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1.
Article in Chinese | WPRIM | ID: wpr-920596

ABSTRACT

@#All-ceramic restorations are widely used in oral restoration because of their beauty and high strength. Glass ceramics and zirconia all-ceramic materials are the two most widely used all-ceramic materials in the clinic. However, when all-ceramic restorations need to be removed due to marginal microleakage and secondary caries, its high strength and high bonding strength greatly increase the difficulty of removal. In recent years, clinicians have tried to use Er: YAG lasers to remove all-ceramic restorations. The Er: YAG laser can be safely and efficiently applied to the removal of glass restorations, and it can also play a role in thinner zirconia restorations. Various factors, such as the material and thickness of the all-ceramic restoration, the type of cement, and the laser power, can affect the speed of removal of the Er: YAG laser. However, the current research is limited to case reports and in vitro studies, lacking systematic clinical research. The specific mechanism of Er: YAG laser removal of all-ceramic restorations and the influence of laser frequency, adhesive type, and abutment on the removal speed need to be further demonstrated by follow-up research.

2.
Chinese Journal of Geriatrics ; (12): 360-365, 2022.
Article in Chinese | WPRIM | ID: wpr-933086

ABSTRACT

Lung cancer is one of the most common malignant neoplastic diseases in the elderly.Immunotherapy represented by immune checkpoint inhibitors mobilizes the body's immune system to achieve antitumor effects.Immune checkpoint inhibitors and their combination with other drugs have played an increasingly important role in the treatment of patients with advanced non-small cell lung cancer.In this review, we summarize the therapeutic effects, adverse reactions and hyperprogressive disease of immune checkpoint inhibitors in the elderly with advanced non-small cell lung cancer, in order to provide insight on immunotherapy strategies for non-small cell lung cancer in the elderly.

3.
Article in Chinese | WPRIM | ID: wpr-930853

ABSTRACT

Infant tachycardia is a critical disease, mainly with supraventricular tachycardia and ventricular tachycardia.The treatment of tachycardia in infant is quite different from that of older children, and there is no relevant guidelines at present.Drug therapy in the acute stage of supraventricular tachycardia and atrial fluttery is mainly intravenous adenosine injection.Digoxin is widely used in neonates.Propranolol is the first choice for prophylactic treatment, and landilolol is in the development stage.Ventricular tachycardia can be spontaneously subsided, the treatment is dominated by intravenous lidocaine.For non-drug therapy, heart cardioerter is the emergency treatment for serious rapid arrhythmia.Radiofrequency ablation is used in infants with more severe conditions and where the onset of tachycardia can not be controlled.Bury cardioverter-defibrillator is effective in preventing infant ion channel disease complicated with malignant ventricular tachycardia induced sudden cardiac death.Subcutaneous implantion of a defibrillator may be superior to intravenous implantation in infants and young children.

4.
Article in Chinese | WPRIM | ID: wpr-928170

ABSTRACT

Lonicerae Japonicae Flos, as common Chinese medicine, has been used for thousands of years in the treatment of inflammation and infectious diseases with definite efficacies. The complex composition of Lonicerae Japonicae Flos results in its extensive pharmacological effects, so the assessment of its quality by only a few index components is not comprehensive. Guided by the quality marker(Q-marker), the present study comprehensively analyzed and predicted the quality connotation of Lonicerae Japonicae Flos based on the chemical composition and component transfer, the phylogenetic relationship, chemical composition effectiveness, measurability, and specificity. Chlorogenic acid, isochlorogenic acids A, B, and C, luteoloside, rutin, sweroside, and secoxyloganin were predicted as candidate Q-markers of Lonicerae Japonicae Flos.


Subject(s)
Chromatography, High Pressure Liquid , Drugs, Chinese Herbal/chemistry , Flowers/chemistry , Lonicera/chemistry , Phylogeny , Quality Control
5.
Acta Pharmaceutica Sinica ; (12): 1336-1343, 2022.
Article in Chinese | WPRIM | ID: wpr-924732

ABSTRACT

Preliminary research in our laboratory found that compound YZG-330 can reduce mouse body temperature, which could be blocked by adenosine A1 receptor (A1R) antagonist DPCPX. Based on the downstream signaling pathway of the A1R, the mechanism by which YZG-330 lowers body temperature was further studied. The pharmacodynamics of YZG-330 was evaluated by measuring the rectal temperature; expression of the transient receptor potential (TRP) ion channel, the P38 protein and its phosphorylated form in mouse hypothalamic homogenate were detected by Western blotting. A Ca2+ fluorescent probe, Fluo-3AM, was added to cells to detect the effect of YZG-330 on the Ca2+ content of mouse hypothalamic cells. YZG-330 dose-dependently reduced the body temperature in mice, and the selective P38 inhibitor SB-203580 (20 mg·kg-1, i.p.) significantly inhibited the hypothermic effect of YZG-330. A TRPM8 antagonist 2 (0.1 μg per mouse, i.c.v.) markedly attenuated the hypothermic effect of YZG-330 (0.25 or 1 mg·kg-1, i.p.). YZG-330 (2 mg·kg-1, i.p.) significantly increased the phosphorylation of P38, an effect that could be attenuated by the A1R antagonist DPCPX (5 mg·kg-1, i.g.) in mouse hypothalamus. In addition, YZG-330 also prominently enhanced the expression of TRPM8, which could be blocked by SB-203580; YZG-330 (0.1-10 μmol·L-1) increased intracellular Ca2+ concetration in mouse hypothalamic cells in a dose-dependent manner, and was inhibited by the A1R inhibitor DPCPX (0.5 and 1 μmol·L-1) and TRPM8 antagonist 2 (1 μmol·L-1). In conclusion, YZG-330 exerts its hypothermic effect by activating the A1R to promote the phosphorylation of P38 protein and thereby up-regulating the expression and activity of the TRPM8 ion channel, resulting in increased intracellular Ca2+ concentration to stimulate mouse hypothalamus cells to down-regulate body temperature. All animal experiments were approved by the Ethics Committee of the Institute of Materia Medica, Chinese Academy of Medical Sciences.

6.
Article in Chinese | WPRIM | ID: wpr-908404

ABSTRACT

Objective:To analyze the clinical characteristics of Kawasaki disease(KD)with complications of acute abdominal disease and to improve the diagnosis, treatment and prognosis of patients.Methods:A total of 2 931 cases with KD hospitalized from January 2016 to December 2019 in our department were retrospectively analyzed, including 14 children with acute abdominal disease(acute abdomen group). And 62 patients with KD but without acute abdominal disease were randomly selected as the control group.The clinical characteristics, laboratory examination and treatment between two groups were compared and analyzed.Results:There were 8 males and 6 females.The average age of patients was(4.46±0.74) years.Compared with control group, there was no significant difference in age, sex and proportion of coronary artery injury in acute abdomen group( P>0.05). Acute abdominal disease group were more likely to have gastrointestinal symptoms, intravenous immunoglobulin(IVIG) resistance and longer fever duration( P<0.05). C-reactive protein(CRP), alanine aminotransferase(ALT), aspartate aminotransferase(AST), γ-glutamyltranspeptidase(GGT) and total bilirubin(TBIL) in acute abdominal disease group were significantly higher( P<0.05). There was no significant difference in white blood cell, erythroayte sedimentation rate, hemoglobin, platelet, Na + , albumin between two groups( P>0.05). All of the 14 patients used IVIG, 3 of them were treated with hormone(methylprednisolone)and 1 patient accepted infliximab.All patients were discharged from hospital.After follow-up for 6 months to 3 years, all patients had no sequelae of digestive system. Conclusion:KD can be complicated with acute abdominal disease, some of which as the first symptom.Gastrointestinal manifestations such as abdominal pain are common.For children with obvious gastrointestinal symptoms, IVIG resistance, and long duration of fever, attention should be paid to the possibility of acute abdominal disease.For children with significantly elevated CRP, ALT, AST, GGT, and TBIL should to be alert to the possibility of acute abdominal disease.KD complicated with acute abdominal disease generally has good prognosis.It is important to treat KD in the first place.

7.
Article in Chinese | WPRIM | ID: wpr-908377

ABSTRACT

Objective:To provide a theoretical basis for diagnosing and treating recurrent Kawasaki disease based on data analysis of clinical symptoms.Methods:Data analysis of children with recurrent Kawasaki disease admitted to Beijing Children′s Hospital of Capital Medical University from January 2016 to December 2019 was conducted, including comparisons of the initial onset and the recurrence on patients′ clinical features, auxiliary examination and treatment.Results:During the four-year scale, 3 041 children with Kawasaki disease were admitted to the department of Cardiology.The recurrence data involved 65 children[male∶female 3.1∶1, average aged(2.42 ± 2.04) years]. First, children′s fever duration was(5.66 ± 2.37) days in recurrence data, significantly shorter than that of their initial onset.The recurrence data also reported a lower incidence of rash and limb changes, together with respiratory and gastrointestinal symptoms.Then, 19 cases out of the 65 children got coronary artery lesion(CAL) at their initial onset.A relief of CAL was reported from 15 children when the disease recurred, along with 11 new-reported CAL cases.Intravenous immunoglobulin(IVIG) refractory Kawasaki disease cases accounted for nine at the initial onset and 12 at the recurrent onset, respectively.Five IVIG refractory recurrent cases reported significant relief after 2 g/kg IVIG treatment.Conclusion:The recurrent Kawasaki disease in children usually occurs among children under three years old, within the first year after the initial onset.Most of the recurrent cases report a shorter fever duration and less typical clinical symptoms than their first onset.In some cases, IVIG treatment showed effects initially but failed to work when the disease recurred.Therefore, glucocorticoid or infliximab should be considered for further treatment.

8.
Article in Chinese | WPRIM | ID: wpr-908349

ABSTRACT

Objective:To summarize the characteristics of hypertension and target organ damage in hospitalized children, so as to provide scientific basis for comprehensive prevention and management of hypertension children.Methods:The clinical data of 165 hospitalized children diagnosed with hypertension at Beijing Children′s Hospital from January 2017 to December 2019 were analyzed retrospectively.Data including medical history, clinical symptoms, signs, auxiliary examination and treatment strategy were collected and analyzed statistically.Results:Of 165 admitted hypertensive children who met the inclusion criteria, 35(21.2%)were classified as having primary hypertension, and 130(78.8%)were secondary hypertension.The body mass index(BMI)and the rate of family history of children with primary hypertension were higher than those of children with secondary hypertension, the differences were statistically significant( t=2.052, P=0.026; χ2=3.321, P=0.009). Among 165 children with hypertension, 137 had varying degrees of clinical symptoms(83.0%), only nine primary hypertension cases showed symptoms.The original etiologies of secondary hypertension included 78 cases of renal disease(60.0%), 23 cases of cardiogenic disease(17.7%), six cases of endocrine disease(4.6%)and five cases of rheumatic disease(3.8%). Of all admitted patients, the blood pressure of 158 cases(95.8%)decreased to normal with weight control, low-fat and low-salt diet, antihypertensive drugs and treatment of primary disease.Besides, the parents of seven cases gave up any treatment and left hospital. Conclusion:Secondary hypertension is the main type of hypertension in children, among which renal parenchymal disease is the most common etiology.The clinical symptoms also vary by its original etiology.The overall goal of this study is to reduce the risk of target organ damage, and get blood pressure under control relatively early and effectively.

9.
Article in Chinese | WPRIM | ID: wpr-907950

ABSTRACT

The clinical data of a child with giant coronary aneurysm complicated with myocardial infarction admitted to the Department of Cardiology, Beijing Children′s Hospital, Capital Medical University in February 2019 was retrospectively analyzed.The child, male, aged 2 years and 8 months, presented with symptoms related to cardiac insufficiency.Echocardiography showed giant coronary aneurysm with thrombosis, severe enlargement of the heart, reduction of cardiac function and ventricular aneurysm formation.After anticoagulation, antiplatelet, cardio tonic, diuretic and vasodilator therapy, the clinical symptoms of the patient were slightly relieved, but the ventricular aneurysm gradually expan-ded, and the prognosis was poor.Myocardial infarction is very rare in children, the main cause of which is coronary aneurysm caused by Kawasaki disease.Its early recognition and diagnosis are particularly important, and timely and correct treatment can significantly improve the prognosis.

10.
Article in Chinese | WPRIM | ID: wpr-907888

ABSTRACT

Objective:To summarize the clinical and genetic characteristics of catecholaminergic polymorphic ventricular tachycardia (CPVT) in children caused by CASQ2 gene variants. Methods:The clinical data of 8 children (4 males and females, respectively) with CPVT caused by CASQ2 gene variants admitted to Beijing Children′s Hospital, Capital Medical University from January 2017 to November 2018 were retrospectively analyzed.The targeted next generation sequencing was employed to identify CASQ2 variants and Sanger sequencing was conducted to conform the candidate variants and determine the parental origin. Results:As for 8 children in this study, the average age of onset was 6.4 years, the mean age at diagnosis was 9.4 years, and the average interval from onset to diagnosis was 3 years.Only 2 cases had clearly diagnosis at onset, other 6 cases had a delay to diagnosis and 3 cases of them were diagnosed at other hospitals as having epilepsy and did not respond to anti-epileptic therapy.During physical activity and/or emotional stress, 8 cases presented with recurrent syncope and were able to regain consciousness after a few minutes.They had no a history of sudden cardiac death or family history.There was no abnormality on resting electrocardiogram during the paroxysmal interval in 6 cases and mild sinus bradycardia in 2 cases.Typical bidirectional ventricular tachycardia (VT) and/or polymorphic VT were detected in 8/8 cases and 5/5 cases, respectively, based on Holter electrocardiography and cardiac stress test.The CASQ2 gene variant was found in all children, with 6 cases carrying compound heterozygous variants and 2 cases carrying homozygous variants.A total of 9 different CASQ2 variants were detected in 8 cases, of which 5 had not been previously reported.According to the family-line verification, all of them had a familial variant, with no novel variants.All 8 cases were treated orally with β-blockers, with asymptomatically recurrent episodes, with a mean follow-up of 1.5 years, during which implantable cardioverter defibrillation was performed in 1 case owing to severe sinus bradycardia.There was no death case among them. Conclusions:CPVT with CASQ2 variants is characterized by early onset before preschool age, recurrent syncope after exercise or emotional stress and bidirectional/polymorphic VT.Early diagnosis of CPVT remains challenging due to delayed diagnosis or misdiagnosis.Treatment with β-blockers can achieve favorable effectiveness and safety.Five novel variants in this study would further expand the database of CASQ2 genes.

11.
Article in Chinese | WPRIM | ID: wpr-907887

ABSTRACT

Objective:To summarize characteristics and rules of blood pressure variability (BPV) in children with H-type hypertension, in an attempt to explore some basis for further selection of the time points of treatment.Methods:A total of 117 children diagnosed as essential hypertension in Children′s Hospital Affiliated to Capital Institute of Pediatrics from March 2018 to September 2019 were selected as the research objective.According to the serum level of homocysteine (Hcy), those children were divided into the simple essential hypertension group (74 cases, Hcy≤13.9 μmol/L) and the H-type hypertension group (43 cases, Hcy>13.9 μmol/L). All children received 24 h ambulatory blood pressure monitoring (24 h ABPM), and BPV indexes were recorded and subject to group comparison.Meanwhile, the serum Hcy level was monitored.Besides, the demographic data and such blood biochemical indexes as blood glucose, blood fat and renal function were recorded or measured for an analysis of the correlation between BPV and each index.Results:There were no significant differences in gender, age, body mass index (BMI) and biochemical indexes between the simple essential hypertension group and the H-type hypertension group (all P>0.05). Compared with the simple essential hypertension group, the H-type hypertension group had a significantly higher 24 h systolic blood pressure standard deviation [24 h SSD, (11.21±3.23) mmHg vs.(9.64±2.73) mmHg, 1 mmHg=0.133 kPa, t=-2.806, P<0.05], nighttime systolic blood pressure standard deviation [nSSD, (10.79±3.89) mmHg vs.(9.26±3.23) mmHg, t=-2.292, P<0.05], and nighttime diastolic blood pressure standard deviation [nDSD, (10.23±3.53) mmHg vs.(8.73±2.93) mmHg, t=-2.617, P<0.05]. Pearson correlation analysis showed that the serum Hcy level was significantly positively correlated with 24 h, SSD, nSSD and nDSD ( r=0.194, 0.183, 0.182, all P<0.05). Conclusions:24 h SSD in children with H-type hypertension is significantly higher, with an obvious increase in both nSSD and nDSD, and the serum Hcy level was significantly positively correlated with BPV, which suggested that it was required to effectively control the serum Hcy level, reduce the range of blood pressure fluctuation and select the optimal time points of treatment, thus delaying the progress of hypertension.

12.
Rev. bras. cir. cardiovasc ; 35(5): 713-721, Sept.-Oct. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1137324

ABSTRACT

Abstract Objective: To modify the chronic atrial fibrillation of atrial tachycardia pacing in beagles with a homemade pacemaker placed outside the body and to evaluate connective tissue growth factor and fibrosis of atrial tissue in our modified atrial tachycardia pacing beagle model. Methods: Twelve adult beagles of either sex were randomly divided into an atrial tachycardia pacing group and a control group (n=6 in each group). We performed the temporary pacemaker implantation at the right atrial appendage and put the pacemaker into the pocket of dog clothing in the atrial tachycardia pacing group. After eight weeks of atrial tachycardia pacing, the electrocardiography, transthoracic echocardiography, hematoxylin-eosin staining, and Masson's staining of the right atrial appendages were performed along with the immunohistochemistry, quantitative real-time polymerase chain reaction, and Western blot analysis of connective tissue growth factor, collagen I, and collagen III. Results: In the atrial tachycardia pacing group, atrial fibrillation was induced in five beagles (83.3%); the left atrium enlarged significantly; more canines had mitral regurgitation; and the Masson's staining, quantitative real-time polymerase chain reaction, and Western blot results demonstrated more obvious fibrosis of the left atrium. Conclusion: The modified beagle model of atrial fibrillation using a right atrium pacemaker outside the body was effective, increased connective tissue growth factor and collagen I messenger ribonucleic acid overexpression, and induced atrial fibrosis.


Subject(s)
Humans , Animals , Dogs , Pacemaker, Artificial , Atrial Fibrillation/etiology , Disease Models, Animal , Heart Atria/diagnostic imaging
13.
Chinese Journal of Cardiology ; (12): 772-776, 2020.
Article in Chinese | WPRIM | ID: wpr-941174

ABSTRACT

Objective: To analysis the clinical characteristics and to summarize therapy experience of pediatric patients with cardiac syncope caused by anomalous origin of the left coronary artery from the right sinus (ALCA-R). Methods: We retrospectively analyzed the clinical data including clinical manifestations, myocardial injury biomarkers, radiological features, treatments and prognoses of pediatric patients with ALCA-R who were admitted to Beijing Children's Hospital from November 2015 to June 2018. Results: Four female patients were included in this analysis, age of onset was 7 to 14 years. All the patients presented with exercise-induced syncope and acute myocardial infarction. During the course, three patients presented with acute left heart failure, and one patient had history of sudden cardiac arrest. Laboratory data showed significant elevation of both the creatine kinase and troponin levels in four patients. All electrocardiogram (ECG) showed left main coronary artery occlusion, echocardiography suggested the possible anomalous origin of the left coronary artery in one child. Coronary CT angiography (CTA) revealed there was no coronary ostium in the left coronary sinus, and the left coronary artery had an anomalous origin from the right sinus. The left main coronary artery passed between the ascending artery and the root of the main pulmonary artery, which was compressed by these two large vessels. Two patients underwent cardiac magnetic resonance examination, which detected late gadolinium enhancement in ALCA-R with an interarterial course. Unroofing of the left coronary ostium (cut-back procedure) was performed in two patients, and the other two patients who were not operated were recommended to restrict their physical activities. During a regular follow-up period of 12-43 months, all the children survived without recurrent cardiovascular event. Conclusion: If an adolescent presents with exercise-induced syncope, acute myocardial infarction and even sudden death, and ECG shows left main coronary artery occlusion characteristics, we should consider the possibility of developmental abnormality of coronary artery, particularly the ALCA-R. Once diagnosed as ALCA-R, patients should be recommended to avoid strenuous activities,early recognition and surgical treatment are imperative for these patients.


Subject(s)
Adolescent , Child , Contrast Media , Coronary Angiography , Coronary Vessel Anomalies , Female , Gadolinium , Humans , Retrospective Studies , Syncope
14.
Chinese Journal of Epidemiology ; (12): 629-633, 2020.
Article in Chinese | WPRIM | ID: wpr-821111

ABSTRACT

Objective To investigate the epidemiological characteristics of a family clustering of COVID-19. Methods Field epidemiological survey was conducted. Result Case 1 of the long-term residents from Hubei province was the source of infection of this family clustering. There were 6 cases (from case 2 to case 7) infected in the whole incubation period. The incubation period was more than 14 days for 3 of the second-generation cases. Routes of transmission include respiratory droplets (from case 1 transmitted to case 6, from case 1 to her family members) and closecontact (from case 1 to other cases in her family). All the age groups were generally susceptible, while elderly were easier to progress to critically ill. Besides respiratory symptoms, there were also gastrointestinal symptoms, of which diarrhea was the most common one. Conclusion Family clustering had been an important part for COVID-19 cases.

15.
Article in Chinese | WPRIM | ID: wpr-864939

ABSTRACT

Objective:To analyze the changes of myocardial damage markers during ventricular tachycardia (SVT) onset and efficacy of various therapeutic approaches.Methods:The clinical data of 256 children with SVT admitted to Beijing Children′s Hospital Affiliated to Capital Medical University from October 2018 to October 2019 were retrospectively analyzed.According to the age of onset, children were divided into groups of 0~3 years old, >3-6 years old, and >6 years old.According to the different heart rates at the time of attack, patients were divided into the groups of <180 times/min, 180~260 times /min, and >260 times /min.According to the treatment methods, children were divided into physical therapy group, drug therapy group and radiofrequency ablation group.Frequency of SVT attacks, heart rate at the onset, serum creatine kinase isoenzyme (CK-MB), troponin (cTn) I, and brain natiuretic peptide(BNP) were collected within 2 h after the onset stop.The recovery rate of each treatment group was counted.Results:Among the 256 cases, there were 135 males and 121 females, which aged from 1 month to 18 years, mean age was (10.2±2.2) years and SVT attacked from 1 to 8 times.The faster the heart rate during SVT attack, the higher CK-MB, cTnI and BNP ( P<0.05). The recovery rate was 27.6% in the mechanical stimulation group, 98.0% in the drug treatment group and 100% in the radiofrequency ablation group, respectively.Successful recovery rate was 47.2%(34 cases)with ATP, 71.7%(109 cases)with Propafenone, 67.3%(64 cases)with Cediland, 59.6%(31 cases)with Verapamil, 61.5%(24 cases)with Sotalol and 54.7%(29 cases)with Amiodarone.Eithty-two cases were successfully converted by two drugs(32.7%) and 38 cases were successfully converted by three drugs(15.1%). Conclusion:When SVT attacks, most children have myocardial damage.The faster the heart rate, the greater the damage in the heart muscle; The treatment of SVT in children should still be the first choice of physical therapy in older children, and if it is not effective, drug therapy should be selected.Radiofrequency ablation is the most effective method to cure tachyarrhythmia.

16.
Article in Chinese | WPRIM | ID: wpr-864291

ABSTRACT

Objective:To study the method and clinical effect of transcatheter closure of children′s secondary atrial septal defect (ASD) by femoral vein under the guidance of echocardiography.Methods:A total of 306 children (137 males and 169 females) with secondary ASD undergoing transcatheter closure surgery in the Department of Car-diology of Beijing Children′s Hospital from January 2017 to October 2019 were enrolled.The age of the patients was 2.1-15.0 years old [(6.18±2.45) years old], and the weight was 10-63 kg [(23.05±9.97) kg]. Among 306 children, 259 cases had single central ASD, with the defect diameter of 5-25 mm; 47 cases had ethmoid ASD, and the shunting range was measured to be 11-31 mm by echocardiography.Patients had normal cardiac function, and no other cardiac malformations were found.Eighteen children are complicated with other system malformations, including funnel chest in 5 children, chicken chest in 4 children, scoliosis in 4 children, epilepsy in 2 children, and Down′s syndrome in 3 children.In addition, there were 8 children with ASD and arrhythmia.Specifically, 3 cases were complicated by preexcitation syndrome, 3 cases by ventricular premature beat and 2 cases by supraventricular tachycardia.Three patients with ventricular premature beat, 1 patient with supraventricular tachycardia and 1 patient with preexcitation syndrome had indications of radiofrequency ablation.All the operations were performed in the same time with ASD occlusion via femoral vein under basic anesthesia.ASD occlusion was guided by transthoracic or transesophageal echocardiography.Results:Of all 306 cases enrolled, ASD occlusion was successfully performed in 301 cases under the guidance of echocardiography, but it failed in 5 cases due to the large ultrasonic defect during the operation.For these 5 patients, the occluder was successfully released by the method of left superior pulmonary vein under X-ray.The operation time (from the beginning of anesthesia to the sheath extubation) was 17-45 min, with an average of (21.25±8.84) min.The occluder model was 10-30 mm.The operation process was smooth, and there were no serious complications during and after the operation.Conclusions:ASD transcatheter closure by femoral vein puncture under the guidance of echocardiography is safe and feasible operation for children with ASD.It is minimally invasive and causes no radiation injury.

17.
Article in Chinese | WPRIM | ID: wpr-864141

ABSTRACT

Objective:To summarize the changes of serum cytokines in 301 children with Kawasaki disease(KD) and analyze their clinical significance.Methods:Three hundred and one pediatic patients with KD admitted to Beijing Children′s Hospital, Capital Medical University between June 2018 and July 2019 were enrolled and divided into the immunoglobulin sensitive group and immunoglobulin non-response group according to the therapeutic effect.The levels of interferon gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), interleukin-6 (IL-6), interleukin-4 (IL-4), and interleukin-2 (IL-2) were compared between the 2 groups.Results:(1)Fifty (16.6%) children had no-response to immunoglobulin.Before treatment, the level of serum cytokines in the immunoglobulin non-response group and the immunoglobulin sensitive group were as follows: IFN-γ[11.32(10.88) ng/L vs. 4.52(5.09) ng/L], TNF-α[7.43(11.25) ng/L vs. 4.42(6.04) ng/L], IL-10[14.44(20.3) ng/L vs. 8.32(7.99) ng/L], IL-6[100.28(126.39) ng/L vs. 41.34(49.32) ng/L], IL-4[1.06(1.79) ng/L vs. 0.98(1.42) ng/L], IL-2[0.48(0.90) ng/L vs. 0.40(0.62) ng/L]; there were significant differences in IFN - γ, TNF - α, IL-10 and IL-6 between the 2 groups (all P<0.05); there was no significant difference of IL-4 and IL-2 between the 2 groups (all P>0.05). (2)Before treatment and after the temperature was normal, the levels of cyto-kines in the immunoglobulin non-response group were as follows: IFN-γ[11.32(10.88) ng/L vs. 1.26(2.10) ng/L], TNF-α[7.43(11.25) ng/L vs. 1.52(3.46) ng/L], IL-10[14.44(20.3) ng/L vs. 4.63(7.00) ng/L], IL-6[100.28(126.39) ng/L vs. 22.85(39.95) ng/L], IL-4[1.06(1.79) ng/L vs. 0(0.25) ng/L], IL-2[0.48(0.90) ng/L vs. 0(0.02) ng/L]. Before treatment and after the temperature was normal, the levels of cytokines in the immunoglobulin sensitive group were as follows: IFN-γ[4.52(5.09) ng/L vs. 0.79(1.53) ng/L], TNF-α[4.42(6.04) ng/L vs. 1.60(3.4) ng/L], IL-10[8.32(7.99) ng/L vs. 3.59(3.74) ng/L], IL-6[41.34(49.32) ng/L vs. 11.90(18.84) ng/L], IL-4[0.98(1.42) ng/L vs. 0(0.88) ng/L], IL-2[0.40(0.62) ng/L vs. 0(0.14) ng/L]. The levels of cytokines decreased significantly after treatment in between 2 groups (all P<0.05). (3) Logistic regression analysis showed that IFN-γ, IL-6, fever duration and albumin were independent risk factors for no-response to immunoglobulin. Conclusions:Children with abnormally high serum IFN-γ and IL-6 levels before treatment are more likely to resist immunoglobulin.Therefore, the change of the condition in such children should be closely monitored.If there is no response to immunoglobulin, immunoglobulin should be used again as soon as possible or second-line drugs should be applied to improve the prognosis.

18.
Article in Chinese | WPRIM | ID: wpr-846008

ABSTRACT

Objective: To study the constituents from the roots of Paeonia lactiflora. Methods: The chemical constituents were isolated by various chromatographic techniques and their structures were elucidated by physicochemical properties and NMR data. Results: Eleven compounds were obtained and characterized as (4S)-perillic acid 6-O-α-L-arabinopyranosyl-(1'→6'')- β-D-glucopyranosyl (1), 4,9-dihydroxy-8,10-dehydrothymol-1-O-β-D-glucoside (2), emodin-8-O-β-D-glucoside (3), resveratrol (4), β-D-glucopyranosyl benzoate (5), ilexperphenoside A (6), catechol (7), methyl gallate (8), ethyl gallate (9), 3-methoxygallic acid (10), 1,2,3,4,6-penta-O-galloyl-β-D-glucopyranoside (11). Conclusion: Compound 1 is identified as a new compound, named perillic acid glycoside, compounds 2 and 5 are identified from the genus Paeonia for the first time.

19.
Chinese Journal of Pediatrics ; (12): 113-117, 2020.
Article in Chinese | WPRIM | ID: wpr-799310

ABSTRACT

Objective@#To investigate the clinical features and improve the diagnosis and treatment of anomalous origin of the left coronary artery from the right coronary sinus with an interarterial course (ALCA-R-IAC) between the ascending aorta and main pulmonary artery in children.@*Methods@#A retrospective analysis of the clinical manifestation, laboratory test, radiological feature, treatment and prognosis were conducted in four female children presented with ALCA-R-IAC in Beijing Children′s Hospital from November 2015 to June 2018.@*Results@#The four girls with onset age of 7.5-14.7 years were diagnosed with ALCA-R-IAC by CT coronary angiography (CTCA). Four children presented with exercise-induced syncope and clinical manifestations of acute myocardial infarction including 3 patients with acute left heart failure, 1 cardiogenic shock and 1 cardiac arrest. Nervous system involvement was found in one patient. Troponin I increased significantly to 20.65-50.00 μg/L in the four patients. Electrocardiogram (ECG) developed signs of left main coronary artery involvement. Echocardiography revealed reduced left ventricular ejection fraction (LVEF) of 25%-45% in three children and suspected anomalous origin of the left coronary artery in one child. CTCA showed an anomalous left coronary artery originating from the right coronary sinus, which had an interarterial course between the aorta and pulmonary artery leading to a slim left main coronary trunk. Two children underwent unroofing procedure and the other two children in whom physical activities were restricted received conservative managements. During a regular follow-up period of 12-43 months, all the children survived without recurrent symptoms and had good prognosis.@*Conclusions@#ALCA-R-IAC can present as exercise-related syncope and acute myocardial infarction, even sudden death in children and adolescents. CTCA is helpful to clarify the early diagnosis of ALCA-R-IAC. Surgical intervention is the main treatment for ALCA-R-IAC and strenuous physical activities should be avoided.

20.
Rev. bras. cir. cardiovasc ; 34(6): 711-722, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1057503

ABSTRACT

Abstract Objective: To determine the role of the dishevelled binding antagonist of beta catenin 1 (DACT1) in the cytoskeletal arrangement of cardiomyocytes in atrial fibrillation (AF). Methods: The DACT1 expression and its associations with the degree of fibrosis and β-catenin in valvular disease patients were analyzed by immunohistochemistry and Masson's staining. DACT1 was overexpressed in the atrial myocyte cell line (HL-1) and the cardiac cell line (H9C2) by adenoviral vectors. Alterations in the fibrous actin (F-actin) content and organization and the expression of β-catenin were detected by flow cytometry, immunofluorescence, and Western blotting. Additionally, the association of DACT1 with gap junctions connexin 43 (Cx43) was detected by immunohistochemistry, immunofluorescence, and Western blotting. Results: Decreased cytoplasmic DACT1 expression in the myocardium was associated with AF (P=0.037) and a high degree of fibrosis (weak vs. strong, P=0.028; weak vs. very strong, P=0.029). A positive association was observed between DACT1 and β-catenin expression in clinical samples (P=0.028, Spearman's rho=0.408). Furthermore, overexpression of DACT1 in HL-1 and H9C2 cells induced an increase in β-catenin and subsequent partial colocalization of DACT1 and β-catenin. In addition, F-actin content and organization were enhanced. Interestingly, DACT1 was positively correlated with the Cx43 expression in clinical samples (P=0.048, Spearman's rho=0.370) and changed the Cx43 distribution in cardiac cell lines. Conclusion: DACT1 proved to be a novel AF-related gene by regulating Cx43 via cytoskeletal organization induced by β-catenin accumulation in cardiomyocytes. DACT1 could thus serve as a potential therapeutic marker for AF.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Atrial Fibrillation/metabolism , Cytoskeleton/metabolism , Nuclear Proteins/metabolism , Connexin 43/metabolism , Myocytes, Cardiac/cytology , Adaptor Proteins, Signal Transducing/metabolism , Atrial Fibrillation/physiopathology , Atrial Fibrillation/genetics , Immunohistochemistry , Nuclear Proteins/genetics , Cell Movement , Connexin 43/genetics , Adaptor Proteins, Signal Transducing/genetics
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