Objective To assess the therapeutic effect and safety of radiofrequency catheter ablation of atrial fibrillation.Methods We analyzed the clinical data of 47 patients with atrial fibrillation who underwent radiofrequency catheter ablation between March 2013 and January 2008,in the First Affiliated Hospital of Xi'an Jiaotong University.In the average 32 months’follow-up,Holter monitering and echocardiography were reviewed for the left atrial diameter.Results The immediate success rate of catheter ablation for atrial fibrillation was 82.6%.The long-term success rate was 65%,the rate of paroxysmal atrial fibrillation was 69.7%,and the rate of longstanding persistent atrial fibrillation was 42.9%.After ablation,the left atrial diameter were markedly reduced compared with that before treatment [(36.3 ± 4.3 )mm vs .(38.1 ± 5.9 )mm)(P < 0.001 ).The patients with recurrent atrial fibrillation were older than those without recurrence,their left atrial diameter was bigger,and the prevalence rate of hypertension was higher (P <0.05).The average atrial fibrillation load was 14.9% after ablation compared with 46.1% before (P <0.05).Conclusion Radiofrequency catheter ablation is an effective and safe treatment of atrial fibrillation,especially for paroxysmal atrial fibrillation.The left atrial diameter was significantly decreased after radiofrequency catheter ablation compared with that before the ablation.

Objective To reveal the role of serum ACE2/Ang (1-7)in the occurrence of atrial fibrillation (AF)and find new targets for the prevention and treatment of AF by analyzing the correlation between the serum concentration of ACE2/Ang (1-7 )in patients with rheumatic valvular heart disease and the occurrence of AF. Methods We collected the basic clinical information and peripheral venous blood of patients with rheumatic heart valve disease (totally 46 patients,including 24 with AF and 22 with SR).ELISA method was used to detect the serum concentration of ACE2,Ang (1-7)and AngⅡ in the serum samples.Then the differences and correlation between the two groups were analyzed.Results In the AF group ① the diameter of the left atrium was significantly greater than that in the SR group [(60.70±3.08 vs.48.15±2.16)mm,P<0.05];② the serum concentration of AngⅡ was significantly higher than that in the SR group [(45.88±2.87 vs.35.78±1.08)pg/mL, P<0.05],AngⅡ and left atrium diameter were positively correlated (Pearson test,P<0.05);③ the serum concentrations of ACE2 [(7.87±0.74 vs.11.65±0.57)U/L,P<0.05]and Ang (1-7)[(146.05±17.61 vs. 321.71±36.50)pg/mL,P<0.05]were significantly lower than those in the SR group,and negatively correlated with left atrium diameter (Pearson test,P<0.05);④ the serum concentration of Ang (1-7)was negatively correlated with AngⅡ concentration (Pearson test,P<0.05).Conclusion For patients with rheumatic valvular heart disease,ACE2/Ang (1-7 )may play a protective role in the occurrence of AF via antagonizing AngⅡ and inhibiting atrial remodeling.

ABSTRACT:Objective To observe the effects of late Na current (INa‐L ) and rapidly activating delayed rectifier K current (IKr ) on ventricular heterogeneity and frequency dependency by using high resolution voltage sensitive optical mapping technology .Methods The model of 12 isolated hearts was constructed in rabbits . Voltage sensitive dye Di‐4‐ANEPPS were perfused into the isolated hearts by Langendorff method .LED source with the wave length of 532 nm was used to record APD80 and APD50 of the left and right ventricles .Experimental groups were divided into 3 groups by perfusion drugs dofetillide (30 nmol/L) ,dofetillide+ATX‐Ⅱ(1 nmol/L) ,and dofetillide +ATX‐Ⅱ +mexiletine (10μmol/L) .The subjects were intervened by the above drugs in order ,and they were self‐compared before dosing .After each drug administration ,the hearts were stimulated respectively with the BCL of 2 000 ms ,1 000 ms ,500 ms ,and 300 ms .Then we observed the changes of APD80 and APD50 in the left and right ventricles before and after the interventions .Results ① In the control group ,APD80 and APD50 of the right ventricle were longer than those of the left ventricle in response to different stimulation , and the differences increased with the decrease of stimulating frequency .② When BCL was 1000 ms ,APD80 and APD50 of the left and right ventricles were prolonged respectively after administration of dofetillide , but the differences in APD80 and APD50 were insignificant between the left and right ventricles (P>0 .05) .ΔAPD80 of the two ventricles increased significantly with the decrease of stimulating frequency . ③ After administration of ATX‐Ⅱ , when BCL was 1000 ms ,APD80 and APD50 of the left and right ventricles increased significantly compared with those in the control group and dofetillide intervention group (P<0 .05) .And the increase of APD in the left ventricle was greater than that of the right ventricle .ΔAPD80 of the two ventricles increased significantly with the decrease of stimulating frequency .④ After administration of mexiletine ,when BCL was 1000 ms ,APD80 and APD50 of the left and right ventricles reduced significantly compared with those of the primary state (P<0 .05) .APD80 and APD50 of the left and right ventricles reduced significantly compared with those of the control group (P< 0 .05) and ATX‐Ⅱ group (P>0 .05) .The increase of ΔAPD80 of the two ventricles became milder when the stimulating frequency decreased . Conclusion ① IKr blocked by dofetillide did not affect the heterogeneity between the two ventricles , which showed reverse‐frequency dependence . ② In the context of blocking IKr , ATX‐Ⅱ increased the heterogeneity between the left and right ventricles and enhanced the reverse‐frequency dependence .In contrast ,mexiletine ,the blocker of INa‐L ,decreased the heterogeneity between the two ventricles and reverse‐frequency dependence .

A hugh performance luquud chromatographuc ( HPLC) method was extablushed for determunatuon of the content of 7 polycycluc aromatuc hydrocarbons ( PAHs) un soul and earthworm samples based on accelerated solvent extractuon ( ASE) for extractuon and solud phase extractuon ( SPE) column for sample purufucatuon. In thus method, the samples were furst extracted by the muxed solutuon of n-hexane and acetone extractuon (4∶1, V/V) , and then purufued by SPE column ( suluca gel column for soul sample purufucatuon and Al2 O3-suluca gel column for earthworm sample purufucatuon ) , eluted by 10 mL of elutuon of n-hexane and duchloromethane (9∶1, V/V), and evaporated to dryness wuth rotary evaporator. After that, the pretreated samples were re-dussolved wuth acetonutrule to a constant volume, followed by a fultratuon wuth a 0. 22-μm organuc fulter membrane for the quantufucatuon by HPLC. The recoverues of the method for 7 PAHs were 83. 5%-110. 2% un soul samples and 81. 2%-97. 1% un earthworm samples. The detectuon lumuts of the method for 7 PAHs were 0. 15-0. 85 μg/kg. The method had good reproducubuluty and met the qualuty control requurements of sample analysus.

Objective To explore the efficacy of postoperative adjuvant transarterial chemoembolization (TACE) on the survival of patients after radical resection for hepatocellular carcinoma (HCC).Methods Between March 2007 and March 2010,229 HCC patients who underwent radical resection were retrospectively studied.Patients who underwent resection alone were used as the control group (138 patients) while those who received post-operative adjuvant TACE was used as the interventional group.In order to balance the covariates between the groups,a matched comparison of the patients was done by selecting patients using the propensity score matching (PSM).Then,the efficacy of adjuvant TACE upon survival was evaluated.Results After PSM,we obtained 67 pairs of patients.The survival time for the interventional and the control groups were 32.1 months and 28.3 months respectively.The survival rates at year 1,2,3 post-resection were 94.0％,84.8％ and 75.3％ in the interventional group versus 83.6％,69.9％ and 61.5％ in the control group respectively.There were no significant differences between the two groups (P =0.062).Univariate analysis showed the serum level of AFP,tumor size,number of tumor,BCLC stage,and adjuvant TACE significantly affected the survival of HCC patients who received radical resection (P ＜0.05).Cox model suggested that AFP≥400 μg/L and tumor diameter ＞ 5 cm were independent risk factors of survival for HCC patients who received radical resection (P ＜ 0.05).Conclusion Postoperative adjuvant TACE had no positive effect on survival,and AFP level ≥ 400 μg/L and tumor size ＞5 cm were independent risk factors of survival of HCC patients who received radical resection.

Objective: The effect of thymosin alpha 1 (Tα1) on patients with hepatocellular carcinoma (HCC) after radical hepatectomy was assessed. Methods: A total of 558 HCC patients treated by radical hepatectomy were retrospectively collected. Patients in the treatment group (n=146) received postoperative Tα1 therapy, whereas patients in the control group (n=412) did not. Propensity scale matching was conducted to improve the balance between the two groups. Changes in liver function, recurrence-free survival rates, and overall survival rates were compared between the two groups. Results: Postoperative liver function (i.e., TBIL, ALB, ALT, and PT) in the treatment group was significantly better than that in the control group (P<0.05). The one-, two-, and three-year recurrence-free survival rates and overall survival rates in the treatment group were significantly higher than those in the control group (P=0.019 and P=0.011, respectively). Conclusion:Postoperative Tα1 therapy can improve postoperative liver function, thus significantly prolonging recurrence-free survival and overall survival.

Objective To assess the effectiveness and safety of radiofrequency catheter ablation for idiopathic ventricular arrhythmia in patients with idiopathic ventricular arrhythmia after radiofrequency catheter ablation treated in the First Affiliated Hospital of Xi’an Jiaotong University based on the follow-up and retrospective analysis.Methods We retrospectively analyzed the clinical data of 63 patients with idiopathic ventricular arrhythmia who underwent radiofrequency catheter ablation during January 2008 and March 2014 in the First Affiliated Hospital of Xi’an Jiaotong University.In the follow-up,Holter moniterings were reviewed to evaluate ventricular arrhythmia and echocardiography to assess the ejection fractions and left ventricular end-diastolic diameters.Results The immediate success rate of catheter ablation for the treatment of idiopathic ventricular arrhythmia was 89.29% and the long-term success was 82.14%.The ejection fractions and left ventricular end-diastolic diameters were not obviously improved after radiofrequency ablation (P > 0.05 ). The ventricular premature contractions were significantly reduced after radiofrequency ablation (P <0.05).In postoperative care, one case was found with ruptured sinus valsalva tumor and another patient was found with the complication of hematoma in femoral artery puncture.Conclusion Radiofrequency ablation for idiopathic ventricular arrhythmia is safe and effective.

Background:The evaluation system for predicting prognosis in patients with liver cirrhosis includes Child-Pugh,model for end-stage liver disease (MELD) and its derivative system,which provides important guiding value for evaluating the prognosis.However,its value still needs to be verified by further clinical studies.Aims:To investigate the predictive value of Child-Pugh,MELD,MELD-Na and iMELD score in assessing 3-month and 1-year survival rates in patients with hepatitis B cirrhosis.Methods:A total of 236 patients with hepatitis B cirrhosis from January 2012 to December 2016 at Fukang Hospital were enrolled.The 3-month and 1-year survival rates of patients with hepatitis B cirrhosis were determined,and Child-Pugh,MELD,MELD-Na and iMELD score were calculated.Area under ROC curve (AUC) was used to evaluate the accuracy of Child-Pugh,MELD,MELD-Na and iMELD score for predicting 3-month and 1-year survival rates.Results:Of the 236 patients with hepatitis B cirrhosis,43 died within 3 months,and 71 died within 1 year.The causes of death were upper gastrointestinal bleeding,hepatic encephalopathy,hepatorenal syndrome,spontaneous peritonitis and infection.Child-Pugh,MELD,MELD-Na and iMELD score in 3-months and 1-year survival group were significantly decreased than those in death group (P ＜ 0.05 or 0.01).AUC of Child-Pugh,MELD,MELD-Na and iMELD score for predicting 3-month survival were 0.791,0.818,0.853 and 0.897,respectively,and the difference among the four groups was significant (P ＜ 0.05).AUC of Child-Pugh,MELD,MELD-Na and iMELD score for predicting 1-year survival were 0.772,0.832,0.861 and 0.906,respectively,and the difference among the four groups was significant (P ＜ 0.05).The accuracy of Child-Pugh,MELD,MELD-Na and iMELD score for predicting 3-month and 1-year survival were 70.1％,79.8％,86.2％ and 89.3％,respectively.Conclusions:The accuracy of Child-Pugh,MELD,MELD-Na and iMELD score for assessing 3-month and 1-year survival rates of patients with hepatitis B cirrhosis is high,and is worthy to be applied in clinical practice.

Objective: To investigate the risk factors of poor graft function (PGF) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for severe aplastic anemia (SAA) . Methods: Clinical data from 111 SAA patients who received allo-HSCT were analyzed retrospectively. Factors including age, gender, interval to transplantation, the level of serum ferritin before transplantation were analyzed by Cox multivariate regression analysis. Results: Among the 111 patients who underwent allo-HSCT, 16 developed PGF (14.4%) . Multivariate analysis showed donor type (HR=2.656, 95%CI 1.204-5.858, P= 0.016) and the level of serum ferritin before tansplantation (HR=3.170, 95%CI 1.400-7.180, P=0.006) were significant risk factors for PGF. Conclusion Unrelated donor transplantation and the high level of serum ferritin before transplantation are risk factors for PGF.