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Objective:To explore the clinical characteristics, diagnosis, treatment and prognosis of inverted Meckel′s diverticulum in children, and to summarize the clinical experience.Methods:Ten children who received surgical treatment in Beijing Children′s Hospital, Capital Medical University from October 2018 to October 2021 were retrospectively analyzed.The children were diagnosed with Mecker′s diverticulum.Their data were complete and their fo-llow-up information was available.The clinical features, diagnosis, treatment and prognosis were summarized.There were 6 males and 4 females, whose age of onset ranged from 5 months to 12 years and 5 months.The clinical manifestations were abdominal pain in 8 cases, crying in 2 cases and bloody stool in 3 cases.B-ultrasound showed suspected diseases secondary to inverted Meckel′s diverticulum, including small intestinal intussusception in 6 cases and back junction type intussusception in 4 cases.One case of small intestinal intussusception was misdiagnosed after laparoscopic exploration in other hospitals and suffered from recurrent intussusception.All patients underwent segmental bowel resection.Results:Of the 10 children, 8 cases received laparoscopic exploration and 2 cases underwent open surgery for secondary intestinal necrosis.Postoperative pathology revealed Meckel′s diverticulum.Ectopic tissue was accessible in 8 cases, including ectopic gastric tissue in 7 cases, and ectopic pancreas in 1 case.During the postoperative follow-up period (1 month-3 years), the patients were generally in good condition with no complications such as intestinal obstruction.Conclusions:Intussusception secondary to inverted Meckel′s diverticulum is rare and difficult to diagnose before operation.The diagnosis should be confirmed by surgical exploration and postoperative pathology.However, careful surgical exploration is required since inverted Meckel′s diverticulum is prone to be misdiagnosed during exploration.
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Objective:To investigate the relationship between the polymorphisms of two SNP loci (rs901823 and rs3736228) in the low density lipoprotein receptor-associated protein 5 (LRP5) gene and glucocorticoids-induced osteoporosis (GIOP) in children.Methods:87 children with GIOP who were treated in Beijing Aiyuhua Women’s and Children’s Hospital and Beijing Children’s Hospital affiliated to Capital Medical University from Jan. 2015 to Dec. 2020 were selected as the research objects, and 100 children with normal bone mass who were treated with corticosteroids in this hospital during the same period were enrolled as the control group. Capillary electrophoresis and fragment analysis (SNaPshot) technology were used to genotype SNP sites rs901823 (T>C) and rs3736228 (C>T) ; Quantitative real-time fluorescence quantitative polymerase chain reaction detection method was employed to determine the relative mRNA of LPR5 gene The amount of expression.Results:For the rs901823 locus of the LRP5 gene, the TT, TC, and CC genotype distribution differences between the GIOP group and the control group were statistically significant ( χ2=14.176, P=0.001) . Compared with the TT genotype, carriers of the TC and CC genotypes had a higher risk of GIOP, with OR values of 3.022 (1.189-6.387) and 5.483 (1.452-20.883) ; For academic significance, OR values were 3.412 (1.795-6.587) and 4.352 (1.215-15.982) . For the rs3736228 locus, the distribution of CC, CT, TT genotypes between the GIOP group and the control group was significantly different ( χ2=9.597, P=0.008) . Compared with CC carriers, CT genotype carriers had a significantly increased risk of GIOP, with an OR value of 5.125 (1.721-16.241) . The result of a dominant model was statistically significant, with an OR value of 4.165 (1.335-14.652) , while for TT there was no statistically significant difference between the carrier and the CC genotype ( P=0.512) , and the results of the recessive model also showed no significant statistical significance ( P=0.887) . There was a statistically significant difference in the frequency distribution of T and C alleles at rs901823 between the GIOP group and the control group ( χ2=17.298, P<0.001) , and the difference in the frequency distribution of C and T alleles at rs3736228 was also statistically significant ( χ2=9.356, P=0.002) . The relative expression level of LRP5 gene mRNA in children with GIOP was 1.34±0.26, which was significantly lower than the expression level of LRP5 gene mRNA in children in the control group of 3.06±0.42 ( t=8.248, P<0.001) . Among children with GIOP, the relative expression of LRP5 gene mRNA in patients with rs901823 locus TT, TC, and CC genotypes was statistically significant ( P<0.001) ; the differences in rs901823 locus CC, CT, TT genotype patients were significant. Pairwise comparison of the relative expression of LRP5 gene mRNA showed that there was no significant difference between the TT group and the CT group ( P>0.05) , but the expression of the CC group was significantly higher than that of the CT group and the TT group ( P<0.05) . Conclusion:The rs901823 and rs3736228 polymorphisms of LRP5 gene are correlated with the occurrence of GIOP and can be used as genetic markers for predicting GIOP in children.
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BACKGROUND:Medical glue as a biological hemostatic material shows a good diffusivity in body fluids and blood, and has a rapid polymerization reaction, which plays an ideal hemostatic effect and promotes wound healing. OBJECTIVE:To investigate the clinical value of medical glue as a hemostatic material in the open wound of the frontal plane in children. METHODS:Totaly 1 218 children with open wounds of the frontal plane treated with medical glue were enroled as observation group, and another 600 children with open wounds of the frontal plane treated with silk sutures as control group. Wound healing time, postoperative wound bleeding, suture reaction, pigmentation and scar hyperplasia were compared between the two groups. RESULTS AND CONCLUSION:Compared with the control group, the operative time, blood loss and wound healing time were al less in the observation group (P < 0.05), and the effective bleeding rate was higher in theobservation group (P < 0.05). Stage I wound healing occurred in 1 215 cases of the observation group, and 586 cases of the control group. At the end of 12-month folow-up, healed scar formed with no knot scar and needle scar, the skin color was similar and cosmetic results were good in the observation group; in the control group, there were more obvious scars, visible knot and needle scars, and erythema, induration and hypertrophic scars were found around the most wounds. The medical glue for open wounds of the frontal plane in children has good biocompatibility and cosmetic results, which is safe and convenient in clinical use.
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A kind of active catheter used for minimally invasive surgery and actuated by shape memory alloy (SMA) was developed in this paper. The outer diameter of the catheter is 1.25 mm. The catheter was designed to consist of several bending units for achieving a large bending angle, but at the same time not increasing the outer diameter too much. It was considered that the deflection curve of axis of the catheter is determined by the output force of the SMA actuators. Based on large deflection theory, the deflection curve equation of the axis of the catheter was set up using precise form of the curvature. Through integral transform, the length and output force of each SMA actuator under the anticipative attitude of the tip of the active catheter were obtained, and the accurate coordinate of the center of the joint was givein. This study has provided great convenience to get control of the catheter, and has improved, to a certain extent, the design philosophy of problems such as active catheter.