Objective: To investigate the acute and long-term outcome of catheter ablation for the treatment of ventricular tachycardia (VT) in patients with arrhythmogenic left ventricular cardiomyopathy (ALVC). Methods: This retrospective, cross-sectional study enrolled ALVC patients undergoing radiofrequency ablation for the treatment of VT at the First Affiliated Hospital of Nanjing Medical University from January 2011 to December 2018 and collected their clinical characteristics and intraoperative electrophysiological examination. Patients were followed up every 6 months after radiofrequency ablation until August 2021. Echocardiographic results and VT recurrence post radiofrequency ablation were analysed. Results: Totally 12 patients were enrolled (mean age: (42±15) years, 11 males(11/12)). The mean of left ventricular end diastolic diameter (LVDd) and left ventricular ejection fraction (LVEF) were (51±5)mm and (65±5)%, respectively. Twelve VTs were induced in 10 patients during the electrophysiological study, and the mean tachycardia cycle length was (293±65) ms. Three-dimensional substrate mapping revealed the diseased area at endocardial site in one patient, at epicardial sites in the other 11 patients (involved endocardial sites in 2 cases) with the basal part near the mitral annulus being the predilection for the substrate (10/11). After the catheter ablation at the endocardial and epicardial sites respectively, the complete procedure endpoint was achieved in all patients (VT cannot be induced post ablation). The median follow-up time was 65 (25, 123) months. One patient was lost to follow-up, and the other 11 patients survived without VT. No significant cardiac function deterioration was detected by the echocardiographic examination ((51±5)mm vs. (52±5)mm, P>0.05 for LVDd, (65±5)% vs. (60±6)%, P>0.05 for LVEF) at the end of follow-up. Conclusion: After radiofrequency ablation, the complete procedure endpoint is achieved in ALVC patients, and the catheter ablation provides long-term ventricular tachycardia control during the long-term follow-up.
Adult ; Cardiomyopathies ; Catheter Ablation ; Cross-Sectional Studies ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pericardium/surgery* ; Recurrence ; Retrospective Studies ; Stroke Volume ; Tachycardia, Ventricular/surgery* ; Treatment Outcome ; Ventricular Function, Left

Objective: To explore the heterogeneity and correlation of clinical phenotypes and genotypes in children with disorders of sex development (DSD). Methods: A retrospective study of 1 235 patients with clinically proposed DSD in 36 pediatric medical institutions across the country from January 2017 to May 2021. After capturing 277 DSD-related candidate genes, second-generation sequencing was performed to analyzed the heterogeneity and correlation combined with clinical phenotypes. Results: Among 1 235 children with clinically proposed DSD, 980 were males and 255 were females of social gender at the time of initial diagnosis with the age ranged from 1 day of age to 17.92 years. A total of 443 children with pathogenic variants were detected through molecular genetic studies, with a positive detection rate of 35.9%. The most common clinical phenotypes were micropenis (455 cases), hypospadias (321 cases), and cryptorchidism (172 cases) and common mutations detected were in SRD5A2 gene (80 cases), AR gene (53 cases) and CYP21A2 gene (44 cases). Among them, the SRD5A2 mutation is the most common in children with simple micropenis and simple hypospadias, while the AMH mutation is the most common in children with simple cryptorchidism. Conclusions: The SRD5A2 mutation is the most common genetic variant in Chinese children with DSD, and micropenis, cryptorchidism, and hypospadias are the most common clinical phenotypes. Molecular diagnosis can provide clues about the biological basis of DSD, and can also guide clinicians to perform specific clinical examinations. Target sequence capture probes and next-generation sequencing technology can provide effective and economical genetic diagnosis for children with DSD.
3-Oxo-5-alpha-Steroid 4-Dehydrogenase/genetics* ; Child ; China/epidemiology* ; Cryptorchidism/genetics* ; Disorders of Sex Development/genetics* ; Female ; Genital Diseases, Male ; Genotype ; Humans ; Hypospadias/genetics* ; Male ; Membrane Proteins/genetics* ; Penis/abnormalities* ; Phenotype ; Retrospective Studies ; Steroid 21-Hydroxylase/genetics*

The importance of pressing hand in clinical practice of acupuncture was explored in this paper. Through literature review and clinical experience, the role of pressing hand before, during and after acupuncture was summarized and analyzed. Before acupuncture, the pressing hand helped to diagnose diseases, examine pulse and locate acupoints; during acupuncture, it participated in needle insertion and reinforcing-reducing manipulation; after acupuncture, it played a role in needle withdrawal and regulate human body. It is indicated the pressing hand is a key role not only during acupuncture or reinforcing-reducing manipulation, but also participates in the overall process of acupuncture, which has great significance in guiding clinical treatment and enhancing practice level.

Objective: To introduce the construction idea and function for establishing China Cardiovascular Surgery Registry (CCSR)database and to provide a reference for domestic congener databases. Methods: Using peer database as reference, taking current status of cardiovascular surgery registry and hardware in our country with the necessity of international communication, we worked on a variables selection, metadata instruction, logic rules, case report form develpment and finally established a web-based, multi-functional database that enabled cross-database and international merging of data, forming a national intelligent data-exchanging platform for cardiovascular surgery. Results:CCSR database has over 300 variables of multiple topics including basic information, risk factors, medical procedures and endpoint events. Taking clinical and association data exchange standards as reference, it may conduct cross-discipline data connection, record important peri-operative information in relevant patients and meanwhile, it has the functions of automatic logic check, data report, statistical study, data export and importing the electronic medical records. Conclusion:CCSR database is a national platform accord with current status of Chinese cardiovascular surgery and characteristics, meanwhile it gives consideration to international communication and data exchange; which may play a important role in improving medical care and clinical investigation.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Meningioma ; diagnosis ; Middle Aged ; Retrospective Studies ; Young Adult

BACKGROUNDMeningioma is one of the most common primary tumors of the central nervous system, but there are not many detailed studies on the sex, age, subtypes and locations of large series. This study was a retrospective analysis of the characteristics of meningioma cases consecutively operated on at a single institution in China from 2001 to 2010.

METHODSThis study investigated the demographic background of 7084 meningioma cases, and the subtypes and locations of the tumors. Sex and age distributions were analyzed, and the pathological subtypes were classified according to the World Health Organization (WHO) classification. The location of the meningiomas was also categorized.

RESULTSThe female:male ratio of the 7084 cases was 2.34:1. The mean age was 51.4 years (range, 11 months-86 years). The mean age of cases of WHO grade I meningioma was significantly older than that of grade II or III meningiomas (P < 0.001, Fisher's Least Significant Digit test). There was a significantly higher female:male ratio in WHO grade I meningiomas than in grade II or grade III meningiomas (2.57, 1.03 and 0.76, respectively; P < 0.001, χ(2) test). Meningothelial (n = 2061) and fibrous meningiomas (n = 3556) were the most common subtypes, comprising 79.3% of all meningiomas. All meningioma cases were classified into 23 locations in this study, with the cerebral convexity the most common site (38.33%, n = 2722). Cases with uncommon locations such as extra-cranial and sylvian fissure meningiomas were also present in this series.

CONCLUSIONSFemale predominance was found for benign meningiomas, while malignant subtypes showed male predominance. The mean age of patients with WHO grade I meningiomas was older than that of patients with higher-grade tumors. Meningothelial and fibrous meningiomas were the most common subtypes. The cerebral convexity was the most common meningioma location.

Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Meningioma ; epidemiology ; Middle Aged ; Sex Distribution ; Young Adult

BACKGROUNDDespite extensive research, the mechanism of immature dendritic cells (DCs) induced immune hyporesponsiveness remains incompletely understood.

METHODSRecipient DCs from C3H mouse bone marrow cells were incubated with donor antigen from splenic lymphocytes of C57BL/6 mouse; these DCs were transfected with CD80/86 specific siRNA using lentiviral vectors. Flow cytometry was used to evaluate expression of CD80/86 on the antigen-pulsed recipient DCs. Immune regulatory activity was examined by mixed lymphocyte reaction, in which irradiated DCs were cultured with C3H spleen T cells. After the reaction, interleukin (IL)-2, IL-4, IL-10, and interferon (INF)-γ levels of mixed lymphocyte reaction culture supernatant were measured by enzyme-linked immunosorbent assay. The apoptotic T lymphocytes were identified by Annexin V and CD3 staining.

RESULTSThere was a significant inhibition of CD80/86 expression in DCs transfected with CD80/86 lentiviral vectors compared with the control groups (P < 0.05), indicating the specificity of RNA interference. Enzyme-linked immunosorbent assay results showed a significant reduction of INF-γ, IL-2 and IL-10 in the CD80/86 lentivirus transfected group compared to the control groups (P < 0.05). There was no significant difference in IL-4 levels between the groups (P > 0.05). We also showed that CD80/86 low DCs loaded with alloantigen (1) stimulated low T cell proliferative responses via the indirect recognition pathway and (2) enhanced apoptotic activity (P < 0.05) in co-cultured T cells.

CONCLUSIONSLentiviral vector transfection can effectively and specifically knock down target genes in DCs. The CD80/86 low DCs may show tolerogenic activity via induction of T-cell apoptosis, thereby modulating the activity of recipient-derived DCs. The use of this approach may potentially be clinically applicable.

Animals ; Apoptosis ; B7-1 Antigen ; genetics ; physiology ; B7-2 Antigen ; genetics ; physiology ; Dendritic Cells ; immunology ; Lentivirus ; genetics ; Lymphocyte Activation ; Mice ; Mice, Inbred C3H ; Mice, Inbred C57BL ; RNA Interference ; T-Lymphocytes ; cytology ; immunology

OBJECTIVETo study the effect of vertebrae semi-dislocation on the stress distribution in facet joint and interuertebral disc of patients with cervical syndrome using three dimensional finite element model.

METHODSA patient with cervical spondylosis was randomly chosen, who was male, 28 years old, and diagnosed as cervical vertebra semidislocation by dynamic and static palpation and X-ray, and scanned from C(1) to C(7) by 0.75 mm slice thickness of CT. Based on the CT data, the software was used to construct the three dimensional finite element model of cervical vertebra semidislocation (C(4)-C(6)). Based on the model,virtual manipulation was used to correct the vertebra semidislocation by the software, and the stress distribution was analyzed.

RESULTSThe result of finite element analysis showed that the stress distribution of C(5-6) facet joint and intervertebral disc changed after virtual manipulation.

CONCLUSIONThe vertebra semidislocation leads to the abnormal stress distribution of facet joint and intervertebral disc.

Adult ; Cervical Vertebrae ; injuries ; physiopathology ; Finite Element Analysis ; Humans ; Intervertebral Disc ; physiopathology ; Joint Dislocations ; physiopathology ; Male ; Models, Anatomic ; Stress, Physiological ; Zygapophyseal Joint ; physiopathology

OBJECTIVETo compare the intracephalic imaging differences of stroke treated with combined therapy of scalp and body acupuncture and body acupuncture only, in order to apply the image basis for the differences of clinical curative effects.

METHODSTwenty cases of stroke were randomized into a body acupuncture group (group A) and a scalp and body acupuncture group (group B), ten cases in each group respectively. In group A, body acupuncture was applied simply, and different acupoints were selected according to the symptoms: Shousanli (LI 10), Jianliao (TE 14), Huantiao (GB 30) and Jiaji (EX-B 2) etc. were selected for hemiplegia, Fengchi (GB 20), Xiaguan (ST 7) and Quanliao (SI 18) etc. were for facial paralysis, Fengfu (GV 16) and Lianquan (CV 23) etc. were for aphasia. In group B, combined therapy were applied, the body acupoints selection was same as above; for scalp acupoints, corresponding motor area, sensory area and foot motor sensory area were selected. Instant changes of local cerebral blood flow before and after treatment were examined and evaluated by NIRS and the curative effects of both groups were evaluated.

RESULTSThe total therapeutic effective rate was 90.0% (9/10) and the basically cured rate was 30.0% (3/10) in group A; and 100.0% (10/10) and 50.0% (5/10) respectively in group B, indicating that the clinical curative effect in group B was superior to that in group A at 20, 30 min of acupuncture treatment (P < 0.05). Both imaging results showed that blood flows of prefrontal cortex in both groups were increased with varying degrees after treatment (P < 0.05, P < 0.01); the cerebral blood flow in group B was much more improved than that in group A at 20, 30 min of acupuncture treatment (all P < 0.05).

CONCLUSIONAcupuncture can significantly increase blood flow and oxygen saturation in brain cortex, and the effect with combined therapy of scalp and body acupuncture is superior to that with body acupuncture.

Acupuncture Therapy ; Adult ; Aged ; Brain ; physiopathology ; Brain Chemistry ; Female ; Humans ; Male ; Middle Aged ; Phototherapy ; instrumentation ; Spectroscopy, Near-Infrared ; Stroke ; physiopathology ; therapy ; Treatment Outcome

OBJECTIVETo observe the influence of electric-moxibustion at Baihui (GV 20) or Shenque (CV 8) on the cerebral blood flow.

METHODSTwenty healthy volunteer were treated by electric-moxibustion at Baihui (GV 20) or Shenque (CV 8) with multi-functional electric-moxibustion instrument. The changes of the forehead cortex blood flow during moxibustion were detected by dynamic continuous spectrum near-infrared imaging.

RESULTSThere were significant differences as the forehead cortex blood flow after electric-moxibustion at Baihui (GV 20) for 20 and 30 minutes compared with their initial data (P < 0.05, P < 0.01); and as the forehead cortex blood flow after electric-moxibustion at Shenque (CV 8) for 10, 20 and 30 minutes compared with their initial data (P<0. 05, P<0. 01).

CONCLUSIONElectric-moxibustion at both Baihui (GV 20) and Shenque (CV 8) can improve the volume of brain cortex blood flow and electric-moxibustion at Shenque (CV 8) has rapid effect.

Acupuncture Points ; Adult ; Brain ; blood supply ; Brain Chemistry ; Brain Mapping ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Regional Blood Flow ; Spectroscopy, Near-Infrared