Purpose To explore the diagnostic value of two-dimensional speckle tracking echocardiography(2D-STE)in differentiating left ventricular hypertrophy(LVH)caused by Fabry disease from other etiologies.Materials and Methods A total of 23 patients clinically confirmed Fabry disease with LVH(Fabry disease group)in Peking University First Hospital from August 2014 to February 2023,retrospectively.23 patients with hypertensive LVH(hypertensive LVH group)and 23 with hypertrophic cardiomyopathy(HCM)(HCM group)were also included.Conventional echocardiographic parameters and 2D-STE-derived left atrial strain and left ventricular longitudinal strain were analyzed and compared among the three groups.LASSO regression was used to select variables and construct a diagnostic model to differentiate hypertensive LVH,HCM and Fabry disease group.Results The Fabry disease group showed significantly reduced left ventricular global longitudinal strain and segmental left ventricular longitudinal strain in the basal anterior wall,basal anterolateral wall and mid inferior wall compared to the hypertensive LVH group(P<0.05).There were no significant differences in left atrial strain,left ventricular global longitudinal strain and segmental left ventricular longitudinal strain between the Fabry disease and HCM groups(P>0.05).Compared to the conventional echocardiography-based model,the combined model did not significantly improve diagnostic accuracy for differentiating the three etiologies(Z=-1.314--0.594,all P>0.05).Conclusion Compared to patients with hypertensive LVH,HCM and Fabry disease group exhibit varying degrees of decrease in global and segmental longitudinal strain of the left atrium and left ventricle.Additional measurements of left ventricular longitudinal strain and left atrial strain do not provide significant incremental diagnostic value over conventional echocardiography in distinguishing among Fabry disease,hypertensive LVH and HCM.

Purpose To explore the diagnostic value of two-dimensional speckle tracking echocardiography(2D-STE)in differentiating left ventricular hypertrophy(LVH)caused by Fabry disease from other etiologies.Materials and Methods A total of 23 patients clinically confirmed Fabry disease with LVH(Fabry disease group)in Peking University First Hospital from August 2014 to February 2023,retrospectively.23 patients with hypertensive LVH(hypertensive LVH group)and 23 with hypertrophic cardiomyopathy(HCM)(HCM group)were also included.Conventional echocardiographic parameters and 2D-STE-derived left atrial strain and left ventricular longitudinal strain were analyzed and compared among the three groups.LASSO regression was used to select variables and construct a diagnostic model to differentiate hypertensive LVH,HCM and Fabry disease group.Results The Fabry disease group showed significantly reduced left ventricular global longitudinal strain and segmental left ventricular longitudinal strain in the basal anterior wall,basal anterolateral wall and mid inferior wall compared to the hypertensive LVH group(P<0.05).There were no significant differences in left atrial strain,left ventricular global longitudinal strain and segmental left ventricular longitudinal strain between the Fabry disease and HCM groups(P>0.05).Compared to the conventional echocardiography-based model,the combined model did not significantly improve diagnostic accuracy for differentiating the three etiologies(Z=-1.314--0.594,all P>0.05).Conclusion Compared to patients with hypertensive LVH,HCM and Fabry disease group exhibit varying degrees of decrease in global and segmental longitudinal strain of the left atrium and left ventricle.Additional measurements of left ventricular longitudinal strain and left atrial strain do not provide significant incremental diagnostic value over conventional echocardiography in distinguishing among Fabry disease,hypertensive LVH and HCM.

Helicobacter pylori ( H. pylori) is classified as Class I carcinogen in the World Health Organization. It was reported that approximately 90% of gastric cancer cases were associated with H. pylori infection. The eradication of H.plyori can effectively reduce the recurrence rate of peptic ulcers and the incidence of gastric adenocarcinoma. With the escalating antibiotic resistance, the eradication is facing significant challenges. The Maastricht VI/Florence consensus recommends routine antibiotics susceptibility testing to improve the eradication rate of H.plyori. The traditional bacterial culture and identification method require high compliance, laboratory conditions and operative technical, which is difficult to be routinely executed in clinical practice. Molecular biological detection methods have emerged as a proficient tool to identify antibiotic resistance with high efficiency, convenience, accuracy and repeatability. This review summarizes the molecular biological detection strategies for assessing H.plyori resistance, including advantages, limitations, opportunities and challenges.

Helicobacter pylori ( H. pylori) is classified as Class I carcinogen in the World Health Organization. It was reported that approximately 90% of gastric cancer cases were associated with H. pylori infection. The eradication of H.plyori can effectively reduce the recurrence rate of peptic ulcers and the incidence of gastric adenocarcinoma. With the escalating antibiotic resistance, the eradication is facing significant challenges. The Maastricht VI/Florence consensus recommends routine antibiotics susceptibility testing to improve the eradication rate of H.plyori. The traditional bacterial culture and identification method require high compliance, laboratory conditions and operative technical, which is difficult to be routinely executed in clinical practice. Molecular biological detection methods have emerged as a proficient tool to identify antibiotic resistance with high efficiency, convenience, accuracy and repeatability. This review summarizes the molecular biological detection strategies for assessing H.plyori resistance, including advantages, limitations, opportunities and challenges.

Objective Through analyzing and summarizing the main pathogens of bacterial infections of children in Sichuan Province and trends of drug resistance in 2013 to provide a reference for the clinical use of antibiotics.Methods The pediatric pathogen were collected by member of Sichuan province in china antimicrobial resistance surveillance system.Results A total of 22 470 clinical bacterial were isolated from the members,in which Staphylococci,Escherichia coli,Streptococcus pneumoniae,Kleb-siella pneumoniae,Hemophilus influenza,Moraxella catarrhalis were the most common Bacteria.The resistance rates of Staphylo-coccus aureus and Coagulase-negative staphylococci to oxacillin were 1 7.7% and 71.1%.4 strains of Staphylococcus aureus and 20 strains of coagulase-negative staphylococci were teicoplanin resistance.Escherichia coli and Klebsiella pneumoniae were clearly re-sistant to the third generation cephalosporins,ampicillin and ampicillin/sulbactam,with the exception of ceftazidime.Carbapenems remained highly active against all the target bacteria.The resistance rate of Streptococcus pneumoniae to Penicillin was 3.9% .All antibiotics excepted cotrimoxazole remained highly active against the haemophilus influenzae.All antibiotics except macrolide anti-biotics remained highly active against the moraxella catarrhalis.Conclusion Penicillin-insensitive Streptococcus pneumoniae,mac-rolides-resistant gram-positive cocci,cephalosporin-resistant Enterobacteriaceae ,Oxacillin-resistance coagulase-negative staphylo-cocci were revealed to be the most serious problems in terms of bacteria resistance for children in Sichuan province.

Objective To find out risk factors affecting the prognosis of adult cardiogenic shock patients treated with extracorporeal membrane oxygenation.Methods From January 2003 to December 2010,patients with cardiogenic shock required veno-arterial ECMO after failure of conventional therapy and intra-aortic balloon pump counterpulsation therapy were retrospectively studied. Patients with severe traumatic brain injury,advanced malignancies and multiple organ failure were excluded.All patients were divided into survival group and death group.The risk factors were found out using one-way ANOVA and a multivariate logistic regression analysis was used to determine independent factors associated with survival.Results Thirty-one patients successfully weaned from ECMO. Twenty-two patients were successfully discharged.The average duration of ECMO was 41.56 ± 43.07 hours.Factors associated with failure of hospital discharge were age,pre-ECMO levels of ejection fraction,pre-ECMO levels of lactate,disseminated intravascular coagulation,renal failure and multiorgan failure (P ＜ 0.05). Conclusions Irreversible heart failure and the complications are significantly correlated with survival,and the early use of ECMO for cardiogenic shock and recognize the factors are key to the success of ECMO treatment.

Objective To investigate the effects and values of extracorporeal membrane oxygenation (EC-MO) used in patients after cardiac arrest. Method During five years period from June 2002 to June 2007,fifteen cases taken for cardiopulmonary resuscitation were treated by using ECMO in the emergency department and ICU. All the measures for disgnosis and treatment were observed to the guidelines for cardiopulmonary resuscitation and emergency cardiovasculat care set by the American Heart Association in 2005, and ECMO was applied in addition. The study was a self-comparison trial. The biomarkers including heart rate (HR), mean arterial pressure (MAP), central venous pressure( CVP) , arterial partial oxygen pressure (PaO2), arterial partial pressure of carbon dioxide ( PCQ2), oxygen saturation (SaO2), hydrogen power (PH), and concentration of lactic acid were taken and assayed before and 10 min, 1 h,6 h, 12 h, and 24 h after treatment. Differences between the results of measurements were analysed by t -test for matched pairs using SPSS version 10.0 software package. Neurological sequelae was also observed and described. Results Ten minutes after ECMO treatment, MAP rose dramatically (P < 0.01) and got to further higher level one hour later ( P < 0.05). On the other hand, CVP dropped off 10 minutes after ECMO treatment and further lowered one hour later, and PaO2 and SaO2 were improved apparently ( P < 0.01), and pH was increased significantly (P < 0.01), while a derease in concentration of arterial LA of significantly (P < 0.01). Of the 15 cases, 11 patients got well,including completely recovered without sequelae in 5,memory disorders in 2 and hemipleggia in 2 patients. Conclusions ECMO provides effective blood flow to hearts, and therefore, improves oxygenation and oxygen consumption greatly. Moreover, it provides stable oxygenated blood to brain and therefore, it is a good approach to cardiopulmonary cerebral resuscitation.

Objective To explore the effective countermeasures for treatment of multiple trauma. Methods The clinical data of 135 cases with multiple trauma admitted into the emergency center of Zhongshan City from June 2002 to June 2003 were applied to study the mode and the key point of integrated treatment for multiple trauma. Results Of 135 cases,107 survived with a success rate of 79.3% and 28 died with a mortality of 20.7%. Conclusions (1)The integrated treatment in the emergency center is an effective way to improve the curative rate of multiple trauma as well as a development trend in treatment of multiple trauma. (2) The mode to make integrated diagnosis and treatment includes the following parts: set up wound center in emergency center,build a united rescue system and train high quality professional personnel. The diagnosis and treatment of multiple trauma must be organized and carried out by doctors in the emergency center. (3)The key treatment points for serious multiple trauma include firstly,active pre-hospital medical care and in-hospital medical care to save the lives;secondly,timely surgical operation to repair the damaged organ and eliminate the factors of lethality and cripples;and thirdly,necessary intensive care to treat the original damage further,protect various function of organs,promote recovery of body and prevent the complications.