This paper presents an algorithm for data interpolation and approximation used in the whole atria mapping. Multilevel B-splines are introduced to compute the whole atria surface through a set of irregularly spaced points and to draw the 3D isopotential map, which can reflect the conduction process of depolarization in complex arrhythmia such as atrial fibrillation.
Algorithms ; Electrocardiography ; Epicardial Mapping ; Models, Cardiovascular ; Signal Processing, Computer-Assisted

Objective To study the clinical presentations,diagnosis and managements of primary hyperparathyroidism (pHPT) in pregnancy.Methods A total of five cases of pHPT in pregnancy were enrolled from January 2005 to December 2014 in Peking Union Medical College Hospital.Their clinical presentations,managements,maternal-fetal complications and pregnancy outcomes were retrospectively analyzed.Results The median age was 32 (29,41) years.Of the five cases,three were diagnosed in the second trimester,one was before pregnancy and one was after delivery.Most of the clinical symptoms were nonspecific to pHPT,such as nausea,vomiting and loss of appetite.Frequent urination and nocturia occurred in one;unconsciousness and manifestations of acute pancreatitis and eclampsia relevant symptoms were complained of by one.The common maternal complications were nephrolithiasis and hydronephrosis (3/5),osteoporosis (2/5),anemia (2/5) and kaliopenia (2/5),while the severe complications were hypercalcemic crisis (2/5),acute pancreatitis (1/5),eclampsia (1/5),HELLP (hemolysis,elevated liver enzymes and low platelets) syndrome (1/5),disscminated intravascular coagulation (DIC) (1/5),cerebral infarction (1/5) and intrauterine fetal death of one twin (1/5).The median level of calcium in serum samples was 3.70 (2.78,4.50) mmol/L;the median level of parathyroid hormone (PTH) in serum samples was 294 (151,634) pg/ml.All of the five cases were positive for parathyroid ultrasonography.Four cases received parathyroid radionuclide imaging and had positive results.One asymptomatic patient received no specific treatment,whereas the neonate presented with hypocalcemia after birth.Two cases received surgical resections in the second trimester;one of them had a live birth without fetal complication,while the other had induced abortion.Two cases received postpartum surgery;one asymptomatic patient had a live birth without fetal complication,whilc thc other with twin pregnancy suffered stillbirths (one intrauterine fetal death and one neonatal death).Pathologic diagnosis were solitary parathyroid adenomas in four cases who received surgery.Their operations were effective except that one case,which was improved after treatment,was complicated with secondary hypoparathyroidism.Conclusions The symptoms of pHPT in pregnancy are often nonspecific,but it can cause maternal and fetal morbidity and mortality.Early diagnosis of pHPT,followed by appropriate managements,has been shown to significantly reduce the complications.Surgical management should be a safe and effective choice.

Objective To analyze the epidemiological characteristics of Klebsiella pneumoniae car-bapenemase(KPC)-producing Escherichia coli(E. coli)strains isolated in Hangzhou,China. Methods A total of 25 KPC-producing Escherichia coli strains were collected from four hospitals in Hangzhou from July 2012 to January 2014. Antibiotic susceptibility of the isolates to 22 common antimicrobial agents was deter-mined by using Kirby-Bauer(K-B)disk diffusion method. PCR analysis and gene sequencing were used for bla KPC gene screening. The modified Hodge test was performed to detect the production of carbapenemase. Pulsed-field gel electrophoresis(PFGE)and multi-locus sequence typing(MLST)were used for homology analysis. Results All of the 25 clinical isolates were confirmed to be KPC-producing E. coli strains,harbo-ring the blaKPC-2 gene. These KPC-producing isolates showed high drug resistance rates and were resistant to almost all β-lactam antibiotics. PFGE typing classified the 25 isolates into three main homologous clone groups,including clone group A(4 isolates),clone group B(5 isolates)and clone group C(2 isolates), and some single clones(14 isolates). MLST typing classified the isolates into eight ST types,including ST131(14 isolates),ST167(3 isolates),ST2003(3 isolates),ST410(1 isolate),ST457(1 isolate), ST1463(1 isolate),STnew1(1 isolate)and STnew2(1 isolate). The typing results of PFGE and MLST were consistent with each other. Conclusion The prevalent KPC-producing E. coli strains in Hangzhou, China were ST131 type,which were resistant to multiple antibiotics and had been detected in several hospi-tals. The epidemic of KPC-producing E. coli strain often occurred at some special wards,such as Intensive Care Unit(ICU)and emergency ICU.

OBJECTIVETo investigate the gene expression of MAPEG in the cortex of concanavalin A (Con A)-induced mouse immune inflammatory model and the effect of cyclosporine A (Cs A).

METHODSMale Balb/c mouse immune inflammation model was developed by intravenous injection of Con A (20 mg/kg). Cs A (150 mg/kg) was intravenously infected prior to Con A administration. The MAPEG expressions were determined by RT-PCR.

RESULTmGST1, mGST3, LTC(4)S, FLAP and mPGES-1 were detected by RT-PCR but not mGST2. Eight hours after Con A treatment, mGST1 level was up-regulated to 1.2 approximately 1.5 folds of control with or without Cs A treatment. mGST3ìLTC(4)S, FLAP and mPGES-1 mRNA levels were not influenced by Con A administration.

CONCLUSIONImmune mechanism may be not involved in mGST1 up-regulation in this model and Con A does not alter arachidonic acid metabolism in cortex.

5-Lipoxygenase-Activating Proteins ; Animals ; Brain ; metabolism ; Carrier Proteins ; genetics ; metabolism ; Concanavalin A ; toxicity ; Cyclosporine ; pharmacology ; Eicosanoids ; metabolism ; Glutathione ; metabolism ; Glutathione Transferase ; genetics ; metabolism ; Intramolecular Oxidoreductases ; genetics ; metabolism ; Male ; Membrane Proteins ; genetics ; metabolism ; Mice ; Mice, Inbred BALB C ; Prostaglandin-E Synthases

Objective To investigate the association of HLA-DRB31*03,*04 and *11 alleles with alopecia areata(AA)in Han Nationality in East China.Methods Polymerase chain reaction-sequence specific primer(PCR-SSP)method was conducted in 158 Chinese Han patients with AA as well as in 172 healthy human controls in East China.The relationships of HLA-DRB1 polymorphism to age of onset,episode frequency,clinical course,family history,and severity of AA were evaluated.Results No significant differences were observed for the frequency of HLA DRB1*03,*11 alleles between the patients and human controls,while increased frequency of HLA-DRB1*04 was observed in patients(OR=1.99,Pc=0.01).Multiple logistic regression analysis revealed that HLA-DRB1*04 was more prevalent in patients with an onset after 16 years of age(OR=1.94,Pc=0.02),those without family history(OR=1.97,Pc=0.02),those with recurrent AA(OR=2.49,Pc=0.02),those with a clinical course of more than 1 year(OR=2.94,Pc=0.01),those with severe AA(OR=3.53,Pc=0.00)and tbose with single episode of AA(OR=1.83,Pc=0.04)in comparison with the normal human controls.Conclusion This study demonstrates that HLA-DRB1*04 allele is associated with the occurrence and clinical types of AA in Han Nationality in East China.

Metabolic characteristics of 39 human brain tumor tissues, including 15 astrocytomas, 13 fibroblastic meningiomas and 11 transitional meningiomas from 39 individual patients, have been studied using high resolution magic-angle spinning (HRMAS) 1H NMR spectroscopy in conjunction with principal component analysis (PCA). With rich metabolite information, 1H NMR spectra showed that the tumor-tissuc metabonome was dominated by lipids, lactate, myo-inositol, ereatine, choline metabolites such as choline, phosphocholine and glycerophosphocholine, amino acids such as alanine, glutamate, glutamine, taurine, N-acetyl-aspartate and glutathione. PCA of the tumor NMR spectra clearly showed metabonomic differences between low-grade astrocytomas and meningiomas whereas such differences were more moderate between fibroblastic and transitional meningiomas. Compared with meningiomas, the low-grade astrocytomas had higher levels of glycerophosphocholine, phosphocholine, myo-inositol and creatine but lower levels of alanine, glutamate, glutamine, glutathione and taurine. The N-acetyl-aspartate level was low but detectable in low-grade astrocytomas whereas it was not detectable in meningiomas. It is concluded that tissue metabonomics technology consisting of HRMAS 1H NMR spectroscopy and multivariate data analysis (MVDA) offers a useful tool (1) for distinguishing different types of brain tumors, (2) for providing the metabolic information for human brain tumors, which are potentially useful for understanding biochemistry of tumor progression.

Objective To investigate the prevalence and pattern of androgenetic alopecia (AGA) in Shanghai through a community-based survey. Methods A cluster sampling survey was done among the residents in Beixinjing Community, Changning District, Shanghai. All the subjects were asked to fill a questionnaire to provide their general information, including sex, age, native place, physical status, life habit, family history, etc. The diagnosis of AGA was made by dermatologists. To determine the pattern of hair loss,Norwood-Hamilton classification system and Ludwig classification system were used for male AGA and female AGA, respectively. All the data were statistically analyzed by EpiData and SPSS11.5 software. Results Totally, 7056 subjects completed the questionnaire, including 3519 males and 3537 females, and the response rate was 72.5%. AGA was diagnosed in 809 patients, consisting of 701 males aging from 19 to 91 years (mean 64.16±11.9 years) and 108 females aging from 35 to 91 years (mean 70.46±18.89 years). The standardized prevalence (SP) was 9.47% in total, 15.73% in males and 2.73% in females; the difference was significant between males and females (χ2=356.00, P<0.001). A family history of AGA was observed in 52.7% of all subjects including 391 (55.78%) males and 35 (32.41%) females. Type Ⅲ vertex involvement was the most common type in men aging from 20 to 70 years old, and type Ⅵ in those over 70 years old. Grade Ⅰ and Ⅱ predominated in female AGA. Conclusions The results of this survey indicate that the prevalence of AGA is remarkably higher in men than that in women. Furthermore, the prevalence is steadily increased with advancing age in Shanghai.

OBJECTIVETo investigate the effect of testosterone on neointimal proliferation and blood lipids after balloon-induced aorta injury in male rabbits.

METHODSTwenty-five male white rabbits were randomly divided into five groups with 5 in each. G1 underwent sham castration served as control group, rabbits in remaining 4 groups were castrated. One week after the castration, rabbits in G3, G4, G5 groups received 3 mg/kg, 6 mg/kg, 12 mg/kg testosterone undecanoate i.m, respectively, G2 was not received. Two weeks after the castration, deendothelializing balloon-induced injury in right iliac artery was performed in all animals. Two weeks after the injury, blood samples were drawn for measurement of plasma testosterone and lipids, and the right iliac arteries were excised for computer imagining analysis.

RESULTCompared with G1, plasma levels of total cholesterol(TC), triglycerides(TG), low density lipoprotein(LDL) in G3, G4 and G5, gradually decreased, plasma levels of high density lipoprotein(HDL)gradually increased. There were most significant differences of plasma TC, TG and LDL(P<0.05) between G2 and G1. There were not significant differences of plasma TC, TG, HDL and LDL among all groups before endothelial denudation and 2 weeks after endothelial denudation (P>0.05). In G3, G4 and G5 the intimal area and radio of intima/media gradually decreased, there were significant differences between G2, G3, G4 and G1(P<0.05), the differences between G1 and G2 were most significant, and those of G5 were close to G1. Endothelial cell repair was observed with electron microscope. Endothelial cells from G2 to G5 became smoother gradually, which in G5 were very close to G1.

CONCLUSIONTestosterone inhibits the intima proliferation induced by balloon-induced injury and improves blood lipids levels. The effects are enhanced by the dose increasing.

Animals ; Aorta ; pathology ; Catheterization ; adverse effects ; Cholesterol ; blood ; Hyperplasia ; Lipids ; blood ; Lipoproteins ; blood ; Male ; Orchiectomy ; Rabbits ; Random Allocation ; Testosterone ; pharmacology ; Triglycerides ; blood ; Tunica Intima ; pathology

Fluorescence intraoperative cholangiography (IOC) is a potential alternative for identifying anatomical variation and preventing iatrogenic bile duct injuries by using the near-infrared probe indocyanine green (ICG).However,the dynamic process and mechanism of fluorescenceIOC have not been elucidated in previous publications.Herein,the optical properties of the complex of ICG and bile,dynamic fluorescence cholangiography and iatrogenic bile duct injuries were investigated.The emission spectrum of ICG in bile peaked at 844 nm and ICG had higher tissue penetration.Extrahepatic bile ducts could fluoresce 2 min after intravenous injection,and the fluorescence intensity reached a peak at 8 min.Inaddition,biliary dynamics were observed owing to ICG excretion from the bile ducts into the duodenum.Quantitative analysis indicated that ICG-guided fluorescence IOC possessed a high signal to noise ratio compared to the surrounding peripheral tissue and the portal vein.Fluorescence IOC was based on rapid uptake of circulating ICG in plasma by hepatic cells,excretion of ICG into the bile and then its interaction with protein molecules in the bile.Moreover,fluorescence IOC was sensitive to detect bile duct ligation and acute bile duct perforation using ICG in rat models.All of the results indicated that fluorescence IOC using ICG is a valid alternative for the cholangiography of extrahepatic bile ducts and has potential for measurement of biliary dynamics.

Objective To evaluate the long-term efficacy of antiretroviral therapy and drug resistance among human immunodeficiency virus-1(HIV-1)-infected children in Yunnan.Methods In this retrospective study,CD4+T cell counts,HIV viral loads and genetic drug resistance results were obtained from HIV-1-infected children who were treated with antiretroviral treatment between January 2004 to July 2015.Results A total of 1 078 HIV/acquired immune deficiency syndrome(AIDS)children were treated with antiviral therapy.Before treatment,the average CD4+cell number was(466.8 ± 397.2)cells/μL. The percentages of children with CD4+cell count >750 cells/μL after 1-year,3-year,5-year and 8-year treatment were 54.31%,62.87%,68.46% and 74.19%,respectively.Virological failure occurred in 150 HIV/AIDS children(13.9%),and the virological failure rate was 4.3/100 child-years.Among those 150 patients with virological failure,104 cases(69.33%)exhibited genetic resistance to antiretroviral drugs.The prevalent mutations associated with drug resistance were M 184V/I(75.0% [78/104]), K103N(43.3%[45/104]),G190A(29.8%[31/104]),Y181C(22.1%[23/104]),T215Y/F(20.2%[21/104]).Conclusions After long-term antiretroviral treatment,most of the HIV-infected children have restored the immunity and suppressed HIV viral replication successfully.HIV resistance is the main cause of virological failure.Drug resistance mutations mainly occur in nucleoside reverse transcriptase inhibitor and non-nucleoside reverse transcriptase inhibitor,and the resistance rate of proteinase inhibitor is low.Early genetic resistance testing and switch to second-line therapy will improve the treatment outcome.