Hongkong pediatric specialist training had successful experiences in the last twenty years.Hongkong hospital authority and Hongkong college of pediatricians managed pediatric specialist training together and made a series of regulations,which have strict training rotation requirements.Training hospitals all need to obtain the authentication including basic training,higher training and overseas training agencies.After 6 years strict training,the trainees have strong pediatric basic theories,procedure abilities,evidence-based practice and team work spirit.In short,the experiences of Hongkong pediatric specialist training is deserved to be learned by the standard training of pediatric resident in mainland China.

ObjectiveTo investigate the risk factors for acute renal injury (AKI) in patients with ischemic stroke.MethodsPatients with ischemic stroke were enrolled retrospectively.The general clinical data, vascular risk factors, drug use, stroke etiological typing, stroke severity, and baseline biochemical indices were collected.They were divided into either an AKI group or a control group according to whether AKI occurred or not.Multivariable logistic regression analysis was used to analyze the independent risk factors for occurring AKI in patients with ischemic stroke.ResultsA total of 214 patients with ischemic stroke were enrolled, including 32 (14.95%) had AKI and 182 (85.05%) did not have AKI.The proportions of patients in heart failure (62.50% vs.41.21%;χ2=4.998, P=0.025), mannitol use (87.50% vs.43.96%;χ2=20.643, P<0.001), furosemide use (87.50% vs.43.96%;χ2=20.643, P<0.001), contrast agent use (37.50% vs.19.23%;χ2=5.300, P=0.021), and contrast dosage >200 ml (28.13% vs.9.89%;χ2=6.637, P=0.010), as well as NIHSS score (18.0±4.5)vs.8.0±3.2;t=15.249, P<0.001), diastolic blood pressure (89.98±9.1 mmHg vs.80.56±8.19 mmHg, 1 mmHg=0.133 kPa;t=5.898, P<0.001), fasting blood-glucose (10.54±4.31 mmol/L vs.6.32±1.32 mmol/L;t=5.898, P<0.001), blood urea nitrogen level (11.21±2.13 mmol/L vs.7.98±2.34 mmol/L;t=7.293, P<0.001), and arterial lactate concentration (3.98±0.12 mmol/L vs.0.91±0.25 mmol/L;t=68.003, P<0.001) in the AKI group were significantly higher than those in the non-AKI group.Multivariate logistic regression analysis showed that after adjusting various confounding factors, higher NIHSS score (odds ratio [OR] 1.910,95% confidence interval[CI] 1.517-6.012;P=0.024), higher diastolic pressure (OR 1.816, 95% CI 1.652-3.876;P=0.018), arterial lactate concentration (OR 1.553, 95% CI 1.256-1.763;P=0.019), mannitol use (OR 3.765, 95% CI 2.081-9.658;P=0.017), furosemide use (OR 5.329, 95% CI 3.085-8.763 P=0.010), contrast agent use (OR 2.097, 95% CI 1.364-2.456;P=0.031), and contrast dosage >200 ml (OR 3.294, 95% CI 1.464-2.786;P=0.021) were the independent risk factors for AKI in patients with acute ischemic stroke.ConclusionsThe NIHSS score, diastolic blood pressure, arterial lactate concentration,mannitol use, furosemide use, contrast agent use and contrast dosage >200 ml were associated with AKI in patients with ischemic stroke.

OBJECTIVE: To detect potential mutation in a Chinese pedigree affected with split hand/split foot malformation (SHFM). METHODS: The patients were screened for genome-wide copy number variations with single nucleotide polymorphism (SNP) microarray. Copy number variations were verified by real-time fluorescence quantitative PCR. RESULTS: There were 3 SHFM patients from three generations, which conformed to an autosomal dominant inheritance. SNP microarray assay revealed that all patients have carried a 0.34 Mb duplication in 10q24.31-q24.32 (102 993 649-103 333 271) encompassing the BTRC and DPCD genes. The result was verified by real-time fluorescence quantitative PCR, confirming that the duplication has co-segregated with the SHFM phenotype in the pedigree. CONCLUSION The 10q24.31-q24.32 duplication probably underlies the pathogenesis of SHFM in this pedigree. Tiny copy number variations can result in diseases featuring autosomal dominant inheritance.
Asian Continental Ancestry Group ; China ; Chromosome Duplication ; Chromosomes, Human, Pair 10 ; genetics ; DNA Copy Number Variations ; Foot Deformities, Congenital ; genetics ; Hand Deformities, Congenital ; genetics ; Humans ; Mutation ; Pedigree ; Polymorphism, Single Nucleotide

Objective:To investigate the risk factors for retrograde type A dissection (RTAD) associated with thoracic endovascular aortic repair (TEVAR) which provided the basis for clinical risk stratification and treatment decision.Methods:The clinical data of 1 688 patients with thoracic aortic disease who underwent TEVAR in our center from January 2004 to December 2019 were retrospectively analyzed. The pathological classification included aortic dissection (1 592 cases) and other thoracic aortic diseases (96 cases). Univariate analysis and categorical multiple logistic regression analysis were used to explore the risk factors for the development of RTAD during or after TEVAR.Results:A total of 18 cases of RTAD were found, with an overall incidence of 1.1% (18/1 688), all of which occurred in aortic dissection group. After adjusting for confounding factors, multivariate logistic regression analysis showed that the incidence of RTAD was significantly decreased(OR=0.27,95%CI 0.07-0.96, P=0.043) when the oversize of stentgraft was 11%-20%, the oversize of stentgraft was ≤10% as the control group, and the difference was statistically significant( P<0.05). The ascending aorta diameter was <40 mm as the control group, and there was no significant difference in the incidence of RTAD between the ≥40 mm group and the control group(OR=2.71,95%CI 0.94-7.84, P=0.065). Conclusions:Aortic dissection is more likely to develop RTAD than other thoracic aortic diseases. A proper stentgraft oversizing ratio could reduce the probability of RTAD. That is to say that a too low stentgraft oversizing ratio is not recommended.