Objective To study the characteristics of craniocerebral injury caused by the handgun bullet impacting on the bulletproof helmet.Methods Fourteen healthy landrace pigs were involved and randomly divided into injury group(n =9)and control group(n =5).The landrace pigs of the injury group were shot vertically on the head under the protection of helmet plate with 9 mm handgun bullet at velocity of 360 m/s.While the landrace pigs of the control group were dealt with the same process as the injury group except for use of unarmed handgun bullet of the same ammunition dose.The changes of vital sign in the early period and the retina injury at two hours after injury were observed.Porcine cerebrospinal fluid (CSF)at pre-injury and at three hours post-injury were obtained for investigating the levels of neuron specific enolase(NSE)andαⅡ-spectrin protein.Then,the landrace pigs were sacrificed and dissected to examine the general morphological changes of the brain.The brain cortex was taken,fixed and stained with hematoxylin-eosin for microscopic observation.Results The landrace pigs in the injury group manifested decrease of the blood pressure and increase of the heart rate and respiratory rate in the early stage after injury.General morphological observation found retinal hemorrhage(3/9),skull fracture(3/9)and brain surface damage including local impact lesion(9/9)and contrecoup lesion(9/9),with severe impact lesion than contrecoup lesion.Optical microscopic observation revealed acute injury of the cerebral cortex neuron both on the impact and contrecoup locations.The concentrations of NSE and αⅡ-spectrinwere significantly increased in CSF three hours after injury(P ＜ 0.05).Conclusions The handgun bullet impacts on the pig head protected by the bulletproof helmet may induce blunt craniocerebral injury in the early period,with severe impact lesion than contrecoup lesion.Therefore,traumatic brain injury of the soldiers armed with the helmets should be stressed and managed early.

OBJECTIVETo analyze the unipolar electrogram from successful and unsuccessful ablation sites of focal atrial tachycardia (AT), and to evaluate its value in the identification of successful targets.

METHODSFifteen consecutive patients with focal AT were referred for radiofrequency catheter ablation (RFCA). Both unipolar (from the tip electrode of ablating catheter) and bipolar (from the distal pair of electrode of ablating catheter) electrograms were used to identify the ablation targets of focal AT.

RESULTSSuccessful ablation was echieved in 14 patients. Radiofrequency energy was delivered at a total of 27 sites. The bipolar electrograms associated with successful ablation sites showed earlier atrial deflection relative to P wave onset (36 ms +/- 15 ms vs 30 ms +/- 11 ms, P < 0.05) than the electrograms associated with failed ablation sites. At the 14 successful ablation sites, the unipolar electrograms displayed a completely negative atrial wave ("QS" morphology) beginning with intrinsic deflection. However, at the 13 unsuccessful ablation sites, a "rS" morphology of atrial wave was shown on the unipolar electrogram.

CONCLUSIONThe "QS" morphology of the atrial wave on unipolar electrograms appears to represent a reliable marker for identifying the successful ablation targets of focal AT, with a high sensitivity and specificity.

Adolescent ; Adult ; Aged ; Catheter Ablation ; methods ; Child ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tachycardia ; diagnosis ; surgery

Objective Evaluating the effects of Bushen-Gufeigao and breathing movements on the patients with chronic obstructive pulmonary disease of Lung and kidney deficiency TCM pattern. Methods The patients with chronic obstructive pulmonary disease of lung and kidney deficiency TCM pattern were recruited and randomly divided into two groups the treatment group (32 cases) and the control group (34 cases). The control group was treated with the conventional medicine, and the treatment group were added Bufei-Gushengao and breathing movements based on the treatment of control group. Both groups were treated for 1 month. The changes of the clinical symptoms, lung function and frequency of attack and duration of each attack in 10 months after treatment were observed. Results After the treatment, compared with the control group, the TCM patterns scores (5.32 ± 2.67 vs. 9.12 ± 4.11, t=4.424) of the treatment group significantly decreased, while the FVC (3.00 ± 0.49 L vs. 2.71 ± 0.47 L, t=2.408), FEV1 (2.27 ± 0.44 L vs. 1.85 ± 0.54 L, t=3.496), and the percentage of FEV1%(75.62 ± 6.84 vs. 66.86 ± 9.32, t=4.333) increased significantly. In the 10 mouths after the treatment, the treatment group showed significantly fewer patients who had attacked more than 6 times than that in the control group, and the duration of attacks showed significantly fewer minutes in the treatment group than the control group (5.56 ± 1.45 d vs. 8.06 ± 1.80 d, t=6.190). Conclusion Bushen-Gufeigao and breathing movements can effectively improve patient's lung function and symptoms.

Objective: To analyze the clinical characteristics of patients with idiopathic right ventricular outflow tract (RVOT) ventricular arrhythmias (VA) and factors related to the immediate success rate of radiofrequency ablation. Methods: Patients diagnosed as idiopathic RVOT arrhythmia in Fuwai Hospital from February 2009 to January 2013 were retrospectively screened. Patients with structural heart disease or inherited arrhythmia were excluded. All patients underwent endocardial electrophysiological study and radiofrequency catheter ablation. Baseline clinical and operation records were collected and analyzed. Immediate success rate was defined as no inducible ventricular arrhythmia by isoprinosine and electrophysiological induction at the end of ablation. The origins of idiopathic RVOT were classified as septal, anterior, posterior, free wall site, epicardial and RVOT-aorta root site. Results: A total of 468 patients were finally included, and the age was (40.4±13.3) years old and 60.5%(283/468) patients were female. Immediate radiofrequency success rate was 89.3%(418/468). Patients were divided into ablation success group (n=418) and ablation failure group (n=50). Percent of female patients and patients with interventricular septal origin was significantly higher in the ablation success group than in ablation failure group (261(62.4%) vs. 22 (44.0%) , P=0.01, and 233(55.7%) vs. 18(36.0%), P=0.005), while percent of patients with epicardial origin was significantly lower in the ablation success group than in ablation failure group (17(4.1%) vs. 11(22.0%), P<0.001). Immediate success rate was the highest for patients with the septal origin and the lowest for patients with epicardial origin (92.8%(233/251) vs. 60.7%(17/28), P<0.05). Multivariate analysis showed that the origin site of VAs was the most important independent factor related to the success rate of ablation. Compared with the septal origin patients, patients with RVOT-aorta root and epicardial origin VAs faced with 1.82-fold and 8.26-fold increased risk of failed ablation, respectively (OR=2.82, 95%CI 1.05-7.57, and OR=9.26, 95%CI 3.60-23.86). Sex category was not the independent risk factor for failed ablation(OR=1.76, 95%CI 0.93-3.33, P=0.08) . Conclusions The immediate success rate of radiofrequency catheter ablation for idiopathic RVOT ventricular arrhythmia is relative high, however, immediate success rate of radiofrequency catheter ablation is relatively low for patients with epicardial and RVOT-aorta root origin arrhythmia and VAs origin is an independent risk factor of immediate ablation success rate.

Objective To observe the regulatory effect of olfactory ensheathing cells (OECs) on polarization of M2 macrophages after acute contusion of spinal cords in rats,and explore the mechanism of OECs transplantation in promoting repair of spinal cord injury.Methods The primary OECs were isolated and cultured for transplantation.The T10 spinal cords of SD rats were exposed and impacted by impact stick (10 g) dropping vertically from a height of 25 mm with a NYU-Ⅱ impactor.Twenty-four rats with contusion of spinal cord immediately after injury were randomly divided into DMEM/F12 control group and OECs transplantation group according a random number table.DMEM/F12 culture medium or OECs suspension (3×104/μL,1 μL×3 times) was implanted into the injured spinal cords.At one to 9 weeks after injury,Basso Beattie Bresnahan (BBB) scale was used to evaluate the motor functions in rats.At one week after injury,M2 macrophages and Nogo-A positive cells were labeled by immunofluorescence staining;the expressions of interleukin (IL)-4 and IL-6 were detected by Western blotting.At 9 weeks after injury,the pathological changes of injured spinal cords were observed by HE staining.Results One and 9 weeks after injury,BBB scores in OECs transplantation group were significantly higher than those in control group at each time point after injury (P＜0.05).One week after injury,the number of M2 macrophages in OECs transplantation group was significantly larger than that in control group (3.24％ ±0.56％ vs.0.63％ ±0.21％),and the number of Nogo-A positive cells was significantly smaller and fluorescence intensity was significantly lower in OECs transplantation group than those in control group ([43±24] field vs.([207±88]/field;0.042±0.006 vs.0.062±0.011,P＜0.05);the IL-4 protein level was significantly higher and the IL-6 protein level was significantly lower in OECs transplantation group than those in the control group (0.717±0.152 vs.0.183±0.063;0.550±0.124 vs.1.060±0.209;P＜0.05).Nine weeks after injury,the cytoplasmic cavity area in OECs transplantation group ([1.511±0.581] mm2) was significantly lower than that in control group [2.939±0.823] mm2,P＜0.05).Conclusion OECs transplantation may promote macrophages polarizing to subtype M2,improve the microenvironment of inflammation,reduce Nogo-A secretion,thus promote the structure and spinal cord function recovery.