Objective To investigate the efficacy of Amplatzer duct occluder-Ⅱ device(ADO-Ⅱ)in treating ventricular septal detect(VSD)with aortic sinus prolapse(ASP)in child patients.Methods The clinical data of 94 child patients with VSD complicated by ASP,who were admitted to the Hunan Provincial Children's Hospital of China between January 2018 and September 2022,were retrospectively collected.The child patients included 60 males and 34 females with a mean age of(4.7±3.1)years.Mild-moderate ASP was seen in 83 child patients,with a mean(4.12±0.97)mm-sized VSD.Severe ASP was seen in 11 child patients,with a mean(4.95±0.51)mm-sized VSD.Perimembrane VSD was observed in 54 child patients and intracristal VSD in 40 child patients.The relationship of VSD size and degree of ASP to the selection of ADO-Ⅱ,postoperative middle period aortic valve regurgitation and residual leakage was analyzed,so as to clarify the applicability of ADO-Ⅱ to such child patients.Results In the postoperative middle period,6 child patients had mild aortic valve regurgitation,most seen in the child patients who received 4-4 mm or 5-4 mm ADO-occluder;and 10 child patients had residual leakage,mainly seen in the child patients who received 5-4 mm or 6-4 mm occluder.Conclusion In the condition when the ADO-Ⅱ occluder shows satisfactory placement pattern,this treatment is suitable for the child patient having＜6 mm VSD with ASP.Although there are some residual leakage and aortic valve regurgitation after surgery,this interventional therapy still meets the clinical requirements.(J Intervent Radiol,2024,32:17-21)

ObjectiveTo provide a new idea for exploring the molecular genetic approach to the pathogenesis of schizophrenia via construction of microRNA-messenger RNA （miRNA-mRNA） regulatory network in schizophrenia. MethodsThe microarray datasets of GSE54578 miRNA expression profiles in peripheral blood and GSE145554 mRNA expression in the anterior cingulate in postmortem brain of schizophrenic subjects were downloaded from Gene Expression Omnibus （GEO） database since July 2021. The GEO2R was used to identify the differentially expressed miRNAs and mRNAs， screen the miRNA with target differentially expressed mRNA， and predict their potential upstream transcription factors. The overlapping genes from the mRNA targeted by the differentially expressed miRNA and the mRNA differentially expressed in GSE145554 dataset were collected. Then the biological features of hub genes were analyzed via Gene Ontology （GO） analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis， and the protein-protein interaction （PPI） network and miRNA-mRNA regulatory network of hub genes were constructed. ResultsA total of 8 up-regulated differentially expressed miRNAs with targeted mRNA were screened out in GSE54578 datasets regarding schizophrenia， which involved in the regulation of 10 transcription factors， 247 down-regulated differentially expressed mRNAs were screened out in GSE145554 datasets， and 17 overlapping mRNAs were obtained. GO analysis showed that the target mRNAs were mainly involved in astrocyte differentiation and development. KEGG pathway enrichment analysis showed that the target mRNAs were mainly involved in Rap1 and Ras signaling pathways. PPI network analysis showed that the mRNAs （KRAS and CD28） might be key genes in schizophrenia. ConclusionThe integrated bioinformatics analysis based on GEO database can identify potential susceptibility genes in schizophrenia， and it also contributes to the construction of miRNA-mRNA regulatory network in schizophrenia.

ObjectiveTo explore the influencing factors of health seeking behavior of delivery women in Guangdong province.MethodsStratified random sampling method was used,and 1491 delivery women from primary,secondary and tertiary hospitals were investigated with self-made maternal health seeking behavior questionnaire.Logistic regression analysis was used to analyze the impact of environmental factors and population characteristics on health seeking behavior.ResultsDelivery women with qualified health seeking behavior account for 83.4%.Present pregnancy was planned (OR=2.114),prenatal examination was needed when self-feeling good (OR=2.323),social medical insurance system was socialized medicine (OR=2.755) or medical insurance (OR=1.697),hospital level of secondary hospital (OR=1.568) or tertiary hospital (OR=1.800) were independent positive influencing factors of health seeking behavior.ConclusionThe qualified rate of health seeking behavior of delivery women in Guangdong province is low.Delivery women with the following characteristics of low educational level,low family income,uninsured,coming from rural area and delivery in primary hospital need to be guided scientifically at seeking for health.

Objective To explore the clinical application of GlideScope video laryngoscope combined with fiberoptic bronchoscope for double-lumen endobronchial tube intubation in patients with difficult glottis exposure.Methods Forty patients undergoing scheduled for thoracic surgery (24 males,1 6 females,aged 24-78 years,falling into ASA Ⅰ or Ⅱ,Mallampati classification Ⅲ or Ⅳ, were randomly divided into two groups (n=20 each):GlideScope video laryngoscope combined with fiberoptic bronchoscope group (group GF)and Macintosh laryngoscope group (group M).In group GF,GlideScope video laryngoscopy combined with fiberoptic bronchoscope was used to guide the double-lumen tube bronchial intubation and then bronchoscope was used to check the placement of the tube.In group M,the double-lumen endobronchial tube was intubated with conventional macintosh laryngoscope,and then the placement of the tube was checked by bronchoscope.The results of the Cormack and Lehane grade measuring the degree of glottic opening during laryngoscopy,the intuba-tion time consumed,one-time intubation success rate,patients manoeuvre needed to aid tracheal intu-bation and endotracheal intubation related complications within 48 hours after operation were recorded and compared between the two groups.Results Compared with group M,the Cormack and Lehane grade was significantly better (P < 0.01 ), intubation time consumed was significantly shorter [(104.3±1 1.1)s vs.(138.6 ± 33.0)s](P < 0.01 ),one-time intubation success rate was higher (90% vs.55%)(P <0.05 ),fewer patients needed manoeuvre to aid tracheal intubation (20% vs. 90%)(P < 0.01 )and postoperative complications of hoarseness and pharyngalgia within 48 hours were significantly fewer (5% vs.35%,25% vs.75%)in group GF(P <0.05 ).Conclusion Com-pared with conventional method, GlideScope video laryngoscope combined with fiberoptic bronchoscope used to guide double-lumen endobronchial tube intubation in patients with difficult glottis exposure may improve the success rate of intubation,reduce the stress response of intubation and postoperative complications of hoarseness and pharyngalgia.

Objective To compare the efficacy and safety of the non-invasive high frequency ventilation (NHFV) and non-invasive intermittent positive pressure ventilation (NIPPV)in neonates with respiratory distress syndrome (RDS) after extubation.Method Neonates with RDS from January 2015 to January 2016,who required high frequency ventilation after birth and were extubated after treatment were retrospectively studied.The enrolled patients were divided into NHFV group and NIPPV group to compare the rate of successful extubation within 7 days,non-invasive respiratory ventilation support time and complication incidence.Result In total 42 neonates were included,NHFV group were 21 cases and NIPPV group were 21 cases.The rates of successful extubation were not statistically different (71.4％ vs.80.9％,P ＞ 0.05);Compared with NIPPV group,NHFV group had shorter ventilation time [3.5 (2.2,4.1) d vs.4.6 (2.8,5.3)];the incidence of bronchopulmonary dysplasia,pneumothorax,intraventricular hemorrhage,periventricular leukomalacia,retinopathy of premature and necrotizing enterocolitis between groups were not statistically different (P ＞ 0.05).Conclusion NHFV is a new safe and efficient ventilation support method for extubated neonates,and needs further research.

Objectives To assess treatment outcomes and prognosis in infants with atrial flutter (AFL).Methods Thirty-four (34) cases of infants with AFL in Hunan Children's Hospital had been analyzed for clinical features, treatment outcomes and follow-up between March, 2009 and September, 2015. Based on ECG characteristics, the patients had been divided into simple and complex AFL groups. Based on age, they had been divided into neonates and non-neonates group. The aim of this study is to compare the clinical effects of drug treatment in different types of AFL.Resultsb With digitalis alone, the cardioversion rate was 37.5%,no signiflcant difference was observed between simple and complex AFL groups (45.8% vs 12.5%,P=0.206). Combining with other drugs, the cardioversion rate was 54.5%, which showed signiflcant difference between simple and complex AFL groups (76.9% vs 22.2%,P=0.036). The overall cardioversion rate was 70.6%, which showed signiflcant difference between simple and complex AFL groups(87.5% vs 30%,P=0.003). There was no signiflcant difference in pharmaceutical cardioversion rate between neonates and non-neonates group (85.7% vs 60.0%,P=0.216). Two cases with symptoms of heart failure used synchronized cardioversion. One patient restored to sinus rhythm, and another case was still recurrent of AFL after repeated electrical cardioversion, and eventually died of cardiogenic shock. After treatment, 9 patients were still with paroxysmal AFL and atrial tachycardia episodes, including 3 cases of simple type and 6 cases of complex type who were discharged with oral digoxin and propafenone treatment at home. 24 patients were followed up (3 months to 3 years and 4 months). 16 cases restored to sinus rhythm during hospitalization had no recurrence of AFL.Conclusions The overall treatment effects of AFL in infants were good. In simple type of AFL, most of patients did not need long-term antiarrhythmic drug therapy and the prognosis was good. The prognosis of treatment with conventional drug was poor in complex AFL group, with a higher rate of recurrence of AFL.

Objective To establish the evaluation index system on maternal health seeking behavior with Delphi method.Methods Based on Andersen health service utilization models,literature analysis was used to establish evaluation index system on maternal health seeking behavior,then Delphi method was carried out to revise index system through two rounds questionnaire consulting from 24 experts.Results The confirmed index system of maternal health seeking behavior included 4 first-level index,12 second-level index and 57 third-level index.The average authority degree of experts were 0.869,and the coordination coefficients of expert in the total index were 0.195 and 0.166(P＜0.01).The weight coefficients of the indicators at first level were 0.1529,0.3403,0.2786 and 0.2281,respectively.Condusion The representativeness,authority degree and coordination of expert are good,and the tentatively established evaluation index system on maternal health seeking behavior is scientific and reasonable.

Objective To explore the prophylactic effect of methylprednisolone combined with granisetron on postoperative nausea and vomiting.Methods Two hundred patients scheduled for lumpectomy of breast were randomly divided into four groups with 50 cases each.The patients in group M1 received a pre-anesthesia intravenous doses of methylprednisolone 25 mg,the patients in group M2 were injected methylpredsisolone 25 mg repeatedly four hours later,in group D received a pre-anesthesia doses of dexamethasone 5 mg,in group N normal saline 2 ml.All the four groups of patients received granisetron 3 mg intravenously at the end of surgery.The incidence of nausea and vomiting in the 24 hours were observed.Results The PONV incidences of group M1,M2,D,N were 36%,18%,38% and 58%.Both group M1,M2 and D significantly decreased the total inci-dence of PONV (P <0.05)in the 24 h.The incidence of PONV was significantly lower in group M2, compared with group M1 and group D respectively (P <0.05).Conclusion Methylprednisolone-gran-isetron combination is as equally effective as dexamethasone-granisetron combination for preventing PONV in lumpectomy,but repeated methylprednisolone after 4 h is more effective than dexametha-sone and single-used methylprednisolone.

Objective To build the method of computerized case classification,for the purpose of perfecting the diseases typing and classification,and supporting the management based on the quality and expenses of the disease.Methods 875 cases were defined into two types.Eight parameters were selected for non-surgery cases,namely the disease diagnosis,severity at admission,and age.For surgery cases,five parameters were defined,namely the disease diagnosis,operative quantity,and severity at admission.Then Fisher function was called into play to obtain the function descriminant equation,realizing computerized classification.Results The rate of matching was 86.2％ between computerized classification and manual classification.The high accuracy of function descriminant equation proves the satisfactory outcomes of the classification.Collusion The computerized classification is satisfactory in its outcomes,and therefore it can better quality of care and cost management of diseases in clinical practice.