Objective To investigate the application and curative effect ofnasoalveolar molding plate in the presurgical orthodontic treatment of completeunilateral cleft lip and palate in infants. Methods From January 2003 to March 2004, 100 infants with complete unilateral cleft lip and palate received presurgical orthopedics by using nasoalveolar molding plate. According to the age, 100 infants(aging 10 days to 3 months, including 60 males and 40 females) were divided into the test group (10 days to 1 month) and the control group (1.3 months). The widths of lip cleft and dentoalveolar cleft and the rate of satisfaction for nose wing were compared between 2 groups before treatment and after the treatment.Results The widths of cleft lip and dentoalveolar cleft before orthodontic (5.0±1.6 mm,6.9±2.6 mm) and after orthodontics (4.1±2.7 mm, 6.4±29 mm）in the test group were less than those in the controlgroup（7.5±3.1 mm, 12.5±4.0 mm and 8.3±3.0 mm,10.8±2.6 mm）, being statistically different(Plt;0.05). The satisfactory rate of nose wing inthe test group (86.3%) was significantly higher than that in the control group(62.4%，Plt;0.05). Conclusion The advantagesof presurgical orthodontic treatment of complete unilateral cleft lip and palate in infants are as follows: repositioning the premaxillary segment, reducing the width of palate cleft, correcting the nasal deformities and facilitating surgical repair of cleft lip and palate.
【Abstract】 Objective Through a retrospective study, to observe the cl inical therapeutic effect for closed reductiontreatment of developmental dislocation of the hip (DDH), and to dynamically analyze characteristics of acetabular development after closed reduction in DDH. Methods A total of 100 single side DDH children who were treated by “the treatment mode of closed reduction” from January 2002 to December 2005 were followed up, including 18 males and 82 females, with the average age of 19.4 months (ranging from 7 months to 36 months). Sixty-eight patients had left side dislocation, while 32 had right side dislocation. According to Zionts dislocation grades, 15 cases were degree I, 50 degree II, 26 degree III and 9 degree IV. Adductor tenotomies and skeletal traction were carried out in 74 cases, while direct closed reduction was performed in 26 cases. The four-level functional evaluation criterion was used to assess the cl inical therapeutic effect. Lesional and homeochronous normal hips were paired, and acetabular index (AI) and AI (D/W) of lesional and normal hips, before the reduction and in the 3rd, 6th, 9th and 12th month, respectively, after the reduction, were dynamically measured. Results The total choiceness rate of 100 children was 88.00%. Twelve months after the reduction, lesional AI decreased from (37.17 ± 2.17) º to (27.02 ± 3.54) º, while lesional AI(D/W) increased from 22.06% ± 1.65% to 29.80% ± 3.56%, and the differences among each time-point had statistical significance (P lt; 0.01). Both rates of lesional AI decrease and AI(D/W) increase were obviously faster than those of normal side physiological development (P lt; 0.01). In all durations after 12 months reduction, the rates of lesional AI were (3.22 ± 1.42) º and (3.41 ± 2.03) º in 1 - 3 months and 10 - 12 months , respectively, and the rates of AI(D/W) were 2.69% ± 1.83%and 2.33% ± 1.13%, respectively, and they were obviously faster than the other durations (P lt; 0.01). Both rates of lesional AI decrease and AI(D/W) increase were obviously faster than the homeochronous rate of normal side physiological development in each duration (P lt; 0.01). The rates of lesional AI were (13.71 ± 3.96) º and (11.48 ± 4.15) º in 7 - 12 age group and 13 - 18 age group, respectively, and the rates of AI(D/W) were 9.95% ± 3.81% and 8.28% ± 3.58%, respectively, and they wereobviously faster than the other age groups (P lt; 0.05). Both changes of lesional AI and AI(D/W) were obviously faster than the homeochronous changes of normal side in each age group(P lt; 0.01). Conclusion There are simple operating requirements and fine therapeutic effect of “the treatment mode of closed reduction” . Within 12-month after the closed reduction treatment, the rate of lesional acetabular development is obviously faster than that of normal side physiological development. The cresttime of lesional acetabular development is during 1 - 3 months and 10 - 12 months, and the best treatment time of closed reduction is the age before 18 months.
ObjectivesTo systematically review the clinical characteristics of pregnant females, newborns, children and adolescents with SARS infection.MethodsThe clinical characteristics of patients with SARS infection were searched using PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang Data and VIP databases. Descriptive analysis was performed to analyze the clinical characteristics of the patients, clinical manifestations, treatment and prognosis.ResultsA total of 13 studies including 19 pregnant females, 14 newborns, and 81 children and adolescents were identified. The ratio of male to female was 1 to 1.2 in children and adolescents patients aged 56 days to 17.5 years. Children under 12 years old accounted for 58.3% (28/48). Of the child patients, 34.0% (16/47) had close contact with patients with SARS. Fever (93.8%, 76/81) and cough (49.4%, 40/81) were the most common symptoms in children and adolescents with SARS infection, and 17.5% (11/63) occurred with shortness of breath or dyspnea. The positive ratio of nucleic acid detection for SARS-CoV was 9.2% (14/48), and the positive ratio of serum antibody was 92.9% (13/14). Peripheral blood lymphocyte reduction was approximately 65.7% (44/67). Approximately 70.8% (51/72) unilateral and 29.2% (21/72) bilateral lesions were found by thoracic X-ray or CT scan. No child fatalities were reported. As of maternal patients, aged 23 to 44 years, 10 cases (52.6%) were infected during early and middle pregnancy, and 9 cases (47.4%) during late pregnancy. Fever (100.0%, 19/19) and cough (78.9%, 15/19) were the main clinical symptoms, and shortness of breath/dyspnea occurred in 36.8% (7/19) of infected pregnant females. The positive ratio of nucleic acid detection for SARS-CoV was 50.0% (8/16), whereas the positive ratio of serum antibody was 93.3% (14/15). The ratios of thrombocytopenia, lymphopenia, and liver enzymes abnormalities were 38.9% (7/18), 61.1% (11/18) and 50.0% (3/6). All patients were identified for lesions by thoracic X-ray or CT scan examination. Seven cases were severe (36.8%). Five patients were treated with mechanical ventilation (26.3%). Three patients died (15.8%). Four patients were spontaneous abortion (40.0%, 4/10). Nine patients were cesarean sectioned (75.0%, 9/12). Six fetuses (46.2%, 6/13) with fetal distress, 7 cases (53.8%, 7/13) with premature delivery were identified. Three fetuses (23.1%) had intrauterine growth retardation. None of the fourteen newborns was diagnosed as SARS infection.ConclusionsThe clinical symptoms such as fever and cough in children and adolescents with SARS infection are similar to that of adult patients. However, children and adolescents are usually manifested as mild infection without reported death. There is no evidence to support that SARS-CoV could transmit vertically from infected mother to their fetuses.
Objective To systematically evaluate the clinical effect and safety of Bifidobacterium tetravaccine tablets in the treatment of antibiotic associated diarrhea (ADD) in infants in China. Methods Randomized controlled trials (RCTs) of treatment of AAD by Bifidobacterium tetravaccine in infants were searched by computer from China Knowledge Resource Integrated Database, VIP and Wanfang Data from their inception to November 2016. Meta-analysis of the data was carried out by RevMan 5.3 software. Results Twelve RCTs were chosen, which included 1 761 infant patients. The Meta analysis showed that the effects of treatment of ADD were significantly superior to those of the control group [OR=5.74, 95%CI (4.14, 7.96),P<0.000 01]. Among the 12 RCTs, 8 had no adverse reactions, while the rest4 articles did not mention adverse reactions. Conclusions Based on the present clinical evidences, treatment of ADD by Bifidobacterium tetravaccine in infants is effective and safe. But due to the small number and different quality of RCTs, this conclusion still needs to be confirmed by large sample, multicenter, and high-quality clinical RCTs.
ObjectiveTo investigate the high-risk factors for death in infants with severe pneumonia. MethodsWe analyzed hospitalized infants and young children diagnosed with severe pneumonia from January 2011 to December 2013, and investigated the risk factors for death. ResultsA total of 1 411 infants with severe pneumonia were included in the analysis. The mortality rate was 3.12%. In single factor analysis, the following factors were significant:age, severe infection, artificial feeding, congenital heart diseases, bad habitation, repeated infection history, surgical history, multi-organ dysfunction, internal environment disorder, multiple drug-resistant strains infection. The results of Logistic multiple regression analysis showed that there were statistical significance in severe infection, repeated infection history, Multiple drug-resistant strains infection, multi-organ dysfunction, and internal environment disorder. ConclusionInfants with severe pneumonia should be intensively monitored and actively treated for reducing the mortality rate if they have one of the following high-risk factors:age, congenital heart diseases, repeated infection history, multiple drug-resistant strains infection, surgical history, multi-organ dysfunction, and internal environment disorder.
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.
ObjectiveTo analyze the results of surgical treatment of severe aortic stenosis in infants.MethodsFrom August 2012 to December 2019, 28 infants undergoing aortic valvuloplasty in our hospital were selected, including 22 males and 6 females, aged 62.00 (47.00, 82.50) d. The baseline characteristics of the patients, postoperative complications and follow-up results were analyzed.ResultsTwenty (71.43%) patients had bicuspid aortic valves. Five (17.86%) patients had heart failure and two (7.14%) patients used prostaglandin before surgeries. Postoperative mechanical ventilation time was 25.00 (17.00, 62.75) h, ICU stay was 3.50 (2.00, 8.50) d and postoperative hospital stay was 10.00 (7.00, 16.50) d. Four (14.29%) patients got delayed recovery (ICU stay>14 d). One (3.57%) perioperative death was observed. The follow-up time was 55.00 (43.25, 82.25) months. No death was found during follow-up. Four (14.81%) patients underwent a second operation, including three (11.11%) patients with severe aortic stenosis, and one (3.70%) patient with severe regurgitation.ConclusionInfants with severe aortic stenosis are seriously ill and have a long postoperative recovery time, requiring early surgery. The postoperative follow-up results are satisfactory.
Objective To summarize the clinical characteristics, diagnosis and treatment of Bochdalek hernia in neonates and infants. Methods The data of 15 neonates and 10 infants with Bochdalek hernia，undergoing the normal diagnosis and surgical repair from August 1983 to June 2004, were retrospectively reviewed. Location was left in 22 cases and right in 3 cases. Twenty-four cases were treated by operation and 1 case died of respiratory failurebefore operation.Results Before April 1998，7 of 8 (5 neonates，3 infants) cases of Bochdalek hernia stayed healthy and respiratory symptomfree 1 year after operation; they were followed up 1 year and 3 months to 11 years. One premature neonate with Bochdalek hernia died of respiratory failure before operation, and his lung volume was found to be dysplasia. From April 1998 to June 2004, 15（8 neonates，7 infants） of 17 （10 neonates，7 infants）cases of Bochdalek hernia survived postoperatively, while 2 neonates died of respiratory failure. Conclusion The earlier dyspnoea of neonates ofBochdalek hernia occur，the worse their healthy status appear. The standard andtimely surgical repairs could improve the curative ratio. Whether the operationwas suspended depended on the healthy states of babies.
ObjectiveTo measure the ventricular size and extracerebral space of normal neonates and infants, and discuss the diagnostic criteria of MRI in external hydrocephalus. MethodsNeonates and infants suspected to have brain diseases treated in our hospital from January 2009 to January 2013 were selected, and through strict inclusion and exclusion, 671 neonates and infants within 3 years of age and without neural system disease were included in our study. They were divided into 9 age groups. The ventricular size was measured on T1WI, that was bifrontal index, bibody index and the ratio of ventricle and cranial cavity diameter (VT/ST). And the width of extracerebral space, intercerebral fissure and sylvian fissure were measured on T2WI. A total of 149 neonates and infants with external hydrocephalus underwent the same measurement, and the changes in external hydrocephalus were dynamically observed. ResultsVentricular volume increased gradually with age, but the bifrontal index[(0.32±0.05) mm] and the ratio of VT/ST (14.09%±1.56%) were relatively constant. The extracerebral space widened with age during 0-6 months, after which it began to narrow, and the age of 3-6 months was the turning point for this trend. The frontal subarachnoid, intercerebral fissure, and sylvian fissure of infants with external hydrocephalus were wider than standard values of the corresponding age group, and the ratio of VT/ST was less than 15%. ConclusionThe standard values of ventricular size and extracerebral space of each age group provide the basis for the evaluation of brain development. Among them, the bifrontal index and the ratio of VT/ST are reliable indicators to determine the ventricular size. Subarachnoid depth, intercerebral fissure, and the ratio of VT/ST play an important role in the diagnosis of EH. But for secondary external hydrocephalus, early treatment should be carried out.
ObjectiveTo observe the ocular clinical features and efficacy of young infants with incontinentia pigmenti (IP). MethodsA retrospective study. Clinical data of 18 young infants with IP aged 0-3 months in the Department of Ophthalmology of Henan Children's Hospital from October 2017 to February 2019 were collected in this study. All patients were underwent fundus examination under topical anesthesia or general anesthesia. Among them, 9 cases were underwent genetic testing. Patients were determined whether to treated with retinal laser photocoagulation (LIO) or intravitreal conbercept (IVC, 0.25 mg/0.025 ml) according to the condition of eyes. The followed-up time ranged from 4months to 43 months. The ocular clinical features and treatment were observed. ResultsThere were 1 male and 17 females of the 18 patients. The age of first visit were 1.2±1.0 months (2 d-3 months). All cases had typical skin lesions, 4 cases had neurological symptoms, 10 cases had tooth abnormalities, and 4 cases had cicatricial alopecia. Among the 9 cases that were underwent genetic testing, 5 cases were deleted in exons 4-10 of the IKBKG gene and 1case were a heterozygous mutation c.1124delT in exon 9 of the IKBKG gene. Among the 36 eyes, 21 eyes of 13 cases with incontinentia pigmenti-associated ocular diseases were all retinopathy (58.3%,21/36). Retinopathy of 9 cases were asymmetrical (69.2%,9/13). Among the 21 eyes, 3 eyes were simple retinal pigment abnormalities (14.3%,3/21) and 18 cases had retinal vascular lesion (85.7%, 18/21). Among the 36 eyes, 8 eyes were treated; 4 eyes were underwent LIO; 3 eyes were treated with IVC; 1 eye was treated with LIO combined with IVC. They were all improved significantly after the operation without serious complications. 1 eye with retinal detachment did not undergo surgical treatment due to guardian reasons. Perceptual exotropia and eyeball atrophy was found during the follow-up. ConclusionsThe onset of IP-related ocular anomalies is early. The early anomalies were mainly retinal vascular abnormalities. Treatment in early time is effective.