In order to guide diagnosis and treatment in children with sleep disordered breathing aged 1 to 23 months, the European Respiratory Society(ERS) summarized the evidence and released the European Respiratory Society statement based on clinical experience in 2016. This article aims to interpret the ERS statement. Children with apparent upper airway obstruction during wakefulness and those with SDB symptoms and complex conditions requires treatment. Adenotonsillectomy and continuous positive airway pressure are the most frequently used treatment measures along with interventions targeting specific conditions. Obstructive SDB in children aged 1 to 23 months is a multifactorial disorder that requires objective assessment and treatment of all underlying abnormalities.
Objective To investigate the optimal timing for surgical treatment of infants less than six months of age with tetralogy of Fallot (TOF), and to improve surgical results and reduce early mortality. Methods Clinical material of 108 consecutive patients with TOF who were less than six months of age undergoing early surgery from Oct.1996 to Dec. 2006 were retrospectively reviewed. There were 70 males and females with mean age of 4.70 months (9 d-6 months). 104 patients underwent complete repair and four patients underwent BlalockTaussig (B T) shunt. Emergency procedures have been performed in 5 patients. Results Five patients (4.63%) died of low cardiac output syndrome (3 patients), pulmonary infection and acute respiratory distress syndrome (1 patient), and acute necrotizing enteritis (1 patient).82 patients were followed up, followup period was 31.17±40.00 months.21 patients lost to followup. One patient(0.92%) required additional intervention for pulmonary valve stenosis 6 months after operation. Heart functional class(New York Heart Association) recovered toⅠ-Ⅱgrading in other patients. Echocardiography shows: no residual ventricular shunt, no stenosis in right ventricular outflow tract and pulmonary valve, pressure difference≤50 mm Hg. No late deaths. Conclusion Early definitive repair of TOF can be performed safely on infants less than six months of age, the results of low mortality is acceptable.
ObjectiveTo compare and analyze the electroencephalographic (EEG) characteristics of infants with infantile epileptic spasms syndrome (IESS) and healthy infants during sleep using power spectral density (PSD) analysis. MethodsInfants aged 5 to 9 months with IESS were included, along with an equal number of age-matched healthy controls. EEG signals during sleep were recorded using the Nihon Kohden EEG-1200C system. The energy distribution in the theta (θ), alpha (α), sigma (σ), and beta (β) frequency bands, as well as the morphology and values of PSD within the 4 ~ 30 Hz range, were analyzed. Additionally, spectral entropy (SpEn) was calculated to evaluate signal complexity. Results A total of 10 IESS patients and 10 healthy infants were included. There were no significant differences in gender or age between the two groups (P=0.64, P=0.88). In both groups, PSD values showed a linear decreasing trend with increasing frequency. However, the IESS group showed notable differences in PSD morphology, amplitude, and energy distribution compared to controls. These included the absence of a σ-band peak, greater PSD dispersion across electrodes, significant alterations in energy distribution across θ, α, σ, and β bands, and significantly higher PSD values in the 4 ~ 30 Hz range (P<0.000 1). SpEn analysis revealed significantly elevated spectral entropy across the sigma band in the IESS group, indicating a lack of dominant frequencies, increased complexity, reduced rhythmicity, and enhanced disorder. In contrast, healthy controls exhibited elevated SpEn in the alpha band, reflecting the physiological reduction or disappearance of dominant alpha rhythms during sleep. Conclusion Infants with IESS demonstrate distinct EEG characteristics in both PSD and SpEn analyses compared to healthy infants. These quantitative spectral features reflect the underlying abnormalities of EEG in IESS and provide objective insights that complement conventional visual assessment, offering a novel perspective for early diagnosis and therapeutic monitoring.
Objective To identify proteins that have expressed in human eyes from adults and two-month old infants by proteomics approach, so as to build a two-dimensional gel electrophoresis (two-DE) reference map for human retina. The difference of proteomics between the retinas of adults and two-month old infants are also studied. Methods Human retina tissues were collected from donor eyes (nine adults and two infants). Proteins were separated by two-DE. The gels were analyzed by image software. Protein spots were excised from the gels and detected by matrix assisted laser desorption ionization time off light mass spectrometry (MALDI-TOF-MS). Results A total of 1179 spots and 1295 spots were detected respectively on two-DE gels of Coomassie-stained adults and two-month old infants retina, of which 1039 spots were matched in the position. Five spots up-regulated were successfully identified. Human serum albumin and 4 guanylate kinase 1 (GUK1) were identified in adult retina. beta;2-tubulin, transaldolase1 and alpha A-crystallin were identified in infant retina. Conclusion The two-DE reference map for retina proteomics is successfully established. This study provides an evidence of changes in retinal protein levels between adults and infants and biochemical pathways for future studies of human retina development.