Objective To investigate the quality of life (QOL) of patients with frequent premature ventricular contractions (PVCs) and the effects of radiofrequency catheter ablation (RFCA) on them.Methods 120 patients with frequent PVCs,100 cases with frequent APCs and 60 healthy persons were assessed by 36-Health survey questionnaire (SF-36) originally.Three months later,the QOL of 48 cases received RFCA and 72 cases with drug therapy were evaluated again by SF-36.Meanwhile,decrease of PVCs were also calculated between these two groups.Results The scores of physiological function and mental health in patients with PVCs were lower than that of cases with APCs,while the score of bodily pain in patients with PVCs was higher (P value:0.0002-0.0380).In addition,the quality of life in patients with frequent PVCs were worse than healthy control(P value:0.0001-0.0915).Three months later,PVCs in 48 cases with frequent PVCs received RFCA were much fewer than that of 72 cases with drug therapy (t=18.8682,P＜0.01),and the quality of life in the former was much better than the latter (F=15.329-39.274,P＜0.01).Conclusion Frequent PVCs can deteriorate the patients' quality of life.RFCA can control or eliminate PVCs in these patients and markedly improve the quality of life of them.

Objective To investigate the clinical efficacy of LigaSure vessel sealing system(LVSS)in laparoscopic splenectomy(LS).Methods From August 2005 to September 2006,11 cases underwent LS with LVSS.LVSS was applied to cut off lienocolic ligament and gastrosplenic ligament,and separate splenic artery from the superior border of spleen tail and blocked by an absorbable clip,and then splenic stalk was separated and cut off near the hilum of spleen with LVSS.Results LS was successfully completed in 10 cases,in which 9 with LVSS entirely,and 1 case used Endo-GIA due to difficulties in splenic stalk separation.And one case was converted to laparotomy for close adhesion of spleen with the surrounding tissues.The operation time was 60-150 min,110 min in average;blood loss was 80-400 ml.No complications such as postoperative massive hemorrhage,pancreatic leakage,or gastric leakage occured.Conclusions Application of LVSS in LS is characterized by safety,reliable hemostasis,and leaving no internal foreign body.

Objective To compare elasticity imaging and conventional ultrasound when applied to the diagnosis of benign and malignant breast tumors.Methods Totally 124 breast tumor patients (140 lesions) from some hospital were analyzed retrospectively,who were divided into a control group and an observation group according to ultrasound examination ways.The control group involved in 60 patients with 66 lesions undergoing conventional ultrasound examination,and the observation group had 64 patients with 74 lesions undergoing elasticity imaging.Pathological findings were considered as gold standard,and the two groups were compared on accuracy,specificity and sensitivity.Results Pathological detection found the accuracy,specificity and sensitivity of the malignant tumor in the control group were 85.00％,84.78％ and 84.85％ respectively,and the ones of the malignant tumor in the observation group were 95.83％,96.00％ and 95.95％ respectively.The two groups had significant differences between the accuracies,specificities and sensitivities (P＜0.05).Conclusion Elasticity imaging describes the size,shape,number,margin and etc of the breast tumor,and thus can enhance the accuracy,specificity and sensitivity for diagnosing breast tumors.

Objective To study the impact of depression disorder in patients after coronary stent implantation on incidence rate of in-stent restenosis (ISR) in the coronary heart disease( CHD ), and its possible pathophysiological mechanisms. Methods According to the Hamilton Depression Scale (HAMD-24) and Self-rating Depression Scale(SDS) score,95 patients with unstable angina received coronary drug-eluting stent implantation combined with depression disorder were serve as the study group; randomly selecte 246 cases without depression due to unstable angina pectoris after coronary stent implantation as the control group in the same period. The incidence rate of ISR in these two group were observed, and serum aldosterone ( ALD), high-sensitivity C-reactive protein (hs-CRP) ,Leptin levels in two groups were compared. Results The incidence rate of ISR in study group were significantly higher than that of the control group (28/95 vs 46/246, P＜0. 05). Following with the aggravation of depression disorder,the incidence rate of ISR were elevated( χ2 =8. 148, P=0.017). Serum ALD,hs-CRP and Leptin levels of study group were significantly higher than the control group 7 days later after drug-eluting stent implantation ( ALD:277.4 ± 35.9 vs 258.9 ± 60.9, t= 3. 459, P= 0. 001; hs-CRP: 12.03 ± 3.06 vs 11.10 ±2. 806, t = 2.573, P = 0.008; Leptin:5.27 t 1.07 vs 4.98 ± 0.99, t= 2.323, P= 0.021 ). Pearson correlation analysis showed that its HAMA-24 score was positively correlated with serum ALD ,hs-CRP and Leptin( r=0.291,P=0.026; r=0.350, P=0.014; r=0. 312, P=0.023) ,and SDS score was positively correlated with hs-CRP( r=0. 302, P= 0. 020). Conclusion Serum ALD, hs-CRP and Leptin levels are higher in patients after coronary stent implantation combined with depression in patients, and the incidence rate of ISR is also higher in these patients, and the rates are elevated according to the aggravation of depression disorder.

Objective: To observe therapeutic effects of ticagrelor combined tirofiban on patients with ST elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) and their short-term prognosis.Methods: A total of 280 STEMI patients undergoing emergency PCI were selected.According to random number table, patients were randomly divided into clopidogrel group (received clopidogrel combined tirofiban therapy) and ticagrelor group (received ticagrelor combined tirofiban therapy).TIMI blood flow grade of infarct related arteries, platelet aggregation rate and P2Y12 reaction unit (PRU) before and after PCI, and incidence of major adverse cardiovascular events (MACE) within 30d follow-up, hemorrhage event and cardiac function were measured and compared between two groups.Results: Compared with clopidogrel group after PCI, there was significant rise in percentage of TIMI blood flow grade 3 (81.4% vs.91.4%), and significant reductions in platelet aggregation rate [(55.2±4.1)% vs.(50.8±4.4)%] and PRU [(196.2±15.1)U vs.(180.8±12.0)U] in ticagrelor group, P<0.05 all.Compared with clopidogrel group after 30d follow-up, there were significant reductions in incidence rates of re-myocardial infarction (5.0% vs.2.9%) and cardiogenic death (2.9% vs.0.7%), left ventricular end-diastolic dimension [(53.1±2.8)mm vs.(49.0±2.0)mm] and left ventricular end-systolic dimension [(40.2±2.1)mm vs.(37.4±1.8)mm], and significant rise in left ventricular ejection fraction [(51.8±2.7)% vs.(55.4±2.5)%] in ticagrelor group, P<0.05 all.There were no severe hemorrhage events in both groups, and no significant difference in incidence rate of mild hemorrhage (5.0% vs.6.4%) between clopidogrel group and ticagrelor group, P=0.591.Conclusion: For STEMI patients undergoing emergency PCI, ticagrelor combined tirofiban can effectively reduce platelet aggregation rate, improve TIMI blood flow of infarct related arteries, therapeutic effects and their short-term prognosis without increasing hemorrhage risk, which is worth extending.

Objective: To study the impact of astragaloside on ventricular remodeling and peroxisome proliferator activated receptor a (PPARa) expression in pressure-overload rats and to preliminarily explore its mechanism. Methods: Pressure-overload rat's model was established by abdominal aorta constriction (AAC) in 8-week old SD rats and the result was conifrmed by echocardiography at 6 weeks later. Pressure-overload rats were divided into 4 groups with different intragastric treatment: Model control (normal saline) group, Benazepril hydrochloride [10mg/(kg.d)] group, Low-dose astragaloside [40mg/(kg·d)] group and High-dose astragaloside [80mg/(kg.d)] group; in addition, Sham operation group, the rats received intragastricnormal normal saline.n=20 in each group and all animals were treated for 8 weeks. Rat's cardiac structure and function indexes were assessed by echocardiography, hemodynamic parameter was examined by left ventricular intubation, myocardium and blood levels of free fatty acid (FFA) were determined, morphological changes of myocardial tissue was observed by HE and Masson staining, mRNA and protein expressions of PPARa were measured by qRT-PCR and Western blot analysis. Results: Compared with Sham operation group, Model control group showed increased left ventricular mass index(LVMI), collagen volume fraction (CVF) and FFA level, allP<0.05, while decreased mRNA and protein expressions of PPARa, bothP<0.05. Compared with Model control group, Low-dose and High-dose astragaloside groups presented reduced LVMI, CVF and FFA level, allP<0.05-0.01, while elevated mRNA and protein expressions of PPARa, bothP<0.01. Conclusion:Astragaloside IV mayinhibit myocardial remodeling in pressure-overload rats, which might be via up-regulating mRNA and protein expressions of PPARa, enhance myocardiumFFA utilization, and therefore improve myocardial energy metabolism.

AIM:To observe the effects of astragaloside IV (AS-IV) on myocardial fibrosis in chronic heart failure ( CHF) rats and to explore the underlying mechanism preliminarily .METHODS:Chronic heart failure model rats established by abdominal aorta constriction (AAC) were divided into CHF group, valsartan group and AS-IV group.Sham operation group was also established .The rats in valsartan group and AS-IV group received valsartan and AS-IV at 2 and 30 mg· kg-1 · d-1 , respectively.The rats in sham operation group and CHF group received normal saline .After 8 weeks of treatment, the cardiac structure and the hemodynamic parameters were measured .The morphologic changes of myocardial tissue were observed after staining .The expression of long-chain acyl-CoA dehydrogenase ( LCAD) and 6-phosphofructoki-nase-1 (PFK1) at mRNA and protein levels was determined by RT-qPCR and Western blot.RESULTS:Compared with sham operation group , left ventricular mass index ( LVMI) , collagen volume fraction ( CVF) , left ventricular posterior wall depth (LVPWD), and the mRNA and protein of PFK1 in CHF group were increased (P<0.05), while the mRNA and protein levels of LCAD were decreased (P<0.05).Compared with CHF group, the LVMI, CVF, LVPWD, and the mRNA and protein levels of PFK1 in valsartan group and AS-IV group were decreased (P<0.05), while the mRNA and protein levels of LCAD were increased (P<0.05).CONCLUSION:AS-IV inhibits myocardial fibrosis in the CHF rats , the mechanism of which might be associated with up-regulating the expression of LCAD , down-regulating the expression of PFK1 and normalizing the myocardial energy metabolism .

Objective: To observe the effects of astragaloside IV on myocardial fibrosis and connective tissue growth factor (CTGF) expression in experimental rats with chronic heart failure (CHF).
Methods: CHF model was established by abdominal aorta constriction (AAC) and the rats were divided into 5 groups:Sham operation group, the rats received normal saline 2 ml/day, n=10, CHF group, the rats received normal saline 2 ml/day, n=12;Astragaloside IV groups, CHF rats received astragaloside IV at (20, 40, 60) mg/kg respectively and n=12 in each group. All animals were treated for 4 weeks. Hemodynamic indexes were monitored, left ventricular mass index (LVMI) was calculated, morphologic changes of myocardial tissue was observed by HE staining, myocardial ifbrosis degree and collagen volume fraction (CVF) were measured by Masson staining. The mRNA and protein expressions of CTGF were detected by RT-PCR and immunohistochemistry, Western-blot analysis respectivety.
Results: Compared with CHF group, 3 Astragaloside IV groups had decreased LVMI and CVF, P<0.05-0.01;Astragaloside IV (40 and 60) mg/kg groups presented decreased LVEDP and LVSP, increased ±dp/dtmax, P<0.01 to P<0.05 and improved pathological morphology. Compared with Sham group, CHF group had increased average CTGF OD value (0.09 ± 0.03) vs (0.45 ± 0.04) and increased expression of myocardial CTGF (0.57 ± 0.06);compared with CHF group, the average CTGF OD values in Astragaloside IV (20, 40, 60) mg/kg groups were all decreased (0.39 ± 0.05), (0.30 ± 0.06), (0.24 ± 0.04) and decreased expressions of myocardial CTGF (0.44 ± 0.05), (0.35 ± 0.02), (0.28 ± 0.03) respectively, all P<0.01.
Conclusion: Astragaloside IV can inhibit myocardial ifbrosis and improve cardiac function in CHF rats, which might be via inhibiting the over expression of myocardial CTGF.

Objective To investigate the relationship between the plasma levels of ET-1,TAT,and hs-CRP and slow coronary flow syndrome (SCFS),and explore effects of coronary endothelial function,coagulation function,and inflammatory reaction on blood flow of coronary artery.Methods A total of 400 cases with normal blood flow of coronary artery by coronary angiogram was randomly selected.The coronary flow patterns were determined by corrected thrombolysis in myocardial infarction frame count method (cT-FC).Among them,45 cases whose average cTFC more than 27 were assigned as SCFS group,the other 45 cases no SCFS.Plasma levels of ET-1,TAT and hs-CRPwere examined with enzyme-linked immunosorbent assay (ELISA),and were compared between two groups.Moreover,multivariate analysis evaluating predictors of SCFS was performed with regression test.Results No statistical difference was found between two groups concerning the gender,history of hypertension,diabetes mellitus,and cigarette alcohol percentage..The plasma level of HDL in SCFS group was lower than that of no SCFS [(1.22 ± 0.42) mmol/L vs (1.44±0.34) mmol/L,t =-2.731,P ＜0.01],but the plasma level of glucose in the former was higher than that of the latter [(5.68 ±0.62) mmol/L vs (5.10 ±0.84) mmol/L,t =3.727,P ＜0.01].However,Plasma levels of ET-1,TAT and hs-CRP in SCFS were higher than that of no SCFS [(94.3 ± 16.78) ng/Lvs (83.5±12.53) ng/L,t =3.051,P ＜0.01;(12.96±3.24)μg/Lvs (8.76 ±2.64)μg/L,t =5.945,P ＜ 0.01 ; (2.48 ± 0.35) μg/L vs (1.38 ± 0.46) μg/L,t =11.259,P ＜ 0.01].Furthermore,Logistic regression analysis showed that ET-1,TAT and hs-CRP were risk factors for SCFS (OR ＞ 1.22).Conclusions Due to coronary endothelial dysfunction,endothelial inflammatory reaction,and activated coagulation function,slow coronary flow of coronary artery occurs.

Objective To investigate the stress characteristics of atlanto-axial bony structure under conditions of anteflexion,posterior extension,lateral flexion,and rotation after artificial atlanto-odontoid joint arthroplasty using three-dimensional finite element method and to improve the orientation of artificial atlantoodontoid joint from perspective of stress.Methods A three-dimensional finite element model of prosthetic atlanto-odontoid joint arthroplasty was created from CT images of the artificial atlantoodontoid joint and cervical vertebrae using software Mimics,Freeform,and Ansys.Stress characteristics of the model dealt with proneness,posterior extension,lateral flexion,or rotation loads were observed.Biomechanical performance of the bony structure of the model was analyzed and the orientation in improving the prosthesis was discussed.Results Anteflexion loading produced a maximum stress of 0.138 ×l08 N/m2 at the junction of lateral mass and posterior arch of the atlas,and 0.201 × 108 N/m2 at axial nail hole,contact point of plates with the axis,and posterior arch of the axis.Posterior extension loading produced a maximum stress of 0.666 × 107 N/m2 at junction of lateral mass and posterior arch of the atlas and 0.254 × 108 N/m2 at arch of the axis.Besides,stress concentration occurred at atlantoaxis nail hole.Right bending produced a maximum stress of 0.124 × 108 N/m2 at nail hole of right mass of atlas and 0.178 × 108 N/m2 at right contact point of the axis with plates.Right rotation produced a maximum stress of 0.847 × 107 N/m2 at junction of lateral mass and posterior arch of the atlas and 0.170 × 109 N/m2 at contact point of the axis with plates.The finite element model comprised 28 620 nodes and 107 441 units and provided good defining of the structural properties of artificial atlanto-odontoid joint arthroplasty.Under different loading conditions,the stress was mainly distributed in contact point of the vertebral body with plates,nail holes,junction of lateral mass and posterior arch of the atlas,and axial pedicle.Conclusions Prosthetic atlanto-odontoid joint scatters a part of the stress and alters the stress distribution of the atlas and axis from the intact condition.Finite element method can obtain complete analysis of the stress distribution of the artificial atlanto-odontoid joint arthroplasty.