Objective To research and develop the mobile platform-oriented echocardiogram data visualization technology for the evaluation of left ventricular diastolic function,and investigate its application value.Methods First,diagnostic algorithms for the evaluation of left ventricular diastolic function (based on recommendations from ASE & EAE guidelines) were programmed into a mobile application software package,using Adobe Flex builder 4.0 as a basic tool for data visualization.Second,the program was installed in the Apple iPad4 tablet computer,then debugged and improved according to feedback information from practical applications.Results The echocardiogram data visualization for the estimation of left ventricular filling pressures in patients with depressed ejection fraction(EF) or normal EF and grading diastolic function can be implemented in mobile platform device,and simultaneously with emergency bedside echocardiography.The evaluation process can be visually presented by using the graphics to show the algorithm framework,the animation to express the analysis step,the axis to indicate the direction of information,and the color to differentiate the degree of the diastolic dysfunction.Conclusions The mobile platform-oriented echocardiogram data visualization technology makes the evaluation of left ventricular diastolic function more convenient,efficient and fast,and shows its potential to become an important adjunct to evaluation of cardiac function in the context of mobile health.

Objective To observe the parameters of echocardiography in persistent pulmonary hypertension of the newborn(PPHN),and to discuss the influence of persistent pulmonary hypertension on cardiac geometry and left ventricul ar function.Methods 25 cases with PPHN were selected,including 11 mild,9 moderate,and 5 severe cases.Another 23 cases of neonatal jaundice were selected as control group.The left atrium diameter(LAD),left ventricular end diastolic diameter (LVDd),right ventricular end diastolic diameter (RVDd),right atrium diameter (RAD),left ventricular posterior wall thickness (LVPW),interventricular septum thickness (IVS) were measured by echocardiography.The results of echocardiography were analyzed.Results Compared with the control group,the RVDd and RAD of PPHN group were significantly increased,RVDd and RAD dilated with the increasing of pulmonary artery systolic pressure in PPHN group (t =2.53,7.09,2.14,4.77,2.88,2.04,4.59,7.12,2.34,5.12,3.07,all P ＜0.05) ;LVDd decreased in severe group (14.80 ±2.16) mm compared with that in the control group (15.26 ±1.83) mm,mild (16.55 ± 1.50) mm and moderate group (15.67 ± 1.87) mm(t =3.76,4.80,3.74,all P ＜ 0.05).Conclusion Echocardiography is one of the most important method to diagnose PPHN,and can be observed in newborns with non-invasive cardiac changes directly.lt has important value in judgement of severity degree,and provide a reliable basis for clinical diagnosis and treatment.

Objective To explore the diagnosis,treatment and outcome of testicular torsion in children. Methods The clinical data (including the onset,treatment and prognosis) of 19 children of acute testicular torsion were reviewed.The age ranged from 5 days to 13 years. Results There were 15 cases of left side testicular torsion and 4 cases of right side.All of the 19 cases underwent operation.Seventeen cases were with intravaginal torsion,of these 14 testicles were removed for necrosis and only 3 testicles were salvaged by operative detorsion.Two cases were of extravaginal torsion with testicular necrosis and therefore were removed. Conclusions Testicular torsion is a common emergency of scrotum in children.Immediately operation after admission to hospital is the key treatment for salvage of the testicle.

A total of 55 children aged under 14 years with cholecystolithiasis were treated at our hospital between January 2005 to December 2011.Their clinical data were collected and analyzed.The etiologies included pseudolithiasis (n =36),chronic hemolytic disease (n =2),obesity (n =9) and unknown (n =8).Among 50 cases on conservative treatment,42 cases were cured.Four cases underwent laparoscopic cholecystectomy.During a follow-up period of 2-4 years,there was no occurrence of significant complications.The removal of gallbladder stone was performed via laparoscopy plus choledochoscope in 1 case.There was no recurrence during a follow-up period of 2 years.Ceftriaxone sodium and obesity were the major cause of pediatric cholecystolithiasis.A proper selection of treatment regimens should be based upon the considerations of etiologies and symptoms.

AIM: To validate the alternations of flow velocity patterns in the infarct-related artery (IRA) during no-reflow phenomenon in a canine model of acute myocardial ischemia and reperfusion by transthoracic Doppler echocardiography (TTDE) combined with myocardial contrast echocardiography (MCE) by means of administration of Albunex. METHODS: Nineteen dogs first underwent 60 min myocardial ischemia and then followed by 60 min,120 min and 180 min reperfusion ( n = 6, 6 and 7, respectively). The perfusion defect area determined by MCE at 60 min myocardial ischemia was regarded as risk area (RAMCE). The perfusion defect area defined by MCE after reperfusion was considered as no-reflow area (NRAMCE). The ratio between NRAMCE and RAMCE ≥ 25 %was regarded as the development of no-reflow phenomenon and the ratio of NRAMCE to RAMCE＜25% was considered as the myocardial reflow. The coronary flow velocity parameters in IRA were determined through TTDE. RESULTS: Two dogs died during experiment and the remaining seventeen dogs completed throughout the procedure.There were seven dogs in reflow group and ten dogs in noreflow group. No significant difference was present in reflow group between at baseline and at 60 min reperfusion in systolic peak velocity (PVs), systolic velocity time integral (VT Is), corrected systolic flow duration (cFDs),diastolic peak velocity (PVd), diastolic velocity time integral (VT Id), corrected diastolic flow duration (cFDd),diastolic deceleration rate (DDR), corrected diastolic deceleration duration (cDDD) (P＞0.05), however, a significant difference was found in no-reflow group between at baseline and at 60 min reperfusion in PVs,VTIs, cFDs, PVd, VTId and cFDd (P＜0.05). The most marked alterations during diastolic phase were the increase of DDR and reduction of cDDD. CONCLUSION: The impaired microvasculature may profoundly affect the coronary flow velocity pattern in the IRA. The increase in microvascular resistance and decrease in coronary perfused pressure can contribute to the changes.Transthoracic Doppler echocardiography combined with MCE has the capability of noninvasive assessment of coronary flow velocity pattern in the IRA during no-reflow phenomenon.

AIM: To evaluate the cardiac contractility and relaxation by Doppler tissue imaging (DTI) combined with myocardial contrast echocardiography (MCE) via injection of contrast media, Albunex. METHODS： Nineteen healthy mongrel dogs were conducted 60 min ligation of left anterior descending coronary artery (LAD), followed by reperfusion of 60, 120 and 180 min to establish an acute myocardial ischemic-reperfused canine model. (1) MCE was performed by bolus injection of Albunex at pre-reperfusion and at post-reperfusion. The perfused defect area defined by MCE at pre-reperfusion was regarded as risk area (RAMCE), while perfused defect area at post-reperfusion was regarded as no-reflow area (NRAMCE). When the ratio of NRAMCE to RAMCE exceeded 25%, myocardial reperfusion was considered incomplete, I.e., no-reflow group; If the ratio was <25%, myocardial reperfusion was considered adequate, I.e., reflow group. (2) Left ventricular ejection fraction (LVEF) and wall thickness ratio (△T%) of LV anterior wall were determined. (3)S-wave, e-wave and a-wave velocities at the LV anterior wall were determined by DTI. The e/a ratio was measured. RESULTS: The results of MCE showed 7 dogs in reflow group and 10 dogs in no-reflow group. (1) LVEF in reflow group gradually increased with time course after myocardial reperfusion, and in no-reflow group, however, LVEF increasingly declined with ongoing myocardial reperfusion. At the same reperfusion time point, LVEF of no-reflow group was significantly lower than that of reflow group. (2) △T% in reflow group improved gradually, and however, it can not come back to that of baseline at 180-min reperfusion. △T% in no-reflow group had no signal of recovery with progressive reperfusion. (3) S-wave, e-wave velocities measured by DTI significantly declined after ligation of LAD, and a-wave velocity increased, leading to decline of e/a. After myocardial reperfusion, s-wave, e-wave velocities and e/a in reflow group gradually increased at post-reperfusion, and a-wave velocity somewhat declined. In no-reflow group, on the other hand, s-wave, e-wave velocities and e/a progressively declined and a significant difference was present between reflow group and no-reflow group (P<0.05). CONCLUSION: Cardiac contractility and relaxation can not be recovered during myocardial microvascular impairment. This change may be further deteriorated with size enlargement of no-reflow area. DTI may provide a sensitive, reliable method for quantifying cardiac contractility and relaxation.

Objective To observe the effect of acupuncture penetrated from Tiaokou (ST38) to Chenshan (BL57) combined with exer-cise on affected limbs of shoulder-hand syndrome (SHS) at stage I after stroke. Methods 40 inpatients with SHS at stage I after stroke from January, 2013 to December, 2014 were randomly divided into treatment group (n=20) and control group (n=20). The treatment group accept-ed acupuncture from Tiaokou to Chenshan on unaffected sides and exercise of affected upper limbs, and the control group accetpted routine acupuncture on Triple Shoulder Acupoints on affected sides. They were assessed with Pain Rating Index (PRI), Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) before and 4 weeks after intervention. Results The incidence of improvement was 90% in the treatment group, and 80%in the control group (χ2=0.784, P=0.376). The scores of PRI decreased (t>5.37, P<0.001), and the score of FMA and MBI increased (t>4.66, P<0.001) significantly after intervention. The score of FMA and MBI improved more in the treatment group than in the control group (t>2.25, P<0.05). Conclusion Acupuncture from Tiaokou to Chenshan combined with exercise is more effective on SHS at stage I after stroke than conventional Triple Shoulder Acupoints.

Objective To evaluate the value of the 7-joint ultrasound score (US7) in treatment of rheumatoid arthritis (RA) with Chinese and western medicine.Methods A total of 160 RA patients were divided into 2 groups based on different methods of treatment,including Yi Shen Qing Luo (YSQL) group and western medicine group.The patients were examined by grey scale ultrasound (GSUS) and power Doppler ultrasound (PDUS) with US7 at baseline and after 3 and 6 months later.There were 7 related joints and 5 single factors for scoring in US7 system.The joints included the wrist joints,the second/third metacarpophalangeal joints (MCP Ⅱ/Ⅲ),the second/third proximal interphalangeal joints (PIP Ⅱ / Ⅲ) and the second/fifth metatarsophalangeal joints (MTP Ⅱ/Ⅴ).And the factors included synovitis of GSUS,synovitis of PDUS,myotenositis/tenosynovitis of GSUS,myotenositis/tenosynovitis of PDUS and bone erosion (ES).Meanwhile,the laboratory index included C-reactive protein (C-RP) and erythrocyte sedimentation rate (ESR) were examined.And the clinical indexes as disease activity score in 28 joints (DAS28) were evaluated.Results The statistical differences of synovitis of GSUS,synovitis of PDUS,myotenositis/tenosynovitis of GSUS and myotenositis/tenosynovitis of PDUS scores in US7 system were found in both 2 groups at baseline,3 months and 6 months after treatment (all P＜0.01).There was no statistical difference of ES before and after treatment in all cases (P＞0.05).The factors of US7 were positively correlated with DAS28,C-RP and ESR in different extent.Condusion US7 is a viable tool for examining patients with RA.

Objective To explore the effect of the rehabilitation of Traditional Chinese Medicine(TCM)and neurophysiological therapy(NPT)on motor function in patients with stroke.Methods62 patients with ischemic or hemorrhagic stroke at the recovery stage were divided into two groups.They were given the routine medical treatment and rehabilitation.The patients in the TCM group were given rehabilitation of TCM,while the patients in the control group were given rehabilitation of NPT.They were evaluated with Fugl-Meyer Assessment(FMA)and the Barthel Index(BI)at the beginning and the end of the treatment.ResultsAfter the treatments,the scores of FMA and BI improved obviously in both groups.The BI of the TCM group improved more than that of the control group after the treatments(P=0.015).But the improvement of the FMA between these two groups was not significant.ConclusionBoth the rehabilitation of TCM and NPT can significantly improve the function of stroke patients during the convalescent stage,and TCM is more effective on activity of daily living.

Objective To explore the therapeutic effects of electroacupuncture on regional cerebral blood flow (rCBF) in patients with post-stroke depression. Methods 21 patients with post-stroke depression were randomly divided into electroacupuncture group (n=11) and drug group (n=10). The electroacupuncture group received electroacupuncture on double Hegu (LI4) and Taichong (LR3) once a day for 8 weeks, while the drug group took fluoxetine hydrochloride dispersible tablets 20 mg a day for 8 weeks. They were evaluated with Hamilton Self-rating Scale for Depression (HAMD) before, and 2 weeks, 4 weeks and 8 weeks after treatment respectively. The rCBF were measured with single positron emission computerized tomography (SPECT) before and 8 weeks after treatment. Results The score of HAMD decreased more in the electroacupuncture group than in the drug group 2 weeks after treatment (P<0.05), and there was no significant difference between the two groups 4 and 8 weeks after treatment (P>0.05). The rCBF was significantly greater in the electroacupuncture group than in the drug group. Conclusion That electroacupuncture is effective on post-stroke depression, which may be related with the increase of the rCBF levels.