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.
Objective To investigate the incidence of urolithiasis in infants aged 0-3 years old fed by milk powder tainted with melamine in the middle area of the Anhui province, as well as its relationship to gender, age, milk powder consumption and drinking water. Methods Questionnaires were distributed to 1079 infants who were screened for urolithiasis by ultrasound examination from September 25, 2008 to October 17, 2008. Data was collected by Epidata and analyzed by SPSS 13.0 software. Results A total of 646 (59.87%) male infants and 433 (40.13%) female infants underwent ultrasound examination in Anhui Provincial Hospital. Of these, 86 infants were diagnosed with urolithiasis with an incidence of 7.97%, including 62 males (72.09%) and 24 females (27.91%). The mean age of those infants with urolithiasis was 1.85±0.77, and all of calculus was located in kidney. The relationship between the incidence of urolithiasis and gender, age, drinking water, feeding bottle sanitation, birth status, as well as the amount of milk powder intake was assessed by using the Pearson Chi-square test. Results showed that significant differences were noted in the incidence of urolithiasis among infants of different genders or with different drinking water sources (Plt;0.05). The result of multiple logistic regression analyses indicated that gender was related to the incidence of urolithiasis (Plt;0.05). The incidence of urolithiasis in female infants was only 58.7% of that in male infants (OR 0.587, 95%CI 0.359 to 0.959). Conclusion The incidence of urolithiasis in infants aged 0-3 years of old in the middle area of Anhui province is relatively high and has anatomical specificity. Further data during the follow-up of these cases should be collected.
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 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 observe the efficacy and safety of lacosamide (LCM) as a monotherapy or as an add-on in the treatment of focal epilepsy in children aged 4 months to 4 years. MethodsThe study included 20 children with focal epilepsy who received oral LCM monotherapy or add-on therapy in Children's Hospital Affiliated to Soochow University from March 2022 to September 2022, including 9 males and 11 females with an average age of (22.4±13.0) months. The curative effects and adverse reactions at 1, 2, 3, 4, and 6 months after LCM treatment were analyzed. The initial dose of LCM was 2 mg/(kg·d) and increased by 2 mg/(kg·d) every week, maintenance dose 6 ~ 12mg/(kg·d). Results During the follow-up period of this study, the total effective cases were 17 (85.00%), and the number of control-free cases was 15 (75.00%). Conclusion LCM can effectively reduce the frequency of epileptic seizures in the monotherapy or add-on treatment of infants and young children with focal epilepsy, with few adverse reactions and high retention rate, which has high clinical application value.
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 summarize the clinical usage of modified ultrafiltration in pediatric cardiopulmonary bypass. MethodsWe selected 40 infants with congenital heart defects as our study subjects between January 2010 and February 2012. They were randomly divided into two groups. One group used modified ultrafiltration, while the other did not, during the operation with cardiopulmonary bypass. The different perioperative changes of pulmonary pressure and the tumor necrosis factor (TNF) and interleukin-8 (IL-8) concentration in plasma were observed in both the two groups. ResultsNo complication relative to modified ultrafiltration was found. After the operations began, TNF and IL-8 concentration in the two groups rose fast; at the end of operations and 2 hours after operation, the pulmonary pressure and TNF and IL-8 concentration in the two groups decreased, and the decrease in the modified ultrafiltration group was faster. ConclusionThe use of modified ultrafiltration during operations with cardiopulmonary bypass can reduce residual water within the body in a short period and decrease the concentration of inflammatory factors, which is helpful for postoperative recovery of the cardiac and lung functions.
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.
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 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.