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Assessment of the vascular status following limb fracture in children is important to evaluate the risk of compartment syndrome, which is an emergency condition.

To establish a simple and efficient grading scale of limb perfusion in children undergoing surgery for limb fracture.

This retrospective study included pediatric patients with a limb fracture and postoperative plaster fixation who were admitted at The Department of Pediatric Orthopedics of Xinhua Hospital between February 2017 and August 2017. The outcome was poor limb perfusion, which is defined as the postoperative use of mannitol. The children were divided into two groups The normal perfusion group and the poor perfusion group. Key risk factors have been selected by univariable analyses to establish the Grading Scale for Vascular Status.

A total of 161 patients were included in the study 85 in the normal perfusion group and 76 in the poor perfusion group. There were no significant differences in age, sex, body mass index, ethnicity, cause urrence of poor limb perfusion. A prospective study is required for validation.

Implant vagus nerve stimulation is an adjunctive treatment for intractable epilepsy when patients are not suitable for resective surgery.

To identify the safety and efficacy of vagus nerve stimulation in children with intractable epilepsy and analyze the effects on different epilepsy syndromes.

Eligible children with intractable epilepsy were admitted to the study. We collected data from preoperative assessments as the baseline. During the follow-up time, we recorded the process of seizures (frequency, duration, and seizure type), the changes of drugs or parameters, the complications,

. The mean reduction rate of seizures, response rate, and McHugh scale were chosen as the outcomes.

A total of 213 patients were implanted with Tsinghua Pins vagus nerve stimulators, and the average age was 6.6 years. In the follow-up time of postoperative 3 mo, 6 mo, 12 mo, 18 mo, and 24 mo, the average reduction rate was 30.2%, 49.5%, 56.3%, 59.4%, and 63.2%, while the response rate was 21.8%, 62.5%, 57.1%, 69.2%, and 70.7%. In addition, implanted vagus nerve stimulation had different effects on epilepsy syndromes. The reduction rate of West syndrome increased from 36.4% (postoperative 6 m) to 74.3% (postoperative 24 m). The reduction rate of Lennox-Gastaut syndrome improved from 25.4% to 73.1% in 24 mo. The chi-square test of the five efficacy grades showed

< 0.05. The comparison between the 3-mo follow-up and the 6-mo follow-up showed

< 0.05, and the comparison between the 6-mo follow-up and the 24-mo follow-up showed

> 0.05.

Vagus nerve stimulation is safe and effective in children with intractable epilepsy, and the seizure reduction occurred in a time-dependent manner. Moreover, patients with West syndrome may get the most benefits.

Vagus nerve stimulation is safe and effective in children with intractable epilepsy, and the seizure reduction occurred in a time-dependent manner. Moreover, patients with West syndrome may get the most benefits.

Focal intrahepatic strictures (FIHS) refer to local strictures of the small and medium intrahepatic bile ducts. FIHS are easily misdiagnosed due to their rare incidence, and few studies have focused on the diagnosis and treatment approaches.

To propose a new classification for FIHS in order to guide its diagnosis and treatment.

The symptoms, biochemistry results, imaging results, endoscopic examination results and initial and final diagnoses of 6 patients with FIHS admitted between January 2010 and December 2019 were retrospectively analyzed.

The 6 patients were diagnosed with intratubular growth-type intrahepatic cholangiocarcinoma (IG-ICC), recurrent multiple hepatocellular carcinoma (rmHCC) with bile duct tumor thrombus (BDTT), adenosquamous carcinoma (ASC), hepatolithiasis, small duct primary sclerosing cholangitis (SD-PSC) and autoimmune hepatitis (AIH). The initial and final diagnoses were not consistent in 4 patients. Hepatectomy was performed in patients with IG-ICC, ASC and hepatolithiasis according to the locations of their FIHS. Patients with rmHCC with BDTT received lenvatinib/sintilimab, while patients with SD-PSC and AIH received UDCA. Deutenzalutamide We proposed the following classification system for FIHS type I FIHS located within one segment of the liver; type II FIHS located at the confluence of the bile ducts of one segment or two adjacent segments; type III FIHS connected to the left or right hepatic duct; and type IV Multiple FIHS located in both lobes of the liver.

Our proposed classification system might help to guide the diagnosis and treatment of FIHS. Hepatectomy should be performed not only for malignant FIHS but also for benign strictures with severe secondary damage that cannot be improved by nonsurgical methods.

Our proposed classification system might help to guide the diagnosis and treatment of FIHS. Hepatectomy should be performed not only for malignant FIHS but also for benign strictures with severe secondary damage that cannot be improved by nonsurgical methods.

Intracranial infection is a common clinical disease. Computed tomography (CT) and magnetic resonance imaging (MRI) have certain sensitivity and have good diagnostic efficacy.

To study the application value of MRI and CT in the diagnosis of intracranial infection after craniocerebral surgery.

We selected 82 patients who underwent craniocerebral surgery (including 40 patients with intracranial infection and 42 patients without infection) during the period from April 2016 to June 2019 in our hospital. All 82 patients received CT and MRI examinations, and their clinical data were reviewed. A retrospective analysis was performed, and the coincidence rate of positive diagnosis and the overall diagnosis coincidence rate of different pathogenic infection types were measured with the two examination methods. The diagnostic sensitivity and specificity as well as the positive and negative predictive values of the two examination methods were compared.

For all types of pathogenic infections (

,

,

, and othery higher with MRI than with conventional CT, which can be actively promoted.