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 assess the epidemiology and clinical characteristics of sleep disorders in a single center in northwest China.Methods Using the International Classification of Sleep Disorders, 3rd Edition, all consecutive patients which were suspected as sleep disorders in Tangdu Hospital between January 2007 and December 2016, were included retrospectively.Results The average age of 8 037 patients was (46.59±15.83) years with male-female ratio 1∶1.24.Chronic insomnia was found in 3 848 (47.9%) patients, obstructive sleep apnea was found in 2 648 (32.9%) patients, narcolepsy was found in 294 (3.7%) patients, Kleine-Levin syndrome was found in 11 (0.1%) patients, circadian rhythm sleep-wake disorders were found in 14 (0.2%) patients, rapid eye movement behavior disorder was found in 193 (2.4%) patients, restless legs syndrome was found in 139 (1.7%) patients, periodic limb movement disorder was found in 109 (1.4%) patients, and other possible sleep disorders were found in 478 (5.9%) patients, respectively.Chronic insomnia and obstructive sleep apnea combided with somatic diseases.Conclusions Patients diagnosed by polysomnography in our single center suggested consultation rate of sleep disorders was increasing in past ten years, of which chronic insomnia and obstructive sleep apnea were dominant and comorbided with somatic diseases.

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 compare the efficacy and safety of Cardi-O-fix patent foramen ovale (PFO) occluder and Amplatzer PFO occluder for the treatment of patients with PFO. Methods: A total of 246 consecutive patients (105 males and 141 females) with PFO were prospectively enrolled from May 30, 2013 to March 30, 2015 in our hospital. PFO interventional closure was applied according to the anatomical structure of the disease and patients′ wishes.Cardi-O-fix PFO occluder was used in 180 cases (COF group), Amplatzer PFO occluder was used in the remaining 66 cases (Amp group). Post-procedure safety including recurrent stroke, transient ischemic attack, death, and complete closure rate, and efficacy including procedure related complications of different devices were compared during the 12 months follow-up. Results: (1) Rate of transient ischemic attack was similar between COF group and Amp group at 12 months after procedure(1.1%(2/180) vs. 1.5%(1/66), P=1.000). There was no recurrent stroke and death during the 12 months follow-up period.Complete closure rate was similar between COF group and Amp group at 12 months after the procedure(90.6%(163/180)vs. 86.4%(57/66), P=0.355). (2) Three cases(1.7%) of paroxysmal atrial fibrillation were observed in COF group during the 12 months follow-up period, 1 patient converted spontaneously to sinus rhythm and 2 patients received successful pharmacologic conversion and converted to sinus rhythm. One patient(1.5%)developed paroxysmal atrial fibrillation and was pharmacologically converted to sinus rhythm in the Amp group. There was no significant difference in rate of paroxysmal atrial fibrillation between the two groups(P=1.000). There was no complications such as occluder translocation, erosion, pericardial effusion and puncture site bleeding in the 2 groups during the 12 months follow-up. Conclusion Efficacy and safety are similar for PFO treatment with Cardi-O-fix PFO occluder or Amplatzer PFO occluder in this patient cohort.

OBJECTIVETo observe the effect of oversized occluder on endothelialization post percutaneous closure of experimental atrial septal defect (ASD) in dogs.

METHODSASD was established with the help of transthoracic echocardiography in 18 dogs. ASD size was (6.0 ± 0.2) mm. Dogs were randomly divided into normal size group (implanted with 8 mm occlude, n = 9) and oversized group (implanted with 12 mm occluder, n = 9). Dogs were randomly killed at 3, 6 and 14 months after percutaneous closure. The endothelialization process on device surface was observed by scanning electron microscope.

RESULTSFour animals died around 1 month post procedure. Microscopic sections from normal group showed nearly complete endothelialization at 3 months after device implantation and complete endothelialization at 6 and 14 months after device implantation. While microscopic sections showed lack of endothelialization at 3 months post implantation, nearly endothelialization at 6 months, and complete endothelialization at 14 months after device implantation in oversized group.

CONCLUSIONIncomplete endothelialization of occluder surface is observed at 6 months after implantation of an oversized ASD occluder device in this model.

Animals ; Dogs ; Echocardiography ; Heart Septal Defects, Atrial ; diagnostic imaging ; therapy ; Percutaneous Coronary Intervention ; Septal Occluder Device

Objective　To understand the relationship between elective motivation and sleep emotional characteristics of students in sleep medicine course.Methods　The study used Wenjuanxing to investigate data,including demographic data,motivation to elect the Sleep Medicine Course,Pittsburgh Sleep Quality Index (PSQI),Insomnia Severity Index (ISI),Epworth Sleep Score (ESS),Morningness/Eveningness Questionnaire (MEQ),Self-Rating Depression Scale (SDS),Self-Rating Anxiety Scale (SAS) and Fatigue Severity Scale (FSS).Results　From 2017 to 2019,410 students selected the Sleep Medicine Course,in which 70.3% were interested in the course and 27.4% had the demands to resolve sleep problems.The percentage of PSQI≥6 is 28.85%，ESS ≥9 is 6.15%,ISI≥8 is 29.49%,SAS≥508 is 9.1%,SDS≥53 is 25%，the score of FSS is 35.9±12.5.Students were separated to three different groups by cluster analysis.The characteristic of first group was depression (14%),the second group was anxiety and fatigue (63%),and the third was poor sleep quality,sleepiness,anxiety,fatigue,and depression (23%).Conclusions　The motivation of taking Sleep Medicine Courses may be related to the high level of anxiety.Sleep problems are prone to comorbid anxiety and depression and affect daytime function.