Objective To investigate the incidence of urolithiasis in infants aged 0-3 years old fed by milk powder tainted with melamine in the middle area of the Anhui province, as well as its relationship to gender, age, milk powder consumption and drinking water. Methods Questionnaires were distributed to 1079 infants who were screened for urolithiasis by ultrasound examination from September 25, 2008 to October 17, 2008. Data was collected by Epidata and analyzed by SPSS 13.0 software. Results A total of 646 (59.87%) male infants and 433 (40.13%) female infants underwent ultrasound examination in Anhui Provincial Hospital. Of these, 86 infants were diagnosed with urolithiasis with an incidence of 7.97%, including 62 males (72.09%) and 24 females (27.91%). The mean age of those infants with urolithiasis was 1.85±0.77, and all of calculus was located in kidney. The relationship between the incidence of urolithiasis and gender, age, drinking water, feeding bottle sanitation, birth status, as well as the amount of milk powder intake was assessed by using the Pearson Chi-square test. Results showed that significant differences were noted in the incidence of urolithiasis among infants of different genders or with different drinking water sources (Plt;0.05). The result of multiple logistic regression analyses indicated that gender was related to the incidence of urolithiasis (Plt;0.05). The incidence of urolithiasis in female infants was only 58.7% of that in male infants (OR 0.587, 95%CI 0.359 to 0.959). Conclusion The incidence of urolithiasis in infants aged 0-3 years of old in the middle area of Anhui province is relatively high and has anatomical specificity. Further data during the follow-up of these cases should be collected.
【摘要】 目的 探讨CT对婴幼儿腹部巨大囊性病变的诊断价值及其鉴别诊断。 方法 搜集2003年-2009年间经手术病理证实的2岁以内患儿腹部巨大囊性病变62例，分析其病变部位、大小、形态、分隔、密度和强化、囊壁及与周围脏器关系等要素。 结果 62例中，先天性胆总管囊肿4例，重度肾积水36例，巨输尿管2例，囊性肾母细胞瘤4例，大网膜囊肿4例，肠系膜囊肿3例，卵巢囊肿6例，囊性畸胎瘤3例。 各种囊性病变有其一定的发病部位和特征性的CT表现。 结论 CT是婴幼儿腹部囊性病变定位、定性诊断的重要影像学方法。【Abstract】 Objective To explore the value of CT diagnosis and differential diagnosis of the giant cystic lesions in abdomen of the infants. Methods A total of 62 infants younger than 2 years old with the giant cystic lesions in abdomen confirmed by surgery and histopathology from 2003 to 2009 were collected. The location of the lesion, range, configuration, thickness of cystic wall and septa, density, contrast enhancement, and adjacent organs were observed and analyzed. Results In 62 infants, there were congenital cyst of common bile duct in 4, giant hydronephrosis in 36, primary megaureter in 2, cystic Wilms tumor in 4, greater omentum cyst in 4, mesenteric cyst in 3, ovarian cystic in 6, and cystic teratoma in 3. Each disease had its own lesions location and features of CT images. Conclusion CT is very effective on the localized and qualitative diagnosis of the giant cystic lesions in abdomen of infants.
【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.
Abstract:Objective To evaluate the effects of modified uhrafihration （MUF）on blood rheology in infants after open cardiac surgery. Methods According to admission number, 22 infants of body weight less than 10 kilograms with ventricular septal defect （VSD） and pulmonary hypertension （PH） were divided into control group （10 infants, the mantissa of their admission number was odd number） and experimental group （12 infants, the mantissa of their admission number was even number）. Cases in control group didn＇t undergo MUF at the end of cardiopulmonary bypass （CPB）, while cases in experimental group underwent MUF; the flow rate of MUF ranged from 10 ml/min · kg to 15 ml/min · kg. MUF lasting for 10-15 minutes. Blood samples were repeatedly collected as following time： before operation, at the end of CPB, 15 minutes after CPB or the end of MUF, 2, 24 h after operation. Blood sample of 2. 5 ml was collected from the radial artery with hepathrom test-tube. The changes of relative indexes of the blood rheology were observed by MDK-3200 completely automatic dual pathways blood rheology testing analysator at 37±1 C. Results Hemoglobin, hematocrit, red cell count, blood yielding stress, plasma viscosity, the whole blood viscosity at high shear rate, the whole blood viscosity at middle shear rate and low shear rate, the whole blood reduction viscosity at high shear rate and middle shear rate, the whole blood reduction viscosity at low shear rate and Casson viscosity in experimental group at the end of MUF were significantly higher than those in control group at 15 minutes after CPB （P〈0. 05）. There was no significant difference in red cell aggregation index and red cell deformity between two groups at each moment （P 〉 0.05 ）. Conclusion Hemoglobin, hematocrit and red cell count are significantly elevated through MUF after CPB. Whole blood viscosity in infants undergone open cardiac surgery after CPB with MUF is higher than those who didn＇t undergo MUF.
Objective To investigate the incidence of urolithiasis in infants aged 0-3 years old fed by melaminetainted milk powder in Gansu province. Methods Questionnaires were distributed to 7 856 infants who were screened for urolithiasis in the Second Hospital of Lanzhou University by ultrasound examination from September 25, 2008 to November 15, 2008. Data were collected by Excel and analyzed by SPSS 13.0 software. Results A total of 4 090 (52.06%) male infants and 3 766 (47.94%) female infants underwent ultrasound examination in the Second Hospital of Lanzhou University. The mean age of the infants with urolithias was 18.30±9.68 months. Of those, 704, including 434 males (61.65%) and 270 females (38.35%), were diagnosed with urolithiasis, with an incidence of 8.96%, and 99.14% of calculus was located in kidney. And, 58 aged 0-6 months with an incidence of 3.16%, 218 aged 6-12 months with an incidence of 11.01%, 275 aged 12-24 months with an incidence of 12.55%, and 153 aged 24-36 months with an incidence of 8.27%. The relationship between the incidence of urolithiasis and gender as well as age was assessed by using the Pearson Chi-square test. The results showed significant differences in the incidence of urolithiasis among infants of different genders and different ages (Plt;0.05). The result of multiplelogistic regression analysis indicated that gender was related to the incidence of urolithiasis (Plt;0.05). Conclusion The incidence of urolithiasis in the infants aged 0-3 years old in Gansu province is relatively high. The incidence of urolithiasis focuses on the infants aged 6-24 months and has anatomical specificity.
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.
Objective To summarize the clinical characteristics, diagnosis and treatment of Bochdalek hernia in neonates and infants. Methods The data of 15 neonates and 10 infants with Bochdalek hernia，undergoing the normal diagnosis and surgical repair from August 1983 to June 2004, were retrospectively reviewed. Location was left in 22 cases and right in 3 cases. Twenty-four cases were treated by operation and 1 case died of respiratory failurebefore operation.Results Before April 1998，7 of 8 (5 neonates，3 infants) cases of Bochdalek hernia stayed healthy and respiratory symptomfree 1 year after operation; they were followed up 1 year and 3 months to 11 years. One premature neonate with Bochdalek hernia died of respiratory failure before operation, and his lung volume was found to be dysplasia. From April 1998 to June 2004, 15（8 neonates，7 infants） of 17 （10 neonates，7 infants）cases of Bochdalek hernia survived postoperatively, while 2 neonates died of respiratory failure. Conclusion The earlier dyspnoea of neonates ofBochdalek hernia occur，the worse their healthy status appear. The standard andtimely surgical repairs could improve the curative ratio. Whether the operationwas suspended depended on the healthy states of babies.