肺炎衣原体、幽门螺杆菌抗体及超敏CRP检测与冠心病关系的临床研究

目的探讨肺炎衣原体(CP)及幽门螺杆菌(HP)抗体、炎症标记物C反应蛋白(CRP)与冠心病(CHD)的相互关系。方法采用酶联免疫法测定50例冠心病患者、33例冠脉造影正常非冠心病组患者和44例正常对照者血清CPIgG和IgM及HPIgG和IgM,同时应用免疫比浊法测定上述人群血清超敏CRP。结果冠心病组与非冠心病组和正常对照组CPIgG、HPIgG抗体阳性率比较均有显著性差异(P<0.01);冠心病组血清CRP含量较两个对照组明显升高(P<0.01);CPIgG和HPIgG同时阳性较CPIgG阳性或这两种病原体IgG阴性CHD的发病率明显升高(P<0.01),且CRP值亦随这两种病原体抗体阳性而增高;CPIgG较HPIgG阳性率高(P<0.01)。但此两种病原体的IgG阳性存在正相关(r=0.467)。结论CP、HP感染及超敏CRP含量与CHD的发生密切相关。     

超敏C反应蛋白检测在冠心病诊断中的临床价值探讨

目的 探讨超敏c反应蛋白（HS—CRP）检测在冠心病（CHD）诊断中的应用价值。方法结合临床检查及冠脉造影情况,将150例冠心病患者分为稳定性心绞痛（SAP）、不稳定性心绞痛（UAP）、急性心肌梗死（AMI）3个组。分别测定150例冠心病患者血清超敏c反应蛋白（Hs—CRP）、肌酸激酶（CK）、肌酸激酶同工酶（CK—MB）,并与50例健康人做对比。结果与正常对照组比较,CHD组血清Hs—cRP均明显升高差异具有统计学意义（P〈0．05）,且AMI组患者血清的Hs—CRP浓度明显高于UAP组（P〈0．01）;UAP组患者血清的hs—cRP浓度明显高于SAP组（P〈0．01）,且AMI组治疗后Hs—CRP浓度显著下降;冠心痛阳性检出率HS—CRP（90．7）〉CK（41．3％j〉CK—MB（34．6％）。结论血清HS—CRP水平高低与CHD病情密切相关,可作为冠心病患者病情严重程度的敏感性指标。     

冠心病患者肺炎衣原体感染与C反应蛋白、血脂相互关系的研究

目的探讨冠心病（CHD）患者肺炎衣原体（Cpn）感染与C反应蛋白（CRP）、血脂的相互关系，探讨其可能的发病机制。方法采用微量免疫荧光法检测急性心肌梗死（AMI）组、心绞痛（AP）组度对照蛆患者各35例外周血Cpn IgG抗体，同时测定血脂度CRP。结果AMI组、AP组及对照组血清Cpn IgG抗体阳性率分别为82．2％、65．7％及25．7％，AMI蛆、AP组分别与对照组比较差异有统计学意义（均P〈0．01），但AMI组与AP组间比较差异无统计学意义；血清CRP及血脂总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、我脂蛋白A（apoA）AMI组、AP组显著高于对照组（均P〈0．01），而高密度脂蛋白胆固醇（HDL-C）AMI组、AP组显著低于对照组（P〈0．01），AMI组也明显低于AP组（P〈0．01）；Cpn感染者特异性抗体IgG滴度与血中CRP、TG、LDL-C及apoA有明显相关性（r分别为0．44、0．64、0．36和0．32），而与HDL-C成负相关（r=0．78）（均P〈0．01）。结论CHD患者Cpn感染率明显增高，Cpn可能通过炎症反应及影响脂质代谢在CHD的发生、发展中起作用。     

血清hs—CRP检测在冠心病中的临床应用

目的探讨冠心病（CHD）患者血清hs—CRP水平的变化规律及其临床意义。方法采用免疫荧光法检测方法定量动态检测80例不同类型CHD患者血清hs—CRP水平变化,同时与30例健康志愿者血清的hs—CRP水平对照,并结合临床资料分析。结果冠心病患者组hs—CRP含量明显高于正常对照组（P〈0．01）;不同类型的CHD患者中,急性心肌梗死患者（AMI）的hs—CRP水平明显高于不稳定型心绞痛组（UAP）及稳定型心绞痛（SAP）,差异有统计学意义（P〈0．01）。结论冠心病患者血清hs—CRP水平与CHD关系密切,可作为CHD危险度分层以及预后判断的一个重要指标。     

冠心病患者血清超敏C-反应蛋白的表达和意义

目的探讨血清超敏C-反应蛋白（Hs—CRP）与冠心病严重程度的关系。方法218例冠心病患者分为心肌梗死（AMI）急性期组36例、不稳定型心绞痛（UA）组48例、稳定型心绞痛（SA）组42例、AMI恢复期组47例和陈旧性心肌梗死（OMI）组45例，同时选取40例建康体检者作为正常对照组；均进行血清Hs—CRP的测定并进行组间比较。结果冠心病患者的血清Hs—CRP水平明显高于正常对照组（P〈0．01）；AMI急性期组和UA组血清Hs—CRP水平明显高于SA组、AMI恢复期组和OMI组（均为P〈0．01），AMI急性期组亦明显高于UA组（P〈0．01）。结论血清Hs-CRP在预测冠心病的严重程度及心血管事件方面具有重要意义。     

超敏C反应蛋白在冠心病诊断中的应用价值

目的研究不同病情冠心病（CHD）患者血清超敏C反应蛋白（hs—CRP）水平的变化，评价hs—CRP在CHD诊断中的应用价值。方法应用日立7180生化分析仪测定hs-CRP水平；用HP2500彩色超声仪测定颈动脉内-中膜厚度（IMT）；统计学分析采用t检验和多因素Logistic回归分析。结果CHD组hs-CRP水平和IMT显著高于对照组，2组结果分别为（5．64&#177;1．83）、（0．89&#177;0．51）mg／L；（1．62&#177;0．35）、（0．83&#177;0．21）mm（P〈0．01），而且hs—CRP水平与IMT呈明显正相关（r=0．6278，P〈0．01）；稳定型心绞痛（SAP）、不稳定型心绞痛（uAP）和急性心肌梗死（AMI）组hs—CRP水平呈递增趋势，并且在AMI组和UAP组的表达明显高于SAP组（P〈0．01）；hs—CRP作为新的危险因素在CHD的病理过程中发挥着重要的作用。结论hs—CRP是CHD的危险因素之一；hs—CRP在CHD不同分组中呈规律性变化，提示hs—CRP检测对CHD的诊断及预后具有潜在的应用价值。     

超敏C反应蛋白、纤维蛋白原、D-二聚体在冠心病诊断中的临床价值

目的探讨血清超敏C反应蛋白（hypersensitiveC—reactiveprotein,Hs—CRP）、纤维蛋白原（fibrinogen,FIB）、D-二聚体（D—dimer,D—D）与冠心病（coronaryheandisease,CHD）病变程度的相关性。方法回顾性分析156例行冠状动脉造影患者,根据造影结果分为非CHD组56例和CHD组100例．同期测定各组Hs—CRP、D—D和FIB水平,并进行统计学分析。结果CHD组与非CHD组间基线水平比较,除糖尿病史、高血压史差异有统计学意义外,其他指标组间差异均无统计学意义（P均〉0．05）。CHD组血清Hs-CRP、FIB、D—D水平均高于非CHD组,且差异均有统计学意义（P均〈0．01）;CHD各组血清Hs—CRP、FIB、D—D水平随病变严重程度的增高均呈递增趋势,且组间两两比较差异均有统计学意义（P均〈0．05）。多支病变组Hs—CRP、FIB、D—D水平均高于双支病变组（P均〈0．05）和单支病变组（P均〈0．01）,双支病变组Hs—CRP、D—D均显著高于单支病变组,差异均有统计学意义（P均〈0．05）。结论血清Hs—CRP、FIB、D—D水平与CHD的严重程度及冠状动脉病变支数相关。     

首发精神分裂症患者弓形虫感染情况及其对精神症状的影响

背景：弓形虫感染被认为至少与部分精神分裂症的发生有关，不少临床和实验性研究支持该假说。目的：调查首发精神分裂症患者及其母亲弓形虫抗体阳性率，比较弓形虫抗体阳性与阴性患者在临床表现上的区别。设计：采用成组病例对照观察。单位：武汉大学人民医院精神卫生中心。对象：选择2000-01／2004-12武汉大学人民医院精神科住院600例精神分裂症患者为精神分裂症组，患者家属同意参加此调查。选择同期本院参加健康体检的、无任何躯体疾病和精神障碍的正常人200人为正常对照组。选择本院内外科住院的、精神健康的躯体疾病患者200例为疾病对照组。收集252份精神分裂症患者母亲的血样本。方法：①采用酶联免疫法检测血清样本中弓形虫IgG，IgM抗体的水平。②在患者人院两三天后作30～40min的半结构式晤谈，结合患者家属和管床医师提供的有关资料，记录患者的精神障碍家族史、病程、受教育程度、发病年龄、母亲年龄、居住地区。③精神症状评定采用阳性与阴性症状量表，该量表包括阳性症状量表7项（分别为妄想、概念紊乱，幻觉行为、兴奋、夸大、多疑／被害、敌对性），阴性症状量表7项[分别为情感迟钝、情绪退缩、（情感）交流障碍、被动／淡漠社交退缩、抽象思维困难、交谈缺乏自发性和流畅性、刻板思维]和一般精神病理量表16项（分别为关注身体健康、焦虑、自罪感、紧张、装相和作态、抑郁、动作迟缓、不合作、不寻常思维内容、定向障碍、注意障碍、判断和自知力缺乏、意志障碍、冲动控制障碍、先占观念、主动回避社交），共30项，及3个补充项目（分别为愤怒、延迟满足困难、情感不稳）评定攻击危险性（7项评分：1为无．7为极重度）。④计量资料差异比较采用两样本独立t检验；计数资料差异比较采用X^2检验。主要观察指标：①正常对照组、疾病对照组、精神分裂症组及其母亲弓形虫抗体阳性率比较。②弓形虫抗体阳性组和阴性组患者年龄、教育程度、病程、发病年龄和母亲年龄比较。③弓形虫抗体阳性组患者和阴性组患者精神障碍家族史阳性率、居住地区比例．母亲弓形虫抗体阳性率比较。④弓形虫抗体阳性组和阴性组患者阳性与阴性症状量表评分结果。结果：精神分裂症组600例，正常对照组200人，疾病对照组200例，精神分裂症患者母亲252例，其中抗体阴性组患者母亲206例，阳性组患者母亲46例，均进入结果分析。①正常对照组、疾病对照组、精神分裂症组和精神分裂症患者母亲间IgG抗体阳性率、IgM抗体阳性率、IgG或IgM抗体阳性率差异明显（P〈0．01）。②进一步X^2检验表明，正常对照组和疾病对照组IgG抗体阳性率、IgM抗体阳性率、IgG或IgM抗体阳性率差异不明显。③精神分裂症患者母亲IgG抗体阳性率明显高于精神分裂症组和正常对照组＋疾病对照组（P〈0．05，0．01），精神分裂症组明显高于正常对照组＋疾病对照组（P〈0．01）。④精神分裂症患者母亲IgM抗体阳性率明显高于精神分裂症组和正常对照组＋疾病对照组（P〈0．05，0．01），精神分裂症组明显高于正常对照组＋疾病对照组（P〈0．05）。⑤分裂症患者母亲IgG抗体或IgM抗体阳性率明显高于精神分裂症组（P〈0．01）和正常对照组十疾病对照组（P〈0．01），精神分裂症组明显高于正常对照组＋疾病对照组（P〈0．01）。⑥根据患者弓形虫抗体是否阳性分组，IgG抗体或IgM抗体中任一个为阳性则为阳性组n=99），IgG和IgM抗体均为阴性则为阴性组（n=501）。弓形虫抗体阴性组和阳性组患者年龄、受教育情况、发病时间、病程、母亲年龄相近。⑦弓形虫抗体阴性组患者有精神障碍家族史的比例显著高于弓形虫抗体阳性组患者（P〈0．01）；弓形虫抗体阳性组患者的母亲IgG抗体阳性率、IgM抗体阳性率、IgG或IgM抗体阳性率均高于阴性组患者（P〈0．05～0．01）；弓形虫抗体阳性组和阴性组患者阳性与阴性症状量表、阳性症状量表、阴性症状量表、一般精神病理量表总分差异不明显。⑧弓形虫抗体阳性组阳性与阴性症状量表分量表患者兴奋、敌对、装相和作态、意志障碍、冲动控制障碍、愤怒、延迟满足困难得分明显高于弓形虫抗体阴性组（P〈0．01）；而多疑得分低于弓形虫抗体阴性组（P〈0．01）。结论：①弓形虫感染是精神分裂症的重要候选病因。②弓形虫感染与精神分裂症患者年龄、受教育情况、发病时间、病程、母亲年龄关系不大。③未感染弓形虫的精神分裂症患者有精神障碍家族史的更多，感染弓形虫的精神分裂症患者母亲感染弓形虫情况更多见。④弓形虫感染阳性的精神分裂症患者临床表现倾向于兴奋、激越和行为紊乱，对于紊乱性兴奋的精神病患者应注意其是否存在弓形虫感染。     

幽门螺杆菌细胞毒素在冠心病病因中的探讨

目的;研究幽门螺杆菌（HP）感染细胞毒素相关蛋白A与冠心病（CHD）之间的关系。方法：测定了74例CHD患与71例非CHD对照组的血清HP抗体及CagA抗体阳性率,并进行比较。结果：CHD组HP抗体血清学阳性率高于对照组（48．25％／44．16％）,但两组之间无显性差异（P＞0．05）,CHD组CagA抗体的血清学阳性率明显高于对照组（37．83％／25．49％）,两之间有显性差异（P＜0．01）。结论：CHD组HPCagA菌株感染的血清学阳性率明显高于对照组,提示HPCagA及其细菌毒素有可能在CHD的发病病因中起一定作用。     

感染幽门螺杆菌的慢性萎缩性胃炎患者血清hs-CRP水平及其与Cag-A的关系

目的：探讨感染幽门螺杆菌（HP）的慢性萎缩性胃炎（CAG）患者血清超敏C-反应蛋白（hs—CRP）水平及其与HP细胞毒素相关基因CagA的关系。方法：以ELISA法检测CAG组患者血清hsCRP水平和CagA—IgG，并与无临床症状（As）感染者及健康对照者进行比较。结果：CAG组血清hs—CRP平均值（1．30±0．34）mg／L明显高于AS组（0．19±0．03）mg／L和健康对照组（0．11±0．03）mg／L（P均〈0．01），AS组血清hs—CRP平均值显著高于对照组（P〈0．05）；CAG组CagA^＋HP与CagAHP患者之间血清hsCRP水平无明显差异，AS组CagA^＋HP与CagAHP入选者之间血清hsCRP水平亦无明显差异。结论：CAG组与AS组血清hs—CRP水平明显高于对照组。尽管HP感染可导致血清hs～CRP水平升高，但与是否表达CagA无关。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.