Relationship Between the Changes of Left Atrium, Pulmonary Vein Ostia and AF Recurrence After Radiofrequency Catheter Ablation by Enhanced Cardiac MRI Evaluation / 中国循环杂志

Objectives: To evaluate the changes of left atrial volume (LAV) and the maximum ostial cross-sectional area (CAS) of pulmonary vein (PV) in atrial fibrillation (AF) patients after circumferential pulmonary vein isolation radiofrequency catheter ablation (CPVA-RFCA) and to explore their relationship to AF recurrence by enhanced cardiac MRI evaluation. Methods: Our research included in 2 groups: Control group, n=20 healthy subjects and AF group, n=78 patients whom were classified into 2 subgroups as Paroxysmal AF subgroup, n=46 and Persistent AF subgroup, n=32; 66 patients received CPVA-RFCA and based on 6 months post-operative recurrence, they were divided into another set of 2 groups: AF recurrent subgroup, n=17 and Non-AF recurrent subgroup, n=49. Pre- and 6 months post-operative maximum ostial CSA of PV were measured by enhanced cardiac MRI, LAV were obtained by 3D reconstruction and the differences were compared between AF group and Control group, Paroxysmal AF subgroup and Persistent AF subgroup, AF recurrent subgroup and Non-AF recurrent subgroup; their relationships to AF recurrence were studied.Results: Compared with Control group, AF group had increased LAV and elevated ostial CSA of superior PV (SPV), both P<0.05. Compared with Paroxysmal AF subgroup, Persistent AF subgroup had increased LAV and elevated ostial CSA of SPV, both P<0.05. Compared with pre-operative condition, at 6 months after the operation, Non-AF recurrent subgroup showed reduced ostial CSAs in left SPV (LSPV), right SPV (RSPV), right inferior PV (RIPV) and decreased LAV, all P<0.05;while AF recurrent subgroup showed expanded RSPV and increased LAV,allP<0.05.Post-operative reductions of LAV and ostial CSA of SPV had close correlation; multivariate Logistic regression analysis indicated that LAV (HR=1.05, P<0.01)and ostial CSA of RSPV(HR=1.09,P=0.05)were related to AF recurrence after RFCA. Conclusions: CAPV-RFCA could reverse left atrial and PV remodeling in AF patients, LAV and ostial CSA of RSPV were related to post-operative AF recurrence.

Hydroxysafflor yellow A reduces anoxia/reoxygenation-induced injury in rat cardiomyocytes / 基础医学与临床

Objective To observe the protective effect of hydroxysafflor yellow A(HSYA) on anoxia/reoxygenation (A/R) injury of neonatal primary cardiomyocytes, and its relationship with phosphoinositide 3-kinase/protein ki-nase B/glycogen synthase kinase 3β(PI3K/Akt/GSK3β) signaling pathway. Methods Primary cardiomyocytes of neonatal rats were isolated from the rats and incubated for 48 hours. The cells were adhered to each other and then divided into five groups:control group (Con group), anoxia/reoxygenation group (A/R group),HSYA treatment group(A/R+H group),PI3K inhibitor (LY294002)treatment group(A/R+L group)and HSYA+LY294002 treat-ment group (A/R+H+L group),then to collect the supernatant fluid of each group to measure LDH.The flow cy-tometry was used to measure the apoptotic cells. The protein levels of Bcl-2,Bax,Akt,p-Akt (Ser473),GSK3β, p-GSK3β (Ser9) were evalated by Western blot. Results A/R increased LDH release,the apoptosis rate (P<0.001),and the expression of pro-apoptotic protein Bax (P <0.001) with the decrease of anti-apoptotic protein Bcl-2,p-Akt(Ser473), p-GSK3β(Ser9)(P<0.001) as compared with the control group. HSYA treatment de-creased LDH release,the apoptosis rate (P<0.001),and the expression of Bax (P<0.001) and increase the ex-pression of Bcl-2,p-Akt(Ser473),p-GSK3β(Ser9)(P<0.001). Compared with the A/R+H group,the expres-sion of Bax was increased (P<0.001),while the expression of Bcl-2, p-Akt(Ser473), p-GSK3β(Ser9)was de-creased (P<0.001) in the A/R+H+L group. Conclusions HSYA protects rats'cardiomyocytes from anoxia/reoxy-genation injury by regulating PI3K/Akt/GSK3β signaling pathway.

Resveratrol improves coronary collateral circulation in pigs with experimental acute coronary occlusion / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the impact of resveratrol on coronary collateral circulation in pigs suffered from experimental acute coronary occlusion.</p><p><b>METHODS</b>Eighteen healthy pigs were randomly divided into 3 groups: resveratrol group, nitroglycerin group and control group. Animal model of acute coronary occlusion was established through PTCA method, and the blood flow spectrum in the left circumflex artery (LCX) was detected using intracoronary Doppler ultrasound.</p><p><b>RESULTS</b>The average peak velocity (APV) in infarction correlation artery (IRA) was significantly decreased immediately after coronary occlusion [(0.85 ± 0.25) cm/s vs. (24.83 ± 3.43) cm/s, P < 0.05]. The APV remained unchanged during 0, 30 and 60 minutes after the occlusion. Reversed or bidirectional blood flow was observed and the APV increased significantly [(9.22 ± 0.80) cm/s vs. (0.84 ± 0.21) cm/s, (8.93 ± 1.28) cm/s vs. (0.86 ± 0.26) cm/s respectively, P < 0.05] after the coronary injection of resveratrol (2 mg) or nitroglycerin (0.3 mg). There was no significant difference in peak APV between the resveratrol and nitroglycerin groups. The duration of increased APV was significantly longer in resveratrol group than that in nitroglycerin group [(58.83 ± 6.15) min vs. (21.80 ± 5.79) min, P < 0.05].</p><p><b>CONCLUSIONS</b>The collateral circulation after acute coronary occlusion was obviously insufficient in pigs. Resveratrol could significantly improve the blood flow in coronary collateral circulation after acute occlusion in this model.</p>

Transaxillary dual-plane breast augmentation with endoscope assistant / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of transaxillary dual-plane breast augmentation with endoscope assistant.</p><p><b>METHODS</b>The submuscular pockets were separated through a 4 cm transverse incision in the axilla. The pectoralis major muscle were split from the costal margin with the help of a 10 mm, 30 degree endoscope and endoscopic diathermy scissors. Soft cohesive gel microtextured anatomic style silicone implants ranging in size from 185 to 315 g were placed through the axillary incision. The vacuum drainage was used for 3 approximately 5 days.</p><p><b>RESULTS</b>79 patients underwent the dual-plane breast augmentation. Postoperative analgesia requirements were reduced because of muscle strength releasing. The follow-up period was 4 to 6 months with satisfactory results. All the patients had aesthetically natural appearance, with the nipple at the most projected part of the breast. No rippling, lateral displacement, double-bubble deformity, or muscle contraction-associated deformities were seen. There was no complications such as capsular contracture, hematoma, hypertrophic scar, and infection.</p><p><b>CONCLUSIONS</b>Dual-plane breast augmentation using textured silicon gel implant can be completed with the endoscope assistance through the axillary incision. The technique combined retromammary and partial retropectoral pocket locations to optimize the benefits of each pocket location while avoiding the drawbacks of extra incision on the breast.</p>

Repeated operation for removement of polyacrylamide hydrogel from breast / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the technique of repeated operation for removement of polyacrylamide hydrogel from breast.</p><p><b>METHODS</b>17 cases after uncomplete removement of PHG were reoperated through inferior periareolar incision. The PHG and affected denatured muscle and gland tissue were removed.</p><p><b>RESULTS</b>Preoperative MRI or CT showed PHG distributed diffusely in muscle and gland. There was only minimal residual PHG after operation. Histological examination showed PHG distributed in the denatured and proliferative fibrous tissue, including giant cells, many neutrophilic cells infiltration, and foreign body granuloma. The symptoms, such as intramammary pump or nodule, chest and back pain, infection, were relieved after operation.</p><p><b>CONCLUSIONS</b>Blinded suction technique can not remove PHG completely and can also result in malposition of PHG and make the tissue denaturation worse. We suggest open approach to remove the PHG and denatured tissue completely through periareolar incision.</p>