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Objective:To investigate the characteristics and management of the emergency patients with orthopaedic trauma during COVID-19 epidemic.Methods:A retrospective analysis was performed of the 32 emergency inpatients at Department of Orthopedics, Nanfang Hospital from January 20 to February 26, 2020. They were 23 males and 9 females, aged from 4 to 66 years (mean, 35 years). The causes for their injury included traffic accident in 14 cases, sharp cutting (e.g. by a kitchen knife) in 6 cases, heavy object crushing in one, machine crushing in one, fall in 2, and machine twisting in one. High energy injury occurred in 13 cases and low-energy injury in 9 cases. The injury involved the upper limb in 7 cases and the lower limb in 15 cases. Grade Ⅱ protection was adopted during the diagnosis and treatment for the one emergency patient who had not undergone nucleic acid screening for 2019-nCoV while grade Ⅰ protection for the other 21 patients. 2019-nCoV infection was recorded in the patients and medical staff as well. The measures and experience were reviewed in the management of orthopaedic emergencies during the COVID-19 epidemic.Results:During the diagnosis and treatment of 22 emergency patients with orthopaedic trauma, none of the medical staff or patients was infected with COVID-19. As the one emergency patient was treated as a suspected case and protected by grade Ⅱ measures, COVID-19 infection was ruled out after surgery.Conclusions:During the COVID-19 epidemic, front-line medical staff dealing with traumatic emergencies faced a higher risk of infection. The emergency orthopaedic traumas were mainly caused by a traffic accident or a machine, and those in the elderly patients by a sharp cutting or a fall. The incidence of COVID-19 infection could be reduced by COVID-19 screening before admission, appropriate anesthesia and surgical methods, protection of perioperative medical staff, postoperative wards care and psychological counseling.
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Objective:To analyze the characteristics of ultrasound in children with myocardial hypertrophy and to understand the etiology.Methods:From December 2016 to December 2019 in our hospital, 44 cases of children with ventricular septum and left ventricular posterior wall thickness Z value >2 were retrospectively analyzed.Results:There were 10 cases of hereditary myocardial hypertrophy (22.7%), 6 cases of hypertrophic cardiomyopathy showed asymmetric myocardial hypertrophy, the hypertrophy mainly concentrated in the apex, anterior septum and posterior septum, and the thickened myocardial fibers were disorderly arranged, the myocardial echo was disorderly and uneven; 2 cases had family history but did not do gene detection; 2 cases of glycogen storage disease type Ⅱ showed symmetrical myocardial hypertrophy, enhanced and dense myocardial echo, and progressive myocardial hypertrophy, 1 case was misdiagnosed as hypertrophic cardiomyopathy; 1 case of primary carnitine deficiency showed symmetric hypertrophy of myocardium with dense and uniform echo, which was misdiagnosed as hypertrophic cardiomyopathy for the first time; 1 case was clinically diagnosed as myocardial amyloidosis, symmetric hypertrophy of myocardium, dense and uniform echo, with unique signs of " ground glass degeneration" and granular strong echo. There were 29 cases (65.9%) with acquired myocardial hypertrophy, including 14 cases caused by aortic disease, 1 case with Williams syndrome, showing myocardial thickening mainly with ventricular septum thickening, but without abnormal myocardial echo; 12 cases were mothers with abnormal glucose metabolism during pregnancy, with thickening of interventricular septum and posterior wall of left ventricle without abnormal myocardial echo; 2 cases of renal hypertension showed concentric myocardial hypertrophy. The remaining 5 cases (11.4%) are unknown.Conclusions:The causes of myocardial hypertrophy are complex and diverse. Comprehensive analysis of imaging characteristics and clinical results should be used to identify the cause of the disease as early as possible and take timely intervention to the cause to save the child's life and improve the quality of life.
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The children with dilated cardiomyopathy (DCM) are in the different stages of growth and development,so the measurements of the cardiac size and the function in the echocardiography can change with those growth and development.But the influence factors of growth and development had been ignored by the previous standards,which was not conducive to evaluate the efficacy of drugs and the prognosis of patients.The disadvantages above can be overcome by converting the echocardiographic measurements into the Z score after correction of the body surface area.With the development of the ultrasonic technology,there have been some studies of the Z score combined with the ultrasound to assess the left/right ventricular heart function and prognosis in children with dilated cardiomyopathy.The progresses of Z score in children with dilated cardiomyopathy were reviewed in this article.
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Objective To explore the clinical value of two-dimensional speckle tracking imaging (2DE-STI) by measuring global longitudinal strain (GLS) in normal children.Methods Totally 176 normal children underwent cardiac ultrasound examination,the left ventricular GLS were measured,and the difference of GLS between gender was analyzed.And the changes of GLS with body surface area (BSA) and age were discussed.Results GLS had no significant difference between male and female ([-24.90 ± 2.06]％ vs [-24.93 ± 2.01]％,t =0.83,P =0.934).GLS had significant differences among different BSA groups (F=3.84,P =0.003),and the differences of GLS in BSA＞ 1.0 group and the other five groups were statistically significant (all P＜0.05).GLS had statistically significant differences among different age groups (F=4.81,P=0.001),and the differences of GLS in ＞9 years old group and the other four groups were statistically significant (all P＜0.05).Conclusion Left ventricular GLS presents certain regularity with children's growth.
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Bile collected from 28 cases with various hepatic or biliary diseases during operation was assayed for the ?-glucuronidase level. In Group I consisting of 14 patients with primary intrahepatic stone, the ?-glucuronidase level averaged 2250.67 u/dl, while in Group II consisting of 14 patieats with other hepatic diseases, it averaged only 463.99 u/dl(P = 0.01).The patients of both groups showed a declination of the enzyme level gostoperatively, but in Group I, the enzyme level raised with other hepatic diseases, he T-tube. The AMPS and MP contents of the bile .remarkable inhibitory effect on two substances exert their function in positive remarkable inhibitory effect on at pH4,6. It is believed that. ?-glucuronidase, Group 11 consisting the results of thisles in the reformation of biliary stones reformation biliaryWhen ?-glucuronidase level is lower than 200u/dl.Chinese traditional prescriptions with glycynrhizae liquid extract shows a remarkable inhibitory effect on this enzyme. In Chinese traditonal prescriptions, the drugs which can promote circulation and clear deposit are usually added. According to the results of this study, the authors suggest that the therapeutic effect of glycyrrhizae be emphasized.