Objective To compare efficacy of procedure for prolapse and hemorrhoids (PPH) and rubber band ligation (RBL) in treatment of Ⅲ degree internal hemorrhoids.Methods One hundred patients with Ⅲ degree internal hemorrhoids were randomly divided into two groups and received PPH (42 cases) and RBL (58 cases) respectively.At once and after two weeks and two and six months the efficacy were compared.Results PPH and RBL were equally effective in controlling symptomatic prohpse (P>0.05),but RBL was associated with an increased incidence of recurrent bleeding (PPH 8/42 vs RBL 30/58,P<0.05);there was no difference in scores of patient satisfaction (P>0.05); PPH was associated with increased pain and analgesia usage at both at once and 2-week follow-up (P<0.05);the rate of complications in PPH was higber than in RBL (7/42 vs 0/58,P<0.05).Conclusion RBL can be used as treatment of first-line treatment of Ⅲ degree internal hemorrhoids.

OBJECTIVEThis study investigated the effect of catheter-based renal sympathetic denervation (RDN) in pigs with rapid pacing induced heart failure.

METHODSHeart failure was induced by rapid right ventricular pacing in 12 pigs and pigs were randomly divided into RDN group (n = 6): pacing+RDN at 7 days post pacing; control group (n = 6): pacing only. Echocardiography examination (LVEF, LVEDD and LVESD) was performed before pacing and at 1 and 2 weeks post pacing. Serum biochemical markers including renin, aldosterone and creatinine were also measured at baseline, 1 and 2 weeks after pacing. Repeated renal artery angiography was performed at 1 week after RDN. All pigs were sacrificed to examine the heart and renal pathology and renal artery sympathetic nerve staining at 2 weeks post pacing.

RESULTSLVEF decreased 1 week after rapid pacing from (60.5 ± 6.0)% to (35.3 ± 9.8)%. LVEF was significantly higher [(42.8 ± 5.9) % vs. (33.4 ± 9.7)%, P = 0.001 8] while LVESD was significantly lower [(28.4 ± 3.7) mm vs. (33.0 ± 2.0) mm, P = 0.001 6] in the RDN group than in the control group at 2 weeks post pacing. At 2 weeks after pacing, plasma concentrations of renin and aldosterone were significantly lower in RDN group compared to the control group (all P < 0.05) . Kidney function and blood pressure were comparable between the two groups at 2 weeks post pacing. There were no signs of renal damages such as renal artery stenosis, dissection and thrombus in all pigs after 2 weeks pacing. Sympathetic neurons of adventitia were injured in RND group.

CONCLUSIONRDN could significantly improve cardiac function and attenuate left ventricular remodeling via inhibiting renin-angiotensin-aldosterone system in this pacing induced pig heart failure model.

Animals ; Cardiac Pacing, Artificial ; adverse effects ; Catheter Ablation ; methods ; Disease Models, Animal ; Female ; Heart Failure ; etiology ; surgery ; Kidney ; innervation ; Male ; Swine ; Sympathectomy ; methods