In order to guide diagnosis and treatment in children with sleep disordered breathing aged 1 to 23 months, the European Respiratory Society(ERS) summarized the evidence and released the European Respiratory Society statement based on clinical experience in 2016. This article aims to interpret the ERS statement. Children with apparent upper airway obstruction during wakefulness and those with SDB symptoms and complex conditions requires treatment. Adenotonsillectomy and continuous positive airway pressure are the most frequently used treatment measures along with interventions targeting specific conditions. Obstructive SDB in children aged 1 to 23 months is a multifactorial disorder that requires objective assessment and treatment of all underlying abnormalities.
【摘要】 目的 探讨婴幼儿常见泌尿系统先天发育异常的超声特征。 方法 回顾性分析2008年9月17日-2010年6月1日体检的婴幼儿中所发现的各种泌尿系统先天性发育异常的超声表现。 结果 发现泌尿系统先天性发育异常88例，其中肾缺如50例，多房性肾囊性变10例，多囊肾2例，肾旋转不良1例，重复肾10例，输尿管囊肿6例，异位肾7例，融合肾2例。 结论 婴幼儿常见的泌尿系统先天性发育异常有较特异的超声表现，超声检查是筛查婴幼儿泌尿系统先天性发育异常的首选影像学检查方法。【Abstract】 Objective To study the ultrasonic characteristics of congenital malformation of infantile urinary system. Methods We analyzed various ultrasonic appearances of congenital malformation of infantile urinary system in our hospital in the recent two years retrospectively. Result We found 88 cases of congenital urinary system malformation in all infants, including 50 cases of renal agenesis, 10 cases of multi-cystic kidney, 2 cases of policystic kidney, 1 case of malrotation of kidney, 10 cases of duplex kidney, 6 cases of ureter cyst, 7 cases of ectopic kidney, and 2 cases of fused kidney. Conclusion Special ultrasonic appearances can be detected for congenital malformation of infantile urinary system, so ultrasound can be regarded as the first-line iconographical examination for the disease.
Objective To evaluate the effect and safety of infantile femoral vein blood sampling with vacuum versus disposable needle. Methods Such databases as VIP, CNKI, CBM, Google Academic and Wanfang data were searched to collect the randomized controlled trials (RCTs) about infantile femoral vein blood sampling with vacuum versus disposable needle published from January 2000 to July 2010. The studies were screened according to the inclusive and exclusive criteria, the data were extracted, the methodology quality was assessed, and meta-analysis was conducted by using RevMan 5.0 software. Results A total of 15 RCTs were included. Of 3 490 patients in all, 1 770 were in the treatment group and 1 726 were in the control group. The baseline conditions were reported in 14 studies, and the random methods were mentioned in 11 RCTs. All studies didn’t report the allocation concealment and blind method. Only 2 RCTs reported separately that, the degree of neonatal pain was lower in the treatment group (Plt;0.01), and the satisfaction of parents was higher in the treatment group (Plt;0.01). Four RCTs compared the sampling time between the two groups without meta-analysis mentioned due to the disunity of standard, only the descriptive outcomes showed a shorter time in the treatment group. The meta-analysis showed that, compared with the control group, the reject rate of sample quality was lower (RR=0.20, 95%CI 0.15 to 0.26), the success rate of one time sampling was higher (RR=1.20, 95%CI 1.16 to 1.24), the injury of local tissue was slighter (RR=0.62, 95%CI 0.45 to 0.86), and the iatrogenic contamination was lower (RR=0.62, 95%CI 0.45 to 0.86) in the treatment group. Conclusion This review shows that the vacuum sampling is superior to the disposable needle sampling for domestic infantile femoral vein blood collection. Due to the low quality of the included studies with high possibility of bias, this conclusion needs to be further verified by performing more high-quality studies.
Objective To optimize image quality and radiation dose of infant chest digital radiography and to explore feasibility of reducing tube voltage and adjusting according to infant chest area. Methods 0 to 3-year-old infants were randomly divided into two average groups of 0- and 1-3 year-old, and then each age group was randomly assigned to optimization and control groups in digital radiography. Measurement of radiation dose used dose area product (DAP). Mean DAP between groups was compared by using t test, and the image quality of optimization was compared by rank sum test. Results A total of 400 cases of 0 to 3-year-old infants were identified, and finally 391 cases of infants anteroposterior chest image were included, including 196 cases in the optimization group (0-years: n=91; 1-3 years: n=105) and 195 cases in the control group (0-years: n=103; 1-3 years: n=92). The results showed: there were significant differences in the mean DAP in 0-years, 1-3 years and total infants between the optimization group and the control group (all P valuelt;0.05). The DAP of the optimization group was lower, and reduction of DAP was approximately 21.6% compared to the control subject. The Wilcoxon signed-rank test showed the difference of subjective evaluation of image quality was significantly different (P=0.000). High-quality image of the optimization group increased approximately 43.9% more than control subject. Conclusion Reducing tube voltage and adjusting according to infants chest area can not only reduce the radiation dose but also improve image quality in digital radiography.