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Objective:To evaluate the application value of double-layer spectral detector CT (DLSDCT) in differentiating central lung cancer from atelectasis.Methods:Fifty-one patients with central lung cancer accompanied by atelectasis confirmed by pathology in Shandong Cancer Hospital from January to December 2020 were enrolled. The differentiating rates of tumor from atelectasis of the conventional CT, 40 keV virtual monoenergetic imaging (MonoE), iodine density map (ID), and 40 keV MonoE-ID fusion images of unenhanced scan, arterial and venous phase were retrospectively analyzed. Cochran′s Q test was used to compare the differentiating rate (Bonferroni correction afterwards), and Friedman test was used to compare the maximum diameter of the tumor of each imaging method.Results:Of the 51 patients, none of the conventional CT images, 40 keV MonoE, ID and 40 keV MonoE-ID fusion images in the unenhanced scan could distinguish lung tumors from atelectasis; the number of cases in which the conventional CT images, 40 keV MonoE, ID and 40 keV MonoE-ID fusion images in the arterial phase could distinguish lung tumors from atelectasis regions was 4, 5, 5 and 6, respectively; the number of cases in which the conventional CT, 40 keV MonoE, ID and 40 keV MonoE-ID fusion images in the venous phase could distinguish lung tumors from atelectasis regions was 17, 35, 39 and 38, respectively, and the difference was statistically significant (χ 2=52.40, P<0.001). The differentiating rates of the 40 keV MonoE, ID, and 40 keV MonoE-ID fusion image were significantly higher than that of conventional CT image (χ2=-0.35, -0.43, -0.41, P<0.001, Bonferroni correction afterwards); There was no significant difference in the differentiating rate among 40 keV MonoE, ID and MonoE-ID fusion image ( P=1.00). Seventeen tumors could be differentiated in conventional CT images, 40 keV MonoE, ID and 40 keV MonoE-ID fusion images of venous phase, and the maximum diameters of lung tumors were (50±21) mm, (50±23) mm, (50±23) mm, and (50±23) mm, respectively, and the difference was not statistically significant (χ2=3.61, P=0.31). Conclusions:The venous phase spectral images of DLSDCT can differentiate most central lung cancer from atelectasis. Therefore, it has great clinical application value in tumor staging, efficacy evaluation, and radiotherapy.
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Objective@#To investigate students' satisfaction degree on "organ-centered" integrated teaching model for Circulatory Disease, and reveal potential problems and propose improvement methods.@*Methods@#All grade 2016 students from the second department of clinical medicine and pediatrics major were selected as study objects and students' satisfaction degree on "organ-centered" integrated curriculum for circulatory system were investigated. Self-designed questionnaires were adopted; eighteen questions related to the satisfaction degree were designed; questionnaires were distributed and collected by WJX software. Multivariate Logistic regression analysis and word frequency analysis of the results were performed using R software.@*Result@#The results of the questionnaire showed that students were not satisfied with the integrated teaching model. Word frequency analysis showed that students' problems mainly were limited class hours but too many learning content, fast teaching speed and insufficient curriculum integration. Multivariate Logistic regression analysis further showed that students' satisfaction degree was related to their mastery of knowledge and post-class review (P<0.05).@*Conclusion@#Our teaching and research section should fully summarize the teaching experience and shortcomings in the "organ-centered" integrated curriculum for Circulatory System Disease, and try our best to make the in-class teaching clearer, integrate the basic and clinical knowledge, encourage students to review lessons in time and cultivate their ability of independent learning, so as to ultimately improve students' satisfaction for teaching and teachers' teaching quality.
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Objective To investigate students' satisfaction degree on "organ-centered" integrated teaching model for Circulatory Disease,and reveal potential problems and propose improvement methods.Methods All grade 2016 students from the second department of clinical medicine and pediatrics major were selected as study objects and students' satisfaction degree on "organ-centered" integrated curriculum for circulatory system were investigated.Self-designed questionnaires were adopted; eighteen questions related to the satisfaction degree were designed; questionnaires were distributed and collected by WJX software.Multivariate Logistic regression analysis and word frequency analysis of the results were performed using R software.Result The results of the questionnaire showed that students were not satisfied with the integrated teaching model.Word frequency analysis showed that students' problems mainly were limited class hours but too many learning content,fast teaching speed and insufficient curriculum integration.Multivariate Logistic regression analysis further showed that students' satisfaction degree was related to their mastery of knowledge and post-class review(P＜0.05).Conclusion Our teaching and research section should fully summarize the teaching experience and shortcomings in the "organ-centered" integrated curriculum for Circulatory System Disease,and try our best to make the in-class teaching clearer,integrate the basic and clinical knowledge,encourage students to review lessons in time and cultivate their ability of independent learning,so as to ultimately improve students' satisfaction for teaching and teachers' teaching quality.
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Objective@#To compare the value of two 3D imaging reconstruction methods for left atria and pulmonary vein on guiding the catheter ablation for atrial fibrillation (AF).@*Methods@#From January 2014 to January 2017, a total of 100 drug refractory paroxysmal AF patients were divided into left atria direct angiography group (n=50), and indirect angiography group (n=50). 3D CARTO system was applied for mapping and guiding the ablation procedure. Patients assigned to direct angiography group were treated as follows: intraoperative puncture of atrial septum, inject contrast agent directly into the left atrium, conduct left atrial and pulmonary venous rotation angiography, reconstruct three-dimensional image, integrate the image into real-time X-ray system to facilitate circumferential pulmonary vein isolation. Patients assigned into the indirect angiography group were treated as follows: inject contrast agent through the right ventricle, conduct delayed rotation angiography of the left atria and pulmonary vein to guide circumferential pulmonary vein fixation and ablation. The left atrial and pulmonary venous image acquisition, the operation and X-ray exposure time, the success rate and the incidence of complication of the two groups were compared. The patients were followed up for 3-6 months.@*Results@#General clinical characteristics of the two groups were similar(all P>0.05). Ablation was successful in all 100 patients. The operation time[(112.0±21.4)min vs. (134.0±24.3)min]and X-ray exposure time((10.7±4.7)min vs. (15.8±5.2)min)were significantly lower in direct angiography group than in indirect angiography group (both P<0.01). There was no significant difference between the two groups in the immediate (86%(43/50) vs. 82%(41/50), P=0.59) and short-term (76%(38/50) vs. 72%(36/50), P=0.65) success rate and complication rate (1 aneurysm in the direct angiography group, 1 pericardial tamponade in the indirect angiography group). In-hospital mortality was zero percent.@*Conclusion@#It is safe and effective method to guide the radiofrequency catheter ablation of paroxysmal atrial fibrillation by reconstruction 3D image of left atrium and pulmonary vein. Compared with indirect angiography group, direct angiography group can improve the imaging quality of left atrium and pulmonary vein, decrease the X-ray exposure time of the ablation procedure.
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Objective: To investigate the safety and efficacy of CARTO3 fast anatomical mapping during radiofrequency ablation in patients with paroxysmal atrial ifbrillation (PAF). Methods: A total of 120 PAF patients treated in our hospital from 2013-01 to 2015-07 were enrolled. All patients received CARTO3 system for mapping and they were randomly divided into 2 groups: Control group, the patients had selective pulmonary vein angiography, followed by conventional point by point method to reconstruct left atrial model for guiding the ablation of PFA and Treatment group, the patients had selective pulmonary vein angiography followed by fast anatomical mapping to build left atrial model for guiding the ablation of PFA; the rest operational steps such as trans-septal and circumferential pulmonary vein ablation were the same.n=60 in each group. The times of operation, X-ray exposure and the rates of success, complication occurrence were compared between 2 groups. Results: All patients were successfully completed radiofrequency ablation for PAF. Compared with Control group, Treatment group had increased modeling time (8.5 ± 3.6) min vs (5.2 ± 2.3) min, while decreased pulmonary vein ostium determing time (12.0 ± 5.6) min vs (25.0 ± 8.4) min, circumferential pulmonary vein ablation time (95.0 ± 22.0) min vs (115.0 ± 25.0) min and X-ray exposure time (15.0 ± 6.3) min vs (24.0 ±5.5) min, allP0.05. Conclusion: CARTO3 fast anatomical mapping is safe and effective for guiding radiofrequency ablation in PAF patients, it may decrease the X-ray exposure time and operation time which were important for treating the relevant patients.
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AIM:To investigate the effect of renal denervation ( RDN) by radiofrequency catheter ablation on the expression of aquaporins ( AQP) in dog kidneys .METHODS:Adult Chinese Kunming dogs ( n=12 ) were randomly divided into RDN group and control group (6 for each group).The dogs in RDN group underwent bilateral RDN using ra-diofrequency catheter ablation , and radiofrequency catheter was positioned in bilateral renal artery without ablation in con -trol group.The levels of norepinephrine (NE) and AQP1~3 in the renal tissues were detected 1 month after RDN, and blood pressure (BP) measurements were performed at baseline and 1 month after RDN.RESULTS: The level of NE in RDN group was significantly lower than that in control group (P<0.01).The expression of AQP1~3 in the renal cortex and medulla was lower in RDN group than that in control group .RDN also caused a substantial BP reduction (P<0.05). CONCLUSION:RDN substantially decreases the tissue levels of NE and AQP in dog kidneys , and also decreases BP sig-nificantly , which might be involved in the mechanism of BP reduction by RDN .Renal sympathetic nerve plays an excitatory role in the regulation of AQP in the kidney.
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Objective To explore the effects of corticosteroids on the recurrence of atrial fibrillation (AF) after radio fre-quency catheter ablation (RFCA ) .Methods A total of 50 patients with paroxysmal AF who underwent RFCA and then treated with corticosteroids from January 2011 to April 2014 were enrolled in this study .At the same period ,37 patients with paroxysmal AF who also underwent RFAC but without corticosteroids treatment were selected as control group .The follow-up was carried out by the fixed physician at 1st week ,1st month ,3rd months ,6th months ,12th months after RFCA through a telephone visit or a hos-pital visit ,including the 12-lead electrocardiogram (ECG) and the HOLTER examination ,symptom of heart-throb inquiry and the interpretation of ECG ,AF recurrence were analyzed and compared between hormone treatment group and control group .Results After 1 week treatment ,the maintenance rates of sinus rhythm in treatment group and control group were 80 .0% and 54 .1% ,re-spectively ,there was statistic difference(P < 0 .05) ,the recurrence of AF in treatment group was significantly decreased ;after 1 month treatment ,the maintenance rates of sinus rhythm in treatment group and control group were 80 .0% and 67 .6% ,respective-ly ,there was no statistic difference(P = 0 .187) ;after 12 months treatment ,the recurrence of AF in treatment group and control group ,was not found statistic significance(P= 0 .711) .Kaplan-Meier survival rate was drew to conduct Log-rank test ,the difference of AF recurrence between the two groups was no statistic significance(P= 0 .711) .Conclusion Transient use of small amounts of corticosteroids after AF ablation may be effective for preventing AF recurrences within 1 week after ablation but it is not effective for preventing AF recurrences at 1st month and 12th months after ablation .
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[ ABSTRACT] AIM: To evaluate the guiding effect of high-frequency stimulation ( HFS) on renal denervation ( RDN) , and to compare the similarities and differences of blood pressure changes at the time of electrical stimulation and radiofrequency ablation .METHODS:A total of 6 Kunming dogs were included in this study .Renal artery abnormalities were excluded by angiography .High-frequency stimulation and radiofrequency ablation were performed at the same sites from distal to proximal segments of the renal artery .Invasive blood pressure ( BP) was recorded during the whole proce-dure.The change of the blood pressure was analyzed .HE and Masson staining was adopted to detect the structural changes in the wall of the renal artery and surrounding tissues .The immumohistochemical staining for tyrosine hydroxylase ( TH) was used to observe the renal nerve damage after ablation .RESULTS: Electrical stimulation and radiofrequency ablation were delivered in a total of 50 sites.The BP increasing response was induced at 34%sites (n=17), while the rest sites (66%, n=33) had no response.Compared with the baseline , HFS caused the increases in systolic BP of (0.34 ±3.38), (0.41 ±3.04), (10.47 ±5.73), (13.27 ±3.63), (10.17 ±1.87) and (0.78 ±1.87) mmHg in 6 serial 20 s time segments during 120 s of HFS at positive BP response sites .Similarly, the increases in systolic BP by (-0.88 ±3.44) , (-1.64 ±3.47), (13.17 ±3.12), (12.82 ±3.21), (9.50 ±2.68) and ( -6.09 ±2.21) mmHg were observed dur-ing 120 s of ablation procedure at the same sites in 6 serial 20 s time segments .At non-responding sites , HFS and ablation failed to cause a significant increase in systolic BP .The mean area of nerves in the response sites was ( 0.51 ±0.28 ) mm2, whereas that in non-response sites was (0.09 ±0.06) mm2(P<0.01).The average absorbance values of TH in re-nal nerves at ablation and non-ablation sites were 0.031 ±0.015 and 0.085 ±0.018 ( P <0.01 ) , respectively . CONCLUSION:Renal sympathetic nerves can be effectively mapped by HFS .Radiofrequency ablation guided by HFS is valid to injure sympathetic nerves around renal artery .
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Objective To observe the effect of different doses of atorvastatin in treating elderly acute coronary syndrome.Methods Totally 78 cases with acute coronary syndrome were randomly divided into two groups:low-dose atorvastatin group and high dose atorvastatin group,39 cases for each.The triacylglycerol (TG),total cholesterol(TC),low-density lipoprotein-cholestrol (LDL-C)and high-density lipoprotein-cholestrol (HDL-C) were compared between before and after the treatment.The adverse drug reactions were observed.Results Before treatment,the levels of TG,TC,LDL-C and HDL-C were not statistic significant between the two groups.After treatment of 1 month,3 months,6 months and 12 months,TC and LDL-C of the two groups were decreased than those before treatment,and TC and LDL-C of high-dose atorvastatin group were lower than those of low-dose atorvastatin group,but HDL-C level was not changed compared with before treatment.After treatment of 3 months,6 months and 12 months,TG levels of the two groups were decreased than those before treatment,and TG of high-dose atorvastatin group were reduced than those of low-dose atorvastatin group.The incidence rate of cardiovascular events of high-dose atorvastatin group was significantly lower than those of low-dose atorvastatin group.There was no difference in the incidence rate of adverse drug reactions between the two groups.Conclusions I(s worthy to apply high-dose atorvastatin in clinical treatment for acute coronary syndrome because of its ability to decrease the levels of TG,TC,LDL C,HDL-C and cardiovascular events.
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Objective To explore the bioeffects of canine myocardium under microbubble destruction via diversity of ultrasonic intension, in order to optimize ultrasonic intension for experiments. Methods Nine mongrel dogs were randomly divided into 3 groups. Ultrasound (1 MHz) in diversity of different intension (0.5 W/cm~2, 1.0 W/cm~2, 2.0 W/cm~2) was applied to expose canine myocardium after intravenous injection microbubbles of 2.0 ml. All the dogs were killed after being exposed for 5 min. The myocardium was harvested for HE staining and observed with transmission electron microscope for the tissue microstructures. Results The myocardium of hyperemia, disfiguration and necrosis wer observed in all groups. Myocardial edema but not hemorrhage appeared with 0.5 W/cm~2 , mild myocardial hemorrhage and slight inflammatory cell infiltration happened with 1.0 W/cm~2, whereas obvious hemorrhage and certain degree of inflammatory cell infiltration occurred with intension of 2.0 W/cm~2. With the augmentation of ultrasonic intension, myocardium trend to aggravate. Conclusion Ultrasound of diversity intension can induce different bioeffects of canine myocardium. Ultrasound mediated microbubble destruction with the intensity of 1.0-2.0 W/cm~2 can provoke a certain degree of inflammatory reaction with mild myocardial damage.
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Objective:To compare the efficacy and safety between cryoablation(Cryo)and radiofrequency (RF)ablation in patients with atrioventricular nodal reentrant tachycardia(AVNRT). Methods: A total of 83 patients with AVNRT underwent electrophysiological treatment in our hospital from October 2006 to March 2009 were studied. Patients were divided into two groups according to their own choices. Cryo group (n=41) and RF group (n=42). The clinical characteristics,success rate,procedural time and ablative time were compared between two groups. Results:The procedural time and ablative time in Cryo group was significantly longer than those in RF group (119.14±40.16 min vs.85.86±28.24 min,P=0.001; 1118.91±620.62 s vs.370.97±279.23 s,P<0.001). The acute success rate was achieved in 40/41(97.6%)patients in Cryo group,and 42/42(100.0%) in RF group. Transient AV-block was encountered in 6 (15%) patients in the Cryo group and 5 (11.9%) in RF group (P=0.681). There was no complete atrial-ventricular(AV)conduction block at the end of procedures. There was no recurrence of AVNRT in either Cryo group nor in RF group during 11.6±5.5 months of follow up period.Conclusion:Cryoablation was as effective and safe as RF ablation for AVNRT. Cryo-energy was one kind of alternative ablation energy for AVNRT.
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This study was aimed to shed light on the association of beta-adrenoceptor (beta-AR, includeing three subgroups: beta1, beta2 and beta3)gene polymorphism with resting heart rate (RHR). The RHRs of 150 healthy subjects (male 80; female 70) in the supine were detected by computerized system for analyzing the electrocardiosignals. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and allele specific-PCR techniques were used to determine Ser49Gly and Arg389Gly polymorphism of beta1-adrenoceptor gene; Arg16Gly and Gln27Glu polymorphism of beta2-adrenoceptor gene and Trp64Arg polymorphism of beta3-adrenoceptor gene; in these subjects. The results were as follows: The Arg389Gly polymorphism of beta1-adrenoceptor gene is significantly associated with RHR (P<0. 05), and the difference among three RHRs in male group is significantly higher than in group female group (P=0.0030 vs 0.0045). Individuals with Gly/Gly genotype have the highest RHR (male: 80.98+/-3.09; female: 84.23+/-6.28). No significant association was found among Ser49Gly, Arg16Gly, Gln27Glu and Trp64Arg polymorphism with RHR respectively (P> 0.05). RHR is associated with genotype. Arg389Gly polymorphism of beta1-adrenoceptor gene is significantly associated with RHRs, and the higher significant difference among male's RHRs,when compared with that among female's, suggests that male's RHRs be more influenced by genotype. Thus the clinical phenomenon of "the correlation of heart rate and mortality in male is higher than that in female" could be explained at the gene level.
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Female , Humans , Male , Middle Aged , Electrocardiography , Heart Rate , Physiology , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , Receptors, Adrenergic, beta , Genetics , Signal Processing, Computer-AssistedABSTRACT
DNA was extracted from the peripheral venous blood of 338 subjects using BLOOD DNA MINI KIT. The 5 site SNP in 3 subtypes of Beta-AR were genotyped by PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) and allele-specific primer PCR techniques. The genotypes combination distribution of SNP at 5 sites in the 3 subtypes of Beta-AR were determined by clustering analysis technique. The natural combination distribution characteristics for SNP at 5 sites in the 3 subtypes of Beta-AR in 338 subjects were obtained. Sixty-seven combinations types were found. The preceding 5 combinations in the natural combination distribution of the SNP were: (1) The genotype combination of forty subjects was B1-AR S/S49+B1-AR R/R389+B2-AR R/G16+B2-AR Q/E27+B3-AR W/W64, its probability was 11.83%. (2) The genotype combination of thirty-three subjects was B1-AR S/S49+B1-AR R/R389+B2-AR R/G16+B2-AR Q/Q27+B3-AR W/W64, its probability was 9.76%. (3) The genotype combination of nineteen subjects was B1-AR S/S49+B1-AR R/G389+B2-AR R/G16+B2-AR Q/Q27+B3-AR W/W64, its probability was 5.62%. (4) The genotype combination of sixteen subjects was B1-AR S/S49+B1-AR R/G389+B2-AR R/G16+B2-AR Q/E27+B3-AR W/W64, its probability was 4.74%. (5) The genotype combination of thirteen subjects was B1-AR S/G49+B1-AR R/R389+B2-AR R/G16+B2-AR Q/E27+B3-AR W/W64, its probability was 3.85%. The obvious correlations exist among full sample and female or male subgroup, and between female and male subgroups.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Genotype , Polymerase Chain Reaction , Methods , Polymorphism, Single Nucleotide , Genetics , Receptors, Adrenergic, beta , Classification , Genetics , Receptors, Adrenergic, beta-1 , Genetics , Receptors, Adrenergic, beta-2 , Genetics , Receptors, Adrenergic, beta-3 , GeneticsABSTRACT
To extract sub-signal of heart period signal (HPS), a new statistical signal processing approach, namely independent component analysis (ICA) was addressed. Electrocardiosignal (ECS) was acquired from ten volunteers. ECS was sampled 8 minutes when the volunteer was in supine position, and then when the same volunteer was in erect position. HPS was extracted from ECS. According to time-delay, HPS was divided into five groups as mixed signals. Five signals were reconstructed into two groups by ICA. The rebuilt signals were transformed by Fourier transformation. One centralized in low frequency (called IC1); the other did in high frequency (called IC2). The power of IC1 was significantly increased (P<0.01) while that of IC2 showed no significant change (P>0.05), and the ratio of IC1 to total power also significantly increased with the change from supine position to erect position. Comparsion between the two postural results reveals that IC1 may express sympathetic activity, and IC2 represents parasympathetic activity. Sympathetic and parasympathetic nervous functions can be evaluated respectively and quantitatively by use of data and graphs from the two decomposed components.
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Humans , Autonomic Nervous System , Physiology , Electrocardiography , Heart Rate , Physiology , Parasympathetic Nervous System , Physiology , Signal Processing, Computer-AssistedABSTRACT
Objective To explore the etiology of hyperthyroid cardiomyopathy. Methods Forty New Zealand rabbits were randomly and equally divided into 4 groups: control group, levothyroxine(L-Thy) group, imidapril group, and valsartan group. Except the control group, rabbit model of hyperthyroidism was established by daily intraperitoneal injections of L-Thy (45 ?g?kg-1?d-1? 28 d), and the animals of later 2 groups received 0.5 mg/kg imidapril and 8 mg/kg valsartan respectively at same period. Ventricular tissues were collected at 4 weeks. Cardic hypertrophy index, cardiomyocyte diameter, structural and ultrastructural changes were detected. Cardiac fibrosis was displayed by Masson’s staining and collagen volume fraction (CVF) was measured using pathological image analytic system. Expressions of angiotensin converting enzyme (ACE), extracellular signal-regulated kinase (ERK), and phosphorylated ERK (p-ERK) were evaluated with Western blot analyses. Results Compared with control group, rabbits of L-Thy group displayed remarkable myocardial hypertrophy, extracellular matrix fibrosis, and morphological changes in both structure and ultrastructure. Western blot analysis revealed increased protein expressions of ACE,ERK and p-ERK proteins. ERK and p-ERK expressions were correlated positively well with both cardiomyocyte diameter and CVF. Both imidapril and valsartan alleviated cardiomyocyte hypertrophy, extracellular matrix fibrosis, and structural damage induced by L-Thy. Compared with L-Thy group, expressions of lower ERK and p-ERK were found in both imidapril and valsartan groups. Conclusion Renin-angiotension system (RAS) and ERK signaling pathway may play important roles in hyperthyroid cardiomyopathy. Activated RAS is possibly responsible for activation of ERK signaling pathway. Imidapril and valsartan may inhibit activation of ERK signaling pathway and retarding myocardial remodeling in hyperthyroid cardiomyopathy induced by L-Thy.