ABSTRACT
Objective:To investigate the high resolution CT (HRCT) features of COVID-19 in children.Methods:A retrospective analysis was performed on the chest HRCT findings of 22 children who were diagnosed as COVID-19 by clinical and nucleic acid testing in Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 25 to February 5, 2020. There were 12 boys and 10 girls, aged from 2 months to 14 years old, with a median age of 4 years, and 14 patients were under 5 years old. The characteristics of lung lesions on HRCT such as distribution, shape, density and so on and whether there were hilar and mediastinal lymph node enlargement and pleural changes were evaluated by 2 radiologists.Results:In all of the 22 patients, the chest CT manifestations were normal in 3 patients (3/22) , meanwhile the lung involvement of the lesion was found in 19 patients (19/22). Among them, 7 patients had unilateral lung involvement, and 12 patients had bilateral involvement. The HRCT manifestations were as follows. The HRCT showed the ground glass opacity (GGO) in 6 patients, including 4 cases with light opacity and 2 with typical crazy paving sign. Four patients had lung consolidation, with local fibrous stripes and patchy hyperdensity. Six patients had mixed GGO, including 1 case with right white lung. The bronchopneumonia-like changes were seen in 3 cases with scattered spot-like or mixed patchy. The lesions in the lower lobe were more serious than those in the upper lobe, and the lesions in the lateroposterior zone of the lung were more common than those in the apical and central area of the lung. No enlarged lymph nodes and pleural effusion were seen in all patients, but 1 case had thickened interlobar pleura.Conclusions:The HRCT manifestations of COVID-19 in children are varied, and the comprehensive assessment need to be made in combination with epidemiological data, clinical manifestations and laboratory tests. However, the chest HRCT plays an important role in early diagnosis, prevention and management of COVID-19.
ABSTRACT
Objective@#To investigate the high resolution CT (HRCT) features of novel coronavirus pneumonia (NCP) in children .@*Methods@#A retrospective analysis was performed on the chest HRCT findings of 22 children diagnosed with 2019-nCov pneumonia by clinical and nucleic acid testing in Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 25, 2020 to February 5, 2020. There were 12 boys and 10 girls, aged from 2 months to 14 years old, with a median age of 4 years, and 14 patients were under 5 years old. The characteristics of lung lesions on HRCT imaging such as distribution, shape, density, etc. and whether there were hilar and mediastinal lymph node enlargement and pleural changes were observed by 2 radiologists.@* Results@#In all of the 22 patients, 3 patients (3/22) had normal chest CT, and 19 patients (19/22) had infiltrated lesions in lung. Among them, 7 patients had unilateral lung involvement, 12 patients had bilateral involvement. The HRCT manifestations were as follows. Six patients showed ground glass shadow, including 4 cases showed light ground glass shadow and 2 had typical crazy paving sign. Four patients showed lung consolidation, with localized strip shadow and patchy high-density shadow. Six patients showed patchy lesions with surrounding ground glass shadow, including 1 case with white lung in the right. The bronchopneumonia-like changes in 3 cases, showed scattered spot-like or patchy uneven high-density shadows. The lesions in the lower lobe were more serious than those in the upper lobe, and the lesions in the lateroposterior zone of the lung were more common than those in the apical and central area of the lung. No enlarged lymph nodes and pleural effusion were seen in all patients, and 1 case had thickened interlobar pleura.@*Conclusions@#The HRCT manifestations of NCP in children are diversified, comprehensive judgments need to be made in combination with epidemiological data, clinical manifestations, and laboratory tests, but the chest HRCT can be used as an important basis for early clinical diagnosis and prevention and control interventions.
ABSTRACT
Objective To explore the feasibility and effect of laparoscopic Ladd's surgery for the treatment of intestinal malrotation in infants.Methods The clinical data of 50 infants with intestinal malrotation who were admitted to the Wuhan Medical & Health Center for Women and Children from January 2011 to December 2013 were retrospectively analyzed.Of 50 infants, 27 infants receiving the open Ladd's surgery were allocated into the open surgery group and 23 infants receiving the laparoscopic Ladd's surgery were allocated into the laparoscopy group.The operation time, time to anal exsufflation, duration of hospital stay, postoperative incision infection and intestinal obstruction in the 2 groups were observed.All the patients were followed up by outpatient examination or telephone interview till March 2014.The measurement data with normal distribution were presented as x-± s and analyzed by the t test, and count data were analyzed using the chi-square test or Fisher exact probability.Results The operation time, time to anal exsufflation and duration of hospital stay were (69 ± 7)minutes, (41 ±9)hours and (10.4 ± 2.4)days in the open surgery group, which was significantly different from (92 ± 13)minutes, (28 ±5)hours and (6.4 ± 1.5) days in the laparoscopy group (t =6.21, 16.50, 6.34,P ＜ 0.05).Two infants had incision infection and 1 infant had intestinal obstruction in the open surgery group.There was no patient with complications in the laparoscopy group.All the patients were followed up for the median time of 13 months (range, 6-24 months), with a good survival and no other symptoms.Conclusion Laparoscopic Ladd's surgery is safe and feasible compared with open surgery, and it could be used as a prior operation method for treatment of intestinal malrotation in infants.
ABSTRACT
Objective To investigate the clinical value of prenatal MRI in the diagnosis of fetal bowel obstruction.Methods Pregnant women suspected to have fetal abdominal abnormalities by ultrasonography were suggested to undergo MRI examinations within two days.Scanning sequence included FIESTA,SSFSE and T1WI SPGR sequence,with field of view focused on the fetal abdomen.After the final diagnoses of the cases were obtained by induced labor pathological examination or postpartum imaging or operation,the imaging data and the clinical data were reviewed and analyzed retrospectively.Results A total of 23 cases with bowel obstruction were included in the study.Four fetuses with duodenal atresia showed low T1 signal,high T2 signal characterized by double-bubble sign on MRI.There were 10 fetuses with jejunoileal atresia,showing bowel dilatation and hyperintense micro-colon on T1WI.Five cases of them depicted expansion of the terminal ileum with high T1 meconium signal.One each fetus had colonic atresia,intestinal malrotation with double-bubble and whirl sign.Annular pancreas with double-bubble sign and pressure trace of the bracket shape was detected in 3 fetuses.Meconium peritonitis was present in 4 fetuses,with 2 of them showing dilatation of intestine,ascites and pseudocysts.Conclusions According to the signal characteristics of amniotic fluid and meconium in the gastrointestinal tract on MRI,the obstructive level and development status of the distal bowel can be determined with MRI.It can provide additional information to ultrasonography,which brings clinical significance to prenatal diagnosis and intrapartum surgical operation.
ABSTRACT
The aim of this study was to develop a derivative of chitosan as pharmaceutical excipient used in sustained-release matrix tablets of poorly soluble drugs. A water-soluble quaternary ammonium carboxymethylchitosan was synthesized by a two-step reaction with carboxymethylchitosan [CMCTS], decylalkyl dimethyl ammonium and epichlorohydrin. The elemental analysis showed that the target product with 10.27% of the maximum grafting degree was obtained. To assess the preliminary safety of this biopolymer, cell toxicity assay was employed. In order to further investigate quaternary ammonium carboxymethylchitosan application as pharmaceutical excipient, aspirin was chosen as model drug. The effect of quaternary ammonium CMCTS on aspirin release rate from sustained-release matrix tablets was examined by in-vitrodissolution experiments. The results showed that this biopolymer had a great potential in increasing the dissolution of poorly soluble drug. With the addition of CMCTS-CEDA, the final cumulative release rate of drug rose up to 90%. After 12 h, at the grade of 10, 20 and 50 cps, the drug release rate increased from 58.1 to 90.7%, from 64.1 to 93.9%, from 69.3 to 96.1%, respectively. At the same time, aspirin release rate from sustained-release model was found to be related to the amount of quaternary ammonium CMCTS employed. With the increase of CMCTS-CEDA content, the accumulated release rate increased from 69.1% to 86.7%. The mechanism of aspirin release from sustained-release matrix tablets was also preliminary studied to be Fick diffusion. These data demonstrated that the chitosan derivative has positive effect on drug release from sustained-release matrix tablets
Subject(s)
Aspirin/chemistry , Drug Compounding , Delayed-Action Preparations/chemistry , Chitosan/chemistry , Tablets , Solubility , Quaternary Ammonium Compounds , Biopolymers , EpichlorohydrinABSTRACT
In this study, the time-dependent changes on dynamic computed tomograph (CT) of radiation-induced liver injury in gastric cancer patients was examined. The CT images of 52 gastric cancer patients who had received chemoradiotherapies were reviewed on the PACS system. Dynamic CT scan was performed in all the subjects. Our results showed that 18 patients were found to have radiation-induced liver injury. The CT findings of radiation-induced liver injury in gastric cancer patients tend to show up one month after radiation treatment. The damaged area was of low density on all three phases, and then it was enhanced on portal vein phase or delay phase. The focal radiation reaction of liver without basic disease vanished 9-11 months later after treatment. We are led to conclude that dynamic CT is of help in the diagnosis of CRT-induced liver injury, and it may be the method of choice for following up the whole course of the CRT-induced liver injury, i.e., form hepatic damage to healing. The classification of CT findings we recommend can avoid the influence of technological factors, and thereby serve as a better guide for treatment of CRT-induced liver injury.
ABSTRACT
The integration of natural and human sciences has resulted in the evolution of the connotation and framework of medicine, thus enriching its scientific nature. The high degree of the integration of the scientific, technological, economic, and social factors in the field of the medical sciences with human sciences reveals the significance of the human spirit in medical care. Reliability, impartiality, effectiveness and satisfaction, which embody the human spirit in medical care, signify a hospital's character and core values and are the prerequisite and guarantee for satisfying medical care. The authors point out emphatically that the development of the codes of ethics and the human ideology in medical care constitutes both the core of the cultural construction of the modern hospital and an important foundation for its economic growth.