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Acute infectious osteomyelitis in children: new treatment strategies for an old enemy

World Journal of Pediatrics 2020年第5期16卷 446-455页

作者： sabrina Congedi Chiara Minotti Carlo Giaquinto Liviana Da Dalt Daniele Don department of women's and children's health University of PaduaPaduaItaly Division of Paediatric Infectious Diseases Department of Women's and Children's HealthUniversity of PaduaPaduaItaly Paediatric Emergency department Department of Women's and Children's HealthUniversity of PaduaPaduaItaly

Background Acute osteomyelitis still represents a significant clinical challenge,with an increasing incidence in paediatric population.A careful assessment and a rapid diagnosis with proper timing and choice of empirical antimicrobial therapy are necessary to avoid sequelae.The initial treatment should consist of empirical antibiotic therapy,to cover the major responsible pathogens in each age group.Data sources We made a literature search with PubMed and Cochrane database from 2000 to 2019 in English,French,and spanish languages using the key words"osteomyelitis,children,clinical,diagnosis,and treatment".Results The child's clinical features,age,and the microbiological profile of the geographic area should be evaluated for diagnosis and in the choice of antibiotic treatment.Latest data suggest the administration of intravenous antibiotics for a short period,with subsequent oral therapy,according to the improvement of clinical status and inflammatory markers.For children older than 3 months,the shift to oral medications is already possible after a short course of intravenous therapy,until recovery.The timing for the shift from cefazolin to cephalexin or cefuroxime,intravenous clindamycin to oral clindamycin,and intravenous ceftriaxone+oxacillin to oral equivalents will be decided according to the improvement of clinical status and inflammatory markers.We also present the approach to osteomyelitis due to difficult pathogens,such as Methicillin-resistant staphylococcus aureus(MRsA)and Panton-Valentine leukocidin(PVL)-positive s.aureus infections.Conclusion In this review,we present the current approach to the clinical diagnosis and management of osteomyelitis in childhood,with an update on recent recommendations,as a useful instrument to understand the rationale of antibiotic therapy.

关键词： Acute osteomyelitis children Diagnosis Treatment

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A Clinical Observation Report on Prenatal Management and Postnatal Treatment of Congenital Granular Cell Epulis

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Maternal-Fetal Medicine 2024年第2期6卷 102-105页

作者： Feng Qin Xiaochuan Xu Yong Yang Qiong Li Ting Huang Xiaoyan Chen Xiaolan Chen Yamin Liu Gongli Chen department of Gynecology and Obstetrics Chongqing Health Center for Women and ChildrenWomen and Children's Hospital of Chongqing Medical UniversityChongqing 401147China department of Pathology Chongqing Health Center for Women and ChildrenWomen and Children's Hospital of Chongqing Medical UniversityChongqing 401147China.

Introduction Congenital granular cell epulis(CGCE)is a rare,benign tumor that manifests on the mucosal surface of the alveolar ridge in newborns.It was initially described by Neumann in 1871 and has been referred to by various names such as congenital epulis,congenital epulis of the newborn,and congenital granular cell tumor.1 Documentation on larger tumors is limited and reported diameters vary.2 Diagnosis necessitates histological examination and immunohistochemical staining,typically revealing negative immunoreactivity for s-100 and cluster of differentiation 68(CD68).3,4 This article presents a case of CGCE with weakly positive s-100 and CD68 staining,alongside a relatively large size.Additionally,it conducts a literature review on diverse aspects,encompassing multidisciplinary prenatal diagnosis,antenatal management,choice of delivery mode during childbirth,and postnatal treatment,with the objective of augmenting clinicians’comprehension of the ailment.The study adhered to the guidelines of the Declaration of Helsinki and obtained informed consent from the patient and approval from the medical ethics committee of Chongqing health Center for women and children.

关键词： Congenital epulis Fetal Immunohistochemical Prenatal management Postnatal treatment

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Long-Term Outcomes of systemic-to-Pulmonary Artery shunt in Patients with Functional single Ventricle and Heterotaxy syndrome

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Congenital Heart Disease 2023年第4期18卷 399-411页

作者： shota Kawai Takashi Kido Yuta Teguri Koji Miwa Tomomitsu Kanaya Yoichiro Ishii Hisaaki Aoki Futoshi Kayatani sanae Tsumura department of Cardiovascular surgery Osaka Women’s and Children’s HospitalIzumiOsakaJapan department of Pediatric Cardiology Osaka Women’s and Children’s HospitalIzumiOsakaJapan

Objectives: We sought to determine the long-term outcomes and mortality-associated factors after systemic-topulmonaryartery shunt (sPs) in patients with heterotaxy syndrome. Methods: We retrospectively analyzed allpatients with a functional single ventricle and heterotaxy syndrome who underwent sPs at our center from January2001 to April 2022. Results: This study involved 84 patients. Restrictive pulmonary blood flow requiringearly modulation was presented in 34 (40%) patients. Compared with patients without restrictive pulmonaryblood flow (N = 50 [60%]), the postnatal survival of these 34 patients was significantly lower at 10 years (log rank:p = 0.04), but the statistical significance disappeared at 20 years (log rank: p = 0.18). Among 31 patients whounderwent sPs, 11 (35%) had extracardiac total anomalous pulmonary venous connection (TAPVC). The survivalrate after sPs was 80% at 10 years. Cox regression analysis showed that extracardiac TAPVC (hazard ratio6.44, 95% confidence interval 1.23–33.7, p = 0.03) and pulmonary venous obstruction (PVO) at TAPVC repair(hazard ratio 11.2, 95% confidence interval 2.13–58.5, p = 0.004) were significantly associated with death. In25 patients who underwent bidirectional cavopulmonary shunt (BCPs), surgical interventions on the pulmonaryartery (PA) were performed after sPs in 7 of 9 patients with PA coarctation, 3 of 4 with non-confluent PAs, and4 of 12 with normal PAs. At sPs, primary central PA plasty was performed in three patients with PA coarctationand 2 with non-confluent PAs. There was no significant difference in the PA index before BCPs between patientswith and without primary central PA plasty (p = 0.49). Among 20 patients who underwent total cavopulmonaryconnection (TCPC), adverse events occurred in 7 (35%) patients, including death in 1 (5%), intervention for pulmonaryarteriovenous malformation (PAVM) in 3 (15%), and surgical intervention for PVO in 3 (15%). TheB-type natriuretic peptide concentration was significantly higher in patients with than without adverse

关键词： Heterotaxy syndrome single ventricle total anomalous of pulmonary venous connection pulmonary artery coarctation

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Effectiveness of acupuncture-related therapies on schizophrenia:a Bayesian network Meta-analysis

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Journal of Traditional Chinese Medicine 2023年第2期43卷 239-251页

作者： HUANG Zhaohan FANG Yuan WANG Xiaolu HAN Yue YU Qi WANG Tong school of Traditional Chinese Medicine Beijing University of Chinese MedicineInstitute of traditional Chinese medicineBeijing 102488China Maternal and women’s health department Shanghai Center for Women and Children’s HealthShanghai 200062China

OBJECTIVE:To create the hierarchical model for the comparison of efficacy of different ATs for schizophrenia.METHODs:PubM ed,Web of science,Embase,The Cochrane Library,ClinicalTrials,China National Knowledge Infrastructure Database,China science and Technology Journal Database,Wanfang Database,and sinoM ed were searched using a specified search strategy to identify relevant studies up to December 2021.The data were extracted independently by two reviewers.The quality of included trials was evaluated based on the guidelines of“Cochrane Handbook for systematic Reviews of Interventions”.Bayesian network metaanalysis was conducted by statistical analysis software Addis 1.16.6 and stata 15.1.REsULTs:In total,60 randomized controlled trials covering 4810 patients were enrolled.The network metaanalysis result showed that Body Acupuncture(BA),BA+Electro-acupuncture(EA),scalp Acupuncture(sA)+EA,Auricular Acupuncture(AA),Low-dose medication and Acupuncture(LA),Acupoint Injection(AI),and Acupoint Catgut Embedding(ACE),when combined with Western Medications(WM),demonstrated a better clinical effect at improving the symptoms of schizophrenia,compared to WM alone.Results of rank probability showed that BA,when combined with WM,was the most optimal AT for schizophrenia at decreasing three aspects of PANss scale score.CONCLUsIONs:Acupuncture-related therapies help improve the symptoms of schizophrenia,and BA combined with WM may be a better therapy for schizophrenia.

关键词： schizophrenia Acupuncture Acupuncture-related therapy Network Meta-analysis

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China’s Actions to Achieve Universal health Coverage for children

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China CDC weekly 2022年第36期4卷 802-806页

作者： Zhimin He Tao Xu National Center for women and children’s health Chinese Center for Disease Control and PreventionBeijingChina

The United Nations General Assembly adopted the 2030 sustainable Development Goals(sDGs)in september 2015.Through this,governments have also committed to universal health coverage(UHC)as a development sub-goal within the sDG health field(1-2).In its effort to fully safeguard universal child health,China has established a management system for child healthcare to provide all children with continuous healthcare services starting at birth.since 1950,China has implemented a system of local physicians who take responsibility for child healthcare services within their areas.Under the three-tier management system at the county,township,and village levels,every newborn is included in the child health management system starting immediately after birth.The urban and rural community-based health facilities in the area provide unified,standardized,and systematic healthcare services.Moreover,since 2009,child health management has been included in the National Essential Public health service Program,which mandates that community-based primary health facilities provide free health management services for children 0–6 years old in their area.This has led to equitable and comprehensive coverage of health services for these children.When children enter school at the age of six,they receive an annual routine physical examination at school.In 2020,the national coverage for neonatal visits,the health management rate for children under 3 and the health management rate for children under 7 all surpassed 92%,while the prevalence of stunting among children under 5 continued to decline.In addition,urban-rural disparities in major child health indicators have also narrowed significantly.Moreover,the inoculation rate of children in National Immunization Programme Vaccines has remained over 99%since 2011(3).

关键词： routine starting children

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Reducing Neonatal Mortality with a Three-stage Neonatal Resuscitation Training Programme—China,2004–2021

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China CDC weekly 2022年第36期4卷 807-810页

作者： Chenran Wang Qing Yue Tao Xu National Center for women and children’s health Chinese Center for Disease Control and PreventionBeijingChina

Neonatal asphyxia is a leading cause of neonatal death that is largely preventable with neonatal resuscitation techniques.In July 2004,China launched a 15-year,three-stage Neonatal Resuscitation Programme(NRP)with stages in 2004–2009,2011–2016,and 2017–2021(1).The objective of China’s NRP was to ensure the presence of at least one trained attendant proficient in neonatal resuscitation at every delivery.With consistent effort,both incidence and mortality from neonatal asphyxia decreased remarkably during 2003–2020:incidence decreased from 6.32%to 1.42%and mortality decreased from 0.76‰to 0.19‰(1–2).China’s empirical experience shows that widespread promotion of high-quality neonatal resuscitation techniques can reduce preventable neonatal deaths and provide important insight into“ending preventable deaths in newborns by 2030,”as proposed in the United Nations sustainable Development Goal’s third target(3).

关键词： Neonatal mortality promotion

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Chinese Medicine Plaster as A New Treatment for surgical site Infection in Patients with Cesarean Delivery:A Randomized,Double-Blind,Controlled Trial

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Chinese Journal of Integrative Medicine 2023年第6期29卷 483-489页

作者： HAN Guan-ya WU Xiao-li LI Dong-mei CAI Hai-rui ZHOU Jun-jun HE Xiao-bo department of Obstetrics Ningbo Women and Children's HospitalNingboZhejiang Province(315012)China department of Medical Intensive Care Unit Ningbo Women and Children's HospitalNingboZhejiang Province(315012)China

Objective To evaluate the efficacy of Chinese plaster containing rhubarb and mirabilite on surgical site infection(ssI)in patients with cesarean delivery(CD)by performing a randomized controlled trial.Methods This randomized controlled trial included 560 patients with CD due to fetal head descent enrolled at a tertiary teaching center between December 31,2018 and October 31,2021.Eligible patients were randomly assigned to a Chinese medicine(CM)group(280 cases)or a placebo group(280 cases)by a random number table,and were treated with CM plaster(made by rhubarb and mirabilite)or a placebo plaster,respectively.Both courses of treatment lasted from the day 1 of CD,followed day 2 until discharge.The primary outcome was the total number of patients with superficial,deep and organ/space ssI.The secondary outcome was duration of postoperative hospital stay,antibiotic intake,and unplanned readmission or reoperation due to ssI.All reported efficacy and safety outcomes were confirmed by a central adjudication committee that was unaware of the study-group assignments.Results During the recovery process after CD,the rates of localized swelling,redness and heat were significantly lower in the CM group than in the placebo group[7.55%(20/265)vs.17.21%(47/274),Pstoperative antibiotic intake was shorter in the CM group than in the placebo group(Pstoperative hospital stay was significantly shorter in the CM group than in the placebo group(5.49±2.68 days vs.8.96±2.35 days,Pstoperative C-reactive protein elevation(≽100 mg/L)was lower in the CM group than in the placebo group[27.6%(73/265)vs.43.8%(120/274),Ps no difference in purulent drainage rate from incision and superficial opening of incision between the two groups.No intestinal reactions and skin allergies were found in the CM group.Conclusions CM plaster containing rhubarb and mirabilite had an effect on ssI.It is safe for mothers and imposes lower economic and mental burdens on patie

关键词： Chinese medicine plaster rhubarb and mirabilite surgical site infection cesarean delivery randomizedcontrolledtrial

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Fetal pulmonary valvuloplasty for pulmonary atresia with intact ventricular septum:a single-center clinical experience

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Chinese Medical Journal 2023年第6期136卷 740-742页

作者： Gang Luo Bei Zhang Dunliang Wang silin Pan Yue sun sibao Wang Heart Center Women and Children’s HospitalQingdao UniversityQingdaoShandong 266034China department of Anesthesiology Women and Children’s HospitalQingdao UniversityQingdaoShandong 266034China department of Obstetrics Women and Children’s HospitalQingdao UniversityQingdaoShandong 266034China

To the Editor:Fetal pulmonary atresia with intact ventricular septum(PA/IVs)or critical pulmonary stenosis(CPs)is a progressive disease from the time of midgestation diagnosis to birth.Elevated right ventricular(RV)afterload results in RV hypertrophy and reduced compliance,as well as a lack of flow through the right side of the heart.

关键词： septum diagnosis pulmonary

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staging surgery for intraventricular bilateral giant Rosai–Dorfman disease in children

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Pediatric Investigation 2022年第1期6卷 50-54页

作者： Jiyin Zhang Dapeng Li Ran Cheng Nan Zhang Xin Ni Ming Ge department of Otolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapitalMedical UniversityNational Center for Children’s HealthBeijingChina department of Neurosurgery Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina department of Emergency surgery Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina department of Pathology Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina

Introduction:Rosai-Dorfman disease(RDD)is an uncommon,benign,and idiopathic histiocytic proliferative disorder.Multiple intracranial RDD is extremely rare and treatment varies.Case presentation:A 9-year-old girl was admitted with 3-month history of blurred vision and facial paralysis,a 2-month history of recurrent giggle,and cognitive impairment.Computed tomography and magnetic resonance imaging scans revealed bilateral ventricular masses based on the dural membrane and the diameters of the masses were 9.1 cm and 9.2 cm,respectively.The lesions were completely removed with staging surgeries.Fifteen months after operation,blurred vision was still present but facial paralysis and giggle and cognitive impairment disappeared.Imaging examinations suggested that there were no new or recurring lesions.Conclusion:For multiple large intracranial masses,surgical treatment is necessary and staged surgery benefits perioperative safety.Active follow-up with magnetic resonance imaging is necessary.

关键词： Intraventricular Pediatric Rosai-Dorfman disease sinus histiocytosis staging surgery

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screening and Treatment of syphilis for Pregnant women—China,2011−2018

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China CDC weekly 2020年第26期2卷 476-480页

作者： Yaping Qiao Xiaoyan Wang Qian Wang Zhen Li Xi Jin Ailing Wang National Center for women and children's health China CDCBeijingChina

What is already known on this topic?The national program of prevention of mother-to-child transmission(PMTCT)of syphilis was initiated in 2011 and scaled to a national level since 2015.A better understanding of the implementation and outcomes of the program on PMTCT of syphilis is needed for future strategies to achieve the World health Organization(WHO)goal of elimination of motherto-child transmission(EMTCT)of syphilis.What is added by this report Between 2011 and 2018,as the coverage of syphilis screening of pregnant women and treatment for syphilis-seropositive pregnant women and their infants have increased consistently,the incidence of congenital syphilis was significantly reduced from 91.6 cases per 100,000 live births to 18.4 cases per 100,000.Treatment rates and adequate treatment rates of syphilis-seropositive pregnant women were below the criteria of validation of EMTCT of syphilis and regional disparities were found.What are the implications for public health practice?We recommend continuing to strengthen the current PMTCT intervention strategies with further commitments to achieve the targets set by the WHO’s dual EMTCT of HIV and syphilis.Barriers to achieving high coverage of adequate treatment should be investigated and addressed at the provincial level to ensure prompt treatment for syphilis-seropositive pregnant women.

关键词： mother prevention prompt

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