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Objective To quantitatively evaluate the vulnerability of carotid plaques in patients with acute ischemic cerebral infarction by using Gray-scale median (GSM) based on Three-dimensional ultrasound (3D-US).Methods Totally 207 patients were examined with carotid plaques in the PLA Army General Hospital from December 2015 to August 2016,including 102 patients with acute cerebralischemic stroke (cerebral infarction group) and 105 patients without cerebral infarction (control group).The Vascular plaque quantification (VPQ) software was applied to acquire GSM value of carotid plaques automatically.Results The GSM value of carotid plaques in cerebral infarction group was significantly lower than that in control group (44.78± 11.58 vs 54.36± 11.99,t=7.70,P ＜ 0.01),and the low density lipoprotein in the cerebral infarction group was significantly higher than that in the control group [(3.51 ± 1.20) mmol/L vs (3.10± 1.07) mmol/L,t=1.58,P ＜ 0.05].There was no significant difference between the two groups in age,gender,body mass index,smoking,drinking,history of diabetes,history of hypertension,systolic blood pressure,diastolic blood pressure,triglyceride,total cholesterol,high density lipoprotein,plaque thickness,plaque area stenosis rate and plaque volume (all P ＞ 0.05).Conclusion The GSM value of carotid plaques based on 3D-US-VPQ technology can effectively reflect the vulnerability of carotid plaques,and may be valuable in the risk assessment of carotid plaques.
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Objective To explore the value of three-dimensional ultrasound (3D-US) gray scale median (GSM) in quantitative evaluation of the drug treatment of carotid plaques.Methods Eighty-one patients with 93 carotid plaques were enrolled from May 2015 to October 2015.Patients were received 3D-US,3.0T MRI and blood lipid examination including total cholesterol(TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),and high-density lipoprotein cholesterol(HDL-C) before drug treatment.After atorvastatin therapy with a daily dose of 20mg for 6-12 months,3D-US and blood lipid examination were repeated,and 55 patients were followed successfully with a total of 62 plaques obtained.According to data acquired by MRI and 3D-US before treatment,the patients were divided into low-risk group,medium risk group,and high-risk group.The differences of GSM value and blood lipid levels were compared among groups and the changes of these parameters before and after the treatment in each group were compared.Results There was no significantly difference in serum TC,TG,LDL-C and HDL-C levels among the groups before treatment.After treatment,the serum TC and LDL-C levels were significantly lower than those before(P ＜0.05),the differences of TG and HDL-C levels were not significant,and the LDL-C level in high-risk group was significantly lower than those in other groups(P ＜0.05).The GSM values in of high-risk and medium-risk group were significantly increased after drug treatment than those of before (33.87 ± 6.53 vs 27.50 ± 7.82,47.35 ± 5.42 vs 44.56 ± 4.36,P ＜0.05),and had no significantly change in low risk group(62.01 ± 10.68 vs 63.13 ± 10.41,P ＞0.05).The difference of GSM between before and after treatment in each group was negatively correlated with the difference of LDL-C (r =-0.28,P =0.03).Conclusions Three-Dimensional ultrasound (3D-US) gray scale median (GSM) can be a reliable parameter in clinic quantitative evaluation drug treatment of carotid plaques,and has a better value especially for high-risk and medium-risk plaques.
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Objective To investigate the vessel structure changes of carotid artery with age in normal adults with a newly-developed 3-dimensional ultrasound imaging modality.Methods One hundred and twenty-five normal adult volunteers were divided into five groups:group A,20-29 years old,25 cases;group B,30-39 years old,27 cases;group C,40-49 years old,28 cases;group D,50-59 years old,23 cases;group E,older than 60 years old,22 cases.The straight sections of common carotid arteries were scanned by full-volume three-dimensional ultrasound probe.With a vessel plaque quantification software (VPQ),the following parameters were obtained:intima-media thickness (IMT),vessel total area (VTA),vessel lumen area (VLA),vessel wall area (VWA),and normalized wall index (NWI).Results IMT,VTA,VWA,VLA and NWI were all positively correlated with age (r =0.79,0.48,0.77,0.27 and 0.67 respectively,P =0.00),and there was significant difference among age groups (P ＜0.01).IMT,VTA,VWA increased with age gradually whereas VLA increased only in group E and NWI showed no significant difference between group E and D.VWA and VTA of males were significantly greater than those of females in group A,B and C,and VLA of males was significantly greater than females in group A and B.There was no significant difference in IMT and NWI between gender groups.Conclusions Age is an important factor to carotid remodeling,and IMT,VTA and VWA increase with age,but VLA keeps constant in people under 60-year-old while NWI becomes stable in people over 50-year-old.It is essential to consider the physiological changes of carotid with age when pathophysiological process of atherosclerosis is involved.
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Objective To establish a rat model at the same time in accordance with the “hot sheng syndrome” of traditional Chinese medicine and primary immune thrombocytopenic purpura of peripheral blood platelet reduction. Methods Using back multi-point injection of 20% dry yeast suspension on SD rats and 1∶4 dilution of rabbit anti SD rats platelet serum (APS) by intraperitoneal injection to establish a primary immune thrombocytopenic purpura “heat sheng”rat model.And observing rats of TCM syndrome characteristics, hemogram, myelogram and serotonin (5-HT) level of the temperature regulating center in thalamus.Results After injection of 2 h ~6 h temperature and daily water of the model group rats increased significantly,toe purper showed in fourth day of modeling and intestinal mucosal bleeding in thirty day of modeling(P <0.05);Platelet count in peripheral blood decreased significantly, bone marrow megakaryocyte number reduced significantly((P <0.05);5-HT level of the temperature regulating center of brain increased significantly((P <0.05).Conclusions The study of the primary immune thrombocytopenic purpura heat sheng rat model of combination of disease and syndrome reflected basically the pathological characteristics of purpura caused by “heat sheng” in primary immune thrombocytopenic purpura rat mode.
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Objective To observe features of twist of the left ventricle (LV) in patients of essential hypertension (EH) with LV normal geometry (LVN) by three-dimensional speckle tracking imaging (3D-STI).Methods Thirty EH patients with LVN and 32 healthy control subjects were included.From the dynamic images of LV apical two-and four-chamber-views and three-dimensional full volume dataset acquired,the following parameters were obtained:peak of LV basal,middle and apical segment rotation (Prot-B,Prot-M and Prot-A),peak of LV global segment twist (LV-tw) and rotation (LV-rot),the global radial and longitudinal displacement (Dr,Dl) and the global 3D displacement (D3d).The difference of these parameters was compared between EH and control groups,and the correlation between LV-tw and the displacements in EH group was studied.Results Compared with the normal control group,Prot-B,Prot-M,Prot-A,LV-tw,LV-rot,Dr,Dl and D3d of EH group were significantly increased (P ＜ 0.01 or 0.05),and LV-tw showed significant correlation with Dr,Dl and D3d (P ＜0.01 or 0.05).Conclusions The evaluation of LV twist with 3DSTI in EH patients can reflect the changes of LV systolic function in early stage,3D-STI may provide a new modality for quantitative evaluation of early abnormality of LV function in clinical practice.
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Objective To evaluate the clinical efficacy of integration of traditional Chinese and western medicine (ITWM) or pure western medicine on the patients with immune thrombocytopenia (ITP). Methods Randomized controlled trials (RCTs) on ITWM treatment of ITP were searched in PubMed, EMBASE, Wanfang database, CBMDisc, CNKI and VIP. Quality of the RCTs was evaluated strictly, and statistical analysis was performed with Cochrane Collaboration’s RevMan5.1.7 software. Results Twenty-two trials involving 1527 patients were included. The results of Meta-analysis showed that the ITWM treatment of ITP significantly improved the total effective rate [RR=1.23, 95%CI (1.17, 1.29), P<0.000 01] compared with that of pure western medicine treatment. Funnel plot showed that publication bias was small. Meanwhile, peripheral platelet count and the number of megakaryocyte which can generate platelet in bone marrow increased, obvious advantage was showed in long-term effect, and adverse reactions were reduced with ITWM treatment in ITP patients. Conclusion The existed limited evidences suggest that ITWM treatment of ITP can significantly improve clinical efficacy. The quantity and quality of research literature were limited, and well-designed randomized double-blind controlled trials with large sample and multi-centers are required for a more reliable conclusion.
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Objective To investigate the clinical and cytogenetic features of myelodysplastic syndrome (MDS) ,and to investigate the application of the International Prognostic Scoring System Revised (IPSS-R) in myelodysplastic syndrome .Methods A retro-spective analysis was conducted on 112 patients diagnosed with MDS on basis of French-American-British(FAB) and World Health Organization(WHO) criterion .Conventional cytogenetics are performed to investigated the cytogenetics changes .Results Karyo-type abnormalities are found in 46(41 .1% ) patients .Cytogenetics subgroups are devided into 5 groups according to IPSS-R criteri-on :very good ,good ,intermediate ,poor ,very poor ,which account for 2 cases(1 .8% ) ,48 cases (42 .9% ) ,41 cases (36 .6% ) ,10 ca-ses (8 .9% ) ,11 cases (9 .8% ) ,with a median survival time(MS) 59 ,36 ,15 ,10 month respectively ,except for very good .Conclusion It is of great guiding significance of IPSS-R criteria for prognostic stratification .