Objective: To study the change of chemokine receptor CXCR2 in monocytes in postmenopausal women with coronary artery disease (CAD) after estrogen replacement therapy. Methods: Randomized placebo controlled trial was conducted in 22 post menopausal women with CAD and 20 normal menopausal women by giving 0.625 mg premarin daily or vitamin C treatment for 3 months. Serum estradiol (E 2) and chemokine receptor CXCR2 in peripheral blood monocytes were measured at 0 and 3 months of treatment. Results:(1) E 2 and CXCR2 levels in the CAD group was lower than that in the normal group ( P

Objective To investigate the effect of patient positioning on the Duplex ultrasound evaluation of great saphenous vein reflux elicited by the pneumatic cuff method. Methods FFifty great saphenous veins (GSV) with relfux (relfux group) and iffteen with no prior history of venous disease (healthy group) were examined by duplex scanning in the supine, 20 degrees reverse-trendelenburg (RT-20), 40 degrees reverse-trendelenburg (RT-40) and standing position. Each GSV was assessed for relfux at three venous sites:two centimeter below the sapheno-femoral junction (SFJ), the greater saphenous vein in the mid thigh (MGV) and the greater saphenous vein in the upper calf (CGV). Pneumatic cuff compression pressure of conifned 100 mmHg (1 mmHg=0.133 kPa) was used onto the calf to elicit relfux. The incidence of positive venous relfux was calculated. The statistical differences of the peak relfux velocity and duration of relfux in four positions were analyzed. Results TThe relfux elicited in the standing position was set as the gold standard. In healthy group, there was no false positive results of relfux in supine, RT-20 and RT-40 positions. In relfux group, false negative results were found at all venous sites when limbs were examined in supine position [false negative rate:59%(19/32), 22%(11/50), 24%(12/50)]. At RT-20 and RT-40 positions, the incidence of venous relfux reached 100% at MGV and CGV, and false negative cases were only detected at SFJ [false negative rate:12%(4/32), 12%(4/32)]. The relfux time in standing, supine, RT-20 and RT-40 positions were (7.75±3.23) s, (5.27±3.66) s, (8.67±3.72) s, (8.55±3.93) s respectively. There were signiifcant differences among different positions in reflux time (F=56.9, P<0.01). In detail, no significant differences were identified between standing position and RT-20 or RT-40 position (q=1.51, 1.33 respectively, both P > 0.05), except for supine position (q=4.11, P<0.01). Peak relfux velocity in standing, supine, RT-20 and RT-40 positions were (55.26±22.24) cm/s, (22.87±12.03) cm/s, (38.46±16.30) cm/s, (45.13±19.21) cm/s respectively. There were also signiifcant differences among different positions in peak relfux velocity (F=13.7, P<0.01). Comparing the supine, RT-20 and RT-40 positions with standing position, differences of the peak relfux velocity between them were all statistically signiifcant (q=12.71, 6.59, 3.98 respectively, all P<0.01). Conclusions When GSV reflux was examined by pneumatic cuff compression, false negative rate was higher in the supine position. RT-20 and RT-40 position were effective to detect GSV relfux, espically for GSV at mid-thigh and upper calf.

Objective To compare the efficacy and safety of two kinds of homemade sirolimus-eluting stents (Firebird and Excel) for treatment of acute ST segment elevation myocardial infarction (STEMI) in patients who underwent percutaneous coronary intervention (PCI). Methods The 249 consecutive patients with STEMI who underwent PCI were randomly divided into two groups: Excel group (n=136) and Firebird group (n=113). They were followed up for 6-24 months, and coronary angiography was reviewed average 12 months later. The primary endpoints were major adverse cardiac events, including death, reinfarction and target vessel revascularization. The second endpoints included late luminal loss and restenosis 12 months after treatment. Results There were no significant differences in baseline data, coronary arterial lesion before operation, and immediateness condition after PCI between the two groups (all P＞0.05). Within follow-up, there were 2 (1.47%) death cases and 1 (0.88%) death case, 1 (0.74%) and 1 (0.88%) nonfatal myocardial infarction case, 2 (1.47%) and 2 (1.77%) target vessel revascularization cases in the two groups respectively (all P＞0.05). There were no significant differences in late luminal loss of in-stent and in-segment, the rates of in-stent restenosis, in-segment restenosis and stent thrombosis, the in-stent minimal lumen diameter and in-segment minimal lumen diameter between the two groups (all P＞0.05). Conclusions The two kinds of homemade sirolimus-eluting stents may have similar efficacy and safety in patients with STEMI treated with primary PCI.

Objective To investigate the feasibility of low-dose CT perfusion imaging(CTPI)examination combined with iterative model reconstruction (IMR) in the brain.Methods 80 patients with clinical suspicion of acute cerebral infarction underwent the cerebral CTPI were enrolled in this study.30 normal hemispheres on group A [35 cases,80 kV,150 mAs, filtered back projection(FBP)] and group B(45 cases,80 kV,30 mAs, IMR) were selected to evaluate respectively.The pictures' subjective scores, effective radiation dose (ED),CT value,SD,signal to noise ratio(SNR), contrast to noise ratio(CNR) and the perfusion parameters of the grey matter (GM) and white matter(WM) in each hemisphere of the middle cerebral artery(MCA) territory were respectively compared at ASPECTS level 2 for the two groups.Results The ED were 2.52,0.50 mSv for group A,B.There were no statistical significances in the perfusion parameters,CT value, SD, CNR of the ROIs of the GM and WM,the SNR of the ROIs of the GM and the pictures' subjective scores between group A, B (P>0.05).There was statistical significance in the SNR of the ROIs of the WM between group A,B (P<0.05).Conclusion IMR combined with 30 mAs of the CTPI can reduce the radiation dose apparently while maintain the stability of the image quality and perfusion parameters.

Objective To investigate the feasibility of iterative model reconstruction (IMR) combined with low tube voltage and low iodine intaken of contrast media in head and neck CT angiography (CTA). Methods Eighty patients with clinical suspicion of head and neck vascular disease underwent head and neck CTA were enrolled in this prospective study. According to random number table, patients were randomly divided into two groups. Group A (n=40) was scanned according to the protocol of 120 kV, 50 ml iopromide (370 mg/ml) and filtered back projection (FBP) reconstruction, and group B (n=40) was scanned with 80 kV, 30 ml iohexol (300 mg/ml) and IMR, while the other parameters kept consistent. Mann-Whitney U test was used to compare the enhanced CT value of arteries, image noise, signal noise ratio (SNR), contrast noise ratio (CNR), the score of image quality, effective radiation dose (ED) and iodine intaken of contrast media between two groups. Results The CT value at the origin level of common carotid artery were (316.9 ± 53.0) and (433.4 ± 101.8)HU in group A and B, image noise were (28.1 ± 6.8)and (12.1 ± 2.6)HU ,SNR were (11.9 ± 3.2) and (37.7 ± 13.3) ,and CNR were (10.2 ± 2.9) and (32.6 ± 13.3), respectively. There were showed significant differences in CT value, image noise, SNR and CNR between two groups (Z=-5.490,-7.592,-7.698,-7.660, P<0.05). The CT value at the origin level of internal carotid artery were (359.5 ± 54.3) and (443.5 ± 120.1) HU in group A and B, image noise were (18.8±6.2) and (6.8±1.7) HU ,SNR were 21.5±8.7 and 69.7±27.4 ,and CNR were 18.0±7.3 and 62.7± 26.4, respectively. The significant differences were acquired in CT value, image noise, SNR and CNR between two groups (Z=-3.022,-7.376,-7.496,-7.515, P<0.05). The CT value at M1 segment level of middle cerebral artery were (321.1±47.3) and (401.6±104.0) HU in group A and B, image noise were (32.3± 17.2) and (11.2 ± 2.7) HU,SNR were 12.4 ± 5.6 and 39.3 ± 18.4,and CNR were 10.7 ± 4.7 and 36.4 ± 17.7, respectively. There also showed significant differences in CT value, image noise, SNR and CNR between two groups (Z=-3.527,-7.487,-7.482,-7.535, P<0.05). The score of image quality of group A and B were 3.9 ± 0.7 and 4.5±0.6, which also showed significant difference between two two groups (Z=-3.517, P<0.05). The ED were (2.78 ± 0.13) and (0.84 ± 0.04) mSv for group A and B, which also showed significant difference between the two groups (Z=-7.706, P<0.05). The iodine intaken of contrast media were 1.85 g and 0.90 g in group A and B. Conclusion IMR combined with low tube voltage and low iodine intaken of contrast media can not only decrease effective radiation dose and iodine intaken of contrast media significantly, but also improve the imaging quality in head and neck CTA examination.

Objective To evaluate the diagnostic value of ultrasound-guided pleural biopsy combined with thoracic biochemical detections in malignant and tuberculous pleural effusions. Methods Sixty-four patients with moderate or large pleural effusions and pleural thickening received the ultrasound-guided diagnostic pleural biopsy. All patients had chest CT enhancement scans to find out the suspicious pleural thickening preoperatively, facilitating the selection of puncture sites by ultrasound. Pleural tissue samples were sent for pathological examinations immediately. After successful achievements of pleural biopsy, ultrasound-guided aspiration or drainage was performed to alleviate symptoms, more importantly, to get pleural effusions for biochemical analysis. Biological results including carcinoembryonic antigen(CEA), CA125, CYFRA21 and lactate dehydrogenase(LDH) in malignant and tuberculous effusions were analyzed by group design t tests. The positive rates of CEA, CA125, CYFRA21, LDH in malignant and tuberculous effusions were compared by chi square tests. Results Pleural tissues in all cases were got by one pleural biopsy procedure. The strategy of pleural biopsy we used in this study had a successful rate reaching 100%(64/64), and 73% (46/64) patients had a definitive diagnosis as malignant or tuberculous effusion. Twenty-seven cases were diagnosed as malignant effusions and thirty-seven cases as tuberculous effusions based on the deifnitive clinical diagnosis. The positive rates of CEA, CA125, CYFRA21, LDH in malignant effusions were 100%(27/27), 100%(27/27), 100%(27/27), 89%(24/27) respectively, and 0%(0/37), 84%(31/37), 78%(29/37), 76%(28/37) respectively in tuberculous effusions. The positive rate of CEA between malignant and tuberculous effusions differed signiifcantly (χ2=64.0, P < 0.01), so did CA125 (χ2=3.1, P < 0.01) and CYFRA21(χ2=4.8, P<0.01). The average levels of CEA, CA125, CYFRA21, LDH in pleural effusion were (727.1±658.8)μg/L, (795.2±1249.6)×103 U/L, (296.2±320.7)μg/L, (1077.9±1058.5) U/L respectively, and (1.7±1.1)μg/L, (336.3±208.6)×103 U/L, (20.7±14.9)μg/L, (309.2±182.7) U/L in tuberculous effusions.There were signiifcant differences in CEA, CYFRA21 and LDH concentrations among malignant and tuberculous effusions (t=45.1, 27.4, 18.8 respectively, all P<0.01). Conclusion Ultrasound-guided pleural biopsy combined with CEA, CYFRA21 and LDH in pleural effusions had an important value in the etiological diagnosis of pleural effusions, while CA125 showed little value in the differential diagnosis.

Objective This study was to evaluate the usefulness of the model of end-stage liver disease (MELD) score in comparison with the Child-Pugh classification to predict postoperative mortality and short-term survival in liver transplant patients. MethodsMELD score and Child-Pugh score were computed for each patient according to the original formula on admission day. Kaplan-Meier survival curves were made using the cut-off points calculated by Youden index. ResultsSix out of 40 patients died within three months, MELD scores and Child-Pugh scores for non-survivors (32.2?8.0, 12.3?2.0) were higher than those for survivors (13.4?6, 9.12?2.31) significantly (P

Medical imaging is an interdisciplinary subject closely related to clinical and pathological subject. Its clinical reading skills' training has become the focus of postgraduate teaching. In the process of clinical teaching, the interactive reading mode of problem-based learning (PBL) combined with multi-disci-plinary team (MDT) was introduced into clinical reading meeting. The tutors chose the reading cases proved by pathology; designed in-depth issues step by step for execution of PBL teaching; guided postgraduates to delineate imaging signs and propose the diagnostic results, evidences and differential diagnoses according to the step from localizing to qualitative and then to pathological diagnosis;then guided postgraduates to attend in-depth case analysis of MDT and analyze the correlation or inconsistency between the imaging diagnosis and clinical and pathological diagnosis; exercise document retrieval and verbalization, multimedia design, and writing level of the records of the reading cases and papers. The interactive reading mode of PBL com-bined with MDT has achieved significant effects, which is worthy of further exploration and promotion.

Objective To explore the new method for noninvasively measuring the time constant of left ventricular relaxation (Tau) in animals with mitral regurgitation by continuous-wave Doppler.Methods The acute ischaemic left diastolic heart failure with mitral regurgitation was produced in 9 dogs.Dobutamine hydrochloride or esmolol hydrochloride had been applied to change the hemodynamic states.In different hemodynamic states,left ventricular pressures,left atrial pressures,curves of dP/dt and continuous-wave mitral regurgitant spectra were synchronously recorded.Doppler spectra were laterly processed through Matlab workstation.Paired t-test was used to compare the difference between Tau-catheter (Tau-c) and Tau-doppler ultrasound (Tau-d),and the correlation between Tau-c and Tau-d was analyzed by Pearson correlation analysis.Results Thirty-nine hemodynamic status had been obtained in 9 dogs.Tau-c was 21.03-78.45 ms and the average was (48.76± 17.60) ms.Tau-d was 21.24-94.60 ms and the average was (49.33 ± 18.79) ms.There was no significant difference (t=0.353,P=0.726) between Tau-d and Tau-c.The correlation analysis between Tau-d and Tau-c suggested a strong positive relationship with the correlation coefficient (r=0.85,P ＜ 0.001).Conclusions The dog aortic regurgitation model under ultrasound guidance is less traumatic.The method of inducing left ventricular diastolic dysfunction by repeatedly injecting microspheres into the left coronary sinus is safe and reliable.Choosing three points (t1,1 m/s;t2,2 m/s;t3,3 m/s) in aortic regurgitant velocity spectrum and putting them into the corresponding formula,we can obtain Tau,which had a good correlation with the catheter-derived Tau.

Objective To evaluate the left atrial(LA) function in patients with severe preeclampsia ( SPE) by full-volume imaging technology. Methods Forty-two patients of SPE were randomly chosen as SPE group,34 healthy pregnant women were selected as the control group. LA related function parameters including LA maximum volume( LAVmax),LA minimum volume( LAVmin),LA pre-atrium contraction volume(LAVpre),LA reservoir volume(LARV),LA passive emptying volume(LAPEV),LA contraction volume(LACV),LA expansion index(LAEI),LA passive emptying fraction(LAPEF),LA passive emptying fraction( LAAEF ) were separately required by biplane area-length method and full-volume imaging technology in antepartum and postpartum. Results Compared with control group before delivery,the parameters of SPE group before delivery such as LAVmax,LAVmin,LAVpre were higher,LAEI,LAPEF, LAAEF indexed to body surface area(BSA) were lower(all P ＜0.01).Compared with control group before delivery,the parameters of control group after delivery such as LAVmax,LAVmin,LAVpre were lower( all P ＜0.05),LAEI, LAAEF calculated as ratio to BSA were somewhat reduced,LAPEF calculated as ratio to BSA was relatively higher(all P ＞0.05).Compared with SPE group before delivery,the parameters of SPE group after delivery such as LAVmax,LAVmin,LAVpre were lower,LAEI,LAPEF,LAAEF indexed to BSA were higher( all P ＜0.01). Compared with control group after delivery,the parameters of SPE group after delivery such as LAVmax,LAVmin,LAVpre were still incresed ( all P ＜ 0.05 ), LAEI,LAPEF, LAAEF indexed to BSA were relatively lower( all P ＞0.05). Conclusions Full-volume imaging technology can quantitatively evaluate the LA function. LA reservoir function,conduit function and booster pump function are reduced in SPE before delivery,LA rereservoir function,conduit function and booster pump function are basically recovery in SPE after delivery.