Objective To identify the suitable echocardiographic predictor,the standard 2-demensional echocardiography and speckle tracking imaging (STI) techniques were applied for the late referred children with transposition of great arteries with intact ventricular septum (TGA-IVS) after neonatal period.Methods 22 children with TGA-IVS after neonatal period were enrolled.According to the intraoperative left ventricular (LV)/right ventricular systolic pressure ratio,they received pulmonary artery banding (PAB group,n =10) or arterial switch operation (ASO group,n =12).15 body surface area matched healthy children were served as control group,Echocardiography was performed before the operation.The dynamic images in basal and apical short axis view were collected respectively.Meanwhile,using the STI technique,the rotation curves at apex and base was analyzed.Results All the patients discharged eventually.A right to left bulging of the ventricular septum was observed in all the patients by the 2D short-axis view.There were no differences in wall thickness and ejection fraction between control,PAB and ASO group.Compared with the control group,the end diastolic diameter,end diastolic volume and indexed LV mass in PAB and ASO group were significantly reduced,however,no difference in the end diastolic diameter and volume and LV mass was observed between the PAB and ASO group.The hypoplasia of LV in PAB and ASO group was associated with an extended time to peak basal rotation and reduced basal rotation and global torsion.Furthermore,the shorter time to peak apical rotation and reduced apical rotation and global torsion were only observed in PAB group.Conclusions The standard echocardiography could be useful for the initial evaluation for regressed LV of the children with TGA-IVS.However,STI allows a much more precious approach to the assessment of LV regressing after neonatal period.The apical rotation and global torsion might be the better predictor to identify the borderline or regressed LV for the surgical management for the children with TGA-IVS.

ObjectiveTo identify the suitable echocardiographic predictor of speckle tracking imaging (STI) for evaluation of development of left ventricle(LV) after pulmonary artery banding (PAB).Methods Seven children older than 3 months with transposition of great arteries with intact ventricular septum (TGA) were enrolled,they received pulmonary artery banding (PAB group).Eight body surface area matched healthy children were severed as control group.Using the STI technique,the rotation curves at apex and base were analyzed.ResultsAll the patients discharged eventually.The intraoperative LV/RV systolic pressure ratio in PAB group was (0.32 ± 0.04):1.There were no differences in ejection fraction and wall thickness between control and PAB group.However,the end diastolic diameter and end diastolic volume in PAB group was significantly reduced.Compared with the control group,the hypoplasia of LV in PAB group was associated with an extended time to peak basal rotation,and furthermore,the basal and global torsion was significantly reduced by 3 times.ConclusionsSTI showed local rotation and global torsion might be thevaluable predictor to evaluate the regressed and the development of LV peri-PAB procedure for the older children with TGA.

Objective:To evaluate the effects of learning initiative on teaching effectiveness.Methods:The research subjects were the 2nd year medical students of Tongji Medical College of Huazhong University of Science and Technology. The learning initiative factor was calculated from the data of the attendance registration of the on-line learning of Physiology, and the performance of the on-line test was used as an evaluation indicator of teaching effectiveness. SPSS software was used to perform correlation analysis between the learning initiative factor and teaching effectiveness. Results:We found that learning initiative could significantly affect the teaching effectiveness, with differences among different specialties. There was a positive correlation between learning initiative and teaching effectiveness in clinical and pediatric medicine, while no correlation was observed in preventive medicine and medical imaging.Conclusion:In conclusion, learning initiative can affect teaching effectiveness, and the intensity of this effect shows difference among different specialties.