Objective To investigate papillary muscle function and construction in myocardial infarction(MI) patients by two-dimensional speckles tracking imaging(2D-STI),and to analyze the influence factors of ischemic mitral regurgitation.Methods Fifty myocardial infarction with ischemic mitral regurgitation(IMR) patients were brought into case group.The patients were divided into two groups:Ant MI group and Inf-Pos-MI group.Forty-five health volunteers were involved as control group.Anterior,posterior papillary muscle longitudinal strain (ALS,PLS),delay time(DT),fractional shortening (FS),length between the posterior or anterior papillary muscle tips and the contralateral anterior mitral annualr (APM AMA,PPM AMA),mitral leaflet closure (MLC),inter distance papillary muscle (IPMD) were aquired respectively.Papillary muscle function and construction among the groups were compared,and the effective factors of IMR were evaluated.Results Between the control group and Ant-MI group,the left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic and end-systolic volume(LVEDV,LVESV),left ventricular ejection fraction(LVEF),ALS,delay time(DT),A FS,IPMD,MLC,APM-AMA,PPM-AMA were significantly different(all P ＜0.05).Between the control group and Inf-Pos-MI group the LVEDD,LVEDV,LVESV,EF,DT,PPM-AMA,MLC,PLS,P-FS were significantly different(P ＜0.05).Between the Ant-MI group and Inf-Pos-MI group,the LVEDD,LVEDV,LVESV,EF,MLC,ALS,PPM-AMA,PLS were significantly different (all P ＜ 0.05).In the Ant-MI group,LVEDV,ALS,MLC were significantly correated with Gensini score(r =0.71,-0.65,0.56;P ＜0.05).In the Inf-Pos-MI group,PPM AMA,PLS were significantly correated with Gensini score(r =0.65,-0.76;P ＜0.05).In the Ant MI group and Inf-Pos-MI group,the ALS,PLS,PPM-AMA were significantly different (P ＜ 0.05).Its correlates in Logistic analysis of Ant-MI group included LVEDV,MLC,DT with OR 1.48,1.72,1.54(P ＜0.05),respectively.Its correlates in logistic analysis of Inf Pos-MI group included PLS,PPM-AMA,DT with OR 1.78,1.57,1.56 (P ＜0.05),respectively.Conclusions There are different extent of damage of papillary muscle function and construction in Ant-MI group and Inf-Pos-MI group.The increases of LVEDV and MLC and desynchronization of PMs are risk factors of IMR in Ant-MI group.The increases of PMP-AMA,decrease PLS and desynchronization of PMs are risk factors of IMR inInf-Pos-MI group.

Purpose To evaluate papillary muscle function in ischemic mitral regurgitation (IMR) with two-dimensional speckle tracking imaging (2D-STI) and three-dimensional ultraphonic technology,and to investigate the primary factors influencing IMR so as to provide clinical information for the prediction of IMR.Materials and Methods Seventy-six IMR patients were enrolled as research group and other 66 healthy volunteers as control group.Two groups were both examined by transthoracic echocardiography and 2D-STI.The parameters including fractional shortening of anterior and posterior papillary muscles (AFS,PFS),length of anterior or posterior papillary muscle tips to contralateral anterior mitral annular (APM-AMA,PPM-AMA),mitral leaflet closure (MLC),inter distance papillary muscle (IPMD),the angle between the anterior papillary muscle and the anterior LV free wall (Ang Ⅰ) and the angle between the posterior papillary muscle and the anterior LV free wall (Ang Ⅱ),anterior and posterior papillary muscle longitudinal strain (ALS,PLS) and peak time (APT,PPT),delay time (DT),left ventricular end-diastolic diameter (LVIDD),left ventricular end-diastole volume (LVEDV),and left ventricular ejection fraction (LVEF) were compared.Results Compared with control group,LVIDD,LVEDV,LVEF,AFS,PFS,IPMD,MLC,ALS,PLS and DT in research group were all significantly different (all P＜0.05).ALS,PLS,AFS,and PFS had positive correlation with LVEF (P＜0.05) and negative correlation with LVEDV (P＜0.05).MLC,IPMD,DT had negative correlation with LVEF (P＜0.05).ALS,PLS,MLC,AFS,PFS,IPMD were significantly correlated with Gensini score (r=-0.65,-0.78,0.54,-0.51,-0.57,0.49,respectively,P＜0.05).The multivariant Logistic regression analysis showed that IMR was correlated with IPMD,MLC,PLS and DT (OR=1.26,1.32,1.37,1.52,respectively,P＜0.05).Conclusion 2D-STI can accurately evaluate the papillary muscle dysfunction caused by myocardial ischemia.Moreover,the risk factors of IMR include increase of IPMD and MLC,decrease of PLS,and desynchronization of papillary muscles.These findings contribute to the clinical prediction of IMR.

ObjectiveTo investigate the clinical effect ofcarboprost tromethamine combined with uterine strap suture in hemorrhage during cesarean section.MethodsSixty patients with hemorrhage during cesarean section were selected and divided by random digits table method into observation group and control group with 30 cases each.The patients in observation group were treated with carboprost tromethamine combined with uterine strap suture,while the patients in control group were treated with carboprost tromethamine alone.The clinical effect,blood loss,blood transfusion cases,transfusion volume and the occurrence of recurrent hemorrhage and complication of two groups were compared.ResultsCompared with control group,the efficiency in observation group was significantly higher [93.33％(28/30) vs.70.00％ (21/30),P＜ 0.05];blood loss,blood transfusion cases,transfusion volume and recurrent hemorrhage rate of observation group were obviously lower [ (603.35 ± 52.62) ml vs.(689.17 ± 50.36) ml,3 cases vs.10 cases,(640.21 ±63.58) ml vs.(726.17 ±68.74) ml,3.33％(1/30) vs.26.67％(8/30),P ＜0.05];the occurrence rate of complication of two groups had no statistical significance (P ＞ 0.05).ConclusionsCarboprost tromethamine combined with uterine strap suture can improve the clinical effect of patients with hemorrhage during cesarean section,decrease blood loss and transfusion volume,and reduce the recurrent hemorrhage rate.

Hepatitis C virus (HCV)-related thyroid dysfunction is a common complication in patients with chronic hepatitis C,including Graves' disease,Hashimoto thyroiditis,destructive subacute thyroiditis,hyperparathyroidism or hypothyroidism,with or without abnormal autoantibodies or thyroidrelated antibodies.The possible pathogenesis of HCV-related thyroid dysfunction includes bystander activation,molecular mimicry,effects of interferon and susceptibility associated with genetic polymorphism on particular locus.By now,there is still no criteria for diagnosis and treatment of HCV-related thyroid dysfunction.For patients with mild HCV-related thyroid dysfunction,observation may be appropriate; and for those with serious symptoms,anti-thyroid drug,levothyrocine,surgery or symptomatic treatment may be applied according to clinical symptoms.This paper gives an overview of the prevalence,clinical characteristics and possible pathogenesis of HCV-related thyroid dysfunction.

Objective:To study the mechanism and clinical significance of the precordial ST segment deviations in acute inferiorwall myocardial infarction (AIMI) involving adjacent area. Methods: Characteristics of electrocardiogram were analyzed in118 patients with AIMI. Results: (1)The magnitude of ST segment elevation of inferior wall leads (Ⅱ, Ⅲ and aVF) wassignificantly negatively correlated with that of precordial leads (P＜0.01). (2)The changed magnitude of ST segment oflead V2 (0.63±1.82 mm) and V2/aVF ratio (0.84±1.61) in 16 cases associated with right ventricular infarction weresignificantly higher than those of only inferior wall myocardial infarction group (V2:0.35±1.65 mm,V2/aVF ratio:0.29±1.28)(P＞0.05 and P＞0.05). (3)The magnitude of ST segment fall of lead V2(-1.20±1.52 mm) and V2/aVFratio (-0.33±1.15) in 38 cases associated with lateral-posterior wall in farction were higher than those of only inferiorwall infarction group (P＜0.05). (4)If the cases associated with right ventricular and lateral-posterior wall infarction werenot included, the ST segment correlation coefficient between inferior and precordial leads would significantly increase inAIMI (r =-0.797, P＜0.01). Conclusion:The directions of ST segment deviations of precordial leads elevate in casesassociated with right ventricular infarction and fall in eases associated with lateral-posterior wall infarction in AIMI.

AIM: To compare the therapeutic effects and adverse reactions of nicardipine and labetalol injection in treating acute and severe hypertensions. 　METHODS: Sixty-seven patients in nicardipine group (M 46, F 21; age 52 a± s 11 a) were given nicardipine 2 mg in 0.9 % sodium chloride or 5 % glucose injection 10 mL within 2 min iv, first, and then given 30 mg nicardipine in 0.9 % sodium chlocide or 5 % glucose injection 250 mL by continual intravenous infusion for 6 h. Sixty-one patients in labetalol group (M 41, F 20; age 53 a±9 a) received 50 mg labetalol in 5 % glucose injection 20 mL by intravenous once. The treatment could be repeated every 15 min, in case it was less effective, but the total dose should be no more than 200 mg.　RESULTS: The treatment for the nicardipine group and the labetalol group, reached the marked effect within 5 min. The total marked effective rate was all 100 % (P>0.05). Severe adverse reactions occured in the two patients (one occured significantly lowering of blood pressure, and the other aggravated asthma) in the labetalol group. 　CONCLUSION: Intravenous nicardipine and labetalol are fast and smooth in reducing the blood pressure of the patients with acute and severe hypertension, but the safety of nicardipine is superior to that of labetalol

Uterine natural killer cells (uNK) are distinct from peripheral blood NK (pbNK) cells,which constitute up to 70％ of the decidual leukocyte population in the first half of pregnancy,and are considered to have a cytokine-secreting role rather than cytotoxic function.It plays an important role in trophoblast invasion and uterine spiral artery remodeling.As a result of imbalance of uNK cells,pathological pregnancy appeared.Herein,the origin of uNK cells and its function in pregnancy were veviewed.

The formation of advanced glycosylation end products (AGEs) is enhanced in diabetes mellitus, closely associated with diabetic vascular complication. In this review, biochemical properties and structures of AGEs,AGEs receptors and binding proteins ,pathogenic properties of AGEs,deposition and turnover of AGEs, inhibitors of AGEs were summarized.

Objective: To study the affection of immobilization stress (IMS) on mice splenic lymphocytic function. Methods:The proliferation of lymphocytes was examined by MTT, and intracellular[Ca2+] was examined by fluorescence probe, Fura-2/AM, membrane of lymphocytes IL-2 receptor(mIL-2R) and cell cycle were examined by flow cytometry. Results;The end of IMS was found to be the lowest proliferation response after IMS, at the same time mIL-2R expression was impaired. Analysis of cell cycle showed the proliferation of splenocytes from IMS mice might be bloched in G2/M phases. Intracellular[Ca2+] was significant increased after IMS. Conclusion: IMS may induce the disfunction of lymphocytes and immunosuppression.

OBJECTIVE:To analyze the current status of counterfeit in China and indicate the difficultie of identification.METHODS:The main characteristics of counterfeit drugs were discussed by representative cases.RESULTS & CONCLUSION:It is suggested that the department of the drug administrave should establish a more scientific,reasonable standardization procedure of conterfeit drugs identification aiming directly at the characteristics of counterfeit drugs,which was more sufficient,intensive and practicable legal evidence for defining,fighting and preventing counterfeit drugs.