Objective To comprehensively evaluate the clinical effect of cryoballoon ablation (CBA) and radiofrequency ablation (RFA) in treating paroxysmal atrial fibrillation (PAF).Methods Computer retrieval of PubMed,EMbase,the Cochrane Library,Web of Knowledge,China national knowledge infrastructure (CNKI),Chinese Biomedical Medical Literature (CBM),China Wan Fang,China VIP,and other database to collect the randomized control trials (RCT) related to RFA and CBA treatment for PAF.The retrieval time was from the establishment of database to December 2015.The data extraction and methodological quality of the included studies were assessed by two reviewers independently.And meta-analysis was conducted by using RevMan 5.2 software.Results A total of 6 research papers (636 patients in total) were included.The results of meta-analysis showed that the incidence of phrenic nerve paralysis in CBA group was significantly higher than that in RFA group (RR=9.26,95％CI:2.17-39.63,P=0.003).No statistically significant differences in the operation time (MD=10.07,95％CI:-9.10-30.52,P=0.29),fluoroscopy time (MD=-0.18,95％CI:-8.14-7.77,P=0.96),12-month success rate (RR=0.91,95％CI:0.72-1.14,P=0.40) and the incidences of atrial tachycardia,atrial flutter,atrioventricular reentrant tachycardia existed between CBA group and RFA group (RR=0.47,95％CI:0.11-2.02,P=0.31).Conclusion For the treatment of PAF,no obvious differences in the operation time,fluoroscopy time,12-month success rate,and the incidences of atrial tachycardia,atrial flutter,atrioventricular reentrant tachycardia exist between CBA and conventional RFA,but CBA can increase the incidence of phrenic nerve paralysis.

Objective To evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) and hemoglobinto-white blood cell ratio (HWR) prior to treatment in prognosis of non-operative esophageal squamous cell carcinoma (ESCC) patients.Methods From October 2009 to November 2014,a total of 362 non-operative ESCC patients were enrolled in this prospective study.x2 test was used to analyze the relationship between NLR,HWR and general clinical features;Univariate and multivariate Cox regression analysis was performed to evaluate the association between variables and prognosis of non-operative ESCC patients.Results The optimal cutoff level of 1.23 for NLR and 24.92 for HWR were identified by X-title software.x2 test indicated NLR was significantly associated with gender,tumor length,T stage,TNM stage and fasting blood glucose level.Moreover,univariate and multivariate analyses showed that high NLR and high HWR were all associated with a poor prognosis in non-operative ESCC.However,when patients were specifically stratified by treatment modus,subset analysis showed that NLR was only predictive of prognosis in the concurrent chemoradiotherapy group (HR =4.080,95％ CI:1.074-15.497,P =0.039),whereas the influence of HWR on prognosis was just existed in the sequential chemoradiotherapy group (HR =2.625,95％ CI:1.311-5.254,P =0.006).Conclusions In this investigation,we found that high NLR and high HWR were associated with poor prognosis in non-operative ESCC.

Objective:To investigate the wear resistance of four low-shrinkage commercial composite resins and two traditional composite resins in vitro and discuss the relative influencing factors, and to illustrate the inner relationship of the wear resistance of resins and material composition.Methods:Four low-shrinkage commercial composite resins including CLEARFIL MAJESTY Posterior(CMP), Filtek LS(LS), Admira(AD), Kalore(KA) and two traditional composite resins including Filtek Z350XT (Z350), Solitaire2(S2) were chosen.The bar-shaped specimens were fabricated and mounted in a UMT-2 wear testing machine and abraded with the two-body media (distilled water) with a Si3N4 ball as antagonist.The maximum wear depth was determined after 14 400 cycles.The friction coefficient was determined during the test.The worn surfaces were examined with SEM.Results:CMP showed the lowest maximum wear depth and KA presented the highest maximum wear depth.The maximum wear depth ranked as follows: CMP

The brain pharmacokinetics of hyperoside and 1 , 5-dicaffeoylquinic acid and the effects of acanthopanax senticosus leaves on neurotransmitters in cerebral ischemic rat brain were investigated. In the study, acute incompleteness cerebral ischemia model was developed by ligating the bilateral common carotid arteries of rats. The differences of brain pharmacokinetics of hyperoside and 1,5-dicaffeoylquinic acid between control and cerebral ischemic rats were determined by online microdialysis coupled with MS/MS method. At the same time, the contents of glutamic acid (Glu), aspartic acid (Asp), γ-aminobutyric acid (GABA), serotonin (5-HT) , dopamine ( DA) , and acetylcholine( Ach) in rat hippocampus among different groups were determined simultaneously in MRM mode. ACE 5 C18-AR column was used for separation. Results showed that the online analytical method had excellent linearity (R2>0. 99). The accuracy and precision could meet the analysis requirement. Besides, the hyperoside and 1,5-dicaffeoylquinic acid penetrated the blood-brain barrier successfully and metabolized quickly, but the absorption reduced and elimination became faster in cerebral ischemic rats; the contents of Glu, Asp, GABA and DA in brain issue of cerebral ischemic rats decreased significantly ( p<0 . 01 ) and the level of Ach increased remarkably ( p<0 . 05 ) after a preventive medication with the extract of acanthopanax senticosus leaves for one week.

Aim To study the inhibitory activities of potential new anti-influenza virus agents,3-O-β-chaco-triosyl pentacyclic triterpenoids against the entry of H5N1influenza viruses.Methods Three target com-pounds were designed and synthesized structurally re-lated to the lead compound 3-O-β-chacotriosyl dioscin derivative (1 )with inhibitory activities against H5N1 influenza viruses.The inhibitory activities of these tar-get compounds were tested at a cellular level pseudo vi-rus system targeting H5N1 influenza viruse entry.Re-sults All the compounds 1 a,1 b and 1 c showed po-tent inhibitory activities against the entry of A/Thai-land/Kan353/2004 pseudo virus into the target cells, of which compound 1 b showed the best inhibitory activ-ity with an IC50 value of (1.25 ±0.22)μmol·L-1. Conclusion The SARs analysis of these compounds indicated that replacement of the aglycone moiety of compound 1 with pentacyclic triterpenoids could in-crease antiviral activity.Different types of pentacyclic triterpen as aglycone residue had the significant influ-ence on the inhibitory activity (1 b >1 c >1 a),sug-gesting ursane type of triterpenes was superior to the two other kinds of triterpenes as aglycone residue.

To evaluate the effects of ginseng aqueous extract on learning and memory abilities and neurochemicals in diabetic encephalopathy rat brain. Diabetes mellitus model was established. Cognitive abilities were evaluated with Morris water maze test by the indexes of escape latency time ( ELT) , times of passing through the target area and the percent of swimming track in goal quadrant. We applied online MD-LC-MS/MS method to determine eight neurochemicals in rat hippocampus among different groups in MRM mode. Venusil C18 column was used for separation. Treatment with ginseng aqueous extract significantly improved the cognitive abilities of diabetic rats (p<0. 05). The method had excellent linearity (R2>0. 99). The accuracy and precision could meet the analysis requirement. Comparing with the model group, the concentrations of taurine and acetylcholine were significantly increased ( p<0 . 01 ) after treated with ginseng aqueous extract, but the glutamic acid, aspartic acid,γ-aminobutyric acid, serine, dopamine and serotonine decreased dramatically. Ginseng aqueous extract can efficiently regulate the levels of eight neurochemials in diabetic rat brain to normal.

Objective To obtain area strain parametersuse of left ventricle in patients with coronary heart disease (CHD) by three-dimensional speckle tracking imaging(3D-STI),evaluate the systolic function and synchronization of left ventricle depending on different degrees of coronary artery stenosis,and then search new evidence for evaluation and diagnosis of the systolic function of left ventricle.Methods 94 patients were recruited diagonosed as CHD were recruited and their 3D-STI dynamic images were stored 24 hours before coronary angiography.All patients were divided into three groups (the severe stenosis group,the moderate stenosis group,and contrast group) according to the results of coronary angiography.Then the conventional echocardiographic parameters,area strain(AS),area strain dyssynchrony index(ASDI),and the standard deviation of the peak time of AS(AS-SD) were measured.Results There were no significant differences among conventional echocardiographic parameters of the three groups.Compared to the moderate stenosis group and the contrast group,the AS,ASDI and AS-SD of the severe stenosis group were significant different (P ＜0.001),however there were no differences between the moderate stenosis group and the contrast group (P ＞0.05).The ROC curve showed that the diagnostic value was the highest to detect severe stenosis when using ASDI≥1.90％ as the cutoff value,with 84.2％ of the sensibility,and 94.1％ of the specificity.Conclusions The area strain parameters of 3D-STI are effective indice as clinical references to evaluate the systolic function of left ventricle and the degree of coronary artery stenosis,in particular,the ASDI is the most effective parameter.

Objective To explore the efficacy of sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy and the factors associated with the prognosis.Methods 106 cases with esophageal varices in control group was treated with drugs alone;study group had 113 cases, was given endoscopic therapy add drugs, The study group randomly divided into two groups, one was treated with endoscopic variceal ligation all the time (EVL group), another was treated with sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy (sequential group). After the treatment, the rate of removal of varicose veins, the rate of rebleeding, the number of total treatment,mortality and intra-operative complications and postoperative complications were compared. And compared rebleeding rate and mortality with the control group and study groups with different CTP and MELD, analyze the factors of prognosis, and evaluate their prognostic value.Results Rebleeding, rate in control group, EVL group and sequential group were 41.51%,10.53% and 10.64%,sequential group was significantly better than control group (P = 0.000); mortality in control group, EVL group and sequential group were 15.09%, 5.26% and 2.13%, sequential group was also significantly better than control group (P = 0.001); rate of recurrence in EVL group and sequential group within half a year were 73.68% and 44.68%, sequential group was significantly better than EVL group (P = 0.021). In all control group and EVL group and the sequential group, rebleeding rate and mortality of the liver function Child-Turcotte-Pugh (CTP) class C was significantly higher than that of calss A; In MELD model, AUC area under the ROC curve of rebleeding rate in control group and sequential group were 0.944 and 0.851, mortality of the two groups were 0.881 and 0.984, while the rate of recurrence in the EVL group and sequential group were respectively 0.914 and 0.765, the MELD score has the important value to the prediction of rebleeding and death.Conclusion The rebleeding rate and mortality in cirrhotic patients with esophageal varices treated with sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy were significantly decreased and the recurrence rate was lower than that of the patients with endoscopic variceal ligation all the time. Liver function Child-Turcotte-Pugh (CTP) score and the MELD score have important value in prediction of rebleeding and death, ligation and sclerosing sequential therapy can significantly reduced rebleeding and mortality in CTP class B and C, and improve the MELD threshold of rebleeding and death.

Objective To introduce the competing risk model into outcome prediction of mild cognitive impairment (MCI) of seniors and to explore influencing factors for the prognosis of MCI to Alzheimer' s disease (AD).Methods Data were collected from six follow-up visits to 600 seniors from communities in Taiyuan city,which were conducted at an interval of six months from October 2010 to May 2013.MCI state was defined as the transient state,AD and death before AD as two absorbing states (death before AD in which was regarded as a competing risk event),building the competing risk model to identify the model parameters,and to explore influencing factors on MCI prognosis to AD.In the meantime,the 3-year MCI-AD transition probability was estimated based on the multi-state Markov model.Results Based on screening with the multivariate competing risk model analysis,factors such as higher age (estimate HR=1.56,95％CI:1.01-2.39),female gender (HR=1.72,95％CI:1.02-2.92),higher education(HR=0.64,95％CI:0.41-1.00),reading frequently (HR=0.57,95％CI:0.32-0.99),hypertension (HR=3.43,95％CI:1.08-10.85) and high SBP(HR=1.67,95％CI:1.04-2.66),were statistically significant for transition from MCI to AD in three years.3-year MCI-AD transition probability was 10.7％(95％CI:8.6％-13.2％).Conclusion Age,gender,education,reading and blood pressure were the influencing factors for the prognosis of MCI to AD.Competing risk model was advantageous in studying longitudinal data with multiple potential outcomes.

Hybrid operating room refers to clean operating rooms equipped with advanced MRI(magnetic resonance ima-ging), DSA(digital subtraction angiography) and CT(computer tomography), radiation therapy C-arm and navigation equip-ment.Currently, hospitals attach great importance to install and use DSA, so that the doctor can not only perform the conven-tional operation, but also directly explore the angiograpic and interventional therapy, which greatly improve the efficiency and the success rate of the surgery.After check out database, choosen about 40 papers of high quality.This paper introduces the concept of hybrid operating room, the development process, clinical application status and advantages in cardiovascular dis-ease, and prospects for its development in the future , and provides some suggestions to more easily build hybrid operating room.