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Research and clinical application progress of cardiac mapping in the electrophysiological mechanism of atrial fibrillation

Atrial fibrillation is one of the most common arrhythmia. Cardiac mapping technology, an important method to study the electrophysiological mechanism of atrial fibrillation, can determine the abnormal origin and record the distribution and transmission way of these atrial electrical signals. This technology offers a new way for research the electrophysiological mechanism of atrial fibrillation. The purpose of this study is to review the research progress of cardiac mapping in the electrophysiological mechanism of atrial fibrillation and clinical application.

Advances in artificial intelligence in prediction of atrial fibrillation

Atrial fibrillation (AF) is one of the most common arrhythmias. Today, there are a large number of AF patients worldwide, and incidence increases with the increase of age. However, the current diagnosis rate of AF via auxiliary examination is relatively low. In view of the widespread application of artificial intelligence (AI) in the medical field, the diagnosis of AF using AI has also become a research hotspot. This article briefly introduces the relevant aspects of AI and reviews the application of AI in AF prediction.

Research Progress in Cell Transplantation for Treatment of Myocardial Infarction

The capacity for self-regeneration of the adult heart is very limited, conventional therapies cannot solve the loss of cardiomyocytes in the infarcted heart leads to continuous ventricular remodeling. Cell transplantation therapy is emerging as a novel approach for myocardial repair over conventional therapies. Various types of cell transplantation have improved cardiac function and angiogenesis in animal models and clinical settings. The safety and feasibility of some clinical trials have been initiated. In this review, we summarize the advantages and limitations of different cell types proposed for cell transplantation in myocardial infarction and give an overview of the clinical trials using this novel therapeutic approach in patients with myocardial infarction.

華法林抗凝過量致自發性后腹膜出血一例

胸部閉合傷的損傷嚴重度評估及臨床意義

目的 探討胸部閉合傷的臨床特點及其損傷嚴重度評估的臨床意義。方法 分析456例胸部閉合傷的致傷因素和死亡率，并按有無合并傷（分為單純胸傷組、合并傷組）和結局（分為生存組、死亡組）分組進行創傷評分，分別比較不同組間的損傷嚴重程度。結果 致傷原因為交通傷發生率最高（60.97%）,其次為高處墜落傷(13.82%)。456例中288例合并其它部位損傷，占63.16%。死亡18例，死亡率3.95%。單純胸傷組的格拉斯哥昏迷指數(GCS)、修正創傷評分(RTS)和生存概率(Ps)較高，損傷嚴重度評分(ISS)低于合并傷組，胸部簡明損傷定級(AIS)評分兩組間差別無顯著性意義。死亡組和生存組比較，前者生理評分低，解剖評分高，生存概率亦低。結論 胸部閉合傷常合并全身多發傷，傷情判斷困難。合理使用創傷評分有助于判斷損傷嚴重度，指導臨床救治。

心內直視下射頻消融改良迷宮術治療心房顫動

目的 總結心內直視下射頻消融改良迷宮手術治療心房顫動的臨床經驗。 方法 2005年5月～2006年8月在心內直視手術同期采用射頻消融改良迷宮手術治療心房顫動30例，術前診斷風濕性心臟病26例，二尖瓣關閉不全3例，冠心病1例。手術采用Cardioblate TM沖洗式射頻消融系統，每例患者分別應用單極系統和雙極系統，按照迷宮手術線路分別于左、右心房行心內膜射頻消融手術，并切除左、右心耳，同期完成相應的心臟手術。 結果 手術均順利完成，射頻消融手術時間30.5±12.6 min。術后死亡1例，其余29例順利出院。術后當天21例患者（70.0％）轉為竇性心律。29例患者出院后隨訪7.6±4.8個月，24例（82.8%）為竇性心律,5例（17.2％）為心房顫動或房室結性心律。 結論 心內直視下射頻消融改良迷宮手術治療心房顫動簡單、有效，具有良好的臨床應用前景。

心臟直視手術圍術期尿微量蛋白變化的臨床觀察

目的 觀察心臟直視手術圍術期尿微量蛋白的變化并分析其臨床意義.方法 40例心臟直視手術患者按疾病種類不同分為兩組,組Ⅰ:風濕性心臟病瓣膜置換術患者(n=20);組Ⅱ:非紫紺型先天性心臟病患者(n=20).采用速率散射比濁法分別于術前1天,手術結束時,術后1天,術后3天和術后5天測定微白蛋白、轉鐵蛋白、免疫球蛋白G和α1-微球蛋白的濃度變化.結果 兩組術后微白蛋白、轉鐵蛋白、免疫球蛋白G和α1-微球蛋白的濃度均明顯升高(P＜0.05或P＜0.01),到達峰值后逐漸下降.兩組比較,組Ⅰ術后改變較明顯,持續時間也較長(P＜0.05或P＜0.01).結論 心臟直視術后存在不同程度的腎臟損害,風濕性心臟病瓣膜置換術患者術后的腎臟損害較重.尿微量蛋白測定可以敏感、準確地發現心臟直視術后亞臨床腎臟損害.

Safety of the removal of pericardial and mediastinal drain within a different drainage volume after cardiac valvular replacement surgery: A case control study

ObjectiveTo assess the safety of the removal of pericardial and mediastinal drain within different drainage volume after cardiac valvular replacement surgery.MethodsBetween July 2013 and July 2017, 201 patients with rheumatic heart disease (CHD) were treated with valve replacement in our hospital, including 57 males and 144 females, aged 15 to 72 years. They were divided into two groups according to the amount of 24-h drainage before the drain removal: a group one with 24-h drainage volume≤50 ml (n=127) and a group two with 24-h drainage volume>50 ml (n=74). The postoperative hospital stay and the incidence of severe complications between the two groups were compared.ResultsThere was no difference between the two groups in the baseline information or the incidence of severe pericardial effusion and tamponade, while the group two tended to have a shorter length of hospital stay after surgery (8.0 d vs. 7.5 d, P=0.013).ConclusionIn CHD patients undergoing valvular surgery, compared with a relatively low amount of drainage before the drain removal, drawing the tube at a greater amount of drainage (24-h drainage volume>50 ml) will shorten the length of hospital stay after cardiac surgery while incidence of severe complications remains the same.

起源于二尖瓣瓣環的心臟粘液瘤一例

流動對兔動脈縮窄區域內皮細胞形態的影響

目的 在體考察不同流場環境中血管內皮細胞形態學和完整性的改變,及其與流場的空間相關性. 方法 將10只大耳白兔分成動脈縮窄組和對照組,建立兔頸總動脈環縮狹窄,使用脈沖多普勒超聲系統考察縮窄下游的湍流流場及對側血管的層流流場;用掃描電子顯微鏡探測內皮細胞(ECs)計數、形狀指數和定向角等形態學指標. 結果 縮窄下游的湍流流場中ECs大量脫落,細胞下基質和膠原組織暴露,ECs變形,無明顯定向性.越遠離縮窄,ECs的殘留率越高,細胞也逐漸重新建立了定向性. 結論 縮窄血管下游的湍流流動是導致血管ECs形態結構異常和損傷的重要原因.