Objective To determine whether Ca2+ activated Cl- current(Icl(Ca)) contributes to the functional remodeling of the failing heart.Methods Whole cell patch-clamp recording technique was employed to record the Icl(Ca) in cardiac myocytes enzymatically isolatedfrom rapidly pacing induced canine failing hearts at room temperature and compared that of the normal hearts (Nor).Results Thecurrent density of DIDS(200M)sensitive Icl(Ca) induced by intracellular Ca2+ release trigged by L-type Ca2+ current(Ica,L)wassignificantly decreased in heart failare(HE)cells compared to Nor cells.At membrane voltage of 20mV,the Icl(Ca) density was 3.02±0.54 pA/pF in Nor(n=6)vs.1.31±0.25 pA/pF in HF(n=8)cells,(P＜0.01),while the averaged Ica,L density did not show differencebetween two groups.The time constant of current decay of Icl(Ca) was similar in both types of cells.On the other hand,in intra cellularCa2+ clamped mode,where the[Ca2+];was maintained at 100nmol/L,Icl(Ca) density be increased significantly in HF cells when themembrane voltage at+30mV or higher.Conclusions Our results suggest that Icl(Ca) density was decreased in pacing induced failingheart but the channel function be enhanced.Impaired Ca2+ handing in HF cells rather than reduced,Icl(Ca) channel function itself may havecaused this abnormality.The Icl(Ca) density reduction might contribute to the prolongation of action potential in failing heart.The Icl(Ca)channel function up-rugulation is likely to cause cardiac arrhythmia by inducing a delayed after depolarization,when Ca2+ overloadoccurred in diastolic failing heart cells.

Objective To investigate the influence of nursing care on the anxiety and depression of patients with coronary heart disease,who underwent percutaneous coronary intervention (PCI). Methods Sixty-five patients who received the coronary intervention treatment were selected and randomly divided into the intervention group (33 cases) and the control group (32 cases). The degrees of depression and anxiety in these patients were assessed by the patient Health Questionnaire-9 (PHQ-9) scale and Generalized Anxiety Disorder-7 (GAD-7) scale before and after PCI. The control group received clinical conventional nursing care. The intervention group received psychological intervention on the basis of conventional nursing. Results Before the intervention, there was no difference of PHQ-9 and GAD-7 scores between the two groups (P>0.05). However,after the intervention, the PHQ-9 and GAD-7 scores of both groups reduced significantly (P<0.05). Moreover,significant importance was found in the reduction of the two scales′ scores in the intervention group compared with the control group (P<0.05). Conclusions Psychological intervention can obviously relieve the negative emotions of patients with coronary heart disease,which is of important clinical importance to the guarantee of successful surgery and patient recovery.

Objective? To summarize the nursing experience for 6 patients receiving wireless pacemaker implantation. Methods? The nursing experience for 6 patients who received wireless pacemaker implantation for the first time in Beijing Anzhen Hospital, Capital Medical University from August to October 2018. The nursing highlights included preoperative nursing, operative nursing, postoperative monitoring, nursing, follow-up and education. Results? 2 of the 6 patients sustained atrial fibrillation combined with long pause, and 4 sustained atrionector lesion combined with incidental long pause. The threshold value and perception of pace-making was sound and the impedance was ideal during operation. No complication was found during and post operation. The surgical time for implanting wireless pacemakers was short and the patients' appearance was not affected. Their mental burden was relatively light. Nursing procedures were simpler than the those for traditional pacemakers. Conclusion? Wireless pacemakers reduce airbag and wire-related complications and is promising in clinical use. But nursing experience needs to be observed clinically and summarized.

Objective To explore the mechanisms of ligament of Marshall (LOM) initiat and sustain atrial fibrillation (AF).Methods The electrophysiologic properties of canine LOM were investigated using multipolar catheter mapping(normal canines,n =4,group A;AF canines,n =5,group B).The programmed stimulation were performed in the LOM,PV-left atrium(LA)junction and LA,respectively.Activations maps of LOM were analyzed from episodes of spontaneous onset of AF and initiation of induced AF by a single extrastimulus.The effectives refractory period of each part was compared and statistically analyzed among three parts in each group and between the two groups.LOM were cutted with surgical incision technology.The inducing rate of AF and the mapping rate of double potential and fragmented electrocardiogram were compared and statistically analyzed pro and post isolation of LOM.Results The incidence of abnormal potential of LOM in the two groups was significantly different(P ＜0.01),re-entry cycle(group A 25％ vs.B group 80％),tachycardia(group A 25％ vs.B 100％),double potential(group A 25％ vs.group B 80％),fragmentation potential(group A 25％ vs.group 80％).There was a significant difference in the rate of LOM tachycardia induction before and after LOM intervention in group B (P ＜ 0.05,before 100％ vs.after 20％).Conclusion There are two possible mechanisms of LOM involved in the occurrence and maintenance of AF:one is that LOM induces AF through spontaneous excitation,the other is that LOM participates in the reentry of left atrium and pulmonary vein in the form of bypass to induce and maintain AF.