Pulmonary arterial hypertension(PAH)has a subtle onset,rapid progression,and high mortality rate.Imaging evaluation is an important diagnostic and follow-up method for PAH patients.Right ventricular(RV)strain evaluation can identify early changes in RV function and predict the prognosis.Currently,various methods such as tissue Doppler imaging,velocity vector imaging,speckle tracking imaging,and cardiac magnetic resonance imaging can be used to evaluate RV strain in PAH patients.This article aims to summarize the research progress of RV strain imaging evaluation technology in PAH patients,in order to provide a basis for clinical diagnosis and follow-up of PAH patients.

BACKGROUNDOperative decision-making of Pilon fractures are of great challenges until now. The aim of this study was to investigate the guidance of the four-column theory in decision-making therapeutic strategies for Pilon fractures and its result.

METHODSOne hundred and ten cases (107 patients) of Pilon fractures classified by the four-column theory and treated by ORIF, were reviewed. According to the four-column classification scheme, lateral column of 85 cases, posterior column of 66 cases, medial column of 77 cases, and anterior column of 61 cases are involved. Among all the 110 cases, single column of 14 cases, two columns of 46 cases, three columns of 17 cases, and all of four columns of 33 cases are involved.

RESULTSOne hundred and eight cases have been followed up. The average follow up time is 14.7 months, varying between 7 and 52 months. The average healing time is 3.6 months, ranging from 2.5 to 8.0 months. Reduction of 86.1% reviewed Pilon cases are good or acceptable according to Burwell and Charley's Radiology Evaluation System. Ankle function of 87.1% cases are excellent or good according to the AOFAS evaluation system.

CONCLUSIONAs a simple and comprehensive classification, the four-column classification can contribute to reasonable operation decision-making and good prognosis of Pilon fracture.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; classification ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo study the guidance of four column theory in decision making of Pilon fractures and its result.

METHODSNinety-one cases of Pilon fractures classified by four column method and treated by open reduction internal fixation (ORIF) were reviewed from March 2005 to June 2009. Four column classification:lateral column of 67 cases were involved, posterior column of 34 cases were involved, medial column of 34 cases were involved and anterior column of 34 cases were involved. Among all the 94 fractures, single column of 20 fractures were involved, 2 columns of 49 fractures were involved, 3 columns of 15 fractures were involved and all of 4 columns of 10 fractures were involved.

RESULTSEighty-nine cases had been followed up. The average follow-up time was 16.2 months ranging between 6.0 and 39.0 months. The average healing time was 3.7 months ranging from 3.0 to 5.0 months. Reduction of 91% reviewed Pilon cases were good or acceptable according to Burwell and Charley's radiology evaluation system. Ankle function of 87.6% cases were excellent or good according to AOFAS evaluation system.

CONCLUSIONAs a simple and comprehensive classification, four column classification can contribute to reasonable operating decision making and good prognosis of Pilon fracture.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Decision Making ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult

Purpose:In order to investigate the effects of repair of arteriovenous fistula on heart function soas to widen the range of the indication of allogenetic transplantation of kidney. Methods :Repair of arteriovenousfistula was performed in 8 patients who have received long term hemodialysis and then complicated with repeatedattack of heart failure 5 months before renal transplantation. Results:There are 7 patients had their cardiac cham-bers returned to normal, and 1 returned to normal upper limit. Renal transplantation was successfully performedin 6 patients, but death occurred in 1 case resulting from liver function failure. Superacute rejection and sponta-neous rupture of the kidney occurred in 1 patient. Conclusions:It is considered that the repair of arteriovenous fis-tula before renal transplantation is beneficial to improvement of heart function in these patients so as to widen therange of operative indications and create favourable condition for renal transplantation and decrease complica-tions. Color doppler sonography is of great value in monitoring pre-and postoperative heart function.