Objective To validate the accuracy of real-time three-dimensional echocardiography(RT3DE) in measuring spatial geometric parameters of mitral annulus.Methods Hearts in vivo of nine healthy hybrid canines were examined by RT 3DE.Three-dimensional full-volume images of mitral annuli were acquired.The annuli were annotated and measured by TomTec 4D MV-assessment software and MATLAB.The distance between anterolateral and posteromedial commissure (commissure-commissure, CC),septolateral distance (septal-lateral, SL) and height (H) of mitral annulus were measured.Parameters correlation coefficients of CC,SL and H derived by two methods were 0.83( P＜0.01),0.78( P＜0.05)well consistent with anatomic measurements, the mean differences of CC, SL and H between two methods were 0.22 cm,0.12 cm and-0.08 cm respectively.Conclusions RT-3DE is feasible in measuring mitral annulus, which provided a convenient, accurate and reliable new method for quantitative assessing annulus geometry configuration.

Objective To explore the value of transthoracic echocardiography in diagnosis of univentricle and analyze the sonogram typing. Methods The results of 66 patients with univentricle were reviewed retrospectively,and analayzed their typing connected with the reports in the literature. Results There were 3 ultrasonic types in 66 cases:①Type A(single left ventricle) 19 cases,single ventricle with left ventricular shape,residual cavity in front of it. ②Type B(single right ventricle) 38 cases, single ventricle with right ventricular form,and residual cavity in the rear.③Type C (solitary single-ventricle) 9 cases,there was only one ventricle. Thirty-one of them were treated surgically, 5 cases without operation had MRI or cardiac catheterization examination and the remaining 26 patients were only observed by echocardiography,the positive rate of diagnosis in type was 100%, the results were compared with cardiac catheterization or MRI examination and the operation: 1 cases of mixed type total anomalous pulmonary venous connection was misdiagnosed as heart-type total anomalous pulmonary venous drainage. But 1 case of descending aorta limitations narrow complicated patent ductus arteriosus(PDA), PDA was missed. The rest were completely correct diagnosis. Conclusions The transthoracic echocardiography can be used to evaluate types and all containing malformations of univentricle,and offers reliable information for operation.

Objective To evaluate the value of echo‐contrast RT‐3DE for assessment of left ventricular volume and function in patients with left ventricular non‐compaction(LVNC) .Methods Twenty‐one patients of LVNC were involved and underwent non‐enhanced and contrast‐enhanced RT‐3DE to evaluate left ventricular end‐diastolic volume (LVEDV) ,left ventricular end‐systolic volume (LVESV) ,left ventricular ejection fraction (LVEF) .The endocardial border definition of LV was graded for each of the 16 LV segments as follows :0 = border invisible ,1 = border visualized only partially ,and 2 = complete visualization of the border .Three image‐quality groups (good ,fair ,and uninterpretable) were identified . Results ①Duringcontrast‐enhancedRT‐3DE,ascomparedwithnon‐enhancedRT‐3DE,thenumberof segments with complete visualization of the endocardial border increased significantly (55% vs 82% ,P <0.01) ,and the number of patients with a good‐quality echocardiogram increased significantly (33% vs 81% , P <0.01) .②Contrast‐enhanced RT‐3DE provided significantly larger values of LVEDV ( P < 0 0.1) and LVESV ( P < 0 0.1) as compared with non‐enhanced RT‐3DE ,the values of LVEF were not statistically different between the two techniques ( P =0.07) .③Intra‐and inter‐observer agreement for assessment of LV volumes and systolic function improved during contrast‐enhanced RT‐3DE ,as compared with non‐enhanced RT‐3DE .Conclusions Contrast‐enhanced RT‐3DE can increase the prevalence of good‐quality echocardiograms and significantly improve the reproducibility of LV volumes and function measurements .

Objective To understand the status of implementation of invasive ventilator circuit changes in ICU nurses at the 3A general hospitals in Shanxi Province, and mastering and demand of related knowledge of ICU nurses, and by this discuss the possible causes of execution inconsistency in invasive ventilator circuit changes interval so as to provide a clear basis for the specification and circuit changes. Methods After a review of relevant literature at home and abroad as well as expert consultation, a self-designed questionnaire was established, take two ways of on-site issuance and mailing, ICU nurses from 13 hospitals were selected randomly to investigate about the invasive circuit changes interval in Shanxi Province. Results A total of 724 nurses from 34 ICU of 13 hospitals were surveyed. A unified circuit changes interval of ICU accounted for 73.5% (527/717). ICU nurses currently provisions and practical implementation of invasive ventilator circuit changes interval tend to 7 d. Different ICU provisions and ICU nurses actual implementation of circuit change were significantly different (χ2=24.839, 35.760, P < 0.01). Conclusions Hospitals should choose the right way to strengthen the ICU nurses invasive ventilator circuit changes training interval and knowledge, to develop the term for their own security environment, thereby reduce the workload of nurses, reduce medical costs and improve care service quality.

Objective:To detect the characteristics of bacteria in the feces of patients with rheumatoid arthritis (RA) and to further discover the relationship between intestinal flora and the status of peripheral cytokine, which might be able to provide new ideas for clinical treatment.Methods:The bacterial diversity and abundance of 111 RA patients and 100 age-and gender-matched healthy controls (HC) were detected by 16S high-throughput sequencing platform and compared. Based on the 16S rDNA high-throughput sequencing platform, the 16S rDNA V3 region in the participants' fecal specimens were analyzed and compared to screen for different bacterial groups. Alpha diversity was analyzed by the mothur software and the screening for different flora was tested by using Mann-Whitney, and the relationship between intestinal flora and peripheral cytokines were analyzed, too.Results:There was no significant difference in gender ( χ2=0.005, P=0.947) and age ( t=0.728, P=0.467) between the two groups. Patients with RA had a lower chao1 index ( Z=-2.188, P=0.029) and ACE index ( Z=-2.078, P=0.038) of species richness, and the Shannon index ( Z=-2.064, P=0.039) and Simpion index ( Z=-2.064, P=0.039) of diversity index in the feces compared with those of HC. At the genus level, the relative abundance of Bifidobacterium ( Z=-2.388, P=0.017), Lactobacillus ( Z=-2.543, P=0.011), Clostridium sensu stricto ( Z=-3.842, P<0.01), Blautia ( Z=-2.064, P=0.039) , Clostridium Ⅺ ( Z=-2.682, P<0.01), Turicibacter ( Z=-2.437, P=0.015), Phascolarctobacterium ( Z=-3.524, P<0.01), Megasphaera ( Z=-2.87, P<0.01), Veillonella ( Z=-2.472, P=0.013), Citrobacter ( Z=-3.263, P<0.01) and Escherichia/Shigella ( Z=-4.265, P<0.01) in RA were significantly higher than those of HC ( P<0.05), Butyricimonas ( Z=-3.071, P=0.002), Odorbacter ( Z=-2.257, P=0.024), Blautia ( Z=-2.064, P=0.039), Clostridium_ⅩⅣb ( Z=-2.901, P<0.01), Lachnospiracea_incertae sedis ( Z=-2.159, P=0.031), Acetivibrio ( Z=-2.995, P<0.01), Butyricicoccus ( Z=-2.162, P=0.031) and Gemmiger ( Z=-2.949, P<0.01) relative abundance were significantly decreased in RA patients ( P<0.05). LEfSe analysis showed γ-proteobacteria and Lachnospiraceaehad the most significant difference between the two groups. Further, patients with high inflammatory cytokines such as IL-17 and TNF-α hada higher relative abundance of Prevotella. Conclusion:The diversity and abundance of intestinal flora in RA patients are significantly different from those of healthy population, which is closely related to the levels of inflammatory cytokines, suggesting imbalance of intestinal flora might be involved in the occurrence and development of RA.

The application of real-time three-dimensional echocardiography (RT 3DE) in the diagnosis of double orifice mitral valve (DOMV) was explored. Five cases of DOMV were examined by using 2-dimensional echocardiography (2DE) and RT 3DE. The spatial morphology of malformed mitral valve and its change in hemodynamics were observed. DOMV associated with partial atrioventricular septal defect was found in 3 cases (in which 2 cases had cleft mitral valve) and isolated DOMV in 2 cases; and moderate to severe mitral regurgitation was detected in 3 cases, and mild mitral regurgitation in 1, and no regurgitation in 1 case; 1 case had complicated rhumatic heart disease. Three cases were preoperatively discovered by 2DE, while 2 missed (1 case was discovered postoperatively). Four cases were diagnosed by RT 3DE preoperatively, and 1 case was diagnosed postoperatively (not examined by RT 3DE preoperatively). It was suggested that RT 3DE is a reliable technique in the diagnosis of DOMV; it permitted comprehensive and noninvasive assessment of mitral valve and may supplement 2D TTE in the assessment of DOMV.

Objective To observe the value of two-dimensional speckle tracking imaging (2D-STI) in assessing regional myocardial viability of rats after acute myocardial infarction. Methods Twenty Wistar rats were randomly divided into acute myocardial infarction group and sham-operation group (each n=10). Echocardiography was performed at baseline and 24 h after reperfusion. High frame rate two-dimensional images were recorded from the left ventricular short-axis views at the papillary muscle level. Peak radial strain (PRS) and peak circumferential strain (PCS) of each segment were measured at systolic period. Left ventricular internal diameter at diastole (LVID_d) and systole (LVID_s), fractional shortening (FS), ejection fraction (EF), wall thickening rate (TR) were measured with anatomical M-model echocardiography. Area of necrosis (AN) of each segment was measured after triphenyl tetrazolium chloride (TTC) staining. Based on TTC staining, ROC curve was used to analyze the accuracy of two-dimensional strain and TR index in identifying infarcted segment. Results ①Compared with acute myocardial infarction group at baseline and sham-operation group after operation, LVID_d and LVID_s of acute myocardial infarction group after operation increased significantly respectively (P<0.05), FS, EF and anteroseptal wall TR reduced significantly (P<0.05). ②Compared with acute myocardial infarction group at baseline and sham-operation group after operation, PRS and PCS decreased significantly in anteroseptal, anterior, anterolateral, inferolateral and inferoseptal segments of myocardial infarction group after operation (P<0.05), especially in anterosepetal, anterior and anterolateral segments (P<0.05). ③ROC analysis showed PCS had the best ability to identify infarcted myocardium as defined by AN>50%. Using a cut-off of -6.14%, PCS had a sensitivity of 93.75% and specificity of 90.91% for distinguishing infarcted from viable myocardium. Conclusion 2D-STI can accurately quantify regional myocardial function, providing a sensitive and noninvasive means to assess regional myocardial viability.

Objective To evaluate the collateral circulation after canine acute coronary artery occlusion with contrast real-time three-dimensional echocardiography (RT-3DE). Methods Left anterior descending coronary artery was ligated in 12 healthy mongrel dogs. All dogs underwent myocardial contrast echocardiography (MCE) before ligation, immediately after ligation, at 30 min and 180 min after ligation respectively, and myocardial mass with collateral supply was calculated. Results Different degrees of collateral circulation were established in all dogs after left anterior descending coronary artery ligation. At 30 min after ligation, the myocardial mass with collateral supply was (9.65±2.90) g, while at 180 min after ligation were (12.58±3.98) g (P<0.01). Conclusion The coronary collateral circulation can be observed clearly and myocardial mass with collateral supply can be quantified accurately with contrast RT-3DE.

0.05 ). The average enhancement rate of LV endocardial border was 96.6 %. The myocardial contrast agent perfusions of left ventricular walls were clearly visualized in 30 patients. CONCLUSION: Clinical application of intravenous left heart contrast echocardiagraphy with perfluoropropane-albumin microsphere is feasibility and effective.

Objective To investigate the effects of bone marrow stem cells autologous transplantation on left ventricular remodeling after acute myocardial infarction. Methods Acute myocardial infarction models were successfully established in 10 swines, which were ran-dom divided into two groups, placebo group and trasplantation group. One week after operation, bone marrow stem cells autologous transplan-tation was performed, and control group was administrated with placebo. B-ultrasound and emission computed tomography aexaminations were performed to assess the left ventrieular end diastolic dimension, left ventricular tip wall thickness, left ventricular end diastolic volume and left ventricula ejection fraction before operation, one week, three months after acute myocardial infarction. Results Compared with that of control group, three months after acute myocardial infarction, transplantation group witnessed smaller left ventricular end diastolic dimension, thicker left ventricular tip wall, smaller left ventricular end diastolic volume and higher left ventricular ejection fraction. Conclusions Bone marrow autologous transplantation after acute myocardial infarction can alleviate left ventricular remodeling.