Cardiomyopathies ; classification ; genetics ; Humans ; Molecular Biology ; trends

Child, Preschool ; Coronary Aneurysm ; diagnosis ; etiology ; prevention & control ; Diagnosis, Differential ; Early Diagnosis ; Humans ; Immunoglobulins, Intravenous ; administration & dosage ; therapeutic use ; Immunologic Factors ; administration & dosage ; therapeutic use ; Infant ; Mucocutaneous Lymph Node Syndrome ; classification ; complications ; diagnosis ; drug therapy ; Prognosis

Child ; Humans ; Hypertension, Pulmonary

Objective To explore the effect of the ?-blocker —metoprolol on the treatment of vasovagal syncope(VVS) in children.Methods Twenty-nine children with unexplained syncope and positive responses to head-up tilt test(HUT) were included in the study.Sixteen of them took metoprolol(treatment group) and 13 of them took vitamin B or oryzanol (control group) at least 2 weeks and HUT were repeated and syncope episodes were observed.Results In treatment group,9 of 16 patients had no syncope episode while 5 of 16 patients had fewer syncope episodes,1 case had more syncope episodes,and 1 case remained the same.HUT were repeated and 6 of 9 cases had negative outcome.In control group,1 of 13 patients had no syncope episode while 5 of 13 patients had fewer syncope episode,3 cases had more syncope episodes and 4 cases remained the same.HUT were repeated and 3 of 7 cases had ne-(gative) outcome.Conclusion These results indicate that adminstering metoprolol orally may be effective for VVS in children.

Humans ; Postural Orthostatic Tachycardia Syndrome

Diagnostic Errors ; Humans ; Inflammation ; diagnosis ; etiology ; Laryngeal Neoplasms ; surgery ; Male ; Middle Aged ; Papilloma ; surgery ; Pneumonia ; diagnosis ; Postoperative Complications ; diagnosis

Objective To study the characteristics and clinical features of positive response during head - up tilt test (HUT) in children. Methods Forty- nine cases of syncope and aura of syncope were included in the study. All of them underwent HUT (tilt angle 60 degree,lasting 45 minutes). During the test,children' blood pressure,heart rate.electrocardiography and clinical symptoms and signs were dynamically observed. Results The common syncope aura symptoms were headache, dizziness, chest distress, difficulties in breathing, pale, perspiration, blurred vision, auditus depression and symptoms related to digestive symptoms. Among the 28 positive cases, 7 cases were of vaso - inhibitory pattern (25%), with a decrease in blood pressure and an increase in heart rate, 3 cases inhibitory pattern (11%), with a decrease in heart rate but withoilt'blood pressure changes, 4 cases mixed pattern (14 %), with decreases in heart rate and blood pressure obviously, 10 eases POTS (36%), with an increase in heart rate by 30 bpm or up to 120 bpm within 10 minutes while testing, and 4 cases orthostatic hypotension (14%), with a decrease in blood pressure within 3 minutes. Conclusion HUT can be regarded as the main tool in differential diagnosis of unexplained syncope in children.

OBJECTIVEThe study was designed to explore the value of the New York University Pediatric Heart Failure Index (NYU PHFI) for diagnosing and grading chronic heart failure in children.

METHODSTotally 105 children with chronic heart failure or structural heart disease but without signs and symptoms of heart failure were enrolled. They were diagnosed using modified Ross score, NYU PHFI and NT-proBNP, respectively. According to modified Ross score as the referent criteria, the diagnostic value of NYU PHFI in quantifying chronic heart failure severity in children was studied. Furthermore, according to the grading of heart failure using modified Ross score, the area under the ROC curves of NYU PHFI was examined, respectively, in order to find out the optimal cut-off point.

RESULTSNYU PHFI score was positively correlated with the modified Ross score (r = 0.909, P = 0.000). According to modified Ross score, NYU PHFI scores in different severity of heart failure in children differed significantly (F = 80.034, P = 0.000). A significantly positive correlation was found between plasma NT-proBNP and modified Ross score, and between NT-proBNP and NYU PHFI score. Correlation coefficients between plasma NT-proBNP and modified Ross score, and between plasma NT-proBNP and NYU PHFI score were 0.752 and 0.918, respectively. The correlation between NYU PHFI and plasma NT-proBNP was superior to that between modified Ross score and plasma NT-proBNP. According to modified Ross scores of 0 - 2 as being without heart failure, 3 - 6 as mild degree of heart failure, 7 - 9 as moderate degree of heart failure and 10 - 12 as severe degree of heart failure, the areas under the ROC curve of the NYU PHFI diagnosing if heart failure was present, differentiating moderate from mild and severe from moderate heart failure were 0.982, 0.942 and 0.918, respectively, and the sum of sensitivity and specificity was favorite when 6, 10 and 13 scores were set as cut-off value diagnosing the presence of heart failure, differentiating moderate from mild, and severe from moderate heart failure, respectively. According to above classification of heart failure based on NYU PHFI score, plasma NT-proBNP concentration was significantly different in different degree of heart failure (F = 53.31, P < 0.001). Plasma NT-proBNP concentration in those without heart failure was significantly lower than that of mild heart failure, and it was also significantly lower in mild heart failure than that of severe heart failure.

CONCLUSIONNYU PHFI was highly valuable for diagnosing chronic heart failure in children and 0 - 6 scores as being without heart failure, 7 - 10 scores as mild degree, 11 - 13 scores as moderate degree and 14 - 30 scores as severe degree of heart failure could be used as the reference criteria of different severities of heart failure.

Adolescent ; Child ; Child, Preschool ; Chronic Disease ; Female ; Heart Failure ; diagnosis ; Humans ; Infant ; Male ; Severity of Illness Index

Objective To discuss the clinical diagnostic method of postural orthostatic tachycarda syndrome(POTS) in children.Methods Thirty-six children with POTS were selected for the research.Among them 15 were boys,21 cases were girls.The age ranged from 5.9 to 16 years,average age 12.3 years.Among them 28 patients(78%) were in between 11-16 years.The age distribution,clinical courses and hemodynamic indexes were analyzed and also the incidence of clinical manifestations and investigation reports were observed.Results Among 81 patients of orthostatic regulation disturbance,36 patients were diagnosed POTS,which was 47% of total.The clinical courses ranged from 1 day to 5 years,average clinical course 10.2 months.The clinical courses of more than half of the total patients were within 6 months(56%).The common clinical features of POTS were chest tightness on standing,vertigo,fatigue,palpitation,syncope,orthostatic regulation disturbance.Ten patients were also associated with gastrointestinal symptoms like nausea,vomiting.The most common feature of POTS patients was tachycardia(HR increased by ≥30 times/min) within 10 min after head-up tilt test(HUT).Average HR increased by 38 times/min.In some patients HR increased up to ≥120 times/min.There were no significant changes in blood.In 23 cases(64%),the T waves were descended by ≥0.2 mV in 2 or more than 2 leads in ECG reading.Investigations reports showed that there were 12 cases whose urine specific gravity was increased.In 11 cases HCO_3~-decreased.Conclusions POTS is commonly seen in schooling female children.The common symptoms are vertigo,chest tightness,fatigue,palpitation.HUT is an important method for the diagnosis of POTS.

Objective To ascertain the level and dynamic changes of environmental health hazards in the rural areas of Pukou, Nanjing, to objectively evaluate the situation of rural environmental sanitation, providing basis and support for formulating policies and measures by the higher authorities. Methods According to the requirements of the rural environmental sanitation monitoring program of Jiangsu Province in 2017, 5 streets, 20 administrative villages were selected as monitoring points and 100 families used as monitoring objects.The monitoring data were obtained through interviews, access data, field records and laboratory tests. Results Centralized water supply was realized by 20 monitoring points.The rate of collection and centralized disposal of domestic waste was 95.00%.The sewage disposal sites were mainly discharged into sewage treatment plants and harmless sanitary toilets, accounting for 41.00% and 42.00% respectively.The coverage rate of sanitary toilets was 95.54%.Those who did the work of killing rats, flies and mosquitoes accounted for 40.00% and those who did the work of killing cockroaches 25.00%.And 98.00% of the families used fuel for gas, 98.00% of the families never burned straw in the fields, 88.00% of the families did not use the film, and the membrane recycling rate was 91.67%.It was found that 100% of the households drank boiled water, and 90.00% of the respondents developed the habit of washing hands before and after meals.The detection rate of Ascaris eggs was 20.00% in 20 soil samples, and the contents of Pb, CD and Cr were all within the normal range. Conclusion Although some achievements have been made in the rural environmental sanitation in Pukou, the management of pollution of rural sewage, waste and feces should be further strengthened, and the dangerous factors that affect the health of rural residents should be decreased and four pests removal activities actively carried out.