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Objective:To investigate the reproducibility of whole-heart and volume-targeted balanced steady-state free precession (bSSFP) non-contrast MR coronary angiography (CMRA) for displaying coronary trunks.Methods:From February and September 2021, the whole-heart and volume-targeted CMRA examinations of 58 volunteers were prospectively and consecutively acquired in The First Affiliated Hospital of Fujian Medical University. Each volunteer underwent CMRA twice within a week. The subjective score, vessel-to-myocardium ratio (VMR), vessel-to-fat ratio (VFR), signal-noise ratio (SNR), and coronary corresponding coordinate was analyzed and extracted. Inter-observer, intra-observer and inter-scan consistency were evaluated by intraclass correlation coefficient (ICC), Bland-Altman analysis, Hausdorff Distance (HD), and Dice Similarity Coefficient (DSC).Results:The inter-observer and intra-observer consistencies of subjective scores, VMR, and VFR of the whole-heart and volume-targeted coronary artery images were excellent (ICC>0.76, P<0.001). The inter-scan VFR consistencies of RCA, LM, and LCX of whole-heart coronary scans were moderate (ICC=0.235, 0.264, 0.380, all P<0.05), while the consistencies of the remaining variables were good, (all ICCs>0.49, P<0.001). Bland-Altman method showed that most VMR, VFR, and SNR of two CMRA imaging were within the 95% limits of agreement. Whole-heart CMRA inter-and intra-observer mean HD was 1.79 (1.35, 3.25), 1.68 (1.09, 4.10), mean DSC was 0.96±0.04, 0.97±0.03. Volume-targeted CMRA inter-and intra-observer mean HD were 1.74 (1.63, 3.11), 1.74 (1.63, 1.98), and the mean DSC was 0.91±0.10, 0.95±0.05. The subjective score of raw images of the total artery trunk of volume-targeted CMRA [3.86 (3.68,4.00) vs. 3.80 (3.58,3.96) ], VMR [1.45 (1.27,1.58) vs. 1.22 (1.13,1.41) ], and VFR [7.36 (6.44,8.60) vs. 5.97 (4.97,6.64) ] were better than those of whole-heart CMRA (all P<0.05). The overall subjective score of whole-heart CMRA coronary trunk curved projection reformation was better than volume-targeted CMRA [3.75 (3.57, 3.88) vs. 3.63 (3.44, 3.71)] ( P<0.001). Conclusions:Whole-heart and volume-targeted bSSFP non-contrast CMRA represent good reproducibility and image quality in the main coronary artery of healthy volunteers. Both of the two methods have their advantages and complement each other.
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Objective@#To investigate the effectiveness and safety of intraoperative sac coiling embolization among patients who are athigh-risk developing type-Ⅱ endoleak after endovascular aortic repair(EVAR).@*Methods@#From Jan 2014 to Jan 2018, one hundred and twelve consecutive patients with infra-renal AAA were enrolled for this study, There were 76 patients undergoing standard EVAR (standard-group)and 36 patients doing aneurysmal sac coiling embolization (embo-group). Baseline characteristics, aneurysmal sac parameters, radiological intervention details and follow up results were recorded.@*Results@#Mean follow-up time was 25.9 m for embo-group. During follow-up period, no coils-related complications were noted and no type-Ⅱ endoleak associated secondary interventions were reported. A mean of (2.72±1.16) coils (range 1-7) was used in the embo-group. The incidence of type Ⅱ endoleak was 30.3%(23/76) in standard-group and 11.1%(4/36) in embo-group(χ2=4.90, P=0.027). Logistic multivariate analysis revealed that the independent risk factors of type Ⅱ endoleak after endovascular aortic repair for high-risk patients were those EVAR without sac embolization and sac volume≥128 cm3. In the subgroup analysis (sac volume≥128 cm3), the incidence of type-Ⅱ endoleak was lower in embo-group compared to standard-group (χ2=6.07, P=0.014).@*Conclusion@#Intraoperative sac coiling embolization in high-risk patients is safe and effective in prevention of type Ⅱ endoleak. This preventive effect is more significant with large sac aneurysm compared to small sac aneurysm.
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Objective To investigate the effectiveness and safety of intraoperative sac coiling embolization among patients who are athigh-risk developing type-Ⅱ endoleak after endovascular aortic repair (EVAR).Methods From Jan 2014 to Jan 2018,one hundred and twelve consecutive patients with infrarenal AAA were enrolled for this study,There were 76 patients undergoing standard EVAR (standard-group) and 36 patients doing aneurysmal sac coiling embolization (embo-group).Baseline characteristics,aneurysmal sac parameters,radiological intervention details and follow up results were recorded.Results Mean follow-up time was 25.9 m for embo-group.During follow-up period,no coils-related complications were noted and no type-Ⅱ endoleak associated secondary interventions were reported.A mean of (2.72 ± 1.16) coils (range 1-7) was used in the embo-group.The incidence of type Ⅱ endoleak was 30.3％ (23/76) in standard-group and 11.1％ (4/36) in embo-group(x2 =4.90,P =0.027).Logistic multivariate analysis revealed that the independent risk factors of type Ⅱ endoleak after endovascular aortic repair for high-risk patients were those EVAR without sac embolization and sac volume ≥ 128 cm3.In the subgroup analysis (sac volume≥ 128 cm3),the incidence of type-Ⅱ endoleak was lower in embo-group compared to standard-group (x2 =6.07,P =0.014).Conclusion Intraoperative sac coiling embolization in high-risk patients is safe and effective in prevention of type Ⅱ endoleak.This preventive effect is more significant with large sac aneurysm compared to small sac aneurysm.
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Objective To observe the effect of sling exercise therapy combined with acupuncture at Jiaji acupoints on balance function of stroke patients with hemiplegia. Methods From October, 2013 to October, 2015, 40 hemiplegic stroke patients with balance dysfunction were randomized to control group and treatment group equally. Both groups accepted routine rehabilitation, while the treatment group com-bined with sling exercise therapy and acupuncture at Jiaji acupoints. They were assessed with Berg Balance Scale (BBS), 10-metre maxi-mum walking speed (10MWS), Fugl-Meyer Assessment of lower limbs (FMA-L) and modified Barthel Index (MBI) before and four weeks after treatment. Results The scores of BBS, FMA-L and MBI, and 10MWS improved in both groups (t>2.249, P2.954, P<0.01). Conclusion Sling exercise therapy combined with acupuncture at Jiaji acupoints can further improve the function of balance, walking and activities of daily living in stroke patients with hemiplegia.
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Objective To determine the minimal clinically important differences ( MCID) of chinese version of the Fugl-Meyer( FM) motor scale for evaluating the motor function of the stroke patients ( upper extremity, lower ex-tremity and total) . Methods The research used anchor-based methods and distribution-based methods together to determine the MCID of chinese version of the FM motor scale. Results The intra-rater retest reliabilities of chinese version of the FM motor scale of motor functions were 0. 997, 0. 989 and 0. 997 for upper extremity, lower extremi-ty, and the total. The inter-rater retest reliabilities were 0. 993, 0. 952 and 0. 990 respectively. The MCID of chi-nese version of FM motor scale were 4. 58 , 3. 31 and 6. 0 . Conclusion The MCID of chinese version of the FM motor scale which could be gained in this study can help both clinical and research staff to identify whether the im-proved effect of motor function, which assessed by chinese version of the FM motor scale, made sense or not in clinical trials or in clinical practice.