Objective To measure right ventricular longitudinal strain (RVLS) of pulmonary hypertension(PH) patients by two-dimensional speckle tracking echocardiography,and explore its clinical application value on evaluating right ventricular function and hemodynamics in PH.Methods A total of 66 patients diagnosed as PH by right-heart catheterization were divided into Group Ⅰ (WHO FC Ⅰ / Ⅱ) and Group Ⅱ(WHO FC Ⅲ/Ⅳ) according to WHO pulmonary hypertension function classification.The right ventricular function parameters included:global right ventricular longitudinal strain (RVLSglobal),free-wall right ventricular longitudinal strain (RVLSFw),tricuspid annular plane systolic excursion (TAPSE),right ventricular fractional area change (FAC),tissue Doppler-derived tricuspid lateral annular systolic velocity (s') and right ventricular index of myocardial performance (RIMP).Systolic pulmonary artery pressure (sPAP) was calculated through tricuspid regurgitation pressure gradient.Hemodynamic parameters include:mean pulmonary arterial pressure (mPAP),pulmonary vascular resistance (PVR),pulmonary capillary wedge pressure (PCWP) and cardiac index (CI).Results ①Compared with Group Ⅰ,Group Ⅱ presented with higher sPAP (P ＜0.05).There also were significant differences between two groups in RVLSglobal,RVLSFw (P ＜0.01) and conventional right ventricular function parameters:TAPSE,RIMP and s' (P ＜0.05).②mPAP,PVR and CI had significant difference between two groups (P ＜0.01),while PCWP had no significant difference.mPAP and PVR increased more remarkable and CI decreased more significant in Group Ⅱ.③RVLSglobal had positive correlation with mPAP (r =0.646,P =0.000) and PVR (r =0.628,P =0.000) measured by right-heart catheterization;RVLSFW also had positive correlation with mPAP (r =0.652,P =0.000) and PVR (r =0.634,P =0.000).Conclusions Right ventricular longitudinal strain could evaluate the degree of decrease in right ventricular function of PH patients and reflex the change of hemodynamics at the same time,which may offer more reliable information to clinical treatment.

Objective To measure tricuspid annular displacement by two-dimensional speckle tracking echocardiography in pulmonary hypertension (PH) patients,and compare with the right ventricular function parameters,finally discuss the clinical application value of this technology in evaluating the right ventricular function in PH.Methods A total of 58 patients diagnosed or suspected diagnosed as PH were divided into PH group and control group according to pulmonary arterial systolic pressure measured by echocardiography.The right ventricular function parameters included:tricuspid annular plane systolic excursion (TAPSE),right ventricular fractional area change (FAC),tissue Doppler-derived tricuspid lateral annular systolic velocity (s') and right ventricular index of myocardial performance (RIMP).The parameters of tricuspid annular displacement included:the peak systolic tricuspid annular displacement at right ventricular free wall (TMAD1),the peak systolic tricuspid annular displacement at interventricular septum (TMAD2),the peak systolic tricuspid annular displacement at midpoint of tricuspid annulus (TMADm) and the right ventricular longitudinal shortening (TMADm％).Results ① There were significant statistical differences between two groups in TAPSE,RIMP,FAC and s' (P ＜0.01),TMAD1 (P＜0.05),and TMAD2,TMADm and TMADm％ (P ＜0.01).② Area under ROC curve indicated that parameters of tricuspid annular displacement had moderate predictive value in predicting the decline of right ventricular function in PH patients (P ＜0.01).③ Setting 15.5％ as cut-off value for TMADm％ to assessment FAC＜35 ％,TAPSE＜17 mm,RIMP＞0.54 and s'＜9.5 cm/s,their sensitivities were 81.8％,84.4％,85.7％ and 72.3％ respectively,and their specificities were 72.0％,73.1％,70.3％ and 100％ respectively.Conclusions The tricuspid annular tissue displacement parameters can predict the decrease of right ventricular function in patients with PH,and provide a new diagnostic index for clinical treatment and prognosis.

Objective To assess the right atrial(RA) function using two-dimensional speckle-tracking echocardiography(2D-STE) and the value of predicting WHO functional class in patients with pulmonary hypertension(PH).Methods Fifty-four consecutive PH patients were studied and compared with a control group of 24 healthy volunteers.RA function was evaluated by 2D-STE,and the following parameters were recorded:an average longitudinal strain (LS) curve that included LSpos during RA filling and LSneg representing RA active contraction (their summation is LStot),the phasic RA volumes,total RA emptying fraction (TotEF),RA passive(PassEF) and active emptying fraction(ActEF).The associations between these indices and the results of invasive pulmonary hemodynamics,cardiac structure and function level were evaluated.Results LStot,TotEF,LSpos,PassEF were significantly lower in PH patients than in controls(all P<0.01).ActEF/TotEF were significantly higher in WHO functional class (WHO-FC) Ⅱ and WHO-FC Ⅲ patients than in controls(all P<0.05),while were lower in WHO-FCIV patients than in controls(P<0.001).Among PH patients,LStot was negatively correlated with greater RA size and RA pressure (all P<0.01).LStot was also associated with right ventricular (RV) functional and overload parameters.In receiver-operator characteristic analysis,RA LStot was of optimal accuracy for prediction of WHO-FC≥Ⅲ in PH patients (P=0.002).Conclusions PH is associated with impaired reservoir and conduit function,but active contract function of RA is enhanced in WHO-FC Ⅱ and WHO-FC Ⅲ patients,and reduced in WHO-FCIV patients.RA LStot confers an optimal predictive effect of poor WHO-FC in PH patients and indicating prognosis.

Objective To investigate the effect and mechanism of decorin (DCN) on invasion of colorectal cancer cell line HCT116 in vitro.Methods Transwell assay was employed to detect the invasion of HCT116 cells;Real-time PCR was used to detect the expression of CD133 and TIMP-2 mRNA of HCT116 cells;Western blot method was used to detect the expression of HIF-1α, CD133 and TIMP-2 protein of HCT116 cells.Results 1) When the concentrations of DCN was 0, 1 and 3 mg/L, under the conditions of normal oxygen and hypoxia, the numbers of invasive cells were (241±46), (168±46), (51±17) fields in each well (P<0.01) and (207±61), (213±64), (156±54), (44±17) fields in each well (P<0.01).2) Under the normoxic conditions, the TIMP-2 mRNA and protein in HCT116 cells were increased by DCN (3 mg/L) (P<0.01), but that of CD133 were not affected.3) DCN (3 mg/L) significantly decreased the expression of HIF-1α/CD133/TIMP-2 protein in HCT116 cells under hypoxia (P<0.01), but had no significant effect on the expression of CD133 mRNA.ConclusionsUnder the conditions of hypoxia and normal oxygen, DCN may function through different mechanisms to inhibit the invasion of colorectal adenocarcinoma cell line HCT116 in vitro.

Objective To evaluate the right atrial(RA)volume and phasic function using three-dimensional echocardiography(3DE),and to examine the clinical relevance in pulmonary hypertension(PH). Methods Fifty PH patients and 20 control subjects were studied.RA volume,including maximum RA volume(Vmax),minimum RA volume(Vmin)and the volume before active systolic(Vpre-A)were evaluated by 3DE.RA maximum volume index(VmaxI),total emptying volume index(TotEVI),passive emptying volume index(PassEVI)and active ejection fraction(ActEF)were calculated.The correlation between RAVmaxI and the parameters of RV structure,function,pulmonary hemodynamics were analyzed.Results Maximum RA volume index(RAVmaxI)was higher in WHO functional class(WHO-FC)Ⅲ,Ⅳ of PH patients than in controls(all P <0.01).TotEVI was significantly higher in PH patients than in controls (P<0.001),but PassEVI was lower in PH patients than in controls(P =0.01 1).ActEF was similar when comparing PH patients of WHO-FC Ⅱ with controls.ActEF increased in PH patients with WHO-FCⅢ as compared with controls(P =0.008)but reduced in advanced with WHO-FC Ⅳ patients(P <0.001).RAVmaxI correlated with the indices of right ventricular(RV)structure,function and RV cardiac output index(all P <0.05).Conclusions PH is associated with increased RA size,increased TotEVI,and decreased PassEVI.ActEF increases in PH patients with WHO-FC Ⅲ but decreases in patients with WHO-FCⅣ.RA systolic function plays an important role in compensating RV dysfunction.

Objective:To identify the risk factors of cognitive dysfunction in patients with atrial fibrillation and to establish a risk prediction model.Methods:The convenience sampling method was used to evaluate 260 patients with atrial fibrillation who were hospitalized in the Department of Cardiology of the Affiliated Hospital of Jining Medical College from January to December 2020. The cognitive function of the patients was evaluated with the Montreal Cognitive Function Assessment Scale (MoCA). Univariate analysis was used to screen the independent variables that had influence on the occurrence of cognitive dysfunction, and the statistically significant variables were included in the multivariate Logistic regression model. According to the regression coefficients of statistically significant variables, a line map was drawn to construct the risk prediction model of cognitive dysfunction in patients with atrial fibrillation.Results:There were 209 cases with cognitive impairment and 51 cases without cognitive impairment. Univariate analysis showed that sex, age, smoking history, drinking history, education level, free thyroxine, hemoglobin, D-dimer and BMI ( χ2 values were 4.08-18.83, t values were -6.04-2.94, Z=-2.76) were significantly different between the patients with or without cognitive dysfunction. The results of multivariate Logistic regression analysis showed that age ( OR values were 1.13), education level ( OR=0.01-0.05), quit smoking history ( OR=0.36), drinking history ( OR=0.35) and free thyroxine( OR=1.14) had significantly statistical significance ( P<0.05). The area under ROC curve (AUC) = 0.878 and AUC>0.8, this model had good clinical prediction ability. Conclusions:The construction of cognitive dysfunction risk prediction model for patients with atrial fibrillation can prevent or intervene high risk factors in advance, facilitate clinical use, and provide data support for the improvement of cognitive function in patients with atrial fibrillation.

OBJECTIVE: To evaluate the effectiveness of limited internal fixation combined with a hinged external fixator in the treatment of peri-elbow bone infection. METHODS: The clinical data of 19 patients with peri-elbow bone infection treated with limited internal fixation combined with a hinged external fixator between May 2018 and May 2021 were retrospectively analyzed. There were 15 males and 4 females with an average age of 44.6 years (range, 28-61 years). There were 13 cases of distal humerus fractures and 6 cases of proximal ulna fractures. All the 19 cases were infected after internal fixation of fracture, and 2 cases were complicated with radial nerve injury. According to Cierny-Mader anatomical classification, 11 cases were type Ⅱ, 6 cases were type Ⅲ, and 2 cases were type Ⅳ. The duration of bone infection was 1-3 years. After primary debridement, the bone defect was (3.04±0.28) cm, and the antibiotic bone cement was implanted into the defect area, and the external fixator was installed; 3 cases were repaired with latissimus dorsi myocutaneous flap, and 2 cases were repaired with lateral brachial fascial flap. Bone defects repair and reconstruction were performed after 6-8 weeks of infection control. The wound healing was observed, and white blood cell (WBC), erythrocyte sedimentation rate (ESR), and C-reaction protein (CRP) were reexamined regularly after operation to evaluate the infection control. X-ray films of the affected limb were taken regularly after operation to observe the bone healing in the defect area. At last follow-up, the flexion and extension range of motion and the total range of motion of the elbow joint were observed and recorded, and compared with those before operation, and the function of the elbow joint was evaluated by Mayo score. RESULTS: All patients were followed up 12-34 months (mean, 26.2 months). The wounds healed in 5 cases after skin flap repair. Two cases of recurrent infection were effectively controlled by debridement again and replacement of antibiotic bone cement. The infection control rate was 89.47% (17/19) in the first stage. Two patients with radial nerve injury had poor muscle strength of the affected limb, and the muscle strength of the affected limb recovered from grade Ⅲ to about grade Ⅳ after rehabilitation exercise. During the follow-up period, there was no complication such as incision ulceration, exudation, bone nonunion, infection recurrence, or infection in the bone harvesting area. Bone healing time ranged from 16 to 37 weeks, with an average of 24.2 weeks. WBC, ESR, CRP, PCT, and elbow flexion, extension, and total range of motions significantly improved at last follow-up ( P<0.05). According to Mayo elbow scoring system, the results were excellent in 14 cases, good in 3 cases, and fair in 2 cases, and the excellent and good rate was 89.47%. CONCLUSION Limited internal fixation combined with a hinged external fixator in the treatment of the peri-elbow bone infection can effectively control infection and restore the function of the elbow joint.
Male ; Female ; Humans ; Adult ; Elbow ; Elbow Joint/surgery* ; Retrospective Studies ; Bone Cements ; Treatment Outcome ; External Fixators ; Fracture Fixation, Internal/methods* ; Fractures, Bone ; Range of Motion, Articular