To explore the effect of products of nan A gene on the changes of cell surface carbohydrates of the chinchilla eustachian tube after infection with Streptococcus pneumoniae. Methods Using lectin histochemical techique to compare the changes of the cell surface carbohydrates in the chinchilla eustachian tube after infection with S.pneumoniae D39 or ?NA1 mutant. Results The labeling pattern revealed that the staining with Limax flavus agglutinin (LFA) and Sambucus nigra agglutinin (SNA) was decreased in epithelium of the eustachian tube in the D39 cohort compared to the uninfected control, which indicated that the normal terminal sialic acid residue were removed. Concurrently, the increased staining with wheat germ agglutinin (WGA), succinylated wheat germ agglutinin (Succ WGA), Bandeiraea simplicfolia lectin II (BSL II), peanut agglutinin (PNA) and Erythrina cristagalli lectin (ECL) was observed in the lumen surface of eustachian tube subsequent to intranasal inoculation with D39. However, the ?NA1 neuraminidase deficient mutant did not show any significant changes in the lectin labeling patterns as compared with those of the control cohort. Conclusions The products of the nan A gene play an important role in the changes of cell surface carbohydrates and thus may be responsible for the colonization in the chinchilla eustachian tube after infection with Streptococcus pneumoniae.

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.

Objective To explore the effect of kangfuxin liquid topical treatment on open wound of postoperative perianal abscess.Methods200 cases of patients with open wound abscess surgery in our hospital from February 2014 to September 2016 were randomly divided into control group and experimental group,with 100 cases in each group.The control group was given conventional treatment, the experimental group were treated by kangfuxin liquid.The relevant therapeutic indicators and clinical healing time between two groups were compared.ResultsThe effective rate of the treatment group was 93.0%, which was significantly higher than that of the control group (85.0%), the difference was statistically significant(P<0.05).The granulation growth period of the experimental group was (5.14±1.41) days, and the average healing time was (15.21±2.49) days.Which were significantly shorter than those of the control group[(7.45±1.32) days, (21.16±2.69) days], and the differences were Statistical differences (P<0.05).ConclusionTo improve the treatment effect to a great extent open wound infection of kangfuxin liquid in treatment of perianal abscess after surgery, shorten the healing time, improve the patient's symptoms, with further clinical promotion and application significance.

Objective To investigate the hemostasis effect of alginate dressing for puncture point bleeding after peripherally inserted central catheter (PICC) by ultrasound-guided modified Seldinger technique (MST).Methods Between November 2013 and May 2016, 538 cases of cancer in our department underwent PICC, including 270 cases from November 2013 to February 2015 selected as control group (after PICC was successfully placed, sterile gauze and 3M transparent film were used to fix the puncture point) and 268 cases from March 2015 to May 2016 selected as observation group (after PICC was successfully placed, alginate dressing, sterile gauze and 3M transparent film were used to fix the puncture point).The patients in both groups were given 20 minutes of pressure for puncture point and elastic bandage compression fixation for 24 h.The degree of puncture point bleeding and times of dressing change in 24 h and 24-72 h between the two groups were compared.Results In the observation group, mild, moderate, and severe bleeding was seen in 232 cases, 34 cases, and 2 cases within 24 h, and in 242 cases, 25 cases, and 1 case between 24-72 h, respectively.In the control group, mild, moderate, and severe bleeding was seen in 12 cases, 196 cases, and 62 cases within 24 h, and in 21 cases, 212 cases, and 37 cases between 24-72 h, respectively, with significant differences (Z=-18.647, P=0.000;Z=-18.768, P=0.000).In the observation group, there were zero, once, twice, and ≥3 times of puncture point dressing change in 232 cases, 33 cases, 3 cases, and 0 case within 24 h and in 242 cases, 25 cases, 1 case, and 0 case between 24-72 h, respectively.In the control group, there were zero, once, twice, and ≥3 times of puncture point dressing change in 12 cases, 196 cases, 51 cases, and 11 cases within 24 h and in 21 cases, 209 cases, 37 cases, and 3 cases between 24-72 h, respectively, with significant differences (Z=-18.560, P=0.000;Z=-18.755, P=0.000).Conclusion The hemostasis effect of alginate dressing for puncture point bleeding after ultrasound-guided PICC by MST is satisfactory.

Objective To analyze the distribution of key target sites(KTSs) during initial circumferential pulmonary vein isolation(CPVI) for atrial fibrillation(AF) and during re-ablation.Methods Forty eight cases(30 males,average age 54.3?10.2 years) with recurrent AF were enrolled.AF was paroxysmal in 24 cases and persistent in 24 cases.Re-ablation was performed 37.2?7.4 days after initial CPVI.KTS was defined as the target sites where pulmonary vein potentials(PVPs) delayed,conduction sequence changed,PVPs slowed down or PV isolated during ablation.Circumferential pulmonary vein(PV) lesions were divided eaqually into 8 segments.KTSs were analyzed during initial CPVI and re-ablation.Results One hundred and forty five KTSs were identified during initial CPVI.The mean KTSs per case were 3.02?1.08,compared with 1.58?1.09 during re-ablation,P

Objective To evaluate the electrophysiological mechanism of early recurrence of atrial tachyarrhythmias(ATa) after initial ablation for paroxysmal atrial fibrillation(AF)and the feasibility of early re-ablation.Methods Forteen cases(8 males,average age of 61.8?8.4 years) presented with early recurrent ATa within 1 month after initial ablation were included.Early recurrence was observed after a mean of 4.9?3.7 days post-ablation.During re-ablation,all pulmonary vein(PV) reconnection was re-isolated,and AF induction was applied to map and ablate non-PV triggers.ECG and Holter monitor was applied to evaluate the effect.Results Re-ablation was performed after a mean follow-up of 24.7?5.5 days after the first ablation.PV re-connection was identified in 13 cases(92.9%) and was re-isolated by closing conduction gaps along initial lesion lines.By AF induction,superior vena cava(SVC) originated AF was detected in 3 cases and was terminated by SVC isolation.Upper crista terminalis(CT) foci was found in 1 case which was eliminated by focal ablation.Typical atrial flutter(AFL) in 3 cases and left atrial AFL in 1 case were terminated by linear ablation.At the end of follow-up of 5.8?1.4 months,13 cases were free from ATa recurrence and anti-arrhythmic drugs.Paroxymal ATa was observed in 1 case which could be suppressed by verapamil.Conclusion PV re-connection is the main influencing factor of early recurrence of ATa after initial ablation for paroxysmal AF.Other factors include foci located in SVC and CT.Early re-ablation is feasible and effective.

Objective To analyze the prevalence of complications following catheter ablation for atrial fibrillation and to describe the characteristics of transition of complications.Methods From October 2004 to December 2008,2 260 cases(1 265 males)with atrial fibrillation(AF)were admitted for catheter ablation.AF was paroxysmal in 1 449 cases and chronic in 811 cases.Circumferential pulmonary vein isolation(CPVI)was carried out alone for paroxysmal AF and in combination with fractionated electrograms ablation for chronic AF.Complications were summarized and analyzed by dividing the whole duration into three sections:Year 2004-2006,Year 2007 and Year 2008.Results Complications occurred in 61 cases(2.70%).Cardiac tamponade developed in 11 cases,embolism in 18 cases,pulmonary vein stenosis in 14 cases,and vessel access related complications in 18 cases.In Year 2004-2006,cardiac tamponade occurred in 5 cases,cerebral embolism in 3 cases,mesenteric artery embolism in 1 case,pulmonary vein stenosis in 6 cases,and vessel access related complications in 6 cases.In Year 2007,cardiac tamponade occurred in 4 cases,cerebral embolism in 3 cases,Mesenteric artery embolism in 1 case,pulmonary vein stenosis in 4 cases,and vessel access related complications in 5 cases.In Year 2008,cardiac tamponade occurred in 2 cases,cerebral embolism in 7 cases,mesenteric artery embolism in 3 cases,pulmonary vein stenosis in 4 cases,and vessel access related complications in 7 cases.There was no significant difference in the prevalence of complications among three sections.The prevalence of cardiac tamponade was lower in Year 2008 compared with that in the other two sections,P=0.5.However,the prevalence of embolism was higher in Year 2008 compared with that in the other two the sections,P=0.2.Conclusion It is safe to perform catheter ablation for the treatment of AF.Despite the improvement of technical skills,the prevalence of severe complications such as cardial tamponade,pulmonary vein stenosis or stroke did not decrease.

Purpose To evaluate the clinical and pathological features of extramammary Paget’ s disease ( EMPD) and to investigate the related prognostic factors. Methods The clinical and pathological data of 30 patients with EMPD were reviewed retrospectively. The HE slides in the file were rechecked. Immunohistochemical stains were performed on archival paraffin-embedded sections with En-Vision method in 20 cases. Follow-up data were recorded. The relationship between the clinicopathological parameters and prognosis was statistically analyzed. Results Among the 30 patients, there were 26 males and 4 females, aged from 53 to 88 years with median age 70. Macroscopically, typical presentations of EMPD were eczematoid lesions. Microscopically, Paget’s cells were distributed sin-gly or in groups ( as glandular or nests patterns) within the epidermis. Immunohistochemical stains showed that Paget’ s cells were pos-itive for CK7, and negative for CK5/6 and p63. Follow-up data were available in 23 cases, 8 cases recurred resection, among them, 6 patients had positive resected margin and 4 died. The recurrent rate and mortality between the groups of dermal invasion and no der-mal invasion (P<0. 01 and P<0. 05), the groups of lymphatic metastasis and no lymphatic metastasis (P<0. 01), and the groups of positive and negative resected margin (P<0. 01 and P<0. 05) were statistically different. There were no statistically different with age and extent of lesion (P>0. 05). Conclusions CK7 is a sensitive and specific marker of Paget’s cells. Dermal invasion, lymphatic metastasis and positive resected margin are poor prognostic factors in EMPD.

Objective To explore the feasibility and advantages of early open-heart radical operation on infants and children with Tetralogy of Fallot(TOF) in different ages and to analyze its perioperative outcomes.Methods The clinical data of 390 infants and children with TOF were analyzed, who underwent extracorporeal circulation open-heart surgery from January 2007 to January 2014 at the Department of Cardiovascular Surgery,the Third Affiliated Hospital of Zhengzhou University.The operative age ranged from 3 months to 14 years(mean 3 years).There were 172 infants(＜ 1 year old)and 218 children(≥ 1 year old).Some accompanied abnormalities included atrial septal defect (33 cases),patent ductus arteriosus (17 cases),coronary artery anomalies (8 cases), and multiple ventricular septal defect (5 cases).Results Ten patients died, and the overall mortality during hospital stay was 2.56％.The mortality of the infants group and the children group was 2.32％ (4/172 cases) and 2.75 ％ (6/218 cases), respectively,and there was no significant difference (x2 =0.000, P =1.000).Extracorporeal circulation time was (89.16 ± 74.38) min and (83.14 ± 66.72)min, respectively, aortic clamping time was (59.75 ± 35.20) min and (54.70 ± 38.54)min respectively, operation time were (185.34 ± 168.64)min and (163.35 ± 150.15) min respectively, duration of postoperative ventilation were (57.17 ± 67.46) h and (47.50 ± 58.39) h, respectively, the hospitalization time in the Intensive Care Unit was (5.08 ± 7.93) d and (3.71 ± 5.40) d, respectively, and the postoperative stay averaged (13.82 ± 17.78) d and (9.52 ± 8.74) d respectively in the infants group and the children group;there was no significant differences between 2 groups (t =1.937,1.890, 1.991,1.887,1.951,1.931;P =0.259, 0.713, 0.194, 0.739,0.241,0.308).Conclusions The curative effect of early cardiac surgical treatment on infants with TOF is considerably good with low morbidity and mortality.Early cardiac surgical treatment can avoid delayed development and growth in children, hypoxemic spells,sudden death and some other kind of adverse events.