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Subglottic cyst is a rare cause of laryngeal tinnitus in infants and young children, and only a few cases have been reported at home and abroad. In this paper, we report the clinical characteristics and treatment experience of three cases of subglottic cysts in Children's Hospital of Nanjing Medical University. All the 3 childrem were prematurechildren, with a history of tracheal intubation, and the main symptoms were coughing and wheezing.Electronic nasopharyngolaryngoscopy revealed spherical neoplasm under the glottis. Neck computed tomography （CT） showed a slightly hypodense shadow with poorly defined borders, and no significant enhancement was observed after enhancement. Under the self-retaining laryngoscope, the new organisms were clamped and nibbled, and the cyst wall was cauterized by low temperature plasma. There was no recurrence in postoperative follow-up.
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Child, Preschool , Humans , Infant , Cysts/surgery , Glottis/surgery , Laryngeal Diseases/surgery , Laryngoscopy/methods , LarynxABSTRACT
Infants with laryngotracheal anomalies are clinically manifested as stridor or noisy breathing, choking, hoarseness, feeding difficulties, and cyanotic spells, followed by developmental and growth retardation and other health issues; in severe cases, patients may present with severe dyspnea, which is associated with high mortality. A timely diagnosis as well as appropriate strategy for laryngotracheal anomalies is still challenging for pediatric otolaryngologists. This consensus statement, evolved from expert opinion by the members of the Pediatric Otorhinolaryngology Professional Committee of the Pediatrician Branch of the Chinese Medical Doctor Association, provides comprehensive recommendations and standardized guidance for otolaryngologists who manage infants and young children with laryngotracheal anomalies in evaluation and treatment based on symptomatology, physical and laboratory examinations.
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Humans , Child , Infant , Child, Preschool , Laryngostenosis/surgery , Airway Obstruction/complications , Hoarseness/complications , Consensus , Respiratory SoundsABSTRACT
Pertussis is a highly contagious respiratory disease.Although widespread vaccination has greatly reduced the incidence of pertussis, there was a " recurrence of pertussis" in the past 30 years, and pertussis outbreaks occurred in some areas.Infants who have not been vaccinated or have not completed the full course of immunization suffer from more severe pertussis infections.Because of the atypical symptoms of young infants, missed diagnosis and misdiagnosis often occur, and pertussis cannot be diagnosed and treated in time.As a result, they can easily develop into severe pertussis or even die.In this article, recently published research on severe pertussis are summarized, so as to provide guidance for the clinical diagnosis, treatment, prevention and basic scientific research of severe pertussis.
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Objective@#To investigate the feasibility of using a carbon dioxide(CO2) laser in the treatment of facial papilloma in children and to evaluate its curative effect and prognosis.@*Methods @#A case of pediatric facial papilloma treated with a CO2 laser was reported, and the effects of this disease and CO2 laser treatment were reviewed and analyzed in combination with the literature. @* Results@#Under general anesthesia, the lesion tissue of the left lip was excised for pathological biopsy, and the diagnosis was maxillofacial papilloma. The lesions were surgically ablated in stages with a CO2 laser, and erythromycin ointment was applied to the surgical incision after surgery. A total of three rounds of CO2 laser treatment were performed for 3 treatment courses. The child had no complications during or after the operation, the facial appearance was significantly improved, and there was no sign of recurrence during the 6-month follow-up. A literature review showed that CO2 lasers have been widely used in the excision of various surface lesions. In clinical practice, continuous CO2 laser with power of 10-50 W and wavelength of 10.6 μm is used to treat superficial tissue lesions, which can achieve accurate vaporization resection of diseased tissue, less bleeding and a good prognosis.@* Conclusion@#CO2 laser was accurate and minimally invasive for the removal of facial papilloma in children.
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Objective:To investigate the epidemiological characteristics of classic human astrovirus (HAstV) among children under five years old with acute diarrhea, and to understand the role of HAstV in children acute diarrhea.Methods:A total of 1 010 fecal specimens were collected in 1 010 outpatients under five years old with acute diarrhea admitted to Children′s Hospital of Fudan University, Shanghai from January 2012 to December 2016. Reverse transcription polymerase chain reaction (PCR) or PCR was used for screening classic HAstV, group A rotavirus, norovirus and adenovirus. Genotypes of classic HAstV were determined by nucleotide sequencing and phylogenetic tree analysis.Results:The overall positive rate of classic HAstV was 2.7%(27/1 010). The detection rates of classic HAstV from 2012 to 2016 were 6.9%(10/144), 3.5%(5/144), 2.1%(3/144), 1.5%(4/265) and 1.6%(5/313), respectively. Almost 96.3%(26/27) of children infected with HAstV were 0 to 36 months of age. The prevalence of classic HAstV infections displayed a typical autumn/winter seasonality except in 2016. All the positive classic HAstV strains were genotyped as HAstV-1 with two lineages of HAstV-1a and HAstV-1b. Among them, the lineage of HAstV-1a was the predominant subtype (63.0%, 17/27). There were 77.8%(21/27) of the children with acute diarrhea only infected with classic HAstV, whereas for the remaining cases a variety of other enteric viruses were detected (three cases co-infected with HAstV and group A rotavirus, two cases co-infected with HAstV and adenovirus, and one case co-infected with HAstV, group A rotavirus and adenovirus).Conclusions:Children infected with HAstV are mainly less than 36 months of age. Although the genotype of classic HAstV detected in this study is single, but the lineages are in a state of dynamic change. Long-time and continuous monitor for the epidemiology of classic HAstV is needed to avoid outbreak of diarrhea in children.
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Objective To analyze the application of serum 25-hydroxyvitamin D (25-OH-D), bone source alkaline phosphatase (BAP) and ultrasonic bone mineral density (BMD) in the detection of infantile rickets aged 3-12 months. Methods Six to 12 months old rickets infants and healthy ones were randomly selected from March to December 2018 in a hospital in Changning, who were divided into two groups as observation or control group (160 infants in each).Two groups were respectively tested with serum 25-OH-D, BAP activity and ultrasonic bone density, so as to explore the diagnostic efficacy of the three combined tests for infant rickets. Results The serum 25-OH-D level and the BMD in the observation group were significantly lower than that in the control group (P < 0.05), and the abnormal detection rate of BAP in the control group was significantly lower than that in the observation group (P < 0.05).There was no statistical significance (P>0.05) between the three detection methods, but the sensitivity and accuracy of the three detection methods combined were significantly better than that of any single detection method (P < 0.05). Conclusion The combined detection with serum 25-OH-D level, BAP activity and ultrasonic BMD can significantly improve the detection efficiency of rickets in infants aged 6-12 months, which is valuable and worthy of clinical application.
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INTRODUCCIÓN: la cátedra de pediatría con apoyo del Instituto de Investigación en Salud y Desarrollo de la UMSA, ha elaborado un módulo de enseñanza teórico práctico para brindar conocimiento científico actualizado sobre alimentación y nutrición del menor de dos años. Durante la última gestión universitaria se ha incursionado en la enseñanza virtual para incrementar el tiempo de lectura, y contar con mayor espacio para las actividades prácticas. MÁTERIALES Y MÉTODOS: el objetivo de este artículo es identificar las fortalezas y debilidades del proceso de enseñanza y aprendizaje (PEA) combinado; usando metodología cuantitativa (pre y post-prueba) y cualitativa (grupo focal). Se contó con un total de 39 estudiantes. La prueba de conocimientos post intervención tuvo un puntaje de 771 mayor que la previa (p=0,000 ((IC 95% 642,35 - 901,23); y se respondió en menor tiempo (-219,43 segundos p=0.0000 (IC 95% (146,98 291,88). Un 81% de estudiantes estaba en el límite o por encima de lo que se consideró mínimo adecuado de facilidades informáticas. El grupo focal evidencio dificultades en el portal virtual, como muchos pasos para el ingreso, la saturación del servicio y otras; se dieron múltiples sugerencias para mejorar el módulo. RESULTADOS: este estudio demuestra que además de adquirir conocimientos, los estudiantes se han involucrado en los diferentes aspectos PEA; en base a sus sugerencias se ha comenzado a realizar cambios incluyendo la introducción de herramientas digitales de uso colaborativo como Wiki. CONCLUSIÓN: se concluye que el PEA combinado aplicado en la catedra de pediatría de la UMSA mejora la adquisición de conocimientos y prácticas sobre lactancia materna y alimentación complementaria del menor de dos años.
INTRODUCTION: the pediatric department with the support of the Institute of Research in Health and Development of the UMSA has developed a practical and theoretical teaching module to provide updated scientific knowledge on food and nutrition for children under two years of age. During the last university year, virtual teaching has been introduced to increase reading time, and to have more space for practical activities. MATERIAL AND METHODS: the objective of this article is to identify the strengths and weaknesses of the combined Learning Teaching Process using quantitative (pre and post-test) and qualitative methodology (focus group); 39 students participated in the study. In the post-intervention knowledge test obtained a score of 771 higher than the one prior to intervention (p = 0.000 ((95% CI 642.35 - 901.23), and spent shorter time in answers (-219.43 seconds p = 0.0000 (95% CI % (146.98 - 291.88). A total of 81% of students were in the limit or above what was considered adequate or minimum computer facilities. The focus group evidenced difficulties in the virtual portal, as many steps for the entrance, the saturation of the service and others, multiple suggestions were given to improve the module. RESULTS: this study shows that in addition to acquiring knowledge, students have been involved in the different aspects of the Teaching Learning Process (TLP). Based on their suggestions, changes such as the introduction of collaborative digital tools (Wiki) have been made. CONCLUSIONS: the article concludes indicating that the combined TLP applied in the pediatric department of the UMSA improves the students' acquisition of knowledge and practices on breastfeeding and complementary feeding of the child two years.
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Teaching/education , Universities , LearningABSTRACT
@#Hemangioma is the most common vascular benign tumor in infants and young children, 60% of which occur in the oral maxillo-facial region. One characteristic of oral and maxillofacial hemangioma is spontaneous regression, which generally does not require treatment; however, a few hemangiomas can produce complications including ulceration, functional disorders and disfigurement, which require active treatments. Currently, the treatment of oral and maxillofacial hemangioma include drug treatment, laser treatment and surgical treatment. The drugs used to treat hemangioma mainly include beta blockers, glucocorticoids, alpha-interferon, imiquimod and antitumor drugs. Drug therapy is suitable for multiple, rapidly proliferating hemangiomas and hemangiomas that affect vital organ function or endanger life. Laser therapy can be applied to the early treatment of rapidly growing hemangiomas at exposed sites. Surgical treatment is suitable for proliferative hemangioma with serious complications, the reconstruction of any external deformity and the repair of a scar after an ulcer. Combined therapy and the development of new technologies provide new directions for the treatment of hemangioma but the efficacy remains to be proven by large sample prospective studies. Clinicians should appropriately evaluate the patients with hemangioma and develop individualized treatment programs for patients with treatment indications. This article reviews the efficacy, mechanism, clinical application and adverse reactions of different treatment methods and provides references for clinical treatment.
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Objective@#To conduct a viral pathogen surveillance program on pediatric inpatients less than five years old with acute gastroenteritis in Shanghai and to better understand the pathogenic spectrum and molecular features in the target population, for setting up programs on control, prevention, medication and vaccine applications of the diseases.@*Methods@#Fecal samples were collected from inpatients less than 5 years old who were admitted to a pediatric hospital for having acute gastroenteritis. Information related to demographic, clinical and epidemiological features of the patients was also collected. Laboratory assays including ELISA, real-time PCR and nested PCR, were performed to detect the presence of pathogens as rotavirus, calicivirus, astrovirus and adenovirus.@*Results@#A total of 1 018 samples were collected (male 671 and 347 female), with the positive detection rate as 40.57% which peaked from autumn till winter, annually. Calicivirus and rotavirus A presented with the highest detection rates (24.75% and 13.95% respectively). The lowest detection rate was found in the 0-6 month-olds (32.20%). 65% of the patients with positive virus had received antibiotic treatment prior to the hospitalization. However, no statistically significant difference was seen, regarding the rates of antibiotic medication in the virus positive or negative populations (P>0.05). Data from the Rotavirus genotype analysis revealed that G9P[8] genotype was the predominant strain, and causing majority of rotavirus infections in all the age groups.@*Conclusions@#Among the inpatients under 5 years of age in Shanghai, the positive detection rate for Calicivirus was higher than that for rotavirus group A, suggesting the necessity to carefully monitor the changes regarding the pathogenic spectrum and subtypes of the virus. Antibiotics should also be attentively administered, together with the development of suitable vaccine.
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OBJECTIVE: To investigate the risk factors of purulent meningitis complicated with subdural effusion in infants and young children. METHODS: The clinical data of the infants and young children who were diagnosed with purulent meningitis in PICU of Shengjing Hospital of China Medical University from January 2014 to December 2017 were analyzed retrospectively.All of them were divided into 2 groups according to whether there was complication of subdural effusion. The statistical data were analyzed by SPSS 20.0 software. RESULTS: There were significant differences in hemoglobin,C reactive protein and protein in cerebrospinal fluid between control group and subdural effusion group(P<0.05). Logistic regression analysis showed that hemoglobin(OR=0.940,95%CI:0.899—0.998),C reactive protein(OR=1.015,95%CI:1.004—1.028)and protein in cerebrospinal fluid(OR=2.490,95%CI:1.151—6.315)were independent risk factors for purulent meningitis complicated with subdural effusion(P<0.05). CONCLUSION: Infants and young children diagnosed with purulent meningitis are with lower hemoglobin. Higher C reactive protein and higher protein in cerebrospinal fluid are likely to be complicated with subdural effusion.
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Objective@#To investigate the clinical efficacy of dexamethasone combined with budesonide in the treatment of children with acute infectious laryngitis.@*Methods@#From May 2014 to May 2017, 85 children with acute infectious laryngitis in our hospital were randomly divided into observation group(43 cases) and control group(42 cases) according to the digital table.The control group was treated with dexamethasone, the observation group inhaled budesonide on the basis of the dexamethasone treatment.The clinical effect was compared between the two groups.@*Results@#The effective rate of the observation group was significantly higher than that of the control group(97.9% vs.85.7%), the difference was statistically significant(χ2=4.022, P<0.05). The symptoms disappeared time of laryngeal obstruction [(1.2±0.2)d vs.(1.8±0.4)d], hoarseness [(2.2±0.6)d vs.(2.7±0.9)d], dyspnea [(1.5±0.4)d vs.(2.2±0.6)d], fever [(2.3±0.7)d vs.(3.0±0.9)d]and cough [(5.1±1.2)d vs.(6.7±1.7)d], the hospitalization time [(6.7±1.3)d vs.(8.9±1.9)d]in the observation group were significantly shorter than those in the control group (t=8.778, 3.020, 6.343, 4.008, 5.023, 6.243, all P<0.05). There was no statisticallysignificant difference in the incidence rate of adverse reactions between the two groups(χ2=0.508, P>0.05).@*Conclusion@#The combination of dexamethasone and budesonide in the treatment of acute infectious laryngitis can significantly improve the therapeutic effect, shorten the time of improvement of clinical symptoms, and with high safety, so it is worthy of clinical application.
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Objective To evaluate the growth and survival of single kidney transplants with donation after citizen death (DCD) donors from infants and children (＜3 years of age) to adults.Methods We retrospectively analyzed the data of single kidney transplants with donors from infants and young children to adults in our center.All the recipients were divided into infant donor group (≤3 years of age) and children donor group (1 year＜ age ≤3 years) in terms of the donor's age.The serum creatinine (SCr) level after surgery was determined and the major diameter of the kidney was measured by Doppler B ultrasonography.DGF,vascular complications,urinary tract complications,proteinuria,acute rejection,and infection were recorded during the follow-up period.Results There were 24 cases in infant donor group and 37 in children donor group.The mean follow-up period was 28 months.The SCr level at 1 st month post-transplantation was significantly higher in infant donor group than in children donor group (350.67 ± 35.57 μmol/L versus 193.70 ± 86.76 μmol/L),and the major diameter ((X-)± s) of the kidney in children donor group was significantly greater than that in infant donor group (78.29 ± 4.68 mm versus 93.62 ± 5.57 mm),but there was no significant difference during the subsequent 3-year follow-up period.The incidence of DGF in infant donor group was significantly higher than in children donor group,but there was significant difference in the rate of vascular complications,urinary tract complications,proteinuria,acute rejection,and infection between two groups.Conclusion The single kidney transplants from infants and young children to adults can grow rapidly,and their survival rate is relatively high.
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Objective@#To describe the situation and identify factors associated with malnutrition among infants and young children aged 6-23 months in poor rural areas in Hunan Province in 2015.@*Methods@#8 735 rural infants and young children aged 6-23 months in 30 poor counties of Wuling Mountains and Luoxiao Mountains in Hu'nan province were selected by township-level probability proportional to size sampling (PPS) in August 2015, infants' body length and weight were measured, and questionnaires were used to collect infants' information on personal and family, and feeding status in the past 24 h. The prevalence of stunting, underweight and wasting were calculated according to the Growth Standards of Child Aged Under 7 in China which was established in 2009 by Community Health Department of National Health and Family Planning Commission, China (formerly Chinese MOH), and the prevalence of malnutrition was calculated according to the classification of children with anthropometric failure. Multi non-conditional logistic regression model were used to analyze factors associated with malnutrition among infants and young children aged 6-23 months.@*Results@#The prevalence of malnutrition among infants and young children aged 6-23 months was 13.7% (1 198/8 735), the prevalence of stunting, underweight and wasting among infants and young children aged 6-23 months were 4.8% (419/8 735), 9.7% (849/8 735) and 6.1% (531/8 735) respectively. Compared with male group, the OR value of malnutrition for the female group was 1.16; Compared with Han ethnic group, the OR value of malnutrition for the Miao and Tujia ethnic group were 0.83 and 0.66, respectively; Compared with mother with an education level of primary school or below, the OR value of malnutrition for the mother with junior high school, senior high school and university or above education were 0.65, 0.61 and 0.56, respectively; Compared with father with an education level of primary school or below, the OR value of malnutrition for the father with senior high school and university or above education were 0.71 and 0.61 respectively; Compared with normal birth weight group, the OR value of malnutrition for the low birth weight group and high birth weight group were 2.85 and 0.27 respectively; Compared with normal delivery group, the OR value of malnutrition for the premature delivery group was 1.37; all P values<0.05.@*Conclusion@#The prevalence of malnutrition among infants and young children aged 6-23 months in poor rural areas in Hunan province in 2015 was high; Infants and young children who were female, Han ethnic, parents with low education, low birth weight and premature delivery had higher risk of malnutrition.
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Objective To investigate the Vitamin D levels of 3 030 infants and young children and the application rate of Vitamin D supplements.To evaluate the nutritional status of Vitamin D and to find out the problems in the application of Vitamin D supplements.Methods Enzyme linked inmmnosorbent assay was used to determine the level of 25-hydroxyvitamin D[25 (OH)D] in all the subjects.The subjects were divided into 4 groups according to their ages:≤6 months,＞ 6-12 months,＞ 12-24 months,＞ 24-36 months.The average levels of Vitamin D in different ages and seasons were compared.Three hundred and forty-one cases were randomly selected to undergo a parent questionnaire survey and a laboratory test including hemoglobin (Hb) and bone alkaline phosphatase (BALP).The association of 25 (OH)D level with feeding methods,gestational age,birth weight,Hb,and BALP were compared.Results The average level of 25 (OH) D was (60.2 ± 26.2) nmol/L with the minimum of 12.9 nmol/L and the maximum of 286.0 nmol/L.The total deficiency rate was 36.6％ (1 109/3 030 cases),and young children who were ＞ 24-36 months old had the lowest level of 25 (OH) D [(47.22 ± 21.93) nmol/L] (F =50.006,P ＜ 0.01).The levels of Vitamin D in autumn were(62.00 ± 27.42) nmol/L,which were significantly higher than those in other seasons (F =2.750,P ＜0.05).The levels of 25 (OH) D in preterm infants were (62.00 ± 27.42) nmol/L,which were significantly lower than those in full term infants (F =12.355,P ＜0.01).The application rate of Vitamin D supplements was 97.1％ (331/341 cases).Conclusions Although the application rate of Vitamin D supplementation in infants and young children is very high,there is still a certain proportion of Vitamin D deficiency.This may be because of the poor compliance of the supplementary process.Therefore,it is necessary to strengthen the publicity and education and improve the parental cognition and recognition.During pregnancy and age after birth,effective monitoring mechanism of Vitamin D levels and the application of Vitamin D supplements should be considered into the existing maternal and child health care system.
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Objective:To investigate the status and influential factors associated with 2-week prevalence of fever and diarrhea among infants and young children at the age of 6-23 months in poor rural areas.Methods:A total of 8 735 rural infants and young children aged 6-23 months in 30 poor counties of Wuling Mountains and Luoxiao Mountains in Hunan Province were selected in August 2015,and the questionnaires were used to collect information on the prevalence of fever and diarrhea,person and families,and feeding status.The data for prevalence of fever and diarrhea in infants and young children were calculated,and multi-non-conditional logistic regression model were used to analyze the influential factors.Results:The 2-week prevalence of fever and diarrhea in infants and young children was 20.8％ and 12.2％ respectively.The ages (OR=0.66,95％CI 0.58 to 0.75),Dong ethnicity(OR=1.42,95％CI 1.17 to 1.74) and low body weight (OR=1.31,95％CI 1.11 to 1.54) were influential factors for fever among infants and young children in poor rural areas;female (OR=0.86,95％CI 0.76 to 0.98),12-17 months (OR=0.80,95％CI 0.69 to 0.93),18-23 months (OR=0.51,95％CI 0.43 to 0.60),other ethnic minorities (OR=1.70,95％CI 1.13 to 2.56),non-complementary feeding (OR=1.65,95％CI 1.05 to 2.59) and low body weight (OR=1.39,95％CI 1.14 to 1.70) were the influential factors of diarrhea among infants and young children.Conclusion:The 2-week prevalence of fever and diarrhea among infants and young children aged 6-23 months in poor rural areas were quite serious.Low age,Dong ethnicity,and low birth weight are high risk factors for fever.Male,no addition of complementary feeding,and low birth weight are high risk factors for diarrhea.
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Objective To evaluate the reliability of children anthropometric indicators measured by medical students in clini-cal practice .Methods The convenient sampling was adopted to collect the data of the head circumference (HC) ,recumbent length (RL) and crown-rump length (CRL) of infants and young children measured by the students in clinical practice from entering-de-partment training to exiting-department .The re-measured data by clinical teachers were simultaneously collected .The measurement difference were compared between the students and clinical teachers .The measurements reliability was described by using the indi-cators such as the mean absolute differences (MAD) ,percentages of difference within a critical value (PDCV) and so on .Results MAD of HC ,RL and CRL at entering-department were 0 .46 ,0 .55 ,0 .81 cm respectively ,which at exiting-department were 0 .30 , 0 .43 ,0 .51 cm respectively ,the difference were statistically significant (P<0 .05) .PDCV of HC ,RL and CRL belonging to good quality standard at entering-department were 41 .5% ,58 .0% and 36 .0% respectively ,which at exiting-department were increased to 53 .5% ,70 .0% and 59 .0% respectively .PDCV of HC ,RL and CRL belonging to error data were 19 .0% ,10 .0% and 13 .0% re-spectively .Conclusion RL measured by medical students in clinical practice has good quality ,while the bigger errors exist in the measurement values of HC and CRL .
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Objective To investigate 0-24 months infantile breastfeeding and service requirement of child care clinic in Tianjin Binhai district. Methods A total of 350 cases from June 1,2014 to June 1, 2016 were adopted by questionnaire method about breastfeeding and service requirement. Results In the survey, all of them were breastfeeding, and the 0-6 months breastfeeding rate was 84.4%(295/350). They were divided into three groups: urban, rural and external population, the main of population was urban(64.0%, 224/350). The breastfeeding rate was closely relate to the education of mother, graduate and above almost above 63.7%(223/350);exclusive breastfeeding of three groups were 25.4%(57/224), 25.8%(16/62), 34.4%(22/64) in urban, rural and external population respectively. Generally lower the national level because of the food supplement,4-5 months was 31.8%(21/66), 6-9 months was 65.4%(34/52),10-12 months was 85.0%(51/60). Insufficient breastmilk, mother was ill, working mother, think should be the four main reasons in the weaned process. Conclusions There are still some problems for the ideas and methods of breastfeeding in child care clinic, still need to strengthen the nursing management of breastfeeding.
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Objective To investigate 0-24 months infantile breastfeeding and service requirement of child care clinic in Tianjin Binhai district. Methods A total of 350 cases from June 1,2014 to June 1, 2016 were adopted by questionnaire method about breastfeeding and service requirement. Results In the survey, all of them were breastfeeding, and the 0-6 months breastfeeding rate was 84.4%(295/350). They were divided into three groups: urban, rural and external population, the main of population was urban(64.0%, 224/350). The breastfeeding rate was closely relate to the education of mother, graduate and above almost above 63.7%(223/350);exclusive breastfeeding of three groups were 25.4%(57/224), 25.8%(16/62), 34.4%(22/64) in urban, rural and external population respectively. Generally lower the national level because of the food supplement,4-5 months was 31.8%(21/66), 6-9 months was 65.4%(34/52),10-12 months was 85.0%(51/60). Insufficient breastmilk, mother was ill, working mother, think should be the four main reasons in the weaned process. Conclusions There are still some problems for the ideas and methods of breastfeeding in child care clinic, still need to strengthen the nursing management of breastfeeding.
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Objective To optimize the exposure parameters and reduce the irradiation dose level in infants and young children during digital radiography (DR) chest radiography under the premise of satisfied image quality.Methods The thoracic thickness of 100 patients were measured.Determined the aluminum equivalent of the thoraxes of the infants and young children by comparing the grayscale value and the aluminum step wedge.Another 100 infants and young children of experimental exposure were performed with the aluminum step wedge as a phantom,under AEC control,kV was the only variant to explore the optimal exposure parameters with dose monitor simultaneously.At last,clinical validation was performed.Images quality was compared with x2 test.The radiation dose of two groups was compared with t test.Results The maximum,minimum,average thoracic thickness and their correspondent aluminum equivalent were 13.5 and 2.3 cm,8.0 and 1.4 cm,(10.6 ± 1.3) and 2.0 cm,respectively.The average thoracic thickness of experimental group was (10.1 ± 2.2) cm.The range of entrance surface dose was 0.068-0.056 mGy while the tube voltage range was 55-65 kV.The exposure index range was 0.60-0.74.The visual inspection of aluminum step wedge was from grades 8 to 11 with satisfying image quality at lower radiation.The infant chest X-ray photography exposure parameters formula have been optimized,that was kV =thoracic thickness (cm) × 2 + 38 (constant),mAs (0.8-1.0) with SID =100 cm,without filter grid.Compare to the conventional parameters,the image quality of new method had no significant differences (P ＞ 0.05).The actual average entrance surface dose was (0.048 ± 0.007) mGy,lower than AEC group (0.066 ± 0.008) mGy.The difference was statistically significant (t =16.781,P ＜ 0.001).Conclusions The optimized formula kV =thoracic thickness (cm) ×2 + 38(constant),mAs (0.8-1.0) with SID =100 cm was credible for lowering the radiation exposure with good image quality for clinical diagnosis.
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Objective To study the effect of transcutaneous electrical acupoint stimulation (TEAS) on emergence agitation in children undergoing cochlear implantation.Methods Sixty patients (age range,1-4 years) scheduled to undergo pediatric cochlear implantation were enrolled and randomized into the TEAS group (group T,n =30) that received continuous TEAS and the control group (group C,n =30) that did not receive TEAS.Anesthesia time,operation time,change in blood flow dynamics during the perioperative period,extubation time,and PACU stay time were recorded.The incidence of emergence agitation and postoperative nausea and vomiting (PONV) was monitored.Results No significant intergroup differences were observed in age,sex,weight,operation time,and PACU stay time (P ＞ 0.05).The MAP and HR in group T were lower than those in group C at different time points such as 30 min after the start of surgery,the end of the surgery,the extubation and 5 min after extubation,and the difference was statistically significant (P ＜ 0.05).The FPS-R,FLACC,and PAED scores in group T were lower than those in group C at different time points within 30 min after exmbation (including the time of extubation),and the difference was statistically significant (P ＜ 0.05).Extubation time,anesthesia time,and incidence of PONV were lower in group T than in group C,and the difference was statistically significant (P ＜ 0.05).Conclusion TEAS combined with general anesthesia significantly reduces the incidence of emergence agitation in children undergoing surgery for congenital hearing loss;it also helps control hypotension,reheve dramatic hemodynamic changes during the waking period,and reduce the incidence of PONV.