Objective To analyze the clinical features of severe pneumonia complicated with congenital heart disease (CHD) . Methods The clinical data of 270 children patients with severe pneumonia complicated with CHD (CHD group) were collected to analyze the relative medical history ,etiology ,bacterial drug resistance and clinical outcomes .Moreover ,636 age-matched children pa-tients with pure severe pneumonia were selected as the control group .Results In the CHD group ,250 cases were infants and 35 ca-ses suffered from repeated pneumonia .Compared with the control group ,the CHD group was earlier in onset and more prone to re-peated pneumonia .Among 270 cases ,totally 220 cases were checked out the pathogens ,but no statistically significant difference in the detection rates of pathogens between the CHD group and the control group was found (P>0 .05);179 cases were infected by bacteria ,in which 126 cases were Gram-negative bacteria ,the positive rate of bacterial infection and the detection rate of Gram-nega-tive bacterial were relatively higher than those in the control group ,the difference was statistically significant (P<0 .05);95 cases were infected by virus ,with respiratory syncytial virus being the most common pathogen ,30 cases were infected by fungi ,with Can-dida albicans being predominant ,the infection rates of virus and fungus had no statistical difference between two groups (P>0 .05);in the drug sensitive test ,the detection rate of extended spectrum beta lactamase (ESBLs)-producing positive bacteria in the CHD group was higher than that in the control group ,the difference was statistically significant (P<0 .05) .Main Gram-negative bacteria Pneumonia klebsiella pneumonia subspecies ,Escherichia coli and haemophilus inf luenzae were highly sensitive to imipenem ,mero-penem ,levofloxacin and ciprofloxacin ;main Gram-positive bacteria Staphylococcus aureus and streptococcus pneumoniae were highly sensitive to vancomycin and gentamicin .Especially ,pneumonia klebsiella pneumonia subspecies ,Escherichia coli and haemophilus influenzaewere100% resistanttopenicillin.TheaveragelengthofhospitalstayintheCHDgroupwas (20.9±12.5)d,207cases developed the respiratory failure ,88 cases appeared the heart failure and 205 cases were effective in treatment ;compared with the control group ,the CHD group had a longer length of hospital stay ,higher occurrence rate of heart and respiratory failure and lower treatment effective rate (P<0 .05) .Conclusion Because of the earlier onset ,more prone to repeated pneumonia ,more sensitive to bacterial infection ,esp .Gram-negative bacteria ,more ESBLs production ,longer hospital stay and more prone to complications ,com-pared with the control group ,children with severe pneumonia complicated with CHD require active treatment .

Objective To detect the effect of ox‐LDL on self‐renewal and Oct‐4 express of MSCs in vitro .Methods MSCs cul‐tured in vitro were divided into 4 groups :blank control(no reagents in culture system ) ,ox‐LDL (1 ,5 ,10 ,20 μg/mL ox‐LDL were added into culture system) ,ox‐LDL+NAC(corresponding ox‐LDL were added into culture system after NAC treatment ) ,negative control(corresponding nLDL were added into culture system ) .Growth curve were drawn at different time ,Oct‐4 ,a stem cell special marker ,were detected by real‐time PCR ,the production of ROS (reactive oxygen species ,ROS) in culture system were measured with electron paramagnetic resonance spectroscopy .Results proliferation of MSCs was inhibited by ox‐LDL ,when concentration of ox‐LDL was more than 5μg/mL ;apoptosis of MSCs appeared as well as attenuated expression of Bcl‐2 ,ox‐LDL generated a signifi‐cant amount of ROS in the culture system ,which was completely prevented by NAC .Conclusion The proliferation and Oct‐4 ex‐pression of MSCs were inhibited by ox‐LDL ,which may be related to increase of ROS in culture system .

This study primarily explored and discussed‘generality and individuality’mode in clinical teaching of congenital heart disease(Congenital heart disease,CHD)from the aspects of teaching methods,comparison with traditional method,requirements for teachers and problems existed under present conditions.At last the paper summarized advantages and disadvantages of this model in clinical teaching of CHD and offered a new approach for clinical teaching of cardiology.

Idiopathic ventricular tachycardia(IVT), which is a clinical entity without any structural heart disease or definite inducing factors, has a low incidence and a good overall prognosis in children, but long-term episode can lead to hemodynamic collapse or even be life-threatening.According to the origin of IVT, the response to drugs and the morphological characteristics of electrocardiogram, it can be divided into different subtypes whose electrophysiological mechanisms are also different.Besides, these is no guideline for the indications and treatment of IVT.This paper summarizes the electrophysiological mechanisms and progress of treatment of idiopathic ventricular tachycardia in children by reviewing the relevant literatures.