ObjectiveTo assess myocardial perfusion by the end-systolic and end-diastolic replenishment parameters of real-time myocardial contrast echocardiography (MCE).MethodsTwenty-one patients with myocardial infarction(MI) and normal control group of 6 cases underwent intravenous realtime myocardial contrast echocardiography via slow and homogeneous venous injections of SonoVue.MCE images were obtained from the apical 4-chamber,2-chamber,and long-axis views.According to the exponential function:y(t) =A [1 - e-kt] + B,the time intensity curves were obtained.By an off-line ECG triggering and curve fitting,the replenishment parameters A value,k value,A × k value were obtained separately from end-systolic and end-diastolic images.ResultsIn normal control group,the end-systolic replenishment parameters A value,k value,A × k value were all lower than that of the end-diastolic replenishment parameters[(6.21 ± 2.69)dB vs (7.93 ± 3.66)dB,P ＜0.05；0.36 ± 0.15 vs 0.42 ± 0.19,P ＜ 0.01 ;2.88 ± 1.29 vs 3.39 ± 1.61,P ＜0.05,respectively].The end-diastolic replenishment parameters were found significantly greater variability than the end-systolic values (variation coefficient CV:A value 46.2％ vs 43.3％,k value 45.2％ vs 41.4％,A× k value 47.5％ vs 44.8％,all P ＜0.05).In 21 patients,the end-systolic replenishment parameters in myocardial segments supplied by infarct-related coronary artery were significantly lower than that in myocardial segments supplied by non - infarct - related coronary artery.ConclusionsThe end-systolic and end-diastolic replenishment parameters of real time myocardial contrast echocardiography can assess myocardial perfusion.The variability of the end-systolic replenishment parameters is smaller than that of the end diastolic parameters.Significant variability in k-value suggests that this parameter is best suited for before-after study in the same patient.

BACKGROUND:There is lack of an objective and standardized animal model for assessing the therapeutic effect of physical and medication treatment on bone defoct, the effectiveness of operation, as well as the role of bone substitute in the repairing of bone defects.DESIGN:Verified study on the experimental model of bone nonunion in rabbitsSETTING: Department of Orthopaedics in Shenzhen people' s Hospital MATERIALS:Twenty common grade pure New Zealand rabbits of either gender were selected with body mass of (2.5±0.5)kg,aged 6 to 8 months.METHODS :This experiment was carried out at the experimental animal center of Shenzhen people's Hospital between May and August 1999. 1.5cm bone segment (including periosteum)was cut off in the middle of forearm radius in 20 common grade pure NewZealand rabbits,the broken ends were covered with bone wax, 10 weeks later, the bone nonunion status was assessed by macropathological observation, pathohistological and X-ray examination.MAIN OUTCOME MEASURES:Observations on rabbit forearm radius defects by macropathological observation, pathohistological and X-ray examination.RESULTS :Twenty rabbits(40 side radius)were enrolled in this study and weeks later, bone defect region was found filled with fibrous cicatricial tissue without osseous connection ,bone wax was not absorbed, capitulum was ossified with medullary cavity blocked,a small amount of callus formed at both broken ends of fractural bone ,length of bone defect ranged from 0.8 to blocked under optical microscope,chondrocyte and osteocyte could be observed arranging disorderly and covered with fibrous membrane,defect reosseous connection could be detected at defect region at week 10,broken end was ossified and medullary cavity was blocked ,there was small amount of callus appeared at both broken ends displaying irregular shape.CONCLUSION:Bone nonunion experimental animal was successfully established on rabbits in this study, with pathological changes meeting the need of bone nonunion and displaying typical properties,which can be used as reliable and feasible experimental animal model.

Objective To compare the characteristics of intrahepatic cholangiocarcinoma (ICC) and different differentiated hepatocellular carcinoma (HCC) by CEUS and evaluate the diagnostic value of CEUS.Methods The cases who underwent CEUS and were pathologically demonstrated as ICC (n=34) and HCC (n=136) were observed.The characteristics of ICC and different differentiated HCC in conventional ultrasound and CEUS were analyzed,and the diagnostic efficiency of wash out time were calculated.Results ICC had higher percentage (24/34,70.59％) of washout emerging in early portal phase than those of HCC.And ICC had lower percentage (0;4/34,11.76％) of washout emerging in middle and late portal phase than poorly and moderate differentiated HCC.Poorly differentiated HCCs had higher percentage (16/41,39.02％) of washout emerging in middle portal phase than well differentiated HCC.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy,positive likelihood ratio and negative likelihood ratio of washout time in diagnosis of ICC were 82.35 ％ (28/34),91.18％ (124/136),70.00％ (28/40),95.38％ (124/130),89.41％ (152/170),9.4,0.2,respectively.The rise time of ICC and well,moderate and poorly differentiated HCC were (13.03 ± 3.49) s,(13.80 ± 3.04)s,(14.89±4.12)s,(16.00±3.38)s,respectively,and the difference was significant (F=4.369,P＜0.05).The rise time of ICC was significantly higher than that of well differentiated HCC (P＜0.05).Conclusion The CEUS performances are different significantly among ICCs and different differentiated HCCs,which has value for the differential diagnosis.

[ ABSTRACT] AIM:To establish the insulin resistance rat model for evaluating the correlation of omentin-1 level and insulin resistance.METHODS: SPF male Wistar rats ( n =30 ) were randomly divided into normal control group (NC, n=15) and high-fat diet group (HF, n=15).The rats in NC group were fed with basic diet.The insulin resistant model was established by feeding the rats with high-fat diet in HF group.After 10 weeks, 5 rats in each group were as-sessed by the technique of hyperinsulinaemic-euglycaemic clamp.After the insulin resistant model was successfully estab-lished, the body weight and fasting blood glucose were detected.The concentration of fasting serum omentin-1 was analyzed by ELISA.Fasting serum insulin was measured by radioimmunoassay.RESULTS: No difference of fasting blood glucose between the 2 groups was observed.The level of fasting serum insulin in HF group was significantly higher than that in NC group ( P <0.05 ) .The level of serum omentin-1 in HF group were significantly decreased compared with NC group (P<0.01).Pearson’s correlation analysis showed that negative correlations between serum omentin-1 and fasting serum insulin (r=-0.654,P<0.01), serum omentin-1 and free fatty acid (r=-0.446, P<0.05) was found.CONCLU-SION:In rats, serum omentin-1 level began to decrease at insulin resistance stage.As serum omentin-1 level decreased, the basal insulin level increased, indicating that decreased serum omentin-1 level may be an early factor of IR, diabetes and cardiovascular diseases.

The etiology of rotated maxillary central incisor is unclear, but it has a clear familial tendency. Except for the environmental factors, gene expression directly influences craniofacial growth and the types of malocclusion deformity. In this article, a case of 180° rotated left maxillary central incisor of a male with family history of the deformity was reported. Relevant literature was also reviewed.
Humans ; Incisor ; Male ; Malocclusion ; diagnosis ; Maxilla

Objective To evaluate the feasibility and accuracy of full volume three-dimensional echocardiography(FV3DE) for quantifying the left ventricular volume in healthy fetuses. Methods Two hundred and twenty-two normal fetuses with gestational ages between 20 and 40 weeks were investigated. Full volume three-dimensional, two-dimensional (2D) and M-mode images were acquired by Philips iE33 system and data was processed offline using QLAB analysis software. Left ventricular end-systolic volume(ESV) and end-diastolic volume ( EDV) were measured using semiautomated border detection echocardiographic techniques, and compared with 2D biplane Simpson's method and M-mode Teichholz formula. Results Thirty-six fetuses with poor three-dimensional images and 5 twin pregnancies were excluded,the study subjects consisted of 181 singleton fetuses. The highest concordance correlation ( r =0.987 for EDV, r =0.988 for ESV) P <0. 001) was noted between 2D biplane Simpson's and FV3DE-derived values with a small bias (0. 332 ml for EDV,0. 135 ml for ESV). The Bland-Altman analysis showed that FV3DE had the best reproducibility than M-mode Teichholz formula and 2D biplane Simpson's method. Intra- and interobserver error of EDV were 2.85% and 4.22% for FV3DE,8.37% and 8.98% for 2D biplane Simpson's rule,30. 63% and 54. 70% for M-mode Teichholz formula. Intra- and interobserver error of ESV were 2.34% and 6. 14% for FV3DE,6. 26% and 11.7% for 2D biplane Simpson's rule,43.06% and 66.03% for M-mode Teichholz formula. Conclusions FV3DE is a novel technique that can be more accurate than conventional methods in quantification of fetal left ventricular volumes, it may provide new insight into evolving fetal cardiac structure and function.

Objective To evaluate the clinical significance and cardiac function of fetuses with intracardiac hyperechogenic focus(ICEF) by fetal echocardiography. Methods Fetal echocardiograms were performed on 1291 fetuses for evaluation of fetal heart structures and rhythms. Echocardiographic characteristics of ICEF were investigated. Fetal systolic and diastolic functions of 399 fetuses with an isolated ICEF were compared with 128 normal fetuses using conventional two-dimensional, M-mode, pulsed Doppler echocardiography and myocardial Doppler tissue imaging(DTI). Results The prevalence of ICEF was 34. 7% (448/1291). Twenty-four(5.4%) cases were found with cardiovascular malformations. There was 1 (0.22%) case of ICEF fetus associated with chromosomal abnormality (trisomy 21 ). Comprehensive fetal echocardiographic data analysis showed no significant differences in heart dimensions, global cardiac functions,and myocardial performances in the two groups( P ＞0.05). Conclusions An isolated ICEF in the fetal heart is not associated with increased risk for chromosome abnormalities. Fetuses with ICEF do not indicate impaired left ventricular systolic or diastolic function, therefore having no hemodynamic significance.

Objective A cross-sectional survey was conducted to investigate difference in job-related satisfaction indexes among staff working at community health-care service centers ( CHSC ) employing appropriate techniques on a trial basis between east and west areas of China. Methods In total, 339 staff members working at CHSC employing appropriate techniques on a trial basis, including good practice of community medical records management for hypertension , good practice of community case management for type 2 diabetes , good practice of community case management for tuberculosis , etc. , were recruited for questionnaire survey from Tianjin, Jinan and Shenzhen of east China and Chengdu and Chongqing in westChina by cluster sampling. Their demographic information, training for appropriate techniques and job-related satisfaction were collected. Results There was a significant difference in proportion of CHSC staff who receiving training for tuberculosis management launched by local government between west and east areas (34. 8% vs. 41. 4% , P <0. 05). There also was significant difference in satisfaction with the support from the superior sectors of government between west and east areas ( 59. 6% vs. 52. 0% , P = 0. 022 ) . Satisfaction towards income ranked the highest, and that towards work environment the lowest among the staff either in west or east areas. Conclusions Proportion of CHSC staff receiving training for tuberculosis and satisfaction with the support from superior sectors of government vary with communities in east and west areas employing appropriate techniques on a trial basis, and work condition of CHSC should be improved further.

Objective To quantitatively study right ventricular function in the normal second and third trimester fetuses by M-mode tricuspid annular displacement(TAD).Methods TAD was measured using conventional M-mode echocardiography on 161 normal second and third trimester fetuses with gestation age (GA) between 19-38 weeks,meanwhile multiple parameters for evaluating right ventricular function were obtained using pulsed Doppler echocardiography (PW) and myocardial Dopple tissue imaging (DTI).The correlation between TAD and other parameters were analyzed using SPSS 17.0.Results In normal second and third trimester fetuses,the TAD was (9.38 ± 1.71)mm with a range of 5.79-13.90 mm,and was increased with the growth of GA.TAD was correlated with GA,E,A,Em,Am and Sm significantly (r =0.759,0.547,0.320,0.497,0.483 and 0.598 respectively,all P ＜0.001).TAD was not correlated with HR(P ＞0.05).TAD showed differences between the second trimester fetuses and the third trimester fetuses (P ＜ 0.05).Conclusions In normal second and third trimester fetuses,the TAD is increased with the growth of GA,and has good correlation with GA,E,A,Em,Am and Sm respectively,and may become a new promising modality to evaluate function of RV simply and accurately.The technique will be propitious to use in hospitals (without DTI) because of simplicity of operator and lower requirement on the technology and equipment precision.

Objective To investigate the feasibility of spatiotemporal image correlation(STIC)to assess left ventricular volume in normal fetuses.Methods The volume data acquisition of 162 normal fetuses ranging between 22 and 38 weeks of gestation was achieved by automatic sweep scan.The virtual organ computer-aided analysis(VOCAL Ⅱ)was then used to evaluate end-systolic and end-diastolic volumes of left ventricle and compared with that obtained by M-mode Teichholz formula and 2D biplane Simpson's method.Results Twenty-six fetuses with poor STIC image and 2 twin pregnancies were excluded,the study subjects consisted of 134 singleton fetuses.The highest concordance correlation(r =0.968,for EDV,r =0.956 for ESV;P =0.000)was noted between 2D biplane Simpson' s and STIC VOCAL Ⅱ values with a small bias(0.282 ml for EDV,0.117 ml for ESV).The Bland-Altman analysis showed that STIC VOCAL Ⅱ had the best agreement than M-mode Teichholz formula and 2D biplane Simpson's method.The result showed that there were significant difference between Mmode Teichholz formula and Simpson's method in EDV and ESV(P＜0.05).There were significant differences between M-mode Teichholz formula and STIC VOCAL Ⅱ(P＜0.05).There were no significant differences between STIC VOCAL Ⅱ and Simpson' s method in EDV and ESV.Conclusions There is a good agreement between left ventricular volumes measured either by STIC VOCAL Ⅱ or by 2D biplane Simpson's method.STIC is a novel technique that can be more accurate than conventional Methods in quantification of fetal left ventricular volumes.All the volume data acquisition is achieved by postprocessing facilities.STIC promises to become a new method for left ventricular volume quantification.