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Objective:To analyze the clinicopathological characterization of primary esophageal benign tumor (EBT). Methods:A total of 1,058 EBTs were enrolled from 500,000 cases in an esophageal and cardiac tumor biological sample and clinical information data-base of Henan Key Laboratory for Esophageal Cancer Research (1973-2015) in the First Affiliated Hospital of Zhengzhou University. SPSS 21.0 software was applied for data analysis. Results:In this database, 1,058 cases with primary EBTs among the 249,246 esopha-geal tumor patients with detailed clinical and pathological information were identified with an incidence of 0.42%(1,058/249,246). A total of 544 patients were male with an average age of 50±11 years old, whereas 514 patients were female, with an average age of 52± 11 years old. Among the 10 types of EBTs, leiomyoma was the most common type (84.50%, 894/1,058), followed by papilloma (6.90%, 73/1058). Adenoma (0.38%, 4/1,058) was the rarest type. Leiomyoma, gastrointestinal stromal tumor, and neurofibroma mainly oc-curred in male patients. By contrast, lipoma, granulosa cell tumor, schwannoma, and hemangioma mainly occurred in female patients.All five cases of hamartoma occurred only in female patients. Given the incidence of≥50%as the common standard, the common EBT in sequence in young male patients was leiomyoma and gastrointestinal stromal tumor, whereas that in young female patients was granulosa cell tumor and lipoma. The common EBT in sequence in older male patients was papilloma, gastrointestinal stromal tumor, and leiomyoma, whereas that in older female patients was schwannoma, papilloma, leiomyoma, gastrointestinal stromal tumor, and hamartoma. Additionally, lipoma, hemangioma, neurofibroma, and adenoma in male patients and neurofibroma in female patients oc-curred in older patients. The different ages of patients with EBTs (P=0.034) and leiomyoma (P=0.004) had a statistical significance. In these EBTs, leiomyoma, papilloma, gastrointestinal stromal tumor, and schwannoma mainly occurred in the middle esophagus, where-as lipoma mainly occurred in the lower esophagus. The major treatment for EBT in the present study was surgery (57.54%, 492/855), which was followed by endoscopic resection (38.01%, 325/855) and others (4.45%, 38/855). Conclusion:The incidence of EBT is low, with a couple of different histological types. Gender, age, and predilection sites are different depending on the histological types of EBTs. Surgery and endoscopic resection are the major treatment methods.
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Objective: To explore the effects of letrozole [LE] in combination with low-dose intramuscular injection of human menopausal gonadotropin [HMG] on the ovulation induction and pregnancy of patients with polycystic ovary syndrome [PCOS]
Methods: A total of 156 patients with PCOS infertility were randomly divided into an LE group, a clomiphene citrate [CC] group and an LE + HMG group [n= 52]. LE and CC were orally taken according to the prescribed dosage on the 3rd-5th days of menstruation respectively, and 75 IU HMG was given through intramuscular injection. The ovulation induction parameters and pregnancy outcomes were observed
Results: The number of ovulation cycle of LE + HMG group was significantly higher than that of LE group [chi[2]=8.451, P<0.001]. After injection of human chorionic gonadotropin, both endometrial thickness and number of mature follicles of LE + HMG group were significantly higher than those of other two groups [P<0.001], and the daily estradiol [E2] level was also higher [q=4.531, P<0.05]. The pregnancy rate of LE + HMG group was 55.7%, which exceeded those of other two groups [compared to LE group, chi[2]=4.012, P<0.05]. In LE + HMG group, the average medication cycle of clinically pregnant patients was [2.9 +/- 0.3] weeks, which was significantly shorter than those of CC and LE groups [F=17.241, P<0.001]
Conclusion: The regimen using LE in combination with low-dose intramuscular injection of HMG has satisfactory therapeutic effects on ovulation induction, short medication cycle and high clinical pregnancy rate, which is promising for treating patients with PCOS infertility
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Objective To investigate if women with subclinical hypothyroidism (SCH), positive thyroid gland peroxidase antibody(TPOAb) in early pregnancy accepted treatment or not had effect on perinatal outcomes. Methods 15 000 pregnant women who delivered in Women and Infants Hospital of Zhengzhou from January 1, 2013 to June 30, 2014 were recruited retrospectively. Among them, 2 042 women had SCH in early pregnancy. The diagnostic standard of SCH was serum free thyroxine (FT4) between 12.91-22.35 pmol/L and TSH level between 5.22-10.00 mU/L. TPOAb level ≥34 U/L was defined as positive result. The 2 042 patients with SCH were divided into the treated group (1 236 cases) and the untreated group (806 cases), according to whether or not women accepted the levothyroxine treatment. Meanwhile, the 2 042 patients with SCH were divided into the TPOAb (+) treated group (1 021 cases), the TPOAb (+) untreated group (201 cases), the TPOAb (-) treated group (215 cases) and the TPOAb (-) untreated group (605 cases), according to the TPOAb result and acceptance the levothyroxine treatment. 2 000 pregnant women with normal thyroid function who delivered in the same period were selected as the control group. Perinatal outcomes were analyzed. Results (1) The incidence of SCH in early pregnancy was 13.61%(2 042/15 000). 60.53%(1 236/2 042) accepted levothyroxine treatment and 39.47%(806/2 042) did not. (2) The incidence of abortion (5.71%, 46/806), premature delivery (6.20%, 50/806), gestational hypertension disease (13.90%, 112/806), gestational diabetes mellitus (GDM;6.58%, 53/806), fetal growth restriction (FGR;12.28%, 99/806)and low birth weight infants (10.17%, 82/806)in the untreated group were higher than those in the treated group [3.96%(49/1 236), 4.21%(52/1 236), 10.76%(133/1 236), 4.13%(51/ 1 236), 8.90%(110/1 236), 7.52%(93/1 236), respectively] and the control group [3.60% (72/2 000), 4.00%(80/2 000) , 10.70%(214/2 000) , 3.80%(76/2 000), 9.60%(192/2 000), 7.50%(150/2 000), respectively]. The differences were statistically significant (P0.05). (3)The incidences of abortion (11.44%, 23/201), premature delivery (12.44%, 25/201), gestational hypertension disease (22.89%, 46/201), GDM (8.46%, 17/201), FGR (19.90%, 40/201) and low birth weight infants (16.42%, 33/201) in the TPOAb (+) untreated group were higher than those in TPOAb (+) treated group [4.02% (41/1 021), 4.21% (43/1 021), 10.77% (110/1 021), 4.11% (42/1 021), 8.72% (89/1 021), 7.35%(75/1 021), respectively] and the control group, with statistically significant differences (P0.05). (4)There were no statistically significant difference (P> 0.05) in the incidence of abortion (3.72%, 8/215), premature delivery (4.19%, 9/215), gestational hypertension disease (10.70%, 23/215), GDM (4.19%, 9/215), FGR (9.77%, 21/215) or low birth weight infants (8.37%, 18/215) among the TPOAb (-) treated group, the TPOAb (-) untreated group [3.80% (23/605), 4.13%(25/605), 10.91%(66/605), 5.95%(36/605), 9.75%(59/605), 8.10%(49/605), respectively] and the control group. Conclusions (1) The incidence of abortion, premature delivery, gestational hypertension disease, GDM, FGR and low birth weight infants could be increased in women with SCH in early pregnancy.(2) Thyroxine treatment could reduce the incidence of pregnancy complications in women with SCH in early pregnancy. Objective To investigate if women with subclinical hypothyroidism (SCH), positive thyroid gland peroxidase antibody(TPOAb) in early pregnancy accepted treatment or not had effect on perinatal outcomes. Methods 15 000 pregnant women who delivered in Women and Infants Hospital of Zhengzhou from January 1, 2013 to June 30, 2014 were recruited retrospectively. Among them, 2 042 women had SCH in early pregnancy. The diagnostic standard of SCH was serum free thyroxine (FT4) between 12.91-22.35 pmol/L and TSH level between 5.22-10.00 mU/L. TPOAb level ≥34 U/L was defined as positive result. The 2 042 patients with SCH were divided into the treated group (1 236 cases) and the untreated group (806 cases), according to whether or not women accepted the levothyroxine treatment. Meanwhile, the 2 042 patients with SCH were divided into the TPOAb (+) treated group (1 021 cases), the TPOAb (+) untreated group (201 cases), the TPOAb (-) treated group (215 cases) and the TPOAb (-) untreated group (605 cases), according to the TPOAb result and acceptance the levothyroxine treatment. 2 000 pregnant women with normal thyroid function who delivered in the same period were selected as the control group. Perinatal outcomes were analyzed. Results (1) The incidence of SCH in early pregnancy was 13.61%(2 042/15 000). 60.53%(1 236/2 042) accepted levothyroxine treatment and 39.47%(806/2 042) did not. (2) The incidence of abortion (5.71%, 46/806), premature delivery (6.20%, 50/806), gestational hypertension disease (13.90%, 112/806), gestational diabetes mellitus (GDM;6.58%, 53/806), fetal growth restriction (FGR;12.28%, 99/806)and low birth weight infants (10.17%, 82/806)in the untreated group were higher than those in the treated group [3.96%(49/1 236), 4.21%(52/1 236), 10.76%(133/1 236), 4.13%(51/ 1 236), 8.90%(110/1 236), 7.52%(93/1 236), respectively] and the control group [3.60% (72/2 000), 4.00%(80/2 000) , 10.70%(214/2 000) , 3.80%(76/2 000), 9.60%(192/2 000), 7.50%(150/2 000), respectively]. The differences were statistically significant (P0.05). (3)The incidences of abortion (11.44%, 23/201), premature delivery (12.44%, 25/201), gestational hypertension disease (22.89%, 46/201), GDM (8.46%, 17/201), FGR (19.90%, 40/201) and low birth weight infants (16.42%, 33/201) in the TPOAb (+) untreated group were higher than those in TPOAb (+) treated group [4.02% (41/1 021), 4.21% (43/1 021), 10.77% (110/1 021), 4.11% (42/1 021), 8.72% (89/1 021), 7.35%(75/1 021), respectively] and the control group, with statistically significant differences (P0.05). (4)There were no statistically significant difference (P> 0.05) in the incidence of abortion (3.72%, 8/215), premature delivery (4.19%, 9/215), gestational hypertension disease (10.70%, 23/215), GDM (4.19%, 9/215), FGR (9.77%, 21/215) or low birth weight infants (8.37%, 18/215) among the TPOAb (-) treated group, the TPOAb (-) untreated group [3.80% (23/605), 4.13%(25/605), 10.91%(66/605), 5.95%(36/605), 9.75%(59/605), 8.10%(49/605), respectively] and the control group. Conclusions (1) The incidence of abortion, premature delivery, gestational hypertension disease, GDM, FGR and low birth weight infants could be increased in women with SCH in early pregnancy.(2) Thyroxine treatment could reduce the incidence of pregnancy complications in women with SCH in early pregnancy.
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BACKGROUND: Heme oxygenase-1 (HO-1) promotor region has a pair of dinucleotide(guanosine thymidine, GT) repeats with a lengthy polymorphism, also named microsatellite polymorphism. Experiments in vitro have shown that we can indirectly learn about the level of gene transcription by measuring the number of GT repeats.OBJECTIVE: To investigate if an association exists between restenosis after percutaneous coronary intervention(PCI) and microsatellite polymorphism in HO-1 gene promoter.DESIGN: A case-control study based on the observation of the patients with coronary heart disease after undergoing coronary stenting.SETTING: Wards of the department of cardiology of a university hospital.PARTICIPANTS: A total of 118 patients were admitted from April 1996 to May 2002 at the Department of Cardiology of the First Hospital of Peking University who underwent successful coronary stenting. Inclusion criteria: The patients with coronary heart disease who underwent coronary stent implantation for more than 3 months now came to perform coronary angiography in follow-up. Exclusion criteria: Angiography showed that the stenosis of lumen in diameter in the patients with coronary heart disease was less than 50%and the follow-up in angiography was less than three months. There were 92males and 26 females aged(62±10) years old and the informed consents were obtained. The patients were divided into two groups according to the criteria stipulated by American Heart,Lung and Blood Association: in-stent restenosis(68 cases) and non-restenosis (50 cases).METHODS: DNA of the peripheral blood was isolated from the whole blood. The length of GT repeat was confirmed by PCR amplification and Spreadex Gel electrophoresis. Selected samples were sequenced with Sanger's method.MAIN OUTCOME MEASURES: Microsatellite gene frequency of HO-1promoter and its relationship with restenosis RESULTS: Patients with GT repeats <25 GT in the HO-1 gene promoter on either allele had significantly less often restenosis than patients without (47.5% vs. 68.4% ,P<0.05). After controlling some possible confound ing factorsfor coronary heart diseases, multivariate analysis indicated that still there was a significant difference between the two groups in restenosis rate(odd ratio 0. 418,95% CI: 0. 197 to 0. 887,P<0.05).CONCLUSION: The present study indicated that short(GT) n repeats of HO-1 gene promoter is associated with reduced post-PCI restenosis, which suggests the genetic contribution to in-stent restenosis after stent implantation. It may have important meanings to prevent the occurrence of restenosis.
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0 05 There was 1 case of cardiac tamponand and 1 case of 60% stenosis of the left superior PV associated with the procedure Conclusion ERAF after segmental PV isolation is common, occurring in approximately 39% of patients with paroxysmal AF However, approximately 35% of ERAF patients without early repeat ablation have no further AF during long term follow up It is suggested that temporary antiarrhymic drug therapy may be more appropriate than early repeat ablation in patients with ERAF
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Objective The aim of this study was to investigate the mechanisms and the possible treatment of early and frequent recurrence of atrial fibrillation after segmental pulmonary veins isolation (PVI) in patients with paroxysmal atrial fibrillation (AF). Methods and Results Guided by Lasso mapping catheter, segmental pulmonary veins isolation was performed using radiofrequency energy in 54 consecutive patients (mean age 53?15 years) with recurrent documented symptomatic paroxysmal AF. Early recurrence of AF and rapid atrial arrhythmia occurred in 10 out of 54 patients (18.5%) within two weeks after PVI. 4 out of 10 patients (7.4 %) experienced early and frequent recurrence of atrial fibrillation and atrial tachyarrhythmia, which we termed as “atrial arrhythmic storm". The 4 patients were treated with class Ⅰ and Ⅲ antiarrhythmic drugs for 3 months. The “atrial arrhythmic storm" subided apparently and disappeared within two weeks after antiarrhythmic drug therapy. Only 1 patient still suffered from paroxysmal AF after drug control at mean follow-up of 3 months. After repeat ablation, there was no occurrence of AF and atrial arrhythmia in this patient.Conclusion A few paroxysmal atrial fibrillation patients experienced “atrial arrhythmic storm" after segmental pulmonary veins isolation. It is suggested that “atrial arrhythmic storm" after PVI may due to a lot of factors and combined antiarrhythmic drug therapy may be feasible. Early repeat ablation in patients with “atrial arrhythmic storm" may not be necessary.
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Objective To investigate the incidence and clinical significance of coronary artery anomalies in adults undergoing coronary angiography. Methods Data of all patients underwent coronary angiography from Jan 2001 to Nov 2003 in our hospital were reviewed retrospectively. Results Among 2?824 adult patients, 61 had coronary artery anomalies of which 84.1% were anomalous origin and distribution. The total detection rate of coronary artery anomalies was 2.1%. Anomalies were found to be happened more in the right coronary artery than in the left coronary artery. Four cases failed to undergo selective right coronary angiography. Conclusion Coronary artery anomalies are not rare in adults. Some types of coronary artery anomalies can induce myocardium ischemia and require intervention. Catheterization diagnosis and therapy of patients with anomalous origin of coronary artery may be difficult2?
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Objective To investigate the efficacy and safety of segmental electrical isolation of pulmonary veins (PVs) during atrial fibrillation (AF) Methods Nine patients were included, of whom 4 had recently persistent AF (3～4 months) and 5 suffored from paroxysmal AF occurred AF frequently We adopted one transseptal procedure Lasso mapping catheter and ablation catheter were positioned into target pulmonary vein ostium through the same site of atrial septum RF ablation was applied at the pulmonary vein potential (PVP) breakthrough using thermo control RF catheter during AF Results Twenty nine PVs were targeted for segmental RF ablation and isolated completely PVPs in target PVs were in higher spike and more frequent than left atrial potentials There were no complications associated with the procedure Seven patients were converted to sinus rhythm during the procedure Two patients restored sinus rhythm by cardioversion Conclusion It is suggested that the method of segmental PV isolation during AF is safe and has higher success rate It is not necessary to stop antiarrhymic drugs before RF ablation This study provides a reliable method for segmental electrical isolation of pulmonary veins in patients with persistent AF
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Objective To evaluate the clinical value of 12-lead Holter monitoring for coronary heart disease (CHD) patients with inferior myocardial ischemia. Methods Ninety-six patients with CHD had accepted coronary angiography (CAG) and 12-lead Holter examination. Results The sensitivity for detecting inferior myocardial ischemia in 12-lead Holter monitoring was 64.91%, the specificity 53.85%, and the positive detecting value 67.20%. In 12-lead Holter monitoring, inferior myocardial ischemia was recorded in 20% of only RCA lesion group, and in 70.37% of double -vessel lesion group, and in 80% of three-vessel lesion group.Conclusion 12-lead Holter monitoring is of some value to evaluate the inferior myocardial ischemia in CHD patients, but other clinical data should be considered.
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Objective To investigate the efficacy and safety of the segmental electrical isolation of pulmonary veins (PVs) in patients with paroxysmal atrial fibrillation (PAF). Methods Thirty-nine patients (28 males, 11 females) with recurrent documented symptomatic PAF were included. In order to avoid the risk of cardiac tamponand, we adopted one transseptal procedure and obtained unselective angiography of all PVs and left atrial appendage using pigtail catheter. Lasso mapping catheter and ablation catheter were put into target pulmonary vein ostium through the same site of atrial septum. We routinely mapped the right inferior PV lest any pulmonary vein potential (PVP) that triggered PAF should be omitted. RF ablation was applied at the PVP breakthrough and slightly right and left by moving the RF catheter. Results Eighty-five PVs were targeted for segmental RF ablation. Eight-one were isolated completely. Immediate successful rate was 95%. There was not any complication associated with the procedure. Conclusion It is suggested that the method of segmental PV isolation has a higher cure rate and a shorter procedure time compared with other traditional methods. It can minimize the lesion of pulmonary veins and avoid PV stenosis.
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Objective To evaluate the relationships between serum C-reactive protein(CRP) level and the risk factors of coronary heart disease ( CHD) as well as the severity of coronary lesions. Methods In 50 patients with primary diagnoses as unstable angina that were undergone coronary angiography, the serum CRP levels were measured by using particle enhanced immunonephelometry. The relationships between the serum CRP level and the risk factors of CHD as well as the severity of coronary lesions were assessed. Results Serum CRP level was higher in patients with hypertension (4.87?3.82)mg/ml vs. (1.81 ? 2.17)mg/ml, P = 0.0038
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Objective To investigate the prognostic implications of the size of left atrium with catheter ablation of atrial fibrillation.Methods Forty-two consecutive patients with symptomatic and drug-refractory paroxysmal or persistent AF admitted from 2005 May to 2006 November were included in the present study.The mean age was 60?12 years and 25 patients(58%)were male.Paroxysmal AF was present in 37 patients(88%)and persistent AF in 5 patients(12%).A 3D electroanatomic map of the LA including the pulmonary vein(PV)ostia was constructed with a nonfluoroscopic navigation system(Carto,Biosense Webster).The left and right PVs were encircled by continuous radiofrequency ablation lines.The left atrial diameter(LAD)was measured by 2D-guided M-mode echocardiography,in terms of anteroposterior diameter,left-right diameter and superior-inferior diameter by ”Simpson” method.Left atrial volume(LAV)was calculated by ”Pumbo” method.Body surface area(BSA)(m2)was used for indexing body size variables.The respective formulae are:left atrial volume index(LAVI)=LAV/BSA(mL/m2);left atrial diameter index(LADI)=LAD/BSA.Results Fifteen patients(34%)suffered from recurrent AF after 3 months of follow up.The LAVI of the recurrent group of patients was(68.19?23.68)mL/m2 compared with that of the non-recurrent group of(52.07?17.34)ml/m2(P=0.019).Logistic regression analysis revealed LAVI was the only independent risk factor of recurrence(OR=1.04,95% CI 0.99-1.09,P=0.04).Age(P=0.806),sex(P=0.338),AF history(P=0.46),hypertension(P=0.963),LAD(P=0.41),LADI(P=0.093),LAV(P=0.471),LVEF(P=0.91)between the 2 groups had no statistic differences.Conclusion Left atrial volume index(LAVI)is a better parameter compared with LAD,LADI and LAV in reflecting the left atrial size.LAVI is an independent predictor of recurrence of AF after catheter ablation.We found that LAVI≥55 mL/m2 was the strongest predictor,independent of age and other clinical parameters.
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Objective To investigate electrophysiologic characteristics,the original site of atrial tachycardia(AT)and the results of radiofrequency catheter ablation(RFCA)in children without structural heart disease.Methods Electrophysiologic study and RFCA were performed in 46 children with AT.The site of origin of AT was mapped by using activation mapping during tachycardia.Magnetic electroanatomical mapping(CARTO system)for ablation of atrial tachycardia was performed in 4 patients.Preselecting a temperature of 50~60 ℃ was selected for ablation.Results Electrophysiologic study verified that the mechanism of all the tachycardias in 46 children was focal AT,which might be short paroxysmal,paroxysmal or persistent.1 child also had atrioventricular nodal reentrant tachycardia.ATs were successfully ablated in 41 children(89%),in which 39 had one original site(27 foci in right atrium and 12 foci in left atrium),2 had at least two original sites.Conclusion The success rate of RFCA in ATs of children without structural heart disease was relatively high.Atrial taclycardia could be eliminated by radiofrequency current with safety and efficacy.
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Objective To analyze the electrophysiological characteristics of atrioventricular nodal reentrant tachycardia(AVNRT) requiring ablation at the mitral annulus.Methods Ablation was carried out at the mitral annulus by mapping the slow pathway with resetting method in order to acquire the electrophysiological parameters needed for successful ablation of AVNRT.Results Three cases with AVNRT who had prior failed ablation were successfully ablated by targeting the slow pathway located at the mitral annulus.The location of the left-sided slow pathway was selected by a positive resetting response and verified by junctional automaticity elicited by radiofrequency application and elimination of tachycardia.Conclusion AVNRT refractory to ablation of slow pathway at the posteroseptal area may require ablation at the mitral annulus.Resetting response may help to locate the slow pathway along the mitral annulus.
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1.5 mm were included for the analysis. The results were compared with catheter coronary artery angiography. Results In all patients, 16-slice CT were performed without complications. 1?267 segments were considered as stenosis by 16-slice CT. With the results of conventional coronary angiography as the golden standard, the sensitivity of 16-slice CT was 75.43% and its specificity was 95.88%. Its positive predicted value was 74.58% while its negative predicted value was 96.01% and its accuracy was 93.05% for stenosis of greater than 50%. Conclusion 16-slice CT provides a good visualization of the coronary tree in most patients, allowing accurate non-invasive detection of significant coronary stenosis.
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Objective To study the incidence and the effect of intracoronary stenting for spontaneous coronary artery dissection (SCAD). Methods Data from coronary angiography performed in 2?216 patients were analyzed to discover SCAD. Intracoronary stents were implanted in the patients with SCAD suited for percutaneous coronary intervention (PCI). Aspirin, clopidogrel, heparin or low molecular weight heparin were used on demand during the operation-around period. Results Twenty-six cases of SCAD [19 males, 7 females, mean age (60.9?11.6) years] were discovered. The incidence was 1.17%. Among the 26 patients, 15 suffered from acute myocardial infarction and 11 unstable angina. SCAD occurred in 28 blood vessels of the 26 cases, of which, 1 was in LM, 9 in LAD, 4 in LCX and 14 in RCA. Twenty-three stents were implanted in 19 coronary arteries of 18 patients (15 stentings after PTCA and 4 direct stentings). After PCI, remaining stenosis of one SCAD lesion was