Cardiogenic syncope is the relatively common type of syncope in children. The state of illness is more serious at the onset,the prognosis of partial patients is very dangerous,even it can cause cardiac sudden death, so clinical doctors pay close attention to cardiogenic syncope. The common pathogeny of cardiogenic syncope in children includes serious arrhythmia, obstruction of the outflow tract of heart, restricted diastole of heart or weak systole of heart. Before the particular cause of disease is determined,some examinations and laboratory tests should be made. In this article, the writer introduces detailed methods of the emergent treatment.

Severe cardiac arrhythmias is not rare in chilaren.Because they usually induce striking disturbance of the blood dynamics,heart failure,cardiogenic shock,Adams-stokes attack or sudden death can happen in sick child,therefore they belong to pediatric emergency.Though cardioversion-defibrillation and cardiac pacemaker implantation are widely applied to clinical practice recently,antiarrhythmic drugs are still the most common treatment method at present.In this article,dose and usage,harmful reactions,indications and contraindications of common fist-aid medicines would be introduced,and some important problems in clinical use also be discussed.

AIM To analyze the mechanism of the adriamycin induced cardiomyopathy. METHODS The patch clamp technique in the whole cell recording was used to study the effect of adriamycin on L type calcium channel current( I Ca L ) in the isolated cardiomyocyte of the guinea pig. RESULTS The current voltage( I U ) curveshowed the bell shape in the control and in 0 1 mmol?L -1 adriamycin. Their peak potentials were about +10 mV. The amlitude of peak calcium current increased from (-0 93?0 05) nA to (-1 31?0 08) nA( P

Myocardial injury and myocarditis are the two diagnostic words frequently used by pediatricians,myocardial enzymes and cardiac troponin are also frequently detected in laboratory tests. But up to now,some pediatricians still lack a comprehensive understanding of the clinical significance of cardiac enzymes and their isoenzymes. There are still some misunderstandings about how to interpret the test results correctly. Currently,it is not uncommon for myocardial injury and myocarditis to be over-diagnosed and over-treated. In addition,new biochemical markers of myocardial injury ( cardiac troponin and highly sensitive troponin) are not well understood. This paper discussed the above clinical hot issues and introduced the relat-ed progress. It is expected that correct cognition can guide the diagnosis and treatment of myocardial injury and myocarditis in children in the future.

Coronary artery lesions caused by Kawasaki disease has become the most common cause of acquired heart disease in children, and it is also a key factor affecting the prognosis of Kawasaki disease.The Subspecialty Group of Cardiology, the Society of Pediatrics, Chinese Medical Association has issued an update "Recommendations for clinical management of Kawasaki disease with coronary artery lesions (2020 revision)" . Combining the latest clinical guidelines in China and related researches at domestic and abroad in recent years, the current status of diagnosis and treatments of coronary artery lesions caused by Kawasaki disease is summarized as follows.

OBJECTIVETo explore the effect of embolization of bronchial artery (BAE) in patients with pneumoconiosis massive hemoptysis.

METHODS49 patients with pneumoconiosis massive hemoptysis in observation group were underwent BAE, and 66 patients with pneumoconiosis hemoptysis in control group were cured with internal medicine. The rate of hemoptysis recurrence and controlling were counted during a year follow up.

RESULTSThe rate of hemoptysis recurrence in observation group was 18.8% (9/48), and in control group was 35.9% (23/64) during a year follow up, there was a significant difference (P < 0.05). The rate of massive hemoptysis recurrence in the both group were 4.2% (2/48) and 9.3% (6/64) respectively, there was not a significant difference (P > 0.05).

CONCLUSIONBAE is an effective technique in patients with pneumoconiosis massive hemoptysis.

Bronchial Arteries ; Embolization, Therapeutic ; Hemoptysis ; therapy ; Humans ; Pneumoconiosis ; therapy ; Recurrence ; Treatment Outcome

OBJECTIVETo establish a rabbit model of silicotic pulmonary fibrosis and to investigate the effect of cordyceps sinensis in this model.

METHODSThirty healthy male white rabbits were randomly divided into control group, silicosis model group, and intervention group. The rabbits in silicosis model group and intervention group received endotracheal perfusion of silicon dioxide suspension (120 mg/kg), and the control group was treated with the same volume of saline. All the rabbits were sacrificed 30 days later. The lung coefficient was calculated by comparing the lung weight and body weight; the right lung tissue was stained with hematoxylin-eosin (HE). The content of hydroxyproline in lung tissue was measured by alkaline hydrolysis. The mRNA levels of transforming growth factor beta 1 (TGF-β₁) and mothers against decapentaplegic homolog 7 (Smad7) in rabbit lung sections were determined by real-time PCR.

RESULTSNo abnormalities were observed by HE staining in the lung tissues of control group, while fibrosis and silicotic nodules were discovered in the silicosis model group and intervention group. The lung coefficient and the content of hydroxyproline in lung tissue were significantly higher in the silicosis model group than in the control group and intervention group (P < 0.05 or P < 0.01). Compared with the control group, the silicosis model group and intervention group had significantly increased TGF-β₁ mRNA levels but significantly reduced Smad7 mRNA levels (P < 0.02). Compared with the silicosis model group, the intervention group had a significantly reduced TGF-β₁ mRNA level but a significantly increased Smad7 mRNA level (P < 0.05).

CONCLUSIONCordyceps sinensis is able to reduce the expression of TGF-β₁ mRNA and increase the expression of Smad7 mRNA in lung tissues of rabbits with silicotic pulmonary fibrosis, and thus postpone the progression of fibrosis.

Animals ; Cordyceps ; chemistry ; Disease Models, Animal ; Lung ; metabolism ; Male ; Pulmonary Fibrosis ; drug therapy ; metabolism ; Rabbits ; Silicosis ; drug therapy ; metabolism ; Smad7 Protein ; metabolism ; Transforming Growth Factor beta1 ; metabolism

Objective To explore the changes in serum creatine kinase(CK)and myoglobin(Mb)levels in benign acute childhood myositis(BACM)and their clinical significance.Methods The clinical data of 78 children with BACM treated in our hospital from January 2011 to December 2023 were collected,and the dynamic changes and clinical performance of serum CK and Mb levels were re-trospectively analyzed.Results The CK levels of the 78 patients ranged from 432 U/L to 18 440 U/L,with the mean level being 2 178.8 U/L.The levels exceeded the upper reference limit(310 U/L)in all the patients.They were 2 and 10 times the upper reference limit in 72(92.31％)and 15(19.23％)patients,respectively,and were greater than 5 000 U/L in 5(6.41％)patients and greater than 10 000 U/L in 1 patient.The CK level usually peaked in the first 3 days of BACM onset before decreasing gradually.By the 7th day,CK levels in 73％of the cases decreased to the normal reference range,which was consistent with the change in clinical symptoms.Serum Mb samples were col-lected from 66 patients,and the levels ranged from 13.3 ng/mL to 2 603.8 ng/mL,with the mean level being 260.17 ng/mL.In 34 patients(51.52％),the Mb levels were higher than the upper reference limit(116.3 ng/mL).Among these patients,20(30.30％),7(10.61％),and 3(4.55％)patients had Mb levels 2,5,and 10 times higher than the upper reference limit,respectively.Serum Mb levels peaked in the first 3 days of BACM onset and then decreased quickly.Furthermore,in 84.38％of the total cases,serum Mb levels decreased to the normal reference range by the 5th day of onset.Conclusion Serum CK levels in children with BACM are significantly increased,consistent with the changes in clinical symptoms,and therefore,could be regarded as an important basis for BACM diagnosis.Furthermore,serum Mb levels increase to varying extents,indicating a great reference value in BACM diagnosis,and should be tested simultaneously with serum CK.Testing for serum CK and Mb is of great significance for understanding the clinical conditions and guiding the treatment of BACM.