Objective To investigate the relationship between coronary myocardial bridge and the symptoms of the patients and its related factors, and to provide evidence for rational treatment. Methods Sixty-one patients di-agnosed as myocardial bridge by coronary angiography and the examination of nuclide myocardial perfusion imaging were recruited and their clinical data was analyzed retrospectively. The patients were divided into ischemic group and non-ischemic group according to the nuclide imaging, and were followed up on the compliance of β-blocker taking and the symptoms. Results Among the 61 patients ,7 patients were ischemic,and the others were non-ischemic. There was no significant difference on symptoms between the two groups (P>0.05). The prevalence of Grade Ⅲ narrowing was higher in ischemic group (6/7) than that in the non-ischemic group (18/54) (χ~2=5. 009, P = 0.024) ,and the ischemic patients with Grade Ⅲ narrowing were older than those in the non-ischemic patients. Two patients in the ischemic group did not insist on taking β-blocker and their symptoms did not change,40 patients in the non-ischemia group did not insist on taking β-blocker,of which 33 patient's symptoms were improved. The symp-toms of all patients with good compliance of β-blocker taking were improved. Conclusions The symptoms of some patients are unrelated with myocardial bridge and treatment is not recommended.

The present situation and development of such medical image processing techniques are summarized as the techniques of image segmentation, pseudo-color processing, image registration and image fusion. Particular attention is paid to the evaluation criterion for image segmentation and study focuses of image registration and fusion. At the end of this paper, the development tendency of medical image processing is predicted.

Objective:To investigate the mechanism of survivin, p53 and Ki-67 on Hep-2 human laryngeal cancer endothelial cell proliferation and invasion.Methods:Laryngeal squamous cell carcinoma and paracancerous normal tissues were collected, total RNA was extracted from tissues,survivin,p53and Ki-67gene mRNA expression levels in laryngeal cancer and the adjacent tissues were detected by Real-time PCR. Human laryngeal cancer Hep-2 epithelial cells were selected,survivin gene was overexpressed, and cell proliferation was detected by MTT.p53 andKi-67gene expression changes in overexpressedsurvivin gene were detected by Western blot. Changes in Hep-2 cell invasive ability were studied whensurvivin was overexpressed as detected by Transwell invasion assay.Results: In the adjacent tissues, survivin,p53andKi-67 gene relative expression levels were 1.72 ± 0.9, 13.7 ± 5.7 and 5.7 ± 1.3, respectively; while in cancer tissues, gene relative expression levels were 53.7 ± 8.3, 66.7 ± 5.2 and 61.0 ± 3.1, respectively, which was significantly increased. As detected by MTT, relative cell survival rate within 12 h ofsurvivinoverexpression were: load control group, (88.5±1.6)%; overexpressed group, (90.3±1.9)%. Transwell invasion assay results indicated that overexpressedsurvivincould significantly increase the relative survival rate of cells. Conclusions:Expressions ofp53,Ki67 and survivin are increased in cancer; and there is a positive correlation betweensurvivin, p53andKi67 expressions in laryngeal carcinoma.

Aged ; Female ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Middle Aged ; Pectoralis Muscles ; transplantation ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

OBJECTIVE To observe the effect of 32P intertissue injection on advanced head and neck cancer. METHODS Eight patients with advanced head and neck cancer were treated with 32P injection into the tumors according to the size of the cancer as determined by CT scan. RESULTS Local tumors were controlled evidently and the pain of the patients were alleviated. The survival periods of the 8 cases ranged from 3 to 18 months (average 14.2 months). CONCLUSION 32P intertissue injection offer an useful method for patients with advanced head and neck cancer .

OBJECTIVE: To investigate the expression of Survivin, p53 and Ki67 in laryngeal carcinoma and the relation with clinical data. METHOD: Immunohistochemical staining (SP) was used to detect expression of Survivin, p53 and Ki67 of 64 cases with laryngeal carcinoma, 26 cases with precancerosis, 34 cases with vocal polyps. RESULT: The positive expression rates of Survivin, p53 and Ki67 were 59.4%, 68.8%, 65.6% respectively in laryngeal carcinoma, which were significantly higher than those in precancerosis and vocal polyps (P < 0.01). The expression of Survivin, p53 and Ki67 in laryngeal carcinoma were significantly statistical different in TNM stage and lymph node metastasis (P < 0.05), but were not correlated with patients' ages, the pathological grades, 3 years and 5 years surviving rates (P > 0.05). The expression of Survivin, Ki-67 and p53 was positively correlated (r = 0.607, 0.541, 0.648, P < 0.01) in laryngeal carcinoma. CONCLUSION Survivin, p53 and Ki-67 may play an important role in the carcinogenesis and progress of laryngeal carcinoma. They may play synergetic roles in the process of carcinogenesis of laryngeal carcinoma.
Carcinoma, Squamous Cell ; metabolism ; Humans ; Immunohistochemistry ; Inhibitor of Apoptosis Proteins ; metabolism ; Ki-67 Antigen ; metabolism ; Laryngeal Neoplasms ; metabolism ; Larynx ; Lymphatic Metastasis ; Polyps ; metabolism ; Survivin ; Tumor Suppressor Protein p53 ; metabolism

The authors reviewed the practice of integrated health care delivery system( IDS) at home and abroad, and based on experiences of collaborations between medical service institutions in Zhejiang province,proposed the strategic positioning,responsibilities and service innovation of urban public hospitals in a regional medical service system. It is held that the direction of China′s health care reform should move towards IDS in the future,and such hospitals should play an active role in the process via integration of its own resource and provide multi-level,diversified services for the regional health care system.

Objective:To investigate the effect of the combination of Auto-prescription and ODM full on image quality and radiation dose of chest enhanced CT inorder to explore the feasibility of individualized low radiation dose chest enhanced CT. Methods:The phantoms PH-75 in two sizes were scanned with four scanning modes: group A, 120 kVp + Smart-mA; group B, 120 kVp + Smart-mA+ ODM full; group C, Auto-prescription + Smart-mA; group D, Auto-prescription + Smart-mA+ ODM full. The images of each group were reconstructed with 40%-80% ASIR-V (interval 20%), recorded as A 1-3-D 1-3. Image quality and radiation dose were evaluated in order to obtain optimal scanning modes. Totally 35 cases(from the First Hospital of Dalian Medical University during November 2021 to July 2022) of chest enhancement CT were collected prospectively in the clinical study using the parameters of D 2 group recorded as D patients. Patients in this group received chest enhancement CT scanning for the second time within three months. The CT parameters in first enhanced scanning recorded as A patient were as same as those in group A 1, and the parameters in second scanning recorded as D patient were as same as those in group D 2. The SNRs, CNRs, subjective grading and imaging findings of the lesion in two groups were compared. Results:In phantom study, the radiation dose of each group was statistically significant, and that in D group was the lowest. For two sizes of phantoms, A 1 was uesd as the control group in pairwise comparison. The SDs of B 1, C 1, and D 2 images had no statistical difference with that of A 1 ( P > 0.05), and SD of D 1was higher than that of A 1, and SDs of other groups were lower than that of A 1( F=10.77, 122.50, P<0.05). CNR of B 1 had no statistical difference with that of A 1, and the CNRs of other groups were higher( F=136.20, 30.21, P<0.05). Subjective scores of A 2, C 2, D 2 had no statistical difference with that of A 1 and those of other groups were lower than that of A 1( H=52.89, 43.95, P<0.05). In clinical study, 80 kVp was uesd for 22 cases and 100 kVp was used for 13 cases in D patients group. SNRs and CNRs in the D patients group were all higher than those in the A patients group ( P > 0.05). The consistency of image quality scores for two observers was good ( kappa = 0.754, P < 0.05). The median scores of the two groups were (4, 4). Conclusion:Auto-prescription combined with ODM full in chest enhanced CT imaging can achieve individualized low radiation dose with meeting the requirements of image quality and clinical diagnosis.

Objective To investigate the application value of spectral computed tomography venography(CTV)in the display and staging of deep venous thrombosis(DVT)in the lower extremity.Methods Eighty-two patients with CTV were selected and ran-domly divided into group A(42 patients)and group B(40 patients).Group A:tube voltage 120 kVp.Group B:gemstone spectral ima-ging(GSI)mode,reconstruction of 50 keV and iodine(water)maps.The CT and standard deviation(SD)values of the veins were measured,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated in 120 kVp images of group A and in 50 keV images of group B.Two observers scored the image quality of the 2 groups subjectively,and Kappa test was used to examine the con-sistency.Based on the duration from the occurrence of clinical symptoms,the DVTs were classified.The CT values and iodine con-centration(IC)of DVT were measured in the 120 kVp images of group A and in the iodine(water)maps of group B,respectively.The receiver operating characteristic(ROC)curve was drawn to compare the effectiveness of CT values and IC in diagnosing DVT staging.Results CT values,SNR,and CNR of veins in group B were higher than those in group A(P<0.05).The subjective scores of the two groups were consistent(Kappa=0.926-0.955,P<0.05).The score for the display of veins and thrombus clarity in group B was 5(4,5),which was better than the score of 4(3,4)in group A(P<0.05).The efficiency of IC in diagnosing DVT staging[area under the curve(AUC)=0.973]was better than that of CT values(AUC=0.891).Conclusion The spectral CTV can improve the contrast of lower extremity deep veins and the clarity of thrombus,and can provide more objective indicators for the diagnosis of thrombus staging,which is conducive to accurate clinical diagnosis and treatment.

Objective:To study the changes of patient-related costs and the use of stents and other consumables before and after the centralized procurement of coronary stents.Methods:The inpatient medical insurance settlement case data of 1,973 patients with coronary stent implantation admitted to Daping Hospital of Army Medical University from December 2019 to October 2021 were selected.Among them,the data of 1,317 cases of percutaneous cardiovascular surgery and coronary stent implantation with serious or complications and accompanying disease group were slected according to disease diagnosis related groups(DRG),which were divided into the pre-centralized procurement group(667 cases)and the post-centralized procurement group(650 cases)according to the centralized procurement of coronary stents before and after.The costs of patients'medical consumables with the consumption of patients'medical consumables and the impact of the use of consumables such as coronary stents on the costs of medical consumables were compared.Results:There was no significant statistical difference in the hospitalization days and the average number of stents used in patients undergoing percutaneous cardiovascular procedures and coronary stent implantation with centralized procurement of coronary stents.There was a statistically significant difference in the total diagnosis and treatment cost,medical consumables cost,medicines and consumables cost and medicines cost between the pre-centralized procurement group and the post-centralized procurement group(Z=-22.316,-23.546,-22.917,-5.724,P<0.05).The cost of stents[16 260(13 300,32 272)yuan],the number of catheter guidewire balloon sheaths consumables[5(4,8)sets(pieces)],and the cost of catheter guidewire balloon sheaths consumables[8 719(5 805,15 372)yuan]in the pre-collection group were collected.There were statistically significant differences in the stent cost[1 059(590,1 770)yuan],the number of catheter guidewire balloon sheaths consumables[8(7,12)sets(pieces)],and the cost of catheter guidewire balloon sheaths consumables[5 708(3 392,12 871)yuan]between the two groups(Z=-30.452,16.582,-7.670,P<0.05).There was a statistical correlation between the cost of coronary stents and the cost of catheter guidewire balloon sheaths before and after centralized volume procurement on the cost of medical consumables for patients(r=0.903,0.473,0.785,0.953,P<0.05).The correlation coefficient between the cost of coronary stents and the cost of medical consumables for patients in the post-centralized procurement group decreased compared to the pre-centralized procurement group,the correlation coefficient between the cost of catheter guidewire balloon sheath and the cost of medical consumables for patients increased.Conclusion:The centralized procurement of coronary stents has a significant cost control effect on patients in the disease groups,and affects the cost structure of medical consumables.Combined with DRG reform,it can continuously improve the standardization and scientificity of clinical use of medical consumables.