If heart function is normal, the atrial cells are excited in a stable rhythm. But this would change during atrial fibrillation. In this paper, after comparing with the method of characteristic point, we use the dominant frequency method to analyze the activation pattern under sinus and atrial fibrillation rhythm in different parts of atria based on epicardial mapping system. It is found that the activation rhythm changes a lot in different parts of atria, and the automaticity of atrial cells change obviously in somewhere. The result shows that dominant frequency method is very suitable for the analysis of atrial fibrillation signal. What's more, we also roughly discuss the role of this method in exploring the driving sources during atrial fibrillation.
Atrial Fibrillation ; Epicardial Mapping ; Heart Atria ; Humans

Objective To study the assessment value of enhanced CT for axillary lymph node in breast cancer.Methods 71 patients meeting the inclusion criteria in our hospital were reviewed.They had level Ⅲ lymph nodes pathologically confirmed for almost 2 years.CT scan by a 64-detector row scanner were performed from the lower edge of breast to neck.CT images were analyzed from these aspects:with or without lymph node enlargement; the size and shape of the lymph nodes; lymph node with or without enhancement.Through the determination of CT net increase value,the metastasizing lymph node signs were explored.Diagnostic index of axillary lymph nodes imaged by breast sonography and enhanced CT were calculated separately.The size of level Ⅲ lymph node and CT net increase value were statistically analyzed.The correlation of metastasizing level Ⅲ lymph node and tumor location was analyzed.Results The accuracy,sensitivity,specificity,and positive predictive value of diagnosed axillary lymph node was 70.4％,85.7％,64.0％,and 50.0％ by three-dimensional ultrasound and 88.7％,90.6％,83.3％,and 94.1％ by enhanced CT.The accuracy,sensitivity,specificity,and positive predictive value of diagnosed level Ⅲ lymph node was 95.8％,90.5％,98.0％,and 95.0％ by enhanced CT.The maximal diameter of level Ⅲ lymph node was ＞ (8.7 ± 1.3) mm and the short diameter was ＞ (5.3 ±0.5) mm.CT net increase value was ＞ (50.0 ±9.0) HU.The shape of lymph nodes was mainly round or oval solid.Conclusions The diagnosis rate for level Ⅲ lymph node is obviously higher by enhanced CT than by three-dimensional ultrasound.There is no obvious correlation between level Ⅲ lymph node and tumor location.

Objective To evaluate diagnostic value of the combined examination of ultrasound , contrast-enhanced CT and physical examination in axillary lymph node status in breast cancer .Methods 316 cases of breast cancer were studied from Jan .2012 to Dec.2013.The axillary lymph nodes were divided into negative group, suspicious negative group , suspicious positive group and positive group by physical examination , axillary ultrasound , and contrast-enhanced breast CT imaging .ROC curve was used to evaluate diagnostic value and the sensitivity,specificity,and accuracy were analyzed .Results The evaluation model presented the AUC of 0.859. The accuracy, sensitivity, specificity, positive and negative predictive value was 91.3%, 93.8%, 92.5%, 94.0%and 90.9%in negative group and positive group .Conclusion This evaluation method can accurately predict the axillary lymph node status and may be instructive to clinical operation mode selection .

Objective To find out the factors which would be likely to affect the occurrence of lactation mastitis.Methods 216 patients with lactation mastitis,who met our grouping criteria,were chosen for survey and clinical data collection.Their age,time of onset,mode of delivery,post-partum colostrum time,mastering of breast-feeding skills,feeding habits,occurring site of their mastitis and other data were input into SPSS 17.0 software,respectively,to perform retrospective analysis.Results Patients' average age and their age of first breast-feeding were all 30 years old ; the average age of their first pregnancy were 27 years old.Their initial post-natal breast-feeding was about 2 to 4 days.The onset of incidence of mastitis was about 28 days post-natal.First,second and third pregnancy patients represented 1/3 of the total patients respectively.63.4％ patients had cesarean delivery and only 36.6％ patients had vaginal delivery; 91.7％ were outpatients and 8.3％ patients were inpatients.10.6％ patients had abscess and 89.4％ patients hadn't.The distribution ratio of inflammation in the upper outer,lower outer,lower inner and upper inner quadrants of the breast was 30.6％,48.1％,19％,2.3％ respectively.If the mode of delivery is considered as a factor to investigate incidence time of mastitis and postpartum colostrums time,no significant difference between the two groups was found (P ＞ 0.05).Our survey indicated that 79.2％ patients did not have any knowledge of breastfeeding,8.8％ patients got the breast-feeding knowledge from their mothers,11.6％ patients got the breastfeeding knowledge from books or web resources,only 0.5％ of the patients participated in the training of breast-feeding.76.9％ patients never had breast massage,19％ of patients had a few times of massage,2.8％ of patients had occasional massage,and only 1.4％ of patients had regular breast massage with the help of their family.85.6％ patients didn't have their breasts emptied from breast-feeding to incidence of mastitis,11.6％ patients occasionally emptied their breasts,and only 2.8％ of patients can ensure one side of the breasts emptied daily.56.5％ patients used lying position with the lower breast as the most common breastfeeding posture,37％ patients used sitting position,only 6.5％ of patients used lying position with the upper breast.The correlation analysis of breeding posture and occurring site of lactation mastitis revealed that the Spearman coefficient was-0.14,P value was 0.04,which is statistically significant,suggesting there is correlation between occurring sites of lactation mastitis and breeding posture.Conclusions Mothers need to master breast-feeding skills including breast massage,breast milk emptying and breast-feeding postures to prevent the occurrence of mastitis.Furthermore,gravity probably affects the occurring sites of mastitis through its impact on patients' preferred breast-feeding postures.

The pathogenesis of diabetes is complicated by several factors including autoimmunity, environment, heredi?ty, and etc. Autophagy is a kind of intracellular biodegradation processes, which plays an important role in intracellular ho?meostasis of islet cells. In diabetes, autophagy is involved in the endoplasmic reticulum stress, mitochondrial dysfunction and inflammatory, and it affects the development of the disease. In this paper, we reviewed the interactions of autophagy with endoplasmic reticulum stress and mitochondrial dysfunction with inflammation in diabetes in order to investigate the patho?genesis of diabetes, to find new strategies for prevention or treatment of diabetes.

Objective:To study the detection value of platelet activation indexes and platelet parameters in patients with hepatitis B-induced cirrhosis.Methods:40 patients with hepatitis B-induced cirrhosis in our hospital from November 2015 to August 2016 were selected as the observation group.40 healthy subjects went through physical examination during the same period were chosen as the control group.The platelet activation indexes and platelet parameters of subjects with same age in two groups were detected and compared.The detection results of the two items in patients with different stages of hepatitis B-induced cirrhosis were compared,too.Results:The PLT of observation group was lower than that of control group,while the other platelet parameters and platelet activation indexes were all higher than those of control group.The detection results of two items in patients with different stages of hepatitis B-induced cirrhosis were with significant differences,all P＜0.05.Conclusion:The platelet activation indexes and platelet parameters in patients with hepatitis B-induced cirrhosis are obviously abnormally expressed.There are significant differences among the detection results in patients with different stages.Therefore,surveillance of those indexes in patients with hepatitis B-induced cirrhosis should be strengthened.

Objective To discuss the role of miRNA-374a in invasion and metastasis of breast cancer.Methods Breast tissues from 48 patients(32 patients with breast cancer)were classified into high invasive and metastatic group(HIMG,group A),low invasive and metastatic group(LIMG,group B),and normal group (group C).Each group contained 16 specimens.6 samples were selected randomly from each group and were detected by microRNA array.Key microRNA (miRNA-374a)was selected and its target protein(BMP-2) was predicted by bioinformatics software.The rest 10 specimens of each group were detected by real-time qRT-PCR and Western blot to test the content of miRNA-374a,mRNA and protein of BMP-2.Correlation analysis was performed between miRNA and the target protein.SPSS 18.0 was used to make statistical analysis.Results The relative content of miRNA-374a was higher in group C than in group B,higher in group B than in group A(P ＜ 0.05).BMP-2 mRNA level was higher in group A and group B than in group C (P ＜ 0.05).The expression level of BMP-2 protein was lower in group C than in group B,lower in group B than in group A(P ＜0.05).Correlation analysis showed that miRNA-374a was negatively correlated with BMP-2 protein(P =-0.412 8).Conclusion miRNA-374a inhibits the invasion and metastasis by regulating BMP-2 in human breast cancer.

BACKGROUND: Tissue-engineered skin plays an important role in the repair and reconstruction of large-area skin lesion. Little is known about the effects of Chinese medicine-loading tissue-engineered skin scaffold on cell adhesion and wound surface infection. OBJECTIVE: To screen the application concentration of shengji solution, which can promote tissue regeneration, using keratinocytes and fibroblasts, and to observe the effects of shengji solution-gelatin-chitosan drug-loading skin scaffold on cellular adhesion and biocompatibility. DESIGN, TIME AND SETTING: Taking keratinocytes and fibroblasts as subjects, the present randomized and controlled experiment was performed at the Laboratory of Cell Engineering, Orthopedic Institute, Tianjin Hospital between February and August 2005. MATERIALS: One healthy big-ear rabbit was included for harvesting skin seed cells. Shengji solution, Danggui (Radix Angelicee Sinensis) and Shengdi (rehmannia dride rhizome) extract (self-extracted, 1.5 g/mL), gelatin-chitosan scaffold and shengji solution-gelatin-chitosan scaffold were provided by Tianjin University, China. METHODS: Passage 3 keratinocytes and fibroblasts were harvested by dispase Ⅱ- trypsase- ethylenediamine tetraacetic acid(EDTA) digestion. The prepared cells were divided into 5 groups: control, shengji solution, Danggui, Shengdi, and epidermal growth factor (EGF). Common culture solution containing 0.1 volume fraction of fetal bovine serum, shengjisolution (5, 6, 8, and 12 g/L), Danggui extract (8 g/L), Shengdi extract (8 g/L), and EGF culture medium (10 μ g/L) were used in corresponding groups for cell culture. At 1, 3, 5, and 7 days, cellular proliferation was detected by methyl thiazolyl tetrazolium (MTT) assay. Keratinocytes and fibroblasts were cultured in different concentrations of shengji solution (50, 60, 80, and 120 g/L) and grouped according to different concentrations. At 7 and 14 days, cellular adhesion was observed by semi-quantitative method. At 4, 7, and 14 days, keratinocytes cultured by 60 and 80 g/L shengji solution were harvested for hematoxylin-eosin staining and subsequent scanning electron microscope observation. MAIN OUTCOME MEASURES: Effects of shengji solution on skin seed cell proliferation; effects of drug-loading scaffold on cellular adhesion; and cell-carrier biocompatibility. RESULTS: MIF detection results demonstrated that cells significantly proliferated after treatment of 5, 6, and 8 g/L shengji solution compared to the control group (P < 0.05). Obvious proliferation of passage 3 keratinocytes and fibroblasts was found on 60 and 80 g/L drug-loading scaffold. Keratinocytes on the drug-loading scaffold exhibited good cellular morphology and closely adhered to the scaffold. Shengji solution had no apparent toxic effects on cells. CONCLUSION: Shengji solution (60 and 80 g/L)-gelatin-chitosan scaffold can effectively promote the adhesion and proliferation of keratinocytes and fibroblasts.

Objective To investigate the extent of axillary lymph node dissection which can not only ef-fectively evaluate the axillary status but also reduce the complications to the minimum in early stage breast can-cer. Methods 331 patients with early breast cancer surgically treated from Jan. 2011 to Dec. 2013 were retro-spectively analyzed. Their preoperative axillary state was evaluated. They undertook sentinel lymph node biopsy (SLNB) by pure methylene blue dye method and frozen section examination during surgery. According to the ex-tent of axillary lymph nodes dissection, patients were divided into SLNB group (98 cases) and intercostobrachial nerve level lymph node dissection (ILND) group (233 cases). The pros and cons of the operation were compared. Results The sentinel lymph nodes (SLN) labeled by methylene blue were located under the intercostobrachial nerve level. The average number of SLN and intercostobrachial nerve level lymph nodes were 5.64+1.68 and 13.34+3.61 respectively. The detection rate and the false negative rate of SLNB was 97.42% and 2.58% respec-tively. The medium follow-up was 27.5 months. There was no significant difference in postoperative complications including upper limb paresthesia, swelling or limitation of shoulder activity between the two groups. Conclusion ILND is an effective and suitable surgical method in early breast cancer patients with failed intraoperative SLN labeling or with one SLN metastasis.

Objective Less than a decade ago, ER-positive and PgR-positive diagnostic criteria decrease from 10%to 1%. Up to 20%of current immunohistochemical determinations of ER and PgR worldwide may be inaccu-rate. It is necessary to study patients whose tumors are between luminal A (LABC) and triple-negative (TNBC) breast cancer. Methods Survival analysis grouping by the level of positive hormone receptor, CK5/6 and EGFR, and en-docrine therapy was carried out in 206 patients whose tumors were junction zone between LABC and TNBC. Re-sults There were no significant differences between the low-positive (1%-9%) HR group and positive HR (10%-19%) group in overall survival (OS) and disease-free survival (DFS). There was an apparent difference between the nor-mal-like group and basal-like group in OS and DFS, and between the patients with and without endocrine therapy. There were significant differences between death and tumor progression for EGFR and CK5/6, chemotherapy, and endocrine therapy. Conclusions We conclude that EGFR and CK5/6 are better prognostic indicators than the lev-el of positive HR in patients whose tumors are junction zone at the junction zone between LABC and TNBC. En-docrine therapy can be highly beneficial to these patients regardless of the positive HR level.