Objective To evaluate the results of treatment with the high tibial osteotomy and fixtation with the new Giebel blade plate for osteoarthritis of the knee, and to discuss the indication for this technique. Methods Seventy patients(108 knees), 14 male and 56 female, with an average age of 59.6 years (range 38-76)were reviewed. The average postoperative follow up was 12 months (from 6 to 20 months ). Pain was complained chiefly in the medial aspect of the knee joint and the majority of patients had slight degree of genu varum. This new Giebel blade plate acts as a tension band when it is placed on the site for fixation, the proximal tibial fibular joint was not exposed during surgery so that the fibular head was well preserved, avoiding common peroneal nerve injury. The periosteum opposite to the incision position was left intact for the sake of the stability and acted as a hinge around which the wedge osteotomy was closed. AP and lateral radiography of knee joint was taken pre and post operation for comparison. Results During the follow up, the patients show satisfied pain relief, improvement of joint function, correction of the deformity either genu varum or valgum. Earlier rehabilitation exercise should be carried out and the complication was rare. Conclusion The characteristics of this method are its convenient application, the stable fixation and the well preserved joint function. The advantage of high tibial osteotomy was shown sufficiently by the use of Giebel blade plate.

Objective To explore the effect of Ferroprotin 1 expression on tumorigenesis,invasiveness and survival of breast cancer.Methods In this study,100 breast cancer patients were enrolled.IHC SP was used to detect the expression of Ferroprotinl in paraffin-embedded tissues.The `association of Ferroprotin 1 expression and clinico-pathological parameters was evaluated by chi-square test.Survival analysis was calculated by Kaplan-Meier model and Log-rank test.Results The expression of Ferroprotin 1 was significantly higher in para-cancerous normal tissues (37/100,37％ ) than that in breast cancer tissues (24/100,24％ ;P =0.046 ).In these with positive axillary LN,there were more with low expression level of Ferroprotin 1 ( 36/40,90％ ) than those with high expression level ( 4/40,10％ ),P =0.007.More patients with low Ferroprotin1 were at advanced stage than those with high ferroprotin1 [Ⅲ 44/57 (77.2％) ;Ⅳ 17/18 ( 94.4％ )]( P =0.05 ).No significant association was found between ferroprotin1 and tumor grade,histology type,ER/PR,HER2,tumor size (P＞0.05).Ferroprotin1 has no significant effect on breast cancer survival ( P =0.591 ) by Kaplan-Meier curve and Log-rank test.Conclusions Low Ferroprotin 1 may lead to the tumorigenesis of breast cancer.Downregulated Ferroprotin1 promotes the LN involvement of breast cancer and accompanies with more advanced disease.However Ferroprotinl might not play an important role in the survival of breast cancer.

OBJECTIVETo explore if CHA2DS2 VASc score can predict substrate for persistent atrial fibrillation ( AF) and outcome post catheter ablation of AF.

METHODSFrom January 2011 to December 2012,116 patients underwent catheter ablation of persistent AF in our department and were enrolled in this study. CHA2DS2VASc score was calculated as follows: two points were assigned for a history of stroke or transient ischemic attack and age ≥ 75 and 1 point each was assigned for age ≥ 65, a history of hypertension, diabetes,recent cardiac failure, vessel disease, female. Left atrial geometry ( LA) was reconstructed with a 3.5 mm tip ablation catheter with fill-in threshold 10 in CARTO system. The mapping catheter was stabled at each endocardial location for at least 3 seconds for recording. The electrogram recordings at each endocardial location were analyzed with a custom software embedded in the CARTO mapping system. Interval confidence level (ICL) was used to characterize complex fractionated atrial electrograms (CFAEs) . As the default setting of the software, ICL more than or equal to 7 was considered sites with a highly repetitive CFAEs complex. CFAEs index was defined as the fraction of area of ICL more than or equal to 7 to the left atrial surface. The CFAEs index and outcome of catheter ablation among different CHA2DS2VASc groups were compared.

RESULTSOf the 116 patients, CHA2DS2VASc was 0 in 33 patients, 1 in 31 patients and ≥ 2 in 52 patients. Left atrial surface ((121.2 ± 18.9) cm2, (133.6 ± 23.8) cm2, (133.9 ± 16.1) cm2, P = 0.008), left atrial volume ((103.6 ± 24.8) ml, (118.3 ± 27.8) ml, (120.9 ± 20.9) ml, P = 0.005) and CFAEs index (44.6% ± 22.4%, 54.2% ± 22.2%, 58.7% ± 23.1%, P = 0.023) increased in proportion with increasing CHA2DS2VASc. ICLmax, ICLmin and CFAEs spatial distribution were similar among the three groups. During the mean follow-up of (13 ± 8) months, the recurrence rate were 36.4%, 35.5%, 55.8% among the three groups (P = 0.025).

CONCLUSIONA high CHA2DS2VASc score is associated with extensive AF substrate and higher recurrence rate post catheter ablation of persistent AF.

Aged ; Atrial Fibrillation ; Catheter Ablation ; Electrophysiologic Techniques, Cardiac ; Female ; Heart Atria ; Heart Failure ; Humans ; Hypertension ; Recurrence ; Stroke ; Treatment Outcome

OBJECTIVETo evaluate the efficacy of catheter ablation in Chinese hypertrophic cardiomyopathy (HCM) patients with atrial fibrillation (AF), and to determine the risk factors of AF recurrence.

METHODSThis study enrolled 40 HCM patients with AF who underwent primary AF ablation at Beijing Anzhen Hospital from June 2005 to June 2013. Ablation strategy included bilateral pulmonary vein isolation (PVI) for paroxysmal AF (n = 27) and PVI plus left atrial roof, mitral isthmus and tricuspid isthmus linear ablations for persistent AF (n = 13). AF recurrence was followed-up by means of electrocardiography or Holter monitoring. Risk factors associated with AF recurrence were determined by a Cox regression model and the predictive power was evaluated by receiver operating characteristic (ROC) curve.

RESULTSAfter (34 ± 18) months follow-up, 30% (12/40) cases remained in sinus rhythm off antiarrhythmic drug, most AF recurrence (18/28, 64.3%) occurred within 1 year post ablation. Multivariate Cox regression demonstrated that left atrial dimension (LAD, HR = 1.124, 95% CI 1.051-1.202, P = 0.001) and female gender (HR = 3.304, 95% CI 1.397-7.817, P = 0.007) were independent risk factors of AF recurrence. The cut-off value of LAD at 43.5 mm predicted AF recurrence with sensitivity of 93.5% and specificity of 60.0%. Every 1 mm enlargement in LAD was associated with an increased risk of arrhythmia recurrence (HR = 1.095, 95% CI 1.031-1.163, P = 0.003).

CONCLUSIONSAF ablation in Chinese HCM patients is safe and feasible. However, sinus rhythm maintenance rate is low at long-time follow-up. Most of the recurrent AF occurs within 1 year post AF ablation procedure. Left atrial diameter and female gender are independent risk factors of AF recurrence.

Anti-Arrhythmia Agents ; Atrial Fibrillation ; pathology ; therapy ; Beijing ; Cardiomyopathy, Hypertrophic ; Catheter Ablation ; Electrocardiography ; Electrocardiography, Ambulatory ; Female ; Heart Atria ; anatomy & histology ; Humans ; Male ; Pulmonary Veins ; ROC Curve ; Recurrence ; Risk Factors ; Sensitivity and Specificity ; Treatment Outcome