Electrocardiographic characteristics of idiopathic ventricular arrhythmias originating from the tricuspid annulus regions / 中华心血管病杂志

Object@#To explore the electrocardiographic characteristics of ventricular arrhythmias (VAs) originating from tricuspid annulus region.@*Methods@#Present study included 169 consecutive patients undergoing catheter ablation of VAs from tricuspid annulus origin in our department from August 2007 to September 2016. Based on the origin sites, the patients were divided into two subgroups, the free wall group (81 cases) and septal wall group (88 cases). Based on the location, patients in the free wall group were classified into anterolateral (22 cases), lateral (26 cases) and posterolateral (33 cases) subgroups. Patients in the septal group were classified into anteroseptal (10 cases), midseptal (71 cases) and posteroseptal (7 cases) subgroups. We analyzed the electrocardiographic features of these patients and in 87 patients with PVCs/VT originating from right ventricular outflow tract.@*Results@#(1) A positive R wave inⅠ, aVL, V5-V6 leads were found among most of patients, only few cases originating from tricuspid annulus anteroseptum group and tricuspid annulus anterolateral group demonstrated qr or qs pattern in aVL lead. 97.53% (79/81) patients demonstrated rS pattern in V1-V3 leads with VAs originating from tricuspid annulus free wall, and 9/10 patients demonstrated rS pattern in V1 lead with VAs originating from anteroseptum, and 97.44% (76/78) patients demonstrated QS pattern in V1 lead with VAs originating from midseptum and posteroseptum. Precordial lead transition zone was on or behind V3 for tricuspid annulus free wall group (96.3%, 78/81), but in front of V3 for tricuspid annulus septum wall group (47.73%, 42/88) (P<0.01). The S wave's amplitude smaller than-1.81 mV in lead V2 can be used as a cutoff value to identify if PVC/VT is originating from free wall or septum of TA. R wave in inferior wall leads was found among 98.85% (86/87) patients with PVCs/VT originating from right ventricular outflow tract.@*Conclusion@#A positive R wave in Ⅰ, aVL, V5-V6 leads was found among most of patients with idiopathic ventricular arrhythmias originating from the tricuspid annulus regions, but VAs originating from different portions of tricuspid annulus area have distinct electrocardiographic characteristics.

Electrocardiogram characteristics of patients with ventricular arrhythmia originating from the distal great cardiac vein / 中华心血管病杂志

Objective@#To explore the electrocardiographic characteristics of patients with idiopathic ventricular arrhythmias (VAs) originating from different portions of distal great cardiac veins (DGCV).@*Methods@#The study included 49 patients underwent successful RFCA of premature ventricular complex(PVCs)/ventricular tachycardia(VT) from different portions of the DGCV in our department from July 2009 to March 2016. The surface 12-lead electrocardiogram (ECG) and intraventricular ablation mapping features were analyzed. Patients were divided into four groups according to the mapping and ablation results: DGCV1(10 patients), DGCV2 (13 patients), proximalanterior interventricular vein (PAIV, 17 patients)and extend distal great cardiac vein (EDGCV, 9 patients). We analyzed the similarities and differences between surface 12-lead ECG of patients with PVCs/VT from different portions of DGCV, and compared with random chosen 290 patients with PVCs/VT from ventricular outflow tract and adjacent structure.@*Results@#A positive R wave in inferior leads, a negative QS morphology in lead aVL and aVR were found among all groups. The different characteristics of surface 12-lead ECG of VAs originating from DGCV were as follows: (1)EDGCV patients demonstrated a positive R or r wave on lead Ⅰ(6/9) while a negative rS or qr wave was evidenced in other three groups (39/40). (2)A positive R pattern on lead V1, V5-V6 (11/13) was presented in patients of DGCV2 group; R (without S or s) wave on V1 (9/10), RS or Rs wave on V5-V6 were found in DGCV1 group; RS or rS wave was seen on lead V1, R(without S)wave in lead V5-V6 (25/26) were found in EDGCV and PAIV group and the amplification of R wave in EDGCV was higher than V1 of PAIV group.(3)Precordial lead transition zone was in front of V1 for DGCV1 and DGCV2 groups (23/23), within V1-V3 for EDGCV group, but on V2 or within V2-V3 for PAIV group.(4)Patients of DGCV1 and DGCV2 demonstrated a longer Pseudo delta wave time(PdW), intrinsicoid deflection time (IDT), significantly larger maximum deflection index (MDI) than those in PAIV and EDGCV groups (P<0.001). (5)The different characteristics of surface 12-lead ECG between VAs originating from DGCV and those from ventricular outflow tract and adjacent structure were as follows: ① The ECG features were similar between PVIA and LCC group, both demonstrated a rs wave on the lead Ⅰ, rS wave on V1-V2 and R wave on V5-V6; ②The ECG features were similar betweenEDGCV and RCC group, both presented with R or r wave on the lead Ⅰ, the QRS wave of precordial leads was similar as PAIV and LCC groups; ③A R wave on the lead V1, V5-V6 was found in group DGCV2, and ILCC; ④Similar to the group Endo-MAA, patients in DGCV1 group also demonstrated a R wave on the lead V1 and a Rs wave on V5-V6.@*Conclusion@#A positive R wave in inferior leads, a negative QS morphology in lead aVL and aVR are seen in all patients, but different electrocardiographic characteristics of PVC/VT originating from the different portions of the DGCV are presented on lead Ⅰ and V1-V6.

Unmet needs in health training among nurses in rural Chinese township health centers: a cross-sectional hospital-based study / 보건의료교육평가

PURPOSE: Maintaining a sufficient and competent rural nursing workforce is an important goal of the Chinese health delivery system. However, few studies have investigated the health training status or conducted a needs assessment of rural Chinese nurses during this time of great transformations in health policy. This study was conducted to explore the current health training status of nurses working in rural Chinese township health centers (THCs) and to ascertain their perceived needs. METHODS: A cross-sectional survey using a self-administered structured questionnaire was conducted among 240 THC nurses in Guangxi Zhuang Autonomous Region, China from March 2014 to August 2014. The survey questionnaire was adapted from the Second Chinese Survey of Demographic Data and Training Demand for Health Professionals in THCs developed by the Ministry of Education. RESULTS: The nurses in THCs were young, with a low educational level. Their perceived needs for health training included further clinical studies at city-level hospitals to improve their skills and theoretical studies at medical universities in emergency medicine and general practice. Overall, 71.9% of the nurses with a secondary technical school background expected to pursue junior college studies, and 68.5% of the nurses with a junior college education expected to pursue a bachelor's degree. A decentralized program with theoretical studies at medical universities and practical studies at county hospitals was regarded as feasible by 66.9% of the respondents. CONCLUSION: Health-training programs for nurses in Chinese THCs must be improved in terms of coverage, delivery mode, and content. A decentralized degree-linked training program in which medical universities and city hospitals collaborate would be an appropriate mode of delivery.

Effect of amiodarone hydrochloride treatment time on treatment success rate of ventricular premature beats after radiofrequency ablation / 中国生化药物杂志

Objective To investigate the effect of treatment time with amiodarone hydrochloride on treatment success rate of ventricular premature beats after radiofrequency ablation. Methods 46 cases of patients with frequent premature ventricular arrhythmia who received RFCA for the first time in department of gardiology,huangyan hospital of wenzhou medical university from February 2013 to February 2015 were selected,and randomly divided into two groups,the control group were treated with amiodarone hydrochloride for one months,the study group were treated with amiodarone hydrochloride for six months.Left ventricular function and structural parameters,heart rate variability were measured in two groups,the main clinical symptom scores,success rate,efficacy and safety were compared. Results Compared with before treatment,two groups of LVESD,LVEDD and PVC decreased (P<0.05),LVEF increased (P<0.05),SDNN,rMSSD,PNN50,LF and HF increased (P<0.05),scores of palpitation,shortness of breath,chest tightness and main symptom score decreased (P<0.05).Compared with the control group,level of PVC in the study group was lower (P<0.05),LVEF was higher(P<0.05),LVESD and LVEDD were had no significant differences,levels of SDNN,rMSSD,PNN50,LF,HF were higher (P<0.05),scores of palpitations,shortness of breath,chest tightness main symptom score were lower (P<0.05).There were no significant differences in the success rate, clinical efficacy and adverse reaction rate between the two groups. Conclusion The time of taking amiodarone after radiofrequency catheter ablation in patients with PVCs,but taking six months and medication compared to one month,can reduce heart palpitations,chest tightness and other symptoms,and improve left ventricular function,with high security.

Effect of Ezetimibe with loaded dose on hematologic parameters and re-infarction in patients undergoing PCI / 中国生化药物杂志

Objective To investigate the prevention effect of Ezetimibe with loaded dose on hematologic parameters and re-infarction in patients undergoing PCI.Methods 240 cases of patients with non ST segment elevation myocardial infarction performed PCI from October 2012 to October 2014 were selected and randomly divided into two groups,the control group received conventional dose Ezetimibe 10 mg every time,qd,the study group received loading dose ezetimibe 20 mg every time, qd, both two groups treatment 30 days.The inflammatory factors, myocardial injury and vascular endothelial function were compared before, 24 h and 30 d after the operation, and patients were followed up for two years,record adverse reactions. Results Compared with before treatment,levels of serum inflammatory factor,myocardial injury and vascular endothelial function index in different time points had differences by single factor analysis of variance(P<0.05),and compared with the control group, levels of serum hs-CRP,TNF-α,IFN-γand IL-6 in the study group were lower, levels of serum CK-MB,cTnI and BNP were lower,the contents of ET in serum were lower,and the contents of NO were higher(P<0.05).The improvement degree in the study group of myocardial microcirculation perfusion after treatment was higher(P<0.05).No case shedding phenomenon occurred during the two year follow-up, and there was no statistical significance in the incidence of cardiovascular events between two groups.Conclusion Loading dose of ezetimibe can protect myocardium,and it can inhibit the inflammatory reaction and vascular endothelial injury caused by operation,it also can improve myocardial microcirculation.

Role of cyclic adenosine monophosphate response element binding protein in ventricular pacing induced cardiac electrical remodeling in a canine model / 中华心血管病杂志

<p><b>OBJECTIVE</b>This project is designed to explore the potential role of cyclic adenosine monophosphate (cAMP) response element binding protein (CREB) in cardiac electrical remodeling induced by pacing at different ventricular positions in dogs.</p><p><b>METHODS</b>An animal model by implanting the pacemakers in beagles was established. According to the different pacing positions, the animals were divided into 4 groups:conditional control group (n=6), left ventricle pacing group (n=6), right ventricle pacing group (n=6) and bi-ventricle pacing group (n=6). Cardiac and electrical remodeling were observed by echocardiography, electrocardiogram and plasma BNP. Myocardial pathology and protein expression of extracellular regulated protein kinases1/2 (ERK1/2), P38 mitogen activated protein kinases (P38 MAPK) and CREB were examined at 4 weeks post pacing.</p><p><b>RESULTS</b>Cardiac structure and plasma BNP level were similar among 4 groups (all P>0.05). Electrocardiogram derived Tp-Te interval was significantly prolonged post pacing (92±11, 91±10, and 79±13 ms vs. 60±12 ms), and the Tp-Te interval in bi-ventricle pacing group was shorter than in left or right ventricle pacing group (P < 0.05). Western blot results showed that the expression of p-ERK1/2 in left ventricular myocardium of left ventricle pacing group, right ventricular myocardium of right ventricle pacing group and bi-ventricular myocardium of bi-ventricle pacing group was 2.7±0.4, 2.4±0.2, 1.7±0.1 and 1.9±0.2, respectively, the expression of p-P38 MAPK was 1.9±0.3, 1.7±0.2, 0.8±0.1 and 1.1±0.1, respectively, and the expression of p-CREB was 2.1±0.2, 2.0±0.2, 2.7±0.4 and 2.6±0.3, respectively. The p-ERK1/2 and p-P38 MAPK expression of bi-ventricle pacing group was lower,but the p-CREB expression was higher compared to the other pacing groups (P < 0.05).</p><p><b>CONCLUSIONS</b>Ventricular pacing could induce electrical remodeling evidenced by prolonged Tp-Te interval and increased phosphorylation of ERK1/2 and p38 MAPK and reduced phosphorylation of CREB. Compared with single ventricle pacing, bi-ventricle pacing could attenuate electrical remodeling in this model.</p>

Efficacy of atorvastatin combined with neuroendocrine antagonist in chronic heart failure / 中国生化药物杂志

Objective To observe the clinical efficacy of atorvastatin combined with neuroendocrine antagonist in the treatment of chronic heart failure.Methods 70 patients of Wenzhou Medical College Theorem Clinical College of Cardiology Department from March 2014 to March 2015 were randomly divided into observation group and control group of 35 cases in each group.The control group were given the neuroendocrine antagonist, observation group were given atorvastatin combined with neuroendocrine antagonist treatment. The changes of related indicators were recorded. Results The aminoterminal pro-brain natriuretic peptide (NT-ProBNP) and ejection fraction in observation group were [(1264.7 ±174.6)pg/mL, (0.58 ±0.07)], which were higher than those in control group [(2106.5 ±164.8)pg/mL,(0.49 ±0.08)](P<0.05).The total effective rate in observation group was 91.43%, which was higher than 71.43%in control group(P<0.05).Conclusion Atorvastatin joint neuroendocrine antagonist in treatment of chronic heart failure has clinical exact effect with no significant side effects.

A case and pedigree report of hereditary hemorrhagic telangiectasia / 临床耳鼻咽喉头颈外科杂志

A case of hereditary hemorrhagic telangiectasia was reported. Repeated hemorrhage in nasal and digestive system are main clinical manifestation. Capillary expanded on tongue and finger is the main physical sign. Main clinical manifestation and typical physical signs, combined with family history, can help to establish a diagnosis.

Early compliance and efficacy of sublingual immunotherapy in patients with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The study aimed to investigate the efficacy and adverse effects of sublingual immunotherapy (SLIT) of dust mite drops to allergic rhinitis with mite allergy. The compliance and satisfaction of SLIT were also assessed.@*METHOD@#One hundred and three patients of allergic rhinitis sensitive to dust mites were treated with SLIT for 6 months or more. The symptom questionnaire,including items on rhinorrhea, sneezing, nasal obstruction, itchy nose, olfactory disturbance, eye discomfort and sleep disturbance were obtained before and 6 months after SLIT. The patients' satisfaction and adverse effects were also investigated.@*RESULT@#Seventy-five of the 103 patients insist on SLIT for more than 6 months and completed the questionnaire. The duration of receiving SLIT was 9.8 months on average (range from 6 to 13 months). The satisfaction rate was 89.3%. The drop-out rate of SLIT was 31.0%.@*CONCLUSION@#The subjective symptoms were improved with SLIT in patients with allergic rhinitis sensitive to dust mites. The drop out rate was high despite of the symptomatic improvement.

Application of mucoperiosteal flap of nasal septum to repair defect of fossa orbitalis, hard palate and the anterior skull base / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the neoplasia of fossa orbitalis, hard palate and the anterior skull base defect by making use of mucoperiosteal flap of nasal septum.@*METHOD@#A retrospective study was reviewed in 12 patients with tumors in nasal cavity and nasal sinuses. According to tumor character and range, by partial or total maxillectomy and ethmoidectomy, fossa orbitalis, hard palate and the anterior skull base defects were repaired synchronously on the heels of resection of the tumors which damaged fossa orbitalis, hard palate and the anterior skull base.@*RESULT@#Among the 12 patients there were 5 patients with the destructions on ethmoidal horizontal plate, 2 patients with the destructions on hanging wall of ethmoid, 1 patient with the destruction on hanging wall of fossa orbitalis, 1 patient with the destruction on medial wall of fossa orbitalis and on floor of orbit respectively, 2 patients with the destructions on hard palate and all the destructions were repaired following detection synchronously. There were no complications of surgical death, cerebrospinal fluid leaks, encephalomeningocele.@*CONCLUSION@#During the operation of tumor in nasal cavity and/or nasal sinuses when defect of fossa orbitalis, hard palate and anterior skull base were found and the defects need repair, we can take advantages of mucoperiosteal flap of nasal septum to perform the transplantation of mucoperiosteal flap in order to avoid forming local defect.

Effects of puerarin on expression of apelin and its receptor of 2K1C renal hypertension rats / 中国中药杂志

<p><b>OBJECTIVE</b>To examine the change of puerarin on the expression of apelin and its receptor of the two-kidney, one-clip (2K1C) rats.</p><p><b>METHOD</b>Tirty male Sprague-Dawley rats were randomly divided into normal control group (C), model group (M) and puerarin group (P). The mean of carotid arterial pressure (mCAP), mean of left ventricular end diastolic pressure (LVEDP), and the weight ratio of left ventricular mass (left ventricle plus septum) to bodyweight (LVM/BW) were measured to evaluate the model of 2K1C renal hypertension. The concentrations of apelin in the plasma and left ventricle (LV) were measured with radioimmunoassay. Apelin mRNA and APJ mRNA expressed in the LV were examined by reverse transcription-polymerase chain reaction (RT-PCR). The peptides of apelin and APJ expressed in the LV were detected with immunohistochemistry (IHC).</p><p><b>RESULT</b>Compared with C group, the mCAP, LVEDP and LVM/BW of M group were higher 36.58%, 333.8% and 20.24%, respectively (P<0.05, P<0.01, P<0.01). Compared with M group, LVEDP and LVM/BW of P group were lower 65.24% and 13.12%, respectively (both P<0.05). However mCAP was of no significant difference between these two groups. The levels of apelin-36 in the plasma and LV of M group were respectively higher 18.56% and 207.38% than those of C group (both P<0.05), while ones of P group were lower 24.21% and 49.40% than those of M group (both P<0.05). The expressions of apelin mRNA and APJ mRNA at left ventricle tissues of 2K1C rats were higher 77.66% and 119.00% (both P<0.05) than those of C group. The ones of P group were lower 27.40% and 45.66% than those of M group (both P<0.01). The IHC results indicate that the expressions of apelin and APJ peptides at left ventricle tissues of 2K1C rats were higher 129.51% and 154.1% (both P<0.01) than those of C group, respectively. Whereas the ones of P group were lower 65.36% and 62.87% than those of M group (both P<0.01).</p><p><b>CONCLUSION</b>Through regulating apelin/APJ system puerarin has protective effect on the development of left ventricular hypertrophy by renal hypertension.</p>

Effects of danshensu on function of EPCs which were damaged by Ox-LDL and study its possible mechanism / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the effects of danshensu on function of endothelial progenitor cells (EPCs) from peripheral blood which were damaged by oxidative low density lipoprotein (Ox-LDL). And study its possible mechanism.</p><p><b>METHOD</b>Total mononuclear cells (MNCs) were isolated from peripheral blood by ficoll density gradient centrifugation, and were identified by demonstrating the expression of CD34, VEGFR-2 and AC133 with flow cytometry, to sure that all the cells needed were EPCs. Then the cells were plated on fibronectin-coated culture dishes. After incubation for 7 days, attached cells were collected and divided into three groups: Control group, Ox-LDL group, danshensu intervention group, stimulated with different cencentrations of danshensu (2, 10 and 50 mg x L(-1)), adhesion assay respectively. EPCs adhesion assay were performed by replating those on fibronectin-coated dishes, then adherent cells were counted. And take cell supernate of each group to carry on the SOD, MDA content examination.</p><p><b>RESULT</b>Ox-LDL impaired EPC proliferative and adhesive capacity. In Ox-LDL group, The SOD content obviously drops, the MDA content obviously elevates. After danshensu interventing for 24 h, adhesive EPCs and migratory EPCs were significantly increased. Compared with Ox-LDL group, the SOD content of Danshensu intervention group obviously increased and the MDA content obviously reduced.</p><p><b>CONCLUSION</b>danshensu could improve proliferative and adhesive capacity of EPCs that were impaired by Ox-LDL. The mechanism might relate to the oxidation resistance damage.</p>

Assessment of left ventricular systolic dyssynchrony in heart failure patients with two different etiology using real-time three-dimensional echocardiography / 中华超声影像学杂志

Objective To investigate left ventricular(LV) systolic dyssynchrony in heart failure of different etiology which caused respectively by ischemic heart disease and dilated cardiomyopathy and analyse the correlation between the systolic dyssynchrony index(SDI) and the LV ejection fraction(LVEF). Methods Forty-three subjects were divided into two groups. Group A consisted of 17 heart failure patients which caused by ischemic heart disease and group B included 26 heart failure patients which caused by dilated cardiomyopathy. Three-dimensional datum of left ventricle were obtained using real-time three-dimensional echocardiography (RT-3DE) in full volume mode. Post-processing software Qlab was used for advanced analysis. The end-diastolic volume (EDV), end-systolic volume (ESV), LVEF and bull eye graph of seventeen segments were obtained. Standard deviation of time-to-minimal-systolic-volume of 16-LV segments corrected by R-R interval was calculated as SDI of LV. Results There was no statistical difference in age, heart rate, LVEF and EDV between the two groups (P >0.05). SDI of group A was lower than that of group B,but there was no statistical difference between them (P>0.05). Bull eye graph of seventeen segments revealed that the distribution of delayed systolic segments were different between the two groups. SDI of two groups appeared negative correlation with LVEF(r = -0.83, r = -0.71, P-< 0.01). Conclusions LV systolic dyssynchrony existed in heart failure which caused by ischemic heart disease and dilated cardiomyopathy,but the distribution of delayed systolic segments were different between them. SDI increased with worsening LV systolic function.

The effects of QRS duration on left ventricular systolic synchronicity in patients with heart failure by real-time three-dimensional echocardiography / 中华超声影像学杂志

Objective To assess the effects of QRS duration on left ventricular systolic synchronicity in patients with heart failure by real-time three-dimensional echocardiography(RT-3DE).Methods Thirty-four patients with heart failure(LVEF≤35%)were selected and divided into two groups.Group A consisted of 20 patients with normal QRS duration,and group B included 14 patients with long ORS duration.All the patients underwent two-dimensional echocardiography(2DE)and RT-3DE respectively.Parameters including left ventricular inlernal diameter(LVIDd),left ventricular ejection fraction(LVEF)of 2DE,and left ventricular endsystolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),LVEF,the time to minimal systolic volume of 16-segmental standard deviation as a ratio of R-R interval(Tmsv16-sd/RR)of RT-3DE were obtained and analyzed between the two groups.Results There were no significant differences of LVIDd,LVEF acquired by 2DE between the two groups(P＞0.05);LVESV,LVEDV,Tmsv16-sd/RR of RT-3DE were slightly higher in group B than those in group A,but didn't reach the significant difference between the two groups(P＞0.05).The mechanical dyssynchrony maybe related to the severity of heart failure.Conclusions RT-3DE can quantify global left ventricular systolic synchronicity.QRS duration has no significant effect on left ventricular systolic synchronicity in patients with heart failure.

The safety and clinical effects using single cathter ablation of arrhythmia originating from right ventricular / 中华急诊医学杂志

Objective To evaluate the safety and clinical effects of radiofrequency single catheter ablation (RESCA)for right ventrieular arrhythmia(RVA).Method A total of 111 patients data in the Second Affiliated Hospital of Wenzhou Medical College from May 2003 to May 2008,were retrospectively analyzed aged(45.2±16.7)years old including 41 men and 70 women,consisted of 13 patients of ventricular tachycardia(VT)and 98 patients of premature ventricular contractions(PVC).There were 104 casess from right ventricular outflow tract arrhythmia(RVOTA)and 7 cases from right ventricular inflow tract arrhythmia(RVITA).According to use single catheter approach or common technique,electrophysiolo-gical study,pacing and/or activation mapping and Catheter ablation were performed,were separated into two groups.①Single catheter group:27 men and 49 women,ages(44.5±16.9)years old;consisted of 62 patients of RVOT-PVC,9 patients of RVOT-VT and 5 patients of RVIT-PVC.②Control group:14 men and 21 women,ages(46.7±16.5)years old;consisted of 29 patients of RVOR-PVC,4 patients of RVOT-VT and 2 patients of RVIT-PVC.Results Operations in two groups came off smoothly and no ablation related complications in two groups.Procedure time and fluoroscopy time[(55.23±26.24)min and(9.93±5.32)min]in single catheter group were significantly shorter than those in control group [(68.37±21.83)min and(12.96±4.54)min,t=2.76 and 3.09,all P<0.01].Cost in the fromer (12440.32±761.24)RMB were significantly less than those in the latter[(22119.51±1071.07)RMB,t=46.09,P<0.01].Ablated successful rate in the near future,at a specified future date and other parameter were similar in two groups.Conclusions Right ventricular arrhythmia can be ablated with single catheter approach in safety,efficacious,easy to operate and lower cost.

Cardiac syncope caused by malignant rapid ventricular arrhythmia / 中国医师进修杂志

Objective To explore causes and high risk electrocardiogram expression of cardiac syncope caused by malignant rapid ventricular arrhythmia.Methods Forty-eight patients were analysed, they had cardiac syncope once or more that after which were admitted to the hospital. Results The basic causes of cardiac syncope were individed following types in 48 patients: coronary heart disease with acute or dated myocardial infarction,dilated or hypertrophic cardiomyopathy,hypokalaemia were ordinarist inducer.Torsade de pointes(TdP) were most common type of malignant rapid ventricular arrhythmia.They had some high risk electrocardiogram expression: secondary long QT syndrome,Brugada's syndrome,idiopathic abnormal J wave,complex ventricular ectopic beats,acute myocardial infarction with ST-T electrical alternation; or extensive anterior myocardial infarction with tombstone ST segment elevation,dilated cardiomyopathy with advance QRS complex low voltage.They were different electrocardiographic and clinical characteristic. Conclusion The cardiac syncope caused by malignant rapid ventricular arrhythmia is not single and independent clinical entity, which presents different the causes and high risk electrocardiogram expression.

Construction of TRAIL eukaryotic expression vector driven by the hTERT promoter and apoptotic effect on nasopharyngeal carcinoma cell line CNE-2 / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the effect of gene therapy on the nasopharyngeal carcinoma (NPC) cell line CNE-2 by using the combination of TRAIL gene with hTERT promoter. METHODS Total RNA was ex-tracted from PBL (peripheral blood lymphocytes)whose proliferation had been stimulated. TRAIL gene with interleukin 2 signal peptide gene was amplified by RT-PCR and cloned into the vector pGL3-181hTE down-stream to the RT promoter to form an eukaryotic vector. The vector was transfected into CNE-2 cells and HL-7702 cells through lipofection. Flow cytometry (FCM), agarose gel electrophoresis and cell morphology were used to examine the cell apoptosis. RESULTS In tranfected nasopharyngeal carcinoma cells CNE-2, FCM analysis showed that apoptotic peak appeared before G1 phase. A ladder-like pattern of DNA fragmentation appeared upon agarose gel electrophoresis. Many cells exhibited apoptotic changes such as cell shrinkage , nulear condensation , and nuclear fragmenta-tion under transmission electron microscope (TEM). CONCLUSION The recombinant eukaryotic ex-pression vector for TRAIL gene driven by hTERT pro-moter was successfully constructed and shown to induced apoptosis in CNE-2 cells. The results suggest that TRAIL may be a promising target for gene therapy of NPC.