Objective To analyze influencing factors of paclitaxel coated ballon(PCB)on long-term restenosis in patients with severe subpatellar artery lesions in type 2 diabetes mellitus(T2DM),and to construct a prediction model.Methods A total of 268 T2DM patients with severe infra-popliteal artery disease and received PCB treatment were selected.Patients were followed up for 1 year after treatment.Patients with target vessel restenosis were included in the observation group,and the other patients were included in the control group.Clinical data of two groups were analyzed.Multivariable Logistic regression analysis was used to analyze influencing factors of long-term restenosis in T2DM patients with severe infra-knee arterial disease,and a nomogram prediction model was constructed.Results A total of 260 patients(97.00%)completed the follow-up,and the incidence of restenosis was 13.85%(36/260).Both univariate and multivariate Logistic regression analysis showed that age,coexisting coronary heart disease,Trans-Atlantic Inter-Society Consensus(TASC)Ⅱ classification,Fontaine staging,glycosylated hemoglobin(HbA1c)and low density lipoprotein cholesterol(LDL-C)were independent influencing factors for the occurrence of long-term restenosis in T2DM patients with severe infra-popliteal artery disease(P<0.05).The risk factor with the highest score in the constructed nomogram prediction model was HbA1c,followed by age,LDL-C,TASCⅡ classification,Fontaine stage and coronary heart disease.According to the column chart,the total score was 210 points,and the probability of long-term restenosis was 90%.The discrimination of the nomogram model was 0.866,with a Brier score of 0.081 and a calibration slope of 0.733.When the risk threshold was 0.15 to 1.0,the net benefit rate of long-term restenosis in T2DM patients with severe infra-popliteal artery disease was greater than that of individual evaluation.The smaller the risk threshold,the greater the net benefit rate.The benefit was the best when the threshold reached 0.23.Conclusion The influencing factors for long-term restenosis in T2DM patients with severe subknee artery disease treated by PCB include age,combined coronary heart disease,TASCⅡ grade,Fontaine stage,HbA1c and LDL-C.The prediction model based on the above influencing factors has important value in predicting long-term restenosis in patients.

Objective To investigate the development of the temporomandibular joint in patients with developmental malformations of the external middle ear.Methods Retrospective analysis of high-resolution computed tomography(HRCT)images of 183 patients with external middle ear malformation,a total of 248 affected ears were examined,and 53 patients with 67 temporomandibular joint abnormalities(abnormal group)were detected visually,accounting for approximately 27％.Further quantification and measurement of the internal and external diameters and anterior and posterior diameters of the mandibular condyle,the depth of the temporomandibular joint fossa,and the angle of the transverse axis of the condyles bilaterally,and the corresponding data of 30 healthy controls(control group)were also measured,and the differences between the two groups were statistically analyzed.Results The internal and external diameters of the condyle was(12.22±3.30)mm in the abnormal group,compared with(17.67±2.90)mm in the control group(t=-9.814,P＜0.001);the anterior and posterior diameters of the condyle was(7.58±1.82)mm in the abnormal group,compared with(8.62±1.09)mm in the control group(t=-3.850,P＜0.001);the joint fossa depth was(4.16±2.83)mm in the abnormal group,compared with(6.12±1.65)mm in the control group(t=-4.700,P＜0.001);the angle of the transverse axis of the condyles bilaterally was(122.17±21.12)° in the abnormal group,compared with(136.49±11.04)° in the control group(t=-3.437,P＜0.001),all differences were statistically significant(P＜0.05).Conclusion Visually visible temporomandibular joint abnormalities are present in 27％of patients with external middle ear malformation,as evidenced by shortening internal and external diameters and anterior and posterior diameters of the condyle,shallowing joint fossa,and reducing angle of the transverse axis extension line of the condyles bilaterally.

Objective To observe the value of MRI for differentiating flaps and tumor recurrence after tongue cancer reconstruction.Methods Totally 139 patients after flap reconstruction for tongue cancers were retrospectively enrolled,and MRI manifestations of flaps and recurrence of tongue cancer were comparatively analyzed.Results During follow-up,local flaps mainly presented as equal signals on T1WI,high signals on T2WI within 5 months but then predominately as equal signals.Free flaps consistently showed mixed high signals on both T1WI and T2WI,with striated and sheeted muscle signals.The recurrent lesions consistently showed slightly inhomogeneous equal signals on T1WI and high signals on T2WI.The degree of enhancement of flaps gradually decreased,while the recurrent lesions continued to show severe enhancement.The margins of flaps were predominantly indistinct within 5 months after reconstruction,then became distinct in≥13 while＜74 months with smaller size than before,while recurrent lesions continued to show indistinct borders.The mylohyoid muscles and hyoglossus muscles predominantly swelled within 5 months after construction but then atrophied.Hematoma and cyst cavity in the operation area could be observed 5 months after construction.The recurrence lesions located in the lower and posterior junction part of flaps and the residual tongue tissue,spiculated margins could be found in the ipsilateral or contralateral mylohyoid muscles and hyoglossus muscles,as well as cervical lymph node and distant metastases.Conclusion MRI was helpful to differentiating flaps and recurrence lesions after tongue cancer reconstruction.