Objective To evaluate the regional long-axis systolic function of left ventricular in patients with coronary artery disease and healthy subjects by two-dimensional strain rate imaging (2D-SRI). Methods During October 2011 to August 2012 , 53 inpatients with coronary artery disease in the department cardiology from the Afifliated Hospital of Medical College, Qingdao University were enrolled. Twenty-nine patients with anterior wall infarction induced by left front-descending coronary artery disease (group LCA) and twenty-four with interior wall infarction induced by right coronary artery disease (group RCA) proved by coronary angiography and echocardiography were enrolled into the study and thirty healthy volunteers in the control group. High frame rate two-dimensional dynamic images were recorded in apical four-chamber view and two-chamber view of the left ventricle. Using two-dimensional strain software, peak systolic longitudinal strain rate (PSRs) of interventricular septum, anterior wall, lateral wall and interior wall of left ventricle were measured. All data of 3 groups were analyzed using One-Way analysis of variance, and LSD-q test used to compare the 2 groups. Results The PSRs were (4.61±0.60) s-1, (5.18±0.87) s-1, (5.60±0.70) s-1, (6.05±0.74) s-1 from interventricular septum, anterior wall, lateral wall to interior wall in the control group. There were signiifcant differences among the groups (F=20.95, P=0.00), and there were signiifcant gradient changes from intervetrivular septum, anterior wall, lateral wall to interior wall in the control group. The PSRs were (4.31±0.85) s-1, (1.96±0.93) s-1, (5.54±0.83) s-1, (5.93±0.80) s-1 from interventricular septum, anterior wall, lateral wall to interior wall in the LCA group respectively. There were signiifcant differences among the different walls (F=127.25, P=0.00), which was signiifcant lower in ischemic anterior wall than interventricular septum, lateral wall and interior wall, and the significant differences were identified in anterior wall with lateral wall and interior wall (q=22.62, 25.04, both P<0.01). The PSRs were (4.51±0.62) s-1, (4.99±1.13) s-1, (5.31±0.81) s-1, (2.84±0.85) s-1 from interventricular septum, anterior wall, lateral wall to interior wall in RCA group respectively. There were signiifcant differences among the different walls (F=38.12, P=0.00), which were signiifcant lower in ischemic interior wall than interventricular septum, anterior wall, and lateral wall, and the signiifcant differences were identiifed in interior wall with lateral wall and interior wall (q=13.88, 12.08, both P<0.01). Comparing the same part among 3 groups, signiifcant differences were identiifed as following:the PSRs of anterior wall in group LCA vs control group (q=20.17, P<0.01), the PSRs of interior wall in group RCA vs control group (q=19.98, P<0.01). Conclusions Longitudinal systolic function changes of left ventricular regional myocardium in patients with coronary artery disease and healthy subjects could be accurately analyzed by 2D-SRI. The early changes in ischemic myocardium would be assessed quickly in patients with coronary artery disease using 2D-SRI.

Objective:To investigate the changes and significances of serum cystatin C and transforming growth factor-β1 levels for the neonatal asphyxia.Methods:Forty-six asphyxia newborns were chosen as the asphyxia group,and thirty healthy newborns were selected as the control group.The TGF-β1,CysC,BUN,Scr,and GFR levels of both groups were detected on the 1st,3rd,7th day after hospitalization.According to the renal injury,the 46 newborns were divided into normal group and asphyxia group,and the serum indexes were detected and analyzed.Results:On the 1st,3rd,7th day after hospitalization,the TGF-β1,GFR of asphyxia group was obviously increased and was lower than those of the control group (P＜0.05);the level of CysC,BUN,Scr in both groups were decreased,and the change degree in asphyxia group were higher than that of the control group (P＜0.05);the CysC,BUN,Scr in renal injured group were higher than those of normal group,and TGF-β1,GFR were much lower (P＜0.05).Additionally,TGF-β1 level of renal injured group was negatively correlated to the BUN and Scr,and positively correlated with the GFR (P＜0.05).The level of serum CysC in renal injured group was positively correlated to BUN and Scr and negatively correlated to GFR (P＜0.05).Conclusion:The serum TGF-β1,CysC in asphyxia newborns had significant changes compared with the healthy newborns and was correlated to the renal injured indexes,which had clinical directive significance on the early diagnosis,condition judgment,and prognosis of neonatal asphyxia with renal injury.

Objective To evaluate the feasibility of real-time triplane strain rate imaging for the quantitative assessment of left atrial function in normal subjects. Methods Totally 40 healthy volunteers were enrolled. Left atrial expansion index (LAEI), left atrial passive emptying fraction (LAPEF) and left atrial active emptying fraction (LAAEF) were measured using real-time triplane volume analysis. Mean systolic peak strain rate (MSRs), mean early diastolic peak strain rate (MSRe) and mean late diastolic peak strain rate (MSRa) were measured using real-time triplane strain rate imaging. The results were compared respectively. Results MSRs correlated positively with LAEI (r=0.61, P<0.01). MSRe correlated inversely with LAPEF (r=-0.67, P<0.01), so did MSRa with LAAEF (r=-0.78, P<0.01). Conclusion Real-time triplane strain rate imaging is feasible for the quantification of left atrial function in normal subjects.

ObjectiveTo investigate the effect of arterial stiffness on systolic deformation in hypertensive disease.MethodsSixty essential hypertensive patients were enrolled, including 25 cases with left ventricular normal geometric (group LVN) and 35 cases with left ventricular hypertrophy (group LVH) in the Affiliated Hospital of Qingdao University during July 2013 to March 2014. Thirty patients in the control group were enrolled in the same period. The peak systolic strains and strain rates were determined by using velocity vector imaging. Stroke volume was obtained by using real-time three-dimensional echocardiography. And pulse pressure/stroke volume was used as a surrogate index of arterial stiffness. Pulse pressure/stroke volume, the differences of strain and strain rate in three groups were compared by analysis of variance, and SNK-q test was used for further comparison between two groups. Multiple linear regression was performed to estimate predictors for systolic longitudinal deformation. Pearson?s correlation was used to analysis the relevance of systolic longitudinal strain and body mass index, triglyceride, left ventricular ejection fraction, age, left ventricular mass index, pulse pressure/stroke volume.ResultsPulse pressure/stroke volume were (1.26±0.45) mmHg·m2·ml-1, (1.53±0.59) mmHg·m2·ml-1, (1.82±0.43) mmHg·m2·ml-1 (1 mmHg=0.133 kPa) in the control group, LVN, LVH respectively. The systolic strains and strain rates in the control group, LVN, LVH were recorded as follows:systolic longitudinal strains were (23.60±1.94)%, (19.69±2.56)%, (17.34±2.48)%, the systolic longitudinal strain rates were (1.64±0.17) s-1, (1.52±0.14) s-1, (1.38±0.18) s-1; the systolic radial strains were (28.69±5.2)%, (30.81±4.14)%, (26.53±3.50)%, the systolic radial strain rates were (2.51±0.56) s-1, (2.60±0.45) s-1, (2.00±0.41) s-1; the circumferential strains were (24.50±5.21)%, (24.01±4.60)%, (21.00±3.70)%, the circumferential strain rates were (1.38±0.38) s-1, (1.30±0.30) s-1, (1.10±0.26) s-1. Pulse pressure/stroke volume was higher in LVN and was more pronounced in the LVH group compared with the control (LVN/LVH with the control group:q=2.90, 6.56, LVN with LVH:q=3.22, allP<0.05). The strains and strain rates in LVH were lower than those of LVN and the control group, and the differences were statistically significant. (longitudinal strains:q=15.22, 5.43; longitudinal strain rates:q=8.88, 4.54; radial strains:q=2.85, 5.36; radial strain rates:q=6.10, 6.81; circumferential strains:q=4.42, 3.61; circumferential strain rates:q=5.04, 3.42; allP<0.05). The strains and strain rates in LVN were lower than the normal group, the signiifcant differences of the longitudinal strains and longitudinal strain rates were found (q=8.73, 3.77, bothP<0.05) while there were no statistically signiifcant differences of radial strains and radial strain rates, circumferential rates and circumferential strain rates. In a multivariate analysis, LVMI and AS were found to be predictors for systolic longitudinal strain. Body mass index, triglyceride, left ventricular ejection fraction, age, left ventricular mass index and pulse pressure/stroke volume were negatively related to systolic longitudinal strain (r=-0.10,-0.09,-0.14,-0.42,-0.56, allP<0.05) by Pearson?s correlation, while LVEF was positively related to mean systolic longitudinal strain (r=0.13,P<0.05).ConclusionArterial stiffness is suitable as an predictor for left ventricular systolic deformation in hypertensive disease.

Objective To explore the clinical related prognostic factors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in treating malignant hematological diseases. Methods From September 1997 to August 2008,a total of 26 patients with hematological diseases were treated with allo-HSCT from HLA identical-sibling and haplo-identical donors in our hospital, including 14 patients with acute leukemias,10 with chronic myeloid leukemias,and 2 myelodysplastic syndromes. Results All patients achieved sustained full donor type engraftment. The cumulative overall survival (OS) was 63.9 %,and cumulative disease free survival (DFS) was 62.6 %. Fifteen patients had graft-versus-host disease (GVHD) (57.7 %),including 8 acute GVHD(aGVHD) (30.8 %) (grade Ⅲ-Ⅳ aGVHD was 15.4 %) and 7 chronic GVHD. GVHD between HLA identical-sibling and haplo-identical donors was different and there was statistic difference between the two groups (P=0.014). 4 patients relapsed,7 patients died. The univariate analysis showed OS were correlated with grade Ⅳ aGVHD (P=0.05) and CMV infection (P=0.027). Conclusion Allo-HSCT is effective for the cure of patients with malignant hematological diseases. The key to improve the efficacy of HSCT is to reduce the incidence of transplant-related complications,especially GVHD and infection.

Objective To investigate the efficacy and safety of Bevacizumab (Bev) combined with chemotherapy protocols in the patients with metastatic colorectal cancer (mCRC).Methods 43 patients with mCRC were treated with Bev combined with various of chemotherapy protocols.The efficacy was assessed based on Response Evaluation Criterion for Solid Tumors (RECIST),and the adverse events were evaluated according to National Cancer Institute-Common Toxicity Criterion for Adverse Events (NCI-CTCAE) 3.0.Results The data of 43 patients (16 males and 27 females) were analyzed.17 patients achieved partial remission (PR),19 patients stable disease (SD) and 7 patients progressive disease (PD).The median progression-free survival (PFS) time was 10.3 months.The major of 3-4 adverse events included leucocytopenia,neutropenic febrile,and nausea/vomiting.Bey-associated adverse events were proteinuria,hypertension,rhinorrhagia,hemorrhagic hemorrhoid,menstrual blood increased,gastrointestinal perforation and venous thrombosis.Conclusions Bey combined with various chemotherapy protocols is more effective for patients with mCRC.Most patients can tolerate the side effects of the combined treatment.The long-term effects of the combined treatment need to be followed up.

Objective:To evaluate the heart hemodynamics in fetuses with premature ductus arteriosus constriction or closure using fetal heart quantification (FHQ).Methods:The clinical data of 50 singleton fetuses with ductus arteriosus constriction ( n=35) or ductus arteriosus closure ( n=15) who underwent echocardiography in Department of Ultrasound, Beijing Anzhen Hospital were retrospectively analyzed, from May 2013 to January 2020. Fifty healthy singleton fetuses were randomly selected as the control group. The ductus arteriosus diameter (DA), pulsatility index (PI), diameter of the left atrium(LA) and right atrium(RA), diameter of the left ventricle (LV) and right ventricle (RV), tricuspid regurgitation/right atrium area ratio (TR/RA Ratio), pressure gradient of tricuspid regurgitation (PG of TR), and heart/chest ratio were measured using conventional fetal echocardiography; the correlations among the parameters were analyzed. Speckle-tracking analysis was used to analysis and compute the LV and RV global spherical index (GSI), fractional area change (FAC) and global strain (GS), the LV ejection fraction(EF) and stroke volume (SV). These variables and their correlations were compared and analyzed. Results:Compared with the control group, the GS and FAC of the LV and RV in the ductus arteriosus constriction or closure groups were lower ( P<0.05) while the LV-SV was higher ( P<0.05). The FAC, GS, and EF values of the LV were higher in the premature ductus arteriosus closure group than in the ductus arteriosus constriction group ( P<0.05), while the RV-FAC was lower ( P<0.05), the RV-GS and LV-SV showed no significant changes ( P>0.05). Correlation analyse showed that the PI was positively correlated with DA( r=0.364, P<0.05); the PG of TR was negatively correlated with DA( r=-0.414, P<0.05); the TR/RA Ratio was negatively linearly correlated with PI( r=-0.388, P<0.05), and positively correlated with RV/LV Ratio ( r=0.369, P<0.05); the other parameters were not significantly correlated with the DA or PI ( P>0.05). Conclusions:Fetal heart hemodynamics in the premature ductus arteriosus constriction or closure groups change significantly, FHQ can provide valuable information for the evaluation of the fetal heart with ductus arteriosus constriction or closure.

To explore the feasibility and accuracy for evaluating mitral regurgitation (MR) severity with MR jet volume (MRvol) by means of general imaging three-dimensional quantification (GI3DQ). Methods: A total of 93 MR patients were divided into 2 groups: Central MR group, n=41 and Eccentric MR group, n=52. According to real-time three-dimensional echocardiography (RT3DE) examined planimetry of effective regurgitation orifice area (EROA), the patients were graded into mild MR, moderate MR and severe MR. MRvol was directly measured by GI3DQ. Results: In Central MR group, ROC analysis showed that as GI3DQ measured MRvol>16.2 ml, AUC=0.93, P<0.0001, the sensitivity and specificity for distinguishing mild MR and moderate MR were 96.0% and 70.0%respectively; as MRvol>44.5 ml, AUC=0.96, P<0.0001, the sensitivity and specificity for distinguishing moderate MR and severe MR were 97.6% and 91.7% respectively. In Eccentric MR group, as MRvol>14.2 ml, AUC=0.77, P=0.0243, the sensitivity and specificity for differentiating mild MR and moderate MR were 91.8% and 62.5% respectively; as MRvol>40.5 ml, AUC=0.83, P<0.0001, the sensitivity and specificity for differentiating moderate MR and severe MR were 82.3% and 77.9% respectively. Conclusion: Taking RT3DE examined EROA as reference, GI3DQ directly measured MRvol could more accurately assess MR severity especially in patients with central MR, it may distinguish moderate MR and severe MR with the higher sensitivity and specificity.

Objective To evaluate diagnostic value of mitral regurgitation jet volume(MRvol) in the quantification of mitral regurgitation severity by general imaging three-dimensional quantification (GI3DQ) using the guideline recommended 2D integrative method as a reference.Methods Ninety-three patients with MR were divided into central MR group(n =41) and eccentric MR group(n =52).The American Society of Echocardiography (ASE)-recommended 2D integrative method was used as a reference for MR grading and MRvol was directly measured by GI3DQ method.Results In central MR,as assessed by receiver operating characteristic (ROC) analysis,the area under the curve(AUC)was 0.87(P <0.0001), and MRvol by GI3DQ at a cutoff value of 16.2 ml yielded 96.2% of sensitivity and 63.6% of specificity to differentiate mild from moderate MR;the AUC was 0.98(P < 0.0001),and a cutoff value of 47.8 ml yielded 98.6% of sensitivity and 96.2% of specificity to differentiate moderate from severe MR. In eccentric MR,the AUC was 0.76(P =0.086),and MRvol at a cutoff value of 14.8 ml yielded 90.9% of sensitivity and 60.0% of specificity to differentiate mild from moderate MR;the AUC was 0.84(P <0.0001) and a cutoff value of 40.7 ml yielded 80.0% of sensitivity and 79.7% of specificity to differentiate moderate from severe MR.Conclusions MRvol measured directly by GI3DQ could more exactly evaluate MR severity,and have better sensitivity and specificity to differentiate moderate from severe MR in central MR.

ObjectiveTo evaluate the significance of flexion priority strategy and the principle of joint mobilization technique in the rehabilitation of posttraumatic stiffness of the elbow. Methods24 patients with posttraumatic stiffness of the elbow were divided into 2 groups, 12 patients in each group. The treatment group was treated with flexion priority strategy of joint mobilization technique only in the treatment of flexion contracture. In order to decrease the pain caused by joint mobilization training of extension and achieve the restoration of flexion as early as possible, the rehabilitation of extension was altered to self-exercise under the consultation of doctors combined with gentle passive traction by the therapist. The control group was treated with joint mobilization technique of both flexion and extension once a day. All the patients were measured the flexion range, extension range, and flexion-extension arc after 6 weeks of rehabilitation. Results6 weeks after rehabilitation, the treatment group got 124° of flexion (range 95°～135°), much better than the control group of 95° (range 80°～110°) （P<0.01）. There was no significant difference of extension degrees between the treatment group (15°, range 10°～35°) and the control group (16°, range 10°～30°) （P＞0.05）. The final arc of flexion and extension in the treatment group had an increase of 53°, significantly greater than 30° in the control group（P<0.01）. ConclusionFlexion priority strategy of elbow rehabilitation can significantly restore the flexion function of posttraumatic elbow stiffness.