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Aortic stenosis is a common heart valve disease.Among adults,the most crucial cause of aortic stenosis is aortic valve calcification. Recent studies have shown that several factors may efficiently lead to aortic valve calcification such as age,valve structure,metabolism and genes.Although the main treatment for aortic valve calcification is still via surgery, with the further and deeper investigation in pathomechanism of aortic stenosis,we have made progress in pharmaceutical therapy for aortic valve stenosis patients.This article mainly focuses on the pathogenesis and treatment of calcified aortic valve stenosis.
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BACKGROUND: Comparing with diabetic nephropathy and diabetic retinopathy, diabetic cardiomyopathy is put forward exceeded later and the research about it was not enough. It is difficult to detect diabetic cardiomyopathy in the earlier period so that it has usually been neglected.OBJECTIVE: To evaluate features of dysfunction of left ventricle in early diabetic cardiomyopathy by Doppler tissue imaging.DESIGN: Completely randomized and controlled experiment.SETTING: Ultrasound Department of General Hospital of Chengdu Military Area Command of Chinese PLA.MATERIALS: The experiment was carried out at Ultrasound Department of General Hospital of Chengdu Military Area Command of Chinese PLA from March to June 2002. Totally 56 New Zealand rabbits of either gender were selected.METHODS: ① Ten New Zealand rabbits was pulled out randomly from 56 as control group. The rest of 46 New Zealand rabbits were replicated diabetes mellitus by Streptozotocin (STZ), rabbits were absolute diet 18 hours and injected intravenously to ear marginal vein with 65 mg/kg of STZ. Then these rabbits were randomly divided into 4 groups as 2, 4, 6, 8th experimental group, with 10 rabbits in each group. ② Digit ultrasonic cardiogram equipment was used to examined interventricular motion of mitral annulus at 2nd,4th, 6th and 8th week in model groups and comparison group. The parameters such as systolic peak velocity (Sa), preejection period (PEP), local ejection time (ET), systolic mean velocity (Vm) of four various portions in mitral annulus and diastole early period velocity (Ea), diastole later period velocity (Aa), Ea/Aa were determined. ③ SPSS 11.0 was used for statistical analysis,one-factor analysis was adopted to compare difference of groups.MAIN OUTCOME MEASURES: The motion of lateral wall and posterior interventricular septum at mitral annulus were estimated by PW-DTI.RESULTS: Among 56 rabbits, 50 entered the final analysis and other 6 were lost because of failure modeling. Diastole dysfunction of left ventricle was discovered in STZ-inducod diabetic rabbits detected by tissue Doppler imaging at the 4th week. It showed that not only the tite of early period of diastole peak velocity (Ea) in mitral ring lateral wall and post-interval of left ventricle was reduced, but also the tite of Ea/Aa was reduced notably (P ＜ 0.05). Systolic dysfunction of left ventricle was discovered in STZ-in-duced diabetic rabbits detected by tissue Doppler imaging at the 6th week.It showed that local contraction peak velocity (Sa) of lateral wall and postseptum of mitral ring was decreased strikingly (P ＜ 0.05). Mean systole velocity of four various parts of mitral ring (Vm) was reduced at the 6th week (P ＜ 0.05). Pre-ejection period time (PEP) at post-septum and ejection time (ET) was elongated at lateral wall at the 8th week (P ＜ 0.05).CONCLUSION: ① Diastolic dysfunction of left ventricle is characterized by decrease of early period of diastole peak velocity and the tite of Ea/Aa.② Systolic dysfunction of diabetic cardiomyopathy is characterized by decrease of local contraction peak velocity and elongation of pre-ejection period time and ejection time.
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Objective To explore the value of two dimensional and color Doppler flow imaging(2D CDFI)for the diagnosis and differentiation of the carotid body tumor.Methods Retrospective analysis was made on 12 patients with carotid body tumor examined by 2D CDFI,and differentiations were conducted between several similar diseases.All the cases were confirmed by surgical pathology.Results The carotid body tumor in 2D CDFI was shown as follows: Low echoic substantial masses were found in the carotid branch with clearly boundary,and or partly outline.Most in small size were located at the branch of common carotid artery,so the interval between external and internal carotid arteries was enlarged.The masses in big size always grew around common cartid artery internal carotid artery and external carotid artery.More color flow signals were detected in the masses,and most were artery flow.The relationship between the mass and the carotid was shown clearly by 2D CDFI.Conclusions 2D CDFI is a valuable and practical method in diagnosis of carotid body tumors.
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The development of medical technology draws the doctor-patient relationship ever closer.However,the abundance and complexity of medical knowledge and technology make it a difficult task for medical personnel to grasp medical knowledge and skills,setting up a higher request for handling physician-patient relationship.Besides,medical disputes between doctors and patients caused by the abuse of medical technology in clinical practice also contribute to the contradiction between the advancement of medical technology and the latency of medical morality.Therefore,it is one important part in the study on medical morality from the perspective of medical technology ethics to take a rational view on the development of medical technology and construct a harmonious physician-patient relationship.
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Objective To investigate the effects of clod plasma cardioplegia on the function and structure of immature myocardium. Methods Thirty-two new Zealand white rabbits of 17-26 days weighing (512 ?56) g were anesthetized and heparinized. Their hearts were excised and perfused in a Langendorff apparatus with warm (37℃) oxygenated (95%O2, 5%CO2) Krebs-Henseleit buffer(KHB) at 60 cm H2O perfusion pressure. After the isolated heart had been beating regularly for 10 min, the heart was perfused with clod (10℃) St. Thomas cardioplegic solution (group C, n = 16) or cold cardioplegic solution mixed with plasma (St. Thomas solution: plasma = 1:4) (group P, n=16). The K+ concentration of the cardioplegic solution in both groups was the same. After 30 min cardiac arrest the heart was again perfused with KHB. The following observations were made: (1) the interval from the beginning of cardioplegic solution infusion to cardiac arrest and the amount of cardioplegic solution used; (2) the duration from KHB reperfusion after 30 min cardiac arrest to the recovery of regular heart beat; (3) heat rate after recovery from cardioplegia; (4) coronary flow; (5 ) myocardial water content; (6) myocardial structural changes shown by microscopic examination. Results (1) There was no significant difference in the time needed to induce cardiac arrest and for recovery of regular heart beat from cardioplegia. (2) The heart rate was (129 ?5)beat/min in group P and (120?) beat/min in group C, the coronary flow was (5.10?0.20) ml?L-1 in group P and (3 50? 0.50) mi ?L -1 in group C, the differences were statistically significant (P
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Since the current worldwide medical education and clinical practice lay a particular stress on training medical students with scientific knowledge and medical technical skills,enormous medical staffs are shaped into medical technical workers who lack medical morality and emotions,leading to the contradiction between medical morality and technologies.Medical personnel should know that medicine not only observes illness closely,but also attaches importance to the patients themselves who are suffering the pain.Medical students should pay attention to the forming process of medical morality and emotion in their preparative stage,accept the exercise to prepare for medical morality,and recalls their love and concern for life.
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To explore the value of two dimensional ultrasonography used in gunshot wound, features of gunshot wound in pig thigh were studied by high frequency ultrasound and compared with pathologic examination. The primary wound tract showed remarkable features in ultrasonography with a cured anomalous pipelike image, which changed with time. Tissues around the wound tract also revealed some sonographic characteristics. The results indicate that two dimensional ultrasound can clearly manifest not only the shape and distribution of the wound tract, but also the relation between the tract and its adjacent tissues. Therefore, the method is of important value in treatment of gunshot wound.