To evaluate the value of left ventricular diastolic function in type 2 diabetes mellitus (DM) using dual-gate Doppler and relative factors, we included 50 non-obesity and hypertension-free DM patients into the controlled group in the study along with 48 age-and-gender-matched healthy volunteer subjects. The peak early diastolic velocity (E), peak later diastolic velocity (A), deceleration time (DT), anterior mitral annulus diastolic peak velocity (e') , isovolumic relaxation time (IVRT), E/A, E/e', Tei index and T(E-e), were measured with dual-gate Doppler. 20 subjects were randomly selected for repetitive analysis. Study showed statistical difference in E/A, DT, e', E/e', IVRT, Tei index and T(E-e), between the two groups (P < 0.05). Linear regression analysis showed positive correlation between T(E-e), and IVRT, course of DM patients and T(E-e), (Beta = 0.295, P = 0.020), and HbA1c control level and T(E-e), (Beta = 0.399, P = 0.010). Repeated analysis showed good reproducibility for both within and between groups. Dual-gate Doppler has clinical value in evaluating left ventricular diastolic function in type 2 diabetes mellitus patients. The course of type 2 diabetes mellitus patients and HbA(1C) control level were both closely related with left ventricular diastolic function.
Case-Control Studies ; Diabetes Mellitus, Type 2 ; physiopathology ; Diastole ; Echocardiography, Doppler ; Humans ; Hypertension ; Mitral Valve ; Regression Analysis ; Reproducibility of Results ; Ventricular Dysfunction, Left ; Ventricular Function, Left

Objective To explore the accuracy of three dimensional speckle tracking imaging (3D-STI) in quantitative coronary evaluation of (CHD) patients' left ventricular global systolic function.Methods Sixty-eight CHD patients were divided into three groups according to the coronary artery angiography (CAG) results:32 cases in severe stenosis group,23 cases in moderate stenosis group,and 13 cases in mild stenosis group.Thirty gender-age-matched healthy subjects(control group) were enrolled in this study.All patients underwent 2D-echocardiography and real-time three-dimensional echocardiography (3DE).The global longitudinal strain(GLS),global radial strain(GRS),global circumferential strain(GCS),global area strain (GAS),global area strain rate (GASrate) and 3D global LV strain (3D-Strain) were analyzed using 3D-STI.Correlation between strain measurements and left ventricular ejection fraction (LVEF) by simpson method,3D-LVEF by 3DE were assessed using linear regression analysis.Results All 3D-STI parameters in the severe stenosis group were significant decreased compared with the other groups.GLS,GRS,GCS,GAS,3D-Strain of moderate stenosis group shown more significant decrease than both mild stenosis group and control group (P ＜ 0.05).Strong correlations were demonstrated in all 3D-STI parameters between 3D-LVEF and LVEF.The strongest correlation was observed between GAS with 3D-LVEF in severe stenosis group(r =-0.910,P ＜0.05).Intraobserver and interobserver reliability of GAS was better than other parameters.Conclusions Global strain of 3D-STI can quantitatively evaluate the global LV function in CHD patients,and GAS is more sensitive and reproducible than other parameters.

Objective To evaluate the feasibility, efficacy and safety of new nano material occluder of single rivet type (left-disk with no-hub) in treating ventricular septal defect (VSD) in order to provide experimental basis for clinical application. Methods A total of 26 healthy adult dogs were selected for this study . Under thoracotomy , VSD model was established through fluoroscopically-guided percutaneous puncturing of the right ventricular free wall. The models were randomly and equally divided into the study group(n=13, using nano material VSD occluder) and the control group(n=13, using double-hub nitinol occluder). Every two dogs from each group were sacrificed each time at one, 2, and 3 months after percutaneous closure of VSD with corresponding occluder, the tissue samples were collected and sent for gross examination as well as for the optical and electronic microscopy study;the blood concentration of nickel ion was also determined. The state of endothelialization after implantation of the new type occluder was evaluated, and the complications such as residual shunt and superficial thrombus formation were recorded. The results were analyzed. Results By open chest operation with small incision and percutaneous puncturing of the right ventricular free wall, VSD model was successfully established in all 26 dogs. The success rate of the implantation of the VSD occluder in the study group was 100%, while it was 91.7% in the control group. One, 2, 3 and 6 months after the implantation, the heart specimens of 25 dogs were removed and gross examination showed that neither occluder displacement nor alloy wire fracture occurred in both groups. No thrombus formation or vegetation attached on the disk surface was observed. One month after the procedure , in the study group the bilateral disk surfaces of the occluder were covered with thin layer transparent tissue , which were proved to be composed of the fibrous tissue and endothelial cells through pathologic and electronic microscopy study. Six months after implantation, the superficial tissue of the occluder became further thickened and the occluder edge became fused with the surrounding heart tissue. Conclusion The design of the new VSD nano materials occluder, which has a left-disk with no hub, is very scientific. Compared with double-hub nitinol occluder, the new device can shorten the time of complete endothelialization and effectively occlude the VSD. Therefore, this new nano material occluder has promising prospect in clinical application.

Objective To evaluate the effect of angiotensin Ⅱ ( Ang Ⅱ ),angiotensin- (1-7) [ Ang- ( 1-7 ) ],and co-action of Ang Ⅱ and Ang-( 1-7 ) on β cell insulin signaling pathway.Methods Mouse pancreatic β cell line NIT-1 was incubated with( 1 )0,10-7,10-6,10-s,10-4 mol/L concentrations of Ang Ⅱ for 24 h ; ( 2 )0,10-7,10-6,10 -5,10-4 mol/L concentrations of Ang- ( 1-7 ) for 24 h; ( 3 ) co-administration of Ang Ⅱ and Ang- ( 1-7 ) was divided into control,10-5mol/L Ang Ⅱ,10-6mol/L Ang-( 1-7 ),10-5mol/L Ang Ⅱ + 10-6mol/L Ang-( 1-7 ) group.Tyrosine phosphorylation of insulin receptor β subunit(IR-β-Tyr) and serine phophorylation of protein kinase B(Akt-Ser) were detected by Western blot.ResultsInsulin-stimulated IR-β-Tyr and Akt-Ser phosphorylation was significantly decreased in Ang Ⅱ 10-5 and 10-4 mol/L group; no significant changes in insulin-stimulated IR-β-Tyr and Akt-Ser phosphorylation were detected between Ang-( 1-7 ) treatment groups and control; Ang-( 1-7 ) blocked the inhibitory effect of Ang Ⅱ on Akt-Ser phosphorylation,yet exerted no effect on Ang Ⅱ-induced IR-β-Tyr phosphorylation inhibition.Conclusion Ang Ⅱ significantly inhibits insulin signaling pathway in β cell; Ang-( 1-7 ) reverts the inhibitory effect of Ang Ⅱ on insulin-stimulated Akt-Ser phosphorylation in β cell.

Objective:To explore the application of 16-words formula " resection surrounding the proximal part of seminal colliculus, lateral tunnel, plane extending and bladder neck preservation" in transurethral enucleation resection of prostate with plasma rod electrode (TUERP).Methods:The clinical data of 88 patients with benign prostatic hyperplasia (BPH) admitted to our department from May 2018 to July 2019 were retrospectively analyzed. The age of patients was (67.0±8.6)years, and the volume of prostate was (51.0±27.3)ml. All patients were treated with TUERP using transurethral plasma rod electrodes according to the above 16-words formula. The perioperative clinical data and follow-up results at the 3rd month postoperation were statistically analyzed.Results:All operations were successfully completed. The operation time was (49.7±17.7)min, including gland enucleation time (16.8±6.7)min, tissue resection time (33.0±12.3)min, enucleated tissue weight (45.5±24.4)g, intraoperative blood loss (10.2±2.9)ml, postoperative continuous bladder irrigation time (1.9±0.8)d, postoperative hospital stay (4.1±0.7)d. There were no significant changes in hemoglobin and sodium concentration at 2 hours after operation ( P>0.05). The International Prostate Symptom Score (IPSS), quality of life score (QOL), maximum urinary flow rate (MFR) and residual bladder urine were significantly improved at 3 months after operation ( P<0.05). The patients were followed up for 3 to 14 months (average 6.8 months). There were 6 cases of Clavien grade Ⅰ complications, 1 case of Clavien Ⅱ complications, 1 case of Clavien Ⅲ complications, and no Clavien Ⅳ-Ⅴ complications occurred. Conclusions:The TUERP with plasma rod electrode according to the 16-words formula is an ideal choice for BPH treatment, which has the advantages of simple operating, high efficiency of enucleation, less blood loss, fast recovery and satisfied improvement of urination symptom.

OBJECTIVE: To explore the association between the blood oxygenation T₂* values of resectable esophageal squamous cell carcinomas (ESCCs) and tumor stages. MATERIALS AND METHODS: This study included 48 ESCC patients and 20 healthy participants who had undergone esophageal T₂*-weighted imaging to obtain T₂* values of the tumors and normal esophagi. ESCC patients underwent surgical resections less than one week after imaging. Statistical analyses were performed to identify the association between T₂* values of ESCCs and tumor stages. RESULTS: One-way ANOVA and Student-Newman-Keuls tests revealed that the T₂* value could differentiate stage T1 ESCCs (17.7 ± 3.3 ms) from stage T2 and T3 tumors (24.6 ± 2.7 ms and 27.8 ± 5.6 ms, respectively; all p(s) < 0.001). Receiver operating curve (ROC) analysis showed the suitable cutoff T₂* value of 21.3 ms for either differentiation. The former statistical tests demonstrated that the T₂* value could not differentiate between stages T2 and T3 (24.6 ± 2.7 ms vs. 27.8 ± 5.6 ms, respectively, p > 0.05) or between N stages (N1 vs. N2 vs. N3: 24.7 ± 6.9 ms vs. 25.4 ± 4.5 ms vs. 26.8 ± 3.9 ms, respectively; all p(s) > 0.05). The former tests illustrated that the T₂* value could differentiate anatomic stages I and II (18.8 ± 4.8 ms and 26.9 ± 5.9 ms, respectively) or stages I and III (27.3 ± 3.6 ms). ROC analysis depicted the same cutoff T₂* value of 21.3 ms for either differentiation. In addition, the Student's t test revealed that the T₂* value could determine grouped T stages (T0 vs. T1–3: 17.0 ± 2.9 ms vs. 25.2 ± 6.2 ms; T0–1 vs. T2–3: 17.3 ± 3.0 ms vs. 27.1 ± 5.3 ms; and T0–2 vs. T3: 18.8 ± 4.2 ms vs. 27.8 ± 5.6 ms, all p(s) < 0.001). ROC analysis indicated that the T₂* value could detect ESCCs (cutoff, 20 ms), and discriminate between stages T0–1 and T2–3 (cutoff, 21.3 ms) and between T0–2 and T3 (cutoff, 20.4 ms). CONCLUSION: The T₂* value can be an additional quantitative indicator for detecting ESCC except for stage T1 cancer, and can preoperatively discriminate between some T stages and between anatomic stages of this tumor.
Carcinoma, Squamous Cell* ; Epithelial Cells* ; Esophagus ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging* ; Oxygen* ; ROC Curve

Cancer is one of the malignant diseases threatening human. In recent years, nanotechnology is becoming the hope the cancer treatment, as it can take the drugs targeting to tumor sites, with enhanced efficacy and reduced toxicity. Chitosan is the only alkaline polysaccharide in nature with good biocompatibility and biodegradability. Moreover, chitosan has many reaction sites to make derivatives with different properties. Chitosan and its derivatives are widely used for drug delivery systems and tissue engineering scaffolds. Hence, they are valuable in the field of biomedicine. In this paper, the recent advances chitosan nanoparticles as drug delivery system for delivering anticancer drugs are reviewed, especially the advances of the preparation, passive targeting, active targeting, and stimuli-responsive drug delivery systems of chitosan nanoparticles.

Liver regeneration is an important response after liver injury and necrosis to maintain liver volume and function, with the involvement of various factors and signaling pathways. This process has three main stages, i.e., the initial stage of mitosis triggered by certain factors, the proliferation stage of promoting hepatocytes to enter the cell cycle, and the termination stage of promoting liver cells to reach a certain number and the recovery of liver mass. This article introduces various factors and multiple cellular signaling pathways that promote the differentiation of liver stem cells into liver cells to restore liver volume and function and summarizes the previous research findings of our group that alpha-fetoprotein is an important serum marker for liver regeneration after liver failure. The analysis shows that in-depth studies of the occurrence and clinical application of liver regeneration will help to improve the understanding of liver regeneration, better predict the prognosis of acute and chronic liver diseases, and provide new ideas and methods for the clinical diagnosis and treatment of various advanced liver diseases.

Objective To investigate the difference in blood lipid parameters between acute-on-chronic pre-liver failure (pre-ACLF) and acute-on-chronic liver failure (ACLF) and the risk factors for disease progression. Methods A retrospective analysis was performed for the related data of 118 patients with ACLF (ACLF group) and 44 patients with pre-ACLF (pre-ACLF group) who were treated in The General Hospital of Western Theater Command from January 2012 to December 2020, including baseline age, albumin, creatinine, routine blood test results, and blood lipids. The independent samples t -test was used for comparison between normally distributed continuous data; and the Mann-Whitney U test was used for comparison between non-normally distributed continuous data; the chi-square test was used for comparison of categorical data between groups. A binary logistic regression analysis was used for multivariate analysis to identify independent predictive factors. The receiver operating characteristic (ROC) curve was used to compare the sensitivity and specificity of related indicators, and Youden index was used to calculate cut-off values. Results Compared with the pre-ACLF group, the ACLF group had significantly lower levels of total cholesterol (TC)[2.02(1.56-2.37) mmol/L vs 3.01(2.57-3.66) mmol/L, Z =5.411, P < 0.001], high-density lipoprotein [0.40(0.25-0.49) mmol/L vs 0.62(0.47-0.75) mmol/L, Z =4.781, P < 0.001], and low-density lipoprotein (LDL) [1.52(1.22-1.84) mmol/L vs 1.93(1.49-2.36) mmol/L, Z =3.146, P =0.002] and significantly higher levels of total bilirubin [352.13(284.32-451.19) μmol/L vs 135.80(112.80-154.68) μmol/L, Z =-9.775, P < 0.001], international normalized ratio [1.96(1.71-2.51) vs 1.39(1.33-1.44), Z =-9.776, P < 0.001], white blood cell count (WBC) [6.74(5.07-9.19)×10 9 /L vs 5.04(4.13-7.09)×10 9 /L, Z =-3.985, P < 0.001], and neutrophils [4.67(3.40-7.06)×10 9 /L vs 3.30(2.72-5.01)×10 9 /L, Z =-3.676, P < 0.001], while there were no significant differences between the two groups in age, creatinine, albumin, alanine aminotransferase, aspartate aminotransferase, and triglyceride (all P > 0.05). The logistic regression analysis showed that TC (odds ratio [ OR ]=0.003, 95% confidence interval [ CI ]: 0.000-0.068, P < 0.05), LDL ( OR =61.901, 95% CI : 3.354-1142.558, P < 0.05), and WBC ( OR =3.175, 95% CI : 1.097-9.185, P < 0.05) had an independent predictive value, and the ROC analysis showed that the area under the ROC curve of TC was 0.852, the sensitivity of LDL was 0.887, and TC had the best specificity of TC was 0.840. Conclusion There are reductions in blood lipid parameters in the progression from pre-ACLF to ACLF, suggesting that clinicians should pay attention to the changes in lipids in the pre-ACLF stage and adjust the nutritional regimen in a timely manner.