Objective To evaluate changes of left atrial (LA) structure and function in non-alchoholic cirrhosis patients with real-time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging (2D-STI).Methods Totally 60 cirrhosis patients (cirrhosis group) and 16 healthy volunteers (control group) were enrolled,and the patients were divided into Child-Pugh A,B and C subgroup according to liver function.RT-3DE was used to obtain LA diameters (LAD),maximum volume (LAVmax),pre-contraction volume (LAVpre) and minimum volume (LAVmin).LA total emptying fraction (LATEF),expansion index (LAEI),active emptying fraction (LAAEF) and passive emptying fraction (LAPEF) were calculated.2D-STI was used to measure mean peak longitudinal strain of LA in systolic,earlydiastolic,end-diastolic phase (mSs,mSe,mSa)and strain rate of systolicm (mSRs,mSRe,mSRa),and LA stiffness (LAst) were calculated.Results Compared with those in control group,LAD,LAV LAVpre,LAVmin and LAst increased in Child-Pugh A,B and C subgroup (all P＜0.05),while LAPEF,mSe and mSRe decreased in Child-Pugh B and C subgroup (all P＜0.05),LATEF,LAEI,mSs,mSRs,LAAEF,mSa,mSRa increased in Child-Pugh A and B subgroup (all P＜0.05).Child-Pugh C subgroup showed increased LATEF,LAEI,LAAEF and decreased mSs,mSRs (both P＜0.05).LASt had negative correlation with LAEI,mSs,mSRs,LAPEF,mSe and mSRe,whereas no significant correlation was found between LASt and LATEF,LAAEF,LAV LAVpre,LAVmin,mSa nor mSRa.Conclusion The dysfunction of LA varies with liver function in non-alcoholic cirrhosis patients.RT-3DE and 2D-STI can detect and evaluate dysfunction of LA in early stage.

Purpose To prepare multifunctional SiO2@MnO2 nanoplatforms(SiO2@MnO2 NPs)with chemo dynamic therapy(CDT)efficacy and observe their effects on in vitro MRI and ultrasound imaging.Materials and Methods SiO2 nanoparticles(SiO2 NPs)were firstly prepared by dehydration-condensation reaction of ethyl orthosilicate in alcohol phase,and then SiO2@MnO2 NPs were prepared by reduction reaction of polyethylene glyco with KMnO4.The morphology of the two nanoparticles was observed,and the particle size and surface potential were detected.Methylene blue degradation verified the ability of SiO2@MnO2 NPs to produce toxic hydroxyl radicals,one of the reactive oxygen species.Simulation of different conditions to evaluate the effect of nanoparticles for in vitro MRI imaging.To observe the cellular uptake and the intracellular production of reactive oxygen species by SiO2@MnO2 NPs.CDT efficacy of nanoparticles was assessed on human pancreatic cancer cell PANC-1 cells.Results The SiO2@MnO2 NPs was successfully prepared,and the shell of fragmented MnO2 was observed to be encapsulated around the surface of spherical SiO2 NPs under transmission electron microscopy.The average size was(115.9±2.0)nm and the average zeta potential was(-32.51±0.30)mV.Methylene blue was gradually degraded with the increased concentration of SiO2@MnO2 NPs,suggesting the generation of toxic hydroxyl radicals.In vitro simulated tumor microenvironment,SiO2@MnO2 NPs could enhance the MRI and ultrasound imaging effect.Large amount of reactive oxygen species production was detected in PANC-1 cells and exerted CDT effect to kill tumor cells.Conclusion The successfully prepared multifunctional SiO2@MnO2 NPs possess favorable CDT effect and dual-mode imaging effect,which can also kill PANC-1 cells,laying a foundation for synergistic CDT and the construction of multifunctional nanoplatform.