As English and Chinese belong to different language families,the left and right branching structures in the two languages are both similar and different.Generally speaking,Chinese has a predominance of left-branching ...As English and Chinese belong to different language families,the left and right branching structures in the two languages are both similar and different.Generally speaking,Chinese has a predominance of left-branching structures and English has a predominance of right-branching structures.That is to say,Chinese is used to using left branches in its expressions,while English is used to using right branches in its expressions.展开更多
目的探讨左束支区域起搏(left bundle branch area pacing,LBBaP)对房室传导阻滞(AVB)患者术后新发心房颤动(new-onset atrial fibrillation,NOAF)和心房高频事件(atrial high rate episodes,AHREs)的影响。方法回顾性纳入84例行起搏治...目的探讨左束支区域起搏(left bundle branch area pacing,LBBaP)对房室传导阻滞(AVB)患者术后新发心房颤动(new-onset atrial fibrillation,NOAF)和心房高频事件(atrial high rate episodes,AHREs)的影响。方法回顾性纳入84例行起搏治疗的三度房室传导阻滞(ⅢAVB)患者,根据心室电极位置分为LBBaP组(n=42)和右室间隔部起搏(RVSP)组(n=42)。比较两组患者术前术后QRS波时限(QRSd)、心室起搏参数,并发症、脑卒中事件和NOAF、AHREs发生率。结果(1)LBBaP组术后NOAF、AHREs发生率均低于RVSP组(P<0.05)。(2)LBBaP组的p-QRSd短于RVSP组(P<0.05)。(3)两组患者心室起搏参数、并发症及脑卒中事件发生率之间差异无统计学意义(P>0.05)。结论相对于右室起搏,LBBaP术后AHREs、NOAF的发生率较低,可改善患者预后。展开更多
Pacemaker post-transcatheter aortic valve replacement is related to multifactorial risk.Nwaedozie et al brought to the body of evidence electrocardiogram and clinical findings.However,procedural characteristics have a...Pacemaker post-transcatheter aortic valve replacement is related to multifactorial risk.Nwaedozie et al brought to the body of evidence electrocardiogram and clinical findings.However,procedural characteristics have at least as much impact on the final need for a permanent pacemaker and potentially on the pacing rate.In this regard,long-term follow-up and understanding of the impact of long-term stimulation is of utmost importance.展开更多
目的评估右心室起搏后,患起搏诱导性心肌病的老年病人升级至希浦系统起搏的临床疗效和安全性。方法在PubMed、Cochrane Library、Web of Science、Embase、中国知网、万方数据库、维普数据库检索希浦系统起搏对起搏诱导性心肌病疗效的...目的评估右心室起搏后,患起搏诱导性心肌病的老年病人升级至希浦系统起搏的临床疗效和安全性。方法在PubMed、Cochrane Library、Web of Science、Embase、中国知网、万方数据库、维普数据库检索希浦系统起搏对起搏诱导性心肌病疗效的相关文献,提取研究中有关临床获益和安全性的数据,在RevMan 5.4软件上进行Meta分析。结果共纳入8篇文献,包括185例病人,升级希浦系统起搏的成功率为95%。Meta分析结果显示:升级希浦系统起搏后,随访期间病人的左心室射血分数(MD=-11.73,95%CI:-14.74~-8.72,P<0.01)较升级术前提高,QRS波时限(MD=59.84,95%CI:55.98~63.70,P<0.01)较升级术前缩短,NYHA心功能分级(MD=1.05,95%CI:0.70~1.41,P<0.01)较升级术前明显降低,差异均有统计学意义。起搏阈值(MD=-0.11,95%CI:-0.24~0.02,P=0.08)和R波振幅(MD=-0.35,95%CI:-1.94~1.24,P=0.66)升级术前后差异无统计学意义。同时研究中观察到2例病人死亡。结论对于老年起搏诱导性心肌病病人,可考虑升级起搏方式为希浦系统起搏,不仅可以纠正长期右心室起搏引起的心脏电不同步和心室重塑,同时也能改善病人的临床心功能并减少手术相关并发症。展开更多
This letter is regarding the study titled‘Targeted puncture of left branch of intrahepatic portal vein in transjugular intrahepatic portosystemic shunt(TIPS)to reduce hepatic encephalopathy’.Prior to the approval of...This letter is regarding the study titled‘Targeted puncture of left branch of intrahepatic portal vein in transjugular intrahepatic portosystemic shunt(TIPS)to reduce hepatic encephalopathy’.Prior to the approval of TIPS dedicated stents(Viatorr stents)in China in October 2015,Fluency covered stents were typically used.As Fluency covered stents have a strong support force and axial elastic tension,a‘cap’may form if the stent is located too low at the end of the hepatic vein or too short at the end of the portal vein during surgery,leading to stent dysfunction.Since the blood shunted by the stent is from the main trunk of the portal vein,the correlation between the incidence of postoperative hepatic encephalopathy and the location of the puncture target(left or right portal vein branch)is worth discussion.Notably,no studies in China or foreign countries have proven the occurrence of left and right blood stratification after the accumulation of splenic vein and mesenteric blood flow in the main trunk of the portal vein in patients with cirrhotic portal hypertension.展开更多
We report an unusual case of an isolated right ventricular infarction with haemodynamic compromise caused by spontaneous isolated proximal occlusion of the right ventricular branch of the right coronary artery(RCA), s...We report an unusual case of an isolated right ventricular infarction with haemodynamic compromise caused by spontaneous isolated proximal occlusion of the right ventricular branch of the right coronary artery(RCA), successfully treated by balloon angioplasty. A 58-yearold gentleman presented with epigastric pain radiating into both arms. Electrocardiograph with right ventricular leads confirmed ST elevation in V4 R and a diagnosis of isolated right ventricular infarction was made. Urgent primary percutaneous intervention was performed which revealed occlusion of the right ventricular branch of the RCA. During the procedure, the patient's blood pressure dropped to 80/40 mm Hg, and echocardiography showed impaired right ventricular systolic function. Despite aggressive fluid resuscitation, the patient remained hypotensive, continued to have chest pain and persistent electrocardiograph changes, and hence balloon angioplasty was performed on the proximal right ventricular branch which restored flow to the vessel and revealed a severe ostial stenosis. This was treated with further balloon angioplasty which restored TIMI 3 flow with resolution of patient's symptoms. Repeat echocardiography showed complete resolution of theST-elevation in leads V4 R and V5 R and partial resolution in V1. Subsequent dobutamine-stress echocardiography at 4 wk showed good left and right ventricular contractions. The patient was discharged after a 3-d inpatient stay without any complications.展开更多
基金sponsored by the teaching program“English Grammar” (No.209/1541801009).
文摘As English and Chinese belong to different language families,the left and right branching structures in the two languages are both similar and different.Generally speaking,Chinese has a predominance of left-branching structures and English has a predominance of right-branching structures.That is to say,Chinese is used to using left branches in its expressions,while English is used to using right branches in its expressions.
文摘目的探讨左束支区域起搏(left bundle branch area pacing,LBBaP)对房室传导阻滞(AVB)患者术后新发心房颤动(new-onset atrial fibrillation,NOAF)和心房高频事件(atrial high rate episodes,AHREs)的影响。方法回顾性纳入84例行起搏治疗的三度房室传导阻滞(ⅢAVB)患者,根据心室电极位置分为LBBaP组(n=42)和右室间隔部起搏(RVSP)组(n=42)。比较两组患者术前术后QRS波时限(QRSd)、心室起搏参数,并发症、脑卒中事件和NOAF、AHREs发生率。结果(1)LBBaP组术后NOAF、AHREs发生率均低于RVSP组(P<0.05)。(2)LBBaP组的p-QRSd短于RVSP组(P<0.05)。(3)两组患者心室起搏参数、并发症及脑卒中事件发生率之间差异无统计学意义(P>0.05)。结论相对于右室起搏,LBBaP术后AHREs、NOAF的发生率较低,可改善患者预后。
文摘Pacemaker post-transcatheter aortic valve replacement is related to multifactorial risk.Nwaedozie et al brought to the body of evidence electrocardiogram and clinical findings.However,procedural characteristics have at least as much impact on the final need for a permanent pacemaker and potentially on the pacing rate.In this regard,long-term follow-up and understanding of the impact of long-term stimulation is of utmost importance.
文摘目的评估右心室起搏后,患起搏诱导性心肌病的老年病人升级至希浦系统起搏的临床疗效和安全性。方法在PubMed、Cochrane Library、Web of Science、Embase、中国知网、万方数据库、维普数据库检索希浦系统起搏对起搏诱导性心肌病疗效的相关文献,提取研究中有关临床获益和安全性的数据,在RevMan 5.4软件上进行Meta分析。结果共纳入8篇文献,包括185例病人,升级希浦系统起搏的成功率为95%。Meta分析结果显示:升级希浦系统起搏后,随访期间病人的左心室射血分数(MD=-11.73,95%CI:-14.74~-8.72,P<0.01)较升级术前提高,QRS波时限(MD=59.84,95%CI:55.98~63.70,P<0.01)较升级术前缩短,NYHA心功能分级(MD=1.05,95%CI:0.70~1.41,P<0.01)较升级术前明显降低,差异均有统计学意义。起搏阈值(MD=-0.11,95%CI:-0.24~0.02,P=0.08)和R波振幅(MD=-0.35,95%CI:-1.94~1.24,P=0.66)升级术前后差异无统计学意义。同时研究中观察到2例病人死亡。结论对于老年起搏诱导性心肌病病人,可考虑升级起搏方式为希浦系统起搏,不仅可以纠正长期右心室起搏引起的心脏电不同步和心室重塑,同时也能改善病人的临床心功能并减少手术相关并发症。
文摘This letter is regarding the study titled‘Targeted puncture of left branch of intrahepatic portal vein in transjugular intrahepatic portosystemic shunt(TIPS)to reduce hepatic encephalopathy’.Prior to the approval of TIPS dedicated stents(Viatorr stents)in China in October 2015,Fluency covered stents were typically used.As Fluency covered stents have a strong support force and axial elastic tension,a‘cap’may form if the stent is located too low at the end of the hepatic vein or too short at the end of the portal vein during surgery,leading to stent dysfunction.Since the blood shunted by the stent is from the main trunk of the portal vein,the correlation between the incidence of postoperative hepatic encephalopathy and the location of the puncture target(left or right portal vein branch)is worth discussion.Notably,no studies in China or foreign countries have proven the occurrence of left and right blood stratification after the accumulation of splenic vein and mesenteric blood flow in the main trunk of the portal vein in patients with cirrhotic portal hypertension.
文摘We report an unusual case of an isolated right ventricular infarction with haemodynamic compromise caused by spontaneous isolated proximal occlusion of the right ventricular branch of the right coronary artery(RCA), successfully treated by balloon angioplasty. A 58-yearold gentleman presented with epigastric pain radiating into both arms. Electrocardiograph with right ventricular leads confirmed ST elevation in V4 R and a diagnosis of isolated right ventricular infarction was made. Urgent primary percutaneous intervention was performed which revealed occlusion of the right ventricular branch of the RCA. During the procedure, the patient's blood pressure dropped to 80/40 mm Hg, and echocardiography showed impaired right ventricular systolic function. Despite aggressive fluid resuscitation, the patient remained hypotensive, continued to have chest pain and persistent electrocardiograph changes, and hence balloon angioplasty was performed on the proximal right ventricular branch which restored flow to the vessel and revealed a severe ostial stenosis. This was treated with further balloon angioplasty which restored TIMI 3 flow with resolution of patient's symptoms. Repeat echocardiography showed complete resolution of theST-elevation in leads V4 R and V5 R and partial resolution in V1. Subsequent dobutamine-stress echocardiography at 4 wk showed good left and right ventricular contractions. The patient was discharged after a 3-d inpatient stay without any complications.
