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Objective To explore the safety and efficacy of the renal sympathetic denervation under the guidance of EnSite-NavX three-dimensional mapping system. Methods A three-dimensional model of abdominal aorta and renal artery was constructed under the guidance of EnSite-NavX three-dimensional mapping in 6 healthy Guangxi Bama mini-pigs. Then a radiofrequency ablation catheter was put into the bilateral main trunks of renal artery and six points were marked within each trunk from far to near the heart. One side of the renal artery was ablated and the other received no ablation serving as control. The mini-pigs were followed up for 6 months after the procedure. The norepinephrine (NE) content in the renal tissues was detected by ELISA. Sympathetic nerve damage in the renal tissue of the ablation side was observed by Haematoxylin-Eosin staining. Results Modeling and unilateral renal sympathetic denervation were successfully performed in the six mini-pigs. Subcutaneous hematoma was formed after operation in one pig. None of the pigs had the complications such as renal artery stenosis, thrombopoiesis, or dissection. The NE content of ablation side was significantly lower than that of the opposite side ([170.13±52.60] ng/g vs [429.86±131.43] ng/g, P<0.05). Haematoxylin-Eosin staining showed broken epineurium and loss of axons in the renal sympathetic nerve of the ablation side. Conclusion A three-dimensional model of abdominal aorta and renal artery can be clearly constructed under the guidance of EnSite-NavX three-dimensional mapping. Renal sympathetic denervation can be achieved safely and effectively without fluoroscopy or renal arteriography under the navigation of NavX.
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Objective To assess the safety and effectiveness of self-made side hole balloon for treating no-reflow following percutaneous coronary intervention(PCI). Methods Twenty-three patients diagnosed with no-reflow during PCI from Jan. 2012 to Jan. 2013 were enrolled. Residual stenosis, thrombosis, dissection, and spasm of coronary artery were excluded. The mean age of the 23 patients was (62. 0±13. 8) years old. Of the 23 patients 14 had ST segment elevation myocardial infarction (STEMI), and 9 underwent elective PC.I. There were 11 cases with no-reflow in the left anterior descending branch, 8 in the right coronary artery and 4 in the circumflex branch. The drugs (nitroglycerin and tirofiban) were selectively injected into the vessel using sel-made side hole balloons. The thrombolysis in myocardial infarction (TIMI) grade before and after procedure, ST segment resolution (STR),ST-T changes for 24 and 72 hours and complications (perforation, dissection,and thrombosis of coronary artery) were observed postoperatively. Patientswere followed up by ECG and echocardiogram at 1 month after PC.I. Incidence of major adverse cardiovascular events (MACEs) and cardiac function were observed 6 months after PC.I. Results After intracoronary administration of drug therapy, TIMI grade-1 flow was found in 3 patients, TIMI grade-2 flow in 5 patients and TIMI grade-3 flow in15 patients. In patients with STEMI, complete resolution ((≥3;70%) was found in 8 patients,partial resolution (30%-69%) in 4, and no resolution (<30%) in 2. One of the 2 patients with ventricular electrical storm was treated with temporary cardiac pacing and drug therapy and recovered within 1 week; the other one with pericardial tamponadewho was treated with emergency surgery repair died. In 9 patients undergoing selected PCI, transient ST segment changes were noted in 3 patients which recovered within 1 week after conservative treatment; with no perforation, dissection,or thrombosis of coronary artery. One month after discharge, echocardiogram of the 22 patients showed a mean left ventricular ejection fraction (LVEF) of (50. 6± 14. 3) % and a fractional shortening in the short axis view of 0. 36±0. 04, and ECG showed non-specific changes of ST-T in 6 patients. In 4 patients with STEMI, culprit artery showed TIMI grade-3 by angiography performed during PCI for non-culprit vessel 1 month after primary PC.I. At 6 months after primary PCI, there was no MACE; 18 patientswere in New York Heart Association Class I and 4 in Class E. Conclusion Self-made side hole balloon is a safe, economical, effective and convenient method for intracoronary administration of nitroglycerin and tirofiban in treating no-flow during PCI, but the result still needs further verification.
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<p><b>OBJECTIVE</b>To evaluate the effects on cardiac remodeling post transcatheter closure by Amplatzer septal occluder selected by oval circumference formula in patients with atrial septal defect (ASD).</p><p><b>METHODS</b>A total of 146 patients with ASD (68 males,mean 33.5 years) treated by transcatheter closure with the Amplatzer occluder were enrolled in this study. The diameter of defects was corrected with the oval circumference formula (group A, 73 cases) or by echocardiography (group B, 73 cases). Cardiac remodeling was assessed by transthoracic echocardiography (TTE) before the procedure, 3 days, 3 months and 6 months after ASD closure.</p><p><b>RESULTS</b>The mean ASD diameter was similar between the two groups [(20.16 +/- 4.98) mm vs. (21.36 +/- 5.69) mm, P > 0.05] and the mean diameter of the selected occluder of group A was significantly smaller than that in group B [(21.95 +/- 6.78) mm vs. (25.85 +/- 6.75) mm, P < 0.05]. Procedural success rate was identical between the two groups (97.3%) and the defects were completely occluded and there was no residual shunt during the 6 months follow up period, there were also no complications during and after the procedure. The lateral diameter of right atrial (RALD), the diastolic diameter of right ventricle (RVDD), RALD/LALD, RVDD/LVDD and pulmonary diameter (PD) were significantly decreased while the lateral diameter of left atrial (LALD) and left ventricle (LVDD) were significantly increased post ASD closure in both groups. At 6 months follow up, RALD decreased by (18.63 +/- 10.59)% in group A versus (10.14 +/- 6.59)% in group B, LALD increased by (13.42 +/- 8.38)% in group A versus (9.28 +/- 4.95)% in group B and RALD/LALD ratio decreased by (26.35 +/- 11.24)% in group A versus (13.98 +/- 8.96)% in groups B (all P < 0.05).</p><p><b>CONCLUSION</b>ASD occluder selection based on the oval circumferen ce formula is superior to that made by echocardiography in terms of more favorable cardiac remodeling post ASD closure.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Cardiac Catheterization , Methods , Follow-Up Studies , Heart Septal Defects, Atrial , Therapeutics , Ventricular RemodelingABSTRACT
<p><b>OBJECTIVE</b>To search for a better therapy for temporomandibular joint dysfunction syndrome.</p><p><b>METHODS</b>Two hundred and ten cases of temporomandibular joint dysfunction syndrome were randomly divided into a treatment group, a control group I and a control group II, 70 cases in each group. The treatment group were treated with warming needle moxibustion plus exercise, with Hegu (LI 4), Xiaguan (ST 7), Yifeng (TE 17) and so on selected, in combination with opening and closing the mouth; the control group I were treated with simple filiform needle needling, and the control group II with local blocking therapy. The therapeutic effects of the 3 groups were compared.</p><p><b>RESULTS</b>The total effective rate was 94.3% in the treatment group, 87.1% in the control group I and 85.7% in the control group II with a significant difference among the 3 groups, the treatment group being better than the two control groups (P < 0.05).</p><p><b>CONCLUSION</b>Warming needle moxibustion plus exercise has a good therapeutic effect on temporomandibular joint dysfunction syndrome.</p>