Heart rate variability change after circumferential pulmonary vein ablation in patients with paroxysmal ;atrial fibrillation and its relationship with recurrence / 心血管康复医学杂志

Objective:To explore dynamic change of heart rate variability (HRV) before and after circumferential pulmonary vein ablation (CPVA ) in patients with paroxysmal atrial fibrillation (PAF) and its relationship with postoperative recur‐rence .Methods:A total of 108 PAF patients undergoing left atrial circumferential pulmonary vein electrically isolated ra‐diofrequency ablation were selected .According to 12‐lead DCG on 3d and three months after operation ,patients were di‐vided into early recurrence group (n=10) ,late recurrence group (n=21) and no recurrence group (n=77) .HRV changes were followed up and compared among all groups .Results:Compared with before ablation ,on 3d after ablation ,there were significant reductions in standard deviation of normal to normal RR intervals calculated over the 24 h period (SDNN) , standard deviation of normal to normal RR intervals in all 5 min segments of the entire recording (SDANN) ,root‐mean square of differences betweensuccessive normal to normal intervals (rMSSD) ,low frequency (LF) ,high frequency (HF) in no recurrence group ;significant rise in mean heart rate ,and significant reductions in SDNN ,LF and LF/HF in early recur‐rence group ( P< 0.05 or <0.01);compared with no recurrence group ,there were significant rise in mean heart rate [(69.3 ± 11.2) beats/min vs .(75.4 ± 14.0) beats/min] ,SDANN[(66.9 ± 25.7)ms vs .(137.5 ± 92.3)ms] ,rMSSD [(22.1 ± 10.6)ms vs .(46.2 ± 19.2)ms] ,LF [(233.1 ± 31.4)ms vs .(251.7 ± 17.3)]and HF[(228.0 ± 82.4) ms2 vs . (508.0 ± 13.5) ms2 ] ,and significant reduction in LF/HF[(1.13 ± 0.53) ms2 vs .(0.41 ± 0.13) ms2 ]in early recurrence group (P<0.05 or < 0.01);significant rise in rMSSD [(23.9 ± 11.10) ms2 vs .(52.0 ± 28.7) ms2 ]and HF[(344.4 ± 103.2) ms2 vs .(482.1 ± 100.6) ms2 ] ,and significant reduction in LF/HF[(1.16 ± 0.41) vs .(0.85 ± 0.43)]in late recur‐rence group , P<0. 05 or <0. 01. Conclusion:Vagal tone reduction may reduce recurrence after CPVA in PAF patients .

Research on exploration of medical undergraduate teaching method of ECG / 中国医学装备

Objective:To explore the medical undergraduate teaching method of ECG. Methods:random sampling in the practice of medical undergraduates in our hospital ,2013 medical undergraduates as the experimental group, 2012 medical undergraduates as control group, two groups of 40 (male, female 20), age 22~23 years old, the experimental group internship period adjustment of ECG in 2 week internship, ECG during the internship period, by the junior high the doctor, according to a set of prior to the development of the teaching plan, practice teaching, the control group had no ECG internship content; in the two groups before and after the end of internship, were an ECG, theory of knowledge, operation and map reading test. Results:In the experimental group in the ECG theoretical knowledge, operation method, normal electrocardiogram, abnormal electrocardiogram exam scores, were more than that of the control group, there was significant difference in two groups(x2=22.321, x2=37.883, x2=31.179, x2=10.66;P<0.001). Conclusion: According to undergraduate medical situation, summarize the clinical teaching process ideas, enhance the practice ability, is before the practice was significantly increased in the reading and analysis abilities of ECG, far more than the control group. The teaching plan is feasible and effective;it is worth further exploration and promotion.

Diagnostic value of treadmill exercise test and its Duke score in menopausal women with coronary heart disease / 心血管康复医学杂志

Objective:To explore the diagnostic value of treadmill exercise test (TET)and its Duke score in menopa-usal female patients with coronary heart disease (CHD).Methods:A total of 102 menopausal female patients re-ceived TET and coronary angiography (CAG)examination.With CAG as control,accuracy indexes etc.of TET combined Duke score diagnosing coronary artery disease in these patients were compared and analyzed.Results:Compared with single application of TET or Duke score,there were significant rise in specificity (27.12% vs. 30.50% vs.44.44%),positive predictive value (47.56% vs.46.75% vs.54.55%),negative predictive value (80%vs.72% vs.90.91%)and accuracy (53.92% vs.52.94% vs.64.94%)diagnosing CHD by TET combined Duke score both positive and negative,P 0.05 both. There was no significant difference in CHD diagnosis between single use of TET and Duke score,P >0.05 all.Con-clusion:False positive rate of treadmill exercise test is higher in menopausal women.Treadmill exercise test com-bined Duke score is helpful to improve specificity,positive predictive value,negative predictive value and accuracy of the test.

Value of treadmill test Duke score on diagnosis of coronary heart disease / 心血管康复医学杂志

Objective: To explore value of treadmill test Duke score on diagnosis of coronary heart disease (CHD). Methods: A total of 200 patients suspected CHD were selected. All patients received biochemical examinations, treadmill exercise test (TET) and coronary angiography (CAG) within two weeks. The results of TET, Duke treadmill score（DTS）and CAG were compared and analyzed. Results: The CAG was regard as gold standard diagnosing CHD. （1）Compared with TET alone, there were significant decrease in specificity (72.3% vs.55.4%, χ2=5.161, P=0.021) in positive DTS alone for diagnosing CHD; there were significant increase in sensitivity(72.6% vs. 87.8%，χ2=7.860, P=0.005), negative predictive value(56% vs.76.9%，χ2=6.128, P=0.013) in combined use of TET and DTS for diagnosing CHD; （2）Compared with positive DTS alone, there were significant increase in sensitivity (76.3% vs. 87.8%，χ2=4.334, P=0.037),negative predictive value(52.9% vs. 76.9%，χ2=7.298, P=0.007) and accuracy (69.5% vs. 80.8%，χ2=5.849, P=0.016)in combined use of TET and DTS. Conclusion: Combined use of treadmill exercise test and Duke score can significantly increase sensitivity, negative predictive value and accuracy diagnosing CHD.

Increased circulating myostatin in patients with type 2 diabetes mellitus / 华中科技大学学报（医学）（英德文版）

The changes of plasma myostatin levels in patients with type 2 diabetes mellitus (T2D) and their clinical correlation were investigated. We recruited 43 T2D patients and 20 age-matched healthy subjects. Plasma myostatin, lipid and glucose, and serum insulin were determined. T2D patients showed significantly higher fasting plasma glucose (FPG), serum insulin and triglyceride levels, and lower high-density lipoprotein levels than normal control subjects (P<0.01). Mean plasma myostatin level in T2D patients and health controls was (66.5±17.8) and (46.2±13.8) ng/mL, respectively. An unpaired t test showed that the increase of myostatin in the T2D patients was significant (P<0.001). In both healthy control and T2D groups, the female subjects showed higher myostatin levels than the male subjects. In the T2D patients, plasma level of myostatin was negatively correlated with body mass index (BMI, r=-0.42, P<0.01) and FPG (r=-0.51, P[Symbol: see text]0.01), but positively correlated with insulin resistance index (HOMA-IR, r=0.48, P<0.01). Up-regulation of plasma myostatin in the T2D patients and its correlation with BMI, FPG and blood insulin sensitivity suggests that plasma myostatin may be implicated in the pathogenesis of T2D and thus presented as a therapeutic target for treating the disease. Furthermore, circulating myostatin levels may be used as a biomarker for the disease.

Increased circulating myostatin in patients with type 2 diabetes mellitus / 华中科技大学学报（医学）（英德文版）

The changes of plasma myostatin levels in patients with type 2 diabetes mellitus (T2D) and their clinical correlation were investigated. We recruited 43 T2D patients and 20 age-matched healthy subjects. Plasma myostatin, lipid and glucose, and serum insulin were determined. T2D patients showed significantly higher fasting plasma glucose (FPG), serum insulin and triglyceride levels, and lower high-density lipoprotein levels than normal control subjects (P<0.01). Mean plasma myostatin level in T2D patients and health controls was (66.5±17.8) and (46.2±13.8) ng/mL, respectively. An unpaired t test showed that the increase of myostatin in the T2D patients was significant (P<0.001). In both healthy control and T2D groups, the female subjects showed higher myostatin levels than the male subjects. In the T2D patients, plasma level of myostatin was negatively correlated with body mass index (BMI, r=-0.42, P<0.01) and FPG (r=-0.51, P[Symbol: see text]0.01), but positively correlated with insulin resistance index (HOMA-IR, r=0.48, P<0.01). Up-regulation of plasma myostatin in the T2D patients and its correlation with BMI, FPG and blood insulin sensitivity suggests that plasma myostatin may be implicated in the pathogenesis of T2D and thus presented as a therapeutic target for treating the disease. Furthermore, circulating myostatin levels may be used as a biomarker for the disease.