Objective:To summarize the clinical data and imaging characteristics of patients with PHACES syndrome treated with oral Propranolol.Methods:The clinical data of 4 cases of PHACES syndrome treated with oral Propranolol in Children′s Hospital, Capital Institute of Pediatrics from October 2018 to October 2022 were retrospectively analyzed.Relevant studies reporting the treatment of PHACES with Propranolol were retrieved in PubMed, China National Knowledge Infrastructure (CNKI) and Wanfang Data.Results:Three cases of the 4 patients with PHACES syndrome treated with Propranolol obtained relieved symptoms of facial hemangioma, and 1 case died due to late treatment, complication of severe cardiovascular malformation, and treatment abandonment by parents.A total of 7 clinical studies on the use of Propranolol in the treatment of PHACES were retrieved, including 6 retrospective studies and 1 observational study.Most studies have shown that Propranolol is well tolerated in the treatment of PHACES syndrome, and most of cases have relieved facial hemangioma.The main factors affecting the prognosis are the degree of damage to middle and small arteries such at brain, aorta, chest and neck.Propranolol treatment can improve the prognosis.Conclusions:Oral Propranolol is currently the first-line treatment for PHACES syndrome, and most patients tolerate oral Propranolol well.

Objective: To analyze the phenomenon of alcohol drinking among school-aged children in Beijing, and to provide a reference for making measures for possible preventive interventions. Methods: Data were from the Beijing Students’ Nutrition and Health Surveillance among 3 776 school-aged children in Beijing in 2015. Prevalence, frequency and pattern of drinking, daily consumption of alcoholic drinks, as well as influencing factors were described. Results: Drinking was found in 11.2% of school-aged children, the drinking differences of students of different genders, grades, areas were of statistical significance(χ2=8.49, 126.91, 18.36, P<0.01), and the average age of the 423 drinking students was (10.5±1.6)years old. 290 children reported alcohol drinking once or twice in the past 1 week, accounting for 68.6% of the drinking children. 93 children reported drinking for three to six times, accounting for 22.0%, 40 students reported drinking for more than 7 times. Blending wine(58.2%) ranked as the most preferred, followed by beer(33.3%).Drinking was more likely reported among school-aged children who were boys, in higher grade, living in suburbs of Beijing, while children whose parents were more likely to drink in the past month, or from family with lower income and lower education level were also more likely to drink(P<0.05). Conclusion Drinking among school-aged children in Beijing in the past 1 is common, but their drinking amount per day was relatively low. Drinking was influenced by age, gender, living place, family and other factors. It is recommended that non-alcoholic intervention should be carried out as soon as possible for them.

Objective:To explore the clinical effect and safety of interventional treatment of autogenous arteriovenous fistula(AVF) stenosis.Methods:From July 2017 to September 2018, 96 patients with arteriovenous fistula stenosis and occlusion admitted to Handan First Hospital, Hebei Province were retrospectively analyzed.All of them were dialysis patients with chronic renal failure.All patients underwent percutaneous balloon angioplasty via the cephalic vein.The success rate of technique, clinical success rate, perioperative complications and follow-up were observed.Results:(1) Technical success rate and clinical success rate: 90 patients were treated with percutaneous transluminal angioplasty (PTA) via the cephalic vein, the other 3 patients were treated with interventional therapy via the brachial artery, and 3 patients underwent reconstruction of internal fistula.The technical success rate was 93.8% (90/96), and the clinical success rate was 89.6% (86/96). (2) Perioperative complications: thrombosis in 4 cases, vasospasm in 3 cases.There were no serious complications such as vascular rupture, aneurysm, vascular dissection, and no perioperative death.(3) The first stage patency rate was 100% (90/90), 74.4% (67/90), 62.2% (56/90) and 46.7% (42/90) in 3, 6, 12 and 18 months after operation.Conclusion:Venipuncture can be used as the first choice for AVF stenosis interventional therapy because of its advantages of small trauma, no serious complications, no need of long-term compression at the puncture point, immediate dialysis, and avoidance of local hematoma and other complications caused by artery puncture.

Objective:To compare the clinical effect and perioperative complications of the treatment of autogenous arteriovenous fistula stenosis by arterial and venous approach.Methods:The clinical data of 120 patients with AVF stenosis and occlusion who were treated with interventional therapy and met the inclusion criteria were collected and analyzed by retrospective case-control study.from September 2017 to August 2018, 60 patients with internal fistula stenosis were treated by transarterial approach (arterial approach group), and from September 2018 to may 2019, 60 patients were treated with a new surgical scheme(venous approach group). The operation success rate, perioperative complications and patency rate of 3, 6, 12 months after operation were compared between the two groups.Results:(1) The technical success rate was 96.7% (58/60) and the clinical success rate was 91.7% (55/60) in the arterial approach group, and 95.0%(57/60) and 93.3%(56/60) in the venous approach group.There was no significant difference in the technical success rate and clinical success rate between the two groups ( P=0.718 and 1.000, respectively) (2) Perioperative complications: in the arterial approach group, 3 patients had hematoma at the puncture point, 2 pseudoaneurysms and 5 thrombosis.There were 3 patients with thrombosis in the venous access group, and the difference in the incidence of complications between the two groups was statistically significant (χ 2=4.227, P=0.036). (3)The primary patency rates at 3, 6 and 12 months after operation were 95.0%(57/60), 75.0%(45/60) and 60.0%(36/60) in the arterial approach group, and 96.7%(58/60), 71.7%(43/60) and 61.7%(37/60) in the venous access group, respectively.There was no statistically significant difference between the two groups ( P=0.718, 0.749, 0.885). Conclusion:The interventional treatment for autogenous arteriovenous fistula stenosis through artery and vein approach can achieve good effect.There were many complications during the perioperative period, It is suggested that venous approach is preferred.

Objective:To discuss the effects of transjugular intrahepatic portosystemic shunt (TIPS) procedure on hemodynamics in cirrhotic patients.Methods:A total of 23 cirrhotic patients for TIPS insertion were enrolled from January 2018 to October 2018. Serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), transthoracic echocardiography and non-invasive cardiac output measurement based on impedance cardiogram were carried out before and 24h, 1 month, 6 months after TIPS in order to observe cardiac function and hemodynamic changes after TIPS.Results:Significant increases in right atrial area [(17.2±4.0) cm 2 vs. (15.0±3.4) cm 2, P<0.05], right ventricular area [(15.1±3.8) cm 2 vs. (13.7±3.5) cm 2, P<0.05] and left ventricular volume [(97.4±21.5) ml vs. (91.1±22.7) ml, P<0.05] were observed 24 h after TIPS. These changes were accompanied with significant reduction in collapsible index of inferior vena cava [(20.7± 8.1)% vs. (28.6±11.3)%, P<0.01] and elevation in pulmonary arterial systolic pressure [(36.0±8.4) mmHg (1 mmHg=0.133 kPa) vs. (31.8±5.4) mmHg, P<0.01]. There also existed significantly elevated serum NT-proBNP [(551.2±325.1) ng/L vs. (124.2±94.4) ng/L, P<0.01], cardiac output [(5.82±0.96) L/min vs. (5.12±1.28) L/min, P<0.01], cardiac index [(3.47±0.64) L·min -1·m -2 vs. (3.05±0.78) L·min -1·m -2, P<0.01], early diastolic filling rate [(59.0±14.3)% vs. (54.5±11.0)%, P<0.05], and reduced systemic vascular resistance index (SVRi) [(1 798.4±357.3) dyne·s·cm -5·m -2 vs. (2 195.7±508.7) dyne·s·cm -5·m -2, P<0.01] 24 h after TIPS. At the end of 6-month follow-up, all these parameters, but not SVRi, returned towards baseline values. Moreover, peak early to late diastolic tissue velocity ratio at the level of lateral mitral annulus (E′/A′) was significantly higher at the end of 6-month follow-up than that at baseline (1.06±0.32 vs. 0.90±0.45, P<0.05). Neither the right ventricular fractional area changes nor the left ventricular ejection fractions during the follow-up period were different from those at baseline ( P>0.05). Conclusion:Cirrhotic patients who had no cardiovascular pathologies had adequate adaptation and good compensation ability to reach a new hemodynamic homeostasis for the increased volume load after TIPS insertion.

Objective To investigate the willingness of hearing screening of non-hearing disease patients and analysis the hearing test result,in order to make people pay more attention to auditory healthy.Methods Patients clinical data including the willingness of hearing screening,gender,age,residence,hearing disease of someone important,long-term medicine usage,noise exposure were collected.Pure tone audiometry testing wereconducted for those who were willing to hearing screening;and a questionaire were conducted to those not.Results Among the 280 interviewers,only 72 patients were willing to hearing screening;frequent reason for refusing hearing screening were no self reported hearing loss and coming to doctor for non-hearing disease;60 years old or elders and have someone important were hearing diseases patients were more willing to hearing screening (P＜0.05);40.00％ longterm medicine usage patients weresuffering hearing loss(P＜0.05);self reported hearing loss was not the same as the test result (P＜0.05).Conclusion Hearing loss is common in patient who came to doctor for non-hearing diseases.More attention should be paid to those patients who are old,long-term medicine usage,people have no self reported hearing loss should pay attention to hearing loss.

Objective To apply the ultrasound microbubble to mediate basic fibroblast growth factor(bFGF) for conducting the injuried facial nerve(rat model) repair and to investigate its feasibility and efficiency.Methods After establishing the models of facial nerve injury,40 SD rats were divided into 4 groups,10 cases in each group:group A,bFGF +ultrasound+microbubble(bFGF + MB/US),group B,bFGF and microbuble(bFGF+ MB),group C,bFGF and ultrasound(bFGF + US) and group D,simple operation(PBS).The general status of rats on 1,10,20,28 d after bFGF gene transfection was observed.The nerve conduction velocity (NCV),incubation period and amplitude of facial nerve action potential were measured.After taking the facial nerve tissue in injuried site,mRNA expression was detected by RT-PCR.Western blot was used to detect the bFGF protein expression.Results On 20 d after transfection,small swing of a small quantity of beard in the operation site of the group A could be observed;on 28 d after transfection,the general slatws of recavely in rats in the group A was better than that in the group B,C and D.The nerve electrophysiology manifestations after facial nerve repair in the group A were superior to the group B,C and D;the amount of bFGF mRNA and protein pxpression in the group A was significantly higher than that in the group B,C and D.Conclusion Ultrasound microbubble mediated bFGF is conducive to the repair of facial nerve injury.

BACKGROUND/AIMS: Hyponatremia is a well-known risk factor for poor outcomes in Western studies of heart failure (HF) patients. We evaluated the predictive value of hyponatremia in hospitalized Asian HF patients. METHODS: The Clinical Characteristics and Outcomes in the Relation with Serum Sodium Level in Asian Patients Hospitalized for Heart Failure (the COAST) study enrolled hospitalized patients with systolic HF (ejection fraction < 45%) at eight centers in South Korea, Taiwan, and China. The relationship between admission sodium level and clinical outcomes was analyzed in 1,470 patients. RESULTS: The mean admission sodium level was 138 +/- 4.7 mmol/L, and 247 patients (16.8%) had hyponatremia defined as Na+ < 135 mmol/L. The 12-month mortality was higher in hyponatremic patients (27.9% vs. 14.6%, p < 0.001), and hyponatremia was an independent predictor of 12-month mortality (hazard ratio, 1.72; 95% confidence interval, 1.12 to 2.65). During hospital admission, 57% of hyponatremic patients showed improvement without improvement in their clinical outcomes (p = 0.620). The proportion of patients with optimal medical treatment was only 26.5% and 44.2% at admission and discharge, respectively, defined as the combined use of angiotensin-converting-enzyme inhibitor/angiotensin receptor blocker and beta-blocker. Underuse of optimal medical treatment was more pronounced in hyponatremic patients. CONCLUSIONS: In hospitalized Asian HF patients, hyponatremia at admission is common and is an independent predictor of poor clinical outcome. Furthermore, hyponatremic patients receive less optimal medical treatment than their counterparts.
Aged ; Aged, 80 and over ; Asia/epidemiology ; *Asian Continental Ancestry Group ; Biomarkers/blood ; Cardiovascular Agents/therapeutic use ; Disease-Free Survival ; Female ; Guideline Adherence ; Healthcare Disparities ; Heart Failure/*diagnosis/drug therapy/ethnology/mortality/physiopathology ; *Hospitalization ; Humans ; Hyponatremia/blood/*diagnosis/drug therapy/ethnology/mortality ; Male ; Middle Aged ; Practice Guidelines as Topic ; Predictive Value of Tests ; Proportional Hazards Models ; Risk Factors ; Sodium/*blood ; Stroke Volume ; Time Factors ; Treatment Outcome

BACKGROUNDDual sensor (DS) for rate adaption was supposed to be more physiological. To evaluate its superiority, the DS (accelerometer [ACC] and minute ventilation [MV]) and normal sinus rate response were compared in a self-controlled way during exercise treadmill testing.

METHODSThis self-controlled study was performed in atrioventricular block patients with normal sinus function who met the indications of pacemaker implant. Twenty-one patients came to the 1-month follow-up visit. Patients performed a treadmill test 1-month post implant while programmed in DDDR and sensor passive mode. For these patients, sensor response factors were left at default settings (ACC = 8, MV = 3) and sensor indicated rates (SIRs) for DS, ACC and MV sensor were retrieved from the pacemaker memories, along with measured sinus node (SN) rates from the beginning to 1-minute after the end of the treadmill test, and compared among study groups. Repeated measures analysis of variance and profile analysis, as well as variance analysis of randomized block designs, were used for statistical analysis.

RESULTSFifteen patients (15/21) were determined to be chronotropically competent. The mean differences between DS SIRs and intrinsic sinus rates during treadmill testing were smaller than those for ACC and MV sensor (mean difference between SIR and SN rate: ACC vs. SN, MV vs. SN, DS vs. SN, respectively, 34.84, 17.60, 16.15 beats/min), though no sensors could mimic sinus rates under the default settings for sensor response factor (ACC vs. SN P-adjusted < 0.001; MV vs. SN P-adjusted = 0.002; DS vs. SN P-adjusted = 0.005). However, both in the range of 1 st minute and first 3 minutes of exercise, only the DS SIR profile did not differ from sinus rates (P-adjusted = 0.09, 0.90, respectively).

CONCLUSIONSThe DS under default settings provides more physiological rate response during physical activity than the corresponding single sensors (ACC or MV sensor). Further study is needed to determine if individual optimization would further improve adaptive performance of the DS.

Adult ; Aged ; Cardiac Pacing, Artificial ; methods ; Exercise ; physiology ; Exercise Test ; Female ; Humans ; Male ; Middle Aged ; Pacemaker, Artificial

Objective To estimate the radiation dose and cancer risk of thyroid for children who underwent head CT or chest CT scans.Methods The parameters used in the CT scans were accessed from the DICOM files through PACS used DCMTK software, then the thyroid radiation dose was estimated with the CT-Expo(C) software and the cancer risk induced by CT scan was projected based on BEIR Ⅱ model combined with the Chinese cancer incidence and lifetime table in 2008.Results CT parameters used for different ages were roughly the same, the thyroid equivalent dose for head CT ranged from 1.2-2.0 mGy, the highest thyroid cancer risk occurs for newborn girls, about 9.6/100 thousand population;while for chest CT the thyroid equivalent dose ranged from 8.1 to 38.0 mGy, the highest thyroid cancer risk was also for newborn girls, about 244.7/100 thousand population.The radiation dose and cancer risk for thyroid decreased with the increased age.Conclusions The radiation dose for thyroid from chest CT was relatively higher than head CT, especially for newborn babies;therefore more protection should be given to the thyroid and other radio-sensitive organs during CT scanning.