Value of coronary CT angiography in assessment of bifurcation lesions / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the value of coronary CT angiography in assessment of bifurcation lesions.</p><p><b>METHODS</b>The original image of 79 established and suspected coronary artery disease patients who underwent both coronary CT angiography and conventional artery angiography (CAG) sequentially were included in this analysis. Bifurcation lesions were assessed on primary and secondary vessels with diameter ≥ 2.0 mm, bifurcation lesions were graded according to Chen's classification. CAG was used as golden standard. The sensitivity, specificity, positive predictive value and negative predictive value were calculated. Spearman's test and Kappa test were used to evaluate the correlation and classification identity of the two methods.</p><p><b>RESULTS</b>CAG evidenced 177 bifurcation lesions out of 445 bifurcation vessels and coronary CT detected 168 bifurcation lesions out of 404 bifurcation vessels with satisfactory imaging quality and 390 bifurcation vessels could be analyzed by both CAG and coronary CT. Sensitivity, specificity, positive predictive value and negative predictive value of coronary CT angiography were 94.2%, 94.6%, 90.7%, 96.1%, respectively. The results for the lesions at LM-LAD/LCX + LAD/Mid, LAD/Diag, RCA/PDA were more satisfactory and the sensitivity and specificity were as high as: 97.1% and 94.2%, 95.7% and 89.5%, 92.3% and 98.7%, respectively. There were significant correlations for evaluating the narrow degree of the opening of the bifurcation branch with these two methods (r = 0.799 58, P < 0.01) and for identifying I, II, III type bifurcation lesions (Kappa coefficient = 0.7959, P < 0.01) as well as for identifying the subtype bifurcation lesions (Kappa coefficient = 0.6328, P < 0.01) using the two methods.</p><p><b>CONCLUSION</b>Coronary CT angiography is efficient in identifying the bifurcation lesions and offers a reasonable indication for bifurcation lesion classification.</p>

Expression of nucleophosmin in glandular epithelium of non-pregnant human endometrium during the menstrual cycle / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Nucleophosmin plays a critical role in embryonic development. This study aimed to examine the expression pattern of nucleophosmin in glandular epithelium of human endometrium during the menstrual cycle.</p><p><b>METHODS</b>Endometrial tissues used for this study were obtained from 46 non-pregnant patients who underwent hysterectomy which had been performed to treat benign diseases. Nucleophosmin expression was assessed by in situ hybridization and immunohistochemistry.</p><p><b>RESULTS</b>At the early-, mid- and late-proliferative phase, nucleophosmin mRNA was highly expressed in glandular epithelium of human endometrium. At the secretory phase, the expression of nucleophosmin mRNA was reduced in glandular epithelium in early-secretory phase, and the expression in mid- and late-secretory phases was not detected. Similarly, nucleophosmin protein was strongly expressed in endometrial glands throughout the proliferative phase, but was gradually reduced during secretory phase.</p><p><b>CONCLUSION</b>Nucleophosmin mRNA and protein are expressed in glandular epithelium of human endometrium throughout the menstrual cycle.</p>

Study on Transformation of Complete Atrioventricular Block in Children / 实用儿科临床杂志

Objective To observe the transformation features of children with complete atrioventricular block(CAVB), and to improve the diagnosis and treatment of this disease.Methods Seventeen children with primary diagnosis of CAVB were reviewed by retrospective and follow-up study and the clinical characteristics, treatment schemes and prognosis were evaluated.Results Four cases of congenital CAVB lived normally without obvious symptoms in the tracing period from 6 months to 9 years;1 case had the onset of Adams-Stokes syndrome induced by diarrhea;3 cases of the CAVB caused by virus myocarditis turned into sinus rhythm after comprehensive therapy;2 cases persistently presented with the CAVB Complicated with enlarged heart;1 case gave up treatment after deterioration, and one case died.Three cases of temporary CAVB after the open heart operation turned to sinus rhythm in transitory time, while other two cases presented with permanent CAVB and treated with epicardium pacemaker,among whom one had the pacemaker replaced for one time in the 8-year follow-up,and the follow-up of other cases were intermitted.Conclusions The congenital CAVB in the study group with normal QRS interphase and no obvious symptom might not require treatment but follow-up is needed. While infants with heart malformation and wide QRS wave could not endure the low ventricular rhythm are in high risk. Virus myocarditis induced CAVB children tend to present the Adams-Stokes syndrome, and require effective treatments. Partial cases of the CAVB caused by open heart operation may turn to normal sinus rhythm in 2-4 weeks after surgery. cases has persistent CAVB for over 4 weeks, or Adams-Stokes syndrome onset after the surgery demand epicardium pacemaker treatment.