Objective To evaluate the value and characteristics of left ventricular global systolic strain and its relation to the left ventricular global systolic function in patients with myocardial infarction(MI) by three-dimensional speckle tracking echocardiography (3D-STI).Methods In 24 patient subjects and 20 control subjects,the myocardial motion was tracking by 3D-STI,left ventricular ejection fraction(LVEF),and global longitudinal peak systolic strain(LVGLS),global circular peak systolic strain(LVGCS),global radial peak systolic strain(LVGRS),global area peak systolic strain(LVGAS) were measured.The values were compared between the two groups,the correlations between LVEF and LVGLS,LVGCS,LVGRS,LVGAS were analyzed respectively.Results (1)There was significant difference of each index about LVEF and global strain between normal group and MI group (all P ＜0.05).(2)The correlations among LVEF and LVGLS,LVGCS,LVGRS,LVGAS were found (r =-0.626,-0.770,0.772,-0.748 respectively,P ＜0.01 for all).(3) Bland-Altman analysis showed there were good agreements in both patients with MI and control subjects.Conclusions 3D-STI could be applied non-invisibly and objective to assess alteration of myocardial global systolic function by accurately measuring strain.Therefore,3D-STI appears to be a reliable and useful tool to estimate the left ventricular systolic function of MI.

Objective To estimate the assay performance of two different kind of reagent with different concentration of NADH.Methods Verificated function index of these two reagents,such as accuracy,sensitiveness,blank space and so on, and determined the molar extinction coefficient of NADH using hexokinase method and calculated the NADH density in two kind of AST reagents.Then estimated the effect of concentation of NADH on the analysis performance.Results NADH concentration was 0.21 mmol/L,and the sample detection limit of the linear was 1 629 U/L.NADH concentration was 0.13 mmol/L,and the sample detection limit of the linear was 1 263 U/L.So the gap between the two reagent’s detection linear was visible.But there were no significant changes in other performance indicators such as detection sensitivity,reagent blank,precision.Conclusion The NADH concentration in the reagent of AST had greatimpact on the detecting linear range, so should pay attention to the potential change of linear range in the daily work.

ObjectiveTo investigate the ability of three-dimensional(3D) speckle tracking imaging (STI) for assessing left ventricular (LV) strain,and measure the value and angle of myocardial main strain vector.MethoodsLongitudinal,circumferential and radial strain of LV were measured in 31 healthy adults by 3D-STI and two-dimensional(2D) STI.The main strain vector and the angle between main strain vector and the LV short-axis plane were calculated from longitudinal and circumferential strains.Results The global longitudinal,circumferential strains and strains at basal,middle,apical level of LV by 3D-STI were significantly smaller than those by 2D-STI,whereas radial strain showed an opposite trend.The 3D strains presented significant difference between different levels of LV,longitudinal,circumferential and radial 3D strains were greater at middle level than at basal and apical level of LV,meantime 2D stain didn't show such obvious trend.Calculated from three-dimensional longitudinal and circumferential strain,the main strain vector was greatest at middle level of LV,whereas the angle between main strain vector and LV short axis plane didn't show any significant difference between three levels of LV.Conclusions3D-STI provides us a new and reproducible method for the evaluation of LV regional function by measuring LV strains.

Objective To summary MRI findings and its diagnostic value of Balo's concentric sclerosis .Methods Brain MRI images of 4 cases with Balo's concentric sclerosis were studied with review of the literature in 13 cases.Results MRI showed multiple ring-like lesions within brains in 16 patients and single lesion only in 1.The deep white matters of cerebrum were involved in all patients.The cerebellum and brain stem were invaded in 2 and 4 respectively. Typical concentric sclerosis lesions demonstrated alternate middle and low signal rings on T1WI, middle and high on T2WI. The ring-like lesions were best seen on T1WI. The middle signal rings were enhanced on post-contrast images.The typical multiple sclerosis lesions were seen in 7 patients. Conclusion Balo's concentric sclerosis has characteristic findings on MRI.MRI is a very reliable diagnostic methed for this disease.

Objective To assess the usefulness of contrast echocardiography in differential diagnosing space-occupying lesions of the heart.Methods Contrast echocardiography was assessed for 38 patients of space-occupying lesion of the heart (SOLH).Contrast enhancement of SOLH was assessed visually,comparing with that in the adjacent myocardium:significant contrast enhancement,intensity higher than or equal to the adjacent myocardium; mild or partial contrast enhancement,intensity lower than the adjacent myocardium,or no contrast enhancement.Respectively,malignant tumors,benign tumors,and thrombus were diagnosed.Twenty-eight patients among the 38 cases had gold standard diagnosis.The consistency between visual assessment diagnosis and gold standards were compared with Kappa statistic.Results Visual semi-quantitative diagnosis of contrast echocardiography:thrombus,benign tumors and malignant tumors were diagnosed for 8,8 and 12 cases,separately.Except two highly vascular benign tumors (1rhabdomyoma and 1 paraganglioma) were misdiagnosed as malignant tumors,the rest 26 cases matched gold standard diagnosis.Quantitative analysis of contrast echocardiography,16 cases were suitable for quantitative an alysis,10 cases were diagnosed as benign tumors or thrombus (quantitative analysis could not differentiate the two),the rest 6 cases were diagnosed as malignant tumors.Quantitative analysis got the same 2 misdiagnosis as visual semi-quantitative diagnosis.Kappa value on visual semi-quantitative diagnosis of contrast echocardiography comparing with gold standard diagnosis was 0.892.Conclusions The characteristics of vascularity of SOLH can be accurately determined by the contrast enhancement level in diseased region through visual semi-quantitative analysis with contrast echocardiography.Contrast echocardiography can be mainly used in SOLH except thrombus that has been clearly diagnosed,especially for patients with on going or fore-past malignancy in other organs.

The value of tissue strain imaging (SI) in regional myocardial systolic and diastolic function assessment was studied. In 18 patients with nonobstructive hypertrophic cardiomyopathy (HCM) and 20 age-matched healthy subjects, regional myocardial longitudinal peak systolic strain in eject time (represented by epsilon(et)) was measured at basal, mid and apical segments of septal, lateral and posterior walls of the left ventricle (LV) and compared between groups. Epsilon(et) had no significant difference between segments in control group (P > 0.05), which displayed a decreasing trend from basal segments to apical ones. Epsilon(et) in the HCM group was significantly decreased (P < 0.05) as compared with that in the healthy group. In the HCM group, epsilon(et) in the midseptum was significantly less than at the basal and apical septum, and was also less than at the rest LV walls in the same group (P < 0.01). The systolic reversed epsilon(et) was noticed in 35% of the hypertrophic segments in HCM group. Significantly negative correlation existed between the absolute value of epsilon(et) and wall thickness in the midseptum (r = -0.83). The post-systolic strain (PSS) segment number the and amplitudes in healthy group were significantly less than those in HCM group (P < 0.05). Both regional myocardial systolic and diastolic functions were impaired in hypertrophic or non-hypertrophic segments in patients with the HCM, especially in hypertrophic segments. Strain imaging technique is a sensitive and accura tool in myocardial dysfunction assessment.

Objective To assess the two-dimensional carotid strain as an index of arterial stiffness in patients without carotid atherosclerotic plaques,and its clinic value in cardiovascular risk stratification.Methods All patients were divided into three groups (low risk,intermediate risk,high risk group) by Framingham cardiovascular risk scores,two-dimensional carotid circumferential strain (CS),carotid intimamedia thickness (IMT) were evaluated.CS was adjusted for pulse pressure (CS/PP).Results CS,CS/PP,IMT were significant difference between low risk and intermediate risk groups,low risk and high risk groups (P ＜0.05).IMT and CS were not significant difference between intermediate risk and high risk group (P =0.23,P =0.57).CS/PP was significant difference between three groups (P ＜0.05).Both CS and CS/PP were correlated with IMT (r =-0.30,r =-0.33,P ＜0.05).Conclusions Two dimensional strain could assess the carotid arterial mechanics.IMT and CS could evaluate the structural and functional alternations of carotid stiffness.Combining these two indices allowed more accurate evaluation of the subclinical phase of the atherosclerotic disease.

Objective To explore the situation of respiratory virus co-infection with EV71 and CA16 in patients with hand,foot and mouse disease(HFMD) ,and analyze the influence of co-infection on clinical aspects.Methods From June to October of 2010,there were 348 patients enrolled in the study,with 248 hospitalization cases and 100 mild outpatients.All the patients were diagnosed as HFMD in Beijing You-an Hospital.The viral RNA from the pharynx swab samples were extracted and reversely transcribed by RT-PCR.All the samples were detected with the EV71 and CA16 by real-time fluorescence quantitative PCR.Twelve kinds of respiratory viruses were detected by a commercial multiplex-PCR method.The PCR products were confirmed by electrophoresis.Chi square test was used in the data analysis.Results Of the 348 HFMD patients,36 subjects were detected as positive for respiratory virus co-infection.In the 248 hospitalization cases,111 cases were positive for EV71 or CA16,with eight cases identified with respiratory virus co-infection(7.2%); the other 137 cases were negative for EV71 and CA16,with eleven cases identified with respiratory virus co-infection(7.4%).There was not significant difference between respiratory virus co-infection and the identification of EV71 /CA16(x2 = 0.059,P ＞ 0.05).In the 100 mild outpatients positive for EV71 or CA16,seventeen cases were identified with respiratory virus co-infection(17%).The rate of respiratory virus co-infection in the mild outpatients was much higher than in the severe hospitalization patients(x2 = 4.830,P＜ 0.05).Among the 111 EV71(+) or CA16(+) inpatients,there were 101 cases diagnosed as severe cases(91.0%); similarly,there were 132 cases diagnosed as severe cases(96.4%) among the 137 EV71(-) CA16(-) cases.There was not difference between the identification of EV71/ CA 16 and illness of HFMD(x2 = 3.099,P ＞ 0.05).The leading respiratory virus being identified were HRV A/B,PIV3 and FLU A in the 348 HFMD patients.Conclusions Co-infection with respiratory virus exists in the HFMD patients. However,the respiratory virus infection has no significant influence to the state of HFMD illness.

BACKGROUND:Cytoskeleton plays an important role in the transduction of mechanical signal, and intermittent tensile stress can promote osteogenic differentiation. However, there is no relevant study about the change of cytoskeleton in osteoporosis rat bone marrow mesenchymal stem cells under intermittent tensile stress. OBJECTIVE:To investigate the effects of intermittent tensile stress on the cytoskeleton of osteoporosis rat bone marrow mesenchymal stem cells during osteogenic differentiation. METHODS:Bone marrow mesenchymal stem cells were obtained from osteoporosis rats and cultured in vitro. The 5%, 10%and 15%tensile stress were strained on the bone marrow mesenchymal stem cells through FX-4000T Flexcell. No stress was in the control group. Osteogenic differentiation of bone marrow mesenchymal stem cells was observed through alkaline phosphatase staining, while the change of cytoskeleton was observed by confocal laser scanning microscopy with figures col ected for analysis by Image-ProPlus 6.0 software. The area of cells, ratio of length to width and integrated fluorescence intensity of cytoskeleton protein F-actin were measured. RESULTS AND CONCLUSION:Under tensile stress, bone marrow mesenchymal stem cells from osteoporosis rats arranged in the direction vertical to mechanical stimulation. cells under different tensile stress differentiated towards osteoblasts. The result of alkaline phosphatase staining showed the most significant difference in 10%group, and quite an amount of cells lining lost succession in the 15%group. Under stress, the F-actin filaments were rearranged in paral el accordingly, which showed a reconstruction of cytoskeleton. Imaging analysis indicated that the area of bone marrow mesenchymal stem cells was decreased in 10%and 15%groups (P<0.05) with the increased ratio of length to width (P<0.05), and expression of F-actin increased in5%, 10%, 15%groups (P<0.05) after tensile stress. Under mechanical stimulation, the cytoskeleton of bone marrow mesenchymal stem cells from osteoporosis rats is shown to have corresponding alterations during osteogenic differentiation.

Objective:To investigate the expression levels of microRNA-124 (miR-124) and microRNA-494(miR-494) in the serum of elderly patients with Parkinson disease (PD) and its clinical significance.Methods:Ninety PD patients (PD group) who were hospitalized in Zhengzhou Central Hospital Affiliated to Zhengzhou University from March 2018 to April 2020 were selected.At the same time, 100 non-PD elderly people examined in the physical examination center of the same hospital who matched with age and gender of PD patients were selected as the control group.After 12 hours of fasting, 4 ml of venous blood was taken from all subjects.All PD patients were graded by unified Parkinson disease rating scale(UPDRS) from the aspects of mental state, behavior and emotion, quality of life and motor examination, and graded by the Hoehn-Yahr rating scale for Parkinson disease.The expression levels of miR-124 and miR-494 in serum were detected by real-time fluorescent quantitative PCR (qRT-PCR), and the diagnostic values of miR-124 and miR-494 in PD patients were evaluated by ROC curve.Results:Hoehn-Yahr grade of PD patients with UPDRS≤60 points was significantly lower than that of patients with UPDRS >60 points((2.47±0.43) vs (3.42±0.47))( t=9.055, P<0.001), and there was no significant difference in serum miR-124 and miR-494 expression levels((0.72±0.14) vs (0.70±0.12), (1.17±0.19) vs (1.18±0.22)) ( t=0.633, 0.230, P=0.529, 0.819). Compared with that in control group, the expression of miR-124 in PD group was down-regulated ((0.71±0.20) vs (1.05±0.24)), and the expression of miR-494 was up-regulated((1.18±0.26) vs (0.96±0.22)) ( t=10.542, 6.315, P<0.001). The results of ROC showed that the area under curve (AUC) of serum miR-124 and miR-494 in the diagnosis of PD were 0.847 and 0.760 respectively, the cutoff values were 0.901 and 1.126, respectively, the sensitivities were 86.67% and 61.11% respectively, and the specificities were 75.03% and 79.00% respectively. The AUC of the combined diagnosis of PD was 0.898, and the sensitivity and specificity were 85.56% and 85.00% respectively. Conclusions:The expression of miR-124 is low in PD patients, while the expression of miR-494 is high, which suggests that the changes of the two miRNA levels may be related with the occurrence and development of PD.Both of them have a certain diagnostic value for PD, and the value of combined diagnosis is higher.