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

Objective To investigate the effect of tumor necrosis factor alpha ( TNF-?) in combination with Go6976 on murine liver cancer cells (H22). Method H22 cells were divided into two groups. Each group was further divided into four subgroups. Group 1 was treated with TNF-? 0, 20, 40, 60ng/ml. Group 2 was treated with TNF-? 0, 20, 40, 60 ng/ml and Go6976 (4.6 nmol/ml). The apoptotic rate, protein kinase C alpha (PKC-?) expression and phosphorylation-PKC-? (p-PKC-?) were detected by flow cytometer and Western blotting respectively in 4 h, 8 h and 16 h. Result Treated with TNF-? (0, 20, 40, 60 ng/ml) for 4 h, the apoptotic rates of H22 cells were 2. 44% ? 0. 31 % , 1. 80% ? 0. 32% , 2. 73% ?0. 14% and 3. 05% ?0. 78% respectively, with no change on the expression of PKC-? and p-PKC-?; For 8 h, the expressions of PKC-? and p-PKC-? in H22 cells were up-regulated with increasing concentration of TNF-?; When PKC-? was inhibited with Go6976 at the same time, the apoptotic rates of cells increased significantly, being 2. 90% ?0.39%, 7.76% ?0.35%, 11.43% ?1.05% and 12.96% ?2.44% , respectively. Moreover, PKC-? and p-PKC-? were down-regulated accordingly. When H22 cells were treated with TNF-? only or combined with Go6976 for 16 h, the result was similar to that of 8 h; The apoptotic rate dropped in the group in which PKC-? was inhibited by Go6976 with TNF-? at 60 ng/ml, but the proportion of necrotic cells increased. Conclusion TNF-? up-regulates the expression of PKC-? and p-PKC-? in H22 cells. Inhibiting the activity of PKC-? significantly enhances the toxicity of TNF-? to H22 cells.

A novel oral delivery system that TPGS modified docetaxel proniosomes, DTX-TPGS-PN, was developed and the characterization after hydration was observed. Firstly, Doce-TPGS-PN was optimized by investing the factors, including the type of surfactant, methods of adding TPGS, content of TPGS and the molar ratio of span40/cholesterol, which may affecting the particle size, encapsulation efficiency and instantaneous release of drug in the formulation. Then, the morphology, particle size, Zeta potential, encapsulation efficiency and in vitro release of the formulation were evaluated. The result showed that hydrated nanoparticles of DTX-TPGS-PNs were (93 ± 6.5) nm in size,(-83.95 ± 3.69) mV in zeta potential, (97.31 ± 0.60)% in encapsulation efficiency, exhibiting spherical morphology and biphasic release process that a low burst effect within the first 0.5 hour and a relative-sustained release for the next several hours in PBS. These results indicate the oral delivery system of DTX-TPGS-PN was successfully built with good properties.
Chemistry, Pharmaceutical ; methods ; Particle Size ; Polyethylene Glycols ; chemistry ; Taxoids ; chemistry ; pharmacology ; Vitamin E ; analogs & derivatives ; chemistry

Objective: Enteral nutrition was used to correct the malnutrition in the patients suffered from esophageal rupture postoperatively. Methods: The naso intestinal tube was placed during operation and the enteral nutrition was used postoperatively. The albumin, prealbumin and transferrin were measured before and day1, 5, 8 and 12 after operation. Results: All 27 patients were discharged with no death. Albumin, prealbumin and transferrin decreased on the 1st day postoperatively and reached the preoperative level on the fifth postoperativeday. Conclusion: Enteral nutrition plays an important role in the postoperative treatment for esophageal rupture.