Objective To compare the value of speckle-tracking imaging and tissue Doppler strain imaging in evaluating left atrial (LA) mechanical contraction. Methods Forty patients after successful percutaneous atrial septal defect (ASD) closure were enrolled in this study. Two-dimensional strain imaging (2D strain echocardiography, 2DSE) and tissue Doppler imaging (TDI) were performed one weak after ASD closure. Off-line analysis was done for atrial longitudinal peak systolic strain on the interatrial septum, in correspondence of the device, and on the lateral wall of the left atrium from apical 4 chamber view with 2DSE and color-coded strain imaging, respectively. Results There was no statistical difference of the inter- and intra-observer viability as well as time consumption on the off-line analysis between 2DSE and TDI. LA lateral wall strain was much higher than that of LA septum assessed by both color-coded strain imaging (47.31%±27.25% vs 30.06%±14.29%, P<0.01) and 2DSE (43.49%±25.55% vs 12.74%±9.16%, P<0.001). LA lateral wall strain was similar with either method (P=NS). However, at the site of ASD occluder, a non-contractile element, deformation was significantly higher in color-coded strain imaging than 2DSE (P<0.001). Five patients (12.50%) presented absence of deformation on ASD occluder with 2DSE, whereas there was no patient with TDI assessment (χ~2=5.33, P=0.027). Conclusion Speckle-tracking imaging is superior to tissue Doppler strain imaging in assessing left atrium mechanical function.

By means of comparative analysis and literature review,the paper identified differences of private non-profit hospitals at home and abroad in terms of their historical background,fund-raising,tax-free qualification,and governance structure.On such basis,an analysis was made on the development paths of such hospitals in China,for theoretical references and decision support for their development.

OBJECTIVETo explore the risk factors of neural tube defects (NTDs) in Shanxi province where the incidence of NTDs had been the highest in China.

METHODS1:1 matched case-control study was used. All the objects collected from hospitals were investigated in standardized questionnaires about susceptible risk factors for NTDs and were genotyped for methylenetetrahydrofolate reductase (MTHFR) C667T polymorphism by PCR-RFLP method. The risk factors of NTDs were analyzed by conditional logistic regression and by SPSS 11.5 statistical software. We also analyzed the univariable and multi-variables in order to independently investigate the MTHFR genotype and maternal periconceptional adverse factors influencing on NTDs.

RESULTSComparing MTHFR gene frequency between case group and control group, our results showed that three genotypes were found in MTHFR C677T. There was significant difference between two groups at 0.01 level (chi2 = 14.61, P = 0.001) about the three genotypes. The MTHFR T allele frequency of mother with NTDs (60.6%) was higher than that of the control (41.4%), and there was significant difference between them (chi2 = 14.59, P < 0.001). By univariate conditional logistic regression analysis, it was indicated that 15 factors were correlated with NTDs (P < 0.05) in the level alpha = 0.05. By multi-variables conditional logistic regression analysis, four factors were connected to NTDs: frequency of pregnancy (OR = 2.87, 95%CI: 1.28 - 6.44), contacting chemical combination in early pregnancy (OR = 16.18, 95%CI: 1.18 - 221.59), frequent taking of germinated potato (OR = 4.66, 95%CI: 1.78 - 12.17) and MTHFR C677T mutation (OR = 2.13, 95%CI: 1.08 - 4.21).

CONCLUSIONFactors as 'frequency of pregnancy', 'history of contacting chemicals', 'taking germinated potatoes in early pregnancy', as well as 'MTHFR C677T mutation' in mothers were important risk factors affecting the occurrence of NTDs in Shanxi province.

Adult ; Case-Control Studies ; China ; epidemiology ; Female ; Gene Frequency ; Genotype ; Humans ; Logistic Models ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Mutation ; Neural Tube Defects ; epidemiology ; genetics ; Parity ; Polymorphism, Genetic ; Pregnancy ; Risk Factors ; Surveys and Questionnaires

Objective To describe the characteristics of the criss-cross heart with comprehensively segmental echocardiographic scanning in order to explore the diagnostic value of the echocardiography.Methods Ten cases of criss-cross heart were retrospectively reviewed with 2-dimensional,color Doppler echocardiography to summarize the main diagnostic methods.Results The right ventricle was located superiorly and the left ventricle inferiorly in 9 patients and paralleled alignment in 1.The solitus situs was observed in 9 patients and dextrocardia in 1;the atrioventricular connections were concordant in 8 patients and discordant in 2.Echocardiography revealed that 5 patients presented with transposition of great artery and 5 with double outlet of right ventricle as well as all with ventricular septum defect.Conclusions Clear visualization is available with echocardiography to show the crossing inflow streams at the level of atrial-ventricular valve,abnormal alignment of the ventricular septum as well as the associated abnormalities.

OBJECTIVETo compare therapeutic effects between unilateral decompression technique only and open decompression technique with fusion and internal fixation for the treatment of lumbar spinal stenosis.

METHODSFrom March 2008 to February 2011, 82 patients with lumbar spinal stenosis were treated with operations, and divided into two groups. There were 13 males and 19 females in group A, with a mean age of (56.31±4.31) years old. The patients in group A were treated with unilateral decompression via fenestration technique only, including 23 patients obtaining single level decompression and 9 patients obtaining two levels decompression. In group B, there were 18 males and 32 females, with a mean age of (57.53±4.28) years old. The patients in group B were treated with open decompressive technique with fusion and internal fixation, including 38 patients obtaining single level decompression and 12 patients obtaining two levels decompression. The VAS of back pain and leg pain, ODI were recorded before and after surgery to evaluate low back pain,leg pain and walking tolerance.

RESULTSAll the patients were followed up, and the duration ranged from 10.9 to 43.4 months,with a mean of 32.8 months. There were no differences in age, stenosis level, VAS of back and leg pain and ODI before surgery between two groups. Compared with the corresponding ones in group B, the operation time, blood loss, hospitalization time,recovery time of routine daily life and finacial expenditure of patients were all shorter or less in group A. There was no statistically difference in complications between two groups.

CONCLUSION"Unilateral decompression via fenestration technique" is a less invasive and more effective decompressive technique for degenerative spinal stenosis without posterior elements damage. It has advantages in operation time, blood loss, hospitalization time, recovery to daily life and financial expenditure. When controlling the operative indications strictly, the technique could be an important procedure for surgical treatment of degenerative spinal stenosis, especially in the elderly population.

Adult ; Aged ; Case-Control Studies ; Decompression, Surgical ; methods ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Spinal Fusion ; methods ; Spinal Stenosis ; surgery

Objective: To observe the effects of Yanggan Lidan Granule (YGLDG), a compound traditional Chinese herbal medicine, on insulin resistance in guinea pigs with induced cholesterol gallstones. Methods: Eighty guinea pigs were randomly divided into normal control group, untreated group, YGLDG group and ursodeoxycholic acid (UDCA) group, with 20 guinea pigs in each group. Except the normal control group, gallstones were induced by high-cholesterol diet in the guinea pigs. The guinea pigs in the normal control group and the untreated group were administered with normal saline. UDCA and YGLDG were given to the guinea pigs in the corresponding groups for seven weeks. Eight guinea pigs of each group were used to measure the glucose infusion rate (GIR) by using hyperinsulinemic-euglycemic clamp technique. At the end the guinea pigs were killed and their gallstone formation was observed. Results: The gallstones in guinea pigs were identified as cholesterol stones by qualitative analysis through infrared spectrum. The incidence rate of cholelithiasis of the untreated group was 82.35% . The GIR of guinea pigs in the untreated group was obviously lowered down as compared with the normal control group. Compared with the untreated group, the GIRs of the YGLDG group and the UDCA group were obviously increased, especially in the YGLDG group. Conclusion: YGLDG may improve insulin resistance in guinea pigs with cholesterol gallstones by elevating GIR obviously.

OBJECTIVE: To explore the mechanism of the inhibiting effects of recipe for dispersing stagnated liver qi to promote bile flow (Danshijing Tablets) on cholesterol gallstone formation and provide experimental evidence for its clinical application. METHODS: Eighty guinea pigs were randomly divided into 4 groups, which were normal control group, untreated group, ursodeoxycholic acid (UDCA)-treated group and Danshijing Tablets-treated group. The gallstones in guinea pigs were induced by high-cholesterol diet. UDCA and Danshijing Tablets were given orally to guinea pigs in the corresponding group respectively for seven weeks. Then the physical signs of the guinea pigs, the rates of gallstone formation and the histomorphological changes of the gallbladder were examined. RESULTS: The behavior of guinea pigs in the Danshijing Tablets-treated group was obviously improved and the rate of gallstone formation was significantly decreased as compared with those in both untreated and UDCA-treated groups (P<0.05). The inflammation reaction of mucous membrane in gallbladder was evidently reduced in the Danshijing Tablets-treated group and its morphological appearance turned to be approximately normal. CONCLUSION: Recipe for dispersing stagnated liver qi to promote bile flow may decrease gallstone formation. Its mechanism may be related to reducing pathologic changes in gallbladder tissues, which will reduce the damages of cholesterol to the smooth muscle in gallbladder and enhance the contractility of gallbladder.

Rivaroxaban is one of the new oral anticoagulants (NOAC) for preventing stroke and systemic embolism in patients with non-valvular atrial fibrillation. It has clear pharmacokinetic parameters, stable plasma concentration, less drug-drug interaction and higher compliance of patients. However, the discrepancy of pharmacokinetics between individuals and drug-induced hemorrhage events frequently occur clinically, therefore the association of gene polymorphism with drug metabolism has become a research hotspot. This article reviews the research progress on pharmacokinetic characteristics of rivaroxaban and its relationship with gene polymorphism, to provide a reference for the individualized rational use of rivaroxaban.

Objective To evaluate the cLinical outcome and influencing factors of open reduction and internal fixation in treatment of hip dislocation combined with acetabular fractures. Methods A retrospective analysis was performed on 51 patients with hip dislocation combined with twetabular frac-tures, who were treated with open reduction and internal fixation under general anesthesia in the emergen-cy department on admission. Of all, 41 patients were treated with open reduction and plate/screw internal fixation, for which the reduction result was evaluated by postoperative X-rays and follow up X-rays accord-ing to Matta's criteria and the functional outcome by Merle d' Aubigne's criteria. Results Of 41 pa-tients, 33 were followed up for 1-7 years (mean 3.1 years). X-ray evaluation showed anatomic reduction in 27 patients (82%), imperfect reduction in five (15%) and poor reduction in one (3%). The clini-cal outcome at the time of final follow-up was graded as excellent in 18 patients (55%), good in 8 (24%), mederate in 3 (9%) and peor in4 (12%), with total excellence rate of 79%. Conclusion Prompt reduction of hip dislocation, precise reduction of the acetabular fracture and decrease of periopera-tive comphcations are key to excellent clinical outcome.

Objective To compare the effect of atorvastatin and rosuvastatin on myocardial injure and inflammatory factors in patients with unstable angina pectoris(UAP)undergoing percutaneous coronary intervention(PCI).Methods Ninety six UAP pa-tients undergoing PCI were enrolled in the study and divided into two groups,patients were given atorvastatin(20 mg/d)or rosuv-astatin(20 mg/d)besides conventional treatment for 1 week before PCI.Datas were collected before medication,PCI and Twenty-four hours after PCI,including CK-MB,cTnI,hs-CRP,TNF-α,IL-6 and IL-10.Results Twenty-four hours after surgery,the PCI, CK-MB,cTnI,hs-CRP,TNF-α,IL-6 of rosuvastatin group were lower than those of atorvastatin group(P <0.05),but IL-10 of ro-suvastatin group was higher than that of atorvastatin group(P <0.05).Conclusion Rosuvastatin (20 mg/d)is better than atorvas-tatin (20 mg/d)in the efficacy of UAP patients undergoing PCI,which can reduce the level of myocardial injure and inflammatory factors effectively.