ABSTRACT
@#【Objective】Fibroscan has been recommended by multiple clinical guidelines as the first choice among the non-invasive tools for evaluating hepatic steatosis and liver stiffness. The study herein assessed the factors related to the success rate and reliability of the measurement.【Methods】A total of 788 volunteers from Year 2018′ s staff physical checkup in The First Affiliated Hospital of Sun Yat- sen University were recruited. Relationship between age ，gender， body mass index ，waist circumference of the subjects ，and the operator′s experience ，and their effect on success rate and reliability were analyzed.【Results】had a higher detection rate for fatty liver as compared with ultrasound（55.9% vs.39.9% ，P<0.001）. Detection failure and unreliable measurements occurred in only 1.4% of all the participants. Success rate was not associated with gender ，but decreased significantly with increased age ，body mass index and waist circumference （P<0.05）. LSM IQR/Median increased accordingly ，thus reduced the reliability of the measurement. With accumulated number of measurements by the same operator，so did the success rate and reliability of the results. An operator with more than 300 measurements could be deemed as experienced operator.【Conclusions】The success rate and reliability of the measurement was affected by increased age ，body mass index ，waist circumference and operator′ s experience. Fixed operator could also achieve very high success rate and reliable measurement using Fibroscan after short- term training.
ABSTRACT
Objective: To evaluate the clinical value of echocardiography in aortic valvuloplasty (AVP) in the low-age pediatric patients with congenital aortic valve stenosis. Methods: We retrospectively studied 39 low-age (at median of 23 months) patients with congenital aortic valve stenosis who received aortic valve repair in our hospital for their echocardiography information, and statistically analyzed the main indicator changes by 4 time points as pre-operation and 1 week, 1-3 months, 6-12 months after the operation respectively. Results: In our study, the bicuspid to tricuspid valve ratio was approximately at 5.5/1 and 2 patients died during peri-operative period. Compared with pre-operative time point, Doppler aortic valve peak velocity (Vmax ) and the mean aortic transvalvular pressure gradient (MPG) were reduced accordingly, for Vmax: (4.30 ± 0.73) m/s vs (2.65 ± 0.78) m/s, (2.93 ± 0.63) m/s, (3.01 ± 0.83) m/s,P<0.01, for MPG: (45.78 ± 15.19) mmHg vs (18.24 ± 10.08) mmHg, (21.01 ± 10.08) mmHg, (22.31 ± 13.41) mmHg. Compared with pre-operative time point, left ventricular ejection fractions (LVEF) were similar in 3 post-operative time points. Compared with 1 week post operative time point, left ventricular end-diastolic anteroposterior diameter (LVEDD) was increased at 6-12 months post-operative time point, the relative wall thickness (RWT) was decreased, bothP<0.05, and aorta valve regurgitation (AR) was increasedP<0.01. Pearson correlation analysis showed that aortic annulus (AA) inner diameter was positively related to LVEDD (r= 0.648,P<0.01), negatively related to Vmax (r= -0.205,P<0.05) and RWT was positively related to Vmax (r= 0.196,P<0.05). There were 6 patients with pre-operatively decreased LVEF, 1 of them died and the rest 5 with elevated LVEF at 6-12 months post-operative period,P<0.05. Conclusion: Echocardiograghy could be used as the ifrst choice of imaging method for diagnosing congenital aortic valve stenosis, it has the important role for in-operative monitoring and post-operative evaluation of AVP in relevant patients.
ABSTRACT
Objective To study the effects of allopurinol in different dose on the cardiac function of chronic heart failure rats induced by adrimycin. To explore dose-dependency of allopurinol in improving blood vessel endothe-lium function and cardiac ventricle remodeling of the rats heart, as to supply evidence and new sight in clinical treat-ment of congestive heart failure. Methods 40 Sprague-Dawley male rats were randomly divided into four groups: normal control group (group A)、model control group (group B)、low-dose allopurinol group (group C)、high-dose allopurinol group (group D). The heart failure model was made by administering adriamycin to rats. After the model myocardial pathological changes were detected. Results Compared with the normal control group, the weight and heart weight of rats in model control group and allopurinol groups were obviously lessen (group A=(300.10± 9.85)g,group B=(200.67±9.91)g, group C=(233.14±9.42)g,group D=(248.25±13.34) g;group A= (828.30±50.97) nag, group B=(681.50±16.97) mg, group C=(743.00±17.20) nag, group D=(784.88± 36.83) mg,P<0.05). Heart weight indexes were all incerased ( group A=(2.76±0.15) mg/g, group B=(3.41± 0.17) mg/g, group C=(3.26±0.76) mg/g, group D=(3.11±0.65) mg/g, P<0.05). The hemedynamics resuh showed that myocardial contractile force were enhanced in drug groups. The level of NO, SOD were increased in the allopurinol groups compared with the model control group (group B: NO=(41.55±6.28) μmol/L, group C: NO= (52.47±5.59) μmoL/L,group D:NO=(61.04±4.26) μmoL/L; group B:SOD=(63.83±6.40) U/ml,group C: SOD=(76.29±7.99) U/ml, group D: SOD=(100.13±7.43) U/ml, P<0.05) and MDA levels were obviously decreased (group B: MDA=(9.70±1.08) μmol/L, group C: MDA=(6.64±0.34) μmol/L, group D: MDA= (5.72±0.71)p.moVL,P<0.05). The level of NO, SOD were obviously increased in the allopurinol of high-dose group compared with low-dose allopurinol group(P<0.05). MDA levels were obviously decreased(P<0.05). The myocardial pathological changes were relieved obviously in the allopufinol groups. Conclusion Allopurinol improves blood vessel endothelium function dose-dependently. High-dese allopurinol obviously decreases MDA, improve NO, SOD, thereby can improve the cardiac function of heart failure.