ABSTRACT
Objective To study the clinical features, diagnosis and treatment of torsion of testes in newborn. Method Neonates who were diagnosed with neonatal testicular torsion and admitted to Shenzhen Children's Hospital from March 2008 to July 2018 were studied. The clinical data such as days in age, time of onset, clinical manifestations, time of ultrasound examination, characteristics of ultrasound examination, surgery time, surgical types, postoperative conditions, pathological findings, and follow-up results were retrospectively analyzed. Result A total of 12 infants with torsion of testes were enrolled. The average onset time was 2.9 d, ranged from 1～10 d. The time of onset was within 24 h after birth in six infants. The median duration from onset to seeing a doctor was 3.5 d, ranged from 2 h to 28 d. First manifestations being reported grammer were scrotal swelling or mass, including 7 cases on the left side and 5 cases on the right side. Among them, 9 cases were associated with redness or cyanosis of the scrotum. Ultrasound was characterized by the disappearance or significant reduction of testicular parenchymal blood flow signal, and the sensitivity of ultrasound was 100％. The average time from admission to operation was (2.1±1.1) h. All the 12 infants had orchiectomy,after necrosis of unilateral testicle was confirmed. Eight of them underwent contralateral test icular fixation. The average operation time was 46 min. There was no wound bleeding or infection postoperatively, and the average hospital stay was 6.4 d. The pathological features were blurred residual contour of the seminiferous tubule (9 cases) or the disappearance of the seminiferous tubule structure (3 cases). After 3 to 24 months of follow-up, no contralateral testicular torsion or atrophy was found. Conclusion The rate of testicular necrosis in children with torsion of testes is high. The newborn with scrotal swelling should be diagnosed promptly with color Doppler ultrasound. If necessary, surgical exploration should be performed in time.
ABSTRACT
Objective To investigate the relationship between interventricular septum thickness(IVS) and renal function in patients with diabetes mellitus.Methods Two hundred and sixty-five patients of type 2 diabetes without dialysis were enrolled in a cross-sectional study.According to their IVS,the patients were divided into normal group (IVS≤ 11 mm) and higher IVS group (IVS ＞ 11 mm).All patients according to evaluated glomerular filtration rate (eGFR) level were divided into eGFR≥60 ml· min-1 · (1.73 m2) 1 group and eGFR ＜ 60 ml· min-1 · (1.73 m2)-1 group.The demographic characteristic,biochemical examination,eGFR,and proteinuria of different groups were compared.Pearson or spearman correlation was used to analyze the relationship between eGFR,IVS and other parameters.eGFR ＜ 60 ml · min-1 · (1.73 m2)-1 and IVS thickening were analyzed by binary logistic regression.Risk factors affect the prognosis of renal function in patients with diabetes mellitus were analyzed by Cox regression analysis.Results Compared with normal group,patients in the higher IVS group had higher systolic pressure (P=0.002),their level of Scr,BUN,24 h urinary protein were increased (all P ＜ 0.05),while the level of eGFR,albumin (ALB),hemoglobin (Hb) and fasting blood glucose were decreased (all P ＜ 0.05).The prevalence of hypertension was increased (81.16％ vs 58.67％,x2=11.273,P=0.001),and there was also a difference in the proportion of patients in each stage of CKD (x2=34.593,P ＜ 0.001).Correlation analysis showed that IVS was positively correlated with BMI,systolic BP,Scr,BUN,24 h urinary albumin,24 h urinary protein (all P ＜ 0.05),while negative correlation was observed between the thickened degree of IVS and Hb,albumin,eGFR and total calcium (all P ＜ 0.05).It's worth noting that IVS also correlated with history of hypertension and degree of renal injury (all P ＜ 0.01).Logistic regression analysis showed that longer duration of diabetes,higher systolic pressure and BUN were independent risk factors for eGFR ＜ 60 ml·min-1·(1.73 m2)-1 (all P ＜ 0.05),while higher Hb and Alb were independent protective factors for eGFR ＜ 60 ml· min-1· (1.73 m2)-1 (all P ＜ 0.05).Logistic regression analysis also showed that the baseline increased Scr was independent risk factor for interventricular thickening (P ＜ 0.05),while the increase of fasting blood-glucose was independent protective factor for interventricular thickening (P ＜ 0.05).Cox regression analysis showed that interventricular thickening was an independent risk factor in predicting the progression of type 2 diabetes (HR=1.396,95％ CI=1.098-1.774,P=0.006).Conclusion Interventricular septum thickness is closely related to the state of renal function,as well as is an independent risk factor to predict kidney function decline in patients with type 2 diabetes.