Objective To explore the value of transesophageal atrial pacing (TEAP) in assessing the mechanism of paroxysmal supraventricular tachycardia (PSVT) in children. Methods The electrophysiological data of 50 children with PSVT who had undergone TEAP and, at a later stage, radio-frequency catheter ablation (RFCA) examination were retrospectively analyzed from January 2008 to December 2013. Results When using the intracardiac electrophysiological study (IEPS) as the diagnostic gold standard, the sensitivity of TEAP for atrioventricular nodal reentrant tachycardia (AVNRT), left accessory pathway (LAP) and right accessory pathway (RAP) was 92.9%, 83.1%and 90%respectively;the speciifcity was 86.4%, 100%and 95%respectively;the accuracy was 90%, 96%, and 94%respectively. The diagnostic accuracy of TEAP for AVNRT was 92.9%(26/28), the diagnosis accuracy for slow-fast AVNRT was 100%, but 2 cases of fast-slow AVNRT were both misdiagnosed as AVRT. The diagnostic accuracy of TEAP for AVRT was 86.4%(19/22) and 3 cases were misdiagnosed as slow-fast AVNRT. Conclusions TEAP has good clinical value in ifnding the mechanism of PSVT and its preliminarily location in children, but it has some limitations for some types of PSVT.

This research was aimed to study the effect of Emodin gel on the hypertrophic scars of rabbit ears. A total of 18 rabbits were randomly divided into Emodin group (9 rabbits) and control group (9 rabbits) after the successful animal model for hypertrophic scars had been made. The rabbits in the Emodin group were treated with Emodin Gel, while no special treatment was given to those in the control group. The other living conditions were all kept the same in the two groups. The diameter,hardness, and expression of transforming growth factor-beta (TGF-beta) and interleukin-1 (IL-1) of hypertrophic scars were measured after 4 weeks. Transmission electron microscopy was applied to observe the ultra-structure of the fibroblasts of hypertrophic scars. But there was no difference between the two groups in the diameter of hypertrophic scars (P>0.05). The hardness, expression of TGF-beta and IL-1 in hypertrophic scars in the Emodin group decreased, compared to the control group (P<0.05, P<0.01, P<0.05). Transmission electron microscopy showed that the fibroblast and organelle lessened in the cytoplasm and the collagen fibers dissolved obviously. The study showed that Emodin gel decreased the hardness of hypertrophic scars in the rabbit ears, and inhibited the proliferation of fibroblasts in local area. Therefore, Emodin gel treatment would be one of the methods to prevent and treat hypertrophic scars.
Animals ; Cicatrix, Hypertrophic ; drug therapy ; Cytoplasm ; Disease Models, Animal ; Emodin ; pharmacology ; Fibroblasts ; drug effects ; Gels ; Hardness ; Interleukin-1 ; metabolism ; Microscopy, Electron, Transmission ; Rabbits ; Transforming Growth Factor beta ; metabolism

Objective To study the condition of rehabilitation in Community Health Service (CHS) in rural areas after earthquake. Methods 274 medical personnels of CHS were invistigated with the questionnaire. Results There was no rehabilitation therapist in those medical personnel, and no difference of requirement, referral will and acquaintance of therapy between rehabilitation and acupuncture in CHS （P=0.056，P=0.293，P=0.654）. There was a significant difference in acquaintance of rehabilitation among different ages of medical personnel （P<0.01）, but there wasn't of acupuncture （P=0.104）. Conclusion It still lack rehabilitation therapist in CHS. Techniques and resources were the key points in the development of community-based rehabilitation.

Low-frequency repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation method that has been used in the treatments of stroke patients. Our purpose was to investigate the effects of low-frequency rTMS on the hand motor function recovery for stroke patients. After searching from electronic database from January 1990 to April 2012, we collected randomized controlled trials explored the low-frequency rTMS effects on the hand motor function rehabilitation. A total of 7 comparisons (N = 216) from 5 articles were included in this study. We summarized the effect size by calculating the standardized mean difference (SMD). Summary of effect size (SES) indicated positive effects of low-frequency rTMS on the finger motor ability (SMD = 0.58) and hand function (SMD = -0.98). Few adverse effects occurred. The evidence showed that low-frequency rTMS could improve the paretic hand recovery after stroke.
Hand ; physiopathology ; Humans ; Recovery of Function ; Stroke ; therapy ; Transcranial Magnetic Stimulation

Objective To investigate the effects of nuclear factor-kappaB(NF-κB)/p65 signaling transduction on the apoptosis and expressions of apoptosis-related genes Bax in nude mouse lung tumour cell xenografts. Methods The nude mice Lewis lung carcinoma cell xenograft model was established,and then the mice were intraperitoneally injected with NF-κB/p65 small interfering RNA(siRNA). The apoptosis of xenografted tumor cells in nude mice was detected by TUNEL assay. Expressions of Bax mRNA and protein were detected by RT-PCR and Western blotting. Results The result of TUNEL assay demonstrated that p65 siRNA evidently evoked cell apoptosis. Compared to the PBS treatment group or the normal control mice,both mRNA and protein expression levels of Bax in tumor xenografts were significantly up-regulated. There were significant differences among three groups(P<0.05). Conclusion NF-κB/p65 subunit may play an essential role in cell apoptosis of Lewis lung tumor.

ObjectiveTo report the treatment of the first imported Middle East respiratory syndrome (MERS) in China, and to investigate the clinical features and treatment of the patient.Methods On May 28th, 2015, the first patient of imported MERS to China was admitted to Department of Critical Care Medicine of Huizhou Municipal Central Hospital. The clinical features and treatments of this patient were analyzed.Results①A 43 years old male of South Korean nationality was admitted with the complaint of back ache for 7 days and fever 2 days with the following characteristics: back ache 7 days ago, without fever or cough or expectoration. He had been suspected to suffer from infection of Middle East respiratory syndrome coronavirus (MERS-CoV) by the Disease Control Department of South Korea, but no specific treatment was given. He had fever for 2 days with maximum body temperature of 39.7℃. He had no chills, cough, expectoration, short of breath, abdominal pain, diarrhea, frequent micturition, or urgency or pain of urination, and no sore throat. The patient had a history of exposure to MERS-CoV patient. He was considered to be a patient of the second batch of South Korean epidemic.② Auxiliary examination: 3 copies of throat swab specimens for virus nucleic acid detection were performed by the Disease Prevention Control Center of China (China CDC), and they were positive on May 29th, 2015, and also for serum, sputum and stool. Based on the results of whole genome sequence analysis, the virus strains were implicated to be derived from Riyahh and Jeddah regions of Saudi Arabia. On admission, the patient's blood test showed that the white blood cell count was low (3.22×109/L), the proportion of the neutrophils was high (0.73), and that of the platelet was low (81×109/L). On admission, the patient's chest X-ray showed that a small amount of infiltration in the lung.③ Treatment: a high-flow nasal cannula (HFNC) with oxygen concentration of 0.50-0.80 was given, with a flow rate was set at 60 L/min if tolerated. It was changed to a low flow oxygen inhalation nasal cannula on the 20th day, and oxygen treatment was stopped on the 24th day. Ribavirin 2.0 g was given as the first dose, and was switched to 600 mg every 8 h (q8h), and it was reduced to 600 mg q12h after 10 days, and extenuated since the 13th day. Ceftriaxone was added on the 4th day with 2.0 g a day , and it was changed to meropenem 2.0 g, q8h on the 7th day for 2 weeks. Gamma globulin was given for 7 days (20 g, qd). Thymosin-α1 was given on the 8th day for 2 weeks. Interferon was given once a week, but only one dose was used. At the same time symptomatic treatment such as methimazole and liver protection therapy were given.④ Patient began to cough at admission, and it disappeared on the 18th day. There was no sputum at first, then a small amount of sputum with a little blood appeared after the admission. Then there was cough without sputum. Mild shortness of breath and diarrhea after exertion were noticed. He had no chest pain, difficulty in breathing or other symptoms. There was dullness on percussion in both sides of chest, and it disappeared gradually. Fine moist rales were detectable in scapular area and interscapular area on the 5th day, and they disappeared after 3 days. Breath sounds on both sides was weak, and it became more obvious in the right lung after 5 days, and returned to normal after 18 days. He had a sustaining fever for 1 week with the maximum temperature of 39.5℃, then the body temperature returned to normal. The viral nucleic acid test as performed by the Center for Disease Control of Guangdong (CDC, Guangdong) showed that the pharyngeal swab cultured turned negative on the 3rd day, that of serum specimens turned negative on the 8th day, that of stool specimen after 2 weeks, and it was persistently positive for sputum culture until 5 days before discharge. The oxygenation index gradually increased, and it was over 300 mmHg (1 mmHg = 0.133 kPa) after 15 days. Pleural effusion was rapidly increased during the first week as shown by chest X-ray films, and it began to be absorbed gradually in the second week, but it was not completely absorbed until discharge.Conclusions The disease course of the reported patient was short, with an acute onset, with fever as the chief complaint, but there were no respiratory symptoms, though there were high fever, cough, shortness of breath, diarrhea and other clinical symptoms after admission. Virus in sputum disappeared after treatment, but pleural effusion was not completely absorbed. Negative test for virus in sputum was late, indicating that clearance of virus was slow from the lungs. It is the first case of MERS in China, therefore, the clinical manifestations and the treatment strategy need to be further explored.

Objective To investigate the effect of high-voltage electrostatic therapy on chronic migraine. Methods 86 cases who met inclusioncriteria were randomly divided into two groups: high-voltage group (n=43) was treated with high-voltage therapeutic device for 20d. Control group (n=43) was blank control. The recovered cases were followed up for 4 weeks after cessation of treatment. They were assessedwith McGill Pain Questionnaire (MPQ), and their results of laboratory tests were recorded before and after treatment. The data set analyzedincluded Intention-To-Treat, and per protocol. Results The differences between 2 groups were statistically significant in Pain RatingIndex, Visual Analog Score and Present Pain Intensity after treatment (P<0.05). 6 patients in the treatment group and 1 patient in the controlgroup recovered. During the 4-week follow-up, 1 case recured in each group, the intensity of pain was not statistically significant. There wasno difference in the laboratory indice of blood, urine, stool routine, liver and kidney function (ALT, BUN, Cr) and ECG in both groups beforeand after treatment. Conclusion The high-voltage electrostatic therapy is effective and safe on chronic migraine.

ObjectiveTo investigate the value of high flow nasal cannula (HFNC) in treating a patient with Middle East respiratory syndrome (MERS).Methods The effect of HFNC applied in the first imported MERS patient with complication of acute respiratory distress syndrome (ARDS) to China was observed. The patient was admitted to Department of Critical Care Medicine of Huizhou Municipal Central Hospital on May 28th, 2015, and the changes in various clinical parameters and their significance were analyzed.Results A 43-year old male was admitted to negative pressure isolation intensive care unit with the complaint of back ache for 7 days and fever for 2 days. Vital signs and saturation of pulse oximetry (SpO2) were monitored continuously. After admission, ribavirin was given orally for 12 days andα-interferon was administered once on the first day. However, after 2-week anti-virus therapy, the virus test was positive. Ceftriaxone was given on the 4th day, and it was changed to meropenem on the 3rd day for 2 weeks. Immune globulin was given on the 4th day and continued for 1 week. Thymosin-α1 was given on the 8th day and continued for 2 weeks. According to his past history, methimazole had been given continuously for hyperthyroidism and other symptomatic treatment. Oxygen inhalation (6 L/min) was given immediately after admission, but the condition of patient worsened with the following symptoms: frequent cough and obvious shortness of breath. Moreover pleural effusion gradually increased as shown by X-ray. SpO2 was maintained only at about 0.91. Oxygenation index (PaO2/FiO2) decreased to 144 mmHg (1 mmHg = 0.133 kPa). So oxygen inhalation via nasal cannula was changed to HFNC after 2 days. The parameters were set as follows: temperature 34℃, flow rate 20 L/min, fraction of inspired oxygen (FiO2) 0.50. The flow was raised 5 L/min every 10 minutes, and was continued till the target value reached 60 L/min. FiO2 was modified according to SpO2 and PaO2/FiO2. FiO2 was set to 0.80 on the 5th day of admission. Shortness of breath of the patient was improved on the 7th day of admission after the application of HFNC. FiO2 was then decreased to 0.58 as PaO2/FiO2 rose. Then the flow was gradually decreased to 30 L/min. HFNC was reduced with continuous improvement in PaO2/FiO2. HFNC was changed to low flow oxygen inhalation nasal cannula (2-3 L/min) on the 20th day. Oxygen treatment was stopped on the 23rd day, and SpO2 was maintained at 0.98-1.00. Activities on bed were gradually increased. The patient was cured and discharged from hospital on June 26th. The patient showed good tolerance and high compliance during the treatment with HFNC. No nosocomial spread occurred during the treatment.ConclusionsHFNC could improve respiratory function of the patient with MERS obviously, and complication ARDS was prevented. HFNC might reduce nosocomial spread.