Objective To determine postoperative resting energy expenditure ( REE) in children with congenital heart disease ( CHD) requiring open heart surgery , to compare measured resting energy expenditure (MREE) with current predictive equations (PEE), and to investigate the possible influencing factors on the metabolic status of the postoperative CHD children .Methods From February 2015 to June 2015 , 150 ventila-ted children admitted to the cardiac intensive care unit after surgery for congenital heart disease in Shanghai Children's Medical Center were enrolled consecutively .Indirect calorimetry ( IC) measurements were performed using metabolic cart 4 hours after surgery .General clinical data were recorded .Results Totally 104 male and 46 female patients were enrolled, with a median age of 14 months (8.3-36.0 months).The non-protein re-spiratory quotient of patient was 0.79 ±0.20, MREE was (264.76 ±61.74) kJ/(kg· d), and PEE using Schofield equations was (278.51 ±93.42) kJ/(kg· d).Although there was no significant differences (P=0.096 ) between MREE and PEE , the agreement was poor between them ( R2 =0.119 ) .Multivariate stepwise regression analysis showed that MREE had significant positive correlation with risk adjustment in congenital heart surgery (RACHS-1) score (P=0.012) and negative correlation with age (P=0.010).Up to 97.33%of children (146/150) had lower energy intake compared with MREE on the 1st postoperative day .Conclu-sions MREE does not increase after surgery in CHD children;however , the substrate utilization is influenced . Factors influencing the postoperative REE include RACHS-1 score and age.The energy intake at 1st day after surgery is generally lower than REE in these children .

Objective To explore the prospects for applying a brain-computer interface system in the reha-bilitation of dyskinesia by testing the brain-electricity signals of spinal cord injury patients and stroke patients during motor imagery. Methods The brain-electricity signals of 5 healthy people, 4 spinal cord injury patients and 2 stroke patients were tested during motor imagery, and the results were analyzed with a computer. Results All of the 5 healthy people showed event-related synchronization and desynchronization (ERS/ERD) in the α and β bands in the motor related cortex. Three of the 4 spinal cord injury patents showed similar characteristics, and 1 showed ob-vious and stable characteristics, but the 2 stroke patients did not show meaningful characteristics. Conclusions Spinal cord injury patients have brain-electrlcity characteristics similar to those of healthy people when they are expe-riencing motor imagery, whilst in the affected hemisphere of stroke patients the brain-electricity characteristics are not similar to those of healthy people.

Objective:To investigate the efficacy and safety of ticagrelor and clopidogrel in patients with coronary atherosclerotic heart disease (CHD) and hyperhomocysteinemia (Hhcy).Methods:A total of 101 patients with CHD complicated with HHcy who had successfully undergone percutaneous coronary intervention (PCI) were enrolled. They were divided into ticagrelor group ( n=49) and clopidogrel group ( n=52) according to the different antiplatelet drugs used. The clinical data of the two groups were collected, and the incidence of major cardiovascular and cerebrovascular adverse events (MACCE) and bleeding events in one year were compared between the two groups. Results:There was no statistical difference in baseline datas and PCI datas between the clopidogrel and ticagrelor groups ( P>0.05). Compared with clopidogrel group, ticagrelor can reduce the total MACCE (8.16% vs 32.69%, P<0.05) and the incidence of unstable angina pectoris events (0 vs 13.46%, P<0.05) in patients with hyperhomocysteinemia PCI 1 year after operation. The incidences of ischemic stroke, unstable angina pectoris, recurrent myocardial infarction, and cardiogenic death were compared separately between the two groups, and the difference was not statistically significant ( P>0.05). The incidence of major bleeding events, minor bleeding events, and minimal bleeding events were similar between the two groups, and the difference was not statistically significant (4.08% vs 0; 4.08% vs 1.92%; 20.41% vs 9.62%; P>0.05). Conclusions:In patients with CHD and Hhcy, ticagrelor can play a better antithrombotic effect, reduce the incidence of ischemic events, and has good security, which is more worthy of clinical recommendation.

Objective To explore the effect of a multimodal electroencephalogram ( EEG) data visualiza-tion system on the motor imagery ability of stroke survivors. Methods Twenty stroke patients were randomly di-vided into an experimental group and a control group, each of 10. Both groups were provided with brain-computer interface-based motor imagery ( MI) training. At the same time, the experimental group was monitored and guided using an online, multimodal EEG data visualization system developed in our department. The classification accuracy ( CA) and event-related desynchronization ( ERD) of the 2 groups′ motor imagery were compared before and after the treatment. Results Before the treatment, no significant differences in the average CA of MI were found be-tween the experiment group (50.92±2.08) and the control group (49.35±4.20)(P>0.05). After the treatment, however, the experimental group′s average CA had increased to (64.52±5.27), significantly higher than that of the control group (51.18±5.02). When the stroke patients imaged affected upper extremity movements, obvious ERD was observed in the α frequency around the bilateral central motor regions of both groups, especially in the experi-mental group, but without significant differences between the two groups. However, no significant changes were found in the ERD of theβwaves of the two groups( P>0.05) . Conclusion The proposed online multimodal elec-troencephalogram data visualization system can help stroke patients imagine movements actively. It is worth sprea-ding in clinical practice.

Objective To study the efficacy of linezolid on gram positive bacterial infection in elderly patients and risk factors associated with thrombocytopenia.Methods A retrospective analysis of 50 elderly patients treated with intravenous linezolid for gram-positive bacterial infection from January 2008 to October 2010 was conducted.Clinical data and bacteriological responses were assessed.Efficacy of linezolid on infection and risk factors associated with thrombocytopenia in elderly patients were analyzed.Results The average duration of treatment was (13±2) d,the efficacy rate was 74 ％ and the bacteriological eradication rate was 69 ％ (18/26).Thrombocytopenia occurred in 24 patients during the treatment,and the average platelet count was significantly reduced compared with pretreatment[(146±87) 109/L vs.(239± 114) 109/L,t=3.888,P=0.000)].Thromhocytopenia was associated with the baseline platelet count and the mean time of linezolid treatment.Based on a Logistic regression analysis,the baseline platelet count ＜ 200 × 109/L was identified as the only significant risk factor for linezolid-associated thrombocytopenia in elderly patients (OR =0.244,95％CI:0.068-0.874,P=0.030).The mean platelet count was decreased significantly after 7 days of treatment,and decreased to the lowest value 1-2 days after the end of therapy.Conclusions Linezolid is effective and safe for the elderly with gram-positive bacterial infection,especially hospital acquired methicillin-resistant staphylococcus aureus infection.Linezolid has little effect on liver and renal function in elderly patients,but it can cause thrombocytopenia,which is associated with baseline platelet count and the mean time of linezolid treatment.Platelet counts should be monitored during treatment and measures should be taken to prevent hemorrhagic tendencies.

Soluble guanylate cyclase is a key signal transduction enzyme in the body, which can activate the NO-sGC-cGMP signaling pathway and inhibit the TGF-β signaling pathway. cGMP is one of the most important second messengers and also involved in a series of physiological or pathological responses including vasodilation, inhibition of platelet aggregation, inhibition of cell proliferation and so on. When TGF-β signaling pathway is inhibited, it can inhibit issue fibrosis and cell proliferation. Recent studies have shown that sGC can be activated directly to treat a variety of diseases. As a new class of potential drugs, sGC stimulators have shown many unique advantages. Herein, the mechanism and the latest research progress of sGC stimulators are reviewed, which could provide a useful information for further research of sGC stimulators.

To evaluated the multi-detector CT (MDCT) and magnetic resonance imaging (MRI) features of localized Castleman's disease (CD), we retrospectively analyzed the clinical data, MDCT and MRI findings of 13 patients with CD proved pathologically. All patients underwent plain MDCT scan, 11 underwent enhanced CT, and 2 MRI. 14 lesions were detected in the 13 patients, and all of them were hyaline-vascular type (HV-CD) histopathologically. On plain MDCT scans, all lesions were homogeneously attenuated soft tissue mass; intra-tumoral calcification with punctate and "arborizing" patterns was detected in the center of 2 lesions each. Of the patients with enhanced MDCT, all lesions showed obvious enhancement homogeneously except two lesions with central stellate and 1 lesion with dotted low attenuation. Tortuous vessels could be revealed at the periphery of 8 lesions. Of the 2 patients with MRI, the lesions showed slightly hyper-intensity on T1WI, hyper-intensity on T2WI and marked homogenous enhancement. In addition, one of them showed signal void appearance in the center on unenhanced MRI and large supplying artery with tortuous vessels at the periphery on enhanced MRI. In a word, Localized HV-CD usually demonstrated as soft tissue mass with obvious enhancement on MDCT and MRI. Central stellate area of low attenuation and calcification with punctate or "arborizing" pattern may also be present.
Adolescent ; Adult ; Castleman Disease ; diagnosis ; diagnostic imaging ; pathology ; Female ; Humans ; Image Enhancement ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multidetector Computed Tomography ; Retrospective Studies ; Young Adult

OBJECTIVE:To provide reference for the improvement of Chinese patent medicine instruction.METHODS:The outpatients were selected randomly from a Third Grade Class A hospital.A questionnaire survey was conducted on the attention degree of the outpatients to Chinese patent medicine instructions when taking medicine orally.The concern content label of patients in 221 Chinese patent medicine instructions were counted,analyzed and graded according to survey results.RESULTS:A total of 515 questionnaires were distributed,and 498 effective questionnaires were collected with effective recovery rate of 96.7％.The results of questionnaire survey showed that the highest concern from the patients was usage and dosage (92.4％),followed by attentions and taboos (88.0％,70.3％).The following items were drug interaction,pregnant and lactating women medication,children medication and the elderly medication (56.2％,46.4％,45.2％,42.4％).Among the description of medication methods (usage and dosage) in 221 Chinese patent medicine instructions,203 prescriptions clearly marked medication times (91.9％),160 clearly marked drug dosage (72.4％) and 36 clearly marked medication course (16.3％).In matters of taboos (attentions,taboos,pregnant and lactating women medication,children medication and the elderly medication),124 prescriptions clearly marked population taboos (56.1％),82 clearly marked symptom taboos (37.1％) and 71 clearly marked diet taboos (32.1％).According to the scoring statistics of 221 Chinese patent medicine instructions,there were 52 instructions with score of 6,followed by 47 instructions with score of 8;there were only 4 instructions with full score (12).CONCLUSIONS:At present,related contents of medication methods highly concerned by the patients are well marked in Chinese patent medicine instructions,especially its guidance is basically able to meet the requirements in respect of medication times.The related contents of medication taboos,which is next only to attention degree of medication methods by patients,is poorly marked.Its guidance remains to be improved.

OBJECTIVETo study the histochemical staining in the diagnosis of osteosarcoma.

METHODSTo compare the effectiveness of picrosirius red, improved Ponceau trichrome and Masson trichrome staining methods on bone formation tissues in conventional osteosarcoma, paraosteal osteosarcoma, periosteal osteosarcoma, extraskeletal osteosarcoma, inflammatory myofibroblastic tumour, malignant fibrohistiocytoma, chondrosarcoma, fibrosis with ossification and calcification.

RESULTSWith modified Ponceau trichrome staining, bone formation tissues showed a homogenous, orange-red interblended with blue in color. From osteoid to mature bone the color changed from orange-red, light blue to dark blue. Fibrotic tissue was stained blue in color with striated appearance. Cartilage was not stained. Picrosirius red method gave bone formation tissues homogenous staining. Along with bone maturation, from osteoid tissue to mineralized bones, the color showed changes from light red, yellow, orange-red, red to dark purple. The cartilage demonstrated homogenous light red in color. Fibrous tissue stained red interblended with yellow in color, striated in shape. With Masson trichrome staining osteoid displayed pale blue and mineralized bone showed dark blue in color. Fibrotic tissue showed a striated blue staining.

CONCLUSIONThe modified Ponceau trichrome and Picrosirius red staining methods are better than Masson trichrome to demonstrate bone formation tissue in osteosarcoma. The former two methods could be also used in study on bone formation.

This paper was aimed to explore the features of single ventricle with dual source computed tomography (DSCT) and the value of the modality in diagnosis of the single ventricle disease. Dual-source computed tomography imaging of 14 cases of single ventricle compared with the results of surgery and cardiac catheter were retrospectively analyzed. Firstly, 14 cases were classified into three types according to Anderson classification method, including 7 cases(50. 0%) left ventricular type, 3 cases(21. 4%) right ventricular type and 4 cases (28. 6%) undecided ventricular type. Secondly, in accompanying malformation respect, pulmonary stenosis, bilateral superior vena cava, atrial septal defect (ASD) and common atrioventricular valve were presented frequently. Thirdly, affiliated cardiac chamber of left ventricular type were mostly in front of the major cardiac chamber (5 cases,71. 4%), while affiliated cardiac chamber of right ventricular type were behind of the major cardiac chamber totally. Fourthly, more than half of aortas and pulmonary arteries stemming from common cardiac chamber can be seen (8 cases, 57. 1%). Meanwhile the aorta valves were more on the right of pulmonary valve (9 cases, 64. 3%). The classification of 10 cases of single ventricle was compared with the results of surgery, and the coincidence rate is 100%. DSCT can diagnose the single ventricle disease accurately. The aorta, pulmonary artery and coronary artery can be displayed completely and simultaneously as well.
Adolescent ; Child ; Child, Preschool ; Female ; Heart Ventricles ; abnormalities ; diagnostic imaging ; Humans ; Infant ; Male ; Radiography, Dual-Energy Scanned Projection ; methods ; Retrospective Studies ; Tomography, X-Ray Computed ; methods