Objective: To evaluate the efficacy of ultrasound-guided caudal epidural block for postoperative analgesia in the infants undergoing lobectomy under general anesthesia. Methods: Sixty American Society of Anesthesiology physical status Ⅱ or Ⅲ pediatric patients of both sexes, aged 1-3 yr, weighing 10-16 kg, scheduled for elective lobectomy under general anesthesia, were divided into 2 groups (n=30 each) using a random number table method: control group (group C) and epidural block group (group E). Caudal epidural block was performed under ultrasound guidance after induction of general anesthesia and at 15 min before surgery in group E. An epidural catheter was inserted at T_{6, 7} interspace, 0.1% ropivacaine 1 mg/kg was injected at 5 min after injecting 1% lidocaine 3 ml, the diffusion of epidural fluid was controlled at T_3-10, and the epidural catheter was then removed.An analgesia pump was connected at the end of the surgery in two groups.Pain was evaluated using Face Legs Activity Cry Consolability scale.When Face Legs Activity Cry Consolability scale score>3, the pump was pressed.When pain was still unrelieved 5 min later, sufentanil 0.1-0.2 μg/kg was intravenously injected.The patients were followed up for 48 h after operation, and the requirement for additional remifentanil and sufentanil, and the occurrence of postoperative nausea and vomiting, respiratory depression, hypoxemia and over-sedation was recorded.The number of pressing times, extubation time and duration of intensive care unit stay were also recorded.Pain at 1 and 2 days after operation was evaluated using the Postoperative Pain Measure for Parents. Results: Compared with group C, the consumption of remifentanil, the number of pressing times and requirement for additional sufentanil were significantly decreased, the incidence of each index of the Postoperative Pain Masure for Patients was decreased at 1 day after surgery, the extubation time and duration of intensive care unit stay were shortened, and the incidence of nausea and vomiting and over-sedation was decreased in group E (P<0.05). Conclusion Ultrasound-guided caudal epidural block provides better efficacy and fewer side effects for postoperative analgesia in the infants undergoing lobectomy under general anesthesia.

Objective: To evaluate the clinical effectiveness of combining electrical stimulation with manual massage in treating women′s myofascial pelvic pain (MPPS). Methods: A total of 93 MPPS patients were recruited and randomly divided into an infrared irradiation group (n=30), an electrical stimulation group (n=31) and a combination group (n=32). Those in the infrared group and the electrical stimulation group were given 30 minutes of infrared irradiation or electrical stimulation daily for 10 days, while the combined group was given a manual massage with electrical stimulation. The response to treatment was evaluated using a visual analogue scale (VAS) to rate discomfort, plus a physical examination, and surface electromyography results using Glazer′s protocol. The treatments′ efficacy and the recurrence of pain were evaluated 1 month after the treatment. Results: The average VAS ratings, resting potentials and their variability of the three groups all improved significantly after the treatment. The average VAS scores of the combined and electrical stimulation groups after the treatment were significantly lower than that of the infrared group. Moreover, the total effective rates of the combined group (96.87%) and the electrical stimulation group (80.65%) were significantly higher than that of the infrared group (56.67%), and the resting potential and variability of the former two groups were also significantly better. All of the above measurements among the combined group after the treatment were significantly better, on average, than in the electrical stimulation group. A month later the recurrence rate in the combined group (6.25%) was significantly lower than in the electrical stimulation group (25.81%) and the infrared group (56.67%). Conclusion Electrical stimulation combined with manual massage is effective in relieving myofascial pelvic pain.

Male infertility microsurgery represents the fastest growing sub-specialty in urology and clinical andrology over the past two decades. The importance of microsurgery for male infertility has risen as a part of the urologist's armamentarium in the medical and surgical management of male infertility. Despite the advances in male infertility microsurgery in China, the lack of standardized and well-organized training programs for male infertility microsurgery remains a serious problem affecting its development. In this article, Zhao and Peng have shared their experience with the learning curve of male infertility microsurgery at the Center for Male Reproductive Medicine and Microsurgery, Weill Medical College of Cornell University, which centers on how to pay attention to the details and basic principles of microsurgery. Male infertility microsurgery is physically, technically and mentally challenging, and must be first learned in the laboratory. Clinical success depends heavily upon appropriate training in a microsurgical laboratory. Good training can significantly reduce operation time and surgical errors as well as improve the quality of outcomes.
Andrology ; education ; Humans ; Infertility, Male ; surgery ; Male ; Microsurgery ; education

The pathogenesis of neonatal diabetes mellitus (NDM) is mostly associated with mutations in genes related to the function or the number of islet β cells and pancreatic development and differentiation.Some of them are aberrant gene mutations related to chromosome methylation.With the amplification of pathogenic gene spectrum, new characteristics of clinical phenotypes have been discovered.In addition to insulin therapy, safe and effective sulfonylurea drugs can improve the neurodevelopmental disorders of some children with K-ATP channel related gene mutations by shutting down the K-ATP channel and releasing insulin.The review describes the recent research on the mechanism of NDM gene mutations and summarizes its clinical features to provide new ideas for treatment.

Objective: To establish the review criteria for children′s blood cell analysis, ensure the accuracy of blood cell analysis results, and ensure that pathological cells are not missed. Methods: A total of 1 420 samples of blood cell analysis were collected from outpatients and inpatients in Shanxi Children′s Hospital from May to June 2018, which were detected by SYSMEXXN-350 and XN-A1 automated blood cell analyzer. Blood smears weredouble-blindly examinedunder microscope. Among them, 463 were used for the establishment of review criteria, 586 were used for the verification and evaluation of review criteria, and 371 were used for the application effect study of review criteria. According tothe 41 rules recommended by ISLH, combining the characteristics of children′s physiology, pathology, disease and abnormal alarming information of hematology analyzer, the review criteria suitable for children′s blood cells were established. Results: Through the evaluation and optimization of 41 rules recommended by ISLH, 23 rules for reexamination of children′s blood cell analysis were formulated, with a reexamination rate of 25.09%, and a false positive rate was 14.16%. A total of 371 samples of patients with hematological diseases were selected for the application of the review criteria. The false negative rate was 2.96%, and no pathological cells were missed. Conclusion The children′s blood cell review criteria established in this study has been verified and evaluated, which not only ensures the quality of the report, but also improves the work efficiency, and provides an important basis for the diagnosis and differential diagnosis of childhood leukemia, infectious mononucleosis and other hematological diseases.

The application of 3D printing technology in medicine may greatly affect the surgical methods of spinal surgery. Currently, 3D printing technology has been applied to preoperative and intraoperative. Before surgery, 3D printing can be used to create precise anatomical models of spinal deformities. In addition, these anatomical models can be used to plan and simulate complex spinal lesions. 3D printed anatomical models can provide better understanding of anatomy than CT or MRI. During surgery, 3D printing has been used to create surgical guidance systems, create templates and customize specific shapes of implants. Although 3D printing technology still faces the challenge of expensive equipment and materials, this technology has many advantages such as improving patient prognosis and reducing the radiation dose of patients. This article mainly introduces the clinical application and future development of 3D printing technology in spine surgery.

Congenital heart disease (CHD) is the most common type of congenital malformation, representing a major public health problem affecting the health of Chinese children.Great progress has been made in many aspects in the treatment of CHD in China.The vast majorities of children with CHD have been treated and they have survived for a long time, but cardiac dysfunction and pulmonary hypertension are still common complications of it before or after surgery.In this paper, the advances in drug treatment of CHD in children in recent years were mainly discussed, focused on the evaluation, treatment and management of CHD with heart failure and pulmonary hypertension in order to further improve the pediatrician′s therapeutic level of managing common complications of CHD.

Hand, foot and mouth disease is a common acute fever and rash disease in pediatrics, which seriously affects children′s health.It is still an important public health problem for children in China.Now, a comprehensive review of early identification and standardized diagnosis and treatment of severe cases, especially critical hand, foot and mouth disease is performed, in order to improve the success rate of severe hand, foot and mouth disease.

Renovascular hypertension accounts for 5%-10% of hypertension in children, which is usually di-fficult to control by medicine and leads to severe clinical complications.However, it is potentially amenable to curative treatment.Clinical early recognition and proper treatment might not only effectively control hypertension, but also preserve renal blood supply and renal function, which is of great significance for the long-term prognosis in children.In this review, the author provide current knowledge of renovascular hypertension in children, including its cause, pathogenesis, diagnostic method, and medical, interventional, and surgical treatment.

Objective: The research was to investigate the intermediary effect of school adjustment between famale college students’ life meaning and mobile phone addiction and to provide reference for mobile phone addiction prevention. Methods: Totally 1 355 female college students in Jinan City were investigated with Life Meaning Scale, School Adjustment Scale and Mobile Phone Addiction Scale. Results: Score of freshmen’ mobile phone addiction (34.02±7.87) was significantly lower than that of sophomores’ and junior’(36.67±8.03, 37.19±10.40)(F=4.58, P<0.05). Female college students’ life meaning and school adjustment were negatively correlated with mobile phone addiction(r=-0.50, -0.58, P<0.01). Female college students’ life meaning was positively correlated with school adjustment(r=0.51, P<0.01). Having a sense of life meaning and seeking a sense of life meaning could jointly explain 24% of the variation in mobile phone addiction. School adjustment played a complete mediating role between life meaning and mobile phone addiction in female college students. Conclusion Female college students’ life meaning can affect mobile phone addiction through school adjustment.