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Objective:To discuss the value of real-time three-dimensional speckle tracking imaging(RT3D-STI) in the evaluation of the left atrial (LA) volume and function in end-stage renal disease (ESRD) patients with different dialysis methods.Methods:Eighty-three ESRD patients who were treated in the Affiliated Hospital of Qingdao University from February to August 2019 were enrolled and divided into non-dialysis group ( n=25), hemodialysis group (HD group, n=31) and peritoneal dialysis group (PD group, n=27). And 30 healthy volunteers were enrolled as control group. Subsequently, the LA volume indexs including LA maximal volume index (LAVImax), LA minimal volume index (LAVImin) and LA presystolic volume index (LAVIpre), the LA function parameters including LA ejection fraction (LAEF), LA passive ejection fraction(LApEF) and LA active ejection fraction (LAaEF) and the LA global strain parameters including global longitudinal strain(GLS), global radial strain(GRS) and global circumferential strain(GCS) were obtained by RT3D-STI. The differences of the parameters among these groups were compared and the correlations between the myocardial strain parameters and dialysis time were analyzed. Results:①The LAVImax, LAVImin and LAVIpre of the non-dialysis group, PD group and HD group were higher than those in the control group, while the LAEF, LApEF, GLS, GRS and GCS were lower than those in the control group(all P<0.05); the LAVImin of the PD group as well as the LAVImin, LAVIpre and LAVImax of HD group were higher than those of non-dialysis group, while the LAEF, LApEF, GLS, GCS of the PD group and the LAEF, LApEF, GLS, GRS, GCS of HD group were lower than those of non-dialysis group (all P<0.05). The LAVImax, LAVImin, LAVIpre of HD group were higher than those of PD group, while the LAEF, LApEF, GLS, GRS and GCS of HD group were lower than those of PD group (all P<0.05). ②The GLS and GCS in PD group were negatively correlated with the dialysis time( r=-0.670, -0.596, all P<0.05), and the GLS, GCS and GRS in HD group were negatively correlated with the dialysis time( r=-0.624, -0.631, -0.551, all P<0.05). Conclusions:RT3D-STI can assess the LA volume and function of ESRD patients with different dialysis methods effectively and can further evaluate the prognosis of patients and guide timely clinical intervention.
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Objective@#To assess left atrial(LA)function by evaluating changes of LA wall movement and volume detected by real-time three-dimensional speckle tracking imaging(RT3D-STI)in elderly patients with ischemic mitral regurgitation(IMR).@*Methods@#Eighty-six elderly patients with coronary heart disease(CHD)were enrolled in this study.According to whether or not to have IMR, the patients were divided into the pure CHD group(n=32)and the CHD-induced ischemic mitral regurgitation(IMR)group(n=54, including 20 cases of mild IMR, 18 cases of moderate IMR and 16 cases of severe IMR). Thirty-two healthy elderly volunteers were considered as control group.RT3D-STI was used to evaluate the global atrial longitudinal strain(GLS), global circumferential strain(GCS), global radial strain(GRS)and LA maximal, minimal and pre-systolic volumes(LAVmax, LAVmin, and LAVp). LA ejection fraction(LAEF), LA passive ejection fraction(LApEF)and LA active ejection fraction(LAaEF)were calculated.The relationship of LA volume changes and myocardial strain with LA function was analyzed.@*Results@#The left ventricular ejection fraction(LVEF)and LAEF were reduced in CHD group and IMR group as compared with the control group, and were lower in IMR group than in CHD group(P<0.05). Compared with the control group, the LAVmin was increased, and the LAaEF was decreased in the IMR group(P<0.05). Compared with the control group, the GLS, GCS, GRS were declined in the CHD and IMR groups, and were lower in IMR group than in control group(P<0.05). Along with the increased severity of regurgitation, GLS, GCS, and GRS were decreased in varying degrees.The standard deviations of time to peak longitudinal strains(TLS-SD), of time to peak circumferential strains(TCS-SD), and of time to peak radial strain(TRS-SD)rose in the IMR group as compared with the control group(P<0.05). The myocardial motion indicators(GLS, GCS, GRS)had a quite strong correlation with LAEF in the CHD and IMR groups(CHD group: r=-0.745, -0.718 and 0.627, P=0.006, 0.007 and 0.009; IMR group: r=-0.785, -0.781, 0.643, P=0.006, 0.007 and 0.008). The receiver operating characteristic(ROC)curves analysis showed that the sensitivity and specificity of TLS-SD, TCS-SD and TRS-SD were 89.7% and 81.8%, 78.6% and 84.8%, 85.7% and 72.1%, respectively in the evaluation of LA function changes.@*Conclusions@#RT3D-STI can precisely and objectively assess the LA function changes by measuring the volume changes and tracing the myocardial motion in elderly IMR patients.
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Objective To assess left atrial(LA)function by evaluating changes of LA wall movement and volume detected by real-time three-dimensional speckle tracking imaging(RT3D-STI)in elderly patients with ischemic mitral regurgitation(IMR).Methods Eighty-six elderly patients with coronary heart disease(CHD)were enrolled in this study.According to whether or not to have IMR,the patients were divided into the pure CHD group (n =32)and the CHD-induced ischemic mitral regurgitation(IMR)group(n=54,including 20 cases of mild IMR,18 cases of moderate IMR and 16 cases of severe IMR).Thirty-two healthy elderly volunteers were considered as control group.RT3D-STI was used to evaluate the global atrial longitudinal strain (GLS),global circumferential strain (GCS),global radial strain(GRS)and LA maximal,minimal and pre-systolic volumes (LAVmax,LAVmin,and LAVp).LA ejection fraction (LAEF),LA passive ejection fraction (LApEF) and LA active ejection fraction (LAaEF)were calculated.The relationship of LA volume changes and myocardial strain with LA function was analyzed.Results The left ventricular ejection fraction (LVEF)and LAEF were reduced in CHD group and IMR group as compared with the control group,and were lower in IMR group than in CHD group(P＜0.05).Compared with the control group,the LAVmin was increased,and the LAaEF was decreased in the IMR group(P＜0.05).Compared with the control group,the GLS,GCS,GRS were declined in the C HD and IMR groups,and were lower in IMR group than in control group(P＜0.05).Along with the increased severity of regurgitation,GLS,GCS,and GRS were decreased in varying degrees.The standard deviations of time to peak longitudinal strains(TLS-SD),of time to peak circumferential strains(TCS-SD),and of time to peak radial strain (TRS-SD)rose in the IMR group as compared with the control group(P ＜0.05).The myocardial motion indicators(GLS,GCS,GRS)had a quite strong correlation with LAEF in the CHD and IMR groups(CHD group:r=-0.745,-0.718 and 0.627,P=0.006,0.007 and 0.009;IMR group:r=-0.785,-0.781,0.643,P =0.006,0.007 and 0.008).The receiver operating characteristic (ROC)curves analysis showed that the sensitivity and specificity of TLS-SD,TCS-SD and TRS-SD were 89.7％ and 81.8％,78.6％ and 84.8％％,85.7％ and 72.1％,respectively in the evaluation of LA function changes.Conclusions RT3D-STI can precisely and objectively assess the LA function changes by measuring the volume changes and tracing the myocardial motion in elderly IMR patients.
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Objective To investigate the expression and clinical significance of epithelial cell adhesion molecule(EpCAM) and Claudin-18 in gastric cancer.Methods Surgical specimens of gastric cancer were taken from 64 patients.The histological diagnostic criteria were based on WHO standards.Immunohistochemical staining was used to detect expression levels of EpCAM and Claudin-18 in all samples.The relationship between the expression of EpCAM and Claudin-18 and clinicopathological parameters of gastric cancer was analyzed.Correlations of the prognosis of gastric cancer patients with EpCAM and Claudin-18 expression were analyzed using the Cox proportional hazards regression model.Results The positive expression rate of EpCAM was elevated with the increase in tumor size and the occurrence of distant metastasis(x2 =4.526 and 36.090,P=0.033 and 0.000).There were significant differences in Claudin-18 protein expression among different age,TNM stage,growth pattern,depth of invasion and distant metastasis patients(all P＜0.05).Cox regression model analysis showed that tumor size and distant metastasis were the main risk factors affecting the survival of patients with gastric cancer (RR =50.076 and 1.617,P =0.016 and 0.032),while levels of EpCAM and Claudin-18 were not independent risk factors (both P ＞ 0.05).Conclusions EpCAM and Claudin-18 are closely related to the invasiveness of gastric cancer,but abnormally high levels of EpCAM and Claudin-18 are not independent risk factors for the prognosis of gastric cancer patients.
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Purpose Recently the incidence of bone and joint degeneration is increased,with the increasing of cardiovascular disease complication.This study aims to utilize realtime three-dimensional echocardiography (RT-3DE) in evaluating left ventricular remodeling index (LVRI),to guide treatment and improve the survival rate.Materials and Methods Fifty-seven cases of healthy volunteers (normal control group) and sixty-seven patients with bone and joint degeneration (research group) were respectively divided into two subgroups according to the age.Both groups underwent conventional echocardiography and RT-3DE.The LVRI,left ventricular end diastolic volume index (LVEDVI),left ventricular mass index (LVMI),left ventricular end systolic volume index (LVESVI) and left ventricular ejection fraction (LVEF) measured by different methods were analyzed,and the differences and correlations between groups and within each group were compared.Results The age of normal control group and research group was not significantly different (P＞0.05).The LVMI and LVRI in research group were significantly higher than those in the normal control group with same age (P＜0.05).The LVEDVI,LVMI and LVRI measured by two-dimensional echocardiography and M-mode echocardiography were higher than those measured by RT-3DE,and the difference was statistically significant (P＜0.05).Bland-Altman agreement analysis showed good agreement of measured LVRI using 2D echocardiography and RT-3DE.Conclusion Patients with bone and joint degeneration have left ventricular remodeling.RT-3DE can accurately assess LVRI with the advantages of convenience and lack of radiation,which can be widely used in clinic.
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Purpose To detect left atrial volume change and myocardial strain,and to evaluate left atrial (LA) function in coronary heart disease patients with mitral regurgitation (MR) by real-time three-dimensional speckle tracking imaging (RT3D-STI).Materials and Methods Eighty-eight patients with coronary disease were divided into non mitral regurgitation group (NMR group,n=30) and mitral regurgitation group (MR group,n=58),including mild MR (n=20),moderate MR (n=20) and severe MR (n=18).Thirty healthy participants were also included as control group.Using RT3D-STI,the global atrial longitudinal strain (GLS),global radial strain (GRS),global circumferential strain (GCS),LA maximal,minimal and pre-systolic volume (LAVmax,LAVmin and LAVp),LA passive ejection fraction (LApEF) and LA active ejection fraction (LAaEF) were measured,and the relationship between LA myocardial strain and left ventricular function was analyzed.Results ① The LAEF,LVEF,LApEF in NMR group and MR group decreased compared those with the control group (P＜0.05),and the LApEF in MR group were lower than those in NMR group (P＜0.05);② compared with the control group,the GLS and GCS in NMR group and MR group decreased observably (P＜0.05),and the parameters in MR group was lower than those in NMR group (P＜0.05);along with the severity of mitral regurgitation,GLS,GCS and GRS declined in varying degrees.③ The overall strain ability of left atrial myocardium (GLS,GCS,GRS) had a positive correlation with LAEF (NMR group:r=-0.810,-0.760 and 0.851;MR group:r=-0.680,-0.745 and 0.583;P＜0.05).Conclusion RT3D-STI plays an important role in assessing LA myocardial movement change and evaluating left atrial function of mitral regurgitation patients by nvestigating left atrial volume change,calculating LAEF and tracing myocardial motion,which provides valuable references for clinical diagnosis and treatment.
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In order to study the the impact of cognitive difference between doctors and patients on doctor-patient relationship, five tertiary hospitals in city B were investigated with questionnaire and quantitative interviews, and the outcomes were analyzed with SPSS16. 0 software. Cognitive differences were found in the nature of the relationship, the main part of responsibility for the relationship, and principles for communication between the parties. By analyzing the causes of the difference and their impact on the relationship, it draw the conclusion that this cognitive difference found between the two parties functions as a key to the conflicts between doctors and patients. Return of health care back to non-profit nature, encouragement of patient-doctor communication and mutual understanding will be conducive to minimizing such a cognitive difference, and building a harmonious doctor-patient relationship.
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Objective To probe into the current services and outcomes of township hospitals following their transformation, and their future positioning of functionality. Methods Pinpointing townships A, B and C as samples from a district in Beijing, in which field surveys were made in the township hospitals to learn their services, service provision methods and outcomes. Results Among the current services provided by these three hospitals, those of public health and primary healthcare nature in hospital A account for 50% each; those in hospital B account for 70% and 30% respectively; those in hospital C account for 60% and 40% respectively. Recommendable services provided in these hospitals include universal coverage of medical files, management of infectious diseases, public health emergency management, and immunization. Conclusion Township hospitals as the center of the 3-tier rural health service network, deserve a repositioning of their functionality to fit the health needs of residents at large.
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Objective To evaluate the effects of Xuefurong capsules,the traditional Chinese medicine for invigorating the kidney,on sexual function and expression of neuronal nitric oxide synthase(nNOS) in paraventricular nucleus(PVN) in adult castrated SD rats.Methods The male castrated rat model was made and three days after operation the liquid of Xuefurong capsules(5 mg/kg) was given by intragastric administration once a day for 28 days.The sexual function was observed and the nNOS expression in PVN was detected by using ABC immunohistochemical method.The number,area and gray degree of nNOS were counted and analyzed with semi-quantitative method.Results ①Compared with that in the castrated group,the serum testosterone level increased obviously in Xuefurong group(P0.05).Conclusion Xuefurong capsules can increase the level of testosterone,enhance the sexual function of castrated rats and nNOS expression in PVN.
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Objective: To study the relationship between mental health and achievement motivation of teachers.Methods: 322 high school teachers completed SCL-90 and Achievement Motivation Scale.Results: The percent of high-score teachers with at least one SCL-90 subscale scored more than 3 is more than 5%.There is obvious correlation between the score of SCL-90 and the AMS's.Conclusion: The high level of achievement-seeking or the high level of failure-avoiding is harmful to the mental health of teachers.