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Objective:To investigate the influence of left atrial size on the ablation efficacy, cardiac morphology and function after valve replacement combined with X-type radiofrequency ablation on posterior wall of left atrium.Methods:From January 2015 to December 2019, 416 patients with mitral valve disease complicated with atrial fibrillation were divided into two groups according to the size of left atrium(Anteroposterior diameter 60 mm). Valve replacement combined with " X" radiofrequency ablation on posterior wall of left atrium was performed. The clinical data were analyzed retrospectively.Results:Except for the AF types, gender, length of stay and postoperative complications, other clinical data, operative and perioperative indicators were better in small left atria group(SLA)than in large left atria group(LLA). The differences were statistically significant( P<0.05). Fractional shortening(FS), ejection fraction(EF) in SLA at any time point were higher than that in LLA, P<0.05. The sinus rhythm conversion rates, the change rate of LA anteroposterior diameter in SLA at postoperative time points were higher than that in LLA, P<0.05. There was no significant difference of cardiac troponin(cTn) and myoglobin(MYO) between the two groups in 6 months after operation, P>0.05. The B-type natriuretic peptide(BNP), cTn, MYO in the other time points were lower than that in LLA, P<0.05. Conclusion:Larger left atrium reduces the rate of sinus rhythm conversion and maintenance in patients undergoing valve replacement combined with fibrillation ablation. There were worse ventricular remodeling and cardiac function recovery. Preoperative evaluation of left atrial size is helpful for prognosis.
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@#The prevalence of 1X type ranks the second among Charcot-Marie-Tooth disease (CMT). Mutations of GJB1 gene causes abnormality of Connexin32's structure and function, which leads to the defect of the intercellular passage, and at last Results in CMT1X. This article reviewed the typical clinical features and the advance of molecular genetics of CMT1X, and summarized the pathogenic researches.
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With multiple-choice questions presenting one, two, or three of five choices (types A, K or X), the expected probability of a correct answer (P) can be obtained with a five-dimensional equation for the knowledge level (q), which is the probability of discriminating correct and incorrect items. From equations for each question type, we inversely estimated the q value (the estimated knowledge level), replacing P with the raw score rate in the actual examinations for promotion. The distribution and mean value of the raw score rate of type X differed from those for types A and K. However, distributions of estimated q values for the three question types were similar. This method can be used to estimate the actual knowledge level of students without the question type affecting the raw score but cannot be used to estimate incorrect knowledge.
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Ikebukuro's index is identical to the index described by Nukada in 1978. Nukada's index has not been used because it is not realistic or useful. Because a “ standard score rate” can be calculated from the weighted average of Nukada's index, Ikebukuro's index is also closely related to the “ standard score rate.”
ABSTRACT
X type questions have been used for the national medical licensing examination since 1997. At Tsukuba University, X type questions have been used since 1996. We compared X typeand K type questions on the basis of the percentage of correct answers and discrimination power. The average percentage of correct answers was 68.2% for K type questions and 53.1% for X type questions. However, the average discrimination power was +0.227 for K type questions and +0.257 for X type questions. These results indicate that X type questions are more difficult and are suitable for achievement tests. The estimated knowledge quantity was 2.04 for K type questions and 2.32 for X type questions. This suggests that the person writing the questions decreased the essential difficulty of X type questions.