Objective: To study the influence of ablated cardiac fat pad on atrial fibrillation induced by a single extra-stimulus in dogs. Metbods: Twenty-two dogs were anesthetized and their chest cavity was openned through a median sternotomy (2 dogs died of fibrillation immediately after opening) to expose the 3 cardiac fat pads: the medial superior vena cava and aortic root fat pad (SVC-Ao FP), the right pulmonary vein-atrial junction fat pad (RPV FP), and the inferior vena cava-left atrial junction fat pad (IVC-LA fat pad). The atrial effective refractory period (AERP), dispersion of AERP (dAERP), and pulmonary vein effective refractory period (PVERP) were measured under baseline and after ablation of the 3 fat pads. The left superior pulmonary veins were stimulated by S1S1 bursting stimulation and S1S2 program stimulation to induce atrial fibrillation before and after ablation. Results: After ablation, AERP increased from (137±16) ms to (147±16) ms and PVERP increased from (131±14) ms to (141+9) ms, while dAERP decreased from (17.0±4.6) ms to (12.0±4.3) ms (P<0.05). After ablation, S1S1 cycle length decreased from (173+25) ms to (145±21) ms when used for restimulation after ablation (P<0.05 ). S1S2 could not induce AF again. Conclusion: Ablation of the 3 cardiac fat pad can influence the electrical remodeling of the atrial and the pulmonary vein, which may hamper the induction of atrial fibrillation.

With the increasing incidence and prevalence of male sexual dysfunction, andrologists are more and more in need of accurate and efficient tools to assess therapeutic efficacy and patients' satisfaction and to help patients achieve satisfactory treatment results. This article summarizes some of the most commonly used questionnaires for the diagnosis and assessment of the treatment of male sexual dysfunction, including International Index of Erectile Function (IIEF), Erection Hardness Score (EHS), Quality of Erection Questionnaire (QEQ), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), Treatment Satisfaction Scale (TSS), Self-Esteem and Relationship (SEAR), Premature Ejaculation Profile (PEP), Premature Ejaculation Diagnostic Tool (PEDT), Index of Premature Ejaculation (IPE), Arabic Index of Premature Ejaculation (AIPE), Aging Male Symptoms Scale (AMS), Androgen Deficiency in the Aging Male (ADAM), and Symptomatic Inventory for Screening Late-Onset Hypogonadism in Males (SILOH), and presents an overview on their clinical application.
Erectile Dysfunction ; Humans ; Male ; Surveys and Questionnaires

Objective To investigate the impacts of long cold ischemic preservation time on the ultrastructural changes of donor heart and to provide the data for expanding the heart donor pool. Methods Heart was obtained from brain dead donor and preserved in the the University of Wisconsin (UW) solution at 4℃. Cardiac tissues were harvested at different time points of cold ischemic preservation (6, 8, 10, 12, 14 h) and observed under electron miscroscope. Results Donor heart did not have significant pathologied and ultrastructural changes when cold ischemic preservation time was 6 h. After that, time related impairment of myocardia and endothelium of coronary artery was seen.When ischemic time was longer than 12 h, focal myocardial necrosis and complete loss of the endothelium were detected. Conclusions Myocardial ultrastructure is an important index to evaluate the donor heart quality. Heart, which underwent 10 h of cold ischemia preservation time, causes no significant irreversible and pathological ultrastructural changes, and could be used for heart transplantation. When ischemia time was over 10 h, the donor heart presented with irreversible change and was nolonger unsuitable for transplantation.

Apoptosis ; Apoptosis Regulatory Proteins ; genetics ; Genetic Vectors ; Humans ; K562 Cells ; Transfection

Objective To summarize the outcomes and clinical experience of orthotopic heart transplantations in Shanghai Zhongshan Hospital.Methods From May 2000 through October 2005,141 patients,101 males and 40 females,diagnosed as having dilated cardiomyopathy in 118,hypertrophic cardiomyopathy in 2,restrictive cardiomyopathy in 2,end-stage ischemic heart disease in 9, primary malignant cardiac tumor in 4,valvular heart disease in 3 and others in 3,underwent orthotopic heart(transplantations) at our center.The operative procedures included 120 bicaval anastomotic cardiac transplantations,19 conventional Stanford orthotopic cardiac transplantations and 2 total heart transplantations.The immunosuppressive therapy strategies included Cyclosporine A or tacrolimus,corticosteroids and mycophenolate mofetil.For the latest 28 patients,induction therapy with Daclizumab was applied.Results There were 3 operative deaths with an operative survival of 97.9 %.During the follow-up from 1 month to 65 months,the actuarial survival rate was 90.8 % after 1 year,84.6 % after 3 year and 81.4 % after 5 year.Acute rejection,infections,graft failure and metastasis of primary cardiac tumor were the main causes of death in the 1st postoperative year,while acute rejection and graft coronary vasculopathy were the leading causes of death thereafter.Postoperative complications included acute rejection,infections,renal dysfunction and graft failure.Conclusions Orthotopic heart transplantation was proved to be a reliable choice for endstage heart disease with excellent outcomes.More attention should be paid to surveillance and management of acute rejection, infections and graft coronary vasculopathy in the long-term follow-up.

Objective To investigate the effect of paclitaxel on the intimal proliferation in rat aortic allografts and the possible mechanism on preventing graft arteriosclerosis.Methods Thirty-two inbred(Wista)r rats and 16 SD rats were divided into three groups:the isografts control group(Wistar/Wistar),the(allografts) control group ((Wistar)/SD) and test group(Wistar/SD) randomly(16 rats each groups).The rat abdominal aortic allograft model was used.The rats in test group were treated with paclitaxel after operation and those in control group with(0.9 %) normal saline.The grafts were removed and measured by means of pathology and immunohistochemistry 30 days later.Results The results showed that the thickness of the(aortic) intima,the degree of inflammatory cells infiltration in adventitia,stenosis ratio and the expression of(PCNA) were decreased in test group as compared with the allografts control group.Conclusions Paclitaxel can inhibit intimal proliferation in aortic allografts and prevent the graft arteriosclerosis.The mechanism is related to inhibition of vascular smooth(muscle) cell proliferation and alleviation of aortic allografts rejection.

Objective To introduce the donor heart preservation techniques and study the clini- cal results in 26 patients undergoing orthotopic heart transplantations with long donor ischemia time (DIT) in our center.Methods From Sept.2004 to Aug.2006,26 patients underwent orthotopic heart transplantation at our center with DIT longer than 360 min.Crystalloid cardioplegia was infused through aortic root after aorta was cross clamped.UW solution was used when donor heart was removed.All patients underwent bicaval anastomotic cardiac transplantation.NO was inhaled through ventilator during and after operation in patients with pulmonary hypertension.Results DIT was 360- 560 (mean 401?43) min.There was no operative death in this group.Echocardiography and X-ray examinations in one month were normal.One case of abnormal coronary orifice was subjected to re- anastomosis of aorta.One case of renal failure post-operation was subjected to blood dialysis.Conclu- sion With proper donor heart procurement and preservation,recipient selection,anastomotic technique,efficient postoperative surveillance and pulmonary hypertension treatment,transplanted patients with long DIT can obtain the satisfactory short-term outcome.

green light(480 nm).

Objective To investigate bacterial spectrum characteristics and distribution of urinary tract infections with different time phase in intensive care unit(ICU).Methods From January 2012 to March 2013,the clinical data of 1330 cases in ICU,treated with urinary catheter indwelling,was retrospectively reviewed.Among them,705 cases were male and 625 cases were female.Their age ranged from 11 to 94 years old,mean (55.4 ± 19.2)years old.Acute physiology and chronic health scores (APACHE Ⅱ) were 1 to 69,mean 17.1 ±9.3.Duration of catheter indwelling ranged from 1 to 28 days,mean 23 days.The urine was collect through catheter via sterile syringe for bacterial culture.The incidence of urinary tract infection,bacterial infection spectrum,composition ratio and bacteria distribution in 1,2 and 4 weeks after admission were recorded.Results Total urinary tract infection cases were 36(2.7％).There were 15 urinary tract infection cases in 625 famale cases(2.4％),There were 21 cases in 705 male cases (3.0％).49 pathogens were obtained,including 32 gram-negative bacilli (65.3％),17 gram-positive cocci (32.7％) and 1 fungus 2.0％.Enterococcus faecium (30.6％),E.coli (22.4％),Acinetobacter baumannii(10.2％),and Klebsiella pneumoniae (10.2％) were the predominant species.According to hospitalized time,the bacteria spectrum distribution showed Gram negative bacilli were 50.0％ (8 pathogens),57.1％ (4 pathogens),76.9％ (20 pathogens) and Gram positive bacteria were 43.8％ (7 pathogens),42.9％ (3 pathogens),23.1％ (6 pathogens) in the differet observed time point,respectively.A fungus was only observed in the first week after admission 6.3％.Concluusions Gram-negative bacilli were predominant bacterial of urinary tract infections in ICU patients.The incidence of fungus infection was low.E.coli,Acinetobacter baumannii and Klebsiella pneumoniae were the predominant species in Gramnegative bacilli.And Enterococcus faecium was the predominant specie in gram-positive cocci.It was similar for gram-negative bacilli and gram-positive cocci in the first two weeks.After two weeks Gram-negative bacilli turned to the main species.

Objective To investigate the value of acoustic radiation force impulse (ARFI) on evaluating the renal tubular atrophy and interstitial fibrosis of IgA nephropathy(IgAN).Methods 117 patients diagnosed with IgAN,and 80 normal cases were examined with conventional ultrasonography and ARFI,recording the shear wave velocities(SWV),the hemodynamics and the renal biopsy results to quantify the elastic changes of renal cortex,with the aim of assessing AFRI's advantages on early diagnosing the impair of kidney.Results The SWV value of renal cortex,renal medulla of IgAN group were smaller than that of normal group (P ＜0.05),while the collective system SWV value had no difference(P ＞0.05).According to the ROC curve,the cut-off value of SWV in renal cortex was 2.7 cm/s.The accuracy of the diagnosis was 71 ％,which was better than RI (61.9％).The SWV value of the renal cortex decreased with the different stage of 1,2,3,4,but stage 5 was larger than stage 4.The degree of renal tubular atrophy and interstitial fibrosis(T) can be classified by the SWV of renal cortex,and the SWV of T2 was larger than T1 (P ＜0.05).Conclusions By quantifying the elastic change of kidney,ARFI technology is able to distinguish the degree of renal tubular atrophy and interstitial fibrosis,diagnose renal impairment early and judge the clinical stages.Furthermore the sensitivity,specificity,accuracy of it are superior to hemodynamic.