1.Noninvasive assessment of coronary artery flow reserve by transthoracic Doppler echocardiography in patients with coronary artery disease
Yongsheng ZHU ; Hongling LI ; Ting ZHU ; Jun LI ; Jun ZHANG
Chinese Journal of Ultrasonography 2010;19(11):929-932
Objective To assess the feasibility of evaluation of coronary flow reserve (CFR) for left anterior descending (LAD),left circumflex (LCx),and right coronary posterior descending artery(PDA) as well as diagnostic accuracy for patency of each branches by transthoracic Doppler echocardiography (TTDE). Methods CFR of main coronary artery branches at the distal sites were studied by TTDE with adenosine infusion (140 μg · kg-1 · min-1) in 439 consecutive patients with suspected coronary heart disease. The relations between CFR and stenosis rates of coronary bifurcations were analyzed. Results Twenty-eight of LAD,12 of LCx and 21 of PDA were occluded in 439 patients. The success rate of CFR assessment of LAD, LCx and PDA were 96.8% (395/411), 74.9% (320/427), 83.0% (347/418)respectively. Then CFR≤2.0 and CFR≤1.7 were chosen as the criteria of coronary stenosis (≥50 %) and severe stenosis(≥75%). The sensitivity and specificity of detection of LAD,LCx and PDA stenosis were 81% and 87% ,64% and 82%, 79% and 85%, respectively. The sensitivity and specificity of diagnosis of LAD, LCx and PDA severe stenosis were 86% and 81%, 70% and 85%, 81% and 82%, respectively.Conclusions CFR evaluation of main coronary artery branches has high feasibility and can provide valuable information for relevant vessel patency.
2.Analysing on failure in transcatheter closure of ventricular septal defect
Jun LI ; Jun ZHANG ; Lixun LIU ; Ting ZHU ; Liwen LIU ; Yongsheng ZHU ; Mei LI
Chinese Journal of Ultrasonography 2010;19(12):1020-1022
Objective To analyse the failure reason in transcatheter closure of ventricular septal defect(VSD) ,in order to improve the succeeding rate of occlusive operation on screening VSD patients with echocardiography. Methods Echocardiographic datas were summarized in 50 cases who were failed in VSD occlusion. Results Atrio-ventricular block was occurred in 14 patients,residual shunt was visualized in 13 cases,transcatheter occlusive track could not be set up in 19 cases,arotic valve regurgitation in two cases were screened obviously after occlusive device was released into the intracristal VSD. One case was suffered from cononary heart disease(CAD) and another one was suffered from acute myocardial infarction with ventricular septal perforation. All these patients did not succeed in closure procedure. Conclusions The defect sizes of left and right sides of ventricular septal, structure close to defect must be considered in selecting patients before operation by echocardiography. Occlusion operation should be strictly chosen in cases who were children,or suffered from complex VSD,or senior patients with CAD.
3.The effects of DR2 on myocardial ischemic postconditioning and its underlying mechanisms.
Hong-Zhu LI ; Jun GAO ; Xiao-Min HAO ; Li-Min ZHANG ; Jun-Ting CHEN
Chinese Journal of Applied Physiology 2014;30(4):301-305
OBJECTIVETo study the effects of dopamin receptors-2 (DR2) on myocardial ischemic postconditioning and explore its underlying mechanisms.
METHODSThe myocardial ischemic postconditioning (PC) model was established in cultured primary rat neonatal cardiomyocytes which were then randomly assigned in the following groups: Nomial control group, Isehemia/reperfusion (L'R) group, PC (ischemic postconditioning) group, PC + Bro (Bromocriptine, a DB2 antagonist) group, PC + Hal (Haloperidol, a DB2 repressor) and PC + Hal + Bro groups. The lactate dehydrogenase (LDH) and superoxide dismutase (SOD) activity and malondialdehyde (MDA) content in cell medium were analyzed by colorunetry. The cell ultrastructure changes were observed by transmission electron microscope. The cell apoptosis was analyzed using flowcytometiy. The protein expression level of D112 and activity of p-p38 and p-JNK were detected by Western blot.
RESULTSCompared with the nonnal control group, hR increased the protein expression level of DB2, enhanced LDH activity and MDA content, promoted cell injury and apoptosis, decreased SOD activity, up-regulated the activity of p-p38 and p-JNK. Compared with the hR group, although PC further increased the expression of DR2 protein, it decreased LDH activity and MDA content, cell injury and apoptosis, increased SOD activity, down-regulated activity of p-p38 and p-JNK. Bromocriptine treatment further enhanced PC-induced canlioprotective effect, yet Hal addition attenuated this enhancing effect exerted by bromocriptine.
CONCLUSIONThe activation of DB2 is involved in the protective effect of ischemic postconditioning on myocardial ischemia/reperfusion injury through down-regulating the activity of p-p38 and p-JNK.
Animals ; Apoptosis ; Cells, Cultured ; Ischemic Postconditioning ; JNK Mitogen-Activated Protein Kinases ; metabolism ; Myocardial Reperfusion Injury ; prevention & control ; Myocytes, Cardiac ; pathology ; Rats ; Rats, Wistar ; Receptors, Dopamine D2 ; physiology ; p38 Mitogen-Activated Protein Kinases ; metabolism
4.Value of transthoracic echocardiography on guiding occlusion of soft-rim atrial septal defect
Jun ZHANG ; Jun LI ; Jing SHI ; Yushun ZHANG ; Jian ZUO ; Zhengxue DAI ; Huan LI ; Ting ZHU
Chinese Journal of Ultrasonography 2008;17(6):494-497
Objective To evaluate the feasibility and effect of transthoracic echocardiography(TTE)on guiding the occlusion of the soft-rim atrial septal defect(ASD).Methods Sixty two patients with the soft-rim ASD were enrolled.The size of ASD was measured and rim of ASD was observed by TTE on various views by using color Doppler system with tissue harmonic function before occlusion,and filmy rim of ASD with flapping which could not sustain occluder was eliminated.The size of occluder was selected by integratively judging the size of ASD and"sustainable diameter of ASD"The waist size of occluder was measured after releasing occluder and compared with the longest diameter of ASD and"sustainable diameter of ASD"measured by TTE.Results The longest diameter of ASD measured by TTE before occlusion was 11-35 mm[average(21.6±5.2)mm],the "sustainable diameter of ASD"was 15-37 mm[average(25.6±5.(J)mm],the size of selected occluder was 18-44mm[average(30.7±5.5)mini and the waist size of released occluder was 13-35 mm[average(24.2±5.6)mm].Fine correlation was existed between the longest diameter of ASD measured by TTE and the waist size of released occluder(r=0.86,P<0.000I).Morever,improved correlation was found between the"sustainable diameter of ASD"measured by TTE and the waist size of released occluder(r=0.89,P<0.0001).Occluder was firmly fixed without falling in all patients.Conclusions TTE with tissue harmonic function can be used to measure the size of soft-rim ASD and the"sustainable diameter of ASD".It is a feasible,and effective method on guiding occlusion of soft-rim ASD.
5.Quantitative assessment of global and regional left ventricular function in patients with acute myocardial infarction by real-time three-dimensional echocardiography
Jun ZHANG ; Ye ZHENG ; Liwen LIU ; Hongling LI ; Ting ZHU ; Hui XU ; Jun LI ; Xiaodong ZHOU
Chinese Journal of Ultrasonography 2008;17(5):381-384
Objective To probe into clinical value of real-time three-dimensional echocardiography (RT-3DE) in evaluating global and regional left ventricular function in patients with acute inferior, posterior and lateral myocardial infarction(MI).Methods The study consisted of 41 normal subjects and 23 patients with acute MI.RT-3DE was performed and three-dimensional image data was analyzed offline with software.A series of global and regional left ventricular volume curves were plotted.Regional and global diastolic volumes, regional and global systolic volumes, regional and global ejection fractions, regional stroke volume to global diastolic volume were compared respectively between control group and MI group.Results By contrast with control group, global left ventricle function and regional left ventricle function in the zones with infarction and part of the zones close to infarction had significant difference( P<0.05),however,no effective statistic change was found in the most of the distal zones of infarction( P>0.05).Conclusions RT-3DE can accurately evaluate measurement the left ventricular global and regional function in patients with acute MI.
6.Application of asymmetric occluders in ventricular septal defect interventional occlusion and analysis of complications
Jun LI ; Jun ZHANG ; Ting ZHU ; Mei LI ; Haili SU ; Minjuan ZHENG ; Yun HU
Chinese Journal of Ultrasonography 2011;20(5):382-385
Objective To investigate the feasibility and clinical effectiveness of interventional ventricular septal defect(VSD) occlusion using asymmetric occluders in patients whose VSD are adjacent to aortic valves.Methods One hundred and fifty-two patients from our hospital whose VSD were occluded with asymmetric occluders were examined by echocardiography.Dimensions,shapes and shunts of VSD,structures around defects were observed and aortic valve prolapse(AVP) degrees were accessed before the interventions.The patients were followed up periodically after the procedures.The longest follow-up was 6 years.Results Sizes of VSD measured from left ventricular side were larger than those measured from right ventricular side.Twenty-seven cases with VSD had mild AVP.Right sides of defects had adhesions with variable morphological patterns in 85% patients with perimembranous VSD.After occlusion,there were 7 cases showed residual shunt,2 cases with the third degree atrio-ventricular blockages,3 cases appeared aortic-valve regurgitations (AR) and 1 case with slightly increased AR.Conclusions Immediate and medium-term effects of interventional occlusion with asymmetric occluders were satisfactory in the patients with VSD and mild AVP whose aortic valve margin were insufficient to symmetric occluders.Surgical operation should be preferred to patients with VSD and moderate to severe AVP and to very young children.Pre-closure echocardiographic evaluation is critical to the success of interventional closure with asymmetric occluder and the long-term out coming.
7.PICK1 is associated with central nervous system diseases.
Journal of Zhejiang University. Medical sciences 2009;38(6):649-654
PICK1 (protein interacting with C kinase 1) contains a PDZ (PSD-95/Dlg/ZO1) domain and a BAR (Bin/amphiphysin/Rvs) domain. Via the PDZ domain, PICK1 interacts directly with more than 40 proteins. Among these interacting proteins, some are important for physiological and pathophysiological processes of central nervous system. In this review, recent findings about how PICK1 is associated with central nervous system diseases are summarize.
Animals
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Carrier Proteins
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chemistry
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metabolism
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physiology
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Epilepsy
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metabolism
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Humans
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Nuclear Proteins
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chemistry
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metabolism
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physiology
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Schizophrenia
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metabolism
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Stroke
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metabolism
8.Study of pretreatment on microfiltration of huanglian jiedu decoction with ceramic membranes based on solution environment regulation theory.
Bo LI ; Lian-Jun ZHANG ; Li-Wei GUO ; Ting-Ming FU ; Hua-Xu ZHU
China Journal of Chinese Materia Medica 2014;39(1):59-64
To optimize the pretreatment of Huanglian Jiedu decoction before ceramic membranes and verify the effect of different pretreatments in multiple model system existed in Chinese herb aqueous extract. The solution environment of Huanglian Jiedu decoction was adjusted by different pretreatments. The flux of microfiltration, transmittance of the ingredients and removal rate of common polymers were as indicators to study the effect of different solution environment It was found that flocculation had higher stable permeate flux, followed by vacuuming filtration and adjusting pH to 9. The removal rate of common polymers was comparatively high. The removal rate of protein was slightly lower than the simulated solution. The transmittance of index components were higher when adjust pH and flocculation. Membrane blocking resistance was the major factor in membrane fouling. Based on the above indicators, the effect of flocculation was comparatively significant, followed by adjusting pH to 9.
Ceramics
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chemistry
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Drugs, Chinese Herbal
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chemistry
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Flocculation
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Membranes, Artificial
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Polymers
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chemistry
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Solutions
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chemistry
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Ultrafiltration
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methods
9.Clinical study of wave intensity in assessing short-term effects of cardiac resynchronization therapy
Liwen LIU ; Bin MA ; Jun ZHANG ; Haibin ZHANG ; Yunyan DUAN ; Xiaodong ZHOU ; Ting ZHU ; Liping YANG
Chinese Journal of Ultrasonography 2010;19(9):761-764
Objective To investigate the clinical application of wave intensity (WI) technique in assessing the short-term effects of cardiac resynchronization therapy(CRT). Methods Sixteen patients with congestive heart failure treated with CRT were chosen. Before the implantation of CRT pacemaker and 1 week, 1 month,3 month after it,the diameters and volumes of left ventricle(LV) in the end-diastole and the end-systole were measured by echocardiography. LV ejection fractions(LVEF) were calculated by Simpson's way,and the variation ratio of left ventricular end-systolic volume(△ESV) was assessed each time after the CRT. The maximal rate of LV pressure rise (LVdP/dtmax) was assessed in the continuous-wave Doppler spectrum of mitral regurgitation. The magnitude of W1, and the length of R-W1 interval as well as W1-W2interval were recorded by WI technique applied on the left carotid artery of each patient. Results Compared to the data before CRT,W1 and W1-W2 interval were significantly higher in different period after CRT (P <0. 01). This result was conformed with echocardiographic remodeling data and LV systolic function.Conclusions WI provides a potential usage in conveniently and effectively assessing the CRT effects in short-term.
10.Assessment of myocardial microcirculation in diabetic rats using myocardial contrast echocardiography
Zhangrui WEI ; Jun ZHANG ; Haili SU ; Haibin ZHANG ; Hong SHI ; Ting ZHU
Chinese Journal of Ultrasonography 2009;18(12):1064-1067
Objective To investigate whether myocardial contrast echocardiography(MCE)combined with stress echocardiography could detect myocardial microcirculation disturbance of left ventricular(LV)in diabetic rats.Methods MCE were performed at rest and after dipyridamole infusion from parasternal shortaxis views at the papillary muscle level in DM rats(n=18,12 weeks later after STZ administration)and control rats(n=12).Regions of interest(ROI)were positioned with the anterior, lateral, posterior and septum walls.Plateau intensity(PI), initial slope of the curve(β)and time to PI(TTP)were obtained from the curve and myocardial blood flow(MBF)and myocardial flow reserve(MFR)was estimated.After the performance of MCE, myocardium was prepared for γ Well counting with ~(99m)Tc-MIBI and CD31 immunohistochemistry staining.Results There was no significant difference in MBF between the ROI of anterior, lateral, septum walls beyond posterior wall in each group at rest and after stress.MCE values from anterior wall were selected as the indexes for comparisons between the two groups.The PI., MBF and MFR in the DM group were significantly lower than those in the control group at rest and after stress(all P< 0.05).The β in the DM group was significantly lower and TTP was significantly longer after dipyridamole stress(P<0.05).The nuclide intake of myocardial tissue in different walls was similar in the DM group, but theY were all lower than those in the control group(P<0.05).The capillary density decreased significantly in the DM group compared with the control group.Conclusions The PI,β,TTP,MBF and MFR derived from MCE were all sensitive parameters in detecting the microcirculation disturbances in the earlier period of DM.