Objective To evaluate the clinical efficacy of Ningxin decoction in treating patients with permanent atrial fibrillation(AF)of deficiency of both qi and yin type infected by coronavirus disease 2019(COVID-19).Methods From February to August 2023,120 patients with permanent AF of deficiency of both qi and yin type infected by COVID-19 were collected from the outpatient clinic of Guang'anmen Hospital South Campus,China Academy of Chinese Medical Sciences.Patients were randomly divided into a control group and a treatment group using a random number table method,there were 60 cases in each group,and 1 case fell off in each group,leaving 59 cases in each group.The treatment group was given Ningxin decoction(drug composition:Cassia branch 15 g,Cornus officinalis 15 g,Rehmannia 15 g,Rhodiola rosea 15 g,Ginseng 6 g,Mulberry parasitica 10 g,Coptis coptis 3 g,Salvia miltiorrhiza 12 g,Ligusticum chuanxiong 10 g,Ophiopogon 12 g,and schisandra Vinegar 6 g)using formula granules to rinse with water,twice a day.The control group was given 10 mg of coenzyme Q10 twice a day,and both groups were treated continuously for 4 weeks.The improvements in traditional Chinese medicine(TCM)symptoms,including chest pain,dizziness,fatigue,lethargy,palpitations,chest tightness and shortness of breath,insomnia,and excessive dreams before and after treatment in two groups,as well as changes in heart rate variability(HRV)and heart rate deceleration indicators were observed.Results The treatment group showed significant therapeutic effects in improving chest pain,fatigue,palpitations,chest tightness and shortness of breath,there were also improvements in lethargy,insomnia,and excessive dreaming,there was no significant therapeutic effect in improving dizziness.The control group showed significant therapeutic effects in improving palpitations,there were also improvements in chest pain,chest tightness and shortness of breath,while there was no significant therapeutic effect in other aspects.The treatment group showed significantly higher effective rates in improving chest pain,fatigue,lethargy,chest tightness and shortness of breath,insomnia,and excessive dreaming compared to the control group[chest pain:95.45%(42/44)vs.78.57%(33/42),fatigue:83.67%(41/49)vs.31.25%(15/48),lethargy:73.91%(34/46)vs.12.77%(6/47),chest tightness and shortness of breath:88.89%(48/54)vs.63.64%(35/55),insomnia:78.43%(40/51)vs.12.24%(6/49),excessive dreaming:76.09%(35/46)vs.43.75%(21/48),all P<0.05].The standard deviation of all normal to normal RR intervals(SDNN),root mean square of the difference between adjacent NN intervals(RMSSD),standard deviation of all 5-minute RR intervals(SDANN),and percent of NN50 in the total number of NN intervals(PNN50)in both groups after treatment were significantly increased compared to before treatment,and the RMSSD,SDANN,and PNN50 in the treatment group were significantly higher than those in the control group after treatment[RMSSD(ms):28.96±3.59 vs.24.34±2.66,SDANN(ms):108.55±11.80 vs.100.44±13.58,PNN50:7%(6%,7%)vs.5%(5%,6%),all P<0.05].There was no statistically significant difference in heart rate deceleration between the two groups before and after treatment.Conclusion Ningxin decoction has a good effect on the improvement of TCM syndromes and heart rate variability in patients with permanent atrial fibrillation of deficiency of both qi and yin type after being infected by COVID-19.

Objective To establish the measurement of IgA1 O-glycan-specific antiglycan autoantibodies in patients with IgA nephropathy (IgAN),and evaluate their role in the development and progression of IgAN.Methods In the IgAN regular follow-up cohort of Peking University Institute of Nephrology from January 2006 to December 2015,170 patients drawn by stratified randomization were enrolled in this study.Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of plasma galactose-deficient IgA1 (Gd-IgA1) and antiglycan autoantibody (IgG and IgA1).The correlation between antiglycan autoantibodies and clinicopathological parameters was analyzed by linear correlation and multiple linear regression analysis.The receiver operating characteristic curve (ROC) was used to evaluate the value of plasma anti glycide antibodies in the diagnosis of IgAN.Results IgG and IgA1 antiglycan antoantibodies that specifically recognized Fab-hinge region (Fab-HR) antigens could be detected in both IgAN and healthy control group.Agglutinin inhibition test showed that the specific antigen epitope was N-acetylgalactosamine (GalNAc) residue exposed to galactose deficiency in IgA1 hinged region.There was no significant difference in the absolute levels of plasma IgG antiglycan autoantibodies between IgAN and healthy controls (P=0.963).After adjustment of the plasma level of IgG,the normalized antiglycan autoantibody (ln[IgG antiglycan antibody/IgG]) in patients with IgANwas significantly higher than that in healthy controls (0.58±0.31 vs 0.37±0.11,P ＜ 0.01).The normalized level of IgG antiglycan autoantibody in IgAN patients was positively correlated with 24 h urine protein level during renal biopsy (Spearman r=0.183,P ＜ 0.05),and was also significantly correlated with 24 h urinary protein level after adjusting for baseline clinical and pathological factors (β=0.713,95％CI 0.323-1.102,P ＜ 0.01).The area under ROC curve (AUC) of normalized IgG antiglycan autoantibody in the diagnosis of IgAN was 0.764 (95％ CI 0.682-0.845,P ＜ 0.05).Using the cut-off value of 0.396,the sensitivity and specificity of normalized IgG antiglycan autoantibody for IgAN were 0.729 and 0.700 respectively.There was no significant difference in the absolute or normalized levels of IgA1 antiglycan autoantibodies between IgAN patients and healthy controls.Conclusions Gd-IgA1-specific antiglycan autoantibodies can be detected both in IgAN patients and healthy controls.They are elevated in some patients with IgAN and possibly involved in the development of IgAN.

Objective To investigate the effect of metoclopramide combined with psychological intervention on nausea and vomiting after laparoscopic cholecystectomy (LC). Methods From January 2015 to January 2017, 90 patients with nausea and vomiting after laparoscopic cholecystectomy according to the different treatment and nursing intervention mode were divided into the control group and the observation group, 45cases in each group. The control group were given granisetron and routine nursing, the observation group were received metoclopramide and psychological intervention. The experimental data was recorded and compared, the improvement of nausea and vomiting were observed. Results The clinical effect in the observation group is better than that in the control group. The improvement of nausea and vomiting, the nursing satisfaction in the observation group were better than those in the control group. The differences were statistically significant (P<0.05). Conclusion Metoclopramide combined with psychological intervention on the treatment of the patients with nausea and vomiting after laparoscopic cholecystectomy, curative effect is obvious, which can effectively improve the nausea and vomiting, nursing satisfaction is high, which is worthy of clinical application.

Objective To confirm the hepatotoxicity of valproic acid (VPA ) and its metabolites (2-propyl-4-pentenoic acid ,3-hydroxy valproic acid ,5-hydroxy valproic acid) on human liver cells .Methods Cells were divided into control group and VPA-treated group .The control group was conventionally cultured while the VPA-treated group was treated with valproic acid and its metabolites . The rate of cell proliferation was assayed by CCK 8 protocol . The mRNA levels of CYP1A1 , CYP1A2 ,PCNA ,Bax and Bcl-2 were measured by real time PCR .The correlated protein levels were measured by Western Blotting .The activity of LDH ,AST and ALT were also detected .Results Compared to the control group ,with the increases of concentrations and reaction time of VPA and its metabolites ,the proliferation rate of L02-cell was reduced ,the mRNA and protein levels of CYP1A1 ,CYP1A2 ,and Bax was increased ,the mRNA and protein level of PCNA and Bcl-2 was decreased , AST ,ALT ,and LDH were also elevated in the treated group .Conclusion Valproic acid and its metabolites were positively re-lated to hepatotoxicity .

Objective To evaluate the value of echo‐contrast RT‐3DE for assessment of left ventricular volume and function in patients with left ventricular non‐compaction(LVNC) .Methods Twenty‐one patients of LVNC were involved and underwent non‐enhanced and contrast‐enhanced RT‐3DE to evaluate left ventricular end‐diastolic volume (LVEDV) ,left ventricular end‐systolic volume (LVESV) ,left ventricular ejection fraction (LVEF) .The endocardial border definition of LV was graded for each of the 16 LV segments as follows :0 = border invisible ,1 = border visualized only partially ,and 2 = complete visualization of the border .Three image‐quality groups (good ,fair ,and uninterpretable) were identified . Results ①Duringcontrast‐enhancedRT‐3DE,ascomparedwithnon‐enhancedRT‐3DE,thenumberof segments with complete visualization of the endocardial border increased significantly (55% vs 82% ,P <0.01) ,and the number of patients with a good‐quality echocardiogram increased significantly (33% vs 81% , P <0.01) .②Contrast‐enhanced RT‐3DE provided significantly larger values of LVEDV ( P < 0 0.1) and LVESV ( P < 0 0.1) as compared with non‐enhanced RT‐3DE ,the values of LVEF were not statistically different between the two techniques ( P =0.07) .③Intra‐and inter‐observer agreement for assessment of LV volumes and systolic function improved during contrast‐enhanced RT‐3DE ,as compared with non‐enhanced RT‐3DE .Conclusions Contrast‐enhanced RT‐3DE can increase the prevalence of good‐quality echocardiograms and significantly improve the reproducibility of LV volumes and function measurements .

Objective To assess regional left ventricular systolic function in patients with hypertrophic cardiomyopathy (HCM) using real-time three-dimensional echocardiography (RT-3DE).Methods Twenty-five patients with HCM which was asymmetric septal hypertrophy,and twenty healthy subjects were enrolled in the study.The apical four-chamber view of left ventricular was acquired by RT-3DE.The left ventricular volume-time curves were analyzed quantitatively with Tomtec 4D LV-Analysis 3.0,and regional end-diastolic volume and end-systolic volume of left ventricular (rEDV,rESV),the time to minimum systolic volume (rESVT),regional stroke volume (rSV),regional ejection fraction (rEF),regional-global ejection fraction (rgEF) and the parameters of left ventricular dyssynchrony were measured.Results In the HCM group,the values of Tmsv16-Dif,Tmsv16-SD,Tmsv16-Dif％,Tmsv16-SD％ were significantly lower compared with the control group (P ＜ 0.01),and rEDV,rSV,rEF and rgEF in hypertrophic segments were lower than those in non-thickening and mild-thickening segments (P ＜0.05).In the control group,there were no significant difference of those parameters among all segments (P ＞0.05).The values of rEDV,rSV and rgEF in hypertrophic segments decreased in the HCM group (P ＜0.05),at the basal level,rEF in hypertrophic segments decreased,at the apical level,it increased,but the differences at the mid-ventricular level between the two groups were not significant;the values of rEF and rgEF in non-thickening and mild-thickening segments increased (P ＜0.05).Conclusions RT-3DE could sensitively detect left ventricular dyssynchrony and accurately assess regional left ventricular volume and function of different segments in patients with HCM.

Objective To investigate the value of two-dimensional speckle tracking imaging (2D-STI) in assessing left ventricular global and regional myocardial function in normal rats. Methods Echocardiography was performed during low-dose dobutamine stress in 20 normal adult male Wistar rats. High frame rate of 2D images were recorded from the left ventricular short-axis views at the papillary muscle level. Peak systolic radial strain (PRS) and circumferential strain (PCS) of each segment, left ventricular global peak systolic radial strain (G_(PRS)) and circumferential strain (G_(PCS)) were measured at EchoPAC work station. Left ventricular internal diameter at diastole (LVIDd), systole (LVIDs), fractional shortening (FS) and ejection fraction (EF) were measured with anatomical M-model echocardiography. Dynamic changes of each index during stress experiment were observed. The correlations between EF and left ventricular global two-dimensional strain (G_(PRS), G_(PCS)) were analyzed respectively. Results PRS was similar in all segments of mid-ventricular in short-axis view (P>0.05) at baseline, while PCS of each segment showed heterogeneity, with the anteroseptal and anterior wall showing the largest value and the inferior wall showing the lowest value (P<0.05). G_(PRS), G_(PCS), PRS and PCS of each segment increased correspondingly when the dobutamine dose increasing, as well as FS and EF, whereas LVIDd and LVIDs decreased. When dobutamine dose was 10.0 μg/(kg·min), these parameters were not significantly different compared with those of 5.0 μg/(kg·min) (P>0.05). Conclusion With good reproducibility, 2D-STI can noninvasively and easily assess global and regional left ventricular myocardial deformation of normal rats at rest and during low-dose dobutamine stress.

Objective To explore the value of transthoracic echocardiography in diagnosis of univentricle and analyze the sonogram typing. Methods The results of 66 patients with univentricle were reviewed retrospectively,and analayzed their typing connected with the reports in the literature. Results There were 3 ultrasonic types in 66 cases:①Type A(single left ventricle) 19 cases,single ventricle with left ventricular shape,residual cavity in front of it. ②Type B(single right ventricle) 38 cases, single ventricle with right ventricular form,and residual cavity in the rear.③Type C (solitary single-ventricle) 9 cases,there was only one ventricle. Thirty-one of them were treated surgically, 5 cases without operation had MRI or cardiac catheterization examination and the remaining 26 patients were only observed by echocardiography,the positive rate of diagnosis in type was 100%, the results were compared with cardiac catheterization or MRI examination and the operation: 1 cases of mixed type total anomalous pulmonary venous connection was misdiagnosed as heart-type total anomalous pulmonary venous drainage. But 1 case of descending aorta limitations narrow complicated patent ductus arteriosus(PDA), PDA was missed. The rest were completely correct diagnosis. Conclusions The transthoracic echocardiography can be used to evaluate types and all containing malformations of univentricle,and offers reliable information for operation.

Objective To explore the value of echocardiography in the diagnosis of the criss-cross heart. Methods The echocardiographic results of 6 patients with the criss-cross heart were reviewed retrospectively. The echocardiographic characteristics were analyzed and compared with the surgery results in 4 operated cases. Results The 6 cases were interpreted as representing a criss-cross heart with solitus atria,D-loop ventricles and concordant atrioventricular connections. The ventriculo-arterial alignments of 5 cases were abnormal including double outlet right ventricle with anterior aorta in 2 and transposition of the great arteries in 3 while 1 patient had concordant connection. The following principal characteristics were tilting the transducer from posterior to anterior could demonstrate the connection of the left-sided left atrium and the right-sided left ventricle through mitral valve at first. The more anterior angulation of the transducer then showed the right-sided right atrium was connected to the left-sided right ventricle through tricuspid imaging displayed the two atrial outflows crossed each other without mixing at atrioventricular valve level.right ventricle often occured. The echocardiographic diagnosis of the criss-cross heart and its associated cardiac abnormalities were confirmed by surgery in 4 cases except 1 persistent left superior vena cava was missed. Conclusions The invisibility of a standard 4-chamber view in any cut was very characteristic in the echocardiographic diagnosis of the criss-cross heart. The definitive appearance was the separate display of the two ventricular inlets and the crossed atrioventricular connections with each atrium emptying into the contralateral ventricle by continuous subxiphoid or apical scanning. The transthoracic echocardiography can diagnose this rare heart disease and associated cardiac abnormalities accurately.

Objective To observe the value of two-dimensional speckle tracking imaging (2D-STI) in assessing regional myocardial viability of rats after acute myocardial infarction. Methods Twenty Wistar rats were randomly divided into acute myocardial infarction group and sham-operation group (each n=10). Echocardiography was performed at baseline and 24 h after reperfusion. High frame rate two-dimensional images were recorded from the left ventricular short-axis views at the papillary muscle level. Peak radial strain (PRS) and peak circumferential strain (PCS) of each segment were measured at systolic period. Left ventricular internal diameter at diastole (LVID_d) and systole (LVID_s), fractional shortening (FS), ejection fraction (EF), wall thickening rate (TR) were measured with anatomical M-model echocardiography. Area of necrosis (AN) of each segment was measured after triphenyl tetrazolium chloride (TTC) staining. Based on TTC staining, ROC curve was used to analyze the accuracy of two-dimensional strain and TR index in identifying infarcted segment. Results ①Compared with acute myocardial infarction group at baseline and sham-operation group after operation, LVID_d and LVID_s of acute myocardial infarction group after operation increased significantly respectively (P<0.05), FS, EF and anteroseptal wall TR reduced significantly (P<0.05). ②Compared with acute myocardial infarction group at baseline and sham-operation group after operation, PRS and PCS decreased significantly in anteroseptal, anterior, anterolateral, inferolateral and inferoseptal segments of myocardial infarction group after operation (P<0.05), especially in anterosepetal, anterior and anterolateral segments (P<0.05). ③ROC analysis showed PCS had the best ability to identify infarcted myocardium as defined by AN>50%. Using a cut-off of -6.14%, PCS had a sensitivity of 93.75% and specificity of 90.91% for distinguishing infarcted from viable myocardium. Conclusion 2D-STI can accurately quantify regional myocardial function, providing a sensitive and noninvasive means to assess regional myocardial viability.