Objective:To discuss the clinical application value of echocardiography in evaluating the early outcomes of transcatheter aortic valve replacement(TAVR)via the transapical approach,and to clarify the role of echocardiography in assessing the efficacy of the surgery.Methods:The clinical data of 85 patients who received J-Valve prosthetic valves via the transapical TAVR were retrospectively analyzed.The patients were divided into AS group(simple aortic stenosis,n=20),AR group(simple aortic regurgitation,n=37),and AS&AR group(aortic stenosis with regurgitation,n=28).Echocardiographic examination was performed on all the patients before operation,1 week after operation,3 months after operation,and 6 months after operation.The parameters including left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),aortic valve peak flow velocity(AV Vmax),aortic valve mean transvalvular pressure gradient(AV PGmean),and paravalvular leak(PVL)width were measured to evaluate the cardiac function and the function of the prosthetic valve;the occurrence of postoperative complications of the patients in various groups was also analyzed.Results:J-Valve prosthetic valves were successfully implanted in all 85 patients.There were no significant differences in age,gender,New York Heart Association(NYHA)heart function classification,history of hypertension,history of diabetes,history of hyperlipidemia,and history of coronary artery disease among various groups befor operation(P＞0.05),ensuring comparability.Compared with before operation,1 week after operation,the AV Vmax and AV PGmean of the patients in AS group and AS&AR group were decreased(P＜0.05);there were no significant differences in various parameters of the patients in AR group(P＞0.05).Compared with before operation,3 months after operation,the LVEF and LVFS of the patients in AS group were increased(P＜0.05),while the AV Vmax and AV PGmean were decreased(P＜0.05);the LVEDV and LVESV of the patients in AR group were decreased(P＜0.05),while the LVEF and LVFS were increased(P＜0.05);the LVEDV,LVESV,AV Vmax,and AV PGmean of the patients in AS&AR group were decreased(P＜0.05),while the LVEF and LVFS were increased(P＜0.05).Compared with before operation,LVEDV,LVESV,IVST,and LVPWT of the patients in all three groups 6 months after operation were decreased(P＜0.05),while LVEF and LVFS were increased(P＜0.05);the AV Vmax and AV PGmean of the patients in AS group and AS&AR group were decreased(P＜0.05);the AV PGmean of the patients in AR group was decreased(P＜0.05).The postoperative complications included 3 cases of permanent pacemaker implantation(2 cases in AS group,1 case in AR group),1 case of stroke(in AS group),and 13 cases of PVL(4 cases in AS group,5 cases in AR group,4 cases in AS&AR group).No deaths occurred during follow-up.Conclusion:Echocardiography can accurately and quantitatively evaluate early changes in cardiac function and the functional state of prosthetic valves after transapical TAVR,providing objective evidence for evaluating surgical outcomes and postoperative complications.

Inflammatory myofibroblastoma is a rare soft tissue tumor that is most common in the lungs and less common in the bladder. Inflammatory myofibroblastoma is a borderline tumor with a probability of malignant transformation, and surgical resection is the preferred treatment. Umbilical duct cysts belong to benign lesions and can be treated conservatively for asymptomatic patients. Surgical resection is preferred for those with concurrent infections. Due to the lack of specificity in clinical and imaging manifestations of cystitis myofibroblastoma, it is prone to misdiagnosis and over treatment. Currently, the diagnosis mainly relies on postoperative pathological results.

Bladder cancer is one of the most common malignant tumors of the urinary system, among which urothelial carcinoma is the main one. The traditional treatment methods are mainly surgical resection and chemotherapy, but the treatment effect of advanced patients is not good, and the prognosis is poor. In recent years, with the development of immune checkpoint inhibitors, there are many treatment options that are more effective than traditional therapies. Programmed cell death protein 1 (PD-1)and programmed cell death ligand 1(PD-L1)inhibitors stop the negative regulation of the immune system by blocking the binding of PD-1 and PD-L1, thereby enhancing the anti-tumor activity of the body's immune system. This article mainly reviews the efficacy and safety of PD-1/PD-L1 inhibitors commonly used in the clinical treatment of locally advanced or metastatic urinary tract carcinoma of the bladder.

ObjectiveTo study the CT values of certain phantoms scanned by various CT scanners with dissimilar parameters.Methods The CT values of tissue equivalent inserts was measured in the TM164 and CIRS-062 phantom scanned by TOSHIBA AQUILIONTM,SIEMENS SOMATOMTMSENSATIONTM 64 and SIEMENS SOMATOMTM SENSATIONTM OPEN with different voltages,currents and slice thicknesses and then the corresponding CT-to-density curves was compared. Results There are no significant differences of CT values with various currents and slice thicknesses and also for low atom number materials scanned by different scanners with various tube voltages.The CT values of high atom number materials have obvious differences scanned with tube voltage,the maximum is about 400 HU.There are also significant differences between CT-density curves of two phantoms in the range from soft tissues to dense bone,the maximum is up to 500 HU.ConclusionsCT-density curves were highly affected by materials of phantoms,scanners and tube voltages.It is necessary to measure the curve with a comfortable phantom and certain scanner to assure the accuracy for dose calculation for treatment planning system.