Child ; Female ; Humans ; Muscular Dystrophies ; complications ; congenital ; Spondylitis, Ankylosing ; complications

Objectives: To assess the feasibility and stability of right ventricular outflow tract (ROVT) pacing under current technology by comparing the results of ROVT pacing with the traditional right ventricular apex (RVA) pacing. Methods: A total of 42 patients (at mean age of 63.5±10.4 years) without structural heart disease were randomly divided into two groups. RVA pacing group (n=14),and RVOT pacing group(n=28). An active fixation lead was implanted in all patients whose pacemaker could automatically measure the pacing threshold every day. The operation time,X-ray exposure time and lead parameters detected during the operation were collected to evaluate the feasibility of RVOT pacing. The complications related to lead and implantation procedure and the trend of threshold change during the follow-up time were used to assess the stability of RVOT pacing.Results: There were no statistic differences between RVA pacing group and RVOT pacing group in terms of operation time,X-ray exposure time and lead parameters. In RVOT group,the change of threshold during acute period was similar to those in RVA group (P=0.23). Chronic pacing threshold was also comparable between two groups,mean threshold at 6 months follow-up time was 0.55±0.11V and 0.54±0.09V at 0.4 pulse width in RVA group and RVOT group respectively (P=0.787).Conclusion: RVOT pacing was feasible and stable in operation time and lead characteristics compared with the conventional RVA pacing under current pacing technology.

AIM: To examine the change of serum tumor necrosis factor-? (TNF-?), nitric oxide (NO) in patient with congestive heart failure (CHF) and the effect of angiotensin Ⅱ (AngⅡ), valsartan on TNF-? and NO production in culture peripheral blood mononuclear cells (PBMC), to assess the relationship between the renin-angiotensin system and cytokines. METHODS: Venous blood of both healthy volunteers (n=12) and patients with CHF (n=16) were collected. Serum TNF-? and NO were examined. Peripheral blood mononuclear cells (PBMC) were obtained from both the control and the patients groups and cultured with AngⅡ at concentrations of 0, 0.01, 0.1, 1 ?mol/L, respectively. AngⅡ at concentration of 0.1 ?mol/L combined with 0.1 ?mol/L of valsartan was also used. After 24 h incubation, the contents of TNF-? and NO in the culture supernatants were measured. RESULTS: Serum TNF-? and NO production in CHF group were significantly higher than that in control group (P0.05) were observed. AngⅡ stimulated TNF-? and NO release from PBMC of patients with CHF and normal person, which was inhibited by valsartan. CONCLUSIONS: AngⅡ obviously increases TNF-? and NO production from PBMC, which indicates there is relationship between the renin-angiotensin system and TNF-?, NO. The fact that valsartan inhibits TNF-? production may be one of the mechanisms in treating CHF.

Objective To explore if there is a difference in blood pressure in left and right extremities.Methods A total of 20164 adults who took part in health check-up at Health Examination Center of Chinese PLA General Hospital between December 2009 and August 2011were enrolled in this study.Age,height and body weight were recorded,and blood pressure in extremities was measured in synchronous way by using an arteriosclerosis detector.Results (1) Blood pressure in upper left extremity was slightly higher than that in upper and lower right extremity ( all P =0.0001).( 2 ) Difference in diastolic blood pressure in upper left and right limbs in females (2.1±6.7) mm Hg(1mm Hg =0.133 kPa) was more significant than that in males (1.4 +6.5 ) mm Hg ( P =0.0000).In males,difference in systolic blood pressure between two lower extremities ( 2.3 ± 9.6 )mm Hg was more significant than that in females (1.9 ±13.4) mm Hg ( P =0.0225 ).( 3 ) The above mentioned differences were found in low or normal weight and over-weight/obesity populations,which was not correlated with body mess index.(4) The difference of diastolic blood pressure in left and right limbs of relatively taller adults ( ＞170 cm) was more significant than that in shorter populations ( ＜170 cm ) (P =0.001).Conclusion The differences in blood pressure in left and right extremities do exist.

[Objective] To study the factors relative to the delayed diagnosis of spontaneous dual arteriovenous fistulas (DAVF) and its influence on the prognosis.[Methods] We included 102 continuous patients diagnosed DAVF in the First Affiliated Hospital of Sun Yat-sen University,and analyzed the correlative factors and impact on outcome of diagnostic delay.Outcome was whether symptoms were non-improvement,improvement or restoration at discharge.[Results] Median delay from onset to diagnosis was 3 months (interquartile range,1 to 6).Compared with patients diagnosed carlier(diagnose time≤3 months),patients diagnosed later (diagnose time ＞ 3 months) had a lower frequency of headache (P =0.012),ptosis (P =0.035) and parenchymal lesions (P =0.001),a higher frequency of conjunctival congestion (P =0.004),tinnitus (P =0.021),visual dysfunction (P ＜ 0.001),isolated visual dysfunction (P =0.007) and delayed imaging scan (P ＜ 0.001),a higher frequency of endovascular treatment,and a lower frequency of improvement or restoration at discharge (P =0.033),in which patients with visual dysfunction had a lower frequency of improvement or restoration than those without visual dysfunction (P =0.023).Compared to those with visual dysfunction and other symptoms,patients with isolated visual dysfunction had a higher frequency of onset with paroxysmal blurring or blinding (P ＜ 0.001),two eyes involved (P ＜ 0.001) and more severe visual loss (P =0.057),a higher frequency of draining into transversesigmoid sinus (P ＜ 0.001) instead of cavernous sinus (P ＜ 0.001),and suffered intracranial hypertension all (median intracranial pressure,405 mmH2O;interquartile range,370 ～ 512 mmH2O).However,no statistically significant differences were found in the frequency of improvement or restoration at discharge between two groups (P =0.739).[Conclusion] Diagnostic delay was considerable in this cohort and was associated with outcome,especially in patients with visual dysfunction.

AIM: To evaluate the accuracy of central conreal thickness ( CCT ) using EX500 Excimer Laser workstation (EX500) in laser in situ keratomileusis (LASIK) patients.METHODS:The CCT of 120 eyes (63 patients) who had LASIK between January 2013 and June 2013 were measured by A- scan and EX500. Three groups were classified: >550μm, 500 ~550μm, <500μm according the CCT value of A-scan. The CCT were measured again by corneal flap creating by moria SBK microkeratome. The thickness of the corneal bed stroma were measured by A-scan and EX500 after keratomileusis. All outcomes were analyzed with paired t test.
RESULTS: The average preoperative CCT value was 527. 9±34. 3μm measured by A-scan, 528. 5±34. 6μm measured by EX500. There was no significant difference between these two measurements (t=1. 736, P=0. 085). In group which CCT >550μm, the average preoperative CCT value was 571. 4±17. 3μm measured by A-scan, 572.7±15. 7μm measured by EX500. There was no significant difference between these two measurements (t=1. 857, P=0. 072). In group which CCT 500 ~ 550μm, the average preoperative CCT value was 523. 4±13. 1μm measured by A-scan, 524. 2±12. 4μm measured by EX500. There was no significant difference between these two measurements ( t=1. 934, P = 0. 058 ). In group which CCT <500μm, the average preoperative CCT value 484. 5±9.8μm measured by A-scan, 483. 7±8. 9μm measured by EX500. There was no significant difference between these two measurements (t=1. 395, P=0. 174). The average CCT value after corneal flap lifting was 401. 3 ± 34. 2μm measured by A-scan, 393. 4±38. 9μm measured by EX500. There was a significant difference between these two measurements ( t = 6. 669, P = 0. 000 ). The average thickness of the corneal bed stroma value after keratomileusis was 332. 6±38. 3μm measured by A-scan, 307. 3 ± 37. 1μm measured by EX500. There was a significant difference between these two measurements ( t=17. 165, P=0. 000).
CONCLUSION: There is no significant difference between preoperative CCT value measured by A-scan and EX500. After corneal flap lifting and keratomileusis, the CCT value measured by EX500 is smaller than measured by A-scan.

Objective To evaluate the clinical efficacy of lamivudine in preventing liver injury induced by anti-tuberculosis drugs in hepatitis B virus(HBV)carriers.Methods One hundred and ten HBV carriers treated with anti-tuberculosis drugs were randomly divided into lamivudine group and control group.Patients in both groups were treated with conventional anti-tuberculosis drugs (isoniazid,rifampicin,pyrazinamide,streptomycin or ethambutol)for 6-8 months.However, patients in lamivudine group were treated with lamivudine 100 mg orally dairy concomitantly.Before and after treatment,the clinical manifestation,liver function and serum HBV DNA level of patients were evaluated.Statistical analysis was performed using t test and x~2 test.Results During 6-8 months of treatment,the incidence rate of liver injury was 9.1% in lamivudine group,while it was 38.2% in control group(P0.05).Conclusion Lamivudine is effective and safe in reducing liver injury induced by anti-tuberculosis drugs in HBV carriers.

Abstract: Objective　To detect the antibody levels of hantavirus in serum samples from patients suspected with hemorrhagic fever with renal syndrome (HFRS) in Heilongjiang Province from 2019 to 2021, and to provide scientific basis for the prevention and control of disease. Methods　Enzyme-linked immunosorbent assays (ELISA) were used to detect the IgM antibodies to hantavirus in serum samples collected from suspected patients with HFRS in the acute-phase, and IgM and IgG antibody in convalescent-phase serum samples. The positive rate of IgM antibody in acute-phase serum samples of patients in different years was analyzed with χ2 test by SPSS 19.0, and the data were sorted out and analyzed about patients' gender, occupation, age, date of onset and interval from onset to initial diagnosis by EpiData 3.1, Excel 2003 software. Results　A total of 351 acute-phase serum samples and 208 convalescent-phase serum samples were detected in patients suspected with HFRS, respectively. There were 317 positive IgM antibodies of serum samples in the acute stage, with the positive rate of 90.31%. There was no significant difference in the positive rate of IgM antibodies in the acute stage between different years (χ2=0.895, P=0.639). T The IgM antibodies and IgG antibodies were positive in 32 (15.39%) and 28 (13.46%) of the convalescent-phase serum samples, respectively. Moreover, 148 patients (71.15%) were double-positive for IgM and IgG antibodies at the convalescent stage. The ratio of male to female patients was 4.56∶1, for which male patients were much more than female patients. Occupation was dominated by farmers (253 cases, 79.81%), followed by workers (19 cases, 5.99%) and the unemployed (17 cases, 5.36%), respectively. The age of patients ranged from 10 to 88 years old, with a median age of 49 years old. Most of the patients were in the age group from 30 years old to 60 years old (209 cases, 65.93%), among which the age group from 40 years old to 50 years old (86 cases, 27.13%) had the highest proportion, and the age group from 60 years old to 90 years old had a proportion of 20.18% (19 cases). May and November were the peak periods of HFRS in Heilongjiang Province. The median interval between onset and initial diagnosis was 4 days. Conclusions　There is a gap of about 10% between the clinical diagnosis of HFRS cases and the confirmed cases detected by laboratory in Heilongjiang Province from 2019 to 2021. The virus-specific detection results are important for confirming the diagnosis of local patients with HFRS.

Objective To investigate the effect of excessive fluoride,aluminum on Zn,Fe,Ca,Mg,Cuin rat blood.Methods Forty eight SD rats were randomly divided into 4 groups matched with their weights:control group,high aluminum group,high fluorine group and high fluorine-aluminum group.Aluminum content in their drinking water was 0,90,0,90 mg/L respectively.Fluorine content of their feed was 5.2,5.2,106.0,106.0 mg/kg and aluminum Was 6.8,6.8,19.7,19.7 mg/kg respectively.90 days later,the level of blood Zn,Fe,Ca,Mg, Cu Was detected by the atomic absorption spectrometry.Results Compared among these groups,Zn,Fe,Mg and Cu content of the whole blood had significant difierences(F=46.25,14.74,6.10,2.93,P<0.05),while Ca content of the whole blood did not significantly change(F=2.81.P>0.05).Factorial analysis showed that excessive intake of aluminum could significantly decreased Zn,Fe,Mg content of the blood(F=42.66,5.41,7.04,P<0.05)and excessive intake of fluorine could significantly decreased Zn,Fe,Mg,Cu content of the blood(F=64.50,37.90,9.75,6.74, P<0.05).The coexistence offluorine and Muminum had interaction to the level of Zn(F=31.59,P<0.05)and did not obviously interact with other elements(F=0.91,1.63,1.51.0.00,P>0.05).Compared with the control group [(131.30 ±13.86)μmol/L,(10.24 ±1.02),(1.71 ±0.19)mmol/L,(20.43 ±4.42)μmol/L],Zn content in the high aluminum group[(90.84±9.98)μmol/L]decreased significantly(P<0.05),so did Zn,Fe,Mg content in tlle high fluorine group[(85.85 ±10.92)μmol/L,(8.49 ±0.68),(1.52 ±0.13)mmol/L],the difference being statistically significant(P<0.05)0Zn,Fe,Mg,Cu content in the high fluorine-aluminum group,being(82.82 ±11.00)μmol/L, (8.16±0.45),(1.46±0.09)mmoL/L,(15.69±2.38)μmol/L,respectively,all decreased signitlcarIdy(P<0.05). Compared with the high aluminum group[(9.43±1.09)mmol/L],Fe content of the high fluorine aluminum group[(8.16±0.45)mmol/L]decreased significantly(P<0.05).Conclusions Excessive fluoride can cause blood zn, Fe,Mg,Cu decline,so can excessive aluminum.Combination of excessive fluofine and aiuminum has 8ignificant synergic effect on the level of Zn but have rio influence on Ca.

In order to provide the maximum benefit of cardiac resynchronization therapy (CRT), we tried to use an echocardiography method to optimize the atrioventricular and interventricular delay. Methods The study included 6 patients who underwent implantation of biventricular pacemakers for drug-resistant heart failure. Two-dimensional echocardiography and tissue Doppler imaging were carried out before and after the pacemaker implantation. The optimal AV delay was defined as the AV delay resulting in maximum timevelocity integral (TVI) of transmitral filling flow, the longest left ventricular filling time (LVFT) and the minimum mitral regurgitation(MR). The optimal VV delay was defined as the VV delay producing the maximum LV synchrony and the largest aortic TVI. Results CRT was successfully performed in all patients. After pacemaker implantation, an acute improvement in left ventricular ejection fraction (LVEF) was observed from 26.5% to 35%. Meanwhile, the QRS duration decreased from 170ms to 150ms. The optimal AV delay was programmed at 130, 120, 120, 120, 150 and 110ms respectively with heart rate corrected, LVFT significantly lengthened and TVI of MR decreased (non-optimal vs optimal AV delay: LVFT: 469ms vs 523ms; TVI of MR: 16.43cm vs 13.06cm, P＜0.05). The optimal VV delay was programmed at 4, 4, 4, 8, 12 and 8ms with LV preactivation respectively. Programming the optimal VV delay increased the aortic TVI from 17.33cm up to 21.42cm (P＜0.05). In the septal and lateral wall, peak systolic velocities improved from2.70cm/s to 3.02cm/s (P＞0.05) and froml.31cm/s to 2.50cm/s (P＜0.05) respectively. The septal-to-lateral delay in peak velocity improved from 56.4ms to 13.3ms after CRT (P＜0.01). Conclusions Optimization of AV and VV delays may further enhance the efficacy of CRT. However, there was interindividual variability of optimal values, warranting individual patient examination.