Objective To investigate the effect of berberine hydrochloride tablets combined with compound glutamine in treating ulcerative colitis(UC).Methods One hundred and two patients with UC admitted to our hospital were collected and grouped into two groups according to the random number table.Fifty-one patients in the control group were given conventional treatment+compound glutamine,and 51 patients in the experimental group were given berberine hydrochloride tablets based on the control group.Both groups were treated for 8 weeks.The efficacy,modified Mayo score,intestinal mucosal barrier function,soluble late glycation end product receptor(sRAGE),interleukin-17(IL-17),IL-6 and incidence of untoward reactions were compared between the two groups.Results The total effective rate of the experimental group was higher than that of the control group(92.2%vs.76.5%,P＜0.05).After treatment,scores of defecation frequency,blood in stool,endoscopic findings,physician's overall evaluation,diamine oxidase(DAO),D-lactic acid,endotoxin,sRAGE,IL-17 and IL-6 were lower in both groups than those before treatment(P＜0.05),and the research group was lower than the control group(P＜0.05).There was no significant difference in the total incidence of untoward reactions between the experimental group and the control group(P＞0.05).Conclusion Berberine hydrochloride tablets combined with compound glutamine are effective in treating UC,which can reduce the activity of UC,improve the intestinal mucosal barrier function,regulate serum sRAGE,IL-17 and IL-6 levels,without increasing adverse reactions.

OBJECTIVETo determine whether the level of serum cardiac troponin T (cTnT) was increased in patients with congestive heart failure (CHF).

METHODSThis study consisted of 265 patients with CHF and 75 healthy people. Serum cTnT was measured by electrochemiluminescence immunoassay using an Elecsys 1010 automatic analyzer.

RESULTScTnT concentration was 0.181 +/- 0.536 ng/mL in CHF patients and 0.003 +/- 0.001 ng/mL in controls (P < 0.001). Patients were categorized according to the levels of heart function and left ventricular ejection fraction (LVEF). In the first group consisting of 105 patients with LVEF 35%, cTnT was 0.07 +/- 0.0 5 ng/mL (P < 0.01). In patients with NYHA class I, II, III and IV, cTnT values were 0.062 +/- 0.022 ng/mL, 0.113 +/- 0.121 mg/mL, 0.191 +/- 0.231 mg/ml and 0.384 +/- 0.211 mg/mL, respectively (class I vs class II P > 0.05, class II vs class III P < 0.01, class III vs class IV P < 0.01). A negative correlation was observed between serum cTnT concentration and LVEF in 265 patients with CHF (r = -0.493, P < 0.001).

CONCLUSIONSThis study shows that the level of serum cTnT is increased in patients with CHF and that the increased level indicates the severity of CHF.

Adult ; Aged ; Female ; Heart Failure ; blood ; physiopathology ; Humans ; Male ; Middle Aged ; Stroke Volume ; Troponin T ; blood ; Ventricular Function, Left

Objective:To evaluate left atrial(LA) function and its value in predicting left ventricular(LV) remodeling in patients with coronary heart disease (CHD) by four dimensional automatic left atrial quantitation (4D Auto LAQ).Methods:A total of 176 patients with CHD were prospectively enrolled in Fuwai Central China Cardiovascular Hospital from October 2021 to September 2022. They were divided into two groups according to left ventricular mass index: LV remodeling group (female>95 g/m 2, male>115 g/m 2, n=88) and Non-LV remodeling group (female≤95 g/m 2, male≤115 g/m 2, n=88). The 3D dynamic image of LA was analyzed by 4D Auto LAQ on machine to obtain the LA parameters, including the minimum, maximum, pre-systolic and emptying volumes of LA (LAVmin, LAVmax, LAVpreA, LAEV), LA ejection fraction (LAEF), LA reservoir longitudinal and circumferential strains (LASr, LASr-c), LA conduit longitudinal and circumferential strains (LAScd, LAScd-c) and LA contraction longitudinal and circumferential strains (LASct, LASct-c). Logistic regression models were used to analyze the value of LA parameters in predicting LV remodeling in patients with CHD. ROC curve was used to evaluate LA parameters and left atrial volume index (LAVI) to predict the diagnostic efficiency of LV remodeling. Results:Compared with the Non-LV remodeling group, LAVmin, LAVmax, LAVpreA were significantly increased and LAEF, LASr, LAScd, LASct, LASr-c, LAScd-c, LASct-c were significantly decreased in the LV remodeling group ( P<0.05). Logistic regression model showed that LASct-c was an independent risk factor for LV remodeling in patients with CHD after adjustment( OR=2.018, 95% CI=1.214-3.355). ROC curve analysis showed that the area under the curve of LASct-c for predicting LV remodeling in CHD patients was 0.844, the sensitivity was 0.784, and the specificity was 0.761. Conclusions:4D Auto LAQ can effectively evaluate LA function in patients with CHD.LASct-c can be used as a reference index to predict LV remodeling in patients with CHD, which provides a new evaluation method in prognosis evaluation of CHD patients.

Objective:To quantitatively evaluate the global myocardial work of left ventricle in patients with chronic kidney disease (CKD) by left ventricular pressure-strain loops (PSL).Methods:Forty patients with chronic kidney disease (CKD) in Henan Provincial People′s Hospital from February 2019 to October 2019 were chosen as case group.According to the decreased level of the glomerular filtration rate (GFR), CKD patients were divided into CKD 2-3 stage group( n=20) and CKD 4-5 stage group( n=20), and 20 healthy volunteers were selected as control group.The working parameters of the global left ventricular myocardium including the global work index (GWI), the global constructive work (GCW), the global wasted work (GWW), the global work efficiency (GWE) were measured by the left ventricular PSL, and the differences of the parameters among the three groups were compared. Results:Compared with the control group, the GWI, GCW, GWW in the CKD 2-3 stage group and CKD 4-5 group were significantly higher and the GWE was lower than those in the control group differences were all (all P<0.05). Compared with the CKD 2-3 stage group, the GWI and GCW of the CKD 4-5 stage group were increased (all P<0.05), but there were no significant differences in GWW and GWE ( P>0.05). Conclusions:Left ventricular PSL provides a new method for evaluating the changes of left ventricular systolic function in patients with CKD.

Objective:To evaluate the distribution of diastolic left ventricular pressure in patients with type 2 diabetes mellitus (T2DM) by relative pressure imaging (RPI) based on vector flow mapping (VFM), and to explore the clinical risk factors for the diastolic left ventricular pressure distribution.Methods:Thirty patients with T2DM and thirty normal controls were included from August 2020 to July 2021 in Fuwai Central China Cardiovascular Hospital. All selected subjects underwent conventional echocardiography.Left intraventricular pressure difference (IVPD) and left intraventricular pressure gradient (IVPG) were measured using RPI of VFM in isovolumic relaxation (IR), rapid filling (RF), atrial contraction (AC), isovolumic contraction (IC) and rapid ejection (RE) phases. The relationships between IVPD with other parameters were analyzed.Results:①Compared with the control group, E/A, e′, IVPD-IR, IVPG-IR, IVPD-RF, IVPG-RF, IVPD-AC, and IVPG-AC were significantly lower and E/e′ was significantly greater in the T2DM group ( P<0.05). ②IVPD-IR, IVPD-RF, and IVPD-AC were positively correlated with E/A ( r=0.309, P<0.05; r=0.274, P<0.05; r=0.273, P<0.05). IVPD-IR, IVPD-RF, and IVPD-AC were negatively correlated with E/e′ ( r=-0.587, P<0.05; r=-0.273, P<0.05; r=-0.415, P<0.05). IVPD-IR and IVPD-AC were positively correlated with e′ ( r=0.451, P<0.05; r=0.431, P<0.05). ③Multivariable linear regression analysis showed that hemoglobin A 1c (HbA 1c) was an independent risk factor affecting IVPD-IR, IVPD-RF, and IVPD-AC (β=-0.417, P<0.05; β=-0.451, P<0.05; β=-0.460, P<0.05). Conclusions:RPI of VFM can quantitatively evaluate diastolic left ventricular pressure distribution in patients with T2DM. HbA 1c is an independent risk factor affecting IVPD-IR, IVPD-RF, and IVPD-AC.

Objective:To evaluate the right ventricular function in patients with dilated cardiomyopathy (DCM) by four-dimensional automatic right ventricular quantitative analysis (4D Auto RVQ), and compare with the right ventricular ejection fraction measured by cardiac magnetic resonance (CMR-RVEF), and to explore the clinical application value of 4D Auto RVQ technique in evaluating the right ventricular function of patients with DCM.Methods:A prospective study was conducted to select 52 patients with DCM who were treated in Fuwai Central China Cardiovascular Hospital of Zhengzhou University from March to October 2022 as DCM group, and 52 healthy volunteers were selected as the control group during the same period. The four-dimensional right ventricular ejection fraction (4D-RVEF), right ventricular stroke volume index (RVSVI), right ventricular end-diastolic volume index (RVEDVI), right ventricular end-systolic volume index (RVESVI), four-dimensional right ventricular basal diameter (4D-RVDd-base), four-dimensional right ventricular middle diameter (4D-RVDd-mid), four-dimensional right ventricular long axis diameter (4D-RVLd), four-dimensional tricuspid annular plane systolic excursion (4D-TAPSE) and four-dimensional right ventricular fractional area change (4D-RVFAC) were obtained by 4D Auto RVQ technique. The differences of the above parameters between DCM group and control group were compared.Pearson linear correlation analysis was used to evaluate the correlation between echocardiographic parameters and CMR-RVEF. The ROC curve was used to find the most sensitive parameters for evaluating right ventricular function, and the area under the ROC curve ( AUC ) was calculated and compared.Results:Compared with the control group, RVEDVI, RVESVI, 4D-RVDd-base and 4D-RVDd-mid in the DCM group were increased, and the absolute values of 4D-RVEF, 4D-TAPSE, 4D-RVFAC, right ventricular global longitudinal strain(RVGLS) and right ventricular free wall longitudinal strain(RVFWLS) were decreased (all P<0.05). Correlation analysis showed that 4D-RVEF was positively correlated with CMR-RVEF ( r=0.711, P<0.05). ROC curve analysis showed that 4D-RVEF was superior to other parameters in evaluating right ventricular function in DCM patients (AUC: 0.916). Conclusions:4D Auto RVQ technique can quantitatively evaluate right ventricular function in DCM patients. 4D-RVEF has a significant correlation with CMR-RVEF, and 4D-RVEF has the best efficacy in evaluating right ventricular function in DCM patients.

Objective:To analyze the application value of 18F-FDG PET in the preoperative evaluation of patients with extratemporal lobe epilepsy (ETLE) and explore improved methods to enhance its localization accuracy. Methods:A total of 41 patients (25 males, 16 females, age (22.7±7.5) years) who underwent surgery and ultimately confirmed ETLE in Peking Union Medical College Hospital between January 2006 and November 2022 were enrolled. The accuracy of preoperative independent 18F-FDG PET imaging and the combined application of 18F-FDG PET and MRI in detecting epileptogenic foci and their impacts on treatment decisions were retrospectively analyzed by using visual and semi-quantitative methods. Fisher′s exact test was used to analyze the data. Results:In all 41 patients, 40 cases were found metabolic abnormalities in extratemporal lobe by independent 18F-FDG PET based on visual analysis. Among them, 26 showed unifocal metabolic abnormalities, which were localized as epileptogenic foci. Fourteen patients showed multifocal metabolic abnormalities, and the epileptogenic foci were further verified in 8 cases through semi-quantitative analysis. In 1 case with negative PET visual analysis, a micro-metabolism focus was found at the abnormal MRI signal area. Among 13 patients with negative independent MRI, 9 were found microstructures abnormalities in brain regions with hypometabolism. 18F-FDG PET improved clinical decision-making in 18 patients (43.9%, 18/41). There were 30 patients (73.2%, 30/41) with seizure-free postsurgery, and the prognosis was not significantly different between patients with unifocal 18F-FDG PET metabolic pattern and those with multifocal ones (73.1%(19/26) vs 10/14, P=1.000). Conclusions:18F-FDG PET can be a useful diagnostic tool for patients with ETLE. Semi-quantitative analysis helps to detect more epileptogenic foci with multifocal metabolic abnormalities. The combined evaluation of 18F-FDG PET and MRI can improve the accuracy in localizing epileptogenic foci outside the temporal lobe.

Objective: To study the causes and influencing factors of no seeking medical treatment among pneumoconiosis patients. Methods: Using stratified sampling method and typical survey method, we carried out the questionnaire survey in nine provinces in China including the east, the medium and the western region using a questionnaire on the seeking medical behavior pf pneumoconiosis patients and the influencing factors. The subjects include occupational pneumoconiosis cases and clinically diagnosed cases and the response rate is 94.3 percent. The data was entered twice with epidate3.1 and error detection and statistical analysis was completed with SPSS 20.0. Chi-square test was used for univariate analysis, and multivariate logistic regression was used for multivariate analysis. Results: One thousand and thirty-seven subjects were investigated with average age 55.9±11.2 years. Seventy percent of them were silicosis and 21.9 percent were coal worker’s pneumoconiosis with 67.5 percent of them residing permanently in the countryside, and 37.9 percent of their education background were primary school culture and 33.1 percent of them had junior high school culture. Thirty two point six percent of respondents had no personal income with a median monthly income of 1 200 yuan. Four hundred and thirty four of subjects hadn't seek medical treatment since they got the pneumoconiosis accounting for 41.9 percent with three hundred and thirty seven of them hospitalized directly. The reasons of no seeking medical treatment for the respondents mainly include the self-induction symptoms lighter, the high cost of treatment and cannot claiming the payment of the medical expenses, buying drugs in drugstore, thinking that no medicine can cure pneumoconiosis or no effect, complex procedures, too far away from medical institutions, no unaccompanied, needing a long time or no time, communication disorders, etc. accounting for 44.4 percent, 24.6 percent, 10.9 percent, 9.1 percent, 6.9 percent, 4.4percent, 3.2 percent, 2.9 percent, 1.9 percent, 1.5 percent, respectively. The results of multivariate analysis showed the main characteristics of subjects with restrictions to the outpatient health service utilization are as follows: demographic sociological indicators such as registered permanent residence area is western (OR_western=2.18, 95%CI:1.38-3.43) , more than seventy five years old (OR_{over 75}=6.82, 95%CI:2.04-22.9) , unemployment, temporary or permanent employment (OR _unemployment=1.90, 95%CI:1.17-3.08; OR_{temporary employment}=3.11, 95%CI:1.57-6.14; OR_{permanent employment}=2.10, 95%CI:1.18-3.74) , self-rated health score of 50 or above (OR_{self-rated-70}=2.04, 95%CI:1.18-3.51; OR_{self-rated-90}=3.00, 95%CI:1.97-5.37; OR_{self-rated 90}=2.95, 95%CI:1.74-8.07) ; with increase to the outpatient health service utilization are breath with difficulty (OR=0.57, 95%CI:0.41-0.78) , emphysema (OR=0.48, 95%CI:0.26-0.90) , hospitalized with pneumo-coniosis (OR=0.12, 95%CI:0.07-0.20) . Conclusion Pneumoconiosis patients no covered by injury insurance should be orderly included in the basic medical security system, and be given the medical treatment actively; It should be strengthened the health management for the pneumoconiosis patients and correctly guided the utilization of medical services.

Objective: To explore the application value of pressure-strain loop (PSL) in evaluating left ventricular myocardial work (MW) in patients with chronic heart failure (CHF). Methods: Seventy patients with CHF were selected as case group(CHF group) and were divided into 2 groups according to the left ventricular ejection fraction (LVEF) in ultrasonic cardiogram: LVEF preserve group (HFpEF group, LVEF≥50%, n=35) and LVEF reduced group (HFrEF group, LVEF<50%, n=35). Thirty-three healthy volunteers were selected as control group at the same period. Two-dimensional dynamic images in apical two chamber, three chamber and four chamber views were collected by two-dimensional speckle-tracking. Using the off-line EchoPAC software, a tracing analysis was conducted and the blood pressure was entered to obtain left ventricular global longitudinal strain (GLS), global MW index (GWI), global constructive work (GCW), global wasted work (GWW) and MW efficiency (GWE). The differences of GLS and MW parameters (GWI, GCW, GWW, GWE) were compared between each groups, and Pearson correlation was used to analyze the correlation between MW parameters and LVEF. Results: Compared with the control group and HFpEF group, the left atrial dimension(LAD), left ventricular end-diastolic dimension(LVDd), left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume(LVESV) in HFrEF group increased, while LVEF decreased significantly(P<0.05). Compared with the control group, LAD in HFpEF group increased, the vaules of GLS, GWI, GCW were obviously lower in HFpEF group and HFrEF group(all P<0.05), GWW was higher and GWE was lower in HFrEF group(all P<0.05). GLS, GWI, GCW, GWE decreased and GWW increased in HFrEF group than those in HFpEF group, and all the differences were statistically significant(all P<0.05). In CHF group, GWW was negatively correlated with LVEF (r=-0.521, P<0.001) while positive correlations between GWI, GCW, GWE and LVEF were discovered (r=0.846, 0.807, 0.788; all P<0.001). Conclusions PSL can effectively evaluate the left ventricular MW in CHF patients. It has a certain correlation with LVEF and can reflect left ventricular systolic function. It provides a new reference index for the clinical diagnosis and evaluation of prognosis in CHF patients.