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 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 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 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 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 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 assess the left ventricular systolic function after renal sympathetic denervation(RSD) in beagles with heart failure by layer-specific two-dimensional speckle tracking imaging.Methods Twenty-three beagles were randomly divided into control group (8 dogs),URSD group (8 dogs)and RSD group (7 dogs).Control group was implanted with pacemakers without pacing,URSD group was implanted with pacemakers and underwent 3 weeks of rapid right ventricular pacing,and RSD group underwent catheter-based RSD bilaterally and was simultaneously implanted with pacemakers.All standard measurements were obtained from the left ventricular short-axis views at the levels of mitral annulus,papillary muscle and apex,and apical four-chamber,two-chamber,and long-axis views.The peak systolic longitudinal strain and circumferential strain of each layer of the left ventricle were measured by layerspecific two-dimensional speckle tracking imaging.Results After 3 weeks,all of the dogs in both the URSD and RSD groups showed lower left ventricular diastolic and systolic function compared with those in the control group,however,the dogs in the RSD group had a higher LV ejection fraction (LVEF) than the dogs in the URSD group(P ＜ 0.05).Compared with the control group,the global longitudinal strain,circumferential strain and radial strain all decreased significantly in URSD and RSD groups.The longitudinal strain of endo-and mid-cardium and the circumferential strain in endo-cardium were significantly higher in RSD group than those in URSD group(P ＜0.05).Conclusions Myocardial systolicfunction is impaired in dogs with heart failure,layer-specific two-dimensional speckle tracking imaging can provide effective tools to assess the left ventricular systolic function.Renal sympathetic denervation can improve the myocardial systolic function in dogs with heart failure.

Objective To evaluate left atrial function in patients with ischemic cardiomyopathy(ICM)and dilated cardiomyopathy(DCM)by two dimensional-speckle tracking imaging(2D-STI).Methods Twenty-two patients with ICM,twenty-six with DCM and thirty-two healthy subjects were studied.The maximum volume(LAVmax),minimum volume(LAVmin)and volume before the systole(LAVp)of left atria were acquired using biplane area-length method,and calculated the total emptying volume(LATV),expansion index(AEI),active emptying volume(LAEV)and fraction(LAEF)of left atria.The strain and strain rate during systole and late of diastole(Ss,SRs,Sa and SRa)were measured at each left atrial wall (septal,lateral,anterior and inferior).The average of them were worked out.The correlation of left atrial function and strain rate were analysed.Results ①No significant differences were found at the age,sex,heart rate and the E wave between the mitral leaflet tips during all the groups.Compared with the control group,the peak of A wave,the deceleration time of E wave and LVEF decreased in ICM and DCM groups,while the LAD,LVEDD and E/A increased significantly in the two groups(P＜0.05).There were no significant differences between ICM and DCM.②Compared with the controls,the LAVmax increased,AEI and LAEF decreased significantly in patients with ICM and DCM,even lower in DCM(p＜0.05).③Compared with the controls,the Ss,SRs,Sa and SRa reduced significantly in patients with ICM and DCM(P＜0.05),and the DCM showed much significant differences than ICM(P＜0.05).④The AEI had a positive correlation with SRs(r =0.765,P＜0.01).The LAEF had a significant correlation with SRa(r =0.830,P＜0.01).Conclusions The accumulation during systole and active emptying function during late of diastole are both lower in ICM and DCM,even worse in the latter.The 2D-STI may paly an important role in the evaluation of left atrial function.