5.Delay in Diagnosis of Spontaneous Dual Arteriovenous Fistulas : Correlative Factors and Influence on Outcome
Wenjin SHANG ; Hongbing CHEN ; Liming SHU ; Shujin TANG ; Hua HONG
Journal of Sun Yat-sen University(Medical Sciences) 2017;38(3):427-432
[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.
8.Clinical study on treatment of chronic aplastic anemia assisted by TCM for reinforcing shen and activating blood circulation to dredge channels.
Shu-qing WANG ; Ying-xue TANG ; Jian-hua LI
Chinese Journal of Integrated Traditional and Western Medicine 2003;23(4):254-257
OBJECTIVETo observe the clinical efficacy of TCM for reinforcing Shen and activating blood circulation to dredge Channels in auxiliary treating chronic aplastic anemia (CAA), and to explore its mechanism.
METHODSSeventy-nine patients with CAA were randomly divided into the treated group treated with TCM plus western medicine and the control group treated with western medicine alone. The clinical efficacy was observed and levels of plasma sFas and sFasL before and after treatment were determined by ELISA.
RESULTSThe basic cure rate and total effective rate in the treated group were 37.50% and 87.50%; while in the control group were 20. 51% and 61.54% respectively. Comparison between the two groups showed significant difference (P < 0.01). The sFas level was markedly lower in both groups before treatment, but after treatment, it got elevated in the treated group significantly (P < 0.05), as compared with that in the control group, the difference was significant (P < 0.01).
CONCLUSIONTCM is effective in treating CAA with less toxic and side-effect, the mechanism might be the inhibition on over apoptosis of hematopoietic cells in CAA patients through regulating immune function of organism.
Adolescent ; Adult ; Aged ; Anemia, Aplastic ; drug therapy ; Apoptosis ; drug effects ; Child ; Chronic Disease ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hematopoietic Stem Cells ; pathology ; Humans ; Male ; Middle Aged ; Phytotherapy ; Single-Blind Method ; Ubiquinone ; therapeutic use
9.Radiofrequency Catheter Ablation of Left Bundle Branch Guided by Left Bundle Potential, X-ray Image With EnSiteNavX System in Experimental Canine Model
Ligang DING ; Chi CAI ; Wei HUA ; Xu LIU ; Gang CHEN ; Yong JIANG ; Yue TANG ; Shu ZHANG
Chinese Circulation Journal 2015;(1):72-75
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.