Objective To assess regional left ventricular systolic function in patients with hypertrophic cardiomyopathy (HCM) using real-time three-dimensional echocardiography (RT-3DE).Methods Twenty-five patients with HCM which was asymmetric septal hypertrophy,and twenty healthy subjects were enrolled in the study.The apical four-chamber view of left ventricular was acquired by RT-3DE.The left ventricular volume-time curves were analyzed quantitatively with Tomtec 4D LV-Analysis 3.0,and regional end-diastolic volume and end-systolic volume of left ventricular (rEDV,rESV),the time to minimum systolic volume (rESVT),regional stroke volume (rSV),regional ejection fraction (rEF),regional-global ejection fraction (rgEF) and the parameters of left ventricular dyssynchrony were measured.Results In the HCM group,the values of Tmsv16-Dif,Tmsv16-SD,Tmsv16-Dif％,Tmsv16-SD％ were significantly lower compared with the control group (P ＜ 0.01),and rEDV,rSV,rEF and rgEF in hypertrophic segments were lower than those in non-thickening and mild-thickening segments (P ＜0.05).In the control group,there were no significant difference of those parameters among all segments (P ＞0.05).The values of rEDV,rSV and rgEF in hypertrophic segments decreased in the HCM group (P ＜0.05),at the basal level,rEF in hypertrophic segments decreased,at the apical level,it increased,but the differences at the mid-ventricular level between the two groups were not significant;the values of rEF and rgEF in non-thickening and mild-thickening segments increased (P ＜0.05).Conclusions RT-3DE could sensitively detect left ventricular dyssynchrony and accurately assess regional left ventricular volume and function of different segments in patients with HCM.

Objective To evaluate the association between the left carotid arterial stiffness and left ventricular diastolic function in patients with lower extremity atherosclerosis (AS).Methods ①A total of 32 patients with AS and 34 control objects were enrolled.The carotid arterial stiffness parameters:compliance coefficient (CC),distensibility coefficient (DC),stiffness parameter (α,β),pulse wave velocity β (PWVβ) were measured by using quality arterial stiffness(QAS) technology.And the values were compared between the two groups.②The parameters of left ventricular (LV) structure and function:LV end-diastolic interventricular septal thickness (IVSd),LV end-diastolic diameter (LVDd),LV end-diastolic wall thickness (PWd),LV ejection fraction (EF),systolic velocity (s'),early-diastolic velocity (e'),Tei index and E/e' ratio were measured by using two-dimensional echocardiography and tissue Doppler.These parameters were compared between the two groups.The association between the carotid arterial stiffness parameters and LV function parameters were analyzed by correlative analysis.Results ①Compared with the control group,the DC and CC were lower,and α,β,PWVβ,IMT were higer than the control group,with statistically significant differences(P ＜0.05).②The IVSd,Tei index and E/e'was significantly higher in the AS group than those in the control group.And the PWd,s',e' were lower than those in the control group (P ＜ 0.05).There was no significant difference in EF between the two groups (P ＞0.05).③The e' was correlated positively with DC and CC (r =0.39,0.36,P ＜0.01),and negatively with α,β,and PWVβ (r =-0.42,-0.42,-0.49,P ＜0.01).Tei index was correlated negatively with DC and CC (r =-0.50,-0.52,P ＜0.01),and positively with α,β,and PWVβ (r =0.58,0.58,0.62,P ＜0.01).The E/e' was correlated regatively with CC (r =-0.27,P ＜0.05),and positively with PWVβ (r =0.28,P ＜0.05).There were no significant correlation between s',EF and the stiffness parameters of carotid artery (P＞0.05).Conclusions In patients with AS,the left carotid artery stiffness increases and left ventricular systolic and diastolic function are impaired.The carotid artery stiffness and left ventricular diastolic function is correlated.Changes in carotid artery stiffness reflect the change in left ventricular diastolic function.

Objective To evaluate the correlation between left ventricular function and arterial stiffness of left femoral artery in patients with lower extremity atherosclerotic disease (LEAD).Methods Thirty-three patients with LEAD and 37 healthy subjects (control group) were enrolled in this study.The intima-media thickness (IMT),diameter and parameters of arterial stiffness [dispensability coefficient (DC),compliance coefficient (CC),stiffness α,stiffness β,pulse wave velocity (PWVβ) ]were measured by ultrasonography with the technology of QIMT and QAS.The thickness of the interventricular septum (IVSd),end-diastolic left ventricular diameter (LVDd) and left ventricular mass (LVM),and parameters of the left ventriculsr function (EF,E/A,E'/A',E/E' and Tei index) were measured by echocardiography.These parameters were compared between two groups.Correlations between the parameters of the arterial stiffness and those of the cardiac function were evaluated by Pearson correlative analysis.Results ①The IVSd,LVM and E/E' ratio were significantly higher in LEAD group than those in control group ( P ＜0.05).There were no significant differences in EF,E/A,E'/A',and Tei index between two groups ( P ＞0.05).②The IMT,α,β,PWVβ of left femoral artery were significantly higher in LEAD group than those in control group,while DC and CC were significantly lower in LEAD group than those in control group ( P ＜0.05).③The E/E' ratio,one of the parameters representing the left ventricular diastolic function,was correlated negatively with CC and positively with α,β,and PWVβ ( P ＜0.05 or P ＜0.01 ).The E'/A' ratio was correlated positively with DC and CC,and negatively with α,β,and PWVβ ( P ＜0.05 or P ＜0.01 ).Both EF and Tei index were not significantly correlated with the above parameters of arterial stiffness ( P ＞0.05).Conclusions Patients with LEAD have thickened femoral IMT,higher arterial stiffness of left femoral artery,as well as impaired left ventricular function.There is a close correlation between the atherosclerosis of the femoral artery and the early left vcntricular dysfunction.

BACKGROUND:There are few studies concerning estrogen receptorβgene, and its mechanism of regulating the bone metabolism is stil unclear now. OBJECTIVE:To analyze the effect of estrogen receptorβ(ERβ) silencing on the expressions of transforming growth factorβ1 (TGF-β1) and bone morphogenetic protein 2 (BMP-2) in human osteoblasts METHODS:There were three groups:blank control group (hFOB 1.19 uninfected with any retrovirus);negative control group (containing invalid interference fragment ERβ-shRNA-nc);optimal RNAi group (ERβ-shRNA-3). ERβ-shRNA retroviral vectors in the optimal RNAi group were used to transfect human osteoblasts fol owed by resistance screening and cel expansion. MTT assay was used to detect the proliferative activity of ERβ-silenced osteoblasts. Then under estrogen intervention, the stable inhibition rate of ERβwas determined using western blot assay, and the expressions of TGF-β1 and BMP-2 in human osteoblasts after ERβsilencing were detected by RT-PCR technology and western blot assay. RESULTS AND CONCLUSION:Human osteoblasts that were stably transfected by ERβ-shRNA-3 retroviral vector was selected successful y, and ERβsilencing had no significant influence on the cel proliferation (P>0.05). Under the interference of estrogen, the silencing efficiency of ERβprotein was (93.11±0.57)%(P<0.05), and after ERβsilencing, the expressions of TGF-β1 and BMP-2 were increased by (26.65±3.81)%and (16.62±1.71)%at mRNA level, and increased by (23.79±3.76)%and (18.08±3.20)%at protein level (both P<0.05). In conclusion, ERβmay play an important role in bone metabolism by regulating the expressions of TGF-β1 and BMP-2.

Objective To investigate the Oncomelania hupensis snail control effect of schistosomiasis control engineering in marshland within Wuhan City. Methods The engineering measures including surface barrier removal,molluscicide,flatting surface,topsoil stripping,topsoil covering and ditch renovation were applied to transform Hankou marshland. Then the corre-sponding technical parameters of engineering measures were put forward. The situation of snails was analyzed before and after the transform project. Results The total length and area of the project were 6015 m and 87.21 hm2,respectively,including 17.44 hm2 of topsoil landfill,52.08 hm2 of topsoil covering and 23 new ditches. After the transformation,the average length of the new groove,the groove top width,groove depth,height difference,and the average values of slopes and ditch bottom slope were all increased,while the average values of the width and height of the ditch were decreased. At the same time,the marsh-land beach surface had a new slope that the embankment was higher than the river and no living O. hupensis snails were found then. Conclusions The snail breeding environment in Hankou marshland has been effectively changed by the project. Howev-er,the constant monitoring and engineering management are still needed to consolidate the effect.

Objective To assess the peripheral arterial structural and elastic remodeling in patients with lower extremity atherosclerotic disease (LEAD).Methods Thirty-one patients with LEAD and 34 age-,sex-matched healthy subjects (control group) were enrolled in this study.The intima-media thickness (IMT),diameter (D) and parameters of arterial stiffness (β,pulse wave velocity (PWVβ)) were measured by acquiring the longitudinal view of left and right common femoral artery (LCFA,RCFA) and common carotid artery (LCCA,RCCA) by quality intima-media thickness (QIMT) and quality arterial stiffness (QAS) techniques.The factors correlated with arterial stiffness in LEAD patients were analyzed.Results ① The systolic blood pressure(SBP),pulse pressure(PP),smoking pack-year and smoking extent (nonsmoker,smoker with ＜40 pack-year,or smoker with ≥40 pack-year) were significantly higher in LEAD group than those in the control group (P ＜0.05).②IMT of the LCCA and the diameters (D) of LCCA and RCCA were significantly increased in the LEAD group (P ＜0.05-0.01).As to the both sides CFA,IMT and IMT/D values were significantly increased (P ＜ 0.01).The mean IMT (mIMT) of both sides of CCA and CFA were increased (P ＜0.05).The values of β,PWVβ of LCCA and PWVβ of RCCA were significantly increased,and β and PWVβ values of both sides of CFA were significantly increased in the LEAD group (P ＜ 0.05).There was a positive correlation between the stiffness indexes of the carotid artery and that of the femoral artery (P ＜0.01).③The femoral mβ was correlated with femoral mIMT,SBP,PP,smoking amount and smoking extent,and the femoral mPWVβ was also correlated with mIMT,age,SBP,PP,smoking pack-year and smoking extent (P ＜0.05-0.01).In multivariable stepwise regression analysis,mIMT and PP were factors independently correlated with femoral mβ.And SBP,smoking extent,and mIMT were independently correlated with femoral mPWVβ.Conclusions Peripheral arteries in patients with LEAD experience vascular remodeling,as well as increased carotid and femoral stiffness.Femoral stiffness is correlated with IMT,arterial blood pressure and smoking extent.

Objective In this study ,to explore the relationship between the renal blood flow PI ,and the AKI was caused by CPB .Methods 14 cases with heart disease were accepted .The renal aorta and renal segmental artery PI of all cases were monitored by the CDFI at the preoperative and postoperative 1 h ,2 h ,4 h ,8 h ,16 h ,24 h .The renal blood urea nitrogen (Urea) ,uric acid (UA) ,creatinine (Crea) ,were detected at the same time .All datas for statistical analysis .Results The renal aorta PI was higher at the postoperative 1 h ,2 h ,4 h ,8 h ,16 h than that at the preoperative .The renal segmental artery PI was higher at the postoperative 1 h ,2 h ,4 h ,16 h than that at the preoperative .The renal blood flow PI was positively correlated with Urea ,UA and Crea .Conclu-sion The renal aorta ,renal segmental artery PI was positively correlated with Urea ,UA and Crea after CPB .The PI may be seen as an evaluation index to assess AKI after CPB .

Objective:The purpose of our study was to assess the clinical value of ultrasound in the diagnosis of retroaortic left renal vein (RLRV) behind abdominal aorta.Methods:The ultrasound images of patients with RLRV diagnosed by ultrasound in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from 2013 to 2018 were retrospectively analyzed. The general information, clinical symptoms, ultrasound images and other clinical data of the patients were collected and analyzed.Results:RLRV was detected in 16(0.46%) cases of the 3 519 patients from 2013 to 2018 using ultrasonography, and the male to female ratio was 11 to 5. All patients presented with hematuria, including 7 patients with other symptoms, such as left flank pain. Ultrasound were firstly performed in all patients. Of the 16 patients, 15(93.75%) cases were of complete retroaortic type Ⅰ, including 13(81.25%) cases with left renal vein compression and 2(12.5%) cases with complete retroaortic type without left renal vein compression. In 16 cases, 1 case (6.25%) was type Ⅲ, with compression of both branches.Conclusions:Ultrasound may be the preferred method for the left renal vein examination when a clinical suspicion of Nutcracker syndrome is required. Ultrasound can clearly show the left renal vein in most patients, to determine whether the left renal vein is mutated or compressed. Ultrasound has the highest sensitivity for detecting the type Ⅰ, which is not easy to misdiagnose. However, type Ⅲ is easy to misdiagnosis. Whereas the type Ⅱ and type Ⅳ is difficult to detect using ultrasound, which may be related to the limitations of ultrasound imaging.

BACKGROUND:The monocyte chemoattactant protein-1 gene polymorphism is associated with spinal tuberculosis susceptibility. OBJECTIVE:To investigate the association between serum monocyte chemoattactant protein-1 expression level and spinal tuberculosis susceptibility in Han population of Hunan province. METHODS:The patients with spinal tuberculosis and the healthy volunteers were recruited in Xiangya Hospital of Central South University from December 2004 to December 2010. The empty peripheral venous blood 2 mL were col ected from the subjects in early morning, then the monocyte chemoattactant protein-1-362 genotypes were detected by polymerase chain reaction and DNA sequencing technology. And the serum monocyte chemoattactant protein-1 level was detected by enzyme linked immunosorbent assay technology. The ROC curve was used for diagnostic tests to calculate diagnostic threshold value of serum monocyte chemoattactant protein-1 level to spinal tuberculosis susceptibility, and to analyze the diagnostic titer. RESULTS AND CONCLUSION:208 patients with spinal tuberculosis and 210 healthy volunteers were included. The serum monocyte chemoattactant protein-1 level of the spinal tuberculosis patients was significantly higher than that of the healthy volunteers [(134.58±51.63) ng/L vs. (39.18±17.45) ng/L, P<0.01]. The serum monocyte chemoattactant protein-1 level could not be affected by gender, but over-expressed in patients with monocyte chemoattactant protein-1-362-CC genotypes. The serum monocyte chemoattactant protein-1 level higher than 101.65 ng/L indicated that the patients might suffered from spinal tuberculosis (sensitivity:85.5%, specificity:94.3%, Youden index:0.799, area under curve of ROC:0.946, 95%confidence interval:0.916-0.975, P<0.01). The serum monocyte chemoattactant protein-1 level may be associated with spinal tuberculosis susceptibility in Han population of Hunan province, highly expressed serum monocyte chemoattactant protein-1 can be used as one of the indicators for the diagnosis of spinal tuberculosis.

In order to better construct important diseases of traditional Chinese medicine ( TCM ) clinical re-search base , and strengthen the construction of medical and clinical research of TCM information sharing sys-tem, Hubei Provincial Hospital of Traditional Chinese Medicine has constructed research type clinic. The con-struction idea of research type clinic is the mode of real world TCM clinical research . The construction of research type clinic mode was from three aspects, which were the clinical research, health management and distinctive diagnosis and treatment .