Abstract:Aim To investigate the structure and hemodynamics characteristics of carotid and vertebral artery by ultrasonography in patients with acute cerebral infarction (ACI). Methods Carotid artery and vertebral artery were detected by ultrasonography in 298 patients with ACI and 101 healthy controls. The differences of blood vessel diameter, intima-media thickness (IMT), vascular resistance index (RI) and blood flow velocity were analyzed between the two groups. According to the NIHSS score, the ACI group was divided into two subgroups:progressive ACI group and non-progressive ACI group. The differences of the above ultrasonic parameters were compared between the two subgroups. Results (1)Common carotid artery internal diameter, internal carotid artery internal diameter, common carotid artery RI, left internal carotid artery RI in ACI group were higher than those in healthy control group (P＜0.05). End diastolic velocity (Vd) of common carotid artery, peak systolic velocity (Vs) of internal carotid artery, internal carotid artery Vd, right vertebral artery Vs and Vd in ACI group were lower than those in healthy control group (P＜0.05). (2)Left common carotid artery Vs and RI, internal carotid artery IMT in progressive ACI group were higher than those in non-progressive ACI group (P＜0.05). Right vertebral artery Vs in progressive ACI group was lower than that in non-progressive ACI group (P＜0.05). (3)Pearson correlation analysis showed that age was correlated with various vascular ultrasonic parameters. Conclusions Carotid atherosclerosis vascular structural decompensation is one of ACI characteristics. IMT thickening of the internal carotid artery may be a risk signal of ACI progression.

Abstract:Aim To assess myocardial fibrosis with ultrasonic backscatter measurement combined with collagen metabolite in ischemia/reperfusion （I/R） injury canine. Methods 12 adult mongrel dogs were randomly divided into 2 groups: sham operation group （sham group） and ischemia/reperfusion group （I/R group）,6 dogs in each group. Integrated backscatter （IBS） and cyclic variation of integrated backscatter （CVIB） were detected in ventricular septal and posterior wall of the left ventricular with quantitative analysis of ultrasonic backscatter. Serum levels of connective tissue growth factor （CTGF） and aminoterminal propeptide of type Ⅰ procollagen （PⅠNP） were examined by enzyme-linked immunosorbent assay （ELISA）. Myocardial fibrosis of ventricular myocardium was tested by Masson staining,and expression of collagen Ⅰ was detected with pathologic immunohistochemistry. Results Compared with sham group,CTGF and PⅠNP levels were increased,IBS significantly was enlarged,and CVIB significantly was decreased in I/R group,the differences were statistically significant （P<0.05）. CTGF and PⅠNP levels were positively correlated with IBS and negatively correlated with CVIB in I/R group （P<0.05）. Masson staining showed that myocardial fibrosis was significantly increased and expression of collagen Ⅰ protein was strongly positive in I/R group. Conclusions IBS is increased,CVIB is decreased,and CTGF and PⅠNP levels were increased in ischemia/reperfusion injury canine. Myocardial fibrosis was involved in I/R damage to induce ventricular remodeling. Ultrasonic backscatter measurement combined with collagen metabolites could be an early and non-invasive method to examine ventricular fibrosis degree at I/R stage.

Abstract:Aim To research the correlation between atherosclerosis on carotid artery and the systolic and diastolic function of left ventricular in cerebral infarction combined hypertension patients. Methods The study collected ultrasonic indexs of atherosclerosis on carotid artery and left ventricular systolic and diastolic function in 100 hypertension patients （abbreviated group of hypertension）, 100 cerebral infarction patients （abbreviated group of cerebral infarction） and 100 cerebral infarction combined hypertension patients （abbreviated group of combination）. Ejection fraction （EF） was used as systolic function index, ratio of blood flow velocity between early filling of E peak and late filling A peak （E/A） on flow chart of mitral was used as diastolic function index. Logistic regression analysis was used to explore the correlation in themselves. Results There aren’t correlations between atherosclerosis on carotid artery and the systolic function of left ventricular in the three groups of patients （P>0.05）. However there are correlations between atherosclerosis on carotid artery and the diastolic function of left ventricular in the three groups of patients （P<0.05）. And the correlation between the form of carotid atherosclerotic plaque and diastolic function of left ventricular in group of combination is more significant than in other groups （P<0.01）. Conclusions Atherosclerosis on carotid artery is related with the diastolic function of left ventricular in the three groups of patients. Moreover it is most obvious in the group of combination. The more serious damage of left ventricular diastolic function, the more obvious arteriosclerosis on carotid artery.

Abstract:Aim To study the relationship between carotid atherosclerotic plaques and transient ischemic attack(TIA).Methods 84 cases with internal carotid artery TIA were tested by doppler ultrasound technology in extracranial carotid artery.The testing analysis indicators are distribution,narrow degree and the ultrasonic parting of extracranial carotid atherosclerotic plaques.And comparing and studying the symptoms side to asymptomatic lateral.Results The soft spot was the most frequent,followed by mixing spot and ulcer spot in TIA patients with extracranial carotid atherosclerotic plaques,and the differences were significant(P<0.01).There was no obvious difference in hard spot and flat spot.The incidence in Asymptomatic lateral patches(60.34%) was obviously higher than symptomatic lateral patches(39.66%),and the difference was significant(P<0.01).The moderate or above narrow incidence in Asymptomatic lateral extracranial carotid artery(29.31%) was obviously higher than symptomatic side(6.70%),and the differences were significant(P<0.01).Conclusions Extracranial carotid atherosclerosis is a significant risk factor in TIA patients.There is important reference value to evaluate extracranial carotid atherosclerosis severity and causes in TIA patients by color ultrasonic testing regularly.

Abstract:Aim To discuss the correlation factor of carotid angiosclerosis plaque in the patients with type 2 diabetes mellitus(T2DM). Methods 123 cases of patients with T2DM,including non-carotid angiosclerosis plaque and carotid angiosclerosis plaque,were explored by color ultrasonoscope.The physical examinations included measurement of age,diabetes course,body mass index,blood pressure,smoking history,hypertension history,microangiopathy,carotid intima-media thickness,etc.Laboratory tests included serum C-reactive protein(CRP),fasting blood glucose,total cholesterol,triglycerides,high density lipoprotein cholesterol,low density lipoprotein cholesterol,atherogenic index of plasma,uric acid and serum creatinine. Results The levels of serum CRP(P<0.05),age(P<0.01),carotid intima-media thickness(P<0.01) and microangiopathy incidence(P<0.05) in angiosclerosis plaque group were higher than those in non-angiosclerosis plaque group.Stepwise regression analysis of relative factors for carotid angiosclerosis plaque showed that only the carotid intima-media thickness was significantly associated with the carotid angiosclerosis plaque(P<0.05). Conclusions Carotid angiosclerosis plaque may be related to carotid intima-media thickness,age and CRP in the patients with T2DM.Carotid intima-media thickness may be a risk factor of carotid angiosclerosis plaque.Micrangium complication incidence will be raised accompanying with the formation of carotid angiosclerosis plaque.

Abstract:Aim To discuss the relevance between cerebral infarction and carotid atherosclerotic plaque.Methods 47 patients with cerebral infarction were tested by ultrasound,and the site,nature and artery lumen diameter of their plaque were observed and compared with the result detected from 39 patients suffering carotid artery atherosclerotic plaque of the comparative group.Results The carotid artery atherosclerotic plaque of patients with cerebral infarction are mostly unstable plaques and associated with lipid levels(P<0.05),the distribution of carotid atherosclerotic plaque are mostly at the BIF.Conclusions The occurrence of cerebral infarction is closely related to carotid atherosclerotic plaque,the nature and distribution of carotid atherosclerotic plaque has something to do with the lipid levels.Through ultrasonic inspection we can detect the formation of plaque at an early stage,which is critical to the prevention of the occurrence of cerebral infarction.

Abstract:Aim To investigate the value of rest 99m Tc-MIBI myocardial single photon emission computed tomography(SPECT) in diagnosis of old myocardial infarction.Methods Vector cardiogram(VCG),ultrasonic cardiography(UCG) and rest 99m Tc-MIBI SPECT were performed in the 25 patients with dubious old myocardial infarction(22 inferior and 3 anterior myocardial infarction).Positive rate of rest 99m Tc-MIBI SPECT myocardial imaging were compared with VCG and UCG for diagnosis of old myocardial infarction.Results In diagnosis of old myocardial infarction,positive rate of rest 99m Tc-MIBI SPECT was 88%,and were significantly higher than VCG(32%) and UCG(24%;P<0.05).In diagnosis of old inferior myocardial infarction,positive rate of rest 99m Tc-MIBI SPECT(82%) were significantly higher than VCG(27%) and UCG(23%;P<0.05).Consistent rate of rest 99m Tc-MIBI SPECT with angiography was higher than the VCG(100% vs 25%).Conclusion In diagnosis of old myocardial infarction especially inferior myocardial infarction,rest 99m Tc-MIBI SPECT myocardial imaging has significant clinic value.

Abstract:Aim To explore whether there is relationship among the inflammation markers, acute coronary syndrome (ACS) and carotid atherosclerotic plaque. Methods 92 patients with ACS, 97 patients with stable angina pectoris (SAP) who underwent coronary angiography were enrolled in our study, 40 healthy people were selected as control. The bilateral carotid ultrasounding by high sensitive was investigated to measure the intima-media thickness (IMT), the number of the carotid plaques and the characteristics of the plaques, the serum levels of intercellular adhesion molecular-1 (ICAM-1), matrix metalloproteinase-9 (MMP-9) and high sensitive C-reaction protein (hs-CRP) were determined and the Logistic statistic analysis was used to study the relationship of the inflammatory markers and the unstable plaque. Results The levels of MMP-9, ICAM-1 and hs-CRP in the patients with ACS were significantly higher than those of the patients with SAP and the normal people. According to the Logistic analysis, the results indicated that serum MMP-9, ICAM-1 and hs-CRP were related to the unstable plaque (MMP-9>300 μg/L, OR: 3.12, 95%CI: 1.11～8.98, P=0.027; ICAM-1>200 μg/L, OR: 4.78, 95%CI: 1.34～9.89, P=0.010; hs-CRP >4.0 mg/L, OR: 5.37, 95%CI: 1.43～15.21, P=0.003). Conclusion The numbers of the complex carotid plaques in patients with ACS were significantly higher than those of the patients with SAP and normal control people. There was significant relationship between the complex carotid plaques and ACS.

Abstract:Although ultrasonic therapy on the coronary heart disease have been identified as in effect, no studies have evaluated the capability of the ultrasound eliminating atherosclerotic lesions. The purpose of the present study was to elucidate the roles of the ultrasound in the hyperlipedemia reduction and the plaque ablation on the basis of the experimental animal models.Abstract: Methods Thirty Chinese white rabbits were divided into 3 groups: model, natural eliminating and ultrasonic therapeutic group, according the age and the body weight. In every group the experimental hyperlipedemia and atherosclerosis were produced by feding high lipid diets for 110 days. Then model group served as contral to assess on the atherosclerotic lesions, other two groups were given to normal diets maintaining 63 days so as to evalurate the role of ultrasonic plaque ablation. In the therapeutic group ultrasound was irritated every day for 15 min in front of the heart area, using pulsed mode, frequency 800 kHz and intensity 1. 0 W·cm~(-2). At the all experimental process the serum total cholesterol level was measured once every twenty days. At the end of experiment samples from coronary arteries and aortae were taken using different sections. Light sections were stained with hematoxylin-eosin and weigert and examined by light microscopy lesions with point lattice test system. Ultrathin sections were only to qualitative investigation. Results in the experimental handred-tenth days the serum total cholesterol level of the three groups was distinctly higher than that of the beginning of experiment. By the end of experiment the serum total cholesterol level; the incidence of coronary arterial sections with lesion, and the volume density of atherosclerotic lesions of coronary arteries and aortae in the therapeutic groups were 26.01±8. 15 mmol·L~(-1), 7.86%, 36.59%±6. 98%, 7. 95%±13. 16%, respectively. These results were remarkably lower than those of the natural eliminating groups (P=0. 05 ～0.01). Conclutions Our results suggest that the ultrasound has the significant effects to decrease concentrations of the serum total cholesterol and to eliminate the atherosclerotic pleques. This study was provided the theoretical base to treat coronary heart diseases with the ultrasound.