Objective To explore the important anatomic structures associated with pulmonary veins and similar sections to transthoraeic echocardiography using 64一slice spiral CT and tO locate the pulmonary veins on echocardiography. Methods The transthoracic echocardiography and 64-slice spiral CT were performed in 12 patients with atrial fibrillation.The 3-dimensional information of four pulmonary veins on CT was analyzed and the relationship between the locations of four pulmonary veins and adjacent anatomic structures were observed.The comparison of CT and echocardiography for assessing the location of pulmonary veins was performed.Results All of the pulmonary veins were demonstrated optimally without abnormal structures and anatomic variations.The ostium of right superior pulmonary vein adjoined the atrial septum and the proximal of the right superior pulmonary vein was near to the superior vena cava.The right inferior superior pulmonary was a little bit far from atrial septum.The left superior pulmonary vein adjoined the left atrial auricle.The left inferior pulmonary vein was a little bit far from the 1eft atrial auricle and adjoined the thoracic descending aorta.According to adjusting the angle of the probe on echocardiography,the four pulmonary veins could be demonstrated in the standard parasternal left ventricular long-axis view, parasternal short-axis view and apical four chamber view.The non-standard views assisted in identifying the pulmonary veins.Conclusions Transthoracic echocardiography can demonstrate all the four pulmonary veins and also locate the spatial location based on the adjacent anatomic structures.

OBJECTIVETo evaluate the efficacy of sacral nerve stimulation (SNS) therapy for fecal incontinence.

METHODSClinical researches which evaluated the efficacy of SNS and were published between 1946 and 2016 were systematically searched from electronic databases, including PubMed, Ovid Medline, Web of Science, Wanfang database and Chinese Journal Full-text Database. Grey area literatures were also searched. Influence of SNS therapy on fecal incontinence episodes (FIE) or Wexner incontinence score (WIS) was systematically evaluated. The statistical analysis was performed by RevMan5.2.

RESULTSA total of 6 studies including 270 patients (147 patients in SNS group and 123 patients in control group) with fecal incontinence were enrolled in this systematic review. SNS therapy was associated with a significant reduction in FIE (SMD=-0.69, 95%CI: -0.97 to -0.41, P<0.001) and a significant reduction in WIS (SMD=-5.05, 95%CI: -8.73 to -1.36, P=0.007). Sensitivity analysis showed that the results of this study were stable and the direction and significance of results were not changed (P=0.000 for both). Publication bias was not found by funnel picture in this study.

CONCLUSIONSNS significantly improves the outcome of patients with fecal incontinence.