To explore the clinical and imaging profiles of left ventricular (LV) diverticulum in adults and review the key points for its differential diagnosis.The clinical and imaging features were reviewed for 2 female and 2 male patients clinically diagnosed with LV diverticulum.Their clinical manifestations and electrocardio graphic presentations were nonspecific.On echocardiography,all diverticula,located at LV apex,had a thinned and weakened wall continuing and contracting synchronously with the adjacent LV wall.Two cases were diagnosed as congenital diverticulum without any other cardiac or thoraco-abdominal anomaly.And the other two had existing coronary artery diseases with significantly reduced global and apical LV systolic function.Mural thrombosis in diverticulum was determined in one congenital case.One patient died of cardiac failue.It suggested that LV diverticulum in adults may be congenital and secondary etiologically.The former is mostly isolated and apically situated while the latter often results from regional myocardial ischemia and elevated intracavitary LV pressure at an ill-perfused area.Echocardiography can demonstrate the 2-dimensional and flow hemodynamics of diverticulum in real time so as to facilitate its diagnosis and differential diagnosis.

Objective To evaluate the efficiency and safety of hair removal in different areas with Lightsheer Duet diode laser and to compare clinical effect and safety in axillae hair removal between the two models,high-speed and standard model.Methods Lightsheer Duet diode laser was used to remove hairs from different areas in 200 cases,for 4-8 weeks treatment 1 time,4 times for 1course.The curative effect and adverse reaction were observed after the treatment.Thirty axillae hair removal subjects were chosen randamly and received treatments using the different models,high-speed hand piece on one side and the standard hand piece on the other side.Hair removal efficiency and the immediate pain were compared and evulated on each subject.Results The hair was significantly reduced after 4 times treatments in 200 cases.The total effective rate was 95.54 ％ and positively related with the treatment times.Pigmentation was found in 3 cases,but it disappeared after 1-3 months.The total effective rate was 100 ％ after the 3 times treatments in axillae hair removal subjects both using the high-speed model or the standard model in 30 cases.There was no statistical difference between the two models except less pain in the high-speed model.Conclusions Lightsheer Duet diode laser is a safe and efficient method in hair removal.The high-speed model has more advantage on speed and causing pain.

Objective To establish programs of home healthcare service by investigation and analyzing the current status of the elderly requirements towards community nursing in yunnan province.Methods A self-administrated questionnaire which includes functional status,living situations,and home healthcare demands was distributed in 105 community elderly around Yunnan Province by professional staff. Results 76.20% of the community elderly people had different home care nursing service demands. The highest needs for community elderly is daily medical and nursing care.Conclusion Developing home healthcare can effectively improve the self- care consciousness of aged people, and also improving the quality of life in elderly has important significance for healthcare insurance of elderly.

Objective To investigate the optimal scan time of MRI using the imaging probe alphamethyl-L-tryptophan(α-MTrp)-superparamagnetic iron oxide nanoparticles (SPIONs) for localizing temporal lobe epilepsy (TLE) foci.Methods α-MTrp-SPIONs were injected into rat models of TLE through the tail vein during the acute and chronic stages (72 h and 8 weeks after status epilepticus,respectively).MRI was performed before and 1,2,4,8,24 h after the injection in all animals,and the T2 values of the epileptogenic regions were measured.One-way repeated measures analysis of variance was used for data analysis.Results Compared with the T2 values before the injection of α-MTrp-SPIONs,the T2 signal of epileptogenic regions after the injection had a negative increased change.The T2 values before and 1,2,4,8,24 h after the injection in acute stage were 112.08±5.85,107.83±6.59,105.08±6.79,95.58±5.14,100.92± 5.81,105.17±6.31 respectively,and those in chronic stage were 112.08±7.53,107.75±7.10,102.75± 5.50,96.17±5.01,97.75±4.37,102.92±4.74.The T2 values after the injection were significantly different from those before the injection (both P＜0.01).The T2 value at 4 h after the injection decreased mostly.Conclusions α-MTrp-SPIONs can precisely localize epileptogenic regions of TLE on MRI.The optimal scan time is 4 h after the injection.

Objective To explore the clinical and echocardiographic characteristics of primary malignant pericardial mesothelioma (PPM).Methods Cases of PPM with description of echocardiographic presentations from China mainland were searched from database during 1981 to 2015.Data about the clinical and echocardiographic features of the patients were collected.Results A total of 122 patients were included for analysis.It involved mainly middle-aged [(39.9 ± 14.7)years] and male patients (79,64.8％).The most common echocardiographic demonstration was pericardial effusion (74.6％) with were mostly bloody (97.7％),followed by pericardial masses (36.9％) and pericardial thickening (18.0％).The echocardiographic diagnostic accordance rate was about 26.2％.Conclusions The most common presentation of PPM on echocardiogram is massive pericardial effusion.Echocardiography is of great value in screening and assessment of PPM.The definitive diagnosis is made by histopathological examination.

Objective To review the clinical characteristics of left ventricular pseudo-aneurysm (LVPA) in China mainland.Methods The China National Knowledge Infrastructure (CNKI),Wanfang Data,VIP information and PubMed database were searched to extract information on clinical profile,diagnostic imaging,treatment and outcome of patients with LVPA from January 1986 to April 2012.Results Clinical data of 77 patients with LVPAs (including 5 coexistent with true aneurysm) were extracted from 65 articles.There were 56 males (72.7％) and 11 females (27.3％) with a median age of 48 years old(range 5 to 82).The most common etiology was myocardial infarction (40,51.9％).Breathlessness/dyspnea (44.6％),chest discomfort (41.9％) and chest pain (41.9％) were the most frequently reported symptoms,but asymptomatic patients accounted for 10.8％ of all.86.4％ of the patients had electrocardiographic abnormalities,most of which were nonspecific ST segment changes.No event of thromboembolism was reported.Transthoracic echocardiography was the most commonly used diagnostic imaging test,followed by angiography with which no complication was reported.19 cases of pseudo-aneurysms(24.7％)were reported to rupture and 15 patients(19.5％) died,mostly of cardiac tamponade and sudden death.Conclusions LVPA is a rare and life-threatening disorder.It lacks of specific clinical manifestations distinguishable from coronary disease or heart failure.Emergency surgery is warranted once it is identified.

Objective To explore the preventive effect of early umbilical cord mesenchymal stem cells (UC-MSCs) transplantation on MRL/lpr mice and the underly mechanisms.Methods Fourteen 10-week-old MRL/lpr mice were labeled and numbered.They were randomly divided into 2 groups by using random number table and injected with 1 ×106 UC-MSCs or PBS via tail vein respectively.Proteinuria was measured with Bradford method every 4 weeks.All mice were sacrificed at the age of 28 weeks, with the level of serum antidsDNA antibody and IL-17 detected by enzyme linked immunosorbent assay (ELISA).Splenic Th17 cells, as well as regulatory T cells (Treg) were examined by flow cytometry.Data were analyzed with t test and Pearson's correlation test.Results The onset of proteinuria was delayed for 4 weeks in UC-MSC-treated group compared with that in the control group.At the age of 28 weeks, the 24 hour proteinuria [(1.78±0.17) mg vs (4.77±0.98)mg, t=2.99, P＜0.05] and the spleen weight [(0.149±0.009) g vs (0.273±0.052) g, t=2.33, P＜0.05] in UC-MSCtreated group were significantly lower than those in the control group.There was also a trend of the decline of serum anti-dsDNA antibody and IL-17 level after UC-MSCs transplantation.Compared with those in the control group, both the percentage and the absolute number of Th17 cells were significantly decreased in UC-MSC-treated group [(0.90±0.19)％ vs (2.81±0.50)％, t=3.54, P＜0.01 and (3.7±0.8)×105 vs (19.3±3.7)×105, t=4.12,P＜0.01].Meanwhile, the percentage of Treg elevated after UC-MSCs treatment.The ratio of Th17/Treg was significantly lower in UC-MSC-treated group than that in the control group (0.11±0.03 vs 0.50±0.09, t=4.23,P＜0.01).Both the ratio of Th17/Treg (r=0.73, P＜0.01;r=0.59, P＜0.05) and serum IL-17 level (r=0.78, P＜0.01;r=0.56, P＜0.05) was positively correlated with the level of 24 hour proteinuria and anti-dsDNA antibody respectively in MRL/lpr mice.Conclusion Early UC-MSCs transplantation helps to delay disease onset and ameliorate disease progression in MRL/lpr mice, which may act through the modulation of Th17/Treg balance.

Objective To explore the effects of umbilical cord-derived mesenchymal stem cells (UCMSCs) on fibroblast-like synoviocytes(FLSs) from patients with rheumatoid arthritis(RA). Methods collagen-induced arthritis(CIA) models were developed on Wistar rats and 1 ×106 UCMSCs were given by intravenous injection from tail vein on the 17th day. On day 42, rats were sacrificed and synovial tissues were obtained to detect matrix metalloproteinase (MMP)-1, MMP-3 and MMP-13. Synovial tissues from patients with RA and osteoarthritis(OA) treated by knee arthroplasty were used to isolate FLSs. RNA of FLSs were extracted to compare MMP-1, MMP-3 and MMP-13 expression. FLSs and UCMSCs were cocultured through transwell for 72 hours. Then levels of MMPs were compared in the supernatants by Luminex. The MMPs expressed by FLSs and soluble factors expressed by MSCs were detected by real time-polymerase chain reaction(PCR). After adding antibodies to soluble factors, the MMPs expressions of RA FLSs were compared. Results MMP-1 (6.9±5.4, 1.3±1.4, P<0.05), MMP-3 (6.0±6.5, 1.4±1.0, P<0.05) and MMP-13 (21.8± 20.8, 1.5±1.6, P<0.05) expression were much higher in CIA rats compared with healthy controls. MMP-1 (1.3±1.4, 6.9±5.4,8.7±6.8, P<0.05), MMP-3(1.4±1.5, 6.0±6.5, 6.0±5.7, P<0.05) and MMP-13(3.0±3.2,
22±21, 22±26, P<0.05) expression were inhibited by UCMSCs in vivo. In vitro, MMP-1 (1.8±0.9, 0.9±0.7, t=2.44, P<0.05), MMP-3(2.6±1.7, 1.1±1.0, t=2.25, P<0.05) and MMP-13(2.4±2.3, 0.6±0.7, t=2.37, P<0.05) levels were higher in RA than OA FLSs. After coculture, MMP-13(1.3±1.2, 0.9±1.2, t=3.63, P<0.05) expressed by FLSs were down-regulated, however MMP-1 (1.5±1.4, 6.6±6.0, t=3.90, P<0.05) and MMP-3 (7±17, 22±35, t=2.86, P<0.05) were up-regulated when analyzed by paired t-test. Soluble factors such as I-DO, HGF and IL-10 were elevated. Anti-IL-10 antibody could decrease the function of UCMSCs by inhibiting MMP-13 expression in RA FLSs. Conclusion UCMSCs ameliorates RA by secreting soluble factor IL-10, which may inhibit MMPs expressed by FLSs.

Objective To investigate the influencing factors for left atrial appendage (LAA) spontaneous echo contrast (SEC) or thrombosis in patients with non-valvular atrial fibrillation(NVAF) and normal left ventricular ejection fraction(LVEF).Methods This study prospectively enrolled 255 patients with NVAF [paroxysmal atrial fibrillation(PaAF) 196 cases and persistent atrial fibrillation(PeAF) 59 cases].Patients were divided into two groups according to the findings on transesophageal echocardiography (TEE):positive group with the presence of the LAA SEC or thrombosis (group Ⅰ) and negative group (group Ⅱ) without this two presences.The clinical and echocardiographic data were compared between the two groups.The multivariate logistic regression analysis was used to explore the independent risk factors for development of LAA SEC or thrombosis.Receiver operating characteristic (ROC) curve was performed to determine the predictive value of the factors.Results A total of 255 patients were enrolled.There were 26 cases(10.2％) in group Ⅰ,and 229 cases (89.8％) in group Ⅱ.The age,NT-proBNP,occurrence rate of PeAF,left atrial volume index(LAVI),and LAA orifice long diameter and depth were higher in group Ⅰ than those in group Ⅱ (all P ＜0.01).The left atrial appendage emptying velocity(LAAV),global left atrial longitudinal strain(GLALS) and LVEF were lower in group Ⅰ compared with those in group Ⅱ (all P ＜ 0.01).Multivariate logistic regression analysis and ROC curve showed that GLALS＜12.2％ and LAAV＜ 31.2 cm/s were independent risk factors of LAA SEC or thrombosis in patients with NVAF and perserved LVEF.Conclusions The impairment of left atrial and LAA function are potential risk factors for cardiogenic embolism.GLALS and LAAV can be used as useful referenced parameters for prediction of stroke in patients with NVAF.

Objective To evaluate the practical value of the method of contrast enhanced ultrasoundguided reduced-fine needle aspiration (CEUS-FNA) in decreasing the complications of prostate nodule puncture.Methods Nine hundred patients with suspected prostate cancer(PCa) who underwent traditional 10-point blind transperineal prostate nodule puncture(n =548) or CEUS-FNA(n =352) were collected retrospectively and classfied into normal group or CEUS group,respectively.The ratio of prostate cancer diagnosis,number of punctur and compliations were observed in both groups.Results Altogether 362 PCa were diagnosed from 900 patients.Among these cases the diagnosis ratio of normal group was 38.0％ (208/548) and that of CEUS group was 43.8 ％ (154/352).There was no significant difference in diagnosis ratio between two groups (x2 =2.992,P =0.084).The puncture number of normal group were more than that of CEUS group(P ＜0.01).There were 134 cases occurred infection and other complications in tradition group and 56 cases in CEUS group.The complication rate in normal group was higher than that in CEUS group (24.5 ％ vs 15.9 ％),with significant differences between the two groups (x2 =9.393,P =0.002).Conclusions CEUS-FNA could reduce puncture number,but not decrease the PCa diagnsis rate.And also that could reduce the complication rate of prostate puncture.