Objective: To investigate the application of coronary angiography (CAG) in children with Kawasaki disease complicated with coronary artery lesion (CAL). Methods: A total of 139 patients (115 boys and 24 girls, age (48±42) months) with Kawasaki disease complicated with CAL underwent CAG between June 2006 and June 2018 in Children′s Hospital of Fudan University. CAL in all children were at grade Ⅲ and above assessed by echocardiography and underwent CAG under general anesthesia with parental consent. A retrospective analysis was performed to identify the safety and complication of CAG, degree of satisfaction of image, distribution of CAL, and the treatment and follow-up management according to the result of CAG. Results: All the 139 patients underwent CAG, and 17 patients received CAG twice. In these cases, there was a total of 309 CAL with an average of 2.22 CAL per patient. After CAG, children were re-graded as grade Ⅲ in 33 cases, grade Ⅳ in 56 cases, grade Ⅴa in 33 cases and grade Ⅴb in 17 cases according to the clinical severity. Ten patients (7.2%) had only aortic root angiography and 129 (92.8%) patients had selective left or right CAG. Among these, 27 cases (19.4%) showed thrombosis in coronary aneurysm, 23 cases (16.5%) showed coronary artery stenosis, 4 cases (2.9%) showed recanalization after occlusion in right coronary artery. All the patients obtained satisfied images, and no complication was found. Eight of the grade Ⅴb patients underwent coronary artery bypass grafting (CABG). One patient died during the surgery due to severe heart failure, and the other seven patients received CABG successfully and recovered well during a long-term follow up (18 to 108 months). Conclusions CAG is safe for children with Kawasaki disease with CAL, and the images of CAG are satisfied. Patients who were graded according to CAG and received the corresponding surgical treatment could get satisfied effect in the medium and long-term follow-up.

【Objective】 To study the feasibility of whole blood thromboelastogram (WB-TEG) and its correlative kit for plasma thromboelastogram (P-TEG) detection and the characteristics of P-TEG in healthy subjects. 【Methods】 17 healthy volunteers were detected by WB-TEG instrument and its correlative kit, and the results were compared with those by P-TEG. The P-TEG characteristics of 17 healthy volunteers were analyzed. Three groups (7 cases/group)of plasma samples with different platelet (Plt) count and the other three groups of plasma(7, 6 and 4 cases, respectively) with different fibrinogen(Fib) concentration were tested for P-TEG. The effects of Plt and Fib on P-TEG detection were observed. 【Results】 There was no significant difference in R and MA value (P>0.05)as WB-TEG was compared with P-TEG in healthy subjects, while in K(min) (1.71±0.47 vs 1.07±0.45), A(°) (66.1±5.41 vs 75.59±5.77), and CI value (0.9±1.8 vs 2.52±2.58)(all P <0.05). Various parameters of healthy individuals were basically within the range of 95% CI of WB-TEG, but there were significant diffferences in K, A and CI value(P<0.05). When Plt count (×10¹¹/L) was≥2.5 in plasma, the MA value of P-TEG was significantly extended than that of normal individuals(P<0.05); when Plt count (×10¹¹/L) was 6.0 ~12.0, the MA and CI value of P-TEG significantly decreased(P<0.05). When Fib(g/L) was 6.4~6.91 in plasma, the R and K value of P-TEG were prolonged, but A, MA and CI value all decreased(P <0.05); when Fib(g/L) <1, the A and MA value significantly decreased(P<0.05), and K and CI value could not be detected. 【Conclusion】 The WB-TEG and its correlative kit can be used in P-TEG detection, and corresponding reference values of TEG parameters should be established in combination with the conditions of laboratories.

Objective: To assess the olfactory function in children with adenoid hypertrophy and investigate the changes of both olfactory function and appetite in children with adenoid hypertrophy before and after adenoidectomy. Methods: Forty-four children with adenoid hypertrophy admitted for adenoidectomy, aged 7-12 years, mean age (10.0±2.0) years were tested by Sniffin′ Sticks test and visual analog scale(VAS) of the children′s appetite preoperatively between March and August 2015.In a appointment 6 months after operation, all of them returned and were tested again. The control group consisted of 40 healthy children, aged 7-12 years, mean age (11.2±0.8) years.SPSS 13.0 software was used for statistical analysis Results: The olfactory function of the study group TDI scores (32.4±3.5) preoperatively were significantly lower in comparison with the results of the control group TDI scores (37.3±2.8)(t=7.057, P<0.001). Significant improvement of olfaction TDI scores (36.8±1.9) was observed in the follow-up appointment(t=13.573, P<0.001). The VAS of the children′s appetite during post-adenoidectomy was higher compared to pre-adenoidectomy(t=16.765, P<0.001). There was a strong correlation between the increase in appetite of children and the change of TDI score (r=0.59, P<0.01). Conclusions Children with adenoid hypertrophy have a reduced ability of both olfactory function and appetite. Surgery had a greater impact on olfaction and appetite.

Objective To investigate the distribution and epidemiological characteristics of disease spectrum in patients with pre-hospital care in Urumqi, so as to provide reference for the establishment of mature pre-hospital care system. Methods Data retrieved from Urumqi Emergency Medical Center Command System were collected, and stratified random sampling method was used to selected 2400 patients from 8 districts and counties. The disease spectrum was analyzed, then the epidemiological characteristics was analyzed from the aspects of age, gender, season and aid time. Results The top 6 diseases were trauma in 696 cases (29.00%), cardiovascular disease in 521 cases (21.71%), poisoning in 328 cases (13.67%), respiratory system disease in 245 cases (10.21%), nervous system disease in 202 cases (8.42%) and digestive system disease in 139 cases (5.79%). Trauma and cardiovascular disease were the main types of pre-hospital care for both males and females, moreover, the incidence of trauma, nervous system disease, digestive system disease and other diseases in male was significantly higher than that in female (P<0.05). The distribution of trauma, cardiovascular and cerebrovascular disease, poisoning, respiratory disease, nervous system disease, digestive system disease and other diseases showed significant difference among patients in difference age groups (P<0.05). The distribution of trauma, cardiovascular and cerebrovascular diseases, poisoning, respiratory system diseases, nervous system disease and digestive system diseases showed significant difference in different seasons (P<0.05). The emergency calls in three shifts were the most on middle shift and were the least on night shift in Urumqi, accounting for 43.88%( 1 053 / 2 400) and 15.33% (368 / 2 400). Conclusion The distribution of disease types of pre-hospital care in Urumqi varies with gender, age, season and times, so relevant departments should improve the professional abilities of first aid and allocate first aid resources reasonably.

Objective: To analyze the variation characteristics of HIV-1 Gp120 sequences in men who have sex with men (MSM) in Guangzhou. Methods: Plasma samples were collected from HIV-1 infected MSM before antiretroviral treatment. Viral RNA was extracted from plasma. Gp120 gene sequences were amplified by reverse transcription and nested-PCR using specific primers. Phylogenetic tree, length polymorphism, amino acid characteristics of V3 loop, co-receptors and signature amino acids were analyzed. Results: The phylogenetic tree were divided into 4 clusters, and the most prevalent subtypes were CRF07_BC (34/61, 55.74%) and CRF01_AE (24/61, 39.34%). Majority of HIV-1 Gp120 sequences had 496-515 amino acids. Among five hypervariable regions, the V1 region had the highest levels of length polymorphism and V3 region had the lowest. The top four peptide of V3 loop were GPGQ (56/58, 96.55%). Most of the co-receptors HIV-1 strains used was CCR5(50/58, 86.21%)according to four methods of comprehensive prediction. There are four signature amino acids in CRF01_AE subtype strains, and the frequency of occurrence was 0.75-0.83; there are eight signature amino acids in CRF07_BC subtype strains, and the frequency was 0.74-0.94. Conclusions The length of Gp120 sequences in MSM in Guangzhou has a high polymorphism. The top four peptide of V3 loop, co-receptor and signature amino acid of V3 ring have formed unique patterns.

OBJECTIVETo study the death risk factors in children with severe hand, foot and mouth disease (HFMD).

METHODSA total of 164 children with severe HFMD between May 2010 and September 2012 were recruited and classified into death and survival groups according to their prognosis. The differences in general information, clinical signs and symptoms and laboratory examinations were compared between the two groups. The multivariate logistic regression analysis was used to identify death risk factors in children with severe HFMD.

RESULTSThere were significant differences in the incidences of atypical rash, persistent fever, dyspnea, pulmonary hemorrhage, heart rate increase, blood pressure abnormalities, cold sweat, capillary refill time>3 seconds and frequent seizures, and blood glucose, serum creatine kinase and serum lactate levels between the death and the survival groups (P<0.05). The multivariate logistic regression analysis showed three independent death risk factors for children with severe HFMD: pulmonary hemorrhage (OR=9.466, 95%CI: 1.786-21.256), abnormal blood pressure (OR=5.224, 95%CI: 1.012-28.985) and elevated serum lactate level (OR=2.154, 95%CI: 1.020-8.253).

CONCLUSIONSPulmonary hemorrhage, abnormal blood pressure and elevated serum lactate are major death risk factors for children with severe HFMD.

Blood Pressure ; Child ; Child, Preschool ; Female ; Hand, Foot and Mouth Disease ; blood ; mortality ; physiopathology ; Humans ; Infant ; Lactic Acid ; blood ; Logistic Models ; Male ; Prognosis ; Risk Factors

Background: Circulating endometrial cells (CECs) have been reported to be present in the peripheral blood of women with endometriosis (EM), providing clear and specific evidence of the presence of ectopic lesions. In this study, we established a method with a high detection rate of CECs, assessed the diagnostic value of CECs for EM and compared with serum CA125, and proposed a hypothesis for the pathogenesis of EM from the new perspective of CECs. Methods: The participants were enrolled prospectively from October 2015 to July 2016. The peripheral blood samples were collected from 59 participants, and the blood cells were isolated for immunofluorescence staining via microfluidic chips. The cells that were positive for vimentin/cytokeratin and estrogen/progesterone receptor and negative for CD45 were identified as CECs. The serum CA125 level was tested with electrochemiluminescence immunoassay. Results: The detection rate of CECs reached 89.5% (17/19) in the EM group, which was significantly higher than that of the control group (15.0% [6/40], P < 0.001) and was independent of menstrual cycle phases. Furthermore, a positive CEC assay detected 4/5 cases of Stage Ⅰ–Ⅱ EM. In contrast, a positive CA125 test had limited value in detecting EM (13/19, 68.4%) and detected only one case of Stage Ⅰ–Ⅱ EM. Conclusion: CECs are promising biomarkers for EM with great potential for a noninvasive diagnostic assay.

Objective: To investigate the reversibility of ischemic core defined by CT perfusion imaging in acute ischemic stroke (AIS) patients receiving intravenous thrombolysis within different time windows and influencing factors. Methods: The data of AIS patients who received intravenous thrombolysis in the Department of Neurology of Lishui People′s Hospital from May 2016 to December 2018 were retrospectively reviewed. All patients had finished multi-model CT imaging before thrombolysis and multi-model MRI examination 24-48 hours after thrombolysis. The baseline ischemic core volume (hypoperfusion area with relative cerebral blood flow (rCBF)<30%) was quantitatively assessed based on CT perfusion images using MIStar software, and the final ischemic core volume was assessed based on diffusion weighted imaging acquired 24-48 hours after thrombolysis. The reversibility of ischemic core was defined as baseline ischemic core volume-the final infarct volume ≥5 ml. Then the clinical and imaging features of the patients between reversible group and irreversible group were compared, and the predictors of ischemic core reversibility were analyzed by binary Logistic regression analysis. Results: Finally, 97 patients were enrolled in the present study, of which 64 (66%) patients achieved successful recanalization, 51 (53%) patients with reversible baseline ischemic core. For patients with recanalization, the incidence of reversibility was 76% (26/34), 71% (17/24), 2/5 and 0 (0/1) in patients with time window from onset to thrombolysis (ONT) <3.0 h, 3.0-4.5 h, 4.6-6.0 h, and >6.0 h, respectively. In the non-recanalization group, six patients were also showed with ischemic core reversibility, including 4 (4/12) in the ONT<3.0 h group and 2 (2/12) in the ONT 3.0-4.5 h group. It was found that the reversible volume was positively correlated with baseline ischemic core volume (r=0.805, P<0.001) by Spearman correlation analysis. Finally, binary Logistic regression analysis revealed that the history of hypertension, ONT and recanalization were independent predictors of reversible changes of baseline ischemic core. Conclusions The ischemic core defined by CT perfusion imaging (rCBF<30%) was considerably inaccurate for patients with ONT<6.0 h. If recanalization could be achieved within this time window, most of the patients would manifest with ischemic core reversibility, the predictors of which also included hypertension history and ONT.

ObjectiveTo analyze the difference in esophageal microbiome between the patients with esophageal squamous cell carcinoma （ESCC group） and the healthy controls （HC group）， and to screen out the characteristic bacteria in tumor tissues of patients with esophageal squamous cell carcinoma. MethodsEsophageal tissues were collected from 105 patients with esophageal squamous cell carcinoma and 54 healthy controls. The total DNA of the samples was extracted， and the 16S rDNA V4 region was amplified by PCR， followed by high-throughput sequencing. The data were subjected to OTU clustering and diversity analysis to screen the characteristic bacteria in the ESCC group. Finally， the screening results were to be verified by Q-PCR amplification. ResultsDiversity analysis showed that there were differences in diversity and composition between the ESCC group and the HC group. Species analysis showed that the main components of microbiome in the ESCC group were Fusobacterium， Gemella， Neisseria， Porphyromonas and Streptococcus. While in the HC group the main components of microbiome were Fusobacterium， Actinobacillus， Streptococcus and Prevotella. The LEfSe analysis showed that the expression of porphyrin and Fusobacteria in the ESCC group increased and the difference is statistically significant （P<0.05）. The results of Q-PCR showed that the presence of Porphyromonas gingivalis and Fusobacterium nucleatum in the ESCC group significantly increased. ConclusionsEsophageal cancer has its characteristic flora composition. Porphyromonas gingivalis and Fusobacterium nucleatum in esophageal squamous cell carcinoma tumor tissue are the characteristic bacteria.

BACKGROUND AND OBJECTIVES: Recent studies showed that, in addition to parasympathetic nerves, cervical vagal nerves contained significant sympathetic nerves. We hypothesized that cervical vagal nerve stimulation (VNS) may capture the sympathetic nerves within the vagal nerve and activate the stellate ganglion. MATERIALS AND METHODS: We recorded left stellate ganglion nerve activity (SGNA), left thoracic vagal nerve activity (VNA), and subcutaneous electrocardiogram in seven dogs during left cervical VNS with 30 seconds on-time and 30 seconds off time. We then compared the SGNA between VNS on and off times. RESULTS: Cervical VNS at moderate (0.75 mA) output induced large SGNA, elevated heart rate (HR), and reduced HR variability, suggesting sympathetic activation. Further increase of the VNS output to >1.5 mA increased SGNA but did not significantly increase the HR, suggesting simultaneous sympathetic and parasympathetic activation. The differences of integrated SGNA and integrated VNA between VNS on and off times (DeltaSGNA) increased progressively from 5.2 mV-s {95% confidence interval (CI): 1.25-9.06, p=0.018, n=7} at 1.0 mA to 13.7 mV-s (CI: 5.97-21.43, p=0.005, n=7) at 1.5 mA. The difference in HR (DeltaHR, bpm) between on and off times was 5.8 bpm (CI: 0.28-11.29, p=0.042, n=7) at 1.0 mA and 5.3 bpm (CI 1.92 to 12.61, p=0.122, n=7) at 1.5 mA. CONCLUSION: Intermittent cervical VNS may selectively capture the sympathetic components of the vagal nerve and excite the stellate ganglion at moderate output. Increasing the output may result in simultaneously sympathetic and parasympathetic capture.
Animals ; Autonomic Nervous System ; Dogs* ; Electrocardiography ; Heart Rate ; Stellate Ganglion* ; Vagus Nerve Stimulation*