OBJECTIVE:To observe the hemostasis effect of combination of repilase and nitroglycerine against Emptysis.METHODS:90patients with Emptysis were randomly divided into treatment group and control group.The treatment group were treated with Reptilase together with nitroglycerine while the control group were treated with conventional hypophysin therapy.RESULTS:The total effective rate of hemostasis against hemoptysis was95.6%in the treatment group,which ex-celled the control group which has a total effective rate of66.7%.No significant adverse effect was found in the treatment group,which had a significant difference(P

With a high success and low recurrence,catheter ablation has become the standard of cure in children with tachycardia.With the innovation of mapping ablation techniques,catheter ablation for children with tachycardia has been developed.In this review, green cardiac electrophysiology,complex arrhythmias ablation with electroanatomic mapping systems and cryoablation in children will be discussed.

Objective To discuss the application effects of fast track surgery treatment in hysterectomy. Methods 120 patients underwent hysterectomy. They were randomly assigned to two groups,namely,fast track sur-gery group(60 cases) and control group(60 cases ). two groups underwent separately fast track surgery mode and tradi-tional mode therapy. To observe the duration of passing flatus, the hospital stay, the aching time, the complication rate after operation between two groups. Results All patients got recovery. The duration of passing flatus(29.2±7.9) h,the aching time 96.7% (58/60)、the hospital stay( 3.9±2.5 )d of fast track surgery group were significantly shorter than the duration of passing flatus (50.3±15.8 ) h 、the aching time 8.3% (5/60)、the hospital stay (6.7±2.8 ) d of control group( allP<0.01 ). there was no severe complication in two groups. Conclusion Fast track surgery treat-ment mode could accelerate postoperative rehabilitation of hysterectomy patients. It shoud be popularized.

Persister cells are dormant or slowly grown variations in microbial populations .They are highly tolerant to antibiot-ics but the tolerance are not inherited as the genetic resistance , when persisters are inoculated to fresh medium , most bacteria are still susceptive to antibiotic , while only a small fractiont become persisters again .Persisters are believed to be closely related to clinic bio-film forming and the recurrence and recalcitrance of chronic infections .Different persisters have been found in Escherichia coli , Pseud-omonas aeruginosa , Staphyococcus aureus , Mycobacterium tuberculosis , Candida albicans and so on , and a few mechanisms about per-sisters formation have been studied .This article reviews the current progresses of research methods and achievements on persisters from different levels .

Idiopathic pulmonary fibrosis is divided into chronic progression stage and acute exacerbation stage according to progression of disease;early,middle and late stage according to onset time and clinic symptoms.It is considered that the etiological factors of idiopathic pulmonary fibrosis are repeated suffering of exogenous pathogen,environmental pathogen, deficiency of lung and kidney.The basic pathological products are blood stasis and phlegm turbid,the key point of pathopoiesis is that phlegm and stasis hides deeply and stagnated,the pulmonary collaterals are blocked.In addition,the evolutions of pathogenesis during its different stage are discussed.

OBJECTIVEEctopic atrial tachycardia (EAT) is a common type of supraventricular tachycardia in pediatric population, and it can be resistant to antiarrhythmic drugs and lead to tachycardia induced cardiomyopathy (TIC) if not properly managed. This study assessed the clinical course and response to treatment of EAT in children.

METHODA retrospective review included 144 children at the First Hospital of Tsinghua University diagnosed with EAT from January 2009 to April 2014. The clinical detailed history, 12 lead ECG, 24-h Holter recording, echocardiography, response to therapy and follow-up were analyzed.

RESULTThe onset of EAT occurred at any age with a distribution with positive skewness, 57 children ≤1 years, 22 children > 1 - 3 years, 25 children > 3 - 6 years and 40 children ≥ 6 years of age. The percentages of the three tachycardia types were 36. 1% (n = 52) for incessant EAT, 52. 8% (n = 76) for paroxysmal EAT and 11. 1% (n = 16) for sporadic EAT, respectively. There were 115 patients received drug therapy in our hospital and in 72 cases the EAT was completely controlled. Antiarrhythmic therapy had been discontinued in 35 children with complete control. Normal sinus rhythm was observed by telemetry or Holter within 4 to 90 days and the mean duration of medical therapy was 310 days (range 15 to 608 days) in these children. The combination of sotalol and propafenone showed better effectiveness for control of children with EAT (54%, 41/76), compared with single sotalol (36%, 24/66) and the combination of amiodarone and metoprolol (30%, 7/23) (χ2 = 6. 296, P = 0. 043). Tachycardia type was able to predict the response to antiarrhythmic drugs for children with EAT, sporadic tachycardia had best control rate on pharmacological therapy compared with paroxysmal tachycardia and incessant tachycardia (94% (15/16) vs. 67% (42/63) vs. 42% (15/36), χ2 = 17. 925, P = 0. 000) . Acute success of radiofrequency ablation (RFA) in children who showed poor response to antiarrhythmic drugs was achieved in 45 of 49 (92%), ultimate success was achieved in 33 of 49 (67%). The incidence of TIC secondary to EAT was 18. 1% (n =26), and left ventricular ejection-fraction (LVEF) returned to normal in 23 children after successful control of EAT ((61 ± 4) % vs. (43 ± 5) %, t = - 10. 036, P = 0. 000). Side effects including abnormal thyroid function (in 3) and abnormal liver function (in 1) occurred in 4 (17%) of 23 children who received amiodarone and disappeared when amiodarone was discontinued.

CONCLUSIONEAT in children predominantly occurred in young infants and children. Incessant EAT comprised a great percentage. The combination of sotalol and propafenone provided the best results for control of children with EAT. RFA should be considered as a preferred treatment for older children who displayed poor response to medical therapy.

Amiodarone ; Anti-Arrhythmia Agents ; Cardiomyopathies ; Catheter Ablation ; Child ; Child, Preschool ; Echocardiography ; Electrocardiography ; Humans ; Infant ; Retrospective Studies ; Sotalol ; Tachycardia, Ectopic Atrial ; drug therapy ; physiopathology ; Tachycardia, Supraventricular ; drug therapy ; Ventricular Function, Left

Objective To investigate the effect of independent on duty assessment in the process of new nurse standardized training.Methods Totally 64 new nurses graduated in 2010 were set as the control group.Totally 68 new nurses graduated in 2011 were named as the observation group.The nurses in the control group received hospital standardized training,on the basis of the hospital standardized training,the observation group received independent on duty training.One year later,all nurses participate in the assessment of independent on duty organized by nursing department and the evaluation results were analyzed.Results The score of emergency response capacity of the observation group was significantly higher than that of the control group.Conclusions The implementation of the independent on duty assessment can strengthen the results of standardized training and promote emergency ability of new nurses,and effectively improve the ability of new nurses in clinical work.

Objective To screen and identify International Classification of Functioning,Disability and Health (ICF) core sets for spasticity and make a dedicated and comprehensive assessment tool for spasticity after stroke.MethodsFifty patients with spasticity after stroke were involved in this study.Information about them was collected by clinical investigation and self-completed questionnaires.The ICF scale was used to assess the severity of each item.Each item's frequency was calculated and those items with frequencies ≥ 30％ were selected as the first ICF core set for spasticity.The ICF check list was designed as a questionnaire and 8 doctors and 5 therapists were consulted.Items with frequency ≥50％ were chosen as the second level ICF core set for spasticity.The two results (termed ICF core sets Ⅰ and Ⅱ) were integrated with the initial ICF core sets for spasticity and sent to 42 experts in the area of neurological rehabilitation.Items with a frequency ≥80％ were chosen as the final ICF core set for spasticity.ResultsA total of 32 ICF items were included in the ICF core set for spasticity after stroke.There were 10body function items,4 body structure items,13 activity and participation items and 5 environmental items involved.ConclusionThe ICF core set for spasticity was identified in this study.The selected items covered content broader than other common spasm assessment scales.The result is a comprehensive description of spasticity.

Objective To evaluate the safety and efficacy of radiofrequency catheter ablation(RFCA)in chil-dren with tachycardia arrhythmias. Methods One hundred and twenty - three children under 3 years old with drug -refractory tachycardia underwent an interventional electrophysiology procedure and RFCA in Medical Center of Tsinghua University from April 1994 to December 2014,including 98 male and 25 female,and their average age was(22. 9 ± 9. 6)months(2 - 35 months)and body weight was(13. 64 ± 2. 80)kg(4. 66 - 19. 40 kg). The mechanism,RFCA methods,the success rate,recurrence rate and complication rate of the different types of tachycardia were investigated. Results Among these children,interventional electrophysiological study confirmed 94 cases(76. 4% ,94 / 123 cases) with atrioventricular reentrant tachycardia(AVRT),7 cases(5. 7% ,7 / 123 cases)with atrioventricular nodal reentrant tachycardia(AVNRT),3 cases(2. 4% ,3 / 123 cases)with focal atrial tachycardia(FAT),8 cases(6. 5% ,8 / 123 ca-ses)with atrial flutter(AF),5 cases(4. 1% ,5 / 123 cases)with idiopathic left ventricular tachycardia(ILVT),6 ca-ses(4. 8% ,6 / 123 cases)arrhythmia was not induced. RFCA was performed in 109 cases(88. 6% ,109 / 123 cases). The success rate of RFCA was 94. 5%(103 / 109 cases)and the recurrence rate was 6. 8%(7 / 103 cases). In 88 cases of AVRT,the success rate was 96. 6%(85 / 88 cases),and the recurrence rate was 8. 2%(7 / 85 cases). In 5 cases of AVNRT,the success rate was 100. 0%(5 / 5 cases). In 3 cases of FAT,the success rate was 33. 3%(1 / 3 cases). In 8 cases of AF,the success rate was 87. 5%(7 / 8 cases). In 5 cases of ILVT,the success rate was 100. 0%(5 / 5 cases), and there was no recurrence. The complication of RFCA was puncture vascular occlusion in 2 cases(1. 6% ,2 / 123 ca-ses),without other serious complications and death cases. In this group of children,the fluoroscopy exposure time was (11. 2 ± 5. 8)min(5. 7 - 18. 2 min)and dose area product(DAP)exposure was(954. 5 ± 117. 4)mGy × cm2(707 -2 201 mGy × cm2 ). Compared with the elder children(379 cases over 3 years old)of the exposure fluoroscopy time (10. 8 ± 6. 4)min(3. 9 - 20. 5 min)and DAP exposure(927. 5 ± 193. 4)mGy × cm2(439 - 3 201 mGy × cm2 ),there was no statistically significant difference(t = 0. 616,1. 463,all P ﹥ 0. 05). Conclusions AVRT was the most common type of arrhythmia in infants and a higher incidence of multiple accessory pathways was found in infants. Application of radiofrequency ablation to children with tachycardia arrhythmias can be relatively safe and effective to the infants with drug - resistant tachycardia.

Objective To reveal the epidemic characteristics of influenza in Huainan of Anhui Province and provide scientific basis for prevention and control of influenza surveillance by summarizing the work of influenza virus isolation performed in 2012-2013.Methods First nucleic acid fast typing by real-time PCR method for sentinel hospitals in throat swab specimens for inspection from sentinel hospital ,the influenza virus isolation was performed by using MDCK cells and the identification of the isolates was carried out by hemagglutination ( HA) and hemagglutination inhibition(HI) tests.Results 68 strains of influenza virus were isolated (45.9%) from 148 of positive specimens detected by fluorescent quantitative real-time PCR.The number of subtype A(H1N1),A(H3N2),BY and BV were 26 strains,25 strains,4 strains and 13 strains,respectively,the success rate of the separation were 56.5%,33.3%, 63.0%,respectively.There were significant difference among the separation of the strain rate of success (P<0.05). 2012 epidemic strain in Huainan was influenza BV virus ,and reached epidemic peak in March;2013 epidemic strain was A(H1N1)influenza virus,the epidemic peak was December.Conclusion During the period of influenza surveillance in Huainan,the main subtype of influenza of the year 2012 is BV which reached epidemic peak in March , while subtype A(H1N1) is the main subtype of the year 2013,with the epidemic peak month December .