Objective To study the influence of cilostazol to aspirin resistance in patients with coronary heart disease.Methods A total of 165 patients with coronary heart disease were set apart two groups:group A:coronary heart disease,group B:coronary heart disease by 2-diabetes mellitus,Both group A and group B received 100 mg of aspirin daily for 7 days and no other antiplatelet agent.The blood samples were analyzed by platelet aggregation(PAG)test.Platelet aggregation using adenosine diphosphate(ADP)and arachidonic acid(AA).then two groups were randomized four groups:A1,A2,B1,B2 separately.both group A1 and B1received aspirin 100 mg qd continuely,group A2 and B2 added anther antiplatelet drug cilostazol 50 mg bid,redetected platelet aggregation after a week.compared PAG and AR using statistic methods.Results PAG and AR of group A is lower than group B(P0.05).The PAG and AR of group A2 was significantly lower than group A and group A1(P0.05),the PAG and AR of group B2 is significantly lower than group B and group B1(P

Objective To investigate a mechanism protected radiation-induce injure for radiated guinea pigs'nasal mucosa treated with intranasal corticosteroids (fluticasone nasal cavity spray). Methods 50 health guinea pigs were divided into 2 groups randomly: the irradiated group (control group) with 25 guinea pigs and the administration group after irradiation (test group)with 25 guinea pigs. The nasal part of all guinea pigs were performed irradiation by the 6 MV X-ray with single 5 Gy, one time each week for three weeks. The guinea pigs of test group received intranasai eorticosteroids with one time every day and one spray each side nasal cavity on the second day after three weeks irradiation. Five guinea pigs in each group were saeritieed randomly at 1 week, 1 month, 2 months, 3 months and 4 months after irradiation, and the histopathologie changes were observed under optical microscope and electron microscope. At the same time, blood were drawn from the heart and the concentration of IL-1, IL-6 and TNF-α in serum were measured by ELISA. Results The early nasal mucosa inllammatory reaction of the test group was less than the control group. The coverage rate of cilia of the test group was much than that of the control group (72.9% vs 50.2%) at four months after irradiation. The atrophy of submucosal glandular organ was lessened and they displayed some extent secretory function. The concentration of IL-1 in serum was increased very much in the test group compared with the control group after irradiation and kept higher level in the first two months. After two months, it began to decrease;on four months, it still kept equivalency level with the control group. The concentration of IL-6 and TNF-α in serum were reduced all the while. Conclusions The intranasal eortieosteroids with fluticasene nasal cavity spray can reduce radiation-induced injury of guinea pigs' nasal mucosa. The concentration change of IL-I, IL-6 and TNF-α in serum may be one of mechanism protected radiation-induce injure of guinea pigs' nasal mueosa.

Preoperative qualitative diagnoses of 118 eases of renal tumour.made by B-mode ultrasound were analyzed.The final diagnoses were proven operatively and pathologically.The resultsshowed that by B-mode altrasound the detective rate was 92.2%,a correct qualitative diagnosis rate 49.1%,incorrect rate 18.1%and false positive rate 1.7%.Qualitatively unidentified turnouts accounted for 32.8%of all the cases.It is assumed that B-mode ultrasound can be used to make correct qualitative diagnosis only on certain tumours with typical image features.It is difficult for it to distinguish some tumours which have complicated displays.The accuracy of preoperative qualitative diagnosis could be raised by combining B-mode uhradound with other imaging technologicol examinations.

Objective To discuss the effect of microsurgery of intracranial arachnoid cyst. Methods 42 cases of intracranial arachnoid cyst treated with microsurgery were studied retrospectively.Results Total resection was performed in 23 cases and partial resection in 14 cases. 5 cases received partial resection and communication between cystic cavity and brain cistern. CT scans of 29 cases after operation showed completely obliteration or marked diminution in cystic size. The symptoms and signs of all the patients were improved significantly after a 1-year follow-up.Conclusion The effect of microsurgery of intracranial arachnoid cysts is satisfactory. It is important to communicate cystic cavity with subarachnoid space or brain cistern.

Objective The Application of Circular Mapping during Circumferential Pulmonary Vein Ablation (CPVA) for Atrial Fibrillation Guided by Ensite/NavX System. Methods To evaluate the effect of combined circular mapping on the success rate of CPVA. 61 consecutive cases (40 males and 21 females) were included in the study. 50 cases with paroxysmal atrial fibrillation (PAF) and 11 cases with chronic atrial fibrillation (CAF) underwent CPVA guided by the Ensite/NavX system. A circular electrode catheter was used to map the pulmonary vein (PV) potentials. Pulmonary vein isolation was taken as the endpoint for ablation. Results All the 61 cases underwent the procedure successfully. LPVs were isolated in 34 cases and 35 cases underwent single RPVs isolation. Circumferential ablation of both LPVs and RPVs were carried out in 23 cases. Atrial fibrillation was terminated when delivering radiofrequency energy in 16 cases with PAF and 5 cases with CAF. The termination sites were located near the anterior or posterior roof of the superior PVs in 19 cases and at the mid-portion of the posterior wall from RSPV in 1 case. Atrial fibrillation was terminated when after comple to LPV ablation in 1 case. During the follow-up of 6?2 months, 42 PAF cases and 5 of 11 CAF cases were atrial fibrillation free. The total success rate was 77%. Complications: Pericardium effusion was found in 1 case and disappeared after pericardium puncture and drainage. 1 case developed hemothorax and was cured after thorax puncture and drainage. Conclusion The application of circular mapping during circumferential pulmonary vein ablation guided by Ensite/NavX System contributes to improve the success rate of atrial fibrillation ablation.

Objective To evaluate the safety and effectiveness of circumferential pulmonary vein(PV) isolation in cases with persistent/permanent atrial fibrillation(AF) guided by the EnSite-NavX system.Methods Sixty cases(43 males,mean age 59.2?13.6 years) with persistent/permanent AF were enrolled from September 2004 to August 2005.The mean duration of AF was 4?6 years(6 months-24 years).The mean left atrium diameter was 43.2?6.4(42-58)mm.Circumferential PV isolation was performed guided by the EnSite-NavX system,combined with linear ablation of the superior-posterior wall of left atrium and mitral isthmus.Results All 60 cases underwent the procedure successfully,with the mean procedural time 170?34(150-240)min and the mean fluoroscopic time 23?10(12-45)min.The pulmonary vein isolation rate for the left ipsilateral PVs was 83.3% and was 78.3% for the right PVs.Segmental ostial ablation was applied for the rest cases.AF was terminated in 7 cases and was converted to atrial tachycardia(AT) or atrial flutter(AFL) in 5 cases.Sinus rhythm was restored by cardioversion in 48 cases.Post-ablation AT/AFL was documented in 10 cases (16.7%) which diminished automatically in 8 cases,and was abolished by re-ablation in 2 cases.After a mean of 6.5?3.2(4-11)months of follow-up,43 cases (71.7%) were free of AF(18 cases with anti-arrhythmic drugs).Complications: pseudo-aneurysm of femoral artery was found in 1 case and was cured after proper treatment.Conclusion Circumferential PV isolation and combination with left atrial linear ablation guided by the EnSite-NavX system was safe and effective for eliminating persistent/permanent AF.

Objective To explore the clinical characteristics of primary central nervous system malignant lymphoma (PCNSML). Methods The clinical data of 22 cases of PCNSML were analyzed retrospectively.Results The patients in our study mainly presented with headache (16 cases), vomiting (11 cases), weakness of extremities (5 cases) and numbness (1 case). The tumors were supratentorial in 19cases, infratentorial in 3 cases and multiple in 5 cases. CT scan showed same density or high-density lesions with surrounding mild edema. Brain MRI demonstrated slight-hypointense lesion of 9 cases and isointense lesion of 5 cases on T1-weighted imaging. On the T2-weighted imaging, the lesions were slight-hyperintense in 11 cases and isointense in 3 cases. Enhanced scanning showed that the lesions were contrasted evenly and obviously on CT and MRI. Misdiagnosis was given preoperatively in 17 patients. The pathological examination revealed B cell malignant lymphoma in all cases. In 18 cases of follow-up, 5 patients with multiple lesions who only received stereotactic biopsy all died within 6 months, the mean survival time of 6 patients who were treated with total resection of the tumors and radiotherapy was 27 months, 4 patients treated with partial resection and ?-radiotherapy was 21 months, 4 patients treated with partial resection and radiotherapy was 10 months. The patient who was treated with only total resection of the tumor died in 11 months because of recurrent. Two patients with only partial resection died in 5 and 8 months, respectively.Conclusions There are no specific clinical manifestations of PCNSML and the disease is often misdiagnosed preoperatively. Although certain characteristic performance may be found on CT and MRI scans, the final diagnosis of this disease depends on pathological examination. Comprehensive treatments may prolong the survival time of the patients.

Objective To investigate the level of myocardical injury by measuring serum levels of cTnI, MYO, CK and CK-MB before and after catheter ablation in patients with atrial fibrillation. Methods Forty nine patients underwent catheter ablation for atrial fibrillation were involved in the study, cTnI, MYO, CK and CK-MB levels were measured before and 4 h after catheter ablation. Results Myocardical enzymes were increased in all patients (P0.05). Conclusion The serum myocardial enzymes levels increase after catheter ablation for atrial fibrillation. Of the above myocardical enzymes, cTnI is the most sensitive and specific parameters.

Objective To compare the clinical outcomes of 2 different catheter ablation strategies for patients with chronic atrial fibrillation(CAF).Methods One hundred and thirty four consecutive patients(77 males,mean age 56.8?12.3 yrs)were randomized into 2 groups of different catheter ablation strategies.All the patients suffered from frequent attacks(more than 3 times per month),drug refractory and symptomatic CAF.One group received circumferential pulmonary rein ablation(CPVA group,n=68)and the other group received complex fractionated electrogram ablation additional to CPVA(CPVA+CFEA group,n=66).All ablation was guided by 3 dimensional mapping system(CARTO).Follow-up ECG,Holter and clinical outcomes of the 2 groups within 6 months after the procedures were analyzed.Results The baseline characteristics were comparable between the 2 groups.The mean procedure time in the CPVA+CFEA group was longer than that in the CPVA group but the mean fluoroscopy time between two groups had no significant difference.After the first procedure,60%of patients in the CPVA group and 77% of patients in the CPVA +CFEA group were free from symptomatic atrial tachycardia without any use of antiarrhythmic drugs for at least 3 months(P

Objective To evaluate the safety and effectiveness of catheter ablation for atrial fibrillation(AF)therapy guided by 3-D mapping systems.Methods Eight hundred cases(482 male,mean age 62.1?15.6 years)were enrolled.AF was paroxysmal in 611 cases,and persistent in 189 cases.The mean left atrium diameter was 38.4 9.2 mm.Ablation was guided by EnSite-NavX in 260 cases and by CARTO in 540 cases.Circumferential pulmonary vein isolation(CPVI)was performed for paroxysmal AF,and CPVI combined with complex fractionated atrial electrograms(CFAEs)and mitral isthmus ablation was applied for persistent AF.Every case received oral anticoagulation with warfarin and class IC and class III antiarrhythmic drugs for 1 to 3 months.ECG and Holter were applied every month during follow-up.Results Seven hundred and ninty-five cases underwent the procedure successfully,with the mean procedural time 161 33 min and fluoroscopic time 17 13 min.PV isolation was achieved in 96.5% of cases for left-sided PVs,and in 98.6% of cases for right-sided PVs.Radiofrequency application terminated paroxysmal AF in 90 out of 98 cases.AF recurred in 137 cases within 2 weeks post-ablation,and subsided in 103 cases during subsequent follow-up.Fifty-seven cases underwent re-ablation and 6 cases required third ablation.Persistent AF was terminated in 30 cases(16.1%)and was converted to atrial tachycardia in 15 cases(8.1%)by CPVI.For patients receiving CFAEs ablation,persistent AF was terminated in 20 cases(10.8%)and was converted to atrial tachycardia in 23 cases(12.4%).AF recurred in 78 cases(41.9%)early after ablation and 65 cases underwent re-ablation(10 cases received third ablation).Atrial tachycardia/flutter developed in 104 cases(13.1%)after ablation,and remitted in 68 cases.Atrial tachycardia/flutter was mapped and ablated in 30 cases,and was eliminated in 23 cases.Complications:Cardiac tamponade developed in 5 cases,requiring pericardiocentesis in 3 cases and surgical repair in 2 cases.PV stenosis was present in 6(0.7%)cases,TIA in 1 case,cerebral embolism in 2 cases,mesentery artery embolism in 1 case,hemothorax in 1 case and pneumothorax in 1 case.There were femoral artery pseudo-aneurysm in 3 cases and femoral artery-vein fistula in 1 case.All the patients were cured by conservative therapy.During a mean follow-up of 16.2?5.7 months,550 cases(9.4% of them received re-ablation and 11.5% received antiarrhythmic drugs)with paroxysmal AF and 159 cases(34.9% of them received re-ablation and 28.5% received antiarrhythmic drugs)with persistent AF were free of atrial tachyarrhythmias recurrence.Conclusion Catheter ablation guided by 3-D mapping systems were safe and effective for AF therapy.CPVI alone was enough for paroxysmal AF treatment,while CPVI combined with CFAEs and isthmus ablation were preferable for persistent AF treatment,and re-ablation were needed in 40% of the patients to improve effectiveness.