Objective To evaluate transthoracic echocardiographic guidance for closure of atrial septal defects with Amplatzer occlusion device in the adults Methods Thirty patients with atrial septal defects were occluded by use of Amplatzer septal occluder The mean age was (32 3?14 7) years (ranging from 13-65 years) Transthoracic echocardiography was undertaken for guidance for closure before and in the procedure of intervention Transthoracic echocardiography was done immediately, one month and three month respectively after intervention to evaluate the treatment efficiency Results Twenty four patients were treated successfully directly by guidance of transthoracic echocardiography during the period of closure, the total effectiveness was 80%. Five patients needed to have transesophageal echocardiography before closure to select indication and another one patient was treated successfully by adding transesophageal echocardiography for guidance in the procedure There was no significant complication that occurred during the procedures, and there was no emergency surgical case Trivial to small residual shunts were found in 2 cases (6 7%) immediately after the procedure No residual shunts were found in the one month follow up, and all patients had no displacement and recanalization in the one month follow up Conclusion Transthoracic echocardiography can guide most of atrial septal defect patients for closure of atrial septal defects with the Amplatzer occlusion device

Objective To evaluate the clinical effect of interventional occlusion for atrial septal defect(ASD) with domestic occluder by X-ray in combination with echocardiography.Methods 38 patients with ASD were all implanted with domestic occluder.The imageological data before and 6 months after treatment were analysed and compared.Results There were no residual shunts after interventional treatment.The heart surface area,right inferior pulmonary artery diameter,the base lines of pulmonary cone,the diameters of pulmonary trunk and the degree of protrusion of pulmonary cone were all decreased after operation(P

Object To establish a method for the assay of myricetin in Ampelopsis grossedentata (Hand. Mazz.) W. T. Wang. Methods The determination was carried out with RP HPLC on Nova pak C 18 stainless steel column (150 mm ? 3 9 mm) with methanol∶water (40∶60) as the mobile phase, and detected at a UV wave length of 254 nm. Results The coefficient of variation was 2.763% with average recoveries=97.4%. The minimal detectable limit was 15 ng. Contents of myricetin in different parts of A. grossedentata from Hunan Province varied from 1.57% to 2.17%. Conclusion The method is rapid, simple, accurate and good for the determination of myricetin in A. grossedentata.

Objective To investigate the algorithm and efficacy of interventional treatment for combined congenital heart diseases. Methods Thirty-four patients (12 males and 22 females) with combined congenital heart disease underwent simultaneous transcatheter therapy. The types of the congenital heart defect combination were as follow: ASD and PS (16 cases); ASD and VSD (7 cases); ASD and PDA (3 cases); ASD and MS (2 cases); VSD and PDA (3 cases); Taussig-Bing and PDA(1 case); PDA, ASD and PS (1 case); ASD, VSD and PDA (1 case). The algorithm of transcatheter intervention was: PBPV or PBMV at first followed by the occlusion of VSD, PDA and ASD successively. Transthoracic echocardiography (TTE) and X-ray examination were done 3d, 1 m and 3 m after the procedure to evaluate the outcome of the procedure. Results All patients were treated successfully at one time. No complications occurred during and immediately after the procedure. There was no residual shunt and all the occlusion devices were found in the suitable site evaluated by means of TTE and X-ray right after the procedure. In 16 patients with ASD and PS, the systolic pressure across the pulmonary valve decreased from (53?20) mm?Hg to (14?10) mm?Hg (P

ObjectiveTo evaluate the changes of left atrialsize and function after transeatheter closurein adults with atrial septal defect(ASD).Methods Forty-nine adults with ASD received transcatheter closure successfully were chosen.Transthoracic echocardiogram examination was performed to detect the diameter and volume of left atrium before treatment and in 2 days,1,3 and 6 months after treatment.ResultsLeft atrial diameter in 2 days,1 and 3 months after treatment compared with that before treatment had no statistical significance (P ＞ 0.05),and the data in 6 months after treatment was shorter than that before treatment [ (32.06±4.78 ) mm vs.(34.63±5.60) mm,P ＜ 0.05 ].Left atrial total volume reduced in 2 days after treatment compared with that before treatment [ (30.84±4.24) ml vs.(32.43±4.30) ml,P ＜0.05],and further reduced in 3 and 6 months after treatment [(30.51±4.97),(28.94±5.97) ml vs.(32.43±4.30) ml,P ＜ 0.05 or ＜0.01 ].Left atrial active emptying volume before and after treatment had no statistical significance(P ＞ 0.05 ).Left atrial passive emptying volume in 2 days and 1 month after treatment showed no statistical significance compared with that before treatment (P ＞ 0.05),and reduced significantly in 3 and 6 months [ (10.28± 5.51 ),(10.27± 4.82) ml vs.(12.31± 3.51 ) ml,P ＜ 0.01 ].Compared with that before treatment,left atrial ejection fraction in 2 days after treatment had no significant difference(P＞0.05 ),and had statistical significance in 1,3 and 6 months after treatment [(41.70± 7.00)％,(45.47±5.23 )％,(48.55± 7.86)％ vs.(37.39± 4.84 )％,P ＜ 0.01 ].ConclusionThe formation and function of left atrium of adults with ASD would be significantly improved after transcatheter closure.

Objective To evaluate the feasibility and effect of transthoracic echocardiography(TTE)on guiding the occlusion of the soft-rim atrial septal defect(ASD).Methods Sixty two patients with the soft-rim ASD were enrolled.The size of ASD was measured and rim of ASD was observed by TTE on various views by using color Doppler system with tissue harmonic function before occlusion,and filmy rim of ASD with flapping which could not sustain occluder was eliminated.The size of occluder was selected by integratively judging the size of ASD and"sustainable diameter of ASD"The waist size of occluder was measured after releasing occluder and compared with the longest diameter of ASD and"sustainable diameter of ASD"measured by TTE.Results The longest diameter of ASD measured by TTE before occlusion was 11-35 mm[average(21.6±5.2)mm],the "sustainable diameter of ASD"was 15-37 mm[average(25.6±5.(J)mm],the size of selected occluder was 18-44mm[average(30.7±5.5)mini and the waist size of released occluder was 13-35 mm[average(24.2±5.6)mm].Fine correlation was existed between the longest diameter of ASD measured by TTE and the waist size of released occluder(r=0.86,P＜0.000I).Morever,improved correlation was found between the"sustainable diameter of ASD"measured by TTE and the waist size of released occluder(r=0.89,P＜0.0001).Occluder was firmly fixed without falling in all patients.Conclusions TTE with tissue harmonic function can be used to measure the size of soft-rim ASD and the"sustainable diameter of ASD".It is a feasible,and effective method on guiding occlusion of soft-rim ASD.

Platypnea orthodeoxia syndrome is associated with dyspnea and arterial oxygen desaturation accentuated by an upright posture. It can be secondary to an intracardiac shunt. We report a case of platypnea-orthodeoxia syndrome (POS) in a 58-year old male patient who had a pre-existing patent foramen ovale (PFO) and substantial pulmonary pathologies. He was successfully treated by percutaneous transcatheter closure of the PFO. Our case highlights the importance of recognition of this rare syndrome in patients who present with unexplained hy-poxia for whom transcatheter closure of the interatrial shunt can be safely carried out.

Objective: To investigate the effect of electroacupuncture (EA) on rat with diet induced obesity (DIO) and to explore the possible neurochemical mechanisms using the technique of immumohistochemisty. Methods:To establish DIO rat model by feeding the animals with high fat diet for 14 weeks. DIO rats were randomly divided into 4 groups: (1) 2Hz EA group, (2) 100Hz EA group, (3) restrain control group,(4) diet resistance (DR) group,(5) DIO group and (6) normal control group. EA treatment: (1) The acupoints used were Zusanli and Sanyinjiao on both legs. (2) The intensities of stimulation were 0.5, 1.0 and 1.5mA for 10 mins each. EA treatment was administered 3 times per week. Food intake and body weight were measured daily for 4 weeks. (3) The changes of the expression of ? melanocyte stimulating hormone (? MSH) in the hypothalamic arcuate nucleus (ARC) were measured with immunohistochemical semiquantitative analysis. Results: (1) The food intake and body weight of 2 Hz EA group and 100 Hz EA group were decreased significantly compared with the restrain control group and DIO group. (2) The number of ? MSH positive cells in hypothalamic ARC in 2 Hz EA and 100 Hz EA group was significantly higher than that in restrain control group and DIO group. The number of ? MSH positive cells in hypothalamic ARC in DIO group is significantly lower than those in DR group or normal control group. Conclusion: A decrease of ? MSH level in hypothalamus may be associated with diet induced obesity. The therapeutic effect on obesity produced by EA may be accounted for by the stimulation of pro opio melanocortin neurons in hypothalamic ARC to release ? MSH, which inhibits food intake , resulting in a decrease of body weight.

Background The objective of this study was to assess the clinical safety and efficacy of vena cava filter (VCF) placement,with particular emphasis on the incidence and risk factors of inferior vena cava thrombosis (VCT) after VCF placement.Methods Clinical data of patients with venous thromboembolism (VTE),with or without placement of VCF,were analyzed in a retrospective single-center audit of medical records from January 2005 to June 2009.The collected data included demographics,procedural details,filter type,indications,and complications.Results A total of 168 cases of VTE (82 with VCF; 86 without VCF) were examined.Over a median follow-up of 24.2months,VCT occurred in 18 of 82 patients with VCFs (11 males,7 females,mean age 55.4 years).In 86 patients without VCFs,VCT occurred in only 6 individuals (4 males,2 females) during the study period.VCT was observed more frequently in patients fitted with VCFs than in those without VCFs (22% vs.7.0%).Conclusions The incidence of VCT in patients with VTE after VCF implantation was 22% approximately.Anticoagulation therapy should be continued for all patients with VCF placement,unless there is a specific contraindication.Almost all instances of VCT in patients with VCF implants in our study occurred after stopping anticoagulation treetment.The use of VCFs is increasing,and more trials are needed to confirm their benefit and accurately assess their safety.

Background The incidence and progression of glaucomatous optic neuropathy is related to a disturbance of the retrobulbar hemodynamics.Compound anisodine is clinically applied for the treatment of ischemic ocular diseases.Objective To evaluate the effects of compound anisodine injection on the ocular blood flow of glaucoma patients.Methods Twenty-one patients with primary glaucoma were divided into the treatment group and the control group.The eyes of each patient in the treatment group were selected further into the treatment eye group (11 eyes with greater mean deviation [MD]) or the opposite eye group(11 eyes with lesser MD).One of the eyes of each patient in the control group with MD value were selected as control eyes (10 eyes).The treatment eye group received compound anisodine on the para-superficial temporal artery via subcutaneous injection once a day for 2 treatment periods (each period equals 14 days,with 7 days intermittent between periods,totally 35 days) in addition to routine treatment.The retrobulbar blood flow,optic disc data,refraction error,visual field and intraocular pressure were measured in 3 time points:Before treatment period (baseline test),one day after treatment period (the 1st postreatment test) and 35 days after treatment period (the 2nd posttreatment test).Results Compared with the control group,the peak systolic velocity (PSV) and end diastolic velocity (EDV) of short posterior ciliary artery (SPCA) of the treatment eye group were relatively increased significantly in the 1st posttreatment test (P =0.017,0.028),the PSV of SPCA of the opposite eye group was relatively increased significantly in the 1 st posttreatment test (P =0.049),the EDV of central retinal artery (CRA) of the opposite eye group was relatively increased significantly in the 2nd posttreatment test (P =0.035).In contrast to the treatment eye group,the inferior quadrant RNFL thickness of the optic disc decreased significantly in the 2nd posttreatment test in the control group (P =0.009),the 6 o'clock RNFL thicknesses of the optic disc decreased significantly in the 1 st posttreatment test in the control group (P =0.014),and the 6 o'clock and 7 o'clock RNFL thicknesses of the optic disc decreased significantly in the 2nd posttreatment test in the control group (P =0.029,0.011).Conclusions The application of compound anisodine for the treatment of primary glaucoma relatively increases the PSV and EDV of SPCA.