Objective To compare the clinical outcomes of segmental pulmonary veins isolation (SPVI) and circumferential pulmonary veins ablation (CPVA) for patients with paroxysmal atrial fibrillation. Methods Sixty-eight patients with paroxysmal atrial fibrillation from January 2004 to April 2008 were divided into SPVI group (30 cases) and CPVA group (38 cases).The mean procedure time,the mean fluoroscopy time and relapse rate were compared. Results The mean procedure time in CPVA and SPVI group had no significant difference [(171.0 ± 25.8) min vs (168.2 ± 21.7) min, P = 0.579], but the mean fluoroscopy time in CPVA group [(38.5 ± 8.4) min]was less than that in SPVI group [(45.8 ± 16.1) min (P= 0.019). Mean term of the follow up was (17.1 ± 7.8) months. Relapse rate in CPVA group was less than that in SPVI group (5.3% vs 23.3%, P= 0.029). Both groups had no severe complications. Conclusion In patients with paroxysmal atrial fibrillation, CPVA strategy provides a more favourable clinical outcomes and less fluoroscopy time.

Objective To investigate the therapy efficiency and complication prevention in patients undergoing radiofrequency current catheter ablation combined with multiple X-ray projecting angles.Methods Two hundred and six atrioventricular nodal reentrant tachycardia (AVNRT) patients were involved in this study. The distance between the tip of His and the ostium of coronary sinus were measured under different X-ray projecting angles respectively, including posterior anterior (PA), right anterior oblique 30° (RAO 30° ) and left anterior oblique 45° (LAO 45° ) in each patient, and mapping was proceeding under the corresponding X-ray projecting angles with the longest distance. The distance between ablating catheter and His was confirmed again before powering by the other two X-ray projecting angles. Results The longest distance between the tip of His and the ostium of coronary sinus were obtained in 66,75 and 65 patients under PA,RAO 30° and LAO 45° respectively(P＞ 0.05 ),and the data were (2.94 ± 0.87), (2.98 ± 0.76)and (2.91 ± 0.52) cm(P＞ 0.05). Transient first or second degree of atrioventricular blocking was observed in 4 cases among 22 high risk patients in which the powering sites were above the medium level of the distance between the tip of His and the ostium of coronary sinus under three kinds of X-ray projecting angles obviously.However,only 1 case was observed in other 184 patients(P＜ 0.01 ). All patients were cured successfully and no permanent atrioventricular blocking occurred. Conclusion Radiofrequency current catheter ablation combined with multiple X-ray projecting angles is helpful to increasing the successful rate and preventing complication in ablating therapy.

OBJECTIVETo analyze the changes of patients with type 2 diabetes in different stages in glucagon (GC) and free fatty acid (FFA) in fasting, OGT and L-Arg experiments, and discusses the role of pancreatic alphabeta cells in diabetes pathogenesis by studying the relations among indexes such as glucagon (GC), free fatty acid (FFA) and blood glucose (BG), insulin, insulin homeostasis model (HOMA) and glucose metabolism hormone secretion curve, in order to provide theoretical basis for the treatment of diabetes.

METHODStudy objects were divided into the T2DM group (45 cases), the IGT group (28 cases) and the NGT group (30 cases) for an OGTT experiment and then an L-Arg experiment on the next day. Under the fasting state, their blood glucose (FBG), insulin (F), glucagon (FGC), free fatty acid (FFA) were detected to calculate HOMA-beta, insulin sensitivity index (ISI) and HOMA-IR of different groups. Meanwhile, efforts were made to calculate different time quantum detected in OGTT and L-Arg experiments and area under the curve AUC(BG), AUC(INS) and AUC(GC).

RESULTObvious overall differences were observed in FFA and FGC of the three groups. FGC of each group was negatively correlated with HOMA-beta and ISI. Among all of the 103 study objects, FGC was positively correlated with FBG and HOMA-IR and negatively correlated with HOMA-beta and ISI, with no correlation with FINS; FFA was positively correlated with FBG, HOMA-IR and negatively correlated with FINS, HOMA-beta, ISI. FGC and FFA were positively correlated in the T2DM group and the IGT group, but with no statistical correlation in the NGT group. The sequence of the three study objects was T2DM > IGR > NGT in AUC(GC) in the OGTT experiment and T2DM > IGR > NGT in in AUC(GC) in the L-Arg experiment, with the significant positive correlation between AUC(GC) and AUC(BG) and significant negative correlation with AUC(INS).

CONCLUSIONGlucagon and free fatty acid of T2DM and IGT patients increased, which was positively correlated with blood glucose and HOMA-IR and negatively correlated with INS, HOMA-beta and ISI. The increase in glucagons of T2DM and IGT patients indicated inappropriate secretion of pancreatic alphabeta cells among patients with type 2 diabetes.

Adult ; Blood Glucose ; metabolism ; Diabetes Mellitus, Type 2 ; metabolism ; Fatty Acids, Nonesterified ; metabolism ; Female ; Glucagon ; blood ; Humans ; Insulin ; secretion ; Islets of Langerhans ; secretion ; Male ; Middle Aged

Drugs, Chinese Herbal ; Medicine, Chinese Traditional ; Terminology as Topic ; Translations

Objective To evaluate CT characteristics of pulmonary sclerosing hemangioma(PSH) so that to improve the knowledgeof this disease.Methods CT characteristics of PSH pathologically verified were retrospectively analysed.Conventional scan andcontrast-enhanced scan were performed in all the patients.Results 14 lesions were in right lung,while 10 were in left,Diameters of these lesions ranged from 0.8 to 10 cm,and the average diameter was 3.08 cm.3 lesions were located in hilum of lung,while the rest(87.5%)were located in peripheral lung tissue.20 lesions were oval,and 4 were lobulated in morphology.21 lesions were smooth in edge.45.8% of the cases had calcification.All the lesions enhanced obviously on contrast-enhanced scan,and average CT value of(46.62?9.47) HU was increased.The dilated and distorted blood vessels could be detected in 2 large lesions.Conclusion On the basis of general benign tumor features, obvious enhancement and calcification are the characteristics of PSH on CT.

OBJECTIVETo investigate the tumor proliferation and apoptosis changes after preoperative hepatic and regional arterial infusion chemotherapy (PHRAIC) after radical colorectal cancer resection.

METHODSFive hundred and nine patients with stage II or stage III colorectal cancer from June 2001 to June 2007 were randomly assigned to PHRAIC group (n = 256) or control group (n = 253, surgery alone). Tumor proliferation and apoptosis index were evaluated in tumor tissues of the control and PHRAIC group (pre and after intervention). The survival rates were also recorded in the two groups.

RESULTSThere was no significant differences in sex, age, tumor location, tumor size, tumor stage, tumor differentiation and follow-up time for the two groups (P > 0.05). There was no significant differences in all the evaluation factors between the control group and PHRAIC group before intervention (P > 0.05). Before and after intervention for PHRAIC group: stage 3 necrosis rate were 3.1% and 22.7%, stage 4 necrosis rate were 0 and 13.5% (P < 0.05); label index of Ki67 were 48.6 +/- 17.1 and 38.4 +/- 13.3 (P < 0.05); expression rate of Bax, bcl-2 and survivin were 48.0% vs 77.0%, 75.0% vs 43.0%, 52.0% vs 31.6%, respectively (P < 0.05); apoptosis rate were 4.3% +/- 2.2% and 16.7% +/- 6.4%(P < 0.05). In the PHRAIC group, 42.1% +/- 11.2% of the cells in the tumor tissue were in S phase before intervention and the rate fell to 21.8% +/- 10.7% after intervention (P < 0.05); and G0-G1 phase rate of the group pre and post intervention were 35.1% +/- 12.1% and 57.1% +/- 18.1% (P < 0.05). All the patients were followed-up for a mean time of 42 +/- 14 months. For patients with stage III tumor in PHRAIC group and control group, the 5-year liver metastasis rate were 18.9% and 27.3% (P = 0.033), recurrence and metastasis rate were 26.3% and 38.0 (P = 0.024), overall survival rate were 81.0% and 60.4% (P = 0.011), median survival time were 45 and 40 months (P = 0.02); no significant differences of aforementioned factors was found in patients with stage II tumors between the two groups.

CONCLUSIONThe schedule of preoperative hepatic and regional arterial infusion chemotherapy before surgery can restrain proliferation, promote apoptosis and reduce liver metastasis and improve survival rate in stage III colorectal cancer.

Adult ; Aged ; Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Chemotherapy, Adjuvant ; Colorectal Neoplasms ; drug therapy ; pathology ; surgery ; Female ; Follow-Up Studies ; Hepatic Artery ; Humans ; Infusions, Intra-Arterial ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Preoperative Care ; Retrospective Studies

Objective To analyze clinical diagnosis and management of 5 patients with actinomycete keratitis.Design Retro- spective case series.Participants 5 patients (5 eyes) with actinomycete keratitis.Methods The clinical features and microbiologic da- ta of 5 culture-proven cases of actinomycete keratitis recorded between October 2004 to March 2006 were analyzed.Main Outcome Measures clinical characteristics,isolations identification,drug susceptibility test and treatments.Results All patients were males and farmers.Of the 5 cases presented in this study,4 cases were followed by minor trauma as a predominant risk factor,and were pre- sented by a chronic progressive corneal ulcer with a wreath pattern of infiltrate.The diagnosis of all cases was based on laboratory in- vestigations,by which 4 cases of nocardia and one case of streptomyce were identified.A variable drug sensitivities were presented in nocardia isolates,which including TMP-SMZ,amicasin,gentamicin and fluorine-quinolones.Conclusions Nocardia keratitis is mainly followed by a minor trauma.It is identified predominantly by laboratory investigations.Tropical and systemically sensitive biotic are the initial choice,while debridement and amnionic transplantation could be an effective alternative.

Objective The aim of this study was to investigate the relationship between phosphotyrosine interac-tion domain containing 1 ( PID1 ) gene and variation in intramuscular fat ( IMF ) content and the possibility to generate transgenic animals by testicular injection .Methods Expression vector pIRES2-acGFP-PID1 carrying pig PID1 gene was incubated with transfection reagents and injected into the testes of male New Zealand rabbits .We examined the F1 genera-tion by fluorescence detection , PCR, Western blotting and measuring the IMF content .The F1 generation gave birth to the F2 generation.Then we examined the F2 generation through detecting the positive rate and the IMF content .Results The exogenous PID1 gene and fluorescent protein gene were expressed at different levels both in the F 1 generation and the F2 generation, and the positive rates were 35.88%and 34.33%, respectively.The IMF content was significantly elevated (P<0.05) in the transgenic positive individuals compared with the negative ones and the control group , and the PID1 protein expression was similarly higher .Conclusions The results of this study demonstrate that PID 1 gene affects intramuscular fat content significantly .Moreover, the results of our analysis provide further evidence that transgenic animals can be gener -ated by testicular injection , and the exogenous gene can be inherited steadily .

Objective To evaluate the efficacy and safety of proton pump inhibitor (PPI)plus prokinetic drug on the treatment of laryngopharyngeal reflex .Methods According to predetermined criteria of inclusion and exclu-sion ,Cochrane Central Register of Controlled Trails(CENTRAL) ,Embase ,Elsevier ,Pubmed ,VIP ,Wanfang Data , CNKI and CBM were searched for the randomized controlled trails of proton pump inhibitor and prokinetic drug on the treatment of laryngopharyngeal reflex diseases from the date of establishment of the datebases to November 2012 .Revman 5 .1 software and GRAED profiler 3 .6 software were applied to analysis the data ,which was extrac-ted by three independent evaluators .Results A total of 346 related articles were obtained ,7 trails were included , 614 patients in total .The results of Meta -analysis showed that :the overall effictive rate of combination therapy with proton pump inhibitors plus prokinetic drug in patients with laryngopharyngeal reflex was higher than those in the control group [RR=1 .18 ,95% CI(1 .10 ,1 .28) ,P<0 .0001] .The rate of improvement of laryngeal signs exam-ined by fiberoptic laryngoscope was higher than those in the control group [RR= 1 .38 ,95% CI(1 .16 ,1 .65) ,P<0 .001] .The average relief time of dysphonia symptoms was shorter than those in the control group [MD = -1 .70 , 95 CI (-2 .95 ,-0 .45) ,P<0 .001] .Conclusion The effect of proton pump inhibitor plus prokinetic drug on the treatment of laryngopharyngeal reflex is superior to those of proton pump inhibitors or prokinetic drug only ,but in terms of safety ,more large-sample ,high-quality randomized controlled trails are required .

Objective To investigate the role of soluble CD305(sCD305)in renal allograft rejection.Methods Concentration of serum sCD305 was detected on 20 healthy volunteers and 153 cases of recipients after kidney transplantation by using double monoclonal antibody sandwich enzyme linked immunosorbent assay.Results In the healthy volunteers and 98 recipients with normal renal funetion,sCD305 was detected at low levels of(4.3±2.3)μg/L and(6.3±3.7)μg/L.In 20 cases of acute rejection and 5 cases of graft loss,serum sCD305 levels were(36.3±14.7)μg/L and(28.8±9.4)μg/L,and significantly higher than those in the healthy volunteers and recipients with normal renal function.Meanwhile,in the 30 cases of chronic rejection and 6 cases under dialysis treatment,the levels of sCD205were(13.1±5.5)ttg/L and(11.2±4.6)μg/L and significantly higher than those in the healthy volunteers and recipients with normal renal function.Conclusions CD305 was presented at high level in the recipients with renal acute or chronic rejection,and it might be a potential marker for monitoring graft rejection after transplantation.