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Objective:To investigate the current basic situation of ultrasound machines of ultrasound departments in Shanghai medical institutions, and to provide the basis for making management policy in order to promote medical quality.Methods:Questionnaire surveys about ultrasound machines and service ability including producing countries of ultrasound machines, the number of ultrasound machines, using years of ultrasound machines, yearly workload and the yearly number of patients that each ultrasound machine accepted were made in 2013 and 2018, respectively. Statistical results were compared between the two surveys.Results:Compared with 2013, the share of imported ultrasound machines declined in 2018 (82% vs 91%). Compared with 2013, the number of ultrasound machines in Shanghai medical institutions had increased by 31% in 2018 (2 123 vs 1 617). The occupancy rate of ultrasound machines in tertiary hospitals was the highest (tertiary hospitals 40%, secondary hospitals 25%, primary grade hospitals 20%, and private hospitals 15%). Compared with 2013, the proportion of ultrasound machines that have been used for more than 10 years increased (9% vs 4%), the yearly workload of ultrasound examination had increased by 46% (19.82 million person-time vs 13.59 million person-time). Tertiary hospitals bored the highest proportion of the workload (tertiary hospitals 51%, secondary hospitals 35%, primary grade hospitals 4%, and private hospitals 10%). Currently, the number of ultrasound machines per 10, 000 people in Shanghai was 1.14. The yearly number of patients that each ultrasound machine accepted had increased by 11% (9300 person-time vs 8400 person-time in 2018).Conclusions:The scale of ultrasound departments in Shanghai medical institutions has been developing. Brand localization of ultrasound machines is improving. However, the renewal ability of ultrasound machines still needs to be improved. The workload of ultrasound department is getting heavier. Hierarchical diagnosis and treatment is unbalanced.
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Objective@#To investigate the current basic situation of ultrasound machines of ultrasound departments in Shanghai medical institutions, and to provide the basis for making management policy in order to promote medical quality.@*Methods@#Questionnaire surveys about ultrasound machines and service ability including producing countries of ultrasound machines, the number of ultrasound machines, using years of ultrasound machines, yearly workload and the yearly number of patients that each ultrasound machine accepted were made in 2013 and 2018, respectively. Statistical results were compared between the two surveys.@*Results@#Compared with 2013, the share of imported ultrasound machines declined in 2018 (82% vs 91%). Compared with 2013, the number of ultrasound machines in Shanghai medical institutions had increased by 31% in 2018 (2 123 vs 1 617). The occupancy rate of ultrasound machines in tertiary hospitals was the highest (tertiary hospitals 40%, secondary hospitals 25%, primary grade hospitals 20%, and private hospitals 15%). Compared with 2013, the proportion of ultrasound machines that have been used for more than 10 years increased (9% vs 4%), the yearly workload of ultrasound examination had increased by 46% (19.82 million person-time vs 13.59 million person-time). Tertiary hospitals bored the highest proportion of the workload (tertiary hospitals 51%, secondary hospitals 35%, primary grade hospitals 4%, and private hospitals 10%). Currently, the number of ultrasound machines per 10, 000 people in Shanghai was 1.14. The yearly number of patients that each ultrasound machine accepted had increased by 11% (9300 person-time vs 8400 person-time in 2018).@*Conclusions@#The scale of ultrasound departments in Shanghai medical institutions has been developing. Brand localization of ultrasound machines is improving. However, the renewal ability of ultrasound machines still needs to be improved. The workload of ultrasound department is getting heavier. Hierarchical diagnosis and treatment is unbalanced.
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Objective To investigate the value of three-dimensional speckle tracking imaging (3D-STI) in quantitative evaluation of left ventricular global strain in patients with atrial septal defect (ASD) before and after transcatheter closure.Methods Totally 35 patients with secondary ASD who received successful transcatheter occlusion were selected.Routine echocardiography and 3D-STI examination were performed before the operation,2 days,1 month,3 months and 6 months after the operation.Routine echocardiography was used to obtain the parameters of left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter (LVEDS),left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV),stroke volume (SV) and other parameters.The left ventricular global peak longitudinal strain (GPLS),left ventricular global peak circumferential strain (GPCS),left ventricular global peak radial strain (GPRS) and left ventricular global peak area strain (GPAS) were examined with 3D-STI.The preoperative and postoperative parameters at each time point were analyzed statistically.Results Routine echocardiography showed that LVEDD,LVEDS,LVEDV,LVESV and SV increased significantly after operation,but no significant difference was found to compare each other 2 days,1 month,3 months and 6 months after operation (all P＞0.05).3D-STI examination showed that left ventricular GPLS,GPCS,GPRS and GPAS increased after operation,and the most increase was noticed at the second day after transcatheter occlusion.GPLS,GPCS and GPAS 6 months after operation were larger than those 3 months after operation (all P＞0.05).Conclusion 3D-STI technique can evaluate the left ventricular global strain in patients with ASD before and after occlusion.Compared with conventional echocardiography,3D-STI technique can objectively and effectively evaluate the changes of left ventricular systolic function.
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Objective@#To explore the application of real-time three-dimensional ultrasound in locating the course, the brand and the blind end of internal opening of congenital preauricular fistula.@*Methods@#Congenital preauricular fistula patients from Changhai Hospital were studied. All the cases were evaluated using two-dimensional and three-dimensional ultrasound before surgeries. The surgery findings were utilized as the gold standard. The imaging features of 3D ultrasound were described to determine the accuracy of the blind end location, the course of the main fistula tract and the branch tracts. The diagnosis was compared with the surgery findings.@*Results@#In 89 cases, among which there were 21 branch fistulae. There were 68 bend fistulae without branch. The diagnostic accuracy of both two-dimensional ultrasound and three-dimensional ultrasound was 100%. The accuracy in locating the blind end of internal opening, the course of the branch tracts with 3D ultrasound was 92.1%(82/89), 85.7%(18/21) , compared to 80.9%(72/89), 57.1%(12/21) with 2D ultrasound. It was obvious that 3D ultrasound had more advantages. These differences were statistically significant (χ2=4.8, P<0.05; χ2=4.2, P<0.05).@*Conclusions@#Compared with 2D ultrasound, 3D ultrasound can accurately locate the blind end of internal opening, the course, and the branch of preauricular fistula, clearly display the morphology and the spatial structure of preauricular fistulaand its surroundings. It has high clinical application value in preoperative imaging examination.
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Objective To investigate the correlation between serum osteocalcin and type 2 diabetes mellitus (T2DM) in elderly patients.Methods A total of 55 T2DM patients (diabetic group) and 50 non-diabetic subjects (control group) aged ≥60 years were enrolled in this study.The levels of fasting blood glucose (FBG),glycated hemoglobin (HbAlc),insulin resistance index (HOMA IR),osteocalcin (OC),body mass index (BMI) and bone mineral density (BMD) in groups were compared.The correlations between serum osteocalcin and the above indicators were analyzed.Results The levels of OC and BMD were higher in control group than in diabetic group [(11.2±3.2)μg/Lvs.(4.1±3.0)μg/L,(-1.3±0.3) vs.(-2.6±0.5),respectively,both P＜0.05].The levels of FBG,HbAlc,FINS,HOMA-IR were lower in control group than in diabetic group [(4.7±2.0) mmol/L vs.(9.4±2.1) mmol/L],[(4.8±1.5) ％ vs.(7.6±1.6)％,(7.4±3.2) U/L vs.(23.7±3.0) U/L,(1.5±0.7) vs.(9.9±1.2),respectively,all P＜0.05].Serum osteocalcin concentration was negatively correlated with the levels of FBG,HbAlc,FINS and HOMA-IR in elderly patients with T2DM (r=-0.739,-0.713,-0.613,-0.092,all P＜0.01).Conclusions Serum osteocalcin concentration is correlated with the levels of blood sugar and insulin resistance index in elderly patients with T2DM.A further study on the correlation between osteocalcin and T2DM may provide a new target for the treatment of type 2 diabetes mellitus.
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ObjectiveTo study the association of SNP276 in adiponectin gene with impaired glucose regulation (IGR) complicating with the different component numbers of metabolism syndrome (MS) in population of IGR in Han people of Shanxi region.MethodsThe study population consisted of 256 subjects with IGR which was composed of 123 subjects with component numbers of MS ＜2 (IGRA) and 133subjects with component numbers of MS≥2 (IGRB),and 128 subjects with normal healthy (Normal) who were Chinese Hans residents and in Shanxi province.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was applied to test the adiponectin SNP276G/T polymorphism.ResultsThe distributions of genotypes and alleles of SNP276 both displayed significant difference among the three groups ( x2 =16.893,P =0.002 ; x2 =18.149,P =0.000).In the IGRA,the SNP276 non-TT ( GT + GG) genotype was no difference which increased risk of complicating with the different component numbers of MS( P =0.781,P =0.809).In IGRB,the SNP276 non-TT ( GT + GG) genotype was associated with increased risk of complicating with the different component numbers of MS,and after age and sex-adjusted,there was significant difference ( P =0.007,P =0.007).ConclusionsSNP276 in APM1 increased the risk of complicating with the components of MS in population with impaired glucose regulation in Han people of Shanxi region.
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Objective To observe the effect of oxidized low-density lipoproteins (Ox-LDL),15-Deoxy-△ 12,14-prostaglandin J2 ( 15d-PGJ2 ),leukotrienes B4 ( LTB4 ) on mRNA expressions of peroxisome proliferator activated receptor γ2 ( PPARγ2 ),receptor activator of NF-κB ligand (RANKL),alkaline phosphatase ( ALP),and osteoprotegerin(OPG) in osteoblastic cells of rats; and to investigate the influence of these PPARγ2 endogenous ligands on bone metabolism.Methods Rat osteoblastic cells were cultured in vitro for 24 h in medium with different PPARγ2 endogenous ligands at various concentrations ( the final concentrations of Ox-LDL were 0,12.5,25,50μg/ml; the final concentrations of 15 d-PGJ2 were 0,10,20,30 μmol/L; the final concentrations of LTB4 were 0,0.1,1.0,10 μ mol/L).RT-PCR was performed to determine the mRNA expressions of PPARγ2,RANKL,ALP,and OPG in osteoblastic cells.Results RT-PCR analysis showed that Ox-LDL,15d-PGJ2,and LTB4 all down-regulated the mRNA expressions of RANKL,ALP,and OPG,while up-regulated the mRNA expressions of PPARγ2 in osteoblastic cells in a dose-dependent manner.Significant differences were found in interclass comparisons( P＜0.05 or P＜ 0.01 ).Conclusions These findings suggest that Ox-LDL,15d-PGJ2,and LTB4 suppress the expressions of osteogenic genes through activating the transcription activity of PPARγ2,and this may be a plausible mechanism of senile osteoporosis.
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Objective To explore dynamic changes of renal cortex blood perfusion in Goto-Kakizaki rats(GK rats) by contrast-enhanced ultrasonography.The clues for early diagnosis and intervention of diabetic renal impairment may be obtained from the study.Methods Male GK rats were taken as experimental groups,and Wistar male rats were used as controls.Contrast-enhanced agent SonoVue was administered via the femoral vein cannulation in a bolus fashion.Image changes of renal cortex were observed in real time, and dynamic image changes within 0 - 5 minute after injection were observed and stored.The renal cortex blood perfusion changes were analyzed using the time-intensity curve (TIC).Results (1) The kidney was quickly enhanced after the injection of contrast agent.The renal artery, cortex, renal vein were displayed in sequence.(2)The shape of renal perfusion TIC in all the objects was a single peak,steep ascending, flat descending curve.The overall shape of TIC in GK rats was wider than controls and they were wider and wider with age increasing of the GK rats.(3) Compare to controls,the time to peak (TTP)and the half time of peak descending (HDT) in GK rats was longer (P ＜0.01), the slope rates of the ascending curve (S1) and the slope rates of the descending curve (S2) decreased and the area under the curve increased in 12-week-old and 20-week-old GK rats (P ＜ 0.05 or P ＜ 0.01).Conclusions The abnormal blood perfusion of renal cortex microcirculation was present in the early stage of diabetic in GK rats.Real-time contrast-enhanced ultrasonography and TIC could display this change effectively.
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Objective To analyze the normal hepatic contrast perfusion blocked by ultrasound excited microbubble cavitation using the visual scoring method. Methods Twenty-four healthy New Zealand rabbits were divided into the microbubbles group (MB + US), the simple ultrasound group (US) and the sham group. The MB + US group was insonated by US and intravenous injection of lipid microbubbles. Microbubble was replaced by saline in the US group and sham US exposure was used in the sham group. US contrast liver perfusion imaging was performed before and 0 min,15 min,30 min,45 min,60 min,24 h after treatment in each group. Results The visual perfusion scores of each group before treatment were no statistical difference ( P >0. 05). The visual score of pre-treatment significantly higher than that of post 0 min, 15 min in the MB+ US group ( P<0. 05), but no difference with post 30 min,45 min,60 min and 24 h ( P >0. 05). There were no statistical significance between all the time points of the US and the sham groups. Conclusions Ultrasound excited microbubble cavitation can temporarily and significantly interrupt liver blood perfusion in the visual score analysis.
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Objective To assess left ventricular(LV) regional and global systolic function of patients with coronary artery disease using strain parameter of velocity vector imaging(VVI) technique in quiescent condition. Methods Thirty patients with coronary artery disease and 30 healthy volunteers were enrolled in this study. The two-dimensional gray scale images were obtained in apical 4-chamber view,apical 2-chamber view and long axis view of left ventricle, and three levels of the short axis views(mitral valve, papillary muscle and cardiac apex). The LV wall was divided according to 18 segment model and the longitudinal,radial and circumferential systolic strain (SL, SR, SC) of each segment were analyzed. The difference between the epicardial and endocardial strain measurement were defined as strain gradient and the average of each strain component as global systolic strain. The correlation between global systolic strain of each strain component and the LV ejection fraction(LVEF) were analysed. Results Group A (coronary stenostic degree≤70%) included 176 segments, compared with control group, LS and LS gradient (LSG) decreased significantly from control group( P ＜0.05), while there was no significant difference in CS, RS and CS gradient (CSG) ( P ＞ 0.05). Group B ( coronary stenostic degree＞ 70% ) included 132 segments, compared with control group, LS, CS and RS decreased significantly in group B ( P ＜ 0.05), while there was no significantly difference in LSG and CSG( P ＞0.05). There were also significant difference in LS, RS,CS and LSG between group A and B( P ＜0.05). Global systolic strain of each strain component shown significant correlation with LVEF (P ＜ 0.0001 ). And the global longitudinal systolic strain (GLS) correlated with LVEF most tightly. Conclusions Strain parameter of VVI technique could not only accurately analyze the LV systolic dysfunction but also reflect the stenostic degree of coronary artery. GLS could be a new index for LV systolic function assessment in patients with coronary artery disease.
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Objective To analyze the motion, elastic and derived parameters of normal common carotid artery (CCA) wall in short-axis orientation with velocity vector imaging (VVI) technique. Methods Two-dimensional dynamic images of CCA in 40 healthy volunteers people were obtained in short-axis view with Siemens Acuson Sequoia 512 color Doppler ultrasound. The motion, elastic and derived parameters were analyzed in right CCA including 6 segments: Anterior wall, posterior wall, anterolateral wall, anterior internal wall, posterolateral wall and posterointernal wall. Relationship between these parameters and the influencing factors were analyzed as well. Results There was no statistical difference of the elastic parameters among 6 walls (P>0.05). Some of the motion parameters of the lateral wall and anterior wall were higher than those of the posterior wall and internal wall (P<0.05). Age and intima-media thickness were negatively correlated with some elastic parameters and some motion parameters (P<0.05). Heart rate were positively correlated with some elastic parameters and some motion parameters (P<0.05). Elastic parameters were positively correlated with motion parameters (P<0.05) and positive correlation was found between time to peak of elastic and motion parameters (P<0.05). Conclusion VVI is an effective technique for observing CCA mechanical characteristics of the movement in normal human, and has potential for studying some of related factors of the characteristics.
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Velocity vector imaging (VVI) is a promising and relatively new noninvasive method of assessing wall movement and flexible features of vessels,being able to qualitatively, quantitatively, accurately and intuitively assess mechanical characteristics of vascular wall movement. VVI can reflect changes of characteristics of flexibility and movement of carotid artery in early atherosclerosis and plaque rotation angle. It provides a new way for the study of unstable plaque. The research and current status of clinical application of VVI were reviewed in this article.
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Objective To investigate the value of ultrasound integrated backscatter (IBS) in quantitative analysis of in-traluminal thrombus in abdominal aortic aneurysm (AAA).Methods IBS of intraluminal thrombus in 29 patients were measured,including All (average image intensity) and SDI (standard deviation of image intensity).Meanwhile,different echoes and characteristics of IBS in thrombus were compared and pathologic analysis was performed.Results ①Individual All value of homogenous thrombus differed remarkably,SDI value was low.There was no significant difference about All in homogeneous group and adjacent cavity group (P>0.05).All and SDI value in adjacent wall group were higher than those in other groups (P<0.01).②According to pathologic analysis,cellulose contents were abundant in adjacent wall group,but fewer in adjacent cavity group and homogeneous group.Conclusion IBS might be regarded as a sensitive and specific method and a quantitative basis for estimating and predicting the rupture risk of AAA.
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Objective To study the effect of pioglitazone on the differentiation and function of rat osteoclast-like cells (OLC), and to probe the relationship between activated PPARγ2 and osteoclasts. Methods On day 1 of OLC formation from nonadherent bone marrow ceils (BMC) obtained from rats induced by M-CSF and receptor activator of NF-кB ligand (RANKL), 1, 5 and 10μmol/L pioglitazone hydrochloride was added. RT- PCR was performed to determine the mRNA expressions of PPARγ2 and receptor activator of NF-кB (RANK) on day 3, 5 and 7 during incubation, the number of tartrate-resistant acid phosphatase (TRAP)-positive cells,the number of bone resorption pits and the ratio of its area on dentin slice were counted, the activity of TRAP and the mean fluorescence intensity of integrin β3 (CD61) of OLC were also measured. Results (1) The effect on the differentiation of OLC: The addition of pioglitazone at the start of the culture period induced a dose-dependent decrease in TRAP-positive OLC and the activity of TRAP (P < 0.01 or P < 0.05) ; the mRNA expression of PPARγ2 was up-regulated by 5 and 10 μmol/L pioglitazone in the early stage of incubation and attenuated with thematuration of OLC on the contrary, however, the expression of RANK was down-regulated by 5 and 10 μmol/L piolitazone in every stage of incubation (P < 0.05 or P < 0.01), combined with decrease in TRAP-positive OLC from day 3 by 10 μmol/L pioglitazone. (2) The effect on the function of OLC: the number of bone resorption pits and the ratio of its area on dentin slice were decreased in groups of 5 and 10 μmol/L pioglitazone (P < 0.01 orP < 0.05), no obvious change was noted in the group with 1 μmol/L pioglitazone compared with the control group; the mean fluorescence intensity of CD61 were down-regulated in groups of 5 and 10 μmol/L pioglitazone (P < 0.05 or P <0.01). Conclusion Activation of PPARγ2 pathway by pioglitazone could partially inhibit differentiation and function of OLC derived from rat BMC.
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Objective To evaluate the changes of middle cerebral arterial (MCA) hemodynamics before and after intraluminal stent-assisted angioplasty for their stenosis. Methods A total of 11 patients with MCA stenosis treated by intraluminal stent-assisted angioplasty were selected. In these cases, their stenosis before treatment and the state of stents after treatment were observed using transcranial color Doppler ultrasonography(TCCD). Meanwhile, the blood flow velocities (including peak systolic velocity, end diastolic velocity and mean velocity) were measured and studied comparatively at stenosis and post-stenosis place before and after the treatment, respectively. Results ①Among 11 cases implanted stents, 10 stents were in good state after treatment, only one expanded incompletely. ②The blood flow velocities were significantly higher in patients at stenosis place than in normal adults, and lower at post-stenosis place before treatment (P<0.05). The blood flow velocity lowered obviously at stenosis place after treatment (P<0.05) ,among which 90.9% were restored. The one which expanded incompletely was slightly higher. The blood flow velocity increased at post-stenosis place after treatment (P<0.05) and all returned to normal.Conclusions TCCD can observe the MCA stenosis and the state of stent,and analyze the changes of their hemodynamics.
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Objective:To explore the relationship between the coronary atherosclerosis and endothelium function or lipidoxidative function. Methods:All subjects underwent selective coronary angiography.Their age,sex,body mass index,smoking status,blood pressure,plasma and serum of levels of glucose,total cholesterol,triglycerides,high density lipoproteins,non-hingh density lipoproteins,oxidized LDL,endothelin(ET)and nitric oxide(NO)were measured. Results: Subjects were divided into two groups,according to coronary lesion(50 cases),and non-coronary lesion(25 cases).The plasma levels of OxLDL〔(65.31?9.87)mmol vs(46.95?7.74)mmol/L〕and ET 〔(91.92?8.50)ng/L) vs (82.81?7.37)ng/L〕 were higher in group with coronary lesion than those of group with non-coronary lesion (P
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Objective To observe the perfusion changes of porcine chronic ischemic myocardium before and after gene transfer by myocardial contrast. Methods Ten normal pigs were divided into two groups: groupⅠfor gene transfer(6 pigs) and groupⅡ for control(4 pigs). Myocardial contrasts were performed respectively in basic status, 4 weeks after an Ameroid constrictor was placed around the proximal left circumflex artery (LCX) and another 4 weeks after the replication deficient recombinant adenovirus coding for the vascular endothelial growth factors (Ad. VEGF)was administrated into the regional ischemic myocardium in groupⅠ, and the phosphate buffer(PB) was administrated into similar situs in groupⅡ. The perfusion of above mentioned different blood supply myocardium was observed with HP Sonos 5500 and S4 transducer by myocardial contrast. Results The normal left ventricular myocardial wall was uniformly thick and its perfusion was bright and well filling. The chronic ischemic myocardium was thinned and its echo showed the contrast defect. The echo of the myocardium for gene transfer returned to good, but the echo of the control group remained bad including some bright bits and pieces. Conclusions The blood supply of the porcine chronic ischemic myocardium was ameliorated by gene transfer. The perfusion characters of the different blood supply myocardium can objectively reflect the blood supply status of the myocardium.
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Objective To study the extracranial and intracranial arterial hemodynamic changes before and after carotid artery stenting(CAS). Methods Thirty-eight patients with extracranial internal carotid arterial(EICA) stenosis were selected.Before and after CAS, the vessel diameter,the peak systolic velocity(PSV) in bilateral EICA and the PSV, pulsatility index(PI) in bilateral middle cerebral artery(MCA),ophthalmic artery(OA) were measured respectively by color Doppler flow imaging(CDFI) and transcranial color-coded duplex sonography(TCCD).Results Compared with pre-CAS,the diameter of ipsilateral EICA showed obviously increase post-CAS(P 0.05 ).The established collateral circulation were closed. Conclusions The extracranial and intracranial arterial hemodynamic data measured by CDFI and TCCD are valuable in evaluation of CAS.CAS is an effective and safe treatment for carotid stenosis,and the long time follow-up remains to be.
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Objective: To establish porcine chronic ischemic myocardium model and to evaluate ultrasonic integrated backscatter(IBS) and Doppler tissue imaging(DTI) in detecting this model. Methods: An Ameroid constrictor was placed around the porcine proximal left circumflex artery. The calibrated average image intensity (%AⅡ), cyclic variation of IBS (CVIB), the subendo-epicardical gradient index (TGI) and the spectrum of left ventricular papillary muscle level short axis view (LVPM-SAM) and apical four chamber view (AP-4CV) were measured at normal state, 2 w, 4 w, 6 w and 8 w after Ameroid placement. Results: Normal %AⅡ, CVIB and TGI were 2.29?0.32,(9.69?2.22)dB and 0.22? 0.08 respectively. After Ameroid placement, the %AII increased gradually, the CVIB decreased gradually, and the decrease was higher in subepicardium than that in subendocardium. The most obvious decrease of TGI occurred from 2 w to 4 w after Ameroid placement and became zero at 8 w(P
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70 y).Five hundred common carotids were assessed in 250 healthy subjects using two-dimentional color Doppler ultrasound (2D-CDUS).The diameter(D),intimal medial thickness(IMT), hemodynamics parameters including shear rate(SR) were recorded. Results:The diameter of normal carotids increased along with age, there was no significant difference among groupⅠ, Ⅱ, Ⅲ and between group Ⅳ, Ⅴ; Respectively compared with group Ⅰ,Ⅱand groupⅢ, the D of group Ⅳ, Ⅴ increase significantly(P