Hypertrophic cardiomypathy is a genetically heterogeneous cardiac disease transmitted as an autosomal dominant trait,mostly caused by mutant of myofribrilla gene such as β-MHC, MYBPC3, cTnT.cTnI,cTnC, a-Tm and some other gene which coding non-myofribrilla. Different mutant caused different regional myocardium systolic or diastole function, which involve in dysfunction of systolic and diastolic deformation, increase of the sensitive of Ca2+ . This review summarizes the most common gene mutations in hypertrophic cardiomypathy and explains the changes of myocardial functions.

Objective To study the correlation between fluid management during liver transplantation and postoperative intra-abdorninal hypertension (IAH),and the correlation between intra-abdominal pressure and hemodynamics during liver transplantation.Method From Sep.2008 to Sep.2014,95 cases were admitted to ICU following liver transplantation were enrolled.All recipients were given abdominal color ultrasound examinations,and the IAH was measured.The preoperative Child-Pugh score,total operating time,anhepatic phase time,intraoperative blood loss,crystal solution input,colloidal fluid input,red blood cell infusion,plasma infusion,intraoperative total fluid input,intraoperative fluid input per h,and urinary volume per h and their correlation with postoperative IAH were analyzed by the Logistic regression method.The relationship between hemodynamics data and IAH intra-abdominal pressure was analyzed by the correlation analysis of two variables.Result IAH occurred in 18.94％ (18/95) recipients at 72nd h after operation.Fluid input per h (＞2000 ml/h) was risk factor (B=1.62;P＜0.05;OR=5.07,95％ CI:1.41-18.23) of IAH.Urinary volume per h (＜200 ml/h) is risk factor (B=-3.21 ;P＜0.01:OR =0.04,95％ CI:0.01-0.18) of IAH.There was correlation between hepatic artery peak flow velocity (r =0.83,P＜0.01),portal vein peak flow velocity (r =-0.182,P＜0.05),and retrohepatic inferior vena cava peak flow velocity (r=-0.184,P＜0.05) with IAH.Conclusion Fluid input per h should be controlled in a low level and urinary volume per h should be increased in order to prevent IAH.There is correlation between hepatic artery peak flow velocity,portal vein peak flow velocity and retrohepatic inferior vena cava peak flow velocity with IAH.

Objective:To compare hemodynamic changes under general anesthesia with those under general + epidural anesthesia during endotracheal intubation in senile patients.Methods:Forty ASA Ⅰ or Ⅱ senile patients aged 65-75 years were equally randomized into a G(general anesthesia) and a GE(general + epidural anesthesia) group and received intravenous injection of sufentanil 0.2 ?g/kg,midazolam 0.06 mg/kg,vecuronium 0.12 mg/kg and propofol 1.6 mg/kg for general anesthesia induction and endotracheal intubation.SBP,DBP,HR,EDV,SV,EF and CO were recorded at 5 different time points,i.e.,before induction(T0),just before intubation(T1),immediately after intubation(T2),1 minute after intubation(T3),and 5 minutes after intubation(T4) via ultrasoundcardiogram.Results:Significant hemodynamic changes were observed in both groups(P

Objective To investigate early postoperative impact on recipients after liver transplantation with the two hemodynamic management strategies by using the "gold standard" Swan-Ganz catheter and central venous catheter (CVC) to monitor hemodynamics and guide liquid and vasoactive drug therapy.Methods From May 2006 to January 2009,102 from 107 cases of liver transplantations in our hospital were randomly divided into two groups:PAC group (pulmonary artery Swan-Ganz catheter group,n = 52) and CVC group (n = 50 cases).Hemodynamic parameters were monitored.Results There was no significant difference in the general characteristics between two groups In PAC group and CVC group,the mortality during ICU stay was 7.7 % and 4 %; postoperative 28-day mortality was 11.5 % and 8 % ; the median mechanical ventilation time was 26.5 and 24 h; the median ICU stay was 2.5 and 2 days,respectively.There was no significant difference in the aforementioned parameters (P＞0.05).There was no significant difference in renal function and liver function before and 1,5 days after operation,and mean blood lactic acid level 1,2,and 3 days after operation between two groups (P＞0.05).In PAC group and CVC group,transient ventricular arrhythmias occurred in 26 cases and 2 cases Conclusion It is not a good strategy using "gold standard" Swan-ganz catheter to monitor hemynamic parameters and guide therapy after liver transplantation in ICU,and on the contrary,the application of "gold standard" Swan-ganz catheter increases incidence of transient ventricular arrhythmias.

Objective To assess the value of early evaluation of left ventricular global systolic function in patients with metabolic syndrome(MS) by three-dimensional speckle tracking echocardiography (3D-STI).Methods 33 healthy subjects and 41 MS subjects who didn't have the left ventricular remodeling were recruited in this study,and the myocardial motions were tracking by 3D-STI.The parameters of left ventricular global longitudinal peak systolic strain(LS),circular peak systolic strain(CS),radial peak systolic strain(RS) and area peak systolic strain (AS) and the values of body mass index (BMI),waist circumference,waist-to-hip ratio and biochemical indicators were compared between the two groups.Results Compared with controls,LS of MS group was significantly decreased (P ＜ 0.01),while no significantly differences were found in CS,RS,and AS(P ＞0.05).The BMI,waist circumference and waist-to-hip ratio were positive correlated with LS (r =0.559,0.617,0.681,P ＜0.01).Conclusions 3D-STI could early evaluate the changes of left ventricular global systolic function for metabolic syndrome patients,and longitudinal peak systolic strain could be the most sensitive index.

Objective:To compare the efficacy and safety of stone extraction with a single peroral choledochoscopy system under direct visualization and conventional X-ray endoscopic retrograde cholangiopancreatography (ERCP) for non-difficult common bile duct stones.Methods:A total of 164 patients with common bile duct stones who underwent stone extraction by using the single peroral choledochoscopy system under direct visualization (the observation group, n=82) and conventional X-ray endoscopic retrograde cholangiopancreatography (ERCP) (the control group, n=82) from January 2018 to April 2022 in Dongfang Hospital, Beijing University of Chinese Medicine were enrolled. The observation group was directly selected from the database, while the control group was randomly matched by age stratification with baseline data validated. The success rates of intubation, stone removal, postoperative complication incidence, and radiation exposure between the two groups were compared. Results:There was no significant difference between the baseline data of the observation group and the control group ( P>0.05). The number of patients with detected stones≥2 in the observation group and the control group were 59 (71.95%) and 37 (45.12%) respectively with significant difference ( χ 2=12.16, P=0.001). The success rates of bile duct intubation in the observation group and the control group were both 100.00% (82/82). The success rates of stone extraction were 98.78% (81/82) and 100.00% (82/82) respectively with no significant difference ( P>0.05). The one-time stone removal rates of the two groups were 93.90% (77/82) and 92.68% (76/82) respectively with no significant difference ( χ2=0.10, P=0.755). There was no significant difference in the incidence of postoperative complications between the observation group and the control group ( P>0.05). The amount of intraoperative ray exposure volume in the observation group was significantly lower than that of the control group [10.20 (6.69, 18.94) mGy VS 15.41 (10.70, 22.77) mGy, U=2 462.00, P=0.003]. Conclusion:The efficacy and safety of stone extraction with single peroral choledochoscopy system under direct visualization are comparable to those of traditional X-ray ERCP for non-difficult common bile duct stones, but it can significantly reduce the intraoperative ray exposure volume during therapeutic ERCP stone extraction.

Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals.
Algorithms ; Clothing ; Electrocardiography ; Equipment Design ; Female ; Humans ; Internet ; Machine Learning ; Maternal Health ; Monitoring, Ambulatory ; instrumentation ; Telemedicine ; instrumentation

Objective To clarify the applied anatomy of Chinese female breasts,to improve the breast reduction mammoplasty,and to compare the quality of life in women with symptomatic macromastia before and after reduction mammoplasty with the modified round block technique.Methods The blood supply and innervation of the nipple-areolar complex were dissected in 6 Chinese adult females (12 breast specimens).Special attention was paid to the Würinger horizontal septum and the medial and lateral ligaments.The specific beneficial effects of reduction mammoplasty were evaluated with the modified round block technique,and a general questionnaire the Short Form-36 Health Survey Questionnaire (SF-36) was used in this study,which has good reliability and validity.The scores of the patients before and after the surgery were collected respectively.Results In 12 breast specimens,there existed Würinger horizontal septum and the medial and lateral ligaments.The blood supply and nerve innervation of nipple-areolar complex went along Würinger horizontal septum.In all the patients enrolled,SF-36 showed significant higher quality of life after the operation with regard to 7 of 8 investigated domains.Role of emotion increased most significantly.Increased self-esteem and increased personal and public self-consciousness after surgery were observed.Conclusions The incidence of postoperative complications is reduced after using the modified round block technique.Patients have a higher degree of satisfaction overall.These data are further evidence that breast hypertrophy is not solely an esthetic problem.The reduction mammoplasty with the modified round block technique is an ideal technique.

Objective:To seek the biomarkers of diagnostic value for an early postoperative onset of intensive care unit acquired weakness(ICUAW)in liver transplant(LT)recipients.Methods:Between September 2017 and August 2019, A total of 62 consecutive allogeneic orthotopic LT liver transplantation recipients at The First People's Hospital of Kunming between September 2017 and August 2019 are prospectively reviewedenrolled in this study. Upon After entering ICU, blood samples are assayed taken for adenosine 5'-monophosphate-activated protein kinase alpha(AMPK-α)、and glucose transporter type 4(GLUT-4)test. Clinical and bBiochemical specimens are collected. When transplant recipients are during awake and cooperative hours. Their muscle strength is recordedexamined. The score table of Medical Research Council(MRC)is utilized sed as the diagnostic standard of ICUAW. And ICUAW is diagnosed with < 48 points. Based on this, 62 subjects are divided into two groups of ICUAW group(17 cases)and non-ICUAW group (45 cases). The age, sex, mechanical ventilation time, ICU hospitalization time, partial blood oxygen pressure, systolic blood pressure, central venous pressure(CRP), blood glucose, total bilirubin, alanine aminotransferase(ALT), aspartate aminotransferase(AST), γ- Glutamyl transpeptidase(γ- GGT), blood urea nitrogen, blood creatinine and levels of AMPK-α and GLUT-4 are compared between patients in ICUAW group and non-ICUAW two groups. and levels of AMPK-α and GLUT-4 were compared between patients in ICUAW group and non-ICUAW two groups. The powers of AMPK-α And and GLUT-4 in predicting ICUAW was were evaluated by receiver operating characteristic curve(ROC)and area under the curve(AUC). Differences with P<0.05 is deemed as significant. Results:ICUAW is diagnosed in 17/62(27.42%)LT recipients. ICUAW patients had longer mechanical ventilation time(27 vs. 10h, P<0.05)and extended ICU hospitalization time(4 vs. 3d, P<0.05). No significant inter-group difference existed in AMPK-α(1.01±2.43 vs. 1.74±4.24 units/ml, 95% CI: -2.92~1.45, P>0.05). And the expression of GLUT-4 declined in ICUAW patients(137.86±127.87 vs. 419.15±267.68 ng/L, 95% CI: -417.13~-145.45, P<0.05). GLUT-4 ROC curve hint at some negative predictive value for the occurrence of ICUAW. ROC curve area was 0.88 and SE 0.05( P<0.05, 95% CI: 0.78~0.98). Conclusions:ICUAW patients have longer mechanical ventilation time and extended ICU hospitalization time. Monitoring GLUT-4 offers some predictive value for ICUAW in LT recipients. Elevated GLUT-4 is associated with a low probability of ICUAW.