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Objective:To explore the feasibility and accuracy of three-dimensional (3D) modeling methods based on ultrasound imaging data for normal and abnormal fetal cardiac structures, and to construct a methodology system for 3D printing of fetal heart based on ultrasound.Methods:A total of 93 fetuses examined in Tangdu Hospital of Air Force Military Medical University from January to December 2019 were selected. Fetal echocardiography was obtained using spatio-temporal image correlation (STIC). Ninety-three hearts were 3D modeled by blood flow modeling, blood pool modeling and cavity modeling, and printed by stereolithography technique. The data measured on the 3D digital models and 3D printed solid models were compared with the corresponding fetal echocardiographic images respectively in order to evaluate the accuracy of the modeling methods.Results:The fetal cardiac blood flow models based on Doppler flow image data showed the malformation and trend of small blood vessels. The fetal cardiac structure models printed based on blood pool modeling displayed the malformation of heart and large blood vessels. Models printed based on cavity modeling method accurately displayed valve and structural defects.For 83 normal fetal hearts, the long diameters of left and right ventricles measured on echocardiography [(15.3±1.9)mm, (13.2±1.9)mm] were compared with those measured on digital models [(15.1±1.9)mm, (12.9±1.9)mm] and 3D printed models[(15.1±1.9)mm, (13.0±1.9)mm], respectively, and there were no significant differences between any two groups of them ( P>0.05). Bland-Altman showed good consistency for all measurements within and between operators. Conclusions:The three modeling methods, including blood flow modeling, blood pool modeling and cavity modeling, have their own advantages in displaying different types of fetal heart malformations. Appropriate modeling methods should be selected for 3D modeling and printing to make up for the limitations of single modeling method. The consistency between measurements on 3D models and those on echocardiography is high, and the repeatability between operators is good.
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Objective:To explore the features of atherosclerotic plaque in patients with type 2 diabetes mellitus by contrast-enhanced ultrasound (CEUS), and to analyze the correlation between the features and leukocyte count in peripheral blood.Methods:A total of 30 type 2 diabetic patients with carotid atherosclerotic plaque treated in Tangdu Hospital of Air Force Military Medical University who underwent CEUS from March 2018 to September 2021 were included as the diabetes group. Thirty-two non-diabetic patients with carotid atherosclerotic plaque who were matched for age and sex during the same period served as the control group. The optimized plaques were performed by CEUS to obtain parameters including peak (P), time to peak (TP), sharpness (S) and area under the curve (AUC) of time-intensity gamma fitting curve (FC curve). The differential count of leukocytes in peripheral blood was detected by the automatic hematology analyzer. Spearman rank correlation and multiple linear regression were used to analyze the correlation between CEUS parameters of plaque and the differential leukocyte count in peripheral blood.Results:①The peripheral blood leukocyte count, monocyte count and monocyte proportion in the diabetes group were higher than those in the control group (all P<0.05). ②P and AUC in the diabetes group were higher than those in the control group (all P<0.05). ③There was linear relationship( B=75.440, P<0.001) and positive correlation ( rs=0.929) between P and peripheral blood monocyte count in the diabetes group. Conclusions:The neovascularization density and perfusion in carotid plaques in patients with type 2 diabetes mellitus are increased, which may be related to the increase of leukocytes in circulation, especially monocytes.
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At present, the clinical skills training process for ultrasound medicine professional postgraduates is still facing many problems, such as inadequate guidance from tutors, little accumulation of clinical knowledge and practice, not solid basic ultrasonic skills, imperfect assessment system, and disconnection between scientific research and clinical practice. Analyzing the cause of problems, combining with the characteristics of ultrasound medicine and our experience in the clinical skills training process, we have put forward targeted solutions, such as building a complete and efficient training team, attaching importance to rotation and cultivation of relevant clinical departments, realizing teaching objectives by different levels and stages, establishing a perfect management, supervision and assessment system, paying attention to the combination of clinical and scientific research ability, so as to improve the quality and efficiency of clinical skills training process of ultrasound medicine.
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Objective:To study the prognostic value of left atrial strain in diastolic function response by treadmill exercise stress echocardiography.Methods:During May 2018 to February 2019, 64 patients underwent treadmill exercise stress echocardiography for diastolic function evaluation in Tangdu Hospital, Air Force Medical University, were recruited.Patients were categorized into diastolic stress test negative group (pre-stress E/e′ <14 & post-stress E/e′<14) (DST- group), and diastolic stress test positive group (pre-stress E/e′ <14 & post-stress E/e′>14) (DST+ group). Patients′ characteristics of the stress test, left ventricular diameter, left atrial volume index, systolic and diastolic function, and left atrial strain parameters were compared between these two groups. ROC analyses were performed based on the echocardiographic parameters with significant group differences ( P<0.01) to determine the predictive values for diastolic stress test response. Results:The pre-stress E/e′ and left atrial strain parameters were significantly differently between DST- and DST+ group. The DST- showed significantly lower E/e′ (8.20±1.27 vs 10.32±1.33, P<0.01), but higher left atrial strains than DST+ group[reservoir function(33.7±5.7)% vs (26.5±5.5)%, P<0.01; conduit function(16.8±4.0)% vs (11.8±3.4)%, P<0.01; pump function(16.9±5.7)% vs (14.7±5.5)%, P<0.05]. The left atrial reservoir function, conduit function and pre-stress E/e′ could predict the diastolic stress test response, the areas under ROC curve were 0.81 ( P<0.01), 0.62 ( P=0.04) and 0.71 ( P<0.01). Conclusions:The left atrial strain parameters under resting condition could predict the diastolic stress test response. It may serve as an alternative method of exercise stress echocardiography for diastolic function evaluation.
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Objective To decompose left ventricular contractile motions and analyze the corresponding contributions of different components to left ventricular systolic function . Methods Sixty‐nine healthy adults with normal left ventricular eject fraction ( LVEF ) were recruited . T wo‐dimensional speckle tracking echocardiography was performed by GE Vivid E 9 system ,and strain parameters were analyzed by EchoPac software . Correlation and multiple stepwise regression analysis were performed to analyze the contributions of different components of myocardial motion to left ventricular contraction . Results Global longitudinal strain ( GLS) ,global circumferential strain ( GCS ) ,global radial strain ( GRS ) and twist were all significantly correlated with LVEF ( r ＝ －0 .668 , P ＜0 .001 ; r ＝ －0 .552 , P ＜0 .001 ;r ＝0 .335 , P ＝0 .006 ; r ＝0 .428 , P ＜0 .001) . Significant correlations were found between all the strain parameters ,except for GRS and twist . M ultiple stepwise regression adjusted for sex ,and age showed that the uni‐contributions of GLS , GCS , GRS and twist to LVEF were 21 .3% , 13 .0% , 7 .5% , 8 .8% , respectively . However ,with all strain parameters in the general regression model ,only GLS and twist were still significantly related with LVEF ( R2 ＝0 .566 , P ＜0 .001) . Conclusions T he contributions of various components of myocardial motion to left ventricular contraction in healthy adults are different . Although every component is significantly related with LVEF ,the longitudinal and twist motion are most important in the integrated view .
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Objective To observe the effect of excessive fluoride exposure on expression of tight junction protein zonula occludens-1 (ZO-1) in human vascular endothelial cells and to explore the mechanism.Methods Human umbilical vein endothelial cells (HUVECs) were cultured in vitro.Group design was adopted.Groups of 0.0 (control group) and 0.4,0.8,1.2 mg/L fluoride treatment groups (low,medium and high dose groups) and insulin-like growth factor-1 (IGF-1) group [before adding 1.2 mg/L fluoride ion (F-),100 nmol/L of IGF-1 was added in advance for 2 hours] were set up respectively.Each group of cells was cultured for 24 h to extract cellular proteins.The expression of ZO-1,phosphatidylinositol kinase (PI3K),protein kinase B (AKT) and phosphorylated AKT (p-AKT)were detected and analyzed by Western blotting.Results The expression of intracellular ZO-1 (0.063 ± 0.002,0.043 ± 0.007,0.039 ± 0.004,0.028 ± 0.007) decreased obviously with gradual increase of F-concentration in cultural medium (F =21.36,P ＜ 0.01).And the expressions of ZO-1 in all three fluorine groups were clearly lower than that in the control group (P ＜ 0.05).At the same time,the expression of ZO-1 in high fluorine group was significantly lower than those in other fluorine groups (P ＜ 0.05).There were significant differences in the expression of PI3K (0.032 ± 0.004,0.031 ± 0.002,0.017 ± 0.001,0.017 ± 0.005) and p-AKT/AKT (0.745 ± 0.046,0.806 ±0.007,0.666 ± 0.058,0.641 ± 0.040) among all groups (F =20.38,9.57,P ＜ 0.01 or ＜ 0.05).The expressions of PI3K and p-AKT/AKT in high fluorine group were obviously lower than those of control and mild fluorine groups,and p-AKT/AKT in moderate fluorine group was clearly lower than that of mild fluorine group (P ＜ 0.05).After pretreatment with IGF-1,the expression of ZO-1 (0.055 ± 0.015) increased significantly compared to that of high fluorine group (P ＜ 0.05).Conclusion Excessive fluoride exposure has decreased the expression of ZO-1 in HUVECs through the PI3K/AKT signaling pathway.
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Objective To explore the value of contrast-enhanced ultrasonography ( CEUS ) breast predictive model in the optimization of BI-RADS classification of breast lesions . Methods A total of 1049 BI-RADS 4 ,5 breast lesions were obtained from 1039 patients in 8 centers . CEUS examination was performed prior to biopsy or surgery . According to the classification of the model ,class 3 ,4A ,4B and 4C were selected as biopsy thresholds ,and the ROC curve was drawn . The diagnostic sensitivity ,specificity , accuracy ,positive predictive value ,negative predictive value and Jordanian index were calculated for the biopsy threshold . The biopsy rate of breast lesions before and after angiography ,cancer detection rate , follow-up cases of malignant risk were compared . Results There were benign lesions 586 ( 55 .9％ ) , malignant lesions 463 (44 .1％ ) in the 1049 breast lesions . The area of ROC with thresholds of 3 ,4A ,4B and 4C were 0 .695 ,0 .838 ,0 .847 and 0 .757 ,respectively ( all P < 0 .01) . Ultrasonography had a certain diagnostic effect on benign and malignant breast lesions . The diagnostic sensitivity ,specificity ,accuracy , positive predictive value and negative predictive value with class 4A after CEUS set as the biopsy threshold were 93 .32％ ,75 .65％ ,82 .75％ ,75 .57％ and 93 .35％ ,respectively ,and the Jordanian index was 0 .690 . When chass 3 after CEUS was set as the biopsy threshold ,the biopsy rate was reduced from 100％ to 76 .74％ ,the detection rate was increased from 44 .23％ to 56 .77％ ,and the risk of cancer was only 0 .67％ in the follow-up cases . When class 4A was set as the biopsy threshold ,the biopsy rate was reduced from 100％ to 55 .58％ after CEUS . The detection rate of cancer increased from 44 .23％ to 74 .44％ . The risk of cancer was 2 .96％ . Conclusions The biopsy rate of breast lesions in category 4 and 5 would be reduced and cancer detection rate of them would be increased after CEUS ,however ,the risk of malignancy in the follow -up cases would be controlled as low as category 3 and 4A in previous BI-RADS . Thus ,CEUS has a good prospect of in optimizing BI-RADS and reducing biopsy rate in unnecessary lesions .
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Objective To explore the consistency of different physicians in diagnosis of malignant breast lesions with breast CEUS predictive model.Methods Totally 953 patients with solitary breast nodule from multicenter who underwent ultrasound and CEUS were collected.The research team was composed by the initial group (one junior physician from each hospital),check group (one or two physicians who had at least two-year experience of CEUS examination from each hospital),research group (two senior physicians from Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital) and cross-blinded group (one or two vice directors or chief physicians from each hospital).At first,the lesions were classified according to the breast imaging reporting and data system (BI RADS) by the initial group and the check group,then new BI RADS classifications were performed by research group and cross blind group with breast CEUS predictive model.The consistency of different physicians in diagnosis of malignant breast lesions was analyzed.Results Among 953 patients,benign lesions were found in 451 patients (451/953,47.32％),malignant lesions were found in 435 patients (435/953,45.65％),and precancerous lesions were found in 67 patients (67/953,7.03％).The accuracy of the initial group,check group,research group and cross-blinded group was 71.67％(683/953),74.92％(714/953),80.17％ (764/953) and 83.42 ％ (795/953),respectively.The consistency of different physicians for diagnosis of malignant breast lesions between initial group and check group was good (Kappa =0.82,P＜0.001),while between initial group and crossblinded group,initial group and research group were both moderate (Kappa =0.56,0.41;all P＜0.001).The consistency of different physicians for diagnosis of malignant breast lesions between cheek group and cross-blinded group,between check group and research group were both moderate (Kappa =0.68,0.51;all P＜0.001).The consistency between research group and cross-blinded group with breast CEUS predictive model was moderate (Kappa =0.74,P＜ 0.001).Conclusion The consistency of different physicians in diagnosis of malignant breast lesions with breast CEUS predictive model was moderate.
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Objective To investigate the value of S-Detect classification in differential diagnosis of breast mass . Methods The data of forty-seven patients with breast mass lesions ( n=61) from our hospital during January to December in 2016 were retrospectively analyzed . Both the man-made BI-RADS classification ( identified by three different specialist physicians with 2 ,5 and 7 years of experience , respectively) and computer S-Detect classification were performed . The sensitivity ,specificity ,accuracy , positive predictive value and negative predictive value of the man-made BI-RADS classification and S-Detect classification of the benign or malignant diagnosis of breast lumps were calculated . The ROC curve was further plotted ,and the area under the curve ( AUC) of each group was compared ,respectively . Results Sixty-one breast mass lesions were confirmed 36 benign lesions and 25 malignant lesions by pathological biopsy . The sensitivity ,specificity and accuracy of man-made BI-RADS classification were as follows:2-year experience physicians 69 .4％ ,72 .0％ and 70 .5％ ;5-year experience physicians:64 .0％ ,92 .0％ and 75 .4％ ;7-year experience physicians:69 .4％ , 92 .0％ and 78 .7％ . The diagnostic sensitivity , specificity , and accuracy of S-Detect classification were 80 .6％ ,96 .0％ and 86 .9％ . The specificity ,accuracy and positive predictive value of S-Detect classification were significantly higher than those of 2-year experience physicians by BI-RADS classification ( P <0 .05) . The area under the ROC curve of each group was 0 .729 ,0 .786 and 0 .801 for 2 , 5 and 7-year experience physicians , respectively , and 0 .917 for S-Detect classification . Conclusions Compared with the man-made BI-RADS classification ,S-Detect classification has advantages in diagnosis of the benign or malignant of breast mass and is helpful to improve the accuracy of diagnosis , especially for junior physicians .
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Objective To evaluate the diagnostic value of contrast-enhanced ultrasound in breast precancerous lesions . Methods Retrospectively analyzed the contrast-enhanced ultrasound model and angiographic predictive model of 465 cases of the A prospective multicenter study of breast nodules contrast-enhanced ultrasound" that led the Sichuan Provincial People′s Hospital from January 2016 to April 2017 ,which included 69 cases of breast precancerous lesions and 396 other types benign lesions ,and the sensitivity ,specificity and accuracy of the diagnosis of breast precancerous lesions were calculated . Results The sensitivity of ultrasound predictive model for the diagnosis of precancerous lesions was 60 .9％ and AUC was 0 .681 . Precancerous lesions mainly showed non-concentricity , increased homogeneity , and increased lesions;other types of benign lesions mainly showed non-centripetal ,high uniformity enhancement and lesion size unchanged . Conclusions Contrast-enhanced ultrasound shows a potential value in the differential diagnosis of precancerous lesions and other types of benign lesions ,that can help clinicians to take early intervention measures for breast precancerous lesions ,but there are still many problems to be solved .
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Objective To observe the blood flow changes of left ventricular cavity and quantify the energy loss (EL) and circulation of left ventricular during systole and diastole in patients with dilated cardiomyopathy(DCM) via vector flow mapping(VFM).Methods Thirty-six healthy volunteers and 32DCM patients were enrolled.According to the severity of mitral regurgitation(MR),DCM patients were divided into two groups.The quantitative parameters,including average energy loss(EL-base,EL mid,EL-apex) and circulation (vortex quantity,vortex area,circulation) were measured in the different periods of VFM imaging mode in apical four-chamber view,apical three-chamber view and apical two-chamber view respectively.The difference of parameters was evaluated between different groups during the different periods.The early transmitral valve blood flow velocity E,the late transmitral valve blood flow velocity A,the ratio of early transmitral valve blood flow velocity to the early diastolic mitral valve velocity E/e,the ratio of early transmitral valve blood flow velocity to the late transmitral valve blood flow velocity E/A and Tei index were derived via dual-Doppler imaging technology.Meanwhile,the correlation between VFM parameters with E,A,E/A,E/e or Tei index was also analyzed.Results ①The level of EL were decreased significantly among EL-mid and EL-apex during early diastole,EL-mid during mid-systole,EL-mid and EL-apex during late-systole (P ＜0.05),when compared with the control group.The vortex quantity,vortex area and circulation during early diastole and the vortex area and circulation during atrial contraction period were significantly different between two groups (all P ＜ 0.05).As for mid-diastole,only vortex area showed significant difference (P ＜0).01).(②) When compared with different grades of MR in DCM patients,the level of all segments EL during diastole and EL-base during systole increased with severity of MR(P ＜0.05).The circulation during diastole also increased with the severity of MR(P ＜0.05).③The vortex area and circulation had positive correlation with E/e during diastole in all subjects(all P ＜0.05).The vortex area during atrial contraction period and early diastole had positive correlation with E/A and Tei index in all subjects(r =0.630,0.345,0.468,0.316,0.663,0.264,respectively,allP ＜0.01).EL-mid during late-systole were negatively correlated with LV end diastolic volume,end systolic volume,but positively correlated with ejection fraction in all subjects(r =0.335,-0.312,0.340,respectively,all P ＜0.05).While,there was positive correlation between E/A with the basal segment of mid-diastole(r =0.376,P ＜0.01).Conclusions The visualization of hydromechanics inside the heart of DCM patients could be directly accomplished by VFM,which can provide a new method for diagnosis and evaluation of DCM.
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Purpose The mean pulmonary artery (MPAP) has been widely used as an important parameter to diagnose and evaluate pulmonary hypertension (PH).The purpose of this paper is to compare the efficacy of two methods in evaluating PH,including estimating pulmonary artery systolic pressure (PASP) using Doppler ultrasonography to measure tricuspid regurgitation (TR) velocity,and directly using the peak velocity of TR.Materiasl and Methods From January 2012 to June 2013,eighty patients with left-to-right shunt congenital heart diseases (CHD) planned for closure procedure in Tangdu Hospital of the Fourth Military Medical University and the General Hospital of Shenyang Military region were included in this prospective study,who underwent right heart catheterization to measure pulmonary artery pressure,and underwent Doppler ultrasonography to measure the peak velocity ofTR.Results Using catheter-measured MPAP of≥ 25 mmHg as diagnostic reference,the false positive rate was 62.96％,and the false negative rate 0％ when the estimated PASP of ＞30 mmHg determined by TR method was used to diagnose PH.There was high diagnostic agreement when peak velocity of TR was used to diagnose PH.When 320 cm/s and 340 crn/s were used as diagnostic cutoff values,false positive rates were 14.81％ and 7.41％,and false negative rates were 15.91％ and 20.45％,respectively.Conclusion In patients with left-to-right shunt CHD,peak velocity of TR measured on echocardiography can be used to diagnose PH which overcomes the high false positive rate in estimation method.It is more suitable to diagnose PH when the MPAP is used as the diagnostic criterion.
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Objective To analyze the dose dependent cardiotoxicity of cyclophosphamide and thus establish the mouse models for understanding the underlying mechanisms . Methods Thirty mice ( 7 -8 weeks old) were randomly divided into 6 groups:control of one course group ,control of two courses group , one course of low dose ( 50 mg/kg) group ,two courses of low dose group ,one course of high dose ( 100 mg/kg) group ,two courses of high dose group . The changes of cardiac function and morphology were analyzed at indicated times by ultrasound and histology respectively . Results Compared with the control groups , injection of low dose cyclophosphamide either with one course or two courses ,and injection of high dose with only one course had no in statically significant changes in hair color ,physical activity ,body weight and cardiac function( P > 0 .05) . Treatment of two courses with high dose resulted in significant decrease of physical activity and body weight ( P < 0 .05 ) . Meanwhile ,cardiac systolic function was significantly decreased( P <0 .05) . Histology study revealed robust cardiac hypertrophy and fibrosis . Conclusions Two courses of intraperitoneal injection of cyclophosphamide at high dose result in obvious cardiotoxicity , especially systolic dysfunction .Intraperitoneal injection of two courses of cyclophosphamide serves as a good strategy to induce cardiotoxicity in mice ,which could be applied for future mechanism study .
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Objective To compare the respective diagnostic efficiency for breast cancer with ultrasound diffusion optical imaging (DOI),ultrasonic elastography (UE),contrast-enhanced ultrasound (CEUS),X-ray mammography(XRM),magnetic resonance imaging (MRI),and combinations of these imaging modalities.Methods Seventy-five breast lesions were collected.These lesions were confirmed by surgery and histopathology.All of breast lesions were examined ultrasound,mammography and enhancedMRI examinations before surgical excision.The specificity,sensitivity,positive predictive value and negative predictive value of each modality were compared.Results The sensitivities and the diagnostic negative predictive values for MRI + US + XRM (97.44％,96.15％),CEUS (92.31％,90.63％) and MRI (94.87 ％,92.86％) were significantly higher than those for XRM (74.36 ％,71.43 ％),respectively.The sensitivity for DOI + CEUS + UE was the same as one for CEUS,they were not significantly higher than those for UE and DOI (P ＞0.05),while they were significantly higher than that for XRM (P ＜0.05).The kappa values for DOI,UE,CEUS,USG(UE + DOI + CEUS),XRM,MRI and MRI + US + XRM were 0.678,0.624,0.732,0.705,0.439,0.677 and 0.676,respectively.Conclusions Different imaging modalities have themselves advantages to diagnose malignant or benign lesions.CEUS,MRI and combinations of these imaging modalities have highly important clinical values in breast disease diagnosis.
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Objective To explore the relationship between atherosclerotic plaque stability and junctional adhesion molecule A (JAM-A) in atherosclerotic mice.Methods Twenty-six apolipoprotein E gene knockout(ApoE-/-) mice were divided into three groups.Group A (six mice) was control group,group B (ten mice) was disposed by ligation and high-fat diet and group C was disposed by high-fat diet with ten mice.The formation process of plaques were observed with high resolution ultrasound(22 MHz),and plaque markers were detected to evaluate palque stability for secondary grouping (group D was vulnerable plaque group and group E was stable plaque group).The plaque stability were evaluated by plaque vulnerability index and the expression of JAM-A were analyzed using immunohistochemical staining.The relationship between atherosclerotic plaque stability and JAM-A in atherosclerotic mice were estimated with statistical methods at last.Results There was no plaque in carotid artery of group A.On the contrary,obvious plaques were observed in carotid artery of group B and C.The total serum lipids level in group A was normal.But high-fat diet could obviously decrease the serum HDL-cholesterol level of group B and group C when compared with the controls(P ＜0.05).High-fat diet could increase the ratio of non-HDL-cholesterol (TC,TG,LDL).As shown with pathological staining,the content of extracellular lipids and foam cells in the plaque were significantly increased vs.control (P ＜ 0.05).On the contrary,the content of smooth muscle cells and collagen fibers were significantly increased vs.control(P ＜0.05).The plaque vulnerability index of group D was higher than that in group E(P ＜0.01).The expression of JAMA was increased in group D and E,and in group D was higher(P ＜0.01).While,few JAM-A expression in group A.There was significant correlation between plaque vulnerability index and JAM-A (P＜0.01).Conclusions High resolution uhrasound(22 MHz) can observe the formation of carotid plaque in ApoE-/-mice.There was a positive correlation between JAM-A expression and the vulnerability of plaque in carotid artery.JAM-A might be used for evaluation of plaque stability as a new indicator.
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Tianjin Medical University set up the module of Early Clinical Practice in the 2012 year's new curriculum system which takes the teaching mode of combining the in-class curriculum and the extracurricular scientific research as well as the social practice.The in-class curriculum refers to the early contact clinical curriculum,namely making the early contact clinical practice training as a compulsory course,which focuses on the cultivation of students' medical professional ethics and the cultivation of doctor-patient communication ability,health promotion and preventive medicine consciousness,to strengthen students' clinical thinking,clinical research ability and basic skills training.The extracurricular part mainly takes the innovation credit project as the instruction,which will make the social practice,scientific and technological innovation activity project,clinical basic skills training comprehensive,and train students' ability of organization plan,communication and coordination,word expression and scientific research ability.
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Currently, medical ultrasound teaching focuses on the delivering the image infor-mation itself, while its connection with basic medicine and clinical medicine is neglected. Such a teaching method is not good for students to establish a systemic view. To conduct the ultrasound medi-cine education effectively in undergraduate students, we have tried some reforms, including: perform-ing diseases or problem based teaching, integrating basic medicine, ultrasound medicine and clinical medicine throughout the whole teaching process, providing as many practice opportunities as possible for the graduates and integrating the ultrasound imaging with other medical imaging modalities. The practice shows that with the reform, the students have a better understanding of ultrasonic knowledge itself, a better grasp of the whole medical knowledge structure, and also have a preliminary impression on how to diagnose the disease through reasonable application of different treatments. In addition, students have more passion for study.
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Objective To observe the peripheral arterial Doppler flow velocity curve changes and elucidate the blood flow characteristics by adding extra pressure on the limbs,and to provide evidence for better diagnosis of peripheral arterial diseases by ultrasound.Methods Color Doppler ultrasound instrument was used to record the brachial artery(BA),radial artery(RA),common femoral artery(CFA) and popliteal artery(POA) Doppler flow velocity curves both at rest and under different grades of distal and proximal limb pressuring in 40 randomly selected healthy adults.The peak systolic and early diastolic reverse flow velocity(PSV,PRV) and the resistance index (RI) were measured and analyzed.Results Three-phase waveform was seen at rest.Significant changes were noticed in PRV and RI under distal pressuring,while no significant difference was seen in PSV between groups.Conclusions Normal peripheral arteries show pulsed step-by-step blood flow pattern along with the cardiac cycles.Peripheral arterial Doppler flow curves changes regularly with limb grading pressuring.
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Objective To explore the value of superior vena cava (SVC) Doppler spectrum in evaluation of the therapeutic effects of intermittent hypobaric hypoxia (HBHO)-induced pulmonary hypertension (PH) in rats and establish a new method for assessing pulmonary hypertension.Methods Fifty male SD rats were included.Forty of them were developed HBHO-PH and randomly divided into four groups with different manipulations:beraprost treatment group,sildenafil treatment group,placebo group and model group,with 10 rats in each group.The rest of 10 rats served as controls.Cardiac structure,pulmonary peak velocity (PAVmax),tricuspid peak velocity (TVEmax) and SVC Doppler ultrasound were performed in all rats before and after treatment for 2 weeks.Pulmonary arterial pressure was determined by the right heart catheterization.The relationship of the parameters with the pulmonary arterial pressure was analyzed.HE staining was done in lung tissues.Results Right heart catheterization showed that pulmonary artery systolic pressure (PASP) of the treatment groups were lower than that of the model group,the difference was significant(P ＜0.01).Pulmonary artery pressure decreased in varying degrees both after placed in a normal environment and after 2 weeks of treatment.PASP of the beraprost treatment group and the sildenafil treatment group decreased significantly and showed no statistical significant difference with the control group.In contrast,PASP of the placebo group was significant higher than that of control group(P ＜ 0.05).No statistically significant difference was found between the non-placebo treatment groups in PASP.Compared with the control group,the right ventricle/body weight ratio of the model group was statistically significant increased in all other groups(P ＜0.01).Right SVC AR/S ratio was well correlated with PASP (r =0.603,P =0.001).Right SVC AR/S ratio was statistically significant lower in treatment groups compared with the model group (P ＜0.01).All groups except the control group demonstrated various degrees of pulmonary arterial wall thickening.Conclusions The right SVC spectrum of AR/S correlates well with PASP and can be used to evaluate the pharmacological therapeutic effect of rats with HBHO-PH,in particular with moderate to severe PH.
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Objective To investigate the affecting factors of interventricular septum (IVS) swing by study of the mechanical model of the respiration-driven variation of cardiac function using echocardiography.Methods In present study,the equivalent mechanical model of septal swing in previous study was used.By changing the end-diastolic pressure difference between the simulated right and left ventricles and simulated intrapericardial pressure,the subsequent influences on IVS swing using echocardiography were observed.Results Under the rhythmic respiratory intrathoracic pressure change(RIPC)(0--4 mm Hg,1 mm Hg =0.133 kPa),the swing amplitude of simulated IVS increased with decrease of the simulated end-diastolic pressure difference between the simulated right and left ventricles (2.2-17.6 mm).With increasing of the simulated intrapericardial pressure,the simulated right ventricle and left ventricle collapsed in succession,the swing amplitude of simulated IVS also increased to a maximal amplitude of 22.4 mm.Conclusions The affecting factors of IVS swing including the magnitude of RIPC,the end-diastolic pressure difference between the two ventricles and the intrapericardial pressure.