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 establish the pharmacokinetic-pharmacodynamic(PK-PD) modeling to characterize the antipyretic effects of coptisine, an active component in coptis chinensis on rats.Methods Nine healthy male Sprague-Dawley(SD) rats were randomly divided into three groups, each with three.The rats in the first group were injected intravenously with lipopolysaccharide(LPS,100 μg·kg-1) alone.The second and third group rats were given coptisine high-dose(3.87 mg·kg-1) and coptisine low-dose(1.93 mg·kg-1) by tail vein injection at 30 min after LPS injection, respectively.Body temperature was measured at different time points, and blood samples from tail vein were collected simultaneously.The blood concentration of coptisine was determined by ultra performance liquid chromatography.Monolix software was used to model PK-PD of coptisine mean plasma concentration and temperature effects,by population computation with non-covariates.Besides.the model with advantage was selected by the fitting goodness.Results Coptisine could inhibit body temperature of endotoxin-induced fever in rats significantly.Two-compartment linear elimination model was used to describe the final PK model.Gaussian function, an input function of body temperature changes, which was used to depict PD model, the PK and PD models were connected by the Emax model.At last, the final model was fitted better;the fitting results indicated that the EC50 of antipyretic effect of coptisine was 89.7 μg·L-1, and the Emax was 1.88℃.Conclusions Coptisine has a powerful anti-pyretic effect on endotoxin-induced pyrexia of rats with high potency, Low in vivo distribution and quick clearance.

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.

Objective To investigate the mechanism of soluble β-1, 3-D-glucan in G-test positive serum in inhibiting ROS-dependent killing of Candida albicans ( C.albicans ) mediated by neutrophil Dectin-1.Methods The expression and distribution of internalized Dectin-1 and triggered ROS in human neutrophils were detected by using confocal/two-photon laser scanning microscopy upon stimulation with C.albicans (MOI=10) which was pretreated with β-1, 3-D-glucanase (10 U/ml) or not.Abrogation test was used to analyze whether intracellular Dectin-1 was involved in C.albicans-triggered ROS production in human neutrophils.Furthermore, flow cytometry analysis was performed to detect the expression of intracel-lular Dectin-1 and ROS in neutrophils which were pretreated respectively with G-test positive serum at differ-ent dilutions for 60 min and then stimulated with C.albicans for another 60 min at 37℃.Results After stimulated with C.albicans (MOI=10) for 60 min, the expression of Dectin-1 in neutrophils was recruited to the spores of opsonophagocytized C.albicans, and partly co-localized with the triggered ROS production . However, the expression of intracellular Dectin-1 was not observed in neutrophils when stimulated with β-1, 3-D-glucanase pretreated C.albicans for 60 min at 37℃.Abrogation test further showed that C.albicans-trig-gered ROS production in neutrophils was partly and irreversibly inhibited by adding Dectin -1 blocking mAb of 5 μg/ml.In addition , both the triggered expression of intracellular Dectin-1 and ROS production in neu-trophils stimulated with C.albicans ( MOI=10 ) in the presence of G-test positive serum were significantly lower than those of neutrophils stimulated only with C.albicans (LSD-t test, P<0.01).Linear regression a-nalysis suggested that the triggered intracellular Dectin-1 and ROS production in neutrophils upon stimulation with C.albicans were both inhibited by soluble β-1, 3-D-glucan in a dose-dependent manner (Dectin-1,R2=0.702,P<0.01;ROS,R2=0.588,P<0.01 ).Conclusion Taken together, these results demonstrated that the soluble β-1, 3-D-glucan in G-test positive serum may play a role in inhibiting the ROS-dependent killing of C.albicans by interfering with internalized expression of neutrophil Dectin-1.

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