ObjectiveTo determine the possibility of r eal-time perfusion imaging in the quantitative evaluation of myocardial perfusion in various segments of left ventricle. MethodsImages of ten anesthetized dogs were obtained at the mid-papillary muscle short-axis view with a real-time imaging system. Mechanical index (MI) was adjusted to 0.1 , 0.2 and 0.4 respectively, and frame rate was set at 20 Hz. Optison was infused intravenously at a rate of 0.1 , 0.2 and 0.5 ml/min, respectively. Images were recorded for 150 real-time frames commencing immediately after a couple of Doppler bursts. Myocardial opacification was assessed both visually and quantitatively for six segments of left ventricle (antero- and infero-septum, inferior, posterior, lateral and anterior wall). Myocardial signal intensity versus real-time frame curves were made and fitted to an exponential function: Y=A(1-e -?t ). ResultsUsing low MI (MI= 0.1 or 0.2 ) and with continuously infusion of Optison at a rate of 0.2 or 0.5 ml/min, real-time imaging resulted in sufficient myocardial opacification and left ventricular endocardial border definition, and displayed myocardial thickening and wall motion simultaneously. ConclusionsReal-time imaging has a potential in the quantitative assessment of myocardial perfusion, and allows simultaneous assessment of perfusion and myocardial function.

0.05.Only 1 of 28 (3.6%) showed positive survivin signal in the control group.The difference of the positive rate of survivin between groups of TCCB and control was significant ( P

0.05). ④ High correlations were also found between 2-DE, RT-3DE derived LVEDV and TV (r= 0.80- 0.88), but 2-DE and RT-3DE 2-plane methods underestimated TV significantly (P

Objective To explore the practicability of real-time myocardial contrast echocardiography (MCE) in assessing the transmural distribution of myocardial perfusion. Methods Three grades of left anterior descending coronary artery(LAD) stenoses were created in 6 open-chest dogs. Stenoses reduced LAD flow by 50%, 75% and 90% of hyperemia guided by flow probe. Low-energy MCE were performed at baseline, hyperemia reduced by dipyridamole, three different stenoses, reperfusion and complete occlusion, respectively, during continuously infusion of SonoVue. Regions of interest(ROI) were placed individually within endocardial and epicardial layers and myocardial signal intensity-versus-time plots just after high-energy FLASH frames were fitted to an exponential function to obtain values of A, ?, A??. The corresponding transmural gradients, defined as endocardial-epicardial ratios of A (A-EER),?(?-EER) and A??(A??-EER) were also calculated. Results The transmural distributions of A,? and A?? were more or less homogeneous at baseline,hyperemia and 50% reduced LAD flow, with their transmural gradients near 1. When LAD flow was reduced by 75%,? and A?? from endocardial layer decreased (P

Objective To explore the value of quantitative tissue velocity imaging (QTVI) in quantitatively evaluating segmental systolic function of left ventricle. Methods Fifteen healthy volunteers(group A) and fifteen myocardial infarction patients (group B) were studied at apical four-chamber view, two-chamber view and apical longitudinal view using QTVI. Septal, lateral, anterior, inferior, ante-septal and posterior walls were divided into basal, middle and apical segments respectively, in total 18 segments. The systolic peak velocity (Vp), systolic peak displacement (D), systolic peak strain rate (SR) and strain (S) were measured respectively for each segment of both groups. Results For abnormal wall motion segments in group B, the value of Vp showed significant lower in 16(16/18) segments, D in 15(15/18) segments, SR in 17(17/18) segments and S in 16(16/18) segments than those in the corresponding segments of group A (all P

Objective To explore the influence of nursing intervention on the pocket infection and other related problems following CRT-D therapy in chronic heart failure patients.Methods The causes of pocket machinery burst and skin incision dehiscence,pocket bleeding or hematoma and pocket infection following CRT-D therapy from March 2008 to March 2011 were reviewed,then analyzing and summarizing them to work out a detailed nursing interventions plan.During April 2011 to June 2013,nurses carried out the nursing intervention on patients who accepted CRT-D implantation.At last we compared the occurrence of pocket machinery burst and skin incision dehiscence,pocket bleeding or hematoma and pocket infection during the period of 6 months after CRT-D therapy between the two groups.Results After the implementation of nursing interventions,the incidence of pocket infection and other related problems following CRT-D therapy in chronic heart failure patients reduced significantly.Conclusions The interventions such as rigorous preoperative skin preparation,eliminating the potential factors of infection,intraoperative strict aseptic operation,choosing the appropriate position of pocket,the implementation of interventions to prevent bleeding,meticulous and rigorous postoperative nursing,providing healthy knowledge sufciently and strengthening follow-up,finding problems and solving them timely can prevent the pocket machinery burst and skin incision dehiscence,pocket bleeding or hematoma and pocket infection following CRT-D therapy effectively.

Objective To evaluate the efficacy of nucleoside analogues (NAs) antiviral therapy on clinical outcome for hepatitis B virus (HBV)-related primary hepatic carcinoma patients after hepatectomy. Methods The clinical data of 156 HBV-related primary hepatic carcinoma patients after hepatectomy were retrospectively analyzed..According to whether accepted postoperative antiviral treatment, all patients were divided into control group (n = 80)and observation group (n = 76). The serum HBV DNA capacity, recurrence-free survival (RFS)and overall survival (OS)were compared between two groups. Results One week, 1 month, 2 months and 3 months after operation , the serum HBV DNA capacity of observation group was significantly lower than that of control group(P < 0.05). One year, 3 years and 5 years after operation, intergroup comparison of RFS rate of both groups showed statistical significance (P < 0.05) and 1 year, 3 years and 5 years after operation, the difference of OS rate of both groups indicated statistical significance (P < 0.05). Conclusion Standard NAs antiviral treatment for HBV-related primary hepatic carcinoma patients after hepatectomy ,can improve prognosis and prolong survival time. The inhibition the HBV copy active may be its mechanism.

Objective To explore the diagnostic value of color Doppler echocardiography in the patients with anomalous origin of coronary artery.Methods Six patients were studied using color Doppler echocardiography.The origin sites,running courses,blood flow directions of coronary arteries, other accompanied cardiovascular abnormalities and valvular regurgitations were investigated.The diameters of coronary artery trunks and left ventricular ejection fraction (LVEF) were measured.And the results were compared with those of coronary angiography and surgery.Results Left coronary artery(LCA) originated from pulmonary artery(PA) in 4 cases,left anterior descending(LAD) branch originated from PA in 1 case,and accessory coronary artery originated from PA in 1 case.The main accompanied cardiovascular abnormalities included ventricular septum defect,atrial septum defect,complete endocardial cushion defect,and so on.For all the patients,the diagnostic results by echocardiography were consistent with catheterization and surgery.High correlations existed between echocardiographic and catheterization measurements for left and right coronary artery diameter and LVEF (r= 0.94 , 0.96 , 0.89 ,respectively,all P 0.05 ).Conclusions Color Doppler echocardiography can accurately diagnose the patients with anomalous origin of coronary artery, provide reliable information for surgical treatment.

BACKGROUND:Clinical trials have shown that oral administration of valsartan can decrease in-stent restenosis after stent implantation.But whether valsartan used locally also has the sanle effect and the possible mechanism should be validated.OBJECTIVE:To observe the effect of valsartan-eluting stents on collagen deposition in neointima and AT2 receptor expression after implanting valsartan-eluting stents into rabbit abdominal orta.DESIGN:Randomized and controlled animal experiment.SETTING:Beijing Friendship Hospital.MATERIALS:The experiment was performed at the Laboratory of Beijing Friendship Hospital between October 2004 and March 2006.Fifteen New Zealand white rabbits,irrespective of gender,weighing 2.75-3.25 kg were selected(Animal Laboratory of Beijing Friendship Hospital).The rabbits were adaptively fed for one week.All the operations of rabbits during the experiment were accorded with animal ethical standards.Valsartan powder was presented as a gift by Novartis.China;Reagent of MASSON was provided by Department of Pathology of Beijing Friendship Hospital;1%picrosirius solution was provided by the Department of Pathology of China-Japan Friendship Hospital:Mice-anti-rabbit monoclonal AT2 antibody was product of Santa Cruz Biotechnology (USA);Envision reagent was purphased from Dako;primers were synthesized by SBS Genetech(SBS).METHODS:①The animals were randomized into bare-metal stent group,carrier-eluting stent group and valsartan-eluting stent group with 5 animals in each group.All rabbits were implanted with corresponding types of above-mentioned stents into abdominal aortas down below renal artery.②Quantitative angiography before,immediately after and 3 months after stent implantation were performed to compare vascular diameters of the aortas.③Three months Iater,the rabbits were executed after anaesthesia.The vessels with stents were processed with HE staining.Indices of the vascular neointimal formation,I.e. iBrier and external elastic membrane luminal area,the maximal intimal thickness,neointimal area and stenosis area percent were measured.④The collagen deposition in neointima was observed through MASSON staining,and the type of collagen was identified through picrosirius stain.⑤The expressions of AT2R mRNA and proteins were also compared by RT-PCR and immunohistochemistry among three groups.MAIN OUTCOME MEASURES:①The diameters of aorta with stent at different time;②Inner and extemal elastic membrane luminal area,the maximal intimal thickness,neointimal area and stenosis area percent;③Collagen deposition and type of collagen of the aorta with stent;④AT2R mRNA and protein expressions.RESULTS:Of 15 rabbits selected in the experiment,1 rabbit of the bare-metal stent group died during stent implanting,and 1 of the carrier-eluting stent group died during breeding after stenting.Finally,13 rabbits were included in final analysis.①There were no significant differences in the mean aortic diameters between any two of the three groups before,immediately after and 3 months after stent implantation(P＞0.05).②A larger 1uminal area and a less neointimal hyperplasia in valsartan eluting-stents group were found compared with the other two groups(P＜0.01).③MASSON staining showed that collagen deposition was rich in neointima of bare-metal stent group and carrier-eluting stent group while rare in neointima of valsartan eluting stent group.Pierosirius staining suggested that the deposited collagen was type Ⅲ collagen predominantly accompanied by type Ⅰ collagen around stents struts;the type Ⅲcollagen deposition was obviously decreased in valsartan eluting stent group.④AT2R protein only expressed in adventitia of bare-metal stet group and arrier-eluting stent group while expressed in all layers of valsartan eluting-stents group.The AT2R mRNA/a-Actin mRNA of valsartan eluting stent group was significantly higher than that in the other two groups(P＜0.01).CONCLUSION:Valsartan eluting-stents inhibits neointimal hyperplasia after stenting by decreasing collagen deposition.especially collagen Ⅲ.The mechanism may be related with the upregulation of AT2R mRNA and protein expressions by valsartan-eluting stent.

Objective To explore the efficacy and adverse reactions of improved VTD regimen (pirarubicin combined with vincristine and dexamethasone) plus low-dose thalidomide in patients of newly diagnosed multiple myeloma(MM).Methods Twenty-nine cases of newly diagnosed MM were enrolled in this study.The improved VTD regimen was intravenous injection vincristine 2 mg/d on the first day,intravenous drip pirarubicin 20-30 mg/d from the first day to the second day,and intravenous drip dexamethasone 8 mg/d from the first day to the tenth day.Twenty-eight days was one course of treatment.Response and adverse reactions were evaluated after 4 course of treatment.On the first day of chemotherapy,all the patients were orally administered thalidomide 50 mg/d.Three days later,thalidomide was added to 100 mg/d and chronically maintained if toxicities could be tolerated.Results There were 3 cases(10.3％) in complete response,12 cases (41.2％) in very good partial response,10 cases (34.5％) in partial response,3 cases (10.3％) in stable disease,and 1 case(3.5％) in progressive disease.The overall response rate was 86.2％.Main adverse reactions were myelosuppression,asthenia and constipation,all could be tolerated.Conclusion It has significant response rate and less side effects of improved VTD regimen plus low-dose thalidomide for the patients of newly diagnosed multiple myeloma,and deserves further clinical practice.