Objective To investigate the mechanisms of right atrial tachycardia(AT) occurring after atriotomy of structural heart disease under the guidance of image integration system(CartoMerge system) and explore the efficacy of catheter ablation by using the aboved technique.Methods From January 2005 to December 2006,forty consecutive drug-refractory patients presenting with AT underwent complete electroanatomic mapping of spontaneously occurring and inducible right ATs.The ablation strategy was to avoid visible anatomic anomaly under the guidance of image integration system and to transect the isthmus,usually targeting the narrowest portion of the isthmus.Patients were followed up on an outpatient basis with clinical evaluation and 24-hour Holter recordings being performed at three months,six months,and afterwards on a yearly basis.Results Three main tachycardia mechanisms were identified: single-loop macroreentrant atrial tachycardia(MAT)(n=36),double-loop MAT(n=16),and focal AT(n=4).In most MATs,critical isthmus areas were identified most frequently the cavotricuspid isthmus(CTI)(n=35) and the surgical incision isthmus(n=36).Surgical incision causing obvious morphological anomalies including scar-like anomaly,pouch-like anomaly,and node-like anomaly could be visible by image integration technique in 12 patients,which had the electrophysiological characteristics of a surgical incision(a CDP or scar).A mean number of 19.5?10.1 radiofrequency(RF) applications were delivered to terminate the circuit.During a follow-up of 18?10 months the RF ablation was acutely successful in all patients.Eight patients(20%) had an early recurrence of MAT and needed an additional ablation procedure.Conclusion Image integration system not only allows reconstruction of AT mechanisms,but also represents an advance in the accurate localization and ablation of the arrhythmogenic substrate of postsurgical AT.Three-dimensional MR/CT images of RA can be successfully extracted and registered to anatomically guide catheter ablation in RA.The display of real and detailed anatomic information during the procedure enables tailored RF ablation to individual distorted anatomy related with surgical incision.

Intracytoplasmic sperm injection,which combined with in vitro fertilization and micromanipulation techniques,has been applied to research the molecular mechanisms of fertilization,and produce the sexing livestock and transgenic animals.The research advances in porcine intracytoplasmic sperm injection,including in vitro maturation and pretreatment of oocytes,selection and treatment of spermatozoon,artificial activation of injected oocytes after injection,and improvement of the operation technique were reviewed.

The challenge of the emergence of drug-resistant influenza strains, which is caused by wide spread utilization of direct-acting antivirals (DAAs), accelerates the research and exploration towards host targeted agents. In contrast to DAAs targeting viral replication components, host targeted agents, which regulate host factors and pathways linked to viral replication, can interfere the replication of influenza. Additionally, the innate immune system is activated by influenza during the early stage of infection, so manipulating the innate immune response may prevent the viral infection. However, the excessive inflammatory response induced at the late phase of influenza infection would lead to severe tissue injures. Thus, it is very important to explore drugs with anti-inflammatory actions to suppress these immune imbalances and tissue injures. Here we overview the current progresses about host targets related to anti-influenza drugs.
Anti-Inflammatory Agents ; pharmacology ; Antiviral Agents ; pharmacology ; Humans ; Immunity, Innate ; Influenza, Human ; drug therapy ; Virus Replication

Cardiac Catheterization ; methods ; Female ; Heart Septal Defects, Ventricular ; etiology ; therapy ; Humans ; Male ; Wounds and Injuries ; complications

Objective To investigate the value of postprocessing technique of multi-slice helical CT for the occult fracture located in complicated structure. Methods One hundred-thirteen patients with acute trauma but negative on plain X-ray film were reviewed retrospectively. All of the patients underwent MSCT ,and original data were reformed with reconstruction. Results Of one hundred-thirteen injuried patients , fractures were demonstrated with MSCT imaging in forty-eight cases. Conclusion The combination use of axial image of MSCT , reconstruction and post-processing is of high value in definite detection of occult fracture , and play an important role in selecting therapy project and evaluating prognosis.

Objective To compare radiation dose and image quality between prospective and retrospective ECG gating CT coronary angiography (CTCA) with 64-slice CT scanner. Methods Sixty patients with suspected coronary artery disease were selected, and randomly devided into two groups. Thirty patients in research group (average body-mass index [BMI]:[25.30±3.15] kg/m~2, heart rate ≤65 beats per minute [bpm]) underwent CTCA using prospective ECG-gating (120 kV, mA tailored to weight), while the rest 30 patients in control group (average BMI:[25.40±3.00] kg/m~2, heart rate ≤65 bpm) underwent CTCA using retrospective ECG-gating (120 kV, 650 mA). The average effective dose (ED) and standardizing radiation dose (ED_(Sd)) which was standardized by 12 cm length were respectively calculated, and statistical analysis was then conducted, meanwhile image quality was evaluated. Results The average ED of research group and control group was (5.97±1.04) mSv and (26.25±2.36) mSv, respectively (t_(A,B)=43.13, P<0.05). The ED_(Sd) of two groups was (5.49±0.45) mSv and (23.77±1.64) mSv (t_(Sd)=59.00, P<0.05). ED_(Sd) decreased by 76.62% in research group compared with that of control group. No significant difference of image quality was found between two groups (χ~2=4.26, P=0.235). Conclusion Prospective ECG-gating CTCA can effectively reduce radiation dose without compromising image quality.

85 cm) before 65 years old and descended after 65 (P

Objective To evaluate the effect of transnasal optic nerve decompression for traumatic optic neuropathy in different surgery time. Methods The databases of the Cochrane library, Embase, PubMed, Wanfang Database, China Journal Full-text Database (CNKI), Weipu Database(VIP) were searched for retrospective studies and clinical controlled trials. The search words included traumatic optic neuropathy, TON, eye traumas, transnasal endoscopicoptic decompression, TEOND, decompression of optic canal and endoscopy. According to the inclusion and exclusion criteria, the data were extracted. The RevMan 5.3 was used to analyze the data. Results All of 1 087 studies were detected. Sixteen eligible studies were enrolled, including 803 eyes. Meta analysis showed that the recovery degree of visual acuity, curative effect in operation group within 7 d of trauma was obviously superior to the operation group 7 d after trauma (OR=2.78;95%CI:2.02-3.82;P<0.01). Conclusions Transnasal endoscopic optic nerve decompression in treatment of traumatic optic neuropathy should be operated as soon as possible, and it is better to operate within 7 d.

Objective To evaluate the value of phased array probe of transesophageal echocardiography miniature (micro-TEE) in the neonatal and infant cardiac surgery intraoperation.Methods Micro-TEE probe was used in children with weight ≤5 kg undergoing cardiac surgery to detect the atrial and ventricular cavity size,the left and right ventricular outflow tract diameter were detected by transthoracic echocardiography(TTE) 3-7 d after operation,and compared with the measured value immediately after the TEE.Results Before and after intubation,airway index not statistically significant (P ＞ 0.05).Preoperative TEE and TTE inspection results were consistent with intraoperative diagnosis.Postoperative TEE measuring intracardiac structural data (each room,chamber size and left and right ventricular outflow tract diameter) and postoperative TTE measurement value representing the difference was not statistically significant (P ＞ 0.05).Conclusions Micro TEE intraoperative guardianship of low birth weight infants is safe and feasible,and can supplement and improve the preoperative diagnosis,and can accurately and timely evaluate postoperative curative effect.

Objective To assess the feasibility and accuracy of transesophageal echocardiography (TEE) in screening patients,intraoperative guidance of occluder releasing and efficacy assessment in the patients of percutaneous left atrial appendage (LAA) occlusion with Watchman.Methods Ultrasonic instrument Philips iE33(proble model X7-3t) were used to measure the maximum diameter and the depth of LAA ostium in enrolled patients by TEE,and intraoperative guided puncture of interatial septum,positioning Watchman transmission system and instruction closure release under TEE,immediate evaluate the postoperative therapeutic effect and record the complications by TEE.At 45 days after implantation,patients should repeat TEE to assess the efficacy.Results Eighteen patients underwent device implantation.Seventeen patients implant successfully,except one patient can't implant device beacuse of the LAA morphologe was not suitable.There was one patient showing thrombus formation on the surface of device,one patient of LAA and the device axial angulation was 90 °.At 45 days after implantaion,16 patients were fullowed up,there were no major stroke at all.Conclusions TEE has important application value in screening of preoperative patients,intraoperative guidance of occluder releasing and efficacy assessment in the patients of percutaneous left atrial appendage occlusion with Watchman.