70%) were group R. The distal LAD flow signal could be observed in all cases in group N and 6 cases in group R. The PVd, PVs and DSVR had no significant difference between group N and the controls. The PVd and DSVR were significantly lower in patients of group R than those in patients of group N and the controls. Conclusions Monitoring of the distal LAD flow velocity by TTCDE was useful in the noninvasive assessment of re-stenosis after stent intervention for the LAD lesions.

OBJECTIVE:To evaluate the application of acid inhibitors in our hospital and to provide reference for rational use of drugs in the clinic. METHODS:The consumption sum and DDDs of acid inhibitors in our hospital from 2005 to 2009 were statistically analyzed with the method of DDD analysis. RESULTS:Consumption sum of acid inhibitors in our hospital increased year by year,especially for proton pump inhibitor. Consumption sum of H2 receptor antagonist decreased year by year. Omeprazole and pantoprazole took up the top place of DDDs order. Rank ratio of pantoprazole had been kept at 1 for five years with sound synchrony. DUI of these drug were no more than 1,which meant rational drug use. CONCLUSION:The acid inhibitors in our hospital are applied rationally and safe and highly effective proton pump inhibitor is the best choice in the clinic.

Objective To investigate the clinical value of mitral valve quantitative(MVQ)soft ware,select the significant parameters in diagnosing mitral valve prolapse and analysis the mechanism of mitral valve regurgitation by MVQ in clinical.Methods Live three dimensional transesophageal echocardiography was performed on thirty-one patients,in which 13 patients with mitral valve prolapse,another 18 patients with suspected intracardiac thrombosis without mitral valve regurgitation regarded as control group.The images were stored and processed with MVQ soft ware off line.Eighteen parameters of mitral valve structure were measured in mitral valve 3D mode.Results Comparing with the control group,the parameters of mitral valve annulus of mitral valve prolapse were larger significantly(P＜0.05).Seven parameters of mitral valve leaflets,θant,θpost,θNPA,Htent,Vtent,L2DALPm,θAv-Mv,had no significant difference between tWO groups(P＞0.05).L3Dant,L3Dpost,Hprol,Vprol,A3Dpost,A3Dant of mitral valve prolapse were larger than those of control group(P＜0.05).Conclusions MVQ can measure the parameters of mitral valve stereo structure quantitatively,result in more detailed diagnosis of mitral valve disease by echocardiography,provide more important information to surgeons,and help them to formulate detailed and complete operation scheme.

Objective To evaluate the accuracy of coronary flow velocity reserve(CFVR) measured by color Doppler coronary flow imaging(CFI) in the patients with myocardial bridging(MB) of the left anterior descending (LAD) coronary artery and to analyze coronary hemodynamic changes and clinical significance of the LAD MB. Methods Consecutive 110 patients with suspected or known coronary disease were examinated by coronary angiography(CA), coronary intravascular ultrasound(IVUS) and intracoronary Doppler(ICD). Of these patients, 11 cases were diagnosed as MB of LAD. The LAD flow were measured by CFI at baseline and hyperemic conditions (intravenous administration of adenosine 140 μg·kg-·min-)and CFVR were calculated. Compared with the measurements of ICD, the accuracy of CFI was analyzed. Nine normal cases served as control group. Results The prevalence of MB was 10% in this study. Seven eases presented with stable angina. MB located in the middle segment of LAD in 7 cases and in the middle-distal segment of LAD in 2 cases. The ratio of LAD stenosis was greater than 80% in 2 cases, one of them simultaneously combined with circumflex stenosis(90 %). CA showed no significant stenosis in 9 cases (MB group) in the LAD and IVUS showed no plaque. Flow velocities were measured by CFI in the middle-distal LAD in nine patients without significant stenosis. CFVR calculated by average peak velocity well correlated with those measured by ICD (regression equation: Y=0.87 X+0.39; correlation coefficient: r=0.81,P<0.01). The coronary flow velocities in hyperemic conditions were significantly lower in MB group than in control group. CFVR were also significantly lower in MB group than in control group. Conclusions CFI is an accurate method for assessment of CFVR. Decreased CFVR of patients with MB may be one of the causes of angina pectoris.

Objective: To evaluate the cytotoxicity of nano-hydroxyapatite. Methods: Mouse lung fibroblast L-929 and primary cultured human periodontal ligament fibroblast-like cells (PDLF) were cultured in the medium of extraction of nano-hydroxyapatite or commerce hydroxyapatite at 100%,50%,10% and 0% (control) respectively.Cell growth was tested by MTT assay and the cell relative growth rate (RGR) was calculated.The cytotoxicity was graded by generally accepted standard.Results: RGR of both cell lines cultured in nano-hydroxyapatite extraction was higher than that in control HA. In 7-day culture the cytotoxicity grade of HA was 1 in 100% of HA extraction medium and 0 in 100% of nano-hydroxyapatite extraction,or in 50% and 10% of nano-hydroxyapatite or control HA extraction medium.Primarily cultured PDLF showed lower RGR than L-929 under the same condition. Conclusion: Nano-HA do not have cytotoxic effect.

Objective By exploring echocardiographic ch aracters and pathologic examination of noncompacted ventricular myocardium(NVM), to prevent life-threatening arrhythmias and embolism. Methods Echocardiographic examinations included four-chamber view, two-chamber view and short axis view of left ventricle, with an emphasis on observing left ventricular myocardium and endocardium approach to one-third of apex of heart. Results All 24 patients showed obvious echocardiographic findings characterized by prominent and excessive myocardial trabeculations and deep intratrabecular recesses in the affected ventricular cavity. Three cases complicated with other congenital heart malformations, 20 cases with congestive heart failure and only 2 cases were asymptomatic. Coronary arteriography was performed in 13 cases and revealed normal findings. Two cases eventually underwent heart transplantation because of severe congestive heart failure. Gross and histological findings demonstrated prominent muscular trabeculations, with deep intratrabecular recesses into lesion heart. Serial section from the base of the ventricle toward the apex revealed gradually weaker myocardium. Noncompaction of ventricular myocardium showed a thin, compacted epicardial and an extremely thickened endocardium by fibrous tissue. Conclusions Noncompaction of ventricular myocardium has characteristic echocardiographic manifestations and specific pathologic changes, which are different from those of primary enlarged type of cardiomyopathy.

Objective To show left anterior descending artery and interventricular septal branch Doppler flow and Doppler flow spectrum using coronary Doppler flow imaging,provide reference to select target artery,and judge collateral circulation formation after percutaneous transluminal septal myocardial ablation (PTSMA) of hypertrophic cardiomyopathy. Methods In 28 patients with hypertrophic cardiomyopathy left anterior descending artery and interventricular septum branch flow were displayed using coronary flow Doppler imaging system before and after PTSMA,and flow velocity were measured by Doppler spectrum. Results In 22 patients the target arteries were successfully selected in the first time using coronary flow Doppler imaging combined with coronary angiography and proved by the results of PTSMA. In 2 patients PTSMAs were performed successfully after additional choosing other interventricular septal branch. Therefore,PTSMAs in 24 patients were performed effectively in total. In 4 patients PTSMAs were given up due to vessel thinness and suffusion of interventricular septal branch in 2 patients,myocardial contrast agent distributing right ventricular and right ventricular papillary muscle during operation in one patient and contrast agent distributing left ventricular papillary muscle in another patient. Left ventricular flow tract pressure rebounded in 5 patients postoperatively,and neighboring interventricular septum branch extending to melting area were seen in 3 patients accompanied by flow velocity increasing. Melted vessel nub markedly prolonged in 1 patient. Conclusions Coronary Doppler flow imaging can directly reveal interventricular septum branch flow in hypertrophic cardiomyopathy,provide detailed hemodynamic information for myocardial PTSMA and monitor PTSMA for hypertrophic cardiomyopathy effectively and reliably.

Objective To validate the measurement of coronary flow velocity and coronary flow velocity reserve(CFVR) by transthoracic Doppler echocardiography(TTDE) compared with invasive intracoronary Doppler flow wire technique(ICD) and to evaluate changes in coronary flow dynamics due to microvascular dysfunction in the patients with angiographically normal coronary arteries and chest pain.Methods Coronary flow velocity was measured in the distal left anterior descending artery(LAD) in 35 patients by TTDE at baseline and during intravenous adenosine infusion of 140 ?g?kg -1 ?min -1 . CFVR, coronary vascular resistance(CVR) and minimal coronary vascular resistance index(CVRI) were analysed in the patients with angiographically normal coronary arteries and chest pain (group A, n =20) and compared to a control group (group B, n =15).Results Average peak velocity at baseline (APVb),average peak velocity at hyperemia (APVh) and CFVR determined from TTDE correlated closely with those from ICD measurements.CFVR was lower and CVRI was higher in group A than in group B.Conclusions Noninvasive TTDE provides reliable measurement of coronary flow velocity and CFVR in the distal LAD.Microvascular dysfunction existed in the patients with normal angiograms and chest pain.