Objective To investigate the effect of sodium citrate on the efficacy of oral midazolam premedication in children with congenital heart disease. Methods Forty ASA Ⅱ or Ⅲ children, aged 2-6 yr, weighing 12-20 kg, undergoing cardiac surgery, were randomly divided into 2 groups (n = 20 each): control group (gronp C) and sodium citrate group (group S). Group S received oral mixture of midazolam 0.12 ml/kg (0.6 my/kg), ketamine 0.12 ml/kg (6 my/kg), glucose 0.12 ml/kg (60 mg/kg) and sodium citrate 0.12 ml/kg (3 mg/kg), total volume 0.48 ml/kg. Group C received oral mixture of midazolam 0.12 ml/kg, ketamine 0.12 ml/kg and glucose 0.24 ml/kg, total volume 0.48 ml/kg. Hydrochloric acid (pH value 1.75) was mixed with the mixtures in the two groups and pH values were measured. Preoperative anxiety scale and the onset time,sedation score and parental separation score after receiving oral drugs were recorded in preparation room for anesthesia. After entering the operating room, HR, MAP and SpO2 were monitored, and the response to venepuncture in children and the adverse effects associated with oral drugs were also observed and recorded. Results The pH value was 1.97 in group C and 4.52 in group S. The parental separation score, sedation score and response score were significantly lower and the onset time was significantly shorter in group S than in group C. HR, MAP and SpO2 were in the normal range after entering the operating room. There was no obvious adverse effect after administration of oral drugs in the two groups. Conclusion Application of sodium citrate in the oral premedication in children with congenital heart disease can raise the pH value, shorten the onset time of midazolam, and enhance the sedative efficacy.

Objective To compare the respective diagnostic efficiency for breast cancer with ultrasound diffusion optical imaging (DOI),ultrasonic elastography (UE),contrast-enhanced ultrasound (CEUS),X-ray mammography(XRM),magnetic resonance imaging (MRI),and combinations of these imaging modalities.Methods Seventy-five breast lesions were collected.These lesions were confirmed by surgery and histopathology.All of breast lesions were examined ultrasound,mammography and enhancedMRI examinations before surgical excision.The specificity,sensitivity,positive predictive value and negative predictive value of each modality were compared.Results The sensitivities and the diagnostic negative predictive values for MRI + US + XRM (97.44％,96.15％),CEUS (92.31％,90.63％) and MRI (94.87 ％,92.86％) were significantly higher than those for XRM (74.36 ％,71.43 ％),respectively.The sensitivity for DOI + CEUS + UE was the same as one for CEUS,they were not significantly higher than those for UE and DOI (P ＞0.05),while they were significantly higher than that for XRM (P ＜0.05).The kappa values for DOI,UE,CEUS,USG(UE + DOI + CEUS),XRM,MRI and MRI + US + XRM were 0.678,0.624,0.732,0.705,0.439,0.677 and 0.676,respectively.Conclusions Different imaging modalities have themselves advantages to diagnose malignant or benign lesions.CEUS,MRI and combinations of these imaging modalities have highly important clinical values in breast disease diagnosis.

Objective: To investigate the status and trend of low vision of junior and senior high school students in Beijing from 2009 to 2018, and to provide evidence for myopia prevention. Methods: Data came from the results of physical examination of eyesight in 2009-2018 in Beijing, which were cdlected among juncor and senior high school students in March every year. Detection rate of low vision of students and the difference across different districts and counties were analyzed. Results: From 2009 to 2018, the rate of low vision of high school and college entrance examination students in Beijing was on the rise, with the average rate of low vision of 86.07% and 76.36% respectively. Similar trend was found in the rate of high myopia(16.39% and 18.64%,respectively), while that of light and medium myopia tends to be stable. The highest rate of low vision among junior middle school students was in Xicheng (84.75%) District and Chaoyang District (84.03%), and for high middle school students,the highest rate of myopia was found in Fengtai District (91.17%) and Dongcheng District (89.92%). Conclusion In Beijing, the detection rate of low vision of middle school and college entrance examination students increased steadily, especially the high myopia. The health education of eyesight protection is of great significance to students. It is necessary to strengthen the extensive intervention of eyesight protection in middle and college entrance examination students.

Objective To investigate the clinical value of chest CT in assessment and diagnosis of mass in breast area in children. Methods The chest CT data of 30 cases under 16 year-old with breast area mass confirmed by surgery and pathology were analyzed retrospectively.Of 30 patients,28 also underwent contrast enhanced CT scan,and 4 underwent both CT and MRI.Results CT detected all the 37 masses in the 30 cases with the diagnostic sensitivity and accuracy of 100% and 78.38%,respectively.The long diameter of masses were from 9 mm to 80 mm (average 34.5 mm).CT also detected accurately the intrathoracic invasion,rib and lung metastases, lymph nodes enlargement,patent ductus arteriosus and postoperative changes of lung congenital cystic adenomatoid malformation. Conclusion Chest CT is useful in the assessment and diagnosis of mass in breast area in children.

Perinatal loss is one of the most serious childbirth trauma,which seriously affects maternal physical and mental health.At present,the management strategy of maternal lactation can be divided into two aspects:milk return and milk donation.Breast milk donation may build new values of perinatal loss,which can promote maternal physical and mental recovery.This article reviewed the conception,status,motivations,facilitators,barriers and interventions of lactation management in women following perinatal loss,so as to provide bases for improving the awareness of obstetric nursing staff,quality of obstetric care and future research on lactation management in women following perinatal loss in China.

Circular RNAs (circRNAs), a novel type of non-coding RNAs (ncRNAs), are generated from pre-mRNA by covalently backsplicing of a downstream 5′ splice donor site onto an upstream 3′ splice acceptor site. Recent studies have shown that circRNAs have diverse biological functions, such as acting as a miRNA sponge to repress miRNA function, participating in splicing of target genes and translating genes into protein. These functions are involved in pathogenesis and progression of many diseases, including viral infection. In this review, we provided a brief introduction on the biological characteristics and functions of circRNAs, and summarized recent findings on the emerging roles of circRNA in viral infections, which might provide a new angle to study pathogenic characteristics and to understand the virus-host interaction mechanism.