Objective To determine the clinical value of myocardial performance index (MPI) in the assessment of right ventricular function in the patients with atrial septal defect (ASD). Methods The study included 23 patients with ASD and 81 normal subjects. MPI, defined as the sum of isovolumic relaxation time and isovolumic contraction time derived by ejection time, was measured from tricupid inflow and right ventricular outflow Doppler velocity profiles recorded during routine echocardiography. Results ①The isovolumic relaxation and isovolumic contraction times [respectively ( 74.78 ? 13.86 )ms vs ( 60.93 ? 12.94 )ms, P

Objective To explore value of quantitative tissue velocity imaging(QTVI) in the regional systolic and diastolic myocardial function of hypertrophic cardiomyopathy(HCM) patients and healthy persons. Methods By Doppler myocardial imaging 20 HCM patients and 18 healthy subjects were collected,then the regional velocity were measured in the mid and basal segment in systolic,early diastolic and later diastolic period respectively. Results The parameters as systolic velocity(Vs),early diastolic velocity(Ve) and early systolic velocity/later diastolic velocity (Ve/Va) of the HCM group were significantly lower than those of the normal group,while later diastolic velocity(Va) showed no statistic difference between two groups. Conclusions The systolic and diastolic myocardial functions of hypertrophic cardiomyopathy patients are reduced. The abnormality of heart function in HCM patients could be accurately detected by QTVI.

Two cases of the aortopulmonary scptal defect were operated on our hospital. Among them, one was associated with patent ductus arterious and primary thrombocytopenia and the other with chronic heart failure. The defects were repaired successfully with a patch through a transaortic approach by means of four-point fixation. The diagnosis and surgical technique were discussed.

Objective To know the remote quality of life of patients with tumor of larynx when ab-scised by different type, and then summarize proper countermeasures of nursing. Methods Selected 82 laryngocarcinoma patients with exacte]y diagnosis. There were 40 cases had received total laryngectumy, 42 cases had received partial laryngectomy. Evaluated the level of remote quality of life of 82 patients by QLQ-H&N65, and then analyzed the datum. Results The level of quality of life of patients with total laryn-gectomy were worse than those in patients with partial laryngectomy in the aspects such as general health, swallow, language, emotional function, social function, body fuction and so on. Conclusions The quality of life of patients with tumor of larynx is influenced by several factors, their remote quality of life should be emphasised by nurses.

Objective To evaluate the regional myocardial systolic function in the patients with hypertrophic cardiomyopathy(HCM) by strain imaging technique.Methods Doppler myocardial imaging of 20 HCM patients(HCM group) and 22 healthy subjects(control group) was collected,and their regional peak systolic strain in the mid and basal segment was measured respectively.The data were compared and analyzed between the two groups.Results In the healthy subjects,the strain value showed no difference between regional myocardium.In the interventricular septum,anterior and inferior wall of left ventricle,the strain value of HCM group was significantly lower than that of control group.Conclusions Strain imaging could detect the abnormal regional myocardial function of HCM patients accurately, and provide a new quantitative parameter for evaluating the regional myocardial functions.

Objective To assess alternations in left ventricular volume and systolic synchrony in patients with frequent premature ventricular complexes(PVCs) from the right ventricular outflow tract(RVOT).Methods Twenty-nine patients with frequent isolated PVCs from RVOT were included and 30 healthy subjects as control.Instantaneous full-volume imaging(IFI) was performed to evaluate left ventricle volumetric parameters,including end-systolic volume (ESV),end-diastolic volume (EDV),stroke volume (SV),ejection fraction (EF),and systolic synchrony parameters,including systolic dyssynchrony index (SDI),dispersion end-systole (DISPES),mean end-systolic time (MES),pre-contraction time volume (PreContr) and post-contraction time volume (PostContr).Contraction front mapping was performed to visualize volumetric contraction sequence.All values of patients with PVCs were recorded during sinus beats (PVC-S) and premature ventricular beats (PVC-V) respectively.Results Significant differences were observed in left ventricular systolic volumetric and synchrony parameters between PVC-V and control subjects (P＜0.01),as well as in MES and PreContr between PVC-S and control subjects (P＜0.01).Conclusions Left ventricular systolic dysynchrony was demonstrated in patients with PVCs from RVOT.IFI was a novel tool to analyze left ventricular global and regional volumetric alternations.

Objective Chronic atrial fibrillation (AF) results in dedifferentiation of atrial cardiomyocytes that plays an important role in the perpetuation of AF.In this study,we aimed to investigate the changes of titin and α-smooth muscle actin (α-SMA) after long time of AF reversal.Methods Twenty-four goats were randomized into four groups:(1) sinus rhythm (SR),(2) 3 months AF (3-mo AF),(3) 3 months SR after 3 months AF (3-mo post AF),(4) 6 months SR after 3-mo AF (6-mo post AF),with 6 in each group.By pacing on the anterior bottom of left atria appendage (LAA),we established a goat model of chronic AF.Atria effective refractory period (AERP) was measured with electrophysiological methods.Ultra-structure was studied with echocardiography,light and electron microscopy.Titin and α-SMA protein expressions were determined by Western blot.Results The animals underwent high rate pacing on LAA for a mean of 42.23±21.70 days before presenting AF.Electrophysiological analysis revealed that AERP completely resumed in 3-mo post AF goats.Echocardiography displayed that the size of left atrium resumed almost in 6-mo post AF goats (P＜ 0.01).Pathological and electron microscopic examination revealed the disorder of myofibrils,augmentation of intercellular space,myolysis,accumulation of glycogen,and numerous bigger mitochondria among atrial cardiomyocytes in 3-mo AF goats.They recovered mostly in 6-mo post AF goats.Western blot showed that the band density of titin significantly reduced in 3-mo AF goats compared to SR ones [1826±319 vs 5012±854,P＜0.01].In 3-and 6-mo post AF goats,titin increased gradually and it reversed completely in 6-mo post AF goats (3841±601 and 4523±833 respectively,P ＜ 0.01).Conversely,the band density of α-SMA was significantly higher in 3-mo AF goats (5324±948) than in SR ones (1619± 271,P＜0.01).In 3-and 6-mo post-AF goats,α-SMA decreased gradually,and it recovered mostly in 6mo post AF goats (4437± 792 and 2205±540 respectively,P＜0.01,).Conclusions These data indicate that the reversal of dedifferentiation of atrial cardiomyocyts is a very slow process,and it is definitely essential for normal cardiac function.

Objective To detect the level of serum fragmented cytokeratin 18 (CK-18 M30) in patients with nonalcoholic steatohepatitis (NASH), to explore the relationship between the expression of CK-18 M30 and NASH. Methods 33 healthy people as control group, 24 nonalcoholic simple fatty liver (NAFL) patients, and 21 NASH patients were included in this study. CK-18 M30, ALT, AST and GGT were detected in all patients’ vein blood. NAFLD activity points (NAS) was examined in biopsy specimens of NAFL patients and NASH patients. Pearson correlation was applied to analyze the correlations between serum CK-18 M30, ALT, AST, GGT and the NAS of liver tissue in NASH group. Results Serum CK-18 M30 level of healthy control, NAFL and NASH group were (96.557 2 ± 41.226 8)U/L, (104.321 7 ± 45.167 3)U/L, (263.125 5 ± 61.578 1)U/L respectively. Serum CK-18 M30 level in NASH patients positively correlated with both NAS of liver tissue and serum ALT, which correlation coefficient r values were 0.601 5 and 0.420 6. Conclusion The concentration of serum CK-18 M30 could be used as a marker in the diagnosis of NASH.

ObjectiveTo explore the correlation between the respiration-induced clinical target volume (CTV) motion and volume variation and the dosimetric variation of planning target volume (PTV) and organs at risk (OAR) during free-breathing (FB) with whole breast intensity-modulated radiotherapy (IMRT).MethodsSeventeen patients with breast conserving surgery underwent respiration-synchronized four-dimentional computed tomography (4DCT) simulation scans on the state of FB.The treatment plan was constructed using the end-inspiration phase scan,then copied and applied to the other respiratory phases.The dose distribution was calculated separately to evaluate the dose-volume histograms parameters for the PTV,ipsilateral lung and heart.ResultsDuring FB,the CTV motion vector was (2.09 ±0.74) mm,and the volume variation was (3.05 ± 0.94) ％.There was no correlation between the volume variation of CTV and dosimetric variation of PTV/OAR ( r =-0.390 -0.480,P =0.182 -0.775 ).In anteroposterior (AP),superoinferior (SI) and vector directions,the CTV movement correlated well with the PTV mean dose,conformal index,and the lung volume receiving high dose (V20,V30,V40,and V50;r=-0.975-0.791,P =0.000 -0.041 ).In SI and vector directions,the CTV displacement only correlated with the heart volume receiving ＞ 5 Gy ( V5 ) ( r =-0.795,0.687,P =0.006,0.028 ).The lung volume variation and the lung volume receiving high dose correlated reasonably well (r=0.655 -0.882,P=0.001-0.04 0).The heart volume variation only correlated with the V5 of heart (r =-0.701,P =0.024).ConclusionsDuring free-breathing,the effect of breast volume variation can be ignored for whole breast IMRT,and whole breast IMRT assisted with breath-hold may improve the accuracy of dose delivery during radiotherapy.

Objective To observe the influence of trunk control training on motor function and the ability of cerebral palsy (CP) patients in the activities of daily living (ADL).Methods Forty patients with CP were randomly divided into a treatment group (n =20) and a control group (n =20).Both groups were treated with routine rehabilitation,while the treatment group also received trunk control training.All patients were assessed with function ambulation category (FAC) classification,time to walk 10 m,the Berg balance scale (BBS),and the modified Barthel index (MBI) at the beginning and eight weeks later.Results Before the intervention there was no significant difference between the two groups in terms of any of the assessments.Eight weeks later,all the assessment scores were significantly better in the treatment group than in the control group.Conclusion Trunk control training can significantly improve motor function and the ADL ability of patients with CP.