Objective To explore the epidemic characters of Pathological Internet Usage (PIU) in the newly enrolled post-graduates and further to detect the relationship between PIU and relative social environment, etc., so as to provide more evidence for the etiology of PIU. Methods Questionnaire was conducted in 556 newly enrolled post-graduate students of a medical university. The recovery rate of the valid questionnaires was 94.72%, and the data were analyzed by chi-square test, t-test and logistic regression. Results The rate of internet-utilizing students in recent one year was 95.3%, thereinto, 5.3% of them was with internet addiction disorder. Multivariate logistic regression analysis showed that the major impact factors were gamble, playing games, the heavy study pressure, psychoticism personality characteristic tendency and low self-respect, the OR values (95%CI) were 13.966 (1.662~117.835), 3.440 (1.401~8.450), 1.249 (1.096~1.423), 0.889 (0.821~0.963) and 2.749 (1.167~6.475), respectively (all P

Objective To evaluate the additional value of CACS in detection of coronary artery disease (CAD) with MPI.Methods A total of 188 suspected CAD patients (128 males,60 females;average age (61.93±9.16) years) who underwent one-step examination of MPI combined with CACS from December 2012 to August 2014 were enrolled in this retrospective study.According to the gold standard of CAG,the diagnostic efficacy of MPI was calculated.ROC analysis was performed to determine the optimal CACS threshold for the detection of CAD.Mann-Whitney u test and x2 test were used for statistical analysis.Results (1) Seventy-three CAD cases were confirmed (≥ 50％ stenosis) among 188 patients.The sensitivity,specificity,accuracy for CAD diagnosis with MPI were 65.8％ (48/73),75.7％ (87/115),71.8％ (135/188),respectively.Twenty-five CAD patients had negative findings with MPI,including 2 with LM disease,4 with three-vessel disease (LAD±LCX±RCA,3-VD),3 with 2-VD,16 cases with 1-VD.Among them 13 cases (52.0％,13/25) had intermediate lesions of 1-VD (50％ ≤ stenosis＜70％).(2) The CACS of CAD group was significantly higher than that of non-CAD group (172.40(19.25,516.45) vs 0;z=-8.465,P＜0.001).According to the ROC analysis,95.1 was the optimal CACS cutoff to detect CAD patients.Combining MPI with CACS (at cutoff of 95.1) improved the sensitivity of MPI (80.8％,59/73;x2 =4.233,P＜0.05) for the detection of CAD,with no significant decrease in specificity and accuracy (71.3％,82/115;75.0％,141/188;x2 values:0.558 and 0.490,both P＞0.05).(3) Of the 25 CAD patients with negative MPI results,11(44.0％,11/25) showed abnormal CACS(CACS≥95.1),consisted of 2 cases of LM disease,4 cases of 3-VD,2 cases of 2-VD,3 cases of 1-VD.Diagnosis was corrected by CACS in 8/9 cases of severe CAD (LM CAD or multivessel disease) which were missed by MPI.Conclusion CACS could offer additional information for MPI in detection of suspected CAD patients,which can improve the sensitivity of MPI for diagnosing CAD,especially for severe CAD with LM lesions or multivessel CAD.

Purpose The one-step examination of myocardial perfusion imaging (MPI) combined with coronary artery calcium score (CACS) can obtain both coronary functional information and anatomical information simultaneously, this paper aims to evaluate the value of the one-step examination of MPI combined with CACS for detecting coronary artery disease (CAD). Materials and Methods 188 cases who underwent one-step examination of MPI combined with CACS and invasive coronary angiography (ICA) because of chest tightness, chest pain with suspected coronary artery disease were analyzed retrospectively, with the results of ICA used asgold standard, the diagnostic efficacy of MPI, CACS and one-step examination with combination of the two techniques for CAD was investigated. Results ①Pre-test probability of CAD was intermediate in 79.8%(150/188), and high in 20.2%(38/188) cases. Seventy-three cases were confirmed as CAD and 115 of 188 patients were negative according to ICA.②The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of CAD by MPI were 65.8%, 75.7%, 71.8%, 63.1%and 77.7%, respectively. ③ The CACS of CAD group was significantly higher than the non-CAD group (494.96±99.60 vs. 38.15±16.03, P<0.05). According to the features of the ROC curve, the best threshold for the diagnosis of CAD with CACS was 96.45, with CACS≥96.45 as the positive standard in diagnosis of CAD, the sensitivity, specificity, accuracy, PPV and NPV for the diagnosis of CAD by CACS were 60.3%, 93.9%, 80.8%, 86.3%and 78.8%, respectively. ④ The sensitivity of MPI combined with CACS were significantly higher than MPI (80.8% vs. 65.8%, P<0.05), while the specificity (71.3% vs.75.7%, P>0.05) and accuracy (75.0% vs. 71.8%, P>0.05) showed no statistically significant difference; the sensitivity of MPI combined with CACS were significantly higher than CACS (80.8%vs. 60.3%, P<0.05), while the specificity was lower than CACS (71.3%vs. 93.9%, P<0.05) and the accuracy showed no statistically significant difference (75.0%vs. 80.8%, P>0.05). Conclusion The one-step examination of MPI combined with CACS can reduce coronary heart disease misdiagnosis, improve the diagnostic sensitivity of CAD compared with the MPI or CACS, with high application value for the diagnosis of CAD, especially in moderate risk groups.

Objective:To estimate the remineralization of enamel of primary teeth with early caries protreated by NaF-chitosan gel.Methods:Early stage caries was created on anterior primary teeth.The samples were divided into 4 groups randomly (n =6),and treated by NaF-chitosan gel,chitosan gel,duraphat and non-treatment(the control) respectively.Then all samples were underwent a 7days pH cycle.Then samples were tested with SEM and EDS.Data were analyzed with SPSS 19.Results:The SEM data showed that chitosan gel protected the enamel surface from being mined by erosion.NaF-chitosan gel group showed more mineral crystal formation on the enamel surface.The NaF-chitosan gel group showed more Ca remineralized on the enamel surface.Conclusion:NaF-chitosan gel can increase the remineraliztion of on the anterior primary teeth with early stage caries.

Objective To assess the left ventricular (LV) systolic synchrony by phase analysis of gated myocardial perfusion imaging (GMPI) with SPECT/CT in patients with old myocardial infarction (OMI) and further to identify independent predictors for LV dyssynchrony.Methods Seventy-six OMI patients and seventy-four healthy volunteers (control group) underwent resting GMPI from October 2010 to September 2013 in our hospital were included in this study.The left ventricular systolic synchrony parameters including phase histogram bandwidth (BW) and phase standard deviation (SD) were obtained by Cedars-Sinai quantitative gated SPECT (QGS) phase analysis technique,and LV cardiac function was also measured.The extent of myocardial perfusion defect was analyzed by the Quantitative Perfusion SPECT (QPS) software.The value of BW and SD were compared between OMI and the control groups,between LVEF ≤ 35％ and LVEF ＞ 35％ groups in OMI patients.Dyssynchrony was defined when the BW exceeded the abnormality threshold derived from a normal control group (threshold =x-± 2s for normal BW).Results (1) TheBW ((91.3±58.6)°vs.(37.2 ±11.7)°) and SD ((27.3 ±20.8)° vs.(11.8± 5.4) °) were significantly higher and the LVEF was significantly lower in OMI group than in the normal controlgroup (all P ＜0.01).In addition,BW ((136.0 ± 52.9)° vs.(51.0 ± 24.0)°) and SD ((38.7 ± 21.3) ° vs.(17.1 ± 14.0)°) were significantly higher in patients with LVEF ≤ 35％ than in patients with LVEF ＞ 35％ (all P ＜ 0.001).(2) Dyssynchrony (BW ＞ 60.6°) prevalence was 57.9％ (44/76) in OMI patients.Compared with the synchrony group,LVEF was significantly lower,while the left ventricular end-diastolic volume,end-systolic volume,summed motion score,summed thickening score and extent were significantly higher in dyssynchrony group (all P ＜ 0.001).(3) Additionally,dyssynchrony prevalence was significantly higher in patients with LVEF≤35％ compared with patients with LVEF ＞ 35％ (91.7％ (33/36) vs.27.5％ (11/40),P ＜0.001).(4) Pearson correlation analysis showed that LVEF was negatively correlated with BW (r =-0.807,P ＜ 0.001).(5) Multivariate logistic regression analysis revealed that the extent of myocardial perfusion defect was an independent predictor for dyssynchrony in OMI patients (OR =1.076,95％ CI:1.015-1.141,P =0.015).Conclusions GMPI phase analysis can reliably reflect left ventricular systolic synchrony.The left ventricular systolic dyssynchrony in OMI patients is significantly increased.Left ventricular dyssynchrony is closely related to LVEF.The extent of myocardial perfusion defect (Extent) is an independent predictor for left ventricular systolic dyssynchrony in OMI patients

Objective To prepare FLIVIGSII peptide(FI peptide)and investigate its physicochemical properties and hemostatic effect in vivo and in vitro.Methods The self-assembling peptide-based hydrogels were prepared by the FI peptide mixed with water.After gross observation for the hydrogel state of the FI peptide,scanning electron microscopy(SEM)and transmission electron microscopy(TEM)were used for its microstructure,and dynamic light scattering(DLS)was performed for its size.The hemostatic effect of FI peptide after being mixed with blood samples treated with 3.8％sodium citrate was observed,and the microstructure of the blood clot was observed with SEM.CCK-8 assay and hemolysis assay were performed to verify its biocompatibility.After a rat model of hepatic parenchymal perforation and hemorrhage was established,15 female SD rats(6～8 weeks old,weighing 150 g)were randomly divided into control group,FI peptide group and fibrin sealant group.The hemostatic effect of FI peptide and prognosis was observed and analyzed after treatment in each group,and the hemostatic mechanism was also investigated.Results FI peptides were successfully prepared,and it could rapidly self-assemble into a nanofiber network hydrogel in water,and further cause formation of blood clots.SEM showed that FI peptides self-assembled to form fibrous hydrogels after mixing with water.TEM results verified that the FI peptide formed into nanofibers in a diameter of 13.70±2.31 nm after gelatinization in water,and DLS results verified that the FI peptide formed polydisperse and multi-size nanofibers in water(in a range of 148.2～208.0 nm or 575.0～807.0 nm).The fibrous hydrogel formed by the FI peptide mixed with the blood could envelop the red blood cells,thus form a physical hemostatic barrier to achieve blood clotting in seconds.FI peptide hydrogel had no cytotoxicity to normal hepatocytes(L-O2 cells)and did not cause hemolysis of red blood cells.In in vivo experiment,FI peptide quickly formed nanofiber hydrogel when in contact with blood,thus formed physical hemostasis barrier to achieve hemostasis within a few seconds(hemostasis time＜5 s).Conclusion The FI peptide exhibits a rapid and efficient hemostatic effect,indicating a promising clinical application in the hemostasia of hepatic parenchymal traumatic hemorrhage.

Heart specialists team has become one of the core concepts of diagnosis and treatment mode for cardiovascular diseases.Multidisciplinary collaboration has proved its beneficial effects on the diagnosis and treatment strategies, patient selection, follow-up and management of some cardiovascular diseases.At present,it is chiefly seen in the diagnosis and treatment of coronary artery revascularization and transcatheter aortic valve replacement.During implementation there still exist such problems as lack of awareness,attention and effective operation of the medical staff,and lack of an incentive mechanism, thus incurring controversies over such a model.Therefore further follow-up and improvements are expected in combination with the characteristics of China′s medical institutions.

Objective:To analyze the efficacy of percutaneous variceal embolization (PTVE) in children with portal hypertension at high risk of esophageal variceal bleeding.Methods:Clinical data of 14 children undergoing PTVE in Children's Hospital Affiliated to Chongqing Medical University from October 2018 to May 2023 were retrospectively analyzed, including 9 males and 5 females, with a median age of 1 years and 11 months, ranging from 7 months to 12 years and 10 months. The causes of portal hypertension were portal vein spongiosis in 5 cases, portal vein anastomotic stenosis after liver transplantation in 7 cases and decompensated cirrhosis in 2 cases. PTVE was performed in all patients. The surgical approach, intraoperative portal vein pressure, complications, prognosis, and gastrointestinal bleeding were analyzed.Results:The portal vein pressure was (21.3±4.1) mmHg (1 mmHg=0.133 kPa), ranging from 15.8 to 28.6 mmHg. PTVE was successfully completed in all cases, with 11 cases by hepatic approach and 3 cases by splenic approach. All patients were embolized without puncture bleeding. Among the 5 cases with portal vein spongiosis, Meso-Rex was performed in 4 cases from 1 to 27 months after PTVE, and liver transplantation was performed in 1 case 11 months after PTVE for there was no indication of Meso-Rex. Balloon dilatation was performed during embolization in 7 patients with portal vein anastomotic stenosis after liver transplantation. Two cases of decompensated cirrhosis underwent liver transplantation at 3 months and 7 months after embolization, respectively. All children were followed up for 5 to 60 months, and no death occurred, two cases had gastrointestinal bleeding.Conclusion:PTVE could be an effective minimally invasive treatment for children with portal hypertension at high risk of esophageal and gastric varices bleeding, and the incidence of posttreatment gastrointestinal bleeding rate is low.