Objective To analyze the clinical characteristics and treatments of children with myocarditis,and to investigate the relation-ship between arrhythmia and prognosis.Methods A total of 244 patients diagnosed with myocarditis from January 2012 to December 2023 were included and retrospectively analyzed.The patients were divided into three groups:fulminant myocarditis(FMC),myocarditis(MC),and suspected myocarditis(SMC).The data included the clinical characteristics at disease onset,the treatment,and the relationship between different arrhythmias and the prognosis among the three groups.Results Among the 244 children with FMC/MC/SMC,132/244(54.1％)developed arrhythmia,ventricular arrhythmia was observed in 83/132(62.9％),and 86/105(81.9％)showed no persistent arrhythmia.The proportion of children in the FMC group who presented with palpitations,cardio-cerebral syndrome,cardiogenic shock,cardiac insufficiency,and death was significantly higher than that in the MC and SMC groups(P＜0.01).Five children with third-degree(Ⅲ°)atrioventricular block(AVB)recovered after controlling their ventricular rate without a temporary pacemaker.Conclusion Most children with FMC/MC/SMC have different types of arrhythmias,of which ventricular arrhythmias are the most common,and rarely persist.FMC has severe clinical symptoms and the highest mortality rate.Ventricular tachycardia usually occurs during the administration of vaso-active drugs in patients with Ⅲ ° AVB;if the ventricular rate can be controlled promptly,these patients have a good prognosis.

Objective To analyze the clinical characteristics and treatments of children with myocarditis,and to investigate the relation-ship between arrhythmia and prognosis.Methods A total of 244 patients diagnosed with myocarditis from January 2012 to December 2023 were included and retrospectively analyzed.The patients were divided into three groups:fulminant myocarditis(FMC),myocarditis(MC),and suspected myocarditis(SMC).The data included the clinical characteristics at disease onset,the treatment,and the relationship between different arrhythmias and the prognosis among the three groups.Results Among the 244 children with FMC/MC/SMC,132/244(54.1％)developed arrhythmia,ventricular arrhythmia was observed in 83/132(62.9％),and 86/105(81.9％)showed no persistent arrhythmia.The proportion of children in the FMC group who presented with palpitations,cardio-cerebral syndrome,cardiogenic shock,cardiac insufficiency,and death was significantly higher than that in the MC and SMC groups(P＜0.01).Five children with third-degree(Ⅲ°)atrioventricular block(AVB)recovered after controlling their ventricular rate without a temporary pacemaker.Conclusion Most children with FMC/MC/SMC have different types of arrhythmias,of which ventricular arrhythmias are the most common,and rarely persist.FMC has severe clinical symptoms and the highest mortality rate.Ventricular tachycardia usually occurs during the administration of vaso-active drugs in patients with Ⅲ ° AVB;if the ventricular rate can be controlled promptly,these patients have a good prognosis.

Objective:To investigate the popularization of non-iodized salt among residents in water-borne high iodine areas and the iodine nutrition status of key populations in Shandong Province.Methods:In 2021, monitoring was conducted on a county-by-county basis in 47 counties (cities, districts, hereinafter referred to as counties) in 9 cities of Shandong Province, in accordance with the newly designated high iodine areas in the "Definition of Water Source High Iodine Areas and High Iodine Disease Areas" (GB/T 19380-2016) and historical high iodine areas. In each monitoring county, administrative villages with a median water iodine level greater than 100 μg/L were sorted by water iodine value, and a systematic sampling method was used to select 5 administrative villages as monitoring sites to investigate the water improvement situation and the iodine level of residents' drinking water. Totally 40 non boarding students aged 8 to 10 from one primary school and 20 pregnant women were selected in each village location to collect household edible salt samples and random urine samples for testing salt iodine and urine iodine levels, and the B-ultrasound method was used for thyroid examination in children.Results:A total of 364 high iodine administrative villages had been monitored, all of which had completed water improvement with a water improvement rate of 100.0%. The median iodine content in residential drinking water was 20.3 μg/L, ranging from 0.1 to 869.1 μg/L; and 11 464 edible salt samples were collected from residents' homes, with a non-iodized salt rate of 82.7% (9 481/11 464). A total of 9 197 urine samples from children and 2 335 urine samples from pregnant women were tested, with median urinary iodine levels of 219.0 and 139.0 μg/L, respectively. A total of 9 197 children were examined for thyroid, with 262 cases detected and a goiter rate of 2.8%.Conclusions:The rate of non-iodized salt in high iodine areas of Shandong Province still needs to be improved. Children's iodine nutrition is above the appropriate level, while pregnant women are at an iodine deficiency level.

Myocarditis is an inflammatory disease of myocardium caused by a variety of factors.The most common etiology is enterovirus, followed by respiratory viruses, especially the new coronaviruses, mycoplasma, rickettsia, and toxoplasma, etc.The probability of arrhythmia is relatively high in myocarditis due to increased myocardial susceptibility, and its type may be suggestive of disease progression and prognosis.Electrophysiological changes in the cardio-myocytes are observed by electrocardiography and ambulatory electrocardiography.Echocardiography and cardiac magnetic resonance are used to detect specific changes in the internal structure of the myocardium and left ventricular systolic function and to assist in the diagnosis.For the treatment of myocarditis, in addition to general treatment, according to the needs of the condition, intravenous immunoglobulin, glucocorticoids, and receptor antagonists of some cytokines can be used.The prognosis of pediatric myocarditis is related to the type of myocarditis, the speed of progression, the degree of myocardial damage, the electrophysiological changes and the structural changes of the heart.

Objective To explore the pulse diagram parameter changes of chronic renal insufficiency patients with five symptoms types(spleen kidney qi deficiency ,spleen kidney Yang deficiency ,kidney liver Yin deficiency and the deficiency of Yin and Yang ) , and to establish the differentiation mode of each symptoms type for assisting the clinical diagnosis .Methods The DS01-C pulse manifestation instrument made by the Shanghai Daosh company was adopted to detect and analyze the pulse manifestations in the healthy control group and the chronic renal insufficiency group .Results The healthy control group was dominated by the normal pulse manifestation .The chronic renal insufficiency group was dominated by the taut pulse and its concurrent pulse .Along with the progress of the disease ,the pulse manifestations also appeared the corresponding changes .The patients with spleen kidney qi defi-ciency and spleen kidney Yang deficiency were dominated by the taut pulse .Comparing the patients with liver kidney Yin deficiency and Qi Yin deficiency ,the taut pulse and concurrent rapid pulse were common ,in addition ,the former also had the deep pulse .The patients with Yin and Yang deficiency showed the slow pulse and the taut pulse or the taut pulse and rapid pulse .Conclusion The pulse manifestation change in the patients with chronic renal insufficiency is dominated by the taut pulse and the concurrent pulse , the pulse manifestation change of various symptoms types are complex .