Objective To study the clinical characteristics of children with chaotic atrial tachycardia (CAT),and to improve its clinical diagnosis and treatment.Methods Clinical data,follow-up,treatment and prognosis concerning 33 patients with CAT from Sep.2001 to Oct.2013 in Beijing Children's Hospital were analyzed.Results The 33 patients included 23 boys and 10 girls with ages ranging from 3 days to 13 months,5 months on the average.CAT was conformed by electrocardiogram in all patients:multifocal atrial tachycardia defined by 3 distinct P'-waveforms,irregular P'R,RR and P'-P' intervals,and isoelectric baseline between P'-waves.Combined with symptoms of atrial flutter,atrial fibrillation,atrial premature beats,atrial tachycardia,and interior conduction,differences were detected by 24-hour holter electrocardiography.Echocardiographic features indicated mild heart enlargement in 19 cases,medium enlargement in 4 cases,severe enlargement in 3 cases,atrial septal defect in 5 cases,ventricular septal defect in 3 cases,atrial septal defect coupled with patent ductus arteriosus in 1 case,congenital total anomalous pulmonary venous cormection in 1 case,and patent foramen ovale closure in 12 cases.Twenty-three patients had heart failure.Digoxine,amiodarone and Betaloc were administered to the patients for maintaining their heart functions.No antiarrhythmic drug therapy was used in 2 patients.Twenty-six of the patients (78.8％) had normal electrocardiographic sinus rhythm within 3 to 18 months after their discharge from hospital.Three of the patients (9.1％) still had CAT symptoms in their eletroccardiogram,but their heart rates were kept under control during the 12-month follow-up clinical visits.Of 26 children with cardiac enlargement,echocardiograms in 21 cases (80.8％) returned to normal within 1-3 months after their electrocardiograms returned to normal,and for the other 5 cases (19.2％),the recovery took 6-12 months.One patient died and 3 patients did not participate in the follow-up visits.Conclusions CAT is often found in newborns and infants.Its diagnosis relies on electrocardiography and 24-hour holter electrocardiography.Treatment with Digoxine,and/or β-receptor block,and amiodarone according to with the heart functions of patients can restore sinus rhythm,and achieve good prognostic results.

Objective To study the clinical characteristics and curing methods of non-compaction of ventricular myocardium(NVM) in children with a view to improve its diagnosis and treatment.Methods From Jan.2009 to Dec.2012,the clinical data,treatment and follow-up of 22 patients with NVM in Beijing Children's Hospital Affiliated to Capital Medical University were analyzed.Results The 22 patients included 13 boys and 9 girls aged from 4 months to 13 years and 3 months with an average age of 3 years and 7 months.Five of them had a family history of cardiac diease.Twenty patients suffered from ventricular dysfunction,with 2 cases at level Ⅰ,5 cases at level Ⅱ,7 cases at level Ⅲ and 6 cases at level Ⅳ.Asymptomatic heart murmur was heard in 6 patients and creatine kinase car-diac isoenzymes raise was found in 6 patients.X-ray indicated that heart shadow enlargement and electrocardiographic abnormalities in all 22 patients.Echocardiography features of all cases indicated left ventricular enlargement,and 20 cases of the children had ventricular systolic dysfunction.Left ventricle was detected in 21 patients,while double ventricle dysfunction detected in 1 patient.Thrombus was found in none of the patients.Magnetic resonance imaging was performed in 8 cases of the patients and CT was performed in 14 cases,all of them showed abnormalities.Anti-heart failure medications were administered to 20 patients and aspirin to all of the children.The patients were followed up for 0.5 to 3.0years.Two patients died from heart failure during the follow-up.In 2 cases whose cardiac ejection fraction was more than 60％ had little change of the internal diameter of left ventricle and cardiac function.In 3 cases,the left ventricular diameter narrowed by 3 to 5 millimeter and ejection fraction increased by 5％ to 10％ over the previous.In 5 cases,the left ventricular diameter expanded by 5 to 7 millimeter and ejection fraction decreased by 3％ to 5％.In 10 cases,the left ventricular diameter and heart function had no significant change.Conclusions The main clinical manifestions of NVM in children are cardiac dysfunction,and the prognosis is usually poor.Echocardiography is the principal means of diagnosis.Magnetic resonance imaging can contribute to the diagnosis.

Objective To investigate the clinical characteristics,diagnosis,treatment and prognosis of hypertrophic cardiomyopathy(HCM) in children.Methods Twenty-five cases of children confirmed with HCM in Beijing Children's Hospital from October 2000 to September 2013 were analyzed retrospectively through their clinical manifestations,laboratory tests,treatment and prognosis.Results HCM was found to be more common in older children.The average age of the patients in the studied cases was 8 years and 9 months and the male to female ratio was 3.1:1.Their clinical manifestations were as the follows:5 cases with shortness of breath and fatigue,4 cases with chest tightness and long breath,3 cases with precordial discomfort,5 cases with cough and wheezing and found to have cardiac abnormalities,8 cases found with asymptomatic heart murmurs with no other symptom,2 cases with syncope episodes,6 cases with a clear HCM family history,3 cases with a family history of infant deaths (specific condition not clear).ECG:18 cases showing left ventricular and/or right ventricular hypertrophy and ST-T changes,3 cases showing abnormal Q waves,2 cases showing ST-T changes,2 cases with Ⅰ ° atrio-ventricular block,1 case with left bundle branch block,and 1 case with left anterior division block.Cardiac enzymes were elevated in 5 cases.Chest X-rays showed enlarged heart shadow in 17 cases.Echocardiography revealed non-obstructive hypertrophic cardiomyopathy in 23 cases and obstructive hypertrophic cardiomyopathy in 2 cases.Left ventricular systolic function was decreased in 2 cases,and diastolic dysfunction in 3 cases.Twenty-one patients took oral metoprolol,1 patient took verapamil,1 patient took propranolol and 2 patients took no medication.The follow-up period of 2 months to 13 years witnessed 2 cases of death and 23 cases of survival.Conclusion HCM in children lacks specific clinical manifestations and the conditions of the patient are usually severe with progressive development.HCM is one of the main reasons of sudden death in adolescent,with poor prognosis.

Objective To study the clinical characteristics and therapy of children with idiopathic ventricular tachycardia(IVT).Method Clinical features,laboratory examination,treatment and outcomes of cases involving 36 children with IVT were retrospectively and statistically analysed.Results IVT often happened in teenagers.The average age of selected patients was 7 years and 8 months,and the ratio of male and female was 1.11.Electrokardiogram(EKG)results showed 23 cases(63.8%)were VT that arised from the left ventricular tachycardia(ILVT)with right bundle branch block,and 13 cases(36%)were VT that arise from the right ventricular outflow tract(RVOT VT)with left bundle branch block.Among the 23 children with tachycardia,15 children had palpitation,2 children had syncope.Of the 13 children with right ventricular tachycardia,3 children had increased heartbeat,and 1 child suffered from weakness,others had no significant clinical symptoms.Cases with ILVT had more serious clinical symptoms than cases with right ventricular tachycardia.It was of marked significance to compare their differences(P

Objective To explore the clinical characters,therapy and prognoses of hyperthyroid cardiac disease in children.Method Fourteen hospitalized cases with hyperthyroid cardiac disease(5-14 years old) collected from January 2001 to January 2005 were analyzed(retrospecti)vely.Results Fourteen children with hyperthyroid cardiac disease had different degree of enlarged of heart,arrhythmia and heart failure.All of the cases were received treatment of hyperthyroidism and anti-arrhythmia.After admission for 2 weeks,the symptoms of 13 cases relived or disappeared,and after 4-6 weeks the enlarged heart,arrhythmia and heart failure disappeared.One case died after recurrent heart failure.Conclusions Hyperthyroid cardiac disease in children can be curative and the changes of cardiac blood-vessel can be recuperative.It is critical for doctors to know the manifestations of hyperthyroidism and take the cardiac examination and the function of the thyroidism and take proper treatment as soon as possible.

Tumor invasion model is an important tool to study the mechanisms of tumor mvasion and to evaluate prevention and treatment of cancer.Compared to the in vitro model,in vivo model can simulate the tumor microenvironment and tumor mvasion biological behaviour better.Morphological observation and invasion-related protein detection can be used to evaluate the animal invasion model,which are widely used in basic and clinical research now.

Objective To explore the therapeutic effect of endoscopic treatment for common bile duct stricture secondary to chronic pancreatitis.Methods The clinical data of 58 patients with common bile duct stricture secondary to chronic pancreatitis diagnosed between January 2007 and January 2014 were retrospectively analysed.Results A total of 58 patients with common bile duct stricture secondary to chronic pancreatitis underwent 157 endoscopic procedures with placement of 204 polyethylene stents.The mean time of stenting was 12.2 months(3-33 months).After treatment,stricture disappeared in 20 patients(34.5％),with a mean stenting period of 7.8 months(3-22 months).Treatment was successful in 37 patients(63.8％),with a mean stenting period of 9.5 months (3-22 months),and was incompletely successful in 12 patients (20.7％) with a mean stenting period of 19.8 months(12-33 months).Nine patients(15.5％) referred to surgery were considered a failure of endoscopic therapy.Conclusion The endoscopic treatment of common bile duct stricture due to pancreatic edema or pancreatic cyst is effective.Endoscopic treatment is a safe,effective and minimally invasive method for common bile duct stricture secondary to chronic pancreatitis,which can be the first option.

Objective to analyze the basic situation of university and college teachers′psychological empowerment,and investigate the effect of perceived organizational support,organizational identification,supervisory commitment on psychological empowerment. Methods the instruments which were used include perceived organizational support questionnaire(POS),organizational identification questionnaire(OIQ),supervisory com-mitment scale(SCS)and psychological empowerment scale(PES). A total number of 1 500 teachers were recruited conveniently from 6 university and colleges. Results the average score of psychological empowerment was 60.09±14.21. Positive correlation was found among perceived organiza-tional support,organizational identification,supervisory commitment and psychological empowerment(P < 0.05). Perceived organizational support, organizational identification and supervisory commitment explained 86.5% of variance of psychological empowerment. Conclusion Overall level of university and college teachers′psychological empowerment is in moderate or above degree. Perceived organizational support,organizational identifi-cation,and supervisory commitment can predict a deep level of psychological empowerment.

Objective To assess the safety and feasibility of hybrid trans-gastric endoscopic and laparoscopic cholecystectomy in a porcine model.Methods A total of 6 pigs underwent hybrid trans-gastric endoscopic and laparoscopic cholecystectomy from July to October,2010 under general anesthesia.The operation time and complications during the procedure were recorded,as well as post-operative changes of eating habits and weight.Animals underwent autopsies on post-operative days(POD)14 for evaluation of infection,abscesses and adhesion.Results All procedures were successfully performed and all dogs survived.There was no severe complication except for hemorrhage in one porcine,which was successfully managed under laparoscopy.The mean operation time was 87mins(ranging from 69-124 mins).After the operation,there was no change in eating habits or weight.At autopsy on POD 14,no abscess or hemorrhage was found.Sites of gastric closure were found to be completely healed.Conclusion The hybrid approach increases the safety of initial gastric puncture and gastric wall incision,simplifies peroral trans-gastric cholecystectomy,and decreases invasiveness of laparoscopic surgery.It is a bridge between laparoscopic and transluminal surgery.

Objective To study the changes of serum high-sensitivity C-reactive protein (ha-CRP) and depression in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS),and investigate the relationship between them.Methods Thirty healthy volunteers (control group) and 54 OSAHS patients (OSAHS group) were recruited for the study.The level of serum hs-CRP was determined by scatter rate nephelometry,and the state of depression was assessed by self-rating depression scale (SDS).Results The level of serum hs-CRP and SDS score were higher in OSAHS group than those in control group [(48.8 ± 12.7) scores vs.(36.3 ± 6.3) scores,(3.3 ±0.7) mg/L vs.(1.4 ± 0.4) mg/L](P＜0.01).SDS score and the level of serum hs-CRPwere positively correlated to apnea-hypopnea index(AHI) (r = 0.636,0.628 ;P<0.01) and negatively related to the MSaO2 (r =-0.509,-0.614;P <0.01) and LSaO2 (r =-0.607,-0.512;P <0.01).The level of serum hs-CRP was positive correlation to SDS score (r = 0.536,P<0.01).SDS score was related to the AHI,the level of serum hs-CRP and LSaO2 in multiple linear regression(F= 33.31,P = 0.002).Conclusion Depression is correlated to AHI and the level of serum hs-CRP in patients with OSAHS.