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Objective To explore the relevant prognostic factors for children with sacrococcygeal teratoma (SCT). Methods A retrospective analysis of 65 hospitalized SCT children was performed between March 2011 and April 2019. Presence or absence of tumor recurrence and postoperative defecation and urination functions were recorded. Those with tumor recurrence, defecation or urination dysfunction belonged to group of poor prognosis. And the remainders were classified as group of good prognosis. Risk factors included operative age, tumor size, Altman type, surgical route and spillage of tumor. Results Among them, 7 cases had tumor recurrence, including type Ⅰ (n=2), type Ⅱ (n=3), type Ⅲ (n=1) and type Ⅳ (n=1). There were mature teratoma (n=2), immature teratoma (n=4) and malignant teratoma (n=1). And 7 cases developed constipation, including type Ⅰ (n=1), type Ⅱ (n=2), type Ⅲ (n=3) and type Ⅳ (n=1). There were mature teratoma (n=2), immature teratoma (n=4) and malignant teratoma (n=1). Three children had recurrent urinary tract infections, including type Ⅰ (n=1), type Ⅱ (n=2), type Ⅲ (n=3) and type Ⅳ (n=1). There were mature teratoma (n=2), immature teratoma (n=4) and malignant teratoma (n=1). Among 61 SCT children, prognosis was good (n=48) and poor (n=13). Univariate analysis indicated that Altman type, surgical roué, spillage of tumor and pathology were poor risk factors. And multi-factorial Logistic regression analysis revealed that pathological type (OR=17.322, 95%CI: 2.723-110.182) and Altman type (OR=6.133, 95%CI: 1.281-29.374) were independent risk factors of poor prognosis (P﹤0.05). Conclusion In SCT children, prognosis is correlated with defecation and urination function and tumor recurrence. Altman type, spillage of tumor and pathology are the relevant prognostic factors. Thus maintaining the integrity of tumor and minimizing the injuries of pelvic floor muscles and nerve may improve the prognosis of SCT in children. [ABSTRACT FROM AUTHOR]

Objective To explore the clinical characteristics of multiple-birth preterm infants with necrotizing enterocolitis (NEC) and examine the effects of multiple births on clinical manifestations and outcomes of NEC infants. Methods In this retrospective study, 234 premature infants with NEC admitted to Shanghai Children's Hospital from July 2014 to June 2021 were included as research objects, among which 79 were multiple premature infants with NEC and 155 were single premature infants with NEC, According to the presence of single/multiple birth, they were divided into two groups of singleton (group A, n = 155) and multiple-birth (group B, n = 79). Twin group of vaginal delivery was divided into primary birth (group C, n = 9 and secondary birth (group D, n = 4) based upon birth order. Twin group was also assigned into two groups of higher birth weight (group E, n = 20) and lower birth weight (group F n = 45. And twin group was divided into two groups of concordant twins (CT, group G, n = 42 and discordant twins (DT, group H, n = 26). The latter group was further divided into DT with higher birth weight (group l, n = 5 and DT with lower birth weight (group J,n= 21). Demographic profiles (birth weight, gestational age & birth mode), clinical data (time of NEC onset, laboratory results & Bell stage), treatment (medical or surgical, intestinal perforation & extent of disease) and outcomes (postoperative complications & in-hospital mortality) were recorded. Results Seventy-nine cases of multiple preterm NEC infants were recruited, including 75 twins and 4 triplets. Seventy-five preterm NEC twins had a mean gestational age of 31. 60 weeks and a mean birth weight of 1 476.51 gram. Bell stage was 1 (n= 35), II (n = 21) and III n = 19 Eighteen cases (24%) underwent operation. As compared with group A, NEC infants in group B had a lower birth weight [1618.77 ± 481.30) g. (1 479.34 ±376.88) g, P = 0.016], higher rates of cesarean delivery [84(54.2%) vs. 65 (82.3%), P < 0.001 ] and assisted reproductive technology [11(7.1%) vs. 21 (26.6%) P < 0.001 ]. However, no differences existed in demographic profiles, clinical manifestations, laboratory results, Bell stage, surgery or outcomes (P > 0.05). There was no significant effect of birth order on demographic profiles, clinical manifestations, laboratory results, Bell stage, surgery or outcomes (P > 0.05) As compared with group E, group F had a lower birth weight [(1677.65 ±458.23) gus. (1382.89±300.81) g,P=0.019], lower WBC count [(12.31 ±4.22) ts. (9.13 plus/minus 4.01) * 109/L P = 0.023], greater intestinal lesion [5(45.4%) ts.0(0.0%), P = 0.002 ] and more postoperative complications [11(100%) 18. 3 (42.9%), P = 0.011 ] No difference existed in demographic profiles, clinical manifestations, other laboratory results, Bell stage, surgery or in-hospital mortality (P > 0.05). As compared with group G, group J had a greater gestational age [(30.95±2.44), (32.71 ±2.30) week, P = 0.027 ] and a higher rate of cesarean delivery [30 (71.4%) ts. 20 (95.2%) P = 0.045) rfloor. However, no differences existed in demographic profiles, clinical manifestations, laboratory results, Bell stage, surgery or outcomes (P > 0.05) Conclusions Multiple-birth NEC infants have no greater severity of Bell stage, more surgery, greater extent of intestinal lesion, more postoperative complications or higher in-hospital mortality. Twins with lower birth weight are prone to greater extent of intestinal lesion and more postoperative complications. However, birth order and discordance of twins have no significant effect on disease severity, surgery or in-hospital mortality. [ABSTRACT FROM AUTHOR]

Objective To explore the middle/long-term native liver survival and examine its influencing factors of Kasai portoenterostomy for type III biliary atresia (BA). Methods From January 2011 to December 2020, single-center retrospective analysis was performed for 234 type III BA children undergoing Kasai portoenterostomy. Gender, operative age, liver function test, blood routine test, cytomegalovirus (CMV) IgM examination and aspartate aminotransferase-to-platelet ratio index (APRi) were recorded. Operative age ≤ eerativewas defined as early operation group while operative age > 60 days as late operation group. IgM antibodies against CMV were detected by immunoenzyme-linked reaction. They were assigned into two groups of IgM positive and IgM negative according to the detection results. Ratio index of aspartate aminotransferase-to-platelet = AST/(up- per limit of AST) x 100/PLT(109/L). Aspartate aminotransferase and platelets were measured at the same time 1 week pre-Kasai. They were divided into two groups of APRi < 0.6 and APRi of. Total bilirubin ≤ 2 mg/ dL. being more than once post-Kasai within 6 mouths was defined as jaundice-eliminating group and the rest as jaundice group. And 5/10-year native liver survival was calculated by Kaplan Meier method. Univariate analysis was performed by Log rank test and multibariate analysis by Cox regression. Results There were 118 boy and 116 girls with an average operative age of (72.7 ± 23) days. The 5/10-year native liver survival rate was 41.2% and 38.9% respectively. Univariate Kaplan-Meier liver survival and Log Rank test analysis revealed that gender (x² = 0.01,P=0.91), CMV (x² = 1.3,P = 0.25) and APRi (x² = 0,P = 0.98) had no effect on native liver survival. Compared with late operative age group, native liver survival rate spiked markedly in early operative age group (x² =7.6,P=0.006). Compared with total bilirubin level greater than or equal to 2 mg/dL, native liver survival rate rose significantly in < 2 mg/dL of total bilirubin (x² = 74.6,P<0.001). Multivariate Cox regression analysis showed that only total bilirubin < 2 mg/dl. within 6 months post-Kasai was an independent influencing factor of middle/long-term liver survival. Conclusions Total bilirubin < 2 mg/dL within 6 months after Kasai portoenterostomy is an independent influencing factor of middle/long-term liver survival. [ABSTRACT FROM AUTHOR]