Objective To investigate the hemodynamic characteristics of superior thyroid artery and its corresponding clinical significance with patients of Graves'hyperthyroidism.Methods Thirty patients with Graves'hyperthyroidism received Doppler ultrasonography.Patients were grouped with different serologic indices at 4 month after radioiodine therapy as relief(R),uncured(U)and hypothyroidism(H).The relationships between thyroid volume(V),superior thyroid artery peak systolic velocity(PSV),end diastolic velocity(EDV),RI,PI and systolic accelerating time(SAT)and the 4-month outcome were analyzed respectively.Results Besides the effect of 24 h-131I uptake rate on patients'short-term outcome,V,PSV and RI were of predominate prognosis value(P＜0.01).PSV and V of group R were positively correlated with 131I dose respectively(r1=0.825,r2=0.697;P＜0.001),while SAT of group R was negatively correlated with 131I dose(r=-0.489,P＜0.05).Conclusions Patients with high V,PSV and RI maybe still suffering hyperthyroidism after regular dosage of 131I therapy.Doses of 131I should be added appropriately for patients with high PSV and V,but short SAT to achieve complete remission,while it should be reduced for patients in opposite condition to avoid occurrence of hypothyroidism.

The combination of medical humanistic spirit and medical scientific spirit is the sign of the maturity of medicine.The modern medical mode of ' biology-psychology-society-environment' sets new requirements for medical humanistic education.Clinic medical postgraduates,the front -line medical workers,play a very important role in medical work,but they show huge deficiency in interpersonal communication,humanistic knowledge and humanistic possession nowadays.The paper tried to draw some lessons from the successful education mode of George Washington university and discussed practicable methods to improve humanistic education among medical postgraduates aiming at cultivating qualified medical workers who have both noble medical ethics and perfect medical technology and ability.

Objective To evaluate left ventricular regional systolic myocardial function quantitatively before and after coronary artery bypass graft(CABG) in patients with coronary artery disease(CAD) by strain rate imaging(SRI),and determine the effect of CABG.The diagnostic value of two-dimensional echocardiography(2-DE) method and SRI parameter method was compared.Methods The values of systolic strain rate(SRs) at 9 segments supplied by left anteior descending were measured in study group(20 patients with CAD) at 1 d before and 10 d,1 month,3 months and 6 months after CABG.The regional myocardial function befose CABG was analyzed and compared with that of controls,and abnormal segments were found.Then the values of these abnormal segments before and after CABG were compared.Results In control group,SRs displayed a wide and negative peak and was homogeneous in every segments.The SRs peak values decreased,and the homogeneity disappeared in study group.Beginning from 1 month after CABG,the SRs peak values at the graft segments increased in varying degrees,and there was significant difference at basal segments of anterior wall,middle segments of anteroseptal,and middle segments of posteroseptal in the different periods(P

Objective To assess the value of high-frequency color Doppler ultrasound technique combined with hemorheology in detecting early atherosclerosis and monitoring its progression.Methods Twenty-four white big ear rabbits were divided into two groups randomly.Group A (6 rabbits) was fed normal rabbit chow,while group B (18 rabbits) was fed high cholesterol diet and was divided into three subgroups: B1(6 rabbits) with high cholesterol diet for 4 weeks,B2(6 rabbits) for 8 weeks,B3(6 rabbits) for 12 weeks.Intima-media thickness (IMT),diameter of common carotid artery and hemorheology index were observed dynamically and compared with the findings of histological examination.Results IMT of common carotid artery increased gradually in group B at different phases of atherosclerosis.Diameter compensationally enlarged at the early stage,and then stenosed with the progression of atherosclerosis.RBC deformation index of group B began reducing in the second week,but blood viscosity,plasma viscosity,RBC aggregation index and rigidity index gradually increased from the fourth week( P

Objective To evaluate the value of dual‐Doppler imaging technology (referred to as dual‐Doppler modality for short) in assessing left ventricular diastolic function in patients with atrial fibrillation (AF) and normal left ventricular ejection fraction (LVEF) .Methods A total of 40 patients with AF and normal LVEF were enrolled as the AF group ,and 40 healthy volunteers were composed of the control group .①Peak early diastolic transmitral flow velocity (E) and tissue Doppler lateral (L ) mitral annular early diastolic velocity (e′) were measured simultaneously in the particular cardiac cycle by dual‐Doppler modality .②Peak early diastolic transmitral flow velocity (E) and tissue Doppler septal (S) mitral annular early diastolic velocity (e′) were measured simultaneously in the particular cardiac cycle .③ Peak early diastolic transmitral flow velocity (E) and color M‐mode Doppler flow propagation velocity (Vp) were measured simultaneously in the particular cardiac cycle .Then E/e′(L) ,E/e′(S) and E/Vp were calculated , respectively .Results Compared to the control group ,E/e′(L) ,E/e′(S)and E/Vp were all higher in AF group ( P <0 0.5) .Bland‐Altman showed that E/e′(L) ,E/e′(S)and E/Vp measured by the dual‐Doppler modality had better reproducibility and higher intraclass correlation coefficient (ICC) than the conventional Doppler modality .Conclusions The dual‐Doppler modality is valuable for evaluating left ventricular diastolic function in patients with AF and has better reproducibility and more accurate results than the conventional Doppler modality .

Objective To investigate the clinical significance of atrial septal aneurysm(ASA)and the value of echocardiography in detecting ASA. Methods One hundred and fifty-one patients with ASA diagnosed by transthoracic echocardiography(TTE) or transesophageal echocardiography(TEE) were analyzed retrospectively.The patients were divided into two groups:group Ⅰ included 57 patients who had experience of transient ischaemic attack(TIA)or cerebral shock and group Ⅱ included 94 age-and sexmatched patients without those cerebral ischemic event who underwent echocardiography during the same period of time. The following parameters of the ASA were measured:maximal excursion or protrusionbeyond the plane of the atrial septum,direction of protrusion,thickness of the wall,presence of theombi attaching to the wall and other structural abnormalities associated with ASA. Results One hundred and thirty-two of 151 cases(87.42%) located at fossa ovalis of atrial septum. The wall thickness of ASA increased with depth.The extent of bulging and thinkness of wall in group Ⅰ were greater than those in group Ⅱ and more patent foramen ovale(PFO)were observed in group Ⅰ. However,no difference was found in direction of protrusion and incidence of oscillations between the two groups. As to the performance of the two techniques in the evaluation of ASA,TEE showed better result than TTE. Conclusions Echocardiography is a reliable means to detect ASA and its complications. Greater maximal excursion and thicker aneurysm wall of ASA is associated with a higher risk of cerebral ischaemic event.

ObjectiveTo evaluate regional and global systolic function of left ventricle (LV) after mitral valve replacement(MVR) of different methods by 2-dimensional strain (2DS).MethodsAccording to the operational method whether preserve the posterior leaflet and its subvalvular apparatus,48 patients who underwent MVR were divided into two groups,the preservation group (group A) and the resection group (group B).Echocardiography was examinated before and after MVR and the apical four-chamber view,two-chamber view and long-axis view of LV were acquired.Regional peak strain (Sp) and global strain (GS) of LV longitudinal movement were analysed by 2DS software.Results①Compared to preoperation,the Sp in basal segment of posterior septum and inferior wall and middle segment of lateral wall in group A increased significantly ( P ＜0.01 or P ＜0.05).The Sp of group B were improved in both basal and middle segments of posterior septum ( P ＜0.05),while declined in middle segment of lateral wall and anterior wall,basal segment of lateral wall and apical segment of anterior wall significantly (P ＜0.01 or P ＜0.05).②Compared with group A,subtractions between preoperative and postoperative Sp of group B decreased in middle segment and apical segment of anterior wall,middle segment of lateral wall and middle segment of inferior wall significantly ( P ＜0.01 or P ＜0.05).③The GS of group A increased significantly ( P ＜0.05),while that in group B tended to reduce with no statistical significance ( P ＞0.05).Compared with group A,subtractions between preoperative and postoperative GS of group B droped significantly (P ＜ 0.05).ConclusionsAppropriate preservation of the posterior leaflet and its subvalvular apparatus has morebeneficial effect in improving the early regional and global function of LV after surgery,which would be recommended in MVR.Early regional and global systolic function of LV after MVR could be accurately evaluated by 2DS relatively,which has the application value of guiding clinical treatment and estimating prognosis.

Objective To evaluate the changes of ventricular synchrony in patients with acute myocardial infarction(AMI)before and after percutaneous coronary intervention(PCI)by speckle tracking imaging(STI).Methods Thirty patients with AMI were examined by traditional echocardiography and STI before and 5 d,1 month after PCI.Myocardial imaging of left ventricular apical long views and parasternal left ventricular short axis views were recorded and stored.The time to peak longitudinal systolic and diastolic strain rate(TS-SRL,TE-SRL)and to peak radial systolic and diastolic strain rate(TS-SRR,TESRR)were measured respectively.The differences of the maximum and minimum systolic and early diastolic peak time(TSL-diff,TER-diff)and the standard deviation(TSL-SD,TER-SD)in 18 longitudinal segments were calculated.And the differences and standard deviation of TS-SRR and TE-SRR(TSR-diff,TSR-SD,TER-diff,TER-SD)were calculated also.These parameters were compared before and after PCI.Results Compared with before and 5 d after PCI,the values of TSL-diff,TSL-SD,TEL-diff and TEL-SD in 1 month after PCI were decreased significantly(P＜0.01).TSR-diff,TSR-SD,TER-diff and TER-SD were decreased also and the differences had statistical significance(P＜0.01).The cardiac synchronized index and LVEF values showed good negative correlation.Conclusions The systolic and diastolic synchrony of left ventricle in AMI patients was abnormal.STI can evaluate left ventricular synchronized function and the changes before and after PCI to assess the effect of PCI.

Objective To investigate the value of contrast-enhanced ultrasound (CEUS) in evaluation of the protective effect of edaravone injection in rabbit skeletal muscle ischemia-reperfusion injury.Methods Thirty healthy New Zealand white rabbits were established a model of skeletal muscle ischemia-reperfusion injury in left hind limb and randomly divided into the experimental group and control group.Edaravone was injected with the dose of 1.5 mg/kg at the time of 30 minutes before reperfusion in the experimental group,the control group were given an equal volume of physiological saline.Blood samples were collected respectively at the times of pre-ischemia,post-ischemia and 24 hours after reperfusion for detecting creatine kinase(CK),lactic dehydrogenase(LDH),and CEUS parameters such as peak intensity(PI),time to peak (TTP) and area under the curve(AUC) were measured at the same time.Pathological examination was carried out after the rabbits were sacrificed.Results ①Serological tests:compared to before the blocking of blood supply,the content of CK and LDH after the blocking were significantly increased (P ＜ 0.01);compared to before or after the blocking,the content of CK and LDH at the time of 24 hours after reperfusion in the two groups were increased,and was lower in the experimental group than the control group.(②CEUS:compared to before the blocking,PI,TTP and AUC in each group were significantly increased after the blocking and at the time of 24 hours after reperfusion(P ＜0.01);compared to those in the control group,PI and AUC in the experimental group were decreased at the time of 24 hours after reperfusion,but there was no significant difference in TTP(P ＞0.05).③Correlation analysis:there was a good correlation between PI,AUC and CK,LDH (r =0.87,0.81,0.86,and 0.80,respectively).④Pathological analysis:muscle fibers were swelling with no stripes,partial fractures and interstitial edema and a large amount of inflammatory cells were infiltrated in the control group,while muscle fibers were almost normal with a small amount of inflammatory cells infiltrated in the experimental group.Conclusions Edaravone injection before reperfusion can obviously improve rabbit skeletal muscle ischemia-reperfusion injury,and CEUS can be used to observe these changes directly and effectively.

Objective To assess the clinical application value of vector flow mapping (VFM) in evaluating the left ventricular diastolic function in hypertensive patients with different left ventricular geometric patterns.Methods One hundred and sixty-nine patients with hypertension and 50 healthy volunteers were enrolled.Hypertensive patients were divided into four groups with different ventricular configurations according to ASE guide line in 2005:normal geometry group,concentric remodeling group,concentric hypertrophy group and eccentric hypertrophy group.The quantitative parameters,including average energy loss(aEL) and circulation were measured.Difference was evaluated among five groups at apical,mid and basal segments and at different periods.The correlationship was analyzed between aEL,circulation and E/e',respectively.Results ① Compared to control group,aEL was higher in four hypertension groups at three segments of atrial systole(P ＜0.05).aEL in eccentric hypertrophy group was higher than those in control group,normal geometry group or concentric remodeling group at apical and mid segments of atrial systole,and higher than those in other hypertensive groups at basal segment (P ＜ 0.05).In four hypertension groups,circulations in rapid filling phase of anterior mitral valve were lower than that in control group,but circulations in slow filling phase of posterior mitral valve were higher than that in control group(P ＜0.05).The circulation in slow filling phase of posterior mitral valve in concentric remodeling group was higher than that in normal geometry group,and that in eccentric hypertrophy group was higher than those in normal geometry group and concentric remodeling group(P ＜0.05).②When intra-group comparison,aEL were different in different segments of same phase or at different phases of same segment(P ＜0.05).③aEL had a good correlation with E/e'at basal segment of atrial systole in four hypertension groups(r =0.66,P ＜0.01).Conclusions VFM can be utilized to analyze left ventricular hemodynamics features of hypertensive patients with different left ventricular geometric patterns,it may be a good supplement for assessing cardiac diastolic function and reflect the extent of damage.