Objective To evaluate right ventricular systolic function in patients with pulmonary hypertension (PH) by real-time three-dimensional echocardiography (RT-3DE),and compared with cardiac magnetic resonance.Methods A total of 23 patients with PH who underwent MRI and echocardiography in the study.Right ventricular index of myocardial performance (RIMP),fractional area change (RVFAC),tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler-derived tricuspid lateral annular systolic velocity (S') were measured by echocardiography.RV end-diastolic volume (RVEDV) and endsystolic volume (RVESV) were measured by RT-3DE and cardiac magnetic resonance and RV ejection fraction (RVEF) was calculated.Results A positive correlation was found between RVFAC and RVEF (r =0.595,P =0.003),there was a negative correlation between RIMP and RVEF (r =-0.745,P =0.000),has no correlation between TAPSE and RVEF (r =-0.029,P =0.896),a positive correlation was found between S' and RVEF (r =0.489,P =0.018).There were close correlation between RVEDV,RVESV and RVEF measured by RT-3DE and MRI (P ＜0.001,respectively);Bland-Altman analyses showed good agreement between them.Conclusions RT-3DE can noninvasive,accurate assessment right ventricular systolic function in patients with PH,and provide prognosis and treatment choice for clinical demands.

Objective To discuss the correlation between right ventricular function and systolic pulmonary artery pressure (PASP ) in patients with chronic thromboembolic pulmonary hypertension (CTEPH)and explore the change of right ventricular function under different degree of PASP.Methods One hundred and thirty-seven CTEPH patients were divided into four groups by PASP:Group Ⅰ (50 mmHg≤PASP<70 mmHg),20 cases;Group Ⅱ (70 mmHg≤PASP<90 mmHg),35 cases;Group Ⅲ,55 cases (90 mmHg ≤ PASP < 1 10 mmHg);Group Ⅳ (PASP ≥ 1 10 mmHg),27 cases.Echocardiographic parameters include:PASP,tricuspid regurgitation area (ATR ),left ventricular transverse diameter (LVTD), right ventricular transverse diameter (RVTD),inner diameter of main pulmonary artery (DMPA ),inner diameter of left arterial branch (DLPA ),inner diameter of right pulmonary arterial branch (DRPA ).Right ventricular function parameters include:tissue Doppler-derived tricuspid lateral annular systolic velocity (s'),tricuspid annular plane systolic excursion (TAPSE),RV index of myocardial performance (RIMP)and right ventricular fractional area change (FAC).Results There were significant differences in RVTD, TAPSE,FAC and RIMP in CTEPH patients under different PASP(P <0.05).RV structure and function was significantly correlated with PASP in CTEPH patients.With the elevation of PASP,RV was significantly enlarged and RV function becomes worse.Conclusions Echocardiography may contribute to evaluate RV function in CTEPH patients and provide basis for clinical treatment and prognosis evaluation.

Objective: To evaluate the effect of online lifestyle intervention based on cognitive behavior adjustment on the female patients with infertility and central obesity. Methods: From November 2019 to November 2020, the women with infertility and central obesity in the Reproductive Medicine Center of Zhejiang Provincial People's Hospital were recruited and divided into two groups. The intervention group received online lifestyle intervention based on cognitive behavior adjustment for twelve weeks, and the control group received routine health education. Body weight, waist circumference, fasting blood glucose, fasting insulin, insulin resistance index (HOMA-IR), body fat, the pregnancy rate and the abortion rate were compared between the two groups. Results: There were 78 cases each in the intervention group and the control group, aged (31.15±4.87) years and (31.17±4.81) years, respectively. There were no significant differences between the two groups in age, body weight, body mass index, waist circumference, waist-hip ratio, fasting blood glucose, fasting insulin, HOMA-IR and body fat percentage before intervention (all P>0.05). After twelve-week intervention, the results of mixed effect model showed that the decrease of waist circumference, fasting insulin and body fat percentage in the intervention group were greater than those in the control group (all P<0.05). After six-month follow-up, there was no significant differences in the pregnancy rate (33.33% vs. 23.08%) and the abortion rate (7.69% vs. 16.67%) between the two groups (both P>0.05). Conclusion Online lifestyle intervention based on cognitive behavior adjustment helps to control central obesity and hyperinsulinemia.

Objective To detect the new views for pulmonary vascular by transesophageal echocardiography(TEE) during lung transplantation.Methods Seventeen cases with respiratory failure underwent lung transplantation.A series of scans were detected by TEE during preoperative anesthesia, preand pro-pulmonary vascular occlusion and pro-donor lung, and bronchus, pulmonary veins, pulmonary artery anastomoses.Left and right lung veins open and left and right pulmonary artery branch were key to observed.Pulmonary artery trunk and branch diameter, velocity of blood flow were measured.Results All left and right pulmonary artery,pulmonary vein images were given by TEE.TEE detected the normal blood flow velocity of pulmonary artery branches during pre-operation,average of 65 cm/s.After clipping the side of the pulmonary artery, the lateral pulmonary blood flow disappeared.TEE detected pulmonary veins,pulmonary artery anastomoses pro-operation.Except for 1 case of anastomotic pulmonary vein flow velocity increased,all the pulmonary vein and pulmonary artery branch anastomoses flow velocity increased slightly faster than those before transplantation (mean pulmonary artery branch of 160 cm/s, the average pulmonary vein 149 cm/s).Conclusions TEE can monitor diameter and flow velocity of pulmonary artery branch and pulmonary vein during lung transplantation,and can detect the rightventricular function.The views of left and right branch pulmonary artery and pulmonary vein branches play an important role during lung transplantation.

Objective To evaluate right ventricular function of chronic thromboembolic pulmonary hypertension (CTEPH) patients by echocardiography and cardiac magnetic resonance (CMR),and to evaluate the value of clinical application of those right heart function indexes.Methods 32 patients with CTEPH who underwent CMR and echocardiography were involved in the study.Right ventricular index of myocardial performance (RIMP),fractional area change (FAC),tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler-derived tricuspid lateral annular systolic velocity (S') were measured by echocardiography.Right ventricular end-diastolic volume (RVEDV) and end-systolic volume (RVESV) were measured by cardiac magnetic resonance and right ventricular ejection fraction (RVEF) was calculated.Results A positive correlation was found between FAC and RVEF (r =0.423,P =0.022),there was a negative correlation between RIMP and RVEF (r =-0.387,P =0.048),there was no correlation between TAPSE and RVEF (r =0.451,P =0.22),a positive correlation was found between S' and RVEF (r =0.689,P =0.000).Conclusions The echocardiographic parameters FAC,RIMP and S' can reflect right ventricular function in patients with CTEPH and can be used as a routine clinical parameters.

Objective To assess the usefulness of left ventricular contrast echocardiography in diagnosis of left ventricular myocardium noncompaction.Methods Contrast echocardiography was done in ten patients who were diagnosed or suspected with left ventricular noncompaction by common transthoracic echocardiography,for further study of the trabecular muscles extent,the continuity of the endocardium,the compact myocardium thickness,and the contrast agent in the trabecula recessus.Results By contrast echocardiography,noncompaction myocardium thickness can be perspicuously observed,the turgor of the contrast agent was vividly detected in the trabecular recessus.Especially for the measurement of compaction myocardium,the contrast echocardiography was more accurate than in the condition of the common echocardiography.Conclusions Left ventricular contrast echocardiography can be used in the diagnosis of left ventricular noncompaction,it was a good added method of conventional echocardiography.

Objective To study the correlation between serum adiponectin along with insulin resistanee and vascular dilation function in patients with different rates of glucose metabolism.Method A total of 83 patients aged 50-65 years,including 17 with normal glucose tolerance(NGT),22 with impaired fasting glucose (IFG),23 with impaired glucose tolerance(IGT)and 21 with diabetes(DM)were enrolled. Serum adiponectin was measured,and homeostasis model assessment for insulin resistance index (HOMA-IR)and B cell function index were used to evaluate the function of insulin secretion before and during oral glucose tolerance test(OGTr).The brachial artery responses to flow-mediated endothelium-dependent vascular dilation(EDVD)and nitroglycerin-mediated vascular dilation (EIVD) were evaluated by using the vascular ultrasound with high resolution.Results The serum adiponectin and EDVD decreased that the degrees of reduction from slightness to greatness were in turn from NGT,IFG,IGT to DM,whereas,the insulin resistance index (HOMA-IR) increased just in reverse order.Adiponectin was negatively associated with HOMA-IR(r=-0.353,P<0.01)but positively associated with EDVD and EIVD(rl=0.391,r2=0.375,P<0.01),and was not associated with HOMA-B.On the other hand,EDVD was not associated with HOMA-IR(P>0.05).In a multiple regression analysis with a stepwise manner to predict adiponectin concentration and EDVD.HOMA-IR was supposed to predict adiponectin concentration.Meanwhile APN but not HOMA-IR was used to predict EDVD(P<0.05).Condusions The decrease in serum adiponectin,endothelial dysfunction and insulin resistance can be observed in the early stage of impaired glucose metabolism. Serum adiponectin concentration appears to be associated with vascular function and insulin resistance.The association between serum adiponectin concentration and vascular function seems to be independence from its link with insulin resistance index.

To explore micro-course suitable for human morphology in high vocational nursing pro-fession and meanwhile attempt to make a combination between micro-course and flipped-classroom in some chapter, accompanied by taking advantage of the digital equipments such as computer, tablet and smart phone to carry out teaching. Based on digitization, we aim to lead the fragmented time and energy of students to this beloved teaching method, realizing “self-inquiry learning before class, interactive learning between teacher and students in class, effect assessment after class to reinforce the independent participation and inspire the interest of students in human morphology learning.

To explore the clinical and imaging profiles of left ventricular (LV) diverticulum in adults and review the key points for its differential diagnosis.The clinical and imaging features were reviewed for 2 female and 2 male patients clinically diagnosed with LV diverticulum.Their clinical manifestations and electrocardio graphic presentations were nonspecific.On echocardiography,all diverticula,located at LV apex,had a thinned and weakened wall continuing and contracting synchronously with the adjacent LV wall.Two cases were diagnosed as congenital diverticulum without any other cardiac or thoraco-abdominal anomaly.And the other two had existing coronary artery diseases with significantly reduced global and apical LV systolic function.Mural thrombosis in diverticulum was determined in one congenital case.One patient died of cardiac failue.It suggested that LV diverticulum in adults may be congenital and secondary etiologically.The former is mostly isolated and apically situated while the latter often results from regional myocardial ischemia and elevated intracavitary LV pressure at an ill-perfused area.Echocardiography can demonstrate the 2-dimensional and flow hemodynamics of diverticulum in real time so as to facilitate its diagnosis and differential diagnosis.

ObjectiveTo enhance understanding on echocardiographic and clinical characteristics of valve lesions of non-infective endocarditis (NIE), particularly in patients with systemic lupus erythematosus (SLE). Comparative analysis of the diagnostic value of echocardiography was performed in patients with non-infective endocarditis and atypical infective endocarditis (IE).MethodsData from 38 patients with clinically diagnosed NIE in the institution were collected retrospectively during July 2005 and January 2015, including 10 patients with SLE, 10 with rheumatic heart disease, 11 with rheumatoid arthritis, and 7 with hepatitis B. Data of 42 patients diagnosed as atypical IE during the same period were collected as control group. All patients underwent examinations of blood culture, sero-immunological tests, electrocardiogram and echocardiography. Comparison was made between the two groups using SPSS 11.5 software package. ResultsThe difference in blood culture, sero-immunological tests and electrocardiogram was statistically signiifcant between the groups (χ2 value, 26.29, 5.53, and 4.80, respectively, allP<0.05), although there was no statistical difference in results of echocardiography (χ2=0.03,P>0.05). Echocardiography identiifed valvular vegetations in 27 of 38 patients, with NIE with a detection rate of 71.0%; The size of the vegetations ranged from 2 to 7 mm in diameter; Valve vegetations was found in 36 of 42 patients with atypical IE, with a detection rate of 85.7%; the other six cases demonstrated valvular thickening only; in this group, the vegetations ranged from 2 mm to 19 mm in size and were located in the left heart in 28 patients, 8 cases in the right heart. In the case group, two cases of valve lesions in patients with SLE were confirmed by transesophageal echocardiography (TEE), while missed on TEE examination. Nine cases with more than mild valve regurgitation were identiifed. Ten cases were treated with hormones and cyclophosphamide, after which valve lesions resolution was found on serial echocardiography tests with a follow-up period of 5 days to 3 years.Conclusions Echocardiography is capable of detecting valve lesions at early stage in patients with NIE, particularly in patients with SLE. Echocardiography plays a crucial role in identifying the non-infective thrombotic vegetations, guiding clinical treatment and monitoring the therapeutic effects.