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 discuss the value of the new parameter of myocardial elasticity derived from circumferential strain.Methods Right ventrieular apical pacing was established on the beagle dogs.Before and after pacing,the peak of early diastolic flow velocity (E peak),peak of atrial flow velocity (A peak),and the ratio of A/E were measured.The peak pressure-rise rate (+ dp/dtmax),peak pressure-fall rate (-dp/dt max),left ventricular systolic pressure(LVSP),LV diastolic pressure(LVDP)were measured by cardiac catheterization.The circumferential strain at the levels of base (CSRA),papillary (CSPM) and cardiac apex (CSAP) were measured,and the parameter of myocardial clasticity at the levels of base (EBA),papillary (EPM) and cardiac apex (EAP) were measured and calculated,respectively.Results ①After pacing,the + dp/dt and LVDP were increased,but the-dp/dtmax was decreased (P ＜0.05).② After pacing,the CSPM and CSAP were all decreased,but EBA,EPM,EA were all increased(P ＜0.05).③ The areas under the receiver operating characteristic curves (ROC) of CSAP,CSPM,EAP,EPM and EBA were all 1,and the area under the curve of CSBA was 0.687.EAB,EPM and EAP were significant negative correlation with CSPM and CSAP,but are positive correlated with A/E and LVDP (P ＜ 0.05).Conclusions The parameter of myocardial elasticity derived from circumferential strain includes useful information about myocardial deformation and function.The new parameter can be applied to assess the diastolic function of left ventricle.

Objective To investigate the evaluation value of spatiotemporal image correlation (STIC) on fetal cardiac systolic function .Methods The fetal cardiac cycle images were collected by the four-dimensional(4D) STIC ultrasound technique in 160 normal singleton pregnancies .The virtual organ computer-aided analysis(VOCAL) technique was used to measure the ventricular end-systolic volume (VESV) and ventricular end -diastolic volumes(VEDV) .The stroke volume(SV) ,ejection fraction(EF) and cardiac output(CO) were calculated .Results VESV ,VEDV together with SV and CO in normal pregnancy were increased with gestation week increase .EF remained constant with advancing gestational week .VESV ,VEDV ,SV ,CO and EF of right ventricle were all larger than those of the left ventricle .Conclusion The fetal cardiac systolic function in normal pregnancy is increased with gestational age increase ,the right heart systolic function is superior to the left heart .

Objective To evaluate the cardiovascular stiffness and its coupling of patients with hypertension by ultrasound.Methods Fifty patients with essential hypertension and 30 age- and gendermatched subjects without hypertension,diabetes and other cardiovascular diseases as control group were enrolled in this study.The parameters of structure and function of left ventricle,blood flow were measured by echocardiography.The blood pressure and carotid-femoral pulse wave velocity (CFPWV) were also measured.The derived corresponding parameter:end-systolic pressure(ESP),effective arterial elastance (Ea),end-diastolic (Ed),end-systolic ventricular elastance (Ees) and Ea/ Ees were calculated respectively.Results Ees was correlated positively with ejection fraction (r =0.378,P =0.005),while Ea was correlated positively with CFPWV( r =0.289,P ＜0.001).Ed was correlated negatively with e/a ( r =- 0.333,P =0.027).Posterior wall of left ventricle was correlated positively with Ed and Ea( r =0.388,P =0.016; r =0.336,P =0.026).Ea and Ed in patients with hypertension were significantly higher than those in control group( P ＜0.05),but there was no significant difference of Ees and Ea/ Ees between two groups( P ＞ 0.05).Conclusions Arterial stiffness is associated with ventricular stiffness,and their matching relation can be applied to evaluate ventricular-arterial coupling.

Objective To assess global and regional cardiac twist function in hypertrophic cardiomyopathy(HCM) patients by velocity vector imaging(VVl).Methods Thirty HCM patients and 33 normal subjects were enrolled into this study.Two dimensional echocardiographic images of parasternal left ventricular basal level,middle and apical level short axis plane,apical four-and two-chamber plane were obtained.Maximal rotation degree,peak rotation rate,circumferential strain (CS) and strain rate (CSR),radial strain(RS) and strain rate(RSR) in systole were measured using VVI offline software.In addition,diastolic peak un-rotation rate,untwisting rate(unTwR) were measured.Each parameters was analyzed both in subendocardial and subepicardial layer.Results There was no significant difference in left ventricular ejection fraction between two groups.EDV,ESV,SV were significantly decreased (P＜0.01) in HCM group.Left ventricular twist(LVtw),CS of subendocardial layer were higher in HCM group than control group(P＜0.05),while the peak rotation rate,un-rotation rate,CS,CSR were lower of subepicardial layer (P＜0.05).The RSR of each short axis level were significantly decreased in HCM group (P＜0.01).The diastolic unTwR was decreased in HCM group (P＜0.05).For further analysis of the two subgroups in HCM,more regional torsion deterioration occurred in patients with left ventricular outflow tract obstruction than those without obstruction.Conclusions The global cardiac twist angle of HCM was higher than normal person,but the circumferential deformation ability of regional myocardium was impaired,left ventricular outflow tract obstruction may aggravate the regional myocardial dysfunction.

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.

AIM: To determine the HPLC fingerprint of ultramicro decoction piece of Radix paeoniae Alba. METHODS: HPLC was used to analyze the extracts of ultramicro decoction piece of Radix paeomae Alba from 10 different sources. RESULTS: The fingerprint of ultramicro decoction piece of Radix paeoniae Alba was composed of 20 peaks,among which there were 10 characteristic peaks. CONCLUSION: The fingerprmt can be used to control the ultramicro decoction piece of Radix paeoniae Alba qualities.

Objective To explore the immuniated function of infants with bronchiolitis. Methods In vitro production of IL-18,12, 10, 4, IFN-? by peripheral blood mononuclear cells (PBMC) and plasma IgE of bronchiolitis infants measured by enzyme-linked im-munosorbent assay, expression of lymphocyte activation gene - 3 (LAG - 3) mRNA from PBMC measured by semi - quantitative RT- PCR.Forteen healthy children were as normal control. Results Compared with normal control, IL - 12 (390. 94 ? 95. 88 vs 452.44?195.07) ng/L and IL-18(146.23? 55. 81 vs 246.69?121.29) ng/L activity were significantly decreased (P0.05) ;The levels of IL-4(30. 52 ? 17. 65 vs 16.20? 8.94) ng/L and IL-10 (302. 40 ? 100.04 vs 195.30? 84.01) ng/L were elevated significantly(P

Objective To explore the clinical and laboratory characteristics of langerhans cell histiocytosis (LCH) in children, so as to improve diagnosis level and decrease misdiagnosis rate.Methods Twenty-five cases of LCH from Jan.1996 to Feb.2006 were analyzed by retrospective study. The clinical data were collected and abstracted for information regarding clinical symptom, physical sign, laboratory examination, imaging,pathology,diagnosis and treatment.Results Some laboratory findings in hemogram, bone marrow examination and chest X-ray were non-specific.The X-ray characteristic of skeleton was osteolysis. Computerized tomography and magnetic resonance imaging were important in defining the extent of lesion in fundus cranii and sella.Seven cases were examined for anti-Epstein-Barr virus(EBV) IgM, 3 cases were positive;5 and 3 cases out of 10 cases showed humoral and cellular immunity abnormality,respectively. The misdiagnosis rate was 52%,1 case had been misdiagnosed for 7 years. Chemotherapy was effective in the future.Conclusions The clinical manifestations of LCH varies widely, leading to high rate of misdiagnosis.The etiology of LCH is unclear,and some of our patients show the evidence of EBV infection or immunity abnormality. Definitive diagnosis of LCH is based on pathology. Ultrastructure and immunophenotype should be done to improve diagnosis level.

Background Many studies showed that attenuation of retinal nerve fiber layer(RNFL)in early glaucoma is one of the important signs.How to accurately and quantitatively measure RNFL thickness is very important for the early diagnosis and monitoring of glaucoma.0bjective This study was to evaluate the clinical value of Optovue RTVue OCT and Heidelberg Retina Tomograph Ⅲ(HRT-Ⅲ)confocal scanning laser ophthalmoscopy in glaucomatous eyes. Methods This cross-sectional study included 40 eyes of 26 patients with suspected open-angle glaucoma(SOAG),48 eyes of 29 patients with open-angle glaucoma and 48 eyes of 27 healthy subjects.Optical nerve head(ONH) parameters and peripapillary RNFL thickness were measured in all the subjects with Optovue RTVue OCT and HRT-Ⅲ,meanwhile all the eyes received perimetry with Humphrey 750-I.Glaucoma variables obtained from Optovue RTVue OCT and HRT-Ⅲ were analyzed among the groups.Topographic Optovue RTVue OCT and HRT-Ⅲ parameters,including disc area(DA),cup area(CA),rim area(RA),rim volume(RV),cup volume(CV),cup/disc area ratio(C/DAR)as well as superior,temporal,inferior and nasal average RNFL thickness,were analyzed.The relationship of ONH parameters and RNFL thickness was analyzed using a linear correlation.The correlation between the mean defect(MD)of the visual field and the tomography parameters in glaucomatous eyes was described by bivariate Pearson correlation coefficients.Resuits The ONH parameters and RNFL thickness obtained by HRT-Ⅲ and OCT showed significant difference(P<0.05).ONH parameters such as RA,C/DAR,CA and RV were statistically changed in SOAG and the POAG patients compared with the normal subjects(q=6.47,q=7.67,P<0.05).The superior and inferior RNFL thickness parameters in three groups were positively correlated between HRT-Ⅲand OCT(r=0.362,r=0.441,r=0.395,P<0.05),Topographic Optovue RTVue OCT and HRT-Ⅲ parameters including CV,CA,RA and C/DAR fitted Pearson analysis(all P<0.05).In POAG group。The RA,RV,CV,C/DAR from Optovue RTVue OCT were correlated with MD with the significant coefficient 0.284,0.286,0.340,0.371 respectively(P<0.05),and evidently correlations also were found between RA,RV,C/DAR with MD respectively with the coefficient 0.339,0.859,0.422(P<0.05)by HRT-Ⅲ. Conclusion Both Optovue RTVue OCT and HRT-Ⅲ can difierentiate ONH analysis with a similar outcome in glaucomatous eye.The C/D value.RA,superior and inferior RNFL thickness based on Optovue RTVue OCT and HRT-Ⅲare distinguishing indexes in the diagnosis of early glaucomatous damage.