The recombinant human thyroid-stimulating hormone (rhTSH) can be used for differentiated thyroid cancer (DTC) preparation before ¹³¹I therapy, and follow-up. Since its approval by the American Food and Drug Administration (FDA) in 1998, rhTSH has been clinically used in European countries, the United States, and other countries for nearly 30 years. In April 2024, China’s first independently developed rhTSH agent was approved. Based on clinical experience and evidence from domestic and international studies, an expert consensus on the application of rhTSH has been developed following thorough consultations among experts. The consensus offers evidence-based recommendations to guide the appropriate use of rhTSH in clinical practice.

Objective:To discuss the clinical application value of echocardiography in evaluating the early outcomes of transcatheter aortic valve replacement(TAVR)via the transapical approach,and to clarify the role of echocardiography in assessing the efficacy of the surgery.Methods:The clinical data of 85 patients who received J-Valve prosthetic valves via the transapical TAVR were retrospectively analyzed.The patients were divided into AS group(simple aortic stenosis,n=20),AR group(simple aortic regurgitation,n=37),and AS&AR group(aortic stenosis with regurgitation,n=28).Echocardiographic examination was performed on all the patients before operation,1 week after operation,3 months after operation,and 6 months after operation.The parameters including left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),aortic valve peak flow velocity(AV Vmax),aortic valve mean transvalvular pressure gradient(AV PGmean),and paravalvular leak(PVL)width were measured to evaluate the cardiac function and the function of the prosthetic valve;the occurrence of postoperative complications of the patients in various groups was also analyzed.Results:J-Valve prosthetic valves were successfully implanted in all 85 patients.There were no significant differences in age,gender,New York Heart Association(NYHA)heart function classification,history of hypertension,history of diabetes,history of hyperlipidemia,and history of coronary artery disease among various groups befor operation(P＞0.05),ensuring comparability.Compared with before operation,1 week after operation,the AV Vmax and AV PGmean of the patients in AS group and AS&AR group were decreased(P＜0.05);there were no significant differences in various parameters of the patients in AR group(P＞0.05).Compared with before operation,3 months after operation,the LVEF and LVFS of the patients in AS group were increased(P＜0.05),while the AV Vmax and AV PGmean were decreased(P＜0.05);the LVEDV and LVESV of the patients in AR group were decreased(P＜0.05),while the LVEF and LVFS were increased(P＜0.05);the LVEDV,LVESV,AV Vmax,and AV PGmean of the patients in AS&AR group were decreased(P＜0.05),while the LVEF and LVFS were increased(P＜0.05).Compared with before operation,LVEDV,LVESV,IVST,and LVPWT of the patients in all three groups 6 months after operation were decreased(P＜0.05),while LVEF and LVFS were increased(P＜0.05);the AV Vmax and AV PGmean of the patients in AS group and AS&AR group were decreased(P＜0.05);the AV PGmean of the patients in AR group was decreased(P＜0.05).The postoperative complications included 3 cases of permanent pacemaker implantation(2 cases in AS group,1 case in AR group),1 case of stroke(in AS group),and 13 cases of PVL(4 cases in AS group,5 cases in AR group,4 cases in AS&AR group).No deaths occurred during follow-up.Conclusion:Echocardiography can accurately and quantitatively evaluate early changes in cardiac function and the functional state of prosthetic valves after transapical TAVR,providing objective evidence for evaluating surgical outcomes and postoperative complications.

Objective To detect the important parameters of three dimensional structure of the aortic annulus by using real time three dimensional transesophageal echocardiograhy (RT 3D TEE) and analyse morphological and physiological characteristics , in order to establish simplified model of aortic valve and provide references for designing aortic annulus .Methods A total of 95 ca‐ses of healthy individuals carrying out RT 3D TEE were selected ,and the images of total volume of aortic root were collected .The important parameters of three dimensional aortic valve in four cardiac cycles ,including sinus tube junction(S) ,distance between ad‐jacent valve junction(L ,R and N) ,diameter of the circumcircle of triangle(J) ,aortic annulus height(H) ,long diameter(A) ,short di‐ameter(B) and eccentricity ratio (B/A) of the aortic valve ,were measured by using the QLAB7 .0 software .In the 3D imaging ,the extending relationship between the bottom of aortic valve and aortic annulus was analysed ,the structural characteristics of the aortic valve were simplified ,and the model was established .Results The values of the parameters measured at the end‐diastole were as follows :sinus tube junction (26 .3 ± 3 .3)mm ,three‐dimensional aortic annulus height(12 .4 ± 1 .9)mm ,aortic valve long diameter and short diameter (25 .9 ± 2 .7)mm and (19 .8 ± 2 .0)mm ,adjacent valve junction distance(L ,R and N) all was(21 .6 ± 2 .5)mm . These three structures approximately formed an equilateral triangle .The values of the adjacent cycle time ,the change of sinus tube junction ,distance between adjacent valve junction ,aortic annulus height and long diameter were compared ,and there was no statisti‐cal significant differences(P>0 .05) ,while statistically significant differences were found in the aortic valve short diameter and long short diameter between those at the end‐diastole and those at the medium‐systole(P<0 .01) .Conclusion RT 3D TEE can accu‐rately measure the size of each part of the aortic valve and display its shape and change ,which contribute to simplifying and recon‐structing the aortic annlus .

Aorta ; abnormalities ; Child ; Heart Defects, Congenital ; diagnosis ; Heart Ventricles ; abnormalities ; Humans ; Male

Objective To evaluate the clinical value of epicardial echocardiographic examination in cardiac valve surgery.Methods Epicardial echocardiography were performed in 46 patients undergoing valvular plasty or valvular replacement surgery to estimate the function of valve and left ventricle and residual shunt during cardiac surgery.Results Twelve cases of 46(26.1％)showed abnormality during cardiac surgery.Two cases of 15 patients performed valvuloplasty were changed to valvular replacement because of remarkable regurgitation of native valves.There was 1 case of periprosthetic leakage,3 cases of left atrial appendage thrombus,1 case of patent foramen ovale and 5 cases of low ejection of left ventricle in all 31 cases of valvular replacement.Conclusions Epicardial echocardiograpyc examination is an effective examination in cardiac valve surgery with clearly image,simplicity operation and promptness.

ment with simple operation, high successful rate, high safety, less invasiveness and low complication rate.

Objective To evaluate the clinical value of speckle tracking imaging in the measurement of two-dimensional strain in patients with myocardial infarction. Methods High frame rate two-dimensional echocardiography were performed in 30 healthy subjects,21patients with anterior myocardial infarction and 15 patients with inferior myocardial infarction. Longitudinal strain (LS), radial velocity (Vs), regional shortening fraction (RFS),radial strain (RS) were measured in the apical two-chamber view and short-axis view(the level of papillary muscle) using two-dimensional strain software. Results Compared with healthy subjects, LS, Vs, RFS, RS decreased in the segments with infarction(P<0.05). LS, Vs, RFS, RS of the two myocardial infarction groups had partly differences(P<0.05). Conclusions Regional wall motion of left ventricle in patients with myocardial infarction can be evaluated accurately with speckle tracking imaging.

Objective To evaluate the role of polymorphonuclear (PMN) in patients with acute myocardial infarction (AMI).The preventive effects of Vitamin C-a potent free radical scavenger,on parameters of PMN oxygen free radicals (OFR) production in patients with AMI were also studied.Methods 60 patients with AMI were randomized to receive either conventional treatment only (group Ⅰ,n=30) or conventional treatment supplemented with vitamin C infusion,3.0 g/d,for 7 days (group Ⅱ,n=30).Parameters of PMN OFR production were assayed by a method named as polymorphonuclear chemiluminescence (PMN-CL) on the 1st,3rd,7th and 10th day after been hospitalized.62 healthy controls of similar age,sex were also studied.Results Parameters of PMN-CL increased significantly in patients with AMI compared with that in the healthy controls.Parameters of PMN-CL decreased significantly in group Ⅱ on the 3rd,7th and 10th day compared with that in group Ⅰ(P<0.05,0.01,0.001,respectively).ST segment score was significantly higher in group Ⅱ than that in group Ⅰ on the 3rd,7th and 10th day.Conclusion These results indicate that the PMN act as a potential contributor to extension of tissue injury induced by OFR.Supplementation with vitamin C may suppress PMN OFR production and could be beneficial in preventing myocardial necrosis.

Objective　To explore left atrial(LA) structur e and function changes in 86 cases of essential hypertension disease (EH) and ef fects of age,gender,hypertension duration,hypertension stage and left ventricula r function on them.Methods　 Using M-mode echocardiogram to detect LA diameter, Usi ng ultrasonic acoustic quantification (AQ) to detect LA area,LA systolic and dia stolic function,LV systolic and diastolic function. Results　①Compared with normal group, LA diameter and LA area we re larger in EH group, LA systolic and diastolic function were impaired. ② Gend er had no effect on LA structure and functione in EH patients; LA diameter and L A area dilated with age, LA systolic function was impaired with age. ③ Hyperten sion duration had no effect on LA structure and function in EH patients. ④LA d iameter and area dilated with hypertension stage. With the development of hypert ension, LA diastolic function was first impaired,then LA systolic function was a lso impaired.⑤LA structure and function had signifficant relationship with LV d iastolic function, LA might dilate and LA systolic function might be impaired wi th LV diastolic function damage.Conclusions　LA diameter and LA area are dilated and LA function i s impaired in EH patients, which changes become more signifficant with age. LA s tructure change and systolic function impairment have a relationship with LV dia stolic dysfunction.

Objective To study the telomerase activity,the keratinocyte apoptosis in condyloma ac-cuminatum(CA)and the correlation between them.Methods CA specimens from30patients were stud-ied,and compared with normal tissue and tumor cell lines.Telomerase activity was detected with telomeric repeat amplification polymerase chain reaction(TRAP)-ELISA.Terminal deoxynucleotidyl transferase(TdT)-mediated biotin dUTP nick end-labeling(TUNEL)was used to evaluate apoptotic cells.Results Increased telomerase activity was detected in27(90%)patients with CA,with A 450 ranging between0.50and2.76(mean1.3022).Apoptotic keratinocytes were found in24out of30CA cases(80%).A statistically signifi-cant inverse correlation was found between telomerase activity and apoptotic index(r =-0.52,P=0.004).Conclusion Keratinocyte telomerase is activated in condyloma acuminata,which is correlated with the downregulation of apoptosis,thus they might be involved in the pathogenesis of CA.