Phenotype analysis of 11 fetuses with 22q11.2 microduplication diagnosed prenatally / 中华全科医师杂志

Objective:To analyze the clinical phynotypes of fetuses with 22q11.2 microduplications.Method:Eleven fetuses were diagnosed with 22q11.2 microduplications among 2 969 cases who underwent prenatal chromosomal microarray analysis from January 2016 to February 2020. The phenotypes, indications for invasive prenatal diagnosis, genetic results, pregnancy outcomes and postnatal clinical presentation were analyzed.Results:There were 6 cases diagnosed with classic 3.0 Mb microduplication (DiGeorge and velocardiofacial syndromes, DGS/VCFS) in the 22q11.2, 1 case with 1.5 Mb proximal microduplication and 4 cases with distal small segment microduplication (E-H). Out of 11 fetuses with 22q11.2 microduplications,7 cases were inherited, 2 cases was de novo and data were not available for 2 cases. Vicular septal defect and anencephalu were diagnosed by ultrasonography in 2 cases,fetal growth restriction was diagnosed in 2 cases,no any abnormalities were found in remaining 7 cases. Seven cases(3 cases of classic 3.0 Mb microduplication, 1 case of proximal microduplication and 3 cases of distal small segment microduplication) were delivered at full-term;and pregnancy was terminated in 4 cases. Seven infants were followed up after birth, 4 infants were normal, 3 showed abnormal phenotypes.Conclusion:The clinical phenotypes after birth of fetuses with 22q11.2 microduplication are diverse. Prenatal genetic counseling is necessary,so that pregnant women and their families can fully understand the possible clinical phenotypes and make informed choices.

Prenatal diagnosis and genetic analysis of 17 fetuses with skeletal dysplasia / 中华医学遗传学杂志

OBJECTIVE@#To explore strategies of prenatal genetic testing for fetuses featuring abnormal skeletal development.@*METHODS@#Clinical data of 17 fetuses with skeletal dysplasia was collected. The results of genetic testing and outcome of pregnancy were analyzed.@*RESULTS@#For 12 fetuses, the femur-to-foot length ratio was less than 0.9. Thirteen fetuses had a positive finding by genetic testing. One fetus was diagnosed with chromosomal aneuploidy, three were diagnosed with microdeletion/microduplications, and nine were diagnosed with hereditary bone diseases due to pathological variants of FGFR3, COL1A2, GPX4 or ALPL genes.@*CONCLUSION@#For fetuses with skeletal dysplasia characterized by short femur, in addition to chromosomal karyotyping and microarray analysis, sequencing of FGFR3 and other bone disease-related genes can improve the diagnostic rate.

Study of antioxidant effect of cannabinoid receptor type 2 agonist on rat hepatic stellate cell line / 中华肝脏病杂志

Objective@#To investigate the action and antioxidant effects of CB2 agonist AM-1241 on rat hepatic stellate cell line (HSC-T6).@*Methods@#HSC-T6 was randomly divided into four groups: control group, oxidative stress group, AM-1241 intervention group and AM-1241+AM-630 antagonist group. Survival rate of HSC-T6 was detected by thiazolyl blue assay under 24 h interventions with 0, 20, 50, 80 μmol/L AM-1241 and 0, 10, 20, 30, 40 μmol/L AM-630, respectively. Besides control group, the remaining groups were well cultured in low-glucose DMEM containing 100 mU/L glucose oxidase (GO) for 12 h to prepare the oxidative stress model. Then, AM-1241 intervention group was treated with 50 μmol/L low-glucose DMEM medium. After incubation for 12 h, the AM-1241+AM-630 antagonist group was treated with CB2 antagonist AM-630 (20 μmol/L) for 2 h, and cultured with 50 μmol/L AM-1241 in complete low-glucose medium for 12 h. The optimal drug concentration was selected according to the cell viability considered by the experiment results. Type III collagen (C III) content in the HSC-T6 supernatant was detected by enzyme-linked immunosorbent assay. Glutathione (GSH) content in HSC-T6 was detected by spectrophotometry. CB2 and heme oxygenase-1(HO-1) in each group of HSC-T6 were detected by western blotting.@*Results@#HSC-T6 proliferation was inhibited in each group of AM-1241 in a concentration-dependent manner (P < 0.05). The inhibition was highest at 80μmol/L, and the cell survival rate was (41.61% ± 3.13%) (P < 0.05). AM-630 concentration group had no significant inhibitory effect on the proliferation of HSC-T6 (P > 0.05). HSC-T6 expressed CB2 receptor in each group. The expression level of CB2 in the AM-1241 intervention group was higher compare with control group (P < 0.05).The expression of Col III were significantly higher in oxidative stress group (P < 0.05) than in control group, and the expression of Col III of AM-1241 intervention group was significantly lower than that in oxidative stress group (P < 0.05). Col III level in AM-1241+AM-630 antagonistic group was significantly higher than that in AM-1241 intervention group (P < 0.05). There was no significant difference between AM-1241+AM-630 antagonistic group and oxidative stress group (P > 0.05). The content of GSH and HO-1 in oxidative stress group was higher (P < 0.05) than control group. The content of GSH and HO-1 in the AM-1241 intervention group was higher compared with oxidative stress group, while content of AM-1241 + AM-630 antagonist group was lower compared to AM-1241 intervention group (P < 0.05), and the differences were not statistically significant for oxidative stress group.@*Conclusion@#CB2 agonist AM-1241 can inhibit the proliferation and activation of HSC-T6 and its mechanism may activate the nuclear translocation of Nrf2 binding to HSC-T6, initiating the up-regulation of antioxidant enzymes HO-1 and GSH protein expression, and thus increase the antioxidant effect of HSC-T6.

Application of transesophageal echocardiography in the monitor of allogeneic lung transplantation / 中华超声影像学杂志

Objective To investigate the application value of transesophageal echocardiography(TEE) in allogeneic lung transplantation. Methods The study enrolled 37 patients receiving allogeneic lung transplantation because of end stage lung disease,including sequential bilateral lung transplantation 20 cases and unilateral lung transplantation 17 cases,the latter included 4 cases with extracorporeal membrane oxygenation (ECM O).Echocardiographic parameters before surgery,including right ventricular transverse diameter (RVTD),left ventricular transverse diameter (LVTD),right atrial transverse diameter (RATD), left atrial transverse diameter (LATD),main pulmonary artery (DMPA),left ventricular ejection fraction (LVEF),pulmonary arterial systolic pressure (SPAP),and TEE parameters during surgery,including pulmonary artery anastomosis diameters (DRPAand/or DLPA) and blood flow velocity (VRPAand/or VLPA), pulmonary vein anastomosis blood flow velocity (V RPVand/or VLPV),were measured. Results ①Preoperative transthoracic echocardiographic showed a slight increase of right heart in patients with allogeneic lung transplantation,different degrees of increase in SPAP,a normal or slightly increase of D MPA and a normal LVEF,according to the ASE guidelines. ②Compared with pre-operation,the diameters of left and right pulmonary artery decreased ( P < 0.001) and the blood flow velocity of arteries and veins increased ( P <0.001). ③Patients with ECMO support had a higher SPAP before operation ( P <0.05) and a lower LVEF ( P <0.05),but within a normal range.The blood flow velocity of pulmonary artery and vein had no difference between two groups ( P > 0.05). Conclusions During allogeneic lung transplantation,TEE plays an important role in the monitor of pulmonary arteriovenous anastomosis. It could remind the surgeon whether anastomosis is narrow timely,and determine the patient′s hemodynamic status and cardiac load to guide the surgical process.

Effect of cannabinoid receptor-2 agonist AM1241 on platelet-derived growth factor expression in the liver tissue of mice with hepatic fibrosis / 中华肝脏病杂志

Objective@#To investigate the effect of cannabinoid receptor-2 (CB2) agonist AM1241 on the mRNA and protein expression of platelet-derived growth factor (PDGF) and collagen-III (Col-III) in the liver tissue of mice with experimental liver fibrosis induced by carbon tetrachloride (CCl4).@*Methods@#Totally 38 8-week-old male C57BL/6J mice were randomly divided into control group, model group, 3 mg/kg CB2 receptor agonist (AM1241) group, and 9 mg/kg AM1241 group. All mice, except for the control group, were treated with 30% CCl4 (three times a week, 5 ml/kg body weight, 16 weeks) to establish a liver fibrosis model. Meanwhile, 3 and 9 mg/kg AM1421 was intraperitoneally injected for daily intervention, respectively. The dosage was adjusted according to actual body weight. The same solvent was given in the control group. The serum level of aspartate aminotransferase (AST) was measured by serum enzyme digestion. The liver inflammation and fibrosis were observed by HE staining of tissue slices. The mRNA and protein expression of PDGF and Col-III in hepatic tissue was determined by real-time PCR and immunohistochemistry.@*Results@#Compared with the control group, the mice in model group showed severe liver fibrosis, significantly elevated serum AST level (742 ± 300.8 U/L vs 118.1 ± 31.1 U/L, P < 0.05), and significantly increased mRNA and protein expression of PDGF and Col-III in liver tissue (P < 0.05). Compared with the model group, the mice in 3 mg/kg AM1241 group and 9 mg/kg AM1241 group had less severe liver fibrosis, and significantly reduced serum AST levels (116.6 ± 13.68 U/L vs 742 ± 300.8 U/L, P < 0.05; 113.8 ± 16.01 U/L vs 742 ± 300.8 U/L, P < 0.05) and mRNA and protein expression of PDGF and Col-III in liver tissue (P < 0.05).@*Conclusion@#CB2 receptor agonist AM1241 can inhibit the mRNA and protein expression of PDGF in the liver tissue of mice with hepatic fibrosis, and reduce extracellular matrix synthesis.

Clinical and echocardiographic features of left ventricular diverticulum in adults: a report of 4 cases / 中华全科医师杂志

To explore the clinical and imaging profiles of left ventricular (LV) diverticulum in adults and review the key points for its differential diagnosis.The clinical and imaging features were reviewed for 2 female and 2 male patients clinically diagnosed with LV diverticulum.Their clinical manifestations and electrocardio graphic presentations were nonspecific.On echocardiography,all diverticula,located at LV apex,had a thinned and weakened wall continuing and contracting synchronously with the adjacent LV wall.Two cases were diagnosed as congenital diverticulum without any other cardiac or thoraco-abdominal anomaly.And the other two had existing coronary artery diseases with significantly reduced global and apical LV systolic function.Mural thrombosis in diverticulum was determined in one congenital case.One patient died of cardiac failue.It suggested that LV diverticulum in adults may be congenital and secondary etiologically.The former is mostly isolated and apically situated while the latter often results from regional myocardial ischemia and elevated intracavitary LV pressure at an ill-perfused area.Echocardiography can demonstrate the 2-dimensional and flow hemodynamics of diverticulum in real time so as to facilitate its diagnosis and differential diagnosis.

Correlation between pulmonary arterial presure and right ventricular function by echocardiography in chronic ;thromboembolic pulmonary hypertension / 中华超声影像学杂志

Objective To discuss the correlation between right ventricular function and systolic pulmonary artery pressure (PASP ) in patients with chronic thromboembolic pulmonary hypertension (CTEPH)and explore the change of right ventricular function under different degree of PASP.Methods One hundred and thirty-seven CTEPH patients were divided into four groups by PASP:Group Ⅰ (50 mmHg≤PASP<70 mmHg),20 cases;Group Ⅱ (70 mmHg≤PASP<90 mmHg),35 cases;Group Ⅲ,55 cases (90 mmHg ≤ PASP < 1 10 mmHg);Group Ⅳ (PASP ≥ 1 10 mmHg),27 cases.Echocardiographic parameters include:PASP,tricuspid regurgitation area (ATR ),left ventricular transverse diameter (LVTD), right ventricular transverse diameter (RVTD),inner diameter of main pulmonary artery (DMPA ),inner diameter of left arterial branch (DLPA ),inner diameter of right pulmonary arterial branch (DRPA ).Right ventricular function parameters include:tissue Doppler-derived tricuspid lateral annular systolic velocity (s'),tricuspid annular plane systolic excursion (TAPSE),RV index of myocardial performance (RIMP)and right ventricular fractional area change (FAC).Results There were significant differences in RVTD, TAPSE,FAC and RIMP in CTEPH patients under different PASP(P <0.05).RV structure and function was significantly correlated with PASP in CTEPH patients.With the elevation of PASP,RV was significantly enlarged and RV function becomes worse.Conclusions Echocardiography may contribute to evaluate RV function in CTEPH patients and provide basis for clinical treatment and prognosis evaluation.

Evaluation of right ventricular function in patients with pulmonary arterial hypertension by real-time three-dimensional echocardiography / 中华超声影像学杂志

Objective To evaluate right ventricular systolic function in patients with pulmonary hypertension (PH) by real-time three-dimensional echocardiography (RT-3DE),and compared with cardiac magnetic resonance.Methods A total of 23 patients with PH who underwent MRI and echocardiography in the study.Right ventricular index of myocardial performance (RIMP),fractional area change (RVFAC),tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler-derived tricuspid lateral annular systolic velocity (S') were measured by echocardiography.RV end-diastolic volume (RVEDV) and endsystolic volume (RVESV) were measured by RT-3DE and cardiac magnetic resonance and RV ejection fraction (RVEF) was calculated.Results A positive correlation was found between RVFAC and RVEF (r =0.595,P =0.003),there was a negative correlation between RIMP and RVEF (r =-0.745,P =0.000),has no correlation between TAPSE and RVEF (r =-0.029,P =0.896),a positive correlation was found between S' and RVEF (r =0.489,P =0.018).There were close correlation between RVEDV,RVESV and RVEF measured by RT-3DE and MRI (P ＜0.001,respectively);Bland-Altman analyses showed good agreement between them.Conclusions RT-3DE can noninvasive,accurate assessment right ventricular systolic function in patients with PH,and provide prognosis and treatment choice for clinical demands.

The ultrasonographic and clinical characteristics of valve disorders in patients with non-infective endocarditis due to systemic lupus erythematosus / 中华医学超声杂志（电子版）

ObjectiveTo enhance understanding on echocardiographic and clinical characteristics of valve lesions of non-infective endocarditis (NIE), particularly in patients with systemic lupus erythematosus (SLE). Comparative analysis of the diagnostic value of echocardiography was performed in patients with non-infective endocarditis and atypical infective endocarditis (IE).MethodsData from 38 patients with clinically diagnosed NIE in the institution were collected retrospectively during July 2005 and January 2015, including 10 patients with SLE, 10 with rheumatic heart disease, 11 with rheumatoid arthritis, and 7 with hepatitis B. Data of 42 patients diagnosed as atypical IE during the same period were collected as control group. All patients underwent examinations of blood culture, sero-immunological tests, electrocardiogram and echocardiography. Comparison was made between the two groups using SPSS 11.5 software package. ResultsThe difference in blood culture, sero-immunological tests and electrocardiogram was statistically signiifcant between the groups (χ2 value, 26.29, 5.53, and 4.80, respectively, allP0.05). Echocardiography identiifed valvular vegetations in 27 of 38 patients, with NIE with a detection rate of 71.0%; The size of the vegetations ranged from 2 to 7 mm in diameter; Valve vegetations was found in 36 of 42 patients with atypical IE, with a detection rate of 85.7%; the other six cases demonstrated valvular thickening only; in this group, the vegetations ranged from 2 mm to 19 mm in size and were located in the left heart in 28 patients, 8 cases in the right heart. In the case group, two cases of valve lesions in patients with SLE were confirmed by transesophageal echocardiography (TEE), while missed on TEE examination. Nine cases with more than mild valve regurgitation were identiifed. Ten cases were treated with hormones and cyclophosphamide, after which valve lesions resolution was found on serial echocardiography tests with a follow-up period of 5 days to 3 years.Conclusions Echocardiography is capable of detecting valve lesions at early stage in patients with NIE, particularly in patients with SLE. Echocardiography plays a crucial role in identifying the non-infective thrombotic vegetations, guiding clinical treatment and monitoring the therapeutic effects.

Relationship between echocardiographic and magnetic resonance derived measures of right ventricular function in patients with chronic thromboembolic pulmonary hypertension / 中华超声影像学杂志

Objective To evaluate right ventricular function of chronic thromboembolic pulmonary hypertension (CTEPH) patients by echocardiography and cardiac magnetic resonance (CMR),and to evaluate the value of clinical application of those right heart function indexes.Methods 32 patients with CTEPH who underwent CMR and echocardiography were involved in the study.Right ventricular index of myocardial performance (RIMP),fractional area change (FAC),tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler-derived tricuspid lateral annular systolic velocity (S') were measured by echocardiography.Right ventricular end-diastolic volume (RVEDV) and end-systolic volume (RVESV) were measured by cardiac magnetic resonance and right ventricular ejection fraction (RVEF) was calculated.Results A positive correlation was found between FAC and RVEF (r =0.423,P =0.022),there was a negative correlation between RIMP and RVEF (r =-0.387,P =0.048),there was no correlation between TAPSE and RVEF (r =0.451,P =0.22),a positive correlation was found between S' and RVEF (r =0.689,P =0.000).Conclusions The echocardiographic parameters FAC,RIMP and S' can reflect right ventricular function in patients with CTEPH and can be used as a routine clinical parameters.

Suprasternal notch echocardiography determination of right pulmonary artery lesions / 中华超声影像学杂志

Objective To evaluate the value of suprasternal long axis view in echocardiography for right pulmonary artery (RPA) lesions.Methods Echocardiography was performed in 31 patients with clinical suspicion of pulmonary vascular disease.Through suprasternal long axis view,RPA,right superior pulmonary artery and right inferior pulmonary artery were identified,and the vessel wall,intraluminal echoes,and location of the lesion were obtained.Blood flow in pulmonary artery was detected with color Doppler flow imaging.The results of echocardiography were compared with those of computer tomography of pulmonary angiography (CTPA) and clinical diagnosis.Results With suprasternal notch echocardiography,RPA lesions were identified in 27 patients.H owever,RPA could not be clearly identified in four patients.There were 22 patients with moderate or low echo mass in RPA,and five patients with intimal thickening and artery stenosis/obliteration.In the 27 patients with detected lesions,20 lesions were located in RPA,seven lesions were located in distal RPA or its branches.Among the results obtained with echocardiography,25 were in accordance with CT results,6 were not in accordance with CT results.Conclusions The suprasternal long axis view of RPA can be an important alternative imaging modality in identification of pulmonary vascular diseases.

Value of left ventricular contrast echocardiography in diagnosis of left ventricular myocardium noncompaction / 中华超声影像学杂志

Objective To assess the usefulness of left ventricular contrast echocardiography in diagnosis of left ventricular myocardium noncompaction.Methods Contrast echocardiography was done in ten patients who were diagnosed or suspected with left ventricular noncompaction by common transthoracic echocardiography,for further study of the trabecular muscles extent,the continuity of the endocardium,the compact myocardium thickness,and the contrast agent in the trabecula recessus.Results By contrast echocardiography,noncompaction myocardium thickness can be perspicuously observed,the turgor of the contrast agent was vividly detected in the trabecular recessus.Especially for the measurement of compaction myocardium,the contrast echocardiography was more accurate than in the condition of the common echocardiography.Conclusions Left ventricular contrast echocardiography can be used in the diagnosis of left ventricular noncompaction,it was a good added method of conventional echocardiography.

Evaluate of transesophageal echocardiography during lung transplantation / 中华胸心血管外科杂志

Objective To investigate the clinical value of transesophageal echocardiography during the lung transplanta tion. Methods From August 2005 to August 2009, 19 patients with advanced lung diseases received lung transplantation.The average age was(48.35±13.04) years. The echocardiographic probe was placed in patient's esophagus before surgery.The left and right pulmonary venous openings, artery blood flow velocity, right ventricular wall motion, left and right ventricular volume, right ventricular ejection fraction were recorded at different time intervals during lung transplantation, especially at the break and after completion of bronchus, pulmonary veins, and pulmonary artery anastomosis. Results The procedure included sequential-type lung transplantation in 6 cases and single lung transplantation in 13. The blood flow disappeared when blocking pulmonary artery and vein and right ventricular volume increased slightly. The right ventricular volume restored after completion of trachea, pulmonary veins, pulmonary artery anastomosis. TEE detected that the blood flow velocity of pulmonary veins, pulmonay artery anastomosis increased slightly. In 1 case the opening of the right pulmonsry artery blood flow velocity increased significantly and blood flow velocity decresed and blood oxygen partial pressure resumed after re-anastomosis of pulmonary artery. Conclusion TEE play an important role in monitoring pulmonary artery and vein anastomosis diameter and blood flow velocity and right ventricular function and predicting complications during lung transplantation.

Detection of pulmonary vascular by transesophageal echocardiography during lung transplantation / 中华超声影像学杂志

Objective To detect the new views for pulmonary vascular by transesophageal echocardiography(TEE) during lung transplantation.Methods Seventeen cases with respiratory failure underwent lung transplantation.A series of scans were detected by TEE during preoperative anesthesia, preand pro-pulmonary vascular occlusion and pro-donor lung, and bronchus, pulmonary veins, pulmonary artery anastomoses.Left and right lung veins open and left and right pulmonary artery branch were key to observed.Pulmonary artery trunk and branch diameter, velocity of blood flow were measured.Results All left and right pulmonary artery,pulmonary vein images were given by TEE.TEE detected the normal blood flow velocity of pulmonary artery branches during pre-operation,average of 65 cm/s.After clipping the side of the pulmonary artery, the lateral pulmonary blood flow disappeared.TEE detected pulmonary veins,pulmonary artery anastomoses pro-operation.Except for 1 case of anastomotic pulmonary vein flow velocity increased,all the pulmonary vein and pulmonary artery branch anastomoses flow velocity increased slightly faster than those before transplantation (mean pulmonary artery branch of 160 cm/s, the average pulmonary vein 149 cm/s).Conclusions TEE can monitor diameter and flow velocity of pulmonary artery branch and pulmonary vein during lung transplantation,and can detect the rightventricular function.The views of left and right branch pulmonary artery and pulmonary vein branches play an important role during lung transplantation.

Echocardiography evaluation of pulmonary hypertension in hemodialysis patients / 中国医学影像技术

Objective To investigate the incidence and the relation between pulmonary hypertension (PH) and cardiac output in hemodialysis (HD) patients with PH. Methods The incidence of PH was estimated with Doppler echocardiography in 78 patients receiving HD. Left ventricular ejection fraction, cardiac volume, cardiac output and cardiac index were compared between patients with or without PH. Results PH was found in 20 patients (25.64%), among them15 had mild PH, 4 had moderate PH and 1 had severe PH. There was no statistical difference of ejection fraction, cardiac volume, cardiac output and cardiac index between the two groups. PH was not related to cardiac output. Conclusion HD can lead to PH, but cardiac output can not result in PH. Further investigations about the effect of elevated cardiac output induced by internal arteriovenous fistula and other factors on PH are needed.

Assessment of the right ventricular function after pulmonary thromboendarterectomy by Doppler echocardiography / 中华超声影像学杂志

Objective To evaluate the right ventricular function of chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary thromboendarterectomy (PTE) by Doppler echocardiography. Methods In 16 patients with CTEPH,end-diastolic left ventricular diameter(LVDd), end-diastolic right ventricular areas (RVEDA), end-systolic right ventricular areas (RVESA), right ventricular fractional area change (RVFAC), pulmonary accelerative time (Pact), pressure gradient of tricuspid valve regurgitation (PGT1), area of tricuspid valve regurgitation (AT1) were measured by echocardiography. Results Fifteen and thirty days after surgery,the LVDd and Pact had increased,RVEDA, RVESA,PGT1 and AT1 had decreased while RVFAC had increased in all cases. Conclusions PTE may effectively improve the right ventricular function of patients with CTEPH.

Diagnostic value of echocardiography combined with lower-limb venous ultrasonography in pulmonary thromboembolism / 中华超声影像学杂志

Objective To evaluate the diagnostic value of deep venous thrombosis(DVT)on lowerlimb venous ultrasonography combined with right ventricular dysfunction (RVD) on transthoracic echocardiography(TTE) in patients with acute pulmonary thrombo embolism(PTE). Methods This prospective multicenter control trial included 520 patients with confirmed acute PTE from 41 hospitals between June 2002 and February 2005.Results The incidence of RVD and DVT was associated with the severity of PTE.There were 57.0%(207/363)patients with RVD,49.6%(1 80/363)patients with DVT,265(73.0%)patients with RVD and/or DVT,and 121(33.3%)patients with combined sign of DVT plus RVD in the whole population.As to major PTE population,206(99.5%)patients had RVD and 121 (58.5%)patients had DVT.In addition,the rate of RVD was much greater in proximal PTE than in lobar PTE and segmental PTE(78.7%,51.4%and 21.7%,respectively,P＜0.001).DVT occurred more frequently in proximal PTE than in lobar PTE and segmental PTE(61.7%,46.8%and 37.0%,respectively,P＜O.001).The incidence of the combined sign was 51.1%,24.3%and 8.7%,respenctively (P＜0.001).Conclusions The incidence of the combined sign of RVD plus DVT was associated with the severity of PTE and the localization of emboli.The combined sign of RVD plus DVT help diagnose major PTE especially in emergency department.

Relationship between carotid artery stenosis severity and 3-vessel coronary artery disease / 中国组织工程研究

BACKGROUND: Previous studies showed that the prevalence and extent of carotid artery stenosis increased with thedevelopment of coronary artery disease. There was a higher incidence of intracranial small-vessel disease, but lower of carotid artery disease in the Chinese stroke patients as compared with the white.OBJ ECTIVE: To observe the distribution of carotid and intracranial artery stenosis in patients with 3-vessel coronary artery disease.DESIGN: An observational study.SETTING: Department of Neurology; Heart Center, Beijing Chaoyang Hospital affiliated to Capital Medical University.PARTICIPANTS: From August 2003 to August 2004, The coronary angiography was performed in the outpatients and inpatients suspected to be coronary arteriosclerotic cardiopathy in the Department of Neurology, Beijing Chaoyang Hospital affiliated to Capital Medical University, and 126 patients of them with 3-vessel diseases were examined with carotid arteriography, including 56 males and 70 females, 47-76 years of age. Informed contents were obtained from all the participants.METHODS: Digital substraction angiography (DSA) was performed immediately after coronary angiography in the 126patients. All catheterizations were performed through a transfemoral approach using the Seldinger technique, and thenan appropriate amount of nonionic Ominipaque was injected. The angiography of bilateral carotid arteries, subclavian artery, or vertebral artery was taken from different angles. The percentage of stenosis was calculated directly from DSAmachine. Evaluative standards: Based on the stenosis degree from carotid angiography results, the patients were divided into 5 categories as normal, mild stenosis, moderate stenosis, severe stenosis and complete occlusion.MAIN OUTCOME MEASURES: Severity of carotid stenosis.RESULTS: All the 126 patients were involved in the final analysis of results. There were 13 (10.32%), 18 (14.29%), 12(9.5%), or 10 (7.9%) patients found to have mild, moderate, severe carotid stenosis, or complete occlusion, and the incidences of these changes were fairly similar. However, the incidence of angiographic carotid stenosis coupled with 3-vessel carotid artery disease was 42.06%.CONCLUSION: The prevalence of carotid stenosis in patients with 3-vessel carotid artery disease was as high in the Chinese population as that in Westem countries. In patients with 3-vessel disease, the prevalence of carotid stenosis was higher than that of intracranial artery stenosis, thus they may require both coronary and carotid interventions.

Assessing longitudinal wall motion characteristics at different phases in regional myocardial in patients with myocardial infarction by quantitative tissue velocity imaging / 中国组织工程研究

BACKGROUND: At present, Doppler tissue imaging can be used extensively to make a quantitative assessment of left ventricular regional myocardial function. Postsystolic shortening is a delayed relaxation in regional myocardium following acute ischemia.OBJECTIVE: To observe longitudinal wall motion characteristics in left ventricular regional myocardiun and evaluate the clinical significance of postsystolic shortening in isovolumic relaxation period.DESIGN: Case-control observation.SETTING: Heart Center of Beijing Chaoyang Hospital.PARTICIPANTS: We selected 30 myocardial infarction inpatients hospitalized in the Heart Center of Beijing Chaoyang Hospital between April 2003 and September 2003 as myocardial infarction group; another 30 patients with non-cardiac diseases were set as control group. Subjects of the two groups volunteered in the experiment.METHODS: Dynamic images were collected and information was analyzed off-line. Left ventricular myocardial velocity and time velocity integral profiles were acquired along long axis asynchronously in basal and mid- segments of different walls. Peak velocity of isovolumic contraction period (VIC), ejection period (Ye), isovolumie relaxation period (VIR), rapid filling period (VRF) and atrial systole (VAS) and maximum time velocity integral (TVIMAX) in regional myocardium were measured.Doppler in different segments at longitudinal wall of myocardium in the the two groups.RESULTS: Thirty patients were recruited in myocardial infarction group and control group separately and all of them entered the result analysis ocardium was lower in myocardial infarction group than in control group,especially in infarcted segments, suggesting that the function of cardiac contraction and relaxation in patients with myocardial infarction was demyocardial isovolumic relaxation in myocardial infarction group, indicating period and isovolumic relaxation period in TVIMAX in myocardial infarction group.mal movement at isovolumic relaxation phase suggests the presence of postsystolic shortening and abnormal wall motion in regional myocardium.chemic myocardium.

Assess dyssynchrony in left bundle branch block by tissue Doppler imaging / 中华超声影像学杂志

Objective To observe longitudinal motion characteristics of regional myocardium in left bundle branch block(LBBB) patients. Methods Left ventricular regional myocardium of 15 LBBB patients and 15 normal subjects were assessed by tissue Doppler imaging(TDI). Peak velocities(V_S,V_E,V_A) during isovolumic contraction, ejection, isovolumic relaxation, early relaxation, atrial systole phases and maximum time velocity integral(TVI_(max)), displacement(D_(max)) in mitral(tricuspidal) annulets of different walls were measured. Furthermore, the different parameters from the beginning of electrocardiogram QRS wave to the beginning of S wave(Q-Sb),to the tip of S wave(TTP), the acceleration time of IVC wave(IVA), the acceleration time of the E wave(Eac),the durations of different phases(IVC,S,IVR,D)and IVC/S and others were acquired. Results Peak velocities(V_S,V_E)and TVI_(max) in left ventricular septal, inferior, anterior, posterior walls were lower in LBBB group than control group; those parameters in different segments of left and right ventricular lateral myocardium were not significantly lower in LBBB group than control group. What is more, D_(max) of mitral annular sites in LBBB group were lower than control group. Q-Sb, TTP and IVC in left ventricular septal, inferior, anterior, posterior walls were longer in LBBB group than in control group; IVA lengthened, Eac and Edc shortened in left ventricular septal, inferior walls; IVR lengthened, diastole shortened, IVC/S increased in left ventricular septal, inferior, and posterior walls. Conclusions Abnormal left ventricular activation sequence during LBBB caused obvious impairment in total and regional systolic and diastolic function. And delayed contraction with different degrees were resulted from different walls of left ventricle with intraventricular dyssynchrony; but contraction in right ventricle was not significantly delayed, with interventricular dyssynchrony.