Intraoperative management of potentially fatal arrhythmias after anesthesia induced by severe hypokalemia: A case report / 北京大学学报(医学版)

Severe hypokalemia is defined as the concentration of serum potassium lower than 2.5 mmol/L, which may lead to serious arrhythmias and cause mortality. We report an unusual case of potentially fatal ventricular arrhythmias induced by severe hypokalemia in a patient undergoing laparoscopic partial nephrectomy in Peking University Third Hospital due to irregular use of indapamide before operation. Indapamide is a sulfonamide diuretic with vasodilative and calcium antagonistic effects, which enhances sodium delivery to the renal distal tubules resulting in a dose-related increase in urinary potassium excretion and decreases serum potassium concentrations. The electrolyte disorder caused by the diuretic is more likely to occur in the elderly patients, especially those with malnutrition or long-term fasting. Hence, the serum potassium concentration of the patients under indapamide therapy, especially elderly patients, should be monitored carefully. Meanwhile, the potassium concentration measured by arterial blood gas analysis is different from that measured by venous blood or laboratory test. According to the previous research, the concentration of potassium in venous blood was slightly higher than that in arterial blood, and the difference value was 0.1-0.5 mmol/L. This error should be taken into account when rapid intravenous potassium supplementation or reduction of blood potassium level was carried out clinically. In the correction of severe hypokalemia, the standard approach often did not work well for treating severe hypokalemia. The tailored rapid potassium supplementation strategy shortened the time of hypokalemia and was a safe and better treatment option to remedy life-threatening arrhythmias caused by severe hypokalemia with a high success rate. Through the anesthesia management of this case, we conclude that for the elderly patients who take indapamide or other potassium excretion diuretics, the electrolyte concentration and the general volume state of the patients should be comprehensively measured and fully evaluated before operation. It may be necessary for us to reexamine the serum electrolyte concentration before anesthesia induction on the morning of surgery in patients with the history of hypokalemia. For severe hypokalemia detected after anesthesia, central venous cannulation access for individualized rapid potassium supplementation is an effective approach to reverse the life-threatening arrhythmias caused by severe hypokalemia and ensure the safety of the patients.

Analysis of the number of beds required in trauma intensive care unit in the branch campus of a tertiary hospital in Beijing / 中华急诊医学杂志

Objective:Severe trauma events are emergent, with low incidence and unpredictable. Current guideline does not provide precise recommendations on how the trauma centers should arrange the number of beds in trauma intensive care units while making rational use of medical resources. We analyzed the trauma intensive care unit bed requirement in the branch campus of our hospital to propose a reasonable assessment.Methods:Patients with severe trauma sent to the Intensive Care Unit of Peking University People's Hospital from January 2022 to June 2022 were collected. The daily number of patients received intensive care was counted. The bed requirement of the intensive care unit covering 99% of clinical needs was calculated based on the probability distribution function.Results:From January 2022 to June 2022, 103 patients with severe trauma [74 males and 29 females, aged (51.47±16.06) years, ranging 16 to 87 years] were included in the study. Among the 103 patients, 57 were injured in traffic accidents, 26 fell from a high altitude, 12 fell, 4 were hit by heavy objects, and 4 were stabbed. TISS ranged from 16 to 50. The range of the daily bed requirement in the intensive care unit was 0–10, which was consistent with the Poisson distribution. According to the probability distribution function, nine trauma intensive care beds could meet 99.19% of clinical needs.Conclusions:In severe traumatic events, patients need to be transferred to intensive care unit as soon as possible. For our branch campus, nine trauma intensive care beds can cover more than 99% of clinical needs. It follows that, in accordance with the basic requirements of trauma center construction, hospitals with trauma centers need at least 9 beds in intensive care units. However, traumatic events cannot be predicted; thus, the bed requirement needs to be regularly evaluated.

Characterization of the critical quality attributes for hydroxypropyl methylcellulose with different sources and analysis of the release of sustained-release tablets in vitro / 药学学报

The quality difference of pharmaceutical excipients from different sources affects the molding properties of the powder, resulting in changes in the properties of the final product. In this study, the critical quality attributes of hydroxypropyl methylcellulose (HPMC) with different specifications from two manufacturers (manufacturer A and manufacturer B) were characterized including particle size, physical morphology, viscosity and powder physical quality attributes. Aminophylline, diclofenac sodium, and metformin hydrochloride were utilized as model drugs with different solubility to prepare sustained-release tablets, and the effect of HPMC from different sources on drug release of sustained-release tablets in vitro was investigated. The results showed that HPMC with the same viscosity specification from different sources had outstanding differences in the physicochemical properties (including particle size, physical morphology, viscosity, dimension, compressibility and powder flow), which could change the hardness and friability of the sustained-release tablets. The differences in the physicochemical properties of HPMC had different effects on the dissolution of different sustained-release tablets in vitro. It had no significant effect on the release of easily soluble aminophylline and metformin hydrochloride, but had a greater impact on the release of poorly soluble diclofenac sodium. Compared with manufacturer A, the sustained-release effect of matrix tablets prepared by HPMC from manufacturer B was more excellent. The results of this study will provide a theoretical reference on selecting the appropriate excipients for formulation design.

Development and internal validation of China mortality prediction model in trauma based on ICD-10-CM lexicon: CMPMIT-ICD10 / 中华医学杂志(英文版)

BACKGROUND@#Models to predict mortality in trauma play an important role in outcome prediction and severity adjustment, which informs trauma quality assessment and research. Hospitals in China typically use the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) to describe injury. However, there is no suitable prediction model for China. This study attempts to develop a new mortality prediction model based on the ICD-10-CM lexicon and a Chinese database.@*METHODS@#This retrospective study extracted the data of all trauma patients admitted to the Beijing Red Cross Emergency Center, from January 2012 to July 2018 (n = 40,205). We used relevant predictive variables to establish a prediction model following logistic regression analysis. The performance of the model was assessed based on discrimination and calibration. The bootstrapping method was used for internal validation and adjustment of model performance.@*RESULTS@#Sex, age, new region-severity codes, comorbidities, traumatic shock, and coma were finally included in the new model as key predictors of mortality. Among them, coma and traumatic shock had the highest scores in the model. The discrimination and calibration of this model were significant, and the internal validation performance was good. The values of the area under the curve and Brier score for the new model were 0.9640 and 0.0177, respectively; after adjustment of the bootstrapping method, they were 0.9630 and 0.0178, respectively.@*CONCLUSIONS@#The new model (China Mortality Prediction Model in Trauma based on the ICD-10-CM lexicon) showed great discrimination and calibration, and performed well in internal validation; it should be further verified externally.

Discriminant analysis of the risk of nosocomial mortality in patients with traumatic hemorrhagic shock / 中华普通外科杂志

Objective:To investigate the use of discriminant analysis to predict the risk of nosocomial mortality in patients with traumatic hemorrhagic shock.Methods:The clinical data of 238 patients with traumatic hemorrhagic shock admitted to Peking University People's Hospital from Sep 2013 to Aug 2020 were retrospectively analyzed. Patients were divided into survival group (214 cases) and death group (24 cases). Stepwise discriminant analysis was used to establish a discriminant model.Results:The difference of history of stroke (9.8% vs. 25.0%), main site of bleeding (extremities)(58.9% vs. 29.2%), APACHEⅡ score (16.4±5.1 vs. 23.2±6.1), blood lactic acid [2.1(1.1-3.5) mmol/L vs. 4.9(2.0-13.4) mmol/L] and surgery (92.5% vs. 58.3%) between the two groups was all statistically significant (all P<0.05). Finally, There are five indicators that entered the discriminant model: history of stroke, main site of bleeding (extremities), blood lactic acid, APACHE Ⅱ score and surgery. The area under the ROC curve for predicting the risk of mortality in patients with traumatic hemorrhagic shock was 0.857, 95% CI 0.754-0.959. Conclusions:The established discriminant model has a high accuracy in predicting the risk of in-hospital mortality in patients with traumatic hemorrhagic shock.

Article Effect and Mechanism of Ganoderma lucidum Polysaccharides on Human Fibroblasts and Skin Wound Healing in Mice / 中国结合医学杂志

OBJECTIVE@#To investigate the effects of Ganoderma lucidum polysaccharides (GL-PS) on human fibroblasts and skin wound healing in Kunming male mice and to explore the putative molecular mechanism.@*METHODS@#Primary human skin fibroblasts were cultured. The viability of fibroblasts treated with 0, 10, 20, 40, 80, and 160 μg/mL of GL-PS, respectively were detected by 3-4,5-dimethyl-2-thiazolyl-2,5-diphenyl-2-Htetrazolium bromide (MTT). The migration ability of fibroblasts treated with 0, 10, 20, and 40 μg/mL of GL-PS were measured by transwell assay. The secretion of the C-terminal peptide of procollagen type I (CICP) and transforming growth factor-β1 (TGF-β1) in the cell supernatant was tested by enzyme-linked immunosorbent assay. The expression of β-catenin was detected by Western blot. Furthermore, the Kunming mouse model with full-layer skin resection trauma was established, and was treated with 10, 20, and 40 mg/mL of GL-PS, respectively as external use. The size of the wound was measured daily, complete healing time in each group was recorded and the percentage of wound contraction was calculated.@*RESULTS@#Compared with the control group, 10, 20, and 40 μg/mL of GL-PS significantly increased the viability of fibroblasts, promoted the migration ability of fibroblasts, and up-regulated the expressions of CICP and TGF-β1 in fibroblasts (Plt;0.05 or Plt;0.01). The expression of β-catenin in fibroblasts treated with 20 and 40 μg/mL of GL-PS was significantly higher than that of the control group (Plt;0.01). Furthermore, after external use of 10, 20, and 40 mg/mL of GL-PS, the rates of wound healing in mice were significantly higher and the wound healing time was significantly less than the control group (Plt;0.05 or Plt;0.01).@*CONCLUSION@#A certain concentration of GL-PS may promote wound healing via activation of the Wnt/β-catenin signaling pathway and up-regulation of TGF-β1, which might serve as a promising source of skin wound healing.

Establishment of A Serum-Free Culture System Based on Heparin and Anti-CD16 Antibody for Expansion of Human Cord Blood NK Cells / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To establish a novel method for ex vivo expansion of natural killer cells from human umbilical blood, so as to provide the basis for NK cell therapy.</p><p><b>METHODS</b>Mononucleated cells from human umbilical blood were harvested and suspended in a serum-free medium containing 5% autologous plasma, recombinant human IL-15 (50 ng/ml) and hydrocortisone sodium succinate (5×10 mol/L) at a concentration of 1.5×10/ml, then the cells were seeded into flasks pre-coated with heparin sodium (100 U/cm) or/and anti-human CD16 antibody (1 µg/cm). After culture for 2 weeks, the cells were harvested and counted. Ratios of CD3/CD56 of the cells were determined by flow cytometry. MTT test was performed to assess the cytotoxicity against K562 cells with graded ratios of effector/target cells.</p><p><b>RESULTS</b>In contrast to the cells in flasks without pre-coating, the attached colonies appeared predominantly within 1 week of culture from heparin- and antibody-coated groups. The cell numbers from the pre-coated groups were significantly higher than that of uncoated one after culture for 2 weeks. Furthermore, the ratios of CD3/CD56 cells were much higher in pre-coated groups, and that of the cells from flasks pre-coated with heparin and antibody were the highest (all the P values <0.01). MTT test showed that the cytotoxic activity of the cells stimulated by precoating were much more potent than that of the cells without the stimulation.</p><p><b>CONCLUSION</b>Advantageous expansion of NK cells can be achieved by precoating with heparin and anti-CD16 antibody, and also by supplement with IL-15 and hydrocortisone into the media, so the umbilical NK cells with high purity and potent cytotoxicity can be obtained.</p>

Correlation of semen parameters with inflammatory factors in the seminal plasma of obese males / 中华男科学杂志

Objective@#To investigate the influence of inflammatory factors on semen parameters in the seminal plasma of obese men.@*METHODS@#Based on the body mass index (BMI), 171 males were divided into a normal group (BMI 0.05).@*CONCLUSIONS@#The levels of TNF-α and IL-6 are increased and that of VEGF decreased in the seminal plasma of obese males, which may affect the semen quality.

Comparative analysis on drug-resistant bacterial distribution and drug resistance characteristics of lower respiratory tract infection in different regions of respiratory department / 重庆医学

Objective To investigate the distribution and constituent of drug‐resistant bacteria of lower respiratory tract in‐fection among different regions (outpatient department ,wards ,RICU) to provide the basis for the clinical reasonable application of antimicrobial agents .Methods The K‐B disc diffusion method and the instrument method (VITEK‐TWO) were adopted and the detection results were interpreted according to the standards of CLSI 2010 .The detection data of 480 drug‐resistant strains isolated from the sputum ,branchoalveolar lavage fluid samples submitted in 3 regions of respiratory outpatients department by bacterial cul‐ture identification and drug susceptibility test were analyzed by using the WHONET5 .6 statistical software .Results The distribu‐tion and constituent of drug‐resistant bacteria of lower respiratory tract infection had obvious difference among 3 different regions . The top 4 of drug resistant bacteria were dominated by Gram‐negative bacteria .The drug resistance rate of Klebsiella pneumoniae in RICU was higher than that in the respiratory outpatients department and wards(P<0 .05) ,the resistance rate in the respiratory outpatients department ,wards and RICU to commonly used antibacterial drugs was similar;the multiple drug resistance of ESBLs‐producing strains was obviously higher than that of non‐ESBLs‐producing strains (P<0 .05) .Pseudomonas aeruginosa maintained the higher antibacterial activity to quinolone ,aminoglucosides ,cefepime ,imipenem ,cefoperazone/sulbactam ,and piperacillin/tazobactam ,but the resistance rate in RICU was significantly higher that in the respiratory outpatient department and wards (P<0 .05);the drug resistance of Acinetobacter baumanii in the respiratory wards and RICU was higher than that in the respiratory out‐patient department ,the resistances to imipenem were 64 .6% and 70 .4% respectively .The resistance of MRSA to rifampin in RICU was higher than that in the respiratory outpatient department and wards(P<0 .05) .Conclusion The distribution constituent and drug‐resistance rates have obvious differences among the respiratory outpatient department ,wards and RICU .Except being familiar with the drug resitant bacterial distribution and drug resistance rate monitoring situation ,clinical doctors should grasp the drug re‐sistance situation of drug resistant bacteria among different areas in various departments of own unit in order to rationally and effec‐tively use antibacterial drugs .

An evaluation of left ventricular function in NMT by velocity vector imaging / 预防医学

Objective To evaluate of velocity vector imaging technology in methadone maintenance treatment patients. Methods From June to December in 2011,78 cases of heroin addicts were selected as observation group,and 78 healthy persons who received physical examination at the same period were selected as the control group.Velocity vector imaging technology was measured for both groups.Results All of early diastolic peak velocity and early diastolic max strain rate of the basement,left ventricular interval before,left ventricular apex,left ventricular wall between basement,in the left ventricular wall,the left ventricular segmental wall apex in observation group were significantly lower than that in the control group (P <0.05).Conclusion The velocity vector imaging technology could be applied to evaluate left ventricular function among methadone maintenance treatment patients.

Synthesis, characterization, and anti-cancer activity of emodin-Mn(II) metal complex / 中国天然药物

To synthesize and characterize a novel metal complex of Mn (II) with emodin, and evaluate its anti-cancer activity. The elemental analyses, IR, UV-vis, atomic absorption spectroscopy, TG-DSC, (1)H NMR, and (13)C NMR data were used to characterize the structure of the complex. The cytotoxicity of the complex against the human cancer cell lines HepG2, HeLa, MCF-7, B16, and MDA-MB-231 was tested by the MTT assay and flow cytometry. Emodin was coordinated with Mn(II) through the 9-C=O and 1-OH, and the general formula of the complex was Mn(II) (emodin)2·2H2O. In studies of the cytotoxicity, the complex exhibited significant activity, and the IC50 values of the complex against five cancer cell lines improved approximately three-fold compared with those of emodin. The complex could induce cell morphological changes, decrease the percentage of viability, and induce G0/G1 phase arrest and apoptosis in cancer cells. The coordination of emodin with Mn(II) can improve its anticancer activity, and the complex Mn(II) (emodin)2·2H2O could be studied further as a promising anticancer drug.

Study on the multi-marker components quantitative HPLC fingerprint of the compound chinese medicine wuwei changyanning granule

The aim of this paper is to develop a rapid and highly sensitive quantitative HPLC fingerprint method with multiple indicators by using the Compound Chinese Medicine Wuwei Changyanning granule and 5 herbs in the prescription. The quantitative fingerprint chromatogram with multiple indicators was investigated. i]6 compositions included rutin, gallic acid, chlorogenic acid, atractylenolide I, pachymic acid and apigenin, which originated from 5 herbs respectively, were selected as quantitative compositions, and their contents were determined using HPLC from 11 batches granules and the corresponding 5 medicinal materials. ii] The precision, stability and repeatability of fingerprinting were investigated. In addition, common peaks number, the percentage of non-common peaks and similarity were also studied. Among them, 21 common peaks in the granule could find the source of peaks from the 5 herbs, among of 10 peaks from Niuerfeng, 9 peaks from Laliao, 3 peaks from Baishu, 3 peaks from Fuling and 5 peaks from Guanghuoxiang. The results showed that the identification method of fingerprinting was reliable

Long term outcome of atrial fibrillation patients with KCNA5 and NPPA mutations post circumferential pulmonary vein ablation / 中华心血管病杂志

<p><b>OBJECTIVE</b>The outcome of atrial fibrillation patients with genetic mutations post ablation was not well evaluated.</p><p><b>METHODS AND RESULTS</b>Three atrial fibrillation patients with evidence of mutations in KCNA5 and NPPA post successful circumferential pulmonary vein ablation were included. Mutation in KCNA5 was found in one male patient with paroxysmal atrial fibrillation. He was free of atrial fibrillation post ablation after 46 months follow-up. Mutations in NPPA were found in two male patients with persistent atrial fibrillation and they were free from atrial fibrillation after 64 months and 38 months follow-up post circumferential pulmonary vein ablation, roof line and mitral isthmus line ablation.</p><p><b>CONCLUSION</b>Satisfactory long term results are observed in atrial fibrillation patients with KCNA5 and NPPA mutations post circumferential pulmonary vein ablation.</p>

Unsuspected gallbladder cancer during or after laparoscopic cholecystectomy / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To summarize the clinical features and outcomes of unsupected gallbladder carcinoma ( UGC) detected during or after laparoscopic cholecystectomy.</p><p><b>METHODS</b>Medical records of 8005 patients, who underwent laparoscopic cholecystectomy in Peking Union Medical College Hospital between June 1993 and June 2011, were reviewed. Patients that pathologically diagnosed as UGC were retrospectively studied in terms of clinical features, preoperative and postoperative diagnosis, surviving period, and complications.</p><p><b>RESULTS</b>In the 8005 patients who received laparoscopic cholecystectomy, 36 (0.45%) were diagnosed as UGC during (25 patients) or after (11 patients) laparoscopic cholecystectomy. The gallbladder cancer was staged as T1 in 16 patients, T2 in 11 patients, and T3 in 9 patients. The 1-, 3-, and 5-year survival rates of all the patients were 88.9% (32/36), 63.9% (23/36), and 58.3% (21/36). The 5-year survival rates in T1 stage, T2 stage, and T3 stage patients were 100%, 75.0%, and 0.0%, respectively.</p><p><b>CONCLUSIONS</b>The survival rate of UGC is associated with tumor stage, not with operation approaches. Laparoscopic cholecystectomy is appropriate for T1 patients.</p>

The Efficacy of Rotational Atherectomy in Coronary Artery Calcification Lesions used Domestic Drug Eluting Stent / 昆明医科大学学报

Objective To investigate the safety and efficacy of rotational atherectomy in coronary artery calcification lesions used domestic drug eluting stent.Methods Clinical data of 14 patients with 20 coronary artery calcification lesions were analyzed. The success rates and follow-up results of rotational atherectomy in coronary artery calcification lesions used domestic drug eluting stent were analyzed.Results Procedural success was achieved in all patients.No main adverse cardiovascular events (including cardiac death, Q wave myocardial infarction and emergency coronary surgery) occurred during operation. 9 patients (64.3%) were checked by coronary angiography after 9 months, and no one was found with in-stent restenosis. Conclusion Rotational atherectomy in coronary artery calcification lesions used domestic drug eluting stent is effective and safe in the treatment of coronary artery calcification lesions, it can increase the success rate of percutaneous coronary intervention .

Lamivudine, interferon-alpha and oxymatrine treatment for the surviving hepatic failure patients with hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effect of lamivudine, interferon alpha and oxymatrine treatment for surviving hepatic failure patients with hepatitis B.</p><p><b>METHODS</b>200 hepatitis B patients, including 100 subacute or acute-on-chronic hepatic failure survivals (group A), and 100 chronic (group B, n=100) hepatic failure survivals, were enrolled in this study. Patients in group A received interferon alpha (n=35), lamivudine (n=33) , or combinational lamivudine and oxymatrine (n=32) therapy for six months; Patients in group B received lamivudine (n=49), or combinational lamivudine and oxymatrine (n=51) therapy for six months, respectively. After the treatment, all patients were followed-up for six months.</p><p><b>RESULTS</b>At the end of follow-up, all patients in group A survived, while in group B three patients (6.1%) receiving lamivudine, and four (7.8%, P>0.05) receiving combinational therapy died; more than 90% of all survivals had their HBV DNA loss. The HBeAg/anti-HBe seroconversion rate in patients of group A treated with interferon alpha (9/17, 52.9%) was higher than that in patients treated with combinational lamivudine and matrine (5/16, 31.3%, P<0.05), which was higher than that in the patients treated with lamivudine alone (1/17, 5.9%, P<0.01), and the Knodell histological activity index score in patients treated with lamivudine (7.2+/-0.8, P<0.05) was lower than that in patients treated with interferon alpha (8.2+/-1.3, P<0.05), and the best efficacy was found in receiving combinational therapy (6.9+/-0.7, P<0.01); Lamivudine or lamivudine in combination with matrine significantly inhibited the intrahepatic inflammatory activities, but had no effect on the existing fibrosis in group B patients.</p><p><b>CONCLUSION</b>Long term nucleotide analogues treatment may delay the progress of fibrosis in hepatitis B-induced hepatic failure survivals, and the administration of matrine in time may further enhance the anti-fibrotic effect of nucleotide analogues.</p>

Clinical effect of Sizi Zhongwang capsule combined with Western medical therapy in treating male sterility / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the clinical effect of Sizi Zhongwang Capsule (SZC) combined with Western medicine (WM) in treating male sterility.</p><p><b>METHODS</b>Two hundred and sixty-one male patients with sterility were assigned to 3 groups, 64 in the WM group were treated with conventional Western medical therapy alone, 87 in the SZC group were treated with SZC alone, and 110 in the combined group were treated with SZC combined Western medical therapy. The treatment lasted for 90 days in total. Changes of semen related parameters before and after treatment were observed, and the conditions of pregnancy in patients' spouse were followed-up.</p><p><b>RESULTS</b>The difference in semen related parameters before and after treatment showed insignificant in the WM group (P > 0.05), but it did show statistical significance in the SZC group and the combined group (P < 0.05, P < 0.01). Moreover, the best effect was shown in the combined group, showing significant difference to the other two groups (P < 0.01, P < 0.05). The pregnancy rate of patients' spouse in the combined treated group was higher than that in the other two groups (P < 0.01, P < 0.05).</p><p><b>CONCLUSION</b>SZC combined with Western medical therapy could effectively improve the quality of semen in males with infertility and enhance the pregnancy rate in their spouse.</p>

Choice fusion therapy of PUMC Ⅱ d_2 adolescent idiopathic scoliosis A finite element analysis of optimal fusion segment / 中国组织工程研究

BACKGROUND:At present,experimental animal models of primate idiopathic scoliosis with erect feet have not been established.With rapid development of computer and imaging,we can use computer software to simulate models of human idiopathic scoliosis,and do relevant biomechanical analysis and provide instructions for clinical surgery operation.OBJECTIVE:To research the best surgical fusion level for the adolescent idiopathic scoliosis (AIS) of PUMC Ⅱ d_2 with the finite element model (FEM).DESIGN,TIME AND SETTING:The compadson observation was performed at the Department of Orthopedics,Beijing Union Hospital from May 2007 to May 2008.PARTICIPANTS:One female patient with PUMC Ⅱ d_2 scoliosis (double curve malformation) was included.METHODS:FEM (T5-S) of PUMC Ⅱ d_2 idiopathic scoliosis was used to simulate upper thoracic curve,lower lumbar curve and double curve fusion manners.Hollow lateral curvature pedicle of vertebral arch received 50,100,150 N load.Displacement of T_5 and T_(11) on upper sagittal plane (displacement of Z axis positive value on upper sagittal plane,displacement of negative value on lower sagittal plane) and their difference value were compared.T_5 displacement represented outcomes of double curve orthopaedics.T_(11) displacement represented outcomes of lower lumbar curve orthopaedics.Their difference value (T5-T11) represented outcomes of upper thoracic curve orthopaedics.MAIN OUTCOME MEASURES:Different fusion segments and displacement of T_5 and T_(11) under different orthopedic forces were measured.RESULTS:In PUMC Ⅱ d_2 lateral curvature,T_5 displacement on Z axis:fusion displacement of double curves was greater compared with upper curve alone or lower curve alone (P < 0.01 ).Difference of T_5-T_(11) displacement:double curves orthopaedics > upper thoracic curve orthopaedics alone > lower lumbar curve orthopaedics alone (P < 0.01).Displacement of T_(11) on Z axis:double curves orthopaedics > lower lumbar curve orthopaedics alone > upper thoracic curve orthopaedics alone (P < 0.01).CONCLUSION:Fusing two curves would get the best effect on the AIS of PUMC Ⅱ d_2 compared with upper curve alone or lower curve fusion alone.Effects of 3 kinds of load on correction of upper thoracic curve:double curve orthopaedics < upper thoracic curve orthopaedics alone > lower lumbar curve orthopaedics alone.Effect of 3 kinds of load on correction of lower lumbar curve orthopaedics alone:double curve orthopaedics > lower lumbar curve orthopaedics alone > upper thoracic curve orthopaedics alone.Three-dimensional finite element analysis is an effective method to analyze biomechanics of scoliosis deformity correction and provides a virtual non-invasive verification manner,and can optimize surgery scheme.

Color Doppler flow image of Budd-Chiari syndrome / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the diagnostic value of color Doppler flow image (CDFI) for the diagnosis of Budd-Chiari syndrome (B-CS).@*METHODS@#CDFI findings of 35 patients with B-CS were retrospectively analyzed and compared with the findings of venography of inferior vena cava (IVC).@*RESULTS@#Thirty-four patients were diagnosed as B-CS by CDFI, while one patient with local tunica stenosis was misdiagnosed. The correct diagnostic rate was 97.1%. In the 34 patients, CDFI displayed stenosis or occlusion in the hepatic vein and IVC in 24 patients, IVC only in 8,and hepatic vein only in 2.@*CONCLUSION@#CDFI may be a principal non-invasive technique to diagnose B-CS.