Objective To assess the velocity patterns of right ventricular long axis myocardial motion during isovolumic contraction phase in the patients with dilated cardiomyopathy(DCM) by Doppler tissue imaging(DTI).Methods Right ventricular systolic free wall myocardial(the place close to the tricuspid annular) motion velocities were examined by DTI on apical four-chamber view in 28 patients with DCM and 30 healthy volunteers.Peak positive and negative velocities(V_(IVC1),V_(IVC2)),velocity time integrals(VTI_(IVC1),VTI_(IVC2)),times(T_(IVC1),T_(IVC2)) of right ventricular free wall myocardial motion during isovolumic contraction,and the peak velocity(V_S),time(T_S),velocity time integral(VTI_S) of ejection wave(S) were measured.Right ventricular percent changes in area(RVPCA) on three different views were calculated.Results V_(IVC1),V_S,VTI_S and differential IVC(the difference between V_(IVC1) and V_(IVC2)) in the patients with DCM were significantly decreased than those in control group(P(0.05)).Conclusions The changes of DTI indices of right ventricular long axis myocardial motion during isovolumic contraction in the patients with DCM are characteristic,which could be a new method to evaluate right ventricular systolic function.

Objective To study the metastasis rule and influence factors of cervical central group (Ⅵ region) lymph node in patients with papillary thyroid microcarcinoma.Methods The clinical data of 195 patients with papillary thyroid microcarcinoma were analyzed retrospectively.All patients received bilateral thyroidectomy and bilateral cervical central group lymph node dissection.Results All patients died without surgery and hospitalization,the incidence of postoperative complications was 2.1％ (4/195).The total incidence of cervical central group lymph node metastasis was 35.4％ (69/195).Factors relating to cervical central group lymph node metastasis rate were:age (OR =0.924),gender (OR =0.213),the number of foci (OR =2.208) and the sum of the tumor diameters (OR =2.106).Conclusions Patients with papillary thyroid microcarcinoma may suffer from lymph node metastasis of the cervical central group,and lymph node metastasis rate increases significantly in young or male patients,and when the lesions are multifocal or the sum of the tumor diameter ＞ 0.5 cm.

Non-alcoholic fatty liver disease (NAFLD) has become a new health issue in the world due co its increasing incidence rate,and in particular,nonalcoholic steatohepatitis is progressive and has poor prognosis.Therefore,there is an argent need to search for the methods for the prevention of disease progression and treatment.Bile acid,as an important metabolite and signal molecule,can adjust the metabolism of lipids and carbohydrates and energy balance inside and outside the liver.Bile acid interacts with is receptors,such as the farnesoid X receptor and Takeda G-protein coupled receptor 5,bile acid transporter,and gut microbiota and is involved in the pathogenesis of NAFLD and nonalcoholic steatohepatitis at different levels.This article summarizes the research advances in the pathogenesis of bile acid-related NAFLD and related pharmacotherapy.

To assess the normal value of left ventricular twist (LVtw) and examine the changes with normal aging by 2-dimensional ultrasound speckle-tracking imaging (STI), 121 healthy volunteers were divided into three age groups: a youth group (19-45 y old), a middle-age group (46-64 y old) and an old-age group (> or = 65 y old). Basal and apical short-axis images of left ventricular were acquired to analyse LV rotation (LVrot) and LVrot velocity. LVtw and LVtw velocity was defined as apical LVrot and LVrot velocity relative to the base. Peak twist (Ptw), twist at aortic valve closure (AVCtw), twist at mitral valve opening (MVOtw), untwisting rate (UntwR), half time of untwisting (HTU), peak twist velocity (PTV), time to peak twist velocity (TPTV), peak untwisting velocity (PUV), time to peak untwisting velocity (TPUV) were separately measured. The results showed that the normal LV performs a wringing motion with a clockwise rotation at the base and a counterclock-wise rotation at the apex (as seen from the apex). The LVtw velocity showed a systolic counterclock-wise twist followed by a diastolic clockwise twist. Peak twist develops near the end of systole (96%+/-4.2% of systole). With aging, Ptw, AVCtw, MVOtw, HTU and PUV increased significantly (P<0.05) and UntwR decreased significantly (P<0.05). However, no significant differences in TPUV, PTV and TPTV were noted among the 3 groups (P>0.05). It is concluded that LV twist can be measured non-invasively by 2-dimensional ultrasound STI imaging. The age-related changes of LVtw should be fully taken into consideration in the assessment of LV function.
Aging ; Echocardiography ; Heart Ventricles/anatomy & histology ; Heart Ventricles/*ultrasonography ; Ventricular Function, Left/*physiology ; Young Adult

The effects of cardiomyocyte grafting on left ventricular (LV) remodeling and function in rats with chronic myocardial infarction were evaluated using high-frequency ultrasound. Chronic myocardial infarction was induced in 50 Wister rats by ligating the left anterior descending artery. They were randomized into two groups: a trial group that received neonatal rat cardiomyocyte transplantation (n=25) and a control group which were given intramyocardial injection of culture medium (n=25). The left ventricular (LV) geometry and function were evaluated by high-frequency ultrasound before and 4 weeks after the cell transplantation. After the final evaluation, all rats were sacrificed for histological study. The results showed that 4 weeks after the cell transplantation, as compared with the control group, the LV end-systolic dimension, end-diastolic dimension, end-systolic volume and end-diastolic volume were significantly decreased and the LV anterior wall end-diastolic thickness, LV ejection fraction and fractional shortening were significantly increased in the trial group (P<0.01). Histological study showed that transplanted neonatal rat cardiomyocytes were found in all host hearts and identified by Brdu staining. It was suggested that transplantation of neonatal rat cardiomyocytes can reverse cardiac remodeling and improve heart function in chronic myocardial infarction rats. High-frequency ultrasound can be used as a reliable technique for the non-invasive evaluation of the effect of cardiomyocyte transplantation.
Animals, Newborn ; Echocardiography/*methods ; Myocardial Infarction/physiopathology ; Myocardial Infarction/*therapy ; Myocardial Infarction/ultrasonography ; Myocytes, Cardiac/*transplantation ; Random Allocation ; Rats, Wistar ; Ventricular Function, Left/*physiology ; Ventricular Remodeling

Objective To quantitatively describe the texture features of myocardial image in the acute myocardiac infarction (AMI) using image texture analysis. Methods Anterior descending branch of left coronary artery was ligated to set up AMI model in 11 dogs. Image texture was analyzed using grey tone co-occurrence matrix method, and 4 kinds of texture parameters including angular second moment(ASM), contrast(CON), entropy(ENT), and inverse difference moment(IDM) in normal myocardium and infarct myocardium were observed. Results A significant difference in 4 kinds of texture parameters was found between pre- and post-infarct myocardium (P

Objective To evaluate the results of the treatment and prevention measures for pathological dislocation of the hip following septic arthritis in the newborns. Methods Twenty cases undergone open reduction were studied restropectively. In addition, greater trochanterplasty was penformed in 15 cases, acetabularplasty in 14 cases, greater and lesser trochanterplasty in 2 cases. Rusults A successful rate of reduction achieved in 90％ of the patients; however, central reduction was achieved in only 38.8％ . 20 patients were followed-up for 6 months to 12 years. The stability and motility of the hip gradually improved in majority of the patients. The cases with severe destruction followed by absence of femoral head and neck had unsatisfactory results. Shortening deformity were found in six cases, and subluxation, dislocation, rigidity of the hip in one case each. Conclusion The greater trochanterplasty had a good result for reduction and maintaining the position. Early diagnosis and early open drainage were key measures for prevention of pathological dislocation of the hip resulting from the acute septic arthritis in the newborn.

Objective To evaluate left atrial(LA)function in patients with prophase essential hypertension (EH)by left atrial volume tracking(LAVT)method.Methods Thirty prophase EH patients and 35 healthy subjects(control group)were enrolled in this study.Ultrasound LAVT(Hitachi EUB-6500)was applied to display and analyze the LA volume loop imaging on the standard LV apical two and four chamber views.The maximal LA volume at end-systole(LAVmax),LA volume at the onset of ECG-P wave(LAVP),the minimal LA volume at end-diastole(LAVmin)from the LA volume loop were recorded,and body surface area was used to revise these volume indexs(LAVImax,LAVIp,LAVImin).LA pass,act and total empting volume(LAVIpass,LAVIact,LAVItotal)and empting rate(%LAVIpass,%LAVIact,%LAVItotal),effective pass and act erupting rate(%eLAVIpass,%eLAVIaet),and the proportionality of pass empting volume and act empting volume were caculated.Results The LAVIp,LAVIact,LAVItotal,%LAVIact,%LAVItotal,%eLAVIact in the prophase EH group were significantly higher than those in the control group,wheras the LAVIpass,%LAVIpass,%eLAVIpass,LAVIpass/act were lower(all P＜0.05,or P＜0.01).Conclusions The LA volume change in prophase EH is the act empting volume increased at end-diastole in main,LAVT is a potientially useful tool to evaluate the function of LA.

Objective To evaluate the clinical effect of one-stage posterior-anterior approach surgery for patients with cervical fracture and dislocation combined with locked facet.Methods A retrospective review was conducted on 21 cases of cervical dislocation and fracture combined with locked facet treated by one-stage posterior-anterior approach surgery between April 2011 and December 2012.There were 16 males and 5 females at age ranging from 23 to 61 years (mean,38.3 years).Posterior unlocking reduction by partial facetectomy and lateral mass screw fixation was performed,followed by anterior decompression,internal fixation and interbody fusion by titanium meshes.Outpatient or telephone follow-up was performed to evaluate bone fusion and recovery of neurologic function.Results Mean operation time was 140 minutes (130-210 minutes) and mean blood loss was 340 ml (range,150-600 ml).All incisions got primary healing with no operation-correlated complications.Five patients complicated with severe lung infection after surgery and one died of respiratory failure two week later.Titanium meshes achieved bone fusion within 3-9 months (mean,6 months) after surgery.At a mean follow-up of 17 months (range,12-30 months),there was no implant breakage and mesh displacement or collapse.According to the American Spinal Injury Association (ASIA) score,preoperative neurologic deficit restored by mean one grade at final follow-up.Conclusion One-stage posterior-anterior approach surgery is an ideal choice for cervical fracture and dislocation combined with locked facet,for it provides unlocking reduction,canal decompression,and rigid reconstruction of the anterior-posterior column.

Objective To study the early and mid-term outcome in terms of left ventricular(LV)geometry and function in patients with transposition of great arteries with intact ventricular septum (TGA/IVS) undergoing arterial switch operation.Methods Twenty patients were followed up and divided into 2 groups according to age:the earlier group and the later group.Age and sexual matched controls were also designed as control group 1 and control group 2.LV posterior wall thickness(PWTd),dimension(LVIDd)and length(L) at end diastolic phase,LV end-diastolic volume (EDV),end-systolic volume (ESV),ejection fraction (EF),mitral valve early (E) and late (A) inflow velocities and E/A,isovolumic relaxation time (IVRT) were obtained by two-dimensional echocardiography,normalized isovolumic relaxation time (IVRTn),wall thickness index (PWTd/LVIDd) and LV geometry index(LVIDd/L) were calculated,and these indexes between groups were compared.Results ①Compared with control group 1,PWTd in earlier group was higher [(0.41 + 0.06)cm vs (0.36 + 0.05)cm,P =0.022],but LVIDd had no significant statistical difference [(2.08 + 0.21)cm vs (2.21 + 0.23)cm,P =0.117],indicating PWTd/ LVIDd differed between groups(0.20 + 0.04 vs 0.16 + 0.01 P =0.001).②No abnormalities were observed in later group.③Compared with different age groups in TGA,EDV,ESV,L,LVIDd,PWTd were significantly higher in later group(P =0.000).There were obvious correlations between EDV,ESV,L,LVIDd and examined age (r =0.90,0.83,0.73,0.90,P =0.000,R2 =0.809,0.694,0.528,0.808) while there were no significant correlation between PWTd and examined age(r =0.56,P =0.000,R2 =0.309).Conclusions Early after operation,LV is undergoing hypertrophy or hyperplasia in TGA/IVS,but will recover in the mid-term period,and the function is normal all the time indicating that the LV myocardium may avoided irreversible pathological changes if operated in time.All in all,LV develops well in mid-term period.