Long-term comparison of full-bed deep anterior lamellar keratoplasty and penetrating keratoplasty in treating keratoconus

Objective

To compare postoperative outcomes of full-bed deep anterior lamellar keratoplasty (DALK) with penetrating keratoplasty (PK) in treating keratoconus.

Methods

Seventy-five eyes of 64 patients who received full-bed DALK and 52 eyes of 51 patients who received PK between June 2000 and August 2010 were included in this retrospective study. Full-bed DALK was performed using Yao’s hooking-detaching technique. PK was performed using a standard technique. Intraoperative and postoperative complications, visual acuity, rejection, graft survival, endothelial cell density, corneal sensation recovery, and re-innervation were compared between the two groups.

Results

A best correct visual acuity of 0.5 or better was achieved in 90.7% of eyes after full-bed DALK and in 92.3% of eyes after PK (P=0.75). By the fifth postoperative year, graft endothelial cell loss reached 34.6% in the PK group vs. 13.9% in the full-bed DALK group (P<0.001). There were no statistical differences in corneal sensitivity recovery or corneal re-innervation between the groups (P>0.05). Intraoperative microperforation occurred in seven out of 75 (9.3%) eyes with a temporally postoperative double anterior chamber in two eyes in the full-bed DALK group. Postoperative complications in the PK vs. the full-bed DALK groups respectively were: rejection (7.7% vs. 0%, P=0.015), high intraocular pressure (IOP) (46.2% vs. 1.3%, P<0.001), secondary glaucoma (9.6% vs. 0%, P=0.006), complicated cataract (19.2% vs. 0%, P<0.001), and wound dehiscence (9.6% vs. 0%, P=0.006).

Conclusions

Both full-bed DALK and PK can offer long-term satisfactory visual outcomes for keratoconus. Graft rejection, secondary glaucoma, complicated cataracts, and constant endothelial cell loss were observed in eyes only after PK.     

Factors underlying the association of body mass index with serum ALT in Chinese hypertensive adults without known hepatic diseases

Objective:High body mass index (BMI) is considered as the most important risk factor for elevated serum alanine aminotransferase (ALT) concentration. This study examined an array of factors, including waist circumference (WC) and folate deficiency, which may mediate the association of BMI with serum ALT concentration in Chinese hypertensive adults without known hepatic diseases. Methods:A multicenter, cross-sectional study was carried out. A total of 378 patients with mild or moderate hypertension and without known hepatic diseases were recruited from five hospitals in Harbin, Shanghai, Beijing, Xi’an, and Nanjing. Results:Of the 360 hypertensive patients with complete data in our final analysis, 13.6% had high ALT concentrations (>40 IU/L). Factors including BMI, WC, triglyceride level, and folate concentration were associated with ALT concentration in univariate analysis. Consistently higher prevalence rates of elevated ALT were observed in subjects with lower folate concentrations (≥12 vs. <12 nmol/L, 9.9% vs. 17.8%, P=0.03), with higher BMI (≥28 vs. <28 kg/m2, 21.5% vs. 11.4%, P=0.02) or higher WC (≥90 vs. <90 cm, 18.5% vs. 10.0%, P=0.02). However, in multivariate analysis, the association between BMI and ALT concentration disappeared (P=0.802 in males and 0.369 in females), while WC in females (P<0.001) and folate concentration (P=0.036 in males and 0.044 in females) remained as significant predictors for ALT concentration. Conclusions:This multicenter study demonstrated that WC and low folate concentration were important factors underlying the association between BMI and ALT concentrations in Chinese hypertensive adults without known hepatic diseases.     

Effects of Huangqi and bear bile on recurrent parotitis in children: a new clinical approach

Objective:To evaluate the pharmacological effects of traditional Chinese medicine,bear bile capsule and Huangqi granule,on recurrent parotitis in children.Methods:In this prospective,controlled,and randomized study,a total of 151 young children were divided into three groups:Group A included massaging the children’s parotid region and melting vitamin C in their mouth daily;Group B included swallowing bear bile capsule and Huangqi granule daily;and Group C included massages and vitamin C as prescribed in Group A,and traditional Chinese medicine as prescribed in Group B.Children were treated individually for one month and then a follow-up study was conducted for 1 to 3.5 years.Analysis of variance(ANOVA) and Ridit analysis were employed for statistical analysis.Results:The recurrence rate decreased in every group,but was significantly more in Groups B and C when compared to Group A.The recurrences significantly decreased(P<0.01) in Group B and their recovery rate was as high as 63%,significantly better than those of the other groups(P<0.01).Conclusions:Huangqi and bear bile could be a novel clinical approach for treating recurrent parotitis in children.     

Periodontal status and associated risk factors among childbearing age women in Cixi City of China

Objective:To investigate the periodontal status and associated risk factors among women of childbearing age to increase the awareness of oral health.Methods:The study was conducted on childbearing age women in Cixi,a city in Zhejiang Province in the southeast of China.A total of 754 women participated in periodontal examination while receiving prenatal care.Data of the women were collected from the Cixi Family Planning Commission and during an interview.Clinical periodontal indices,such as bleeding on probing(BOP),probing depth(PD),and clinical attachment level(CAL) were measured during the examination.Statistical analysis on subject-based data was performed.Results:The prevalence of periodontal disease among childbearing age women in Cixi was high(84.7%).A significant association was found between the disease and educational level,pregnancy,taking oral contraceptives,stress,alcohol consumption,overweight,dental visit,and teeth brushing(P<0.05).Women who suffered periodontal disease showed deep PD,obvious BOP,and clinical attachment loss.Among this population,pregnancy was closely associated with higher BOP percentage;teeth brushing no more than once per day or brushing for less than 1 min(P<0.001) after adjusting for age and stress.Conclusions:The periodontal status of childbearing age women in Cixi needs to be improved urgently.Attention towards the periodontal health should be warranted,especially for those in special statuses and with poor awareness.     

Effects of zinc-substituted nano-hydroxyapatite coatings on bone integration with implant surfaces

Objective:The purpose of this study was to investigate the effects of a zinc-substituted nano-hydroxyapatite(Zn-HA) coating,applied by an electrochemical process,on implant osseointegraton in a rabbit model.Methods:A Zn-HA coating or an HA coating was deposited using an electrochemical process.Surface morphology was examined using field-emission scanning electron microscopy.The crystal structure and chemical composition of the coatings were examined using an X-ray diffractometer(XRD) and Fourier transform infrared spectroscopy(FTIR).A total of 78 implants were inserted into femurs and tibias of rabbits.After two,four,and eight weeks,femurs and tibias were retrieved and prepared for histomorphometric evaluation and removal torque(RTQ) tests.Results:Rod-like HA crystals appeared on both implant surfaces.The dimensions of the Zn-HA crystals seemed to be smaller than those of HA.XRD patterns showed that the peaks of both coatings matched well with standard HA patterns.FTIR spectra showed that both coatings consisted of HA crystals.The Zn-HA coating significantly improved the bone area within all threads after four and eight weeks(P<0.05),the bone to implant contact(BIC) at four weeks(P<0.05),and RTQ values after four and eight weeks(P<0.05).Conclusions:The study showed that an electrochemically deposited Zn-HA coating has potential for improving bone integration with an implant surface.     

冰片在中风及假手术大鼠体内的药代动力学研究(英文)简

Objective： This study was designed to investigate the pharmacokinetics of borneol in the pathological conditions of stroke and evaluate the pharmacokinetic differences of borneol caused by stroke after oral administration of borneol and Xingnaojing （XNJ）. Methods： The rats were divided into two groups, ischemia-reperfusion （IR） and sham-operated （SO） rats. Each group contained two subgroups： pure borneol and XNJ subgroups. After administration with the same dosages of borneol 162.0 mg/kg, plasma samples were collected. The cerebral ischemia-reperfusion model was created by reversible middle cerebral artery occlusion （MCAO）. The blood samples were collected punc- tually after oral administration and a specific gas chromatographic system-flame ionization detector （GC-FID） method was developed and employed to determine the level of borneol in the plasma. The pharmacokinetic parameters were analyzed using non-compartmental methods with Kinetica. Results： After administration of borneol, the maximum plasma concentration （Cmax） and area under the curve （AUC） values in stroke rats significantly increased by 302% and 275%, respectively, compared with the SO rats, and the same phenomenon appeared after administration of XNJ. In the rats with the same physiological conditions, the Cmax and AUC had higher values in the borneol subgroup （P〈0.05）. Conclusions： These results suggest that the pathological damages of ischemia-reperfusion have a significant impact on the pharmacokinetic traits of borneol and that there are some components in XNJ inhibiting the absorption of borneol.     

Systematic review of laparoscopy-assisted versus open gastrectomy for advanced gastric cancer

Objective

The study compared laparoscopy-assisted gastrectomy (LAG) with open gastrectomy (OG) in the management of advanced gastric cancer (AGC).

Methods

Literature search was performed in the Medline, Embase, and Cochrane Library databases to identify control studies that compared LAG and OG for AGC. A meta-analysis was conducted to examine the surgical safety and oncologic adequacy, using the random-effect model.

Results

Seven eligible studies including 815 patients were analyzed. LAG was associated with less blood loss, less use of analgesics, shorter time of flatus and periods of hospital stay, but longer time of operation. The incidence of most complications was similar between the two groups. However, LAG was associated with a lower rate of pulmonary infection (odds ratio (OR) 0.19; 95% confidence interval (CI) 0.05 to 0.68; P<0.05). No significant differences were noted in terms of the number of harvested lymph nodes (weighted mean difference (WMD) 1.165; 95% CI–2.000 to 4.311; P>0.05), overall mortality (OR 0.65; 95% CI 0.39 to 1.10; P>0.05), cancer-related mortality (OR 0.64; 95% CI 0.32 to 1.25; P>0.05), or recurrence (OR 0.62; 95% CI 0.33 to 1.16; P>0.05).

Conclusions

LAG could be performed safely for AGC with adequate lymphadenectomy and has several short-term advantages compared with conventional OG. No differences were found in long-term outcomes. However, these results should be validated in large randomized controlled studies (RCTs) with sufficient follow-up.     

Serum lipids and other risk factors for diabetic retinopathy in Chinese type 2 diabetic patients

Objective

To investigate the association of serum lipids and other risk factors with diabetic retinopathy (DR) in Chinese type 2 diabetic patients.

Methods

Five hundred and twenty-three type 2 diabetic patients underwent ophthalmic examination by experienced retinal specialists to assess their DR. Serum lipids, including triglycerides, total cholesterol, high density lipoprotein cholesterol (HDLC), and low density lipoprotein cholesterol (LDLC), were measured using Roche automated clinical chemistry analyzers. The concentration of very low density lipoprotein cholesterol (VLDLC) was calculated based on total cholesterol, HDLC and LDLC. Hyperlipidemia was defined as a total cholesterol concentration of 6.2 mmol/L or higher or the use of lipid-lowering medications. The association of risk factors with any DR or proliferative diabetic retinopathy (PDR) was assessed using the odds ratio (OR) and its 95% confidence interval (CI), calculated from logistic regression models.

Results

In multivariate logistic regression models, hyperlipidemia (OR=2.39, 95% CI: 1.02–5.66), higher VLDLC (OR=1.59, 95% CI: 1.14–2.23), and higher triglyceride (OR=1.18, 95% CI: 1.03–1.37) were associated with increased risk of DR. A longer diabetic duration was associated with increased risk of DR (P<0.0001) and PDR (P=0.002) in a dose-response manner. Higher systolic blood pressure (P=0.02) and higher serum creatinine (P=0.01) were independently associated with increased risk of DR, and female gender was associated with increased risk of PDR (P=0.03).

Conclusions

Among Chinese type 2 diabetic patients, hyperlipidemia, higher VLDLC, and higher triglyceride were independently associated with increased risk of DR, suggesting control of serum lipids may decrease the risk of DR.     

Effects of orthodontic load on the periodontium of autogenously transplanted teeth in beagle dogs

Objective:To observe the periodontal healing of autogenously transplanted teeth loaded orthodontically after autotransplantation in Beagle dogs.Methods:Forty-eight teeth were autogenously transplanted,24 of which were loaded postoperatively with orthodontic force at different time points and for different durations.Periodontal healing was evaluated by probing pocket depth(PPD),the expression of relevant proteins,and histomorphometric analyses.Results:The dental pockets of loaded and non-loaded teeth were both much deeper after the first postoperative week than before transplantation(P<0.05).Later,the PPD,which was measured after postoperative weeks 1,3,5,9 and 13,gradually became shallow.The expressions of alkaline phosphatase(ALP)and basic fibroblast growth factor(bFGF)were higher in loaded teeth than in non-loaded teeth(P<0.05),and in groups subjected to two weeks duration of loading than in other groups at the same load time point(P<0.05).For the same load duration,the expressions of ALP and bFGF in teeth loaded after postoperative week 4 were higher than those of other treatments(P<0.05).According to histomorphometric analyses,an orthodontic force on transplanted teeth applied after postoperative weeks 4 or 8 for two weeks duration should be favorable for periodontal healing.Conclusions:It is advisable to apply an appropriate magnitude of force on autotransplanted teeth,such as orthodontic force,at appropriate time points and for a suitable duration,to achieve the optimal clinical prognosis following autogenous tooth transplantation.These results may serve as a basis for subsequent studies in humans so as to make clinical improvements.     

Streptomycin inhibits electrophysiological changes induced by stretching of chronically infarcted rat hearts

Objective

To investigate stretch-induced electrophysiological changes in chronically infarcted hearts and the effect of streptomycin (SM) on these changes in vivo.

Methods

Sixty Wistar rats were divided randomly into four groups: a control group (n=15), an SM group (n=15), a myocardial infarction (MI) group (n=15), and an MI+SM group (n=15). Chronic MI was obtained by ligating the left anterior descending branch (LAD) of rat hearts for eight weeks. The in vivo blockade of stretch-activated ion channels (SACs) was achieved by intramuscular injection of SM (180 mg/(kg·d)) for seven days after operation. The hearts were stretched for 5 s by occlusion of the aortic arch. Suction electrodes were placed on the anterior wall of left ventricle to record the monophasic action potential (MAP). The effect of stretching was examined by assessing the 90% monophasic action potential duration (MAPD₉₀), premature ventricular beats (PVBs), and ventricular tachycardia (VT).

Results

The MAPD₉₀ decreased during stretching in both the control (from (50.27±5.61) ms to (46.27±4.51) ms, P<0.05) and MI groups (from (65.47±6.38) ms to (57.47±5.76 ms), P<0.01). SM inhibited the decrease in MAPD₉₀ during inflation ((46.27±4.51) ms vs. (49.53±3.52) ms, P<0.05 in normal hearts; (57.47±5.76) ms vs. (61.87±5.33) ms, P<0.05 in MI hearts). The occurrence of PVBs and VT in the MI group increased compared with that in the control group (PVB: 7.93±1.66 vs. 1.80±0.86, P<0.01; VT: 7 vs. 1, P<0.05). SM decreased the occurrence of PVBs in both normal and MI hearts (0.93±0.59 vs. 1.80±0.86 in normal hearts, P<0.05; 5.40±1.18 vs. 7.93±1.66 in MI hearts, P<0.01).

Conclusions

Stretch-induced MAPD₉₀ changes and arrhythmias were observed in chronically infarcted myocardium. The use of SM in vivo decreased the incidence of PVBs but not of VT. This suggests that SACs may be involved in mechanoelectric feedback (MEF), but that there might be other mechanisms involved in causing VT in chronic MI.     

Is right ventricular mid-septal pacing superior to apical pacing in patients with high degree atrio-ventricular block and moderately depressed left ventricular function?

Objective

We are aimed to investigate whether right ventricular mid-septal pacing (RVMSP) is superior to conventional right ventricular apical pacing (RVAP) in improving clinical functional capacity and left ventricular ejection fraction (LVEF) for patients with high-degree atrio-ventricular block and moderately depressed left ventricle (LV) function.

Methods

Ninety-two patients with high-degree atrio-ventricular block and moderately reduced LVEF (ranging from 35% to 50%) were randomly allocated to RVMSP (n=45) and RVAP (n=47). New York Heart Association (NYHA) functional class, echocardiographic LVEF, and distance during a 6-min walk test (6MWT) were determined at 18 months after pacemaker implantation. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured using an enzyme-linked immunosorbent assay (ELISA) kit.

Results

Compared with baseline, NYHA functional class remained unchanged at 18 months, distance during 6MWT (485 m vs. 517 m) and LVEF (36.7% vs. 41.8%) were increased, but BNP levels were reduced (2352 pg/ml vs. 710 pg/ml) in the RVMSP group compared with those in the RVAP group, especially in patients with LVEF 35%–40% (for all comparisons, P<0.05). However, clinical function capacity and LV function measurements were not significantly changed in patients with RVAP, despite the pacing measurements being similar in both groups, such as R-wave amplitude and capture threshold.

Conclusions

RVMSP provides a better clinical utility, compared with RVAP, in patients with high-degree atrioventricular block and moderately depressed LV function whose LVEF levels ranged from 35% to 40%.     

Methylenetetrahydrofolate reductase C677T polymorphism predicts response and time to progression to gemcitabine-based chemotherapy for advanced non-small cell lung cancer in a Chinese Han population

Objective:The aim of this study was to evaluate the association between the methylenetetrahydrofolate reductase(MTHFR) C677T excision repair cross-complementation group 1(ERCC1) genetic polymorphisms and the clinical efficacy of gemcitabine-based chemotherapy in advanced non-small cell lung cancer(NSCLC).Methods:A total of 135 chemonaive patients with unresectable advanced NSCLC were treated with gemcitabine/platinum regimens.The polymorphisms of MTHFR C677T,ERCC1 C8092A,and ERCC1 C118T were genotyped using the TaqMan methods.Results:The overall response rate was 28.9%.Patients with MTHFR CC genotype had a higher rate of objective response than patients with variant genotype(TT or CT)(41.2% versus 19.1%,P=0.01).Median time to progression(TTP) of patients with MTHFR CC genotype was longer than that of patients with variant genotype(7.6 months versus 5.0 months,P=0.003).No significant associations were obtained between ERCC1 C118T and C8092A polymorphisms and both response and survival.Conclusions:Our data suggest the value of MTHFR C677T polymorphism as a possible predictive marker of response and TTP in advanced NSCLC patients treated with gemcitabine/platinum.     

肝功能对意识消失时咪达唑仑血浆浓度和脑电双频谱指数的影响(英文)

研究目的:探索不同肝功能指数对镇静药咪达唑仑的敏感性以及脑电双频谱指数(BIS)的预测意识消失的影响。创新要点:明确不同肝功能状态的患者对中枢抑制药的敏感性以及BIS预测意识消失概率发生的敏感性。指导临床医生根据患者的肝功能状态合理使用中枢抑制药以及正确利用BIS预测镇定深度。研究方法:选择意识消失作为研究终点,以50%患者意识消失时的咪唑安定的浓度以及BIS值作为观察指标。重要结论:终末期肝病患者对中枢镇静药咪唑安定更敏感,该类患者在BIS预测意识消失概率发生的敏感性存在差异。     

Gorham-Stout syndrome in mainland China: a case series of 67 patients and review of the literature

Objective:Gorham-Stout syndrome (GSS) is a rare disorder of uncertain etiology and unpredictable prognosis. This study aims to present a comprehensive understanding of this rare entity. Methods:A literature search in PubMed and three Chinese databases was performed to screen histologically proven GSS cases among Chinese residents in the mainland. We analyzed the patients’ clinical characteristics, the value of different treatment modalities and their influence on the clinical outcome. Results:Sixty-seven cases were finally enrolled. There were 43 men (64.2%) and 24 women (35.8%). The mean age at diagnosis was 28 years (1.5-71 years). The most common clinical symptoms included pain (n=40, 59.7%), functional impairment (n=13, 19.4%), and swelling (n=12, 17.9%). The radiographic presentation of 37 cases (55.2%) was disappearance of a portion of the bone. The others presented as radiolucent foci in the intramedullary or subcortical regions. A total of 42 cases provided data on therapy, these included surgery (n=27, 40.3%), radiation therapy (n=6, 9.0%), surgery combined with radiation therapy (n=2, 3.0%), and medicine therapy (n=7, 10.4%). For 30 of these 42 cases, follow-up data were available:21 cases had the disorder locally controlled and 9 had a symptom progression. Fortunately, the disease is not fatal in the majority of cases. Conclusions:GSS has no specific symptoms and it should be taken into consideration when an unclear massive osteolysis occurs. The efficacies of different treatment modalities are still unpredictable and further research is required to assess the values of different treatments.     

Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis

Objective

Mitral valve disease tends to be treated with anterolateral minithoracotomy (ALMT) rather than median sternotomy (MS), as ALMT uses progressively smaller incisions to promote better cosmetic outcomes. This meta-analysis quantifies the effects of ALMT on surgical parameters and post-operative outcomes compared with MS.

Methods

One randomized controlled study and four case-control studies, published in English from January 1996 to January 2013, were identified and evaluated.

Results

ALMT showed a significantly longer cardiopulmonary bypass time (P=0.001) and aortic cross-clamp time (P=0.05) compared with MS. However, the benefits of ALMT were evident as demonstrated by a shorter length of hospital stay (P<0.00001). According to operative complications, the onset of new arrhythmias following ALMT decreased significantly as compared with MS (P=0.05); however, the incidence of peri-operative mortality (P=0.62), re-operation for bleeding (P=0.37), neurologic events (P=0.77), myocardial infarction (P=0.84), gastrointestinal complications (P=0.89), and renal insufficiency (P=0.67) were similar to these of MS. Long-term follow-up data were also examined, and revealed equivalent survival and freedom from mitral valve events.

Conclusions

Current clinical data suggest that ALMT is a safe and effective alternative to the conventional approach and is associated with better short-term outcomes and a trend towards longer survival.     

Early effects of oral administration of omeprazole and roxatidine on intragastric pH

Objective

The ideal medication for the treatment of acid-related diseases, e.g., peptic ulcers, stress-related gastric bleeding, functional dyspepsia, and gastroesophageal reflux disease, should have a rapid onset of action to promote hemostasis and relieve the symptoms. The aim of our study was to investigate the inhibitory effects on gastric acid secretion of a single oral administration of a proton pump inhibitor, omeprazole 20 mg, and an H₂-receptor antagonist, roxatidine 75 mg.

Methods

Ten Helicobacter pylori-negative male subjects participated in this randomized, two-way crossover study. Intragastric pH was monitored continuously for 6 h after single oral administration of omeprazole 20 mg and roxatidine 75 mg. Each administration was separated by a 7-d washout period.

Results

During the 6-h study period, the average pH after administration of roxatidine was higher than that after administration of omeprazole (median: 4.45 vs. 2.65; P=0.0367). Also during the 6-h study period, a longer duration of maintenance at pH above 2, 5, and 6 was observed after administration of roxatidine 75 mg than after administration of omeprazole 20 mg (median: 90.6% vs. 55.2%, P=0.0284; 43.7% vs. 10.6%, P=0.0125; 40.3% vs. 3.3%, P=0.0125; respectively).

Conclusions

In Helicobacter pylori-negative healthy male subjects, oral administration of roxatidine 75 mg increased the intragastric pH more rapidly than that of omeprazole 20 mg.     

Effects of body mass index on the outcomes of in vitro fertilization in Chinese patients with polycystic ovary syndrome: a retrospective cohort study

Objective

To investigate the effects of body mass index (BMI) on the outcomes of in vitro fertilization (IVF) in Chinese patients with polycystic ovary syndrome (PCOS).

Methods

In the retrospective cohort study, a total of 1074 patients with PCOS undergoing IVF between April 2010 and May 2017 in two reproductive medicine centers, respectively in eastern China (Women’s Hospital, School of Medicine, Zhejiang University, Zhejiang Province) and in southern China (Maternal and Child Health Care Hospital of Liuzhou, Guangxi Province), were included. The patients were divided into four groups according to the recommended Chinese BMI cut-off points: underweight (BMI< 18.5 kg/m²), normal weight (18.5 kg/m²≤BMI<24.0 kg/m²), overweight (24.0 kg/m²≤BMI<28.0 kg/m²), and obese (BMI≥ 28.0 kg/m²). The basic characteristics of the PCOS patients, the details of IVF treatment, and the pregnancy outcomes were collected.

Main results

There were no significant differences among the normal weight, overweight, and obese PCOS patients undergoing IVF on the biochemical pregnancy rate, clinical pregnancy rate, miscarriage rate, live birth rate, or term delivery rate (P>0.05), although the overweight and obese PCOS patients required more gonadotropin (Gn) (P<0.001) as well as longer stimulation period (P<0.001), and got less retrieved oocytes (P<0.05) and fertilized oocytes (P<0.05). The underweight PCOS patients required less Gn (P<0.05) and achieved higher live birth rate and term delivery rate (P<0.05), compared with the normal weight PCOS patients.

Conclusions

High BMI had no negative effects on the outcomes of IVF in Chinese patients with PCOS; however, the conclusion may seem a little limited due to the retrospective design and the potential bias.

     

Association between mandibular posterior alveolar morphology and growth pattern in a Chinese population with normal occlusion

Objective:To investigate the relationship between growth patterns and mandibular posterior tooth-alveolar bone complex morphology in a Chinese population with normal occlusion.Methods:Forty-five patients with normal occlusion(23 males,22 females) were included in this study.Among these patients,20 displayed the vertical growth pattern,and 20 had the horizontal growth pattern,while the remaining patients displayed the average growth pattern.All of the patients underwent dental cone beam computed tomography(CBCT),which included the region of the mandibular posterior teeth and the alveolar.A linear regression analysis and a correlation analysis between the facial height index(FHI) and the alveolar bone morphology were performed.Results:The inclination of the molars,the thickness of the cortical bone,and the height of the mandibular bone differed significantly between patients with the horizontal growth pattern and those with the vertical growth pattern(P<0.05).Significant positive correlations were found between:the FHI and the inclination of the molars;the FHI and the thickness of the cortical bone;and the FHI and the height of the mandibular bone.Conclusions:The mandibular posterior tooth-alveolar bone complex morphology may be affected by growth patterns.     

Non-pulmonary vein foci induced before and after pulmonary vein isolation in patients undergoing ablation therapy for paroxysmal atrial fibrillation: incidence and clinical outcome

Objective

To evaluate the incidence and clinical outcome of adenosine triphosphate (ATP) plus isoproterenol (ISP)-induced non-pulmonary vein (PV) foci before and after circumferential PV isolation (CPVI) during index ablation in patients with paroxysmal atrial fibrillation (PAF).

Methods

In 80 consecutive patients undergoing catheter ablation for drug-refractory, symptomatic PAF at our hospital from April 2010 to January 2011, atrial fibrillation (AF) was provoked with ATP (20 mg) and ISP (20 μg/min) administration before and after CPVI. The spontaneous initiation of AF was mapped and recorded.

Results

Before ablation, AF mostly originating from PVs (PV vs. non-PV, 36/70 vs. 3/70; P<0.01) was induced in 39 patients with sinus rhythm. CPVI significantly suppressed AF inducibility; however, more non-PV foci were provoked (post-CPVI vs. pre-CPVI, 13/76 vs. 3/70; P=0.016). Patients with pre- and post-CPVI induced AF (n=49) were divided according to non-PV foci being induced (group N, n=17) or not (group P, n=32). After mean (19.2±8.2) months follow-up, 88.2% (15/17) and 65.6% (21/32) of patients in groups N and P, respectively, were free from AF recurrence (P=0.088).

Conclusions

ATP+ISP administration effectively provokes non-PV foci, especially after CPVI in PAF patients. Although in this study difference did not achieve statistical significance, supplementary ablation targeting non-PV foci might benefit clinical outcome.