Decreased plasma nesfatin-1 levels in patients with acute myocardial infarction

Nesfatin-1 is a novel anorexigenic hormone which has close relationship with diabetes, obese, anorexia nervosa, psychiatric disorders and neurogenic diseases. The aim of our study was to evaluate levels of plasma nesfatin-1 among patients presenting with coronary artery disease and the correlation between nesfatin-1 levels and other clinical parameters. Fasting plasma levels of nesfatin-1 were tested in 48 acute myocardial infarction (AMI) patients, 74 stable angina pectoris (SAP) patients and 34 control subjects. All of them were examined by coronary angiography. The severity of coronary atherosclerosis was assessed using the Gensini score. Plasma nesfatin-1 levels were significantly lower in AMI group than SAP group or control group (0.91 ± 0.08 ng/mL vs. 0.98 ± 0.19 ng/mL and 1.09 ± 0.39 ng/mL, respectively, P < 0.05). In AMI patients, plasma nesfatin-1 levels were negatively correlated with high-sensitivity C-reactive protein, neutrophil% or Gensini scores. Such information implies that lower nesfatin-1 concentration may play a very important role in the development of AMI.     

平板运动试验对冠心病的诊断意义

目的:探讨平板运动试验(TET)对诊断冠状动脉粥样硬化性心脏病(冠心病)的临床意义。方法:对比分析217例疑诊或临床诊断冠心病患者的平板运动试验和选择性冠状动脉造影(CAG)结果。结果:以选择性冠状动脉造影为标准,平板运动试验敏感性为68.4%,特异性为88.4%,阳性预测值为77.1%,阴性预测值为82.9%。结论:简便、易行及无创的平板运动试验是诊断冠心病的重要手段。     

64层螺旋CT血管造影在胸部大血管成像中的临床应用

目的探讨64层螺旋CT血管造影在胸部大血管成像的临床应用价值。方法回顾分析了112例患者行64层螺旋CT胸部大血管造影资料,以临床手术或随访结果为金标准,进行图像分析。结果CT能够显示主动脉、肺动静脉的结构,可以诊断主动脉夹层、主动脉瘤、肺栓塞、先天性心脏病等多种大血管病变,诊断准确率100%。结论64层CT血管造影扫描速度快、安全、准确,是胸部大血管病变的首选方法。     

不同造影方法显示弹性酶诱导的兔囊状动脉瘤

目的评估经股动脉穿刺超选造影、静脉造影、心脏穿刺造影和左侧耳中央动脉穿刺造影方法显示弹性酶诱导的兔囊状动脉瘤的可行性。方法取10只新西兰兔,采用弹性酶诱导方法制作兔右侧颈总动脉起始部囊状动脉瘤模型。术后3周对所有动物分别进行经股动脉穿刺超选造影、静脉造影、心脏穿刺造影和左侧耳中央动脉穿刺造影,根据造影结果测量动脉瘤短径、长径和瘤颈宽。采用重复测量设计的方差分析方法比较不同造影方法显示的动脉瘤相关参数测量结果差异。结果采用经股动脉穿刺超选造影、静脉造影、心脏穿刺造影和左侧耳中央动脉穿刺造影方法均能较清楚的显示的动脉瘤,比较不同造影方法测量的动脉瘤短径、长径和瘤颈宽均无统计学差异（P值分别是0.646,0.427和0.625）。结论不同的造影方法均能较准确显示弹性酶诱导的兔囊状动脉瘤大小,根据不同的实验目的和条件可选用不同的造影方法。     

Serum antibody titers against heat shock protein 27 are associated with the severity of coronary artery disease

Antibody titers to several heat shock proteins (anti-Hsps) have been reported to be associated with the severity and progression of cardiovascular disease. However, there are little data regarding anti-Hsp27 titers in patients with coronary artery disease (CAD). A total of 400 patients with suspected CAD were recruited. Based on the results of coronary angiography, these patients were classified into CAD⁺ (n = 300) and CAD⁻ (n = 100) groups defined as patients with ≥50% and <50% stenosis of any major coronary artery, respectively. Eighty-three healthy subjects were also recruited as the control group. Serum anti-Hsp27 IgG titers were measured using an in-house enzyme-linked immunosorbent assay. CAD⁺ patients had significantly higher anti-Hsp27 titers compared with both CAD⁻ and control groups. Anti-Hsp27 titers were also higher in the CAD⁻ group compared with the control group. With regard to the number of affected vessels in the CAD⁺ group, patients with three-vessel disease had higher anti-Hsp27 titers compared with both two-vessel disease (2VD) and one-vessel disease (1VD) subgroups. However, there was no significant difference between 1VD and 2VD subgroups. In multiple linear regression analysis, the number of narrowed vessels and smoking were significant independent determinants of serum anti-Hsp27 titers. The present findings indicate that serum anti-Hsp27 titers may be associated with the presence and severity of coronary artery disease.     

下肢动脉阻塞性病变多层螺旋CT 低剂量扫描成像初探

目的:探讨低剂量CT扫描在下肢动脉脉阻塞性病变诊断中的应用价值.方法:选择127段经DSA确诊的不同部位下肢动脉阻塞性病变行低剂量CT扫描,并采用MPR,VR,MIP等重建方法获得各下肢动脉CTA图像,将CTA图像与DSA图像的诊断结果利用统计学软件SAS8.1行加权Kappa一致性检验,检验水准为:Kaapa.系数大于0.75.结果:所得CTA图像与DSA图像诊断结果的一致性检验的kappa系数为0.8058,两种诊断结果的一致性为优.结论:采用低剂量扫描条件获得高质量的CTA图像在下肢动脉阻塞性病变的诊断上有肯定的价值.     

自由呼吸状态下冠状动脉CT血管成像的可行性研究

目的:探讨自由呼吸状态下冠状动脉CT血管成像(Coronary CT Angiography, CCTA)的可行性。方法:收集187例疑似冠心病患者,所有患者均行CCTA检查,其中108例采用传统屏气法扫描,79例采用自由呼吸法扫描。扫描采用前门控预估法(Auto Gating)测得冠脉扫描期相,设置扫描范围和参数(准直宽度256×0.625、224×0.625、192×0.625,球管转速0.28 s,kV100,智能管电流,噪声指数25)。对比剂浓度为370 mg I/m L,注药量为0.86 m L/kg,注药时间维持12 s。由2名高年资放射科医师对冠状动脉图像采用5分法评分。测量升主动脉根部(冠状动脉左主干开口水平)和胸壁肌肉的CT值及标准差,计算图像的信噪比和对比噪声比。结果:自由呼吸状态下右冠状动脉(Right coronary artery, RCA)、左前降支(Left ascending artery, LAD)、左旋支(Left circumflex artery, LCx)的优良血管率分别为46.5%(87/187)、51.9%(97/187)及48.7%(91/187);屏气状态下RCA、LAD、LCx的优良血管率分别为32.6%(61/187)、36.4%(68/187)及36.9%(69/187),两组之间无统计学差异(Fisher值分别为6.94、1.54、0.81,P均0.05)。采用自由呼吸和屏气状态下CCTA检查的主动脉CT值、噪声、SNR和CNR均无统计学差异(P均0.05)。结论:采用超宽探测器CT,自由呼吸法CCTA可完全取代传统屏气法CCTA检查,从而降低受检者的配合难度,提高工作效率。     

Skeletonization of Volumetric Angiograms for Display

The display of three-dimensional angiograms can benefit from the knowledge of quantitative shape features such as tangent and curvature of the centerline of vessels. These can be obtained from a curve-like skeleton representation. If connectivity and topology are preserved, and if geometrical constraints such as smoothness and centeredness are satisfied, it is possible to estimate length, orientation, curvature, and torsion. It is also required that no part of the original object be left unrepresented. An efficient method for the identification of such shape components is developed. First, a suitable representation is obtained using a voxel coding approach to yield connected and labeled unit-thick paths. The desired features are estimated from a smoothed version of the skeleton produced by a moving average filter. The computational cost is linear, of the order of N_object, the total number of object voxels contained in the binary volumetric data. The method is also shown to be robust to boundary noise. Examples are discussed.     

Transvenous pacing in complex post-operative congenital heart disease guided by angiography: A case report

Transvenous pacing in patients with postoperative complex congenital heart disease (CHD) can be challenging and pose technical challenges to lead placement because of the complex anatomy, distortions produced by the surgical procedures, and the altered relationship of cardiac chambers. We describe the utility of angiography for transvenous dual chamber pacemaker implantation in a post-operative complex congenital heart disease.     

对比剂动力学时间分辨成像及弥散加权成像技术活体动态监测兔VX2肌肉肿瘤生物学生长与血管生成

目的:应用对比剂动力学时间分辨成像(Time Resolved Imaging of Contrast Kinetics,TRICKS)技术增强磁共振血管成像(MRangiography,MRA)及弥散加权成像(Diffusion Weighted Imaging,DWI)技术活体动态监测兔VX2肌肉肿瘤生物学生长与血管生成,探讨肿瘤血管生成与肿瘤生长的关系。方法:30只新西兰白兔,每只均在右后腿肌肉内接种VX2肿瘤细胞1×107建立肿瘤模型。分别在肿瘤接种后第4、7、10、13、16天(每个时间点6只)分别进行T1WI、T2WI、DWI、TRICKS动态增强MRA及T1WI增强延迟扫描,活体监测兔VX2肌肉肿瘤血管生成,肿瘤标本HE及CD31免疫组化染色进行验证。两位医师双盲法分别测量不同生长点肿瘤的长、短径及体积,并与大体病理标本比较;测定TRICKS增强动态MRA所能显示肿瘤血管的最小直径及形态变化;观察ADC值变化与肿瘤生长的关系。结果(:1)ADC值随着肿瘤体积的长大而逐渐增大。(2)MRI活体测定肿瘤大小与病理大体标本所测算肿瘤体积的差异无显著性。(3)TRICKS增强MRA动态显示肿瘤血管的最小...