Two-dimensional ultrasound combined with HD-live silhouette technology in embryos/fetuses with normal or abnormal central nervous system during early pregnancy / 中华围产医学杂志

Objective:To study the ultrasonographic characteristics of embryos/fetuses with normal or abnormal central nervous system (CNS) from 7 to 13 +6 weeks of gestation using high resolution two-dimensional ultrasound combined with HD-live silhouette technology and provide a reference for early diagnosis of CNS abnormalities. Methods:Eighty normal embryos/fetuses during 7-13 +6 weeks and 41 fetuses with CNS malformations in early pregnancy during 11-13 +6 weeks were selected to observe the ultrasonographic features of embryos/fetuses with normal or abnormal CNS using transvaginal high resolution two-dimensional ultrasound and HD-live silhouette technology. Descriptive analysis was performed on the results. Results:From seven weeks of gestational age, high resolution two-dimensional ultrasound combined with HD-live silhouette technology can clearly and stereoscopically show the prosencephalon, mesencephalon and rhombencephalon. The rhombencephalon changed the most in the brain development of embryos. At nine weeks of gestation, cleared structures of pons curvature, the fourth ventricle and cisterna magna were observed. The developing cerebellum and the original Blake pouch cyst were seen at 10 weeks of gestation. From 11 to 13 +6 weeks, the most remarkable change was the choroid plexus of the fourth ventricle changed from perpendicular to parallel to the long axis of the neural tube. Of the 41 fetuses with CNS malformation, 16 (39.0%) were exencephaly, 11 (26.8%) were holoprosencephaly, five (12.2%) were encephalocele, four (9.7%) were anencephaly, three (7.3%) were fourth ventricle dilatation, and two (4.9%) were open spina bifida. Conclusions:High resolution two-dimensional ultrasound combined with HD-live silhouette technology can clearly and stereoscopically display the morphological changes in embryonic embryos/fetuses with development of normal CNS at 7-13 +6 weeks, which is helpful to better understand the origin of CNS embryonic abnormalities and provide diagnostic clues for the early detection of CNS abnormalities.

Clinical analysis and etiology factors of pulmonary embolism in 30 children / 中华实用儿科临床杂志

Objective:To investigate the clinical characteristics and etiology of pulmonary embolism in children, and to discuss the efficacy and safety of anticoagulation therapy.Methods:The data of 30 children with pulmonary embolism, who were treated with anticoagulation therapy in the Department of Pediatrics, Provincial Hospital Affiliated to Shandong First Medical University from January 2017 to December 2021, were analyzed retrospectively.The etiology, clinical characteristics, complications, outcomes and prognosis after anticoagulation treatment were analyzed.Results:There were 17 males and 13 females, with an average age of (8.95±2.58) years (age range: 4-13 years). The follow-up duration was 3-59 months.(1) The symptoms included cough in 30 cases (100.0%), fever in 29 cases (96.7%), shortness of breath in 27 cases (90.0%), chest pain in 15 cases (50.0%), hemoptysis in 9 cases (30.0%), bloody secretions under bronchoscopy but no hemoptysis in 4 cases (13.3%), and respiratory failure in 2 cases (6.7%). (2) The protopathy was Mycoplasma pneumoniae infection in 23 cases (76.7%), whose symptoms accorded with refractory Mycoplasma pneumoniae pneumonia.About 16 cases (53.3%) were positive for Mycoplasma pneumoniae drug resistance mutation 2063A>G or 2064A>G.Two cases (6.7%) had nephrotic syndrome.One case (3.3%) had purpura nephritis (nephrotic syndrome type). One case (3.3%) was lupus nephritis (nephrotic syndrome type). One case (3.3%) was hereditary protein S deficiency.One case (3.3%) had osteomyelitis and Staphylococcus aureus sepsis.One case (3.3%) had congenital heart disease.(3) Complications included limb thrombosis in 7 cases (23.3%), atrial thrombosis in 2 cases (6.7%), thoracic and abdominal deep venous thrombosis in 2 case (6.7%), cerebral infarction in 2 cases (6.7%), and splenic infarction in 1 case (3.3%). (4) Imaging examination showed that 30 children had lung consolidation/atelectasis (100.0%), and 24 cases had pleural effusion (80.0%). (5) Coagulation function examination suggested D-dimer increased to ≥ 5 mg/L in 21 cases (70.0%). (6) One case (3.3%) was given thrombolytic therapy with urokinase at the acute stage.Nine cases (30.0%) were treated with heparin/low molecular weight heparin.Twenty-one cases (70.0%) first received anticoagulation therapy with heparin/low molecular weight heparin and later took oral anticoagulant.Four cases (13.3%) were treated with Warfarin and 17 cases (56.7%) with Rivaroxaban.The anticoagulant treatment lasted 1-9 months.No recurrence of embolism or sequelae of chronic thromboembolic pulmonary hypertension was observed. Conclusions:Infection, especially Mycoplasma pneumoniae infection, is the main cause of pulmonary embolism in children.The symptoms of pulmonary embolism in children are atypical, so it is difficult to distinguish this disease from primary underlying diseases.Bronchoscopy can help find occult pulmonary hemorrhage.Unexplained shortness of breath in children of any age suggests the possibility of pulmonary embolism.Combination of clinical symptoms and necessary examination contribute to early diagnosis of pulmonary embolism.Then selection of appropriate anticoagulant drugs and timely anticoagulant therapy can improve the prognosis of children.

Clinical analysis and etiology factors of pulmonary embolism in 30 children / 中华实用儿科临床杂志

Objective:To investigate the clinical characteristics and etiology of pulmonary embolism in children, and to discuss the efficacy and safety of anticoagulation therapy.Methods:The data of 30 children with pulmonary embolism, who were treated with anticoagulation therapy in the Department of Pediatrics, Provincial Hospital Affiliated to Shandong First Medical University from January 2017 to December 2021, were analyzed retrospectively.The etiology, clinical characteristics, complications, outcomes and prognosis after anticoagulation treatment were analyzed.Results:There were 17 males and 13 females, with an average age of (8.95±2.58) years (age range: 4-13 years). The follow-up duration was 3-59 months.(1) The symptoms included cough in 30 cases (100.0%), fever in 29 cases (96.7%), shortness of breath in 27 cases (90.0%), chest pain in 15 cases (50.0%), hemoptysis in 9 cases (30.0%), bloody secretions under bronchoscopy but no hemoptysis in 4 cases (13.3%), and respiratory failure in 2 cases (6.7%). (2) The protopathy was Mycoplasma pneumoniae infection in 23 cases (76.7%), whose symptoms accorded with refractory Mycoplasma pneumoniae pneumonia.About 16 cases (53.3%) were positive for Mycoplasma pneumoniae drug resistance mutation 2063A>G or 2064A>G.Two cases (6.7%) had nephrotic syndrome.One case (3.3%) had purpura nephritis (nephrotic syndrome type). One case (3.3%) was lupus nephritis (nephrotic syndrome type). One case (3.3%) was hereditary protein S deficiency.One case (3.3%) had osteomyelitis and Staphylococcus aureus sepsis.One case (3.3%) had congenital heart disease.(3) Complications included limb thrombosis in 7 cases (23.3%), atrial thrombosis in 2 cases (6.7%), thoracic and abdominal deep venous thrombosis in 2 case (6.7%), cerebral infarction in 2 cases (6.7%), and splenic infarction in 1 case (3.3%). (4) Imaging examination showed that 30 children had lung consolidation/atelectasis (100.0%), and 24 cases had pleural effusion (80.0%). (5) Coagulation function examination suggested D-dimer increased to ≥ 5 mg/L in 21 cases (70.0%). (6) One case (3.3%) was given thrombolytic therapy with urokinase at the acute stage.Nine cases (30.0%) were treated with heparin/low molecular weight heparin.Twenty-one cases (70.0%) first received anticoagulation therapy with heparin/low molecular weight heparin and later took oral anticoagulant.Four cases (13.3%) were treated with Warfarin and 17 cases (56.7%) with Rivaroxaban.The anticoagulant treatment lasted 1-9 months.No recurrence of embolism or sequelae of chronic thromboembolic pulmonary hypertension was observed. Conclusions:Infection, especially Mycoplasma pneumoniae infection, is the main cause of pulmonary embolism in children.The symptoms of pulmonary embolism in children are atypical, so it is difficult to distinguish this disease from primary underlying diseases.Bronchoscopy can help find occult pulmonary hemorrhage.Unexplained shortness of breath in children of any age suggests the possibility of pulmonary embolism.Combination of clinical symptoms and necessary examination contribute to early diagnosis of pulmonary embolism.Then selection of appropriate anticoagulant drugs and timely anticoagulant therapy can improve the prognosis of children.

Analysis of the bronchodilation test in asthmatic children with normal forced expiratory volume in 1 second, forced vital capacity and 1-second rate / 中华实用儿科临床杂志

Objective:To evaluate the positive rate of the bronchodilation test (BDT) in asthmatic children with normal forced expiratory volume in 1 second (FEV 1), forced vital capacity (FVC) and FEV 1/FVC, so as to improve the recognition of the importance of the BDT test in asthmatic children with normal FEV 1, FVC and FEV 1/FVC. Methods:Children aged 5-14 who were diagnosed with asthma in the outpatient clinic of Shandong Provincial Hospital Affiliated to Shandong University from September 2018 to August 2019 and willing to receive pulmonary function and BDT examinations were enrolled.Data of pulmonary function of children with normal FEV 1, FVC and FEV 1/FVC were collected to analyze the rate of positive BDT results and the status of small airway function. Results:A total of 1 631 asthmatic children with normal FEV 1, FVC and FEV 1/FVC were enrolled in this study, including 1 414 children with normal pulmonary function and 217 children with small airway dysfunction.Fifteen minutes after the bronchodilator was inhaled, 127 children (87 males and 40 females) showed positive BDT results, accounting for 7.8%.Among these children, 62 cases (28.6%) with co-existing small airway dysfunction showed positive BDT results.The improvement rate of FEV 1 was 8.0% to 11.9% in 132 cases (8.1%). The FEV 1 before bronchodilator inhalation accounted for (98.5±10.3)% of the predicted value.Fifteen minutes after terbutaline sulfate inhalation, the improvement rate was 13.5% (12.5%, 16.2%). The improvement rates of forced expiratory flow at 50% of FVC exhaled (FEF 50, r=-0.339, P<0.01), forced expiratory flow at 75% of forced vital capacity exhaled (FEF 75, r=-0.400, P<0.01), maximum mid-expiratory flow(MMEF, r=-0.375, P<0.01) were negatively correlated with their baseline values.The improvement rate of FEV 1 was not associated with its baseline value ( r=-0.128, P=0.153), but negatively correlated with the baseline value of MMEF ( r=-0.231, P<0.01). Conclusions:BDT results are positive in some asthmatic children with normal FEV 1, FVC and FEV 1/FVC.It is recommended that BDT testing should be conducted as much as possible in the diagnosis and follow-up of children with typical or atypical asthma.In this way, the diagnosis can be confirmed and the current optimal results can be obtained.Meanwhile, small airway function testing is helpful for comprehensive assessment of asthma and its control level.

Application of stem cells - 3D scaffold complex in wound dressing / 国际外科学杂志

The clinical treatment of large-area trauma or intractable wound is very difficult. Finding a suitable wound dressing is very important for wound healing. Stem cells can secrete and express a variety of cytokines necessary for wound healing, and can grow and proliferate for a long time in three-dimensional (3D) scaffold materials to maintain their proper structure and function. A large number of studies have shown that transplanting stem cells-3D scaffold complex into the skin wound in the form of a moist dressing can significantly improve the efficiency of stem cells transplantation, shorten the wound healing time, and reduce scar formation. Stem cells-scaffold complex are likely to be a good wound dressing. This article mainly summarizes the selection of wound dressing and the research status of stem cells-3D scaffold complex as a wound dressing, aiming to provide a theoretical basis for the clinical application of stem cells-3D scaffold complex.

Clinical efficacy of anti-anxiety treatment in patients with arrhythmia / 中国基层医药

Objective@#To analyze the relationship between arrhythmias and anxiety, and to evaluate the effect of anti-anxiety treatment in patients with arrhythmias while given conventional treatment.@*Methods@#From February 2015 to February 2017, 111 patients with arrhythmia in the Fourth Hospital of Handan were selected in the study, and they were divided into treatment group(n=62) and control group(n=49) according to the admission to single and double wards.The control group was treated with conventional anti-arrhythmias drugs, while the treatment group was treated with low-dose of anti-anxiety drugs and conventional anti-arrhythmias drugs.The therapeutic effects, symptoms improvement time and adverse reactions were compared between the two groups.@*Results@#The effective rate in the treatment group was 96.8%(60/62), which in the control group was 77.6%(38/49), the difference was statistically significant between the two groups (χ2=9.78, P<0.05). The time of symptoms improvement significantly was (4.7±1.1)d in the treatment group, which in the control group was (6.9±1.3)d, there was statistically significant difference between the two groups(t=7.33, P<0.05). There was no statistically significant difference in side effect between the two groups(P>0.05).@*Conclusion@#Arrhythmia has a certain relationship with anxiety.Anti-anxiety combined with anti-arrhythmic treatment can improve the curative effect of patients with arrhythmia and shorten the time when symptoms begin to improve.

Clinical efficacy of anti－anxiety treatment in patients with arrhythmia / 中国基层医药

Objective To analyze the relationship between arrhythmias and anxiety , and to evaluate the effect of anti －anxiety treatment in patients with arrhythmias while given conventional treatment .Methods From February 2015 to February 2017,111 patients with arrhythmia in the Fourth Hospital of Handan were selected in the study,and they were divided into treatment group (n＝62) and control group (n＝49) according to the admission to single and double wards.The control group was treated with conventional anti －arrhythmias drugs,while the treatment group was treated with low －dose of anti －anxiety drugs and conventional anti －arrhythmias drugs.The therapeutic effects,symptoms improvement time and adverse reactions were compared between the two groups .Results The effective rate in the treatment group was 96.8%(60／62), which in the control group was 77.6%(38／49), the difference was statistically significant between the two groups (χ2 ＝9.78,P＜0.05).The time of symptoms improve－ment significantly was (4.7 ±1.1)d in the treatment group ,which in the control group was (6.9 ±1.3)d,there was statistically significant difference between the two groups (t＝7.33,P＜0.05).There was no statistically significant difference in side effect between the two groups (P＞0.05).Conclusion Arrhythmia has a certain relationship with anxiety.Anti－anxiety combined with anti －arrhythmic treatment can improve the curative effect of patients with arrhythmia and shorten the time when symptoms begin to improve.

Cilia ultrastructural and gene variation of primary ciliary dyskinesia: report of three cases and literatures review / 中华儿科杂志

Objective@#To analyze the clinical manifestations, cilia ultrastructure and gene variations of primary ciliary dyskinesia (PCD).@*Methods@#Analysis of three cases diagnosed as PCD by transmission electron microscopy of the endobronchial biopsy material in Division of Pediatric Pulmonology of Shandong Provincial Hospital between 2013 and 2016. Target gene sequence capture and next generation sequencing were used to analyze the gene. Related literatures on gene variation of PCD in Chinese were reviewed from Online Mendelian Inheritance in Man, Human Gene Mutation Database, PubMed and CNKI up to July 2017 by using search terms of "PCD" , "gene" , "Chinese".@*Results@#There were one male and two females aged from 10 to 11 years. The common symptoms included recurrent respiratory infection, sinusitis and bronchiectasis. Two of them had situs inversus. Case 1 had lack of outer and inner dynein arms with compound heterozygous mutation of LRRC6. Case 2 had outer and inner dynein arms defects with heterozygous mutations of DNAH5 and DNAH11. Case 3 had abnormality in microtubule and inner dynein arms with homozygous mutation of CCDC39. All the variations mentioned above have not been reported before. Twelve cases have been reported about gene variations in PCD in Chinese from eight reports. All these patients had recurrent respiratory infection starting soon after birth, rhinosinusitis, and bronchiectasis. Nine of them had dextrocardia. Four cases have taken an effective nasal (or bronchial) mucosal biopsy. 1 case had inner and outer dynein arms defects. One case had inner dynein arms and radial spokes defects. One case had microtubule and central pair defects. And 1 case had normal cilia ultrastructure. Eight kinds of gene variations were found. Three cases had gene variations of DNAH5. 2 cases had gene variations of DYX1C1. 2 cases had gene variations of CCNO. There was 1 case with gene variations of CCDC39, CCDC40, HYDIN, ARMC4 and DNAI1 separately.@*Conclusions@#Recurrent respiratory infection starting soon after birth, rhinosinusitis, and bronchiectasis are the common symptoms of PCD. Eleven of fifteen Chinese PCD patients with positive gene mutations were Kartagener syndrome. Cilia ultrastructure showed defects of inner and outer dynein arms, radial spokes, microtubule and central pair. Ten kinds of gene variations were found: DNAH5, DYX1C1, CCNO, CCDC39, CCDC40, HYDIN, ARMC4, DNAI1, LRRC6、DNAH11.

Association of ORMDL3 and HLA-DQ single nucleotide polymorphisms in children with asthma associated Mycoplasma pneumoniae infection / 国际儿科学杂志

Objective Childhood asthma is closely related to MP infection.This study was to investigate the distribution of ORMDL3 and HLA-DQ gene SNP in children with MP-associated asthma and gene-gene interactions.Methods One hundred and ninety-four patients with MP infection were enrolled.Extraction of whole blood genomic DNA was carried out.The genotype was collected by Flnidigm Juno 96.96 Genotyping integrated fluid pathway system.The patients were divided into MP-asthma group and MP-non-asthma group.Gene-gene interaction was analyzed by generalized multifactor dimensionality reduction.Results MP-asthma group included 63 cases (32.5％),MP-non asthma group included 131 cases (67.5％).ORMDL3 gene rs4794820 had three genotypes of AG,GG,AA.,MP-asthma group GG genotype and G allele frequency was higher than that in MP-non-asthma group.The frequency of AA genotype was the lowest among the two groups,but in the MP-non-asthma group were higher than that in the MP-asthma group.The rs7216389 had three genotypes of TT、TC、CC,the frequency of TT genotype and T allele in MP-asthma group was significantly higher than that in MP-non-asthma group.The frequency of CC genotype was the lowest among the two groups,but CC genotype in MP-non-asthma group was significantly higher than that in MP-asthma group.The rs794820 GG genotype and rs7216389 TT genotype were found to be risk factors.ORMDL3、HLA-DQA1 and HLA-DQA2 have gene-gene interaction.Conclusion MP infection is an important external cause of asthma in children.The genotype of rs7794820 GG genotype and rs7216389 TT genotype are an important internal cause of asthma after childhood MP infection.ORMDL3 rs4794820,rs7216389 and HLA-DQA1 rs9272346,HLADQA2 rs7773955 have gene-gene interaction,synergistically enhance the risk of asthma associated with asthma in children with MP.

Effect of mind mapping-oriented health education on patient's fluid intake during hemodialysis intervals / 现代临床护理

Objective To evaluate the effect of mind mapping-oriented health education on patient's fluid intake during hemodialysis intervals. Methods From June 2015 to April 2016, 72 patients with poor compliance with fluid intake were randomly divided into control group (n=36) and observation group (n=36). In the control group, routine health education was used and the observation group was treated with mind mapping-oriented health education. The two groups were compared before intervention and 6 months after that in terms of compliance with fluid intake and daily fluid intake, ultrafiltration volume and body weight gain/dry weight ratio and incidence of complications. Results In the observation group, the fluid intake compliance, daily fluid intake, ultrafiltration volume and body weight gain/dry weight ratio 6 months after intervention were superior to those of the control group (all P<0.05). The incidences of complications such as hypotension, hypertension, muscle spasms and cardiac arrhythmia were also significantly lower than those of the control group (P<0.05). Conclusion The health education based on mind mapping is helpful to enhance the degree of cognition of fluid intake compliance, improve self-efficacy of chronic diseases, control the growth of body weight during dialysis and reduce the incidence of complications.

Value of three-vessel and trachea view plus aortic arch coronal section in ultrasonic diagnosis and classification of fetal right aortic arch / 中华超声影像学杂志

Objective To explore the value of three-vessel and trachea(3VT) view plus aortic arch coronal section in ultrasonic diagnosis and classification of fetal right aortic arch(RAA).Methods Echocardiography data and follow-up results of 44 fetuses with RAA were retrospectively analyzed.Sonographic features on 3VT view and aortic arch coronal section were summarized.Results Among 44 fetuses with RAA,27 cases(61.36%) were RAA with aberrant left subclavian artery(ALSA) and the left ductus arteriosus(LDA) connecting the ALSA and U-shaped vascular ring was formed;17 cases(38.64%) were mirror right aortic arch(MRAA).Among 17 cases with MRAA,3 cases were with LDA connecting the descending aorta(DAO) and U-shaped vascular ring was formed;1 case was with LDA connecting the left innominate artery(LINA),8 cases were with absent ductus arteriosus(ADA),5 case were with right ductus arteriosus(RDA),no vascular ring was formed.Parts of MRAA were combined with other complex intracardiac abnormalities.RAA-ALSA-LDA were rarely combined with intracardiac abnormalities.Conclusions 3VT view is simple and intuitive for diagnosing RAA.Aortic arch coronal section has great clinical value in determining the concrete type of RAA.

Polymorphisms of asthma susceptibility gene ORMDL3 in infantile wheezing / 中华实用儿科临床杂志

Objective To discuss the polymorphisms of asthma susceptibility gene ORMDL3 in infantile wheezing,in order to provide a theoretical basis for early diagnosis of asthma.Methods One hundred and fifty wheezing infants were recruited and divided into 2 groups as asthma predictive index(API) positive group(n =80) and negative group (n =70).Taqman probe was applied to detect the genotypes of 2 single nucleotide polymorphisms (SNPs)in childhood asthma susceptibility gene ORMDL3,which were rs4794820 and rs7216389.The genotype distributions were analyzed and compared between 2 groups,and the correlations among genotype distribution and tidal breath pulmonary function,fractional exhaled nitric oxide (FeNO) concentration,percentage of eosinophils (EOS％),serum immune globulin E (total IgE) levels respectively were also analyzed,respectively.Results (1) The frequencies of rs4794820 AG and rs7216389 TC heterozygotes in the API positive group were the highest,which were significantly higher than those in the negative group(58.75％ vs.31.42％,56.25％ vs.32.86％ respectively,all P ＜0.01).The frequencies of GG and TT homozygotes in the API negative group were the highest,which were significantly higher than those in the positive group (58.57％ vs.30.00％,57.14％ vs.31.25％ respectively,all P ＜0.01).(2)The time to reach the peak expiratory flow in tidal breathing over the total expiratory time (TPTEF/TE) and the volume to reach the peak expiratory flow in tidal breathing over the total expiratory volume (VPEF/VE) of the infants in the API positive group were less than those in the API negative group(16.87 ±5.31 vs.20.12 ± 5.23,20.87 ± 5.92 vs.25.56 ± 6.77,respectively),and the FeNO concentration was higher than that in the API negative group [(22.44 ± 9.77) ppb vs.(13.23 ± 7.90)ppb],and the differences were significant (t =-3.776,-4.490,6.377,respectively;all P ＜ 0.01).(3) In the API positive group,the TPTEF/TE and VPEF/VE of the infants who expressed AG/TC genotype were lower than those who expressed GG/TT genotype (14.55 ± 4.83 vs.19.91 ± 4.17,18.85 ± 4.26 vs.25.20 ± 7.06,respectively,t =-4.727,-3.976,all P ＜ 0.01);while the FeNO concentrations,EOS％ and total IgE levels were higher than those who expressed GG/TT genotype [(25.02 ± 8.77) ppb vs.(18.39 ± 6.56) ppb,7.16 ± 2.62 vs.5.50 ± 1.34,(366 727 ±275 533) IU/L vs.(166 826 ± 62 865) IU/L,respectively] (t =3.484,3.409,4.589 respectively;all P ＜ 0.01).Conclusions Childhood asthma susceptibility gene ORMDL3 SNPs rs4794820 AG and rs7216389 TC heterozygotes are the risk factors for API positive infantile wheezing.The pulmonary function damage and airway inflammation of the infants who expressed AG/TC genotype are more serious than those who expressed GG/TT genotype,and more likely to develop persistent asthma.

Analysis of epidemic characteristics and clinical features of inpatients with pertussis in 2012-2014 / 中华实用儿科临床杂志

Objective To provide basis for the diagnosis,treatment,prevention and control of pertussis by analyzing serological test findings and clinical features of inpatients.Methods Serological test findings (including outpatients and inpatients) of suspected cases and medical records diagnosed as pertussis (severe group and non-severe group) were analyzed in Shandong Provincial Hospital Affiliated to Shandong University from January 1,2012 to December 31,2014.This retrospective study was conducted to explore the epidemiological characteristics,clinical manifestations,image manifestations of pertussis in recent years.Results The incidence of pertussis was obviously higher in 2014 than the previous 2 years,nearly 10 times than that of 2013;summer and autumn were high-occurrence seasons;pertussis was found predominately in children under 6 years old,as 68％-80％,and the majority of them were 3 months-1 year old and 4-6 years old,and there was a notable increase in children more than 6 years old in 2014;the clinical manifestations tended to be atypical,primarily spasmodic cough (79.01％,64/81 cases),cyanosis (60.49 ％,49/81 cases),vomiting after cough (35.80％,30/81 cases),conjunctiva haemorrhage (22.22 ％,18/81 cases) apnea or heart rate decrease(9.88％,8/81 cases),and whooping cough (7.41％,6/81 cases).There were significant differences(all P ＜ 0.05) in age (t =2.940),paroxysmal cyanosis (x2 =4.505),elevated white blood cell count (x2 =4.410),and lymphocyte percentage increase(x2 =7.830) between severe group and non-severe group.There was no statistical difference in sex(x2 =0.847),season (x2 =0.178),spasmodic cough (x2 =0.097),whooping cough (x2 =0.002),conjunctiva hemorrhage (x2 =0.395),apnea (x2 =0.395) and fever (x2 =0.301) between the 2 groups (all P ＞ 0.05).Mixed infection with mycoplasma was most common.Imaging manifestations of pertussis were not specific,and they might manifest uneven density,patchy inflammatory infiltrates and atelectasis.Conclusions The morbidity of pertussis is rising and atypical cases is increasing in these years,and severe cases are seen most frequently in small infants,it is necessary to perfect the laboratory test methods and immunization strategy.

Evaluation of right ventricular global and regional function in patients with metabolic syndrome by two-dimensional speckle tracking imaging / 中华超声影像学杂志

Objective To evaluate the right ventricular global and regional strain and strain rate in patients with metabolic syndrome(MS) by two‐dimensional speckle tracking imaging(2D‐STI) ,and explore the correlation between different MS criteria and global strain and strain rate of right ventricle . Methods Forty‐four MS subjects ,35 pre‐MS subjects and 40 healthy subjects were enrolled . The basal ,middle and apical systolic longitudinal peak strain( Ss) and strain rate( SRs) ,early diastolic and late diastolic peak strain rate(SRe ,SRa) of right ventricular free wall were measured using 2D‐STI and global strain and strain rate ( GSs ,GSRs ) ,early diastolic and late diastolic peak strain rate ( GSRe ,GSRa ) of right ventricle were calculated . The correlation between different MS criteria and GS ,GSR of right ventricle were analyzed . Results Compared with control group ,Ss ,SRs ,SRe and SRa in basal and middle segments in MS group and Ss ,SRs in basal segment in Pre‐MS group decreased( all P 0 .05) . There were good correlation of waist circumference(WC) ,systolic blood pressure(SBP) ,fasting blood‐glucose with GSs( r =-0 .73 ,-0 .69 ,-0 .46 , P < 0 .01) and GSRs( r = -0 .63 ,-0 .78 ,-0 .48 , P < 0 .01) . The multiple regression analysis of MS criteria showed that waist circumference and systolic blood pressure were independently associated with GSs and GSRs of right ventricle(β= -0 .44 ,-0 .77 , P <0 .01) . Conclusions 2D‐STI could accurately assess right ventricular global and regional function in MS patients .Among all MS risk factors ,waist circumference and systolic blood pressure are the most responsible for right ventricular function .

Expression of TNFSF13 in human breast cancer tissues and its clinical significance / 实用肿瘤学杂志

Objective To detect the TNFSF13 expression and to evaluate its possible use as a potential prognostic marker in breast cancer .Methods We analyzed TNFSF13 expression by Western blot and qRT -PCR in 93 breast cancer patients .Results Our results showed that TNFSF 13 was overexpressed in breast cancer tis-sue.High TNFSF13 mRNA expression was closely correlated with tumor differentiation , pN classification ( P=0.003,0.022).In addition,patients with high TNFSF13 expression had a significantly shorter survival analyzed by Kaplan-Meier(P=0.04,log-rank test).Cox proportional hazards regression multivariable analysis revealed that high expression of TNFSF13 was identified as an independent prognostic factor (P=0.03).Conclusion TNFSF13 expression might be a novel target for prognosis and intensive therapy in breast cancer patients .

Overexpression of CPE-ΔN predicts poor prognosis in colorectal cancer patients / 实用肿瘤学杂志

Objective Carboxypeptidase E ( CPE) is one of the most important carboxypeptidases in-volved in the biosynthesis of numerous peptide hormones and neurotransmitters and plays an important role in en -docrine regulation .A splice variant of CPE ( CPE-ΔN) has been detected and the mechanism of CPE -ΔN action in tumorigenesis has been studied in many different cancers .The aim of this study is to examine CPE -ΔN ex-pression in human colorectal cancer ( CRC) and to evaluate its possible application as a potential prognostic mark-er.Methods In the present study ,we have analyzed isoform expression of CPE -ΔN by qRT-PCR and West-ern blot in 219 CRC patients .Results Our results showed that CPE -ΔN was overexpressed in colorectal tumor tissue and that high CPE -ΔN mRNA expression was closely correlated with tumor differentiation ,pT classifica-tion,pN classification,tumor recurrence and lymph node metastasis .High CPE-ΔN expression was also identi-fied as an independent prognostic factor using a multivariate analysis (P=0.011).Conclusion Based on these results,we can conclude that CPE -ΔN expression might be a potential prognostic marker for CRC patients .

Clinical study of high-dose glucocorticoid on early active rheumatoid arthritis / 中国医师进修杂志

Objective To investigate the effects and adverse reactions of high-dose glucocorticoid on early active rheumatoid arthritis patients.Methods The early active rheumatoid arthritis patients were randomly divided into three groups:high dose group (16 patients,with large doses of glucocorticoid therapy),low dose group (17 patients,with small doses of glucocorticoid therapy),and control group (41 patients,with no glucocorticoid therapy).Compared the differences among the three groups.Results The changes in the three groups were different in joint pain,joint swelling,morning stiffness,erythrocyte sedimentation rate,rheumatoid factor and C-reactive protein (P ＜ 0.05).The high dose group was significantly better than the other two groups in the above variables alleviating,in the 1 week after the treatment.The changes in the three groups had no significant difference of bone mineral density,Larsen hip score (P＞ 0.05).The NSAIDs days in the control group was significantly longer than the high dose group,low dose group [(51.17 ± 2.56) d vs.(14.16 ± 0.71) d,(26.50 ± 1.59) d],the difference was statistically significant (P ＜ 0.05).Rate of weight gain in the high dose group,low dose group was significantly higher than the control group [5/16,4/17 vs.4.9％ (2/41)],the difference was statistically significant (P ＜ 0.05).Body weight increased in the high dose group and low dose group occurred mainly in the following 1.5 months of therapy,with the discontinuation of cortices-teroids,weight gradually fell to normal.Gastrointestinal discomfort incidence in the control group was significandy higher than that in the high dose group,low dose group [51.2％ (21/41) vs.2/16,3/17],the difference was statistically significant (P＜ 0.05).Conclusions High-dose glucocorticoid can rapidly relieve clinical symptoms and inflammation in early active rheumatoid arthritis patients.High-dose corticosteroids do not bring too many side effects to patients but weight gain,and it reduces the patients' gastrointestinal discomfort greatly,because of the decrease use of NSAIDs.

Effect of comfort care on the quality of life and the curative compliance of elderly patients undergoing hemodialysis / 现代临床护理

Objective To invesgate the effects of comfort care on the quality of life and the curative compliance of elderly patients undergoing hemodialysis.Methods Forty-nine elderly patients undergoing hemodialysis were managed with comfort care including comfortable settings,mental care,and care to arteriovenous fistula and intubated tubes,observation of complications and the related care.The Short Form 36 Health Survey Questionnaire(SF-36)and questionnaire on medical compliance were used for the assessments.Result The scores on SF-36 and medical compliance were both significantly higher than those before the manipulation of comfort nursing(P<0.05).Conclusion Comfort care may be helpful for the improvement of the quality of life and the medical compliance of hemodialysis in elderly patients undergoing hemodialysis.

Follow up of the children with complications after percutaneous closure of atrial septal defect / 中国综合临床

Objective To observe the complications in children after percutaneeus closure of atrial septal defect (ASD). Methods 192 children,who successfully received percutaneous closure of ASD in our hospital were enrolled in this study. Diameter of ASD was 8.0 ～ 33.0( 16.7± 8.0) mm, the diameter of occluder was 8.0 ～ 38.0 ( 18.9 ± 8.2) mm. The follow-up term ranges from 1 month to 4 years, with a mean of 19.0 ± 4.5 months. Standard 12-lead electrocardiography (ECG) and transthoracic echocardiography (TIE) were performed before closure, 24 including: minimal-moderate residual shunt in 3 patients ( 1.6% ), atrial-ventricle block (AVB) in 1 ( 0.5 % ), sinus There were 184 cases of single-hole ASD, with complication rate of 2.7% (5/184) , including the complication rate in diameter of siagle-hole ASD less than 10mm was 0% , that in ASD between 10 mm and 20 mm was 1.7% (2/119) ,that in ASD more than 20 mm was 5.0% (3/60) ,while there were 8 cases of two- and multi-hole ASD, clusion, including 3 cases of minimal-moderate residual shunt, 1 case of atrial-ventricle block, 1 case of sinus brady-cardia, and 1 case of device-micro-malplesition. 2 days to 2 weeks after procedure, 1 case developed pelade ( 1/192 ). completely recovered (57. 1% ), including 1 case of residul shunt, 1 case of atrial-ventricle block, sinus bradycardia and 1 case of pelade. 2 cases of minimal residual and 1 case of device-micro-malposition were not recov-ered. Conclusions Transeatheter closure of ASD is safe and effective with few complications, most of which disapp-eare completely during follow up term. Long-term follow-up is needed to evaluate the progress of some rare complica-tions.

Analysis of Adverse Drug Reactions Associated with Proprietary Chinese Medicine from 2002 to 2006 in Beijing Hospital / 药物流行病学杂志

Objective:To analyze adverse drug reactions(ADRs)associated with proprietary Chinese medicine occurring in Beijing Hospital.Method:The ADRs associated with proprietary Chinese medicine between 2002 and 2006 were collected and the associated information was retrospectively analyzed.Result:a total of 179 ADRs were analyzed. Most of them occurring in women patients(76.1%)with hyperplasia of mammary glands who took Xiaojin pills and Xi- huang pills(22.1% & 12%).The herbal medicine injections were the other most associated ones.The clinical appearances of ADRs were rash and bodily manifestation of hypersensitiveness.Condusion:The investigation of Chinese medicine ADR plays a very important role in the modernization of Chinese medicine.