OBJECTIVETo explore the distribution features of Chinese medicine syndrome types in immunoglobin A (IgA) nephropathy patients complicated with hypertension and its correlation with main prognostic indicators of hypertension classification and chronic kidney disease (CKD) staging, thus providing the diagnostic standards of Chinese medicine syndrome types and reliance for accurate syndrome differentiated medication.

METHODSBy on-the-spot survey, the Chinese medicine syndrome and laboratory testing data of 154 IgA nephropathy patients complicated with hypertension confirmed by the pathology of kidneys were collected to analyze the distribution of Chinese medicine syndrome types, its correlation with hypertension classification and CKD staging.

RESULTSAsthenia was the most common syndrome in the 154 patients (146 cases, 94.81%), covering Pi-Shen deficiency syndrome (58, 37.66%), Shen qi-yin deficiency syndrome (48, 31.17%), and Gan-Shen yin deficiency syndrome (40, 25.97%). Of them, asthenia accompanied by asthenia was seen in 80 cases (54.79%) and pure asthenia in 8 cases (5.2%). Shen qi-yin deficiency syndrome and Gan-Shen yin deficiency syndrome were mostly seen in hypertension III, while Pi-Shen deficiency syndrome was mostly seen in hypertension I. Pi-Shen deficiency syndrome was mostly seen in CKD stage 4, Shen qi-yin deficiency syndrome mostly seen in CKD stage 1-2, and Gan-Shen yin deficiency syndrome mainly distributed in CKD stage 1-3. No obvious correlation was seen between Chinese medicine syndrome types and 24-h urine protein quantitation.

CONCLUSIONSPi-Shen deficiency syndrome, Shen qi-yin deficiency syndrome, and Gan-Shen yin deficiency syndrome were main Chinese medicine syndrome types in IgA nephropathy patients complicated with hypertension. Asthenia accompanied by asthenia was mostly seen. Pi-Shen deficiency syndrome was mostly seen in hypertension I. Shen qi-yin deficiency syndrome and Gan-Shen yin deficiency syndrome were mostly seen in hypertension III, Shen qi-yin deficiency syndrome mostly seen in CKD stage 1-2, and Gan-Shen yin deficiency syndrome mainly distributed in CKD stage 1-3. Pi-Shen deficiency syndrome was mostly seen in CKD stage 4 patients.

Adolescent ; Adult ; Aged ; Causality ; Female ; Glomerulonephritis, IGA ; classification ; complications ; diagnosis ; Humans ; Hypertension ; classification ; complications ; diagnosis ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Young Adult

OBJECTIVETo investigate the expression of epidermal growth factor receptor (EGFR) during the mineralization of human periodontal ligament cells (hPDLC) in vitro.

METHODSStudies using specific antibodies to immunolocalize EGFR in the mineral differentiating hPDLC were undertaken to investigate the different expression during the inducing process. In situ hybridization and RT-PCR technique were used to investigate the transcripts encoding the protein of EGFR.

RESULTSThe results showed that immunocytochemical labeling gradually decreased following the elong of the induce time, downing to nearly negative at the 4th week and the signal of EGFR transcripts was weaker in the induced hPDLC than that in uninduced.

CONCLUSIONEGFR has a negative regulation function during the mineralization of hPDLC.

Cells, Cultured ; Humans ; In Situ Hybridization ; In Vitro Techniques ; Periodontal Ligament ; Receptor, Epidermal Growth Factor

OBJECTIVETo investigate the feasibility and effectiveness of radiofrequency catheter ablation (RFCA) to treat per-manent atrial fibrillation (AF) under the guidance of Carto-Merge technique.

METHODSFifteen male patients with permanent AF underwent RFCA under the guidance of Carto-Merge technique. The mean age was 54.00 +/- 10.44 years, and duration of AF was 23.66 +/- 14.93 months. Cardiac magnetic resonance angiography (MRA) was performed to obtain pre-procedural three-dimensional (3D) images on the anatomy of left atrium (LA) and pulmonary veins (PVs) before RFCA procedure. Then the electroanatomical map was integrated with 3D images of MRA to form Carto-Merge map that guided step-by-step ablation strategy of permanent AF. Circumferential PV ablation was performed first until complete PVs electric isolation confirmed by Lasso catheter. If AF was not terminated, lesion lines on roof of LA, mitral isthmus, and tricuspid isthmus were produced.

RESULTSThe episodes of AF were terminated during RFCA in 2 patients, by direct current cardioversion in the remaining 13 patients. Transient AF occurred in 2 patients after ablation on 1st day and 1st week respectively, AF terminated spontaneously not long after taking metoprolol. One patient developed persistent atrial flutter (AFL) in 2 months after procedure and AFL was eliminated by the second ablation. Persistent AF recurred on 1st day, 1st and 5th week respectively in 3 patients, and did not terminate after 3 months even though amiodarone was given. The remaining 12 patients were all free of AF during 2-11 months of follow-up. The recent success rate for RFCA of permanent AF was 80%.

CONCLUSIONSCarto-Merge technique can effectively guide RFCA of permanent AF. When combined with single Lasso mapping, it can simplify the mapping, lower expenses, and enhance the success rate of RFCA of permanent AF.

Adult ; Atrial Fibrillation ; physiopathology ; radiotherapy ; Catheters, Indwelling ; Humans ; Male ; Middle Aged ; Radio Waves

BACKGROUNDTypical accessory pathways (APs) of Wolf-Parkinson-White syndrome have been widely discussed in recent decades. However, the characteristics of the special AP, Mahaim fibre, are not so clear. It is known that these fibres have antegrade conduction only, long conduction time, decremental node-like conduction and automaticity properties. This study was to elucidate the automaticity of Mahaim fibre and its response to effective ablation.

METHODSThirteen patients with Mahaim fibre (ten atrioventricular and three atriofascicular accessory pathways) were subjected to electrophysiological study and radiofrequency ablation via catheter. The incidence and characteristics of anautomatic rhythm originating from Mahaim fibre were observed during the whole procedure, especially during radiofrequency current delivery.

RESULTSRepetitive and short-run automatic rhythm (rate: 65-72 beats per minute), with a QRS morphology similar to that of clinical pre-excited atrioventricular re-entrant tachycardia (AVRT), occurred in two patients during sinus rhythm. Conduction via Mahaim fibre was successfully eliminated by radiofrequency current. Fourteen applications of RF were associated with irregularly accelerated automatic tachycardia of Mahaim fibre (with a sensitivity of 78%), lasting for 1.2-14 seconds. However, such automatic tachycardia of Mahaim fibre did not occur during 54 failed applications of radiofrequency current.

CONCLUSIONSMahaim fibre has the function of automaticity. The accelerated automatic tachycardia of Mahaim fibre occur red during radiofrequency catheter ablation can be used as a predictor for successful procedure.

Adolescent ; Adult ; Catheter Ablation ; Child ; Female ; Humans ; Male ; Middle Aged ; Pre-Excitation, Mahaim-Type ; physiopathology ; surgery ; Tachycardia, Atrioventricular Nodal Reentry ; physiopathology ; surgery

OBJECTIVETo investigate the effectiveness and advantages of the Carto merge technique in guiding radiofrequency catheter ablation (RFCA) of permanent atrial fibrillation (AF).

METHODSA total of 15 patients with permanent AF underwent RFCA under guidance of the Carto merge technique. The virtual electroanatomical map of the left atrium (LA) and pulmonary veins (PVs) were reconstructed with Carto system during the procedure. Then the electroanatomical map was integrated with 3-D images of cardiac magnetic resonance angiography to form Carto merge map. Circumferential pulmonary vein ablation was performed first until complete PVs electric isolation confirmed by lasso catheter. If AF was not terminated, lesion lines on roof of LA, mitral isthmus, and tricuspid isthmus were produced. Finally direct current (DC) cardioversion were given if sinus rhythm did not return.

RESULTSAF were terminated spontaneously during RFCA in 2 patients, and by DC cardioversion in the remaining 13 patients. Persistent AF recurred on 24 hours, first week, and 5th week, respectively in three patients. The remaining 12 patients were all free of AF during follow-up (1-10 months). The success rate was 80% in the study.

CONCLUSIONSCarto merge technique can effectively guide RFCA of permanent AF. When combined with single Lasso mapping, it can simplify the mapping and enhance the success rate of RFCA of permanent AF.

Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Humans

OBJECTIVETo investigate the time course of positive head-up tilt test (HUTT) for patients with suspected vasovagal syncope.

METHODSConsecutive patients referred to the syncope unit of our center for recurrent unexplained syncope were included. The HUTT consisted of a 30 minute passive basic phase and a 20 minute sublingual nitroglycerin provocation phase if syncope did not develop during the passive phase.

RESULTSPositive HUTT was observed in 427 out of 773 consecutive patients (55.2%) patients including 43 patients (10.1%) during the passive basic phase and 384 patients (89.9%) during the nitroglycerin provocation phase. During the basic phase, the positive Hutt developed at 7.5 minute (n = 2) and peaked at 22.5th minute (20.9%, n = 9) and then decreased gradually. Most positive reactions (93.0%, n = 40) occurred between the 10 and 25 minutes during the basic phase. During the nitroglycerin provocation phase, the percentage of positive reactions increased rapidly after sublingual nitroglycerin, peaked at the 10th minute (35.7%, n = 137) and decreased thereafter. Most positive reactions (96.1%, n = 369) occurred within the first 15 minutes of provocation phase.

CONCLUSIONThe appropriate duration for HUTT test could be modified to a 25 minutes passive basic phase plus 15 minutes nitroglycerin provocation phase.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Syncope, Vasovagal ; diagnosis ; Tilt-Table Test ; Young Adult

BACKGROUNDVerapamil-sensitive, idiopathic left ventricular tachycardia (ILVT) with right bundle branch block configuration and left-axis deviation is known to be due to re-entry mechanism but the exact nature of reentrant circuit in ILVT is not fully elucidated. Radiofrequency (RF) ablation was applied during ventricular tachycardia (VT) and termination of the VT or abolishing the inducibility of the tachycardia was used as an endpoint for successful RF. In this study, the left posterior fascicular block in surface electrocardiogram (ECG) was used as a new endpoint of ablation to cure ILVT.

METHODSElectrophysiological studies and radiofrequency ablation were performed in 39 consecutive patients [30 men, 9 women; age ranging from 10 to 64 years, mean (29 +/- 16) years] with verapamil-sensitive ILVT and structurally normal hearts. VT could be terminated by the intravenous administration of verapamil in all patients. The target site was the midseptum of LV where the earliest Purkinje potentials were recorded during VT. RF current was applied to the target site with or without late diastolic potential (LDP) during sinus rhythm in 37 patients and during VT in 2 patients to meet the ablation endpoint: the left posterior fascicular block in the surface ECG.

RESULTSThirty-seven patients with ILVT had been treated by RF ablation during sinus rhythm and two had been treated during VT. All of them met the endpoint of the left posterior fascicular block. Thirty-eight cases were symptom-free without medications during the follow-up period (range from 3 to 95 months, median 17 months). One patient developed a clinical recurrence and the left posterior fascicular block in surface ECG disappeared. The patient received another treatment. The endpoint was met and the procedure was successful.

CONCLUSIONSThe left posterior fascicular block in surface ECG used as an endpoint of RF ablation to treat ILVT is effective. It is important especially in those patients whose VT can not be induced or the inducible condition is unstable. The effective endpoint implied that the left posterior fascicle might be a critical part of the re-entrant circuit.

Adolescent ; Adult ; Catheter Ablation ; methods ; Child ; Diastole ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Tachycardia, Ventricular ; physiopathology ; surgery ; Verapamil ; therapeutic use

OBJECTIVETo determine the bioinformatical characteristics of differential gene expression in patients with chronic superficial gastritis (CSG) with the Pi-deficiency syndrome (PDS) and those of the non-Pi-deficiency syndrome (non-PDS), i.e. patients of CSG with Pi-Wei dampnese-heat syndrome and healthy persons.

METHODSWith the BRB-Array Tools software package, original data collection and bioinformatic: analysis of gene arrays were conducted in 6 CSG patients of PDS (CSG-PDS), 6 CSG patients of non-PDS (CSG-nPDS), and 6 healthy volunteers (Normal).

RESULTSCompared with non-PDS, the gene expressions: in PDS with regards to protein synthesis, energy metabolism, immune reaction and ionic transport tended to be down-regulated, while those concerning secretion, cytoskeleton and ubiquitinization were up-regulated dominantly.

CONCLUSIONSThe two kinds of samples, CSG-PDS/Normal and CSG-PDS/CSG-nPDS, have their respective gene expression profiles with different characteristics. Gene expression profile has certain referential significance in syndrome classification.

Chronic Disease ; Cluster Analysis ; Computational Biology ; Gastritis ; genetics ; Humans ; Oligonucleotide Array Sequence Analysis ; Syndrome

Adolescent ; Adult ; Aged ; Arrhythmias, Cardiac ; diagnosis ; etiology ; Child ; Child, Preschool ; Ebstein Anomaly ; complications ; pathology ; Humans ; Infant ; Middle Aged ; Young Adult

BACKGROUNDPatients with persistent or permanent atrial fibrillation (AF) often need direct current cardioversion after radiofrequency ablation. The aim of this study was to investigate the effectiveness and safety of ibutilide for cardioversion of persistent or permanent atrial fibrillation after radiofrequency ablation and the factors related to conversion.

METHODSPatients with persistent or permanent atrial fibrillation were treated with combined ablation strategy including circumferential pulmonary vein isolation, linear ablation and CAFÉ potential ablation. If AF was not terminated after ablation, ibutilide was used for cardioversion (1 mg, intravenous injection in 10 minutes). These patients were divided into a conversion group and a non-conversion group according to whether AF was converted to sinus rhythm within 30 minutes after administration. ECG monitoring was performed during the injection of ibutilide. Atrial waves recorded by coronary sinus electrodes were measured for calculating average wavelength of AF waves in six seconds. The QT interval was measured immediately after conversion and 2 hours after injection of ibutilide.

RESULTSForty patients whose AF was not converted to sinus rhythm after radiofrequency ablation were given an intravenous injection of ibutilide. Of the 40 patients, 29 cases were converted to sinus rhythm, with a conversion rate of 72.5%. The average conversion time was (13.2 ± 5.5) minutes. Compared with the conversion group, patients in the non-conversion group had a longer history of AF (9.4 ± 5.3) years vs. (4.3 ± 2.8) years, P < 0.05), and a markedly enlarged left atrium (47.3 ± 2.9) mm vs. (42.1 ± 4.5) mm, P < 0.05). There were no significant differences in gender, age, body mass index and left ventricular function between the two groups. Ibutilide significantly prolonged the average wavelength of the AF wave (171.8 ± 29.5) ms vs. (242.0 ± 40.0) ms, P < 0.001). Two hours after ibutilide treatment, the QT interval was significantly shortened (421.0 ± 24.7) ms vs. (441.0 ± 37.4) ms, P < 0.05). No cases of serious arrhythmias or other adverse reactions were found.

CONCLUSIONSA single dose of ibutilide for conversion of persistent or permanent AF after radiofrequency ablation is safe and effective.

Adult ; Anti-Arrhythmia Agents ; therapeutic use ; Atrial Fibrillation ; drug therapy ; therapy ; Electric Countershock ; methods ; Female ; Humans ; Male ; Middle Aged ; Sulfonamides ; therapeutic use ; Treatment Outcome