Objective:To compare the clinical efficacy of high frequency oscillatory ventilation (HFOV) and conventional mechanical ventilation (CMV) in the treatment of infants with severe respiratory syncytial virus (RSV) pneumonia.Methods:A prospective randomized controlled trial was conducted. The infants with severe RSV pneumonia who received invasive mechanical ventilation admitted to intensive care unit (ICU) of Children's Hospital Affiliated to Capital Institute of Pediatrics from January 2018 to December 2019 were enrolled. According to the order of admission, each infant was assigned to HFOV group or CMV group by random number table. The basic data, pediatric critical score, blood gas analysis, ventilator parameters, oxygenation index [OI, OI = mean airway pressure (Pmean)×fraction of inspired oxygen (FiO 2)/arterial partial pressure of oxygen (PaO 2)×100], duration of mechanical ventilation, length of ICU stay, complications, prognosis, use of muscle relaxants and vasoactive drugs and other clinical indicators of the two groups were recorded. Results:A total of 28 infants were enrolled in the analysis, including 15 infants receiving CMV and 13 infants receiving HFOV. There were no significant differences in age, body weight, pediatric critical score and OI before enrollment, type Ⅱ respiratory failure, multiple organ dysfunction, basic diseases and laboratory examination indexes before enrollment between the two groups. Six hours after enrollment, compared with CMV group, heart rate (HR), respiratory rate (RR), case of transcutaneous oxygen saturation (SpO 2) decrease, case of HR decrease, case of cardiopulmonary resuscitation (CPR) and OI in HFOV group were significantly decreased [HR (bpm): 130 (125, 138) vs. 144 (140, 160), RR (times/min): 35 (34, 38) vs. 40 (35, 45), SpO 2 decrease (case: 1 vs. 10), HR decrease (case: 0 vs. 6), CPR (case: 0 vs. 4), OI: 6.5 (4.4, 8.9) vs. 9.3 (8.0, 12.8)], while case of use of muscle relaxants (case: 3 vs. 0) and volume of 7-day positive fluid balance [mL/kg: 167.1 (113.8, 212.6) vs. 90.8 (57.8, 112.7)] were significantly higher, the differences were statistically significant (all P < 0.05). There was no use of blood purification treatment, no severe complications such as pneumothorax and intracranial hemorrhage, and no death within 28 days in the two groups. Conclusion:Compared with CMV, HFOV in the treatment of infants with severe RSV pneumonia can improve the oxygenation level and clinical physiological indexes earlier, reduce the incidence of adverse events such as HR, SpO 2 decrease and CPR, increase the use of muscle relaxants and the positive fluid balance, and do not increase the incidence of severe complications such as pneumothorax and intracranial hemorrhage, so its clinical application is safe.

Purpose To detect the expressions of stress induced phosphoprotein 1 (STIP1) and estrogen receptor-α(ER-α) in papil-lary thyroid carcinoma and to analyse the relationship between STIP1 and ER-α. Methods 54 cases of paraffin-embedded tissues of papillary thyroid carcinoma, 18 cases of papillary thyroid carcinoma with lymph node metastasis, 15 cases of Hashimoto’ s thyroiditis, 10 cases of adjacent normal thyroid tissue were collected. The expressions of STIP1 and ER-αwere detected by immunohistochemistry, and the relationship between the expressions and clinicopathological features of papillary thyroid carcinoma was analyzed. Results The expression of STIP1 and ER-α in papillary thyroid cancer group ( 55. 6% and 44. 4%) were higher than that of normal thyroid group (10% and 0) and Hashimoto’s thyroiditis group (8. 3% and 0, all P<0. 05). STIP1 expressions was related to lymph node metastasis ( P<0. 05 ) , while ER-α expression was related to gender, TG-Ab and the merger of nodular goiter, but not related to lymph node metastasis (P>0. 05). The expressions of STIP1 and ER-α in papillary thyroid carcinoma were not related to patients’ age , tumor location, number of tumors, tumer size, invasion of capsule, the concomitant Hashimoto’ s thyroiditis and TPO-Ab ( all P>0. 05). And the expressions of STIP1 was not related to gender, TG-Ab and the merger of nodular goiter (all P>0. 05). A positive correlation was found between the expressions of STIP1 and ER-αin thyroid papillary carcinoma (P<0. 05). Conclusion STIP1 and ER-α in papillary thyroid carcinoma may be related with lymph node metastasis.

Objective To explore the ultrasonographic method in fetal coronary sinus (CS) dilation.Methods Totally 145 normal fetuses (normal group) and 72 fetuses of CS dilation (CS group) diagnosed prenatally were retrospectively reviewed.The long axis of coronary sinus was displayed in the non-standard four chamber view and the area of the sagittal view of CS was measured.Transverses scans combined with color Doppler were used to acquire four chamber view,left and right ventricular outflow tract views,three vessel view.In addition,sagittal scans with color Doppler were used to get short-axis view at the level of great arteries,vena cava long axis view,aortic arch view,and ductal arch view.The characteristics of CS were observed.Results CS area of sagittal view was positively correlated with gestational age (normal group:r=0.954,P＜0.05;CSgroup:r=0.904,P＜0.05).In the samegestational weeks,the CS area of the sagittal view in the normal group was less than that in the CS group (all P＜0.01).In CS group,52 fetuses were persistent left superior vena cava,15 fetuses were total anomalous pulmonary venous connection,5 fetuses were associated with right heart pressure overload.Conclusion Fetal CS sagittal section area is positively correlated with gestational age.When the fetal heart ultrasonography found CS dilation,other intracardiac malformations should also be considered.The etilogies of CS dilation should be analyzed clinically through multi-slice,multi-angle scanning.

Objective To analyze the abnormal fetal ductus arteriosus (DA) by echocardiography.Methods Seventy fetuses of abnormal DA diagnosed prenatally were retrospectively reviewed.Transverse scans combined with color Doppler were used to acquire four chamber view,left and right ventricular outflow tract views,three vessel view,and three-vesseltrachea view.In addition,sagittal scans with color Doppler were used to get vena cava long axis view,aortic arch view,and ductal arch view.The spatial relationship of the great arteries and trend of DA were observed.Results Abnormal fetal DA is mainly composed of DA absence,DA abnormal function and DA morphological abnormality.Among 70 cases of fetal DA,9 cases were diagnosed with DA absence,8 cases were DA atresia,11 cases were DA completed closure nearly,9 cases were shown with reverse DA blood perfusion,33 cases were shown with DA curvature and dilatation.Conclusion Prenatal diagnosis of DA absence and DA abnormal function is of great significance.Three-vessel-trachea view and ductal arch view combined with CDFI can make a definitive diagnosis.

Objective To investigate the effect of folic acid intervention on plasma homocysteine (Hcy) metabolic changes and pulse wave velocity(PWV)in patients with type H hypertension. Methods Patients(hos-pitalized from March 2014 to December in our hospital)with H type hypertension were randomly divided into treat-ment group and control group randomly ,and were given routine antihypertensive drug therapy. Treatment group was given oral folic acid 0.8 mg,1 times a day,the control group was given placebo,1 times a day. All patient were treated for 12 months. Changes of plasma Hcy and PWV levels were observed. Results 432 patients(Han nationality)with type H hypertension were enrolled in this study with the age of 61.7 ± 13.6 years old and the ratio of men and women is 1.3:1. The most common diseases were coronary heart disease and type 2 diabetes mellitus. 2 groups were treated for a period of 12 months,with follow-up time from 6 to 10 months(average duration in 8 months). After treatment,the difference between plasma Hcy(Z=-7.63,P=0.000)and PWV(Z=-3.16,P=0.002)levels of the two groups were statistically significant. Conclusion Folic acid intervention can significantly reduce the level of plasma Hcy in patients with type H hypertension ,slow down the progression of atherosclerosis and reduce the risk factors of cardiovascular disease.

Objective To explore the serum level of vascular endothelial growth factor (VEGF) of the patients with asymptomatic and symptomatic peripheral artery disease (PAD) in diabetics for providing evidence for screening the patients with PAD early. Methods Selected the study population including diabetics without PAD(90 cases),diabetics with asymptomatic PAD patients(93 cases)and diabetics with symptomatic PAD patients(92 cases). The level of serum VEGF was measured using enzyme linked immunosorbent assay(ELISA) and analyzed in the three groups. The varia-tion of serum VEGF was further analyzed in the three groups excluding the diabetic retinopathy in the stratified analysis. Results The serum level of VEGF with asymptomatic and symptomatic PAD in diabetics were increased,compared with the diabetics without PAD (P<0.05). Excluding the patients with diabetic retinopathy, the serum level of VEGF of the patients with asymptomatic and symptomatic PAD in diabet ics was still increased, compared with the dia betics without PAD (P<0.05). The serum level of VEGF level was significantly positively associated with HbA1c in the pa-tients with asymptomatic and symptomatic PAD in diabetics (r=0.267, 0.352, P all<0.05). Conclusion The level of serum VEGF in the patients with asymptomatic and symptomatic PAD in diabetics had been significantly increased.