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Objective:To explore the technical feasibility of CT feature tracking (CT-FT) technique in evaluating left ventricular myocardial strain and evaluate the change of myocardial strain in patients with coronary heart disease.Methods:Eighty-one patients with coronary heart disease (lesion group) and 33 patients with normal coronary artery (control group) matched with age and sex were collected retrospectively from the Second Affiliated Hospital of Nanchang University from April 2019 to October 2020. The lesion group was first divided into single vessel stenosis group (42 cases) and multi vessel stenosis group (39 cases) according to the number of coronary artery stenosis branches, and the global myocardial strains of the left ventricle between the groups were analyzed. Lesion site included the left anterior descending branch (LAD), right coronary artery (RCA) and left circumflex branch (LCX), respectively. According to the degree of vascular stenosis, the lesion groups were divided into normal group, mild stenosis group, moderate stenosis group and severe stenosis group. The segmental myocardial strains of the branch segment of LAD, RCA or LCX were analyzed between groups. All CCTA examinations were performed with retrospective electrocardiogram gating. CVI 42 cardiac postprocessing software was used to obtain myocardial strain parameters, including global peak longitudinal strain (GPLS), global peak circumferential strain (GPCS), global peak radial strain (GPRS), and the segmental myocardial strains of the branch segment of LAD, RCA or LCX. The segmental myocardial strains included the peak longitudinal strain (PLS), peak circumferential strain (PCS) and peak radial strain (PRS). One way ANOVA or Kruskal Wallis H test were used for multi group analysis. Results:With the increased number of coronary artery stenosis branches, the absolute value of GPLS gradually decreased. The GPLS of the control group, single vessel stenosis group and multi vessel stenosis group were -14.1%±2.7%, -11.5%±2.3% and -8.8%±2.0%, respectively. The difference of GPLS between the 3 groups or any 2 groups was statistically significant (all P<0.001). The absolute values of GPRS and GPRS in multi vessel stenosis group were significantly lower than those in control group and single vessel stenosis group (all P<0.001). There was no significant difference in GPRS or GPRS between single vessel stenosis group and control group ( P=0.083, 0.118). And there were significant differences in the segmental myocardial strains of the branch segment of LAD, RCA or LCX among 3 groups ( P<0.001). In severe stenosis group, the absolute values of PRS, PCS and PLS in LAD, RCA or LCX were significantly lower than those in moderate stenosis group, mild stenosis group and normal group (all P<0.05). In the moderate stenosis group, the absolute value of PLS in each branch segment was lower than that of the mild stenosis and normal group (all P<0.05), and there was no significant difference in any 2 other myocardial strain parameters of each branch (all P>0.05). Conclusions:CT-FT technique was feasible to evaluate left ventricular myocardial function. With the increased number or degree of coronary artery stenosis, the global and segmental myocardial strain parameters of left ventricle gradually decreased, and the longitudinal strain was more sensitive.
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Objective To explore clinical value of cardiac MRI feature tracking (CMR-FT) in evaluation of left ventricular global and regional myocardial strain in hypertrophic cardiomyopathy (HCM).Methods Totally 60 patients with HCM (HCM group) and 10 healthy volunteers (control group) were enrolled and underwent cardiac MR.MR Sequences included fast imaging employing steady state acquisition (FIESTA) and late gadalinum enhancement (LGE) at ventricular short-axis,two-chamber and four-chamber planes.The patients in HCM group were divided into LGE negative subgroup and LGE positive subgroup.CMR-FT processing software was used to measure myocardial global radial peak strain (GPSR),global circumferential peak strain (GPSC) and global longitudinal peak strain (GPSL).The radial,circumferential and longitudinal peak strain (PSR,PSC and PSL) at the apex,middle and basal parts of left ventricular were also measured as well.Resuits GPSR,GPSC,GPSL in LGE positive subgroup,LGE negative subgroup and control group had significant differences (all P＜0.05),and showed upward trends.Except PSL at the apex had no significent difference among three groups,PSR,PSC and PSL at the apex,middle and basal parts had significant differences (all P＜0.05),and also showed upward trends.There were positive correlations between the LVEF,SV and GPSR,GPSC,GPSL (all P＜0.05).The area under ROC curve of GPSR,GPSC and GPSL in diagnosis of HCM were 0.79,0.82,0.77 (all P＜0.05),and the area under ROC curve of GPSC was the largest.Conclusion The CMR-FT technology can find myocardial strain dysfunction in HCM sensitively,and the longitudinal strain is damaged earlier or worse than circumferential and radial strains.
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Objective To explore the mechanism and inhibition of botulinum toxin type A (BTXA) on hypertrohic scar fibroblasts.Methods The cells were treated by 0 (control),0.2,0.4,0.8 U/ml BTXA for 48 h.Cell viability was detected by MTT assay.Cell apoptosis was detected by Hoechst staining.Cell cycle was detected by flow cytometry.The level of cell cycle related protein D1 (Cyclin D1),proliferation nuclear antigen (PCNA) and activation of phosphatidylinositol 3 kinase (PI3K) / protein kinase B (AKT) signaling pathway were assayed by western blot.Results Compared with control group(0.75±0.07),0.2,0.4,0.8 U/mL BTXA(0.59 ± 0.06,0.43 ± 0.04,0.34± 0.03) inhibited hypertrohic scar fibroblasts cell viability,increased cell apoptotic rate[control group(2.38±0.24)％;BTXA(15.79±1.54)％,(27.32±2.69)％,(38.46±3.90)％],down-regulated the expression of Cyclin D1(control group 1.57±0.18;BTXA 0.93±0.07,0.42±0.04,0.35±0.03) and PCNA(control group 1.46±0.16;BTXA 0.50±0.05,0.59±0.05,0.37±0.03),inhibited the expression of PI3K(control group 0.98±0.06;BTXA 0.49±0.04,0.50±0.04,0.39±0.03) and the phosphorylation of AKT(control group 1.38±0.08;BTXA 0.97±0.06,0.60±0.04,0.29± 0.02),made cell cycle arrested in G1 phase,The difference was statistically significant (P＜0.05).Conclusion These results suggested BTXA inhibit proliferation via blocking the activation of PI3K/AKT signal pathway and down-stream related cell cycle related protein.
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Objective To evaluate the coronary microvascular dysfunction in patients with hypertrophic cardiomyopathy(HCM) by MR first-pass perfusion and late gadolinium enhancement. Methods From January 2011 to May 2015, 47 cases with HCM (HCM group) from the second affiliated hospital of Nanchang University were retrospectively analyzed. Additionally, 21 healthy volunteers were recruited as the control group. HCM group and control group underwent cardiac MR examinations at rest, including short axial cine, first-pass myocardial perfusion and late gadolinium enhancement scanning. Time to peak(tpeak), maximal upslope of time-intensity curve(Slopemax), peak signal intensity(SIpeak), myocardial thickening, and late myocardial gadolinium enhancement(LGE) were assessed for each myocardial segment. HCM group were divided into LGE segments group and non-LGE segments group. LGE segments group were divided into mild, moderate and severe LGE segments group. The SIpeak, Slopemax and tpeak in multiple groups were compared by one-way ANOVA and Kruskal-Wallis test. Spearman correlation tests were used to determine the relationships between perfusion parameter and LGE. Results The average values of tpeak in non-LGE segments group (527 segments), LGE segments group (225 segments) and control group (336 segments) were (67.0 ± 27.4), (79.4 ± 27.4), (59.7 ± 21.6)s, respectively. The average values of Slopemax in the three groups were 17.2±7.0, 16.4±7.4, 20.4±6.3, respectively. The average values of SIpeak in the three groups were 442.7 ± 143.2, 465.1 ± 138.4, 521.9 ± 146.7, respectively. Compared to the control group, tpeak increased and Slopemax, SIpeak decreased in non-LGE segments group and LGE segments group (P0.05). There were significant differences among LGE segments groups, as the tpeak and SIpeak increased with increasing degrees of myocardial LGE (P0.05). The degree of LGE were positively correlated with tpeak (r=0.237, P<0.01). Conclusions 3.0 T magnetic resonance myocardial perfusion imaging can show microvascular dysfunction accurately and reliably in non-LGE segments. It may be helpful in the early diagnosis of coronary microvascular dysfunction for HCM.
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Objective To study the value of MR diffusion tensor imaging(DTI) in the staging of chronic kidney disease(CKD).Method MR diffusion tensor imaging was used on 26 CKD patients.All patients were diagnosed as CKD according to the criteria of clinical diagnostic.All MR images achieved diagnostic requirements.Diethylenetriamine pentaacetic acid(99mTc-DTPA) renal dynamic imaging was used to determine the unilateral renal function.CKD patients were determined as mildly renal impairment group and moderately to severely renal impairment group based on the glomerular filtration rate(GFR).Twenty healthy volunteers underwent DTI at the same time.The cortical and medullary ADC value and FA value were measured in all subjects who underwent conventional MRI and DTI.The paired Student's t test was used to compare the cortico-medullary difference of the mean ADC and FA values in all subjects.The oneway analysis of variance(ANOVA) was carried out to assess the difference among the medullary and cortical diffusion parameters(ADC,FA) of all the three groups,and LSD was used to assess multiple comparisons.The correlation of GFR and ADC value of the patients,and FA value of the patients were tested by Pearson correlation analysis.Results The cortical and medullary ADC values of 46 subjects were(2.25±0.25) × 10-3 and(2.10±0.20) × 10-3 mm2/s respectively,FA of them were(3.48±0.61) and(4.27±0.75) respectively(t =6.754,10.043 respectively; P＜0.01).The cortical ADC values of volunteers,mild renal impairment group,severely renal impairment group were(2.25±0.22) ×10-3,(2.31±0.19) ×103,(2.18±0.32) ×10-3mm2/s respectively.The medullary ADC value of the three groups were(2.09±0.19) × 10-3,(2.17±0.17) × 10-3,(2.06±0.24) × 10-3mm2/s respectively(F=0.968,0.882 respectively; P＞0.05).The cortical FA values of the three groups were 3.85± 0.47,3.18±0.62,3.20±0.52 respectively.The medullary FA of the three groups were 4.92±0.38,3.93±0.57,3.62 ± 0.53(F=8.725,33.705 respectively; P＜0.01).There was no correlation between cortical ADC,medullary ADC,cortical FA of the patients and GFR [(30.14±15.79) ml· min-1 · 1.73 m-2](r =0.243,0.197,0.196 respectively; P＞0.05).There was a positive correlation between medullary FA of the patients and GFR (r=0.556,P=0.003).Conclusion FA value has certain value in evaluating CKD early diagnosis and renal function.
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OBJECTIVE To investigate the factors related to sharp injuries of medical staff and explore the standardized occupational safety management model. METHODS According to the recent 4-year registration of 66 cases of medical staff suffered from exposure to sources of blood-transmitted diseases because of sharp injury,a retrospective investigation was taken and the relevant factors were analyzed. RESULTS Operating room and transfusion room had a high incidence of sharp injury,36.4% and 9.1%,respectively. It occurred frequently in treatment of the morning hours (45.5%). As lack of occupational safety prevention and awareness of the standardized preventive measures,there was a high incidence in lower stage clinical medical staff and interns (60.6%). CONCLUSIONS It is necessary to pay attention to the occupational safety standardized management of sharp injuries for medical staff in order to promote medical professional safety.