Electrocardiography ; Humans ; Male ; Middle Aged ; Myocardial Bridging ; complications ; Myocardial Infarction ; etiology ; Myocardium ; pathology

Objective To compare the effect of right ventricular outflow tract (RVOT) and right ventricular apex (RVA) pacing on ventricular systolic synchrony using gated blood pool SPECT (GBPS).Methods A total of 50 patients implanted with pacemaker due to high degree or complete atria-ventricular block were enrolled in the study. Twenty-three patients were RVOT paced ( Group A, n = 23) and 27 were RVA paced (Group B, n=27). Twenty-four patients with malignancy, normal echocardiographic findings and no history of cardiac diseases were scheduled for pre-chemotherapy evaluation of cardiac structure and function and were enrolled as control group ( Group C, n = 24). All patients underwent GBPS imaging and the values of phase angle (PS), mean phase of each wall, standard deviation (SD) of mean phase of each wall, lateral-septal motion delay of left ventricle ( LV Sep-Lat Delay), septal-right ventricular (RV) delay of LV ( LV Sep-RV Delay) and LV-RV Delay were acquired. The parameters of ventricular systolic synchrony among the three groups were compared using one-way ANOVA. Results The mean phase of LV lateral wall in Groups A and B were significantly higher than that in Group C: Group A (120.50 ±40.58) ms; Group B (103.23±28.34) ms; Group C (84.63 ±22.38) ms (F=7.72, P ＜0.05). There was no significant difference between Groups A and B ( t = 1.30, P ＞ 0.05 ). The mean phase of RV in Group A was significantly larger than those in Groups B and C: Group A ( 137.05 ± 39.27) ms, Group B ( 100.85 ± 23.79) ms,Group C (59. 13 ±30.52) ms (F=35.55, P＜0.05). PS, SD and LV Sep-Lat Delay in Groups A and B were significantly higher than those in Group C: (85.73 ± 12.00)°vs (89.85 ± 15.61 )°vs (58.95 ±9.87)°, (27.68±10.66) ms vs (26.15 ±13.02) ms vs (15.63 ±8.35) ms, (25.06±34.23) ms vs (2. 62 ± 60. 31 ) ms vs ( - 23.66 ± 31.39) ms, F = 41.54,8.55,6.81, all P ＜ 0.01 ), however, there was no significant difference between Groups A and B ( t = 0. 68, 0.68, 1.30, all P ＞ 0.05 ). LV Sep-RV Delay and LV-RV Delay were significantly different among the three groups ( LV Sep-RV Delay: Group A (57.60 ±56.77) ms, Group B (6.36 ±61.88) ms, Group C ( -41.89 ±35.78) ms; LV-RV Delay:Group A (47.36 ±42.59) ms, Group B ( 3.08 ± 38.81 ) ms Group C ( - 26.50 ± 20.99 ) ms, F = 20. 32,25.38, both P ＜ 0.01 ). Conclusion Both RVA and RVOT pacing increase the segmental phases detected by GBPS, causing inter- and intra- ventricular asynchrony compared with patients without pacemakers.

A fetal/maternal multi-parameter monitor is introduced here in the paper. It can monitor the vital signs of a fetus and his/her mother in a same screen synchronously. It is more useful in obstetric clinics. Its other functions include management of patient file, computer-assistant analyses.
Adult ; Automatic Data Processing ; instrumentation ; Electrocardiography, Ambulatory ; instrumentation ; Equipment Design ; Female ; Fetal Monitoring ; instrumentation ; Heart Rate, Fetal ; Humans ; Microcomputers ; Monitoring, Ambulatory ; instrumentation ; Pregnancy ; Signal Processing, Computer-Assisted ; Software

OBJECTIVETo evaluate the clinical and angiographic outcomes of vasospastic angina patients with severe organic stenosis treated by drug-eluting stents.

METHODSBetween January 2006 and December 2010, severe organic stenosis (diameter stenosis more than 70%) was evidenced in 7 out of 46 vasospastic angina patients and treated with drug-eluting stents. Coronary angiography was repeated at 6 - 18 months after percutaneous coronary intervention and the patients were clinically followed up. The clinical and angiographic outcomes were observed.

RESULTSNine drug-eluting stents [mean diameter 2.75 - 3.50 (3.08 ± 0.24) mm, length 24 - 33 (27.3 ± 3.6) mm] were successfully implanted in these 7 patients. Stents were implanted into left anterior descending artery (LAD) in 5 patients (71.4%), right coronary artery (RCA) in 1 patient (14.3%), both LAD and RCA in 1 patient (14.3%). Transient RCA spasm and distal LAD spasm were observed during percutaneous coronary intervention of LAD in 2 patients. Anginal attack at rest with transient ST segment elevation at V(1)-V(3) leads occurred 24 hours after LAD stenting in 1 patient. Follow-up coronary angiography showed significant in-stent restenosis or focal edge restenosis (diameter stenosis more than 50%) in 3 patients (42.9%), mild neointimal proliferation but without significant restenosis in 2 patients (28.6%), and no neointimal proliferation in 2 patients (28.6%). During clinical follow-up of 17 to 50 months after percutaneous coronary intervention, 2 patients (28.6%) remained asymptomatic, while effort angina and/or rest angina was documented in the remaining 5 patients (71.4%).

CONCLUSIONSOur results from this small patient cohort suggest that drug eluting stent implantation for severe organic stenosis in patients with vasospastic angina is linked with high incidence of restenosis and recurrent chest pain. Further observation in larger patient cohort is warranted to clarify the efficacy of this strategy for treating vasospastic angina patients with severe organic stenosis.

Aged ; Angina, Unstable ; etiology ; therapy ; Angioplasty, Balloon, Coronary ; Coronary Stenosis ; therapy ; Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo evaluate the in-hospital outcome and determinants relating to success rate of percutaneous coronary intervention (PCI) for patients with chronic total occlusion (CTO) using contemporary techniques.

METHODSA total of 1485 patients with total occluded coronary artery were identified from January 2004 to December 2008 in Zhongshan hospital. Of them, 638 patients were affirmed as CTO and 447 patients underwent PCI. The clinical data and the in-hospital outcome of patients underwent PCI were retrospectively analyzed.

RESULTSProcedure success was achieved in 382 patients (85.5%). Coronary perforation (C-F type dissection or coronary perforation) occurred in 27 patients (6.0%), cardiac tamponade developed in 6 out of the 27 patients, 2 patients (0.4%) received in-hospital repeat revascularization. Two patients (0.4%) died post PCI: one died of acute stent thrombosis and the other one died of refractory heart and respiratory failure.Compared with patients of successful recanalization, patients failure to recanalization were more aged [(62.9 ± 10.4)years vs. (65.9 ± 9.9) years, P < 0.05] and excessive tortuosity (16.2% vs. 38.5%, P < 0.01), absence stump (47.1% vs. 80.0%, P < 0.01) and excessive calcification (36.9% vs. 72.3%, P < 0.01) were more common. Multiple logistic regression analysis revealed that excessive calcification (OR: 3.866, P < 0.01), absence stump (OR: 3.346, P < 0.05) and excessive tortuosity (OR: 3.055, P < 0.01) were independent predictors for the procedural failure.

CONCLUSIONSPCI for patients with CTO is safe and effective. Apart from progress on the equipment development, procedural success rates are closely related with the clinical and angiographic features of CTO.

Aged ; Angioplasty, Balloon, Coronary ; Chronic Disease ; Coronary Occlusion ; therapy ; Humans ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo analyze the clinical and angiographic characteristics of patients with slow coronary flow (SCF).

METHODSIn this retrospective study, 140 patients with SCF and 140 control subjects without SCF were included. SCF were diagnosed by the combination of TIMI flow grade method and TIMI frame count method. All subjects had angiographically normal coronary arteries. The clinical and laboratory data were obtained from medical records at admission.

RESULTSCompared to control group, patients with SCF were younger [(57.8 +/- 10.7) years vs. (59.8 +/- 8.2) years], rate of smokers (59.3% vs. 46.4%) and diabetes mellitus (49.3% vs. 30.7%), fasting blood glucose (FBG) level [(7.8 +/- 2.8) mmol/L vs. (6.2 +/- 2.0) mmol/L, P < 0.05] and triglyceride (TG) level [(2.11 +/- 1.93) mmol/L vs. (1.67 +/- 1.01) mmol/L, P < 0.05] were higher, while high density lipoprotein cholesterol (HDL-C) level [(1.05 +/- 0.35) mmol/L vs. (1.42 +/- 0.74) mmol/L, P < 0.01] and apolipoprotein A1 (apoA1) level [(1.10 +/- 0.19) mmol/L vs. (1.31 +/- 0.31) mmol/L, P < 0.01] were lower. Among the 140 SCF patients, left anterior descending artery (LAD), left circumflex artery (LCX) and right coronary artery (RCA) were involved at the same time in 92 patients. Among the three vessels, RCA is the most frequent involved vessel (n = 119). After adjusting for other risk factors, current smoking (OR = 1.92, 95% CI: 1.04 - 3.57, P < 0.05), DM history (OR = 2.44, 95% CI:1.32-4.76, P < 0.01), FBG (OR = 2.13, 95% CI:1.16-3.98, P < 0.05), TG (OR = 1.47, 95% CI:1.03-2.13, P < 0.05), HDL-C (OR = 0.47, 95% CI:0.24-0.85, P < 0.05) and apoA1 (OR = 0.55, 95% CI:0.40 - 0.75, P < 0.01) were independent factors for SCF (all P < 0.05).

CONCLUSIONSOur results demonstrated that patients with SCF were prone to have a significant metabolic disorder compared to the control group. Patients with high levels of FBG, TG and low levels of HDL-C were more likely to suffer from SCF, which maybe explained by the development of coronary endothelium and microvascular dysfunction.

Aged ; Case-Control Studies ; Coronary Angiography ; Coronary Artery Disease ; diagnostic imaging ; physiopathology ; Coronary Circulation ; Coronary Vessels ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo explore the influence of obesity on surgical procedure and short-term surgical outcome in patients with gastric carcinoma.

METHODSA total of 426 patients with gastric carcinoma underwent laparotomy in our hospital during January 2006 and June 2008. All the patients were divided into obesity group and non-obesity group according to body mass index (BMI). The thickness of subcutaneous fat (SCF), abdominal anterior-posterior diameter (APD) and transverse diameter (TD) at the umbilicus level were measured by abdominal CT. Furthermore, the surgical data and postoperative conditions including short-term outcome were reviewed and compared between two groups.

RESULTSThe incidence of obesity was 29.8% in gastric carcinoma patients. Mean values of SCF thickness, APD and TD in obesity group and non-obesity group were (21.8+/-7.1) mm vs (14.4+/-7.5) mm, (223.2+/-24.6) mm vs (181.8+/-23.5) mm and (323.6+/-23.8) mm vs (285.8+/-24.4) mm (P=0.000). Longer operative time (P=0.007) and less amount of dissected lymph nodes were found in obesity group as compared to non-obesity group (P=0.000). Also, obesity group lasted a longer postoperative period of fever (P=0.000) and experienced more post-operative complications (P=0.005) than non-obesity group did.

CONCLUSIONSAbdominal CT scan may display the abdominal shape of gastric carcinoma patients, hence, it is useful to evaluate the difficulty of surgical procedure. These patients may involve in complicated surgical procedure and worse short-term outcome due to obese abdominal shape. Therefore, perioperative management should be emphasized for these patients.

Abdomen ; surgery ; Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Female ; Gastroplasty ; Humans ; Male ; Middle Aged ; Obesity ; Stomach Neoplasms ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo evaluate the components and characteristics of coronary atherosclerotic plaques in type 2 diabetic patients using virtual histology intravascular ultrasound (VH-IVUS).

METHODSIn vivo atherosclerotic plaques (over 50% angiographic diameter stenosis) of the three main coronary arteries were analyzed by gray-scaled IVUS with planar and volumetric VH-IVUS in consecutive patients examined between September 2008 and March 2009. Patients were divided into two groups: diabetic mellitus (DM) group with 22 patients (39 lesions) and non-DM group with 46 patients (69 lesions).

RESULTSAt the minimal lumen area (MLA) site, the percentage of NC (necrotic core) area (19.4% +/- 1.2% vs. 15.1% +/- 1.1%, P = 0.015) and dense calcium (DC) area (15.2% +/- 1.6% vs. 10.7% +/- 1.1%, P = 0.016) were significantly larger while fibrotic tissue (FT) area (56.7% +/- 2.3% vs. 64.8% +/- 1.8%, P = 0.007) was smaller in DM group than in non-DM group. Likewise, volumetric VH-IVUS analysis showed that the percentage of NC volume (21.3% +/- 1.3% vs. 16.5% +/- 1.1%, P = 0.008) and DC volume (16.6% +/- 1.4% vs. 11.3% +/- 1.1%, P = 0.003) were significantly larger while FT volume (55.1% +/- 2.1% vs. 63.9% +/- 1.8%, P = 0.003) was significantly smaller in DM group than in non-DM group. Moreover, significantly higher incidence of VH-TCFA (thin-cap fibro atheromas) was evidenced in the DM group than in the non-DM group (69.2% vs. 42.0%, P = 0.009). However, the remodeling index and the positive remodeling frequency were similar between the 2 groups.

CONCLUSIONIncidence of necrotic core, dense calcium plaque and vulnerable plaques in stenotic lesions was higher in DM patients than in non-DM patients.

Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Coronary Artery Disease ; diagnostic imaging ; etiology ; Coronary Vessels ; diagnostic imaging ; Diabetes Mellitus, Type 2 ; complications ; diagnostic imaging ; pathology ; Female ; Humans ; Male ; Middle Aged ; Plaque, Atherosclerotic ; diagnostic imaging ; etiology ; Ultrasonography, Interventional ; methods

OBJECTIVETo study the expression and significance of GCS gene in human pancreatic cancer cell line SW1990 and its drug-resistant sublines.

METHODSSW1990 and its drug-resistant sublines, SW1990/FU, SW1990/ADM and SW1990/GEM were cultured in vitro. CCK-8 (Cell Counting kit-8) was used to detect the drug resistance of the sublines. Relative quantitation of GCS mRNA expression was evaluated by real-time PCR and Western blot was adopted to evaluate the expression of GCS protein.

RESULTSThe drug resistance indexes of SW1990/FU, SW1990/ADM and SW1990/GEM were 339.7, 11.9 and 56.6, respectively. The GCS mRNA and protein were expressed in all SW1990 and its drug-resistant sublines. There was a higher expression of GCS mRNA in all the sublines and a significant difference of GCS protein expression was detected in SW1990/ADM and SW1990/GEM compared with SW1990.

CONCLUSIONSGCS gene is expressed in SW1990 and its drug-resistance sublines. The high expression of GCS protein in SW1990/ADM and SW1990/GEM might be one reason of resistance to ADM and GEM in the sublines.

Cell Line, Tumor ; Drug Resistance, Neoplasm ; genetics ; Gene Expression ; Glucosyltransferases ; biosynthesis ; genetics ; Humans ; Immunoblotting ; Pancreatic Neoplasms ; enzymology ; genetics ; pathology ; RNA, Messenger ; genetics ; Reverse Transcriptase Polymerase Chain Reaction

The human UDP-glucuronosyltransferase 1A1 (UGT1A1), one of the most essential conjugative enzymes, is responsible for the metabolism and detoxification of bilirubin and other endogenous substances, as well as many different xenobiotic compounds. Deciphering UGT1A1 relevance to human diseases and characterizing the effects of small molecules on the activities of UGT1A1 requires reliable tools for probing the function of this key enzyme in complex biological matrices. Herein, an easy-to-use assay for highly-selective and sensitive monitoring of UGT1A1 activities in various biological matrices, using liquid chromatography with fluorescence detection (LC-FD), has been developed and validated. The newly developed LC-FD based assay has been confirmed in terms of sensitivity, specificity, precision, quanti-tative linear range and stability. One of its main advantages is lowering the limits of detection and quantification by about 100-fold in comparison to the previous assay that used the same probe substrate, enabling reliable quantification of lower amounts of active enzyme than any other method. The precision test demonstrated that both intra- and inter-day variations for this assay were less than 5.5％. Further-more, the newly developed assay has also been successfully used to screen and characterize the regu-latory effects of small molecules on the expression level of UGT1A1 in living cells. Overall, an easy-to-use LC-FD based assay has been developed for ultra-sensitive UGT1A1 activities measurements in various biological systems, providing an inexpensive and practical approach for exploring the role of UGT1A1 in human diseases, interactions with xenobiotics, and characterization modulatory effects of small mole-cules on this conjugative enzyme.