18 patients with atrioventricular nodal reentant tachycardia (AVNRT)and 5 patients with atrioventricular reentrant tachycardia (AVRT) with AVN double pathway (AVNDP) received radiofrequency ablation of slow pathway with inferior approach in order to modify AVN. AVNRT was induced in slow-fast form in 16 patients, in fast-slow form in one patients,and in coexistent slow-fast and fast-slow forms in one patients. Selective ablation of slow pathway was achieved in 18 patients. AVRT was induced in 5 patients (one obvient accessory pathway, 4 concealed accessory pathways) ,4 patients with reentrant cirucit of consisting of anterograde conduction by slow pathway of AVN and retrograde conduction by accessory pathway (AP) , one patient coexistent AVRT and AVNRT. Slow pathway in 5 patients and AP in 3 patients were successfully ablated. Junctional rhythm appeared in 21 patients during duation of discharge of radiofrequency current. No severe complicationwere noted. AVNRT in one patient recurred during a follow-up period of 1 to 15 months. The patient experienced second catheter ablation and was successed. It was suggested radlofrequency ablation of slow pathway with Inferior approach may be a method with high rate of success and less complication.

Gene therapy has been widely explored as a promising therapeutic tool in modem medical treatment. It is one of key steps for gene therapy to choose efficient carrier. In spite of the high transfection efficiencies of viral vectors, their utilization has been impaired due to immunogenicity and safety. Nanoparticles made by chemical reaction act as non-viral vector, which solved above-mentioned problems, enhanced efficiency of gene transfection. In recent years, polyethyleneimine-based nanoparticles have become ideal carriers in the research of gene transfection, drug controlled release system and cell biology. This review focuses on properties,preparation and application of nanoparticles based on polyethyleneimine.

Objective To analyze the difference of the peripherally inserted central venous catheter (PICC) and central venous catheter (CVC) in cancer chemotherapy.Methods All eligible studies on PICC and CVC were searched in China National Knowledge Infrastructure,Wanfang database and VIP database.The Jadad scale was used for quality assessment of all the included studies.All analysis were conducted in Stata 12.0.Results Thirty-six studies with a total of 4920 cases of patients were included in this meta-analysis,with 2349 cases in PICC group and 2571 cases in CVC group.PICC group had advantages in puncture success rate for the first time,the average puncture time,the average catheter time than the CVC group.PICC group had fewer complication,such as the hemopneumothorax incidence,the strayed artery incidence and catheter infection incidence; however,the phlebitis incidence was higher than the CVC group.Conclusions PICC has some advantages specific in simple operation,a long retention time,fewer complications and safety.Therefore,PICC can be widely used in cancer chemotherapy.

Objective To examine the distribution of HA in monocytes and expression of CD44 and ICAM-1 on the monocytes and effects of HA and HA receptors on adhesion and migration of the monocytes. Methods Canine peripheral blood monocytes were isolated by non-continuous density centrifugation with percoll solution.HA on the cell surface,intracellular HA,CD44 and ICAM-l of the monocytes were labeled with immunofluorescence.Effects of HA on the cell surface,substrate HA and free HA on adhesion and migration of the monocytes were examined by digesting HA on the cell surface with HAase,coating the bottom of the dishes and the membrane of the cell culture inserts with HA and adding HA into the medium.Regulating effects of HA receptors on adhesion and migration of the monocytes were investigated after blockade of the receptors. Results There was HA on the surface and in the cytoplasm of the monocytes.CD44 and ICAM-1 were expressed on the monocytes.The adhered and migrated monocytes decreased after HA on the cell surface was digested with HAase.The numbers of the adhered and migrated monocytes were greater when the cells were incubated on HA-coated dishes and membranes of the cell culture inserts.The adhered and migrated monocytes decreased after HA was added into the medium.When CD44 was blocked with antibody,the adhered and migrated monocytes decreased.There were not significant changes in the numbers of the adhered and migrated monocytes after ICAM-1 was blocked with antibody.Conclusion There is HA on the surface and in the cytoplasm of monocytes.HA on the cell surface is essential for adhesion and migration of the monocytes.HA substrate promotes adhesion and migration of the monocytes,while free HA reduces adhesion and migration of the cells.CD44 mediates HA-induced adhesion and migration of the monocytes.

Objective To investigate apoptosis and bcl-2 expression of dust cells in human bronchopulmonary lymph nodes and murine peritoneal macrophages treated with carbon particles and study the relation of apoptosis of dust-laden macrophages and structural changes of the lymph nodes. Methods Distribution of dust particles, apoptotic cells and structural changes of the lymph nodes were viewed on paraffin sections and ultrathin sections. Apoptosis and bcl-2 expression of dust cells in human bronchopulmonary lymph nodes and macrophages treated with carbon particles were observed with TUNEL staining and bcl-2 antibody labeling. Results In the bronchopulmonary lymph nodes of the adult group, dust particles were deposited significantly in macrophages, the lymphatic tissue decreased, collagen fibres and density of blood vessels increased. In ultrathin section, the nucleus condensed and contained vacuoles. There were TUNEL-positive cells and bcl-2 labeling positive cells in dust cells of the lymph nodes and macrophages 24*!h after phagocytizing carbon particles. Bcl-2 was expressed strongly in the active macrophages decomposing dust particles or carbon particles. Conclusion Deposition of dust particles induces apoptosis and overexpression of antiapoptotic gene bcl-2 of macrophages in human bronchopulmonary lymph nodes. Structural changes of the bronchopulmonary lymph nodes in adult may relate to apoptosis of dust-laden macrophages.

Objective To examine location of hyaluronan(HA) in macrophages and effects of HA on adhesion and migration of macrophages and explore regulating mechanism of HA. Methods HA of macrophages was labeled with aggrecan.Location of intracellular and extracellular HA of the cells was viewed using optic microscope and confocal laser scanning microscope.Effects of HA on adhesion and migration of macrophages were examined by adhesion assay and migration assay. Results Macrophage synthesized HA.HA located mainly on the membrane and in premeter and perinuclear area of the quiescent cells.In the moving cells,most of intracellular HA located in pseudopodia,tail and perinuclear area.HA was rich on the surface of the pseudopodia and tail of the cells.HA on the surface of macrophages and HA substratum increased cell adhesion and migration,addition of free HA into the medium decreased cell adhesion.Conclusion There are characteristics of HA distribution in macrophages.HA synthesized by macrophages and HA substratum promoted adhesion and migration of macrophage,while free HA reduces cell adhesion.

Objective:To investigate the effect of potassium sodium hydrogen citrate in the treatment of renal uric acid calculi with heavy load.Methods:The clinical data of 6 patients with intrarenal high-load uric acid calculi (long diameter >4 cm) treated with potassium sodium hydrogen citrate in our hospital from January 2018 to July 2020 were reviewed. All of the patients were male. Their ages ranged from 42 to 66 years, with an average age of 51.3 years old. The average length to diameter was 6.0(4.1-7.6) cm. The average density of stone was 475 (418-535) HU. The average blood uric acid was 453.3(258.7-570.0)μmol/L, and all patients had a urine pH ≤5.5. The blood uric acid level was higher than normal serum uric acid level before treatment, and 3 cases had a history of gout. Stone composition analysis revealed 100% uric acid stone in two patients before treatment. The remaining patients were more likely to have uric acid calculi before treatment. None of the patients had a history of urinary tract infection. All patients were treated with oral potassium sodium hydrogen citrate. During the treatment, the starting dose was 10g/ day, which was divided into 2.5 g after breakfast, 2.5 g after lunch and 5.0 g after dinner. The dose was adjusted according to the pH value of urine, and the urine pH was maintained between 6.5-7.0. CT plain scan was repeated every 2-3 months during the treatment period to evaluate the treatment effect.Result:After 2.5-8.0 months’ treatment, the stone load of all the patients was reduced to different degrees, and the average length diameter was shortened by 3.2cm, among which two patients’ stones disappeared. CT scan showed the stone edge changed from smooth to rough after the treatment, and there would be worm erosion defect and cavity on the surface and inside of the stone, showing obvious stone dissolution phenomenon.Conclusions:Potassium sodium hydrogen citrate has a good therapeutic effect on renal uric acid calculi with heavy load. Non-infected patients with uric acid calculi should be treated with potassium sodium hydrogen citrate.

ObjectiveTo establish the rat model of multi-infarct dementia. MethodsSephadex (4 mg/ml, 8 mg/ml) was injected into the internal carotid artery through the common carotid artery. Neurological deficits were measured 24 h after the operation, and Morris water maze test as well as Nissl stain were observed 26～30 d after the operation. ResultsThere was significant difference between the model groups injected sephadex of 8 ml/ml and 4 mg/ml in the neurologic deficits. In the following experiment, the rats injected sephadex of 8 mg/ml were only used as model. For the water maze test, the escape latency was longer (P＜0.01) and the frequency across target area reduced (P＜0.01) in the model, while the apoptotic Nissl body could be observed. ConclusionA model of multi-infarct dementia could be established with the sephadex in rats.

Objective To study the microstructural characteristics of white matter fiber tracts of visual pathways using diffusion tensor imaging (DTI)in the patients with primary glaucoma.Methods Twenty patients with primary bilateral glaucoma and 30 nor-mal adults were recruited and scanned with visual pathways magnetic resonance imaging (MRI)and DTI,obtaining T1 FLAIR ima-ges and directionally encoded color (DEC)images.On DEC images,ROIs were put in the anterior,middle and posterior part of bi-lateral optic nerve,optic tract and optic radiation,to calculate the average FA and MD value of each region.Results T1 FLAIR and DEC images could clearly show the optic nerve,optic tract and optic radiation.In patients with glaucoma,the FA values of optic nerve,optic tract and optic radiation were:0.372±0.040,0.340±0.036,0.31 5±0.026,while the MD values were:1.760±0.1 1, 1.831±0.09,1.927±0.10.The FA values of optic nerve,optic tract and optic radiation of normal adults were:0.538 ±0.073, 0.460±0.082,0.455±0.083,whilst the MD values were:0.995 ±0.27,1.312 ±0.40,1.347 ±0.37.Compared with the normal controls,FA values of all parts are deceased whereas the MD values of all parts are increased in patients.Conclusion Glaucoma is a central nervous system disease involving the whole visual pathways.Use DTI can evaluate the microstructural characteristics of white matter fiber tracts of visual pathways in the patients with glaucoma.

Objective To discuss the clinical feature ,diagnosis and treatment of the occult cerebrospinal fluid rhinorrhea after tracheotomy in patients with severe traumatic brain injury .Methods The clinical data of 18 cases of the occult cerebrospinal fluid rhinorrhea after tracheotomy in patients with severe traumatic brain injury were retro -spectively analyzed .Results 15 cases showed involuntary swallowing movements ,frequent stimulus-likecough, abnormal increased secretions in the oral and nasal;3 cases performance of aspiration ,hypoxemia ,respiratory distress . After a three -dimensional thin skull CT , cisternography , nasal endoscopic examination can confirm the diagnosis . After the treatment with replacing the tracheostomy tube with a balloon ,continuous lumbar drainage ,endoscopic repair leak,the cerebrospinal fluid rhinorrhea were cured .Conclusion Patients with occult cerebrospinal fluid rhinorrhea performance the diversity and easily missed ,early detection and timely treatment can prevent cerebrospinal fluid rhi-norrhea delayed healing and intracranial infection and promote patient recovery .