Animals ; Antineoplastic Agents ; therapeutic use ; Apoptosis ; Apoptosis Regulatory Proteins ; metabolism ; Autophagy ; physiology ; Beclin-1 ; Humans ; Membrane Proteins ; metabolism ; Neoplasms ; drug therapy ; metabolism ; pathology ; Signal Transduction ; TOR Serine-Threonine Kinases ; metabolism ; Tumor Suppressor Protein p53 ; metabolism

Objective To investigate the alternation of left ventricular systolic function in patients underwent transcatheter aortic valve implantation operation(TAVI) by three-dimensional speckle tracking technology (3D-STI).Methods Totally 20 patients with severe aortic stenosis were enrolled.All the subjects underwent successful TAVI operation.The real-time 3D full volume datasets on apical four-chamber view were acquired on before,7 days and 1 month after TAVI.Left ventricular global longitudinal strain(GLS),regional peak systolic longitudinal strain(LS),regional peak systolic circumferential strain(CS) and regional peak systolic radial strain(RS),were analysed using off-line TomTec software,the differences among the three groups were compared.Results Compared with the preoperation,aortic valve blood flow velocity (AV),mean aortic valve pressure gradient(mPAG) of 7 days after operation decreased significantly.Threedimensional left ventricular ejecation fraction(3D-LVEF) among the patients whose 3D-LVEF under 50％had a remarkable increase and whose 3D-LVEF exceed 50％ before operation had no significant change,while 1 month after operation the 3D-LVEF had a significant improvement compared with the preoperational data regardless of 3D-LVEF under 50％ or not.The GLS and LS of all segments of 7 days after TAVI were higher than pre-operation(all P ＜0.05),and it had a further improvement 1 month after TAVI.Conclusions LV systolic function had improvement early after TAVI.3D-STI is a new,convenient way to detect the global and regional left ventricular systolic function of TAVI patients.

PurposeTo investigate the image quality of Dual Source CT (DSCT) high pitch prospective scan in acute chest pain examination by using triple-rule-out (TRO) protocol and its responses to heart beat rate change.Materials and Methods Thirty-two consecutive patients who planned to undergo TRO acute chest pain examination were enrolled and randomly divided into research group and control group. The conventional retrospective spiral scanning protocol was applied to the patients in the control group, while the high pitch prospective spiral scanning mode was used in the research group. CT value, noise level, SNR, CNR and radiation dosage in aorta and pulmonary arteries were recorded and compared between the two groups, and the image quality of the coronary arteries was scored subjectively.Results No significant difference was found in the aspects such as CT value, noise level, SNR, CNR radiation dosage in aorta and pulmonary arteries (P>0.05); however, the subjective scoring for coronary artery in the research group (85.5%) was significantly lower than that in the control group (93.9%) (χ2=8.33,P<0.05). Considering the influence of severe heart rate changes, we excluded those patients whose heart rate variance was more than 5 beats/min (control group:n=5; research group:n=4) and then compared the image quality of the two groups again. The subsequent results showed no difference (χ2=0.12,P>0.05). In addition, the radiation dosage in the control group was significantly higher than that in the research group [(20.8±6.2) mSvvs. (2.3±0.4) mSv;t=17.142,P<0.01].Conclusion DSCT high pitch prospective scanning in TRO protocol shows high success rate in examining patients with acute chest pain whose heart beat rate is lower than 80 beats/min and heart beat variance is less than 5 beats/min. The image quality has no difference with that derived from retrospective scan but with far more less radiation dose (2.3±0.4) mSv. This method thus is promising and can be widely promoted clinically.

In order to induce heavy Pneumocystis pneumonia, rats were treated with dexame-, thasone twice a week for 14 weeks. Mature cysts, immature cysts and ruptured cysts were, identified on lung imprints. By phase-contrast microscopy mature cysts were spherical in, shape containing intracystic bodies both spherical and irregular, small to large trophozoites having polymorphic shapes, one nucleus and many vacuoles. Elcctro-microscopically, large amount of irregular trophozoites adhered to the surface of the type I alveolar epithelial cells in the alveolar cavity were observed. The above histological findings were typical features of Pneumocystis pneumonia (Figs. 1-8).

Objective To discuss the clinical value of application of three-dimensional reconstruction technique of MSCT in examination of colonic tumours.Methods Thirty patients underwent scanning using helical CT and post-processing on the workstation.All CTC images were reconstructed using shaded surface display (SSD) on workstation.Perspestive images such as the ones from DCBE were generated via raysum.The images could clearly demonstrate the extent and detail of the disorder by adjusting the CT value threshold.These results and that of barium enema and colon endoscopy were compared.Results Thirty cases had completely clinical and pathological data.3D images could correctly reveal the macroscopic morphology of colon tract and location of lesions.The correctly diagnostic rate was 100％ by MSCT,while the diagnostic rate by CTVE and colon endoscopy was basicly identical.Conclusion With the utilization of multiple methods,3D reconstruction can effectively demonstrate colonic tumours,and can be applied routinely in examination of colonic tumours.

Purpose To study the expression of Ech1 in hepatocarcinoma and its clinical significance, and to explore the relationship between subcellular location of Ech1 and malignant biologic behaviour of hepatocarcinoma. Methods Immunohistochemical analysis was used to detect Ech1 expression in the 20 cases of normal liver tissue and the 30 cases of hepatocarcinoma. Subcellular location of Ech1 in Hca-F and FEch1-down cell was observed with subcellular protein extraction. Results The expression of Ech1 in primary hepa-tocarcinoma was increased compared to that of normal liver tissues ( P<0. 05 ) , while there was no significant difference between the expression of Ech1 with the age, AFP, and with or without liver cirrhosis or hepatitis virus in hepatocarcinoma (P>0. 05). Ech1 was found expressed almost at the same location although the expression level one is normal and the other is downregulation. Ech1 expres-sion was found in cytosol, membrane fraction, and its expression was higher in cytosol than other fractions both in Hca-F cell and Ech1 downregulated Hca-F cell. Conclusions The expression of Ech1 in primary hepatocarcinoma was increased, which may indicate that Ech1 is a critical factor in the development of primary hepatocarcinoma, but the subcellular location of Ech1 has not much contribution to that.

Objective To study the the feasibility of real-time 3D transesophageal echocardiography (RT-3D TEE) in measuring the distance between the coronary artery ostia and the aortic annulus.Methods RT-3D TEE image of aortic root was collected intraoperatively in 18 cases who were refered to our center for transcatheter aortic valve implantation.The aortic annulus was reconstructed and the height of the annulus (H) was generated.Meanwhile RT-3D TEE and MDCT was used to determine the left coronary artery ostia-aortic annulus distance (E-LAA,C-LAA) and the right coronary artery ostia-aortic annulus distance (E-RAA,C-RAA).Results The display rate of right coronary artery was 94.4％ (17/18),with the left coronary artery 88.9％ (16/18) on the RT-3D TEE imaging.The height of the annulus(H) was lower than the distance between the coronary artery ostia and the aortic annulus(P ＜0.05).No statistically significant differences was found in the parameters of the distance between the coronary artery ostia and the aortic annulus between RT-3D TEE and MDCT (P ＞0.05).Conclusions RT-3D TEE imaging can display and measure the distance between the coronary artery ostia and the aortic annulus.

Objective To discuss the preliminary experience of transcatheter aortic valve implatantion in patients with severe aortic valve stenosis. Methods The baseline characteristics, hemodynamic changes and clinical outcomes of the patients received TAVI in our institution were analyzed. Results A total of 36 patients underwent TAVI between April 2012 and March 2014. The mean age was (73.4±8.7) years and 24 (66.7%) of them were men. The mean logistic EuroSCORE was (20.6±9.9)%. 25(70%) patients had bicuspid aortic valves. TAVI was successful in 35 patients (97.2%) and valve-in-valve implantation was required in 4 (11.1%) of them. After the procedure, the mean aortic-valve gradient reduced to (10.5±5.7) mmHg. In 2 patients (5.6%), there was marginal moderate periprosthetic leak. At 30 days, the survival rate was 97.2%. Two patients (5.6%) developed who later showed fuel recovery, without significant sequela. Permanent pacemakers were implanted in 10 patients (27.8%) due to the onset of third-degree atrioventricular block after TAVI. To date, the median follow-up duration has exceeded 323 days. 2 patients died of cancer on 374 days and 680 days after TAVI, respectively. Conclusions TAVI is feasible, safe and effective in treating severe stenosis of bicuspid as well as tricuspid aortic valve in selected Chinese patients unsuitable for surgery.

Objective To explore the feasibility of biplane-transesophageal echocardiography (Bip-TEE) in measuring the aortic annulus dimension (AAD).Methods Totally 24 patients underwent transcatheter aortic valve implantation (TAVI) were collected,and their AAD was measured by two-dimensional transthoracic echocardiography (2D-TTE),two-dimensional transesophageal echocardiography (2D-TEE),Bip-TEE and three-dimensional transesophageal echocardiography (3D-TEE) respectively.These four methods were compared with each other.The correlation between 3D-TEE measures and other three methods were analyzed.Results The AAD measured by 2D-TTE,2DTEE,Bip-TEE and 3D-TEE were (22.02±2.21)mm,(23.34±2.34)mm,(23.89±2.37)mm,(24.21±2.78)mm,respectively.The differences among 4 groups was significant (F=3.88,P=0.01).No statistically significant differences were found between Bip-TEE and 3D-TEE,2D-TEE and 3DTEE,Bip TEE and 2D-TEE (all P＞0.05).There were significant differences between 2D-TTE and 2D-TEE,2D-TTE and Bip-TEE,2D-TTE and 3D-TEE (all P＜0.05).The AAD measured by 3D-TEE were positively correlated with that of 2D-TTE,2D-TEE,Bip-TE (r=0.79,0.88,0.94,all P＜0.05).Conclusion Bip-TEE is a feasible method to measure the AAD rapidly and can provide reliable measurements for the prosthetic valve size in TAVI.

Objective To study the feasibility and accuracy of real-time three-dimensional transesophageal echocardiography (RT 3D-TEE) in measuring the aortic annulus dimension(AAD),and compared with CT measurements.Methods The AAD was measured by transthoracic echocardiography (TTE),transesophageal echocardiography(TEE) and RT 3D-TEE in 26 cases who were refered to our center for transcatheter aortic valve implantation(TAVI).Cross-sectional RT 3D-TEE can offer the AAD derived from the aortic annulus area,the maximal AAD,the minimal AAD and the eccentric index(the maximal AAD/the minimal AAD).The echo dimensions were compared with the CT measurements.Results No statistically significant differences were found between RT 3D-TEE and CT,and they have the best correlation(r =0.92,P ＜ 0.05).Meanwhile,There was no statistically significant difference in the eccentric index of the AAD between RT 3D-TEE and CT(1.25± 0.12 vs 1.28± 0.13,P ＞0.05).Conclusions RT-3D TEE imaging not only measure the AAD accurately,but also provide the maximal AAD,minimal AAD and the eccentric index for TAVI.