简介：研究观察年龄对潘库溴铵药代动力学的影响。选择２４例施择期整形外科手术的患者，根据年龄分成三组：１组为５例婴幼儿，年龄０．７５～２．９５岁；２组为１３例儿童，年龄４～１４岁；３组为６例成人，年龄１６～２７岁。静注潘库溴铵１００μｇ／ｋｇ后用改良荧光法测定其血浓度。潘库溴铵的体内过程能用二室开放模型完整描述，年龄愈小，分布容积愈大，血浆清除率愈高，潘库溴铵的血药浓度愈低。Ｖ１（中央室分布容积）、Ｖ２（周边室分布容积）、Ｖｄｓｓ（稳态分布容积）、Ｃｌ（血浆清除率）和ＡＵＣ（曲线下面积）在三组间有明显差别。１组的Ｔ１／２β和ＭＲＴ明显比２、３组长，但Ｔ１／２α和Ｋ２１在三组间无明显差别。

简介：BackgroundCongenitaltrachealstenosis(CTS)isachallengingairwayproblem.CTSininfantsandchildrencanbelife-threatening.Duringlastthirtyyears,alargenumberofstudiescoveringthediagnosis,clinicalpresentation,managements,especiallysurgicaltreatmentsofCTShavebeenreported.ThisreviewaimedtoconcluderecognizedknowledgeofCTSandprovidecluesformanaginginfantsandchildrenwithCTS.

简介：Inthispaper,afacialfeatureextractingmethodisproposedtotransformthree-dimension(3D)headimagesofinfantswithdeformationalplagiocephalyforassessmentofasymmetry.Thefeaturesof3Dpointcloudsofaninfant’scraniumcanbeidentifiedbylocalfeatureanalysisandatwo-phasek-meansclassificationalgorithm.The3Dimagesofinfantswithasymmetriccraniumcanthenbealignedtothesamepose.Themirroredheadmodelobtainedfromthesymmetryplaneiscomparedwiththeoriginalmodelforthemeasurementofasymmetry.Numericaldataofthecranialvolumecanbereviewedbyapediatriciantoadjustthetreatmentplan.Thesystemcanalsobeusedtodemonstratethetreatmentprogress.

简介：OBJECTIVE:Ameta-analysisofpublishedrandomizedcontrolledtrialsinvestigatingthelongtermeffectofdexamethasoneonthenervoussystemofpreterminfants.DATASOURCES:OnlineliteratureretrievalwasconductedusingTheCochraneLibrary(fromJanuary1993toJune2013),EMBASE(fromJanuary1980toJune2013),MEDLINE(fromJanuary1963toJune2013),OVID(fromJanuary1993toJune2013),Springer(fromJanuary1994toJune2013)andChineseAcademicJournalFull-textDatabase(fromJanuary1994toJune2013).KeywordswerepreterminfantsanddexamethasoneinEnglishandChinese.STUDYSELECTION:Selectedstudieswererandomizedcontrolledtrialsassessingtheeffectofintravenousdexamethasoneinpreterminfants.Thequalityoftheincludedpaperswasevaluatedandthosewithoutthedevelopmentofthenervoussystemandanimalexperimentswereexcluded.QualityassessmentwasperformedthroughbiasriskevaluationinaccordancewithCochraneHandbook5.1.0softwareintheCochraneCollaboration.ThehomogeneousstudieswereanalyzedandcomparedusingRevman5.2.6software,andtheneffectmodelwasselectedandanalyzed.Thosepapersfailedtobeincludedinthemeta-analysisweresubjectedtodescriptiveanalysis.MAINOUTCOMEMEASURES:Nervoussysteminjuryinpreterminfants.RESULTS:Tenrandomizedcontrolledtrialswerescreened,involving1,038subjects.Amongthem512casesreceiveddexamethasonetreatmentwhile526casesservedasplacebocontrolgroupandblankcontrolgroup.Meta-analysisresultsshowedthattheincidenceofcerebralpalsy,visualimpairmentandhearinglossinpreterminfantsafterdexamethasonetreatmentwithin7daysafterbirthwassimilartothatinthecontrolgroup(RR=1.47,95%CI:0.97–2.21;RR=1.46,95%CI:0.97–2.20;RR=0.80,95%CI:0.54–1.18;P>0.05),butintelligencequotientwassignificantlydecreasedcomparedwiththecontrolgroup(MD=-3.55,95%CI:-6.59to-0.51;P=0.02).Preterminfantstreatedwithdexamethasone7daysafterbirthdemonstratedaninci

简介：运用推拿手法治疗婴幼儿肌性抖颈33例，并观察治疗前后患侧胸锁乳突肌包块的B超影像的变化。结果痊愈27例，有效5例，无效1例，总有效率97．0％；B超影像显示，患侧颈部可探及梭型或卵圆形包块．呈低回声者28例，中等回声者2例，高回声者3例。治疗前后包块的长度、厚度和宽度均有明显差异，P<0．017表明推拿治疗小儿肌性斜颈疗效著；超声检查可作为推拿治疗过程中评价治疗效果的一种客观标准，是一种简捷、方便、又经济的检查方法，有利于一临床推广。

简介：ObjectivesToexplorethefeasibility,necessity,andsecurityoftranscatheterclosureofpatentductusarteriosus(PDA)ininfants.MethodsTherewere230infantswithPDA.Theageswere(7.3±3.2)monthsandtheweight(6.6±2.8)Kginaverage.Theywereseparatedintotwogroups.GroupAwasformedbytheinfantsweighinglessthan6Kg,GroupBover6Kg.RightheartcatheterizationwasperformedfirsttocalculatetheratioofQp/Qs.ThendescendingaortographydemonstratedthediameterandshapeofPDA.Properoccluderwasselectedtofinishtheintervention.Echocardiographywasperformedafterintervention24hoursand1,3,6,12and24months.ResultsInGroupAthetechnicalachievementratiowas94.6%withtheaveragediameterofPDA(6.2±3.2)mm.InGroupBthetechnicalachievementratiowas100%withtheaveragediameterofPDA(4.8±2.5)mm.WeusedtheAmplatzerDuctOccluderwiththetypefrom6-8mmto12-14mm,thedeliverysheathfrom6Frenchto8French.24hoursafterintervention,echocardiographydemonstratedthattherewere6residualshuntsinGroupAwhile22inGroupB.After1year,residualshuntexistedinneithergroup.Therewere4patientswhosefemoralarteriespulsedweaklyafterinterventioninGroupA,whileinGroupBtherewere3.Theyallrecovered24hoursaftertheapplicationofurokinase.InGroupAbloodflowvelocityindescendingaortaincreasedin5infants,whileinGroupBtherewere3.Theyallresumedin6-12months.ConclusionsTranscatheterclosureofPDAininfantsissafeandtechnicallyfeasible.However,indicationshouldbestrictlyselectedandtheinterventionshouldbeperformedbyexperiencedphysician.

简介：ObjectiveToassesstheutilityoflow-andhigh-frequencytympanometryinthediagnosisofmiddleeardysfunctioninChineseinfants.MethodsTympanogramswereobtainedwith226Hz,678Hzand1000Hzprobetonesfrominfantsaged5-25weekswithnormalauditorybrainstemresponses(ABRs)(15infants,30ears)andwithprolongedwaveIlatencies(17infants,20ears),suggestingmiddleeardysfunction,usingaGSITympstarmiddleearanalyzerVersionII.ResultsThesingle-peakedtympanogramwasthemostcharacteristictypeinbothgroupsandseenin25ears(83.3%)inthenormalABRgroupandin18ears(90%)inthedelayedwaveIgroup,respectively.Thepeakpressure,peakcompensatedstaticacousticadmittanceandgradientof226Hztympanometrywereofnosignificantdifferencesbetweenthetwogroups.The678Hztympanogramsofadmittance,susceptanceandconductancedemonstratednon-peak,single-,double-andtri-peakedpatternsinbothgroups.TheagreementbetweenABRsand678Hztympanogramsofadmittance,susceptanceandconductancewere70.0%,58.0%and64.0%(kappa=0.324,0.234and0.118)respectively.For1000Hzprobetone,admittance,susceptanceandconductancetympanogramsshowedsinglepeakedpatternsin28(93.3%),25(83.3%)and26(86.7%)ofthe30normalears.Admittance,susceptanceandconductancetympanogramsusingthe1000Hzprobetonewereflatin15(75%),17(85%)and13(65%)oftheearsininfantswithprolongedwaveIlatencies.For1000Hzadmittance,susceptanceandconductanceTympanograms,theagreementbetweentympanometryandABRresultswere90.0%,92.0%and86.0%withkappaat0.783,0.831and0.690,respectively.Conclusion1000Hzprobetonetympanometryisapromisingmiddleearfunctiontestforinfantsof1-6monthsage,while226Hzand678Hzprobetonesarelessefficientindetectingmiddleeardysfunctionininfants.

简介：目的：探讨针刺疗法结合康复对围产期脑损伤高危儿智力及运动发育的影响。方法：对97例经新生儿重症监护室（NICU）救治存活的围产期脑损伤高危儿，按患儿家长意愿划分两组，针刺组53例，采用针刺结合康复治疗。对照组44例，采用常规育儿方式。两组均系统跟踪随访至2周岁，于6、12、24月龄时由专人定期采用婴幼儿智能发育量表进行智能测定。结果：针刺组在2岁时智力发育指数（MDI）与运动发育指数（PDI）分别高于对照组14．69、9．82分；针刺组智能异常率为15．1％，明显低于对照组40．9％，两组间差异具有统计学意义（χ2=8．1659，P〈0．01）。结论：针刺结合康复能有效地促进围产期脑损伤高危儿智力及运动发育，是改善预后、减少伤残率．提高患儿生存质号自勺有效丰段．

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简介：AIM:TostudytheevolutionoftherefractivestatusandexaminetheaffectedfactorsininfantsduringthefirstyearoflifeinalargesamplesizeinChina.METHODS:Atotalof1258babies(2516eyes)aged32wkgestationalageto1yparticipatedinthestudy,including766prematureand492full-terminfants.First,eachbabyreceivedanorthopticexamination,slit-lampcheckingandfundusimaging.Patientswithdiseaseswhichmightaffectrefractivestatuswereexcludedfromthecohort.Thecycloplegiaretinoscopywasperformed.Theirneonatalhistorieswerereviewed.Eachmeasurementcontainedtherefractivestatusandcalculationofthesphericalequivalent(SE).RESULTS:Refractivestateshowedanaveragehyperopiaof+0.94±1.63Datearlyages,followedbyatrendtowardmorehyperopia.Therefractivestatereachedthetop(+2.43±1.46D)attheageofonetotwomonths.Thenglidingtilloneyearoldwhentherefractivestatereached+0.59±1.41D.Theprevalenceofastigmatismwas42.17%inthestudy,being2.82%myopicastigmatismand39.35%hyperopicastigmatism.The94.1%ofhyperopicastigmatismwaswith-the-ruleastigmatismand71.83%ofmyopicastigmatismwaswith-the-ruleastigmatism.Refractivestatebetweenboysandgirlswasdifferent.ThemeanSEofboyswas+1.97±1.57D,whilethatofgirlswas+1.79±1.46D,andthedifferencewassignificant.CONCLUSION:Beforeoneyearold,thechangeofrefractivestatusisassociatedwithcheckingageandsex.Attheageofonetotwomonths,thedegreeofhyperopiareachesthetop.Boyshavemorehyperopicdegreethangirls,andwiththe-ruleastigmatismispredominant.Excludingprematureinfantswithadvancedretinopathyofprematurity,prematureandfull-termchildrenhavesamerefractionstatus.

简介：AbstractMaternal urogenital human papillomavirus (HPV) infection may place neonates at risk of HPV acquisition and subsequently lower respiratory infections as HPV can influence development of immunity. The respiratory HPV prevalence is not known in remote-dwelling Aboriginal infants, who are at high risk of respiratory infection and where the population prevalence of urogenital HPV in women is high. These data are necessary to inform HPV vaccination regimens. A retrospective analysis using PCR specific for HPV was performed on 64 stored nasopharyngeal swabs from remote-dwelling Aboriginal infants < 6 months of age, with and without hospitalised pneumonia. HPV DNA was not detected in any specimen. Despite the negative result, we cannot exclude a role for HPV in respiratory infections affecting infants in this population; however, our data do not support HPV as an important contributor to acute respiratory infection in remote-dwelling Aboriginal children.

简介：BACKGROUND:Exposuretolow-levelleadhasatoxiceffectonthedevelopmentofneonates,whichhasattractedwideattention.Colostrumleadlevelcanbeusedastheindicationofleadexposure.OBJECTIVE:Toobservetherelationshipofcolostrumleadlevelandtheneurobehavioraldevelopmentofinfants.DESIGN:Aprospectivecontrolobservation.SETTING:CenterforMaternalandChildHealth,ShanxiProvincialChildren'sHospital.PARTICIPANTS:Totally128neonatesoffull-termnormaldelivery,76maleand52female,fromShanxiProvincialMaternalandChildHealthCenterandJiexiuMaternalandChildHealthCenterwereinvolvedinthisstudy.Alltheinvolvedneonateshadnoperipartalischemic/hypoxichistoryorfetusintrauterinedevelopmentallag.Pregnantwomenhadnovariousacuteandchronicdiseasesinpregnancy,familyhistoryofneurologicaldiseaseoroccupationalleadexposure.128portionsofcolostrumsampleoffull-termnormaldeliverywerecollected.Informedconsentsofdetecteditemswereobtainedfromthepuerperantsandtheirrelatives.METHODS:①Experimentalgrouping:Leadlevelinthecolostrumwasdeterminedbyatomicabsorptionspectrometry.Accordingtoleadlevelinthecolostrum,theneonateswereclassifiedintotwoexposuregroupsofgreaterthanorequalto0.24μmol/Linahigh-levelleadgroupandlessthan0.24μmol/Linalow-levelleadgroup.②Experimentalevaluation:Mentaldevelopmentalindex(MDI)andpsychologicaldevelopmentalindex(PDI)of3-month-oldinfantswereevaluatedwithBayleyScalesofInfantDevelopment(BSID).TherelationshipsofMDI,PDIandcolostrumleadlevelwereperformedcorrelationregressionanalysis;Therelationshipofcolostrumleadlevelanddevelopmentwasperformedmulti-factoranalysiswithfamilyenvironmentandhealthquestionnaires.MAINOUTCOMEMEASURES:①EvaluationresultsofMDIandPDI.②Multi-factoranalysisresults.RESULTS:Totally128neonateswereinvolvedinthestudy.Tenandelevenneonateswerelostduetoemigra

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简介：AbstractImportance:Congenital tuberculosis (TB) is a rare, potentially fatal disease. There is currently a lack of detailed clinical information available regarding this disease.Objective:This retrospective study investigated the clinical manifestations, treatment, and long-term prognosis of congenital TB.Methods:Patients were treated in Beijing Children’s Hospital, Capital Medical University (Beijing, China) between 2009 and 2018. Their demographic data, maternal and family histories, symptoms and signs, treatment information, and follow-up data were retrospectively collected using the hospital’s electronic information system.Results:Ten infants with congenital TB were enrolled. The mean gestational age was 36.6 ± 2.2 weeks and mean birth weight was 2517 ± 487 g. All 10 patients exhibited fever, nine patients (90%) had anemia, and six patients (60%) had extrauterine growth retardation. On chest computed tomography scans, all 10 patients presented multiple pulmonary nodules and four patients (40%) had mediastinal adenopathy. Nine out of ten (90%) completed the T-spot test, and eight of them (8/9, 89%) were positive. Anti-TB treatment was initiated upon diagnostic confirmation. All patients (100%) received combined treatment with isoniazid (INH) and rifampicin (RIF). Eight of 10 patients (80%) received combined treatment with INH, RIF, and pyrazinamide. The survival rate was 100%. One patient was lost to follow-up and four patients are currently continuing treatment. Three of nine patients (33%) achieved normal developmental milestones at 6 months of age.Interpretation:Early diagnosis based on maternal history, typical imaging results, and timely treatment can improve outcomes in infants with congenital TB.

简介：AbstractBackground:It is still unclear if and to what extent antenatal or infant or childhood vitamin D supplementation would affect the development of allergy diseases later in life. This study aimed to review the efficacy of vitamin D supplementation in pregnant women, infants, or children for the prevention of allergies.Methods:MEDLINE (PubMed), EMBASE (OVID), and the Cochrane Central Register of Controlled Trials were searched up to March 1, 2020. We included only randomized controlled trials (RCTs). We performed a systematic review and meta-analysis for vitamin D supplementation in primary allergy prevention. These trials were assessed for risk of bias using the Cochrane Collaboration domains and the consensus was reached via discussion with the full study group. We descriptively summarized and quantitatively synthesized original data to evaluate vitamin D supplementation in primary allergy prevention by using Review Manager software for meta-analysis.Results:The search yielded 1251 studies. Seven RCTs were included in this analysis. A meta-analysis revealed that vitamin D supplementation for pregnant women or infants may not decrease the risk of developing allergic diseases, such as asthma or wheezing (supplementation for pregnant women, risk ratio [RR]: 1.01, 95% confidence interval [CI]: 0.81-1.26, P = 0.90, I2 = 47%; supplementation for infants, RR: 1.00, 95% CI: 0.70-1.43, P = 0.99, I2 = 0%; supplementation for pregnant women and infants, RR: 0.35, 95% CI: 0.10-1.25, P= 0.11), eczema (supplementation for pregnant women, RR: 0.95, 95% CI: 0.80-1.13, P= 0.77, I2= 0%; supplementation for infants, RR: 0.84, 95% CI: 0.64-1.11, P= 0.19, I2= 42%), allergic rhinitis (supplementation for pregnant women, RR: 0.93, 95% CI: 0.78-1.11, P = 0.15, I2 = 47%), lower respiratory tract infection (LRTI) (supplementation for pregnant women, RR: 0.97, 95% CI: 0.85-1.11, P = 0.59, I2 = 0%), or food allergy.Conclusions:Supplementation of vitamin D in pregnant women or infants does not have an effect on the primary prevention of allergic diseases.Systematic Review Registration:PROSPERO (CRD42020167747)

简介：AbstractBackground:Delivery room resuscitation assists preterm infants, especially extremely preterm infants (EPI) and extremely low birth weight infants (ELBWI), in breathing support, while it potentially exerts a negative impact on the lungs and outcomes of preterm infants. This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China.Methods:The clinical data of EPI (gestational age [GA] <28 weeks) and ELBWI (birth weight [BW] <1000 g), admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018, were analyzed. The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation (DRI). The secondary outcomes were survival rates, incidence of bronchopulmonary dysplasia (BPD), and risk factors for BPD.Results:A cohort of 952 preterm infants were enrolled. The incidence of DRI, chest compressions, and administration of epinephrine was 55.9% (532/952), 12.5% (119/952), and 7.0% (67/952), respectively. Multivariate analysis revealed that the risk factors for DRI were GA <28 weeks (odds ratio [OR], 3.147; 95% confidence interval [CI], 2.082-4.755), BW <1000 g (OR, 2.240; 95% CI, 1.606-3.125), and antepartum infection (OR, 1.429; 95% CI, 1.044-1.956). The survival rate was 65.9% (627/952) and was dependent on GA. The rate of BPD was 29.3% (181/627). Multivariate analysis showed that the risk factors for BPD were male (OR, 1.603; 95% CI, 1.061-2.424), DRI (OR, 2.094; 95% CI, 1.328-3.303), respiratory distress syndrome exposed to ≥2 doses of pulmonary surfactants (PS; OR, 2.700; 95% CI, 1.679-4.343), and mechanical ventilation ≥7 days (OR, 4.358; 95% CI, 2.777-6.837). However, a larger BW (OR, 0.998; 95% CI, 0.996-0.999), antenatal steroid (OR, 0.577; 95% CI, 0.379-0.880), and PS use in the delivery room (OR, 0.273; 95% CI, 0.160-0.467) were preventive factors for BPD (all P < 0.05).Conclusion:Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.