Unilateral absence of a pulmonary artery in congenital heart disease may be considered as a risk factor for the surgical treatment of the basic anomaly especialy in cyanotic type of patients. This paper presents 9 such cases: tetralogy of Fallot in 7, dextrocardia and PDA in 1 and truncus arterio-sus with persistent left superior vena cave in one. Absence of left pulmonary artery was present in 7 cases and of right in two. Corrective surgical treatment were performed on 7 patients with tetralogy of Fallot. Two of them died in the early postoperative period. It was recommended that valved extracardiac conduit or woven dacron patch with pericardial monocusp be used for reconstruction of the outflow tract of right ventricle to alleviate the pulmonary regurgitation which was aggravated by higher pulmonary vascular resistance. Appropriate and active management of postoperative low cardiac output is also vital important.

Objective To investigate the effects of different blood pH of the recipients on ischemiareperfusion (I/R) injury to the transplanted lungs in rats. Methods Sixty-four pure bred male SD rats weighing 250-350 g were randomly divided into equal numbers of donors and recipients and the recipient rats were randomly divided into 4 groups(n = 8 each). Both donor and recipient rats were anesthetized with intraperitoneal (IP)ketamine 15 mg/kg and diazepam 6 mg/kg, tracheostomized and mechanically ventilated. In donor rats heparin 1 ml was injected via inferior vena cava and 4 ℃ LDP solution 40 ml was injected via pulmonary artery . The left lung was then removed and placed in 4℃ LDP solution and kept for 4 h. The left lung transplantation was performed using two-cuff-one-stent anastomosis technique. Before the transplanted lung was reperfused, the recipients' blood pH was adjusted to 7.4 (group Ⅰ), 7.2 (group Ⅱ), 7.3 (group Ⅲ) and 7.5 (group Ⅳ) by HCI and NaHCO3 solutions infused via femoral vein. After 2 h reperfusion, the transplants were removed for microscopic examination and determination of W/D lung weight ratio, MPO and SOD activities and MDA, TNF-α and IL-8 contents. Results SOD activity was significantly higher while MPO activity, and MDA, TNF-α and IL-8 contents in the lung tissue were significantly lower in group Ⅲ than in group Ⅰ . There was no significant difference in SOD and MPO activities and MDA, TNF-α, and IL-8 contents in the lung tissue among group Ⅰ , Ⅱ and Ⅳ. There was no significant difference in W/D lung weight ratio among the 4 groups. Microscopic examination showed that the histological damage was attenuated in group Ⅲ compared with the other 3 groups. Conclusion The I/R injury to the transplanted rat lungs can be effectively alleviated by reducing blood pH of the recipients to 7.3.

Objective To observe hemodynamic changes in patients with primary hypertension with wave intensity (WI). Methods Carotid arteries of 36 patients with primary hypertension and 30 age-matched normal controls were examined with imaging technique of WI. The following parameters were measured: the first wave peak in early ejection (W1), the second wave peak in late ejection (W2), the negative area during the mid-ejection (NA), the interval between the R wave of the ECG and the first peak of W1 (R-1st), the interval between the first peak and the second peak (1~(st)-2~(nd)), the ratio of R-1st and a cardiac cycle time R-1_(HR)~(st)) and the ratio of 1~(st)-2~(nd) , as well as one cardiac cycle time (1~(st)-2(_(HR)~(nd)). Results ①W1 in primary hypertension group increased compared with those of normal controls (P＜0.01), while no significant difference of W2, NA, R-1st, 1~(st)-2~(nd), R-1_(HR)~(st), 1~(st)-2_(nd)~(HR) was detected (P＞0.05). ②Both W1 and W2 correlated positively with pulse pressure (PP) and systolic blood pressure (SBP) (r=0.66, 0.55, P＜0.01;r=0.62, 0.44, P＜0.01). W1, W2 and age, DBP were not related significantly (P＞0.05). Conclusion The hemodynamic parameters of WI technology provide a new way to evaluate the dynamics of the heart and vascular system and their interaction.

Objective To explore the characteristics of resting myocardial perfusion of type 2 diabetes mellitus(T2DM) by real-time myocardial contrast echocardiography(RT-MCE). Methods Thirteen patients with T2DM and 12 in control were enrolled in the study. RT-MCE was performed using a continuous infusion of SonoVue with vena mediana in elbow. Images of left ventricle filled with contrast were acquired from apical 4-, 2-chamber and long axis views with real-time myocardial contrast mode of GE Vivid 7 Dimension system. All above images were captured in continuous 3 cardiac cycles before "flash" ,and then 15 cardiac cycles after "flash". All clips were stored for off-line analysis. Results In quiescent condition, there were significant decrease on indices of A,k and A × k in patients compared with control group (A:6.46 ±1.60 vs 6.81 ± 1.53, P ＜0.05;k:1.04 ± 0.39 vs 1.28 ± 0.31*, P ＜0.01;A× k:6.55 ± 2.72 vs 8.78 ±3.16, P ＜ 0.01, respectively). Conclusions RT-MCE could evaluate the early change of myocardial perfusion in T2DM patients and offers important reference for clinical diagnosis and treatment.

Objective To investigate the elasticity of the radial artery wall in type 2 diabetes mellitus (T2DM) patients with elastosonography. Methods A total of 37 patients with T2DM and 42 normal subjects were studied with elastosonography. The systolic diameter (Ds) and diastolic diameter (Dd) of the radial artery were measured, and the strain ratio of the blood in the radial artery to the wall of the radial artery was calculated. Results The strain ratio of the radial artery in T2DM group was significantly higher than that in normal group (P＜0.05). There was no significant difference in Ds and Dd of the radial artery between T2DM group and the control group (P＞0.05). Conclusion The early change of the radial artery wall elasticity in patients with T2DM can be assessed with elastosonography.

Objective:To investigate the ultrasonographic features of internal jugular venous vein pseudo-aneurysm.Methods:The ultrasonographic and clinical features of a patient with internal jugular venous vein pseudo-aneurysm in Union Hospital Affiliated to Huazhong University of Science and Technology were retrospectively analyzed. These characteristics of this patient combined with cases from literatures were summarized.Results:Ultrasound showed that the 38.6 mm×14.0 mm×29.9 mm anechoic area in the soft tissue layer of the left neck communicated with the left internal jugular vein through the 3.8 mm wide breach, and a 12.9 mm×6.6 mm slightly hyperechoic mass was found in the anechoic area. Color Doppler flow imaging showed that the internal jugular vein communicated with the anechoic area through the crevasse. There was no obvious blood flow signal in slightly hyperechoic mass. The bidirectional burr-like blood flow signal could be detected by pulse-wave Doppler. Contrast enhanced ultrasound showed that the contrast agent flowed into the mass from the internal jugular vein through the breach, and the slightly hyperechoic mass appeared the contrast filling defect, and contrast agent was well filled in the rest of the anechoic area. Ultrasound diagnosis: left internal jugular vein pseudoaneurysm with thrombosis. 35 cases of cervical vein pseudo-aneurysm patients were finally included in 23 documents, including 12 males, 23 females, 15 cases on the left side, 20 cases on the right side, 6 cases of the internal jugular vein, 27 cases of the external jugular vein; one case only describes the neck veins and supraclavicular vein in another one case. Among them, 34 cases showed subcutaneous anechoic masses on ultrasound, 1 case showed slightly hyperechoic masses, and 35 cases showed venous wall breaches.Conclusions:Ultrasound examination has high diagnostic value for vein pseudo-aneurysm owing to its convenience, fast and serial observation. Therefore, it is the preferred method and can be widely used in clinical practice. Contrast-enhanced ultrasound can clearly show the blood perfusion, and help to improve the diagnostic confidence of the operator.

Objective To evaluate left atrial(LA) function in patients with prophase type 2 diabetes mellitus(T2DM) combinated with or without hypertension using left atrial volume tracking method(LAVT). Methods Thirty-one simple T2DM(T2DMI group) ,21 T2DM accompany with hypertension(T2DM2 group) and forty-five healthy subjects (control group) were enrolled in this study. Ultrasound LAVT(EUB-6500, Hitachi Medical Corporation) was applied to display and analyzed the LA volume loop imaging on the standard LV apical two and four chamber views. The maximal and the minimal LA volume (LAVmax, LAVmin) and the volume before LA contraction (LAVp) were recorded from the LA volume loop. The body surface area was used to correct these volume indexs. The LA reservoir function was assessed by calculating the total of LA filling volume (LAVItotal) and the expansion index(iLAVIe). The passive and active emptying percentage of the total emptying volume(LAVIpass, LAVIact) and the emptying index(iLAVIpass,iLAVIact) were caculated as the parameters of the LA conduit and booster pump function. Results Compared with the values in the control group, the LAVhotal,LAVIact were significantly higher and the LAVlpass,iLAVlpass were lower in the T2DM group (all P<0.05) ,while the iLAVIact was higher only seen in the T2DM2 group(P<0. 05). The LAVlact, iLAVIact were higher and the LAVIpass was lower in T2DM2 group than those in the T2DM1 group (all P<0.05). Conclusions The LA conduit hypofunction in primary in the prophase T2DM,when combinated with hypertension the LA constriction function compensatorily increased, LAVT can evaluate the function of LA in patients with T2DM accurately and rapidly.

Objective To observe the rotation of subendocardium and subepidium by two-dimensional speckle tracking imaging(2D-STI),and to evaluate its performance in diastolic heart failure patients(DHF)with a normal left ventricular ejection fraction. MethodsNinety-seven consecutive clinically stable patients were enrolled in this study [41 healthy controls,36 with diastolic heart failure,20 with systolic heart failure (SHF)]. High frame rate dynamic two-dimensional images were recorded at the left ventricular short-axis view,including basal, papillary muscle and apical planes. Subendocardial and subepicardial global rotation were measured using Q-lab 7.0 software offline. Results ① In all the subjects, the rotation of the subendocardium was obviously greater than that of subepicardium. ②As seen from the apex,left ventricular subendocardium and subepicardium performed a wringing motion with a clockwise rotation at the base and countclockwise rotation at the apex. ③In the apical plane, subendocardial rotation was significantly lower in both heart failure groups than in controls,and was depressed to a larger extent in SHF patients than in those with DHF. Subepicardial rotation was no significant difference between the DHF group and the control group, though it was significantly lower in patients with SHF. ④At the base, the rotation of subendocardium and subepicardium were not different between DHF and control groups, but it was significantly reduced in patients with SHF. Conclusions The subendocardial rotation is reduced, but subepicardial rotation is normal in DHF patients. On the other hand, in patients with SHF, subendocardial and subepicardial rotation are both reduced. The left ventricular systolic properties are impaired in DHF patients.