Impairment of left atrial function in pediatric patients with repaired tetralogy of Fallot: a cardiovascular magnetic resonance imaging study.

We aimed to assess left atrial (LA) strain before LA dilatation in patients with repaired tetralogy of Fallot (rTOF) compared with healthy controls. We also determined the effects of right atrial (RA) dilatation on LA performance using cardiovascular magnetic resonance-feature tracking (CMR-FT). Forty-nine pediatric patients with rTOF and 36 age- and sex-matched healthy controls were prospectively recruited between June 2017 and August 2019. Balanced steady-state free precession (2D b-SSFP) cine, 2D late gadolinium enhancement (LGE) and phase-contrast (PC) sequences were acquired on 1.5 and 3.0 Tesla scanners. Both ventricular and atrial volumes and ejection fraction were measured. Left ventricular (LV) strain and diastolic strain rates were evaluated between the rTOF patient and control groups. LA reservoir (Ɛs), conduit (Ɛe), and booster strain (Ɛa) were determined at LV end-systole, LV diastasis, and pre-LA systole, respectively. The first derivatives of the respective strains yielded corresponding peak strain rates. Statistical analysis was performed using the t-test and Mann-Whitney test for parametric and non-parametric variables, respectively. Correlations were assessed using Pearson's correlation coefficient for normally distributed variables and Spearman's correlation coefficient for non-parametric data. Intra-observer and inter-observer variabilities of LA strain and strain rate measurements were determined from ten randomly selected rTOF patients and ten control subjects. LA strain was significantly lower in patients with rTOF compared with controls (Ɛs, P < 0.001; Ɛe, P = 0.002; Ɛa, P < 0.001). The correlations between LA strain and RA stroke volume indices (SVi) and RA ejection fraction (EF) were moderate (Ɛs and SVi, r = 0.538, P < 0.001; Ɛs and RA EF, r = 0.493, P < 0.001; Ɛe and SVi, r = 0.532, P < 0.001; Ɛe and RA EF, r = 0.466, P < 0.001). LA strain and strain rates had good reproducibility in intra-observer and inter-observer analyses. LA strain and strain rates decreased in pediatric patients with rTOF compared with controls before LA enlargement. A dysfunction in LA performance might precede LV dysfunction in patients with rTOF, even in the early stages after repair.

Computer-based assessment of ventricular mechanical synchrony from magnetic resonance imaging.

Cardiac resynchronization therapy (CRT) has revolutionized the care of a substantial portion of patients with advanced heart failure (HF). From current guideline (NYHA III or IV heart failure, left ventricular ejection fraction ≤35% and ECG QRS duration ≥ 120 ms), CRT improves clinical status in about 70% of those treated. Ideally, the ability to accurately predict likelihood of response will enhance the quality of treatment. This study aims to develop an automated method to assess left ventricular mechanical synchrony from magnetic resonance imaging (MRI), which has been considered as gold standard cardiac imaging for ventricular structure and function assessment. 26 healthy volunteers (age ranges from 24 years to 73 years) were prospectively recruited and underwent standard MRI scans. MRI images (e.g. 2-chamber, 3-chamber and 4-chamber views) were processed and atrioventricular junction (AVJ) motions were auto-tracked during cardiac cycle. The myocardial velocities Sm1 and Sm2 at systolic phase; Em and Am at early and late mitral filing phase, were derived respectively. The time to these measures (e.g., TSm1, TSm2, TEm and TAm) were determined and ventricular synchrony indices TSm1-SD-6, TSm2-SD-6, TEm-SD-6 and TAm-SD-6 (standard deviations of TSm1, TSm2, TEm and TAm for 6 AVJ points) were assessed and correlated with age. The computational time per dataset is approximately 5 minutes. One-way ANOVA analysis found that there were no significant differences in time to peak velocities in 6 segments. Second, linear regression analysis found that there were no significant correlation between TSm2-SD-6 and TAm-SD-6 with age, and fair positive correlation between TSm1-SD-6 and TEm-SD-6 with age. In this prospective study, noninvasive ventricular synchrony derived from typically acquired MRI images offers a novel method that may enable ventricular mechanical dyssynchrony assessment in heart failure.

Research on the value of Kang'ai injection on gastric cancer patients’ chemotherapy / 中国医学装备

Objective:To analyze the value of Kang'ai injection on gastric cancer patients’ chemotherapy.Methods: Chosen gastric cancer patients with chemotherapy between December 2012 to December 2013 in our hospital as study subject, randomly divided into control group received conventional chemotherapy and observation groups received Kang'ai injection combine with chemotherapy, compared term effect after chemotherapy, immune function and quality of life scores.Results: 1)Observation group patients’ complete remission and partial remission after chemotherapy were significantly higher than control group patients(x2=2.471,x2=2.748;P<0.05); 2)Observation group patients’ IL-6, TNF-α, CD3+, CD4+ value was significantly higher than control group after receiving chemotherapy, CD8+ value was significantly lower than control group patients(t=2.627,t=2.462,t=2.748,t=2.846,t=2.735;P<0.05); 3)two groups of patients’ life quality scores before chemotherapy was no significant,after chemotherapy observation group patients’ life quality scores were significantly higher than control group patients(t=2.637,t=2.647,t=2.983;P<0.05).Conclusion: Kang'ai injection can significantly improve the effectiveness of chemotherapy in patients with gastric cancer,and optimize immune function, while improving the quality of life after chemotherapy.

Qualitative research in postoperative experience for patients with relapsed bladder tumor / 中国实用护理杂志

Objective To understand postoperative experience for patients with relapsed bladder tumor and analyze its influence factors in order to supply references of postoperative nursing for nurses. Methods Patients with relapsed bladder tumot(10 cases) were interviewed and the obtained results underwent analysis and finishing thematically. Results Factors influencing postoperative experience included education haekground,whether having faith and hobbies or not,the disease,medical charge and pressure of future life.The supporting system came from family,group and society. Conclusions Nurses should strengthen mental care and health education based on patients' specific circumstances in order to improve postoperative quality of life.