The value of speckle-tracking echocardiography in identifying right heart dysfunction in patients with chronic thromboembolic pulmonary hypertension

Right ventricular (RV) function is a significantly important factor in the determination of the prognosis of chronic thromboembolic pulmonary hypertension (CTEPH) patients. Speckle-tracking echocardiography (STE) is an angle-independent new technique for quantifying myocardial deformation that is capable of providing data on multiple parameters including longitudinal and transverse information of the myocardium. In the present study, we aimed to study the advantages of STE-derived parameters in identifying RV dysfunction in CTEPH patients. Sixty CTEPH patients (mean age: 55 years?±?13 years; 25 males) and 30 normal controls (mean age: 54 years?±?14 years; 14 males) were enrolled in this study. RV free wall (RVFW) systolic peak longitudinal strain (LS) including the basal, mid-, and apical-segments and the basal longitudinal and transverse displacement (basal-DL and basal-DT) were measured by STE. Global LS (GLS) of the RV was calculated by averaging the LS value of the 3 segments of RVFW. Clinical data of CTEPH patients were collected. CTEPH patients were divided into 2 subgroups according to the World Health Organization function classification. Clinical right heart failure (RHF) was defined as the presence of symptoms of heart failure and signs of systemic circulation congestion during hospitalization. The apical segment LS of the RVFW was lower than that in the basal and mid-segments in the control group (P?<?0.001), but no significant difference was found among the 3 segments of LS in the CTEPH group (P?=?0.263). When we used the cutoff value recommended by the American Society of Echocardiography guidelines to identify abnormal RV function, 30 CTEPH patients (50%) by tricuspid annular plane systolic excursion (TAPSE), 42 patients (70%) by fractional area change (FAC), 20 patients (33.33%) by RV index of myocardial performance (RVIMP), and 46 patients (77%) patients by GLS were determined to have abnormal RV function, respectively. Among multiple RV function indicators, TAPSE, FAC, GLS, basal-DL, and N-terminal pronatriuretic B-type natriuretic peptide showed significant differences between CTEPH patients with mild (WHO II) and severe symptoms (WHO III/IV) (all P?<?0.001), while RVIMP and basal-DT showed no significant difference (P?=?0.188 and P?=?0.394, respectively). Pearson correlation analysis showed that GLS has no correlation with sPAP as evaluated by echocardiography in CTEPH patients (r = ??0.079, P?=?0.574), and a weak to moderate correlation with RA area (r?=?0.488, P?=?0.000), the RV diameter (r?=?0.429, P?=?0.001), and the RVFW thickness (r?=?0.344, P?=?0.009). On receiver operating characteristic analysis, GLS has the largest area under the curve to identify RHF when the cutoff value was ??13.45%, the sensitivity was 78.2%, and the specificity was 84.6%, separately. Our study demonstrated that the depression of regional LS of RVFW is more pronounced in the basal and middle segments in CTEPH patients. Also, the longitudinal movement is much more important than the transverse movement when evaluating RV systolic function. As compared with conventional parameters, RVFW GLS showed more sensitivity to identify abnormal RV function and had the largest AUC for identifying RHF. Additionally, GLS showed no correlation with sPAP and a weak correlation with right heart morphological parameters in our CTEPH cohort.     

速避凝治疗肺心病疗效观察及对血液流变学的影响

目的：观察速避凝治疗肺心病的临床疗效及对血液流变学的影响。方法：采取随机抽样，观察68例肺心病患者，其中治疗组34例。结果：治疗组总有效率97．1％，治疗前后全血黏度、血浆黏度、纤维蛋白原、红细胞压积均明显下降（P＜0．05）。无1例继发出血。结论：速避凝治疗肺心病，效果好，不良反应少。     

Self-reported reasons among HIV-infected patients for missing clinic appointments

Although adherence to clinic visits is important for successful clinical outcome in HIV treatment, little is known about the reasons patients with HIV miss appointments. We prospectively monitored the self-reported reasons for missed clinic appointments among HIV patients at a university hospital in South Korea from June through December 2006. Of the 1562 scheduled clinic visits, 131 (8%) of appointments were missed. Work schedule, forgetfulness and lack of motivation were the primary reasons given for missed appointments. Considering these factors when scheduling appointments may improve adherence to clinic attendance among HIV-infected patients.     

应用Super SMART cDNA合成技术扩增哮喘嗜酸性粒细胞总RNA

目的 应用Super SMART cDNA合成技术从嗜酸细胞微量总RNA扩增大量双链cDNA。方法 利用Percoll密度梯度离心分离哮喘病人血嗜酸性粒细胞，用Trizol试剂盒提取细胞总RNA，利用Super SMART cDNA合成技术合成cDNA第1链及优化扩增第2链。通过梯度电泳鉴定cDNA产品质量，通过对获得的cDNA定量来评估扩增效能。结果 从20ng总RNA成功扩增出双链cDNA 7．155 μg，电泳结果显示cDNA质量及纯度较高。结论 Super Smart cDNA合成技术可实现从微量总RNA高效扩增高质量的cDNA，为进一步从基因水平研究哮喘机制奠定了基础。     

Improvement of heat－tolerance by training Ⅲ． Evaluation of effectsofcombined training of march and cross－country race on heat

Ｉｍｐｒｏｖｅｍｅｎｔｏｆｈｅａｔ－ｔｏｌｅｒａｎｃｅｂｙｔｒａｉｎｉｎｇⅢ．Ｅｖａｌｕａｔｉｏｎｏｆｅｆｆｅｃｔｓｏｆｃｏｍｂｉｎｅｄｔｒａｉｎｉｎｇｏｆｍａｒｃｈａｎｄｃｒｏｓｓ－ｃｏｕｎｔｒｙｒａｃｅｏｎｈｅａｔ－ｔｏｌｅｒａｎｃｅ￥（邱仞之）...     

手压井井水消毒的研究

试验表明，在手压井水面下安放特制的装有次氯酸钙片（３６０ｍｇ／片）的消毒管后３０分钟，井水含氯量可达０．３０ｍｇ／Ｌ以上，并使细菌总数与大肠菌群数减至饮水卫生标准。消毒管释氯孔径愈大，管装消毒剂片数愈多，水中有效氯含量愈高。     

Multisensory orientation behavior is disrupted by neonatal cortical ablation

The integration of visual and auditory information can significantly amplify the sensory responses of superior colliculus (SC) neurons and the behaviors that depend on them. This response amplification depends on the development of SC inputs that are derived from two regions of cortex: the anterior ectosylvian sulcus (AES) and the rostral lateral suprasylvian sulcus (rLS). Neonatal ablation of these cortico-collicular areas has been shown to disrupt the development of the multisensory enhancement capabilities of SC neurons and the present results demonstrate that it also precludes the development of the normal multisensory enhancements in orientation behavior. Animals with neonatal ablation of AES and rLS were tested at maturity and found unable to benefit from the combination of visual and auditory cues in their efforts to localize targets in contralesional space. In contrast, their ipsilesional multisensory orientation capabilities were indistinguishable from those of normal animals. However, when only one of these cortical areas was removed during early life, later behavioral consequences were negligible. Whether similar compensatory processes would occur in adult animals remains to be determined. These observations, coupled with those from previous studies, also suggest that a surprisingly high proportion of SC neurons capable of multisensory integration must be present for orientation behavior benefits to be realized. Compensatory mechanisms can achieve this if early lesions spare either AES or rLS, but even the impressive plasticity of the neonatal brain cannot compensate for the early loss of both of them.     

Differential Presentations,Clinical Courses,and Survivals of Osteosarcomas of the Proximal Humerus over Other Extremity Locations

Background  

Although there are controversies about the prognosis of proximal humeral osteosarcoma, our previous study showed poor survival in those patients. In the present study, we undertook to determine why this site is associated with a poor outcome and to identify the clinicopathologic variables involved.