急性脑血管病与心功能障碍的关系

为探讨急性脑血管病与心功能障碍的关系,对105例急性脑血管病患者做了无创性心功能检测.

Deep learning echocardiographic intelligent model for evaluation on left ventricular regional wall motion abnormality

Objective To observe the value of deep learning echocardiographic intelligent model for evaluation on left ventricular(LV)regional wall motion abnormalities(RWMA).Methods Apical two-chamber,three-chamber and four-chamber views two-dimensional echocardiograms were obtained prospectively in 205 patients with coronary heart disease.The model for evaluating LV regional contractile function was constructed using a five-fold cross-validation method to automatically identify the presence of RWMA or not,and the performance of this model was assessed taken manual interpretation of RWMA as standards.Results Among 205 patients,RWMA was detected in totally 650 segments in 83 cases.LV myocardial segmentation model demonstrated good efficacy for delineation of LV myocardium.The average Dice similarity coefficient for LV myocardial segmentation results in the apical two-chamber,three-chamber and four-chamber views was 0.85,0.82 and 0.88,respectively.LV myocardial segmentation model accurately segmented LV myocardium in apical two-chamber,three-chamber and four-chamber views.The mean area under the curve(AUC)of RWMA identification model was 0.843±0.071,with sensitivity of(64.19±14.85)%,specificity of(89.44±7.31)%and accuracy of(85.22±4.37)%.Conclusion Deep learning echocardiographic intelligent model could be used to automatically evaluate LV regional contractile function,hence rapidly and accurately identifying RWMA.

ASSESSMENT OF LEFT VENTRICULAR FUNCTION IN HEALTHY SUBJECTS BY PUSLED WAVE DOPPLER TISSUE IMAGING

Objective To examine the clinical application of pulsed Doppler tissue imaging(DTI)for regional left ventricular function assessment in normal subjects. Methods We examined 50 healthy subjects(range 12-42 years,mean age 28.3 ± 6.9 years)using pulsed Doppler tissue imaging to characterize the diastolic and systolic velocity profiles of mitral annulus. Recordings were made along the long axis in the apical 4-chamber, 2-chamber, and long apical views of 6 sites(posterior-septum, lateral, anterior, inferior, anterior-septum, posterior)at the mitral annulus. Myocardial velocities were determined with use of variance F statistical analysis. Correlation analysis was employed to test the relationship between age and mitral annular velocities. Results Both early diastolic and systolic velocities at the septum were lower than other sites. There were no differences in mitral annulus late diastolic velocities. Mean early diastolic and systolic velocities was negatively correlated with age. Conclusions Doppler tissue imaging can directly reflect regional left ventricular function.

Improvement of increased cQTd is associated with heart function in patients with ischemic heart failure

Background Chronic heart failure （CHF） is life-threatening without timely or effective intervention. In this study, we investigated the association between QT dispersion corrected for heart rate （cQTd） and heart function in patients with CHF. Methods From January 2013 to December 2015, we continuously enrolled 240 patients categorized as New York Heart Association functional class （NYHA） III-IV with a left ventricular ejection fraction （LVEF） 〈 40%. Based on the etiology, the patients were divided into a dilated cardiomyopathy （DCM） group （n = 120） and an ischemic cardiomyopathy （ICM） group （n = 120）. Then, based on the cQTd width, the ICM group was divided into two subgroups： a QS group （cQTd ≤60 ms, n = 70） and a QL group （cQTd 〉 60 ms, n = 50）. All patients were examined by echocardiography and 12-lead electrocardiography （ECG） at 1, 3, 6, and 12 months after enrollment. Results After one year of optimized medical treatment, patients in both groups showed significant improvement in LVEF and NYHA classification from baseline. However, the cQTd in the ICM group, especially the QL, was significantly shorter than that in the DCM group at each time point. In addition, the cQTd was negatively correlated with LVEF and 6-min walking test and positively correlated with NYHA class in the ICM group. Conclusions The present findings clearly demonstrate that cQTd is a meaningful parameter for assessing heart function in the follow-up of ICM patients.

Functional dyspepsia:Are psychosocial factors of relevance?

The pathogenesis of Functional Dyspepsia （FD） remains unclear, appears diverse and is thus inadequately understood. Akin to other functional gastrointestinal disorders, research has demonstrated an association between this common diagnosis and psychosocial factors and psychiatric morbidity. Conceptualising the relevance of these factors within the syndrome of FD requires application of the biopsychosocial model of disease. Using this paradigm, dysregulation of the reciprocal communication between the brain and the gut is central to symptom generation, interpretation and exacerbation. Appreciation and understanding of the neurobiological correlates of various psychological states is also relevant. The view that psychosocial factors exert their influence in FD predominantly through motivation of health care seeking also persists. This appears too one-dimensional an assertion in light of the evidence available supporting a more intdnsic aetiological link. Evolving understanding of pathogenic mechanisms and the heterogeneous nature of the syndrome will facilitate effective management. Co-morbid psychiatric illness warrants treatment with conventional therapies. Acknowledging the relevance of psychosocial variables in FD, the degree of which is subject to vadation, has implications for assessment and management. Available evidence suggests psychological therapies may benefit FD patients particularly those with chronic symptoms. The rationale for use of psychotropic medications in FD is apparent but the evidence base to support the use of antidepressant pharmacotherapy is to date limited.

Development of functionally graded aluminium composites using centrifugal casting and influence of reinforcements on mechanical and wear properties

Functionally graded Al/B_4C, Al/Si C, Al/Al_2O_3 and Al/TiB_2 composites with constant 12%(mass fraction) of reinforcement were fabricated by centrifugal casting and hollow cylindrical components were obtained. Microstructural characteristics were investigated at outer surface of all composites and segregation of reinforcement particles was observed. Graded property of the composites with different reinforcements was investigated through hardness and tensile measurements. Results revealed that the outer peripheries of all composites exhibit higher hardness except in Al/B_4C composite and the outer zones of all composites show higher tensile strength. Abrasive wear test was conducted on the outer peripheries of all composites and Al/TiB_2 composite exhibits less wear rate.

Exercise intolerance in heart failure with preserved ejection fraction： more than a heart problem

Heart failure （HF） with preserved ejection fraction （HFpEF） is the most common form of HF in older adults, and is increasing in preva- lence as the population ages. Furthermore, HFpEF is increasing out of proportion to HF with reduced EF （HFrEF）, and its prognosis is worsening while that of HFrEF is improving. Despite the importance of HFpEF, our understanding of its pathophysiology is incomplete, and optimal treatment remains largely undefined. A cardinal feature of HFpEF is reduced exercise tolerance, which correlates with symptoms as well as reduced quality of life. The traditional concepts of exercise limitations have focused on central dysfimction related to poor cardiac pump function. However, the mechanisms are not exclusive to the heart and lungs, and the understanding of the pathophysiology of this dis- ease has evolved. Substantial attention has focused on defining the central versus peripheral mechanisms underlying the reduced functional capacity and exercise tolerance among patients with HF. In fact, physical training can improve exercise tolerance via peripheral adaptive mechanisms even in the absence of favorable central hemodynamic function. In addition, the drug trials performed to date in HFpEF that have focused on influencing cardiovascular function have not improved exercise capacity. This suggests that peripheral limitations may play a significant role in HF limiting exercise tolerance, a hallmark feature of HFpEF.

Androgen actions on endothelium functions and cardiovascular diseases

The roles of androgens on cardiovascular physiology and pathophysiology are controversial as both beneficial and detrimental effects have been reported. Although the reasons for this discrepancy are unclear, multiple factors such as genetic and epigenetic variation, sex-specificity, hormone interactions, drug preparation and route of administration may contribute. Recently, growing evidence suggests that androgens exhibit beneficial effects on cardiovascular function though the mechanism remains to be elucidated. Endothelial cells （ECs） which line the interior surface of blood vessels are distributed throughout the circulatory system, and play a crucial role in cardiovascular function. Endothelial progenitor cells （EPCs） are considered an indispensable element for the reconstitution and maintenance of an intact endothelial layer. Endothelial dysfunction is regarded as an initiating step in development of atherosclerosis and cardiovascular diseases. The modulation of endothelial functions by androgens through either genornic or nongenomic signal pathways is one possible mechanism by which androgens act on the cardiovascular system. Obtaining insight into the mechanisms by which androgens affect EC and EPC functions will allow us to determine whether androgens possess beneficial effects on the cardiovascular system. This in turn may be critical in the prevention and therapy of cardiovascular diseases. This article seeks to review recent progress in androgen regulation of endothelial function, the sex-specificity of androgen actions, and its clinical applications in the cardiovascular system.

Neuropsychological alterations in hepatitis C infection:The role of inflammation

About 50% of patients with hepatitis C virus(HCV)infection complain of neuropsychiatric symptoms,"brain fog",weakness,fatigue,and exhibit some degree of quality of life impairment,irrespective of the severity of liver disease.Since the first observation of HCV-related cognitive deficits,10 studies have been published that have evaluated neuropsychiatric performance in patients with HCV infection and different degrees of hepatic impairment.Unfortunately,these have often included patients with cirrhosis,patients who had acquired the infection through previous intravenous drug misuse,who had a history of relatively recent treatment with interferon,or were on psychoactive medication.In addition,different neuropsychological batteries and tests that explored different cognitive domains were used,which makes the results of the studies difficult to compare.Finally,limited information is available on the pathogenesis of HCV-related cognitive impairment.Cerebral and/or systemic inflammation may be important players but their potential role has not been substantiated by experimental data.The present review outlines the available evidence of the presence of cognitive impairment in patients with HCV infection,with a focus on the potential relationship with cerebral and/or systemic inflammation.

Effects of Bisoprolol on the ventricular function and hemodynamics in patients with atrial fibrillation and chronic heart failure

Background: Recent data suggest that beta-blockers can be beneficial in patients with chronic heart failure (CHF). Atrial fibrillation (AF) is present in a significant number of patients with CHF and is associateing with significant morbidity and increasing mortality rates. Thus it is necessary to establish therapy to improve the poor prognosis in this high-risk population, but a specific benefit of beta-blockers to the subset with concomitant AF and CHF has been little demonstrated. Objective: To examine the effects of Bisoprolol (6 months treatment) on the ventricular function and hemodynamics in patients with AF and CHF. Methods: 84 patients with stable CHF (NYHA≤Ⅲ class) and AF were assigned to Treated Group( n = 37) or Control group Ⅰ ( n = 22, 24-hour heart mean rate < 70/min) or Control Group Ⅱ ( n = 25, 24-hour heart mean rate ≥ 70/min) . All patients were given the basic therapy for CHF, and Treated Group received Bisopolol. Clinical and echocardiographic variables were measured in 3 groups at baseline and after 6 months, and the results were compared . Results: After 6 months of treatment with Bisoprolol, left ventricular ejection fraction (LVEF) and NYHA class had significandy improved (P < 0.05), and a trend towards a reduction in combined end point of death or CHF hospitalization was also observed (P < 0.20) in Treated Group; The increase of LVEF in Treated Group were associated with a reduction in mitral regurgitation degree and left atrial volume; The heart rate in mean 24-hour and at peak exercise decreased in Treated Group, but were similar to that in Control Group Ⅰ. Conclusion: 6 months of Bisoprolol therapy resulted in an improvement in the NYHA class and LVEF, and also showed a trend towards a reduction in hospitalization or death. The beneficial effects of Bisoprolol on patients with AF and CHF may be partly mediated by improvement of ventricular diastolic function.

Educational Practices in the Model of Music Learning Theory of E. Edwin Gordon： An Observational Research

This paper analyzes the supervision activity, to which educators and teachers enrolled with AIGAM （Gordon Italian Association for the Musical Learning） are subject to every year and intends to verify the application of those principles expressed in the learning model of the MLT （Music Learning Theory） developed by educational psychologist E. Edwin Gordon （1989, 1999, 2000, 2001, 2007） and promoted internationally by various institutions and organizations specifically accredited. It describes the influence of the videotaped supervision on the process, functions of monitoring, and evaluation of educational practices, starting with an empirical model that has guided the interventions in a study of supervision on training aimed at consolidating and developing professional skills in music education in early childhood. This paper sought to understand： the kind of practices, interactions, communications developing during an educational actions, the existence of a consistent relationship between the principles expressed in the MLT and their application, the type and benefits of supervision performed by of video recording on stakeholders in terms of change in professional behavior, and finally whether the active supervision could be comparable with other kinds of approaches.

Perspectives of Chunk Analyses

This paper reviews three main perspectives of chunk analyses： traditional phraseological, psycholinguistic, and corpus linguistic perspectives. Traditional phraseological perspective focuses on syntactic and semantic aspects of chunks and its most important criteria of chunk identifications and classifications are compositionality and frozenness/fixedness. Psycholinguistic perspective focuses on the psychological salience of chunks and its most important criterion of identifying a chunk is whether it is processed as a whole unit. Corpus linguistic perspective focuses on frequencies of chunks and its identification of chunks is done on the basis of frequency counts. All of the three perspectives have tapped into the phenomenon of multi-word combinations and yielded fruitful findings on the use of chunks in aspects of quantitative, syntactic, semantic, functional, and psychological features; however, each has their pros and cons

Sports Games Theory and Practice of Teaching in Physical Fitness

The prevalence of physical fitness is for school to teach methods single-issue research, students try to find suitable ways and means of physical and mental exercise, play sports and fitness educational value of the original features. The traditional physical education is to become a vibrant so that life becomes boring exercises. The students＇ passive learning is for active participation, so that physical exercise achieves sterile body, sterile heart function, rich life, regulating mood, emotional exchange, harmonious sense of community for students to experience the joy of sports environment to promote the development of students＇ physical and mental health.

急性心肌梗死患者介入手术护理配合的效果及满意度分析

分析护理急性心肌梗死患者时,应用介入手术配合护理方式的具体效果。方法 随机抽取2022年1月至2023年7月,我院收治的92例急性心肌梗死患者,均开展介入手术治疗,随机分组,分析干预效果。结果 研究组患者在护理后,效果更优,差异有意义(P<0.05)。结论 对急性心肌梗死患者进行时,应用介入手术护理配合的方式,可以更好地维护患者的治疗效果,提升手术治疗的成功率,改善患者的心功能,确保患者的生命安全,建议推广。

Early changes and rules of cardiac function and hemodynamics in rabbits with experimental myocardial contusion

Objective: To study changes and rules of the left ventricular functions in rabbits with myocardial contusion through parallel functional analysis by using echocardiography combined with cardiac catheter intervention. Methods: Thirty healthy rabbits were selected and impacted to make moderate or severe myocardial contusion by BIM II biomedical impact machine. The changes of hemodynamics and cardiac systolic and diastolic functions were respectively observed before injury and 1, 4, 8 and 24 hours after injury. Results: After myocardial contusion, the heart rate, systolic pressure, diastolic pressure and mean arterial pressure of rabbits decreased remarkably at 1 4 hours. The left ventricular end systolic pressure (LVESP), the maximum increasing rate of the left intraventricular pressure (+dp/dtmax), isovolumic pressure (IP) and the maximum systolic velocity of the left ventricle (Vmax) also decreased markedly. And then these parameters recovered to the level of preinjury at 8 24 hours. The left ventricular end diastolic pressure (LVEDP), the rate of the left intraventricular pressure (-dp/dtmax) and the decreasing time constant of the left intraventricular pressure (T) increased remarkably 1 hour after myocardial contusion, and did not decrease until 8 hours after myocardial contusion. Detection by echocardiography showed that ejection fraction of the left ventricle markedly decreased at 24 hours after myocardial contusion, while the systolic volume decreased obviously as early as 1 hour after myocardial contusion, at 4 8 hours it recovered a little and again decreased at 24 hours. The end systolic volume and end diastolic volume increased after myocardial contusion, but statistical significance was only seen at 8 hours after myocardial contusion.Conclusions: Cardiac functions of the left and right ventricles are markedly injured after myocardial contusion with disorders of the left ventricle diastolic function and of the right ventricle systolic function as the dominant injury. While the systolic function of the left ventricle can recover. Echocardiography shows clinical importance in detection of early injuries of cardiac functions.

Fracture healing with osteopathy in traditional Mongolian medicine

OBJECTIVE: To explore the concept and norm of fracture healing with osteopathy in traditional Mongolian medicine (TMM). METHODS: Based on the correspondence between man and the universe (including psychosomatic integration) in fracture healing with osteopathy in TMM, we used modern physio-psychological and biomechanical principles and methods to probe the integrated, dynamic and functional characteristics of fracture healing. RESULTS: Based on the integration of limbs and the body, unification of the body and function and harmony of man and nature (including psychoso-matic integration), fracture healing with osteopathy in TMM comprises the concept of natural functional healing of fractures, and follows the norm of considering physiological healing and psychological function as well as limb healing and motor function. CONCLUSION: Fracture healing with osteopathy in TMM is characterized by a lack of trauma without future complications. This therapy makes the concept of fracture healing develop in the direction of humanity, behaviorism and integration.

Salusins protect myocardium against ischemic injury by alleviating endoplasmic reticulum stress

Salusins are regulatory peptides that affect cardiovascular function. We previously reported that salusin-a and -β protected cultured cardiomyocytes from serum deprivation-induced cell death through upregulating glucose-regulated protein 78 （GRP78）, an endoplasmic reticulum （ER） resident protein whose overexpression acts as a marker and suppressor of ER stress. The present study examined whether salusin-α and -β inhibit ER stress in ischemic myocardium. In a rat model of myocardial infarction created by ligating the left anterior descending coronary artery （LAD）, salusin-α or -β was intravenously injected at 5 or 15 nmol kg-1 15 min prior to 2 h of LAD occlusion. The high dose of salusin-α and -β3 significantly improved heart function and hemodynamics in LAD-occluded rats, but had no effects in sham-operated rats. The arrhythmias caused by LAD oc- clusion were markedly attenuated by salusin-α and -β. The apoptotic rate in ischemic myocardium was reduced from 31.5%±3.7% to 19.8%±2.2% and 12.3%±2.2%, and the infarct size was reduced from 53.4%±4.0% of the risk area to 26.5%±9.7% and 23.7%±8.9% by 15 nmol kg-1 salusin-α and -β, respectively. Furthermore, salusin-α and -β prevented the ac- tivation of GRP78 and ER stress-specific apoptotic effectors caspase-12 and CHOP （C/EBP homologous protein）, and attenu- ated the reduction of an ER stress-associated antiapoptotic protein Bcl-2 in ischemic cardiac tissue. The salusins also inhibited the ER stress induced by tunicamycin in cultured rat H9c2 cardiomyocytes. These results indicate that salusins protect myo- cardium against ischemic injury by inhibiting ER stress and ER stress-associated apoptosis.