Objective To investigate the effect of treatment time with amiodarone hydrochloride on treatment success rate of ventricular premature beats after radiofrequency ablation. Methods 46 cases of patients with frequent premature ventricular arrhythmia who received RFCA for the first time in department of gardiology,huangyan hospital of wenzhou medical university from February 2013 to February 2015 were selected,and randomly divided into two groups,the control group were treated with amiodarone hydrochloride for one months,the study group were treated with amiodarone hydrochloride for six months.Left ventricular function and structural parameters,heart rate variability were measured in two groups,the main clinical symptom scores,success rate,efficacy and safety were compared. Results Compared with before treatment,two groups of LVESD,LVEDD and PVC decreased (P<0.05),LVEF increased (P<0.05),SDNN,rMSSD,PNN50,LF and HF increased (P<0.05),scores of palpitation,shortness of breath,chest tightness and main symptom score decreased (P<0.05).Compared with the control group,level of PVC in the study group was lower (P<0.05),LVEF was higher(P<0.05),LVESD and LVEDD were had no significant differences,levels of SDNN,rMSSD,PNN50,LF,HF were higher (P<0.05),scores of palpitations,shortness of breath,chest tightness main symptom score were lower (P<0.05).There were no significant differences in the success rate, clinical efficacy and adverse reaction rate between the two groups. Conclusion The time of taking amiodarone after radiofrequency catheter ablation in patients with PVCs,but taking six months and medication compared to one month,can reduce heart palpitations,chest tightness and other symptoms,and improve left ventricular function,with high security.

Objective To observe the clinical efficacy of atorvastatin combined with neuroendocrine antagonist in the treatment of chronic heart failure.Methods 70 patients of Wenzhou Medical College Theorem Clinical College of Cardiology Department from March 2014 to March 2015 were randomly divided into observation group and control group of 35 cases in each group.The control group were given the neuroendocrine antagonist, observation group were given atorvastatin combined with neuroendocrine antagonist treatment. The changes of related indicators were recorded. Results The aminoterminal pro-brain natriuretic peptide (NT-ProBNP) and ejection fraction in observation group were [(1264.7 ±174.6)pg/mL, (0.58 ±0.07)], which were higher than those in control group [(2106.5 ±164.8)pg/mL,(0.49 ±0.08)](P<0.05).The total effective rate in observation group was 91.43%, which was higher than 71.43%in control group(P<0.05).Conclusion Atorvastatin joint neuroendocrine antagonist in treatment of chronic heart failure has clinical exact effect with no significant side effects.

Objective To investigate the prevention effect of Ezetimibe with loaded dose on hematologic parameters and re-infarction in patients undergoing PCI.Methods 240 cases of patients with non ST segment elevation myocardial infarction performed PCI from October 2012 to October 2014 were selected and randomly divided into two groups,the control group received conventional dose Ezetimibe 10 mg every time,qd,the study group received loading dose ezetimibe 20 mg every time, qd, both two groups treatment 30 days.The inflammatory factors, myocardial injury and vascular endothelial function were compared before, 24 h and 30 d after the operation, and patients were followed up for two years,record adverse reactions. Results Compared with before treatment,levels of serum inflammatory factor,myocardial injury and vascular endothelial function index in different time points had differences by single factor analysis of variance(P<0.05),and compared with the control group, levels of serum hs-CRP,TNF-α,IFN-γand IL-6 in the study group were lower, levels of serum CK-MB,cTnI and BNP were lower,the contents of ET in serum were lower,and the contents of NO were higher(P<0.05).The improvement degree in the study group of myocardial microcirculation perfusion after treatment was higher(P<0.05).No case shedding phenomenon occurred during the two year follow-up, and there was no statistical significance in the incidence of cardiovascular events between two groups.Conclusion Loading dose of ezetimibe can protect myocardium,and it can inhibit the inflammatory reaction and vascular endothelial injury caused by operation,it also can improve myocardial microcirculation.

A case of hereditary hemorrhagic telangiectasia was reported. Repeated hemorrhage in nasal and digestive system are main clinical manifestation. Capillary expanded on tongue and finger is the main physical sign. Main clinical manifestation and typical physical signs, combined with family history, can help to establish a diagnosis.
Humans ; Male ; Middle Aged ; Pedigree ; Telangiectasia, Hereditary Hemorrhagic ; genetics

Objective: To investigate the molecular transmission network characteristics of HIV-1 among men who have sex with men (MSM) in Shaoxing City, Zhejiang Province, so as to provide insights into AIDS prevention and control among MSM. Methods: Newly reported HIV/AIDS cases among MSM in Shaoxing City were selected from January 2021 to September 2023. Plasma samples before the antiviral treatment were collected. The HIV-1 pol gene was amplified using reverse transcription PCR and nested PCR to construct phylogenetic trees for gene subtype analysis. The HIV-TRACE method was used to construct a molecular transmission network with a genetic distance of 1.5% to analyze clustering and the characteristics of cases within molecular clusters. Results: A total of 216 HIV/AIDS cases among MSM were included, and 179 qualified sequences were obtained. The predominant HIV-1 subtypes were CRF07_BC and CRF01_AE, with 95 and 66 cases, respectively. At 1.5% genetic distance, 20 molecular clusters were formed, with 61 nodes and 58 edges. A total of 61 sequences were connected to the transmission network (34.08%). HIV/AIDS cases among MSM from all the counties (cities, districts) in Shaoxing City were included in the network. There was the largest molecular cluster with ≥10 nodes, involving 12 cases from five counties (cities, districts), 3 medium-sized molecular clusters with 4 to 5 nodes, and the 16 small-sized molecular clusters with 2 or 3 nodes. Seven cases with high risk of transmission, each with ≥4 edges, were all CRF07_BC subtypes. Among them, two cases were from the large molecular cluster, and five cases were from the same molecular cluster composed of cases from Shengzhou City and Xinchang County. Conclusions The predominant HIV-1 subtypes among MSM in Shaoxing City were CRF07_BC and CRF01_AE. There was cross-regional HIV transmission, and potential transmission risk might exist in Shengzhou City and Xinchang County.

The toxicity of HCN inhaled via the respiratory tract in dogs and the therapeutic effects of DMAP and AmNO2 for such form of HCN intoxication were studied. The LD50 of HCN when inhaled was 850.4?80.4?g/kg.When the dosage of 2?LD50 of HCN was given to the experimental animals, the signs of intoxication developed rapidly. Uneasiness, struggling, strident barking, and respiratory excitation were observed several seconds after the exposure. Subsequently there was spasm of the extensors and rigidity of the extremities. Finally general inhibition and paralysis ensued. Respiration and heart beat stopped 6 and 7 minutes after exposure. If DMAP (3.25 mg/kg intramuscularly) or AmNO2 (2 ampules through inhalation) was administered 15 seconds after exposure, the survival rate of the animals was 90% or 100% respectively.When the dosage of 4?LD50 of HCN was inhaled and the two drugs were administered 45 seconds after exposure, the survival rate of the animals treated with DMAP remained as high as 90% (9/10) .But the survival rate of those treated with two ampules of AmNO2 or even three ampules reduced to 20% or 40% respectively.The amount of HCN inhaled during respiratory intoxication, the problems of early diagnosis and the administration of DMAP at the site of accident were analyzed and discussed.

Objective To explore causes and high risk electrocardiogram expression of cardiac syncope caused by malignant rapid ventricular arrhythmia.Methods Forty-eight patients were analysed, they had cardiac syncope once or more that after which were admitted to the hospital. Results The basic causes of cardiac syncope were individed following types in 48 patients: coronary heart disease with acute or dated myocardial infarction,dilated or hypertrophic cardiomyopathy,hypokalaemia were ordinarist inducer.Torsade de pointes(TdP) were most common type of malignant rapid ventricular arrhythmia.They had some high risk electrocardiogram expression: secondary long QT syndrome,Brugada's syndrome,idiopathic abnormal J wave,complex ventricular ectopic beats,acute myocardial infarction with ST-T electrical alternation; or extensive anterior myocardial infarction with tombstone ST segment elevation,dilated cardiomyopathy with advance QRS complex low voltage.They were different electrocardiographic and clinical characteristic. Conclusion The cardiac syncope caused by malignant rapid ventricular arrhythmia is not single and independent clinical entity, which presents different the causes and high risk electrocardiogram expression.

Objective To evaluate the safety and clinical effects of radiofrequency single catheter ablation (RESCA)for right ventrieular arrhythmia(RVA).Method A total of 111 patients data in the Second Affiliated Hospital of Wenzhou Medical College from May 2003 to May 2008,were retrospectively analyzed aged(45.2±16.7)years old including 41 men and 70 women,consisted of 13 patients of ventricular tachycardia(VT)and 98 patients of premature ventricular contractions(PVC).There were 104 casess from right ventricular outflow tract arrhythmia(RVOTA)and 7 cases from right ventricular inflow tract arrhythmia(RVITA).According to use single catheter approach or common technique,electrophysiolo-gical study,pacing and/or activation mapping and Catheter ablation were performed,were separated into two groups.①Single catheter group:27 men and 49 women,ages(44.5±16.9)years old;consisted of 62 patients of RVOT-PVC,9 patients of RVOT-VT and 5 patients of RVIT-PVC.②Control group:14 men and 21 women,ages(46.7±16.5)years old;consisted of 29 patients of RVOR-PVC,4 patients of RVOT-VT and 2 patients of RVIT-PVC.Results Operations in two groups came off smoothly and no ablation related complications in two groups.Procedure time and fluoroscopy time[(55.23±26.24)min and(9.93±5.32)min]in single catheter group were significantly shorter than those in control group [(68.37±21.83)min and(12.96±4.54)min,t=2.76 and 3.09,all P<0.01].Cost in the fromer (12440.32±761.24)RMB were significantly less than those in the latter[(22119.51±1071.07)RMB,t=46.09,P<0.01].Ablated successful rate in the near future,at a specified future date and other parameter were similar in two groups.Conclusions Right ventricular arrhythmia can be ablated with single catheter approach in safety,efficacious,easy to operate and lower cost.

Objective To investigate left ventricular(LV) systolic dyssynchrony in heart failure of different etiology which caused respectively by ischemic heart disease and dilated cardiomyopathy and analyse the correlation between the systolic dyssynchrony index(SDI) and the LV ejection fraction(LVEF). Methods Forty-three subjects were divided into two groups. Group A consisted of 17 heart failure patients which caused by ischemic heart disease and group B included 26 heart failure patients which caused by dilated cardiomyopathy. Three-dimensional datum of left ventricle were obtained using real-time three-dimensional echocardiography (RT-3DE) in full volume mode. Post-processing software Qlab was used for advanced analysis. The end-diastolic volume (EDV), end-systolic volume (ESV), LVEF and bull eye graph of seventeen segments were obtained. Standard deviation of time-to-minimal-systolic-volume of 16-LV segments corrected by R-R interval was calculated as SDI of LV. Results There was no statistical difference in age, heart rate, LVEF and EDV between the two groups (P >0.05). SDI of group A was lower than that of group B,but there was no statistical difference between them (P>0.05). Bull eye graph of seventeen segments revealed that the distribution of delayed systolic segments were different between the two groups. SDI of two groups appeared negative correlation with LVEF(r = -0.83, r = -0.71, P-< 0.01). Conclusions LV systolic dyssynchrony existed in heart failure which caused by ischemic heart disease and dilated cardiomyopathy,but the distribution of delayed systolic segments were different between them. SDI increased with worsening LV systolic function.

Objective To analyze and summarize the efficacy and the experience in the application of type Ⅰ and type Ⅱ bundled pancreaticojejunostomy in pancreaticoduodenectomy. Methods Between Jan.2005 and Dec. 2009, a total of 38 patients who underwent bundled pancreaticojejunostomy was enrolled, and their clinical data were retrospectively analyzed. 20 patients received type Ⅰ bundled pancreaticojejunostomy and 18 patients received type Ⅱ bundled pancreaticojejunostomy. The operative time, postoperative hospital stay, mortality and complications were compared. Results The operative time of type Ⅰ bundled pancreaticojejunostomy was (91 ± 20) min, and it was (63 ± 21) min in type Ⅱ procedure, and the difference was statistically significant (P ＜ 0. 05). The mortality and complications, postoperative hospital stay were 10.0%(2/20), 45.0% (9/20) and (20 ±2)d in type Ⅰ procedure, while they were 5.6% (1/18),38.9% (7/18) and(23 ±2)d in type Ⅱ procedure, and the difference was not statistically significant.Conclusions There was no significant difference in the effects between type Ⅰ and type Ⅱ bundled pancreaticojejunostomy. Carefully selective application of type Ⅰ and type Ⅱ bundled pancreaticojejunostomy helps complete these procedures.