Objective To investigate the effect and safety of urinary kallidinogenase on acute cerebral infarction.Methods One hundred and sixty-four patients with acute cerebral infarction were randomly divided into two groups:treatment group with urinary kallidinogenase(86 cases)and control group (78 cases).According to Chinese guidelines for prevention and management cerebrovascular disease,two groups were treated with basic therapy,such as antiplatelet,neurologic protection,blood pressure control,and so on.On basis of control group,treatment group Was administrated intravenous injection of urinary kallidinogenase 0.15 PNA U per day for 10 days.The primary efficacy Was evaluated by the National Institutes of Health Stroke Scale(NIHSS)score and Barthel index.Results The score of NIHSS and Barthel index at 15 days after treatment in the treatment group were higher than those in the control group[(6.67±3.02)scores vs(7.42±3.02)scores;75.36±23.56 vs 68.36±22.36,P＜0.05].Urinary kallidinogenase could significantly reduce neurological deficits in big artherosclerosis type by TOAST typing.Conclusion Urinary kallidinogenase may be effective and safe in the treatment of acute cerebral infarction.

Objective Letter fluency test is one of the important neuropsychological tests which can examine the cognitive function of the prefrontal cortex (PFC) of human brain.However,there is no successful Chinese version.This research is trying to develop a Chinese letter fluency test similar to the English version,and to provide an effective approach to investigate the function of the PFC of the native Chinese speakers.Methods Thirty 19 ～33 years old healthy native Chinese speakers were chosen (13 men and 17 women).The near-infrared spectroscopy was used to observe the activation of the PFC while the participants carried out the Chinese letter fluency tests.Some of the participants carried out three kinds of letter fluency tests and category fluency test.Results The average score of the Chinese letter fluency test using syllable cue in 60 s was 12.8 ±4.7.The relative value of [oxy-Hb] in 12 channels of 13 ones located in the PFC during carrying out the test was higher than before and after the test significantly (P＜ 0.05 ).Conclusion The novel Chinese letter fluency test using syllable cue is similar to the English version formally.The objective evidence shows that it can activate neural activity located in the PFC of human brain, and can be applied to the native Chinese speakers as a neuropsychological test investigating the function of the PFC.

Objective To explore the manifestations of chest multi-slice spiral CT in patients with initial infection of swine-origin influenza A (H1N1) virus (S-OIV). Methods The chest multi-slices spirals CT images of 19 firstly diagnosed patients with swine-origin influenza A (H1N1) in our institution were retrospectively studied. CT manifestations were evaluated by three experienced radiologists. Location, appearance of lung abnormalities, abnormal distribution, pleural effusion and others (pericadiaum, lymphadenopathy and pleural thickening) were observed and quantitatively analyzed. The correlation of ground-glass and consolidation CT scores with the fever time was studied. Results The abnormal CT findings were observed bilaterally in 18 of 19 subjects including ground-glass (n= 3), consolidation (n=3 ), consolidation accompanied with ground-glass (n=12). Most of these lesions were distributed diffusively (n=14) while the others located in the middle and low lobes (n= 4). Unilateral (n=3) or bilateral (n=2) pleural effusion were observed. Lymphadenopathy (n=2), effusion of pericadium (n=1), pleural thickening (n=1) and cardiac enlargement (n=2) were also found in patients with H1N1. CT scores of ground-glass were 4. 25(n=2),3.75 (n=1),2.25(n=1),1.75(n=1),1.00(n=6),0.75(n=2), 0.50(n=2),0(n=4).CT scores of consolidation were4.25(n=1),4.00(n=1),3.75 (n=1), 2.75(n=1),1.25(n=3),1.00(n=2),0.75(n=2),0.50(n=1),0.25(n=3),0(n=4). CT scores of ground-glass were significantly correlated with the fever time (r= 0.776, P < 0.01), CT scores of consolidation had no correlation with the fever time(r=0.322,P > 0.01). Conclusions The most common CT findings in patients with S-OIV infection are diffuse distribution of bilateral ground-glass opacities with or without associated focal or multifocal areas of consolidation. The increasing of ground-glass's range could be the marker of progression of H1N1 pulmonary infection at initial stage.

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 To discuss the clinical features and therapeutic effects of adrenogenital syndrome in children. Methods Clinical and follow up data were summarized for 42 children with adrenogenital syndrome, including 30 cases of congenital adrenal hyperplasia (CAH) and 12 cases of adrenal cortex tumor. Results Endocrine function examination in 15 cases of CAH showed that 24h urine 17 KS was elevated in 10 cases and normal in 5.There was obvious clitorism in all 30 CAH children and urogenital sinus malformation in 28.Of the 12 cases of adrenal cortex tumor 7 had sexual abnormality and hypercortisolism simultaneously.Clitoris shortening or clitoridectomy was performed in CAH cases plus vaginal vestibule plasty simultaneously.Of the 12 cases of adrenal cortex tumor 10 underwent complete tumor resection;1 partial tumor resection and the remaining 1 declined treatment.During the follow up 8 case of cortex tumor,4 cases of adenoma survived tumor free with an average survival time of 7.5 years;2 cases of cortex carcinoma survived tumor free for 3 and 4 years;while the other 2 cases died soon after discharge. Conclusions The diagnosis can be established based on clitorism,labium confluence or male sexual precocity,increase in urine 24h 17 KS and blood testrone.Cortex hormone should be taken early,properly,life long in CAH patients,and appropriate perineoplasty should be performed.Early detection and resection of tumor is the key point for treating adrenogenital syndrome caused by cortex tumor.

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.

Objective To study prospectively the safety and efficacy of the thromblytic therapy in acute submassive pulmonary thromboembolism (PTE) without randomized control.Methods A total of consecutive 177 patients with acute submassive PTE admitted to the emergency intensive care unit were screened from June of 2005 to May of 2012.After a comprehensive screening,102 patients were treated with thrombolytic therapy (TT group),and 75 with anticoagulation therapy (AT group).Clinical signs and physical examination findings were recorded 2 hours,24 hours and 7 days after treatment.Echocardiography (ECG) was repeated 24 hours later.Lung perfusion scan and CT pulmonary artery (CTPA) were repeated on the 7th day.All data was analyzed by paired t test and Chi-square test.Results ①Bleeding happened in 6 patients of TT group and in 1 patient of AT group (P ＞ 0.05),and no lethal hemorrhage occurred in the two groups.There were no statistically significant differences in demographics and clinical history of patients between TT group and AT group (P ＞ 0.05).②There were statistically significant changes in respiratory rate,heart rate and systolic blood pressure in the TT group 2 hours after treatment and great changes in systolic pressure of pulmonary artery (SPAP) and tricuspid regurgitation at 24 hours after treatment (P ＜0.01),whereas obvious change in respiratory rate in AT group was found 24 hours after treatment.③In the TT group 7 days after treatment,significant efficiency rate and total improvement of the deep vein thrombosis (DVT) identified by ultrasonography were 83.0％ and 96.2％ respectively,and those of CTPA and lung perfusion scan were 66.7％ and 98％ respectively.The efficiency of TT was significantly superior over AT in this respect (P ＜ 0.01).④The efficiency of TT given within 3 days after onset of PTE was significantly higher than that of TT conferred over 3 days after onset of PTE (P ＜ 0.01).Conclusions ①Thrombolytic therapy is safe and effective for the submassive PTE,but atypical cerebrovascular accident must be rule out first.②Thrombolytic therapy can improve the symptom of the patient in 2 hours compare with AT.③ Thrombus burden can be reduced more obviously in TT group after 7 days treatment compare with the AT group.④The effect of thrombolytic therapy depends on the time as ti given during the course of disease,the earlier administration the better efficacy.

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 describe the characteristics of the criss-cross heart with comprehensively segmental echocardiographic scanning in order to explore the diagnostic value of the echocardiography.Methods Ten cases of criss-cross heart were retrospectively reviewed with 2-dimensional,color Doppler echocardiography to summarize the main diagnostic methods.Results The right ventricle was located superiorly and the left ventricle inferiorly in 9 patients and paralleled alignment in 1.The solitus situs was observed in 9 patients and dextrocardia in 1;the atrioventricular connections were concordant in 8 patients and discordant in 2.Echocardiography revealed that 5 patients presented with transposition of great artery and 5 with double outlet of right ventricle as well as all with ventricular septum defect.Conclusions Clear visualization is available with echocardiography to show the crossing inflow streams at the level of atrial-ventricular valve,abnormal alignment of the ventricular septum as well as the associated abnormalities.

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.