Objective To assess left ventricular systolic and diastolic function in patients with hypertrophic cardiomyopathy(HCM) with the aid of pulsed Doppler tissue imaging (DTI) to measure the four sides of mitral annular. Methods Thirty subjects with HCM and Twenty five age and sex matched controls were performed 2D and Doppler echocardiography . Two groups were studied with pulsed tissue Doppler imaging of the 4 sides of the mitral annulus (septal, lateral, inferior, anterior) in 4 and 2 chamber views. The velocities of systolic wave(Sa)、early diastolic filling wave (Ea)、late filling wave (Aa) and isovolumetric relaxation time were measured by DTI. Results Compared with normal control group, HCM group shows: (1) conventional data: LV wall thickness and mass indices were significantly greater. There were no significant difference in mitral flow Velocity. (2) DTI: There were more lower velocities of systolic and early diastolic filling wave. But isovolumetric relaxation time、mitra flow velocity / mitral annual early diastolic velocity ratio(E/Ea) increased. The velocities of systolic and early diastolic of septal site were the lowest among the 4 sides of the mitral annular and were the most closely with the average velocities of systolic and early diastolic of mitral annual. In addition, DTI may detect the pseudonormalization of mitral inflow. Conclusions DTI is more sensitive than conventional echocardiogram data and may be clinically used in exactly detecting left ventricular systolic and diastolic dysfunction in patients with HCM

Objective To study the cause of mis-diagnosis on carcinoma of large intestine in young people. Methods We retrospectively reviewed and analyzed the diagnosis and treatment of 62 young people with carcinoma of large intestine from 1990 to 2002. Results Among 36 cases of rectal carcinomas, 7 were diagnosed as colonitis,5 as hemorrhoid,3 as dysentery and 2 as perianal abscess with anal fistula. Among 26 cases of colon carcinomas, 3 were diagnosed as periappendic abscess,2 as colonitis and 1 as iron deficiency anemia.The rate of mis-diagnosis was 37 1%. Conclusions Carcinoma of large intestine in young people was a high malignant tumor with bad prognosis and little symptom in early stage. Surgeons should pay a great attention to the characteristic of this carcinoma to diagnose and treat early

Objective To explore the operative timing and cause of death in the patients with acute cholangitis of severe type(ACST). Methods The clinical data on the treatment and the prognosis of 116 patients with ACST were analyzed retrospectively. Results 10 cases died during perioperative period.The patients who received operation within 6 hours after toxic shock all survived.Of 8 cases who received operation after 24 hours,7cases died from toxic shock and multiple organ deficiency of function (MODF) within 4 days of post-operation. Conclusion Operation should be performed before toxic shock or mental symptom occurred in the patients with ACST. The earlier the operation was performed, and the better the prognosis was. The main causes of death were delayed operative time,severe complications and senility.

Phospholipid fatty acids are the major constituents of the membranes of all living cells, and different groups of microorganism synthesize a variety of PLFA through various biochemical pathways. Several PLFAs can be used as "signatures" to analyze changes in microbial biomass and microbial communities structure. More and more PLFA method was used in soil microbial analysis. This article briefly reviewed the applications of PLFA methods in soil microbial analysis.

Objective: To modify the pulsatile bioreactor we constructed previously for simulating the high-flow, high-pressure hemodynamics of heart valve in vivo, and to experimentally cultivate the tissue-engineered heart valves (TEHV) in the modified bioreactor. Methods: T-PLS system (NewheartBio Co., Ltd Korea) was used to generate pulsatile f1ow in the modified bioreactor and we designed a new air-exchange pathway to avoid contamination. The TEHV were made by seeding human bone mesenchymal stem cells (BMSCs) on de cellularized porcine heart valve. After cultured under static condition for 4 d, the TEHVs were moved to the modified bioreactor and exposed to low-flow (0-600 ml/min) or high-flow(0-4 800 ml/min) pulsatile hydrodynamics for 7d, then the cells on TEHVs were evaluated. Results: After modification, the flow range expanded from (0-1 200) ml/min to (0-6000) ml/min and the pressure range expanded from (0 40) mmHg to (0-180) mmHg. In culture experiments, 26.3% of the seeded cells remained under low-flow environment and cells were completely lost under the high-flow dynamics. Conclusion: The modified bioreactor can basically simulate the dynamics of heart valve in vivo and can be used in TEHV cultivation research. However, the current TEHV can not tolerate the high-flow pulsatile hydrodynamics.

ObjectiveTo understand the detections of influenza A (H1N1) in 2009,and haemagglutinin (HA) gene mutations and the comparisons with standard strains.MethodsThe nasopharyngeal swabs from patients with influenza-like illness (ILI) in National Influenza Sentinel Surveillance Hospital and the outbreak epidemic area were collected.The virus typing and A (H1N1) viruses were tested by real time-polymerase chain reaction (RT-PCR).Then the pathogens were isolated with MDCK cells,the virus titer was determined with hemagglutination test and the virus typing was identified with hemagglutination inhibition test (HA1).The RT-PCR products of HA1 gene of virulent strains were sequenced and then analyzed through bioinformatics.Results A total of 996 pharyngeal swab specimens were tested,and nucleic acid positive cases included 337 A (H1N1) subtype,1 seasonal A (H1N1) subtype,67 A (H3N2) subtype,and 12 B type.The positive rate of nucleic acid detection of influenza was 41.87％ and that of A (H1N1) was 33.84％.Thirty-six influenza A (H1N1) virus strains were isolated,and 10 of them were successfully sequenced and several amino acid mutations were identified.There were 6 amino acid mutations found compared with vaccine strain A/California/07/2009 (H1N1),and 1 site was in area B of epitope.Conclusions A (H1N1) is absolute predominant among isolated strains in 2009.HA gene of virulent strains is mutated compared with vaccine strain provided by World Health Organization,which shows that the area B of epitope changes,while the key amino acid position 222 doesn't change.

Objective To investigate the feasibility and accuracy of velocity vector imaging(VVI)to assess strain and strain rate of right ventrieule(RV)during varying myocardial functional states.Methods VVI of the longitudinal RV were recorded in 7 closed-chest anesthetized mongrel dogs from the apical 4-chamber view during 3 different inotropic states.Peak dp/dt from the RV contraction during the right cardiac catheterization,which was used as the gold standard of RV contractility,was obtained simultaneously in each inotropic state.Peak systolic velocities(V), peak systolic strain rates(SR),peak systolic strains(S)at the basal, middle and apical segments of RV free wall and septal from the longitudinal axis were quantitatively measured by using VVI software system respectively.Results The peak systolic strain and strain rate of the longitudinal RV free wall and septal were increased with the infusion of dobutamine and decreased with the infusion of metoprolol.A significant correlation was found between peak RV dp/dt and RV mean strain and mean strain rate(r=0.79, 0.75;P <0.01).Among all RV segments, the peak systolic S,SR of RV basal free wall had the most significant correlation to peak dp/dt (r=0.83,0.78;P<0.01).Conclusions Strain rate imaging drived from VVI could quantitatively and sensitively detect the longitudinal RV contractile function.Peak systolic S and SR determined at the longitudinal RV basal free wall were the strong noninvasive indices of RV contractility.

Objective To characterize the systolic torsion in dilated cardiomyopathy (DCM) by velocity vector imaging(VVI).Methods Eighty-seven subjects were studied using VVI:27 patients with DCM and 60 healthy control subjects.Left ventricular short-axis acoustic images were acquired at base and apex levels.The rotation angle and rotation velocity of endocardium and epicardium were measured.Results LVEF of DCM group was significantly lower than that of control group ( P＜0.01).The basal and apical rotation angle, rotation velocity were significantly lower in DCM group.The endocardial and epicardial rotation angle, rotation velocity were also significantly lower in DCM group than those in control group (P＜0.01).Conclusions VVI is a rapid and noninvasive tool to quantitatively assess cardiac torsional deformation in DCM patients,which providing another useful modality for evaluating cardiac function.

Objective To investigate strain and strain rate of right ventricular(RV)based on twodimensional image by velocity vector imaging in normal subjects.Methods Thirty-two healthy adults were rolled in this study.Echocardiographic images in 4 chamber view were analyzed by conventional manual tracing for volumes and ejection fractions,which were also measured by velocity vector imaging.Myocardial velocity,strain rate,and strain were determined at the basal,mid,and apical segments of the RV free wall and ventricular septum by velocity vector imaging.Results RV ejection fractions obtained with manual tracing correlated strongly with the same indexes obtained by velocity vector imaging method in all subjects(r=0.91,P＜0.01).The strain and strain rate value of middle segment and basal segment in RV free wall were higher than those of apical segment.There were same trend in ventricular septal.The strain and strain rate of middle segment and basal segment in RV free wall were higher than those of homologous segments in ventricular septal,but the indexes of apical segment in free wail and septal had no difference.The strain and strain rate in RV were not correlated with age.Conclusions Velocity vector imaging could accurately and quantitatively assess the strain and strain rate of RV.

Objective To discusse the mechanism and clinical significance of bradycardia -hypotension phenomenon which is caused by vagal reflex during and after the RFCA and present the experience of using appropriate measures to decrease the incidence of this situation. Methods The patients who were suffering from tachyarrhythmias and treated by RFCA were divided into two groups. The groups were as follows:148 patients who were not taken special measures in the early stage were selected in control group;1 540 patients who were taken measures to prevent vasovagal reflex were selected in observation group. Result During the RFCA, the incidence of bradycardia -hypotension phenomenon in control group was 13.5% (20/148), the incidence of bradycardia-hypotension phenomenon in observation group was 5.0%(77/1540) (<0.01) .Conclusions The incidence of bradycardia-hypotension phenomenon caused by vagal reflex during the RFCA is related to catheter irritation to the heart,pressure on the vessels and hypovolemia. The incidence of this phenomenon can be decreased obviously by some measures,such as non-restricted diet before RFCA,discretion rehydration during and after the RFCA and hemostasis with appropriate force after extubation. The key to rescue patients successfully are early detection and timely processing.