Archive

06 December 2022, Volume 37 Issue 12 Previous Issue   

---

For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

Select

Interpretation of Chinese rapid guideline for bowel preparation related to the diagnosis and treatment of children’s digestive endoscopy （2020， Xi’an） WANG Feng-fan, LIU Huan-yu, FANG Ying 2022, 37(12): 881-885.  DOI: 10.19538/j.ek2022120601 Abstract ( )   In 2020，the Pediatric Collaborative Group of Chinese Society of Digestive Endoscopology and Pediatric Digestive Endoscopy Professional Committee of Chinese Endoscopist Association organized experts to formulate the Chinese rapid guideline for bowel preparation related to the diagnosis and treatment of children’s digestive endoscopy （2020， Xi’an）. This guideline is the first bowel preparation guideline for children undergoing digestive endoscopy based on systematic evidence retrieval and application of GRADE grading system in China. This article aims to provide a detailed interpretation of the key points of the guideline， including health education，dietary intervention，implementation methods，assessment，remedial measures and management of bowel preparation for children，and analyze the existing problems of bowel preparation in children，so as to provide more basis for pediatricians to conduct bowel preparation before digestive endoscopy in children.

Select

Clinical features of colorectal polyps in children MA Xin, ZHONG Xue-mei 2022, 37(12): 886-889.  DOI: 10.19538/j.ek2022120602 Abstract ( )   Colorectal polyp is a common disease and the common cause of painless hematochezia in children. With the popularization of colonoscopy technology in children，more and more children with colorectal polyps have been diagnosed and treated. Colorectal polyps often have symptoms in early childhood. Colonoscopy can confirm the location，size and quantity of polyps，and pathological examination can be carried out to determine their nature. Colorectal polyps in children include inflammatory polyps，hamartomatous polyps，adenomatous polyps and other types. Pediatricians need to raise awareness and actively perform colonoscopy in children with symptoms or a relevant family history.

Select

Prevention and management of complications of encloscopic treatment for children with colorectal polyps XIAO Yuan, XU Chun-di 2022, 37(12): 889-893.  DOI: 10.19538/j.ek2022120603 Abstract ( )   For children suspected with lower gastrointestinal bleeding caused by colorectal polyps，using a colonoscopy to diagnose and treat has become very important. The main complications after polypectomy under colonoscope are bleeding，coagulation syndrome，and perforation. Compared with adults，children have a thin intestinal muscle layer，tender mucosa，and poor intestinal barrier function，but have fewer comorbidities and less use of anticoagulants. These characteristics determine the different risks and incidences of complications of post-polypectomy between children and adults. Pediatric endoscopists should take appropriate measures to prevent related complications according to the characteristics of children's polyps. This article will describe the risk factors，prevention，and management of bleeding，coagulation syndrome，and perforation after polypectomy in  children.

Select

Principles of selecting endoscopic resection of colorectal polyps in children GE Ku-ku, FANG Ying 2022, 37(12): 893-898.  DOI: 10.19538/j.ek2022120604 Abstract ( )   Colorectal polyp is one of the most common gastrointestinal diseases in children. Endoscopic examination and polypectomy are the main methods of diagnosis and treatment. It is essential to select appropriate way of resection according to polyp classification to reduce postperative complications. This review mainly focuses on the principles of selecting endoscopic resection of colorectal polyps in children.

Select

Endoscopic minimally invasive treatment for hereditary polyps in children LIU Zhi-feng 2022, 37(12): 899-900.  DOI: 10.19538/j.ek2022120605 Abstract ( )   Hereditary polyps in children are mostly rare autosomal dominant diseases，which are related to the increased risk of benign and malignant tumors inside and outside the intestine. The diagnosis of most hereditary polyps in children can be confirmed based on clinical and endoscopic findings. In some cases，gene testing is required to assist  diagnosis. Most of the hereditary polyps in children need to be removed once diagnosed. Preoperative imaging examination is very important，which can not only guide the treatment，but also reduce missed diagnosis and misdiagnosis. The methods of polypectomy vary with the shape，size and location of polyps. Once hereditary polyps are found by imaging and endoscopy，re-examination should be carried out every 2~3 years. Timely enteroscopy is needed once the clinical manifestations occur.

Select

Research progress in intestinal microbiota and colorectal polyps in children ZHANG Ying, ZHANG Lin 2022, 37(12): 901-905.  DOI: 10.19538/j.ek2022120606 Abstract ( )   Colorectal polyps are the common cause of gastrointestinal bleeding in children. Juvenile polyps are the most common， most of which are benign lesions，but there is also the possibility of malignant change. Intestinal microbiota is closely related to colorectal polyps，and genetic factors play an important role in the occurrence of colorectal polyps. However，many environmental factors，such as high-fat diet，obesity，Helicobacter pylori infection，affect the incidence of colorectal polyps by changing the intestinal microbiota. The intestinal microecology of children with colorectal polyps is unbalanced，and the intestinal microecology structure of different types and locations of polyps is also different. Dietary intervention，supplement of probiotics，prebiotics，synbiotics and some drugs to regulate the intestinal microecology balance may become a new strategy to prevent and treat children with colorectal polyps.

Select

Pathological features and postoperative follow-up of colorectal polyps in children QI Ling-li, PANG Xiao-li, JIAO Xu-guo, et al 2022, 37(12): 906-911.  DOI: 10.19538/j.ek2022120607 Abstract ( )   Colorectal polyps are one of the main causes of hematochezia in children，which can be divided into hamartomatous polyps，adenomatous polyps，inflammatory polyps and serrated polyps according to the pathology. Colorectal polyps in childhood are mostly benign，but some of them are giant in size，large in number，growing rapidly，or even resulting in carcinogenesis，which causes bowel obstruc-tion，malnutrition，anemia and gastrointestinal tumor，seriously affecting their growth and quality of life. In addition to polypectomy，it is very important to develop systematic and scientific follow-up strategies in order to improve prognosis. In this article，colorectal polyps in childhood are systematically reviewed according to different pathological types，and individualized and precise follow-up strategies are summed up.

Select

Nursing cooperation in endoscopic colorectal polypectomy in children YANG Zhao, FANG Ying 2022, 37(12): 912-915.  DOI: 10.19538/j.ek2022120608 Abstract ( )   The treatment for colorectal polyps in children mainly includes endoscopic minimally invasive therapy and surgery. Endoscopic minimally invasive treatment is the preferred treatment currently. Effective nursing cooperation in the whole process of diagnosis and treatment improves the therapeutic effect of endoscopic colorectal polypectomy and reduces the occurrence of postoperative complications significantly. This article reviews the preoperative，intraoperative and postoperative nursing care and follow-up of endoscopic polypectomy in children.

Select

Application of miniprobe ultrasonography in the diagn-osis and treatment of colorectal polyps in children ZHU Li-ping, WEI Xu-xia 2022, 37(12): 915-919.  DOI: 10.19538/j.ek2022120609 Abstract ( )   Miniprobe ultrasonography （MPS） has important clinical value in the diagnosis and treatment of colorectal polyp lesions. Before the endoscopic resection of colorectal polyps，miniprobe ultrasonography examination can effectively diagnose colorectal polyps in children and accurately understand the source of colorectal polyps. MPS provides an important basis for the treatment methods，and reduce the occurrence of complications. This paper reviews the characteristics，methods，and clinical application of colorectal MPS.

Select

Anesthesia management of painless digestive endoscopy in diagnosis and treatment for children ZHAO Zhe, MIAO Yi 2022, 37(12): 919-924.  DOI: 10.19538/j.ek2022120610 Abstract ( )   In recent years，with the rapid development of diagnosis and treatment technology of digestive endoscopy for children，painless digestive endoscopy for children complies with the needs of modernized comfort medicine，and is accepted by more and more parents and children. Infants and children have special characteristics of growth and development. Based on the author's own experience，the selection of anesthesia methods，key perioperative management strategies，and the management of anesthesia-related complications in the diagnosis and treatment by painless digestive endoscopy for children were elaborated，in order to contribute to the popularization and safe application of painless digestive endoscopy for children.

Select

Clinical characteristics and influencing factors of prognosis of children with septic shock in pediatric intensive care unit LI Yi-pei, LIU Chun-feng 2022, 37(12): 925-931.  DOI: 10.19538/j.ek2022120611 Abstract ( )   Objective　To investigate the clinical characteristics and influencing factors of prognosis of PICU children with septic shock. Methods　According to the 2015 version of China's Expert Consensus on the Diagnosis and Treatment of Septic Shock （Septic Shock） in Children，a  total of 104 children with septic shock who were admitted to the PICU Ward of Shengjing Hospital of China Medical University from January 2015 to December 2019 were screened out.  Study the onset status and clinical characteristics of septic shock in children， and at the same time through univariate analysis and Logistic regression analysis，learn about the independent risk factors related to the prognosis of septic shock. Results　There were 104 children diagnosed with septic shock in the 5 years，accounting for 2% of the PICU hospitalized children during the same period. Among them，60 were boys and 44 were girls. The median age was 8 months，and infants and young children accounted for 77.9%（81 /104）; the overall mortality rate was 55.8%（58/104）; the digestive tract was the most common site of infection（48.1%），followed by the respiratory system（ 23.1%）; the proportion of confirmed pathogenic bacteria was 45.2%（47/104）；children with confirmed bacterial infection were gram-negative bacilli and gram-positive cocci；the top three bacteria were Escherichia coli，Pseudomonas aeruginosa and Streptococcus pneumoniae. Among 47 specimens with confirmed pathogen infection，42 cases were tested for drug sensitivity，and the drug resistance rate was 92.9%（39/42）. nivariate analysis suggested that mechanical ventilation，vasoactive drug use，respiratory and cardiac arrest，coagulation function，blood glucose，lactate，albumin，VIS score，PRISM score，PCIS score，and oxygenation index（P/F）≤300 were related to the death of children with septic shock;multivariate stepwise logistic regression showed that mechanical ventilation，respiratory and cardiac arrest and oxygenation index ≤300 were independent risk factors for death in septic shock，and albumin >30 g/L was a protective factor. Conclusion　The fatality rate of septic shock in PICU children is extremely high. The primary disease should be treated actively，and mechanical ventilation and vasoactive drugs should be used rationally to improve lung function and maintain hemodynamic stability. Enhancing management of mechanical ventilation and correcting hypoalbuminemia may be effective ways to reduce the mortality rate.

Select

High-throughput sequencing analysis of neonates with thalassemia and study on primary screening methods CHEN Shao-yun, WANG Jun, CHEN Ming-fang, et al 2022, 37(12): 932-936.  DOI: 10.19538/j.ek2022120612 Abstract ( )   Objective　To investigate the occurrence and genotype，and to evaluate the value of mean corpuscular volume（MCV） and mean corpuscular hemoglobin（MCH） in the primary screening of neonatal thalassemia. Methods　The dried blood tablets of cord blood of 1127 neonates of vaginal delivery from December 2018 to August 2019 were collected in Shenzhen Baoan Women’s and Children’s Hospital，and were screened by gap polymerase chain reaction（GAP-PCR），reverse dot blot hybridization polymerase chain reaction（RDB-PCR） and high-throughput sequencing（NGS）. Among them，392 neonates had blood routine examination within one week after birth and the hematological indexes such as MCV and MCH of 392 neonates were analyzed retrospectively. Results　（1）Among 1127 neonates，therer were 128 positive cases of thalassemia; 85 cases were α-thalassemia and 40 cases were β-thalassemia；3 cases were α&β complex thalassemia；5 cases were abnormal hemoglobin mutation. Moreover，we identified a novel mutation at HBA2：c.217_218insC heterozygosity for the first time. （2）Both MCV and MCH of neonatal thalassemia were significantly lower than those of control newborns，and the difference between the two groups was statistically significant［（93.50±8.38）fl vs. （103.00±4.59）fl，（31.10±3.29）pg vs. （35.20±1.68）pg］（P<0.001）. MCV and MCH of α-thalassemia newborns were significantly lower than those of β-thalassemia newborns［（89.70±7.57）fl vs. （101.00±4.76）fl，（29.50±3.01）pg vs. （34.00±1.42）pg］（P<0.001）. The area under the ROC curve for screening neonatal thalassemia using MCV and MCH were 0.837 and 0.872，and the cut-off values were 95.5fl and 33.5pg，respectively. Conclusion　NGS technology can accurately detect the type of thalassemia in neonates. MCV and MCH have important reference value for early diagnosis of neonatal thalassemia.

Select

Clinical characteristics of 18 children with congenital nephrogenic diabetes insipidus ZHU Wan-hong, YANG Min, XIN Ying 2022, 37(12): 937-941.  DOI: 10.19538/j.ek2022120613 Abstract ( )   Objective　To explore the clinical characteristics of congenital nephrogenic diabetes insipidus（CNDI） in children and improve the ability of diagnosis and treatment. Methods　The clinical characteristics，laboratory examination，imaging findings，water deprivation vasopressin test results，gene detection and treatment effects of 18 children with CNDI admitted to Shengjing Hospital of China Medical University from January 2012 to December 2021 were retrospectively analyzed. Results　Among the patients with CNDI，94.4% （17 cases） were male. The age ranged from 7 months to 7 years old，and they all developed within 2 years old. Most of them had symptoms of polydipsia and polyuria. The symptoms of 3 cases less than 1 year old were nonspecific，manifested as anorexia，nausea and vomiting，slow weight gain and intermittent fever，accompanied by severe hypernatremia as well. There were 14 cases（77.8%） of short stature and 4 cases（22.2%） had hydronephrosis. In 5 cases（27.8%），pituitary enhanced magnetic resonance imaging（MRI） showed that the high signal intensity of posterior pituitary disappeared or did not show clearly. Five cases underwent gene detection，and all of them were AVPR2 gene mutation. All patients were treated with hydrochlorothiazide，which was effective in some patients. Conclusion　Most cases of CNDI occur at young age, and the symptoms of infants are atypical. For children with anorexia, nausea and vomiting, constipation, slow growth of height and weight, and intermittent fever, water and urine volume should be carefully recorded, urine specific gravity should be repeatedly measured, and water abstinence - vasopressin test and gene testing should be performed when necessary for clear diagnosis and early treatment. To avoid affecting the growth and development of children and the occurrence of urologic hydrops and renal damage.

Select

Research progress in mechanism of human adenovirus infection and anti-adenovirus drug treatment DING Wei, CAO Ling 2022, 37(12): 942-945.  DOI: 10.19538/j.ek2022120614 Abstract ( )

Select

Research progress in the role of matrix metalloproteinase-9 in children with bronchiolitis obliterans SU Song, ZOU Hao-chen, QIAO Hong-mei 2022, 37(12): 946-951.  DOI: 10.19538/j.ek2022120615 Abstract ( )

Select

One case report on mitochondrial complex V deficiency caused by TMEM70 gene novel compound heterozygous mutation GAO Hai-ming, LIU Xiao-liang 2022, 37(12): 952-955.  DOI: 10.19538/j.ek2022120616 Abstract ( )

Select

The main manifestation of pseudoserous effusion is chest and abdominal magnification cystic tumor:A report of 2 cases LIU Jin-rong, LI Xiao-li, ZHANG Xiao-yan et al 2022, 37(12): 956-960.  DOI: 10.19538/j.ek2022120617 Abstract ( )