Time-course changes in left ventricular myocardial deformation in STZ-induced rabbits on velocity vector imaging.

OBJECTIVES: To clarify the time-course changes in left ventricular myocardial deformation using velocity vector imaging and to provide insights into our understanding of the cardiac pathophysiology in diabetes mellitus. METHODS: Thirty New Zealand white rabbits were randomly divided into either the control group (n = 10) or the diabetes mellitus (DM) group (induced with STZ, n = 20). For the myocardial deformation studies, echocardiography and syngo-vector velocity imaging (VVI) were performed at baseline and after 2, 4, 8, and 12 weeks in all of the rabbits. The left ventricular (LV) global longitudinal and circumferential strain and strain rate were measured. For histomorphological study of the heart structure, 2 of the STZ-induced rabbits were killed at 2, 4, 8, and 12 weeks. Routine hematoxylin and eosin staining was performed. RESULTS: At 2 weeks, the global longitudinal strain (GLS), systolic strain rate (GLSRs), and diastolic strain rate (GLSRd) were significantly lower in the DM group compared with the control group (-18.16% versus -24.00%, -1.86 s(-1) versus -2.49 s(-1), 1.93 s(-1) versus 2.42 s(-1), respectively, P < 0.05), while, compared with the control group, the global circumferential strain (GCS), systolic strain rate (GCSRs), and diastolic strain rate (GCSRd) in the DM group were significantly decreased (-12.77% versus -23.31%, -1.31 s(-1) versus -2.20 s(-1), 1.41 s(-1) versus 2.15 s(-1), respectively, P < 0.05) at 8 weeks. With the progression of untreated diabetes, the histoanatomical alterations intensified gradually beginning at 2 weeks. CONCLUSIONS: The progressive impairments in LV myocardial deformation and structure occurred early in diabetic rabbits with normal LV ejection fraction (EF), FS, and E/A. VVI could be used to evaluate subtle cardiac dysfunction in the early phase of DM.

Accuracy of Endorectal Endoscopic Ultrasound (EUS) for Locally Advanced Rectal Cancer (LARC) Restaging After Neoadjuvant Chemoradiotherapy (NAT): A Meta-Analysis.

BACKGROUND/AIMS: Endorectal endoscopic ultrasound (EUS) can provide accurate and reliable information for initial staging of locally advanced rectal cancer (LARC) in both the depth of rectal cancer penetration (T-stage) and regional lymph node involvement (N-stage). However, there is still no consensus about its accuracy in retagging LARC after neoadjuvant chemoradiotherapy (NAT). METHODOLOGY: In this study, we retrieved previous studies and performed a meta-analysis for assessing the accuracy of EUS for retagging of LARC after NAT. RESULTS: It was found the accuracy of EUS for T restaging of LARC was relatively low and over-staging was common, although the accuracy for assessing T3/4 was significantly higher than T0-T2 stage. The specificity of EUS for assessing N stage was relatively high, but the sensitivity was relatively low. CONCLUSIONS: Data obtained in this study confirmed the overall accuracy of EUS is not sufficient to serve as a basis for decisions on restaging Exploring the possible application of new techniques is necessary for better restaging.

Primary cardiac angiosarcoma with spontaneous ruptures of the right atrium and right coronary artery.

Primary tumors of the heart are rarely seen. Cardiac angiosarcomas are malignant tumors that almost always have a poor prognosis. Atrium rupture and coronary artery fistula are very rare complications of primary cardiac angiosarcoma. We describe a 57-year-old man suffering from primary cardiac angiosarcoma with spontaneous ruptures of the right atrium and right coronary artery (RCA). Theoretically, either of these ruptures invariably results in pericardial effusion and tamponade that is rare but potentially life threatening. In this instance, however, the patient might have developed fibrous adhesions resulted from previous bloody pericardial effusion. A massive pericardial effusion was localized, which consequently prevented cardiac tamponade and hemodynamic collapse. Echocardiography revealed the tumor progression leading to detectable infiltration of solid mass into the right atrial (RA) wall, which is close to RCA. And color Doppler displayed the flow into the pericardial cavity through a disrupted RA wall and perforated RCA. Echocardiography remains the primary method of choice for evaluation of cardiac masses.

Quantitative assessment of left ventricular systolic function in patients with coronary heart disease by velocity vector imaging.

OBJECTIVE: To assess the left ventricular (LV) longitudinal systolic function and asynchrony in patients with coronary atherosclerotic heart disease (CAD) by syngo velocity vector imaging (VVI). METHODS: Twenty-eight control subjects and 79 patients with CAD were examined, including 28 patients with myocardial infarction, 26 patients with coronary lumen stenosis <50%, and 25 patients with myocardial ischemia. According to the results of coronary arteriography and electrocardiogram (ECG), the myocardial segments of the LV of CAD patients were divided into four groups: ischemic, infarcted, nonischemic, and normal. Dynamic imaging was performed on all subjects. The systolic peak strain (Smax), systolic strain rate (SRmax), time to peak strain (PTs), and time to peak strain rate (PTsr) in every cardiac cycle were measured. RESULTS: A total of 1,253 out of 1,712 (96.5%) segments were successfully analyzed with VVI. Smax and SRmax of the ischemic and infarcted segments were impaired in CAD patients. Optimal sensitivity and specificity were obtained with strain and strain rate cutoffs of -14.08% and -0.83 s(-1) , respectively, for detecting ischemic segments and -6.65% and -0.38 s(-1) , respectively, for detecting infarcted segments. The PTs and PTsr were significantly longer in the ischemic and infarcted segments compared to those of the control group. CONCLUSIONS: Utilizing VVI, the longitudinal strain, strain rate, and peak time in CAD patients are easy to obtain and reproducible. Strain and strain rate cutoff values of abnormal myocardium are valuable for detecting ischemia and infarction. The PTs and PTsr values possibly estimate myocardium asynchrony in CAD patients.

[The experimental study of magnetic resonance diffusion-weighted imaging to the treatment of acute hepatic injury with allogeneic MBMCs transplantation into liver].

OBJECTIVE: To investigate the therapeutic effect of mononuclear bone marrow cells (MBMCs) transplantation to rabbit liver with acute hepatic injury (AHI) and the feasibility that evaluated the functional recovery of acute hepatic injury model with MR-DWI. METHODS: 10 healthy rabbits were chosen to be normal control group which was only carried out MR-DWI scan of normal liver. 42 model rabbits of acute liver injury were randomly selected and divided into 2 groups:transplanted group (n = 21) and control group(n = 21). Each rabbit of the transplanted group was infused 5 ml MBMCs suspension (about containing 2 × 107 MBMCs) into its liver at multiple sites. All manipulations to each rabbit in the control group were as same as those in the transplanted group except that 5 ml of D-Hanks solution was injected instead of MBMCs suspension.7 model rabbits respectively chosen from the transplanted group and the control group were carried out MR-DWI scan and calculated the mean ADC value of the injury liver and then were killed on day 7, day 14 and day 28 of AHI establishment after transplantation. Other comparative assays were performed including: functional assay of liver, pathological examination of liver sections. RESULTS: Before MBMCs transplantation, the difference of liver function was not significant between the transplanted group and the control group. But after MBMCs transplantation, the liver functions of the transplanted group were significantly better than those of the control group at all time points tested (P < 0.05). On day 7 of AHI establishment after MBMCs transplantation, the mean ADC values of the transplanted group and the control group were significant lower than those of the normal control group (P < 0.05). The mean ADC values of the transplanted group and the control group increased to the mean ADC values of the normal control group over time. At the same time point, the mean ADC values of the transplanted group were significantly higher than those of the control group. In the transplanted group, the difference of average ADC values between any two time points were significantly (P < 0.05). In the control group, the mean ADC values on day 7 were lower than those on day 14 and day 28 (P < 0.05), the mean ADC values on day 14 were lower than those on day 28 (P = 0.417). The correlation between the average ADC value and the ALT or AST was negative (P < 0.05), the correlation between the average ADC value and the ALB was positive (P < 0.05). Along with the increase of the average ADC value, the liver function of the AHI model rabbit gradually got better. CONCLUSION: Transplantation of MBMCs promoted the recovery of liver function of AHI model rabbit. The recovery of the injury liver could be detected with observing dynamic change of its mean ADC value.

[Impact of selective fetoscopic laser photocoagulation for twin-twin transfusion syndrome on myocardial deformation].

OBJECTIVE: To investigate the changes in myocardial deformation in donor and recipient hearts in response to selective fetoscopic laser photocoagulation (SFLP) for twin-twin transfusion syndrome (TTTS). METHODS: Totally 25 twin pairs before 24-hour and 1 week after SFLP had fetal echocardiography and digital dynamic two-dimensional four chamber views which were interrogated off-line using velocity vector imaging (VVI) software. Global longitudinal strain (S), systolic strain rate (SRs) and diastolic strain rate (SRd) were measured off-line in the left (LV) and right (RV) ventricles. RESULTS: In the donor, SFLP resulted in increase in cardiothoracic ratio (CTR, 0.29 ± 0.03 versus 0.34 ± 0.05, P < 0.01), with development of new onset tricupid regurgitation (n = 7) and pericardial effusion (n = 5) and worsening of all measures of myocardial deformation in both systole and diastole for LV and RV [LV-S: (-19.24 ± 3.68)% versus (-13.78 ± 3.64)%, P < 0.01; LV-SRs: (-2.28 ± 0.53) versus (-1.43 ± 0.41) s(-1), P < 0.01; LV-SRd: (1.67 ± 0.43) versus (1.15 ± 0.70) s(-1), P < 0.01; RV-S: (-20.20 ± 3.19)% versus (-16.10 ± 3.07)%, P < 0.01; RV-SRs: (-2.03 ± 0.65) versus (-1.72 ± 0.38) s(-1), P < 0.05; RV-SRd: (1.71 ± 0.30) versus (1.50 ± 0.36) s(-1), P < 0.05]. In the recipient, CTR decreased (0.42 ± 0.04 versus 0.37 ± 0.04, P < 0.01) and all parameters for both LV and RV improved substantially [LV-S: (-10.62 ± 2.72)% versus (-16.46 ± 3.23)%, LV-SRs: (-1.09 ± 0.30) versus (-1.60 ± 0.31) s(-1), LV-SRd: (0.99 ± 0.34) versus (1.53 ± 0.32) s(-1), RV-S: (-11.66 ± 4.56)% versus (-17.96 ± 3.97)%, RV-SRs: (-1.26 ± 0.39) versus (-1.74 ± 0.45) s(-1), RV-SRd: (1.15 ± 0.49) versus (1.63 ± 0.44) s(-1); all P < 0.01]. CONCLUSION: Myocardial deformational mechanics improve in the recipient but worsen in the donor following SFLP for TTTS.

A Nomogram Predicting the Prognosis of Children With Biliary Atresia After Hepatoportoenterostomy.

Background: Although Kasai portoenterostomy (KPE) is performed timely for most children with biliary atresia (BA), the native liver survival (NLS) is still poor due to the progressive liver fibrosis. Many children have to receive liver transplantation (LT) within 2 years after KPE. Early prediction of the prognosis permits the implementation of prophylactic treatments for BA children. However, studies about the prediction are limited. Objective: The purpose of this study is to establish a nomogram to predict the prognosis of BA children within 2 years after KPE. Methods: The follow-up data of 151 BA children were retrospectively reviewed, and were randomly divided into a training cohort for constructing a nomogram (n = 103) and a validation cohort (n = 48). In the training cohort, patients were divided into Group A and Group B according to whether death or LT were observed within 2 years post-KPE. Multivariate Cox regression based on the baseline characteristics, liver function indicators and LSM (liver stiffness measurement) values at KPE and 3 months after KPE was utilized for the establishment of the nomogram in predicting the prognosis of BA within 2 years after KPE. The discrimination and calibration of the nomogram were internally and externally validated. Results: Fifty-six BA children were included in Group A and 47 were included in group B. Age at KPE, METAVIR score F4, LSM at 3 months, first onset of cholangitis within 3 months, and jaundice clearance time were the independent predictors for the prognosis of BA children within 2 years after KPE (all P < 0.05). The developed nomogram based on these independent predictors showed good discrimination and calibration by the internal and external validation. Its performance was better than each predictor in predicting the prognosis (all P < 0.05). Conclusions: The established nomogram based on the indicators from the first 3 months after KPE may be useful for predicting the prognosis of BA children within 2 years post-KPE and helpful for the consideration of LT.

Clinical applications of N-terminal pro B-type natriuretic peptide in heart failure and other cardiovascular diseases.

N-terminal fragment of pro B-type natriuretic peptide (NT-proBNP) has emerged as an important adjunct in the management of heart failure (HF) and other cardiovascular diseases. NT-proBNP is a 76-amino acid peptide created during cleavage of the precursor molecule, Pro B-type natriuretic peptide (ProBNP). NT-proBNP is of significant diagnostic value in patients presenting with possible HF and is an important prognostic factor in this condition and other cardiovascular diseases. Ongoing research supports the potential value of this biomarker in non-cardiovascular disease. This review will describe clinical applications of NT-proBNP in HF and a broad range of other conditions.

Four-dimensional echocardiography with B-flow imaging and spatiotemporal image correlation in the assessment of congenital heart defects.

OBJECTIVE: The objective of the present study was to evaluate the role of four-dimensional ultrasound with B-flow imaging and spatiotemporal image correlation (STIC) in the detection of congenital heart defects. METHODS: Automated longitudinal and transverse sweeping of the fetal chest was utilized to obtain the volume datasets of the heart. Among the fetuses recruited in the study, 20 were normal and 13 were fetuses with congenital heart anomalies. Reconstructed images of abnormal hearts were compared with those of normal fetuses. RESULTS: Of the 20 normal fetuses, all extracardiac vessels such as aorta, pulmonary artery, ductus artery, inferior vena cava, and ductus venosus could be detected on reconstructed images of 16 fetuses. In five normal cases, a four-dimensional image was recorded to allow simultaneous visualization of all four pulmonary veins. In the 13 fetuses with cardiac anomalies, four-dimensional sonography with B-flow imaging and STIC detected the 'digital casts' of the outflow tracts, great arteries, and veins draining into the heart. These results demonstrate spatial relationship among these structures which provide important anatomical information. CONCLUSIONS: The use of four-dimensional ultrasound examination with B-flow imaging and STIC is a very useful technique in identifying anatomical features of different congenital cardiac anomalies.

Assessment of regional right ventricular longitudinal functions in fetus using velocity vector imaging technology.

OBJECTIVES: The velocity vector imaging (VVI) technique is useful to assess regional myocardial mechanics. The aim of this study was to evaluate the usefulness of this technology in assessing regional right ventricular longitudinal functions in the fetus and to establish a nomogram of the right ventricle (RV). METHODS: We studied 170 healthy fetuses that were divided into five groups based on gestational age. Dynamic digital images of four chambers were collected and analyzed off-line. The longitudinal VVI parameters were calculated in the right free wall and ventricular septum, respectively. RESULTS: A total of 151 out of 170 fetuses (89%) were successfully analyzed using VVI, with good inter- and intra-observer agreements. Normal values for velocity, strain, and strain rate were established. The tissue velocity gradually decreased from basal to apical segment (P < 0.05), whereas strain and strain rate remained stable. The tissue velocity increased with gestational age (P < 0.05), whereas strain and strain rate were stable (P > 0.05). CONCLUSION: Fetal myocardial velocity, strain, and strain rate measurements are easy to obtain and are reproducible. From mid-to-late gestation, the longitudinal tissue velocity of the RV increases with gestational age, whereas strain and strain rate remain stable. These results indicate that myocardial contractility is established in mid-gestation and remains constant throughout gestation.

Differences in left ventricular twist related to age: speckle tracking echocardiographic data for healthy volunteers from neonate to age 70 years.

OBJECTIVE: To determine normal left ventricular (LV) twist characteristics in different age groups and assess changes between neonates and the elderly. METHODS: Short-axis left ventricle images at basal and apical levels were acquired in 274 healthy volunteers (aged 15 days to 72 years) by two-dimensional echocardiography, and were analyzed off-line using Speckle tracking echocardiography (STE) software to obtain LV twist measurements. The peak apical rotation (PAr), peak basal rotation (PBr), peak LV twist (Ptw), peak LV twist normalized by LV length (PtwN), peak untwisting velocity (PutwV), and isovolumic untwisting% (Iutw%) were measured. RESULTS: LV twist values vary with age. Ptw was higher in older volunteers. PtwN varied inconsistently with age. PutwV and Iutw% were lower in the young and old with a peak in mid-age ranges. CONCLUSIONS: STE is an effective noninvasive method to assess LV twist. Age-related differences in LV twist may reflect maturation and adaptive modulation of LV torsional biomechanics from neonate to the elderly.

Evaluation of regional left ventricular longitudinal function in 151 normal fetuses using velocity vector imaging.

OBJECTIVE: The purpose of this study was to investigate the clinical value of velocity vector imaging (VVI) in the assessment of normal fetal regional myocardial performance and to establish a normative data set for normal Chinese fetuses. METHODS: One hundred and fifty-one healthy Chinese fetuses were divided into five groups according to their gestational age. Digital dynamic four-chamber views were collected and analyzed offline. The regional tissue velocity, strain, and strain rate of the interventricular septum and left lateral wall were measured in systole and diastole. RESULTS: Normal systolic and diastolic values for tissue velocity, strain, and strain rate were established. Tissue velocity decreased gradually from the basal segment to the apical segment (P < 0.01), whereas the strain and strain rate were stable among all segments in every group (P > 0.05). Tissue velocity was dependent on gestational age (P < 0.05), whereas strain and strain rate were stable throughout gestation (P > 0.05). CONCLUSION: VVI is a novel noninvasive tool for quantitative assessment of regional systolic and diastolic function of the fetal heart. Fetal myocardial velocity, strain, and strain rate measurements can be measured easily and reproducibly. This technique is useful for evaluating cardiac function.

Assessment of regional myocardial function in patients with dilated cardiomyopathy by velocity vector imaging.

OBJECTIVE: To assess the left ventricular (LV) longitudinal systolic and diastolic function in patients with dilated cardiomyopathy (DCM) by syngo Velocity Vector Imaging (VVI). METHODS: Digital dynamic images of 30 DCM patients and 30 healthy subjects were collected; then the longitudinal velocity, strain, and strain rate were measured in systolic early and late diastolic periods, and the time to peak systolic velocity, strain, and strain rate were measured and recorded. The parameters of the two groups were compared. RESULTS: All of the parameters of the DCM were significantly lower than those of the normal group (P < 0.05-0.01), except that the parameter of late diastolic strain was not different between the two groups (P > 0.05). CONCLUSIONS: VVI is a novel noninvasive tool to assess quantitatively and objectively LV regional systolic and diastolic function in patients with DCM; it provides another useful modality for evaluating cardiac function.

MMP-1/TIMP-1 expressions in rectal submucosa of females with obstructed defecation syndrome associated with internal rectal prolapse.

OBJECTIVE: To explore the MMP-1/TIMP-1 expressions in rectal submucosa of females with obstructed defecation syndrome (ODS) associated with internal rectal prolapse (IRP). METHODS: Fifty-six female patients with ODS associated with IRP were enrolled as Case group, and 43 female hemorrhoids of stages III-IV without constipation and IRP were enrolled as Control group. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) and immunohistochemistry were performed to test the expressions of MMP-1/TIMP-1 in the rectal submucosa. Western blotting was used to examine protein expressions of MMP-1/TIMP-1 and pro-inflammatory cytokines (IL-6 and TNF-α) in the rectal submucosa. EVG staining was conducted to detect collagen and elastic fibers in rectal submucosa. RESULTS: The increased expression of MMP-1 was negatively linked to the decreased TIMP-1 level in the rectal submucosa of patients with ODS associated with IRP. Besides, the expressions of IL-6 and TNF-α were increased in the Case group as compared with the Control group. Additionally, ODS severity and the pro-inflammatory cytokines was positively linked to MMP-1, but negatively related to TIMP-1 in Case group. EVG staining showed that the area ratios of collagen and elastic fibers were lower in Case group than Control group. Through Pearson's correlation analysis, the area ratios of collagen and elastic fibers were positively associated with MMP-1 expression, but negatively correlated with TIMP-1 expression in rectal submucosa of patients with ODS associated with IRP. CONCLUSION: Elevated MMP-1 and reduced TIMP-1 were found in ODS associated with IRP, which was related to the ODS severity, inflammation and contents of collagen and elastic fibers.

[Comparison of five different ultrasonographic parameters for diagnosis of lethal fetal pulmonary hypoplasia].

OBJECTIVE: To evaluate the clinic value of five different ultrasonographic fetal parameters for prenatal diagnosis of pulmonary hypoplasia. METHODS: Two hundred and seventy-one normal singleton pregnancies with well-established dates between 20 and 40 weeks of gestation were studied to establish normal reference range of five different ultrasonographic fetal parameters. The five parameters, which could reflect fetal lung mass, were as follows: lung area/body weight ratio, lung area, thoracic circumference/ abdominal circumference ratio, lung area/thoracic area ratio and lung area/head circumference. Thirty pregnancies with risk factors for pulmonary hyperplasia were studied for the usefulness of five parameters. Two or more standard deviations below the mean control group measurement were considered abnormal. The prenatal ultrasonic diagnoses of pulmonary hyperplasia were confirmed at neonatal follow-up examinations, on autopsy and by pathologic findings. RESULTS: Lung area and lung area/head circumference increased with gestational age, lung area /body weight ratio decreased with gestational age. The relationships among the two ratios (thoracic circumference/abdominal circumference ratio, lung area/thoracic area ratio) and gestational age were relatively constant. Abnormal lung area/body weight ratio had a higher diagnostic accuracy than other parameters. Sensitivity of the parameters, including lung area, lung area/body weight ratio, thoracic circumference/abdominal circumference ratio, lung area/thoracic area ratio and lung area/head circumference were 83%, 97%, 50%, 70% and 87% , respectively. Sensitivity of the lung area/body weight ratio was 95% (20/21 fetuses); specificity, 9/9 fetuses; positive predictive value, 100% (20/20 fetuses); negative predictive value, 9/10; and accuracy 97% (29/30 fetuses). CONCLUSION: Lung area/ body weight ratio is a good predictor of pulmonary hypoplasia.

Role of miR-22 in intestinal mucosa tissues and peripheral blood CD4+ T cells of inflammatory bowel disease.

OBJECTIVE: miR-22 is known to be involved in the pathogenesis of several autoimmune diseases, but it remains unclear whether miR-22 is associated with inflammatory intestinal disease (IBD). METHODS: The patients with ulcerative colitis (UC) and Crohn's disease (CD) were enrolled in this study. After the CD4+ T cells from healthy controls and active IBD patients were isolated and then transfected with miR-22 mimics/inhibitors, Quantitative real-time polymerase chain reaction (qRT-PCR) was conducted to measure expressions of miR-22, HDAC4, specific transcription factors in intestinal mucosa tissue and CD4+ T cells, while enzyme-linked immuno sorbent assay (ELISA) to detect expressions of inflammatory cytokines in PB. Antisense miR-22 was administered into mice during trinitrobenzene sulphoni cacid (TNBS)-induced colitis to determine its role in IBD. RESULTS: A significant elevation of miR-22 but an evident decrease of HDAC4 was found in CD4+ T cells in PB and intestinal mucosa tissues from IBD patients. In addition, there was a great reduction in HDAC4 and a dramatic enhancement in Th17 cell specific transcription factor (RORC) and inflammatory cytokines (IL-17A, IL-6 and TNF-α) after overexpression miR-22, which was opposite to the effect of inhibition of miR-22. Furthermore, administration of antisense miR-22 in TNBS-induced mouse colitis model significantly decreased numbers of interleukin (IL)-17A+ CD4+ T cells and the expressions of IL-17A, RORC, IL-6 and TNF-α. CONCLUSION: MiR-22 was up-regulated in CD4+ T cells in PB and intestinal mucosa tissues of IBD patients, which could promote Th17 cell differentiation via targeting HDAC4 to be involved in IBD progression.

Quantitative evaluation of atherosclerotic plaques and intraplaque neovascularization using contrast-enhanced ultrasound after treatment with atorvastatin in rabbits.

INTRODUCTION: This study is supposed to investigate the value of contrast-enhanced ultrasound (CEUS) in quantitative evaluation of atherosclerotic plaques and intraplaque neovascularization after treatment with atorvastatin (ATV) in rabbits. MATERIAL AND METHODS: Forty-five New Zealand white rabbits were enrolled to construct the rabbit model of AS. All rabbits were assigned into the control, AS group and ATV groups (n=15 individually). The AS plaque formation and relative parameters were observed and calculated by CEUS respectively. Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured. Serum levels of matrix metalloproteinase-3 and 9 (MMP-3/9) and high-sensitivity C-reactive protein (hs-CRP) were examined by ELISA. The histological changes plaques, maximal plaque thickness (MPT), plaque area (PA) and corrected plaque area (PA/CVA) were evaluated by HE staining. Immunohistochemistry (IHC) was used to measure the positive protein expressions of VEGF, FVIII-Rag, MMP-3, CD40L and F8. The correlation between CEUS parameters with ELISA and IHC was analyzed by the Spearman correlation analysis. RESULTS: At the 8th week, no plaque and new blood vessel were observed in the control group. The ATV group showed more plaques and new blood vessels, and lower IMT, plaque thickness and area than the AS group. The PI and RI were significantly increased in the AS and ATV groups compared to the control group. PI, RI. Plaque EI and its ratio in plaque and arterial lumen of the ATV group were lower than those in the AS group. Compared with the control group, the AS and ATV groups had higher serum levels of TC, TG, LDL, MMP-3, MMP-9 and hs-CRP, and higher AI. However, compared with AS group, serum levels of TC, TG, LDL and AI fell in ATV group. In comparison of the AS group, serum levels of MMP-3, MMP-9 and hs-CRP, MPT, PA and PA/CVA, and the positive expressions of VEGF, FVIII-Rag, MMP-3, CD40L and F8 were significantly reduced in the ATV group. The AS and ATV groups showed a positive correlation of EI in the plaque and its ratio in the plaque and arterial lumen with F8 protein expression, MMP-3 and MMP-9. CONCLUSION: In conclusion, our results indicated that ATV stabilizes atherosclerotic plaques and reduces intraplaque neovascularization in a rabbit model with AS, which can be characterized using CEUS.

[Diagnostic value of 2-dimentional ultrasonography and color Doppler flow imaging in primary bone tumor].

OBJECTIVE: To explore the diagnostic value of 2-dimentional ultrasonography and color Doppler flow imaging (CDFI) in primary bone tumor. METHODS: The hemodynamic parameters such as systolic maximum velocity (Vmax), diastolic minimum velocity (Vmin), resistance index (RI), and pulsatility index (PI) of intratumoral folw in 93 patients with primary bone tumors proved by histopathology were studied using 2-dimentional ultrasonography and CDFI techniques. RESULTS: The bone destruction periosteum response and soft tissue mass were essentially revealed with 2-dimentional ultrasonography techniques. The intratumoral flow features were clearly shown by CDFI. The Vmax and Vmin in malignant bone tumor were significantly higher than those in benign one (P < 0.01). RI and PI in malignant bone tumor were lower than those in benign one (P < 0.01). CONCLUSION: Observing the features of bone tumor and hemodynamic parameters by 2-dimentional ultrasonography and CDFI has a great clinical value in diagnosing primary bone tumor and distinguishing the malignant and benign bone tumors.

Utilising ductus venosus Doppler waveform and four-chamber view to screen for foetal cardiac malformation in early second trimester of pregnancy.

BACKGROUND: Foetal echocardiography has become a diagnostic method to detect foetal congenital heart disease with high probability. However, it is not only time consuming and but also difficult to visualize outflow tract of foetus early in the second trimester of pregnancy, even for an experienced obstetric ultrasonographer. Recently, many methods for screening foetal cardiac anomalies were explored, but much more work is needed to develop an effective and suitable screening method. The aim of this study was to investigate the clinical significance of utilising the ductus venosus (DV) Doppler examination and the four-chamber view of heart to screen for foetal cardiac malformation in early second trimester of pregnancy. METHODS: Heart and DV of 401 consecutive foetuses in early second trimester (12(+1) - 17(+6) weeks) in high risk pregnancies were examined with Acuson 128 xp/10 or Sequoia 512 ultrasound diagnostic systems. Absent or reversed flow during atrial contraction (A-wave) in the DV was defined as sufficiently abnormal to screen for foetal cardiac malformations. The foetal echocardiographic diagnosis was confirmed by postnatal echocardiography (or postmortem). The sensitivities of screening tests were compared among the three methods: DV Doppler examination, four-chamber view alone, and the combination of both techniques. RESULTS: Satisfactory examinations were obtained in 383/401 foetuses (95%). Thirty foetuses with cardiac abnormalities were confirmed by neonatal echocardiography (or postmortem). The sensitivity of DV Doppler examination or four-chamber view alone is 63% (19/30) and 60% (18/30), respectively. The sensitivity of combining information, DV Doppler flow waveform and four-chamber view, to screen for foetal cardiac malformation is 83% (25/30) and significantly better than that of either DV Doppler flow waveform or four chamber view alone (P < 0.05). CONCLUSION: Doppler flow waveform of DV can be used to screen for foetal cardiac malformation early in the second trimester. Combining information from Doppler flow waveform of DV and four-chamber view will improve the overall sensitivity of the screening.

[Application of ultrasound-guided percutaneous biopsy in the preoperative diagnosis and treatment of bone tumors].

OBJECTIVE: To investigate the value of color Doppler ultrasonography (CDUS)-guided percutaneous biopsy in the diagnosis and treatment of bone tumors. METHODS: Ultrasound-guided percutaneous biopsy was performed in 64 patients who was diagnosed by CDUS. Puncture instruments included automatic core biopsy device and 14 to approximately 18G crude needle. All cases were identified by the operation and pathological examination. RESULTS: Tissue-obtained rate was 97% (62/64). Comparing preoperative pathological diagnosis with postoperative pathological diagnosis, we found the diagnostic correct rate was 97%. No complications resulted from this procedure. According to their pathological results, 33 patients were treated with preoperative chemotherapy. The tumor sizes decreased, and 26 patients saved their limbs and had normal functions. CONCLUSION: CDUS-guided percutaneous biopsy is safe and quick for the preoperative diagnosis and selecting appropriate surgical procedure for bone tumor treatment.