Objective To investigate the possible mechanism and re-ablation of recurrent atrial arrhythmias after atrial fibrillation(AF) ablation by utilizing the Carto system and double LASSO technique.Methods A total of 77 AF patients were enrolled and among them,56 with paroxysmal AF and 21 with persistent AF.Eight-F Swartz long sheaths were positioned in the left atrium by transseptal technique.One to two LASSO catheters were placed in the ipsilateral pulmonary veins(PV).The anatomy of the left atrium and PV was established using the Carto system.PV selective venography was carried out to identify the PV ostium.Continuous circular lesions(CCL) were made at the left atrium at 0.5 to 1.0 cm outside the PV ostium.Irrigated radiofrequecy energy was delivered in all the patients.The end point of the CCL was defined as absence of all PV spikes documented with LASSO catheters within the ipsilateral PVs.Results A repeat ablation was performed in 14 patients who experienced highly symptomatic atrial tachyarrhythmia.During the repeat procedures,conduction gaps in the previous CCL were found in 13 out of the 14 patients,and a typical atrial flutter was found in the other patient which was eliminated by ablation of the tricuspid isthmus.During the second procedure,pulmonary vein tachycardia was demonstrated in 7 patients.The pulmonary vein tachycardia activated the LA via the conduction gaps.All conduction gaps were successfully ablated by irrigated RF applications.After the second procedure,12 out of the 14 patients were free of AF during 3 to 30 months of follow-up.Conclusion Continuous circular lesions(CCL) in the left atrium utilizing the Carto system and double LASSO technique had a high success.In patients with recurrent atrial tachyarrhythmia after CCLs,recovered PV conduction is a main cause for the recurrence.

AIM: To evaluate the significance of cytokeratin19 (CK19) expression in diagnosing micrometastases in lymph nodes in patients with laryngeal carcinoma. METHODS: Forty cases of laryngeal carcinoma together with 163 lymph nodes were studied by the staining with hematoxylin and eosin(HE)and immunostaining with antibody against cytokeratin 19 (CK19) on histological sections of the primary tumor and regional lymph nodes. RESULTS: In all cases, CK19 was positively expressed in the primary tumor. Among 163 lymph nodes, metastases were confirmed by HE in 23 lymph nodes, and in 42 lymph nodes staining with immunohistochemistry, micrometastases were found in 19 lymph nodes. Micrometastases in the lymphonodes were significantly related to the T staging. CONCLUSION: Immunohistochemical staining is a valuable method for the detection of node micrometastases in patients with laryngeal carcinoma.

Based on the survey of the learning preference of Kunming Medical College students,we analyze relationship between students’learning style and personalities.In order to match different learning style,teachers must find some strategies in their English teaching.

According to an activity that create a model public health department , to strengthen internal man-agement, standardize the word flow, strive to achieve public interest, longterm, specification system and science of the public heath work , and strengthen the sense of mission and responsibility which general hospital of heath technical personnel should have .

It is proposed that following peripheral nerve injury abnormal sprouting of Aβ fiber primary afferent neurons in the spinal cord contributes to the allodynia that often occurs with such injury. The present investigation is to determine whether this sprouting is reversal after compression of peripheral nerve was relieved. In a rat model of neuropathic pain made by rat sciatic nerve compression,chorela toxin B subunit conjugated horseradish peroxidase (CB-HRP) was used to trace the termination of Afiber primary afferents and sections were reacted for using tetramethylbenzidine (TMB) as the chromagen. We demonstrated that the compression to the sciatic nerve also results in hyperalgesia and novel transganglionic CB-HRP staining in laminae Ⅱ, and this sprouting can not be reversed by decompression. This structural reorganization in central nervous system and its irreversible character may contribute to the development and maintenance of neuropathic pain.

Objective To discuss the application of scenario simulation technique in emergency rescue training of hospital grave pubic health events.Methods Based on the simulate function in the scenario simulation technique,we designed the emergency drill script of hospital grave pubic health events,set the simulate scene,communication system and indicators measuring emergency rescue,drilled and trained the hospital rescue crews,compared with the rescue crews trained in routine method.40 nurses were selected before or after the application of scenario simulation technique separately.Results The qualified rate of indicators such as communication and medical rescue system that were trained by scenario simulation method was higher than the rescue crews trained in routine method.Conclusions Scenario simulation technique would improve the training effect of emergency rescue in hospital grave pubic health events.

ObjectiveTo evaluate the clinical value of the rate of fetal urine production rate (UPR) in fetus with twin-to-twin transfusion syndrome(TTTS).Methods 22 continuative normal monochorionic diamniotic(MCDA) twin fetuses were selected as controll group.Eight fetuses with TTTS were selected as disease group,and UPR was measured by three-dimensional ultrasound virtual organ computer-aided analysis (VOCAL) and the rate of UPR in twin was calculated.Results1)The rate of UPR of twin fetuses in MCDA did not vary significantly throughout pregnancy (0.97 ± 0.28).The correlation coefficient between the rate of UPR and gestational age was 0.13,without obvious correlation.2)The rate of UPR-recipient/UPR-donor in TTTS fetuses increased significantly compared with MCDA twin fetus (7.83 ± 2.61,t =6.19,P ＜0.05).ConclusionsThe rate of UPR may be an important index in the assessment of TTTS.

Objective To discuss the short-term effect of Sextant system fixation for thoracolumbar fractures without neurological deficit in the field comprehensive operation rescue shelter.Methods There were 32 patients with thoracolumbar fractures without neurological deficit which rescued by our hospital.Those patients included 18 males and 14 females, with average age of (25.54±2.86) years old.All patients were undergoing internal fixation with Sextant system in the field comprehensive operation rescue shelter.Clinical and surgical evaluation including surgery time,intraoperative blood loss,postoperative ambulation time and wound healing time were observed.Functional outcomes of pre-operation and postoperation 3-days were evaluated by visual analog scale(VAS) and Oswestry disability index(ODI).Cobb angle and front height of fracture vertebral body were compared between pre-operation and postoperation 3-days.Results The operation time was (96.55±14.15)minutes, intraoperative blood loss was (45.25±3.55)mL, postoperative ambulation time was (1.20±0.61)days.There were statistical differences in terms of Cobb angle,front height of fracture vertebral body,VAS and ODI between pre-operation and postoperation 3 days.Conclusion The Sextant system fixation in the field comprehensive operation rescue shelter is a timely,safe and effective method for thoracolumbar fractures without neurological deficit,which is deserved to utilize at the scene when war or disaster urgency treatment.

Objective:To explore the effect of tectorigenin on myocardial fibrosis(MF) in the rats and clarify the related mechanism,and to provide reference for its clinical application. Methods:Sixty Wistar rats were randomly divided into normal control group,model group,positive drug (capropril) control group, and low,middle,high doses of tectorigenin groups(n=10).Except normal control group, the rats in other groups were used to construct MF models by subcutaneous injection of 5 mg·kg -1·d -1 isoproterenol (Iso) for 7 d.The rats in tectorigenin groups and captopril group were intragastricly administrated with different doses of tectorigenin (25,50,100 mg·kg-1·d-1)and captopril(10 mg·kg -1·d -1) from the second day after modeling for consecutive 28 d.Bl-420E+ biological function experiment system was used to detect the heart function;Heart mass index (HMI) and left ventricular mass index (LVMI) were measured after experiment.UV detection was used to measure the levels of malondialdehyde (MDA) and the activities of superoxide dismutase (SOD) in myocardial tissue.Microplate reader was used to measure the activities of lactic dehydrogenase(LDH) and creatine kinase(CK) and the levels of nitric oxide (NO)in serum.ELISA were used to detect the levels of collagen typeⅠ(ColⅠ) and collagen type Ⅲ (Col Ⅲ) in myocardium tissue of the rats.The pathological changes of myocardium tissue of the rats in various groups were observed by HE staining.Results:Compared with normal control group,the HR of rats in model groups was increased,and the left ventricular systolic pressure (LVSP) was decreased(P<0.01);the HMI and LVMI were increased(P<0.05),the levels of MDA in left ventricular myocardial tissue was increased(P<0.01),and the activity of SOD was decreased,the levels of serum ColⅠ,Col Ⅲ and the activities of LDH , CK were also increased(P<0.01);the level of NO in serum was decreased(P<0.01).Compared with model groups, the HR were decreased,LVSP were increased, and HMI and LVMI of the rats in different doses of tectorigenin groups were decreased in a dose-dependent manner;the levels of MDA were reduced;the activities of SOD were increased in myocardium tissue,and the CK activities and the ColⅠ and ColⅢ levels were decreased(P<0.05 or P<0.01);the LDH activities in middle and high doses of tectorgenin groups were decreased(P<0.01);and the levels of NO in serum in different doses of tectorigenin groups were significantly increased(P<0.05 or P<0.01) .Conclusion:Tectorigenin could inhibit the MF induced by Iso in the rats, and its mechanism may be related to antioxidation,scavenging free radical and inhibition of collagen synthesis.

Objective To discuss the recent clinical efficacy of percataneous pedicle screw internal fixation for thoracolumbar fractures without neurological deficit in the new field comprehensive operation rescue shelter at the war or disaster treatment place.Methods Retrospectively analyzed the clinical data of 29 patients with thoracolumbar fractures who were rescued by our hospital.Those patients included 18 males and 11 females,with the average age of (31.54±2.86) years old.All these patients underwent percutaneous pedicle screw internal fixation in the new field comprehensive operation rescue shelter.Clinical and surgical evaluation including surgery time,blood loses,exercise time after operation and complications.Functional outcomes of pre-operation and post-operation were evaluated by visual analog scale (VAS) and Oswestry disability index (ODI).Cobb's angle and fracture vertebral body front height were compared before and after operation as well.Results All these patients were all successfully completed operation in the field comprehensive operation rescue shelter,and the general post-operation condition was well.The operation time was (86.55±16.15)min,the blood loss was (42.35±6.55)mL,the exercise time after operation was (1.20±0.61) days.There was no complications after operation, and pain of thoracolumbar after operation was obviously alleviated.There was statistical differences in terms of Cobb's angle,fracture vertebral body front height,VAS score and ODI score between pre-operation and post-operation (P<0.05).Conclusion The percataneous pedicle screw internal fixation in the new field comprehensive operation rescue shelter is a quite effective method for thoracolumbar fractures without neurological deficit, and this method is worthy of promoting at the scene when war or disaster urgency treatment.