Objective: To compare the detection rate of arrhythmia in chronic heart failure (CHF) patients by different time of ambulatory electrocardiogram (Holter). Methods: A total of 108 consecutive elderly CHF patients received 72h Holter in our hospital from 2016-01 to 2016-09 were enrolled. According to NYHA classification, LVEF and plasma NT-proBNP level, the patients were divided into 3 sets of groups. Detection rates of supra-ventricular arrhythmia and ventricular arrhythmia were compared among 24h, 48h and 72h Holter recording. Results: Based on NYHA classification, the patients were divided into 3 groups: NYHA Ⅱ group, n=24, NYHAⅢ group, n=42 and NYHAⅣ group, n=26; based on NT-proBNP level, the patients were divided into 2 groups: NT-proBNP≥1000 pg/ml group and NT-proBNP<1000 pg/ml group, n=54 in each group; based on LVEF, the patients were divided into 3 groups: HFpEF group, n=80, HFmrEF group, n=13 and HFrEF group, n=15. Detection rate for non-sustained atrial tachycardia (NSAT) was 81.7% by 48h Holter which was higher than 64.6% at 24h, P<0.01; for non-sustained ventricular tachycardia (NSVT) was 38% at 72h which was higher than 25.9% at 24h, P<0.01. For new-onset paroxysmal atrial fibrillation, only 1 patient was detected by 24h Holter and the additional 3 patients were detected by 72h. Group analysis indicated that the detection rate of NSVT was different by 72h and 24h Holter in NYHA Ⅲ patients, P<0.05; while it was similar in NYHA Ⅳ patients, P>0.05. Conclusion: Long term (72h/48h) Holter had the higher detection rate of arrhythmia in HF patients, 24 h monitoring was easier to find NSVT in severer HF patients. In moderate to severe HF patients, the detection time may be prolonged if NSVT couldn't be found by 24h Holter which was helpful for clinical treatment.

OBJECTIVETo explore the diagnostic value of the dual-energy technique with dual-source computed tomography (DSCT) for anterior cruciate ligament injuries.

METHODSThe clinical data of 8 patients with arthroscopic results were retrospectively reviewed. All patients underwent two- and three-dimensional imaging by multiplanar reconstruction, volume rendering, and tendon mode on DSCT. Dual-energy characteristics were compared with arthroscopic results.

RESULTSSix patients who were arthroscopically diagnosed as anterior cruciate ligament injuries, all of them were also correctly diagnosed by DSCT. Two patients who were arthroscopically diagnosed as normal, one was also diagnosed as normal by DSCT and the other was misdiagnosed. The overall agreement rate was 87.5% (7/8) . Under the dual energy tendon mode, the dual energy staining of the injured anterior cruciate ligament was lower than that of the contralateral normal cruciate ligament of the patient.

CONCLUSIONThe staining diminution in DSCT imaging may be a new feature that can be used to effectively diagnose anterior cruciate ligament injury.

Adolescent ; Adult ; Anterior Cruciate Ligament Injuries ; Female ; Humans ; Knee Injuries ; diagnostic imaging ; Male ; Tomography, X-Ray Computed ; methods ; Young Adult

Background and purpose:Adenosine triphosphate-binding cassette superfamily G member 2 (ABCG2), which has been found over-expressed in a variety of cancer cells, takes part in the drug resistance of cancer through effux of anticancer drugs. The purpose of this study was to investigate the mechanisms of human glioblastoma cells sensitivity to pyropheophorbide-a methyl ester (MPPa)-mediated photodynamic therapy (PDT) eradicating tumour cells and its relationship to ABCG2.Methods:U87 and A172 glioma cell lines in the logarithmic growth phase were selected and exposed to the treatment of MPPa-PDT and MPPa-PDT+fumitremorgin C (FTC) respectively. The cell viability was measured with the use of CCK-8 assay. The expression of ABCG2 was detected by Western blot. The intracellular contents of MPPa in each group without illumination were tested by lfow cytometry. Flow cytometry with AnnexinⅤ-FITC/PI double staining was used to detect the cell apoptotic rate. DCFH-DA staining was used to assess the generation of intracellular reactive oxygen species (ROS).Results:The MPPa-mediated PDT could eradicate A172 and U87 cancer cells in an energy-dependent manner. The light energy density in A172 was 8 times of that in U87 when the cell viability reached median lethal dose after MPPa-mediated PDT. The high expression of ABCG2 in A172 cells affected the accumulation of intracellular MPPa. Inhibition of ABCG2, not only could enhance the eradicating effect of MPPa-PDT on A172 cells, but also could increase the yield of ROS triggered by MPPa-PDT and the accumulation of intracellular MPPa.Conclusion:The human glioblastoma cell line A172 is insensitive to MPPa-mediated PDT. The mechanism may relate to ABCG2, which decreases the MPPa content in cancer cells through effux of MPPa, resulting in decline of cytotoxicity.

Objective To study the effect of ulinastatin on no reflow or slow flow in the infarct related artery in patient with acute ST-elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary interventional therapy (PCI).Methods 180 STEMI patients were divided into the control group (n=100) and the ulinastatin treatment group (n=80).The control group received conventional PCI treatment and the treatment group received conventional PCI treatment plus ulinastatin. The level of serum inflammatory factors IL-6,IL-10,superoxide converting enzyme,the infarct related coronary artery reperfusion TIMI flow grade (TFG) and myocardial perfusion grade (TMPG),the results of postoperative cardiac ultrasound examination and clinical outcomes were compared between the two groups.Results Compared with the control group,the level of IL-6 was decreased,while the levels of IL-10 and superoxide converting enzyme were increased significantly in the ulinastatin treatment group(P<0.05).The TFG and TMPG of the infarct related vessels were increased significantly in the ulinastatin treatment group. The left ventricular end diastolic diameter[(54.6 ± 5.2 mm vs. (50.4±4.6) mm,P=0.046)]and left ventricular ejection fraction [(58.4±10.2) % vs. (62.2±9.8) % P=0.048] showed statistical difference between the two groups.Compared to the control,the major cardiovascular event rate of the treatment group during hospitalization (1% vs. 5%, P=0.038), after one month (1.2% vs. 3%,P=0.046) and 6 months (3% vs 12%,P=0.018) were all significantly lower .There was no significant difference in mortality between the 2 groups.Conclusion Ulinastatin may lower the incidence of no flow and slow flow after emergency PCI,improve heart function and the lower the rates of MACE.

Objective: To understand the current status of diagnosis and treatment of chronic lymphocytic leukemia (CLL) /small lymphocytic lymphoma (SLL) among hematologists, oncologists, and lymphoma physicians from hospitals of different levels in China. Methods: This multicenter questionnaire survey was conducted from March 2021 to July 2021 and included 1,000 eligible physicians. A combination of face-to-face interviews and online questionnaire surveys was used. A standardized questionnaire regarding the composition of patients treated for CLL/SLL, disease diagnosis and prognosis evaluation, concomitant diseases, organ function evaluation, treatment selection, and Bruton tyrosine kinase (BTK) inhibitor was used. Results: ①The interviewed physicians stated that the proportion of male patients treated for CLL/SLL is higher than that of females, and the age is mainly concentrated in 61-70 years old. ②Most of the interviewed physicians conducted tests, such as bone marrow biopsies and immunohistochemistry, for patient diagnosis, in addition to the blood test. ③Only 13.7% of the interviewed physicians fully grasped the initial treatment indications recommended by the existing guidelines. ④In terms of cognition of high-risk prognostic factors, physicians' knowledge of unmutated immunoglobulin heavy-chain variable and 11q- is far inferior to that of TP53 mutation and complex karyotype, which are two high-risk prognostic factors, and only 17.1% of the interviewed physicians fully mastered CLL International Prognostic Index scoring system. ⑤Among the first-line treatment strategy, BTK inhibitors are used for different types of patients, and physicians have formed a certain understanding that BTK inhibitors should be preferentially used in patients with high-risk factors and elderly patients, but the actual use of BTK inhibitors in different types of patients is not high (31.6%-46.0%). ⑥BTK inhibitors at a reduced dose in actual clinical treatment were used by 69.0% of the physicians, and 66.8% of the physicians had interrupted the BTK inhibitor for >12 days in actual clinical treatment. The use of BTK inhibitors is reduced or interrupted mainly because of adverse reactions, such as atrial fibrillation, severe bone marrow suppression, hemorrhage, and pulmonary infection, as well as patients' payment capacity and effective disease progression control. ⑦Some differences were found in the perceptions and behaviors of hematologists and oncologists regarding the prognostic assessment of CLL/SLL, the choice of treatment options, the clinical use of BTK inhibitors, etc. Conclusion: At present, a gap remains between the diagnosis and treatment of CLL/SLL among Chinese physicians compared with the recommendations in the guidelines regarding the diagnostic criteria, treatment indications, prognosis assessment, accompanying disease assessment, treatment strategy selection, and rational BTK inhibitor use, especially the proportion of dose reduction or BTK inhibitor discontinuation due to high adverse events.
Female ; Humans ; Male ; Aged ; Middle Aged ; Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy* ; Prognosis ; Lymphoma, B-Cell ; Immunohistochemistry ; Immunoglobulin Heavy Chains/therapeutic use*