Alterations in the transmural gradient of ventricular repolarization with different pacing sites in normal and heart failure canines / 生理学报

Alterations of the transmural gradient of repolarization may contribute to the increase of transmural dispersion of repolarization and ventricular arrhythmias. The transmural gradient of repolarization may play an important role in sudden death associated with left ventricular epicardial pacing. To investigate the changes of transmural gradient dispersion of ventricular repolarization with different pacing sites in heart failure (HF) canines, 8 mongrel dogs were randomized into healthy group and HF group (n = 4). We mapped the monophasic action potential duration (MAPD) in the subendocardial, subepicardial and mid-myocardial layers of the left ventricle (LV) in canines of healthy and HF groups during right atrium (RA) pacing, right ventricular apical endocardial (RV) pacing, left ventricular lateral epicardial (LV) pacing and biventricular (Biv) pacing respectively. The results showed that in the healthy group, the MAPDs were significantly different among the three layers during RA pacing (all P 0.05). In the HF group, the MAPDs in all three layers were prolonged compared with those in the same locations in the healthy group (all P 0.05). By MAP recording with our new mapping electrode, we found a transmural MAPD gradient among the three layers of the LV during RA pacing and the gradient between the subendocardial and subepicardial layers vanished during RV, LV or Biv pacing in healthy dogs. In contrast, there was no transmural MAPD gradient during RA, RV, LV or Biv pacing in HF dogs. These results are helpful to understand the mechanism of ventricular arrhythmias in patients with HF.

Clinical Features and Outcomes of Paraduodenal Pancreatitis / 中国医学科学院学报

Objective To summarize the clinical features and outcomes of paraduodenal pancreatitis (PP). Methods Five clinically or pathologically diagnosed PP patients in Peking Union Medical College Hospital and 31 other PP cases reported in Chinese literature since 1988 were retrospectively analysed. Results Most PP patients were young or middle-aged males with a history of alcohol abuse. The clinical symptoms included upper abdominal pain,vomiting,weight loss,and fluctuating jaundice. Serum pancreatic enzymes were normal or elevated. Radiological features in most cases included thickening of the duodenal wall and duodenal stenosis (88.9%,32/36),cysts in the duodenal wall and groove area (47.2%,17/36),dilated bile duct (36.1%,13/36),and dilated pancreatic duct (16.7%,6/36). The main pathological finding was chronic pancreatitis,which could be accompanied by local acute inflammation,which was limited in the groove-duodenal area in most cases. The disease can be well controlled by conservative treatment,although surgery was needed in a small number of cases. Conclusion sPP typically occurs in young or middle-aged males. Radiological examination is valuable for diagnosis. Conservative treatment is the mainstream treatment in most patients.

Effect of simultaneous integrated boost intensity-modulated radiation therapy in the treatment of multiple metastasis tumor of brain / 新乡医学院学报

Objective To investigate the clinical effect of simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT)and whole brain radiation therapy (WBRT) plus sequential boost conformal radiation therapy (SBCRT) in the treatment of multiple metastasis tumor of brain.Methods A total of 98 patients with multiple metastasis tumor of brain in the Radiation Oncology Center of the First Affiliated Hospital of Xinxiang Medical University from August 2014 to July 2015 were divided into observation group (n =60) and control group (n =38) according to the treatment plan.The patients in the observation group were treated with SIB-IMRT,the whole brain planned target dose was 2 Gy every time,and the target dose of the metastatic target volume was 3 Gy every time for 20 times (5 times weekly).The patients in the control group received WBRT plus SBCRT,the WBRT dose was 3 Gy every time for 10 times(5 times weekly),then the metastatic tumor target area was treated with SBCRT,the prescribed dose was 3 Gy every time for 10 times.All patients were followed up from the end of treatment to December 2016.The effective rate,disease control rate and one-year survival rate were compared between the two groups.Results The patients in the two groups were successfully treated with radiotherapy.Ninety patients were followed up,eight patients were lost to follow-up,the follow-up rate was 91.8％ (90/98).The effective rate,disease control rate and oneyear survival rate in the observation group were significantly higher than those in the control group (x2 =5.371,4.352,6.002;P ＜ 0.05).The median progression free survival time in the observation group was significantly longer than that in the control group (x2 =6.537,P ＜ 0.05).There were no significant differences in the incidence of bone marrow suppression,digestive system reaction and nervous system damage between the two groups (x2 =1.821,2.032,3.782;P ＞ 0.05).Conclusion SIB-IMRT can improve the effective rate,disease control rate and one-year survival rate of patients with multiple metastasis tumor of brain.