Objective:To investigate the use of quantitative flow ratio(QFR) for selecting suitable anastomosis targets of radial artery in coronary artery bypass grafting.Methods:From January 2019 to June 2023, clinical data of patients undergoing coronary artery bypass grafting with using radial artery obtained from Beijing Anzhen Hospital were retrospectively collected. A total of 186 patients were included in this study, including 175 males and 11 females. The average age was(54.26±7.91) years, ranging from 34 to 70 years. They were divided into study group(n=46) and control group(n=140) according to whether QFR was examined before operation. The distal radial artery in the study group was anastomosed to a non-LAD artery with the lowest QFR value, while in the control group was randomly anastomosed to the most important non-LAD artery with the anatomic stenosis greater than 75%. All patients were followed up. The endpoint event was major adverse cardiovascular events(MACE) and radial grafts stenosis/occlusion. The preoperative baseline data, perioperative indexes and follow-up were analyzed and compared.Results:There was no significant difference in preoperative baseline data between the two groups. The pulse index(PI) in the study group was significantly lower than that in the control group(1.88±0.45 vs. 2.11±0.61, P<0.05). There were no serious perioperative complications in both groups. All patients survived and were discharged from hospital. The average follow-up time was 30 months. There were no significant differences in cardiogenic death, stroke, recurrent myocardial infarction, and revascularization between the two groups. The rate of recurrent angina in the study group was significantly lower than that in the control group(8.7% vs. 22.1%, P<0.05). The complete patency rate of radial graft in the study group was significantly higher than that in the control group(96.4% vs. 86.0%, P<0.05), the occlusion rate was significantly lower than that in the control group(0 vs. 9.4%, P<0.05), and the stenosis rate had no significant difference between two groups. Conclusion:QFR can clarify the functional changes of coronary blood flow, select suitable anastomosis target for radial graft, reduce the occurrence of competing flow, and then improve the patency rate and clinical prognosis.

Objective:To investigate the use of quantitative flow ratio(QFR) for selecting suitable anastomosis targets of radial artery in coronary artery bypass grafting.Methods:From January 2019 to June 2023, clinical data of patients undergoing coronary artery bypass grafting with using radial artery obtained from Beijing Anzhen Hospital were retrospectively collected. A total of 186 patients were included in this study, including 175 males and 11 females. The average age was(54.26±7.91) years, ranging from 34 to 70 years. They were divided into study group(n=46) and control group(n=140) according to whether QFR was examined before operation. The distal radial artery in the study group was anastomosed to a non-LAD artery with the lowest QFR value, while in the control group was randomly anastomosed to the most important non-LAD artery with the anatomic stenosis greater than 75%. All patients were followed up. The endpoint event was major adverse cardiovascular events(MACE) and radial grafts stenosis/occlusion. The preoperative baseline data, perioperative indexes and follow-up were analyzed and compared.Results:There was no significant difference in preoperative baseline data between the two groups. The pulse index(PI) in the study group was significantly lower than that in the control group(1.88±0.45 vs. 2.11±0.61, P<0.05). There were no serious perioperative complications in both groups. All patients survived and were discharged from hospital. The average follow-up time was 30 months. There were no significant differences in cardiogenic death, stroke, recurrent myocardial infarction, and revascularization between the two groups. The rate of recurrent angina in the study group was significantly lower than that in the control group(8.7% vs. 22.1%, P<0.05). The complete patency rate of radial graft in the study group was significantly higher than that in the control group(96.4% vs. 86.0%, P<0.05), the occlusion rate was significantly lower than that in the control group(0 vs. 9.4%, P<0.05), and the stenosis rate had no significant difference between two groups. Conclusion:QFR can clarify the functional changes of coronary blood flow, select suitable anastomosis target for radial graft, reduce the occurrence of competing flow, and then improve the patency rate and clinical prognosis.

Objectives:To systematically evaluate the clinical efficacies of unilateral biportal endoscopic lumbar interbody fusion(ULIF)and minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)in the treatment of lumbar degenerative diseases(LDD).Methods:Clinical controlled studies on ULIF and MIS-TLIF in the treatment of LDD were systematically retrieved from Chinese and English databases,including CNKI,VIP,WanFang,SinoMed,PubMed,Cochrane Library,Embase,and Web of Science.The retrieval time limit was from the establishment of the database to September 2023.The quality of the included studies was evaluated by the Newcastle-Ottawa scale(NOS).The indexes of operation time,surgical bleeding,hospitalization time,visual analog scale(VAS),Oswestry disability index(ODI),incidence of complications,disc height,and fusion rate were extracted,and Meta-analysis was performed by RevMan 5.4.1 software.Results:A total of 11 studies were included,all of which were cohort studies,and all of which were evaluated as medium-high quality by NOS.There were 800 patients,including 380 in the ULIF group and 420 in the MIS-TLIF group.The results of Meta analysis showed that the hospitalization time[WMD=-0.75,95％CI(-1.33,-0.17)],low back pain VAS(1-3 months after operation)[MD=-0.43,95％CI(-0.70,-0.15)],low back pain VAS(final follow-up＞l year)[MD=-0.09,95％CI(-0.18,-0.00)],ODI(1-3 months after operation)[MD=-1.37,95％CI(-2.46,-0.28)],and intraoperative bleeding[MD=-78.72,95％CI(-113.20,-44.23)]in the ULIF group were better than those in the MIS-TLIF group.The operation time[MD=30.28,95％CI(13.86,46.71)]in the MIS-TLIF group was better than that in the ULIF group.There were no significant differences in leg pain VAS(1-3 months after operation)[MD=-0.12,95％CI(-0.30,0.06)],leg pain VAS(final follow-up＞1 year)[MD=-0.04,95％CI(-0.15,0.07)],ODI(final follow-up＞1 year)[MD=-0.46,95％CI(-1.02,0.11)],lumbar lordosis angle[MD=0.39,95％CI(-1.12,1.90)],disc height[MD=0.03,95％CI(-0.24,0.30)],fusion rate[MD=0.97,95％CI(0.92,1.03)]and complication rate[MD=0.82,95％CI(0.45,1.48)].Conclusions:Compared with MIS-TLIF,ULIF has advantages in improving low back pain symptoms and early recovery of function,reducing intraoperative blood loss,shortening hospital stay,which is less in surgical trauma and faster in recovery.There is no significant difference in long-term efficacy,complications,and fusion rate between the two methods.

OBJECTIVE:To investigate the effectiveness and economics of 10 mg/d rosuvastatin and 20 mg/d atorvastatin in the treatment of hyperlipidemia (HLP). METHODS:The information of 180 HLP patients selected from Tianmen Municipal First People's Hospital during Mar. 2015-Feb. 2016 were divided into group A and B according to medication regimen,with 90 cases in each group. Group A was given Atorvastatin calcium tablet 20 mg,qd;group B was given Rosuvastatin calcium tablet 10 mg,qd. Treatment course of 2 groups lasted for 8 weeks. Blood lipid indexes before and after treatment,lipid-lowering efficacy,the rate of qualified blood lipid and the occurrence of ADR after treatment were compared between 2 groups. Cost-effectiveness analysis was adopted for economic evaluation. RESULTS:Before treatment,there was no statistical significance in the levels of blood lipid in-dexes between 2 groups (P>0.05). After treatment,TC and LDL-C levels of 2 groups were significantly lower than before treat-ment,and those of group B were significantly lower than those of group A,with statistical significance(P<0.05). Total response rate of lipid-lowering in group B(97.78％)was significantly higher than group A(86.67％),and the rate of qualified blood lipid (66.67％)was also significantly higher than group A(51.11％),with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). The costs of group A and B were 488.32,436.24 yuan,and cost-effectiveness ratios were 5.63,4.46;incremental cost-effectiveness ratio was -4.69. The plan of group B had cost-effective-ness advantage. The results of cost-effectiveness analysis were supported by sensitivity analysis. CONCLUSIONS:In the view of short-term efficacy,10 mg/d rosuvastatin plan is better than 20 mg/d atorvastatin plan in lowering lipid and has cost-effectiveness advantage,and both have similar safety.

Tree shrews have an excellent visual system, their cones accounted for 96%of the photorecepter cells, so that their color vision and stereo vision are well developed.With their rich resources and low cost, tree shrews have been considered as an ideal animal model in eye research in comparative medicine and genomics research.The ophthalmological research on tree shrew mainly focused on the establishment of myopia model, as well as the changes in myopic sclera and choroids, and the basic studies of their retina, optic and visual cortex.This paper reviewed the basic ophthalmological re-search of tree shrew.

Objective To introduce a kind of operative technique in repair for the prolapse of the anterior mitral valve leaflet.Methods From January 2004 to October 2010,the operation of chordal transfer based on theedge-to-edge technique was performed in 18 cases with serious mitral valve regurgitation because of prolapse of the anterior leaflet.First,the edge-to-edge suturing was performed at the free edge of the prolapsed anterior leaflet with corresponding posterior leaflet.After that,quadrangular resection was performed to transfer these segments of posterior leaflet with its attached chordae.At last,the posterior leaflet was repaired after a quadrangular resection which would be much easier for the surgeons.After the operation,echocardiography was performed in each patient before discharge and at the time of follow-up.Results All patients survived after the operation,1 case required the rnitral valve replacement because of anterior leaflet performation occurring 3 days after the operation,1 case with hemoglobinuria and 1 case with low cardiac output,who all got symptomatic treatment afterwards.All the other patients were well discharged.At the time of follow-up,all of the patients were in NYHA functional class I.In all these patients,pre-discharge and follow-up echocardiography showed neither stenosis nor significant regurgitation of the mitral valve:the cross-sectional area of the mitral valve was 2.8-4.8 (3.78 +0.52) cm2,the mean regurgitation area was (0.45 +0.22) cm２.At the same time,both dimension of left atrium and left ventricular reduced significantly [ left atrium diameter:pre-operation ( 48.26 + 11.12 ) mm,post-operation ( 37.57 ± 9.56) mm (P ＝ 0.028 );the end-diastolic diameter of the left ventricular:pre-operation(61.43 ± 8.24) mm,post-operation (42.35 ±10.79) mm (P＝0.008)].Conclusion Chordal transfer based on the edge-to-edge technique provides good results for repair of anterior leaflet prolapse.

Objective To Study the expression of apo E protein changed in different wound age and position of the experimental traumatic brain injury(TBI) in rat. Methods The animal model of cerebral contusion was established by impact to the parietal lobe with a free fall weight,observed the changes of apo E in different wound age (0.5h、2h、6h、12h、24h、3d、7d、14d). The results were measured quantitatively with computer imaging analysis system. Results In cortex apo E-positive neurons definitely detected in 0.5h after brain injury, reaching the peak in 3d, then it shows the gradual decrease from 3d to 14d; In hippocampus apo E-positive neurons definitely detected in 0.5h after brain injury, reaching the peak in 3d in CA1 section and 24h in CA2～CA4. Then it shows the gradual decrease. We found the expression of apo E protein in CA1 section is stronger than others. Conclusion The location and intersity of the immunoreactivity of apo E protein changed at the different stages after TBI. These changes observed in the present study might be used for determination of injury time,early diagnosis and distinguish antemortem and postmortem brain injury in forensic medicine.