Objective To evaluate the left ventricular mechanical dyssynchrony in patients with chronic heart failure(CHF)by two dimensional speckle tracking imaging(2D-STI).Methods 37 CHF patients were enrolled in this study.According to left ventricular ejection fraction(LVEF),the patienst were classified into two subgroups:group A,LVEF≤ 35 ％;group B,35 ％＜LVEF＜50 ％.35 healthy volunteers constituted the control group(group C).Standard 2D images were acquired in the 2-,3-and 4-apical views as well as the parasternal short-axis views at the level of the mitral valve and papillary muscles.The time to peak-systolic strain and strain rate were measured for each segment in the level of the mitral valve and papillary muscles in Qlab software.Dyssychrony parameters were defined as the standard deviation and the maximal time delay of the time to peak-systolic strain and strain rate for 12 segments.Parameters were compared among the three groups respectively.The correlation between dyssynchrony parameters and LVEF were analysed in CHF patients.The cut-off value of each parameter were derived from group C based on statistical principles.Dyssychrony rate of each parameter were calculated in group A and B,and compared within each group respectively.Results Compared with group C,all the dyssychrony parameters in group A were significant higher(P＜0.05),and part of the parameters(Tsl-12SD,Tsl-12Dif,Tslr-12SD,Tslr-12Dif and Tsr-12SD)in group B were remarkable higher(P＜0.05).Dyssychrony parameters in CHF patients correlated closely with LVEF(P＜0.05).Significant differences among dyssychrony rates were noted in both group A and B(P＜0.05),and Ts1-12SD showed the highest value in both subgroups.Conclusions 2D-STI is useful in quantifying left ventricular systolic dyssychrony in CHF patients,and the longitudinal parameters are more efficient to detect mechanical dyssychrony than the radial parameters and circumferential parameters.

Objective:To explore the relationship between eosinophil(EOS) and IL-5,sIL-2R in asthmatic patients in sputum. Methods:Thirty asthmatic patients (asthmatic group) during exacerbation and stable stage and twenty healthy persons were selected.IL-5 and sIL-2R in sputum were determined by ELISA ,EOS apoptosis was identified by flow cytometre.Results:IL-5 ,sIL-2R and EOS apoptosis percentages in the patients during exacerbation and stable stage in sputum were increased significantly,.There were no expression of EOS apoptosis in the healthy persons. Data analyses revealed a negative correlation between EOS apoptosis and the levels of IL-5, and a closer correlation between the percentages and IL-5.Conclusion:EOS underwent apoptosis in asthmatic airway and EOS apoptosis was regulated by IL-5.There were no correlation between EOS apoptosis and sIL-2R.

Objective To study the correlation between serum homocysteine (Hcy) levels and chronic heart failure (CHF) with ultrasound cardiac function patients.Methods The subjects were 88 cases of CHF (CHF group) in our hospital between April 2014 to June 2015 between patients,selected 65 cases of healthy people as a control group over the same period in our hospital,using color Doppler ultrasound measurement of two groups patients of the left ventricular ejection fraction of patients groups (LVEF) and left ventricular end-diastolic diameter (LVEDd),and compared serum Hcy and NT-proBNP levels,LVEF and LVEDd in different NYHA classification patients,analysis of serum Hcy and NT-proBNP levels and LVEF,LVEDd between correlation of serum Hcy levels on cardiovascular incident.Results CHF group of the Hcy,NT-proBNP levels and LVEDd were significantly higher than control group (P ＜ 0.01),LVEF was significantly lower than the control group (t =31.78,P =0.00);different NYHA functional class (Ⅱ ～ Ⅳ level) of Hcy,NT-proBNP,LVEDd and LVEF compared were statistically difference (P ＜ 0.01);Pearson correlation analysis showed,CHF patients with LVEF serum Hcy levels were negatively correlated (r2 =0.974,P ＜ 0.01),with LVEDd was positively correlated (r2 =0.896,P ＜ 0.05),and higher serum Hcy levels,the higher the rate of cardiovascular happened in patients with CHF.Conclusion The serum Hcy and NT-proBNP levels in patients with CHF were significantly higher than healthy,and with the deterioration of heart function and increased while the LVEF was negatively correlated positively with LVEDd,cardiovascular events in high Hcy levels may also increase the incidence risk,so Hcy levels is expected as a new diagnostic marker CHF conditions change.

Objective To evaluate the right ventricular function in patients with congestive heart failure (CHF) after cardiac resynchronization therapy (CRT) by 2-dimensional speckle imaging (2D-STI).Methods 46 patients with CHF were divided into responders to CRT and non-responders to CRT according the standard of a decline in LV end-systolic volume ≥ 10％.All the patients received echocardiography examination 1-3 days before CRT and 6 month after CRT.Tissue Doppler imaging (TDI) indices included SD of time to peak velocity in systole (Ts-SD) among 12 segments.Right ventricular diameters included RV basal transverse diameter (D1),RV middle transverse diameter (D2) and RV longitudinal diameter (D3) in apical four views.2D-STI indices included systolic strain (S) and stain rate (SR) of basal or middle segment of RV free wall.Results Compared with before CRT,LVEDd,LVEDV,LVESV and Ts-SD significantly decreased,LVEF significantly increased in responders 6 months after CRT.Before CRT,compared with nonresponders,there was no significant difference of D1,D2 and D3 in responders,while S and SR in basal or middle segment of RV free wall were higher than non-responders.Compared with before CRT,D1,D2 and D3 in responders decreased significantly,S and SR in basal or middle segment of RV free wall increased significantly,while there was no difference in non-responders.There were significant negative correlation between S and SR in basal or middle segment of RV free wall and Ts-SD in responders.Conclusions The remodeling and systolic function of RV are improved after CRT.It may help for improving the efficacy of CRT when takes RV function data into account before CRT.

Objective To evaluate the diastolic function in patients with congestive heart failure (CHF) after cardiac resynchronization therapy (CRT) by conventional echocardiography or Doppler tissue imaging (TDI).Methods 31 patients with CHF were divided into responders to CRT (group R) and nonresponders to CRT (group N) according the standard of a decline in left ventricular(LV) end-systolic volume ≥10％.All the patients received echocardiography examination 1-3 days before CRT and 6 month after CRT.Color M-mode echocardiography indices included Vp,E/Vp.TDI indices included the peak velocity in early diastole (e) at 4 sites of mitral annulus,E/e,time to peak velocity in systole (Ts),Ts-SD and maximum difference of Ts (Ts-Dif) among 12 segments.Results Compared with before CRT,Ts-SD and Ts-Dif significantly shortened in group R;Vp increased significantly,E/e at each 4 site and mean value at 4 sites of mitral annulus,E/Vp decreased significantly; but there were no significant difference in group N.There were significant positive correlation between mean value at 4 sites of E/e,E/Vp and Ts-SD in group R.Conclusions The diastolic function in responders to CRT improved after CRT,which was associated with the decreased LV filling pressure and improved LV relaxation.

Objective:To explore genetic counseling and prenatal diagnosis strategies for women who have androgen insensitivity syndrome (AIS) family history or pregnancy history of AIS proband.Methods:Three families of complete AIS (CAIS) were retrospectively reported and summarized. The subsequent pregnancies and processes of prenatal diagnosis were followed up.Results:Among three CAIS families, one family had androgen receptors (AR) gene mutation diagnosis; the other two families were diagnosed clinically without gene diagnosis. All three mothers of CAIS probands were in pregnant again when they sought counseling, with gestational weeks between 7－13 weeks. They underwent chorionic villi sampling or amniocentesis in their second trimester (at 12, 16, 17 weeks respectively). Chromosome gender of all three fetuses were 46,XY, which was inconsistent with the ultrasonographic phenotype of external genitalia. All patients chose selective abortion in their second trimester. The external genitalia of all aborted fetuses were female phenotype, which supported the diagnosis of CAIS.Conclusion:Genetic counseling and prenatal diagnosis should be provided to high-risk patients with family history of AIS or proband pregnancy history, so as to achieve the goal of good childbearing and sound childrearing.

Objective To evaluate the left ventricular synchronicity in patients with dilated cardiomyopathy(DCM) by real-time three-dimensional echocardiography(RT-3DE).Methods Twenty-eight DCM patients and twenty-nine healthy volunteers were enrolled in this study,and clear full volume pictures were aquired using RT-3DE.The time to minimal systolic volume (Tmsv) of each segment was measured,and a mean value of Tmsv for the same segment in each group(Tmsv') was caculated.The standard deviation (Tmsv-SD) and the maximal difference (Tmsv-Dif) of Tmsv were calculated for basal level,mid level,apical lever,12 segments and 16 segments (Tmsv1-6-SD,Tmsv7-12-SD,Tmsv13-16-SD,Tmsv12-SD,Tmsv16-SD,Tmsv1-6-Dif,Tmsv7-12-Dif,Tmsv13-16-Dif,Tmsv12-Dif,Tmsv16-Dif).Results There were no significant differences among 1-17 Tmsv' within each group.No significant differences were found between two groups for Tmsv' derived from the same segment.All asynchrony indexs of DCM patients were remarkably higher than those of the healthy volunteers (P＜0.01 or P＜0.05),and correlated closely with LVEF determined by RT-3DE (r=-0.576～-0.768,P＜0.01 or P＜0.05) except for those of the mid level(r=-0.402～-0.449,P＞0.05).Conclusions Dyssynchrony exist in globle and each level of DCM patients' left ventricle.RT-3DE is an available technique for left ventricular synchronicity quantification.

ObjectiveTo explore the chnical application value of ultrafine electronic endoscopy on the diagnosis of pediatric diseases of upper digestive tract.MethodsSeventy-five cases suspected upper gastrointestinal diseases from January 2009 to June 2010 were selected and were divided by systematic sampling method into observation group(47 cases) which was diagnosed with ultrafine electronic endoscopy and control group(28 cases) which was diagnosed by normal endoscopy.The data of diagnosis and compliance of two groups were observed and compared.ResultsCompliance rate of observation group and control group had significant difference[ 100.0％(47/47) vs.67.9％(19/28),P ＜ 0.01 ].The incidence rates of nausea,salivation and restless of observation group [ 8.5％(4/47 ),6.4％(3/47),8.5％(4/47 ) ]were lower than those of control group [39.3％(11/28),28.6％(8/28),50.0％(14/28)](P＜ 0.01 or ＜ 0.05).Correct diagnosis rate of control group was 84.2％ (16/19),while that of observation group was 95.7％ (45/47),but comparison of diagnosis showed no significant difference(P ＞ 0.05).The incidence rates of diaphragmatic spasm,sore throat and slow heartbeat in successful examination cases of control group[21.1％ (4/19),31.6％ (6/19),21.1％ (4/19) ]significant higher than those of observation group [0,2.1％ ( 1/47),2.1％(1/47) ](P ＜ 0.01 or ＜ 0.05 ).ConclusionUltrafine electronic endoscopy can achieve the same accuracy as normal endoscopy,but compared with normal endoscopy,it can improve the compliance of children during the examination and reduce the incidence of postoperative complications.

Objective To observe the effect of the volatile oil of zanthoxylum bungeanum in killing demodex in vitro.Method The mites were collected with adhesive cellophane tape technique.The killing effect of the pure volatile oil with different concentrations volatile oils on human demodex was investigated by microscope.Results The pure volatile oil was highly powerful in killing D.f and D.b in vitro,and for the D.b,the killing effect was better.With the increase of dilutus multiple,the killing effect dareased.Conclusion The pure volatile oil of zanthoxylum bungeanum is an effective component in killing demodex in vitro.

Objective:To explore the role of matrix metalloproteinase 12 (MMP12) in airway macrophages and pulmonary neu-rogenic substance P ( SP ) in the pathogenesis of asthma by analyzing their relationship in different categories of asthmatic patients.Methods:Twenty patients of asthma remission phase ( remission asthma group ) , twenty ones of mild acute exacerbation asthma (mild asthma group) and twenty healthy adults (normal control group) were included,respectively.After lung function was measured,the numbers of macrophage in induced sputum were counted.The expression levels of MMP12 mRNA and protein in sputum macrophages were detected by quantitative reverse transcription polymerase chain reaction and Western blot.The concentration of sputum SP was assayed by enzyme immunometric assay.Results: ( 1 ) Compared with the subjects in normal control group, forced expiratory volume in 1 second%predicted ( FEV1 ) and forced expiratory flow rates at 50% of the forced vital capacity % predicted ( FEF50 ) were much lower and the numbers of sputum macrophages were much higher in the patients in different asthmatic groups.Compared with the patients in remission asthma group,FEV1 and FEF50 were much lower in the ones in mild asthma group.(2) MMP12 expressions in the macrophages and the concentrations of SP in sputum were significantly increased in the patients in different asthmatic groups compared with those in normal control group;Furthermore,MMP12 and SP in mild asthma group were much higher than in remission asthma.(3) In all patients from different asthmatic groups,mRNA expressions of MMP12 in the macrophages were positively correlated with the levels of sputum SP or the numbers of sputum macrophages,whereas negative correlations between mRNA expressions of MMP 12 and FEV 1 or FEF50 were observed.Conclusion: The regulatory imbalance of macrophages′MMP12 and pulmonary neurogic SP may participate in the pathogenesis of asthma and become the potential targets for asthma therapy.