Objective To investigate the right ventricular morphology and function of patients with atrial septal defects by single beat real-time three-dimensional echocardiography.Methods Thirty-four healthy volunteers and twenty-seven ASD patients were enrolled consecutively as normal controls and the ASD group respectively.Single cardiac cycle real-time three dimensional echocardiography was performed in all to evaluate parameters concerning modality and systolic function of participants' right ventricle.The relationship of indexed right ventricular end diastolic volume (IEDVRV) and end systolic volume(IESVRV)with mean pulmonary arterial pressure measured through cardiac catheter and systolic pulmonary artery pressure calculated though the three tricuspid regurgitation were observed.Results Indexed right ventricular end diastolic volume (IEDVRv),end systolic volume(IESVRV),right ventricular stroke volume (ISVRV) and right ventrieular ejection fraction (RVEF) were greater in the ASD group than in controls (P ＜ 0.05).IEDVRv and IESVRV had positive relation with pulmonary pressure measured by cardiac catheter and systolic pulmonary artery pressure calculated though the three tricuspid regurgitation.Conclusions Single cardiac cycle real-time three dimensional echocardiography has an obvious advantage than normal test in evaluating the change of the right ventricular function and shapes,furthermore,single cardiac cycle real-time three dimensional echocardiography can indirectly determined the pressure of the pulmonary without wound.

Objective To investigate the diagnostic value of two-dimensional and color Doppler ultrasonngraphy on diagnosis and judgement of prednisone withdraw in patients with subacute thyroiditis.Methods Sixty-six patients with clinically proved subacute thyroiditis underwent two-dimensional and color Doppler ultrasonography before treatment of prednisone. The ultmsonographic features and bloodtlow distribution in thyroid of these patients were analyzed retrospectively. Target of prednisone withdraw was judged according to ultrasonographic images (36 eases) and clinical symptom (30 cases). Results The ultmsonographic features of subacute thyroiditis mainly presented as bilateral or unilateral diffussion or focal low echogenicity in the affected thyroid, and color Doppler ultrasonography showed the increased vascularity around the lesions. Intraarterial bloodflow feature was low velocity and low resistance pattern, prednisone withdraw was performed according to ultrasonographic images after the treatment of prednisone, then relapse rate was decreased compared with the group of clinical symptom [8.33% (3/36) vs 26.67% (8/30)] (P <0.05). Conclusion Two-dimensional and color Doppler ultrasonography is highly valuable for diagnosing and treating subacute thyroiditis.

ObjectiveTo research the relationship between the plasma levels of myeloperoxidase (MPO) and the onset and progress of acute coronary syndrome (ACS) and the severity of coronary lesions in patients with ACS.MethodsSeventy-eight patients hospitalized with chest pain were enrolled,including 41 patients with ACS (ACS group),17 patients with stable angina pectoris(SAP,SAP group) and 20 patients serving as control (control group).Forty-one patients undergoing coronary angiography were divided into single vessel lesions group (7 patients),double vessel lesions group (7 patients),multiple vessel lesions group ( 12 patients) and no vessel lesions group ( 15 patients) based on the vessel lesions of the left anterior descending,left circumflex artery and right coronary artery.According to the diameter stenosis of major coronary artery,there were 15 patients in no vascular stenosis group,2 patients in mild vascular stenosis group,6 patients in moderate vascular stenosis group and 18 patients in severe vascular stenosis group.The levels of MPO were measured by enzyme-linked immunosorbent assays(ELISA).ResultsThe levels of MPO in ACS group [( 252.10 ± 27.07 ) μ g/L]were higher than those in SAP group[( 185.81 ± 17.85 ) μ g/L]and control group [( 140.42 ± 71.40) μ g/L](P ＜ 0.05 ),the levels of MPO in SAP group were higher than those in control group(P＜ 0.05 ).The levels of MPO in single vessel lesions group and multiple vessel lesions group were higher than those in no vessel lesions group (P ＜ 0.05 ),but there was no significant difference among single vessel lesions group,double vessel lesions group and multiple vessel lesions group (P ＞ 0.05 ).The levels of MPO in mild vascular stenosis group,moderate vascular stenosis group and severe vascular stenosis group were higher than those in no vascular stenosis group (P ＜ 0.05),but there was no significant differenceamong mild vascular stenosis group,moderate vascular stenosis group and severe vascular stenosis group(P ＞ 0.05 ).A positive correlation was observed between the levels of MPO and neutrophils (r =0.288,P=0.018 ),creatine kinase isoenzyme-MB(r =0.469,P=0.043 ),subject groups( r =0.757,P=0.000),vessel lesions (r =0.584,P=0.000) and the degree of vascular stenosis (r =0.491,P=0.001).Conclusion MPO may predict ACS and reflect the severity of coronary lesions in ACS as a novel inflammatory marker.

database until 2015-01, and all randomized controlled trials (RCT) upon (RVS) pacing and (RVA) pacing in Chinese population were enrolled. According to Cochrane Handbook 5.0.2 quality evaluation criteria, the publications were selected by 2 independent researchers and Meta-analysis was conducted with RevMan5.0 software.
Results: A total of 16 RCT articles including 1199 patients were enrolled in this study. The research was divided into 2 groups: RVS group,n=602 and RVA group,n=597. Meta-analysis indicated that the following indexes in RVS group were better than those in RVA group: the differences between post-and pre-operation for the combination value in LVEF (MD=1.90, 95% CI 0.75-3.05,P=0.001), stroke volume (MD=7.08, 95% CI 2.39-11.76,P=0.003), QRS wave width (MD=29.13, 95% CI 5.71-52.54,P=0.01), LVESV (MD=2.04, 95% CI -4.22 to 8.31,P<0.00001), LVEDV (MD=2.64, 95% CI 1.80-3.49, P<0.00001), BNP (MD=68.00, 95% CI 57.57-78.43,P<0.00001), inter ventricular septum and left ventricular posterior wall motion delay time (SPWMD) (MD=22.68, 95% CI 16.91-28.45,P<0.00001), E/A (MD=0.49, 95% CI 0.41-0.57, P<0.00001), LRVPEI (MD=14.06, 95% CI 12.36-15.75,P<0.00001), resistance of electrode (MD=-67.02, 95% CI -119.96 to -14.08,P=0.01) and pacing threshold (MD=0.09, 95% CI 0.00-0.18,P=0.04). The time of operation in RVS group was longer than that in RVA group, (MD=-11.76, 95% CI -14.69 to -8.82,P<0.00001). The differences between post- and pre-operation in LVEDD, Tei index and X-ray exposure time were similar between 2 groups,P>0.05.
Conclusion: RVS is a relatively feasible pacing method in Chinese population.

Objective: To explore the risk factors for ventricular aneurysm formation in patients after acute myocardial infarction (AMI).
Methods: Our research included 2 groups of AMI patients who received percutaneous coronary intervention (PCI)
in our hospital from 2012-04 to 2014-07 as Ventricular aneurysm group,n=146 and Control group,n=142, in which the AMI patients without ventricular aneurysm formation. The baseline condition with aneurysm related risk factors were analyzed and compared between 2 groups including age, gender, hypertension, hyperlipidaemia, diabetes, smoking, family history, MI history, anterior myocardial wall infarction, angina pectoris, left main (LM) disease, the lesion at proximal left anterior descending (LAD) artery, NYHA classiifcation III/IV, chest pain time ≥ 24 hours and ST-segment elevation ≥ 4 adjacent leads in ECG.
Results: Compared with Control group, the patients in Ventricular aneurysm group had the elder age (OR=1.023, 95% CI 1.000-1.046), higher incidence rates of smoking (OR=1.819, 95% CI 1.130-2.928) and anterior MI (OR=9.162, 95% CI 4.657-18.028), more patients with ≥ 4 adjacent ST-segment elevation (OR=6.571, 95% CI 2.426-17.798), while less patients with angina pectoris (OR=0.557, 95% CI 0.335-0.927, allP<0.05. With adjusted relating factors of age, gender, hypertension, diabetes and angina pectoris, the multivariate Logistic regression analysis indicated that smoking (regression coefifcient: 0.833, OR=2.301, 95% CI 1.283-4.125), anterior MI (regression coefifcient: 1.799, OR=6.041, 95% CI 2.831-12.894) were positively related to ventricular aneurysm formation.
Conclusion: Smoking and anterior MI were strongly related to ventricular aneurysm formation in patients after AMI.

Objective To use real-time three-dimensional echocardiography(RT-3DE) to compare the cardiac function related indicators between before operation and at postoperative 2 months in the patients with left ventricular aneurysm(LVA) undergoing emergency percutaneous coronary intervention(PCI),and to assess the PCI short term effect.Methods RT-3DE was applied to observe the left ventricular end-diastolic volume(LVEDV),end systolic volume(LVESV),cardiac output(CO),end-diastolic volume index(EDVI),end systolic volume index (ESVI),cardiac index (CI),left ventricular ejection fraction (LVEF) and left ventricular spherical index(SPI) before operation and at postoperative 2 months in 31 cases of acute anterior myocardial infarction(AAMI) complicating LVA.The patients were divided into the functional LVA group(A),anatomical LVA group (B) and complicating thrombus LVA group(C).The cardiac function parameters in various groups conducted the intra-group and inter group comparisons.Results Compared with before operation,LVEF at postoperative 2 months in the group A was increased and SPI was decreased(P＜0.05);CO,CI and LVEF before operation and at postoperative 2 months in the group B were increased and SPI was decreased(P＜0.05);SPI at postoperative 2 months in the group C was decreased(P＜0.05);EF and SPI before operation and at postoperative 2 months had no statistical difference among 3 groups(P＞0.05).SPI before operation and at postoperative 2 months was negatively correlated with LVEF and positively correlated with EDV,ESV,EDVI,ESVI,CO and CI.Conclusion The left ventricular morphology and overall systolic function at 2 months after PCI in the patients with functional and anatomical LVA are improved,but the curative effect in the patients with complicating thrombus LVA is unobvious.

Objective To explore the clinical value of transthoracic echocardiography(TTE)and related clinical indexesin the evaluation of percutaneous coronary intervention(PCI)supported by arteriovenous extracor-poreal membrane oxygenation(VA-ECMO)in the treatment of patients with acute myocardial ischemia complicated by refractory cardiogenic shock.Methods The clinical data of 70 patients with acute myocardial ischemia complicated by refractory cardiogenic shock treated with VA-ECMO in the First Hospital of Lanzhou University from January 2022 to April 2023 were analyzed retrospectively.According to the success of VA-ECMO withdrawal,the patients were divided into success group(54 cases)and failure group(16 cases).The general data,Intraoperative condi-tion,hemodynamic and biochemical indexes of the two groups were compared,and the independent risk factors affecting the clinical outcome were analyzed.Results The time of ECMO assistance in the success group was significantly shorter than that in the failure group(P<0.05).There was no significant difference inother general information between the two groups(all P>0.05).There was no significant difference in preoperative TIMI grade,number of diseased vascular branches,use of IVUS,ECG results and SYNTAX score between the two groups(all P>0.05).Compared with those before treatment,arterial oxygen saturation(SaO2),left ventricular stroke volume(LVSV),left ventricular ejection fraction(LVEF),mitral annulus systolic velocity(Sa),aortic orifice forward flow spectrum(AV),velocity-time integral(VTI)and tricuspid annulus systolic displacement(TAPSE)increased significantly after ECMO plus PCI treatment(all P<0.05).Left ventricular end systolic volume(LVESV)decreased significantly(P<0.05).Compared with those in the failure group,the heart rate(HR),shock index(SI),blood lactic acid(Lac),C-reactive protein(CRP),aspartate aminotransferase(AST)and total bilirubin(TBIL)were lower in the success group(all P<0.05).There was no significant difference in ECMO flow and SaO2 between the two groups(P>0.05).Univariate logistic regression analysis showed that ECMO-supporting time,HR,Lac,CRP,AST and TBIL were the influencing factors of weaning failure in patients with acute myocardial ischemia complicated with refractory cardiogenic shock.Conclusion VA-ECMO combined with PCI can significantly improve cardiac function in patients with acute myocardial ischemia complicated by refractory cardiogenic shock.Echocardiographic parameters(LVESV,LVSV,LVEF,Sa,AV,VTI,TAPSE)and clinical indexes(HR,Lac,CRP,AST,TBIL)have certain clinical value for theprognosis.