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Objective:To investigate the clinical features and outcome of congenital chylothorax and chyloperitoneum ascites in infants.Methods:The clinical data of infants admitted to the Neonatal Department of Shengjing Hospital of China Medical University and diagnosed with congenital chylothorax and chyloperitoneum from January 2011 to December 2018 were analyzed retrospectively.According to outcome, the infants were assigned into survival group and death group.The clinical characteristics between the two groups were compared.Results:The total cases were 25(the ratio of male to female is 3.2). The gestational age ranged from 30 to 39 weeks, and the birth weight was 1 620 to 4 770 g. There were twenty infants were diagnosed before delivery accounted for 80%.Five infants(20%)presented with fetal edema.There were twenty-one infants were diagnosed with congenital chylothorax(84.0%, 5 with chyloperitoneum). Fourteen cases of congenital chylothorax were bilateral(66.7%), seven infants were unilateral, six infants(85.7%)were right-sided chylothorax.There four infants(16.0%)were diagnosed with chyloperitoneum.There were fifteen cases in the survival group, including eleven cases of chylothorax(73.3%), three cases of chyloperitoneum(20.0%), and one case of chylothorax combined with chyloperitoneum(6.7%). There were ten cases in the death group, all of which were premature infants, including nine cases of chylothorax and seven cases of bilateral chylothorax(70.0%). The median gestational age(33w)and birth weight(2 486 g)of the death group was significantly lower than the survival group(38w and 3 342 g), and the median gestational age when prenatal diagnosis[(30±1)weeks]was significantly lower than the survival group[(34±1)weeks]. The difference between the two groups was statistically significant( P<0.05). The proportion of mechanical ventilation in the death group was significantly higher than the survival group( P<0.05). Conclusion:The gestational age, birth weight, and the time of intrauterine diagnosis affect the outcome of congenital chylothorax and chyloperitoneum.The mortality rate is higher in premature, lower gestational age at the time of intrauterine diagnosis and bilateral chylothorax.
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Neonatal lymphatic dysplasia is a congenital maldevelopment,causing effusion of chyle or lymph into the limbs or into the pleural,pericardial or peritoneal cavities,forming chylothorax ascites or edema,resulting in immunodeficiency and malnutrition.Neonatal lymphatic dysplasia is rare in neonate,but associated with significant mortality.So far,the etiology and pathological mechanism are still unclear.Lymphoscintigraphy is a diagnostic tool in newborns to obtain early diagnosis.Octreotide has been proposed for treatment of lymphatic dysplasia recently,however,the effiency and safety remain controversial.This article is to review the update in diagnosis and treatment of neonatal lymphatic disorders.
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In the practice of building its humanistic environment of a research hospital,Nanjing Drum Tower hospital adheres to such humanistic characteristics of the hospital as humanistic concept,planning, environment,management,service,and quality.Furthermore,the hospital upholds such keys as learning, innovation, cooperation, undertaking, competition and development. High focus, high starting point planning,persistence,and down-to-earth efforts,effectively promoting hospital development.
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<p><b>OBJECTIVE</b>To observe the effects and safety of clinical common symptoms of active Crohn's disease at the mild and moderate stages treated with acupuncture and moxibustion.</p><p><b>METHODS</b>One hundred and two patients were randomly divided into an observation group and a control group, 51 cases in each one. Herb-partition moxibustion and acupuncture were used in the observation group. Herbal cakes with(),(),(),(),(),() and() as the main ingredients were used on Tianshu (ST 25), Qihai (CV 6) and Zhongwan (CV 12); acupuncture was used at Zusanli (ST 36), Shangjuxu (ST 37), Sanyinjiao (SP 6), Taixi (KI 3), Gongsun (SP 4) and Taichong (LR 3). Bran-partition moxibustion and shallow acupuncture were applied in the control group. Wheat bran-partition moxibustion in the shape of cake was implemented on the same acupoints as the observation group; shallow acupuncture was used 1~2 cm next to the acupoints. Treatment was given three times a week for 12 weeks, 36 times totally. Clinical effects of eight symptoms were evaluated by TCM symptom score, and the symptoms included abdominal pain (degree, frequency, time), diarrhoea (number, shape and frequency), fatigue, anorexia, borborygmus andflatus, fear of cold, soreness and weakness of waist and knees, tenesmus.</p><p><b>RESULTS</b>After 12-week treatment, the eight symptoms were improved apparently (all<0.05), with the scores of abdominal pain (degree, frequency, time), diarrhoea (shape and frequency), fatigue and anorexia in the observation group decreasing more obviously (all<0.01). There was no statistical significance about the other symptom scores between the two groups (all>0.05).</p><p><b>CONCLUSIONS</b>Herb-partition moxibustion combined with acupuncture achieve safety and efficacy for mild and moderate Crohn's disease, and can improve the clinical common symptoms. Furthermore, their effects on abdominal pain (degree, frequency, time), diarrhoea (shape and frequency), fatigue and anorexia are better than those of bran-partition moxibustion and shallow acupuncture.</p>
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BACKGROUND:Chronic visceral pain is one of major complaints of irritable bowel syndrome which seriously affects patient’s quality of life. Recent researches have shown that moxibustion therapy has positive effects on aleviating chronic visceral pain in irritable bowel syndrome patients. OBJECTIVE: To study the clinical utility of moxibustion in coping with chronic visceral pain of irritable bowel syndrome patients, and shed light on the theoretical basis of moxibustion analgesia, thereby to give insights into the further research and application on moxibustion. METHODS: With the key words of “moxibustion, irritable bowel syndrome, visceral pain, abdominal pain” in Chinese and in English, respectively, a computer-based search was performed in CNKI, VIP, Wanfang and PubMed databases for articles published from January 1990 to October 2014. After the initial screening, the remained articles went through further selection and categorization. RESULTS AND CONCLUSION:The result shows promising results of moxibustion on relieving chronic visceral pain for both two subtypes of irritable bowel syndrome patients, diarrhea type and constipation type. Moxibustion may exert an analgesic effect on chronic visceral pain in irritable bowel syndrome patients through regulation of visceral hypersensitivity, gastrointestinal motility disorders, brain-gut axis and neuroendocrine system disorders, immune dysfunction and low-grade inflammation in the gut, psychological abnormalities, and alteration of intestinal flora. However, to fuly understand the analgesia effect of moxibustion and elucidate its mechanism, more standardized randomized controled trials employing advanced scientific techniques and equipments wil stil be needed in the future.