2012年 · 第50卷第05期

The child, male, 5 d, was found to be defecating from the umbilicus immediately after birth, and was admitted to hospital with patent vitelline duct. He was born for the second birth, the second birth, and delivered naturally at full term. He had a birth weight of 3.7 kg and had no abnormal crying after birth. Less urine and stool, normal body temperature, slightly yellowish skin, purple-red bulge on the umbilicus, exudation of feces and yellow-green liquid when squeezing the abdomen, inflammatory infection of the surrounding skin, clinical diagnosis of patent vitelline duct. Ultrasound showed that the umbilical region was about 1.1 cm wide, communicating with the abdominal cavity, extending in the left and right directions in an eight-figure shape, communicating with the intestinal tube on the right side, extending toward the bladder on the left side, communicating with the top of the bladder (Figure 1)。 Ultrasound diagnosis: patent urachus combined with patent vitelline duct? On the next day of admission, vitellodectomy was performed under general anesthesia, routine anesthesia, disinfection and towels were spread, and the subcutaneous skin, anterior sheath, muscle and peritoneum were incised in turn along the left side of the umbilical chakra. When the peritoneum was opened, a small intestinal tube communicated with the umbilicus 70 cm away from the ileocecal part was found. The yolk tube was ligated and removed at the root, and the stump of the yolk tube was embedded with 8-figure suture, and the yolk tube was intussuscepted and dragged out through the umbilicus. At the same time, patent urachus was detected, and the urachus was bluntly separated. It was found that it was 4 cm long and 0.3 cm in diameter, and it was muscular. The upper end was connected to the umbilicus and the lower end was connected with the top of the bladder. It was ligated and resected, embedded near the bladder end, and completely resected near the umbilical end. The children returned to the ward safely after surgery. He was discharged after 7 days of indwelling urinary catheter. The development has been normal since follow-up.

Pulmonary sequestration is a congenital lung development abnormality caused by the separation of some lung tissues from normal lungs during embryonic development, also known as bronchopulmonary tissue separation. Isolated lungs generally do not communicate with the trachea and bronchi of normal lungs, receive systemic circulation for blood supply, and the veins flow back into the pulmonary veins. Antenatal and postpartum Doppler color ultrasound can detect abnormal vascular origin^[1,2]Postpartum MRI can show the supply artery and reflux vein^[3]。 A case of pulmonary sequestration diagnosed by prenatal color Doppler ultrasound and reconfirmed by postpartum MRI was treated in our hospital. The report is as follows.

A 4-year-old and 8-month-old male was admitted to hospital with nephrotic syndrome in May 2011 due to "swelling of the face and limbs for 40 days, rash for 4 days, and fever for half a day". The onset of the child was slow, and the swelling of the face appeared at the beginning of the disease, and then the limbs were gradually involved, accompanied by hoarseness, pain in the joints and muscles of the limbs, and decreased urine output (details unknown). He was treated in another hospital (medication unknown), and his condition was not significantly relieved. Four days ago, the child appeared purple-red rash around both eyes, and gradually appeared unsteady walking and lameness. Fever occurred half day before admission, with a maximum temperature of 39 ℃. At the time of admission, the child had obvious limitation of movement, passive posture, systemic edema, purple-red rash around the orbits of both eyes, and suspicious Gottron's sign in his right hand. Pharyngeal congestion, coarse breathing sounds in both lungs, strong heart sounds, occasional smell and premature beats. Edema of the abdominal wall, soft abdomen, 3 cm subcostal to the liver and 0.5 cm subcostal to the spleen, soft texture, sharp margins, mobile voicing (-). The limbs were swollen, non-depressed, especially in the right upper limb, with local skin temperature increased, obvious tenderness, obvious limb mobility impairment, lower limb muscle strength grade II ~ III, upper limb muscle strength grade III.

transient hyperphosphatasemia of infancy and early childhood (THI) refers to a temporary and isolated significant increase in serum alkaline phosphatase (ALP) activity in infants and young children without liver or bone disease^[1,2,3]。 According to Ilham et al.^[4]It is recorded that the disease was first described by Bach et al. in 1954. In 1977 Posen et al.^[5]For the first time, it was named transient hyperphosphatasemia in infants. Until 1985, Kraut et al.^[6]The diagnostic criteria for THI were established. THI may be a relatively common condition in infants and young children^[2]。 One case was admitted to our hospital, and the report is as follows.

The 3rd National Academic Conference on Children's Syncope sponsored by Shanghai Children's Hospital, Peking University First Hospital, Central South University Second Xiangya Hospital and Cardiovascular Group of Pediatrics Branch of Chinese Medical Association was held in Shanghai on October 27th, 2011.

According to the statistics of the World Health Organization, more than 12 million premature babies are born worldwide every year, accounting for 9.6% of the total number of newborns. Premature birth, asphyxia and infectious diseases have always been the three main causes of neonatal death worldwide. According to the current birth rate and incidence of premature birth in China, about 1.5 million premature babies are born every year, accounting for more than one tenth of the total number of premature babies in the world. It is a large group that has become a high-profile medical and social issue. With the survival rate of premature infants, especially very low birth weight infants, increasing year by year, people pay more attention to the nutrition and health of premature infants. At present, there are many hot issues around the nutrition management of premature infants. How to recognize the programmed influence of early nutrition on long-term health and how to grasp appropriate nutrition support strategies to improve the quality of life and prognosis of premature infants are challenges that we are facing.