Objective:To summarize the clinical characteristics of congenital chylothorax (CC) in neonates, and to analyze the effects of conservative treatment and the prognosis.Methods:A case control study was conducted.Clinical data of neonates with CC treated in the Department of Neonatal Surgical Intensive Care Unit, Guangzhou Women and Children′s Medical Center Guangzhou Medical University, from January 2015 to April 2023 were collected.The patients were divided into a survival group and a death group according to the outcome.SPSS 26.0 software was used for statistical analysis, and binary Logistic regression was used for the analysis of risk factors for death.Results:A total of 55 patients were included in this study, including 35 males and 20 females.The gestational age at birth and birth weight were 37.1 (34.7, 38.7) weeks and 3 250 (2 640, 3 540) g, respectively.Among the patients included, 30 cases had bilateral pleural effusion, 25 cases had unilateral pleural effusion, and 22 cases had hydrops fetalis; 50 cases were prenatally diagnosed with pleural effusion, with the mean gestational age at diagnosis being 31.0(26.0, 34.6) weeks.Additionally, 21 cases had polyhydramnios, and 18 cases had mediastinal displacement.Ten cases received intrauterine treatment and 17 cases were treated with octreotide.The maximum daily amount of pleural effusion was 31.7(12.0, 62.5) mL/kg, and pleural effusion resolved within 14 (6, 22) days.The length of hospital stay was 23 (12, 36) days.Forty-four cases survived, while 11 cases died.The differences in polyhydramnios, gestational age, bilateral pleural effusion, hydrops fetalis and Apgar score were significant between the survival and death groups (all P<0.05).Binary Logistic regression analysis revealed that bilateral pleural effusion and a low 5-minute Apgar score were independent risk factors for early death in neonates with CC (all P<0.05).A total of 38 children were followed up at the age of 2.30 (1.24, 3.46) years.There was 1 case of recurrence, and none of the patients experienced recurrent respiratory infections. Conclusions:CC is most common in full-term infants and has a predominantly bilateral effusion, its long-term prognosis with conservative treatment is promising.However, neonates with CC who present with bilateral pleural effusion or low 5-minute Apgar scores have an increased risk of early mortality.

Objective:To summarize the clinical characteristics of congenital chylothorax (CC) in neonates, and to analyze the effects of conservative treatment and the prognosis.Methods:A case control study was conducted.Clinical data of neonates with CC treated in the Department of Neonatal Surgical Intensive Care Unit, Guangzhou Women and Children′s Medical Center Guangzhou Medical University, from January 2015 to April 2023 were collected.The patients were divided into a survival group and a death group according to the outcome.SPSS 26.0 software was used for statistical analysis, and binary Logistic regression was used for the analysis of risk factors for death.Results:A total of 55 patients were included in this study, including 35 males and 20 females.The gestational age at birth and birth weight were 37.1 (34.7, 38.7) weeks and 3 250 (2 640, 3 540) g, respectively.Among the patients included, 30 cases had bilateral pleural effusion, 25 cases had unilateral pleural effusion, and 22 cases had hydrops fetalis; 50 cases were prenatally diagnosed with pleural effusion, with the mean gestational age at diagnosis being 31.0(26.0, 34.6) weeks.Additionally, 21 cases had polyhydramnios, and 18 cases had mediastinal displacement.Ten cases received intrauterine treatment and 17 cases were treated with octreotide.The maximum daily amount of pleural effusion was 31.7(12.0, 62.5) mL/kg, and pleural effusion resolved within 14 (6, 22) days.The length of hospital stay was 23 (12, 36) days.Forty-four cases survived, while 11 cases died.The differences in polyhydramnios, gestational age, bilateral pleural effusion, hydrops fetalis and Apgar score were significant between the survival and death groups (all P<0.05).Binary Logistic regression analysis revealed that bilateral pleural effusion and a low 5-minute Apgar score were independent risk factors for early death in neonates with CC (all P<0.05).A total of 38 children were followed up at the age of 2.30 (1.24, 3.46) years.There was 1 case of recurrence, and none of the patients experienced recurrent respiratory infections. Conclusions:CC is most common in full-term infants and has a predominantly bilateral effusion, its long-term prognosis with conservative treatment is promising.However, neonates with CC who present with bilateral pleural effusion or low 5-minute Apgar scores have an increased risk of early mortality.

Objective:To evaluate the predictive value of postnatal esophageal deviation index for clinical outcomes of fetuses with left-sided congenital diaphragmatic hernia (L-CDH).Methods:This retrospective study analyzed the clinical data of 103 neonates with prenatally diagnosed L-CDH who were admitted to Guangzhou Women and Children's Medical Center from January 2016 to February 2023. These patients were divided into the survival group ( n=82) and the death group ( n=21) according to the outcomes, and the extracorporeal membrane oxygenation (ECMO) group ( n=25) and the non-ECMO group ( n=78) according to whether ECMO support was required. Thoracoabdominal X-ray screening was performed on all neonates within 24 h after admission and the esophageal deviation index and cardiac deviation index were calculated. Independent sample t-test or Fisher's exact probability test were used to analyze the differences in general condition and postnatal imaging features between different groups. Receiver operating characteristic (ROC) curve was used to evaluate the value of postnatal imaging features in predicting the prognosis of L-CDH. Results:The esophageal deviation index and the cardiac deviation index of neonates in the survival group were lower than those in the death group [(10.5±5.3)% vs. (18.0±4.5)%, t=－5.47; (37.7±7.1)% vs. (42.8±8.2)%, t=－2.62; both P<0.05], while that were both higher in the ECMO group compared with the non-ECMO group [(18.0±4.3)% vs. (10.1±5.2)%, t=6.34; (42.4±7.9)% vs. (37.6±7.1)%, t=2.63; both P<0.05]. ROC curve showed that the area under the curve (AUC) for predicting the need for ECMO support was 0.879 (95% CI: 0.805-0.953) for esophageal deviation index and 0.712 (95% CI: 0.570-0.854) for cardiac deviation index, with the optimal cut-off values of 11.7% and 41.7%, respectively. The AUC for predicting the survival rate in patients with L-CDH by esophageal deviation index and cardiac deviation index were 0.854 (95% CI: 0.761-0.947) and 0.735 (95% CI: 0.582-0.887), respectively, with the corresponding optimal cut-off values of 15.8% and 41.7%. Conclusion:Postnatal esophageal deviation index is of value in predicting the need for ECMO support and survival rate in patients with L-CDH.

Objective:To investigate the clinical features and management of right-sided congenital diaphragmatic hernia (RCDH) with hepatopulmonary fusion (HPF).Methods:This retrospective study analyzed the clinical characteristics of three cases of RCDH complicated by HPF that were treated in Guangzhou Women and Children's Medical Center from June to December 2022. Diaphragm defects in the three cases were classified according to the international standard of diaphragm defect classification. Besides, an extensive search of publications was performed including domestic and foreign databases, including CNKI, Wanfang Database, Yiigle, VIP Chinese journals, PubMed, Embase and UpToDate databases from January 1997 to April 2023 using terms including "congenital diaphragmatic hernia" and "hepatopulmonary fusion". Clinical features and prognosis of RCDH complicated by HPF were summarized.Results:(1) Cases in the present study: RCDH was found in case 1 and case 2 during routine prenatal ultrasound examination; antenatal fetal MRI showed partial displacement of the hepatocele into the right hemithorax, right lung hypoplasia, a normal-sized left lung and without left shift of the mediastinum in both cases. Postnatal chest radiographs of case 1 and case 3 showed dense shadow in the left lung and mediastinum shifted to the right. Case 2 had a D-type defect and a slight shift of the mediastinum to the left was observed on the postnatal chest radiograph. Preoperative imaging findings indicated highly suspected HPF in the three cases. Case 1 and case 2 had complete separation of liver and lung and underwent diaphragmatic herniorrhaphy with patch. Partial lung resection was performed in case 2. Both case 1 and case 2 survived (length of hospital stay was 22 d and 23 d, respectively). Case 3 did not undergo hepatopulmonary separation or herniorrhaphy after exploratory operation and died of persistent pulmonary hypertension. (2) Literature review: Only 40 cases of CDH with HPF were retrieved from PubMed. Among the 43 cases including the above three cases, 27 (62.8%) had a right shift or no deviation of the mediastinum before surgery and nine (20.9%) had a left shift of the mediastinum, while the condition of seven patients (16.3%) were not described. There were 26 patients undergoing complete separation of liver and lung and 19 (73.1%) of them survived. Thirteen patients underwent partial separation of liver and lung and six of them survived. Four patients died without receiving separation.Conclusions:HPF should be considered in patients with RCDH, especially in cases with no left shift in the mediastinum in the imaging. Preoperative evaluation for surgery in such cases needs to be managed as if it were a major operation that may require hepatectomy or partial pneumonectomy.

Increasing peripheral pulmonary nodules are detected given the growing adoption of chest CT screening for lung cancer. The invention of electromagnetic navigation bronchoscope provides a new diagnosis and treatment method for pulmonary nodules, which has been demonstrated to be feasible and safe, and the technique of microwave ablation through bronchus is gradually maturing. The one-stop diagnosis and treatment of pulmonary nodules can be completed by the combination of electromagnetic navigation bronchoscopy and microwave ablation, which will help achieve local treatment through the natural cavity without trace.

The incidence of peripheral pulmonary lesions (PPLs) is growing following the adoption of lung cancer screening by low-dose chest CT. The diagnosis and treatment of pulmonary nodules is one of the most difficult problems. Based on the electromagnetic positioning technology, the electromagnetic navigation bronchoscope is guided to the pulmonary nodules for biopsy or treatment, providing a new minimally invasive diagnosis and treatment method for suspicious lung lesions. This paper provides an overview of the current status and progress of electromagnetic navigation bronchoscopy in the diagnosis and treatment of peripheral pulmonary diseases.

Objective To understand the prevalence of alcohol dependence in individuals living in Guangxi Zhuang Autonomous Region,China. Methods From July 2007 to December 2007,21290 subjects aged more than 15 were randomly selected for 6 Prefecture-level cities and 10 counties by stratified multi-stage cluster sampling method. All subjects were investigated by face to face interview. The Chinese version of Composite International Diagnostic Interview (CIDI3.0) Provided by the Chinese Center for Disease Control And Prevention was used as the screening tool and the diagnoses were made with the 10th edition of international classification of Disease Criteria. Results 18 219 subjects completed the screening,the Completion rate was 85.58‰. The general point prevalence and the general lifetime prevalence of alcohol dependence in individuals living in Guangxi was both 4.50‰. The general lifetime prevalence was higher in rural (6.17‰) than in urban (1.85‰) ( RR =0.31,95% CI =0. 17 ～0.57, P=0. 000) ,higher in men (8.59‰) than in women (0. 33‰) ( RR =0.04,95% CI =0. 01 ～ 0.13, P = 0.000 ) and higher in Zhuang (9.63‰) than in Han(1.95‰) ( RR = 5. 01,95% CI = 3.02 ～8.34, P = 0.000). The lifetime prevalence of alcohol dependence tends upwards as age increasing (P＜0.05 ) and it differs in different marital status,higher in divorce groups (P ＜ 0.05). Conclusion Schizophrenia, Depression disorder, Alcohol dependence disorder are the most common mental disorders and have become the public health problem in Guangxi. To do this,it is necessary to carry out targeted research in prevention and rehabilitation.

Objective To study the influence of PYLL on life span of residents. Methods The reduce of potential life span in Kunshan residents from 1982～1999 was analysed between the male and female. Results The life span reduced significantly in injury, poisoning and c ancer, which accounted for over 56% of total causes o f death in PYLL, especially, over 60 % in male. PYLL rate in male was higher than that in female. PYLL rate in male a nd female (except brain blood vessel disease) from 1991～1999 was lower than tha t from 1982～1990. It was consistent with increasing of old age population pr oport ion and prolonging of expected life span in Kunshan residents year by year. Conclusions The reasons that causes to death of residents were injury a nd poisoning and cancer.