RÉSUMÉ
Objective:To explore the risk factors for recurrence of intussusception in children after successful ultrasound-guided saline enema reduction.Methods:The clinical and follow up data of 355 hospitalized children with intussusception at the First Affiliated Hospital of Zhengzhou University from Feb 2018 to Feb 2023 were reviewed.Patients were divided into two groups by recurrence develped and the differences were compared, Data with significant differences were incorporated into multi-factor logistic analysis.Results:The overall recurrence rate was 15.8% (56/355). By univariate variable analysis model, there were statistically significant differences between the two groups in age, previous intussusception history, vomiting, maximum diameter of concentric circles shown by ultrasound, and concurrent bowel organic diseases (lead points) (all P<0.05). In multivariate Logistic regression model, age, previous intussusception history, maximum diameter of concentric circles, and lead points were independent risk factors for recurrent intussusception after saline enema.The optimal cut-off values for age and maximum diameter of concentric circles were 2 years and 33.5 mm, respectively, according to ROC curve analysis. Conclusion:Age older than 2 years, previous intussusception history, maximum diameter of concentric circles longer than 33.5 mm, and lead points are independent risk factors for recurrence after saline enema.
RÉSUMÉ
Objective:To investigate the clinical efficacy of anal dimple anorectoplasty on female infants with congenital anal atresia combined rectal vestibular fistula.Methods:Clinical data of 69 female infants with congenital anal atresia combined rectal vestibular fistula admitted to Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from July 2012 to July 2022 were retrospectively analyzed.They were divided into 2 groups according to the surgical methods: 34 cases of anal dimple anorectoplasty(group A) and 35 cases of anterior sagittal anorectoplasty(group B). The operation time, length of stay, short-term complications, long-term complications and bowel function (determined by the Rintala score at 6 months postoperatively) of the two groups were compared.The difference in the incidence of postoperative complications between groups was compared by Chi- square test, and the remaining differences between groups were compared by the paired t-test. Results:The operative time [(80.18±9.29) min vs.(103.85±8.26) min] and postoperative hospital stay[(6.10±1.52) d vs.(7.63±2.40) d] in group A were significantly shorter than those of group B ( t=11.40, 2.62; all P<0.05). The Rintala total score at 6 months postoperatively in group A was significantly higher than that of group B[(19.36±0.93) points vs.(18.76±0.44) points]( t=3.20, P<0.05). There were no significant differences in the incidences of short-term [(4/34, 11.8%) vs.(7/35, 20.0%)] and long-term complications [(2/34, 5.9%) vs.(4/35, 11.4%)]between group A and group B ( χ2=0.75, 0.75; all P>0.05). Conclusions:Anal dimple anorectoplasty for female infants with congenital anal atresia combined rectal vestibular fistula is safe and effective.
RÉSUMÉ
Objective To investigate the iodine nourishment in women of child-beating age in high risk region of iodine deficiency disorders (IDD) in Qinghai Province. Methods According to The Notice to Launch a Reinforced Survey on IDD in High Risk Region issued by The Ministry of Public Health, 17 counties in 6 districts were selected as investigated area in Qinghai Province in 2007, using two stage cluster sampling and combining The National IDD Preliminary Surveillance Scheme, 30 women aged from 18 to 40 years were selected in each village, 1 or 2 villages in each town, 3 to 5 towns in each county, who were divided into newly wedding, pregnant, lactation and other women of child-bearing age. Iodine concentration in urine was detected by the method of As3+-Ce4+catalytic spectrophotometry. Results One thousand six hundreds and four urine iodine samples were analyzed. The median was 93.3 μg/L,52.1%(836/1604),31.8%(510/1604) and 12.4%(199/1604) was lower than 100,50 and 20 μg/L, respectively. It was 70.5%(527/747) and 43.0%(128/298) of women in Yushu and Haixi that had urinary iodine lower than 100 μg/L, respectively, while it was 50% of women in the 6 districts, to be specific, 88.3%(91/103) in Nangqian, 83.8% (62/74) in Zaduo and 70.7%(118/167) in Zhiduo Counties respectively. The median of urinary iodine in women who were not lactating and not pregnant was only 88.6 μg/L, of whom 53.9% (763/1415) lower than 100 μg/L. Conclusions The women of reproductive age in high risk region of IDD are deficient of iodine in Qinghai Province.