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Objective:To evaluate the left ventricular myocardial strain and mechanical synchrony in patients suspected of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) by two-dimensional speckle tracking imaging (2D-STI) and real-time three-dimensional echocardiography (RT-3DE), and to investigate the value of combined echocadiographic parameters in predication of significant coronary artery stenosis.Methods:A total of 95 patients suspected of NSTE-ACS, definitely planed to run coronary angiography (CAG) within 24-72 hours of admission were recruited in the Department of Cardiology, General Hospital of the Southern Theatre Command, PLA from December 2020 to June 2021. Regular echocardiography exam, 2D-STI and RT-3DE were performed prior to CAG.Global longitudinal peak strain (GLPS), territorial longitudinal peak strain (T RCALPS, T LADLPS, T LCXLPS) were computed by 2D-STI; the maximal difference of time to minimal systolic volume of 16-segments (Tmsv16-Dif), standard deviation of time to minimal systolic volume of 16-segment (Tmsv16-SD) and heart rate adjusted standard deviation of time to minimal systolic volume of 16-segment (Tmsv16-SD/R-R) were obtained by RT-3DE. The patients were divided into two groups according to the degree of coronary stenosis.Significant coronary artery stenosis group was defined as ≥70% of left main or any other main branch luminal narrowing ( n=53), non-significant coronary artery stenosis group was defined as <70% of luminal narrowing ( n=42). The differences of general clinical features, left ventricular strain and mechanical synchronization parameters between the two groups were compared. A binary logistic regression model was established to draw the ROC curve for predicting the severity of coronary stenosis by single and combined ultrasound parameters, and calculate the area under the ROC curve (AUC). Results:Compared with non-significant coronary artery stenosis group, GLPS were significantly reduced, while Tmsv16-SD, Tmsv16-Dif and Tmsv16-SD/R-R were significantly increased in sginificant coronary artery stenosis group (all P<0.05). The AUC of GLPS and Tmsv16-SD, Tmsv16-Dif and Tmsv16-SD/R-R for predicting significant coronary stenosis in suspected NSTE-ACS patients were 0.78, 0.69, 0.71 and 0.67, respectively. The result of joint test analysis for the dignosis of NSTE-ACS suspected significant coronary stenosis were as follows: the specificity of tandem test was 90.5%; the sensitivity of parallel test was 83.0%; the sensitivity, specificity and AUC of GLPS-Tmsv16-Dif joint index prediction test were 90.7%, 60.1% and 0.82 (95% CI=0.73-0.89) with 0.508 as Youden index. Conclusions:NSTE-ACS suspected patients with significant coronary stenosis are often accompanied by impaired left ventricular myocardial strain and mechanical dyssynchrony. A simple combination of left ventricular myocardial strain and contractility synchronization improves noninvasive prediction of high-risk coronary artery stenosis in suspected NSTE-ACS, which maybe helpful for screening patients requiring invasive examination.
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Objective To investigate the changes of plasma 8-iso-prostaglandin F2 alpha (8-iso-PGF2α) before and after treatment in the neonatal hyper-uneonjugated bilirubinemia, so as to confirm theperoxidation damage of serum tolal bilirubin (TBil). Methods One hundred and twenty-six neonates who were 2-7 days old were divided into three groups according to TBil concentration: group hyper-bihrubinemia A (HBE-A)(51 cases), group hyperbilirubinemia B (HBE-B)(25 cases), and healthy control group (50 cases). The serum TBil and unconjugated bilirubin contents were measured by automatic biochemical analyzer. The level of 8-iso-PGF2α in plasma was measured by enzyme linked immunosorbent assay. Results Plasma 8-iso-PGF2α level in healthy control group was (13.84±6.13)ng/L, 95% confidence interval was 10.88-18.02 ng/L.Plasma 8-iso-PGF2α level before treatment and 7 days after serum TBil recovering to be normal in group HBE-A and group HBE-B were (19.56±2.74), (14.13±5.93) ng/L and (22.30±6.33), (14.88±6.44) ng/L, respectively. Plasma 8-iso-PGF2α level increased with serum TBil increased. Plasma 8-iso-PGF2α level decreased with serum TBil decreased. Conclusions The neonatal hyper-unconjugated bilirubinemia can induce peroxidation damage.The determination of plasma 8-iso-PGF2α level may accurately evaluate the bilirubin- induced peroxidation in early stage and progression of jaundice, suggesting the antioxidants should be added to treat neonatal hyper-unconjugated bilirubinemia.
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Objective To observe the clinical effect of gonadotropin releasing hormone analogues in treatment of the girls with idiopathic central precocious puberty(ICPP). Methods Twelve girls with ICPP received therapy with GnRH-A.Before and after the end of treatment for 6 months,secondary sexual characteristics and growth velocity were observed,pelvic ultrasonic examination,X-ray bone age(BA),serum level of E_2 and LHRH stimulating test were detected,and the predicted adult height(PAH) was analysed. Results After treatment,the size of breasts,uterus and ovaries were significantly reduced.The basic and peak levels of serum LH and FSH by LHRH stimulation were also significantly reduced.The ratio of BA/CA(chronology age)was decreased.The PAH was increased. Conclusions GnRH-A can effectively depress the sexual characteristics,reduce the maturation of BA,and also improve the PAH in girls with ICPP.