Feasibility of MR urography in neonates and infants with anomalies of the upper urinary tract

The aim of this study was to evaluate the feasibility and diagnostic potential of dynamic MR urography (MRU) in neonates and infants with sonographically detected abnormalities of the upper urinary tract. Thirty infants (age range 5 days to 3 years, mean age 7.9 months; male:female: 22:8) underwent MRU using T2 and contrast-enhanced dynamic T1-weighted sequences. The results were compared with the findings of ultrasound ( n=30), intravenous urography (IVU, n=19) and/or scintigraphy ( n=25) based on the criteria suggestive of obstructive uropathy. Oral sedation was sufficient to perform MRU with diagnostic quality in 20 of 21 patients younger than 1 year; 9 older patients needed intravenous sedation. Diagnosis of the 66 renal units (58 kidneys, 29 successful examinations) included normal systems (contralateral units), duplex systems, vesico-ureteral reflux, obstructive megaureter, ureteropelvic junction obstruction and accompanying renal parenchymal disease, with complex pathology in 10 patients. Magnetic resonance urography demonstrated anatomy better than IVU, particularly the renal parenchyma, (ectopic) ureters, and poorly functioning dilated systems. Magnetic resonance urography was superior to US in showing ureteral pathology. Tiny cysts in dysplastic kidneys were better seen by US. Gadolinium-enhanced dynamic MRU allowed accurate assessment of obstruction applying IVU criteria. Here MRU matched IVU results, and most of the scintigraphic findings. Magnetic resonance urography can be performed in young infants with diagnostic quality using oral sedation. Magnetic resonance urography correctly depicts anatomy and allows assessment of the urinary tract better than US and IVU, with additional functional information. Magnetic resonance urography thus has the potential to replace IVU for many indications.     

20例23指小儿断指再植术后的护理

目的探讨小儿断指再植术后的护理。方法对患指严密观察,并采取有效的护理措施。结果19例21指功能恢复良好,1例2指失败,成活率91.3%。结论断指再植术后的严密观察及术后护理对断指成活率有举足轻重的作用。     

1998-2003年福州市婴幼儿腹泻的病原谱及耐药谱的变迁

目的了解近年来福州市婴幼儿细菌性腹泻的病原谱及耐药谱的变迁.方法用选择性培养基分离细菌及真菌,以全面系统的生化反应、诊断血清、诊断胶乳、显色培养基等鉴定分离菌,以K-B纸片法作药敏试验.结果 1998-2003年病原菌总检出率为63.1%,病原性大肠埃希菌检出率为5.1%,沙门菌为2.4%,克雷伯菌为25.2%,酵母菌为22.2%,枸椽酸杆菌为7.1%.病原性大肠埃希菌及沙门菌耐药率最低者为妥布霉素、丁胺卡那霉素、头孢三嗪、头孢哌酮、头孢噻肟、头孢唑啉.结论与1996和1997年比较,志贺痢疾杆菌近年未曾检出,条件致病菌克雷伯菌、酵母菌、枸椽酸杆菌的检出率显著升高.病原性大肠埃希菌及沙门菌的抗生素耐药性趋于严重,对利福平、红霉素和青霉素G已100%耐药.     

锌对幼儿体内钙水平影响的研究

目的：探讨补锌对幼儿体内钙水平的影响。方法：对370名1～3岁幼儿采用配对双盲分组的方法进行补锌补钙实验研究。结果：补锌对幼儿体内钙水平有显著的影响（P〈0．05）。补充锌剂能改善幼儿对钙的吸收。结论：锌可能与钙代谢有关。补钙时应同时补锌。     

a-细辛脑注射液佐治婴幼儿毛细支气管炎疗效观察

目的探讨a-细辛脑注射液治疗毛细支气管炎的临床疗效。方法对2004年10月~2005年2月收治住院的60例毛细支气管炎随机分作治疗组34例和对照组26例,两组均采用常规治疗方法,而治疗组加用静脉a-细辛脑注射液每日0.5~1mg/kg,每日1次,重者每日2次。结果治疗组在症状、体征的消失及治愈天数上均优于对照组(P<0.05)。结论a-细辛脑注射液可明显提高常规抗感染治疗婴幼儿毛细支气管炎的疗效。     

小儿急性肠套叠腹部平片特点分析

目的:探讨小儿急性肠套叠的腹部平片特点。方法:回顾分析158例诊断明确的小儿急性肠套叠的腹部立卧位片。结果:腹部平片主要特点为腹腔内局限性积气、肠胀气或不完全性肠梗阻、完全性肠梗阻以及结肠内充盈缺损(包块可能)等。结论:小儿急性肠套叠的腹部平片有一定特征,对诊断有一定意义。     

婴幼儿川崎病的回顾性分析

目的川崎病是一种病因未明的急性全身性血管炎综合征，好发于5岁以下儿童。本研究的目的是进行回顾性分析我院婴儿川崎病的患病情况，临床诊断、治疗及预后。方法2006年1月－2006年12月在浙江大学附属儿童医院心内科诊治的患川崎病的婴儿（年龄在1岁以内）的临床资料作系统的回顾性分析。分析的资料包括：患者基本情况，临床特点，实验室以及心脏超声检查结果和治疗情况以及转归。结果共发现27例婴儿川崎病，男性患儿17例，女性10例。大多数病例出现双侧眼球结膜充血（22／27，81％），口唇和口腔改变（29／27，70％）。共有67％（18／27）的病例出现多形性皮疹。四肢改变大部分病例表现为手足硬性水肿（60％）。共有14例发现有淋巴结肿大症状。这些患儿中共有6例发生冠状动脉受损，其中4例左右冠状动脉均扩张，2例左冠状动脉扩张。在4例左右冠脉扩张的患儿中，其中一例发展成小冠脉瘤。12例（45％）诊断为不完全性川崎病。结论婴儿川崎病有很大一部分为不典型川崎病，因此要早期做出鉴别诊断治疗，以减少冠状动脉受损的发生。     

洛阳市8月龄内婴儿麻疹流行病学分析

目的了解洛阳市〈8月龄麻疹病例流行病学特征。方法收集洛阳市2000--2006年麻疹监测系统报告的256例〈8月龄婴儿麻疹病例，将流行病学个案调查资料整理后，进行描述性统计分析。结果2000--2006年共发生〈8月龄麻疹病例256例，其中年龄在6～8月龄的196例，占总数的76．56％；全年均有病例发生，3-6月份为发病高峰。结论对未到免疫起始月龄（〈8月龄）的发病儿童要制定针对性措施和方案，以降低〈8月龄婴儿发病率。     

Endocarditis in neonatal intensive care unit

Summary The clinical spectrum of infective endocarditis (IE) in infants is examined in four infants between 3 and 9 months of age. None of the patients had signs of IE; all four had an anatomically normal heart. Echocardiograms showed echodense vegetations in the left side of heart in three cases and in the right side in one. Three of the four patients recovered after the episode of endocarditis. Three of the four patients had necrotizing enterocolitis in the neonatal period. The important predisposing factor was the presence of indwelling central catheter for intravenous nutrition. Unlike previously reported cases, coagulase-negativeStaphylococci andEnterococci were important causative organisms in this high-risk nursery population.Presented in part at the APS/SPR Meeting in Anaheim, California, May 8, 1990.     

Abbreviated oesophageal pH monitoring in infants

The results of 24 h oesophageal pH monitoring, performed in 129 infants aged 6–10 weeks, were compared to those in the same patients after shorter periods (3, 6, 9 and 12 h). In the investigated population there was no significant difference between the reflux index (percentage of time with a pH<4.0) after 12 or 24 h. Moreover, the correlation coefficient between the reflux index after 12 and 24 h was excellent (r0.95). However, the intra-individual difference in reflux index after 12 and 24 h was 5% in 19% of the infants, and even exceeded 10% in more than 5% of the infants, making the interpretation of the results unreliable. Even in this particular population of infants in whom a 24-h period could be divided into almost identical periods (including a feeding and a sleeping period), 24-h registrations provided the most reliable results. However, if for some reason the investigation had to be interrupted after a minimum of 12 h, the risk for erroneous interpretation of the data appeared to be acceptable. The results of this study must not be extrapolated to older children.