Objective To quantitatively analyze myocardial function and the degree of myocardial ischemia with strain rate imaging (SRI). Methods SRI was performed in 34 patients with left anterior descending coronary artery disease diagnosed with coronary angiography and compared with 35 healthy volunteers. Isovolumic relaxation strain rates (SRivr) of anterior wall and anterior septal were measured. Results There was no significant cut-off value for LAD＜50%. A cut-off value of SRivr=-0.42 s~(-1) (sensitivity 84.85%, specificity 80.36%) for LAD 50%-74% stenosis. A cut-off value of SRivr=-0.91 s-1 (sensitivity 91.07%, specificity 89.91%) for LAD＞75% stenosis. Conclusion SRivr can quantitatively differentiate LAD 50%-74% or LAD＞75% stenosis. SRI can evaluate the coronary stenosis extent quantitatively.

Objective To explore the correlation between time-intensity curve (TIC) parameters of CEUS and microvessel density (MVD) of inverted papilloma of bladder (IPB) and bladder urothelial carcinoma (BUC).Methods Clinical and CEUS characteristics of 30 patients with IPB and 50 patients with BUC confirmed by pathology were retrospectively analyzed.CEUS TIC parameters included rise time (RT),mean transit time (MTT),peak intensiy (PI),time from peak to one half (TPH),wash in slope (WIS),time to peak (TP),semi-descending slope (DS) were acquired by QLab software and statistical analysis was carried out.The MVD of the resectioned tissue specimens were quantified via immunohistochemistry for CD34 and the correlation with CEUS TIC parameters was investigated.Results In CEUS quantitative parameters,PI,TPH,TP and DS had statistical significance in IPB and BUC (all P＜＜0.05).MVD of BUC was obviously higher than that of IPB (P＜0.05);TPH and DS both correlated with MVD (rs =0.74,-0.81,both P＜0.05).Conclu sion CEUS characteristics has certain clinical value in identification of IPB and BUC.TIC parameters of CEUS can reflect the MVD of IPB and BUC.

Objective To evaluate whether estradiol can inhibit and cure the inflammation of experimental preeclampsia in rats. Methods Experimental preeclampsia was induced in 14-day-pregnant rats by infusion of endotoxin (1.0 ?g/kg). Rats with normal pregnancy were infused with sodium chloride solution.A group of preeclampsia rats was injected with 17?-estradiol (17?-E_2, 1 mg?kg -1 ?d -1 ). Blood pressure, albuminuria,inflammation associated adhesion molecule CD_ 49d and tumor necrosis factor-?(TNF-?) were assessed. Results On pregnant day 19, for normal pregnancy group(group C) the blood pressure was (120.4?2.0)mm Hg (1 mm Hg=0.133 kPa),urinary protein (0.47?0.06)mg/24 hours;for experimental preeclampsia group(group A) blood pressure was (134.2?2.4) mm Hg,urinary protein(0.79?0.10)mg/24 hours; for experimental preeclampsia with 17?-E_2 treatment group (group B) blood pressure was(123.3?1.7)mm Hg,urinary protein (0.51?0.08)mg/24 hours. A significant increase of blood pressure and urinary albumin was observed in group A. CD_ 49d expression and TNF-? concentration were also increased. 17?-E_2 reduced the expression of CD_ 49d , concentration of TNF-?,blood pressure and albuminuria of experimental preeclampsia. However, the weight of fetuses in 17?-E_2 treatment group were less than that in other groups. Conclusion 17?-E_2 can improve the symptoms of experimental preeclampsia,but its effects on fetus need to be further studied.

Objective To explore the application value of real-time three-dimensional echocardiography (RT-3DE) in diagnosis of structural heart disease through a comparison with two dimensional echocardiography (2DE).Methods Ninety-two patients with heart disease were enrolled from October 2009 to February 2014 , all of whom were examined by RT-3DE.By cutting and spiraling structural 3D images of lesions in regions of interest , we made a diagnosis of lesions .In addition, the size of atrial(ASD) and ventricular septal defects (VSD),based on surgical results,was measured and analyzed.By comparing the coherence and difference of diagnosis on structural heart disease examined by 2DE and RT-3DE, the accuracy and superiority of RT-3DE were evaluated.Results (1)The 3D images of 92 patients with heart disease were successfully obtained by RT-3DE.The structure of lesions was displayed directly from various angles .In addition, the position, scope and degree of lesions and the spatial relationship of adjacent structures were accurately confirmed.RT-3DE provided more direct, accurate and abundant information than 2DE.(2)In the diagnosis of congenital heart disease, the diagnostic accordance rate of RT-3DE was the same as that of 2DE, but was slightly higher in the diagnosis of valvular disease and other lesions .( 3 ) Compared with 2DE, the ASD maximum diameters obtained from RT-3DE were more correlaed with surgical findings (r=0.94,0.86),so were the VSD maximum diameters (r=0.93, 0.84).Conclusion RT-3DE is easy to operate and quick to produce image ,which can provide more spatial information than 2DE in structural heart disease diagnosis , increase the accuracy rate of diagnosis , and serve as a supplement to 2DE.

Purpose To evaluate the value of real-time contrast-enhanced ultrasound (CEUS) combined with comparative observation in determining the initial time of peripheral lung lesion,and to provide a new method for the diagnosis of peripheral lung disease by CEUS.Materials and Methods Sixty patients with peripheral lung disease diagnosed by chest X-ray or CT examination were examined by CEUS,and the lesions and perfusion of surrounding lung tissue were observed in real time and comparatively.The time of initial enhancement of peripheral lung lesion was determined by real-time comparative observation method,that is,to compare the time of contrast agent to reach the peripheral lung lesion with the time to reach the adjacent gas-containing lung tissue.All lesion specimens were obtained by surgery or ultrasound-guided percutaneous biopsy,and the pathological diagnosis was performed.According to the pathological results,the peripheral lung lesions were classified into the malignant group,the chronic inflammation group and the pneumonia group.Results Sixty cases of peripheral lung lesions were identified as 38 cases of malignant tumors (including 15 cases ofsquamous cell carcinomas,9 cases of adenocarcinoma cell carcinomas,2 cases of large cell carcinomas,9 cases of small cell carcinomas and 3 cases of metastatic carcinomas),14 cases of chronic inflammation lesions (including 7 cases of tuberculomas,3 cases of inflammatory pseudotumors and 4 cases of lung abscess) and 8 cases of pneumonia.The detection rates of pulmonary arterial phase and bronchial artery phase using the real-time comparative observation method were 100％ (60/60) and 85％ (51/60),respectively.The initial time of pulmonary arterial phase and bronchial artery phase were (6.1 ± 0.9) s and (10.5 ± 1.6) s,respectively.The initial time of pulmonary arterial phase was sooner than bronchial artery phase,the difference was statistical significance (P＜0.05).Conclusion The real-time CEUS combined with comparative observation method has important diagnostic value in judging the initial enhancement time of peripheral lung lesion and can provide a new method for the accurate diagnosis of peripheral lung disease,which is worth popularizing.

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.

Hematopoietic stem cell transplantation (HSCT) patients undergo tremendous psychological stress during the long course of treatment, which affected the quality of life and the prognosis of the disease. This paper reviews the psychological state of HSCT patients in recent years,to provide a basis for psychological support in appropriate time. The psychological status of HSCT patients is mainly manifested as anxiety, depression, loneliness and post-traumatic stress disorder. The main influencing factors of bad psychological status include: gender, personality, physical function, family and social support, coping style; Intervention measures are: health education, music therapy, comprehensive nursing intervention, palliative care.

Purpose To observe the changes of perineal body morphology and modulus of primiparas with real-time shear wave elastography (SWE) combined with gray-scale ultrasound and to explore the influence of delivery on perineal body tension. Materials and Methods One hundred and sixty primiparas after 42 to 56 days of delivery in the Department of Gynecology and Obstetrics of the First Affiliated Hospital of Nanchang University from December 2016 to August 2017 were enrolled and divided into cesarean section group (n=80) and vaginal delivery group (n=80). Meanwhile, 100 healthy married nulliparous women during the same period were selected as nulliparous group. Perineal body depth, height and Young's modulus were measured by using gray-scale sonography and SWE at resting state and retraction status. Values of each ultrasonic parameter were analyzed. Results Difference of perineal body depth and height contraction amplitude was of statistical significance among subjects in the three groups (P<0.05). The mean Young's modulus of perineal body during resting state and retraction status in nulliparous group was higher than those in the cesarean section group and vaginal delivery group, while that in cesarean section group was higher than that in vaginal delivery group. The differences were statistically significant (P<0.05). Conclusion Different delivery modes have different effects on female perineal body muscle, among which vaginal delivery is of more obvious damage to perineal body.

Objective To investigate the value of conventional ultrasound and CEUS in the diagnosis of peripheral lung lesions.Methods Totally 120 patients with peripheral lung lesions found with chest CT were enrolled.Conventional ultrasound and CEUS were performed.The site,size,shape,echo and blood flow signals,as well as the adjacent tissue of lesions were evaluated with conventional ultrasonography.Then,the contrast enhancement pattern,degree and uniformity of lesions were observed with CEUS,and the time-intensity curve analysis was performed to obtain the relevant parameters,including the rise time (RT),peak intensity (PI),mean transit time (MTT),area under the curve (AUC),half washout time (TPH),clearance time and descending slope (DS).The above parameters of benign and malignant lesions were statistically analyzed.Results Among 120 cases,there were 52 benign and 68 malignant tumors.Statistically significant differences were found in morphological comparison between benign and malignant lesions (P＜0.05),while benign lesions were more multi wedge-shaped or triangular shape,and malignant lesions were more round or irregular shape.RT,DS and clearance time of benign and malignant lesions were statistically different (all P＜0.001),but there was no significant difference in PI,MTT,AUC and TPH (all P＞0.05).Conclusion Conventional ultrasound and CEUS can provide important information for diagnosis of peripheral lung lesions.

Objective:To summarize the evidence-based practice of a steroid-resistant patient with severe acute skin graft-versus-host disease caused by donor lymphocyte reinfusion.Methods:Clear the clinical problems of patients, through the development of a rigorous search strategy, according to the "6S" Pyramid model from the top to the bottom of the relevant literature in turn, after the evaluation of evidence level to determine the best clinical evidence.Combined with team experience and patient's actual situation, the acute graft-versus-host disease of steroid-resistant patients was treated while infection was strictly prevented. The non-invasive method of wet healing by topical high concentration tacrolimus smearing and sterile dressing sealing was compared with the invasive optical separation replacement therapy in vitro, which avoided puncture and sterile dressing. A series of possible complications of phototherapy.Results:The patient was relieved of swelling and pain 5 days after treatment, and was discharged on the 15th day of this hospitalization.Conclusions:Local high concentration tacrolimus smear plus aseptic dressing to seal wet healing is a noninvasive method that can relieve and treat severe acute graft-versus-host disease symptoms of steroid resistant patients. It is useful for similar clinical cases.