ABSTRACT
Objective To understand the infection status, epidemiological characteristics and genetic evolution of adenovirus in children with diarrhea in Tianjin. Methods A total of 1609 fecal specimens were collected from hospitalized children with diarrhea from July 2017 to July 2018 in Tianjin Children's Hospital. Viral nucleic acid was extracted and amplified by the hexon gene fragment. Positive specimens were used for nucleic acid sequence determination and sequence alignment and phylogenetic tree analysis with known sequences in GenBank. Rotavirus in the stool specimens was detected by gold standard method, and campylobacter was detected by latex agglutination method. Bocavirus, Norovirus and Clostridium difficile were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Results A total of 69 specimens with adenoviruses were detected in 1609 cases, with a positive rate of 4.3％, in which 82.6％adenovirus-positive children were between 7 and 48 months old. The positive rate of adenovirus peaked in the summer and autumn, and the differences of this value among seasons were statistical significance (χ2=11.467,P=0.009). In these cases, the mixed infection rate of adenovirus was 26.1％(18/69), in which 7 cases were mixed with Norovirus, 7 cases were mixed with rotavirus and 4 cases were mixed with Clostridium difficile. A total of 39 adenovirus-positive PCR products were randomly selected for gene sequence detection, and 7 adenovirus genotypes were detected. Results showed that these viruses were mainly the type 41 enteric adenovirus (46.1％, 18/39), followed by type 31, type 3 and type 7 non-intestinal adenovirus, while types 1, 5 and 6 were relatively rare. Conclusions There are diverse types of adenovirus in children with diarrhea in Tianjin. The adenovirus-infected diarrhea mostly happen in summer and autumn, and is common in children.
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Objective To explore the feasibility of laparoscopic surgery in the treatment of pediatric periappendicural abscess.Methods A total of 22 cases of pediatric periappendicural abscess were treated with laparoscopic surgery from April 2013 to May 2016.In the operation, we performed the separation from the side of the abdominal wall and abscess adhesion, and then lifted the abscess for blunt separation into the abscess cavity.After the management of appendix stump, the abdominal cavity was washed and a peritoneal drainage tube was placed.Results Laparoscopic appendectomy was performed successfully in all the cases.No conversion to open laparotomy was needed.The operation time was (65.3±8.2) min, the intraoperative blood loss was (10.5±4.2) ml, and the postoperative hospitalization was (6.5±1.4) days.Follow-ups for 6-24 months (mean, 12 months) in the 22 cases found no complications, such as abdominal abscess, stump fistula, stump appendicitis or adhesive ileus.Conclusion The application of laparoscopic surgery in the treatment of pediatric periappendicural abscess is feasible and safe.
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Objective To evaluate the clinical features and key points in treatment of ovarian torsion in children. Methods The clinical data of 64 children with ovarian torsion, hospitalized in our hospital from January 2005 to October 2012, were analyzed retrospectively. The clinical manifestations in children of all ages were summarized. The anal examina-tion, B ultrasound examination, CT examination were used for the early diagnosis of ovarian torsion. All children were per-formed laparoscopic surgical exploration. All children were found the typical lower abdominal cramps. The B ultrasound and CT examination showed non-homogeneous mass in pelvic, which suggested the early diagnosis of ovarian torsion. The detec-tion rate of anal examination reached 70.3%(45/64). Results All patients were performed laparoscopic surgical explora-tion. Five patients were treated with ovariectomy. The rest were treated conservatively. The postoperative follow-up was good. Conclusion Ovarian torsion in children was likely to be misdiagnosed. Doppler, CT, anal examination and laparo-scopic operation were important for the early diagnosis and treatment of ovarian torsion.