To investigate the value of echocardiography in the diagnosis of total anomalous pulmonary venous connection (TAPVC), 16 patients in our hospital were diagnosed to have TAPVC by echocardiography from year 1994 to 2001. In 11 cases the results of echocardiography were compared to those of surgery. Each patient was examined by using a combination of precordial, suprasternal and subcostal windows to visualize all the pulmonary veins and their drainage sites, common pulmonary venous trunk, and other associated abnormalities. Of the 16 cases, the drainage sites were as follow: supracardiac in 10, via vertical vein in 9, directly to superior vena cava in 1; cardiac in 5, via coronary sinus in 2, directly to right atrium in 3. Diagnoses were correctly made in all the 11 cases as confirmed by surgery. Echocardiography can also assess pulmonary arterial pressure and detect other associated abnormalities. It is concluded that echocardiography is the preferred examination method in the diagnosis of TAPVC before surgery. With careful examination using multiple windows and sections, TAPVC can be accurately diagnosed by echocardiography.
*Echocardiography, Doppler, Color ; Heart Defects, Congenital/*ultrasonography ; Pulmonary Veins/*abnormalities ; Pulmonary Veins/ultrasonography

BACKGROUND:In the clinical orthodontics, ceramic brackets have deficiencies in the aspects of antibacterial and mechanical properties, which easily lead to the emergence of a variety of adverse events and influence the orthodontic effect. OBJECTIVE:To observe the antibacterial and mechanical properties of nano silver hydroxyapatite coating ceramic brackets. METHODS:The nano silver hydroxyapatite coating ceramic brackets were prepared. Scanning electron microscopy was used to observe the coating surface. Coating antibacterial experiment was conducted. Totaly 50 in vitro human maxilary premolars were randomly divided into two groups (n=25 per group): experimental and control groups. Premolars in the experimental group were bonded to nano silver coating hydroxyapatite ceramic brackets, and premolars in the control group were bonded to ordinary ceramic brackets. The shear strength was detected in these two groups.RESULTS AND CONCLUSION: The overall structure of nano silver hydroxyapatite coating was order, uniform and compact. Hydroxyapatite had a porous structure with a micro-nanometer aperture and there were a large number of nano-silver particles uniformly distributed. Quantitative antibacterial experiments showed that nano silver hydroxyapatite coating ceramic brackets had a strong inhibition to Escherichia coli and Staphylococcus albus, with an antibacterial rate of more than 95%. The shear strength in the experimental group was lower than that of the control group (P < 0.05). These results demonstrate that the nano silver hydroxyapatite coating ceramic brackets have good antibacterial and mechanical properties, which meet the requirement of mechanical change in the clinical orthodontics.

The TLD(thermoluminescent dosimetry)must be calibrated before used in individual dosimetry.In this paper,some related issues that affect the accuracy of calibration,including principle and performance of the instruments,conditions of annealing and measuring,method of curve fitting are discussed and an appropriate calibration method is proposed.The results show that the method we proposed is valid and efficient,which ensures the accuracy of individual dosimetry.

Operation of radiological equipment affects not only the quality of clinical diagnosis & treatment,but also the health of the radiographer and subjects.The operation and safety protection of the aged radiological equipment in primary medical units has to be paid particular attention to.Based on the survey,some advices are put forward from the aspects of equipment management,personnel training and protection supervision.

We began our teaching reform by following the step of national adjustment of majors frame at the end of last century.We perfected our teaching contingent,created advanced content, composed high quality text book,used multiple teaching methods and ways, paid attention to practical teaching,carried out effective access system and in the end,we firstly combined Meridian and Collateral and Acupuncture,which are the two major courses,into one basic course called Meridian and Acupoint.It covers different levels of students including doctors,postgraduates,undergraduates and seven-year-class students and has the features of abundant and detailed content,creative methods and excellent effects.

The optimal plane for measurement of the right ventricular (RV) volumes by real-time three-dimensional echocardiography (RT3DE) was determined and the feasibility and accuracy of RT3DE in studying RV systolic function was assessed. RV "Full volume" images were acquired by RT3DE in 22 healthy subjects. RV end-diastolic volumes (RVEDV) and end-systolic volumes (RVESV) were outlined using apical biplane, 4-plane, 8-plane, 16-plane offline separately. RVSV and RVEF were calculated. Meanwhile tricuspid annual systolic excursion (TASE) was measured by M-mode echo. LVSV was outlined by 2-D echo according to the biplane Simpson's rule. The results showed: (1) There was a good correlation between RVSV measured from series planes and LVSV from 2-D echo (r = 0.73; r = 0.69; r = 0.63; r = 0.66, P < O. 25-0. 0025); (2) There were significant differences between RVEDV in biplane and those in 4-, 8-, 16-plane (P < 0.001). There was also difference between RV volume in 4-plane and that in 8-plane (P < 0.05), but there was no significant difference between RV volume in 8-plane and that in 16-plane (P > 0.05); (3) Inter-observers and intro-observers variability analysis showed that there were close agreements and relations for RV volumes (r = 0.986, P < 0.001; r = 0.93, P < 0.001); (4) There was a significantly positive correlation of TASE to RVSV and RVEF from RT3DE (r = 0.83; r = 0.90). So RV volume measures with RT3DE are rapid, accurate and reproducible. In view of RV's complex shape, apical 8-plane method is better in clinical use. It may allow early detection of RV systolic function.
Cardiac Volume ; Echocardiography, Three-Dimensional ; Electrocardiography ; Systole ; Ventricular Function, Right/*physiology

Objective To explore the value of transthoracic echocardiography in diagnosis of univentricle and analyze the sonogram typing. Methods The results of 66 patients with univentricle were reviewed retrospectively,and analayzed their typing connected with the reports in the literature. Results There were 3 ultrasonic types in 66 cases:①Type A(single left ventricle) 19 cases,single ventricle with left ventricular shape,residual cavity in front of it. ②Type B(single right ventricle) 38 cases, single ventricle with right ventricular form,and residual cavity in the rear.③Type C (solitary single-ventricle) 9 cases,there was only one ventricle. Thirty-one of them were treated surgically, 5 cases without operation had MRI or cardiac catheterization examination and the remaining 26 patients were only observed by echocardiography,the positive rate of diagnosis in type was 100%, the results were compared with cardiac catheterization or MRI examination and the operation: 1 cases of mixed type total anomalous pulmonary venous connection was misdiagnosed as heart-type total anomalous pulmonary venous drainage. But 1 case of descending aorta limitations narrow complicated patent ductus arteriosus(PDA), PDA was missed. The rest were completely correct diagnosis. Conclusions The transthoracic echocardiography can be used to evaluate types and all containing malformations of univentricle,and offers reliable information for operation.

Objective To explore the value of echocardiography in the diagnosis of the criss-cross heart. Methods The echocardiographic results of 6 patients with the criss-cross heart were reviewed retrospectively. The echocardiographic characteristics were analyzed and compared with the surgery results in 4 operated cases. Results The 6 cases were interpreted as representing a criss-cross heart with solitus atria,D-loop ventricles and concordant atrioventricular connections. The ventriculo-arterial alignments of 5 cases were abnormal including double outlet right ventricle with anterior aorta in 2 and transposition of the great arteries in 3 while 1 patient had concordant connection. The following principal characteristics were tilting the transducer from posterior to anterior could demonstrate the connection of the left-sided left atrium and the right-sided left ventricle through mitral valve at first. The more anterior angulation of the transducer then showed the right-sided right atrium was connected to the left-sided right ventricle through tricuspid imaging displayed the two atrial outflows crossed each other without mixing at atrioventricular valve level.right ventricle often occured. The echocardiographic diagnosis of the criss-cross heart and its associated cardiac abnormalities were confirmed by surgery in 4 cases except 1 persistent left superior vena cava was missed. Conclusions The invisibility of a standard 4-chamber view in any cut was very characteristic in the echocardiographic diagnosis of the criss-cross heart. The definitive appearance was the separate display of the two ventricular inlets and the crossed atrioventricular connections with each atrium emptying into the contralateral ventricle by continuous subxiphoid or apical scanning. The transthoracic echocardiography can diagnose this rare heart disease and associated cardiac abnormalities accurately.

Transthoracic echocardiographic characteristics of 17 cases of cardiac amyloidosis (CA), a rare disease in China, were analyzed in order to improve the understanding of the disease. Seventeen cases of biopsy-proven CA, admitted to Wuhan Union Hospital from June 1994 to September 2008 were retrospectively reviewed. Twenty normal volunteers served as control group. Left atrial and ventricular functions and mitral inflow velocity were measured by two-dimensional, and Doppler echocardiography, and tissue Doppler imaging (TDI)-derived peak systolic wall motion velocities (Sv), peak early diastolic wall motion velocities (Ev), and peak late diastolic wall motion (Av) were measured at the septum, lateral, inferior and anterior corners of mitral annulus from the apical 4- and 2 chamber views. Compared with the control group, the interventricular septal thickness (IVSd), the left ventricular posterior wall (LVPWd), right ventricular transverse diameter (RVTDd) near the end of diastole and the interauricular septum thickness (IASs), left atrial anteroposterior diameter (LAADs), right atrial transverse diameter (RATDs) near the end of systole were increased significantly (all P<0.05) and left ventricular ejection fraction (LVEF) decreased (P<0.05) in the CA group. Compared with the control group, Sv, Ev at each wall and Av at almost all walls were significantly decreased in the CA group. In the CA group, Myocardial echoes of interventricular septum and free wall of left ventricle were enhanced evidently and distributed unevenly. The echoes presented as ground glass-like images, with some spotty hyper echoes. Both atria were enlarged, and LVEF decreased, with diastolic function impaired, and mild-moderate hydropericardium found in the CA group. It was concluded that echocardiography was a relatively sensitive and highly specific non-invasive method for the diagnosis of CA.
Amyloidosis/*ultrasonography ; Cardiomyopathies/*ultrasonography ; Case-Control Studies ; Echocardiography ; Echocardiography, Doppler/*methods ; Retrospective Studies ; Sensitivity and Specificity

Objective To assess regional left ventricular systolic function in patients with hypertrophic cardiomyopathy (HCM) using real-time three-dimensional echocardiography (RT-3DE).Methods Twenty-five patients with HCM which was asymmetric septal hypertrophy,and twenty healthy subjects were enrolled in the study.The apical four-chamber view of left ventricular was acquired by RT-3DE.The left ventricular volume-time curves were analyzed quantitatively with Tomtec 4D LV-Analysis 3.0,and regional end-diastolic volume and end-systolic volume of left ventricular (rEDV,rESV),the time to minimum systolic volume (rESVT),regional stroke volume (rSV),regional ejection fraction (rEF),regional-global ejection fraction (rgEF) and the parameters of left ventricular dyssynchrony were measured.Results In the HCM group,the values of Tmsv16-Dif,Tmsv16-SD,Tmsv16-Dif％,Tmsv16-SD％ were significantly lower compared with the control group (P ＜ 0.01),and rEDV,rSV,rEF and rgEF in hypertrophic segments were lower than those in non-thickening and mild-thickening segments (P ＜0.05).In the control group,there were no significant difference of those parameters among all segments (P ＞0.05).The values of rEDV,rSV and rgEF in hypertrophic segments decreased in the HCM group (P ＜0.05),at the basal level,rEF in hypertrophic segments decreased,at the apical level,it increased,but the differences at the mid-ventricular level between the two groups were not significant;the values of rEF and rgEF in non-thickening and mild-thickening segments increased (P ＜0.05).Conclusions RT-3DE could sensitively detect left ventricular dyssynchrony and accurately assess regional left ventricular volume and function of different segments in patients with HCM.