Aortic Valve ; pathology ; Calcinosis ; Heart Defects, Congenital ; pathology ; Heart Valve Diseases ; pathology ; Humans

Child ; Child, Preschool ; Humans ; Sleep Apnea, Obstructive

Child, Preschool ; Female ; Home Care Services ; Humans ; Infant ; Male ; Positive-Pressure Respiration ; instrumentation ; methods ; Risk Factors ; Sleep Apnea, Obstructive ; prevention & control ; therapy ; Telemedicine ; instrumentation ; methods

Bronchoscopy ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Tracheal Neoplasms ; diagnosis ; surgery

Objective To evaluate the protective effect of sinomenine (SIN) on renal ischemia/reperfusion (I/R) in mice. Methods In the experiment one, 12 C57BL/6 mice were randomly divided into 2 groups: SIN group (mice were injected with 200 mg/kg SIN by tail vein) and control group (mice were injected with equal volume of saline). Six and 24 hs later, the serum was collected and the contents of alanine aminotransferase (ALT) and creatinine (SCr) were determined. In the experiment two, C57BL/6 mice were randomly divided into 3 groups: sham-operated (SO) group, SIN group (mice were injected with 200 mg/kg sinomenine just before ischemia induction) and saline group (mice were injected with equal volume of saline at the same time). At the 6th h after reperfusion, the sera and renal samples subject to IR injury were collected. The SCr and BUN levels in serum were determined and renal histological changes were also examined. The apoptosis of renal tubular epithelial cells was measured by using terminal deoxynucleotidyl transferase mediated dUTP nick end labeling assay. The infiltration of F4/80 positive macrophages was measured by using immunohistochemistry and that of neutrophils with myeloperoxidase (MPO) kits. The mRNA expression of tumor necrosis factor (TNF)-α, chemokine CXC ligand (CXCL)-10, intercellular adhesion molecule (ICAM)-1 and IL-17 was detected by using real-time reverse transcription PCR. The activation of transcription factor NF-κB was measured by using Western blotting. Results In the experiment one, there was no significant difference in ALT and SCr between the two groups at 6 or 24 h. In the experiment two,levels of SCr and BUN were lower in SIN group (P＜0. 05 or P＜0. 01 ), histological damage was milder (P＜0. 01 ), and apoptosis rate of renal tubular epithelial cells apoptosis was lower than in saline group (P＜0. 05). The infiltration of macrophages, neutrophils and the mRNA expression of TNF-α, CXCL-10, ICAM-1 and IL-17 in the renal tissue in SIN group were reduced as compared with saline group (P＜0. 05 or P＜0. 01 ). The activation of NF-κB in SIN group was significantly downregulated as compared with saline group. Conclusion SIN can ameliorate the renal IR injury without hepatic or renal toxicity, which is associated with inhibition of acute inflammatory response induced by reperfusion.

OBJECTIVETo explore how obstructive sleep apnea syndrome (OSAS) affects children's sleep architecture.

METHODSEighty-three children with OSAS were reviewed; every patient was monitored with polysommography for 7 hours at night for 11 parameters, including the number of arousal, snoring index, nadir O(2) desaturation, stage I %, stage II %, show wave sleep (SWS)% and rapid eye movement (REM)%. The basis for diagnosis of OSAS was the widely accepted pediatric diagnostic criteria of apnea/hypopnea index, apnea/ hypopnea index of > 1 episode/hour, nadir O(2) desaturation < 92%. Sleep was scored manually according to the standard set by Rechtschaffen.

RESULTSIn OSAS group, the number of arousal was 22.5 +/- 1.4, snoring index was 70.6 +/- 16.5, and/or SaO(2) was (73.8 +/- 1.9)%. OSAS group had increased stage I : (45.8 +/- 2.0)% vs. (2.3 +/- 1.1)%, t = 22.46, P < 0.01 and decreased stage II : (23.9 = 1.7)% vs (47.9 = 4.4)%, t = - 14.18, P < 0.01, SWS (15.6 +/- 1.8)% vs. (21.1 +/- 5.0)%, t = - 3.123, P < 0.01, REM (14.7 +/- 1.5)% VS. (28.2 +/- 4.1)%, T = -8.923, p < 0.01.

CONCLUSIONThe severity of OSAS relates to changes of sleep architecture in children. Intermittent nocturnal hypoxia secondary to apnea/hypopnea, and frequent electroencephalogram arousals from sleep may result in significant sleep fragmentation. Children with OSAS had learning problems and failure to thrive.

Child ; Child, Preschool ; Female ; Humans ; Male ; Monitoring, Ambulatory ; Polysomnography ; Severity of Illness Index ; Sleep Apnea, Obstructive ; classification ; pathology ; physiopathology ; Sleep Stages ; physiology

Aged, 80 and over ; Heart Valve Prosthesis Implantation ; methods ; Humans ; Male ; Prosthesis Failure

This case report we presented aims to report a-31-year-old man with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) who developed myocardial infarction (MI) and also aims to discuss the possible mechanisms. The results showed that traditional risk factors alone do not cause coronary heart disease with SLE, and SLE-related factors influence the atherogenic process. We found that although SLE patients with acute MI benefit from percutaneous coronary intervention (PCI) therapy, it is very important to choose the reasonable antithrombotic strategies in patients with SLE and APS undergoing PCI who require oral anticoagulant therapy.
Adult ; Angioplasty, Balloon, Coronary ; Antiphospholipid Syndrome ; complications ; Humans ; Lupus Erythematosus, Systemic ; complications ; Male ; Myocardial Infarction ; etiology ; therapy

OBJECTIVETo discuss the factors associated with non-adherence to therapy with home-based remote monitoring noninvasive positive pressure ventilation (NIPPV) in children with obstructive sleep apnea-hypopnea syndrome (OSAHS) and risk factors.

METHODSTwenty-one children with OSAHS and risk factors from March 2001 to December 2012 were enrolled in this study. They all received home-based remote monitoring NIPPV therapy. After admission, all children underwent NIPPV titration, then the parents were trained to operate the ventilator, after that, the children were discharged. Remote monitoring started to monitor NIPPV parameters and the adherence to NIPPV.

RESULTSUnder remote monitoring, ten children (50.0%) were adherence to NIPPV therapy. Seven children (31.8%) gave up NIPPV therapy within one week and four children (19.0%) gave up one month after NIPPV therapy started. The reason for non-adherence was as follows: 3 cases (27.3%) had some economic problems, 3 cases (27.3%) considered NIPPV therapy as a inconvenient therapy and lost patience; 2 cases(18.2%) resisted the therapy and 3 cases (27.3%) could not tolerate the therapy.

CONCLUSIONSUnder remote monitoring, non-adherence to home-based remote monitoring NIPPV therapy is still high in children during the early treatment, mainly due to economic problems, intolerance to the therapy and lack of the recognition of the importance of the therapy.

Apnea ; Child ; Humans ; Patient Compliance ; Positive-Pressure Respiration ; methods ; Remote Sensing Technology ; Risk Factors ; Sleep Apnea, Obstructive ; therapy

OBJECTIVETo summarize the clinical manifestation, operative method and therapeutic effect of various type of laryngeal web in infants.

METHODSThe clinical data of 12 cases were analyzed, 5 cases of which were congenital laryngeal web (4 cases, glottic type; 1 case, subglottic type), 7 cases of which were secondary laryngeal web (1 case, tuberculous laryngeal web; 6 cases, traumatic laryngeal web). Diagnosis was mainly depended on history and clinical manifestation. Final diagnosis was depended on fibrolaryngoscope and pathological report. Microlaryngoscopic surgery was the main operative method. However, specific infection should be cured before operation.

RESULTSDuring 3-18 months follow-up, 4 glottic laryngeal webs were cured. One subglottic laryngeal web case well recovered and secondary surgery is not needed at least recently. One tuberculous laryngeal web was followed up for 6 months, no vocal adhesion was observed. During 3-6 months follow-up, 1 traumatic laryngeal web was cred, while the other 6 cases need secondary surgery.

CONCLUSIONSFinal diagnosis of congenital laryngeal web is mainly depended on fibrolaryngoscope. And prognosis of it is well. Laryngeal web induced by specific infection should be cured specific infection before operation. The prevention is the key for traumatic laryngeal web because the surgery outcome is not satisfactory.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Laryngeal Diseases ; diagnosis ; surgery ; Laryngoscopy ; Larynx ; abnormalities ; Male ; Respiratory System Abnormalities ; diagnosis ; surgery