18 patients with atrioventricular nodal reentant tachycardia (AVNRT)and 5 patients with atrioventricular reentrant tachycardia (AVRT) with AVN double pathway (AVNDP) received radiofrequency ablation of slow pathway with inferior approach in order to modify AVN. AVNRT was induced in slow-fast form in 16 patients, in fast-slow form in one patients,and in coexistent slow-fast and fast-slow forms in one patients. Selective ablation of slow pathway was achieved in 18 patients. AVRT was induced in 5 patients (one obvient accessory pathway, 4 concealed accessory pathways) ,4 patients with reentrant cirucit of consisting of anterograde conduction by slow pathway of AVN and retrograde conduction by accessory pathway (AP) , one patient coexistent AVRT and AVNRT. Slow pathway in 5 patients and AP in 3 patients were successfully ablated. Junctional rhythm appeared in 21 patients during duation of discharge of radiofrequency current. No severe complicationwere noted. AVNRT in one patient recurred during a follow-up period of 1 to 15 months. The patient experienced second catheter ablation and was successed. It was suggested radlofrequency ablation of slow pathway with Inferior approach may be a method with high rate of success and less complication.

Objective To characterize the electroanatomical mapping and to assess the value of radiofrequency ablation of atrial tachycardia (AT) in left atria. Methods Nine patients with AT in left atria were studied. Three-dimensional electroanatomical maps were constructed in left atrium using electroanatomical mapping system (Carto). The type of AT (focal or macroreentrant) was identified by the electroanatomical maps, and the ablation targets were at the earliest activation sites or the isthmus of circuit. Results There were ten ATs in 9 cases. The relatively early A waves were recorded in middle, distal or proximal parts of coronary sinus catheter. Nine focal ATs were diagnosed. The activation maps demonstrated that the earliest activation sites were at the ostium of pulmonary veins ( n =5), posterior area of left atrium ( n =2), ostia of left atria appendage ( n =1) or left atria appendage ( n =1) respectively. One macroreeentrant AT was diagnosed, whose circuit propagated through the isthmus, formed by the right superior pulmonary vein and fossa ovalis. Eight focal ATs were all ablated successfully at the earliest activation sites, and one AT from left atria appendage was ablated unsuccessfully. Line of ablation was performed at the isthmus of the macroreentrant AT. During a period of 6-30 months follow-up, one patient with focal AT recurred and underwent another ablation with successful result. No complication occurred. The procedure time and the fluoroscopic time were 90-140 min, 8-16 min respectively in successful cases. Conclusion These results suggest that electroanatomical mapping of AT in left atria may facilitate rapid and accurate identification of the type of AT and guide ablation safely or effectively with less fluoroscopic time and higher success rate, especially in unsuccessful cases with conventional technique.

Objective To evaluate clinically electroanatomical mapping and ablation of cardiac arrhythmias under the Carto system. Methods Fifty-six patients with various tachycardias indicated for electrophysiological study and radiofrequency ablation were included in this study, among of whom, 49 suffered from supraventricular tachycardia, and 7 ventricular tachycardia (VT). Carto system was utilized during ongoing tachycardia or sinus rhythm, 7F Navi-Star catheter was introduced into the interested cardiac chamber and underwent three-dimensional electroanatomical mapping. The mechanism and origin of cardiac arrhythmia were assessed by activation and propagation map, with which to guide radiofrequency ablation. Results The success ablation rate was 94.6% (53/56). One right accessory pathway (AP), one atrial tachycardia (AT) and one atypical atrial flutter (AF) had failed session. The procedure time was 128?59 minutes, and the fluoroscopic time 14?12 minutes. One patient had complcation of pneumothorax. No conduction block occurred. After follow-up of 1-14 months, one left AT recurred and had another succssful session. Conclusion The study demonstrates that Carto system is a safe and effective tool and may be applied for mapping and ablation of various tachyarrhythmias. It is helpful to guide catheter ablation and shorten fluorocopic time by its ability of associate intracardiac electrograms with their three-dimensional anatomic structure. It also lessen complication and recurrence by tagging the critical cardiac structures and utilize its location memory function. Our experience suggest that carto system has important role in the guidance of mapping and ablation in AT、AF、VT and complex or recurrent AP cases.

Objective To evaluate left atrial function serial change after circumferential pulmonary vein ablation(CPVA)for paroxysmal atrial fibrillation using tissue Doppler echocardiography.Methods One hundred and eight patients with paroxysmal atrial fibrillation underwent CPVA guided by CARTO.Tissue Doppler imaging and conventional echocardiography were underwent 48 h before CPVA,48 h,1 month,3 month and 6 month after CPVA.Results One hundred and six patients with paroxysmal atrial fibrillation finished CPVA successfully.Compared tO 48 h pre-CPVA,left atrial diameter and volume decreased 48 h,1 month,3 month,6 month after CPVA,significant change were found at 3 month,6 month after CPVA(P＜0.05).Left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD).left ventricular ejection fraction(LVEF),mitral flow E revealed no significant change(P＞0.05).Mitral flow A decreased significantly 48 h after CPVA(P＜0.05),restored significantly after 3 month.Tissue Doppler parameter S'and E'revealed no significant change(P＞0.05)through the period,A'decreased significantly 48 h after CPVA(P＜0.05),restored significantlv after 1 month.Conclusions Left atrial diameter and volume decreased after CPVA.Left atrial active contraction function decreased shortly after CPVA(LA stunning),and restored progressively.

Objective To find out a quick,simple and convenient method of determining the viability of Oncomelania hupen-sis. Methods O. hupensis snails were stained for 30 minutes by 0.05%water soluble dye neutral red,0.5%methylene blue,red ink,methylene blue-eosin-borax(MEB)and 0.4%trypan blue,respectively. The soft tissue samples of the snails were observed by a stereoscopic microscope after crushing their shells. Results The vital snails were stained and the dead were unstained in the neutral red. The vital and dead snails were unstained in methylene blue. However,the vital and dead snails were stained in red ink. The partial vital and dead snails were stained in MEB. The vital snails were stained and the partial dead were stained in trypan blue. Conclusion The use of 0.05%water soluble dye neutral red is simple,rapid and accurate in determination of the viability of O. hupensis.

The ergonomics of equipment is important,it is essential to make the ergonomic evaluation in the stage of design. The operation of expanded shelter is a typical form of combination of human labor and machine. The fuzzy comprehensive evaluation model is founded. The high-level factor set include the states of operation, the ratio of every state time to the total time is the corresponding weight for the elements in high-level factor set, the lower-level factor set include the elements which influence the states of operation. For the elements in lower-level factor set, the corresponding weight is given by the experts.

Objective To evaluate the effects of TIMP-1 and Ang-1 gene-modified BMSCs transplantation on the left ventricular function of rats with myocardial infarction.Methods The rat BMSCs were.transfected with eukaryotic expression plasmid encoding TIMP-1 or/and Ang-1 gene by liposome.Acute myocardial infarction was made in male rats by ligation of the left anterior descending (LAD) coronary artery.BMSCs carrying TIMP-1 or/and Ang-1 gene were injected into the ischemic myocardium after LAD ligatior.Four weeks after the administration,cardiac function was assessed by echocardiography and the hearts were harvested and sectioned for immunohistochemistry to examine the apoptosis,the collagen content and angiogenesis density.Results TIMP-1 and Ang-1 genemodified BMSCs transplantation significantly improved the cardiac function,myocardial apoptosis was alleviated,collagen content decreased and the angiogenesis density in border-zone was increased significantly (P＜0.05).Conclusions The results suggest that the combination of TIMP-1 and Ang-1-gene modified BMSCs transplantation can improve the cardiac function of rats with myocardial infarction.The increase of the blood supply,the alleviation of myocardial apoptosis and ventricle remolding after myocardial infarction possibly play important roles in the mechanism.

Objective To investigate the level and the source of inflammatory factors in patients with paroxysmal atrial fibrillation.Methods Thirty patients with paroxysmal atrial fibrillation were selected as observation group,and 20 cases of patients with paroxysmal supraventricular tachycardia were selected as control group.The blood samples of coronary sinus,right atria,left atria and femoral vein were consecutively collected during the procedure of radiofrequency ablation.The level of tumor necrosis factor (TNF)-α,soluble tumor necrosis factor receptor-1 (sTNFR1),and interleukin(IL)-6 was detected by ELISA separately and compared between two groups.Results The level of TNF-α and IL-6 of coronary sinus,right atria,left atria and femoral vein in observation group was significantly higher than that in control group [TNF-α:(4.45 ± 1.76) ng/L vs.(0.59 ± 0.36) ng/L,(6.67 ± 1.43) ng/L vs.(0.51 ± 0.30) ng/L,(8.35 ± 2.03) ng/L vs.(0.85 ± 0.50) ng/L,(9.97 ± 2.70) ng/L vs.(0.28 ± 0.29) ng/L,P=0.000;IL-6:(2.02 ± 0.87) ng/L vs.(1.04 ± 0.63) ng/L,(1.51 ± 0.68) ng/L vs.(0.74 ± 0.26) ng/L,(2.00 ± 0.51) ng/L vs.(0.88 ± 0.35) ng/L,(1.32 ±0.47) ng/L vs.(0.48 ±0.28) ng/L,P =0.000].The level of high sensitivity C reactive protein (hs-CRP) in observation group was significantly higher than that in control group [(2.41 ± 1.35) mg/L vs.(1.10 ±0.53) mg/L,P =0.002].The level of TNF-αof left atrium in observation group was significantly higher than that of other three sites (P=0.000).The level of IL-6 in the coronary sinus and femoral vein was significantly increased,compared with that in the right atria and left atria (P ＜ 0.05).The level of sTNFR 1 in the femoral vein,right atria and coronary sinus difference was not statistically significant (P ＞ 0.05),but was significantly higher than that in the left atria(P ＜ 0.05).The level of TNF-α,IL-6 and hs-CRP was correlated with the diameter of left atrium (LAD) (P ＜ 0.01 or ＜ 0.05).The level of sTNFR1 in left atria was positively correlated with LAD,and the level of sTNFR1 in right atria was negatively correlated with LAD (P ＜ 0.01).Conclusions The level of TNF-α,IL-6 and hs-CRP is increased in patients with paroxysmal atrial fibrillation.TNF-α and IL-6 may come from the heart and is related with the enlargement of left atrium.

Objective To design and develop an air purification system for intensive care ambulances,which can effectively purify the air in the compartment and sterilize the microbes in the air.Methods By integrating titanium dioxide photocatalysts with air filtration materials,an air purification system was designed that was capable of effective sterilization of microbes in the air via photocatalytic oxidation and decomposition,and of effective filtration of particles in the air through HEPA filters.The protection effect was evaluated by air filtration and sterilization tests in accordance with the related national standards.Results The air cleanliness could reach the 100 000 level with bacteria counts no more than 1 CFU per pan for 15 minutes in the ambulance compartment when the air purification system worked normally,which could meet the demands of environmental hygienic standards for intensive care units.Conclusion The air purification system can effectively purify and sterilize the air in the compartment of an intensive care ambulance.The effects of air purification meet the requirements of related hygienic standards,which can satisfy the demands of treatment and intensive care for the victims in the ambulance.

AIM:To explore the role of survivin-2B in the process of tumor cell apoptosis .METHODS:The survivin-2B gene was cloned into pcDNA3.1 vector and the recombinant plasmid pcDNA3.1-survivin-2B was obtained.Hu-man breast cancer MCF7 cells were transfected with pcDNA3.1 and pcDNA3.1-survivin-2B using Lipofectamine 2000.The cell cycle was determined by propidium iodide staining , and the apoptosis was detected by annexin V/7-AAD staining 48 h after transfection.Meanwhile, tatal RNA was extrated and multiplex polymerase chain reaction based on GenomeLab GeXP Genetic Analysis System was performed to detect the expression of 21 tumor-related genes .RESULTS: Flow cytometry analysis indicated that over-expression of survivin-2B promoted the apoptosis and cell cycle arrest of MCF 7 cells.Compared with control group , totally 10 differential expressed genes were related to the over-expressed survivin-2B, among which 2 were up-regulated and 8 were down-regulated. The expression of aldehyde dehydrogenase 4 family member A1 (ALDH4A1) was 48%down-regulated, and the expression of protein regulator of cytokinesis 1 (PRC1) was 1.08 folds up-regulated.CONCLUSION:Survivin-2B induces the expression changes of some tumor-related genes, which results in the apoptosis and G 2/M arrest of MCF7 cells.