成人肠套叠的CT影像特征及其临床应用价值

目的：探讨成人肠套叠的CT影像特征及其临床应用价值。方法：回顾性分析经手术证实的42例成人肠套叠患者的CT和临床资料。结果：42例成人肠套叠CT均见肿块样改变,其中＂靶征＂27例（64%）例,＂肾形征＂18例（43%）,＂彗星尾征＂15例（36%）,＂腊肠征＂11例（26%）,＂双肠管征＂8例（19%）,＂胎儿征＂3例（7%）,近端肠管扩张30例（71%）,肠梗阻15例（36%）,肠壁增厚12例（29%）。42例肠套叠均为继发性,共42处原发病变,其中脂肪瘤、息肉各8例（19%）,腺癌6例（15%）,恶性淋巴瘤、梅克尔憩室各3例（7%）,间质瘤、血管瘤、神经纤维瘤、盲肠游离症、术后粘连各2例（5%）,粘液腺癌、恶性间皮瘤、错构瘤、胰腺导管异位各1例（2%）。套叠部位：小肠型肠套叠17例（41%）,回盲部型10例（24%）,回-结肠型9例（21%）,结肠型6例（14%）。结论：成人肠套叠的CT表现具有特征性,对其诊断、原发病的确定和手术治疗均具有重要的参考价值。     

复发性妇科恶性肿瘤腹腔镜下病灶切除术^125I粒子植入后血清CA125水平变化及临床意义

目的：研究复发性妇科恶性肿瘤腹腔镜下病灶切除术^125I粒子植入后血清CA125水平变化及临床意义。方法：选取2012年4月-2013年4月来我院就诊的40例复发妇科恶性肿瘤患者,平均分为实验组和对照组,每组各20例。实验组20例行腹腔镜下切除病灶并进行^125I粒子植入治疗,对照组20例仅行腹腔镜切除病灶治疗。监测术后6个月内患者血清CA125的变化情况。结果：术后随访的6个月内,实验组的血清CA125水平明显降低,术后3个月降低至正常水平共有14例（75％）;术后随访的6个月内,对照组血清CA125水平降低后逐步升高,术后3个月降低至正常水平共有3例（15％）,两组比较有统计学意义（P〈0．05）;同时实验组的2a肿瘤生存率为20％,对照组为80％,两组比较有统计学意义（P〈0．05）。结论：复发性妇科恶性肿瘤腹腔镜下病灶切除术125I粒子植入后血清CA125水平显著降低,该法是评估肿瘤治疗疗效的有效方法。     

伊曲康唑治疗复发性念珠菌性生殖器感染98例的临床观察

本研究使用伊曲康唑（商品名美扶,天津力生制药生产）口服治疗复发性念珠菌性生殖器感染患者98例,获得了满意的疗效,现报告如下： 1资料与方法 1．1临床资料 196例患者均来自2000年1月～2005年6月本院皮肤科门诊,男性114例,女性82例,年龄19～55岁,年龄19～55岁,病程3个月～1年,复发次数最少2次;均经临床和真菌学检查确诊为念珠菌性生殖器感染患者。     

家庭氧疗配合呼吸操治疗慢性阻塞性肺疾病患者的疗效

目的：观察长期家庭氧疗配合呼吸操治疗慢性阻塞性肺疾病（COPD）的临床效果。、方法：选择本院收治的COPD患者80例,随机分为研究组和对照组,各40例,两组均给予常规治疗,研究组同时由医务人员指导给予家庭氧疗和呼吸操训练,随访1年．观察两组治疗前、治疗后6个月和1年肺功能,应用StGeorge’S呼吸问卷（SGRQ）评价生存质量、结果：研究组1年内急性发作1次5人,2次2人,3次及以上1人,对照组1年内急性发作1次9人,2次7人,3次及以上4人（P〈0．05）;研究组治疗后6个月、1年用力肺活量（FVC）、第1秒用力呼气容积（FEVl）和FEVl／FVC均明显升高（P〈0．05）,对照组治疗后6个月、1年FVC、FEVI／FVC与治疗前比较无统计学差异（P〉0．05）;研究组治疗后6个月、1年SGRQ明显降低（P〈0．05）,对照组治疗后6个月、1年SGRQ与治疗前比较无统计学差异（P〉0．05）．结论：家庭氧疗配合呼吸操能明显改善COPD患者肺功能,延缓患者肺功能恶化,提高患者生存质量。     

布拉酵母菌联合左西替利嗪治疗小儿特应性皮炎的 临床疗效及安全性评价

摘要：目的 观察布拉氏酵母菌联合左西替利嗪口服液治疗小儿特应性皮炎的临床疗效及安全性。方法 随机将80例特应性皮炎患儿分为观察组和对照组各40例。对照组采用左西替利嗪口服液,2~5岁5 mL/次,1次/d：≥6岁 10 mL/次,1次/d。观察组在对照组基础上联合布拉氏酵母菌散剂,<3岁1袋 qd,≥3岁1袋,bid口服。2周1个疗程, 治疗结束 1个月后评价两组临床疗效及安全性。结果 总有效率：治疗组为90.00%,对照组为67.50%,两组比较差异有统计学意义（统计值,P＜0.05）。复发率：治疗组4例复发（10.00%）,对照组12例复发（30.00%）,两组比较差异有统计学意义（统计值,P＜0.05）。结论 布拉氏酵母菌联合左西替利嗪治疗小儿特应性皮炎临床疗效优于单用左西替利嗪,未见明显不良反应。     

单倍体相合造血干细胞移植联合脐带间充质干细胞输注治疗儿童重型再生障碍性贫血的临床观察及安全性分析

目的观察单倍体相合造血干细胞移植（hi-HSCT）联合脐带间充质干细胞（hUC-MSC）输注治疗儿童重型再生障碍性贫血（SAA）的临床效果及安全性。 方法整理海军总医院儿科2010年2月至2014年1月收治的11例接受hi-HSCT联合hUC-MSC输注治疗的SAA患儿的临床资料,进行回顾性分析。对其治疗情况、并发症发生情况及生存情况进行观察,总结该治疗方案的临床效果与安全性,以及治疗体会。 结果患儿全部获得造血重建,移植后1个月复查嵌合体均为70% ~ 100%供者嵌合。白细胞植入时间8 ~ 21 d,中位时间为12 d;血小板植入时间10 ~ 24 d,中位时间为15 d。11例患儿中,2例发生Ⅰ度急性移植物抗宿主病（GVHD）,1例发生Ⅲ度急性GVHD,均经相关治疗后好转;1例发生局限性慢性GVHD,经相关治疗后好转;2例发生广泛性慢性GVHD,发生率为18.18%。患儿移植期间均发生不同程度的恶心、呕吐、纳差和发热等症状,给予对症支持治疗后好转。8例（72.73%）发生口腔黏膜炎,2例（18.18%）发生肺部感染,9例（81.82%）发生病毒感染,2例（18.18%）发生腹泻,均经综合治疗后好转。11例患儿随访时间12 ~ 29个月,中位随访时间16个月,截止末次随访时1例因广泛性慢性GVHD接受持续治疗,2例接受免疫抑制剂减量治疗,其余4例均停用免疫抑制剂;1例患儿因家属自行停用环孢素A发生排异死亡。 结论hi-HSCT联合hUC-MSC输注治疗儿童SAA具有良好临床疗效,值得进一步关注。     

孟鲁司特与糠酸莫米松鼻喷剂联合治疗儿童变应性鼻炎的近期疗效观察

目的：评价口服孟鲁司特和糠酸莫米松鼻喷剂联合治疗儿童变应性鼻炎的近期疗效,以优化儿童变应性鼻炎的治疗方案。方法：选择2011年4月-2012年4月在潍坊市人民医院耳鼻喉科就诊并确诊为变应性鼻炎的患儿48例,随机分为联合用药组（MM组,24例）和糠酸莫米松组（MS组,24例）。MM组患者给予糠酸莫米松喷鼻（早晨喷鼻1次,每次2喷）,孟鲁司特片口服（5mg／次,1次／天,睡前30分口服）;MS组患者给予糠酸莫米松喷鼻（早晨啧鼻2次,每次2啧）。两组的治疗疗程均为3个月,治疗后观察和比较两组患者鼻塞、鼻痒、流清涕、喷嚏等,临床症状及鼻内镜的检查结果。结果：治疗1个月后,两组治疗总有效率的差异无统计学意义（P〉0．05）;治疗3个月后,两组症状评分的改善高于1月朱（P〈0．05）;治疗3个月后,MM组的治疗总有效率显著高于MS组（P〈0．05）。结论：糠酸莫米松与孟鲁司特联合治疗儿童常年性变异性鼻炎的临床疗效优于单用糠酸莫米松治疗,且不良反应少。对于常年性变应性鼻炎患儿的治疗应以序贯性和个体化治疗为原则,最大程度发挥糠酸莫米松与孟鲁司特间的相互协同作用。     

乌鸡白凤丸巩固治疗复发性外阴阴道念珠菌病的临床研究

目的 应用乌鸡白凤丸巩固治疗复发性外阴阴道念珠菌病（Recurrent Vulvovaginal Candidiasis,RVVC）,通过观察其疗效及安全性,探讨其有无降低RVVC复发率的作用.方法 486名处于VVC急性发作且以往有RVVC史的非孕育龄妇女,急性期阴道给予克霉唑栓强化治疗.达到临床及真菌治愈标准后,随机分为3组采取不同方案进行巩固治疗或临床观察.A组：每月月经净后3～7 d,继续单次阴道给予克霉唑栓500 mg,为期3个月;B组：每月月经净后口服乌鸡白凤丸每次1丸,1次/d,3周为1个疗程,连用3个月.对照组：仅作随访观察.各组在巩固治疗期间及巩固治疗结束后6个月内进行随访,观察疗效及不良反应发生情况.结果 巩固治疗期间,A组和B组分别累计有17人（10.12％）和23人（13.61％）出现复发,显著低于对照组（P＜0.001）.巩固治疗结束后,随访第3个月A组和B组分别累计有31人（21.83％）和37人（26.62％）出现复发;随访第6个月A组和B组分别累计有73人（51.41％）和79人（56.83％）出现复发,均显著低于对照组（P ＜0.001）,A、B组间各阶段复发率无显著差异（P＞0.05）,不良反应轻微.结论 RVVC近期治愈后采用乌鸡白凤丸巩固治疗,能够抑制念珠菌生长,增强免疫功能,控制阴道局部炎症反应,有效预防复发,效果满意且相对安全,值得临床应用与推广.     

皮下免疫治疗联合沙美特罗替卡松粉吸入剂对中度支气管哮喘缓解期患儿血清Th1/Th2相关细胞因子表达水平的影响

摘要 目的：探讨皮下免疫治疗联合应用沙美特罗替卡松粉吸入剂治疗中度支气管哮喘缓解期患儿的临床疗效及对Th1/Th2相关细胞因子表达水平的影响。方法：选取南方医科大学佛山市妇幼保健院2020年1月～2020年12月收治的中度支气管哮喘缓解期120例患儿,按随机分组原则分为观察组和对照组各60例。对照组予以沙美特罗替卡松粉吸入剂（舒利迭）治疗,早上及晚上各吸1次。观察组在对照组的基础上给予皮下免疫治疗,进行12个月疗程的治疗。对比两组患儿支气管哮喘发作次数以及临床控制率、肺功能变化。检测两组患儿血清Th1相关细胞因子[白细胞介素-2（IL-2）、γ干扰素（IFN-γ）]和Th2相关细胞因子[白细胞介素-4（IL-4）、白细胞介素-6（IL-6）]水平。结果：与治疗前相比,两组患儿治疗6月及治疗12个月后发作次数均显著降低（P＜0.05）,且观察组患儿哮喘发作的次数低于对照组（P＜0.01）;治疗12个月后,观察组患儿的临床控制率显示为90%,显著高于对照组的66.67％（P＜0.05）。治疗6个月后、治疗12个月后,观察组患儿的第1 秒呼气流速（FEV₁）占正常预计值百分比（FEV₁%）及呼气峰流速（PEF）占正常预计值百分比（PEF%）均显著高于对照组（P＜0.01）;而与治疗6个月后相比,两组治疗12个月后上述2项指标均显著升高,且观察组明显高于对照组（P＜0.01）。治疗12个月后,两组患儿血清IL-2、IFN-γ水平均显著升高,且观察组明显高于对照组（P＜0.01）;而两组血清IL-4、IL-6水平均显著下降,且观察组明显低于对照组（P＜0.01）。结论：皮下免疫治疗联合沙美特罗替卡松粉（舒利迭）治疗中度支气管哮喘缓解期患儿的临床疗效确切,患儿支气管哮喘发作次数明显减少,肺功能改善明显,其作用机制可能与调节Th1/Th2相关细胞因子平衡有关。     

布拉氏酵母菌联合阴道用药治疗复发性外阴阴道假丝酵母菌病的临床疗效及安全性

目的 探讨布拉氏酵母菌联合阴道用药治疗复发性外阴阴道假丝酵母菌病（RVVC）的临床疗效及安全性。方法 将98例RVVC患者随机分为观察组和对照组各49例,两组均给予硝酸咪康唑栓0.2 g/粒联合重组人干扰素α2b栓10万IU/粒,于月经干净3 d后阴道给药,每次1粒,1次/d。观察组联合布拉氏酵母菌0.5 g/次,2次/d,口服。连续用药3个月经周期,比较两组临床疗效、治疗前及治疗后3、6个月阴道分泌物炎性指标水平、复发情况及不良反应等。结果 观察组临床总有效率明显高于对照组（χ2=4.305,P0.05）。治疗后3个月、6个月两组IL-6水平逐渐下降,IFN-γ水平逐渐上升,但观察组升降幅度明显高于对照组（P<0.01）。结论 布拉氏酵母菌联合阴道用药治疗RVVC的临床疗效显著,能有效改善阴道炎症因子水平,安全有效且复发率低。     

双吻合器在全直肠系膜切除低位直肠癌保肛手术中应用的探讨

目的探讨双吻合器在全直肠系膜切除低位直肠癌保肛手术中的应用方法、并发症及临床效果。方法回顾性分析在全直肠系膜切除的基础上,应用双器械吻合技术,对48例中低位直肠癌行低位或超低位吻合的保肛手术方法,观察其术后并发症,以及术后排便功能,局部复发率。结果随访1～4年,低位吻合44例,超低位吻合4例。15例6个月内大便次数每天多于5次,6个月后大便次数均在每天3次以下,无大便失禁。吻合口漏1例,吻合口狭窄1例,吻合口出血3例,吻合口复发1例,全组无手术死亡。结论双吻合器能简化手术操作,维持正常排便功能,提高了生活质量。     

Age-dependent levels of plasma neuropeptides in normal children

Several neuropeptides are secreted in high amounts in pediatric tumors such as neuroblastoma and have been used as markers of residual or recurrent disease. Plasma levels of neuropeptides might be expected to change during development, but have not been determined in normal children. We have obtained fresh plasma from cord blood of six full-term infants and from peripheral blood in 41 healthy children, ages 1 month to 21 years. Levels of six neuropeptides, vasoactive intestinal peptide (VIP), somatostatin, gastrin releasing peptide (GRP), substance P, pancreastatin and neuropeptide Y (NPY) were measured by radioimmunoassay along with insulin-like growth factor-1 (IGF-1) whose plasma levels are known to vary during development. A child with neuroblastoma was treated with the somatostatin analogue, octreotide, and the effect on plasma neuropeptides quantified. Octreotide doses of 2-3 microg/kg daily resulted in a 40-60% decrease in plasma levels of IGF-1, pancreastatin and GRP. These results are the first publication of plasma neuropeptide levels in normal children.     

Recurrent Invasive Pneumococcal Disease in Children: Underlying Clinical Conditions,and Immunological and Microbiological Characteristics

Purpose

Clinical, immunological and microbiological characteristics of recurrent invasive pneumococcal disease (IPD) in children were evaluated, differentiating relapse from reinfection, in order to identify specific risk factors for both conditions.

Methods

All patients <18 years-old with recurrent IPD admitted to a tertiary-care pediatric center from January 2004 to December 2011 were evaluated. An episode of IPD was defined as the presence of clinical findings of infection together with isolation and/or pneumococcal DNA detection by Real-Time PCR in any sterile body fluid. Recurrent IPD was defined as 2 or more episodes in the same individual at least 1 month apart. Among recurrent IPD, we differentiated relapse (same pneumococcal isolate) from reinfection.

Results

593 patients were diagnosed with IPD and 10 patients died. Among survivors, 23 episodes of recurrent IPD were identified in 10 patients (1.7%). Meningitis was the most frequent form of recurrent IPD (10 episodes/4 children) followed by recurrent empyema (8 episodes/4 children). Three patients with recurrent empyema caused by the same pneumococcal clone ST306 were considered relapses and showed high bacterial load in their first episode. In contrast, all other episodes of recurrent IPD were considered reinfections. Overall, the rate of relapse of IPD was 0.5% and the rate of reinfection 1.2%. Five out of 7 patients with reinfection had an underlying risk factor: cerebrospinal fluid leak (n = 3), chemotherapy treatment (n = 1) and a homozygous mutation in MyD88 gene (n = 1). No predisposing risk factors were found in the remainder.

Conclusions

recurrent IPD in children is a rare condition associated with an identifiable risk factor in case of reinfection in almost 80% of cases. In contrast, recurrent IPD with pleuropneumonia is usually a relapse of infection.     

Cytology of lleal conduit urine in bladder cancer patients: diagnostic utility and pitfalls

OBJECTIVE: To study the cytomorphology of urine obtained from the ileal conduit and to determine its utility and identify the pitfalls. STUDY DESIGN: Urine specimens from 469 cases of suspected or proven bladder cancer received over a period of 5 years were analyzed in the cytology laboratory. In 35 cases, total bladder resection was followed by ileal conduit reconstruction. The follow-up cytologic analysis of these 35 ileal conduit cases formed the basis of this study. RESULTS: There was absence of urothelial cells in all but 2 cases. The smear predominantly showed small, scattered intestinal mucosal cells with pyknotic nuclei, extensive karyorrhexis and numerous bacteria. In 2 cases, cytology proved superior to endoscopy and radiology in detecting recurrent disease. We had 2 false negative cases, and the negativity was attributed to sampling errors. There was 1 false positive case in which 3-dimensional clusters of intestinal columnar cells were erroneously diagnosed as adenocarcinoma. CONCLUSION: Urine obtained from ileal conduit specimens shows a smear picture that is different from that of specimens from the bladder. Thus, it is imperative to understand the difference between the cytomorphology of bladder urine and ileal conduit urine, to minimize the pitfalls and increase diagnostic utility.     

CT平扫对肠坏死诊断价值

目的:探讨CT平扫对肠坏死诊断价值,总结肠管坏死征象。方法:分析98例可疑肠坏死患者CT平扫图像,所有患者均经手术证实或未能及时治疗死亡患者CT平扫影像,总结、分析影像特点。结果:全部患者中40例患者存在肠坏死,肠壁厚度改变,包括29例肠壁增厚,8例肠壁菲薄,5例表现为肠壁密度减低,3例表现为肠壁密度增加,25例表现肠管扩张,8例表现肠管塌陷,36例肠管内积液,其中34例见气液平面,4例仅见积气,5例肠壁内见气泡影,38例见腹腔积液,10例见系膜水肿,2例见肠系膜血管密度增高,1例肠系膜静脉内气体,1例门静脉内气体,5例见腹腔游离气体。结论:多排螺旋CT平扫对肠坏死部位及范围的评价有较高的价值,同时CT平扫能明确病因,为及早治疗打下良好基础。     

托烷司琼与帕洛诺司琼用于小儿骨科术后镇痛预防恶心呕吐的效果研究

摘要 目的：比较托烷司琼与帕洛诺司琼用于小儿骨科术后镇痛时预防恶心呕吐的效果。方法：纳入2019年3月到2021年3月在我院进行骨科手术的儿童60例,根据术后镇痛泵中使用止吐药物的不同分为托烷司琼组和帕洛诺司琼组,每组30例,比较两组患儿术前、术后的心率（HR）、平均动脉压（MAP）,在术后48小时内,观察两组患儿恶心呕吐、头晕头痛、皮肤瘙痒以及呼吸抑制等术后并发症。视觉模拟评分法（VAS）评估患儿术后疼痛,Ramsay量表评估患儿术后镇静效果。结果：托烷司琼和帕洛诺司琼组患儿在术前和术后HR和MAP比较均无显著差异（P>0.05）;托烷司琼组和帕洛诺司琼组患儿术后VAS评分、Ramsay评分均随时间延长而降低,且同一时间点两组患儿VAS评分无显著差异（P>0.05）;帕洛诺司琼组术后PONV发生率（20.00 %）高于托烷司琼组（3.33 %）（P<0.05）。帕洛诺司琼组和托烷司琼组患儿出现头晕头痛、皮肤瘙痒以及呼吸抑制例数分别为3/2例、1/0例和1/0例。两组间术后并发症发生率比较无差异（P>0.05）。结论：托烷司琼与帕洛诺司琼对骨科手术后儿童血流动力学、疼痛和镇静效果并无差异,但在预防术后恶心呕吐方面托烷司琼效果优于帕洛诺司琼。     

Imaging of pediatric brain tumors using somatostatin analogue 111Ih-DTPA-D-Phe1-octreotide

Malignant solid tumors and leukemias are the second most common causes of death in childhood. The most frequent pediatric solid tumors are brain tumors. Brain tumors, especially medulloblastoma should be treated by surgery, irradiation and chemotherapy. However, chemotherapy has only moderate effect. Pediatric brain tumors, especially medulloblastomas, express somatostatin receptors. The aim of this study was the investigation of the expression of somatostatin receptors in pediatric brain tumors for diagnostic and therapeutic purpose. Fifty-six scintigraphic imagings (111In-DTPA-D-Phe1-octreotide) made in 45 children treated with brain tumor at the Unit of Oncology of the 2nd Department of Pediatrics, Semmelweis University. The diagnosis was medulloblastoma in 21 cases (46.7%). MRI scans have been performed parallel with the Octreoscan images. Octreoscan images were positive in 27 of 56 (48.2%) cases. The 27 positive Octreoscan images consisted of 16 medulloblastomas, 4 ependymomas, 4 astrocytomas and 3 glioblastomas. In 37 (66.1%) cases the results of Octreoscans were the same as those of the MRI scans. However, in 19 scans (33.9%) the outcome was different. Octreoscan imaging is not suitable for differential diagnosis in pediatric brain tumors, including medulloblastomas. Isotopes specifically binding to the somatostatin receptors (111In-DTPA-D-Phe1-octreotide) can be applied in medulloblastomas for diagnosis and follow-up treatment. In Octreoscan-positive tumors the Octreoscan images establish the opportunity to somatostatin analogue and/or specifically targeted radiation therapies.     

Ocular Hypertension after Pediatric Cataract Surgery: Baseline Characteristics and First-Year Report

Monitoring intraocular pressure (IOP) is essential for pediatric cataract treatment but always difficult due to lack of cooperation in young children. We present the baseline characteristics and the first-year results of a long-term prospective cohort study, which are aimed to determine the relationship of the incidence of ocular hypertension (OH) in children after cataract surgery during the first-year period and the risk of developing late-onset glaucoma. Children were included with the following criteria: they were≤10 years old and scheduled to undergo cataract surgery with/without intraocular lens implantation; they were compliant with our follow-up protocol, which included monitoring IOP using a Tono-Pen under sedation or anesthesia. Incidence of OH, peak OH value, OH onset time and OH duration within a 12-month period following surgery were measured. In brief, 206 patients (379 eyes) were included and OH developed in 66 of 379 (17.4%) eyes. The mean follow-up period was 14.0±3.2 months (median, 12 months; range, 10–16 months). Moreover, 33 of 196 (16.8%) aphakic eyes and 33 of 183 (18.0%) IOL eyes were diagnosed with OH. The peak OH onset times were at 1-week (34/66, 51.5%) and 1-month (14/66, 21.2%) appointments postsurgery. The peak IOP value in the OH eyes was 29.9±7.5 mmHg (median, 29 mmHg; range, 21–48 mmHg). The duration of OH was 30.9±31.2 days (median, 30 days; range, 3–150 days). OH recurred in 13 eyes with a history of OH diagnosed within 1 month postsurgery (13/54, 24.1%), which needed temporary or long term use of antiglaucoma medications. In conclusion, the incidence of OH in children after cataract surgery was 17.4% during the first-year period. Children who have suffered elevated IOP in the first year after cataract surgery should be followed closely to determine if there is an increased risk of developing late-onset glaucoma.     

Total family unit Helicobacter pylori eradication and pediatric re-infection rates

BACKGROUND: Re-infection with Helicobacter pylori is more common in children than adults, and it is generally accepted that the family unit plays a significant role in primary childhood infection. We investigated whether the family unit plays a significant role in pediatric re-infection and if eradication of H. pylori from the entire family reduces the risk of childhood re-infection. METHODS: Fifty families, each with an H. pylori-infected pediatric index case (mean age 9.48 years), were recruited. A 13carbon urea breath test was performed on all family members in the same house as the index case. Each family unit was randomized into a 'family unit treatment' group (all infected family members treated) or an 'index case treatment' group (index case only treated). RESULTS: At long-term follow-up (mean 62.2 months), there were three re-infected children in the 'index case treatment' group compared with one in the 'family unit treatment' group. The re-infection rate was 2.4% per patient per year in the 'index case treatment' group and 0.7% per patient per year in the 'family unit treatment' group (p = .31). CONCLUSIONS: This study is the first to evaluate the effect of total family unit H. pylori eradication on pediatric re-infection rates and reports the longest period of re-infection follow-up in children. In childhood, re-infection with H. pylori is not significantly reduced by family unit H. pylori eradication.     

等离子刀扁桃体部分切除术联合腺样体射频消融术治疗儿童鼾症的 短期疗效研究

目的:探讨等离子刀扁桃体部分切除术(Tonsillotomy,TT)联合腺样体射频消融术治疗儿童鼾症的短期临床疗效。方法:选取2015年1月至2016年1月于我院接受扁桃体和腺样体手术的鼾症患儿77例机分为实验组即扁桃体部分切除术组(TT组)和对照组即扁桃体全部切除术(Tonsillectomy,TE)组(TE组)。选用儿童OSA-18生活质量调查表对儿童鼾症患者术前1个月和术后6个月进行调查随访和评估比较两组临床疗效的差异。采用VAS量表计量两组患儿术后1-7天的吞咽疼痛情况。观察两组患儿术后出血、术后扁桃体发炎情况以及扁桃体增生情况。结果:TT组和TE组患儿术后6个月OSA-18量表的总评分及5个维度的总分较术前比较均下降差异均具有统计学意义(P值均等于0.000),但两组术后OSA-18量表的总评分比较差异无统计学意义(P=0.246)。TT组术后第1天至术后第7天的吞咽疼痛VAS评分均较TE组低差异均具有统计学意义(P值均小于0.01)。两组患者术后均无患儿出血、无扁桃体反复发炎以及扁桃体组织增生。结论:等离子刀扁桃体部分切除术联合腺样体射频消融术治疗儿童鼾症短期临床疗效明确术后吞咽疼痛程度轻微、疼痛时间短,短期内无扁桃体增生及反复扁桃体发炎,可作为治疗儿童鼾症的首选术式之一。