Objective To study the effect of circumferential pulmonary vein isolation(CPVI) guided by Carto-Merge and Lasso catheter for the treatment of atrial fibrillation(AF).Methods Fifty-six drug refractory patients(41 male) with paroxysmal AF were enrolled into this study with a mean age of(58.5?12.7) years.Ostia of pulmonary veins(PVs) were identified by Carto-Merge.Then circumferential pulmonary vein isolation was performed.The endpoint of ablation was abolishment or dissociation of the pulmonary vein potentials(PVPs).Results Mean distance between electroanatomic mapping points and MRI surfaces was(1.79?0.33) mm as a whole in this group.Abolishment or dissociation of PVPs was accomplished in 52 patients(92.9%) during the first procedure.After a mean(18.3?5.7) months of follow up,41 patients(73.2%) maintained sinus rhythm.Ten patients received a second ablation procedure,and 8 were free of atrial tachyarrhythmias after a mean(8.2?6.9) months of the second follow up.No PV stenosis was identified after ablation procedure.Conclusion Combination of Lasso catheters with Carto-Merge to guide the CPVI procedure can confirm the isolation of PVs and lower the incidence of PVs stenosis.

In order to realize the seamless connection between superior and inferior medical institutions and simplify the process of patient referral to superior medical hospitals from the community medical institutions,Zhenjiang First People's Hospital designs a two-way referral platform for direct registration to Zhenjiang First People’s Hospital from community medical institutions.The paper introduces the design process,features and realization steps of this platform.The platform can realize the sharing of patient information between the community medical institutions and the hospital,facilitate patients' seeing a doctor and improve medical service level.

Objective To compare the surgical modes of cholecystectomy in patients with diabetes mellitus. Methods The intraoperative blood loss, operation time, duration of hospital stay and incidence of complications were respectively compared in 46 patients with diabetes receiving either laparoscopic cholecystectomy (LC, n=23) or open cholecystectomy (OC, n=23). Results In the Group LC and the Group OC, the intraoperative blood loss was (80?23) ml and (120?40) ml, respectively ( t = -4.518 , P = 0.000), the operation time was (45?20) min and (69?28) min, respectively ( t =-3.345, P =0.002), and the hospital stay was (6?2) d and (11?3) d, respectively ( t =-6.651, P =0.000). There were no statistical significances between the two groups in the incidence of complications. Conclusions LC can be performed safely in patients with diabetes mellitus. It offers the advantages over OC in less blood loss, shorter operative time and shorter hospital stay.

Objective To explore the syndrome of vital energy deficiency and blood stasis of CHF rat model. Methods The Wistar male rats were deligated the main stem of left coronary artery. The succeeded twenty rats were cut the diet half from the second week, and swam exhausted every day, compared with normal group. After four weeks, the general condition, heart function, heart construction and NE, PRA, AngⅡ,TXB2, PAI-1 were observed. Results General condition: Model group seemed tired, pelage dimed, tongue ecchymosis, meanwhile breath and heart rate raised. Heart function: There was significant difference between model group and normal group (P

Craniocerebral Trauma ; Earthquakes ; Head ; Humans

OBJECTIVE: To analyze the characteristics of medical malpractice from different grades of hospitals and to explore forensic investigation strategies in assessing medical dispute. METHODS: A total of 206 cases of medical dispute from 2009 to 2010 investigated by the Department of Forensic Medicine in Nanjing Medical University were selected and analyzed according to fault incidence, fault-prone part, and degree of causality in the treatment. RESULTS: Among the 206 cases analyzed, tertiary hospitals, secondary hospitals and primary hospitals showed medium, high and low error rate, respectively. A majority of medical malpractice cases were distributed in the departments of surgery, medicine and gynecology. CONCLUSION The frequency and severity of medical malpractice in primary hospitals were high, which were gradually reduced in tertiary and secondary hospitals.
Dissent and Disputes ; Expert Testimony ; Forensic Medicine ; Gynecology/statistics & numerical data* ; Hospital Departments/statistics & numerical data* ; Humans ; Incidence ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Retrospective Studies ; Time Factors

Adolescent ; Anesthesia ; methods ; Electrocardiography ; Humans ; Hypokalemia ; complications ; physiopathology ; Long QT Syndrome ; etiology ; Male ; Propofol ; adverse effects ; Ventricular Fibrillation ; chemically induced ; physiopathology

Child ; Critical Illness ; Humans ; Status Epilepticus

Objective To evaluate clinical features, therapeutic regimen and prognosis of unexplained rhabdomyolysis. Method Clinical manifestations, therapeutic regimen and prognosis were recorded in 23 patients,who were admitted to The First Affiliated Hospital of Nanjing Medical University 13 to 27 August,2010.The 23 patients were diagnozed as unexplained rhabdomyolysis. Results The patients all presented myalgia of upper body,like neck,waist and back,maybe with asthenia, nausea,dyspnea,abdominal pain, red urine or changed color of urine. Laboratory examination: obviously step-up of creatine kinase [CK: (4655 ± 2556) U/L( normal: 25 ～ 190U/L) AST:(141 ±78) U/L(normal:10～45 U/L),LDH:(348± 127) U/L(normal: 110～ 250 U/L)]and myoglobin[( Mb ＞ 1000 μg/L (normal: 0 ～ 50 μg/L)]. Therapeutic regimen included treatment of the underlying diseases, volume repletion, alkalization and dealing with the complications. No patients developed acute renal failure.All the patients recovered. Conclusions Rhabdomyolysis is a syndrome with different clinical manifestations.However, early diagnosis, proper treatment could prevent serious complications,and prognosis is good.