AIM: To evaluate the effect of simvastatin on the left ventricular mass in patients with essential hypertension (EH). METHODS: 50 patients with hypertension without severe complication were randomly divided into two treatment groups: combination treatment group and hydragogue group, and 25 normal subjects without any treatment were taken as the control. The 25 patients in combination treatment group were given simvastatin and hydragogue for 12 weeks while the other patients in hydragogue group were given hydragogue during the same time. The left ventricular mass was examined from ultrasonography in all patients before and after treatment. RESULTS: The left ventricular mass index (LVMI) was higher in the two treatment groups of patients (133.61±31.02, 118.04±39.62 g·m-2) than that in the control group (88.79±22.73 g·m-2) before treatment (P<0.01, 0.0001, respectively) while the blood pressure was higher. There was no significantly difference in age, serum concentrations of total cholesterol or triglyceride, sugar and blood pressure between the two treatment groups and the control group (P>0.05). There was no significant difference in all variables between the two treatment groups before treatment. After treatment, the LVMI was decreased (133.61±31.02 vs 91.07±16.01 g·m-2, P<0.01) in the combination treatment group while there was no significant change in LVMI in the hydragogue group compared with the control group. The blood pressure in the two treatment groups was decreased to the normal. Compared with hydragogue group, the change of LVMI was higher in the combination group though the serum concentrations of total cholesterol, triglyceride or sugar were not significantly different. No significant change in serum concentrations of total cholesterol, triglyceride or sugar was found during treatment in the two groups. The change of LVMI did not correlate with the change of blood pressure, serum concentrations of total cholesterol , triglyceride or sugar in the combination treatment group(P>0.05). CONCLUSION: Being independent of the changes of serum concentrations of total cholesterol, triglyceride or sugar and blood pressure, simvastatin can inhibit the increase of left ventricular mass in patients with essential hypertension.

AIM:To investigate the role of damaged mitochondria in dendritic cell ( DC) apoptosis induced by Vibrio vulnificus (Vv) and its possible mechanism.METHODS: DC2.4 cells were co-cultured with Vv 1.1758 strain. Fluorescent probes DCFH-DA and Fluo-8-AM were used to detect reactive oxygen species ( ROS) and intracellular Ca 2+concentration in the invaded cells , respectively .The cellular apoptotic rates and mitochondrial membrane potential (Δψm ) were measured by flow cytometry.The expression of nuclear factor-kappa B p65 (NF-κB p65) and tumor necrosis factor-al-pha (TNF-α) was detected by Western blotting.RESULTS:Vv 1.1758 induced DC2.4 cell apoptosis.Vv 1.1758 bacte-ria invaded into the DC2.4 cells by binding with cellular membrane though the end of the body .In the invaded DC2.4 cells, the visible mitochondrial damage, elevated ROS and intracellular Ca2+levels, and declinedΔψm were presented.Af-ter 1 h of co-culture, NF-κB p65 began to rise and reached the peak at 5 h, and then slightly decreased at 6 h.The TNF-αlevel increased after 2 h of co-culture and reached the peak at 6 h.CONCLUSION:The damaged mitochondria play an important role in DC apoptosis induced by Vv , and its possible mechanism may associate with the elevation of ROS and in-tracellular Ca2+level, and the declined Δψm.Meanwhile, NF-κB p65 and TNF-αare potential critical signaling molecules in the process of apoptosis .

Objective To investigate the role of three-dimensional speckle tracking echocardiography (3D-STE) in providing a novel approach to assessing myocardial viability in patients with myocardial infarction (MI).Methods The subjects from the Department of Cardiology and the Department of Cardiac Surgery admitted from April 2010 through December 2012 were diagnosed as MI by electrocardiogram,myocardial enzymes and angiography.The clear imaging of angiography was selected out and collected.All patients had different degrees of segmental wall motion abnormalities,and some already had percutaneous transluminal coronary angioplasty and coronary stenting or coronary artery bypass grafting.Patients with diabetes,heart disease and severe valvular disease of heart were excluded.A total of 45 MI patients were checked with routine echocardiography,two-dimensional speckle tracking echocardiography (2D-STE) and 3D-STE.Then,radionuclide myocardial perfusion/metabolic imaging was served as a golden standard to distinguish the viable from nonviable myocardium in each patient within a day.In order to determine the most sensitivity and specificity threshold values of circumferential peak-systolic strain (Cs),longitudinal peak-systolic strain (Ls),radial peak-systolic strain (Rs),3D strain and area strain for viability detection from 3D-STE,the receiver operating characteristic curve was used to investigate the sensitivity and specificity of the detection of viable myocardium with strain parameters in the study.Comparisons between viable and non-viable groups were carried out with t test.Data were expressed as the mean value ± standard deviation (-x ± s).Results The ventricular wall motion abnormality by visual assessment was observed in 368 segments from 720 segments in 45 patients.Furthermore,204 segments were confirmed to be viable by radionuclide myocardial perfusion/metabolic imaging whereas the rest 164 segments were identified as nonviable among 368 abnormal segments.There were no significant differences in circumferential peaksystolic strain (Cs),longitudinal peak-systolic strain (Ls) and radial peak-systolic strain (Rs) by 2D-STE between viable and nonviable group.Compared with those in viable group,there wasn' t any difference in Cs,but Rs and Ls decreased significantly by 3D-STE in nonviable group.The 3D strain and area strain in absolute value decreased in nonviable group compared with viable group.According to 3D-STE,when Rs higher than 11.1％,the sensitivity was 95.1％ and the specificity was 53.4％ for identification of viable myocardium,whereas Ls higher than 14.3％ resulted in sensitivity of 65.2％ and a specificity of 65.7％.Besides,3D strain higher than 17.4％ had a sensitivity of 70.6％ and a specificity of 77.2％ for detection of viable myocardium,while area strain higher than 23.2％ allowed a sensitivity of 91.5％ and a specificity of 78.8％.Conclusions The 3D-STE might have potential reliability of myocardial viability detection in the patients with left ventricular dysfunction after MI.

OBJECTIVETo analyze the clinical characteristics and imaging features of sternum tumor, in order to improve the knowledge of the diseases.

METHODSThe clinical data and imaging data of 18 patients with sternum tumor were retrospectively analyzed. There were 13 males and 5 females, aged from 24 to 73 years old with an average of 58.3 years. Eleven patients were treated by conservative treatment and 7 patients were treated by surgery. The course of disease ranged from 2 months to 6 years. One patient had no obvious symptoms and 1 patient had a history of chest trauma. Lesion location, pattern of bone destruction, cortical bone abnormality, MRI signal characteristics and contrast enhancement were observed in the patients.

RESULTSEighteen cases included malignant bone tumor in 16 cases and benign tumor in 2 cases;and 7 cases located in sternal manubrium, 9 cases located in sternal body, and 2 cases located in both. On the imaging, sternal tumor had expansively developing tendency, and the bone destruction zone boundary continuity or partial disruption occurred in 15 cases, the border of cortical bone thinning in 2 cases, the cortical bone increased thickness in 1 case. No bone marrow edema around tumor was found in 7 cases by MRI and soft tissues was encroached in 2 cases; in T1WI of MRI, 4 cases showed the hypointense signal and 3 cases showed the iso or hyper intensity signal; in T2WI of MRI, 6 cases showed the iso or hyper intensity signal and 1 case showed confounding signal. Enhancement scanning in MRI, premodinantly tumors showed obviously strengthening.

CONCLUSIONSThe types of the sternum tumors are various and the most tumors are malignant. The images of the mostly sternum tumor absented same charactiristic, and it must combine with clinical manifestation to analyze the X rays, CT scanning and MRI, it will conduce to improve the diagonstic accuracy of the sternum tumors.

Objective To seek a new method to identify viability of myocardium by adenosine stress echocardiography combined with quantitative tissue velocity imaging(QTVI)and tissue tracking(TT).Methods Fifteen healthy canines were selected to establish the models of acute myocardial infarction and reperfusion by ligating anterior descending branch of coronary artery for 90 minutes and then releasing the artery to get reperfusion.After reperfusion.peak velocity in systole(Vs),peak velocity in isovolumic contraction(VIVC)and the displacement in systole(Ds)were measured on anterior wall and anterior septum at baseline.The 2,3,5-triphenyl tetrazolium chloride(TTC)staining was set as a"gold standard"for defining the viable and non-viable groups.The sensitivity and specificity of assessing myocardial viability were determined with QTVI and TT.Comparison of variables between viable and non-viable group was made by using t test.One way analysis of variance and LSD-t test were used to estimate the significance of differences in different states.Results Compared with baseline,Vs,VIVC and Ds decreased significantly(P＜0.01)after reperfusion in both viable and non-viable group.After administration of adenosine,Vs and Ds increased(P＜0.05),but VIVC didn't change significantly compared with that before administration of adenosine in viable group(P＞0.05).Variables in non-viable group didn't change significantly after administration of adenosine(P＞0.05).By receiver operating characteristic(ROC)analysis for predicting myocardial viability,when a cutoff value of △Vs(%)rate was 17.9,the sensitivity and the specificity was 78.6%and 81.1%,respectively,and when the cutoff value of △Ds(%)rate was 18.4,the sensitivity and the specificity was 75.0%,83.6%,respectively.Combined △Vs(%)with △Ds(%),the sensitivity and specificity to prediction of myocardium viability could reach 94.6%and 68.0%,respectively.Conclusions When the viability of myocardium after myocardial infarction is assessed by using the method of adenosine stress echocardiography with QTVI and TT,the sensitivity and the specificity are greatly enhanced.

nd targeted-ultrasound can facilitate VEGF gene transfer of vascular endothelial. Targeted-ultrasound group transfer efficiency is higher than that of microbubble group, and the plasmid alone can not promote transfer of vascular endothelial.

Objective To discuss the value of leukocyte-targeted myocardial contrast echocardiography (MCE) as a tool in observing the degree of acute rejection after heart transplantation. Methods Abdominal heterotopic cardiac transplantation was performed on 32 rats successfully, among which 8 isografts served as group A, and groups B, C and D involved 8 allografts respectively. The rats in groups B and C were treated with cyclosporine A (CsA) at a high dose (10mg· kg-1 · day-1 ), a low dose (3 mg · kg-1 · day-1 ) from 3rd day before transplantation respectively.The rats in groups A and D were untreated with CsA. MCE was performed during continuous intravenous SonoVue injection postoperatively on the third day after operation. We performed 2 types of MCE: perfusion imaging and leukocyte-targeted imaging. The images were obtained at 20 s and 5 min after injection of contrast agent. The value of the contrast image grayscale (GS) was measured by image analyzer (GS20s, GS5 min). GStarget was calculated as the GS5min minus the GS20s in the same rat.Postmortem histology was performed after observation. The degree of myocardial rejection was determined by HE-stained graft myocardium. Immunohistochemistry was performed to quantify the CD3-positive cells, and correlation analysis was performed between CD3-positive cell count and GS20s,GS5min, GStarget. Results Perfusion imaging showed no significant difference in myocardial GS20s of each group. Leukocyte-Targeted imaging exhibited a clear gradient in these groups (P＜0. 05). There was significant difference in GStarget of each group (P＜0. 001). Postmortem histology showed 0- Ⅰ grade rejection in group A, Ⅰ -Ⅱ grade rejection in group B, Ⅱ-Ⅲ grade rejection in group C, Ⅲ-Ⅳ grade rejection in group D. Immunohistochemistry revealed the CD3-positive cell infiltration was increased in turn from the group A to the group D. There was a significantly positive correlation between the CD3-positive cell count and GStarget ( r = 0. 86, P ＜ 0. 001 ). Conclusion Leukocyte-targeted contrast echocardiography may thus offer a noninvasive and effective ultrasound imaging technique for detecting the degree of acute cardiac transplant rejection.

The experimental researches of applying emodin for prevention and treatment of liver diseases in recent years were reviewed. Emodin can inhibit the growth of liver tumor cells in vitro and in vivo, inducing cell apoptosis is one of its mechanisms. Emodin also has the effects of liver protection, anti-liver fibrosis, and so on, the mechanisms for those effects still need more studies.
Animals ; Apoptosis ; drug effects ; Cell Line, Tumor ; Emodin ; pharmacology ; therapeutic use ; Humans ; Liver Cirrhosis ; drug therapy ; Liver Neoplasms ; drug therapy ; pathology ; Protective Agents ; pharmacology ; therapeutic use

Objective To evaluate left ventricular myocardial function altemation by three-dimensional speckle tracking imaging (3D-STI) after surgical aortic valve replacement (AVR) in severe aortic stenosis (AS) patients with preserved left ventricular ejection fraction (LVEF),and discuss its clinical value.Methods Forty patients with severe aortic stenosis who were hospitalized or outpatient in Nanjing First Hospital Affiliated to Nanjing Medical University during the period of October 2014 to October 2016 (AS group),and forty healthy volunteers (normal control group) were enrolled in this study.Normal control group underwent conventional echocardiography and 3D-STI measurement,while the AS group underwent conventional echocardiography and 3D-STI measurement at preoperative,1 week postoperative and 3 months postoperative,then we obtained left ventricular end-diastolic diameter (LVEDD),left ventricular end-systolic diameter (LVESD),interventricular septum thickness diameter (IVSd),left ventricular posterior wall thickness diameter (LVPWd),left ventricular ejection fraction (LVEF),global longitudinal strain (GLS),global circumferential strain (GCS),global radial strain (GRS),global area strain (GAS) strain and 3D-strain.The independent sample t test was used to compare the difference of conventional ultrasound parameters and 3D-STI parameters between AS preoperative patients and healthy controls,AS patients at 3 months postoperative and healthy controls.The single factor analysis of variance was used to compare the difference of conventional ultrasound parameters and 3D-STI parameters in severe patients at preoperative,1 week postoperative and 3 months postoperative.LSD-t test was used to compare in different AS groups.Results Compared with normal control group,IVSD,LVPWD and GCS of severe AS patients increased significantly (t=13.824,11.298 and-6.584,all P ＜ 0.001),GLS,GRS and 3D-Strain decreased significantly (t=10.221,-6.237 and-5.674,all P ＜ 0.001),LVEDD,LVESDand GAS had no significant difference.Compared with preoperative AS patients,LVEF,GLS,GAS and GCS decreased significantly (t=-2.205,-2.093,-2.034 and-3.152,all P ＜ 0.05 or 0.01) at 1 week postoperative,LVEDD,LVESD,IVSD,LVPWD,GRS and 3D-strain had no significant difference at 1 week postoperative;GLS,GRS and 3D-strain increased significantly (t=5.446,-4.923 and-4.388,all P ＜ 0.05 or 0.01) at 3 months postoperative,GCS,IVSD and LVPWD decreased significantly (t=-3.988,4.794 and 4.211,all P ＜ 0.05 or 0.01) at 3 months postoperative,LVEDD,LVESD,LVEF and GAS had no significant difference at 3 months postoperative.Compared with AS patients at 1 week postoperative,LVEF,GLS,GRS,GAS and 3D-strain increased significantly (t=-2.631,7.383,-4.719,2.923 and-4.154,all P ＜ 0.05 or 0.01) at 3 months postoperative,GCS,IVSD and LVPWD decreased significantly (t=-2.109,4.747 and 4.323,all P ＜ 0.05 or0.01) at 3 months postoperative.But in AS patients at 3 months postoperative,IVSD,LVPWD,GLS and GCS were still higher than those of normal control group (t=9.809,7.066,4.752 and-2.553,all P ＜ 0.001 or ＜ 0.05),LVEDD,LVESD,LVEF,GRS,GAS and 3D-strain had no significant difference.Conclusion The alternation of left ventricular myocardial function have a certain characteristic before and after aortic valve replacement in severe aortic stenosis patients with preserved LVEF,and 3D-STI can evaluate it more accurately.

Objective : To investigate a cluster of coronavirus disease 2019 (COVID-19) in Pingyang County,and to put forward targeted prevention and control suggestions. Methods: According to the Prevention and Control Plan of COVID-19 (Third Edition),we carried out epidemiological investigation to collect the information of demographic features,diagnosis and treatment,clinical manifestations,laboratory examination,exposure history and close contact. We analyzed the mode and frequency of exposure,so as to figure out the route of transmission. Results: This epidemic resulted in 6 confirmed cases of COVID-19 and 3 asymptomatic cases,with an attack rate of 6.52% (9/138). The median age of the cases was 48 years old. The confirmed cases mainly had imaging features of pneumonia, fever and cough. Their incubation period ranged from 4 to 9 days,and the median was 6 days. The first case,Wang,returned for the funeral of her grandmother from Wuhan with his husband and son on January 18 and lived with her mother. She had cough on January 19,and went to see her grandmother during January 19 to 23. She had contact with 6 cases,and the other 2 cases were Wang's mother and husband,who lived with Wang. All the cases except Wang had no COVID-19 related symptoms before the funeral,no contact history of COVID-19 cases or no other common exposure history except during the funeral. Therefore,Wang was determined as the source of the epidemic,staying in the same room and eating at the same table with her were risk factors for the infection of COVID-19 in this epidemic (P<0.05). Conclusions This was a local clustering epidemic caused by COVID-19 imported cases from Wuhan. It spread mainly by close contacts like staying in the same room and eating at the same table.