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Objective To evaluate the systolic and diastolic function of the left ventricular regional myocardium in patients with anterior descending lesion by real-time three-dimensional speckle tracking imaging (RT3D-STI) and investigate the value of RT 3D-STI in the diagnosis of anterior descending stenosis.Methods According to coronary angiography,112 patients were divided into four groups:normal group (20 coronary artery branches without stenosis),mild stenosis group ( 30 coronary artery branches with stenosis<50% ),moderate stenosis group(26 coronary artery branches with stenosis 50% -75% ) and sever stenosis group (36 coronary artery branches with stenosis > 75% ). Transthoracic acquisition of conventional 2D and full-volume real-time three-dimensional image,the routine parameters and the globle longitudinal strain (GLS),globle radial strain (GRS),globle circumferential strain (GCS) and globle area strain (GAS) at the end of the anterior descending blood supply area and corresponding strain of 1/3 of pre-diastolic period were obtained to calcute L-SI-DI,R-SI-DI,C-SI-DI,and A-SI-DI. The diagnostic value of each parameter to the stenosis degree of the anterior descending branch was analyzed. Results Compared among the anterior descending group without stenosis group,mild stenosis group,moderate stenosis group and severe stenosis group,there were no significant differences in conventional ultrasonic parameters such as LVEDV,LVESV,LVEF,E,A,E/A and E/e (all P >0.05).There was no significant difference in GLS, GRS,GCS and GAS between mild stenosis group and no stenosis group(all P >0.05),but the difference in L-SI-DI,R-SI-DI,C-SI-DI and A-SI-DI were statistically significant (all P <0.05).The ROC curve showed that the sensitivity and specificity of the middle anterior segment L-SI-DI were the highest,with 90.0% and 81.5%.Conclusions RT3D-STI can quantitative evaluate myocardial function changes in patients with anterior descending lesion,the anterior septal L-SI-DI can reflect the stenosis degree of the anterior descending branch to a certain extent,it has important guiding significance for clinical diagnosis of the stenosis degree of the anterior descending branch.
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Objective To evaluate left ventricular systolic function by real-time three-dimension speckle tracking imaging (RT3D-STI) in coronary artery diseases (CHD) patients,to determine the clinical value of RT3D-STI in CHD.Methods 34 control subjects and 55 patients with CHD by coronary angiography were involved.Left ventricular global longitudinal strain (GLS),left ventricular global circumferential strain (GCS),left ventricular global radial strain (GRS),left ventricular global area strain (GAS) and left ventricular ejection fraction (LVEF),etc,was acquired by RT3D-STI,respectively.The parameters by RT3D-STI to diagnose CHD were analyzed.Results Compared with control group,GLS,GCS,GRS and GAS were significantly decreased in CHD group (P ＜ 0.05).The area under receiver operating characteristics (AUC) curve of GLS to diagnose CHD was 91.6％.The cutoff value,the sensitivity and Youden index of GLS were-12.5,90.3 ％ and 0.612,respectiuely.The cutoff value,the sensitivity and Youden index of GAS were-23.0,95.8％ and 0.539,respectiuely.GLS,GAS correlated well with LVEF in CHD group (r =-0.860,r =-0.926).Conclusions GLS is the most sensitivity and GAS is the most specificity in the all of strain parameters.RT3D-STI can early show the changes of left ventricular global systolic function in patients with CHD.
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Objective To investigate the left ventricular remodeling (LVR) patterns and its relationships with cardiovascular risk factors in patients with obstructive sleep apnea syndrome (OSAS).Methods 148 patients with habitual snoring were diagnosed OSAS by polysomnography with AHI≥5 /h and blood pressure was monitored at same time.The clinical characteristics were collected and echocardiography was done next morning.LVR patterns was categorized as normal geometry (NG),concentric remodeling (CR),eccentric hypertrophy (EH) and concentric hypertrophy (CH) on the basis of RWT ＞0.42 and LVMI ＞46.7 g/m2.7 (female) or 49.2 g/m2.7 (male).Multinomial logistic regression was used to analysis the correlation of cardiovascular risk factors and LVR patterns.Results ①Of 148 OSAS patients,there were 115 (77.7％) with abnormal LVR,NG 33 (22.3％),CR 35 (23.6％),EH 37 (25％)and CH 43 (29.1 ％).②General clinical characteristics:Compared with NG group,BMI and waistline were increased in EH group (P ＜0.05 or P ＜0.01) ; Age,BMI,waistline,hypertension,dSBP and nSBP were increased in CH group (P ＜0.05 or P ＜0.01).Compared with CR group,male,age,BMI and waistline were increased in EH group (P ＜0.05 or P ＜0.01).Male,age,BMI,waistline,hypertension,nSBP and TG were increased in CH group (P ＜ 0.05 or P ＜ 0.01); Compared with EH group,the prevalence of hypertension was increased in CH group (P ＜0.05); Compared with EH group,the prevalence of hypertension was increased in CH group (P＜0.05).③Polysomnography parameters:Compared with NG group,AHI and ODI were increased in CR group (P＜0.05 or P＜0.01).AHI,ODI and T90 were increased,while Mean SaO2 and Lowest SaO2 were decreased in CH group (P ＜0.05 or P ＜ 0.01);Compared with CR group,AHI was decreased in EH group (P ＜0.05).Mean SaO2 was decreased,but T90 was increased in CH group (P＜0.05 or P ＜0.01); Compared with EH group,Lowest SaO2 was decreased in CH group (P＜0.05).④Blood pressure:Compared with NG group,4:00 SBP and 6:00 SBP were increased in CH group (P＜0.05) ;Compared with CR group,22:00 SBP was increased in CH group (P ＜0.05).⑤ In multinomial logistic regression analysis,after adjusting the confounding factors,CR was associated with AHI [odds ratio (OR) 1.035,P =0.024.EH was associated with Age (OR 1.094,P =0.016),BMI (OR 1.397,P =0.011) and 4:00 SBP (OR 1.124,P =0.026).CH was associated with Age (OR 1.084,P =0.028).Conclusions OSAS could cause result in LVR and the prevalence of four patterns were similar..Age and AHI were significant determinants of CH and CR respectively.Age,BMI and 4:00 SBP were significant determinants of EH.
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<p><b>OBJECTIVE</b>To observe the difference between the combination therapy of alpha-interferon (IFN-alpha) therapy Yixuesheng Capsule and the monotherapy of IFN-alpha in treatment of chronic hepatitis B.</p><p><b>METHOD</b>A total of 288 patients with HBeAg-positive chronic hepatitis B proven by liver biopsy were included in this study. During the individualized therapy, they received hypodermic injection of IFN-alpha 1b, with 5 MU x time(-1) and three times x w(-1). Of them, 125 patients received combination therapy with Yixuesheng Capsule for three months, with 1.0 g/time and three times/d; and 163 patients received only IFN-alpha 1b (the IFN-alpha monotherapy group). After the course of therapy, all patients were followed up for at least 24 months. The intention-to-treat analysis was adopted for statistic analysis.</p><p><b>RESULT</b>The two groups showed no statistical significance by gender, age, liver necroinflammation grading, liver fibrosis staging, serum ALT levels, serum HBV DNA levels and IFN-alpha therapy course. The whole course and the 24-month follow-up visit cover all of 112 patients in the combination treatment group and 141 cases in the IFN-alpha monotherapy group. The response rates of the combination treatment group and the IFN-alpha monotherapy group were 48.0% (60/125) and 35.0% (57/163) (x = 4.980, P = 0.026) at the end of treatment, respectively, 45.6% (57/125) and 33.1% (54/163) (x2 = 4.645, P =0.031) at the end of 12-month-follow-up period, respectively, and 38.4% (48/125) and 32.5% (53/163) (x2 = 1.076, P = 0.300) at the end of 24-month follow-up period, respectively.</p><p><b>CONCLUSION</b>The combination treatment with IFN-alpha and Yixuesheng Capsule shows a slightly better sustained efficacy on HBeAg-positive chronic hepatitis B patients compared with IFN-alpha monotherapy.</p>
Subject(s)
Adult , Female , Humans , Male , Capsules , Combined Modality Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Follow-Up Studies , Hepatitis B, Chronic , Drug Therapy , Interferon-alpha , Therapeutic Uses , Treatment OutcomeABSTRACT
Three pSIREN-siRNA plasmids were constructed using a pSIREN-RetroQ vector to silence the expression of muhidrug resistance-associated protein (MRP1) gene, and subsequently characterized by restriction endonuclease digestion and DNA sequencing. A truncated MRP1 and a full-length MRP1 were cloned into pEGFP-N2 and PeDNA3.1 respectively as pEGFP-MRP1T and pcDNA-MRP1. The plasmid pEGFP-MRP1T was co-transferred with each of the three pSIREN-siRNAs into HEK293 cells for MRP1T-GFP targeted silencing, and pSIREN-siRNA1 was used as the negative control, pSIREN-siRNA2 and pSIREN-siRNA3 appeared to be more effective to silence MRP1T-GFP compared to pSIREN-siRNA1 as shown by fluorescence microscopy. For the silencing of full-length MRP1 expression, HEK293 ceils were co-transferred with pcDNA-MRP1 and either of the three pSIREN-siRNAs, then subjected for Western blot analysis and MTT assays, pSIREN-siRNA2 and pSIREN-siRNA3 were able to inhibit the expression of 190 kD MRP1, but not pSIREN-siRNA1. The MDR of MRP1-transfected HEK293 ceils was abolished with pSIREN-siRNA2 or pSIREN-siRNA3 transfections. RNA secondary structure predictions demonstrated that the mRNA local free energy (△G) of the siRNA1 targeted sequence was lower, as the GC content and Tm value of siRNA1 were higher than those of siRNA2 and siRNA3. These data suggest that the local structure siRNAs and target mRNA may influence the silencing efficiency of MRP1 expression.