Objective To evaluate right ventricular (RV) global and regional systolic function using real-time three-dimensional echocardiography (RT-3DE) in patients with pulmonary hypertension (PH).Methods Thirty patients with PH and 27 controls were studied.RT-3DE images were acquired on a Philipa iE33 system with an X3-1 probe,then analyzed with a new software(TomTec) to determine RV global and regional (inflow, body, outflow) end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF).The difference of RT-3DE parameters between the two groups,as well as the correlation between RT-3DE and routine echoeardiography parameters was analyzed.Results In patients with PH ,RV global and regional EDV and ESV were significantly higher than those in normal controls (all P ＜0.05); RV global and regional EF were significantly lower than those in normal controls (all P ＜0.05).In the PH group, RV inflow EDV,SV and EF were higher than that of RV body and outflow part (P ＜ 0.05) ;RV global EF was lower than that of RV inflow part and higher than that of RV body and outflow part.In the PH group, RV global and inflow EF correlated with pulmonary artery systolic pressure negatively (r = - 0.611, P ＜0.001 and r = - 0.576, P = 0.001 ,respectively) ,and with the ratio of peak velocity of tricuspid regurgitation over outflow time-velocity integral negatively (r = -0.772, P = 0.002and r = -0.721, P ＜0.001, respectively)Conclusions RV global and regional volume was enlarged and systolic function was impaired in patients with pulmonary hypertension.RV global and regional systolic function was changed in liner relationship with RV after-load.

Objective To investigate the value of real-time three-dimensional echocardiography timing-excursion parametric index and 17 segment volume curves index in patients with restrictive cardiomyopathy.Methods Eight patients with restrictive cardiomyopathy (proven by biopsy),twenty eight subjects with normal left ventricular(LV) function were examined by Philips iE33 with X3-1 probe.Results Parameter index of the SD and maximum difference of Tmsv of 16 segments,12 segments,and 6 basal segments(Tmax 16SD,Tmsv-12SD Tmsv -6SD,Tmsv-16Dif,Tmsv-12 Dif,Tmsv-6Dif,Tmsv 16-SD%,Tmsv 12-SD%,Tmsv 6-SD%,Tmsv 16-Dif%,Tmsv 12-Dif%,Tmsv 6-Dif%) was significantly higher in patients with restrictive cardiomyopathy than that in subjects with normal LV function(all P＜0.001).Average and maximum value and minimum of excursion was significantly lower in patients with restrictive cardiomyopathy than that in subjects with normal LV function(P＜0.001,P＜0.005,P＜0.005).And parameter index of 17 segment volume curves index showed higher sensitivity,specificity,positive predictive value and negative predictive value for diagnose restrictive cardiomyopathy.Conclusions Real-time threedimensional echocardiography can evaluate and diagnose restrictive cardiomyopathy fastly.

Objective To investigate the value of real-time three-dimensional transesophageal echocardiography(RT-3DTEE) in mitral valve repair. Methods RT-3DTEE was performed in six patients[5 male,1 female,mean age (45.7±12.6)years] with mitral valve prolapse by using Philips IE33 with X7-2t probe.Preoperative RT-3DTEE studies were compared with surgical findings in patients undergoing surgical repair. Results RT-3DTEE could display dynamic morphology of mitral valve,the location of prolapse,and spatial relation tO the surrounding tissues.It could provide surgical views of the valves and the valvular apparatus.RT-3DTEE results were consistant with surgical findings.Conclusions RT-3DTEE is a unique new modality for rapid and accurate evaluation of mitral prolapse and mittal repair.

Objective To evaluate the effect of edge-to-edge technique of anterior mitral valve prolapse using transthoraeic echocardiography(TTE). Methods Nineteen patients with anterior mitral valve prolapse underwent randomized operation using edge-to-edge technique. The grade of mitral regurgitation(MR),mitral valve are (MVA), the diameter of left atrial(LAD) and left ventricle(LVD), left ventricular ejection fracion(LVEF) and pulmonary artery systolic pressure(PASP) were evaluated. Results All the patients with anterior mitral valve prolapse had severe MR before the operation whereas the degree of MR changed into absence to mild degree after the procedure. There were significant statistic differences between pre- and post edge-to-edge procedure:LAD(51.63±10.03)mm vs (44.79±9.22)mm, P = 0.000, LVD(59.37±8.29)mm vs (52.68±7.31)mm, P = 0.000 ; PASP (45.37±18.34)mm Hg vs (33.00± 9.43)mm Hg, P = 0.002,1 mm Hg = 0.133 kPa;MVA(4.13±0.24)cm<'2> vs (2.90±0.28)cm<'2>, P = 0.000,while LVEF changed little[(66.0±9.0)% vs (67.0±6.0) %, p = 0.751]. Conclusions The edge-to-edge technique is a simple and effective surgical method which can remain subvalve structure,restore the normal morphology of left atria,left ventricle and maintain the function of left ventricle.

Objective To evaluate the application valve of intraoperative device closure secundum atrial sepetal defect (ASD) associated with deficient rims inducted by transoesophageal echocardiography (TEE). Methods Twenty-three patients with ASD were diagnosed by transthoracic echocardiography (TTE) ,and underwent an attempted intraoperative device closure through a right antierior minithoraetomy. The positon, type and size and rim of ASD were defined by TEE in preoperation, the placement of the device inducted and evaluated by TEE intraoperation,and followed by TTE after one week. Results Twenty-three patients with ASD were closed excellently. There were not shunt of atrial level in 20 patients, trivial shunt in 3 patients. However,follow-up after one week TTE indicated that all patients had no shunt,and the diameter of right atrium and right ventricle was decrease significantly (P <0.05), and pulmonary artery pressure was less than before (P <0.05). Conclusions It is very important that TEE induct the closure of ASD associated with deficient rims in micro-operative room.

Objective To investigate left ventricular rotation in heahhy subj ects and patients with hypertrophy cardiomyopathy(HCM). Methods Twenty-five healthy subjects and 41 patients with HCM were enrolled. Two-dimensional standard echocardiography were performed and analyzed using Siemens Sequoia C512 system and velocity vector imaging 2.0 version. Left ventricular end diastollc volume(EDV).end systolic volume(ESV),left ventricular ejection fraction(LVEF),systolic peak rotation velockv and displacement of endocardium and epicardium of basal and apical part of left ventricle were measured.Difference of basal and apical rotation velocity and displacement between endoeardium and eDicardium(DVbase,DVape,DDbase,DDape) were calculated. Results Left ventricle rotated clockwise at basal part and counterclockwise at apex during systole. It rotated stronger at apex(P＜0.05 or P＜0.001)than at basal part and stronger in endocardium than in epicardium(P＜0.01 or P＜0.001). The rotation velocitv time curve consisted of a peak during systole and two peak during diastole,while the rotation displacementtime curve was composed of a smaller diastolic peak and a larger systolic peak. There was asvmmetricalhypertrophy at the basal part of HCM patients,and DVbase and DDbase were significantly increased(P＜0.01 or P＜0.001) in the significant hypertrophy segment. Conclusions Velocity vector imaging can assess left ventricular rotation effectively. HCM patients acquire mismatch of endocardium and epicardiuIn rotation.

Objective To evaluate right ventricular (RV) global and regional volume and systolic function in patients with secondum atrial septal defect (ASD) using real-time three-dimensional echocardiography (RT3DE),and to explore the relationship between parameters derived from RT3DE and parameters measured by conventional echocardiography.Methods RT3DE images were acquired from 22 patients with secundum ASD and 22 normal controls for evaluation and analysis to obtain RV global and regional end-diastolic volume (EDV),end systolic volume (ESV),systolic volume (SV) and ejection fraction (EF) in three compartments (inflow,body and outflow).RV dyssynehrony parameters were calculated as the standard deviation (SD) and maximum difference (dif) of time to minimum systolic volume (Tmsv) and Tmsv corrected by heart rate (Tmsv％) in three RV compartments.Conventional echocardiographic parameters including pulmonary artery systolic pressure (PASP),pulmonary vascular resistance (PVRe) and maximum diameter of ASD (ASD-D) were calculated and recorded.Results RV global and regional EDV,ESV and SV were larger (all P ＜0.001) and EF was lower (all P ＜0.05) in the ASD group than in the controls.RV regional volume and systolic function were changed to various degrees in different compartment in the patients group.There were no significant differences in Tmsv,Tmsv％ and RV dyssynchrony parameters between the two groups.In patients with ASD,RV global and regional EDV,ESV and SV in the inflow compartment were positively correlated with ASD-D and PASP (r =0.463-0.704,all P ＜ 0.05) ; RV global EF was negatively correlated with PVRe (r =-0.477,P ＜ 0.05).Conclusions In patients with ASD,RV global and regional volume was enlarged and systolic function was impaired with distinct characteristics; RV global volume and regional volume in the inflow compartment were positively correlated with RV pre-load while RV global EF was negatively correlated with RV afterload.

Objective To explore the effects of early hospital-family comprehensive rehabilitation on the development of pretenn infants. Methods A total of 256 premature infants were chosen and divided into an early intervention group (n = 148) and a control group (n =108). Besides being given the conventional mothering instruction , the early intervention group was given early assessment, regular visits and hospital-family comprehensive rehabilitation treatment. The control group was only given the conventional mothering instruction. The fine and gross motor growth quotients, adaptation, verbalisation and social behavior and general growth quotient of all the premature infants were assessed periodically using the infant neuropsychology growth scale. Results The growth quotient assessment indicators of the infants receiving the intervention were obviously better at the 6th, 12th, 18th and 24th month after birth, and the differences between the two groups were statistically significant. The incidence of cerebral palsy in the early intervention group was 0.71% (1/148), with only one cerebral palsy infant in the early intervention group who was at level Ⅲ of the gross motor function classification system ( GMFCS) , while the incidence of cerebral palsy in the control group was 5.1% (5/98) , with 5 cerebral palsy infants, one of whom was at GMFCS level Ⅲ and 4 of whom were at level Ⅳ. Conclusions Early systematic hospital-family comprehensive rehabilitation can improve the general growth of premature infants, decrease the incidence of cerebral palsy, and neurobehavior deficits.

Objective To prepare carcino-embryonic antigen (CEA) targeted and paclitaxel loaded phase-shifting PLGA nanoparticles (Ab-PTX-NPs),and investigate the targeting capability and inhibition to the ovarian cancer cell in vitro.Methods Single-emulsion/solvent evaporation (O/W) and carbodiimide method were used to prepare the Ab-PTX-NPs.The size of nanoparticles was determined by Malvern analyzer.The encapsulation and drug loaded efficiency of paclitaxel were detected by high performance liquid chromatography.And the drug release characteristics was measured by dialysis method in constant temperature shaker.The targeting ability of Ab-PTX-NPs to the ovarian cancer SKOV3 cell was evaluated by the laser scanning confocal microscope and flow cytometry.And the inhibition ability of Ab-NPs was investigated by the CCK-8 assays.Results The size of Ab-PTX-NPs was (397.70±99.95)nm.The encapsulation efficiency and drug loading capacity of PTX were (67.26±4.15) ％ and (6.31±0.39) ％,respectively.The conjugating rate of Anti-CEA antibody was (92.74 ± 5.75) ％.The targeting study in vitro showed that such a number of contrast agents landed around the SKOV3 cells in targeting group,and the mean fluorescence intensity of ovarian cells in targeting group was significantly higher than other groups (P＜0.05).After 24 h,the viability rate of ovarian cells in targeting group was lower than the non-target group (P＜0.05),only higher than that of the pure PTX group (P＜0.05).But there was no significant difference between the targeting group and the pure PTX group (P＞0.05) at 48 h.Conclusion The CEA targeted and paclitaxel loaded phase-shifting PLGA nanoparticles are successfully prepared.It can enhance ultrasound imaging well after activated by LIFU.With high drug-loading efficiency and fast drug release velocity,the Ab-PTX-NPs appeares great targeted ability.

Objective To investigate the impact of myocardial contrast echocardiography (MCE) on evaluating the myocardial perfusion in beagles with ischemic cardiomyopathy and cardiac resynchronization therapy (CRT),and to estimate the myocardial perfusion by myocardial blood flow (MBF) value.Methods Twelve adult beagles were randomly divided into two groups (CRT group and non-CRT group).Each beagle underwent a ligature in the first diagonal branch and a pacemaker was implanted.The pacing was started in CRT group,but was not started in non-CRT group.MCE and speckle tracking imaging were performed to evaluate the MBF value and circumferential strain (Cir1 2SD),radial strain (R12SD) and longitudinal strain (L12SD) of 12 segments of left ventricle at baseline,before CRT,and 4 weeks after CRT.Results There was no significant difference of LVEF,LVEDV,LVESV,Cir12SD,and R12SD between two groups at baseline or before CRT( P ＞0.05).After 4 weeks of CRT,LVEF,LVEDV,LVESV,Cir1 2SD,and R 12SD in two groups were ( 58.8 ± 8.2 ) ％ vs (39.5 ± 8.7 ) ％,(28.2 ± 2.9) ml vs (34.2 ± 2.5 ) ml,( 13.9± 2.6 ) ml vs (21.5± 4.7)ml,(29.1 ± 6.6)ms vs (46.5 ± 10.1)ms and (36.1 ± 10.7)ms vs (67.6± 11.2)ms( P ＜0.05 ).A,β,and MBF value between two groups were ( 13.6 ± 2.2 )dB vs ( 14.9 ± 3.0)dB,(5.1±1.1 )s- 1 vs (4.8 ± 2.1 )s- 1,(67.6 ± 12.1)dB/s vs (72.8 ± 8.6)dB/s( P ＞0.05) at baseline and were (7.4 ± 1.2)dB vs (7.3±2.7)dB,(3.9±0.9)s-1 vs (2.9±0.9)s-1,(23.4±4.2)dB/s vs (22.2±4.1)dB/s (P＞0.05)before CRT.After 4 weeks of CRT,A,β,and MBF value in CRT group were higher than those in non-CRT group (12.1 ± 1.8)dB vs (9.5 ± 1.7)dB,(4.7 ± 0.3)s-1 vs (3.1 ± 0.8)s-1,(47.2 ± 8.6)dB/s vs (29.5 ±4.2)dB/s,all P ＜0.05).Conclusions In beagles with ischemic cardiomyopathy,CRT can not only improve cardiac synchrony,but also increase myocardial perfusion.