Objective To study the feasibility, safety, effectiveness of left atrial circumferential ablation of pulmonary veins for atrial fibrillation(Af) guided by EnsiteNavX mapping system. Methods Seventeen patients with paroxysmal or persistent Af were included. Real time 3-dimensional left artial (LA) and pulmonary veins (PVs) maps were constructed through EnsiteNavX mapping system. Pulmonary veins isolation was performed by encircle the left and right sides PVs at adistance of 1 to 2 cm away from the ostium of PVs. Results Seventeen patients were all reached the endpoint of abalation completely. The mean procedure time and fluoroscopy time were (226.1 ± 36.2) minutes and (41.3 ± 12.8) minutes. Mean radiofrequency energy delivery time was (61.9 ±15.4) minutes. Recur-rence of Af occurred in two patients, one was repeat ablation succnssfully. During 3 ～ 36 months followup, fourteen patients (82.3%) were free of Af without any antiarrhythmic drugs. Recurrence of Af occurred in three(11.7%) patients treated with amiodarone. No complications occurred during the procedure and the following up. Conclusion Left atrial circumferential isolation of pulmonary veins for Af guided by Ensite NavX mapping system was effective and salty.

BACKGROUND:Many studies have shown that different nanostructures produce different influences on cellbioactivity, but the nanonetwork structure is not reported yet. OBJECTIVE:To study the influence of the nanonetwork topography on the bioactivity of bone marrow mesenchymal stem cels. METHODS:The nanonetwork topography was fabricated on biomedical titanium surface by alkali-heat treatment, and pure titanium served as control group. Bone marrow mesenchymal stem cels were co-cultured with the above two types of samples. cellmorphology and cytoskeleton were observed using scanning electron microscope and immunofluorescence method. The celladhesion, proliferation and osteogenic differentiation were detected by measurement of absorbance values at different culture time. RESULTS AND CONCLUSION: The nanonetwork topography had significant advantage on the number of adherent cels at 30, 60 and 120 minutes of co-culture. The cellproliferation was significantly accelerated by the nanonetwork topography at days 1, 3, 5 of co-culture, and the absorbance values in the nanonetwork group were significantly higher than those in the pure titanium group (P < 0.05). The alkaline phosphatase activity in the nanonetwork group was also significantly higher than that in the pure titanium group at 14 days of osteogenic induction (P < 0.05). The cellshape and cytoskeleton on the nanonetwork surface were better than those on the titanium surface. These findings indicate that the nanonetwork topography has better effects on cellbioactivity compared with pure titanium.

Objective To investigate the effects of Bushen Yangxue decoction combined with hormone replacement effects on sex hormone level and symptom score in patients with premature ovarian failure .Methods 112 patients with premature ovarian failure from March 2014 to November 2015 in Zhejiang Tongde Hospital were divided into two groups with 56 cases in each group.The control group was treated with hormone replacement therapy , the combined group was treated with Bushen Yangxue decoction on the basis of the control group.The curative effect was compared between the two groups, the sex hormone, traditional Chinese medicine symptoms score, QOL score and endometrial thickness were compared between the two groups before treatment, at the end of treatment and 3 months after discontinuation.Results At the end of the treatment, there was no significant difference in total effective rate between the combined group (91.07%) and the control group (85.71%).At the end of the treatment, the scores of TCM symptoms and QOL scores were significantly lower in the two groups, and the endometrial thickness was significantly higher (P<0.05), compared with the control group at the end of treatment,the combined group TCM symptom score was lower(P<0.05), QOL score and endometrial thickness had no significant difference, after stopping drug for three months, there was no significant difference in the levels of TCM score, QOL score, endometrial thickness between the two groups.In the control group TCM score, QOL score were significantly higher, and significantly higher than the levels of the same period of the combined group, endometrial thickness was significantly lower, and the level of the same period was significantly lower than that of the combined group(P<0.05), at the end of treatment, the two groups of FSH, LH significantly decreased, E2 significantly increased(P <0.05), there was no significant difference between the two groups, after stopping drug for three months, there was no significant difference in the levels of E2, LH, FSH.The control group, LH and FSH levels were lower and E2 levels were higher in the control group at three months after discontinuation compared with those at the end of treatment (P<0.05).Compared with the control group, LH and FSH levels were lower and E2 levels were higher in the combined group after 3 months of drug withdrawal (P<0.05).Conclusion Bushen Yangxue decoction combined with hormone substitution method can significantly increase in patients with premature ovarian failure of sex hormone level, improve the recovery of patients with ovarian function.

Objective To investigate the clinical effect of intra-articular injection of sodium hyaluronate combined with psychological intervention in the treatment of knee osteoarthritis.MethodsA total of 90 patients with knee osteoarthritis treated in our hospital from June 2015 to June 2016 were selected as the research object, according to the different treatment methods, the patients were divided into two groups,with 45 cases in each group.The patients in the control group were treated with conventional treatment, while the observation group was treated with conventional therapy and intra-articular injection of sodium hyaluronate.The experimental data of the two groups were compared.ResultsAfter treatment, the changes of knee joint pain score, joint effusion and joint mobility in the observation group is better than those in the control group.The change of knee function score in the observation group was better than that in the control group.The clinical therapeutic effect of the observation group (95.6%) is better than that of the control group (75.6%);There was significant difference between the two groups (P<0.05);There were no serious adverse reactions in the two groups of patients receiving treatment,and there was no significant difference between the two groups.ConclusionThe clinical effect of intra-articular injection of sodium hyaluronate combined with psychological intervention in the treatment of knee osteoarthritis is good, which is worthy of clinical application.

BACKGROUND:Autologous cartilage has a poor self-repair effect due to low chondrocyte density, low metabolism rate and no blood supply.
OBJECTIVE:To summarize the recent study about tissue engineering techniques and surgical treatment for cartilage injury.
METHODS:A computer-based online retrieval of PubMed database was performed by the first author for articles published between January 1992 and December 2013. The key words are“articular cartilage, injury, tissue engineering, repair”in English. According to the inclusion and exclusion criteria, 61 literatures were included into the final analysis.
RESULTS and CONCLUSION:The current clinical treatment of articular cartilage injury includes joint debridement, mosaicplasty, perichondrium transplantation and autologous chondrocyte implantation. However, their long-term result is unsatisfactory. One reason for limited clinical success is that new cartilage can be formed at the site of a defect, and the repaired tissue canot compare with the autologous cartilage in mechanical property. Tissue engineering technique is stil a hot topic in recent years, because it can potential y induce autologous cartilage formation. Through endogenous or ectogeneous seed cells and inducting factor and nutrient factors, tissue engineering technique can be applied to induce the self-repair of articular cartilage, thus regenerating into hyalinc cartilage with the similar even same biological property. How to simplify the treatment protocols and reduce treatment cost is the key to promote cartilage repair.

Objective The mononuclear cells(MNCs) were cultivated and expanded into mesenchymal stem cells(MSCs) from human umbilical cord blood,and the purpose of this study was to explore the biological characteristics and induced differentiation ability in vitro.Methods Human umbilical cord blood samples were obtained and the mononuclear cells were isolated from it,then inoculated the MNCs into 25-mm culture flasks containing DMEM/F12 medium.The morphology was observed under microscope.Nissl body staining was used,The passage 2,4,7 of the expanded MSCs were induced to differentiate to neuron-like cells.The expressions of nestin and neuron-specific enolase (NSE) on the treated cells were detected by immunocytochemical method.Results Nissl body staining was positive;Nestin expression was found in(51.2?3.2)% of the second,(34.6?2.7)% of the fifth,(11.3?3.3)% of the seventh passage of MSCs;NSE expression was found in(11.4?2.3)% of the second,(21.78?3.1)% of the fifth,(40.7?3.4)% of the seventh passage of MSCs.Conclusion Cord bloodMSCs possess some features of neural stem cells,and have the capacity to differentiate into neuron-like cells under proper conditions.

Objective To explore the clinical pathological data of the elderly patients with paroxysmal supraventricular tachycardia(PSVT) and the timing of the radiofrequency ablation treatment for PSVT and its clinical efficacy.Methods The clinical pathological data of 45 elderly patients with PSVT for radiofrequency ablation were retrospectivly analyzed,and the information of cardiovascular and cerebrovascular diseases,the duration of PSVT and frequency of attacks,the reason of patients had to accept radiofrequency catheter ablation,the treatment effective of electrophysiological study and radiofrequency ablation were recorded.Results The duration and frequency of attacks with PSVT were positively related with pathogenesis in the elderly patients.Elderly PSVT patients with severe cardiovascular disease accounted for 28.89％.The first radiofrequency ablation treatment success rate was 100％ in this research and the recurrence rate was 4.4％.Conclusion It is recommended that elderly PSVT patients early access to the radiofrequency ablation.

Objective Through the correlation study of fibroblast growth factor 23 (FGF-23) and chronic heart failure to investigate the pathogenesis of chronic heart failure and provide a new method for chronic heart failure diagnosis.Methods One hundred and twenty-eight chronic heart failure patients (chronic heart failure group) were involved in this study.According to the level of left ventricular ejection fraction (LVEF),they were divided into LVEF slightly lowing group (LVEF 40％-50％,50 patients),LVEF moderately lowing group (LVEF 30％-39％,35 patients),LVEF severely lowing group (LVEF ＜30％,43 patients).Fifty healthy people was as control group.The level of FGF-23,parathyroid hormone (PTH),creatinine (Cr),urea nitrogen (BUN),blood calcium,blood phosphorus,N-terminal pro-B-type natriuretic peptide (NT-proBNP) were detected.The patients in two groups were performed color Doppler ultrasonography.Results The level of FGF-23,blood phosphorus,PTH,left ventricular mass index (LVMI),NT-proBNP in chronic heart failure group were significantly higher than those in control group [68.44(55.85-94.73) ng/L,34.18(30.57-38.87) ng/L,(1.13 ± 0.13) mmol/L vs.(1.02± 0.12) mmol/L,(15.51 ± 3.99) ng/L vs.(9.97 ± 0.89) ng/L,(112.27 ± 52.02) g/m2 vs.(71.37 ± 12.95) g/m2,(6 265.3 ± 15 991.6) ng/L vs.(76.12 ± 51.80) ng/L](P ＜ 0.01).The level of blood calcium,glomerular filtration rate (GFR) in chronic heart failure group were significantly lower than those in control group [(2.28 ±0.16) mmol/L vs.(2.48 ±0.13) mmol/L,(78.28 ± 14.20) ml/ (min ·1.73 m2) vs.(85.03 ± 14.44)ml/ (min·1.73 m2)] (P ＜ 0.01).Spearman correlation analysis showed that FGF-23 had positive correlation with age (r =0.256,P ＜0.01),blood phosphorus (r =0.326,P ＜0.01),PTH (r =0.584,P ＜0.01),NT-proBNP (r =0.799,P ＜ 0.01),LVMI (r =0.540,P ＜ 0.01),and had negative correlation with blood calcium (r =-0.308,P ＜ 0.01),GFR(r =-0.527,P ＜ 0.01).The level of FGF-23 was increased when LVEF reduced.Conclusions It has significant correlation between the level of FGF-23 and the degree of chronic heart failure.It suggests that the level of FGF-23 can evaluate the myocardial systolic function and ventricular remodeling.

Objective To investigate the effects of different pacing sites of right ventricle on serum N terminal Pro brain natriuretic peptide (NT-ProBNP) and left ventricular systolic function.Methods A total of 76 patients with an implanted DDD pacemaker were randomly divided into right ventricular septal pacing group (RVSP group,n=40) and right ventricular apex pacing group (RVAP group,n=36) according to the ventricular leads position.Serum NT-proBNP level,left ventricular end diastolic dimension(LVEDD)and left ventricular ejection fraction(LVEF)were analyzed before and 6 months after operation in the two groups.Results There was no difference in serum NT-proBNP level between the two groups before operation,but the serum NT-proBNP level increased in both groups 6 months after operation,and it was higher in RVAP group than in RVSP group (P＜0.05).There were no significant differences in LVEDD and LVEF in RVSP group before and after implantation (P＞0.05).Compared with pre-implantation,LVEDD was increased and LVEF was decreased in RVAP group 6 months after implantation (both P＜0.05).Linear correlation analysis showed that serum NT-proBNP level was negatively correlated to LVEF (2γ=-0.76,P＜0.05).Conclusions Compared with RVAP,RVSP can keep the normal sequence of electrical activity and exert less adverse effects on left ventricular systolic function.Therefore,RVS is an ideal pacing location.

Objective To explore the transfection efficiency of primary lymphocytes from human peripheral blood by different methods to acquire the method with higher transfection efficiency.Methods Mononuclear cells from human peripheral blood were isolated using Ficoll-Hypaque.Cell viability was detected by Trypan blue staining.Suspending lymphocytes were sucked out and were incubated in 24-well plate after cultured in 6-well plate for 2 h.Activated lymphocytes were transfected by electroporation with plasmid(PEGFP-N1).Resting or activated lymphocytes were transfected by lentivirus vector(LVGFP) single infection or repeated infection,respectively.Green fluorescence protein (GFP) was detected under the fluorescence microscopy and percentage of positive cells was checked by flow cytometry at different time points after infection.At the same time,the effectiveness of lentivirus infection was compared under different conditions.Results Purity of mononuclear cells isolated by Ficoll-Hypaque was 95 ％ and its viability was over 95 ％.The percentage of lymphocytes obtained with a uniform shape was 90 ％-95 ％.Scattered fluorescence was observed by electroporation under the conditions of voltage 2 100 V,pulse width 10 ms,pulse number 1 for lymphocyte,while fluorescent became weaker over time and no green fluorescent was observed after transfection for 72 h.After resting lymphocytes were infected once for 48 h by lentivirus vector,green fluorescent was not found and positive cells were less than 1％.1％-5 ％ of activated lymphocytes could express GFP after single lentivirus infection and the expression levels were enhanced with concentration increasing,while 5 ％-10 ％ of activated lymphocytes showed strong green fluorescent by repeated lentivirus infection.In contrast with electroporation,the fluorescent with lentivirus infection was stronger over time.Conclusion Repeated lentivirus infection could efficiently transfect exogenous genes into activated lymphocytes for stable expression.