Purpose To explore the relationship between epicardial adipose tissue (EAT) volume and ascending aortic stiffness by CT,so as to early evaluate the lesions of ascending aortic by measuring EAT.Materials and Methods 169 patients with suspected coronary artery disease who underwent coronary CT angiography and coronary angiography in First Affiliated Hospital of Jinzhou Medical University from January 2016 to September 2016 were enrolled.According to the presence of coronary atherosclerosis or not,the patients were divided into research group (109 cases) and control group (60 cases).The research group were further divided into slight,mild,moderate and severe group according to the Gensini score of coronary atherosclerosis.The recorded threshold of EAT volume was 107.2 cm3.The patients with EAT volume higher than 107.2 cm3 belonged to the exposure group,and the rest belonged to the non exposure group.The EAT volume and ascending aortic stiffness were measured,and the relationship between them was assessed.The relationship between EAT volume and coronary atherosclerosis was also analyzed.Results In the control group,there was no correlation between EAT volume and ascending aortic stiffness (r =-0.156,P＞0.05).However,there were negative correlations between EAT volume and ascending aortic stiffness in slight,mild,moderate and severe group (r=-0.378,-0.340,-0.514 and-0.459,P＜0.05).The EAT volumewas an independent risk factor of ascending aortic stiffness (β=-0.009,t=-2.653,P＜0.05).The incidence of CAD in the exposure group was 9.318 times of that in the non exposure group.Conclusion There is obvious correlation between EAT volume and ascending aortic stiffness in patients with CAD.The evaluation of EAT volume can provide an effective reference for the early prediction of ascending aortic lesions in patients with CAD.

Objective To investigate the correlation between normal ascending aortic elasticity and the left ventricular function by 256 slice iCT.Methods 105 subjects who underwent CTA and echocardiography inspection and diagnosed with normal coronary artery and without ascending aortic atherosclerosis were collected.Subjects were divided into three groups according to age and two groups according to gender respectively.Left ventricular function parameter values on CT were measured, including ESV,EDV,SV,EF,CO and MM.The aortic elasticity on CT and echocardiography was measured and calculated respectively on cross-sectional area at 15 mm above aortic valve.The relationship between ascending aortic elasticity and the left ventricular function was evaluated.Results Bland-Altman plot revealed that there was a good conformity between CT and echocardiography in measurement the value of ascending aortic elasticity(ICC=0.988,P<0.05).In different grougs of age,normal ascending aortic elasticity was positively correlated with EDV,ESV,SV,EF and negatively correlated with MM.There was no correlation with the CO.There was a negative relationship between aortic elasticity and age(r=-0.546,P<0.05)

Objective:To analyze the risk factors for early ostomy complications after Miles surgery for rectal cancer and construct a nomogram model.Methods:A case-control study method was used to collect clinical data of 205 patients who underwent Miles surgery for rectal cancer at Xinxiang Central Hospital from January 2019 to January 2022. Patients were divided into early ostomy complications group and no early ostomy complications group based on whether early ostomy complications occurred. Single factor analysis and multivariate Logistic regression analysis were used to determine the influencing factors for early ostomy complications after Miles surgery for rectal cancer. R language was used to construct a nomogram model for early ostomy complications after Miles surgery for rectal cancer. The area under the receiver operating characteristic curve (ROC) was used to evaluate the predictive performance of the nomogram model. By drawing a calibration map for consistency testing, the Hosmer-Lemeshow test was used to determine the goodness of fit of the model. P>0.05 indicated a good fit of the model. R software was used to randomly select 30% of cases as validation groups for internal validation. Results:This study included a total of 205 patients, including 115 males and 90 females. Among them, 37 had early ostomy complications, with an incidence of 18.0%. The results of multivariate Logistic regression analysis showed that failure to receive rapid surgical rehabilitation nursing [ OR=2.779, 95% CI (1.144, 6.750) ], age ≥65 years old [ OR=2.862, 95% CI (1.186, 6.906) ], albumin<35 g/L [ OR=3.414, 95% CI (1.373, 8.488) ], and failure to locate the preoperative ostomy position [ OR=4.846, 95% CI (1.488, 15.776) ] were risk factors for early ostomy complications after Miles surgery for rectal cancer, and the differences were statistically significant ( P<0.05) . Based on this result, a prediction model was constructed, with an area under the ROC curve of 0.801 [95% CI (0.713, 0.868) ]. After internal validation, the area under the ROC curve of the validation group was 0.807 [95% CI (0.641, 0.973) ]. The calibration curves of the modeling group ( P=0.980) and the validation group ( P=0.981) showed a good coincidence between the predicted results and the actual results. Conclusions:Failure to receive rapid surgical rehabilitation nursing, age ≥65 years old, albumin<35 g/L, and failure to locate the preoperative ostomy position are risk factors for early ostomy complications after Miles surgery for rectal cancer. This study constructs a nomogram model based on the results of Logistic regression analysis, which can effectively predict the probability of early ostomy complications after Miles surgery for rectal cancer. For high-risk patients, individualized intervention should be carried out as soon as possible to reduce the incidence of ostomy complications and improve the patient's quality of life.

Objective To observe the value of dynamic contrast enhanced MRI(DCE-MRI)combined with intravoxel incoherent motion(IVIM)for preoperative evaluation on pathological type of rectal cancer.Methods Totally 81 patients with rectal adenocarcinoma were enrolled and divided into mucinous adenocarcinoma group(n=36)or non mucinous adenocarcinoma group(n=45)based on postoperative pathological results.Parameters of DCE-MRI and IVIM,including rate constant(Kep),volume transfer constant(Ktrans),extravascular extracellular volume fraction(Ve),true diffusion coefficient(D),pseudo diffusion coefficient(D*)and perfusion fraction(f)were compared between groups.Logistic regression analysis was performed,the efficacy of the above parameters for evaluation on pathological type of rectal cancer were explored.Results Kep,Ktrans,D*and f of mucinous adenocarcinoma group were all smaller than those of non mucinous adenocarcinoma group(all P＜0.05).Kep and f were both impact factors of pathological type of rectal cancer(both P＜0.05).The area under the curve(AUC)of Kep,f and Kep+f for preoperative evaluation on pathological type of rectal cancer was 0.774,0.880 and 0.906,respectively,with sensitivity of 69.44％,77.78％and 86.11％,specificity of 82.22％,91.11％and 91.11％,respectively.AUC of Kep was lower than that of Kep+f(P＜0.05).Conclusion DCE-MRI combined with IVIM could effectively evaluate the pathological type of rectal cancer preoperation.

Objective:To explore the genetic etiology of a fetus with Coffin-Siris syndrome2 (CSS2).Methods:A fetus with abnormal ultrasound findings detected at Luoyang Maternal and Child Health Care Hospital in July 2023 was selected as the study subject. Clinical data were analyzed retrospectively. Whole exome sequencing was carried out on fetal tissue and parental peripheral blood samples, and candidate variant was verified by Sanger sequencing and pathogenicity analysis. This study was approved by Medical Ethics Committee of the Luoyang Maternal and Child Health Hospital (Ethics No. LYFY-YCCZ-2023011).Results:Color Doppler ultrasound at 16 + gestational weeks revealed bilateral ventriculomegaly and cerebellar hypoplasia in the fetus. Trio-WES found that the fetus has harbored a heterozygous c. 553C>T (p.Gln185Ter) variant of the ARID1A gene, which was verified by Sanger sequencing to have a de novo origin. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the c. 553C>T (p.Gln185Ter) variant of the ARID1A gene was classified as pathogenic (PVS1+ PS2+ PM2_Supporting). Conclusion:The fetus was diagnosed with CSS type 2, and the heterozygous c. 553C>T (p.Gln185Ter) variant of the ARID1A gene probably underlay its brain malformations.

Objective To explore the application value and diagnostic efficiency of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and intravoxel incoherent motion(IVIM)in prognostic staging of early-stage rectal adenocarcinoma.Methods Eighty-one patients with early-stage rectal adenocarcinoma confirmed by surgery were retrospectively selected.They were examined by high-resolution MRI,IVIM and DCE-DWI before operation.According to prognostic staging criteria,they were divided into stageⅠ and stage Ⅱ A groups.The quantitative parameters of DCE-MRI and IVIM were obtained by GenIQ or MITK software respectively.The differences of parameter values between the two groups were compared by independent sample t-test or Mann-Whitney U test,and the diagnostic efficiency was analyzed.Results The values of rate constant(Kep),volume transfer constant(Ktrans)and pseudo diffusion coefficient(D*)in stage Ⅰ group were lower than stage Ⅱ A group(P＜0.05).The f value in stage Ⅰ group was higher than stage Ⅱ A group(P＜0.05).D*and Kep values were included in the binary logistic regression equation.The receiver operating characteristic(ROC)curves of D*,Kep values and their joint prediction probability values were obtained,and the area under the curve(AUC)were 0.791,0.770 and 0.852 respectively.The sensitivities were 90.91％,66.67％and 81.82％respectively.The specificities were 66.67％,83.33％and 79.17％respectively.Conclusion D*and Kep values have the potential to be imaging indicators of prognostic staging of early-stage rectal adenocarcinoma,and to guide the selection of clinical treatment schemes.