Objective To study the changes and clinical significance of heart rate turbulence(HRT)in patients with diabetic cardiomyopathy.Methods 24h Holter ECG recordings were examined in 33 patients with diabetic cardiomyopathy(DC)and 30 patients in the control group.Turbulence onset(TO)and turbulence slope (TS)were calculated from Holter recordings.The mean value of TO,TS between the two groups were compared,the relativity among TO,TS,SDNN and LEVDD were analyzed as well.Results TO was significantly higher in the DC group compared with the control group[(-0.38 ± 0.12)％ vs(-1.88 ± 0.13)％,t =7.38,P =0.01)].TS in the DC group was significantly lower than that in the control group[(2.02 ± 0.82)ms/R-R vs (9.72 ± 1.18)ms/R-R,t =18.69,P =0.02)].TO was significantly related to SDNN(r =-0.35,P =0.02)and LEVDD(r =0.68,P =0.01),TS was also significantly related to SDNN(r =0.45,P =0.01)and LEVDD (r =-0.39,P =0.03).Conclusion The manifest of heart rate turbulence is significantly impaired in patients with diabetic cardiomyopathy.

Objective To explore sinus heart rate turbulence (HRT) in patients with different subtypes of essential hypertension (EH), and analyze the relationship between HRT and autonomic nervous system function damage in these patients. Methods The study consisted of 107 patients with EH (EH group) and 46 controls (control group). Based on 24 hours dynamic electrocardiogram, all patients were divided into dipper,non-dipper,and anti-dipper blood pressure group. The indexes about HRT and heart rate variability (HRV) among these groups were calculated and compared,and the relationship between turbulence onset (TO),turbulence slope (TS) and 24 hours mean systolic blood pressure,diastolic blood pressure was analyzed. Results There were significant differences in TO,TS,SDNN between EH group and control group(P ＜ 0.05 ). TO in non-dipper and anti-dipper blood pressure group was significantly higher than that in control group( P ＜ 0.05 ), and TS was lower than that in control group(P ＜ 0.05 ). There was no significant difference in TO,TS between dipper blood pressure group and control group (P ＞ 0.05). TO in non-dipper and anti-dipper blood pressure group was significantly higher than that in dipper blood pressure group, but TS was lower than that in dipper blood pressure group (P ＜0.05). Correlation analysis showed that TO had positive relationship with average heart rate and age (rs = 0.265, P = 0.004;rs = 0.217, P = 0.018 ), but had negative correlation with SDNN and left ventricular ejection fraction (LVEF) (rx = -0.287,P = 0.002;rx =-0. 179, P = 0.049). Whereas, TS had negative correlation with average heart rate and age (r = -0.335, P =0.015 ;r = -0.238,P= 0.009), but had positive relationship with SDNN and LVEF(r = 0.540,P = 0.001 ;r =0.432,P = 0.001 ). Conclusions HRT of EH patients becomes significantly low. It suggests that the autonomic nerve function in EH patients be injured seriously.

OBJECTIVETo explore the candidate disease causing gene for a case with floppy infant syndrome (FIS).

METHODSSingle nucleotide polymorphism array (SNP array) was used for analyzing the whole genome copy number mutations in the proband. Multiple PCR combined with denaturing high performance liquid chromatography (DHPLC) was employed to verify the suspected mutations in the proband and his family members.

RESULTSA large duplication arr [hg19] Xq13.1: 67 987 646-73 805 828, which spans approximately 5.818182 Mb and encompasses 66 known genes, was identified in the proband. The multiple PCR-DHPLC assay confirmed duplication of HDAC8, PHKA1, TAF1, DLG3, KIF4A, IGBP1, PJA1 and SLC16A2 genes in the proband. His mother and grandmother both had duplication of the above genes in one X chromosome, but his aunt had not.

CONCLUSIONThe large Xq13.1 duplication identified by the SNP array probably underlies the FIS in this family. For its high-throughput, high resolution and capacity of automation, SNP array has provided a first line method for the genetic testing for infants featuring developmental delay with unknown reason, mental retardation, autism, multiple malformation and FIS.

Objective To analyze the effects of massage therapy on the inflammatory state and lung function of pediatric refractory Mycoplasma pneumonia(RMPP).Methods A total of 320 chil-dren with RMPP treated in Hebei Seventh People's Hospital from September 2022 to August 2023 were selected in the study.According to different treatment methods,they were divided into two groups,with 160 cases in each group.The western medicine group was given conventional anti-in-flammatory and other symptomatic treatment,while the massage group was given dialectical massage treatment based on the western medicine group.The clinical efficacy,duration of disappearance of clinical symptoms,pulmonary function indexes,serum inflammatory factors,immune function indexes and total incidence of adverse reactions were compared between the two groups.Results The total effective rate of massage group was higher than that of control group(P＜0.05).The disappearance time of fever,cough,sputum and lung moist rales in observation group was shorter than that in control group(P＜0.05).After treatment,the peak expiratory flow(PEF),maximum mid-expiratory flow(MMEF)and forced vital capacity(FVC)in the massage group were higher than those in the control group(P＜0.05).The levels of serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in the massage group were lower than those in the control group after treatment(P＜0.05).After treatment,CD3+,CD4+,CD4+/CD8+in the massage group were higher than those in the control group(P＜0.05),and CD8+was lower than that in the control group(P＜0.05).There was nosignificant difference in the total incidence of adverse reactions between the massage group and the western medicine group(P＞0.05).Conclusion Massage based on syndrome differentiation combined with western medicine can effectively relieve fever,cough and other symptoms of RMPP children,reduce inflammatory response,improve lung function and immune function,and has less adverse reactions.

Objective To analyze the effects of massage therapy on the inflammatory state and lung function of pediatric refractory Mycoplasma pneumonia(RMPP).Methods A total of 320 chil-dren with RMPP treated in Hebei Seventh People's Hospital from September 2022 to August 2023 were selected in the study.According to different treatment methods,they were divided into two groups,with 160 cases in each group.The western medicine group was given conventional anti-in-flammatory and other symptomatic treatment,while the massage group was given dialectical massage treatment based on the western medicine group.The clinical efficacy,duration of disappearance of clinical symptoms,pulmonary function indexes,serum inflammatory factors,immune function indexes and total incidence of adverse reactions were compared between the two groups.Results The total effective rate of massage group was higher than that of control group(P＜0.05).The disappearance time of fever,cough,sputum and lung moist rales in observation group was shorter than that in control group(P＜0.05).After treatment,the peak expiratory flow(PEF),maximum mid-expiratory flow(MMEF)and forced vital capacity(FVC)in the massage group were higher than those in the control group(P＜0.05).The levels of serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in the massage group were lower than those in the control group after treatment(P＜0.05).After treatment,CD3+,CD4+,CD4+/CD8+in the massage group were higher than those in the control group(P＜0.05),and CD8+was lower than that in the control group(P＜0.05).There was nosignificant difference in the total incidence of adverse reactions between the massage group and the western medicine group(P＞0.05).Conclusion Massage based on syndrome differentiation combined with western medicine can effectively relieve fever,cough and other symptoms of RMPP children,reduce inflammatory response,improve lung function and immune function,and has less adverse reactions.

To obtain specific antibodies against nsp4 protein of porcine reproductive and respiratory syndrome virus (PRRSV), nsp4 gene was amplified by RT-PCR and cloned into pET-28a(+) vector, designated pET28a-nsp4. pET28a-nsp4 was transformed into Escherichia coli Trasseta (DE3) cells and expressed after induction of IPTG. SDS-PAGE analysis showed that the recombinant protein was expressed in soluble form with the molecular weight of 26 kDa. The soluble fusion protein in the supernatant was purified using Ni+-NTA affinity chromatography. New Zealand rabbits were immunized by the purified nsp4 and anti-sera against nsp4 were obtained. The titer of polyclonal antibodies was about 106 and showed good specificity and sensitivity in the immunofluorescence assay and Western blotting analysis. The polyclonal antibodies also recognized native nsp4 form PRRSV infected Marc-145 cells, providing a useful tool in PRRSV replication mechanism study.

Objective: To investigate the pathogenic characteristics of viral encephalitis in children living in Hebei province. Methods: We randomly collected cerebrospinal fluid specimens from a total of 399 children diagnosed with viral encephalitis in Hebei Children′s Hospital from May to December 2017. Real-time fluorescence quantitative PCR and Sanger sequencing were used to detect viral nucleic acids in cerebrospinal fluid by an automatic laboratory station. Statistical analysis was performed on the experimental data using SPSS 21.0 software and the clinical data were analyzed. Comparison of infection rates of EV encephalitis in different months, using line × column chi-square test. The MRI and EEG positive rates of different viral encephalitis and viral encephalitis patients not infected with the virus were analyzed by Fisher′s exact probability test. The positive rate of infection with different viruses and non-virus agents was analyzed by Fisher′s exact probability test. Results: The result showed that 80 of 399 samples were positive, and the positive rate was 20.05%. It included 22 cases of enterovirus, 4 cases of influenza A virus, 3 cases of mumps virus, 2 cases of herpes simplex virus type 1, 1 case of herpes simplex virus type 2, 4 cases of EB virus, 7 cases of cytomegalovirus, 7 cases of herpes zoster virus, 8 cases of adenovirus, 14 cases of human herpesvirus type 6. Eight cases had combined viral infection. Eight cases had concurrent infections: 3 cases had enterovirus and herpesvirus type 6 concurrent infection, 1 case had enterovirus and Japanese encephalitis virus concurrent infection and 1 case had herpes simplex virus type 2 and adenovirus, 1 case had influenza A virus herpesvirus type 6, 1 case had mumps virus and herpesvirus type 6, 1 case had mumps virus and herpesvirus type 6, 1 case had herpes simplex virus type 1 and herpes zoster virus concurrent infections. Children with EV viral encephalitis in Hebei Province were highly prevalent in May and June (P=0.016). HHV6 virus encephalitis was more susceptible to infection than non-HHV6 virus (P=0.016); The rate of MRI positive findings in patients with different viral encephalitis was not statistically significant (P>0.05). The result of EEG of different viral encephalitis were P>0.05, which was not statistically significant. Conclusions EV was the most common pathogen of children with viral encephalitis in Hebei province. Encephalitis caused by influenza A virus cannot be ignored in clinical practice.