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Objective@#To summarize the clinical characteristics of pilomatricoma in children and analyze the preoperative diagnostic method.@*Methods@#468 cases (479 tumors) of pilomatricoma in children were treated in Department of Plastic and Maxillofacial Surgery, Wuhan Children’s Hospital from January 2013 to January 2018. All cases were confirmed by pathology after operation. There were 224 males and 244 females, aged from 3 months to 13 years and 10 months. The general situations, case histories, physical signs, auxiliary examinations and preoperative diagnoses of all patients were analyzed retrospectively. SPSS 22.0 software was used for statistical analysis of data. Median or mean±standard deviation was used for describing measurement data, and component ratio or rate was used for describing counting data.@*Results@#The peak age was 0-2 years old, accounting for 47.22%(221/468). The male to female ratio was 1∶1.09. The most common site of lesions was head(348 cases), followed by neck(76 cases), upper limbs(40 cases), trunk(10 cases) and lower limbs(5 cases). All patients had histories of subcutaneous mass, 85.90%(402/468) had histories of tumor growth, 16.24%(76/468)had pain, 7.91%(37/468) had histories of infection, 28.42%(133/468) had histories of previous treatment, and 12.18%(57/468) had histories of external stimulation. The masses were (1.2±0.6) cm(from 0.3 cm to 3.5 cm) in diameter. By inspection, 98.33%(471/479) of skin overlying the tumor were intact, and 63.29%(269/425) were pale blue. By palpation, 79.62%(375/471) of masses were hard, 100% adhered to the skin, 94.15%(451/479) didn’t cause tenderness, 31.73%(152/479) appeared "tent sign" , and 27.77%(133/479) appeared "teeter-totter sign" . The diagnostic accuracy rate of ultrasonographic examination was 75.24%(155/206). 31.55%(65/206) showed hypoechoic nodule containing internal hyperechoic dots, 27.67%(57/206) showed hyperechoic band with wide acoustic shadowing below. 88.83%(183/206) of Color Doppler Flow Imaging showed peripheral blood flow signal around the nodule, and the internal blood flow signal decreased or disappeared. The diagnostic accuracy rate of CT examination was 98.44%(126/128), 58.59%(75/128) of plain CT scans showed high density mass shadows of which the internal densities were homogeneous or heterogeneous. 39.84%(51/128) of plain CT scans showed soft tissue density mass shadows of which the internal densities were heterogeneous, and the dot high density shadows in different size scattered. The diagnostic accuracy rate of needle aspiration cytology was 61.54%(8/13). The preoperative diagnostic accuracy rate was 81.63%(391/479).@*Conclusions@#Typical pilomatricoma often occurs on a child’s head. The overlying skin is pale blue. The tumor is hard in texture, adheres to the skin, and appears a "tent sign" or "teeter-totter sign" . Ultrasonography and CT examinations suggest calcification in the subcutaneous lesion, which is helpful for preoperative diagnosis. Needle aspiration cytology can be used for differential diagnosis of atypical case.
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OBJECTIVE To invest igate the immediate to middle-term outcome of operation for 22 children with first branchial cleft anomalies(FBCA). METHODS Twenty-two hospital ized cases who underwent s urgery for fi rst branchial cleft a nomalies f rom Jan. 2010 to Jan. 2017 were included in the study. Among them, 14 patients were male and the others were female. The median age at operation was 4.0 years old(11 months to 12 years old), and the weight of body was 14 kg(10 kg to 37 kg). There were 11 cases complicated with infection before operation. Eight patients had a history of incision and drainage. RESULTS Thirteen patients were diagnosed as Work Type I and the others were Type II. There were 2 cysts, 9 sinuses and 11 fistulas. All of the patients underwent surgery to remove the tract of FBCA. Based on the intraoperative anatomy, the tract ran superficial to the facial nerve in 15 cases, deep to it in 2 and passed between the branches in 5. There were no severe postoperative complications except 3 facial paralyses. At a median followup of 46 months (range from 7 to 84 months), one of the 3 patients with facial paralyses developed into normal and the other two became permanent. None of the patients had postoperative external auditory canal stenosis. There were 2 cases of recurrence who accepted a total of another three operations, and the others were free from reoperation. CONCLUSION Complete excision of the tract is the only way to cure FBCA, which has a close relationship with facial nerve. The surgical approach should be chosen according to the various types.
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This study examined the effects of a combined surgery of sleeve gastrectomy (SG) and modified jejunoileal bypass (JIB) on the body weight, food intake, and the plasma levels of active glucagon-like peptide-1 (GLP-1) and total ghrelin of rats. Rats were divided into 3 groups in terms of different surgical protocol: SG-JIB (n=12), SG (n=12), JIB (n=12) and sham surgery groups (n=10). In SG-JIB group, rats was subjected to sleeve gastrectomy and end to side anastomosis of part of the jejunum (25 cm from the ligament of Treitz) to the ileum 25 cm proximal to the cecum. The body weight and food intake were evaluated during 10 consecutive weeks postoperatively. The levels of active GLP-1 and total ghrelin in the plasma of the rats were measured by ELISA assay. The results showed that the SG-JIB treated rats relative to SG- or JIB-treated ones produced a sustained reduction in food intake and weight gain. The level of active GLP-1 was elevated and total ghrelin level decreased in SG-JIB-treated rats as compared with SG- or JIB-treated ones. It was concluded that SG-JIB could efficiently reduce the body weight and food intake, alter obesity-related hormone levels of the rats, indicating that SG-JIB may be potentially used for the treatment of obesity.
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Objective To evaluate the differential diagnostic values of combined detection of adenosine de aminase (ADA),carcinoembryonic antigen (CEA),carbohydrate antigen 153 (CA153),neuron-specific enolase (NSE) and carbohydrate antigen 199 (CA199) in patients with pleural effusion.Methods Serum and hydrothorax fluid of CEA,CA153,NSE and CA199 in patients with plearal effusion were measured by electrochemiluminescence assay(ECLA),ADA from pleural effusions were measured by enzyme rate assay,and the clinical value of combined detection in the differential diagnosis of pleural effusion was evaluated.Results The levels of ADA(65.89±19.81 U/L) in hydrothorax fluid group with tuberculous pleural effusion were beth higher than those in the groups with inflammatory pleural effusion (17.33±16.58) U/L and malignant pleural effusion(27.44±22.64) U/L (q=12.19 and 10.72,P＜0.01).The positive rate of A DA was 82.88% (29/135) in hydrothorax fluid group with tuberculous pleural effusion,13.41% (11/135) in malignant pleural effusion and 11.11% (2/135) in inflammatory pleural effusion (X~2=59.07,P＜0.01).The levels and positive rate of CEA,CA153,NSE,and CA199 in serum and hydrothorax fluid group with malignant pleural effusion were both higher than those in the group with tuberculous pleural effusion (P＜0.05).Compared with the group with malignant pleural effusion,the levels of CA153 and CA199 in serum and the levels and the positive rate of NSE in serum and hydrothorax fluid were not statistically different in inflammatory pleural effusion group.In the 82 cases with malignant pleural effusion,the positive rate of the four kinds of serum tumor markers including CEA,CA153,NSE and CA199 was 74.39% (61/82) and the positive rate of those hydrothorax fluid tumor markers was 82.93% (68/82).Conclusions Combined detection of ADA,CEA,CA153,NSE and CA199 is of some significance to the differential diagnosis of pleural effusion.