Construction and demonstration of mobile health management model for elderly patients with coronary heart disease / 中华老年医学杂志

Objective:To observe the construction of mobile health management model for elderly patients with coronary heart disease, and to conduct empirical research.Methods:A total of 86 elderly patients with coronary heart disease treated in Henan Provincial People's Hospital from January 2019 to January 2021 were selected.They were randomly divided into 2 groups: the control group receiving routine intervention(n=43), and the observation group receiving mobile health management mode as an add-on to routine interventions(n=43).After 3 months of intervention in control versus observation groups, angina, readmission risk factors were assessed, and status of target criteria for low-density lipoprotein cholesterol(LDL-C), resting heart rate, systolic, and diastolic blood pressure as readmission risk factors were evaluated.Before and 3 months after intervention, the self-care ability of patients was evaluated.Results:Number of angina pectoris attacks was less in observation(0.53±0.18)than in control group(0.64±0.15)( t=3.079, P=0.003).Duration of the angina pectoris was shorter in observation(2.72±0.40)min than in control group(3.06±0.55)min, ( t=3.278, P=0.002).Rate of achieving effectiveness of indicators for the risk factors of readmission was higher in observation group than in control group as following data: LDL-C(90.7% and 72.1%, χ2=4.914, P=0.027), resting heart rate(95.4% and 81.4%, χ2=4.074, P=0.044), systolic blood pressure(86.1% and 60.5%, χ2=7.182, P=0.007)and diastolic blood pressure(88.4% and 67.4%, χ2=5.472, P=0.019).The scores of self responsibility, health knowledge, self-care skills and self-concept were higher in the observation group than in the control group, with a statistical significant difference(all P<0.05). Conclusions:The construction of mobile health management model and its application in elderly patients with coronary heart disease are beneficial to improve the symptoms of angina pectoris, reduce the risk factors of readmission and improve the ability of self-care of patients.

Evaluation of clinical effects of the early warning scale on systemic juvenile idiopathic arthritis complicated with macrophage activation syndrome / 中华实用儿科临床杂志

Objective:To compare the disease outcome, quality of life score [evaluated by child health assessment questionnaire - disability index(CHAQ-DI)] and medical expenses of children with systemic juvenile idiopathic (sJIA) combined with macrophage activation syndrome (MAS) diagnosed by two different criteria.And to analyze the impacts of early MAS diagnosis criteria on the prognosis of sJIA combined with MAS in children.Methods:From January 2016 to December 2020, children with high disease activity of sJIA who were diagnosed and initially treated in the Department of Rheumatology of Beijing Children′s Hospital were enrolled in this study.Clinical characteristics on admission were recorded as baselines.Patients were divided into 2 groups according to different diagnostic criteria.Children diagnosed as MAS based on the 2016 The European League Against Rheumatism/American College of Rheumatology/Paediatric Rheumatology International Trials Organisation MAS diagnostic criteria were included in MAS control group(38 cases), and those diagnosed as early MAS based on the sJIA combined MAS early warning scale but did not meet the 2016 diagnostic criteria were included in MAS early warning group(38 cases). Basic information, clinical manifestations and laboratory test results were collected.According to the clinical manifestations and laboratory results in different periods of follow-up at 4 weeks, 8 weeks, 12 weeks, 6 months and 12 months after treatments, the di-sease activity, CHAQ-DI and medical expenses were compared between the two groups.Results:There were no signi-ficant differences in the disease activity, duration of sJIA and medical expenses between the two groups (all P>0.05). In terms of laboratory results, serum ferritin in MAS early warning group were significantly lower than that of MAS control group at 4 weeks after treatment[(333.97±186.66) μg/L vs.(389.66±221.76) μg/L]( t=-83.47, P<0.05). In terms of disease activity, after 12 months of treatment, the evaluation of American College of Rheumatology pediatric indexes 70 in MAS early warning group was better than that in MAS control group [34.2%(13/38 cases) vs.7.9% (3/38 cases)]( χ2=6.067, P<0.05). In terms of CHAQ-DI, at 4 weeks, 8 weeks, 12 weeks and 6 months of treatment, CHAQ-DI in MAS early warning group were better than those in MAS control group, and the difference were statistically significant ( t=-0.34, -0.27, -0.23, -0.09; all P<0.05). In terms of cumulative medical expenditure at 12 months of treatment, the MAS early warning group was lower than the MAS control group [(114.3±80.7) thousand yuan vs.(157.9±111.7) thousand yuan]( t=-3.97, P<0.05). Conclusions:Quickly judge the condition through the quantitative integral of clinical examination and test indexes, screening and treatment of MAS in early stage are helpful to improve the prognosis and reduce the medical consumption.

Efficacy and safety of vagus nerve stimulation in the treatment of refractory epilepsy / 中南大学学报(医学版)

OBJECTIVES@#Vagus nerve stimulation (VNS) is a neuromodulative therapeutic technique for patients with drug-resistant epilepsy who are not suitable for resection or who have experienced a failed resection. This study aims to explore the efficacy and safety of VNS in patients with refractory epilepsy, and to analyze the influential factors for the efficacy.@*METHODS@#A retrospective review of clinical data were conducted for 35 patients, who were treated for refractory epilepsy through VNS surgery in the Department of Neurosurgery, Xiangya Hospital, Central South University from April 2016 to August 2019. All patients were analyzed in terms of the clinical and follow-up data.@*RESULTS@#After a mean follow-up of 26 months (6-47 months), outcome was as follows: 7 patients were MuHugh class I, 13 patients were MuHugh class II, 8 patients were MuHugh class III, and 7 patients were MuHugh class IV-V. The total efficacy rate in the short duration group was significantly higher than that in the long duration group (77.8% vs 50.0%, @*CONCLUSIONS@#VNS is a safe and effective option in treating patients with refractory epilepsy, especially for those with short duration.

Clinical characteristics and follow-up of thrombosis in pediatric patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective:To investigate the clinical characteristics and follow-up of thrombosis of pediatric patients with systemic lupus erythematosus (SLE).Methods:In this retrospective study, inpatients who were diagnosed in Beijing Children's Hospital with SLE complicated with arterial or venous thrombosis from January 2006 to December 2019 were collected, the clinical characteristics and outcomes were analyzed. Statistical product and Service solutions (SPSS) 25.0 was used for statistical analysis. T test or χ2 test (counting data) was used to compare the differences between groups, and Kaplan-Meier survival curve was used to analyze the time of thrombus endpoint events in lupus children. Results:A total of 1 395 newly diagnosed SLE patients were admitted. Twenty-seven cases were diagnosed with thrombosis, accounting for 1.9% of all the lupus patients. The median course from diagnosis to thrombosis was 20 days (49 days before diagnosis to 1 year after dia-gnosis). Among the 27 patients, 22(81%) cases had renal involvement. The mean SLE disease activity index (SLEDAI) score was (14±6) and (11±4) at the diagnosis of lupus and at onset of thrombosis, respectively ( t=2.547, P=0.017). 30% (8/27) of the patients had no apparent clinical manifestations of thrombosis. The patients received standard anticoagulant therapy after the diagnosis of thrombosis. During follow-up, 6 patients stopped taking medications due to the severity of the primary disease. Twenty-one patients were followed up regularly for 1-3 years. Thrombosis disappeared in 12 cases (44%), thrombolysis time ranged from 16 days to 1 year. Thrombosis were getting smaller in 9 cases (33%). And the disease was stable during follow up. Conclusion:Thrombosis is not rare in pediatric patients with systemic lupus erythematosus patients. Some patients do not have apparent clinical manifestations related to thrombus. Pediatricians should be alert to patients with renal involvement need to be more vigilant for thrombosis. Early detection and active treatment are the keys to improve the prognosis of thrombosis in pediatric SLE patients.

Clinical analysis and long-term follow-up of 612 cases with juvenile dermatomyositis / 中华风湿病学杂志

Objective:To explore the clinical characteristic and prognosis of juvenile dermatomyositis (JDM) by retrospectively study of the clinical manifestations, laboratory examinations, treatment and follow-up results. The aim of this study was to improve the diagnosis and treatment of JDM and reduce the complications and mortality.Methods:Medical charts of 612 JDM cases hospitalized to Beijing children's hospital from July 2002 to July 2018. We retrospectively analyze the onset, clinical manifestations, laboratory examinations, treatment and the follow-up, and then summarize the clinical characteristics and assess the therapeutic effect and prognosis.Results:There were 278 male and 334 female. The maleto female ratio was 1∶1.2. Themedian age at symptoms onset was 5.4(2.9-8.4) years old (range 6 months to 14 years). Rash was the most common initial presentation. The main clinical manifestations were rash (100%, 612 cases) and muscles weakness (96.1%, 588 cases). The most commonly involved organs by JDM were lung (57.5%, 352 cases), digestive tract (38.5%, 236 cases) and heart (32.5%, 199 cases). Muscle enzymes elevated in 95.5% (584 cases) of the patients and 89.5%(534 cases) of the patients had typical changes on electromyography. Muscle biopsy was performed in 134 patients and pathologicresults were compatible with JDM. For the treatment, all of the patients were treated by steroids plus therapy combined with immunosuppressive agents. Mostof the patients got good effect and outcome. Twenty-four patients died, and acute respiratory failurewas the most common cause of death. 17.9%(105 cases) of patients had complications. The complications included calcinosis in 70 patients and amyotrophy in 35 patients.Conclusion:JDM is a rare disease of children, andis characterized by muscle weaknessand rash. Severe organ involvement may cause death. Treatments include corticosteroids and immunosuppressive agents, andthe outcome is generally good.

Staging evaluation and prognostic judgement of 8th edition of the American Joint Committee on Cancer staging system for breast cancer with different molecular subtypes / 肿瘤研究与临床

Objective:To explore the analysis of staging alteration and prognosis of 8th edition of the American Joint Committee on Cancer (AJCC) staging update for breast cancer with different molecular subtypes.Methods:The clinical data of 965 breast cancer patients treated in Xijing Hospital from January 2011 to December 2017 were retrospectively collected, and 103 patients met the inclusion criteria. The staging results between all the patients and patients with 4 different molecular subtypes were compared according to the 7th and 8th edition of the AJCC. Fisher's exact test was used for staging differences, Kaplan-Meier was used for survival analysis, log-rank test was used to compare survival rates of different groups, the prognostic judgement efficacy and staging alteration for all patients and cases with different molecular subtypes in the 8th edition was also compared.Results:Compared with the 7th edition, a total of 52 cases (50.5%) had staging declined and 8 cases (7.8%) had staging risen in the 8th edition, and there was a statistically significant difference in composition change ( P < 0.05). There was no rise in staging for Luminal subtype patients, but the decline in 34 cases, with the decline rate of 87.2% (34/39); no rise in staging for patients of HER2 + subtype, but the decline in4 cases, with the decline rate of 19.0% (4/21). No rise in staging for triple positive subtype patients, but the decline in 14 cases, with the decline rate of 82.4% (14/17). Oppositely, for the patients with previous subtypes, no decline in staging of patients with triple negative subtypes, but the rise in 8 cases with the rise rate of 30.8% (8/26). The difference in all the above staging changes was statistically significant ( P = 0.001). According to the 7th edition of the AJCC, the disease-free survival (DFS) time of all the cases and Luminal subtype patients had no statistical differences among different staging groups ( P > 0.05), but according to the 8th edition of the AJCC, the differences were statistically significant ( P < 0.05). DFS time was shorten with the increase of staging, indicating that the 8th edition of staging could more accurately assess the prognosis of patients. Conclusions:Compared with the 7th edition of the AJCC, for the staging changes determined by the 8th edition of the AJCC, the proportion of staging declined in all the cases is significantly higher than that of staging risen, and patients with different molecular subtypes has different staging changes, among which the patients with the triple negative subtypes have staging risen and the rest have staging declined. The DFS analysis for all the patients and patients with Luminal subtypes indicates that the 8th edition of the AJCC staging is a more accurate predictor of prognosis compared with the 7th edition of the AJCC.

Analyses of gene mutation, clinical phenotype, treatment and follow up of 10 cases with chronic infantile neurologic, cutaneous, articular syndrome / 中华风湿病学杂志

Objective To explore the gene mutation,clinical phenotype,treatment and prognosis of chronic infantile neurologic,cutaneous,articular (CINCA) syndrome,so as to improve the diagnosis rate,reduce the disability rate and teratogenicity rate of CINCA syndrome.Methods Ten children with CINCA syndrome admitted to our hospital were retrospectively analyzed in terms of the clinical phenotypes,auxiliary examinations,treatment and follow-up.Three ml ethylene diamine tetraacetic acid (EDTA) anticoagul-ation was taken from children and their parents with the consents.Genomic DNA was extracted by QIAamp whole blood Deoxynbonucleic acid (DNA) extraction kit (German Qiagen Company).The whole exons were detected by Agilent liquid phase capture technology (Agilent Company).Finally,Sanger sequencing was used to verify the results.Results In this study,eight mutations of NLRP3 gene were found in children with CINCA syndrome,namely 913G/A (D305N),1057G/T(V353L),1702T/A (F568I),1703T/A (F568Y),1710G/C (K570N),1789A/G (S597G),1991T/C (M664T),2269G/A (G757R).The onset age of most of the cases was less than half a month,and the initial manifestation was mainly urticaria-like rash.Short stature and special face could be seen in all 10 cases.All the patients had fever and urticarial rash in varying degrees during the course of the disease.Nine of them had obvious arthritis.Nine children had central nervous system involvement.There were 8 cases of binaural nervous deafness,7 cases of binocular optic neuritis,and 6 cases of hepato-splenomegaly and/or lymphadenopathy.Amyloid A was significantly increased.Glucocorticoids and immunosup-pressive agents are the basic drugs for the treatment of this disease.If the curative effect was not good,biological agents should be added early to alleviate the disease.Conclusion CINCA syndrome is a rare autosomal dominant hereditary disease,the main clinical manifestations of which are skin,joint and central nervous system involvement,and even amyloidosis of organs.Early diagnosis and active treatment can reduce the involvement of important organs.

The correlation between CB2R and autophagy-related protein LC3 expression in the hippocampal CA1 re-gion of the model with status epilepticus / 国际儿科学杂志

Objective The expression and correlation between cannabinoid receptor type 2 ( CB2R) and autophagy-related protein microtubule-associated protein 1 light chain 3 (LC3) in the hippocampal CA1 re-gion of developing rats with status epilepticus ( SE) were investigated. Methods SE model was established u-sing lithium chloride-pilocarpine intraperitoneally in Sprague-Dawley ( SD) rats and all the rats were randomly divided into four groups ( control group and 3h, 24h, 3d groups after SE). The expressions of CB2R and LC3 in the hippocampal CA1 region at different times were observed using double-label immunofluorescence and Western blotting. Spearman correlational analysis was used to compare the relationship between the two factors. Results Immunofluorescence showed that the expression of CB2R was up-regulated dynamically and peaked at 24h and presented parabolic changes over time. The expression of LC3 changed in accordance with CB2R and e-ven co-expressed with CB2R partly, especially on neurons. Western blotting results furtherly showed the simi-larity of the expression of CB2R and LC3, and finally Spearman correlational analysis presented the significant correlation between these two factors (r=0. 7161, P<0. 05). Conclusion Significant correlation exists be-tween the expression of CB2R and LC3 in the hippocampal CA1 neurons of developing rats with SE, indicating the essential role of CB2R in autophagy regulation of hippocampal CA1 neurons.

Clinical features analysis of osteonecrosis in 59 children with rheumatic diseases / 中华风湿病学杂志

Objective@#To analyze the clinical data of children with rheumatic diseases complicated with osteonecrosis and summarize the clinical characteristics, so as to guide clinical work.@*Methods@#The clinical data of 59 children with rheumatic diseases complicated with osteonecrosis from January 2010 to July 2018 were collected and analyzed retrospectively.@*Results@#Among 59 children with rheumatic diseases complicated with bone infarction, 25 cases were systemic lupus erythematosus (SLE), 4 cases were mixed connective tissue disease, 6 cases were juvenile dermatomyositis, 1 case was Takayasu arteritis, 1 case was leukocy to clystic vasculitis, 13 cases were systemic onset juvenile idiopathic arthritis (SJIA), 1 case was polyarthritis, and 8 cases were juvenile ankylosing spondylitis. The median time from the onset of rheumatic diseases to osteonecrosis onset was 18 (7.00, 38.75) months. A total of 115 joints were involved in 59 children, the most common of which were bilateral hips and knees. Twenty-five were single joint involvement and 34 were multiple joints involvement. There were 37 cases (63%) with vasculitis, 9 cases (15%) with oralulcer, 5 cases (8%) with Raynaud's phenomenon, 31 cases (53%) with Cushing's face, 18 cases (31%) with kidney involvement, 25 cases (42%) with hypertension, and 12 cases (24%) with spinal compression frac- tures. According to statistics, 10 children with osteonecrosis occurred without glucocorticoid intake. The longest duration of glucocorticoid therapy was 13 years, and the average duration was about (27±35) months whensymptomatic osteonecrosis occurred. The median cumulative dose of prednisone was 381.9(209.77, 561.19) mg/kg.@*Conclusion@#SLE, SJIA and juvenile ankylosing spondylitis are the three most common rheumatic diseases in children with osteonecrosis. The locations of osteonecrosis are mostly the bilateral hips and knees. It is necessary to strengthen joint examination, physical examination and imaging screening for children with rheumatic diseases after 18 months of onset, so early detection, early treatment are the strategy to improve the prognosis of the diseases.

Analysis on correlation between orthodontic pain score and occlusal function at 24 h after first time treatment in patients with fixed-orthodontics / 重庆医学

Objective To investigate the correlation between the orthodontic pain score and occlusal function at 24 h after the first time treatment in the patients with fixed orthodontics.Methods Seventy-eight voluntary subjects were selected and treated with MBT straight wire correcting appliance.The VAS scores of spontaneous odontalgia and biting odontalgia (SO-VAS and BOVAS),masticatory efficiency (ME),masticatory times (MT),maximal occlusal force(MF)and occlusion rate before wearing the fixed appliance(T0),at 24 h after wearing(T1) were measured.The changes of above indicators were observed and the correlation among indicators was investigated:Results (1) BO-VAS and SO-VAS were increased after 24 h of orthodontic treatment,while BO VAS was (59.49 ± 19.06) mm,which was significantly higher than SO-VAS[(23.21± 20.80) mm].After 24 h of fixed orthodontic treatment,the patients had occlusal dysfunction,which manifested by ME,MT,MF and SO decrease compared with T0 (P＜0.05).(2) BO-VAS was negatively correlated with ME,MT and MF (P＜0.05).There was no correlation between SO-VAS and occlusal dysfunction.Conclusion There is no obvious magnitude correspondence relation between the occlusal dysfunction grade and the pain grade on the first day after fixed orthodontic treatment,the VAS grading is not yet fully representative of the occlusal dysfunction level,but the credibility of BO-V.AS score is higher than that of SO-VAS score in assessing the degree of occlusal dysfunction.

Effect of periopusside administration of ambroxol combined with psychological intervention on patients with lung cancer after thoracoscopic lobectomy / 中国生化药物杂志

Objective To investigate the effect of perindox administration combined with psychological intervention on patients with lung cancer after thoracoscopic lobectomy.Methods Fifty patients with lung cancer underwent thoracoscopic lobectomy from November 2015 to November 2016 in our hospital were randomly divided into experimental group and experimental group according to the time of hospitalization.Control group, 25 cases.The rats in the experimental group were treated with ambroxol hydrochloride(600 mg/d)from the day of operation to the postoperative 3d administration.The control group was treated with the same volume of saline.At the same time, the experimental group was treated with psychological intervention and the necessary psychological guidance was carried out.The data were collected and compared with the two groups before and after the general information, intraoperative conditions, lung function before and after surgery and blood gas analysis Results , mechanical ventilation time, early postoperative complications, postoperative hospital stay and treatment costs.ResultsThere were no cases of death in the perioperative period.Compared with the control group, the total incidence of postoperative complications was not significant, but the pulmonary complications were significantly reduced, only 1 case and 9 cases in the control group The In addition, the postoperative mechanical ventilation, ICU time, postoperative hospital stay, total treatment costs, the difference between the two groups was significant, the data were statistically significant(P<0.05).Conclusion The patients with lung cancer underwent thoracoscopic lobectomy with high dose intravenous ambroxol hydrochloride in the perioperative period can greatly improve the postoperative pulmonary function and reduce the postoperative complications, and effectively reduce the postoperative hospitalization Time, the material pressure on the patient is further reduced.

Analysis on correlation between orthodontic pain score and occlusal function at 24 h after first time treatment in patients with fixed-orthodontics / 重庆医学

Objective To investigate the correlation between the orthodontic pain score and occlusal function at 24 h after the first time treatment in the patients with fixed orthodontics.Methods Seventy-eight voluntary subjects were selected and treated with MBT straight wire correcting appliance.The VAS scores of spontaneous odontalgia and biting odontalgia (SO-VAS and BOVAS),masticatory efficiency (ME),masticatory times (MT),maximal occlusal force(MF)and occlusion rate before wearing the fixed appliance(T0),at 24 h after wearing(T1) were measured.The changes of above indicators were observed and the correlation among indicators was investigated:Results (1) BO-VAS and SO-VAS were increased after 24 h of orthodontic treatment,while BO VAS was (59.49 ± 19.06) mm,which was significantly higher than SO-VAS[(23.21± 20.80) mm].After 24 h of fixed orthodontic treatment,the patients had occlusal dysfunction,which manifested by ME,MT,MF and SO decrease compared with T0 (P＜0.05).(2) BO-VAS was negatively correlated with ME,MT and MF (P＜0.05).There was no correlation between SO-VAS and occlusal dysfunction.Conclusion There is no obvious magnitude correspondence relation between the occlusal dysfunction grade and the pain grade on the first day after fixed orthodontic treatment,the VAS grading is not yet fully representative of the occlusal dysfunction level,but the credibility of BO-V.AS score is higher than that of SO-VAS score in assessing the degree of occlusal dysfunction.

Efficacy analysis of Chuanxiongqingnaokeli treatment of children with migraine / 中国综合临床

Objective To observe the clinical efficacy and adverse reaction of Chuanxiongqingnaokeli for children with migraine. Methods One hundred children patients with migraine were randomly divided into treatment group( n = 50 ) and control group( n = 50 ). Patients in treatment group were given Chuanxiongqingnaokeli,10 g/once,and three times one day,while in control group were given Flunarizine Hydrochloride Capsules,2. 5 mg/once,and who's body mass ﹥50 kg with 5. 0 mg/once,and one times each night. Three months as one course of treatment,and compared the efficacy of two groups after tree course of treatment. Results The hemodynamics of two groups all decreased after treatment compared with before treatment,but ACA,MCA,PCABA and VA in treatment group(( 81. 10 ± 11. 95 ),( 93. 3 ± 14. 16 ),( 70. 2 ± 11. 57),(70. 6 ± 13. 02),(65. 5 ± 12. 6)cm/s respectively)decreased more significantly than that of control group(( 104. 2 ± 12. 63 ),( 116. 2 ± 15. 82 ),( 93. 5 ± 11. 91 ),( 93. 5 ± 12. 71 ),87. 4 ± 12. 92 ) cm/s respectively),and the differences were significant( P﹤0. 05). The headache frequency and duration in treatment group were(1. 0 ± 0. 6)and(3. 3 ± 1. 0),less than that of control group((2. 3 ± 0. 9)and(5. 6 ± 1. 7);t= -3. 345,-3. 269;P﹤0. 05). The total effective rate in treatment group was 90. 0%(45/50),higher than that of control group(74. 0%(37/50);χ2 =4. 336,P﹤0. 05). There was no severe adverse reaction in both two groups. Conclusion The Chuanxiongqingnaokeli is safe and effective for treatment of children with migraine.

Analysis of clinical characteristics of juvenile scleroderma / 中华风湿病学杂志

Objective To describe and analyze the clinical and laboratory findings in a group of children diagnosed with scleroderma at Beijing Children's Hospital in the last 10 years.Methods The clinical charts of children with scleroderma in the Rheumatology Department at Beijing Children's Hospital,between January 2002 and October 2013 were reviewed.All of them fulfilled the classification criteria for juvenile sclerodema,both systemic scleroderma (SSc) and localized scleroderma (LS) types.T test was used for comparison between the two groups.Results Forty-six patients were enrolled and were diagnosed as scleroderma.Seven patients(15％) suffered from SSc and 39 patients(85％) were LS.Mean age-at-onset of LS was (5±4) years old.The male to female ratio was 1.2:1.Mean age-at-onset of SSc was (9±4) years old.All patients were female.The lesions found in LS were linear scleroderma (54％),mixed morphea (36％),generalized morphea (8％),and panclerotic morphea (3％).Twenty-six patients had internal organs involved.Three patients with nerve system involvement was found in en coup de sabre (ECDS).Systemic involvement included lung and gastrointestinal tract primarily.The heart,nerve system,kidney,eye involvement was also found.One girl had SSc combined with renal crisis.Antinuclear antibodies were positive in 77％ of LS patients and 100％ of SSc patients.Rheumatic factor was positive in 6 patients (15％),5 patients had joint involvement.Tests for anti-Scl-70 antibodies were positive in 5 (71％) patients with SSc.The most common drugs used were methotrexate and prednisone.Conclusion In this study,LS is common in children.SSc is more severe than LS.Multi-center and large sample study is needed to know the characteristics of juvenile scleroderma in China.

Therapeutic effect of gamma knife on intracranial cavernous angioma / 中南大学学报(医学版)

Objective: To evaluate the therapeutic effect of gamma knife on patients with intracranial cavernous angioma (CA). Methods: The medical records of 122 patients (134 lesions) who underwent radiosurgery were reviewed retrospectively. Results: hT e average follow-up period was 43 months. No patient died. One patient underwent CA resection. In patients with epilepsy, 83% patients showed alleviation of seizures. About 44% of the lesions shrank in size after treatment with gamma knife radiosurgery (59/134). Seven cases had hemorrhage again after radiosurgery, and the overall annual hemorrhage rate was 1.6%. Edema was found in 11.5% patients (14/122) and all patients showed improvement atf er treatment. Conclusion: Gamma knife is a safe treatment for CA, which could obviously improve the symptoms of epilepsy. Gamma knife radiosurgery is the if rst option for the treatment of cavernous sinus angiomas.

Curative effect observation of plasma eardrum perforation homochronous with palatoplasty in the treatment of chronic secretory otitis media / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the effect of plasma eardrum perforation homochronous with palatoplasty on hearing and tympanic cavity pressure in cleft palate children with secretory otitis media.@*METHOD@#Fifty-six cases of cleft palate children with secretory otitis media were randomly divided into observation group and control group. For the control group, palatoplasty was carried out alone. For the observation group, homochronous with palatoplasty, plasma eardrum perforation was performed with the diameter of the aperture 2-3 mm, which was decided by observing viscosity of tympanum fluid under microscope or otoscope.@*RESULT@#Compared with the simple cleft palate repairing palatoplasty, the perforation in the observation group could keep for 6-8 weeks after the surgery. Followed up 6 months later, the children in observation group improved better in terms of hearing restoration and tympanometry.@*CONCLUSION@#By means of plasma eardrum perforation homochronous with palatoplasty, the children of cleft palate with secretory otitis media could improve hearing and tympanometry in a short period, recovering the function of middle ear.

Multislice spiral CT diagnosis error analysis of children's airway foreign bodies / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Analysis of multislice CT (MSCT) on the misdiagnosis reasons of children bronchial foreign body, avoid missed diagnosis, to achieve reasonable application.@*METHOD@#Fourteen cases of misdiagnosed cases of data were retrospectively analyzed in our department of suspicious in children with bronchial foreign body, and discuss the misdiagnosis reasons.@*RESULT@#Fourteen cases of misdiagnosis of children with 9 cases by MSCT examination showed no obvious foreign matter. Through bronchoscopy intraoperative found foreign body, 5 cases by multislice CT (MSCT) to found foreign body, 4 cases of phlegm scabs, 1 case is inflammatory granulation, all recovered after treatment. Reasons of misdiagnosis were threshold selection error, scanning level from the inception glottis, imaging error, etc.@*CONCLUSION@#MSCT is a very valuable diagnostic on airway foreign body check method, but there are certain limitations, we should improve the understanding of misdiagnosis and reduce the occurrence of this phenomenon.

Comparative study of neonatal rat models of hypoxia-ischemia induced white matter injury of brain / 中国小儿急救医学

Objective To investigate the difference among neonatal rat models of hypoxia-ischemia induced white matter injury of brain by three different methods and to provide theory basis on choosing the proper animal model for deep study on white matter injury of premature infants.Methods Three different hypoxia-ischemia methods were applied to induce brain white matter injury model of Wistar rats of postnatal 3rd day which were left carotid artery ligation followed by 6％ oxygen for 30 minutes and for 4 hours respectively,and bilateral carotid artery ligation followed by 8％ oxygen for 30 minutes.Compared brain pathological results of rats in different groups,changes in white matter of brain by glial fibrillary acidic protein (GFAP) and myelin basic protein (MBP) immunostaining,and changes in time of opening eyes and eyes appearance.Results Left carotid artery ligation followed by 6％ oxygen for 30 minutes resulted in sparse and vague periventricular white matter without necrotic lesions,and the degree of GFAP intensity [(5 021.63 ± 358.92) OD] increase and MBP intensity [(18 488.63 ± 1 822.62) OD] decrease were lowest (P ＜ 0.000 1),as well as the delay of opening time of the left eye.Left carotid artery ligation followed by 6％ oxygen for 4 hours resulted in necrotic lesions of periventricular white matter,with the degree of GFAP intensity [(6 069.13 ± 458.61) OD] and MBP intensity [(15 003.38 ± 1 559.11) OD],and also the delay of opening time of the left eye.Bilateral carotid artery ligation followed by 8％ oxygen for 30 minutes caused cystic necrosis of bilateral periventricular white matters,and the degree of GFAP intensity [(6 194.50 ±432.69) OD] increase and MBP intensity [(10 119.35 ± 735.16) OD] decrease of the left side were highest(P ＜ 0.000 1),as well as the delay of opening time and cataract in both eyes.Conclusion Left carotid artery ligation followed by 6％ oxygen for 30 minutes is more suitable for investigating mild brain white matter injury.Left carotid artery ligation followed by 6％ oxygen for 4 hours and bilateral carotid artery ligation followed by 8％ oxygen for 30 minutes are more proper for the investigation of severe periventricular leukemacia cases.

Clinical features and etiology of cerebral infarction in children / 中国小儿急救医学

Objective To summarize the clinical features and etiology of cerebral infarction in children.Methods The clinical data of 47 children with cerebral infarction who were hospitalized in Shengjing Hospital of China Medical University from Jan 2009 to Jul 2011 were analyzed retrospectively.Results There were 30 boys and 17 girls in all the 47 children.The median age of onset was 3.1 years(ranged from 2 months to 11 years old).Among 47 cases,the common neurological manifestations included limb paralysis in 32 cases(68.1％ ),central facial paralysis in 15 cases(31.9％ ),convulsion in 12 cases(25.5％ ),disturbance of consciousness in 10 cases(21.3％ ),and language disorders in 10 cases(21.3％ ).Among 47 cases,31 cases had basal ganglia infarction with neuronal imaging( CT or MRI),of whom 4 cases accompanied with other location infarction.Several lobes of infarction in 5 cases,hemispheric infarction in 3 cases,parietal infarction in 2 cases,frontal lobe infarction in 2 cases,temporal lobe infarction in 2 cases,and thalamic infarction in 2 cases.Nineteen cases were carried out blood vessel imageology examination,11 cases showed abnormality,the most common affected cerebral blood vessel were middle cerebral artery(5 cases).The common causes of 47 cases were trauma ( 19 cases,40.4％ ),infection( 12 cases,25.5％ ) and moyamoya disease (5 cases,10.6％ ).Ten children (21.3％) had no identifiable cause.Conclusion The common period of cerebral infarction is in infancy.The most frequent neurological symptom is hemiplegia.The most common region of infarction is in basal ganglia with neuronal imaging.The common causes of cerebral infarction are trauma,infection and moyamoya disease.

Role of miR-155 in myasthenia gravis and effect of dexamethasone on miR-155 / 中南大学学报(医学版)

OBJECTIVE@#To determine the role of miR-155 in the pathogenesis of generalized myasthenia gravis (GMG) and the effect of dexamethasone (DXM) on miR-155.@*METHODS@#The expression of miR-155 in B cells from the GMG patients and healthy controls was analyzed by qPCR. The B cells were cultured with DXM and PBS. The B cell proliferation was examined by MTT; CD80 and CD86 frequencies were detected by flow cytometry; and anti-AChRIgG and isotypes anti-AChR-IgG1, 2, 3 in the supernatant were detected by ELISA.@*RESULTS@#qPCR revealed that the expression of miR-155 in the B cells was much higher than that in the controls, and the miR155 expression decreased after DXM treatment. flow cytometry showed that there was no significant difference in the proliferation and the expressions of CD80 and CD86 in the B cells between the DXM group and the PBS group. The concentration of anti-AChR-IgG1 was obviously lower in the DXM group than in the PBS group, but the concentration of anti-AChRIgG, anti-AChR-IgG2, and anti-AchR-IgG3 was similar.@*CONCLUSION@#high expression of miR-155 may be associated with myasthenia gravis progression. DXM may disturb the antibody class switch of B cells by suppressing the expression of miR-155 and improve the symptom of MG patients.