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    25 August 2005, Volume 20 Issue 08 Previous Issue    Next Issue

    论著
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    论著
    Application of non-pain bronchofibroscopy to the diagnosis and treatment of pediatric respiratory disorders.
    Huang Ying,Liu Enmei,Li Qubai
    2005, 20(08): 469-471 . 
    Abstract ( )  
    To explore and to analyse the application of non-pain bronchofibroscopy to the diagnosis and treatment of pediatric pulmonary disorders difficult to diagnose. MethodsUnder general anesthesia of propofol,Olympus BF3c-20 bronchoscopy was used for pathogenesic examination and/or treatment of 92 cases from 2 months old to 15 years old with atelectasis of unknown origin,recurrent or prolonged wheezing and chronic cough. ResultsIn 38 cases with atelectasis,18 cases were found with inflammatory narrowness and stenosis(47.4%).After bronchoalveolar lavage and administration of drugs by bronchoscopy,29 cases were cured in 38 cases(76.3%).In 25 cases of recurrent and prolonged wheezing,14 cases were found with stenosis and mucus clog,9 cases with tracheobronchial softness,stenosis,2 cases with tiny foreign body.Optimal effect was acquired after bronchoalveolar lavage and administration of drug.In 29 cases of chronic cough,4 cases were caused by foreign body,19 cases by chronic endobronchialitis.92 cases were anesthesed through propofol and blood satuation was maintained over 90%. ConclusionNon-pain bronchofibroscopy is very important in pathogenesis diagnosis and treatment for atelectasis,recurrent or prolonged wheezing and chronic cough.And it has featured value in diagnosis for tiny foreign body.Bronchofibroscopy through non-pain propofol general anesthesia is a technique easy to perform,with decreased impair risk and with increased safety.
    Clinical study of 15 cases of incontinentia pigmenti.
    Li Li,Song Guowei,Xu Fangsheng
    2005, 20(08): 472-475 . 
    Abstract ( )  
    To summarize the manifestations of incontinentia pigmenti,especially the characteristics in skin,nerve system,eyes and gene mutations. MethodsFifteen cases of incontinentia pigmenti in our hospital from 1994 to 2004 were enrolled in this study.Their clinical characteristics were studied in several aspects,and some of the cases were followed up for several years.The genes of 7 cases were analyzed in this study. ResultsThe dermatological manifestations were present in all the 15 cases of incontinentia pigmenti.Ten cases had neurological involvement.Of the 10 cases whose nerve system involved,5 suffered from epilepsy,2 of them were complicated with hydrocephalus and dead in infant,and 6 of the 10 cases had mental retardation.There were 6 of 15 cases present with different eye defects:2 with optic nerve atrophy,1 with congenital cataract,1 with retinal dystrophy,and 2 with strabismus.5 of the 7 studied cases had NEMOΔ4~10 gene segment deletion in their NEMO gene. ConclusionThe dermatological manifestations are prominent in incontinentia pigmenti,and the involvement in nerve system and eyes is severe.It should be diagnosed and managed properly soon after birth.
    Levels of hydroxyproline,matrix metalloproteinase-9 and its inhibitor in bronchoalveolar lavage fluid of children with airway foreign body aspiration.
    Tang Lanfang,Du Lizhong,Chen Zhimin
    2005, 20(08): 475-478 . 
    Abstract ( )  
    To observe the extracellular matrix remodeling on children with airway foreign body aspiration (FBA) through detecting the expression of matrix metalloproteinase-9 (MMP-9),tissue inhibitor of matrix metalloproteinase-1 (TIMP-1),and hydroxyproline (HYP) in bronchoalveolar lavage fluid (BALF). Methods12 controls and 46 children with FBA removed via fiberoptic bronchoscopy from 2002~2003 were studied in our unit.Patients were divided into 3 subgroups according to the duration of FBA (subgroup A:<7 days; subgroup B:7~30 days; subgroup C:>30 days).Cell count,levels of MMP-9,TIMP-1 in BALF cells and HYP of BALF was measured. ResultsThe total number of cells and differential cells recovered in BALF did not differ significantly between patients and controls (P=0.431).The positive rate of MMP-9 in controls and subgroups of patients were 33.3%,62.5%,80.0%,and 93.3% with a significant difference (P=0.006).The positive rate of TIMP-1 was 16.3%,50.0%,80.0%,and 93.3% with a significant difference (P<0.001).The differences of HYP in controls and different patients are significant as well (P<0.001).There were positive correlations between the MMP-9,TIMP-1,HYP levels in patients and duration of FB retention (P<0.05).The levels of MMP-9 and TIMP-1 were also associated with percent of mast cell (P=0.009,P=0.005).The differences of MMP-9 and TIMP-1 before and after FB removed were not significant (P=0.131,P=0.522),while the HYP levels decreased significantly than that before FB removed (P=0.001). ConclusionMMP-9,TIMP-1 and HYP are significantly elevated in children with FBA and are related to the extracellular matrix remodeling.These changes are irreversible in short time
    Mid-term follow-up outcome of left ventricle function and size of the great arteries in patients after arterial switch operation.
    Sun Yong,Jia Bing,Ma Xiaojing
    2005, 20(08): 479-481 . 
    Abstract ( )  
    To evaluate left ventricle function and size of the great arteries after the arterial switch operation (ASO) for transposition of the great arteries (TGA). Methods16 cases with TGA/IVS (n=8),TGA /VSD (n=6) and Taussig Bing abnormality (n=2) were examined at 4~37 months \[(19.6±11.1) m\] after ASO by using M-mode,2D,Doppler and color Doppler echocardiography.The outcome data were compared with normals. ResultsLeft ventricle function was normal in all.Endsystolic diameter of neo-aortic valve annulus and root beyond 95% confidence interval for normal values were in 10 cases (62.5%) and 14 cases (87.5%) respectively.The diameter of neo-pulmonary valve annulus and root in 95% confidence interval for normal values were in 10 cases (62.5%) and 9 cases (56.25%) respectively.Mild aortic regurgitation was observed in 6 cases (37.5%).No correlation was found between aortic and aortic regurgitation dilatation.Neo-aortic stenosis was not observed.Mild supravalvular pulmonary stenosis happened in 4 cases (25.0%),pulmonary regurgitation in 2 cases (12.5%). ConclusionMid-term follow-up after ASO for TGA reveals satisfactory outcome of left ventricle function and dilation of neo-artery root and annular.
    Endothelial function in children with vasovagal syncope via color Doppler flow imaging.
    Zhang Qingyou,Du Junbao,Li Yuan
    2005, 20(08): 482-484 . 
    Abstract ( )  
    To investigate artery endothelial function in children with vasovagal syncope via color Doppler flow imaging. MethodsTen patients with vasovagal syncope diagnosed by head-up tilt test were selected as study group and another ten patients without vasovagal syncope (excluded by the same test) were selected as control group.Endothelial function of all children was detected by measuring endothelium-dependent flow-mediated vasodilation of brachial artery with color Doppler flow imaging system. ResultsThere were no significant difference in age,gender,stature,body weight,baseline blood pressure and baseline brachial artery diameters between the two groups.Flow-mediated vasodilation in children with vasovagal syncope were significantly greater than those in controls,(11.93±4.46 )% vs (8.46±2.18)%,P<0.05). ConclusionAugmented endothelium-dependent vasodilation may play an important role in children with vasovagal syncope.
    Emotion question,adaptive behavior and visual perception in children with Tourette’s syndrome.
    Liu Zhisheng,Wu Gefei,Hu Jiasheng
    2005, 20(08): 485-487 . 
    Abstract ( )  
    To explore the emotion problem,social adaptive ability and visual perception function in children with Tourette's syndrome (TS). MethodsThe anxiety,depression,adaptive behavior and visual perception function of 48 children with TS aged 8~12 years (29 males and 19 females) were measured by means of the Social Anxiety Scale for Children (SAS),Depression Self-rating Scale for Children (DSRS),Scale of Adaptive Behaviors for Children (SAB) and Benton Visual Retention Test (BVRT),and 46 healthy children formed the control group. ResultsTotal scores of SAS and DSRS in TS group were significantly higher than those in control group (P<0.01).T scores of independent function factor and social/self-direction factor of SAB in TS group were significantly lower than those in control group (P<0.01),and T score of cognitive function factor and adaptability quotient (ADQ) in TS group showed no significant difference as compared with control group (P>0.05).All right and wrong scores of VRT in TS group showed no significant difference as compared with control group (P>0.05). ConclusionChildren with TS show anxiety,depression,and poor social adaptability.They possess lower ability of independent life,social intercourse and self-direction.Children with TS have no visual perception deficit.