Objective To investigate the consistency of the anatomical parameters of left atrial appendage (LAA) based on three-dimensional transesophageal echocardiography (3D-TEE) and CT of 3D print datasource by the post-processing of DICOM data.Methods Sixty-three patients with atrial fibrillation in our hospital who underwent 3D-TEE and cardiac CT examination were selected and the original DICOM data of the LAA were obtained.The volume images of LAA were acquired by the postprocessing of Mimics software.After measuring and evaluating the anatomical parameters,the differences of parameters between TEE and CT were compared and the consistency of the two methods was evaluated.Results The data of 63 patients with atrial fibrillation obtained by 3D-TEE and CT were successfully post-treated and the detailed anatomical parameters of LAA were obtained.Morphological parameters:the Kappa values of the anatomical shape and opening shape of the LAA based on the 3D-TEE and CT data were 91.0%,69.3%,respectively.Measurement parameters:the area,perimeter,long axis,short axis of ostiums of LAA,and depth of LAA by CT were larger than those by 3D-TEE(all P<0.05).The post-processing results showed that 57 patients (90.5%) had significant bending of LAA′s main lobe in the 3D-TEE group and CT group,the difference in the measurements of the angle of the first bend and the distance from the first bend of the LAA to the orifice of the 57 cases between by 3D-TEE and CT were no statistical significance (P>0.05).LAA′measurements of 3D-TEE was concordant well with CT′s by Bland-Altman analysis.Conclusions In agreement with CT,3D-TEE can also be used as a datasource for 3D printing by evaluating spatial morphology of the LAA.

BACKGROUNDMultifocal lens has become popular in cataract surgery. Short-term outcome after AcrySof ReSTOR Lens implantation had been reported by many studies, but long-term visual performance and the effect of posterior capsular opacification (PCO) on visual performance need further investigation.

METHODSThis retrospective study involved 54 eyes from 41 cataract patients implanted with ReSTOR lens, with a follow-up period of 12 to 31 months. Manifest refraction spherical equivalence (MRSE), monocular uncorrected and best-corrected distance visual acuity, uncorrected and distance-corrected near and intermediate visual acuity, contrast sensitivity were assessed. The effect of PCO on visual performance was evaluated by comparing visual parameters between pre and post-capsulotomy.

RESULTSUncorrected distance visual acuity of eyes with MRSE within +/-0.5 diopter (D) was better than those with MRSE greater than +/-0.5 D (P < 0.05). Uncorrected distance and near visual acuity (LogMAR) was 0.10 and 0.17 respectively. Best corrected distance visual acuity and best distance-corrected near visual acuity (LogMAR) was 0.00 and 0.16, a significant improvement was noted after correction (P = 0.000, P = 0.001, respectively). Contrast sensitivity logarithm was comparable with the normal value at difference spatial frequencies except at 12 cpd. In 5 eyes with mild PCO, post-capsulotomy visual parameters were better than pre-capsulotomy (P < 0.05).

CONCLUSIONReSTOR lens provides a good long-term distance and near vision, functional intermediate vision and contrast sensitivity. Mild PCO significantly affects visual performance and needs early intervention.

Adolescent ; Adult ; Child ; Female ; Humans ; Lens Implantation, Intraocular ; Male ; Refraction, Ocular ; Retrospective Studies ; Visual Acuity

Adolescent ; Adult ; Environmental Monitoring ; methods ; Hazardous Substances ; analysis ; Humans ; Male ; Occupational Exposure ; analysis ; prevention & control ; Sentinel Surveillance ; Young Adult

Objective To evaluate the left ventricular diastolic function in patients with uremia by two-dimensional speckle tracking technology ( 2D-STI ) . Methods Ninety-three patients with uremia ( serum creatinine value≥ 700 μmol/l) and 29 controls were included . Uremia patients were divided into group with decreased LVEF ( LVEF < 50％ ,group C ,19 cases) and group with normal LVEF ( LVEF≥50％ ) . The latter were divided into group with normal diastolic function ( group A ,31 cases) and group with diastolic dysfunction ( group B ,23 cases) according to the diastolic function;pulsed wave tissue Dopper imaging datas included:diastolic velocity e1′,a1′ and e2′,a2′ at septal or lateral sites of mitral annulus , average E/e′and e′/a′. 2D-STI strain and strain rate parameters included:the longitudinal peak systolic strain ( GLS) ,the longitudinal peak systolic strain rate ( LSRs) ,longitudinal peak strain rate in early diastole (LSRe)andE/LSRe.Results ①Systolicfunctionparameters:comparedwithcontrolgroup,LVEF decreased significantly only in group C( P <0 .05) ,while there was no significant difference among group A ,B and control group ( P> 0 .05 ) ;GLS in group A ,B and C decreased significantly and showed a decreasing trend among these three groups( P <0 .05) ;LSRs in group B and C decreased significantly ,while there was no significant difference between group A and control group( P > 0 .05) . ② Diastolic function parameters:compared with control group ,the average E/e′decreased significantly in group B and C( P <0 .05) ,while group A showed no significant difference( P > 0 .05) . Compared with group A ,the average E/e′increased significantly in group B and C ( P < 0 .05) . Compared with control group ,LSRe in three uremia groups decreased significantly ,which showed a decreasing trend among these three groups ( P <0 .05) ;however ,E/LSRe in three uremia groups increased significantly and showed an increasing trend among these three groups ( P < 0 .05 ) . ③ The correlation analysis showed that there were positive correlations between average e′ and LSRe and between average E/e′ and E/LSRe in uremic patients . Conclusions In patients with uremia ,left ventricular systolic and diastolic function impaired in the early phase . Strain rate parameters in diastole especially E/LSRe obtained by 2D-STI can be used as sensitive , early parameter for evaluation of left ventricular diastolic dysfunction .

Antibodies, Viral ; blood ; China ; epidemiology ; Female ; Humans ; Immunoglobulin G ; blood ; Male ; SARS Virus ; immunology ; isolation & purification ; Seroepidemiologic Studies ; Severe Acute Respiratory Syndrome ; epidemiology ; virology

AIM To observe the effects of Tangzhi Kangping Granules (Astragali Radix,Ligustri lucidi Fructus,Schisandrae chinensis Fructus,etc.) on regulating blood sugar and lipid of rats with glucose and lipid metabolism disorders.METHODS Among the seventy rats for the trial,ten rats were randomly assigned to normal control group,the other 60 rats were injected with STZ citric acid-sodium citrate solution (60 mg/kg) combined with high-fat emulsion (10 mL/kg) for 4 weeks to be the models of glucose and lipid metabolism disorders.The model rats were divided into model control group,mefformin + fenofibrate group,Xiaoke Pills + Xuezhikang group,and high,medium and low dose Tangzhi Kangping Granules groups.After 4-week intragastric administration,the rats had their levels of fasting serum glucose (GLU),triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipids (LDL-C),insulin (INS),adiponectin (ADP),leptin (Leptin),interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) measured.RESULTS Compared with the model control group,the rats in high,medium and low dose Tangzhi Kangping Granules groups displayed significantly decreased serum contents of GLU,TG and TC,lowered levels of LDL-C,ADP,Leptin,IL-6,TNF-α,and yet significantly increased levels of HDL-C and INS.CONCLUSION Tangzhi Kangping Granules,a blood sugar andlipid regulator may adjust the levels of insulin,adiponectin and leptin,and therefore improves the body's inflammatory environment to alleviate insulin resistance.

To evaluate the right ventricular systolic function in uremia patients and the effects of maintenance hemodialysis on right ventricular systolic function by volume and strain parameters obtained by 4D RV Volume . Methods Seventy‐six patients with uremia and twenty‐two controls were selected . According to left ventricular ejection fraction ( LVEF) ,uremia patients were divided into normal LVEF uremia group and decreased LVEF uremia group . T hen normal LVEF uremia group was divided into maintenance hemodialysis group and non‐dialysis group . Conventional ultrasound parameters included :LVEF ,pulmonary artery systolic pressure ( PASP) and tricuspid annular plane systolic excursion ( T APSE‐2D) . 4D RV Volume parameters included : right ventricular end‐diastolic volume ( RVEDV ) , tricuspid annular plane systolic excursion ( T APSE‐4D ) ,right ventricular area change rate ( FAC ) ,right ventricular ejection fraction ( RVEF) and right ventricular free wall longitudinal systolic strain ( RV‐GLSfree ) . Results①Compared with the control group ,T APSE‐2D decreased significantly in the decreased LVEF uremia group ( P ＜0 .05) ,w hile there was no significant difference of T APSE‐2D in normal LVEF uremia group ( P ＞ 0 .05) . Compared with the control group and normal LVEF uremia group ,PASP increased significantly in the decreased LVEF uremia group ( P ＜ 0 .05 ) . Compared with the control group ,RVEDV increased significantly both in the normal LVEF and decreased LVEF uremia group ,w hich showed an increasing trend in these three groups ( P ＜0 .05) ,while T APSE‐4D ,FAC ,RVEF and RV‐GLSfree all decreased significantly and showed a decreasing trend in these three groups ( P ＜ 0 .05 ) . ② Compared with the control group , T APSE‐2D decreased significantly in non‐dialysis group ( P ＜0 .05) ,but there was no significant difference in uremia hemodialysis group ( P ＞0 .05) . Compared with the control group ,PASP and RVEDV increased and T APSE‐4D ,FAC ,RVEF and RV‐GLSfree decreased significantly in uremia hemodialysis group and non‐dialysis group ( P ＜ 0 .05 ) . Compared with non‐dialysis group , T APSE‐2D and T APSE‐4D increased significantly in hemodialysis group ( P ＜0 .05) ,while there was no significant difference in RVEDV ,FAC , RVEF and RV‐GLSfree in uremia hemodialysis group ( P ＞0 .05) . Conclusions 4D RV Volume could early and accurately evaluate the right ventricular systolic dysfunction in uremia patients . Furthermore ,w hen evaluating right ventricular systolic function in uremia patients treated with maintenance hemodialysis , indices such as right ventricular strain and volume parameters should be comprehensively considered .

OBJECTIVETo Study the effect of C677T and MTHFR gene polymorphism on side effects of HD-MTX in ALL children.

METHODSThe gene polymorphism of C677T A303G and MTHFR C677T were detected by PCR in 98 ALL children from January 2014 to January 2016. The side effects during HD-MTX therapy were observed, and the relationship among GSTP1, MTHFR gene polymorphism and incidence of side effect of HD-MTX were analyzed.

RESULTSAmong 98 ALL children, the gene variation was observed in 61 ALL children (62.24%). Polymorphism study on C677T A303G showed that the gene frequency of A was 84.69%, while that of G was 15.31%; for polymorphism of MTHFR C677T, gene frequency of C was 66.33%, and that of T was 33.67%. Seven patients(7.14%) experienced with bone marrow supression, 23 patients(23.47%) with liver function damage, 15 patients(15.31%) with renal function damage, 48 patients(48.98%) with gastrointestinal reactions and 46 patients(46.94%) with mucosal lesions. After adjustment of sex, age, risk stratification and dosage of MTX, the gene polymorphism had no significant relationship with bone marrow suppression, gastrointestinal reactions and mucosal lesions(P>0.05). However, the number of the mutant genes had statistically significant relationship with liver and renal function damage(P<0.05).

CONCLUSIONThe risk of side effects during HD-MTX therapy increases in ALL children with combined mutation of MTHFR and C677T.

Objective To investigate the current status of outpatient pain management in patients with pulmonary disease after surgery by WeChat and to provide a basis for postoperative pain management. Methods A total of 449 patients who underwent thoracic surgery in our hospital from December 2017 to May 2018 were enrolled, including 156 males and 293 females with an average age of 22-83 (55.54±11.17) years. Brief Pain Inventory was adopted for pain assessment in 24-48 hours after discharge and 24 hours after removal of from the wound. Results Totally 98.22% of the patients reported that they suffered from pain in 24-48 h after discharge, most pain position was still at drainage port (45.21%), the overall pain score was 2.75 (2.00, 3.25) points, and 82.85% of patients adopted physical methods to relieve pain. After removal of stitches at the drainage port, 79.29% of the patients suffered from pain, the pain site was mainly at the drainage port (47.88%), and the overall pain score was 1.75 (1.25, 2.25) points, and 73.94% of patients adopted physical methods to relieve pain. The score of the overall influence degree of pain on patients was 2.29 (1.86, 2.86) points and 1.86 (1.29, 2.43) points, while pain had the greatest influence on sleep and mood. The scores were 4.00 (3.00, 5.00) points, 3.00 (2.00, 4.00) points and 2.00 (1.00, 4.00) points, 3.00 (2.00, 4.00) points, respectively. Conclusion Under the concept of enhanced recovery after surgery, the overall pain level of patients with pulmonary disease after discharge is mild pain, but the application rate of drug analgesia in patients is low. The overall effect of pain on postoperative patients with lung cancer is low, but it has a great impact on sleep and mood. Medical staff should strengthen the pain education for patients in order to improve their pain self-management ability.

OBJECTIVE: To analyze the prognostic value of BCL-2, BCL-6 and MYC in patients with diffuse large B cell lymphoma (DLBCL). METHODS: One hundred and sixty three cases of DLBCL in our hospital from March 2012 to March 2015 were selected. The specimens of lymphoma tissue of patients were collected. The expression of BCL-2, BCL-6 and MYC was detected by immunohistochemical method. The fusion of IGH/BCL-2, the gene breakage of BCL-6 and MYC were detected by interphase fluorescence in situ hybridization. The correlation of the expression levels of BCL-2, BCL-6 and MYC with the clinicopathological features and prognosis in the patients with DLBCL was further analyzed. RESULTS: MYC, BCL-2 and BCL-6 showed pale brown or reddish brown positive signals, among them MYC mainly positively expressed on the cell membrane, and BCL-2 mainly expressed on the cytoplasm and local cell membrane, and BCL-6 mainly expressed in the nucleus. The expression level of BCL-2 in ECOG physical status score 2 was higher than that in patients with ＜2 scores, and the expression level of BCL-2 in CD5 and germinal center B-cell-like (GCB) was significantly higher than that in patients with non-GCB (P＜0.05), and the international prognostic index (IPI) for 3-5 scores at the MYC expression level was significantly higher than that of the 0-2 score (P＜0.05); the expression level of BCL-6 in immune subtype CD5 and GCB was significantly lower than that in non-GCB (P＜0.05). The results of Cox multivariate analysis showed that the expression level of BCL-2, BCL-6 and MYC significant correlate with the overall survival and progression-free survival (P＜0.05) of the patients with DLBCL. CONCLUSION BCL-2, BCL-6 and MYC as important molecular markers are of high value for evaluating the prognosis of patients with DLBCL.
Humans ; In Situ Hybridization, Fluorescence ; Lymphoma, Large B-Cell, Diffuse ; Prognosis ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Proto-Oncogene Proteins c-bcl-6 ; metabolism ; Proto-Oncogene Proteins c-myc ; metabolism