Diagnosis of perimenopausal coronary heart disease patients using radiomics signature of pericoronary adipose tissue based on coronary computed tomography angiography.

To assess whether the radiomics signature of pericoronary adipose tissue (PCAT) from coronary computed tomography angiography (CCTA) can distinguish between perimenopausal women with coronary heart disease (CHD) and those without coronary artery disease (CAD). This single-center retrospective case-control study comprised 140 perimenopausal women with CHD presenting with chest pain who underwent CCTA within 48 h of admission. They were matched with 140 control patients presenting with chest pain but without CAD, based on age, risk factors, radiation dose and CT tube voltage. For all participants, PCAT around the proximal right coronary artery was segmented, from which radiomics features and the fat attenuation index (FAI) were extracted and analyzed. Subsequently, corresponding models were developed and internally validated using Bootstrap methods. Model performance was assessed through measures of identification, calibration, and clinical utility. Using logistic regression analysis, an integrated model that combines clinical features, fat attenuation index and radiomics parameters demonstrated enhanced discrimination ability for perimenopausal CHD (area under the curve [AUC]: 0.80, 95% confidence interval [CI]:0.740-0.845). This model outperformed both the combination of clinical features and PCAT attenuation (AUC 0.67, 95% CI 0.602-0.727) and the use of clinical features alone (AUC 0.66, 95% CI 0.603-0.732). Calibration curves for the three predictive models indicated satisfactory fit (all p > 0.05). Moreover, decision curve analysis demonstrated that the integrated model offered greater clinical benefit compared to the other two models. The CCTA-based radiomics signature derived from the PCAT model outperforms the FAI model in differentiating perimenopausal CHD patients from non-CAD individuals. Integrating PCAT radiomics with the FAI could enhance the diagnostic accuracy for perimenopausal CHD.

Rupture of the right sinus of Valsalva aneurysm and formation of ventricular septal dissection and third-degree atrioventricular block: A case report.

Sinus of Valsalva aneurysm is a rare congenital or acquired cardiac structural abnormality. The sinus of Valsalva aneurysm refers to the local development defect of the aortic sinus wall. Under aortic hypertension, the sinus wall becomes thinner and expands outward. Its clinical manifestations range from asymptomatic to severe life-threatening complications caused by compression or rupture of important surrounding structures. A few cases of aortic aneurysm sinus with arrhythmias have been reported, including complete heart block. Here, we present the case of a 50-year-old male patient with recurrent syncope due to a third-degree atrioventricular block. We found a right sinus of Valsalva aneurysm that ruptured into the basal segment of the interventricular septum and formed a basal septal dissection on echocardiography, which could have caused a third-degree atrioventricular block. This case report highlights the importance of finding secondary etiologies in the sudden or transient onset of third-degree atrioventricular block and using echocardiography to evaluate patients with heart block.

Clinical effect of a guided resin cementation technique in the treatment of vertical food impaction / 口腔疾病防治

Objective@# To explore the clinical effect of a guided resin cementation technique on vertical food impaction symptoms and to provide a new method for the treatment of vertical food impaction. @* Methods @#Treatment of 76 patients with vertical food impaction with guided resin cementation was performed. A specially fabricated contact shaping wire was used to aid the shaping of the contact. Cementation was applied under a rubber dam with the total-etch technique with flowable composite resin. Patient subjective perception was recorded after treatment (i.e., “totally relieved”=3, “significantly improved”=2, “slightly improved”=1 and “no change”=0). Follow-up visits lasted for one year. Scores of 1 to 3 were recorded as effective. The efficiency rates at different times were calculated. @*Results@#Patient subjective perceptions scored 2.47, 2.21, 1.79, 1.30 and 0.97 on the day immediately after and 1, 3, 6, and 12 months after treatment, respectively. There were significant differences among scores at each time point (P<0.01). The Efficacy rate reached 91.78% immediately after treatment and was sustained above 50% within half a year. Management of resin debonding or fracture successfully relieved the symptoms again.@*Conclusion@#The guided resin cementation technique relieves vertical food impaction symptoms immediately, and the effect of the guided resin cementation technique is maintained for a short period of time. Management of resin debonding or fracture helps consolidate treatment outcomes.

[Clinical effectiveness of double-shaft classification and sequential diagnosis and treatment method of food impaction].

OBJECTIVE: This study aimed to determine the clinical effectiveness of double-shaft classification and sequential diagnosis and treatment of food impaction. METHODS: A total of 227 patients with food impactionwere subjected to double-shaft classification and subsequently treated by sequential diagnosis and treatment method. Treatment effectiveness was evaluated according to the subjective feelings of patientsat five time points (immediately after treatment and at 1, 3, 6, and 12 months after treatment). RESULTS: The average scores of patient's subjective perception were 2.00, 1.93, 1.59, 1.20, and 0.98 immediately and at 1, 3, 6, and 12 months after treatment, with treatment-efficiency values of 87.17%, 81.70%, 73.21%, 55.80%, and 44.59%, respectively. There were differences in scores of patient's subjective perception at each time point (P<0.05). CONCLUSIONS: Double-shaft classification and sequential diagnosis and treatment can effectively guide the treatment of food impaction.