Objective To investigate the procedure and clinical effect of revascularization for arterial occlusion in lower extremity. Methods From July 1998 to March 2005, 29 cases of arterial occlusion were treated by microsurgery. Of 29 cases, there 22 males and 7 females, aging 22-86 years, including 9 cases of thromboangiitis obliterans(TAO), 17 cases of arterial sclerosis obstruction(ASO) and 3 cases of diabetic foot(DF). The location was the left in 17 cases, the right in 11 cases and both sides in 1 case. All cases were inspected by color-Doppler ultrasonic scanning before operation. The cases of ASO and DF were checked with MRA. The results of examinations showed that the locations of arteriostenosis and obstruction were: in 9 cases of TAO, the distal superficial femoral artery in 3 cases, popliteal artery in 5 cases, bilateral dorsal metatarsal artery in 1 case; in 17 cases of ASO, common iliac artery in 2 cases, external iliac artery in 4 cases, femoral artery in 10 cases and popliteal artery in 1 case; and were all superficial femoral artery in 3 cases of DF. DSA examination confirmed that there was appropriate outflow in 15 cases. Basing on the location and extent of the arterial occlusion, 11 cases were treated by the primary deep vein arterializing, 16 cases by arterial bypass distribution and 2 cases of extensive common iliac arterial occlusion were amputated in the level of 1/3 distal thigh. Results The postoperative duration of follow-up for all cases was 3 months to 7 years. In 9 cases of TAO, 2 healed by first intention after deterioration, 4 healed after changing dressing and 3 had fresh soft tissue growth after debrided superficial secondary necrosis. In 17 cases of ASO, 13 healed by first intention, 2 healed after changing dressing and 2 were amputated. In 3 cases of DF, 2 healed after changed dressing and debrided, 1 was aggravated with the second toe necrosis. Conclusion Performing primary deep veinarteriolization and arterial bypassdistribution is effective for treatment of arterial occlusion of lower extremity. The arterial reconstructive patency rate can be improved by microsurgical treatment.
Objective To study the predictive value of red blood cell distribution width in severity stratification of community-acquired pneumonia(CAP). Methods One-hundred and seventeen CAP patients admitted between August 2014 and August 2015 were recruited in the study.According to the severity of CAP evaluated by pneumonia severity index (PSI)and CURB score,the patients were divided into a severe group,a moderate group and a mild group with 39 cases in each group.Meanwhile 39 healthy volunteers were recruited as control.The blood red blood cell distribution width and high sensitive C-reactive protein(hs-CRP)levels were measured in all subjects. Results The PSI score and CURB score were significantly higher in the CAP patients than the control group and increased with the deterioration of the disease.The red blood cell distribution width and hs-CRP level were also significantly higher in the CAP patients than the control group and increased with the deterioration of the disease (P<0.05). Conclusion The red blood cell distribution width is correlated with the severity of CAP and has predictive value in CAP severity stratification.
Objective To explore the prognostic value of red cell volume distribution width (RDW) for hematological malignancies. Methods PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were searched for related literatures on myelodysplastic syndrome, leukemia and other hematological malignancies and pretreatment RDW from the establishment of databases to April 5, 2022. The main statistical indicators were Hazard ratio (HR) and its 95% confidence interval (CI). Stata 12.0 SE software was used for analysis, and Q test was used to evaluate literature heterogeneity. Subgroup pooled analysis was used to evaluate the prognostic value of RDW. Results A total of 7 articles were included, with a total of 804 patients. A fixed-effect model was selected for meta-analysis, and the results showed that patients with elevated pretreatment RDW had worse overall survival [HR=2.91, 95%CI (2.01, 4.22), I2=0%, P=0.714]. The results of subgroup analysis for different types of diseases showed that in myelodysplastic syndrome group [HR=2.61, 95%CI (1.28, 5.31), I2=22.0%, P=0.258)], chronic myeloid leukemia group [HR= 3.24, 95%CI (1.91, 5.51), I2=0%, P=0.546], and adult T-cell leukemia/lymphoma group [HR=2.64, 95%CI (1.22, 5.70)], the overall survival rate of patients with elevated pretreatment RDW were worse. Sensitivity analysis showed that the study was stable and there was no heterogeneity in the overall study result.Conclusion Elevated pretreatment RDW is associated with overall survival and can be used as an indicator for evaluating the prognosis of hematological malignancies, but large sample studies are still needed to determine the best predictive cutoff for various diseases.
Objective To prepare a new glycoproteinopticin specific antibody and to explore the distribution of opticin in human eye. Methods Firstly, take the opticin specific antibody to compound a synthetic peptide chain（CLPRLPIGRFT）, and then get the opticin antibody. To verify the availability of antibody through the western blot for human vitreous extract, to test the distribution of opticin in human eye by immunohistochemistry. Results Through the western blot for human vitreous extract, we can see a band with wild range at molecular weight 45times;103~50 times;103. We find that opticin exact in retina, vitreous and non-pigmented epithelium of ciliary body which distributes along the collagen fibrils in vitreous. Conclusion The availability of the antibody was confirmed by western blot. Opticin are mainly in retina, vitreous and nonpigmented epithelium of ciliary body. Opticin distributes along the collagen fibrils which may be related to the stability of vitreous. （Chin J Ocul Fundus Dis，2008，24：286-288）
Objective To investigate the role of red cell distribution width ( RDW) in coronary artery diseases patients complicated with obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods 134 coronary artery diseases patients who had at least one-vessel disease confirmed by coronary angiography were investigated by polysomnography for OSAHS. The patients were classified according to theapneahypopnea index(AHI) . The level of RDW, triglyceride, cholesterol, high density lipoprotein, low density lipoprotein, hemoglobin, white blood cells and hematocritwere measured. The receiver operating characteristic curve was drawn to predict the moderate-severe OSAHS in coronary artery diseases patients according to RDW value. Results When 134 coronary artery diseases patients were classified into a control group and an OSAHS group according to the AHI, the level of RDW in two groups was not significantly different [ ( 13.44 ±1.30) % vs. ( 13.12 ±0.92) % , P gt; 0.05] . When 134 coronary artery diseases patients were classified into a control and mild OSAHS group and a moderate-severe OSAHS group according to the AHI, the level of RDW in two groups was significantly different [ ( 13.07 ±0.94) vs. ( 14.02 ±1.41) % , P lt; 0.05] . And no difference was found in hemoglobin, triglyceride, cholesterol, high density lipoprotein, low density lipoprotein, platelet, and hematocrit between two groups. The ROC curve analysis revealed that the area under ROC curve was 0.748 ( 0.523-0.972) , and the best cut-off for moderate-severe OSAHS was 13.95% with sensitivity of 71.43% and specificity of 82.98% . Conclusion RDW may be a useful and simple tool to predict moderate-severe OSAHS in coronary artery diseases patients.
Objective To survey the drug distribution status in 24 township medical units in Shuangliu county, so as to provide references to explore the drug distribution mode for well-off township hospital. Methods An outline was made to interview the relevant workers who were in charge of the rural drug distribution management in all levels of the food and drug supervision bureaus of Sichuan province, Chengdu city or Shuangliu county, the township hospitals, the village clinics, and the drug distribution enterprises. At the same time, a self-designed questionnaire was distributed to 24 county township medical units (ie, three central township hospitals, three community health centers, and 18 general township hospitals). The Epidate3.1 was used for data-inputting, and the SPSS 17.0 was used for descriptive statistics and stratified analyses. Results At present, there was only one enterprise taking responsibility of the rural drug distribution in Shuangliu county since the strategy of enterprise direct-distribution under “two nets” supervision starting iShuangliu county of Sichuan province; Township medical units; Drug distribution; Status surveyn 2003, and there was no obvious difference in distribution before and after that strategy. The general satisfaction of 24 county township medical units with the distribution enterprise was only 50%, and the satisfaction with the price and the number of drug distribution was the lowest, accounting for 37.5% and 33.3%, respectively. Conclusion The enterprise direct-distribution under the “two nets” supervision for rural drug distribution makes the drug distribution market regular and gets good social effect, but there are still the same problems such as lack of marketization, low transparency, and high drug price, so it is necessary to introduce a new competition and management mechanism to promote the new breakthrough in rural drug distribution.
Objective To establ ish sophisticated three-dimensional finite element model of the lower cervical spine and reconstruct lower cervical model by different fixation systems after three-column injury, and to research the stress distribution of the internal fixation reconstructed by different techniques. Methods The CT scan deta were obtained from a 27-year-old normal male volunteer. Mimics 10.01, Geomagic Studio10.0, HyperMesh10.0, and Abaqus 6.9.1 softwares were usedto obtain the intact model (C3-7), the model after three-column injury, and the models of reconstructing the lower cervical spine after three-column injury through different fixation systems, namely lateral mass screw fixation (LSF) and transarticular screw fixation (TSF). The skull load of 75 N and torsion preload of 1.0 N•m were simulated on the surface of C3. Under conditions of flexion, extension, lateral bending, and rotation, the Von Mises stress distribution regularity of internal fixation system was evaluated. Results The intact model of C3-7 was successfully establ ished, which consisted of 177 944 elements and 35 668 nodes. The results of the biomechanic study agreed well with the available cadaveric experimental data, suggesting that they were accord with normal human body parameters and could be used in the experimental research. The finite element models of the lower cervical spine reconstruction after three-column injury were establ ished. The stress concentrated on the connection between rod and screw in LSF and on the middle part of screw in TSF. The peak values of Von Mises stress in TSF were higher than those in LSF under all conditions. Conclusion For the reconstruction of lower cervical spine, TSF has higher risk of screw breakage than LSF.
Objective To establ ish sophisticated three-dimensional finite element model of reconstructing the whole pelvis and defects in pelvis caused by the resection of periacetabular tumor, and to research the stress distribution regularity ofthe pelvis reconstructed by the fibular transplantation through three different internal fixation techniques. Methods The CTdatasets including L3 to middle-femur, unilateral fibular and internal fixation system from 1 healthy 35-year-old male volunteer were collected to establ ish finite element models of reconstructing the pelvis after the resection of periacetabular tumors through 3 different internal fixation means, namely fibular with plates, pedicle-rods and sacral-il iac rods. Bilateral leg standing position was simulated, then vertical load of 500 N was imposed on the surface of L3, the stress distribution regularity of reconstructed pelvis, transplanted fibular and internal fixation system were evaluated. Results The finite element models of the pelvis reconstruction after resection of periacetabular tumors were establ ished. The stress concentration of transplanted fibular was extremely high in the vicinity of the host junction sites. For the three internal fixation systems, the connection between steel plate and screw or between titanium bar and screw inclined to have stress concentration; and when the titanium bar was adopted to reconstruct, the transplanted fibular and the healthy side of femoral neck had less stress concentration, while sacral-il iac rods had the most obvious stress concentration. Conclusion For the reconstruction pelvis, the three fibula transplantation and steel plate internal fixation are consistent with intact state of pelvis in terms of the stress distribution, which is a relatively good method for the treatment of bone defect after periacetabular tumor. The finite element model can be used as a tool for the pelvis biomechanics research.
In the present work, Monte Carlo simulations were employed to study the characteristics of the dose distribution of high energy electron beam in the presence of uniform transverse magnetic field. The simulations carried out the transport processes of the 30 MeV electron beam in the homogeneous water phantom with different magnetic field. It was found that the dose distribution of the 30 MeV electron beam had changed significantly because of the magnetic field. The result showed that the range of the electron beam was decreased obviously and it formed a very high dose peak at the end of the range, and the ratio of maximum dose to the dose of the surface was greatly increased. The results of this study demonstrated that we could change the depth dose distribution of electron beam which is analogous to the heavy ion by modulating the energy of the electron and magnetic field. It means that using magnetic fields in conjunction with electron radiation therapy has great application prospect, but it also has brought new challenges for the research of dose algorithm.
Heart sound segmentation is a key step before heart sound classification. It refers to the processing of the acquired heart sound signal that separates the cardiac cycle into systolic and diastolic, etc. To solve the accuracy limitation of heart sound segmentation without relying on electrocardiogram, an algorithm based on the duration hidden Markov model (DHMM) was proposed. Firstly, the heart sound samples were positionally labeled. Then autocorrelation estimation method was used to estimate cardiac cycle duration, and Gaussian mixture distribution was used to model the duration of sample-state. Next, the hidden Markov model (HMM) was optimized in the training set and the DHMM was established. Finally, the Viterbi algorithm was used to track back the state of heart sounds to obtain S1, systole, S2 and diastole. 500 heart sound samples were used to test the performance of our algorithm. The average evaluation accuracy score (F1) was 0.933, the average sensitivity was 0.930, and the average accuracy rate was 0.936. Compared with other algorithms, the performance of our algorithm was more superior. It is proved that the algorithm has high robustness and anti-noise performance, which might provide a novel method for the feature extraction and analysis of heart sound signals collected in clinical environments.