OBJCTIVE :To investigate the fundus ocu]i changes in hypnxie isehemic encepbalnpa ally(HIE)of new[x,rns. METHODS:One hundred and two newblt;~rns suffered from HIE were investi- gated to observe lhe pathological neular fundus changes by di~et ophthabnoseopy after mydria~s. RE- SULTS:Seventy seven ca.~s(154 eyes)were found to have ophthalmoscopic changes in the ~ular fundi including papilledema .white retina vaseolar abnormality and hemorrhage. CONCLUSIONS:In clinical view .the severity of HIE depends on the pathological ebanges of the brain .and ftmdus ahnormalby will be very often in middle and .~vere sufforers of HIE.
【Abstract】 Objective Through a retrospective study, to observe the cl inical therapeutic effect for closed reductiontreatment of developmental dislocation of the hip (DDH), and to dynamically analyze characteristics of acetabular development after closed reduction in DDH. Methods A total of 100 single side DDH children who were treated by “the treatment mode of closed reduction” from January 2002 to December 2005 were followed up, including 18 males and 82 females, with the average age of 19.4 months (ranging from 7 months to 36 months). Sixty-eight patients had left side dislocation, while 32 had right side dislocation. According to Zionts dislocation grades, 15 cases were degree I, 50 degree II, 26 degree III and 9 degree IV. Adductor tenotomies and skeletal traction were carried out in 74 cases, while direct closed reduction was performed in 26 cases. The four-level functional evaluation criterion was used to assess the cl inical therapeutic effect. Lesional and homeochronous normal hips were paired, and acetabular index (AI) and AI (D/W) of lesional and normal hips, before the reduction and in the 3rd, 6th, 9th and 12th month, respectively, after the reduction, were dynamically measured. Results The total choiceness rate of 100 children was 88.00%. Twelve months after the reduction, lesional AI decreased from (37.17 ± 2.17) o to (27.02 ± 3.54) o, while lesional AI(D/W) increased from 22.06% ± 1.65% to 29.80% ± 3.56%, and the differences among each time-point had statistical significance (P lt; 0.01). Both rates of lesional AI decrease and AI(D/W) increase were obviously faster than those of normal side physiological development (P lt; 0.01). In all durations after 12 months reduction, the rates of lesional AI were (3.22 ± 1.42) o and (3.41 ± 2.03) o in 1 - 3 months and 10 - 12 months , respectively, and the rates of AI(D/W) were 2.69% ± 1.83%and 2.33% ± 1.13%, respectively, and they were obviously faster than the other durations (P lt; 0.01). Both rates of lesional AI decrease and AI(D/W) increase were obviously faster than the homeochronous rate of normal side physiological development in each duration (P lt; 0.01). The rates of lesional AI were (13.71 ± 3.96) o and (11.48 ± 4.15) o in 7 - 12 age group and 13 - 18 age group, respectively, and the rates of AI(D/W) were 9.95% ± 3.81% and 8.28% ± 3.58%, respectively, and they wereobviously faster than the other age groups (P lt; 0.05). Both changes of lesional AI and AI(D/W) were obviously faster than the homeochronous changes of normal side in each age group(P lt; 0.01). Conclusion There are simple operating requirements and fine therapeutic effect of “the treatment mode of closed reduction” . Within 12-month after the closed reduction treatment, the rate of lesional acetabular development is obviously faster than that of normal side physiological development. The cresttime of lesional acetabular development is during 1 - 3 months and 10 - 12 months, and the best treatment time of closed reduction is the age before 18 months.
Objective To observe the characteristics of images of ocular fundus obtained by computer-assisted imaging system of binocular indirect ophthalmosco p y (CABIO) in the healthy premature infants and the ones with retinopathy of prem aturity(ROP), and evaluate the value of the clinical practice of CABIO in ROP s creening. Methods From January, 2006 to December, 2006, we exa mined 150 prematur e infants in ROP screening procedure by using the computerassisted imaging sys t em of binocular indirect ophthalmoscope, beginning at the infantsprime;age of postn a tal 4-6 weeks or the corrected age above 32 weeks. The follow-up duration was co nfirmed according to the first examination results. The procedure of the operati on was recorded and the typical pictures were shot to obtain the images of the o cular fundus of the healthy premature infants and the ones with ROP. The charact eristics of the images were retrospectively analyzed and compared. Resu lts The typical images of normal ocular fundus and that with ROP in the 150 premature i nfants were successfully obtained by indirect ophthalmoscope. In normal fundus o f infants, the color of optic disc was pale, peripheral retina was not completel y vascularized and presented gray-tone in color;while all stages of ROP present ed dif ferent appearances under the indirect ophthalmoscope. Conclusions Computer-ass isted imaging system of the binocular indirect ophthalmoscopy can clearly observ e the characteristics of normal ocular fundus of premature infants and the ocula r fundus with ROP, and can save the objective examination results, which may pro vide significant references in screening and treating ROP.
Objective To systematically evaluate the clinical effect and safety of Bifidobacterium tetravaccine tablets in the treatment of antibiotic associated diarrhea (ADD) in infants in China. Methods Randomized controlled trials (RCTs) of treatment of AAD by Bifidobacterium tetravaccine in infants were searched by computer from China Knowledge Resource Integrated Database, VIP and Wanfang Data from their inception to November 2016. Meta-analysis of the data was carried out by RevMan 5.3 software. Results Twelve RCTs were chosen, which included 1 761 infant patients. The Meta analysis showed that the effects of treatment of ADD were significantly superior to those of the control group [OR=5.74, 95%CI (4.14, 7.96),P<0.000 01]. Among the 12 RCTs, 8 had no adverse reactions, while the rest4 articles did not mention adverse reactions. Conclusions Based on the present clinical evidences, treatment of ADD by Bifidobacterium tetravaccine in infants is effective and safe. But due to the small number and different quality of RCTs, this conclusion still needs to be confirmed by large sample, multicenter, and high-quality clinical RCTs.
In order to guide diagnosis and treatment in children with sleep disordered breathing aged 1 to 23 months, the European Respiratory Society(ERS) summarized the evidence and released the European Respiratory Society statement based on clinical experience in 2016. This article aims to interpret the ERS statement. Children with apparent upper airway obstruction during wakefulness and those with SDB symptoms and complex conditions requires treatment. Adenotonsillectomy and continuous positive airway pressure are the most frequently used treatment measures along with interventions targeting specific conditions. Obstructive SDB in children aged 1 to 23 months is a multifactorial disorder that requires objective assessment and treatment of all underlying abnormalities.
Kangaroo mother care has reduced mortality and morbidity in preterm and low birth weight infants and has many benefits, such as promoting breastfeeding. Based on the current evidence in China and internationally, we developed clinical practice guidelines for kangaroo mother care in preterm and low birth weight infants using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE), and proposed 34 recommendations for 20 key questions. Our goal is to promote the appropriate implementation of kangaroo mother care in clinical practice.
Objective To systematically review the efficacy of salbutamol for infants with bronchiolitis. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 3, 2016), CBM, VIP, WanFang Data and CNKI were searched from inception to March 2016 to collect randomized controlled trials (RCTs) about salbutamol for infants with bronchiolitis. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 20 RCTs, involving 1?735 patients were included. The results of meta-analysis showed that, compared with the control group, the salbutamol group had shorter cough relief time (MD= –1.44 d, 95%CI –1.93 to –0.95, P < 0.000?01), dyspnear relief time (MD= –0.87 d, 95%CI –1.17 to –0.56, P < 0.000?01), asthmatic remission time (MD= –1.38 d, 95%CI –1.93 to –0.83, P < 0.000?01), pulmonary rales disappear time (MD= –1.58 d, 95%CI –2.00 to –1.17, P < 0.000?01) and average hospitalization time (MD= –1.40 d, 95%CI –2.12 to –0.68, P=0.000?1), but could not improve clinical severity score (MD= –0.17, 95%CI –0.35 to 0.00, P=0.05). Conclusion Current evidence indicates that salbutamol can significantly improve the bronchiolitis with cough, dyspnea and wheezes symptoms and lung’s signs, shorten the length of hospital stay, but can not improve the clinical severity score of infants with bronchiolitis. Due to the limited quality of included studies, more high quality studies are needed to verify the above conclusion.
Objective To investigate the effect of new type ultrafiltration technique in preventing and relieving the main organ injury that may follow open heart surgery with cardiopulmonary bypass (CPB),and improve the operative effects and decrease the postoperative complications. Methods Thirty patients with congenital heart diseases were randomly divided into two groups. Modified ultrafiltration group: modified ultrafiltration was used after CPB; new type ultrafiltration group: new type ultrafiltration technique was used throughout CPB. The serum concentrations of nflammatory mediators,hematocrit,serum albumin concentrations, pulmonary function, operative duration time and main organ function parameters were measured in both groups. Results Ultrafiltration time after CPB in new type ultrafiltration group was significantly shorted as compared with modified ultrafiltration group（6.35±1.28 min vs. 12.45±4.52 min，P=0.000）; serum concentrations of interleukin6(IL-6)and tumor necrosis factor α(TNF-α) after CPB were significantly decreased as compared with modified ultrafiltration group（292.84±58.23 μg/L vs. 383.79±66.24 μg/L,P=0.000; 13.32±2.31 μg/L vs. 16.41±2.65 μg/L,P=0.000）; the hematocrit and serum albumin concentrations at the ten minutes after CPB were increased as compared with modified ultrafiltration group (0.39±0.04 vs. 0.35±0.03,P=0.003; 38.32±4.26 g/L vs. 34.04±2.83 g/L, P=0.003); the mechanical ventilation support time and ICU time after operation was shorted as compared with modified ultrafiltration group (Plt;0.05); main organ function was improved as compared with the modified ultrafiltration group. Conclusion The clinical application of new type ultrafiltration throughout CPB can effectively exclude some harmful inflammatory mediators, concentrate blood,short operation time,attenuate the main organ edema and injury.
ObjectiveTo analysis the causes of infant spasm (IS) and provide a theoretical basis for clinical diagnosis and treatment. MethodsCollected the clinical data of 116 IS cases in our hospital from May 2011 to December 2013, which conform to the diagnostic standard, and analysis its causes. ResultsIn the116 cases we collected, symptomatic IS is primarily for 78 cases (67.24%); the onset age of symptomatic IS within 6 months was 76.39% (55/72), higher than the rates of symptomatic IS beyond 6 months 52.27% (23/44) (P=0.007); The pathogenic factor in symptomatic IS, prenatal accounted for 48.72%, intrapartum factors accounted for 34.62%; for sexually transmitted diseases accounted for 47.44%, venereal disease accounted for 52.56%. In 78 cases of symptomatic IS, gender has no relation with its pathogenic factors; the onset age within 6 months of antepartum and intrapartum factor is significantly higher than the rates of symptomatic IS beyond 6 months (89.09% VS 69.57%); distribution between urban and rural areas and its pathogenic factors is related, prenatal factors of urban IS significantly lower than which in rural areas (38.30% VS 64.51%), intrapartum factor IS significantly higher than the rural IS (44.68% VS 19.35%). ConclusionThe cause of the IS given priority to with symptomatic, IS in the majority with, and prenatal or developmental factors in the higher flight in symptomatic, and the smaller of the onset age antepartum and intrapartum factor becomes more apparent, prenatal factors in the rural areas is higher than which in the unban areas, but intrapartum factor in the unban areas is higher than which in the rural areas. Magnetic resonance imaging (MRI) still plays an important role in etiology diagnosis.
Objective To explore the effectiveness and appropriate energy parameters of high-intensity focused ultrasound (HIFU) in treating infant hemangiomas. Methods Between January 2009 and September 2010, 60 infants with hemangioma were treated. There were 23 boys and 37 girls, aged from 3 to 30 months with an average of 10 months. These hemangiomas were located at head and face (24 cases), trunk (15 cases), l imb (16 cases), buttocks (2 cases), perineum (1 case),and multiple lesions (cervix, abdomen, and upper l imbs, 2 cases). The size of hemangiomas ranged from 0.8 cm × 0.6 cm to 6.0 cm × 5.0 cm. The 60 infants were randomly divided into 3 groups: groups A, B, and C (n=20) based on different ultrasound energies used in treatment. The lesion surface was irradiated with 3-5 mm/second for 5 continuously by ultrasonic therapeutic apparatus at a frequency of 9 MHz, impulse of 1 000, and 10% of scanning overlap; the powers of 3.5, 4.0, and 4.5 W were used in groups A, B, and C, respectively, 3 times as a course of treatment with 1 month interval. The effect and ulcer and scar risk in irradiation region were observed after 6 months of treatment. Results All cases were treated for one course. After 6 months of treatment, no significant difference in the effect was found among 3 groups based on hemangioma treatment judging criterion (P gt; 0.05). Neither ulcer nor scar occurred in group A; ulcer occurred in 4 cases (20%) of group B with superficial scars, and in 7 cases (35%) of group C with obvious scars. The rates of ulcer and scar in groups B and C were significantly higher than that in group A (P lt; 0.05). Conclusion HIFU irradiating is one of effective methods for treating infant hemangioma, but the appropriate energy was below 3.5 W.