Objective To explore the influence of early high-energy-density milk powder feeding on recovery and nutritional status in infants with congenital heart disease after surgery. Methods A total of 82 infants with congenital heart disease were selected and randomly divided into control group (early routine formula feeding) and study group (early high-energy-density formula feeding), with 41 cases in each group. The recovery outcomes, nutritional status, feeding conditions, and cardiac function were compared between the two groups. Results Mechanical ventilation time, treatment duration in Cardiac Intensive Care Unit (CICU), and hospital stay in the study group were significantly shorter than those in the control group (P < 0.05). Compared with preoperative levels, the levels of prealbumin (PA), retinol-binding protein (RBP), transferrin (TRF) and albumin (ALB) increased significantly in both groups at 3 months after operation (P < 0.05); at 3 months after operation, the levels of PA, RBP, TRF and ALB in the study group were significantly higher than those in the control group (P < 0.05). Compared with preoperative measurements, both groups showed significant improvements in height and body weight at 3 months after operation (P < 0.05); the height and body weight of the study group were significantly higher than those of the control group at 3 months after operation (P < 0.05). Compared with the control group, the study group had a significant lower rate of inadequate feeding and a significant higher rate of appropriate feeding (P < 0.05). Cardiac function of the study group was significantly better than that of the control group (P < 0.05). Conclusion Early high-energy-density milk powder feeding after congenital heart disease surgery in infants can promote faster recovery, improve nutritional status, and result in more appropriate feeding, with a lower incidence of heart failure.

Objective:To evaluate percutaneous mechanical thrombectomy (PMT) using Aspirex device for treating acute iliofemoral deep vein thrombosis (IFDVT).Methods:The clinical and follow-up data of 68 patients with IFDVT at our institution from Jan 2019 to Jun 2021 was retrospectively analyzed.Results:Twenty-six patients who had received PMT combined with auxiliary catheter directed thrombolysis (CDT) were included into group A, and 42 patients received CDT alone were into group B.The final thrombus clearance rates were more than 50%, and the clinical efficacy of thrombolysis was achieved. Group A associated a significant reduction in lysis duration and UK dosage and hospital days and degree of detumescence after 24 h compared with group B,and all aforementioned differences were statistically significant. Hospitalization costs in group A were more than group B. At one year follow-up, there were no significant differences between the two groups in the cumulative prevalence post-thrombotic syndrome (PTS) and the Villalta score and primary patency (92.0% vs. 90.0% , χ2=0.059, P=0.807). Conclusions:The application of PMT using the Aspirex device for acute IFDVT was safe and effective, which could accelerate the clearance of thrombus, and reduce UK dosage, lysis duration, hospital days. However, it increased the hospitalization costs.

Objective:To investigate the risk factors associated with post-thrombotic syndrome (PTS) within 2 years after the first diagnosis of deep venous thrombosis (DVT) of the lower extremities.Methods:The clinical data and 2-year follow-up data of 260 patients who were first diagnosed with DVT at our department from Jan 2017 to May 2019 were retrospectively analyzed.By Villalta score, the patients were divided into non-PTS group, mild PTS group and moderate-severe PTS group. Ordered multiple classification logistic regression was used to analyze the risk factors for the development of PTS.Results:The incidence of mild and moderate-severe PTS was 22.7% and 15.8%, respectively. Multivariate Logistic regression analysis showed that recurrence history of DVT ( OR=4.754, 95% CI 1.84-12.01, P=0.001), duration of oral anticoagulation treatment ≤6 months (0-3 months: OR=7.791, 95% CI 1.79-33.90, P=0.006; 4-6 months: OR=4.242, 95% CI 1.13-15.99, P=0.033), time length of stretch sock wearing≤ 12 months (0-6 months: OR=9.708, 95% CI 1.81-52.14, P=0.008; 7-12 months: OR=4.899, 95% CI 1.42-16.88, P=0.012) and exercise frequency ≤4 times/week (1-2 times/week: OR=7.691, 95% CI 1.92-30.72, P=0.004; 3-4 times/week: OR=4.284, 95% CI 1.33-13.80, P=0.015) were risk factors for PTS. Catheterized thrombolytic therapy ( OR=0.436, 95% CI 0.20-0.96, P=0.039) and low body mass index (BMI<18.5 kg/m 2: OR=0.142, 95% CI 0.02-0.81, P=0.028), central thrombus ( OR=0.322, 95% CI 0.15-0.72, P=0.005) and peripheral thrombus ( OR=0.020, 95% CI 0.01-0.07, P<0.001) were protective factors for PTS. Conclusions:Patients with DVT have a high risk of developing PTS within 2 years. Catheter-directed thrombolysis, no history of recurrence of DVT, low BMI (<18.5 kg/m 2), central or peripheral thrombosis, long-term oral anticoagulant therapy (≥7 months), longer wearing time of elastic socks (≥1 year), and higher exercise frequency (≥ 5-6 times/week) can be conducive to the reduction of incidence and severity of PTS.

Adult ; COVID-19 ; China/epidemiology* ; Disease Outbreaks ; Female ; Humans ; Incidence ; Infant, Newborn ; Male ; SARS-CoV-2

Objective:To evaluate the application of one-stop dynamic volume perfusion CT (dVPCT) in upper abdomen, and its feasibility of replacing conventional enhanced CT, perfusion, and angiography.Methods:A total of 94 patients with upper abdominal perfusion examinations were retrospectively enrolled in Deyang People's Hospital of Sichuan Province from April 2017 to June 2019. The data of another 64 patients underwent routine upper abdominal enhancement with 64-slice CT (28 patients) and dual-source CT (26 patients) were analyzed in the same period. The radiation dose and image quality were compared. According to different contrast agent concentration and dosage, 4 perfusion groups and 2 conventional enhanccement groups were divided, including 60 ml iohexol group (350 mg/ml) and 60 ml ultravist group (370 mg/ml), 60 ml and 80 ml iomeprol group (400 mg/ml), 64-slice routine group and dual-source CT routine group. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the liver, pancreas and abdominal aorta images in the arterial and portal vein phases were measured by two radiologists in a blinded way. Subjective image quality was evaluated by two radiologists using a 5-point Likert Scale in a blinded method. Statistical analysis was performed using analysis of variance and kappa test. Imaging findings and typical cases of perfusion were retrospectively analyzed.Results:Radiation dose: the effective dose of each perfusion group was lower than that of the 64-slice spiral CT scan, but higher than that of the dual-source CT routine scan. The SNR and CNR of the 80 ml iomeprol dVPCT group were better than that of 64-slice spiral CT and dual-source CT routine scan ( P<0.05), and were better than that of 60 ml iohexol, ultravist and iomeprol dVPCT groups ( P<0.05). However, the subjective index was lower than that of the dual-source CT routine scan group ( P<0.05). The comprehensive information of multi-phase images, vascular images and perfusion quantitative parameters of volume perfusion data reconstruction in this group is superior to conventional enhanced CT in the detection of lesions, visualization of normal tissues and blood vessels. Conclusion:One-stop dVPCT imaging of the upper abdomen has lower radiation dose with good image quality and more diagnostic information. dVPCT with 80 ml Iomeprol (400 mg/ml) can obtain much better images.

Objective:To investigate the effects of different local complications of acute pancreatitis (AP) on the microcirculation of multiple organs in the upper abdomen.Methods:A dynamic volume perfusion computed tomography (DVPCT) scan in the upper abdomen was prospectively conducted in 101 patients with AP and 24 patients with neither AP nor other obvious upper abnominal lesions diagnosed in People′s Hospital of Deyang City from April 1 to October 31, 2019, 86 patients with AP (AP group) and 21 controls (control group) were enrolled in the study. AP patients were divided into no local complications group (21 cases), acute peripancreatic fluid collection (APFC) group (19 cases), acute necrotic collection (ANC) group (27 cases), walled-off necrosis (WON) group (11 cases) and walled-off necrosis with infection (WONI) group (8 cases). The blood flow (BF) of pancreas, liver, spleen, two kidneys and adrenal glands was measured by deconvolution. The hepatic arterial perfusion (HAP), hepatic portal perfusion (HPP) and hepatic perfusion index (HPI) of each group were calculated by maximum slope. T test was used for statistical analysis. Results:The BF of pancreas, spleen and left adrenal gland of ANC group was (139.89±34.28), (141.42±47.85) and (107.87±26.41) mL·min -1·(100 g) -1, respectively, the BF of pancreas, spleen and left adrenal gland of WON group was (130.00±44.83), (106.12±38.16) and (98.38±41.39) mL·min -1·(100 g) -1 respectively, and the BF of pancreas, spleen and left adrenal gland of WONI group was (127.91±35.86), (102.09±23.73) and (105.66±27.01) mL·min -1·(100 g) -1, respectively, which were all lower than those of control group ((161.22±31.60), (174.00±62.73) and (134.53±36.36) mL·min -1·(100 g) -1), and the differences were statistically significant ( t=2.440, 2.043, 2.943; 2.296, 3.796, 2.548; 2.448, 4.479, 2.154; all P<0.05). The BF of left kidney cortex of WONI group was lower than that of control group ((247.44±39.32) mL·min -1·(100 g) -1 vs. (294.80±39.13) mL·min -1·(100 g) -1), and the difference were statistically significant ( t=2.910, P<0.05). The HAP of ANC group, WON group and WONI group was (18.63±9.54), (19.10±7.47) and (19.51±6.26) mL·min -1·(100 g) -1, respectively, and the HPI was (25.01±15.51)%, (45.98±31.42)% and (35.92±24.95)%, respectively, which were all higher than those of control group ((12.18±5.14) mL·min -1·(100 g) -1 and (13.44±6.49)%), and the differences were statistically significant ( t=2.997, 3.088, 3.235; 3.503, 3.397, 2.517; all P<0.05) . The HPP of ANC group, WON group and WONI group was (72.37±21.76), (48.83±35.10) and (57.55±29.45) mL·min -1·(100 g) -1, respectively, which were all lower than that of control group ((86.43±17.98) mL·min -1·(100 g) -1), and the differences were statistically significant ( t=2.391, 3.331 and 3.226, all P<0.05). The HAP and HPI of APFC group were both higher than those of control group ((18.67±10.24) mL·min -1·(100 g) -1 vs. 12.18±5.14) mL·min -1·(100 g) -1 and (23.75±20.41)% vs. (13.44±6.49)%), and the differences were statistically significant ( t=2.572 and 2.108, both P<0.05) . Conclusions:AP complicated with ANC, WON and WONI can reduce the BF of pancreas, spleen and left adrenal gland, and WONI can induce the decrease of BF of left kindney cortex. AP complicated with ANC, WON and WONI can increase HAP and HPI, but decrease HPP. Furthermore, AP complicated with APFC can increase HAP.

OBJECTIVE: To establish GC-MS fingerprint of volatile oil from Citrus aurantium. METHODS: GC-MS method was adopted. The determination was performed on RTX-5MS capillary column with injector temperature of 250 ℃, high pure helium as carrier gas(≥99. 999％), flow rate of 1. 0 mL/min, split ratio of 10:1,and sample size of 1 μL (temperature programming). Mass spectrum condition included electron bombardment ion source, ion source temperature of 230 ℃, detector temperature of 250 ℃, 3 min solvent delay, scanning range of m/z 35-550. GC-MS chromatograms of 21 batches of volatile oil samples were determined using Laurene as reference. The similarity of them was evaluated by using TCM Chromatographic Fingerprint Similarity Evaluation System (2004 A edition), and common peak was determined. The components of common peak were determined by LC Solution 2 mass database (NIST05. LIB and NIST05s. LIB). Relative content of common peak was determined with area normalization. RESULTS; There were 20 common peaks in GC-MS chromatograms of 21 batches of volatile oil samples, and the similarity was higher than 0. 90. After validation, GC-MS chromatograms of 21 batches of volatile oil samples were in good agreement with control fingerprint. The main constituents of the volatile oil of C. aurantium were Limonene, Terpinene, Laurene and D-Cadinene. CONCLUSIONS: Established fingerprint can provide reference for identification and quality evaluation of volatile oil of C. aurantium.

Objective To study the trends over time in meningococcal meningitis with Neisseria meningitidis .Methods Routine reported data on Meningococcal meningitis with Neisseria meningitidis in Shijiazhuang from 1949 to 2014 were used to study the trends of disease severity,disease distribution and serogroup switching of Neisseria meningitidis strains over time.The qualitative description and the quantitative evaluation was performed by the annual percent change (APC)in incidence to demonstrate the secular trends.The t test and χ2 test were performed when appropriate.Results From 1949 to 2014, 53 779 meningococcal meningitis cases were reported in Shijiazhuang.Of the 53 779 cases,36 170 were male and 17 609 were female,which was significantly different (χ2 =581 .04,P =0.000).It occurred all the year round,with an increased incidence between February and April,accounting for 81 .44%.The epidemic peak occurred about every 10 years.The range of annual incidence rate was from 0.01/lakh to 387.21/lakh.APC was -4.65 (t=-11 .72,P =0.000).The significant decline of APC were found in the age group of 0—1 year (t=-10.56,P =0.000),1 —5 year (t =-14.32,P =0.000),5 —10 year (t=-11 .01 ,P =0.003 ),10—15 year (t = -8.34,P =0.033 )and 40—50 year (t = -7.42,P =0.045).The risk population was those under 5 years old during 1949 to 2002 period and the serogroup was dominated by A strains.Whereas during 2003 to 2014,that was those of 5 —15 years old,and the dominant serogroup was C strains. Conclusions There is a remarkable decline in incidence of meningococcal meningitis in Shijiazhuang.The serogroup changes from A strains to C strains and the risk population of cases shifts to older children.

Objective To explore the effect of prevention and treatment on steroid-induced osteonecrosis of mice femoral head(ONFH) treated with metformin. Methods Thirty-six Kunming mice were randomly divided into three groups (n = 12):A (Control Group), B (Model Group)and C (Prevention Group). For producing ONFH mice models, did the intraperitoneal injection of horse serum (10 mL/kg) to B and C firstly. After two weeks, continuing the intraperitoneal injection of horse serum (5 mL/kg) again with the prednisolone intramuscularly [45 mL/(kg· day), totally for 5 days]. Meanwhile, feeding normal saline 10 mL/(kg·day) to B and feeding metformin hydrochloride [0.2 g/(kg·day)] to C. For A, mice were only given normal saline intramuscularly and intragastrically in equal quantity at the same time. The contents of serum cholesterol (TC), triglycerid (TG), plasma von willebrand factor (VWF) and plasminogen activator inhibitor 1 (PAI-1) were determined at the 2nd, 4th and 6th week after treatment. The micewere sacrificed at 2nd, 4th, and 6th weekafter treatment, and femoral heads were harvested to do histopathology analysis. Results The appearance and shape of the femoral head and the surface of cartilages were normal. The percentage of empty osteocyte lacunae in B was significantly higher than that in C (P < 0.05), there was no significant difference between A and C (P>0.05). TC and TG contents in C were significantly lower than that in B in 2th、4th、6th weeek(P<0.05), and higher than that in A(P<0.05). VWF and PAI-1 level in C were significantly lower than that in B at 2nd and 4th week (P<0.05), but there were no statistical significance at 6th week. there were no statistical significance for the comparison between A and C. Conclusion Metformin can prevent steroid-induced ONFH by improving hyperlipemia, hypercoagulability and hypofibrinolysis, then effectively prevent osteonecrosis.

Objective To detect the expression of bone morphogenetic protein receptor Ⅱ ( BMPR Ⅱ ) in human focal cortical dysplasia ( FCD Ⅱ b). Methods Fourteen specimens of FCD Ⅱ b surgically removed and pathologically verified were collected from June 2008 to June 2010 and the expression of BMPR Ⅱ in the normal brain tissues and the pathological specimens was detected by means of immunohistochemistry and western blot. Results In the normal brain tissues, BMPR Ⅱ was widely expressed in the cortical neurons of the grey matter, with no positive immunostaining in the white matter. In the cortical lesion of FCD Ⅱ b, BMPR Ⅱ was strongly expressed in the misshapen cells including balloon cells (BCs) , dysmorphic neurons (DNs) and giant neurons (GNs). Positive BMPR Ⅱ expression was also observed in the reactive astroeytes and low level expression of BMPR Ⅱ was found in the normal-appearing (NA) neurons. Western-blot analysis showed that BMPR Ⅱ expression tended to be lowered in the FCD Ⅱ b specimens compared with the normal brain tissues ( P < 0. 05 ). Conclusion The expression of BMPR Ⅱ is altered and reduced in the FCD Ⅱ b, suggesting that BMP signal pathway may participate in the pathogenesis of FCD.