Objective To evaluate the safety and effectiveness of circumferential pulmonary vein(PV) isolation in cases with persistent/permanent atrial fibrillation(AF) guided by the EnSite-NavX system.Methods Sixty cases(43 males,mean age 59.2?13.6 years) with persistent/permanent AF were enrolled from September 2004 to August 2005.The mean duration of AF was 4?6 years(6 months-24 years).The mean left atrium diameter was 43.2?6.4(42-58)mm.Circumferential PV isolation was performed guided by the EnSite-NavX system,combined with linear ablation of the superior-posterior wall of left atrium and mitral isthmus.Results All 60 cases underwent the procedure successfully,with the mean procedural time 170?34(150-240)min and the mean fluoroscopic time 23?10(12-45)min.The pulmonary vein isolation rate for the left ipsilateral PVs was 83.3% and was 78.3% for the right PVs.Segmental ostial ablation was applied for the rest cases.AF was terminated in 7 cases and was converted to atrial tachycardia(AT) or atrial flutter(AFL) in 5 cases.Sinus rhythm was restored by cardioversion in 48 cases.Post-ablation AT/AFL was documented in 10 cases (16.7%) which diminished automatically in 8 cases,and was abolished by re-ablation in 2 cases.After a mean of 6.5?3.2(4-11)months of follow-up,43 cases (71.7%) were free of AF(18 cases with anti-arrhythmic drugs).Complications: pseudo-aneurysm of femoral artery was found in 1 case and was cured after proper treatment.Conclusion Circumferential PV isolation and combination with left atrial linear ablation guided by the EnSite-NavX system was safe and effective for eliminating persistent/permanent AF.

Objective To determine the expression of peroxisome proliferators-activated receptors (PPARs), nuclear factor-κB (NF-κB) and activity of superoxide dismutase (SOD) in rats with obstructive jaundice induced by bile duct ligation (BDL) and elucidate the molecular regulation mechanisms of hepatic injury due to obstructive jaundi(c)e. Methods All rats were sacrificed on the 7th day and 19th day after BDL and blood and liver tissue samples were obtained. SOD enzyme activity was detected by SOD kit. RT-PCR was performed to determine the mRNA expression of PPARs in all groups. The detection of PPARs protein and activation of NF-κB were performed using an immunohistochemical method. Results The activities of normal SOD and CuZn-SOD were decreased compared to the sham group (P＜0.01), and the decrease on 19th day after BDL were more significant. The level of PPARs expression in the BDL groups liver except the PPARβ in the BDL 7th group was reduced compared to the sham group (P＜0.01), and the level on the 19th day after BDL were more significantly reduced. PPARs protein expression was significantly inhibited (P＜0.01) in the sham group. SOD in BDL groups had significant positive correlation as compared with PPARs protein expression (P＜0.01), but NF-κBp65 protein expression had significant negative correlation as compared with PPARs protein expression (P＜0. 01). Conclusion PPARs are inhibited in expression level, and this inhibition becomes more significant as the pathological process progresses. PPARs might be key regulatory factors for SOD and NF-κB. The low expression of PPARs might be one of the important molecular mechanisms in liver injury due to obstructive jaundice.

AIM: To study the inducing effect of human mutant p27 gene on apoptosis of the colorectal cancer cells. METHODS: The recombinant adenovirus Ad-p27mt was constructed to infect the colorectal cancer cell SW480. The inducing effect of Ad-p27mt on apoptosis in colorectal cancer cells was measured by flow cytometry, DNA fragment analysis and TUNEL method. RESULTS: Ad-p27mt was successfully constructed. When the multiplicity of infection (MOI) was ≥50, the infection efficiency reached 100%. After 24 h of infection, there was an apoptotic hypodiploid peak observed by flow cytometry before G_1 and there were apoptotic characteristic bands in the DNA electrophoresis. The apoptotic index detected by TUNEL method was 82.6?3.2 (Ad-p27mt group) and 5.0?3.5 (control group), respectively, the difference of which was significant (P

Objective To investigate the effect of letrozole in decreasing the early-stage ovarian hyperstimulation syndrome (OHSS) occurrence during the luteal phase for patients of OHSS high-risk after oocyte retrieval.Methods A total of 176 high-risk OHSS patients were randomly divided into two groups after oocyte retrieval.Patients in experiment group (n=86) received 5 mg letrozole per day from the retrieval day and last for 5 days.Others in control group (n=90) received placebo.The serum concentration of FSH,LH,estradiol (E2),progesterone (P) and vascular endothelial growth factor (VEGF) from the day of hCG injection to days after injection (5 days,8 days,10 days) were measured.And the incidence of moderate and severe OHSS was observed.Results The concentration of E2 on the indicated days (5 days,8 days,10 days after hCG injection) in experiment group and control group were (5 727±2 089) versus (11 826±4 281) pmol/L,(1 613±879) versus (7 925±3 507) pmol/L,(193±90) versus (1 628±888) pmol/L; the concentration of VEGF on the indicated days in the two groups were (80± 14) versus (108± 19) ng/L,(66± 11) versus (126± 14) ng/L,(48±7) versus (148± 14) ng/L; the concentration of E2 and VEGF were lower than those in control group (all P＜0.01).The FSH concentration in experiment group were (2.1 ± 1.1) and (3.5± 1.3) U/L on the day of fifth and eighth day after hCG injection,which were significantly higher than (0.7±0.3) and (0.7±0.4) U/L in control group (P＜0.05); the LH concentration in experiment group were (0.26±0.19) and (0.72±0.60) U/L on the day of fifth and eighth day after hCG injection,which were significantly higher than (0.11 ±0.03) and (0.14±0.08) U/L in control group (P＜0.05).The incidence of moderate and severe OHSS was signicantly decreased after letrozole treatment compared with control group [2％ (2/86) versus 12％ (1 1/90),P＜0.05].Conclusion Administration of 5 mg/d letrozole for 5 days during the luteal phase can reduce the E2 and VEGF levels for the high-risk OHSS patients who needed cryopreserve all embryos,and also reduce the occurrence of early OHSS.

Objective To investigate the appropriate cross-matching methods for the direct antiglobulin test (DAT)positive patients.Methods The DAT was used to screen the irregular antibodies on the surface of erythrocytes.The microcolumn gel test was used for blood identification.The antiglobulin test and manual polybrene test were used for cross-matching.Re-sults A total of five DAT positive cases were collected in study.The blood groups of each case were detected,including A-DCcEe,O-DCCee,O-DCcee,A-DCCee and A-DCcee.The donor samples with corresponding blood-antigen negative were cho-sen for cross-matching,and the agglutination intensity of each cross-matching tube was weaker than the control.The transfu-sion of washed red blood cells was suggested.Finally,each transfusion was safe and efficient.Conclusion The infusion of the washed red blood cells with corresponding blood-antigen negative could efficiently ensure the safety of blood transfusion.

BACKGROUND: Ethanol chemical damage method can be used to establish thin endometrium rat model. Expression of proliferation-related proteins is decreased in thin endometrium animal model, which contributes to the study of thin endometrium-related mechanism and provides guidance for clinical treatment. OBJECTIVE:To explore the changes in vimentin and vascular endothelial growth factor expression in rat modelsof high concentrations of ethanol-induced thin endometrium. METHODS: 0.3 mL 95% ethanol was slowly injected in the right uterus of female Sprague-Dawley rats to establish rat models of thin endometrium. An equal volume of physiological saline was injected into the left uterus as control sides. RESULTS AND CONCLUSION:The thickness of endometrium in the injured uterus was significantly thinner than the control ones. Number of glands reduced, structure became disorder, and vimentin and vascular endothelial growth factor expression markedly diminished. These results suggest that 95% ethanol injury can effectively establish rat models of thin endometrium. Proliferation-related protein expression altered in the thin endometrium.

BACKGROUND: The incidence rate of colon cancer is on an obvious increase. Previous treatments are primarily surgical therapy; radiotherapy and chemotherapy. Gene therapy has been applied in the clinical practice for treating colon cancer.OBJECTIVE: To construct replication deficient hp27mt recombinant adenovirus and detect its expression in SW480 cell in order to investigate the viability of gene therapy based on adenovirus and study the anti-tumor characteristic of mutant p27.DESIGN: A non-randomized controlled trial.SETTING: Department of Gastroenterology, Affiliated People' s Hospital of Yunyang Medical College, Institute of Clinical Medical Science of Yunyang Medical College; Department of Gastroenterology, Zhongnan Hospital of Wuhan University.MATERIALS: The experiment was conducted in the Institute of Clinical Medicine, Yunyang Medical College from January 2002 to September 2003. Restriction endo-nucleases Age Ⅰ, Nhe Ⅰ, Kpn Ⅰ, Pac Ⅰ and Pme Ⅰ;Taq polymerase; T4 DNA ligase; Western blot kit; mouse anti-human p27kipl polyclonal antibody, horseradish-peroxidase conjugated goat anti mouse second IgG monoclonal antibody; pORF9-hp27mt plasmid, adenovirus framework plasmid pAdeasy-1, shuttle plasmid pShuttle-CMV, LacZ recombinant adenovirus Ad-LacZ, liposome, colon cancer cell line SW480.METHODS: hp27mt was excised from vector pORF9-hp27mt by restriction endonucleases, and inserted into shuttle plasmid pShuttle-CMV after two cycles of subclone, forming plasmid pShuttle-CMV-hp27mt. Then it was transformed by linear terminus(cut by PmeI) plasmid pShuttle-CMV-hp27mt into competent E. coli BJ5183 which contained adenovirus framework plasmid pAdeasy-1 to ensure that homologous recombination occurred. After correct identification of the transformant, it was digested by PacⅠ and transfected Ad293 cells, and packed into recombinant adenovirus Ad-hp27mt. Recombinant adenovirus was identified by polymerase chain reColon cancer cell line SW480 was infected with recombinant adenovirus Ad-p27mt, and expression of p27 protein was detected by Western blot.of expressed p27 protein after Ad-p27mt transfected colon cancer cell.novirus framework plasmid pAdeasy-1 with pShuttle-CMV-hp27mt, 30%combinant adenovirus DNA contained the target gene. Virus titer of the recancer cells, p27 was highly expressed in SW480 cells, as compared to low expression in non-transfected cells and Ad-LacZ transfected cells.CONCLUSION: Adenovirus, a type of gene transferring vector, can efficiently mediate p27 expression in tumor cells, which provides effective gene transfecting carrier for treating colorectal cancer with mutation p27 gene.

Objective Measurement of ankle brachial index (ABI) is a simple method of assessing lower limb arterial blood supply,while measurement of toe brachial index (TBI)has only been advocated as an alternative.The aim of this study was to obtain information about whether TBI should be taken in type 2 diabetes,even when ABI is normal,and to evaluate the relationship between TBI and atherosclerosis.Methods In a crosssection study,ABI,TBI,and carotid intimal-medial thickness (IMT) were measured on 979 outpatients with type 2 diabetes in Ruijin Hospital.Those with normal ABI (0.9 ≤ABI ＜ 1.3,n = 945) were divided into two groupsnormal TBI group(TBI≥0.6,n=893) and low TBI group(TBI＜0.6,n=52),and then the clinical and laboratory data were compared between these two groups.Furthermore,the relationship between TBI and atherosclerosis was investigated.Atherosclerosis was defined as the maximum IMT ≥ 1.1 mm.Results Low ABI and low TBI were detected in 1.3% and 6.6% of the patients,respectively.Comparison of the clinical and laboratory data between the two groups showed that age and HbA1C values were significantly higher in the low TBI group.Furthermore,TBI was inversely associated with IMT(β=-0.217,P＜0.01),an indicator for atherosclerosis of the carotid artery.Multiple logistic regression analysis revealed that decline of TBI was an independent risk factor of atherosclerosis (OR=1.30,95% CI 1.01-1.69,P＜0.05).Conclusion In type 2 diabetes,the decline of TBI is associated with atherosclerosis,indicating the necessity for diabetic patients to detect TBI,even when ABI is within normal range,in order to detect peripheral artery disease in early stage,and reduce the risk for atherosclerosis.

Objective To examine the advanced oxidation protein products (AOPP) in patients with acute coronary syndrome(ACS) and discuss the relationship between oxidative stress with the development of atherosclero-sis(AS). Methods Plasma were collected in 59 acute myocardial infarction (AMI) patients including 35 patients underwent selective PCI,24 patients underwent emergency PCI,43 unstable angina pectoris(UA) patients and 10 non-coronary artery disease (non-CAD) patients. All cases underwent coronary angiography (CAG). Plasma was collected immediately,post-24 hours and post-48 hours after admission. AOPP was determined by measurements of absorbance (A) at 340 nm under acidic conditions via spectrophotometry. Results AOPP was (236.42±30.41) ( n = 35 ), ( 207.84±29.50 ) mmol/L ( n = 35 ), ( 227.79 ± 35.18 ) mmol/L ( n = 31 ) respectively immediately, post-24 hours and post-48 hours after admission in AMI ( selective PCI ), ( 239.95 ±39.94 ) mmol/L ( n = 43 ), (175.92 ±29.46) mmol/L(n =38) ,and (156.54 ±28.29) mmol/L(n =35) in UA group and (57.41 ± 13.60) mmol/L( n = 9 ), (56.11 + 11.90) mmol/L ( n = 10 ) and ( 61.75 ± 12.28 ) mmol/L ( n = 8 ) in non-CAD group. Compared with normal group ( without CAD ) , significantly higher plasma AOPP was detected in AMI ( selective PCI) and UA patients ( P < 0.05 ). AOPP level was significantly increased in AMI selective PCI patients as compared with that of emergency PCI group immediately and post-24 hours after admission( P <0.01 ) ,and post-48 hours after admission( P < 0.05 ), but there was no statistical significance between emergency PCI and UA group( P > 0.05 ). Conclusions Oxidative stress is an important step in the development of atherosclerosis, and the higher levels of AOPP in ACS patients show that AOPP may be as good markers in these patients.