the best cut-off value of LAP for predicting carotid atherosclerosis was 32.13 cm·mmol/L in men and 33.70 cm·mmol/L in women. Conclusions:LAP is an independent risk factor for carotid atherosclerosis in female population, and its predictive ability for carotid atherosclerosis is higher than that of body mass index and waist circumference. LAP ≥ 33.70 cm·mmol/L can be used as the best cut-off value for screening carotid atherosclerosis in female population.

Vertebral compression fractures, the most common complication of the osteoporosis, results in significant morbidity of prolonged and intractable pain in some patients. Vertebroplasty procedure that involves percutaneous injection of bone cement into a collapsed vertebra has recently been introduced to treat osteoporotic patients who have prolonged pain following vertebral compression fracture. To determine the details of the procedure and to gather information on its safety and efficacy, we performed a MEDLINE search using the terms ‘vertebroplasty’. We reviewed reports of these procedures in patients with osteoporosis. Several reports suggest that the vertebroplasty is associated with pain relief in 67% to 100% of the cases. Short-term complications, mainly the result of extravasation of cement, can increase pain and damage from heat or compression to the spinal cord or nerve roots. Proper patient selection and good technique can decrease such complications so that the decompression surgery is rarely needed. But long-term complications, which include foreign-body reaction at the cement-bone interface, the wear of the cement, and increased risk of fracture in the adjacent vertebrae due to changes of mechanical stresses, have not been fully evaluated. In short, there is still a long way to go for the vertebroplasty.

Objective To introduce a two-stage operative method to treat ma lu nion after the distal femoral fracture. Methods From Aug. 1992 to Aug. 2000, 12 patients underwent osteotomy and secondary fixation due to malunion after the di stal femoral fracture. There were 10 closed fractures and 2 open ones. The prima ry treatment was conservative for 2 patients, and operative for 10. We first per formed the osteotomy along the primary fracture line where the deformity was the most severe. When the roentgenogram confirmed that the deformity had been corre cted satisfactorily, a secondary operation of ORIF (open reduction with internal fixation) was performed. Results On average, all the 12 patients gained bone un ion 5.1 months postoperatively. The mean follow-up duration was 7.2 years (rang e: 3.5 to 11.5 years). None of the patients was afflicted by infection or loosen ing of the internal fixator. According to the Schatzker scoring scale system, al l the patients were evaluated as poor preoperatively, but as excellent in 7, goo d in 4 and fair in 1 at the last follow-up. Conclusion Osteotomy and secondary fixation is not only simple and accessible but also can lead to confirmed clinic al results. However, it is still very important to reduce and fix the acute frac tures stably to avoid malunion.

Objective To investigate the current situation of iodine deficiency disorders and the effect of control measures in Sanmenxia city of Henan province, and to formulate targeted control measures for iodine deficiency disorders. Methods In 2008, five villages(offices) were selected according to the east, west, south,north and center position in each county in 6 counties(cities, districts) of Lingbao, Shan, Hubin, Yima, Mianchi,and Lushi in Sanmenxia city. One primary school was selected in each village(office), fifty students aged 8 - 10 in each primary school were randomly selected to check thyroid and their urine and edible salt were collected to detect iodine. Thirty 5th-grade students in each school were selected to carry out the questionnaire survey of health education about iodine deficiency disorders. According to the east, west, south, north and center position, five potable water samples were selected to detect iodine in the village where the primary school was in. Questionnaire survey was also carried out among ten housewives in the village. Thyroid was examined by palpation;ammonium persulfate digestion-arsenic cerium catalytic spectrophotometry(WS/T 107-2006) was used to detect urinary iodine;direct titration(GB/T 13025-1999 ) was used to detect salt iodine;arsenic cerium catalytic spectrophotometry (GB/T 5750.5-2006) was used to detect water iodine. Results One thousand and five hundreds children aged 8 - 10 were analyzed in 6 counties(cities, districts), the rate of goiter was 3.30%(50/1500), the median of urinary iodine was 273.15 μg/L. One thousand and five hundreds salt samples were detected, the coverage rate of iodized salt was 99.93% (1499/1500), the qualified rate of iodized salt was 98.00% (1469/1499), the edible rate of qualified iodized salt was 97.93% (1469/1500), the coverage rate of non-iodized salt was 0.07% (1/1500), the median of salt iodine was 28.9 mg/kg. One hundred and fifty water samples were collected, the median of water iodine was 2.76 μg/L. The pass rate of the questionnaire survey of health education about iodine deficiency disorders was 97.11% (874/900) in students and 98.67% (296/300) in housewives, respectively. Conclusions The prevention and control of iodine deficiency disorders has achieved significant results and the monitoring indicators have reached the national standard for eliminating iodine deficiency disorders in Sanmenxia city.

Objective To investigate the effects of exogenous biliverdin on lung injury induced by brain death (BD) in rats. Methods Twenty-three adult male Wistar rats in which Fogarty balloon catheter was successfully inserted into cranial cavity were randomly divided into 3 groups: group Ⅰ sham operation (group S,n = 7); group Ⅱ brain death (group BD, n = 8) and group Ⅲ biliverdin + BD (group B, n = 8). The animals were anesthetized, intubated and mechanically ventilated. Femoral artery and vein were cannulated for MAP monitoring and drug and fluid administration. Brain death was induced by injecting slowly normal saline into the balloon in group Ⅱ and Ⅲ. BD was confirmed by dilated and fixed pupils, apnea, transient hypertension and EEG changes. In group Ⅲ biliverdin 35 mg/kg was injected intraperitoneally as soon as BD was confirmed. The animals were mechanically ventilated for another 1.5 h during which MAP was maintained at 80-120 mm Hg by iv norepinephrine infusion. Arterial blood samples were obtained before anesthesia, immediately before and at 5, 30,60, 90 min after intraperitoneal biliverdin for blood gas analysis and determination of plasma bilirubin concentration. PaO2/FiO2 was calculated. The animals were sacrificed at 1.5 h after biliverdin administration. The left lung was removed for detection of MDA content, SOD activity, total antioxidant capacity, cell apoptosis and biliverdin reductase expression in lung tissue. Results Brain death significantly decreased PaO2/FiO2, lung SOD activity and total antioxidant capacity and increased lung MDA content and apoptosis as compared with sham operation group. IP biliverdin significantly attenuated BD-induced lung injury in group B as compared with group BD. The plasma bilirubin concentration and biliverdin reductase expression were significantly higher in group B than group BD. Conclusion Exogenous biliverdin can attenuate BD-induced lung injury by inhibiting pulmonary oxidative stress response and apoptosis.

Objective To study the image quality control system to ensure that equipment meet clinical needs.Methods It was scanning the Catphan504 phantom with models of high quality head,standard dose head and pelvis,we could get the results of CT numbers linearity,uniformity,spatial resolution,contrast resolution.Using T test to compare different scanning technique results.Results The standard dose head scanning technique was better than the pelvis scanning technique in CT numbers linearity test,and gets the best result in uniformity test.The result of CT numbers uniformity was higher in the standard dose head scanning than the high quality head and the pelvis scanning (9.7 ±3.9 vs.17.9 ±5.3,P =0.00 and 9.5 ± 4.0 vs.31.1 ± 5.7,P =0.00).The result of contrast resolution was higher in the pelvis scanning than the high quality head and the pelvis scanning (5.6 ± 0.1 vs.1.3 ± 0.5,P =0.00 and 6.0 ± 1.0 vs.1.3 ± 0.5,P =0.00).The result of spatial linear distance was very accurate,the range was 4.98 -5.06 cm.Conclusions The results of spatial linearity test are stable and accuracy,but CT numbers linearity and uniformity test are affected by the scanning technique significantly for device.To spatial resolution test and contrast resolution test,we need to set the standard and tolerance according to each linear accelerator specialty.

Objective To observe the effects of tissue factor pathway inhibitor(TFPI) on thrombosis formation in rabbit carotid arteries after ballon injury. Methods Fouty rabbits with the weight 2.5-3.0 kg were respectively divided into 4 groups, Ad-TFPI, Ad-LacZ, PBS and normal control groups. The normal control group was not given any treatment and other 3 groups were given 0.2 ml Ad-TFPI, Ad-LacZ or PBS reproduced by the Dispatch catheter respectively after the PTCA balloon iniury on the right carotid arteries. Ten days after gene transfer the repeated balloon injury was performed in the 3 groups, and the first balloon injury was performed in the normal control group by the same method. The carotid blood flow was recovered immediately after the injury. Thirty minutes later all the animals were sacrificed. The injured carotid arteries and one part of contralateral normal artery were cut down, scissored along the long axis, flattened and fixed in the 2% glutaral. The platelet aggregation and thrombosis formation on the luminal surfaces was observed under electron microscope. Results The electron microscope results showed that the vascular endothelial cell structure was integrated and lined up in order in the nomal artery which had no any injury. After the balloon injury in the normal control group, the structure of the endothelial cell was disintegrated, and there was some platelet aggregation but no fibrosis formation. A large amount of platelet aggregated but no fibrosis formed in Ad-TFPI group after the repeated balloon injury. A large amount of fibrosis formed and red cells piled up in the Ad-LacZ and PBS group. The positive rate of thrombosis formation among groups had siginificant differences(χ2=14.95, P<0.01). The positive rate in Ad-TFPI group(20%) was lower than that in Ad-LacZ group(80%, χ2=7.20, P<0.01) and PBS group(70%, χ2=5.05, P<0.05), but was higher than that in the normal control group(10%, χ2=0.39, P>0.05). The positive rate in Ad-LacZ group(80%) was higher than in the normal control group(10%, χ2=9.90, P<0.01) and in the PBS group(70%, χ2=0.27, P> 0.05). The positive rate in PBS group(70%) was higher than that in the normal control group(10%, χ2=7.50, P< 0.01). Conclusions The repeated balloon injury method can cause a large amount of fibrosis formation in the rabbit carotid. TFPI gene inhibits thrombosis formation in balloon-injured rabbit carotid arteries.

Adenoma ; pathology ; Brain Neoplasms ; secondary ; Chromogranin A ; metabolism ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Pituitary Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Reoperation ; Synaptophysin ; metabolism ; Temporal Lobe ; pathology

OBJECTIVE: To explore the application of mixed reality technique for the surgery of oral and maxillofacial tumors. METHODS: In this study, patients with a diagnosis of an oral and maxillofacial tumor who were referred to Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from December 2018 to January 2020 were selected. The preoperative contrast-enhanced computed tomography data of the patients were imported into StarAtlas Holographic Medical Imaging System (Visual 3D Corp., Beijing, China). Three-dimensional (3D) model of tumor and key structures, such as skeleton and vessels were reconstructed to three-dimensionally present the spatial relationship between them, followed with the key structures delineation and preoperative virtual surgical planning. By using mixed reality technique, the real-time 3D model was displayed stereotactically in the surgical site. While keeping sterile during operation, the surgeon could use simple gestures to adjust the 3D model, and observed the location, range, and size of tumor and the key structures adjacent to the tumor. Mixed reality technique was used to assist the operation: 3D model registration was performed for guidance before tumor excision; intraoperative real-time verification was performed during tumor exposure and after excision of the tumor. The Likert scale was used to evaluate the application of mixed reality technique after the operation. RESULTS: Eight patients underwent mixed reality assisted tumor resection, and all of them successfully completed the operation. The average time of the 3D model registration was 12.0 minutes. In all the cases, the surgeon could intuitively and three-dimensionally observe the 3D model of the tumor and the surrounding anatomical structures, and could adjust the model during the operation. The results of the Likert scale showed that mixed reality technique got high scores in terms of perceptual accuracy, helping to locate the anatomical parts, the role of model guidance during surgery, and the potential for improving surgical safety (4.22, 4.19, 4.16, and 4.28 points respectively). Eight patients healed well without perioperative complications. CONCLUSION By providing real-time stereotactic visualization of anatomy of surgical site and guiding the operation process through 3D model, mixed reality technique could improve the accuracy and safety of the excision of oral and maxillofacial tumors.
Augmented Reality ; China ; Humans ; Imaging, Three-Dimensional ; Neoplasms ; Retrospective Studies ; Surgery, Computer-Assisted

Objective:To analyze the causes of death of elderly inpatients,so as to provide direction for the precaution of geriatrics.Methods:The first page data of hospitalized medical records of elderly inpatients in medical department in the Second Hospital of Dalian Medical University from 2102 to 2019 were extracted, and the causes of death were analyzed. The statistical analysis was performed by Excel and SPSS 21.0 statistical software.Results:The number of deaths of elderly inpatients in medical department from 2012 to 2019 was 5 249. The proportion of deaths in ICU was 34.43%(1 807/5 249), in oncology department was19.03%(999/5 249), and in cardiovascular department was12.08%(634/5 249). The average age was (78.52 ± 7.82) years. Besides, the age of men was younger than women: (78.18 ± 8.00) years vs. (79.02 ± 7.52) years, and the differences was statistically significant ( P<0.01). Men(59.1%, 3 099/5 249) were more than women (40.96%, 2 150/5 249). The largest number of deaths was in the age of 75-84 years (42.56%, 2 234/5 249). The number of cases with combined above five diseases was 4 552(86.72%, 4 552/5 249). The top three causes of deaths of elderly inpatients in medical department from 2012 to 2019 were cardiocerebrovascular diseases (27.21%, 1 428/5 249), malignant tumor (25.74%, 1351/5 249) and respiratory system diseases (22.10%, 1160/5 249). From 2012 to 2015, the top three causes of deaths were malignant tumor, cardiocerebrovascular diseases and respiratorysystem diseases. From 2016 to 2019,the top three causes of deaths were cardiocerebrovascular diseases, malignant tumor, and respiratory system diseases. The most common cause in cardiocerebrovascular diseases of death was coronary heart disease (51.47%,735/1 428), cerebrovascular disease (43.70%,624/1 428),and hypertension(4.34%, 62/1 428). Among the patients with malignant tumor death, first cause of death waslung malignant tumor (37.53%, 507/1 351), the others in turn were gastric carcinoma (11.10%,150/1 351) and intestinal cancer (11.10%,150/1 351). Among the patients with respiratory system diseases, first cause of death was pulmonary infection (69.66%,808/1 160), the others in turn were chronic obstructive pulmonary disease (15.43%, 179/1 160) and interstitial lung disease (5.09%, 59/1 160). Conclusions:The average age of elderly inpatients in medical department is (78.52 ± 7.82) years. The death age of male is less than that of female, and the number is slightly more than that of female. The top three causes of deaths of elderly inpatients in medical department are cardiocerebrovascular diseases, malignant tumor, respiratorysystem diseases. From 2012 to 2015 the first cause of deaths is malignant tumor. From 2016 to 2019, the cardiocerebrovascular diseases rise to the first.