Echocardiographic evaluation of cardiac dyssynchrony in patients with congestive heart failure / 华中科技大学学报（医学）（英德文版）

The present study investigated the application of echocardiography to evaluation of cardiac dyssynchrony in patients with congestive heart failure (CHF). A total of 348 consecutive CHF patients who were admitted for cardiac resynchronization (CRT) and presented with low ejection fraction (EF) and wide QRS duration were enrolled in this study, along with 388 healthy individuals. Dyssynchrony was assessed based on filling time ratio (FT/RR), left ventricular pre-ejection delay (PED), interventricular mechanical delay (IVMD), longitudinal opposing wall delay (LOWD) and radial septal to posterior wall delay (RSPWD). Response to CRT was defined as a ≥15% increase in EF. The results showed that FT/RR was decreased while PED, IVMD, LOWD and RSPWD were increased in the CHF group compared with the control group (P<0.01). In the CHF group, FT/RR was negatively correlated with the QRS duration, LV end-diastolic diameter (LVESd), LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) (P<0.01), but positively with the LVEF (P<0.01). Additionally, PED, IVMD, LOWD and RSPWD were positively correlated with the QRS duration, LVESd, LVEDV and LVESV (P<0.01), but negatively with the LVEF (P<0.01). The CHF group was divided into three subgroups according to the varying degrees of LVEF. FT/RR decreased successively from the LVEF-1 group to the LVEF-2 group to the LVEF-3 group, while the PED, IVMD, LOWD and RSPWD successively increased in the same order (P<0.01). The CHF group was divided into three subgroups according to the varying degrees of QRS duration, and FT/RR decreased successively in a sequence from the QRS-1 group to the QRS-2 group to the QRS-3 group, while the PED, IVMD, LOWD and RSPWD successively increased in the same order (P<0.01). Speckle tracking radial dyssynchrony ≥130 ms was predictive of an EF response in patients in QRS-1 group (78% sensitivity, 83% specificity), those in QRS-2 group (83% sensitivity, 77% specificity) and in QRS-3 group (89% sensitivity, 79% specificity). In conclusion, echocardiography is a convenient and sensitive method for evaluating cardiac dyssynchrony in patients with CHF.

Posterior interosseous nerve entrapment after Monteggia fracture-dislocation in children / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Although most of nerve injuries associated with Monteggia fracture-dislocation in children are neurapraxias and will recover spontaneously after conservative treatment, surgical exploration of the involved nerve is always required in the cases with the entrapment of posterior interosseous nerve (PIN). However, the necessity and time frame for surgical intervention for specific patterns of nerve dysfunction remains controversial. The aim of the report is to observe and understand the pathology of PIN injury associated with Monteggia fracture-dislocation in children, and to propose the possible indication for the exploration of nerve.</p><p><b>METHODS</b>Eight cases, six boys and two girls, with Monteggia fracture-dislocation complicated by PIN injury, managed operatively at the authors?Hospital from 2007 to 2008 were retrospectively reviewed. All the patients underwent the attempted closed reduction before they received exploration of PIN, with open reduction and internal fixation or successful closed reduction.</p><p><b>RESULTS</b>The PIN was found to be trapped acutely posterior to the radiocapitellar joint in 4 out of 5 Type III Bado's Monteggia fractures. In the remaining cases, since there were longer time intervals from injury to operation, chronic compressive changes and epineural fibrosis of radial nerve were visualized. After a microsurgical neurolysis performed, the complete recovery in the nerve function was obtained in all the cases during the follow-up.</p><p><b>CONCLUSION</b>The findings from this study suggest that every case of type III Monteggia fracture-dislocation with decreased or absent function of muscles innervated by PIN and an irreducible radial head in children should be viewed as an indication for immediate surgical exploration of the involved nerve to exclude a potential PIN entrapment.</p>

Investigation on anxiety state of NICU newborn babies' family members / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the anxiety state of family members of newborns admitted to the neonatal intensive care unit (NICU) and investigate the influencing factors of their anxiety state.</p><p><b>METHODS</b>The self-designed questionnaire was used to collect the associated family information of 200 newborns who were admitted to the NICU. A self-rating anxiety scale was applied to investigate the anxiety state of the newborns' family members.</p><p><b>RESULTS</b>The anxiety score of the newborns' family members averaged 44.86+/-7.59, which was significantly higher than that of domestic norm of adult (37.23+/-0.58; P<0.05). The differences of the family members' anxiety score were related to the severity of baby's diseases, their educational level and family's economic condition as well as the locality of the family (countryside or city). The more severe the baby's illness, the higher anxiety score of the family members had. The family members with higher educational levels or poorer economic conditions had higher anxiety scores. The anxiety score of the family members from the countryside was higher than that of the family members from city.</p><p><b>CONCLUSIONS</b>The family members of NICU newborns have obvious anxiety. The degree of anxiety is associated with the severity of baby's illness, educational level of the family member, family's economic condition and the family locality (countryside or city). These results remind the medical staff working in the NICU should pay more attention to communicating with the family members in a compassionate way and help them to cope with this stressful situation.</p>