Objective To measure right ventricular longitudinal strain (RVLS) of pulmonary hypertension(PH) patients by two-dimensional speckle tracking echocardiography,and explore its clinical application value on evaluating right ventricular function and hemodynamics in PH.Methods A total of 66 patients diagnosed as PH by right-heart catheterization were divided into Group Ⅰ (WHO FC Ⅰ / Ⅱ) and Group Ⅱ(WHO FC Ⅲ/Ⅳ) according to WHO pulmonary hypertension function classification.The right ventricular function parameters included:global right ventricular longitudinal strain (RVLSglobal),free-wall right ventricular longitudinal strain (RVLSFw),tricuspid annular plane systolic excursion (TAPSE),right ventricular fractional area change (FAC),tissue Doppler-derived tricuspid lateral annular systolic velocity (s') and right ventricular index of myocardial performance (RIMP).Systolic pulmonary artery pressure (sPAP) was calculated through tricuspid regurgitation pressure gradient.Hemodynamic parameters include:mean pulmonary arterial pressure (mPAP),pulmonary vascular resistance (PVR),pulmonary capillary wedge pressure (PCWP) and cardiac index (CI).Results ①Compared with Group Ⅰ,Group Ⅱ presented with higher sPAP (P ＜0.05).There also were significant differences between two groups in RVLSglobal,RVLSFw (P ＜0.01) and conventional right ventricular function parameters:TAPSE,RIMP and s' (P ＜0.05).②mPAP,PVR and CI had significant difference between two groups (P ＜0.01),while PCWP had no significant difference.mPAP and PVR increased more remarkable and CI decreased more significant in Group Ⅱ.③RVLSglobal had positive correlation with mPAP (r =0.646,P =0.000) and PVR (r =0.628,P =0.000) measured by right-heart catheterization;RVLSFW also had positive correlation with mPAP (r =0.652,P =0.000) and PVR (r =0.634,P =0.000).Conclusions Right ventricular longitudinal strain could evaluate the degree of decrease in right ventricular function of PH patients and reflex the change of hemodynamics at the same time,which may offer more reliable information to clinical treatment.

Objective To assess the right atrial(RA) function using two-dimensional speckle-tracking echocardiography(2D-STE) and the value of predicting WHO functional class in patients with pulmonary hypertension(PH).Methods Fifty-four consecutive PH patients were studied and compared with a control group of 24 healthy volunteers.RA function was evaluated by 2D-STE,and the following parameters were recorded:an average longitudinal strain (LS) curve that included LSpos during RA filling and LSneg representing RA active contraction (their summation is LStot),the phasic RA volumes,total RA emptying fraction (TotEF),RA passive(PassEF) and active emptying fraction(ActEF).The associations between these indices and the results of invasive pulmonary hemodynamics,cardiac structure and function level were evaluated.Results LStot,TotEF,LSpos,PassEF were significantly lower in PH patients than in controls(all P<0.01).ActEF/TotEF were significantly higher in WHO functional class (WHO-FC) Ⅱ and WHO-FC Ⅲ patients than in controls(all P<0.05),while were lower in WHO-FCIV patients than in controls(P<0.001).Among PH patients,LStot was negatively correlated with greater RA size and RA pressure (all P<0.01).LStot was also associated with right ventricular (RV) functional and overload parameters.In receiver-operator characteristic analysis,RA LStot was of optimal accuracy for prediction of WHO-FC≥Ⅲ in PH patients (P=0.002).Conclusions PH is associated with impaired reservoir and conduit function,but active contract function of RA is enhanced in WHO-FC Ⅱ and WHO-FC Ⅲ patients,and reduced in WHO-FCIV patients.RA LStot confers an optimal predictive effect of poor WHO-FC in PH patients and indicating prognosis.

Objective To discuss the correlation between right ventricular function and systolic pulmonary artery pressure (PASP ) in patients with chronic thromboembolic pulmonary hypertension (CTEPH)and explore the change of right ventricular function under different degree of PASP.Methods One hundred and thirty-seven CTEPH patients were divided into four groups by PASP:Group Ⅰ (50 mmHg≤PASP<70 mmHg),20 cases;Group Ⅱ (70 mmHg≤PASP<90 mmHg),35 cases;Group Ⅲ,55 cases (90 mmHg ≤ PASP < 1 10 mmHg);Group Ⅳ (PASP ≥ 1 10 mmHg),27 cases.Echocardiographic parameters include:PASP,tricuspid regurgitation area (ATR ),left ventricular transverse diameter (LVTD), right ventricular transverse diameter (RVTD),inner diameter of main pulmonary artery (DMPA ),inner diameter of left arterial branch (DLPA ),inner diameter of right pulmonary arterial branch (DRPA ).Right ventricular function parameters include:tissue Doppler-derived tricuspid lateral annular systolic velocity (s'),tricuspid annular plane systolic excursion (TAPSE),RV index of myocardial performance (RIMP)and right ventricular fractional area change (FAC).Results There were significant differences in RVTD, TAPSE,FAC and RIMP in CTEPH patients under different PASP(P <0.05).RV structure and function was significantly correlated with PASP in CTEPH patients.With the elevation of PASP,RV was significantly enlarged and RV function becomes worse.Conclusions Echocardiography may contribute to evaluate RV function in CTEPH patients and provide basis for clinical treatment and prognosis evaluation.

Objective To evaluate the application value of cardiopulmonary ultrasound(CPUS) in patients with interstitial lung diseases(ILD).Methods Ninety patients with clinically diagnosed interstitial lung diseases and 30 healthy subjects were included in this study.The conventional echocardiographic parameters and right ventricular free wall longitudinal strain (RVLS_FW) were measured in all patients and healthy subjects.The degree of pulmonary fibrosis or the disease severity of each ILD patient was scored using a semi-quantitative scoring method.Patients’ pulmonary function parameters and clinical outcome score (GAP score) were recorded.Fourteen patients belong to other types of ILD and 19 patients with incomplete clinical data were unable to perform GAP scoring,finally 57 patients' clinical and ultrasonographic parameters were measured.On the basis of the pulmonary arterial systolic pressure (PASP) obtained by Doppler echocardiography,90 patients were divided into two groups:ILD patients with pulmonary hypertension(ILDpH,PASP ≥36 mmHg,1 mmHg =0.133 kPa) and ILD patients without PH (ILDNpH,PASP＜ 36 mmHg).Comparsion between ILDpH,ILDNpH and healthy subjects were then evaluated.According to the GAP score,all cases were divided into three groups:low risk,moderate risk and high risk.Statistical analysis was performed to examine the relationship between CPUS parameters and clinical parameters.Results ①Compared with ILDNpH patients,ILDpH patients had significantly lower right ventricular function,wider basal right ventricular diameter (RVD),proximal right ventricular outflow diameter (DRvor1) and right pulmonary artery diameter (DRPA).Compared with healthy subjects,ILDNpH patients had mildly lower right ventricular function and wider left pulmonary artery diameter (DLPA) and right ventricular outflow tract dimensions at the distal or pulmonic valve (DRvoT2).②A good correlation was found between lung ultrasound (LUS) scores and pulmonary function parameters,especially diffusion capacity for carbon monoxide of the lung(DLco)(r =-0.68,P ＜0.001).③With the increased risk of patients,the right ventricular function was gradually decreased,DRVOT2,DRPA,DLPA were gradually widened,and the lung ultrasound score was gradually increased.A weak correlation was found between GAP scores with RVLS_FW,LUS scores,DRpA(r =0.44,0.34,0.31,P ＜0.05).Conclusions CPUS parameters are useful in the assessment of interstitial lung disease and could reflect the prognosis of ILD patients to some extent.Therefore,on the basis of GAP scores,addition of RVLS_FW and LUS score will be more helpful to evaluate the prognosis ofILD patients.

Objective: To evaluate the effect of online lifestyle intervention based on cognitive behavior adjustment on the female patients with infertility and central obesity. Methods: From November 2019 to November 2020, the women with infertility and central obesity in the Reproductive Medicine Center of Zhejiang Provincial People's Hospital were recruited and divided into two groups. The intervention group received online lifestyle intervention based on cognitive behavior adjustment for twelve weeks, and the control group received routine health education. Body weight, waist circumference, fasting blood glucose, fasting insulin, insulin resistance index (HOMA-IR), body fat, the pregnancy rate and the abortion rate were compared between the two groups. Results: There were 78 cases each in the intervention group and the control group, aged (31.15±4.87) years and (31.17±4.81) years, respectively. There were no significant differences between the two groups in age, body weight, body mass index, waist circumference, waist-hip ratio, fasting blood glucose, fasting insulin, HOMA-IR and body fat percentage before intervention (all P>0.05). After twelve-week intervention, the results of mixed effect model showed that the decrease of waist circumference, fasting insulin and body fat percentage in the intervention group were greater than those in the control group (all P<0.05). After six-month follow-up, there was no significant differences in the pregnancy rate (33.33% vs. 23.08%) and the abortion rate (7.69% vs. 16.67%) between the two groups (both P>0.05). Conclusion Online lifestyle intervention based on cognitive behavior adjustment helps to control central obesity and hyperinsulinemia.

Objective:To study the concentrations of fine particulate matters and ultrafine particles and influenced factors during winter in an area of Beijing .Methods:Real-time monitoring of particles ’ mass and number concentrations were conducted in an area of Beijing from February 7th to 27th , 2013.At the same time, the meteorological data were also collected from the Beijing meteorological website .Differences of the particles ’ mass and number concentrations during different periods were analyzed using Mann -Whitney U test.Meanwhile, the influenced factors were also analyzed .Results: The mean concentra-tions of fine particulate matters and ultrafine particles were ( 157.2 ±142.8 ) μg/m3 and (25 018 ± 9 309) particles/cm3, respectively.The particles’ number and mass concentrations in haze days were 1.27 times and 2.91 times higher than those in non-haze days, respectively.The mass concentrations of fine particulate matters in the self-monitoring site were higher than those in the nearest central monitoring sites, and the hourly-average concentrations of particles were significantly consistent with those at the commuter times.Meanwhile, the setting off of fireworks/firecrackers during the Spring Festival could lead to short-term increases of the particles ’ number and mass concentrations .When the wind speed was low and the related humidity was high , the concentrations of particulate matters were relatively high , and the mass concentrations of fine particulate matters were lagged about 1-2 d.Conclusion: The level of the particulate matters in this area was high .Heavy traffic , setting off of fireworks/firecrackers and meteoro-logical factors may be some of the main factors affecting the concentrations of the particulate matters in this area.Among those factors, the effect of setting off of fireworks/firecrackers didn’t last long and the effect of the meteorological factors had a hysteresis effect .

Objective To measure tricuspid annular displacement by two-dimensional speckle tracking echocardiography in pulmonary hypertension (PH) patients,and compare with the right ventricular function parameters,finally discuss the clinical application value of this technology in evaluating the right ventricular function in PH.Methods A total of 58 patients diagnosed or suspected diagnosed as PH were divided into PH group and control group according to pulmonary arterial systolic pressure measured by echocardiography.The right ventricular function parameters included:tricuspid annular plane systolic excursion (TAPSE),right ventricular fractional area change (FAC),tissue Doppler-derived tricuspid lateral annular systolic velocity (s') and right ventricular index of myocardial performance (RIMP).The parameters of tricuspid annular displacement included:the peak systolic tricuspid annular displacement at right ventricular free wall (TMAD1),the peak systolic tricuspid annular displacement at interventricular septum (TMAD2),the peak systolic tricuspid annular displacement at midpoint of tricuspid annulus (TMADm) and the right ventricular longitudinal shortening (TMADm％).Results ① There were significant statistical differences between two groups in TAPSE,RIMP,FAC and s' (P ＜0.01),TMAD1 (P＜0.05),and TMAD2,TMADm and TMADm％ (P ＜0.01).② Area under ROC curve indicated that parameters of tricuspid annular displacement had moderate predictive value in predicting the decline of right ventricular function in PH patients (P ＜0.01).③ Setting 15.5％ as cut-off value for TMADm％ to assessment FAC＜35 ％,TAPSE＜17 mm,RIMP＞0.54 and s'＜9.5 cm/s,their sensitivities were 81.8％,84.4％,85.7％ and 72.3％ respectively,and their specificities were 72.0％,73.1％,70.3％ and 100％ respectively.Conclusions The tricuspid annular tissue displacement parameters can predict the decrease of right ventricular function in patients with PH,and provide a new diagnostic index for clinical treatment and prognosis.

OBJECTIVETo observe the efficacy and safety of acupuncture therapy on moderate and severe allergic rhinitis via the comparison evaluation of western medicine.

METHODSSixty cases of moderate and severe allergic rhinitis were divided into an acupuncture group (30 cases) and a western medicine group (30 cases). In the acupuncture group, the main acupoints included Yingxiang (LI 20), Shangxing (GV 23), Fengchi (GB 20), Quchi (LI 11), Xuehai (SP 10), Feishu (BL 13), Geshu (BL 17), Pishu (BL 20), etc. The supplementary points were selected according to syndrome differentiation. In the western medicine group, budesonide nasal spray and cetirizine tablets were prescribed. All the cases were treated for 8 weeks in the two groups. Separately, before treatment, in 4 weeks and 8 weeks of treatment, the scores of clinical symptoms and physical signs were observed and the clinical efficacy and safety were compared between the two groups.

RESULTSIn 4 weeks and 8 weeks of treatment, the scores of symptoms such as sneezing, nasal discharge, nasal obstruction, nasal itching, eye itching and turbinate hypertrophy, the score of physical signs and total score were all reduced apparently as compared with those before treatment (all P<0. 05). The differences were not significant between the acupuncture group and the western medicine group (all P>0. 05). The total effective rates were 90. 0% (27/30) and 93. 4% (28/30) in the acupuncture group after 4 and 8 weeks of treatment, and were 76. 6% (23/30) and 80. 0% (24/30) in the western medicine group separately, without significant difference in comparison (all P>0. 05).

CONCLUSIONAcupuncture achieves the similar efficacy on moderate and severe allergic rhinitis as western medicine. It is the safe therapy and has no apparent adverse reactions.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; physiopathology ; therapy ; Sneezing ; Treatment Outcome ; Young Adult

Low back pain is becoming an important factor affecting people's quality of life, while the age of its onset is getting younger and younger, and the social and economic losses caused by low back pain are huge every year. Intervertebral disc degeneration (IDD) is an important cause of low back pain. Due to multiple factors, biomechanical and structural changes occur in intervertebral disc tissue, including rupture of annulus fibrosus, protrusion of nucleus pulposus, which cause compression of spinal cord and nerve root, and lower back pain. Micro-RNA (miRNA) is a kind of single-stranded non-coding small molecule RNA, with 18-24 nucleotides in length, which exists widely in eukaryotes. As one of the important regulatory molecules of gene expression, it has been proved to play a key role in the initiation and progression of many diseases, and it may also play an important role in intervertebral disc degeneration. At present, the clinical treatment for IDD is mainly surgical treatment to alleviate clinical symptoms. Even if surgical treatment can achieve good results, it will bring great physical trauma and economic burden to patients. The role of miRNA in IDD is one of the hotspots in the current academic research. Studies have shown that miRNA has abnormal expression patterns in degenerative intervertebral disc tissues and participates in a variety of pathological processes of IDD. At present, some miRNAs have been proved to be related to a variety of pathological processes in IDD, including nucleus pulposus cell apoptosis and proliferation, extracellular matrix degradation, autophagy, inflammation and cartilage endplate degeneration. The comparative study of gene chip showed that there were significant differences in the expression of some miRNAs between degenerative and normal nucleus pulposus cells. These differentially expressed miRNAs may be involved in the process of nucleus pulposus cell degeneration by regulating their respective upstream or downstream pathways. Most of the regulatory pathways are crossed and parallel, thus constructing a huge miRNA regulatory network. Understanding the target genes and mechanisms of miRNA in the pathogenic process can provide an important reference for the origin, development and prognosis of IDD. In this article, the important role of miRNA in IDD and the potential significance of clinical treatment are reviewed. With the in-depth study of miRNA and the molecular biological mechanism can provide new ideas for the diagnosis and treatment of IDD, which is likely to become a new strategy for biological treatment of IDD.