Purpose To evaluate papillary muscle function in ischemic mitral regurgitation (IMR) with two-dimensional speckle tracking imaging (2D-STI) and three-dimensional ultraphonic technology,and to investigate the primary factors influencing IMR so as to provide clinical information for the prediction of IMR.Materials and Methods Seventy-six IMR patients were enrolled as research group and other 66 healthy volunteers as control group.Two groups were both examined by transthoracic echocardiography and 2D-STI.The parameters including fractional shortening of anterior and posterior papillary muscles (AFS,PFS),length of anterior or posterior papillary muscle tips to contralateral anterior mitral annular (APM-AMA,PPM-AMA),mitral leaflet closure (MLC),inter distance papillary muscle (IPMD),the angle between the anterior papillary muscle and the anterior LV free wall (Ang Ⅰ) and the angle between the posterior papillary muscle and the anterior LV free wall (Ang Ⅱ),anterior and posterior papillary muscle longitudinal strain (ALS,PLS) and peak time (APT,PPT),delay time (DT),left ventricular end-diastolic diameter (LVIDD),left ventricular end-diastole volume (LVEDV),and left ventricular ejection fraction (LVEF) were compared.Results Compared with control group,LVIDD,LVEDV,LVEF,AFS,PFS,IPMD,MLC,ALS,PLS and DT in research group were all significantly different (all P＜0.05).ALS,PLS,AFS,and PFS had positive correlation with LVEF (P＜0.05) and negative correlation with LVEDV (P＜0.05).MLC,IPMD,DT had negative correlation with LVEF (P＜0.05).ALS,PLS,MLC,AFS,PFS,IPMD were significantly correlated with Gensini score (r=-0.65,-0.78,0.54,-0.51,-0.57,0.49,respectively,P＜0.05).The multivariant Logistic regression analysis showed that IMR was correlated with IPMD,MLC,PLS and DT (OR=1.26,1.32,1.37,1.52,respectively,P＜0.05).Conclusion 2D-STI can accurately evaluate the papillary muscle dysfunction caused by myocardial ischemia.Moreover,the risk factors of IMR include increase of IPMD and MLC,decrease of PLS,and desynchronization of papillary muscles.These findings contribute to the clinical prediction of IMR.

Objective To investigate papillary muscle function and construction in myocardial infarction(MI) patients by two-dimensional speckles tracking imaging(2D-STI),and to analyze the influence factors of ischemic mitral regurgitation.Methods Fifty myocardial infarction with ischemic mitral regurgitation(IMR) patients were brought into case group.The patients were divided into two groups:Ant MI group and Inf-Pos-MI group.Forty-five health volunteers were involved as control group.Anterior,posterior papillary muscle longitudinal strain (ALS,PLS),delay time(DT),fractional shortening (FS),length between the posterior or anterior papillary muscle tips and the contralateral anterior mitral annualr (APM AMA,PPM AMA),mitral leaflet closure (MLC),inter distance papillary muscle (IPMD) were aquired respectively.Papillary muscle function and construction among the groups were compared,and the effective factors of IMR were evaluated.Results Between the control group and Ant-MI group,the left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic and end-systolic volume(LVEDV,LVESV),left ventricular ejection fraction(LVEF),ALS,delay time(DT),A FS,IPMD,MLC,APM-AMA,PPM-AMA were significantly different(all P ＜0.05).Between the control group and Inf-Pos-MI group the LVEDD,LVEDV,LVESV,EF,DT,PPM-AMA,MLC,PLS,P-FS were significantly different(P ＜0.05).Between the Ant-MI group and Inf-Pos-MI group,the LVEDD,LVEDV,LVESV,EF,MLC,ALS,PPM-AMA,PLS were significantly different (all P ＜ 0.05).In the Ant-MI group,LVEDV,ALS,MLC were significantly correated with Gensini score(r =0.71,-0.65,0.56;P ＜0.05).In the Inf-Pos-MI group,PPM AMA,PLS were significantly correated with Gensini score(r =0.65,-0.76;P ＜0.05).In the Ant MI group and Inf-Pos-MI group,the ALS,PLS,PPM-AMA were significantly different (P ＜ 0.05).Its correlates in Logistic analysis of Ant-MI group included LVEDV,MLC,DT with OR 1.48,1.72,1.54(P ＜0.05),respectively.Its correlates in logistic analysis of Inf Pos-MI group included PLS,PPM-AMA,DT with OR 1.78,1.57,1.56 (P ＜0.05),respectively.Conclusions There are different extent of damage of papillary muscle function and construction in Ant-MI group and Inf-Pos-MI group.The increases of LVEDV and MLC and desynchronization of PMs are risk factors of IMR in Ant-MI group.The increases of PMP-AMA,decrease PLS and desynchronization of PMs are risk factors of IMR inInf-Pos-MI group.

Objective To sum up the experience of renal transplantation in order to improve transplant effect and enhance the long-term survival and recovery rate.Methods The data of renal transplantation of 1 124 cases who received renal transplantation from Jul. 1978 to Oct. 2001 were summarized. All the possible factors that could influence the transplant effect such as pre-operative preparation, HLA match, donors' quality, surgical procedure, immunosuppressive therapy and so on were analyzed. Results The 1-, 3-, 5-year survival rate (%) of patient/kidney was 83.1/ 70.3, 74.6/ 68.6 and 62.6/ 56.1 respectively. The rate of AR was decreased significantly from 3.09?% only with LXM to 0.89?% with LXM test in combination with HLA serological test. The rate of HAR and AR in 130 cases with additional PRA test were lower than those only with LXM test.Conclusions The well pre-operative preparation, the ideal HLA match, the high quality of donor's kidney and transplant operation were keys for successful renal transplantation. Reduction of the complications, individual and combined medication in reason and long-term follow-up were very important in the long-term survival time.

0.05). The open time of the modified groups was significantly shorter than that of the routine group (P

Humans ; Infant, Newborn ; Male ; Polycystic Kidney Diseases ; diagnosis

Acupuncture Therapy ; Adult ; Aged ; Diplopia ; therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged

OBJECTIVETo evaluate digital rectal examination (DRE) , transrectal ultrasonography (TRUS) , free/total (f-PSA/ t-PSA) prostate-specific antigen (PSA), and PSA density (PSAD) in the diagnosis of prostate cancer (PCa) in patients with PSA < or = 4.0 microg/L.

METHODSBetween April 1996 and December 2012, a total of 343 subjects, aged 30 -91 years, with PSA < or =4.0 microg/L and abnormal findings on DRE or TRUS underwent prostatic biopsy. Based on the levels of PSA, the subjects were divided into four groups: 0 -1.0, 1.1 -2. 0, 2.1 -3. 0, and 3.1 -4.0 microg/L. The diagnostic values of DRE, TRUS, f-PSA/t-PSA, and PSAD were assessed in those with different PSA levels. According to the age, the subjects were again divided into five groups: C49 yr, 50 -59 yr, 60 -69 yr, 70 -79 yr, and > 80 yr. The rates of PCa detection in relation to PSA levels were estimated in different age groups.

RESULTSOf the 343 subjects, 65 (19.0% ) were diagnosed with PCa, with detection rates of 16.28% (21/129) , 17. 17% (17/99), 21.82% (12/55), and 25.00% (15/60) in those with the PSA levels of 0 -1.0, 1.1 -2.0, 2.1 -3.0, and 3.1 -4.0 microg/L, respectively. There were statistically significant differences in f-PSA/t-PSA between the PCa patients and non-PCa subjects with the PSA level > 2.0 microg/L (P <0.05) , but not with the PSA level < or =2.0 microg/L (P > 0.05) , nor did PSAD show any significant difference between the PCa and non-PCa groups ([0.09+/-0. 16] versus [0. 06 +/- 0. 07] micro/L/ml, P > 0. 05). The rate of cancer detection rose -with the elevation of the PSA level, but had no statistically significant difference among different age groups (P >0.05).

CONCLUSIONPSA 2.1 -4.0 microg/L with abnormal DRE and TRUS findings should be considered as a warning signal, which requires regular follow-up and PSA detection. With f-PSA/t-PSA <0. 15 with or without abnormal DRE and TRUS findings, routine prostate biopsy should be performed. PCa diagnosis cannot be effectively established by DRE, TRUS, f-PSA/t-PSA, and PSAD in those with PSA < or = 2.0 microg/L.

Adult ; Aged ; Aged, 80 and over ; Biopsy ; Humans ; Male ; Middle Aged ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; diagnosis ; pathology

Objective To explore the clinical manifestations of toxic epidermal necrolysis(TEN) and its rare pulmonary complications.Methods Clinical symptoms,treatment and prognosis of 1 child with TEN caused by carbamazepine were analyzed.Radiological images were reviewed to evaluate the manifestations and the outcome of chronic pulmonary complications associated with TEN.Results The patient had high fever shortly after a dosage increment of carbamazepine.A confluent erythematous exanthema developed rapidly into painful blistering with skin erosion,denudation and involvement of conjunctive and oropharyngeal mucosa.The diagnosis of TEN was made.The mucocutaneous damage was gradually recovered with steroid plus intravenous immunoglobulin for 3 weeks.However,the patient presented with respiratory failure in the recovery phase of TEN.The computer tomography revealed pulmonary bullae and pneumothorax in the right lung.Lung parenchyma was squeezed and pulmonary bullae ruptured with pneumothorax and atelectasis,which were absorbed gradually through thoracic drainages.The patient′s lung function and pulmonary bullae were partly improved during a 7-month follow-up.Conclusions TEN is a severe form of blistering skin di-sease which is characterized by an extensive loss of epidermis and mucous membrane.Chronic pulmonary complications may occur in recovery phase of TEN.Pulmonary bullae,which might be caused by mucous damage and respiratory obstruction,is a rare complication of TEN.

Objective:To evaluate the efficacy and safety of low molecular weight heparin and unfarction heparin in patients with coronary heart disease during percutaneous coronary intervention by investigating the MACE beteewn the percutaneous coronary intervention procedure and post percutaneous coronary intervention 72 hours.Methods:200 patients with coronary heart disease who accepted percutaneous coronary intervention were investigated in this study.According to the anticoagulants,these patients were divided into LMWH subgroup(117 cases) and UFH subgroup(83 cases).According to conventional method,the MACE what happened during percutaneous coronary intervention procedure and post percutaneous coronary intervention 72 hours come from each group of patients was investigated and these statistics were analysised so that evaluate the efficacy and safety of low molecular weight heparin and unfarction heparin.Results:(1) There were no statistical significance in baseline characteristics between the each group (P＞0.05).(2) There were statistical significance in the incidence of TIMI flow slows between the each group (P＜0.05),low molecular weight heparin is superior to unfarction heparin in terms of efficacy.(3)There were no statistical significance in death between the each group (P＞0.05),but there were statistical significance in bleeding / hematoma complications,and other (pericardial tamponade,chest pain,cardiogenic shock,cardiac rapture,ventricular septal perforation,ventricular tachycardia,ventricular fibrillation,cardiac arrest,Aspen attack,stent thrombosis and so on) between the each group (P＜0.05),low molecular weight heparin less adverse reactions,higher safety.Conclusion:Low molecular weight heparin in the percutaneous coronary intervention effect is more significant,and less than UFH adverse reactions and high safety,more suitable for percutaneous coronary intervention anticoagulant therapy.