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01 January 2013, Volume 33 Issue 1 Previous Issue    Next Issue

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Critical care medicine in 2012：review and beyond QIU Xiao-hua,QIU Hai-bo 2013, 33(1): 1-6.  Abstract ( )   PDF (941KB) ( )   Abstract：Critical care medicine plays a pivotal role in clinical medicine and reflects the capacity of treatment and overall competitiveness of the hospital.It has been in 2012 when critical care medicine attained a considerable stride in disciplinary construction and scientific research.Emerging clinical research achievements have allowed physicians to fulfill indepth understanding of severe acute respiratory distress syndrome，acute kidney injury，severe sepsis and septic shock，as well as control of infection and intensive nutrition management.In addition，the latest guidelines have entailed more standardized treatments in criticallyilled patients.Here，we did a review and delineated the prospective for clinical references.

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More attention to be paid on the diagnosis and treatment of inherited cardiac arrythmia GUO Ji-hong 2013, 33(1): 7-8.  Abstract ( )   PDF (886KB) ( )   Abstract：Inherited cardiac arrhythmia，as with an increasing incidence year after year，is clinically featured by early onset，severe symptoms，high mortality and familial aggregation，rendering it a major cause for cardiac sudden death.This has resulted in an heary burden on patients and their family and the society.China is currently challenged with undeniable issues regarding inherited cardiac arrhythmia，including improper diagnosis and differential diagnosis that have led to longterm underdiagnosis or misdiagnosis，failure to popularize genetic screening on the population basis and the insufficient administration of the target treatment.Sufficient alert should be attached to the diagnosis and treatment of inherited cardiac arrhythmia that urgently merits improvement.

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Risk grading，diagnosis and treatment of Brugada syndrome YANG Xin-chun，SHI Liang 2013, 33(1): 9-12.  Abstract ( )   PDF (914KB) ( )   Abstract：Brugada syndrome (BS) is an inherited heart disease without structural abnormality that arises mostly from an accelerated inactivation of Na+ channels and potentiation of transient outward K+ current (Ito) that generates a voltage gradient.This triggers a phase 2 reentrant mechanism leading to ventricular tachycardia or fibrillation that is featured by a coved STsegment elevation in the right precordial leads (V1～V3) during electrocardiography (ECG).The diagnosis of BS is established based on the ECG pattern and clinical symptoms and by excluding the confounding factors that could account for the ECG abnormality.Although the risk factors of sudden cardiac death consist mainly of being male，presence of spontaneous ECG abnormality and a history of syncope，the role of electrophysiologic assay remains controversial in terms of risk grading，particularly in prediction of sudden death.In this review，we delineated the latest progress in the risk grading，diagnosis and treatment of Brugada syndrome.

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The clinical typing and significance of long QT syndrome ZHANG Ping 2013, 33(1): 13-16.  Abstract ( )   PDF (906KB) ( )   Abstract：Long QT syndrome (LQTS) is major risk factor inducing the child and youth sudden death.Its phenotype is classified according to genotype .Now，it has been established the 13 autosomal dominant genetic types and two autosomal recessive genetic types，the most common clinical is LQT1，LQT2 and LQT3.Different subtype of LQTS has different inducing factor for malignant ventricular arrhythmia，different ECG findings，different risk stratification，different prognosis and different clinical treatment strategies.

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Diagnosis and treatment of short QT syndrome HONG Kui 2013, 33(1): 17-20.  Abstract ( )   PDF (916KB) ( )   Abstract：Short QT syndrome (SQTS)，an ion channel abnormalityrelated disease with normal cardiac structures，is clinically characterized of a shortened QT interval on electrocardiogram (ECG) and a high incidence of familial atrial fibrillation and (or) ventricular fibrillation that is linked to sudden cardiac death (SCD).Mutations in the genes encoding potassium ion channel (KCNH2，KCNQ1 and KCNJ2)，calcium ion channel (CACNAIC，CACNB2B and CACNA2D1) and sodium ion channel (SCN5A) subunits have been identified.Increased variation in repolarization and shortened refractory period have been linked to the pathogenesis of cardiac arrhythmia in SQTS.Intracardiac defibrillator has been suggested to be the firstline therapy for prevention of grade 1 and 2 SCD，for which quinidine is considered as an effective medication.

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Research progress in diagnosis of arrythmogenic right ventricular cardiamyopathy/dysplasia LIU Chang-le，LI Guang-ping 2013, 33(1): 21-22.  Abstract ( )   PDF (901KB) ( )   Abstract：Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a genetic cardiomyopathy characterized pathologically by progressive fibrotic fatty tissue replacement of the right ventricular myocardium and is clinically characterized of right ventricular enlargement，arrhythmia and sudden cardiac death.The exact mechanisms of ARVC remain elusive and warrant further exploration in the strategies for clinical diagnosis.

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Catecholaminergic polymorphic ventricular tachycardia CHU Ying-jie 2013, 33(1): 24-26.  Abstract ( )   PDF (1464KB) ( )   Abstract：Catecholaminergic polymorphic ventricular tachycardia (CPVT)，induced by adrenergic stress，is an inherited cardiac arrhythmia syndrome mostly found in adolescence.Patients with CPVT typically present with exerciseor emotioninduced ventricular arrhythmia leading to onset of syncope or sudden cardiac death.Beta-blockers are strongly indicated (Ⅰa) for patients with clinicallydiagnosed CPVT based on the previous history，whereas intracardiac defibrillator implantation is recommended for those with CPVT who previously experienced cardiac arrest. 　　

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Lenegre’s disease：an inherited conductive system disease DONG Lei 2013, 33(1): 26-29.  Abstract ( )   PDF (911KB) ( )   Abstract：Lenegre’s disease is the most common cause of inherited conductive blockade disorder caused by SCN5A gene mutation leading to an autosomal dominant hereditary disease that is characterized of a higher incidence rate in males than in females，a lower age of onset (mostly <40 years) and a significant familial aggregation.This has been pathophysiologically linked to the conductive system fibrosis with extensive lesions that often involved multiple sites of the conductive system.The right bundle branch may be initially and mostly involved，followed by the left anterior fascicle and the highly or complete atrioventricular block found in severe cases.Patients with single or double bundle branch block frequently appear asymptomatic and do not require treatment，yet may experience considerable palpitation，amaurosis，syncope or AdamsStokes syndrome in case of highly or gradethree atrioventricular block.This urgently indicated the administration of pacemaker therapy，and if warranted，the addition of implantable cardioverter defibrillator (ICD) when brachycardia developed. 　　　　

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Genetic assay for inherited cardiac arrhythmia SUN Ya-xun，JIANG Chen-yang,FU Guo-sheng 2013, 33(1): 30-32.  Abstract ( )   PDF (898KB) ( )   Abstract：Inherited arrhythmia is referred to the inherited cardiac diseases with or without cardiac structural changes that are featured by familial aggregation，increased propensity of tachycardia or ventricular fibrillation and sudden cardiac death.The gene assays may facilitate the diagnosis and treatment of inherited arrhythmia.There have been various methods and technologies that are characterized of respective merits and demerits and specific indications for application.As with monogenetic inherited diseases，genetic markers，i.e.single nucleotide polymorphism (SNP)，may specifically locate and determine the gene responsible for the disease by sequencing of the candidates.Linkage analysis may be employed for multigenetic disorders and genomewide association study (GWAS) for locating the candidate genes.Genechip and high throughput sequencing will shed light on gene mutation assaying for inherited cardiac arrhythmia.

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Gene assaying for inherited cardiac arrhythmia：a Chinese consensus PU Jie-lin 2013, 33(1): 33-37.  Abstract ( )   PDF (927KB) ( )   Abstract：In 2011，based on worldwide research progress and opinions，experts of Chinese Society of Cardiology，Chinese Medical Association and Editorial Board of Chinese Journal of Cardiology issued the “2011 China Expert Consensus Statement on Genetic Testing for Cardiac Channelopathies and Cardiomyopathies”.The statement mostly delineated the impacts of genetic testing on the diagnosis，prognosis，treatment and prophylaxis of inherited cardiac arrhythmia and has offered instructions for genetic testing in China.

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The 2012 American College of Rheumatology Recommendations for treatment of rheumatoid arthritis 　　 XIAO Wei-guo 　　 2013, 33(1): 38-41.  Abstract ( )   PDF (909KB) ( )   Abstract：The 2012 American College of Rheumatology (ACR) Recommendations for Treatment of Rheumatoid Arthritis has updated delineation in the selection and switching of medications，optimization of biologic agents in highrisk population，screening of tuberculosis and vaccination，as compared with the 2008 recommendations.In this review，the major updates were outlined to steer clinical management of rheumatoid arthritis in China. 　　