BACKGROUNDThe CHA2DS2-VASc score is used clinically for stroke risk stratification in patients with atrial fibrillation (AF). We sought to investigate whether the CHA2DS2-VASc score predicts stroke and death in Chinese patients with sick sinus syndrome (SSS) after pacemaker implantation and to evaluate whether the predictive power of the CHA2DS2-VASc score could be improved by combining it with left atrial diameter (LAD) and amino-terminal pro-brain natriuretic peptide (NT-proBNP).

METHODSA total of 481 consecutive patients with SSS who underwent pacemaker implantation from January 2004 to December 2014 in our department were included. The CHA2DS2-VASc scores were retrospectively calculated according to the hospital medical records before pacemaker implantation. The outcome data (stroke and death) were collected by pacemaker follow-up visits and telephonic follow-up until December 31, 2015.

RESULTSDuring 2151 person-years of follow-up, 46 patients (9.6%) suffered stroke and 52 (10.8%) died. The CHA2DS2-VASc score showed a significant association with the development of stroke (hazard ratio [HR] 1.45, 95% confidence interval [CI] 1.20-1.75, P< 0.001) and death (HR 1.45, 95% CI 1.22-1.71, P< 0.001). The combination of increased LAD and the CHA2DS2-VASc score improved the predictive power for stroke (C-stat 0.69, 95% CI 0.61-0.77 vs. C-stat 0.66, 95% CI 0.57-0.74, P= 0.013), and the combination of increased NT-proBNP and the CHA2DS2-VASc score improved the predictive power for death (C-stat 0.70, 95% CI 0.64-0.77 vs. C-stat 0.67, 95% CI 0.60--0.75, P= 0.023).

CONCLUSIONSCHA2DS2-VASc score is valuable for predicting stroke and death risk in patients with SSS after pacemaker implantation. The addition of LAD and NT-proBNP to the CHA2DS2-VASc score improved its predictive power for stroke and death, respectively, in this patient cohort. Future prospective studies are warranted to validate the benefit of adding LAD and NT-proBNP to the CHA2DS2-VASc score for predicting stroke and death risk in non-AF populations.

OBJECTIVETo analyze the risk factors for biliary complications of liver transplantation from donation after cardiac death (DCD).

METHODSClinical data of 109 patients undergoing liver transplantation from DCD in First Affiliated Hospital of Zhejiang University School of Medicine from October 2010 to October 2013 were studied retrospectively. The risk factors of biliary complications following DCD liver transplantation were analyzed.

RESULTSTwenty-four (22%) patients developed biliary complications after DCD liver transplantation. Univariate analysis showed that biliary complications were associated with warm ischemia time (P<0.001) and length of ICU stay (P=0.013), but not associated with ABO blood types match (P>0.05). Administration of inotropic agents and fatty liver increased the trend of biliary complications. Multivariate analysis demonstrated that warm ischemia time and length of ICU stay were independent risk factors for predicting biliary complications.

CONCLUSIONWarm ischemia time and days of ICU stay are independent risk factors for predicting biliary complications after DCD liver transplantation.

Biliary Tract Diseases ; epidemiology ; Death ; Humans ; Length of Stay ; Liver Transplantation ; adverse effects ; Postoperative Complications ; epidemiology ; Retrospective Studies ; Risk Factors ; Time Factors ; Warm Ischemia ; adverse effects

OBJECTIVETo investigate the effects of anluohuaqianwan on experimental hepatic fibrosis induced by dimethyl nitrosamine (DMN) in rats.

METHODS36 male SD rats were randomly dividied into three groups: model group, normal group, anluohuaqianwan group. The rats in the three groups were treated with DMN daily for 4 weeks. The liver function was detected using auto biochemistry analyzer, the serum HA, LN, IV-C, PIIIP were detected by immunoradiometry, the histopathology was observed in the left liver lobe after HE staining, the expression of matrix metalloproteinase-2 (MMP-2) in liver tissue were detected by immunohistochemistry.

RESULTSThe serum levels of ALT, AST, ALP, TP, ALB and the contents of HA, LN, IV-C in model group were significantly increased compared to these in the normal group (P less than 0.01). The serum levels of ALT, AST and the contents of HA in anluohuaqianwan group were significantly lower than those in the model group (P less than 0.01). The liver MMP-2 in the model group was significantly increased compared to that in the normal group (P less than 0.05). The expression of MMP-2 in liver tissue of model group was lower than that in the anluohuaqianwan group (P less than 0.05).

CONCLUSIONAnluohuaqianwan can inhibit liver fibrosis in rats induced by DMN.

Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Dimethylnitrosamine ; Drug Combinations ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Hyaluronic Acid ; blood ; Hydroxyproline ; metabolism ; Immunohistochemistry ; Liver ; drug effects ; metabolism ; pathology ; Liver Cirrhosis, Experimental ; chemically induced ; drug therapy ; metabolism ; pathology ; Liver Function Tests ; Male ; Matrix Metalloproteinase 2 ; metabolism ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo search for an effective therapy for the acute stage of peripheral facial paralysis.

METHODSOne hundred and twenty cases of facial paralysis patients were randomly divided into an observation group and a control group, 60 cases in each group. Both groups were treated with routine medication, and the observation group was treated with shallow needling combined with acupoint application using self-made "acupoint application formula for facial paralysis" on the basis of the routine medication. The acupoints of Yifeng (TE 17), Wangu (GB 12), Dicang (ST 4), Jiache (ST 6), Yangbai (GB 14), Taiyang (EX-HN 5), Qianzheng (EX-HN 17), Cuanzhu (BL 2) in affected side and Hegu (LI 4) in healthy side were selected as main acupoints for shallow needling, and Qianzheng (EX-HN 17), Dicang (ST 4), Yangbai (GB 14) and Wangu (GB 12), or Jiache (ST 6), Taiyang (EX-HN 5), Quanliao (SI 18) and Yifeng (TE 17) were selected for acupoint application. The cure rate and the course of cured patients in both groups were compared.

RESULTSThe cure rate of 88.3% (53/60) in observation group was superior to that of 66.7% (40/60) in control group (P < 0.01). The course of cured patients in observation group was obviously shorter than that of control group (P < 0.01).

CONCLUSIONOn the basis of routine medication, shallow needling combined with acupoint application can improve the therapeutic effect and shorten the course for acute stage of peripheral facial paralysis.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Facial Paralysis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult