Objective To investigate the relationship between the volume of left atrial appendage and recurrence of atrial fibrillation(AF)after radiofrequency ablation. Methods In this retrospective cohort study, 66 cases of first atrial fibrillation radiofrequency catheter ablation in the Department of cardiovascular medicine of the First Affiliated Hospital of Zhengzhou University were enrolled from June 2014 to June 2016 and divided into the recurrence group(n=18)and the non recurrent group(n=48)based on the 1 year follow-up results ,Collecting the patient's clinical data and following up.64 layers of spiral CT scans were performed for all patients before operation,and the volume of left atrium( LAV)and left atrial appendage volume(LAAV)were measured. The general data ,laboratory examinationresults ,echocardiographic parameters and left atrial CT parameters of two groups were compared. The relationship between patient parameters and recurrence of atrial fibrillation after radio-frequency ablation were analyzed by multivariate logistic regression analysis. Results There was no significant difference in blood lipid and left ventricular ejection fraction(LVEF%)between the two groups in terms of sex, age ,hypertension ,coronary heart disease and other common diseases (P > 0.05).The volume of left atrial appendage and left atrial volume in the recurrent group were larger than those in the non recurrence group (P <0.05). The left atrial appendage volume(OR=1.518,95%CI:1.151-2.000,P = 0.003)can be used as an independent risk factor for postoperative recurrence of atrial fibrillation. The area under the ROC curve of left atrial appendage volume in predicting the recurrence of atrial fibrillation after radiofrequency ablation is 0.806(95%CI:0.689-0.922 ,P < 0.001). Conclusion Greater left ventricular volume is an independent risk factor for recurrence of atrial fibrillation after radiofrequency catheter ablation ,whether in paroxysmal atrial fibrillation or persistent atrial fibrillation.

Objective:To explore any effect of transcranial magnetic stimulation and peripheral magnetic stimulation of the mylohyoid muscle on dysphagia among stroke survivors.Methods:Sixty stroke survivors with dysphagia were randomly divided into a control group, a peripheral magnetic stimulation group, a central magnetic stimulation group, and a central + peripheral magnetic stimulation group, each of 15. In addition to routine swallowing training, the subjects were given the appropriate magnetic stimulation daily, five times a week for two weeks. Before and after the intervention, swallowing was evaluated using the Functional Oral Intake Scale (FOIS), Penetration-Aspiration Scale (PAS) and a functional dysphagia scale (FDS).Results:The average FDS, PAS, and FOIS scores of all four groups had improved significantly after the treatment. Improvement significantly greater than in the control group was observed in the average FOIS, FDS and PAS scores of the other three groups. The peripheral + central magnetic stimulation group showed the greatest average improvement.Conclusion:Combining mylohyoid muscle magnetic stimulation with magnetic stimulation of the cerebral cortex can significantly relieve dysphagia. It is more effective than conventional swallowing rehabilitation or either magnetic stimulation alone.

Objective:To explore the prognostic value of circulating tumor cell (CTC) for colorectal cancer.Method:We analyze the correlation between CTC and clinicopathological data, survival curve and overall survival.Results:The positive rates of preoperative and postoperative CTC in 181 colorectal cancer patients were 66.3% and 65.7% respectively ( χ2=0.012, P=0.912). The postoperative CTC positive rates for recurrence and non-recurrence of stage Ⅱ colorectal cancer were 29.2% and 8.0%, respectively ( χ2=4.303, P=0.038). The progress free survuval of CTC-positive and CTC-negative in postoperative stage Ⅱ colorectal cancer patients were 28.7 months and 34.0 months, respectively ( χ2=4.096, P=0.043). Conclusion:Postoperative CTC detection has predictive prognostic value for patients with stage Ⅱ colorectal cancer.

Objective:To evaluate the effect of ultrasound-guided adductor canal block with bupivacaine liposome on analgesia in elderly patients undergoing total knee arthroplasty.Methods:This was a prospective study. Sixty American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients, regardless of gender, aged 65-83 yr, weighing 50-80 kg, scheduled for elective unilateral total knee arthroplasty under subarachnoid anesthesia from April 2023 to January 2024 in Zhengzhou Orthopaedic Hospital, were divided into 2 groups ( n=30 each) using a random number table method: bupivacaine liposome group (LB group) and ropivacaine group (R group). Ultrasound-guided adductor canal block was performed at 30 min before subarachnoid anesthesia, bupivacaine liposome diluent 20 ml (133 mg) was injected in LB group, and 0.5% ropivacaine 20 ml was injected in R group. Patient-controlled intravenous analgesia was performed after operation, and tramadol was used for rescue analgesia when the visual analogue scale (VAS) score ≥3. VAS scores at rest and during activity were recorded at 8, 12, 24, 48 and 72 h after surgery. The time to the first pressing analgesia pump and rescue analgesia were recorded within 72 h after surgery. The quadriceps muscle strength was measured at 1 day before surgery and 12, 24, 48 and 72 h after surgery. The knee joint range of motion was assessed at 1 day before surgery and 24, 48 and 72 h after surgery. Patient′s satisfaction with analgesia was recorded at 72 h after surgery. The adverse reactions within 72 h after surgery were also recorded. Results:Compared with R group, VAS scores at rest and during activity were significantly decreased at 12, 24, 48 and 72 h after surgery, the time to the first pressing analgesia pump was prolonged, the rate of rescue analgesia after surgery was decreased, the score for the patient′s satisfaction with analgesia was increased, the knee joint range of motion was increased ( P<0.05), and no significant change was found in the quadriceps muscle strength and incidence of adverse reactions in LB group ( P>0.05). Conclusions:Ultrasound-guided adductor canal block with bupivacaine liposome provides better analgesia than ropivacaine in elderly patients undergoing total knee arthroplasty.