Objective To evaluate left ventricular(LV) twist and untwist using velocity vector imaging(VVI) in patients with apical hypertrophic cardiomyopathy (ApHCM). Methods Twenty-three patients diagnosed with ApHCM were consecutively enrolled and compared with normal controls. After a standard echocardiographic examination, parasternal basal and apical short-axis planes were scanned to quantify LV rotations,twist and LV untwist using VVI. Results Compared with the normal controls, the rotation and rotaional velocity of apical subendocardial myocardium were markedly decreased in ApHCM patients during the period of systole ( P＜0.05) ,but the decreases in basal planes were not significant. As a consequence,LV twist was significantly lower in ApHCM patients (P＜ 0.05). Compared to normal controls,the velocity of LV untwisting was also significantly decreased in ApHCM patients ( P＜0.05).Conclusions The twist and untwist of LV subendocardial myocardium were decreased in ApHCM patients.VVI is a useful method to assess the characteristics of LV twist and untwist in ApHCM patients.

Objective To evaluate the echocardiographic features of apical hypertrophic cardiomyopathy( ApHCM). Methods Twenty-seven patients with ApHCM including 21 men and 6 women, average age (42.7 ± 5. 1 ) years old were followed up from 1995 to 2008 to investigate the clinical, electroeardiographic and echocardiographic features. Results The major features of ECG were increased R amplitude( V_4 > V_5 > V_3)and inverteted T wave(especially in V_(3-5) leads and the voltage of the inverteted T waves may be up to ≥10 mm). The major feature of echocardiography was the thickening of left ventricular apical wall to 15 - 37 ( 18. 0± 3. 3 ) mm. The final follow up showed that the mean thickness of the apical wall was ( 19. 7 ±3. 7) mm. The ratio of the thickness of left ventricular apical wall to posterior wall before and after the follow up was 1. 7 ±0. 3 and 1. 9 ±0. 9 respectively, with significant statistical difference ( P < 0. 05). There was no difference in the left ventricular end-diastolic dimension and left ventricular ejection fraction. The main cardiovascular events were atrial fibrillation ( 16 cases) , heart failure of NYHA ID-IV class (3 cases) , anterior wall myocardial infarction ( 1 case) and sudden death ( 1 case). Conclusions The final diagnosis of ApHCM depends on the characteristic inverteted T wave in ECG and apical hypertrophy in echocardiography. The prognosis of ApHCM is rather good for its progression is relatively slow.

Objective To explore the influences of the path clinical health education on the self-management ability, health-promoting lifestyle, compliance, level of blood lipid in patients with PCI of one-day ward.Methods A total of 93 patients with PCI of one-day ward were selected as subjects and were randomly divided into observation group(n=47, the path of clinical health education) and control group(n=46, routine health education) by means of random number table. And then, we compared the self-care ability, health-promoting lifestyle, medication compliance, and level of blood lipid between two groups before and three months after intervention.Results After intervention, the proportion of low level, medium level, high level of self-care ability was 2.1%, 21.3%, 76.6% in observation group which was better than those(10.9%, 41.3%, 47.8%) in control group. The total score of health-promoting lifestyle in observation group [(157.40±17.86) points] was higher than that [(127.04±11.64) points] in control group. Moreover, the score of medication compliance in observation group [(27.98±3.89) points] was higher than that [(21.00±4.52) points] in control group. Besides, the level of total cholesterol, low density lipoprotein cholesterol, triglyceride in observation group was all lower than those in control. There were statistically significant differences in them between two groups( P<0. 05).Conclusions The path of clinical health education has an important role in improving health-promoting awareness and ability, self-management ability, compliance, level of blood lipid in patients with PCI.

Objective To explore the effect of solution-focused approach on self perceived burden, anxiety and depression in elderly patients with coronary heart disease complicated with type 2 diabetes. Methods From January to June 2016, 76 elderly patients with coronary heart disease complicated with type 2 diabetes from inpatients department of Wuxi Second People's Hospital were selected as the research objects by convenience sampling method. The patients were divided into control group and observation group by random number table, each with 38 cases. Patients in the control group were given routine nursing and patients of the observation group were given solution-focused approach intervention on the basis of routine nursing. Self-perceived burden scale, self-rating anxiety scale and self-rating depression scale were used to evaluate theeffect of intervention.Results Compared with the score before intervention, there was statistical difference in the self-perceived burden score after intervention in two groups (P<0.05). Before intervention, there was no statistical difference in the self-perceived burden score between the patients of the two groups (P>0.05). After 3-month intervention, the self perceived burden score of the observation group was lower than that of the control group (P<0.05). After intervention, there was statistical difference in anxiety and depression score of the intervention group compared with that before intervention (P<0.05). Before the intervention, there was no statistical difference in anxiety and depression of the two groups (P>0.05). After 3-month intervention,the score of anxiety and depression in the intervention group was significantly lower than that in the control group (P<0.05).Conclusions Solution focused approach can reduce the self-perceived burden of the elderly coronary heart disease patients with type 2 diabetes and alleviate the patients' negative emotions effectively.

Objective To explore the clinical value of noninvasive left ventricular pressure-strain loop(LV-PSL)technique in evaluating myocardial work and left ventricular remodeling before and after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods Seventy patients with AMI admitted to our hospital(coronary heart disease group)and 50 healthy adults(control group)who underwent physical examination during the same period were selected,The conventional echocardiographic indexes,left ven-tricular global longitudinal strain(GLS)and left ventricular myocardial work indexes,[global work index(GWI),global work efficiency(GWE),global constructive work(GCW),global wasted work(GWW)]were examined before and 7 days after operation in control group and coronary heart disease group.The differences of the above indexes between the coronary heart disease group and control groups were compared.According to the results of coronary angiography,AMI patients were further divided into a coronary heart disease single-branch group(34 cases)and a coronary heart disease multi-branch group(36 cases),and the differences of the above indexes between the two groups were compared.Analyze the correlation between left ventricular myocardial work indexes and GLS,conventional echocardiographic indexes.Result Left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV)and GWW were higher incoronary heart disease group than in control group before and 7 days after surgery,while left ventricular ejection fraction(LVEF),GWI,GWE,GCW and GLS were lower than control group,with statistical significance(all P<0.05).At 7 days after surgery,LVESV,LVEDV and GWW in the coronary heart disease group were lower than those before surgery,while LVEF,GWI,GWE,GCW and GLS were higher than those before surgery,with statistical significance(all P<0.05).LVESV,LVEDV and GWW at 7 days before and after surgery in the coronary heart disease multi-branch group were higher than those in the coronary heart disease single-branch group,while LVEF,GWI,GWE,GCW and GLS were lower than those in the coronary heart disease single-branch group,with statistical significance(all P<0.05).Correlation analysis showed that GWW was negatively correlated with GLS and LVEF,while GWE,GCW and GWI were positively correlated with GLS and LVEF(all P<0.001).Conclusion LV-PSL technique has good application value in evaluating left ventricular function and left ventricular remodeling in AMI patients before and after PCI,and provides a new non-invasive method for clinical practice.

Objective To explore the related factors for the unilateral flap and bilateral flap by changing the origi-nal operation plan in the extraction of maxillary impacted mesiodens.Methods 81 patients with impacted mesio-dens in the middle of the maxillary were retrospectively analyzed.The primary outcome variables were planned sur-gery (unilateral flap) and unplanned surgery (bilateral flap) .The secondary outcome variables consisted of opera-tion time and postoperative swelling.The predictive variables were as follows:the differential value of the shortest distance from the supernumerary tooth to the labial and palatal bone plates, which was divided into≥1.5 mm group and<1.5 mm group; the ratio of the distance from the adjacent tooth apex to the nasal floor, compared to the length of the supernumerary teeth, was recorded as≥1 and< 1.A statistical software SPSS 20 was used to com-plete the statistical analysis.Results When the differential value was less than 1.5 mm, the possibility of un-planned surgery increased, and the probability of planned surgery was 0.085 times than that of unplanned surgery.With age growing each 1-year, the probability of planned surgery gradually decreased, HR=0.745.The postopera-tive swelling of the palatal approach was only 0.374 times than that of the labial approach.With age increasing, the operation time increased gradually, B=1.213.The ratio of the distance from the adjacent tooth apex to the na-sal floor to the length of the supernumerary teeth did not affect the change of the surgical plan during the operation.Conclusion The shortest distance difference between the supernumerary teeth and the labial and palatal bone plates can be used as a reference for the selection of surgical approach for the extraction of maxillary impacted me-siodens.