The role of frontal plane cardiac axis shift in the diagnosis of wide QRS tachycardia / 实用医学杂志

Objective To explore the value of axis shift between the baseline normal sinus rhythm (NSR) and WCT in diagnosis of wide QRS-complex tachycardia (WCT). Methods 390 surface ECGs of 186 patients with WCT were obtained from April 2012 to April 2018 at Ningbo Medical Center Lihuili Hospital at which the arrhythmia diagnosis was proven by intracardiac electrophysiological study. The axis shift between the baseline NSR and WCT was calculated by table lookup method. Then we analyzed the role of axis shift in diagnosis of WCT. Results Among the 186 patients with WCT, 147 (79.03％) were ventricular tachycardia (VT) , and 39 (20.97％) were supraventricual tachycardia (SVT) with conduction abnormalities. In the 95％ confidence interval, the axis shift showed an outstanding discrimination performance. The area under the ROC curve is 0.708 (0.579-0.817, P =0.007). Compared with left axis deviation, right axis deviation, the right axis deviation of LBBB morphology, the axis shift> 68 degree is more sensitive (53.06％) , and the specificity (91.43％) is also more desirable. Moreover, if the axis shift set> 130 degree, the specificity can reach 100％, and the sensitivity (12.24％) is equivalent to northwestern axis. Conclusion A significant axis shift between the baseline NRS and WCT can distinguish WCT accurately. Given the ease of grasping, it can probably be feasible to popularize as a routine diagnosis method for WCT in primary hospitals.

The characteristics and risk factors of suicidal ideation among persons aged 18 years and older in Xiamen city / 中华行为医学与脑科学杂志

ObjectiveTo explore the characteristics and risk factors of suicidal ideation among community subjects in Xiamen city and to provide appropriate suicide intervention strategies.MethodsUsing multi-stage stratified cluster sampling,12071 subjects aged 18 years and older were identified in Xiamen City.Their suicidal ideation was recorded with the investigation list made by Beijing Huilongguan Hospital Beijing Suicide Research and Prevention Center.Psychiatrists determined their diagnosis with Diagnostic and Statistical Manual of Mental Disorder 4th edition (DSM-Ⅳ).ResultsA total of 10757 subjects completed the survey,the completion was 89.1％.The life-time prevalence of suicidal ideation was 2.48％ (95％CI:2.19％ ～ 2.77％ ),the prevalence was higher in female(3.00％ ) than male( 1.88％ ) (RR =1.60,95％CI:1.24 ～2.06).Analysis of risk factors by single logistic regression showed that the suicidal ideation of persons were mostly in female,44 years and older group,in rural,not-being married,no medical insurance,poor mental or physical health in last month,being in hospital due to the mental problems,low quality of life,living alone,having blood relatives or acquaintance with suicidal behavior.While the risk factors by muhivariate logistic regression were ranked as follows:having acquaintance with suicidal behavior (OR =3.66,95％CI:2.44 ～5.50),being in hospital because of mental problems (OR =3.30,95％CI:1.08 ～10.09),poor mental health in last month(OR =3.17,95％CI:2.37 ～4.24),any blood relatives having suicidal behavior (OR =2.91,95％CI:1.61 ～ 5.25 ),low of quality of life (OR =2.21,95％CI:1.50 ～ 3.26 ),not-being married (OR =1.73,95％CI:1.28 ～ 2.32),living alone (OR =1.65,95％CI:1.18 ～ 2.32),being female (OR=1.57,95％CI:1.21 ～ 2.05).The prevalence of mental disorders in suicidal ideation was 46.4％.ConclusionThe prevalence of suicidal ideation is significantly higher in female residents than in male.Having acquaintance with suicidal behavior,being in hospital due to the mental problems as well as poor mental health in last month are the main risk factors of suicidal ideation.

A novel mutation of the KCNH2 gene in a family with congenital long QT syndrome / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To perform mutation analysis in a family with long QT syndrome.</p><p><b>METHODS</b>The medical record of the affected child and his parents were collected. The locus of gene associated with the long QT syndrome was mapped by linkage analysis. Mutation analysis was done by PCR-single strand conformation polymorphism (SSCP) and direct sequencing.</p><p><b>RESULTS</b>A mutation (L539fs/47) and a SNP (L564L) were found in exon 7 of the KCNH2 gene of the proband. The mutation was from the father.</p><p><b>CONCLUSION</b>A novel mutation of L539fs/47 in the KCNH2 gene was identified in the LQTS family, which might be the disease-causing mutation for the family.</p>

Clinical study of cerebral infarction prevention with warfarin in nonvalvular atrial fibrillation / 中国医师进修杂志

Objective To investigate the efficacy and safety of warfarin in the prevention of cerebral infarction in nonvalvular atrial fibrillation (NVAF). Methods One hundred and thirty-six NVAF patients were randomized into warfarin group [receiving adjusted-dose warfarin,international normalized ratio(INR)was 2.0 - 3.0], aspirin group( receiving aspirin 100 mg/d) and control group (treated without anticoagulants )by random digits table. Followed up 18 months, and the main end point events and adverse effect of the three groups were compared. Results In 136 cases,4 cases lost,and 77 cases(58.3%) were male. The mean dose of warfarin was(2.5 ± 1.0) mg. During the follow-up period, main end point events occurred in 12 cases,with 1 case (2.50%, 1/40) in warfarin group, 4 cases(9.52%, 4/42 ) in aspirin group and 7 cases ( 14.00%, 7/50)in control group. There was no significant difference in main end point events among the three groups ( x2 =2.084,P =0.353). But in the patients with 3 or above risk factors,there was significant difference in the survival curve among the three groups ( x2 = 6.404, P = 0.041 ). The incidence rate of bleeding was higher in warfarin group than that in aspirin group,but there was no significant difference [5.00%(2/40) vs. 2.38%(1/42),P ＞ 0.05]. Conclusions Warfarin can improve survival rate especially in the patients with 3 or above risk factors,and the complication of bleeding occurs mostly when INR ＞ 3.0.Under closed monitoring (INR 2.0-3.0),adjusted-dose warfarin is safety and efficacy.

A novel mutation-L539fs/47 of hERG in a Chinese long QT syndrome family / 药物分析学报

Objective To identify the mutation of human ether-a-go-go-related gene (hERG) and analyze the clinical characteristics of a Chinese family with long ST syndrome (LQTS). Methods The electrocardiogram and DNA samples were obtained from a Chinese LQTS family of 26 members. Genotype was performed with polymorphic short tandem repeat (STR) markers at the known LQT1, LQT2, and LQT3 loci. SSCP analysis was used to find aberrant conformers. hERG mutation was confirmed by cloning and sequencing. Results Three gene carriers were linked to chromosome 7q35-36, where the potassium channel gene hERG was encoded. A 19-base pair deletion was identified. The mutation was located at nucleotide position 1 619-1 637 between transmembrane domains S4 and S5. Furthermore, A1692G polymorphism was found both in the normal control and patients. Conclusion A novel 19 bp deletion mutation of hERG is identified in a Chinese family. All gene carriers are demonstrated to be typical LQT2 ECG phenotype.

Genotypic diagnosis of long QT syndrome by analysis of candidate genes / 药物分析学报

Objective To diagnose 6 LQTS families by genetic analysis. Methods A total aof 6 LQTS pedigrees with 43 family members were brought together for genetic diagnosis by using short-sequence tandem-repeat (SIR) markers or sequencing. Genomic DNA was extracted from blood samples by standard procedure. STR markers or KCNQ1, KCNH2 and SCN5A were amplified. The haplotype analysis for LQTS was performed. If the family got the negative haplotype analysis, the sequencing was performed. Results LQTS patients were always linkaged with the SCNSA gene in family 1. KCNH2 was linkaged with the disease in family 2 to 5.21 gene carriers were identified from these 5 families. A mutation (A561V-KCNH2) was only found in the proband of family 6 and an SNP (G1691A) was found in all the members of the family. Conclusion Genetic diagnosis can not only improve presymptomatic diagnosis,bnt also provide the basis for personal therapy and research on disease-causing mutations.

Study on Determination of Combustion Heat of Matrimony Vine / 中国中医药信息杂志

Objective To determine the colorific value of Matrimory Vine in Qinhai. Method Calorific value of Qinghai matrimony-vine was determined by the method of oxygen bomb type-calorimeter instrument. Results Combustion heat of Qinghai matrimony-vine was 18.36 kJ/g. Conclusion The method is easy and reliable, and its principle is accurate. The data may provide a scientific basis for people’s diet structure and medical use.

Determination of the Content and Extraction of Total Flavonoids in Orange Peel / 中国中医药信息杂志

Objective To extract the flavomids from orange peel and determine the content of total flavmoids in orange peel. Methods The total flavonoids in orange peel were determined by using hesperidine as standard sample and edible alcohol as extraction solvent. Results The total content of flavonids is 19.44 g/kg. Conclusion The method is simple and reproducible. It provides a scientific basis for using orange peel.