Two-dimensional speckle tracking imaging(2D-STI)can accurately evaluate myocardial strain with non-angle dependent and good reproducibility. In this study, 16 patients with hypertrophic cardiomyopathy (HCM), 18 athletes and 20 normal subjects underwent 2D-STI examination. The global longitudinal strain (GLS) and regional peak systolic strain (PSS) were assessed by 2D-STI in the apical four-chamber-view. Compared to athletes and normal subjects, GLS in patients with HCM was significantly reduced [GLS: -(8. 0±3.6)% , P ＜ 0. 01]. There was no significant difference in GLS between athletes and the controls, but GLS in basal or middle segments of interventricular septum and middle segments of lateral wall; PSS in basal, middle or apical segments of interventricular septum and basal or middle segments of lateral wall of the normal controls were significantly higher than those of the athletes. A cut-off value of less than -10% in GLS for diagnosis of pathologic hypertrophy resulted in a sensitivity of 84. 0% and a specificity of 94. 0%. The results suggest that 2D-STI can quantify global and regional myocardial function and may be used for the differentiation between physiological and pathologic LVH.

Objective To evaluate the effect of torsion on remodeling and function of left ventricle by two-dimensional speckle tracking imaging(2D-STI) in patients with dilated cardiomyopathy(DCM).MethodsThirty-nine patients with DCM and thirty-five controls accepted conventional echocardiography,pulsed-wave Doppler tissue imaging examination.Basal and apical short-axis view of left ventricle were accorded for Q-lab analysis.Indices included:left ventricular diameter in end diastole (LVEDd),left ventricular ejection fraction (LVEF),left ventricular sphericity index (LVSI),left ventricular mass index (LVMI),e-wave of mitral valvular flow (E),velocity of mitral annulus in systole (S),velocity of mitral annulus in early distole ( E'), E/ E',rotation of left ventricle at basal and apical level(Rbasal,Rapical),twist (T),torsion (T').Results Compared with controls,LVEDd,LVMI of patients with DCM increased significantly,LVEF and LVSI decreased significantly,S and E' decreased significantly,E/ E' increased significantly.Patients with DCM were divided into two groups:group DCM-1 (clockwise rotation at apical level) and group DCM-2 (countclockwise rotation at apical level).Compared with controls,Rasal,Rapical,T,T' of two DCM groups decreased significantly.Compared with group DCM-1,Rbasal,Rapical,T,T' of group DCM-2 decreased significantly,LVEDd,LVMI increased significantly,LVEF and LVSI decreased significantly,E' decreased significantly,E/ E' increased significantly.Conclusions The torsion of left ventricle decrease in patients with DCM,DCM patients with decreased or reversed torsion of left ventricular apex have more severe LV remodeling or damage of LV function.

f strain rate in left atrial wall, which is prior to the remodeling geometry of left ventrieular, could be detcted by STI more sensitively than by SRI.

Objective To evaluate the changes of the left atrial function in patients with old myocardial infarction(OMI) by strain rate imaging(SRI). Methods The velocity of the left atrial lateral wall and atrial septum was measured by SRI in 30 patients with OMI(OMI group) and 25 normal subjects (control group). Left atrium passive eject volume index(LAPEVl) and left atium active eject volume index (LAAEVI) were measured using Simpson method. Results ①Compared with the control group, the velocity of the left atrium was reduced obviously in ventricular systole and early ventricular diastole in OMI group(P<0.05) ,but was increased in late ventricular diastole(P<0.05). ②Compared with the controls, LAAEVI was increased significantly in OMI group, but LAPEVI was decreased signicantly(P <0.001). Conclusions SRI could be used to evaluate the left atrial function accurately in patiens with OMI.

Objective To investigate the clinical practice pressure and mental health of medical students with type D personality.Methods Type D Scale-14 (DS14) and Beck-Srivastava Stress Inventory (BSSI) test were applied to 371 medical students to assess the personality types and pressure.The symptom checklist 90 (SCL-90) was used to evaluate the psychological health.Results ①The detection rate of type D personality of medical students was 36.39％.②The average score in BSSI of medical students of type D personality was (99.27± 10.51),which was higher than medical students of non-type D personality (87.60± 11.37),and the difference was statistically significant (t=9.9711,P=0.0000).The medical students' score of type D personality in SCL-90 of 9 factors were all higher than medical students of non-type D personality,but the statistically significant difference were only in the score of depression,anxiety and psychosis-like symptoms (t=2.4409,P=0.0151;t=2.8662,P=0.0044;t=2.7783,P=0.0057).Conclusion In face of the same pressure of medical clinical practice,the medical students of type D personality are more likely to have a heavier psychological burden,and the college should pay special attention to the problem and try to intervene the problem,so as to reduce the pressure caused by a variety of psychological problems.

AIM: To study the effect of selectin on lung injury in rabbits with diabetic ketoacidosis(DKA). METHODS: 12 male New Zealand rabbits were divided into experimental group (DK groups, intravenous injection of streptozocin and alloxan monohydroate, n =6) and normal control group (received same dose of saline, n =6). After 72 hours, all the animals were killed and blood and lung tissue were collected. Blood gases, expressions of selectin-P and selectin-L were detected. RESULTS: The expression of selectin in DK group were higher than that in NS group. CONCLUSION: These results indicate that selectin expression may play an important role in lung injury during diabetic ketoacidosis.

Objective To evaluate the feasibility of beside color Doppler ultrasound-guided popliteal vein catheter in treatment of lower extremity deep venous thrombosis (LEDVT).Methods Data of 50 patients with unilateral LEDVT were reviewed,including 25 cases underwent beside color Doppler ultrasound-guided catheter thrombolytic therapy (catheter thrombolytic group) and 25 cases underwent systemic thrombolysis and anticoagulant therapy (anticoagulant thrombolysis group).The cure rate,hospitalization time and the bilateral diameter differences were compared between the 2 groups.Results Thrombolytic effective rate was 100％ in both the 2 groups.Thirty patients were clinical cured,including 22 cases in catheter thrombolytic group and 8 cases in anticoagulant thrombolysis group.The cure rates were significantly different between the 2 groups (88.00％ [22/25] vs 32.00％ [8/25],x2 =16.333,P＜ 0.001).The hospitalization time of catheter thrombolytic group ([12.32 ± 1.49] days) was shorter than that of anticoagulant thrombolysis group ([16.44±2.95]days;t=-6.426,P＜0.001).The diameter differences between LEDVT side and contralateral side of the upper and lower 15 cm form knees in catheter thrombolytic group showed no statistical difference compared with anticoagulant thrombolysis group before the treatment (both P＞0.05),while of catheter thrombolytic group were smaller than those of anticoagulant thrombolysis group after the treatment (both P＜0.05).And the bilateral diameter differences before the treatment were larger than those after the treatment in both groups (all P ＜ 0.05).Conclusion Both of beside color Doppler ultrasound-guided catheter thrombolytic therapy and systemic thrombolysis and anticoagulant therapy can be used to treat LEDVT,while the efficacy of ultrasound-guided catheter thrombolytic therapy is better.

Objective:To understand the quality of life of high risk population of stroke in community and analyze the influencing factors.Methods:Four community health service centers in Huangpu District were randomly selected, and the subjects were included by using convenient sampling method among the high risk groups of stroke found in the community stroke screening and prevention and control project in Shanghai.The World Health Organization quality of life scale-brief form questionnaire(WHOQOL-BREF), self-rating depression scale (SDS) and self-rating anxiety scale (SAS) were used as the survey tools to study 1200 high-risk stroke subjects.Single sample t-test was used to compare the differences between the scores and the data of 24 centers in the world, and multiple linear stepwise regression were used to analyze the influencing factors. Results:The scores of physical field, psychological field and social relationship field ((13.60±1.86), (14.58±1.97), (13.72±2.10)respectively) of high-risk population of stroke were lower than the scores of general population of 24 centers in the world ( P<0.01), and the scores of environmental field (14.08±1.95) were higher than it ( P<0.01), of which the differences were all statistically significant.The results of multiple linear stepwise regression analysis showed that old age, anxiety and depression were the risk factors influencing the scores of physical field( β=-0.027, -0.056, -0.051), psychological field( β=-0.019, -0.055, -0.050) and environmental field( β=-0.017, -0.040, -0.054); old age and depression were the risk factors influencing the scores of social relationship field( β=-0.026, -0.067); anxiety and depression were the risk factors influencing the self-assessment of quality of life and health ( β=-0.012, -0.014 for quality of life; -0.012, -0.014 for health, all P<0.01). Conclusion:The quality of life of high-risk population of stroke may be related to age, depression, anxiety and other psychological factors.The prevention and treatment of stroke should take both physical and mental measures, take timely intervention for poor psychological status, and gradually improve the quality of life.

Objective:To explore the potential mechanism and feasibility of sonic hedgehog (SHH) signal pathway inhibitor NVP-LDE225 combined with radiotherapy in the treatment of melanoma.Methods:The Gli1 mRNA expression of the melanoma cells (Melan-A and SK-MEL-2) was detected by qPCR. After treatment with NVP-LDE225, GDC-0449 or combined with radiation for 24 hours, the number and activity of Melan-A and SK-MEL-2 were detected by cell counting and CCK-8 kit. The survival and proliferation ratio of Melan-A and SK-MEL-2 were detected by cell cloning. The changes of cell cycle of melanoma Melan-A cells were determined by flow cytometry. The levels of the Bax and Caspase3 of Melan-A apoptosis protein in melanoma cells were detected by Western blot.Results:NVP-LDE225, an inhibitor of Smo, decreased the mRNA expression of Gli1 in the melanoma cells in a dose-dependent manner, inhibited the proliferation ratio of the melanoma cells, induced apoptosis, and arrested melanoma cells in G 0 / G 1 phase. Gamma ray irradiation after NVP-LDE225 treatment further inhibited the SHH signal pathway, arrested the melanoma cells in G 2 / M phase, and further increased the inhibitory effect on melanoma cell proliferation. Conclusions:NVP-LDE225, an inhibitor of Smo, can inhibit SHH signal pathway in melanocytes, suppress cell proliferation, and further increases the effect of inhibiting cell proliferation after combining with irradiation. It can be used as a potential drug in combination with radiotherapy in the treatment of melanoma, which is worthy of further study.