ObjectiveTo compare the effect and safety of basiliximab in ABO incompatible pediatric liver transplant recipients.MethodsABO incompatible pediatric liver transplantation operated between January 2019 and August 2020 were studied. The patients were allocated randomized into two groups. Patients in experimental group were treated with basiliximab as immune induction therapy, but basiliximab was not used in patients of control group. Tacrolimus combined methylprednisolone were used after liver transplantation. The clinical characteristics, graft and recipient survival rate, rejection, infectious complications, and kidney functions after liver transplantation were observed. Donor specific antibody (DSA) was tested in 3 months after liver transplantation. The growth and development were assessed too after liver transplant.ResultsFourty-four patients were enrolled in the study, including 19 patients in the experimental group and 25 patients in the control group. The median follow-up time was 16.6 months (3.8–25.4 months), and there were no statistically differences between the two groups in terms of age, sex, weight, pediatric end-stage liver disease (PELD) score, and other basic conditions. There were no significant differences between the two groups in tacrolimus dose, tacrolimus trough concentration, kidney functions, height and weight growth after liver transplantation. There were no statistical differences in lung infection, blood stream infection within 3 months after liver transplantation, cytomegalovirus, EBV infection, graft/patient survival rate after liver transplantation (P>0.05). However, the acute rejection rate was lower and the DSA positive rate in 3 months after liver transplantation was lower in the experimental group (P<0.05).ConclusionsBasiliximab can be safely used in ABO incompatible pediatric liver transplant recipients. Acute rejection rate and DSA positive rate after transplantation can be decreased with the useof basiliximab.
Objective To improve the diagnosis and treatment of concealed penis in children. Methods From August 1998 to January 2004, 43 cases of concealed penis in children were treated with Huang Lugang’s procedure aging aged 2-14 years (7 years on average). Eight children are obesity. The albuginea tissue were fixed to the lateral Buck’s fascia at the base of the penis. Removal of the excessive suprapublic fat was given in 2 cases of obesity type. Results All patients were followed up from 3to 24 months. The results were satisfactory in 35 (81.4%).The penile contour were dissatisfactory in 8 patients with obesity including 2 patients given removal of the excessive suprapublic fat. Conclusion The Huang Lugang’s procedure was simple and can achieved satisfactory results, but it should be used carefully in case of obesity type.
ObjectiveTo evaluate the effectiveness of the screw-based intermaxillary traction combined with occlusal splint in the treatment of pediatric mandibular condylar fracture. MethodsBetween June 2005 and December 2013, 35 pediatric patients with 49 mandibular condylar fractures were treated, and the clinical data were retrospectively reviewed. There were 25 boys and 10 girls, aged 3-13 years (mean, 7.3 years). The injury causes included falling (18 cases), traffic accident (14 cases), and violence (3 cases). The time between injury and treatment was 2-30 days (mean, 6.8 days). Restricted mouth opening was observed, and the maximal mouth opening was (22.74±7.22) mm except 3 patients who were too young to measure. Condylar fractures were located at the left (12 cases), at the right (9 cases), at bilateral (14 cases) based on the sites; and fractures were classified as intra-capsular (35 fractures), neck (10 fractures), and subcondylar (4 fractures) based on the fracture line. Four self-drilling titanium screws were inserted into the alveolar bone of both maxilla and mandible. After screw inserting, an occlusal splint with a fulcrum was used on the affected side and elastic band was put to perform anterior intermaxillary traction. After 1 month, the screws and splint were removed. Follow-up examinations were carried out on schedule. ResultsAll the patients were followed up from 6 months to 8 years and 10 months (median, 71 months). No screw-related complication occurred in the others except one case of screw loosening. The postoperative maximal mouth opening was (38.82±2.02)mm. Mild joint noise was found in 4 cases and opening deviation occurred in 6 cases. Radiographic results demonstrated complete condyle remodeling was achieved in 24 cases (32 fractures), and moderate remodeling in 11 cases (17 fractures) at last follow-up. ConclusionThe screw-based intermaxillary traction combined with occlusal splint might be an effective method for pediatric mandibular condylar fracture. The screw-related complications may be avoided by careful preoperative investigations.
Objective To evaluate the efficacy and its affecting factors of silicone oil as an introocular tamponade for copmlicated retinal detachments in children(le;14 years). Methods We analysed retrospectively 34 cases(36 eyes) of complicated retinal detachments in children, who were performed with pars plana vitrectomy combined with silicone oil tamponade from June 1993 to November 1997. Results After 3-21 months of follow-up, the detached retinas in 19 eyes(52.7%) were reattached, in 10 eyes(27.8%) partially reattached and in 6 eyes (16.7%) redetached, 1 eye(2.8) had a media opacity that precluded evaluation of the retina. Postoperative visual acuity was less than 0.05 in 12 eyes(33.3%), and 0.05-0.2 in 20 eyes(55.6%), 2 cases(4 eyes) could not tell their visions(11.1%). Conclusion Silicone oil tamponade is an effctive therapy for complicated retinal detachments in children. The major cause of surgical fai;ure was development of recurrent proliferative vetrioretinopathy. (Chin J Ocul Fundus Dis,1999,15:7-8)
目的:探讨儿童糖尿病患者的营养治疗方法以提高治疗效果。 方法:随机选择20例胰岛素依赖型儿童糖尿病患者,结合年龄、体重、病情、胰岛素用量、营养状况、生长发育需要设计个体化营养治疗方案。结果:通过营养治疗,除1例患儿家属在病情控制相对稳定,但血糖未有效控制提前出院外,其余19例患者均坚持营养治疗。治疗前后,随机血糖、餐后2 h血糖差异有统计学意义,P＜0.05;糖化血红蛋白差异无统计学意义。结论:个体化的营养治疗有助于儿童糖尿病患者血糖控制,并能促进儿童的生长发育及提高生活质量。