Objective To evaluate regional myocardial mechanical dysfunction of left ventricle in patients with ECG T-wave inversion using echocardiographic velocity vector imaging.Methods One hundred nineteen female patients with T wave inversion divided into three groups:V1-6 T-wave inversion group(52 patients),V1-4 Twave inversion group (33 patients),V3-6 T-wave inversion group (34patients),while selected 44 healthy women in control group.Peak systolic radial strain (SRSmax) and strain rate (SRSrmax),peak systolic circumferential strain (SCSrmax) and strain rate (SCSmax) were derived and compared from three short-axis views of left ventricle at 18 wall segments using a dedicated Syngo VVI software and workstation,and the depth of T-wave inversion in different precordial lead was measured and correlated with mechanics parameters between four groups.Results In V1-6 T-wave inversion group,each mechanical variable of anteroseptal,anterior,anterolateral and inferolateral walls decreased (P ＜0.05-0.01).In V1-4 T-wave inversion group each mechanical variable of anteroseptal,anterior and inferoseptal walls declined (P ＜0.05-0.01).In V3-6 T-wave inversion group four mechanical variables(i.e.,SRSmax SRSr SCSmax and SCSrmax) of anteroseptal,anterior,anterolateral and inferolateral walls reduced,mainly at basal segment (P ＜0.05-0.01).The ventricular segments of reduced SRSmax,SRSrmax and SCSrmax in V1-6 T-wave inversion group and of SRSrmax in V3-6 T-wave inversion group were more than those in V1-4 T-wave inversion group (P ＜0.05-0.01).In V1-6 T-wave inversion group,negative correlationships between radial mechanical variables of anteroseptal wall and the depths of V4 and V5 lead T-wave inversion were found (r =-0.29--0.37,P ＜0.05-0.01).Otherwise a positive correlationships between SCSmax of anterolateral wall and the depth of V3 lead T-wave inversion were established (rs =0.44,P =0.01) in V1-4 T-wave inversion group.Conclusions There is a regional myocardial dysfunction of LV in female patients with ECG T-wave inversion.The extent of electrical repolarization abnormality is correlated to the severity of regional myocardial dysfunction.

Objective To develop an in vivo procedure f or His bundle pacing (HBP) and radio-frequency (RF) ablation of the atrio-ventricular node (AVN) guided by intracardiac echocardiography (ICE) and tissue Doppler imaging (TDI). The procedure included a custom designed bipolar active fixation pacing lead and steerable delivery catheter, and a commercial RF generator and ablation catheter. Methods Six anesthetized- closed-chest canines were tested. The anatomy in the His bundle and AVN regions, and the onset of myocardial electro-mechanical activation were identified using ICE and TDI. The lead and RF ablation catheter were navigated using an ICE catheter (for local detailed imaging) and fluoroscopy (for global imaging). Surface QRS morphologies were recorded to confirm HBP and third degree block post-ablation. Results Direct His bundle pacing was achieved in one canine, and His + ventricular septal pacing in the remaining five. QRS width in sinus rhythm and HBP were ( 59.7-? 5.3-)ms and ( 82.8-? 16.6-)ms separately (P= 0.02-). The increased QRS width for HBP was due to early septal activation. HBP thresholds were ( 3.0-? 1.0-) volts at 0.5 ms (N=5 due to a late exit block). The mean procedure durations were: HBP 40 minutes (3 to 81 minutes), AVN ablation 3 minutes (2 to 5 minutes), and total X-ray exposure 13 minutes (1 to 55 minutes). Post-mortem analysis of the lead and ablation lesions confirmed correct anatomic localization for HBP and AVN ablation. Conclusions ICE provides precise anatomic guidance of HBP lead implantation and AVN ablation and can significantly reduce exposure to fluoroscopy.

Objective To detect stunned myocardium using low-dose dobutamine stress (DBS)combined with two-dimensional speckle tracking imaging (2D-STI),and to evaluate the difference and characteristics of mechanical parameters in different conditions between stunned myocardium and adjacent normal myocardium.Methods The acute myocardium ischemia/reperfusion (I/R) of anterior wall of left ventricle(LV) was induced with 60 minutes ligation of left anterior descending coronary artery (LAD),and with reperfusion of 120 minutes in 10 open-chest beagle dogs.Dobutamine was administered continuously via vein with two different dose of 5 μg · kg-1 · min-1 and 10 μg · kg-1 · min-1.At baseline,post ischemia/reperfusion,after the first DBS and the second,the gray-scale dynamic images of three cardiac cycle of left ventricular short axis at the levels of mitral annulus,papillary muscle and apex were acquired.The systolic peak of circumferential strain (CS),radial displacement (RD) of eighteen segments of subendocardium and subepicardium were analyzed by Speckle tracking workstation.LV end-systolic dimension(LVIDS),LV end-diastolic dimension (LVIDD),LV eject fraction (LVEF),heart rate (HR),aortic valve forward flow velocity time integral(AV-VTI) were also measured.Results ①There was no statistical significance (P ＞0.05) under the conditions of baseline,post I/R,the first DBS and the second for LVIDD,LVIDS,LVEF,HR and AV-VTI.②Compared with baseline,the peak systolic subendocardium and subepicardium CS,RD decreased significantly at the apex and middle of short-axis anterior wall of LV under the conditions of post I/R;The parameters of the first DBS was significantly increased compared with the I/R (P ＜ 0.05) ; There was no difference between the two DBS and baseline(P ＞0.05).The peak systolic subendocardium and subepicardium CS,RD at the bottom segment of LV were no statistical significance under the four conditions.③There was no difference for anterolateral wall and anterior septum of LV at the level of papillary muscle under the four conditions.Conclusions ①Low-dose DBS combined with two-dimensional speckle tracking imaging can detect stunned myocardium accurately.② After the occurrence stunning myoeardium,the peak systolic subendocardium RD decreased slightly,subepicardium RD was normal,the subendocardium CS of the surrounding myocardium was still normal,and the peak systolic subepicardium CS decreased to some degree.

Objective To evaluate the effectiveness of mindfulness-based stress reduction( MBSR) on anxiety and depression in spouses of breast cancer patients and to analyze the mediating effect of caregiver burden for the training effects. Methods Randomized control trial was used in this research.100 spouses of breast cancer patients were recruited and they were randomized into experimental group or control group. 91 of them completed the study finally (45 in experimental group and 46 in control group). Participants in con-trol group received no intervention,while participants in experimental group received MBSR once a week for 8 weeks. All participants were assessed with the Zarit Caregiver Burden Interview ( ZBI,measuring caregiver burden) ,Beck Depression Inventory( BDI,measuring depression level) and Hamilton Anxiety Scale( HAMA, measuring anxiety level) before and after intervention. Results After 8-week intervention,participants in experimental group got significantly lower total scores of ZBI,BDI and HAMA compared with pretest ((22.31 ±5.76) vs (25.98±6.00),(8.47±3.21) vs (11.87±3.51),(14.98±4.75) vs (17.93±4.65), P<0. 01), while there were no significant differences between posttest and pretest on any score in control group (P>0.05).Caregiver burden played mediating effect in MBSR for improving depression,and mediating effect was 56.6% of the total effect. Conclusion MBSR can effectively improve anxiety and depression with the spou-ses of breast cancer patients,and the caregiver burden is the intermediary variable in the effect of MBSR for improving depression.

Objective To establish the preferable puberty pathological aggression animal model.Methods The experimental models were established towards puberty rats by frustration test of non-reward and instigation test.Rat models were tested for specificity using open-field test,saccharine test,elevated plus-maze(EPM)and olfactory sensibility.Results ①Compared with normal aggression(52.5±5.36)and control group(8.83±1.34)in total aggressive times,the pathological aggression group(101.17±2.85)increased significantly(P<0.01);②Some behavior items of each model group were moderately or hishly correlated to total score(r=0.379～0.929);③There was a significant difference between pathological aggression group and normal aggression group in the numbers of attack toward vulnerable-body regions,persistence attack after intruder displayed submissive and hish attack/threat ratios(P<0.01);④The pathological aggression group did not show depression,anxiety and olfactory disorder,except for space cognitive function(P>0.05).However,the normal aggression group displayed obvious depressive mood.Conclusion Each behavioral index matches the criteria of pathological aggression model.Meanwhile,it also excludes other factors of disturbing the specificity of the model.It suggests this model may be preferable puberty pathological aggression animal model.

OBJECTIVE To investigate the prevalence of erythromycin resistance genes ermB and mefA and the relationship of drug resistance and genes in Streptococcus pneumoniae.METHODS Forty three strains of S. pneumoniae were collected from respiratory system infected children from Dec 2004 to Oct 2005 at Yuying Pediatric Hospital of Wenzhou Medical College.Erythromycin sensitivity test was done by using MIC method.The erythromycin resistance genes ermB and mefA were detected by PCR.RESULTS In all forty three strains,forty were erythromycin resistant(93%),three were erythromycin sensitive.The total detection rate of erythromycin resistance genes ermB and mefA was 76.7% and 23.3%,respectively.There were neither gene ermB nor gene mefA in 3 erythromycin-sensitive S.pneumoniae.In 40 strains the detection rate of gene ermB was 82.5% and that of gene mefA was 25%.The erythromycin resistance gene ermB or mefA were detected in 35 of the 43 strains.The total detection rate of erythromycin resistance gene was 81.4%.In the 35 erythromycin resistance strains there were 25 strains in which gene ermB existed lonely and 2 strains in which gene mefA existed lonely.There were both genes ermB and gene mefA in 8 of the 35 erythromycin resistance strains.CONCLUSIONS The erythromycin resistance of S.pneumoniae can be caused mainly by gene expression of ermB or mefA,but the gene mefA seems to be less important than gene ermB.Obviously the erythromycin isn′t useful in treating S.pneumoniae infection.

Objective To observe left ventricular transmural peak radial strain and strain time-to-peak of peri-infarct different layers myocardium using tissue Doppler strain imaging, to assess its mechanical pattern during acute myocardial ischemia.Methods Left anterior descending coronary artery (LAD) were ligated in experimental open-chest Beagle dog models (n = 9),the two-dimensional apical short-axis views of left ventricle in three complete cardiac cycles were acquired and stored in TDI-Q workstation at baseline(the control group of peri-infarc myocardium) and during acute myocardial ischemia respectively.Sampling volume was uesd to measure the peak radial strain and the strain time-to-peak consesquently on the derived M -mode tissue Doppler velocity images at peri-infarct myocardium before and after ischemic segments and different layers(subendocardium, medium, subepicardium).Statistical analies was performed using student's t- test or Pearson's correlations.Results Peak radial strain decreased at peri-infarct subendoeardium (P<0.05) with no significant difference between those at baseline and at peri-infarct medium (P >0.05), the peak radial strain increasd at peri-infarct subepieardium (P < 0.05) ,and the strain time-to-peak at different layers of peri-infarct myoeardium was significantly postponed (P< 0.05).There was a good correlationship of peak radial strain between subendocardium and segment as well as between the medium and segment (r = 0.617, P<0.01 ; r = 0.556, P<0.01).This correlationship disappeared at peri-infarct myocardial segment (r = 0.287, P > 0.05, r = 0.243, P > 0.05).Conclusions The left ventricular transmural mechanical remodeling at peri-infarct myocardium is the integrant of result of mechanical interactions between ischemic and nonischemic myocardium,which might be one of the trigger the structural and fundational remodeling processes involving in the pathophysiological foundation of ischemie cardiomyopathy.

To explore the therapeutic efficacy of extracorporeal shock wave (ESW) for persistent heel pain.A total of 98 patients of persistent heel pain were randomly divided into ESW treatment and control groups (n =49 each).Treatment group had ESW while control group received infrared physical therapy.And their visual analogue scale (VAS) scores were assessed.After one course of treatment, VAS heel pain and function scores were (39.6 ± 6.2) and (25.1 ± 4.6) in ESW group versus (32.3 ± 6.5) and (17.4 ±7.2) in control group.And before treatment, (16.5 ±4.6) and (14.4 ±8.6), (16.1 ±4.7) and (14.6 ± 8.4) respectively.Heel pain significantly decreased with functional improvement (all P ＜ 0.05).After one course, the effective rate was 65％ (32/49) in treatment group.And the improvement rate of 31％ (15/49) was better than control group [27％ (13/49) and 63％ (31/49)] (all P ＜ 0.05).ESW treatment of persistent heel pain was more efficacious than physical therapy and it could be applied clinically.

Objective To investigate the relationship between family function and unhealthy mood in patients with vascular dementia (VD).Methods 120 VD patients were investigated by the Family APGAR index (APGAR),Hamilton Depression Scale (HAMD),Hamilton Anxiety Scale (HAMA),and Mini-Mental State Examination (MMSE).Results 98 cases (81.7％) were in depression with anxiety.Family dysfunction was presented in 83.3％ of 120 VD patients.The mild and moderate cognitive impairment were present in 55.8％ and 44.2％.The score of MMSE,the total score and factors scores of APGA were negatively related to the score of HAMD and HAMA.The score of MMSE was positively related to the total score and factors scores of APGA.The family dysfunction,self-reported financial burden and cognitive disorder were the risk factors of unhealthy mood (OR＞1).Conclusions The results suggest that improvement of VD patients' family function,reducing the economic burden and enhancing cognitive function can possibly relieve the unhealthy mood of patients.

Objective To investigate the effects of miR-335-5p on the proliferation and apoptosis of osteoblasts which were exposed to high glucose condition, and explore its possible molecular mechanisms. Methods MC3T3-E1 osteoblasts were divided into four groups:control group(5. 5 mmol/L glucose), high glucose group(HG group, 22. 0 mmol/L glucose), agomir-335-5p group(transfected with agomir-335-5p and exposed to 22. 0 mmol/L glucose) , and agomir negative control group( agomir NC group, transfected with agomir negative control and exposed to 22. 0 mmol/L glucose), cultured for 7 days. Cell proliferaton, cell apoptosis, expressions of miR-335-5p and dickkopfhomolog1(DKK1)mRNA,proteinlevelsofDKK1andcysteinylaspartate-specificproteinase-3(caspase-3) were detected using MTT, flow cytometry, quantitative realtime PCR and western blot, respectively. Results Compared with control group, the expression of miR-335-5p mRNA and cell proliferation in HG group were significantly decreased(P<0. 05), while cell apoptosis and the protein levels of DKK1 and caspase-3 were increased significantly(P<0. 05), the expression of DKK1 mRNA did not change (P>0. 05). The miR-335-5p mRNA expression and cell proliferation in agomir-335-5p group were higher than those in HG group and agomir NC group(P<0. 05). However, Cell apoptosis and the protein levels of DKK1 and caspase-3 in agomir-335-5p group were lower than those in HG group(P<0. 05). Conclusion High glucose inhibits the proliferation and induce the apoptosis of MC3T3-E1 osteoblast through decreasing the expression of miR-335-5p and subsequently increasing the DKK1 expression.