Objective To explore risk factors,prevention and treatment of common complications of benign esophageal stenosis treated with the retrievable covered stents in children.Methods Fifteen cases,diagnosed as benign esophageal stenosis by barium esophagogram were treated with retrievable covered stents under fluoroscopy,Then the stents were removed after 2-3 weeks.The cases were followed-up and complications were observed.Results The stents were successful implanted in all cases.The diet was improved obviously after operation,and gradually transformed from liquid,semiliquid to normal feeding.At the same time,narrow section gradually expanded from 0.1-0.6 cm to 0.6-1.5 cm.Postoperative follow-up was in 1,2,3 weeks and 3 months.Main complications were stents shift in 5 cases,esophageal restenosis in 2 cases,esophageal-tracheal fistula in 1 case,postoperative dull pain behind sternum and foreign body sensation in 6 cases.Relevant preventions and treatments were performed based on different complications.Conclusion It should not be ignored that complications after covered stent placement are more in children than in adults,preventions and treatments should be taken positively.

Objective To explore the feasibility of using the modified continuous balloon dilatation substituting the traditional membrane-covered stent in the treatment of benign esophageal stenosis in children.Methods A retrospective analysis of the clinical data of 25 cases with esophageal stenosis from January,2012 to February,2014 was conducted.Preoperative esophageal stenosis was confirmed by angiography,and the expansion of the stenosis segment was examined after 2-4 weeks postoperatively.According to the age and the location of the esophageal stricture,25 cases were classified into two groups.Twelve cases of group A without obvious contraindications were treated by continuous balloon dilatation,while 13 cases of group B with age of less than 3 years or upper esophageal stenosis,retrievable stent implantation was performed.All cases were followed up from 6 months to 2 years.Clinical symptoms,swallowing fluency and the degree of esophageal stricture were followed up at 1,3,and 6 months postoperatively,and the effect of treatment was evaluated.Results Two groups of patients were successfully treated,and the stents were removed successfully after 2-4 weeks.The average diameter of the stenosiswas significantly increased after treatment,swallowing was improved obviously,with no perforation,hematemesis and melena and other serious complications.The balloon moved down happened in one case,which was adjusted under perspective observation.One case in group A underwent colonic interposition for esophageal replacement because of recurrence of restenosis.The balloon dilatation was effective in 10 cases.In Group B,5 patients had stent migration or displacement,3 cases had recurrent esophageal stricture,and the treatment was effective in 5 cases.There was significant difference in complications between the group A and B (x2=5.23,P＜0.05).Conelusions Continuous balloon dilatation is a simple,effective procedure with fewer complications in the treatment of children with benign esophageal stenosis.In addition to stenting,it may be another ideal choice for benign esophageal stenosis in children.

Objective To understand the antibody levels after the inoculation of measles ,poliomyelitis ,epidemic encephalitis B and hepatitis B vaccines among healthy children aged 7 - < 13 years old in Guangshui City of Hubei province to provide the scientif ‐ic basis for formulating the immune prevention and control strategy and risk assessment in whole city .Methods 4 616 healthy chil‐dren aged 7 - < 13 years old were sampled from the whole city .The enzyme‐linked immunosorbent assays (ELISA) was used to de‐tect the 4‐antibody levels .Results The antibody positive rates of measles ,poliomyelitis ,epidemic encephalitis B and hepatitis B a‐mong healthy children aged 7 - < 13 years old in Guangshui City were 94 .41% ,93 .07% ,93 .78% and 68 .72% respectively .The protection levels of first three kinds of antibody reached more than 85% ;the positive rates had statistical difference among 4 kinds of antibody(χ2 = 1 987 .08 ,P = 0 .000) .The antibody positive rates of epidemic encephalitis B had no statistical difference among different age periods (χ2 = 10 .141 ,P= 0 .071) ;the antibody positive rates of measles ,poliomyelitis and hepatitis B had statistical difference among different age periods(χ2 = 40 .471 ,P = 0 .000 ;χ2 = 25 .174 ,P = 0 .000 ;χ2 = 283 .641 ,P = 0 .000) .The positive rates of 4 kinds of antibody had no statistical difference between different genders (χ2 = 0 .019 ,P= 0 .889 ;χ2 = 1 .017 ,P= 0 .313 ;χ2 = 0 .018 ,P= 0 .892 ;P= 0 .639 ,P= 0 .424) ;the antibody positive rates of measles ,poliomyelitis and epidemic encephalitis B had no statistical differences among 17 villages and towns in the whole city (χ2 = 0 .099 ,P= 1 .000 ;χ2 = 0 .117 ,P= 1 .000 ;χ2 = 0 .134 , P= 1 .000) ,while the antibody positive rate of hepatitis B had statistical difference among these villages and towns (χ2 = 186 .179 , P= 0 .001) .Conclusion The antibody levels of measles ,poliomyelitis and epidemic encephalitis B reach the protection rate ,but the antibody level of hepatitis B needs to be increased .The monitoring work should be continuously strengthened and the seeking missed inoculation and re‐inoculation work should be reinforced .

Objective To explore the therapic effect of the combination of endovascular embolization and clinical hormone in treatment of Kasabach-Merritt phenomenon (KMP),and analyze the advantages.Methods Six cases with KMP from May 2010 to June 2012 were retrospectively analyzed.All the patients underwent large dose hormone shock therapy after admission for 7-10 d.Subsequently,selective endovascular embolization was performed using Seldinger technique under general anesthesia Then,the hormone therapy was continued for 2 weeks after embolization.The platelet count and the effect were recorded.If the area of the tumor reduction is less than 50％,3-4 courses of local hardening treatment was conducted for the residual tumor.The local treatment used multipoint puncturing of the tumor and injection drugs under X-ray fluoroscopic monitoring until the tension of local vascular increased.Results On DSA,the lesions of all the 6 cases showed rich blood supply with a large number of hybrid distribution of tumor blood vessels.The lesions disappeared in 4 cases after 1-2 weeks combination therapy and no recurrence for 0.5-1.0 year follow-up.Two cases whose tumor reduced less than 50％ after combination therapy received local hardening treatment,and faded after 3-4 courses.The number of platelet for all patients kept normal and the spirit of the patients showed great improvement,the bleeding tendency and local soft tissue swelling was in remission.Subcutaneous blood stasis and petechiae disappeared.There were no serious adverse reaction and complications.Conclusion Combination therapy with endovascular embolization and clinical hormone for Kasabach-Merritt phenomenon has a good curative effect.

Objective To explore therapeutic effects of different interventional approaches to neonatal Kasabach-Merritt syndrome (K-MS) Methods A retrospective analysis of therapeutic effects of different interventional approaches to K-MS in 12 neonates from May 2010 to August 2014. All the patients received local treatment (n=5), chemoembolization (n=4) and combined local treatment and endovascular chemoembolization (n=3), respectively, depending on size, location and blood supply of K-MS. The K-MS patients with angioma measuring< 5 cm, 5 to 10 cm and >5 cm received local treatment, endovascular chemoembolization and combined local treatment and endovascular chemoembolization, respectively. The patients were categorized as cured, improved and clinical inefficient, respectively, based on therapeutic effect. The criteria for cured patients were: (1) angioma faded completely or mostly; (2) the platelet count stabilized within the normal range; (3)no recurrence for more than six months. The criteria for improved patients were: (1) angioma shrinked significantly; (2) the platelet stabilized within the normal range. The criteria for clinical inefficient patients were: (1) agioma no obviously shrinked, the platelet count has no improvement over 2 months after interventional approaches. Results All the 12 patients with K-MS were cured and had no complication. Of the 12 patients, 5 patients received local treatment had decreased localized tension and ecchymosis of hemangioma at the first day of therapy, were cured after 2 to 7 courses of therapy. Of the 4 patients received endovascular chemoembolization, 3 were cured after one course of treatment, 1 had recurrent disease one month later after one course of therapy and were cured after the second course of treatment.One had recurrent disease a month later after one course of treatment and were cured after the second course of treatment. Three received combined local treatment and endovascular chemoembolization, angioma shrinked significantly and increased platelet count after the first course of treatment, and 2 to 3 courses local treatment were combined, hemangioma faded and platelet count stabilized within the normal range after 2 to 3 courses of local treatment. Conclusions Interventional therapy is the most effective treatment of neonatal K-MS.There are different interventional approaches to optimize treatment of neonatal K-MS depending on sizes, location and blood supply of K-MS.

Objective To investigate the method for the normal three‐dimensional ultrasound imaging and the characteristics of the fetal hard palate .Methods 210 single fetus free of deformity were examined using three‐dimensional ultrasound(3DUS) .Offline analysis was made after reconstruction ,the hard palate was observed and the width was measured .Results With reconstruction ,the fetal palate was clearly displayed 1.97 cases in 210 cases were successfully displayed (93 8.% ) .The front palate and both frontalis processus of maxillary bone composed similar triangular structure in the coronal plane .The retral part showed sustained linear hyperechoic and the radian increased along with the gestational age .Early palate showed flaky hyperechoic in the cross section and it became horse‐shoe shaped in the second or third trimester pregnancy surrounded by alveolar bone .Linear regression yielded the following formula for the hard palate width (PW) according to gestational age (GA):PW= -0 5.47+0 0.13 × GA( r =0 9.82 ,P <0 0.01) .Conclusions 3DUS acquired palate images fast and easily .The hard palate in the coronal ,sagittal and cross plane showed obvious characteristic images in different gestational stages .With increasing gestational age ,the curvature ,width ,trend and the contrast with the surrounding tissue had the corresponding changes . The successful three‐dimensional image reconstruction of the postnasal triangle and the retral part of fetal hard palate would have an important significance in terms of assessing its continuity and integrity .

OBJECTIVE: The purpose is to report a calcification of the cartilaginous of the tracheobronchial case in child, and to recognize the clinical and imaging features on Keutel syndrome. METHOD: A comprehensive analysis of the clinical data and X-ray,CT. Some literatures involving some symptoms of this child were reviewed. RESULT: This patient diagnosed with Keutel syndrome finally. CONCLUSION When we meet calcification of the cartilaginous of the tracheobronchial patient in clinic, it may be Keutel syndrome.
Abnormalities, Multiple ; diagnosis ; pathology ; Calcinosis ; diagnosis ; pathology ; Cartilage Diseases ; diagnosis ; pathology ; Hand Deformities, Congenital ; diagnosis ; pathology ; Humans ; Infant ; Male ; Pulmonary Valve Stenosis ; diagnosis ; pathology

OBJECTIVETo explore the experimental basis of the "water metabolism theory" in traditional Chinese medicine by observing the changes of aquaporin-1 in the lung, spleen and kidney.

METHODSRat models of Kidney Yang Deficiency induced by gavage with 2% adenine suspension for 4 weeks were treated with cistanches decoction for 6 weeks. Urinary 17-hydroxy cortisol, urine creatinine, urine osmolality value content, and aquaporin-1 mRNA and protein expressions in the lung, spleen and kidney tissues were detected after the treatment.

RESULTSTreatment with adenine induced Kidney Yang Deficiency in rats by causing a reduction in urinary 17-hydroxy cortisol, urine creatinine and urine osmolality. Aquaporin-1 mRNA expression in the spleen and kidney were down-regulated after adenine treatment. Compared with the rat models, intervention with cistanche significantly increased aquaporin-1 mRNA expression in the lung and kidney tissues. Adenine resulted in increased aquaporin-1 protein expression in the lung, spleen and kidney of the rats, while cistanche intervention lowered its expression in lung and kidney tissues.

CONCLUSIONThe lung, spleen, kidneys are involved in water metabolism, and aquaporin-1 is one of its molecular basis. Cistanche can increase aquaporin-1 expressions, which is also regulated by other factors.

Adenine ; pharmacology ; Animals ; Aquaporin 1 ; metabolism ; Cistanche ; chemistry ; Kidney ; metabolism ; Lung ; metabolism ; Male ; Medicine, Chinese Traditional ; Rats ; Rats, Wistar ; Spleen ; metabolism ; Yang Deficiency ; metabolism

One severely burned patient, caused by heat lead slag and combined with shock, was hospitalized in our burn unit on 2nd June, 2016. The patient received treatments including anti-shock, intensive care, anti-infection, and organ protection. On post injury day 16, the patient suffered outbreak of acute hemorrhagic necrotizing enteritis after eating dumplings. Plasma and albumin were given, octreotide was intravenously infused to inhibit the secretion of intestinal fluid, the broad-spectrum antibiotics were used for anti-infection, abdominal puncture and drainage were performed, sodium tanshinone ⅡA sulfonate was applied to improve the intestinal microcirculation, ulinastatin was applied to alleviate inflammatory reaction, somatostatin was given to reduce intestinal bleeding, and voriconazole was given for antifungal treatment. The patient gradually recovered and was finally cured and discharged. Among critically ill patients, gastrointestinal tract is not only the initiating organ of sepsis, but also one of the target organs which can be easily damaged during sepsis. This case reminds us the importance of gastrointestinal management in severely burned patients.

The clinical data of a child with bronchial Dieulafoy disease treated in Wuhan Children′s Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, was analyzed retrospectively.The patient was a 9-month-old boy, who was admitted to hospital due to " intermittent hematemesis vomiting blood for 6 hours" . Chest CT suggested ground-glass opacity in both lungs.Electronic bronchoscopy showed that the neoplasm bulged into the lumen at the opening of the right inferior lobar bronchus, and fresh blood oozed from the basal segment of the neoplasm during the operation.Bronchial arteriography and transcatheter bronchial artery embolization were performed due to recurrent hemoptysis, during which the patient was diagnosed with bronchial arterial vascular malformation and finally diagnosed with bronchial Dieulafoy disease after consulting the relevant literatures.The disease is infrequent and characterized by rupture hemorrhage of bronchial submucosal malformed artery, the etiology and pathogenesis of which are still unclear, and it may be related to congenital vascular malformation in children.Bronchoscopy for hemoptysis of unknown cause in children should be performed with caution.If small and smooth protruded nodular lesions are seen under the bronchoscope, the bronchial Dieulafoy disease should be considered, and the lesions should not be touched too much or subjected to biopsy blindly.Fatal massive hemorrhage can be avoided by bronchial arteriography and bronchial artery embolization.