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Chinese Journal of Orthopaedics ; (12): 1545-1552, 2021.
Article in Chinese | WPRIM | ID: wpr-910746


Objective:A new measurement index, femoral neck-lesser trochanter anteversion (FN-LTA), is proposed. To explore the feasibility and advantage of applying the FN-LTA to evaluate the proximal femoral deformity of unilateral developmental dislocation of the hip in children, so as to solve the current clinical problems.Methods:The imaging data of 90 patients with unilateral DDH admitted to our department from February 2016 to April 2017 were retrospectively analyzed, There were 13 males and 77 females. The age ranged from 0.6 to 11 years, with an average of 2.6±2.3 years. Femoral neck anteversion (FNA) and FN-LTA were measured at the affected and healthy sides. Analyze the correlation between FN-LTA and FNA, analyze the influence of gender, age, side, dislocation degree and other factors on FN-LTA, compare the difference between the affected side and the healthy side of FNA, FN-LTA, and analyze the influence of dislocation degree on this difference, compare the diagnostic efficacy and intra group consistency of FNA and FN-LTA. The possible advantages of FN-LTA in clinical application were preliminarily analyzed.Results:There was a positive correlation between FN-LTA and FNA in both healthy and affected sides (healthy side r=0.217, P=0.040, affected side r=0.298, P=0.004). FNA and FN-LTA in the affected side of DDH children were both larger than the healthy side, FNA affected side 38.86°±11.70°, healthy side 35.44°±11.16°; FN-LTA affected side 72.19°±9.17°, healthy side 61.17°±10.30°. The difference had statistical significance. FN-LTA was not affected by gender, side, degree of dislocation and other factors (gender P=0.060, side P=0.550, degree of dislocation of healthy side P=0.130, affected side P=0.705), but negatively correlated with age (healthy side r=-0.261, P=0.013, affected side r=-0.287, P=0.006). The diagnostic efficiency of FN-LTA is better, AUC FNA=0.561, AUC FN-LTA=0.736 ( P<0.05). FN-LTA and FNA had excellent intra group and inter group consistency. Inter group ICCFNA=0.956, ICCFN-LTA=0.973; intra group ICCFNA1=0.937, ICCFNA2=0.893, ICCFN-LTA1=0.887, ICCFN-LTA2=0.874. With the increase of dislocation degree, the difference between FNA and FN-LTA decreased. This decreasing trend was statistically significant in FNA ( P=0.030) but not in FN-LTA ( P=0.180). Conclusion:FN-LTA is a reliable method with a higher degree of differentiation for the assessment of anteverted deformity in DDH children' proximal end of femur, the measured data are more capable of guiding the rotation of osteotomy.

Article in Chinese | WPRIM | ID: wpr-817961


Acute liver failure(ALF)is a life-threatening clinical syndrome in children,which has a high mortality. Extracorporeal liver support systems include bioartificial liver,nonbioartificial liver and hybrid artificial liver,with the aim of supporting children with ALF,as a bridge to recovery or liver transplantation. The theoretical basis of non-bioartificial liver support system is blood purification. Although biochemical efficacy has been demonstrated by these devices,the effect on the final prognosis has been unclear. Compared with adults,there are less data on the treatment for children with ALF,and some new blood purification modes and combined blood purification modes have shown potential in the treatment of ALF in recent years. The aim of this review is to introduce the practice of blood purification and to provide references for the treatment of children with ALF.

Article in Chinese | WPRIM | ID: wpr-638818


Objective To detect brain natriuretic peptide(BNPs) level in serum in order to confirm its applical value.Methods Forty-eight patients with congestive heart failure(CHF) were chosen,which included 36 patients with pneumonia,12 patients with congenital heart diseases.Forty heathy children were chosen as control group.BNPs level of two groups were detected by enzyme label.Results The level of BNP in patients with CHF(that′s positive group) was obviously higher than that in control group in the stage of CHF and recoverty(t=14.30,20.38 all P0.05),this included that the cardiac function had significantly changes in the stage of CHF,at the same time,the level of BNP had negative correlation to CI and LVEF(r=-0.61,-0.79 all P