Objective To investigate the clinical effect of cervical circular cutting technique in the treatment of cervical intraepithelial neoplasia.Methods 120 patients with cervical intraepithelial neoplasia were selected.They were treated with cervical circular cutting technique,and the effect was analyzed.Results 120 patients after treatment,the obvious effective rate was 76.67 ％ (92/120),the effective rate was 19.17 ％ (23/120),the ineffective rate was 4.17％ (5/120),the total effective rate was 95.83％.The LEEP operation time was controlled at (9.0 ± 0.5)min,the intraoperative blood loss was (16.2 ± 1.2)mL.The postoperative pathologic examination results compared with cervical multi-point biopsy under colposcope had no statistically significant difference (x2 =1.238,P ＞ 0.05).Conclusion The cervical circular cutting technique in the treatment of cervical intraepithelial neoplasia has good effect,can not only completely remove cervical lesions,and has less blood loss,fewer complications,it is worthy of widely use in clinic.

By using the image processing function and programming tomography,the following functions are realized: the contour line,edge line and gradation histogram of medical images are displayed;the selected regions of medical images are freely zoomed;the gray level of discretional regions is displayed using medical image processing tool and the distance of the given points is freely measured.

Objective To investigate the value of real-time three-dimensional echocardiography 17 regional volume curves index in patients with heart transplantation. Methods Sixty patients with heart transplantation (no rejection), ten patients with heart transplantation (rejection), forty subjects with normal left ventricular(LV) function were examined by Philips iE33 with a X3-1 probe. Results Parameter index of 17 segment time to minimal systolic volume in patients with heat transplantation (rejection) were more than those in patients with heart transplantation (no rejection) and in subjects with normal LV function(all P <0.05). Parameter index of 17 segment time to minimal systolic volume were not significantly different in patients with heart transplantation (no rejection) compared with subjects with normal LV function. Parameter index of Tmsv16-SD (%), Tmsv12-SD (%) and Tmsv6-SD (%) show higher sensitivity and specificity for forecast rejection after heart transplantation. Conclusions Real-time three-dimensional 17 regional volume curves index can fast forecast early rejection after heart transplantation.

Objective To investigate longitudinal systolic function of transplanted heart using two dimensional speckle tracking echocardiography and tissue Doppler imaging.Methods 56 consecutive patients with heart transplant were recruited,according to myocardial biopsy and 1 year's follow up,they were divided into non-rejection group (group A) and rejection group (group B).36 healthy controls (group C) were also randomly recruited.Left ventricular ejection fraction (LVEF),pulmonary arterial systolic pressure,tricuspid annular plane systolic excursion (TAPSE),tricuspid annular plane systolic velocity (TAS') and global longitudinal strain (GLS) were calculated via Qlab 9.0 analysis software offline.Results Compared with group C,LVEF was reduced in group B (P ＜0.01).Differences of GLS,TAPSE,and TA-S' among groups were all statistically significant (P ＜0.01),group B＜group A＜ group C.LVEF,TAPSE and TA-S' were correlated with GLS (r =-0.64,r =-0.69,r =-0.71 ; all P ＜ 0.01).Conclusions Left and right ventricles were a functional unity,the systolic function of which was impaired in patients with heart transplant.

Objective To examine whether speckle tracking imaging(STI) could provide for the assessment of acute cardiac rejection. Methods Hearts from Brown Norway rats or Lewis rats were transplanted into other Brown Norway rats. Isografts and groups of allografts either untreated or treated with cyclosporin A (CsA) at a low dose (3 mg ·kg-1 ·d-1) or high dose (10mg · kg-1 ·d-1) from 1　day before transplantation were compared at posttransplantation day 7. Results Echocardiography-derived left ventricular post wall thickness was increased only in untreated allografts. The left ventricular eject fraction was significant lower in the allografts compared with isograft, but allografts treated without or with low-dose CsA showed similar results. The radial systolic radial strain rate showed a lower value in untreated allografts than other grafts,but there was no significant differences between allograft treated with high- or low-dose CsA and isografts. The circumferential strain and circumferential strain rate was comparable among the 4 groups. However the radial strain exhibited a clear gradient in these groups [(2. 8 ± 1.3)％ in untreated allografts, (5.2 ± 0.9)％ in allografts treated with low-dose CsA, (6.3 ± 1.8 )％ in allografts treated with high-dose CsA,and (12.7 ± 7.9) in isografts, P＜0.001]. The radial strain exhibited a clear correlation with the severity of rejection ( r =-0.812, P＜ 0.0000). Conclusions The radial strain decreased as the severity of rejection worsen. STI offers promise as a noninvasive method for detecting transplant allograft rejection.

Objective To evaluate left and right ventricular function by real-time three-dimensional echocardiography in patients with heart transplantation.Methods Fourteen patients with heart transplantation ( rejection)[12 male,2 female,mean age (49.21±17.91)],twenty four patients with heart transplantation (no rejection) [21 male,3 female,mean age (40.11±12.57)],and fifty one subjects with normal left ventricular function [26 male,25 female,mean age (43.69±14.81) ] were examined by Philips iE33 with a X3-1 probe.Results Right ventricular stroke volume (RVSV) and right ventricular ejection fraction (RVEF) in heart transplantation (including no rejection and rejection) was reduced compared with subjects with normal heart function (all P<0.05),but right ventricular end-diastolic volume (RVEDV) and right ventricular end-systolic volume (RVESV) were no significantly different between heart transplantation and subjects with normal heart function (all P>0.05),but the volume and function of right ventricle were no significantly different between rejection heart transplantation and no rejection heart transplantation.Parameter index of 17 segment including standard deviation (SD) and maximum difference(Dif) of 16,12 and 6 segment time to minimal systolic volume(Tmsv 16-SD,Tmsv 16-Dif,Tmsv 12-SD,Tmsv 12-Dif,Tmsv 6-SD,Tmsv 6-Dif),and the percent of SD and maximum difference 16,12 and 6 segment time tominimal systolic volume [Tmsv 16-SD(%),Tmsv 16-Dif(%),Tmsv 12-SD(%),Tmsv 12-Dif(%),Tmsv 6-SD(%),Tmsv 6-Dif(%)] was significantly higher in patients with heart transplantation (rejection) than that in subjects with normal heart function and in patients with heart transplantation (no rejection)[except Tmsv 16-SD and Tmsv 16-SD(%),other P<0.05],however,there was no significantly different between heart transplantation (no rejection) and subjects with normal heart function(all P>0.05).But also average,maximum and minimum value of excursion in three groups was no significantly different (all P>0.05).Conclusions Real-time three-dimensional echocardiography can rapidly and acurately evaluate left and right ventricular function in patients with heart transplantation.

Objective To investigate new parameters to predict the response to cardiac resynchronization therapy (CRT) by using real-time three-dimensional echocardiography (RT3DE) and speckle tracking imaging(STI). Methods Twenty-one adult beagle dogs were divided into three groups:group A (CRT group, n =10) ,group B (heart failure group, n =7) and group C (control group, n =4).Seventy patients who accepted CRT and were followed up 6 months after CRT were enrolled. Response to CRT was defined as a ≥15％ decrease in left ventricular end-systolic volume. RT-3DE parameters were the dispersion of time to minimum regional volume for 16 segments (Tmsv16-SD) ,and the ratio of Tmsv16-SD to R-R interval (SDI). STI parameters were the ratios of standard deviation of the time to peak radial and circumferential strain at midventricular level to R-R interval (Trs-6SD,Tcs-6SD). Results In experimental study,Tmsv-16SD, Trs-6SD, Tcs-6SD had negative relationship with left veutricular ejection fraction (r were - 0. 86, - 0.75, - 0.83 respectively, all P ＜0.01 ). Trs-6SD was the strongest predictor to CRT. A cut-off value of Trs-6SD≥12.2％ was able to predict response to CRT with a sensitivity of 83.3％ and a specificity of 100％. Clinical studies found SDI was the strongest predictor to CRT. A cut-off value of SDI≥6.55％ was able to predict response to CRT with a sensitivity of 80. 0％ and a specificity of 81.8％.Conclusions RT-3DE and STI can assess left ventricular dyssynchrony, and are promising methods to predict the response to CRT.

Objective To evaluate the effect of edge-to-edge technique of anterior mitral valve prolapse using transthoraeic echocardiography(TTE). Methods Nineteen patients with anterior mitral valve prolapse underwent randomized operation using edge-to-edge technique. The grade of mitral regurgitation(MR),mitral valve are (MVA), the diameter of left atrial(LAD) and left ventricle(LVD), left ventricular ejection fracion(LVEF) and pulmonary artery systolic pressure(PASP) were evaluated. Results All the patients with anterior mitral valve prolapse had severe MR before the operation whereas the degree of MR changed into absence to mild degree after the procedure. There were significant statistic differences between pre- and post edge-to-edge procedure:LAD(51.63±10.03)mm vs (44.79±9.22)mm, P = 0.000, LVD(59.37±8.29)mm vs (52.68±7.31)mm, P = 0.000 ; PASP (45.37±18.34)mm Hg vs (33.00± 9.43)mm Hg, P = 0.002,1 mm Hg = 0.133 kPa;MVA(4.13±0.24)cm<'2> vs (2.90±0.28)cm<'2>, P = 0.000,while LVEF changed little[(66.0±9.0)% vs (67.0±6.0) %, p = 0.751]. Conclusions The edge-to-edge technique is a simple and effective surgical method which can remain subvalve structure,restore the normal morphology of left atria,left ventricle and maintain the function of left ventricle.

Objective To investigate the feasibility of ultrasound speckle tracking imaging(STI)in assessing left ventricular(LV)systolic and twist function in patients with heart transplantation.Methods Nine patients with heart transplantation and 10 subjects with normal LV function were examined by GE Vivid 7 with a M3S probe.Eighteen regional peak systolic strain and displacement in longitudinal,radial,circumferential,and 18 regional degree of rotation were measured respectively.Results The segmental regional peak systolic strain and displacement were less than those in subjects with normal LV function(P ＜0.05),but segmental regional degree of rotation was more than that in subjeets with normal LV function (P＜0.05).Conclusions STI may provide a noninvasive,simple and quick tool for evaluation of left ventricular systolic and twist function in patients with heart transplantation.

Objective To investigate the value of real-time three-dimensional transesophageal echocardiography(RT-3DTEE) in mitral valve repair. Methods RT-3DTEE was performed in six patients[5 male,1 female,mean age (45.7±12.6)years] with mitral valve prolapse by using Philips IE33 with X7-2t probe.Preoperative RT-3DTEE studies were compared with surgical findings in patients undergoing surgical repair. Results RT-3DTEE could display dynamic morphology of mitral valve,the location of prolapse,and spatial relation tO the surrounding tissues.It could provide surgical views of the valves and the valvular apparatus.RT-3DTEE results were consistant with surgical findings.Conclusions RT-3DTEE is a unique new modality for rapid and accurate evaluation of mitral prolapse and mittal repair.