Objective To study the echocardiographic characteristics and its diagnosis value on congenital supravalvular aortic stenosis (SVAS) in children. Methods Thirty-one patients with SVAS diagnosed by multiplane echocardiography were enrolled in the study. Their echocardiographic characteristics were compared with cardiac catheterization, operation, and gene detection results. Echocardiographic changes were mainly observed in aortic valve, supravalve, descending aortic arch, pulmonary artery valve, main pulmonary artery and its branches,and coronary artery. Results Of the 31 patients,26 had hourglass type SVAS,4 hypoplastic type,and 1 membranous type; 2 patients had extremely mild stenosis (defined as a Doppler gradient <25 mm Hg) ,20 mild (25～49 mm Hg) ,5 moderate (50～75 mm Hg) ,and 4 severe C>75 mm Hg) ones. Nineteen patients were diagnosed with Williams syndrome by gene detection. Three patients were associated with aortic valve stenosis including one missed at the initial diagnosis; 10(32.26%) patients with pulmonary stenosis, including pulmonary valve stenosis in 6, left and right pulmonary artery stenosis in 3 ,and branch stenosis in 1:6 patients with coronary stenosis. Conclusions The sternal border and five chamber apical views are the best to detect SVAS. Williams syndrome patients are prone to SVAS.Pulmonary stenosis echocardiography forms a great proportion of the SVAS patients. Routine examination is necessary for coronary stenosis in cases of SVAS.

Objective To evaluate the clinical efficacy and safety of iMliximab (IFX) in the treatment of Crohn's disease (CD).Methods From February 2009 to March 2013,the clinical data of 62 CD patients with IFX treatment were retrospectively analyzed.At week 14th after IFX injection and the end of follow-up of this study (March 2013) were two observation points.At week 14th after IFX injection (three times of IFX injection),C reactive protein (CRP) level,Crohn's disease activity index (CDAI) score and clinical remission were investigated.At the end of follow-up,clinical remission,fistula closure,mucosal healing and side effects were inspected.Normal distribution data were expressed as 2±s,which were compared with t test.Non normal distribution data were expressed as M (QL-QU) and compared with Wilcoxon test.Results Four cases without complete three times of IFX injection and one case lost to follow-up were eliminated.And nine postoperation cases with IFX treatment to prevent recurrence after surgery were excluded.A total of 48 cases of CD in active period were enrolled in this study on efficacy.At week 14th,CRP level of 48 patients [1.9(0.5,5.4) mg/L]decreased compared with that before treatment [28.9(6.4,51.1) mg/L] (Z=-5.468,P＜0.01);CDAI score (87.0±35.8) also decreased compared with that before treatment (245.1±59.1) (t=18.579,P＜0.01).At week 14th,46 patients in active period achieved clinical remission and the remission rate was 95.8％.By the end of follow-up,38 patients were still in remission period and the remission rate was 79.2％.Among 26 patients with anal fistula before IFX treatment,seven cases (26.9％) were completely closed,17 cases (65.4％) was partially closed and two cases was responseless.Fifteen patients were reviewed by colonoscopic examination after more than six times of IFX treatment.The median of simple endoscopic score for Crohn's disease (SES-CD) was 3 (0,5)after treatment,which decreased compared with that before treatment (8(7,9),Z=-3.306,P=0.001).Twenty-two of 48 cases in active period received,step-up strategy and 26 cases received with top-down strategy.At week 14th,20 cases (90.9％) of group with step-up strategy and 26 cases (100.0％) of group with top-down strategy were in remission period.By the end of follow-up,14 cases (63.6％) of group with step-up strategy and 24 cases (92.3％) of group with top down strategy maintained remission.Among 26 cases with anal fistula,two cases without response were treated with step-up strategy and seven cases with complete closure were all with top-down strategy.Among 62 patients,five had side effects,three of whom had acute infusion reaction,one had delayed infusion reaction and the other had anemia.Conclusions IFX had good clinical efficacy in controlling inflammation,inducing clinical remission,promoting fistula closure and mucosal healing in CD patients.For some CD patients with high risk,the initial top-down strategy showed good clinical efficacy.

Ballistocardiogram (BCG) signal is a physiological signal, reflecting heart mechanical status. It can be measured without any electrodes touching subject's body surface and can realize physiological monitoring ubiquitously. However, BCG signal is so weak that it would often be interferred by superimposed noises. For measuring BCG signal effectively, we proposed an approach using joint time-frequency distribution and empirical mode decomposition (EMD) for BCG signal denoising. We set up an adaptive optimal kernel for BCG signal and extracted BCG signals components using it. Then we de-noised the BCG signal by combing empirical mode decomposition with it. Simulation results showed that the proposed method overcome the shortcomings of empirical mode decomposition for the signals with identical frequency content at different times, realized the filtering for BCG signal and also reconstructed the characteristics of BCG.
Algorithms ; Ballistocardiography ; methods ; Humans ; Monitoring, Physiologic

Objective To investigate the distribution features and antibiotic drug resistance of infection pathogens isolated from elderly patients with malignancies complicated with infection following treatment in an open hematology ward.Methods From January 2010 to June 2012,specimens from hospitalized elderly patients with concurrent infection were cultured to isolate infection pathogens through routine methods.Antimicrobial susceptibility tests were performed by the microdilution method.Results A total of 302 strains of infection pathogens were isolated from all detected samples,among which isolated strains of Gram-positive bacteria,Gram-negative bacteria and fungi were 91,194 and 17 strains,respectively.Isolated fungi were mostly susceptible to antifungal drugs.Gram-negative bacteria were highly susceptible to carbapenem,while Gram-positive bacteria were most sensitive to vancomycin and teicoplanin.Conclnsion The nosocomial infection pathogens of elderly patients with malignancies in hematology ward are most likely Gram-negative bacteria.Before specimens culture results and susceptibility are known,all these patients should be empirically treated with broad spectrum antibiotics,which have the most activity against Gram-negative bacteria as well as Gram-positive bacteria coverage.

Objective To explore the value of echocardiography in the diagnosis of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) in children.Methods The echocardiographic images of 14 patients with ALCAPA confirmed by operation and 18 patients with endocardial fibroelastosis (EFE) diagnosed by clinical were compared and analyzed.Results Both ALCAPA and EFE exhibited obvious dilated left ventricle,decreased left ventricular systolic function,thick endocardium and mitral regurgitation of different degree.The former additionally showed dilated right coronary artery(RCA) with normal origin,left coronary artery(LCA) emerging from the root or wall of the pulmonary artery(PA),the retrograde flow into PA in LCA and abundant collateral vessels in myocardium.However the later exhibited normal diameter of LCA and RCA and no collateral vessels.Conclusions Color Doppler echocardiography not only demonstrates left ventricular systolic function,endocardium,mitrial regurgitation and collateral vessels in myocardium,but also shows the origination and courses of LCA clearly,which provide exact informations to diagnose ALCAPA.The echocardiography can be used as a powerful tool of ALCAPA diagnosis and preoperative assessment.

Objective To evaluate the clinical application value of real-time three-dimensional transesophageal echocardiography (RT-3D-TEE) in diagnosis of mitral valve prolapse(MVP).Methods Twenty patients with MVP with more than moderate mitral regurgitation referred for mitral valve repair (MVR) were studied.All patients underwent RT-3D-TEE and mitral valve quantification(MVQ) before MVR.The location of scallop lesions and ruptured mitral chordae tendineae for mitral valve were evaluated,and compared with surgical findings.Carpentier's nomenclature was applied to the mitral valve anatomic localization either RT-3D-TEE or surgery.There were three anterior leaflet scallops defined as A1,A2 and A3,and three posterior leaflet scallops defined as P1,P2 and P3.Results ① The shape and spatial structure of the scallop lesions and ruptured mitral chordae tendineae of mitral valve were clearly displayed by RT-3D-TEE,also could be observed through left atrium view and left ventricular view.② Compaired with surgical findings,RT-3D-TEE was of high sensitivity (100 ％),higher specificity (95.46 ％) and crude agreement (95.83％) in the location of P2,the positive likelihood ratio of location of P2 (22.03) was the biggest,the negative likelihood ratio (0) was the smallest.③ RT-3D-TEE had lower sensitivity (66.67％),specificity (83.76 ％) and crude agreement (83.33 ％) in the diagnosis of location of P1 than other locations,the positive likelihood ratio(4.11) was the smallest,the negative likelihood ratio (0.40) was the biggest.④ The sensitivity,specificity,crude agreement,positive likelihood ratio and negative likelihood ratio of RT-3D-TEE in diagnosis of ruptured mitral chordae tendineae accompanied by MVP were 100％,91.67％,95.00％,12.00,0 respectively.Conclusions RT-3D-TEE could clearly display the three-dimensional structure of the lesions of mitral valve.It was of better accuracy in diagnosis of the location of scallop lesions of mitral valve and the rupture of chordae tendineae,and was of important clinical application value in MVR.

Objective To observe the effects of lower limb motion control training using virtual games combined with core stability training (CST) on the lower limb motor function of hemiplegic patients after stroke.Methods Sixty hemiplegic stroke patients were divided into an observation group and a control group (n =30 in each) using a random number table.The control group was given conventional treatment and CST,while the observation group received lower limb motion control training using virtual games in addition to conventional treatment and CST.All of the patients were assessed using the Fugl-Meyer lower limb assessment (FMA),the Berg balance scale (BBS),the modified Barthel index (MBI),10 metre maximum walking speed (MWS) and functional ambulation categorization (FAC)before and after 8 weeks of treatment.Results Before the intervention there was no significant difference between the two groups in any of the measurements.After the treatment,however,the average FMA,BBS,MBI,MWS and FAC in the observation group were significantly better than those before treatment and those in the control group.Conclusions Lower limb motion control training using virtual games combined with core stability training can improve effectively the lower limb motor function of hemiplegic patients after stroke.Such a combination is worth applying in clinical practice.

Objective To explore the impact of short-term meditation on ego-depletion in college students.Methods Sixty college students without any meditation and mental calculation experience were recruited voluntarily,and were allocated randomly and equally into three groups: the control group,the rest group,and the meditation group(n=20 in each group).Participants completed the positive affect and negative affect scale and the first handgrip test.A difficult mental calculation task was used to induce ego depletion.After that,the control group performed the second handgrip test immediately,and the rest group had a 5-min break,while the meditation group had a 5-min meditation practice following a meditation audio.Participants then reported the task difficulty and the impulse to write down intermediate answers during the mental calculation task.They also finished the positive and negative affect scale again.The task difficulty and impulse scores,the number of response items and correct items,the change of the handgrip time and the mood between pretest and posttest were compared among three groups.Results There were no differences in the task difficulty score,the impulse score,the number of response items and correct items among the three groups (all P>0.05).The handgrip time was shorter in posttest ((71.91±24.58) s) than in pretest ((91.39±37.63) s) in the control group (P<0.05).The handgrip time was also shorter in posttest ((81.75±25.77) s) than in pretest ((97.88±33.77) s) in the rest group (P<0.05).However,the difference between the handgrip time in posttest ((82.21±34.63) s) and in pretest ((83.11±42.45) s) was not significant in the meditation group (P>0.05).There were no differences in the change of positive and negative affect between pretest and posttest (all P>0.05).Conclusions hort-term meditation buffers ego depletion in college students,which cannot be attributed to affect.

Objective To report the clinical and imaging characteristics of 9 cases of gastric duplication in children,as well as to probe into all kinds of imaging examination methods,with an aim to improve preoperative diagnostic accuracy.Methods Nine cases of children with gastric duplication that received surgical resection and were pathologically confirmed in our hospital from January 2009 to November 2016 were retrospectively analyzed.The clinical manifestations,complications,complicated malformation and imaging findings of the cases were summarized.Three asymptomatic cases were carried out regular ultrasound examination follows-up preoperatively.Results Gastric duplication in children varied in terms of cliuical manifestations.All the 9 cases were performed ultrasonography preoperatively,and 5 of them were accurately diagnosed.Meanwhile,7 cases received preoperative CT examination,with 2 cases being confirmed.Three cases received magnetic resonance imaging (MRI) examination,with 2 cases being confirmed.And 2 cases had upper abdominal gastrointestinal imaging (GI) examination,but no definite diagnosis was made.Three cases of asymptomatic children with enlarged lesion can be seen in follow-up.Conclusions Gastric duplication is a rare congenital malformation,ultrasound allows to clearly display the capsule wall structure and the relation between gastric duplication with gastric wall,which is associated with high utilization rate and diagnosis rate,and it can be served as the preferred imaging examination method for gastric duplication in children.

Objective To investigate the effect of caffeine citrate in the treatment of neonatal apnea and the corresponding intervention measures. Methods A total of 88 children with apnea were enrolled in this study from December 2015 to February 2017, and were randomly divided into control group and study group, 44 cases in each group.The study group on the basis of conventional therapy plus caffeine citrate, the control group on the basis of conventional therapy plus aminophylline group, two newborns with apnea were duration of treatment should be 7 for 7 days, record the treatment effect and the incidence of adverse reactions. Results The total effective rate was 88.64％ in the study group and 72.73％ in the control group (P<0.05). The incidence of adverse reactions was 11.36％ in the study group and 40.91％ in the control group (P<0.05). Conclusion The application of caffeine citrate treatment of apnea with clinical efficacy and safety of the ideal of the newborn, in the course of treatment given targeted clinical nursing intervention is conducive to the protection of newborns with apnea of quality of life and life safety.