Objective To investigate the function of the left ventricular (LV) myocardial regional contractility in hyperthyroid by measuring the LV rotation and torsion using speckle tracking imaging (STI).Methods 58 patients with hyperthyroidism had accepted 131 I treatment the first time and cured and improved after treatment for 6 months were enrolled.According to the course of disease,they were divided into two groups:Group A,duration less than 6 months,28 cases;Group B,duration more than 6 months,30 cases.30 normal cases age and gender matched were enrolled as control group.LV peak rotation and torsion of endocardium and epicardium at basal and apical of levels were measured using STI in groups A and B before and after treatment,and correlation with cardiac function and structure parameters,heart rate,blood pressure,and the thyroid hormone were analyzed.Results ①Comparing group A and group B before and after treatment with control group,there was no statistically significant in the LV structure and function parameters (LVDd,LVDs,IVSd,PWd,LVEF) (P ＞0.05).②As for LV peak rotation of endocardium and epicardium at apical levels (EN PAR,EP-PAR) before treatment,group A was higher than the control group (P ＜0.05),group B was lower than the control group (P ＜0.01);After treatment,group A has improved (P ＜0.01),group B has improved only in EP-PAR (P ＜0.05),and there was no statistically significant compared with the control group (P ＞0.05).③ LV peak torsion of endocardium and epicardium (EN-Ptor,EP-Ptor) in group A was higher than the control group before treatment (P ＜0.05),group B was lower than the control group (P ＜0.01) ;After treatment,group A has improved (P ＜0.05),group B has only improved in EP-Ptor(P ＜0.05),and comparing with the control group,there was no statistically significant (P ＞0.05).④LV peak apical rotation and LV torsion were positively correlated with systolic blood pressure,heart rate,E-peak,A-peak,LVOT-V in different degree (P ＜0.01 or P ＜0.05),but no correlation with FT3,FT4,TSH (P ＞0.05).Conclusions Myocardial contractile function strengthens in early patients with hyperthyroidism and lessens with the extension of the course.Have not yet appeared heart diseases in patients with hyperthyroidism whose myocardial regional systolic function had changed,short duration can recover after treatment,but the long duration can not restore completely.Change of myocardial motion of patients with hyperthyroidism is associated with blood flow dynamics.

Objective To observe the kinetics of myocardial during isovolumic relaxation (IVR) in normal subjects during exercise stress testing,and evaluate the relationship between the recovery rate of circumferential strain during IVR and the diastolic function of the heart.Methods Echocardiography was performed in 43 healthy students at rest,at peak stress and at recovery of the exercise test.The ratio of peak early-diastolic mitral orifice flow velocity and peak early-diastolic mitral annular velocity in left ventricular posterior wall (E/e) was measured.The records of the movement in the basal,papillary muscle and apical short-axis views of the left ventricular were stored.The circumferential strain during the end systolic (ES) and the end isovolumetric relaxation (IRA) of the subendocardial and subepicardial layers in the three short axis were analyzed using X-strain software.The circumferential strain recovery rate of the subendocardial and subepicardial layers during the IVR (ENCSrec,EPCSrec) were calculated.The circumferential strain of the subendocardial and subepicardial layers in the three short-axis during ES and IRA phases in different status were compared.The relationship between the circumferential strain recovery rate during IVR and E/e were analyzed.Results The circumferential strain of the basal,papillary level in short axis during ES and IRA phases decreases at the beginning and then increased along with the exercise intensity (P ＜0.05).The circumferential strain of the subendocardial layer is greater than the subepicardial layer in the three shortaxis during ES and IRA in different exercise status (P ＜0.01).The ENCSrec and EPCSrec of the three short-axis increases at the beginning and then decreased along with the exercise intensity (P ＜0.05).The ENCSrec and EPCSrec of 3 short axis are correlated with E/e in different exercise phases (P ＜0.05).Conclusions In normal subjects,the kinetics of circumferential strain during IVR is consisted with the physiological changes of the heart during IVR in different exercise phases.The circumferential strains in different myocardial layers are different during IVR.The circumferential strain recovery rate of left ventricular myocardial during IVR may reflex the diastolic function of the heart.

Objective To evaluate the effects of high frequency ultrasound in the assessment of vascular function during exercise in healthy subjects. Methods Forty-nine healthy subjects were enrolled in this study. The parameters of vascular function were measured at different stages (rest, exercise peak and recovery). Compliance coefficient (CC), distensibility coefficient (DC), stiffness indexα, stiffness indexβand pulse wave velocity (PWV) were measured by RF-Data technique of ultrasound vascular measurement (quantitative arterial stiffness, QAS). Endocardium-circumferential strain (EN-CS), epicardium-circumferential strain (EP-CS), endocardium-circumferential strain rate (EN-CSR) and epicardium-circumferential strain rate (EP-CSR) were collected by two-dimensional speckle tracking imaging (X-strain). The correlation between EN-CS, EN-CSR, EP-CS, EP-CSR and CC, DC, stiffness indexα, stiffness indexβand PWV were analyzed. Results At different stages (rest, exercise peak and recovery), CC were (1.436±0.448), (1.041±0.432) and (1.191±0.467) mm2/kPa DC were (0.040±0.016), (0.031±0.013) and (0.034±0.013) 1/kPa. CC and DC signiifcantly decreased at exercise peak (F=12.99 and 7.65, both P<0.01). At different stages (rest, exercise peak and recovery), PWV were (5.037±0.798), (5.845±1.165) and (5.683±1.367) m/s, stiffness indexαwere 2.298±0.633, 3.303±1.697 and 3.092±1.533, stiffness index β were 4.762±1.284, 6.794±2.515 and 6.158±3.089. PWV, stiffness index α and stiffness index β significantly increased at exercise peak (F=9.21, 13.24 and 12.33, all P<0.01). At different stages (rest, exercise peak and recovery), EN-CS were (7.825±2.445)%, (9.105±4.234)%and (6.271±2.527)%, EN-CSR were (0.831±0.276), (1.219±0.556) and (0.765±0.282) s-1, EP-CS were (6.894±2.465)%, (7.936±3.628)%and (5.489±2.306)%, EP-CSR were (0.714±0.247), (1.019±0.414) and (0.656±0.237) s-1. EN-CS, EN-CSR, EP-CS and EP-CSR signiifcantly increased at exercise peak (F=25.92, 43.76, 21.22 and 47.98, all P<0.01). EN-CS, EN-CSR, EP-CS and EP-CSR were positively correlated with PWV, stiffness indexαand stiffness indexβ(r:from 0.253 to 0.494, all P<0.05), negatively correlated with CC and DC (r:from-0.234 to-0.562, all P<0.05). Conclusions CC, DC, stiffness indexα, stiffness indexβ, PWV, EN-CS, EN-CSR, EP-CS and EP-CSR all can relfect the changes of vascular function during exercise. Properly exercise has positively direct effect on vascular elasticity.

Objective:To establish a quantitative evaluation system for medical equipment procurement and to explore its application value in the allocation and management of hospital assets.Methods:Based on theoretical research and on-site evaluation,an evaluation index system was developed from four levels of clinical demand,technical level,procurement process and service capabilities.The quantitative evaluation of the procurement process was conducted by using covariance-analytic hierarchy process(Cov-AHP),and a"6-stage"optimization process of medical equipment procurement was developed.A total of 257 sets of medical equipment purchased by Beijing Shunyi Hospital from August 2019 to July 2023 were selected,and the expert demonstration model(126 units)and the quantitative evaluation model(131 units)were used for medical equipment asset allocation management.The standardization of the medical equipment procurement process,effectiveness of performance objectives and satisfaction of clinical services of medical equipment procurement under different management methods were compared.Results:The standardization degrees of the procurement process of the medical equipment in the quantitative evaluation model in terms of startup,demonstration,implementation,installation and use stages were(98.42±2.83)%,(98.97±2.45)%,(96.24±3.87)%,(96.42±2.54)% and(94.82±5.31)%,respectively,which were higher than those in the expert demonstration model,the difference was statistically significant(t=3.741,4.385,6.551,7.620,4.563,P<0.05).The achievement rates of quality index,progress index,social benefit index and cost-benefit index of medical equipment procurement in the quantitative evaluation model were(96.15±4.08)%,(96.41±2.37)%,(92.77±3.89)% and(93.06±4.33)%,respectively,which were higher than those in the expert demonstration model,the difference was statistically significant(t=4.156,4.562,5.014,4.069,P<0.05).The clinical satisfaction scores of medical equipment users of medical equipment in the quantitative evaluation model for large medical equipment,life support and first aid equipment,laboratory testing equipment,surgical treatment equipment and other medical equipment were(90.24±1.89)points,(93.45±2.64)points,(95.67±3.64)points and(93.82±2.55)points and(97.25±3.89)points,respectively,which were higher than those in the expert demonstration model,the difference was statistically significant(t=3.678,4.079,2.845,3.628,5.023,P<0.05).Conclusion:The quantitative evaluation system can standardize the procurement process of medical equipment,improve the achievement rate of the performance target of medical equipment procurement,and improve the clinical service level of medical equipment.

Objective To investigate the main cell types expressed brain-derived neurotrophic factor (BDNF) in the posterior cortical infarction area in cerebral infarction rats after early vein allograft of bone marrow mesenchymal stem cells (BM-MSCs) and the effect of BM-MSCs transplantation on their ce11 numbers and percentages.Methods (1) Fifteen SD rats were randomly divided into sham-operated group 1,ischemia control group 1,and BM-MSCs transplantation group 1 (n=5);distal middle cerebral artery occlusion (dMCA) models were used in the later two groups;1 × 106 CM-DiI labeled BM-MSCs were intravascularly transplanted into the tail vein of rats from the transplantation group 1 at one h after ischemia;all rats were sacrificed 48 h after ischemia;BM-MSCs with co-existence of CM-Dil and BDNF in the ischemia cortex areas were detected by immunofluorescence staining.(2)Fifteen SD rats were randomly divided into sham-operated group 2,ischemia control group 2,and BM-MSCs transplantation group 2 (n=5);dMCAO models were used in the later two groups;1 ×106 non-labeled BM-MSCs were intravascularly transplanted into the tail vein of rats from the transplantation group 2 at one h after ischemia;48 h after ischemia onset,all rats were sacrificed;the number of BDNF+ and CD68+ microglia cells,BDNF+ and Iba-1+ microglia cells,and BDNF+ and neuron-specific nucleoprotein (NeuN)+ neurons were measured by immunofluorescence staining.Results (1) CM-Dil red fluorescence labeled allogeneic BM-MSCs were only found in BM-MSCs transplantation group 1;the labeled cells scattered in the infarct and peri-infarct cortices;9.70％±3.47％ CM-Dil labeled BM-MSCs expressed BDNF,accounting for 13.32％±4.48％ of all BDNF+ cells in the infarct brain cortex.(2) In the brain tissues of cortex infarct area of BM-MSCs transplantation group 2,38.40％±9.04％ BDNF+ cells were Iba-1+ microglia cells,11.65％±2.76％ BDNF+ cells were CD68+ microglia cells,and 28.96％±6.99％ BDNF+ cells were NeuN+ neurons;the Iba-1+ cell numbers and Iba-1+/BDNF+ double positive cell percentages in the BM-MSCs transplantation group 2 ([92.06±36.52]/mm2 and 79.21％±12.27％) were significantly increased as compared with those in the ischemia control group 2 ([31.13±10.23] mm2 and 60.15％±28.20％,P＜0.05).Conclusion Allogeneic BM-MSCs is capable of migrating into the infarct cortex when intravenous transplantation of BM-MSCs is performed at the early stage after ischemia;the main sources of BDNF in these areas are microglias cells and neurons;these BM-MSCs increase both number and percentage of Iba-1+/BDNF+ double positive cells,which may be one of the underlying mechanisms of therapeutic effects.

Objective To evaluate the changes of myocardial mechanics before and after percutaneous coronary intervention ( PCI ) in patients with acute myocardial infarction ( AM I ) by ultrasonic speckle tracking technique ,and investigate the recovery of left ventricular myocardium mechanics and the effects of common complications on the improvement of myocardial mechanics . Methods Sixty‐two patients with AM I were examined by echocardiography within 12 hours ,1 week and 3 months after PCI . According to the complications the patients were divided into simple AM I group ( 21 cases ) ,AM I with diabetes mellitus group ( 21 cases) ,and AM I with hypertension group ( 20 cases) . T hirty healthy volunteers were selected as control group . Conventional echocardiographic parameters and left ventricular strain parameters were evaluated in all subjects . Results ①Left ventricular end‐diastolic diameter ( LVEDD) ,left ventricular end‐systolic diameter ( LVESD) ,left ventricular end‐diastolic volume ( LVEDV ) ,and left ventricular end‐systolic volume ( LVESV ) in each AM I group before PCI were greater than the control group ( P ＜ 0 .05 ) ,left ventricular ejection fraction ( LVEF ) , global longitudinal and circumferential endocardial ( midcardial , epicardial) strain ,and left ventricular global radial strain were smaller than the control group ( P ＜0 .05) ;the global longitudinal and circumferential endocardial ( midcardial ,epicardial ) strain ,and left ventricular global radial strain in AM I with diabetes group were less than simple AM I group and AM I with hypertension group ( P ＜0 .05) ; the global longitudinal endocardial strain in AM I with hypertension group was less than simple AM I group ( P ＜0 .05) . ② The LVESV in the third month after PCI was less than that before and during 1 week after surgery ( P ＜ 0 .05 ) ,still greater than control group ( P ＜ 0 .05 ) . LVEF ,the left ventricular global longitudinal and circumferential endocardial( midcardial ,epicardial) strain , and left ventricular global radial strain were greater than those before and during 1 week after surgery ( P＜0 .05) ,still less than control group ( P＜0 .05) ; T here was no significant difference before PCI and during 1 week after PCI about routine and strain parameters ( P＞0 .05 ) . ③ T he degree of improvement of global longitudinal and circumferential endocardial strain in AM I with diabetes group were less than those in simple AM I group( P ＜0 .05) . T he degree of improvement of global longitudinal endocardial strain in AM I with hypertension group was less than that in simple AM I group ( P ＜0 .05) . Conclusions Patients with AMI have poor myocardial mechanics before PCI ,especially those with diabetes mellitus ; myocardial mechanics improves significantly 3 months after PCI ; diabetes mellitus or hypertension affectes the improvement of myocardial mechanics in patients with AM I after PCI .

Objective To investigate whether human bone marrow mesenchymal stem cells (hBC-MSCs) have the immune-suppression ability on the proliferation of peripheral blood mononuclear cells (PBMCs) and their pro-inflammatory cytokine production in rats,to explore what kinds of human cytokines are required for the induction of hBM-MSCs to become immune-suppressive,and to observe the effect of intravenous delivery of hBM-MSCs on tumor necrosis factor (TNF)-α transcription and expression in the core infarct areas of rats after cerebral ischemia.Methods The fetal-originated hBC-MSCs and rat PBMCs were extracted;the rat PBMCs were activated by adding 10 μg/mL concanavalin A (ConA).(1) The first experiment was divided into hBM-MSCs+PBMCs group,hBM-MSCs+PBMCs+ConA group,PBMCs group and hBM-MSCs group;CCK-8 assay was employed to detect the proliferation of these cells.(2) The second experiment was divided into hBM-MSCs+PBMCs+ConA group,PBMCs+ConA group;ELISA was used to detect the TNF-α,interferon-γ (IFN-γ) and intedeukin (IL)-10 expressions.(3) The third experiment was divided into hBM-MSCs+PBMCs (IFN-γ+IL-1α) group,hBM-MSCs+PBMCs (IFN-γ+IL-1β) group,hBM-MSCs+PBMCs (IFN-γ+TNF-α) group and hBM-MSCs+PBMCs group;CCK-8 assay was used to detect the proliferation of these cells.(4) Thirty SD rats were randomly divided sham-operated group,control group (giving normal saline after ischemia) and hBM-MSCs group (giving hBM-MSCs after ischemia,n=10);on the third d of ischemia,the TNF-α mRNA and protein expressions at the infarct areas was detected by real time PCR and Western blotting,respectively.Results (1) The optical density (OD) in the hBM-MSCs+PBMCs group was significantly increased as compared with that in the PBMCs group and hBM-MSCs group (P＜0.05);OD in the hBM-MSCs+PBMCs group was significantly increased as compared with that in the hBM-MSCs+PBMCs+ConA group (P＜0.05).(2) The TNF-α,IFN-γand IL-10 levels in the PBMCs+ConA group were (1030±196) pg/mL,(2880±250) pg/mL and (330±45) pg/mL;the TNF-α and IFN-γlevels in hBM-MSCs+PBMCs+ConA group were (160±10) pg/mL and (240±55) pg/mL,which were significantly lower than those in the PBMCs+ConA group (P＜0.05);the IL-10 level in hBM-MSCs+PBMCs+ConA group was (750±110) pg/mL,which was significantly higher than that in the PBMCs+ConA group (P＜0.05).(3) The OD in the hBM-MSCs+PBMCs(IFN-γ+IL-1α)group,hBM-MSCs+PBMCs (IFN-γ+IL-1 β) group and hBM-MSCs+PBMCs (IFN-γ+TNF-α) group was significantly decreased as compared with that in the hBM-MSCs+PBMCs group (P＜0.05).(4) The TNF-α mRNA expression in the sham-operated group,control group and hBM-MSCs group was 0.490±0.128,2.369±0.788 and 1.002±0.408;the TNF-α protein expression in the sham-operated group,control group and hBM-MSCs group was 0.144±0.028,0.314±0.029,0.240±0.029;the TNF-α protein and mRNA expressions in the hBM-MSCs group were significantly decreased as compared with those in the control group (P＜0.05).Conclusions The allogeneic transplantation of hBC-MSCs is competent in suppressing the inflammation of rats in vitro and in vivo.Furthermore,this immune-suppression ability is not innate,but cytokine stimulation dependent.The immune-suppression ability of hBM-MSCs on rat PBMCs are at least partly responsible for the therapeutic effect of hBM-MSCs transplantation into the rat models,such as ischemia stroke.