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Objective:To explore the influence of the value of the echocardiography in the detection of cancer therapeutics-related cardiotoxicity by World Alliance Societies of Echocardiography(WASE) study.Methods:Tirty-seven breast cancer patients underwent echocardiography at baseline before chemotherapy (T0) and after the second (T2), fourth (T4), sixth (T6) chemotheraphy cycles in Qilu Hospital of Shandong University from March 2017 to March 2018. According to different guidelines[ASE lower limit of normal left ventricular ejection fraction(LVEF-LLN) 53%, ESC LVEF-LLN 50% and the WASE study (Women LVEF-LLN 58%, Asian Women LVEF-LLN 59%)], the number of patients with myocardial injury during chemotherapy was evaluated, and compared with the global longitudinal strain(GLS) standard, the percentages of patients with myocardial injury in different standards were analyzed.Results:With the up-regulation of LVEF-LLN, more patients with early myocardial damage were found. During chemotherapy, 1 patient showed left ventricular ejection fraction (LVEF) fell by >10% from baseline to LVEF<50% (2016 ESC Guidelines), 3 patients showed LVEF fell by >10% from baseline to LVEF<53% (2014 ASE Guidelines), 7 patients for LVEF fell by >10% from baseline to LCVEF<58%, and 9 patients for LVEF fell by >10% from baseline to LVEF<59%, which was still less than the number of patients detected by GLS criteria (18 patients), but the sensitivity of LVEF fell of >10% from baseline to LVEF<59% was not statistically different from GLS standard ( P>0.05). Conclusions:With the up-regulation of LVEF-LLN, the sensitivity of LVEF in evaluating early myocardial damage was increased, but GLS was still the most sensitive index to monitor the cancer therapeutics-related myocardial damage.
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Objective To explore the effect of blended teaching model based on "Rain Class" in general practitioner training.Methods Random sampling method was adopted in which totally 132 general practitioners were divided into two groups,66 in experimental group,66 in the control group.Blended teaching method and traditional teaching method was implemented in the experimental group and the control group,respectively.At the end of the course,unified examination questions were used to evaluate the teaching effect,and questionnaires were used to investigate the students' evaluation of the "rain classroom" teaching method.Results The final exam score of experimental group was significantly higher than that of control group [(82.95 ± 12.86) vs.(60.45 ± 18.91),P=0.000].Further stratification analysis was conducted according to educational background,and the average score of low education group in the observation group was significantly higher than that of high education group [(88.06 ± 9.12) vs.(49.66 ± 13.88),P=0.000].55.3％ of the general practitioners in experimental group were very satisfied with "Rain Class" teaching,34.8％ satisfied,and only 9.9％ of the general practitioners were dissatisfied.Conclusion Blended teaching model could help to promote the exchange and interaction between students and teachers and improve learning efficiency and clinical ability.
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Objective@#To compare the distribution characteristics of left ventricular configuration in Chinese adult patients with hypertension under Chinese and international standard using echocardiography.@*Methods@#A total of 201 patients with primary hypertension were included in the study.Left ventricular end systolic left atrial diameter (LAD), ascending aortic diameter (AO), left ventricular end diastolic diameter (LVDd), left ventricular posterior wall thickness (PWTd) and ventricular septal thickness (IVSd) were measured and then relative wall thickness (RWT), left ventricular mass (LVM), left ventricular mass index (LVMI) were calculated. Left ventricular systolic left atrial volume (LAV) was measured by Simpson′s biplane method and left atrial volume index (LAVI) was then calculated. Ganau classification was done according to Chinese and international standard respectively. The differences of left ventricular configuration in hypertension were compared.@*Results@#According to the Chinese standard, the analytic results of left ventricular configuration showed that there were 103 cases (51.2%) in normal configuration (NG) group, 28 cases (13.9%) in concentric remodeling (CR) group, 52 cases (25.9%) in eccentric hypertrophy (EH) group and 18 patients (9.0%) in hypertrophic (CH) group, respectively. Whereas, according to the international standard, there were 47 cases (23.4%) in NG group, 93 cases (46.3%) in CR group, 18 cases (8.9%) in EH group and 43 cases (21.4%) in CH group.Each group in the configuration analysis had significant difference between Chinese and international standard (P<0.01). Patients with left atrial enlargement according to the Chinese and international standard had statistical difference in the EH and CH groups (P<0.05).@*Conclusions@#Analysis of left ventricular configuration according to the Chinese and international standard has significant difference. According to Chinese standard, it may be more accurate to reflect the changes of left ventricular configuration in Chinese hypertensive population, so as to evaluate the changes of left heart structure and function more accurately.