Objective To discuss the clinical value of 99Tcm-sestamibi(99Tcm-MIBI) myocardial perfusion imaging on detecting myocardial ischemia in children with Kawasaki disease(KD) at convalescence period.Methods Twenty-one children wih KD at convalescence period were divided into 2 groups according to results of echocardiography.Four cases with coronary artery dilation,17 cases without coronary artery dilation.All cases accepted dipyridamole stress myocardial perfusion imaging.These patients who had positive results were given rest myocardial perfusion imaging again next day.Results Among 21 cases,9 cases(42.8%) were positive in perfusion imaging.Four cases with coronary artery dilation showed myocardial ischemia in different degree detected by myocardial perfusion imaging.Among 17 cases without coronary artery dilation,5 cases(29.4%) were positive.Conclusions Compared to echocardiography,99Tcm-MIBI myocardial perfusion imaging can objectively evaluate the location,extent and degree of myocardial ischemia of children with KD.It will be a routine test in observing its phase development.

Objective To explore the changes of plasma angiotensinⅡ (AngⅡ) and cardiac function,and the curative effect of children with acute viral myocarditis (VMC) treated with captopril(CAP).Methods Concentrations of plasma AngⅡ were measured with radio-immunity and cardiac function was detected by Doppler echocardiography for the VMC group (n=60) before and after treatment [the CAP group (n=30), the routine group (n=30) and the control group (n=30)].Results 1. The level of plasma AngⅡ significantly increased and the contractive and diastolic function obviously declined in children with acute VMC. There was a significant difference between VMC group and control group, with a significant correlation between the level of AngⅡand the contractive diastolic function.2. Compared with the level before treatment, the level of AngⅡ decreased and the contractive function obviously ameliorated in two groups; the diastolic function obviously ameliorated in the CAP group and did not ameliorate in the routine group after treatment. In CAP group the level of AngⅡ and the cardiac function significantly improved; there were statistical differences between the two groups after treatment.Conclusions 1.The increase of the plasma AngⅡ was an important factor for decrements of the contractive and diastolic function in acute viral myocarditis.2.It could decrease the concentration of plasma AngⅡ and ameliorate cardiac function in children with acute VMC treated with captopril,which was an effective therapy for acute VMC.

Deafness ; etiology ; Facial Paralysis ; etiology ; Hematologic Diseases ; etiology ; Humans ; Meningitis ; etiology ; Mucocutaneous Lymph Node Syndrome ; complications ; Respiratory Tract Diseases ; etiology ; Urologic Diseases ; etiology

Objective To investigate clinical nursing pathway management combined with nurse hierarchical system so as to promote the smooth implementation of clinical pathways.Methods The process of clinical nursing pathway was distributed into the work of nurses at different levels by using the present available resources; their process quality was quantitatively evaluated, which was closely related to their achievements, with the aim of making the nursing activity procedurized and standardized.Results Patients' satisfaction before and after implementing the clinical care pathway management combined with nurse hierarchical system was significantly different (P<0.01); the average hospital stay for a single disease was decreased after its implementation (P<0.05).Conclusions Implementing clinical nursing pathway management combined with nurse hierarchical system could effectively control the health care costs, improve quality of care and achieve the best possible care and management objectives.

Objective To investigate the methods for establishment of evaluation index system of clinical nursing pathway management.Methods Delphi method was used to screen evaluation indexes of clinical nursing pathway management and three rounds of expert consultation was carried out to establish the clinical nursing pathway management evaluation system. Analytic hierarchy process and comprehensive evaluation method was used to determine the levels of the index weight,and finally the establishment of weight factors at all levels.Results Aiming at the process of clinical nursing pathway management and following the principle of continuous improvement,an evaluation index system of clinical nursing pathway management was established.Conclusions The evaluation index system of clinical nursing pathway management provides a feasible and effective evaluation tool for the application and improvement of clinical nursing pathway and guides the promotion of application and development of clinical nursing pathway.

OBJECTIVETo explore cell death and apoptosis in rat hippocampal neurons at different time points after ischemia, hypoxia and reperfusion injury and to elucidate time window characteristics in ischemia neuronal injury.

METHODSHippocampal neurons were obtained from rat embryo and were cultured in vitro. The ischemia and reperfusion of cultured rat hippocampal neurons were simulated by oxygen-glucose deprivation (OGD) and recovery. OGD at different time points (0.25 h to 3.0 h) and then the same recovery (24 h) were prepared. Annexin V-PI staining and flow cytometry examined neuron death and apoptosis at different time after injury.

RESULTSAfter OGD and recovery, both necrosis and apoptosis were observed. At different times after OGD, there were statistically significant differences in neuron necrosis rate (P < 0.05), but not in apoptosis rate (P > 0.05). At recovery, survival rate of hippocampal neurons further decreased while apoptosis rate increased. Furthermore, apoptosis rates of different time differed greatly (P < 0.05). Apoptosis rate gradually increased with significant difference among those of different time points (P < 0.05). However, 2 h after ischemia, apoptosis rate decreased markedly.

CONCLUSIONSApoptosis is an important pathway of delayed neuron death. The therapeutic time window should be within 2 h after cerebral ischemia and hypoxia.

Animals ; Apoptosis ; physiology ; Brain Ischemia ; pathology ; Cell Death ; physiology ; Cell Hypoxia ; Cells, Cultured ; Disease Models, Animal ; Female ; Fetus ; cytology ; Flow Cytometry ; Hippocampus ; pathology ; Neurons ; pathology ; Pregnancy ; Pregnancy, Animal ; Probability ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; pathology ; Sensitivity and Specificity ; Time Factors

OBJECTIVETo construct an eukaryotic expression vector carrying rat brain-derived neurotrophic factor receptor trkB gene.

METHODSUsing the total RNA isolated from rat brain as template, the trkB gene was amplified by reverse-transcription-polymerase chain reaction (RT-PCR) with a pair of specific primers which contained the restrictive sites of EcoR I and BamH I. The amplified fragment of trkB gene was digested with EcoR I and BamH I, and then subcloned into cloning vector pMD18-T and expression vector pEGFP-C2 respectively. The recombinant plasmids were identified by restriction endonuclease enzyme analysis and PCR.

RESULTSThe amplified DNA fragment was about 1461 bp in length. Enzyme digestion and PCR analysis showed that the gene of trkB had been successfully cloned into vector pMD18-T and pEGFP-C2.

CONCLUSIONSThe trkB gene of rat has been amplified and cloned into the eukaryotic expression vector pEGFP-C2.

Animals ; Brain-Derived Neurotrophic Factor ; genetics ; pharmacology ; Cloning, Molecular ; methods ; Eukaryotic Cells ; Female ; Gene Expression Regulation ; Genetic Therapy ; methods ; Genetic Vectors ; Male ; Models, Animal ; RNA ; analysis ; Rats ; Rats, Wistar ; Receptor, trkB ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Schwann Cells ; cytology ; Sensitivity and Specificity ; Templates, Genetic ; Transfection

Abnormalities, Multiple ; epidemiology ; Adolescent ; Child ; Child, Preschool ; Heart Defects, Congenital ; complications ; Humans ; Infant ; Infant, Newborn

Objective To establish a kind of animal model and methods for neuroendoscope training. Methods With rat abdominal cavity hypothesized as cerebral ventricle, a set of programs for neuroendoscopic operative skill training were designed, including endoscopic techiniques, electronic coagulation, suction, flush, biopsy and balloon dilatation, and so on. Results Simulation operation was performed on rat abdomen under neuroendoscope. The procedure helped to practice the endoscopic manipulation, get to know well how to perform endoscope, coagulation, suction, flash instruments, be familiar with the usage of electric coagulation in the liquid condition. The emphasis was put on the basic skills of pure neuroendoscopic operation such as balloon dilatation, electric coagulation, cutting off,forcep biopsy and flush. Conclusions The rat model can provide a way to train pure neuroendoscopic operation. The trainer can get basic experience with regard to endoscopic manipulation, balloon dilatation, electric coagulation, suction, flush and biopsy under endoscope. The method can be an important part of neuroendoscopic laboratory training.

Objective To observe the changes of heart rate variability (HRV),adrenomedullin (ADM) and B-type natriuretic peptide(BNP) before and after transcatheter closure in children with patent ductus arteriosus.Methods HRV spectral values (TF,VLF,LF,HF,LF/HF) were detected by 24 dynamic electrocardiogram and the concentrations of plasma ADM and BNP were measured in 55 children with patent ductus arteriosus(Group PDA,n =55) before and 3~(rd) day,3~(rd) month after transcatheter closure therapy,and in 60 normal children (Group C).Results (1) Compared with Group C,the HRV spectral values (TF,VLF,HF)were significantly lower (all P＜0.01),LF/HF and the concentrations of plasma ADM,BNP were significantly higher in patients with PDA before transcatheter closure (all P＜0.01).(2) Compared with the values before transcatheter closure values,plasma ADM were significantly reduced at 3~(rd) day and 3~(rd) month after transcatheter closure(P＜0.01),the HRV spectral values (TF,VLF,HF) were significantly increased while LF/HF and plasma BNP were significantly decreased at 3~(rd) month after transcatheter closure (P＜0.01 or P＜0.05).Conclusions HRV and plasma ADM,BNP improved significantly post tnmscatheter closure in children with patent ductus arteriosus.