Cryoablation and Angiographic Evidence of a Concealed Right Atrial Appendage to Right Ventricle Accessory Pathway in an Infant

We report a case of successful cryoablation of a concealed accessory pathway from the right atrial appendage to the right ventricle in an infant. A 4‐month‐old female who had previously undergone successful ablation of a left‐sided accessory pathway was taken to the electrophysiology lab due to recurrent supraventricular tachycardia. While in this second supraventricular tachycardia, we found earliest atrial activation in the distal right atrial appendage. Angiography confirmed a connection between right atrial appendage and the right ventricle. Cryoablation at this location promptly terminated the supraventricular tachycardia. Following ablation, there were no further inducible arrhythmias and ventriculo‐atrial dissociation was appreciated.     

某高校医院合理用药健康教育调查分析

目的为大学生《合理用药健康教育》课程提供数据参考,同时为开展教师《健康教育大课堂》提供数据支持。方法以2018年5月期间来本院就诊的患者为研究对象,大学生201人,教师100人,结合对大学生开展的《合理用药健康教育》课程的药学部分,随机对其发放问卷调查,按问题类型进行统计分析。结果大学生年龄(18~30岁),教师年龄(30~60岁),在患者用药知识了解情况方面,两者基本无差异;在患者用药知识需求方面,两者有所差异。结论学生和教师在用药知识方面需求较高,今后健康教育应有针对性的进行。     

单独肝尾状叶血管瘤切除术

肝尾状叶由于解剖位置特殊,位置深,难以显露,手术难度大,是肝脏外科领域手术操作的难点与研究热点.随着肝血流控制技术的发展、肝实质离断技术的提高,肝尾状叶肿瘤切除率明显提高[1].2006年4月至2008年10月,我科完成单独肝尾状叶血管瘤切除术9例,现将手术技巧与疗效报道如下.     

西洛他唑出现心律失常1例

<正>西洛他唑(cilostazol)目前已逐渐广泛应用于临床,它对下肢动脉硬化引起的溃疡、疼痛、冷感及间歇性跛行等缺血性症状通过抑制血小板聚集,显示其良好的抗栓效果。同时该药物有扩张血管、抑制     

一种空气消毒器对手术室空气消毒效果观察

为了解空气消毒器对手术室空气动态消毒效果,采用现场试验方法,对手术室空气中自然菌消毒效果进行了观察。结果,手术过程中有人正常工作状态下,启动空气消毒洁净器消毒1 h,可以使空气中的自然菌总数减少至170 cfu/m3,对不同手术室空气中自然菌平均消除率≥58.54%。在同一手术室内有人活动情况下,启动空气消毒洁净器1 h,对空气中自然菌消除率为81.43%,开机4 h消除率为88.07%,持续开机能保持细菌总数呈下降趋势。结论,空气消毒洁净器在有人正常工作情况下,对手术室空气中自然菌具有明显消毒效果,持续作用可使空气中菌数达到II类环境要求。     

Atrial tachyarrhythmias and permanent pacing after pediatric heart transplantation.

BACKGROUND: Atrial tachyarrhythmias have been reported in as high as 50% of adult heart recipients. Limited information is available on arrhythmias in pediatric transplant patients. Our objective was to determine the prevalence and significance of atrial tachyarrhythmias and permanent pacing following pediatric heart transplantation. METHODS: A retrospective review of the medical records, electrocardiograms, and Holter recordings of all consecutive patients following heart transplantation at Children's Hospital, Boston (n = 104) and Lucile Packard Children's Hospital, Stanford (n = 123) was performed. The study group consisted of 227 patients with a median age at transplant of 10.2 yrs (1 day-23.3 yrs). RESULTS: Atrial tachyarrhythmias occurred in 32 patients (14%) at a median of 15 days post-transplant (1 day-9.2 yrs) and included atrial flutter (n = 13), atrial fibrillation (n = 7), ectopic atrial tachycardia (n = 5), atrioventricular reciprocating tachycardia or atrioventricular node reentry (n = 5), and other (n = 2). Atrial flutter was the only tachyarrhythmia associated with allograft rejection (6/13 atrial flutter vs. 0/7 atrial fibrillation vs. 0/5 ectopic atrial tachycardia, p = 0.03). Patients with atrial fibrillation had a 2.5 fold (95%CI 1.7-3.5) higher risk of death or retransplant compared to patients without atrial fibrillation. Ectopic atrial tachycardia tended to occur in younger recipients compared to atrial fibrillation and flutter (2.7 yrs vs 18.6 yrs and 8.5 yrs respectively, p = 0.06) and was associated with a benign clinical course. There was no association between atrial tachyarrhythmias and graft ischemic time, surgical technique, or coronary artery disease. Pacemakers were required in 12 patients (5.2%), 7 with sinus node dysfunction and 5 for intermittent complete atrioventricular block. There was no consistent association between the need for permanent pacing and coronary artery disease, rejection, or surgical technique. CONCLUSIONS: Atrial tachyarrhythmias and permanent pacing were uncommon in this cohort of pediatric heart transplant recipients. Association with cardiac rejection, clinical course, and mortality varied depending on the tachyarrhythmia mechanism.     

在市场经济的大潮中对军队中小医院生存与发展的思考

我院地处改革开放的前沿海口市，80年代在当地和军区同类医院中小有名气，由于种种原因，困难多多，现已被挤入后进行列，在改革中求生存、求发展，已成为当务之急。     

超声刀在鼻内镜鼻腔血管瘤切除术中的应用

目的探讨鼻内镜下超声刀应用于鼻腔血管瘤切除术的可行性及优点. 方法 10例鼻腔血管瘤患者在鼻内镜下,利用超声刀直接闭合切除血管瘤. 结果 10例均一次成功摘除血管瘤,术中出血少,术后无出血及并发症发生.均在术后2～3天治愈出院. 结论鼻内镜下超声刀切除鼻腔血管瘤,具有视野清晰、术中出血少、手术安全可靠等特点.     

Effects of florfenicol on early cytokine response and survival in a murine septic shock model

氟苯尼考对内毒素休克小鼠生存率和细胞因子的影响@张雪梅$Department of Pharmacology, College of Animal Science and Veterinary Medicine, Jilin University!Changchun 130062, Jilin, China;Department of Animal Medicine, Agricultural College of Yanbian University,