Objective To explore the application value of real time three-dimensional echocardiography (RT-3DE) on right ventricular systolic function in patients with moderate and severe pulmonary hypertension (PH).Methods Twenty-five patients with moderate PH (group Ⅱ) and 25 patients with severe PH(group Ⅲ) were selected,30 normal cases were selected to be control group(group Ⅰ).Tricuspid annular systolic peak velocity (S'),right ventricular Tei index(RIMP),tricuspid annular planet systolic excursion(TAPSE) and right ventricular fractional area change(RVFAC) were measured by conventional ultrasound echocardiography.Right ventricular end diastolic volume (RVEDV),right ventricular end systolic volume (RVESV),right ventricular stroke volume (RVSV) and right ventricular ejection fraction (RVEF) were measured by RT-3DE.The correlation between all the parameters and pulmonary artery systolic blood pressure (PASP),and the correlation between RVEF and S',RIMP,TAPSE,RVFAC were analyzed respectively.Results The differences of RVEDV,RVESV,TAPSE,RVFAC in each group were all statistically significant (all P ＜0.01);RIMP,RVEF between group Ⅰ and group Ⅱ,as well as between group Ⅰ and group Ⅲ were statistically significant (all P ＜0.01);S',RVSV only between group Ⅰ and group Ⅲ was statistically significant (P ＜0.01).The correlation coefficients of RVEF and RIMP,S',TAPSE,RVFAC were-0.707,0.402,0.574,0.763,respectively (all P ＜ 0.01).The best parameters associated with RVEF in each group were RVFAC,RIMP,RVFAC,which correlation coefficients were 0.787,-0.679,0.744,respectively (all P ＜0.01).Conclusions RT-3DE is a objective and accurate method to evaluate the right ventricular volume and RVEF in patients with moderate and severe PH,and it can select out the sensitive indicators to evaluate those patients' right ventricular systolic function from conventional echocardiographic parameters,provide important reference value for clinical.

Humans ; Occupational Diseases ; prevention & control ; therapy ; Radiographic Image Enhancement ; instrumentation ; X-Rays

Tryptophan (TRP) is an essential amino-acid and the precursor of many signaling molecules. Under the catalysis of indoleamine 2, 3-dioxygenase, kynurenine pathway can form its metabolites uroquinolinic acid and quinolinic acid, which is the main channel of TRP metabolism.Through different mechanisms in N-methyl-D-aspartate receptor, they participate in nervous modulation, affect cognitive processes and play an important role in many central nervous system diseases development. Kynurenine pathway is different under physiological and pathological conditions. In addition, there are many rate-limiting enzymes in the kynurenine pathway, which can interfere kynurenine pathway. This article reviews the relationship between tryptophan/kynurenine pathway and cognitive dysfunction.

Objective To assess the left ventricular systolic function in young strength male athletes by three-dimensional speckle tracking echocardiography (3D-STE).Methods A total of 45 young strength male athletes (athlete group) and 30 healthy young men (control group)were enrolled.Traditional echocardiography combined with 3D-STE were applied for all the subjects to obtain heart rate (HR),left ventricular end-diastolic diameter (LVEDD),the thickness of interventricular septum (IVS) and posterior wall thickness (PWT),relative wall thickness (RWT),left ventricular end-diastolic volume (EDV),endsystolic volume (ESV),left ventricular ejection fraction(LVEF),stroke volume (SV),left ventricular mass (LVM),left ventricular global longitudinal strain (GLS),global circumferential strain (GCS),global area strain (GAS),global radial strain (GRS).Results There were a significant increase inLVEDD,IVS,PWT,RWT,EDV,ESV,SV,LVM and significant decrease in HR,GLS,GCS,GAS and GRS in athlete group compared with the control group (P ＜ 0.05).However,there was no significant difference in LVEF between two groups (P ＞0.05).Conclusions There are subclinical changes of left ventricular systolic functionin of young strength male athletes.3D-STE can accurately assess the changes,and provide reliable information for clinical assessment of athletes' heart function.

Objective:To investigate the level of peripheral blood regulatory T cells in rheumatoid arthritis (RA) patients with cardiovascular disease (CVD) and its clinical significance.Methods:A total of 191 patients with RA in the Department of Rheumatology and Immunology, the Second Affiliated Hospital of Shanxi Medical University and 86 healthy controls (HCs) were enrolled from January 2019 to January 2021. All peripheral blood CD4 + T lymphocyte subsets of participants were assessed by flow cytometry. Patients were divided into RA-CVD group ( n=71) and RA only group ( n=120) and their clinical data were recorded. The differences between the groups were analyzed by Independent-Samples t test, Mann-Whitney U test or χ2 test, and risk factors that affected CVD were analyzed using Logistic regression. Results:① The age of patients and the proportion of male patients in the RA-CVD group were significantly higher than those in the RA only group [age: (64±10) years old vs (56±12) years old, t=-4.16, P<0.001; male patients: 35 cases vs 31 cases, χ2=10.86, P=0.001]. ② The level of Treg cells in the peripheral blood of patients with RA only and RA-CVD groups was significantly lower than that of HCs ( Z=-4.14, P<0.001; Z=-6.27, P<0.001), while the numbers of peripheral Th17 cells in the two groups of patients were not significantly different from those of HCs ( P>0.05). The ratios of Th17/Treg cells in the two group patients were higher than those of HCs, but only the difference between RA-CVD patients and HCs was significant ( Z=-5.49, P<0.001). ③ Compared with the RA only group, the absolute number of Treg cells in peripheral blood of RA-CVD group was significantly lower [19.00(13.62, 26.73) vs 24.94 (19.32, 34.12), Z=-3.19, P=0.001], the level of Th17 cells was significantly higher [absolute number: 7.77 (3.86, 13.64) cell/μl vs 5.59 (3.49, 8.91) cells/μl, Z=-2.14, P=0.033; percentage: 1.37%(0.78, 2.00)% vs 0.80%(0.56, 1.24)%, Z=-4.20, P<0.001], and the ratio of Th17/Treg cells was significantly higher [0.40(0.24, 0.62) vs 0.23(0.14, 0.35), Z=-4.46, P<0.001]. ④ Logistic regression analysis showed that Treg cell [ OR(95% CI)=0.934 (0.903, 0.967)] was a protective factor, while elder age [ OR(95% CI)=1.038(1.003, 1.074), male [ OR(95% CI)=2.450(1.005, 5.973)], hypertension [ OR(95% CI)=2.654 (1.219, 5.779)] and Th17 cell [ OR (95% CI)=1.066 (1.019, 1.116)] were risk factors of RA complicated with CVD. Conclusion:The level of Treg cells in peripheral blood of RA patients with CVD decreases significantly, and the immune imbalance of Th17/Treg is more singificant than that of RA patients without CVD. It is suggested that the immune imbalance and dysfunction caused by the number and/or functional deficiency of Treg cells may be involved in the occurrence and development of RA complicated with CVD.

Objective:To investigate the level and clinical significance of peripheral blood CD4 +T cell subpopulations in late-onset systemic lupus erythematosus (SLE) patients. Methods:This study included 260 SLE patients hospitalized in the Rheumatology and Immunology Department of the Second Hospital of Shanxi Medical University from January 2016 to December 2021: of whom 58 and 202 were late- (≥50 years) and adult-(18~49 years) onset patients. This study also included 160 subjeces as healthy controls(HCs), of whom 35 and 125 were Control Group 1 (≥50 years) and Control Group 2 (18~49 years). Peripheral blood CD4 +T lymphocyte subsets of these participants were assessed by flow cytometry. The clinical data of all patients and healthy controls (HCs)were recorded. The differences between the groups were analyzed by Mann-Whitney U test or χ2 test. Results:(1)The time of diagnosis of late-onset SLE was longer than that of adult-onset SLE [Median time: 5.0 (2.0, 24.0)months vs 3.0 (1.0, 7.3)months, Z=-3.13, P=0.002]. Compared with adult-onset SLE, the SLEDAI score of late-onset SLE was lower [12.0 (8.0, 15.2) vs 14.0 (10.0, 18.0), Z=-2.12, P=0.034]. Some manifestations occurred more frequently in late-onset SLE, such as weight loss, nausea, abdominal pain, cerebral infarction, interstitial pneumonitis, Sj?gren′s syndrome and infection. The manifestations of skin and mucos a occurred less frequently in late-onset SLE. (2)CD4 +T cell subpopulations: ①The absolute counts of Treg, Th17, Th1 and Th2 cells in the peripheral blood of patients with late-onset SLE were significantly lower than those of HCs [Treg: 10.94 (6.14, 19.23) vs 32.65 (28.07, 41.65), Z=-6.79, P<0.001; Th17: 3.43 (0.94, 5.64) vs 6.13 (3.77, 7.82), Z=-3.24, P=0.001; Th1: 36.02 (10.80, 76.38) vs 128.70(89.82, 159.89), Z=-5.29, P<0.001; Th2:3.56 (1.56, 6.06) vs 8.25 (4.69, 12.98), Z=-4.57, P<0.001]. The ratio of Th17/Treg cells was higher than that of HCs[0.28(0.13, 0.59) vs 0.17 (0.12, 0.28), Z=-2.38, P=0.017].②The absolute counts of Treg, Th17, Th1 and Th2 cells in peripheral blood of patients with adult-onset SLE were significantly lower than those of HCs [Treg: 10.28 (5.37, 17.04) vs.30.19 (21.20, 39.75), Z=-11.28, P<0.001; Th17: 3.44 (1.84, 6.14) vs 6.48 (4.23, 10.66), Z=-6.53, P<0.001; Th1: 29.59(15.14, 56.81) vs 90.75(42.67, 162.00), Z=-7.01, P<0.001; Th2: 2.74 (1.62, 4.77) vs 8.25 (4.75, 11.99), Z=-9.91, P<0.001]. The ratio of Th17/Treg was higher than that of HCs[0.35 (0.17, 0.65) vs 0.23(0.14, 0.37), Z=-3.89, P<0.001].③The ratios of Th17/Treg in patients with late-and adult-onset SLE were higher than those of HCs. The ratio of Th17/Treg was the highest in adult-onset SLE patients. Conclusion:Patients with late-onset SLE have reduced numbers of Treg cells and the immune imbalanced of Th17/Treg. However, the immune imbalance of Th17/Treg in late-onset SLE patients is milder than that in adult-onset SLE patients, which may be related to lower disease activity.