The outcome of early screening and treatment of developmental dysplasia of the hip in infants and toddlers in the Northern Guizhou region.

This study is an observation of the early screening and treatment effect of infant developmental dysplasia of the hip (DDH) in an area in China. From January 2016 to December 2017, we selected infants and toddlers with high-risk factors for DDH, such as asymmetric gluteal folds, unequal length of lower limbs, and limited hip joint abduction, who visited the Department of Child Health Care and the Outpatient Clinic of Pediatric Orthopedics at the Affiliated Hospital of Zunyi Medical University. In total, 1485 cases were divided into age groups, examined using Graf ultrasound and X-ray, and the results were analyzed. Meanwhile, early interventions were actively adopted for cases with abnormalities during the screening. The detection rates of DDH were 24.0%, 2.8%, 9.3%, and 12.2% among those with 0 to 6 months, 7 to 12 months, 13 to 18 months, and 19 to 24 months of age, respectively. Early and individualized corrective conservative treatment was considered for children with abnormalities, and the cure rates were 87.0%, 65.7%, 41.0%, and 16.7% among those with 0 to 6 months, 7 to 12 months, 13 to 18 months, and 19 to 24 months of age, respectively. There was a statistically significant difference in the detection and cure rates of DDH in infants and toddlers of different ages (P < .01).

Analysis of a Case of Facial Nerve Injury Caused by Bee Sting in a Child.

Background: Bee sting injuries in children are accidental and occur in rural areas in summer and autumn. They have the characteristics of rapid onset, rapid change, many complications, complex treatment, and high disability rate. Patients experience various symptoms, such as vomiting, diarrhea, dyspnea, angioedema, multiple neuritis, myocardial infarction, acute renal failure, hypotension, and collapse. Systemic complications of the nervous system are rare. However, some cases of stroke, optic neuritis, and acute disseminated encephalomyelitis are related to bee stings. There are many cases of systemic multiple organ dysfunctions after bee sting injury, but there are few reports of facial nerve injury. The case presented here was caused by bee venom. This report is important because there are few instances of facial paralysis in the large number of notified bee sting cases. After active treatment, the facial paralysis of the child recovered gradually. Case Presentation: The patient was a 6-year-old boy. The bee stings by bee swarm induced pain in many parts of the body for 8 h. After the injury, he had skin itching, rash, swelling, and pain in the head and face. The boy had soy sauce-colored urine later and was transferred to the Affiliated Hospital of Zunyi Medical University from a lower-level hospital for treatment. On the seventh day after transfer, the child suddenly suffered from deviated mouth, which was considered a delayed facial nerve injury. After active treatment, he recovered from facial paralysis and was discharged from the hospital. Conclusion: This case report adds the clinical manifestation of facial paralysis after bee stings. They require close observation and being alert to possible clinical manifestations, as well as carrying out active intervention treatment.

Bilateral sleeve fracture of the inferior pole of the patella in children: A case report.

Background: A patellar avulsion fracture is a unique fracture type in children with an extremely low incidence rate in knee joint injuries, most of which are unilateral. Cases of simultaneous bilateral fracture are rare. Due to the physiological and anatomical characteristics of patellar sleeve fractures in children, obvious avulsed bony fragments are seldom seen with plain radiography after trauma; thus, this fracture type is often misdiagnosed or missed on first evaluation. Early diagnosis of patellar sleeve fracture is the key to successful treatment. Case report: This paper presents a case of bilateral patellar sleeve fracture in a 10-year-old girl that was missed in another hospital and treated successfully by open reduction and fixation of the osteochondral fragments after the patient was transferred to our hospital, yielding good clinical outcomes at the one-year follow-up. Conclusion: Overall, this case report described the clinical and imaging characteristics of inferior pole sleeve fractures in children and highlight clinicians' awareness of this injury to assist in early, accurate diagnosis and reduce the incidence of misdiagnosis and missed diagnosis due to unfamiliarity.

Paediatric Osteomyelitis and Septic Arthritis Pathogen Distribution and Antimicrobial Resistance in a Single Centre: A 15-Year Retrospective Analysis.

BACKGROUND: The epidemiological characteristics of the common pathogens underlying acute haematogenous osteoarticular infection (AHOI) and their resistance to drugs have temporal and regional differences. AIMS: To determine the antimicrobial treatment most effective for culture-negative AHOI patients and those without bacterial cultures. METHODS: Retrospective analysis of clinical data of children with AHOI who were culture positive from January 2007 to December 2021. And the distribution of the main pathogens and the drug resistance Staphylococcus aureus were analysed in different time periods, age groups and infection types. RESULTS: A total of 188 cases met the inclusion criteria, including 97 cases of acute haematogenous osteomyelitis (AHO), 75 cases of septic arthritis (SA) and 16 cases of AHO concomitant with SA. The commonest causative pathogen in local children was S. aureus of Gram-positive cocci, followed by Streptococcus, and occasionally Gram-negative bacilli. The distribution of S. aureus had no significant correlation with age or infection type. Staphylococcus aureus accounted for 81.82%, 90.91% and 96.15% of all pathogens, and methicillin-resistant S. aureus (MRSA) accounted for 24.22%, 53.33% and 76.00% of S. aureus in 2007-11, 2012-16 and 2017-21, respectively. The frequency of MRSA infection showed an increasing trend over time. CONCLUSION: Staphylococcus aureus is still the main pathogen of AHOI in local children. The proportion of MRSA in S. aureus has also increased over time to 76% in the last 5 years, and the increased proportion of MRSA can affect the choice of initial empirical medication.

[Protective effects of rhizoma paridis total saponins on septic rats].

OBJECTIVE: To investigate the protective effect of rhizoma paridis total saponins and its mechanism on septic rats. METHODS: Septic model was reproduced by cecal ligation and puncture (CLP) in Wistar rats. Rhizoma paridis total saponins was administered to observe its protective effects on septic rats. Blood was collected to determine serum tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta(IL-1 beta)levels at 2, 6, 12, 24 and 48 hours after operation by means of enzyme-linked immunosorbent assay (ELISA). The pathological changes of lung tissue were observed with light microscope at 72 hours after operation. The peritoneal macrophages (PMPhi) in rats were isolated and the release of TNF-alpha and IL-1 beta in PMPhi after exposure to lipopolysaccharide (LPS, 100 microg/L) were measured by ELISA. RESULTS: Mortality in the rhizoma paridis total saponins group was significantly lower than the CLP group (50.0% vs. 85.0%, P < 0.05). The levels of TNF-alpha and IL-1 beta in serum were significantly lower than those of the CLP group at the same time (P < 0.05 or P < 0.01). The degree of inflammatory injury to the lung was much milder than that in the CLP group. In the in vitro experiment, it was shown that rhizoma paridis total saponins in concentrations of 5, 10, 20 and 40 mg/L could inhibit remarkably the release of TNF-alpha and IL-1 beta from LPS-stimulated PMPhi of rats (all P < 0.01). The differences in TNF-alpha levels among the groups showed no statistically significant difference(all P > 0.05). The level of IL-1 beta in 5 mg/L group was significantly higher than that of the 10 mg/L group (P < 0.05), but showed no difference with those of 20 mg/L and 40 mg/L groups (both P > 0.05). CONCLUSION: Rhizoma paridis total saponins can protect the CLP rats by inhibiting the activation of rat PMPhi to release cytokines and ameliorating acute lung injury.