Precision diagnosis of hepatocellular carcinoma / 中华医学杂志(英文版)

Hepatocellular carcinoma (HCC) is the most common type of primary hepatocellular carcinoma (PHC). Early diagnosis of HCC remains the key to improve the prognosis. In recent years, with the promotion of the concept of precision medicine and more in-depth analysis of the biological mechanism underlying HCC, new diagnostic methods, including emerging serum markers, liquid biopsies, molecular diagnosis, and advances in imaging (novel contrast agents and radiomics), have emerged one after another. Herein, we reviewed and analyzed scientific advances in the early diagnosis of HCC and discussed their application and shortcomings. This review aimed to provide a reference for scientific research and clinical practice of HCC.

To compare the efficacy and incidence of severe hematological adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia / 中华血液学杂志

Objective: To analyze and compare therapy responses, outcomes, and incidence of severe hematologic adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia (CML) . Methods: Data of patients with chronic phase CML diagnosed between January 2006 and November 2022 from 76 centers, aged ≥18 years, and received initial flumatinib or imatinib therapy within 6 months after diagnosis in China were retrospectively interrogated. Propensity score matching (PSM) analysis was performed to reduce the bias of the initial TKI selection, and the therapy responses and outcomes of patients receiving initial flumatinib or imatinib therapy were compared. Results: A total of 4 833 adult patients with CML receiving initial imatinib (n=4 380) or flumatinib (n=453) therapy were included in the study. In the imatinib cohort, the median follow-up time was 54 [interquartile range (IQR), 31-85] months, and the 7-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.2%, 88.4%, 78.3%, and 63.0%, respectively. The 7-year FFS, PFS, and OS rates were 71.8%, 93.0%, and 96.9%, respectively. With the median follow-up of 18 (IQR, 13-25) months in the flumatinib cohort, the 2-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.4%, 86.5%, 58.4%, and 46.6%, respectively. The 2-year FFS, PFS, and OS rates were 80.1%, 95.0%, and 99.5%, respectively. The PSM analysis indicated that patients receiving initial flumatinib therapy had significantly higher cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) and higher probabilities of FFS than those receiving the initial imatinib therapy (all P<0.001), whereas the PFS (P=0.230) and OS (P=0.268) were comparable between the two cohorts. The incidence of severe hematologic adverse events (grade≥Ⅲ) was comparable in the two cohorts. Conclusion: Patients receiving initial flumatinib therapy had higher cumulative incidences of therapy responses and higher probability of FFS than those receiving initial imatinib therapy, whereas the incidence of severe hematologic adverse events was comparable between the two cohorts.

Application status and progress of pancreaticoduodenectomy / 国际外科学杂志

As the most complicated and challenging operation in general surgery, pancreaticoduodenectomy is also a classic operation for the treatment of pancreatic head and periampullary tumors. With the continuous improvement of medical technology and medical instruments, minimally invasive technology is increasingly widely used in pancreaticoduodenectomy, but there are many controversies. In this paper, the clinical application and research progress of open, laparoscopic and robotic pancreaticoduodenectomy were reviewed based on the experience of author′s team and domestic and foreign literatures, so as to provide reference for grasping surgical indications and formulating individualized treatment strategies.

High protein acetylation/succinylation levels and their correlation with high histone 2AX expression level in breast cancer / 解剖学报

Objective To explore the protein acetylation/succinylation and histone 2AX (H2AX) expression levels in breast cancer, as well as their correlation. Methods By Western blotting and RT-PCR methods to detect the protein modification and H2AX expression levels in 11 breast cancer tissues and cells, as well as to explore the common regulation way of protein acetylation and succinylation by treatment of histone deacetylase inhibitors ; To study the relationship between H2AX expression level and protein modification level through the construction and over-expression of indicated plasmids. Results Compared with the adjacent normal tissues, there existed an increase protein acetylation/succinylation levels in breast cancer tissues, and the protein acetylation and succinylation were both regulated by histone deacetylase (HDAC) members. The H2AX mRNA and protein expression levels were increased both in breast cancer cell and tissues, its expression level and the expression and modification level of represented protein nucleophosmin 1(NPM1) showed a positive correlation. Conclusion The breast cancer possesses a characteristic of high protein acetylation/succinylation levels and high H2AX expression level, the H2AX expression level and the modification level of partial proteins in breast cancer have a positive correlation.

Expression and clinical significance of visfatin, hsa-miR-199a and extracellular signal regulating protein kinase 1/2 in colorectal cancer / 解剖学报

Objective To investigate the expression and correlation of visfatin, hsa-miR-199a and extracellular regulated protein kinase 1/2 (ERK1/2) in colorectal cancer (CRC) tissues. Methods The expression levels of visfatin mRNA and hsa-miR-199a were detected by Real-time PCR in 64 primary cases of radical resection of colorectal cancer who underwent pathological clinical examination in the clinicopathological examination in our hospital center from January 2017 to December 2017, the protein expression levels of visfatin and ERK1/2 were detected by immunohistochemistry and Western blotting. The relative expression levels of hsa-miR-199a in each group were compared according to the expression levels of visfatin and ERK1/2. Results The levels of visfatin gene and protein in colorectal cancer tissue (observation group, 64 cases) were higher than those in normal colorectal cancer (control group, 64 cases), and the expression was consistent. The colorectal cancer tissue(observation group) expression level of hsa-miR-199a was lower than that of normal colorectal tissue(control group), and visfatin mRNA was significantly negatively correlated. The colorectal cancer tissue (observation group) expression of ERK1/2 was higher than normal colorectal tissue (control group) and visfatin was significantly positively correlated. The relative expression of hsa-miR-199a in the visfatin and ERK1/2 positive group was significantly different from that in the test variables. Conclusion The overexpression of visfatin in colorectal cancer affects the down-regulation of hsa-miR-199a and is related to the ERK signaling pathway.

Application of 5G technology in surgery / 中华消化外科杂志

The fifth generation wireless systems (5G technology) has the characteristics of high system capacity, high data transmission rate, massive device connectivity, extremely low latency, and ultra-reliability. With the advent of 5G technology, modern surgery has made new progress in telesurgery, tele-consultation, remote instruction and teaching, remote monitoring and ambulance. "5G+ surgery" is still in its infancy, and with the gradual improvement of 5G technology, its application in the surgical field will continuously deepen and expand.

Evaluating inferior vena cava wall invasion in renal cell carcinoma tumor thrombus with MRI / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the diagnostic performance of MRI for the assessment of inferior vena cava (IVC) wall invasion by IVC thrombus in patients with renal cell carcinoma (RCC).@*METHODS@#We retrospectively collected patients who underwent radical nephrectomy and thrombectomy for RCC between 2010 and 2018 at Peking University First Hospital. All the patients underwent imaging on a 1.5 Tesla or 3.0 Tesla MRI scanner. Fifty-six patients met the inclusion criteria. Preoperative imaging was reviewed by two radiologists blinded to details of the patient's surgical procedure and histopathology. Two radiologists measured the maximum anterior-posterior diameter and coronal diameters of the IVC and renal vein, and the craniocaudal extent of tumor thrombus, and evaluated the MRI features of IVC thrombus, including occlusion of the IVC lumen, the margin of the tumor thrombus (smooth vs. irregular), contact of the IVC thrombus and IVC wall, and altered signal of the IVC wall. Univariable and multivariable associations of clinical and radiographic features with IVC wall invasion were evaluated by Logistic regression.@*RESULTS@#Of the 56 patients [male: 43, female: 13, mean age: (55.64±0.43) years], 17 (30.36%) were detected with IVC wall invasion, and most were clear cell carcinoma. Tumor thrombus with IVC wall invasion showed an increase in length of IVC thrombus [(7.91±3.59) cm vs. (5.94±3.57) cm, P=0.049], and more features of complete occlusion of the IVC lumen (P=0.002), irregular margin of the IVC thrombs (P=0.005), contact of the IVC thrombus and IVC wall (P=0.001), and altered signal of the low-intensity vessel wall (P<0.001), with a sensitivity of 94.12% and a specificity of 79.49%.@*CONCLUSION@#The present study indicates that MRI could be a means of evaluating RCC with IVC wall invasion, and the combination of tumor thrombus length and subjective impression of IVC wall invasion achieved a high sensitivity and specificity for diagnosis.

Diagnostic value on the analysis of contrast-enhanced ultrasound and quantitative mode of benign and malignant thyroid nodule and the diagnostic value of quantitative model on it / 中国医学装备

Objective: To study ultrasound contrast enhanced mode of benign and malignant thyroid nodule and the change of related quantitative parameter of time intensity curve(TIC).Methods: Retrospective analysis was applied to analyze the mode that contrast agent went into nodules when 125 thyroid nodules of 112 patients with thyroid nodule received ultrasound contrast,and to analyze enhanced mode and distribution situation of contrast agent.The change of TIC was observed and analyzed.And when contrast agent went into nodule,the quantitative parameters included arrive time(AT),peak intensity(PI),time to peak(TTP)and K value of rate of curve were recorded.Results: 58 nodules were benign and 67 nodules were malignant in the 125 thyroid nodules.The rim of benign nodules appeared circular enhancement(82.7％)after contrast agent went into benign nodule.And the malignant nodules appeared non-circular enhancement(77.6％),and the difference of them was no significant(x2=28.32,P＜0.05).Most of malignant nodules appeared asymmetrical enhancement after contrast agent was infused in them(91.0％),and the difference of ultrasound contrast between benign nodules and malignant nodules was significant(x2=17.56,P＜0.05).When the contrast agent of malignant nodules achieved peak value,its main appearance was low enhancement(83.6％),and the contrast agent of benign nodules achieved peak value,the main appearance was equivalent enhancement(86.2％),and the difference of appearance between malignant nodule and benign nodule was significant(x2=41.65,P＜0.05).The differences of parameters of TIC included AT,PI,TTP and K value between malignant nodules and benign nodules were significant(t=2.964,t=3.021,t=-2.914,t=2.652,P＜0.05).Conclusion: For diagnosis of thyroid nodule that mainly contained solid nodule and cystic solid nodule,ultrasound contrast enhancement and TIC included variously quantitative parameters have higher clinical application value.

Application of ABC Classification in Inventory Management of Anti-tumor Drugs and Its Adjuvant Drugs in Our Hospital / 中国药房

OBJECTIVE:To shorten the turnover days of hospital drug inventory,reduce the cost of drug inventory and improve the level of hospital drug inventory management.METHODS:The data of 65 kinds of antitumor drugs and its adjuvant drugs during Jan.1st,2016-Dec.31st,2016 were collected from hospital information system (HIS) of our hospital,such as price,inventory to classify by using ABC classification method.According to demanded quantity of class A drugs in the secondary drug storage,the amount purchased of upper and lower limitation of class A drugs could be calculated.The data of class C drugs were analyzed one by one to determine the "temporary use" drug directory.The turnover days of class A drugs and the inventory cost of class C drugs were counted before and after classification management.RESULTS:There were 10 class A drugs,accounting for 15.38％ of total types and 78.27％ of total consumption sum;the turnover days of pharmacy inventory decreased from (43.96 ± 19.04) d to (13.64 ± 8.02) d by adopting the principle of purchasing in small quantity by several times.There were 10 "temporary use" drugs of class C drugs,accounting for 26.32％ of total types,270 thousand yuan inventory cost saved each year.CONCLUSIONS:Hierarchical management of hospital drug inventory by ABC classification can effectively optimize the inventory types and amount,and provide definite evidence for "temporary use" drugs so as to shorten turnover days of pharmacy inventory and recue the cost of pharmacy inventory.

Effect of 1q21 amplification on bortezomib therapeutic response and prognosis of newly diagnosed multiple myeloma patients / 中华血液学杂志

Objective: To investigate the effect of 1q21 amplification (1q) on the therapeutic response and prognosis of bortezomib(Btz) in the treatment of newly diagnosed multiple myeloma (MM) patients. Methods: A total of 180 newly diagnosed MM were included for analyses of clinical characteristics, cytogenetics, objective response rate (ORR), progression-free survival (PFS) and overall survival (OS), retrospectively. Gene expression profiling (GEP) was analyzed using publicly available R2 platform. Results: ① In 180 patients, 1q was found in 51.1% cases. Of them, 174 patients had complete follow-up data, including 88 cases with 1q and 86 without 1q (non-1q). ②Incidence of 1q was positively associated with percentage of IGH rearrangement (72.2%, P=0.017) and 1p deletion (1p) (27.8%, P=0.040). ③ The median PFS was 15.0 and 20.3 months for the 1q group and non-1q group, and the median OS was 29.4 and 44.0 months, respectively. Both PFS and OS of 1q group was significantly shorter than those of the non-1q group (P=0.029 and 0.038, respectively). Multivariate analysis further revealed that 1q was an independent prognostic factor for both PFS (HR=1.910, 95% CI 1.105-3.303, P=0.020) and OS (HR=2.353, 95% CI 1.090-5.078, P=0.029). ④ In 91 evaluable cases with 1q, very good partial remission (VGPR) rate was higher after treatment with Btz than those without Btz (62.1% vs 40.0%, P=0.032). Of note, the patients with 1q who received auto-HSCT after induction with Btz had significantly longer PFS than those without auto-HSCT (19 months vs 13 months, P=0.048). ⑤GEP analysis revealed that 1q21 amplification predominantly up-regulated expression of >50% genes within 1q21 region, and also altered expression of 28% genes in chromosome 1 and 10% genes in whole genome, particularly related to DNA repair and cell cycle. Conclusions: 1q is an independent adverse prognostic factor in patients with newly diagnosed MM. It is often associated with 1p deletion and IGH rearrangement. Patients with 1q respond well to Btz-based regimen, but they fail to gain long-term benefit from this treatment itself. However, auto-HSCT following Btz induction might improve survival of patients with 1q, suggesting a potential strategy to treat this high-risk subset of MM. GEP analysis warrants further attention in understanding the mechanisms underlying the high-risk of 1q.

Expression of miR-494 in breast cancer and its clinical significance / 临床检验杂志

Objective To investigate the expression levels of miR-494 in breast cancer tissues and cell lines,and its correlations with the clinical stages,metastasis and prognosis of breast cancer.Methods The expression levels of miR--494 in 5 breast cancer cell lines,including MDA-MB-231,MDA-MB-453,HCC-1937,MDA-MB-468 and MCF-7,and normal breast cell line HBL-100,were detected by quantitative real-time polymerase chain reaction (qRT-PCR).The breast cancer tissues and normal adjacent tissues from 54 patients with breast cancer were collected,and their expression levels of miR-494 were determined by qRT-PCR.Then,the correlations of miR-494 levels with clinical stages,metastasis and prognosis of breast cancer were analyzed.Results The expression levels of miR-494 in MDA-MB-231,MDA-MB-453,HCC-1937,MDA-MB-468 and MCF-7 cells were significantly lower than that in HBL-100 cells (t =212.9,37.73,27.53,10.61 and 19.46,respectively,and all P ＜0.05).The expression levels of miR-494 in breast cancer tissues were also significantly lower than that in normal adjacent tissues (t =5.80,P ＜ 0.01).Moreover,the expression of miR-494 was significantly related to the clinical stage (x2 =17.41,P ＜0.05),tumor grade (x2 =5.33,P ＜0.05),C-erbB-2 expression (x2 =9.83,P ＜ 0.05) and the percentage of Ki-67 positive cells ((2 =6.13,P ＜ 0.05) of breast cancer.Conclusion The expression levels of miR-494 are significantly dowrregulated in breast cancer tissues and cell lines,and related to the clinical stage,metastasis and prognosis of breast cancer,indicating that miR-494 may serve as a new biomarker for the diagnosis and prognosis of breast cancer.

Effects of Acupotomy Therapy on mRNA Expressions of Bcl-2, Bax, Caspase-3 in Posterior Cervical Extensor Muscles in Cervical Spondylosis Rabbits / 针刺研究

OBJECTIVE: To observe the effect of acupotomy therapy on mRNA expressions of Bcl-2, Bax , Caspase-3 in posterior cervical extensor muscles in cervical spondylosis rabbits, and explore its mechanisms for apoptosis of cervical muscles. METHODS: New Zealand rabbits were randomly divided into normal, model, electroacupuncture (EA) and acupotomy groups, 6 in each group. The cervical spondylosis model was established by forced head-bowing for a long term. After model establishment, acupotomy was used at the trapezius muscle starting point and attachment site of sternocleidomastoid muscle, etc., once a week, total 3 times. EA was used at "Tianzhu" (BL 10), "Jingbailao" (EX-HN 15) and "Dazhu" (BL 11) for 3 weeks, 20 min a time, 3 times a week. Bcl-2, Bax, Caspase-3 mRNA expressions in posterior cervical extensor muscles were detected by real-time PCR. RESULTS: There was no significant difference in the expression of Bcl-2 mRNA among all the groups (P>0.05). Compared with the normal group, Bax mRNA increased in the model group (P<0.01), and that in the acupotomy group was lower than that in the model group (P<0.01). The ratio of Bcl-2/Bax mRNA in the model group decreased significantly compared with that in the normal group (P<0.01); in comparison with the model group, the ratio in the acupotomy group increased (P<0.01); and that in the acupotomy group was higher than the ratio in the EA group (P<0.05). The Caspase-3 mRNA expression in the model group increased compared with that in the normal group (P<0.05), and its expression in the acupotomy group decreased compared with those in the model and EA groups (P<0.05). CONCLUSIONS: Acupotomy therapy can regulate the mRNA expressions of Bax and Caspase-3, and retard apoptosis in posterior cervical extensor muscles, therefore the strained muscles are relieved, which may be one of its mechanisms for improving cervical spondylosis.

Analysis on Prescription Writing Norms of Narcotic Drugs for Injection in Operation Room and Inpatient Area of Our Hospital / 中国药师

Objective:To statistically analyze the prescription writing norms of narcotic drugs for injection in the operation room and inpatient area of our hospital to improve the prescription writing quality and the efficiency of management. Methods:A retrospec-tive research method was adopted, and 17 103 prescriptions for narcotic drugs for injection in the operation room and inpatient area were collected and analyzed from June to August in 2014. Results:The irregular proportion of prescriptions of narcotic drugs for injec-tion was 9. 05%, and the abnormal item was lack of the text. The proportion of prescriptions using residual amount and needing to be marked was 4. 01%. Conclusion: Improving the management and unifying the prescriptions of narcotics, or applying the electronic prescription if allowed will improve the quality of prescriptions of narcotics and achieve the purpose of fine management.

A two-point Dixon technique for water-fat separation using multiresolution and region-growing algorithm / 南方医科大学学报

<p><b>OBJECTIVE</b>An improved water-fat separation method based on region-growing was proposed for use in regions with low signal-noise ratio (SNR).</p><p><b>METHODS</b>Region-growing method was applied to 4 sub-images acquired by a down- sampling operation on the acquired phasor maps. The spatial smoothing constraint was exploited to calculate 4 error phasor maps to construct the final smooth error phasor map, which was used in two-point Dixon technique for water-fat separation.</p><p><b>RESULTS</b>The simulation experiment showed that the proposed method produced smaller errors, and for clinical images of the knees, abdomen and lower limbs, the proposed method achieved accurate water-fat separations.</p><p><b>CONCLUSION</b>The proposed method is more robust and reliable than the original global region-growing algorithm, and serves as a promising water-fat separation method for clinical applications.</p>

Clinical value of ultrasound and X-ray guided percutaneous nephrolithotomy (PCNL) for treatment of kidney calculi:a meta-analysis / 局解手术学杂志

Objective To compare the clinical value of ultrasound and X-ray guided percutaneous nephrolithotomy ( PCNL) for treat-ment of kidney calculi. Methods We searched relevant clinical controlled articles in PubMed,EMBASE/Cochrane library and CNKI data-base. The outcome indicators included stone clearance rate, complication rate,puncture time,blood loss,and hospital days. All data were ana-lyzed by Revman 5. 0 software. Results There were 9 articles involved in 1693 patients. The results suggested that there was no significant difference in stone clearance rate between ultrasound group and X-ray group[OR=1. 11,95%CI(0. 83,1. 49),P=0. 47]. However,the complication [OR=0. 43,95%CI (0. 27,0. 69),P=0. 0004],time to puncture[WMD= -4. 54,95%CI( -0. 45,-8. 62),P=0. 03], blood loss[WMD= -22. 77,95%CI( -36. 57,-8. 97),P=0. 001],and hospital days[WMD= -0. 16,95%CI( -0. 28,-0. 03),P=0. 02] were better in ultrasound group than those in X-ray group. Conclusion Ultrasound and X-ray guided PCNL had an equal stone clear-ance rate,but it seemed that ultrasound was better than X-ray in time to puncture and hospital days after operation. However,the results of this meta-analysis should be treated carefully because of limitation of data and heterogeneity.

Preliminary Investigation of Residual Narcotics for Injection in Wards of Our Hospital / 中国药师

Objective:To investigate the residual narcotics for injection after used in wards in order to provide evidence for the use standardization of narcotics for injection. Methods:A retrospective research method was adopted. Totally 5 288 prescriptions including narcotic drugs for injection in wards were collected and analyzed from June to August in 2014. Results:Only four kinds of narcotics for injection were used in wards, the residual proportion of morphine hydrochloride injection and pethidine hydrochloride injection was 2%, and that of fentanyl citrate injection was 0. 2%. Conclusion:The residue of narcotics for injection in wards is very little, and the specifi-cations of the medication in our hospital meet the demands of clinics. The research is beneficial to improving the management efficiency.

Morphologic measurement of entry points and landmarks of retrosigmoid approach using volume rendering with thin-section computed tomography and its significance / 吉林大学学报(医学版)

Objective To research the jugular foramen,internal auditory pore (IAP)and the turning point between its components by imageological methods and to provide theoretical basis for retrosigmoid approach in the operation of acoustic neurinoma.Methods The skulls of 100 volunteers were scanned to get the final result with thin-section computed tomographic image. High-resolution spiral CT multiplane reformation was used to reform images that were parallel to the Frankfort horizontal plane to measure the distance between the turning point of retrosigmoid (A),the edge of jugular foramen(B)and the lower edge of the internal auditory canal(C)(denoted AC,AB,BC) and the shortest distance from the jugular foramen to AC.The angles between AC,AB and sagittal axis(α,β) were measured.Results The distance of AC was (44.94 ± 3.84)mm,the distance of AB was (43.68 ± 4.56)mm.The distance of BC was (6.15 ±2.04)mm,and the shortest distance between jugular foramen and AC was (5.21±0.23)mm.The angleαwas measured as (39.50±4.74)°,and the angleβwas measured as (46.35± 5.51)°.Conclusion The research measure the distance and angle between entry points and landmarks of retrosigmoid approach and the safe distance.

Resources investigation of medicinal plants of Huangfu mountain in city of Chuzhou based on grid sampling method / 中国中药杂志

<p><b>OBJECTIVE</b>To conduct preliminary investigation to the species and reserves of medicinal plants in Huangfu Mountain, and to provide references to the general survey of those plants for medicine.</p><p><b>METHOD</b>Combined with global positioning system (GPS), the program of investigation with grid sampling was used in this resource survey of medicinal plants.</p><p><b>RESULT</b>After the preliminary investigation of the plants for medical use of Huangfu Mountain, it is found that there are 103 families with 313 kinds of plants. There are many medicinal plants and large distribution, such as Pseudostellaria heterophylla, Semiaguilegia adoxoides and Pinellia ternate.</p><p><b>CONCLUSION</b>Huangfu Mount, with so many different kinds of medicinal plants and comfortable environment for part of the medicinal plants to grow, could be developed as a base for planting Chinese herbal medicines.</p>

99Tcm-MIBI gated myocardial perfusion imaging in patients with myocardial bridging diagnosed by CT angiography / 中华核医学杂志

Objective To explore the clinical value of 99Tcm-MIBI G-MPI in patients diagnosed with myocardial bridging(MB) by CTA. Methods Forty-five patients with MB and 17 normal controls diagnosed by CTA(64 slices CT) were included. All patients underwent rest 99Tcm-MIBI G-MPI and 17 MB patients and 9 normal controls also underwent stress 99Tcm-MIBI G-MPI. Myocardial ischemia, function and wall motion were assessed. G-MPI results were compared with CTA results by χ2 test, Fisher exact test and t test. Results In patients with MB, the positive rate of abnormal perfusion by gated stress 99Tcm-MIBI G-MPI was 64.7% (11/17) and 41.2% (7/17) using quantitative analysis and visual evaluation respectively; while the data were 42.2% (19/45) and 22.2% (10/45) by rest G-MPI (P=0.035). The positive rate by rest G-MPI in MB patients was significant different among mural coronary arteries of different depths and different locations. By quantitative analysis of the stress G-MPI, the reversible, fixed, and mixed ischemia patients were 4 (35.3%), 6 (23.5%) and 1 (5.9%) respectively; the reversed, reversible and fixed abnormity of wall motion was found in 4 (23.5%), 4 (23.5%) and 2 (11.8%) patients respectively; the reversed, reversible and fixed wall thickening were found in 6 (35.3%), 5 (29.4%) and 1 (5.9%) patients respectively. There was no significant difference in left ventricular ejection fraction and peak filling rate between MB patients and normal controls in both rest and stress studies (t: from -0.564 to 1.292, all P>0.05). Conclusion The G-MPI may be useful for the evaluation of myocardial ischemia and myocardial function simultaneously in patients with MB.

Analysis of the vacuum sealing drainage technique combined with sural neurovascular pedicle fascio-cutaneous flap to repair deep wounds in the foot near the ankle joint with exposed bone and tendons / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the practical method of vacuum sealing drainage (VSD) technique combined with sural neurovascular pedicle fasciocutaneous flap to repair deep wounds in the foot near the ankle joint with exposed bone and tendons.</p><p><b>METHODS</b>From January 2006 to January 2009, 79 patients with deep wounds in the foot near the ankle joint with exposed bone and tendons were treated by VSD technique combined with sural neurovascular pedicle fasciocutaneous flap including 58 males and 21 females with an average age of 34 years old ranging from 7 to 59 years. There were 17 cases in low 1/3 part of leg and achilles tendon, 28 in lateral malleolus and lateral dorsum of foot, 21 in medial malleolus and medial dorsum of foot, 13 in heel and pelma. Firstly the wounds were debrided and cultivated by using VSD technique, then the soft tissue defections were repaired with sural neurovascular pedicle fasciocutaneous flap.</p><p><b>RESULTS</b>The area of flap was from 6 cm x 5 cm to 18 cm x 15 cm; All patients stayed in hospital for 14 to 30 days, 18 days in average. Living flaps of all patients were followed-up from 6 months to 3 years, the flaps of 2 patients were mostly necrotic, 3 were necrotic, 5 cases appeared obstacle of venous back streaming. The others survived with no infections.</p><p><b>CONCLUSION</b>The wound would become fresh and clean as soon as possible with VSD. The sural neurovascular pedicle fasciocutaneous flap could provide a good covering for the exposed wound. Therefore the wound healed faster with friction resistance and fine appearance. The time of hospitalization were greatly shortened after combined application.</p>