0.8 mm) of carotid artery in patient group (42.3%) were more than those in control group (7.4%)((P45 yrs).Conclusion Cerebral infarction in young and middle-aged patients is closely related to atherosclerosis of carotid artery.

Objective: To explore the effects of cardiac resynchronization therapy (CRT) in patients with dispersion of re-polarization and ventricular arrhythmia.
Methods: A total of 86 consecutive patents with CRT implantation were enrolled. According to weather absolute value of LVEF increased≥10% from baseline at 6 months after CRT implantation, the patients were divided into 2 groups: Response group and Non-response group,n=43 in each group. Dispersion of re-polarization indexes as QRS duration, QTc interval, TpTe interval and the events of ventricular arrhythmia were compared between 2 groups at different time points after CRT.
Results:①In Response group, compared with pre-operation, QRS duration and TpTe interval were shorter at 1 year and within 24h after CRT implantation, allP<0.05, while the above indexes were similar in Non-response group, allP>0.05.②During 1 year after CRT implantation, the incidences of PVCs and PVC runs in Response group were much less than those in Non-response group, for lgPVCs: (1.78 ± 0.77) vs (2.73 ± 0.61), for lgPVC runs: (0.64 ± 0.48) vs (1.98 ± 0.72),P<0.05.③Multi liner regression analysis demonstrated that TpTe interval within 24h after CRT implantation was an independent predictor for both lgPVCs: (B=0.143, OR=1.154,P=0.001) and lgPVC runs: (B=0.122, OR=1.047,P=0.001).
Conclusion: CRT ventricular reverse remodeling may reduce dispersion of re-polarization and the risk of ventricular arrhythmia, therefore improve the prognosis in relevant patients; TpTe interval within 24h after CRT had the predictive value for ventricular arrhythmia.

In order to provide the maximum benefit of cardiac resynchronization therapy (CRT), we tried to use an echocardiography method to optimize the atrioventricular and interventricular delay. Methods The study included 6 patients who underwent implantation of biventricular pacemakers for drug-resistant heart failure. Two-dimensional echocardiography and tissue Doppler imaging were carried out before and after the pacemaker implantation. The optimal AV delay was defined as the AV delay resulting in maximum timevelocity integral (TVI) of transmitral filling flow, the longest left ventricular filling time (LVFT) and the minimum mitral regurgitation(MR). The optimal VV delay was defined as the VV delay producing the maximum LV synchrony and the largest aortic TVI. Results CRT was successfully performed in all patients. After pacemaker implantation, an acute improvement in left ventricular ejection fraction (LVEF) was observed from 26.5% to 35%. Meanwhile, the QRS duration decreased from 170ms to 150ms. The optimal AV delay was programmed at 130, 120, 120, 120, 150 and 110ms respectively with heart rate corrected, LVFT significantly lengthened and TVI of MR decreased (non-optimal vs optimal AV delay: LVFT: 469ms vs 523ms; TVI of MR: 16.43cm vs 13.06cm, P＜0.05). The optimal VV delay was programmed at 4, 4, 4, 8, 12 and 8ms with LV preactivation respectively. Programming the optimal VV delay increased the aortic TVI from 17.33cm up to 21.42cm (P＜0.05). In the septal and lateral wall, peak systolic velocities improved from2.70cm/s to 3.02cm/s (P＞0.05) and froml.31cm/s to 2.50cm/s (P＜0.05) respectively. The septal-to-lateral delay in peak velocity improved from 56.4ms to 13.3ms after CRT (P＜0.01). Conclusions Optimization of AV and VV delays may further enhance the efficacy of CRT. However, there was interindividual variability of optimal values, warranting individual patient examination.

Background and objectives Right ventricular apical (RVA) pacing has been reported impairing left ventricular (LV)performance. Alternative pacing sites in right ventricle (RV) has been explored to obtain better cardiac function. Our study was designed to compare the hemodynamic effects of right ventricular septal (RVS) pacing with RVA pacing. Methods Ten elderly patients with chronic atrial fibrillation (AF) and long RR interval or slow ventricular response (VR) received VVI pacing. The hemodynamic difference between RVS and RVA pacing were examined by transthoracic echocardiography (TTE). Results Pacing leads were implanted successfully at the RVA and then RVS in all patients without complication. The left ventricular (LV) parameters,measured during RVA pacing including left ventricular ejection fraction (LVEF), FS, stroke volume (SV) and peak E wave velocity (EV) were decreased significantly compared to baseline data, while during RVS pacing, they were significantly better than those during RVA pacing. However, after 3-6 weeks there was no statistical significant difference between pre- and post- RVS pacing.Conclusions The LV hemodynamic parameters during RVA pacing were significantly worse than baseline data. The short term LV hemodynamic parameters of RVS pacing were significantly better than those of RVA pacing; RVS pacing could improve the hemodynamic effect through maintaining normal ventricular activation sequence and biventricular contraction synchrony in patients with chronic AF and slow ventricular response.

Objective To prepare the multi-functional ultrasound contrast agents,which were investigated for ultrasound(US)/MR dual-mode imaging and high-intensity focused ultrasound(HIFU)synergism in vitro.Methods Double emulsion method was used to prepare the superparamagnetic iron oxide(SPIO)-loaded PLGA microcapsules(s-PLGA),and its morphology,size,Fe3O4 loading capacity were assessed.Then,the prepared s-PLGA microcapsules with different concentrations were applied to perform ultrasound and MR imaging in vitro.In addition,the degassed bovine liver in vitro was directly injected into 200 μl s-PLGA in saline(0.5 mg Fe/ml)just before HIFU ablation,the saline(200 μl)and pure PLGA (200 μl)were employed for control.After HIFU ablation,the volume of coagulated tissue irradiated by HIFU was calculated.Results The s-PLGA microcapsules were observed with regular spherical morphology and its average size was(885.6 ± 133.2)nm.In vitro,the s-PLGA showed hyperechogenicity in US imaging and MR negatively enhanced effeet in T2WI,the volume of coagulated tissue irradiated by HIFU after local injection of s-PLGA was larger than that of saline and pure PLGA(P＜0.05).Conclusions The prepared s-PLGA microcapsules are successfully acted as dual-mode biological imaging contrast agents for ultrasound and MR imaging and HIFU synergism in vitro.

Objective: To analyze the clinical features and outcomes of cardiac resynchronization therapy (CRT) in patients with dilated-phase hypertrophic cardiomyopathy (DHCM). Methods: A total of 16 DHCM patients received CRT in our hospital from 2007-03 to 2016-01 were retrospectively studied to analyze their clinical features and outcomes. Results: There were 12 male and 4 female patients at the mean age of (53.3±13.5) years. Pre-operative QRS duration of ECG was (158.7±32.2) ms, left ventricular ejection fraction (LVEF) was (33.6±6.3) %, the patient with NYHA class I, II, III and IV were 1, 5, 8 and 2 respectively. 13 patients received new CRT device, 3 received upgraded device and 8 (50%) combining atrial fibrillation (AF). The patients were followed-up for (2.56±2.13) years, 5 of them died including 3 of heart failure, 1 of sudden death and 1 of stroke. At 6 months follow-up time, 7 patients had the response to CRT which was defined by the improvement of NYHA class≥1 and the absolute elevation of LVEF≥5%; NYHA class improved from (2.69±0.79) to (2.38±0.89), P=0.02; LVEF increased from (33.6±6.3) % to (40.03±9.83) %, P=0.01. Conclusion: DHCM patients with CRT indication had the higher incidence to suffer from AF, those were more in patients with traditional pacemaker or ICD upgrading. DHCM patients with CRT had the poor general prognosis, while there was still certain proportion of patients had the response to CRT.

To analyze the predictors and prognosis for super-response to cardiac resynchronization therapy (CRT) in patients with different etiology. Methods: A total of 181 patients received CRT in our hospital from 2012-01 to 2016-01 were enrolled. The patients were divided into 3 groups: Non-response group, n=63, Response group, n=62 and Super-response group, n=56. The patients were followed-up at 6 months after CRT. Results: There were 30.9% (56/181) patients having super-response. Compared with the other 2 groups, Super-response group had more patients with NYHA II-III and less NYHA IV, the patients were with the smaller LAD, LVESD, LVEDD andless patients had CRT-D implantation. The baseline cardiac function was obviously improved at 6 months after CRT in all 3 groups. The basic LVEDD, LVESD, CRT-D implantation, non-ischemic cardiomyopathy (NICM) and NYHA IV were the independent predictors for super-response occurrence. In addition, compared with ischemic cardiomyopathy (ICM), NICM patients had the higher ratio for super-response occurrence (37.6% vs 7.5%), P<0.001. Survival analysis indicated that NICM patients had the lower risk of all cause mortality (HR=0.31, 95% CI 0.14-0.80), cardiac death (HR=0.27, 95% CI 0.09-0.48) and combined endpoints (HR=0.36, 95% CI 0.27-0.78). Conclusion: At baseline condition, the patients with less degree of left ventricular reconstruction, CRT-D implantation, NICM and NYHA IV had more chance to suffer from super-response after CRT. NICM patients had the better response and prognosis to CRT.

Objective To investigate the correlation between retinal deformation degree and retina thickness (RT) detected by optic coherent tomography (OTC) in patients with idiopathic macular epiretinal membrane (IMEM). Methods The 66 eyes (56 patients) with IMEM diagnosed by OCT were retrospectively analyzed in this study. After best corrected visual acuity (BCVA), ocular fundus and OCT examination, patients were divided into three groups (mild, medium and severe) according to retinal deformation degrees. The RT value was measured manually. Results There were significant differences in RT values between mild, moderate and severe groups:(311.95 ±51.78) μm, (447.13±41.95) μm and (560.00± 58.23) μm (P<0.05). The values of BCVA were 0.78±0.16, 0.38±0.12 and 0.27±0.14 for mild, moderate and severe groups, there were significant differences between them (P<0.05). There was no significant correlation between RT and BCVA in mild group (r=-0.352,P=0.128). There was negative correlation between RT and BCVA in medium group and serious group (r=-0.768 and-0.482,P<0.05). Conclusion The retinal deformation degree and RT are two objective indicators to assess visual performance in patients of IMEM. When RT is more than 400 μm, it can be used as objective criteria for surgical intervention.

s E in Beijing belong to HEV genotype Ⅳ.

Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. At present, the situation of tuberculosis control in China and even the world is severe. Bacillus Calmette-Guerin (BCG) vaccine is the only approved vaccine for tuberculosis, but its protective effect is limited. Hence, it is imperative to develop more effective tuberculosis vaccines. Currently, many new tuberculosis vaccine candidates are in clinical or preclinical trials. In this paper, to provide reference for the development of tuberculosis vaccines in China, the status of the research on vaccine candidates were reviewed and the progress in new tuberculosis vaccine strategies were summarized.