Objective Because a three-dimensional reconstucted imaging resulting from any site or orientation was acquired,the useful and helpful images for diagnosis should be identified.The present study is to identify a series of right-sided three-dimensional echocardicgraphy over transesophageal two-dimensional echocardicgraphy.Methods Three-dimensional echocardiography was performed in 5 normal subjects and 10 patients.With transesophageal echocardiography,the transducer was inserted into esophagus in different depth which can be visualized right atrium,tricuspid valve and right ventricular cavity.In these different depth,ninety rotational(2 degree interval)sector images of the heart were separately collected and digitized with the echo-scan system.After the images were processed,a three-dimensional data set was established.Any desired right-sided three-dimensional echocardiography could be computed,volume rendered and displayed in monitor.Results The images Of right-sided three-dimensional echoeardiography were reconsturcted in all subjects.A series of useful and helpful right-sided three-dimensional echocardiography were identified for diagnosis as following:①The image of sagital SVC and IVC.②IAS visualized from right atrium.③TV displayed from right atrium.④IVS rendered frma right ventricle.⑤IVS visualized from fight ventricle.⑥RA,TV,RV and RVOT entire appearance.(Z) RARVOT.PV and PA image.⑧The image of free wall of right ventride.⑨IAS,TV,IVS and RVOT entire appearancL Conclusions Three-dimensional eehocardiography is clinically feasible and useful.The images of richt-sided three-dimensional echocardiography identified with be helpful to diagnose the right-sided heart diseases.

Objective To compare the effect of mirror therapy (MT) supplemented by early rehabilitative intervention and acupunture therapy on recovery of hemiplegic limb function versus routine occupational training in post-stroke elderly patients.Methods Totally 120 acute-stroke elderly patients with limb paralysis were randomly divided into two groups:MT group and control group (n=60,each).All 120 patients received routine rehabilitative intervention and acupunture therapy except for 30 minutes mirror therapy daily as add-on therapy to the MT group,all patients were assessed with Chinese Stroke Scale(CSS) and the Barthel index(BI) before and after treatment 1 and 3 months.Results At the end of 1 and 3 months of treatment,CSS in the MT groups was (15.6±8.5)scores,(11.6±7.2)scores,ADL was (75.3±13.9)scores,(80.1±13.0)scores;CSS in the control group was (16.2±5.8)scores,(14.8±6.1)scores,ADL was (68.2±13.5)scores,(70.5±12.9)scores.Before treatment,CSSandADLwas (21.3±7.1)scores,(63.7±12.6)scoresin the MT group; (20.8 ± 7.6) scores,(61.7 ± 11.4) scores in the control group.There were significant differences in CSS and ADL between groups,except CSS after 1 month (t=1.40,2.38,-3.27,-3.47; P=0.166,0.019,0.001,0.001,respectively).After 3 months of treatment,CSS and ADL in the MT group had considerably outperformed those of the control group(t=2.40,-3.47,P＜0.05 or 0.01).Conclusions Mirror therapy is better than routine occupational training in improving the motor function of limbs and activities of daily living(ADL) ability 3 months after stroke,on the basis of early rehabilitative intervention and acupunture therapy.

Objective To evaluate the clinical significance of detecting platelet parameters in platelet transfusion patients by Investigating the relationship between platelet parameters and efficacy of platelet transfusion and prognosis.Methods A total of 50 patients who underwent platelet transfusion in our hospital in 2014 to 2016 were reviewed.Patients divided into two groups (with normal platelet counts group or subnormal platelet counts group) according to outcomes of blood biochemistry and routine after five days of platelets transfusion.Platelet parameters (platelet count,platelet distribution width,mean platelet volume,large platelet ratio) and CCI were evaluated by statistical analysis.Results The numbers of patients with CCI＞4.5 in normal platelet counts group is 21 (77.78％),that in subnormal platelet counts group is 11 (47.83％).Platelet parameters before transfusion showed no significant difference between two groups (P＞ 0.05).After transfusion,in normal platelet counts group Plt,PDW,MPV and P-LCR were significantly higher than another group (P＜0.01).MPV and P-LCR were increased in normal platelet counts group,and decreased in normal platelet counts group after transfusion.Condusion Detection of platelet parameters,especially MPV and P-LCR,is important for evaluating the efficacy and prognosis of platelet transfusion.

Objective Investigate the relationship between thromboelastography and coagulation tests,and evaluate of two kinds of methods in guiding significance in cardiac surgery patients perioperative blood transfusion.Methods Analysis of 108 patients with cardiac surgery in September 2014-August 2016 treated in our hospitalwere randomLy divided into TEG detection guide blood transfusion group (experimental group) and coagulation test guide blood transfusion group (control group),Respectively on two groups of blood transfusion rate,different components of blood transfusion and transfusion effect comparison.Results Through the comparison of the heart surgery perioperative blood use rate guided by TEG and coagulation test,found the transfusion rate of experimental group guide cryoprecipitate 25.9％ and fresh frozen plasma(FFP) 33.3％ was significantly lower than the control group 68.5％,however,platelet transfusion rate was significantly higher than the control group of 57.4％ to 20.4％.There was no statistically significant difference of red cell suspension (RCS) infusion rate between two groups,but the RCS infusion quantity of experimental group(3.6+ 1.6) was clearly lower than the control group (5.8+ 1.9),and the FFP and cryoprecipitate infusion quantity of experimental group was obviously lower than control group(P＜0.05),too.Experimental groups of intraoperative blood loss,postoperative blood loss and rebleeding rate was lower than control group (P＜ 0.05).Concltsion That TEG guide cardiac surgery patients perioperative blood transfusion can reduce the use amount of blood products,and the prognosis of disease outcome is better than that of routine coagulation tests guidance.TEG can reduce the surgical complications and the bleeding amount,and it has great sense to guide clinical composition blood transfusion,so it is worth promoting.

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.

Inflammation and lung function decline are the main pathophysiological features of chronic obstructive pulmonary disease (COPD). Acupuncture can improve lung function in patients with COPD, but the underlying mechanisms are not well understood. Orexins (OXs), which are found in peripheral plasma, are neuropeptides that regulate respiration and their levels are related to COPD. Therefore, we hypothesized that acupuncture might alter OXs, reduce lung inflammation and improve lung function in COPD.

BACKGROUND: Experimental evidence suggests that growth factors can promote myocardial angiogenesis, but the effect and mechanism of basic fibroblast growth factor (bFGF) in controlled release delivered via fibrin glue has not been fully recognized.OBJECTIVE: To evaluate the effect of controlled-release bFGF delivered via fibrin glue in the myocardium on the expressions of vascular growth factors and cell proliferation in the local acute myocardial infarct area in canines, and assess the therapeutic effect of this strategy.DESIGN: Completely randomized controlled experiment.SETTING: Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences; Department of Cardiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology; Shanghai Xinxing Blood Product Research Institute.MATERIALS: This experiment was carried out in the Laboratory of Animal Surgery, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, and the Experimental Animal Center of Chinese PLA General Hospital between June 2001 And March 2003.Twelve clean healthy adult mongrel dogs of either sex were selected and randomized into transmyocardial laser revascularization group and bFGF group with 6 in each group.METHODS: With appropriate anesthesia, the chest of the dog was opened and the left anterior descending (LAD) branch of the coronary artery was ligated to establish acute myocardial infarction (AMI) model.The dogs were then randomized into transmyocardial laser revascularization group to receive transmural myocardial penetration 30 minutes after AMI and bFGF group with non-transmural myocardial penetration 30 minutes after AMI and subsequent injection of bFGF-containing fibrin glue into the channel. The expressions of vascular epithelial growth factor (VEGF), transforming growth factor beta 1 (TGFβ1) and proliferating cell nuclear antigen (PCNA) in the loacl ischemic myocardium were examined immunohistochemically (IHC) at postoperative 18 weeks.MAIN OUTCOME MEASURES: Quantitative IHC analysis of VEGF,TGFβ1 and the PCNA expressions in the local ischemic myocardia in transmyocardial laser revascularization group and bFGF group.RESULTS: Five dogs in the transmyocardial laser revascularization group and 6 in the bFGF group survived the operations. Quantitative IHC analysis revealed obviously larger positive area stained for myocardial VEGF,TGFβ1 and PCNA in bFGF group than in transmyocardial laser revascularization group (t=-7.505, -2.690 and -6.895, P ＜ 0.05), and the average absorbance of PCNA staining in bFGF group was greater than that in the transmyocardial laser revascularization group (t= -5.271, P ＜ 0.05).CONCLUSION: Controlled-releasing bFGF delivered in the myocardium can increase local expressions of the vascular growth factors in the ischemic myocardium and enhance cell proliferation, promoting revascularization after AMI.

【Objective】 To standardize the application process of therapeutic plasma exchange (TPE) in Blood Transfusion Departments for neurological diseases. 【Methods】 Working procedures of 2 785 TPE sessions in 617 patients with neurological diseases, from January 2019 to May 2021, were analyzed and summarized. The experiences and methods during TPE, druing patient evaluation, protocol formulation and implementation, and the management of adverse reaction during or at the end of TPE were summarized to optimize the application process of each link. 【Results】 A systematic application process could standardize the responsibilities of blood transfusion physicians and neurologists in indication, adverse reaction and treatment program. During the TPE treatment, different degrees of adverse reactions were handled in time, providing a reliable guarantee for patient safety. 【Conclusion】 Standardized application process, as the basis for TPE implementation in neurologic diseases, is the premise of safety treatment for patients.