ObjectiveTo explore the effect of statin in reduction of my ocardial injury in patients undergoing percutaneous coronary intervention(PCI).MethodsTotal of 185 patients undergoing PCI were included,140 patients were received atorvastatin before PCI,while 145 were not given statins at the time of PCI.Creatine kinase-MB and troponin Ⅰ were measured at baseline and at 8 and 24 hours after the procedure.ResultsPost procedurul peak levels of troponin Ⅰ and creatine kinase-MB were(0.12 ±0.26) μg/L and(2.61 ± 3.07) μg/L in the observation group,which were significantly lower than(0.51 ± 1.14) μg/L and( 6.85 ± 14.38 ) μg/L in the control group( t =3.951,3.414,P ＜ 0.05).ConclusionPretreatment with atorvastatin for 7 days could significantly reduces procedural myocardial injury in elective PCI.

Objective Through establishing a rat model of atrial fibrillation,to study myocardial angiotensin type Ⅰ (AT1R) and type Ⅱ receptor (AT2R) mRNA expression levels in of the state atrial fibrillation and Artemisia annua extract on its expression.Methods Rat model of atrial fibrillation was established,Artemisia annua extract was used for intervention and captopril was adopted as controls.AT1R,AT2R mRNA and protein expression were observed by PCR and Western-blot technology.Results Compared with the control group (0.36±0.05),myocardial AT1R mRNA expression was significantly increased in the model group (0.84±0.04) (P＜0.05).BothArtemisia annua (0.56±0.03) and captopril (0.53±0.04) could significantly reduce the myocardial AT1R mRNA expression in the atrial fibrillation rats (P＜0.05).Captopril showed obvious AT1R mRNA reduction trend,but there was statistical significance compared with Artemisinic extract (P＞0.05).Artemisinic extract showed no impact on AT2R mRNA expression.Conclusion AT1R was closely related to the incidence of atrial fibrillation.AT1R expression was significantly increased in atrial fibrillation rat.The artemisinic extract can be effectively reduced fibrillation myocardial AT1R expression,which may link with its artemisinic antiarrhythmic mechanism.

The Traditional Chinese Medical Pulse Instrument uses the HKG-07B infrared pulse sensor to get pulse signal from the body. It makes full use of the TMS320VC5402 chip to realize time-frequency domain parameters extracting, classification and identification of the pulse signal. The system can store a plenty of pulse signal and realize data communication with the PC via the USB interface. According to acquisition and classification of pulse signal experiments of 200 subjects, the results show that the recognition rate of pulse signal can reach to 87.4%. It is applicable to the clinical diagnosis and detection of the pulse signal and home healthcare.
Equipment Design ; Humans ; Medicine, Chinese Traditional ; methods ; Signal Processing, Computer-Assisted ; Software Design

OBJECTIVE:To observe therapeutic efficacy and safety of entecavir combined with long-acting interferon in the treatment of HBeAg positive chronic hepatitis B (CHB).METHODS:A total of 140 patients with HBeAg positive CHB selected from our hospital during May 2013-May 2015 were divided into observation group and control group according to random number table,with 70 cases in each group.Both groups received routine liver-protecting treatment;control group was additionally given Peginterferon α-2b injection 80 μg subcutaneously,once a week;observation group was additionally given Entecavir dispersible tablets 0.5 mg,po,qd,on the basis of control group.Both groups received treatment for consecutive 50 weeks.Clinical efficacies,liver function indexes before and after treatment,virological efficacies and the occurrence of ADR of 2 groups were observed.RESULTS:Each 5 cases withdrew from the study in 2 groups,and 130 cases (65 cases in each group) completed the study.Total response rate of observation group was 90.8％,which was significantly higher than 76.9％ of control group,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in the levels of ALT,AST,ALB or TBIL between 2 groups (P＞0.05).After treatment,the levels of ALT,AST and TBIL in 2 groups were decreased significantly,while ALB level was increased significantly,the observation group was significantly better than the control group,with statistical significance (P＜0.05).After 50 weeks of treatment,the negative conversion rate of HBV-DNA,HBeAg serology conversion rate and ALT normalizing rate of observation group were significantly higher than those of control group,and virologic breakthrough rate was significantly lower than control group,with statistical significance (P＜0.05).No severe ADR was found in 2 groups.There was no statistical significance in the incidence of ADR (P＞0.05).CONCLUSIONS:The entecavir combined with long-acting interferon show defmite therapeutic efficacy for HBeAg positive CHB,inhibit the replication of HBV and improve liver function of patients with good safety.

Objective:To investigate the value of CT imaging radiomics in predicting the therapeutic effect of extracorporeal shock wave lithotripsy (ESWL) for pancreatic duct stones.Methods:The clinical data of 167 patients with pancreatic duct stones treated with ESWL in the Department of Gastroenterology, the First People's Hospital of Hangzhou, Westlake University from July 2016 to January 2023 were retrospectively analyzed. Patients were divided into complete lithotripsy group (stone diameter ≤3 mm, n=94) and incomplete lithotripsy group (stone diameter>3 mm, n=73), according to the size of the largest residual stone after the first ESWL treatment. ITK SNAP software was used to delineate the images of pancreatic duct stones, and the artificial intelligence tool kit developed by United Shadow Company was used to extract the image radiomics characteristics. The pancreatic duct stone data set was randomly assigned into the training set ( n=118) and the test set ( n=29) in the ratio of 8∶2, and the absolute maximum normalization treatment was used, followed by peacekeeping selection through the minimum absolute contraction and selection operator (Lasso) to calculate the CT image radiomics score, and the logistic regression classifier was used to construct the ESWL treatment effect prediction model of pancreatic duct stones. Receiver operating characteristic curves (ROC) were plotted, and the area under the curve (AUC) and sensitivity, specificity, and accuracy were calculated to assess the performance of the prediction model. Decision curve analysis was used to evaluate the clinical value of CT radiomics score in the diagnosis of ESWL for pancreatic duct stones. Results:A total of 2 287 imaging radiomics characteristics were extracted, and 11 optimal imaging radiomics characteristics were finally screened by Lasso regression dimensionality reduction to establish a prediction model for ESWL treatment effect of pancreatic duct stones. The AUC values of the training set and the test set were 0.89 and 0.87, respectively, and the sensitivity, specificity, and accuracy were 82% and 79%, 82% and 82%, 82% and 80%, respectively. The AUC value in the independent validation set was 0.90, and the sensitivity, specificity, and accuracy were 78%, 90%, and 85%, respectively. The results of decision curve analysis showed that when the probability of ESWL efficacy in the diagnosis of pancreatic duct stones with CT image radiomics score was >0.05, the use of CT image radiomics score in the diagnosis of ESWL efficacy in pancreatic duct stones was more beneficial to patients in clinical practice than not.Conclusions:The treatment effect of ESWL for pancreatic duct stones can be predicted by CT imaging radiomics model.

Objective To explore the correlation of MPV,NLR,PT,APTT and FIB with early pro-gression of ACI in patients with BAD.Methods A total of 303 ACI patients with BAD admitted in our department of neurology from October 2021 to September 2023 were consecutively recrui-ted,and according to their progression within 7 d of onset,they were divided into progression group(89 cases)and un-progression group(214 cases).The general clinical data,blood routine re-lated indicators(MPV,NLR)and coagulation related indicators(PT,APTT,FIB)were compared between the two groups.Multivariate logistic regression analysis was applied to identify the rela-tionship of above indicators with early progression of ACI in BAD patients.ROC curve was plot-ted to analyze the predictive value of the indictors for disease progression in these patients.Results The progression group had significantly advanced age,larger proportions of diabetes,hyperlipi-demia and stroke history,and increased levels of uric acid,LDL-C,homocysteine,MPV,platelet distribution width,NLR,D-dimer and FIB,and shorter TT,PT and APTT when compared with the un-progressed group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that MPV,NLR,PT,APTT,and FIB were all independent influencing factors for early disease pro-gression of ACI in patients with BAD(P＜0.05,P＜0.01).ROC curve indicated that the AUC value of combined MPV,NLR,PT,APTT and FIB in detecting early disease progression was 0.859(95％CI:0.813-0.905).Conclusion Blood routine(MPV,NLR)and coagulation related indicators(PT,APTT,FIB)are closely associated with the early disease progression of ACI in BAD patients,and these indicators are of high value in predicting the early disease progression.

Objective: To investigate the feasibility and effectiveness of endoscopicretrograde cholangio-pancreatography(ERCP)in the management of long-term complications after pancreaticoduodenectomy. Methods: From January 2009 to July 2018, the clinical data of 62 patients with biliary or pancreatic long-term complications after pancreatoduodenectomy were reviewed at Department of General Surgery, and the corresponding ERCP were carried out in the multi-disciplinary cooperation.There were 39 males and 24 females.The age was 56.5 years(aging from 13 to 76 years). The time of treatment was 3 months to 20 years after pancreatoduodenectomy.The long-term biliopancreatic complications after pancreatoduodenectomy included 51 cases of biliary calculi, 42 cases of bilioenteric anastomotic stenosis with proximal bile duct dilatation, and 11 cases of pancreaticointestinal anastomosis stenosis with distal pancreatic duct dilatation.All patients received conventional duodenoscopy or single-balloon enteroscopy assisted ERCP under general anesthesia. Results: A total of 95 ERCP were performed in 62 patients, averaging 1.5 times per case.The long-term complications of cholangiopancreatic after pancreatoduodenectomy(ERCP indications) included 56 times of bile duct stones(58.9%), 45 times of bilioenteric anastomatic stricture(47.4%), 11 times of recurrent pancreatitis(11.6%), 6 cases(6.3%) of bilioenteric anastomatic foreign body, 3 times of intrahepatic bile duct stenosis(3.2%). Among the 95 times, 82 times(86.3%) achieved endoscopic endoscopy, 76 times(80.0%) were diagnosed successfully, and 72 times(75.8%) were successfully treated with ERCP.Small intestinal perforation occurred in 1 patient undergoing duodenoscopy, and then healed by surgical repair. Conclusion Multi-disciplinary collaboration of ERCP is safe and effective in the treatment of long-term complications after pancreaticoduodenectomy, but the long-term effect still needs further clinical follow-up.

This article briefly describes the imaging performance standards of the kilovolt X-ray image guidance system used in radiotherapy, analyzes the main aspects that should be considered in the image quality of X-IGRT system, and focuses on parameters that should be considered in the imaging performance evaluation criteria of the CBCT X-IGRT. The purpose is to sort out the imaging performance evaluation standards of kilovolt X-IGRT system, clarify the image quality requirements of X-IGRT equipment, and reach a consensus when evaluating the imaging performance of X-IGRT system.
Radiotherapy Planning, Computer-Assisted/methods* ; Cone-Beam Computed Tomography/methods* ; Spiral Cone-Beam Computed Tomography ; Radiotherapy, Intensity-Modulated/methods* ; Radiotherapy, Image-Guided/methods*

Objective: To evaluate the safety and efficacy of foam sclerotherapy for bleeding internal hemorrhoids. Methods: Consecutive adult patients (aged 18-60 years) with bleeding hemorrhoids were prospectively enrolled between March 2017 and March 2018. All patients were randomly assigned to the foam sclerotherapy (FS) group and the liquid sclerotherapy (LS) group. The foam and liquid sclerotherapy of hemorrhoids nucleus was performed by cap-assisted colonic endoscopy. Results: A total of 108 patients were enrolled, including 62 males (57.4%) with mean age of 44.0±7.6 years. There was no significant difference in gender, age, or body mass index between the FS (n = 55) group and the LS (n =53) group. The total amount of lauromacrogol injection in the FS group was 3.7±0.9 mL, which was significantly lower than that in the LS group (8.0±2.2 mL, P<0.001). In the LS group, 8 patients (15.1%) developed bleeding after needle removal, which was significantly higher than that in the FS group [5.5%(3/53), P=0.022]. Significant pain was found in 2 patients (3.8%) in the LS group and 0 in the FS group (P= 0.025). The short-term cure rate and effective rate of the FS group were 87.3% (48/55) and 9.1% (5/55), while those were 69.8% (37/53) and 22.6% (12/53) in the LS group, respectively (P=0.046). Conclusion Foam sclerotherapy is safe and effective in the treatment of bleeding internal hemorrhoids.

【Objective】 To compare the enhancement effects of lean body weight （LBW） and total body weight （TBW） as indexes to calculate the contrast agent dosage under the condition of energy spectrum CT scanning. 【Methods】 A total of 218 patients who received liver enhancement CT from November 2018 to January 2019 were enrolled in this study. There were 101 patients in LBW group and 117 patients in TBW group. Both groups were scanned by energy spectrum CT， and the parameters of scanning and reconstruction were identical. The contrast agent dose was 500 mgI/kg （LBW） in LBW group and 450 mgI/kg （TBW） in TBW group， and the injection rate was 2.8 mL/s. Images were transferred to a GE AW4.7 workstation and the 50 keV monochromatic images were analyzed. We compared the dosage of contrast medium， CT value of aorta in arterial phase （HU-aorta）， hepatic enhancement CT value in venous phase （-liver）， the rate of reaching the enhancement standard and variability in the two groups. 【Results】 Compared with TBW group， LBW group had lower contrast agent dosage， HU-aorta and ∆-liver （P<0.05）， LBW and TBW group had no statistically different enhanced rate of HU-aorta as （91.09% vs. 90.60%） or ∆-liver （92.08% vs. 88.89%） （P>0.05）. The variation rate of HU-aorta and ∆-liver in LBW group was lower than that in TBW group. Using LBW as an index to calculate the dosage of liver enhanced CT also made the enhancement of liver parenchyma more consistent in different patients. 【Conclusion】 Even on the premise of energy spectrum CT scanning， using LBW-based contrast injection in liver enhanced CT can not only reduce contrast dose， but also make the enhancement in liver parenchyma more consistent among different patients.