The relationship between serum levels of epidermal growth factor and ß-human chorionic gonadotropin and the type and prognosis of ectopic pregnancy.

PURPOSE: This work aimed to explore the relationship between epidermal growth factor (EGF) and ß-human chorionic gonadotropin (ß-HCG) and ectopic pregnancy types and impact on prognosis. METHODS: Twenty women with normal pregnancies (NPs) were recruited as control group, and twenty women each with tubal pregnancy (TP) and cervical pregnancy (CP) were recruited. Blood samples were collected to detect EGF and ß-HCG. Data on length of hospital stay and incidence of complications were collected. The differences in serum EGF and ß-HCG levels were compared among groups and within various types of ectopic pregnancy using analysis of variance and Pearson correlation analysis. RESULTS: Serum EGF and ß-HCG were notably lower in TP and CP group vs. controls (P < 0.05). In subgroup analysis within the types of ectopic pregnancy, serum EGF levels were drastically higher in TP group vs. CP group (P < 0.05). Serum EGF levels were negatively correlated with pregnancy outcomes and incidence of complications (P < 0.05). In patients with TP and CP, serum EGF and ß-HCG recovery time and hospital stay differed drastically (P < 0.05). Serum EGF and ß-HCG levels showed optimal cutoff values identified at 2.65 µg/L and 11,745.35 IU/L, respectively. The corresponding area under the curve (AUC) values were 0.885 and 0.841. CONCLUSION: Elevated levels of EGF may be associated with the occurrence of ectopic pregnancy and may impact the type of ectopic pregnancy, pregnancy outcomes, and the incidence of complications. Further clinical research is warranted to investigate these findings.

Catheter ablation of idiopathic left fascicular ventricular tachycardia: Implications of false tendons for mapping and ablation.

INTRODUCTION: The anatomical substrate for idiopathic left ventricular tachycardia (ILVT) remains speculative. Purkinje networks surrounding false tendons (FTs) might be involved in the reentrant circuit of ILVT. The objective was to evaluate the anatomical and electrophysiological features of false tendons FTs in relation to ILVT. METHODS: Intracardiac echocardiography (ICE) was conducted on patients with ILVT. The relationship of the FTs with ILVT was determined using electro-anatomical mapping. RESULTS: Electrophysiological evaluation and radiofrequency ablation were conducted in 23 consecutive patients with ILVT. FTs were identified in 19/23 cases (82.6%) with P1 potentials during VT recorded at the FT in 14 of these patients (73.7%). Three FT types were identified. In type 1, the FT attached the septum to the base of the posteromedial papillary muscle (PPM) (4/19); type 2 FTs ran between the septum and the PPM apex (3/19), while in type 3, the connection occurred between the septum and apex (11/19) or between the septum and the LV free wall (1/19). The effective ILVT ablation sites were situated at the FT-PPM (3/19) and the FT-septum (16/19) attachment sites. CONCLUSIONS: This series demonstrates the association between Purkinje fibers and FTs during catheter ablation of ILVT and verifies that left ventricular FTs are an important substrate in this type of tachycardia.

Direct detection system based on a single photodiode receiving the independent quadruple-SSB signal.

We propose and verify a direct detection (DD) system based on a single photodiode (PD) receiving the independent quadruple-single-sideband (quadruple-SSB) signal. At the transmitter side, an I/Q modulator is utilized to modulate the independent quadruple-SSB signal, the signal is received via one PD without optical bandpass filters (OBPFs). Then, the independent quadruple-SSB signal is separated into four sideband signals by subsequent digital signal processing (DSP). In the scheme of back-to-back (BTB), 1-km and 5-km standard single-mode fiber (SSMF) transmission, the four sideband signals are extensively studied and analyzed. The simulation results show that the bit error rate (BER) of 1Gbaud, 2Gbaud and 4Gbaud independent quadruple-SSB signal can reach the 7% hard-decision forward error correction (HD-FEC) threshold of 3.8 × 10-3 when the received optical power (ROP) is -21, -20 and -17.2 dBm in 5-km SSMF transmission. Meanwhile, as the frequency interval gets wider, the crosstalk in the sideband signal reception can be mitigated and the BER decreases. This scheme for the first time demonstrates that the independent quadruple-SSB signal can further expand the system transmission capacity and enhance the spectrum efficiency. Our simplified independent quadruple-SSB signal direct detection system has a simple structure and high spectral efficiency, which will have a promising future in high-speed optical communication.

Simplified independent triple-sideband signal generation and transmission scheme based on one I/Q modulator at 0.3-THz.

To meet the ultra-bandwidth high-capacity communication, improve spectral efficiency and reduce the complexity of system structure, we have proposed the independent triple-sideband signal transmission system based on photonics-aided terahertz-wave (THz-wave). In this paper, we demonstrate up to 16-Gbaud independent triple-sideband 16-ary quadrature amplitude modulation (16QAM) signal transmission over 20 km standard single mode fiber (SSMF) at 0.3 THz. At the transmitter, independent triple-sideband 16QAM signals are modulated by an in-phase/quadrature (I/Q) modulator. Carrying independent triple-sideband signals optical carrier coupled with another laser to generate independent triple-sideband terahertz optical signals with a carrier frequency interval of 0.3THz. While at the receiver side, enabled by a photodetector (PD) conversion, we successfully obtain independent triple-sideband terahertz signals with a frequency of 0.3THz. Then we employ a local oscillator (LO) to drive mixer to generate intermediate frequency (IF) signal, and only one ADC is used to sample independent triple-sideband signals, digital signal processing (DSP) is finally performed to obtain independent triple-sideband signals. In this scheme, independent triple-sideband 16QAM signals is delivered over 20 km SSMF under the bit error ratio (BER) of 7% hard-decision forward-error-correction (HD-FEC) threshold of 3.8 × 10-3. Our simulation results show that the independent triple-sideband signal can further improve THz system transmission capacity and spectral efficiency. Our simplified independent triple-sideband THz system has a simple structure, high spectral efficiency, and reduced bandwidth requirements for DAC and ADC, which is a promising solution for future high-speed optical communications.

Direct detection system for independent triplet-sideband signals based on a single photodiode.

This paper proposes a novel, to the best of our knowledge, independent triplet-single-sideband (triplet-SSB) transmission system scheme aimed at increasing channel capacity and improving spectrum efficiency. The conventional independent multiband transmission systems are limited by their complexity and high computational requirements, which hinder the improvement of spectrum efficiency and channel capacity. To address these challenges, this scheme uses three independent signals, modulated by an in-phase/quadrature (I/Q) modulator, and transmits them over a 5-km standard single-mode fiber (SSMF). At the receiver end, a single photodiode (PD) is used for signal reception, and the signals are separated using digital signal processing (DSP) algorithms. Through simulation and verification, the feasibility and reliability of the system are demonstrated, with the bit error rates (BERs) of all three signals below the hard decision forward error correction (HD-FEC) threshold value of 3.8 × 10-3. This independent triplet-SSB transmission system scheme effectively improves spectrum efficiency and channel capacity, providing a valuable solution for meeting the growing demands of data transmission.

Deep learning and radiomics based automatic diagnosis of hippocampal sclerosis.

Accurate and rapid segmentation of the hippocampus can help doctors perform intractable temporal lobe epilepsy (TLE) preoperative evaluations to identify good surgical candidates. This study aims to establish a radiomics system for the automatic diagnosis of hippocampal sclerosis with the help of machine learning. A total of 240 cases were analysed to develop a diagnostic model. First, an automatic hippocampal segmentation process was established that exploits a priori knowledge of the relatively fixed location of the hippocampus in brain partitions, as well as a deep-learning segmentation network based on an Attention U-net. Then, we extracted 527 radiomics features from each side of the segmented hippocampus. The iterative sparse representation based on feature selection and a support vector machine classifier were finally used to establish the diagnostic model of hippocampal sclerosis. The diagnostic model consists of two consecutive steps: distinguish hippocampal sclerosis (HS) from normal control (NC) and detect whether the HS is located on the left or right side. When the automatic diagnosis model identified HS and NC, the sensitivity and specificity reached 0.941 and 0.917 in the 10-fold cross-validation set and 0.920 and 0.909 in the independent testing set. When the diagnostic model detected HS lateralization, the sensitivity and specificity reached 0.923 and 0.920 in cross-validation and 0.909 and 0.929 in independent testing. Our results show that the developed radiomics model can help detect TLE patients with hippocampal sclerosis and has the potential to simplify preoperative evaluations and select surgical candidates.

Graphene quantum dots enhance the osteogenic differentiation of PDLSCs in the inflammatory microenvironment.

BACKGROUND AND OBJECTIVE: Graphene quantum dots (GQDs), a type of carbon-based nanomaterial, have remarkable biological, physical, and chemical properties. This study investigated the biological mechanisms of the proliferation and osteogenic differentiation of human periodontal ligament stem cells (PDLSCs) induced by GQDs in an inflammatory microenvironment. MATERIALS AND METHODS: PDLSCs were cultured in osteogenic-induced medium with various concentrations of GQDs in standard medium or medium mimicking a proinflammatory environment. The effects of GQDs on the proliferation and osteogenic differentiation activity of PDLSCs were tested by CCK-8 assay, Alizarin Red S staining, and qRT‒PCR. In addition, Wnt/ß-catenin signalling pathway-related gene expression was measured by qRT‒PCR. RESULTS: Compared with the control group, the mRNA expression levels of ALP, RUNX2, and OCN and the number of mineralized nodules were all increased in PDLSCs after treatment with GQDs. Moreover, during the osteogenic differentiation of PDLSCs, the expression levels of LRP6 and ß-catenin, which are Wnt/ß-catenin signalling pathway-related genes, were upregulated. CONCLUSION: In the inflammatory microenvironment, GQDs might promote the osteogenic differentiation ability of PDLSCs by activating the Wnt/ß-catenin signalling pathway.

Synthesis of a GS-16QAM signal for a simplified optical ISB system and direct detection with the K-means clustering algorithm.

An independent sideband (ISB) is a promising scheme for short-reach and metro applications because of its high spectral efficiency, low complexity, and tolerance to chromatic dispersion. Here, we develop a signal synthesis scheme to further reduce the complexity of ISB direct-detection (DD) systems. Two lower-order quadrature amplitude modulation (QAM) sideband signals are generated digitally, then the left sideband (LSB) and right sideband (RSB) are modulated with regular quadrature phase shift keying (QPSK) and geometrically shaped shifted QPSK (GS-S-QPSK), respectively. Then, the two independent sideband signals are received in a single photodiode to synthesize a GS-16QAM signal. The LSB and RSB signals can be separated and demodulated by a digital signal process (DSP) instead of using two optical bandpass filters. The proposed scheme significantly reduces the complexity of the ISB-DD receiver, thus saving system cost. Three different GS-S-QPSK signals are evaluated, with the square GS-S-QPSK achieving the best bit error rate (BER) with its optimal shaping factor. Considering signal-signal beating interference, a sub-blind K-means clustering algorithm is used to improve the BER performance, and the results indicate that it can achieve a large received optical power (ROP) gain at a threshold of 3.8 × 10-3.

Independent dual-single sideband lower-IF RF receiver based on a single photodetector.

The two sidebands of the independent dual-single-sideband (dual-SSB) signal can carry different information, which achieves higher spectral efficiency and system capacity. However, the receiver divides the signal into two channels, so a pair of optical bandpass filters (OBPFs) and photodetectors (PDs) are generally required to select and detect an independent dual-SSB signal. To reduce the complexity and cost of the receiver, we propose an independent dual-SSB lower intermediate frequency (IF) radio frequency (RF) signal detection scheme based on a single PD combined with conventional digital signal processing (DSP). A theoretical analysis is presented and validated by a simulation. The left sideband (LSB) and the right sideband (RSB) are quadrature phase-shift keying (QPSK) modulated. After 50-km standard single-mode fiber (SSMF) transmission, a 10-Gbps 16QAM signal is synthesized from 2 × 5-Gbps dual-SSB QPSK and the independent dual-SSB is extracted by DSP. The bit error rate (BER) of the dual-SSB (LSB and RSB) is below the hard-decision forward-error-correction (HD-FEC) threshold of 3.8 × 10-3.

Thyroid function in children with Prader-Willi syndrome in Southern China: a single-center retrospective case series.

BACKGROUND: To investigate hypothalamic-pituitary-thyroid function in children of different ages, nutritional phases, and genotypes that were diagnosed with Prader-Willi syndrome (PWS), as well as the effects of recombinant human growth hormone (rhGH) treatment on thyroid hormones in PWS patients. METHODS: One hundred and thirty PWS patients (87 boys and 43 girls) aged from newborn to 15 years (y) (median 1.25 y, mean, SD: 2.95 ± 3.45 y), were surveyed in this study. Serum thyroid hormone levels were examined at least once per3-6 months during the 2 years follow-up study. Central hypothyroidism (C-HT) was identified as low/normal thyroid-stimulating hormone (TSH) and low free thyroxine 4 (FT4). RESULTS: All study participants had normal neonatal TSH screening test results. The prevalence of C-HT is 36.2% (47/130). No C-HT cases were diagnosed in PWS either below 1 month (m) or above 12 y. The prevalence of C-TH would be increased with age before 3 y until reaching the peak, followed by a gradual decline over the years. The prevalence of C-HT varies significantly at different ages (Pearson's χ2 = 19.915; p < 0.01). However, there is no correlation between the C-HT prevalence and nutritional phases (Pearson's χ2 = 4.992; p = 0.288), genotypes (Pearson's χ2 = 0.292; p = 0.864), or rhGH therapy (Pearson's χ2 = 1.799; p = 0.180). CONCLUSIONS: This study suggests the prevalence of C-TH was increased with the age before 3 y, and reached the peak in the 1 to 3 y group, then gradually declined over the years. There is no correlation between C-HT prevalence and nutritional phases, genotypes, or rhGH treatment.

Optical Polarization Division Multiplexing Transmission System Based on Simplified Twin-SSB Modulation.

Optical twin-single sideband (Twin-SSB) modulation, due to the left sideband (LSB) and right sideband (RSB) signal carrying individual data, has become an attractive technique in fiber transmission because it satisfies the demand of the explosive increase in data traffic. This paper focuses on reducing the complexity of Twin-SSB system and further enhancing the spectral efficiency by proposing a polarization division multiplexing (PDM) Twin-SSB modulation scheme. LSB and RSB signals are extracted using de-mapping algorithm instead of optical bandpass filters (OBPFs) to reduce system complexity. To further improve spectral efficiency, PDM is employed to meet the polarization multiplexing transmission and achieve a higher transmission capacity. Based on the PDM Twin-SSB system, the LSB is 3-arr phase-shift-keying (3PSK) modulated, while RSB is quadrature phase-shift keying (QPSK) modulated. We simulated that the bit error ratio (BER) performance of LSB and RSB of X-polarization (X-Pol) and Y-polarization (Y-Pol) at 8-Gbaud, 10-Gbaud, 12-Gbaud, 14-Gbaud, and 16-Gbaud in the case of back-to-back (BTB) and 2 km standard single-mode fiber (SSMF) transmission. The simulation results verify the effectiveness and practical feasibility of the proposed PDM Twin-SSB scheme for future short-distance transmission owing to low cost, simplified structure, low algorithm complexity, and high data transmission capacity.

Characterizing the hyper- and hypometabolism in temporal lobe epilepsy using multivariate machine learning.

Mesial temporal lobe epilepsy (MTLE) is the most common type of focal epilepsy, presenting both structural and metabolic abnormalities in the ipsilateral mesial temporal lobe. While it has been demonstrated that the metabolic abnormalities in MTLE actually extend beyond the epileptogenic zone, how such multidimensional information is associated with the diagnosis of MTLE remains to be tested. Here, we explore the whole-brain metabolic patterns in 23 patients with MTLE and 24 healthy controls using [18 F]fluorodeoxyglucose PET imaging. Based on a multivariate machine learning approach, we demonstrate that the brain metabolic patterns can discriminate patients with MTLE from controls with a superior accuracy (>95%). Importantly, voxels showing the most extreme contributing weights to the classification (i.e., the most important regional predictors) distribute across both hemispheres, involving both ipsilateral negative weights over the anterior part of lateral and medial temporal lobe, posterior insula, and lateral orbital frontal gyrus, and contralateral positive weights over the anterior frontal lobe, temporal lobe, and lingual gyrus. Through region-of-interest analyses, we verify that in patients with MTLE, the negatively weighted regions are hypometabolic, and the positively weighted regions are hypermetabolic, compared to controls. Interestingly, despite that both hypo- and hypermetabolism have mutually contributed to our model, they may reflect different pathological and/or compensative responses. For instance, patients with earlier age at epilepsy onset present greater hypometabolism in the ipsilateral inferior temporal gyrus, while we find no evidence of such association with hypermetabolism. In summary, quantitative models utilizing multidimensional brain metabolic information may provide additional assistance to presurgical workups in TLE.

Catheter ablation for atrial tachycardias: How to interpret the unclear activation map?

BACKGROUND: Post-ablation atrial tachycardias (ATs) are characterized by low-voltage signals that challenge current mapping methods. In this study, we analyzed common mistakes during activation mapping and delineated a mapping strategy for correct interpretation of tachycardia mechanisms in patients with challenging underlying substrate. METHODS AND RESULTS: Thirty-one patients referred for AT ablation were selected for the study. Three types of incorrect activation patterns were identified, which were referred to as unrecognized block line (pseudo-macroreentry and pseudo-fig-8 reentry), incorrect activation timing window of interest (WOI) (chaotic activation), and mis-annotation of complex signals (multiple sites of "early meets late"). Pseudo-macroreentry and chaotic activation occur in focal or localized reentry AT with the error related to the WOI selection (four cases), incorrect annotation of local activation time (six cases), or a previous line of atrial block in (seven cases). Pseudo-fig-8 reentry (five cases) and multiple sites of "early meets late" (nine cases) occur in macroreentrant AT with blocked areas and low-voltage atrial substrate. All ATs were successfully eliminated at the origin site. CONCLUSIONS: We delineated a series of ATs in the setting of a disordered pattern of activation mapping encountered in patients after previous extensive ablation or atriotomy. The algorithm proposed rapidly corrects the activation map and identifies the mechanism of the AT.

Ensemble Learning Based on Policy Optimization Neural Networks for Capability Assessment.

Capability assessment plays a crucial role in the demonstration and construction of equipment. To improve the accuracy and stability of capability assessment, we study the neural network learning algorithms in the field of capability assessment and index sensitivity. Aiming at the problem of overfitting and parameter optimization in neural network learning, the paper proposes an improved machine learning algorithm-the Ensemble Learning Based on Policy Optimization Neural Networks (ELPONN) with the policy optimization and ensemble learning. This algorithm presents an optimized neural network learning algorithm through different strategies evolution, and builds an ensemble learning model of multi-intelligent algorithms to assess the capability and analyze the sensitivity of the indexes. Through the assessment of capabilities, the algorithm effectively avoids parameter optimization from entering the minimum point in performance to improve the accuracy of equipment capability assessment, which is significantly better than previous neural network assessment methods. The experimental results show that the mean relative error is 4.10%, which is better than BP, GABP, and early stopping. The ELPONN algorithm has better accuracy and stability performance, and meets the requirements of capability assessment.

The morphological characteristics of hippocampus and thalamus in mesial temporal lobe epilepsy.

BACKGROUND: Mesial temporal lobe epilepsy (MTLE) is the most common form of focal epilepsy, which is frequently characterized by hippocampal sclerosis (HS). Accumulating studies have suggested widespread cortico-cortical connections related to MTLE. The role of subcortical structures involved in general epilepsy has been extensively investigated, but it is still limited in MTLE. Our purpose was to determine the specific morphological correlation between sclerotic hippocampal and thalamic sub-regions, using quantitative analysis, in MTLE. METHODS: In this study, 23 MTLE patients with unilateral hippocampal sclerosis and 24 healthy controls were examined with three-dimensional T1 MRI. Volume quantitative analysis in the hippocampus and thalamus was conducted and group-related volumetric difference was assessed. Moreover, vertex analysis was further performed using automated software to delineate detailed morphological patterns of the hippocampus and thalamus. The correlation was used to examine whether there is a relationship between volume changes of two subcortical structures and clinical characteristics. RESULTS: The patients had a significant volume decrease in the sclerotic hippocampus (p < 0.001). Compared to controls, obvious atrophic patterns were observed in the bilateral hippocampus in MTLE (p < 0.05). Only small patches of shrinkage were noted in the bilateral thalamus (p < 0.05). Moreover, the volume change of the hippocampus had a significant positive correlation with that of the thalamus (P < 0.001). Intriguingly, volume changes of the hippocampus and thalamus were correlated with the duration of epilepsy (hippocampus: P = 0.024; thalamus: P = 0.022). However, only volume changes of thalamus possibly differentiated between two prognostic groups in patients (P = 0.026). CONCLUSIONS: We demonstrated the morphological characteristics of the hippocampus and thalamus in MTLE, providing new insights into the interrelated mechanisms between the hippocampus and thalamus, which have potential clinical significance for refining neuromodulated targets.

Furan formation from ingredient interactions and furan mitigation by sugar alcohols and antioxidants of bamboo leaves in milk beverage model systems.

BACKGROUND: Furan is a potential carcinogen that can be formed in various heat-treated foods, including milk beverages. Studies on the formation and mitigation of furan in milk beverages are rare. In the present study, the effects of ingredients on furan formation and the reduction of furan by sugar alcohols and antioxidants of bamboo leaves (AOB) were investigated in a milk beverage model system. RESULTS: The results obtained demonstrated that the Maillard reaction is the major pathway for furan formation in a milk beverage model system, and the type of sugar has a great influence on furan formation. High fructose corn syrup (HFCS 55) was more favorable for furan formation than sucrose. Thermal oxidation of ascorbic acid and lipids significantly enhanced furan generation. Xylitol, sorbitol and mannitol inhibited furan formation in model systems by replacing sucrose or HFCS. The maximum inhibition percentage of furan formation was observed when sucrose/HFCS was substituted completely by xylitol and the inhibition rate was 78.28% and 88.64% separately for the sucrose/HFCS-containing system. AOB significantly inhibited furan formation and the inhibition rate reached 32.13% and 28.52% separately for the sucrose/HFCS-containing system. CONCLUSION: The present study demonstrates that the use of sugar alcohols and AOB could be a feasible way of reducing furan formation in thermally processed milk beverages. © 2019 Society of Chemical Industry.

Mediation analysis of alcohol consumption, DNA methylation, and epithelial ovarian cancer.

Epigenetic factors and consumption of alcohol, which suppresses DNA methylation, may influence the development and progression of epithelial ovarian cancer (EOC). However, there is a lack of understanding whether these factors interact to affect the EOC risk. In this study, we aimed to gain insight into this relationship by identifying leukocyte-derived DNA methylation markers acting as potential mediators of alcohol-associated EOC. We implemented a causal inference test (CIT) and the VanderWeele and Vansteelandt multiple mediator model to examine CpG sites that mediate the association between alcohol consumption and EOC risk. We modified one step of the CIT by adopting a high-dimensional inference procedure. The data were based on 196 cases and 202 age-matched controls from the Mayo Clinic Ovarian Cancer Case-Control Study. Implementation of the CIT test revealed two CpG sites (cg09358725, cg11016563), which represent potential mediators of the relationship between alcohol consumption and EOC case-control status. Implementation of the VanderWeele and Vansteelandt multiple mediator model further revealed that these two CpGs were the key mediators. Decreased methylation at both CpGs was more common in cases who drank alcohol at the time of enrollment vs. those who did not. cg11016563 resides in TRPC6 which has been previously shown to be overexpressed in EOC. These findings suggest two CpGs may serve as novel biomarkers for EOC susceptibility.

Cavotricuspid-Dependent Atrial Flutter in Patients With Prior Atriotomy: 12-Lead ECG Interpretation and Electroanatomical Characteristics.

BACKGROUND: The aim of this study was to describe the electrocardiogram (ECG) morphology and electroanatomical characteristics of counterclockwise tricuspid annular atrial flutter (CCWTA-AFL) in the patients with prior atriotomy. METHODS AND RESULTS: This retrospective study included 34 patients with CCWTA-AFL after cardiac surgery and 20 patients with typical CCWTA-AFL without prior surgery. For patients in the postsurgical group, 19 had single-loop CCWTA-AFL and 15 had a double loop CCWTA-AFL. For single loop CCWTA-AFL the F-wave in lead I was very flat in l7 of 19 patients. The F-wave morphology in the inferior leads and V1 were found to be similar to typical AFL in 14 of 19 patients. For double loop CCWTA-AFL, F-waves were positive in lead I in 13 out of 15 patients. A long isoelectric activation was measured between F-waves in most of the patients. The presence of isoelectric segments between F-waves suggested a double loop AFL, which had a sensitivity of 86.7% and a specificity of 100%. Moreover, flat F-waves in lead I suggested a single loop AFL, which had a sensitivity of 89.5% and specificity of 86.7%. All patients in the group without prior cardiac surgery had typical ECGs features of CCWTA-AFL. None of the patients showed isoelectric segments between F-waves in the inferior leads. The amplitudes of most of the leads were higher than those for single loop CCWTA-AFL in patients with prior surgery.

[Risk factors for heart failure after right ventricular apical pacing].

OBJECTIVE: To explore the prevalence and risk factors for the onset of heart failure after right ventricular apical pacing. METHODS: The clinical data of 1 343 patients with pacemaker implantation at our hospital from 2003 to 2008 were analyzed retrospectively. And the predictors of heart failure were evaluated by the Cox proportional hazard model and Kaplan-Meier method. RESULTS: During a median follow-up period of 71 (76±24) months, 303 patients (22.6%) developed a new onset of heart failure. Multivariate Cox analysis revealed that ≥65 years old (hazard ratio 2.37), a history of myocardial infarction (hazard ratio 2.16), VVI mode (hazard ratio 2.37), left ventricular ejection fraction (LVEF)<50% (hazard ratio 2.00), atrioventricular block or atrial fibrillation with slow ventricular rate etiologically (hazard ratio 1.43) were independent risk factors for heart failure (P<0.05). And the risks increased by 19.4%, 33.0%, 20.9%, 38.4%, 17.2% or 25.9% at 71 months respectively. CONCLUSION: After right ventricular apical pacing, heart failure is a progressive syndrome correlated with basal cardiac functions, underlying etiologies and age. And right ventricular apical pacing should be avoided in patients with high risk factors.

[Diagnosis of Muscular Dystrophy Using Western Blot with Micro-sample of Muscle].

OBJECTIVE: To diagnose muscular dystrophy using Western blot (WB) by improving the method of the protein extraction. METHOD: Firstly,we compared the effect of different sample buffer solutions and processing Methods on the extraction of muscle protein in rats,then selected the appropriate extracting method and the process of the muscular protein. RESULTS: We put the selected sample buffer into the micro-sample,then mixed. The concentration of the extracting protein was much more,and the loss during the process was much less. We extracted enough protein in 62 cases. The protein bands were showed clearly by WB,and the abnormal protein bands were shown in some patients. Compared with the Results of immunohistochemical staining detected the severe abnormal expressions of Dys-R,Dys-C,and Dys-N in the specimens,we did not detect the corresponding target band in WB. We detected the target protein band of the specimens were abnormal position,light or normal staining in WB,while Dys were mildly expressed in immunohistochemical staining. CONCLUSIONS: The improved protein extraction method can save the muscle tissue,and the protein bands can be used for diagnosing the muscular dystrophy. For clinically suspected patients with dystrophinopathy,if normal or mild deficiency is shown by immunohistochemistry,WB should be applied to detect the dystrophin protein band.