Objective The aim of this study is to evaluate the effects of drug,electric cardiovertion,radiofrepuency ablation and implantable anti-atrial-fibrillation pacemaker on patients with persistent idiopathic atrial fibrillation.Methods 58 patients with persistent idiopathic atrial fibrillation were treated with drug or electric cardjovertion,radiofrequence ablation and anti-atrial-fibrillation pacemaker.Results There were 30 patients successfully converted to sinus rhythm by drug.The mean conversion time of drug was 8?5 days.22 patients were converted by electric cardioversion.10% of cases(6 of 58)failed to convert by both methods.In follow-up period,12 cases of patients were healed,19 cases got significant improvement,14 cases got moderate improvement,8 cases had no improvement.The total efficiency rate was 76%.18 cases in successful cardioversion patients were healed,5 cases got significant improvement,5 cases got moderate improvement,4 cases had no improvement.The total efficiency rate was 75%(14 of 18).2 cases got improvement by anti-atrial-fibrillation pacemaker.Conclusion Combined treatment of drug,electric cardioversion,radiofreqency ablation and anti-atrial-fibrillation pacemaker can imrove cure rate of persistent idiopathic atrial fibrillation.

Objetcive To analyze the contrast-enhanced ultrasound (CEUS)features in clear cell renal cell carcinoma (CCRCC) of different size and to discuss the diagnostic value of CEUS in CCRCCs. Methods The contrast-enhanced and conventional US features of 80 CCRCCs confirmed pathologically were retrospectively analyzed. Samples were divided into three groups by diameters: small CCRCCs (≤30 mm), medium CCRCCs(＞30 mm) and large CCRCCs(＞50 mm). The tumoral vascularity, lesion homogeneity and presence of an anechoic rim were observed on conventional US. The enhancement of echogenicity, homogeneity and pseudocapsule were evaluated on CEUS. Results Among the 80 renal masses, 32 were small CCRCCs, 28 were medium CCRCCs while the large CCRCCs were 20. On conventional US, 18.8%(6/32) of small CCRCCs, 71.4%(20/28) of medium CCRCCs and 95%(19/20) of large CCRCCs demonstrated as heterogeneous and the differences were highly statistically significant, whereas there were no differences in the tumoral vascularity and the presence of pseudocapsule sign among the three groups. On CEUS, 28.1%(9/32) of small CCRCCs, 85.7%(24/28) of medium CCRCCs and 100%(20/20) of large CCRCCs showed a homogeneous enhancement. The incidence of pseudocapsule sign in medium tumors was higher than small and large groups(71.4%,50% and 25%,respectively). There were statistically significant differences among the three groups in the enhanced homogeneity and the presence of pseudocapsule sign. However, all the three groups revealed mainly isoechoic and hyperechoic and there were no differences among them. Compared with conventional US, CEUS depicted significantly the increased tumoral vascularity (51.3% vs. 87.5%) and pseudocapsule sign(22.5% vs. 51.3%). Eight lesions demonstrated heterogeneous contrast enhancement on CEUS while homogeneous on conventional US, but there were no differences in lesion homogeneity between conventional US and CEUS findings. Conclusions Different sizes of CCRCC showed distinct CEUS features in the enhanced homogeneity and the presence of pseudocapsule sign. CEUS is more effective on improving the sonographic characteristics of tumoral visualization and may provide important information of US findings for the diagnosis of renal cell carcinoma.

Purpose To explore the value of direct CT venography (CTV) for the diagnosis of varicose veins of lower limb. Materials and methods Forty patients diagnosed as varicose veins of lower limbs were enrolled. 40 patients with 56 involved limbs underwent direct CTV examination, and their images were stratified and evaluated according to the severity and the scope of the disease. Main assessment:definition and scope of CT axial scans combined with volume rendering (VR) and maximum intensity projection for the display of the varicose veins; situation for the display of perforating veins, deep veins and iliac veins;diagnostic compliance between CTV and DSA. Results All of the 56 involved limbs underwent laser intra-cavity occlusion surgery, among them 7 cases with 11 limbs underwent venous angiography under DSA at the same time. In the evaluation of the VR, excellent proportion was 92.86%(52/56), moderate proportion was 7.14%(4/56). Among the deep veins, ratio of the imaging that was able to meet the diagnostic standard was 94.34%, 88.46%and 27.27%, respectively for calf vein, femoral vein and external iliac vein. The total demonstration rate of perforating veins was 98.21%(55/56). Diagnostic compliance between CTV and DSA was 100.00%. Conclusion Lower extremity direct CTV imaging is convenient and noninvasive for patients with varicose veins, with high compliance with DSA results, thus is significantly valuable for the guide of clinical treatment.

Animals ; Flunarizine ; pharmacology ; Hippocampus ; drug effects ; physiopathology ; Male ; Neurons ; drug effects ; physiology ; Penicillins ; adverse effects ; Rats ; Rats, Wistar ; Seizures ; chemically induced ; physiopathology

Objective To assess the clinial application of 3D reconstruction with MSCT for acetabular fractures.Methods Volume scanning was performed in 20 patients with acetabular fractures,all data sets were transferred to workstation.Reconstruction were done with more thinner slices.Results Acetabular frature 3D images went all the way with the results of surgery in 17 cases.Conclusion MSCT 3D images can compare beauty with gross specimen,which could be propitious to the subtype of acetabulum fracture and have an advantage in the application.

Objective To establish the oxygen glucose deprivation (OGD)/reoxygenation experimental model of hippocatnpal neurons of rat in vitro, and to try to identify the length of time for producing optimum injury in this model. Method The primary hippocampal neurons of newborn Sprague-Dawley rats were cultured for 7 days and randomly (random number) divided into a control group and OGD groups. The OGD groups were assigned into 1 h, 2 h, 4 h, 6h, 8 h and 10 h subgroups in accordance with different lengths of time for oxygen glucose deprivation. The neurons of OGD groups were placed into a tri-gas incubator containing 0.5% oxygen and the culture medium was substituted with the glucose-free Earle' s balanced salt solution, simulating cerebral ischemia injury in vivo. The morphology of neurons was observed after reoxygenation for 24 hours. The MIT assay was used to determine the rate of survived cells derived from the value of optical density (OD) of cells. The lactate dehydro-genase (LDH) content in culture medium was detected to evaluate the neuron injury. The apoptotic rate of neurons was measured by using flow cytometry. Dunnett-test and Spearman correlation analysis were used to analyze the data with SPSS version 16.0 soft ware package. Results The morphological damage of neurons in OGD groups aggravated gradually, optical density and cell survival rate decreased (rs= -0.961 and rs = -0.966, P <0.01), and the amount of LDH increased (rs = 0.990, P <0.01) with longer duration of exposure to oxygen glucose deprivation, and the rate of neuron apoptosis increased obviously which was significantly statistical difference in com-parison with the control group (P < 0.05). Under the setting of oxygen glucose deprivation for 6 hours, the apop-tosis rate of neurons approximated to 50% . Conclusions The oxygen glucose deprivation/reoxygenation model of rat's hippocampal neurons in vitro was established successfully. From the findings of morphological changes and apoptosis rate of neurons, the oxygen glucose deprivation for 6 hours may be the suitable length of time for inducing neuron injury in this model.

Objective To study the establishment of rat model of asphyxia-cardiac arrest and efficacy of CPR in order to find the length of optimum time of asphyxia to cause injury.Methods One hundred and twenty-six male Sprague-Dawley rats were randomly (random number) divided into sham operation group and experimental groups.Cardiac arrest was induced by asphyxiation after intravenous injection of vecuronium bromide.The experimental groups were assigned into AP4 (four-minute asphyxia period),AP6 and AP8 subgroups in accordance with different lengths of time of asphyxia subjected to.In these groups,CPR,including pre-cordial compression and synchronized mechanical ventilation,was initiated 4,6 and 8 min after asphyxia-induced cardiac arrest,respectively.The successful ratio of resuscitation and hemodynamic variables were recorded.Brain water content,neural deficit scores (NDS),imaging changes on MR,pathological changes of brain tissue and neuronal apoptosis were evaluated at 1 d,3 d and 7 days after ROSC.All the data were analyzed by single-factor analysis of variance or Chi-square test.P ＜ 0.05 was considered statistically significant.Result The lowest NDS occurred at 1 d after ROSC,brain water content and imaging changes on MR were most obvious at 3 d after ROSC,while pathological changes of brain tissue and neuronal apoptosis increased and reached the peak at 7d after ROSC.The survival rates after 24 hours of AP4,AP6 and AP8 groups were 85％,75％ and 45％,respectively.The rate of ROSC and survival rate of AP8 group were significantly lower than those of other groups (P ＜0.01).The longer time of asphyxia the severer pathological changes of brain tissue,brain edema,neural deficit,and magnetic resonance imaging changes in all experimental groups.As compared to other groups,the brain damage index of AP8 group was most serious,while that of AP6 group was moderate.Conclusions The rat model following asphyxia-induced cardiac arrest and cardiopulmonary resuscitation was established successfully.From the evidence of survival rate and damage grade of brain tissue,asphyxia for 6 min may be the rational length of ischemic time in this model.

BACKGROUND: Peripheral arterial occlusive disease is a kind of commonly seen peripheral arterial disease. Its pathogenesy and process of pathological change are still unclear. Most of its clinical symptoms are very severe and therapeutic effect is not very good.OBJECTIVE: To observe the effect of limb negative pressure on substance P (SP)-positive-immunoreactive nerve fibers in the spinal cord and dorsal root ganglion of dogs with peripheral arterial occlusive disease.DESIGN: A randomized and controlled experimental trial.SETTING: Department of Anesthesiology, Shaanxi Provincial Corps Hospital, Chinese People's Armed Police Forces; Third Department of General Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the animal laboratory,Xijing Hospital, Fourth Military Medical University of Chinese PLA between April 2003 and May 2004. Totally 17 healthy hybrid dogs, of clean degree, weighing 12 to 18 kg, were enrolled in the experiment. After being numbered, they were randomly divided into 3 groups: treated group (n=10),non-treated group (n=5) and normal control group (n=2).METHODS: Left hindlimb ischemia models were created on the animals in the treated group. Fourteen days after modeling, the affected limbs were treated by negative pressure, once a day, 15 minutes once. Perfusion was given 10 days after negative pressure treatment. Segment L1-L5 spinal cord and dorsal root ganglion were dissected respectively. Immunohistochemical staining was conducted to detect SP-positive- immunoreactive nerve fibers;In the non-treated group, treatment and detection of affected limbs were performed as those in the treated group, but negative pressure treatment was omitted. Ischemia model preparation and negative pressure treatment were not conducted in the normal control group, and only immunohistochemical staining was given.MAIN OUTCOME MEASURES: Changes in SP of sensory nerve fiber of spinal cord and dorsal root ganglion of dogs among 3 groups RESULTS: The dyeing of SP-positive-immunoactive nerve fibers of spinal cord and dorsal root ganglion at affected sides in non-treated group (mean gray scale value: 70.20 ±3.70,67.00 ±3.30 respectively )was significantly stronger than that in normal control group (20.00 ±2.80,35.50 ±6.40),while that in treated group (48.50±6.60,51.70±4.00) was weaker than that in non-treated group, but was still stronger than that in normal control group (all P ＜ 0.01).CONCLUSION: The number of SP-positive-immunoactive nerve fibers of spinal cord and dorsal root ganglion following peripheral arterial occlusive disease is increased significantly, which might be a kind of self-protective mechanism of organism. Limb negative pressure can reduce the importation of nocuous stimulation and release limb pain following arterial occlusive disease of limbs.

OBJECTIVETo explore methods and clinical effects of composite external fixtor in treating adult patients with unstable middle 1/3 of clavicular fractures.

METHODSFrom March 2008 to March 2011,36 patients with unstable middle 1/3 of clavicular fractures were treated with composite external fixtor. There were 24 males and 12 females, aged from 18 to 55 years old with an average of 43 years old. Twenty cases on the left side and 16 cases on the right side. Time from injury to operation was 2 to 6 days (averaged 3.5 days). According to Robinson classification, there were 7 cases with type 2A2, 18 cases with type 2B1, and 11 cases with type 2B2. No vessels and nerve damage occurred before opreation. The clinical effects were evaluated according to Neer scoring.

RESULTSAll cases were followed up from 6 to 12 months with an average of 8 months. The mean Neer score was 88.3 +/- 6.2, which included pain 31.6 +/- 3.2, functional score 25.7 +/- 2.2, range of motion score 21.1 +/- 1.7, and anatomy score 8.8 +/- 0.8. There were 22 cases in excellent, good in 13, fair in 1. Two cases occurred pin tract infection.

CONCLUSIONComposite external fixtor is an optional method in treating unstable middle 1/3 of clavicular fracture, and can obtain a good clinical effects.

Adolescent ; Adult ; Bone Nails ; Clavicle ; injuries ; surgery ; External Fixators ; Female ; Fracture Fixation ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo compare the early clinical effects of Activ C cervical disc replacement (ACDR) and anterior cervical discectomy and fusion (ACDF) in treating single-level cervical spondylosis.

METHODSThe clinical data of 76 patients with single-level cervical spondylosis underwent surgery from July 2009 to September 2012 were retrospectively analyzed. Among them, 28 patients were treated with ACDR (ACDR group), including 18 males and 10 females, aged from 32 to 62 years old with an average of (45.2±6.2) years; and 48 patients were treated with ACDF (ACDF group), including 28 males and 20 females, aged from 33 to 60 years old with an average of (45.8±6.4) years. Visual analogue scale (VAS), Japanese Orthopedics Association (JOA) score, Short Form-36 (SF-36), imaging data were used to assess the clinical effects after operation.

RESULTSA total of 76 patients were followed up from 6 to 24 months with an average of 13.2 months. VAS of neck pain and brachialgia were improved in all patients after operation (P<0.05), there was no significant difference between two group (P>0.05). Somato-score and psycho-score of SF-36 of two groups were obviously increased (P<0.05), ACDR group was better than that of ACDF group (P<0.05). In ACDR group, there was no significant difference in the range of motion of surgical segments and adjacent segments between preoperative and postoperative (P>0.05); heterotopic ossification around the edge of vertebral body occurred in 1 case on the 6th month after operation, no fusion was found on the 1st year after operation. In ACDF group, the adjacent vertebral disease occurred in 1 case and the patient underwent the reoperation.

CONCLUSIONActiv C cervical disc replacement can reduce the degeneration of adjacent segments and its early outcomes for the treatment of single-level cervical spondylosis are satisfactory, but the long-term effects still need study.

Adult ; Cervical Vertebrae ; surgery ; Diskectomy ; methods ; Female ; Humans ; Male ; Middle Aged ; Spinal Fusion ; methods ; Spondylosis ; surgery ; Total Disc Replacement ; methods