Objective: To explore the efifcacy and safety of sildenaifl for treating the patients of congenital heart disease (CHD) with severe pulmonary hypertension in plateau area.
Methods: A total of 50 CHD patients combining severe pulmonary hypertension treated in our hospital from 2010-01 to 2013-10 were studied. The patients were randomly divided into 2 groups, n=25 in each group. Control group, the patients received conventional treatment and Sildenaifl group, based on conventional treatment, the patients received additional sildenaifl medication. The hemodynamic, blood gas, routine and biochemistry were recorded and compared between 2 groups.
Results: Compared with Control group, Sildenaifl group had more reduction of pulmonary artery pressure, increased arterial pressure of oxygen, left ventricular output, cardiac index and oxygenation index, all P<0.05. The patients’ arterial pressure, blood routine and biochemistry were similar between 2 groups, P>0.05. There was no obvious adverse reaction observed in Sildenaifl group.
Conclusion: Based on conventional treatment, Sildenafil may effectively reduce the pulmonary artery pressure in CHD patients combining pulmonary hypertension in plateau area, it improving the cardiac function without adverse reaction.

Objective To analyze the clinical characteristics and risk factors of myocardial damage in children with mycoplasma pneumonia in Qinghai area, and to provide evidence for clinical diagnosis and treatment. Methods A total of 328 children diagnosed with mycoplasma pneumonia in Qinghai region from June 2016 to June 2020 were selected as the research subjects. According to whether they were complicated with myocardial damage, they were divided into the control group (no myocardial damage, n=185) and the experimental group (complicated with myocardial damage, n=143). The data of the children were collected by using a questionnaire made by our hospital. These included gender, age, fever duration, initiation time of macrocyclic esters and fever degree, etc., and the levels of CK-MB, CK, CTNNI, NT-proBNP, CRP, LDH and RDW were determined. RESULTS: There were no significant differences in age, gender and complications between the two groups (P>0.05). There were statistically significant differences in the use time, fever duration and fever degree between the two groups (P<0.05). In terms of laboratory indicators, there were statistically significant differences in the levels of CK-MB, CK, cTNnI, NT-probNP, CRP, LDH and RDW between the two groups (P<0.05).Logistic regression analysis showed that the duration of fever (OR=3.105), the start time of macrolides (OR=1.457), the degree of fever (OR=2.495), CRP(OR=1.853) and RDW(OR=1.358) were the risk factors for myocardial damage in children with mycoplasma pneumonia in Qinghai area (P<0.05). Conclusion The duration of fever, the initiation time of macrolide drugs, the degree of fever, CRP and RDW are independent risk factors for myocardial damage in children with mycoplasma pneumonia in Qinghai area. The early use of macrolide drugs can prevent myocardial damage, improve the treatment effect and improve the prognosis of children.

Objective To preliminarily analyze the acute myocardial damage and important risk factors caused by sepsis in children in Qinghai, and analyze and discuss preventive measures on the basis of the foregoing. Methods The study selected 385 children with sepsis in our hospital from January 2016 to December 2020 and included 158 children with acute myocardial damage caused by sepsis (case group), and the remaining 227 cases (control group) were not seen Myocardial damage. The study collects basic information such as sociodemographic information of all children, and collects serum troponin I (cTnI) and CK-MB levels (determined by chemiluminescence method); as well as serum CRP levels and PCT levels. To compare and analyze the levels of related indexes in children with myocardial damage, and the differences from those in the control group. Then analyze and see the risk factors that are potentially associated with acute myocardial damage. Use SPSS statistical software package to analyze the data. cTnI enzyme-labeled immunoassay assay, reagents are provided by Nanjing Jidan Biotechnology Co., Ltd.; medicine is (0.00~0.01) μg/mL, cTnI level normal group (≤0.01 μg/mL) and cTnI level elevated group ( > 0.01 μg/mL) ); CK-MB>5 ng/mL is the positive standard for myocardial muscle injury; CRP medical reference value < 8mg/L, PCT< 0.1 ng/mL; CRP is detected by the turbidimetric method, and the instruments and reagents are manufactured by German Deling BNⅡ specific protein analyzer and original matching reagents. Pediatric Critical Case Score (PCIS) and Pediatric Death Risk Factor Score (PRISM Ⅲ) (evaluate twice, take the lowest value). Results In this study, the majority of male children were male, and the proportion of children with active myocardial damage had a higher proportion of low-grade fever. At the same time, the disease was more severe than the control group. It can be seen that the PCIS score is lower and the PRISM Ⅲ is higher. The difference is statistically significant. (P<0.05). The serum troponin I (cTnI), CK-MB, CRP, and PCT levels in the case group were significantly higher than those in the control group, and the differences were statistically significant (P<0.05); the serum albumin levels were significantly lower than those in the control group, and the differences were statistically significant Scientific significance (P<0.05); the risk factor analysis was carried out with the presence of myocardial damage as the dependent variable, and the potential influencing factors as the independent variables (social demographic factors, basic conditions of hospitalization, levels of indicators related to myocardial damage, etc.). Including single factor analysis (adjustment for potential confounding factors) and multivariate analysis. The results showed that increased age, low fever, increased PCT, low albumin level ( ≤ 25g/L), and increased PRISMⅢ were risk factors for myocardial damage (P<0.05). Conclusions Acute myocardial damage caused by sepsis in children with sepsis can be seen in male children, and children with active myocardial damage have a higher proportion of low-grade fever. At the same time, the condition is more severe than that of the control group. It can be seen that the PCIS score is higher. Low, higher PRISMⅢ, and other significant characteristics; analysis of potential influencing factors suggests that increased age, low fever, increased PCT, low albumin levels, and increased PRISMⅢ are positively correlated with the increased risk of acute myocardial damage in children. Therefore, it is planned to be clinically 1. Pay attention to older children with low fever and more critically ill children; 2. Detect or monitor the levels of PCT and albumin in children to early warn the occurrence of myocardial damage; carry out necessary and timely warning and prevention.