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Objective:To analyze the clinical characteristics of children with 2019 novel coronavirus (2019-nCoV) infection in Putian City, and to provide a reference for the diagnosis and treatment of children with 2019-nCoV infection.Methods:Clinical characteristics, laboratory examination, pulmonary compated tomography findings, treatment, and clinical outcomes of 78 children with 2019-nCoV infection who were admitted to Putian University Affiliated Hospital Medical Group Putian City Children′s Hospital from September 10 to October 20, 2021 were retrospectively collected and analyzed.Results:Of the 78 children included in the analysis, two cases (2.6%) were asymptomatic infection, 36 cases (46.2%) were mild and 40 cases (51.3%) were ordinary. Five children were vaccinated against 2019-nCoV. The main symptoms were fever (24 cases), cough (13 cases), and fatigue (nine cases). A total of 34 cases (43.6%) had neutropenia, 29 cases (37.2%) had lymphopenia, 36 cases (46.2%) had D-dimer increase, 38 cases (48.7%) had hypokalemia, 27 cases (34.6%) had hypoglycemia and 11 cases (14.1%) had elevated creatine kinase isoenzyme. The neutropenia mostly occurred two to four days after admission. Fifty-six cases (71.8%) showed pulmonary computed tomography abnormalities. The cycle threshold of virus open reading frame ( ORF)1 ab was 20.90±7.15 and the cycle threshold of N gene was 20.29±7.78 in the first nucleic acid detection of 78 children after admission. The time of nucleic acid negative conversion of the 78 children was (20.73±6.94) days. IgM antibody titer in five vaccinated children was 0.36 (0.34, 4.89) and IgG antibody was 10.42 (0.50, 19.42). IgM antibody titer was 1.82 (1.66, 8.12) and IgG antibody was 76.63 (16.92, 79.84) in cases with disease duration ≥10 days. Nine children (11.5%) had resurgence of virus and were sent to the isolation site. All the other children were cured and discharged from hospital. Conclusions:Children with 2019-nCoV infection have mild clinical symptoms, and some children have lymphopenia, neutropenia, and D-dimer elevation during the course of the disease. The overall prognosis is good. The children vaccinated against 2019-nCoV have higher antibody levels.
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Objective To evaluate the clinical application value of 2-dimentional transesophogeal echocardiography (2D-TEE) ,real-time 3-dimensional transesophogeal echocardiography(RT-3D TEE) and left atrial appendage CT angiography ( LAA CTA ) before percutaneous left atrial appendage closure ( LAAC) with the Watchman occluder . Methods Consecutive 50 atrial fibrillation ( AF) patients underwent 2D-TEE ,RT-3D TEE and LAA CTA examination before LAAC . The number of LAA lobes ,the diameter of landing zone (DLZ) and the depth of LAA were measured by using different methods . The correlation between LAA landing zone diameters measured by different methods and device size were calculated . Results Among 50 patients ,there was no significant difference in lobe nubmers between RT-3D TEE and LAA CTA ( P >0 .05) . The maximum diameter of landing zone(DLZ) from LAA CTA was greater than those from RT-3D TEE and 2D-TEE ( t =3 .977 ,5 .373 ,both P<0 .05) ,and DLZ from RT-3D TEE was greater than that from 2D-TEE ( t=2 .124 , P <0 .05) . The value measured by RT-3D TEE was greater than that by 2D-TEE for the LAA minimum DLZ ( t =2 .142 , P < 0 .05) . LAA depth:CTA value was greater than 2D-TEE and RT-3D TEE values( t =2 .674 ,4 .066 ,both P < 0 .05) ,and 2D-TEE value was greater than RT-3D TEE value( t =2 .114 , P <0 .05) . The correlation coefficient of LAA maximum ,minimum DLZ and LAA depth between 2D-TEE and RT-3D TEE were 0 .638 ,0 .734 ,0 .647 ( all P =0 .000) ,and 0 .517 ,0 .338 and 0 .591 between RT-3D TEE and LAA CTA ,respectively ( all P <0 .05) ,and 0 .503 ,0 .359 and 0 .610 between 2D-TEE and LAA CTA ,respectively ( all P < 0 .05) . LAA DLZ of LAA angiography ( LAA-A) was ( 22 .6 ± 3 .5 ) mm . Fourty-seven AF patients achieved successful LAA occlusion with Watchman device and the size of closure was ( 27 .5 ± 3 .3) mm . Correlation coefficient between the size of device and LAA maximum DLZ by RT-3D TEE ,2D-TEE and LAA CTA were 0 .693 ,0 .647 ,0 .586 , respectively (all P = 0 .000) . Correlation between LAA-A and the size of device was the closest ( r =0 .914 , P =0 .000) .Conclusions The difference in LAA size measured by TEE and LAA CTA could be significant ,and need to be considered before the LAAC . 2D-TEE , RT-3D TEE and CTA LAA measurements all could play important roles in the selection of proper Watchman device size ,and the maximum DLZ of RT-3D TEE has the closest correlation with Watchman device size .
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Objective To assess the value of transesophageal echocardiography (TEE) in left atrial appendage (LAA) closer with Amplatzer Cardiac Plug (ACP).Methods Consecutive 32 atrial fibrillation patients (CHADS2≥1) with high risk bleeding underwent LAA occlusion with ACP LAA occlusion device under the guidance of TEE.Measurements of LAA anchoring area diameter (AAD) and LAA anatomical orifice diameter (AOD) including maximum,minimum values,and LAA depth on 2 dimentional TEE (2D TEE) were conducted before closer device implantation.The outcomes of LAA occlusion were analyzed.Results Among 32 patients,27 cases achieved successful LAA occlusion,including 2 cases with peripheral leakage ≤5 mm,and 5 cases failed occlusion.Among 5 failed closed patients,3 cases with LAA AAD≥ 30 mm,1 case with LAA of short depth,and 1 case with anatomical variation of LAA of low position that access sheath could not be positioned in the LAA.LAA AAD maximum,minimum and LAA depth were (25.9±4.9)mm,(20.0±3.8)mm,(31.0±5.6)mm,respectively,and LAA AOD maximum,minimum diameters were (26.2±6.2)mm,(19.4±4.3)mm,respectively.Among 10 cases with LAA AAD≥30 mm,7 cases achieved successful LAA occlusion,but 3 cases failed.The implanted device diameter was (26.4±3.8)mm,and device compression rate was (7.6±5.5)%.The coefficient of correlation between device diameter and large LAA AAD and AOD is 0.770 and 0.717,respectively.There was no complication but 1 case with pericardial effusion.Conclusions Two dimentional TEE measurements of LAA have clinical guiding significance in the selection of proper size of ACP LAA occluder.The AAD of 2D TEE has the good correlation with ACP occluder′s size,the AADs are important factors which affect the success of LAA occlusion.
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Wound healing results in a scar formation, especially in deep skin injury. As a result of injury in the subcutaneous tissue and skin, scar formation is coupled with surgical operation. Improvement in the knowledge about the pathological mechanism and prevention of scarring would help clinicians to better deal with postoperative care and improve the satisfaction of patients. This review put emphasis on discussing the process of scar formation after surgery and the positive factor in this process. And furthermore, This review presented primary interventions with certain therapeutic effect.
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Objective To investigate the effect of unilateral basal ganglia hemorrhage on long -term behavio-ral development of neonatal SD rats.Methods Forty -eight neonatal SD rats (1 0 days after birth)were equally divided into cerebral hemorrhage (CH)group,sham operation (SH)group and normal control (NC)group randomly, 1 6 cases for each group.Stereotaxic apparatus was used to inject autologous blood 25 μL into rats′brain caudate nu-cleus to establish basal ganglia hemorrhage model,while SH group was injected with nothing,and NC group received no treatment.Berderson scoring method was used to test rats′neurological functions on the first day,the third day,the seventh day,and the fourteenth day after operation,respectively.The open -field environment test and the Lat maze were used to assess behavior of the rats on the fourteenth day after operation,lasting for 3 days continuously.Results (1 )After being modeled rats appeared with different degrees of neurological function damage.SH group rats′neurologi-cal function damage was slight,which was completely restored in the 72 hours after surgery.CH group rats appeared hemiplegia and muscle tension change.CH rats neurological scores′on the first and third day after modeling scores were separate (3.40 ±0.83)scores and (1 .1 3 ±0.92)scores respectively,and the scores were statistically higher than SH group [(0.73 ±0.59)scores and (0.1 3 ±0.35)scores]and NC group (all P 0.05).(2)On the fourteenth day after modeling,in open -field test and the Lat maze,the number of passed panels,straightening(times)and grooming(times)in CH group were more than those in SH group and NC group respectively (all P 0.05 ). Conclusions Neonatal rats focal hemorrhage in unilateral basal ganglia is strongly repairable and compensatory,which leaves no severe neurological dysfunction.The neurological function damage which is caused by unilateral basal ganglia hemorrhage can lead to the increase of autonomic activities,the decrease of non -selective attention level,attention defi-cit and other long -term behavioral abnormalities.
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To adapt the requirement of Chinese education development, and to abandon the defects of two semester system, such as too-long semester, inflexible curriculum, and restricting personality devel-opment of students, Xi'an Jiaotong University has performed semester reform for reforming the contents and methods of the teaching, promoting the innovation ability of students, and improving the quality of the scholastic education since 2013. In the current study, we have attempted to demonstrate the benefits of the semester reform for promoting the innovation ability of students, and to reveal the active role of the semester reform through comparing the presentation of medical undergraduate students in the national competition of innovation training for medical undergraduate students. Overall, the results of our analysis have supported the semester reform, and provided the reference information for the semester reforms of Chinese universities.
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Objective To evaluate right ventricular (RV)systolic function in type-2 diabetes mellitus (T2DM)patients.Methods Fifty T2DM patients and fifty normal controls were included in the study and underwent echocardiographic examinations.The following parameters were measured:1 ) Right heart dimensions,pulmonary artery (PA)diameter,pulmonary acceleration time (AT)and PA systolic pressure (PASP);2)RV systolic function:RV fractional area change (RVFAC),tissue Doppler-derived tricuspid lateral annular systolic velocity (S'),tricuspid annular plane systolic excursion (TAPSE),longitudinal strain of six RV segments by 2-dimensional speckle tracking imaging (2D-STI);3 )RV diastolic function:E,A ratio of the tricuspid inflow spectrum (E/A),E,E'(peak early diastolic velocity of the tricuspid annulus) ratio (E/E');4)RV Tei index.Results Statistic analysis showed that T2DM patients had thicker RV walls,wider PAs and shorter AT than the control group (P =0.000,0.001 and 0.000),while their right heart chamber sizes and PASP remained unchanged.Among systolic parameters,absolute values of RV longitudinal strain at the lateral wall-mid (lat-m),septum-mid (sep-m)and septum-basal (sep-b)segments were significantly lower in the diabetic group than the control group (P =0.001 ,0.000 and 0.005),whereas strain of the other three RV segments and RVFAC,TAPSE.S'were not significantly different.Moreover, E/A,E/E'and Tei index were all significantly different between the two groups (P = 0.000,0.000 and 0.006),indicating declined diastolic and general function of RV in the T2DM group.Conclusions RV myocardial strain by 2D-STI is more sensitive in detecting RV systolic dysfunction than TAPSE,S' and RVFAC.Among the six segments of RV walls,lat-m,sep-m and sep-b are better locations for 2D-STI than the other three.
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Objective To evaluate the role of real-time three-dimensional transesophageal echocardiography(RT-3D TEE)in left atrial appendage (LAA)occlusion.Methods Consecutive 10 atrial fibrillation (AF)patients (CHADS2 ≥ 2 )with high risk bleeding underwent LAA occlusion under the guidance of TEE.The LAA orifice shape and characteristics of lobes were assessed,the size of LAA with RT-3D TEE wee measured before closer implanation,and the position of the LAA occlusion device were evaluated by RT-3D TEE.The correlational analysis between LAA diameter and occluder size was conducted.Results Among 10 patients,the test results revealed 8 cases with complete LAA occlusion and 1 case with incomplete occlusion,and 1 case with failed occlusion.Five cases showed approximate round LAA ostium,and the other 5 showed approximate oval ostium.The average number of LAA lobes were 2.2±0.7. LAA ostium long diameter were larger by 3D TEE compared with 2D TEE[(21 .8±5.1)mm vs (20.8±4.1) mm],and ostium short diameter were smaller by 3D TEE compared with 2D TEE [(16.1 ± 3.0 )mm vs (1 7.0±2.6)mm],however there were no significant differences between 2D and 3D TEE measurements,and the mean ostium diameter and LAA depth were comparable between two methods.LAA ostium long diameter,short diameter,average diameter and LAA depth assessed by 3D TEE and 2D TEE showed good correlation with occluder diameter (3D TEE:r =0.719,0.690,0.791 ,0.71 1 ,and P =0.029,0.040,0.01 1 , 0.032,respectively;2D TEE:r = 0.887,0.894,0.932,0.896,and P = 0.001 ,0.001 ,0.000,0.000, respectively).LAA occlusion device position assessed by RT-3D:6 cases with appropriate position, acceptable position with 2 cases,and 1 case with malposition.Conclusions RT-3D TEE can play important role in evaluating the morphology of LAA,accurately judging LAA ostium shape and size and position of the occlusion device.
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Objective To discuss the feasibility and accuracy of left atrial appendage (LAA)ejection fraction by real-time 3 dimensional imaging (3D-EF),and tissue velocity of the LAA wall by tissue Doppler imaging (TDI)via transesophageal echocardiography (TEE)in assessing LAA functions.Methods A total number of 76 patients with atrial fibrillation (AF)were included in the study consecutively and underwent TEE for LAA investigations.3D-EF,fractional area change by 2 dimensional imaging (2D-FAC),peak emptying velocity (PEV),LAA tissue velocity by TDI at the mid-portion of lateral wall (TDI-L),mid-portion of septal wall (TDI-S)and the apical tip (TDI-A)were calculated.Results Statistic analysis showed the following results:1 )2D-FAC,3D-EF,PEV,TDI-L,TDI-S and TDI-A were all significantly higher in patients with sinus rhythm than those with AF during the TEE examinations (all P <0.05),and significantly higher in patients without spontaneous echo contrast (SEC)than those who had SEC (all P <0.05);2)The results of 3D-EF showed a good correlation with 2D-FAC (r=0.727,P =0.000),and their correlations with PEV were similar (2D-FAC and PEV:r =0.685;3D-EF and PEV:r =0.632,both P =0.000);3)TDI-A [(14.95±4.63)cm/s]were significantly higher than TDI-L [(12.62±3.96)cm/s]and TDI-S [(12.68±3.59)cm/s](both P =0.000).The correlations of TDI-A with PEV,2D-FAC and 3D-EF were all marked higher than those of TDI-L and TDI-S (with PEV:r=0.840 vs r=0.564,r=0.524;with 2D-FAC:r=0.701 vs r=0.486,r=0.504;with 3D-EF:r=0.753 vs r=0.493,r=0.522,all P <0.05). Conclusions 3D TEE is feasible and reliable in assessing LAA emptying function.The best location for LAA tissue velocity evaluation is the apical tip.
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Objective To explore the imaging features of papillary thyroid microcarcinoma(PTMC) with real time contrast-enhanced ultrasound.Methods One hundredand forty-three cases with 149 thyroid nodules(no diffuse lession) were divided into two groups according to the diameter size(group 1,＜0.5 cm;group 2,0.5-1.0 cm) and examined by contrast-enhanced ultrasound during preoperation.Pathology was followed up as golden diagnosis criteria.Results Seventy-five benign tumors and 74 PTMC were confirmed by pathology.There were significant differences in echoes homogeneity between benign and malignant tumors in group 2(W =1 029.5,Z =-5.524,P =0.000) but no in group 1(W =933.0,Z =-1.738,P =0.082).And nonhomogeneous enhancement were showed in most PTMC in group 2.But most PTMC showed homogeneous enhancement in group 1.Conclusions Contrast-enhanced ultrasound is valuable in diagnosis of PTMC with the diameter size of 0.5-1.0 cm.
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Objective To evaluate the diagnostic value of 2D ultrasound (2DUS)-based composite score method and contrast enhanced ultrasound (CEUS) in differentiation between thyroid microcarcinomas and benign micronodules. Methods A total of 216 consecutive patients with 258 thyroid micronodules underwent 2DUS and CEUS examinations before thyroidectomy from June 2011 to October 2013. The scoring of each nodule was based on five 2DUS features including hypoechogencity, irregular shape, macrocalcification, and taller than wide in shape. Microcalciifcation was assigned as 2 points and the remaining features were assigned as 1 point. A composite score was ifnally given to each thyroid nodule ranging from 0 to 6 points. The sensitivity, specificity and accuracy of diagnosing thyroid microcarcinoma by 2DUS composite score method and CEUS were calculated. Results The histopathologic results of all 258 nodules were acquired, including 125 papillary microcarcinomas and 133 benign micronodules. Each nodule′s 2DUS compostie score was ranging from 0 to 6 points. The area of receiver operating characteristic (ROC) curve of 2DUS in diagnosing thyroid microcarcinoma was 0.81. The 2DUS composite score method predicted the thyroid microcarcinoma with sensitivity of 78.4%(98/125), speciifcity of 72.9%(97/133), accuracy of 75.6%(195/258), when the nodule with a score greater than or equal to 3 points was deifned as malignant. Thyroid micronodules′enhancement pattern were divided into 7 types, including early hypoenhancement, hypoenhancement, isoenhancement, hyperenhancement, local nonenhancement, nonenhancement, and ring margin ring enhancement. CEUS predicted thyroid malignant micronodules with sensitivity of 87.2%(109/125), specificity of 75.9%(101/133), and accuracy of 81.4%(210/258), when early hypoenhancement and hypoenhancement pattern was defined as malignant patterns. There were no differences in sensitivity, specificity, and accuracy between 2DUS cumulative score method and CEUS in diagnosing thyroid microcarcinoma (McNemar test, P=0.099, 0.608, 0.096). Conclusion Early hypoenhancement and hypoenhancement are CEUS characteristic enhancement pattern for thyroid microcarcinoma, CEUS has higher sensitivity, speciifcity in diagnosis than 2DUS composite score method, while there are no statistical differences.
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Objective To evaluate the safety of percutaneous radiofrequency ablation (RFA ) in hepatic malignant tumors under the guidance of ultrasonography .Methods The clinical data and the follow‐up radiographic images of the patients with hepatic malignant tumors treated by percutaneous RFA between January 2012 and February 2014 were retrospectively reviewed ,and the major or minor complications of RFA were both calculated .Results 1 568 lesions were ablated by 1 080 percutaneous RFA procedures in 900 patients with hepatic malignant tumors under the guidance of the sonography .The average size of the tumors was (2 6.± 1 2.)cm .The total complications rate of 1 080 RFA procedures was 5 9.3% (64/1 080) , which including intra‐abdominal bleeding 2 7.8% (30/1 080) ,hepatic abscess 0 7.4% (8/1 080) ,biliary tract damage 0 6.4% (7/1 080 ) ,vascular damage 0 5.6% (6/1 080 ) ,tract seeding 0 4.6% (5/1 080 ) ,pleural hemorrhage 0 3.7% (4/1 080) ,gastrointestinal damage 0 1.8% (2/1 080) ,hepatic encephalopathy 0 0.9% (1/1 080) ,and death 0 0.9% (1/1 080) .While major complications was 1 9.4% (21/1 080) vs minor 3 9.8% (43/1 080) .Sixty three patients with complications recovered after treatments including blood transfusion , ablation ,surgery ,interventional drainage procedure and liver transplantation ,only one patient died for irreversible liver failure .Conclusions RFA for hepatic malignant tumors under the guidance of sonography is a safe method with lower complications rate ,however ,the potential major complications and the indications of RFA liver malignant tumors should be carefully focused on .
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Objective To apply the binary Logistic regression model and evaluate the value of grey scale ultrasonography(US),ultrasond elastography(UE) and contrast-enhanced ultrasound(CEUS).Methods US,UE and CEUS were performed in 130 patients with 142 solid thyroid micronodules (the largest diameter less than 10 mm).Pathology was followed up as golden diagnosis criteria.A Logistic model on the basis of ultrasonographic features was obtained.A receiver operating characteristic(ROC) curve was used to assess the performance of Logistic model.Results Four ultrasonic indexes were finally entered into the Logistic regression model including microcalcification,acpect ratio,advanced CEUS mode and elasticity score.The percentage correction of prediction was 92.1％ (129/142),the area under the ROC curve was 0.944.Conclusions The multivariate analysis model of binary Logistic regression can describe and analyze the process of differential diagnosis of malignant and benign solid thyroid micronodules by ultrasonography,and select out the valuable indexes for differential diagnosis.
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Objective To evaluate the short-term efficiency and risk factors for effects after percutaneous radiofrequency ablation (RFA) for hepatic malignant tumors under the guidance of sonography.Methods The clinical data and the follow-up radiographic images of the patients with hepatic malignant tumors treated by percutaneous RFA were reviewed between June 2011 and May 2012,and the short-term incomplete ablation rate,recurrance rate and tumor progression rate were calculated,and the factors affecting the incomplete ablation rate,recurrence rate and progression rate were analyzed.Results 610 lesions were ablated in the total of 462 RFA procedures for 405 patients under the guidance of sonography with percutaneous method.The average size of the tumor was (2.5 ± 1.1)cm.During at least 3-month follow-up,complete and incomplete ablation rate was 89.2％ (544/610) and 10.8％ (66/610)separately,and recurrance rate and progression rate of tumor was 17.5％ (81/462) and 23.8％ (110/462).The numbers (≥3) and the size (≥3 cm) and the location (close to vessels) of the lesions reduced the complete ablation rate.The numbers (≥3) of lesions affected the recurrence rate and progression rate of lesions as only risk factor.Recurrent hepatocellular carcinoma (HCC) and metstasis from gastrointestine or non-gastrointestine had higher recurrence rate and progression rate comparing with primary HCC.Conclusions RFA can effectively control local progression of hepatic maglinant tumors,and the tumor's size,number and location close to velssels could effect complete ablation rate,the number of tumors could effect the recurrence and porgression rate.Recurrent HCC and metstasis from gastrointestine or nongastrointestine had higher recurrence and progression rate comparing with primary HCC.
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Objective To evaluate the diagnostic value of contrast enhanced ultrasonogrphy(CEUS) and quantitative analysis in differentiating between thyroid solid malignant masses and solid benign masses.Methods 40 patients with thyroid solid mass were enrolled into this prospective study between March 2012 and June 2012.A total of 45 thyroid solid masses were evaluated by CEUS,and the final pathology diagnosis was confirmed by core biopsy or thyroidectomy.The diagnostic yield of enhancement patterns and quantitative parameters were assessed for differentiating between the solid malignant and benign masses.Results Enhancement patterns were classified into five types (nonenhancement,early hypo enhancement,hypo enhancement,isoenhancement,hyperenhancement).Two malignant masses had nonenhancement pattern,and 6 malignant masses had early hypoenhancement pattern,and 14 malignant and 4 benign masses had the hypo enhancement pattern,and 5 malignant and 7 benign masses had the isoenhancement pattern,and 1 malignant and 6 benign masses had the hyperenhancement pattern.There was a significant difference between malignant and benign enhancement patterns of thyroid solid masses (x2 =12.184,P =0.016).Nonenhancement,early hypoenhancement and whole phase hypoenhancement pattern predict thyroid solid malignant masses with sensitivity of 78.5 ％ and specificity of 76.5 ％.Among seven quantitative parameters used to predict thyroid malignant mass,the relative maximum intensity (IMAX％) of lesions had highest value in differentiating between the malignant and benign masses with sensitivity of 80.8 ％ and specificity of 82.6％,and area under receiver operating curve (AUC) of the IMAX％ was 0.878.RT (rising time),TTP (time to peak intensity),mTT (mean transit time) had almost non differentiation value with AUC of 0.619,0.601,0.656 separately.And mTT-Ratio (mTT of lesion/mTT of parametric area),RT-Ratio (RT of lesion/RT of parametric area),TTP-Ratio (TTP of lesion/TTP of parametric area) had less differential diagnostic value with AUC of 0.749,0.744,0.704 comparing with IMAX％.Conclusions Nonenhancement and early or whole phase hypoenhancement could be characteristic enhancement pattern of malignant thyroid solid masses,and IMAX％ had good diagnostic value in differentiating between malignant and benign masses among the quantitative parameters.
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Objective To evaluate the clinical significance of serum level of vascular endothelial growth factor (VEGF),angiopoietin (Ang)-1 and Ang-2 in patients with rheumatoid arthritis (RA).Methods Serum levels of VEGF,Ang-1 and Ang-2 were measured with enzyme linked immunosorbent assay (ELISA).Twenty-one healthy subjects,24 osteoarthritis patients and 82 rheumatoid arthritis patients were included.We defined active and inactive group according to RA disease active score,while early active RA and late active RA group were defined on the basis of disease course.There were 28 early active patients,32 late active patients and 22 inactive patients with rheumatoid arthritis.At the same time 29 RA patients were examined with ultrasound.Synovial hypertrophy (US joint count SH,US index SH),synovial fluid(US joint count SF,US index SF),resistance index and power Doppler signal (US joint PD,TSS) were scored.The correlation was analyzed.We also detected the serum levels of VEGF,Ang-1,Ang-2,ESR,CRP and DAS28 in 25patients with active RA after 3 month regular treatment.We used one-way ANOVA to compare the differences between groups,and Wilcoxon test to compare the differences between before and after treatment.We analyzed the correlation with linear correlation or Spearman rank test.Results The serum level of VEGF [(1285 ±272) pg/ml],Ang-1 [(0.55±0.25)ng/ml] in patients with rheumatoid arthritis were higher than osteoarthritis patients [(934±80) pg/ml,(0.32±0.16) ng/ml] and normal controls [(565±115) pg/ml,(0.24±0.21) ng/ml],and the serum level of Ang-2 [(1.36±0.40) ng/ml] was higher than normal controls [(0.52±0.32) ng/ml].The serum level of VEGF [(1355±194) pg/ml] in early active patients was higher than late active patients [(1096±477) pg/ml] and inactive patients [(862±91) pg/ml].The serum level of Ang-1 in early active patients,late active patients and inactive patients with rheumatoid arthritis had no statistically significant differences.The serum level of Ang-2 in inactive patients [(2.0±2.0) ng/ml] was significantly higher than late active patients [0.9±0.8) ng/ml].The serum level of VEGF was positively correlated with US joint SH,US index SH,US joint PD,and TSS.The serum level of Ang-1 was positively correlated with US joint SH,US joint PD,and TSS.The serum level of VEGF and Ang-1 were negatively correlated with RI.The serum level of Ang-2 was not correlated with US joint SH,US index SH,US joint SF,US index SF,US joint PD,TSS and RI.In the active RA patients,the serum level of VEGF,Ang-1 and Ang-2 was positively correlated with each other.In the inactive RA patients,the serum level of VEGF,Ang-1 and Ang-2 was not correlated with each other.The serum level of VEGF and Ang-1 before treatment was slightly higher than that of after treatment,but the difference was not statistically significant.The serum level of Ang-2 after treatment was significantly higher than that before treatment.ESR,CRP and DAS28 of after treatment were lower than those before treatment.Conclusion The serum VEGF and Ang-1 level could be used as useful index to reflect RA synovial thickening and angiogenesis The serum level of Ang-2 could be used as one of the efficacy indices.They may influence each other,and they may be the key factors that mediate the onset and development of RA angiogenesis and synovial inflammation.
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Objective To investigate the value of global longitudinal strain (GLS) in detecting severe coronary artery stenosis (SCAS) in patients with coronary artery disease. Methods Fourty-two patients with SCAS confirmed with coronary arteriongraphy (CAG) underwent two-dimensional strain echocardiography. GLS, wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) were obtained. Taking CAG as gold standard, the sensitivity, specificity and areas under the ROC curve (AUC) of definition of SCAS with GLS, WMSI and LVEF were calculated, respectively. Fifteen healthy volunteers were recruited as control. Results ①Definition of one or more branches with severe stenosis: The sensitivity and specificity was 77.51% and 100% with GLS of -17.50% as a cutoff value, 70.01% and 100% with WMSI of 1.00, and 57.51% and 100% with LVEF of 59.21%. ②Definition of two or more than two branches with severe stenosis: The sensitivity and specificity was 62.52% and 80.81% with GLS of -11.05% as a cutoff value, 56.22% and 65.31% with WMSI of 1.60 and 56.21% and 65.42% with LVEF of 54.31%. ③The correlation coefficient was 0.78 between GLS and LVEF, and -0.82 between WMSI and LVEF. The AUC of detecting one or more branch with severe stenosis with GLS, WMIS and LVEF was 0.87, 0.80 and 0.78, respectively, and AUC of GLS was more than that of LVEF (P＜0.01). AUC of detecting two or more than two branches with severe stenosis with GLS, WMIS and LVEF was 0.76, 0.64 and 0.64, AUC of GLS was more than that of LVEF and WMSI (all P＜0.01). Conclusion GLS can be used in detecting SCAS, and the value of GLS is better than that of WMIS and LVEF.