Objective:To analyze the predictive value of CT coronary flow reserve fraction (CT-FFR) combined with coronary angiography in major adverse cardiovascular events (MACE) in patients with unstable angina pectoris (UAP).Methods:A total of 106 UAP patients treated in Wuhan Huangpi District People′s Hospital/Huangpi District People′s Hospital Affiliated to Jianghan University from April 2021 to April 2023 were retrospectively selected, among which 8 cases were lost to follow-up, and a total of 98 cases finally completed follow-up, and the occurrence of MACE within 1 year was counted, and they were classified into the MACE group (21 cases) and the non-MACE group (77 cases) according to whether or not MACE occurred. The general data, stenosis rate, CT-FFR and coronary plaque characteristics of the two groups were analyzed, and the correlation between each parameter index and B-type brain natriuretic peptide (BNP), Canadian angina pectoris (CCS) grade and the number of diseased vessels were analyzed. The predictive value was analyzed by receiver operating characteristic(ROC) curve, and the relationship between each parameter and the occurrence of MACE was analyzed by Logistic.Results:There were statistical differences in BNP, CCS and the number of diseased vessels between the two groups ( P<0.05). The total plaque volume, stenosis rate, calcified plaque volume and plaque load in the MACE group were higher than those in the non-MACE group, the CT-FFR value was lower than that in the non-MACE group: (142.56 ± 18.94) mm 3 vs. (132.78 ± 15.43) mm 3, (68.22 ± 10.78)% vs. (58.42 ± 9.14)%, (9.35 ± 1.85) mm 3 vs. (8.05 ± 2.02) mm 3, 0.75 ± 0.15 vs. 0.62 ± 0.11, 0.68 ± 0.10 vs. 0.84 ± 0.08, there were statistical differences ( P<0.05); the parameters above mentioned were closely correlated with CCS grade and the number of diseased vessels ( P<0.05). The results of ROC curve analysis showed that the area under the curve of MACE in UAP patients predicted by the combination of all parameters was 0.925, the sensitivity and specificity were 90.48% and 83.12%.The results of Logistic analysis showed that the stenosis rate, CT-FFR value, plaque volume, plaque load and calcified plaque volume were the risk factors for the occurrence of MACE in UAP patients ( P<0.05). Conclusions:The CT-FFR, stenosis rate and coronary plaque characteristics are different in UAP patients, and the combination of these parameters has certain clinical value in predicting the occurrence of MACE in patients.

In this article, a case for random signal interference in resolver (or encoder) of carousel on Varian VitalBeam medical linear accelerator was illustrated. This case was considered as a rare failure of the technology platform (including TrueBeam) by Chinese, European and American technical experts in Varian. In this article, the differences of the carousel in the structure and control system between VitalBeam and traditional accelerator were comparatively analyzed to enable the peers to have a deeper understanding of resolver. The logic and methods to solve the fault were summarized, providing reference experience for analyzing the problems related to carousel. It is found that the interlocking system is imperfect, which provides a factual and technological basis for Varian to optimize the system.

Objective:To analyze the factors influencing prognosis of intrahepatic cholangiocarcinoma (ICC) after surgical resection.Methods:The clinical data of patients diagnosed with ICC and who underwent surgical resection from December 2015 to December 2019 at the Fifth Medical Center of PLA General Hospital were retrospectively analyzed. Of 39 patients who were included in this study, there were 23 males and 16 females, with age of (54.1±7.2) years old. The body mass index, hepatitis B virus infection status, tumor diameter, degree of differentiation, microvascular tumor thrombus, lymph node metastasis, and serum levels of carbohydrate antigen 19-9 (CA19-9) were analyzed as risk factors affecting postoperative recurrence and survival.Results:The median times to recurrence were significantly better in patients with a tumour length <5 cm (11 vs. 5 months), patients without microvascular tumor thrombus (54 vs. 6 months) and patients without lymph node metastasis (8 vs. 5 months) (all P<0.05). The median survival of patients with CA19-9≥100 U/ml was significantly shorter than that of patients with CA19-9<100 U/ml, (9 vs. 27 months, P<0.05). Tumor diameter>5 cm, microvascular tumor thrombus, lymph node metastasis, and CA19-9 ≥100 U/ml are risk factors affecting the recurrence time after ICC resection, CA19-9 ≥100 U/ml is a risk factor affecting survival time after ICC resection. Conclusion:Tumor diameter, microvascular tumor thrombus, lymph node metastasis and CA19-9 can be used to estimate the risk of ICC recurrence, and CA19-9 level can be used to estimate postoperative survival of ICC patients after resection.

Objective:To investigate the clinical characteristics, differential diagnosis, treatments and prognosis of facial nerve hemangioma and schwannoma at genicular ganglion, so as to provide reference for clinical diagnosis and treatments of facial nerve tumor at genicular ganglion.Methods:Clinical data of 13 patients with facial nerve tumors at genicular ganglion confirmed by postoperative pathology in the Ninth People′s Hospital affiliated to Shanghai Jiaotong University School of Medicine from March 2018 to April 2020 were retrospectively analyzed, including seven cases of hemangioma and six cases of schwannoma. There were eight males and five females. Their ages ranged from 20 to 65, with an average age of 40. The course of disease ranged from 3 to 118 months, with an average of 52 months. All the patients underwent preoperative HRCT of the temporal bone and facial nerve dynamic contrast-enhanced(DCE) MRI examinations. All the patients had detailed surgical procedures and at least one-year postoperative follow-up.Results:On HRCT of the temporal bone, (4/7) hemangioma at geniculate ganglion showed characteristic honeycomb appearance, while 6/6 schwannoma and 3/7 hemangiomas showed expansive bone changes. On DCE-MRI, geniculate ganglion hemangioma (7/7) showed characteristic "point-to-surface" enhancement, and schwannoma (6/6) showed characteristic "face-to-surface" enhancement. For five hemangioma-patients with HB-Ⅱ-Ⅳ before surgery, the facial nerve anatomy was completely preserved through transcanal endoscopic approach(TEA), and the facial nerve function improved one year after surgery (two cases of HB-I, two cases of HB-Ⅱ, and one case of HB-Ⅲ). For two patients, with preoperative facial nerve function HB-Ⅴ-Ⅵ, since their tumors was inseparable from the nerves, they were performed with facial nerve anastomosis during the surgery, and the facial nerve function was improved to HB-Ⅳ level one year after surgery. For six patients with meningioma whose facial nerve function was greater than or equal to HB-Ⅲ, based on the preoperative hearing level, the involved segments, and duration of facial paralysis, three of them were conducted surgeries through middle cranial fossa approach, one by translabyrinthine approach, and one via mastoid approach. Two patients among them with complete facial paralysis over three years preoperatively were not performed facial nerve anastomosis after total resections of the tumors, and there was no improvement in facial nerve function one year after surgery. Three patients underwent facial nerve anastomosis after total tumor resections, and their facial nerve function was HB-Ⅲ in one patient, HB-Ⅳ in two patients one year after surgery. One patient (preoperative HB-Ⅲ) had a normal hearing level preoperatively, and the tumor involved the labyrinth segment. To protect the hearing, partial tumor was resected through the middle cranial fossa approach, and facial nerve function improved to HB-Ⅱ one year after surgery.Conclusions:Temporal bone HRCT combined with DCE-MRI are useful for the differential diagnosis of hemangioma and schwannoma at geniculate ganglion and provide references for preoperative clinical decision makings. It is extremely necessary to select the appropriate surgical approach based on the patient′s hearing and involved segments. For geniculate ganglion hemangioma, early surgery can improve the possibilities of anatomical integrity of facial nerve, thereby improving facial nerve function postoperatively.TEA is a kind of surgical method worth consideration, with the characteristics of minimally invasive, favorable postoperative features, and so on. For schwannoma, one-stage functional reconstruction of the facial nerve is recommended during the resection of the tumors because of the inevitable damage to the anatomical integrity of the facial nerve.

This study attempts to develop a reference substance for the live bacteria count of Streptococcicosis live vaccines in order to evaluate the validity of live bacterial count in inspection and testing. We prepared a batch of live Streptococcus suis reference substance for live bacterial count, tested their physical property, purity, vacuum degree, remaining moisture, and determined their homogeneity, thermal stability and transportation stability. Moreover, we organized collaborative calibration to assign count values to the reference substance and determine the shelf life of the reference substance in 12 months. The results showed that the physical property, the purity, the remaining moisture and the vacuum degree of the reference substance were all in compliance with the requirements of the Chinese Veterinary Pharmacopoeia. The homogeneity test showed that the coefficient of variation of the count of the reference substance was less than 10%, indicating a good homogeneity. Transportation stability test showed that the reference substance remained active after 72 h transportation in summer and winter with the package of styrofoam boxes and ice packs. Thermal stability test showed that the reference substance could be stored for up to 3 months at -20 °C, or up to 21 days at 4 °C. According to the collaborative calibration, the reference vaccine was assigned a count value range of (8.5-12.1)×107 CFU/ampoule. The shelf life test showed that the reference substance was stable for 12 months when stored at -70 °C. The reference substance could provide a reference for the live bacterial count of Streptococcicosis live vaccines. Moreover, it could also be used as a reference to evaluate the quality of corresponding agar media.
Bacterial Load ; Reference Standards ; Vaccines, Attenuated

The UDRS interlocking fault is a common dose interlocking of Varian high-energy linear accelerator. Due to the complexity of the system, this fault has brought challenges to the engineers for a long time. Hence, an effective solution is urgently required. In this article, the circuit and principle for UFRS interlocking fault for Varian CLINAC-IX linear accelerator were explicitly analyzed and the maintenance methods were summarized. The management methods of such rare fault were shared, aiming to provide reference for subsequent management of similar interlocking faults.

Objective:To explore the feasibility and effect of evacuated blood collection combined with non sealing technique in the collection of pharmacokinetic blood samples in phase I clinical trials.Methods:Using convenient sampling method, 60 patients in phase I clinical trial who were admitted between November 2017 and October 2019 were selected as the research objects, and were divided into control group and improvement group according to the admission sequence. Among them, 31 patients collected from November 2017 to October 2018 were taken as the control group, and blood samples were collected in 390 tubes by syringe in open indwelling needle; from November 2018 to October 2019, 29 patients were selected as the improvement group, and 388 blood samples were collected by evacuated blood collection combined with non sealing technique in the open indwelling needle. The incidence of indwelling needle plugging, hemolysis of blood samples and the duration of single blood sampling were compared between the two groups.Results:In the incidence of indwelling needle plugging, the improvement group was 3.09% (12/388) , the control group was 2.05% (8/390) , there was no significant difference between the two groups (χ 2=0.800, P>0.05) ; in the incidence of hemolysis of blood samples, the improvement group was 2.66% (10/376) , the control group was 7.33% (28/382) , the difference between the two groups was statistically significant (χ 2=7.857, P<0.01) ; the improvement group was (29.40±1.99) seconds in the duration of single blood sampling, the control group was (40.74±0.88) seconds, the difference between the two groups was statistically significant ( t=101.15, P<0.01) . Conclusions:In the collection of pharmacokinetic blood samples of phase I clinical trials of new drugs, evacuated blood collection combined with non sealing technique can not only protect the blood vessels of the subjects, but also control the time of intensive blood collection within 12 hours, save the operation time of blood collection and guarantee the quality of blood samples. It is worth popularizing to ensure the scientific and standard test.

Objective To set up a living mice colonoscopy platform to establish an orthotopic model of colorectal cancer in mice under direct vision,and to observe its biological behavior such as metastasis.Methods Eighteen-week-old male C57/BL mice were anesthetized,and the intestinal lumen of the mice was examined by a self-developed living mice colonoscopy and Olympus URF-P5 ureteroscopy,respectively.The imaging effects of the two methods were compared.Human colon cancer HT-29 cells were injected into the colonic mucosa of BALB/c-nu mice under direct vision.The colonoscopy was performed on the 3rd,7th and 15th day after the injection to observe the tumor formation in the intestinal lumen.The mice were sacrificed when the body weight decreased significantly or cachexia appeared,and then the abdominal cavity was examined including the tumor formation and metastasis.Results The self-developed living mice colonoscopy platform can provide clear vision of enteric cavity,and no mice died in the colonoscopy examination.In vivo subcutaneous injection of HT-29 cells in mice was performed with a perforation rate of 15％,a mortality rate of 33.3％,a tumor formation rate of 62.5％,an abdominal metastasis rate of 60％,a liver metastasis rate of 25％,and an abdominal wall transfer rate of 25％.Conclusion The self-developed mice colonoscopy platform can be used for the study of colorectum in living mice.The imaging effect is no less than that of Olympus URF-P5 ureteroscopy.In addition,an orthotopic colorectal cancer model can be established by this platform combing with submucosal injection technology.

Objective To investigate the clinical characteristics and prognosis of Idiopathic sudden sensorineural hearing loss (ISSHL) in the elderly.Methods 215 older patients with ISSHL from the department of ENT in our hospital during 2010.12-2015.12 were collected.To analyze the effect of clinical characteristics,the type of hearing curve and the impact of family area on the prognosis of patients.Results Among the 215 elderly patients with ISSHL,there were 105 male patients (48.8％),110 female patients (51.2％),mean age 61-95(65.1 ± 14.6)years;including 197 cases of unilateral deafness (91.6％),bilateral hearing loss in 18 cases (8.4％);treatment onset time of 0.5-40 days,the median was 7 days in time.Deaf type force curve in 103 cases (47.9％),in high frequency descent type in 45 cases (20.9％),41 cases of flat type (19.1％),low frequency descent type in 26 cases (12.1％).After standard treatment,36 cases were cured,90 cases improved,89 cases ineffective,the total effective rate was 58.6％.After statistical analysis,the patient's hearing curve type,the side,first visiting time,and the prognosis from the urban or rural areas had significant effects on the prognosis of the patients,and the effect was statistically significant (P ＜ 0.05).Conclusions The prognosis of ISSHL in elderly patients is significantly related to the side of the disease,visiting time,the type of hearing curve,and the patients from the urban or rural areas.

Objective: To analyze the recent postoperative and long-term postoperative complications of open-splenectomy and disconnection in patients with portal hypertension. Methods: There were 1 118 cases with portal hypertension who underwent open splenectomy and azygoportal disconnection from April 2010 to September 2015 at Department of Surgery, People′s Liberation Army 302 Hospital. Retrospective case investigation and telephone follow-up were conducted in October 2016. All patients had history of upper gastrointestinal bleeding before operation. Short-term complications after surgery were recorded including secondary laparotomy of postoperative abdominal hemostasis, severe infection, intake disorders, liver insufficiency, postoperative portal vein thrombosis and perioperative mortality. Long-term data including postoperative upper gastrointestinal rebleeding, postoperative survival rate and incidence of postoperative malignancy were recorded, too. GraphPad Prism 5 software for data survival analysis and charting. Results: Postoperative short-term complications in 1 118 patients included secondary laparotomy of postoperative abdominal hemostasis(1.8%, 21/1 118), severe infection(2.9%, 32/1 118), intake disorders(1.0%, 11/1 118), liver dysfunction (1.6%, 18/1 118), postoperative portal vein thrombosis(47.1%, 526/1 118)and perioperative mortality(0.5%, 5/1 118). After phone call following-up, 942 patients′ long-term data were completed including 1, 3, 5 years postoperative upper gastrointestinal rebleeding rate(4.4%, 12.1%, 17.2%), 1, 3, 5-year postoperative survival rate(97.0%, 93.5%, 90.3%); the incidence of postoperative malignant tumors in 1, 3 and 5 years were 1.7%, 4.4% and 6.2%. Conclusions Reasonable choosing of surgical indications and timing, proper performing the surgery process, effective conducting perioperative management of portal hypertension are directly related to the patient′s short-term prognosis after portal hypertension. Surgical intervention can reduce the rates of patients with upper gastrointestinal rebleeding, improve survival, and do not increase the incidence of malignant tumors.