Objective To assess right ventricular (RV) regional and global volume and systolic function in patients with right coronary artery disease by real time three-dimensional echocardiography(RT-3DE).Methods RT-3DE images were acquired in 20 normal controls (Group A),30 patients with right coronary artery stenosis(Group B) and 10 patients with RV myocardial infarction(Group C).Volumetric RT-3DE images were analyzed by use of TomTec software,which provided regional (inflow,body and outflow) and global end diastolic volume(EDV),end systolic volume(ESV),stroke volume(SV) and ejection fraction(EF).RT-3DE quantitative data were analyzed to test repeatability.Results Compared with group A and group B,EDV and ESV of body and global were larger in group C;ESV of inflow and outflow were larger (P ＜0.05).EDV of group C was larger than group B(P ＜0.05).Compared with group A and group B,the EF of inflow,outflow and global in group C were lower(P ＜0.05).The EF of body in group C were lower than group B(P ＜0.05).There was no significant difference in regional and global volume and EF between group A and group B(P ＞0.05).The intra-observer and inter-observer's variability was low and consistency was high.Conclusions In patients with RV myocardial infarction,RV regional and global volumes were enlarged and systolic function was impaired.Evaluating right ventricular regional and global volume and function in patients with right coronary artery disease by RT-3DE has high repeatability.

[ ABSTRACT] AIM:To investigate the characteristics of the intestinal microbial flora in the pregnant women with congenital heart disease fetus ( PW group) and normal pregnant women ( NW group) .METHODS: Stool samples were collected from 15 NW and 17 PW cases.The bacterial genomic DNA was extracted.The 16S rDNA was amplified by PCR, and the second generation of Illumina sequencing was conducted.RESULTS: We obtained 2 696 276 ( NW group) and 2 445 530 ( PW group) optimized sequences.The coverage was greater than 97%.We obtained 77 243 operational taxono-mic units ( OTUs) in NW group and 75 600 OTUs in PW group after a 97%similarity merge.In NW group, the Chao 1 in-dex and the Shannon index were greater than those in PW group.The diversity analysis of microbial population indicated that they were mainly composed of Firmicutes, Proteobacteria and Actinobacteria.In family, the Bifidobacteriaceae and Cori-obacteriaceae were significantly different through analysis of variance.CONCLUSION: The Bifidobacteriaceae and Cori-obacteriaceae may play an important role in the occurrence of congenital heart disease.

Objective To study the different oral compound polyethylene glycol electrolyte powder on the effect of bowel preparation before colonoscopy.Methods A total of 602 inpatients or outpatients were selected from department of gastroenterology,and they were randomly divided into tranditional group(n =288)and improvement group(n =314).All patients took a dose of two box of compound polyethylene glycol electrolyte powder 4 hours before colonoscopy.Endoscopic doctor investigated the antibiotic tolerance,adverse reactions,heart rate,blood pressure,blood electrolytes and blood glucose during treatment in form of questionnaire with single blind Bosdon bowel preparation scale (BBPS)score.Results The BBPS scores of the tranditional group and improvement group were (7.03 ± 1.24)points,(7.82 ±1.12)points,the score of the improvement group was significantly higher than the traditional group(t =2.259,P <0.05).The taste scores were (1.89 ±0.07)points,(1.25 ±0.09)points (t =2.624,P <0.05),the fully taking rates were 90.28%,95.86%(χ2 =7.375,P <0.05 ),and the second taking rates were 88.54%,93.95%(χ2 =5.566,P <0.05).In contract,the score of adverse reactions of the improvement group was significantly lower than that of the traditional group [(2.58 ±0.07)points vs(2.22 ±0.09)points,t =2.068,P <0.05].There was no significant difference of colonoscopy time between the two groups[(10.78 ±4.34)min vs (9.89 ± 1.77)min,t =1.766,P >0.05 ],althought the improvement group was shorter than the tranditional group. Conclusion The modified way of oral compound polyethylene glycol electrolyte powder not only can improve the qulity of intestinal cleaning,but also acts as a more effective method in preparation of colonoscopy due to its high tolerance, good comfort,less pain and high acceptance of patients.Therefore,it is worthy of clinical promotion and application.

Objective To explore the effects of application of the new model of evidence-based land humanized nursing in patients with universal pustular psoriasis.Methods Divided 84 patients with universal pustular psoriasis into the experimental group (42 cases) and the control group (42 cases) randomly.Evidence-based questions were raised according to the requests about humanized nursing of patients in the experimental group,and then retrieved and screened literature,sought high-level evidence,combined with previous nursing experience,developed new evidence-based and humanized nursing programs and implemented in the experimental group.The control group used conventional care program.Two weeks after admission,pain,anxiety,depression degree and the complications of two groups were compared.Results Two weeks after admission,the patients with 0 to 5 levels of pain in the experimental group was 0,5,26,7,4 and 0 cases respectively,which in the control group was0,0,0,12,20 and 10 cases respectively,the difference was significant between the two groups (U=6.957,P＜0.01).Anxiety and depression scores in the experimental group was (41.35±4.30) and (42.55±7.71) respectively,which in the control group was (51.31±4.56) and(50.36±6.89) respectively,the difference were significant between the two groups (t=10.540 and 4.893,P＜0.01).Conclusions The new model of evidence-based and humanized nursing can effectively improve the effects of humanized nursing in patients with universal pustular psoriasis.

Objective To investigate the effecs of evidence-based nursing of the treatment with propranolol forthe intractable infantile hemangiomahemangioma. Methods Dividing the children who were treated with propranolol into experimental groups and matched groups randomly according to the random number table each 42 .The experimental group adopted evidence-based care,according to PICO tool description of the problem and combining the results of theresponsibility nurse′s regular follow-up and assessment to come up with evidence-based problems,seeking for high-level evidences,combining the existing conditions of careand having formulated corresponding care norms,contingency plans for adverse reactions,healthy education card,the operation videos and other measures and they are implemented.The control group adopted the routine care procedure.two groups of effects were determined by the Achauer level 4 classification after 12 months of treatment,and evaluating the condition of occur of blood pressure drop ,slow heart beat ,diarrhea, sleepdisorders, hypoglycemia and other adverse reactions in both groups during the process of treatment. Results there was statistical significance in the difference of two groups′Achauer 4 levels. The numbers of Ⅰ, Ⅱ, Ⅲ, and Ⅳ in the two groups were 3, 7, 20, 12, and 11, 15, 11, 5, respectively (t1=1372, t2=2132, P<0.05). The two groups had a statistically significant difference in blood pressure, heart rate, diarrhea, sleep disorder, and low blood sugar response. The numbers of two groups were 12, 2, 3, 6, 1 and 26, 15, 12, 21, 8 respectively (χ2=6.098-12.464, all P<0.05). Conclusions Evidence-based nursing enhances the treatment effectiveness of theintractable infantile hemangioma with propranolol effectively and has preventing the occur of adverse reactions during the process of treatment.

The clinical data, follow-up records and genetic results of a child with growth retardation and systemic multiple malformations, of whom was diagnosed Loeys Dietz syndrome (LDS), were retrospectively analyzed.This was a 3 years and 3 months old boy presented with incomplete cleft palate, spasm of middle fingers in both hands, hernia and hyperextension of knee joint.Color doppler ultrasound showed dilation of aortic sinus and ascending aorta, and mo-derate aortic regurgitation in the child.The analysis of genetic cardiovascular gene sequencing showed that there was a heterozygous mutation in TGFβR2 gene, which was a missense mutation.The child was diagnosed LDS type 2 according to the results of gene detection and clinical characteristics.He underwent " Bentall" aortic valve replacement + coronary artery lengthening transplantation (Cabrol) in Guangdong Provincial People′s Hospital.Postoperative recovery was satisfactory.This is the youngest case of Bentall operation reported in China.Connective tissue and organs are involved in the LDS.Systemic arteries, especially big arteries, are seriously involved and progressing rapidly.The combination of gene detection and clinical symptoms is the great value in the differential diagnosis of LDS.Echocardiography is an important method to monitor the progress of cardiovascular disease in children with LDS, which is important for the selection of surgical methods and timing.Bentall operation can also achieve good prognosis in children under 4 years old.

Objective To evaLuate the Long?term effects of cardiac resynchronization therapy (CRT) in chiLdren with right ventricLe?paced heart faiLure. Methods Five chiLdren with chronicaLLy right ventricuLar?paced heart faiLure underwent operation of upgrading to CRT in Guangdong CardiovascuLar Institute between JuLy 2009 to January 2015. The first time the patients were impLanted with endocardiaL permanent pacemaker was (11.6 ± 4.6) years oLd. The New York Heart Association (NYHA) functionaL cLassification, QRS duration, Left ventricuLar end diastoLic diameter (LVDd), Left ventricuLar ejection fraction (LVEF), standard deviation of peak systoLic time of Left ventricuLar waLL (TS?SD) and foLLow?up data were retrospectiveLy anaLyzed. Comparison between pre?and post?operation was performed using paired t test. ResuLts CRT significantLy improved the NYHA cLass toⅠ?Ⅱdegree, reduced the QRS duration ((126±9) vs. (182±21) ms, t=-7.480, P=0.002) and the Z?score of LVDd (2.8±1.1 vs. 4.7±0.9, t=-2.880, P=0.045), and increased the LVEF (43% ± 10% vs. 28% ± 6%, t=3.350, P=0.029). No significant difference was found regarding the TS?SD ((48±17) vs. (95±41) ms, t=-2.240, P=0.090) pre?and post?CRT. The Longest foLLow?up period was 9 years. During foLLow?up, 1 case died of ventricuLar fibriLLation 2 years after upgrading, and 2 cases underwent CRT repLacement due to battery depLetion 7.2 years and 5.8 years after upgrading, respectiveLy. ConcLusion CRT couLd be considered for chiLdren with chronicaLLy right ventricuLar?paced heart faiLure and improve heart function significantLy.