Objective To investigate the clinical characteristics,diagnosis,and treatment of gastric duplication(GD)in children.Methods A retrospective analysis was conducted on the clinical data of 46 pediatric patients with GD treated at our hospital from January 2008 to January 2025.The evaluated parameters included age,gender,symptoms,comorbidities,imaging data,surgical process,postoperative treatment and follow-up situation.Analyze the clinical characteristics of GD.Results Forty-four cases were cystic structures,and 2 cases were sinus tracts or tubular structures respectively.The most common site was the cardia/fundus area(20 cases).Seventeen cases were asymptomatic(7 detected during prenatal screening and 10 identified incidentally).The most common associated anomalies were inguinal hernia(4 cases),pulmonary airway malformation(3 cases),pulmonary sequestration(3 cases),and hiatal hernia(3 cases).All 46 patients underwent ultrasound examination,with an accuracy of 97.8％.Upper gastrointestinal contrast studies were performed in 16 cases and computed tomography(CT)was conducted in 34 patients.Perforation occurred in 7 cases.Surgical approaches included laparoscopy(35 cases,with 5 conversions to open surgery),open surgery(9 cases),robotic surgery(1 case),transthoracic surgery(1 case).Operative time ranged from 50 to 250 minutes(median:105 minutes).Postoperative pathology identified pancreatic heterotopia in 6 cases.Time to resume oral intake ranged from 1 to 17 days(median:4 days),and postoperative hospital stay lasted 3-21 days(median:7 days).During follow-up,one patient was readmitted for adhesive intestinal obstruction and managed conservatively,with no other significant complications reported.Conclusion Pediatric GD is a rare congenital anomaly,typically presenting as non-communicating cystic lesions with nonspecific clinical manifestations.Ultrasonography is the primary diagnostic tool,with upper GI series,CT/MRI,and endoscopy as adjuncts.While prompt surgical intervention is indicated for symptomatic cases,those complicated by perforation/infection should undergo delayed elective resection ≥ 3 months following complete inflammatory resolution.Laparoscopic approach is the treatment of choice,while endoscopic intraoperative localization or endoscopic therapy may be considered for small intraluminal lesions.

Objective To investigate the clinical characteristics,diagnosis,and treatment of gastric duplication(GD)in children.Methods A retrospective analysis was conducted on the clinical data of 46 pediatric patients with GD treated at our hospital from January 2008 to January 2025.The evaluated parameters included age,gender,symptoms,comorbidities,imaging data,surgical process,postoperative treatment and follow-up situation.Analyze the clinical characteristics of GD.Results Forty-four cases were cystic structures,and 2 cases were sinus tracts or tubular structures respectively.The most common site was the cardia/fundus area(20 cases).Seventeen cases were asymptomatic(7 detected during prenatal screening and 10 identified incidentally).The most common associated anomalies were inguinal hernia(4 cases),pulmonary airway malformation(3 cases),pulmonary sequestration(3 cases),and hiatal hernia(3 cases).All 46 patients underwent ultrasound examination,with an accuracy of 97.8％.Upper gastrointestinal contrast studies were performed in 16 cases and computed tomography(CT)was conducted in 34 patients.Perforation occurred in 7 cases.Surgical approaches included laparoscopy(35 cases,with 5 conversions to open surgery),open surgery(9 cases),robotic surgery(1 case),transthoracic surgery(1 case).Operative time ranged from 50 to 250 minutes(median:105 minutes).Postoperative pathology identified pancreatic heterotopia in 6 cases.Time to resume oral intake ranged from 1 to 17 days(median:4 days),and postoperative hospital stay lasted 3-21 days(median:7 days).During follow-up,one patient was readmitted for adhesive intestinal obstruction and managed conservatively,with no other significant complications reported.Conclusion Pediatric GD is a rare congenital anomaly,typically presenting as non-communicating cystic lesions with nonspecific clinical manifestations.Ultrasonography is the primary diagnostic tool,with upper GI series,CT/MRI,and endoscopy as adjuncts.While prompt surgical intervention is indicated for symptomatic cases,those complicated by perforation/infection should undergo delayed elective resection ≥ 3 months following complete inflammatory resolution.Laparoscopic approach is the treatment of choice,while endoscopic intraoperative localization or endoscopic therapy may be considered for small intraluminal lesions.

Surgical therapy and nursing of a rare case of semi-conjoined deformed twins was summarized. To relieve life threaten, correct deformity and retain function, surgical therapy was performed. Afterwards, patient received nursing strategies including preventing elevation of abdominal pressure, incision care of hemipelvectomy, pelvic fixation, prevention of pressure sores, multi-canal nursing, nutrition support and infection control. Survival of patient was prolonged through a comprehensive therapy and nursing, and the patient was successfully discharged.

Objective To investigate therapeutic effect of endoscope?guided bougie dilatation on children with benign esophageal stricture. Methods Data of 71 patients with benign esophageal stricture were retrospective analyzed.Patients were divided into group A (reflux stricture),B (congenital esophageal atresia stricture) and C ( caustic injuries stricture) ,based on different causes. The expansion effectiveness and factors of the three groups were analyzed. Results A total of 885 expansions were performed on 71 patients with the total efficacy rate 94?37%( 67/71) . No statistic differences were shown in expansion effectiveness among the 3 groups; group C ( 14?9 times/case, P < 0?05 ) showed more expansion frequencies than group A (9?1 times/case,P<0?05)and group B(10?7 times/case, P<0?05),more complications than group A(1?22%VS 0,P<0?05) and group B(1?22% VS 0?31%,P<0?05). Conclusion Endoscope?guided bougie dilatation is safe and effective for childrens′ benign esophageal stricture. Caustic injuries, refractory benign esophageal stricture,need more expansions and may be accompanied with more complications.

Objective To explore the influence of integrated traditional Chinese medicine and western medicine on neurological function in patients with ischemic stroke.Methods One hundred patients with ischemic stroke were randomly divided into a treatment group and a control group.Both groups were given basic treatment.At this basis,sixty patients in the treatment group were given Chinese decoction,Kudiezi injection,traditional Chinese medicine soaking,and comprehensive rehabilitation; forty patients in the control group were given citicoline,modem rehabilitation techniques.Both groups were treated for 21 days.The scores of NIHSS,ADL,and MMSE were assessed at 7th day,14th day,and 21st day after admission of the trial,respectively.Results After 14 days,the scores of NIHSS (22.33± 1.06)in treatment group were decreased significantly (P＜0.05).After 21 days,the scores of NIHSS,ADL,MMSE in treatment group were(18.73±1.23),(20.19±2.17),(38.68±2.85),and(21.65±l.41),(25.37±2.34),(32.12±3.11)in control group,the improvement of scores in treatment group were superior to the control group (P＜0.05).The total effective rate was 91.67％ in treatment group,and 70％ in control group,it was significantly higher in treatment group than that in the control group (x2=7.98,P＜0.05).Conclusion The therapy of integrated traditional Chinese medicine and western medicine can significantly improve ischemic stroke,enhance the therapeutic efficiency of patients with ischemic stroke.

Objective To discuss the surgical treatment for huge hepatoblastoma in children,and the technique of hepatectomy without blockade of the blood supply to the remained liver lobes.Methods We reviewed 12 cases of huge hepatoblastorna who had been operated from July 2001 to January 2009 in our hospital.The mean age of the children was 3.2 years(range,11 months to 12 years).The diameter of the tumor was from 10 to 23 cm.3～7 cycles of chemotherapy was routinely administrated before operation.When the tumor reduced to a certain size that radical resection could be performed safely,regular hepatectomy was conducted.Hepatoblastoma resection without blocking the blood supply to the remained liver lobes was performed in every patient.Results The operations were successfully accomplished in all the 12 children.5 cases received right trihepatectomy (segment Ⅳ,Ⅴ～Ⅷ),4 cases received right hemihepatectomy(segment Ⅴ～Ⅷ),and the other 3 cases received Ⅳ,Ⅶ,Ⅷ segmentectomy,right Ⅴ,Ⅵ segmentectomy,and left hemihepatectomy respectively.The intraoperative hemodynamic parameters were stable,and there was no perioperative mortality.Postoperative chemotherapy wag routinely administrated.The follow-up period varied from 2 to 92 months.11 children survived and were disease free,among those 6 children have survived for more than 5 years.One child had brain and lung metastasis 5 months post operation,and died 7 months post operation. Conclusion Preoperative chemotherapy administrated to children with huge hepatoblastoma can reduce the tumor size and render tumor reseetable.Hepatoblastoma resection without blocking the blood supply to the remained liver lobes is a safe and feasible surgical technique.

Objective To explore the safety and feasibility of laparoscopy in diagnosis and treatment of neonates and infants diseases.Methods Laparoscopic operations were performed in 297 neonates and infants aging from 2 hours to 6 months,from January 2001 to May 2007.The diseases of 297 cases included 80 cases of congenital hypertrophic pyloric stenosis,67 cases of obstructive jaundice,35 cases of indirect inguinal hernia,31 cases of biliary atresia,21 cases of middle or high anal atresia,21 cases of biliary hyperviscosity,7 cases of congenital diaphragmatic hernia,7 cases of jejunal atresia,6 cases of choledochal cyst,5 cases of Hirschsprung's disease,5 cases of duodenal web,3 cases of uronephrosis,2 cases of esophageal hernia,2 cases of esophageal atresia,2 cases of intestinal malrotation,1 case of intestinal obstruction,1 case of intussuception,,and 1 case of congenital muscular troticollis.Results The laparoscopic operations were completed in 294 cases,of which 67 received diagnostic cholangiography,80 received pyloromyctomy,35 received hernia sac high ligation,21 received biliary irrigation,5 received operations for membranous stenosis of duodenum,2 received Ladd operations for malrotation of intestine,1 received reduction of intussusception,1 received enterolysis,and 1 received incision of lower end of sternocleidomastoid muscle;and some complicated procedures including 31 cases of hepatic portal duct-jejunostomy,21 anoplasty,7 repair of diaphragmatic hernia,7 enterectomy and entero-anastomosis of intestinal atresia,6 hepatic duct-jejunostomy,5 radical surgery for Hirschsprung's disease(megadolicho-colon),3 pyeloplasty,2 operations for esophageal atresia,and 2 fundoplication for hiatus hernia.No massive hemorrhage,intra-or post-operative blood infusion,accidental damage or peri-operative death was reported.Three cases of biliary atresia were converted to open surgery due to oozing of blood in hepatic portal.All case were followed for 2 months-6 years,and no long-term or short-term complication was found.Conclusions Laparoscopic technique is safe and reliable in the diagnosis and treatment of diseases in neonates and infants,which is characterized by minimal invasion,quick recovery and satisfactory cosmetic effects.

Objective To evaluate the diagnostic value of 2D-FIESTA sequence of MRI in the detection of the biliary tract lesions in infant and young children patients(less than 3 years).Methods 8 infant and young children patients were examined by MRI to evaluatetheir biliary tract.Images were obtained with a 1.5T whole body MRI system(GE Medical System,Milwakee,Wis,USA),using theCARDIAC coil.The patients were sedated by chloral hydrate orally or by pentobarbital sodium intravenously.No contrast agents wererequired.All of the axial,coronal and sagittal images were reviewed on an independent workstation and maximum intensity projection(MIP) and multiplanar reformations(MPR) techniques were applied.Results The 2D-FIESTA pulse sequence results in images in which the hepatic vascular structures and the biliary tract were highlighted.In this way,a clear visualization of the hepatic vessels and biliarytract could be obtained in all 8 cases.MRI could demonstrate the anatomy and pathology of post-transplantation changes in 3 patients,choledochal cysts in 2 patients,anomalous connection between the bile and pancreatic ducts in 1 patient.All the abnormalities were proved by operation.2 examinees were diagnosed normal by MRI and were confirmed by follow-up.Conclusion 2D-FIESTA is a fast sequence that allows the high quality images to be generated without breath-hold and without administration of contrast material.It has a potential wide application in the evaluation of biliary tract in the infant patients.

Objective To study the characteristic s of laparoscopic operations in infants younger than 6 months. MethodsWe retrospectively analyzed the perio perative course of laparoscopic operations in 98 infants. Results All the 46 cases got definite diagnosis by explorative laparoscopic operations except 1 case shifted to open laparotomy. Two cases were shifted to open laparotomy in 51 therapeutic laparoscopic proced ures. Post-operative complications such as respiratory tract infection, hyperca pnia and elevation of myocardial enzyme were found in 11, 14 and 1 cases respect ively. There was no postoperative mortality, no infection nor hernia of incision s in the peri-operative period. Conclusion Appropriate application of laparoscopy in infantile surgery i s of optimistic future for less trauma and complications.

Objective To explore the method and superiority of laparoscopic management of children's varicocele. Methods High position ligation of varicocele under laparoscope was performed and internal spermatic arteries were reserved intraoperatively. Results 32 cases had smooth recovery after operation, and no complication occurred. The hospital stay was (1～3)days postoperatively. 29 cases had been followed up for 6 months～1 year and no relapse and testis atrophy occurred. Conclusions The method has the advantages of simpleness, minimal invasion and quicker recovery. Reservation of internal spermatic artery can prevent testis atrophy.