Breast Neoplasms ; genetics ; pathology ; Chromosome Aberrations ; Chromosome Deletion ; Chromosomes, Human, Pair 1 ; Chromosomes, Human, Pair 17 ; Chromosomes, Human, Pair 9 ; Female ; Genome, Human ; Humans ; Nucleic Acid Hybridization ; methods ; Phyllodes Tumor ; genetics ; pathology

OBJECTIVETo explore the therapeutic effect of acupuncture on convergence insufficient asthenopia with exotropia.

METHODSEighty cases of convergence insufficient asthenopia with exotropia were randomly divided into an acupuncture group and an eye drug treatment group, 40 cases in each group. The acupuncture group were treated with acupuncture at Jingming (BL 1), Taiyang (EX-HN 5), Chengqi (ST 1), Hegu (LI4); the eye drug treatment group were treated with local dropping of Aiweiduo. The therapeutic effects and changes of exotropia degree, collecting near point, cumulative score of eye symptoms were observed after 2 and 4 weeks of treatment.

RESULTSafter treatment for 2 and 4 weeks, the total effective rates were 87.5% and 92.5% in the acupuncture group which were significantly better than 65.0% and 70.0% in the eye drug treatment group (P<0.01); after treatment of 2 and 4 weeks, the collecting near point and the cumulative score of eye symptoms were significantly better than those before treatment (P<0.01); the acupuncture group in improvement of eye symptoms after treatment of 2 weeks and in collecting near point after treatment of 4 weeks was significantly better than the eye drug treatment group.

CONCLUSIONThe therapeutic effect of acupuncture on convergence insufficient asthenopia with exotropia is better than that of simple Aiweiduo treatment.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Asthenopia ; therapy ; Exotropia ; therapy ; Female ; Humans ; Male ; Middle Aged

Objective: To explore the effects of cardiac resynchronization therapy (CRT) in patients with dispersion of re-polarization and ventricular arrhythmia.
Methods: A total of 86 consecutive patents with CRT implantation were enrolled. According to weather absolute value of LVEF increased≥10% from baseline at 6 months after CRT implantation, the patients were divided into 2 groups: Response group and Non-response group,n=43 in each group. Dispersion of re-polarization indexes as QRS duration, QTc interval, TpTe interval and the events of ventricular arrhythmia were compared between 2 groups at different time points after CRT.
Results:①In Response group, compared with pre-operation, QRS duration and TpTe interval were shorter at 1 year and within 24h after CRT implantation, allP<0.05, while the above indexes were similar in Non-response group, allP>0.05.②During 1 year after CRT implantation, the incidences of PVCs and PVC runs in Response group were much less than those in Non-response group, for lgPVCs: (1.78 ± 0.77) vs (2.73 ± 0.61), for lgPVC runs: (0.64 ± 0.48) vs (1.98 ± 0.72),P<0.05.③Multi liner regression analysis demonstrated that TpTe interval within 24h after CRT implantation was an independent predictor for both lgPVCs: (B=0.143, OR=1.154,P=0.001) and lgPVC runs: (B=0.122, OR=1.047,P=0.001).
Conclusion: CRT ventricular reverse remodeling may reduce dispersion of re-polarization and the risk of ventricular arrhythmia, therefore improve the prognosis in relevant patients; TpTe interval within 24h after CRT had the predictive value for ventricular arrhythmia.

Background The data on the prognostic values of high sensitivity C-reactive protein (hsCRP) levels in patients with advanced symp-tomatic heart failure (HF) receiving cardiac resynchronization therapy (CRT) are scarce. The aim of present study was to investigate the association of serum hsCRP levels with left ventricle reverse remodeling after six months of CRT as well as long-term outcome. Methods A total of 232 CRT patients were included. The assessment of hsCRP values, clinical status and echocardiographic data were performed at baseline and after six months of CRT. Long-term follow-up included all-cause mortality and hospitalizations for HF. Results During the mean follow-up periods of 31.3 ± 31.5 months, elevated hsCRP (>3 mg/L) prior to CRT was associated with a significant 2.39-fold increase (P=0.006) in the risk of death or HF hospitalizations. At 6-month follow-up, patients who responded to CRT showed significant reductions or maintained low in hsCRP levels (–0.5 ± 4.1 mg/L reduction) compared with non-responders (1.7 ± 6.1 mg/L increase, P=0.018). Com-pared with patients in whom 6-month hsCRP levels were reduced or remained low, patients in whom 6-month hsCRP levels were increased or maintained high experienced a significantly higher risk of subsequent death or HF hospitalizations (Log-rank P<0.001). The echocardio-graphic improvement was also better among patients in whom 6-month hsCRP levels were reduced or remained low compared to those in whom 6-month hsCRP levels were raised or maintained high. Conclusions Our findings demonstrated that measurement of baseline and follow-up hsCRP levels may be useful as prognostic markers for timely potential risk stratification and subsequent appropriate treatment strategies in patients with advanced HF undergoing CRT.

Objective:To explore the efifcacy and safety for radiofrequency catheter ablation (RFCA) of left bundle branch guided by left bundle potential (LBP), X-ray image with EnSiteNavX System in canine model.
Methods:The RFCA of left bundle branch was conducted in 13 dogs. A mapping catheter was positioned in right atrium to record right-sided His-bundle (R-His) potential, and an ablation catheter via right femoral artery was retrograded to left ventriclefor LBP mapping and ablation. Meanwhile, EnSiteNavX System was used to identify R-His, L-His and LBP at the same time. The potential characteristics in dogs with successful ablation were observed, the PR interval, QRS shape and time limit, AH interval, HV interval, the A/V electro-gram ratio in ablationcatheter at before and after ablation were recorded. The procedural time and X-ray exposure time between LBP with X-ray image method and LBP, X-ray image with EnSiteNavX System method were compared.
Results: There were 9/13 dogs received successful left bundle branch ablation, 3 dogs failed and 1 suffered from complete A-V block. At the successful ablation target site, the LBP-V was (17.8 ± 2.6) ms with the range of (13-21) ms, and the A/V electro-gram ratio<1/10. The procedural time and X-ray expose time were signiifcantly decreased in LBP, X-ray image with EnSiteNavX System method than those in LBP with X-ray image method P=0.007 and P<0.001.
Conclusion:Under the LBP, X-ray image with EnSiteNavX System guidance method, left bundle branch could be safely and effectively ablated to establish left bundle branch block (LBBB) model in experimental canine.

Objective To study the expression of mdm2 genes in nephroblastoma in children and relationship between mdm2 gene and clinical pathological parameters.Methods The protein expressions of mdm2 in 24 cases of nephroblastoma were detected with S-P immunohistochemical method.The relationships between mdm2 expression and clinicopathological parameters were analyzed.Results The positive rates of mdm2 in 24 cases of nephroblastoma were correlated with lymph node metastasis,clinical stage and tumor differentiation.There was a positive relationship between mdm2 protein expression and clinicopathological parameters such as lymph node metastasis,clinical stage and degree of differentiation(P

Objective: To analyze the clinical features and outcomes of cardiac resynchronization therapy (CRT) in patients with dilated-phase hypertrophic cardiomyopathy (DHCM). Methods: A total of 16 DHCM patients received CRT in our hospital from 2007-03 to 2016-01 were retrospectively studied to analyze their clinical features and outcomes. Results: There were 12 male and 4 female patients at the mean age of (53.3±13.5) years. Pre-operative QRS duration of ECG was (158.7±32.2) ms, left ventricular ejection fraction (LVEF) was (33.6±6.3) %, the patient with NYHA class I, II, III and IV were 1, 5, 8 and 2 respectively. 13 patients received new CRT device, 3 received upgraded device and 8 (50%) combining atrial fibrillation (AF). The patients were followed-up for (2.56±2.13) years, 5 of them died including 3 of heart failure, 1 of sudden death and 1 of stroke. At 6 months follow-up time, 7 patients had the response to CRT which was defined by the improvement of NYHA class≥1 and the absolute elevation of LVEF≥5%; NYHA class improved from (2.69±0.79) to (2.38±0.89), P=0.02; LVEF increased from (33.6±6.3) % to (40.03±9.83) %, P=0.01. Conclusion: DHCM patients with CRT indication had the higher incidence to suffer from AF, those were more in patients with traditional pacemaker or ICD upgrading. DHCM patients with CRT had the poor general prognosis, while there was still certain proportion of patients had the response to CRT.

Objective: To create and validate a scoring system for predicting clinical prognosis in patients with cardiac resynchronization therapy (CRT). Methods: A cohort of 367 consecutive patients received CRT in our hospital from 2010-01 to 2015-12 were enrolled. The endpoint follow-up events were all-cause death including heart transplantation and heart failure re-admission. The patients were randomly categorized into 2 groups: Modeling group, to develop HEAL scoring system,n=300 and Veriifcation group, to validate HEAL model,n=67. HEAL system was established by Cox proportional hazards regression model, discrimination between HEAL and EARRN scoring systems was evaluated by AUC of ROC, HEAL calibration was assessed by Hosmer-Lemeshow test and clinical endpoint evaluation by 2 scoring systems were compared by Kaplan-Meier method. Results: Modeling group analysis indicated that hs-CRP (HR=1.137, 95% CI 1.072-1.205,P<0.001), big endothelin-1 (HR=1.934, 95% CI 1.066-3.507,P=0.03), left atrial diameter (HR=1.045, 95% CI 1.007-1.084,P=0.02) and NYHA IV (HR=2.583, 95% CI 1.331-5.013,P=0.005) were the independent risk factors of adverse prognosis in CRT patients. Based on β partial regression coefifcient, HEAL scoring system was established to classify the patient's risk levels: low risk<4, moderate risk 4-10 and high risk>10. AUC for risk classification in Modeling group and Verification group were 0.719(95% CI 0.629-0.809) and 0.708 (95% CI 0.539-0.878), HEAL can well distinguish clinical prognosis in patients at different risk levels (log-rank test showed in Modeling groupP<0.001 and in Veriifcation groupP=0.002); Hosmer-Lemeshow test presented good calibration,P=0.952. All 367 patients were respectively evaluated by HEAL and EARRN scoring systems, HEAL had the better discrimination than EARRN as AUC 0.763 (95% CI 0.692-0.833) vs AUC 0.602 (95% CI 0.517-0.687). Conclusion: HEAL scoring system can effectively predict adverse prognosis in CRT patients, it had the better discrimination than EARRN system and was valuable to distinguish high risk patients in clinical practice.

Objective To assess the value of computed tomgraphy (CT)in differential diagnosis between medullar thyroid carcinoma (MTC)and papillary thyroid carcinoma (PTC).Methods CT findings of 20 lesions in 16 MTC patients and 35 lesions in 35 PTC patients were retrospectively analyzed.All patients were confirmed by pathology exam.We investigated the shape,location,bitten cookie sign,calification and lymph node metastasis between the two groups of patients to summarize the sensitivity and specificity of regular shape for MTC or lesions located in lower thyroid lobe,bitten cookie sign,lymph node metastasis for PTC.Results Regular shape was more common in MTC patients than in PTC patients (X2=5.815,P=0.016),with sensitivity and specificity of 55％ and 77.1％ respectively.Lesions were located at lower thyroid(X2=10.732,P=0.001),bitten cookie sign(X2=18.832,P=0.000)and lymph node metastasis (X2=4.377,P=0.036)was significantly more common in PTC patients than in MTC patients,with sensitivity and specificity of 40％ (14/35)and 100％ (16/16),80％ (28/35)and 80％ (16/20),and 68.6％(24/35)and 62.5％(10/16)respectively.Calcification was not significantly different between MTC and PTC patients (X2=0.550,P=0.458).Conclusions CT plays an important role in differential diagnosis between MTC and PTC.Regular shape is helpful for the diagnosis of MTC.Leisions located at lower thyroid,with bitten cookie sign and lymph node metastasis are conductive to the diagnosis of PTC.

Background Intrathoracic impedance monitoring has emerged as a promising new technique for the detection of impending heart failure (HF). Although false positive episodes have been reported in case reports and clinical trials, the efficacy and false positive rate in real-world practice remain unclear. Objective The aim of this study is to investigate the utility and reliability of the OptiVol alert feature in clinical practice. Methods We continuously recruited patients who underwent implantable cardioverter-defibrillator (ICD) or cardiac re-synchronization therapy with defibrillator (CRT-D) implantation with feature of intrathoracic impedance monitoring system in our center from Sep. 2010 to Oct. 2012. Regular in-office follow-up were required of all patients and the following information was collected at each visit: medical history, device interrogation, N-terminal pro-brain natriuretic peptide (NT-proBNP) measurement and an echocardiogram. Worsening HF was defined as hospitalization or the presentation of signs or symptoms of HF. Results Forty three patients (male:76.7%, mean age:57 ± 15 years, left ventricular ejection fraction (LVEF):33%± 14%) were included in this observational study. Fifty four alert events and 14 adjudicated worsening HF were detected within 288 ±163 days follow-up. Eleven (20.4%) alert episodes were associated with acute cardiac decompensation in 9 patients with a positive predictive value of 78.6%. Forty three audible alerts showed no connection to worsening HF. The unexplained alerts rate was 79.6%and 1.27 per person-year. Thirty seven alarm alerts were detected in patients with EF<45%, among which 9 accompanied with HF, 17 alerts detected in patients with LVEF≥45%and 2 associated with HF. There was no sig-nificant difference between the two groups (9/37 vs. 2/17;P=0.47). Conclusions Patients with normal or nearly normal left ventricular systolic function also exhibited considerable alert events. The OptiVol fluid index predicted worsening cardiac events with a high unex-plained detection rate, and any alert must therefore be analyzed with great caution. Efforts to improve the specificity of this monitoring sys-tem represent a significant aspect of future studies.