Objective To evaluate the feasibility and effect of three-points ablation approach in in treatment of typical atrial flutter guided by CARTO. Methods Twenty-six patients with typical atrial flutter diagnosed by ECG and electrophysiological study (EPS) were enrolled in this study. Activation sequence mapping and linear ablation were performed in 11 patients (conventional group) . Three-points guided linear ablation with CARTO system was performed in another15 patients (three-points group) . Results There was no significant difference in the success rate between the two groups. Both the procedure and fluoroscopic time in three-points group were significantly shorter than that in conventional group [(72.66±29.82) vs (102.52±32.61) min;(4.26±2.76) vs (7.32±3.16) min] . Conclusions The three-points ablations approach is as safe and effective as conventional ablation approach in treatment of typical atrial flutter;however,the former can significantly shorten the procedure time and fluoroscopy time.

Objective To evaluate the effect of comprehensive control of schistosomiasis along the Xinglong River in Qianji?ang City so as to provide the evidence for improving schistosomiasis control. Methods The comprehensive control measures including infection source control and Oncomelania hupensis snail eradication were surveyed along the Xinglong River in Qianji?ang City. Results The prevalence of schistosomiasis was under control that was the human and cattle infection rates decreased by 53.77%and 100%respectively the snail area decreased by 26.9% the mean density of living snails decreased by 25.5%and no infected snails was found. Conclusions The comprehensive control measures along the Xinglong River are effective and the management and surveillance of snail environments still should be strengthened.

Objective To compare the cardiac function effect of right ventricular septum(RVS) pacing with that of right ventricular apex(RVA) pacing.Methods One hundred and six patients with indication of dual chamber pacemaker implantation were divide into two groups randomly.In each patient,influence of different pacing site to LVEF and pacing parameter were examined and left ventricular eject fractions were compared.Results All patients' operation were successful,LVEF of RVS group compared with that of RVA showed a significant difference.Conclusion The cardiac function are significantly different between right ventricular septum pacing group and right ventricular apex group.

Objective To investigate the expression and relationship of livin and mutant p53 in hepatocellular carcinoma (HCC). Methods The expression of livin and mutant p53 were evaluated using the SP immunohistochemistry in 80 HCC tissue, 39 hepatic cirrhosis tissue, 33 normal tissue beside the hemangiomas of liver. Results The integrated A average results showed that the intension of positive expression of livin aligned by turns was HCC tissue (Median=5.09; P25～P75=3.06～8.28), hepatic cirrhosistissue(Median=3.05; P25～P75=2.49～4.25), normal liver tissue(Median=1.99; P25～P75=1.54～2.54) (P<0.001), respectively. It also showed that the intension of positive expression of p53 in HCC tissue (Median=43.13; P25～P75=20.41～78.53) was higher than that in hepatic cirrhosis tissue (Median=20.30;P25～P75=14.90～28.08), as well as in that of normal liver tissue (Median=15.52;P25～P75=12.81～21.80) (P <0.001), but it made no sense in statistics between hepatic cirrhosis tissue and normal tissue of liver. The expression of livin was obviously correlated with p53 in HCC tissue(r=0.241, P<0.05). Conclusion The overexpressian of livin and p53 and their positive correlation showed that livin may play a crucial role in the origin and development of HCC in coordination with p53.

Objective To study the effect of infrared irradiation on the expression of epidermal growth factor EGF) and epidermal growth factor receptor (EGFR) in the gastric mucosa of rats with chronic atrophic gastritis CAG),and to explore its mechanism.Methods Forty healthy adult and clean Wistar male rats were randomized into a normal control group (N group),a model control group (M group) and an infrared group (I group) using a random number table.CAG was induced in the rats of the M and I groups by intra-gastric infusion of 2 ml of a mixture of 30％ alcohol and 2％ sodium salicylate once every day for 8 weeks.This was combined with compulsory running and irregular fasting as pathogenic factors.After the CAG model had been established,the rats in the I group were given infrared irradiation for 10 rain once every day for 20 days.Then all of the rats were sacrificed and the expression of EGF and EGFR was observed using immunohistochemistry.Results The positive staining scores for EGF and EGFR of the M group were 4.91±2.58 and 6.75±2.63,significantly higher than those of the N group (2.10±0.65 and 4.20±2.24 respectively).Those of the I group were 2.75±1.01 and 4.75± 1.66,significantly lower than those of the M group,though not significantly different from the N group's averages.Conclusion Infrared irradiation can inhibit over-expression of EGF and EGFR in the gastric mucosa of rats with chronic atrophic gastritis.This should protect the gastric mucosa and promote tissue repair and healing.

ObjectiveTo detect the expression level of programmed cell death (PDCD) 5 and tumor necrosis factor(TNF)-α in serum and joint fluid from rheumatoid arthritis (RA) and osteoarthritis (OA)patients,and analyze the correlation between PDCD5 and TNF-α in order to study the role of PDCD5 in the pathogenesis of RA.MethodsFiftypatients(including 26 RA,24 OA) between December 2009 and August 2010 were selected to this study.ELISA was used to detect the concentration of PDCD5 and TNF-α in the serum and joint fluid.Two-independent sample t-test and Pearson's correlation analysis were used for statistics.ResultsIn both serum and joint fluid,the concentration of PDCD5 from RA patients [(37±33) vs (37±26) pg/ml ] was significantly higher than that of OA patients [ ( 13± 14) vs ( 11 ±7 ) pg/ml ] (P＜0.05).The concentration of TNF-α in the serum from RA and OA patients did not differ significantly(P=0.122),but its concentration in joint fluid of RA patients was significantly higher than that of OA patients (P=0.037).In the serum,there was significant correlation between PDCD5 and TNF-α (r=-0.55,P=0.004; r=-0.51,P=0.012)in both RA and OA patients.The correlation between PDCD5 and TNF-α in joint fluid of RA patients was statistically significant(r=-0.49,P=0.012),but no correlation could be found in joint fluid between PDCD5and TNF-α of OA patients(r=-0.353,P=0.09).ConclusionThis study suggests that PDCD5 and TNF-αare important apoptosis-regulatory factors in RA,and play important roles in the occurrence and development of RA.

Glioma is the most common primary intracranial central nervous system tumor, and postoperative radiotherapy is an important treatment for glioma. At present, computed tomography (CT) and magnetic resonance imaging (MRI) are widely applied in the delineation of radiotherapy targets for glioma. However, there are still some deficiencies in evaluating tumor scope, recurrence, radiation necrosis and prognosis, etc. Positron emission tomography (PET) / computed tomography (PET-CT) combines the molecular images of PET with the anatomical images of CT, which plays an important role in the diagnosis and differential diagnosis of glioma. With the popularization and application of multimodal imaging technology in radiotherapy, PET-CT molecular imaging, as an important supplement, contributes to the delineation of glioma target volume and the development of accurate radiotherapy, and brings benefits to the prognosis and follow-up of glioma patients. In this article, the application and research progress on PET-CT in the diagnosis, treatment and follow-up for glioma were reviewed.

Objective: To analyze the prevalence of and risk factors for infections in patients with pemphigus, and to evaluate their effect on prognosis. Methods: Clinical data were collected from 182 inpatients with pemphigus in Department of Dermatology, Xijing Hospital, Fourth Military Medical University from May 2011 to May 2017, and retrospectively analyzed. Associations of infection rates with age, disease severity, comorbidities, maximum dose of glucocorticoids, hospitalization duration and costs were analyzed. Statistical analysis was carried out with SPSS 22.0 software by using Logistic regression analysis for analyzing risk factors for concurrent infections in pemphigus patients who were hospitalized for the first time. Results: Among the 182 patients, 82 (45.05%) experienced infections. Additionally, 107 pathogenic strains were cultured from secretions from skin lesions of 77 patients, including 60 strains of Staphylococcus aureus (56.07%) , and 58 Staphylococcus aureus strains were resistant to penicillin (96.67%) . Among the 182 patients, infections were observed in 11 of 14 patients with hypoproteinemia, 69 (41.07%) of 168 patients without hypoproteinemia, 4 (4.81%) of 27 patients with mild pemphigus, 34 (37.7%) of 90 patients with moderate pemphigus and 44 (67.69%) of 65 patients with severe pemphigus. Logistic regression analysis showed that the prevalence rate of infections was significantly higher in the patients with hypoproteinemia than in those without hypoproteinemia (OR = 5.559, 95% CI 1.053-29.347, P = 0.043) . Compared with the patients with mild pemphigus, the prevalence rate of infections significantly increased in the patients with moderate (OR = 4.676, 95% CI 1.276-17.123, P < 0.05) or severe pemphigus (OR = 16.529, 95% CI 4.183-65.314, P < 0.001) . The prevalence of infections in patients with pemphigus was unaffected by gender, types of pemphigus, or the presence of hypertension or diabetes (all P > 0.05) . Among the 145 patients who were followed up, 33 were completely cured, 67 were cured clinically, 23 received improvement, 10 experienced relapse or exacerbation, and 12 died. Of the 12 dead patients, 3 died of pneumonia, 2 died of exacerbated pemphigus and skin infections, and 1 died of sepsis. Conclusions High disease severity and hypoproteinemia are risk factors for infections in patients with pemphigus. Bacterial infection is a common complication in patients with pemphigus, and severe infections are one of the causes of death in patients with pemphigus.

Current antiviral treatment strategy for chronic hepatitis B (CHB) includes pegylated interferon (PEG-IFN) and nucleos(t)ide analogues (NAs). Whether combination therapy with PEG-IFN and NAs improve therapeutic efficacy has become the key question regarding the antiviral therapy for CHB. This article reviews the recent progress in combination therapy for the management of CHB. The results indicate that the efficacy of simultaneous combination of PEG-IFN and NAs is not superior to that of PEG-IFN monotherapy in terms of HBeAg seroconversion and response after drug withdrawal. Sequential combination or switching therapy in PEG-IFN- or NAs-treated patients, as well as combination with immune cell therapy, is a promising treatment strategy.

Objective:To investigate the clinical outcomes of arthroscopic adhesiolysis on patients with primary frozen shoulder and its effect on shoulder joint function.Methods:The clinical data of 54 patients with primary frozen shoulder who visited Civil Aviation General Hospital from March 2017 to July 2018 were retrospectively analyzed. According to different treatment regimens, the patients were divided into a study group and a control group, with 27 patients in each group, there were 11 males and 43 females, aged (47.6±3.4) years, and the age ranged from 41 to 64 years. Patients in the control group were treated with conventional conservative treatment measures, and patients in the study group were treated with loose adhesion under arthroscope on the basis of the control group. The shoulder joint activity (range of motion angles for flexion, abduction and lateral rotation), Constant score, UCLA score and VAS score as well as the complications of the two groups were compared. The measurement data were expressed as mean±standard deviation ( Mean± SD), the t test was used for comparison between groups. The count data were expressed as percentage and the chi-square test was used for comparison between groups. Results:In the study group, postoperative anterior flexion, abduction, lateral external rotation were (160.2±20.7)°, (163.6±20.1)°, (50.5±8.9)°, respectively. The patients in the control group experienced (119.5±19.5)° of anterior flexion, (121.2±19.5)° of abduction, (35.6±6.4)° of lateral external rotation. After treatment, the activity of the shoulder joint in the study group was significantly better than that in the control group, there were statistically significant differences between the two groups( P<0.05). In the study group, the postoperative Constant score was (83.1± 9.3) scores, VAS score was (2.8±0.3) scores, UCLA score was (31.7±3.1) scores; in the control group, the postoperative Constant score was (71.7±9.7) scores, VAS score was (4.4±0.3) scores, UCLA score was (22.8±3.6) scores ( P<0.05). Compared with the control group, the Constant score and UCLA score in the study group were significantly higher, and the VAS score was significantly lower, differences were statistically significant( P<0.05). The difference in the incidence of complications between the two groups was not statistically significant ( P>0.05). Conclusions:For patients with primary frozen shoulder, arthroscopic adhesiolysis can significantly improve the shoulder function of patients. At the same time, this operation has significant clinical treatment effect, which is conducive to the clinical application and promotion.