Objective To compare and analyze the clinical effects and reliabilities of intermandibular flexible distraction and rigid internal fixation in treating mandibular condylar fractures. Methods Of 40 patients with mandibular condylar fractures, 21 cases were managed with intermandibular flexible distraction (external fixation group, Group A) and 19 with rigid titanium internal fixation (internal fixation group, Group B). There were 15 cases with high position fractures and 25 with low position ones. Results During 2-4 weeks postoperatively, X-rays confirmed the condylar fracture healing in all cases with no loosened mini-tinum plates in the Group B. There were 10 cases in the Group A and 14 cases in the Group B with the opening width over 30 mm, and 11 cases in the Group A and 5 in the Group B with the opening width less than 30 mm. Conclusions Both external and internal fixations can attain condylar fracture healing. However, compared with the internal fixation, the reduction of external fixation is less exact and the function recovery slower after operation, especially in the low position fractures. No irreversible damages on TMJ happen in all cases.

Objective To explore the diagnostic value of CT angiography (CTA) of vertebral artery dissection (VAD) value. Methods We retrospectively analysed vertebral artery dissection in 30 patients (32 branches) according to the results of DSA. Tow radiologists independently analyzed the CTA images, and the sensitivity, specificity and accuracy of CTA in VAD patients were determined. The consistency of DSA and CTA results were evaluated by Kappa test. Results Thirty two branches of 60 vertebral arteries were diagnosed as VAD by DSA, 31 branches were diagnosed as VAD by CTA, 1 branch was misdiagnosis. Eight branches with dissection aneurysm were all displayed by CTA and DSA. Eleven branches of 12 branches withstring of beads signwere diagnosed by CTA. Five branches of 6 branches withstring and pearl signwere diagnosed by CTA;CTA and DSA of 1 branch withdouble-lumen signwere all displayed. Six branches of 5 branch withlinear signwere diagnosed by CTA. One branch showedlinear sign, but was diagnosed thrombosis by CTA. Two branches were showedlinear sign, but were diagnosedstring of beads signandstring and pearl sign. The sensitivity, specificity, accuracy of CT angiography in diagnosing VA dissection were 96.8％(31/32), 100％(28/28), 98.3％(59/60), respectively. The results made good agreement with DSA(Kappa=0.967,P<0.01). Conclusion Dual source CTA was a sensitive and accurate technique for the diagnosis of VAD.

Objective: To explore the predictive value of modified chronic total occlusion (CTO) scores based on coronary computed tomography angiography (CCTA) for the outcome of CTO lesions after percutaneous coronary intervention (PCI). Methods: A total of sixty-six patients who had undergone CCTA examinations were retrospectively enrolled and divided into PCI-success group (n=48) and PCI-failure group (n=18). Age, body mass index (BMI), calcium score (CACS), location and extent of CTO occlusive segments were recorded and compared between the two groups using paired-samples t test. In addition, the differences of gender, hypertension, hyperlipidemia, hyperuricemia, diabetes mellitus, myocardial infarction and angina pectoris were analyzed by using chi-square test and Fisher exact test. J-CTO score based on CCTA images (J-CTO_CT) was calculated. Furthermore, modified-CTO score (m-CTO_CT) was measured by redefining the calcification degree (mild, severe) and range (full segment, part) in the J-CTO scoring system. Predictive value of J-CTO_CT and m-CTO_CT on recanalization success was evaluated by the receiver operating curve (ROC) analysis. Results: There were no significant differences in patients′ clinical indices between the two groups (all P>0.05). Compared to PCI-success group, blunt cap, blending>45 degrees, lesion length>20 mm, full calcification segment of lesion (χ²=5.012, 3.999 and 4.103, respectively; P<0.05) occurred more frequently in the PCI-failure group. In addition, the incidence of occlusive calcification was significantly increased in the PCI-failure group (P<0.05), as well as the total occlusive calcification (P=0.001) and severe occlusive calcification (P=0.000). Nevertheless, the rate of mild occlusive calcification was significantly higher in the PCI-success group (P=0.037). There were no significant differences in calcification location, calcification score and extent of calcification (P>0.05) between the two groups. The area under ROC (AUC) of m-CTO_CT (0.921) was significantly higher than that of J-CTO_CT (0.847, P<0.001). Conclusions Morphological evaluation of CCTA is helpful to predict the surgical success in patients with PCI. m-CTO_CT scoring shows higher predictive value compared to traditional J-CTO_CT score.