Cardiac arrhythmias are varied and very common. They are usually classified as bradyarrhythmias and tachyarrhythmias, which are treated according to their own common principle separately. There is no long term effective oral drugs that can be used to treat bradyarrhythmias effectively up to now. Pacemaker is still the only effective treatment for it. Now catheter ablation has already applied to almost every kind of tachyarrhythmias, and which is the first choice for treating supraventricular tachycardia and atrial flutter because of the satisfactory result. Most patients with other types of tachyarrhythmias, especially atrial fibrillation and all kinds of premature beats are still given drug therapy. Amiodarone, propafenone, sotalol and mexiletine are common used antiarrhythmic drugs in our country. This article overviewed the principle and the matters need to attention in the drug therapy of cardiac arrhythmias.

The safety and effectiveness of catheter ablation in coronary sinus using radiofre-quency energy was studied in 16 dogs. Radiofrequency energy(1229?711 J) was applied between electrode catheter placed inside coronary sinus and a chest wall patch. Thirteen dogs were killed approximately half an hour after ablation and three 3 to 4 weeks. Lesion of abltion area were 3. 2?1. 8mm in length, 2. 2?1. 7mm in width and 2. 1?1. 0mm in depth. Microscopic examination showed well circumscribed area of coagultion necrosis (acute period)and fibrosis (chronic period). The coronary atery and mitral apparatus were not involved,nor was the endocadium. No arrhyth-mias except occationally atrial or ventricular premature beats were observed. No hemodynamic changes and rupture of coronary sinus occurred in any dog. Large amount of radiofrequency energy can be safely applied to the coronary sinus. The location of the lesions produced suggests that this technique may be useful for interruption of left-sided atioventricular pathways of patients.

Objective To estimate whether a change in the polarity of low atrial electrograms recorded near the ablation line is an accurate indicator of complete isthmus block in the radiofrequency ablation of typical atrial flutter. Methods Radiofrequency ablation was performed in 10 patients with typical atrial flutter. Electrograms were recorded around the tricuspid annulus using a duodecapolar halo catheter and the distal electrode of halo catheter positioned just near the ablation line. The electrogram polarity of the distal electrode pair (H potential) was analyzed during atrial flutter and during coronary sinus pacing before and after ablation. Results Radiofrequency ablation was performed during coronary sinus pacing in 8 patients and performed during atrial flutter in 2 patients. Complete isthmus block was achieved in all patients. Before ablation, the initial polarity of H potential was predominantly positive during coronary sinus pacing and predominantly negative during atrial flutter. After complete isthmus block was achieved, the initial polarity of H potential was predominantly negative during coronary sinus pacing in all the patients. Conclusion The change of the electrogram polarity recorded just near the ablation line during coronary sinus pacing after ablation of typical atrial flutter is a simple, quick and accurate indicator of complete isthmus block.

Objective To investigate the relationship between coronary myocardial bridge and the symptoms of the patients and its related factors, and to provide evidence for rational treatment. Methods Sixty-one patients di-agnosed as myocardial bridge by coronary angiography and the examination of nuclide myocardial perfusion imaging were recruited and their clinical data was analyzed retrospectively. The patients were divided into ischemic group and non-ischemic group according to the nuclide imaging, and were followed up on the compliance of β-blocker taking and the symptoms. Results Among the 61 patients ,7 patients were ischemic,and the others were non-ischemic. There was no significant difference on symptoms between the two groups (P>0.05). The prevalence of Grade Ⅲ narrowing was higher in ischemic group (6/7) than that in the non-ischemic group (18/54) (χ~2=5. 009, P = 0.024) ,and the ischemic patients with Grade Ⅲ narrowing were older than those in the non-ischemic patients. Two patients in the ischemic group did not insist on taking β-blocker and their symptoms did not change,40 patients in the non-ischemia group did not insist on taking β-blocker,of which 33 patient's symptoms were improved. The symp-toms of all patients with good compliance of β-blocker taking were improved. Conclusions The symptoms of some patients are unrelated with myocardial bridge and treatment is not recommended.

Objective: To observe the influence of different tocopherol isoforms on oxidized low density lipoprotein (oxLDL) or recombinant human C reactive protein (rhCRP) induced expression of intercellular adhesion molecule 1 (ICAM 1) in human umbilical vein endothelial cells (HUVECs) and to investigate the potential mechanisms and effects of different tocopherols on atherosclerosis. Methods: Cultured HUVECs were incubated with oxLDL,oxLDL+? tocopherol,oxLDL+? tocopherol,oxLDL+mixed tocopherols,rhCRP,rhCRP+? tocopherol,rhCRP+? tocopherol, rhCRP+mixed tocopherols for 24 hours, respectively. The ICAM 1 expressions of protein and mRNA were detected by cell enzyme linked immunosorbent assay (ELISA), flow cytometric technique and RT-PCR. Results : Incubation of HUVECs with oxLDL or rhCRP for 24 hours significantly increased ICAM 1 expressions of proteins and mRNA . The different tocopherols inhibited oxLDL induced ICAM 1 expression in HUVECs in a concentration dependent manner(50-200 ?mol/L) and mixed tocopherols were more potent than ? tocopherol or ? tocopherol alone. However, rhCRP induced ICAM 1 expression in HUVECs was not inhibited by tocopherols. Conclusion :The different tocopherols inhibited oxLDL induced ICAM 1 expression in HUVECs and mixed tocopherols were more potent than ? tocopherol or ? tocopherol alone, which may be important for the beneficial effects of tocopherols on atherosclerosis and cardiovascular disease.

Pancreatic cancer is one of the most malignant tumors with a high mortality rate attributed to its widespread metastasis.A number of cellular signal transduction pathways involved in multiple genes play an important role in regulating this complex metastatic cascade of pancreatic cancer.NF-kappa B is one of the crucial signaling pathways.Studies has indicated that NF-kappa B could modulate a series of biological events relevant to tumor progress by controlling multiple targeted genes expression,such as cell proliferation,anti-apoptosis,angiogenesis,epithelial-mesenchymal transition,inflammation,stress response,etc.Furthermore,it can also up-regulate Hedgehog and MMPs signaling pathways.To help us better understand the potential mechanism and identify more sensitive tumor markers and selective targets,this review will underline the significant roles of NF-kappa B signaling pathway in regulatory network of pancreatic cancer metastasis.

Objective To evaluate the effects of the administration of intracoronary diltiazem before the occurrence of no-reflow during direct PCI. Mtthods One hundred and thirty four AMI patients hospitalized from June 2001 to November 2003 were selected as research objects. 60 patients with AMI received intracoronary diltiazem before the occurrence of no-reflow during direct PCI. 74 AMI patients did not receive intracoronary diltiazem and were enrolled as control subjects. Patients with refractory low blood pressure and complete atrioventricular block before PCI were excluded. Thrombolysis in Myocardial Infarction (TIMI) flow grade, corrected TIMI frame count (CTFC) were assessed during angiography, before and after PCI. Results The two groups had similar baseline. There were significant difference in post-PCI no reflow assessment (P = 0.04) and CTFC (P = 0.00). Conclusion Early administration of intracoronary diltiazem during direct PCI reduces the no reflow occurrence.

BACKGROUND: Hemorrhagic cystitis remains a common complication of hematopoietlc stem cell transplantation.Granulocyte-macrophage colony stimulating factor (GM-CSF) affects proliferation and differentiation of hematopoietic stem/progenitor cells, adjusts functions of monocytes, granulocytes, lymphocytes and endothelial cells.OBJECTIVE: To investigate the protective effects of GM-CSF bladder irrigation in hemorrhagic cystitis after allogeneic hematopoietic stem call transplantation.DESIGN: Case analysis.PARTICIPANTS: A total of 15 hematopathy patients undergoing allogenic hematopoietic stem cell transplantation at the Zhongshan Hospital of Sun Yat-sen University from January 2004 to August 2006 (routine treatment group). A total of 16 hematopathy patients undergoing allogenic hematopoietic stem cell transplantation from September 2006 to December 2008 (GM-CSF group).METHODS: In the routine treatment group, patients received mesna, hydration, alkalization and forced diuresis in the prevention of hemorrhagic cystitis. In the GM-CSF group, GM-CSF was infused into the bladder in addition to mesna,hydration, alkalization and forced diuresis in the prevention of hemorrhagic cystitis 24 hours before cyclophosphamide treatment. Catheter was extracted 3 days following cyclophosphamide withdraw. Following washing with saline, the bladder was emptied. 10 mL of saline and 5 mL of lidocaine were added into 300 μg of GM-CSF. The mixture was infused into the bladder for 60-120 minutes.MAIN OUTCOME MEASURES: The following parameters were measured: occurrence of hemorrhagic cystitis and its correlation to graft versus host disease, as well as the occurrence of cytomegalovirus infection and urinary system infection.RESULTS: Compared with routine treatment group, the occurrence rate of hemorrhagic cystitis was significantly decreased in the GM-CSF group (x2=4.39, P < 0.05), mean duration of hemorrhagic cystitis and duration of hospitalization were significantly shortened (t=3.97, P < 0.05; t=3.13, P < 0.05), and the occurrence rate of over grade HI hemorrhagic cystitis was significantly reduced (x2=5.04, P < 0.05). Cystitis degree was associated with degree and duration of graft-versus-host disease (r = 0.76).Compared with the routine treatment group, cytomegalovirus infection rate was slightly decreased in the GM-CSF group (x2=0.28, P> 0.05), and occurrence rate of over grade Ⅲ hemorrhagic cystitis was higher in patients with cytomegalovirus infection.Compared with the routine treatment group, the occurrence rate of urinary system infection was slightly reduced in the GM-CSF group (x2=0.28, P > 0.05).CONCLUSION: GM-CSF bladder irrigation is well tolerated and often effective, and should be considered as a preparative regimen of hemorrhagic cystitis after allogeneic hematopoietic stem call transplantation.

] AIM: To investigate the expression of the urotensin Ⅱ (UⅡ) receptor GPR14 in the aorta of apoE knockout mouse. METHODS: The expression of GPR14 in the aorta of apoE knockout C57BL/6J mice at various ages (18 weeks, 28 weeks, and 38 weeks old, respectively) was determined with competitive RT-PCR. A binding assay of [ 125 I]-UⅡ on the aortic tissue was also performed in 28 weeks group. RESULTS: We found significant upregulation of GPR14 mRNA at all three ages. Compared with wild type group at the same age, the GPR14 mRNA level in apoE knockout mice increased 54.2% in 18 week group (P

Objective: To observe the automatic ventricular capture management (VCM) conifrmed by paced depolarization integral (PDI) evoked response detection via the follow-up study in patients with Zephyr5826 pacemaker implantation. Methods: A total of 102 relevant patients were enrolled. In order to conduct PDI calculation, pacemakers were set by bipolar sensing and bipolar pacing at immediately after implantation. VCM functions were observed at 1 day, 7 days and 1 month, 3, 6, 12 months after implantation, the ventricular threshold by VCM test and manual test were compared. The symptoms of pectoralis major stimulus, diaphragm stimulus and palpitation were observed in all follow-up patients. Results: There was 1 patient died by MI at 1 month after Zephyr5826 pacemaker implantation, the rest 101 patients were followed-up for 12 months. VCM function was successfully turned-on at immediately after implantation in all patients, no pectoralis major stimulus and diaphragm stimulus occurred. VCM function was turned-off in 6/101 (5.9%) patients at 7 days after implantation due to intolerable palpitation caused by daily automatic VCM, instead they received manual test at follow-up visit. The coincidence rate of ventricular thresholds between VCM test and manual test were 100%. Ventricular pacing output voltage by VCM was (0.99 ± 0.48) V,n=608. Compared with regular pacing output voltage (2.5V, 0.4ms), VCM function may save 84% of energy consumption; compared to high pacing output voltage (3.5V, 0.4ms), VCM may save 92%. Loss of ventricular capture and poor sensation were not found by ECG and 24 h dynamic monitoring. Conclusion: Zephyr5826 pacemaker may conduct bipolar pacing and scanning with VCM function, it can be effectively and safely operated by low energy output. A few patients may not use VCM function due to intolerable palpitation.