Objective To evaluate the applied values of echocadiography in closing membranous ventricular septal defects (VSD) with the Amplatzer devices. Methods The VSD were closed by transcatheter Amplatzer closure devices in nine patients. The patients′ age ranged between 15-45 years old,mean (26?10) years old. The VSD diameter was measured from 3 to 15 mm. Seven patients were guided by transthoracic echocardiography and 2 patients by transesophageal echocardiography. Results All VSD were successfully closed by the Amplatzer devices, without complications. The device size ranged from 6 to 18 mm. No residual shunt and complication were detected by the echocadiography in intraoperation and 3 or 4 days after operation. Conclusions Echocardiography plays an important role in closing VSD with Amplatzer device, not only in intraoperative guidance and monitor, but also in post-operative follow up study.

Objective To study the best titer of recombinant adeno-associated virus serotype 2 (rAAV2) delivered to myocardium by targeted ultrasound microbubbles. Methods Twenty one adult SD rats were divided into seven groups. SonoVue attached with different titer [1.5 × 109~ 3.0 × 1011 vg/ml (virus genome/ml)] of rAAV2-EGFP was infused into the tail vein of rats, following ultrasound mediated microbubbles destruction,as experiment groups. Normal saline was infused into the tail vein of rats as the control group (without rAAV2). Rats were killed after 14 days and hearts were harvested. GFP protein expression which showed rAAV2 transfer was observed under fluorescence microscope in frozen section and integrate optical density(IOD) was measured by Image Pro Plus software. Results When the titer of rAAV2 was 1.5 × 1011 vg/ml infused into the tail vein of rats there was much more GFP expression in myocardium than lower titers (P <0.01). Conclusions The best titer of rAAV2 delivered to myocardium by targeted ultrasound microbubbles is 1.5 × 1011 vg/ml in the tail vein infusion of rats.

Objective To assess the value of the myocardial segment number of color change in the bull's eyes of three-dimensional speckle tracking echocardiography (3D-STE)in the detection of multi-vessel coronary stenosis at the resting state.Methods A total of 125 consecutive patients were enrolled and divided into the following three groups according to the coronary angiography(CAG):multi-vessel coronary stenosis group (n=48),single-vessel stenosis group(n =34)and control group (n =43).All patients underwent two-dimensional (2D)and three-dimensional echocardiography (3D)and three-dimensional speckle tracking echocardiography (STE).The bull's eyes of left ventricular 17 myocardial segments including longitudinal strain(LS),circumferential strain (CS),area strain(AS)and radial strain(RS)were acquired by 3D-STE.The homogeneous colors were regarded as normal wall motion myocardial segment (LS,CS,AS is a uniform red,RS for uniform blue ),the colors were uneven or shallower,or changes were regarded as abnormal wall motion myocardial segment.The myocardial segment number of color change in the bull's eyes can be calculated.Receiver operating characteristic (ROC ) curves were computed to determine optimal strain cutoff values to predict multi-vessel coronary stenosis.Results The myocardial segments of abnormal wall motion in the bull's eyes (LS,CS,AS,and RS)were significantly increased compared with the control group(P <0.001).In particular,the multi-vessel coronary stenosis group were dramatically increased than the single-vessel coronary stenosis group.Meanwhile,these parameters were higher in patients with multi-vessel coronary stenosis than in those with single-vessel coronary stenosis (P <0.05).ROC analysis demonstrated areas under the curve of 0.84 for 3D GLS,0.89 for 3D GCS,0.95 for 3D GAS,and 0.89 for 3D GRS.An optimal cutoff value of magnitude,sensitivity and specificity were LS,12,89.6%,76.7%;CS,11,89.6%,74.4%;AS,12,91.7%,88.4%;RS,13,81.2%,86.0%,respectively. Conclusions The myocardial segment number of color change in the bull's eyes by 3D-STE is useful to detect multi-vessel coronary stenosis,where in GAS are more valuable indicators with higher sensitivity and specificity.

BACKGROUND:Adipose-derived stem cel s have a wide variety of sources and strong proliferation ability, which are easy to access and simple to culture. Therefore, adipose-derived stem cel s that are secondary to bone marrow mesenchymal stem cel s are expected to become the most promising seed cel s for bone tissue engineering.
OBJECTIVE:To explore the feasibility of rabbit adipose-derived stem cel s with demineralized bone matrix to repair ulna defects.
METHODS:Ulna defect model was made in rabbits. Demineralized bone matrix was implanted into the right defect region as control group. After osteogenic induction, rabbit adipose-derived stem cel s/demineralized bone matrix composite was implanted into the left defect region as experimental group. At 12 weeks after implantation, defect tissues were taken for CT scanning and histological detection.
RESULTS AND CONCLUSION:CT results showed that there was unclear boundary between the broken ends of fractured bone and the composite material in the experimental group, and paral el cal uses out of the broken end could be seen. In the control group, the broken end was clearly seen and no cal us occurred continuously. Fibers were connected at the defect site, and no new bone occurred. Histological findings showed that typical regenerated bone tissues were seen in the experimental group with osteocytes, bone lacunae and bone trabeculae;there were more osteocytes and bone lacunae, but bone trabecula was only seen in a part of bone defects;a few of col agens interlarded the regenerated bone tissues. In the control group, the residual of demineralized bone matrix was seen as wel as some col agenous fibers, and periosteal bone formed a little, but no large amount of regenerated osteoid tissues were found. These findings indicate that under osteogenic induction, rabbit adipose-derived stem cel s combined with demineralized bone matrix are feasible to repair ulna defects.

Objective To evaluate the early changes of left ventricular (LV) diastolic function in patients with diabetes mellitus (DM) by two-dimensional speckle tracking echocardiography. Methods Thirty-six patients with DM and forty-five normal subjects (NOR) were studied. The peak early (E') diastole,peak late (A') diastole of longitudinal strain rate(SrL) in 18 myocardial segments and the average peak E' and A' of SrL on base segments, mid segments, apical segments were measured on apical long-axis views respectively. The global peak E'and A' of circumferential strain rate (SrC), radial strain rate (SrR) and rotation rate (RotR) at three levers were measured on short-axis views respectively. The ratio of E' and A', untwisting rate and untwisting half-time were calculated. At the same time, LV conventional ultrasound parameters were measured. Results Compared with NOR group in SrL,E' of 15/18 segments and E'/A' of 16/18 segments were decreased in DM group,A' of 14/18 segments were increased. The E' of global SrL and SrC, E'/A' of global SrL, SrC and SrR were decreased in DM group. The A' of global SrL, SrC and SrR, E' and E'/A' of global RotR were increased. There was no significant difference in LV conventional ultrasound parameters, untwisting rate and untwisting half-time between DM and NOR groups. Conclusions The decrease of SrL and SrC, increase of RotR and disappearance of myocardial regular movement in SrL and SrR are the early changes of diastolic dysfunction in patients with DM.

Objective To investigate the effect of lidocaine on plasma S100β protein in patients with supratentorial tumor surgery.Methods Thirty patients with supratentorial tumor surgery were selected,ASA grade Ⅰ-Ⅱ grade.The patients were divided into lidocaine group and control group by random digits table with 15 cases each.In lidocaine group,a dose of 2％ lidocaine was administered as an intravenous bolus (1.5 mg/kg) after induction,followed by an intravenous infusion at rate of 2 mg/ (kg ·h) until the end of surgery.In control group,0.9％ sodium chloride was given in the same volume and the same rate.Bloods were sampled from bulb of jugular vein to measure the plasma S100β protein before surgery,end of surgery and 1 day after surgery.Results The plasma S100 β protein before surgery,end of surgery and 1 day after surgery in lidocaine group were (21.03 ± 11.67),(32.63 ± 10.14) and (34.16 ± 17.59) ng/L,in control group were (23.04 ± 13.32),(44.98 ± 16.63) and (39.85 ± 21.99) ng/L.There were no statistical differences in the plasma S100 β protein before surgery and 1 day after surgery between the 2 groups (P ＞ 0.05),but there was statistical difference end of surgery between the 2 groups (P ＜ 0.05).Conclusion Intraoperative infusion of lidocaine can decrease the plasma S100β protein end of supratentorial tumor surgery.

Objective To investigate the effects of acupuncture on the improvement of esophageal motility disorder in patients with refractory gastroesophageal reflux disease (GERD).Methods From September 2012 to March 2014,40 patients with refractory GERD were enrolled and evenly divided into the treatment group and the control group. High resolution esophageal impedance manometry was conducted in patients.After the first examination,patients of the control group lay down for 30 minutes, and patients of the treatment group received acupuncture treatment at Neiguan,Gongsun and Zusanli points for 30 minutes.Then all the patients underwent high resolution esophageal impedance manometry again.ManoView ESO 3.0 software was used for analysis.The parameters included swallowing peristalsis defect,lower esophageal sphincter (LES)pressure,LES residual pressure,LES length,upper esophageal sphincter (UES)pressure,distal wave amplitude,peristalsis duration time,starting speed of peristalsis wave,speed of edge contraction and integration of the peristaltic waves.Chi-square test or t test was performed for data analysis.Results The percentage of normal swallows of the treatment group before and after treatment was 56.0% (112/200)and 74.0% (148/200),the percentage of delayed esophageal emptying was 31 .5 % (63/200 )and 11 .5 % (23/200 ),and the differences were statistically significant (χ2 =14.242 and 23.700,both P <0.01 ).However there was no significant difference in those of the control group (both P > 0.05 ).The LES resting pressure of the treatment group before and after treatment was (20.2 ±18.8)mmHg (1 mmHg=0.133 kPa)and (26.3±10.1)mmHg,the length of LES was (2.2 ±0.6 )cm and (3.3 ±0.8)cm,the distal esophageal peristaltic amplitude was (60.2 ± 21 .9)mmHg and (41 .1 ± 16.8 )mmHg,and the differences were statistically significant (t = 5 .519, 6.580 and 6.881 ,all P <0.01 ).There was no significant difference in LES residual pressure before and after treatment (P >0.05 ).There as no significant difference in LES resting pressure and LES residual pressure of the control group before and after lying down (both P >0.05 ).However,before and after lying down,there were significant differences in the length of LES ((2.3 ±0.6)cm vs (2.5 ±0.6)cm) and UES resting pressure ((67.4 ±21 .2 )mmHg vs (53.5 ±18.1 )mmHg)in the control group (t =2.530 and 6.652,both P <0.05 ).The distal wave amplitude of the treatment group before and after treatment was (73.7 ±28.3)mmHg and (88.5 ±29.1 )mmHg,the duration of peristalsis was (2.9 ± 0.4)s and (3.2 ± 0.4 )s,the distal contraction integral was (977.7 ± 733.2 )mmHg · cm · s and (1 225 .9±945 .1)mmHg·cm·s.All the differences were statistically significant (t=7.907,3.404 and 3.325 ,all P <0.01).There were no statistically significant difference in the beginning speed of peristaltic wave and the contractile front velocity (CFV)(all P >0.05).Before and after lying down,there was no significant difference in distal wave amplitude,duration of peristalsis,the beginning speed of the peristaltic wave and CFV of the control group (all P >0.05 ).Conclusion Acupuncture can help increase the LES resting pressure,extend the length of LES,improve the overall peristaltic pressure and completeness of esophageal somatic part,meanwhile,it increases the percentage of normal swallows of patients with refractory GERD.

Objective:To analyze the level and related factors of burden of care,quality of life in family members of patients with schizophrenia.Methods:Totally 312 family members of patients with schizophrenia in 5 blocks of Jing'an District,Shanghai,who consented the investigation,were investigated.Burden of care were evaluated with the Zarit Caregiver Burden Interview (ZBI),and quality of life of the relatives by World Health Organization Quality of Life BREF (WHOQOL-BREF) and Chinese Residents SWB abridged (SWBS-CC20).ZBI score equal or higher than 39 indicated a heavy burden of care,while the score less than 39 indicated a low burden of care.Results:Totally 199 cases (63.8％) were in a heavy burden,whose ZBI score was (52.1 ± 10.8),and 113 cases (36.2％) were in a low burden with a mean score of (23.1 ± 10.4).Their WHOQOL-BREF score and SWBS-CC20 score were lower than normal model (Ps ＜ 0.001).The burden was heavy to those whose spouse was involved (β =-7.76).Patient's age was negatively correlated with quality of life (β3 =-0.18).Relationship with the patient,education level and monthly family income were positively correlated with quality of life (β =1.65,1.68,1.66).Conclusion:Those families of patients with schizophrenia,who are aged,low educated,low paid,or whose spouse have been diagnosed with schizophrenia,may have a heavy burden of care,and low quality of life.

Objective To investigate the relationship between the content of stromal cell-derived factor-1 (SDF-1) in myocardium in different period of myocardial infarction and left ventricular function.Methods Twenty three Chinese miniature pigs were randomly divided into the experimental group and the control group.The swines in experimental group were prepared as acute myocardial infarction model by ligating anterior descending coronary artery and were randomly divided into 6 subgroups according to the different time points after infarction.The left ventricular end-diastolic diameter (LVDd),left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were measured respectively.Global circumferential strain (GCS) and global radial strain (GRS) of left ventricle were measured.The content of SDF-1 were also measured by real-time quantitative PCR.Results Compared with the control group,SDF-1 levels were significantly elevated,and LVEF,LVFS,GCS and GRS were reduced.However,LVDd were significantly increased.The content of SDF-1 and GCS has a negative correlation (r =-0.580,P =0.000).Conclusions The content of SDF-1 in myocardial tissue have a certain relationship with GCS of left ventricular myocardium.

Objective: To observe the effect of preoperative effect on peri-operative pain in patients following a thoracotomy. Methods: 120 cases following lung-cancer thoracotomy were randomly allocated into four groups, 30 in each group. Cases in group A and B were treated with acupuncture analgesia 3 d before operation; cases in group A and C were treated with acupuncture analgesia after operation; and cases in group D were treated with general anesthesia. The pain management indexes in four groups were all controlled below 3. After that, analgesia-related β-endorphin and stress-related cortisol were observed before and after operation. In addition, the specific doses of postoperative analgesic-Fentanyl in four groups were compared. Results: The comparison of β-endorphin between group A, C and D showed P<0.05 one day before operation, so did group B, C and D 1 day before operation. The intra-group comparison of cortisol between the day of admission and 1 day after extubation and between 1 day before operation and one day after extubation in group A, B and D showed P<0.05, so did group C between the day of admission and 1 day after extubation. In addition, the contents of Fentanyl in postoperative analgesic pump in four groups showed P<0.05 through one-factor analysis of variance, showing a significant difference. Conclusion: Preemptive analgesia could increase the β-endorphin in patients following a thoracotomy and showed remarkable advantage when compared with the conventional postoperative analgesia. It did not cause significant difference regarding stress index cortisol. Acupuncture has no remarkable advantage when compared with operation and extubation for the major immediate stress. Additionally, postoperative acupuncture could be a substitute for the dose of pain killers and the match can be reduced by 20%.