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Objective To explore the significance of combining coagulation with bedside index for severity in acute pancreatitis (BISAP) scores in evaluation of severity of acute pancreatitis (AP).Methods One hundred and twenty-six patients with AP were diagnosed according to the AP:mild acute pancreatitis (MAP) group of 64 cases,severe acute pancreatitis (SAP) group of 62 cases,and selected 60 healthy persons as control group.AP patients BISAP scores were calculated in 24 h from admission,and the activity of partial thromboplastic time (AFTT),prothrombin time (PT),D-dimer and fibrinogen (FIB) were measured the next morning or after 8 h of fasting peripheral venous blood collected 3 ml.Results There was no significant difference in APTT,PT among three groups (P＞ 0.05).FIB and D-dimer in MAP group and SAP group were significantly higher than those in control group [(4.25 ± 1.01),(5.44 ± 2.19) g/L vs.(3.47 ± 0.49) g/L; (5.08 ± 3.20),(8.65 ± 6.43) mg/L vs.(3.41 ± 2.32) mg/L,P ＜ 0.05],SAP group was significantly higher than that in MAP group(P ＜ 0.05).The positive rate of D-dimer in MAP group was significantly lower than that in SAP group [26.6％(17/64) vs.85.5％ (53/62),P ＜0.01].BISAP scores and combining coagulation with BISAP scores predict the severity of AP AUC were 0.842(0.775-0.889),0.886 (0.839-0.925),there was no statistically significant difference (P ＞0.05).Conclusion The significance of combining coagulation with BISAP scores in the severity of AP is more accurate than only use BISAP scores,and will not increase the clinical application difficulty.
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Objective To observe safety and efficacy of intrauterine device MYCu IUD that releases indomethacin. Methods In total, 2000 women requiring IUD for contraception were chosen from domestic multiple clinical centers according to an unified standard. MYCu IUD and TCu380A IUD were randomly inserted for 1000 women each, respectively. All women were regularly followed-up one, three, six and 12 months after insertion. Results All the women were followed-up for 11 985.9 and 11 753.6 person-months in MYCu IUD and TCu380A IUD groups, respectively, with cumulative IUD application rates of 97. 80% and 94. 70%, and cumulative pregnancy rates with IUD of 0. 10% and 0. 31%, respectively. Cumulative expulsion (or partial expulsion) rate in MYCu IUD group was 0. 10%, significantly lower than that in TCu380A IUD one (1.73%), P ＜0. 01, and cumulative removal rate due to medical reasons (bleeding or pain) was 1.51 % and 2. 94%, respectively, P ＜ 0. 05. Rate of IUD-associated termination and overall rate of termination differed significantly between the two groups, P ＜0. 01. Adverse reactions one, three, six and twelve months after IUD insertion included irregular bleeding, prolonged menstruation, increased menstrual blood volume and pain, less in indomethacin-containing MYCu IUD group than those in TCu380A IUD without containing it, P ＜ 0. 01. Conclusions MYCu IUD is a comparatively ideal IUD that should be promoted for extensive use, with extremely low expulsion rate, good contraceptive effect, convenience and safety in insertion and removal, and less adverse effects.
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Intra-atrial re-entrant tachycardias (IARTs) are common late after heart surgery. Conventional mapping and ablation is relatively difficult because of the complicated anatomy and multiple potential re-entry loops. In this study we aimed to evaluate the electrophysiological characteristics and radiofrequency catheter ablation of atrial tachycardia (AT) induced by myocardial scar or incision. Methods In 6 patients (three male and three female, aged 33.3+ 11.8 years) who had AT related to myocardial scar or incision,electrophysiological study and radiofrequency catheter ablation (RFCA) were performed. Earliest activation combined with entrainment mapping was adopted to determine a critical isthmus. Results Re-entry related to the lateral atriotomy scar was inducible in 5 of6 patients. With entrainment mapping, the PPI (post-pacing interval)-TCL (tachycardia cycle length) difference was ＜30 ms when pacing at the inferior margins of the right lateral atriotomy scar. Among them, 3 patients had successful linear ablation between scar area to inferior vena cava, and 2 patients between scar area to tricuspid annulus. Re-entry involving an ASD patch was demonstrated in 1 of 6 patients. PPI-TCL differences ＜30 ms were observed when entraining tachycardia at sites near the septal patch. But linear ablation failed in terminating AT. There was no complication during procedure. No recurrence of AT related to incision was observed during follow-up except for the failed patient. Conclusion Under conventional electrophysiological mapping, adopting linear ablation from scar area to anatomic barrier, successful ablation can be obtained in patients with IRATs related to myocardial scar or incision.
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AIM: To investigate the effects of internal change of serum insulin and plasma glucose levels on serum free fatty acid (FFA) concentrations after glucose loading. METHODS: Serum insulin, plasma glucose and FFA concentrations were measured simultaneously in 234 essential hypertension patients who were undergoing oral glucose tolerance test (OGTT) [ including 20 cases with 2 type diabetes mellitus (DM), 74 impaired glucose tolerance (IGT), 140 normal glucose tolerance (NGT); 98 males, 136 females]. RESULTS: Fasting serum FFA concentration (?mol/L) in DM ((1 048.47)?481.6) was higher than that in IGT (760.1?332.1) (P
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Objective: To evaluate the biocompatibility of self made nitinol alloy ventricular septal defect occluder. Methods: Six nitinol alloy ventricular septal defect occluder were implanted in the ventricular septum by catheter in 6 normal anaesthetized open chest pigs, and the animals were observed for 45 to 120 d(2 animals). Results: One deaths resulted from hemorrhage and another from embolization of occluder in abdominal aorta during the placement procedure. Successful placement of the occluder was achieved in 4 animals. Four animals were killed at 45, 60 and 120 d. Postmortem gross and microscopic examination of 4 devices 45 to 120 d after placement showed that both the right and left ventricular discs of the occluder were completely covered by a smooth, shiny, glistening thin layer of neoendocardium, and the surface of neoendocardium was covered by a monolayer of endothelium like cells. The inflammatory infiltrate around the occluder was found at 45 d, and disappeared and fibrosis formed at 120 d. These appeared as a repair process of the injury. Embolization in lung,liver, spleen, kidney, intestinal and colon were not found. Conclusion: These suggest that the self made nitinol alloy ventricular septal defect occluder has good biocompatibility. [
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Objective: To investigate the findings of coronary artery angiography in coronary artery disease patients with diabetes mellitus. Methods: The angiographic fingings of 153 coronary artery disease patients from 1995 to 1997 were reviewed. Among them, 33 were diabetic,23 were impaired glucose tolerance(IGT) and 97 were nondiabetic patients. Results: The age, sex, hypertension, hypercholesterolemia, smoking and the rate of myocardial infarction were the same among 3 groups. But the 2 vessel and 3 vessel disease were more frequent in diabetic group(66.7% ,30.3%) than in nondiabetic group (26.8%,19 6%). Two vessel disease were more frequent in diabetic group(66.7%) than in IGT group (13.1%). Single vessel disease were less frequent in diabetic group(3.0%) than in IGT group(52.2%)and nondiabetic group(53.6%)( P
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Objective To evaluate the methods of electrophysiological study (EPS) and radiofrequency catheter ablation (RFCA) for atrial tachycardia (AT) and the efficacy of RFCA. Methods Thirty-nine patients with AT were selected to undergo EPS and RFCA. The mean illness course was (4.5?1.6) years. Two patients had atrial septal defect, one had coronary artery disease, one dermatomyositis, and the other 35 patients had no structural heart disease. Identification of the earliest endocardial atrial activity (EAA) was based on the activation mapping recorded during AT. Results AT was induced spontaneously by atrial premature beats in 3 patients, and all other AT was inducible by atrial stimulation. Nine patients had other types of tachycardia combining with AT (including 5 patients with atrioventricular nodal reentrant tachycardia, 2 with atrial flutter and 2 accessory pathway). The site of AT was located by recording the EAA during AT and the region of successful FRCA. In 33 patients of successful ablation, the sites of AT were 9 near coronary sinus orifice, 5 near His bundle, 13 in right atrial lateral wall along crista terminalis, 2 in superior vena cava, 3 in atrial septum and 1 in right pulmonary vein. The successful rate was 81% (33/39) with all success of 9 other tachycardia. The mean fluoroscopic time was (16.4?2.1) minutes. None of patients had complications during and after ablation. Conclusions RFCA is an effective and safe treatment for AT. The activation mapping is the most effective method. Atrial septum and crista terminalis are the most common sites of AT.
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Objective To explore the novel method to establish animal model of controllable sized atrial septal defect. Methods Fourteen dogs of both sexes were selected,with weight ranging from 15 to 20kg. Under guidance of fluoroscopy,ASD was established by using Brokenbrough needle and balloon dilatation. Results Tow dogs died of cardiac tamponade.Other twelve dogs had ASD created successfully without complication. Conclusion The method has the advantages of easy manipulation , size controllable and small amount of fluoroscopy exposure.
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Objective To develope a new method producing ventricular septal defect (VSD) model by transcatheter puncture and evaluate its feasibility and practicability. Methods Ten dogs underwent transcatheter ventricular septal puncture with Brockenbrough puncture needle via right jungular vein under fluoroscopy, and then dilated the defect with 6-8mm balloon catheter. Left ventricular (LV) angiography was performed with pigtail catheter by transaortic access after puncture. Right after the procedure and 1-4 months later, the dogs were sacrificed and the defects were inspected. Results VSDs were successfully made in 8 dogs, which were demonstrated by LV angiography with one defect at membranous part. The defects in other dogs were shown near membranous septum or muscular septum not far away from the membranous part. The distance from aortic valves to the rims of defect was 4-16mm, from tricuspid valves 4-10mm. Ⅲ?AVB was found in 1 dog which died 1 week later, with ruptured membranous part at autopsy. CRBBB was found in another dog. Conclusion Establishment of VSD animal by transcatheter puncture is feasible, practicable and of high successful rate and less complication.