Adolescent ; Humans ; Kearns-Sayre Syndrome ; Male

Objective • To evaluate the recurrence rate of atrial fibrillation (Af) and its related risk factors in aged patients with chronic diseases after cryoballoon ablation. Methods • With the method of convenient sampling, a total of 159 patients with Af after cryoballoon ablation were enrolled in the Department of Cardiology, Ruijin Hospital from Oct. 2016 to Jan. 2018. Self-rating depression scale (SDS) and CHA2DS2-VASc scores [congestive heart failure, hypertension, age ≥ 75 y (doubled), diabetes mellitus, stroke(doubled)-vascular disease, age 65-74 and sex category(female)] were used to assess the patients. Follow-up checks consisted of chief complaint, postoperative electrocardiogram (ECG), and 24 h Holter monitoring. Logistic regression models were performed to explore the independent risk factors of Af recurrence after cryoballoon ablation. Results • 152 patients (95.6%) completed the follow-up checks, with an average age of (61.9±8.9) years. The average time of follow-up period was (8.35±2.41) months. A total of 41 patients (27.0%) developed Af after cryoballoon ablation. Logistic regression analysis showed the number of chronic disease ≥ 2 (OR=2.466, 95% CI: 1.375-4.452), CHA2DS2-VASc scores ≥ 2 (OR=2.088, 95% CI: 1.142-5.557), irregular use of anti-arrhythmic drugs (OR=1.581, 95% CI: 1.351-2.125), hypertension (OR=1.317, 95% CI: 1.076-2.809), and body mass index (BMI) (OR=1.147, 95% CI: 1.009-1.174) were the independent risk factors of Af recurrence. Conclusion • There is still a certain percentage of recurrence in aged patients with chronic diseases after cryoballoon ablation. 2 and more chronic diseases, irregular use of anti-arrhythmic drugs, hypertension, CHA2DS2-VASc scores ≥ 2, and overweight may be potential risk factors of Af recurrence after cryoballoon ablation.

Objective:To discuss the clinical characteristics,diagnosis and treatment experience of a case of lateral ectopic thyroid.Methods:The patient with lateral ectopic thyroid was diagnosed by thyroid color ultrasound and single-photon emission computed tomography(SPECT)-CT examination.The right thyroidectomy and the thyroid tissue in cervical section Ⅳ of the patient were removed by received the operation.The pathological examination after operation was performed.The daily usage of euthyrox after operation was 50 μg.Results:The patient recovered well,who accepted 10 months follow-up with normal life and stable condition,and had no recurrence and metastasis.Conclusion:The mechanism of lateral ectopic thyroidy is not clear yet,the surgical treatment can result in good effectiveness and better prognosis.

Objective By means of analyzing the antihypertensive use of hypertension patients of Guiyang in 2013 and impact factors for basic drug use,to evaluate the impacts of the essential medicines list in place in Guiyang to hypertension patients in communities in Guiyang.Methods 969 hypertension patients were surveyed with structured questionnaire of stratified random sampling at 6 community health centers in Guiyang city.Results Hypertension patients in communities averaged 1.4 types of antihypertensive,and the essential medicines used accounted for 39.8％of all the antihypertensive.The distribution differences of the ratio of essential medicines use are significant interms of age,gender,and household annual income.Use ratio of non-essential medicines of the 55～64 age group and 65～74 age group are 3.48 times and 0.47 times over that of the 75 and above age group.For hypertension patients of low income and medium income,their probable use of non-essential medicines is 2.05 and 2.87 times that of high income households.Conclusion As the use ratio of hypertension patients in Guiyang is relatively low,and the factors for it are age and household income,focused intervention is recommended for the 65～74 age group and low-income households,for the purpose of high use ratio of essential medicines of such people.

AIM:To investigate the effects of N-acetylcysteine (NAC) on acute lung injury induced by H9N2 swine influenza virus ( SIV) in mice.METHODS: BALB/c mice were used to establish the animal model of acute lung injury by nasal inoculation of H9N2 SIV.The mice were divided into control group (without SIV infection), H9N2 SIV group (inoculation of H9N2 SIV) and NAC group (inoculation of H9N2 SIV plus pretreatment with NAC).The pulmonary edema was evaluated by determining the lung wet weight /dry weight ( W/D) ratio.The pathological changes of the lung tis-sues were observed .The concontrations of TNF-α, IL-1βand IL-6 in bronchoalveolar lavage fluid ( BALF) were meas-ured.The virus titer, T-SOD activity, MPO activity and MDA content in the homogenate of the lung tissues were detected . RESULTS:Treatment with NAC decreased the morality of infected mice , and significantly prolonged the survival time of infected mice .The pathological changes of the lung tissues , the lung W/D ratio and the lung index were relieved when SIV infected the mice treated with NAC .Treatment with NAC significantly decreased the infiltration of inflammatory cells inclu-ding macrophages, lymphocytes and neutrophils in the BALF .The levels of TNF-α, IL-6, IL-1βand MDA and the activity of MPO were also decreased.Treatment with NAC also significantly increased the T-SOD activity.CONCLUSION: The protective effect of NAC on the acute lung injury mouse model is related to suppression of the oxidative stress and inflamma -tory responses .

Objective To investigate surgical treatment and effect of secondary endocardial fibroelastosis,based on respective analysis of clinical data and follow-up data of patients with secondary endocardial fibroelastosis (SEF) between 2010 and 2012.Methods A retrospective analysis was performed including 10 patients with secondary endocardial fibroelastosis from January 2010 to December 2012 in Wuhan Union Hospital.All patients were diagnosed by Untrasonic Cardiogram and/or CT angiography of heart and great vessel,and had cardiac insufficiency in different degree [EF 0.37 ± 0.08 (0.26 ～ 0.48)].All patients except 2 patients with anomalous origin of the coronary artery received treatment of digitaloid drugs before operation,which promoted preoperative cardiac function.5 patients with SEF complicated with Congenital Coarctation of the Aorta (CoA),2 patients underwent correction of CoA,2 patients underwent correction of CoA and partial resection of endocardium,1 patient underwent correction of CoA,partial resection of endocardium and mitral vavuloplasty.2 patients with SEF complicated with anomalous origin of the left coronary artery from the pulmonary artery,who were underwent correction of anomalous origin of coronary artery.2 patients with SEF complicated with aortic stenosis,who were underwent aortic commissurotomy and partial resection of endocardium.1 patient with SEF complicated with mitral stenosis and insufficiency,who underwent mitral valve replacement.The intraopertive gross appearance of endocardium was opaque greyish-white not transparent pink.The postoperative pathological examination showed obviously positive dyeing of elastic fibers.In 3,6,12 and 24 months after operation,Untrasonic Cardiogram evaluated cardiac function and endocardium.Results one 6 months patients with origin of left coronary from pulmonary artery died of severe post-operative low cardiac output syndrome,while another 1 months patients with origin of left coronary from pulmonary artery obtained post-operative good recovery,and the Untrasonic Cardiogram show disappearance of endocardial fibroelastosis.The post-operative mean time of using respirator(4.0 ± 1.5) days (2-7 days).Compared with the preoperative data,the cardiac function index (EF) was not significantly better at 2 weeks and 3-6 months[0.38 ± 0.07 (0.28 ～ 0.48),P ＞ 0.05 ; 0.39 ± 0.08 (0.30 ～ 0.50),P ＞ 0.05],and the non-resected fibroelatic endocardium still existed and were not attenuated.But the cardiac function index (EF) significantly increased [0.44 ± 0.08 (0.38 ～ 0.55),P ＜ 0.05] than the pre-operative EF,and the 3 of 5 cases the fibroelatic endocardium were attenuated or disappeared,while 2 of 5 cases the fibroelatic endocardium still existed.Conclusion SEF is the important causes of the infant intractable heart failure,which has the characteristic of high mortality and limited therapy.For SEF patients with anomalous origin of the coronary artery,the SEF is completely reversed by early diagnosis and early correction of the malformation.For SEF patients with CoA or aortic stenosis,the surgical treatment could promote recovery of cardiac function,but whether the SEF were reversed is still subject to further follow-up.The heart transplantation is the best therapy for SEF with severse heart failure.

Slow transit constipation(STC)is the common type of chronic idiopathic constipation. Due to failure of routine conservative treatment, laxatives abuse is the most choice for majority of the patients, which could damage the enteric nervous system and result in aggravation of constipation. Resection of the slow transit colon is the ultimate option for some patients. It is hard to prevent and treat STC clinically because of the unknown pathophysiologic mechanism. Abnormalities of enteric neurotransmitters such as VIP, SP, NOS and decreased number of interstitial cells of Cajal have been described in the colon of the patients with STC. However, long term application of stimulant laxatives can also result in the almost same changes in the colon. Exploration of the potential relationship among the above reported abnormalities is the direction of future study.
Constipation ; physiopathology ; Enteric Nervous System ; physiopathology ; Gastrointestinal Transit ; physiology ; Humans ; Interstitial Cells of Cajal ; cytology

OBJECTIVETo research the change of concentration of the amino acid neurotransmitters in the striatum focal cerebral ischemia in rat and the effect of Acorus tatarinowii Schott, one of inducing resuscitation drugs, for 4 of amino acid neurotransmitters.

METHODSTwenty four rats were divided into four groups (n = 6): control group, cerebral ischemia group, sham operation group and Acorns tatarinowii Schott treated group. Rats were established into models of cerebral ischemia by occluding bilateral thread cork method. Formation sampling were performed in a striatum area using microdialysis and the detection of biological sample including aspartic acid, glutamic acid, glycine and gamma-aminobutyric acid by high performance liquid chromatography (HPLC) electrochemical detector system.

RESULTSCompared with the control, the all contents of 4 kinds of the amino acids were significantly increased during cerebral ischemia (P < 0.01). Compared with the cerebral ischemia group, the contents of aspartic acid, glutamic acid that were excitatory amino acids were remarkably decreased in the striatum for Acorus tatarinowii Schott treated group (P < 0.01), It was no significant influence on gamma-aminobutyric acid and glycine that belonged to inhibitory amino acid in a nascent condition but with a elevating in the later period of microdialysis.

CONCLUSIONAcorus tatarinowii Schott can enter the cerebral parenchyma through blood brain barrier and cut down glutamic acid,aspartic acid increased during cerebral ischemia. As a result, the neurotoxicity attributed to the excitatory amino acid has been released in excessive amounts declined so as to avoid the secondary impairment of neurons caused by excitatory amino acids pernicious effects after ischemia. It may be one of the protective mechanism of drugs for inducing resuscitation resembling EAA receptor antagonists to ischemi brain.

Acorus ; chemistry ; Animals ; Brain Ischemia ; metabolism ; Corpus Striatum ; metabolism ; Disease Models, Animal ; Excitatory Amino Acids ; metabolism ; Male ; Neurotransmitter Agents ; metabolism ; Rats ; Rats, Sprague-Dawley