This article is to report three cases of total anomalous pulmonary venous drainage(TAPVD). 2 out of the 3 cases were of the supracardiac form and they were corrected by anastomosis between the trunk of the pulmonary vein and the left atrium with excellent result. The third case was of the intracardiac form. The patient died in the late postoperative period of pulmonary venous obstruction due to the improper judgement during the operative procedure of compartmentalization. Meanwhile, the embryogensis, clinical manifestations, diagnosis, and operative proceduresfof TAPVD were reviewed and discussed.

Objective To evaluate advantages and disadvantages of three procedures-percutaneous ethanol injection,small incision unroofing,and laparoscopic unroofing-in the treatment of renal cysts.Methods Clinical data of 106 cases of renal cysts from January 2001 to November 2004,treated either by percutaneous ethanol injection(Percutaneous Group),or small incision unroofing(Small Incision Group),or laparoscopic unroofing (Laparoscopic Group),were reviewed.The operation time,intraoperative blood loss,hospitalization costs,and cure rate were compared among the three procedures.Results The Percutaneous Group presented the least hospitalization costs(3 261.8?779.2 yuan),the lowest cure rate(78.6%,22/28),and the highest recurrence rate(21.4%,6/28).The Small Incision Group had the shortest operation time(44.1?5.7 min),and the Laparoscopic Group had the highest hospitalization costs(9 050.9?1 116.2 yuan).There were significant differences in these parameters among the three groups(P0.05).Conclusions The three procedures,with each having its own advantages,should be selected depending on individual conditions.For patients with a simple renal cyst

Objective To compare the clinical outcomes of 2 different catheter ablation strategies for patients with chronic atrial fibrillation(CAF).Methods One hundred and thirty four consecutive patients(77 males,mean age 56.8?12.3 yrs)were randomized into 2 groups of different catheter ablation strategies.All the patients suffered from frequent attacks(more than 3 times per month),drug refractory and symptomatic CAF.One group received circumferential pulmonary rein ablation(CPVA group,n=68)and the other group received complex fractionated electrogram ablation additional to CPVA(CPVA+CFEA group,n=66).All ablation was guided by 3 dimensional mapping system(CARTO).Follow-up ECG,Holter and clinical outcomes of the 2 groups within 6 months after the procedures were analyzed.Results The baseline characteristics were comparable between the 2 groups.The mean procedure time in the CPVA+CFEA group was longer than that in the CPVA group but the mean fluoroscopy time between two groups had no significant difference.After the first procedure,60%of patients in the CPVA group and 77% of patients in the CPVA +CFEA group were free from symptomatic atrial tachycardia without any use of antiarrhythmic drugs for at least 3 months(P

Objective To evaluate the safety and effectiveness of catheter ablation for atrial fibrillation(AF)therapy guided by 3-D mapping systems.Methods Eight hundred cases(482 male,mean age 62.1?15.6 years)were enrolled.AF was paroxysmal in 611 cases,and persistent in 189 cases.The mean left atrium diameter was 38.4 9.2 mm.Ablation was guided by EnSite-NavX in 260 cases and by CARTO in 540 cases.Circumferential pulmonary vein isolation(CPVI)was performed for paroxysmal AF,and CPVI combined with complex fractionated atrial electrograms(CFAEs)and mitral isthmus ablation was applied for persistent AF.Every case received oral anticoagulation with warfarin and class IC and class III antiarrhythmic drugs for 1 to 3 months.ECG and Holter were applied every month during follow-up.Results Seven hundred and ninty-five cases underwent the procedure successfully,with the mean procedural time 161 33 min and fluoroscopic time 17 13 min.PV isolation was achieved in 96.5% of cases for left-sided PVs,and in 98.6% of cases for right-sided PVs.Radiofrequency application terminated paroxysmal AF in 90 out of 98 cases.AF recurred in 137 cases within 2 weeks post-ablation,and subsided in 103 cases during subsequent follow-up.Fifty-seven cases underwent re-ablation and 6 cases required third ablation.Persistent AF was terminated in 30 cases(16.1%)and was converted to atrial tachycardia in 15 cases(8.1%)by CPVI.For patients receiving CFAEs ablation,persistent AF was terminated in 20 cases(10.8%)and was converted to atrial tachycardia in 23 cases(12.4%).AF recurred in 78 cases(41.9%)early after ablation and 65 cases underwent re-ablation(10 cases received third ablation).Atrial tachycardia/flutter developed in 104 cases(13.1%)after ablation,and remitted in 68 cases.Atrial tachycardia/flutter was mapped and ablated in 30 cases,and was eliminated in 23 cases.Complications:Cardiac tamponade developed in 5 cases,requiring pericardiocentesis in 3 cases and surgical repair in 2 cases.PV stenosis was present in 6(0.7%)cases,TIA in 1 case,cerebral embolism in 2 cases,mesentery artery embolism in 1 case,hemothorax in 1 case and pneumothorax in 1 case.There were femoral artery pseudo-aneurysm in 3 cases and femoral artery-vein fistula in 1 case.All the patients were cured by conservative therapy.During a mean follow-up of 16.2?5.7 months,550 cases(9.4% of them received re-ablation and 11.5% received antiarrhythmic drugs)with paroxysmal AF and 159 cases(34.9% of them received re-ablation and 28.5% received antiarrhythmic drugs)with persistent AF were free of atrial tachyarrhythmias recurrence.Conclusion Catheter ablation guided by 3-D mapping systems were safe and effective for AF therapy.CPVI alone was enough for paroxysmal AF treatment,while CPVI combined with CFAEs and isthmus ablation were preferable for persistent AF treatment,and re-ablation were needed in 40% of the patients to improve effectiveness.

Objective To analyze the prevalence of complications following catheter ablation for atrial fibrillation and to describe the characteristics of transition of complications.Methods From October 2004 to December 2008,2 260 cases(1 265 males)with atrial fibrillation(AF)were admitted for catheter ablation.AF was paroxysmal in 1 449 cases and chronic in 811 cases.Circumferential pulmonary vein isolation(CPVI)was carried out alone for paroxysmal AF and in combination with fractionated electrograms ablation for chronic AF.Complications were summarized and analyzed by dividing the whole duration into three sections:Year 2004-2006,Year 2007 and Year 2008.Results Complications occurred in 61 cases(2.70%).Cardiac tamponade developed in 11 cases,embolism in 18 cases,pulmonary vein stenosis in 14 cases,and vessel access related complications in 18 cases.In Year 2004-2006,cardiac tamponade occurred in 5 cases,cerebral embolism in 3 cases,mesenteric artery embolism in 1 case,pulmonary vein stenosis in 6 cases,and vessel access related complications in 6 cases.In Year 2007,cardiac tamponade occurred in 4 cases,cerebral embolism in 3 cases,Mesenteric artery embolism in 1 case,pulmonary vein stenosis in 4 cases,and vessel access related complications in 5 cases.In Year 2008,cardiac tamponade occurred in 2 cases,cerebral embolism in 7 cases,mesenteric artery embolism in 3 cases,pulmonary vein stenosis in 4 cases,and vessel access related complications in 7 cases.There was no significant difference in the prevalence of complications among three sections.The prevalence of cardiac tamponade was lower in Year 2008 compared with that in the other two sections,P=0.5.However,the prevalence of embolism was higher in Year 2008 compared with that in the other two the sections,P=0.2.Conclusion It is safe to perform catheter ablation for the treatment of AF.Despite the improvement of technical skills,the prevalence of severe complications such as cardial tamponade,pulmonary vein stenosis or stroke did not decrease.

Objective To analyze the distribution of key target sites(KTSs) during initial circumferential pulmonary vein isolation(CPVI) for atrial fibrillation(AF) and during re-ablation.Methods Forty eight cases(30 males,average age 54.3?10.2 years) with recurrent AF were enrolled.AF was paroxysmal in 24 cases and persistent in 24 cases.Re-ablation was performed 37.2?7.4 days after initial CPVI.KTS was defined as the target sites where pulmonary vein potentials(PVPs) delayed,conduction sequence changed,PVPs slowed down or PV isolated during ablation.Circumferential pulmonary vein(PV) lesions were divided eaqually into 8 segments.KTSs were analyzed during initial CPVI and re-ablation.Results One hundred and forty five KTSs were identified during initial CPVI.The mean KTSs per case were 3.02?1.08,compared with 1.58?1.09 during re-ablation,P

Objective To evaluate the electrophysiological mechanism of early recurrence of atrial tachyarrhythmias(ATa) after initial ablation for paroxysmal atrial fibrillation(AF)and the feasibility of early re-ablation.Methods Forteen cases(8 males,average age of 61.8?8.4 years) presented with early recurrent ATa within 1 month after initial ablation were included.Early recurrence was observed after a mean of 4.9?3.7 days post-ablation.During re-ablation,all pulmonary vein(PV) reconnection was re-isolated,and AF induction was applied to map and ablate non-PV triggers.ECG and Holter monitor was applied to evaluate the effect.Results Re-ablation was performed after a mean follow-up of 24.7?5.5 days after the first ablation.PV re-connection was identified in 13 cases(92.9%) and was re-isolated by closing conduction gaps along initial lesion lines.By AF induction,superior vena cava(SVC) originated AF was detected in 3 cases and was terminated by SVC isolation.Upper crista terminalis(CT) foci was found in 1 case which was eliminated by focal ablation.Typical atrial flutter(AFL) in 3 cases and left atrial AFL in 1 case were terminated by linear ablation.At the end of follow-up of 5.8?1.4 months,13 cases were free from ATa recurrence and anti-arrhythmic drugs.Paroxymal ATa was observed in 1 case which could be suppressed by verapamil.Conclusion PV re-connection is the main influencing factor of early recurrence of ATa after initial ablation for paroxysmal AF.Other factors include foci located in SVC and CT.Early re-ablation is feasible and effective.

In view of the deficiencies of both Qi and Yin in most cases of this tumor, Jinfukang oral solution (JFK). a remedy mainly for benefiting Qi and nourishing -yin. was formulated. 96 cases were treated with one case of CR. 8 cases PR, 52 NC. the rate of PR + NC being 63. 5%. Another 52 cases were treated with chemotherapy +JFK. with 11 cases of PR, 26 cases NC, the rate of PR + NC being 71. 2%. While 25 cases were treated by chemotherapy alone, the cases of PR was 4; NC 26. the rate of PR + NC being 60. 0%, This demonstrated that the effect of JFK and JFK + chemotherapy were all superior to effect of chemotherapy alone. For 1 - and 2 - year survival rates, the JFK group was 67. 3% and 66. 7% respectively, whereas that of JFK + chemotherapy. 67. 3% and 66. 7%. For the chemotherapy group , 1 - year survival rate was 40. 3%, with no survivals within 2 years. For symptom improvement, body weight gaining, and health condition (KPS evaluation) after treatment, the JFK and JFK + chemotherapy groups were, again, superior to the chemotherapy group. The Immunity indices and blood picture in JFK group after treatment were markedly improved as compared with those before treatment, but, those in the chemotherapy group were decreased, while those of the JFK + chemotherapy group remained unchanged.

目的观察中药汽化熏蒸加肩关节运动治疗肩周炎的疗效。方法将128例肩周炎患者分成治疗组68例和对照组60例,前者采用中药汽化热疗加肩关节运动疗法治疗,后者采用口服止痛药加外贴止痛膏治疗。结果治疗组有效率97%,对照组有效率80%,两组间有显著性差异(P<0.05)。结论中药汽化熏蒸加肩关节运动疗法治疗肩周炎可获得明显疗效。

AIM: To study on the differences of chemical compos i tion between extracts of Bushen recipe prepared by decocting together and single , with fingerprint technology. METHODS: The extracts of Bushen recipe were prepared by decocting together and single under the same process. The comparison was done under the different wavelength s and different brand columns, HPLC method determined the extract's fingerprint within the range of optimized conditions. RESULTS: The ratio of The compositions and its main chemical substa nces are the different between the two extracts, and the extract rate of the main chemical substances are higher in extrat decocted single than in extract decocted togethe r. CONCLUSION: There are some chemical substances and composition's ra tio differences in the extracts of Bushen recipe made by decocting together and single.