Prediction of Long‐Term Outcomes of Catheter Ablation of Persistent Atrial Fibrillation by Parameters of Preablation DC Cardioversion

Prediction of Long‐Term Outcomes of Catheter Ablation of Persistent Atrial Fibrillation. Aim: It has been demonstrated that atrial fibrillation (AF) frequently recurred after cardioversion (CV) using direct current (DC) or radiofrequency catheter ablation (RFCA) in patients with persistent (PeAF) or longstanding persistent AF (LPAF). We hypothesized that the atrial substrate impeding successful CV would also produce difficulty in catheter ablation, and therefore, the outcomes of RFCA for PeAF and LPAF could be predicted by the parameters determined at the time of DC CV. Method: From 2006 to 2009, 94 patients with PeAF and LPAF who had undergone elective DC CV before RFCA were studied. The parameters associated with DC CV, including number of shocks, cumulative energy adjusted, highest energy adjusted, with or without intravenous amiodarone use, and other clinical parameters were assessed. Result: Thirty‐two out of the 94 patients (34%) experienced AF recurrence during the follow‐up of 19.8 ± 12.3 months after RFCA. The average time to recurrence of AF after RFCA was 9.2 ± 3.2 months. Of the 62 patients, 29 patients (31%) remained sinus rhythm (SR) without antiarrhythmic drug (AAD). The patients who maintained SR had smaller body mass index (BMI) (P = 0.048), shorter duration of AF (P = 0.012), and lower prevalence of diabetes mellitus (P = 0.023) compared with patients in whom AF recurred. Total number of shocks, total energy, and highest shock energy during CV were lower (P < 0.001, P = 0.002, P = 0.048, respectively) in patients with SR during the follow‐up. The outcome in patients who used amiodarone IV prior to CV, however, was not different from that in those who did not use amiodarone IV. Conclusion: DC energy parameters for successful CV before RFCA were useful to predict the long‐term outcome after RFCA in patients with PeAF and LPAF. The presence of the atrial substrate making DC CV difficult might reflect atrial substrate that subsequently related to the recurrence of AF after RFCA in chronic AF. These DC energy parameters may be related to the chronicity or electroanatomical remodeling of AF. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1165–1170, November 2012)     

下呼吸道感染菌的分布及耐药性分析

目的: 研究下呼吸道所感染病原菌的分布以及耐药状况,给临床治疗下呼吸道感染性疾病提供参考
依据,并且可以指导临床合理使用抗菌药物。方法: 对诊断为下呼吸道感染病人的深部痰液进行培养,共培养分
离出3936 株致病菌,对其鉴定及药物敏感试验的结果进行了回顾性分析。结果: 下呼吸道感染病原菌中鲍曼不
动杆菌检出率最高为905 株( 23%) ,其次为肺炎克雷伯菌818 株( 20．8%) 、铜绿假单胞菌768 株( 19．5%) 、金黄
色葡萄球菌405 株( 10．3%) 、大肠埃希菌350 株( 8．9%) ; 对亚胺培南的耐药率: 大肠埃希菌最低为0．1%,肺炎克
雷伯菌为0．3%。鲍曼不动杆菌和铜绿假单胞菌的耐药率较高,未发现耐万古霉素金黄色葡萄球菌。结论: 下呼
吸道感染主要病原菌为鲍曼不动杆菌和肺炎克雷伯菌,对头孢类和喹诺酮类药物的耐药率明显较高,临床应依
据药敏报告结果合理选用抗菌药物。     

口腔颌面部恶性肿瘤手术前后血清TRF、RBP和PAB变化及临床意义

目的探讨血清中营养状态监测指标转铁蛋白（TRF）、视黄醇结合蛋白（RBP）、前清蛋白（PAB）在口腔颌面部恶性肿瘤手术前后的变化及临床意义。方法采用免疫散射比浊法,检测30例口腔颌面部恶性肿瘤病人术前3d、术后1周、术后1个月血清中TRF、RBP、PAB水平,以30例良性肿瘤病人作为对照组,以30例健康人作为空白对照组。结果口腔颌面部恶性肿瘤病人术前TRF、RBP、PAB水平与对照组及空白对照组相比,差异无统计学意义（P〉o．05）。口腔颌面部恶性肿瘤病人术后1周血清TRF、RBP、PAB水平与术前相比,差异有统计学意义（t=3．37～5．88,P％0．01）;术后1个月与术前相比,差异无统计学意义（P〉0．05）。结论TRF、RBP、PAB的检测可为口腔颌面部恶性肿瘤术后营养状况提供可靠依据,有一定的临床应用价值。     

宫术宁胶棒在绝经后妇女取环术中的应用

目的 观察绝经后妇女取环术中应用宫术宁胶棒(宫颈扩张棒)的临床效果.方法 选择来我所要求取环的绝经妇女共260例.随机分为两组:观察组130例,为宫术宁胶棒联合尼尔雌醇;对照组130例,为尼尔雌醇配伍米索前列醇.观察两组术中宫颈软化扩张情况、镇痛效果、综合反应程度、取器效果.结果 观察组宫颈软化、扩张、镇痛、综合反应与...     

2008年昆山市部分肺结核患者心理状况调查

[目的]探讨肺结核患者心理状况。[方法]使用Zung焦虑自评量表（SAS）、抑郁自评量表（SDS）对120例肺结核患者进行测评,并与120名健康者对照。[结果]肺结核患者两量表评分均显著高于健康者,SAS总分均值病例组为53．79,对照组为35．25,SDS总分均值病例组为51．42,对照组为34．08。[结论]肺结核患者有肯定的焦虑和抑郁,在治疗躯体疾病的同时,也要注重心理治疗。     

农药多菌灵对大青叶有效成分靛蓝、靛玉红含量的影响

目的:探讨农药多菌灵对大青叶有效成分靛蓝、靛玉红含量的影响。方法:通过田间试验设计3个试验组,在9个不同时间段内采集样品,采用高效液相色谱法测定大青叶中靛蓝、靛玉红的含量。结果:施用高、低浓度多菌灵后大青叶的有效成分均低于空白对照组。结论:施用一定浓度的多菌灵可降低大青叶中有效成分的含量。     

Ab and T cell epitopes of influenza A virus, knowledge and opportunities

The Immune Epitope Database and Analysis Resources (IEDB) (www.immuneepitope.org) was recently developed to capture epitope related data. IEDB also hosts various bioinformatics tools that can be used to identify novel epitopes as well as to analyze and visualize existing epitope data. Herein, a comprehensive analysis was undertaken (i) to compile and inventory existing knowledge regarding influenza A epitopes and (ii) to determine possible cross-reactivities of identified epitopes among avian H5N1 and human influenza strains. At present, IEDB contains >600 different epitopes derived from 58 different strains and 10 influenza A proteins. By using the IEDB analysis resources, conservancy analyses were performed, and several conserved and possibly cross-reactive epitopes were identified. Significant gaps in the current knowledge were also revealed, including paucity of Ab epitopes in comparison with T cell epitopes, limited number of epitopes reported for avian influenza strains/subtypes, and limited number of epitopes reported from proteins other than hemagglutinin and nucleoprotein. This analysis provides a resource for researchers to access existing influenza epitope data. At the same time, the analysis illustrates gaps in our collective knowledge that should inspire directions for further study of immunity against the influenza A virus.     

国内康复医学相关资源网站综合评估与分析

目的：探讨网络技术在康复医学资源共享领域的运用。方法：收集近五年来国内有代表性的康复医学资源网站或网络技术，按照各自属性分为学术组织类、专职机构类、特色康复医疗专业类、个体类四组，从一般普通网站共有的特征以及与康复医学资源共享相关的指标两方面进行了分析和比较。结果：所有网站在一般的总体性能指标上差异并不明显，但在与资源共享相关的指标评测中，各类网站总体差异很大。结论：网络技术在康复医学资源共享领域的应用正处于发展阶段，诸多方面尚须深人探究，但将有限的资源最大化共享对推动康复医学事业的整体发展将起到难以估量的作用。     

The inhibition of Src kinase suppresses the production of matrix metalloproteinases in from synovial fibroblasts and inhibits MAPK and STATs pathways

Background/aimThe purpose of this study was to investigate the antiarthritic potentials of the inhibition of Src kinase in vivo and in vitro settings. Materials and methodsArthritis was induced by intradermal injection of chicken type II collagen combined with incomplete Freund’s adjuvant (collagen induced arthritis [CIA] model) in Wistar albino rats. One day after the onset of arthritis, dasatinib, a potent Src kinase inhibitor, (5 mg/kg/day) was given via oral gavage. Tissue Src, Fyn, MAPK and STAT mRNA expressions were determined by real-time polymerase chain reaction. On the other hand, fibroblast like synoviocytes (FLSs) were harvested patients with rheumatoid arthritis (RA) undergoing surgical knee joint replacement. FLSs were stimulated with cytokines and dasatinib was added in different concentrations. MMP –1, –3, and –13 levels in FLSs culture were determined by ELISA.ResultsThe tissue mRNA expressions of Src, Fyn, MAPK and STATs were increased in the arthritis CIA group compared to the control group. Their mRNA expressions in the CIA + dasatinib group were decreased and similar in the control group. In in vitro setting, MMP –1, –3, and –13 expressions from FLSs induced by IL-1β and TNF-α were increased, while dasatinib suppressed their productions from FLSs.ConclusionThe present study shows that the inhibition of Src kinase has antiarthritic potentials in both in vivo and in vitro settings. Src kinase inhibition may be candidate to further research in human RA.