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Objective:To assess the value of acoustic radiation force impulse (ARFI) elastography in the diagnosis of children with biliary atresia.Methods:A prospective survey of infants with hepatitis syndrome and hyperbi-lirubinemia in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2017 to December 2018 was performed.The children with hepatitis syndrome were divided into the biliary atresia group( n=45) and non- biliary atresia group( n=30). Thirty children with hyperbilirubinemia were selected as the control group.Shear wave speed (SWS) of all infants was collected by ARFI ultrasound and compared among 3 groups.Receiver ope-rating characteristic curve(ROC curve) was used to analyze the optimal threshold value for SWS in the diagnosis of biliary atresia. Results:The mean SWS values in the biliary atresia group, non-biliary atresia group and the control group were (1.79±0.29) m/s, (1.26±0.12) m/s and (1.08±0.06) m/s, respectively.Compared with the control group, the mean SWS values in the biliary atresia group and non-biliary atresia group were significantly higher ( t=165.43, 15.75, all P<0.05). The mean SWS value in the non-biliary atresia group was significantly lower than that in the biliary atresia group ( t=90.27, P<0.05). With the non-biliary atresia group as reference, the area under the ROC curve of SWS for diagnosis of biliary atresia was 0.98(95% CI: 0.95-1.00), the optimal threshold was 1.45 m/s, and the sensitivity and specificity were 88.9% and 96.7%, respectively. Conclusions:Rapid non-invasive ARFI elastography is effective in the diagnosis of biliary atresia, and thus has important value for early diagnosis and treatment in clinical practice.
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Objective@#To investigate retrospectively a modified procedure of two-stage urethroplasty with distal urethral preset for proximal pediatric hypospadias and evaluate the feasibility and advantages of the method.@*Methods@#From January 2013 to January 2018, two-stage urethroplasty with distal urethral preset was performed in 36 boys from 19 months to 15 years old (median age 36 months) with proximal hypospadias. The penile straightening and distal urethroplasty were performed at the first stage, meanwhile, the original urethral opening was preserved. After the distal reconstructed urethra performed in 6 months, the neourethra was connected with proximal meatus to re-establish the continuous urethra. The wound infection, urinary leakage, urethral stricture, appearance of penis and urination were observed after the second stage operation.@*Results@#One case had skin infection around the wound after first stage operation and healed after wound management. Another one case had the distal urethra dehiscence but the wound has no signs of infection. The child had moderate anemia, and the hemoglobin is 80 g/L.It was therefore considered that anemia was the cause. The hemoglobin level was normal during the second stage operation, and repaired by Snodgrass method in the second stage. Five cases had the balanue dehiscence.Thirty case had being succeeded after the first stage, included a case of wound infection 5 days after operation. Three cases developed urethral fistula after the second stage repair, which were mended in the third stage. At a mean follow-up of 20 months postoperatively (14 to 48 months), all patients had satisfied appearance of penis, unobstructed urination and continuous urine line, without urinary fistula, urethral stricture and urethrocele at the second stage repair.@*Conclusions@#The distal urethral preset and staged procedure is a feasible operation that corrects proximal hypospadias with few complications and with good cosmetic and functional outcomes.
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Objective To investigate the value of color Doppler ultrasonography in the differential diagnosis of benign and malignant testicular tumors in children. Methods The sonographic findings of 63 children pathologically confirmed testicular tumors were retrospectively analyzed.All children were divided into benign group and malignant group according to pathologic diagnosis. The tumor size,shape,border, echo texture,calcification and color blood flow were compared between two groups. Logistic regression analysis was employed to predict sonographic features of benign and malignant testicular tumors.Receiver operating curve (ROC) was employed to assess the diagnostic performance of sonographic features. Results Among the 63 cases of pediatric testicular tumors,42 cases were histologically confirmed as benign testicular tumors (66.7% ),and the rest 21 cases were malignant testicular tumors (33.3% ). The maximum diameter of tumor in benign tumors was significantly smaller than that in malignant tumors[(1.75 ± 0.75) cm vs (2.90 ± 1.22)cm,P =0.000].In the sonographic features,malignant testicular tumors were more likely to present with solid masses,and benign testicular tumors were more likely to be cystic or cystic-solid ( P =0.024).Calcification was more common in benign tumors than that in malignant tumors ( P =0.000).Compared with benign tumors,malignant tumors had increased blood flow on color Doppler images ( P =0.000).Logistic regression analysis indicated that flow grade was the independent prognostic factors for malignant tumor. By using Alder grade of 2 or above as threshold,the sensitivity,specificity and accuracy were 95.2%,78.6% and 84.1%,respectively. Conclusions The sonographic features vary between benign and malignant testicular tumors. Blood flow is the independent factors for predicting malignant tumor. Color Doppler ultrasonography is an important method for differential diagnosis of testicular tumors in children.
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Objective To inquire into the molecular epidemiology of enterovirus 71 ( EV71 ) in our region by analyzing the whole genome characteristics and genetic evolution of EV 71 strains isolated from Guizhou area. Methods The throat swabs samples of hospitalized children with hand,foot and mouth disease in Guizhou province from 2013 to 2015 were collected,the virus nucleic acid were extracted,then the whole genome of virus were piecewise amplified by reverse transcription polymerase chain reaction( RT-PCR) and sequenced. Sequencing results were edited and spliced by DNAMAN8. 0 software,then the viral genome se-quences were compared with genome sequences of other EV71 strains in the genebank by Blastn,the phyloge-netic tree was constructed by the Neighbor-Joining method in MEGA5. 2 software. Results The whole ge-nome sequences of 17 EV71 strains were successfully isolated and amplified,the whole genome length of 17 EV71 isolates was 7405 base pair,encoded about 2193 amino acids. The 17 isolates were divided into ten species of amino acid sequences by 12 differences of amino acid among the strains,different sequences and clinical types had not shown regularity and correlation. The nucleotide homology in VP1 region,5′untranslat-ed region(5′UTR) and 3′untranslated region (3′UTR) were high among 17 EV71 isolates. The results that the whole genome of 17 EV71 isolates was compared with representative strains of EV71 A,B,C genotype and coxsakievirus A 16 ( CA16) showed that 17 EV71 isolates had higher homology with EV71 C4a sub-type,95. 3%-98. 1%,and the lowest homology with CA16. The phylogenetic tree was constructed based on nucleotide sequence of the whole genome,VP1 region and 5′untranslated region of 17 isolates showed that the 17 isolates were clustered into one cluster,and were clustered in the same branch with C4a isoforms,the phy-logenetic relationships among different regions were different. Conclusion The popular genotype of EV71 strains in Guizhou area for 2013-2015 was C4a subtype,consistenting with the genotype of popular EV71 in other regions of China. EV71 strains hasn′t the antigen transformation and input of a new subtype temporari-ly,but exist nucleotide and amino acid changes,so need be chronically and dynamically monitored. There is no correlation between the amino acid sequence difference of 17 EV71 isolates and the state of an illness.
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Objective To investigate the diagnostic performance of acoustic radiation force impulse (ARFI) imaging in assessing liver cirrhosis preoperatively in infants with biliary atresia (BA).Methods A total of 64 consecutive infants with BA who underwent ARFI imaging in 3 days before Kasai surgery were recruited.Virtual Touch Quantification mode was used to measure shear wave speed (SWS),All infants with BA underwent liver biopsy during the surgery.The mean SWS of infants with and without liver cirrhosis were compared and analyzed.The diagnostic efficacy of SWS was observed using ROC curves.Results Liver cirrhosis was found in 8 of 64 infants.The mean SWS in infants with cirrhosis was significant-ly higher than that in infants without cirrhosis ([2.51±0.50]m/s vs [1.74±0.31]m/s,t=6.039,P＜0.001).The cutoff value of SWS for predicting liver cirrhosis was 2.16 m/s,the area under ROC curve was 0.930 (P＜0.001),and the diagnostc sensitivity and specificity was 87.50％ and 92.86％,respectively.Conclusion ARFI imaging is helpful to predic tion of liver cirrhosis in infants with BA preoperatively.It may be an effective method for clinical management and prognosis prediction in infants with BA.
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Objective To inquire into the molecular epidemiology of enterovirus 71 ( EV71 ) in our region by analyzing the whole genome characteristics and genetic evolution of EV 71 strains isolated from Guizhou area. Methods The throat swabs samples of hospitalized children with hand,foot and mouth disease in Guizhou province from 2013 to 2015 were collected,the virus nucleic acid were extracted,then the whole genome of virus were piecewise amplified by reverse transcription polymerase chain reaction( RT-PCR) and sequenced. Sequencing results were edited and spliced by DNAMAN8. 0 software,then the viral genome se-quences were compared with genome sequences of other EV71 strains in the genebank by Blastn,the phyloge-netic tree was constructed by the Neighbor-Joining method in MEGA5. 2 software. Results The whole ge-nome sequences of 17 EV71 strains were successfully isolated and amplified,the whole genome length of 17 EV71 isolates was 7405 base pair,encoded about 2193 amino acids. The 17 isolates were divided into ten species of amino acid sequences by 12 differences of amino acid among the strains,different sequences and clinical types had not shown regularity and correlation. The nucleotide homology in VP1 region,5′untranslat-ed region(5′UTR) and 3′untranslated region (3′UTR) were high among 17 EV71 isolates. The results that the whole genome of 17 EV71 isolates was compared with representative strains of EV71 A,B,C genotype and coxsakievirus A 16 ( CA16) showed that 17 EV71 isolates had higher homology with EV71 C4a sub-type,95. 3%-98. 1%,and the lowest homology with CA16. The phylogenetic tree was constructed based on nucleotide sequence of the whole genome,VP1 region and 5′untranslated region of 17 isolates showed that the 17 isolates were clustered into one cluster,and were clustered in the same branch with C4a isoforms,the phy-logenetic relationships among different regions were different. Conclusion The popular genotype of EV71 strains in Guizhou area for 2013-2015 was C4a subtype,consistenting with the genotype of popular EV71 in other regions of China. EV71 strains hasn′t the antigen transformation and input of a new subtype temporari-ly,but exist nucleotide and amino acid changes,so need be chronically and dynamically monitored. There is no correlation between the amino acid sequence difference of 17 EV71 isolates and the state of an illness.
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Objective To investigate the diagnostic performance of acoustic radiation force impulse (ARFI) imaging in assessing liver cirrhosis preoperatively in infants with biliary atresia (BA).Methods A total of 64 consecutive infants with BA who underwent ARFI imaging in 3 days before Kasai surgery were recruited.Virtual Touch Quantification mode was used to measure shear wave speed (SWS),All infants with BA underwent liver biopsy during the surgery.The mean SWS of infants with and without liver cirrhosis were compared and analyzed.The diagnostic efficacy of SWS was observed using ROC curves.Results Liver cirrhosis was found in 8 of 64 infants.The mean SWS in infants with cirrhosis was significant-ly higher than that in infants without cirrhosis ([2.51±0.50]m/s vs [1.74±0.31]m/s,t=6.039,P＜0.001).The cutoff value of SWS for predicting liver cirrhosis was 2.16 m/s,the area under ROC curve was 0.930 (P＜0.001),and the diagnostc sensitivity and specificity was 87.50％ and 92.86％,respectively.Conclusion ARFI imaging is helpful to predic tion of liver cirrhosis in infants with BA preoperatively.It may be an effective method for clinical management and prognosis prediction in infants with BA.
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Objective To characterize the population dynamics and spatial distribution of Aleuroglyphus ovatus in the flour warehouse,so as to provide the basic evidence for improving the sampling guidelines that are essential for effective pest monitor?ing and management. Methods The samples from flour warehouses of four localities were collected,examined and counted for A. ovatus in every month in Wuhu City. The dispersion pattern target,Iwao m*/-x regression analysis and Taylor power method were used for analyzing the spatial distribution pattern of A. ovatus in the flour warehouses. Results The peaks of population dynamics of A. ovatus were discovered in July and September,respectively. The indexes of dispersion were as follows:I>0, CA>0,m*/-x >1. At the same time,the parameters in the equation of Iwao:m*=5.471+1.022-x (r=0.999)and Taylor:lgS2=0.697+1.111 lg-x (r=0.987)showed that the spatial distribution pattern of A. ovatus was assembled. Conclusion The peaks of population dynamics of A. ovatus in the flour warehouse are bimodal pattern ,and the spatial distribution pattern of A. ovatus is assembled.
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Objective To investigate the epidemic situation of Metorchis orientalis in Wuhu City Anhui Province. Meth?ods Three lakes Fengming Longwo and Kui lakes were selected in Wuhu City and the poultries around the lakes and fresh?water fishes in the lakes were captured to test the infection of M. orientalis and the infection rates were calculated. Results The adult worms of M. orientalis were found in gall bladder and hepatic duct of domestic ducks with infection rate of 16.7%. The metacercariae of M. orientalis were discovered in the muscle of Pseudorasbora parva and Pseudogobio rivularis with infection rates of 7.13%and 3.38%respectively. Conclusion M. orientalis is endemic in Wuhu City which should be paid enough at?tention to the animal husbandry aquaculture and medicine.