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Objective To analyze the treatment and pathogenetic condition of chronic heart failure of coro -nary heart disease(CHD) and ventricular arrhythmia (VA).Methods 100 patients with chronic heart failure were collected to observe the treatment of chronic heart failure and pathogenetic condition of VA .Results 44 cases occured VA and 56 cases without VA in 100 patients.NT-proBNP(3 110.00 ±522.00)pg/mL of VA group was sig-nificantly higher than that (2 200.00 ±486.00)pg/mL of non-VA group(t=8.996,P (15.38%) with statistically significant(χ2 =5.853,12.532,27.375,all P<0.05).The amount(44.20 ±12.90)mg of use βreceptor blockers of amiodarone group was significantly lower than that of non -amiodarone group(44.20 ± 12.90)mg (t=5.284,P<0.05).Conclusion NT-proBNP of CHEF of CHD and VA patients will improve and amiodarone can reduce the amount of use anti -heart failure drug .
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Objective To evaluate the diagnostic accuracy of dual source CT angiography (DSCTA) for coronary artery stenosis.Methods During the period from November 2012 to November 2013, a total of 210 patients with coronary artery disease underwent DSCTA and selective coronary arteriography (CAG). Taking CAG as the gold standard, the diagnostic accuracy of DSCTA for coronary artery stenosis was evaluated. Thirty patients receiving DSCTA and 30 patients receiving CAG were selected, and all of them underwent stent implantation in the anterior descending branch after imaging examination. The angiography positions, the used time of PCI and the used dosage of contrast agent were compared between the two groups. Results DSCTA was performed in 210 patients and a total of 2 630 segments of coronary stenosis or occlusion were detected. Compared with CAG, the diagnostic sensitivity, specificity, positive predictive value and negative predictive value of DSCTA were 95.4%, 96.2%, 91.3%and 100%respectively, which were not significantly different from those obtained by CAG (P=0.066). In performing DSCTA, 2-3 angiography positions were used (2-4 positions less than that of CAG), the used time of PCI was about 15 min (about 10 min less than that of CAG), and the mean used dosage of contrast agent was 48 ml (30-150 ml) (about half less than that of CAG). Conclusion DSCTA has higher accuracy in diagnosing coronary artery stenosis, quite similar to that of CAG. DSCTA is a safe, reliable and noninvasive examination method. Preoperative DSCTA can reduce exposure positions during angiography, can reduce the dosage of contrast agent, and can shorten the time of PCI as well, thus, iatrogenic radioactive radiation dose can be reduced.
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Objective To explore the application value of pulmonary artery monitoring program for intracranial and cervical artery angiography with dual-energy CT.Methods Sixty patients performed intracranial and cervical artery angiography with dual-energy CT were divided into two groups according to the random number table.Group A (optimization group,30 patients):the monitoring points were located in the main pulmonary artery,with threshold 150 HU,trigger delay time 8-9 s,pitch 0.9,and the iohexol (350 mg I/ml) 60-65 ml.Group B (conventional group,30 patients):the monitoring points were located in aortic arch,with threshold 100 HU,trigger delay time 5 s,and the iohexol (350 mg I/ml)60-70 ml.Patients with the body weight less than 75 kg were injected with the flow rate of 4.0 ml/s,and those weight greater than 75 kg or with body mass index (BMI) greater than 27 kg/m2 were 4.5 ml/s,following 40 ml saline solution with the same flow rate respectively.All images were transferred to Siemens Syngo workstation for further processing and analysis.The attenuation values were measured on axial images in the common carotid artery,internal and external carotid artery,vertebral and basilar artery,the horizontal segment of the middle cerebral artery,the subclavian vein of injection side,the proximal,middle and distal segment of jugular vein,the straight sinus and the superior sagittal sinus.Two experienced observers blinded independently evaluated the image quality of CTA,the impact of contrast material residues artifacts of subclavian vein of injected side and the affect of venous return factors on arterial image display.Images of volume rendering technique(VR),the maximum intensity projection (MIP),and curved planar reformation (CPR) were reconstructed using dual energy bone removal and Inspace and 3D software.The mean intraluminal attenuation of contrast material (HU),the volume of contrast material and the mean image quality scores were compared with t test between the two groups.Chi-square test was used to compare of image contrast agents residual artifacts,the absence segments of the root of the neck artery,and the degree of the jugular vein return in two groups.Results The mean CT values were 372-414 HU for each segment of artery showing no significant differences between two groups (P ＞ 0.05).In group A,the CT values of the jugular vein in proximal,middle,distal segment of the two sides were (95 ± 36),(95 ± 36),(131 ±58),(133 ± 57),(174 ± 68),and (180 ± 66) HU respectively.In group B,CT values were (135 ± 58),(137 ±59),(170 ±58),(181 ±58),(218 ±62),and (224 ±68) HU.The CT value of jugular venous in group A was significantly lower than that in group B (t =-3.30--2.54,P ＜ 0.05).Case numbers of contrast agent residual artifacts of injection side subclavian vein and the absence segments of root of the neck artery at the beginning in group A (5,11) were less than that in group B (12,24) (x2 =4.02,5.65,P ＜0.05).The degree of the jugular vein return in group A were lesser severely than that in group B (x2 =6.79,6.37,P ＜0.05).Below the level of carotid artery bifurcation:slight 5 patients,severe 1 patient in group A vs.slight 15 patients,severe 9 patients in group B.Above the level of carotid artery bifurcation:slight 9 patients,severe 6 patients in group A vs.slight 12 patients,severe 17 patients in group B.Image quality scores of group A (3.84 ± 0.40) was higher than that of group B (3.64 ± 0.63) (t =4.26,P ＜0.05).Conclusions Pulmonary Artery Monitoring combines with 60-65 ml contrast material optimization scheme for intracranial and cervical artery angiography with dual energy CT can significantly reduce the degree of jugular venous return and contrast material residues artifacts of subclavian vein of injected side.This technique is helpful to improve the work efficiency and image quality.
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The cholesterol esterase and its oxidase were respectively immobilized onto sol-gel(tetraethyl orthosilicate)and then an enzymatic reaction column was prepared. Hydrolysis of cholesterol ester took place in the presence of cholesterol esterase to form cholesterol under catalysis of cholesterol oxidase, and Cholesterol was oxidized to produce hydrogen peroxide which reacted with luminal in the presence of simulated enzyme hemoglobin to result in the emission of light. Thereupon, a chemiluminescence system combined with flow injection technology by sol-gel immobilized enzyme was developed for the determination of cholesterol including free and total amount in human serum. The CL intensity was well linear with the concentration of cholesterol;liner range of total and free cholesterol was 1.01×10~(-6)～2.02×10~(-4) mol/L with a detection limit of 7.5×10~(-7) mol/L) and 5.0×10~(-8)～2.18×10~(-5) mol/L) with a detection limit of 5.0×10~(-9) mol/L respectively. Contrasted the method) with the biochemical analyzer (TBA-120FR), both the methods had no significant difference. This method has been successfully applied for the detection of cholesterol in clinic serum samples.
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Objective To investigate the changes of heart function after pacing in right ventricular inlet septum(RVIS) and right ventricular apex(RVA). Methods VVI pacing was performed in 64 patients who were randomly divided into two groups: RVIS group (33 patients) and RVA group (31 patients). The changes of serum brain natriuretic peptide (BNP),pacing parameters and QRS interval were assessed in 24 hours, 3 months and 1 year after the ventricle was paced effectively. Results When the ventricle was paced effectively,the pacing parameters,including voltage threshold and electrode impedance were similar in different stages between the two groups. In 24 hours, 3 months and 1 year after the ventricle was paced effectively,the QRS interval in RVIS group were obviously narrower than those in RVA group [( 128.0±28.6 ) ms vs ( 150.0 ± 37.1 ) ms, ( 131.0±21.5 ) ms vs ( 153.0 ±28.5 ) ms, ( 130.0 ±19.7 ) ms vs ( 155.0±20.2) ms, P < 0.05 ]. After treatment, the level of serum BNP increased significantly in two groups. The BNP level in R VIS group was significantly lower than that in RVA group (P < 0.05). Conclusion The R VIS pacing is not only as safe and effective as RVA pacing, but also is more consistent with the physiological ventricular activation sequence.