Objective To evaluate the accuracy of dual-source CT (DSCT) in diagnosing the degree of coronary artery stenosis,and compare it with coronary artery angiography (CAG).Methods One hundred patients with suspected coronary heart disease,clinical diagnosis of angina pectoris,myocardial infarction and patients after percutaneous coronary intervention,were given DSCT and CAG examination.The CAG results were considered as the reference standard,and the results of the two examinations were compared.The sensitivity,specificity,positive predictive value and negative predictive value of DSCT in diagnosing coronary artery stenosis (mild ＜ 50％,middle 50％-75％,severe ≥75％) were computed.Results CAG displayed coronary artery 1320 segments,DSCT displayed coronary artery 1287 segments,the appreciable rate was 97.5％.The sensitivity of DSCT in diagnosing mild,middle and severe coronary artery stenosis were 64.4％ (105/163),88.7％ (235/265) and 97.4％ (187/192),specificity all were 99.7％ (617/619),positive predictive value were 98.1％ (105/107),99.2％ (235/237) and 98.9％ (187/189),negative predictive valne were 91.4％ (617/675),95.4％ (617/647) and 99.2％ (617/622).There was significant correlation between DSCT and CAG in diagnosing coronary artery stenosis by Spearman test (P＜ 0.01).Conclusions The results of DSCT have high accordance with CAG in diagnosing coronary artery stenosis.It is a kind of non-invasive examination with low cost,and could reduce the pain of invasive examination.So DSCT is a good choice in diagnosing coronary artery disease.

Objective To investigate the therapy efficiency and complication prevention in patients undergoing radiofrequency current catheter ablation combined with multiple X-ray projecting angles.Methods Two hundred and six atrioventricular nodal reentrant tachycardia (AVNRT) patients were involved in this study. The distance between the tip of His and the ostium of coronary sinus were measured under different X-ray projecting angles respectively, including posterior anterior (PA), right anterior oblique 30° (RAO 30° ) and left anterior oblique 45° (LAO 45° ) in each patient, and mapping was proceeding under the corresponding X-ray projecting angles with the longest distance. The distance between ablating catheter and His was confirmed again before powering by the other two X-ray projecting angles. Results The longest distance between the tip of His and the ostium of coronary sinus were obtained in 66,75 and 65 patients under PA,RAO 30° and LAO 45° respectively(P＞ 0.05 ),and the data were (2.94 ± 0.87), (2.98 ± 0.76)and (2.91 ± 0.52) cm(P＞ 0.05). Transient first or second degree of atrioventricular blocking was observed in 4 cases among 22 high risk patients in which the powering sites were above the medium level of the distance between the tip of His and the ostium of coronary sinus under three kinds of X-ray projecting angles obviously.However,only 1 case was observed in other 184 patients(P＜ 0.01 ). All patients were cured successfully and no permanent atrioventricular blocking occurred. Conclusion Radiofrequency current catheter ablation combined with multiple X-ray projecting angles is helpful to increasing the successful rate and preventing complication in ablating therapy.

Objective To evaluate the applicable value of two - dimensional speckle tracking imaging on assessing the local function and coronary collateral circulation of acute myocardial ischemia in dogs.Methods Open-chest model to induce acute myocardial ischemia in 10 dogs was established by ligating their anterior descending coronary artery(LAD). Two-dimensional dynamic gray- scale images of two standard left ventricular short axis views at the levels of mitral annulus and papillary muscle were acquired for the off -line comparative analysis before the operation and 0, 30, 60, 120, 240 and 360 minutes after the operation respectively. Peak systolic circumferential strain(CS), peak systolic radial strain(RS) and left ventricular fraction shortenting(LVFS) of 12 segments at the levels of mitral annulus and papillary muscle were analyzed with QLAB software. After the lab experiment,the fresh hearts of dogs were dyed by TTC.Results ①Compared with the preoperative value , the peak systolic CS and RS of ischemia myocardial regions(anteroseptum,anterior and lateral) in left ventricular short-axis decreased significantly( P ＜0. 05)during 30 to 60 minutes after ligating LAD. Sixty minutes later, the peak systolic CS and RS had a tendency to return to the level before the operation,although the statistical difference was existing. The peak systolic RS and CS also decreased in certain nonischemic regions (inferolateral and inferior). But CS and RS in inferoseptal regions didn't alter significantly. ②Compared with the preoperative value,LVFS in the ischemia regions were significantly decreased( P ＜0.05), while nonischemic regions had no significant difference. ③The results of TTC dyeing showed that the infarcted regions in left ventricular short-axis were anteroseptum, anterior and lateral with blood supplied by LAD, which were consistent with the results of RS and CS. Conclusions RS and CS,as the parameters of myocardial strain may reflect the range and extent of acute myocardial ischemia,and the strain changes of local myocardial segments after the construction of coronary collateral circulatory.

Objective To compare the clinical outcomes of segmental pulmonary veins isolation (SPVI) and circumferential pulmonary veins ablation (CPVA) for patients with paroxysmal atrial fibrillation. Methods Sixty-eight patients with paroxysmal atrial fibrillation from January 2004 to April 2008 were divided into SPVI group (30 cases) and CPVA group (38 cases).The mean procedure time,the mean fluoroscopy time and relapse rate were compared. Results The mean procedure time in CPVA and SPVI group had no significant difference [(171.0 ± 25.8) min vs (168.2 ± 21.7) min, P = 0.579], but the mean fluoroscopy time in CPVA group [(38.5 ± 8.4) min]was less than that in SPVI group [(45.8 ± 16.1) min (P= 0.019). Mean term of the follow up was (17.1 ± 7.8) months. Relapse rate in CPVA group was less than that in SPVI group (5.3% vs 23.3%, P= 0.029). Both groups had no severe complications. Conclusion In patients with paroxysmal atrial fibrillation, CPVA strategy provides a more favourable clinical outcomes and less fluoroscopy time.

Objective To investigate clinical effect of sEMG-BFB training combined with swallowing training for dysphagic patients with cerebral infarction,to provide a reference for life quality improvement of dysphagic patients.Methods 48 patients with cerebral infarction combined swallowing disorder were selected.According to the digital table,patients were divided into the control group and observation group,24 cases in each group.Patients in the control group were given training such as routine training and behavioral swallowing training,while patients in the observation group were given sEMG-BFB training based on training of the control group.FOIS score,Kubota's water drinking test grade,SSA score and SWAL-QOL score were compared between two groups.Results After treatment,FOIS score,SSA score and SWAL-QOL score of the observation group were (3.82 ± 1.04),(19.97 ± 8.17),(158.23 ± 10.27),which were significantly higher than those of the control group [(2.82 ± 1.21),(24.21 ± 6.31),(139.23±7.32),t =4.394,4.115,5.642,all P ＜ 0.05] ; Kubota's water drinking test grade of the observation group was better than the control group,the difference was statistically significant (U =283.43,P ＜ 0.05).Conclusion sEMG-BFB training combined with swallowing training is helpful for dysphagic patients with cerebral infarction to improve swallowing ability and life quality.

ObjectiveTo retrospectively analyse the data of patients with suspected primary aldosteronism (PA) during the last five years.The receiver operating characteristic (ROC) curve was used to evaluate the value of aldosterone to renin ratio (ARR) in screening primary aldosteronism.MethodsThe clinical data of ARR in supine and upright positions were collected in 590 patients with suspected during January 2006 to August 2010.There were 357 patients diagnosed as primary aldosteronism and 233 patients as essential hypertension among these patients.100 patients with suspected primary aldosteronism took the upright and random ARR during September 2010 to April 2011 ; Among these patients,29 patients were diagnosed as primary aldosteronism and 71 as cases of essential hypertension.ROC curve was made to retrospectively define the method and the cut-off value of the supine,upright or random ARR.ResultsThe area under the curve(AUC) of the supine ARR in the 590 patients who took the supine and upright ARR during January 2006 to August 2010 was 0.838 (0.805-0.867 ) and the AUC of the upright ARR was 0.873 (0.843-0.899 ).There was significant difference between these two AUC readings (P＜0.01 ).The AUC in the upright ARR of the 100 patients who took the upright and random ARR during Septeuder 2010 to April 2011 was 0.962 (0.928 -0.995 ) and the AUC of the random ARR was 0.944 (0.893-0.994 ).There was no significant difference between these two AUC readings (P＞0.05).The upright ARR cutoff value with 400 ( pg · ml-1 )/( ng· ml-1 · h 1 ) yielded a sensitivity of 91.9％ and a specificity of 64.2％ to diagnosis of PA.ConclusionUpright ARR value was more suitable in the screening test than supine ARR value.Random ARR showed similar effect as the upright ARR.In our research,under strict control of the drug,position and detection time,ARR value with 400 ( pg · ml-1 )/( ng· ml-1 · h-1 ) can be the cutoff point in screening the suspcctcd PA patients.

Objective To investigate CT findings of concealed rupture of intestine following abdominal trauma.Methods CT findings of 11 cases with concealed rupture of intestine following abdominal trauma proved by surgery were identified retrospectively.Results The main special signs included:(1)Free air in 4 cases,mainly around injured small bowel or under the diaphragnl,or in the retroperhoneal space or and in the lump.(2)High density hematoma between the intestines or in the bowel wall(4 cases).(3)Bowel wall injury sign,demonstrated as low density of the injured intestinal wall,anenuated locally but relatively enhanced in neiighbor wall on enhanced CT.(4)Lump around the injured bowel wall with obvious ring.shaped enhancement(4 cases).Other signs included:(1)Free fluid in the abdominal cavity or between the intestines with blurred borders.(2)Bowel obstruction.Conclusion CT is valuable in diagnosing concealed rupture of intestine following abdominal trauma.

Objective To investigate the effects of different dosages of bone marrow mesenchymal stromal cells (BMSC) on lung fibrosis. Methods BMSCs with red fluorescence protein (RFP) from male FVB mice were cultured in vitro. Twenty-four female wild type FVB mice were randomly divided into four groups: normal group, model group, BMSC 1 group and BMSC 2 group (n = 6). Mouse pulmonary fibrosis models were induced by bleomycin via single intratracheal perfusion. Twenty-four h after model establishment, mice in BMSC 1 group and BMSC 2 group were injected with 1 × 10~6 BMSCs and 2 × 10~6 BMSCs, respectively through vena caudalis for each mouse. All the animals were sacrificed 21 d after model estalishment, and mouse lung tissue samples were obtained. The pathological changes were observed by light microscopy, the hydroxyproline ( Hyp) contents were measured by alkaline hydrolysis assay, the distribution of RFP( + ) BMSCs and quantitation of RFP were analysed by laser scanning confocal microscopy and immunohistochemistry, the expression of surfactant protein A (SP-A) was detected by immunohistochemistry, and the expression of transforming growth factor-β (TGF-β) and platelet-derived growth factor (PDGF) mRNA was detected by Real-time PCR. Results Compared with model group, the pulmonary fibrosis in BMSC 1 group was significantly alleviated, and that of BMSC 2 group became much more severe.A large number of RFP( +) BMSCs were found in fibrosis area of BMSC 2 group,which exhibited morphology similar to fibroblasts. As far as the expression of SP-A was concerned, normal group was higher than BMSC 1 group, BMSC 1 group was higher than BMSC 2 group and model group (P < 0. 05), while there was no significant difference between BMSC 2 group and model group (P >0. 05). Normal group, BMSC I group, model group and BMSC 2 group fell in the increase order by Hyp contents (P <0.01, P <0.05), and BMSC 2 group, BMSC 1 group, model group and normal group fell in the decrease order by expression of TCF-|$ and PDGF mRNA (P < 0.05). Conclusion Proper dose of BMSC has a favourable effect on bleomycin-induced lung fibrosis, while excessive dose of BMSC can aggravate the fibrosis.

Hypertension is the most common chronic non-communicable disease in the world and the most important risk factor for cardiovascular and cerebrovascular diseases. At present, the control rate of hypertension treatment standard is less than 50%, and it is still not effectively managed to a large extent. Despite numerous clinical studies and trials over the past four decades, the progress of new antihypertensive drugs has not been satisfactory. This review discusses recent advances in pharmacological and non-pharmacological treatments for patients with hypertension, and may provide new options for clinical hypertension treatment in the future.

To investigate the distribution of variant genotypes of Fc gamma receptor IIIa (Fc gamma R IIIa) in healthy Chinese population of Zhengzhou city, genomic DNA was extracted from peripheral blood of healthy donators. The genotypes of Fc gamma R IIIa-158 were determined by nested polymerase chain reaction (PCR) in 137 healthy people in Zhengzhou city. The results showed that frequencies of variant genotypes FF, VV and VF were 42.3%, 48.9% and 8.8% respectively. The distribution of Fc gamma R IIIa-158 in healthy Chinese population of Zhengzhou city was polymorphic and different from that of African Americans (AA) and Caucasian Americans (CA).
Asian Continental Ancestry Group ; European Continental Ancestry Group ; Genotype ; Polymerase Chain Reaction ; *Polymorphism, Genetic ; Receptors, IgG/*genetics ; Variation (Genetics)