Objective To explore the predictive value of the fractional flow reserve derived from coronary computed tomography(FFRCT)in CAD.Methods Clinical data of 136 patients(309 ma-jor coronary vessels)with suspected CAD consecutively attending to Northern Jiangsu People's Hospital from January 2020 to February 2022 were collected and retrospectively analyzed.Coro-nary computed tomography angiography(CCTA)and coronary angiography(CAG)data and FFRCT were collected.The accuracy,positive predictive value,negative predictive value,sensitivity and specificity of CCTA and FFRCT for the diagnosis of stenosis in 309 major coronary arteries were compared;the correlation between FFRCT and CAG was analyzed using the consistency test.Imaging parameters of 156 vessels were analyzed by senior radiologists for smallest luminal diam-eter,stenotic plaque length,stenotic diameter rate,stenotic area rate,stenotic lumen area and plaque properties.The 98 vessels with ≥50％coronary stenosis were assigned into the coronary group,and the 58 vessels with＜50％ischaemic stenosis were into the non-coronary group.Logistic regression was used to analyze the relationship between the vessel parameters of 156 ves-sels and coronary heart disease(CHD);ROC curve was plotted to analyze the value of each pa-rameter and their combination for the diagnosis of CHD.Results The diagnostic efficacy of FFRCT was more accurate than that of CCTA for CAD(P＜0.01),and the Kappa agreement anal-ysis showed that the Kappa value of the diagnostic results of FFRCT and CAG was 0.620,indica-ting high agreement(P＜0.01).Lower smallest luminal diameter,lower FFRCT,longer stenotic plaque length,and higher diameter stenosis rate and area stenosis rate were observed in the coro-nary group than the non-coronary group(P＜0.01).Multivariate logistic regression analysis showed that smallest luminal diameter(OR=0.536,95％CI:0.335-0.858),stenotic plaque length(OR=1.109,95％CI:1.054-1.166),and FFRCT≤0.80(OR=0.204,95％CI:0.078-0.532)were independent influencing factors in predicting CAD(P＜0.01).ROC curve analysis revealed that the AUC value of combined smallest luminal diameter,stenotic plaque length,and FFRCT 0.80 together in diagnosis of CAD was 0.853(0.795-0.918).Conclusion FFRCT has a higher di-agnostic value for CAD than CCTA,and the combined diagnosis of FFRCT≤0.80,smallest luminal diameter,and stenotic plaque length can further improve the accuracy of the diagnosis of CAD.

Objective To explore the effect of salmon calcitonin on osteoporosis induced by spinal cord injury. Methods 100 patients with osteoporosis induced by spinal cord injury from September 2011 to September 2014 in our department were included. They were randomly divided into control group (n=50) and observation group (n=50). The control group received vitamin D3 only, while the observation group received vitamin D3 combined with salmon calcitonin on the basis of rehabilitation physiotherapy, for 6 months. Visual Analogue Scale (VAS) of pain was evaluated in different periods. The bone mineral density (BMD) of lumbar spine and femoral neck, the parathyroid hormone (PTH), bone gla protein (BGP) and 1,25- dihydroxy vitamin D3 (1,25-(OH)2D3) were tested and recorded. Results The VAS score was lower in the observation group than in the control group 1, 2, 3 and 6 months after treatment (P<0.001). The BMD of lumbar spine and femoral neck was significantly higher, the PTH and BGP were significantly lower and the 1,25-(OH)2D3 was significantly higher in the observation group than in the control group after treatment (P<0.001). Conclusion Combination of salmon calcitonin can effectively reduce the bone pain and improve the BMD in patients with osteoporosis induced by spinal cord injury.

Objective: To evaluate the clinical outcomes of a series of patients who have undergone reconstruction of craniofacial defects after resection of intracranial tumors or craniofacial trauma with free composite anterolateral thigh flaps. Methods: Retrospective analyses the clinical cases from September 2007 to September 2016. Data included flap survival rate, complication, satisfaction survey was reviewed to evaluate the efficacy and safety of this surgical strategy. Results: Totally 10 free anterolateral thigh flaps including 3 cases of fasciocutaneous flaps, 2 case of adipofascial flaps, 4 cases of myocutaneous flaps, 1 case of chimeric flap, were adopted to reconstruct craniofacial defects. Follow-up ranged from 3 to 17 months (average, 12 months). All flaps were transferred successfully. There were no cranial spinal fluid(CSF) leaks, intracranial infections or donor site complications. All patients were satisfied. Conclusions Because of its abundance of tissue, matched vessels to recipient site, versatility of muscular flaps to fill irregularly intracranial defects, reliable blood supply, feasibility of simultaneous fascia lata harvesting, free composite anterolateral thigh flap is the reconstructive method of choice for craniofacial defects reconstruction after resection of intracranial tumors or craniofacial trauma. The use of ALT flap was reliable in the decrease of CSF leak and infection rate and dependable according to long time follow-up.