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Objective:To evaluate right atrial (RA) volume and function in patients with hepatitis B cirrhosis by four-dimensional automatic quantitation analysis technique, and to explore its correlation with liver function grading.Methods:Ninety patients with hepatitis B cirrhosis who were clinically confirmed in Henan Provincial People′s Hospital from December 2020 to July 2021 were randomly enrolled as the research subjects. According to Child-Pugh liver function score criteria, the patients were divided into three groups: Child-Pugh A group ( n=31), Child-Pugh B group ( n=31), Child-Pugh C group ( n=28). Another 30 healthy volunteers with gender and age matched at the same period were selected as the control group. The RA maximum volume (RAVmax), RA minimum volume (RAVmin), RA presystolic volume (RAVpreA), RA maximum volume index (RAVImax), RA emptying volume (RAEV), RA ejection fraction (RAEF), RA reservoir longitudinal and circumferential strains (RASr, RASr-c), RA conduit longitudinal and circumferential strains (RAScd, RAScd-c), RA contraction longitudinal and circumferential strains (RASct, RASct-c) were obtained by four-dimensional automatic quantitation analysis technique. Spearman correlation analysis was used to explore the correlation between the volume and strain parameters of right atrium and liver function grading, and the independent correlation factors of RASr-c were analyzed by univariate and multivariate linear regression analyses. Results:Compared with the control group, Child-Pugh A and Child-Pugh B groups, RAVmax, RAVmin, RAVpreA, RAVImax, and RAEV were all increased in Child-Pugh C group (all P<0.05). Compared with control group, the absolute values of RASr, RASct, RASr-c and RASct-c were increased, and the absolute values of RAScd and RAScd-c were decreased in Child-Pugh A group (all P<0.05). Compared with control group, Child-Pugh A and Child-Pugh B groups, the absolute values of RASr, RAScd, RASct, RASr-c, RAScd-c and RASct-c were decreased in the Child-Pugh C group (all P<0.05). Correlation analysis showed that the volume and strain parameters of the right atrium were correlated with liver function grading. RASr-c was independently correlated with E/e, ALB and BNP(β=-0.543, 0.521, and -0.562 respectively, all P<0.05). Conclusions:During the compensatory stage in patients with hepatitis B cirrhosis, the RA functions of reservoir and contractile were increased, but the function of conduit was decreased. With the aggravation of liver cirrhosis, the RA functions of reservoir, conduit and contractile were all decreased. The four-dimensional volume and strain parameters of the right atrium were correlated with Child-Pugh liver function grading, and RASr-c was independently correlated with E/e, ALB and BNP.
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Objective@#To understand sleep behavior among primary and middle school students and its impact on overweight and obesity changes, to provide evidence for developing obesity prevention and controlling strategies in children and adolescents.@*Methods@#Primary and middle school students from three cities in Zhejiang Province who participated in questionnaire surveys and physical measurements in both 2017 and 2019 were selected. A follow up dataset of 605 students was developed and the relationship between sleep duration and body mass index was analyzed.@*Results@#From 2017 to 2019, BMI Z scores for male and female participants increased by 0.24 and 0.13, respectively. BMI Z scores increased by 0.29 in students of 9-12 years old and increased by 0.11 and 0.25 in urban and rural students, respectively ( P <0.05). The prevalence of insufficient sleep duration increased from 37.0 % to 41.8% simultaneously ( χ 2=3.68, P =0.06). After adjusting for confounding factors, the BMI Z score of students with insufficient sleep was 0.20 higher than those with sufficient sleep duration ( P <0.01). Compared with participants who had sufficient sleep duration from 2017 to 2019, participants whose sleep duration changed from sufficient to insufficient, and those who always had insufficient sleep duration increased by 0.23, respectively ( P <0.05).@*Conclusion@#Insufficient sleep duration is a risk factor for obesity. Shortened sleep duration is related to weight gain, and maintaining sufficient sleep duration may reduce the risk of obesity in children and adolescents.
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Objective@#To explore the performances of HbA1c when identifying elevated blood glucose among pre pubertal children, and to provide scientific basis for early screening biomarkers of abnormal blood glucose in children.@*Methods@#A total of 1 208 prepubertal children aged 7 to 10 years old in Xiamen were sampled with the cluster sampling method. Fasting venous blood was drawn to measure the level of HbA1c and FPG. According to American Diabetes Association (ADA) criteria, participants were divided into normal group, HbA1c abnormal group, FPG abnormal group and combined abnormal group. Partial correlation analysis was used to analyze the correlation between HbA1c and FPG. The cutoffs of HbA1c were calculated when FPG was 5.6 mmol/L. Receiver operating curve (ROC) was used to judge the performances of HbA1c while screening abnormal blood glucose.@*Results@#With HbA1c, FPG and the combined indicators as the screening criteria, the prevalence of high blood glucose were 2.2%, 4.0%, and 5.8%, respectively. The partial correlation coefficient of FPG and HbA1c was 0.15( P <0.01), and the correlation coefficient in girls( r =0.22) and non overweight group( r =0.16) were higher. The cutoff of HbA1c was 5.15% if FPG was 5.6 mmol/L. Taking the combined indicator as the reference standard, the AUC of FPG was 0.84 (95% CI =0.79-0.90) and the AUC of HbA1c was 0.69 (95% CI =0.63-0.74).@*Conclusion@#There is a low correlation between HbA1c and FPG in pre pubertal children. The performance of HbA1c is different from FPG when used as the indicator to screen children with abnormal blood glucose. It is recommended to use the combined indicator of HbA1c and FPG to screen abnormal blood glucose in prepubertal children.
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Objective:To investigate the value of early diastolic strain rate (e′SR) and peak value of early diastolic velocity (E) to e′SR (E/e′SR) in predicting the severity of coronary lesions in patients with coronary artery disease (CAD) without regional wall motion abnormalities (RWMA) and with preserved left ventricular ejection fraction (LVEF).Methods:A selection of 70 patients with CAD without RWMA and with preserved LVEF (>50%) admitted to Zhengzhou University People′s Hospital from October 2020 to March 2021 were collected and divided into two groups according to the Gensini score method: low group with a score<34 and high group with a score≥34. Another 30 healthy volunteers with matching gender and age at the same period were selected as the control group. Cardiac structural parameters left atrium diameter (LAD), left ventricular end diastolic diameter (LVEDd), left ventricular end systolic diameter (LVEDs), interventricular septum diastolic diameter (IVST), left atrial volume (LAV), E, peak value of late diastolic velocity (A) of mitral inflow, peak value of early diatolic tissue Doppler velocity of septal and lateral walls of mitral annulus and LVEF were routinely measured. Left atrial volume index (LAVI), mean of peak value of early diatolic tissue Doppler velocity of septal and lateral walls of mitral annulus (e′), E/e′were calculated. Speckle tracking imaging (STI) technique was used to collect systolic left ventricular global longitudinal strain (GLS) and e′SR, E/e′SR was calculated. The differences in each parameter among the three groups were compared. The ROC curve was used to obtain the best cut-off values of e′SR and E/e′SR for predicting the severity of coronary lesions in CAD patients, respectively, and the corresponding sensitivity and specificity were obtained, respectively.Results:Compared with the control group, LAV and LAVI were increased in the high group (all P<0.05). Compared with the control and the low group, e′ was decreased and E/e′ was increased in the high group (all P<0.05). Compared with the control group, e′SR and GLS were decreased and E/e′SR were increased in the high and low groups (all P<0.05). Compared with the low group, e′SR and GLS were decreased and E/e′SR was increased in the high group (all P<0.05). ROC curve analysis showed that the maximum area of E/e′SR under the curve was 0.717. When the Youden index was maximum, its best cut-off value was 0.75 m, and corresponding sensitivity and specificity were 60.0% and 85.7%, respectively. The maximum area under the e′SR curve was 0.785. When the Youden index was maximum, its best cut-off value was 1.12 s -1, and the corresponding sensitivity and specificity were 85.7% and 68.6%, respectively. Conclusions:For CAD patients without significant RWMA and with preserved LVEF, left ventricular diastolic and systolic function may be impaired to varying degrees, manifesting as decreased e′SR, increased E/e′SR, decreased GLS. The parameters of diastolic strain rate are a reliable basis for early detection of impaired diastolic function in CAD patients, and have certain clinical significance for predicting the severity of coronary lesions.
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Objective:To explore the value of pressure-strain loop (PSL) for non-invasive quantitative assessment of left ventricular myocardial work index (GWI), global work efficiency (GWE), global constructive work (GCW), global wasted work (GWW) in the evaluation of left ventricular myocardial work in patients with hypertrophic cardiomyopathy (HCM).Methods:Thirty-one HCM patients (HCM group) and 36 healthy volunteers (control group) from December 2018 to September 2019 in Henan Provincial People′s Hospital were selected. Relevant clinical data were collected, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), left ventricular end systolic diameter (LVEDs), left atrial diameter (LAD), the maximum wall thickness (MWT), left ventricular mass index (LVMI), the global longitudinal strain (GLS), the peak strain dispersion(PSD) and GWI, GWE, GCW and GWW between the two groups were compared.Results:Compared with the control group, MWT, LAD, E/e′, LVMI in HCM group were significantly increased (all P<0.05); left ventricular myocardial functional parameters of GLS, GWI, GWE, GCW were significantly decreased, and GWW and PSD were significantly increased (all P<0.05). Left ventricular GLS, PSD and GWI, GCW, GWW, GWE have better repeatability within the observer and between observers. ICC within the observer were 0.852, 0.707, 0.917, 0.955, 0.675, 0.618, respectively. And their ICC between observers were 0.837, 0.631, 0.927, 0.944, 0.555, 0.670, respectively. Correlation analysis showed that GLS was positively correlated with GWI, GWE, and GCW ( r=0.765, 0.737, 0.815; all P<0.001), and negatively correlated with GWW and PSD ( r=-0.517, -0.606; all P<0.001). Conclusions:The left ventricular GWI, GWE and GCW decreased in HCM patients, while the GWW increased. PSL can evaluate the damage of left ventricular myocardial work in HCM patients.