导管射频消融治疗特发性室性心动过速

[目的]探讨标测特发性室性心动过速(IVT)有效靶点的方法及对射频消融成功的影响。[方法]8例IVT的患者,其中右室流出道特发室速(RVOT)5例,左室特发室速(ILVT)3例,先采用激动标测,然后采用起搏标测,标测到靶点后行射频消融。[结果]8例特发性室性心动过速患者均一次消融成功,无复发。[结论]不论RVOT或ILVT,激动标测加起搏标测具有很高的准确性。     

特发性室性心动过速的导管射频消融治疗

目的观察导管射频消融治疗特发性室性心动过速(IVT)的疗效及安全性。方法根据IVT发作时的体表12导联心电图定位起源部位,行心腔内电生理检查,寻找稳定诱发IVT的条件,对起源于左室间隔部的特发性左室室速(ILVT)采用激动标测法或窦性心律下直接标测Purkinje电位(P电位);对特发性右室室速(IRVT)采用激动标测和起搏标测相结合的方法标测靶点,标测靶点后放电消融。结果25例患者行心内电生理检查时均诱发出VT,ILVT消融的靶点在左心室间隔面中、下部,IRVT消融靶点在右室流出道的间隔部及游离壁,24例消融成功,患者的临床症状消失,无手术相关的并发症,随访期间1例复发,再次消融成功。结论导管射频消融技术能够根治IVT,成功率高、安全,可作为治疗IVT首选方法。     

射频消融治疗特发性室性心动过速9例临床报告

目的观察射频消融技术治疗特发性室性心动过速 (IVT)的临床效果。方法根据发作IVT时的体表 12导联心电图定位起源部位 ,行心内电生理检查 ,寻找稳定诱发IVT的条件 ,采用激动标测或 (和 )起搏标测相结合的方法标测靶点 ,对起源左心室间隔部的IVT寻找Purkinie电位 (p电位 ) ,标测靶点后放电消融。结果 11例呈RBBB图形伴电轴左偏或重度右偏 ,靶点在左心室间隔面中、下部 ,10例找到p电位。 7例为LBBB图形伴电轴不偏或右偏 ,靶点在右心室流出道 ;1例为LBBB图形伴电轴左偏 ,靶点在右心室流人道。l例IVT同时起源右室流出道的间隔部和游离壁 ,l例左心室特发性室性心动过速 (ILVT)合并房室结折返性心动过速的患者先消融房室结双径路 ,再行ILVT的消融。 1例右心室特发性室性心动过速 (IRVT)消融虽未立即成功 ,因延迟作用 3周后心动过速消失。消融成功患者的临床症状消失 ,未出现手术相关的并发症 ,随访期内所有病例存活。结论射频消融治疗IVT临床疗效肯定、成功率高、安全 ,应作为首选的根治方法。     

特发性室性心动过速的射频消融治疗

目的：报道５ 例特发性室性心动过速射频消融疗效。　方法：５例患者中,右室流出道特发性室速４ 例,左室特发性室速１ 例,均给予射频消融术治疗。　结果：３例右室特发性室速和１例左室特发性室速消融成功,１ 例右室特发性室速好转。４ 例成功患者随访４～２８ 个月无复发,１ 例好转患者消融后仍有室性早搏,但无室性心动过速发生。　结论：特发性室性心动过速消融成功率高,在体表心电图和影像解剖定位指导下,激动标测与起搏标测的结合是寻找消融靶点的有效方法。     

特发性室性心动过速及室性早搏的射频消融治疗

目的：探讨特发性室性心动过速（IVT）的射频消融（RFCA）治疗效果。方法：对3例左室特发性室速（ILVT）、2例右室流出道室速（RVOT）及3例右室流出道室性早搏，分别采用激动顺序标测法及起搏标测法行射频消融治疗。结果：所有患者术中均成功消融室速或室早，术后随访3个月－2年，无一例复发。结论：射频消融治疗特发性室速或室早是安全、有效且成功率高的一种方法。     

射频消融治疗特发性室性心动过速临床观察

目的观察射频消融（RFCA）治疗特发性室性心动过速（IVT）的可行性、安全性和有效性。方法对21例IVT患者,停用抗心律失常药,以心内激动顺序标测及起搏标测两种方法相结合确定靶点进行消融,温度〈60℃,功率〈50W。结果射频消融治疗的总成功率为95.2%,复发率4.76%,未出现严重并发症。结论射频消融术治疗IVT成功率高、安全性高,寻找靶点是关键。     

导管射频消融治疗特发性室性心动过速

目的:报道不同起源部位特发性室性心动过速(IVT)经导管射频消融(RFCA)治疗结果。方法:采用起搏标测及激动顺序标测法,右室特发性室速(IRVT)和其他未诱发的左室特发性室速(ILVT)均以起搏与室速(VT)发作时,12导联心电图QRS波形态完全相同处为靶点。左室特发性室速(ILVT)起自间隔部者以最早的P电位处为靶点,RFCA治疗IVT。结果:RFCA治疗IVT的成功率93.7%,IVT起源于左室后间隔2例,左室间隔基底部2例,左室游离壁1例,右室心尖部3例,右室流出道中间隔3例、后间隔2例。结论:IVT经RFCA的关键是消融靶点的确定,可根据VT发作时心电图估计其起源部位,IVT的RFVA成功率高。     

特发性室性心动过速的标测和导管射频消融治疗

目的观察导管射频消融(RFCA)治疗特发性室性心动过速(IVT)的效果和安全性。方法根据IVT发作时的12导联体表心电图初步判断起源部位,进行心腔内电生理标测,左室特发性室性心动过速(ILVT)采用激动顺序标测法,以最早的P点位或最早心室激动处为靶点;右室特发性室性心动过速(IRVT)除用以上方法外,结合应用起搏标测法,以起搏与IVT发作时12导联体表心电图QRS波形至少11导联相同处为靶点。结果RFCA治疗109例IVT患者的成功率为95.4%,其中IL-VT成功率95.5%,IRVT成功率95.2%。复发率为4.8%,经再次RFCA成功。均无严重并发症。结论RFCA治疗IVT的关键是消融靶点的标测与确定。RFCA治疗IVT安全、有效且成功率高。     

射频导管消融治疗特发性室性心动过速62例临床观察

目的观察射频导管消融(RFCA)治疗特发性室性心动过速(IVT)的效果。方法62例患者起源于左室间隔部IVT以激动标测到最早P电位并且起搏标测形态与VT形态一致为消融靶点;起源于其他部位IVT以激动标测到最早心室激动点并且起搏标测形态与VT形态一致为消融靶点。结果体表心电图能准确预测IVT的起源;起源于右室流出道36例(58.1%),左室间隔部21例(33.9%),右室流入道4例(6.5%),左室流出道1例(1.5%);消融成功率93.5%(58/62),复发率5.2%(3/58);消融未成功的主要因素为手术中未诱发出IVT;术后出现心包填塞1例。结论RFCA治疗IVT成功率高,并发症发生率低。     

室性心动过速的射频消融体会

１９９５年我院对２例室性心动过速的患者进行了射频消融治疗，１例为左室特发性室速；１例为扩心病并发右室流出道室速。我们均用心内膜起搏标测法，以起搏心电图与室速发作时体表１２个导联心电图完全相同处为消融靶点。１例一次消融成功，另１例三次消融成功，已随访一半，未见复发。笔者初步体会到，室速消融以起搏标测法为好，简单、安全、易掌握，不冒改变血流动力学的危险，适用于刚开展射频消融术的医院。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.