Objective To develop an in vivo procedure f or His bundle pacing (HBP) and radio-frequency (RF) ablation of the atrio-ventricular node (AVN) guided by intracardiac echocardiography (ICE) and tissue Doppler imaging (TDI). The procedure included a custom designed bipolar active fixation pacing lead and steerable delivery catheter, and a commercial RF generator and ablation catheter. Methods Six anesthetized- closed-chest canines were tested. The anatomy in the His bundle and AVN regions, and the onset of myocardial electro-mechanical activation were identified using ICE and TDI. The lead and RF ablation catheter were navigated using an ICE catheter (for local detailed imaging) and fluoroscopy (for global imaging). Surface QRS morphologies were recorded to confirm HBP and third degree block post-ablation. Results Direct His bundle pacing was achieved in one canine, and His + ventricular septal pacing in the remaining five. QRS width in sinus rhythm and HBP were ( 59.7-? 5.3-)ms and ( 82.8-? 16.6-)ms separately (P= 0.02-). The increased QRS width for HBP was due to early septal activation. HBP thresholds were ( 3.0-? 1.0-) volts at 0.5 ms (N=5 due to a late exit block). The mean procedure durations were: HBP 40 minutes (3 to 81 minutes), AVN ablation 3 minutes (2 to 5 minutes), and total X-ray exposure 13 minutes (1 to 55 minutes). Post-mortem analysis of the lead and ablation lesions confirmed correct anatomic localization for HBP and AVN ablation. Conclusions ICE provides precise anatomic guidance of HBP lead implantation and AVN ablation and can significantly reduce exposure to fluoroscopy.

Objective To study the effect of consciousness restoring needling method combined with Jingjin needling method for shoulder-joint semiluxation patients after stroke.Methods The 108 patients were divided randomly into the treated group(n=58) and the control group(n=50).The treated group was treated with consciousness restoring and Jingjin Needling while the control group treated with consciousness restoring only.The therapeutic effect,shoulder joint movement,and severity of nervous impairment of both groups were observed.Results There were significant differences between the two groups in total effective rate and improvement of joint movement and nervous function(P

Objective To explore the related factors of diabetes insipidus and disorders of sodium and water after surgery of sellar region tumor,and to find nursing strategy and improve the prognosis of sellar region tumors.Methods In this study,we retrospectively reviewed 150 cases of sellar region tumor from January 2005 to January 2011 in our department,including 67 cases of pituitary adenoma,53 cases of meningioma,30 cases of craniopharyngiona.Approaches were depended on the size and growing pattern of the tumors.Related factors of postoperative diabetes insipidus and disorders of sodium and water were analyzed.Results Large tumor size,the pathology of tumor,preoperative endocrine dysfunction,preoperative visual field and vision disorders and surgery approach were related to such complications.Conclusions Finding the related factors of these complications in patients and adopting care measures play an important role in improving the prognosis of sellar region tumors.

Objective To detect mutations of p53 gene 2-4 exons from peripheral blood and to explore their relevance in HPV16-positive cervical cancer susceptibility and clinical significance. Methods Collected firstly cases from the Third Affiliated Hospital of Kunming Medical University from October 2012 to April 2014, included 167 cases HPV16-postive cervical cancer and 160 cases HPV-negative healthy women. Genomic DNA from the host peripheral venous blood was taken, mutations of p53 gene 2-4 exons were analyzed with software DNAstar after PCR and bidirectional sequencing. Meanwhile,mutations of p53 gene 2-4 exons among different clinicopathological characteristics in HPV16-postive cervical cancer were distinguished. Results (1)Three mutations and an 16-bp insertion/deletion sequences were found in p53 gene exons 2-4, included C/G mutation of single nucleotide polymorphism(SNP)11827 in intron2, A/C mutation of SNP11992 in intron3, C/G mutation in codon 72 (rs1042522) of exon4 and 16-bp(acctggagggctgggg) repeat insertion or deletion in intron3 (rs17878362), while deletion recorded as A1, insertion recorded as A2. No significant differences were found in each point allele and genotype frequency(P＞0.05). (2) Stratified analysis for cervical cancer group resulted with some differences. Compared group of non-squamous carcinoma with squamous carcinoma group, there were obviously decreased in allete A2 [11.8%(4/34) vs 3.5%(10/284); χ2=4.90,P=0.027], genotype A1A2 [4/17 vs 7.0%(10/142); χ2=5.14,P=0.023], and haplotype C-A2 [11.8%(4/34)vs 3.5%(10/284);χ2=4.91,P=0.027]. Compared with poorly differentiated group,allele C of SNP11827 and rs1042522 were obviously decreased in medium high differentiation group [50.8%(61/120)vs 38.8%(62/160);χ2=4.07,P=0.044], while haplotype G-A1 were apparently higher [49.2%(59/120)vs 61.2%(98/160);χ2=4.07,P=0.044], genotype GG of SNP11827 and rs1042522 were obviously decreased in superficial myometrial invasion depth group than that in deep myometrial invasion depth group [46.3%(25/54) vs 21.1%(8/38); χ2=7.06,P=0.029]. No significant differences were found between stage Ⅰ and Ⅱ, pelvic lymph node metastasis or not (all P＞0.05). Conclusions No obvious correlation is found between polymorphisms in exons 2-4 of p53 gene and susceptibility of HPV16-postive cervical cancer. But the patient with allete C and A2, genotype GG and A1A2, haplotype C-A2 and G-A1 may be increase risk of poorly differentiation, deep muscular invasion and bad pathological type. Analysis of p53 gene polymorphism may be provide a basis for the prognosis evaluation and individualized treatment of cervical cancer.

Objective To study the expression of transcription factor miR‐200b and CEA and the correlation between the two transcription factors in the process of occurrence and development of colorectal cancer .Methods Expression miR‐200b and CEA mRNA by real‐time PCR in 60 colon cancer tissues and corresponding normal tissues were detected and the results were compared with the clinical features and pathological characters .The relationship between the mRNA expression of miR‐200b and CEA in 60 colon cancer tissues was determined .Results The expression rate of CEA mRNA was detectable to highly expressed rates in colon cancer tissues than that in matched normal tissues (P<0 .01) ,whereas miR‐200b mRNA in the colon cancer tissues was signifi‐cantly lower than that in the matched normal tissues(P<0 .01) .There was no significant correlation between miR‐200b ,CEA mR‐NA expression and age ,sex ,tumor location(P>0 .05) .Loss expression or down regulation expression of miR‐200b mRNA was de‐tected ,whereas CEA mRNA was detectable to highly expressed in the different histological grade and Dukes stages .The expression of miR‐200b mRNA and CEA mRNA were positively correlated with the histological grade in colon cancer .A significant correlation was found between the expression of miR‐200b mRNA and CEA mRNA (r= -0 .790 ,P<0 .001) .Conclusion Loss or down regu‐lation expression of miR‐200b mRNA ,whereas CEA is detectable to highly expressed in colon cancer .Negative correlation occurred in miR‐200b mRNA and CEA mRNA indicates that miR‐200b and CEA provide the new clues of genetic diagnosis and treatment .

Objective To analyze the clinical risk factors of type 2 diabetes complicated with cerebral infarction .Methods 508 patients with type 2 diabetes were selected and divided into two groups :group A (complicated with cerebral infarction ,n=240) and group B (without cerebral infarction ,n=268) .The basic clinical information of two groups were recorded .The coagulation indica‐tors and biochemical indicators (including blood glucose ,blood lipid ,HbA1c ,blood β2 microglobulin ,urineβ2 microglobulin ,urine microalbuminuria ,fasting insulin ,fasting C peptide etc) were detected respectively .Results There were significant differences in age ,age at onset of diabetes ,duration of hypertension and systolic blood pressure between group A and group B (P<0 .05) .The in‐cidence of hypertension and coronary heart disease in group A were higher than group B (P<0 .05) .Comparing with group B ,the levels of HbA1c ,ApoB ,fasting insulin ,fasting C‐peptide ,lipoprotein (a) ,Hcy ,blood β2 microglobulin ,urineβ2 microglobulin ,and urine microalbuminuria of group A were significantly different (P<0 .05) .The ATⅢ level of group A was significantly lower than that of group B (P<0 .05) .Conclusion The risk factors of type 2 diabetes complicated with cerebral infarction include age ,hyper‐tension ,HbA1c ,ApoB ,fasting insulin ,fasting C‐peptide ,lipoprotein (a) ,Hcy ,etc make diabetics be more prone to cerebral infarc‐tion ect .

Objective To study the expression of transcription factor Sp1 and CEA and the correlation between the two tran‐scription factors in colorectal cancer .Methods To detect expression Sp1 and CEA mRNA by Real‐Time PCR in 60 colon cancer tis‐sues and corresponding normal tissues and the results were compared with the clinical features and pathological characters .The re‐lationship between the expression of Sp1 mRNA and CEA mRNA in 60 colon cancer tissues was determined .Results The expres‐sion rates of Sp1 and CEA mRNA was detectable to highly expressed rates in colon cancer tissues than the matched normal tissues (P<0 .01) .There was no significant correlation between Sp1 and CEA mRNA expression in age ,sex ,tumor location(P>0 .05) . Sp1 and CEA mRNA was detectable to highly expressed in the different histological grade and Dukes stages .In addition ,a positive correlation was found between the expression of Sp1 mRNA and CEA mRNA(r=0 .706 ,P<0 .01) ,(0< r<1) .Conclusion Sp1 and CEA was detectable to highly expressed in colon cancer .Positively correlation occurred in Sp1 mRNA and CEA mRNA indica‐ted that Sp1 and CEA provide the new clues of genetic diagnosis and treatment .

Objective To observe the effect of 99Tc-MDP in the treatment of metastasis bone disease pain with malignancies,and the influence of 99Tc-MDP to human body's Hb,WBC,PLT,serum calcium,and PS grade.Methods 99Tc-MDP was used for the treatment of bone metastases in 78 cases with malignancies:established the intravenous access,mairdined with the 99Tc-MDP,200mg,the diluted physiological brine,and in tWO hours,once a day for five days.After the rest of twenty one to twenty-eight days,the second cycle Was repeated,and each patient at least three cycles.Results 99Tc-MDP had no influence to the Hb,WBC and PLT in pre-treatment and post-treatment,but had obvious effeet on the serum calcium,the hypocalcaemia reduced obviously(P＜0.01).There was significant difference in ameliorating ache during the periods of pretreatment and post-treatment(P＜0.05).However,there was no marked improvement in PS,and no statistic difference(P＞0.05).Conclusion 99Tc-MDP has deftnite curative effect in the treatment of metastasis bone cancer,can ameliorate the ache induced by it,and can reduce the hypoealcaemia.There is no marrow inhibition and enteron reaction in the application.

Objective To compare the application value of contrast enhanced ultrasound (CEUS) and contrast enhanced magnetic resonance angiography ( CEMRA ) in the diagnosis of carotid plaque characteristics . Methods Fourty-six patients ( 48 carotid plaques) were performed with carotid CEUS and CEMRA examination prior to carotid endarterectomy . The following characteristics of plaque including the surface of the plaque ,the presence of calcification ,the internal composition and the diameter stenosis were observed and measured ,which were compared with pathologic and digital subtraction angiography ( DSA ) results . Results There were 42 vulnerable plaques and 6 stable plaques in the 48 plaques . Fourty-seven carotid plaques had been correctly diagnosed by CEUS and CEMRA ,and one plaque had been misdiagnosed . The sensitivity ,specificity and accuracy between CEUS and CEMRA had no obvious differences in terms of the overall evaluation of plaque vulnerability ( P > 0 .05) ;CEUS and CEMRA in the diagnosion of the plaque surface situation had no statistical difference in terms of sensitivity ,specificity and accuracy compared with pathological results( P > 0 .05) ;There was no significant difference in diagnostic accuracy rate between two modalities ( P < 0 .05) ;In the diagnosis of plaque internal composition ,they had statistically differences in terms of specificity and accuracy ( P < 0 .05) ,while sensitivity had no obvious difference ( P > 0 .05) . With DSA examination results as the gold standard ,the accuracy of CEUS in the diagnosis of the diameter stenosis was 97 .92% (47/48) ,CEMRA was 100% (48/48) ,they had no significant difference between two groups ( P > 0 .05 ) . Conclusions CEUS and CEMRA in carotid plaques characteristic evaluation have respective advantages ,are highly complementary ,and combining two methods can systematically evaluate for plaque characteristics .

Objective To assess longitudinal segmental myocardial strain(?),displacement(D) and the changes of the inner dimension of left ventricle(?L),and to establish their spatial correlationship during cardiac pacing and conductive block.Methods The standard apical four chamber view of left ventricle were acquired during cardiac pacing(n=12),right bundle branch block(RBBB,n=13) and sinus rhythm(n=14) using GE Vivid 7 dimension and the M3S probe with(4.0) MHz for the analysis of the longitudinal myocardial segmental(apical and basal segments) ? and D of left ventricle with two dimensional strain analysis software.The maximal and change longitudinal dimension of left ventricle was measured and calculated at end-diastole and end-systole respectively.The differences of the above parameters were compared and the spatial correlationships among them were analyzed.Results The peak ? of the septal basal segment during cardiac pacing was significant higher than that of the apical segment.There were significant differences in the peak D and(?D)(D_(basal)-D_(apical)) at lateral wall among sinus rhythm,RBBB and pacing group(P