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Objective:To explore the safety and efficacy of Propafenone in terminating paroxysmal supraventricular tachycardia (PSVT) in children and analyze the factors influencing the effectiveness.Methods:A retrospective study was conducted on 169 PSVT children treated with Propafenone in the Department of Pediatric Cardiology, Heart Center, the First Hospital of Tsinghua University from September 2014 to October 2021.There were 118 boys and 51 girls with an average age of (2.84±2.91) years (age range: 14 days-13 years). According to age, they were divided into ≤ 1-year-old group, >1-3-year-old group, >3-7-year-old group, and >7-year-old group.Mea-surement data were compared between groups using t-test and Mann- Whitney U test.Counting data were analyzed by χ2 test. Results:Among the 169 children with PSVT, 65 cases (38.5%) were below 1 year old, 47 cases (27.8%) were >1-3 years old, 40 cases (23.7%) were >3-7 years old, 17 cases (10.1%) were above 7 years old.About 24 cases (14.2%) were combined with congenital heart disease.A total of 153 cases (90.5%) had nonspecific symptoms at the first visit.A total of 4.1% (7/169 cases) were complicated with tachycardia-induced cardiomyopathy, and their left ventricular ejection fraction increased from (44.0±4.0)% to (53.7±6.9)% after successful control of PSVT ( t=-4.700, P=0.003). The complete termination of PSVT by intravenous Propafenone was achieved in 125 of 169 cases (74.0%, 125/169 cases). The complete termination rate after multiple times of administration (74.0%) was significantly higher than that after the first intravenous injection (53.3%, 90/169 cases) ( χ2=15.657, P<0.001). There was a significant difference regarding the complete termination rate between children ≤1 year old (60.0%, 39/65 cases) and those >1 year old (82.7%, 86/104 cases) ( χ2=10.696, P=0.001). For children ≤1 year old, 1.5 mg/kg Propafenone (51.1%, 23/45 cases) showed better efficacy for PSVT termination than 1.0 mg/kg Propafenone (20.0%, 4/20 cases) ( χ2=5.519, P=0.019). For children >1 year old, there was no significant diffe-rence between 1.5 mg/kg and 1.0 mg/kg Propafenone groups (57.9% vs.62.1%) ( χ2=0.180, P=0.671). The adverse reaction rate of intravenous Propafenone was 9.5% (16/169 cases). One case presented with severe hypotension, which occurred in a child with right cardiac insufficiency with tricuspid valve depression; 15 cases showed abnormal cardiac conduction and recovered spontaneously in a short time.There was no deterioration of cardiac function in children with mildly to moderately reduced cardiac function. Conclusions:It is relatively safe and effective to terminate PSVT in children with intravenous Propafenone.The complete termination rate is 74.0%, which is related to age, dose and times of administration.Despite of low incidence of side effects, Propafenone should not be used to treat PSVT with cardiac function which is significantly impaired or unclear secondary to persistent tachycardia.Special attention should be paid to cardiac function deterioration in these patients.
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Objective:To investigate clinical electrophysiological characteristics of idiopathic ventricular arrhythmias (VAs) and outcomes of radiofrequency catheter ablation (RFCA) in pediatric patients.Methods:A total of 328 consecutive pediatric patients with VAs and treated with RFCA in the First Hospital of Tsinghua University from January 2014 to December 2019 were recruited, involving 205 males and 123 females with the mean age of (7.8±3.9) years and the mean body weight of (32.8±17.7) kg.Their clinical electrophysiological characteristics, RFCA outcomes of different origins of VAs and complications were analyzed.Results:Among the 328 patients with the mean onset age of (5.4±4.1) years, 57.6% had frequent premature ventricular complex (PVC), 28.7% had paroxysmal ventricular tachycardia (VT) and 13.7% had incessant VT.A total of 38/328 cases (11.6%) VAs children were complicated with tachycardia-induced cardiomyopathy.Except for 13 cases of non-induced VAs, among 315 cases there were 152/328 cases (46.4%) originated from the ventricular outflow tract (including 46.1% of the origination of the right ventricular outflow tract septum, 27.6% of the origination of the left coronary cusp, 18.4% of the origination of the right coronary cusp, and 7.9% of the origination of the right ventricular outflow tract free wall), 55/328 cases (16.5%) originated from the tricuspid valve, 54/328 cases (17.4%) originated from the left posterior fascicle, 39/328 cases (11.9%) originated from the left posterior papillary muscle, 5/328 cases (1.5%) originated from multi-origin VAs, 3/328 cases (0.9%) originated from the left anterior fascicle, and 7/328 cases (2.1%) originated from other origins.Among 307/328 cases (93.6%) VAs patients receiving RFCA, 271/307 cases (88.3%) were instantly successful, 14/307 cases (4.6%) were effectively treated and 22/307 cases (7.2%) were invalid.During the follow-up time of 3 to 36 months, there were 42/271 cases (15.5%) recurrent cases.The mean radiation time and dose were (3.2±5.8) min, and (1.4±2.6) mGy, respectively.The mean dose-area product (DAP) was (384.2±42.6) mGy·cm 2.A total of 4/328 cases (1.2%) reported perioperative vascular complication.In 20 infant patients younger than 3 years, only 1 case was not induced during procedure of RFCA, and the remaining 19 cases were performed with RFCA, including 18/19 cases (94.7%) with an instant success and 4/18 (22.2%) recurrent cases during follow-up.There were 1/20 case (5.0%) had perioperative vascular complication caused by vascular puncture.No serious complications, such as myocardial perforation, cardiac tamponade and atrioventricular block were reported. Conclusions:The right ventricular outflow tract septum is the most common origin of the idiopathic VAs in pediatric patients.VAs originated from the ventricular outflow tract and tricuspid valve usually have an acceptable outcome following ablation.The recurrent rate is high following ablation in VAs cases originated from the left ventricular fascicle and posterior papillary muscle.RFCA is safe and effective for drug resistant or intolerant VAs in infants, but the surgical indications should be strictly mastered and operated by experienced pediatric electrophysiologists.The radiation dose of RFCA can be limited in a safe range under the guidance of the 3-dimensional mapping system.
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Objective To investigate the mmu-miR-3475-3P possible participating in biology process and signal pathway.Methods The expression of mmu-miR-3475-3P in the mature mouse heart and in the embryonic mouse heart was measured by qRT-PCR.The target genes were predicted through comprehensively using the common microRNA on-line databases such as TargetScan,miRDB and miRanda,and then the obtained targeted genes were performed the gene function annotation and signal pathway analysis.Results There was significant difference between the expression of mmu-miR-3475-3P in the embryonic mouse heart and the expression in the mature heart.Bioinformatics analysis by using TargetScan,miRDB and MiRanda on miR3475-3P revealed that microRNA was likely to regulate 441 target genes.Conclusion mmu-miR-3475-3P is highly expressed in the embryonic mouse heart.The target genes predicted by mmu-miR-3475-3P are enriched in multiple signal pathways and cellular biological processes.
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Objectives To explore the clinical characteristics and prognosis of different degrees of noncompaction of ventricular myocardium (NVM) in children and to investigate the clinical significance of the ratio of the thickness of the non-compact myocardium to the dense myocardium (N/C). Methods The clinical data of the children with NVM were analyzed retrospectively. The differences between children with N/C > 2.0 and children with N/C 1.4~2.0 were compared. Results There were 26 children in each of the two groups. There was no significant difference in age, sex, the ratios of low birth weight and malnutrition, heart disease, and complication (P all > 0.05). When discharged, 8 cases were improved, 15 cases has no obvious improvement, and 3 cases died in N/C>2.0 group; while 18 cases were improved, 8 cases has no obvious improvement, and none died in N/C 1.4~2.0 group, and the effective rate of treatment between two groups was statistically difference (χ2=7.69,P=0.006). In 8 years of follow-up, the mortality rate in N/C > 2.0 group was higher than that in N/C 1.4~2.0 group, and the difference was statistically different (χ2=6.993, P=0.008). Conclusions The treatment efficiency was lower and the prognosis was worse when the N/C value was higher in children with NVM.
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Objective To investigate the relationship of alcohol exposure during pregnancy and non-compaction cardiomyopathy (NCC) in offspring mice.Methods Pregnant mice of ED3.5-ED18.5 were given 56％ alcohol by gavage at a dose of 5 mL/kg.The ED19.5 mice were sacrificed,and the heart of the fetal mice was harvested.Transmission electron microscopy (filaments,mitochondria and sarcoplasmic reticulum) and HE staining were used to verify the changes of structure and ultrastructure of the obtained myocardial tissues.Echocardiography was used to evaluate the cardiac function and ventricular myometrium of the offspring mice after growing up.Results Alcohol exposure during pregnancy caused the disorganized and dissolved myofilaments in the fetal mice.Some offspring mice (31.25％,5/16) had NCC.The ratio of non-compacted myocardium to compact myocardium at the end of systole (N/C) was 2.49 ± 0.6 in the offspring mice of the alcohol exposure group,significantly higher than that in the control offspring mice (0.62 ± 0.23,t =10.397,P =0.000).The volume of heart was decreased in the offspring mice of the alcohol exposure group while the left ventricule was enlarged.Echocardiography showed cardiac dysfunction and thickened ventricular septal/left ventricular posterior walls in the grown-up mice of the exposure group.Conclusion Large dose of alcohol exposure during pregnancy cause trabeculations and non-compaction in ventricular myocardium,and it might be one of causers for NCC in the offspring.
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Objective To investigate the mmu-miR-3475-3P possible participating in biology process and signal pathway.Methods The expression of mmu-miR-3475-3P in the mature mouse heart and in the embryonic mouse heart was measured by qRT-PCR.The target genes were predicted through comprehensively using the common microRNA on-line databases such as TargetScan,miRDB and miRanda,and then the obtained targeted genes were performed the gene function annotation and signal pathway analysis.Results There was significant difference between the expression of mmu-miR-3475-3P in the embryonic mouse heart and the expression in the mature heart.Bioinformatics analysis by using TargetScan,miRDB and MiRanda on miR3475-3P revealed that microRNA was likely to regulate 441 target genes.Conclusion mmu-miR-3475-3P is highly expressed in the embryonic mouse heart.The target genes predicted by mmu-miR-3475-3P are enriched in multiple signal pathways and cellular biological processes.
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Objectives To explore the clinical characteristics and prognosis of different degrees of noncompaction of ventricular myocardium (NVM) in children and to investigate the clinical significance of the ratio of the thickness of the non-compact myocardium to the dense myocardium (N/C). Methods The clinical data of the children with NVM were analyzed retrospectively. The differences between children with N/C > 2.0 and children with N/C 1.4~2.0 were compared. Results There were 26 children in each of the two groups. There was no significant difference in age, sex, the ratios of low birth weight and malnutrition, heart disease, and complication (P all > 0.05). When discharged, 8 cases were improved, 15 cases has no obvious improvement, and 3 cases died in N/C>2.0 group; while 18 cases were improved, 8 cases has no obvious improvement, and none died in N/C 1.4~2.0 group, and the effective rate of treatment between two groups was statistically difference (χ2=7.69,P=0.006). In 8 years of follow-up, the mortality rate in N/C > 2.0 group was higher than that in N/C 1.4~2.0 group, and the difference was statistically different (χ2=6.993, P=0.008). Conclusions The treatment efficiency was lower and the prognosis was worse when the N/C value was higher in children with NVM.
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Objective To evaluate the teaching activity on public health courses from clinical medical students in our university in order to provide a scientific basis for improving the curriculum design and teaching reform. Methods The “Questionnaire on Teaching Evaluation in Public Health Courses”, including teaching attitude, teaching content, teaching methods and teaching effectiveness was designed, and a general investigation was conducted among the clinical medical students of five-year program (840 students) and eight-year program (278 students) in these three aspects to under-stand students' evaluation to the course, who had finished the public health courses, including Preven-tive Medicine, Medical Statistics and Epidemiology (hereinafter referred to as: statistics, epidemiology, prevention) in Sun Yat-sen University. Statistical analysis was made using SPSS 13.0 software. Data analysis methods contain descriptive analysis, T-test, ANOVA, LSD, SNK, hierarchical logistic regres-sion analysis, etc. Results The overall score of teaching evaluation is (4.04±0.60). Differences exist between the evaluation in the five-year medical students and the eight-year medical students. The P values were 0.000 (Medical Statistics), 0.269 (Epidemiology), 0.047 (Preventive Medicine). The com-parison of scores among the four dimensions shows: Teaching effectiveness β' effectiveness. Conclusions Clinical Medical students' overall evaluation on the public health courses offered by this university was good. Teaching effectiveness and teaching methods still need improvement. Teaching contents are the most influential factor of overall teaching satisfaction, followed by teaching effectiveness.
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Objective:To assess the validity and reliability of the Chinese version of the eleven-item Kutcher Adolescent Depression Scale (KADS-11)in Chinese adolescents,calculate its optimal cut-off value and the sensi-tivity and specificity,and explore the possibility of providing a useful tool to assess the severity of adolescent de-pressive symptoms.Methods:Totally 3180 students aged 11 -17 years were selected from schools in 6 provinces and Shanghai.All of them were asked to complete the KADS-11 and Children Depression Inventory (CDI). Students whose CDI scores were above 19 (including 19)were diagnosed with the DSM-IV criteria of depressive disorder,73 students from Shanghai sample were assessed with KADS-11 and CDI to analyze the test-retest reliabil-ity 1 month later.Results:Exploratory factor analysis showed that KADS-11 had 2 factors,and confirmatory factor analysis tested proved the 2-factor model fit better than the one-factor model.The KADS-11 total scores were posi-tively correlated with CDI total scores (r =0.74,P <0.01 ),and the KADS-11 scores were higher in depressive group than those in non-depressive group.The mean area under the curve (AUC)of KADS-11was 0.94,the mean area under the curve of each item ranged from 0.7 to 0.9.The optimal cut-off point of KADS-11 was total score≥9,sensitivity and specificity were 89% and 90% respectively.The Cronbach's alpha coefficient of the KADS-11 was 0.84,the spilt-half reliability coefficient was 0.71 (P <0.01),and the test-retest coefficient was 0.77 (P <0.01).Conclusion:The KADS-11 is appropriate for Chinese adolescents because of its good validity,reliability and diagnosis accuracy,it could be used to assess depressive symptoms for adolescents.
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This paper elaborates on the importance and necessity of implementing information technology in medical education,the application of information technology in the whole process of medical education,the conceptual construction of medical students' life-long education,the construction of practical teaching resources and the cultivation of information capacity both in teachers and students,etc.In the meantime,this paper introduces the basic framework of medical network and remote education center of Sun Yat-sen University under construction.