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Large-scale genomic projects and ancient DNA innovations have ushered in a new paradigm for exploring human evolutionary history. However, the genetic legacy of spatiotemporally diverse ancient Eurasians within Chinese paternal lineages remains unresolved. Here, we report an integrated Y-chromosome genomic database encompassing 15,563 individuals from both modern and ancient Eurasians, including 919 newly reported individuals, to investigate the Chinese paternal genomic diversity. The high-resolution, time-stamped phylogeny reveals multiple diversification events and extensive expansions in the early and middle Neolithic. We identify four major ancient population movements, each associated with technological innovations that have shaped the Chinese paternal landscape. First, the expansion of early East Asians and millet farmers from the Yellow River Basin predominantly carrying O2/D subclades significantly influenced the formation of the Sino-Tibetan people and facilitated the permanent settlement of the Tibetan Plateau. Second, the dispersal of rice farmers from the Yangtze River Valley carrying O1 and certain O2 sublineages reshapes the genetic makeup of southern Han Chinese, as well as the Tai-Kadai, Austronesian, Hmong-Mien, and Austroasiatic people. Third, the Neolithic Siberian Q/C paternal lineages originated and proliferated among hunter-gatherers on the Mongolian Plateau and the Amur River Basin, leaving a significant imprint on the gene pools of northern China. Fourth, the J/G/R paternal lineages derived from western Eurasia, which were initially spread by Yamnaya-related steppe pastoralists, maintain their presence primarily in northwestern China. Overall, our research provides comprehensive genetic evidence elucidating the significant impact of interactions with culturally distinct ancient Eurasians on the patterns of paternal diversity in modern Chinese populations.
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Pueblo Asiatico , Cromosomas Humanos Y , Migración Humana , Humanos , China , Pueblo Asiatico/genética , Masculino , Cromosomas Humanos Y/genética , ADN Antiguo/análisis , Herencia Paterna , Filogenia , Pueblos del Este de AsiaRESUMEN
Metasurfaces have garnered significant attention in recent years due to their substantial electromagnetic (EM) wave manipulation capabilities. However, most previously documented metasurfaces have been limited to controlling just a single EM wave mode, encompassing transmission, reflection, or absorption. Such limitations have impeded the broader applications of metasurfaces. To address this issue, this study introduces a multi-functional metasurface (MFM) in the utilization of Ge2Sb2Te5 (GST), vanadium dioxide (VO2), and graphene. This novel design enables real-time control over the transmission, absorption, and reflection of EM waves as necessitated through thermal control, allowing for seamless transitions from complete transmission to complete reflection. Furthermore, this configuration achieves extensive broadband perfect absorption, spanning up to 1.83 THz. The optical response mechanism of this MFM across distinct operational modes is meticulously analyzed through electric field distribution. Remarkably, this proposed MFM exhibits polarization insensitivity and maintains good optical performance even under conditions of wide-angle incidence. With the ability to switch to different operating modes according to the needs of different environments, the proposed MFM has the potential to be used in a wide range of scenarios, including radar stealth, wireless communications, and military search.
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Ultra-broadband and efficient terahertz (THz) absorption is of paramount importance for the development of high-performance detectors. These detectors find applications in next-generation wireless communications, military radar systems, security detection, medical imaging, and various other domains. In this study, we present an ultra-wideband THz wave metasurface absorber (UTWMA) featuring a composite surface microstructure and a multilayer absorbing material (graphene). This UTWMA demonstrates remarkable capabilities by achieving highly efficient absorption levels, reaching 96.33%, within the 0.5-10 THz frequency range. To enhance the efficiency and precision of the design process, we have incorporated artificial neural networks, which enable rapid and accurate parameter selection. Moreover, we have conducted a comprehensive analysis of the absorption mechanism exhibited by the UTWMA at different frequencies. This analysis combines insights from the electric field distribution and effective medium theory. The findings presented in this paper are expected to catalyze further research in the domain of broadband THz technology, particularly in the context of metasurfaces and related fields. Additionally, this work paves the way for the development of compact, supercontinuous THz photovoltaic or photothermal electrical devices.
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OBJECTIVE: To analyze the clinical characteristics of laryngomalacia in Chinese children and explore the surgical efficacy and factors influencing severe laryngomalacia. METHODS: Children (0-18 years) diagnosed with laryngomalacia in our hospital from January 2016 to January 2022 were enrolled in this study. Clinical data of patients, including general conditions, clinical symptoms, grading and classification, medical comorbidities, surgical efficacy, and the risk factors influencing severe laryngomalacia were retrospectively analyzed. RESULTS: A total of 1810 children were enrolled (male:female; 2.02:1), among which most were infants under 1 year (77.18%). Inspiratory laryngeal stridor (69.56%) was the most common symptom. Most patients had mild laryngomalacia (79.28%), with type IV laryngomalacia being the most common classification (52.27%). Congenital heart disease (37.85%) was the most common medical comorbidity. A total of 168 severe laryngomalacia cases were treated via supraglottoplasty with an effective rate of 83.93%. Notably, preterm birth (OR = 3.868, 95% CI 1.340 ~ 11.168), low birth weight (OR = 4.517, 95% CI 1.477 ~ 13.819) and medical comorbidities (OR = 7.219, 95% CI 2.534 ~ 20.564) were independent risk factors for poor prognosis (P < 0.05). CONCLUSION: Laryngomalacia is common among infants under the age of one, and it is mostly characterized by inspiratory laryngeal stridor with various medical comorbidity. Supraglottoplasty is the first treatment choice for severe laryngomalacia cases with high success rates. However, premature delivery, low birth weight, and medical comorbidities significantly affect the efficacy of surgery.
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Laringomalacia , Laringe , Nacimiento Prematuro , Lactante , Niño , Humanos , Recién Nacido , Masculino , Femenino , Laringomalacia/complicaciones , Laringomalacia/diagnóstico , Laringomalacia/cirugía , Estudios Retrospectivos , Ruidos Respiratorios/etiología , Resultado del Tratamiento , Glotis/cirugíaRESUMEN
This study aims to investigate the effects of obstructive sleep apnea on paediatric psychological and behavioural abnormalities. A total of 1086 paediatric patients with obstructive sleep apnea and 728 sample snoring controls were enrolled in the study. Patients with obstructive sleep apnea underwent bilateral tonsillectomy plus adenoidectomy or adenoidectomy alone. Repeated Autism Behaviour Checklist, Spence Children's Anxiety Scale, and Children's Depression Inventory were performed to assess the autism symptoms, anxiety level and depressive symptoms before and after surgery. The score of Autism Behaviour Checklist in preschool children with obstructive sleep apnea was higher than that in control. In school children with obstructive sleep apnea, the score of Spence Children's Anxiety Scale was also higher. School children with obstructive sleep apnea with depressive symptoms were significantly higher than that in control. The scores of Autism Behaviour Checklist, Spence Children's Anxiety Scale, and Children's Depression Inventory in the obstructive sleep apnea group after surgery were significantly lower than that before surgery. Our study showed that the score of Spence Children's Anxiety Scale and Children's Depression Inventory had a close correlation with the illness course and hypoxia duration. The Spence Children's Anxiety Scale and Children's Depression Inventory scores are also closely associated with the Autism Behaviour Checklist score. These results suggest that obstructive sleep apnea may have a significant impact on autism symptoms, anxiety levels and depressive symptoms in children. We found that the longer the duration of the obstructive sleep apnea course and hypoxia, the greater the impact on anxiety level and depressive symptoms. The suspected autism symptoms, anxiety level and depressive symptoms in children with obstructive sleep apnea were also significantly correlated. Thus, early detection and timely treatment may often reverse the psychological and behavioural abnormalities caused by obstructive sleep apnea.
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Apnea Obstructiva del Sueño , Tonsilectomía , Preescolar , Humanos , Niño , Estudios de Casos y Controles , Apnea Obstructiva del Sueño/complicaciones , Apnea Obstructiva del Sueño/epidemiología , Apnea Obstructiva del Sueño/diagnóstico , Adenoidectomía , Hipoxia/cirugíaRESUMEN
Objective:To analyze the efficacy of endoscopic surgical repair in the treatment of type â ¢ laryngeal clefts and to explore the feasibility of the treatment for type â ¢ laryngeal clefts. Methods:The clinical data of 6 children with type â ¢ laryngeal clefts who underwent endoscopic surgical repair in our department from June 2018 to January 2023 were analyzed retrospectively. The operation was performed under combined intravenous and general anesthesia,preserving the spontaneous breathing of the children. With the assistance of 4 mm/0° endoscope, radiofrequency knife or laryngeal scissors were used to make fresh wounds along the edge of laryngeal clefts,and cotton pads infiltrated with adrenaline ï¼1:10 000ï¼ were used to compress the wound. 6-0 PDP suture was used to suture 3-6 stitches according to the extent of laryngeal clefts. Modified barium swallowing test ï¼MBSï¼ was performed 3 months after operation. Results:All the children were successfully treated with endoscopic surgical repair. After surgery, 2 cases were transferred to pediatric intensive care unit ï¼ICUï¼ for 7 days of monitoring, and the rest were transferred back to the general ward. There were no postoperative complications. The symptoms of dysphagia, laryngitis and recurrent pneumonia were improved in all children. According to the follow-up results of postoperative MBS,no aspiration was found in all children, and 2 children had intermittent cough when drinking large amounts of water. During the follow-up, there were 2 cases of recurrence, and the cracks were completely repaired after the second endoscopic surgical repair treatment,and no recurrence has been observed so far. Conclusion:Endoscopic surgical repair can be applied to some children with type â ¢ laryngeal clefts with less intraoperative bleeding and fewer operative complications. It can significantly improve the symptoms such as swallowing dysfunction and recurrent pneumonia. It is a safe and effective surgical treatment.
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Anomalías Congénitas , Laringoscopios , Laringe , Neumonía , Niño , Humanos , Laringoscopía/métodos , Estudios Retrospectivos , Laringe/cirugía , Anomalías Congénitas/cirugíaRESUMEN
Objective:To investigate the clinical manifestations and the effect of peroral endoscopic-assisted laryngeal microsurgery for children with laryngeal neurofibroma, and to provide clinical reference for the diagnosis and treatment of this disease. Methods:The clinical data of 4 children with laryngeal tumors admitted to the Department of Otorhinolaryngology, Children's Hospital of Chongqing Medical University from January 2021 to June 2023 were retrospectively analyzed. Laryngeal tumors were removed by peroral endoscopic-assisted laryngeal microsurgery. One case underwent tracheotomy at the same time, and one case was simultaneously performed with laryngeal T tube placement and tracheotomy. Results:Surgical resection is the best treatment for laryngeal neurofibroma, and laryngeal microsurgery should be actively used for patients with surgical indications.This surgical method has the advantages of good efficacy, minimal invasion, aesthetics and preservation of laryngeal function, which not only ensures safety, but also improves the quality of life after surgery, and has the value of development and promotion.
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Neoplasias Laríngeas , Neurofibroma , Niño , Humanos , Neoplasias Laríngeas/patología , Laringoscopía/métodos , Microcirugia/métodos , Estudios Retrospectivos , Calidad de Vida , Neurofibroma/cirugía , Neurofibroma/diagnósticoRESUMEN
At present, there is no unified gold standard for the treatment of laryngeal clefts. Type â laryngeal clefts with mild symptoms can be treated conservatively, such as thick diet feeding and using proton pump inhibitor to control reflux, while â ¡-â £ laryngeal clefts mostly requires surgical intervention.There are many different surgical methods for the treatment of laryngeal clefts, including injection laryngoplasty, endoscopic surgical repair of laryngeal clefts and open laryngoplasty through anterior cervical approach. How to choose a more suitable surgical plan for children is a problem worth discussing. This article will review the literature on the surgical treatment of laryngeal clefts both domestically and internationally, and summarize the current situation and challenges of surgical treatment of laryngeal clefts.
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Anomalías Congénitas , Laringoplastia , Laringe , Niño , Humanos , Anomalías Congénitas/cirugía , Endoscopía , Laringoplastia/métodos , Laringoscopía/métodos , Laringe/cirugíaRESUMEN
Background: Many epidemiological studies have demonstrated the short-term effects of air pollution on acute otitis media (AOM) in children, but few studies have explored the association between AOM and air pollution in Chinese children. This study aimed to analyze the effects of air pollution on emergency visits for AOM among children through a time-stratified case-crossover design in Chongqing, China. Methods: The outpatient medical records of children from nine main urban districts who presented with AOM between December 22, 2018 and December 21, 2021 were collected from the Children's Hospital of Chongqing Medical University. Data for air pollution variables, including the air quality index (AQI), particulate matter ≤ 10 µm (PM10), PM2.5, SO2, CO, NO2 and O3 from 17 monitoring sites were collected. Data for meteorological factors as confounding variables also were collected. Conditional logistic regression was used to analyze the data with single-pollutant models, multi-pollutant models, and stratified analyses. Results: Increases in AQI, PM10, PM2.5, SO2, CO and NO2 were positively associated with emergency visits for AOM among children in single-pollutant models and stratified analyses. Increases in PM10, SO2, CO and NO2 were positively associated with emergency visits for AOM among children in multi-pollutant models. NO2 had the most statistically significant OR values in all models, whereas significant effects of O3 were observed only in seasonal stratification. In single-pollutant models, we found that the best lag periods were lag 0-7 for air pollution variables except for O3 and the largest OR values were 1.185 (95%CI: 1.129-1.245) for SO2 in single-pollutant models. In stratified analyses, there were no difference between groups in these statistically significant OR values through gender and age stratification, while the differences between seasons in these OR values of PM10, SO2, CO, NO2 and O3 were statistically significant. Children aged 0 years and 3-5 years represented the most susceptible population, and among the seasons, susceptibility was greater during Winter and Spring. Conclusion: Short-term exposure to air pollution can increase emergency visits for AOM among children in Chongqing, China.
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Contaminantes Atmosféricos , Contaminación del Aire , Contaminantes Ambientales , Otitis Media , Humanos , Niño , Estudios Cruzados , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Dióxido de Nitrógeno , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Material Particulado/efectos adversos , Material Particulado/análisis , Servicio de Urgencia en Hospital , Otitis Media/epidemiologíaRESUMEN
Background: The association between increased nasal resistance (NR) and obstructive sleep apnea syndrome (OSAS) is controversial. The purpose of this study was to examine nasal ventilation function (NVF) in children with OSAS, with a focus on its pathogenetic role. Methods: Children were recruited and divided into the OSAS group (n = 109) and control group (n = 116). The participants underwent polysomnography (PSG), measurement of NR, and acoustic rhinometry (AR). A combination of intranasal corticosteroids (ICS) and oral montelukast (OM) was administered to 90 children with mild to moderate OSAS for 12 weeks. After excluding participants who dropped out or were lost to follow-up, there were 58 children who responded to the treatment, who were divided into 2 groups-A and B. We compared the size of the tonsil adenoids, the PSG, NR, and AR before and after treatment in the 2 groups. Results: Children aged 6 to 12 years with OSAS had significantly higher NR than the control group (P < .05). The OSAS group had a smaller nasal minimal cross-sectional area (NMCA), nasal cavity volume (NCV) from 0 to 5 cm, and nasopharyngeal volume (NPV) from 6 to 8 cm than the control group, and the difference was statistically significant (P < .05 or P < .01). A total of 58 (84.1%) children responded to the 12-week ICS+OM treatment and 11 (15.9%) children did not respond to the treatment. Effective treatment was achieved in 32 children, as evidenced by a significant reduction in tonsil adenoid size and variations in NR and AR values. There were significant improvements in NR, NMCA, and NCV in the remaining 26 children who were successfully treated, but there was no change in tonsil adenoids and NPV value. Conclusion: NVF may play an important pathogenetic role in children with OSAS.
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Marine flow-passing components are susceptible to cavitation erosion (CE), and researchers have worked to find ways to reduce its effects. Laser Shock Peening (LSP), a material strengthening method, has been widely used in aerospace and other cutting-edge fields. In recent years, LSP has been used in cavitation resistance research. However, the current LSP research does not realize a comprehensive predictive assessment of the material's CE resistance. This paper uses m stresses to develop a comprehensive set of strengthening effect prediction models from LSP to CE using finite element analysis (FEA). Results show that the LSP-1 sample (4 mm spot, 10 J energy) introduced a compressive residual stress value of 37.4 MPa, better than that of 16.6 MPa with the LSP-2 sample (6 mm spot, 10 J energy), which is generally consistent with the experimental findings; the model predicts a 16.35% improvement in the resistance of LSP-1 sample to water jet damage, which is comparable to the experimental result of 14.02%; additionally, interactions between micro-jets do not predominate the cavitation erosion process and the final CE effect of the material is mainly due to the accumulation of jet-material interaction.
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BACKGROUND: Chronic infection with Clonorchis sinensis can cause hepatobiliary fibrosis and even lead to hepatobiliary carcinoma. Epstein-Barr virus-induced gene 3 protein (EBI3) is a subunit of interleukin 35, which can regulate inflammatory response and the occurrence of fibrotic diseases. Previous studies have reported that the expression of EBI3 in the serum of patients with liver cirrhosis is reduced. The present study aims to investigate the biological effects of EBI3 on liver fibrosis caused by C. sinensis and the underlying molecular mechanisms. METHODS: We first established a mouse model of liver fibrosis induced by C. sinensis infection and then measured the serum expression of EBI3 during the inflammatory and fibrotic phase. GO (Gene Ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway analyses were performed to investigate the potential role of EBI3 in liver fibrosis by regulating the extracellular matrix structural constituent and collagen catabolic process. Recombinant protein EBI3 (rEBI3) was added to hepatic stellate cells (HSCs) in vitro with C. sinensis antigen to explore its function. Finally, the therapeutic effect of rEBI3 was verified by intravenous injection into C. sinensis-infected mice. RESULTS: The results showed that the serum expression of EBI3 increased in the inflammatory response phase but decreased in the fibrotic phase. The excretory-secretory products of C. sinensis (Cs.ESP) were able to stimulate HSC activation, while rEBI3 reduced the activation of HSCs induced by Cs.ESP. Also, the protein expression of gp130 and downstream protein expressions of JAK1, p-JAK1, STAT3 and p-STAT3 in HSCs were increased after rEBI3 incubation. Finally, intravenously injected rEBI3 inhibited hepatic epithelial-mesenchymal transition in C. sinensis-infected mice by inhibiting HSC activation and reducing liver injury. CONCLUSION: This study confirms that rEBI3 can attenuate C. sinensis-induced liver fibrosis by inhibiting HSC activation and may be one of the potential treatments for liver fibrosis.
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Clonorchis sinensis , Infecciones por Virus de Epstein-Barr , Animales , Ratones , Células Estrelladas Hepáticas , Herpesvirus Humano 4 , Cirrosis Hepática/tratamiento farmacológico , Cirrosis Hepática/prevención & control , InterleucinasRESUMEN
BACKGROUND: The Tibetan group is one of the oldest Sino-Tibetan ethnic groups. The origin, migration as well as the genetic background of Tibetans have become the research hotspots in the field of forensic genetics. The use of ancestry informative markers (AIMs) allows the investigation of the genetic background of the Gannan Tibetan group. METHODS: In this study, the 165 ancestry informative single nucleotide polymorphism (AI-SNP) loci included in the Precision ID Ancestry Panel were used to genotype 101 Gannan Tibetans using the Ion S5 XL system. The forensic statistical parameters of 165 AI-SNP in the Gannan Tibetan group were calculated. Population genetic analyses including Nei's genetic distances, phylogenetic analyses, pairwise fixation index, principal component analyses and population ancestry composition analyses were also conducted to evaluate the genetic relationships between the Gannan Tibetan group and other reference populations. RESULTS: Forensic parameters of the 165 AI-SNP loci indicated that not all of the SNPs showed high genetic polymorphisms in the Gannan Tibetan group. Population genetic analyses indicated that the Gannan Tibetan group had close genetic affinities with East Asian populations, especially with the groups residing in its neighboring geographical regions. CONCLUSIONS: The 165 AI-SNP loci in the Precision ID Ancestry Panel showed high ancestral prediction powers for different continental populations. When trying to predict the ancestral information of East Asian subpopulations using this panel, the prediction results are not particularly accurate. The 165 AI-SNP loci showed varying degrees of genetic polymorphisms in the Gannan Tibetan group, and the combined use of these loci could be an effective tool in the forensic individual identification and parentage testing of this group. The Gannan Tibetan group has close genetic affinities with East Asian populations compared with other reference populations, especially tighter genetic relationships with the groups residing in its neighboring geographical regions.
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Genética de Población , Polimorfismo de Nucleótido Simple , Humanos , Tibet , Etnicidad/genética , FilogeniaRESUMEN
Although the design of graphene-based tunable broadband terahertz (THz) absorbers has attracted much attention, improving the functionality of the absorbers to adapt to different scenarios is still worth studying. This paper presents an innovative design of a quad-functional metasurface absorber (QMA) in the THz region, which can switch the absorption frequency/band by means of dual voltage/thermal manipulation. By electrically manipulating the chemical potential of graphene, the QMA can switch freely between the narrowband absorption mode ("NAM") and the broadband absorption mode ("BAM"), while thermally manipulating the phase transition of VO2 allows switching between the low-frequency absorption mode ("LAM") and the high-frequency absorption mode ("HAM"). Detailed mechanistic analysis shows that the "NAM" and "BAM" are due to the switching of the fundamental and second order graphene surface plasmon polariton (SPP) resonances, respectively, and the switching between "LAM" and "HAM" is due to the phase transformation of VO2. Furthermore, the QMA is polarization insensitive in all absorption modes and maintains excellent absorption performance at large angular incidence of TE- and TM-polarized waves. All the results indicate that the proposed QMA has great potential for stealth, sensing, switching, and filtering applications.
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INTRODUCTION: Allergic rhinitis (AR) in children is associated with various comorbidities, posing challenges for treatment and management. There have been few investigations of these multimorbidities in Chinese children with AR. Here, we investigated the prevalence of multimorbidities in children with moderate to severe AR and analyzed the influencing factors using real-world data. METHODS: In total, 600 children who visited the outpatient clinic of our hospital and were diagnosed with moderate-severe AR were prospectively enrolled. All children underwent allergen detection and electronic nasopharyngoscopy. Parents or guardians completed a questionnaire that included age, sex, mode of delivery, feeding pattern, and familial history of allergy. The multimorbidities investigated included atopic dermatitis (AD), asthma, allergic conjunctivitis (AC), chronic rhinosinusitis (CRS), adenoid hypertrophy (AH), tonsil hypertrophy (TH), recurrent epistaxis, and recurrent respiratory tract infections (RRTIs). RESULTS: The AR multimorbidities reported in children were as follows: recurrent epistaxis (46.5%), AC (46.3%), AD (40.7%), asthma (22.5%), RRIs (21.3%), CRS (20.5%), AH (19.7%), and TH (12.5%). In univariate logistic regression analysis, age (<6 years), birth mode, familial history of allergy, and single dust mite allergy were associated with AR multimorbidity (p < 0.05). Multivariate logistic regression revealed that a familial history of allergy was an independent risk factor for AC (odds ratio [OR] = 1.539, 95% confidence interval [CI]: 1.104-2.145) and AH (OR = 1.506, 95% CI: 1.000-2.267) (p < 0.05). Age (<6 years) was independently associated with the risk of AD (OR = 1.405, 95% CI: 1.003-1.969) and RRTIs (OR = 1.869, 95% CI: 1.250-2.793) (p < 0.05), cesarean section with AR and CRS risk (OR = 1.678, 95% CI: 1.100-2.561), and single dust mite allergy with asthma (OR = 1.590, 95% CI: 1.040-2.432) and CRS (OR = 1.600, 95% CI: 1.018-2.515) risk (p < 0.05). Further, non-dust mite allergy was independently associated with AR and CRS (OR = 2.056, 95% CI: 1.084-3.899). CONCLUSION: AR was found to be accompanied by different comorbidities, including both allergic and non-allergic comorbidities, complicating disease treatment. These findings demonstrated that age (<6 years), familial history of allergy, types of allergens, and cesarean section were risk factors for different multimorbidities associated with AR.
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Asma , Conjuntivitis Alérgica , Dermatitis Atópica , Infecciones del Sistema Respiratorio , Rinitis Alérgica , Sinusitis , Embarazo , Humanos , Niño , Femenino , Multimorbilidad , Cesárea/efectos adversos , Epistaxis/complicaciones , Rinitis Alérgica/epidemiología , Rinitis Alérgica/complicaciones , Asma/etiología , Alérgenos , Dermatitis Atópica/epidemiología , Conjuntivitis Alérgica/epidemiología , Sinusitis/epidemiología , Enfermedad Crónica , Infecciones del Sistema Respiratorio/complicaciones , Hipertrofia/complicacionesRESUMEN
OBJECTIVE: To characterize the risk factors for difficult removal of tracheobronchial foreign body (FB) by rigid bronchoscopy in children. METHODS: We retrospectively analyzed clinical data of 1026 pediatric patients (age: 0-18 years) diagnosed with tracheobronchial FB between September 2018 and August 2021. All patients underwent rigid bronchoscopy as the first intervention at our hospital. RESULTS: Children aged 1-3 years accounted for 83.7% cases in our cohort. The most common symptoms were cough and wheeze. FBs were more frequently found in the right bronchus, and trachea FBs accounted for only 8.19% cases. The success rate of rigid bronchoscopy in a single attempt was 97.27%. 12.18% of the cases were defined as difficult removal of FB. On univariate analysis, age, CT findings (pneumonia), type of FB, diameter of FB, FB location, granulation tissue formation, and the seniority of the surgeon were identified as risk factors for difficult removal of tracheobronchial FBs. On multivariate analysis, age ≥3 years, FB diameter ≥10 mm, FBs located in left bronchus, multiple FBs, granulation tissue, and the seniority of surgeon (<3 years, ≥5 years) were independent risk factors for difficult removal. CONCLUSIONS: Age, FB diameter, location of FB, granulation tissue formation, and the seniority of the surgeon were risk factors for difficult removal of FBs by rigid bronchoscopy.
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Broncoscopía , Cuerpos Extraños , Niño , Humanos , Lactante , Recién Nacido , Preescolar , Adolescente , Estudios Retrospectivos , Bronquios/diagnóstico por imagen , Bronquios/cirugía , Factores de Riesgo , Cuerpos Extraños/cirugía , Cuerpos Extraños/diagnóstico , Tráquea/cirugíaRESUMEN
OBJECTIVE: To characterize the correlative factors for types of tracheobronchial foreign bodies (TFBs) encountered in children. METHODS: All included patients diagnosed with TFB underwent rigid bronchoscopy as the first surgery in the Children's Hospital of Chongqing Medical University. The data of 1026 patients aged 0-18 years were retrospectively collected between February 2019 and January 2022. RESULTS: About 94.44% of the children with TFB had organic FBs, among which, peanuts were the most common FBs, followed by melon seeds and walnuts. The most common inorganic FBs included pen points or caps, plastic toys, and plastic papers. As compared to the children with organic FBs, those with inorganic FBs consisted of a higher proportion of children aged ≥3 years old, a time before surgery of >7 days, dyspnea, FBs size of >10 mm, longer operation time, more than two operation procedures, and atelectasis. On the other hand, the proportion of children with aspiration history, cough, and obstructive emphysema in the inorganic FB group was lower as compared to the organic FBs (P< .05). CONCLUSIONS: The related factors related to the patient's characteristics, symptoms, operation situations, and preoperative complications can be predicted based on the identification of FB type.
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OBJECTIVE: This study aimed to investigate the clinical features and prognostic correlation factors of sudden sensorineural hearing loss in children (CSSNHL). METHODS: From January 2016 to December 2021, the clinical data of hospitalized children presenting with sudden sensorineural hearing loss, including age, gender, the ear of onset, onset of treatment, concomitant symptoms, the degree of hearing loss, and audiogram curve type, were retrospectively collected and the effective rate of treatment and the factors affecting prognosis were statistically analyzed. RESULTS: The effective rate of CSSNHL was 29.97%. Univariate analyses showed that the onset of treatment, the degree of hearing loss, audiogram curve type, and tinnitus were associated with prognosis (P < 0.05). Multivariate analyses showed that onset of treatment was correlated with prognosis (OR = 0.939, 95% CI = 0.911-0.969, P < 0.001). Compared with patients in the profound group, the therapeutic performance of the severe, moderate, and mild groups were significantly different (OR = 9.951, 11.264, 13.373, 95% CI = 2.311-42.856, 2.818-45.028, and 5.310-33.677, P < 0.05). Compared with patients with profound audiogram, ascending audiogram and flat audiogram were related to therapeutic performance (OR = 13.373 and 14.481, 95% CI = 5.310-33.677, 6.509-32.217, P < 0.001). CONCLUSIONS: The prognosis of CSSNHL patients was related to the onset of treatment, the degree of hearing loss, and the audiogram curve type. Patients who received earlier treatment, had lighter hearing loss and the ascending and flat audiograms exhibited improved prognosis.
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Sordera , Pérdida Auditiva Sensorineural , Pérdida Auditiva Súbita , Humanos , Niño , Pronóstico , Estudios Retrospectivos , Pérdida Auditiva Sensorineural/diagnóstico , Pérdida Auditiva Sensorineural/complicaciones , Pérdida Auditiva Súbita/diagnóstico , Pérdida Auditiva Súbita/terapia , Pérdida Auditiva Súbita/complicaciones , Sordera/complicacionesRESUMEN
Objective: To investigate the clinical features and factors affecting the prognosis of children with profound sudden sensorineural hearing loss (SSNHL). Methods: We retrospectively analyzed the clinical data of 147 children with profound SSNHL who received inpatient treatment at our department from January 2016 to January 2021. All children were administered with systemic steroid therapy and/or intratympanic steroid (ITS) treatment for 2 weeks. Statistical analyses were performed for the clinical features, treatment effectiveness, and factors affecting the prognosis using SPSS 23.0. Results: The median age of the study population was 8 (6-10) years. The median treatment onset time was 8 (4-20) days. The most common concomitant symptom was tinnitus (45.58%). Laboratory findings showed that the percentages of children with abnormal leukocytes was 25.85%, abnormal platelet counts was 17.01%, abnormal cytomegalovirus IgG antibodies was 36.73% and abnormal Epstein-Barr (EB) virus IgG antibodies was 41.50%. The overall recovery rate of the treatment was 20.04%. The univariate analysis showed that age, treatment onset time, tinnitus, and ITS treatment were associated with the prognosis (p < 0.05). Regarding laboratory findings, the neutrophil count, lymphocyte count, and neutrophil-to-lymphocyte ratio differed significantly between the effective and invalid treatment effect groups (p < 0.05). The multivariable logistic regression analysis showed that treatment onset time [odds ratio (OR) = 0.936, 95% confidence interval (CI): 0.881-0.994] and ITS treatment (OR = 0.174, 95% CI: 0.044-0.0687) correlated with hearing recovery (p < 0.05). Conclusion: In this study, the earlier the treatment start time of children with profound SSNHL, the better was the prognosis. Further, ITS could be an effective treatment option.
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Adenoid hypertrophy is a common disease in pediatric otorhinolaryngology. Surgical resection is the main treatment at present, but many children still face the risk of postoperative recurrence or even secondary surgery. In order to reduce the postoperative recurrence rate and provide reference information for clinical medical staff and parents of the children, this review was carried out to analyze the domestic and foreign pertinent literature in recent years and put forward overall prevention strategies base on the related factors of recurrence.