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Objective@#To analyze the etiology and clinical characteristics of hypertension in children; to analyze the risk factors for primary hypertension with target organ damage, and to provide evidence for clinical diagnosis of hypertension in children.@*Methods@#Two hundred and thirty-two hospitalized children with hypertension at Children′s Hospital Institute of Pediatrics from April 2013 to December 2017 were retrospectively analyzed, including general situation, clinical manifestation, laboratory examination, auxiliary examination and damage assessment of target organs.@*Results@#(1)There were totally 232 eligible cases, consisting of 184 males(79.3%) and 48 females(20.7%). Among these children: 38 cases(16.4%), 126 cases(54.3%), and 68 cases(29.3%) were diagnosed as prehypertension, hypertension in stage Ⅰ, and hypertension in stage Ⅱ, respectively.(2)The etiological composition of hypertension: there were 181 cases(78%) diagnosed as primary hypertension and 51 cases(22%) diagnosed as secondary hypertension, respectively; the proportion of the primary hypertension children during the period of preschool, school-age, and adolescent was 1.6%(3 cases), 21.0%(38 cases) and 77.4%(140 cases), respectively.The etiology of secondary hypertension was mostly of the renal parenchymal hypertension and renal vascular hypertension(43.1%). (3) The clinical manifestations of primary hypertension were mostly of asymptomatic or mild symptoms, totally 148 cases(64%), and then dizziness, headache, chest pain, chest tightness, palpitation, blurred vision, and other clinical symptoms.(4) The high risk factors for primary hypertension with target-organ damage included cesarean section, glucose metabolism disturbance and body mass index >24 kg/m2.@*Conclusions@#In recent years, the proportion of primary hypertension among hospitalized children has increased.The changes in the etiology of secondary hypertension are not found.Primary hypertension children are often accompanied with target organ damage.It is of great significance to make blood pressure monitoring as a routine physical examination for primary and middle school students, so as to detect hypertension in children earlier, and make active intervention and improve the prognosis of hypertension in children.
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Objective To analyze the etiology and clinical characteristics of hypertension in children;to ana-lyze the risk factors for primary hypertension with target organ damage,and to provide evidence for clinical diagnosis of hypertension in children. Methods Two hundred and thirty-two hospitalized children with hypertension at Children＇s Hospital Institute of Pediatrics from April 2013 to December 2017 were retrospectively analyzed,including general situa-tion,clinical manifestation,laboratory examination,auxiliary examination and damage assessment of target organs. Results (1)There were totally 232 eligible cases,consisting of 184 males(79. 3%)and 48 females(20. 7%). Among these children:38 cases(16. 4%),126 cases(54. 3%),and 68 cases(29. 3%)were diagnosed as prehypertension,hy-pertension in stageⅠ,and hypertension in stageⅡ,respectively.(2)The etiological composition of hypertension:there were 181 cases(78%)diagnosed as primary hypertension and 51 cases(22%)diagnosed as secondary hypertension, respectively;the proportion of the primary hypertension children during the period of preschool,school-age,and ado-lescent was 1. 6%(3 cases),21. 0%(38 cases)and 77. 4%(140 cases),respectively. The etiology of secondary hy-pertension was mostly of the renal parenchymal hypertension and renal vascular hypertension(43. 1%).(3)The clinical manifestations of primary hypertension were mostly of asymptomatic or mild symptoms,totally 148 cases(64%),and then dizziness,headache,chest pain,chest tightness,palpitation,blurred vision,and other clinical symptoms.(4)The high risk factors for primary hypertension with target-organ damage included cesarean section,glucose metabolism dis-turbance and body mass index >24 kg/m2 . Conclusions In recent years,the proportion of primary hypertension among hospitalized children has increased. The changes in the etiology of secondary hypertension are not found. Primary hypertension children are often accompanied with target organ damage. It is of great significance to make blood pressure monitoring as a routine physical examination for primary and middle school students,so as to detect hypertension in children earlier,and make active intervention and improve the prognosis of hypertension in children.
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Objective@#The study assessed the clinical characteristics and response to acute intravenous antiarrhythmic drug therapy of supraventricular tachycardia (SVT) in children.@*Methods@#This was a multicenter prospective descriptive study including 257 children from First Hospital of Tsinghua University, Peking University First Hospital, Children's Hospital Affiliated to Capital Institute of Pediatrics and Beijing Anzhen Hospital who received intravenous antiarrhythmic drug therapy for SVT from July 2014 to February 2017. The clinical and tachycardia features, response to intravenous antiarrhythmic drug therapy of these children were characterized. Statistical analyses were performed using t test, Mann-Whitney U test, χ2 test and H test.@*Results@#The onset of SVT occurred at any age with a distribution with positive skewness, 57.6% (n=148) children<1 year, 17.5% (n=45) children1~<3 years, 10.5% (n=27) children 3~<6 years and 14.4% (n=37) children ≥ 6 years of age. The percentages of SVT types were 49.4% (n=127) for atrioventricular reentry tachycardia (AVRT), 4.3% (n=11) for atrioventricular nodal reentry tachycardia (AVNRT), 26.8% (n=69) for unclassified paroxysmal SVT and 19.5% (n=50) for atrial tachycardia (AT), respectively. Tachycardia-induced cardionyopathy (TIC) secondary to SVT developed in 30 of 225 (13.3%). Left ventricular ejection fraction (LVEF) of the 27 children attacked by TIC returned to normal after successful control of SVT (41.1%±6.3% vs. 60.3%±9.2%, t=-10.397, P=0.000). Complete termination of SVT by antiarrhythmic drugs was achieved in 164 of 257 (63.8%), partial termination rate was 18.7% (48 of 257) and failure to terminate rate was 17.5% (45 of 257). Propafenone (complete cardioversion in 98 (73.1%) of 134) and amiodarone (complete cardioversion in 23 (76.7%) of 30) showed better efficacy for SVT termination than adenosine (complete cardioversion in 26 (44.1%) 59) (χ2=20.524, P=0.000). Paroxysmal SVT had a higher termination rate on pharmacological therapy than AT (67.1% vs. 50.0%, χ2=6.337, P=0.042). Patients of different age groups had significantly different response to antiarrhythmic therapy (χ2=13.904, P=0.031). Children<1 year of age showed the least response to antiarrhythmic drug therapy with complete termination in 51 (55.4%) of 92. Adverse effects occurred in 9 patients (3.5%): Four patients had severe hypotensive shock using propafenone (n=3) and adenosine (n=1), and 3 patients had sinus arrest using adenosine.@*Conclusion@#Most (57.6%) children with SVT have their first clinical episode within 1 year of age, and AVRT is the most common type. TIC occurs in 13.3% of children with SVT. Intravenous antiarrhythmic drug therapy has a 63.8% complete termination rate for children with SVT and incidence of adverse effects is 3.5%. Propafenone and amiodarone are more effective for SVT termination in children than adenosine. Serious adverse effects may occur when using propafenone.
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Objective@#This study aimed to investigate the correlation between supraventricular tachycardia (SVT) and tachycardia-induced cardiomyopathy(TIC) in children and assess the risk factors for the development of TIC.@*Method@#One hundred and eighty-three patients were recruited in four hospitals of Beijing diagnosed as SVT were divided into two groups depending on whether or not complicated with TIC. The age, gender, tachycardia type, ventricular rate during tachycardia, frequency of tachycardia episodes and duration of tachycardia were compared between the two groups and risk factors associated with TIC were analyzed. Statistical analyses were performed using t test, Mann-Whitney U and χ2 test.@*Result@#Totally 183 patients were included in this study (paroxysmal supraventricular tachycardia, PSVT, n=149; atrial tachycardia, AT, n=34). The incidence of TIC was 13.1%. There was significant difference regarding the incidence of TIC between children with AT and children with PSVT (26.5% vs. 10.1%, χ2=6.537, P=0.011). The percentage of AT in patients with TIC was significantly higher than patients without TIC (37.5% vs. 15.7%, χ2=6.537, P=0.011). Patients with TIC had a higher frequency of tachycardia episodes(2.5(1.0-4.8) beats/year vs 4.0(1.0-10.0) beats/year, Z=-2.223, P=0.026)and longer duration of tachycardia(11.0(1.1-36.0) h vs 2.5(1.0-12.0) h, Z=-2.154, P=0.031)compared with patients without TIC. Multivariate predictors of TIC was longer duration of tachycardia (OR=2.041, P=0.028).@*Conclusion@#TIC occurs in 13.1% of children with SVT. The incidence of TIC in children with AT is higher than in children with PSVT. Risk factor for the development of TIC is longer duration of tachycardia.
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The purpose of this study was to investigate the three-dimensional displacement of the cantilever fixed partial denture (CFPD) under an oblique loading. One Beagle dog was used in this experiment. The CFPD, which used the second premolar and the first molar as abutments and the second molar as pontic, was made in vitro fresh mandible of the Beagle dog, and the digital laser speckle (DLS) technique was employed to measure the three-dimensional displacement of the CFPD under the oblique loading for the first time. We found that when an oblique loading was exerted on the pontic, the displacement of CFPD was the greatest, and the displacement of the abutment near the pontic was smaller than that of the pontic but greater than that of the abutment far from the pontic. We also found that when an oblique loading was exerted on the abutment, the displacement of the directly loaded abutment was greater than that of the other abutment and the pontic. Under the oblique loading, the displacement increased with increasing of load. The experiment demonstrated that it would be advisable for the clinicians to avoid oblique loading, especially the oblique loading of the pontic when using the CPDF. The DLS technique may be one kind of methods for measuring the three-dimensional displacements of the small and irregular objects.
Subject(s)
Animals , Dogs , Male , Bite Force , Dental Abutments , Dental Stress Analysis , Methods , Denture Design , Denture, Partial, Fixed , Imaging, Three-Dimensional , Lasers , Mandible , Occlusal Adjustment , Tooth MobilityABSTRACT
The purpose of this study was to research the three-dimensional displacements of implant-supported cantilever fixed partial denture (CFPD) under oblique loading. One Beagle dog was used in this experiment. Two immediate implants of ITI were inserted in the mandible of the dog, and the implant-supported CFPD which used the implants as abutments was made in vitro fresh mandible. Then the digital laser speckle technique was employed to measure the three-dimensional displacements of CFPD under different oblique loading. We found that when an oblique loading was exerted on the pontic, the displacement increased with increasing of load. Under equal loading, the displacement of the abutment near to the pontic was smaller than that of the pontic but greater than that of the abut-ment far from the pontic. When oblique loading was exerted on the abutment, the displacement of the direct loaded abutment was greater than that of the other abutment and the pontic. Under the.eeual loading, the displacement of implant-supported CFPD of loading on pontic was greater than that of loading on abutments. The experiments demonstrated that implant-supported cantilever fixed partial denture (CFPD) is an effective and advisable therapy for totally? or partially edentulous patients. However, it is also suggested that the clinicians should avoid exerting oblique loading, especially the obliqe loading of the pontic when th e CPDF is used.
Subject(s)
Animals , Dogs , Male , Bite Force , Dental Implant-Abutment Design , Dental Stress Analysis , Methods , Denture Design , Denture, Partial, Fixed , Imaging, Three-Dimensional , Tooth MobilityABSTRACT
The purpose of this study was to investigate the effect of four kinds of different contact strength on the three-dimensional displacement of an implant-supported fixed bridge using digital laser speckle photography method. An in vitro model of beagle mandible with an implant-supported fixed bridge in its right premolar region was developed. The bridge was Au-Pt metal-ceramic. The contact was recovered to four different tightnesses, named 0, 1, 2, and 3. Different axial concentrated static load was applied to abutments and bridge respectively. The three-dimensional displacement of the implant-supported fixed bridge was measured using digital laser speckle photographic method. The results demonstrated that the influence of contact tightness was mainly on the mesio-distal and buccal lingual parts. When the contact tightness reached number 3, the regularity of displacement distribution was changed. The present study proved that digital laser speckle photography was an effective method of measuring the micro-displacement. One of the criterions of contact recovering decreased the implant displacement effectively without changing the regularity of displacement distribution.