ABSTRACT
Atrial fibrillation, also known as atrial fibrillation, is a common cardiac arrhythmia, and its incidence increases with age. Catheter ablation is considered to be an effective means to treat atrial fibrillation and maintain sinus rhythm. The common ablation technologies are radiofrequency ablation and cryoablation. However, the existing catheter ablation technology has a "zero-sum effect", and it is difficult to control the optimal dose clinically. In this study, a new method of pulsed electric field ablation for atrial fibrillation was proposed, which effectively solved the "zero-sum effect" problem of temperature ablation. The clinical application results show that the proposed technology effectively overcomes the shortcomings of existing temperature ablation, and can form durable pulmonary vein isolation.
ABSTRACT
Objective@#To evaluate the efficacy of bilateral erector spinae plane block (ESPB) in improving intraoperative wake-up quality in the patients undergoing thoracolumbar scoliosis correction with general anesthesia.@*Methods@#Forty American Society of Anesthesiologists physical status Ⅱor Ⅲ patients of both sexes, aged 18-60 yr, scheduled for elective posterior approach thoracolumbar scoliosis correction, were divided into 2 groups (n=20 each) using a random number table method: control group (C group) and bilateral ESPB group (E group). Bilateral ESPB was performed through injecting 0.375% ropivacaine 15-20 ml to each site in group E. Anesthesia was induced by intravenously injecting propofol, sufentanil and cisatracurium after dexmedetomidine was intravenously infused for 10 min.Anesthesia was maintained by intravenously infusing remifentanil, propofol and dexmedetomidine.Propofol infusion was stopped and the infusion rate of remifentanil and dexmedetomidine was decreased during intraoperative wake-up test.Wake-up test was performed every 30 s starting from 5 min after stopping propofol infusion.The wake-up time, occurrence of agitation and coughing, hemodynamic changes (△MAP and △HR, the difference between MAP while stopping administration before wake-up test and maximum MAP during wake-up test, the difference between HR while stopping administration before wake-up test and maximum HR during wake-up test) and blood loss were recorded.The wake-up quality was assessed during operation.@*Results@#Compared with C group, the wake-up time was significantly shortened, the incidence of agitation and coughing was decreased, blood loss was reduced, △MAP and △HR were decreased, and the wake-up quality was increased in E group (P<0.05).@*Conclusion@#Bilateral ESPB can increase the intraoperative wake-up quality in the patients undergoing thoracolumbar scoliosis correction with general anesthesia.
ABSTRACT
Objective To evaluate the efficacy of bilateral erector spinae plane block (ESPB) in improving intraoperative wake-up quality in the patients undergoing thoracolumbar scoliosis correction with general anesthesia.Methods Forty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes,aged 18-60 yr,scheduled for elective posterior approach thoracolumbar scoliosis correction,were divided into 2 groups (n=20 each) using a random number table method:control group (C group)and bilateral ESPB group (E group).Bilateral ESPB was performed through injecting 0.375％ ropivacaine 15-20 ml to each site in group E.Anesthesia was induced by intravenously injecting propofol,sufentanil and cisatracufium after dexmedetomidine was intravenously infused for 10 min.Anesthesia was maintained by intravenously infusing remifentanil,propofol and dexmedetomidine.Propofol infusion was stopped and the infusion rate of remifentanil and dexmedetomidine was decreased during intraoperative wake-up test.Wake-up test was performed every 30 s starting from 5 min after stopping propofol infusion.The wake-up time,occurrence of agitation and coughing,hemodynamic changes (△ MAP and △ HR,the difference between MAP while stopping administration before wake-up test and maximum MAP during wake-up test,the difference between HR while stopping administration before wake-up test and maximum HR during wake-up test) and blood loss were recorded.The wake-up quality was assessed during operation.Results Compared with C group,the wake-up time was significantly shortened,the incidence of agitation and coughing was decreased,blood loss was reduced,△ MAP and △ HR were decreased,and the wake-up quality was increased in E group (P＜ 0.05).Conclusion Bilateral ESPB can increase the intraoperative wake-up quality in the patients undergoing thoracolumbar scoliosis correction with general anesthesia.
ABSTRACT
Objective To evaluate the effectiveness of renal sympathetic denervation (RDN) for hypertensive heart dis-ease combined with systolic heart failure. Methods Two patients (mean age 35 years) with hypertensive heart disease com-bined with systolic heart failure on maximal tolerated heart failure therapy underwent bilateral renal denervation. Echocar-diography, the six minute walk distance, renal function, glycosylated hemoglobin and NT-proBNP were assessed at baseline and 1 year after renal denervation. Results Renal artery angiography showed that no stenosis and dissection. After 1 year follow up, the left ventricular ejection fraction (LVEF), six minute walk distance and NT-proBNP were significantly im-proved, and the size of left ventricular decreased. Conclusion RDN is effective and feasible for the treatment in patients with hypertensive heart disease and systolic heart failure.
ABSTRACT
Objective To explore the effects of renal denervation (RDN) on hypothalamus angiotensinⅡ(AngⅡ) and oxidative stress in myocardial infarction (MI) dogs. Methods Eighteen mongrel dogs were randomly divided into MI group (n=6), RDN group (n=6) and sham operation group (n=6). Myocardial infarction model was made in the former two groups by gelatin sponge embolization of the left anterior descending artery. One week after MI, RDN was given to dogs in RDN group. Levels of AngⅡ, malondialdehyde (MDA), superoxide dismutase (SOD) and expression of gp91phox protein were detected four weeks after MI. Results Compared with control group, hypothalamus AngⅡ, MDA and expression of gp91phox protein were increased in MI group (P<0.01), but SOD was decreased (P<0.01). There was a negative correlation between AngⅡand SOD activity in MI group (r=-0.849, P < 0.01). There was a positive correlation between AngⅡ and expression of gp91phox protein in MI group (r=0.950, P<0.01). Compared with MI group, hypothalamus AngⅡ, MDA and expression of gp91phox protein were decreased in RDN group (P<0.01), but SOD was increased (P<0.01). Conclusion RDN can de?crease the level of hypothalamus AngⅡand the level of hypothalamus oxidative stress, and improve heart function of MI dogs.
ABSTRACT
Objective To observe the effect of renal denervation (RDN) on the cardiac oxidative stress and sympathetic nerve remodeling after myocardial infarction (MI) in canine. Methods Canine (n=18) were randomly divided into three groups: Sham operation group (SHAM group, n=6), MI group (n=6), MI+RDN group (n=6). Anterior myocardial infarction was gained by gelatin sponge embolization of the left anterior descending artery. At four weeks post-MI, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were examined using echocardiography. Immunohistochemical assay was used to analyze the distribution and density of tyrosine hydroxylase (TH) stained nerve fibers at peri-infarct zone. Myocardial superoxide dismutase (SOD) activity and malondialde?hyde (MDA) were also assessed. Results Compared with dogs in SHAM group, LVEF and SOD expression were decreased in MI group and MI+RDN group (P<0.05), but Left ventricular end diastolic pressure (LVEDP), LVEDV, LVESV, MDA and rate of TH positive staining nerve fibers were increased (P<0.05). There was a negative correlation between the rate of TH positive staining nerve fibers and SOD level (rs=-0.818,P<0.05) and a positive correlation between rate of TH positive stain?ing nerve fibers with MDA level (rs=0.900,P<0.05). By contract, compared with MI group, LVEF and SOD in MI +RDN group were increased (P<0.05), while LVEDV, LVESV, MDA and rate of TH positive staining nerve fibers were significant?ly lowered (P<0.05). Conclusion RDN is effective to decrease the level of cardiac oxidative stress and improve cardiac sympathetic nerve remodeling and heart function after myocardial infarction in canine.
ABSTRACT
Objective To explore the factors that could affect plasma level of D-dimmer test in acute aortic syn-drome. Methods Blood samples (2 mL) from acute aortic syndrome patients (n=76) obtained immediately after admission to detect D-dimmer using ELISA. Blood routine test and biochemical indicators tests including creatinine were also performed. White blood cell (WBC), serum value of creatinine, aortic contrast-enhanced CT, incidence of Shock and death were all re-corded. The receiver-operating characteristic curve (ROC) was established to assess the potency of D-dimmer to predict hospital mortality. Results According to ROC analysis, the optimal cut-off value of D-dimmer to predict hospital mortality was >2 988.6 μg/L (FEU), with 86.7% sensitivity and 70.5% specificity. The patients were divided into group A (D-dim-mer<2 988.6μg/L FEU, n=45) and group B (D-dimmer≥2 988.6μg/L FEU,n=31). Onset timing was longer in group A than that in group B(P<0.01). Involvement of ascending aorta was less common in group A than in group B(P<0.05). Aortic intramural hematoma was less common in group A than in group B(P<0.05). Logistic analysis demonstrated that short time of onset, involvement of ascending aorta, non-aortic intramural hematoma were all independent factors of higher D-dimmer (≥2 988.6μg/L FEU). Conclusion Patients with long time of onset, without involvement of ascending aorta, with intramural hematoma are liable to have lower values of plasma D-dimmer.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the association between expression changes of plasma macrophages scavenger receptor (SR)-BI and CD36 and risk of arteriosclerosis in end-stage liver disease (ESLD) patients post liver transplantation.</p><p><b>METHODS</b>A total of 20 liver transplantation patients were included. Clinical data including blood pressure, blood lipid, blood glucose, incidence of new-onset cardiovascular events were obtained. Plasma macrophages scavenger receptor SR-BIand CD36 expressions were detected by polymerase chain reaction (RT-PCR) and Western-blot before and at 1 year after liver transplantation.</p><p><b>RESULTS</b>The serum levels of TC [(5.34 ± 0.87) mmol/L vs. (4.27 ± 0.91) mmol/L], TG [(2.47 ± 0.81) mmol/L vs. (1.02 ± 0.49) mmol/L] and LDL-C [(3.36 ± 0.67) mmol/L vs. (2.14 ± 0.74) mmol/L] were significantly increased (P < 0.05) while the serum level of HDL-C [(0.98 ± 0.84) mmol/L vs. (1.58 ± 0.34) mmol/L] was significantly reduced (P < 0.05) at 1 year post transplantation compared to before-transplantation levels. One patient developed non-ST segment elevation myocardial infarction and treated with percutaneous coronary intervention, another patient developed atrial fibrillation at one year after transplantation. The plasma mRNA expression of SR-BI was reduced (20.44 ± 0.60 vs. 23.12 ± 0.69, P < 0.05) while the expression of CD36 mRNA was upregulated (20.91 ± 0.35 vs. 18.55 ± 0.62, P < 0.05) at 1 year after liver transplantation compare with that of before the transplantation. Similarly, the plasma protein expression of SR-BIwas reduced (0.21 ± 0.13 vs. 0.64 ± 0.28, P < 0.05) while the protein expression of CD36 was upregulated (0.94 ± 0.13 vs. 0.42 ± 0.19, P < 0.05) at 1 year after liver transplantation compare with that of before the transplantation.</p><p><b>CONCLUSION</b>Plasma expression changes of SR-BI and CD36 might contribute to the dyslipidemia and contribute to the atherosclerosis susceptibility after liver transplantation.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Atherosclerosis , CD36 Antigens , Blood , End Stage Liver Disease , Blood , Follow-Up Studies , Liver Transplantation , Postoperative ComplicationsABSTRACT
Objective To investigate the influence of hypoxia-reoxygenation on the myocardin gene expression of cultured rats' vascular smooth muscle cells(SMC).Methods The SMC were isolated from the media of the thoracic aorta vessel of Sprague-Dawley rats,and cultured with attachment-block manner.The morphology and cell counting of the cultured cells under hypoxia conditions were observed and comparedto that under normal culture condition.Total RNA extracted from the cultured cells,the expression of myocardin mRNA in SMC were measured at hypoxia status and at various time after reoxygenation through RT-PCR.Results The rats' vessel SMC was successfully cultured and showed a "peak-valley" shape.Self-made hypoxia equipment can produce a lower oxygen partial pressure without significant variation of pH value which met the experiment requirements in 2 4 hours .However,in the hypoxia conditions,the expression level of myocardin was lowest at the 12th hours,then increased.After 24 hours of hypoxia,the expression levels of myocardin began to increase at the 6th hour of reoxygenation and reached a normal level at the 12th hour of reoxygenation.Conclusions Hypoxia-reoxygenation has an effect on the expression of myodardin gene.
ABSTRACT
1), attributable risk (AR)=13.33%; ⑤Even though the serum specimens were taken from PB patients, the Ab of majouity of patients converted to positive when relapse occurred. In the majority of patients relapsed the levels of IgM-AbL tended to be increasing or pesistently positive. Usually relapse occurred 1-2 years after IgM-AbL was converted to positive. Relapse occurred 11-30 years after the patients were cured. In very rare case downgrading(from tuberculous to borderline leprosy) occurred. ⑥The levels of IgM-AbL gradually decreased in all relapsed patients after effective treatment except one case whose IgM-AbL was persistently positive. Conclusions The above results indicate that the ND-ELISA might be useful in screening early M.leprae infection and in predicting and monitoring the relapse of leprosy, especially in multibacillary patients.
ABSTRACT
Objective This study reports the early and late results of percutaneous transluminal angioplasty (PTA) and intravascular stenting for atherosclerotic stenosis of the iliac artery. Methods From December 1994 to February 2000, we performed iliac artery angioplasty and primary intravascular stent placement in 42 vessel of 31 patients (23 men and 8 women; mean age, 70.5 years). A total of 44 self expanding Wallstents ( Boston Schneider, Inc. ) were deployed. All patients underwent angioplasty and stent placement successfully. Results Clinical follow up was available for all patients at a mean of (36?13) months. All patients with clinical ischemic category (claudication or rest pain) were improved. Angiographic follow up with completed data are available for 20 of 31 patients at a mean follow up of (10?5) months. The iliac artery restenosis rate was 2%(1/42). The patients again underwent balloon angioplasty successfully. Conclusions PTA and primary stenting of the iliac arteries are effective and safety for treating iliac arterial stenosis,and should be the method of first shoice.
ABSTRACT
AIM: To investigate the expression of CD40 and CD40 ligand(CD40L) during myocardial ischemia/reperfusion injury in rats. METHODS: In the rat modal with myocardial ischemia/reperfusion(MI/R),the changes of CD40 and CD40L expression in blood and myocardial tissues were detected by flow cytometry and immunohistochemistry, respectively. There were seven animal groups in the study, including the normal group ( n= 3), the ischemia 30 min group(I 30 min , n= 6),the ischemia/reperfusion 1 min,5 min,10 min,20 min and 30 min groups(each group, n= 6). RESULTS: The indexes of the expression of CD40 and CD40L in I 30 min group were higher than those in control group,( P