Application of transesophageal echocardiography in high ventricular septal defect closure via the small intercostal incision with eccentric occluder in children / 中华超声影像学杂志

Objective To explore the value of transesophageal echocardiography ( T EE ) in high ventricular septal defect ( VSD) occlusion via a left parasternal ultra‐minimal intercostal incision ( ≤1 cm ) with eccentric occluder in children . Methods Forty‐eight children with high VSD underwent device occlusion via ultraminimal intercostal incision with eccentric occluder . T he w hole operation , including preoperative evaluation ,intraoperative localization and guidance and postoperation evaluation were performed under the guidance of T EE . Results Forty‐six children with high VSD underwent successfully device closure in all 48 cases and the operation success rate was 95 .8% . T he average size of high VSD was 2 .2－6 .0 ( 3 .70 ± 0 .90) mm and the average size of eccentric occluder was 4－8 ( 5 .48 ± 1 .12) mm . T he average operation duration was 18－98 ( 49 .80 ± 16 .71) min . T here were 2 cases of peri‐membranous high VSD and 44 cases of outlet‐typle VSD ,of w hich 10 cases of mild aortic valve prolapses ( AVOP) ,including 5 cases of aortic valve regurgitation ( AR ) . In addition ,there was 1 case of replacement of device ,1 case of having septum below the margin of the defect and 1 case of using a dilator for a small defect . T he 46 cases were followed up for 6 to 42 months ,and the pericardial effusion occured in 3 cases and disappeared during follow‐up . No other abnormal conditions were found . Conclusions During the surgery of high VSD device occlusion via ultraminimal intercostal incision with eccentric occluder ,T EE has an important value in defect assessment ,intraoperative localization and guidance ,and immediate evaluation of efficacy ,and can effectively guide the device occlusion of high VSD .

Application of transesophageal echocardiography in high ventricular septal defect closure via the small intercostal incision with eccentric occluder in children / 中华超声影像学杂志

Objective@#To explore the value of transesophageal echocardiography (TEE) in high ventricular septal defect (VSD) occlusion via a left parasternal ultra-minimal intercostal incision (≤1 cm) with eccentric occluder in children.@*Methods@#Forty-eight children with high VSD underwent device occlusion via ultraminimal intercostal incision with eccentric occluder. The whole operation, including preoperative evaluation, intraoperative localization and guidance and postoperation evaluation were performed under the guidance of TEE.@*Results@#Forty-six children with high VSD underwent successfully device closure in all 48 cases and the operation success rate was 95.8%. The average size of high VSD was 2.2-6.0 (3.70±0.90)mm and the average size of eccentric occluder was 4-8 (5.48±1.12)mm. The average operation duration was 18-98 (49.80±16.71)min. There were 2 cases of peri-membranous high VSD and 44 cases of outlet-typle VSD, of which 10 cases of mild aortic valve prolapses (AVOP), including 5 cases of aortic valve regurgitation(AR). In addition, there was 1 case of replacement of device, 1 case of having septum below the margin of the defect and 1 case of using a dilator for a small defect. The 46 cases were followed up for 6 to 42 months, and the pericardial effusion occured in 3 cases and disappeared during follow-up. No other abnormal conditions were found.@*Conclusions@#During the surgery of high VSD device occlusion via ultraminimal intercostal incision with eccentric occluder, TEE has an important value in defect assessment, intraoperative localization and guidance, and immediate evaluation of efficacy, and can effectively guide the device occlusion of high VSD.

Liver histological changes in patients with hepatitis B e antigen-negative chronic hepatitis B virus infection with low hepatitis B virus load / 中华传染病杂志

Objective To determine the predictive factors for antiviral therapy in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV) infection [HBeAg(-) CHBI] patients with HBV DNA＜4.3 lg IU/mL.Methods A total of 179 HBeAg (-) CHBI patients were retrospective analyzed.Histology activity index (HAI) and fibrosis (S) were scored according to the Knodell HAI scoring system,and HAI＞3 and/or S≥3 was adopted as indications for treatment.Univariate and multiple regression analysis were used to assess factors associated with treatment indications.Receiver operating curves (ROC) and area under curve (AUC) were used to determine the predictive value of relevant factors.Results There were 81 cases with HAI＞3 (45.3％) and 72 with S≥3 (40.22％),and the proportion of patients with indications for treatment was 54.7 ％.Multiple regression analysis showed that age,γ-glutamyl transpeptadase (γ-GT),platelet (PLT) and albumin (Alb) were the predictive factors for the severity of liver damage and indication for treatment (all P＜0.05).The AUC for age,PLT,γ-GT and Alb were 0.655,0.657,0.726 and 0.65,respectively,and the corresponding Yoden index for age,PLT,γ-GT,and Alb were 0.297,0.426,0.03 and 0.012,respectively,the sensitivities of predicting HBeAg (-CHBI for treatment indications were 0.643,0.842,0.705 and 0.653,respectively.Conclusions This study shows that 54.7％ of HBeAg(-)CHBI patients with HBV DNA＜4.3 lg IU/ml have significant liver histological changes and require antiviral treatment.Older age,higher γ-GT,lower PLT and lower Alb levels are the predictive factors for treatment.

Transient elastography in diagnosis of non-alcoholic fatty liver disease / 中华全科医师杂志

Clinical data of 113 patients with non-alcoholic fat liver disease (NAFLD) diagnosed by liver biopsy from January 2015 to January 2017 in Taizhou People's Hospital were retrospectively reviewed . Patients all underwent transient elastographic ( TE) examination and the values of fat attenuation index (FAI) were obtained.The hepatocyt fatty changes in pathological examination were scored as 0 (＜5%, n＝40), 1 (5%-33%,n ＝27), 2 (34% -66%,n ＝28) and 3 (＞66%, n ＝18).There were significant differences in AST , Glu, TC and FAI among patients with hepatocyte fatty change scores 0, 1, 2 and 3, and the FAI was significantly correlated with the degree of fatty liver disease .The areas under the ROC curve (AUCs) of FAI in patients with hepatocyte fatty change scores 1, 2 and 3 were 0.78, 0.90 and 0.96, respectively.Logistic regression analysis showed that FAI was correlated with TG , TC and BMI.The results suggest that FAI in TE can be a non-invasive, rapid and objective evaluation method for patients with NAFLD.

Diagnosis of the downward displacement of the posterior leaflet of tricuspid valve from apical right heart two chamber view by echocardiography / 中华超声影像学杂志

Objective To evaluate the value of echocardiography method for diagnosis of the downward displacement of the posterior leaflet of tricuspid valve with apical right heart two chamber view (AP-RH-2CV). Methods Rotating the probe clockwise from apical four chamber view(AP-4CV) to AP-RH-2CV at the septial and posterior leaflet of tricuspid valve, the shape, moving and position of the posterior leaflet of the tricuspid valve were observed by displaying the degree of downward displacement of the septial and posterior leaflet of tricuspid valve. The location of the orifice of tricuspid regurgitation was examined by color Doppler flow imaging(CDFI). Results In 15 patients with Ebstein's anomaly from the AP-RH-2CV, the downward displacement of posterior leaflet of tricuspid valve was clearly observed at the AP-RH-2CV. These results of echocardiography were confirmed by surgery except one ease missing out mild downward displacement of the anterior leaflet of tricuspid valve. Moreover, all 15 patients showed the obvious downward displacement of the location of the orifice of tricuspid regurgitation from AP-RH-2CV by CDFI. Conclusions The AP-RH-2CV is an ideal view in diagnosis of the downward displacement of the posterior leaflet of tricuspid valve by echocardiography. The downward displacement of the location of the orifice of tricuspid regurgitation is a critical character for diagnosis of the downward displacement of the posterior leaflet of tricuspid valve by CDFI.

STUDY ON THE DISTRIBUTION OF RH STRAIN TOXOPLASMA GONDII IN EXPERIMENTAL INFECTED MICE / 中国人兽共患病学报

Aim In order to observe the pathological features and the dynamic distribution of RH strain T. gondii in main organs of infected mice, using indirect immunoenzymatic technique. To provide pathological diagonsising reference of toxoplasmosis and increase to understand the pathologensis of Toxoplasmosis. Methods Mice were infected intraperitoneally with 103 tachyzoites of T. gondii RH strain,and the parasites were detected using indirect immunoenzymatic technique in the liver, spleen, lungs and brain at 2,4,6 and 8 days postinfection. Results The liver was the first organ parasitized at D2, followed by spleen and lungs at D4, the brain at D8. At the early phase of infection, parasites were found on the edge of the liver and spleen. A few parasites were detected within the liver, spleen and lungs with time being. But parasites increased progressively and distributed well during the whole phase. The brain was the last organ to be parasitized. Parasites multiplicated rapidly so that the mice were seriously ill and died. Conclusions The indirect immunoenzymatic technique can demonstrate tachyzoites and Toaxoplasma antigen clearly in infected mice during acute stage. Many organs were infected such as liver, spleen,lungs and brain. The results suggest that the organs in the peritoneal cavity were infected directly by tachyzoites as IP infection, then the parasites disseminate through a blood way, and in the end, tachyzoites cross the blood-brain barries to reach the brain.

OBSERVATIONS ON THE GROWTH DYNAMICS OF 4 STRAINS OF TOXOPLASMA GONDII IN HELA CELLS / 中国寄生虫学与寄生虫病杂志

Growth dynamics of PP, CN and ZS2 strains of Toxoplasma gondii isolated in China was studied and compared with that of RH strain. HeLa cells were used in this work. It took only 2 min for the organisms of RH strain to infect the HeLa cells when con-tacting with the cells. By contrast, the CN strain requires 5 min, the ZS2 and PP strains, 10 min.Tcxoplasma began its multiplication after a lag time of about 6 h in the HeLa cells. The mean generation time of the 4 strains was assessed by calculating the number of the parasites in the parasitophorous vacuoles at different incubation times and by the linear regression equation. The results showed that the mean generation time was 5.2 h for RH strain, 5.98 h for CN strain, 6.78 h for ZS2 strain and 7.69 h for PP strain.Among the 3 strains of Toxoplasma gondii isolated in China, CN strain was similar to RH strain in their infectivity and proliferation.

PCR in Evaluating the Effect of Allicin and Its Combination with SMZco on Murine Toxoplamosis / 中国寄生虫学与寄生虫病杂志

Objective To evaluate the effect of allicin alone or combined with SMZco on murine toxoplasmosis by aspecific, rapid, and sensitive PCR technique. Methods 147 mice were infected with 2?10~4 tachyzoites intraperitoneallyand divided into 5 groups at random. Each group was divided into two sub-groups except an untreated group. One sub-group was used to get samples for PCR test and the other for observing the survival duration. The therapeutic grouping wasas follows: group A, a combination of allicin and SMZco administered orally for 7 days and continued by allicin alone till 21days; group B, the combination administered for 14 days and continued with allicin till 21 days; group C, allicin alone for21 days; group D, SMZco alone for 7 days; group E, untreated control. The dosage was: SMZco 400 mg/(kg?d) and al-licin 35 mg/ (kg?d). PCR test was used to detect the parasites in samples of liver and blood from infected mice at 5, 10, 15,20, 25, 30, 40 and 50 days after infection. Results Parasites were eliminated in the blood because no signal was seen inall the blood samples except for samples from group C at day 5 after infection. From day 10 after infection until the end ofthe experiment, no amplification of DNA was seen in all the samples. As for liver samples, signals were clear at day 5 postinfection. From day 10 post infection till the day 50 post-infection, parasites were still detected, but the PCR products de-creased significantly than that of day 5 post-infection. Result showed that a combination of SMZco with allicin provided asignificant protection. SMZco alone was also effective, but allicin alone was not. Conclusion When SMZco is used incombination with allicin, a much higher efficacy is received in the treatment of acute murine toxoplasmosis.