BACKGROUND: Several strategies of endovascular ablation with varying success rates and proarrhythmic effects have been proposed to treat persistent atrial fibrillation (AF). Evaluation of ablation patterns by computer simulation provides a tool for examination of its effectiveness and side effects. METHODS AND RESULTS: A biophysical model of the human atria based on magnetic resonance imaging derived geometry and a membrane kinetics model was used. Uniform conduction properties were assigned to the monolayer surface representing the atria. After induction of AF by burst pacing, progressively broader ablation patterns were applied: (A) individual pulmonary vein isolation (PVI); (B) double ipsilateral PVI; (C) double PVI with a roofline; (D) double PVI with a lateral mitral isthmus line, and (E) double PVI with both linear lesions. In addition, the influence of incomplete linear lesions and dilated atria were simulated. The incidence of AF termination was found to increase from pattern (A) to (E). Atrial flutter rate increased with incomplete ablations and in dilated atria. CONCLUSION: Computer simulation of various ablation patterns in persistent AF is feasible and can reproduce clinical results of catheter ablation. This model can be used to develop and simulate new ablation patterns and anticipate success rates and potential adverse effects. 相似文献
Laparoscopic single-port surgery has widely been introduced for the treatment of various abdominal conditions. But controversies still exist regarding its potential advantages and risks, especially for emergency surgery. The aim of this study was to evaluate the results of a single-port laparoscopic repair using straight laparoscopic instruments for the treatment of perforated duodenal ulcers.
Methods
A prospective consecutive case series was conducted including all patients with a perforated duodenal ulcer who underwent a laparoscopic single-port repair at a single institution from January 2012 to June 2018. The operation was performed through a single port using conventional straight laparoscopic instruments and intra-corporeal knot tying techniques.
Results
Out of 75 patients, simple closure of the perforation without omental patch was accomplished in 96% of cases. Conversion to an open operation was required in one patient (1.3%) due to a posterior duodenal perforation, and additional trocar placement was needed in another patient (1.3%). The mean incision length was 2.0 ± 0.2 cm. The mean operation time was 63.0 ± 26.6 min. Meantime a nasogastric tube remained in place was 2.9 ± 0.8 days. Mean duration of analgesic use was 2.8 ± 0.8 days. The rate of postoperative complications was 2.7%, including two patients with wound infections. There were no instances of intestinal leak or abscess. The postoperative hospital stay was 5.7 ± 1.2 days.
Conclusion
Laparoscopic single-port repair using conventional straight laparoscopic instruments with intra-corporeal knot tying technique was safe and feasible for patients with perforated duodenal ulcers with low risk factors. This method offers results comparable to those expected with the standard multiport laparoscopic approach with the addition of improved cosmetic outcomes.
By binding to nicotinic acetylcholine receptors (nAChRs), nicotine induces the proliferation and apoptosis of non-small cell lung cancer (NSCLC). Previous studies have indicated that α5-nAChR is highly associated with lung cancer risk and nicotine dependence. However, the mechanisms through which α5-nAChRs may influence lung carcinogenesis are far from clear. In the present study, we investigated the roles of α5-nAChR in the nicotine-induced expression of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF). Immunohistochemistry was used to detect the expression of α5-nAChR and HIF-1α in 60 specimens of lung cancer and para-carcinoma tissue. The correlations between the expression levels of α5-nAChR and HIF-1α and other clinicopathological data were analyzed. In a cell line that highly expressed α5-nAChR, the loss of α5-nAChR function by siRNA was used to study whether α5-nAChR is involved in the nicotine-induced expression of HIF-1α and VEGF through the activation of the ERK1/2 and PI3K/Akt signaling pathways. Cell growth was detected using the cell counting kit-8 (CCK-8). α5-nAChR (78.3%) and HIF-1α (88.3%) were both overexpressed in NSCLC, and their expression levels were found to be correlated with each other (P < 0.05). In the A549 cell line, α5-nAChR and HIF-1α were found to be expressed under normal conditions, and their expression levels were significantly increased in response to nicotine treatment. The silencing of α5-nAChR significantly inhibited the nicotine-induced cell proliferation compared with the control group and attenuated the nicotine-induced upregulation of HIF-1α and VEGF, and these effects required the cooperation of the ERK1/2 and PI3K/Akt signaling pathways. These results show that the α5-nAChR/HIF-1α/VEGF axis is involved in nicotine-induced tumor cell proliferation, which suggests that α5-nAChR may serve as a potential anticancer target in nicotine-associated lung cancer. 相似文献
A rapid biosensor for the detection of cyromazine in milk is reported based on a fluorescence quenching result. When an FAM labelled G-rich ssDNA Tcy2 is treated with cyromazine, it can form a G-quadruplex-CYR complex and cause a change in fluorescence. As a result, the presence of cyromazine can be determined by fluorescence quenching. This sensor is selective for the detection of cyromazine in raw milk and has a limit of detection of 0.68 ppb and a detection range from 0 to 200 ppb.A rapid biosensor for the detection of cyromazine in milk is reported based on a fluorescence quenching result.相似文献
Al thin film is extensively used in micro-electromechanical systems (MEMS) and electronic interconnections; however, most previous research has concentrated on their quasi-static properties and applied their designs on larger scales. The present study designed a paddle-like cantilever specimen with metal films deposited on the upper surface to investigate the quasi-static properties of Al thin film at room temperature under high vacuum conditions at microscopic scales. Energy loss was determined using a decay technique in the oscillation amplitude of a vibrating structure following resonant excitation. Grain size and film thickness size were strictly controlled considering the quasi-static properties of the films. This study found that the internal friction of ultra-thin and thin Al films was more dependent on the grain boundaries than film thickness. 相似文献