Objective To evaluate the clinical application of COBIO XS automated urine sediment analyzer for screening urinary tract infection(UTI) .Methods Midstream urine samples were collected from 182 patients with suspected UTI .White blood cell counts(WBC) and bacteria counts(BACT) were determined by COBIO XS automated urine sediment analyzer .By comparing with quantitative urine culture as the golden standard of UTI .The area under the ROC curve(AUC) was constructed to evaluate the dis‐criminative power of variables to predict UTI .Results The positive rate of urine culture was 30 .8% .The isolated rate of Esche‐richia coli ,Enterococcus species and proteus species were 53 .6% ,16 .1% ,10 .7% ,respectively .ROC curve analysis showed that AUC was 0 .808(95% CI 0 .710-0 .867) for WBC and 0 .899(95% CI 0 .797 -0 .923) for BACT .The best cutoff value for WBC was 50/μL ,sensitivity was 89 .0% ,specificity was 83 .8% ,positive predictive value was 86 .3% and negative predictive value was 93 .7% .The best cutoff value for BACT was 110/μL ,sensitivity was 82 .5% ,specificity was 85 .6% ,positive predictive value was 78 .5% and negative predictive value was 88 .0% .Conclusion COBIO XS analyzer is adopted to conduct rapid and reliable a screen‐ing tool for UTI .

By using the image processing function and programming tomography,the following functions are realized: the contour line,edge line and gradation histogram of medical images are displayed;the selected regions of medical images are freely zoomed;the gray level of discretional regions is displayed using medical image processing tool and the distance of the given points is freely measured.

Objective To study comparatively the performance of rapid plasma reagin (RPR) test in syphilis detection among pregnant women and non-pregnant women to provide reference for detecting syphilis in pregnant women.Methods The women aged 20-40 years old were selected and divided into the pregnant group and the non-pregnant group.RPR and treponema pallidum particle assay(TPPA) were simultaneously adopted to conduct the syphilis detection.The positive cases were judged by the TPPA detection results combined with the contact history,clinical symptoms and treatment situation.The results were compared with those by RPR for determining the false negative and false positive in RPR.The false negative rate and false positive rate of RPR detection results were analyzed in the two groups.Results Among 117 pregnant women,15 cases were false negative in RPR and 9 cases were false positive in RPR;among 755 non-pregnant women,there were 44 cases of false negative RPR results and 8 cases of false positive RPR results.The false negative rates in the pregnant group and non-pregnant group were 25.0% and 8.8% respectively,the difference was statistically significant(χ2=14.739,P<0.05);the false positive rates in the pregnant group and non-pregnant group were 15.7% and 3.1% respectively,the difference was statistically significant (χ2=14.722,P<0.05).Conclusion There are many factors affecting RPR for detection syphilis,pregnant women are the specific group,so higher false positive rate and false negative rate exist than non-pregnant women,the detection results should be comprehensively judged by combining with clinical symptoms and disease history,if necessary,combining with other syphilis detection method for avoiding missed diagnosis and misdiagnosis.

Objective To evaluate the effects of different right ventricular pacing sites on left ventricular systolic synchrony using tissue Doppler imaging(TDI).Methods A tota[of sixty-nine patients with indications for permanent pacemaker implantation were enrolled sequentially by Pace-ROAD study(Pacemaker-right ventricular outflow tract and apex study,a randomized control study).They were randomized to RVOT pacing group(group A)or RVA pacing group(group B).Echocardiographic study with TDl was performed before and after 3 month follow up,and the data were analysed off-line.The peak velocity(Vs),the time to the peak of S wave(Ts)of all 12 basal and middle segments of left ventricle were measured,and then the standard deviation of Ts(Ts-SD),the average of Vs(Vs-M)were calculated.Results Thirty-six patients were randomized to group A,while the other 33 patients to group B.In each group,one patient was rejected due to non-pacing rhythm during follow-up.After 3 month pacing,the Ts-SD of group A was significantly shorter than that of group B[(23.63±2.32)ms vs(31.54±2.93)ms.P=0.0387-].In the patients with the basal Ts-SD longer than 32.6 ms(group A2 and group B2),the Ts-SD was significantly shortened than the baseline in group A2 during follow-up,while no significant difference was found in group B2.And the follow-up Ts-SD of group B2 was significantly longer than that of group A2 r(38.19±18.34)ms vs(28.55±16.93)ms,P=0.0290].Conclusions RVOT pacing is associated with favorable left ventricular systolic synchrony than RVA pacing,especially in patients with worsened baseline systolic synchrony.

Objective To analyze the strains of patients with hypertrophic cardiomyopathy (HCM) by vector velocity imaging(VVI),and to identify abnormal early systolic function.Methods Forty patients with HCM (HCM group) and 25 healthy subjects (control group) were enrolled.Standard two-dimensional echocardiography was performed.Left ventricular ejection fraction (LVEF),diameters and wall thickness were measured.Peak systolic strains in all directions and their time to peak were analyzed off-line.Results ①All but the endocardial circumferential strain were apparently smaller in HCM group than those in the control group(P ＜0.000 1).The difference was greater in long axis than that in short axis.②The HCM group maintained the characteristics of strain gradient as the control group,including the endocardiumepicardium gradient with endocardial strains was significantly greater than epicardial ones and the base-apex gradient,among which epicardial longitudinal strain decreased from the base to the apex and endocardial circumferential strain increased toward the apex.③The HCM group suffered significant dyssynchrony in terms of strain and rotation,with greater changes in longitudinal than in short axis,in epicardium than in endocardium.Conclusions VVI offers an overall assessment of regional and global left ventricular systolic function,including longitudinal and circumferential strain.Moreover,it can be used to evaluate subclinical systolic dysfunction and dyssynchrony in patients with HCM.

Objective: To evaluate left ventricular energy loss (EL) in patients with hypertrophic cardiomyopathy (HCM) and hypertensive left ventricular hypertrophy (H-LVH) using vector flow map (VFM). Methods: Twenty-five HCM patients, 21 H-LVH patients and 36 healthy subjects were selected as HCM group, H-LVH group and control group respectively in Zhongshan Hospital Fudan University. Color Doppler imaging of long-axis view loops were recorded for VFM analysis. According to the opening and closing of the aortic valve and mitral valve, isovolumic contraction (IVC), isovolumic relaxation (IVR), ejection period (EP) and filling period (FP) were determined. The total left ventricular EL(T-EL), IVC-EL, IVR-EL, EP-EL and FP-EL as well as peak EL during EP and FP were quantified. The measurement results were taken as the average of three cardiac cycles. Results: ①Compared to the control group, FP-PEL was decreased in both patient groups, and HCM group was the lowest (P<0.05). Compared to the control group, EP-EL and EP-PEL were increased, while FP-EL was decreased in HCM group (all P<0.05); IVC-EL, EP-PEL, and EP-EL were increased in H-LVH group (all P<0.05). ②Compared with HCM group, the IVC-EL, FP-PEL, IVR-EL and FP-EL of H-LVH were higher(all P<0.05). ③The ROC analysis of five parameters with statistical difference between HCM group and H-LVH group showed that FP-EL and IVC-EL were more effective in the differential diagnosis of HCM and H-LVH. Conclusions Patients with cardiac hypertrophy and normal LVEF have increased systolic EL and reduced diastolic EL. H-LVH patients have more energy loss than HCM patients.EL might be a sensitive and valuable parameter to distinguish cardiac hypertrophy of different etiologies.

0.05 ). After once injection both observers considered the number of clearly recognized endocardial border segments increased significantly. The number evaluated by observers A increased from 2.68 ? 0.95 to 5.99 ? 0.10 while from 2.82 ? 1.03 to 5.99 ? 0.11 by observers B( P 0.05 ). The average contrast enhancement rate of LV endocardial border was 99.7 %. Perfluoropropane-albumin microsphere injection had no significant effection on vital signs such as blood prssure, heart rate and respiration. Electrocardiogram didn′t change markedly and the variance of the laboratory findings like blood and urine routine examination, hepatic and renal function was in normal range. Only one case( 0.33 %) had slight side-effects who suffered from mild nausea and diarrhea, which suggested the clinical safety of this contrast agent. Conclusions Perfluoropropane-albumin microsphere injection could enhance the resolution of LV endocardial borders and make the judgement of regional myocardial movement easier. It has little side-effects and will be appropriate for clinical use.

Objective To evaluate left ventricular energy loss ( EL ) in patients with hypertrophic cardiomyopathy ( HCM ) and hypertensive left ventricular hypertrophy ( H‐LV H ) using vector flow map ( VFM ) . Methods T wenty‐five HCM patients ,21 H‐LV H patients and 36 healthy subjects were selected as HCM group ,H‐LV H group and control group respectively in Zhongshan Hospital Fudan University . Color Doppler imaging of long‐axis view loops were recorded for VFM analysis . According to the opening and closing of the aortic valve and mitral valve ,isovolumic contraction ( IVC) ,isovolumic relaxation ( IVR) , ejection period ( EP) and filling period ( FP) were determined . T he total left ventricular EL ( T‐EL ) ,IVC‐EL ,IVR‐EL ,EP‐EL and FP‐EL as well as peak EL during EP and FP were quantified . T he measurement results were taken as the average of three cardiac cycles . Results ①Compared to the control group ,FP‐PEL was decreased in both patient groups ,and HCM group was the lowest ( P ＜0 .05 ) . Compared to the control group ,EP‐EL and EP‐PEL were increased ,while FP‐EL was decreased in HCM group ( all P ＜0 .05) ; IVC‐EL ,EP‐PEL ,and EP‐EL were increased in H‐LV H group ( all P ＜0 .05 ) . ②Compared with HCM group ,the IVC‐EL ,FP‐PEL ,IVR‐EL and FP‐EL of H‐LV H were higher( all P ＜0 .05) . ③The ROC analysis of five parameters with statistical difference between HCM group and H‐LV H group showed that FP‐EL and IVC‐EL were more effective in the differential diagnosis of HCM and H‐LVH . Conclusions Patients with cardiac hypertrophy and normal LVEF have increased systolic EL and reduced diastolic EL . H‐LV H patients have more energy loss than HCM patients .EL might be a sensitive and valuable parameter to distinguish cardiac hypertrophy of different etiologies .

Tricuspid regurgitation (TR) interventions are under rapid development. The K-Clip? system is the first domestic transcatheter tricuspid annuloplasty system with unique clamping procedure to achieve annular reduction.Intraoperative echocardiographic monitoring procedures for transcatheter tricuspid annuloplasty have not been reported yet in China. Thus, this review aimed to propose the standard two-dimensional and three-dimensional transesophageal echocardiographic workplanes and procedures to guide and monitor the implantation of K-Clip system based on our experience in Zhongshan Hospital, Fudan University to provide a reference point for the intraoperative echocardiographic monitoring of future transcatheter tricuspid annuloplasty devices in China.

Transcatheter tricuspid valve intervention is the new frontier of interventional cardiology. The LuX-Valve is a radial force-independent orthotopic tricuspid valve replacement device developed in China. The LuX-Valve Plus transcatheter tricuspid valve replacement (TTVR) system is changed from the trans-atrial to the transjugular approach, which further reduces trauma and pulmonary complications compared with the first generation LuX-Valve. The first-in-human study has been completed at Zhongshan Hospital, Fudan University and an exploratory multicentre clinical study is underway. Echocardiography plays an important role in pre-TTVR screening, intraoperative guidance and postoperative evaluation and follow-up, especially two-dimensional transoesophageal echocardiography (2D-TEE) and three-dimensional transoesophageal echocardiography (3D-TEE). However, there is a lack of appropriate intraoperative guidance and assessment protocols. In this study, we briefly described the protocols and imaging considerations for intraoperative 2D-TEE and 3D-TEE to ensure the successful implantation of TTVR.