AIMS:Reperfusion therapy is the most common and effective treatment against ischemic heart disease (IHD), but the process inflicts massive ischemia/reperfusion (I/R) injury for which no treatment exists. Notably, reperfusion after ischemia causes ischemia/reperfusion injury (IR injury) and the "no-reflow" phenomenon seriously affecting the therapeutic effects in clinical practice. The principle purpose of this study is to validate the effect of hydrogen gas on IHD and further explore the mechanism of hydrogen gas in alleviating myocardial I/R injury and no-reflow phenomenon.MATERIALS AND METHODS:The rat model of myocardial ischemia-reperfusion was well established. Myocardial infarct size was evaluated by TTC & Evans blue staining. The no-reflow area and the cardiac function were assessed by thioflavin-S staining and echocardiography respectively. Microstructure and mitochondria of myocardial tissue were assessed by transmission electron microscope. Western blot and immunohistochemistry were used to evaluate the expression of NLRP3 mediated pyroptosis related proteins. The 8-OHdG, MDA and serum total ROS were used to evaluate the degree of oxidative stress.KEY FINDINGS:The myocardial infarct size, no-reflow area, cardiac function, microstructure and mitochondrial morphology of I/R model rats were significantly improved after hydrogen inhalation. In addition, the expression of 8-OHdG, MDA, ROS and NLRP3 mediated pyroptosis related proteins were significantly decreased.SIGNIFICANCE:We found that oxidative stress and NLRP3 mediated pyroptosis are the important mechanisms for hydrogen to alleviate myocardial I/R injury, and we also confirmed that hydrogen can significantly improve no reflow phenomenon caused by ischemia-reperfusion.

With the change of the diet and lifestyle, the incidence of gouty arthritis(GA) is also increasing year by year.At present,the diagnosis of GA is mainly through clinical manifestations and biochemical tests,however the clinical characteristics of GA is variable,which may cause the misdiagnosis and mistreatment.In recent years,various imaging methods for the diagnosis of GA have made a breakthrough progress,such as high-frequency ultrasound,energy Doppler ultrasound,contrast-enhanced ultrasonography,transient wave ultrasonography and interventional ultrasound.With the rapid development of ultrasonography,the application of ultrasonography in the diagnosis of GA has been paid more and more attention,which not only can be a specific diagnosis of GA,but also can be applied to observe its therapeutic effect and discover the complications.

Objective To detect the influence of different percentages and positions of right ventricular pacing on heart function detected with color Doppler ultrasound in elderly patients.Methods The patients implanted dual-chamber pacemakers (n=64) were chosen from the Department of Ultrasound of the First Affiliated Hospital of Harbin Medical University from Jan. 2014 to Jan. 2015, and then divided, according to the percentages of right ventricular pacing, into group A (≥50%) and group B (<50%, eachn=32), and group A was divided further into subgroup A1 (right ventricular outflow tract septum pacing) and subgroup A2 (right ventricular apex pacing, each n=16). The patients’ clinical data was retrospectively analyzed, and left ventricular ejection fraction (LVEF), left ventricular end-diastolic inner diameter (LVEDd) and left atrial diameter (LAD) were compared between group A and group B, and between subgroup A1 and subgroup A2 after the operation for 1 y. The myocardial strain rates of all segments of left ventricular septum and all layers of medium segment of left ventricular septum were detected and compared by using color Doppler ultrasound and x-strain software after the operation for 1 y.Results There were 18 male cases and 14 female cases (average age=78.5±5.1) in group A, and 22 male cases and 10 female cases (average age=77.1±4.9) in group B. There were 16 cases (average age=78.8±5.4) in subgroup A1 and 16 cases (average age=78.0±5.1) in subgroup A2. The difference in LVEF, LVEDd and LAD had no statistical significance between group A and group B (P>0.05) before the operation. After the operation for 1 y, LVEF decreased and LAD increased (P<0.05), and LVEDd had no significant changes (P>0.05) in group A. LVEF, LVEDd and LAD had no significant changes (P>0.05) in group B. LVEF was lower in group A than that in group B (P<0.05), and&nbsp;difference in LVEDd and LAD had no statistical significance between 2 groups (P>0.05) after the operation for 1 y. The difference in LVEF, LVEDd and LAD had no statistical significance between subgroup A1 and subgroup A2 (P>0.05) before the operation. After the operation for 1 y, LVEF, LVEDd and LAD had no significant changes in subgroup A1 (P>0.05), and LVEF decreased and LVEDd and LAD increases in subgroup A2 (P<0.05). LVEF was higher and LVEDd and LAD were lower in subgroup A1 than those in subgroup A2 (P<0.05) after the operation for 1 y. The myocardial strain rates of left ventricular septal basal segment and medium segment at systole, early diastole and late diastole were higher in subgroup A1 than those in subgroup A2 (P<0.05) after the operation for 1 y. The myocardial strain rates of 3 layers of medium segment of left ventricular septum at systole, early diastole and late diastole were higher in subgroup A1 than those in subgroup A2 (P<0.05).Conclusion Compared with right ventricular apex pacing, right ventricular outflow tract septum pacing is more stable and has less influence on left ventricular systolic and diastolic functions in elderly patients implanted pacemakers.

The aim of the present study was to identify genes that may serve as markers for breast cancer prognosis by constructing a gene co-expression network and mining modules associated with survival. Two gene expression datasets of breast cancer were downloaded from ArrayExpress and genes from these datasets with a coefficient of variation >0.5 were selected and underwent functional enrichment analysis with the Database for Annotation, Visualization and Integration Discovery. Gene co-expression networks were constructed with the WGCNA package in R. Modules were identified from the network via cluster analysis. Cox regression was conducted to analyze survival rates. A total of 2,669 genes were selected, and functional enrichment analysis of them revealed that they were mainly associated with the immune response, cell proliferation, cell differentiation and cell adhesion. Seven modules were identified from the gene co-expression network, one of which was found to be significantly associated with patient survival time. Expression status of 144 genes from this module was used to cluster patient samples into two groups, with a significant difference in survival time revealed between these groups. These genes were involved in the cell cycle and tumor protein p53 signaling pathway. The top 10 hub genes were identified in the module. The findings of the present study could advance the understanding of the molecular pathogenesis of breast cancer.

随着分子生物学、蛋白组学、基因组学、计算机工程学等学科的不断进步,交叉融合,分子成像逐渐登上历史的舞台,成为研究热点.而超声分子成像随之迅猛发展,近年来超声微泡制备技术的成熟和超声造影检查技术的不断进步,超声造影不再局限获取组织的血流灌注信息,而是逐渐成为特异性的超声分子成像.目前使用超声对比剂研究分子成像和靶向治疗仍处于初级阶段.但是,各种分子成像技术的不断革新和发展,超声分子成像面临着重大的挑战,而在挑战背后同样面临着难逢的机遇.超声医学和分子生物学的迅猛发展,超声分子成像必将成为诊断和治疗疾病的新的手段和方法.超声造影剂仍有许多未能解决的问题,像如何延长微泡的半衰期、如何增强微泡的敏感性和特异性,如何增强目的基因的表达,如何处理组织损伤和高频超声之间的关系等问题,但是如果能解决这些问题,超声造影在现代医学的诊断和治疗中将起到重要的作用.现将超声分子成像综述如下.

Objective To evaluate the early effects of different calcium concentration on carotid artery elasticity and deformation capability in maintenance hemodialysis patients by quantitative artery stiffness (QAS) and X-strain technique.Methods 60 calcium dialysis patients were Randomly divided into two groups according to the dialysate concentrations: low calcium group (1.25 mmol/L) and standard calcium group (1.50 mmol/L). Each group had 30 patients. Biochemical indexes including but not limited to calcium, phosphorus, parathyroid hormone (PTH) were measured. intima-media thickness (IMT), resistance index (RI) and so on were measured by carotid artery ultrasonography. Compliance coefficient (CC), distention coefficient (DC), stiffness parameter α, stiffness parameterβ, pulse wave velocity (PWV), augmentation index (AIx), circumferential strain (Cs) and circumferential strain rate (Csr) were measured by QAS and X-strain and compared between two groups.Results ①At 6 month after the hemodialysis, calcium, phosphorus and calcium-phosphorus product of the low calcium group were significantly decreased than that of the standard calcium group, while PTH was increased (P<0.05). ②At 6 month after the hemodialysis, the values of IMT, RI, α, β, PWV and AIx of the low calcium group were decreased than that of the standard calcium group, while the values of Cs, Csr were increased (P<0.05). ③There is a correlation among IMT,α, β, PWV, Cs and Csr. ④Calcium has a significant impact on the carotid artery elasticity.Conclusion QAS and X-strain technology can early detect the effects of different calcium dialysate on carotid elasticity and deformation capacity in maintenance hemodialysis patients. It has important implications for clinical timely adjustment of dialysis programs, as well as prevention.

目的:探讨实时超声弹性成像(real-time tissue elastograph,RTE)对慢性乙肝并肝纤维化的临床诊断价值.方法:选择慢性乙肝并肝纤维化患者100例,对患者进行RTE检查及肝病理穿刺检查,将RTE评分结果与病理结果进行对比分析.结果:随着肝脏纤维化S分期的不断增加,RTE评分结果亦逐渐升高,RTE评分结果与肝纤维化病理分期呈显著正相关(r=0.665,P＜0.01).实时超声弹性成像诊断乙肝并肝纤维化的的敏感度为92,31％、特异度为86.36％、准确率为91％、阳性预测值为96.00％、阴性预测值为76.00％.结论:RTE作为一项无创检查技术,对慢性乙肝并肝纤维化具有较高的临床诊断价值.

Objective To investigate the velocity vector imaging (X‐Strain) technique in evaluating right ventricular sys‐tolic function and its clinical significance in patients of different degrees of pulmonary hypertension (PH) .Methods We chose 60 cases of PH patients (sPAP=40 mmHg ,1 mmHg=0 .133 kPa) ,which be divided into mild PH group and se‐vere PH group according to the pulmonary artery systolic pressure (sPAP) severity ,at the same period ,30 control sub‐jects were recruited .We get the right ventricular anterior wall thickness at end diastole (RVAW) ,right ventricular diame‐ter (RVD) ,right atrial diameter (RAD) ,pulmonary artery diameter (MPA) at end systolic ,right ventricular wall seg‐ments of longitudinal peak systolic strain (LS) ,longitudinal peak systolic strain rate (LSR) ,and then ,the parameters be‐tween groups were compared by one‐way analysis of variance (ANOVA) .Results In severe PH group ,RVAW ,RVED , RAD ,MPA were lower than the control group and the mild PH group ( P<0 .05) ,while these parameters were no sta‐tistically significant difference between the mild PH group and the control group ( P >0 .05) .The LS in mild and severe PH group of right ventricular wall segments were less lower than the control group ( P<0 .05) ,in severe PH group ,the LS of right ventricular wall segments decreased than the mild group ( P <0 .05) ,in severe PH group ,right ventricular wall segments of LSR were lower than the control group and the mild PH group ( P<0 .05) ,the LSR of mild PH group only apical septal of right ventricular free wall and ventricular septal lower than the control group ( P <0 .05) ,the mild PH group right ventricular wall in basal ,middle section of LSR than in the control group had no statistical significance ( P>0 .05) .Conclusion X‐Strain technology can quantitatively evaluate regional systolic function of right ventricular ,sensi‐tively reflect the changes of each segment of right ventricular systolic function before a change in the overall right ventricu‐lar function ,which can provide the accurate basis for the clinical treatment of early intervention .

目的 应用速度矢量成像技术(X-Strain)检测低钙透析液对维持性血液透析(MHD)患者颈动脉形变能力及弹性的早期影响.方法 应用X-Strain技术检测30例未发生形态学颈动脉粥样硬化的MHD患者使用低钙透析液前后颈动脉形变能力及弹性的变化.结果 ①使用低钙透析液后MHD患者血钙、血磷、钙磷乘积均降低,甲状旁腺素升高,差异有统计学意义;②使用低钙透析液后,入组前未发生形态学颈动脉粥样硬化的MHD患者颈动脉IMT、RI降低,EDV升高,差异有统计学意义;③使用低钙透析液后,入组前未发生形态学颈动脉粥样硬化的MHD患者颈动脉X-Strain参数,S1、S2、S3、S4、S6、Sr1、Sr2、Sr3、Sr4、Sr5、Sr6、CS、CSr均升高,差异有统计学意义;④CS、CSr与血钙、钙磷乘积、IMT、RI有明显相关性;⑤一元线性回归分析示,血钙、钙磷乘积、IMT、RI对CS、CSr有显著影响,其中血钙对CS及CSr的独立影响力最大.结论 应用X-Strain技术能检测出低钙透析液对未发生形态学颈动脉粥样硬化的MHD患者颈动脉形变能力及弹性的影响,为预防血管异位钙化问题提供新的治疗佐证.

Objective To evaluate the carotid elasticity of patients with subclinical hypothyroidism using ultrasound radio-frequency ( RF) data technique. Methods Ninty-three patients with subclinical hypothyroidism were divided into SCH1 group(TSH4.2~10.0mU/L,46 patients)and SCH2 group(TSH>10.0mU/L, 47 patients) and 50 health contrlos were enrolled. The TC, TG and LDL were examined in all subjects and the carotid elasticity parameters (IMT、CC、DC、α、β、PWV、Aix) were determined by ultrasound RF technique. Results The TC, LDL in SCH2 group were higher than those in the control group. Compared with the control group, the DC、β、PWV、AIX in SCH1 group and the IMT、CC、DC、α、β、PWV、AIx in SCH2 group were higher. The IMT、α、β、PWV、AIX in SCH2 group were higher compared with those in SCH1 group. DC was negatively correlated with IMT、α、βand PWV(P<0.01).CC was negatively correlated with IMT、α、β、PWV(P<0.01)and positively correlated with DC (P<0.01).AIX was positively correlated with IMT (P<0.01),and negatively correlated with DC (P<0.01). Conclusion It can early detect the changes of carotid artery elasticity using ultrasound radio-frequency (RF) data technique, providing an important method for the evaluation of large artery damage in patients with subclinical hypothyroidism.

目的 应用血管硬度检测(QAS)技术及应变和应变率成像(X-strain)技术定量评价系统性红斑狼疮(SLE)患者颈动脉弹性.方法 根据病史将77例SLE患者分为SLE 1组(病史＜5年,46例)和SLE 2组(病史≥5年,31例),另选取40名健康志愿者作为对照组.采用常规超声、QAS技术和X-strain技术检测双侧颈动脉,比较各组间常规超声参数、QAS技术和X-strain技术参数差异,分析各参数间的相关性.结果 SLE 1组与对照组内-中膜厚度(IMT)、弹性系数α、弹性系数β、脉搏波速度和动脉反射波增强指数差异无统计学意义(P均＞0.05),SLE 2组上述参数与对照组和SLE 1组相比明显增高(P均＜0.05);3组间最大圆周应变及圆周应变率比较差异均有统计学意义(P均＜0.05),且随病程延长逐渐减低;颈动脉IMT与QAS参数、X-strain参数之间具有明显相关性.结论 应用QAS和X-strain技术能早期检测SLE患者颈动脉弹性功能改变,对预防和干预SLE患者心血管事件非常重要.

ObjectiveToexploretheapplicationvalueofechocardiographyinevaluatingcardiac structureandfunctionofratswithalcoholiccardiomyopathy (ACM). Methods45maleWistarrats wererandomlydividedintonormalgroup (n=10)andACMgroup (n=35).ACMgroupweredivided into 2-monthgroup (n=10), 4-monthgroup (n=12)and 6-monthgroup (n=13).RatsfromACMgroup were gavaged with alcohol, and then let them drink alcohol at will, while rats from normal group were gavagedwithsalineatthesametimewiththesamedose.Thenratsfrom 2-monthgroup, 4-monthgroup and 6-monthgroupwereexaminedbyechocardiography,andtheresultswerecomparedwiththatofnormal group. All the rats were killed after examination. Heart tissues of those dead rats were took out for pathological examination,andtheresultsofultrasoundexaminationandpathologicalexaminationwerecompared. ResuIts Therewasnosignificantdifferencebetweenratsfrom 2-monthgroupandnormalgroup.Compared withthenormalgroup,LVPWDd,IVSDd,LVEDd,LVMandLVM/BMofratsfrom 4-monthgroup increased,whileEmandEm/Amdecreased,thedifferenceswereallsignificant (P<0.05).Compared withthenormalgroup,LVPWDd,IVSDd,EF,FS,Em,andEm/Amofratsfrom 6-monthgroup decreased, while LVM, LVM/BM and LVEDd increased, which were of significant difference (P<0.05).TheLVMmeasuredbyultrasoundwascloselyrelatedtoautopsyresults (r=0.84,P<0.05). Accordingtopathologicalresults,theHEstainingin 2-monthACMratsandnormalratswere normal,whilethatof 4-monthACMratsand 6-monthACMratswererespectivelyinaccordance withthesubclinicalandclinicalperiodofACM. ConcIusionEchocardiographycanbeusedinthe quantitative and dynamical evaluation of the cardiac structure and function of rats with ACM.

Objective To evaluate the correlation between carotid elasticity and carotid strain in maintenance hemodialysis patients using QAS technique and X-Strain technique. Methods Sixty-two maintenance hemodialysis patients were seleceted , and their carotid arteries were examined using QAS technique and X-Strain technique . Circumferential strain(Cs),circumferential strain rate(Csr),comply coefficient(CC) and elastic coefficient(β) of carotid arteries were acquired, and correlation analysis and regression analysis were proceeded. Results CC of carotid had positive correlation with Cs and Csr, and negative correlation with elastic coefficient. Cs and Csr has statistical significance with the regression coefficient of CC and elastic coefficient. Conclusion There is an obvious correlation between carotid elasticity parameters and carotid strain parameters. The combination of carotid elasticity and carotid strain because of the relationship can become a new method to detect artery damage in maintenance hemodialysis patients.

桥本甲状腺炎(HT)是常见的自身免疫性甲状腺疾病,是造成甲状腺工作减低的主要原因之一.近年来,随着现代影像技术的发展,超声检查已成为诊断桥本甲状腺炎的主要手段.二维灰阶超声结合多普勒超声、弹性评分技术、应变率比值、声触诊组织成像和和声触诊组织定量技术等新技术显著提高了桥本甲状腺炎的诊断准确率.

Objective: To evaluate elasticity score and the critical point of strain ratio by ultrasonograms in differential diagnosis of thyroid nodules.Methods: Elasticity imaging was used to examine 78 cases of patient with 122 thyroid nodules.The elasticity scores and strain ratio were retrospectively reviewed and compared with pathology.According to the pathological findings are divided into benign and malignant groups.Results:(1)An elasticity score of 1-3was observed in 90 of 122 nodules,while a score of 4 and 5 in the rest of 32 nodules,which displayed a sensitivity of 75%,a specificity of 82% and a accuracy of 80%;(2) strain ratio: Of the 122 lesions,90 were benign and 32were malignant.The average of strain ratio of benignnodules was 2.34+1.02,while that of malignancy was 4.15+1.09;(3) According to the ROC curve,the critical point was 3.30,which displayed a sensitivity of 81%,a specificity of 90% and a accuracy of 87%.The area under the receiver operating characteristic curve was 0.831.Conclusion: The strain ratio and elasticity score in elasticity images is helpful in the differential diagnosis of thyroid lesions.

Objective To investigate the relationship between various lines of bilateral kidneys in healthy people with age,gender,height,weight and body mass index(BMI).Methods Ultrasonic assessment of kidneys was performed in 1036 people who came for physical examination.Renal length,transverse and anteroposterior diameters were measured,and the relation between these lines and the correlative factors were assessed.Results The length,transverse and anteroposterior diameters in both kidneys in male were significantly larger than those in female.Univariate analyses showed that the diameters in both kidneys all had relationship with age,height,weight and BMI,except for the length diameter of right kidney with age,height,weight,BMI and the anteroposterior of left kidney with age.Multivariate analyses indicated that age and sex were the main influence factors of renal diameters.Conclusion The renal diameters may be influenced by multifactors except for the length diameter of right kidney,which can be used as the main indicator for assessment of kidney size.

Objective To investigate the clinical application of 3D reformation technique with in the diagnosis of Thoracic injury.Methods 112 patients of Thoracic injury were enrolled in this sdudy.Radiography and 32-slice spiral CT were used with slice thickness as 1.25 mm and post processing technique of multi-planar reformation and volume reformation the fracture location,quantity and neighboring tissue,organ of the situation were observed and analyzed.Results Of the 112 patients,there were rib fractures in 98 cases,thoracic and lumbar compression fracture in 2 cases of sternal fracture in 11 cases,thoracic spinous process fracture in 3 cases,scapula fracture in 16 cases.X-ray rib fractures were found in 82 cases,sternal fracture in 4 cases,scapula fracture in 3 cases,pulmonary contusion in 21 cases,blood pneumothorax in 2 cases.Conclusion 32-slice spiral CT three-dimensional reorganization in combination with image processing technology in patients with chest trauma can make quick,accurate diagnosis,determine chest trauma fracture and adjacent tissue,organ damage,guide clinicians for treating patients in a timely,effective manner,which has a high clinical value.

目的观察胸段食管鳞癌术后放化疗的毒副反应,总结护理经验。方法选择淋巴结阳性胸段食管鳞癌术后放化疗患者164例,术后放疗剂量50Gy,化疗方案为顺铂联合紫杉醇,21d为一个周期,在治疗过程中观察其毒副反应,针对毒副反应给予对症护理。结果毒副反应主要表现为骨髓抑制、脱发、肌肉或关节痛、胃肠道反应、放射性食管炎和放射性气管炎,经对症治疗和护理后好转。结论对食管癌鳞癌术后放化疗患者给予积极对症,支持治疗和精心护理,患者因放化疗引起的毒副反应明显减轻,可以顺利完成治疗。

患者女,37岁.因上腹部不适来诊,曾行胃镜检查诊为浅表性胃炎、胃窦部小弯侧黏膜下占位.清晨空腹并迅速喝下500ml矿泉水后行超声检查,见胃壁层次清晰,黏膜欠光滑,胃窦部小弯侧黏膜下层探及-大小约为1.2 cm×0.7 cm低回声结节(图1),呈类圆形,边界清晰,基底较宽,表面黏膜光滑连续,内部回声不均匀,可探及小无回声及强回声.CDFl:结节内未探及明显血流信号.超声提示:浅表性胃炎,胃内低回声结节(异位胰腺可能).术中冰冻切片证实为异位胰腺.

<正>慢性肾病(CKD)是一个全世界的公共健康问题,并能预测心血管疾病,其定义为肾小球滤过率估测值(eGFR)<60ml-1.min-1.1.73m-2。糖尿病肾病是糖尿病常见而难治的慢性并发症,一旦发生肾脏损害,将会进行性发展,导致肾功能不全,甚至尿毒症,因此早期诊断和防治具有重要意义。