PurposeTo quantitatively assess left ventricular (LV) myocardial work (MW) in pregnant women with autoimmune diseases (AD) using left ventricular pressure-strain loop (PSL) and explore its clinical implications.MethodsNinety-six participants were enrolled between September 2020 and September 2022 at the Affiliated Hospital of Inner Mongolia Medical University, including 33 pregnant women with AD (AD-P group), 26 non-pregnant AD patients (AD group), and 37 healthy pregnant women (H-P group). Clinical data, conventional echocardiography, two-dimensional speckle-tracking, and LV-MW analyses were obtained. Group comparisons and correlations between baseline characteristics and MW parameters were analyzed. Analysis of covariance (ANCOVA) and partial correlation were used for adjusted comparisons and associations.ResultsFollowing adjustment, the AD-P group demonstrated increased LV volume and lower apical constructive work (CW) compared to the AD group, while global MW indices were similar. Compared with H-P group, AD-P patients had lower E/A, increased LV volumes, E/e’, and peak strain dispersion (PSD). After adjustment, AD-P had reduced global work index (GWI), global constructive work (GCW), global work efficiency (GWE), and apical-CW, while PSD remained higher.ConclusionLV myocardial work detected subclinical LV dysfunction in pregnant women with autoimmune disease. Apical-CW showed a consistent reduction in AD-P. These findings suggest that myocardial work, especially apical CW, provides incremental value over global longitudinal strain (GLS) in autoimmune pregnancies.

Journal Article Accepted manuscript Multimodal imaging of a rare left ventricular myxoma mimicking a pericardial tumor Get access Yaxi Wang, MD, Yaxi Wang, MD Department of Ultrasound, Affiliated Hospital of Inner Mongolia Medical University, No. 1, Tongdaobeijie, Huimin District, Hohhot, 010050, China Search for other works by this author on: Oxford Academic PubMed Google Scholar Jiancheng Han, MD, Jiancheng Han, MD Echocardiography medical center, Beijing Anzhen Hospital,Capital Medical University. Beijing 100029, ChinaBeijing Key Laboratory of Maternal-Fetus Medicine in Fetal Heart Disease (BZ0308). Beijing 100029, China Corresponding Authors: Dr. Jiancheng Han, Echocardiographic medical center, Beijing Anzhen Hospital,Capital Medical University,No.2, Anzhen Road, Chaoyang District, Beijing 100029, PR China, Beijing Key Laboratory of Maternal-Fetus Medicine in Fetal Heart Disease (BZ0308); No.2, Anzhen Road, Chaoyang District, Beijing 100029, PR China, Tel: +86 10 84005368, Fax:+86 10 84005368, E-mail: [email protected]; Dr. Xiaoshan Zhang, MD, Department of Ultrasound, Affiliated Hospital of Inner Mongolia Medical University, No. 1, Tongdaobeijie, Huimin District, Hohhot, 010050, China. Tel: +86 471 3451258, Fax:+86 471 3451258, E-mail: [email protected] https://orcid.org/0000-0002-1131-1256 Search for other works by this author on: Oxford Academic PubMed Google Scholar Xiaoshan Zhang, MD Xiaoshan Zhang, MD Department of Ultrasound, Affiliated Hospital of Inner Mongolia Medical University, No. 1, Tongdaobeijie, Huimin District, Hohhot, 010050, China Corresponding Authors: Dr. Jiancheng Han, Echocardiographic medical center, Beijing Anzhen Hospital,Capital Medical University,No.2, Anzhen Road, Chaoyang District, Beijing 100029, PR China, Beijing Key Laboratory of Maternal-Fetus Medicine in Fetal Heart Disease (BZ0308); No.2, Anzhen Road, Chaoyang District, Beijing 100029, PR China, Tel: +86 10 84005368, Fax:+86 10 84005368, E-mail: [email protected]; Dr. Xiaoshan Zhang, MD, Department of Ultrasound, Affiliated Hospital of Inner Mongolia Medical University, No. 1, Tongdaobeijie, Huimin District, Hohhot, 010050, China. Tel: +86 471 3451258, Fax:+86 471 3451258, E-mail: [email protected] Search for other works by this author on: Oxford Academic PubMed Google Scholar European Heart Journal - Cardiovascular Imaging, jeaf029, https://doi.org/10.1093/ehjci/jeaf029 Published: 22 January 2025 Article history Received: 17 January 2025 Accepted: 20 January 2025 Published: 22 January 2025

Objective:We identified a novel mutation in the protein kinase cAMP-dependent type I regulatory subunit α (PRKAR1A) gene in a Chinese patient presenting with multiple recurrent cardiac myxomas, confirming a diagnosis of Carney complex (CNC). By reviewing the relevant literature, we aimed to enhance our understanding of this condition. Case presentation:A 12-year-old girl was referred to the Department of Cardiac Surgery at our hospital due to multiple cardiac myxomas. She had previously undergone two surgical resections of cardiac myxoma, both of which recurred shortly after the procedures. Physical examination revealed a blood pressure of 118/76 mmHg, body weight of 43 kg, height of 158 cm, and body mass index of 17.2 kg/m². No obvious skin pigmentation or nevi were observed. Whole-exome sequencing revealed a mutation in PRKAR1A (c.329dupC: p. A110fs), and the patient was diagnosed with CNC. During follow-up, the child succumbed to heart failure. Discussion:CNC is a rare autosomal dominant endocrine neoplasia syndrome, with approximately 53% of affected individuals having a history of cardiac myxoma. This condition should be suspected in patients initially diagnosed with multiple cardiac myxomas. Early diagnosis and treatment through multidisciplinary cooperation can improve prognosis.

Objective:To screen key genes (Hub genes), pathways, and drug candidates related to myocardial ischemia-reperfusion injury (MIRI) in rats by bioinformatics analysis based on the gene expression omnibus (GEO) database.Methods:The rat GSE122020 dataset was downloaded from the GEO database and differentially expressed genes (DEGs) were screened using the GEO2R online tool. Pathophysiological processes and potential signaling pathways involved in MIRI-related DEGs were investigated by Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. The MIRI-related DEGs protein-protein interaction (PPI) network was constructed using databases such as STRING, and the key genes in the PPI network were screened and visualized using Cytoscape software. Potential drug candidates for key genes were screened using the Enrichr database.Results:A total of 377 differential genes were screened, of which 109 were up-regulated and 268 down-regulated. KEGG pathway enrichment analysis showed that the up-regulated 109 genes were enriched in six pathways including the Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathway, while the 268 down-regulated genes were enriched in 58 pathways including the tumor necrosis factor (TNF) signaling pathway. Combined analysis based on the STRING and Gene MANIA databases and Cytoscape software resulted in the identification of 20 key DEGs, of which 4 were up-regulated and 16 down-reglated. For the 4 up-regulated genes, 55 potential drugs including nicotinic acid and quercetin were predicted based on the DSigDB database in the Enrichr database, while for the 16 down-regulated genes, 92 potential drugs including 3,3'-diindolylmethane and potassium dichromate were predicted.Conclusion:Through bioinformatics methods, the pathogenic genes of MIRI can be effectively discovered, which provides new ideas and entry points for further exploring the molecular mechanism and therapeutic targets for MIRI.

Pregnancy can cause fluctuations in autoimmune diseases (AD) women, which may aggravate the cardiac damage. Maternal heart function is very important for maternal and fetal health. Therefore, early and accurate evaluation of the heart function of AD pregnant women is necessary. This study was aimed to evaluate the left ventricular (LV) function of AD pregnant women using two-dimensional speckle tracking echocardiography (2DSTE). A total of 96 subjects, including 26 non-pregnant AD patients (AD group), 33 AD pregnant women (AD-P group), and 37 healthy pregnant women (H-P group) were conducted. Baseline clinical and conventional echocardiography characteristics of all the subjects were collected. The 2DSTE was performed to acquire layer-specific strain parameters of LV. Compared with H-P group, AD-P group showed no significant differences in GLSmid and GLSepi. However, the GLSendo (24.10 [22.30 to 25.40] vs. 21.70 [19.05 to 25.15], P = 0.023) and ΔGLS (5.50 [4.80 to 6.00] vs. 4.90 [4.20 to 5.80], P = 0.017) were decreased, while the PSD (27 [23 to 32] vs. 32 [24 to 44], P = 0.014) was increased. At the segmental level, there was no significant difference in apex LSmid and LSepi between the two groups, while the AD-P group showed transmural dysfunction in basal and middle segments, and the LSendo in apex segments (32.84 [28.34 to 34.25] vs. 27.97 [21.87 to 33.61], P = 0.021) were significantly decreased. Compared with AD group, AD-P group showed no significant difference in ΔGLS, PSD, and GLS parameters of three layers. For the segmental level, there were no significant differences in the LSepi of the apex segment and the LS in three layers of the basal and middle segments between the two groups, while LSendo (32.69 [29.13 to 35.53] vs. 27.97 [21.87 to 33.60], P = 0.017) and LSmid (24.70 [22.24 to 27.78] vs. 21.32 [16.91 to 26.11], P = 0.023) in apex segments were significantly lower in AD-P group. The anti-SSA/Ro antibody were positive independently correlated with PSD. In conclusion, layer-specific strain parameters and PSD by 2DSTE provide an accurate and reproducible measurement of myocardial function. There are subclinical LV myocardial dysfunction in AD pregnant women. Besides, the positive of anti-SSA/Ro antibody maybe associated with LV myocardial dysfunction.

Congenital heart disease (CHD) is one of the most common causes of death from birth defects in infants and young children. Preschool age can be used as a supplementary stage to the neonatal period for CHD screening, which is an excellent period for early screening, diagnosis, and treatment of CHD. The prevalence of CHD in preschool children in China has obvious regional differences. Atrial septal defect (ASD), ventricular septal defect (VSD), and patent ductus arteriosus (PDA) are the most common three types. Boys more often have more complex and severe CHD, while girls mostly have simple CHD. High altitude is related to the high prevalence of CHD, and the prevalence in low-income areas is relatively high. Studying the epidemiology of CHD in preschool children can provide more help for more accurate risk prediction and primary prevention.

Ethnopharmacological relevance: Naru-3 is a prescribed formulation based on the theory of Mongolian medicine for the treatment of rheumatoid arthritis (RA). Naru-3 consists of three medicinal agents: Aconitum kusnezoffii Reichb (caowu), Terminalia chebula Retz (hezi), and Piper longum L (biba). These medicinal agents are widely distributed in the Mongolian area of China and have been used to treat rheumatism for centuries.Background: Mongolian medicine Naru-3 is commonly prescribed to treat RA, but its mechanism of action is unknown.Methods: A rat collagen-induced arthritis (CIA) model was established to investigate the mechanism of Naru-3. Rats were treated with Naru-3, Etanercept (ETN), and sodium carboxymethylcellulose (CMC) for four weeks. After treatment was terminated, paw thickness, ankle diameter, and arthritis index (AI) were scored. Synovial hyperplasia was evaluated using hematoxylin and eosin (H&E) staining and two-dimensional ultrasonography. Synovitis and neovascularization were assayed using power Doppler imaging (PDI) and contrast-enhanced ul-trasonography (CEUS). Levels of vascular endothelial growth factor (VEGF), interleukin (IL)-1, and CD31 in the serum or synovium were detected using ELISA and immunohistochemistry analyses. Results: Naru-3 and ETN alleviated the symptoms of CIA as evidenced by diminished paw thickness, ankle diameter, and AI scores. Mechanistically, Naru-3 inhibited synovial hyperplasia, synovitis, and neo-vascularization by diminishing systemic and local inflammation, as indicated by the relative expression of CD31, VEGF and IL-1 in the serumor synovium. After four weeks of treatment, no significant neovascularization was observed in the Naru-3 group, but neovascularization and synovitis occurred in the ETN group, as demonstrated by H&E staining, PDI, and CEUS examination. Conclusion: Naru-3 inhibited inflammation, synovial hyperplasia, and neovascularization and alleviates RA in our CIA rat model. No symptom recurrence was observed four weeks after drug treatment.

Objective:To quantitatively evaluate synovial neovascularization in rheumatoid arthritis by high-frequency contrast-enhanced ultrasonography with arginylglycylaspartic acid (RGD) microbubbles.Methods:RGD microbubbles were prepared and their general characteristics (particle size, potential, and microbubble concentration) were detected. A total of 25 rats were randomly divided into a model group (n=20) and a control group (n=5). A rat model of rheumatoid arthritis was created using collagen-induced method. Rats in the control group were injected with the same dose of normal saline. The imaging of RGD microbubbles and naked microbubbles in the synovial tissue of collagen-induced arthritis (CIA) rats was detected by ultrasound contrast-enhanced technology, and a comparison of contrast intensity difference between RGD microbubble and naked microbubble before and after blasting in target tissue was performed by the independent sample t test. Finally, rat ankle joints were taken for hematoxylin-eosin (HE) staining and immunohistochemical staining for αvβ3, CD31, and VEGF to confirm CIA rat ankle joint synovial thickening and angiogenesis.Results:Compared with naked microbubbles, the particle size of the prepared RGD microbubbles was [(0.82±0.25) μm vs (0.80±0.19) μm], and the potential was [(-1.63±3.52) mV vs (-1.65±3.51) mV], with no significant difference between the two (P＞0.05 for both). Microbubble concentration was all 108/ml. A CIA rat model was successfully established, and the rate of successful modeling was up to 70% (14/20). Contrast-enhanced ultrasound showed that the contrast intensity difference between before and after ankle joint explosion in CIA rats in the RGD microbubble group was significantly higher than that of the naked microbubble group [(5.81±1.50) dB vs (0.40±0.06) dB, t=8.032, P=0.001]. Histopathology showed that the synovium of CIA rats was significantly thickened and αvβ3, CD31, and VEGF were highly expressed compared with control rats.Conclusion:Contrast-enhanced ultrasound demonstrates that RGD microbubbles have good targeting ability to neovascularization in the ankle synovial tissue of CIA rats, and it can realize the quantitative evaluation of synovial neovascularization.

川崎病是一种好发于 5 岁以下儿童、病因极为复杂的急性全身性血管炎.冠状动脉是川崎病的主要受累血管之一,其病变导致管腔狭窄和血栓栓塞,进而引发心肌梗死和猝死.对川崎病患儿冠状动脉病变状况进行评估,是制订个体化治疗方案的基础,也是改善患儿预后的关键.目前用于评估川崎病患儿冠状动脉病变的影像学方法较多,本文对其特点进行综述.

类风湿关节炎是一种慢性、全身性、自身免疫性疾病,主要特征是多发性对称性关节炎,可伴有关节外表现.影像学方法常用于诊断和监测疾病进展、评估疗效及预后,如超声、X线、CT、MRI、PET/CT.为明确致病原因和再现疾病发生发展过程,对类风湿关节炎的研究常使用动物模型,上述影像学方法亦可应用于动物实验.本文综述了不同影像学评估方法在类风湿关节炎动物模型诊疗中的应用,并分析其诊断能力及优缺点,以期为相关实验研究方法的选择提供文献支持.

Glioma is the most common primary intracranial malignant tumor in adult popularity. Due to the infiltrating characteristics, glioma can hardly be cleaned via surgical techniques alone. At present, the mainstream treatment is surgical resection combined with radiotherapy, chemotherapy or biological therapy. Nevertheless, multiple factors such as blood-brain barrier, tumor blood-brain barrier and enzyme barrier resist drugs reaching or penetrating tumor. Therefore, the 5-year survival rate of patients has rarely been significantly improved. Ultrasound targeted microbubble destruction technology can reversibly open the blood-brain barrier through ultrasonic cavitation effect, and promote the absorption of targeted drugs, gene therapy veihchel as well as the chemotherapy drug, which is of great significance in the treatment of glioma.

BackgroundMultiparametric magnetic resonance imaging (MP-MRI) has high sensitivity for diagnosing breast cancers but cannot always be used as a routine diagnostic tool. The present study aimed to evaluate whether the diagnostic performance of perfluorobutane (PFB) contrast-enhanced ultrasound (CEUS) is similar to that of MP-MRI in breast cancer and whether combining the two methods would enhance diagnostic efficiency.Patients and methodsThis was a head-to-head, prospective, multicenter study. Patients with breast lesions diagnosed by US as Breast Imaging Reporting and Data System (BI-RADS) categories 3, 4, and 5 underwent both PFB-CEUS and MP-MRI scans. On-site operators and three reviewers categorized the BI-RADS of all lesions on two images. Logistic-bootstrap 1000-sample analysis and cross-validation were used to construct PFB-CEUS, MP-MRI, and hybrid (PFB-CEUS + MP-MRI) models to distinguish breast lesions.ResultsIn total, 179 women with 186 breast lesions were evaluated from 17 centers in China. The area under the receiver operating characteristic curve (AUC) for the PFB-CEUS model to diagnose breast cancer (0.89; 95% confidence interval [CI] 0.74, 0.97) was similar to that of the MP-MRI model (0.89; 95% CI 0.73, 0.97) (P = 0.85). The AUC of the hybrid model (0.92, 95% CI 0.77, 0.98) did not show a statistical advantage over the PFB-CEUS and MP-MRI models (P = 0.29 and 0.40, respectively). However, 90.3% false-positive and 66.7% false-negative results of PFB-CEUS radiologists and 90.5% false-positive and 42.8% false-negative results of MP-MRI radiologists could be corrected by the hybrid model. Three dynamic nomograms of PFB-CEUS, MP-MRI and hybrid models to diagnose breast cancer are freely available online.ConclusionsPFB-CEUS can be used in the differential diagnosis of breast cancer with comparable performance to MP-MRI and with less time consumption. Using PFB-CEUS and MP-MRI as joint diagnostics could further strengthen the diagnostic ability.Trial registration Clinicaltrials.gov; NCT04657328. Registered 26 September 2020.IRB number 2020-300 was approved in Chinese PLA General Hospital. Every patient signed a written informed consent form in each center.

妊娠期心血管系统疾病是导致母胎非产科死亡的重要原因,一些常见妊娠合并症会对孕妇的心脏造成不同程度的损伤.因此准确评价孕妇心脏功能对母胎预后至关重要.超声心动图具有无创、便捷、可准确评价心脏功能的特点.本文总结目前超声心动图技术评价健康孕妇及妊娠合并症孕妇心脏功能的应用价值,并展望超声新技术评价孕妇心脏功能的应用前景.

Objective:To observe the feasibility of evaluating right ventricular (RV) function by the method based on left ventricle (LV) pressure-strain ring (PSL) technique in patients with systemic lupus erythematosus (SLE), and to evaluate the efficacy of non-invasive PSL in the diagnosis of dysfunction of both LV and RV.Methods:Thirty-nine patients were enrolled with SLE who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from March 2020 to September 2021 and 57 sex- and age-matched healthy controls underwent assessment by conventional echocardiography, two-dimensional speckle tracking imaging (2D-STI) and myocardial work (MW). The echocardiographic parameters were compared between the groups. The correlations between RVMW parameters and conventional echocardiographic parameters, and between MW parameters and SLEDAI-2K score were analyzed by Spearman correlation analysis.Results:①The two groups did not show any difference at the conventional echocardiographic parameters of the LV systolic function ( P>0.05). In the SLE group, tricuspid regurgitation maximal velocity (TR V max) and right ventricular index of myocardial performance (RIMP) increased, tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular S′ (S′ tv) decreased (all P<0.05), and others did not show statistical difference (all P>0.05). ②The 2D-STI parameters: There were no significant differences in left ventricular global longitudinal strain (LV GLS) ( P>0.05), however RVGLS decreased ( P<0.05). ③The MW parameters of LV and RV: including global constructive work (GCW), global work index (GWI), global wasted work (GWW), and global work efficiency (GWE). In SLE group, LV GWE, RV GWE decreased and LV GWW, RV GWW increased ( P<0.05), others were no significant differences ( P>0.05). ④The correlation analysis: RV GWI positively correlated with TR V max ( rs=0.481). RV GCW positively correlated with TR V max ( rs=0.587). RV GWW positively correlated with right atrial area (RAA) and TR V max ( rs=0.429, 0.610), negatively correlated with S′ tv ( rs=-0.342). RV GWE positively correlated with S′ tv ( rs=0.326) and negatively correlated with RAA ( rs=-0.462) (all P<0.05). SLEDAI-2K score was negatively correlated with LV GLS ( rs=-0.333) and LV GWI ( rs=-0.326) ( P<0.05). Conclusions:The study has shown the impaired systolic function of both LV and RV in patients with SLE. PSL technique, especially RVMV based on LV PSL technique might emerged as a novel measure to evaluate systolic dysfunction in SLE patients.

Objective:To evaluate the cardiac function and systolic dyssynchrony of fetuses exposed to maternal autoimmune antibodies (anti-SSA/Ro60, anti-SSA/Ro52 and anti-SSB/La) by using two-dimensional speckle tracking imaging (2D-STI).Methods:A total of 52 pregnant women with singleton pregnancy in the Affiliated Hospital of Inner Mongolia Medical University from July 2018 to November 2020 were selected. Eighteen fetuses of mothers with autoimmune antibodies were enrolled as autoimmune disease (AD) group and 34 fetuses of healthy mothers without antibodies were included as control group. Maternal baseline characteristics, fetoplacental Doppler parameters, and conventional echocardiographic data of two groups were prospectively collected. The systolic global and regional longitudinal strain of left and right ventricles (LV and RV) and the time to peak strain of regional myocardium were measured using 2D-STI. The differences in time to peak strain between the LV free wall and RV free wall (two-chamber dyssynchrony, 2C-DYS) and between the septum and LV free wall (one-chamber dyssynchrony, 1C-DYS) were also calculated.Results:There were no significant differences between the two groups in conventional systolic and diastolic functional parameters for the LV and RV(all P>0.05). The myocardial deformation parameters and 2C-DYS obtained by 2D-STI showed no statistical differences between two groups(all P>0.05). However, 1C-DYS was significantly more prolonged in the AD group than control group[28.50(13.50, 39.25)ms vs 19.50(8.00, 29.25)ms, P=0.042]. Conclusions:LV systolic mechanical dyssynchrony in fetuses of mothers with autoimmune antibodies suggests in-utero subclinical damage of the cardiac conduction system.

类风湿关节炎(rheumatoid arthritis,RA)是以滑膜炎为主要特征的慢性自身免疫性疾病,可导致关节畸形及功能障碍.RA动物模型能很好地模拟疾病发生发展的病理生理过程,广泛用于RA实验研究.多模态超声技术可以定性、定量诊断RA,监测病情变化,评估药物疗效,引导局部给药及靶向治疗,为RA动物模型研究提供精准方法.该文综述了多模态超声在RA动物模型诊疗中的应用情况.

Objective:To evaluate the application value of left ventricular pressure-strain loop (PSL) in patients with rheumatoid arthritis (RA) by the PSL.Methods:From April 2020 to June 2021, 75 RA patients(case group) and 35 healthy physical examination person(control group) were selected from the Affiliated Hospital of Inner Mongolia Medical University.According to the disease activity scores 28(DAS28) joint disease range of activity score, the patients were divided into low range of activity group (16 cases), medium range of activity group (35 cases) and high range of activity group (24 cases). Echocardiographic examinations were performed on all patients, conventional ultrasound data were collected and the left ventricular PSL technology was used to analyze the myocardial work parameters, including global work index (GWI), global constructive work (GCW), global waste work (GWW) and global work efficiency (GWE). The mean values of myocardial work index (MWI), constructive work (CW), waste work (WW) and work efficiency (WE) were calculated. The differences of myocardial work parameters between the case groups and the control group were compared, and the correlation analysis of myocardial work parameters with global longitudinal strain of left ventricle(LVGLS), left ventricular ejection fraction(LVEF) and DAS28 scores were conducted.Results:①There were no statistically significant differences of clinical data between each case group and the control group (all P>0.05). ②Compared with the control group and low disease activity group, the LVGLS of medium and high disease activity groups decreased obviously (all P<0.05). ③The GWI and GCW of the medium and high disease activity groups were significantly lower than those of the control group (all P<0.05), and there were no statistically significant differences of GWW and GWE between the case groups and the control group (all P>0.05). The mid-segment MWI, apical MWI and CW of the medium and high disease activity case groups, and the mid-segment CW of the medium disease activity case group were lower than those of the control group (all P<0.05). ④In the case group, GWI, GCW and LVEF were significantly and positively correlated ( rs1=0.253, P=0.008; rs2=0.261, P=0.024), and were significantly negatively correlated with LVGLS ( rs1=-0.525, P<0.001; rs2=0.455, P<0.001). There were no significant correlations between myocardial work parameters and DAS28 score (all P>0.05). Conclusions:PSL can early reflect to the impaired cardiac function of RA patients with moderate and high disease activity, and provide a new imaging method for clinical evaluation of the cardiac function of patients.

Objectives To compare cardiac function and systolic dyssynchrony of fetuses not exposed to and those exposed to maternal autoimmune antibodies using two-dimensional speckle tracking echocardiography (2DSTE). Methods An observational study of 52 fetuses, 18 from mothers with autoimmune antibodies (anti-SSA/Ro60, anti-Ro52 or/and anti-SSB/La) and 34 from healthy mothers without antibodies, was conducted. Maternal baseline characteristics, fetoplacental Doppler parameters, and conventional echocardiographic data were prospectively collected. Systolic global and regional longitudinal strain of left and right ventricle (LV and RV) and the time to peak strain of regional myocardium were measured using 2DSTE. We also calculated the differences in time to peak strain between the LV free wall and RV free wall (two-chamber dyssynchrony, 2C-DYS) and the LV dyssynchrony between the septum and LV free wall (one-chamber dyssynchrony, 1C-DYS). Results There were no significant differences in conventional systolic and diastolic functional parameters for the LV and RV. No effect modification was demonstrated in a myocardial deformation analysis. However, 1C-DYS was significantly more prolonged in the maternal autoimmune disease group (19.50 [8.00 to 29.25] vs. 28.50 [13.50 to 39.25], P = 0.042). Conclusions LV systolic mechanical dyssynchrony in fetuses of mothers with autoimmune antibodies suggests in-utero subclinical damage of the cardiac conduction system. Key points • The left ventricular systolic dyssynchrony was significantly more prolonged in the maternal autoimmune disease (AD) fetuses. • Subclinical damage to the left ventricular conduction system of the fetal heart in maternal AD was observed. • Systolic and diastolic functional of the left and right ventricle were preserved in fetuses exposed to maternal autoimmune disease.

经导管动脉化疗栓塞术(TACE)是治疗肝细胞癌的一种合理有效的方法 .在不能切除的肝细胞癌的临床治疗中,其价值已得到肯定.与全身化疗不同,TACE能有效阻断肿瘤的血液供应,切断癌细胞的营养来源.此外,药物可直接作用于肝动脉和肿瘤组织,提高局部药物浓度,长期发挥抗肿瘤作用.然而,由于肝癌血供丰富,在接受TACE治疗后,癌细胞很难被完全杀死,癌细胞转移的可能性很高.因此,单纯TACE治疗肝癌的效果并不理想.为了延长晚期肝癌患者的生存周期,TACE联合其他综合治疗策略在原发性肝癌的治疗中是必要的.不同的治疗方法 相互配合,相辅相成,可以显著提高治疗效果,减少术后并发症,为肝癌的临床治疗提供新的思路.