Objective To explore the efficacy and safety of radiofrequency catheter ablation for ventricular arrhythmias originated from the right ventricular outflow tract(RVOT-VAs)and its influencing factors.Methods According to the success of a single operation or not,256 patients with RVOT-VAs undergoing radiofrequency catheter ablation were divided into successful single operation group(196 cases)and unsuccessful single operation group(60 cases),then general data and operational data of them were compared.Binary logistic regression analysis was performed to evaluate factors that affect the efficacy and safety of operation.Results In 256 patients,immediate success rate,single operation success rate and recurrence rate were 88.3%,76.6% and 13.2% respectively.Proportion of patients combined with hypertension and organic heart disease,QRS waves with various forms,surgical complications and pericardial tamponade in successful single operation group were lower than those in unsuccessful single operation group（P<0.05）.Results of binary logistic regression analysis showed that combining organic heart disease,lack of experience for operators and target site of catheter ablation locating in free wall were independent risk factors for failure of single operation（P<0.05）.Persistent ventricular tachycardial and target site of catheter ablation locating in free wall were independent risk factors for immediate failure of the first operation（P<0.05）.Combining organic heart disease,lack of experience for operators,target site of catheter ablation locating in free wall and QRS waves with various forms were independent risk factors for recurrence after the first operation（P<0.05）.Advanced age and lack of experience for operators were independent risk factors for complications during the first operation（P<0.05）.Conclusion There is high success rate and safety of radiofrequency catheter ablation treating RVOT-VAs.Combining organic heart disease,target site of catheter ablation locating in free wall and the operator’s experience are important factors which affect the efficacy and safety.

Objective To investigate the relationship between serum uric acid level and 25 hydroxyvitamin D₃[25(OH)VD₃] in women in the second trimester of pregnancy.Method A total of 221 women in second trimester of pregnancy were selected and their age,gestational weeks and other general data were collected.The liver and renal function,fasting plasma glucose(FPG),thyroid function and 25(OH)VD₃ levels were measured.According to the 25(OH)VD₃ levels,they were divided into vitamin D deficiency group[25(OH)VD₃<50 nmol/L] and vitamin D appropriate group[25(OH)VD₃≥50nmol/L].The clinical data of the two groups were compared and the factors influencing the level of 25(OH)VD₃ were analyzed.Results In 221 women of second trimester,vitamin D deficiency was present in 147 cases(67%) and Vitamin D was appropriate in 74 cases(33%).Levels of serum uric acid,thyrotrophin (TSH),gestational week in the vitamin D deficiency group were all lower than those in the vitamin D appropriate group,while levels of free thyroxine (FT₄),FPG and total bilirubin (TBIL) were higher than those in the vitamin D appropriate group,with statistically significant differences(P<0.05).Correlation analysis showed that 25(OH)VD₃ level in the second trimester of pregnancy was positively correlated with serum uric acid，TSH and gestational age，while was negatively correlated with FT₄ and TBIL (P<0.05).Logistic regression analysis showed that serum uric acid reduction was a risk factor for the deficiency of 25(OH)VD₃ (OR=1.008,P=0.024).Conclusion Vitamin D deficiency is common in women in the second trimester of pregnancy.The gestational age，serum uric acid,FT₄,TSH and TBIL are associated with the reduction of 25(OH)VD₃.Serum uric acid reduction is the main risk factor for 25(OH)VD₃ deficiency.

Objective〓〖WT5”BZ〗To investigate the relationship between thyroid hormones and the detection〖JP〗 rate of chronic kidney disease(CKD) in hospitalized patients with type 2 diabetes mellitus(T2DM).〖WT5”HZ〗Methods〓〖WT5”BZ〗A total of 1118 T2DM patients were included in our department.All  patients were divided into CKD group and nonchronic kidney disease(NCKD) group according to whether accompanied with CKD.General and clinical data of the two groups were collected and compared.Multivariate logistic regression analysis was used to study the risk factors related to CKD.〖WT5”HZ〗Results〓〖WT5”BZ〗The detection rate of CKD in T2DM+hypertension(HP) patients was higher than that in T2DM patients（P<0.001）.The age,course of HP,course of T2DM,systolic blood pressure,diastolic blood pressure and the level of thyrotrophin(TSH) in CKD group were higher than those in NCKD group，the level of fasting glucose(FPG),glycosylated hemoglobin(HbA1c),triiodinated thyroxine (TT3),free thyroxine(TT4),free triiodinated thyroxine (FT3) and free thyroxine (FT4) were lower than those in NCKD group（P<0.05）.Multivariate logistic regression analysis showed that the level of FT3,course of T2DM,FPG,lowdensity lipoprotein（LDLC）,systolic blood pressure were independently related to proteinuria accompanied estimated glomerular rate(eGFR) decrease，the level of FT3,gender and systolic blood pressure were independently related to proteinuria，the level of TT4，FT3，the course of T2DM,age,LDLC and diastolic blood pressure were independently related to eGFR decrease，FT3 was an independent risk factor for proteinuria,eGFR decrease and proteinuria with eGFR decrease.〖WT5”HZ〗Conclusion〓〖WT5”BZ〗The levels of thyroid hormone in T2DM patients with CKD are different from those in T2DM patients.FT3 is an independent risk factor for proteinuria,eGFR decrease,and proteinuria with eGFR decrease,it may affect the detection rate of CKD.

Objective To explore the expression level of serum chemokine ligand 18（CCL-18） in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and its diagnostic value.Methods A total of 60 patients with AECOPD(AECOPD group) were concluded.According to the frequency of acute exacerbation of COPD in the past year,they were divided into frequent group(27 cases) and accidental group(33 cases).According to the stage of global initiative for COPD(GOLD),they were divided into stage Ⅰ+Ⅱ group(30 cases),stage Ⅲ group(20 cases) and stage Ⅳ group(10 cases).The 20 healthy smokers with normal lung function were selected as the control group.Levels of serum CCL-18 in subjects of each group were detected by enzyme linked immunosorbent assay(ELISA) and compared.The diagnostic efficacy of serum CCL-18 in distinguishing AECOPD patients from healthy controls,frequent AECOPD patients from occasional AECOPD patients was analyzed by receiver operating characteristic(ROC) curve.Results Level of serum CCL-18 in patiens of AECOPD group was higher than that in control group(P<0.001).Level of serum CCL-18 in AECOPD patietns of frequent group was higher than that in incidental group(P<0.05).Levels of serum CCL-18 in stage Ⅰ+Ⅱ group,stage Ⅲ group and stage Ⅳ group increased gradually,and the differences were significant(P<0.05).Results of ROC curve analysis showed that sensitivity,specificity and area under ROCcurve(AUC) of serum CCL-18 in diagnosing AECOPD were 84.1%,76.7% and 0.86(95% CI 0.77~0.94,P<0.001) respectively.Sensitivity,specificity and AUC of serum CCL-18 in diagnosing frequent AECOPD were 88.0%,88.2% and 0.92(95%CI 0.85~0.99,P<0.001).Conclusion The level of serum CCL-18 in patients with AECOPD is higher than that in healthy controls,and it increases along with GOLD stage increasing.Serum CCL-18 can distinguish AECOPD patients from healthy controls,frequent AECOPD patients and incidental AECOPD patients.

Objective To investigate the relationships between levels of serum platelet-derived growth factor (PDGF),insulin-like growth factor-1 (IGF-1) and collateral circulation formation with prognosis in patients with middle cerebral artery M1 segment occlusion (M1CAO).Methods The 158 patients with M1CAO admitted from February 2017 to August 2018 were selected as disease group,and 169 outpatient health examiners were selected as the control group.All patients with M1CAO were diagnosed by magnetic resonance angiography(MRA) one week after onset.According to the formation of collateral circulation compensation,the patients were divided into the non-compensated group,the isolated anterior cerebral artery(ACA) compensated group,the isolated posterior cerebral artery(PCA) compensated group and the ACA+PCA compensated group.The levels of serum PDGF and IGF-1 were detected by enzyme linked immunosorbent assay(ELISA).The neurological deficits of M1CAO patients were scored by National institutes of health stroke scale（NIHSS） on the day of hospitalization and 15 days after hospitalization.The modified Rankin scale(mRS) was used to evaluate the prognosis of M1CAO patients 90 days after discharge,and the patients were divided into good prognosis group and poor prognosis group according to the mRS score.The clinical data of each group were compared.Pearson correlation analysis was used to analyze the correlation between serum PDGF and IGF-1 levels.Logistic regression analysis was used to analyze the factors affecting the prognosis of patients with M1CAO.Results Compared with the control group,the levels of serum PDGF and IGF-1 of the disease group were significantly lower(P<0.05).Compared with the non-compensated group,the levels of serum PDGF and IGF-1 in patients with M1CAO in isolated ACA compensated group,isolated PCA compensated group and ACA+PCA compensated group increased significantly,while the NIHSS score decreased successively(P<0.05).Compared with the poor prognosis group,the levels of serum PDGF and IGF-1 in good prognosis group were significantly higher(P<0.05).Pearson correlation analysis showed that serum PDGF and IGF-1 levels were positively correlated in M1CAO patients(r=0.414,P<0.05).Logistic regression analysis showed that high levels of serum PDGF and IGF-1 and collateral circulation were independent protective factors of the good prognosis in M1CAO patients(P<0.05).Diabetes mellitus was an independent risk factor of the poor prognosis in M1CAO patients(P<0.05).Conclusion The levels of serum PDGF and IGF-1 in M1CAO patients are significantly decreased,and the increase of PDGF and IGF-1 levels is related to the formation of collateral circulation and good prognosis,and is an independent affective factor for the prognosis of M1CAO patients.

Objective To explore the predictive value of QT interval after correction（QTc） prolongation in electrocardiogram for delayed neuropsychiatric sequelae(DNS) in patients with carbon monoxide(CO) poisoning.Methods Clinical data of 223 patients with CO poisoning were retrospectively analyzed,the patients were divided into DNS group(31 cases) and non-DNS group(202 cases).Univariate and multivariate logistics regression analysis were used to determine independent risk factors for DNS occurrence,the predictive value of QTc detecting time for DNS was evaluated by ROC curve.Results DNS occurred in 31 cases(13.3%) of the 233 patients with CO poisoning.Univariate logistic regression analysis showed that the Glasgow coma score(GCS)<9 points,transient loss of consciousness,CO exposure to prolonged hospital admission and QTc prolongation were associated with DNS(P<0.05).Multivariate logistic regression analysis showed that the GCS score<9 points,CO exposure to admission time>6h and QTc prolongation were independent risk factors for DNS deveplement(P<0.05).ROC curve analysis showed that QTc detection within CO exposure<2h,2~4h,4~6h had high predictive value for DNS development,and with the best predicted value of within 6 hours of CO exposure.Conclusion QTc prolongation within 6h of CO exposure is a new index for predicting DNS occurrence in patients with CO poisoning.

Objective To investigate the effect and mechanism of metformin on the apoptosis of papillary thyroid carcinoma TPC-1 cells.Methods TPC-1 cells were treated with different doses(0mmol/L,1mmol/L,5mmol/L,10mmol/L,20mmol/L and 40mmol/L) of metformin for 24h.3-（4，5-dimethylthiazol-2-yl）-2，5-diphenyltetrazolium bromide(MTT) assay was used to measure the proliferation viability of cell lines.Annexin Ⅴ-FITC/PI flow cytometry was used to detect the rate of apoptosis of TPC-1 cells treated by different concentrations of metformin.At the same time,the adenosine 5’-monophosphate-activated protein kinase（AMPK） inhibitor Compound C was added to the 40mmol/L group,and its effect on the apoptosis of TPC-1 cells was observed.Western blotting was performed to determine the protein expressions of p-AMPK and Caspase-9.Results Compared with the 0mmol/L group,the proliferation viability of TPC-1 cells in 1mmol/L and 5mmol/L groups had no significant changes(P>0.05).But 10mmol/L,20mmol/L and 40mmol/L metformin all significantly inhibited the proliferation activity of TPC-1 cells in a dosedependent manner(P<0.05).Compared with the 0 mmol/L group,the different concentrations of metformin could significantly increase the apoptosis rate of TPC-1 cells(P<0.001).However,after the addition of Compound C,the apoptosis rate of TPC-1 cells in 40mmol/L group was significantly lower than that before(P<0.001).Compared with the 0mmol/L group,the different concentrations of metformin could increase the protein expression of p-AMPK and Caspase-9.Conclusion Metformin can induce apoptosis of TPC-1 cells.The process of apoptosis induced by metformin is probably related to the activation of AMPK signaling pathway,which may be mediated by Caspase-9.

Objective To explore the effect of Suramin on Cyclosporine A(CsA)-induced nephrotoxicity in rats and the relevant mechanism.Methods Forty male SD rats were randomly divided into control group,CsA group,CsA+Suramin(low dose) group and CsA+Suramin(high dose)group,with 10 rats in each group.After 5 weeks of administration,24h urine protein,α₁-microglobulin(MG),β₂-MG,N-acetyl-β-D-glucosaminidase(NAG),serum creatinine(SCr),blood urea nitrogen(BUN),uric acid(UA) and cystatin C（Cys C） in 4 groups were detected.The values of creatinine clearance(Ccr) were calculated.Masson trichrome staining was performed to estimate the degree of interstitial fibrosis.The expression of transform growth factor（TGF）-β₁，collagen-Ⅰand fibronectin were determined qualitatively by immunohistochemistry.The corresponding values of average optical density(AOD) of the above indicators were determined.Results The levels of α₁-MG,β₂-MG,NAG,BUN,UA and Cys C in CsA group were higher than those in control group,while the level of Ccr was lower than that in control group（P<0.05）.The levels of α₁-MG,β₂-MG,NAG,BUN,UA and Cys C in CsA+Suramin(low dose) group and CsA+Suramin(high dose)group were lower than that in CsA group,the level of Ccr was higher than that in CsA group（P<0.05）.The degree of interstitial fibrosis and the AOD of TGF-β₁，collagen-Ⅰ，fibronectin in CsA group were higher than those in control group,while the above indicators in CsA+Suramin(low dose) group and CsA+Suramin(high dose)group were lower than those in CsA group（P<0.05）.ConclusionSuramin may probably antagonize the nephrotoxicity induced by CsA.Down regulated expression of TGF-β₁ may probably associated with the mechanism of interstitial fibrosis.