Objective To evaluate the extra-anatomic bypass surgery for aorto-iliac occlusive disease in the elderly. Methods From January 2005 to December 2008,33 elderly patients/39 limbs (age ranged from 70 to 87 years, mean 76.0 ± 3.0 years) with aortoiliac occlusive disease were retrospectively analyzed. According to Fontaine classification, there were 5 phase Ⅱ b cases (7 limbs), 22 phase Ⅲ cases (26 limbs), and 6 phase Ⅳ cases (6 limbs), all cases were with TASC C, D lesions. Results These 33 cases/39 limbs were tr eated with a variety of bypass, including axillobifemoral bypass (6 cases/12 limbs) ,axillofemoral bypass ( 20 cases/20 limbs ), femorofemoral bypass ( 7 cases/7 limbs ). Intermittent claudication improved in 5 cases, rest pain disappeared in 22 cases, and ulcers healed in 6 cases after operations. The mean ABI increased from 0.29 ± 0.11 to 0.66 ± 0.13 ( t = 2.69, P ＜ 0.05 ). All limbs were salvaged and there was no perioperative mortality within 30 days after operations. Postoperative complication rate was 9.1%. Patients were followed up for a median of 12 ±5 months (range, 6 to 28 months), primary patency rate was 89.7% (35/39), secondary patency rate was 94.9% (37/39), limb salvage rate was 92.3% (36/39). After dischargement the mortality was 6.1% (2/33) with one dying of myocardial infarction and another one of malignant tumor (gastric cancer). Conclusions Extra-anatomic bypass for aorto-iliac occlusive disease in the elderly is feasible, safe and effective, and the cardiopulmonary dysfunctions are the major risk factors for perioperative complications.

Objective:To explore the application of energy spectrum CT single energy combined with adaptive statistical iterative reconstruction-Veo (ASIR-V) for optimizing inferior vena cava imaging.Methods:Thirty patients with negative diagnosis or minimal inferior vena cava lesions who underwent CT venography (CTV) of inferior vena cava in the Second Hospital of Harbin Medical University from August 2021 to April 2022 were enrolled in the study, including 11 males and 19 females with the age of (55.4±8.8) years and the body mass index of (23.2±2.8) kg/m2. The mixed energy group images and 5 single energy groups of 50, 55, 60, 65 and 70 keV images were reconstructed from the images in the inferior vena cava phase. The subcutaneous fat noise, CT values, signal to noise ratio (SNR) and contrast to noise ratio (CNR) for each segment of the inferior vena cava in 5 sets of single-energy images were measured and evaluated subjectively to determine the best single energy level. The images were reconstructed by combining different weight ASIR-V (20%, 30%, 40%, 50%, 60%, 70% and 80%) algorithms, and images from different weight groups and mixed energy groups were evaluated objectively to determine the best ASIR-V weights which was matched with the best single energy level. All images were scored subjectively by 2 senior radiologists based on image noise, uniformity of vessel filling, sharpness of vessel margins and diagnostic confidence.Results:There were significant differences in subcutaneous fat noise and objective evaluation indexes of each segment of inferior vena cava among the monoenergetic groups (all P<0.05), each objective evaluation index increased with the decrease of energy level, the maximum value was obtained in the 50 keV group. The subjective scores of the 5 groups were consistent by the 2 radiologists(all κ≥0.75). The highest subjective scores were obtained in the 60 keV group, the best single energy level is 60 keV in a comprehensive analysis. The differences in objective evaluation indicators among the 7 groups of best single energy combined with different weights ASIR-V image group and the mixed energy group were all statistically significant (all P<0.01). Image noise decreased with increasing ASIR-V weights for different weight groups, all differences among groups were statistically significant (all P<0.01), and the minimum noise was minimal in 80% weight group. There was no significant change in CT value of each segment of inferior vena cava (all P>0.05). The SNR and CNR of each segment of inferior vena cava increased, all differences among groups were statistically significant (all P<0.01), and the SNR and CNR of 80% weight group was the highest. The subjective scores of the 8 groups were consistent evaluated by the 2 radiologists (all κ≥0.75), and the subjective score of 60% weight group was the highest, 60% was the best ASIR-V weight for matching 60 keV in a comprehensive analysis. Conclusions:The study indicates that the best energy level for optimizing energy spectrum CT single energy imaging of the inferior vena cava is 60 keV, on the basis of which the best weighting for combined ASIR-V is 60%.

OBJECTIVE: To determine whether diffusion kurtosis imaging (DKI) is effective in monitoring tumor response to neoadjuvant chemotherapy in patients with osteosarcoma. MATERIALS AND METHODS: Twenty-nine osteosarcoma patients (20 men and 9 women; mean age, 17.6 ± 7.8 years) who had undergone magnetic resonance imaging (MRI) and DKI before and after neoadjuvant chemotherapy were included. Tumor volume, apparent diffusion coefficient (ADC), mean diffusivity (MD), mean kurtosis (MK), and change ratio (ΔX) between pre- and post-treatment were calculated. Based on histologic response, the patients were divided into those with good response (≥ 90% necrosis, n = 12) and those with poor response (< 90% necrosis, n = 17). Several MRI parameters between the groups were compared using Student's t test. The correlation between image indexes and tumor necrosis was determined using Pearson's correlation, and diagnostic performance was compared using receiver operating characteristic curves. RESULTS: In good responders, MDpost, ADCpost, and MKpost values were significantly higher than in poor responders (p < 0.001, p < 0.001, and p = 0.042, respectively). The ΔMD and ΔADC were also significantly higher in good responders than in poor responders (p < 0.001 and p = 0.01, respectively). However, no significant difference was observed in ΔMK (p = 0.092). MDpost and ΔMD showed high correlations with tumor necrosis rate (r = 0.669 and r = 0.622, respectively), and MDpost had higher diagnostic performance than ADCpost (p = 0.037) and MKpost (p = 0.011). Similarly, ΔMD also showed higher diagnostic performance than ΔADC (p = 0.033) and ΔMK (p = 0.037). CONCLUSION: MD is a promising biomarker for monitoring tumor response to preoperative chemotherapy in patients with osteosarcoma.
Bone Neoplasms ; Diffusion ; Drug Therapy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Necrosis ; Osteosarcoma ; ROC Curve ; Tumor Burden

Objective To construct a high-quality practical teaching system of rehabilitation majors for undergraduate based on World Health Organization rehabilitation competence framework(RCF). Methods Using the principles and methods of RCF,the competency requirements for rehabilitation therapy were ana-lyzed and a practical teaching system suitable for undergraduate education in rehabilitation therapy was construct-ed. Results The rehabilitation practice education were constructed as practice courses,clinical practice and social service practice,and the practice education modules and objectives were discussed based on RCF. Conclusion A competency-oriented rehabilitation practice education system has been constructed based on RCF,includ-ing practice courses,clinical practice and social service practice.

Objective:To investigate the predicting value of high sensitivity C-reactive protein (hs-CRP) and albumin (Alb) ratio on prognosis of patients with in-hospital cardiac arrest (IHCA).Methods:A total of 107 patients with IHCA and spontaneous circulation recovery (ROSC) after cardiopulmonary resuscitation (CPR) in the Affiliated Hospital of Xuzhou Medical University during January 1, 2017 and September 30, 2020 were selected as the subjects and divided into the survival group and death group according to the survival condition on day 14 after IHCA. The correlation between ratio of high sensitivity C-reactive protein/albumin (hs-CRP/Alb) and the prognosis of patients was analyzed.Results:No statistical significant differences were found between the survival and death groups in sex, age, medical history, ECG monitoring, recovery ventilation mode, percentage of first monitoring of heart rate and pre-resuscitation Alb (all P > 0.05). However, there were significant differences in the percentage of non-cardiogenic CA and adrenaline dose > 5 mg, time of CPR, concentrations of blood lactic acid, Alb, hs-CRP, and ratio of hs-CRP/Alb (all P < 0.05). Logistic regression analysis showed that percentage of adrenaline dose > 5 mg, concentration of blood lactic acid, time of CPR, and ratio of hs-CRP/Alb were independent risk factors for predicting death. ROC curve analysis showed that hs-CRP/Alb ratio, and concentration of hs-CRP and Alb had predictive value on the death of patients with IHCA; the areas under the curves of hs-CRP/Alb ratio, hs-CRP and Alb concentration were 0.876, 0.864 and 0.745, respectively. The predictive efficiency of hs-CRP/Alb ratio was better than that of hs-CRP concentration or Alb concentration. Conclusions:hs-CRP/Alb ratio has predictive value for the prognosis of patients with IHCA and the predictive value is superior to that of hs-CRP and Alb concentration.

By analyzing the physiological structure and motion characteristics of human ankle joint, a four degree of freedom generalized spherical parallel mechanism is proposed to meet the needs of ankle rehabilitation. Using the spiral theory to analyze the motion characteristics of the mechanism and based on the method of describing the position with spherical coordinates and the posture with Euler Angle, the inverse solution of the closed vector equation of mechanism position is established. The workspace of mechanism is analyzed according to the constraint conditions of inverse solution. The workspace of the moving spherical center of the mechanism is used to match the movement space of the tibiotalar joint, and the workspace of the dynamic platform is used to match the movement space of subtalar joint. Genetic algorithm is used to optimize the key scale parameters of the mechanism. The results show that the workspace of the generalized spherical parallel mechanism can satisfy the actual movement space of human ankle joint rehabilitation. The results of this paper can provide theoretical basis and experimental reference for the design of ankle joint rehabilitation robot with high matching degree.
Ankle Joint ; Biomechanical Phenomena ; Humans ; Movement ; Range of Motion, Articular

In the original publication the labelling on Fig. 2A and B were incorrectly published as E7.5. The correct labelling of Fig. 2A and B should be read as E17.5 which is provided in this correction.

In the original publication the labelling of Figure 1D, Y-axis is incorrectly published. The correct labeling should be read as Fragilis+/SSEA1+ and the correct figure is provided in this correction.