ABSTRACT
Congenital heart disease (CHD) is the most common congenital malformation disease in infants.With the rapid development of clinical treatment, the survival rate of children with CHD increased significantly.However, postoperative complications in children with CHD, including heart failure, heart arrythmia, pulmonary hypertension and brain cognitive dysfunction, are another challenge, among which, brain cognitive dysfunction has been gradually recognized and valued by scholars.At present, the effect of cardiopulmonary bypass on brain cognitive function of children with CHD has been studied by a variety of research methods, including molecular biological technique, magnetic resonance imaging technique, optical imaging technology, brain electrical activity monitoring technology and nervous development scale.Varying degrees of brain cognitive dysfunction will occur in children with CHD after heart surgery, which is closely associated with many factors such as systemic inflammatory response related to cardiopulmonary bypass, cerebral ischemia-reperfustion injury, the duration of cardiopulmonary bypass, aortic cross clamp time, deep hypothermia circulatory arrest time, dynamic changes of temperature, degree of hemodilution and blood gas management strategy.The influence of cardiopulmonary bypass on postoperative brain cognitive function in children with CHD is reviewed in this paper, in order to provide reference for clinical diagnosis and treatment, and to improve the prognosis of children with CHD.
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Objective@#To understand the active screening of tuberculosis in schools in Guizhou province and analyze the results to provide reference for the prevention and control of tuberculosis in schools in Guizhou province.@*Methods@#In 2017, the initiative screening and entrance examination were carried out among students in Guizhou in 2017, with "the provincial school tuberculosis screening questionnaire" issued by the provincial level.A total of 373 679 students(18.31%) from 290 schools(41.31%)were tested as strong positive by PPD test.@*Results@#Rate of positive PPD skin test showed significant differences according to different types of school(χ2=679.62,P=0.00). the abnormal rate of X-ray chest had statistical significant difference between the students in boarding school or not(χ2=14.07,P=0.00), but had no statistical significant difference between the students in private schools and public schools(χ2=0.28,P=0.59). For the rate of suspicious symptom screening, statistical significant differences were found between the private schools and public schools(χ2=4.79,P=0.03) and boarding schools or not(χ2=23.47,P=0.00). PPD test screening was carried out among 166 691 students, 4 667 were tested as strong positive, 191 cases were found as tuberculosis (4.09%); X-ray chest X-ray screening of 104 024 people, abnormal chest radiograph of 298 people, 200 found that the number of tuberculosis cases, the detection rate was 67.11%. Symptom screening was carried out among 102 964 students, 2 272 had suspicious symptoms, 229 cases were pulmonary tuberculosis patients, the detection rate of 10.08%, three methods of screening for difference was statistically significant(χ2=262.44，P=0.00).@*Conclusion@#The school tuberculosis screening work in Guizhou province needs to be further improved, and the tuberculosis screening for college and boarding high school students should be strengthened to control the outbreak of school tuberculosis.
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Objective To study the role of clinical nursing pathway (CNP)in health education for patients undergoing percutaneous nephrolithotomy (PCNL).Methods Ninety patients with PCNL were randomized into the observation group and the control group in equal number: the former received CNP health education and the latter routine health education while hospitalization. The two groups were compared in terms of scores on health education,satisfaction with nursing,incidence of postoperative extubation and hospital stay.Result The scores on health education,satisfaction with nursing and incidence of postoperative extubation in the observation group were all significantly higher than those of the control group (allP<0.05) and the hospital stay in the former was significantly shorter than that of the latter (P<0.05).Conclusions PCNL in use of CNP health education can promote patients’ health education quality,reduce their incidence of extubation,shorten their hospital stays and improve their satisfaction of nursing. It is worthy of clinical promotion and application.
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Brain-derived neurotrophic factor(BDNF) is a key signaling molecule during the development of nervous system.When BDNF is binded tyrosine kinase receptor B ( Trk B ),it can lead to a variety of physiological effects.Although the mechanisms of their action remain unclear,studies have proved that they may be related to effects of nerve cell survival,growth,differentiation,repair after injury and apoptosis,etc.This review describes the affecting factors in the expression of BDNF and TrkB,the effects of BDNF and TrkB in the development of behavioral disorders and the relationship with early environment.
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OBJECTIVE@#To introduce peratrial device closure of secundum atrial septal defects (ASD) under the guidance of transesophageal echocardiography (TEE) without cardiopulmonary bypass (CPB) in children, and to summarize the clinical experiences.@*METHODS@#A total of 115 children with secundum ASD (the occlusion group) underwent peratrial device closure of atrial septal defects through a small sternotomy under TEE guidance without cardiopulmonary bypass. Children were followed up closely for 1-13 months. Another 59 children (the bypass group) had closed atrial septal defects under cardiopulmonary bypass during the same period. The differences in the operation duration, convalescence and complication between the 2 groups were compared.@*RESULTS@#Except 1 patient was operated under the CPB, the rest 114 patients in the occlusion group were successfully closed by the occluders. The duration of the operation, mechanical ventilation, intensive care and hospitalization, and the rate of blood-transfusion in the occlusion group were significantly lower than those in the bypass group (P0.05).@*CONCLUSION@#Minimally invasive peratrial device closure of ASD without CPB is a relatively simple, safe and effective operation under the guidance of TEE for children. The short and mid-term clinical outcomes are promising. Long-term follow-up is indispensable.
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Echocardiography, Transesophageal , Methods , Follow-Up Studies , Heart Septal Defects, Atrial , Diagnostic Imaging , General Surgery , Minimally Invasive Surgical Procedures , Methods , Septal Occluder Device , Ultrasonography, InterventionalABSTRACT
Objective To research the possible influence of operation and human chorionic gonadotropin(HCG) therapy on the development of antisperm antibody (AsAb) and serum levels of estradiol (E_2) and testosterone (T) of cryptorchidism boys after orchiopexy. Methods Forty cryptorchidism boys were studied who were divided into HCG treatment group and without HCG treatment group. Twenty boys who underwent inguinal operation were studied as the operation control group and 20 normal boys as the control group. The serum were collected for detection AsAb, E_2,and T. Results There were no significant difference in serum levels of E_2 and T among the three groups(P 0.05 ). Conclusions The level of AsAb is associated with the destroy of blood barrier and the disorder of immune modulation and endocrine. Treatment with HCG has no effect on AsAb level.