Background One of the major challenges in arrhythmogenic right ventricular cardiomyopathy （ARVC） ablation is ventricular tachy-cardia （VT） non-inducibility. The study aimed to assess whether fast rate （≥ 250 bea...Background One of the major challenges in arrhythmogenic right ventricular cardiomyopathy （ARVC） ablation is ventricular tachy-cardia （VT） non-inducibility. The study aimed to assess whether fast rate （≥ 250 beats/min） right ventricular burst stimulation was useful for VT induction in patients with ARVC.Methods Ninety-one consecutive ARVC patients with clinical sustained VT that underwent electro-physiological study were enrolled. The stimulation protocol was implemented at both right ventricular apex and outflow tract as follows： Step A, up to double extra-stimuli; Step B, incremental stimulation with low rate （＆lt; 250 beats/min）; Step C, burst stimulation with fast rate （≥ 250 beats/min）; Step D, repeated all steps above with intravenous infusion of isoproterenol.Results A total of 76 patients had inducible VT （83.5%）, among which 49 were induced by Step C, 15 were induced by Step B, 8 and 4 by Step A and D, respectively. Clinical VTs were induced in 60 patients （65.9%）. Only two spontaneously ceased ventricular fibrillations were induced by Step C. Multivariate analysis showed that a narrower baseline QRS duration under sinus rhythm was independently associated with VT non-inducibility （OR： 1.1; 95% CI： 1.0-1.1;P = 0.019）.ConclusionFast rate （≥ 250 beats/min） right ventricular burst stimulation provides a useful supplemental method for VT induction in ARVC patients.展开更多
This paper traces the social limitations in the development of Asian American literature. The label ＂Asian American literature＂ is so instrumental in instituting the literature, can also regulate creativity. As a st...This paper traces the social limitations in the development of Asian American literature. The label ＂Asian American literature＂ is so instrumental in instituting the literature, can also regulate creativity. As a strategic term and group identification, ＂Asian American＂ lends itself to the illusion of unity and homogeneity. Scholars differ in the way they elect to demarcate Asian American literature. One of the fundamental barriers to understanding and appreciating Asian American literary expression has been the existence of race stereotypes about Asians in American popular culture. For many Asian American writers, ethnic authenticity is a necessary but weak choice Most early immigrant writers write to challenge the negative view of Asia in the West and see themselves as ambassadors of goodwill to the West. The purpose is to mark difference as exotica and appeal to the benign curiosity of the Western readers while appeal to notions of universal humanity. This type of strong ethnic quotient writing continues to exist in various guises even today. The trade publishers have a predilection for Asian American personal narratives that stress the ＂model minority＂ discourse, ＂good workers＂ image, and Asian Americans＇ ability to accommodate to the basic rules of American society. Asian American writers never stop attempting to build bridges. But we should remind ourselves that boundary crossing must not be merely an aesthetic and intellectual exercise .展开更多
The paper intends to study the formation of the spirit of independence, curiosity, innovation and benevolence which the university teachers in Medieval Europe had under the specific social and historical conditions. B...The paper intends to study the formation of the spirit of independence, curiosity, innovation and benevolence which the university teachers in Medieval Europe had under the specific social and historical conditions. Based on this, by contrast the current crisis of spirits of medieval university teachers in modem society, the paper also analyzes the reasons and tries to find out the mechanism to cultivate the spirit of the university teachers in modem society.展开更多
AIM To compare the aspiration needle(AN) and core biopsy needle(PC) in endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) of abdominal masses.METHODS Consecutive patients referred for EUS-FNA were included i...AIM To compare the aspiration needle(AN) and core biopsy needle(PC) in endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) of abdominal masses.METHODS Consecutive patients referred for EUS-FNA were included in this prospective single-center trial. Each patient underwent a puncture of the lesion with both standard 22-gauge(G) AN(Echo Tip Ultra; Cook Medical, Bloomington, Indiana, United States) and the novel 22 G PC(Echo Tip Pro Core; Cook Medical, Bloomington, Indiana, United States) in a randomized fashion; histology was attempted in the PC group only. The main study endpoint was the overall diagnostic accuracy, including the contribution of histology to the final diagnosis. Secondary outcome measures included material adequacy, number of needle passes, and complications.RESULTS Fifty six consecutive patients(29 men; mean age 68 years) with pancreatic lesions(n = 38), lymphadenopathy(n = 13), submucosal tumors(n = 4), or others lesions(n = 1) underwent EUS-FNA using both of the needles in a randomized order. AN and PC reached similar overall results for diagnostic accuracy(AN: 88.9 vs PC: 96.1, P = 0.25), specimen adequacy(AN: 96.4% vs PC: 91.1%, P = 0.38), mean number of passes(AN: 1.5 vs PC: 1.7, P = 0.14), mean cellularity score(AN: 1.7 vs PC: 1.1, P = 0.058), and complications(none). A diagnosis on the basis of histology was achieved in the PC group in 36(64.3%) patients, and in 2 of those as the sole modality. In patients with available histology the mean cellularity score was higher for AN(AN: 1.7 vs PC: 1.0, P = 0.034); no other differences were of statistical significance.CONCLUSION Both needles achieved high overall diagnostic yields and similar performance characteristics for cytological diagnosis; histological analysis was only possible in 2/3 of cases with the new needle.展开更多
文摘Background One of the major challenges in arrhythmogenic right ventricular cardiomyopathy （ARVC） ablation is ventricular tachy-cardia （VT） non-inducibility. The study aimed to assess whether fast rate （≥ 250 beats/min） right ventricular burst stimulation was useful for VT induction in patients with ARVC.Methods Ninety-one consecutive ARVC patients with clinical sustained VT that underwent electro-physiological study were enrolled. The stimulation protocol was implemented at both right ventricular apex and outflow tract as follows： Step A, up to double extra-stimuli; Step B, incremental stimulation with low rate （＆lt; 250 beats/min）; Step C, burst stimulation with fast rate （≥ 250 beats/min）; Step D, repeated all steps above with intravenous infusion of isoproterenol.Results A total of 76 patients had inducible VT （83.5%）, among which 49 were induced by Step C, 15 were induced by Step B, 8 and 4 by Step A and D, respectively. Clinical VTs were induced in 60 patients （65.9%）. Only two spontaneously ceased ventricular fibrillations were induced by Step C. Multivariate analysis showed that a narrower baseline QRS duration under sinus rhythm was independently associated with VT non-inducibility （OR： 1.1; 95% CI： 1.0-1.1;P = 0.019）.ConclusionFast rate （≥ 250 beats/min） right ventricular burst stimulation provides a useful supplemental method for VT induction in ARVC patients.
文摘This paper traces the social limitations in the development of Asian American literature. The label ＂Asian American literature＂ is so instrumental in instituting the literature, can also regulate creativity. As a strategic term and group identification, ＂Asian American＂ lends itself to the illusion of unity and homogeneity. Scholars differ in the way they elect to demarcate Asian American literature. One of the fundamental barriers to understanding and appreciating Asian American literary expression has been the existence of race stereotypes about Asians in American popular culture. For many Asian American writers, ethnic authenticity is a necessary but weak choice Most early immigrant writers write to challenge the negative view of Asia in the West and see themselves as ambassadors of goodwill to the West. The purpose is to mark difference as exotica and appeal to the benign curiosity of the Western readers while appeal to notions of universal humanity. This type of strong ethnic quotient writing continues to exist in various guises even today. The trade publishers have a predilection for Asian American personal narratives that stress the ＂model minority＂ discourse, ＂good workers＂ image, and Asian Americans＇ ability to accommodate to the basic rules of American society. Asian American writers never stop attempting to build bridges. But we should remind ourselves that boundary crossing must not be merely an aesthetic and intellectual exercise .
文摘The paper intends to study the formation of the spirit of independence, curiosity, innovation and benevolence which the university teachers in Medieval Europe had under the specific social and historical conditions. Based on this, by contrast the current crisis of spirits of medieval university teachers in modem society, the paper also analyzes the reasons and tries to find out the mechanism to cultivate the spirit of the university teachers in modem society.
文摘AIM To compare the aspiration needle(AN) and core biopsy needle(PC) in endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) of abdominal masses.METHODS Consecutive patients referred for EUS-FNA were included in this prospective single-center trial. Each patient underwent a puncture of the lesion with both standard 22-gauge(G) AN(Echo Tip Ultra; Cook Medical, Bloomington, Indiana, United States) and the novel 22 G PC(Echo Tip Pro Core; Cook Medical, Bloomington, Indiana, United States) in a randomized fashion; histology was attempted in the PC group only. The main study endpoint was the overall diagnostic accuracy, including the contribution of histology to the final diagnosis. Secondary outcome measures included material adequacy, number of needle passes, and complications.RESULTS Fifty six consecutive patients(29 men; mean age 68 years) with pancreatic lesions(n = 38), lymphadenopathy(n = 13), submucosal tumors(n = 4), or others lesions(n = 1) underwent EUS-FNA using both of the needles in a randomized order. AN and PC reached similar overall results for diagnostic accuracy(AN: 88.9 vs PC: 96.1, P = 0.25), specimen adequacy(AN: 96.4% vs PC: 91.1%, P = 0.38), mean number of passes(AN: 1.5 vs PC: 1.7, P = 0.14), mean cellularity score(AN: 1.7 vs PC: 1.1, P = 0.058), and complications(none). A diagnosis on the basis of histology was achieved in the PC group in 36(64.3%) patients, and in 2 of those as the sole modality. In patients with available histology the mean cellularity score was higher for AN(AN: 1.7 vs PC: 1.0, P = 0.034); no other differences were of statistical significance.CONCLUSION Both needles achieved high overall diagnostic yields and similar performance characteristics for cytological diagnosis; histological analysis was only possible in 2/3 of cases with the new needle.
