Objective To assess the value of left ventricular (LV) twist and rotation in left-to-right shunt congenital heart diseases(CHD) by two-dimensional speckle tracking imaging(2D-STI).Methods 16 patent ductus arteriosus(PDA),20 ventricular septal defect(VSD) and 36 age,sex matched normal subjects were included.LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were measured by Biplane Simpson method,then LV ejection fraction (LVEF) was calculated.Two-dimensional images in LV basal and apical short-axis views in three complete cardiac cycles were required.Using speckle tracking imaging,the rotation of 6 segments in basal and apical short-axis levels were measured in CHD patients and control subjects,respectively.Basal and apical rotation versus time profiles and LV twist versus time profiles were drawn.Correlation analysis of LVEDV,LVESV and LV peak twist and rotation were made respectively.Results Compared to the control group,LV peak twist and the apical rotation were increased in CDH patients,which was statistically significant (P ＜0.05).LV peak twist had significant correlation with LVEDV and LVESV.Conclusions LV volume overload which was caused by left-to-right shunt CHD significantly impacted LV twist and apical rotation,but has no significant effect in basal rotation.LV peak twist correlated with LVEDV and LVESV.

Great difficulties were existed in clinical teaching in hospitals for infectious diseases. Therefore,a centralized hospital teaching rounds,a new clinical teaching practice was taken in a hospital for infectious diseases. During seven years' practice,a basic mode of centralized hospital teaching rounds was established,which contains many aspects such as organizational form,time arrangement,case se-lection and operation procedures. Its effectiveness was evaluated accoding to the following aspects:number of people attending hospital teaching rounds,composition of these people,satisfaction of these people, comparison of ward rounds data recorded nowadays and 7 years before and assembling all the rounds records into a book. Results indicated that this measure overcame the limitations of the specialized hospi-tals to some extent and played an important role in improving clinical teaching quality.

Objective: To analyze chromosome aberrations in bladder transitional cell carcinoma with exfoliated cells, and to evaluate the clinical value of fluorescence in situ hybridization (FISH) in bladder cancer. Methods: FISH was performed using centromeric probes of 3, 7, 17 and locus probe of p16 to examine chromosome aberrations of exfoliated cells of 56 bladder cancer patients and 20 healthy controls to analyze the correlation of chromosome aberration with the pathological features of bladder cancer. The urine cytology of the 56 bladder cancer patients was performed. Results: The rates of aneuploidy of chromosomes 3, 7, and 17 were 58.9%, 39.3%, 58.9% and 75.0% for aberration of p16 in exfoliated cells from the 56 bladder cancer patients. All of the aberrations had no correlation with tumor stage (P>0.05). The aberrations of chromosomes 3, 7, and 17 were significantly correlated with pathological grade (P<0.05). The sensitivity of the 4 chromosome probes for detecting bladder cancer was 80.4%. The detection rate of FISH was obviously higher than that of udne cytology. Conclusion: Chromosome aberration is correlated with the growth of bladder cancer. The detection of FISH has significance for early di-agnosis, prognosis evaluation, and recurrence monitoring of bladder cancer.

Objective To evaluate global left ventricular(LV) strain of patients with chronic renal failure(CRF) by three-dimensional speckle tracking imaging(3D-STI) and discuss the possible association between global peak strain and ejection fraction of LV.Methods The study includes 22 patients in the renal failure period,25 patients with uremia (pre-dialysis),and 20 healthy controls.Global peak longitudinal strain (GPSL),global peak area strain(GPSA) and global peak radial strain(GPSR) were measured by 3D-STI.Then possible association between GPSL,GPSA,GPSR and LVEF were discussed by the Pearson correlation analysis.Results The GPSL,GPSA,GPSR were statistically different in the control group,patients in the renal failure period and patients with uremia.There were significant differences between groups(F =13.28,4.65,4.68,P ＜ 0.01) as following,all of GPSL,GPSA,GPSR were lower in uremia group compared with control group [q =7.48(GPSL),4.19(GPSA),4.72(GPSR),P ＜0.01],GPSL was lower in renal failure group compared with control group [q =4.9 (GPSL),P ＜0.01].The Pearson correlation analysis revealed GPSL,GPSA,GPSR were strongly associated with LVEF(r =-0.679,-0.781,0.719,P ＜0.01).Conclusions In patients with CRF,the global peak strain can reveal the systolic function of left ventricle and the global peak longitudinal strain can recognize systolic dysfunction more sensitively.

Aim To investigate and evaluate the effect of ligustrazine on the expression of scavenger receptor type AI, the human ?-interferon activation site (GAS) elements regulatory systems of SR-AI expression wasfirst established in the Xenopus oocytes. Methods A plasmid, in which the human SR-AI gene was constructed downstream from the GAS elements, was microinjected into the nucleus of Xenopus oocytes. The oocytes then were cultured in the smooth muscle cell conditioned medium (SCM), In which the cell were cultured with the treatment of oxLDL for 2 days. In the other groups, the oocytes were treated with SCM containing the nature medicines ligustrazine, and the positive control drug ?-interferon respectively. Results The results demonstrated that SCM could upregulate the expression of SR-AI in this system, this action was suppressed by ligustrazine and ?-interferon. Conclusion Similar to the action of ?-interferon, ligustrazine can prevent the over-expression of SR-A induced by oxLDL, via their effect on the GAS elements regulatory pathway.

ObjectiveTo analyze the characteristics of left ventricular (LV) twist and discuss the relationship between LV ejection fraction (LVEF) and LV twist in patients with chronic kidney disease (CKD) by two-dimensional speckle tracking imaging (2D-STI).MethodsForty-six patients with CKD and 30 healthy controls were enrolled in this study. After conventional echocardiography, LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were measured by Biplane Simpson method and the LVEF was calculated. And relevant parameters of LV rotation and twist were measured by speckle tracking imaging. Correlation analysis of LVEDV, LVESV and LV peak rotation and twist were analyzed respectively. ResultsCompared with the control group, LV peak twist and the apical rotation were decreased in CKD patients, which was statistically significant (t=0.002 and 0.020, bothP<0.05). The inferior wall and posterior intermediate septum of basal segment were significantly decreased (t=0.044 and 0.041, both P<0.05). Pearson correlation analysis revealed LV apical peak rotation had a relationship with LVEDV and LVESV (r= 0.355 and 0.409, bothP<0.01).Conclusion2D-STI is an practical noninvasive method which can analyze LV twist accurately and recognize LV systolic dysfunction of CKD patients sensitively.

Objective To evaluate intra-operative radiotherapy after breast conservative surgery in early breast cancer patients in terms of postoperative complications,cosmetic outcome and recurrence events.Methods From June 2007 to Dec 2010,115 early breast cancer patients received breast conserving surgery.Fifty-nine patients (study group) received intra-operative radiotherapy,compared with 56 patients (control group) receiving routine postoperative radiotherapy.Postoperative complications were evaluated 1 month after surgery; cosmetic outcome was evaluated 1 year postoperatively; recurrence and death events were followed up.Results The average wound healing time was 13 -22 days in study group and 9 - 14days in control group.In the study group,2 patients developed fat deliquescence,16 patients showed wound edema while no such side effects were found in control group.No infection or hematoma were found in either group.Overall cosmetic outcome was rated 1 year post operation.In the study group (41 cases),36 patients were graded as excellent or good,5 patients were as fair or poor.Meanwhile in the control group (37 cases),wounds in 25 patients were graded as excellent or good,that in 12 patients were as fair or poor (P =0.031).After a follow-up from 3 to 42 months(median:24 months),two patients (3.39％) in study group developed local cancer relapses,one of them( 1.7％ ) died.In control group,one patient ( 1.8％ )developed local relapse,and no one died.Conclusions Intra-operative radiotherapy is safe and reliable with good cosmetic outcome.

Objectiye To evaluate the value of intraoperative bile leakage test during liver resection in preventing postoperation bile leakage. Methods Eighty-one cases were randomly divided into two groups,in the test group (41 cases) white fat emulsion(sterilized) was injected into common bile tract through cyst bile duct,the leakage points on the transect surface were observed and disposed. In the control group (40 cases) the transect surface were disposed by regular methods. The rate of postoperation bile leakage in the two groups were analyzed. Results The rate of postoperation bile leakage in the test group was 2. 4% (n=1), and the rate of postoperation bile leakage in the control group was 15% (n = 6). There was significant difference between the two groups (x2=4.04, P＜0.05). Conclusion The white bile leakage test is effective in preventing the postoperation bile leakage during liver resection and does not increase other complications.

ObjectiveTo investigate the etiology, diagnosis and choice of treatment for massive hemobilia. MethodsA retrospective analysis was made on the clinical data of 20 patients with massive hemobilia treated from August 1998 to August 2008. ResultsInitially conservative therapy was used on 20 patients and bleeding stopped in 4 patients. For the seven patients who were treated with hepatic artery angiography and embolization, bleeding stopped in 6 patients. 10 patients were treated by operation and bleeding stopped in all these patients. No patient died in this series. ConclusionsHepatic artery angiography and embolization should be used to treat patients with massive hemobilia. Surgery should be offered if conservative therapy and hepatic artery embolization fail.

Objective To investigate the value of dermoscopy in differential diagnosis of actinic keratosis (AK).Methods Pathologically confirmed facial AK lesions were selected from the dermoscopic database of Peking University Third Hospital,and served as case group.At the same time,the facial lesions of other diseases were selected and served as control group,which were firstly suspected to be AK,but pathologically confirmed as other diseases.Dermoscopic features were compared between the two groups.Diagnostic test was used to evaluate the diagnostic value of dermoscopy for AK,based on the gold standard pathological examination.Results There were 43 facial AK lesions in the case group and 22 facial lesions of other diseases in the control group.Eight dermoscopic features were observed more frequently in the case group than in the control group (all P ＜ 0.05),including a background erythema and red pseudonetwork (88.37％ [38/43] vs.36.36％ [8/22]),hair follicle openings surrounded by a white halo (90.70％ [39/43] vs.36.36％[8/22]),hair follicle openings filled with yellowish keratotic plugs (95.35％ [41/43] vs.45.45％ [10/22]),white to yellow surface scales or keratin mass (97.67％ [42/43] vs.72.73％[16/22]),rosette sign (60.47％ [26/43] vs.22.73％ [5/22]),large irregular linear vessels surrounding the hair follicles (44.19％ [19/43] vs.18.18％ [4/22]),fine,linear-wavy vessels surrounding the hair follicles (67.44％ [29/43] vs.36.36％ [8/22]) and peripheral pigmentation (32.56％ [14/43] vs.4.55％ [1/22]).Among the above eight dermoscopic features,hair follicle openings surrounded by a white halo,a background erythema and red pseudonetwork,hair follicle openings filled with yellowish keratotic plugs and rosette sign showed higher Youden's indices of 0.54,0.52,0.50 and 0.38 respectively,white to yellow surface scales or keratin mass showed the highest sensitivity of 97.67％,and peripheral pigmentation showed the highest specificity of 95.45％.The combination of 3 features (including a background erythema and red pseudonetwork,hair follicle openings surrounded by a white halo and follicular plugs) showed the highest diagnostic value,and the sensitivity,specificity,positive predictive value,negative predictive value and Youden's index of the combination were 90.70％,81.82％,90.70％,81.82％ and 0.73,respectively,with the coincidence rate between dermoscopy and pathological diagnosis being 80.00％.Conclusion Facial AK shows characteristic dermoscopy patterns,and the combination of the 3 features (a background erythema and red pseudonetwork,hair follicle openings surrounded by a white halo and follicular plugs) shows the highest diagnostic value for AK.