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Pediatric acute hyperextension spinal cord injury (SCI) named as PAHSCI by us, is a special type of thoracolumbar SCI without radiographic abnormality and highly related to back-bend in dance training, which has been increasingly reported. At present, it has become the leading cause of SCI in children, and brings a heavy social and economic burden. Both domestic and foreign academic institutions and dance education organizations lack a correct understanding of PAHSCI and relevant standards, specifications or guidelines. In order to provide standardized guidance, the expert team formulated this guideline based on the principles of science and practicability, starting from the diagnosis, differential diagnosis, etiology, admission evaluation, treatment, complications and prevention. This guideline puts forward 23 recommendations for 14 related issues.
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Child , Humans , Spinal Cord Injuries/complications , Spinal CordABSTRACT
Objective:To explore the safety and efficacy of the minimally invasive treatment of unstable pelvic fractures with the blunt head technique of Kirschner wire and 3D-printed external template technique.Methods:A retrospective study was conducted of the clinical data of 21 patients with unstable pelvic fracture who had undergone minimally invasive treatment at Department of Orthopaedics, Union Hospital from May 2016 to July 2018 using 3D-printed external templates and the blunt head technique of Kirschner wire. There were 7 males and 14 females with an age of 43.6 years (from 19 to 65 years). According to the Tile classification, there were 3 cases of B1, 7 ones of B2, 6 ones of C1 and 5 ones of C2. The intraoperative fluoroscopy, operation time, postoperative fracture reduction and functional recovery of the pelvis at the last follow-up were recorded.Results:The 21 patients were followed up for an average of 16.3 months (from 12 to 24 months). A total of 33 wires were inserted in the 21 patients, including 15 S 1 ones and 18 S 2 ones. The intraoperative fluoroscopy ranged from 13 to 27 times, averaging 21.8 times. The operation time ranged from 65 to 130 min, averaging 88.6 min. The anterior subcutaneous internal fixation was used to fix the anterior ring in 9 patients. No vascular injury occurred during the operation. By the Matta criteria, the postoperative fracture reduction was assessed as excellent in 14 cases, good in 5, and fair in 2, giving an excellent to good rate of 90.5% (19/21). By the Majeed scoring system, the pelvic function at the last follow-up was assessed as excellent in 10 cases, good in 8, and fair in 3, giving an excellent to good rate of 85.7% (18/21). Lateral femoral cutaneous nerve injury occurred in 2 patients but was recovered by the 3-month follow-up. No other complications were follwed up. Conclusion:The minimally invasive treatment of unstable pelvic fractures with the blunt head technique of Kirschner wire assissted by 3D-printed external templates is safe and effective, showing advatages of reduced fluoroscopic frequency and operation time.
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Objective:To summarize the clinical characteristics and prognosis of acute hyperextension spinal cord injury (SCI) in children, and to provide some recommendations for the treatment and prevention of this disease.Methods:Reviewed the data of children of SCI after sustained or repeated hyperextension of the spine at Wuhan Union Hospital and Wuhan Children's Hospital from September 2010 to September 2020. According to the American Spinal Injury Association impairment scale (AIS grade), the patients were divided into complete SCI group and incomplete SCI group. The age, symptoms and evolution after injury, neurological level of injury, imaging data, laboratory examination data, prognosis and complications of the two groups were analyzed. Retrospectively summarize the characteristics of this type of injury.Results:Forty-four cases of acute hyperextension SCI in children were included. Their age ranged from 3 to 10 years old, 95% of them were under 8 years old and 95% of them were female. There was no significant difference in age at injury and time of dance training between children with complete SCI and incomplete SCI. Back and leg pain, lower limb weakness or paresthesia, and rapidly progress to complete or incomplete SCI in a short period were typical symptoms. All blood test results anddiagnostic analysis of cerebrospinal fluid were unremarkable or negative. There was no fracture or dislocation in the whole spine. Magnetic resonance imaging showed a longitudinally extended intramedullary high-intensity signal in the thoracolumbar spinal cord. Complete SCI accounted for 60% of all cases, and the prognosis was poor with spinal cord atrophy and various complications.Conclusion:Children younger than 10 years old after sustained or repeated hyperextension of the spine may suffer acute hyperextension SCI. Children with complete SCI have poor prognosis and serious complications. Therefore, prevention of this type of injury is the best strategy.
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Objective:To explore the feasibility, safety and clinical efficacy of using the self-developed acetabular posterior wall and column integrative anatomical plate to treat various types of posterior wall/column fractures.Methods:Between January 2016 and January 2019, 21 patients involving acetabular posterior wall and/or column were treated with the novel acetabular posterior wall and column integrative plate, the data were collected and retrospectively analyzed. There were 11 males and 10 females, with an average of 48 years old (range, 18-65 years old). According to the classification of AO/OTA, there were 6 simple fractures, 9 comminuted fractures, and 6 associated with joint surface compression of posterior wall; and there were 16 simple acetabular posterior wall fractures and 5 cases associated with acetabular posterior column fractures. Before operation, the CT data of each patient was collected and imported into Mimics software to reconstruct and print a 3D model of pelvis and injured and mirrored side to simulate operation. All patients were treated with a single Kocher-Langenbeck approach for posterior acetabular fractures, and fixed with the novel integrated anatomical plate after satisfactory reduction was achieved. Matta score was used to evaluate the quality of fracture reduction, and the modified Merle D'Aubigné-Postel score was adopted to evaluate functional recovery of hip joint.Results:21 patients involved in this study, the average time of plate insertion after successful reduction was 20 min (range, 15-30 min); the mean time of operation was 180 min (range, 90-300 min); the intraoperative mean bleeding volume was 700 ml (range, 300-1 500 ml). All the incisions healed by level 1 classification, and no incisions infection and sciatic nerve injury occurred. The patients included in the study have been followed up for at least one year and the imaging data was intact, the mean follow-up time was 19 month (range, 12-26 month). The fracture reduction was evaluated according to the Matta score: 16 cases were anatomical reduction, 3 cases were satisfactory reduction, 2 cases were unsatisfactory reduction, the satisfactory rate of reduction was 90.5% (19/21); the modified Merle D'Aubigné-Postel score at 3 month was 13.0±2.2 (range, 9-16), 6 month was 15.8±2.4 (range, 10-18) and last follow up was 17.0±1.8 (range, 13-18), respectively; the difference was statistically significant ( F=15.38, P < 0.001). At the last follow-up, 15 cases were excellent, 3 cases were good and 3 cases were fair, the total excellent and good rate was 85.7% (18/21). One case developed symptoms of sciatic nerve injury after operation, but the symptoms resolved after treating with neurotrophic drug by 6 months. 2 cases developed arthritis related pain after operation, receiving symptomatic treatment with oral painkillers. During the follow-up period, no complications such as plate broken and screw loosen occurred. Conclusion:The use of an integrative anatomical plate for treating posterior wall/column fractures of acetabulum achieved satisfactory fixation and postoperative functional recovery.
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Objective:To investigate the advantages and disadvantages and clinical effects of integrated acetabular quadrilateral surface buttress plate in the treatment of acetabular both column fractures.Methods:From September 2017 to March 2019, 14 patients with acetabular both column fractures were treated with integrated quadrilateral acetabular buttress plate and were followed up. The clinical data were retrospectively analyzed. There were 10 males and 4 females with an average age of 53.2 years (range, 26-75 years). Fracture classification were both column fractures according to the Letournel-Judet classification system, including 11 cases of combined posterior wall without posterior dislocation. The time from injury to operation was 8-19 days, with an average of 10.3 days. All operations were performed with a supra-ilioinguinal approach. After satisfactory reduction, the integrated acetabular quadrilateral surface buttress plate was used to fix the anterior and posterior column and quadrilateral fractures at the same time. After operation, Matta criteria was used to evaluate the quality of fracture reduction on postoperative images, and modified Merle d'Aubigné-Postel score to evaluate hip joint function.Results:The average operation time was 180 min (range, 120-320 min), and the intraoperative average blood loss was 980 ml (range, 700-1 600 ml). Operations were performed successfully with none intraoperative reshaping conducted, and the plate could fit into the bone surface well. All 14 patients were followed up with an average of 15.6 months (range, 9-20 months). During the follow-up, all fractures healed with an average of 3 months (range, 2.5-5 months). The reduction quality evaluated by the Matta criteria were 7 anatomical, 5 satisfactory, and 2 unsatisfactory, with an excellent and good rate of 85.7% (12/14). The hip joint function at the last follow-up was in accordance with the modified Merle d'Aubigné-Postel score was 12-18 points, with an average of 16.9 points, of which 8 excellent, 4 good, and 2 fair. The excellent and good function rate was 85.7% (12/14). During the operation, 1 patient had a rupture of about 1 cm of the peritoneum during the separation of the spermatic cord, which was immediately sutured and repaired. One patient had obturator nerve paralysis after the operation, without special treatment, and the paralysis symptoms were relieved during the 6th-month follow-up. There were no other operation-related complications.Conclusion:For both-column fractures characterized by central dislocation of the femoral head, the integrated acetabular quadrilateral buttress plate can simultaneously fix the anterior and posterior columns and quadrilateral surface at the same time. Satisfactory reduction and functional outcomes could be achieved by the novel plates.
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Outbreak of COVID-19 is ongoing all over the world. Spine trauma is one of the most common types of trauma and will probably be encountered during the fight against COVID-19 and resumption of work and production. Patients with unstable spine fractures or continuous deterioration of neurological function require emergency surgery. The COVID-19 epidemic has brought tremendous challenges to the diagnosis and treatment of such patients. To coordinate the diagnosis and treatment of infectious disease prevention and spine trauma so as to formulate a rigorous diagnosis and treatment plan and to reduce the disability and mortality of the disease, multidisciplinary collaboration is needed. This expert consensus is formulated in order to (1) prevent and control the epidemic, (2) diagnose and treat patients with spine trauma reasonably, and (3) reduce the risk of cross-infection between patients and medical personnel during the treatment.
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Humans , Betacoronavirus , Coronavirus Infections , Epidemiology , Cross Infection , Emergency Service, Hospital , Pandemics , Patient Care Team , Pneumonia, Viral , Epidemiology , Practice Guidelines as Topic , Spinal Injuries , Diagnosis , Therapeutics , Transportation of PatientsABSTRACT
To evaluate the exported risk of novel coronavirus pneumonia (NCP) from Hubei Province and the imported risk in various provinces across China. Data of reported NCP cases and Baidu Migration Indexin all provinces of the country as of February 14, 2020 were collected. The correlation analysis between cumulative number of reported cases and the migration index from Hubei was performed, and the imported risks from Hubei to different provinces across China were further evaluated. A total of 49 970 confirmed cases were reported nationwide, of which 37 884 were in Hubei Province. The average daily migration index from Hubei to other provinces was 312.09, Wuhan and other cities in Hubei were 117.95 and 194.16, respectively. The cumulative NCP cases of provinces was positively correlated with the migration index derived from Hubei province, also in Wuhan and other cities in Hubei, with correlation coefficients of 0.84, 0.84, and 0.81. In linear model, population migration from Hubei Province, Wuhan and other cities in Hubei account for 71.2%, 70.1%, and 66.3% of the variation, respectively. The period of high exported risk from Hubei occurred before January 27, of which the risks before January 23 mainly came from Wuhan, and then mainly from other cities in Hubei. Hunan Province, Henan Province and Guangdong Province ranked the top three in terms of cumulative imported risk (the cumulative risk indices were 58.61, 54.75 and 49.62 respectively). The epidemic in each province was mainly caused by the importation of Hubei Province. Taking measures such as restricting the migration of population in Hubei Province and strengthening quarantine measures for immigrants from Hubei Province may greatly reduce the risk of continued spread of the epidemic.
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Objective:To introduce a novel anatomical supra-pectineal quadrilateral surface buttress plate, and explore its advantages, disadvantages and clinical efficacy in the treatment of complex acetabular fractures.Methods:Data of eighteen cases of acetabular fractures treated in our department from March 2017 to March 2019were retrospectively analyzed. There were 15 males and 3 females with an average age of 49.6 years (range, 27-62 years). According to the Letournel-Judet’s classification, there were 3 cases of anterior column fractures (involving quadrilateral surface), 2 cases of "T" shaped, 8 of cases anterior column and posterior hemi-transverse (ACPHT) and 5 cases of double columns fractures. The time from injury to operation was 5-14 days (mean, 7 days). Before operation, all patients were taken pelvic anterior-posterior X-ray and CT scan. All patients were adopted supra-ilioinguinal approach and fixed by supra-pectineal quadrilateral surface buttress plate. Surgical time, intraoperative blood loss and postoperative complications were collected. After operations all patients were taken pelvic X-ray in anterior-posterior and Judet position, as well as CT scan. The radiographic quality of reduction was evaluated by Matta criteria and hip functions were evaluated by Matta Modified Merle d’Aubigné-Postel scoring system.Results:The average surgical time was 130 min (range, 100-200 min). The average blood loss was 560 ml (range, 400-900 ml). An additional shaping was unnecessary in 18 patients who were implanted with the anatomical supra-pectineal quadrilateral surface buttress plate and all patients were operated successfully. All patients were followed up for an average time of 9 months (range, 6-15 months). The quality of fracture reduction was evaluated according to Matta standard, of which there were 11 cases excellent, 4 cases good, and 3 cases poor, with an excellent rate of 83.3% (15/18). At the latest follow-up, the function of the hip joint was evaluated according to the Matta Modified Merle d’Aubigné-Postel scoring system for a mean of 15.8 scores (range, 12-18 scores), of which there were 10 cases excellent, 6 cases good, 2 cases fair, with an excellent rate of 88.9% (16/18). All patients recovered well, and there were 2 cases of lateral femoral cutaneous nerve injury postoperative who had recovered one month later. There was no other postoperative complications.Conclusion:The anterior and posterior column and quadrilateral surface could be stabilized simultaneously by the anatomical supra-pectineal quadrilateral surface buttress plate without intraoperative shaping. Moreover, it is more likely to obtain a satisfactory clinical outcome by using this special plate with lower complications and rigid fixation. Therefore, it is a kind of internal fixation method worthy of promotion in the treatment of complex acetabular fractures.
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Objective@#To explore the clinical efficacy of combined plates through superior-ilioinguinal approach for acetabular fractures involving anterior wall and anterior column.@*Methods@#Data of twelve patients with acetabular fractures involving anterior column and anterior wall who were treated by combined plates from June 2015 to August 2017 were retrospectively analyzed. Among them 9 cases were males and 3 cases were females, with an average age of 55.4 years old (range, 22-69 years old). Three cases were combined with posterior hemitransverse fractures. Six cases were combined with posterior column fractures. The mean time from injury to operation was 7.2 d (range, 5-12 d). Simultaneous management of anterior wall and anterior column fractures were achieved through single superior-ilioinguinal approach using the novel combined plates in all patients. The image results were evaluated by Matta’s standard and the functional outcome was evaluated by the Matta's improved Merle d'Aubigné-Postel scores system at the final follow-up.@*Results@#All 12 patients were followed up for average 18.3 months (range, 12-24 months). Average blood loss was 560 ml (range, 200-1 200 ml) and average operative time was 102 min (range, 88-190 min). The mean time of bony union was 2.9 months (range, 2.5-4.5 months). The quality of postoperative fracture reduction was evaluated according to Matta’s standard, of which there were 7 cases anatomic, 3 cases satisfactory, and 2 cases unsatisfactory, with an anatomic or satisfactory rate of 83.3%(10/12). The average Matta’s improved Merle d’Aubigne-Postel score was 16.1 (range, 12-18), and there were 8 cases excellent, 2 cases good, 1 case fair and 1 case poor, with an excellent or good rate of 83.3%(10/12). Rupture of the peritoneum occurred in one patient during the surgery which was repaired immediately. One patient suffered obturator nerve palsy and was fully recovered in one year. No inguinal hernia, surgical site infection and femoral head avascular necrosis occurred.@*Conclusion@#The combined plates could provide simultaneous fixation for anterior column and anterior wall fractures firmly through single superior-ilioinguinal approach. Satisfactory reduction and functional outcomes could be achieved by the novel plates.
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@#【Abstract】 【Objective】To investigate the mechanisms implicated in ataxia telangiectasia mutated(ATM)inhibitioncaused apoptosis in the cultured cerebellar granule neurons.【Methods】Primary cerebellar granule neurons(CGN)isolated from neonatal Sprague Dawley rats of 7-8 days were divided into the following groups:25 K group(survival group),5 K group(apoptosis group)and 25 K + KU-55933 treatment group(ATM inhibition group),25 K + KU-55933 + Mithramycin A treatment group(MMA group),25 K + KU-55933 + Chromonycin A3 treatment group(CMA3 group). The protein expression of p-ATM,ATM,Bim and Caspase 3 were detected by Western Blot. The apoptotic cells with nuclear pyknosis were detected by Hoechst-staining.【Results】Compared with 25 K group,the result of western blot showed that the protein expression of Bim and Caspase 3 were increased in the ATM inhibition group(P < 0.05). Compared with 25 K group,the nuclear pyknosis rate of 5 K group and ATM inhibition group were significantly increased(P < 0.05). Inhibition of Bim by Mithramycin A or Chromomycin A3 remarkably reversed ATM inhibition-caused apoptosis.【Conclusion】Inhibition of ATM induce Bim dependent apoptosis in cultured cerebellar granule neurons.
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Objective To explore the clinical efficacy of combined plates through superior?ilioinguinal approach for ace?tabular fractures involving anterior wall and anterior column. Methods Data of twelve patients with acetabular fractures involv?ing anterior column and anterior wall who were treated by combined plates from June 2015 to August 2017 were retrospectively an?alyzed. Among them 9 cases were males and 3 cases were females, with an average age of 55.4 years old (range, 22-69 years old). Three cases were combined with posterior hemitransverse fractures. Six cases were combined with posterior column fractures. The mean time from injury to operation was 7.2 d (range, 5-12 d). Simultaneous management of anterior wall and anterior column frac?tures were achieved through single superior?ilioinguinal approach using the novel combined plates in all patients. The image re?sults were evaluated by Matta’s standard and the functional outcome was evaluated by the Matta's improved Merle d'Aubigné?Pos?tel scores system at the final follow?up. Results All 12 patients were followed up for average 18.3 months (range, 12-24 months). Average blood loss was 560 ml (range, 200-1 200 ml) and average operative time was 102 min (range, 88-190 min). The mean time of bony union was 2.9 months (range, 2.5-4.5 months). The quality of postoperative fracture reduction was evaluated accord?ing to Matta’s standard, of which there were 7 cases anatomic, 3 cases satisfactory, and 2 cases unsatisfactory, with an anatomic or satisfactory rate of 83.3%(10/12). The average Matta’s improved Merle d’Aubigne?Postel score was 16.1 (range, 12-18), and there were 8 cases excellent, 2 cases good, 1 case fair and 1 case poor, with an excellent or good rate of 83.3%(10/12). Rupture of the peritoneum occurred in one patient during the surgery which was repaired immediately. One patient suffered obturator nerve palsy and was fully recovered in one year. No inguinal hernia, surgical site infection and femoral head avascular necrosis occurred. Con?clusion The combined plates could provide simultaneous fixation for anterior column and anterior wall fractures firmly through single superior?ilioinguinal approach. Satisfactory reduction and functional outcomes could be achieved by the novel plates.
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This study is to establish an HPLC fingerprint by HPLC-DAD method and simultaneous quantitative analysis of 17 components of 18 batches of Citrus aurantium and 10 batches of C. sinensis. The separation was performed on an Agilent Poroshell 120 SB-C₁₈ (4.6 mm×100 mm,2.7 μm) column with the gradient elution of methanol-0.1% formic acid water, the flow was 0.6 mL•min⁻¹. The detection wavelength was set at 318 nm. The column temperature was maintained at 30 ℃. The data calculation was performed with similarity evaluation system for chromatographic fingerprint of traditional Chinese medicine (Version 2004A) together with SIMCA-P 13.0 software to clarify the differential marker between these two different species of Aurantii Fructus Immaturus. This method has good precision stability and repeatability that could provide basis for quality control and evaluation of Aurantii Fructus Immaturus.
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Objective To observe the changes of serum lipids ,hs‐CRP ,MFG‐E8 and Klotho gene levels after rosuvatatin treatment in elderly patients with coronary heart disease complicating hyperlipidemia for investigating the action mechanisms of ro‐suvatatin and its application value .Methods Totally 129 elderly patients with coronary artery disease complicating hyperlipidemia in our hospital were randomly divided into two groups .The control group received only conventional treatment ,while on this basis the rosuvatatin group was given rosuvastatin 10 mg everyday ,with 2 months as a treatment cycle .Blood lipids ,hs‐CRP ,MFG‐E8 and Klotho gene levels before and after treatment were compared between the two groups .The regulation effect of rosuvatatin was investigated Results The blood lipod ,hs‐CRP ,MFG‐E8 and Klotho before treatment had no obvious difference between the two groups .The levels of TC ,LDL‐C and TG after treatment in the rosuvatatin group were significantly decreased compared with the control group ,while the HDL‐C level was significantly increased ,the differences were statistically significant (P<0 .05) .In addi‐tion ,the hs‐CRP level after treatment in the rosuvatatin group was significantly lower than that in the control group (P<0 .05) . Compared with the control group ,the levels of MFG‐E8 and Klotho after treatment in the rosuvatatin group were increased ,the difference was statistically significant (P<0 .05) .Conclusion Rosuvastatin could decrease the blood lipid and hs‐CRP levels ,up‐regulates the MFG‐E8 and Klotho levels ,alleviates the inflammatory reaction and has the anti‐vascular aging effect ,thus effectively treats the patients with coronary heart disease complicating hyperlipidemia .
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Objective To investigate the efficacy and safety of recombinant human Pro urokinase ( rhPro-uk) in treatment of patients with acute ST segment elevation myocardial infarction.Methods 90 cases from 2014 to 2015 selected in three hospital diagnosed with STEMI were randomly assigned into experimental group and control group, 45 cases in each test group.Experimental group received rhPro-uk thrombolytic therapy, control group received urokinase thrombolytic therapy, thrombolytic efficacy and incidence of adverse events were observed and compared between two goups.Results After thrombolysis 2 h, ST segment decline ≥50% of patients in experimental group was 80.00%, ST segment completely fall rate was 55.56%, coronary recanalization rate was 77.78%, all significantly higher than that in control group(60.00%, 33.33%, 55.56 %,separately.P<0.05).After thrombolysis 2h, the difference of TIMI grade between two group was significant (Z=-3.198, P<0.05).After thrombolytic therapy, CTn-I, CK-MB peak levels between two groups were not significantly different.The peak time and average time of experimental group were significantly lower than that in control group (P<0.05).The incidence of adverse events of experimental group 13.33%, significantly lower than 33.33% in control group(P <0.05).Conclusion Therapeutic effect of rhPro-uk on acute ST-segment elevation myocardial infarction is better than urokinase, and has higher safety.
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In this paper, an HPLC-QqQ-MS method for determination of 5 different ginsenosides of Panax japonica collected from different cultivated geographic regions was established. The separation was performed on a Zorbax XDB-C₁₈ (4.6 mm×100 mm, 1.8 μm) column with the gradient elution of acetonitrile (contained 0.1% formic acid)-0.1% formic acid water. The flow rate was 0.5 mL•min⁻¹. The colunm temperature was maintained at 30 ℃. The analytes were detected using electrospray ionization (ESI) in multiple reaction monitoring (MRM) modes. Reaction selected ions were 203.2 for ginsenoside Re, 202.9 for ginsenoside Rg₁, 365.0 for ginsenoside Rf, 789.1 for ginsenoside Rd, 360.9 for ginsenoside Ro. Ginsenosides Re, ginsenosides Rg₁, ginsenosides Rf, ginsenosides Rd, ginsenosides Ro had good linearity in the ranges of 3.33-66.60 μg (r=0.999 1),2.83-56.54 μg (r=0.999 2), 0.32-6.51 μg (r=0.999 2), 12.55-251.00 μg (r=0.999 3), 0.85-16.90 μg (r=0.999 5), respectively. The results of recovery were among 100.8% to 104.6%, and the values of RSD were blow 3.0%. This method is simple, reliable and accurate, and can provide basis for P. japonica basic research.
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Objective To investigate the efficiency and safety of stent implantation for severe pulmonary vein stenosis after radiofrequency ablation (RFA)of atrial fibrillation.Methods The clinical date of 231 cases with atrial fibrillation received RFA treatment were analyzed retrospectively.Eight cases were confirmed with severe pulmonary vein stenosis after RFA by CTA.The stents were implanted after angiography.Results All the 1 9 serious pulmonary vein stenosis from the 8 patients were treated stent implantation.The degree of pulmonary vein stenosis,trans-stenotic gradient,mean pulmonary pressure and the level of BNP were significantly decreased after treatment (P <0.01).The minimal diameter of the stenosis was significantly increased compared with preoperative (P <0.01).Six months after stenting,2 patients in 4 pulmonary veins were stenosis.The stenosis was successfully di-lated by repeated interventions with balloon dilation.There was no stenosis appeared in the patients after the repeated interventions with balloon dilation for 3 months.Conclusion Stenting implantation was a feasible and safety method for severe pulmonary vein stenosis after RFA.