OBJECTIVETo investigate the risk factors for fulminant myocarditis by analyzing clinical symptoms/signs or laboratory findings in children with viral myocarditis.

METHODSThe medical data of 71 children with acute viral myocarditis from March 2005 to September 2008 were retrospectively studied. They were classified into fulminant (n=16) and non-fulminant myocarditis groups (n=55). Chi-square and Student's t-test were used to analyze the clinical presentations, laboratory data, EEG and cardiac ultrasound findings on admission. The multiple regression analysis was used to identify the independent risk factors for fulminant myocarditis.

RESULTSEight children (50%) died in the fulminant myocarditis group, but none in the non-fulminant group. The following factors were closely related to the fulminant course of myocarditis: lower blood pressure, higher serum CK-MB level, positive cTnI, complete atrioventricular block and left bundle branch block, ST segment alterations, prolonged QRS complex, and decreased left ventricular ejection fraction and short axis fractional shortening. Multiple regression analysis revealed that prolonged QRS complex (OR=1.139; CI=1.014-1.279, P<0.05) and decreased left ventricular ejection fraction (OR=0.711; CI=0.533-0.949, P<0.05) were independent risk factors for fulminant myocarditis.

CONCLUSIONSThe mortality of fulminant myocarditis is high in children. Prolonged QRS complex and decreased left ventricular ejection fraction on admission are independent risk factors for fulminant myocarditis in children.

Acute Disease ; Child ; Child, Preschool ; Electrocardiography ; Female ; Humans ; Infant ; Logistic Models ; Male ; Myocarditis ; etiology ; Risk Factors ; Ventricular Function, Left

OBJECTIVES: To study the relationship between early parenteral nutrient intake and the development of bronchopulmonary dysplasia (BPD) in preterm infants with gestational age less than 32 weeks who could not receive enteral nutrition within one week after birth. METHODS: A retrospective study was conducted on preterm infants born between October 2017 and August 2022 with gestational age less than 32 weeks who were admitted to the Neonatal Intensive Care Unit in Children's Hospital of Soochow University within 24 hours after birth and relied solely on parenteral nutrition within the first week of life. The study population included 79 infants with BPD and 73 infants without BPD. Clinical data during hospitalization were compared between the two groups. RESULTS: The proportions of infants with weight loss of more than 10% after birth, extrauterine growth retardation, and parenteral nutrition-associated cholestasis in the BPD group were higher than in the non-BPD group (P<0.05). The time to regain birth weight, time to achieve full enteral feeding, and corrected gestational age at discharge were longer in the BPD group than in the non-BPD group. The Z-scores of physical growth at corrected gestational age of 36 weeks were lower in the BPD group than in the non-BPD group (P<0.05). The BPD group had a higher fluid intake and a lower calories intake in the first week than the non-BPD group (P<0.05). The starting dose and total amount of amino acids, glucose, and lipids in the first week were lower in the BPD group than in the non-BPD group (P<0.05). The BPD group had a higher glucose-to-lipid ratio on the third day and higher energy-to-nitrogen and glucose-to-lipid ratios on the seventh day after birth than the non-BPD group (P<0.05). CONCLUSIONS Preterm infants with BPD had lower intake of amino acids and lipids and a lower proportion of calories provided by amino acids and lipids in the first week of life, which suggests an association between early parenteral nutrition intake and the development of BPD.
Infant ; Child ; Infant, Newborn ; Humans ; Infant, Premature ; Bronchopulmonary Dysplasia/therapy* ; Retrospective Studies ; Gestational Age ; Amino Acids ; Parenteral Nutrition/adverse effects* ; Glucose ; Lipids

Objective To investigate the effect of Clostridium butyricum tablets combined with conventional therapy on the cholinesterase levels and albumin ( ALB) levels in patients with liver cirrhosis.Methods The 236 patients with liver cirrhosis from October 2016 to February 2018 in the Department of Gastroenterology of our hospital were selected as the study subjects.The patients were divided into the treatment group and the control group.The patients in the treatment group were given 2 g Clostridium butyricum tablets orally ,on the basis of general symptomatic treatment,3 times per day for two weeks ;the patients in the control group were stan-dard treatment.The plasma cholinesterase , ALB levels were determined by automatic analyzer.Results The cholinesterase levels in the control group and the treatment group were ( 2.87 ±1.82 ), (7.94 ±2.45) U· L-1, respectively; the ALB levels in the 2 groups were (34.02 ±3.26),(47.63 ±4.05) g· L-1,respectively;comparison between the two groups , the difference was significant ( all P ＜0.05 ) . Conclusion Clostridium butyricum tablets can significantly increase plasma cholinesterase and ALB levels in patients with liver cirrhosis .

Objective To determine whether atorvastatin will induce depressive symptoms in patients with cerebral infarction. Methods The clinical data of 404 patients with large artery atherosclerotic cerebral infarction, admitted to our hospital from June 2009 to December 2010, were clinically analyzed; these patients were divided into common treatment group (atorvastatin ([7.72±3.01])mg/d,n=151) and intensive lipid lowering group (atorvastatin [18.58±9.93] mg/d,n=201) and control group (n=52); 189 males and 163 females accepted lipid-lowering treatment.Hamilton Depression Rating Scale (HAMD) was employed before treatment and 3 months after the treatment and statistical analysis was performed on their scores. Results No significant deviation in scores of HAMD before and after treatment was noted in these patients (P＞0.05).No significant deviation in scores of HAMD was noted neither between intensive lipid lowering group and control group,nor between common treatment group and control group (P＞0.05). No significant deviation in HAMD was observed between the treatment groups with mild/no depression symptoms and control group (P＞0.05).The scores of HAMD in female patients were significantly higher than that in male patients 3 months after treatment (P＜0.05),but no significant deviations in the level of cholesterol, the lowering degree of cholesterol and the dosage of atorvastatin were observed between female and male patients (P＞0.05). Conclusion The lipid-lowering treatment with atorvastatin will not induce depressive symptoms in patients with cerebral infarction.The depressive symptoms of female is not related with the level of cholesterol,the lowering degree of cholesterol and the dosage ofatorvastatin.

OBJECTIVETo investigate the complex differences between high metastatic and low metastatic cells of the Adenoid cystic Carcinoma.

METHODSGene expression patterns were examined in high metastatic cell ACC-M strain and low metastatic ACC-2 strain with the method SSH (suppression subtractive hybridization).

RESULTSalthough extensive similarity was noted between the expression profiles, twelve genes were highly expressed of, in low metastatic cell ACC-2 tester, compared with driver, high metastatic cell ACC-M. These genes were cysteine-rich angiogenic-inducer protein (cyr61), chromosome7 clone RP11-52501, G protein, was family member Iferritin heavy polypeptide I, jumping translocation breakpoint, eukaryotic translation elongation, folate receptor, ribosomal proteins L7a, S21, P0 and other two novel genes-ACC metastasis-associated RNH and ACC metastasis-associated suspected protein. GenBank accession number were AF522024 and AF522025 respectively.

CONCLUSIONSthe result suggests that the obtainment of the ability of metastasis is related to the low expression or mutation of these genes. These data provide insight into the extent of expression differences underlying metastasis-related genes that may prove useful as diagnostic or prognostic markers.

Base Sequence ; Blotting, Northern ; Carcinoma, Adenoid Cystic ; genetics ; secondary ; Cell Line, Tumor ; Gene Expression Profiling ; Humans ; Molecular Sequence Data ; Reverse Transcriptase Polymerase Chain Reaction

BACKGROUNDTo find out the timing of serologic responses after illness onset and distribution of IgG antibody to SARS-CoV in SARS cases of transmission chain or non-transmission chain.

METHODSThe IgG and IgM antibodies to SARS-CoV were tested by indirect ELISA in serum samples from 301 clinically diagnosed SARS cases.

RESULTSTotally 158 SARS cases were involved in 15 chains of transmission. The positive rates of SARS-CoV IgG in those chains were 85.70%-100.00% and the overall rate was 94.30% (149/158). The chain of transmission could spread to four generations, but the SARS cases were reduced with increase of generations. There was no significant difference among positive rates of SARS-CoV IgG for generations, Chi square=5.11, P greater than 0.05. The positive rate of SARS-CoV IgG in cases who were not in chain of transmission was 12.59%(18/143) which was statistically significantly different from that of cases in chain of transmission, Chi square=199.64, P less than 0.001. During days 0-7,8-14,15-21,22-30 after onset, the cumulated positive rate of SARS-CoV IgG was 16.67%, 40.00%, 70.00% and 93.10%, respectively, then was kept at the level above 90% and lasted for 217 days. The cumulated positive rate of SARS-CoV IgM during days 0-7 after onset was the same to that of IgG. During days 8-14, 55.17% of cases had seroconversion for IgM which reached a peak (86.96%) during days 21-30. Then the rate rapidly declined.

CONCLUSIONMore than 94% of cases with SARS could produce IgG antibody when they were infected by SARS-CoV. Detecting SARS-CoV IgG could provide a diagnostic evidence for case confirmation. SARS-CoV IgG appeared as early as 7 days after onset and reached the peak at about weeks 4. Then the high rate of antibody was maintained for more than 6 months.

Antibodies, Viral ; blood ; Disease Transmission, Infectious ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; SARS Virus ; immunology ; Severe Acute Respiratory Syndrome ; immunology ; transmission

Antibodies, Viral ; blood ; China ; epidemiology ; Female ; Humans ; Immunoglobulin G ; blood ; Male ; SARS Virus ; immunology ; isolation & purification ; Seroepidemiologic Studies ; Severe Acute Respiratory Syndrome ; epidemiology ; virology

Objective To analyze the peri-procedural complications of coronary rotational atherectomy. Methods A total of 107 consecutive patients with coronary artery disease received rotational atherectomy from January 2012 to December 2016 were enrolled retrospectively. The occurrence rate and the management of peri-procedural complications were summarized. Results ① The serum level of CK-MB and cTnI in patients who received rotational atherectomy were signifi cantly elevated compared with the level before the procedure,[4.1(2.4-14.1)U/L vs.1.5(1.0-2.1)U/L,P<0.001]and[0.28(0.11-1.11)ng/ml vs.0.01 (0.01-0.02) ng/ml, P<0.001], respectively. Of the 107 target lesions, 104 (97.2%) were classifi ed as type B2 or C lesions.②Peri-procedural complications of coronary rotational atherectomy occurred in 21 patients (19.6%). There were 5 cases (4.7%) of coronary slow fl ow, 1 case (0.9%) of severe coronary spasm, 9 cases (8.4%) of coronary dissection after rotational atherectomy and 1 case (0.9%) of side branch occlusion. Six patients (5.6%) had severe sinus bradycardia, but only 1 patient required temporary pacemaker. Burr entrapment happened in 2 patients (1.9%). Peripheral vascular complications occurred in 2 patients (1.9%) with 1 case of femoral artery hematoma at puncture site and the other 1 case of mediastinal hematoma. One patient (0.9%) developed contrast induced nephropathy after the procedure. ③All the peri-procedural complications of rotational atherectomy were benign. The procedure instant success rate was 98.1%, with no acute or sub-acute stent thrombosis, cardiac death, emergent coronary artery bypass graft occurred during hospitalization. Conclusions The complications associated with coronary rotational atherectomy are not rare, but severe complications are not common. The procedure could be safely performed with a high instant success rate.

Objective To compare the setup accuracies of the surface-guided radiation therapy for nasopharyngeal carcinoma based on volume rendering technique(VRT)reference surface and digital imaging and communications in medicine(DICOM)reference surface.Methods Twenty patients with nasopharyngeal carcinoma who received radiotherapy using the customized AccuCushion with a thermoplastic fixation mask were selected.After the first cone beam CT(CBCT)-based image-guided radiotherapy of each patient was completed,the thermoplastic mask was removed to obtain the VRT reference surface based on optical surface monitoring system(OSMS),during which the patient position was maintained through instructions;the DICOM reference surface was got based on the body surface contour data extracted from the patient's localized CT images.After the completion of the 5th,10th,and 15th CBCT image-guided radiotherapy treatments,the patients'6 dimensions of setup errors were measured based on the 2 reference surfaces,respectively.Dimensional correlation analyses were carried out on the setup errors measured based on the 2 reference surfaces separately using Python's Stats tool to test the independence between the setup errors in each dimension.After independence test,Wilcoxon rank sum test was performed on the data of the setup errors based on each dimension measured with the 2 reference surfaces.Results The two sets of setup errors were independent of each other in all dimensions.The errors based on VRT reference surface were lower than those based on DICOM reference surface in 6 dimensions,while the difference between the 6-D errors of the two groups did not gradually become significant as the treatment progressed.Conclusion In the SGRT of nasopharyngeal carcinoma using a customized cushion combined with a thermoplastic mask,the setup accuracy and consistency based on VRT reference surface are both higher than those based on DICOM reference surface.

OBJECTIVE: To explore the clinical effect in the near future between Zero-profile intervertebral fusion system (Zero-P) and conventional cage-plate intervertebral fusion system (CCP) for the multi-segment(>=2 segments) cervical spondylosis. METHODS: Forty-two patients with cervical spondylosis who underwent multi-segment decompression of the cervical spine from October 2012 to October 2017 were selected as subjects. Zero-P was applied in 21 patients (Zero-P group) and CCP was applied in 21 patients(CCP group). The general condition and perioperative parameters of all the patients were recorded. VAS, JOA scores and incidence of dysphagia were observed before and after operation. The prevertebral soft tissue thickness was measured at 1 week, 1 month after operation and at the last follow-up. At the same time, the Cobb angle of the functional unit of the fusion segments was measured, and the overall curvature change of the cervical vertebra was observed. The clinical efficacy was reviewed at 1 week, 1, 3, 12 months after surgery, and the AP and lateral cervical X-rays were reviewed to evaluate the internal fixation effect. RESULTS: There were no significant differences in age, gender, duration of disease, surgical segment, follow-up time and hospitalization time between two groups(>0.05). The length of the surgical incision, intraoperative blood loss, operation time, postoperative drainage volume in the Zero-P group were(4.37±0.72) cm, (50.9±7.98)ml, (84.4±8.18) min, (76.2±10.13) ml, respectively, and those in CCP group were (6.50±0.71) cm, (108.6±9.25) ml, (118.6±8.55) min, (130.1±9.42) ml, respectively. There were signigicant differences in above items between two groups(<0.05). There were no significant difference in the VAS and JOA improvement rate between two groups at the last follow-up (>0.05). There was no significant difference in the overall physiological curvature of the cervical vertebra between two groups (>0.05). The prevertebral soft tissue thickness at 1 week, 1 month after operation, final follow-up respectively was(11.6±1.9), (9.8±1.4), (9.5±1.6) mm in Zero-P group, and in CCP group those were(12.5±2.6), (11.1±2.4), (11.0±1.9) mm, respectively. There were significant differences in each time point between two groups(<0.05). At the last follow-up, no complication of dysphagia was found in Zero-P group, and three patients had dysphagia in CCP group, with a statistically significant difference between two groups (<0.05). CONCLUSIONS Multiple segmental decompression fusion to treat cervical spondylosis, regardless of the traditional CCP system or new Zero-P system are effective methods, but the Zero-P system has advantages of small surgical incision, short operation time, less intraoperative bleeding, convenient operation, better recovery of prevertebral soft tissue swelling, and lower possibility of postoperative dysphagia.
Bone Plates ; Case-Control Studies ; Cervical Vertebrae ; Humans ; Retrospective Studies ; Spinal Fusion ; Spondylosis ; Treatment Outcome