BACKGROUND:Regional myocardial diastolic dysfunction has been recognized as a sensitive and characteristic sign of myocardial ischemia and infarction,train rate imaging(SRI)is a novel ultrasonic technique with good spatial and high temporal resolution,nd it can be used to quantitatively analyze regional myocardial function.OBJECTIVE:To investigate the characteristics of the longitudinal diastolic strain rate(SR)in ischemic and infarct myocardium by SRI,n order to explore the clinical value of SRI in evaluating regional left ventricular diastolic dysfunction in patients with coronary artery disease.DESIGN:A case-control study.SETTING:Department of Cardiology.Second Affiliated Hospital of Sun Yat-Sen University.PARTICIPANTS:All the participants were selected from outpatients and/or inpatients of the Second Affiliated Hospital of Sun Yat-sen University between October 2005 and April 2006.Twenty-one patients with myocardial infarction(MI group)and 11 patients with angina pectoris(AP group)were enrolled in the study.Twenty age-matched healthy subjects served as controls.METHODS:After performing conventional echocardiographic examination,olor tissue Doppler images from apical four-,three- and two-chamber views (posterior septum and lateral wall,nterior septum and posterior wall,nterior and inferior wall)were recorded on magneto-optical disk.Then SR curves were derived from the stored images off-line using QLAB 4.2software.MAIN OUTCOME MEASURES:Ischemic segments in the AP group,nfarct segments in the MI group and normal segments in the control group were analyzed.The parameters measured included peak early diastolic SR (SRe)and peak late diastolic SR(SRa).RESULTS:Compared with the normal myocardium,oth SRe and SRa decreased significantly in the infarct and ischemic myocardium(all P＜0.05).No significant differences were observed with respect to SRe and SRa between the infarct and ischemic myocardium(both P＞0.05).CONCLUSION:SRI can be used to quantitatively analyze regional myocardial diastolic dysfunction in patients with coronary artery disease,ut its value is limited in differentiating infarct from ischemic myocardium.

AIM:To detect and compare the longitudinal mitral annulus diastolic velocity and time interval changes by pulsed Doppler tissue imaging(DTI)in patients with angina pectoris(AP)and myocardial infarction(MI),and to explore the value of mitral annulus diastolic velocities and time intervals for evaluation of global left ventricular diastolic dysfunction.METHODS:Fifty patients with established coronary artery disease were divided into AP group(16 cases)and MI group(34 cases).Sixteen age-matched healthy individuals served as the control group.The septum,lateral,anterior and inferior walls of the mitral annulus were displayed,and selected for DTI spectrum sampling.Peak early and late diastolic velocities and their ratio,time to the onset and peak of the early diastolic wave,and regional isovolumic relaxation time were measured,and the average values of the four mitral annular sites were calculated and presented as Em,Am,Em/Am,QEm,TEm and IVRTm,respectively.RESULTS:Compared with the control group,Em and Em/Am were significantly lower in both the AP and the MI groups(P＜0.01).Em was even lower in the MI group than that in the AP group(P＜0.01).QEm,TEm and IVRTm were significantly longer in the AP and the MI groups than those in control group(P＜0.01 or P＜0.05).IVRTm was even longer in the MI group than that in AP group(P＜0.01).IVRTm had significantly negative correlation with Em(r=-0.64,P＜0.01).CONCLUSION:Em,Em/Am,QEm,TEm and IVRTm as measured by pulsed DTI may be promising indexes for quantitative assessment of global left ventricular diastolic dysfunction in patients with coronary artery disease.Em and IVRTm may indicate the severity of ischemic myocardial damage.

and adenovirns. The high rate of mixed viral infection brings clinical concern. ELISA combined with PCR improve the diagnostic sensitivity for norovirus, enteric adenovirns and astrovirus.

Objective To study the effect of early enteral nutrition on stress ulcer in patients with severe craniocerebral injury.Methods 134 patients with severe craniocerebral injury were randomly divided into two groups,the early enteral nutrition group (the EEN group,69 cases) was given nasogastric intubation feeding after hospitalization or within 24 hours postoperation,the delayed enteral nutrition group (the DEN group,65 cases) was given nasogastric intubation feeding 24 hours postoperation.The incidence of upper gastrointestinal bleeding in two groups were compared.Results The incidence of upper gastrointestinal bleeding in the EEN group was significantly lower than that of the DEN group.Conclusions Patients with severe brain injury should be given enteral nutrition as soon as possible to reduce the occurrence of stress ulcer and prevent upper gastrointestinal bleeding.

According to medicine high special educational reform’s mentality,we have extracted the knowledge points closely related to basic medical curriculum and the nursing spe-cialty,integrated the basic medical curriculum as "the basis of medical morphology"and"basic medical functions"and have it implemented in the nursing specialty in the three-year program.By doing so,we have gained some experience and provide practical basis for further integration of basic medical courses.

Objective To retrospectively analyze the value of postoperative adjuvant therapy in the treatment of stageⅢthoracic esophageal squamous cell carcinoma ( ESCC) . Methods From 2008 to 2011, a total of 395 patients with stageⅢthoracic ESCC undergoing radical resection were enrolled as subjects. In those patients.97 received surgery alone (S).212 postoperative adjuvant chemotherapy (POCT),and 86 postoperative radiotherapy (PORT).Comparison of categorical data was made by chi?square test. The survival rates were calculated by the Kaplan?Meier method. The log?rank test was used for between?group comparison and univariate analysis. Results All patients were followed up for at least 3 years.125 cases were followed up for at least 5 years. The 5?year overall survival ( OS) rates in patients treated with S,POCT and PORT were 17. 1%,29. 2% and 36. 4%,respectively (P=0. 000).POCT and PORT could mainly increased OS in patients of males.upper?and middle?segment,severe ahhesion at surgery.well?or middle?differentiation,stageⅢa andⅢb(P=0. 000?0. 049);whenever ages.tumor lesion,two?/three field esophagectomy.and the number of removal lymph nodes. PORT could improved OS also (P=0. 001?0. 047).POCT could also improve OS in patients of ages≤60, tumor lesion<6 cm and removal lymph nodes<10 ( P=0. 002?0. 049 ) . The 5?year progression?free survival (PFS) were 19. 0% with S,28. 8% with POCT,36. 4% with PORT,respectively (P=0. 012).PORT could improve PFS (P=0. 012);especially for patients of males,ages ≤60,upper?and middle segment ESCC,tumor lesion ≥6 cm,severe ahhesion at surgery,removal lymph node<10 and ≥10,well or middle differentiation,stageⅢa andⅢb(P=0. 001?0. 042).But POCT could not increased PFS (P=0. 119) . Conclusions In the treatment of patients with stage Ⅲ thoracic ESCC undergoing radical resection,both POCT and PORT can improve the OS rate, particularly in patients with stage Ⅲa or Ⅲb middle and upper thoracic ESCC, severe adhesion formation during surgery. and moderately or well differentiated squamous cell carcinoma. The DFS rate is improved in patients treated with PORT,but not in those treated with POCT.

Humans ; Deglutition ; Time Factors ; Language

BACKGROUNDPostsystolic shortening (PSS) has been proposed as a marker of myocardial dysfunction. Strain rate imaging (SRI) is a novel ultrasonic technique, allowing reliable and noninvasive measurement of myocardial deformation. The purpose of this study was to investigate the characteristics of myocardial longitudinal PSS by SRI in ischemic and infarct myocardium in patients with coronary artery disease, and to explore its clinical applicability.

METHODSEleven patients with angina pectoris, 21 patients with myocardial infarction and 20 healthy subjects were included in the study. Apical four-, three- and two-chamber views were displayed; and septal, lateral, anteroseptal, posterior, anterior and inferior walls of the left ventricle were scanned, respectively. PSS strain (epsilon(pss)), the ratio of epsilon(pss) and systolic strain (epsilon(pss)/epsilon(sys)), the ratio of epsilon(pss) and maximum strain (epsilon(pss)/epsilon(max)) and the duration of PSS (T(pss)) in ischemic, infarct and normal myocardium were analyzed.

RESULTSPSS was found more frequent in the ischemic and infarct segments compared with the normal segments (39% vs 22% and 56% vs 22%, respectively; both P < 0.01). It was even more frequent in the infarct segments than in the ischemic segments (56% vs 39%, P < 0.01). The absolute magnitude of epsilon(pss), epsilon(pss)/epsilon(sys), epsilon(pss)/epsilon(max) were significantly larger and T(pss) significantly longer in the ischemic and infarct segments compared with that in the normal myocardium (P < 0.01). epsilon(pss)/epsilon(sys), epsilon(pss)/epsilon(max) were even larger and T(pss) even longer in the infarct than in the ischemic segments (P < 0.01).

CONCLUSIONSPSS is a common and important feature of the ischemic and infarct myocardium. epsilon(pss), epsilon(pss)/epsilon(sys), epsilon(pss)/epsilon(max) and T(pss) as measured by SRI may be promising markers for the quantitative assessment of regional myocardial dysfunction in patients with coronary artery disease. epsilon(pss)/epsilon(sys), epsilon(pss)/epsilon(max) and T(pss) may be helpful in differentiating infarct from ischemic myocardium.

Aged ; Coronary Artery Disease ; diagnostic imaging ; physiopathology ; Echocardiography ; methods ; Heart ; physiopathology ; Humans ; Middle Aged ; Myocardial Ischemia ; diagnostic imaging ; physiopathology ; Myocardium ; pathology ; Systole

Objective To understand the risk behavioral networks of newly reported HIV infections in Taizhou prefecture, Zhejiang province. Methods Newly reported HIV infections from May 2008 through March 2010 in Taizhou prefecture were invited to participate in a cross-sectional survey which requested numbers and contact information of individuals with whom they had had high risk contacts as well as risk behavioral acts with them. Persons having had risky contacts with HIV-infected cases were thereof approached to participate in this survey and to receive HIV testing.Those who tested positive for HIV were subject to further round of the surveys. Results A total of 267 HIV cases were newly reported during this study period. Among them, 191 participated in the survey and served as 'index cases', including 158 cases identified from routine HIV surveillance programs and 33 cases identified from the present survey. Heterosexual transmission was the primary transmission route (74.9%, or 143/191 ), followed by homosexual transmission ( 19.4%, or 37/191 )and injection drug use (5.8%, or 11/191 ). These 191 HIV cases reported a total of 1152 individuals with whom they had had risky contacts. They were able to provide contact information of 461 risk contacts. Of them, 129 received HIV testing and 61 (47.3%) tested positive for HIV. HIV prevalence was the highest among spouses or long-term sex partners of HIV cases (45.6%, or 47/103) and malesex partners of HIV-infected men having sex with men (MSM) (60.0%, or 12/20). Condom use wasvery low among them, with only 33.9% consistently using condoms for sex. Conclusion Newlyreported HIV infections in Taizhou prefecture reported a large and complicated risk behavioral networks and low condom use, suggesting a potential risk of HIV among these connected people,especially among MSM. Much efforts are needed to intervene these high risk subgroups and high risk behavioral networks.

Objective:To investigate the marital adjustment status of breast cancer patients after surgery and analyze its influencing factors.Methods:Using the convenient sampling method, postoperative breast cancer patients who were treated in 3 ClassⅢ Grade A hospitals in Shanghai from June 2017 to December 2018 were selected as the research objects. The general information questionnaire, Revised Dyadic Adjustment Scale (RDAS) , Breast Cancer Self-Efficacy Scale (BCSES) , Body Image Scale (BIS) , Hospital Anxiety and Depression Scale (HADS) and Medical Outcomes Study Social Support Survey (MOS-SSS) were used for investigation. Univariate analysis, Pearson correlation analysis and multiple linear regression were used to analyze the influencing factors of marital adjustment. In this study, a total of 300 questionnaires were issued and 240 valid questionnaires were returned. The effective recovery rate was 80.0%.Results:The total score of RDAS for postoperative breast cancer patients was (48.88±10.38) . The results of Pearson correlation analysis showed that marital adjustment of postoperative breast cancer patients was positively correlated with self-efficacy, body image, and medical and social support ( r=0.357, 0.382, 0.507; P<0.01) , and it was negatively correlated with anxiety and depression ( r=-0.362, -0.373; P<0.01) . The results of multiple linear regression analysis showed that awareness of tumor staging, actual support, self-acceptance and body image were the influencing factors of marital adjustment in patients after breast cancer surgery ( P<0.05) , explaining 32.9% of the total variation. Conclusions:The marital adjustment ability of patients after breast cancer surgery is at a moderate level. The awareness of tumor staging, actual support, self-acceptance and body image are factors that affect the patients' marital adjustment. It is necessary to actively formulate targeted intervention measures to enhance the psychological adjustment ability of patients in order to improve the ability of marriage adjustment.