Clinical analysis of 10 neonates with primary segmental volvulus / 中国新生儿科杂志

Objective:To summarize the clinical features of primary segmental volvulus (PSV) in neonates.Methods:A retrospective analysis was conducted on the clinical data of neonates with PSV who were admitted to the Department of Neonatal Surgery, Children's Hospital Affiliated to Capital Institute of Pediatrics from May 2014 to May 2023. The clinical manifestations, auxiliary examinations, treatment and prognosis of the neonates were summarized, and descriptive statistical analysis was performed on the collected data.Results:A total of 10 neonates with PSV were included, with a mean gestational age of (34.1±3.0) weeks and birth weight of (2 291±646) g. Eight cases had an onset age of 3 d or less, and 2 cases had an onset age of more than 3 d. Abdominal distension was observed as the main manifestation in all cases, while bilious vomiting occurred in seven cases and hematochezia in five cases. Imaging examinations mainly revealed low intestinal obstruction without specific manifestations. Laboratory tests showed metabolic acidosis and varing degrees of anaemia. Nine cases underwent diagnostic abdominal puncture, of which five had bloody ascites, two had clear ascites, one had bloody mixed with fecal-like ascites, and one had chylous ascites. All the cases underwent emergency exploratory laparotomy and segmental small bowel resections with either primary intestinal anastomosis or enterostomy. All cases were successfully cured and had been followed up to the age of 4 months to 9 years with good growth and development as normal children of the same age.Conclusions:Neonatal PSV is an independent abdominal emergency characterized by non-specific clinical manifestations and difficult preoperative diagnosis, but the overall prognosis is favorable after active surgical treatment.

The relationship between thrombospondin 1 expression and angiogenic factors in acute cerebral infarction / 中风与神经疾病杂志

@#To investigate the relationship between thrombospondin 1 （TSP1） and angiogenesis factors in acute cerebral infarction. Methods 107 cases of acute cerebral infarction in the Department of Neurology，the Second Affiliated Hospital of Zhengzhou University were selected as the case group，and 90 healthy people admitted to hospital for physical examination were selected as the control group. Enzyme-linked immunosorbent assay （ELISA） was used to detect TSP1，transforming growth factor （TGFα） and fibroblast growth factor 2（FGF2），and the expressions of the three were compared between the case group and the control group，as well as under different NIHSS scores；Spearman method was used to analyze the correlation between TSP1 and TGFα，FGF2；multivariate regression method was used to analyze the occurrence of cerebral infarction The risk factors of cerebral infarction；ROC curve analysis of TSP1，TGFα and FGF2 on the prognosis of cerebral infarction. Results TSP1，TGFα，FGF2 in the case group were higher than those in the control group，and the difference was statistically significant （P< 0.05）. NIHSS score grouping only had significant difference in TSP1 （P< 0.05），and mild group

Postnatal prognosis prediction tools for infants with congenital diaphragmatic hernia / 中华围产医学杂志

Symptoms and prognosis of infants with congenital diaphragmatic hernia (CDH) are various, as all mild cases might survive while those severe ones have higher mortality. Therefore, an applicable tool that can screen out high-risk CDH children may help clinicians develop an individualized treatment plan and increase the survival rate. A growing number of international studies for CDH postnatal prediction tools, including single factor index and five score models, have been conducted in recent years, whereas few in China. We hereby summarized the advances in postnatal evaluation tools to predict the outcomes of CDH.

Postnatal prognosis prediction tools for infants with congenital diaphragmatic hernia / 中华围产医学杂志

Symptoms and prognosis of infants with congenital diaphragmatic hernia (CDH) are various,as all mild cases might survive while those severe ones have higher mortality.Therefore,an applicable tool that can screen out high-risk CDH children may help clinicians develop an individualized treatment plan and increase the survival rate.A growing number of international studies for CDH postnatal prediction tools,including single factor index and five score models,have been conducted in recent years,whereas few in China.We hereby summarized the advances in postnatal evaluation tools to predict the outcomes of CDH.

Virtual reduction and design of 3D printed guide template for comminuted patellar fractures / 中华创伤骨科杂志

Objective:To explore the role of virtual reduction and design of 3D printed guide template in assisting reduction and internal fixation of comminuted patellar fractures.Methods:A retrospective study was conducted of 12 patients who had been treated for closed patellar fractures from March 2016 to April 2019 at Department of Orthopaedics, Jiangxi Provincial People's Hospital. They were 8 males and 4 females with an average age of 35.4 years (from 22 to 51). All their fractures were type 34-C3 (more than 3 fragments) according to the AO/OTA classification. Their preoperative CT data were imported into software Mimics to print a full patella, upper and lower halves of the patella, and a guide template for reduction. During operation, bone fragments were first temporarily fixated with a fine Kirschner wire after combined together with the assistance of reduction templates for upper and lower hemi-patellas. Next, the whole patella was precisely reset and definitely fixated using patellar ring ligation and tension band wire with the assistance of the reduction guide template for full patellar. Recorded were operation time, fluoroscopic frequency, and visual analogue scale (VAS), knee range of motion (ROM) and knee function B?stman scores at the last follow-up.Results:In this group of patients, operation time averaged 90 minutes (from 75 to 120 minutes), fluoroscopic frequency 4.5 times (from 3 to 8 times), follow-up duration 19 weeks (from 16 to 22 weeks), and fracture healing time 14 weeks (from 11 to 17 weeks). At their last follow-up, X-ray showed good patellar morphology, fine internal fixation positions and an average VAS pain scores of 0.3 (from 0 to 1), their knee joints could be fully straightened, their knee ROM averaged 130°(from 100° to 138°), and their knee B?stman scores 28.8 points (from 21 to 30 points), giving 9 excellent and 3 good cases.Conclusion:3D printed reduction guide templates can significantly improve the efficiency and quality of surgical reduction in comminuted patella fractures, enhancing fixation strength and facilitating early and full range exercise of the knee joint to achieve excellent recovery.

Application of Mifepristone in One Case of Cushing's Syndrome and Review of Related Guidelines / 中国药师

Objective: To investigate the efficacy of mifepristone in patients with Cushing's syndrome and the incidence of adverse reactions to provide basis for its clinical use.Methods: One case of Cushing's syndrome treated with mifepristone participated by pharmacist was analyzed.Results: Mifepristone could significantly improve hyperlipidemia and the complications of the patient, meanwhile, the risk of hypoglycemia should be paid attention and insulin therapy should be withdrawn timely.Conclusion: Mifepristone can significantly reduce blood glucose levels and improve the appearance of Cushing.At the same time, the level of serum potassium needs close monitoring to avoid the occurrence of hypokalemia.