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Most foreign bodies are often discharged without obvious symptoms after swallowing, but some may be misdiagnosed and stay in the body, resulting in serious complications. Different diagnostic methods should be integrated to diagnose such patients. Once diagnosed, they should be treated as soon as possible if necessary. The authors reported a case of retention in the body for 6 years after swallowing a wooden chopstick, resulting in the insertion into the psoas muscle after duodenal perforation, complicated by abdominal abscess. During the operation, endoscopic assisted laparoscopic foreign body removal was performed, and the patient showed good prognsis, which provided references for the diagnosis and treatment of the disease.
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Objective:To explore the clinical efficiency evaluation and prognostic factors of aspiration guided by neuronavigation in the treatment of pediatric brain abscess (PBA).Methods:A total of 47 patients with PBA were treated with aspiration guided by neuronavigation between January 2013 and January 2019 at the First Affiliated Hospital of Zhengzhou University.All clinical data were retrospectively analyzed.According to Glasgow Outcome Scale on discharge, all children were divided into 2 groups, namely good prognosis group and poor prognosis group.Prognostic factors were analyzed by using univariate analysis and binary Logistic regression multivariate analysis. Results:Among the 47 children, 38 children (80.9%) were assigned to the good prognosis group, and 9 children (19.1%) were assigned to the poor prognosis group.Univariate analysis proved that abscess volume>4 cm( χ2=5.650, P=0.017), multiple or multilocular abscess ( χ2=3.258, P=0.027), and abscess located in functional areas ( χ2=6.187, P=0.013) were correlated with poor prognosis.Multivariate analysis revealed that abscess volume>4 cm( OR=5.913, 95% CI: 2.241-25.917, P=0.023) and abscess located in functional areas ( OR=10.519, 95% CI: 3.918-62.513, P<0.001) were independent risk factors for poor prognosis. Conclusion:The treatment of PBA with aspiration guided by neuronavigation is safe, effective and minimal invasive, and the clinical efficiency is satisfactory.Abscess volume>4 cm and abscess located in deepbrain/functional areas are independent risk factors for poor prognosis.
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Objective:To explore the diagnosis, treatment and prognostic of pediatric intracranial atypical teratoid/rhabdoid tumor(AT/RT).Methods:A total of 15 pediatric patients with intracranial AT/RT were treated between January 2012 and June 2019 at the First Affiliated Hospital of Zhengzhou University.The clinical data were retrospectively analyzed.Overall survival (OS) rate and progression free survival (PFS) rate were calculated by adopting Kaplan- Meier method.The differences between the 2 groups were tested by performing Log- rank method, and the prognostic factors were analyzed by COX regression. Results:There were 12 males and 3 females, with the median age of 5.5 years (ranging from 8 months to 17.1 years). All patients underwent surgical resection.Gross-total resection (GTR) was achieved in 10 cases and subtotal resection (STR) was carried out in 5 patients.The conducted treatments were as follows: surgery+ radiotherapy+ chemotherapy+ intrathecal injection in 6 cases, surgery+ chemotherapy+ intrathecal injection in 4 cases, surgery+ radiotherapy in 2 cases, and surgery alone in 3 cases.Until January 2020, the median survival time of all the 15 patients was 18 months (ranged 1-27 months), and the survival rate was 33.3%.The 1-year OS rate and PFS rate for all 15 cases were 71.5% and 49.7%, respectively.The 2-year OS rate and PFS rate were 17.9% and 0, respectively. Log- rank analyses revealed that the 1-year OS rates of children less than 3 years old and those older than 3 years were 87.5% and 57.1%, respectively ( χ2=6.057, P=0.014). The 1-year OS rates of children with GTR and those with STR were 90.0% and 40.0%, respectively ( χ2=6.057, P=0.014). The 1-year OS rates of children with tumor dissemination and those without tumor dissemination were 100.0% and 33.3%, respectively( χ2=9.865, P=0.002). The 1-year OS rates of children in the standard-risk group and those in the high-risk group were 88.9% and 41.7%, respectively ( χ2=5.111, P=0.024). COX regression analyses proved that age, the extent of tumor resection, tumor dissemination and risk stratification are independent risk factors for prognosis [hazard radio( HR)=3.411, 3.795, 5.245, 3.397; P=0.025, 0.011, 0.001, 0.017]. Conclusions:Pediatric intracranial AT/RT is rare.The preliminary diagnosis and prognosis are difficult and poor, respectively.The complete resection of tumors with maximal safety remains the primary treatment.Age, the extent of tumor resection, tumor dissemination and risk stratification are independent prognostic factors for AT/RT children.
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Multi-drug resistant tuberculosis remains a serious infection disease endangering children health.Linezolid, as an effective and safe anti-tuberculous drug has achieved good results in the treatment of adults with multi-drug resistant tuberculosis.Recently, some advances have been made associated with Linezolid on treatment of multi-drug-resistant tuberculosis in children.Therefore, in this article, theses progresses were reviewed and the information associated with current status and problems to be solved of Linezolid on the treatment of pediatric multi-drug resistant tuberculosis was introduced to promote its rational application based on published guidelines and researches.
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Tuberculous meningitis (TBM) is a serious type of extrapulmonary tuberculosis with a high disability rate and mortality, commonly diagnosed in children under 5 years old.It is known that early diagnosis and reasonable treatment can significantly improve the prognosis of TBM in children.Therefore, the strategies on diagnosis and treatment of TBM in children based on published guidelines and researchs were reviewed in this study, in order to provide guidance for its clinical diagnosis and treatment.
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Objective To study the effects of N,P,and K fertilizers on the growth and accumulation of secondary metabolites,to reveal the accumulation relationship between the biomass and the secondary metabolites in medicinal plants in the plantation,and to establish the basic theory of fertilization in medicinal plant culture.Methods Orthogonal design was used to study the effects of nine combinations of N,P, and K on the biomass and active constituents in three levels of three factors.While plants flowered,they were harvested,weighed,and smashed.Then contents of N,total caffee esters,and scutellarin were anaylzed.Results High amount of N,P,and K fertilizers was optimum to the accumulation of biomass, but low amount of N,P,and K fertilizers was optimum to the accumulation of total caffee esters and scutellarin.The N fertilizer significantly increased the biomass and decreased the content of total caffee esters and scutellarin in Erigeron breviscapus,but did not affect the active constituents yield.The effect of P on the accumulation of active constituents was higher than that of K,but its effect on the biomass accumulation was lower than that of K.The effect of K on the active constituents yield was the highest.Conclusion N,P,and K fertilizers could increase biomass and active constituents yield,nevertheless,decrease the contents of flavonoids in medicinal plants.