Objective:Surgery intervention and its effect on pregnancy heart disease were explored. Meth-ods:Retrospective review of 34 cases of pregnancy heart disease who needed surgery intervention from Jan, 2000 to Dec,2007 was done. Results:17 patients had percutaneous balloon mitral valve (PBMV) dilatation, the area of mitral valve enlarged markedly postoperatively ( P <0.01 ). 9 patients had open chest surgery un-der extracorpory circulation,7 of them had re-replacement mechanical valve due to mechanical valve throm-bosis. One patient had left atrium mucomamectomy. One patient had Wad's sinus breakout and repairmen. 5 patients had Radiofrequency catheter ablation (RFCA) for supraventricular tachycardia. 3 patients had int-racardiac device (ICD) for Ⅲ grade atrioventicular block. 22 patients had cardiac function as grade Ⅲ～Ⅳ and postoperatively recovered to grade Ⅰ～Ⅱ . All 34 patients were alive after treatment, 23 fetus were alive (67.6%), and no adverse results were found during the follow-up. Conclusions:When patients who had pregnancy heart disease need surgery intervention, individualized treatment plan should be made by multidis-cipline experienced doctors according to different heart disease and cardiac function.

The harm of SARS(severe acute respiratory syndrome) in 2003 is remarkable.Through analyzing the influencing factors of the infectious diseases in late 30 years,we find that the biological factors and social circumstance closely related the infectious diseases.The author suggests that we should build a general hygiene concept which aimed to improve social environment,and make effective public hygiene system the measure to prevent and control the infectious diseases.

0.05). Conclusion LCP enrichment formula is suitable to premature infants. Its lipid composition is more close to that of breast milk and benefit to the brain and retina development of premature infants.

ObjectiveTo explore the effect of statin in reduction of my ocardial injury in patients undergoing percutaneous coronary intervention(PCI).MethodsTotal of 185 patients undergoing PCI were included,140 patients were received atorvastatin before PCI,while 145 were not given statins at the time of PCI.Creatine kinase-MB and troponin Ⅰ were measured at baseline and at 8 and 24 hours after the procedure.ResultsPost procedurul peak levels of troponin Ⅰ and creatine kinase-MB were(0.12 ±0.26) μg/L and(2.61 ± 3.07) μg/L in the observation group,which were significantly lower than(0.51 ± 1.14) μg/L and( 6.85 ± 14.38 ) μg/L in the control group( t =3.951,3.414,P ＜ 0.05).ConclusionPretreatment with atorvastatin for 7 days could significantly reduces procedural myocardial injury in elective PCI.

Objective To study the correlation between simple obesity and flbrinogen Bβ-148C/T and Bβ448G/A gene polymorphism in children and to provide theoretical basis for children's imple obesity prevention.Methods 5ml fasting blood sample was taken from each patient.PCR and restriction enzyme digestion were used to detect the fibrinogen Bβ-148C/T and Bβ448G/A gene genotype.Results The genotype distribution of Bβ-148C/T was significantly different between simple obesity and normal controls(CC51/67, CT47/37 ,TT8/2, P =0.03 );The allele frequency in the children with simple obesity was higher than that of the healthy controls{ C 149/171 ,T63/41 ,P = 0.02).However, there was no significance between two groups in genotype distribution of Bβ 448G/A and allele frequency (GG61/69, AG41/32, AA4/5, G163/70, A49/42, P > 0.05 ). Conclusion There is significant cor-relation between simple obesity and fibrinogen Bβ-148 gene polymorphism in children but not between simple obesityand fibrinogen Bβ 448G/A gene polymorphism.

Objective To monitor the situation of iodine deficiency disorders (IDD) in Tibet,and to provide a background information of iodine nutritional status of residents before adjustment of iodine concentration.Methods According to the method of population proportionate sampling (PPS),27 counties were selected to carry out IDD surveillance.One primary school was selected in each county.Forty children aged 8-10 from each primary school were sampled to examine thyroid volume,and edible salt samples were collected from their home to determine salt iodine.In addition,12 of the sampled children,15 pregnant women and 15 lactating women from three townships near the selected schools were chosen to detect urinary iodine.The methods of B-ultrasonography,oxidation-reduction titration (GB/T 13025.7-1999) and arsenic cerium catalytic spectrophotometry (WS/T 107-2006) were used to determine thyroid volume,salt iodine and urinary iodine,respectively.Results One thousand and eighty-one children aged from 8 to 10 were examined,and their goiter rate was 1.9％ (20/1 081).Seven hundred and fifty-eight salt samples were determined,and the median salt iodine level was 38.3 mg/kg and the consuming rate of qualified iodized salt was 88.1％(758/668).Meanwhile,urine samples of 522 children aged 8-10,267 pregnant women and 336 lactating women were also tested,and their median urinary iodine level was 166.1,132.7,138.1 μg/L,respectively.Conclusions The results show that the goiter rate and urinary iodine level of children aged from 8 to 10 have reached the national standard of IDD elimination (＜5％,100-300 μg/L),while the residents consumption rate of qualified iodized salt is still lower than the national standard (90％).In particular,the iodine nutrition of pregnant women is inadequate,which is lower than the national standard (urinary iodine 150 μg/L).It is still necessary to strengthen the monitoring of salt iodine as well as iodine nutrition in special groups in the future,and strengthen health promotion at the same time.

Objectives To screen the high-risk population of stroke in China using color Doppler flow imaging (CDFI)and to establish a stroke risk prediction model in Chinese population in order to prevent and treat stroke early. Methods Forty-one base hospitals and 715 286 people in the project areas of the first 6 provinces of China conducted routine physical examinations and investigated the related risk factors for cardiocerebrovascular diseases from July 2011 to April 2012 using a cross-sectional study,among them 61 860 patients underwent carotid CDFI screening,and 49 386 of them were high-risk population (exposed to≥3 risk factors). The bilateral common carotid interma-media thickness (IMT),the number of plaques and the degree of carotid stenosis were screened and documented. And whether carotid IMT thickening or not,with or without carotid plaques,and degree of carotid artery stenotic rate 0-49% and≥50% were performed by multivariate logistic regression analysis with the risk factors for stroke,respectively. Results (1)Logistic regression analysis showed that hypertension,atrial fibrillation,smoking,and lack of physical exercise were the independent risk factors for carotid IMT thickening (hypertension:OR,1. 17;95%CI 1. 12-1. 22;atrial fibrillation:OR,1. 15;95%CI 1. 09-1. 21;smoking:OR,1. 13;95%CI 1. 08-1. 17;and lack of physical exercise:OR,1. 12;95%CI 1.08-1. 16). (2)Hypertension,atrial fibrillation, smoking,and diabetes were the independent risk factors for carotid plaque and carotid artery stenosis rate≥50%(carotid plaque,hypertension:OR,1. 55;95%CI 1. 47-1. 62;atrial fibrillation:OR,1. 13;95%CI 1.06-1. 21;smoking:OR,1. 16;95%CI 1. 11-1. 22;and diabetes:OR,1. 30;95%CI 1. 24-1. 37). Carotid stenosis rate≥50%,hypertension:OR,1. 78;95%CI 1.55-2. 03;atrial fibrillation:OR,1. 59;95%CI 1. 39-1. 81;smoking:OR,1. 33;95%CI 1. 20-1. 48;and diabetes:OR,1. 30;95%CI 1. 17-1. 45. Simple obesity did not increase the incidences of carotid atherosclerotic plaque and carotid artery stenosis ≥50%(OR,0. 78, 0.83;95%CI 0. 75-0. 82 ,0. 75-0. 92,respectively). Conclusions Neck vascular ultrasound can be used as a valuable means for screening high-risk population and detecting risk factors of stroke. It has an important clinical significance for the early diagnosis and treatment of carotid atherosclerosis disease.

Objective To grasp the prevalence of drinking brick-tea type fluorosis in Tibet,and to provide scientific basis for the development of prevention and control strategies.Methods Twelve counties were selected from 7 regions in Tibet.In accordance with the "Drinking Brick-Tea Type Endemic Fluorosis Monitoring Program",a total of 46 administrative villages were selected as survey points using the cluster stratified sampling method.Household water samples,tea-water samples and adult urine samples were collected,and household fluorine intake status and incidence of skeletal fluorosis in adults over 16 years old were investigated.In the rural grade primary school where the village children were concentrated,all children aged 8-12 were selected,urine samples were collected,and the prevalence of dental fluorosis was investigated.Fluoride contents in tea,water,and urine were detected by ion selective electrode method.The dental fluorosis and skeletal fluorosis were examined and judged according to the "Diagnosis of Dental Fluorosis" (WS/T 208-2011) and the "Diagnostic Criteria for Endemic Skeletal Fluorosis" (WS 192-2008),respectively.Results A total of 46 villages in 12 counties were investigated,1 992 of water samples,1 662 of tea samples,664 of children urine samples,3 186 of adult urine samples were detected;547 children aged 8-12 were examined dental fluorosis and 3 196 adults were examinea skeletal fluorosis,respectively.The water fluoride contents in all the investigated villages were less than 1.0 mg/L;the average fluoride content in brick-tea water was 6.12 mg/L,within the range of 0.11-84.00 mg/L,and the average daily brick tea fluorine intake of residents was 24.98 mg.The geometric mean of urine fluoride in children and adults was 0.76,2.28 mg/L,respectively.The prevalence rates of dental fluorosis in children and skeletal fluorosis in adults over 16 years old were 31.81％ (174/547) and 48.59％ (1 553/3 196),respectively.The children dental fluorosis index was 0.60.The detection rate of skeletal fluorosis in adults aged 36-45 was 13.37％ (69/516).Conclusions The prevalence of drinking brick-tea type fluorosis in Tibet is serious and widely distributed.In particular,the prevalence rate of skeletal fluorosis in adults is relatively high,while that of dental fluorosis in children is relatively mild.The prevention and control of drinking brick-tea type fluorosis in Tibet brook no delay.

Objective:To investigate the pathogenesis, clinical signs and diagnosing procedures of relapsing polychondritis(RP) in children with airway involvement.Methods:The medical history, clinical symptoms, physical examination, electronic laryngoscopy and imaging findings of six patients were retrospectively analyzed. The patients diagnosed as relapsing polychondritis with involving the airway from January 2018 to December 2021 were in our hospital. The clinical features of the 6 cases were summarized.Results:All 6 patients were male, ranging in age from 8 years 1 month to 14 years 1 month, with a median age of 12.04 years. Stridor and dyspnea were observed in all patients, with hoarseness in 2 patients and frequently nocturnal dyspnea during sleep in 2 patients. Initially, all children were diagnosed as laryngitis or laryngotracheitis, and were treated symptomatically with glucocorticoids and aerosol inhalation. Immunosuppressants and targeted therapy with biologics were given after patients diagnosed as RP. All patients were ultimately required tracheostomy. The time from the onset of airway symptoms to tracheostomy ranged from 1 month to 27 months. Two children had a history of endotracheal intubation prior to tracheostomy. All 6 patients underwent electronic laryngoscopy, revealing involvement of the laryngeal and subglottic mucosa and cartilage structures, which showed gradual improvement with medical therapy. Computed tomography (CT) of the trachea with three-dimensional reconstruction was performed in all patients, demonstrating moderate to severe subglottic stenosis. Two patients exhibited complete airway obstruction at the C4-C6 cervical level. Three children underwent suspension laryngoscopy under general anesthesia and endotracheal mucosal biopsy.Of the 6 children, 3 presented with nasal tip collapse or saddle nose, 2 had auricular cartilage changed, and 1 had scleralinvolvement. One patient underwent PET-CT scanning, which revealed tracheal collapse, diffuse increase in FDG(Flurodeoxyglucose)metabolism with increased FDG uptake in the nasal alar regions. All children were followed up for 2-3 years, 1 child died, while the remaining five continued to receive medical treatment.Conclusions:Relapsing polychondritis with airway involvement has an insidious onset and is difficult to diagnose. The airway stenosisresulting from RP is always severe and necessitating tracheotomy to maintain airway patency in the majority of cases.The treatment coursef or RP is prolonged, requiring long-term tracheostomy tube placement.

OBJECTIVE To investigate the therapeutic effect of autologous costal cartilage transplantation with anterior/posterior split of cricoid cartilage on laryngotracheal stenosis in children.METHODS A retrospective analysis of 12 cases of laryngotracheal stenosis in children treated with anterior/posterior split of cricoid cartilage combined with T-tube implantation in Beijing Children's Hospital Affiliated to Capital Medical University in recent years.There were 5 males and 7 females,aged from 2 years and 6 months to 16 years and 9 months,with an average age of 8 years and 9 months.There were 2 cases of grade Ⅱ stenosis,9 cases of grade Ⅲ stenosis and 1 case of grade Ⅳ stenosis.All cases underwent tracheotomy before operation.The course of disease ranged from 4 months to 6 years,with an average of 3 years.RESULTS Of the 12 patients,10(83.3％)were cured,and the tracheotomy cannula was successfully removed to restore normal breathing and pronunciation function.There were 2 cases of extubation failure,including 1 case of grade Ⅲ stenosis and 1 case of grade Ⅳ stenosis.CONCLUSION The etiology of laryngotracheal stenosis in children is complex and difficult to treat.Anterior/posterior split costal cartilage transplantation combined with T-tube implantation through internal/external cervical approach can achieve good therapeutic effect in the treatment of laryngotracheal stenosis in children.