Objective To evaluate right ventricular function of chronic thromboembolic pulmonary hypertension (CTEPH) patients by echocardiography and cardiac magnetic resonance (CMR),and to evaluate the value of clinical application of those right heart function indexes.Methods 32 patients with CTEPH who underwent CMR and echocardiography were involved in the study.Right ventricular index of myocardial performance (RIMP),fractional area change (FAC),tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler-derived tricuspid lateral annular systolic velocity (S') were measured by echocardiography.Right ventricular end-diastolic volume (RVEDV) and end-systolic volume (RVESV) were measured by cardiac magnetic resonance and right ventricular ejection fraction (RVEF) was calculated.Results A positive correlation was found between FAC and RVEF (r =0.423,P =0.022),there was a negative correlation between RIMP and RVEF (r =-0.387,P =0.048),there was no correlation between TAPSE and RVEF (r =0.451,P =0.22),a positive correlation was found between S' and RVEF (r =0.689,P =0.000).Conclusions The echocardiographic parameters FAC,RIMP and S' can reflect right ventricular function in patients with CTEPH and can be used as a routine clinical parameters.

Breast Neoplasms ; etiology ; Female ; Humans ; Integrins ; physiology

Objective To evaluate right ventricular systolic function in patients with pulmonary hypertension (PH) by real-time three-dimensional echocardiography (RT-3DE),and compared with cardiac magnetic resonance.Methods A total of 23 patients with PH who underwent MRI and echocardiography in the study.Right ventricular index of myocardial performance (RIMP),fractional area change (RVFAC),tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler-derived tricuspid lateral annular systolic velocity (S') were measured by echocardiography.RV end-diastolic volume (RVEDV) and endsystolic volume (RVESV) were measured by RT-3DE and cardiac magnetic resonance and RV ejection fraction (RVEF) was calculated.Results A positive correlation was found between RVFAC and RVEF (r =0.595,P =0.003),there was a negative correlation between RIMP and RVEF (r =-0.745,P =0.000),has no correlation between TAPSE and RVEF (r =-0.029,P =0.896),a positive correlation was found between S' and RVEF (r =0.489,P =0.018).There were close correlation between RVEDV,RVESV and RVEF measured by RT-3DE and MRI (P ＜0.001,respectively);Bland-Altman analyses showed good agreement between them.Conclusions RT-3DE can noninvasive,accurate assessment right ventricular systolic function in patients with PH,and provide prognosis and treatment choice for clinical demands.

Objective:To assess type C behavior in patients with oral lichen planus (OLP) in order to provide basis for clinical prevention,treatment and psychological intervention of OLP.Methods:Type C behavior scale was used on 85 OLP patients and 85 control patients,who were in accordance with the inclusion criteria,in order to investigate their type C behavior.The scale included 9 items:anxiety,depression,anger,anger toward inside (anger-in),anger toward outside (anger-out),reasoning,domination,optimism,and social support.Scores of the 9 items between OLP patients and control group were calculated under the instruction of the scale and were statistically analyzed,and OLP group was further stratified statistically by sex,reticulate-erosive-ulcerative (REU) pathological type and course of diseases,and the scores of each group were analyzed and compared.Results:Among the 85 OLP patients,there were more females,more non-erosive lesion type,and the most common site for OLP was the buccal mucosa.The scores of the type-C behavior questionnaire for anxiety,depression,anger and optimism were respectively 43.01 ± 7.47,44.02 ± 7.61,21.56 ± 5.26,22.15 ± 4.00 among the OLP patients and were 37.94 ±8.70,39.58 ±7.35,18.12 ±5.39,24.05 ±3.23 among control group,with significant differences (P ＜ 0.05 for all) between the two groups.The female OLP patients had higher anxiety,depression,anger scores (43.21 ± 6.97,44.29 ± 7.54,21.64 ± 5.09) and lower reasoning,domination,optimism scores (39.12 ±5.66,16.29 ±3.95,22.05 ±4.12) with significant differences (P ＜0.05 for all) compared with those of the female controls.The scores between male patients and male controls showed no significant difference.The patients with erosive lesions had higher anger score (22.94 ± 5.26) than that of the patients without erosive lesions (20.60 ± 5.03),with a significant difference (P ＜ 0.05).With the development of the disease,the tendency of anxiety and depression of the patients were more obvious,while optimism scores remained declining.The patients suffering more than 3 years of OLP had higher anger-toward-outside scores (17.36 ± 3.35) than the patients suffering less than 3 years of OLP (15.19±3.99),with a significant difference (P ＜0.05).Conclusion:OLP patients showed an obvious type C behavior characteristic,especially in anxiety,depression,anger and low optimism.This research provides the C behavior characteristic of OLP for further psychological consultation or intervention during OLP treatment.

Objective To investigate the characteristics and relationship of cognitive function and resting state functional magnetic resonance imaging(fMRI) amplitude of low-frequency fluctuations (ALFF)in childhood and adolescence-first-onset obsessive-compulsive disorder(OCD).Methods Twenty-four childhood and adolescence-first-onset OCD patients (patient group) and thirty-three age/gender/education-matched healthy controls (healthy control group) were enrolled in this study.The participants' cognitive function was tested with trail making test (TMT),symbol coding,Hopkins verbal learning test-revised (HVLT-R),brief visuospatial memory test-revised (BVMT-R),verbal fluency test (VF),digital span test,maze test and Stroop test.Then a resting-state fMRI scan was conducted for each participant.Amplitude of low-frequency fluctuation approach was used to explore the differences of resting-state brain function between patients and controls,and analyze the significant brain regions by adopting t test.The cognitive functions of patients and healthy control group in the significant brain regions were compared by using Pearson correlation analysis.Results The patient group had lower scores than healthy control group in symbol coding,BVMT-R and digital span test,and the differences were statistically significant [(45.24 ± 10.32)scores vs.(56.85 ± 9.57) scores,(21.94 ± 6.99) scores vs.(30.58 ± 3.92) scores,(64.06 ± 20.00) scores vs.(78.03 ±18.08) scores;t =3.96,4.90,2.50;all P ＜ 0.05].Corrected by Alphasim,patient group showed significantly increased ALFF in the left and fight temporal lobe,left and fight posterior lobe of cerebellum,right middle temporal gyrus,but ALFF decreased in the area of left and right lenticula,left putamen compared with the healthy control group (all P ＜ 0.05).The patients group showed that TMT scores were positively correlated with the value of ALFF in the right temporal lobe (r =0.67),and color scores were positively correlated with the value of ALFF in the right middle temporal gyrus (r =0.53),but colour scores were negatively correlated with the value of ALFF in the right tcmporal lobe (r =-0.54);the healthy control group showed that BVMT-R and digital span test scores were positively correlated with the value of ALFF in the left temporal lobe (r =0.47,0.41),but digital span test scores were negatively correlated with the value of ALFF in the right temporal lobe (r =-0.49),and colour scores were negatively correlated with the value of ALFF in the left temporal lobe (r =-0.35),while word and color-word scores were negatively correlated with the value of ALFF in the right middle temporal gyrus (r =-0.39,-0.36);the correlation coefficient above had statistical significance (all P ＜ 0.05).Conclusions The childhood and adolescence-first-onset OCD patients had cognitive impairment,including speed of processing,visual learning and memory,working memory;and the patients showed abnormal spontaneous neural activity at some brain regions.The cognitive dysfunction may be associated with abnormal spontaneous neuronal activity in childhood and adolescence-first-onset OCD.

Objective To investigate the abnormal brain activity of first-episode depression by rest-ing state functional magnetic resonance imaging ( fMRI) .Methods Twenty-one adolescent participants diag-nosed with depression(AD) and 18 healthy controls ( HC) were recruited.Resting state fMRI brain scans were performed on all participants.Regional homogeneity ( ReHo) approach was applied to preprocess the fMRI datasets.The value of ReHo maps were obtained in the whole brain.Results ReHo values in the AD group were higher than those in the healthy controls in the right inferior temporal gyrus ( MINI:66,-24,-20) ,left upper cingulate cortex (-27,47,-6) ,frontal polar (-24,59,14) ,after upper left cingulate cortex (-1,-16,35),after the bottom left cingulate cortex (-2,-38,32),left praecuneus (-1,-48,65) com-pared with that in the healthy controls (P<0.05) .ReHo in the AD group decreased in the right middle tempo-ral gyrus (45,-34,32) compared with that in the healthy controls (P<0.05).Conclusion Extensive ReHo abnormalities were found in the brains of patients with first-episode,drug-naive depression,and these abnor-malities in spontaneous neural activity may contribute to the neuropathology of adolescent depression.

Objective To evaluate the safety of anesthesia endoscopic retrograde cholangio pancreatography (ERCP) under general anesthesia.Methods From January 1st,2008 to June 30th,2016,patients underwent ERCP under general anesthesia were enrolled as anesthesia group and from January 1st,2005 to December 31st,2007,patients accepted ERCP without anesthesia were enrolled as control group.Chi-square test was performed to analyze disease composition,conditions during operation,success rate of operation and complications in these two groups.Results A total of 14 724 patients with ERCP under general anesthesia and 2 102 patients received ERCP without anesthesia were enrolled.In 14 724 patients with ERCP under general anesthesia,1 799 cases had malignant biliary and pancreatic diseases and 12 925 cases with biliary and pancreatic diseases.During the operation,transient hypoxemia occurred in 441 cases (3.00％) and relieved by increasing oxygen flow,lower anesthetic dose or lifting lower jaw.The success rate of ERCP in the anesthesia group (98.41 ％,14 490/14 724) was higher than that in the control group (97.34％,2 046/2 102),and the difference was statistically significant (x2 =11.500,P=0.001).The incidence rate of post-ERCP pancreatitis in the anesthesia group was 2.35％ (346/14 724),which was lower than that in the control group (3.85％,81/2 102),and the difference was statistically significant (x2 =16.813,P＜0.01).Conclusion ERCP under general anesthesia is safe,which could increase the success rate of operation and reduce the incidence rate of post-ERCP pancreatitis.

Objective:To explore the influence of rosuvastatin in the lipid levels, atherosclerosis plaque and apoptosis in the plaque of atherosclerotic apolipoprotein E (ApoE)-knockout mouse models, and to clarify the mechanism of rosuvastatin in inhibiting atheromatous plaque and apoptosis in the plaque.Methods:Thirty healthy six-week old male mice were randomly divided into high fat diet group (n=10),rosuvastatin group (n=10)and general diet control group (n=10).The mice in first two groups were fed with high fat diet,and the mice in general diet control group were fed with general diet;4 weeks later the mice in three groups were respectively given 0.9% NaCl solution,rosuvastatin (10 mg·kg·d-1 )and 0.9% NaCl solution by gavage for 8 weeks.And then ELISA was used to detect the serum lipid levels,the area of atherosclerotic plaque was measured by HE staining, and the apoptosis in plaques was detected by TUNEL method;the expression of apoptosis-assoicated gene Bax protein was measured by immunohistochemical staining.Results:Compared with high fat diet group,the levels of total cholesterol (TC)and low density lipoprotein cholesterol (LDL-C)of the mice in rosuvastatin group were significantly decreased (P<0.05 or P<0.01),and the 1evel of high density lipoprotein cholesterol (HDL-C)was significantly increased (P<0.01).The aortic atherosclerotic plaque of the mice in high fat diet group was massive with a great quantity of foam cells, cholesterol crystal, necrotic cells and inflammatory cells in the plaque;the aortic atherosclerotic plaque of the mice in rosuvastatin group was smaller with less foam cells,necrotic cells and inflammatory cells;the aortic atherosclerotic plaque area of the mice in rosuvastatin group was significantly smaller than that in high fat diet group (P<0.01);the apoptotic index in the aortic atherosclerotic plaque of the mice in rosuvastatin group was significantly lower than that in high fat diet group (P<0.01).Compared with high fat diet group,the expression of Bax protein in rosuvastatin group was significantly decreased.Conclusion:Rosuvastatin may inhibit the progression of atherosclerotic plaque and the apoptosis in plaques through mitochondrial pathway.

Objective To study the value of relative cerebral blood flow(rCBF)changes in patients with amnestic-type mild cognitive impairment (aMCI)and mild Alzheimer disease(AD) using MRI pulsed arterial spin labeling(PASL).Methods A prospective study recruited 37 aMCI patients (aMCI group),30 mild AD patients(mild AD group) and 30 healthy volunteers (normal control group) from March 2011 to December 2013,MRI using PASL for cerebral perfusion imaging was performed and data of rCBF were collected.Taking age as covariate,analysis of variance (ANONA)was carried out to assess the difference of rCBF among all the three groups,then Bonferroni was done between every two groups.A follow-up examination using PASL was performed in the seventeen patients of the aMCI group.And paired t-test was used for comparing the longitudinal change of their rCBF data.Results Compared with the normal control group,the aMCI group showed significant increase of rCBF in bilateral posterior cingulate cortices and precuneus (cluster number 2 785,P＜0.05).While the mild AD group showed decrease of rCBF in the left inferior and superior parietal lobes,the angular,middle frontal lobe,as well as the right superior temporal lobe (cluster number 3 459-5 206,P＜0.05).When compared with the aMCI group,the mild AD group showed regional hypoperfusion in bilateral middle frontal lobes,the left precuneus,the right postcentral and inferior parietal lobe (cluster number 3 236-19 863,P＜0.05).In the longitudinal study of the 17 aMCI patients,an increased rCBF was found to coexist with reduced rCBF in the left inferior frontal and lateral occipital cortex,bilateral frontal poles and paracingulate gyrus,with hyperperfusion dominated.Increased rCBF was also detected in the left temporal lobe,the angular gyrus and precuneus,while decreased rCBF was present in the left putamen,the operculum and right corpus callosum (P＜0.05).Conclusions ASL perfusion imaging is a valuable method for dynamic monitoring of the cerebral perfusion changes in aMCI and AD patients.PASL will assist in finding a useful imaging biomarker for early diagnosis of AD.

Objective To evaluate the role of spinal AMP-activated protein kinase (AMPK) signaling pathway in reduction of neuropathic pain (NP) by dexmedetomidine in rats.Methods One hundred twenty adult male Sprague-Dawley rats, weighing 180-220 g, were randomly divided into 4 groups (n=30 each) using a random number table: sham operation group (group S);group NP;dexmedetomidine group (group Dex) and AMPK inhibitor group (group AI).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The right sciatic nerve was exposed, and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 silk thread in NP and Dex groups.In group Dex, dexmedetomidine 50 μg/kg was injected intraperitoneally once a day starting from the end of operation until the animals were sacrificed.In group AI, AMPK inhibitor Compound C 20 mg/kg was injected intraperitoneally at the end of operation, and the other treatments were similar to those previously described in group Dex.The equal volume of normal saline was given instead of dexmedetomidine in S and NP groups.The mechanical paw withdrawal threshold to von Frey filament stimulation (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before operation (baseline) and 2, 8 and 14 days after operation (T0-3).Results Compared with group S, the MWT was significantly decreased, and the TWL was shortened at T1-3 in NP, Dex and AI groups (P＜0.05).Compared with group NP, the MWT was significantly increased, and the TWL was prolonged at T1-3 in group Dex (P＜0.05) , and no significant change was found in MWT and TWL in group AI (P＞0.05).Conclusion Spinal AMPK signaling pathway is involved in reduction of NP by dexmedetomidine in rats.