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World Journal of pediatrics 2022年第4期18卷 271-277页

作者： Yi Cao Wei-Hui Yan Li-Na Lu Yi-Jing Tao Hai-Xia Feng Qing-Qing Wu Yi-Jing Chu Wei Cai Ying Wang division of pediatric Gastroenterology and Nutrition Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of MedicineNo.1665Kongjiang Rd.ShanghaiChina Shanghai Institute for pediatric Research ShanghaiChina Shanghai Key Laboratory of pediatric Gastroenterology and Nutrition No.1665Kongjiang Rd.ShanghaiChina

Background Children with intestinal failure(IF)have frequent catheter-related bloodstream infections(CRBSIs).This study aimed to analyze the clinical presentation and laboratory parameters of CRBSIs in children with *** This 6-year retrospective study was conducted among IF children with CRBSIs at an intestinal rehabilitation center in *** data were collected,including data of temperature and gastrointestinal ***/catheter culture,fecal tests,and calculation of inflammatory index were performed,which were obtained within 1 week since CRBSI *** Fifty children with 87 CRBSIs were identified,of which there were 17 suspected and 70 confirmed ***-two pathogens were cultured from 70 positive blood cultures:63%were Gram-positive organisms,23%were Gram-negative organisms,and 11%were fungal ***,48.6%were enteric organisms;47.2%of bacterial pathogens were consistent between fecal and blood ***,46.3%fecal routines showed abnormalities including increased white blood cells,occult blood positive and the presence of fat *** consistent symptom at onset of CRBSIs was fever and gastrointestinal symptoms including increased stool output,abdominal distension,or both.C-reactive protein(CRP)and procalcitonin(PCT)were elevated,i.e.,16.5 mg/L[interquartile range(IQR)8.7-44.7]and 0.48 ng/mL(IQR 0.2-1.76),*** IF children had a high rate of CRBSIs,of which larger proportions were due to Gram-positive and enteric *** and/or gastrointestinal symptoms,combined with elevated CRP and PCT,is conducive to the early diagnosis of CRBSIs in IF patients.

关键词： Enteric pathogens Fecal examination Gastrointestinal symptoms

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Hemodynamic Profiling Using a Cardiac Index–Systemic Vascular Resistance Plot in Patients with Fontan Circulation

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Congenital Heart Disease 2023年第4期18卷 431-445页

作者： Yuki Kawasaki Takeshi Sasaki Daisuke Kobayashi division of pediatric Cardiology Osaka City General Hospital Pediatric Medical CenterOsaka5340021Japan division of Cardiology St.Louis Children’s HospitalDepartment of PediatricsWashington University in St.LouisSt.LouisMO 63130USA

Background: Elevated Fontan pressure (FP) alone cannot fully predict clinical outcomes. We hypothesized thathemodynamic profiling using a cardiac index (CI)-systemic vascular resistance (SVR) plot could characterize clinicalfeatures and predict the prognosis of post-Fontan patients. Methods: We included post-Fontan patients whounderwent cardiac catheterization at age < 10 years. Patients were classified into four categories: A, CI ≥ 3, SVRindex (SVRI) ≥ 20;B, CI < 3, SVRI ≥ 20;C, CI ≥ 3, SVRI < 20;and D, CI < 3, SVRI < 20. The primary outcome wasfreedom from the combined endpoint: new onset of protein-losing enteropathy or plastic bronchitis, heart transplant,and death. Clinical and hemodynamic variables and freedom from the endpoint were compared betweenthe hemodynamic categories and outcome predictors were evaluated. Results: Eighty-three patients wereincluded. Median follow-up was 5.3 years. Category A/B/C/D consisted of 4/15/53/11 patients, respectively. Allthe patients in category A were New York Heart Association I/II and had a significantly lower pulmonary vascularresistance index (PVRI). Patients in category C had lower pulmonary/systemic blood flow. Patients in category Dhad a higher PVRI and had the poorest freedom from the endpoint (44% at 5 years). Elevated FP and category Dwere outcome predictors. Conclusions: CI-SVR plots was a novel adjunctive method for Fontan hemodynamicprofiling.

关键词： Cardiac index systemic vascular resistance perfusion pressure hemodynamic category fontan circulation prognosis

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Development and validation of a novel non-invasive test for diagnosing nonalcoholic fatty liver disease in Chinese children

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World Journal of pediatrics 2024年第4期20卷 413-421页

作者： Zhe-Wen Qin Qian-Nan Ren Hong-Xi Zhang Ya-Ru Liu Ke Huang Wei Wu Guan-Ping Dong Yan Ni Jun-Fen Fu division of Endocrinology National Clinical Research Center for Child HealthNational Children’s Regional Medical CenterThe Children’s HospitalDepartment of EndocrinologyNational Clinical Research Center for Child HealthNational Children’s Regional Medical CenterThe Children’s HospitalZhejiang University School of MedicineHangzhou310052China

With the exploding prevalence of obesity,many children are at risk of developing nonalcoholic fatty liver *** anthropometric and laboratory parameters,our study aimed to develop a model to quantitatively evaluate liver fat content(LFC)in children with *** A well-characterized cohort of 181 children between 5 and 16 years of age were recruited to the study in the Endocrinology Department as the derivation *** external validation cohort comprised 77 *** assessment of liver fat content was performed using proton magnetic resonance *** and laboratory metrics were measured in all subjects.B-ultrasound examination was carried out in the external validation *** Kruskal-Wallis test,Spearman bivariate correlation analyses,univariable linear regressions and multivariable linear regression were used to build the optimal predictive *** The model was based on indicators including alanine aminotransferase,homeostasis model assessment of insulin resistance,triglycerides,waist circumference and Tanner *** adjusted R^(2)of the model was 0.589,which presented high sensitivity and specificity both in internal[sensitivity of 0.824,specificity of 0.900,area under curve(AUC)of 0.900 with a 95%confidence interval:0.783–1.000]and external validation(sensitivity of 0.918 and specificity of 0.821,AUC of 0.901 with a 95%confidence interval:0.818–0.984).Conclusions Our model based on five clinical indicators was simple,non-invasive,and inexpensive;it had high sensitivity and specificity in predicting LFC in ***,it may be useful for identifying children with obesity who are at risk for developing nonalcoholic fatty liver disease.

关键词： Biochemical markers Children Magnetic resonance spectroscopy Nonalcoholic fatty liver disease pediatric obesity

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Influence of the water jet system vs cavitron ultrasonic surgical aspirator for liver resection on the remnant liver

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World Journal of Clinical Cases 2022年第20期10卷 6855-6864页

作者： Takehiko Hanaki Ayumi Tsuda Teppei Sunaguchi Keisuke Goto Masaki Morimoto Yuki Murakami Kyoichi Kihara Tomoyuki Matsunaga Manabu Yamamoto Naruo Tokuyasu Teruhisa Sakamoto Toshimichi Hasegawa Yoshiyuki Fujiwara division of Gastrointestinal and pediatric Surgery Department of SurgeryTottori University Faculty of MedicineYonago 683-8504TottoriJapan

BACKGROUND Several methods,such as finger fracture,Pean crush,cavitron ultrasonic surgical aspirator(CUSA),and water jet(WJ),are used for hepatic parenchymal dissection in liver *** is the conventional method in *** is a relatively novel method for parenchymal *** it has several advantages,such as lower volume of blood loss and shorter operative time,the effect of the WJ system for hepatic dissection on the remnant liver has not yet been *** To investigate and compare the effect of the WJ method vs CUSA on the remnant liver cut *** This observational study compared the two types of parenchymal transection methods(WJ vs CUSA)in liver *** total,24 and 40 patients who underwent hepatectomy using the WJ method and CUSA,respectively,were included in the ***,the clinicopathological characteristics and clinical outcomes of 24 and 40 patients were ***,postoperative contrast-enhanced computed tomography(CT)scan was performed to assess the cut surface length of the remnant liver and the degenerative thickness of the areas with a reduced contrast effect in the dissected ***,the two groups were *** On CT scan,the median areas of denaturation in the liver dissection planes were 522(range:109.5-1242)mm^(2) in the CUSA group and 324(range:93.6-1529)mm^(2) in the WJ *** area did not significantly differ between the two groups;however,the denaturation thickness of the WJ group was significantly lower than that of the CUSA group[5.8(range:0.7-11.1)mm vs 3.3(range:1.7-10.4)mm,P<0.001].CONCLUSION The WJ group had significantly thinner contrast-enhanced areas in the post hepatectomy detached section than the CUSA group.

关键词： Water jet Cavitron ultrasonic surgical aspirator Energy device Hepatic parenchymal dissection Liver resection

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Portal gas in neonates;is it always surgical? A case report

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World Journal of Clinical Cases 2020年第17期8卷 3804-3807页

作者： Tariq Ibrahim Altokhais division of pediatric Surgery Department of SurgeryCollege of MedicineKing Saud UniversityRiyadh 4545Saudi Arabia

BACKGROUND Hepatic portal venous gas in infants is frequently due to late presentation of necrotizing enterocolitis which is considered a relative indicator for surgical *** SUMMARY A preterm baby underwent an umbilical catheter placement and discovered in abdominal radiograph to have air in the portal venous system due to malpositioning of the umbilical *** Hepatic portal venous gas in infants without signs of necrotizing enterocolitis could result from malposition of umbilical venous catheter, and in that case, should be managed medically, with no need for surgical intervention.

关键词： Portal gas Neonate Necrotizing Enterocolitis Umbilical Case report Catheter

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Association between balloon atrial septostomy and prostaglandin E1 therapy until repair of transposition of the great arteries in neonates

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pediatric Investigation 2024年第2期8卷 135-138页

作者： Samantha Gilg Sebastian Acosta Rohit S.Loomba Claire Rizk Gary E.Stapleton David Faraoni Fabio Savorgnan Department of pediatrics Divisions of Critical Care Medicine and CardiologyTexas Children’s Hospital and Baylor College of MedicineHoustonTexasUSA Department of pediatrics Division of CardiologyTexas Children’s Hospital and Baylor College of MedicineHoustonTexasUSA Department of pediatrics The Heart InstituteAdvocate Children’s HospitalChicago Medical School and Rosalind Franklin University of Medicine and ScienceOak LawnIllinoisUSA Department of Anesthesiology Arthur S.Keats Division of Pediatric Cardiovascular AnesthesiaPerioperative and Pain MedicineTexas Children’s HospitalBaylor College of MedicineHoustonTexasUSA

The standard of care in the management of d-transposition of the great arteries(TGA)includes the arterial switch operation(ASO).1,2 Although some institutions have begun to publish the results of performing the ASO within the first few hours of life,most centers continue to"electively"delay ASO for several days to allow for a reduction in pulmonary vascular resistance and the stabilization of renal and liver function.1,2 The early initiation of prostaglandin E1(PGE)infusion to maintain ductal patency is a nearly universal component of therapy in order to maintain adequate arterial oxygen saturation and systemic oxygen delivery during the pre-operative period via intercirculatory mixing at the atrial septal and patent ductus arteriosus levels1,3.

关键词： balloon maintain stabilization

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Prevalence and risk factors for impaired renal function among Asian patients with nonalcoholic fatty liver disease

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 241-248页

作者： Chao Sun George Boon-Bee Goh Wan-Cheng Chow Wah-Kheong Chan Grace Lai-Hung Wong Wai-Kay Seto Yi-Hsiang Huang Han-Chieh Lin I-Cheng Lee Hye Won Lee Seung Up Kim Vincent Wai-Sun Wong Jian-Gao Fan Center for Fatty Liver Disease Department of GastroenterologyXinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai Key Lab of Pediatric Gastroenterology and NutritionShanghai 200092China Department of Gastroenterology&Hepatology Singapore General HospitalSingaporeSingapore Gastroenterology and Hepatology Unit Department of MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia Department of Medicine and Therapeutics and State Key Laboratory of Digestive Disease The Chinese University of Hong KongHong KongChina Department of Medicine The University of Hong KongHong KongChina Institute of Clinical Medicine National Yang Ming Chiao Tung University School of MedicineTaipeiTaiwanChina division of Gastroenterology and Hepatology Taipei Veterans General HospitalTaipeiTaiwanChina Faculty of Medicine National Yang Ming Chiao Tung University School of MedicineTaipeiTaiwanChina Department of Internal Medicine Yonsei University College of MedicineSeoulKorea

Background:Nonalcoholic fatty liver disease(NAFLD)is associated with impaired renal function,and both diseases often occur alongside other metabolic ***,the prevalence and risk factors for impaired renal function in patients with NAFLD remain *** objective of this study was to identify the prevalence and risk factors for renal impairment in NAFLD ***:All adults aged 18-70 years with ultrasound-diagnosed NAFLD and transient elastography examination from eight Asian centers were enrolled in this prospective *** fibrosis and cirrhosis were assessed by FibroScan-aspartate aminotransferase(FAST),Agile 3+and Agile 4 *** renal function and chronic kidney disease(CKD)were defined by an estimated glomerular filtration rate(eGFR)with value of<90 mL/min/1.73 m^(2) and<60 mL/min/1.73 m^(2),respectively,as estimated by the CKD-Epidemiology Collaboration(CKD-EPI)***:Among 529 included NAFLD patients,the prevalence rates of impaired renal function and CKD were 37.4%and 4.9%,*** multivariate analysis,a moderate-high risk of advanced liver fibrosis and cirrhosis according to Agile 3+and Agile 4 scores were independent risk factors for CKD(P<0.05).Furthermore,increased fasting plasma glucose(FPG)and blood pressure were significantly associated with impaired renal function after controlling for the other components of metabolic syndrome(P<0.05).Compared with patients with normoglycemia,those with prediabetes[FPG≥5.6 mmol/L or hemoglobin A1c(HbA1c)≥5.7%]were more likely to have impaired renal function(P<0.05).Conclusions:Agile 3+and Agile 4 are reliable for identifying NAFLD patients with high risk of *** glycemic control in the prediabetic stage might have a potential renoprotective role in these patients.

关键词： Nonalcoholic fatty liver disease Impaired renal function Agile 3+ Agile 4 Metabolic syndrome

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Indirect traumatic optic neuropathy:modeling optic nerve injury in the context of closed head trauma

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Neural Regeneration Research 2019年第4期14卷 593-594页

作者： Emma G.Burke Shelby M.Cansler Nathan K.Evanson Medical College of Georgia Augusta University division of pediatric Rehabilitation Medicine Cincinnati Children’s Hospital Department of pediatrics University of Cincinnati

Traumatic optic neuropathy:Traumatic brain injury is one of the leading causes of disability and mortality in the United *** impacts people of all ages and demographics,particularly younger males and members of the *** loss is commonly associated with traumatic brain injuries of all severities and can leave patients permanently *** vision loss can be caused by injury to the visual system at multiple levels,including the eyes,optic nerves,and many different sites in the brain and brainstem(Sen,2017).Despite the far-reaching effects of visual impairment after traumatic brain injury,its incidence after traumatic brain injury is not well measured,and few successful treatments have been identified or implemented.

关键词： Traumatic optic neuropathy Traumatic brain injury disability and mortality

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International consensus guidelines on robotic pancreatic surgery in 2023

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Hepatobiliary Surgery and Nutrition 2024年第1期13卷 89-104页

作者： Rong Liu Mohammed Abu Hilal Marc G.Besselink Thilo Hackert Chinnusamy Palanivelu Yupei Zhao Jin He Ugo Boggi Jin-Young Jang Fabrizio Panaro Brian K.P.Goh Mikhail Efanov Yuichi Nagakawa Hong-Jin Kim Xiaoyu Yin Zhiming Zhao Yi-Ming Shyr Shridhar Iyer Eli Kakiashvili Ho-Seong Han Jae Hoon Lee Roland Croner Marco Vito Marino Arun Prasad Wei Wang Songqing He Kehu Yang Qu Liu Zizheng Wang Mengyang Li Shuai Xu Kongyuan Wei Zhaoda Deng Yuze Jia Tess M.E.van Ramshorst Faculty of Hepatopancreatobiliary Surgery The First Medical Center of Chinese People’s Liberation Army(PLA)General HospitalBeijingChina Department of Surgery Poliambulanza Foundation HospitalBresciaItaly Department of Surgery University Hospital Southampton NHS Foundation TrustSouthamptonUK Amsterdam UMC location University of AmsterdamDepartment of SurgeryAmsterdamThe Netherlands Cancer Center Amsterdam AmsterdamThe Netherlands Department of General Visceral and Thoracic SurgeryUniversity Hospital Hamburg-EppendorfHamburgGermany Department of Minimal Invasive Hernia Surgery GEM Hospital and Research CentreChennaiTamil NaduIndia Department of General Surgery Peking Union Medical College Hospital BeijingBeijingChina Department of Surgery Johns Hopkins University School of MedicineBaltimoreMDUSA division of General and Transplant Surgery University of PisaPisaItaly Department of Surgery Seoul National University HospitalSeoul National University College of MedicineSeoulKorea Department of Surgery/division of HBP Surgery&Transplantation University of MontpellierMontpellierFrance Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre SingaporeSingaporeSingapore Department of Hepato-Pancreato-Biliary Surgery Moscow Clinical Scientific CenterMoscowRussia Department of Gastrointestinal and pediatric Surgery Tokyo Medical UniversityShinjukuTokyoJapan Department of Surgery Yeungnam University College of MedicineDaeguKorea Department of Pancreato-Biliary Surgery The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina 18 division of Hepatobiliary Pancreatic Surgery and Liver TransplantationNational University HospitalSingaporeSingapore Department of Surgery Galilee Medical CenterNahariyaIsrael Department of Surgery Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnam-siKorea division of Hepato-Biliary and Pancreatic Surgery Department of SurgeryAsan Medical Cente

Background:With the rapid development of robotic surgery,especially for the abdominal surgery,robotic pancreatic surgery(RPS)has been applied increasingly around the ***,evidence-based guidelines regarding its application,safety,and efficacy are still *** harvest robust evidence and comprehensive clinical practice,this study aims to develop international guidelines on the use of ***:World Health Organization(WHO)Handbook for Guideline Development,GRADE Grid method,Delphi vote,and the AGREE-II instrument were used to establish the Guideline Steering Group,Guideline Development Group,and Guideline Secretary Group,formulate 19 clinical questions,develop the recommendations,and draft the *** online meetings were held on 04/12/2020,30/11/2021,and 25/01/2022 to vote on the recommendations and get advice and suggestions from all involved *** the experts focusing on minimally invasive surgery from America,Europe and Oceania made great contributions to this consensus ***:After a systematic literature review 176 studies were included,19 questions were addressed and 14 recommendations were developed through the expert assessment and comprehensive judgment of the quality and credibility of the ***:The international RPS guidelines can guide current practice for surgeons,patients,medical societies,hospital administrators,and related social *** randomized trials are required to determine the added value of RPS as compared to open and laparoscopic surgery.

关键词： Robotic surgery guidelines pancreatectomy pancreaticoduodenectomy distal pancreatectomy(DP)

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Recurrent lymphoma presenting as painless, chronic intussusception: A case report

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World Journal of Clinical Cases 2020年第2期8卷 306-312页

作者： Parker Giroux Anderson Collier Michael Nowicki Department of pediatrics University of Mississippi Medical CenterJacksonMS 39216United States division of pediatric Hematology and Oncology University of Mississippi Medical CenterJacksonMS 39216United States division of pediatric Gastroenterology University of Mississippi Medical CenterJacksonMS 39216United States

BACKGROUND The clinical presentation of acute lymphoblastic lymphoma is highly *** prognosis is good, recurrence of disease can occur. Gastrointestinal relapse, including intussusception, is well-described but the absence of abdominal pain in this setting is *** SUMMARY We report a 13-year-old male with B-cell precursor acute lymphoblastic leukemia in remission presenting with anemia and weight loss. Examination was significant for absence of abdominal pain, but a stool sample was positive for occult blood. Pan-endoscopy was performed with colonoscopy revealing a mass filling the colonic lumen. Biopsy of the mass confirmed recurrence of recurrent Bcell lymphoma. Computed tomography scan revealed ileocolic intussusception resulting from the tumor. This case is unusual in that the patient had no abdominal pain despite the presence of *** While intestinal involvement with lymphoma has been well described in the literature, presentation as painless intussusception has not been reported. This case report highlights the wide spectrum of clinical manifestations of recurrent Bcell lymphoma involving the gastrointestinal tract, in particular the near absence of symptoms despite the finding of intussusception.

关键词： B-cell acute lymphoblastic leukemia Tumor relapse Intussusception Case report Anemia

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