Objective To assess the effect of aortic valve replacement (AVR) on left ventricular (LV) twist function in severe aortic stenosis (AS) patients with preserved LV ejection fraction (LVEF) by speckle tracking imaging (STI).Methods Twenty-eight severe aortic stenosis (AS) patients (17 male,age 64.1 ± 10.4 years) with normal LVEF (≥50％) were examined by STI before and six months after AVR.The standard mitral valve and apical short-axis views were obtained to analyze LV basal and apical peak systolic rotation.LV peak systolic twist was calculated as the different between apical rotation and basal rotation.LV fractional shortening (LVFS) was calculated as the percentage fall of LV systolic dimension with respect to diastolic dimension.The data were compared with 28 age and sex-matched normal controls.Results In patients,LVEF remained unchanged after AVR.LV twist increased before (19.7° ± 5.7° vs 12.9° ± 3.2°,P ＜0.001) because of increased apical rotation (13.0° ± 5.8° vs 7.6° ± 2.6°,P ＜0.001),and normalized after AVR (14.4°± 5.2°,P ＜0.001).In controls,LV twist correlated with LVFS (r =0.81,P ＜ 0.001),this relationship was reversed in patients before (r =0.52,P ＜0.01) and after AVR (r =0.34,P ＞0.05).Conclusions In patients with severe AS and normal LVEF,LV twist is exaggerated suggesting potential compensation for reduced long axis function.These disturbances normalize within six months of AVR but lose their relationship with basal LV function.

Objective:In order to find a safe and healthy way to control fish diseases caused by Aeromonas hydrophila,the immune effect of Aeromonas hydrophila inactivated vaccine on Carassius gibelio was studied.Methods: Three groups were randomly made by each of 10 fishes.Injection groups was made intraperitoneally ( i.p.) with 200 μl, and soaked group with 3 L volumes of inactivated vaccine suspensions respectively while the control group with same volumes of saline.Tissues and blood samples of carassius gibelio were collected after the second vaccination.Then the histopathological, immunological indicators and survival percentage were detected.Results:The relative survival percentage of two groups was 90%and 60%respectively.The serum enzymes of injection and soaked group showed significant differences contrasted with the control group.Histopathological studies revealed that the important tissues have been damaged obviously after the bacterium challenge, while the experiment groups were no damage.Conclusion:Therefore the inactivated vaccine could prevent carassius gibelio diseases that caused by A.hydrophila.

Objective:Selected virulence factors more than and high virulent Aeromonas hydrophia strain made into inactivated vaccine,to study the immunization effect of inactivated vaccine.Methods:Crucian were vaccinated with formalin-killed vaccine via in-traperitoneal injection.Controls were injected with the same volumes of saline.Then the antibody titres, histopathology and relative percent survival were analyzed from samples of both groups.Results: The antibody in the indirect agglutination reaction could be detected in vaccinated fish once a weeks after immunization and reached highest level 6 weeks after immunization.The histopathology analysis indicated that the vaccine had a good protective effect on crucian target organs.Vaccinated fish showed 100%relative percent survival and the immune period would be 6 month.Conclusion:The vaccine in this study has a significant protective effect on crucian and may be used as effective fish vaccines against bacterial septicemia.

BACKGROUND: Due to the polymorphism of HLA, a large number of ambiguities have been generated by conventional HLA typing techniques, and confirmed stereotypes of ambiguous results based on group-specific haploid full-length typing are rarely reported.OBJECTIVE: To analyze the accuracy of HLA-typing ambigulity based on group-specific haploid full-length sequencing. METHODS: The low-resolution results were used as the starting point for two ambiguous samples. Sanger sequencing (PCR-SBT) based on haploid full-length was performed after group-specific amplification. RESULTS AND CONCLUSION: One case showed a new A*02:03:01 allele, which was found a mutation in NT817 from C to T in comparison with A*11:01:01:01. The other case indicated another new C*07:02:01:01, which was found a mutation in NT879 from A to G in comparison with C*08:01:01. In conclusion, these results indicate that the group-specific haploid full-length sequencing method can be used to accurately classify HLA alleles and to discover new alleles.

Objective To evaluate the value of echocardiography on the diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC),and to improve the diagnositic accuracy of ARVC by echocardiography.Methods According to the 2010 European Heart Association guideline,twenty-one patients with ARVC were diagnosed from September 2003 to June 2014.The patients were divided into four groups (confirmed,suspiciously diagnosis,miss diagonisis,misdiagnosis) and the echocardiographic features were retrospectively analyzed including the right ventricular (RV) movement,the diameter of RV outflow tract (RVOTd),fractional area change of RV (RVFAC),the severity of tricuspid regurgitation (TR) and peak pulmonary artery systolic pressure (PASP).Results Of 21 patients,15 (71.4％) were confirmed by echocardiography,which had the typical ARVC echocardiographic features including the hypokinetic,akinetic or aneurysm of RV,dilation of RVOTd [mean RVOTd (40 ± 3)mm],and RV FAC＜33 ％ [mean (21 ± 7)％].TR were noticed in all the 15 patients but the PASP were normal [mean (27 ± 9)mmHg,1 mmHg =0.133 kPa].Three (14.3％) were suspiciously diagnosed which had the RV wall hypoakinetic,1 with pure RVOTd dilation and 2 with RV and RVOTd dilation,all 3 patients had mild TR,33％＜RVFAC ≤40％ and PASP were in normal range.Two patients had normal echocardiography which was miss diagnosed,one patient was misdiagnosed as dilated cardiomyopathy.Conclusions The different stages of ARVC patients had different echocardiographic features,the patients were easily diagnosed when the ARVC patients in RV failure stage.But for the early and late stage,the diagnosis should combine the clinical manifestation and other imaging facilities to avoid miss diagnosis and misdiagnosis.

Objective To assess the disorders of glucose metabolism and insulin resistance in patients with rheumatoid arthritis (RA) and its relationship with disease activity.Methods One hundred and twenty-three RA patients along with 98 age and sex matched controls were studied.Seventy-five g oral glucose tolerance test was performed.The homeostasis model assessment of insulin resistance (HOMA-IR) and beta cell function (HOMA-β) were evaluated.Disease activity score (DAS28) was used to assess disease activity.According to their DAS28 values,patients were divided into high disease activity group and low to moderate disease activity group.Glucose tolerance and HOMA-IR were compared between the two groups.Parameters that reflects disease activity,such as CRP and ESR,as well as disease activity scores were compared between patients with T2DM or prediabetes and patients with normal glucose tolerance.The data was analyzed by t test,Pearson correlation analysis and chi-square test.Results The prevalence of T2DM [20.3％(25/123) vs 5.1％ (5/98),x2=10.774,P＜0.01] and prediabetes [39.0％ (48/123) vs 7.1％ (7/98),x2=29.657,P＜0.01] increased in RA patients compared to controls.RA patients had higher HOMA-IR (2.5±1.5 vs 0.8±0.4; t=5.185,P＜0.01) and lower HOMA-β (83±69 vs 192±85; t=3.768,P＜0.01) compared to controls.ESR [(55±30) mm/1 h vs (37±26) mm/1 h; t=3.159,P＜0.01],CRP [(40±23) mg/L vs (19±10) mg/L; t=3.628,P＜0.01] and DAS28 score (5.6±1.3 vs 4.8±1.2; t=2.923,P＜0.01) were higher in RA patients with T2DM or prediabetes than in RA patients with normal glucose tolerance.In RA patients,the HOMA-IR was significantly positively correlated with DAS28 (r=0.39,P＜0.01),ESR (r=0.54,P＜0.01)and CRP (r=0.20,P＜0.05).The HOMA-IR value and fasting insulin levels were higher in high disease activity patients (DAS28＞ 5.5) than in low-to-moderate disease activity patients (DAS28 ≤5.5) although fasting plasma glucose level did not differ significantly in these two groups.Conclusion The prevalence of T2DM and prediabetes increases in RA patients comparing to controls.RA patients have insulin resistance that is associated with disease activity and systemic inflammation.

Objective To retrospectively analyzed the echocardiographic characteristics of ventricular diverticula in fetuses ,children and adults ,and discuss the main points of diagnoses and prognoses of ventricular diverticula . Methods Echocardiographic characteristics ,clinical data and intraoperative findings of ventricular diverticula of 8 fetuses ,3 children and 14 adults were summarized . Results The ventricular diverticula in 8 fetuses and 3 children were all single . Twenty five diverticula were found in the 14 adult patients ;in other words ,there were 3 multiple diverticula found in adult group . A statistical difference was found in ratio of diverticula area and corresponding ventricular area ( P = 0 .021 ) ,and corresponding ventricular fractional shortening ( P =0 .003) between fetal and single adult ventricular diverticula . There were 2 cases with ventricular septal defects ,1 with pericardial effusion ,1 with single umbilical artery ,and 2 with atrioventricular valvular regurgitation in fetal cases . Congenital complex cardiac disease and dextrocardia were found in 1 child . There were 1 case with supravalvular aortic stenosis , 1 with nonobstructive hypertrophic cardiomyopathy ,1 with left ventricular noncompaction ,and 1 with mitral reguigitation in adult group . All the 7 diverticula with ventricular arrhythmias ,ST‐T changes and abnormal Q wave were fibrous type . And 2 multiple diverticula were accompanied with ventricular dysfunction . Among the fetal cases ,2 cases were born ,3 cases were terminated pregnancy ,and 3 cases were lost to follow up . Three children and 2 adults were underwent cardiac operations for diverticula with good outcomes . No such complications as cardiac rupture ,thromboembolism ,and sudden death were found . Conclusions Echocardiography is a useful method to diagnose ventricular diverticulum ,especially for fetuses ,and provide the basis for prognosis consultation .

Objective To investigate the changes and correlation of mitral valve coaptation length index CLI and coaptation area index CAI after mitral valvuloplasty MVP Methods A total of 30 subjects undergoing MVP for mitral regurgitation MR were studied Coaptation length CL CLI coaptation area CA and CAI were determined before and after surgery by 2-dimensional transoesophageal echocardiography 2D-TEE and 3-dimensional transoesophageal echocardiography 3D-TEE Results Compared with preoperative measurements CL CLI CA and CAI were significantly increased in postoperative studies CL 4 7±0 7 mm vs 9 4± 1 1 mm CLI 9 1 ±3 3 vs 38 5 ±4 1 CA 148 9 ± 65 3 mm 2 vs 371 9 ± 144 3 mm 2 CAI 9 3 ±3 1 vs 35 9 ± 7 5 all P < 0 05 CLI was significantly correlated with CAI both preoperatively r = 0 770 P < 0 01 and postoperatively r = 0 771 P <0 01 Furthermore CLI and CAI were significantly negative correlated with the degree of MR r =-0 897 P <0 01 r =-0 886 P <0 01 Conclusions Coaptation variables increased significantly in subjects after MVP CLI by 2D-TEE was related to CAI by 3D-TEE and both were useful for the assessment of mitral valve coaptation But CLI by 2D-TEE was more simple and feasible in clinic.

OBJECTIVETo study the distribution of MICA alleles among ethnic Han Chinese blood donors from Shenzhen and their linkage disequilibrium with HLA-B gene.

METHODSFor 143 randomly selected blood donors, the MICA and HLA-B alleles were determined with a PCR-sequence based typing (SBT) method. Allelic frequency, haplotypic diversity and linkage disequilibrium were analyzed with a Pypop software.

RESULTSThirteen MICA and 35 HLA-B alleles were identified among the 143 blood donors, among which MICA*008:01 had the highest frequency (76/286), whilst MICA*008:01-HLA-B*40:01 and MICA*010-HLA-B*46:01 were the most common haplotypes. No novel allele was identified.

CONCLUSIONThe allele frequencies, haplotype diversities and linkage disequilibrium parameters under a high resolution can facilitate further studies and applications of the MICA and HLA-B genes.