Comparison of N-terminal pro-brain natriuretic peptide and echocardiography in the early diagnosis of Kawasaki disease / 中华实用儿科临床杂志

Objective To compare the differences between roles of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and that of echocardiography in early diagnosis of Kawasaki disease (KD).Methods Medical records of patients with KD at the Department of Pediatrics,Fujian Provincial Hospital from January 2013 to December 2017 were collected retrospectively.The levels of NT-proBNP and the echocardiographic parameters on admission were compared between patients with varying days of fever by the Chi-squared test.Results A total of 154 patients with typical KD (TKD) were identified.Among them,104 cases had fever ≤7 days on admission,90 cases out of them with NT-proBNP≥300 ng/L,14 cases with coronary artery lesion detected by echocardiography,and 13 cases with positive findings in both NT-proBNP and echocardiography.For patients having ≤ 7 days of fever,the positive rate of NT-proBNP value was significantly higher than that of echocardiographic examination (x2 =74.05,P ＜ 0.05).Fortyfour cases had 8-11 days of fever,and among them 7 cases with NT-proBNP≥300 ng/L,8 cases with coronary artery lesion,3 cases with two indexes positive.For patients with 8-11 days of fever,there was no significant difference in the positive rate between NT-proBNP and echocardiography (x2 =0,P ＞ 0.05).Among 6 total cases who had 12-21 days of fever,3 cases had coronary artery lesion,none with NT-proBNP ≥ 300 ng/L.For patients with 12-21 days of fever,there was no significant difference in the positive rate between NT-proBNP and echocardiography (x2 =0,P ＞ 0.05).A total of 102 cases with incomplete KD (IKD) were enrolled,and among them of 69 cases had fever ≤7 days on admission,56 cases with NT-proBNP ≥ 300 ng/L,6 cases with coronary artery lesion,and 6 cases with positive findings in both indexes.For IKD patients with ≤ 7 days of fever,the positive rate of NT-proBNP value was significantly higher than that of echocardiographic examination (x2 =50.00,P ＜ 0.05).Twenty-nine cases had 8-11 days of fever,and among them 5 cases with NT-proBNP ≥ 300 ng/L,4 cases with coronary artery lesion.For IKD patients with 8-11 days of fever,there was no significant difference in the positive rate between NT-proBNP and echocardiography (x2 =0,P ＞ 0.05).In cases with 12-21 days of fever,2 cases had coronary artery lesion,none with NT-proBNP ≥300 ng/L.Echocardiography revealed coronary artery lesions in 2 cases.For patients with 12-21 days of fever,there was no significant difference in the positive rate between NT-proBNP and echocardiography (x2 =0,P ＞ 0.05).Conclusions Higher levels of NT-proBNP can be helpful for early diagnosis of KD in children,which is a better predictor than echocardiography.

Comparison of N-terminal pro-brain natriuretic peptide and echocardiography in the early diagnosis of Kawasaki disease / 中华实用儿科临床杂志

Objective@#To compare the differences between roles of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and that of echocardiography in early diagnosis of Kawasaki disease (KD).@*Methods@#Medical records of patients with KD at the Department of Pediatrics, Fujian Provincial Hospital from January 2013 to December 2017 were collected retrospectively.The levels of NT-proBNP and the echocardiographic parameters on admission were compared between patients with varying days of fever by the Chi-squared test.@*Results@#A total of 154 patients with typical KD (TKD) were identified.Among them, 104 cases had fever ≤7 days on admission, 90 cases out of them with NT-proBNP≥300 ng/L, 14 cases with coronary artery lesion detected by echocardiography, and 13 cases with positive findings in both NT-proBNP and echocardiography.For patients having ≤7 days of fever, the positive rate of NT-proBNP value was significantly higher than that of echocardiographic examination (χ2=74.05, P<0.05). Forty-four cases had 8-11 days of fever, and among them 7 cases with NT-proBNP≥300 ng/L, 8 cases with coronary artery lesion, 3 cases with two indexes positive.For patients with 8-11 days of fever, there was no significant difference in the positive rate between NT-proBNP and echocardiography (χ2=0, P>0.05). Among 6 total cases who had 12-21 days of fever, 3 cases had coronary artery lesion, none with NT-proBNP≥300 ng/L.For patients with 12-21 days of fever, there was no significant difference in the positive rate between NT-proBNP and echocardiography (χ2=0, P>0.05). A total of 102 cases with incomplete KD (IKD) were enrolled, and among them of 69 cases had fever ≤7 days on admission, 56 cases with NT-proBNP≥300 ng/L, 6 cases with coronary artery lesion, and 6 cases with positive findings in both indexes.For IKD patients with ≤7 days of fever, the positive rate of NT-proBNP value was significantly higher than that of echocardiographic examination (χ2=50.00, P<0.05). Twenty-nine cases had 8-11 days of fever, and among them 5 cases with NT-proBNP≥300 ng/L, 4 cases with coronary artery lesion.For IKD patients with 8-11 days of fever, there was no significant difference in the positive rate between NT-proBNP and echocardiography (χ2=0, P>0.05). In cases with 12-21 days of fever, 2 cases had coronary artery lesion, none with NT-proBNP ≥300 ng/L.Echocardiography revealed coronary artery lesions in 2 cases.For patients with 12-21 days of fever, there was no significant difference in the positive rate between NT-proBNP and echocardiography (χ2=0, P>0.05).@*Conclusions@#Higher levels of NT-proBNP can be helpful for early diagnosis of KD in children, which is a better predictor than echocardiography.

A Survey on 578 Clinical Nurses'Knowledge and Skills and Cognition of Rehabilitation Nursing in Seven Hospitals in Yunnan Province / 昆明医科大学学报

Objective To provide suggestions on how to improve the ability of rehabilitation nursing by investigating the current situation of clinical nurses' knowledge, skills and cognition of rehabilitation nursing and analyzing the influential factors. Methods According to the cross-sectional survey method, a self-designed questionnaire was used to investigate the clinical nurses' current status of knowledge and skills, cognition of rehabilitation nursing.Totally 278 nurses from 7 hospitals were included in this study. Results The scores of clinical nurses' knowledge, skeills and cognition of rehabilitation nursing were 11.13 ±3.29 and 33.27 ±3.92. Variables associated with the scores of the rehabilitation nursing are age, nursing professional title, work duration, and degree of education. Conclusion The clinical nurses had positive attitude on rehabilitation,but their knowledge and skill were insufficient. Measures should be taken to improve nurses'ability of rehabilitation nursing.

Correlational Analysis of Diastolic Heart Failure and Bone Mineral Density in the Elderly / 中国医科大学学报

Objective To study the relationship between the severity of diastolic heart failure(DHF)and bone mineral density in the elderly. Methods Totally 80 elderly patients aged over 80 years who were tested as normal for cardiac diastolic function by Doppler tissue imaging(DTI) were selected and divided into four groups by the e/a ratio,i.e.,the normal group(n=18),the DHF 1 group(0.8≤e/a<1,n=25),the DHF 2 group (0.6≤e/a<0.8,n=22),and the DHF 3 group(e/a<0.6,n=15). And the other 20 healthy people by physical examination were set as the normal control group.All subjects underwent bone mineral density(BMD)measurement(including femoral neck,total femoral hip and lumbar vertebra 1?4) by dual energy X?ray absorptiometry. Results Bone mineral density(BMD)was significantly decreased(P<0.05)in DHF groups(DHF 1,DHF 2,and DHF 3). Bone mineral density significantly decreased along with the severity of DHF. Bone mineral density was positively correlated with the e/a ratio in the elderly with DHF(r=0.75,P<0.01). Conclusion The severity of diastolic heart failure is closely related to bone mineral density in the elderly. The severity of diastolic heart failure could predict osteoporosis.

Diagnostic value of echocardiography for cardiac tumors of 87 cases / 心血管康复医学杂志

Objective:To explore the diagnostic value of color Doppler echocardiography for cardiac tumors .Meth-ods:Clinical data of 87 patients with cardiac tumors were retrospectively analyzed ,including their diseased loca-tion ,clinical manif′estations and echocardiography feature .Results:All cardiac tumors obtain pathologic confirma-tion .There were 73 patients (83.9% ) with benign cardiac tumors ,including 66 patients (90.4% ) with myxoma and seven patients with other types ;there were 14 patients (16.1% ) with malignant cardiac tumors .Echocardiography indicated that myxoma was often located in left atrium (n=58) ,most cases possessed pedicell,its activity was large ;Other type benign cardiac tumors feature :The 6 case (86% ) were generated inside cardiac muscle without pedicell, its echo was more strong ;malignant tumors:its attachment surface was wide without pedicell,and it may show with globular or cauliflower ,and accompanied hydropericardium mostly .Conclusion:Echocardiography can dynamically observe the form ,size ,echo and hemodynamic changes of tumors ,its diagnostic accuracy is high .Myxoma is most frequent cardiac tumor .