Objective To research the visualization of congenital heart disease by three-dimensional echocardiographic(3DE) virtual endoscopy(VE) system. Methods Datasets.from 10 healthy children and 22 patients with congenital heart disease were collected (10 patients with atrial septal defects, 6 patients with ventricular septal defects and 6 patients with tetralogy of Fallot). 3DE heart models were reconstructed by virtual reality computing techniques and visualization in scientific computing techniques. The VE system was programmed under the C++ 6.0 language condition,the visualization toolkit (VTK) platform was employed to carry out the graphics and visualization utilities. The virtual eye can move along the navigation paths in the heart by manual camera movements. Results The VE can provide special information in aspects of intracardiac anatomy, The visible heart models show precisely complex anatomy structure and spatial relationships. 3DE intracardiac endoscopic imaging can thus be visualized and navigated successfully by the VE system. Conclusions 3DE VE is a new system for the visualization of congenital heart disease.

Objectve To investigate the association between insertion/deletion (I/D) polymorphism of angiotensin converting enzyme (ACE) gene and autosomal dominant polycystic kidney disease (ADPKD). Methods Polymorphism of ACE gene was analyzed by polymease chain reavtion (PCR) in 103 ADPKD patients and 16 ADPKD family constellations including 35 patients and 30 non-ill people. Clinical data were collected and age of onset, hepatocyst, hypertension, urinary tract infecton, urinary concretion, hematuria were used as the main parameters to analyze the association between ACE gene polymorphism and ADPKD. Results The age of onset in DD genotype was 7.2 years younger than that in DI genotype [(31.90±11.41) vs (39.10±10.08) years, P<0.05] and was 14.25 years younger than that in Ⅱ gene type [(31.90±11.41) vs(46.15±14.74) years, P<0.05]. The age of onset in I/D genotype was 7.05 years younger than that in Ⅱ genotype [(39.10±10.08) vs (46.15±14.74) years, P<0.05]. There were significance differences of main clinical symptoms (hypertension, hematuria and urinary tract infection) among three genotype groups. In 11 family constellations, ACE gene polymorphism presented genetic linkage, but without significant difference (P>0.05); the genotype distribution was not significantly different between ADPKD and non-ill people (P>0.05), as well as between man and woman (P>0.05); the DD genotype frequency was significantly higher in ADPKD patients with chronic renal failure (P<0.05). Conclusions The age of onset in DD gentype is the youngest among three groups. The incidence of hypertension and hematuria in DI genotype is the highest. The ACE gene polymorphism in ADPKD family constellation does not provide diagnosis information. The ACE gene I/D polymorphism may not contribute to ADPKD. The DD genotype of ACE may be a risk factor of renal failure in the ADPKD.

Objective To apply 3C3R model in problem design of PBL for pediatrics teaching.Methods The 3C3R model comprises two classes of components:core components and processing components.Core components of the model are 3C,which are content,context and connection while processing components are 3R,which are researching,reasoning and reflecting.3C3R model was used in the problem design for the PBL case of ‘ Why the mouth of Baobao became purple when he was crying?' Totally 76 eight-year program medical students and 7 tutors were enrolled as teaching object.The anonymous questionnaires from the students were collected for assessment of PBL teaching.Results The percentage of students with scores ≥4 for content in PLB problem design was 90.8％,for context was 80.3％,for connection was 64.5％,for researching was 81.6％,for reasoning was 69.7％ and for reflecting was 40.8％.The percentage of tutors with scores ≥4 for content in PLB problem design was 100％,for context was 71.4％,for connection was 28.6％,for researching was 71.4％,for reasoning was100％,for reflecting was57.1％.Both students and tutors held a positive attitude towards the component of content,context,researching and reasoning in problem design model.But the components of connection and reflection needed to be improved.Conclusion The 3C3R model is helpful for problem design of PBL in pediatric teaching.

Objective To evaluate the effects of dexmedetomidine on hemodynamics during induction of anesthesia in the patients with atrial fibrillation with rapid ventricular rate undergoing noncardiac surgery.Methods Fifty patients with rheumatic valvular heart disease complicated with atrial fibrillation,aged 45-64 yr,weighing 50-75 kg,with ventricular rate ≥ 90 bpm,of ASA physical status Ⅱ or Ⅲll (NYHA Ⅱ or Ⅲ),scheduled for elective surgery,were randomly divided into 2 groups (n =25 each) using a random number table:control group (group C) and dexmedetomidine group (group D).Dexmedetomidine 0.6 μg/kg was infused intravenously at 10 min prior to induction of anesthesia in group D.Anesthesia was induced with iv midazolam 0.06 mg/kg,sufentanil 0.6 μg/kg,and vecuronium 0.12 mg/kg.Tracheal intubation was performed when the BIS value≤≤ 55After admission to operating room (T0,baseline),immediately after the end of dexmedetomidine infusion (T1),immediately before intubation (T2),and at 1,3 and 5 min after intubation (T3-5),SP,DP,MAP and HR were recorded.The adverse cardiovascular events were recorded starting from induction of anesthesia to 5 min after intubation.Results Compared with the baseline value at T0,HR was significantly decreased at T2,5,while increased at T3,4 in group C,and HR was decreased at T1-5 in group D; SP,DP and MAP were decreased at T2,5,while increased at T3 in group C,and no significant changes were found in the indices mentioned above in group D.Compared with group C,the incidence of hypotension,hypertension and tachycardia was significantly decreased,and no significant changes were found in theincidence of bradycardia in group D.Conclusion Dexmedetomidine 0.6 μg/kg infused intravously is helpful in maintaining the hemadynamics stable during induction of anesthesia in the patients with atrial fibrillation with rapid ventricular rate underging noncardiac surgery.

In this paper, we present a virtual endoscopy (VE) for diagnosis of heart diseases, which is proved efficient and affordable, easy to popularize for viewing the interior of the heart. The dual source CT (DSCT) data were used as primary data in our system. The 3D structure of virtual heart was reconstructed with 3D texture mapping technology based on graphics processing unit (GPU), and could be displayed dynamically in real time. When we displayed it in real time, we could not only observe the inside of the chambers of heart but also examine from the new angle of view by the 3D data which were already clipped according to doctor's desire. In the pattern of observation, we used both mutual interactive mode and auto mode. In the auto mode, we used Dijkstra Algorithm which treated the 3D Euler distance as weighting factor to find out the view path quickly, and, used view path to calculate the four chamber plane.
Algorithms ; Endoscopy ; methods ; Heart ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Tomography, Spiral Computed ; methods ; User-Computer Interface

Objective This study aimed to establish a reliable primary culture protocol for preparing murine spleen-derived mesenchymal stem cells ( MSCs) by tissue explant culture.Methods Healthy mouse spleens were crushed by syringe handle to harvest spleen mesenchymal tissues.Then the tiny pieces of spleen tissue were digested by collagenase II before seeded into culture flasks.The morphological characteristics of spleen tissue-derived cells were observed under the inverted microscope.Further, the surface antigen profile of the cells was analyzed by flow cytometry (FACS).The cells were induced to differentiate into osteoblasts and adipocytes.Results The murine spleen-derived MSCs exhibited a spindle-shaped appearance.The FACS results showed that the spleen-derived MSCs highly expressed CD29, CD44, CD105 and Sca-1, but weakly expressed CD11b, CD34, CD45 and Ia. In addition, the spleen-derived MSCs steadily differentiated into osteoblasts and adipocytes in the induction medium.Conclusions A method of primary culture of murine spleen-derived MSCs by explant culture is successfully established.The harvested MSCs exhibit high purity and cell proliferation ability, and provide a reliable cell model for related researches.

Objective:To investigate the influencing factors of goiter in school-age children aged 8 to 10 in non-high iodine areas of Shijiazhuang City.Methods:In April 2018, 9 non-high iodine counties (cities) were selected as monitoring sites in Shijiazhuang City, and capacity proportional probability sampling (PPS) method was used. Each monitoring site was divided into five sampling areas according to five orientations: east, west, south, north, and middle, one township was selected from each area, one elementary school was selected from each township, and 40 school-age children aged 8 to 10 (balanced age, half males and half females) were selected from each school as respondents. Urine samples from any one time of children and drinking water samples from their village were collected, and urinary iodine and water iodine were detected by arsenic cerium catalytic spectrophotometry; the thyroid volume of children was measured by B ultrasound method; at the same time, the height and weight of children were measured and the body mass index was calculated. The influencing factors of goiter were analyzed by logistic regression analysis.Results:A total of 1 867 urine samples of school-age children were collected, and the median urinary iodine was 190.65 μg/L, which was in the suitable level of iodine. A total of 1 046 drinking water samples were collected, water iodine ranged from 0.11 to 87.91 μg/L, and the median water iodine was 3.01 μg/L. A total of 1 867 school-age children were tested thyroid, the median thyroid volume was 3.01 ml. The medians thyroid volume of boys and girls (928 and 939 cases) were 2.90 and 3.13 ml, respectively, the difference was statistically significant between sex ( U = 2.09, P < 0.05); the medians thyroid volume of children aged 8, 9, and 10 years old (622, 629, 616 cases) were 2.47, 2.87, and 3.13 ml, respectively, the differences were statistically significant among ages ( H = 203.96, P < 0.01); the medians thyroid volume of normal, overweight and obese children (1 231, 300, 336 cases) were 2.61, 3.05 and 3.16 ml, respectively, the differences were statistically significant among body mass index ( H = 65.55, P < 0.01). The results of multifactorial logistic regression analysis showed that female and obesity were risk factors of goiter in school-age children [odds ratio ( OR) = 2.08, 2.86, 95% confidence interval ( CI): 1.05 - 4.12, 1.39 - 5.88, P < 0.05]. Conclusion:Female and obesity are risk factors of goiter in school-age children aged 8 to 10 in non-high iodine areas of Shijiazhuang City.

Objective To explore the clinical significance of colonoscopy follow-up in Chinese Lynch syndrome mismatch repair (MMR) gene mutation carriers.Methods The results of colonoscopy follow-up was analyzed in 194 MMR gene mutation carriers of 50 Lynch syndrome families.The follow-up period was from April 2001 to November 2016.The detection rates of advanced adenomas and colorectal cancers,five-year survival rate and ten year survival rate were compared between 123 patients of regular follow-up group (colonoscopy interval less than two years) and 71 patients of irregular follow-up group (time colonoscopy interval more than two years).T test,chi-square test and Kaplan-Meier method were performed for statistically analysis.Results The incidence of colorectal cancer of irregular follow up group was significantly higher than that of regular follow-up group (57.7％,41/71 vs 22.8％,28/123);and the difference was statistically significant (x2 =24.00,P＜0.01).The average age at diagnosis for colorectal cancer in irregular follow up group was younger than that of regular follow up group ((45.3 ± 1.9) years vs (48.7±1.8) years);and the difference was statistically significant (t=4.10,P＜0.01).In regular follow-up group,28.6％ (8/28) advanced-stage colorectal cancer (TNM Ⅲ or Ⅳ) was found,while in irregular follow up group,73.2 ％ (30/41) advanced-stage colorectal cancer was found,and there was statistically significant difference in pathological stage between two groups (x2 =4.90,P =0.032).The five year and ten-year survival rates of regular follow-up group were 96.2 ％ and 85.1 ％,respectively,which were both higher than those of irregular follow-up group (46.3 ％ and 28.7 ％);and the differences were statistically significant (x2 =13.20 and 14.80,both P＜0.05).The incidence of advanced adenomas of irregular follow up group was significantly higher than that of regular follow-up group (49.3％,35/71 vs 18.7％,23/123);and the difference was statistically significant (x2 =20.10,P＜0.05).The detection rate of advanced adenomas of MMR gene mutation carriers was higher than those without MMR mutation gene (85.4％,35/41 vs 14.6％,6/41);and the difference was statistically significant (x2 =5.20,P＜ 0.05).Conclusion Regular colonoscopy surveillance may decrease the incidence and mortality of colorectal cancer in MMR mutation carriers of Lynch syndrome families,and increase five-year and tenyear survival rates.

Objective:To evaluate the effects of ultrasound-guided quadratus lumborum block (QLB) on acute pain after total hip arthroplasty.Methods:A retrospective study was conducted of the 36 patients with hip osteoarthritis who had undergone selective one-side total hip arthroplasty under total intravenous anesthesia (TIVA) from January 2019 to January 2020. According to whether additional QLB was used or not they were divided into 2 equal groups ( n=18). The control group of 10 males and 8 females with an age of 60.5±9.4 years used mere TIVA while the QLB group of 7 males and 11 females with an age of 53.6±12.7 years used TIVA plus QLB. All patients accepted patient-controlled intravenous analgesia (PCIA) postoperatively. The 2 groups were compared in terms of visual analogue scale (VAS) at rest and during exercise and IL-6 level at 24 h postoperation, consumption of opioids and postoperative incidence of nausea and vomiting. Results:There were no significant differences between the 2 groups in their preoperative general data, indicating they were compatible ( P>0.05). The VAS scores at rest and during exercise in the QLB group (0.3 ± 0.5 and 0.8 ± 0.6) were significantly lower than in the control group (2.1 ± 0.7 and 2.7 ± 0.5), the IL-6 level in the former[40.9 (30.5, 56.3) pg/mL] was significantly lower than in the latter[165.0 (82.5, 276.5) pg/mL], the intraoperative total consumptions of sufentanil[6 (6, 7) μg] and remifentanil[1,370 (1,200, 1,485) μg] in the former were significantly lower than in the latter[35 (30, 40) μg and 1, 910 (1, 805, 2, 000) μg], and the postoperative incidenceof nausea and vomiting[27.8%(5/18)] in the former was significantly lower than in the latter[77.8%(14/18)] (all P<0.05). Conclusions:Ultrasound-guided quadratus lumborum block can effectively relieve acute pain in patients after total hip arthroplasty. It can suppress stress-related inflammatory factors, reduce consumption of opioids and incidence of postoperative nausea and vomiting.