Objective: To evaluate the efficiency of left cardiac sympathetic denervation (LCSD) in inherited arrhythmia patients with adrenergic activity-induced malignant ventricular arrhythmia, and observe exercise-stress test features before and after LCSD. Methods: This retrospective observational study included catecholaminergic polymorphic ventricular tachycardia(CPVT) and long QT syndromes(LQTS) patients who underwent video-assisted LCSD at Beijing Tsinghua Changgung Hospital and Peking University People's Hospital from September 2006 to May 2020. The indications for LCSD surgery were intolerant or refractory to beta-blocker medication. Clinical and exercise-stress tests data of included patients were collected before and 1 month after LCSD. Heart rate, exercise tolerance, atrial and ventricular arrhythmia, QTc interval and predictors for sudden cardiac death were analyzed. Patents were regularly followed up at 1, 3, 6, and 12 months after LCSD and then once every year thereafter. Cardiac events and medication adjustment records were collected. Results: Five patients (2 CPVT, 1 LQT1, and 2 LQT2)were included in the study. All patients experienced syncope as first symptom at the median age of 12(10, 16)years, and underwent LCSD at the median age of 21(16, 26)years, Baseline heart rate was similar before and after LCSD ((65.6±6.5) beats/min vs. (68.0±11.1) beats/min, P=0.57); while maximum workload tended to be lower after LCSD ((12.1±2.8) metabolic equivalents (METS) before surgery vs. (10.5±2.4) METS after surgery, P=0.07). Incidence of atrial and ventricular arrhythmia were significantly reduced post LCSD, and the ventricular arrhythmia score was decreased after LCSD in CPVT patients (4 points before LCSD vs. 3 points after LCSD in case 1;5 points before LCSD vs. 3 points after LCSD in case 2). QTc interval was shortened significantly in three LQTs patients (QTc interval at baseline heart rate: (546.6±72.3) ms before surgery vs. (493±61.1) ms after LCSD, P=0.047; QTc interval at maximal exercise heart rate: (516.3±73.7) ms before surgery vs. (486.7±64.2)ms after LCSD, P=0.035). Additionally, sudden cardiac death risk indicator ΔHRR1 (heart rate decreasing value within the first 1 min during recovery phase) decreased from (51.5±21.1) beats/min before surgery to (32.0±13.9) beats/min after surgery (P=0.035). During a median follow-up of 1(1, 4) year, all five patients were on low dosage of propranolol (37.0±21.7) mg/d. Cardiac events free survival was achieved in four out of 5 patients (80%) after sympathectomy, while 1 case suffered from sudden cardiac death after emotional stress. Conclusion: LCSD surgery can be safely and effectively performed in most hereditary arrhythmia patients with adrenergic activity-induced life-threatening cardiac events. Exercise stress test results show that LCSD could reduce malignant arrhythmias and improve sudden cardiac death risk indicators without decreasing heart rate.

Humans ; Hypopharyngeal Neoplasms ; Hypopharynx ; Neurilemmoma

This study was conducted to define the taxonomic status of Spermophilus in the plague area of Dingbian County in Shaanxi Province, China, through the two-factor variance analysis of morphological characteristics, DNA barcoding, and chromosome karyotype analysis. The Spermophilus samples collected from Dingbian and Zhengxiang Baiqi Counties exhibited significant differences in their morphological measurements. All Spermophilus samples form two distinct branches in neighbor-joining (NJ) tree. One branch included the Spermophilus samples collected from Inner Mongolia, and the other branch included samples collected from the plague foci of Shaanxi Province and the Ningxia Region. The Spermophilus samples collected from Dingbian County had a chromosome number of 2n = 38 in 84.40% of all their cells. The Spermophilus species collected from the plague area of Dingbian County was categorized as Spermophilus alashanicus (S.alashamicus). The findings reported in this study are epidemiologically significant for monitoring plague in this region of west-central China.
Animals ; China ; Cytochromes b ; analysis ; DNA Barcoding, Taxonomic ; Electron Transport Complex IV ; analysis ; Karyotype ; Plague ; microbiology ; Sciuridae ; anatomy & histology ; classification ; genetics

Drug resistance of multiple myeloma(MM) has become more and more common, and greatly decreased the survival rate of these patients. The occurence of drug-resistance involves in many factors such as bone marrow microenveronment, tumor cell self-metabolism, cytokines, specific targets and so on. In this review, the potential mechanisms of resistance to glucocorticoid/proteasome inhibitor/immunomodulatory druges are briefly expounded in the aspect of tumor cell self-metabolism, including the changes of heat slock protein expression, mRNA expression, related cytokine levels and down-regulation of thalidomid-effecting site CRBN expression. In this review, the researches on the effect of histone deacetylase inhibitors(HDACi) combined with glucocorticoid, proteasome inhibitors, immunomodulatory drugs and monoclonal antibodies on multiple myeloma, specially, drug-resistant multiple myeloma are also summarized.

Adult ; Female ; Humans ; Meningeal Neoplasms ; complications ; diagnosis ; Meningioma ; complications ; diagnosis ; Otitis Media with Effusion ; diagnosis ; etiology ; Skull Base Neoplasms ; complications ; diagnosis

To explore the new method of discriminating Astragali Radix and Hedysari Radix by using PCR amplification of specific alleles, 30 samples of the different Astragali Radix materials and 28 samples of Hedysari Radix were collected. The total DNA of all samples were extracted, trnL-trnF sequence from Astragali Radix and Hedysari Radix was amplified by PCR and sequenced unidirectionally. These sequences were aligned by using Clustul W. Primer was designed and the PCR reaction systems including annealing temperature, dNTP, etc were optimized. All samples were amplified by PCR with specific primer, DNA from Astragali Radix would be amplified 136 bp, whereas PCR products from all of Hedysari Radix were 323 bp. This method can detect 10% of intentional Hedysari Radix DNA into Astragali Radix. PCR amplification of alleles can be used to identify Astragali Radix and Hedysari Radix successfully and is an efficient molecular marker for authentication of Astragali Radix and Hedysari Radix.
Alleles ; Astragalus Plant ; classification ; genetics ; DNA Barcoding, Taxonomic ; DNA, Plant ; genetics ; Polymerase Chain Reaction

Objective To introduce a new surgical technique for the treatment of bilateral vocal cord paralysis.Methods Twenty-nine patients with bilateral vocal cord paralysis treated in Dalian Municipal Central Hospital between 2008 and 2012 were retrospectively studied.Coblation assisted arytenoidectomy was performed in all cases.The pre and postoperative glottic measurement and vocal acoustic parameters were analyzed.Results All patients were decanulated 1 week after operation.Three months later,the mean glottic area increased from (21.9 ± 4.7) to (40.3 ± 5.2) mm2 (t =5.74.P ＜ 0.05) ; the width of maximal glottic chink increased from (1.47 ±0.37) to (4.82 ±0.54) mm (t =6.24,P ＜ 0.05).Twenty-six patients (89.7％) satisfied with the voice quality.Acoustic parameters (F0,jitter,shimmer) were no significant difference (P ＞ 0.05),but there was a significant difference in maximum phonation time (P ＜ 0.05).During three months to 3.5 years follow-up,the patients had a stable airway and effective phonation.Conclusions Endoscopic coblation assisted arytenoidectomy is a new surgical method for the treatment of patients with bilateral vocal cord paralysis,which is efficient,minimally invasive and safe.

Child, Preschool ; Cysts ; Diagnostic Errors ; Humans ; Leiomyoma ; diagnosis ; Male ; Nose Neoplasms ; diagnosis ; Vestibular Diseases

Objective To establish whether Coblation is a suitable modality for removal of early glottic carcinoma. Methods Fourteen patients with early glottic carcinoma (Tis-T2) without lymph node metastasis underwent resection of laryngeal cancer lesions using transoral endoscopic coblation (TEC),without pre- or post-operative radiotherapy and chemotherapy. Results No severe complication such as bleeding and dyspnea ocuurred in the cases. Only mild postoperative pain happened to the patients. All patients could eat and pronunce on the surgery day. With following-up of 25-37 months, no recurrence was observed in 13 cases. One case, with poorly differentiated squamous cell lesion in the anterior commissure invading subglottic, recurred 3 months postoperatively. The patient received the re-resection of laryngeal lesion by coblation, but another recurrence happened to the patient 6 months postoperatively, and then was cured by partial laryngectomy, with recurrence-free survival 21 months postoperatively. Conclusion The observation suggests that transoral endoscopic coblation is a reliable and safe modality for the resection of early glottic carcinoma.

Objective To evaluate the effect and feasibility of coblation treatment for laryngeal papilloma in adult. Methods A total of 18 patients with laryngeal papilloma treated by coblation from April 2008 to June 2010 was retrospectively analysed. There were 4 cases of multiple laryngeal papilloma and 14 cases of single laryngeal papilloma. All of these patients were treated with CoblatorTM Reflex #7070 under general anesthesia without tracheotomy. Results The volumes of blood loss during surgery varied from l ml to 10 ml, 2 ml on average. There was no postoperative bleeding or other complications. Follow-ups ranged from 6 months to 33 months after surgery, median 18 months. Recurrence occurred 4 months and 8 months after surgery in two patients. They were treated with coblation for the second time and followed up for 4 months and 12 months respectively. Recurrence occurred again in one patient. Conclusion Coblation under suspension laryngoscope for laryngeal papilloma in adult was an ideal way due to less bleeding and less damage.