Comparison of imaging characteristics and risk factors for mortality between young and middle-aged patients with aortic dissection / 中华超声影像学杂志

Objective:To explore the differences in imaging characteristics and risk factors for mortality between the young and middle-aged and elderly patients with aortic dissection.Methods:The data from 1 220 patients with aortic dissection from January 2007 to December 2015 were successively collected. They were divided into young and middle-aged and elderly groups according to their ages. The basic information, computer comography angiography and echocardiogram results, hospital admissions and surgical details were collected and compared between the two groups using single variable regression analysis.Results:The ratio of female patients in the middle-aged and elderly group (>45 years old) was significantly higher than that of the young group (≤45 years old) (24.9% vs 18.7%, P=0.014), the ratio of hypertension patients was also significantly higher than that in the young group (77.5% vs 68.1%, P<0.001). Echocardiographic parameters showed that the prevalences of left ventricular enlargement (39.9% vs 26.9%) and left ventricular dysfunction (22.3% vs 14.1%) in the young group were significantly higher than in the middle-aged and elderly group (all P<0.001). The prevalences of ascending aorta dilation [(43.04±9.12)mm vs (41.69±10.99)mm] and thrombosis (39.1% vs 28.5%) were higher ( P<0.05). Although there was no statistically significant difference in mortality within 60 days after admission between the two groups (12.0% vs 15.1%, P=0.164), univariate regression analysis showed that aortic branch involvement was the main independent risk factor for mortality in young patients. Left ventricular remodeling (left atrial enlargement, ascending aortic dilation, aortic regurgitation) and decreased heart function were the main independent risk factors for death in the elderly patients. Conclusions:The mortality rate of young and middle-aged and elderly patients with aortic dissection are comparable, but the influencing factors are different. Screening out the relevant risk factors that affect the survival rate of the two groups, and conducting targeted prevention and intervention on them areof great significance to improve the survival rate of patients.

Evaluation of morphological and structure parameters of tricuspid in patients with functional tricuspid regurgitation using real-time three-dimensional transthoracic echocardiography / 中华超声影像学杂志

Objective:To explore the morphological parameters of tricuspid in patients with moderate or above functional tricuspid regurgitation (FTR ) by real-time three-dimensional (3D) transthoracic echocardiography.Methods:A total of 31 moderate or above FTR(FTR group) and 36 healthy adults(control group) were included in the study from May to July 2020 in the First Affiliated Hospital of Air Force Medical University (Xijing Hospital). Two-dimensional (2D) and 3D echoardiography were performed on both FTR group and control group. The 2D parameters included tricuspid regurgitation (TR), transverse diameter of right atrium/ ventricle, transverse diameter of tricuspid annulus(TVD), left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS). The tricuspid 3D parameters were analyzed by TomTec software, including annular parameters[annular anterior-posterior diameter (AP), annular left-right diameter (AL-PM), sphericity index (SI=AP/AL-PM), non-planar angle (NPA), annulus circumference (AC), annulus area (AA), annulus height (AH)], leaflet parameters[tenting volume(TV), tenting area(TA), tenting heigh(TH), commissural diameter(CD)], and dynamic parameters[annular displacement max(ADmax), annulus area fraction(AAF)].Results:Compared with the control group, AP, AL-PM, SI, AC, AA, TV, TA parameters of FTR group were larger, ADmax was smaller (all P<0.05). Multiple linear regression model was used to evaluate the effects of RA, RV, AP, AL-PM, SI, TV, TA on FTR, and the results showed that FTR was associated with TV and TA( t=4.253, -2.14; all P<0.05). Conclusions:RT-3DE can be used to assess the morphological parameters of tricuspid valve with moderate or above FTR patients effectively. TV and TA are the two most important factors for moderate or above FTR.

Study on diagnosis of fetal congenital heart disease by echocardiography and integrated management in a single center in northwestern region of China / 中华超声影像学杂志

Objective To explore the detection rate ,types ,accompanying abnormalities and prognosis of fetal congenital heart disease(CHD) in a single center in northwest China ,in order to set up a foundation for further studying the epidemiological characteristics of fetal CHD and integrated management of fetal CHD in the prenatal and postnatal . Methods A total of 2725 CHD in 45015 fetus diagnosed by fetal echocardiography were enrolled . The fetal CHD detection rate and the composition ratio were calculated . Follow-up results between the simple CHD and complex CHD were analyzed . Results The detection rate of fetal CHD in our center was up to 6 .1％ . There were 1589 cases of complex CHD ,accounting for 58 .3％ in all the fetal CHD ,of which the most common type was single ventricle ,followed by tetralogy of Fallot , atrioventricular septal defect and double outlet right ventricle ;Simple CHD 1136 cases ,accounting for 41 .7％ in all the fetal CHD ,the most common type was ventricular septal defect . The number of abortion cases ,intrauterine and postnatal natural deaths of fetal CHD accounted for 60 .3％ ( 1357/2251) of the total follow-up ,of which complex CHD and chromosomal abnormalities accounting for the majority . 68 cases of CHD underwent surgical treatment after birth ,of which complex CHD were predominant . 37 cases of simple CHD spontaneous closure and 27 cases of simple CHD genetic test results were abnormal . Conclusions The detection rate of CHD in this group is relatively high ,which is related to the prenatal diagnosis consultation center . Fetal complex CHD is more common while the prognosis is worse than simple CHD . Prenatal and postnatal integrated management of fetal CHD has important clinical value in early treatment of complex CHD .

Development of early myocardial perfusion in diabetic rats:the stress myocardial contrast echocardiography s tudy / 中华超声影像学杂志

Objective To investigate the development of early myocardial perfusion with myocardial contrast echocardiography (MCE) combined with dipyridamole stress echocardiography in diabetic rats . Methods The diabetes mellitus (DM) group comprised 40 male diabetic rats ,induced with streptozotocin . The control group comprised 40 normal male rats ,comparable body weights with the DM group .The DM group was divided into four subgroups (0 week ,2 weeks ,4 weeks and 8 weeks after diabetic model established) and the control group was also divided into four subgroups matched with the DM group .Each rat was performed with conventional echocardiography ,MCE at baseline and after dipyridamole stress .The reserve parameters were compared between the control group and the DM group .In addition ,the differences among four subgroups in the control group and the DM group were compared ,respectively .Results MCE demonstrated that the 4 weeks and 8 weeks DM subgroup had lower myocardial blood velocity reserve and myocardial blood flow reserve than the control subgroup .The myocardial blood volume reserve was reduced in the 8 weeks DM subgroup ,too .Conclusions The impairment of myocardial perfusion in the DM rats are detected earlier with the MCE combined with dipyridamole stress .

The mTOR inhibitor rapamycin synergizes with a fatty acid synthase inhibitor to induce cytotoxicity in ER/HER2-positive breast cancer cells.

Patients with ER/HER2-positive breast cancer have a poor prognosis and are less responsive to selective estrogen receptor modulators; this is presumably due to the crosstalk between ER and HER2. Fatty acid synthase (FASN) is essential for the survival and maintenance of the malignant phenotype of breast cancer cells. An intimate relationship exists between FASN, ER and HER2. We hypothesized that FASN may be the downstream effector underlying ER/HER2 crosstalk through the PI3K/AKT/mTOR pathway in ER/HER2-positive breast cancer. The present study implicated the PI3K/AKT/mTOR pathway in the regulation of FASN expression in ER/HER2-positive breast cancer cells and demonstrated that rapamycin, an mTOR inhibitor, inhibited FASN expression. Cerulenin, a FASN inhibitor, synergized with rapamycin to induce apoptosis and inhibit cell migration and tumorigenesis in ER/HER2-positive breast cancer cells. Our findings suggest that inhibiting the mTOR-FASN axis is a promising new strategy for treating ER/HER2-positive breast cancer.

Echocardiographic diagnosis of congenital mitral valve malformation / 中华超声影像学杂志

Objective To investigate the clinical value of the echocardiography in the diagnosis of congenital mitral valve malformation and summarize its occurrence and type associated with other cardiac malformations.Methods The echocardiographic image data of 101 patients with congenital mitral valve malformation were retrospectively analyzed,the characteristics of different types were summarized and compared with operation results,CT,cardiac catheterization,transesophageal echocardiography,as well as the data of echocardiographic follow-up.Results Among 101 patients with echocardiographic examination showed mitral valve congenital malformation,63 cases were isolated valve set malformation (62.4％),and multiple valve set malformation were found in 38 cases (32.7％).In another side,39 cases were of single mitral valve malformation (38.6％),while 62 patients combined with other type cardiac malformations (61.4％).No significant difference of dynamic change was shown between patients with solitary and multiple malformation of mitral valve (P ＞0.05).Conclusions Echocardiography can display congenital mitral valve malformation in a fast,robust,real-time way.It has an important clinical value in the diagnosis of congenital mitral valve malformation.

Diagnostic value of fetal single ventricle types and accompanied malformations by echocardiography / 中华超声影像学杂志

Objective To improve detection rate and diagnostic accuracy of single ventricle(SV) in obstetric fetal echocardiography,to investigate the common types and complicated malformations of SV in the fetus,and to summarize the differential announcements in diagnosing fetal SV.Methods In 345 fetal hearts which were diagnosed as congenital heart disease by fetal echocardiography in our hospital,73 cases diagnosed as SV,including 3 cases appeared as ones of twins,were included in this study.Systemic scanning and multiple-views fetal echocardiography were used to examine these enrolled fetuses.Results In all 73 SV eases,3 cases were diagnosed as simple SV,the others were diagnosed as SV accompanied with other abnormalities,among them 44 cases accompanied with single atrium,18 cases with single atrium and persistent truncus arteriosus,2 cases with pulmonary atresia,20 cases with pulmonary artery stenosis,4 cases with partial atrioventricular septal defect,3 eases with aorta dysplasia or aortic valve dysplasia.SV types were classified as 24.7％ in type A,13.7％ in type B,46.6％ in type C and 15.0％ in type D respectively.68.2％ of the cases were diagnosed with aortic D-transposition,and 45.2 ％ with common inlet,42.5 ％ with single inlet and 12.3 ％ with double inlet respectively.42 SV cases were executed termination of pregnancy which 11 cases were confirmed by pathology and the other 31 cases were out of following-up.Conclusions Most cases of fetal SV were accompanied other abnormalities and simple SV was rare.Type C in which ventricular structure was combined with left and right ventricle was the most common type.To avoid the false diagnosis,much attention must be paid to distinguish big papillary muscle and abnormal muscle bundle from interventricular septum during ultrasonic examination.

Ultrasound performance and related factors on the role of normal living rabbit's liver by laser ablation / 中华超声影像学杂志

Objective To explore the ultrasound performance and related factors on the role of normal living rabbit's liver by laser ablation. Methods The rabbit's liver tissue were ablated by Echolaser integrated laser interventional ultrasound system, and the necrosis of the lesion and performance of pathology and anatomy were observed. Results The outline of the lesion was ellipse like. The two-dimensional US showed regular hyperecho area in the center, mild strong echo in the peripheral and mild attenuation backward. Contrast enhanced ultrasound (CEUS) showed a filling defect of contrast media in the ablated area. After dissection, the center of the lesion was slag-like carbon, the peripheral was necrosis area; HE staining showed: the center of the lesion was cavity like and dye-free,peripheral area was irregular red staining, the surrounding area was infiltrative inflammatory cells. Different power and time leaded to differences of the ablative effect and lesion size:the more power and time,the bigger of the ablative size. The ablative effect and lesion size was stable in 3 W 10 min and 5 W 6 min groups and caused the complete necrosis of the zone, there existed statistical differences among the two groups. Conclusions Laser ablation can cause fast, precise, effective and safe necrosis of the liver tissue, and the more power and time, the bigger of the ablative size.

Application of asymmetric occluders in ventricular septal defect interventional occlusion and analysis of complications / 中华超声影像学杂志

Objective To investigate the feasibility and clinical effectiveness of interventional ventricular septal defect(VSD) occlusion using asymmetric occluders in patients whose VSD are adjacent to aortic valves.Methods One hundred and fifty-two patients from our hospital whose VSD were occluded with asymmetric occluders were examined by echocardiography.Dimensions,shapes and shunts of VSD,structures around defects were observed and aortic valve prolapse(AVP) degrees were accessed before the interventions.The patients were followed up periodically after the procedures.The longest follow-up was 6 years.Results Sizes of VSD measured from left ventricular side were larger than those measured from right ventricular side.Twenty-seven cases with VSD had mild AVP.Right sides of defects had adhesions with variable morphological patterns in 85% patients with perimembranous VSD.After occlusion,there were 7 cases showed residual shunt,2 cases with the third degree atrio-ventricular blockages,3 cases appeared aortic-valve regurgitations (AR) and 1 case with slightly increased AR.Conclusions Immediate and medium-term effects of interventional occlusion with asymmetric occluders were satisfactory in the patients with VSD and mild AVP whose aortic valve margin were insufficient to symmetric occluders.Surgical operation should be preferred to patients with VSD and moderate to severe AVP and to very young children.Pre-closure echocardiographic evaluation is critical to the success of interventional closure with asymmetric occluder and the long-term out coming.

Effect of myocardial function in diabetic rats with early insulin treatment / 中华超声影像学杂志

Objective To assess the myocardial function with early insulin treatment by velocity vector imaging (VVI) combined with dipyridamole stress in diabetic rats.Methods The 30 rats comprised 20 diabetic rats and 10 normal rats in the study.The 20 diabetic rats were divided into the diabetes mellitus(DM) group and the treatment group.Every rat in the treatment group was hypodermic injected with protamime biosynthetic human insulin after the diabetic model established.The control group was including 10 normal rats of the same age.After 8 weeks,each rat was performed with VVI at baseline and after dipyridamole stress.Results At baseline VVI,the parameters in the DM and the treatment groups were reduced compared with those in the control group.The systolic velocity,circumferential strain,systolic and diastolic circumferential strain rate in the treatment group were increased significantly compared with those in the DM group.After stress,the VVI reserve parameters in the treatment group were higher than those in the DM group.Conclusions The myocardial function are improved with early insulin treatment in the diabetic rats.

Diagnosis and classification of fetal congenital heart disease by echocardiography / 中华超声影像学杂志

Objective To investigate the common types of fetal cardiac malformations and complicated malformations,and to assess the value of classifying on these types.Methods 3201 pregnant women were undergone with fetal echocardiography (FECG),239 fetuses of them were diagnosed to be suffered with congenital heart disease(CHD),and 8 cases were one of twins with abnormal heart confirmed by FECG.All new-births were examined by echocardiography within half year after their births.Results 155 complex CHD in 239 fetuses were diagnosed by FECG,in them the common malformations were in turn 59 cases with diagnosed univentricular heart,29 cases with double outlet right ventricle,19 with atrio ventricular septum defect,12 with tetralogy of Fallot or quinalogy of Fallot,11 with persistent truncus arteriosus,6 with right ventricular dysplasia syndrome,6 cases transposition of the great vessels.100 cases were induced labor,41 of them were comfirmed by pathology.16 fetuses were born,123 cases were being pregnanted or un-followed up.Conclusions Complex and multi-malformation were common in fetal cardiocascular abnormalities.Diagnosing rate of fetal CHD(FCHD) in our enroll fetuses was 7.47 ％,rate of complex CHD vs CHD was 64.85 ％.According different types of FCHD,able to be operated or not after birth,surgery methods,as well as prognosis evaluations,all FCHD cases were classified into three subtypes:curable type,curable palliative type and untreatable type.This newly viewpoint will help pregnant women and their family to make reasonable selection.

Nerve root lesion of brachial plexus intervertebral part diagnosed by high-resolution ultrasonography / 中华超声影像学杂志

Objective To evaluate the application of high-resolution ultrasonography in the diagnosis of nerve root lesion of cervical vertebra intervertebral foramen part. Methods Twenty-seven patients with root avulsion injury of brachial plexus intervertebral part and 8 patients with schwannoma of brachial plexus root were examined with high-resolution ultrasonography. Thirty healthy volunteers were involved for the sonographic imagings of normal brachial plexus intervertebral part. The ultrasound findings of the patients before operation were compared with surgical outcomes. Results The normal intervertebral part of brachial plexus were shown as hypoechoic tubular strucuture, which could be identified with cervical artery and transverse process used as landmarks for the intervertebral part of brachial plexus root. The detection ratios of normal intervertebral part for C5-C8 and outside part of braehial plexus were 100％. In 27 patients with root avulsion injury of intervertebral brachial plexus, the intervertebral nerve root were enlarged as hypoechoic area, with nerve dissected partly or disappearing, distal nerve parts outside the intervertebral foramen swelling, edema,or cerebrospinal fluid assembling as cystic masses. In 8 patients with schwannoma of brachial plexus root part, the spinal ganglia outside intervertebral foramen were shown as tumor-like hypoechoic mass, with blood supply shown inside. Conclusions High-resolution ultrasonography is of great value for early and convenient diagnosis of root avulsion injury and mass of brachial plexus intervertebral part, especially in community hospitals,which could provide important information for clinical therapy.

Ultrasound diagnosis of traumatic neuroma in peripheral nerve / 中华超声影像学杂志

Objective To analyze sonographic imagings of traumatic neuromas of peripheral nerves,and to investigate the applied values of uhrasonography in the traumatic neuroma of peripheral nerve. Methods The sonographic imagings of 38 patients who had evidences of traumatic neuromas in peripheral nerves were retrospectively reviewed by the last diagnostic results of operations. Results Among 38 cases, 2 incomplete traumatic neuromas were not detected, and 1 incomplete traumatic neuroma was misdiagnosised as neurilemoma by ultrasonography. The coincidence of uitrasonography in incomplete traumatic neuroma and complete severed neuroma was 82.4% and 100%. With regard to the echogenicity of 38 traumatic neuromas of peripheral nerves, the sonographic characteristics of neuromas were all hypoechoic. Thirty-three neuromas appearanced like shuttles and 5 neuromas appearaneed like humps. Conclusions The traumatic neuroma has distinctive ultrasonic appearance. Ultrasonography is useful to direct the diagnosis and treatment of traumatic neuroma.