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It is believed that the fundamental pathogenesis of the connective tissue diseases-associated interstitial lung disease （CTD-ILD） is kidney essence deficiency， with lung collateral obstruction throughout the disease， and environmental toxin pathogen is the important causative factors for the development of CTD-ILD. This article proposed to restore origin and alleviate bi （痹） for CTD-ILD， for which restoring origin means tonifying the lungs， spleen and kidneys to bank up the roots and consolidate the original qi， with modified Erxian Decoction （二仙汤） plus Liu Junzi Decoction （六君子汤）； alleviating bi means expelling wind and dredging collaterals， and eliminating the mass to restore the smoothness of the lung collaterals， with paired medicines of Chuanshanlong （Dioscorea nipponica）-Dilong （Kalanchoe pinnata）， Vinegar-processed Sanleng （Sparganium stoloniferum）-Vinegar-processed Ezhu （Curcuma zedoaria）， and stem-type medicines， and emphasized on removing the environmental toxin pathogens to facilitate the recovery of healthy qi.
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Objective:To analyze the value of shear wave elastography (SWE) in evaluating carotid artery elasticity in type 2 diabetes mellitus (T2DM) patients with nonalcoholic fatty liver disease (NAFLD).Methods:A total of 98 T2DM patients diagnosed in the Second Affiliated Hospital of Dalian Medical University were selected and divided into three groups according to the results of liver ultrasound examination. 35 patients without NAFLD were in group A, 33 patients with mild NAFLD were in group B, and 30 patients with moderate to severe NAFLD were in group C. All selected individuals showed no plaque formation on carotid ultrasound examination. Left carotid artery intima-media thickness (IMT), carotid artery systolic diameter (Ds), carotid artery diastolic diameter (Dd), and peak systolic velocity (PSV) were measured using conventional two-dimensional and M-mode ultrasound. The stiffness coefficient (β) was obtained through calculation. SWE was used to measure the mean longitudinal modulus of elasticity (MEmean), mean minimum modulus of elasticity (MEmin), and mean maximum modulus of elasticity (MEmax) of the left carotid artery at the end of diastole.Results:There was no statistically significant difference in Ds, Dd, and PSV among the three groups (all P>0.05). Compared with group A and group B, group C had significantly higher IMT, β, MEmean, MEmax, and MEmin (all P<0.05). Compared with the group A, the group B had higher levels of MEmean, MEmax, and MEmin (all P<0.05), there was no statistically significant difference in IMT and β between the groups (all P>0.05). Correlation analysis showed that MEmax, MEmean, and MEmin in each group were positively correlated with β ( r=0.537, 0.543, 0.525, P<0.01), and also positively correlated with HbA 1c ( r=0.456, 0.483, 0.438, P<0.01), but not with IMT (all P>0.05). The intra observer Intraclass correlation coefficient (ICC) of MEmax, MEmean and MEmin measured by SWE was 0.847-0.887, and the inter observer ICC was 0.791-0.934, indicating a good repeatability. Conclusions:SWE can quantitatively evaluate the elasticity of the carotid artery in patients with T2DM and NAFLD.
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Objective:Three-dimensional speckle tracking echocardiography (3D-STE) was used to evaluate the left ventricular function in patients with triple vessel coronary artery disease without myocardial infarction.Methods:60 patients with three vessel disease of coronary heart disease without myocardial infarction treated in the Second Affiliated Hospital of Dalian Medical University from June 2018 to December 2020 were selected. They were divided into two groups according to the results of coronary angiography. There were 31 cases in group B, and the stenosis rate of all triple vessel coronary artery was 50%-<75%; 29 cases in group C, the stenosis rate of all triple vessel coronary artery was ≥75%; Thirty healthy subjects were recruited as the group A. We measured left ventricular (LV) end-diastolic and end-systolic volume (LVEDV, LVESV) and LV ejection fraction (LVEF) using real-time dynamic three-dimensional echocardiography. The LV strain parameters were acquired by 3D-STE, including global longitudinal strain (GLS), global area strain, global radial strain (GRS) and global circumferential strain (GCS). The correlation between 3D-STE parameters and N-terminal proBNP (NT-proBNP), left ventricular end-diastolic pressure (LVEDP) were analyzed by Pearson linear correlation analysis.Results:The LVEDV and LVESV in group A and B were significantly lower than those in group C (all P<0.05), and the absolute values of LVEF, GLS, GRS, GCS and GAS were higher than those in group C (all P<0.05). There were no significant difference in LVEDV, LVESV and LVEF between group B and group A (all P>0.05), while the absolute values of GLS, GCS and GAS in group B were significantly lower than those in group A (all P<0.05). The absolute values of GLS, GRS, GCS and GAS in group C were negatively correlated with NT-proBNP and LVEDP (all P<0.05). The absolute value of GLS in group B was negatively correlated with NT-proBNP ( P<0.05), and the absolute value of GLS, GRS, GCS and GAS was negatively correlated with LVEDP (all P<0.05). Conclusions:Our study shows that 3D-STE can evaluate the LV function in patients with triple vessel coronary artery disease without myocardial infarction through multiple strain parameters.
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[Summary] 45 male SD rats with 4 week old were assigned to 3 groups after normal feedstuff for 2 weeks:control group(n=15), diabetic group(n=15), and calcitriol group(n=15).Diabetic rat model were induced using intraperitoneal injection with streptozotocin( STZ) after 12 h fasting.Calcitriol group and diabetic group were treated with calcitriol for 24 weeks.Femoral biomechanics indexes were measured at end of the study.Total 30 SD rats ( 10 rats of each groups) were analyzed.Compared to normal controls, the rats in diabetic group had lower body weight [(437.02±18.66vs267.93±15.64)g,P<0.05],decreasedserumcalciumconcentration[(2.89±0.31vs2.60 ±0.38) mmol/L, P<0.05], and increased serum phosphorus concentration[(2.21 ±0.35 vs 2.80 ±0.66) mmol/L, P<0.05].At the end of the study, the ultimate force[(98.07 ±2.94 vs 70.87 ±5.75) N, P<0.05], ultimate displacement[(0.66 ±0.02 vs 0.51 ±0.02) mm, P<0.05], Young′s modulus[(139 188.51 ±10 617.69 vs 81 969.06 ±6 393.21) N/mm2, P<0.05], and modulus for toughness[(22 492.59 ±2 429.15 vs 8 292.87 ± 1 291.43) N/mm2 , P<0.05 ] of diabetic group were significantly lower than normal control group.However, calcitrol could reverse these changes at some extent.SD rats with diabetes had significant disorder of bone metabolism and decreased bone strength.Calcitriol could improve the decreased bone strength in diabetic rats.
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Objective: To evaluate different patterns for left ventricular configuration on ventricular systolic function in patients with primary hypertension by two-dimensional strain (2DS) echocardiography. Methods: Our research included in 2 groups: Control group,n=40 healthy volunteers, Primary hypertension group,n=70, based on left ventricular mass index, the patients were further divided into 2 subgroups as Left ventricular hypertrophy (LVH) subgroup, n=32 and Non-left ventricular hypertrophy (NLVH) subgroup,n=38. The peaks of systolic longitude strain (SSL) for left ventricular apical layers of subendocardium, midmyocardium and epicardium were compared among different groups. Results:①In Control group and LVH, NLVH subgroups, SSL in different myocardium layers were kept in gradient features as subendocardium > midmyocardium > epicardium.②Compared with Control group, NLVH and LVH subgroups showed decreased SSL of subendocardium, as in apical four chamber level: (-24.11 ± 3.52) % and (-22.78 ± 4.11) % vs (-27.49 ± 2.95) %, in apical two chamber level: (-22.79 ± 5.20) % and (-21.92 ± 4.88) % vs (-27.95 ± 3.13) %, and in apical long-axis level: (-20.07 ± 3.43)%and (-21.34 ± 3.64%)% vs (-27.24 ± 3.05) %, allP0.05.③Compared with NLVH subgroup, LVH subgroup presented decreased SSL of long-axis, in midmyocardium (-17.77 ± 4.35) % vs (-21.73 ± 3.97) % and in epicardium (-14.25 ± 3.78) % vs (-18.27 ± 2.96) %, allP<0.05. The pearson correlation coefifcient calculated by 2 physicians at 2 different times showed that SSL of subendocardium wasr=0.876, of midmyocardium was r=0.838 and of epicardium was r=0.823, allP<0.05. Conclusion: 2DS may quantitatively evaluate the layered myocardial strain of left ventricle, it provided a non-invasive examination for early diagnosing and estimating the heart involvement with severity in patients of primary hypertension.
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BACKGROUND:Toxic effects of excessive thyroid hormone on myocardium can not be ignored with the increased incidence of hyperthyroidism. As a quantitative marker of heart failure, brain natriuretic peptide has a good application prospect to estimate the changes of cardiac function and myocardial damage in hyperthyroid cardiomyopathy. OBJECTIVE:To explore the correlation of brain natriuretic peptide and cardiac function of rabbits with hyperthyroid cardiomyopathy exhibiting different left ventricular geometries. METHODS:Twenty New Zealand purebred rabbits were used in this study. Hyperthyroidism model was established by intraperitoneal injection of levothyroxine (45 μg/kg) for 4 weeks. The success of establishing model is defined upon the appearance of irritation, decreased body weight and increased appetite. Totaly 18 rats were successfuly established. The left ventricular data of hyperthyroidism rabbits were measured by conventional echocardiography. According to the classification of Ganauet al, the 18 hyperthyroidism rabbits were divided into two groups: concentric hypertrophy (n=7) and eccentric hypertrophy (n=11). In addition, ten rats, receiving intraperitoneal injection of 5 mL saline per day, were taken as the control group. RESULTS AND CONCLUSION: Plasma brain natriuretic peptide level of rabbits in the concentric hypertrophy and eccentric hypertrophy groups was obviously higher than that of the control group (alP < 0.01), and the level in the eccentric hypertrophy group was obviously higher than in the concentric hypertrophy group (P< 0.01). Compared with the control group, the average peak diastolic velocity of mitral ring was significantly lower in the concentric hypertrophy and eccentric hypertrophy groups (alP< 0.01), the average peak systolic velocity of mitral ring was also lower in the eccentric hypertrophy group (P < 0.01). The peak systolic and diastolic velocity had a negative correlation with brain natriuretic peptide (alP < 0.01). Experimental findings indicate that brain natriuretic peptide is a sensitive indicator to reflect the cardiac function and myocardial damage in rabbits with hyperthyroid cardiomyopathy, exhibiting different left ventricular geomeies.
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ObjectiveTo explore the characteristics of left ventricular myocardial function after percutaneous coronary intervention (PCI) in patients with angina pectoris of single-vessel and.multiple-vessel coronary artery disease with two-dimensional strain (2DS).MethodsTotally 63 patients with angina pectoris were divided to single-vessel coronary artery group (n=33) and multiple-vessel coronary artery group (n= 30) based on coronary angiography,and 30 healthy volunteers were enrolled as control group.The two-dimensional images were obtained before and 3 months after PCI,and two-dimensional radial strain was analyzed on GE Echo PAC system.Peak radial strain values of left ventricular basal plane,papillary muscle plane and apical plane during systole were measured.ResultsCompared to control group,left ventricular peak systolic radial strain values decreased in many segments in patients with single-vessel coronary artery group and multiple-vessel coronary artery group before and 3 months after PCI (P＜0.05).Totally 136 and 158 left ventricular ischemic segments attained to normal 3 months after PCI in single-vessel coronary artery group (136/185,73.51％) and multiplevessel coronary artery group (158/292,54.11％),respectively (P＜0.01).ConclusionThe improvements of peak systolic radial strain are significantly different between angina pectoris patients with single-vessel and multiple-vessels coronary artery disease after PCI.
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ObjectiveTo assess the value of quantitative tissue velocity imaging (QTVI) in monitoring the establishment of levothyroxine-induced cardiomyopathy models on rabbits.MethodsThirty New Zealand purebred rabbits were divided into experimental group (n=20) and control group (n= 10).Hyperthyroidism models were established by peritoneal injection of levothyroxine (L-Thy) in experimental group (45 μg/ [kg · d]).The same dose of saline was given to rabbits in control group for 4 weeks.QTVI and conventional echocardiographic parameters were obtained at the beginning day and 1,2,4 weeks in two groups.According to the changes of ultrasound parameters,the rabbits of experimental group were divided into two subgroups:Concentric hypertrophy (CH) subgroup and eccentric hypertrophy (EH) subgroup.ResultsAt the first week,left ventricular ejection fraction (LVEF),fractional shortening (LVFS),mitral inflow peak velocity (E),average mitral annularsystolic peak velocity (Vs) and acceleration (a) increased obviously than before injection in experimental group (P＜0.01).At the second week,posterior wall thickness at end diastole (PWTd),interventricular septal thickness at end diastole (IVSTd) and left ventricular mass index (LVMI) increased obviously than before injection in experimental group and control group (P＜0.05),and the average mitral annular early diastolic velocity (Ve) was significantly lower (P＜0.01).Compared with control group,the average Ve was significantly lower in CH subgroup (P＜0.01),while LVEF,LVFS,average Vs,a and average Ve were significantly lower in EH subgroup (P＜0.01).ConclusionQTVI is valuable in the assessment of establishing levothyroxine-induced cardiomyopathy models on rabbits.
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Objective To evaluate the effects of shRNA-TGF-β1 plasmid on Smads signal transduction of rat renal allograft.Methods A Sprague-Dawley to Wistar rat orthotopic transplant kidney-sclerosis accelerated model was constructed and transfected with short hairpin RNA-TGF-β1 based on the hydromechanics.The recipients were divided into three groups:group T(plasmid group)injected with shRNA-TGF-β1;group H(vacant plasmid group)injected with vacant plasmid;group Y(simply transplantation group)injected with no plasmid.In group J(sham-operated group)only right kidney was removed with no transplantation as control group.Transplanted kidneys and blood samples were collected at the first,second and third month after transplantation.The blood urea nitrogen(BUN)and serum Cr were tested by enzyme-linked immunoadsordent assay.The gene transcriptional level of TGF-β1 and Smad3/7 was detected by RT-PCR,and the protein variations of TGF-β1 and phosphorylated Smad3/7 were examined by Western blotting.Results At each test time point,the BUN and serum Cr were significantly higher in the plasmid group than in the sham-operated group(P<0.05 or P<0.01),but obviously lower than in the vacant plasmid group and simply transplantation group(P<0.05 or P<0.01).The expression of TGF-β1 as well as phosphorylated Smad3 was significantly higher in the plasmid group than in the sham-operated group(P<0.05 or P<0.01),but obviously lower than in the vacant plasmid group and simply transplantation group(P<0.05 or P<0.01).However,the expression of phosphorylated Smad7 was significantly lower in the plasmid group than in the sham-operated group(P<0.05 or P<0.01),but obviously higher than in the vacant plasmid group and simply transplantation group(P<0.05 or P<0.01).Conclusion Short hairpin RNA-TGF-β1 plasmid could significantly improve the renal function of rat renal allografts probably by downregulating phosphorylated Smad3 and upregulating phosphorylated Smad7,leading to the inhibition of TGF-beta 1 promoting fibrosis role and delay of the allograft fibrosis.
