Objective To assess the efficacy of cardiac resynchronization therapy (CRT) using real-time three-dimen?sional echocardiography (RT-3DE) and speckle tracking imaging (STI) in patients with heart failure. Methods Thirty-one patients with chronic heart failure were examined by RT-3DE and STI before CRT and 3, 6 months after CRT. The values of left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were measured. RT-3DE was used to evaluate the minimum regional volume for 16 segments (Tmsv-16SD) and the ratio of Tmsv16SD to R-R interval, and the maximum time difference (Tmsv-16Dif). STl was used to evaluate the ratios of standard deviation of the time to peak longitudinal radial and circumferential strain to R-R interval (Tls-16SD%, Trs-16SD%,Tcs-16SD%) from the beginning of Q wave of electrocardiography to the point minimal systolic volume of all 16 segments and the maximum time difference. Results The values of LVEDV and LVESV were smaller 3 and 6 months after CRT than those before CRT. The value of LVEF was significantly improved after CRT (P < 0.05). The values of Tmsv-16SD%, Tmsv-16Dif%, Tls-16SD%, Trs-16SD%, Tcs-16SD%and T-Dif%were gradually decreased after CRT (P<0.05). The values of Tmsv-16SD%, Tmsv-16Dif%,Trs-16SD%and Tcs-16SD%were negatively related with LVEF (r=-0.79,-0.82,-0.69 and-0.74(P<0.05). The better consistency was found between RT-3DE and STI methods(Kappa=0.77). Conclusion Re?al-time three-dimensional echocardiography and speckle tracking imaging can provide more accurate quantitative informa?tion of cardiac resynchronization therapy for assessment of treatment and prognosis in patients with heart failure.

Objective To investigate the characteristic of intelligence of children with attention deficit hyperactivity disorder (ADHD).Methods 60 ADHD children were estimated with Wechsler Intelligence Scale for Children-fourth edition (WISC-Ⅳ). Results The full scale intelligence quotient (FSIQ) and 4 indices of ADHD children were lower than the average (P<0.05). All the subtests scores of ADHD children were lower than the average (P<0.05) except decoding. Conclusion The general intelligence and abilities of verbal comprehension, reasoning,working memory and operation speed are in the normal range in ADHD children, but poorer than normal children.

Objective To investigate the interpersonal disturbances and its related factors among college students.Methods The field questionnaire survey was conducted among 730 college students with stratified-cluster sampling method in Zhengzhou University.The self-administered anonymous survey instruments included the Interpersonal Relationships Integrated Diagnosis Questionnaire,Parental Bonding Instrument questionnaire,Self-Rating Anxiety Scale and Pittsburgh Sleep Quality Index.Results ①Detection rate of interpersonal relationship disturbance was 47.8％ in 730 college students.Severe interpersonal disturbances accounted for 16.3％.The most serious problem was communication and making friends disturbance which accounted for 58.5％ of the total.②)There were statistical differences of conversation scores ((2.15± 1.66),(2.53± 1.83),(2.22± 1.79)) among different major college students (medical,engineering,liberal arts) (P＜0.05).A statistical difference was found in making friends((2.76±1.89),(3.18± 1.92)) and getting along with opposite gender ((2.23 ± 1.82),(1.81 ± 1.66)) between male and female (P＜ 0.05).There were significant differences of conversation ((2.58 ± 1.84),(2.02 ± 1.65)),making friends ((3.28 ± 1.93),(2.78 ±1.88)) and getting along with opposite gender ((2.16± 1.75),(1.77± 1.69)) between grade one and three students(P＜0.05).③The interpersonal disturbances were significantly related to parental bonding styles,anxiety and sleep quality.④The results of logistic regression showed that anxiety was the main risk factor (B =1.42,OR=4.4,95％ CI =1.74-9.86,P＜0.01) and maternal parenting style and sleep quality were protective factors(P＜0.01)of interpersonal disturbances.Conclusion The interpersonal disturbance,which are severe and affected by multiple factors in college students,should be paid attention by school,society and family to improve their learning and growing environment in order to promote their physical and mental health.

Objective To investigate the diagnostic value of preoperative real-time three-dimensional color Doppler transthoracic echocardiography on assessment of patients with structural heart disease (SHD). Methods A total of 111 pa?tients were assessed preoperatively using real-time three-dimensional color Doppler transthoracic echocardiography (RT-3D-CDTTE), which include 31 SHD patients and 80 patients without SHD that were designed as negative control. Conven?tional two-dimensional color Doppler transthoracic echocardiography (2D-CDTTE) were used to compared with RT-3D-CDTTE while cardiovascular angiography and intraoperative findings were used as“Golden Standard”simultaneously. First of all, preoperative echocardiographic examination were performed and diagnosis was given. Angiography and intraoperative findings were hired to verify the accuracy of echocardiographic diagnosis before operation. Results (1) The preoperative RT-3D-CDTTE displayed three-dimensional structure and hemodynamic status of SHD cardiac lesions clearly, which were consistent with cardiovascular angiography and intraoperative findings. (2) P value of McNemar test between 2D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.654 (P<0.001). P value of McNemar test between RT-3D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.932 (P<0.001). Conclusion RT-3D-CDTTE can provides essen?tial information for preoperative evaluation which is important for decision of SHD management.

Objective To investigate the diagnosis and treatment in patients with acute myocardial infarction (AMI) and complicated left ventricular wall rupture (LVWR). Methods A retrospective analysis was made on the clinical features, diagnosis and successful treatment in three AMI patients with LVWR from December 2015 to April 2016. Results Three cases were included in this study. Case 1, the mesh like cardiac rupture after AMI was diagnosed by ultrasonic Doppler. Emergency revascularization was performed due to the combined cardiac shock, and the infarct related artery was opened. The vasoactive drugs were used after revascularization to reduce ventricular pressure load and volume load in the haemodynamic monitoring, and anticoagulation, antiplatelet agents were less used or discontinued to promote local thrombus healing of ventricular rupture. Case 2 was a recurrent myocardial infarction patient. LVWR was diagnosed by ultrasonic Doppler one day after emergency operation. The ruptured ventricular wall was encapsulated by thrombus. The drug therapy was effective in hemodynamic monitoring. LVWR was further confirmed by cardiac CT after clinical stabilization. Case 3 was diagnosed LVWR by ultrasonic Doppler four days after AMI. Because the ruptured ventricular wall was limited by incompletely organized thrombus, and the haemodynamic condition was stable, selective surgical repair of rupture after coronary angiography was performed. Conclusion The effective drug therapy combined with percutaneous coronary intervention and surgical repair can reduce the risk of death in patients with LVWR after AMI.

Objective To assess the clinical and cranial CT/MR features of leptomeningeal metastasis(LM)from lung adenocar-cinoma with non-enhanced T2-fluid attenuated inversion recovery(T2-FLAIR)hyperintensity on the brainstem surface.Methods Eleven cases with LM from lung adenocarcinoma with non-enhanced T2-FLAIR hyperintensity on the brainstem surface confirmed by cere-brospinal fluid cytology were analyzed retrospectively.The clinical features included the pathological classification of the primary tumor,genetic testing results,and treatment methods.The imaging features included lesion location,MRI(T1 and T2)signals,diffusion weighted imaging(DWI)signal,enhancement patterns,CT density characteristics.Results The features of non-enhanced T2-FLAIR hyperintensity on the brainstem surface of 11 cases among 98 patients(11.2％)with LM from lung adenocarcinoma were reviewed.All patients were lung adenocarcinomas with epidermal growth factor receptor(EGFR)gene mutation and were diagnosed with LM after receiving EGFR-tyrosine kinase inhibitors(EGFR-TKIs)targeted therapy.There were 5 cases located in the pons,2 cases in the midbrain and pons,and 4 cases involving the midbrain,pons and medulla oblongata with the symmetrical band-like high signal on non-enhanced T2-FLAIR imaging.On T1WI,1 case showed slightly high signal,10 cases showed equal signal.On DWI,4 cases showed high signal,7 cases showed equal signal,and on enhanced T1WI,1 case showed mild enhancement,and 10 cases showed no enhancement.Additionally,on cranial CT scans,1 case showed calcification on the brainstem.Conclusion Non-enhanced T2-FLAIR hyperintensity on the brainstem surface may be more common among LM patient from lung adenocarcinoma with EGFR gene muta-tions and TKIs treatment,with the most frequent site being the pons.The features may include non-enhanced T2-FLAIR high signal,non-enhancement on enhanced T1 WI,restricted diffusion on DWI,and calcifications on CT imaging.