Objective To explore the changes of different echocardiographic indices in patients receiving catheter ablation for atrial fibrillation with different outcomes. Methods 75 patients received catheter ablation for atrial fibrillation during the period of January 2012 to February 2014. Before and 6 monthes after ablation , all the patients were examined left atrial volume index (LAVi), left atrium pressure (LAP), and left atrial ejection force (LAF) with echocardiography. Then after 6 months, according to the outcomes of the procedure, we divided the patients into two groups and compared the changes of these three parameters. Results In sinus group, LAVi decreased while LAF increased after treatment [LAVi: (29.3 ± 1.9) vs. (41.2 ± 9.3), LAF:(1.31 ± 0.61) (kg·cm)/s2 vs. (0.83 ± 0.22) (kg·cm)/s2, P < 0.05]; But LAP did not change [(55.7 ± 23.3)mmHg vs. (58.9 ± 18.6)mmHg, P > 0.05]; while in recurrent group, there were no changes in LAVi, LAP, and LAF after treatment (P > 0.05). Conclusions Radiofrequency catheter ablation is safe and effective in treatment of atrial fibrillation, resulting in significant improvements in left atrial volume and cardiac function.

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula (BSF). Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types (A and B) of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7(87.5%) of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple,safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. (J Intervent Radiol, 2007, 16: 253-257)[ Key words ] Fistula, pulmonary; Bronchialpleural fistula; Stents and prostheses; Computed tomography

Objective To discuss the clinical value of intravascular ultrasound (IVUS) in treatinginternal carotid arteries occlusion.Methods The patient was diagnosed with internal carotid artery occlusionthat was confirmed by CTA.Cerebral perfusion imaging showed that low perfusion area was consistent withischemic symptoms.Guided by IVUS,percutaneous transluminal angioplasty (PTA) was performed.By usingmicro-catheter coaxial technology,the micro guide wire was inserted in the carotid artery until it passedthrough the obstructed segment;After IVUS examination proved that the micro guide wire was in the truelumen of carotid artery,angiography through micro-catheter was carried out to confirm that the distal arterywas unobstructed;after adjusting the device position the embolism protector was placed.The plaque andlumen condition were assessed with IVUS,which was reevaluated after pre-expansion of balloon.After normaldirection blood flow was regained,the plaque stability was assessed with IVUS virtual organization sequence.Simple balloon dilatation therapy was adopted as the fibrous cap of plaque was in stable condition and thelumen stenosis rate was ＜40％.Results After balloon dilatation,the obstructed artery was reopened and theblood flow regained normal direction.IVUS examination showed that during the whole operation process thefibrous cap of plaque at the narrowed segment remained in stable condition,the lumen stenosis rate was ＜40％.Cerebral perfusion imaging revealed that after the treatment the low perfusion state was markedlyimproved.Conclusion IVUS plays an important guiding role in performing PTA for internal carotid arteryocclusion.This technique can increase the success rate of vascular recanalization and reduce the incidence ofcomplications.

Objective To investigate the effect of cobalt chloride on tumor cell proliferation and apoptosis in vitro, to explore the reasonable strategy of chemical hypoxia induced by CoCl2. Methods Two tumor cell lines (A549 and HeLa) were respectively exposed to CoCl2(0.05～2 mmol/L) for different time period (4～48 h), cells viability、proliferation and apoptosis were maesured by MTT and FCM methods. HIF-1? and related apoptosis proteins expression were detected by Western blot. Results Cells viability was weakly changed in low concentration(≤200 ?mol/L)of CoCl2 within 24 h. However, higher dose or prolonged challenge of CoCl2 significantly decreased cell survival rate (P

ObjectiveTo observe the influence of polyethylene glycol-conjugated hemoglobin (PEG-Hb) solution combined with cisplatin on the expression of erythropoietin/erythropoietin receptor (EPO/EPOR) and tumor angiogenesis in cancer treatment.MethodsHeLa cells were injected subcutaneously into the right oxter of 3-4 weeks old BALB/c nude mice to establish cervical tumor xenograft model.Then animals were randomly assigned to 4 groups (n=10) and treated respectively:group 1(control); group 2,cisplatin (5 mg/kg); group 3,PEG-Hb (0.6 g/kg); group 4 cisplatin (5 mg/kg) plus PEG-Hb (0.6 g/kg).The volume oftumors in each groups were measured in 4 weeks treatment period.Efficacy was measured as percent tumor growth inhibition (TGI) relative to salinetreated group.CD31 was detected by immunohistochemistry and its expression was identified as microvascular density (MVD).Expressions of hypoxia inducible factor-1α(HIF-1α) and EPO/EPOR in tumor tissues were analyzed by irnmunohistochemistry.EPOR protein level was tested by western blot.ELISA method was used in measuring EPO concentration in serum.ResultsTumor volume was significantly decreased in group 4 compared with other groups.Immunoreactivity data demonstrated lower expression of CD31,HIF-1α and EPO/EPOR in group 4.The expression of EPOR in the endothelial cells was also significantly decreased in group 4.Western-blot data indicated lower EPOR protein level in group 4.Serum level of EPO was also decreased in group 4.ConclusionPEG-Hb plus cisplatin is benefit to tumor tissue oxygenation,therefore it can inhibit the tumor angiogenesis and down regulate the erythropoietin/erythropoietin receptor system.The result can provide more evidence for the enhanced sensitivity effect of the artificial oxygen carrier in cancer therapy.

To investigate methods of treating atrial tachycardia by arrhythmias by biatrial pacing and assessments of efficacy． Left atrial pacing had been done in coronary sinus in 5 cases, including 4 c ases in specific electrodes of coronary vein sinus l case in ordinary ventricu lar electrode． Biatrial leads were con nected to atrial port of DDD pacemaker by a “Y” type connector ．The pacing mo de was AAT．Results: 4 coronary sinus leads were put in middle part and l in di stal part． We tested threshhold, sensitivity and impedance in operations． The follow-up time was 4-l 8 months． Biatrial pacing had an effect on 4 cases and had significant effects o n 3 cases． The effective rate was 80 percent．Conclusion:Biatrial pacing can treat atrial tachycardia arrhythmias effectively for intraatrial block．

10.3969/j.issn.2095-4344.2013.25.020

Objective To compare the difference in recurrence rates between the endovenous laser therapy(EVLT) combined with percutaneous continuous circumsature (PCCS) and simplex EVLT following the treatment of great saphanous vein incompetence through the introduction of propensity score matching (PSM).Methods T the baseline data of 170 patients diagnosed with great saphanous vein incompetence who were treated in Punan Hospital in Pudong New District of Shanghai from 2009 to 2014 were retrospectively analyzed,of which underwent EVLT were 87 cases as EVLT group and EVLT combined with PCCS were 83 cases as EVLT +PCCS group.The groups covariate were balanced based on the PSM function of SPSS software using 1 ∶ 1 nearest neighbor matching method.The recurrence rates of the two groups were estimated by Kaplan-Meier method and the differences between the two groups were evaluated by Log-rank test.Results Sixty-seven pairs of patients were successfully matched.No significant difference between the two matched groups in the basic clinical features.Before PSM,the 1,2,and 3 year cummulative recurrence rates were 3.5％,5.4％ and 7.3％ in the EVLT group,and 0.9％,4.7％ and 4.7％ in the EVLT+PCCS group,respectively,there were no statistically significant differences between the two groups by Log-rank test (P =0.491).After PSM,the 1,2,and 3 year cummulative recurrence rates were 5.2％,5.2％ and 7.1％ in the EVLT group,and 0％,1.0％ and 1.0％ in the EVLT+PCCS group,there were statistically significant differences between the two groups (P =0.031).Conclusion The PSM methods can effectively balanced the covariates of groups in non-randomised study.EVLT combined with PCCS can effectively reduce the recurrence rate after the treatment of great saphanous vein incompetence.

Objective To evaluate the efficacy and superiority of intracardiac noncontact catheter mapping system for mapping and ablation of complicated arrhythmia.Methods 12 patients(9 males and 3 females,aged between 28 and 76 years) were included in this study.The characteristics of electrophysiological examination were as follows one was idiopathic ecotopic beats originated in right ventricular outflow tract(RVOT),two cases with idiopathic left ventricular tachycardia(ILVT),one atrial tachycardia(AT) of left atrium,two AT originated in right atrium,six atrial fibrillation(Afi) of left atrium.Among them,4 cases failed with conventional electrophysiological examination and radio frequency ablation(RFA),1 patient was reported recurrence.All patients were introduced 64 non-contact unipolar electrodes and ablation catheter to the same chamber via formal veins,reconstructed three-dimension geometry configuration,isopotential maps and analyzed the foci of reentrant activation and critical isthmus,then ablated the interested sites guided by noncontact mapping system.Results One idiopathic ectopic beat originated in RVOT near septum received segmental ablation.Two ILVT substrates located at left posterior-mid septum and left-posterior septum underwent segmental ablation.One AT of left atrium(LA) originated in right inferior pulmonary vein(RIPV) was given linear ablation between RIPV and mitral.One of the two AT from right atrium(RA) mapped the earliest activation in orifice of inferior cava vein and was given cricoid ablation;another AT originated in posterior wall of superior cava vein across crista terminal received linear lesion.One of the six Afi cases triggered by left atrial ectopic beats was given linear lesion between left superior pulmonary vein(LSPV) and right superior pulmonary vein(RSPV) during sinus rhythm;the other five cases mapped the reentrant origin site of Afi during persistent Afi rhythm received the catheter linear ablation,and the ablation lines respectively were created between RSPV and RIPV,LSPV and left inferior pulmonary vein(LIPV),LSPV and RSPV,LIPV and mitral isthmus.All patients succeeded and no obvious complication observed in operation and postoperation.None recurred during 2~26 month follow-up period.Conclusions It is safe and effective of intracardiac noncontact catheter mapping system for endocardium mapping and ablation of arrhythmia,especially for the clarity of electrophysiological mechanism of complicated arrhythmia and guiding RAF,which has potential clinical values.

Objective To report the clinical oberservation of 50 patients with implantable cardioverter defibrillator(ICD).Methods Observe the patients with ICD from May,1998 to Nov.2005.Results There were more than a thousand episodes of ventricular tachycardia ventricular fibrillation(VT/VF) detected and terminated by ICD devices.Conclusions ICD with tiered therapy function has high efficacy on the termination of ventricular tachyarrhythmias.It is important to follow up the patients and dynamically optimize the system of ICD.