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Objective To investigate the risk factors that may induce pneumothorax resulted from subclavian vein puncture during interventional therapy for arrhythmia.Methods The clinical data of 4 351 patients with heart disease,who were admitted to Wuhan Asia Heart Disease Hospital,China,during the period from January 2010 to January 2014 to receive subclavian vein puncture for the performance of radiofrequency catheter ablation or pacemaker implantation,were retrospectively analyzed.The gender,age,presence of chronic obstructive pulmonary disease (COPD) and the shape of clavicle of patients who developed pneumothorax were analyzed,and their relationships with the occurrence of pneumothorax were evaluated.Results Of the 4 351 patients,47 patients developed pneumothorax(1.08％),their age was 12-72 years old with a mean of (47.1±18.4) years old.Among the 47 patients,37 patients were females (78.7％).The angle between clavicle and sternum ＜60°(oblique clavicle) was seen in 27 patients,coexisting COPD was seen in 2 patients.The occurrence of pneumothorax was strikingly higher in females than that in males (OR=2.7,95％ CI=1.4-5.2).In patients with oblique clavicle the risk of pneumothorax was obviously increased (OR=3.5,95％ CI=1.6-7.9) and in patients with COPD the probability of pneumothorax was remarkably increased (OR=2.3,95％CI=1.2-4.7).No special treatment was employed in 5 pneumothorax patients,and the pneumothorax was absorbed by itself.In 19 patients,the pneumothorax was relieved through thoracic puncture and suction.Closed drainage of thoracic cavity was employed in 23 patients.All patients were discharged from hospital with complete rehabilitation.Conclusion Clinically,pneumothorax has been an important clinical problem in interventional therapy.In female patients and in patients who have oblique clavicle or coexisting COPD,pneumothorax is more likely to occur when they receive subclavian vein puncture.
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Objective To study the diagnostic significance of whole blood sample index in the severity of hand, foot and mouth disease, and to analyze its pathogenesis. Methods 194 cases of severe cases of hand, foot and mouth disease were selected as the case group,and 193 cases of mild hand, foot and mouth disease were selected as the control group. Blood samples were collected after admission to study the whole blood samples, including white blood cells, erythrocytes, platelets, medium cell ratio, lymphocyte ratio, mononuclear cell ratio, C-reactive protein test; The patient's immune system, the nervous system were also tested. Results Compared with patients with mild group, the white blood cell level of the patients in the severe group was higher and the albumin level was higher, the difference was statistically significant (P<0.05), the monocyte ratio, the T cell ratio was lower, the difference was statistically significant (P<0.05). Conclusion The white blood cell level and monocyte ratio of patients with severe hand, foot and mouth disease have changed. The whole blood sample has a certain sensitivity to the diagnosis of severe hand, foot and mouth disease.
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BACKGROUND:Recent studies have suggested that intranasal administration is one of the ways to target drugdelivery, and can effectively make the drug that cannot pass through the blood brain barrier by other pathways to bypass the blood brain barrier, resulting in targeted delivery to the brain. It provides a promising route for the treatment of central nervous system diseases. OBJECTIVE: To study the pharmacokinetic and brain-targeted channel-tropism tissue distribution character of cimicifugoside H-1 after nasal and intravenous administration in plasma and tissues in rats, in order to evaluate the feasibility of developing brain-targeted nasal delivery system of cimicifugoside H-1 by the passage between nose and brain in nasal olfactory area. METHODS: After intravenous injection and nasal administration of cimicifugoside H-1, the drug concentrations of plasma and channel-tropism organs (lung, spleen, stomach, large intestine, liver, kidney, brain, brain, cerebelum, cerebrospinal fluid, olfactory bulb and olfactory region) were detected. Drug-time curve was drawn. DAS program was used to select apartment model and pharmacokinetics parameters. RESULTS AND CONCLUSION:(1) The pharmacokinetics characters of cimicifugoside H-1 are rapidly absorbed and extensively distribution. Among major channel-tropism organs, drug concentrations were higher in the lung and brain than in the other organs. (2) Cimicifugoside H-1 could be straightly transported into brain by the intranasal administration. The molecule through olfactory mucosa in nasal cavity entered into olfactory bulb in arachno-hypostegal cavity, and then entered into olfactory region, cerebrospinal fluid, cerebrum and cerebelum gradualy. Olfactory bulb was the only way for drug molecule to go through nasal cavity into brain. (3) Compared with the intravenous injection, cimicifugoside H-1 through the intranasal administration has a significant
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Objective To investigate the clinical manifestations and inlfuencing factors in the newborns with coagulant function abnormality in the ifrst 24 hours after birth. Methods The coagulation test results and clinical data of 169 newborns in our hospital were studied. Children receiving anticoagulant therapy were assigned as coagulation abnormalities group (n=76) and other healthy newborns were assigned as control group (n=93). The differences of coagulation function between the two groups were analyzed and the inlfuencing factors of coagulation abnormalities were explored. Results The proportions of fetal distress, pneumonia, acidosis and hypothermia of coagulation abnormalities group were signiifcantly higher than that of the control group (χ2=6.18–38.01, P<0.05). Logistic regression analysis showed that fetal distress (OR=12.06, 95%CI:3.71–39.25), pneumonia (OR=4.10, 95%CI: 1.43–11.74) were the high risk factors for coagulant function abnormality, and the differences were statistically signiifcant (both P<0.05). Conclusions Fetal distress, pneumonia were the high risk factors for coagulant function abnormality. Early prevention can help to reduce the incidence of neonatal hemorrhagic disease.
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Objective To investigate the electrophysiological characteristics of atrial tachycardia (AT) originating from the side of the bundle of His, and to analyze the efficacy and safety of transcatheter radiofrequency ablation via the right side of the bundle of His and left noncoronary sinus of aorta for the treatment of AT. Methods A total of 12 patients with AT originating from the side the bundle of His, which was confirmed by conventional electrophysiological study and atrial activation patterns, were included in this study. The patient’s age ranged from 12 to 64 years old with a mean of (47.4±14.6) years. The mapping was carried out at the right side of the bundle of His and radiofrequency ablation was performed. When the ablation procedure failed, or the junction zone rhythm or atrioventricular block occurred, ablation via the left noncoronary sinus of aorta was employed. Results Atrial stimulation could repeatedly induce and terminate AT in all the 12 patients, the average cycle length was (327±76) ms. TA was terminated within 10 seconds after the start of ablation in 10 patients during their AT attacks. Ablation was unsuccessful in 2 patients. Ablation via the right side of His bundle was successfully accomplished in 2 patients, and the ablation via the left noncoronary sinus of aorta was successfully carried out in 8 patients. The average follow-up time was 1-6 years, and no recurrence of AT was observed. Conclusion Atrial tachycardia originating from the side of the bundle of His has certain electrophysiological characteristics, and transcatheter radiofrequency ablation is safe and effective for its treatment. Ablation via the left noncoronary sinus of aorta should be considered as a strategy of priority.
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Objective: To explore the feasibility with the safety at peri-operative and early post-operative periods for left atrial appendage occlusion in patients with non-valvular atrial ifbrillation (AF). Methods: A total of 17 non-valvular AF patients with transesophageal echocardiography (TEE) and CAHDS2 evaluation who received left atrial appendage occlusion in our hospital were summarized. The effect and complications during peri-operative and 1 month post-operative periods were analyzed. Results: All 17 patients had successful operation without severe complications. There were 8 patients having small amount residual shunt by TEE examination, 2 having ecchymosis near the puncture point at peri-operative period and 3 having small amount of hydropericardium by peri-cardio ultrasound examination. At the average of 45 days follow-up study, only 3 patients had small amount residual shunt, no left atrium thrombus and hydropericardium were observed. Conclusion: Left atrial appendage occlusion has the high success rate, it is safe during peri-operative and early post-operative periods in non-valvular AF patients.
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ObjectiveTo study electrophysiological characteristics and catheter ablation left-sided accessory pathways of Mahaim fiber.MethodsTwenty-eight patients underwent catheter ablation for Mabaim fiber and 3 patients was left-sided accessory pathways.All of them were male with 34,20,38 years old.The tachycardia history was1-5years. Electrophysiological characteristics,target sitesand electrocardiogram(ECG,12 leads) were recorded through catheter from coronary sinus(CS),high right atrium(HRA),His bundle and ablation.ResultsOne patient's ECG showed little preexcitation,the other two were normal. Atrial stimulation could be easily induced tachycardia.Their ECG showed wide QRS waves (right bundle branch block or similar right bundle branch block).The characteristics of accessory pathways were slow and anterograde decremental conduction as well as blocked by adenosine triphosphate injection.Ventricular-atrial conduction was via atrioventricular node with centripetal decreasing transmission during ventricular pacing.During tachycardia,the His bundle electrogram resulted in a V-H-A pattern,the retrograde A in His bundle was pioneer.The atriofascicular pathways of 2 patients were completely ablated respectively in left posterior lateral and before the free wall of mitral valve ring.The nodoventricular pathway of 1 patient was successfully ablated in left middle posterior lateral of mitral valve ring.ConclusionsThe left-sided accessory pathways of Mahaim fiber is an uncommon accessory pathway,which has specific electrophysiological characteristics.It is effective and safe to ablate accessory pathway with radiofrequency.
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<p><b>OBJECTIVE</b>To study the relationship between tissue quantitative distribution and pharmacokinetics of 3H-achyranthes bidentata ecdysterone and the channel-tropism of herbal drugs in mice.</p><p><b>METHOD</b>3H-achyranthes bidentata ecdysterone was used as a tracer agent and injected into mice by the caudal vein. In 36 hours, the contents of the tracer agent of samples involving 9 different tracing phases and organ or tissue were determined in order to observe the dynamic quantitative distribution and excretion and pharmacokinetics of 3H-achyranthes bidentata ecdysterone and to understand the channel-tropism of herbal drugs achyranthes bidentata.</p><p><b>RESULT</b>3H-achyranthes bidentata ecdysterone of same organs in different tracing phases and the contents of 3H-achyranthes bidentata ecdysterone in same tracing phases of different organs were significantly different (P<0.01). 3H-achyranthes bidentata ecdysterone was mainly distributed, in the liver, kidney, adrenal gland, small intestine and lung. The concentration-time profiles of achyranthes bidentata ecdysterone in rats injected into mice by the caudal vein were shown to fit a two-compartment open model with half-lives of (778.65 +/- 12.36) min, the elimination of achyranthes bidentata ecdysterone from plasma was found to be in accord with linear kinetics.</p><p><b>CONCLUSION</b>The above mentioned selective distribution of 3H-achyranthes bidentata ecdysterone basically coincides with the meridian affinity and zang fu selection of the traditional Chinese medicine drug Achyranthes bidentata. This study will provide a scientific basis for the channel-tropism of A. bidentata.</p>
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Animals , Male , Mice , Achyranthes , Chemistry , Drugs, Chinese Herbal , Metabolism , Pharmacokinetics , Ecdysterone , Metabolism , Pharmacokinetics , Isotope Labeling , Meridians , Organ Specificity , Tissue Distribution , Tritium , ChemistryABSTRACT
The influence of Cibotium barometz (L.) J. Sm. and its processed samples on thrombin-induced platelet aggregation in rabbits was studied. The results showed that all differently processed sam-ples tested could inhibit platelet aggregation, with activities in the decreasing order of Rhizoma Cibotiiroasted in stirring sand＞steamed after being salted＞steamed after steeped in wine＞simply steamed＞theunprocessed crude Rhizoma Cibotii.
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Objective To investigate the effect of cardiac resynchronization therapy on improving heart function and reversing left ventricular remodeling in chronic heart failure patients. Methods Eleven patients with NYHA class Ⅲ to Ⅳ heart failure, ejection fraction ≤35% and QRS duration ≥130 ms were implanted synchronous biventricular pacemaker. Serial assessment was performed before and up to 1-36 months after pacing. Results There were significant improvement of LVEF、 LVFS; and decrease in MR、 LVED and QRS duration. The NYHA class of heart function was improved from Ⅲ-Ⅳ to Ⅰ-Ⅱ. Six-minute hall walk distances were also improved. Conclusion For patients with NYHA class Ⅲ to Ⅳ heart failure and ventricular conduction delay, cardiac resynchronization therapy could reverse left ventricular remodeling and improve heart function.