Objective To evaluate the feasibility and effect of three-points ablation approach in in treatment of typical atrial flutter guided by CARTO. Methods Twenty-six patients with typical atrial flutter diagnosed by ECG and electrophysiological study (EPS) were enrolled in this study. Activation sequence mapping and linear ablation were performed in 11 patients (conventional group) . Three-points guided linear ablation with CARTO system was performed in another15 patients (three-points group) . Results There was no significant difference in the success rate between the two groups. Both the procedure and fluoroscopic time in three-points group were significantly shorter than that in conventional group [(72.66±29.82) vs (102.52±32.61) min;(4.26±2.76) vs (7.32±3.16) min] . Conclusions The three-points ablations approach is as safe and effective as conventional ablation approach in treatment of typical atrial flutter;however,the former can significantly shorten the procedure time and fluoroscopy time.

AIM: To investigate the effect of L-arginine (L-Arg) on intimal proliferation and expression of related cell cycle regulatory factors after vascular injury in rats. METHODS: Rats were divided into three groups :sham operation group, balloon injury group(this group included balloon 48 h,7 d and 14 d subgroup) and balloon+L-Arg group. Neointima area were calculated morphologiocally. The expression of cyclin dependent kinase-2(CDK2),cyclin E and proliferation cell nuclear antigen (PCNA) were measured by means of immunohistochemical technique and computer image analyzer. RESULTS: After vascular balloon injury, the level of plasma NO decreased, CDK2、cyclin E and PCNA expressed in the media at 48 h and in the neointima at 7 d and 14 d but with low and undetected expression in the media, the expression of CDK2, cyclin E and PCNA increased with the intima thickening. Compared with balloon 14 d group, the plasma NO level increased (P＜0.01）, the neointima area reduced by 59.1%(P＜0.01) and the positive expression indexes of CDK2, cyclin E and PCNA decreased by 36.1%, 46.3% and 76.2% respectively in balloon+L-Arg group (P all＜0.01）. CONCLUSION: L-Arg can effectively repress intima proliferation after vascular injury, which may be associated with its inhibiting the proliferation of vascular smooth muscle cell through downregulating the excessive expression of CDK2, cyclin E and PCNA.

ObjectiveTo explore clinical application of selecting flap by using of digital technique in treatment of hemifacial atrophy.MethodsSeven patients with hemifacial atrophy were selected,preoperative CT angiography was performed,deformity and flap three-dimensional reconstruction and design bone and soft tissues using Mimics 14.3 software, latissimus muscular flap or femur anterolateral flap were selected,according to tilt donor area and recipient area blood vessel diameter. Defect model were printed using rapid prototyping. ResultsHemifacial atrophy had a good postoperative shape,and the flaps survived in all the 7 cases.Follow-up 3 years,the flaps look well and the patients get expecting results. ConclusionsThe digital technique was a relatively useful tool that can assist surgeons with reconstruction of the flap,and accurate marking of the extent of the flap to be harvested.Therefore avoiding intraoperative injuries to the blood vessels to better survival of the flaps.

Objective To observe the efficacy and toxicities of RF transparent heating (RTH) combined with transcatheter hepatic arterial chemoembolization (TACE) in the treatment of advanced primary hepatic carcinoma. Methods In a randomized manner, 69 patients with advanced primary hepatic carcinoma were divided into two groups: study group (TACE+RTH) 34 cases and control group (TACE alone) 35 cases, the control group were treated with DDP 80mg, FU 1000mg and E-ADM 60mg, E-ADM was used with iodized oil embolism 10ml. Results The total effective rate in the near future were 70.59% and 45.71%, the overall survival rates of 0.5, 1.0, 1.5, 2.0 years were 82.35%, 73.53%, 58.82%, 38.24% in study group and 74.29%, 75.14%, 45.71%, 22.86% in control group, respectively. Toxicities were similar comparing with the two groups. Conclusions RTH combined with TACE in the treatment of advanced primary hepatic carcinoma is better than TACE alone, at the same time TACE +RTH method is no increasing toxicity and is an effective safe combined one.

Objective:To investigate the association between age and cardiac tamponade after radiofrequency ablation of atrial fibrillation(RAAF).Methods:Clinical data of patients undergone de novo AF ablation procedures at Beijing Anzhen Hospital from January 2013 to December 2016 were retrospectively collected.Patients were divided into an elderly group(age ≥60 years)and a non-elderly group(age <60 years). Logistic regression analyses were used to evaluate the association between old age and the risk of cardiac tamponade complicating RAAF.Results:A total of 5 313 patients were involved in this study, including 41 patients(0.77%)with cardiac tamponade.The proportion of cardiac tamponade was higher in the elderly group than in the non-elderly group(1.1% or 32/2 950 vs.0.4% or 9/2 363, χ2=8.489, P=0.004). One patient with cardiac tamponade in the elderly group required immediate surgical repair whereas none in the non-elderly group did.No patient died in hospital.Multivariate Logistic regression analysis showed that the risk of cardiac tamponade increased in the elderly group, compared with the non-elderly group( OR=2.570, 95% CI: 1.190-5.570, P=0.017). Stratified analysis revealed that among females and patients with oral anticoagulants, left atrium dimension < 40 mm or procedure duration≥ 120 min in the elderly group carried a higher risk of cardiac tamponade than those in the non-elderly group( OR=1.011, 2.914, 3.922 and 3.244, P<0.05). Conclusions:Old age(age ≥60 years)is an independent risk factor for cardiac tamponade complicating RAAF.

Objective To evaluate the value of neck blood vessel colored doppler ultrasound (NBVCDU) and magnetic resonance angiography (MRA) to extracranial carotid artery stenosis in patients with transient ischemic attack (TIA).Methods After implementing NBVCDU and MRA examinations at the same time,45 TIA patients with at least one examination showing arteriostenosis in extracranial section were chosen to carry out cerebral digital subtraction angiography( DSA ),then the stenosis rate was calculated by American symptomatic carotid endarterectomy trial (NASCET) method.Results Regarding DSA as the gold standard,for 45 TIA patients that having 180 arteriostenosis in extracranial section, sensitivity,specificity,accuracy of NBVCDU examination was 93.51% ,95.15% ,94.44%, Kappa = 0.735; sensitivity,specificity,accuracy of MRA was 92.21% ,94.17% ,93.33% , Kappa =0.681; sensitivity,specificity,accuracy of NBVCDU combined with MPA was 97.40% ,99.03% ,98.33%, Kappa = 0.872.Conclusions The sensitivity and accuracy of arteriostenosis in extracranial section by NBVCDU examination is higher than that by MRA, and it is suitable in the crowd primary examination.NBVCDU combined with MRA has shown good consistence with DSA for diagnosing arteriostenosis in extracranial section,but can't replace DSA comlpetely.

Objective: To observe the efficacy of 755 nm picosecond laser and intense pulsed light in the treatment of facial freckles. Methods: Sixty-six outpatients with freckles were randomly divided into two groups. They were treated with 755 nm picosecond laser (P755 nm) and intense pulsed light (IPL), respectively. Frequent freckles were analyzed before treatment and at 4 week after treatment. Results: Both treatments had good curative effect, but the P755 nm group had better efficacy than the IPL group with significant difference. Conclusions 755 nm picosecond laser and IPL can treat freckles very well, and P755 nm group is superior to IPL.

Objective To evaluate the short-term and long-term outcomes of patients with ST-segment elevation myocardial infarction (STEMI) compared with those with non-STEMI after percutaneous coronary intervention (PCI). Method The DESIRE Ⅱ (Drug-Eluting Stent Impact on Revascularization Ⅱ) was a single-center registered retrospective study of coronary revascularization in our institution between July 2003 and September 2009.Data of demographics, clinical features and revascularization record of STEMI and non-STEMI patients from the DESIRE Ⅱ trial were analyzed. The patients were followed up in OPD or by telephone after discharge. MACCE (major adverse cardiocerebral events) including death, neo-myocardial infarction, stroke and revascularization were recorded. The clinical outcomes of patients of two types were evaluated. Results There were 6005 patients studied with a median follow-up of 566 days. A total of 1009 STEMI and non-STEMI patients were analyzed. The patients with non-STEMI ( n = 206) had higher prevalence of hypertension and history of higher frequency of myocardial infarction as well as revascularization compared with patients with STEMI ( n = 803). The patients with non-STEMI had higher ratio of treatment for multivessel disease (43.7% vs. 34.4%, P = 0.039). There were no significant differences in in-hospital mortality and long-term outcomes (one year survival rate: 96% vs. 98%)between patients with STEMI and non-STEMI. The predictors of 1-year mortality were LVEF and blood creatine.Conclusions Despite different chnical features, patients with STEMI and non-STEMI after PCI had similar both short-term and long-term outcomes.

24 hours) PCI. Results Among 1013 patients enrolled in the SUNDAY registry, 438 (male 74.8%, unstable angina 94.1%) received PCI after CAG, 35 patients received PCI within 24 hours [(1.0?0.0) day, group I], and 403 after 24 hours [ (7.5 ? 7.3) days, group II] of hospitalization (P

Objective To elucidate the clinical characteristics and prognosis of non-ST segment elevation acute coronary syndrome (NSTE-ACS)patients with metabolic syndrome. Methods SUNDAY(The Strategies for UA/NSTEMI and Delay of AngioplastY Registry)study was a retrospective registry of 1 013 patients with unstable angina or NSTEMI from Jan 2000 through Dec 2002. In this analysis , we compared the clinical features and prognosis with patients with or without metabolic syndrome and studied the relation between the number of markers-the MS score and prognosis. Results There were 743 patients with complete data and 343 patients(46.2%)satisfied the definition of Chinese metabolic syndrome .The latter were younger [(59.66?9.67)age vs. (61.11?10.37)age,P=0.052], with higher BMI ,SBP, DBP, blood glucose and disordered blood-lipid(P0.05) and coronary angiographic alterations(left main artery and trivessel) (P=0.006). Conclusion There were prevenlence in NSTE-ACS patients with metabolize syndrome and the later were younger .As the MS score increased so did obesity, dyslipidemia ,blood pressure, fasting glucose. Similarly, an increasing MS score was significantly related to more severe coronary angiographic alterations and cardiac events.