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Mechanisms of organized atrial tachycardia during catheter ablation of chronic atrial fibrillation by stepwise approach

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Chinese Medical Journal 2010年第7期123卷 852-856页

作者： NING Man DONG Jian-zeng LIU Xing-peng YU Rong-hui LONG De-yong TANG Ri-bo SANG Cai-hua MA Chang-sheng Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Background Extensive atrial fibrillation （AF） ablation is associated with an increased success rate of catheter ablation in chronic AF patients and an increased rate of atrial tachycardia （AT） during the procedure. The mechanism of these Ats varies in previous studies. Our study aimed to report the mechanism of organized AT occurring during the stepwise ablation procedure of chronic *** A prospective cohort of 86 consecutive patients who underwent an ablation procedure for chronic atrial fibrillation （CAF） was investigated. The stepwise procedure was performed in the following order： circumferential pulmonary vein ablation, complex fractionated atrial electrograms ablation, mapping and ablation of AT. The endpoint was noninducibility of AF/AT after sinus rhythm （SR） was restored or the procedure time was beyond 6 *** Sixty-nine （80%） of patients converted to SR via AT. A total of 179 sustained ATs were observed in 69 patients during the procedure. There were 81% （n=145） macroreentrant ATs which included 65 perimitral circuits, 48 peritricuspid tachycardia and 32 roof dependent circuits, 12% （n=21） localized reentrant and 7% （n=13） focal ATs. Thirty （15%） patients experienced significant left atrium （LA） and LA appendage （LAA） conduction delay or dissociation in the procedure or during the follow-up *** Most CAF patients converted to SR via ablation of organized AT occurring during the stepwise procedure. The mechanism of most of these ATs was macro-reentry.

关键词： organized atrial tachycardia chronic atrial fibrillation catheter ablation stepwise approach

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Selecting and applying quantification models for ecosystem services to forest ecosystems in South Korea

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Journal of Forestry Research 2016年第6期27卷 1373-1384页

作者： Hyun-Ah Choi Woo-Kyun Lee Cholho Song Nicklas Forsell Seongwoo Jeon Joon Soon Kim So Ra Kim Department of Environmental Science and Ecological Engineering Korea University Seoul 02841 Republic of Korea Ecosystems Services and Management Program International Institute for Applied Systems AnalysisSchlossplatz 1 2361 Laxenburg Austria Department of Forest Management Kangwon National University Chuncheon 24341 Republic of Korea Korea Forest Conservation Association 186 Dongjak-daeroSeocho-gu Seoul 06559 Republic of Korea

There is growing interest in using ecosystem services to aid development of management strategies that target sustainability and enhance ecosystem support to humans. Challenges remain in the search for methods and indicators that can quantify ecosystem services using metrics that are meaningful in light of their high priorities. We developed a framework to link ecosystems to human wellbeing based on a stepwise approach. We evaluated prospective models in terms of their capacity to quantify national ecosystem services of forests. The most applicable models were subsequently used to quantify ecosystem services. The Korea Forest Research Institute model sat- isfied all criteria in its first practical use. A total of 12 key ecosystem services were identified. For our case study, we quantified four ecosystem functions, viz. water storage capacity in forest soil for water storage service, reduced suspended sediment for water purification service, reduced soil erosion for landslide prevention service, and reduced sediment yield for sediment regulation service. Water storage capacity in forest soil was estimated at 2142 t/ha, and reduced suspended sediment was estimated at 608 kg/ ha. Reduced soil erosion was estimated at 77 m^3/ha, and reduced sediment yield was estimated at 285 m^3/ha. These results were similar to those reported by previous studies. Mapped results revealed hotspots of ecosystem services around protected areas that were particularly rich in bio- diversity. In addition, the proposed framework illustrated that quantification of ecosystem services could be sup- ported by the spatial flow of ecosystem services. However, our approach did not address challenges faced when quantifying connections between ecosystem indicators and actual benefits of services described.

关键词： Classification Ecosystem services Quantification stepwise approach

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Workup of difficult-to-treat asthma:implications from treatable

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Precision Clinical Medicine 2023年第1期6卷 30-37页

作者： Qing Zhang Wen Wen Wu Lei Li Vanessa M.McDonald Yu Cheng Chen Gang Wang Peter G.Gibson Department of Respiratory and Critical Care Medicine Clinical Research Center for Respiratory DiseaseWest China HospitalSichuan UniversityChengdu 610041SichuanChina Laboratory of Pulmonary Immunology and Inflammation Frontiers Science Center for Disease-related Molecular NetworkSichuan UniversityChengdu 610041SichuanChina Center of Excellence in Severe Asthma and Priority Research Center for Asthma and Respiratory Disease the University of NewcastleNewcastle 2308Australia National Health and Medical Research Council Center for Research Excellence in Severe Asthma and Treatable Traits the University of NewcastleNewcastle 2308Australia Cardiology Division Department of MedicineWest China HospitalSichuan UniversityChengdu 610041SichuanChina Department of Respiratory and Sleep Medicine John Hunter HospitalHunter Medical Research InstituteNewcastle 2305Australia

Traditional stepwise approach usually adjusts the treatment regimen based on changes in asthma symptoms and severity to achieve good asthma ***,due to the generalized heterogeneity and complexity of asthma,its therapeutic efficacy in difficultto-treat asthma is ***,a precision medicine approach based on the identification and intervention of treatable traits of chronic airway disease has been proposed and appears to be of greater benefit to *** reported a 71-year-old male with uncontrolled asthma and multiple exacerbations over the past *** complained of persistent dyspnea despite high-dose of inhaled corticosteroids plus other *** this patient have some potential treatable traits contributing to difficult-to-treat asthma?Through a multidimensional assessment of three domains including pulmonary,extrapulmonary,and behavioral/risk factors,15 treatable traits were identified in the patient,mainly including airflow limitation,eosinophilic airway inflammation,small airway dysfunction,exacerbation prone,dilated cardiomyopathy,diabetes mellitus,inhaler device polypharmacy,smoking,and the absence of an asthma action *** targeted treatment for these treatable traits,the patient experienced significant improvement in dyspnea and he could maintain good asthma control with low-dose inhaled corticosteroids and long-acting β_(2)-*** study shows that,in response to the limitation of a stepwise approach to therapy,treatable traits is a new strategy where patients are individually assessed for a specified set of treatable problems,and an individualized treatment program is developed and implemented based on this multidimensional assessment,especially for difficult-to-treat asthma.

关键词： difficult-to-treat asthma treatable traits multidimensional assessment comorbidity stepwise approach

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Pain in chronic pancreatitis:What can we do today?

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World Journal of Methodology 2024年第3期14卷 30-39页

作者： Margherita Binetti Valeria Tonini Department of Medical and Surgical Science University of BolognaAlma mater StudiorumBologna 40138Italy

The aim of this study is to illustrate the complexity of pain management in chronic pancreatitis(CP).In this context,pain represents the most common and debilitating symptom,and it deeply affects patient’s quality of *** rating scales(unidimensional,bidimensional and multidimensional)have been proposed to quantify CP ***,it represents the result of complex mechanisms,involving genetic,neuropathic and neurogenic *** all these aspects,the treatment should be discussed in a multidisciplinary setting and it should be approached in a stepwise ***,a lifestyle change is recommended and nonsteroidal anti-inflammatory drugs represent the gold standard among medical treatments for CP *** second step,after medical approach,is endoscopic therapy,especially for complicated *** case of failure,tailored surgery represents the third step and decompressive or resection procedures can be *** conclusion,CP pain’s management is challenging considering all these complex aspects and the lack of international protocols.

关键词： Chronic pancreatitis Pain Multifactorial mechanism stepwise approach Endoscopic treatment Early surgery

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