Objective To evaluate the left ventricular systolic synchrony in hemodialysis depended(HD)patients by tissue synchronization imaging(TSI).Methods GE Vivid 7 ultrasound system with TSI and Q-analyze software was performed in 70 HD patients and 35 control individuals.According to the left ventricular enddiastolic diameter(LVDd),HD patients were divided into left ventricular enlarged group(HD1,LVDd＞55 mm)and non-left ventricular enlarged group(HD2,LVDd≤50 mm).Systolic asynchrony was determined by measuring the time to peak systolic velocity of all 12 segments corrected by the heart rate(Tc).Results ①The mean Tc and the Tc of most segments were greater in both the HD1 and HD2 groups than in controls(both P＜0.05).②The Tc was prolonged in 463(463/840)segments in HD group and left ventricular systolic asynchrony was detected in all patients(70/70).③The mean peak systolic velocity(PSV)and the PSV of most segments in HD group were lower than those in the control group(P＜0.05).④Compared with HD2 group,Tc was increased and PSV was decreased in partial segments of HD1 group(P＜0.05),but no significant differences in mean Tc and mean PSV were found between HDI and HD2 groups(P＞0.05).Conclusions Left ventricular systolic synchronicity was impaired in hemodialysis depended patients.TSI was shown to be useful for the detection of myocardial abnormalities and asynchrony in such patients and provided reliable parameters for clinical therapy.

Objective To discuss the clinical efficacy of balloon occlusion technique in treating pernicious placenta previa.Methods Between January 2015 and March 2016,a total of 16 matcrnal patients with pernicious placenta previa,who were admitted to the Interventional Department of Qujing Municipal First People's Hospital,received balloon occlusion management to assist obstetrician in dealing with placenta previa.Central type of placenta previa with highly suspected placenta implantation were diagnosed in 15 patients by color ultrasound or MRI.Balloon catheters were placed in bilateral internal iliac arteries before cesarean section was carried out,and immediately after the fetus was taken out the balloons were inflated to temporary occlude the targeted arteries.Based on the hemostatic status the balloon catheters were timely retrieved.One patient received emergency temporary balloon occlusion of abdominal aorta,and laparotomy revealed that the placenta had penetrated to the subserosa of uterine anterior wall,and total hysterectomy had to be carried out.Results Successful balloon occlusion was achieved in all 16 patients.The mean blocking time of the artery was 15 minutes and the amount of blood loss was 300-1200 ml.Conclusion In treating pernicious placenta previa,balloon occlusion treatment before cesarean section is safe and reliable,it can significantly reduce the amount of blood loss during surgery,make quick and effective hemostasis,provide a clear surgical field for the performance of cesarean section,and,more important,save the maternal life.This effective technique has fully showed the necessity of multidisciplinary collaboration,including obstetrics,interventional radiology,etc.