Objective To analyze the current status and hotspots of surgical transmural ablation of atrial fibrillation using CiteSpace and VOSviewer. Methods The Web of Science Core Collection database was used as the data source. The CiteSpace 5.8.R3 and VOSviewer software were used to analyze the related studies on surgical transmural ablation of atrial fibrillation about the authors, countries/institutions, literature co-citation and keywords. Results A total of 109 articles were enrolled. Damiano RJ was the most prolific researcher, while Cox JL was the author with the highest number of citations. The United States was the leading country in this research field. The University of Washington was an important institution in the study of atrial fibrillation transmural ablation. The main hotpots were the effectiveness of surgical ablation, especially Cox-maze procedure, selection of the energy source of surgical ablation, combination of surgical and catheter ablations, and pulmonary vein isolation. Conclusion This study visualizes the current research status of surgical ablation of atrial fibrillation. How to improve the effectiveness and transmurality of surgical ablation is a hot research topic in the surgical treatment of atrial fibrillation. The combination of electrophysiology mapping and surgical ablation may be the development direction in the surgical treatment of atrial fibrillation.

Objective    To analyze the early and mid-term safety and effectiveness of concomitant cryosurgical Cox-Maze Ⅳ procedure in minimally invasive mitral valve surgery. Methods    We retrospectively reviewed the clinical data of 68 patients (28 males and 40 females with a mean age of 38.7±9.3 years) who underwent concomitant cryosurgical Cox-Maze Ⅳ procedure in minimally invasive mitral valve and tricuspid surgery in the Department of Cardiovascular Surgery of the Second Xiangya Hospital from August 2013 to October 2017. The heart rhythm of the patients after surgery was supervised by 24 hour holter monitoring eletrocardiogram. Results    No death occurred during operation and follow-up. One patient underwent reexploration for bleeding. The rate of sinus rhythm restored at the time of discharge was 95.8%. The rate of sinus rhythm restored at 6 months, 12 months, 24 months, 36 months after surgery was 93.5%, 91.6%, 90.3% and 89.5% respectively. Conclusion    Concomitant cryosurgical Cox-Maze Ⅳ procedure in minimally invasive mitral valve surgery is quite safe and effective in treatment of rheumatic mitral valve disease and atrial fibrillation in the early and mid-term follow-up.

Objective To evaluation of abnormality of intrarenal veins in the patients of diabetic nephropathy (DN) and the correlation between the intrarenal venous impedance index (VII) and renal function with color Doppler ultrasonography. Methods Sixty-four subjects with type 2 diabetic nephropathy from December 2016 to October 2017 were enrolled and divided into three groups according to glomerular filtration rate(GFR) level: GFR≥90 ml/(min·1.73 m2) as group B (25 cases), 60 ml/(min·1.73 m2)≤GFR＜90 ml/(min·1.73 m2) as group C (21 cases), GFR＜60 ml/(min·1.73 m2) as group D(18 cases), and 25 healthy volunteers were recruited as group A. Color Doppler ultrasonography was used to obtain the intrarenal VII. Results There were significant differences among A, B, C, D group of right renal segmental vein (0.41 ± 0.04, 0.36 ± 0.09, 0.29 ± 0.05, 0.19 ± 0.05; F＝81.85), right renal interlobular vein (0.41 ± 0.03, 0.35 ± 0.04, 0.29 ± 0.04, 0.22 ± 0.11; F＝96.42), left renal segmental vein (0.42 ± 0.08, 0.36 ± 0.05, 0.30 ± 0.08, 0.20 ± 0.04; F＝101.38) and left renal interlobular vein (0.40 ± 0.15, 0.36 ± 0.04, 0.30 ± 0.04, 0.20 ± 0.07; F＝95.71), all P＜0.05. The VII of group B, C and D was significantly lower than that of group A (P＜0.05). The VII of group D was lower than that of group B and C (P＜0.05), and the VII of group C was lower than that of group D(P＜0.05). There were no significant differences of the VII between the left and right kidneys (F＝0.001, P＞0.05). The VII was positively correlative with GFR (r＝0.85, P＜0.05). Conclusions The VII of the patients of DN can be obtained by color Doppler ultrasonography conveniently and non-invasively, which can reflex the renal function changes and provide a new diagnostic index for the patients of DN in diagnosis and treatment.

OBJECTIVE: To summarize the clinical data of patients who experienced cryoablation in minimally invasive mitral valve surgery and to explore safety and effectiveness of the surgery.
 METHODS: We retrospectively collected the clinical data of patients who experienced cryoablation in minimally invasive mitral valve surgery in Department of Cardiovascular of Second Xiangya Hospital from August 2013 to July 2015. Through a right side (4-6 cm) thoracotomy, femoral cannulation and aortic cross-clamp by Chitwood clamper was performed, left atrium was entered from interatrial groove. Modified left and right side cryomaze followed by valve surgery was finished. The left atrial appendage was excluded by oversewing from endocardial surface. The cardiopulmonary bypass time, cross-clamp time, duration in hospital were recorded. The heart rhythm of 3 consecutive post operation days, at 7th day, 3 months, 6 months, 12 months or 18 months after the surgery was monitered by 12-leads electrical cardiogram.
 RESULTS: No death was observed in this group. Reexploration for bleeding was conducted for one case. Operation time, CBP time and cross-clamp time was (197.4±27.2), (103.6±20.3)and (65.3±15.7) min, respectively. Duration in ICU and hospital was (1.2±0.4) and (9.2±1.6) d, respectively. The ratio of sinus rhythm restoration right after surgery was 97.1%. The ratio of sinus rhythm restoration at the time of hospital discharge was 94.3%. No motality was found in follow-up. The ratio of sinus rhythm restoration at 3, 6, 12,18 months after the surgery was 94.3%, 93.5%, 90.5%, 93.3%, respectively.
 CONCLUSION Right minimal invasive thoracoscopic-assisted cryoablation in mitral valve surgery is quite effective in the treatment of atrial fibrillation, displaying the advantages of less complications, motality and hospitalization.
Aorta ; Atrial Fibrillation ; Cardiac Surgical Procedures ; Cryosurgery ; Heart Atria ; Humans ; Minimally Invasive Surgical Procedures ; Mitral Valve ; Retrospective Studies ; Surgical Instruments ; Thoracotomy

Objective To observe the effects of the acupuncture on muscle strain of lower extremities adductors for children with spastic cerebral palsy. Methods 100 children with spastic cerebral palsy were divided into treatment group (n=50) and control group (n=50) randomly.The control group accepted routine rehabilitation, and the treatment group accepted acupuncture in addition. The passive range of motion (ROM) of adductor angle, D and E domains of Gross Motor Function Measure (GMFM-88) were observed before and after treatment. Results ROM and GMFM-88 improved after treatment (P<0.05), and improved more in the treatment group than in the control group (P<0.05). Conclusion Acupuncture can release muscle strain of lower extremities adductors of children with spastic cerebral palsy and improve the motor function.

Objective To investigate the changes in tumor necrosis factor-α(TNF-α) and plasminogen activator inhibitor(PAI) in the presence of obstructive sleep apnea syndrome(OSAS) in patients with type 2 diabetes mellitus,and to investigate if that 2 inflammatory factors is associated with hypoxemia during sleep.Methods Fiftyfour patients with type 2 diabetes mellitus hospitalized for glycemic control were subgrouped into 27 patients with OSAS (group O) and 27 patients without OSAS (group N).26 people without diabetes and OSAS were selected from a health check-up program to serve as control group (group C).Serum TNF-α and PAI levels were measured by commercial ELISA kits.Apnea hypopnea index (AHI),the lowest pulse oxygen saturation (LSpO2) at night were detected by portable sleep monitor.The relativity regarding TNF-α,PAI,homeostasis model assessment for insulin resistance (HOMA-IR),fasting blood glucose(FBG),AHI,LSpO2,and age was discussed.TNF-α and PAI were regard as dependent variables,and FBG,HOMA-IR,AHI,LSpO2,and age as independent variables in multivariate stepwise linear analysis.Results The levels of HOMA-IR,TNF-α,PAI in group O [2.69 ± 1.53,(1.97 ±0.13) ng/ml,and (2.27 ± 0.85) ng/ml] were higher than the those in other 2 groups,and those in group N [1.70 ± 0.88,(1.09 ±0.29) ng/ml,and (1.59 ± 0.13) ng/ml] were higher than group C [1.15 ± 0.67,(0.73 ± 0.19) ng/ml,and (0.89 ±0.25) ng/ml].The levels of FBG in the 2 diabetic groups were higher than those in group C.The level of AHI in group O was higher than that in group N and group C,while LSpO2 in group O was lower than that in group N and group C.Spearman univariate analysis showed that TNF-α and PAl both were associated positively with HOMA-IR,FBG,and AHI,while negatively with LSpO2.Multivariate stepwise linear analysis denoted that TNF-α was independently associated with AHI,FBG,while PAI was independently associated with AHI and HOMA-IR.Conclusions Patients with diabetes and OSAS manifest raised level of chronic inflammatory activity,and therefore,OSAS might be implicated in the pathogenesis of chronic complication of patients with type 2 diabetes.

Objective To investigate the neuroprotective effect of granulocyte colony stimulating factor (G-CSF) combined with behavior training on the learning and memory abilities of cerebral ischemic injury in rats. Methods 96 Wistar rats, 2 months old, were divided as sham group (group A), model group (group B), G-CSF group (group C) and G-CSF+training group (group D). Modified middle cerebral artery occlusion (MCAO) was used to establish a ischemia 2 h/reperfusion 24 h model to all the rats, except sham group. 6 rats were selected in each group 1, 2, 4 and 8 weeks after successfully modeled, respectively. The abilities of learning and memory were detected with the latency of shuttle test video analysis system. The pathology of the hippocampus and the expression of nerve growth factor (NGF) and G-CSF were observed with HE and immunohistochemistry staining, respectively. Results The expression of NGF and G-CSF increased in group B transiently, and increased more and longer in the group C and D, especially in group D, as the time passed (P<0.05). The latency of shuttle test increased in group B, C and D, and gently decreased as the time passed, and the decrease more to less were group D, C and B (P<0.05).Conclusion The neuroprotective effects of G-CSF combined with behavior training are strengthened and long term beneficial than G-CSF alone.

Objective To characterize the baseline status of Chinese diabetic patients based on data derived from Chinese cohort from SOLVETM study.Methods Patients with type 2 diabetes initiating basal insulin detemir at the decision of the physician were eligible for the study.Data on demographics,medical history,glycemic profile and treatment regimen at baseline were collected by physicians.Results A total of 3272 patients [female 42％,male 58％,mean age (56.2 ± 10.8) years] were included in the study.Their BMI was (25.3 ± 3.3) kg/m2.The duration of diabetes was 4.0 (0.1-27.0) years,and the duration of treatment with oral antidiabetic drugs (OADs) was 3.0(0.0-20.2) years.The proportions of subjects with diabetic macro-and micro-vascular complications were 15.8％ (515 cases) and 27.1％ (866 cases),respectively.The hemoglobin Al c (HbAl c) at baseline was (8.33 ± 1.70) ％,and the fasting blood glucose (FPG) was (9.5 ± 2.6) mmol/L.Conclusions A large proportion of patients with type 2 diabetes remain in poor glycemic control,and the prevalence of diabetic complications is high,which requires optimal therapeutic strategy for the patients with suboptimal glycemic control.

Objective To explore oropharyngeal swallowing disorders with videofluoroscopic swallowing study (VFSS). Methods 16 patients with dysphagia accepted VFSS with 10 ml of thin barium meal (50% w/v), thick barium meal (270% w/v), biscuit coated with thick barium meal in single swallow. Their swallowing function was observed on the lateral and anterior/posterior planes, including: symmetry of pyriform sinuses, oral transit time, presence of pharyngeal delay, pharyngeal transit time, oral and pharyngeal residue, and presence of aspiration.Results 5 patients demonstrated oral swallowing disorder. 3 patients demonstrated pharyngeal swallowing disorders, that was pharyngeal delay which caused in aspiration after swallowing. 8 patients demonstrated oropharyngeal swallowing disorders, and 3 of them presented aspiration,2 patients were silent aspirators, 1 was aspiration before and 1 after swallowing. The aspiration time could not be judged from the videofluoroscopy in the other one. For 4 patients with aspiration, 3 were severe, with more than 25% of the bolus aspirated, and 1 aspirated less than 5%. Conclusion VFSS can be helpful to plan individual rehabilitation.