1.Disease spectrum analysis of the NRCMCS hospitalized children in Jin-jiang under the age of 14 in 2013
Peikun HONG ; Qingshuang LIN ; Liangyou CAI ; Wenyu LI ; Fengyu SUN ; Qinghuo LIN ; Dexiong ZHANG
China Modern Doctor 2014;(30):112-115
Objective To explore the disease spectrum characteristics of hospitalized children having joined new rural cooperative medical system (NCMS) in Jinjiang, in order to provide reference for developing disease prevention and control measures for the children. Methods The disease spectrum of NCMS hospitalized children under 14 years old in Jinjiang from January to December 2013 were analyzed. Results The NCMS hospitalized children's disease attack was related to age and sex. Children in different age stages had different ranks of disease constitution, but respiratory and digestive system diseases always ranked the top 3 in each age group. The top 5 system diseases affecting children's health were respiratory diseases ( 63 . 60%) , digestive diseases ( 11 . 04%) , certain infectious and parasitic diseases (5.41%), certain conditions originated in perinatal period (3.17%), and certain consequences caused by injury, poison-ing and external causes (2.76%);The top 5 system diseases affected 85.99%of the total hospitalized children. Regard-ing to single disease rank, the top 5 diseases were all respiratory system diseases, (unspecified) bronchial pneumonia (22.83%), (unspecified) acute tonsillitis (9.26%), (unspecified) acute upper respiratory tract infection (8.99%), (unspecified) acute bronchitis (8.82%) and unspecified pneumonia (5.38%); The top 5 diseases affected 55.28% of the total hospital-ized children. Conclusion Respiratory disease is the major disease threatening the children's health in Jinjiang. It is suggested that medical and health resources be adjusted rationally, specific effective methods and measures be taken to prevent respiratory diseases, and relevant prevention and control measures be developed based on the disease constitu-tions of children in different age groups.
2.MR imaging research of diaphragm sella in patients with pituitary adenoma
Zhiyu XI ; Shousen WANG ; Qingshuang ZHAO ; Junjie JING ; Shun'an LIN
Chinese Journal of Neuromedicine 2014;13(8):807-811
Objective To observe and measure the morphology of diaphragm sella under MR imaging and its parameters in patients with pituitary adenoma,and to explore its clinical significance.Methods Forty-seven patients with pituitary adenoma,admitted to our hospital from March 2012 to April 2013,were collected in our study; the traditional MR imaging of all patients were obtained preoperatively and postoperatively,and 3D-GE sequence scanning was added preoperatively.The parameters of diaphragm sella were measured and compared between patients existed invasion and without invasion,and between patients enjoyed total resection and non-total resection; and the correlation between each two parameters were analyzed.Results Concave,horizontal and convex diaphragm sellae (n=3,10 and 34,respectively) were observed; tumor height of the patients whose diaphragm sella was convex was significantly higher than that of the concave cases ([28.82±11.29] mm vs.[13.57±4.42]mm,P<0.05).The size and elevation angle of the diaphragmal opening were positively correlated with tumor height (r=0.224,P=0.003; r=0.586,P=0.000).The size ofdiaphragmal opening in the invasive group was significantly larger than that in non-invasive group ([10.30±5.79] mm vs.[5.55 ±3.29] mm,P=0.002).The size of diaphragmal opening in non-total resection group was significantly greater than that in the total resection group ([5.58±4.14] mmvs.[11.04±4.80] mm,P=0.000),and the width of diaphragrnal opening was negatively correlated with tumor resection ratio (r=-0.576,P=0.020).Conclusions Diaphragrna sellae could be displayed satisfactorily in contrast-enhanced 3D-GE MRI.The size of the diaphragmal opening and the elevated angle of drua besides diaphragrnal opening are positively correlated with tumor height.The size of diaphragmal opening of the invasive pituitary adenoma patients is larger than that ofnon-invasive ones.The larger the diaphragrnal opening size,the more difficult the tumor being totally resected by transsphenoidal approach.
3.Risk factors for varus ankle deformity after McFarland fracture surgery in children
Yuancheng PAN ; Qingshuang ZHANG ; Yixiang ZHENG ; Linkun WU ; ChenTao XUE ; Zhibin OUYANG ; Ran LIN ; Shunyou CHEN
Chinese Journal of Orthopaedics 2024;44(21):1409-1415
Objective:To analyze the risk factors for ankle varus deformity after McFarland fracture surgery in children.Methods:A total of 48 children with McFarland fracture who underwent surgical treatment in the Second General Hospital of Fuzhou from January 2015 to December 2022 were retrospectively analyzed, including 24 males and 24 females, aged 11.2±3.2 years (range, 2-14 years), 19 cases on the left side and 29 cases on the right side. Salter-Harris classification: 34 cases of type III and 14 cases of type IV. Causes of injuries: 28 cases of sports injuries, 15 cases of fall injuries, and 5 cases of car accident injuries. The time from injury to operation was 2.6±1.7 d (range, 1-7 d). The reduction methods included closed reduction in 38 cases and open reduction in 10 cases. Tibial internal fixation: 42 cases of hollow screws, 6 cases of Kirschner pins. There were 30 cases of combined fibula fracture, 20 cases were fixed with plate, 8 cases were fixed with Kirschner's pin, and 2 cases were not treated with internal fixation. The internal fixation survival time was 6.4±2.8 months (range, 1-12 months). The lateral distal tibial angle (LDTA) was used to determine whether the child had ankle varus deformity. The general data and perioperative indicators of the two groups were compared, and the indicators with statistically significant differences were included in binary logistic regression analysis to determine the independent risk factors for ankle varus deformity after McFarland fracture surgery in children. The receiver operating characteristic curve was drawn and the area under the curve of each independent risk factor was calculated.Results:All patients successfully completed the operation and were followed up for 39.2±21.8 months (range, 15-98 months). At the last follow-up, all the 48 children with McFarland fracture had bone union and the internal fixation was successfully removed, and 5 of them had ankle varus deformity. The LDTA of the affected side was 98.6°±4.8° (range, 94°-106°) in the ankle varus deformity group and 89.0°±0.8° (range, 87°-91°) in the non-ankle varus deformity group. The age of children in the ankle varus deformity group was 6.6±5.1 years, which was younger than that in the non-ankle varus deformity group (11.7±2.5 years), and the difference was statistically significant ( t=3.772, P<0.001). The survival time of internal fixation in the ankle varus deformity group was 4.4±2.2 months, which was shorter than that in the non-ankle varus deformity group (6.6±2.8 months), and the difference was statistically significant ( t=1.750, P=0.087). There was no significant difference in gender, side, cause of injury, fracture type, initial displacement distance, fibular fracture, time from injury to operation, reduction method, or fixation method between the two groups ( P>0.05). Age and duration of internal fixation were included in binary logistic regression analysis. The results showed that age ( OR=0.717, 95% CI: 0.543, 0.945, P=0.018) was an independent risk factor for postoperative ankle varus deformity in children with McFarland fracture. The receiver operating characteristic curve of independent risk factors predicting postoperative ankle varus deformity in children with McFarland fracture was drawn and the area under the curve was calculated. The results showed that the best cut-off value of age was 5.5 years, and the area under the curve was 0.807, and the prediction efficiency of the prediction model was good. Conclusion:Age<5.5 years is an independent risk factor for postoperative varus ankle deformity in children with McFarland fracture.