Growth retardation and its influencing factors in infants aged 0‒3 in Minhang District， Shanghai / 上海预防医学

ObjectiveTo investigate the detection rate and main influencing factors of growth retardation in infants aged 0-3 in Minhang District， and to provide relevant evidence for early intervention， nutrition promotion and health guidance in the future. MethodsFrom September 1， 2020 to August 31， 2021， the height， weight， basic information of parents， feeding methods， and lifestyle habits of infants who received systematic healthcare aged 0‒3 in community health service centers and Minhang maternal child health hospital were collected， and the current situation and influencing factors of infant growth retardation were analyzed. ResultsAmong the 68 637 infants who underwent a systematic physical examination in Minhang District， the total detection rate of growth retardation was 5.03% （3 453/68 637）. The detection rates in the 0-year-old， 1-year-old， 2-year-old， and 3-year-old groups were 6.57% （1 636/24 885）， 3.90% （664/17 031）， 4.62% （827/17 905）， and 3.72% （326/8 773）， respectively. There was no difference in the detection rate of growth retardation between boys and girls （P>0.05）， and a multinomial logistic regression analysis of 13 influencing factors （infant birth weight， birth length， parental weight， height， education level， mother’s childbearing age， delivery mode， household registration， feeding mode within 6 months， infant sleep， etc.） in univariate analysis showed that birth weight <2 500 g （OR=3.99， 95%CI： 2.809‒5.674） or ≥4 000 g （OR=12.78， 95%CI： 8.868‒18.443）， maternal height <150 cm （OR=7.10， 95%CI： 4.294‒11.753）， paternal height <160 cm （OR=5.65， 95%CI： 2.792‒11.422）， maternal education level of junior high school and below （OR=1.31， 95%CI： 1.087‒1.588）， paternal education level of junior high school and below （OR=1.02， 95%CI： 0.838‒1.236）， mixed feeding （OR=1.15， 95%CI： 1.031‒1.288）， and sleep duration exceeding the recommended time （OR=1.58， 95%CI： 1.466‒1.710） were risk factors for growth retardation in infants aged 0‒3. Infants with a birth length <50 cm or with household registration in Shanghai had a higher incidence of growth retardation. ConclusionGrowth retardation in infants aged 0‒3 is influenced by a combination of genetic， environmental， and sleep factors. It is essential for parents to realize the impact of growth retardation on the future of their children early on and actively participate in the early detection， screening， and intervention of growth retardation.

A rare case of eosinophilic meningitis

Eosinophilic meningitis is a rare form of meningitis, usually caused by helminthic infection and the most common agent is Angiostrongylus cantonensis. It has a variable clinical presentation that ranges from cranial nerve abnormalities, ataxia, meningitis, encephalitis and rarely death. As the literature and reviews on this topic are rare, the standard treatment for eosinophilic meningitis caused by A. cantonensis infection has always been controversial. There is evidence that a 2-week course of high dose corticosteroid along with albendazole have helped in management. Here we discuss the case of a toddler with eosinophilic meningitis with Angiostrongylus species.

Research progress on the association between responsive feeding practices and infant and toddler′s eating behavior / 中华实用儿科临床杂志

The eating habits of children developed during infancy and toddlerhood is the foundation of their eating behaviors in later life, and have great influence on their nutritional status and health.Caregivers′ feeding practices affect children′s eating behaviors.Feeding practices are modifiable and can be used as an intervention.In recent years, responsive feeding practices have been extensively recommended.In order to expand knowledge of responsive feeding practices, and promote optimal feeding practices and children′s healthy eating behaviors, evidence about the associations between responsive feeding and infant and toddler′s eating behaviors was summarized in this paper.

A STUDY TO ASSESS THE KNOWLEDGE OF MOTHER OF TODDLER REGARDING GROWTH AND DEVELOPMENT IN SELECTED RURAL AREA AT CHANDRAPUR.

A good start at the beginning of life make a child to be an ef?cient person of the society because the ?rst ?ve years is a crucial period of child growth and development especially the growth of the brain. OBJECTIVES: To assess the existing knowledge of mother of toddler regarding growth and development, to associate the knowledge among mother of toddler regarding growth and development with a selected demographic variable. METHODOLOGY: The researcher conducted study in selected rural area and used descriptive research approach with quantitative quasi experimental research design in selected rural area. For the data collection structured knowledge questionnaire were used. Among 60 samples who gave consent for the study. The researcher found the study feasible and reliable. RESULT: The ?ndings of the study included, the analysis and interpretation of data collected from the subjects in the selected rural area. In this study, out of 60 subjects, the mothers (16.66%) had poor level of knowledge, were (16.66%) had average level of knowledge, then (43.35%) subjects had good level of knowledge, were (23.33%) subjects were having very good level of knowledge & (0%) were having excellent level of knowledge. CONCLUSION: The study revealed that there was a signi?cant knowledge of toddler mother regarding growth and development in selected rural area

The texture analysis of MRI diffusion-weighted imaging for predicting prognosis of neonatal hypoglycemic encephalopathy / 中华全科医师杂志

Objective:To investigate the prognostic value of texture analysis of MRI diffusion weighted imaging (DWI) for neonatal hypoglycemic encephalopathy (HE).Methods:The clinical data and MRI data of 119 patients with neonatal HE admitted to Children′s Hospital of Nanjing Medical University from July 2013 to September 2020 were retrospectively analyzed. The children were followed up to 7—8 months and scored by Bayley scales of infant and toddler development. According to the overall development index, the children were divided into three groups: normal group (≥85, group A, n=42), mild developmental retardation group (70－84, group B, n=46) and developmental retardation group (≤69, group C, n= 31). The whole brain region (except sulcus and cisterna) was delineated as region of interest (ROI) by LIFEx 3.4 software in MRI apparent diffusion coefficient images. A total of 37 parameters were calculated automatically by the software, The clinical data, including gender, gestational age, age at MRI scan, birth weight, mode of delivery, history of asphyxia at birth, maternal preeclampsia or diabetes, minimum blood glucose, duration of hypoglycemia, neonatal behavioral neurological assessment (NBNA), presence or absence of polycythemia); the texture parameters, including histogram, volume, gray level co-occurrence matrix (GLCM), gray level run length matrix (GLRLM), neighborhood gray tone difference matrix (NGTDM), gray level size zone matrix (GLSZM), in the three groups were analyzed; and the diagnostic efficacy of clinical parameters and texture parameters was analyzed. Multivariate Logistic regression was used to analyze statistically significant clinical parameters and texture parameters, and receiver operating characteristic curve (ROC) was used to evaluate the prognostic efficacy of these parameter for neonatal HE. Results:There were no significant differences in gender, gestational age, age at MRI scan, delivery mode and blood glucose minimum among the three groups ( P>0.05). There were significant differences in birth weight [(3 150±130)g, (3 020±220)g, (2 880±140)g, F=-0.31, P=0.015], history of suffocation (10 cases, 18 cases, 20 cases, P=0.001), history of maternal diabetes or preeclampsia (14 cases, 29 cases, 21 cases, P=0.002), blood glucose duration [(5.0±0.2)d, (8.0±0.4)d, (14.0±1.7)d, F=-3.09, P=0.030] and NBNA scores (32.0±3.2, 28.0±2.6, 22.0±1.9, F=-4.21, P=0.010) among three groups. There were significant differences in kurtosis and entropy of histogram (2.57±1.12, 3.66±0.98, 4.23±0.37, F=3.54, P=0.010;5.89±1.09, 7.67±2.12, 8.92±1.62, F=-4.42, P=0.020); energy, contrast and dissimilarity of GLCM (0.48±0.01, 0.36±0.02, 0.23±0.01, F=-3.12, P=0.001;2 419±21, 3 354±31, 4 313±26, F=-4.16, P=0.020;126±14, 153±23, 344±43, F=-3.50, P<0.001); long run emphasis of GLRLM (0.78±0.15, 1.12±0.12, 1.76±0.31, F=-4.13, P=0.006), run length non-uniformity and run percentage (71.7±13.9, 96.6±10.7, 104.1±13.5, F=-0.98, P=0.001;0.91±0.05, 0.84±0.21, 0.72±0.17, F=2.97, P=0.010); coarseness and busyness of NGTDM [0.09±0.01, 0.13±0.03, 0.26±0.07, F=-1.95, P=0.003;0.16(0.04, 4.14), 0.32(0.05, 9.84), 0.45(0.15, 10.14), H=-3.24, P=0.030], short-zone emphasis and short-zone high gray length emphasis of GLSZM (4.74±0.45, 3.44±1.03, 1.88±0.67, F=-3.14, P=0.040; 278 963±239, 164 607±544, 111 653±618, F=-3.84, P=0.001) among three groups. Multivariate Logistic regression showed that duration of hypoglycemia, NBNA score, energy, kurtosis, run percentage and short zone effect were independent risk factors for poor prognosis of neonatal HE ( OR=7.43, 4.09, 1.10, 2.11, 1.36, 1.68, P=0.002, 0.027, 0.001, 0.006, 0.007, 0.010, respectively). ROC curve showed that for combined hypoglycemic duration, NBNA and texture parameters, the area under the curve (AUC) was the highest (AUC=0.94, P<0.001). Conclusion:Texture analysis of the MRI diffusion weighted imaging can predict the prognosis of neonatal hypoglycemic encephalopathy at an early stage, which has better prediction efficiency when combined with clinical features.

Importance of ELABELA in the differential diagnosis of benign and malignant lesions of the thyroid gland

ABSTRACT Objective: This study investigated whether ELABELA plays a role in the differential diagnosis of benign and malignant lesions of the thyroid gland. Subjects and methods: Of the 87 patients included in the study, 12 had undergone surgery for benign thyroid diseases, 30 had papillary thyroid cancer without invasion and/or lymph node metastasis in the surrounding tissues in the pathology report, and 45 had papillary thyroid cancer with invasion and/or lymph node metastasis in the surrounding tissues. Results: In the macrocarcinoma group, the proportion of patients with severe ELABELA staining (61.1%) was higher than that in the adenoma (50%) and microcarcinoma (23.8%) groups, while the proportion of those with mild to moderate staining was lower (p < 0.001). In the microcarcinoma group, the proportion of patients with severe staining was lower than that in the adenoma group, while the proportion of those with mild to moderate staining was higher (p < 0.001). In papillary thyroid carcinomas, the rates of moderate and severe staining in the classical variant, mild staining in the follicular variant, severe staining in the classical + follicular variant, and severe staining in the oncocytic variant were higher. Conclusion: To the best of our knowledge, this study is the first to be conducted on this subject. In this study, ELABELA was not found to be significant in the differential diagnosis of benign and malignant lesions of the thyroid gland. In papillary thyroid carcinomas, severe ELABELA staining patterns were more common in macrocarcinoma patients than in microcarcinoma patients.

Clinical and demographic profile of paediatric patients presenting with acute diarrhea

Background: Diarrhea is a public health problem globally, being the 2nd leading cause of death in children under 5 years. Dehydration as well as malnutrition are also serious consequences of diarrhea. This study was carried out with an aim to focus on the clinical and demographic profile of diarrheal patients of pediatric age.Methods: Infants and children aged 6 months to 5 years were analysed for age and gender distribution, chief complaints, feeding practices, nutritional status and assessment of dehydration; from January 2018 to June 2019 in the Department of Pediatrics of a Tertiary Care Teaching Hospital.Results: Total 150 patients were analysed. Almost 50.67% group A and 41.34% group B patients belonged to toddlerhood. Male preponderance was also noted. Along with diarrhea, vomiting was noted in 22 group A and 21 group B and fever in 19 group A and 29 group B patients. Approximately 41-45% patients had no malnutrition and 55-60% had no dehydration in both the study groups.Conclusions: There is lack of awareness regarding dog bite and its management among the rural people fever and vomiting were most frequently associated with diarrhea. A little less than half of the study participants had some-dehydration. Nearly half of the patients belonged to toddler age group. Majority of the patients were exclusively breast-fed for six months.

Effect of play-based communication and behavior intervention on toddlers with autism spectrum disorder / 中华实用儿科临床杂志

Objective To compare and analyze the short-term effect of play-based communication and behavior intervention (PCBI) and applied behavioral analysis (ABA) on the treatment of toddlers with autism spectrum disorder (ASD).Methods Seventy-four ASD toddlers aged from 19 to 30 months were recruited in Nanjing Brain Hospital Affiliated to Nanjing Medical University from November 2017 to May 2018.The toddlers who participated in this study were randomly assigned into PCBI group and ABA group,then they were intervened weekly by PCBI or ABA for a total of 12 weeks.Portage Early Development Checklist and autism treatment evaluation checklist (ATEC) were used to estimate the toddlers' developmental level and the treatment efficacy respectively.The t-test was used to reveal whether there was significant difference between the 2 groups before and after intervention.Results (1) Compared with the ABA group,there was a significant increase in cognitive scores (△PCBI =9.03 scores,△ABA =4.27 scores,t =3.997) and a significant decrease in social behavior scores (△PCBI =8.87 scores,△ABA =16.91 scores,t =-4.022) of the Portage Early Development Checklist after 12 weeks of intervention in the PCBI group,and there were statistically significant differences(all P ＜ 0.001);while the total score and the scores of language,movement,and self-care subscale of Portage Early Development Checklist were also increased after PCBI intervention but without significant differences (all P ＞ 0.05).(2)Compared with the ABA group,after 12 weeks of PC BI intervention,the scores of social contact,perception,behavior of ATEC were decreased,but the difference was not significant (P ＞ 0.05);the total score of ATEC scale(△PCBI total =14.89 scores,△ABA total =22.22 scores,t =2.209)and the scores of language subscale(△PCBI language =2.89 scores,△ ABA language =6.43 scores,t =2.515) were decreased significantly,and there were statistically significant differences (all P ＜ 0.05).Conclusions After 12 weeks of the very early intervention of PCBI,the ASD toddlers all improved in clinical symptoms and developmental level.Compared with ABA intervention,PCBI very early intervention with parental guidance was comparable in short term efficacy,and PCBI was not taking up as much medical rehabilitation resources as ABA.

Relationship between Complementary Feeding Introduction and Early Childhood Caries: Results from the Korea National Health and Nutrition Examination Survey 2008–2015 / 대한지역사회영양학회지

OBJECTIVES: This study examined whether the infant feeding type and duration are related to the introduction of complementary feeding, and whether the appropriate introduction of complementary feeding in infancy is related to tooth decay in toddlers. METHODS: The subjects were 1,521 toddlers among 2~3 year old children in the Korea National Health and Nutrition Examination Survey from 2008 to 2015. The toddlers were divided into the appropriate group (4~6 months) and delayed group (>6 months) according to the timing of complementary feeding introduction. RESULTS: The delayed group were 26.5% of subjects and the formula feeding period in the appropriate group and delayed group was 8.4 and 10.3 months, respectively (P=0.002). On the other hand, there was no difference in the breastfeeding period between the appropriate group and delayed group (P=0.6955). Early childhood caries was more common in the delayed group (P=0.0065). The delayed introduction of complementary feeding was associated with a risk of early childhood caries according to the logistic models (OR 1.81, 95% CI 1.27–2.57). CONCLUSIONS: The introduction of complementary feeding is associated with early childhood caries. Therefore, the importance of the proper introduction of complementary feeding in infancy should be emphasized, and public relations and education for maternal care and breastfeeding should be provided through health care institutions.

Relationship between Complementary Feeding Introduction and Early Childhood Caries: Results from the Korea National Health and Nutrition Examination Survey 2008–2015 / 대한지역사회영양학회지

OBJECTIVES: This study examined whether the infant feeding type and duration are related to the introduction of complementary feeding, and whether the appropriate introduction of complementary feeding in infancy is related to tooth decay in toddlers. METHODS: The subjects were 1,521 toddlers among 2~3 year old children in the Korea National Health and Nutrition Examination Survey from 2008 to 2015. The toddlers were divided into the appropriate group (4~6 months) and delayed group (>6 months) according to the timing of complementary feeding introduction. RESULTS: The delayed group were 26.5% of subjects and the formula feeding period in the appropriate group and delayed group was 8.4 and 10.3 months, respectively (P=0.002). On the other hand, there was no difference in the breastfeeding period between the appropriate group and delayed group (P=0.6955). Early childhood caries was more common in the delayed group (P=0.0065). The delayed introduction of complementary feeding was associated with a risk of early childhood caries according to the logistic models (OR 1.81, 95% CI 1.27–2.57). CONCLUSIONS: The introduction of complementary feeding is associated with early childhood caries. Therefore, the importance of the proper introduction of complementary feeding in infancy should be emphasized, and public relations and education for maternal care and breastfeeding should be provided through health care institutions.

Diarrea aguda en el lactante y preescolar / Acute diarrhea in toddlers and infants

Acute diarrhea (AD) is the increase in frequency and volume of bowel movements with decrease in their consistency that lasts less than 14 days. AD is a major public health problem and is still nowadays a cause of significant morbidity and mortality during childhood, especially in children with nutritional deficits. At a younger age, there is a greater susceptibility to diarrhea, which is more intense and more likely cause dehydration. The prevention and management of dehydration is the mainstay of treatment. The use of medications must be used with caution, analyzing individual cases and based on the best available evidence. We will analyze the subject with special emphasis on treatment according to scientific evidence.

La diarrea aguda (DA) se define como el aumento en la frecuencia y volumen de las deposiciones con disminución de la consistencia y que dura menos de 14 días. La DA es un gran problema de salud pública y es aún hoy en día una causa de importante morbimortalidad durante la infancia en especial en niños con déficits nutricionales. A menor edad hay mayor susceptibilidad de presentar diarrea, siendo ésta de mayor intensidad y con mayores posibilidades de producir deshidratación. La prevención y el manejo de la deshidratación es el pilar fundamental del tratamiento. El uso de medicamentos debe ser criterioso, analizando cada caso individual y basado en la mejor evidencia disponible. Analizaremos el tema con especial énfasis en el tratamiento según evidencia científica.

Early Linguistic Developments of Simultaneous Bilateral Cochlear Implantees / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The present study aimed to compare receptive and expressive language development in children who have undergone simultaneous bilateral cochlear implantation (SCI) and those who have undergone bimodal stimulation (unilateral CI+ hearing aid). SUBJECTS AND METHOD: In a retrospective analysis of clinical data, 15 pediatric patients who have received SCI and nine patients who have received bimodal stimulation (BM group) were enrolled. CI was performed for all patients at 24 months of age. Category of Auditory Performance (CAP) scores, Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) scores, and developmental quotients (DQ) for expressive and receptive language were compared between the groups at 12 month of follow-up. The Percentage of Consonants Correct (PCC) of children evaluated at 4 years old was also compared. RESULTS: At 12 months of follow-up, significantly greater improvements in CAP scores (Δ4.25±0.5) were noted in the SCI group compared to the BM group (Δ3.56±0.88, p=0.041). Significantly greater improvements in IT-MAIS scores were also noted in the SCI group (Δ36.17±4.09) than in the BM group (Δ30.17±2.91, p=0.004). The DQ of receptive language was higher in the SCI group than in the BM group (87.6±15.4% vs. 75.5±12.0%, p=0.023) at 12 months of follow-up. Moreover, early SCI was associated with better receptive language skills. PCC index of children at 4 years old was higher in the SCI group than in the BM group (88.5±13.2% vs. 62±15.8%, p=0.014). Earlier SCI was associated with even greater improvements. CONCLUSION: Bilateral SCI is associated with significant improvements in language development when compared with bimodal stimulation. Earlier SCI was associated with better outcomes.

Reliability and Validity of the Korean Translation of Quantitative Checklist for Autism in Toddlers: A Preliminary Study

OBJECTIVES: We aimed to assess the test-retest reliability, internal consistency, and validity of the Korean version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT). METHODS: The Korean version of the Q-CHAT and the Korean version of the Child Behavior Checklist (CBCL) 1.5-5 were completed by parents of 24 toddlers and preschoolers with autism spectrum disorder (ASD) and 80 unselected toddlers and preschoolers. Parents of the ASD group also completed the Social Communication Questionnaire (SCQ), and Childhood Autism Rating Scale (CARS) scores were obtained from medical records. RESULTS: The ASD group scored higher on the Q-CHAT than the unselected group. The Cronbach's alpha coefficient of the Q-CHAT was 0.658, and test-retest reliability was calculated to be 0.836. The estimated area under the curve was 0.793. The total scores of the Q-CHAT in the ASD group demonstrated significant positive correlations with findings regarding pervasive development problems in the CBCL, SCQ, and CARS. A total score of 33.5 may be a useful cutoff point to use when identifying toddlers at risk of ASD. CONCLUSION: The Korean version of the Q-CHAT has good reliability and validity and can be used as a screening tool in order to identify toddlers and preschool children at risk of ASD.

Reliability and Validity of the Korean Version of the Infant-Toddler Social and Emotional Assessment

OBJECTIVE: This article examined the psychometric properties of the Korean version of the Infant-Toddler Social and Emotional Assessment (K-ITSEA). METHODS: Translation and back-translation of the K-ITSEA were conducted after obtaining a permission. Two thousand two hundred thirty six Korean community infants (1,199 boys and 1,037 girls) between the ages of 12 and 36 months (M=34.23, SD=3.80) and 90 clinical infant samples (60 boys and 30 girls) between the ages of 12 and 36 months (M=26.84, SD=6.24) participated in the present study. RESULTS: Confirmatory factor analyses supported the Internalizing, Externalizing, Dysregulation, and Competence domains as well as the 17 individual scales that comprise the K-ITSEA. Young children's sex and age differences emerged for some problem and most competence scales. All domains showed adequate intrascale reliability and test-retest reliability. Scale intracorrelation analyses and associations between the K-ITSEA and Korean version of PSI, Korean version of CBCL1.5-5 supported the validity of the assessment. Comparisons of the K-ITSEA scores for the Autism Spectrum Disorder, Psychiatric Disorders and Matched control groups supported the discriminant validity of the K-ITSEA. CONCLUSION: This preliminary results indicate that the K-ITSEA would be a useful assessment for detecting the early childhood's behavior problems and competences in Korean population.

Electronic Media Exposure and Use among Toddlers

OBJECTIVE: These days, young children are exposed to a wide range of smart devices and their usage of smart devices is rapidly increasing worldwide. However, the use of smart devices by young children has not been studied in detail yet because smart device is relatively recent. The purpose of this study was to investigate the exposure status of smart devices among 2–5 years old children in Korea. METHODS: Four hundred parents of 2- to 5-year-old children were invited to enroll. Data on demographic information and the frequency of media use, time of media use, age at first use of media was self-reported. RESULTS: Among 390 toddlers, 39.3% watched TV almost every day, while 12.0% of children used smartphone on a daily basis. During weekdays, 48% of the children watched TV for over an hour. On weekends, 63.1% of the children watched TV for over an hour. On weekends, 23.4% of children use their smartphones for over an hour. Children using smartphones before 24 months of age were 31.3%. CONCLUSION: Research has shown that TV and smartphones are the most popular digital devices used by toddlers. Most toddlers began using smart devices at 12–24 months. This study provides comprehensive information on children’s contemporary use of media.

Rare chronic stridor: Case report and literature review / Estridor de extraña duración: reporte de caso y revisión

Abstract This paper reports the case of a toddler with chronic stridor of four months of evolution, treated several times by micro-nebulization (MNB) with beta 2, adrenergics, O2 and corticosteroids with partial improvement. The patient did not have complementary studies nor a clear history of foreign body aspiration (FB). During the last visit to the ER, a neck X-ray revealed a stippling sign in the upper airway. A bronchoscopy was performed, and a sharp foreign body (fishbone) was found in the upper airway, which was subsequently removed. This case is reported due to the unusual evolution of the foreign body in the upper airway, which manifested as a chronic stridor that resolved without further complications.

Resumen Se presenta el caso de una paciente prescolar con estridor crónico de 4 meses de evolución, tratada varias veces mediante micronebulizaciones (MNB) con beta 2, adrenérgicos, O2 y corticoides con mejoría parcial, sin estudios complementarios ni antecedentes claros de atoramiento con cuerpo extraño (CE). Además, se realizó una radiografía de cuello (Rx) que reveló la presencia de imagen en punta de lápiz traqueal y una broncoscopia que comprobó la existencia de un cuerpo extraño puntiagudo (espina de pescado) en la vía aérea superior. Este caso se reportó por su inusual presentación, pues es un CE en la vía aérea superior que se manifestó con estridor crónico, sin mayores complicaciones.

Ruptura gástrica. Informe de un caso / Gastric rupture. Case report

Resumen La expresión abdomen agudo en pediatría implica el concepto de una emergencia médica de origen abdominal. En los primeros días de la vida, las anomalías digestivas congénitas (presentes en aproximadamente 1 de cada 5000 recién nacidos) constituyen la causa más importante de abdomen agudo. La ruptura gástrica es un cuadro que puede describirse como causa de catástrofe intraabdominal, pudiendo ocasionar shock y muerte del paciente. Este trabajo describe un caso de ruptura gástrica espontánea en un niño de tres años de edad, con cuadro clínico de más o menos 12 horas de evolución, consistente en dolor abdominal asociado a náuseas, distensión abdominal. La madre refirió que no ha había deposiciones ni flatos. Ecografía abdominal reportó abundante líquido en cavidad abdominal. El niño fue llevado a quirófano y falleció.

Abstract The expression acute abdomen in pediatrics, implies the concept of a medical emergency of abdominal origin. In the first days of life, congenital digestive abnormalities (those present in about 1 in 5000 infants) are the most important cause of acute abdomen. Gastric rupture is a condition that can be described as the cause of intra-abdominal cataracts, which can cause shock and death of the patient. This paper describes a case of spontaneous gastric rupture in a 3-year-old boy with a clinical picture of about 12 hours of evolution consisting of abdominal pain associated with nausea, abdominal distension, the mother who has not had bowel movements Abdominal ultrasound reports abundant fluid in the abdominal cavity, which is taken to the operating room and dies.

Development and validation for finite element model of one-year-old toddler head with detailed anatomical structures / 医用生物力学

Objective To explore the brain injury mechanism and enrich the database of human finite element (FE) biomechanical model by developing the FE model of one-year-old toddler head. Methods Based on CT data from Chinese one-year-old toddler head with substantial and detailed information, the head model with detailed anatomical structure was constructed by using the medical software Mimics to get the head geometry data, as well as the reverse engineering software to divide NURBS surface and build the geometric model. Finally, the FE pre-processing software was used mesh the model. The FE model of one-year-old toddle head was validated by data from anatomic and cadaver experiments, and was used for preliminary analysis on damage mechanism of one-year-old toddler head. Results The FE model of Chinese one-year-old male toddler head was developed, which included and distinguished the gray matter and white matter of brain and cerebellum, hippocampus, fontanel, sagittal suture, coronal suture, brainstem and ventricles. The cadaver head static compression experiments and drop experiments were reconstructed by using this head model, and the results showed that the FE model of head had similar mechanical properties with the cadaver, which proved the validity of the FE model. Simulation results showed that skull stiffness and skull injury severity varied with different compression rates. Conclusions The FE model of one-year-old toddler head with detailed anatomical structures is of great biofidelity. The FE head model can be used to further investigate the detailed injury mechanism of deep brain tissues, especially for the closed craniocerebral injury, which provides an effective way and tool for the related research and clinical application.

Clinical Value of ITMAIS in the EPLAD Assessment for Profound Hearing Impaired Children with Hearing Aids / 听力学及言语疾病杂志

Objective To explore the clinical value of ITMAIS in the early prelingual auditory development (EPLAD)assessment for bilateral profound hearing impaired children with hearing aids.Methods Profound sensorineural hearing impaired children fitted with hearing aids during October 2008 and July 2011 in our center were recruited in this retrospective study, and they would be tested with the ITMAIS at baseline, 3 months, and 6 months after hearing aids fitting.A total of 51 children were recruited in the study, and divided into 2 age groups according to the age at fitting, 1 yr group (28 children) and 2 yrs group (23 children).Results The EPLAD of children in both groups improved significantly in the first half of year after fitting (P<0.05).The mean EPLAD levels of children in both groups were close to or achieved the mean level of severe sensorineural hearing impaired children without intervention when they had had the hearing aids for 6 months.Conclusion Hearing aids could help the children with profound sensorineural hearing loss to improve the abilities of EPLAD.ITMAIS is a simple, an effective tool for assessing the early outcome of children with hearing aids, especially for the children who could not cooperate with the behavioral hearing test.

Role of maternal drug use and environmental exposure during pregnancy and delivery pattern in allergic infants and toddlers / 中华流行病学杂志

Objective To understand correlation between maternal drug use and environmental exposure during pregnancy and delivery pattern and allergy in infants and toddlers,and provide theoretical bases for the early prevention and intervention of infantile allergies.Methods Case control study based on cross-sectional investigation was conducted.Thirty-three cities were selected in China.Randomly cluster sampling method was used to select a community in each city as the study sample,the women with infants aged 0-24 months were interviewed in the form of face-to-face questionnaire survey.Infants and toddlers were divided into two groups:case group,including 2113children who had allergic symptoms and were diagnosed with allergic disease,and control group,including 6303 children who never had symptoms of allergic disease.Results Children whose parents had allergic disease histories were more likely to have allergic disease (OR=3.950) compared with the children whose mother or father had allergic disease histories (0R=2.277).Maternal use of antibiotics (OR=1.396),disinfector exposure (0R=1.386),smoking exposure (OR=1.301) during pregnancy and cesarean delivery (OR=1.255) were risk factors for allergic disease in infants and toddlers,the differences were significant (P＜0.05).Conclusion It is essential to conduct primary prevention of infant allergy during pregnancy,and it is necessary to avoid unnecessary cesarean delivery and irrational antibiotic use,disinfector and smoking exposures during pregnancy.