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Objective To explore the feasibility of the promoting effect of ultrasound targeted microbubble destruction(UTMD) on establishment of type Ⅰ diabetic nephropathy in rats.Methods Forty male SD rats were randomly and equally divided into four groups(n =10):control group(group A),streptozocin group(group B),streptozocin and ultrasound microbubble group(group C) and streptozocin and UTMD group(group D).The fasting blood-glucose (FBG) were tested,the 24 h's urine were collected and the 24 h's urine mieroalbumin(mAlb) were measured and then urinary albumin excretion rate(UAER) were calculated twice a week at fixed time in all groups.When greater than 3-fold increase in UAER compared with controls at the same age and gender,the diabetic nephropathy model in rats was considered to be established successfully,then the change of time and weighed were recorded and rats were killed and collected the blood of left atrial appendage to measure,blood urea nitrogen (BUN),serum creatinine (SCr) and Alanine aminotransferase (ALT).The left kidneys were weighted and then observed glomerular pathological changes under light microscope and detected the expression of CD34 in kidney of rats in each group by immunohistochemical method.Results ①The time of establishing diabetic nephropathy model in group D was obviously shorter than that in group B and C (all P ＜ 0.05).The FBG,the kidney index,UAER,BUN and Scr values in group B,C and D were significantly higher than those in group A(all P ＜0.05),but ALT had no significant change among each groups(all P ＞0.05).②The pathological changes of diabetic nephropathy appeared in rats of group B,C and D;the expression of CD34 in B,C and D groups were raised.Conclusions UTMD can obviously shorten the molding time of type Ⅰ diabetic nephropathy rats,which has feasibility.
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Objective To investigate the multivariate analysis of renal parenchymal elastic changes in diabetic and the value of virtual touch quantization ( VTQ ) techniques in the diagnosis of diabetic nephropathy . Methods According to urinary albumin excretion rate( UAER) ,72 cases of diabetics were divided into 3 groups:the normal albuminuria group ( UAER<30 mg/24 h) 16 cases ,the trace albuminuria group(30 mg/24 h< UAER< 300 mg/24 h) 30 cases and the mass albuminuria group ( UAER > 300 mg/24 h) 26 cases . And 50 healthy volunteers were selected as the control group . The basic clinical data of subjects were collected ,routine laboratory tests were detected ,and VTQ was used to measure the left renal parenchymal shear wave velocity ( SWV ) ,then the statistical software was applied to analyze these data . Results The left renal parenchymal SWV in the control group ,the normal albuminuria group ,the trace albuminuria group and the mass albuminuria group increased in turn ,respectively ( 2 .01 ± 0 .22 ) m/s , (2 .20 ± 0 .22) m/s ,(2 .51 ± 0 .42) m/s ,(2 .88 ± 0 .32) m/s ,the difference among 4 groups was statistically significant( P <0 .05) . Multiple linear regression analysis showed that SWV ( Y) had linear relationship with duration of diabetes(X1 ) ,left renal parenchymal thickness(X2 ) and serum creatinine(X3 ) ,and the regression equation was Y = 2 .719 + 0 .043 X1 -0 .051 X2 + 0 .002 X3 . In addition ,SWV was positively correlated with the duration of diabetes and serum creatinine ,and negatively correlated with the left renalparenchymal thickness . Conclusions There is correlation between the left renal parenchymal SWV andduration of diabetes ,left renal parenchymal thickness and serum creatinine ,and the left renal parenchymal SWV increases as the renal injury aggravating . VTQ has a certain reference value to judge the degree of early renal damage in diabetics .
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Objective To explore the feasibility of endothelial function of dorsal artery of foot in patients with type 2 diabetes(T2DM) by high frequency ultrasound combined with warm bath test.MethodsThirty-five patients with T2DM and thirty normal people were collected,all subjects were examined by high frequency ultrasound.Diameter of brachial artery in baseline and after reactive hyperaemia were detected;Diameter of dorsal artery of foot in baseline and after the foot immersed in 40℃ warm water for 5 minutes were acquired.Flow mediated dilatation of dorsalis pedis artery(FMDDPA) and flow mediated dilatation of brachial artery(FMDBA) were calculated and compared.Multiple stepwise regression analysis was used to examine the correlation between FMDDPA and hemoglobin A1c(HbAlc). Results The FMDDPA and FMDBA were decreased in patients with T2DM (P<0.01).The FMDDPA and FMDBA were correlated significantly(r=0.864,P<0.01).In stepwise regression analysis,HbA1c is the most affecting factor for FMDDPA (R2=0.321,P<0.01).Conclusions Ultrasound combined with warm bath test can be used to detect the change of endothelial function of dorsal artery of foot in patients with T2DM,which have a certain clinical application value in endothelial function of terminal limb artery.
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Objective To observe the role of abatacept in the treatment of diabetic nephropathy in rats. Methods Type 2 diabetic nephropathy rat model was established, and was randomly divided into abatacept group and non-intervention group, 15 each. 15 normal rats were served as control group ( NC) . The abatacept group was given abatacept for 8 weeks. The control group was set at the same time period. Then the blood biochemical indexes, blood flow parameters of renal main artery, elasticity of renal parenchymal, HE staining of renal parenchymal and ultrastructure of podocytes were all evaluated. The expression of CD31, CD34, podocin, nephrin, and B7-1 in renal parenchyma were detected. Results Compared to the NC group, the fasting blood glucose, creatinine clearance rate, urine albumin excretion rate, and kidney hypertrophy index in the non-intervention and abatacept groups were significantly increased (P<0. 05);creatinine clearance rate, urine albumin excretion rate, and kidney hypertrophy index in the abatacept group were significantly lower compared to the non-intervention group (P<0. 05). There were significant differences in peak systolic velocity, end diastolic velocity, and mean velocity among these 3 groups, and these differences were ranked as non-intervention group<abatacept group<control group ( P<0. 05 ); there were significant differences in systolic acceleration, pulsatility index, and resistance index among these three groups, with the differences ranked as non-intervention>abatacept>control groups (P<0. 05). There were significant differences in the stiffness of kidneys among these three groups, with the differences ranked as non-intervention>abatacept>control groups (P<0. 05). HE staining and transmission electron microscope observation showed that there were obvious changes in the renal parenchyma of rats in the non-intervention group and the abatacept group, and the changes of kidney in the non-intervention group were worse than those in the abatacept group. CD31 and CD34 expression in kidney parenchyma of rats in the abatacept group and non-intervention group were higher than those in the control group, the abatacept group and non-intervention group>the control group (P<0. 05), while no significant differences between the abatacept group and non-intervention group in CD31 and CD34 expression (P>0. 05). There were significant differences in podocin and nephrin expression in kidney parenchyma of rats among these three groups, and these differences were ranked as the control>abatacept>non-intervention groups (P<0. 05). There were significant differences in B7-1 expression in kidney parenchyma of rats among these three groups, and these differences were ranked as the control<abatacept<non-intervention groups (P<0. 05). Conclusion Abatacept may significantly alleviate the renal injury in type 2 diabetic nephropathy rats.
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Objective Three parameters include circumferential strain (CS),circumferential strain rate (CSr) and stiffness parameter (β) were measured to evaluate the elasticity of carotid artery using two-dimensional(2D) strain imaging and evaluate its clinical value in patients with type 2 diabetes mellitus (T2DM).Methods 60 patients with T2DM were collected and divided into carotid intima-midia thickness (CIMT) thickeness group(34 cases,1.0 mm＜CIMT≤1.2 mm) and plaque group(26 case,CIMT＞ 1.2 mm).33 normal people were supplied as control group.The systolic global peak CS and CSr of the carotid artery were obtained from short-axis view of the common carotid artery and the stiffness parameters β was measured using 2D strain imaging.All the parameters were compared among the three groups.Results The CS and CSr were decreased and β was increased in patients with T2DM (P ＜ 0.01),The CS and CSr obtained from the plaque group were less than that of the CIMT thickeness group(P ＜0.05),but the β was higher than that of the CIMT thickeness group (P ＜0.01).The CS and β were correlated significantly with CIMT respectively (r =-0.79,P ＜ 0.01 ; r =0.72,P ＜ 0.01).Conclusions 2D strain imaging is a technique for early assessing the carotid artery elasticity in patients with T2DM,the thicker the CIMT is,the smaller the deformation is and the larger the β is.
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Objective To investigate the changes of the shear wave velocities on thyroid tissues in patients with Graves disease(GD) and its correlation with thyrotropin (TSH).Methods Forty GD patients and 30 health adults who underwent an ultrasound-based acoustic radiation force impulse (ARFI) technique,the shear wave velocity of thyroid tissues was obtained using virtual touch tissue quantification (VTQ) of ARFI technique,and the changes of the shear wave velocities on thyroid tissues with GD patients and its correlation with the serum TSH level were analyzed.Results The shear wave velocities of thyroid tissues in patients with GD was lower than that of normal,thas were significant difference( P ＜0.05),but there were no significant differences among different locations in GD patients( P ＞0.05).The shear wave velocities of thyroid tissues were correlated with the serum TSH level in patients with GD,the correlation coefficient was 0.707.Conclusions The shear wave velocity may be considered as a helpful index in diagnosing GD and indirectly reflect the serum TSH level,provide some reference for therapy of the GD.
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Objective To investigate the effects in elasticity of anterior tibial artery in new patients with type 2 diabetes caused by medicines of reducing blood sugar. Methods One hundred patients with type 2 diabetes were involved. The patients were divided into control group(50 cases) and case group(50 cases) according the vascular complications (including macroangiopathy and microangiopathy). Maxmum of circumferential strain(CSmax) of anterior tibial artery was acquired through strain and strain rate imaging. Local blood pressure which included local systolic blood pressure(LSBP) and local diastolic blood pressure (LDBP) of anterior tibial artery was measured at the same time. Strain-blood pressure index(SBPI) of anterior tibial artery was calculated, SBPI = CSmax/[(LSBP - LDBP)/LDBP] × 100%. It took six months for each patient to take medicines of reducing blood sugar. Then SBPI of anterior tibial artery was calculated again. Parameters were compared inter- and intra-groups. Results SBPI of anterior tibial artery after therapy was higher than that before therapy in control group( P0. 05). SBPI of anterior tibial artery in case group was lower than that in control whatever before and after therapy( P < 0. 05). Conclusions The protection of medicines of reducing blood sugar on elasticity of anterior tibial artery in new diabetic patients without vascular complications was better.
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Objective To investigate the correlation between intima-media thickness(IMT)and elasticity of carotid in patients with type 2 diabetes accompanied hyperlipidemia by quantitative intima-media thickness(QIMT)and quantitative arterial stiffness(QAS)technique.Methods Fifty-six patients with type 2 diabetes accompanied hyperlipidemia were involved into the study as case group.Forty-eight healthy volunteers were supplied as normal control group in the same period.IMT,compliance coefficient(CC),distensibility coefficient(DC)and stiffness index(β)of carotid were acquired through QIMT and QAS.Case group was divided into case group 1(IMT＜0.9mm)and case group 2(IMT≥0.9 mm),and analysis was performed furtherly.Results β,triglyceride(TG),lowdensity lipoprotein(LDL),cholesterol(Ch),glycosylated hemoglobin(GHb)and IMT had significant differences in case group 1,case group 2 and control group(P＜0.05),control group＜case group 1＜case group 2.DC and CC had significant differences in case group 1,case group 2 and control group(P＜0.05),control group＞case group 1＞case group 2.There was significant positive correlation between β and age,GHb,LDL and IMT of carotid respectively(r=0.811,r:0.764,r=0.732,r:0.729,respectively,P=0.000).Conchmions IMT of carotid could be measured accurately by QIMT.Structure imaging and functional imaging of carotid might be combined organically through QIMT and QAS.Depth study about early change of carotid in structure and function could be performed with these two techniques.
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Objective To explore the clinical value of Doppler tissue imaging (DTI) in evaluating abdominal aortic wall motion to predict pregnancy-induced hypertension (PIH).Methods The velocities of anterior abdominal aortic wall motion in 112 pregnant women with normal 20-40 weeks' pregnancy were detected by DTI and combined with simultaneous electrocardiography.Electromechanical time (EMT), left ventricular pre-ejection period (PEP), patients' height and weight were measured and recorded respectively.Pulsed wave time (PWT, PWT = EMT-PEP) and relative pulse wave velocity (RPWV) were calculated and analyzed.Medium and late stage PIH eases and time were recorded in clinical follow-up.Results PIH group were 11 cases, non-PIH group were 101 cases.E, S_1, S_2, D peak value in PIH group were significantly lower than those in non-PIH group [(2.02 ± 0.39 ) cm/s vs (2.32 ± 0.45 ) cm/s, (6.08 ± 0.87 ) cm/s vs(7.12 ±1.11 ) cm/s, (2.22 ± 0.65 ) cm/s vs( 2.83 ± 0.81 ) cm/s, (3.26 ± 0.54) cm/s vs( 3.86 ± 0.72 ) cm/s, P < 0.01]; EMT shortening[(120.87 ± 11.34) ms vs (134.32 ± 10.62) ms,P<0.05];PEP longer[(92.36±9.04) ms vs(83.11±8.95) ms,P< 0.05];PWT shortening[(31 ± 11) ms vs(45 ± 13) ms,P<0.01]; RPWV faster [( 1 02.28 ± 20.69) m/s vs (75.37 ± 18.74) m/s, P < 0.01].Conclusions Abdominal aortic wall motion has already changed in early stage of PIH.DTI is a valuable method to evaluate the abdominal aorta wall motion for early detection of PIH with high sensitivity, high accuracy and access to promote.
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Objective To establish a quantitative measurement of flow field uniformity of mitral valve in vivo and investigate the correlation between the parameter of flow field uniformity and the degree of mitral stenosis. Methods The flow field uniformity downstream of mitral valve in normal cases and patients with mitral stenosis were studied using vector flow mapping(VFM) technique. Results The flow field uniformity parameter of standard deviation of velocity (Vsd) in patients with mitral valve stenosis was significantly higher than that in control group ( P <0. 05). There was a negative linear correlation between Vsd and effective orifice area(EOA) in patients with mitral valve stenosis (parasternal long-axis: r = - 0. 816, P = 0.000; apical four chamber: r = - 0. 825, P = 0. 000). Conclusions VFM can really reflect the flow field uniformity of normal cases and patients with mitral stenosis.
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Objective To assess the relationship between the enhanced intensity of carotid plaque and risk of cerebral infarction using contrast-enhanced ultrasonography(CEUS). Methods Eighty one patients with cerebral infarction and 95 patients without cerebral infarction were enrolled in this study. All the patients were performed using CEUS. The characteristics of plaque enhancement was categorized: grade Ⅰ , non-enhancement;grade Ⅱ , the arterial wall vasa vasorum enhancement; grade Ⅲ. the arterial wall vasa vasorum and plaque shoulder enhancement; grade Ⅳ , extensive and internal plaque enhancement. The data between the two groups was compared and analysed. Results Plaque enhancement presented with grade Ⅰ in 7 cases of 81 patients and 26 cases of 95 controls,grade Ⅱ in 14 and 37,grade Ⅲ in 26 and 17,grade Ⅳ in 34 and 15. The percentage of stroke in grade Ⅰ was 21.2% (7/33),grade Ⅱ was 27.5%(14/51), grade Ⅲ was 60.5% (26/43) and gradeⅣ was 69.4% (34/49). The percentage of stroke in grade Ⅲ was significantly higher than that in grade Ⅰ and Ⅱ ( P = 0. 001, P = 0. 001 ), and there was no significant difference between grade Ⅲ and Ⅳ ( P = 0.370). The sensitivity and specificity for grade of plaque enhancement (AUC = 0. 721, cutoff value > grade Ⅱ ) were 74. 1 % and 66. 3% respectively. Conclusions The grade of enhancement of carotid plaques in CEUS is a valid indicator to anticipate cerebral infarction. The higher the grade of enhancement of carotid plaques,the higher the risk of cerebral infarction.
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Objective To investigate the clinical value and the feasibility of strain-blood pressure index(SBPI) in assessing the elasticity of brachial artery and anterior tibial artery in patients with type 2 diabetes mellitus. Methods Forty-six type 2 diabetic patients and 50 healthy volunteers were involved. Maxmum of circumferential strain (CSmax) of brachial artery and anterior tibial artery were acquired through strain and strain rate imaging(Xstrain). Local systolic blood pressure(LSBP) and local diastolic blood pressure(LDBP) of brachial artery and anterior tibial artery were measured at the same time. SBPI,tibial-brachial index (TBI), and ankle-brachial index(ABI) were calculated, SBPI = CSmax/[(LSBP-LDBP) /LDBP]×100%,TBI = SBPI of anterior tibial artery/SBPI of brachial artery, ABI = LSBP of anterior tibial artery/LSBP of brachial artery. Parameters were compared between the case group and the control group. Results SBPI of anterior tibial artery and TBI had significant difference between the case group and the control group( P < 0.05), while SBPI of brachial and ABI had no significant difference( P >0. 05).Conclusions SBPI might be a new index for evaluating the elasticity of medium-sized arteries in patients with type 2 diabetes, and different changes caused by type 2 diabetes between brachial artery and anterior tibial artery could be reflected by TBI.
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Objective To investigate the ultrasonographic character of neonatal adrenal hemorrhage (NAH). Methods Forty-four hospitalized NAH were retrospectively analyzed. Doppler ultrasonography detected their shape and supply. Results Forty-one cases were diagnosed by ultrasonography in 44 cases of NAH,3 cases were misdiagnosed, accompanying with scrotal hematoma in 5 cases. Ultrasonography demonstrated mixed, anechoic, hyperechoic, hypoechoic adrenal mass, no color Doppler signal in all of NAH. Conclusions NAH can be diagnosed by color Doppler ultrasound in early stage and it is the first choice method.
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Objective To investigate the clinical value of contrast-enhanced three-dimensional ultrasound in assessing neovascularization within carotid soft plaques. Methods Thirty-six cases with 42 soft plaques were examined with contrast-enhanced two dimensional ultrasound and contrast-enhanced three dimensional ultrasound. Soft plaques were divided into four grades according to distribution and shape of contrast media:grade Ⅰ (there was no enhancement in plaque) , grade Ⅱ (plaque was enhanced with sparse spots pattern or enhanced in small range locally), grade Ⅲ (plaque was enhanced with sparse spots and short-line pattern ),grade Ⅳ (plaque was enhanced with line and grid pattern). Results The results of contrast-enhanced two-dimensional ultrasound were as followed: 4.8% grade Ⅰ , 35.7% grade Ⅱ , 52.4% grade Ⅲ and 7.1% grade Ⅳ. The results of contrast-enhanced three-dimensional ultrasound were as followed:9.5% grade Ⅱ , 47.6% grade Ⅲ and 42.9% grade Ⅳ. Conclusions Spatial distribution of neovascularization within carotid soft plaques could be reflected comprehensively by contrast-enhanced three dimensional ultrasound, and it might be a new mothod to investigate spatial structure and microvascular perfusion of soft plaques furtherly.
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Objective To assess the value of approximal side angle of carotid atherosclerotic plaques in patients with cerebral infarction by ultrasonography.Methods One hundred and seventy six patients with carotid atherosclerotic plaques were examined with uItrasonography and divided into two groups:cerebral infarction group (n=67)and none cerebral infarction group(n=109).Vessel area and residual lumen area of carotid artery were measured in axial view using linear probe.Area stenosis rate was calculated.The approximal side angle and thickness of plaque were measured respectively.The results of two groups were compared.Results The approximal side angle of plaque of cerebral group was significantly higher than that of none cerebral infarction groups(P<0.05).The sensitivity and specificity for approximal side angle of plaque(cutoff value:13.0°)were 79.1%,71.6%,respectively.There were no significant difference of area stenosis rate and plaque thickness between two groups(P>0.05).Conclusions The approximal side angle of plaque can be regarded as a novel index to assess the stability of plaque.
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Objective To assess the elasticity change of common carotid artery in early stage of atherosclerosis in patients with type 2 diabetes by velocity vector imaging(VVI).Methods Sixty patients with type 2 diabetes were divided into group A(32 cases)and group B(28case)according the vascular complications(including Macroangiopathy and Microangiopathy).Patients without vascular complications belong to group A,others belong to group B.Fifty-eight healthy volunteers were supplied as normal control group.Time to the peak of velocity(VTTP),maximum of velocity(Vmax),maximum of strain(Smax),and maximum of strain rate(SRmax)of six segment(anterolateral wall,anterior wall,anteromedial wall,posteromedial wall,posterior wall,posterolateral wall)were measured,which were supplied by VVI automatic analysis software.Results VTTP,Smax and SRmax had no significant differences in any segments intra-group A,B and control group(P＞0.05).Vmax had significant differences in some segments in control group,group A and group B,Vmax of anterior wall,anterolateral wall and posterolateral wall were higher than those of posterior wall,posteromedial wall and anteromedial wall(P＜0.05).VTTP,Vmax,Smax and SRmax of corresponding segments had significant differences among group A,group B and control group(P＜0.05),control group＞group A＞group B(P＜0.05).Conclusions The change of common carotid elasticity can be detected in early stage of atherosclerosis in patients with type 2 diabetes by VVI.
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Objective To study the synchronization of carotid artery wall motion with atheroscleroticsoft eccentric plaque using velocity vector imaging(ⅤⅥ). Methods Seventy-two patients with carotid artery atherosclerotic soft eccentric plaque were enrolled in this study. Their carotid arteries were examined using Acuson Sequoia 512 instrument respectively.Combined with ECG,two dimensional imaging of short axis view of carotid artery atherosclerotic soft eccentric plaque were recorded and analyzed on-line using ⅤⅥ software. The carotid artery wall of short axis was automatically divided into 6 segments. Time to peak index (TTPI)was calculated respectively. Results The TTPI was significantly higher than that of control group (P＜0.001). A cut-off value＜0.595 of TTPI for assessing the synchronization of carotid artery wall motion had a sensitivity of 93.9%,a specificity of 91.7%,respectively. Conclusions ⅤⅥ provides a new tool to assess the synchronization of arterial wall motion.
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Objective To explore the relationship between pulse pressure and aortic relative pulse wave velocity in the patients with hypertension by Doppler tissue imaging.Methods Velocities of abdominal aortic wall motion were measured in ninety one patients with essential hypertension.Electro mechanical time(EMT),pre ejection period (PEP) and the patient height(H) were measured and recorded respectively,and pulse wave time (PWT) was defined as EMT-PEP and relative pulse wave velocity (RPWV) as H/PWT.Results RPWV in the patients with pulse pressure ≥60 mm Hg ( 1 mm Hg = 0.133 kPa) was significantly greater than that of the patients with pulse pressure