Humans ; Hypertension

Objective To investigate the method and the efficacy of applying irrigated tip catheter in radiofrequency ablation Methods The study included 6 patients (M/F 4/2, mean age 34 2?16 7), 2 patients had common atrial flutter, 2 had right outflow tract ventricular tachycardia (ROVT) and other 2 had epicardial atrioventricular accessory pathways All patients failed ablation with conventional radiofrequency (RF) ablation An irrigated tip catheter ablation was performed on these patients Results Bidirectional isthmus block was achieved in 2 patients with common atrial flutter; the successful ablation was achieved in 2 patients with ROVT; V A dissociation was appeared in 2 patients with epicardial atrioventricular accessory pathway, the mean application was 3 4?1 2, the mean time of procedure was 92 4?30 3 minutes, the mean exposure time of X ray was 29 3?12 6 minutes No side effects and no coronary damage was observed Conclusion Irrigated tip catheter ablation is safe and effective for achieving successfully ablation of tachycardia when conventional RF energy has failed

Objective The goal of this study was to examine the association between urotensin Ⅱ (U Ⅱ) concentration and the severity of coronary artery disease (CAD). Methods We studied U Ⅱ concentrations in 100 patients with known or suspected CAD referred for cardiac catheterization. Based on coronary angiograms, subjects were classified as having no or mild CAD (stenosis ＜50%) and significant CAD (stenosis=50%). Micheal score system was used to estimate the severity of CAD. Result U Ⅱ concentration in the significant CAD group had no difference compared with the no or mild CAD group (1.95±1.18 pmol/L vs 2.04±1.47 pmol/L, P＞0.05),but higher in the severe group (score =9) than in the normal or nearly normal group (score＜3)( 2.50±1.62 pmol/L vs 1.61±1.05 pmol/L,P=0.03). U Ⅱ concentration had no relationship with other known risk factors, but it correlated with CAD severity (r=0.213, P=0.034).In multiple regression analysis, U Ⅱ is one of the determinants of the severity of CAD, other than age, abnormal glucose, hypertension and gender. Conclusios U Ⅱ is elevated in severe CAD and there is a significant relationship between U Ⅱ concentration and CAD severity.

Objective:To observe the effects of Yikunjing capsules on the bone histomorphometry indexes and the serum Interleukin-6 (IL-6) level in mice with osteoporosis.Methods:60 cases ofC57 female mice were randomly divided into 5 groups,such as model group (equal volume of normal saline),estrogen group (nilestriol,0.25 mg/kg),Yikunjing capsules high dose group (1.44 g/kg),Yikunjing capsules medium dose group (0.72 g/kg) and Yikunjing capsules low dose group (0.36 g/kg),sham group (equal volume of normal saline) were treated with sham operation.The mice in each group was intragastrically administrated for 70 days.Enzyme linked immunosorbent assay (ELISA) was used to detect the serum IL-6 level.The bone histomorphometry index were detected with BI-2000 Medical Image Analysis System.And the Number of blood vessels in distal femoral metaphysis of each group was measured by CT.Results:Compared with the sham group,the width and area of trabecular bone,the thickness of cortical bone,area of trabecular bone,the number of osteoblasts,the bone mineral density and the number of blood vessels in model group were significantly reduced(P＜0.05),while the number of osteoclasts and serum IL-6 level were significantly increased (P＜0.05).Compared with the model group,above indexes in estrogen group,Yikunjing capsules high,medium,low dose group were improved (P＜0.05),and the effect of Yikunjing capsules high dose group and estrogen group was almost the same (P＞0.05).Conclusion:Yikunjing capsules can rectify the bone histomorphometry indexes reduce the serum IL-6 level and increase the number of blood vessels in mice with osteoporosis,and intragastrically administrating 1.44 g/kg Yikunjing capsules could get the better effect.

Objective To assess the value of real-time myocardial contrast echocardiography (RTMCE) and intermittent triggered myocardial contrast echocardiography (ITMCE) in the detection of myocardial no-reflow phenomenon after reperfusion in acute myocardial infarction on mini-swine models. Methods Thirty close-chest mini-swines were used to create acute myocardial infarction and reperfusion model through interventional method. RTMCE and ITMCE were performed at baseline, 2 h after occlusion of left anterior descending coronary artery and 3 h after reperfusion. The myocardial perfusion defects after occlusion was measured as risk area (RA) and that after reperfusion was measured as no-reflow area (NRA). NRA/RA was calculated and compared with pathological findings. Results The whole study protocol was successfully performed in 27 mini-swines. NRA/RA obtained from RTMCE, ITMCE and pathological staining was (47.94±21.29)%, (38.20±21.04)% and (30.07±14.62)% , respectively. NRA/RA had no significant difference by ITMCE and pathological staining (P=0.124), RTMCE and ITMCE (P=0.071). The correlation coefficient of RTMCE and staining was 0.700 (P<0.001), ITMCE and staining was 0.765 (P<0.001), RTMCE and ITMCE was 0.897 (P<0.001). The sensitivity, specificity and accuracy in the detection of myocardial no-reflow was 100%, 58.33% and 79.17% for RTMCE, 91.67%, 73.33% and 81.48% for ITMCE. Conclusion Both RTMCE and ITMCE could be used as noninvasive methods to reveal the myocardial perfusion and quantitatively detect myocardial no-reflow after reperfusion therapy.

Objective To assess the clinical value of serum uric acid levels in patients with acute ST-elevation myocardial infarction(STEMI).Methods A total of 502 consecutive patients with STEMI were enrolled from January 2005 to December 2010 for retrospective study.The level of serum lipid,echocardiographic data and in-hospital major adverse cardiovascular events(MACE)in patients with hyperuricemia(n =119)were compared with those in patients without hyperuricemia(n =383).The relationship between the level of serum uric acid and the degree of diseased coronary artery was analyzed.All data were analyzed with SPSS version 17.0 software to make t test and x2 test and Pearson correlation analysis.Results Serum uric acid level was positively correlated with serum triglyceride level.Compared with non-hyperuricemia patients,hyperlipidemia was more commonly found among hyperuricemia patients (43.7％ vs.33.7％,P =0.047),and serum triglyceride level was significantly higher in hyperuricemia patients[(2.11 ± 1.24)mmol/L vs.(1.78 ± 1.38)mmol/L,P =0.014].But a significant association between serum uric acid level and one or more diseased vessels was not observed(P ≥ 0.05).Leftventricular end-diastolic diameter(LVEDd)was found to be larger in hyperuricemia patients than non-hyperuricemia patients[(53.52 ±6.19)mm vs.(52.18 ±4.89)mm,P =0.041].Higher incidence in left systolic dysfunction and diastolic dysfunction was discovered in hyperuricemia patients(36.4％ vs.15.1％,P ＜0.01; 68.2％ vs.55.8％,P =0.023).Also,hyp-eruricemia patients had more in-hospital MACE(P ＜ 0.05).Conclusions Serum uric acid level is positively correlated with serum triglyceride level,but not with the severity of coronary artery disease.Hyperuricemia patients after STEMI tended to have higher incidence in left systolic dysfunction and diastolic dysfunction,and have more in-hospital MACE.

Objective To investigate the level of platelet activating factor (PAF) in acute myocardial infarction (AMI) in minipig model and patients, and to study the relationship between PAF and lethal arrhythmia referring to ventricular fibrillation and ventricular tachycardia. Method ( 1 ) The levels of PAF in minipig models ( n = 20) were measured by using ELISA before and 1h after occlusion of left anterior descending coronary artery with balloon at the junction of 1/3 middle and distal portion. The lethal arrythmia was recorded by using electrocardiography. (2) In patients with AMI (n = 72), the levels of PAF were measured on arrival, and 24 h,48 h and 72 h later. The lethal arrythmia, acute heart failure and cardiogenic shock were documented. Results ( 1 ) In minipigs with occlusion of coronary artery for one hour, the mean level of PAF increased from (4.66± 2.89)ng/mL to (6.00±2.82) ng/mL,and thus the increment in PAF was (1 .34± 1.40) ng/mL (P ＜ 0.05). In 13 minipigs with lethal anythmia after occlusion of coronary artery for one hour, the increment in mean level of PAF was ( 1.92 ± 1 .34) ng/mL, whereas the increment in mean level of PAF in other 7 minipigs without lethal arrythmia after occlusion of coronary artery for one hour was as low as (0.28 ± 0. 74 ) ng/mL ( P ＜ 0. 05 ). ( 2 ) In patients, the mean levels of PAF on arrival, 24 h,48 h,and 72 hous after admission were (0.47 ± 0.05) ng/mL,(2.38±0.12) ng/mL,(3.65±0.15) ng/mL and (3.02±0.10) ng/mL, respectively. Of 72 ACI patients, 40 (55%) had complication of lethal arrythnia, heart failure or cardiogenic shock and their mean level of PAF 48 h after admission was (4.72 ± 0.16) ng/mL, whereas mean level of PAF in other 32 (44.44%) without complications was (2.31 ±0.03) ng/mL ( P ＜0.05). Conclusions The level of PAF increased after acute myocardial infarction, and the minipigs and AMI patients complicated with lethal arrythmia had higher levels of PAF.

Objective To investigate the feasibility of the CT texture analysis (CTTA)in differentiating autoimmune pancreatitis (AIP)from pancreatic ductal adenocarcinoma (PDAC).Methods 25 patients with AIP and 31 patients with PDAC who confirmed by pathological or clinical underwent pretreatment three-phase contrast-enhanced CT were enrolled.Histogram parameters (mean CT values,median CT values,25 th,75 th percentile CT values,skewness,kurtosis,entropy and uniformity)were derived from CT images through texture analysis.The differences of histogram parameters between AIP and PDAC groups were compared.ROC and AUC were used to evaluate the diagnostic efficacy of histogram parameters in differentiating AIP from PDAC.Results The values for mean CT values,median CT values,25 th,75 th percentile CT values and uniformity of AIP were significantly higher than those of PDAC group,while the values for entropy of AIP were significantly lower than those of PDAC group in arterial phase,portal phase,and delay phases (all P＜0.05). There were no significant differences in kurtosis and skewness between AIP and PDAC groups (all P＞0.05).The uniformity in portal phase achieved the optimal diagnostic accuracy in differentiating AIP from PDAC (AUC＝0.973 ),the cutoff value was 0.797,the corresponding sensitivity and specificity were 92% and 9 6.8%,respectively.Conclusion CTTA can be used as a quantitative analysis method for differential diagnosis between AIP and PDAC,providing a reference for clinicians to select therapeutic schedules.