Effect of coronary microvascular dysfunction on cardiac mechanical indices in patients with non-obstructive coronary artery disease / 中华超声影像学杂志

Objective:To investigate the effect and relationship of coronary microvascular dysfunction (CMD) on cardiac mechanical indices in patients with non-obstructive coronary artery disease(NOCAD) in the resting state.Methods:This study was a single-center retrospective study. Seventy-nine NOCAD patients who hospitalized in Qilu Hospital of Shandong University from July 2017 to March 2022 were recruited. All patients underwent conventional echocardiography examination and the examination of coronary flow velocity reserved by transthoracic Doppler echocardiography (TTDE-CFVR). Based on the results of TTDE-CFVR, patients were divided into CMD group (CFVR<2.5, 32 cases) and a control group (CFVR≥2.5, 47 cases). Clinical data, routine echocardiographic parameters, regional mechanical indices including regional myocardial work index(RWI) and regional longitudinal strain(RLS), global mechanical indices including left ventricular global longitudinal strain(GLS), global longitudinal strain in the endocardial layer(GLS-endo), global longitudinal strain in the epicardial layer(GLS-epi), left ventricular global work index(GWI), global contractive work(GCW), global waste work(GWW), global work efficiency(GWE) were compared between two groups. Binary logistic regression was used to analyze the risk factors of CMD. ROC curve was used to construct a prediction model for CMD.Results:There was no significant difference in sex ratio, BMI, smoking history, diabetes, hypertension and dyslipidemia between CMD group and control group. Age was significantly higher in the CMD group than in the control group. RWI, GWI, GCW, GWE and the absolute values of RLS, GLS, GLS-endo and GLS-epi were significantly lower in the CMD group than in the control group. Logistic regression analysis showed that the decrease of absolute value of GLS was an independent risk factor for the CMD( OR=1.335, 95% CI=1.041-1.713, P=0.023). ROC curve showed that myocardial strain-related indexes had a good decrease value for the CMD. Conclusions:For patients with NOCAD, the presence of CMD is associated with the decrease of left ventricular regional and global systolic function.

Prevention and treatment of cepharanthine through MAPK/ERK signaling pathway in rats with nasopharyngeal carcinoma and its effect on Survivin, XIAP and Bcl-2 / 西安交通大学学报(医学版)

【Objective】 To investigate the preventive and therapeutic effects of cepharanthine on nasopharyngeal carcinoma rats through the mitogen-activated protein kinase (MAPK)/extracellular signal regulated kinase (ERK) signaling pathway and its effect on Survivin and X-linked inhibitor of apoptosis protein (XIAP), and B-cell lymphoma/leukemia-2 (Bcl-2). 【Methods】 A rat model of nasopharyngeal carcinoma was established by subcutaneous injection of dinitrosopiperazine (DNP). Then the rats were randomly divided into model group, stephenine group, activator group, inhibitor group, and control group. Interleukin (IL)-1β and IL-18 levels in nasal lavage fluid were detected, HE staining was used to observe pathological changes of nasal mucosa, TUNEL method was used to observe cell apoptosis of nasal mucosa, Western blotting was used to detect ERK, p-ERK, Survivin, XIAP, Bcl-2, Bcl-2 associated X protein (Bax) protein expression of nasal mucosa. 【Results】 The histopathological changes of rat nasal mucosa in stephenine group, activator group and inhibitor group were significantly better than those in model group; the improvement in activator group was worse. Compared with model group, the body mass, Survivin, XIAP, and Bcl-2 protein expressions increased, while the levels of IL-1β and IL-18, the rate of apoptosis and p-ERK1/2 and Bax protein expressions decreased in cephalothin group, activator group and inhibitor group (P<0.05). Compared with cephalothin group, in activator group the body mass, Survivin, XIAP, and Bcl-2 protein expressions decreased, whereas IL-1β and IL-18 levels, the rate of apoptosis, and p-ERK1/2 and Bax protein expressions increased. In inhibitor group, the body mass, Survivin, XIAP, and Bcl-2 protein expressions increased, IL-1β and IL-18 levels, the rate of apoptosis, and p-ERK1/2 and Bax protein expressions decreased (P<0.05). 【Conclusion】 Stephaneine has a certain preventive effect on nasopharyngeal carcinoma rats, which may play an effect by inhibiting the MAPK/ERK pathway.

Study of the energy loss and vortex in the left ventricle in patients with mid-range and reduced left ventricular ejection fraction by vector flow mapping / 中华超声影像学杂志

Objective:To quantitatively evaluate the energy loss (EL) and vortex characteristics in the left ventricle by vector flow mapping (VFM) technique in heart failure patients with mid-range ejection fraction (HFmrEF) and reduced ejection fraction (HFrEF).Methods:One hundred and five patients in Qilu Hospital of Shandong University from October 2016 to November 2017 with heart failure and left ventricular ejection fraction (LVEF)<50% were enrolled and divided into HFmrEF Group (LVEF40%~<50%, 56 cases) and HFrEF group (LVEF<40%, 49 cases). Another 32 healthy people at the same period were matched as control group. The EL, vortex area and circulation of isovolumic relaxation phase (IVR), rapid filling phase (RFP), atrial contraction phase (ACP), isovolumic contraction phase (IVC) and rapid ejection phase (REP) in the left ventricle was measured by VFM technique.Results:The EL in HFmrEF group and HFrEF group was lower than that in the control group. In ACP, the EL was gradually decreased among the control group, HFmrEF group and HFrEF group( P<0.05). In ACP, the vortex area and circulation was larger in heart failure patients than those in the control group, and gradually increased from control group, to HFrEF group( P<0.05). Positive correlation between EL and E/e ′ was evidenced in the RFP ( r=0.524, P< 0.001). While in ACP, there was a positive correlation between EL and A peak ( r=0.492, P<0.001), and a negative correlation between EL and vortex area ( r=-0.235, P=0.040). Conclusions:VFM can be applied to evaluate the EL in left ventricle. The EL in the left ventricle of patients with HFmrEF and HFrEF is significantly lower than that in control group. El is correlated with cardiac systolic and diastolic function and vortex area.

Effects of wearing a mask on oxygenation of subjects with spontaneous breathing during supplementary oxygen through facemask / 生物医学工程学杂志

During the COVID-19 epidemic, our national guidelines have suggested that surgical patients should wear a mask to decrease the potential transmission of COVID-19 in the operating room, as long as the condition allows. However, so far, there is no study to discuss the influence of wearing a mask on the ventilation and blood oxygenation status in patients of spontaneous breathing with supplementary oxygen through an anesthetic facemask. This is a before-after study in the same patient, and 10 healthy volunteers were recruited, by testing the arterial blood gas parameters at key time points before and after oxygen inhalation to evaluate the effects of two different supplementary oxygen methods ('disposable medical mask + anesthetic facemask' and 'anesthetic facemask only') on the oxygenation of subjects. Our data demonstrated whether wearing a disposable medical mask or not could effectively increase the oxygen supply of the subjects compared with the basic value before oxygen inhalation; however, compared with the group without mask, the arterial oxygen partial (PaO

A Two-DNA Methylation Signature to Improve Prognosis Prediction of Clear Cell Renal Cell Carcinoma

PURPOSE: Effective biomarkers and models are needed to improve the prognostic prospects of clear cell renal cell carcinoma (ccRCC). The purpose of this work was to identify DNA methylation biomarkers and to evaluate the utility of DNA methylation analysis for ccRCC prognosis. MATERIALS AND METHODS: An overview of genome-wide methylation of ccRCC tissues derived from The Cancer Genome Atlas (TCGA) database was download for analysis. DNA methylation signatures were identified using Cox regression methods. The potential clinical significance of methylation biomarkers acting as a novel prognostic markers was analyzed using the Kaplan-Meier method and receiver operating characteristic (ROC) curves. RESULTS: This study analyzed data for 215 patients with information on 23171 DNA methylation sites and identified a two-DNA methylation signature (cg18034859, cg24199834) with the help of a step-wise multivariable Cox regression model. The area under the curve of ROCs for the two-DNA methylation signature was 0.819. The study samples were stratified into low- and high-risk classifications based on an optimal threshold, and the two groups showed markedly different survival rates. Moreover, the two-DNA methylation marker was suitable for patients of varying ages, sex, stages (I and IV), and histologic grade (G2). CONCLUSION: The two-DNA methylation signature was deemed to be a potential novel prognostic biomarker of use in increasing the accuracy of predicting overall survival of ccRCC patients.

Application of vector flow mapping technique in the assessment of left intraventricular pressure gradients in heart failure patients / 中华超声影像学杂志

Objective@#To evaluate the changes of intraventricular pressure differences (IVPDs) and intraventricular pressure gradients (IVPGs) in different phases of cardiac cycle in patients with heart failure(HF) patients by relative pressure imaging based on vector flow imaging(VFM).@*Methods@#Forty-nine HF patients with left ventricular ejection fraction (LVEF) lower than 0.50 hospitalized in Qilu Hospital of Shandong University from November 2018 to January 2019, including thirty-three patients with HF with reduced ejection fraction (HFrEF group) and fifteen patients with midrange ejection fraction (HFmrEF group), and forty-three controls were enrolled in this study. Clinical data and echocardiographic images were collected and the conventional left ventricular diameter, mass, volume, and systolic and diastolic function parameters were measured. IVPDs and IVPGs during isovolemic systole (IC), rapid ejection (RE), isovolemic diastole (IR), rapid filling (RF) and atrial systole (AC) phases were obtained by the VFM technique. The changes of IVPDs and IVPGs in different phases between the HF and control groups, and their correlations with conventional ultrasound parameters were analyzed.@*Results@#IVPDs and IVPGs in heart failure group were significantly reduced compared with the control group especially in isovolumic relaxation phase(all P<0.001). IVPDs and IVPGs showed a decreasing trend in the control group, HFmrEF group and the HFrEF group(P<0.001). IVPDs and IVPGs were correlated with LVID, LVMI, ESV, LVEF, GLS and E/e′ (all P<0.01), among which IVPD-IR and IVPG-IR were best correlated. IVPD-IR and IVPG-IR had excellent diagnostic efficacy for HF patients with LVEF<0.5, with cut-off values of <0.73 mmHg (AUC=0.915, P<0.001) and <0.103 mmHg/cm (AUC=0.932, P<0.001), respectively.@*Conclusions@#Early diastolic hemodynamics are severely impaired when systolic function declines.IVPG-IR, as a marker of left ventricular diastolic function, significantly correlates with left ventricular systolic function, and can be used as a potential indicator for assessing left ventricular systolic and diastolic function in patients with heart failure and identifying patients with heart failure.

Application of vector flow mapping technique in the assessment of left intraventricular pressure gradients in heart failure patients / 中华超声影像学杂志

Objective To evaluate the changes of intraventricular pressure differences(IVPDs)and intraventricular pressure gradients(IVPGs)in different phases of cardiac cycle in patients with heart failure (HF)patients by relative pressure imaging based on vector flow imaging(VFM).Methods Forty-nine HF patients with left ventricular ejection fraction (LVEF) lower than 0.50 hospitalized in Qilu Hospital of Shandong University from November 2018 to January 2019,including thirty-three patients with HF with reduced ejection fraction (HFrEF group) and fifteen patients with midrange ejection fraction (HFmrEF group),and forty-three controls were enrolled in this study.Clinical data and echocardiographic images were collected and the conventional left ventricular diameter,mass,volume,and systolic and diastolic function parameters were measured. IVPDs and IVPGs during isovolemic systole (IC),rapid ej ection (RE), isovolemic diastole (IR),rapid filling (RF) and atrial systole (AC) phases were obtained by the VFM technique.The changes of IVPDs and IVPGs in different phases between the HF and control groups,and their correlations with conventional ultrasound parameters were analyzed.Results IVPDs and IVPGs in heart failure group were significantly reduced compared with the control group especially in isovolumic relaxation phase(all P <0.001).IVPDs and IVPGs showed a decreasing trend in the control group, HFmrEF group and the HFrEF group(P<0.001).IVPDs and IVPGs were correlated with LVID,LVMI,ESV,LVEF,GLS and E/e'(all P <0.01),among which IVPD-IR and IVPG-IR were best correlated. IVPD-IR and IVPG-IR had excellent diagnostic efficacy for HF patients with LVEF<0.5,with cut-off values of<0.73 mmHg(AUC=0.915,P<0.001)and <0.103 mmHg/cm(AUC=0.932,P<0.001), respectively.Conclusions Early diastolic hemodynamics are severely impaired when systolic function declines.IVPG-IR,as a marker of left ventricular diastolic function,significantly correlates with left ventricular systolic function,and can be used as a potential indicator for assessing left ventricular systolic and diastolic function in patients with heart failure and identifying patients with heart failure.

The differences of left ventricular configuration between Chinese and international standard by echocardiography in Chinese adults with hypertension / 中华超声影像学杂志

Objective@#To compare the distribution characteristics of left ventricular configuration in Chinese adult patients with hypertension under Chinese and international standard using echocardiography.@*Methods@#A total of 201 patients with primary hypertension were included in the study.Left ventricular end systolic left atrial diameter (LAD), ascending aortic diameter (AO), left ventricular end diastolic diameter (LVDd), left ventricular posterior wall thickness (PWTd) and ventricular septal thickness (IVSd) were measured and then relative wall thickness (RWT), left ventricular mass (LVM), left ventricular mass index (LVMI) were calculated. Left ventricular systolic left atrial volume (LAV) was measured by Simpson′s biplane method and left atrial volume index (LAVI) was then calculated. Ganau classification was done according to Chinese and international standard respectively. The differences of left ventricular configuration in hypertension were compared.@*Results@#According to the Chinese standard, the analytic results of left ventricular configuration showed that there were 103 cases (51.2%) in normal configuration (NG) group, 28 cases (13.9%) in concentric remodeling (CR) group, 52 cases (25.9%) in eccentric hypertrophy (EH) group and 18 patients (9.0%) in hypertrophic (CH) group, respectively. Whereas, according to the international standard, there were 47 cases (23.4%) in NG group, 93 cases (46.3%) in CR group, 18 cases (8.9%) in EH group and 43 cases (21.4%) in CH group.Each group in the configuration analysis had significant difference between Chinese and international standard (P<0.01). Patients with left atrial enlargement according to the Chinese and international standard had statistical difference in the EH and CH groups (P<0.05).@*Conclusions@#Analysis of left ventricular configuration according to the Chinese and international standard has significant difference. According to Chinese standard, it may be more accurate to reflect the changes of left ventricular configuration in Chinese hypertensive population, so as to evaluate the changes of left heart structure and function more accurately.

Preliminary study of energy loss in left ventricle obtained by vector flow mapping in patients with hypertension / 中华超声影像学杂志

Objective To quantitatively analyze the energy loss (EL) in left ventricle with vector flow mapping (VFM) in hypertensive patients,and try to reveal the correlation of EL with cardiac structure and function.Methods Hypertension group:52 hypertensive individuals were enrolled in our study,divided into 4 subgroups:①14 patients with normal geometry(NG);②20 patients with concentric remodeling(CR);③15 patients with concentric hypertrophy(CH);④3 patients with eccentric hypertrophy(EH)(not enrolled in subgroup analysis).Health control group were composed of 32 healthy volunteers.LVEF,LVMI and E/e′ were measured.And the EL in left ventricle was measured at different phases and different segments based on VFM images.Results ①EL comparison:in the phrase of late diastole(DL),isovolumic contraction(IVC) and rapid ejection(RE),compared with the control group,EL in entirety and each segment of left ventricle in hypertension group increased (P0.05);②Correlation analysis:in the phrase of DL,IVC and RE,EL in entirety and each segment of left ventricle showed significant positive correlations with LVMI and with E/e′ (P<0.05).In the phrase of DL,EL in entirety and each segment of left ventricle showed significant negative correlations with LVEF(P<0.05).Conclusions EL measured quantitatively by VFM is more sensitive to reflect the changes of hemodynamic in hypertensive individuals.EL is closely correlated with cardiac structure and function.

Relationship between plaque burden and area strain of atherosclerosis with intravascular ultrasound elastography / 中国医学影像技术

Objective To assess the relationship between plaque burden (PB) and area strain (AS) by intravascular ultrasonic elastography (IVUSE).Methods Forty purebred New Zealand rabbits were fed with a high-cholesterol diet.And the abdominal aorta endothelium was balloon-injured after 2 weeks.At the end of the 12th week,2 plaques with moderate echo from each rabbit were chosen for in situ imaging,and 2 consecutive frames near the end-diastole images in situ were used to construct an IVUS elastogram.Cross-sectional external elastic membrane area (EEMare),lumen area (Lumenarea),plaque area (PA),PB,external elastic membrane volume (EEMvolume),lumen volume (Lumenvolume),plaque volume (PV),plaque volume burden (PVB),maximal plaque thickness (Tmax) and minimal plaque thickness (Tmin),eccentric index (EI),remodeling index (RI) and AS were measured and calculated,respectively.According to the PB,the plaques were divided into low PB group (PB≤40 ％) and high PB group (PB＞ 40 ％).The differences of all above parameters between the two groups were compared,and the relationship between the plaque morphological and mechanical parameters were analyzed.Results PA,PV,PB,PVB,Tmin,Tmax,Lumenarea,Lumenvolume and EI were different between the 2 groups (all P＜0.01).On stepwise multiple regression analysis,the regression equation were built,(Y)=-6.921+10.430X1 +12.207X2((Y):AS,X1:EI,X2:PB,R2 =0.272,P＜0.001).After eliminating the effect of EI on the AS,the lower PB group had obviously smaller AS than higher PB group (P =0.010).Conclusion The PB has effect on plaque mechanical stability.The plaques with higher burden are more vulnerable than those with lower burden.

Relationship between plaque burden and area strain of atherosclerosis with intravascular ultrasound elastography / 中国医学影像技术

Objective To assess the relationship between plaque burden (PB) and area strain (AS) by intravascular ultrasonic elastography (IVUSE).Methods Forty purebred New Zealand rabbits were fed with a high-cholesterol diet.And the abdominal aorta endothelium was balloon-injured after 2 weeks.At the end of the 12th week,2 plaques with moderate echo from each rabbit were chosen for in situ imaging,and 2 consecutive frames near the end-diastole images in situ were used to construct an IVUS elastogram.Cross-sectional external elastic membrane area (EEMare),lumen area (Lumenarea),plaque area (PA),PB,external elastic membrane volume (EEMvolume),lumen volume (Lumenvolume),plaque volume (PV),plaque volume burden (PVB),maximal plaque thickness (Tmax) and minimal plaque thickness (Tmin),eccentric index (EI),remodeling index (RI) and AS were measured and calculated,respectively.According to the PB,the plaques were divided into low PB group (PB≤40 ％) and high PB group (PB＞ 40 ％).The differences of all above parameters between the two groups were compared,and the relationship between the plaque morphological and mechanical parameters were analyzed.Results PA,PV,PB,PVB,Tmin,Tmax,Lumenarea,Lumenvolume and EI were different between the 2 groups (all P＜0.01).On stepwise multiple regression analysis,the regression equation were built,(Y)=-6.921+10.430X1 +12.207X2((Y):AS,X1:EI,X2:PB,R2 =0.272,P＜0.001).After eliminating the effect of EI on the AS,the lower PB group had obviously smaller AS than higher PB group (P =0.010).Conclusion The PB has effect on plaque mechanical stability.The plaques with higher burden are more vulnerable than those with lower burden.

Therapeutic Observation of Needle Warming Therapy plus Pelvic Floor Muscle Training for Post-stroke Neurogenic Bladder / 上海针灸杂志

Objective To observe the clinical efficacy of needle warming therapy plus pelvic floor muscle training in treating post-stroke neurogenic bladder.Method A total of 124 patients with post-stroke neurogenic bladder were divided into a treatment group and a control group by random number table, 62 cases in each group. The treatment group was intervened by acupuncture, moxibustion plus pelvic floor muscle training; the control group was intervened by Chinese patent drugs. The intervention was conducted with 2 weeks as a treatment course, for 3 treatment courses in total. The daily voiding frequency test and maximum cystometric capacity (MCC) in the two groups were measured before and after the intervention, and the clinical efficacies were compared between the two groups.Result Each item of the daily voiding frequency test in the two groups was significantly changed after the treatment (P<0.01). Each item of the daily voiding frequency test in the treatment group was significantly different from that in the control group after the treatment (P<0.01). The MCC was significantly changed after the intervention in both groups (P<0.01). The MCC in the treatment group was significantly different from that in the control group after the treatment (P<0.01). The recovery rate and total effective rate were respectively 35.5% and 96.8% in the treatment group versus 19.4% and 77.4% in the control group. There were significant differences in comparing the total effective rate (P<0.01) and the recovery rate between the two groups (P<0.05).Conclusion Needle warming therapy plus pelvic floor muscletraining can produce a significant therapeutic efficacy in treating post-stroke neurogenic bladder, and the therapeutic efficacy is obviously better than that of medication.

Research on the relationship between area strain and eccentric index of atherosclerotic plaques by intravascular ultrasonic elastography / 中华超声影像学杂志

Objective To assess the relationships between area strain (AS) and eccentric index (EI) of atherosclerotic plaques as seen by intravascular ultrasonic elastography (IVUSE),and to reveal the effect of EI on the plaques stability.Methods Forty purebred New Zealand rabbits were fed with a high-cholesterol diet;the abdominal aorta endothelium was balloon-injured after 2 weeks;at the end of week 12,2 plaques with moderate echo from each rabbit were chosen for in situ imaging,and 2 consecutive frames near the end-diastole images in situ were used to construct an IVUS elastogram.Results The eccentric plaques showed significantly greater area stain (AS) than the centripetal plaques [4.77(2.92,8.01)% vs 3.27(2.15,4.82)%,P=0.029] with smaller plaque area and plaque burden (P<0.05).The plaque AS was positively correlated with EI (r=0.392,P=0.003).The eccentric plaques showed significantly greater AS in the shoulder than in body [4.98(3.17,8.48)% vs 4.64(2.51,5.92)%,P=0.008].Conclusions The EI is one of influential factors on plaque AS.Eccentric plaques may be more vulnerable than centripetal plaques,especially in the shoulder of eccentric plaques which have greater AS than their body.

Effects of domestic wire-reinforced epidural catheter on complications related to anesthesia during labor analgesia / 中华麻醉学杂志

Objective To evaluate the effects of the domestic wire-reinforced epidural catheter on complications related to anesthesia during labor analgesia.Methods A total of 2 407 parturients,aged 18-40 yr,weighing 50-100 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective operations under combined spinal-epidural anesthesia for labor analgesia,were divided into 2 groups using a random number table:comnon epidural catheter group (group Ⅰ,n=1 203) and wirereinforced epidural catheter group (group Ⅱ,n=1 204).After successful epidural puncture,the appropriate amount of local anesthetics was injected into the subarachnoid space,and the corresponding epidural catheter was then inserted,and the depth was 3 em.Paresthesia during catheterization,unexpected catheter displacement,difficult extubation,catheter bending,epidural bleeding,successful insertion at first attempt,successful insertion time,the number of successfully delivered doses and consumption of patientcontrolled analgesia solution were recorded.The patients were followed up after operation for nerve damage.Results Compared with group Ⅰ,the incidence of paresthesia during catheterization,unexpected catheter displacement and catheter bending was significantly decreased,the occurrence of epidural bleeding was reduced,the success rate of insertion at first attempt was increased,successful insertion time was shortened,the incidence of difficult extubation was increased (P＜0.05 or 0.01),and no significant change was found in the number of successfully delivered doses,consumption of patient-controlled analgesia solution or incidence of nerve damage after operation in group Ⅱ (P＞0.05).Conclusion Complications related to anesthesia are reduced when the domestic wire-reinforced epidural catheter is used for labor analgesia.

Comparison between continuous subarachnoid block with ropivacaine or sufentanil either alone or in combination for labor analgesia / 中华麻醉学杂志

Objective To compare the continuous subarachnoid block with ropivacaine or sufen?tanil either alone or in combination for labor analgesia. Methods Ninety nulliparous parturients who re?quired labor analgesia voluntarily, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 23-35 yr, with a body height of 155-170 cm, were included in this study. When regular uterine contrac?tion appeared, labor analgesia was performed in the first stage of labor. The parturients were divided into 3 groups ( n=30 each ) using a random number table: ropivacaine group ( group R ) , sufentanil group (group S), and combination of ropivacaine and sufentanil group ( group RS). The spinal catheter was placed at L3,4 interspace. In group R, ropivacaine was given as an initial bolus of (0.6 mg∕ml) 5 ml fol?lowed by an infusion of 0.2 mg∕ml after the analgesia pump was connected. In group S, sufentanil was given as an initial bolus of (1.6 μg∕ml) 5 ml followed by an infusion of 0.2μg∕ml after the analgesia pump was connected. In group RS, the mixture of ropivacaine 0. 3 mg∕ml plus sufentanil 0. 8 μg∕ml was given as an initial bolus of 5 ml, followed by an infusion of the mixture of ropivacaine 0. 1 mg∕ml plus sufentanil 0.1 μg∕ml after the analgesia pump was connected. The analgesia pump was programmed to deliver a 5 ml bolus dose with a 15 min lockout interval, background infusion at a rate of 5 ml∕h, and the total volume of 100 ml in the three groups. The analgesia pump was connected at 30 min after the initial bolus was given, and the infusion was stopped at 2 h after delivery in the three groups. Visual analog scale ( VAS) scores were maintained ≤3. VAS scores were recorded before analgesia and at 5, 10 and 30 min after the initial bolus was given. The interval and duration of uterine contraction were recorded before analgesia, in 0-30 min, 30-60 min and 90-120 min of analgesia periods, and in the second stage of labor. The development of nausea and vomiting, pruritus, lateral episiotomy, assisted vaginal delivery, cesarean section, and post?dural puncture headache and requirement for oxytocin were recorded. Apgar scores at 1, 5 and 10 min after birth were recorded. Results The Apgar score of the newborn was more than or equal to 7 at 1, 5 and 10 min after birth in the three groups. Compared with the value before analgesia, the interval of uterine contraction was significantly prolonged, and the duration of uterine contraction was significantly shortened in the 0-30 min of analgesia period in group R ( P0.05) . Compared with group R, the VAS scores were significantly increased at 5 and 10 min after the initial bolus was given, the interval of uterine contraction was significantly shortened, and the duration of uterine contraction was significantly prolonged in S and RS groups, and the incidence of pruritus was significantly decreased in group S ( P0.05) . Conclusion Continuous sub?arachnoid block with combination of ropivacaine and sufentanil provides better efficacy for labor analgesia than ei?ther alone.

Effect of pregnancy factor on T line corresponding to vertebral level：a multicenter clinical compar-ative study / 中华麻醉学杂志

Objective To investigate the effect of the pregnancy factor on the line drawn between the highest points of the two iliac crests ( T line) corresponding to the vertebral level in a multicenter clini?cal comparative study. Methods Hospitalized patients selected from the obstetric department or gynecolog?ical department, of American Society of Anesthesiologists physical statusⅠorⅡ, were divided into preg?nancy group ( group P ) and non?pregnancy group ( group NP ) . The patients were placed in the lateral posi?tion with their back vertical to the bed surface, the patient′s thighs were at an angle of approximately 90 de?grees to the trunk, and hip flexion was employed by flexing the patient′s knees to the chest. To determine the highest points of the two iliac crests, a line ( T line) was drawn between the highest points using a wire?reinforced epidural catheter. And another vertical line ( T′line) was made between the highest point of the iliac crest on the upper side ( not the side in the lateral position) and the ground. Ultrasonography was per?formed to identify and record the level of T line and T′line corresponding to the spinous process and lumbar interspace. Results A total of 1 763 cases completed the study, and there were 905 cases in group P, and 858 cases in group NP. Compared with group NP, the rate of T line at L3 spinous process and L3,4 in?terspace was significantly increased in group P ( P<0.05) . Compared with T′line, the rate of T line at L2,3 interspace and L3 spinous process was significantly decreased, and the rate of T line at L4 spinous process, L4,5 interspace and L5 spinous process was significantly increased in group P, and the rate of T line at L3 spinous process, L2,3 interspace and L3,4 interspace was significantly decreased, and the rate of T line at L4 spinous process and L4,5 interspace was significantly increased in group NP (P<0.01). Conclusion The level of T line corresponding to the vertebral level is significantly higher in the pregnant patients than in the nonpregnant patients.

Effect of ultrasound-guided transversus abdominis plane block on postoperative analgesia in parturients undergoing caesarean delivery / 临床麻醉学杂志

Objective To investigate the effect of ultrasound-guided transversus abdominis plane (TAP)block on the efficacy of postoperative analgesia in parturients undergoing selective cesar-ean delivery.Methods Eighty ASA Ⅰ or Ⅱ parturients recruited for selective cesarean delivery under combined spinal-epidural anesthesia were randomly divided into two groups(n =40 each):TAP group (group T)and control group(group C).After cesarean delivery,bilateral of ultrasound-guided TAP block were performed,20 ml of 0.5% ropivacaine was injected in each side in group T,while TAP was not done in group C.Both groups received patient-controlled intravenous analgesia (PCIA)after cesarean delivery.The resting and exercise visual analogue scale (VAS)scores,Ramsay sedation score and the Bruggrmann comfort scale(BCS)score were evaluated at 2,4,6,8 and 24 h after operation. The consumption of sufentanil within 24 h after operation,the number of successfully delivered doses (D1 )and the number of attempts (D2 )within 24 hr after operation were recorded.D1/D2 was calculated.The parturients satisfaction and the adverse reactions were also recorded.Each parturient was assessed postoperatively by a blinded investigator.Results The consumption of sufentanil within 24 hr after operation,the resting and exercise VAS scores at 2,4,6 hr after surgery were significant-ly lower,while the BCS score,the value of Dl/D2 and the degree of satisfaction were higher in group T than those in group C (P <0.05).There were no adverse reactions in both groups.Conclusion Ultra-sound-guided TAP block reduces the postoperative sufentanil consumption,enhances the efficacy of post-cesarean analgesia of the parturients.Comfort and satisfaction are achieved in the parturients of the group T.

Evaluation of left ventricular hemodynamic changes of patients with hypertension by vector flow mapping / 中华超声影像学杂志

Objective To investigate the left ventricular hemodynamic changes of patients with hypertension by echocardiography using vector flow mapping (VFM).Methods Twenty-eight patients with hypertension (hypertension group) and 26 normal subjects (control group) were involved.All the subjects underwent conventional transthoracic echocardiographic examination and VFM on apical 3 chambers view.The evolution of velocity distribution,stream line and vorticity line in left ventricle were observed.Left ventricle was divided into basal,mid and apical segments,in which vorticity parameter (Vmax) were quantitatively measured and analyzed.Its relations to conventional left ventricular parameters (E,A,E/A,EDT,E/e') were then analyzed.Results ①Compared with the control group,LV end-diastolic,end-systolic volumes and E/e' significantly increased.The evolution of velocity distribution,stream line and vorticity in the hypertension group was slightly irregular.② In mid-diastole phase,vorticity of the control group showed the trend (middle＞ base ＞ apex)(P ＜0.05),which wasn't shown in hypertension group.In other phases,vorticity of both groups decreased from base to apex (P ＜0.05).③There were statistically differences in vorticity between the two groups in early diastolic phase,late diastolic phase of apex and late systolic phase of middle (P =0.045,0.004,0.015,respectively).④ There were negative correlations between Vmax in late diastolic phase of every segment and E/A (from basal segment to apex:r =-0.310,-0.334,-0.333;P =0.028,0.020,0.021).There was positive correlation between Vmax in isovolumic contraction time and E/e' (r =0.348,P =0.016).Conclusions VFM can be utilized to analyze left ventricular hemodynamics quantitatively and it may be a good supplement for assessing cardiac diastolic function.

Effect of labor analgesia on development of postpartum depression / 中华麻醉学杂志

Objective To evaluate the effect of labor analgesia on the development of postpartum depression.Methods Seventy nulliparous parturients who were at full term with a singleton fetus in vertex presentation,aged 20-35 yr,with body mass index＜27 kg/m2,at 38-41 weeks of gestation,of ASA physical status Ⅰ,were enrolled and divided into 2 groups (n =35 each) using a random number table:vaginal delivery group (group VD) and labor analgesia group (group LA).In LA group,the epidural catheter was placed at L2,3 interspace for combined spinal-epidural analgesia when their cervical dilations were in 2-3 cm.VAS score was maintained below 3 after the analgesia.Parturients completed Edinburgh Postnatal Depression Scale questionnaires 42 days after the labor.The development of depression was recorded.Results The incidence of postnatal depression was significantly lower in LA group (17％) than in VD group (40％).Conclusion Labor analgesia can decrease the development of postpartum depression.

Solution to part of the executive problems by analyzing the control files of brachytherapy / 中华放射医学与防护杂志

Objective To solve part of executive problems by analyzing and editing the control files of brachytherapy.Methods By recording the sources of radioactivity,the time when patients were treated and using the program designed by the C language,the source location and the time treated in this location were tracked to the source urgently.By editing the control files,the follow-up treatment files were produced and then tested with a solid water measuring model.Results For the point A,B defined in the measure model,the deviation between Dose A4 and Dose A1 was 6.12％,the deviation between Dose B4 and Dose B1 was 2.09％.For the planar dose measure in the MapCheck,Plane Dose 4 and Plane Dose 1 rendered as pear-shaped dose distribution,and the dose difference less than 4％ reached 93.8％.The point dose and plane dose meeted the clinical standards.Conclusions The follow-up treatment files can complete the part of the unfinished brachytherapy plan exactly and achieve requirements of the dose distribution.