Radionuclide myocardial perfusion/metabolic imaging and cardiac MR play critical roles in assessing myocardial viability of patients with ischemic heart disease as noninvasive modalities. Given the technical difference between two imaging modalities, each of them has its unique strength to ascertain what causes the injured myocardium and differentiate the viable myocardium from the scarred myocardium. The purpose of this review is to compare the capability of two methods in assessment of myocardial viability, including summarize their consistency and discrepancy, as well as to explore the clinical significance to combine them serving as an essential tool to assist decision making for coronary revascularization comprehensively and accurately.

OBJECTIVE: To investigate the effects of two types of temperature rinses on body temperature, inflammatory cytokine levels, and bleeding volume in percutaneous endoscopic lumbar discectomy. METHODS: Eighty patients underwent percutaneous endoscopic lumbar discectomy from January 2018 to December 2020 were selected and divided into experimental group (40 cases) and control group(40 cases). In experimental group, there were 19 males and 21 females, aged (38.8±9.8) years old;7patients on L_4,5 and 33 patients on L₅S₁;Body msss index(BMI) was (27.8±7.2) kg·m^-2. In contral group, there were 18 males and 22 females, aged (41.5±10.9) years old, 5 patients on L_4,5 and 35 patients on L₅S₁;BMI was (26.4±6.2) kg·m^-2. The patients in the control group were received normal saline rinse at room temperature, and the patients in the experimental group were received normal saline rinse heated to 37 ℃. Body temperature, chills, nausea, vomiting, and other adverse reactions were recorded. The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10) in two groups were recorded before and 2 hours after operation. Visual analogue scale (VAS) was used to evaluate the degree of lumbar pain in two groups before and 2 hours after surgery. Fibrinolytic-coagulation indexes with preoperative and 2 hours after surgery, including the D-dimer (DD), fibrinogen degradation products (FDP), activated partial thrombin time (APTT) and prothrombin time (PT) were recorder. Operation time and blood loss in two groups were recorded. RESULTS: The body temperature of both groups showed a downward trend, while the body temperature of the control group was lower than that of the experimental group. The levels of TNF-α, IL-6 and IL-10 in two groups were increased 2 hours after surgery compared with those before surgery(P<0.05), while the levels in experimental group were lower than those in control group(P<0.05). Postoperative VAS in experimental group 2.19±1.13 was significantly lower than that in the control group 3.38±1.35(P<0.05). The levels of DD and FDP at 2 hours after surgery in both groups were higher than those before surgery (P<0.05), while the levels of DD and FDP in the experimental group were higher than those in the control group (P<0.05). There was no significant difference in APTT and PT levels between two groups after operation (P>0.05). The blood loss in the experimental group of (45.2±14.1) ml was lower than that in the control group of (59.52±15.6) ml. The operation time of experimental group (46.7±13.8) min was less than that of control group (58.3±15.2) min(P<0.05). CONCLUSION Body temperature rinse can reduce the incidence of adverse reactions, alleviate local inflammatory reactions, reduce intraoperative blood loss and shorten the operation time.
Female ; Male ; Humans ; Adult ; Middle Aged ; Diskectomy, Percutaneous ; Interleukin-10 ; Body Temperature ; Interleukin-6 ; Saline Solution ; Tumor Necrosis Factor-alpha ; Intervertebral Disc Displacement/surgery* ; Lumbar Vertebrae/surgery* ; Diskectomy

The Chinese Society of Clinical Oncology (CSCO) issued the new version of the guidelines on diagnosis and treatment of NSCLC in April 2023.The new version updated the diagnostic and therapeutic strategy of rare oncogenic mutations, including ROS1 fusion, BRAF V600E mutation, NTRK fusion, MET exon 14 skipping mutation, RET fusion, and EGFR exon 20 insertion mutation, in NSCLC.This review will interpret the most important updates in the guidelines 2023 regarding the diagnosis as well as first-line and post-line therapies of these rare oncogenic mutations.

The application of artificial neural network algorithm in pathological diagnosis of gastrointestinal malignant tumors has become a research hotspot. In the previous studies, the algorithm research mainly focused on the model development based on convolutional neural networks, while only a few studies used the combination of convolutional neural networks and recurrent neural networks. The research contents included classical histopathological diagnosis and molecular typing of malignant tumors, and the prediction of patient prognosis by utilizing artificial neural networks. This article reviews the research progress on artificial neural network algorithm in the pathological diagnosis and prognosis prediction of digestive tract malignant tumors.
Humans ; Neural Networks, Computer ; Algorithms ; Prognosis ; Gastrointestinal Neoplasms/diagnosis*

Objective:To compare the difference and consistency of anterior corneal surface and total corneal refractive power and astigmatism measured by CASIA2, IOLMaster 700 and Pentacam in patients with age-related cataract.Methods:A diagnostic test was conducted.Two-hundred patients (200 eyes) with age-related cataract were enrolled in Tianjin Medical University Eye Hospital from March to April 2021.The steep keratometry (Ks), flat keratometry (Kf), mean keratometry (Km), degree and axis of astigmatism of the anterior and the total corneal surface of patients were measured by CASIA2, IOLMaster 700 and Pentacam, respectively.The astigmatism was transformed into J0 and J45 by Fourier transform formula.The differences and correlation of the measurements obtained with the three instruments were analyzed by one-way repeated measures analysis of variance and Pearson correlation analysis.The consistency was evaluated by Bland-Altman test.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Tianjin Medical University Eye Hospital (No.2021KY-07).Results:There were statistically significant differences in anterior corneal surface Kf and J0 measured by the three instruments ( F=18.563, 16.172; both at P=0.001). The Kf measured by CASIA2 was significantly higher than that measured by IOLMaster 700, and the J0 measured by IOLMaster 700 was significantly higher than that measured by Pentacam (both at P<0.05). There were statistically significant differences in total corneal Ks, Kf, Km and J0 measured by the three instruments, which from IOLMaster 700 were the largest, followed by CASIA2, then Pentacam ( F=1 300.447, 1 274.117, 1 609.713, 10.372; all at P=0.001). Pearson correlation analysis showed that the corneal refractive power measured by the three instruments was highly correlated (all at r>0.935, P<0.01), and the correlation of astigmatism values was weaker than the corneal refractive power ( r=0.623-0.908, all at P<0.01). Bland-Altman analysis showed that the three instruments had good consistency in measuring the anterior corneal surface refractive power, anterior corneal surface astigmatism and total corneal astigmatism, which were clinically acceptable, while the consistency of total corneal refractive power measurement was poor.The difference in measuring total corneal refractive power was large between IOLMaster 700 and Pentacam, and relatively small between CASIA2 and Pentacam. Conclusions:The consistency of CASIA2, IOLMaster 700 and Pentacam is good in measuring the anterior corneal surface refractive power of patients with age-related cataract, which can be substitutable, but poor in measuring the total corneal refractive power.The total corneal refractive power measurement from IOLMaster700 is the largest, the smallest from Pentacam, which is not recommended to be clinically exchangeable.

OBJECTIVE: To compare the curative effect on diarrhea-predominant irritable bowel syndrome (IBS-D) between acupuncture for regulating METHODS: A total of 231 patients with IBS-D were randomized into an acupuncture group (154 cases) and a western medication group (77 cases) at the ratio of 2 to 1. In the acupuncture group, acupuncture was applied to acupoint regimen for regulating RESULTS: After treatment and in follow-up, the total scores of IBS-SSS in the patients of the two groups were all reduced as compared with those before treatment ( CONCLUSION Acupuncture for regulating
Acupuncture Therapy ; Diarrhea/therapy* ; Humans ; Irritable Bowel Syndrome/therapy* ; Quality of Life ; Serotonin Plasma Membrane Transport Proteins/genetics* ; Spleen ; Treatment Outcome

Objective:To investigate the effectiveness and safety of transcatheter closure of atrial septum defect(ASD) in adults using echocardiography as the only imaging tool.Methods:From April 2017 to August 2019, 118 patients with congenital atrial septum defect were treated by cardiac surgery in Zhongshan Hospital affiliated to Fudan University. There were 31 males and 87 females, aged 15-72 years old[mean(40.3±15.3) years old]. 117 cases of atrial septum defect were secondary foramen and 1 case was residual shunt after repair of atrial septum defect by transthoracic echocardiography. The patients with tricuspid insufficiency and pulmonary hypertension were followed up by transesophageal echocardiography.Results:The transcatheter closure of atrial septum defect(ASD) was successfully performed in 114 patients. 3 patients were successfully treated with right fourth intercostal small incision atrial defect occlusion due to the coaxial problem of occlusive device and atrial defect. One patient underwent repair of atrial septum defect during the correction of right ventricular injury. The selected size of occluder ranged from 12 mm to 38 mm. One case of ethmoidal orifice was successfully blocked with double occlusive device. There was no occlusive device displacement, no obvious residual shunt, peripheral vascular injury and other complications occurred in successful occlusive patients. 110 patients were directly transferred back to the general ward after extubation. The postoperative hospital stay was(2.3±1.1) days and the total hospitalization time was(4.5±1.7) days. There were 7 patients with tricuspid regurgitation above mild to moderate before operation, and 6 patients with tricuspid regurgitation decreased to mild regurgitation after occlusion. One month after operation, the pulmonary artery pressure of 51 patients with moderate and severe pulmonary hypertension decreased from(50.4±11.4)mmHg to(38.9±12.9) mmHg( P<0.05). The occlusive device was well fixed and no residual shunt was found. Conclusion:Transesophageal echocardiography guided transcatheter closure of atrial septum defect is not only safe and effective in adult cardiac surgery, but also can avoid radiation and contrast agent injury.

Objective To investigate the clinical characteristics,surgical experience and mid-term outcome of coronary artery bypass graft surgery in patients aged ≤ 40 years.Methods From Jan.,2009 to Dec.,2015,12 patients with median age of (37.9 ± 2.5) years (range 32-40 years,10 males) were diagnosed with coronary artery disease and underwent coronary artery bypass graft surgery at Zhongshan Hospital,Fudan University.The clinical characteristics included five cases with hypertension,three cases with diabetes mellitus,four cases with hyperlipemia,eight cases with smoking history,seven cases with myocardial infarction.Six cases had at least one branch totally occluded.Two cases once underwent percutaneous coronary intervention surgery and implanted with five and three stents respectively.The perioperative data and follow-up results were retrospectively analysed.Results There was no in-hospital death and no death during follow-up period.Surgical techniques included bilateral internal mammary arteries combined with radial artery were operated in six cases,bilateral internal mammary arteries combined with great saphenous vein in two cases,left internal mammary arteries combined with great saphenous vein in four cases,off-pump in nine cases and on-pump in three cases.The mean follow-up time was (47.8 ± 24.3) months.During the follow-up one case suffered with saphenous vein graft restenosis 5 years after the surgery and underwent percutaneous coronary intervention.Other cases were all alive and assessed New York Heart Association's function class Ⅰ-Ⅱ.Conclusions Younger patients usually suffer with severe coronary artery disease when diagnosed because they often have excellent compensative capacity and the pathogenesis is concealed.The mid-term results of coronary artery bypass graft surgery in patients aged ≤40 years are satisfactory.

Objective To investigate the correlation between the levels of placenta growth factor (PLGF),soluble angiopoietin receptor-2 (sTie-2) and critical coronary artery plaque imaging morphology of coronary borderline lesions in patients with coronary heart disease (CHD).Methods In three consecutive years from April 2007 to September 2009,a cohort of 719 patients with borderline coronary lesions with stenosis in three main vessels with lumen diameter reduction varied all the way from more than 20％ to less than 70％ and with greater than 2.25 mm of the inner diameter were selected in this study from 4 teaching hospitals of tertiary class A in Beijing.These patients fell into three categories:unstable angina pectoris (UAP,n =292),stable angina pectoris (SAP,n =219) and coronary arteriosclerosis (AS,n =208).The vessels involved were analyzed using quantitative coronary angiography (QCA).Plasma levels of PLGF and sTie-2 were measured by using protein chip.The relationship between plasma levels of vascular factors,sTie-2,PLGF and coronary artery plaque imaging morphology among three groups were analyzed.Results (1) Plasma level of PLGF was 80.33 ng/L in the UAP group,which was significantly higher than 54.29 ng/L in the SAP group and 45.16 ng/L in AS group (both P ＜0.05).Plasma level of sTie-2 was 1353.06 ng/L in the UAP group,which was significantly higher than 1308.28 ng/L in the AS group (P =0.008).(2) There was significantly statistical differences in QCA between the SAP group and the UAP group as well as the AS group (both P ＜ 0.05) in terms of the minimal lumen diameter,diameter stenosis rate,minimal lumen cross-sectional area and cross-sectional area of stenosis.The plaque area in the UAP group was larger than that in the AS group (P =0.013).(3) The relationship between vascular factors and plaque imaging morphology was analyzed.There was significantly statistical difference in the involved lesions among the three groups (P ＜ 0.01).(4) There was a positive correlation between plasma level of PLGF and minimal lumen cross-sectional area (r =0.493,P =0.009).Conclusions The plasma levels of PLGF and sTie-2 reflect the level of neo-vascularization in the plaque,and could be taken as predictive factors for potential pathogenesis of coronary plaque.

OBJECTIVETo investigate the clinical application of laparoscopy-assisted subtotal colectomy with transanal specimen extraction for slow transit constipation(STC).

METHODSRetrospective analysis was performed on the clinical data of 8 cases with STC undergoing the procedure mentioned above from February to November 2013. Pre-and post-operative constipation was assessed using Wexner Constipation and Incontinence Scales, and quality of life was assessed using Gastrointestinal Quality of Life Index.

RESULTSAll the operations were completely successful without postoperative complications, such as intestinal fistula, pelvic infection, anastomotic stricture, intestinal obstruction. The Operative time was (287.6 ± 21.5) min, blood loss was (109.7 ± 41.1) ml, time to first flatus was (2.5 ± 0.9) d. The proportion of postoperative constipation symptom index improvement was(77.6 ± 8.3)%. Postoperative quality of life score was 97.3 ± 15.7, significantly higher than that before operation(P<0.05). Postoperative Wexner constipation score was 8.8 ± 3.7, significantly lower than that before operation.

CONCLUSIONLaparoscopy-assisted subtotal colectomy with transanal specimen extraction in the treatment of STC has good short-term efficacy with obvious improvement in quality of life.

Anal Canal ; surgery ; Colectomy ; methods ; Constipation ; surgery ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; Male ; Retrospective Studies ; Treatment Outcome