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| 1 | Different treatment strategies and molecular features between right-sided and left-sided colon cancers显示文摘The colon is derived from the embryological midgut and hindgut separately,with the right colon and left colon having different features with regards to both anatomical and physiological characteristics.Cancers located in the right and left colon are referred to as right colon cancer(RCC) and left colon cancer(LCC),respectively,based on their apparent anatomical positions.Increasing evidence supports the notion that not only are there differences in treatment strategies when dealing with RCC and LCC,but molecular features also vary between them,not to mention the distinguishing clinical manifestations.Disease-free survival after radical surgery of both RCC and LCC are similar.In the treatment of RCC,the benefit gained from adjuvant FOLFIRI chemotherapy is superior,or at least similar,to LCC,but inferior to LCC if FOLFOX regimen is applied.On the other hand,metastatic LCC exhibits longer survival than that of RCC in a palliative chemotherapy setting.For KRAS wild-type cancers,LCC benefits more from cetuximab treatment than RCC.Moreover,advanced LCC shows a higher sensitivity to bevacizumab treatment in comparison with advanced RCC.Significant varieties exist at the molecular level between RCC and LCC,which may serve as the cause of all apparent differences.With respect to carcinogenesis mechanisms,RCC is associated with known gene types,such as MMR,KRAS,BRAF,and mi RNA-31,while LCC is associated with CIN,p53,NRAS,mi RNA-146 a,mi RNA-147 b,and mi RNA-1288.Regarding protein expression,RCC is related to GNAS,NQO1,telomerase activity,P-PDH,and annexin A10,while LCC is related to Topo I,TS,and EGFR.In addition,separated pathways dominate progressionto relapse in RCC and LCC.Therefore,RCC and LCC should be regarded as two heterogeneous entities,with this heterogeneity being used to stratify patients in order for them to have the optimal,current,and novel therapeutic strategies in clinical practice.Additional research is needed to uncover further differences between RCC and LCC. | Hong Shen Jiao Yang Qing Huang Meng-Jie Jiang Yi-Nuo Tan Jian-Fei Fu Li-Zhen Zhu Xue-Feng Fang Ying Yuan | 2015 | World Journal of Gastroenterology2015，21，21： | 33 |
| 2 | A case of acute cerebral infarction caused by myxoma of the left atrium显示文摘To the Editor: The patient was a 42-year-old male with a height of 178cm and weight of 70kg. He was admitted to the emergency department on the 4th of July in 2018, due to dizziness accompanied by on-going left limb weakness for a total of 5 days. | Jia-Qi Zhang Cai-Jun Wu Li-Qiang Niu | 2019 | Chinese Medical Journal2019，，5： | 22 |
| 3 | Split liver transplantation: Current developments显示文摘In 1988, Rudolf Pichlmayr pioneered split liver transplantation(SLT), enabling the transplantation of one donor liver into two recipients-one pediatric and one adult patient. In the same year, Henri Bismuth and colleagues performed the first full right/full left split procedure with two adult recipients. Both splitting techniques were rapidly adopted within the transplant community. However, a SLT is technically demanding, may cause increased perioperative complications, and may potentially transform an excellent deceased donor organ into two marginal quality grafts. Thus, crucial evaluation of donor organs suitable for splitting and careful screening of potential SLT recipients is warranted. Furthermore, the logistic background of the splitting procedure as well as the organ allocation policy must be adapted to further increase the number and the safety of SLT. Under defined circumstances, in selected patients and at experienced transplant centers, SLT outcomes can be similar to those obtained in full organ LT. Thus, SLT is an important tool to reduce the donor organ shortage and waitlist mortality, especially for pediatric patients and small adults. The present review gives an overview of technical aspects, current developments, and clinical outcomes of SLT. | Christina Hackl Katharina M Schmidt Caner Süsal Bernd Dohler Martin Zidek Hans J Schlitt | 2018 | World Journal of Gastroenterology2018，24，47： | 20 |
| 4 | Repeated measurement of growth-differentiation factor-15in Chinese Han patients with post-myocardial infarction chronic heart failure显示文摘Background Growth-differentiation factor-15(GDF-15)is a promising prognostic biomarker in patients with chronic heart failure (CHF).Comparatively little is known about the value of repeated measurement of GDF-15with CI-IF in Chinese Han population.This study sought to identify the clinical value of repeated measurement of GDF-15in Chinese Han patients with post-myocardial infarction CHF. Methods In total,232consecutive Chinese Hart patients with post-myocardial infarction CHF were enrolled prospectively from January 2014to June 2016.The plasma concentration of GDF-15was determined on admission and over 12months.Patients were followed up for all-cause death and a composite outcome of major adverse cardiac events (MACE)included all-cause death,myocardial infarction and first heart failure (HF)re-hospitalization.Association with other clinical variables and adverse outcomes of repeated measurement of GDF-15 was explored.Results The median baseline GDF-15level was 2025ng/L.Baseline GDF-15was moderately associated with baseline N-terminal pro-B type nalriuretic peptide (NT-proBNP)(coefficient 0.561,P <0.001).During a median follow-up of 20months,there were 53deaths and 100MACE.GDF-I5remained an independent predictor of all-cause death (adjusted hazard ratio 1.826per 1Ln U,95%CI: 1.037-8.360;P =0.037)and MACE (adjusted hazard ratio 2.243per I Ln U,95%CI:1.181-1.775;P <0.001)adjusted for established risk factors.Repeated measurement of GDF-15was performed in 173survivals over 12months.Increase of GDF-15over 12months was associ- ated with dilatation of left ventricle and acted as an independent predictor of subsequent all-canse death (adjusted HR =3.164,95%CI: 1.245~.041;P =0.015).In the joint model,GDF-15was also shown to be a risk factor for all-cause death (HR =2.749,95%CI: 1.667-3.831;P <0.001)and MACE (FIR =2.434,95%CI:1.425-3.443;P <0.001).Conclusions Repeated measurements of GDF-15 have promising prognostic value of the risk of all-cause death in Chinese Han patients with CI-IF post-myocardial infarction.GDF-15may influence the post-myocardial infarction CI-IF through the path physiological pathway of myocardial remodeling. | Ji-Xuan LIU Yan-Ping LI Bo-Han LIU Xiao-Jing ZHAO Ze-Yu ZHANG Jin-Da WANG Qian JIA Chun-Lei LIU Xiao-Jian GAO Zhen-Guo XU Hua-Wei ZHANG Lin-Nan SONG Zhi-Jun SUN Kun-Lun HE | 2018 | Journal of Geriatric Cardiology2018，15，10： | 19 |
| 5 | Vascular anatomy of inferior mesenteric artery in laparoscopic radical resection with the preservation of left colic artery for rectal cancer显示文摘AIM To investigate the vascular anatomy of inferior mesenteric artery(IMA) in laparoscopic radical resection with the preservation of left colic artery(LCA) for rectal cancer. METHODS A total of 110 patients with rectal cancer who underwent laparoscopic surgical resection with preservation of the LCA were retrospectively reviewed. A 3 D vascular reconstruction was performed before each surgical procedure to assess the branches of the IMA. During surgery, the relationship among the IMA, LCA, sigmoid artery(SA) andsuperior rectal artery(SRA) was evaluated, and the length from the origin of the IMA to the point of branching into the LCA or common trunk of LCA and SA was measured. The relationship between inferior mesenteric vein(IMV) and LCA was also evaluated.RESULTS Three vascular types were identified in this study. In type A, LCA arose independently from IMA(46.4%, n = 51); in type B, LCA and SA branched from a common trunk of the IMA(23.6%, n = 26); and in type C, LCA, SA, and SRA branched at the same location(30.0%, n = 33). The difference in the length from the origin of IMA to LCA was not statistically significant among the three types. LCA was located under the IMV in 61 cases and above the IMV in 49 cases. CONCLUSION The vascular anatomy of the IMA and IMV is essential for laparoscopic radical resection with preservation of the LCA for rectal cancer. To recognize different branches of the IMA is necessary for the resection of lymph nodes and dissection of vessels. | Ke-Xin Wang Zhi-Qiang Cheng Zhi Liu Xiao-Yang Wang Dong-Song Bi | 2018 | World Journal of Gastroenterology2018，24，32： | 18 |
| 6 | 多层螺旋CT血管成像诊断左侧肾静脉压迫综合征显示文摘 | 符伟军 洪宝发 肖越勇 杨勇 高江平 蔡伟 王晓雄 | 2005 | 中华外科杂志2005，43，14： | 15 |
| 7 | Percutaneous coronary intervention for unprotected left main coronary artery stenosis显示文摘Hemodynamically significant left main coronary artery stenosis(LMCA) is found in around 4% of diagnostic coronary angiograms and is known as unprotected LMCA stenosis if the left coronary artery and left cir-cumflex artery has no previous patent grafts.Previous randomized studies have demonstrated a significant re-duction in mortality when revascularization by coronary artery bypass graft(CABG) surgery was undertaken compared with medical treatment.Therefore,current practice guidelines do not recommend percutaneous coronary intervention(PCI) for such a lesion because of the proven benefit of surgery and high rates of reste-nosis with the use of bare metal stents.However,with the advent of drug-eluting stents(DES),the long term outcomes of PCI with DES to treat unprotected LMCA stenoses have been acceptable.Therefore,apart from the current guidelines,PCI for treatment of unprotected LMCA stenosis is often undertaken in individuals who are at a very high risk of CABG or refuse to undergo a sternotomy.Future randomized studies comparing CABG vs PCI using DES for treatment of unprotected LMCA stenosis would be a great advance in clinical knowledge for the adoption of appropriate treatment. | Seung-Jung Park Young-Hak Kim | 2010 | World Journal of Cardiology2010，2，4： | 12 |
| 8 | Stem cell mechanisms during left ventricular remodeling post-myocardial infarction:Repair and regeneration显示文摘Post-myocardial infarction(MI),the left ventricle(LV)undergoes a series of events collectively referred to as remodeling.As a result,damaged myocardium is replaced with fibrotic tissue consequently leading to contractile dysfunction and ultimately heart failure.LV remodeling post-MI includes inflammatory,fibrotic,and neovascularization responses that involve regulated cell recruitment and function.Stem cells(SCs)have been transplanted post-MI for treatment of LV remodeling and shown to improve LV function by reduction in scar tissue formation in humans and animal models of MI.The promising results obtained from the application of SCs post-MI have sparked a massive effort to identify the optimal SC for regeneration of cardiomyocytes and the paradigm for clinical applications.Although SC transplantations are generally associated with new tissue formation,SCs also secrete cytokines,chemokines and growth factors that robustly regulate cell behavior in a paracrine fashion during the remodeling process.In this review,the different types of SCs used for cardiomyogenesis,markers of differentiation,paracrine factor secretion,and strategies for cell recruitment and delivery are addressed. | Rogelio Zamilpa Mary M Navarro Iris Flores Sy Griffey | 2014 | World Journal of Cardiology2014，6，7： | 11 |
| 9 | Recent approaches to His-Purkinje system pacing显示文摘Objective:Physiologic cardiac pacing is a novel technique which has been largely popularized in recent decades.His bundle pacing (HBP) has been long considered the most physiologic pacing method;however, with the widespread implementation of this method, its disadvantages have become apparent.In this context, left bundle branch pacing (LBBP)-directly engaged in the His-Purkinje system-has been foreseen as the best pacing method to mimic physiologic activation patterns.This review aimed to summarize recent approaches to physiologic cardiac pacing.Data sources:This review included fully peer reviewed publications up to July 2018, found in the PubMed database using the keywords 'His bundle branch pacing,' 'right ventricular pacing,' and 'physiologic pacing.' Study selection:All selected articles were in English, with no restriction on study design.Results:The HBP has been studied worldwide, and is currently considered the most physiologic pacing method.However, it has disadvantages, such as high pacing threshold, unsatisfactory sensing and long procedure times, among others.Although LBBP is theoretically superior to HBP, the clinical relevance of this difference remains under debate, as few large randomized clinical trials with LBBP have been published.Conclusions:Although HBP indeed appears to be the most physiologic pacing method, it has certain shortcomings, such as high pacing threshold, difficult implantation due to specific anatomic features, and others.Further studies are required to clarify the clinical significance of LBBP. | Li-Ting Cheng Jun-Meng Zhang Ze-Feng Wang Hui-Kuan Gao Yong-Quan WU | 2019 | Chinese Medical Journal2019，，2： | 11 |
| 10 | Selforthogonal modules with finite injective dimension显示文摘The category consisting of finitely generated modules which are left orthogonal with a cotilting bimodule is shown to be functorially finite. The notion of left orthogonal dimension is introduced , and then a necessary and sufficient condition of selforthogonal modules having finite injective dimension and a characterization of cotilting modules are given. | 黄兆泳 | 2000 | Science China Mathematics2000，43，11： | 10 |
| 11 | Role of left ventricular twist mechanics in cardiomyopathies, dance of the helices显示文摘Left ventricular twist is an essential part of left ventricular function. Nevertheless, knowledge is limited in 'the cardiology community' as it comes to twist mechanics. Fortunately the development of speckle tracking echocardiography, allowing accurate, reproducible and rapid bedside assessment of left ventricular twist, has boosted the interest in this important mechanical aspect of left ventricular deformation. Although the fundamental physiological role of left ventricular twist is undisputable, the clinical relevance of assessment of left ventricular twist in cardiomyopathies still needs to be established. The fact remains; analysis of left ventricular twist mechanics has already provided substantial pathophysiological understanding on a comprehensive variety of cardiomyopathies. It has become clear that increased left ventricular twist in for example hypertrophic cardiomyopathy may be an early sign of subendocardial(microvascular) dysfunction. Furthermore, decreased left ventricular twist may be caused by left ventricular dilatation or an extensive myocardial scar. Finally, the detection of left ventricular rigid body rotation in noncompaction cardiomyopathy may provide an indispensible method to objectively confirm this difficult diagnosis. All this endorses the value of left ventricular twist in the field of cardiomyopathies and may further encourage the implementation of left ventricular twist parameters in the 'diagnostic toolbox' for cardiomyopathies. | Floris Kauer Marcel Leonard Geleijnse Bastiaan Martijn van Dalen | 2015 | World Journal of Cardiology2015，7，8： | 9 |
| 12 | WJC 6~th Anniversary Special Issues(3):Cardiomyopathy Hypertrophic cardiomyopathy in 2013:Current speculations and future perspectives显示文摘Hypertrophic cardiomyopathy(HCM),the most variable cardiac disease in terms of phenotypic presentation and clinical outcome,represents the most common inherited cardiomyopathic process with an autosomal dominant trait of inheritance.To date,more than 1400 mutations of myofilament proteins associated with the disease have been identified,most of them 'private' ones.This striking allelic and locus heterogeneity of the disease certainly complicates the establishment of phenotype-genotype correlations.Additionally,topics pertaining to patients' everyday lives,such as sudden cardiac death(SCD)risk stratification and prevention,along with disease prognosis,are grossly related to the genetic variation of HCM.This review incorporates contemporary research findings and addresses major aspects of HCM,including preclinical diagnosis,genetic analysis,left ventricular outflow tract obstruction and SCD.More specifically,the spectrum of genetic analysis,the selection of the best method for obstruction alleviation and the need for a unique and accuratefactor for SCD risk stratification are only some of the controversial HCM issues discussed.Additionally,future perspectives concerning HCM and myocardial ischemia,as well as atrial fibrillation,are discussed.Rather than enumerating clinical studies and guidelines,challenging problems concerning the disease are critically appraised by this review,highlighting current speculations and recommending future directions. | Georgios K Efthimiadis Efstathios D Pagourelias Thomas Gossios Thomas Zegkos | 2014 | World Journal of Cardiology2014，6，2： | 9 |
| 13 | Left atrial enlargement and non-paroxysmal atrial fibrillation as risk factors for left atrial thrombus/spontaneous Echo contrast in patients with atrial fibrillation and low CHA2DS2-VASc score显示文摘Objective To determine the risk factors for thromboembolism in lower risk patients with non-valvular atrial fibrillation(AF)and low CHA2DS2-VASc scores,which remain undefined.Methods We retrospectively analyzed the baseline clinical characteristics,routine laboratory parameters,and echocardiographic measurements of 705 patients(71.1%male;mean age:52.10±9.64 years)with low CHA2DS2-VASc score(0 or 1;1 point for female sex)out of 1346 consecutive patients with non-valvular AF who underwent transesophageal echocardiography(TEE)at Guangdong Cardiovascular Institute between January 2013 and December 2015.Results Patients with left atrial thrombus(LAT)or spontaneous echo contrast(SEC)on TEE(24/705,4%)showed a higher incidence rate of vascular disease(54.2%vs.32.9%,P=0.045)and non-paroxysmal AF(79.2%vs.29.4%,P<0.001),larger left atrial diameter(43.08±4.59 vs.36.02±5.53 mm,P<0.001),and lower left ventricular ejection fraction(58.23±8.82%vs.64.15±7.14%,P<0.001)than those without.Multivariate logistic regression analysis identified left atrial diameter[odds ratio(OR)=1.171,95%confidence interval(CI):1.084–1.265,P<0.001]and non-paroxysmal AF(OR=3.766,95%CI:1.282–11.061,P=0.016)as independent risk factors for LAT/SEC.In ROC curve analysis,a left atrial dimeter cutoff of 37.5 mm yielded 95.0%sensitivity and 62.7%specificity(AUC:0.847,P<0.0001,95%CI:0.793–0.914).Conclusion In patients with non-valvular AF with low CHA2DS2-VASc score,the presence of LAT or SEC was associated with left atrial enlargement,which had moderate predictive value,and non-paroxysmal AF. | Wei-Dong LIN Yu-Mei XUE Fang-Zhou LIU Xian-Hong FANG Xian-Zhang ZHAN Hong-Tao LIAO Gary Tse Shu-Lin WU | 2020 | Journal of Geriatric Cardiology2020，17，3： | 8 |
| 14 | Relationship between model for end-stage liver disease score and left ventricular function in patients with end-stage liver disease显示文摘BACKGROUND:Decreased cardiac contractility has been observed in cirrhosis,suggesting a latent cardiomyopathy in these patients.This study was designed to evaluate left ventricular structure and function in patients with end-stage liver disease by the model for end-stage liver disease(MELD) scoring system. METHODS:We recruited 82 patients(72 male,10 female; mean age 50.3±8.9 years)with end-stage liver disease who underwent orthotopic liver transplantation between January 2002 and May 2008.Seventy-eight patients had cirrhosis and 4 had primary liver cancer.Patients were categorized into three groups on the basis of MELD score:≤9(27 patients, 33%);10-19(40,49%);and≥20(15,18%).The relationship between MELD score and cardiac structure and function was determined.Preoperative assessments of blood biochemistry, blood coagulation,serum virology,echocardiography and electrocardiography were performed. RESULTS:MELD score was positively correlated with enlarged left atrial diameter,increased interventricular septum thickness(IVST),increased aortic flow,corrected QT interval (QTc)extension and cardiac output(P=0.033,0.002,0.000, 0.000 and 0.009,respectively).International normalized ratio also had a correlation with the above parameters and enlarged left ventricular end-diastolic diameter(P=0.043,0.010,0.000, 0.001,0.016 and 0.008,respectively).Serum creatinine was positively correlated with IVST(r=0.257,P=0.020),but negatively correlated with early maximal ventricular filling velocity/late diastolic or atrial velocity ratio(r=-0.300, P=0.006).A difference of QTc>440 ms among the three groups was statistically significant(χ2=9.791,P=0.007).CONCLUSIONS:Abnormalities in cardiac structure and function are common in patients with end-stage liver disease. MELD score is a practically useful approach for the assessment of cardiac function in such patients. | Fu-Rong Sun,Ying Wang,Bing-Yuan Wang,Jing Tong,Dai Zhang and Bing Chang Department of Gastroenterology,First Affiliated Hospital, China Medical University,Shenyang 110001,China | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，1： | 7 |
| 15 | Congenital left intrahepatic bile duct draining into gastric wall mimicking biliary reflux gastritis显示文摘Abnormalities and variations of the biliary ducts are not rare.Most aberrant bile ducts eventually drain into the descending part of duodenum through the papilla of vater.However,drainage of the left hepatic bile duct into the stomach is extremely rare.A 29-year old man was admitted to the hospital with the diagnosis of biliary reflux gastritis.Comprehensive imaging modalities were performed including electronic endoscopy,endoscopic ultrasonography,endoscopic retrograde cholangiopancreatography and magnetic resonance cholangio-pancreatography.Finally,congenital ectopic left intrahepatic bile duct draining into the stomach was found,which caused biliary reflux gastritis.The patient did not receive any surgery.Good recovery was achieved by medical treatment. | Jian Guan Ling Zhang Jian-Ping Chu Shao-Chun Lin Zi-Ping Li | 2015 | World Journal of Gastroenterology2015，21，11： | 7 |
| 16 | Caudal approach to pure laparoscopic posterior sectionectomy under the laparoscopy-specific view显示文摘AIM:To study our novel caudal approach laparoscopic posterior-sectionectomy with parenchymal transection prior to mobilization under laparoscopy-specific view.METHODS:Points of the procedure are:(1) Patients are put in left lateral position and posterior sector is not mobilized;(2) Glissonian pedicle of the sector is encircled and clamped extra-hepatically and divided afterward during the transection;(3) Dissection of inferior vena cava(IVC) anterior wall behind the liver is started from caudal.Simultaneously,liver transection is performed to search right hepatic vein(RHV) from caudal;(4) Liver transection proceeds to the bifurcation of the vessels from caudal to cranial,exposing the surfaces of IVC and RHV.Since the remnant liver sinks down,the cutting surface is well-opend;and(5) After the completion of transection,dissection of the resected liver from retroperitoneum is easily performed using the gravity.This approach was performed for a 63 years old woman with liver metastasis close to RHV.RESULTS:RHV exposure is required for R0 resection of the lesion.Although the cutting plane is horizontal in supine position and the gravity obstructs the exposure in the small subphrenic space,the use of specific characteristics of laparoscopic hepatectomy,such as the good vision for the dorsal part of the liver and IVC and facilitated dissection using the gravity with the patient positioning,made the complete RHV exposure during the liver transection easy to perform.The operation time was 341 min and operative blood loss was 1356 mL.Her postoperative hospital stay was uneventfull and she is well without any signs of recurrences 14 mo after surgery.CONCLUSION:The new procedure is feasible and useful for the patients with tumors close to RHV and the need of the exposure of RHV. | Hirokazu Tomishige Zenichi Morise Norihiko Kawabe Hidetoshi Nagata Hisanori Ohshima Jin Kawase Satoshi Arakawa Rie Yoshida Masashi Isetani | 2013 | World Journal of Gastrointestinal Surgery2013，5，6： | 7 |
| 17 | The Relationships between Serum Concentration of IGF-I and Left Ventricular Function as well as Coronary Collateral Circulation in Patients with Coronary Artery Disease显示文摘Objective To investigate therelationships between serum concentration of insulin -like growth factor - I (IGF-I) and left ventricular function as well as coronary collateral circulation in patients with coronary artery disease (CAD) . Methods In 41 patients with CAD and 15 control subjects without CAD, the concentrations of serum IGF - I were measured using radioimmunoassay. The relationships between the concentration of serum IGF - I and Leaman coronary artery score, Rentrop grade of coronary collateral circulation, left ventricular ejection fraction (LVEF) as well as left ventricular wall motion Cortina score were assessed. Results 1. There was no significant difference in the mean level of serum IGF -I between the CAD group and the control group (107. 92±44.74 ng/ml vs 113.05 ±33. 65 ng/ml, P> 0. 05), but the IGF - I concentrations in the subgroup with collateral circulation were significantly greater than that in the control group (147. 33 ±29. 92 ng/ml vs 113. 05±33. 65 ng/ml, P < 0. 01) or | 杜志民 罗初凡 胡承桓 李怡 伍贵富 唐安丽 马虹 | 2001 | South China Journal of Cardiology2001，2，1： | 6 |
| 18 | The right dual of left C-rpp semigroups显示文摘SEMIGROUP S is said to be rpp (dually, lpp) if every principal right ideal aS^1(S^1a) of S, re-garded as a right (left)S^1-system, is projective. The semigroup which is both rpp and lpp is said to be abundant. These kinds of generalized regular semigroups have aroused wideattention. The Green’s,relations (~*-Green’s relations introduced by Pastijn) have formed avery useful tool in study on regular (abundant) semigroups. In order to develop the study onrpp semigroups a step further, we introduced the so-called (1)-Green’s,relation which | GUO YuqiDepartment of Mathematics, Yunnan University, Kunming 650091, China | 1997 | Chinese Science Bulletin1997，42，19： | 6 |
| 19 | 超声评估左室流出道梗阻在肥厚型心肌病的临床意义显示文摘目的确定左室流出道梗阻(left ventricular outflow tract obstruction,LVOTO)在肥厚型心肌病(hypertrophic cardiomyopathy,HCM)的临床意义。方法用超声检查了52例HCM患者的压力阶差,以30 mmHg为界限值分为有梗阻组和无梗阻组,在平均随访(5.9±5.7)年后,用生存分析比较了两组患者的死亡率和发病率并确定了压力阶差与临床终末事件的关系。结果与无梗阻的患者相比,有梗阻组的患者猝死的风险是4.6倍(相对危险度4.6;P=0.047),发展为心力衰竭和中风的风险是3.2倍(相对危险度3.2;P=0.049)。校正年龄后的多变量Cox比例风险回归模型显示LVOTO是进入模型的唯一危险因素(猝死,相对危险度4.1,P=0.084;发展为心力衰竭和中风,相对危险度5.2,P=0.040)。结论 LVOTO是HCM患者猝死及发展为心力衰竭与中风的一个唯一的、独立的、较强的危险因素。压力阶差≥30 mmHg在HCM临床治疗决策中有重要意义。 | 李庆 索晓华 吕京敏 郑丽 | 2014 | 北京医学2014，36，4： | 5 |
| 20 | Right ventricular septal pacing: Safety and efficacy in a long term follow up显示文摘AIM: To evaluate the safety and efficacy of the permanent high interventricular septal pacing in a long term follow up, as alternative to right ventricular apical pacing. METHODS: We retrospectively evaluated:(1) 244 patients(74 ± 8 years; 169 men, 75 women) implanted with a single(132 pts) or dual chamber(112 pts) pacemaker(PM) with ventricular screw-in lead placed at the right ventricular high septal parahisian site(SEPTAL pacing);(2) 22 patients with permanent pacemaker and low percentage of pacing(< 20%)(NO pacing);(3) 33 patients with high percentage(> 80%) right ventricular apical pacing(RVA). All patients had a narrow spontaneous QRS(101 ± 14 ms). We evaluated New York Heart Association(NYHA) class, quality of life(Qo L), 6 min walking test(6MWT) and left ventricular function(end-diastolic volume, LV-EDV; end-systolic volume, LVESV; ejection fraction, LV-EF) with 2D-echocardiography. RESULTS: Pacing parameters were stable duringfollow up(21 mo/patient). In SEPTAL pacing group we observed an improvement in NYHA class, Qo L score and 6MWT. While LV-EDV didn't significantly increase(104 ± 40 m L vs 100 ± 37 m L; P = 0.35), LV-ESV slightly increased(55 ± 31 m L vs 49 ± 27 m L; P = 0.05) and LV-EF slightly decreased(49% ± 11% vs 53% ± 11%; P = 0.001) but never falling < 45%. In the RVA pacing control group we observed a worsening of NYHA class and an important reduction of LV-EF(from 56% ± 6% to 43% ± 9%, P < 0.0001).CONCLUSION: Right ventricular permanent high septal pacing is safe and effective in a long term follow up evaluation; it could be a good alternative to the conventional RVA pacing in order to avoid its deleterious effects. | Eraldo Occhetta Gianluca Quirino Lara Baduena Rosaria Nappo Chiara Cavallino Emanuela Facchini Paolo Pistelli Andrea Magnani Miriam Bortnik Gabriella Francalacci Gabriele Dell’Era Laura Plebani Paolo Marino | 2015 | World Journal of Cardiology2015，7，8： | 5 |
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