Objective To observe the efficacy of laparoscopic surgery combined with sodium hyaluronate in the treatment of adhesive intestinal obstruction and its influence on disease-related indexes.Methods 180 cases of patients with adhesive ileus from September 2010 to April 2014 were selected and randomly divided into control group and observation group two groups, 90 cases in each group.The control group was treated with laparotomy and the observation group was treated by laparoscopic surgery combined with sodium hyaluronate.Then the operation related indexes such as operation time, intraoperative bleeding volume, postoperative gastrointestinal function recovery time, hospitalization time and complications of two groups were compared.And the serum levels of gastrointestinal hormone such as GAS, MTL, CCK and SS and inflammatory cytokines such as hs-CRP, IL-2, IL-6, IL-10 and TNF-αof two groups before and after treatment were detected and compared.Results The intraoperative bleeding volume of observation group was less than control group, postoperative gastrointestinal function recovery time and hospitalization time were shorter than control group, the incidence of complications was lower than control group, the difference was statistically significant (P <0.05).1, 4 weeks postoperative, the serum levels of gastrointestinal hormone such as GAS, MTL and SS of observation group were higher than control group, while the CCK was lower than control group, the difference was statistically significant (P<0.05).1, 4 weeks postoperative, the serum levels of inflammatory cytokines such as hs-CRP, IL-2, IL-6 and TNF-αof observation group were lower than control group, the difference was statistically significant (P<0.05).Conclusion Compared with the traditional laparotomy, laparoscopy combined with sodium hyaluronate has the advantages of small effect on patients with digestive function and postoperative inflammatory reaction, thus helps to shorten the recovery time of patients after surgery and inhibition the occurrence of complications such as recurrent intestinal obstruction.

Pediatric hypertrophic cardiomyopathy (PHCM)is a heterogeneous heart muscle disorder which is characterized by unexplained ventricular hypertrophy.Successful determination of a specific diagnosis is likely to have significant impact on management and survival because of the differences in etiology-specific sur-vival.This review provides an overview of PHCM with a focus on its etiology and their heart features.

Objective To compare the degree of trauma, postoperative pain, and cosmetic outcomes of endoscopic-assisted thyroidectomy (EAT), transthoracic endoscopic thyroidectomy (TET), and conventional thyroidectomy (CT), and to explore the characteristics of EAT and TET. Methods Forty-five patients with thyroid nodules were divided into three groups (n=15 in each) to underwent EAT, TET, or CT. The plasma levels of C-reactive protein(CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-?), and T-lymphocyte subgroups (CD3, CD4+, CD8+, and CD4+/CD8+) were determined before and 24 and 72 hours after the operations. The degree of operative trauma was compared after the operation. Postoperative pain and cosmetic outcomes were evaluated by visual analogue score (VAS) and 5-degree evaluation respectively. Results The VAS in the EAT group was 2.2?1.7 and 1.1?1.1 on the first and third day postoperation, which were significantly lower than those in the TET group (3.6?1.4 and 2.2?0.7, respectively; q=3.698, P0.05).Compared to preoperation, the level of CD4+/CD8+ lymphocyte in the CT group was decreased at 24 hours after the operation (q=4.076, P0.05). The levels of CRP determined at 24 and 72 hours postoperation were both significantly higher than that before the operation in the three groups (EAT group: m=21, P

Objective To evaluate the changes of the left atrial function in patients with old myocardial infarction(OMI) by strain rate imaging(SRI). Methods The velocity of the left atrial lateral wall and atrial septum was measured by SRI in 30 patients with OMI(OMI group) and 25 normal subjects (control group). Left atrium passive eject volume index(LAPEVl) and left atium active eject volume index (LAAEVI) were measured using Simpson method. Results ①Compared with the control group, the velocity of the left atrium was reduced obviously in ventricular systole and early ventricular diastole in OMI group(P<0.05) ,but was increased in late ventricular diastole(P<0.05). ②Compared with the controls, LAAEVI was increased significantly in OMI group, but LAPEVI was decreased signicantly(P <0.001). Conclusions SRI could be used to evaluate the left atrial function accurately in patiens with OMI.

Objective To explore the value of strain rate and dobutamine stress echocardiography(DSE) in the diagnosis of coronary heart disease. Methods High-dose DSE was performed in 18 patients with coronary heart disease and 10 healthy persons, proved by selected coronary angiography. Ten patients had single coronary lesion, and the other 8 patients had more. By strain rate technology, systolic peak strain rate(SR_ SYS ) was measured in 12 segments of healthy persons and ischemic segments of patients. Results SR_ SYS of healthy subjects enhanced by the increasement of dose of DSE. In patients with single coronary lesion, SR_ SYS enhanced on the first states of baseline, 10 and 20 ?g?kg -1 ?min -1 ,while SR_ SYS changed non-significantly on 30 ?g?kg -1 ?min -1 , and began to decrease on 40 ?g?kg -1 ?min -1 . However in patients with more than one coronary lesions, SR_ SYS of 10 ?g?kg -1 ?min -1 became larger than that of baseline, while SR_ SYS didn't increase any longer on 20 ?g?kg -1 ?min -1 , and fell significantly on 40 ?g?kg -1 ?min -1 . Conclusions Combining stain rate and DSE to quantify local myocardial motion is valuable to offer many important clinic messages, and improves the diagnosis of coronary heart disease.

Objective To evaluate the value of echocardiography in the diagnosis of truncus arteriosus communis(TAC)and associated intracardiac malformations. Methods We retrospectively reviewed 30 patients with TAC, their datum of clinical and echocardiographic diagnosis were studied during the period of January 2006 to May 2014 in Shengjing Hospital Affiliated to China Medical University. Results Based on Collet Edwards method, these 30 TAC patients included 10 cases of typeⅠ, 7 cases of typeⅡ, 5 cases of typeⅢ, 8 cases of typeⅣ. The most common associated intracardiac malformation was ventricular septal defect in 24 cases, 16 cases had arterial septal defect, 7 cases had patent ductus arteriosus, 6 cases had single ventricle, 3 cases had right aortic arch, etc. Among them, 8 cases were confirmed by surgery, 5 cases of typeⅠ, 3 cases of typeⅡ, and 1 case of typeⅠdied after operation;16 cases were confirmed by CT angiography (CTA) examinations, all of them died without operation within 6 months. Conclusion Echocardiography is a preferred and non-invasive method for TAC and the intracardiac malformations.

Objective To measure left atrial appendage (LAA)in patients with atrial fibrillation using Flexi Slice imaging by real time 3D transesophageal echocardiography (TEE),and compare with common multiplane TEE.Methods Forty-six patients with atrial fibrillation were performed 2D and real time 3D TEE.Zero degree,45°,90° and 135° plane were acquired by 2D TEE and Flexi Slice remolding. Maximum and minimum values of ostium of left atrial appendage were acquired in the short axis view of LAA by Flexi Slice remolding.Results Compared with 2D TEE,values acquire by Flexi Slice in measurement of LAA ostium showed no significant difference(P >0.05).The depth measurement by Flexi Slicein 45° and 90° plane showed significant difference with 2D TEE (P-values were successively 0.045, 0.002),and in 0 and 135° plane showed no difference.All values measured by 2D TEE and Flexi Slices showed significant correlation.Bland-Altman plot showed that 94.29% of plots were among limits of agreement,which was (-2.5 mm,2.9 mm).The maximum values of LAA ostium values ranged from 30° to 160°,among which 87% (40/46 cases)distributed between 90° and 1 50°,and minimum values ranged from 0°to 160°,among which 85%(39/46 cases)distributed between 0°and 60°.Conclusions Measurement of LAA can be well achieved by Flexi Slice imaging,which showed significant advantage compared with 2D TEE.

Objective To discuss the diagnostic value of two-dimensional speckle tracking imaging in the evaluation of left ventricular rotation and torsion in pre-apical hypertrophic cardiomyopathy(PAHCM)patients. Methods A total of 26 patients with PAHCM,26 patients with hyperten-sive left ventricular hypertrophy(HLVH)and 26 healthy volunteers were recruited for the study. Two-dimensional echocardiographs were performed carefully. Two-dimensional images were obtained from the left ventricular apical four-chamber section,two-chamber section and two short-axis sec-tions,including mitral valve and apical levels. The peak subendocardial rotation(endo-rot),epicardial rotation(epi-rot),transmural torsion(mural-tor)and bulk rotation(bulk-rot)of each short-axis section were measured and analyzed using QLAB 9.1 software. Results In the mitral level, there was no statistically significant difference in endo-rot,epi-rot,mural-tor and bulk-rot between the PAHCM group and normal control group (P>0.05). There was statistically significant difference in endo-rot,epi-rot,mural-tor and bulk-rot between the PAHCM group and HLVH group (all P<0.05). There was statistically significant difference in endo-rot,epi-rot,mural-tor and bulk-rot between the HLVH group and normal control group(all P<0.05). In the apical level,there was no statistically significant difference in epi-rot among three groups(P>0.05). There was statisti-cally significant difference in endo-rot,mural-tor and bulk-rot between each two groups(P<0.05). There was statistically significant difference in G-tor between each two groups(P<0.05). The receiver operating characteristic curve analysis showed that the accuracy of differential diagnosis of G-tor PAHCM was high(the area under the receiver operating characteristic curve is 0.89),the sensitivity was 73.08%,and the specificity was 92.31%. Conclusion Two-dimensional speckle tracking imaging could accurately and quantitatively measure the left ventricular rotation and tor-sion in PAHCM patients. The G-tor could accurately screen and identify between PAHCM and HLVH.

Objective To assess the left ventricular function of patients with acute myocardial infarction (AMI) treated by percutaneous coronary intervention (PCI) by speckle tracking imaging (STI).Methods 75 AMI patients who had AMI for the first time and have been treated by primary PCI were enrolled.Dynamic images were acquired before PCI,at 6 months after PCI and analyzed by STI.Dynamic images were analyzed for longitudinal peak systolic strain (LPSS),radial peak systolic strain (RPSS) and circumferential peak systolic strain (CPSS) values by STI.According to the comparison of left ventricular ejection fraction (LVEF) before PCI and 6 months after PCI,patients were divided into left ventricular function improved group (△LVEF≥5％) and not-improved group.Results Compared to non-improved group,LPSS (P ＜0.001),RPSS (P ＜0.05,P ＜0.001) and CPSS (P ＜0.001) of improved group were all higher before and 6 months after PCI.LPSS (r =-0.578,P ＜0.001) and CPSS (r =-0.817,P ＜0.001) before PCI were both closely related to △LVEF.In single parameter mode of ROC curve analysis,the area under the ROC curve (AUC) (0.867),sensitivity (94.7％) and specificity (74.4％) of CPSS are relatively higher than other STI parameters.In multiple parameters united mode of ROC curve analysis,AUC (0.897),sensitivity (94.7％) and specificity (74.4％) of LPSS,RPSS and CPSS united were the highest among all the combinations of all STI parameters.Conclusions Left ventricular function improvement of patients with AMI 6 months after PCI is accurately assessed and predicted by STI.CPSS is a strong predictor for left ventricular function improvement 6 months after PCI of AMI patients among all the STI parameters and is an effective indicator for the assessment of left ventricular function improvement of AMI patients.

Objective To assess the left ventricular dyssynchrony in coronary artery disease(CAD) without visual segmental wall motion abnormalities using strain delay index (SDI).Methods A total of 135 patients under suspicion of CAD were recruited in this study.Two-dimensional cchocardiography was performed to collect dynamic images of left ventricular apical long axis views,tow-chamber views,four chamber views and parasternal short axis mitral views,papillary views and apical views.The time to minimal systolic longitudinal,radial,circumferential strain (Tssl,Tssr and Tssc) were measured from the start point of QRS wave in electrocardiogram.The left ventricular segmental standard deviation (Tssl-SD,Tssr-SD,Tssc-SD),maximal difference (Tssl-Dif,Tssr-Dif,Tssc-Dif) and longitudinal,radial,circumferential SDI (LSDI,RSDI,CSDI) of 18 left ventricular segments were calculated.Results According to coronary angiography results,patients were divided into three groups:severe stenosis group,mild stenosis group and control group.Compared with the other two groups,SDI and Tssl-SD,Tssl-Dif were decreased in severe stenosis group (P ＜0.001 or P ＜0.05).However,there were not significant differences between the mild stenosis group and the control group except Tssr-SD.The receiver operating characteristic (ROC) curves analysis demonstrated that LSDI had the highest accuracy and Tssl-SD had the lowest accuracy for detecting severe CAD (areas under the curve were 0.891,0.797,0.666,0.580 and 0.556 respectively).High sensitivity and specificity (80.6％ and 86.7％,respectively) were shown when using-12.67％ as a cutoff point of LSDI to diagnose severe CAD.Conclusions SDI can be helpful for assessing the left ventricular dyssynchrony in patients without visual segmental wall motion abnormalities,and LSDI is the most effective parameter to detecting severe CAD.