Pulmonary hypertension(PH) is a clinical hemodynamic syndrome characterized by elevation of pulmonary artery pressure and pulmonary vascular resistance,which was presumed mainly due to pulmonary vasoconstriction,remodeling of the pulmonary vessel wall,and thrombosis in situ.Endothelin,nitric oxide,and prostacyclin pathway were three major pathways involved in the pathogenesis.Current therapies interfered with these 3 pathways in combination with conventional measures have prolonged length of life of patients and improved their quality of life significantly.

Cardiac Catheterization ; Child ; Echocardiography, Three-Dimensional ; Heart Septal Defects ; diagnostic imaging ; Humans ; Prosthesis Implantation ; Time Factors

Background:Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare but potentially life?threatening congenital heart defect. A retrospective analysis was carried out to elucidate the surgical outcomes of ALCAPA in infants and children using follow?up echocardiography. Methods: From September 2008 to March 2017, 26 children diagnosed with ALCAPA underwent left coronary re?implantation. All surviving patients received echocardiography during follow?up. Results: The mortality rate after the operation was 11.5%. Before repair, twenty patients (76.9%) presented with left ventricular (LV) dysfunction. The mean Z?score of the preoperative LV end?diastolic diameter was 4.42 ± 2.09. Mitral regurgitation (MR) was present in all patients. Two patients (7.7%), both with mitral valve prolapse, underwent mitral valve repair at the time of ALCAPA repair. Two children required postoperative extracorporeal membrane oxygenation. LV function normalized at a median time of 5.3 months (range:0.5–36.0 months). The Z?score of the LV end?diastolic diameter decreased simultaneously. The degree of MR gradually decreased in all surviving patients.All patients had patency of the proximal left coronary artery confirmed by echocardiography at the most recent follow?up. Six patients (26.1%) showed supravalvar pulmonary stenosis and seven patients (30.4%) showed right pulmonary stenosis during follow?up. Conclusions: Coronary re?implantation was effective for rebuilding a dual coronary system in patients with ALCAPA and resulted in progressive improved LV function and reduced functional MR. Echocardiography was valuable for evaluating the outcomes. LV function, the degree of MR, and possible complications could be detected with follow?up echocardiography.

OBJECTIVETo evaluate the value of echocardiography in the diagnosis of noncompaction of the ventricular myocardium (NCVM) and to elucidate the echocardiographic characteristics of NCVM.

METHODSThis study included 53 patients (28 boys and 25 girls), with an age for initial diagnosis of 15 days to 18 years, who were diagnosed with NCVM by echocardiography between May 2006 and May 2015. Transthoracic two-dimensional echocardiography and color Doppler were performed for qualitative diagnosis, and the end-diastolic non-compacted layer/compacted layer (N/C) ratio measured in the parasternal ventricular short-axis sectional view was selected as the criterion for quantitative diagnosis.

RESULTSThe excessively prominent ventricular trabeculae and deep inter-trabecular recesses were all seen in 53 cases, and the blood flow in the cardiac chambers was connected to the inter-trabecular recesses. The areas involved in NCVM were mainly the apex (100%) and the middle segment of the left ventricular lateral wall (98%), followed by the middle segment of the left ventricular posterior wall (49%) and the middle segment of the left ventricular inferior wall (42%). In 53 children with NCVM, the N/C ratio was 4.3±1.9 (2.1-10.0). Cardiac insufficiency was found in 83% (44/53) of the children with NCVM, and the left ventricular ejection fraction for these children was (43±9)%.

CONCLUSIONSEchocardiography can be used in the qualitative and quantitative diagnosis of NCVM and in the evaluation of cardiac function. The apex and the middle segment of the left ventricular lateral wall are often involved in NCVM, accompanied by decrease in the left ventricular ejection fraction.

Adolescent ; Child ; Child, Preschool ; Echocardiography ; Female ; Heart Ventricles ; abnormalities ; diagnostic imaging ; Humans ; Infant ; Infant, Newborn ; Male ; Stroke Volume ; Ventricular Function, Left

OBJECTIVETo observe anti-fatigue effect and mechanisms of pre-electroacupuncture (EA) at "Zusanli" (ST 36) in rats undergoing acute treadmill running.

METHODSFifty male SD rats were randomly divided into three groups: a quiet group (group Q, n = 10), a model group (group M, n = 20) and an EA preconditioning group (group EAP, n = 20). After adaptation for undergoing treadmill running, all the rats in group M and group EAP were trained on acute treadmill running. Besides, EA with continuous waves, 2 Hz in frequency and 2 mA in intensity was applied at bilateral "Zusanli" (ST 36) for 30 min, which was applied once daily for continuous 6 days before treadmill running for the rats in Group EAP. Plasma lactate contents were measured immediately and 3 hours after treadmill running, respectively. Changes of dopamine (DA) and serotonin (5-HT) contents obtained immediately and 3 hours after treadmill running, respectively, in hypothalamus and striatum, were detected and compared, and DA/5-HT ratios were calculated.

RESULTSCompared with group Q, the levels of blood lactate and hypothalamic 5-HT tented to increase in rats of group M, and the contents of hypothalamic DA increased significantly (P < 0.01), while the contents of striatal DA and 5-HT in group M decreased significantly (both P < 0.01) at 3 h after treadmill running. Immediately after treadmill running, the contents of DA and 5-HT increased significantly in hypothalamus (both P < 0.01), but decreased significantly in striatum (both P < 0.01) in group EAP, compared with those in group M. Moreover, EA pretreatment markedly decreased the levels of blood lactate (P < 0.05) and hypothalamic 5-HT (P < 0.01), and obviously elevated the ratio of DA/5-HT in the hypothalamus (P < 0.01) at 3 h after treadmill running.

CONCLUSIONPreventive EA at "Zusanli" (ST 36) can accelerate recovery from fatigue, which may be related to its reducing accumulation of blood lactate, elevating DA/ 5-HT ratio in the hypothalamus of the rats undergoing treadmill running.

Acupuncture Points ; Animals ; Corpus Striatum ; metabolism ; Disease Models, Animal ; Dopamine ; metabolism ; Electroacupuncture ; Exercise ; Fatigue ; metabolism ; prevention & control ; therapy ; Humans ; Hypothalamus ; metabolism ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Serotonin ; metabolism

Objective To investigate the situation and influencing factors of neck-shoulder pain of Beijing military university teachers,so as to provide reference for making preventive measures.Methods A total of 190 teachers from a military university in Beijing were chosen by convenience sampling.Nordic,Pittsburgh sleep quality index (PSQI) and self-designed questionnaire were used to investigate and analyze teachers' sleeping quality,neck-shoulder pain and influencing factors.Results Totals of 189 questionnaires were recovered,with the rate of 99.47％.All of 62.43％ teachers had neck-shoulder pain.Female' s occurrence rate of neck-shoulder pain was higher than male.Occurrence rate of those who had history of neck-shoulder disease was higher than that of those who had not.Teachers who used adjusted chair had smaller chance of neck-shoulder pain than those who didn' t.Teachers who had excessive exercise had higher rate of neck-shoulder pain than those who did not.Teachers who did exercise such as swimming or playing basketball had lower rate than those who did not.The differences were statistically significant (x2 =4.38,53.46,7.31,6.14,9.22,7.39,respectively ; P ＜ 0.05).The score of sleep disorder,sleeping time,daily work disorder and sleeping quality in PSQI were respectively (1.03 ± 0.57),(1.04 ± 0.83),(1.58 ± 0.96),(1.08 ± 0.74) for teachers who had neck-shoulder pain,and (0.72 ± 0.59),(0.66 ± 0.65),(1.11 ± 1.01),(0.75 ± 0.81) for teachers who had not.The differences were statistically significant (t =-3.60,-3.29,-3.12,-2.96,respectively; P ＜ 0.01).The influencing factors of teachers' neck-shoulder pain included neck-shoulder disease history,excessive exercise and sleeping time (x2 =36.61,5.99,5.96,respectively; P ＜ 0.05).Conclusions Neck-shoulder pain is a common disease among military university teachers in Beijing,and appropriate exercise as well as improving sleeping quality is helpful for preventing it.

OBJECTIVETo investigate the efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) in the treatment for obesity and type 2 diabetes mellitus (DM).

METHODSTwenty-one cases of obesity and 9 cases of type 2 DM received the LRYGB. Weigh changes, excess body weight lose rate (EWL%) and blood glucose level were measured after surgery and occurrence of complications was observed postoperatively.

RESULTSLRYGB procedures in all the 30 cases were successfully performed with no conversion to open surgery. Average operation time was 168 minutes (110-270 mins), volume of blood loss during the surgery was 24.0 ml (10-75 ml). Twenty-one cases of simple obesity received follow-up from 2 months to 5 years. Body weight and BMI decreased significantly in one month [(85.1+/-10.1) kg vs (97.2+/-15.0) kg, 31.2+/-2.2 vs 35.3+/-3.5, both P<0.01] and to a minimal level in 2 to 3 years [(66.8+/-9.2) kg, 24.3+/-1.1], and then maintained at this level. EWL% was correspondingly higher (all P<0.05). Nine type 2 DM patients were followed up for 3 to 8 months, fasting blood glucose and blood glucose OGTT2 hours decreased significantly [(5.9+/-1.4) mmol/L vs (12.6+/-2.6) mmol/L, (7.8+/-1.4) mmol/L vs (17.8+/-4.1) mmol/L, both P<0.05], of whom 4 patients with obesity decreased in BMI significantly (P<0.05), and 5 patients without obesity had no significant changes in BMI (P>0.05). Five cases (16.7%) had postoperative complications, including 1 case of death due to acute fulminant pancreatitis, 1 case of mesenteric hiatal hernia with obstruction in line for reoperation, and the other 3 cases of healing by conservative therapy.

CONCLUSIONSTreatment of obesity and type 2 DM by LRYGB surgery is feasible with significant short term result. Long term outcome needs further observation.

Adolescent ; Adult ; Aged ; Diabetes Mellitus, Type 2 ; surgery ; Female ; Gastric Bypass ; methods ; Humans ; Laparoscopy ; Male ; Middle Aged ; Obesity, Morbid ; surgery ; Young Adult

OBJECTIVETo research the expectorant components in volatile oil from the root and rhizome of Aster tataricus.

METHODGC-MS was applied to isolate and identify the compounds. In addition, TLC was used to isolate compound, and its structure was elucidated on the basis of spectral data analysis. At the same time, its expectorant effect was observed by method of the excretion quantity of phenol red in trachea of mice.

RESULTSeven compounds were isolated and identified by GC-MS, they were (R)(-)-p-menth-1-en-4-ol (1), 2-undecanone (2), n-decanoic acid (3), (-)-spathulenol (4), hexahydrofamrnesyl acetone (5), hexadecanoic acid (6), and cis-9, cis-12-octaecadienoic acid (7). A known compound 1-acetoxy-2-ene(E)-4,6- decandiyne was isolated from the root and rhizome of A. tataricus, and it was shown to have expectorant effect.

CONCLUSION1-Acetoxy-2-ene(E) -4,6- decandiyne, a main compound in volatile oil, had been found to have expectorant effect.

Animals ; Aster Plant ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Expectorants ; chemistry ; isolation & purification ; pharmacology ; Gas Chromatography-Mass Spectrometry ; Magnetic Resonance Spectroscopy ; Male ; Mice ; Oils, Volatile ; chemistry ; Plant Roots ; chemistry ; Rhizome ; chemistry

BACKGROUNDReal-time three-dimensional echocardiography (RT-3DE) has made revolutionized improvements of cardiac imaging during the past few years. However, there is no standard examination method for RT-3DE so far. This study aimed to establish the diagnostic method of RT-3DE and evaluate its application in the diagnosis of complex congenital heart diseases (CHD).

METHODSFifty patients with complex CHD were examined by RT-3DE with modes of Live 3DE and Full Volume. A series of novel volumetric views combined with Van Praagh sequential segmental approach were introduced to reveal the pathological morphology of the hearts, which were compared with the findings of two-dimensional echocardiography (2DE), angiography and cardiac surgery.

RESULTSIn 50 patients, 190 image acquisitions of Full Volume were performed at several acoustic windows including subcostal, apical and parasternal regions. Among them, 94.2% (179/190) of image acquisitions were successful. Most sectional volumetric views could be clearly displayed in 92.6% of the successful image acquisitions. However, sectional volumetric views could not be clearly displayed in 7.4%, which was mainly due to poor perspective conditions of examination location, improper instrument multi-parameter setting and insufficient information of whole heart captured in Full Volume acquisitions. As compared with surgical findings and angiography, RT-3DE made correction to the diagnoses in 2 cases including 1 with corrected transposition of the great arteries and the other with single atrium and mitral cleft. The diagnoses initially made by 2DE for these 2 patients were double outlet right ventricle with transposition of the great arteries and complete atrio-ventricular septal defect.

CONCLUSIONSRT-3DE can clearly display the pathological morphology of complex CHD by a series of novel volumetric views combined with sequential segmental approach through providing more spatial informative cardiovascular structures, which provides a practical method for RT-3DE diagnosis.

Child ; Child, Preschool ; Echocardiography, Three-Dimensional ; methods ; Female ; Heart Defects, Congenital ; diagnostic imaging ; Humans ; Infant ; Infant, Newborn ; Male