Objective:To explore application value of three-dimensional (3D) echocardiography in mitral insufficiency (MI). Methods:A total of 180 MI patients who admitted to The Affiliated Hospital of Xuzhou Medical University from January 2023 to November 2023 were selected,and they were divided into a severe group (n=130) and a mild group (n=50) based on the MI severity. Both groups received routine echocardiography and 3D echocardiography to compare the parameters of routine echocardiography,and analyze the diagnostic efficacy of echocardiography for left ventricular configuration and systolic function in MI patients. Results:The heart rate and QRS interval of patients in the severe group were respectively higher than those in the mild group (t=3.910,6.336,P<0.05),respectively. The left ventricular end diastolic diameter (LVEDD),LVEDD index,left ventricular (LV) length,LV length index,left ventricular end diastolic volume (LVEDV),LVEDV index,left ventricular end systolic volume (LVESV),LVESV index,LV mass index (LVMI),relative wall thickness (RWT),and two-dimensional echocardiogram sphericity index (2D-SI) in the severe group were all higher than those in the mild group (t=27.729,14.509,11.745,8.182,24.171,32.989,25.988,20.994,22.707,6.331,20.603,P<0.05). The three-dimensional left ventricular ejection fraction (3D-LVEF) of the severe group was lower than that of the mild group,and the three-dimensional end diastolic velocity (3D-EDV) of blood flow,3D-EDV index,and three-dimensional echocardiogram sphericity index (3D-SI) of the severe group were all higher than those of the mild group (t=2.855,24.320,10.409,36.056,P<0.05). The results of receiver operating characteristic (ROC) curve showed that the sensitivities of LVEDD index,LVEDV index,LVESV index,3D-LVEF,3D-EDV index,and 3D-SI were respectively 70.83％,68.47％,81.25％,71.58％,72.42％ and 90.38％ in diagnosing MI. The specificities of them were respectively 67.40％,65.06％,79.64％,68.10％,71.68％ and 90.38％. The area under curve (AUC) values of the ROC curve were respectively 0.658,0.612,0.814,0.726,0.799 and 0.852. 3D-SI had the highest sensitivity and specificity in diagnosing left ventricular remodeling of MI patients. Conclusion:3D echocardiography has higher application value in MI,which can reflect the remodeling and systolic function of left ventricle. Among of them,3D-SI can better describe the remodeling of left ventricle of patients,and can serve as a reference for the research progress of clinical observation for MI.

Objective:To explore application value of three-dimensional (3D) echocardiography in mitral insufficiency (MI). Methods:A total of 180 MI patients who admitted to The Affiliated Hospital of Xuzhou Medical University from January 2023 to November 2023 were selected,and they were divided into a severe group (n=130) and a mild group (n=50) based on the MI severity. Both groups received routine echocardiography and 3D echocardiography to compare the parameters of routine echocardiography,and analyze the diagnostic efficacy of echocardiography for left ventricular configuration and systolic function in MI patients. Results:The heart rate and QRS interval of patients in the severe group were respectively higher than those in the mild group (t=3.910,6.336,P<0.05),respectively. The left ventricular end diastolic diameter (LVEDD),LVEDD index,left ventricular (LV) length,LV length index,left ventricular end diastolic volume (LVEDV),LVEDV index,left ventricular end systolic volume (LVESV),LVESV index,LV mass index (LVMI),relative wall thickness (RWT),and two-dimensional echocardiogram sphericity index (2D-SI) in the severe group were all higher than those in the mild group (t=27.729,14.509,11.745,8.182,24.171,32.989,25.988,20.994,22.707,6.331,20.603,P<0.05). The three-dimensional left ventricular ejection fraction (3D-LVEF) of the severe group was lower than that of the mild group,and the three-dimensional end diastolic velocity (3D-EDV) of blood flow,3D-EDV index,and three-dimensional echocardiogram sphericity index (3D-SI) of the severe group were all higher than those of the mild group (t=2.855,24.320,10.409,36.056,P<0.05). The results of receiver operating characteristic (ROC) curve showed that the sensitivities of LVEDD index,LVEDV index,LVESV index,3D-LVEF,3D-EDV index,and 3D-SI were respectively 70.83％,68.47％,81.25％,71.58％,72.42％ and 90.38％ in diagnosing MI. The specificities of them were respectively 67.40％,65.06％,79.64％,68.10％,71.68％ and 90.38％. The area under curve (AUC) values of the ROC curve were respectively 0.658,0.612,0.814,0.726,0.799 and 0.852. 3D-SI had the highest sensitivity and specificity in diagnosing left ventricular remodeling of MI patients. Conclusion:3D echocardiography has higher application value in MI,which can reflect the remodeling and systolic function of left ventricle. Among of them,3D-SI can better describe the remodeling of left ventricle of patients,and can serve as a reference for the research progress of clinical observation for MI.

Background/Aims: Lipopolysaccharide (LPS) is the key factor inducing mucosal and systemic inflammation in various intestinal and parenteral diseases, which could initially disrupt the epithelial barrier function. EphrinA1/ephA2 is speculated to increase the epithelial permeability for its “repulsive interaction” between adjacent cells. This study aim to investigate the role of ephrinA1/ephA2 in LPS-induced epithelial hyperpermeability. Methods: In vivo model challenged with oral LPS in C57BL/6 mice and in vitro model exposed to LPS in Caco2 monolayer were established. The barrier function was assessed including expression of tight junction proteins (occludin and claudin-1), transepithelial electrical resistance, and permeability to macromolecules (fluorescein isothiocyanate-labeled fluorescent dextran 4 kDa [FD4]). Moreover, the expression and phosphorylation of ephrinA1/ephA2 were quantified, and its roles in the process of epithelial barrier disruption were confirmed via stimulating ephA2 with ephrinA1-Fc chimera (ephrinA1-Fc) and inactivating ephA2 with ephA2-Fc chimera (ephA2-Fc), or ephA2 monoclonal antibody (ephA2-mab), as well as inhibiting extracellular signal-regulated kinase 1/2 (ERK1/2) with PD98059. Results: LPS induced significant barrier dysfunction with dismissed occludin and claudin-1 expression, reduced transepithelial electrical resistance and increased FD4 permeability, accompanied by upregulated ephrinA1/ephA2 pathway and phosphorylation of ephA2 receptor. Furthermore, ephA2-Fc, and ephA2-mab ameliorated LPS-induced epithelial hyperpermeability, which was also inhibited by PD98059. Additionally, ephrinA1-Fc led to apparent epithelial leakage in Caco2 monolayer by promoting the phosphorylation of ERK1/2, which could be obviously blocked by ephA2-mab and PD98059. Conclusion EphrinA1/ephA2 promotes epithelial hyperpermeability with an ERK1/2-dependent pathway, which involves in LPS-induced intestinal barrier dysfunction.

Objective: To explore the efficacy of ossiculoplasty surgery under oto-endoscope in patients of conductive hearing loss with intact tympanic membrane. Methods: A retrospective study was conducted. The clinical data of 45 patients with conductive hearing loss who had undergone simple ossiculoplasty surgery between October 2015 and December 2017 from five hospitals in China (West China Hospital of Sichuan University, General Hospital of the People′s Liberation Army, Shanghai Ninth People′s Hospital, Shanghai JiaoTong University School of Medicine, Xijing Hospital, Fourth Military Medical University and Shenzhen Sixth People′s Hospital) were collected. There were 28 males and 17 females, with the age ranging from 12 to 69 years old. The tympanic membranes of those patients were intact before surgery. The lesion only occurred in the ossicular chain from CT and intraoperative exploration. The cases of otosclerosis, tympanosclerosis, cholesteatoma of middle ear, chronic suppurative otitis media, and tumor of middle ear were excluded. The postoperative complications, hearing improvements and operation time were observed. SPSS 23.0 software was used for statistic analysis. Results: There was neither sensorineural hearing loss nor facial paralysis after surgery in this group. Seven patients had transient mild tinnitus after surgery and gradually relieved during the follow-up period. Nine patients developed dysgeusia after surgery. Two patients developed dizziness after surgery, and the symptoms were mild and relieved during 1 week without special intervention. The air-bone gap (ABG) range of pre-operation was 22.5-45.7 dB, and the average ABG was (25.3±8.6) dB. The ABG range in the third month after surgery was 5.7-26.8 dB, and the average ABG was (9.3±8.6) dB. The mean value of ABG was significantly lower in the third month after surgery compared with that of pre-operation (t=2.31, P<0.05). The operation time of the surgeons in each research center was similar. The overall average of operation time was (43.56±18.25) min. There was no significant difference in the duration of operation between the centers (F=3.26, P>0.05). Conclusion The ossiculoplasty surgery under oto-endoscope has good efficacy.

0.05).Conclusion HV-CVVH is effective in the treatment of severe acute pancreatitis.For SAP patients who are suit for the hemofiltration treatment,the treatment of HV-CVVH for 8h and for more than 8h has nearly the same effectiveness.