Objective:To explore the application value of echocardiography in the management of pediatric mitral valve replacement.Methods:Thirty-three children who underwent mitral valve replacement at Union Hospital Tongji Medical College Huazhong University of Science and Technology from January 2009 to June 2023 were retrospectively analyzed. Clinical data and preoperative and postoperative echocardiographic data were collected. The differences in ultrasound parameters among preoperative，1-week postoperative，1-month postoperative and 1-year postoperative were compared.Results:Of the 33 children，there were 4 cases（12.12%）of mitral stenosis，33 cases（100%）of mitral regurgitation and 4 cases（12.12%）of mitral stenosis combined with regurgitation. Mechanical valve replacement was performed in 30 cases（90.91%）and bioprosthetic valve replacement in 3 cases（9.09%）. Compared with the preoperative period，the left atrial internal diameter and left ventricular end-diastolic internal diameter were significantly reduced at 1-week postoperatively，1-month postoperatively，and 1-year postoperatively，respectively（all P <0.05）.The left ventricular mass was significantly reduced and the left ventricular end-diastolic sphericity index was significantly increased（both P < 0.05）at 1-month postoperatively compared with preoperatively. The left ventricular ejection fraction was significantly higher at 1-year postoperatively compared with 1-week postoperatively（ P <0.05）. Conclusions:After pediatric mitral valve replacement，the left ventricular dimensions decrease，and cardiac function progressively recovers. Echocardiography is an essential tool for accurate preoperative assessment and postoperative follow-up in pediatric mitral valve replacement.

Objective:To explore the application value of echocardiography in the management of pediatric mitral valve replacement.Methods:Thirty-three children who underwent mitral valve replacement at Union Hospital Tongji Medical College Huazhong University of Science and Technology from January 2009 to June 2023 were retrospectively analyzed. Clinical data and preoperative and postoperative echocardiographic data were collected. The differences in ultrasound parameters among preoperative，1-week postoperative，1-month postoperative and 1-year postoperative were compared.Results:Of the 33 children，there were 4 cases（12.12%）of mitral stenosis，33 cases（100%）of mitral regurgitation and 4 cases（12.12%）of mitral stenosis combined with regurgitation. Mechanical valve replacement was performed in 30 cases（90.91%）and bioprosthetic valve replacement in 3 cases（9.09%）. Compared with the preoperative period，the left atrial internal diameter and left ventricular end-diastolic internal diameter were significantly reduced at 1-week postoperatively，1-month postoperatively，and 1-year postoperatively，respectively（all P <0.05）.The left ventricular mass was significantly reduced and the left ventricular end-diastolic sphericity index was significantly increased（both P < 0.05）at 1-month postoperatively compared with preoperatively. The left ventricular ejection fraction was significantly higher at 1-year postoperatively compared with 1-week postoperatively（ P <0.05）. Conclusions:After pediatric mitral valve replacement，the left ventricular dimensions decrease，and cardiac function progressively recovers. Echocardiography is an essential tool for accurate preoperative assessment and postoperative follow-up in pediatric mitral valve replacement.

Objective To investigate the CRBSI rate,risk factors and etiological of PICC in neonates. Methods This is a retrospective case-serials analysis of 640 in-patients of newborn babies with PICC in our Hospital from 2015 to 2016,all the cases received PICC catheter treatment,and the factors of catheter-related bloodstream infections were analyzed. Results The number of PICC catheter-related bloodstream infection was 9, CRBSI rate pet 1000 central line-days was 0.60. The risk factors for CRBSI include the usage of Carbapenem antibiotic and the invasive mechanical ventilation(P < 0.05). The ratio of fungal,Staphylococcus in CRBSI was 80.00 % and 20.00%,respectively.Conclusion Possible risk factors which cause CRBSI are the usage of Carbap-enem antibiotic and the invasive mechanical ventilation.The major pathogen was fungal.

OBJECTIVE:To observe therapeutic efficacy and safety of tripterygium glycosides combined with valsartan in the treatment of idiopathic membranous nephropathy(IMN). METHODS:A total of 85 patients with IMN were enrolled and randomly divided into observation group(42 cases)and control group(43 cases). Based on routine treatment(reducing lipid,anti-platelet ag-gregation,protein dietary restriction),control group was additionally given oral valsartan,with initial dose of 80 mg/d,and gradu-ally adding the amount to 160 mg/d if there was no obvious ADR;based on control group,observation group was additionally giv-en Tripterygium glycosides tablet 40 mg,tid,and reducing the amount to 20 mg,tid after complete remission. 2 groups were treat-ed for 12 months. RESULTS:Total effective rate of observation group was 92.86%,which was significantly higher than that of con-trol group(74.42%),with statistical significance(P<0.05). Compared with before treatment,the levels of 24 h urine protein,TC and TG of 2 groups were decreased after treatment,and serum albumin(ALB)of observation group increased;24 h urine protein and TG of observation group was lower than control group,while the serum level of ALB was higher than control group,with sta-tistical significance(P<0.05 or P<0.01). No obvious ADR was found in 2 groups. CONCLUSIONS:Tripterygium glycosides com-bined with valsartan can improve the kidney function and blood lipid level of IMN patients with high safety.

OBJECTIVE: To learn the relationship between neural response telemetry(NRT) threshold and behavior T-level in cochlear implants patients and to learn how can we made NRT more useful for us to get the best map for cochlear implants who could not cooperate well to get the accurate behavior T-level. METHOD: Seventy-seven children implanted with the cochlear Nucleus 24 system. At each mapping procedure, vNRT threshold and behavior T-level of electrodes 1, 6, 11, 16, 20 were tested. After a time of experience and training, the children could cooperate well for test and the behavior T-level can be used for mapping. At the same time, vNRT and behavior T-level of the same electrode were recorded for statistic analysis. RESULT: Correlation coefficients (r) of vNRT and behavior T-level of each electrode were ranged from 0.40 to 0.54 respectively. The vNRT across each electrode ranged from 135 microV to 215 microV and the behavior T-level of each electrode ranged from 120 CL to 190 CL. The mean difference between vNRT and behavior T-level of electrode 1, 6, 11, 16, 20 were 27 +/- 14, 24 +/- 13, 31 +/- 14, 26 +/- 13, 20 +/- 13 respectively. The maximum difference between vNRT and behavior T-level was 65 and the minimum was -15. The group mean T-level is ranged from 148 CL to 159 CL and the group mean vNRT is ranged from 168 microV to 186 microV from electrodes 20 to electrodes 1. The NRT and behavior T-level both are going up higher a little bit from electrodes 20 to electrodes 1. CONCLUSION NRT can be used to speculate the behavior T level for young child and adults who can not do behavior test. But because of the large individual difference, the result will not always be accurate. So, behavior T-level test should be the first choice for cochlear mapping patients.
Child ; Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Deafness ; rehabilitation ; Female ; Humans ; Infant ; Male ; Software Design