Objective To investigate the relationship between serum cystatin C (Cys C) level and the occurrence of in-stent restenosis after coronary drug-eluting stent implantation.Methods A retrospective analysis of coronary drug-eluting stent implantation was curried out in 592 patients.All patients were from Shengjing Hospital of China Medical University by coronary angiography,and were divided into restenosis group (142 cases) and non restenosis group (450 cases).The Cys C levels before and after surgery and follow-up angiography were analyzed.The biochemical indicators,and transcatheter arterial restenosis were analyzed.Results Either before or after operation and follow-up angiography,serum cystatin C levels were higher in restenosis group patients than that in non restenosis group [before operation:(1.622 ± 1.063) mg/L vs (1.369 ± 0.860) mg/L;after the operation:(1.769 ± 1.062) mg/L vs (1.458 ± 0.883) mg/L;review:(1.924 ± 1.085) mg/L vs (1.440 ± 0.874) mg/L;P ＜ 0.05].Multivariate COX regression analysis showed that serum cystatin C level was an independent risk factor of in-stent restenosis in drugeluting area (P ＜ 0.05).Conclusions The serum cystatin C level is closely related to in-stent restenosis in drug-eluting stents area.High level of serum cystatin C is an independent risk factor of in-stent restenosis after drug-eluting stents implantation.

Objective To investigate the relationship between serum of type Ⅲ collagen and arterial compliance in hypertensive patients.Methods One hundred fifty-eight in-patients of hypertension were enrolled.All subjects underwent laboratory measurements including serum PⅢNP,blood-lipid,glucose and high sensitivity C-reactive protein.Carotid to femoral pulse wave velocity(PWVcf),C1 and C2 were measured by a Complior Colson device and DO-2020.Results(1)PWVcf positively correlated with serum PⅢNP(P

Objective To assess the coronary flow reserve in the patients with systemic lupus erythematosus(SLE)by transthroracic echocardiography(TTE).Methods Coronary sinus blood flow of 24 SLE patients and 18 matched healthy controls were assessed by TTE.The coronary flow reserve was calculated as the ratio of hyperemic to baseline blood flow.Hyperemia was induced by intravenous administration of dipyridamole.Results Adequate recordings of blood flow in the coronary sinus under both conditions were obtained by TTE in all study subjects.Patients with SLE were found to have significantly decreased coronary flow reserve comparing with normal SUbiects(1.55±0.21 versus 2.51±0.33.P＜0.01).Conclusions Coronary flow reserve can be measured by TTE in SLE patients,Coronary flow reserve is impaired suggesting that SLE patients may have subclinical coronary artery disease.

Objective To measure cerebral circulation time(CCT) of a group of normal adults by contrast-enhanced ultrasound. Methods Forty-seven cases of healthy volunteers without any cardio-cerebral disease history were enrolled in the study. Internal carotid artery and vertebral artery were observed and the blood flow was measured with high frequency probe. Contrast-enhanced agent SonoVue was injected bolus into median cubital vein. CCT was measured and calculated according to the contrast curve analysis. Contralateral CCT measurement was repeated when the blood flow signal resume to the baseline intensity. Cerebral blood volume was then calculated according to CCT and cerebral blood flow. Results All the imaging of carotid vessels was presented clearly in all objects. Cerebral blood flow was 603 ～ 990 ml/min with an average (778 ± 171)ml/min. Bi-lateral CCT was measured successfully,the value ranged 4. 1 ～ 10.2 s with average (6.22 ± 1.47) s. There were no significant differences both in contrast of left and right side of the carotid vessels and in contrast of three dosage groups ( P ＞0.05). The cerebral blood volume was 54～96ml with average (76 ± 27)ml. Conclusions Contrast-enhanced ultrasound can be useful in measurement and calculation of CCT and cerebral blood volume.

Objective To investigate hepatic parenchyma and kidney cortex's gray-scale ratio as a new index in evaluating hepatic fibrosis degree.Methods Sixty patients with hepatic fibrosis verified by liver biopsy and 40 normal individuals used as controls were scanned with Acuson Sequoia 512 with the same set-up of all the parameters.The hepatic-right kidney section was selected for offline analysis.The gray-scale value of near-area hepatic,mid-area hepatic,far-area hepatic parenchyma and right kidney cortex were measured by histogram of Photoshop software.The gray-scale ratio of hepatic parenchyma to kidney cortex was calculated and compared with the hepatic firbrosis degree.Results With development of hepatic fibrosis,the ratio of hepatic and kidney gray-scale value was increased.The results between control and experimental groups were significant(P＜0.01).Conclusions Hepatic and kidney gray-scale ratio obtained from gray scale ultrasound was rarely affected by individual conditions of acoustic windows.It could be used as a new index for diagnosing of hePatic fibrosis and evaluating its therapeutic effects.

ObjectiveTo test the reproducibility of wave intensity (WI)analysis derived measurements of pulse wave velocity (PWV),and to compare it with the traditional method-applanation tonometry.MethodsOne hundred and ten outpatient volunteers were enrolled in the study.The R-W1 of right brachial artery and right posterior tibial artery were measured through WI in diagnostic ultrasound equipment (Aloka α10),and were used to calculate the right brachial artery PWV which were also measured by tonometry (VP-1000) simutaneously;thus 30 of these volunteers were randomly selected to repeat the above examinations in the same session.Differences between the two methods were investigated by means of a paired t-test,and their linear correlations were also analyzed.Bland-Altman method was used to analyze the agreement between the two methods and their intraobserver intrasession variabilities.ResultsMean baPWVs determined by WI and tonometry were (13.03 ± 1.93) m/s and ( 12.05 ± 2.02) m/s,respectively (P ＜0.001),and the mean of their difference was (0.98 ± 1.1)m/s giving 95 ％ limits of agreement of ( - 1.18 m/s,3.14 m/s).Values of PWV obtained by the two systems were highly correlated( r =0.85,P＜ 0.001 ),with their intraobserver intrasession variabilities being 8.2％ and 7.0％,respectively.ConclusionsWI provides a new noninvasive and convenient method to measure PWV with good agreement and similar reproducibility to the standard tonometry system.

ObjectiveTo quantify the underestimation of cardiac blood flow velocities measured by Doppler echocardiography and to explore a method for correction using a new explored dual PW/TDI technique.MethodsThe dual PW/DTI mode was used to simultaneously record the aortic,mitral,tricuspid and pulmonary valvular blood flow velocity and the adjacent valvular annulus velocity in forty healthy volunteers,then the underestimations of the flow velocities were calculated.ResultsThe true blood flow velocity relative to the valvular annulus could be obtained by dual PW/TDI technique.Conventional Doppler echocardiographic measurements significantly underestimated the true velocity ( P ＜ 0.001).The actual aortic blood flow velocity had a significant underestimation of (8.5 ± 1.2) ％,the actual flow velocity of the pulmonary artery had a significant underestimation of (6.6 ± 1.1) ％,the underestimations of E and A wave of mitralvalve's were (13.4 ± 1.7)％ and (16.7± 3.4)％,the underestimations of E and A wave of tricuspid valve' s were ( 18.7 ± 1.9) ％ and (26.0 ± 16.1 ) ％.ConclusionsThe cardiac blood flow velocity measured by Doppler ultrasound has been significantly underestimated and this underestimation can bequantified and corrected using dual PW/DTI technique based on the principle of motion relativity.

Objective To investigate the clinical value of blood vessel diameter tracking and X-strain technology in evaluating the carotid elasticity in patients with diabetes.Methods Thirty-eight patients who were confirmed as diabetes without complications were enrolled in this study as the patient group and thirtyseven healthy volunteers matched with the patient group with sex,ages were typed as controls.The parameters reflecting common carotid elasticity:pulse wave velocity ( PWV),compliance coefficient (CC),stiffness index ( β),endovascular circumferential strain,strain rate,strain time ( EN _ CS,EN _ CS_ T,EN_CSR,EN_CSR_T),adventitial circumferential strain,strain rate,strain time (EP_CS,EP_CS_T,EP_CSR,EP_ CSR_ T),radial strain ( RS),radial strain rate (RSR) and radial strain time (RST) were measured using blood vessel diameter tracking technique and X-strain technique.Significant difference between the two groups and correlations among these variables were evaluated.Results In patient group,PWV and β were significantly higher than those of the control group,while variables like CC,EN_CS,EN_CSR,EP_CS,EP_CSR,RS and RSR were lower with P ＜0.05.All strain time prolonged in patient group ( P ＜0.05).No significant differences were observed in longitudinal strain index.Furthermore,CC was inversely related with PWV( r =- 0.872,P ＜0.001 ),and age,systolic pressure,β were positively related with PWV ( r =0.322,P =0.005; r =0.384,P =0.001; r =0.927,P ＜0.001) in patients group.Conclusions The stiffness and compliance indexes measured by blood vessel diameter tracking technique and the circumferential and radial strain index obtained by X-strain technique can reflect vessel elasticity change of patient with diabetes objectively.

Objective To investigate the affecting factors of interventricular septum (IVS) swing by study of the mechanical model of the respiration-driven variation of cardiac function using echocardiography.Methods In present study,the equivalent mechanical model of septal swing in previous study was used.By changing the end-diastolic pressure difference between the simulated right and left ventricles and simulated intrapericardial pressure,the subsequent influences on IVS swing using echocardiography were observed.Results Under the rhythmic respiratory intrathoracic pressure change(RIPC)(0--4 mm Hg,1 mm Hg =0.133 kPa),the swing amplitude of simulated IVS increased with decrease of the simulated end-diastolic pressure difference between the simulated right and left ventricles (2.2-17.6 mm).With increasing of the simulated intrapericardial pressure,the simulated right ventricle and left ventricle collapsed in succession,the swing amplitude of simulated IVS also increased to a maximal amplitude of 22.4 mm.Conclusions The affecting factors of IVS swing including the magnitude of RIPC,the end-diastolic pressure difference between the two ventricles and the intrapericardial pressure.

Objective: To evaluate the efficacy of the third-generation instrumentation including TSRH, CD and ISOLA in the treatment of adult scoliosis. Methods:Thirty-five adult patients with idiopathic or degenerative scoliosis who received treatment with third-generation instrumentation (TSRH,CD and ISOLA) between July 1999 to January 2003 were retrospectively reviewed. The mean preoperative cobb angle of major curves of the frontal plane was 58.1°(42°-95°). The patients received a combined anteroposterior approach or a single posterior procedure. The mean follow-up time was 20 months(10-48 months). Preoperative and postoperative Cobb angles of the frontal plane and sagittal plane and the distance between C7 and CVLS were measured. The subjective assessment was judged by questionnaire. Results: Postoperative clinical appearance of all patients improved significantly. Mean correction of major curves of the coronal plane was 53.2%. Mean loss of correction of the coronal plane in the last follow-up was 4.3°. The distance between the midline of C7 and CVSL was corrected from 2.6 cm to 0.24 cm. The results of follow-up showed that 89.3% patients were satisfied with the outcome. Pneumatothorax and haematothorax occurred in 2 patients. Three patients still complained of low back pain one year after operation because of adjacent degeneration in 2 patients and pseudoarthrosis in the remaining 1 patient. Conclusion: Imageologic findings and subjective assessment of the patients showed that the third-generation instrumentation can achieve good correction and trunk balance in the treatment of adult scoliosis with fewer complications.