Comparison of heart failure and 2019 novel coronavirus pneumonia in chest CT features and clinical characteristics / 中华心血管病杂志

Objective@#To identify the characteristics including clinical features and pulmonary computed tomography (CT) features of heart failure and novel coronavirus pneumonia(COVID-19).@*Methods@#This study was a retrospective study. A total of 7 patients with Heart failure and 12 patients with COVID-19 in the Second Xiangya Hospital of Central South University between December 1, 2019 and February 15, 2020 were enrolled. The baseline clinical and imaging features of the two groups were statistically analyzed.@*Results@#There was no significant difference in age and sex between the two groups, but the incidence of epidemiological contact history, fever or respiratory symptoms in the COVID-19 group was significantly higher than that in the heart failure group (12/12 vs. 2/7, P=0.001; 12/12 vs. 4/7, P<0.001). While the proportion of cardiovascular diseases and impaired cardiac function was significantly less than that of the heart failure group(2/12 vs.7/7, P<0.001; 0/12 vs.7/7, P<0.001). For imaging features, both groups had ground-glass opacity and thickening of interlobular septum, but the ratio of central and gradient distribution was higher in patients with heart failure than that in patients with COVID-19 (4/7 vs. 1/12, P=0.04). In heart failure group, the ratio of the expansion of small pulmonary veins was also higher (3/7 vs. 0, P=0.013), and the lung lesions can be significantly improved after effective anti-heart failure treatment. Besides, there are more disease with rounded morphology in COVID-19 (9/12 vs. 2/7, P=0.048) .@*Conclusions@#More patients with COVID-19 have epidemiological history and fever or respiratory symptoms. There are significant differences in chest CT features, such as enlargement of pulmonary veins, lesions distribution and morphology between heart failure and COVID-19.

Molecular typing and distribution characteristics of Legionella pneumophila isolated from cooling water of central air conditioning system in Zhongshan, 2012-2018 / 公共卫生与预防医学

Objective To analyze the genetic characteristics of Legionella pneumophila isolated from cooling water of central air conditioning system in public places in Zhongshan from 2012 to 2018, and to understand the spatiotemporal distribution of homologous strains, in order to provide evidence for the prevention, control and traceability of Legionella pneumophila infection. Methods Eighty-five Legionella pneumophila strains were isolated for serotype identification, and the molecular typing of the 85 isolates was performed using pulsed field gel electrophoresis (PFGE). The strain location data was converted into latitude and longitude coordinates by GIS geocoding technology. The converted location data was overlaid on the map of Zhongshan City, mapping the molecular typing distribution of clusters using Qgis2.18.11 spatial processing software. Results Eighty-five strains of Legionella pneumophila included 9 serotypes, and the highest proportion was LP1, accounting for 61.18% (52/85). According to the similarity of 100%, 85 strains of Legionella pneumophila were divided into 56 patterns of PFGE bands (T1-T56), with 3 types being dominant. Same serotype of Legionella pneumophila strains showed diverse PFGE patterns. Different serotypes of Legionella pneumophila strains were basically identified as different PFGE patterns, while some were identified as same PFGE pattern. According to over 85% similarity, 8 clusters (A-H) were designated, strains of which were distributed in 12 districts. PFGE clustering clusters did not display obvious temporal and regional distribution differences, nor did they have temporal and regional clustering distributions. Conclusion Strains of Legionella pneumophila isolated from cooling water of central air conditioning system in public places in Zhongshan from 2012 to 2018 showed genetic diversity, and the main serotype was LP1. Isolates of clusters did not exist in different years or regions.

The technique and effectiveness of potency preservation in robotic-assisted laparoscopic radical prostatectomy / 中华泌尿外科杂志

Objective To evaluate the key technique and effectiveness of potency preservation in robotic-assisted laparoscopic radical prostatectomy (RALP).Methods The complete clinical and follow-up data of 30 cases underwent RALP between February and May of 2016 were reviewed retrospectively.The average age of the patients was 67.3 years (48-82 years).The peak PSA level before surgery ranged from 7.6 to 53.4 ng/ml with the average level of 21.1 ng/ml.There were 7,16,6 and 1 case with the Gleason score of 6,7,8,and 9 point,respectively.Preoperative erectile score (IIEF-5) of the 30 patients were list as below:3 cases (0-10 points),4 cases(11-15 points),17 cases(16-20 points),and 6 cases(21-25 points).The key techniques of potency preservation during RALRP includes deep dorsal vein ligation techniques,neurovascular bundles preservation techniques and drain tube placement techniques.Results All 30 cases underwent operation successfully with no transfer to open surgery.Average operative time was 150.7 min (98-240 min) with an estimated blood loss of 165.7ml (50-550 ml).The average drainage removal time was 5.1 d postoperatively.The average bowel recovery time was 2.7 d and average hospitalization time was 8.2 d,respectively.There were two cases with one positive margin on the bladder neck and one on the tip of prostate,respectively.Seventeen cases gained potency preservation six months after surgery.Conclusion It was safe and beneficial for the potency preservation in RALP,which could be considered as one of the best options for the prostate cancer surgery.

Evaluation for the Usability of Carelink Remote Monitoring System by Clinical Physicians / 中国循环杂志

Objective: To conduct a preliminary evaluation for the usability of Carelink remote monitoring system by clinical physician. Methods: A total of 215 patients received cardiovascular implantable electronic devices (CIED) with Carelink remote monitoring function from 12 hospitals in China between 2012-01 and 2013-10 were prospectively enrolled. The patient's mean age was (62.3±14.3) years including 108 male and 107 female. There were 54 physicians completed questionnaire survey. Based on the type of CIED, the patients were divided into3 groups: PM (pace maker) group,n=110, ICD (implantable cardioverter defibrillator) group,n=54 and CRT (cardiac resynchronization therapy) group,n=51. The patients received routine hospital visit at 3 months of CIED implantation and meanwhile, they performed device data transmission at 3 and 6 months of Carelink remote monitoring. The time physician spent to evaluate data was collected at 3 months and the questionnaire survey was completed by physician at 6 months after CIED implantation. Results: All 54 physicians felt that Carelink remote monitoring system was simple to operate and easy to use. There were 147 patients ifnished hospital visit at 3 months after CIED implantation, the mean time for physician to evaluate data was (14.8±8.4) min; 150 patients ifnished Carelink remote monitor at 3 months after CIED implantation, the mean time for physician to evaluate data was (8.2 ±4.6) min,P<0.0001.Conclusion: Carelink remote monitoring system was easy to use, it may save time in follow-up study which with high satisfaction in clinical practice.

Comparison of transperitoneal and retroperitoneal robotic partial nephrectomy：a single center report of 418 cases / 中华泌尿外科杂志

Objective To conclude and compare the technical characteristics and clinical efficacy of retroperitoneal and transperitoneal approach for robotic partial nephrectomy.Methods 418 patients received robotic partial nephrectomy conducted by one surgeon in the urology department of PLA General Hospital from 2013, December to 2015, October, including 157 cases in retroperitoneal approach and 261 cases in transperitoneal approach.There were no significant difference between the transperitoeal and retroperitoneal approach in patient age(51 years, 51 years, P=0.593), BMI(25.5 kg/m2,25.6 kg/m2, P=0.331), gender(male/female:111/46,186/75,P=0.184), location(left/right,80/77,123/138,P=0.575), tumor size(3.1cm,3.5cm,P =0.356), comorbidities, proportion of solitary kidney(11.5%, 9.6%,P=0.253) or bilateral tumors(1.3%,3.4%,P=0.179), RENAL score(6(5-8),6(5-8),P=0.083), ASA score(2 vs.2)(P=0.310) and preoperative serum creatinine(74.7 μmol/L,76.7 μmol/L, P=0.736).Patients in the retroperitoeal approach group were more likely to have abdomen surgery history (21.7%,14.2%,P=0.049).there was significant difference between two approaches in tumor location in the kidney ( anterior/posterior/others: 9/140/8, 212/36/13, P <0.001 ) Results The operation time (105min, 115min, P =0.041 ) and warm ischemia time ( 15min, 20min, P <0.001 ) were shorter and estimated blood loss(50ml,75ml,P<0.001) was less in the retroperitoneal group.No significant difference was observed in postoperative 24h blood loss(45ml,50ml,P =0.093), intraoperative transfusion rate (2.5%,6.5%,P=0.072) and collective system injury(24.8%,27.6%,P =0.539) between the two groups.Peritoneum break occurred in 25 cases in retroperitoneal group, which were repaired by Hem-o-lock.One intestinal injury occurred in transperitoneal group and was repaired intraoperatively.Three and nine cases in the retroperitoneal and transperitoneal group were converted to radical nephrectomy.One case in the transperitoneal group was found positive margin and received laparoscopic radical nephrectomy.Two liver injury and five spleen injury occurred in the transperitoneal group.For postoperative food intake(1 day, 2 days, P <0.001 ) , the length of indwelling drainage ( 3 days, 4 days, P <0.001 ) and the length of postoperative stay ( 5 days, 6 days, P =0.001 ) , the retroperitoneal group had one day shorter than the transperitoneal group.With the median following-up time of both group, 11 months (IQR:6-16) in RPRPN group and 12 months ( IQR: 7-19 ) , no subject with a tumor recovery or metastasis.Conclusions Retroperitoneal robotic partial nephrectomy is feasible and effective, which is similar to transperitoneal approach.The retroperitoneal approach is superior to transperitoneal approach for posterior, lateral and superior renal tumors.

Cardiac perforation and tamponade in percutaneous cardiac intervention / 中南大学学报(医学版)

OBJECTIVE@#To explore the cause of cardiac perforation and tamponade during cardiac catheterization and intervention and to evaluate the effectiveness of the emergency treatment for tamponade in our hospital.@*METHODS@#The clinical data from 23, 319 patients who received diagnostic catheterization or therapeutic procedures were analyzed retrospectively.@*RESULTS@#Cardiac perforation and cardiac tamponade were observed in 22 of the 23, 319 patients during catheter procedures. It includes 1 in coronary artery angiography, 9 in percutaneous balloon mitral valvuloplasty, 3 in diagnosis, 2 in congenital heart disease intervention, 2 in pacemaker implantation, 2 in atrial fibrillation ablation and the other 3 in coronary revascularization. The occurrence of cardiac perforation in 11 patients was related to puncture of the interatrial septum and/or the procedure in the left atrial procedure and 2 were related to high pressure injection. Seventeen patients were found cardiac tamponade in the process of catheterization, and 5 were found at 2-14 h after operation. Pericardiocentesis and pericardial catheter drainage were performed in 20 patients and 11 of them succeeded. Among the other 11 patients, 7 were successfully saved by thoracotomy and 4 died.@*CONCLUSION@#Cardiac tamponade is a severe and fatal complication that may occur in different catheter procedures. Early prevention and diagnosis and performingperi cardiocentesis and drainage timely are critical to reduce the mortality.

Changes of heart rate turbulence and heart rate variability in patients with coronary heart cisease / 中国医师杂志

Objective To analyze the changes of heart rate turbulence (HRT) and heart rate variability (HRV) in coronary heart disease (CHD), and evaluate the relationship between CHD and coronary artery disease (CAD) and two parameters of HRT and HRV, and investigate the correlation between the 2 parameters.Methods We performed coronary angiography in all 103 patients with CHD (group A), who were classified into 3 subgroups: 35 patients of stable angina pectoris ( group A1 ), 28 patients of unstable angina pectoris ( group A2 ) and 40 patients of AMI ( group A3 ), and 30 structurally normal patients with ventricular premature contraction who were included in healthy control group ( group B).The 24-hour ambulatory electrocardiogram was performed in all the patients, and the parameters of HRT and HRV were obtained.Results The value of the TO onset of group A was significantly higher than that of group B( -4.17± 2.75, - 3.16 ± 3.18, - 0.96 ± 2.92; - 6.30 ± 3.47 ), the value of TS of group A was lower than that of groupB(6.81±3.18,5.12±3.31,3.20±1.71;9.52±3.85) (P ＜0.05 orP ＜0.01).The values of SDNN, PNN50, and HF of group A were significantly lower than those of group B (P＜ 0.05).TO was positively correlated with Gensinies score, while TS, SDNN, PNN50 and HF were negatively correlated with Gensinies score, and TS showed the strongest negative correlation with Gensini score (r=-0.45).TO was negatively correlated with SDNN, PNN50, and HF, while TS was positively correlated with SDNN, PNN50 and HF, and TS showed much stronger correlation with HF (r=0.47).Conclusions HRT was dramatically blunted and HRV in patients with CHD was significantly lower;.HRT and HRV of group A1 were significantly correlated with Gensini score, and TS had the strongest correlation with Gensini score.TO and TS were correlated with SDNN, PNN50 and HF, and TS had much stronger relationship with HF.

Diagnostic value of pentraxins-3 and triglyceride/high-density lipoprotein cholesterol in acute coronary syndrome / 中国医师进修杂志

Objective To investigate the value of serum pentraxins-3 (PTX-3) together with triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) as predictor risk factors of future acute coronary syndrome(ACS). Methods One hundred and seventy-one cases of selective coronary angiography from July 2008 to December 2009 were collected and analyzed. According to the situation on admission and coronary angiography, patients were divided into three groups: normal control group (25 cases), stable angina pectoris (SAP) group (23 cases) and ACS group (123 cases). Fasting venous blood was extracted for measuring serum PTX-3 and lipids (TG, HDL-C) in the next morning, and the statistical significanc was analyzed. Results The level of serum PTX-3 and the ratio of TG to HDL-C in ACS group [(6.39 ± 3.01)μ g/L, 2.38 ± 2.00] were significantly higher than those in SAP group[(3.87 ± 2.05 ) μ g/L, 1.70 ± 1.01] and normal control group [(2.90 ± 1.94)μg/L,0.95 ±0.35] (P ＜0.01 or ＜0.05). Conclusion Increased serum PTX-3 levels and ratio of TG to HDL-C in patients are closely related with ACS, both of which increase the accuracy of early diagnosis of ACS.

Efficacy and safety of implantable cardioverter defibrillator avoiding routine defibrillation threshold testing / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the efficacy and safety of implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy-defibrillators (CRT-D) avoiding defibrillation threshold (DFT) testing when treating ventricular tachycardia (VT) or ventricular fibrillation (VF).@*METHODS@#We analyzed a continuous database of the 21 patients who had avoided DFT during ICD implantation from Oct. 1999 to Aug. 2008. Follow-up data were completed and analyzed in the 21 patients with ICD implantation.@*RESULTS@#ICDs were implanted successfully in 17 patients with VT or VF, and CRT-D were implanted successfully in 4 myocardiopathy patients with severe heart failure who avoided DFT during ICD or CRT-D implantation. Eight patients accepted DFT 1 week later, VT or VF was not induced in 3 patients (37.5%). During the mean follow-up of 1 approximately 7 (4.2+/-1.9) years, malignant ventricular arrythmia was recorded in 16 patients. Among them, 89 episodes were successfully terminated by defbrillation (100%), 120 VT events were terminated by the first run of antitachycardia pacing (51.1%) and 22 by low energy cardioversion (59.2%). All patients took antiarrhycardia drugs after ICD or CRT-D implantation. No patient died from malignant ventricular arrythmia during the follow-up.@*CONCLUSION@#No application of routine DFT may avoid complications associated with DFT during ICD or CRT-D implantation. ICD or CRT-D implantation may effectively treat fatal ventricular tachyarrhythmias and prevent sudden cardiac death.

Relationship between pregnancy-associated plasma protein A level and restenosis after elective coronary stenting / 中华老年医学杂志

Objective To investigate the relationship between pregnancy-associated plasma protein A(PAPP-A)level and restenosis after elective coronary stenting by coronary artery angiography(CAG)and intravascular ultrasound(IVUS). Methods The study consisted of 132patients with successful coronary stent placement:left anterior descending coronary artery(LAD)62,left circumflex coronary artery(LCX)36,right coronary artery(RCA)34.The follow-up CAG and IVUS were Derformed at the 6th month after stent placement.Diameter stenosis≥50%on CAG was regarded as in-stent restenosis.Neointimal areas(IA),stent volume(SV)and neointimal volume(IV)were measured by IUVS during follow-up.According to the PAPP-A level,lesions were divided into 2groups:high PAPP-A group(PAPP-A level≥12.11 mIU/L)and low PAPP-A group(PAPP-A level＜12.11 mIU/L). Results Total restenosis rate was 31.8%.There were no significant differences in age.sex and risk factors of coronary heart disease(hypertension,diabetes,smoking)between restenotic and nonrestenotie groups(all P＞0.05).The restenotic group had higher PAPP-A level than nonrestenotic group[(18.14±2.26)mIU/L vs. (10.95±2.12)mlU/L,P＜0.01].Angiographic restenosis occurred in 28 of 66 lesions(42.4%)in the high PAPP-A group and in 14 of 66 lesions(21.2%)in the low PAPP-A group(P＜0.01).Plasma PAPP-A level was positively correlated with IA,IV(r=0.47 and 0.54 respectively,all P＜0.05). Conclusions Elevated PAPP-A level is correlated well with the severity of the intimal hyperplasia.Plasma PAPP-A level affects restenosis after elective stent placement by promoting intimal hyperplasia.

The heart rate turbulence in patients with isolated systolic hypertension / 中国综合临床

Objective To observe the changes of the heart rate turbulence(HRT)in patients with isolated systolic hypertension(ISH).Methods 85 patients with ISH,80 patients with common hypertension and 58 control subjects were investigated.Turbulence onset(TO)and turbulence slope(TS)were recorded of 24 hours dynamic electrocardiogram.Results The difference of HRT in the three groups was significant(P＜0.01).The values of TO and TS was significantly higher in common hypertension group and ISH group than in control group(P＜0.05);TS was significantly lower in ISH group than in common hypertension group(P＜0.05),but the difference of TO between ISH group with common hypertension group was not obvious.Conclusion The HRT in patients with primary hypertension is significantly lower,which is more significant in patients with ISH than in patients with common hypertension.It suggests that the cardiac autonomic nerves dysfunction perhaps has an important influence on development of hypertension and its prognosis.

Determination of Concentration of Irbesartan in Human Plasma by HPLC with Fluorescence Detection / 中国药房

OBJECTIVE:To determine plasma concentration of irbesartan by HPLC with fluorescence detection.METHO-DS:Samples were separated on Diamonsil C18 with mobile phase consisted of 0.02mol?L-1 KH2PO4-acetonitrile(50∶50) at a flow rate of 1.0mL?min-1.The fluorescence detector was set at an excitation wavelength of 250nm and an emission waveleng-th of 375nm.The column temperature was 40℃.RESULTS:The linear range for irbesartan was from 1.0 to 1000ng?mL-1 (r=0.999 8).The mean relative recoveries of irbesartan at low,middle and high concentrations(2.0,50.0,and 500.00ng? mL-1) were 97.4%,106.1% and 101.6%,respectively.Both intra-day and inter-day RSD were below 10%.CONCLUSION:The method is simple,rapid,accurate and specific,and it can be used for the plasma concentration determination and pharmacokinetic study of irbesartan.

Modulatory effects of cognitive behavior therapy on depression and anxiety in patients with implantable cardioverter defibrillator / 中国组织工程研究

BACKGROUND: 60% of the patients receiving implantable cardioverter defibrillator(ICD) believe their quality of life has been improved. However,about 30% to 50% of the patients suffer from postoperative depression and anxiety; especially those patients receive electroconvulsive therapy (ECT).OBJECTIVE: To probe into the modulatory effects of cognitive behavior therapy(CBT) on depression and anxiety in patients with ICD.DESIGN: A retrospective case analysis based on ICD patients SETTING: Room of Cardiac Catheterization, Department of Cardiology, Xiangya Second Hospital PARTICIPANTS: The study was conducted in the Room of Cardiac Catheterization of the Department of Cardiology, Xiangya Second Hospital,Central South University from October 2000 to August 2001. Inclusive criteria: ICD patients that had ineffective medicine therapy for paroxysmal ventricular tachycardia and/or ventricular fibrillation complicated with cardiac syncope. Exclusive criteria: incoorperative patients or patients who unable to receive periodical follow up. A total of 6 patients were involved including 4 male and 2 female patients aged from 45 to 71 years old with an average age of (57.3 ± 2.4) years old. All of the patients received Micro Jewell Ⅱ 7223 ICD made by Medtronic Company. Diagnoses of basic disease:2 cases of coronary heart disease, 2 cases of right ventricular myocardial disease, 1 case of paroxysmal ventricular tachycardia due to unknown reason,and 1 case of Brugada syndrome.METHODS: "Morita therapy" technique was used. Patients were asked to transfer their spirit energies into feasible objectives of their real life, which would be helpful to the rapid improvement of their symptoms. symptom checklist-90(SCL-90) scale was used to evaluate the psychological symptoms before and after the therapy.MAIN OUTCOME MEASURES: Comparison of the scores gained in SCL-90 between before and after CBT.RESULTS: There were significant differences in the items of somatization,compulsion, sensitive human relationship, depression, anxiety, phobia disorder, etc. between before and after CBT ( P ＜ 0.05 or 0.01 ).CONCLUSION: Psychotherapy shouldn't be neglected in the postoperative follow up of ICD, and CBT is helpful to relieve symptoms especially for those depression and anxiety patients with electroconvulsive experiences.

Treatment of limb arterial injuries caused by traffic accidents / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To analyze the features, diagnosis and treatment of limb arterial injuries caused by traffic accidents.</p><p><b>METHODS</b>A total of 43 patients with limb arterial injury admitted in our department over the past 30 years (about 50% of them happened during the last 10 years) were analyzed retrospectively in this article. The popliteal, femoral and brachial arteries were mainly involved, accounting for 43.2%, 20.5% and 20.5% respectively of all the involvements. There were 35 cases of open injury and 9 of close injury. The involved vessels were transected in 43.2% of the cases and contused in 40.9%. All the patients had various complications, such as fractures, dislocations and severe soft tissue injuries. The injured vessels were repaired by means of end-to-end anastomosis in 10 cases, autogenous vein graft in 23 cases and intraluminal hydraulic dilatation in 4 cases.</p><p><b>RESULTS</b>Successful limb salvage was achieved in 34 cases initially, whereas 10 amputations were carried out due to injuries to popliteal arteries in 7, femoral arteries in 2 and humeral artery in 1 and severe soft tissue damages in 9 cases. Twenty-nine patients were followed up for 1-156 months, with the average of 48.8 months. There was good circulation in 22 cases and certain ischemia in 5 cases. Two amputations were carried out in the late stage because of popliteal artery thrombosis after repair in 2 cases. There was no death in this series.</p><p><b>CONCLUSIONS</b>The limb arterial injuries caused by traffic accidents are severe and complicated. It is proposed that particular attentions should be paid to the features in diagnosis and treatment for this type of injury and special efforts should be made for both life saving and limb salvage.</p>

Relationship between intimal hyperplasia and NF-?B expression in carotid artery of hypercholesterolemic rabbits after balloon injury / 中国医师杂志

Objective To investigate the expression of nuclear factor kappa B(NF-?B) in carotid artery of hypercholesterolemic rabbits injured by balloon and its relationship with intimal hyperplasia.Methods Twenty-five New Zealand male rabbits were fed with atherogenic diet and balloon injury was conducted in right carotid artery 4 weeks later.The rabbits were killed at the 6th hour,24th hour,1th week,2th week and 4th week,respectively.Blood samples and right carotid artery were collected in time and intimal hyperplasia was studied by histological morphology method.The expression of NF-?B was measured by in-situ hypridization(ISH).Results Intimal hyperplasia was present at the 7th day after balloon injury in hypercholesterolemic rabbits and it became more obvious with the increasing of the time.The intimal hyperplasia was not detected in the media area.The intima/media ratio was increased as time went on.The expression of NF-?B mRNA was observed in the carotid atery of hypercholesterolemic rabbits at the 6th hour after balloon injury and the expression reached its peak at the 2th week.The expression of NF-?B was much higher in injury group than that of control group.Conclusion The expression of NF-?B is up-regulated in carotid artery of hypercholesterolemic rabbits injured by balloon,which is involved in the inflammatory reaction and restenosis caused by balloon injury.

The Inhibition Effect of Fluvastation on IL-18 Expression of Monocyte Cells in Patients with Acute Coronary Syndrome / 中国医师杂志

Objective To investigate IL-18 expression of monocyte cells and the inhibition effect of fluvastation on its expression in patients with acute coronary syndrome(ACS). Methods Isolated monocyte cells from peripheral blood of patients with ACS were incubated with different concentrations of fluvastatin, and IL-18 mRNA level of the monocyte cells was detected by reverse transcription polymerase chain reaction(RT-PCR). Results The monocyte cells of peripheral blood in patients with ACS expressed IL-18 mRNA. IL-18 mRNA decreased from 54 1?9 9 to 50 1?12 6(P

Clinical Application and Effective Mechanism of Pacemaker with Atrial Fibrillation Preventive Pacing Algorithms / 中国医师杂志

Objective To investigate mechanism and clinical effect of implantation of pacemaker with artial fibrillation(Af) preventive pacing algorithms (Vitatron 900E).Method 24 cases of patients with paroxysmal Af were observed in three phases (each phase two weeks):⑴Monitoring phase,in which onset mechanism of atrial arrtythmias was recorded, the device was programmed into DDD mode with 60 bpm;⑵Lower rate limit phase (LRL),DDDR mode with 85bpm LRL, and evaluating anti-Af effect by elevated rate;⑶Preventive pacing therapy phase,all preventive pacing therapies with programming to on or off, and this phase determined whether combined pacing therapies impacted on incidence of Af. Results 24 cases of patients were free of Af, in which 17 cases were done by using post-PAC-response or/and post-exercise-rate-control therapy only, and 7 cases of 17 casees were done by combining it with cordarone 0 1～0 2g/d also. The other 7 cases were done by DDDR 85 bpm only.Conclusions Af prevention pacing may be benefit for patients with paroxysmal Af,especially with complicated symptomatic bradycardia.