Diagnosis and treatment of five cases with venous leiomyomatosis involving the heart / 中国综合临床

Objective:To investigate the diagnosis and treatment of intravenous leiomyomatosis involving the heart.Methods:From March 2009 to December 2018, 5 patients with intravenous leiomyomatosis with cardiac involvement were collected from The First Hospital of Lanzhou University.All patients were admitted to the hospital as space occupying lesions of right atrium.The relevant data such as echocardiography, CT and MRI were recorded.The preoperative diagnosis, surgical methods and therapeutic effect of the patients were analyzed and summarized.Results:All the 5 patients were female with an average age of (45.8±2.2) years old.Their clinical manifestations were chest tightness and shortness of breath.Three patients had a history of giant hysteromyoma.Echocardiography was performed in all patients, and 3 of them obviously extended to the inferior chamber.Cardiopulmonary bypass was established and thoracoabdominal incision was performed, and the tumors were completely resected in 5 patients, and the origin of tumors was consistent with the result of MRI in 3 cases.The tumor originated from the right uterine vein in 3 cases, and 2 cases originated from the right ovarian vein and was intubated in the femoral vein.The operation was smooth and the postoperative recovery was good.All patients were discharged smoothly.No tumor recurrence was found in pelvic cavity, inferior vena cava and heart after 1 year follow-up.Conclusion:Venous leiomyomatosis involving the heart is rare and easy to be misdiagnosed.Most of them are diagnosed as right atrial space occupying lesions.The diagnosis can be improved by echocardiography, CT and MRI before operation.The operation mode should be adjusted according to the intraoperative findings and different origins, and the tumor should be completely removed as far as possible, and combined with gynecology consultation if necessary.The short-term follow-up showed good prognosis.

Effect of compound scutellaria gargle combined with periodontal non-surgical treatment on periodontal state and gingival crevicular fluid cytokines in patients with periodontitis and T2DM / 中国医师杂志

Objective:To explore the effects of compound radix scutellariae gargle combined with periodontal non-surgical treatment on periodontal state and levels of visceral fat specific serine protease inhibitor (vaspin), interleukin-1β (IL-1β) and matrix metalloproteinase-3 (MMP-3) in gingival crevicular fluid of patients with periodontitis and type 2 diabetes mellitus (T2DM).Methods:Sixty patients with periodontitis and T2DM in North China University of Science and Technology Affiliated Hospital were selected and divided into two groups based on the principle of voluntariness. 30 patients in single group were given periodontal non-surgical treatment, and 30 patients in combined group were given compound radix scutellariae gargle + periodontal non-surgical treatment, and they were treated for 2 months. The tranditional Chinese medicine (TCM) symptoms scores (gingival pain and swelling, gingival atrophy, dry mouth, bad breath and scorched tongue, constipation), periodontal status-related indicators [gingival index (GI), sulcus bleeding index (SBI), periodontal pocket probing depth (PD), plaque index (PLI), clinical attachment loss (CAL), tooth mobility (TM)] and gingival crevicular cytokines (vaspin, IL-1β, MMP-3) were compared between the two groups, and the adverse reactions during treatment were observed and recorded.Results:After treatment, the scores of gingival pain and swelling, gingival atrophy, dry mouth and scorched tongue, bad breath and constipation were significantly decreased in the two groups ( P<0.05), and the scores in combined group after treatment were lower than those in single group ( P<0.05). The GI, SBI, PD, PLI, CAL and TM were significantly decreased in the two groups ( P<0.05), and the indexes in combined group after treatment were better than those in single group ( P<0.05). The levels of vaspin, IL-1β and MMP-3 in gingival crevicular fluid were significantly decreased in the two groups ( P<0.05), and the levels in combined group after treatment were lower than those in single group ( P<0.05). And there was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05). Conclusions:Compound radix scutellariae gargle combined with periodontal non-surgical treatment can significantly relieve the symptoms of periodontitis with T2DM, improve the periodontal status, reduce levels of vaspin, IL-1β and MMP-3 in gingival crevicular fluid, and control disease progression.

Evaluation of right ventricular systolic function and effects of maintenance hemodialysis on it in uremic patients by 4D RV Volume / 中华超声影像学杂志

To evaluate the right ventricular systolic function in uremia patients and the effects of maintenance hemodialysis on right ventricular systolic function by volume and strain parameters obtained by 4D RV Volume . Methods Seventy‐six patients with uremia and twenty‐two controls were selected . According to left ventricular ejection fraction ( LVEF) ,uremia patients were divided into normal LVEF uremia group and decreased LVEF uremia group . T hen normal LVEF uremia group was divided into maintenance hemodialysis group and non‐dialysis group . Conventional ultrasound parameters included :LVEF ,pulmonary artery systolic pressure ( PASP) and tricuspid annular plane systolic excursion ( T APSE‐2D) . 4D RV Volume parameters included : right ventricular end‐diastolic volume ( RVEDV ) , tricuspid annular plane systolic excursion ( T APSE‐4D ) ,right ventricular area change rate ( FAC ) ,right ventricular ejection fraction ( RVEF) and right ventricular free wall longitudinal systolic strain ( RV‐GLSfree ) . Results①Compared with the control group ,T APSE‐2D decreased significantly in the decreased LVEF uremia group ( P ＜0 .05) ,w hile there was no significant difference of T APSE‐2D in normal LVEF uremia group ( P ＞ 0 .05) . Compared with the control group and normal LVEF uremia group ,PASP increased significantly in the decreased LVEF uremia group ( P ＜ 0 .05 ) . Compared with the control group ,RVEDV increased significantly both in the normal LVEF and decreased LVEF uremia group ,w hich showed an increasing trend in these three groups ( P ＜0 .05) ,while T APSE‐4D ,FAC ,RVEF and RV‐GLSfree all decreased significantly and showed a decreasing trend in these three groups ( P ＜ 0 .05 ) . ② Compared with the control group , T APSE‐2D decreased significantly in non‐dialysis group ( P ＜0 .05) ,but there was no significant difference in uremia hemodialysis group ( P ＞0 .05) . Compared with the control group ,PASP and RVEDV increased and T APSE‐4D ,FAC ,RVEF and RV‐GLSfree decreased significantly in uremia hemodialysis group and non‐dialysis group ( P ＜ 0 .05 ) . Compared with non‐dialysis group , T APSE‐2D and T APSE‐4D increased significantly in hemodialysis group ( P ＜0 .05) ,while there was no significant difference in RVEDV ,FAC , RVEF and RV‐GLSfree in uremia hemodialysis group ( P ＞0 .05) . Conclusions 4D RV Volume could early and accurately evaluate the right ventricular systolic dysfunction in uremia patients . Furthermore ,w hen evaluating right ventricular systolic function in uremia patients treated with maintenance hemodialysis , indices such as right ventricular strain and volume parameters should be comprehensively considered .

A preliminary study for the feasibility and accuracy of three-dimensional printing mitral annulus models based on echocardiographic data / 中华超声影像学杂志

Objective To evaluate the feasibility of three-dimensional (3D) printing of mitral annulus with transesophageal echocardiographic volume images as the data source ,and to assess the accuracy of the 3D printing mitral annulus models based on three dimensional transesophageal echocardiography ( 3D-TEE) images preliminarily . Methods A retrospective study was performed in 25 patients with mild or slight mitral regurgitation and 10 patients with moderate to severe mitral regurgitation . All the subjects were underwent 3D-TEE . The 3D-TEE volume images of mitral annulus at the end diastole were post-processed by Mimics software to create images of the mitral annulus in standard tessellation language format . The STL file was output to the 3D printer and the 3D printing models of mitral annulus were obtained . The mitral annulus size parameters including the diameter between anterior and posterior ,the diameter between anterolaterior and posteromedial ,sphericity index and mitral annulus circumference were measured from 3D printing models and 3D-TEE images ,respectively . From which the absolute difference of the measurements between 3D printing models and the 3D-TEE images were calculated . Results All of the 3D-TEE images were successfully post-processed ,and the corresponding 3D printing models were acquired by high-precision 3D printer . It showed no significant difference in all the mitral annulus size parameters between 3D printing modelsand3D-TEEimages(allP >0.05) .Morever,thesizeparameterswereconcordantwellbetweenthe two methods ,all of the data points fell within the limits of agreement . It showed little absolute difference in value of the mitral annulus size parameters between the 3D printing mitral annulus models and the 3D-TEE images . Conclusions It is technically feasible to print 3D models of mitral annulus using 3D-TEE images as the data source . 3D printing mitral annulus models based on transesophageal echocardiographic volume images have high precision .

The predictive effect of myocardial injury markers on the severity of acute pancreatitis / 中华急诊医学杂志

Objective To assess the predictive effect of myocardial injury biomarkers (proBNP, CK-MB, and cTnI) on the severity of acute pancreatitis (AP). Methods The records of 246 patients diagnosed with acute pancreatitis who were treated at Ruijin Hospital Emergency Department from January 2015 to December 2016 were retrospectively analyzed. According to the revised 2012 Atlanta guidelines, these patients were divided into the mild acute pancreatitis (MAP, n=47), moderately severe acute pancreatitis (MSAP, n=151) and severe acute pancreatitis (SAP, n=48) groups. The highest plasma levels of troponin I (cTnI), creatine kinase (CK)-MB, N-terminal B-type brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), and procalcitonin (PCT) were recorded for comparison within 72 h after admission. The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score, sequential organ failure assessment (SOFA), bedside index for severity in acute pancreatitis (BISAP) and Balthazar computed tomography severity index (CTSI) were calculated at admission within 72 h. Whether there is an occurrence of organ dysfunction, and the organ types and persist time of organ dysfunction were recorded. The analysis of variance, SNK-q test and paired samples t test were used for the statistical analysis. Results The levels of proBNP, CK-MB, and cTnI were significantly higher in the SAP group than in the non-SAP group. The receiver operating characteristic (ROC) curve demonstrated cTnI had the maximum predictive power (AUC=0.872), while proBNP had the least predictive ability (AUC=0.763). The established model, which is to explore whether the myocardial injury markers had the predictive value, showed that the combination of myocardial injury indicators (CK-MB, cTnI) and traditional indicators had higher predictive value for SAP than traditional indicators alone (AUC=0.966 vs. AUC=0.945, P=0.04). Conclusions The elevated markers of myocardial injury had certain predictive value for severe acute pancreatitis.

Assessment of left ventricular dyssynchrony and its relationship with cardiac function in dilated cardiomyopathy by two-dimensional strain parameters / 中国医学影像技术

Objective To explore value of two-dimensional speckle tracking imaging (2D-STI) strain parameters in assessment of left ventricular (LV) dyssynchrony and its relationship with cardiac function in patients with dilated cardiomyopathy (DCM).Methods Totally 25 patients with DCM and 25 age-matched normal controls were enrolled.The LV time to peak longitudinal strain (Tls) and time to peak circumferential strain (Tcs) were measured by 2D-STI,from which the standard deviations and maximal differences of the Tls in all 18 segments,6 segments at apical 4-chamber,3-chamber and 2 chamber views (Tls-SD,Tls-SD-4,Tls-SD-3,Tls SD-2,Tls dif,Tls-dif-4,Tls-dif-3,Tls-dif-2) were calculated,as same as the standard deviations and maximal differences of Tcs in all 18 segments,6 segments at mitral valve,papillary muscle,apical short-axis views (Tcs-SD,Tcs-SD-M,Tcs-SD-P,Tcs-SD-A,Tcs-dif,Tcs-dif-M,Tcs-dif-P,Tcs-dif-A) were calculated.Results Compared with the control group,the global and segmental strain parameters of the DCM group increased significantly (all P＜0.05).Except for Tcs-dif-P and Tcs dif,the residual strain parameters were negatively correlated with LV ejection fraction (all P＜0.05).Except for Tcs-dif-M,Tcs dif-P and Tcs-dif,there was a positive correlation between strain parameters and E/e in DCM group (all P ＜0.05).Conclusion In patients with DCM,LV dyssynchrony exists both in global and regional,which may aggravates the LV function damage.2D-STI strain parameters can objectively evaluate LV dyssynchrony and its relationship with cardiac function in patients with DCM.

Evaluation of left ventricular systolic function after renal sympathetic denervation in beagles with heart failure by layer-specific two-dimensional speckle tracking imaging / 中华超声影像学杂志

Objective To assess the left ventricular systolic function after renal sympathetic denervation(RSD) in beagles with heart failure by layer-specific two-dimensional speckle tracking imaging.Methods Twenty-three beagles were randomly divided into control group (8 dogs),URSD group (8 dogs)and RSD group (7 dogs).Control group was implanted with pacemakers without pacing,URSD group was implanted with pacemakers and underwent 3 weeks of rapid right ventricular pacing,and RSD group underwent catheter-based RSD bilaterally and was simultaneously implanted with pacemakers.All standard measurements were obtained from the left ventricular short-axis views at the levels of mitral annulus,papillary muscle and apex,and apical four-chamber,two-chamber,and long-axis views.The peak systolic longitudinal strain and circumferential strain of each layer of the left ventricle were measured by layerspecific two-dimensional speckle tracking imaging.Results After 3 weeks,all of the dogs in both the URSD and RSD groups showed lower left ventricular diastolic and systolic function compared with those in the control group,however,the dogs in the RSD group had a higher LV ejection fraction (LVEF) than the dogs in the URSD group(P ＜ 0.05).Compared with the control group,the global longitudinal strain,circumferential strain and radial strain all decreased significantly in URSD and RSD groups.The longitudinal strain of endo-and mid-cardium and the circumferential strain in endo-cardium were significantly higher in RSD group than those in URSD group(P ＜0.05).Conclusions Myocardial systolicfunction is impaired in dogs with heart failure,layer-specific two-dimensional speckle tracking imaging can provide effective tools to assess the left ventricular systolic function.Renal sympathetic denervation can improve the myocardial systolic function in dogs with heart failure.

The accuracy of ultrasound-derived three-dimensional printing models for atrial septal defect / 中华超声影像学杂志

Objective To evaluate the accuracy of three-dimensional printing atrial septal defect (ASD)models from three dimensional transesophageal echocardiography(3D-TEE)images and to lay the foundation for the application of 3D printing technology in the diagnosis and treatment of ASD.Methods Twenty patients with ASD were analyzed retrospectively.2D-TEE and 3D-TEE were performed before ASD occlusion.The 3D-TEE data were post-processed by Mimics software and the volume images of ASD in STL format were developed.Then the STL file was output and the ASD 3D models were printed.The ASD size parameters included the maximal diameter(Dmax),the minimal diameter(Dmin),circumference(C)and area(A),which were measured from 2D-TEE images,3D-TEE images and 3D printing models,respectively. The absolute difference value of ASD size parameters between 3D printing models and 2D-TEE images,or 3D-TEE images were calculated.The sizes of occluder were recorded during the operation and the preoperative exercises on 3D printing models were performed.Results There were no significant difference in ASD size parameters among 3D printing models,2D-TEE and 3D-TEE images(all P > 0.05),the ASD size parameters were concordant well between 3D printing models and 2D-TEE or 3D-TEE images. Moreover,the absolute difference value of ASD size parameters between 3D printing models and 2D-TEE or 3D-TEE images were little.In addition,linear regression analysis revealed a significant correlation in the Dmaxmeasured from 3D printing models and the sizes of occulder used in the operation(r =0.94,P <0.05).In the ASD 3D printing models the preoperative exercise had an impressive effect.Conclusions It is quite feasible to use 3D-TEE images as the data source of ASD 3D printing models.Ultrasound-derived ASD 3D printing models are of highly accuracy,which have the potential to provide evidence for the clinical application of 3D printing technology.

Assessment for regional and global systolic function of left ventricle in patients with coronary arterial disease by longitudinal layer-specific strain / 中华超声影像学杂志

Objective To analyze longitudinal layer‐specific strain in endocardial ,midcardial and epicardial layers of left ventricle (LV) by two‐dimensional speckle tracking imaging(2D‐STI) in patients with coronary heart disease (CHD) and to evaluate the regional or global systolic function of LV . Methods Seventy‐eight patients with suspected CHD were divided into CHD group (46 subjects) and control group (32 subjects) according to the results of selective coronary arteriography . According to the stenosis degree or number of coronary arteries ,the CHD group was divided into mild stenosis group ( corresponding blood‐supply vessel stenosis 50% -75% ) ,severe stenosis group ( corresponding blood‐supply vessel stenosis ≥75% ) or single‐vessel stenosis group ,multi‐vessel stenosis group . Two‐dimensional images with high frame rate were recorded in apical four‐chamber ,long‐axis ,two‐chamber of LV in all subjects . The strain parameters by EchoPAC analysis software included territorial longitudinal strain ( TLS ) of endocardial , midcardial and epicardial layers ( TLSendo ,TLSmid ,TLSepi) and global longitudinal strain ( GLS) of endocardial ,midcardial and epicardial layers ( GLSendo ,GLSmid ,GLSepi) . Results Regardless of with or without corresponding blood‐supply coronary artery stenosis and range of coronary artery stenosis , TLSendo ,TLSmid ,TLSepi and GLSendo ,GLSmid ,GLSepi all showed a gradient decrease( P 0 .05) . Compared with the mild stenosis group ,TLSendo ,TLSepi of severe stenosis group decreased significantly( P 0 .05) . Moreover ,compared with the control group ,GLSendo ,GLSmid ,GLSepi of single‐vessel stenosis group and multi‐vessel stenosis group decreased significantly( P < 0 .05) . Compared with the single‐vessel stenosis group ,GLSendo ,GLSmid ,GLSepi of multi‐vessel stenosis group decreased significantly( P < 0 .05) . For predicting corresponding blood‐supply vessel stenosis ≥75% ,the sensitivity and specificity were 55 .6% , 72 .6% and 57 .8% ,76 .4% ,when the cut‐off of TLSendo and TLSepi were 20 .5% and 15 .5% respectively . For predicting multi‐vessel stenosis ,the sensitivity and specificity were 54 .5% ,71 .4% ;50 .0% ,87 .5% and 63 .6% ,87 .5% ;when the cut‐off of GLSendo , GLSmid , GLSepi were 21 .5% , 17 .5% and 16 .5%respectively . Conclusions Systolic dysfunction of LV happened through all layers in CHD patients . The longitudinal strain of layer‐specific by 2D‐STI can accurately evaluate the regional and global systolic function of LV in patients with CHD ,which can also be used to predict the degree or range of coronary artery stenosis .

Effect of siRNA interfering vascular endothelial growth factor on radiation sensitization of malignant melanoma / 中国生化药物杂志

Objective To investigate the role of a small RNA interference against VEGF in radiation sensitivity in melanoma .Methods A375 human melanoma cell lines were transplanted into nude mice ,which with malignant melanoma were randomly divided into control group , VEGF negative plasmid group and VEGF positive plasmid group, followed by 4Gy irradiation twice a week for 2 weeks.The volume of tumor was calculated twice a week, the area of tumor necrosis was assayed by HE,the expression of VEGF in tumor was determined by Western-blot and Immunohistochemical. ResuIts The expression of VEGF in VEGF positive plasmid group decreased significantly (P<0.05), VEGF positive group had more tissue necrosis, tumor growth was significantly inhibited (P<0.05).ConcIusion siRNA-VEGF in tumor injection liposome encapsulated in malignant melanoma has a role in the radiation sensitization, which provides an experimental basis for the clinical development of targeted therapy combined with radiotherapy for the treatment of VEGF gene.

The influence of ginkgo dipyridolum injection on blood-rheological and coagulation function in pationts with AECOPD / 国际中医中药杂志

ObjectiveTo evaluate the influence of ginkgo dipyridolum injection on blood-rheological and coagulation function in pationts with AECOPD.Methods78 cases of patients with AECOPD were divided into group A (38 cases)and group B (40 cases)by mean of digital random table method.The routine treatment including oxygen inhalation,spasmolytics and anti-infection was given to patients in both groups while ginkgo dipyridolum injection (30 ml/d)was additionally added to patients in group B for two weeks.The blood-rheological and coagulation function were evaluated.ResultsAs for blood-rheological after the treatment,whole blood high shearing viscosity(5.25 ± 1.24)mPa · S,low shearing viscosity (11.12 ±2.43) mPa · S,plasma viscosity (2.06± 0.14 ) mPa · S and hematocrit (45.52 ± 2.78) ％ in the group A indicated significant differences compared to those in group B [ (4.83 ± 1.42)mPa· S,(8.78± 3.02) mPa · S,(1.73 ±0.21) mPa · S,(39.05 ± 3.41) ％],(P＜0.05); as for coagulation function after the treatment,PT (13.14± 1.31 ) S,APTT (30.85±5.24)S,FIB (4.99±1.04)S,D-D (1.42±0.23)mg/L in the group A indicated significant differences compared to those in group B [ (14.78 ± 3.13) S,(36.67 ± 8.12)S,(3.81 ± 0.42) S,(0.84 ±0.39) mg/L],(P＜0.05).ConclusionFor the patients with AECOPD,the ginkgo dipyridolum injection can decrease hood-viscosity,and obviously improve hypercoagulabale state.

The Effect of Liquiritin on Body Weight and Behavior of Depressive Rats / 中国心理卫生杂志

Objective:To observe the effect of liquiritin on body weight and behavior in depression model rats.Methods:Seventy-two male Sprague-Dawley(SD)rats were randomly assigned into normal control group,model group(stress+vehicle),fluoxetine group(stress+ fluoxetine)and three liquiritin groups(stress+liquiritin at different dose).The behavior of rats was detected by sucrose consumption test and forced swimming test.Results:The model rats showed significantly lower body weight(429?45/494?37,P

Effects of 3 carbohydrates on CAP10 promoter activity of Cryptococcus neoformans capsule-associated gene / 第二军医大学学报

Objective:To study the effects of glucose,mannose and galactose on CAP10 promoter activity of Cryptococcus neoformans capsule-associated gene.Methods: Yeast cells were transfected with plasmid containing a 951 bp length of 5′ upstream flanking sequence of CAP10 coding region and a reporter gene,chloramphenicol acetyl transferase(CAT);the transfectants were treated with different concentrations(10,20,40,60,80 mg/ml) of glucose,mannose and galactose.CAT activity was assessed by ELISA method and CAT activities of different groups were compared.Results: Different concentrations of glucose and mannose had no obvious influence on CAT activity;different concentrations of galactose had obvious influence on CAT activity and the influence was positively dependent with its dose within the experimental concentration range.Conclusion: Glucose and mannose have no obvious effect on the activity of CAP10 promoter;galactose has obvious inductive effect on activity of CAP10 promoter,suggesting that CAP10 gene might be related with galactose metabolism.