Surgical treatment and outcome of primary tracheobronchial tumors in 15 children / 中华胸心血管外科杂志

Objective:To investigate the clinical manifestation, pathological types, treatment and prognosis of primary tracheobronchial tumors in children.Methods:We retrospectively studied the primary tracheobronchial tumors patients who diagnosed from May 2009 to Jan 2021 in Guangzhou Women and Children Medical Center. The clinical manifestations, pathological types, therapeutic methods and prognosis were analyzed.Results:There were 15 patients identified as the primary tracheobronchial tumors, including synovial sarcoma (1 case), pulmonary inflammatory myofibroblastic tumor(IMT 4 cases), mucoepidermoid carcinoma(7 cases), infantile hemangioma (1 case), Ewing's sarcoma (1 case). Respiratory symptoms are the most complaint at the time of diagnosis including 15 patients with cough, 2 with hemoptysis, and 1 with dyspnea. Endoscopic treatment of tracheobronchial tumors was performed under extracorporeal membrane oxygenation (ECMO) support in 1 patient. Sleeve lobectomy was performed in 3 patients, lobectomies in 6, and local tumor resections in 4 patients including 2 patients suffered second surgery due to tumor recurrence.Conclusion:The clinical manifestations of the primary tracheobronchial tumors in children are nonspecific. Complete resection led to excellent outcome.

Screening and influencing factors analysis for nutritional status in hospitalized children with pectus excavatum / 中华实用儿科临床杂志

Objective@#To screen the hospitalized children with pectus excavatum for nutritional status, and to analyze the influencing factors of nutritional status, then to provide the scientific basis for comprehensive management of clinical nutrition.@*Methods@#The body mass index (BMI) of 360 hospitalized children with pectus excavatum in Guangzhou Women and Children′s Medical Center from January 2013 to December 2017 were reviewed and compared with World Health Organization standard and the emaciation rate was calculated.The influencing factors such as CT index, age, weight, height, sex, the width of thorax and surgical treatment were analyzed with BMI.@*Results@#Compared with the lowest standard of BMI, the whole emaciation rate of hospitalized children with pectus excavatum was 93.61% (337/360 cases): in which severe, moderate and slight emaciation were 74.17% (267/360 cases), 13.33% (48/360 cases), and 6.11% (22/360 cases), respectively.BMI was negatively related with CT index (r=-0.172, P=0.001), but positively related with age, weight, height, and the width of thorax (r=0.129, 0.342, 0.022, 0.179, P=0.014, 0.001, 0.673, 0.001). Three years after Nuss procedure, both the whole and severe emaciation rate decreased (93.62% vs. 95.74%; 65.96% vs. 78.72%), but the weight, height and BMI increased [25.5(12.5, 38.5) kg vs.17.0(10.0, 24.0) kg; 126.0(99.0, 153.0) cm vs.108.0(74.5, 143.5) cm; 14.69(12.38, 17.00) kg/m2 vs. 14.36(12.17, 16.56) kg/m2], and the differences were significant (all P<0.01).@*Conclusions@#There is a high nutritional risk in hospitalized children with pectus excavatum, and the deformity severity is the main risk factor.Surgical treatment can improve the nutritional status effectively, but the malnutrition in pectus excavatum can not be corrected completely.

Application of gastric tube esophagoplasty to complicated diseases of esophagus in children / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To summarize the experience of applying gastric tube esophagoplasty for complicated diseases of esophagus in children and the short-middle-term efficacy.</p><p><b>METHODS</b>A retrospective and observational case series study was performed.</p><p><b>INCLUSION CRITERIA</b>(1) burn length of esophagus > 2 cm, multisegmental or extensive esophageal scar stenosis, and about 6 months after burn; (2) longitudinal diameter of esophageal tumor > 2 cm, or esophagus considered as impossible to reserve;(3) Severe esophageal fistula with diameter > 2 cm, or relapse again after ≥3 times of repair; (4) Tracheal cartilaginous esophageal heterotopia with a length of >2 cm or no end to end anastomosis after removal of the esophageal lesion.</p><p><b>EXCLUSION CRITERIA</b>patients with severe cardiopulmonary insufficiency, or poor prognosis of gastric primary disease; the gastric volume did not allow long enough gastric tube; the parents did not accept the surgery. According to above criteria, 36 children with complicated diseases of esophagus who underwent gastric tube esophagoplasty at Department of Thoracic Surgery, Guangzhou Women and Children's Medical Center from March 2010 to June 2017 were enrolled into this study. Among 36 children, 27 were with corrosive strictures of esophagus, 5 with esophageal tumor, 3 with severe esophageal fistula, and 1 with tracheal cartilaginous esophageal heterotopia. Above-mentioned 27 cases with corrosive strictures of esophagus underwent gastric tube esophagoplasty via retrosternal route with preservation of the original esophagus. The other 9 cases underwent resection for esophageal lesion and gastric tube esophagoplasty via prevertebral route. The construction of gastric tube was as follows: the stomach was cut along the lesser curvature from pylorus to cardia and fundus of stomach with stapler, making the diameter of the gastric tube equal to pylorus. Operative time, intra-operative bleeding, time of mechanical ventilation, anastomotic leakage, anastomotic stricture were observed. The postoperative short-middle-term growth presentation of children was evaluated according to CDC 2000 children growth evaluation table(2 to 20 years).</p><p><b>RESULTS</b>All the 36 children survived their operations successfully. Nine cases underwent esophagectomy for lesion esophagus and the other 27 cases received preservation of original esophagus. Average time of postoperative mechanical ventilation was 8 (4-20) hours. Three cases developed anastomotic leakage and were healed after one week. Eight cases developed anastomotic stricture and resumed normal diet after balloon expansion. The patients were followed up from 6 months to 7 years. Five cases were found to have esophageal cyst 4-8 months after the operation, and received resection. One children with infantile esophageal fibrosarcoma recurred 3 weeks after the operation and died 2 weeks later because the family abandoned the treatment. The quality of life of 35 cases was improved significantly. Short-middle-term body height and weight in 85.7%(30/35) children met basically the criteria of CDC 2000 children growth evaluation table.</p><p><b>CONCLUSION</b>Gastric tube esophagoplasty can effectively treat the children with complicated esophagus diseases with good short-middle-term efficacy, and is a recommended esophageal replacement surgery.</p>

B value of magnetic resonance DWI combined with dynamic enhanced scan imaging in the early diagnosis of prostate cancer / 中国基层医药

Objective To explore the early diagnostic value of multi b value magnetic resonance diffusion weighted imaging ( DWI) combined with dynamic enhanced scan imaging for the early diagnosis of prostate cancer . Methods The clinical data of 43 patients with prostate cancer admitted to the Fifth Affiliated Hospital of Southern Medical University from January 2015 to July 2017 were analyzed.All patients underwent routine MRI examination , including 38 cases of DWI examination ,32 cases of dynamic enhanced MRI ,and 30 cases of combined examination . The values of B were 600,800,1000s/mm2 ,and the apparent diffusion coefficient ( ADC) of the DWI high signal region and the analysis of ADC were measured .Results According to different b values , the ADC value could be calculated by drawing ROC curves.When the b value was 600s/mm2,the ADC threshold was 1.62 ×10 -3 mm2/s;when b value was 800s/mm2 ,the threshold was 0.45 ×10 -3 mm2/s;when the b value was 1000s/mm2 ,the threshold value was 1.39 ×10 -3mm2/s.When the b value was 800s/mm2,the diagnosis effect was the best for prostate cancer . The sensitivity,specificity and accuracy of multi b value DWI combined with dynamic enhanced MRI in diagnosing prostate cancer were 83.33％,96.67％ and 93.33％,respectively.Conclusion Multiple b value DWI and dynamic enhanced MRI have distinctive characteristics in the diagnosis of prostate cancer .Their combination makes up their deficiency and greatly improves the early diagnosis rate of prostate cancer .

The application of 3-D scanning in the diagnosis and evaluation of pectus excavatum / 中华胸心血管外科杂志

Objective To investigate the application of 3-D scanning in the diagnosis and evaluation of pectus excava-tum.Methods From July 2016 to June 2017, chest CT concomitant 3-D scanning were performed in 90 pectus excavatum pa-tients before Nuss procudure.Another 30 cases underwent chest CT scanning for non-chest deformity causes were chosen as a control group.The transverse and anterior-posterior maximum diameter through the deepest point of chest wall deformity were measured.The surface topography index and Haller index were calculated respectively .Results There was a positive correla-tion between CT and 3-D scanning diameters of the transverse and anterior-posterior maximum diameters, and consistency rates were 94% and 82%, respectively.There was significant difference between pectus excavatum group 1.82 ±0.21 and control group 1.41 ±0.07 in the STI(P<0.001).There was a positive correlation between Haller index 5.12 ±3.36 and STI 1.82 ± 0.21, and consistency rate was 89%.The Delong's test showed no significant difference between ROC of HI and STI(Z =1.18, P=0.28).Conclusion 3-D scanning and STI of pectus excavatum is a validated alternative for CT and Haller index, especially in the infant and non-surgical treatment PE cases.

One case of adult X-linked adrenoleukodystrophy characterized by cerebellar brainstem symptoms / 中华神经科杂志

X-linked adrenoleukodystrophy is an X-linked recessive genetic disease that mainly affects adrenal and white matter,mostly onset in childhood or adolescence,mainly manifested as progressive psychomotor disorder,visual and hearing loss and/or adrenocortical dysfunction,etc.A case of adult X-linked adrenoleukodystrophy in our hospital is reported and analyzed.The patient's early performances were unclear speech and low emotions,and no obvious positive signs,repeatedly diagnosed as "neurosis".Then gradually emerged drinking cough and unsteady walking,and physical examination showed brainstem and cerebella positive signs.Brain MRI was characterized by symmetrical lesions of bilateral cerebellar hemisphere,bilateral pontine arm,brainstem and pyramidal tract of internal capsule posterior limb,which was reconsidered as " spinal cerebellar degeneration" Finally,the disease was confirmed by gene examination as adrenoleukodystrophy.By summarizing the characteristics of the patient,we hope to provide diagnostic reference for patients with atypical adrenoleukodystrophy.

Statistics and Analysis of 20353 Cases of Pharmaceutical Consultations in a Hospital / 中国药房

OBJECTIVE:To provide reference for improving pharmaceutical consultations and the quality of pharmaceutical care. METHODS:The records of pharmaceutical consultations were collected from medication consultation center of Huilong-guan district in our hospital during Jan. 2014-Dec. 2016,and then summarized in terms of consultants composition,consultation form,consulting contents and drugs consulted,while Pareto Diagram was used to analyze the main and minor factors of consult-ing contents. RESULTS:The medication consultation center provided pharmaceutical consultations 20353 cases during 2014-2016. Main consultants were patients (20039 cases,98.5%). A total of 6307 persons were involved,mostly female (3646 persons,57.8%). Face to face was the most common consulting method (19440 cases,95.5%). There were 13 types of consulting contents,among which usage and dosage and guidance for special formulation use were the main factors,including 10392 cases (51.1%) and 3844 cases (18.9%). Among 20353 cases of pharmaceutical consultations,18874 cases of in-volved drugs,and involved 11 categories,mostly respiratory drugs (11756 cases,62.3%). CONCLUSIONS:Usage and dos-age and guidance for special formulation use are the main contents of pharmaceutical consultations in the hospital district. The services of pharmaceutical consultations for patients,physicians and nurses provided by pharmacists can solve the questions on medications,and can promote rational drug use in clinic.

CT characteristics and clinical analysis of pulmonary cryptococcosis / 实用放射学杂志

Objective To analyze the CT findings of pulmonary cryptococcosis (PC)in patients without HIV infection.Methods CT data of 26 patients with PC proved by pathology were analyzed retrospectively.All cases underwent plain CT scan,8 of whom underwent contrast-enhanced CT scan.Results 26 patients (17 male and 9 female),single lesion on CT was found in 11 cases,multiple nodules or masses in 10 cases,and mixed-type lesions in 5 cases.The lesion was located in left lung in 1 1 cases,in right lung in 7 cases and bilateral lungs in 8 cases.The lesions with burr sign were found in 1 9 cases,with cavities or vacuoles in 10 cases,and with halo sign in 8 cases.Enhanced CT showed marked heterogeneity in 1 case,moderate heterogeneity in 2 cases,slight enhancement in 3 cases and nonenhancement in 2 cases.Conclusion Lesions of PC with various CT findings are easy to be misdiagnosed as lung carcinoma or other lesions.CT-guided percutaneous lung biopsy is an effective method for diagnosis.

Clinical characteristics, diagnosis and treatment of pulmonary inflammatory myofibroblastic tumor in children / 中华肿瘤杂志

Objective@#To explore the clinical characteristics, diagnosis and treatment of pulmonary inflammatory myofibroblastic tumor in children.@*Methods@#The clinical data of 13 patients with pulmonary inflammatory myofibroblastic tumor between October 2009 and October 2015 were retrospectively analyzed, including 9 boys and 4 girls aged 1 to 12 years 4 months (mean 4 years 9 months). Seven patients underwent total tumor resection, 4 had lobectomy, 1 had partial tumor resection and 1 had biopsy. The follow-up time ranged from 2 months to 6 years and 2 months.@*Results@#Among the 13 patients, 9 were cured. Two patients lived with tumor. One of them had tumor which shrinked gradually and the other had stable disease. One patient with multiple lesions encountered recurrence after 3 operations and developed suspicious hepatic metastasis. One died during the operation because of airway mismanagement.@*Conclusions@#Pulmonary inflammatory myofibroblastic tumor in children has rather good prognosis while a few cases have the potential of recurrence and canceration. Surgery is the primary therapeutic approach. Close post-operative follow up is necessary.

Screening and characteristics of children of Miao and Dong nationalities with mediterranean anemia in ethnic minorityareas of Qiandongnan State of Guizhou Province / 吉林大学学报(医学版)

Objective:To discuss the screening results and clinical characteristics of children of Miao and Dong nationalities with mediterranean anemia in ethnic minority areas of Qiandongnan State of Guizhou Province,and to clarify the differences of the mediterranean anemia among different minorities.Methods:A total of 1 623 children of Miao and Dong nationalities with mediterranean anemia in minority areas of Qiandongnan State were selected by multistage stratified random sampling method;quantitative analysis of HbA2 and HbF was used to screen the selected children with mediterranean anemia initially;phenol chloroform extraction method was applied to extract the DNA from the children with mediterranean anemia;ASO/RDB-PCR reverse dot blot hybridization method was used to analyze the gene characteristics of the children with mediterranean anemia.Results:A total of 1 623 children of Miao and Dong nationalities were selected as the subjects.Among 938 children with Miao nationality,there were 18 children with positive α-mediterranean anemia and 36 children with positive β-mediterranean anemia,and the positive detection rate was 1.92%.Among 685 children with Tong nationality,there were 13 children with positive α-mediterranean anemia and 24 children with positive β-mediterranean anemia,and the positive detection rate was 3.50%.The detection rates of composite of α-and β-mediterranean anemia in the children of Miao nationality and Tong nationality were 1.49% and 4.61%.There was no significant difference in the detection rates of different kinds of mealiterranean anemia between two nationalities (P<0.05).The major gene mutations in α-mediterranean anemia were——SEA/-αα and-α3.7,and the major gene mutations in β-mediterranean anemia were CD17/N and CD14-15/N,while the major gene types of the composite of α-and β-mediterranean anemia were——SEA/β41-42 and——SEA/β17.There was no difference in the positive rates of major gene types of different kinds of mediter ranean anemia between two nationalities(P<0.05).Conclusion:There is no difference in the positive rate of children of Miao and Dong nationalities with mediterranean anemia in minority areas of Qiandongnan State.CD17/N,——SEA/-αα and ——SEA/β41-42 are the major gene types of α-,β-,and αβ-mediterranean anemia,respectively.

Short-term impact of fast track surgery combined with minimally invasive surgery on elderly patients with colorectal cancer / 中国内镜杂志

Objective To analyze the short-term impact of fast track surgery (FTS) combined with minimally inva-sive surgery on elderly patients with colorectal cancer. Methods 200 patients with colorectal cancer received laparo-scopic surgery from July 2013 to July 2015 were selected and randomly divided into control group and FTS group. Patients in control group received conventional perioperative treatment and patients in FTS group received perioper-ative management according to fast track surgery. Status of intraoperative, postoperative recovery and the postopera-tive complication rate were compared between the two groups. Patients' quality of life were analyzed after two weeks of operation. Results Compared with the control group, the blood loss, operation time and number of lymph node dissection of patients in FTS group showed no significant difference ( > 0.05). Flatus time, ambulation time, start eating time, the infusion time and length of hospital stay in FTS group was significantly shorter than the control group, the difference was statistically significant ( <0.05). The total cost of hospitalization of FTS group was signifi-cantly lower than the control group ( <0.05). The incidence of sore throat, abdominal distension, lung infections and overall complications incidence rate in FTS group were significantly lower than the control group, the difference was statistically significant ( <0.05). The satisfaction rate in FTS group was 96.0%(96/100), and was significantly high-er than the control group 82.0 %(82/100), the difference was statistically significant ( < 0.05). QLQ-C30 results showed that scores of overall health, emotional function and social function of FTS group were significantly higher than the control group ( <0.05), and scores of nausea and vomiting, pain, insomnia, anorexia, constipation were sig-nificantly lower than the control group ( < 0.05). Conclusion Laparoscopy combined with FTS is safe and effective in treatment of colorectal cancer in the elderly patients, which can promote postoperative rehabilitation, improve pa-tient satisfaction and quality of life in short term.

Effect of vidarabine monophosphate combined with astragalus injection on serum cTnI,IL-1β,IL-10 and TNF-αin children with hand-foot-and-mouth disease / 中国生化药物杂志

Objective To explore effect of vidarabine monophosphate combined with astragalus injection on serum cardiac troponin I ( cTnI), interleukin 1β(IL-1β), interleukin-10 (IL-10) and tumor necrosis factor-α(TNF-α) in children with hand-foot-and-mouth disease.Methods 60 cases with hand-foot-and-mouth disease from March 2013 to March 2015 in the hospital were selected and divided into two groups treated by different therapy, 30 cases in each group.The control group received conventional treatment + ribavirin injection, and experimental group received vidarabine monophosphate combined with astragalus injection on the basis of conventional treatment, one time per day.All patients were treated for a course of 7 days.The serum cTnI,IL-1β,IL-10 and TNF-αlevels were compared before and after treatment.Results After treatment, the serum cTnI, IL-1β, IL-10 and TNF-αlevels in two groups decreased than those of pre-treatment (P<0.05), the above indicators of experimental group were lower than those of control group (P<0.05).Conclusion The combination of vidarabine monophosphate and astragalus injection could significantly decrease serum cTnI, IL-1β, IL-10 and TNF-αlevels in children with hand-foot-and-mouth disease.

Differences in P50 and prepulse inhibition of the startle reflex between male smokers and non-smokers with first episode schizophrenia without medical treatment / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Nicotine may improve schizophrenia patient's cognitive deficit symptoms. This study was to explore the chronic effects of smoking on prepulse inhibition of the startle reflex (PPI) and P50 in the patients with first-episode schizophrenia (FES).</p><p><b>METHODS</b>The event-related potentials (ERP) recording and analysis instrument made by Brain Products, Germany, was used to detect PPI and P50 in 49 male FES patients (FES group, n = 21 for smokers and n = 28 for non-smokers) and 43 normal male controls (control group, n = 19 for smokers and n = 24 for non-smokers).</p><p><b>RESULTS</b>Compared with normal controls, the FES group had prolonged PPI latency when elicited by single stronger stimulus (P < 0.05); the FES group had prolonged PPI latency and increased PPI amplitude (P < 0.05, 0.01) when elicited by weak and strong stimuli. The FES group had lower PPI inhibition rate than normal controls (P < 0.05). Compared with normal controls, the FES group had increased P50-S2 amplitude and increased amplitude ratio S2/S1 (both P <0.05). In the control group, the smokers had a tendency of increase in P50-S2 amplitude (P > 0.05) and shorter P50-S2 latency (P < 0.05) than the non-smokers. The smokers had higher PPI amplitude than the non-smokers (P < 0.05). In the FES group, the smokers had higher P50-S1 amplitude, shorter P50-S2 latency, and higher amplitude ratio S2/S1 than the non-smokers (P < 0.05, 0.01). The smokers had higher PPI amplitude than the non-smokers (P < 0.05).</p><p><b>CONCLUSIONS</b>There is obvious PPI and P50 deficits in schizophrenic patients. However, these deficits are relatively preserved in the smokers compared with the non-smokers, which suggests that long-term smoking might partially improve the sensory gating in schizophrenic patients. Whether this conclusion can be deduced to female patients requires further follow-ups.</p>

The evaluation of the left transthoracic approach in simultaneous antireflux surgery at the time of CDH repair in infancy / 中华胸心血管外科杂志

Objective The aim of this study was to evaluate the left transthoracic approach in simultaneous antireflux surgery at the time of CDH repair in Infancy.Methods Between June 2008 and June 2012,18 patients underwent a left transthoracic approach in the treatment of type Ⅲ and Ⅳ hiatal hernia.,including 1 gastric volvulus.Clinical presentation in these patients included vomiting(n =12) 、pulmonary infections (n =9)、symptomatic anemia、failure to thrive (n =18).All the patients were evaluated before and after the surgery on clinical presentation,symptoms and functional assessment.Surgical techniques included extensive mediastinal esophageal dissection,Nissen fundoplication,resection of the hernial sac,crural closure.Results The average of operative time was 90 minutes.The mean blood loss was 5 ml.The average length of stay was 15 days.The hours stayed in PICU were 21.5 h.Mean follow-up was 22 months.There was no hospital mortality and hernia recurrence.Only one patient suffered gastroesophageal reflux disease after operation,and was controlled with antireflux medications.Conclusion Transthoracic is the optimal operative approach for treating the esophageal hiatal hernia,with relatively low postoperative morbidity and recurrence rates.Advantages of the transthoracic approach include the facilitation of Nissen fundoplication、esophageal lengthening procedures,and excellent exposure for the crural suturing.

Using event-related potentials to explore language processing / 中华物理医学与康复杂志

Objective To investigate the use of component N400 of the event-related potentials (ERPs) elicited by Chinese idioms ending with matching and nonmatching words to explore the cognitive patterns and processing mechanisms elicited by Chinese characters. Methods Sixty-two right-handed healthy adults (age 19-50 years) , were presented with Chinese idioms ending with words with the same pronunciation but different form and meaning, words with similar forms but different pronunciation and meaning, words with same meaning but different pronunciation and form, and words with different pronunciation, form and meaning. A Guangzhou Runjie WJ-1 instrument was used to record component N400 of the potentials evoked. Results N400 showed a midline distribution , and could be detected under electrodes Fz, Cz and Pz. Significant differences were found in N400 latencies and amplitudes between matching and nonmatching ending-words. Compared with idioms with matching ending-words, N400 latencies were prolonged and amplitudes increased in nonmatching cases. The observed changes in N400 latencies and amplitudes were related to stimulus types, and the longest latency and largest amplitude were e-licited by ending-words with different pronunciation, form and meaning. No gender difference in N400 latency or amplitude was observed. Conclusions Compared with Western phonetic words, Chinese ideographic words are more flexible stimuli for N400 research, offering 3 dimensions for change: pronunciation, form and meaning. The N400 features elicited by matching and nonmatching ending words in Chinese idioms are mainly determined by the meaning of the word.

Rationality of the Preventive Use of Antibiotics in Ophthalmologic Patients with Type Ⅰ Incision:Analysis of 1273 Cases / 中国药房

OBJECTIVE:To analyze the rationality of the preventive use of antibiotics in Chinese ophthalmologic patients with type Ⅰ incision.METHODS:By means of retrospective study,a total of 1 273 ophthalmologic cases from 113 hospitals of 2006～2007 from National Monitoring Network of Ministry of Health for Clinical Application of Antibiotic with type Ⅰ incision involving preventive administration of antibiotics via different routes were analyzed.RESULTS:The local administration (eye drops and local injection) was rational on the whole,but the systemic administration (intravenous or oral administration) was irrational to some degree in which the drug grade was on the high side,the antibacterial spectrum was inappropriate,and the medication time was delayed.CONCLUSION:Preoperative local administration and rational use of dosage forms should be emphasized in the preventive use of antibiotics for patients undergoing ophthalmologic surgery.