Objective To investigate the hemodynamic characteristics of superior thyroid artery and its corresponding clinical significance with patients of Graves'hyperthyroidism.Methods Thirty patients with Graves'hyperthyroidism received Doppler ultrasonography.Patients were grouped with different serologic indices at 4 month after radioiodine therapy as relief(R),uncured(U)and hypothyroidism(H).The relationships between thyroid volume(V),superior thyroid artery peak systolic velocity(PSV),end diastolic velocity(EDV),RI,PI and systolic accelerating time(SAT)and the 4-month outcome were analyzed respectively.Results Besides the effect of 24 h-131I uptake rate on patients'short-term outcome,V,PSV and RI were of predominate prognosis value(P＜0.01).PSV and V of group R were positively correlated with 131I dose respectively(r1=0.825,r2=0.697;P＜0.001),while SAT of group R was negatively correlated with 131I dose(r=-0.489,P＜0.05).Conclusions Patients with high V,PSV and RI maybe still suffering hyperthyroidism after regular dosage of 131I therapy.Doses of 131I should be added appropriately for patients with high PSV and V,but short SAT to achieve complete remission,while it should be reduced for patients in opposite condition to avoid occurrence of hypothyroidism.

The combination of medical humanistic spirit and medical scientific spirit is the sign of the maturity of medicine.The modern medical mode of ' biology-psychology-society-environment' sets new requirements for medical humanistic education.Clinic medical postgraduates,the front -line medical workers,play a very important role in medical work,but they show huge deficiency in interpersonal communication,humanistic knowledge and humanistic possession nowadays.The paper tried to draw some lessons from the successful education mode of George Washington university and discussed practicable methods to improve humanistic education among medical postgraduates aiming at cultivating qualified medical workers who have both noble medical ethics and perfect medical technology and ability.

Objective To evaluate left ventricular regional systolic myocardial function quantitatively before and after coronary artery bypass graft(CABG) in patients with coronary artery disease(CAD) by strain rate imaging(SRI),and determine the effect of CABG.The diagnostic value of two-dimensional echocardiography(2-DE) method and SRI parameter method was compared.Methods The values of systolic strain rate(SRs) at 9 segments supplied by left anteior descending were measured in study group(20 patients with CAD) at 1 d before and 10 d,1 month,3 months and 6 months after CABG.The regional myocardial function befose CABG was analyzed and compared with that of controls,and abnormal segments were found.Then the values of these abnormal segments before and after CABG were compared.Results In control group,SRs displayed a wide and negative peak and was homogeneous in every segments.The SRs peak values decreased,and the homogeneity disappeared in study group.Beginning from 1 month after CABG,the SRs peak values at the graft segments increased in varying degrees,and there was significant difference at basal segments of anterior wall,middle segments of anteroseptal,and middle segments of posteroseptal in the different periods(P

Objective To evaluate the value of dual‐Doppler imaging technology (referred to as dual‐Doppler modality for short) in assessing left ventricular diastolic function in patients with atrial fibrillation (AF) and normal left ventricular ejection fraction (LVEF) .Methods A total of 40 patients with AF and normal LVEF were enrolled as the AF group ,and 40 healthy volunteers were composed of the control group .①Peak early diastolic transmitral flow velocity (E) and tissue Doppler lateral (L ) mitral annular early diastolic velocity (e′) were measured simultaneously in the particular cardiac cycle by dual‐Doppler modality .②Peak early diastolic transmitral flow velocity (E) and tissue Doppler septal (S) mitral annular early diastolic velocity (e′) were measured simultaneously in the particular cardiac cycle .③ Peak early diastolic transmitral flow velocity (E) and color M‐mode Doppler flow propagation velocity (Vp) were measured simultaneously in the particular cardiac cycle .Then E/e′(L) ,E/e′(S) and E/Vp were calculated , respectively .Results Compared to the control group ,E/e′(L) ,E/e′(S)and E/Vp were all higher in AF group ( P <0 0.5) .Bland‐Altman showed that E/e′(L) ,E/e′(S)and E/Vp measured by the dual‐Doppler modality had better reproducibility and higher intraclass correlation coefficient (ICC) than the conventional Doppler modality .Conclusions The dual‐Doppler modality is valuable for evaluating left ventricular diastolic function in patients with AF and has better reproducibility and more accurate results than the conventional Doppler modality .

Objective To assess the value of high-frequency color Doppler ultrasound technique combined with hemorheology in detecting early atherosclerosis and monitoring its progression.Methods Twenty-four white big ear rabbits were divided into two groups randomly.Group A (6 rabbits) was fed normal rabbit chow,while group B (18 rabbits) was fed high cholesterol diet and was divided into three subgroups: B1(6 rabbits) with high cholesterol diet for 4 weeks,B2(6 rabbits) for 8 weeks,B3(6 rabbits) for 12 weeks.Intima-media thickness (IMT),diameter of common carotid artery and hemorheology index were observed dynamically and compared with the findings of histological examination.Results IMT of common carotid artery increased gradually in group B at different phases of atherosclerosis.Diameter compensationally enlarged at the early stage,and then stenosed with the progression of atherosclerosis.RBC deformation index of group B began reducing in the second week,but blood viscosity,plasma viscosity,RBC aggregation index and rigidity index gradually increased from the fourth week( P

Objective To investigate the clinical significance of atrial septal aneurysm(ASA)and the value of echocardiography in detecting ASA. Methods One hundred and fifty-one patients with ASA diagnosed by transthoracic echocardiography(TTE) or transesophageal echocardiography(TEE) were analyzed retrospectively.The patients were divided into two groups:group Ⅰ included 57 patients who had experience of transient ischaemic attack(TIA)or cerebral shock and group Ⅱ included 94 age-and sexmatched patients without those cerebral ischemic event who underwent echocardiography during the same period of time. The following parameters of the ASA were measured:maximal excursion or protrusionbeyond the plane of the atrial septum,direction of protrusion,thickness of the wall,presence of theombi attaching to the wall and other structural abnormalities associated with ASA. Results One hundred and thirty-two of 151 cases(87.42%) located at fossa ovalis of atrial septum. The wall thickness of ASA increased with depth.The extent of bulging and thinkness of wall in group Ⅰ were greater than those in group Ⅱ and more patent foramen ovale(PFO)were observed in group Ⅰ. However,no difference was found in direction of protrusion and incidence of oscillations between the two groups. As to the performance of the two techniques in the evaluation of ASA,TEE showed better result than TTE. Conclusions Echocardiography is a reliable means to detect ASA and its complications. Greater maximal excursion and thicker aneurysm wall of ASA is associated with a higher risk of cerebral ischaemic event.

Objective To explore application value of blood flow ratio indexes in the diagnosis of Hashimoto's thyroiditis(HT) with different thyroid functions.Methods One hundred and four patients who were diagnosed clinically as HT were enrolled in the study.The patients were classified into three groups according to thyroid functions:the hyperthyroidism group,the hypothyroidism group and the euthyroidism group.Thirty-two volunteers with normal thyroid functions were enrolled as control group.All the cases were examined with ultrasound and five blood flow ratio indexes were calculated automatically.Their differences in the four groups were compared.Results ①Among the five blood flow ratio indexes,three indexes(mean ratio,maxratio and minratio) had significant differences between each two groups(P ＜ 0.001),the other two indexes didn't have any differences among the four groups.②Two receiver operating characteristic (ROC) curves on meanratio were drew:a)HT with hyperthyroidism and HT with euthyroidism;b) HT with euthyroidism and HT with hypothyroidism.The cutoff value as a result of the ROC analysis of HT with hyperthyroidism and HT with euthyroidism was 0.235 with the maxim of specificity and sensitivity.The cutoff value of HT with euthyroidism and HT with hypothyroidism was 0.113 with the maxim of specificity and sensitivity.Both Bland-Altamn scatter diagrams and high intraclass correlation coefficient(ICC) showed that blood flow ratio indexes have high repeatability.Conclusions Blood flow ratio indexes are promising quantitative indexes in reflecting the vascularity of thyroid parenchyma,and they are helpful in the differential diagnosis of HT with different thyroid functions.

Objective To explore the differential diagnostic value of speckle-tracking imaging (STI) between dilated cardiomyopathy(DCM) and ischemic cardiomyopathy(ICM).Methods 40 DCM patients,32 ICM patients and 30 normal controls were enrolled for this study.Different views of high frame images of left ventricle were recorded.The time to peak radial strain,circumferential strain and longitudinal strain of 18 myocardial segments were measured by STI,and the maximum differential (Ts-dif) and the standard deviation(Ts-SD) of time to the peak strain were calculated.The left ventricular parameters measured by STI were compared between DCM and ICM,and the diagnostic sensitivity and specificity were investigated by the areas under the receiver operating characteristic (ROC) curves.Results Parameters of different segments of ICM were obviously higher than those of DCM (P ＜ 0.05),and there were significant differences between ICM and DCM.The areas under the ROC curves of Ts-dif and Ts-SD to radial strain were 0.920 and 0.946 respectively.At the cut off of 170 ms and 53 ms for diagnosing DCM and ICM,the sensitivity,specificity and accuracy were 87.5％,87.5％,87.5％ and 90.6％,90％,90.2％ respectively.Conclusions These strain parameters by STI,especially Ts-SD to peak strain can offer a new quantitative diagnostic method in distinguishing DCM from ICM.

Objective To investigate the role of aquaporin 4 (AQP4) in partial pathologic process of lung injury in rat models of fat embolism syndrome (FES).Methods A total of 120 healthy male C57BL/6J mice were assigned to control group and FES group which was subgrouped at 4,6,12,24,and 48 hours with 20 mice per group,according to the random number table.Allogeneic perinephric fat was injected to rat caudal veins in FES groups.Lung samples were harvested from each group to examine pathological morphology and lung weight to dry ratio (W/D) to verify the FES models and observe the pathologic process.Expression of AQP4 was detected by western blot and immunohistochemistry.Additional 36 C57BL/6J mice were divided into control group,DMSO group,FES 12-hour group,and AQP4 inhibitor group according to the random number table,with 9 mice per group.Pathologic process of FES-induced lung injury was detected after the inhibition of AQP4.Results Damage to lung tissues was notable in FES group compared with control group.Lung W/D value was 5.06 ± 1.23,5.22 ± 1.58,6.18 ± 1.65,and 5.07 ± 0.31 at 6,12,24,and 48 hours respectively,which was higher than 3.16 ± 1.58 in control group (F =3.62,P ＜ 0.05).Expression of AQP4 was 1.71 ± 1.05 at 12 hours and 1.28 ± 0.68 at 24 hours in FES group,which showed significantly increase when compared with 0.65 ±0.08 in control group (F =4.12,P ＜0.01),whereas at 4 hours (0.76 ± 0.36),6 hours (1.17 ± 0.60),and 48 hours (0.85 ±0.45) in FES group,no statistical difference was observed when compared to control group.W/D value in FES 12-hour group (5.22 ± 1.17),DMSO group (4.96 ±1.66),and AQP4 inhibitor group (3.25 ± 1.19) was higher than 3.03 ± 1.68 in control group (F =3.69,P ＜ 0.05).Meanwhile,there was no statistical difference between DMSO and FES 12-hour groups,but significantly lowered W/D value was observed in AQP4 inhibitor group than in FES 12-hour group.Conclusion AQP4 may be implicated in mitigating lung injury induced by FES.

Objective To evaluate the effect of adenosine triphosphate postconditioning on myocardial ischemia reperfusion injury in rabbits by ultrasound speckle tracking imaging(STI).Methods Forty-two healthy rabbits were randomly divided into three groups averagely:ischemia-reperfusion (IR ) group, ischemia postconditioning(IPost)group,ATP-pharmacological postconditioning(PPost)group.The model of myocardial ischemia reperfusion was established.Echocardiography examinations were conducted before the coronary artery ligatured,after 45 min later and at the end of reperfusion.Pathological examinations were applied to detect the change of which two rabbits randomly selected from each group after the coronary artery ligatured 45 minutes later and the rests after reperfusion of 120 min.Results ①Ischemic and infarct changes could find in the six rabbits which were sacrificed after the coronary artery ligatured 45 minutes later.The same changes also could be found in the three groups after reperfusion,and the damage in IR group was the most significant.②After block of coronary artery,left ventricular ej ection fraction(LVEF) decreased in all groups (P <0.05)and STI index decreased in all groups (P <0.01).③After reperfusion of 1 20 min later,global longitudinal systolic strain rate (GLSrsys ),global longitudinal systolic strain (GLSsys)increased in IPost group and GLSrsys increased in ATP-PPost group,and longitudinal systolic strain rate(SrLsys),longitudinal diastolic strain rate(SrLd),longitudinal systolic strain(SLsys)increased both in IPost group and ATP-PPost group(P <0.05 or P <0.01).Compared in groups,GLSsys,SrLsys, SLsys in IPost group and ATP-PPost group all higher than those in IR group (P <0.05).Conclusions STI can evaluate exactly the global and regional myocardial function of rabbit myocardial infarct-reperfusion model and local index is better than overall index.STI can also detect correctly the protect effects on myocardial reperfusion inj ury of ATP.