A 69-year-old man was admitted to our center to undergo catheter ablation of paroxysmal atrial fibrillation refractory to antiarrhythmic drug therapy. This procedure required access to the left atrium through the inte...A 69-year-old man was admitted to our center to undergo catheter ablation of paroxysmal atrial fibrillation refractory to antiarrhythmic drug therapy. This procedure required access to the left atrium through the interatrial septum. During hospitalization, the patient performed routinely pre-procedure transthoracic echocardiography and gadolinium-enhanced cardiac magnetic resonance showing a normal anatomy of both the fossa ovalis and the interatrial septum. Access to the left atrium proved difficult and several unsuccessful attempts to perform the trans-septal puncture were made under both fluoroscopy and intracardiac echocardiography guidance, even with radiofrequency energy delivery. Finally, trans-septal puncture was successfully carried out using a novel nitinol J-shaped "Safe Sept" trans-septal guidewire, designed to cross the interatrial septum through the trans-septal needle thanks to a special sharp tip. Moreover, thanks to its rounded J shape that reduces the risk of atrial perforation, the "Safe Sept" guidewire, when advanced into the left atrium, becomes atraumatic.展开更多
目的探讨血清代替血浆检测SEPT9基因甲基化在结直肠癌（CRC）诊断中的价值。方法收集70例CRC患者、38例腺瘤或息肉患者及15例其他肠道疾病患者血清样本。用Epi pro Colon 2.0试剂盒进行SEPT9基因甲基化检测,依据肠镜病理诊断进行验证,比...目的探讨血清代替血浆检测SEPT9基因甲基化在结直肠癌（CRC）诊断中的价值。方法收集70例CRC患者、38例腺瘤或息肉患者及15例其他肠道疾病患者血清样本。用Epi pro Colon 2.0试剂盒进行SEPT9基因甲基化检测,依据肠镜病理诊断进行验证,比较SEPT9、癌胚抗原（CEA）和粪便潜血试验（FOBT）的敏感性和特异性,并进行统计学分析。结果 CRC患者血清SEPT9的阳性率（81.4%）明显高于对照组（13.2%）,差异有统计学意义（χ2=92.814,P〈0.01）。CRC患者血清SEPT9的敏感性为81.4%（95%CI：72.4%-90.4%）、特异性为86.7%（95%CI：72.4%-100%）。临床分期为Ⅰ期的CRC患者SEPT9阳性率为42.9%,Ⅱ期为88.9%,Ⅲ期为82.4%,Ⅳ期为100%,差异有统计学意义（χ2=16.572,P〈0.01）。SEPT9的ROC曲线下面积（AUCROC）为0.841,明显高于CEA（0.716）和FOBT（0.792）。3者联合检测AUCROC可达0.935。结论血清SEPT9基因甲基化的检测是早期诊断CRC的有效方法,联合检测CEA及FOBT可以提高诊断效能。展开更多
文摘A 69-year-old man was admitted to our center to undergo catheter ablation of paroxysmal atrial fibrillation refractory to antiarrhythmic drug therapy. This procedure required access to the left atrium through the interatrial septum. During hospitalization, the patient performed routinely pre-procedure transthoracic echocardiography and gadolinium-enhanced cardiac magnetic resonance showing a normal anatomy of both the fossa ovalis and the interatrial septum. Access to the left atrium proved difficult and several unsuccessful attempts to perform the trans-septal puncture were made under both fluoroscopy and intracardiac echocardiography guidance, even with radiofrequency energy delivery. Finally, trans-septal puncture was successfully carried out using a novel nitinol J-shaped "Safe Sept" trans-septal guidewire, designed to cross the interatrial septum through the trans-septal needle thanks to a special sharp tip. Moreover, thanks to its rounded J shape that reduces the risk of atrial perforation, the "Safe Sept" guidewire, when advanced into the left atrium, becomes atraumatic.
文摘目的探讨血清代替血浆检测SEPT9基因甲基化在结直肠癌（CRC）诊断中的价值。方法收集70例CRC患者、38例腺瘤或息肉患者及15例其他肠道疾病患者血清样本。用Epi pro Colon 2.0试剂盒进行SEPT9基因甲基化检测,依据肠镜病理诊断进行验证,比较SEPT9、癌胚抗原（CEA）和粪便潜血试验（FOBT）的敏感性和特异性,并进行统计学分析。结果 CRC患者血清SEPT9的阳性率（81.4%）明显高于对照组（13.2%）,差异有统计学意义（χ2=92.814,P〈0.01）。CRC患者血清SEPT9的敏感性为81.4%（95%CI：72.4%-90.4%）、特异性为86.7%（95%CI：72.4%-100%）。临床分期为Ⅰ期的CRC患者SEPT9阳性率为42.9%,Ⅱ期为88.9%,Ⅲ期为82.4%,Ⅳ期为100%,差异有统计学意义（χ2=16.572,P〈0.01）。SEPT9的ROC曲线下面积（AUCROC）为0.841,明显高于CEA（0.716）和FOBT（0.792）。3者联合检测AUCROC可达0.935。结论血清SEPT9基因甲基化的检测是早期诊断CRC的有效方法,联合检测CEA及FOBT可以提高诊断效能。
