Objective:To explore the role of mechanical hemodynamic support (MHS) in mapping and catheter ablation of patients with hemodynamically unstable ventricular tachycardia (VT), report single-center experience in a cohort of consecutive patients receiving VT ablation during MHS therapy, and provide evidence-based medical evidence for clinical practice.Methods:This was a retrospective cohort study. Patients with hemodynamically unstable VT who underwent catheter ablation with MHS at Beijing Anzhen Hospital, Capital Medical University between August 2021 and December 2023 were included. Patients were divided into rescue group and preventive group according to the purpose of treatment. Their demographic data, periprocedural details, and clinical outcomes were collected and analyzed.Results:A total of 15 patients with hemodynamically unstable VT were included (8 patients in the rescue group and 7 patients in the preventive group). The acute procedure was successful in all patients. One patient in the rescue group had surgical left ventricular assist device (LVAD) implantation, remaining 14 patients received extracorporeal membrane oxygenation (ECMO) for circulation support. ECMO decannulation was performed in 12 patients due to clinical and hemodynamic stability, of which 6 patients were decannulation immediately after surgery and the remaining patients were decannulation at 2.0 (2.5) d after surgery. Two patients in the rescue group died during the index admission due to refractory heart failure and cerebral hemorrhage. During a median follow-up of 30 d (1 d to 12 months), one patient with LVAD had one episode of ventricular fibrillation at 6 months after discharge, and no further episodes of ventricular fibrillation and/or VT occurred after treatment with antiarrhythmic drugs. No malignant ventricular arrhythmia occurred in the remaining 12 patients who were followed up.Conclusions:MHS contributes to the successful completion of mapping and catheter ablation in patients with hemodynamically unstable VT, providing desirable hemodynamic status for emergency and elective conditions.

Humans ; Atrial Fibrillation/surgery* ; Left Atrial Appendage Closure ; Heart Atria/surgery* ; Catheter Ablation/methods* ; Atrial Appendage/surgery* ; Treatment Outcome

Objective: To investigate the effect of non-vitamin K antagonist oral anticoagulants (NOAC) on left atrial or atrial appendage (LA/LAA) thrombi in patients with nonvalvular atrial fibrillation (NVAF). Method: Data from 3 042 patients with atrial fibrillation(AF), who underwent transesophageal echocardiography (TEE) examination before cardioversion or catheter ablation for the detection of LA/LAA thrombus in our department from March 2016 to January 2018 were prospectively analyzed. Among these patients, LA/LAA thrombus was detected by TEE in 57 patients. A total of 19 patients who received dabigatran or rivaroxaban for ≥3 weeks and underwent repeated TEE were included, 38 patients were excluded (7 patients with rheumatic heart disease, 1 patient treated with pericardial decortication, 1 patient treated with surgical repair of endocardial cushion defect, 1 patient with LA thrombus associated with the atrial septal occluder device, 14 patients received warfarin therapy, 14 patients did not receive repeated TEE). Results: First repeated TEE results showed that LA/LAA thrombus was not completely resolved in 4 out of 4 patients treated with dabigatran (110 mg bid) for a median time of 119 (47, 258) days, whereas LA/LAA thrombus was completely resolved in 5 out of 11 patients treated with dabigatran (150 mg bid) for a median time of 80 (58, 147) days. Thrombus was completely resolved in 2 out of 2 patients treated with rivaroxaban (15 mg qd) for 110 days and 95 days respectively, and in 1 out of 2 patients treated with rivaroxaban (20 mg qd) for 91 days. Second repeated TEE was performed in 8 patients. Thrombus was resolved completely in 2 out of 3 patients with undissolved thrombus treated by dabigatran (110 mg bid) after increasing the dabigatran dosage (150 mg bid). Thrombus was resolved in 3 (1 patient prolonged treatment with dabigatran 150 mg bid and 2 patients switched to rivaroxaban 20 mg qd) out of 4 patients with undissolved thrombus under the dabigatran 150 mg bid regimen, whereas the thrombus remained unresolved in 1 patient switched to rivaroxaban (15 mg qd). After receiving rivaroxaban 15 mg bid treatment, the thrombus was finally resolved in 1 patient with undissolved thrombus treated by rivaroxaban 20 mg qd. There was no clinical thromboembolism or major bleeding events during the median follow up time of 462 (305, 558) days. Conclusions Our data show that NOAC is an effective therapeutic option for the treatment of LA/LAA thrombi. When eligible, a higher NOAC dosage may be preferred due to the higher efficacy on thrombus resolvement.

Objective To determine the risk factors associated with surgical site infection in closed calcaneal fractures.Methods A retrospective analysis was made on the clinical data of 312 patients with closed calcaneal fracture who had been treated by open plate osteosynthesis at our trauma centre from January 2008 to November 2014.They were 182 males and 130 females,from 18 to 75 years of age (average,44.3 years).By Sanders classification,52 cases were type Ⅱ,146 type Ⅲ,and 114 type Ⅳ.The fractures were caused by fall from a height in 159 cases,traffic accident in 97 ones,and crushing in 56 ones.All the patients received open reduction and internal fixation via a typical L-shaped lateral incision.Gender,age,cause for injury,smoking history,diabetes,interval between injury and operation,operation time and bone grafting were analyzed as possible risk factors in the study.Multivariate logistic regression was conducted for significant risk factors derived from the univariate analysis.Results The patients were divided into an infection group (28 cases,9.0％) and a non-infection group (284 cases,91.0％).The univariate analysis showed that the rate of smoking was significantly higher,the operation time significantly longer,the interval between injury and operation significantly shorter in the infection group than in the non-infection group (P ＜ 0.05).However,the logistic regression analysis revealed that operation time was the only independent risk factor for surgical site infection (P =0.005,OR =43.870).Conclusion Since operation time may be an independent risk factor for surgical site infection in closed calcaneal fracture,it is important to speed up surgery as quick as possible in control of surgical site infection as long as the surgical quality is ensured.

Objective To evaluate the accuracy and influencing factors of mini-probe endoscopic ultrasonography (EUS) in determining the T stage for early gastric cancer (EGC).Methods The clinical data of 103 patients with EGC who were admitted to the Peking University Cancer Hospital from March 2011 to June 2014 were retrospectively analyzed.The diagnosis results of mini-probe EUS were compared with postoperative pathological findings,of which the differences in the accuracy of mini-probe EUS in determining the T stage of EGC were analyzed according to tumor location,diameter,differentiated types,with or without ulceration and Lauren classification.The rate comparison and univariate analysis were done by the chi-square test,and multivariate analysis was done using the Logistic regression model.Results Among 107 lesions,75 lesions were detected in uT1a stage by mini-probe EUS and 32 lesions in uT1b stage.The results of pathological examination showed that 61 lesions were detected in T1 a stage,40 lesions in T1 b stage and 6 lesions in T2 stage.The accuracy of mini-probe EUS in the T1 stage of EGC was 66.4％ (71/107),including 70.7％ (53/75) in the uT1 a stage and 56.3 ％ (18/32) in the uT1b stage of EGC.There were significant differences in the accuracy of mini-probe EUS for determining the T stage of EGC among the patients with different tumor diameters,different differentiated types and with or without ulceration (x2=7.834,7.432,6.461,P ＜0.05).The results of multivariate analysis showed that tumor diameter more than 30 mm and undifferentiated types of tumors were independent risk factors affecting the accuracy of miniprobe EUS in determining the T stage of EGC (OR =0.340,0.332,95％ confidence interval:0.563-0.932,0.582-1.022,P ＜ 0.05).Conclusions The clinical value of mini-probe EUS in the T stage of EGC is relatively high.The accuracy of mini-probe EUS detecting in the T1 a stage of EGC is higher than the T1 b stage of EGC,and the factors affecting the accuracy of mini-probe EUS in determining preoperative stage of EGC include tumor diameter more than 30 mm and undifferentiated type of tumors.

Animals ; Disease Models, Animal ; Female ; Human papillomavirus 16 ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Uterine Cervical Neoplasms ; Xenograft Model Antitumor Assays

Objective: To observe the eff ect and mechanism of chronic high-fat diet on predation behavior in rats. Methods: Ten female SD rats with 4-week-old were randomly divided into a normal control group (NC group,n=5) and a chronic high-fat diet group (HF group,n=5). The rats in the NC group received the regular diet while rats in the HF group were fed with high-fat diet. Fitf een weeks later, the predation behavior of rats was evaluated by open if eld test and food foraging tests. At the end of experiments, the rats were killed and brain tissues were collected for evaluation of c-Fos protein expression in anterior cingulate cortex by immunohistochemical assay. Results: hT e predation behavior of rats in the HF group was signiif cantly impaired in the competitive or non-competitive food foraging test compared with the control rats (P<0.001). hT e c-fos protein expression in anterior cingulate cortex of rats from the HF group was signiif cantly decreased (P<0.001). Conclusion: Long time high-fat diet can aff ect the predation behavior of rats, which is related todysfunction of neuron in anterior cingulate cortex.

After a description of the background and ideas to introduce the third party testing in information system construction of Sichuan grass-root medical and health institutions and the specific working contents of third party testing team, the problems to which importance should be attached in information system construction were analyzed with suggestions put forward for their solution .

Objective To detection analysis of blood infectious disease markers in patients before blood transfusion or before surgery .Methods HBsAg ,anti-HBs ,HBeAg ,anti-HBe ,anti-HBc ,anti-HCV ,anti-HIV ,TP-Ab were detected for 3 542 cases of se-rum using chemiluminescence immunoassay(CLIA) and ELISA .Results For HBsAg ,there were 704 cases of positive among 3 542 cases ,the proportion was 19 .8% ;For anti-HCV ,there were 52 cases of positive among 3 032 cases ,the proportion was 1 .72% ;For anti-HIV ,there were 3 cases of positive among 3 049 cases ,the proportion was 0 .09% ;For TP-Ab ,there were 200 cases of positive among 3 153 cases ,the proportion was 6 .34% .The infection rate was different in different gender of HBV ,anti HCV ,anti HIV and TP-Ab .But for HBV ,anti-HCV and TP-Ab ,the detection rate of male was higher than female(P<0 .05);The infection rate was different in different age of HBV ,anti HCV ,anti HIV and TP-Ab different age .The detection rate of HBV and Anti-HCV in 21-40 years old was the highest ,They were 31 .9% and 2 .33% ;The detection rate of TP-Ab increases with age increased ,more than 60 years old was the highest ,up to 7 .55% .Detection of the above two methods ,for HBsAg ,there were 51 cases did not match ,the proportion was 1 .44% ;for anti-HCV ,there were 1 case did not match ,the proportion was 0 .03% ;for Tp-Ab ,there were 3 cases did not match ,the proportion was 0 .1% ;for anti-HIV ,CLIA agrees well with ELISA ,there were 3 cases of positive .The samples that did not match were detected by the third party verification of the reagent .The result displayed that CLIA was more accurate . Conclusion CLIA is a high-sensitivity detection method which could effectively avoid positive specimens missed ,detection of infec-tious disease markers in patients before transfusion or before surgery by CLIA had important significance .

Objective To investigate the value of narrow band imaging (NBI) and lugol chromo-endoscopy (LCE) in the diagnosis of advanced esophageal carcinoma.Methods The clinical data of 162 patients with advanced esophageal carcinoma who received NBI and LCE at the Cancer Hospital of Peking University from November 2010 to May 2012 were retrospectively analyzed.Esophageal mucosa was first examined using white light imaging (WLI),and then followed by NBI and LCE,and the lengths of the lesions were recorded.Biopsy histology was obtained in all abnormal mucosa which were detected by NBI or LCE.Difference in the length of lesions detected by the NBI/LCE and WLI was calculated.Surgical approach and method of anastomosis were recorded for patients who received surgical treatment,and the final treatment method was recorded for patients who did not receive surgical treatment.Difference in the treatment methods was compared before and after endoscopy.Results The length of the lesions detected by the 3 methods was identical in 121 patients,different in 41 patients.The difference ranged between 1 and 3 cm was observed in 22 patients,＞3 cm and ≤5 cm in 8 patients,＞5 cm and ≤10 cm in 7 patients,＞ 10 cm in 4 patients.Of the patients in the above mentioned 4 categories,there were 1,2,2,4 patients in each category received neo-adjuvant therapy,and the rest patients received operation.Superficial cancer contiguous to the primary lesion was found in 41 patients,including squamous cell carcinoma in 31 patients,carcinoma-in-situ in 3 patients and severe dysplasia in 7 patients.Of the 153 patients who received surgery,the surgical plan for 12 patients was modified.Intrathoracic anastomosis was changed to cervical anastomosis in 2 patients,anastomosis under the aortic arch was changed to anastomosis above the aortic arch in 3 patients,trans-abdominal operation was changed to thoraco-abdominal operation in 7 patients.Conclusions The combination of NBI and LCE is more accurate to evaluate the extent of lesions of advanced esophageal carcinoma,and is useful to decide the treatment protocol.Pathological examination of the adjacent abnormal mucosa should be carried out for patients whose lesion length was inconsistent under different observation methods.