Objective To assess the changes of right atrial size and mechanical function after radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation using real-time threedimensional echocardiography(RT-3DE), and to study the correlation between the changes of left atrial(LA)and right atrial(RA) volume and function. Methods Thirty-five patients with paroxysmal atrial fibrillation were undergone radiofrequency catheter ablation (RFCA) successfully. Transthoracic echocardiography (TTE),tissue Doppler imaging(TDI) and RT-3DE were performed before, 1 month and 3 months after procedure respectively. Late systolic volume and area of RA and LA,ejection fraction(EF) of RA and LA,late diastolic peak velocity of mitral valve inflow, tricuspid valve inflow and late diastolic peak velocity of mitral annulus and tricuspid annulus were recorded. Results The 3DE images of all patients were satisfied.LA max area and 3DE LA max volume were significantly reduced at 1 months and 3 months after procedure compared with basic stage [ ( 18.8 ± 6.3) cm2 vs (21.5 ± 6.2) cm2 , (38.8 ± 17.0) ml vs (46.1 ± 20.0) ml,P ＜ 0.05]. 3DE LA EF also declined markedly at 1 month after RFCA, and restored at 3 months later compared with baseline [(41.1 ± 13.7) % vs (51.7 ± 15.9) %, (41.1 ± 13.7) % vs (45.6 ± 18.3) %, P ＜0.05]. The size and mechanical function of the right atrial after procedure were no obvious changes. There were no evidently correlation between the changes of LA and RA volume and function. Conclusions RT3DE can provide a precise method to quantify the value of atrial volume and function. The LA size and volume are significantly reduced after RFCA in patients with paroxysmal atrial fibrillation, however, the RA size and function are no obvious changes.

Long non-coding RNA (lncRNA) is a class of RNA molecules, transcripted by RNA polymeraseⅡ, which consists of more than 200 nucleotides and protein-coding function. Many studies have indicated that lncRNA plays an important role in epigenetics, transcription and post-translational processing. The abnormal expression of lncRNA significantly correlates with occurence,development, and metastasis of renal cell carcinoma (RCC) and prognosis of the patients with RCC. This paper summarizes the advances in the research on lncRNA in RCC to reveal the mechanisms of the disease at the molecular level, in order to provide new methods of prevention, diagnosis, treatment and prognostic assessment of RCC.

Aim To investigate the influence of down-regulating adenosine A1 receptor and adenosine A2 A receptor gene expression on proliferation and activation of acetaldehyde-induced hepatic stellate cell-T6 cells through siRNA. Methods Alcoholic liver fibrosis in vitro model was constructed by inducing HSC-T6 cells with acetaldehyde. siRNA targeting A1R and A2AR were designed and synthesized according to its mRNA. The siRNA was transfected into rat HSC-T6 cells by li-posome LipofectamineTM 2000. HSC cell proliferation was measured by MTT. The mRNA levels of A1R, A2AR, α-SMA, Collagen I in the supernatant of the cell culture were measured by Quantitative Real-Time PCR. The protein levels of A1R, A2AR, α-SMA, Collagen I were measured by Western blot. Results A1 R and A2 AR siRNA effectively inhibited the cell proliferation, and they also significantly decreased the levels of A1R, A2AR,α-SMA, Collagen I, suggesting that A1 R and A2 AR might be potential target genes in the alcoholic liver fibrosis. Conclusions Silencing A1 R or A2 AR by RNAi can significantly inhibit the HSC proliferation, A1R and A2AR may be potential therapeutic target genes for alcoholic liver fibrosis.

Objective To explore the role of echocardiography in the therapeutic evaluation after surgical repair of anomalous origin of the left coronary artery from the pulmonary artery(ALCAPA). Methods Six patients with ALCAPA underwent surgery from 2000 to 2007 ,including 3 intrapulmonary tunnel procedures and 3 left coronary artery bypass graft procedures. Post-operative echocardiography was given in every case and the characteristics were compared with the pre-operative results. Results In all cases, the mainly coronary haemodynamics recovered rapidly with decreased severity of mitral regurgitation and excellent cardiac function. Five patients had smooth rebuilded vessels but 1 patient had mild anastomotic block and slight intrapulmonary tunnel leakage. Conclusions Transthoracic echocardiography can evaluate the rebuilded coronary artery, possible complication, cardiac morphous and function and the severity of mitral regurgitation accurately.

Objective To explore the value of transthoracic echocardiography in diagnosis of univentricle and analyze the sonogram typing. Methods The results of 66 patients with univentricle were reviewed retrospectively,and analayzed their typing connected with the reports in the literature. Results There were 3 ultrasonic types in 66 cases:①Type A(single left ventricle) 19 cases,single ventricle with left ventricular shape,residual cavity in front of it. ②Type B(single right ventricle) 38 cases, single ventricle with right ventricular form,and residual cavity in the rear.③Type C (solitary single-ventricle) 9 cases,there was only one ventricle. Thirty-one of them were treated surgically, 5 cases without operation had MRI or cardiac catheterization examination and the remaining 26 patients were only observed by echocardiography,the positive rate of diagnosis in type was 100%, the results were compared with cardiac catheterization or MRI examination and the operation: 1 cases of mixed type total anomalous pulmonary venous connection was misdiagnosed as heart-type total anomalous pulmonary venous drainage. But 1 case of descending aorta limitations narrow complicated patent ductus arteriosus(PDA), PDA was missed. The rest were completely correct diagnosis. Conclusions The transthoracic echocardiography can be used to evaluate types and all containing malformations of univentricle,and offers reliable information for operation.

Objective To explore the value of echocardiography in the diagnosis of the criss-cross heart. Methods The echocardiographic results of 6 patients with the criss-cross heart were reviewed retrospectively. The echocardiographic characteristics were analyzed and compared with the surgery results in 4 operated cases. Results The 6 cases were interpreted as representing a criss-cross heart with solitus atria,D-loop ventricles and concordant atrioventricular connections. The ventriculo-arterial alignments of 5 cases were abnormal including double outlet right ventricle with anterior aorta in 2 and transposition of the great arteries in 3 while 1 patient had concordant connection. The following principal characteristics were tilting the transducer from posterior to anterior could demonstrate the connection of the left-sided left atrium and the right-sided left ventricle through mitral valve at first. The more anterior angulation of the transducer then showed the right-sided right atrium was connected to the left-sided right ventricle through tricuspid imaging displayed the two atrial outflows crossed each other without mixing at atrioventricular valve level.right ventricle often occured. The echocardiographic diagnosis of the criss-cross heart and its associated cardiac abnormalities were confirmed by surgery in 4 cases except 1 persistent left superior vena cava was missed. Conclusions The invisibility of a standard 4-chamber view in any cut was very characteristic in the echocardiographic diagnosis of the criss-cross heart. The definitive appearance was the separate display of the two ventricular inlets and the crossed atrioventricular connections with each atrium emptying into the contralateral ventricle by continuous subxiphoid or apical scanning. The transthoracic echocardiography can diagnose this rare heart disease and associated cardiac abnormalities accurately.

· AIM: To report a rare case of mesenchymalchondrosarcoma in the orbit and to explore its clinicmanifestations, pathologic characters, management andprognosis. · METHODS: We report a case of mesenchymalchondrosarcoma of the orbit. The clinical materials,including ophthalmological examination, computed tomo-graphy scan of the orbit, histopathology and immunohis-tochemistry of the biopsy specimen was reported, and itspertinent literatures were reviewed.· RESULTS: A 36-year-old female was seen with proptosisand decreased vision. Histopathology demonstrated anadmixture of undifferentiated mesenchymal cells andislands of mature hyaline cartilage. Immunohistochemicalstudies revealed positivity for vimentin and S-100, whichwas consistent with the diagnosis of mesenchymalchondrosarcoma.· CONCLUSION: Mesenchymal chondrosarcoma in theorbit is extremely rare malignant tumor. Multi-modalitytreatments (surgery, chemotherapy and radiotherapy)may lead to long-term survival.

Objective To discuss the treatment of urethral stricture after hypospadias reDair.Methods Thirty-seven cases of urethral stricture after hypospadias repair from 1999 to 2006 were ret-rospectively analyzed. Of 37 patients,the stricture was located at the distal end of urethra in 7 cases.There were 3 1 cases with anastomotic stricture.There was 1 case with distal urethral stricture and anastomotic structure.There were 1 3 patients with the simple urethral stricture and the complicated 24 cases.Of 13 simple urethral stricture patients,4 patients were repaired with urethro-meatomy,6 patients with shelf operation and 3 patients with transurethral holmium laser urethrotomy.Eight Pa-tients with complicated urethral fistula,6 patients with urethral diverticula,4 patients with phallo-campsis and 6 patients with many times of postoperative urethral stricture were repaired with shelf op-eration or penis skin flap or septum of scrotum skin flaps urethroplasty. Results The simple stric-tures of 1 2 patients were cured by stage 1 operation,the other one cured after second surgery.Of 8 patients with fistula,7 were cured at stage 1,the other one was cured at the stage 2.Of 6 patients with diverticulum,all were cured at stage 1.Of 4 patients with phallocampsis,3 cases were cured at stage 1,the other one was cured at the stage 2.Of 6 patients with recurrent strictures,all were cured at stage 1.A1l patients were followed up 1 2 to 24 months.The micturition was without difficuItv at stand position. Conclusions Urethral stricture is one of the most common complications after hypos-padias repair.The simple urethral stricture could be repaired with urethro-meatomy or sheIf operation or transurethral holmium laser urethrotomy.The complicated urethral stricture could be reDaired with shelf operation or penis skin flaps or septum of scrotum skin flaps urethroplasty and overjetted with dortos of scrotum flaps.

Objective To compare the efficacy of add-on adefovir dipivoxil (ADV) therapy and switch-to entecavir (ETV) monotherapy in chronic hepatitis B (CHB) patients with suboptimal response to lamivudine (LAM).Methods A prospective study was performed in 120 CHB patients from Zhuji People' s Hospital and the First Affiliated Hospital of Zhejiang University School of Medicine during June 2010 and June 2011.All patients previously received more than 24 weeks LAM treatment,but HBV DNA was still positive.Patients were randomized assigned to two groups:60 patients received add-on ADV therapy and another 60 switched to ETV monotherapy.Both groups were treated for 48 weeks.Liver and kidney function,alpha-fetal protein (AFP),HBV serum markers,HBV DNA and prothrombin time (PT) were examined,and ultrasonography or CT scan of liver was performed every 1-3 months.x2 test was used to compare the HBV DNA negative rates,HBeAg seroconversion rates,resistance rates and adverse reaction at week 48 between two groups.Results Thirty-three out of 38 patients (86.8％) with baseline HBV DNA 103-105 copies/mL became HBV DNA negative after add-on ADV treatment for 48 weeks,twenty-seven out of 39 patients (69.2％) with baseline HBV DNA 103-105 copies/ml became HBV DNA negative after switch-to ETV treatment.There was a statistical difference between two groups (x2 =4.578,P ＜ 0.05).Sixteen out of 22 patients (72.7％) with baseline HBV DNA ＞ 105 copies/mL became HBV DNA negative after add-on ADV treatment for 48 weeks,while only 52.4％ (11/21) patients achieved HBV DNA negative in the switch-to ETV group.There was also a statistical difference between two groups (x2 =4.865,P ＜0.05).None of patients in add-on group developed virological breakthrough and resistance,while 5 patients in switch-to ETV group developed virogical breakthrough and 3 patients developed genetic mutation.Among them,rtM204V + rtL180M + rtS202G mutation was detected in 2 patients,and rtM204V + rtL180M +rtT184A mutation was detected in 1 patient; all mutations happened in the baseline HBV DNA ＞ 105 copies/mL group.Conclusion The add-on ADV therapy is better in viral inhibition than switch-to ETV therapy for CHB patients with suboptimal response to LAM,and it can reduce the occurrence of drug resistance.

Aged ; Giant Cells ; pathology ; Humans ; Male ; Stomach Neoplasms ; pathology