Analysis of risk factors for retinal detachment in myopic patients and construction of Nomogram prediction model / 中华眼底病杂志

Objective:To analyze the risk factors associated with retinal detachment in patients with myopia, and to establish and validate the predictive column-line diagram model.Methods:A cross-sectional clinical study. From January 2020 to November 2021, 90 patients with myopia combined with retinal detachment who were diagnosed by ophthalmologic examination in the People's Hospital of Ningxia Hui Autonomous Region were included in the study (observation group). Ninety myopic patients with age- and gender-matched myopia who underwent ophthalmologic examination for myopia during the same period were selected as the control group. The clinical data of the two groups were analyzed, and the indicators with differences were subjected to univariate and multivariate logistic regression analyses. The results of the regression analyses were visualized by using R software to obtain the column charts, and the accuracy of the column charts was verified by the ROC curves of the subjects' work characteristics; the clinical efficacy of the column chart model was verified by the internal data.Results:Compared with the control group, patients in the observation group were older, had higher myopic refraction, had more visual fatigue, ocular trauma, and cataracts, had lower choroidal and retinal thickness, and had more history of ophthalmic surgery, and the differences were statistically significant ( P<0.05). The area under the ROC curve (AUC) for age, myopic refraction, retinal thickness, and choroidal thickness were 0.612, 0.613, 0.720, and 0.704, respectively; the optimal cutoff values were 43 years old, -3.5 D, 225 μm, and 144 μm. the ROC values were 0.612, 0.613, 0.720, and 0.704 for age (>43 years old), myopic refraction (>-3.5 D), visual fatigue (yes), ocular trauma (yes), cataracts (yes), retinal thickness (≤225 μm), and choroidal thickness (≤144 μm) were the risk factors affecting the development of retinal detachment in myopic patients ( P<0.05). The consistency index of the column chart model for predicting the risk of retinal detachment in patients with myopia was 0.731 (95% confidence interval 0.665-0.824); the risk threshold for predicting the development of retinal detachment in patients was >0.07. Conclusions:Age >43 years, myopic refraction >-3.5 D, presence of visual fatigue, ocular trauma, cataract, retinal thickness ≤225 μm, choroidal thickness ≤144 μm are the risk factors affecting the development of retinal detachment in myopic patients. The column-line diagram model constructed on the basis of the risk factors has good accuracy.

Evaluation of left ventricular rotation and twist in patients with constrictive pericarditis after pericardiectomy with speckle tracking echocardiography / 中华超声影像学杂志

Objective:To evaluate the left ventricular rotation and twist in patients with constrictive pericarditis (CP) after pericardiectomy by using speckle tracking echocardiography (STE), and observe its trend over time.Methods:A total of 29 patients with CP from Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from September 2014 to December 2017 underwent echocardiography 1 week before and 1 month, 6 months, 12 months after pericardiectomy. STE was performed to obtain peak values of basal and apical rotation and left ventricular twist. Twenty-nine healthy subjects were recruited as controls in the same period.Results:The left ventricu1ar apical rotation[before surgery(6.62±3.19)°, 1 month after surgery(7.07±4.02)°, 6 months after surgery(7.88±4.46)°, 12 months after surgery(7.85±4.51)°], the left ventricu1ar twist [before surgery(10.50±4.94)°, 1 month after surgery(9.42±5.40)°, 6 months after surgery(9.59±4.62)°, 12 months after surgery(9.70±4.45)°] were significantly lower in patients with CP than those in controls [(11.22±5.17)°, (16.35±5.21)°](all P<0.05); while basal rotation in patients with CP after surgery among different time points were all significantly lower than those in controls[1 month after surgery(-3.85±3.20)°, 6 months after surgery(-3.49±2.09)°, 12 months after surgery(-3.53±2.01)°; controls(-5.57±2.78)°] (all P<0.05), with no significant difference between patients with CP before surgery (-5.22±3.14)° and controls (-5.57±2.78)°( P>0.05). There were no significant differences in left ventricular twist, basal and apical rotation in CP groups before and after surgery among different time points (all P>0.05). Conclusions:Although the left ventricular global function of patients with CP in the long postoperative period seems "normal" , the left ventricular twist, basal and apical rotation are still significantly lower than those in controls. STE can be used to assess the changes of left ventricular twist and rotation in patients with CP long-term after pericardiectomy.

Evaluation and analysis of Advanced Health Assessmentcurriculum for nursing postgraduates in China / 中国实用护理杂志

Objective To evaluate the satisfaction and current situation of advanced health assessment course for postgraduates. So that it can provide the evidence for the development of teaching reform. Methods Facilitating the convenient sampling of 69 nursing master′s degree authorized schools in China. And a further survey using self-designed questionnaires was conducted in the teacher who in charge of this course and 73 postgraduates in 17 schools offering Advanced Health Assessment. The data were analyzed using reliability, validity, frequency and percentage. Results There were 45 schools responded effectively, of which only 17 schools set up this course. There were no uniform norms of the teaching materials, hours and credits. 73 postgraduates were satisfied with the teaching methods, training practical abilities, meeting academic development needs, practicality, and commonality of the advanced health assessment course. However, 54.8％ of the students said the course is too difficult to handle. Conclusion All the schools should pay more attention to Advanced Health Assessment Course and improve the professional level of postgraduates.

Mechano growth factor promotes the migration of bone marrow-derived mesenchymal stem cells / 中华物理医学与康复杂志

Objective To study the mechanism by which mechano growth factor (MGF) promotes the migration of mesenchymal stem cells (MSCs).Methods MSCs were isolated from Sprague-Dawley rats and treated with MGF at various concentrations.Western blotting was used to evaluate the expression of RhoA protein and its downstream p-MYPT,as well as p-FAK and t-FAK proteins related to focal adhesion kinase.The aim was to illustrate the effect of MGF in regulating the cytoskeleton of MSCs and the formation of focal adhesion.C3 toxin was used to inhibit RhoA activity and western blotting was used to examine the expression of p-MYPT,and the focal adhesion kinases p-FAK and t-FAK.Transwell assays were used to examine MSCs' migration ability,and immunofluorescence was conducted to examine the formation of F-actin cytoskeleton and focal adhesion.Results MGF can significantly promote the expression of MSCs' RhoA and its downstream protein p-MYPT.The effect is dose-dependent.The expression of RhoA and p-MYPT increased most significantly at 50 μM concentration.The ratio of p-FAK to t-FAK indicates that MGF can activate focal adhesion kinase and promote adhesion.C3 toxin significantly inhibited FAK activation.Transwell assays showed that MGF can significantly promote MSC migration,but pretreatment with C3 toxin inhibited it.The immunofluorescence results show that MGF can promote the rearrangement of MSCs' F-actin cytoskeleton and the formation of focal adhesion.C3 toxin disrupted MSCs cytoskeletons and decreased focal adhesion.Conclusion MGF promotes MSCs' migration through RhoA-and kinase-mediated cytoskeleton rearrangement and the formation of focal adhesion.

Analysis of relationship between aldosterone level changes and renal function during perioperative period of renal transplantation / 器官移植

Objective To investigate the relationship between changes of aldosterone level and renal function during perioperative period of renal transplantation and preliminarily discuss the role of aldosterone in chronic allograft nephropathy.Methods One hundred patients undergoing allogeneic renal transplantation in the Department of Urology of the General Hospital of Shenyang Military from January 1 ,201 0 to December 31 ,201 3 were assigned into the experimental group.According to the Scr levels measured at 30 d after renal transplantation,1 00 patients were divided into groups A (Scr≥1 33 μmol/L,n =1 3)and B (Scr <1 33 μmol/L,n =87).Ten healthy individuals aged 25-35 years were recruited into the control group.In the experimental group,blood sample was collected in the morning upon the day of renal transplantation (0 d),1 ,7,1 5 and 30 d after renal transplantation.In the control group,blood sample was obtained at the same time points for measurement of aldosterone and Scr levels.Results On the day of renal transplantation,the Scr level in the experimental group was (598 ±37)μmol/L,significantly higher compared with (75 ±5)μmol/L in the control group (P <0.05).The aldosterone level in the experimental group was (0.26 ±0.06)ng/dl,considerably higher than (0.1 3 ±0.03) ng/dl in the control group (P <0.05).Compared with 0 d,the Scr levels of group A significantly decreased at postoperative 30 d (P <0.05),whereas no statistical significance was noted in aldosterone levels between two time points (P >0.05).In group B,both Scr and aldosterone levels were significantly decreased at postoperative 30 d (both in P <0.05).Correlation analysis revealed that the serum level of aldosterone was positively correlated with Scr level changes (r =0.85,P <0.05).Conclusions After renal transplantation,change of Scr level is positively correlated with aldosterone level alterations, probably suggesting that aldosterone plays a partial role in mediating injury of transplant kidney during renal transplantation.

Clinical effect of percutaneous nephrostolithotomy in the treatment of renal staghorn calculi / 中国医师进修杂志

Objective To evaluate the safety,efficacy,experience and techniques of percutaneous nephrostolithotomy (PCNL) in treating renal staghorn calculi.Methods The clinical data of 60 patients with staghorn renal stone who underwent PCNL were analyzed retrospectively.Results The stone free rate was 68.3％(41/60) in the first procedure.Three patients were performed a secondary procedure.The stone free rate was 73.3％ (44/60) in the second procedure.The total stone free rate was 93.3％(56/60) after the procedure of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic lithotripsy (URL).Conclusions PCNL is a safe and effective method for the staghorn renal calculi.The stone free rate may be improved with skilled operation experience and combination with ESWL and/or URL.

Assessment of myocardial perfusion by the microbubble replenishment parameters of real-time myocardial contrast echocardiography / 中华超声影像学杂志

ObjectiveTo assess myocardial perfusion by the end-systolic and end-diastolic replenishment parameters of real-time myocardial contrast echocardiography (MCE).MethodsTwenty-one patients with myocardial infarction(MI) and normal control group of 6 cases underwent intravenous realtime myocardial contrast echocardiography via slow and homogeneous venous injections of SonoVue.MCE images were obtained from the apical 4-chamber,2-chamber,and long-axis views.According to the exponential function:y(t) =A [1 - e-kt] + B,the time intensity curves were obtained.By an off-line ECG triggering and curve fitting,the replenishment parameters A value,k value,A × k value were obtained separately from end-systolic and end-diastolic images.ResultsIn normal control group,the end-systolic replenishment parameters A value,k value,A × k value were all lower than that of the end-diastolic replenishment parameters[(6.21 ± 2.69)dB vs (7.93 ± 3.66)dB,P ＜0.05；0.36 ± 0.15 vs 0.42 ± 0.19,P ＜ 0.01 ;2.88 ± 1.29 vs 3.39 ± 1.61,P ＜0.05,respectively].The end-diastolic replenishment parameters were found significantly greater variability than the end-systolic values (variation coefficient CV:A value 46.2％ vs 43.3％,k value 45.2％ vs 41.4％,A× k value 47.5％ vs 44.8％,all P ＜0.05).In 21 patients,the end-systolic replenishment parameters in myocardial segments supplied by infarct-related coronary artery were significantly lower than that in myocardial segments supplied by non - infarct - related coronary artery.ConclusionsThe end-systolic and end-diastolic replenishment parameters of real time myocardial contrast echocardiography can assess myocardial perfusion.The variability of the end-systolic replenishment parameters is smaller than that of the end diastolic parameters.Significant variability in k-value suggests that this parameter is best suited for before-after study in the same patient.

Relationship between carotid plaque neovascularization and other cardiovascular risk factors and acute coronary syndrome using contrast-enhanced ultrasound / 中华超声影像学杂志

Objective To evaluate the relationship between carotid plaque neovascularization and other cardiovascular risk factors and acute coronary syndrome(ACS) using contrast-enhanced ultrasound.Methods The study population consisted of 128 patients with coronary heart disease associated carotid plaque thicker than 2.0mm,including 63 patients with ACS and 65 patients with stable coronary artery disease (sCAD).Contrast-agent enhancement in the plaque was evaluated by visual interpretation and quantitative analysis.All blood samples of the patients were sent to the same hospital laboratory for biochemical detection and correction.Results The percentage of contrast-agent enhancement in patients with ACS was significantly greater than that in patients with sCAD by visual interpretation [63%(39/63) vs 37%(24/65),P<0.001].The quantitative analysis showed that the enhanced intensity in the plaque and the ratio of enhanced intensity in the plaque to that in the carotid artery lumen in patients with ACS were significantly greater than those in patients with sCAD (P=0.001,P=0.035,respectively).Logistic regression analysis revealed that age older than 65 years and contrast-agent enhancement within plaque were independent predictor for patients with ACS(OR=2.630,95%CI 0.933-7.409,P=0.006;OR=2.687,95%CI 1.002-8.025,P=0.047).Conclusions Age older than 65 years and contrast-agent enhancement in the carotid plaque may be used as independent predictors for ACS.

Evaluation of the relationship between carotid plaque instability and coronary heart disease by contrast-enhanced ultrasound / 中华超声影像学杂志

Objective To evaluate the relationship between carotid plaque instability and coronary heart disease by contrast-enhanced ultrasound. Methods Thirty-five patients with acute coronary syndrome (ACS) and 32 patients with stable coronary artery disease(sCAD) were included. Inclusion criteria were at least 1 carotid atherosclerotic plaque with thickness larger than 2.0 mm. Contrast-agent enhancement in the plaque was evaluated by visual interpretation and quantitative analysis. Results The percentage of soft plaque in ACS group was significantly higher than that in sCAD group ( P ＜0.001 ). The proportion of contrast-agent enhancement in patients with ACS was significantly than that in patients with sCAD( P =0. 037). The enhanced intensity in the plaque and the ratio of enhanced intensity in the plaque to that in the carotid artery lumen in patients with ACS were significantly larger than those in patients with sCAD ( P ＜0.001, P = 0.026, respectively). Sensitivity and specificity of prediction ACS were 74% and 60%,respectively,for enhanced intensity in the plaque and 86% and 67%, respectively, for ratio of enhanced intensity in the plaque to that in the lumen of the carotid artery. Conclusions The subjects with ACS had more intense contrast-agent enhancement than the subjects with sCAD. Contrast-enhanced ultrasound can be used to evaluate the relationship between carotid plaque instability and coronary heart disease.

Evaluation of vortex within left ventricle in patients with dilated cardiomyopathy by vector flow mapping / 中华超声影像学杂志

Objective To evaluate left ventricular function in the way of intracavitary vortex by vector flow mapping(VFM),and to demonstrate the formation and variation of the vortex. Methods Twenty-six patients with dilated cardiomyopathy(DCM) and 44 healthy controls were involved. The velocity distribution imagings on the section plane of the flow in the left ventricle were obtained by VFM, the location of the vortex and its variation in every phase of cardiac cycle were focused,and series parameters were measured,such as the diameter of the vortex (transverse diameter, vertical diameter), number of the vertex. Results relaxation(e) period. Vortices were observed mostly during diastolic period, nearby the anterior leaflet of mitral valve,middle upper 1/3 of left ventricle,and their shapes changed 2 - 3 times. The diameters of the vortex (transverse diameter,vertical diameter) , number of the vertices in one cardiac cycle during 7 phases mostly nearby the cardiac apex, middle lower 2/3 of left ventricle, and their shapes changed 4 - 5 times.Compared with control group,the diameters of the vortex (transverse diameter, vertical diameter) during 7 phases in DCM group were bigger,and number of the vertices were more ( P ＜0.01 ). The diameters of the vortex (transverse diameter, vertical diameter), number of the vertices within DCM group in one cardiac cycle during 7 phases were significantly different ( P ＜ 0.01 ). Conclusions VFM can demonstrate the variation of intracavitary vortex. Vortex in DCM group were significantly bigger than those of control group.

Evaluation of intraventricular dyssynchrony in patients with coronary artery disease by two dimensional strain imaging / 中华超声影像学杂志

Objective To evaluate the dyssynchrony of left ventricle in patients with coronary artery disease(CAD) by two-dimensional strain echocardiography (2-DS). Methods The myocardium of left ventricle of 33 patients with CAD and 30 nomal controls were detected by 2-DS. The time from onset QRS complexes to peak systolic longitudinal strain(Ts) and the standard deviation of Ts of 18 left ventricular segments (Ts-SD)were measured. Results There were 168 segments whose flow was provided by coronary artery with stenosis≤75% ,210 segments whose flow was provided by coronary artery with stenosis 75 %. ①Ts was delayed significantly and Ts-SD was obviously higher in patients with stenosis≥75% when compared with the control group. ②Ts was delayed and Ts-SD was higher in patients with stenosis≥75% compared with those whose stenosis was ≤75%. ③There were no statistical differences in Ts and Ts-SD between the patients with stenosis ≤75% and the control group. ④When left ventricular systolic dyssynchrony was defined as Ts-SD≥33.0 ms, there were 22 patients with systolic dyssynchrony of all 26 patients whose coronary artery stenosis≥75%, there were no patient with systolic dyssynchrony of all 7 patients whose stenosis ≤75%. Conclusions Although there are no evident regional wall motion abnormalities by routine echocardiography,in patients with severe coronary artery stenosis,2-DS can detect exactly the dyssynchrony of left ventricle.

Evaluation of myocardial perfusion abnormalities in patients with hypertrophic cardiomyopathy by myocardial contrast echocardiography / 中华超声影像学杂志

Objective To evaluate the microcirculation abnormalities in the patients with hypertrophic cardiomyopathy(HCM). Methods Twenty patients with HCM and 20 healthy volunteers were included in the study. Two-dimensional images on the apical four-chamber, two-chamber and long-axis views, including 5 cardiac cycles before 'flash' and 15 cardiac cycles after 'flash', were reeorded and stored for off-line analysis in EchoPAC workstation. Then,contrast time-intensity curves were obtained for each available left ventrieular segment. Results There were significant differences in the A,k and the product A×k between the hypertrophic wall segments (P = 0.01, P<0.001, P = 0.036,respectively) and nonhypertrophic wall segments (P<0.001,respectively) and healthy subjects. A,k and the product A×k in hypertrophic wall segments were significantly different from those in nonhypertrophic wall segments in patients with HCM (P = 0.021, P = 0.016, P = 0. 001,respectively). Accordingly,the normalized value of A and the product A × k were lower in hypertrophied wall segments (P = 0.031, P<0.001, respectively) and nonhypertrophied wall segments(P = 0.002, P<0.001,respectively) in patients with HCM than those in normal segments of healthy controls. The normalized value of A and the product A × k were lower in hypertrophic wall segments than nonhypertrophic wall segments in patients with HCM(P = 0.045, P = 0.021,respectively). Conclusions Myocardial contrast echocardiography is a useful method to investigate myocardial perfusion abnormalities in patients with HCM.

Assessment of myocardial perfusion and systolic function in patients with coronary artery disease after coronary artery bypass surgery by myocardial contrast echocardiography and two-dimensional strain echocardiography / 中华超声影像学杂志

two-dimensional strain echocardiography can observe dynamic change of regional systolic function,combined with the two methods can more accurately assess the treatment results of coronary artery bypass surgery.

Evaluation of atrial septal defect using real-time three-dimensional echocardiography: comparison with surgical findings / 华中科技大学学报（医学）（英德文版）

The present study evaluated the application of three dimensional echocardigraphy (3DE) in the diagnosis of atrial septal defect (ASD) and the measurement of its size by 3DE and compared the size with surgical findings. Two-dimensional and real-time three dimensional echocardiography (RT3DE) was performed in 26 patients with atrial septal defect, and the echocardiographic data were compared with the surgical findings. Significant correlation was found between defect diameter by RT3DE and that measured during surgery (r=0.77, P<0.001). The defect area changed significantly during cardiac cycle. Percentage change in defect size during cardiac cycle ranged from 6%-70%. Our study showed that the size and morphology of atrial septal defect obtained with RT3DE correlate well with surgical findings. Therefore, RT3DE is a feasible and accurate non-invasive imaging tool for assessment of atrial septal size and dynamic changes.

Assessment of myocardial perfusion and systolic function in patients with coronary artery disease after coronary artery bypass surgery by myocardial contrast echocardiography and two-dimensional strain echocardiography / 华中科技大学学报（医学）（英德文版）

The clinically applied value of myocardial perfusion and systolic function in patients with coronary artery disease after coronary artery bypass surgery using real-time myocardial contrast echocardiography (RT-MCE) combined with two-dimensional strain echocardiography was assessed. Twenty patients underwent intravenous RT-MCE by intravenous injections of SonoVue before and after coronary artery bypass surgery. Two-dimensional images were recorded from the left ventricular four-chamber view, two-chamber view and the apical view before, and two weeks and three months after coronary artery bypass surgery, and the peak systolic longitudinal strain was measured. The results showed that myocardial perfusion was significantly increased after coronary artery bypass surgery in about 71.6% segments. In the group that myocardial perfusion was improved, the peak systolic longitudinal strain three months after bypass surgery was significantly higher than that before operation [(-15.78+/-5.91)% vs (-10.45+/-8.31)%, P0.05]. It was concluded that whether or not the improvement of myocardial perfusion can mirror the recovery trend of regional systolic function, two-dimensional strain echocardiography can observe dynamic change of regional systolic function. The combination of myocardial perfusion with two-dimensional strain echocardiography can more accurately assess the curative effectiveness of coronary artery bypass surgery.

Evaluation of carotid atherosclerotic plaque stability with contrast-enhanced ultrasonography / 华中科技大学学报（医学）（英德文版）

This study was aimed to evaluate the relationship between carotid atherosclerotic plaque stability and the clinical symptoms in patients with carotid atherosclerotic plaques by using contrast-enhanced ultrasonography. Fifty patients with carotid atherosclerotic plaques were enrolled and examined with contrast-enhanced ultrasonography. The correlation of contrast agent enhancement of the carotid atherosclerotic plaques and the clinical symptoms was analyzed. The results showed that among the 50 patients, plaques were enhanced in the 23 patients with obvious clinical symptoms. In 27 patients without apparent clinical symptoms, plaques were enhanced sparsely in 15 patients and not enhanced in 12 patients. It was suggested that contrast-enhanced ultrasonography could be used for the examination of the microcirculation in carotid atherosclerotic plaques on real-time basis and serve as a new noninvasive approach for the assessment of stability of carotid atherosclerotic plaques.

Evaluation of the left ventricular remodeling in patients with myocardial infarction after revascularization with intravenous real-time myocardial contrast echocardiography / 华中科技大学学报（医学）（英德文版）

In order to evaluate the left ventricular remodeling in patients with myocardial infarction after revascularization with intravenous real-time myocardial contrast echocardiography (RT-MCE), intravenous RT-MCE was performed on 20 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions: homogeneous opacification=1; partial or reduced opaciflcation or subendocardial contrast defect=2; constrast defect=3. Myocardial perfusion score index (MPSI) was calculated by dividing the total sum of contrast score by the total number of segments with abnormal wall motion. Twenty patients were classified into 2 groups according to the MPSI: MPSI1.5 as poor myocardial perfusion. To assess the left ventricular remodeling, the following comparisons were carried out: (1) Comparisons of left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) before and 3 months after revascularization in two groups; (2) Comparisons of LVEF, LVESV and LVEDV pre-revascularization between two groups and comparisons of these 3 months post-revascularization between two groups; (3) Comparisons of the differences in LVEF, LVESV and LVEDV between 3 months post-and pre-revascularization (DeltaLVEF, DeltaLVESV and DeltaLVEDV) between two groups; (4) The linear regression analysis between DeltaLVEF, DeltaLVESV, DeltaLVEDV and MPSI. The results showed that the LVEF obtained 3 months after revascularization in patients with MPSI>1.5 was obviously lower than that in those with MPSI1.5 was obviously larger than that in those with MPSI1.5 and those with MPSI

Evaluating carotid atherosclerotic plaques stability with contrast-enhanced ultrasonography / 中华超声影像学杂志

Objective To evaluate the relationship between carotid atherosclerotic plaques stability and the clinical symptoms of carotid atherosclerosis by contrast-enhanced ultrasonography. Methods Fifty patients with carotid atherosclerotic plaques were examed with contrast-enhanced ultrasonography,the contrast agent visualization of the carotid atherosclerotic plques were analyzed and compared with their clinical symptoms. Results Twenty-three patients who suffered from obvious clinical symptom were entirely visualized. Twenty-weven patients had not apparent clinical symptom,of these patients,15 were sparse visualized,there was no visualization in other 12 patients. Conclusions Conlrast enhanced ultrasonography can real-time observe microcirculation in carotid atherosclerotic piques,and assess the stability of carotid atherosclerotic plaques.

Value of Acceleration Flow in the Left Anterior Descending Coronary Artery for the Detection of Coronary Artery Stenosis by Transthoracic Coronary Color Doppler Echocardiography / 华中科技大学学报（医学）（英德文版）

Whether the localized flow acceleration occurs in the resting stenotic left anterior descending coronary artery was explored and its value for detection of coronary stenosis estimated.Blood flow in the left anterior descending coronary arteries in 45 patients was detected by transthoracic color Doppler echocardiograph and multipoint pulse Doppler spectrums were recorded in the same segment. The ratio of the maximal peak diastolic velocity to the minimal peak diastolic velocity was calculated. The ratio ≥1.5 was the cutoff value for the presence of localized acceleration flow.There were 23 patients with localized acceleration flow examined by echocardiography. Twenty of them were found to have luminal diameter stenosis (60 %- 98 %) in the left anterior descending coronary arteries by coronary angiography and 3 patients were normal. There were 22 patients without localized acceleration flow examined by echocardiography. Eighteen of them had no or ＜60% stenosis. Four patients had serious stenosis (≥95 %) or occluded segments in the left anterior descending coronary arteries on coronary angiography. The ratio of the maximal peak diastolic velocity to the minimal peak diastolic velocity was significantly higher in patients with left anterior descending coronary artery stenosis than that in those without stenosis (1.9±0.3 vs 1.3±0.2, P＜0.01) and it correlated significantly with left anterior descending coronary artery stenosis (r=0.77, P＜0.01). The specificity by using the ratio≥1.5 for stenosis detection was 85.7 % (18/21), and the sensitivity was 83.3 % (20/24). This study demonstrated that local blood flow velocity was increased in the resting stenotic left anterior descending coronary artery. Transthoracic color Doppler echocardiography is a reliable noninvasive method to detect localized acceleration flow in the left anterior descending coronary artery stenosis and it is useful in the noninvasive diagnosis of stenosis in the left anterior descending coronary artery.

Value of Echocardiography for Evaluation of the Flow-dependent Epicardial Coronary Vasodilation In Vivo / 华中科技大学学报（医学）（英德文版）

To assess the value of echocardiography for detection of the flow-dependent epicardial coronary vasodilation, the changes in internal diameter of the left anterior descending coronary arteries (LAD) induced by reactive hyperemia were studied by echocardiography in 12 health anesthetized open-chest dogs. Reactive hyperemia was induced by brief occlusion of the left anterior descending coronary artery for 30 s followed by rapid release. The two- dimensional images of the left anterior descending coronary artery before and after reactive hyperemia with and without intracoronary infusion of NG-nitro-L-arginine methyl ester (L-NAME), an inhibitor of nitric oxide synthase(NOS) were investigated. The internal diameter of LAD was measured and its percent change induced by reactive hyperemia was calculated. Our results showed that the internal diameter of LAD was 2.23±0.19 mm before intracoronary infusion of L-NAME (baseline). The internal diameter of LAD significantly increased to 2.52±0.24 mm (P＜0.01) after reactive hyperemia at baseline, and the percent change in internal diameter of LAD was (13. 10±3.59) %. The internal diameter of LAD before and after reactive hyperemia under the condition of intracoronary infusion of L-NAME was not different from that before reactive hyperemia at baseline. The percent change in internal diameter of LAD was (1.07±2.97) %, and it was significantly lower than that at baseline (P＜0.001). We are led to conclude that the change in internal diameter of LAD responding to reactive hyperemia was detected sensitively by echocardiography, and this change was associated with endothelium-derived nitric oxide.