Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objeetive To investigate the risk of hemorrhagic transformation (HT) and the outcome as well as its influencing factors at 3 months after thrombolytic therapy in acute ischemic stroke patients with non-valvular atrial fibrillation (NVAF).Methods Consecutive acute ischemic stroke patients with NVAF were enrolled retrospectively.Their demography,vascular risk factors and other clinical data were collected.The modified Rankin Scale (mRS) was used to evaluate the outcome at 3 months after symptom onset.The mRS score ≤ 2 was defined as good outcome,and ＞ 2 was defined as poor outcome.Results A total of 119 acute ischemic stroke patients with NVAF were enrolled,including 63 males (52.9％) and 56 females (47.1％); their mean age was 72.1± 10.0; 45 (37.81％) were treated with recombinant tissue type plasminogen activator (rtPA),55 (46.2％) had a good outcome and 27 (22.7％) combined with HT.Compared with the poor outcome group,the mean age was younger in the good outcome group (P =0.028).The proportions of the patients with ischemic heart disease and the time from onset to treatment ＞ 4.5 h were lower (P ＜0.05).The baseline systolic blood pressure and diastolic blood pressure,as well as the National Institutes of Health Stroke Scale (NIHSS) score were lower (P ＜0.05),while the proportion of patients receiving intravenous thrombolysis with rtPA was higher (P =0.019).Multivariate logistic regression analysis showed that the patients with ischemic heart disease (odds ratio [OR] 4.572,95％ confidence interval [CI] 1.392-15.014; P =0.012),systolic blood pressure before treatment (OR 1.028,95％ CI 1.007-1.049; P =0.009),baseline NIHSS score (OR 1.058,95％ CI 1.002-1.117; P =0.042) were the independent risk factors for poor outcome,while intravenous thrombolysis with rtPA (CI 0.264,95％ CI 0.102-0.683; P =0.006) was an independent protective factor for poor outcome.The proportions of the baseline systolic blood pressure,fasting blood glucose and NIHSS score,as well as the patients with a history of previous stroke or transient ischemic attack (TIA) in the HT group were significantly higher than those in the non-HT group (all P ＜ 0.05).Multivariate logistic regression analysis showed that the baseline NIHSS score (OR 1.147,95％ CI 1.068-1.231; P＜0.001),baseline systolic blood pressure (OR 1.951,95％ CI 1.921-1.982; P =0.002),and blood glucose level (OR 1.191,95％ CI 1.095-1.294; P ＜ 0.001) were the independent risk factors for HT.Compared with the non-thrombolysis group,the mean age of the thrombolysis group was younger (P =0.021),the baseline systolic blood pressure,fasting glucose and NIHSS scores,as well as the proportions of patients with hyperlipidemia,previous stroke or TIA history,and using antihypertensive drugs before admission were higher (all P ＜ 0.05).The proportion of patients with ischemic heart disease were lower (P =0.035),but the proportion of the patients with a good outcome was higher (P =0.019).Conclusions Patients with ischemic heart disease,systolic blood pressure and higher baseline NIHSS score before treatment were the independent risk factors for poor outcome,while intravenous thrombolytic therapy with rtPA was an independent protective factor for poor outcome; the high baseline NIHSS score,baseline systolic blood pressure and glucose level were the independent risk factors for HT.For acute ischemic stroke patients with NVAF,such as no obvious contraindications for thrombolytic therapy,might benefit from intravenous thrombolytic therapy,and it could not increase the risk of HT,but the blood pressure and glucose level of the patients should be controlled appropriately.

Objective To explore the imaging features and clinical significance of solitary costal hot spots on bone scintigraphy (BS). Methods Eighty-four patients with single costal hot spots were enrolled in the study. The sites of lesions were classified into four types: junction betweenaor rib. The shapes of hot spots were classified into three forms: Punctiform, clumping and strip. The above data were respectively analyzed. Results Single hot spots were mainly showed in the punctiform and strip shapes, and the distribution of punctiform spots were mainly in the sites of junction between costal cartilage and rib and frontal ribs, also mainly due to costal fractures (42/61, 68.85%). The majority of spots in strip shape were costal metastases(18/19, 94.74%). Hot spots in posterior ribs were also mainly costal metastases (24/29,82.76%). Conclusion Useful imaging features can be obtained from BS with al diagnosis of benign and malignant lesions.

Objective To evaluate the therapeutic effect of intramyocardial controlled releasing base fibroblast growth factor (b-FGF) stent combined with transplanting bone marrow-derived mesenchymal stem cells (BM-MSCs) in porcine acute myocardial infarction (AMI) models. Methods Eighteen porcines were divided into three groups (each n=6):transmyocardial revascularization (TMR)+naked stent (control group), TMR+b-FGF stent (b-FGF group) and TMR+b-FGF stent+BM-MSCs (b-FGF+BM-MSCs group). Acute myocardial infarction models were induced by ligating the left anterior descending artery in 18 porcine. In the control and b-FGF group, naked stents, b-FGF stents and b-FGF stent+BM-MSCs were implanted into TMR channels in the infarct and border zone. ~(99m)Tc-methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging were performed to evaluate changes in myocardial blood flow, and echocardiography and immunohistochemical studies were also performed. Results After 6 weeks, the quality of myocardial infarction, fractional shortening, neovascular density in b-FGF and b-FGF stent+BM-MSCs group were higher than those of control gruop (P<0.05), and in b-FGF stent+BM-MSCs group was higher than those in b-FGF group (P<0.05). Conclusion BM-MSCs combined with controlled releasing intramyocardial b-FGF stent can improve the flow of myocardial infarction area, promote angiogenesis and heart function, and the therapeutic effect which can be evaluated with myocardial SPECT imaging.

Objective To investigate the clinical value of the gated blood pool imaging phase analysis method in the evaluation of left ventricular mechanical synchronization in patients with chronic heart failure. Methods A total of 169 patients with chronic heart failure were enrolled in our study , using gated blood pool imaging phase analysis method to obtain left ventricular phase angle width ( PHB) and left ventricular phase angle standard deviation ( PSD) as evaluating left ventricular mechanical synchrony index; using tissue Doppler imaging (TDI) measurement of the standard deviation of systolic peak time(Ts-SD) of each segment by using the current prevailing 12 non-apical segments analysis method as evaluating left ventricular mechanical synchrony index, and parameters derived from both methods were compared. Results LVPHB was highly correlated with Ts-SD (r = 0. 83 ,P = 0. 000 ) . LVPSD was modestly correlated with Ts-SD ( r - 0. 69, P = 0. 000) . The ejection fraction measured by echocardiography was (42.93 ± 14. 89) % ,which was significantly higher than that measured by ERNA (39. 76 ± 17. 89)% (P <0. 01). Conclusions The evaluation of left ventricular mechanical synchrony in patients with chronic heart failure by the gated blood pool imaging can provide similar information with TDI, which can simultaneously measure two ventricular functions and get more accurate measurement of ejection fraction. Cardiac resynchronization therapy patients can be identified by combining two kinds of approaches, and cardiac resynchronization therapy responders could be improved as well. More patients with heart failure can benefit from cardiac resynchronization therapy therapy.

BACKGROUND: A new method, i.e., heparin slow-release stent implantation combined with myocardium drilling, is discovered for myocardial revasculadzation, which remarkably improves myocardial perfusion. OBJECTIVE: To investigate the effect of heparin slow-release stent implantation combined with myocardium drilling on myocardial regeneration of pigs with acute myocardial infarction.METHODS: Anterior descending coronary of pig was ligated to induce myocardial infarction model, which was randomly divided into control and implantation groups, with 6 pigs for each group. Self-made borer was used in the implantation group to drill two transmural channels (3.5 mm diameter) on epicardium. A heparin slow-release stent was fixed in the transmural channel. Following intravenous injection, BrdU was used to label DNA duplication so as to observe stromal cell-derived factor-1 (SDF-1) mRNA expression, myocardial perfusion, newborn yocardium, and heart function prior to and following implantation. RESULTS AND CONCLUSION: As compared with control group, SDF-1 expression was enhanced in the implantation group at 6 weeks after stent implantation (P < 0.001), perfusion mass defect percentage was significantly decreased (P < 0.001), ejection fraction of left ventricle was increased (P < 0.05), newborn myocardium was increased (P< 0.001), and survival myocardium in the ischemic region was increased (P < 0.001). The results demonstrated that heparin slow-release stent implantation combined with myocardium drilling could repair damaged myocardial cells and improve heart function through increasing SDF-1 expression and myocardial perfusion.

Objective Dilated cardiomyopathy (DCM) is generally considered to be accompanied by both left and right ventricular dysfunction,but most studies only analyze the left ventricular function. In this study, we evaluated the effect of arotinolol on right ventricular function in patients with DCM. Methods Right ventricular ejection fraction (RVEF) and right ventricular diameter (RVD) were measured by two-dimensional echocardiography (2-DE) in 33 DCM patients; RVEF measured by first-pass radionuclide angiography (FPRA) was compared with that by 2-DE. Results The treatment with arotinolol for one year resulted in a reduction in the right ventricular diameter (baseline, 23.0 ± 8.3 mm vs after one-year treatment, 20.7 ± 5.4 mm; P=0.004 ) and an associated increase in ejection fraction (baseline, 36.9 ± 10.3% vs after one-year treatment, 45.8 ± 9.6%; P ＜ 0.001 ); there is a high correlation between the 2-DE method and radionuclide ventriculographic method. The correlation coefficient is 0.933 (P＜0.001). Conclusion Arotinolol therapy could not only improve left ventricular function, but also improve right ventricular function in DCM patients.

Objective: To study the correlation between radionuclide pulmonary perfusion imaging (PPI) data and quantitative analyzed data of lung biopsy specimens in congenital heart defects with left to right shunt associate with severe pulmonary hypertension in young children. Methods: 52 data of PPI were collected from 43 young children with severe pulmonary hypertension caused by congenital heart defects. Lung biopsies were performed in 26 cases and the specimens were quantitative analyzed. The correlation between PPI and lung biopsy was studied. Results: The percentage of wall thickness (%MT) and percentage of wall area (%MS) were significantly increased in cases with right upper to lower count ratio (RULR)≥0.70 (P