To assess right ventricular free wall longitudinal myocardium deformation and examine the changes with normal age by speckle tracking imaging (STI), myocardial systolic peak strain (epsilon), systolic peak strain rate (SRs), early diastolic peak strain rate (SRe), late diastolic peak strain rate (SRa), the ratio of SRe/SRa were measured in the basal, middle and apical segments of right ventricular free wall in 75 healthy volunteers (age range: 21-71 y) by STI from the apical 4-chamber view. RV longitudinal strain and strain rate were highest in the basal segment of the free wall. Older subjects had lower early diastolic strain rate (SRe) than younger subjects, but they had higher late diastolic strain rate (SRa). A negative correlation between age and the ratio of SRe/SRa was found in all RV free wall segments (r=-0.466 - -0.614, P<0.01). It is concluded that RV diastolic strain rate changes with age and STI can be used for the study of RV myocardial deformation.
Age Factors ; Diagnostic Imaging/*methods ; Echocardiography/methods ; Heart/physiology ; Models, Statistical ; Myocardial Contraction ; Myocardium/*pathology ; Reproducibility of Results ; Stress, Mechanical ; Ventricular Dysfunction, Right ; Ventricular Function, Right

Objective To investigate the effect of right ventricular(RV)volume and RV pressure overload on left ventricular(LV)rotation and twist in patients with atrial septal defecl(ASD).Methods Using speckle tracking imaging(STI),the peak rotation of 6 segments in basal and apical short-axises was measured respectively in 35 patients with ASD(18 of which with pulmonary hypertension)and 21 healthy subjects as controls.The average peak rotation and duration time of the 6 segments in basal and apical short-axises in negative direction during early systolic phase were also measured respectively.LV twist versus time profile was drawn and the peak twist and time to peak twist were calculated.LV ejection fraction(EF)was measured by biplane Simpson method.Results Compared to ASD patients without pulmonary hypertension and healthy subjects,the peak rotation of posterior wall,inferior wall and postsept wall in basal was lower(P＜0.05).And at the basal level,the averagepeak rotation of 6 segments in negative direction during early systolic phase was higher(P＜0.05),and the average duration time was delayed(P＜0.05).LV peak twist was also lower(P＜0.05),and had a significant negative correlation with pulmonary arterial systolic pressure(r=-0.57,P=0.001).There were no significant differences in LVEF among 3 groups.Conclusions Although RV volume overload due to ASD has no significant effects on LV rotation and twist,LV peak twist is lower in ASD patients with pulmonary hypertension.Thus LV twist may be a new index which predicting whether ASD patients also has pulmonary hypertension or not.

Objective To access the left ventricular sysytolic function in children at acute stage of Kawasaki disease using speckle-tracing imaging. Methods Two-dimensional echocardiograghic images of 27 patients and 19 normals were collected in apical long-axis view, two-champer view, four-champer view, short-axis views at the levels of mitral annulus, papillary muscle and apex. The systolic peak values of longitudinal strain, radial strain and circumferential strain were measured by speckle-tracking imaging. Results Compared with controls the values of longitudinal strain and radial strain are lower in most segments in patients(P < 0.05). There were no significant differences between the patients and controls in circumferential strain(P>0.05). Longitudinal strain and radial strain measured were lower in 8 patients with coronary ectasia(including 7 cass with coronary artery aneurysms in vessels) than other 19 patients,but the two groups have no significant differences(P>0.05). Conclusions Long-axis and short-axis function of the heart decreased regardless of coronary artery ectasia.

OBJECTIVE: To explore the safety, effectiveness and feasibility of 3D laparoscopy in thyroidectomy via modified chest and mammary areola approach comparing with 2D. METHOD: Twenty six cases received 3D laparoscopic thyroidectomy (3D group) and 34 cases experienced 2D (2D group). We compared the indexes about general status, operation time, operative blood loss, duration and overall volume of postoperative drainage, complications, etc between two groups. RESULT: Eight cases of thyroid cancer were detected in 3D group and 3 cases in 2D group. While there was no statistical difference between two groups with respect to other observation indexes such as other general status, operation time, operative blood loss, duration and overall volume of postoperative drainage, complications, etc. CONCLUSION 3D laparoscopic thyroidectomy via modified chest and mammary areola approach is a safe, effective and feasible procedure, and it may substitute the place of 2D in the future.
Blood Loss, Surgical ; Breast ; surgery ; Drainage ; Humans ; Laparoscopy ; methods ; Postoperative Period ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; methods ; Treatment Outcome

OBJECTIVE: To explore the safety and feasibility of endoscopic thyroidectomies through modified chest and mammary areola approach. METHOD: We retrospectively analyzed 122 cases of endoscopic thyroidectomies through a modified chest and mammary areola approach without extensive dissection of thoracic flap. The information about general status, surgical procedures and techniques, complications, etc. were summarized and discussed. RESULT: One hundred and twenty-one cases were operated successfully while 1 case was converted to video-assisted thyroidectomy through infraclavicular approach. The maximum diameter of the mass was (2.05 ± 1.06) cm, mean operation time was (88.61 ± 27.87) min, the operative blood loss was (31.23 ± 16.14) ml, duration of postoperative drainage was (3.54 ± 0.88) d and overall drainage volume was (139.09 ± 95.93) ml. Parathyroid glands were detected in specimens of 9 cases while no case of permanent postoperative hypocalcaemia was displayed. 6 cases of hoarseness were developed. One case experienced conversion surgery, all the others obtained satisfactory cosmetic result. All cases were followed up for 0-24 months without relapse and metastasis of the disease. CONCLUSION Endoscopic thyroidectomy via a modified chest and breast areola approach can facilitated the procedure and avoid extensive dissection of thoracic flap, and proved to be safe and effective.
Blood Loss, Surgical ; Breast ; surgery ; Drainage ; Endoscopy ; Feasibility Studies ; Humans ; Postoperative Complications ; Retrospective Studies ; Surgical Flaps ; Thyroidectomy ; methods

Speckle tracking imaging (STI) was employed to investigate the effect of right ventricular (RV) volume and pressure overload on left ventricular (LV) rotation and twist in 35 patients with atrial septal defect (ASD), 18 of which with pulmonary hypertension, and 21 healthy subjects serving as controls. The peak rotations of 6 segments at the basal and apical short-axises and the average peak rotation and interval time of the 6 segments in the opposite direction during early systolic phase were measured respectively. LV twist versus time profile was drawn and the peak twist and time to peak twist were calculated. LV ejection fraction (EF) was measured by Biplane Simpson. Compared to ASD patients without pulmonary hypertension and healthy subjects, the peak rotations of posterior, inferior and postsept walls at the basal level were lower (P<0.05), and the average counterclockwise peak rotation of 6 segments at the basal level during early systolic phase was higher (P<0.05), and the average interval time was delayed (P<0.05). LV peak twist was also lower (P<0.05), and had a significant negative correlation with pulmonary arterial systolic pressure (r=-0.57, P=0.001). No significant differences were found in LVEF among the three groups. It was suggested that although RV volume overload due to ASD has no significant effects on LV rotation and twist, LV peak twist is lower in ASD patients with pulmonary hypertension. Thus LV twist may serve as a new indicator of the presence of pulmonary hypertension in ASD patients.
Cardiology/methods ; Echocardiography/methods ; Echocardiography, Doppler/methods ; Heart Septal Defects, Atrial/metabolism ; Heart Septal Defects, Atrial/*pathology ; Heart Ventricles/pathology ; Hypertension ; Nuclear Proteins/*metabolism ; Systole ; Twist Transcription Factor/*metabolism ; Ventricular Function, Left

OBJECTIVE:To investigate the effects of sufentanil combined with dexmedetomidine on ICU acquired weakness(ICU-AW)of AECOPD patients receiving mechanical ventilation. METHODS:A total of 120 AECOPD patients in ICU of our hospital during Oct. 2015-Oct. 2016 were divided into group A and B according to random number tablet,with 60 cases in each group. Group A was given analgesia and sedation of sufentanil combined with propofol;group B was given analgesia and sedation of sufentanil combined with dexmedetomidine. RAAS sedation score and British Medical Research Committee(MRC)score were compared between 2 groups before treatment and 7 d after treatment. The incidence of ICU-AW,delirium and tracheal extubation were observed. The staying time in ICU,total hospitalization time and the occurrence of ADR were compared between 2 groups after diagnosed as ICU-AW. RESULTS:After treatment,the scores of RASS sedation degree scale in 2 groups were decreased significantly compared to before treatment,with statistical significance (P<0.05);there was no statistical significance between 2 groups(P>0.05). MRC score of group A was decreased significantly compared to before treatment,and significantly lower than group B,with statistical significance(P<0.05). There was no statistical significance in MRC score of group B before and after treatment(P>0.05). After 7 d of treatment,the incidence of ICU-AW in group B was significantly lower than group A(40.00% vs. 56.67%);the incidence of tracheal extubation in group B was significantly higher than group A(70.00% vs. 53.33%),the incidence of delirium was significantly lower than group A(13.33% vs. 20.00%);the staying time in ICU and total hospitalization time in group B after diagnosed as ICU-AW were significantly shorter than group A,with statistical significance(P<0.05). There was no statistical significance in the total incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Compared with sufentanil combined with propofol, sufentanil combined with dexmedetomide shows similar analgesia and sedation effect,but has better influence on the muscle strength of the patient,reducing the incidence of ICU-AW and delirium,shortening the duration of mechanical ventilation,staying time in ICU and total hospitalization time in AECOPD patients receiving mechanical ventilation,with similar safety.

To assess right ventricular free wall longitudinal myocardium deformation and examine the changes with normal age by speckle tracking imaging (STI), myocardial systolic peak strain (ε), systolic peak strain rate (SRs), early diastolic peak strain rate (Sre), late diastolic peak strain rate (Sra), the ratio of Sre/Sra were measured in the basal, middle and apical segments of right ventricular free wall in 75 healthy volunteers (age range: 21-71 y) by STI from the apical 4-chamber view. RV longitudinal strain and strain rate were highest in the basal segment of the free wall. Older subjects had lower early diastolic strain rate (Sre) than younger subjects, but they had higher late diastolic strain rate (Sra). A negative correlation between age and the ratio of Sre/Sra was found in all RV free wall segments (r=-0.466 - -0.614, P<0.01). It is concluded that RV diastolic strain rate changes with age and STI can be used for the study of RV myocardial deformation.

OBJECTIVETo study the effect of microfilament cytoskeleton changes induced by simulated microgravity on the NO/NOS system of osteoblasts, and explore the mechanism of weightlessness leading to osteoporosis.

METHODSMouse osteoblast-like cell line MC3T3-E1 were divided into simulated microgravity (by rotating clinostat) group, 0.5 microg/ml cytochalasins B group, simulated microgravity+cytochalasins B group, and normal gravity group. After cell culture for 48 h with corresponding treatments, immunofluorescence staining of the cells by FITC-phallacidin was performed to observe the changes of microfilament under laser confocal microscope. NOS activity of the cells was tested with NOS detection kit, and the NO concentration in the cell supernatant was measured with nitrate reductase method.

RESULTSDepolymerization of the microfilament cytoskeleton with irregular arrangement and reduced tension fibers occurred in the cells except for those in the normal gravity group, which was especially obvious in the microgravity+cytochalasins B group. Compared with the normal gravity group, the cells in the other groups showed increased iNOS activity and NO concentration but decreased eNOS activity, especially obvious in simulated microgravity+ cytochalasins B group.

CONCLUSIONDisruption of the microfilament cytoskeleton induced by simulated microgravity can regulate the NO/NOS system to influence the signal transduction of the osteoblasts.

Animals ; Cell Line ; Cytoskeleton ; physiology ; Mice ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type II ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Osteoblasts ; cytology ; metabolism ; Signal Transduction ; Weightlessness ; Weightlessness Simulation

Speckle tracking imaging (STI) was employed to investigate the effect of right ventricular (RV) volume and pressure overload on left ventricular (LV) rotation and twist in 35 patients with atrial septal defect (ASD), 18 of which with pulmonary hypertension, and 21 healthy subjects serving as controls. The peak rotations of 6 segments at the basal and apical short-axises and the average peak rotation and interval time of the 6 segments in the opposite direction during early systolic phase were measured respectively. LV twist versus time profile was drawn and the peak twist and time to peak twist were calculated. LV ejection fraction (EF) was measured by Biplane Simpson. Compared to ASD patients without pulmonary hypertension and healthy subjects, the peak rotations of posterior, inferior and postsept walls at the basal level were lower (P<0.05), and the average counterclockwise peak rotation of 6 segments at the basal level during early systolic phase was higher (P<0.05), and the average interval time was delayed (P<0.05). LV peak twist was also lower (P<0.05), and had a significant negative correlation with pulmonary arterial systolic pressure (r=-0.57, P=0.001). No significant differences were found in LVEF among the three groups. It was suggested that although RV volume overload due to ASD has no significant effects on LV rotation and twist, LV peak twist is lower in ASD patients with pulmonary hypertension. Thus LV twist may serve as a new indicator of the presence of pulmonary hypertension in ASD patients.