Objective To explore the mechanism of macro-reentry atrial tachycardia and to guide catheter ablation using electroanatomic mapping system in 3 patients.Methods Three patients(two females),aged 51?12 years,with atrial tachycardia were included.The mean history of symptom was 19?11 years.Conventional electrophysiological study was performed to determine the location of atrial tachycardia before the three dimensional geometry reconstruction.After voltage and activation maps were constructed,the mechanism of tachycardia was analyzed and the slow conduction areas(critical isthmus) were verified.Radiofrequency energy was delivered using irrigated-tip catheter.Results Though there was no evidence to suggest structural heart diseases,scar areas were found in the mapped atria in all the three cases.The mechanism of atrial tachycardia was found to be counter-clockwise macro-reentry around tricuspid valve,counter-clockwise macro-reentry around superior vena cava,and figure "8" reentry in left atria in the 3 patients respectively.The respective critical isthmus was found to be between the lateral scar and tricuspid valve,the lateral scar and superior vena cava,and two scars on the left atria roof.Ablation in the critical isthmus terminated all tachycardia.There were no atrial tachycardia recurrence during a follow-up of 9-10 months.Conclusion The substrate and electrophysiological mechanism of macro-reentry atrial tachycardia could be identified clearly,and navigation ablation could be performed effectively under the guidence of electroanatomic mapping.

Theinnate immunity system of human body has more and more attention for its antibacterial, antiviral, maintainingimmunehemostasis and promoting tissue damage and repair and other physiological functions.As members of NOD-like receptors(NLRs), NOD1 and NOD2 receptors are identified as intracellular pattern recognition receptors(PRRs), can be identified with molecular damage endogenous(damage-associated molecular patterns, DAMPs)and exogenous injury-molecular pathogen associated molecular(pathogen-associated molecular patterns, PAMPs), and initiation of innate and specific immune response, maintain the steady balance of body.Recently, a bunch of evidence have demonstrated that the importance of NOD1 receptor and NOD2 receptor is not limited in field of anti-infection, and the insulin resistance, kidney and liver damage recovery, cardiovascular disease and tumorigenesis are also closely related with these two receptors.So the aim of this article is to interpret the NOD1 and NOD2 general structure and function, and summarize the link between these two PRRs and tumorigenesis and finally make a clue for cancer immunotherapy.

The HPLC-UV-Fluorescence technique and HPLC-UV-MS technique were used to determine fluorescence molecule in gastric juice of patients with malignant gastric cancer,which is identified as tryptophan. Lidocaine was detected in gastric juice of patients who were examined by gastric endoscopy. A method was developed to determine concentration of tryptophan and lidocaine in gastric juice using HPLC-UV technique,in which Kromasil C_(18) column(150 mm×4.6 mm,5μm) and methanol(containing 0.1% trifluoroacetic acid (TFA))-water(containing 0. 1% TFA) as gradient mobile phase were used. The linear relationships were obtained between the concentration of tryptophan in the range of 0.5 - 200 mg/L and its peak area at 278 run with correlation coefficient of 0.9994,and between the concentration of lidocaine in the range of 20 -5000 mg/L and its peak area at 254 nm with correlation coefficient of 0.9992. The limit of detection is 0.15 mg/L for tryptophan and 5 mg/L for lidocaine. The recovery is 70. 8% - 110. 4% for tryptophan and 87. 1% -116.2% for lidocaine. 38 gastric juice samples of patients with malignant gastric disease and 48 gastric juice samples of patients with benign gastric disease were tested and the concentration of tryptophan in those two groups of gastric juice samples was apparently different.

Objective To investigate the expression and clinical value of miRNA -22 in esophageal and gastric cancer tissues and cell lines.Methods Realtime -PCR was performed to detect the expression of miRNA -22 in human esophageal cancer cell lines ECA109,TE -1,TE -8,TE -13 and normal esophageal epithelial cells HEEC,48 cases of esophageal cancer tissues and matched adjacent normal tissues,human gastric cancer cell lines SGC -7901,MKN -45,NCI -N87,AGS,NUGC -3,SUN -1,normal human gastric mucosa cell line GES -1 and normal stomach fibroblastic cell NSFC,88 cases of gastric cancer tissues and matched adjacent normal tissues.Results The expression of miRNA -22 was much less in four esophageal cancer cell lines than that of immortalized normal esophageal epithelial cells HEEC,and the expression of miRNA -22 was much less in six gastric cancer cell lines than that of gastric mucosal epithelial cell line GES -1 and normal stomach fibroblastic cell line NSFC.The esophageal cancer tissues showed aberrant down regulation of miRNA -22 compared with the adjacent non -tumor tissues [(3.51 ±1.05)vs.(11.23 ±2.95),t =18.13,P <0.05].The gastric cancer tissues showed aberrant down regula-tion of miRNA -22 compared with the adjacent non -tumor tissues [(2.15 ±1.23)vs.(9.14 ±2.86),t =22.93, P <0.05].Conclusion The expression of miRNA -22 was much lower in esophageal and gastric cancer tissues and cell lines,which provided basement to nosogenesis,early diagnosis and create drug treatment of the cancers.

Objective The purpose of this study was to evaluate the outcome of autogenous bone grafts in unilateral cleft lip and palate patients following early orthodontic tooth movement,and to determine the volume of new bone formation in the bone grafted region with spiral computed tomography.Methods Computed tomography scans of 12 patients were taken immediately preoperatively and at 6 months postoperatively.The patients underwent bone grafting between 9 and 13 years of age were divided into two groups based on whether postoperative orthodontic tooth movement were initiated or not.Three-dimensional models were created in each period,and the defect of alveolar cleft and volume of the newly formed bone were calculated in each patient.The roots of the moved teeth and their positions to the alveolar bone were also observed.Results The preoperative cleft width and cleft volume were not significantly different between both groups.The volume of the newly formed bone in group A was (0.98±0.23) mm3,significantly higher than that in group B,which was (0.73± 0.15) mm3.The rate of newly formed bone in group A was (72.5 ± 11.9)％,significantly higher than that in group B,which was (53.2±9.7)％.The cleft adjacent teeth could move smoothly into the bone grated area,with no root resorption observed in the computed tomography scans.Conclusions Early orthodontic tooth movement can reduce bone resorption in autogenous bone grafted unilateral cleft lip and palate patients through the observation of spiral computed tomography.It plays an active role in the bone remolding process after bone grafting.

Objective Chronic atrial fibrillation (AF) results in dedifferentiation of atrial cardiomyocytes that plays an important role in the perpetuation of AF.In this study,we aimed to investigate the changes of titin and α-smooth muscle actin (α-SMA) after long time of AF reversal.Methods Twenty-four goats were randomized into four groups:(1) sinus rhythm (SR),(2) 3 months AF (3-mo AF),(3) 3 months SR after 3 months AF (3-mo post AF),(4) 6 months SR after 3-mo AF (6-mo post AF),with 6 in each group.By pacing on the anterior bottom of left atria appendage (LAA),we established a goat model of chronic AF.Atria effective refractory period (AERP) was measured with electrophysiological methods.Ultra-structure was studied with echocardiography,light and electron microscopy.Titin and α-SMA protein expressions were determined by Western blot.Results The animals underwent high rate pacing on LAA for a mean of 42.23±21.70 days before presenting AF.Electrophysiological analysis revealed that AERP completely resumed in 3-mo post AF goats.Echocardiography displayed that the size of left atrium resumed almost in 6-mo post AF goats (P＜ 0.01).Pathological and electron microscopic examination revealed the disorder of myofibrils,augmentation of intercellular space,myolysis,accumulation of glycogen,and numerous bigger mitochondria among atrial cardiomyocytes in 3-mo AF goats.They recovered mostly in 6-mo post AF goats.Western blot showed that the band density of titin significantly reduced in 3-mo AF goats compared to SR ones [1826±319 vs 5012±854,P＜0.01].In 3-and 6-mo post AF goats,titin increased gradually and it reversed completely in 6-mo post AF goats (3841±601 and 4523±833 respectively,P ＜ 0.01).Conversely,the band density of α-SMA was significantly higher in 3-mo AF goats (5324±948) than in SR ones (1619± 271,P＜0.01).In 3-and 6-mo post-AF goats,α-SMA decreased gradually,and it recovered mostly in 6mo post AF goats (4437± 792 and 2205±540 respectively,P＜0.01,).Conclusions These data indicate that the reversal of dedifferentiation of atrial cardiomyocyts is a very slow process,and it is definitely essential for normal cardiac function.

Objective To investigate the effect of different stimulants on the LAG3 expression and function of spleen lymphocytes in mice. Methods The spleen lymphocytes from mice were isolated by density centrifugation.The LAG3 expressions in T cell subsets after exposure to conA, PMA, PHA or anti-CD3/28 antibodies for 24 h or 72 h were analyzed by Flow cytometry.The IFN-γsecretions of conditional medium were detected by ELISA kit.The proliferation of lymphocytes was examined by MTT analysis.Results Treatment with conA for 24 h or 72 h dose-dependently increased LAG3 +CD3 +and LAG3 +CD4 +CD3 +T cell percentages.Similarly, an exposure of anti-CD3/28 antibodies for 72 h significantly increased LAG3 +CD3 +and LAG3 +CD4 +CD3 + T cell percentages.Meanwhile, conA and anti-CD3/28 antibodies increased the IFN-γsecretion of lymphocytes in a time-dependent manner.Furthermore, Treatment with conA, PMA, PHA or anti-CD3/28 antibodies for 72 h could enhance the proliferation of lymphocyte. Conclusion conA and anti-CD3/28 antibodies are effective activators of T cells, and both of them could promote the expression of LAG3 and IFN-γsecretion of lymphocytes.

ObjectiveTo compare the incidence of C5 nerve palsy after laminoplasty and laminectomy with internal fixation for treating multilevel cervical spondylotic myelopathy (MCSM).MethodsFrom January 2005 to June 2010,68 patients with MCSM were treated with laminoplasty (27 patients,group A) or laminectomy with internal fixation(41 patients,group B).There were 21 males and 6 females in group A,aged 33-80 years(average,60.4 years),31 males and 10 females in group B,aged 22-77 years (average,58.7 years).All the patients were followed up for 12-48 months (average,22 months).In both groups,Cobb's method was applied to measure cervical lordotic angle,and Ishihara's method was conducted to measure cervical curvature index(CCI) before and after operation.The incidence of C5 nerve palsy was recorded and compared.Then we further compared preoperative and postoperative the cervical lordosis angle and CCI of 9 patients with C5 nerve palsy (group B1) and 32 patients without C5 nerve palsy (group B2) in group B.ResultsThe incidence of C5 nerve palsy in group A was 3.7％(1/27),while 22.0％(9/41) in group B (x2=4.32,P＜0.05).For all ten patients with C5 nerve palsy,the muscle strengths of paralyzed muscles were recovered to grade 4 or better after being treated with conservative treatment for an average of 14 months.The change rate of preoperative and postoperative CCI in group B1 was 38.07％±18.03％,while 22.81％±12.71％ in group B2.There was a statistical difference between group B1 and group B2 (t=2.88,P＜0.05).Conclusion Compared with laminoplasty,laminectomy with internal fixation has a higher incidence of C5 nerve palsy.The C5 nerve palsy may be associated with postoperative increase of cervical lordosis angle.Moreover,tethering of the C5 root may be one of its important pathomechanisms.

Objective:To explain the present status of licensed pharmacists in China, and put forward suggestions for perfecting the system by a problem-focused method. Methods: The data from Certification Center for Licensed Pharmacists of CFDA and 2535 pieces of questionnaire from nationwide were reviewed, and the practice registration, distribution, educational background, qualifica-tions and the other status were analyzed. Results:Generally, the development of licensed pharmacists in China was promising. Howev-er, there were still some problems existing in China such as the lower registration rate compared with some countries abroad, the une-ven distribution inside, and the unclear duty understanding. Conclusion:It is proposed to formulate relevant policies to strengthen re-gional guidance, improve registration rate, distinguish the content of continuing education and so on in order to promote the quality of licensed pharmacists in China.

Objective To evaluate initial results of Ivor Lewis minimally invasive esophagectomy (MIE) for esophageal carcinoma using a diamond-shaped anastomosis with 45 mm linear-stapler.Methods Clinical data of 12 patients diagnosed middle to distal esophageal carcinoma and undergoing Ivor Lewis minimally invasive esophagetomy using a diamond-shaped anastomosis technique during Dec.2015 and Nov.2016 in Peking Union Medical College Hospital were collected and analyzed retrospectively.Results The mean operation time was (378 ± 56) min,the mean blood loss was (280 ± 120) ml,and the mean postoperative hospital stay was (12.2 ± 2.0) days.No positive margin,no peri-operative death occurred.Postoperative complication included atelectasis and pulmonary infection in 1 patient,paresis of left recurrent laryngeal nerve in 1 patient.No anastomotic leak or constriction occurred.Median follow up was 7 months,11 patients had no evidence of disease progress,1 patient had subcutanecous metastasis and was reoperated.Conclusion The diamond anastomosis technique utilizing in Ivor Lewis MIE for esophageal carcinoma is feasible,easy to manipulate,safe and reliable.