Imaging analysis of 79 cases of hepatic echinococcosis / 中国血吸虫病防治杂志

Objective To analyze the imaging manifestations of 79 cases of hepatic echinococcosis retrospectively, so as to provide evidences for improving the diagnosis and differential diagnosis of the disease. Methods Seventy-nine patients with hepatic echinococcosis who underwent imaging examinations and pathologic confirmation in Qinghai Provincial People’s Hospital from 2014 to 2017 were chosen as the investigation objects, and the data of their medical records and imaging manifestations were collected and analyzed. Results Among the 79 cases of hepatic echinococcosis, 57 were suffered from cystic echinococcosis (CE) and 22 were suffered from alveolar echinococcosis (AE) . Among the patients with CE, those in single cystic type, multiple cysts type, internal capsule collapse type, solid type, and calcification type were 21, 16, 9, 4 cases and 7 cases respectively. The imaging signs of 62 cases were common. The image of the single cystic type was characterized by intrahepatic cystic water-like lesions, the cystic wall was thin and uniform without any enhancement. The multiple cysts were characterized by "cyst in the cyst", "rose petals", and "spoke wheel". The collapse and separation of the internal capsule was manifested as "drift belt sign" and "double ring sign", the calcification of the cyst wall was curved and eggshell-shaped, the contents of the cyst were cotton-shaped or the whole lesion was calcific. The image of the patients with AE was manifested as a solid mass in the liver, the density and signal were heterogeneous, the edge was irregular and not obviously enhanced, the "small vesicles" scattered in the lesion were often accompanied by calcification, and the whole lesion showed a map appearance. The other 17 cases of hepatic echinococcosis showed complex and rare imaging features. The capsules of 6 cases of CE contained fat, the images presented single or multiple fat density nodules in the hepatic hydatid cyst, and CT value was –28 to –84 HU; in 4 cases of echinococcosis, the lesions were broken into the bile duct, the density of adjacent bile duct was increased, with bile duct wall thickening and peripheral biliary dilatation. For the 4 cases of echinococcosis combined with primary liver cancer, the imaging manifestations of the hepatic cysts presented solid-mass enhancement, with "fast forward and fast out" performance. For the image of the 3 cases of CE with infection, the cystic wall was thickening and enhanced obviously, of these, 2 cases had gaseous shadows in the cyst, 1 patient’s cyst was complicated with infection and it invaded the abdominal wall. Conclusion The imaging manifestations of hepatic echinococcosis are varied and complicated, which need careful analysis for differential diagnosis.

Establishment of a predictive model for inpatient sudden cardiac death in a Chinese cardiac department population: a retrospective study / 中华医学杂志(英文版)

BACKGROUND@#Little is known about the risk factors for sudden cardiac death (SCD) in the overall hospitalized cardiac department population. This study was conducted to investigate the risk factors and develop a predictive model for SCD in a hospitalized cardiac department population.@*METHODS@#We conducted a retrospective study of patients admitted to the cardiac department of the First Affiliated Hospital of Xinjiang Medical University from June 2015 to February 2017. We collected the clinical data from medical records. Multiple stepwise logistic regression analysis was carried out to confirm the risk factors for SCD and develop a predictive risk model. The risk score was assessed by the area under receiver operating characteristic (AUROC) curve and the Hosmer-Lemeshow goodness-of-fit test.@*RESULTS@#A total of 262 patients with SCD and 4485 controls were enrolled in our study. Logistic regression modeling identified eight significant risk factors for in-hospital SCD: age, main admitting diagnosis, diabetes, corrected QT interval, QRS duration, ventricular premature beat burden, left ventricular ejection fraction, and estimated glomerular filtration rate. A predictive risk score including these variables showed an AUROC curve of 0.774 (95% confidence interval: 0.744-0.805). The Hosmer-Lemeshow goodness-of-fit test showed the chi-square value was 2.527 (P = 0.640). The incidence of in-hospital SCD was 1.3%, 4.1%, and 18.6% for scores of 0 to 2, 3 to 5 and ≥6, respectively (P < 0.001).@*CONCLUSIONS@#Age, main admitting diagnosis, diabetes, QTc interval, QRS duration, ventricular premature beat burden, left ventricular ejection fraction, and estimated glomerular filtration rate are factors related to in-hospital SCD in a hospitalized cardiac department population. We developed a predictive risk score including these factors that could identify patients who are predisposed to in-hospital SCD.

Imaging analysis of 79 cases of hepatic echinococcosis / 中国血吸虫病防治杂志

Objective To analyze the imaging manifestations of 79 cases of hepatic echinococcosis retrospectively, so as to provide evidences for improving the diagnosis and differential diagnosis of the disease. Methods Seventy-nine patients with hepatic echinococcosis who underwent imaging examinations and pathologic confirmation in Qinghai Provincial People’s Hospital from 2014 to 2017 were chosen as the investigation objects, and the data of their medical records and imaging manifestations were collected and analyzed. Results Among the 79 cases of hepatic echinococcosis, 57 were suffered from cystic echinococcosis (CE) and 22 were suffered from alveolar echinococcosis (AE) . Among the patients with CE, those in single cystic type, multiple cysts type, internal capsule collapse type, solid type, and calcification type were 21, 16, 9, 4 cases and 7 cases respectively. The imaging signs of 62 cases were common. The image of the single cystic type was characterized by intrahepatic cystic water-like lesions, the cystic wall was thin and uniform without any enhancement. The multiple cysts were characterized by "cyst in the cyst", "rose petals", and "spoke wheel". The collapse and separation of the internal capsule was manifested as "drift belt sign" and "double ring sign", the calcification of the cyst wall was curved and eggshell-shaped, the contents of the cyst were cotton-shaped or the whole lesion was calcific. The image of the patients with AE was manifested as a solid mass in the liver, the density and signal were heterogeneous, the edge was irregular and not obviously enhanced, the "small vesicles" scattered in the lesion were often accompanied by calcification, and the whole lesion showed a map appearance. The other 17 cases of hepatic echinococcosis showed complex and rare imaging features. The capsules of 6 cases of CE contained fat, the images presented single or multiple fat density nodules in the hepatic hydatid cyst, and CT value was –28 to –84 HU; in 4 cases of echinococcosis, the lesions were broken into the bile duct, the density of adjacent bile duct was increased, with bile duct wall thickening and peripheral biliary dilatation. For the 4 cases of echinococcosis combined with primary liver cancer, the imaging manifestations of the hepatic cysts presented solid-mass enhancement, with "fast forward and fast out" performance. For the image of the 3 cases of CE with infection, the cystic wall was thickening and enhanced obviously, of these, 2 cases had gaseous shadows in the cyst, 1 patient’s cyst was complicated with infection and it invaded the abdominal wall. Conclusion The imaging manifestations of hepatic echinococcosis are varied and complicated, which need careful analysis for differential diagnosis.

Changes in microRNAs expression are involved in age-related atrial structural remodeling and atrial fibrillation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Small noncoding microRNAs regulate gene expression in cardiac development and disease and have been implicated in the aging process and in the regulation of extracellular matrix proteins. However, their role in age-related cardiac remodeling and atrial fibrillation (AF) was not well understood. The present study was designed to decipher molecular mechanisms underlying age-related atrial structural remodeling and AF.</p><p><b>METHODS</b>Three groups of dogs were studied: adult and aged dogs in sinus rhythm and with persistent AF induced by rapid atrial pacing. The expressions of microRNAs were measured by quantitative real-time polymerase chain reaction. Pathohistological and ultrastructural changes were tested by light and electron microscopy. Apoptosis index of myocytes was detected by TUNEL.</p><p><b>RESULTS</b>Samples of atrial tissue showed the abnormal pathohistological and ultrastructural changes, the accelerated fibrosis, and apoptosis with aging and/or in AF dogs. Compared to the adult group, the expressions of microRNAs-21 and -29 were significantly increased, whereas the expressions of microRNAs-1 and -133 showed obvious downregulation tendency in the aged group. Compared to the aged group, the expressions of microRNAs-1, -21, and -29 was significantly increased in the old group in AF; contrastingly, the expressions of microRNA-133 showed obvious downregulation tendency.</p><p><b>CONCLUSION</b>These multiple aberrantly expressed microRNAs may be responsible for modulating the transition from adaptation to pathological atrial remodeling with aging and/or in AF.</p>

Application experience of attain ® select II catheter delivery system for left ventricular lead implantation in cardiac resynchronization therapy / 中华心血管病杂志

<p><b>OBJECTIVE</b>To summarize application experience of attain ® select II catheter delivery system for left ventricular lead implantation in cardiac resynchronization therapy (CRT).</p><p><b>METHODS</b>CRT/CRT-D was applied for 86 patients with congestive heart failure and left bundle-branch block. Left ventricular lead implantation was applied without use of attain ® select II catheter delivery system in 42 patients without coronary vein anatomy variation (group A). Coronary sinus and cardiac vein angiography detected coronary vein anatomy variations in 44 patients and attain ® select II catheter delivery system was not used in 21 patients (group B) and used in 23 patients (group C). Total procedure time, LV lead implantation time, X-ray exposure time and complications were compared among groups. The optimal LV lead location were observed at the end of procedure.</p><p><b>RESULTS</b>Patients were followed up to 245 days (160 - 368 days). Total procedure time [(119 ± 18) min vs. (142 ± 17) min; (119 ± 18) min vs. (143 ± 17) min], LV lead implantation time [(32 ± 7) min vs. (49 ± 8) min;(32 ± 7) min vs. (51 ± 7) min]and X-ray exposure time [(27 ± 6) min vs. (46 ± 84) min;(27 ± 6) min vs. (45 ± 7) min] were significant reduced in group C compared to group A and B. Procedure-related complications were similar among the 3 groups. The rate of optimal LV lead location was significantly higher in group C than in group B (96% vs. 71%).</p><p><b>CONCLUSIONS</b>It is feasible and safe to implant LV lead through coronary sinus with attain ® select II catheter delivery system. Applying Attain ® select II catheter delivery system can improve the rate of optimal LV lead location with coronary venous anatomy variation.</p>

Use of the Attain Select II catheter delivery system to improve / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Despite technical advances in tools used to facilitate implantation of cardiac resynchronization therapy (CRT) devices, there are many hurdles related mainly to the variation in the anatomy of the coronary veins. One such difficulty is the presence of a very sharply-angulated or tortuous of the lateral or posterolateral cardiac vein.</p><p><b>METHODS</b>Totally 44 patients, 28 males and 16 females, with congestive heart failure and intraventricular conduction delay were studied retrospectively. There were 23 patients who had left ventricular (LV) lead implantation using standard techniques and equipment. For the other 21 patients with LV lead implantation we used the Attain Select II catheter delivery system. The patients were seen every 3 - 6 months for 12 months and the efficacy of the primary procedure, LV lead implantation time, procedure and fluoroscopy time and the complications associated with the two techniques were evaluated.</p><p><b>RESULTS</b>There were no significant differences in the age, gender, New York Heart Association (NYHA) functional class, ischemic etiology, QRS duration, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter and LV dyssynchrony between the two groups. The LV lead implantation time, procedure time and fluoroscopy time were significantly shorter in the group using the Attain Select II catheter delivery system; LV lead implantation time from (51 ± 7) minutes to (40 ± 7) minutes (P < 0.001), procedure time from (143 ± 17) minutes to (124 ± 18) minutes (P = 0.001), and fluoroscopy time from (45 ± 7) minutes to (35 ± 6) minutes (P < 0.001). A successful procedure of LV lead implantation was significantly improved from 17/23 (74%) patients using the standard techniques and equipment, to 20/21 (95.3%) patients using the Attain Select II catheter delivery system (P = 0.06)</p><p><b>CONCLUSION</b>It is feasible and safe to implant LV leads through the coronary sinus using the Attain Select II catheter delivery system.</p>

Differential expression of collagen and matrix metalloproteinases between left and right atria in patients with chronic atrial fibrillation / 生理学报

The present study aimed to investigate the mRNA expression levels of collagen, matrix metalloproteinases (MMPs), and tissue inhibitors of metalloproteinases (TIMPs) in the left and right atria in patients with chronic atrial fibrillation (CAF). Forty five patients with valvular heart disease were sampled in this study, including 18 patients with sinus rhythm (SR), 27 patients with CAF. Clinical data of these patients were collected, and the left and right atrial appendages were obtained from these patients during heart valvular replacement surgery. The mRNA levels of collagen type I, collagen type III, MMP1, MMP9, TMP1 of the atria were then measured by semi-quantitative RT-PCR. The results obtained were as follows. Compared to those in SR group, in atria of CAF group, the mRNA levels of collagen type I, MMP1 and MMP9 increased (P<0.05), while the mRNA level of TMP1 decreased (P<0.01). There were no significant differences in the mRNA levels of collagen type I, collagen type III, MMP1, MMP9 and TMP1 between the left and right atria of SR group (P>0.05). In CAF group, the mRNA level of MMP1 in the right atrium was higher than that in the left atrium (P<0.05), however, the mRNA level of MMP9 in the left atrium was higher than that in the right atrium (P<0.01). In both the left and right atria, the mRNA of collagen type I was positively correlated with the corresponding atrial diameter; the mRNA of MMP1 and MMP9 was positively correlated with the mRNA of collagen type I, and was negatively correlated with the mRNA of TMP1. These results suggest that the increased level of collagen type I associated with selective upregulation of MMP1, 9 and downregulation of TMP1, 9 in the atrium might be the molecular basis of atrial interstitial fibrosis in patients with CAF. Moreover, during CAF development, there is difference in the expression of MMPs between the left and right atria.

A Comparison of Treatment of Tic Disorder with Risperidone and Haloperidol / 中国康复理论与实践

@#ObjectiveTo explore the efficacy and safety of risperidone and haloperidol in treating Tic disorder.Methods78 patients with Tic disorder were randomly divided into the risperidone group and haloperidol group with 39 cases in each group and treated with risperidone and haloperidol respectively for 8 weeks. All patients of two groups were assessed with the Clinical Global Impression Scale (CGI) and Treatment Emergent Symptom Scale (TESS) before treatment and at the end of the 2nd, 4th and 8th week after treatment. Dosages of patients of two groups were recorded.ResultsAfter 8 weeks treatment, the average maximum dosage of risperidone was (1.4±0.34)mg, and that of haloperidol was (7.3±0.52)mg. The total effective rate of risperidone group was 82% and that of haloperidol group was 82.3 %. There was no significant difference between two groups ( P>0.05). The incidence of adverse reactions in risperidone group was 28.2%, and that in haloperidol group was 76.9%. There was a significant difference between two groups (P<0.01), especially at the end of 2nd week after treatment.ConclusionRisperidone and haloperidol both are effect on Tic disorder, but safety and compliableness of risperidone are higher.

Effect of aripiprazole or haldol on intelligence and memory in the first-onset schizophrenia / 中国康复理论与实践

@#ObjectiveTo compare the effect of aripiprazole and haldol on intelligence and memory in the first-onset schizophrenia patients.MethodsResultsThe total score of PANSS significantly decreased after treatment with aripiprazole and haldol but no significant difference were found between two groups (P>0.05).The total score of WAIS-RC was no significant different between two groups (P>0.05). The total score of WMS was significantly higher in aripiprazole group than in haldol group(P<0.05～0.01).ConclusionAripiprazole is more effective on memory recovery in first-onset schizophrenia than haldol.