Pub Date : 2020-02-20DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.02.004
Guocheng Zhang, Xiaoning Cheng, H. Ding, Zhaoling Shi, Ruying Li, Z. Fu, Qiang Chen, Dongchi Zhao, R. Jin, Guoming Nie, J. Lu, Changshan Liu, D. Zhao, Jiahua Pan, Zhichun Feng, Yuan Shi, Z. Xia, Cheng-zhong Zheng, Jinjin Jiang, Junxia Wang, Yuejie Zheng, Y. Shang, Wei Xiang, Bao-Ping Xu, K. Shen, Tianyou Wang, Yonghong Yang, Q. Lu
Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period. Key words: Novel Coronavirus; Novel Coronavirus Pneumonia; Child; Fever outpatient; Process; Management
{"title":"Guidance on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period (First Edition)","authors":"Guocheng Zhang, Xiaoning Cheng, H. Ding, Zhaoling Shi, Ruying Li, Z. Fu, Qiang Chen, Dongchi Zhao, R. Jin, Guoming Nie, J. Lu, Changshan Liu, D. Zhao, Jiahua Pan, Zhichun Feng, Yuan Shi, Z. Xia, Cheng-zhong Zheng, Jinjin Jiang, Junxia Wang, Yuejie Zheng, Y. Shang, Wei Xiang, Bao-Ping Xu, K. Shen, Tianyou Wang, Yonghong Yang, Q. Lu","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.02.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.02.004","url":null,"abstract":"Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period. \u0000 \u0000Key words: \u0000Novel Coronavirus; Novel Coronavirus Pneumonia; Child; Fever outpatient; Process; Management","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"97-104"},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47159036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.006
Bo-ning Li, Cong Liu, Zhiwei Zhang
The interventional treatment of congenital heart diseases has been developed for more than 50 years since Rashkind et al.performed balloon atrial septostomy in 1966.From the initial catheter examination and palliative operation to the current radical occlusion, stent implantation, valve replacement, etc, interventional catheterization has become one of main means of treating congenital heart disease.The interventional therapy of congenital heart disease in China has made great progress, but there is still a certain gap with developed countries.This article summarizes the progress of interventional treatments in septal defect diseases, aortic artery to pulmonary artery shunt diseases, valvular diseases, and hybrid therapy, in order to provide reference for the interventional treatment of congenital heart disease in China. Key words: Congenital heart disease; Interventional treatment; Child
{"title":"Progress in interventional treatment of children with congenital heart disease","authors":"Bo-ning Li, Cong Liu, Zhiwei Zhang","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.006","url":null,"abstract":"The interventional treatment of congenital heart diseases has been developed for more than 50 years since Rashkind et al.performed balloon atrial septostomy in 1966.From the initial catheter examination and palliative operation to the current radical occlusion, stent implantation, valve replacement, etc, interventional catheterization has become one of main means of treating congenital heart disease.The interventional therapy of congenital heart disease in China has made great progress, but there is still a certain gap with developed countries.This article summarizes the progress of interventional treatments in septal defect diseases, aortic artery to pulmonary artery shunt diseases, valvular diseases, and hybrid therapy, in order to provide reference for the interventional treatment of congenital heart disease in China. \u0000 \u0000 \u0000Key words: \u0000Congenital heart disease; Interventional treatment; Child","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"19-23"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48699892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.022
Yaqian Wang, Chonghuai Yan
Childhood obesity continues to be a public health concern worldwide, which seriously affects children′s health.In recent years, children have been generally exposed to low doses of antibiotics, and antibiotic problem has drawn international attention.Domestic and foreign researches show that antibiotic exposure in the early life of children is associated with childhood obesity risk, while its specific mechanism has not been completely clear.It is possible that antibiotics may lead to changes in the normal intestinal flora colonization of infants and young children and damage the early intestinal microflora, thus increasing the risk of childhood obesity, but further research is needed to confirm this causal mechanism. Key words: Early life; Antibiotic exposure; Child; Obesity; Intestinal flora
{"title":"Research progress on correlation between antibiotic exposure in early life and childhood obesity","authors":"Yaqian Wang, Chonghuai Yan","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.022","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.022","url":null,"abstract":"Childhood obesity continues to be a public health concern worldwide, which seriously affects children′s health.In recent years, children have been generally exposed to low doses of antibiotics, and antibiotic problem has drawn international attention.Domestic and foreign researches show that antibiotic exposure in the early life of children is associated with childhood obesity risk, while its specific mechanism has not been completely clear.It is possible that antibiotics may lead to changes in the normal intestinal flora colonization of infants and young children and damage the early intestinal microflora, thus increasing the risk of childhood obesity, but further research is needed to confirm this causal mechanism. \u0000 \u0000 \u0000Key words: \u0000Early life; Antibiotic exposure; Child; Obesity; Intestinal flora","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"78-80"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46351916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.007
Zhenyu Lyu, M. Jin, Yan Gu, Yan-yan Xiao, Yifei Yang
Objective To analyze the ratio of pulmonary valve ring to aortic valve ring (GA ratio), and to explore the application value of GA ratio in predicting the need of transannular patch in the radical operation of children with tetralogy of Fallot (TOF). Methods A retrospective analysis was performed in 355 children (182 males and 173 females) with TOF and underwent radical operation in the Pediatric Cardiac Center of Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2016 to December 2017.They were divided into transannular patch group and non-transannular patch group.The values of pulmonary valve ring and aortic valve ring in two groups were collected, and the Z-score of pulmonary artery and GA ratio were calculated respectively for statistical analysis. Results Among the 355 patients, 156 children (43.9%) required a transannular patch, and 199 patients (56.1%) did not receive transannular patch.The GA ratio and the Z-score of of pulmonary artery in the transannular patch group were lower than those in the non-transannular patch group [0.45±0.12 vs. 0.54±0.15, (-1.75±0.98) scores vs.(-0.86±1.39) scores], and the differences were statistically significant (t=5.29, 6.32, all P<0.01). Receiver operating characteristic curve analysis showed that in the case of the Z-score of pulmonary artery of -2 for the children received transannular patch, the area under the curve (AUC) was 0.702 (95%CI: 0.64-0.76), sensitivity was 69%, and specificity was 83%; in the case of the GA ratio of 0.58 for the children received transannular patch, the AUC was 0.712 (95%CI: 0.66-0.77), sensitivity was 70%, and specificity was 87%. Conclusions The GA ratio is a simple and effective predictor of transannular patch in the radical operation of TOF and can be applied in clinical practice. Key words: Tetralogy of Fallot; Transannular patch; Z-score of pulmonary artery
{"title":"Application of the ratio of pulmonary valve ring to aortic valve ring to predict the need of transannular patch in the radical operation of tetralogy of Fallot","authors":"Zhenyu Lyu, M. Jin, Yan Gu, Yan-yan Xiao, Yifei Yang","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.007","url":null,"abstract":"Objective \u0000To analyze the ratio of pulmonary valve ring to aortic valve ring (GA ratio), and to explore the application value of GA ratio in predicting the need of transannular patch in the radical operation of children with tetralogy of Fallot (TOF). \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was performed in 355 children (182 males and 173 females) with TOF and underwent radical operation in the Pediatric Cardiac Center of Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2016 to December 2017.They were divided into transannular patch group and non-transannular patch group.The values of pulmonary valve ring and aortic valve ring in two groups were collected, and the Z-score of pulmonary artery and GA ratio were calculated respectively for statistical analysis. \u0000 \u0000 \u0000Results \u0000Among the 355 patients, 156 children (43.9%) required a transannular patch, and 199 patients (56.1%) did not receive transannular patch.The GA ratio and the Z-score of of pulmonary artery in the transannular patch group were lower than those in the non-transannular patch group [0.45±0.12 vs. 0.54±0.15, (-1.75±0.98) scores vs.(-0.86±1.39) scores], and the differences were statistically significant (t=5.29, 6.32, all P<0.01). Receiver operating characteristic curve analysis showed that in the case of the Z-score of pulmonary artery of -2 for the children received transannular patch, the area under the curve (AUC) was 0.702 (95%CI: 0.64-0.76), sensitivity was 69%, and specificity was 83%; in the case of the GA ratio of 0.58 for the children received transannular patch, the AUC was 0.712 (95%CI: 0.66-0.77), sensitivity was 70%, and specificity was 87%. \u0000 \u0000 \u0000Conclusions \u0000The GA ratio is a simple and effective predictor of transannular patch in the radical operation of TOF and can be applied in clinical practice. \u0000 \u0000 \u0000Key words: \u0000Tetralogy of Fallot; Transannular patch; Z-score of pulmonary artery","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"24-26"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42687771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.009
Y. Hua, Bin Li, Kaiyuan Wu, Manman Hu, Xuelan Liu, Xiao-Hui Huang
Objective To investigate the efficacy of Levosimendan in the treatment of postoperative low cadiac output syndrome (LCOS) in infants with congenital heart disease (CHD). Methods Clinical data of patients with CHD developed postoperative LCOS in the Children Heart Center of Fuwai Central China Cardiovascular Hospital from January to December 2018 was collected.In patients that traditional vasoactive drugs failed to alleviate LCOS, the efficacy of continuous infusion of 0.1 μg/(kg·min) Levosimendan was observed.Besides, the mechanical ventilation time, ICU stay time, mortality, the changes of ejection fraction (EF) and central venous oxygen saturation (ScvO2) at the infusion of Levosimendan and 48 h after infusion, as well as the changes of heart rate (HR), systolic blood pressure (SBP), vasoactive drugs score (VIS) and lactic acid at the infusion of Levosimendan and 3 h, 6 h, 12 h, 24 h and 48 h after infusion were recorded. Results There were 29 cases, including 17 males (58.6%) and 12 females (41.4%), with median age of 2 (0.5, 40.0) months, median body mass of 4.7 (2.6, 13.5) kg, median mechanical ventilation time of 109.5 (42.5, 367.0) h, ICU stay time of 187.5 (83, 446) h, and 1 case died (3.4%). EF (48% vs.52%) and ScvO2 (53% vs.58%) increased 48 h after infusion, and the differences were statistically significant (all P<0.01). HR level (173 times/min, 176 times/min, 175 times/min, 173 times/min, 170 times/min, 170 times/min) and lactic acid level (4.72 mmol/L, 4.65 mmol/L, 4.34 mmol/L, 3.79 mmol/L, 3.28 mmol/L, 2.74 mmol/L) gradually decreased after infusion, and the differences of both between the beginning of infusion and 48 h after infusion were statistically significant (P=0.029); SBP decreased and then increased (74 mmHg, 70 mmHg, 71 mmHg, 73 mmHg, 74 mmHg, 75 mmHg, 1 mmHg=0.133 kPa), and VIS increased and then decreased (26 scores, 27 scores, 27 scores, 26 scores, 25 scores, 25 scores) at different time points after infusion, however, the data of both between the beginning of infusion and 48 h after infusion had no significant differences (P=0.294, 0.151). Conclusions Levosimendan can increase EF, enhance myocardial contractility and systemic tissue perfusion, thus improving the prognosis, when Levosimendan was applied for the treatment of postoperative LCOS of infants with CHD. Key words: Infant; Congenital heart disease; Low cardiac output syndrome; Levosimendan
{"title":"Efficacy of Levosimendan on postoperative low cardiac output syndrome of infants with congenital heart disease","authors":"Y. Hua, Bin Li, Kaiyuan Wu, Manman Hu, Xuelan Liu, Xiao-Hui Huang","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.009","url":null,"abstract":"Objective \u0000To investigate the efficacy of Levosimendan in the treatment of postoperative low cadiac output syndrome (LCOS) in infants with congenital heart disease (CHD). \u0000 \u0000 \u0000Methods \u0000Clinical data of patients with CHD developed postoperative LCOS in the Children Heart Center of Fuwai Central China Cardiovascular Hospital from January to December 2018 was collected.In patients that traditional vasoactive drugs failed to alleviate LCOS, the efficacy of continuous infusion of 0.1 μg/(kg·min) Levosimendan was observed.Besides, the mechanical ventilation time, ICU stay time, mortality, the changes of ejection fraction (EF) and central venous oxygen saturation (ScvO2) at the infusion of Levosimendan and 48 h after infusion, as well as the changes of heart rate (HR), systolic blood pressure (SBP), vasoactive drugs score (VIS) and lactic acid at the infusion of Levosimendan and 3 h, 6 h, 12 h, 24 h and 48 h after infusion were recorded. \u0000 \u0000 \u0000Results \u0000There were 29 cases, including 17 males (58.6%) and 12 females (41.4%), with median age of 2 (0.5, 40.0) months, median body mass of 4.7 (2.6, 13.5) kg, median mechanical ventilation time of 109.5 (42.5, 367.0) h, ICU stay time of 187.5 (83, 446) h, and 1 case died (3.4%). EF (48% vs.52%) and ScvO2 (53% vs.58%) increased 48 h after infusion, and the differences were statistically significant (all P<0.01). HR level (173 times/min, 176 times/min, 175 times/min, 173 times/min, 170 times/min, 170 times/min) and lactic acid level (4.72 mmol/L, 4.65 mmol/L, 4.34 mmol/L, 3.79 mmol/L, 3.28 mmol/L, 2.74 mmol/L) gradually decreased after infusion, and the differences of both between the beginning of infusion and 48 h after infusion were statistically significant (P=0.029); SBP decreased and then increased (74 mmHg, 70 mmHg, 71 mmHg, 73 mmHg, 74 mmHg, 75 mmHg, 1 mmHg=0.133 kPa), and VIS increased and then decreased (26 scores, 27 scores, 27 scores, 26 scores, 25 scores, 25 scores) at different time points after infusion, however, the data of both between the beginning of infusion and 48 h after infusion had no significant differences (P=0.294, 0.151). \u0000 \u0000 \u0000Conclusions \u0000Levosimendan can increase EF, enhance myocardial contractility and systemic tissue perfusion, thus improving the prognosis, when Levosimendan was applied for the treatment of postoperative LCOS of infants with CHD. \u0000 \u0000 \u0000Key words: \u0000Infant; Congenital heart disease; Low cardiac output syndrome; Levosimendan","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"32-35"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43567565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A retrospective analysis was conducted on the clinical characteristics and genetic data of a child with Johanson Blizzard syndrome (JBS) admitted to the Pediatric Intensive Care Unit (PICU) of Shanxi Children's Hospital. A 3-month-old female patient was admitted to PICU due to severe pneumonia. Due to clinical features such as delayed growth and development, anal atresia and rectal navicular fistula, typical facial features, and endocrine dysfunction, it is considered that chromosomal diseases cannot be ruled out. After genetic testing, the patient was diagnosed with JBS. JBS is caused by a defect in the E3 ubiquitin ligase UBR1, located at 15q15-21. The gene sequencing results showed that the child (proband) had a compound heterozygous mutation in the UBR1 gene, with the mutations originating from their parents. By reporting on JBS, we aim to enhance clinical physicians' understanding of JBS and avoid misdiagnosis and missed diagnosis; At the same time, it is suggested that gene testing is one of the main methods for diagnosing rare diseases.
{"title":"Cases report of Johanson-Blizzard syndrome caused by compound heterozygous variation of UBR1 gene","authors":"F. Zhang, Chaohai Wang","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.017","url":null,"abstract":"对山西省儿童医院儿童重症医学科(PICU)收治的1例Johanson-Blizzard综合征(JBS)患儿的临床特点及基因资料进行回顾性分析。患儿，女，3月龄，因重症肺炎收入PICU，由于患儿存在生长发育落后，肛门闭锁并直肠舟状窝瘘，典型面部特征及内分泌功能紊乱等临床特点，考虑不能排除染色体疾病，经基因检测确诊为JBS。JBS是由E3泛素连接酶UBR1缺陷引起的，定位于15q15-21。基因测序结果显示，患儿(先证者)UBR1基因存在复合杂合变异，突变分别来源于其父母。通过对JBS的报道，以提高临床医师对JBS的认识，避免漏诊和误诊；同时提示基因检测是诊断罕见病的主要手段之一。","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"62-63"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44085137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.008
Dan Zhang, J. Lai, Xuefeng Sun, XiaoLan Huang, Feng-qi Wu, Zhi-xuan Zhou, Xinyu Yuan, G. Su, Yingjie Xu, J. Hou
Objective To improve the understanding and diagnosis and treatment level of infant with Takayasu arteritis (TA) by analyzing the clinical features of 14 pediatric patients and reviewing related articles. Methods The clinical and follow-up data of infants with TA who were admitted to the Children′s Hospital Affiliated to Capital Institute of Pediatrics between July 2016 and May 2019 were retrospectively analyzed.By reviewing related articles, the clinical features of this disease were summarized. Results The age of 14 patients (including 6 males and 8 females) were between 1 month and 23 days and 28 months.The most common clinical manifestations were fever in 10 cases (71.4%), hypertension in 9 cases (64.3%), weak or no pulse in 5 cases (35.7%). According to the clinical type of lesion vessels, 11 cases (78.5%) were generalized type, 3 cases (21.4%) were brachiocephalic artery type, and there was no thoracic abdominal aorta or single pulmonary artery type in this group.Among 14 infants with TA, 12 cases had common carotid artery, carotid artery, subclavian artery, coronary artery and its branches (anterior descending branch, circumflex branch) involved (85.7%); 11 cases had renal artery involved (78.6%); 9 cases had radial artery involved (64.2%); 8 cases had abdominal aorta involved (57.1%); 6 cases had descending aorta involved (42.9%); 6 cases had thoracic aorta involved (42.9%); 6 cases had superior mesenteric artery involved (42.9%); 5 cases had femoral artery involved (35.7%); 5 cases had pulmonary artery involved (35.7%); and 4 cases had brachial artery involved (28.6%). In those 14 patients, 11 cases were misdiagnosed, and 3 cases had unclear diagnosis, with misdiagnosis duration of 18 days to 2 months.In misdiagnosed cases, 8 cases were misdiagnosed as atypical Kawasaki disease.Among those 14 cases, the ranges of most lesions were gradually decreased, and the slightly involved vessels even completely returned to normal state after treatment in 7 cases.The vascular imaging showed no significant exacerbation or improvement in 4 cases.Nine cases developed hypertension, the blood pressure of whom could be controlled within normal range with hypotensive drugs which could not be interrupted.Physical examination found weak or no pulse in 5 cases who were not improved.Among 14 patients, 7 cases showed normal development, while the height and body mass of another 7 cases were the 25th percentile below those of normal children of the same age.All 14 patients were followed up for 2-22 months and received regular treatment without recurrence. Conclusions TA patients aged less than 3 years tend to have more blood vessels involved, be in serious condition and have higher rate of misdiagnosis.The disease can be controlled quickly after treatment, but vascular diseases may be developed easily.Some patients have a poor prognosis. Key words: Infant; Takayasu arteritis; Clinical features
{"title":"Analysis of clinical features of 14 infants with Takayasu arteritis","authors":"Dan Zhang, J. Lai, Xuefeng Sun, XiaoLan Huang, Feng-qi Wu, Zhi-xuan Zhou, Xinyu Yuan, G. Su, Yingjie Xu, J. Hou","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.008","url":null,"abstract":"Objective \u0000To improve the understanding and diagnosis and treatment level of infant with Takayasu arteritis (TA) by analyzing the clinical features of 14 pediatric patients and reviewing related articles. \u0000 \u0000 \u0000Methods \u0000The clinical and follow-up data of infants with TA who were admitted to the Children′s Hospital Affiliated to Capital Institute of Pediatrics between July 2016 and May 2019 were retrospectively analyzed.By reviewing related articles, the clinical features of this disease were summarized. \u0000 \u0000 \u0000Results \u0000The age of 14 patients (including 6 males and 8 females) were between 1 month and 23 days and 28 months.The most common clinical manifestations were fever in 10 cases (71.4%), hypertension in 9 cases (64.3%), weak or no pulse in 5 cases (35.7%). According to the clinical type of lesion vessels, 11 cases (78.5%) were generalized type, 3 cases (21.4%) were brachiocephalic artery type, and there was no thoracic abdominal aorta or single pulmonary artery type in this group.Among 14 infants with TA, 12 cases had common carotid artery, carotid artery, subclavian artery, coronary artery and its branches (anterior descending branch, circumflex branch) involved (85.7%); 11 cases had renal artery involved (78.6%); 9 cases had radial artery involved (64.2%); 8 cases had abdominal aorta involved (57.1%); 6 cases had descending aorta involved (42.9%); 6 cases had thoracic aorta involved (42.9%); 6 cases had superior mesenteric artery involved (42.9%); 5 cases had femoral artery involved (35.7%); 5 cases had pulmonary artery involved (35.7%); and 4 cases had brachial artery involved (28.6%). In those 14 patients, 11 cases were misdiagnosed, and 3 cases had unclear diagnosis, with misdiagnosis duration of 18 days to 2 months.In misdiagnosed cases, 8 cases were misdiagnosed as atypical Kawasaki disease.Among those 14 cases, the ranges of most lesions were gradually decreased, and the slightly involved vessels even completely returned to normal state after treatment in 7 cases.The vascular imaging showed no significant exacerbation or improvement in 4 cases.Nine cases developed hypertension, the blood pressure of whom could be controlled within normal range with hypotensive drugs which could not be interrupted.Physical examination found weak or no pulse in 5 cases who were not improved.Among 14 patients, 7 cases showed normal development, while the height and body mass of another 7 cases were the 25th percentile below those of normal children of the same age.All 14 patients were followed up for 2-22 months and received regular treatment without recurrence. \u0000 \u0000 \u0000Conclusions \u0000TA patients aged less than 3 years tend to have more blood vessels involved, be in serious condition and have higher rate of misdiagnosis.The disease can be controlled quickly after treatment, but vascular diseases may be developed easily.Some patients have a poor prognosis. \u0000 \u0000 \u0000Key words: \u0000Infant; Takayasu arteritis; Clinical features","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"27-31"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41338485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.010
Yanjun Li, De-kun Du, Junjie Li
Objective To investigate the effects of reducing blood transfusion in ventricular septal defect surgery on the volume of blood transfusion, safety and complications of children. Methods A total of 72 children aged 4-10 years who underwent ventricular septal defect repair at Xinxiang Central Hospital between January 2018 and June 2019 were recruited in the study (38 males, 34 females). The patients were randomly divided into reduced transfusion group (36 cases) and control group (36 cases) in accordance with the random number table.Reduced transfusion group: (1) after anesthesia, 5 mL/kg of blood was drained from the central vein based on blood pressure and stored in a special citric acid anticoagulant blood storage bag which was then put into a 4 ℃refrigerator.(2) hemostasis was performed strictly from skin incision, and after sternum was sawed, the whole body was heparinized, wound bleeding was recovered, and autologous blood recovery device was used.(3) the extracorporeal circulation pipeline was shortened as far as possible, and in case of the intraoperative hematokrit (Hct) of above 0.18-0.20, no red blood cells were transfused.After stopping the extracorporeal circulation, the remaining blood from the membrane lung and pipeline was transfused back.(4) antifibrinolytic drugs were adequately used during operation, and autologous blood recovery device was used to salvage blood after protamine neutralization.(5) hemostatic drugs and hemostatic materials were used.(6) after admitted to intensive care unit (ICU) postoperatively, the blood pressure was controlled at an appropriate level, to avoid bleeding caused by high blood pressure.Blind rehydration should be also avoided, and unnecessary blood thinning should be reduced.(7) encouraging children to get out of bed early after surgery, so as to improve the gastrointestinal activity of children, thus enhancing nutrition.Control group: (1) unconventional preoperative preparation of autologous blood; (2) systemic heparinization before aortic intubation; (3) conventional extracorporeal circulation device; (4) routine treatment in ICU.Primary outcomes including general situation, the rate of erythrocytic transfusion, mean consumption of erythrocytes, intraoperative blood loss, the volume of postoperative drainage, operative time, ventilator weaning time, ICU stay time, hospital stay, hospitalization costs, the incidence of pulmonary infection, secondary endotracheal intubation rate, reoperation rate, intra-transportation colloid osmotic pressure (COP), as well as the intra-transportation, preoperative and postoperative concentration of hemoglobin (Hb) and Hct and those at discharge were compared. Results All 72 patients rehabilitated and discharged from hospital successfully.The rate of erythrocytic transfusion in the reduced transfusion group and control group was 22.22% (8/36 cases) and 83.33% (30/36 cases), respectively, and the difference of which was statistically significant (χ2=93.1
{"title":"Study on the safety of surgical transfusion in reducing ventricular septal defect in children with congenital heart disease","authors":"Yanjun Li, De-kun Du, Junjie Li","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.010","url":null,"abstract":"Objective \u0000To investigate the effects of reducing blood transfusion in ventricular septal defect surgery on the volume of blood transfusion, safety and complications of children. \u0000 \u0000 \u0000Methods \u0000A total of 72 children aged 4-10 years who underwent ventricular septal defect repair at Xinxiang Central Hospital between January 2018 and June 2019 were recruited in the study (38 males, 34 females). The patients were randomly divided into reduced transfusion group (36 cases) and control group (36 cases) in accordance with the random number table.Reduced transfusion group: (1) after anesthesia, 5 mL/kg of blood was drained from the central vein based on blood pressure and stored in a special citric acid anticoagulant blood storage bag which was then put into a 4 ℃refrigerator.(2) hemostasis was performed strictly from skin incision, and after sternum was sawed, the whole body was heparinized, wound bleeding was recovered, and autologous blood recovery device was used.(3) the extracorporeal circulation pipeline was shortened as far as possible, and in case of the intraoperative hematokrit (Hct) of above 0.18-0.20, no red blood cells were transfused.After stopping the extracorporeal circulation, the remaining blood from the membrane lung and pipeline was transfused back.(4) antifibrinolytic drugs were adequately used during operation, and autologous blood recovery device was used to salvage blood after protamine neutralization.(5) hemostatic drugs and hemostatic materials were used.(6) after admitted to intensive care unit (ICU) postoperatively, the blood pressure was controlled at an appropriate level, to avoid bleeding caused by high blood pressure.Blind rehydration should be also avoided, and unnecessary blood thinning should be reduced.(7) encouraging children to get out of bed early after surgery, so as to improve the gastrointestinal activity of children, thus enhancing nutrition.Control group: (1) unconventional preoperative preparation of autologous blood; (2) systemic heparinization before aortic intubation; (3) conventional extracorporeal circulation device; (4) routine treatment in ICU.Primary outcomes including general situation, the rate of erythrocytic transfusion, mean consumption of erythrocytes, intraoperative blood loss, the volume of postoperative drainage, operative time, ventilator weaning time, ICU stay time, hospital stay, hospitalization costs, the incidence of pulmonary infection, secondary endotracheal intubation rate, reoperation rate, intra-transportation colloid osmotic pressure (COP), as well as the intra-transportation, preoperative and postoperative concentration of hemoglobin (Hb) and Hct and those at discharge were compared. \u0000 \u0000 \u0000Results \u0000All 72 patients rehabilitated and discharged from hospital successfully.The rate of erythrocytic transfusion in the reduced transfusion group and control group was 22.22% (8/36 cases) and 83.33% (30/36 cases), respectively, and the difference of which was statistically significant (χ2=93.1","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"36-40"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43085396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.001
Xuepeng Guo
{"title":"Remember the past and keep the teachings in mind, embracing the future and create brilliance","authors":"Xuepeng Guo","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.001","url":null,"abstract":"","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48662493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.021
Xiaoying Qiao, J. Liao
Ketogenic dietary therapy (KDT) is a kind of formulated diet with high fat, low carbohydrates, and appropriate protein and other nutrients, which is mainly used for the treatment of intractable epilepsy in children.The main metabolic change in the body during KDT is the production of a large number of ketone bodies which can not only provide energy, but also plays an important role in inhibiting the transmission of abnormal excitatory signals in the brain.However, the anti-epileptic mechanism of ketone bodies in KDT is still not very clear.Some clinical studies have found that the level of blood ketone is inconsistent with the effect of epilepsy control.The latest progress of research on the synthesis, monitoring, effective concentration range and the relationship with efficacy of ketone bodies in ketogenic diet therapy are reviewed in this article, in order to provide reference blood ketone range in clinical ketogenic diet. Key words: Ketone bodies; Ketogenic dietary therapy; Epilepsy
{"title":"Research progress of ketone bodies in ketogenic diet therapy of epilepsy","authors":"Xiaoying Qiao, J. Liao","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.021","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.021","url":null,"abstract":"Ketogenic dietary therapy (KDT) is a kind of formulated diet with high fat, low carbohydrates, and appropriate protein and other nutrients, which is mainly used for the treatment of intractable epilepsy in children.The main metabolic change in the body during KDT is the production of a large number of ketone bodies which can not only provide energy, but also plays an important role in inhibiting the transmission of abnormal excitatory signals in the brain.However, the anti-epileptic mechanism of ketone bodies in KDT is still not very clear.Some clinical studies have found that the level of blood ketone is inconsistent with the effect of epilepsy control.The latest progress of research on the synthesis, monitoring, effective concentration range and the relationship with efficacy of ketone bodies in ketogenic diet therapy are reviewed in this article, in order to provide reference blood ketone range in clinical ketogenic diet. Key words: Ketone bodies; Ketogenic dietary therapy; Epilepsy","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"74-77"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48744323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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