Objective To investigate the value of prothrombotic state (PTS) in prediction of perioperative cardiac events in elderly patients with coronary heart disease undergoing noncardiac surgery.Methods One-hundred and twenty-eight ASA physical status Ⅰ or Ⅱ elderly patients (NYHA class Ⅰ or Ⅱ) of both sexes,aged 6575 yr,undergoing elective abdominal surgery,were enrolled in the study.Total intravenous anesthesia was performed during surgery.Venous blood samples were collected for detection of the levels of D-dimer,thrombus precursor protein and P-selectin (molecular markers of PTS).Detection of PTS was based on the three indexes mentioned above.The patients were divided into 2 groups according to the cardiac events occurred during surgery and within 3 days after surgery:non-cardiac event group and cardiac event group.The general data of patients and each index during surgery were recorded.Logistic regression analysis was used to pick out the potential risk factors for cardiac events.Results Twenty-nine patients developed cardiac events.There was no significant difference in age,obesity,ratio of diabetes,duration of operation,and ratio of PTS between non-cardiac event and cardiac event groups (P ＜ 0.05 or 0.01).Logistic regression analysis showed that old age,diabetes,prolonged duration of operation,and PTS were independent risk factors for cardiac events (P ＜ 0.01).Conclusion PTS produces some value in prediction of perioperative cardiac events in elderly patients with coronary heart disease undergoing noncardiac surgery.

PurposeTo evaluate the motion correction algorithm (snapshot freeze, SSF) and multi-cycle reconstruction on the imaging quality and interpretation of coronary CT angiography (CCTA).Materials and Methods Sixty patients with suspected coronary heart disease were divided into two groups according to the heart rate. Twenty-ifve patients with heart rate ≤65 beats per minute underwent prospectively ECG-gated CCTA on gemstone CT. Image quality and interpretability of standard (STD) and SSF reconstructions at 75% R-R interval were compared. Thirty-five patients with heart rate>65 beats per minute underwent retrospective ECG-gated CCTA. Image quality and interpretability of STD and SSF reconstructions at 45% and 75% R-R interval were compared. The image qualities and interpretability were assessed based on coronary artery segment, coronary artery bifurcation and overall coronary artery.Results For 25 patients with prospectively ECG gated CCTA, SSF reconstructions showed higher interpretability than STD reconstructions on per-segment level [96.3% (341/354)vs 90.7% (321/354),P<0.01]. Image qualities with SSF were higher than that with STD reconstructions for left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA). There was no statistic significance for left main coronary artery (P>0.05). For 35 patients with retrospective ECG-gate CCTA, SSF reconstructions at 45% R-R interval showed higher interpretability (P<0.01,P<0.001). But there were no signiifcant difference for 75% R-R interval images (P>0.05). Image qualities with SSF were higher than that with single and double sector STD reconstructions (P<0.001). The image qualities were signiifcant different among SSF, single and double sector STD reconstructions for 45% R-R interval images of LM (P<0.01), but it was similar for 75% R-R interval images (P>0.05). There were signiifcant different for LAD, LCX and RCA on both 45% and 75% R-R interval images (P<0.01,P<0.001). Conclusion SSF may improve the image quality and interpretability of CCTA images using prospectively and retrospective ECG-gated techniques, especially for improving the image quality.

Objective To explore and compare the prognostic ability of the serum level of M2BPGi and MRI imaging technology for hepatic fibrosis. Methods 118 patients who were diagnosed as hepatitis C were enrolled from March 2014 to March 2015 in our hospital.Their baseline data were recorded,and they were texted by imaging examination of MRI.Then all patients were followed-up 2 years.The patients were divided into hepatic fibrosis group and control group according to the follow-up results.Univariate analysis and Cox model were used to show that the prognostic factors influencing the prognosis of hepatic fibrosis in patients;meanwhile,the statistical significance factors were calculated by ROC curve.Results The serological markers of IV-C,HA and serum level of M2BPGi in hepatic fibrosis group were higher than those in control group,but its ADC values of liver was lower than those in control group,and the difference was statistically significant(P < 0.05). COX regression analysis showed that the difference of M2BPGi(RR = 4.282,P = 0.003)and ADC values(RR = 0.654,P = 0.004). The ROC analysis of the hepatic fibrosis group and the control group showed that the AUC of the combination was 0.865,the sensitivity and specificity were 95.2%,60.5%,respectively.Conclusion The clinical value the com-bined prognostic of them is of high prognostic efficacy,which is hopeful to be used as an auxiliary prognostic meth-od in clinic.