Left Ventricle Longitudinal Strain Parameters Are Effective for Differentiating Cardiac Amyloidosis from Primary Hypertensive Left Ventricular Hypertrophy / 中山大学学报(医学科学版)

ObjectiveTo clarify the value of the left ventricular longitudinal strain（LVLS）parameters in patients with cardiac amyloidosis （CA） and primary hypertension with left ventricular hypertrophy （HLVH）. MethodsForty-one patients confirmed with CA were selected and assigned to CA with hypertension group （n =14） and pure CA group （n=27） based on the initial diagnosis with or without hypertension. Twenty patients with primary hypertension-induced left ventricular hypertrophy （HLVH group） and twenty healthy controls were also selected， matching for gender， age， and body surface area. Clinical data， conventional echocardiography parameters were collected and LVLS parameters were measured. Within-group variations were compared among the four groups， and pairwise comparisons were conducted between groups. The sensitivity and specificity of each parameter in predicting CA were judged by the receiver operator characteristic （ROC） curvy in CA and HLVH patients with left ventricular ejection fraction （LVEF） preserved. ResultsAmong the conventional echocardiography parameters， LVEF and left ventricular end-diastolic diameter （LVEDD） were lower in the CA with hypertension group and pure CA group compared with the higher values in the HLVH group and control group. Whereas， left ventricular posterior wall thickness （LVPWT）， relative wall thickness （RWT）， and average E/e' were higher in the two CA groups compared with the HLVH group （all P＜0.05）.Among the LVLS parameters， Global longitudinal strain （GLS） was the worst in the CA with hypertension group so as pure CA group， modest in the HLVH group， and highest in the control group. On the contrary， relative longitudinal strain and ejection fraction strain ratio （EFSR） were the highest in the CA with hypertension group so as to pure CA group， modest in the HLVH group， and lowest in the control group （all P＜0.05）. ROC analysis showed that when LVEF was preserved， the absolute value of GLS less than 14.35% and EFSR higher than 4.28 could effectively distinguish CA from HLVH （all AUCs＞0.9，all P＜0.05）； meanwhile GLS showed high sensitivity（100%） and EFSR showed great specificity（95%）. There were not statistically significance in any parameter between CA with hypertension group and pure CA group（all P＞0.05）. ConclusionWhether CA was complicated with hypertension or not， there were statistically significance among routine echocardiography and LVLS parameters compared with HLVH. In particular， GLS and EFSR are accurate in predicting CA in patients with myocardial hypertrophy and preserved LVEF.

Pressure-strain loops technique detects the effects of different pacing modes of left bundle branch on left ventricular myocardial work / 中华超声影像学杂志

Objective:To evaluate the effects of different pacing modes (unipolar/bipolar) under left bundle branch pacing(LBBP) on ventricular mechanical synchrony and myocardial work using the pressure-strain loop technique.Methods:Twenty-nine patients with LBBP due to symptomatic bradycardia were collected as LBBP group in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from December 2018 to July 2020. Another 29 matched patients with right ventricular pacing (RVP) during the same period were also included as a RVP group. Each LBBP patient was programmed to different pacing modes (uni-/bio-polar) within 1 week after the operation.Under each pacing mode, the inter- and intra-ventricular mechanical synchronization were evaluated. Meanwhile, the global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) were obtained by the left ventricular pressure-strain loops technique.Results:Compared with the RVP group, the mechanical synchrony in the LBBP group was significantly improved (all P<0.05). GWI, GCW, and GWE increased, while GWW decreased, and the differences were statistically significant (all P<0.05), there were no significant differences in ventricular mechanical synchronization, GWI, GCW, GWE, and GWW between unipolar and bipolar pacing in the LBBP group (all P>0.05), there were no significant differences in these parameters when increasing output voltage (all P>0.05). Conclusions:LBBP induces better mechanical synchronization and higher myocardial work efficiency than RVP. Different LBBP pacing modes do not affect ventricular mechanical synchronization and myocardial work efficiency.

Effect of Magnesium Sulfate, Nifedipine Tablet Combined Salvia Injection on ET-1/NO, TXA2/PGI2 and Hemorheology of Preeclampsia Patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of magnesium sulfate, Nifedipine Tablet (NT) combined Salvia Injection (SI) on endothelin-1 (ET-1), nitric oxide (NO), thromboxane A2(TXA2), prostacyclin I2(PG2), and hemorheology of preeclampsia patients.</p><p><b>METHODS</b>Totally 704 preeclampsia patients were randomly assigned to the treatment group and the control group, 352 cases in each group. All patients were treated with magnesium sulfate combined NT (on the first day: slow intravenous injection of magnesium sulfate 5 g + intravenous dripping of magnesium sulfate injection 10 g + oral administration of NT 30 mg; on the second and third day, intravenous dripping of magnesium sulfate injection 10 g + oral administration of NT 30 mg), while those in the treatment group were dripped with SI additionally at 20 mL per day for 3 consecutive days. Before and after treatment plasma levels of endothelin-1 (ET-1), nitric oxide (NO), TXA2, PGi2, and hemorheology indicators [such as high blood viscosity (HBV), low blood viscosity (LBV), plasma viscosity (PV), erythrocyte rigidity index (ERI), fibrinogen (FIB)] of two groups were detected.</p><p><b>RESULTS</b>Compared with the same group before treatment, serum levels of ET-1, TXA2, HBV, LBV, PV, ERI, and FIB decreased in the two groups after treatment (P <0. 05), but levels of NO and PG2 increased (P <0. 05). Compared with the control group in the same period, levels of ET-1, TXA2, HBV, LBV, PV, ERI, and FIB decreased in the treatment group after treatment (P <0. 05), but levels of NO and PGI2 increased (P <0. 05).</p><p><b>CONCLUSION</b>Magnesium sulfate, NT combined SI could effectively regulate the balance of ET-1/NO and TXA2/PGI2, and improve hemorheology of preeclampsia patients.</p>

Key elements to break through registration barriers on traditional Chinese medicine in EU / 中国中药杂志

The EU is an international bridge of traditional Chinese medicine (TCM), and TCM in EU is of strategic importance. In this paper the progress on policies and regulations and approved products of herbal medical products in EU in 10 years were briefly reviewed, registration regulations were systematically, studied and some typical cases were analyzed. To provide reference for successful registration of TCM in EU and implementation of international strategy of TCM, five key elements (i. e. registration classification, approval procedure, approval authority, application product and application enterprise) to break through the registration barriers on TCM in EU were putted forwards correspondingly.

Effect of hyperbaric oxygen treatment on mitochondrial free radicals after transient focal cerebral ischemia in rats / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effect of hyperbaric oxygen(HBO)therapy on mitochondrial free radicals after transient focal cerebral ischemia in rats.</p><p><b>METHODS</b>The male SD rats were randomly assigned into two groups, control and HBO groups. All animals were subjected to 90 min intra-luminal middle cerebral artery occlusion (MCAO) with the regional cerebral blood flow monitored in vivo by laser Doppler flowmetry. HBO treatment was performed in a pressure chamber with 100% O(2)(3 ATM 1 h) 3 h after ischemia. Twenty-four hours after ischemia, mitochondria in the ischemic core and penumbra were isolated and the contents of H(2)O(2), O(2)(*-), MDA, SOD, GSH-PX and GSH in mitochondria were measured respectively.</p><p><b>RESULT</b>After cerebral ischemia-reperfusion, contents of mitochondrial H(2)O(2), O(2)(*-), MDA increased, while the SOD, GSH-PX and GSH in the mitochondria decreased significantly both in the ischemic core and the ischemic penumbra, compared with those in the normal controls(P<0.05). In the ischemic penumbra, HBO therapy increased significantly the content of O(2)(*-)(P<0.05), enhanced the activity of SOD, and decreased the level of MDA (P<0.05). However, HBO therapy did not change the level of MDA, though it also increased the content of O(2)(*-) and the activity of SOD in the ischemic core. HBO therapy had no significant effect on the contents of H(2)O(2), GSH-PX and GSH in the ischemic mitochondria.</p><p><b>CONCLUSION</b>HBO therapy initiated early after acute transient cerebral ischemia in rats can increase the mitochondrial free radicals level, but also increase the activity of the anti-radical enzymes. HBO treatment inhibits the lipid peroxidation damage of mitochondria in the ischemic penumbra, but not in the ischemic core, which indicates that the mitochondrial function plays a role in the reaction of the free radical in the ischemic area after HBO therapy.</p>

Investigation of regional left ventricular diastolic dysfunction in patients with coronary artery disease by strain rate imaging / 中国组织工程研究

BACKGROUND:Regional myocardial diastolic dysfunction has been recognized as a sensitive and characteristic sign of myocardial ischemia and infarction,train rate imaging(SRI)is a novel ultrasonic technique with good spatial and high temporal resolution,nd it can be used to quantitatively analyze regional myocardial function.OBJECTIVE:To investigate the characteristics of the longitudinal diastolic strain rate(SR)in ischemic and infarct myocardium by SRI,n order to explore the clinical value of SRI in evaluating regional left ventricular diastolic dysfunction in patients with coronary artery disease.DESIGN:A case-control study.SETTING:Department of Cardiology.Second Affiliated Hospital of Sun Yat-Sen University.PARTICIPANTS:All the participants were selected from outpatients and/or inpatients of the Second Affiliated Hospital of Sun Yat-sen University between October 2005 and April 2006.Twenty-one patients with myocardial infarction(MI group)and 11 patients with angina pectoris(AP group)were enrolled in the study.Twenty age-matched healthy subjects served as controls.METHODS:After performing conventional echocardiographic examination,olor tissue Doppler images from apical four-,three- and two-chamber views (posterior septum and lateral wall,nterior septum and posterior wall,nterior and inferior wall)were recorded on magneto-optical disk.Then SR curves were derived from the stored images off-line using QLAB 4.2software.MAIN OUTCOME MEASURES:Ischemic segments in the AP group,nfarct segments in the MI group and normal segments in the control group were analyzed.The parameters measured included peak early diastolic SR (SRe)and peak late diastolic SR(SRa).RESULTS:Compared with the normal myocardium,oth SRe and SRa decreased significantly in the infarct and ischemic myocardium(all P＜0.05).No significant differences were observed with respect to SRe and SRa between the infarct and ischemic myocardium(both P＞0.05).CONCLUSION:SRI can be used to quantitatively analyze regional myocardial diastolic dysfunction in patients with coronary artery disease,ut its value is limited in differentiating infarct from ischemic myocardium.

Mitral annulus velocities and time intervals for evaluation of global left ventricular diastolic function in patients with coronary artery disease / 中国病理生理杂志

AIM:To detect and compare the longitudinal mitral annulus diastolic velocity and time interval changes by pulsed Doppler tissue imaging(DTI)in patients with angina pectoris(AP)and myocardial infarction(MI),and to explore the value of mitral annulus diastolic velocities and time intervals for evaluation of global left ventricular diastolic dysfunction.METHODS:Fifty patients with established coronary artery disease were divided into AP group(16 cases)and MI group(34 cases).Sixteen age-matched healthy individuals served as the control group.The septum,lateral,anterior and inferior walls of the mitral annulus were displayed,and selected for DTI spectrum sampling.Peak early and late diastolic velocities and their ratio,time to the onset and peak of the early diastolic wave,and regional isovolumic relaxation time were measured,and the average values of the four mitral annular sites were calculated and presented as Em,Am,Em/Am,QEm,TEm and IVRTm,respectively.RESULTS:Compared with the control group,Em and Em/Am were significantly lower in both the AP and the MI groups(P＜0.01).Em was even lower in the MI group than that in the AP group(P＜0.01).QEm,TEm and IVRTm were significantly longer in the AP and the MI groups than those in control group(P＜0.01 or P＜0.05).IVRTm was even longer in the MI group than that in AP group(P＜0.01).IVRTm had significantly negative correlation with Em(r=-0.64,P＜0.01).CONCLUSION:Em,Em/Am,QEm,TEm and IVRTm as measured by pulsed DTI may be promising indexes for quantitative assessment of global left ventricular diastolic dysfunction in patients with coronary artery disease.Em and IVRTm may indicate the severity of ischemic myocardial damage.

Characteristics of myocardial postsystolic shortening in patients with coronary artery disease assessed by strain rate imaging / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Postsystolic shortening (PSS) has been proposed as a marker of myocardial dysfunction. Strain rate imaging (SRI) is a novel ultrasonic technique, allowing reliable and noninvasive measurement of myocardial deformation. The purpose of this study was to investigate the characteristics of myocardial longitudinal PSS by SRI in ischemic and infarct myocardium in patients with coronary artery disease, and to explore its clinical applicability.</p><p><b>METHODS</b>Eleven patients with angina pectoris, 21 patients with myocardial infarction and 20 healthy subjects were included in the study. Apical four-, three- and two-chamber views were displayed; and septal, lateral, anteroseptal, posterior, anterior and inferior walls of the left ventricle were scanned, respectively. PSS strain (epsilon(pss)), the ratio of epsilon(pss) and systolic strain (epsilon(pss)/epsilon(sys)), the ratio of epsilon(pss) and maximum strain (epsilon(pss)/epsilon(max)) and the duration of PSS (T(pss)) in ischemic, infarct and normal myocardium were analyzed.</p><p><b>RESULTS</b>PSS was found more frequent in the ischemic and infarct segments compared with the normal segments (39% vs 22% and 56% vs 22%, respectively; both P < 0.01). It was even more frequent in the infarct segments than in the ischemic segments (56% vs 39%, P < 0.01). The absolute magnitude of epsilon(pss), epsilon(pss)/epsilon(sys), epsilon(pss)/epsilon(max) were significantly larger and T(pss) significantly longer in the ischemic and infarct segments compared with that in the normal myocardium (P < 0.01). epsilon(pss)/epsilon(sys), epsilon(pss)/epsilon(max) were even larger and T(pss) even longer in the infarct than in the ischemic segments (P < 0.01).</p><p><b>CONCLUSIONS</b>PSS is a common and important feature of the ischemic and infarct myocardium. epsilon(pss), epsilon(pss)/epsilon(sys), epsilon(pss)/epsilon(max) and T(pss) as measured by SRI may be promising markers for the quantitative assessment of regional myocardial dysfunction in patients with coronary artery disease. epsilon(pss)/epsilon(sys), epsilon(pss)/epsilon(max) and T(pss) may be helpful in differentiating infarct from ischemic myocardium.</p>

Effects of osmotic stress on antioxidant enzymes activities in leaf discs of PSAG12-IPT modified Gerbera / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Leaf senescence is often caused by water deficit and the chimeric gene P(SAG12)-IPT is an auto-regulated gene delaying leaf senescence. Using in vitro leaf discs culture system, the changes of contents of chlorophylls, carotenoids, soluble protein and thiobarbituric acid reactive substance (TBARS) and antioxidant enzymes activities were investigated during leaf senescence of P(SAGl2)-IPT modified gerbera induced by osmotic stress compared with the control plant (wild type). Leaf discs were incubated in 20%, 40% (w/v) polyethylene glycol (PEG) 6000 nutrient solution for 20 h under continuous light [130 micromol/(m(2) x s)]. The results showed that the contents of chlorophylls, carotenoids and soluble protein were decreased by osmotic stress with the decrease being more pronounced at 40% PEG, but that, at the same PEG concentration the decrease in the transgenic plants was significantly lower than that in the control plant. The activities of superoxide dismutase (SOD), catalases (CAT), ascorbate peroxidase (APX), guaiacol peroxidase (GPX) and dehydroascorbate reductase (DHAR) were stimulated by PEG treatment. However, the increases were higher in P(SAG12)-IPT transgenic plants than in the control plants, particularly at 40% PEG treatment. Lipid peroxidation (TBARS content) was increased by PEG treatment with the increase being much lower in transgenic plant than in the control plant. It could be concluded that the increases in the activities of antioxidant enzymes including SOD, CAT, APX, GPX and DHAR were responsible for the delay of leaf senescence induced by osmotic stress.