Three-dimensional electroanatomic mapping systems have demonstrated a significant reduction in radiation exposure during radiofrequency catheter ablation procedures. We aimed to investigate the safety, feasibility and efficacy of a completely zero-fluoroscopy approach for catheter ablation of supraventricular tachycardia using the Ensite NavX navigation system compared with a conventional fluoroscopy approach.A multicenter prospective non-randomized registry study was performed in seven centers from January 2013 to February 2018. Consecutive patients referred for catheter ablation of supraventricular tachycardia were assigned either to a completely zero-fluoroscopic approach (ZF) or conventional fluoroscopy approach (CF) according to the operator's preference. Patients with atrial tachycardia were excluded.Totally, 1020 patients were enrolled in ZF group; 2040 patients ablated by CF approach were selected for controls. There was no significant difference between the zero-fluoroscopy group and conventional fluoroscopy group as to procedure time (60.3 ± 20.3 vs. 59.7 ± 22.6 min, P = 0.90), immediate success rate of procedure (98.8% vs. 99.2%, P = 0.22), arrhythmia recurrence (0.4% vs. 0.5%, P = 0.85), total success rate of procedure (98.4% vs. 98.8%, P = 0.39) or complications (1.1% vs. 1.5%, P = 0.41). Compared with the conventional fluoroscopy approach, the zero-fluoroscopy approach provided similar outcomes without compromising the safety or efficacy of the procedure.The completely zero-fluoroscopy approach demonstrated safety and efficacy comparable to a conventional fluoroscopy approach for catheter ablation of supraventricular tachycardia, and mitigated radiation exposure to both patients and operators.clinicaltrials.gov Identifier: NCT03042078; first registered February 3, 2017; retrospectively registered.
Hydrogen sulfide (H2S) exerts an anti‑atherosclerotic effect and decreases foam cell formation. Lipoprotein‑associated phospholipase A2 (Lp‑PLA2) is a key factor involved in foam cell formation. However, the association between H2S and Lp‑PLA2 expression levels with respect to foam cell formation has not yet been elucidated. The present study investigated whether H2S can affect foam cell formation and potential signalling pathways via regulation of the expression and activity of Lp‑PLA2. Using human monocytic THP‑1 cells as a model system, it was observed that oxidized low‑density lipoprotein (ox‑LDL) not only upregulates the expression level and activity of Lp‑PLA2, it also downregulates the expression level and activity of Cystathionine γ lyase. Exogenous supplementation of H2S decreased the expression and activity of Lp‑PLA2 induced by ox‑LDL. Moreover, ox‑LDL induced the expression level and activity of Lp‑PLA2 via activation of the p38MAPK signalling pathway. H2S blocked the expression levels and activity of Lp‑PLA2 induced by ox‑LDL via inhibition of the p38MAPK signalling pathway. Furthermore, H2S inhibited Lp‑PLA2 activity by blocking the p38MAPK signaling pathway and significantly decreased lipid accumulation in ox‑LDL‑induced macrophages, as detected by Oil Red O staining. The results of the present study indicated that H2S inhibited ox‑LDL‑induced Lp‑PLA2 expression levels and activity by blocking the p38MAPK signalling pathway, thereby improving foam cell formation. These findings may provide novel insights into the role of H2S intervention in the progression of atherosclerosis.
At present, researchers generally focus on the problems of each module of the task-oriented dialogue systems, which is independent of each other. The underlying module cannot use the error information of the upper module. What's more, these methods need manually labeled data, which is created by hand and often too slow and expensive. In this paper, we propose an end-to-end approach to solve these problems. Based on the hierarchical structure of multi-turn dialogue systems, we construct two levels of attention mechanisms-one at the word level and one at the sentence level, which can make good use of context information. At the same time, we identify five key modeling and training techniques, and apply them to our model, yielding a new model of better performance in multi-turn dialogue systems. With evaluations on the Jing Dong Customer Service dataset 1 and the Ubuntu Dialogue Corpus dataset [1], we show that our model improves the conversation performance over previous end-to-end dialogue system methods. 1 It is a multi-turn conversation dataset for the 2018 JD Dialog Challenge.
Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation. However, this procedure remains complex and time-consuming, and the recurrence of AF after PVI is still unsatisfactory. Current technologies have improved our knowledge of the association between radiofrequency lesion creation and ablation parameters (power and duration), which triggered the development of high-power short-duration (HPSD). During the past decade, several preclinical and clinical studies have been conducted to confirm the feasibility, safety, and outcome of PVI ablation with HPSD or very high-power short-duration (vHPSD) settings, which increased electrophysiologists' interests in the utility of HPSD strategies. This paper describes the theoretical basis and recent research findings of HPSD or vHPSD ablation and summarizes the state-of-the-art evidence behind the role of this strategy in PVI.
Postpericardial injury syndrome (PPIS) is defined as pericarditis or pericardial effusion that results from recent myocardial infarction or intracardiac interventions. These symptoms typically include fever, leukocytosis, a high erythrocyte sedimentation rate, and elevated C-reactive protein levels. Additionally, pericardial effusion and pleural effusion may be present. It is considered to be a common complication in cardio-surgery with an occurrence of 3–30%. In the past 20 years, a high number of patients with atrial fibrillation have suffered from PPIS following radiofrequency catheter ablation. However, previous reports focused on identifying cardiac tamponade and pericardial effusion as their main clinical manifestations. Solitary pulmonary involvement following PPIS with the radiofrequency catheter ablation may occur. We report a case of PPIS that presented pleural effusion as the dominant feature soon after the operation and systematic review to illustrate the clinical characteristics of PPIS.
Objective: To investigate the value of serum anti-PLA2 R as a diagnostic marker of idiopathic membranous nephropathy( IMN). Methods: All available articles about serum anti-PLA2 R as a marker of IMN which were published at home and abroad from 2009. 1 to 2013. 12 were pooled from the databases of Pub Med,Elsevier,Springer,CNKI,VIP and Wanfang database et al. The quality of the papers were evaluated by the quality assessment for studies of diagnostic accuracy studies( QUADAS). And then a metaanalysis was conducted by the statistical softwares of Meta-Disc and Stata. The diagnostic value of serum anti-PLA2 R in IMN was evaluated by the statistical indicators of pooled sensitivity,pooled specificity,pooled likelihood ratio and summary receiver operating characteristic curve( ROC curve). Sensitivity analysis was performed by reducing a paper in order,and publication bias was tested by Egger funnel plot. Results: Seven articles were selected to the meta-analysis according to the inclusion criteria and 967 cases were included in the study( 454 IMN patients and 513 controls). Heterogeneity test showed no heterogeneity threshold effect( Spearman correlation coefficient was 0. 107,P = 0. 819),but there was heterogeneity caused by non threshold effects( Cochrane-Q was 16. 89,P = 0. 009 7). So random model was used to pool the effect size. The overall combined effect sizes: sensitivity was 69%,95% CI: 0. 65-0. 73; specificity:98%,95% CI: 0. 96-0. 99; pooled positive likelihood ratio 16. 37,95% CI: 4. 06-65. 95; pooled negative likelihood ratio 0. 32,95% CI:0. 24-0. 43; AUC of SROC: 0. 854 0,Q* = 0. 785 0. Sensitivity analysis showed that this research was stable and reliable and Egger funnel plot showed little publication bias. Conclusion: Serum anti-PLA2 R is an useful biomarker to the diagnosis of IMN.
Social media has been increasing sharply with the development of Web2.0. Entity disambiguation has attracted great attentions recently. Understanding Chinese micro-blogs is a challenging due to the inherent feature of Chinese language, the informal usage of the language and the wide variety of contents it covers. With BaiDu Encyclopedia Webpages, the info and label items, the basics for disambiguation are obtained. BaiDu Encyclopedia and Wikipedia Encyclopedia are used to build the mapping table. Entity disambiguation includes two tasks in this paper: (1)linking entities is mainly based on the created mapping table; (2)removing ambiguities of entities from micro-blogs is crucial in entity reorganization. An improved label disambiguation algorithm is proposed. Binomial classification based on Chinese Family Names is introduced for improvement. SVM model is applied for classifying the to-be-tested entity. We evaluate our method on the open data sets provided by NLP&&CC 2014. We achieved 84.02% in terms of accuracy. The average accuracy rate of all teams is 70.58%. Ours is much higher than the average level. It shows that the proposed method is promising. Our work can provide invaluable insights into entity disambiguation in Chinese micro-blogs.
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