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OBJECTIVES@#Congenital birth defects are the main source of disease burden among children under 5 years old in China. This study aims to compare the trends in disease burden of different congenital birth defects among Chinese children under 5 years old from 1990 to 2019, and to provide a scientific basis for strengthening the comprehensive prevention and control of birth defects.@*METHODS@#Based on data from the Global Burden Disease (GBD) in 2019, the incidence mortality rate, and disability-adjusted life years (DALYs) rate of congenital birth defects among Chinese children under 5 years old from 1990 to 2019 were selected as evaluation indicators. The Joinpoint regression model was used to analyze the trends in disease burden of different types with congenital birth defects over three decades. The study also compared the differences in disease burden of congenital birth defects among children under 5 years old by gender.@*RESULTS@#Compared to 1990, the DALYs rates of congenital heart anomalies (1 931.91/100 000), digestive congenital anomalies (364.63/100 000), neural tube defects (277.20/100 000), congenital musculoskeletal and limb anomalies (133.33/100 000), and Down syndrome (128.22/100 000) in children under 5 years old in China in 2019 were decreased 70.78%, 71.61%, 86.21%, 36.84% and 73.65%, respectively. From 1990 to 2019, the mortality rates and DALYs rates of different congenital birth defects showed an overall downward trend, but the incidence of digestive congenital anomalies and Down syndrome showed an upward trend after 2005 and 2001, respectively. Except for congenital musculoskeletal and limb anomalies, incidence of the remaining categories of birth defects were higher in boys than that in girls.@*CONCLUSIONS@#The disease burden of congenital birth defects in children under 5 years old in China is decreased substantially from 1990 to 2019, but the burden of congenital heart anomalies is still serious and the incidence of some birth defect diseases is on the rise, and it is still crucial to strengthen the prevention and treatment for birth defects in children and propose targeted measures according to their gender characteristics.
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Child, Preschool , Female , Humans , Male , China/epidemiology , Cost of Illness , Down Syndrome/epidemiology , East Asian People , Congenital Abnormalities/epidemiologyABSTRACT
Guaranteeing the rights and safety of subjects is an important responsibility of all participants in the medical devices clinical trial, including medical institutions, sponsors and researchers. The legal disputes caused by serious adverse events in the clinical trial of medical devices are characterized by complex legal relationships, great difficulty in handling, and many points of dispute. Based on a typical case of medical device clinical trials, this paper discussed the litigation subject qualification, the treatment of contract breach and tort in medical device clinical trial, analyzed the responsibility of different subjects, and provided constructive suggestions on the risk management of medical device clinical trial.
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Background and Objectives@#Apoptosis is an outstanding determinant of glucocorticoid (GC)-induced osteonecrosis of the femoral head (ONFH). Human umbilical cord mesenchymal stem cells (hUC-MSCs) have been demonstrated to be associated with apoptosis in diseases models. However, the role of hUC-MSCs in GC-induced ONFH via regulating apoptosis still needs further study. @*Methods@#and Results: In the present study, a GC-induced ONFH model was built in vivo through a consecutive injection with lipopolysaccharide (LPS) and methylprednisolone. The necrosis and apoptosis of the femoral head was evaluated by histological and Terminal-deoxynucleoitidyl Transferase Mediated Nick End Labeling (TUNEL) assay. The level of collagen and TRAP positive cells were determined by Masson and TRAP staining, respectively. M1 macrophage polarization was assessed using immunofluorescence assay. The level of proinflammatory cytokines including tumor necrosis factor (TNF)‐α, Interleukin (IL)‐1β and IL-6 of femoral head was determined by enzyme-linked immunosorbent assay (ELISA) kits. The protein expression of AKT, mTOR, p-AKT and p-mTOR was detected using western blot assay. The results showed that hUC-MSCs treatment prominently promoted the GC-induced the decrease of the collagen level and the increase of TRAP positive cells. Besides, hUC-MSCs treatment decreased necrosis and apoptosis, macrophage polarization, the level of TNF‐α, IL‐1β and IL-6, the protein expression of p-AKT and p-mTOR, and the radio of p-AKT to AKT and p-mTOR to mTOR of femoral head in vivo. @*Conclusions@#Therefore, the present study revealed that hUC-MSCs improved the necrosis and osteocyte apoptosis in GC-induced ONFH model through reducing the macrophage polarization, which was associated with the inhibition of AKT/mTOR signaling pathway.
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ObjectiveTo analyze the epidemiological and clinical characteristics of children's lower extremity amputation and amputation rehabilitation, and to explain the causes of children's amputation and the complications after amputation. MethodsFrom January, 2016 to March, 2021, 51 amputation related children were retrospectively analyzed. The correlation between the cause of amputation and complications post amputation were analyzed. ResultsTraumatic amputations accounted for 58.82%, and the main cause was traffic accidents (70%). Amputations caused by diseases accounted for 41.18%, and the main cause was congenital limb deformities (80.95%). Traumatic amputation was more likely to have stump complications than expected (P < 0.05). The possibility of stump complications after disease-specific amputation was lower than expected (P < 0.05). ConclusionTraffic trauma is the main cause of amputation in children and is characterized clinically by a high incidence of unsatisfactory stumps, mainly due to soft tissue abnormalities, and most cases require stump revision to improve the poor residuals for prosthetic restoration of ambulation. Congenital pseudarthrosis of the tibia is the main cause of disease-specific amputation, and the outcome of amputation often cannot be definitely avoided even after long-term limb preservation treatment.
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This study integrates metabolomics and network pharmacology techniques to systematically analyze the possible mechanism of Pudilan Xiaoyan oral liquid (PDL) in the treatment of acute respiratory infections. GC-MS metabolomics analysis found 8 endogenous metabolites, 3-phosphoglycerate, α-aminoadipate, D-ribulose-5-phosphate, β-mannosylglyceric acid, D-fructose, urea, D-maltose and ornithine in the serum of mice with acute respiratory infection induced by LPS; these substances can be used as biomarkers for PDL use in the treatment of acute respiratory infections. Biological network studies revealed 10 potential targets for intervention by PDL in the glycolysis and pentose phosphate pathways, including GPI, G6PD, H6PD, PFKM, TALDO1, TKT, GAPDH, HK1, PKLR and TPI1. All animal experiments were carried out with approval of the Animal Ethics Committee of Nanjing University of Chinese Medicine. Our findings indicate that the strategy of combining metabolomics and network analysis can provide information on the possible mechanism of PDL in acute respiratory infections, and reveal that PDL may ameliorate the pathological process of acute respiratory infections by regulating disordered metabolic pathways.
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As the first line of defense of the host immune system, natural killer cells play important roles in anti-tumor immunity, either by direct anti-tumor effects, or by assisting T cell immune responses. However, NK cells are usually functionally exhausted in tumor microenvironment, accompanied with dysregulated expression of an array of surface receptors, restricting the effector potentials of NK cells. NK-based checkpoint immunotherapy aims to trigger anti-tumor efficacy by blocking NK cell surface inhibitory receptors, unleashing NK cells from inhibitory signals of the tumor microenvironment, and reversing NK cell exhaustion, representing a novel strategy in cancer therapy. With more in-depth research to reveal the mechanisms of action, indications, and biomarkers for specific NK cell checkpoint molecules, we shall fully exploit the potentials of NK-based checkpoint blockade immunotherapy.
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Flavonoids have many physiological and pharmacological activities. Ionic liquids are increasingly used in the extraction of flavonoids from natural products due to their unique properties. In this paper, various extraction methods of natural flavonoids were reviewed and summarized. The effects of anion and cation type, length of carbon chain, and bond cooperation on the extraction of natural flavonoids in ionic liquids, especially imidazole type ionic liquids, were also reviewed. Suggestions on selection of extractant for ionic liquid extraction of flavonoids were given. The advice of the green recovery of ionic liquids and the development of edible ionic liquids for the future direction of development were suggested. This study will lay the foundation for the basic research and industrial application of ionic liquids in the extraction of natural flavonoids.
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Seven cucurbitane-type triterpenoids were isolated from the ethanol extract of the tubers of Hemsleya dolichocarpa, with a combination of various chromatographic approaches, including silica gel, Sephadex LH-20, Semi-HPLC and so on. On the basis of spectroscopic data analysis, they were identified as 3β,11α,26,27-tetrahydroxycucurbita-5,24(E)-diene-3,26-glucosides (1), scandenogenin D (2), jinfushanencin F (3), scandenoside R3 (4), scandenoside R1 (5), scandenogenin A (6), scandenoside R2 (7). Among them, compound 1 is a new triterpenoid, compound 2 showed remarkable activity against human cancer cell line HeLa with IC50 value of 6.78 μmol·L-1.
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To establish a method for the simultaneous determination of 9 components, namely gardenoside, paeoniflorin, forsythoside A, baicalin, forsythin, glycyrrhizic acid, rhein, honokiol, and magnolol in Xiao'er Chiqiao Qingre granules（XECQ Gra）. Ultra performance liquid chromatography (UPLC) was used on an Acquity UPLC HSS T3 C₁₈ column (2.1 mm×100 mm, 1.8 μm) with 0.1% phosphoric acid acetonitrile (A)-0.1% phosphoric acid solution (B) as mobile phase for gradient elution. The flow rate was 0.3 mL·min⁻¹ ; the column temperature was set at 30 °C, and the determination wavelength was set at 220 nm. All the 9 compounds were well separated, and showed good linear relationship within their concentrations (r>=0.999). The average recoveries were between 95.84%-101.4% and the RSD values were all less than 3.0%. The method is simple, reliable, and accurate, and could be used for the quality control of XECQ Gra.
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A new sensitive method for detection of cumulative radon radiation based on the lead was established. PS2.M which stabilized by K+with hemin as a co-factor exhibits superior peroxidase-like activity, and can effectively catalyze the H2O2-mediated oxidation of TMB. In the presence of Pb2+, K+-stabilized PS2.M DNAzymes are induced to undergo a conformational change,because Pb2+has a higher efficiency with regard to stabilizing G-quadruplexes than K+, accompanied by a decrease of catalytic activity and a sharp decrease of readout signal. In the work, a novel"turn-off"model of colorimetry-Pb2+biosensor based on superior peroxidase-like activity of G-quadruplex for Pb2+analysis was developed. The fading degree of reaction system (△A value) was linearly related to Pb2+concentration in the range of 5. 0×10-9-1. 8× 10-7mol/L. The linear regression equation was △A=0.36+0.13C (10-8mol/L), with R=0.9987. The detection limits of lead and radon were 3.76 nmol/L(S/N=3) and 1.96×103Bq·h/m3(S/N=3), respectively. The method exhibited good selectivity, high sensitivity and convenient operation, and could avoid the radioactive hazard in determination of the radon in environment.
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Objective To observe the effects of peritoneal resuscitation by pyruvate replacing lactate peritoneal dialysis solution on the intestinal mucosal barrier in rabbits with hemorrhagic shock.Methods The hemorrhagic shock model was prepared in 48 healthy male rabbits by adopting the improved Wiggers method.Then the rabbits were randomly divided into the conventional intravenous resuscitation group (group A),conventional intravenous resuscitation plus intraperitoneal injection of lactate peritoneal dialysis solution group (group B),conventional intravenous resuscitation plus intraperitoneal injection of pyruvate peritoneal dialysis solution group (group C) and intravenous pyruvate peritoneal dialysis solution resuscitation plus intraperitoneal injection of pyruvate peritoneal dialysis solution group (group D).The levels of diamine oxidase (DAO) and lipopolysaccharide (LPS) were measured before shock,at 60 min after shock,at 60,180 min after resuscitation.At the end of observation,the ileum tissues were taken from the 5 cm away from the ileocecal region for measuring the dry/wet ratio,malondialdehyde (MDA) level and superoxide dismutase (SOD) activity and their morphological changes was observed.Results There was no statistical difference in the plasma levels of DAO and LPS before shock among the four groups (P＞0.05);which at 50 min after shock were increased,but the comparison among the groups had no statistical difference (P＞0.05);the plasmas levels of DAO and LPS at 60,180 min after resuscitation in the group A,B,C and D were decreased in turn (P＜0.05).The MDA levels of ileum tissues after 180 min of resuscitation in the group A,B,C and D were decreased in turn (P＜0.05),but the SOD activties and tissue dry/wet mass ratios were increased in turn (P＜005),moreover the tissue injury degrees were also relieved in turn.Conclusion The peritoneal resuscitation by pyruvate replacing lactate peritoneal dialysis solution can more effectively protect the intestinal tissue cells and reduce intestinal mucosal damage in hemorrhagic shock rabbits.
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Objective To apply problem-based learing(PBL)and case-based learning(CBL)in course of Outcome Measures in Prosthet-ics and Orthotics.Methods The undergraduate students in Grade 2012 of Prosthetics and Orthotics Engineering in Capital Medical Universi-ty (group A, n=27) were taught in traditional teaching, and those in Grade 2014 (group B, n=25) were taunght with PBL and CBL. Both groups received an immediate test after class,and group B also fulfilled an anonymous questionnaire.Results The score of immediate test was better in group B than in group A(t=-4.972,P<0.001).Most students in group B recognised that the new strategy of learning could im-prove their ability of independent solving clinical problems,literature retrieval,communication and expression.Conclusion Application of PBL and CBL in teaching of Outcome Measures in Prosthetics and Orthotics can promote students'activity in learning and improve teaching quality.
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Objective To compare the effect of two different types of cardiopulmonary resuscitation (CPR)in cardiac arrest.Methods 150 patients with cardiac arrest were selected.The patients were divided into two groups according to the random number table method,each group in 75cases.The patients in the control group were treated with CPR.The patients in the observation group were treated with CPR machine.The body temperature,hemoglobin concentration,hematocrit,arterial blood gas analysis and resuscitation were compared between the two groups after 10min and 30min.Results There were no statistically significant differences in body temperature,hemoglobin and hematocrit between the control group and the observation group at 10min and 30min after CPR (t10min =1.44,2.01,1.23,t30min =1.69,1.81,1.02,all P ＞ 0.05).There were no statistically significant differences in PaCO2 between the two groups at 10 min and 30 min after resuscitation (t =1.54,1.02,all P ＞ 0.05).The arterial blood pH[(7.02 ±0.14)],PaO2 [(16.29 ± 4.38) kPa],HCO3 [(5.66 ± 1.73) kPa] and SaO2 [(0.84 ± 0.05) ％] of the control group recovered 30 min were significantly lower than recovered 10 min (t =7.14,6.55,6.20,7.03,all P ＜ 0.05).The arterial blood pH[(7.11 ± 0.1)],PaO2 [(18.36 ± 4.55) kPa],HCO3 [(6.34 ± 2.15) kPa],SaO2 [(0.86 ±0.04) ％] of the observation group recovered 30 min were significantly lower than recovered 10 min (t =6.75,6.21,6.01,6.60,all P ＜0.05).The arterial blood pH,PaO2,HCO3 and SaO2 of the observation group were significantly higher than those in the control group at 10 min and 30 min,the differences were statistically significant (t10min =6.03,7.34,7.88,6.10,t30min =6.21,8.20,7.10,6.11,all P ＜ 0.05).The effective rate of CPR in the observation group was 69.33％,which was significantly higher than 46.67％ in the control group,the difference was statistically significant (x2 =9.34,P ＜ 0.05).Conclusion Compared with artificial heart and lung resuscitation,CPR machine is more effective for patients with heartbeat respiratory arrest.It is more effective in cycling support and can improve the efficacy of CPR and is worthy of clinical application.
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Objective To explore the efficacy of arthroscopic treatment for acute avulsion fracture of posterior cruciate ligament (PCL) using double titanium plate TightRope. Methods From December 2014 to January 2015, two cases with acute avulsion fracture of PCL were treated with double titanium plate TightRope under arthroscopy, after assessment of three dimensional reconstructive CT and MRI. Rehabili-tation was carried out after operation. Results One case succeeded with double titanium plate TightRope, and rehabilitation could be per-formed early postoperatively. Another case failed in TightRope fixation, and accepted two internal hollow screws fixation instead. Rehabili-tation was delayed until two weeks postoperatively. The function of the knee was satisfactory in the former patient after three months, who could extend the knee in a normal range, without pain or locking. The same effect was gained in the latter patient after four months. Conclu-sion For acute tibial avulsion fracture of PCL with larger and intact fragment without osteoporosis, arthroscopic restoration and fixation with double titanium plate TightRope offers the opportunity to achieve anatomic reconstruction and rigid fixation for early rehabilitation in adult patients.
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Objective To study the application of dexmedetomidine in patients with combined spinal epidural anesthesia and its effects on hemodynamics and renin angiotensin aldosterone system (RAAS).Methods96 patients with open surgery under combined spinal epidural anesthesia from Oct.2013 to Oct.2016 in our hospital were selected.Divided into two groups by randomly, the dexmedetomidine group(46 cases) was given dexmedetomidine before anesthesia, the control group(46 cases) was given sodium chloride solution.The operation condition, and the changed of mean arterial pressure (MAP), heart rate, plasma renin activity (PRA), angiotensin II (ANG-II) and aldosterone (ALD) at before anesthesia (T1), post anesthesia 10min (T2), end of the operation (T3) and end of the operation 30 min (T4) were compared.ResultsThere was no significant difference in the operation time, blood loss, intraoperative transfusion, and wake up time between the two groups;there was no significant difference in MAP and heart rate between the two groups at T1, at T2, T3, T4 point, control group MAP, heart rate were significantly changed(P<0.05), and there was no significant change in dexmedetomidine group, at T2,T3,T4 point, the levels of MAP, heart rate in the dexmedetomidine group were lower than the control group(P<0.05);there was no significant difference between the two groups in PRA, ANG-Ⅱ and ALD at T1, at T2 and T3 point, the PRA, ANG-Ⅱ and ALD in the two groups were increased, at T4 point down, there were significant differences compared with the same group at T1(P<0.05);but at T2,T3,T4, the levels of PRA,ANG-Ⅱ,ALD were lower than the control group(P<0.05).ConclusionIn the combined spinal epidural anesthesia with dexmedetomidine before anesthesia, which can Maintain hemodynamic stability, And inhibit the activation of RAAS.
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Objective To study the analgesic effect of sufentanil combined with Dezocine in endoscopic resection of fallopian.MethodsA total of 188 patients with tubal pregnancy from April 2013 to December 2014 in Haining central hospital were enrolled in the study, they were randomly divided into two groups (n=94).On the basis of conventional intravenous analgesia, the patients in control group was were received sufentan, the observation group were given sufentan combined with dezocine.The score of pain at different time points after operation, the Ramsay sedation score, and the level of IL-6 and IL-10 were compared.The adverse reactions were compared between the two groups.ResultsThe score of VAS in the observation group was significantly lower than that in the control at 4h, 8h, 12h and 24h after operation (P<0.05).The score of VAS in the two groups were similar at 48h after operation;the Ramsay score in the observation group was significantly higher than that in the control group(P<0.05) at five time points (4h, 8h, 12h, 24h and 48h after operation);when compared Compared with the indexes before operation, the level of IL-6 was significantly increased in the two groups at 24h and 48h, but the observation group increased less, the IL-6 in observation group was lower than that in the control group at the two points(P<0.05);while the IL-10 was higher than that beforeoperation, and the observation group was more higher(P<0.05).The adverse reactions in the two groups were mainly dizziness, nausea, pruritus and lethargy, and the incidence was only 12.8% in the observation group, which lower than that in the control of 29.8%(P<0.05).ConclusionIt which dazocine combined with sufentanil had a good analgesic effect in the process of analgesia in gynecological laparoscopic resection of fallopian tube after the operation.The VAS score and Ramsay sedation score was improved significantly.The levels of inflammatory factors were lower, and the incidence of adverse reaction was significantly reduced.It is a reliable method for clinical intravenous analgesia.
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Objective To discuss the relationship between the expression of secretory Phospholipase A2-Ⅱ A(sPLA2-ⅡA) and the pathogenesis psoriasis vulgaris patients lesions.Methods Using Psoriasis Area Severity Index(PASI),50 psoriasis vulgaris were divided into three groups:mild (n =16),moderate (n =18) and severe group (n =16),and compared to the non-psoriasis control group (n=52).The serum level of sPLA2-ⅡA in psoriasis vulgaris patients and the normal control group were detected using ELISA methods.Using RT-PCR,mRNA expression levels of sPLA2-ⅡA and subtypes were detected.Using western blot,the expression levels of Akt and p-Akt were detected.Results The serum level of sPLA2-ⅡA in the psoriasis lesion's group was significantly higher than that in the healthy control (t=13.62,P＜0.01).The mRNA expression of sPLA2-ⅡA in the lesion of psoriasis was significantly higher than that in health control (t=113.41,P＜0.01).In the other subtypes,the mRNA expression of sPLA2 had no distinctive.Among the three groups (mild group,moderate group and severe group),the difference in serum level and mRNA expression of sPLA2-ⅡA were statistically significant (F =28.12,69.62,P＜0.01).There was statistical significance among three groups (t=3.14,5.14,6.38,all P＜0.01;t=4.77,10.42,10.58,all P＜0.01).The expression of Akt/p-Akt in the psoriasis lesion's group were higher than that in health control (t=17.79,19.04,P＜0.01).Conclusion The expression of sPLA2-ⅡA would be associated with order of severity in lesions of psoriasis vulgaris.The pathway was relate to expression of Akt and p-Akt.
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Objective To investigate the diagnostic value of serum tumors M2 pyruvate kinase (TuM2-PK),carcino-embryonic antigen (CEA),CA199,CA724,CA125 and CA242 in colon cancer.Methods Serum levels of TuM2-PK,CEA,CA199,CA724,CA125 and CA242 in 231 patients with colon cancer,105 patients with colon benign lesion diseases and 166 normal controls were measured by the ELISA and electrochemiluminescence assays.The operation working characteristic curve (ROC) and the logistic regression-ROC were used to evaluate the diagnostic value of tumor markers for colon cancer individually and in combination.The models of logistic regression analysis and partial least-squares discriminant analysis (PLS-DA) were established to diagnose patients with colon cancer based on the optimal panel of serum tumor markers.Resalts Concentrations of serum TuM2-PK,CEA,CA199,CA125 and CA724 in the colon cancer group are higher than those in the colon benign diseases group and the normal controls (P＜0.05).The area under the operation working characteristic curve (AUC) of CA199 is the highest 0.79 [95％ confidence interval (95％CI),0.75-0.83] at the cutoff value of 69.5 U/L with 64.1％ of sensitivity and 89.7％ of specificity.The AUC of combined serum tumor markers based on logistic regression analysis is higher than those in individuals,of which serum (CEA+ CA199+TuM2-PK) is the optimal [AUC=0.89,95％ confidence interval(95％CI),0.86-0.92].The diagnostic accuracy of logistic analysis and PLS-DA model for colon cancer is 82.7％ and 77.5％,and for colon cancer is 93.7％ and 95.6％,respectively.Conclusion The combination of serum tumor markers CEA,CA199 and TuM2-PK is more suitable as a diagnostic model for the screening of colon cancer.
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Objective Clinical data of patients who received rotational atherectomy (RA) combined with drug-eluting stent implantation (DES) in TEDA International Cardiovascular Hospital were retrospectively analyzed to evaluate it's safety,short-term and long-term prognosis.Methods A total of 60 patients who underwent RA were consecutively enrolled in the study in TEDA International Cardiovascular Hospital from September 2012 to September 2015.Pre and post procedure coronary angiography and clinical information were collected.Long term outcomes were obtained by outpatient clinical follow-up or telephone interview.We analysed angiographic data.Results Among 60 patients with 65 lesions,RA combined with drug-eluting stent implantation was successful performed in 62(95.3%) lesions and postoperative stenosis degree drop from (90.7±6.2)% to (19.5±6.6)%.4 cases(6.7%)developed complications and were treated accordingly during procedure with satisfactory results.Overall incidence of in-hospital MACCE was 1.7% with one case (1.7%) of myocardial infarction.The mean follow-up time was (23.3±10.6) months.In stent restenosis occurred in 1 case(1.7%) 10 months after operation.Stent thrombosis occurred in 1 case(1.7%) 16 months after operation and myocardial infarction (MI) occurred in 1 case(1.7%) 7 months after operation.One patient died 14 months after operation and another patient died 17 months after operation.Both of them were considered as cardiac death.There was no mortality of other causes recorded.Long-term MACCE was 9.5% and TLR is 5.1%.Conclusions Rotational atherectomy combined with DES implantation in the treatment of severe coronary artery calcification lesions has high success rate, good safety profile and good short and long-term prognosis.
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Objective:To explore the value of echocardiography for diagnosing infectious endocarditis (IE).Methods:A total of 487 patients with cardiovascular implantable electronic devices (CIED) infection treated in our hospital from 2013-01 to 2015-06 were enrolled.Based on symptoms,blood culture and echocardiography,9 patients with suspected IE were further examined by 18F-FDG PET-CT to confirm their diagnosis and classification.Definitive therapy was conducted and the patients were followed-up for 1 year to confirm the diagnostic accuracy of echocardiography on CIED induced IE.Results:3 patients were preliminarily diagnosed for bacteremia since no vegetation was found by echocardiography,while IE was finally diagnosed by PET-CT.2 patients were preliminarily diagnosed for IE by echocardiography presented valvular vegetation,while PET-CT showed no evidence of vegetation;then one of them was diagnosed as bacteremia by positive blood culture and another was diagnosed as non-infection.4 patients were preliminarily diagnosed for IE by echocardiography indicated existing vegetation after CIED lead extraction,while PET-CT demonstrated no infection sign in heart chamber and the finally diagnosed was as "non-infectious fibrous residual tissue".According to final diagnosis,definitive therapies were performed to specific patients with at least 1 year follow-up study,no one had new and recurrent infection.Conclusion:Echocardiography had deficiency for diagnosing vegetation in heart chamber especially in suspicious IE patients after CIED lead extraction.It is necessary to make accurate diagnosis with other method for guiding appropriate therapy.