Juvenile idiopathic arthritis, early symptoms should be vigilant

Juvenile idiopathic arthritis (JIA) is a chronic and systemic disease that occurs in children under 16 years of age and has an unknown cause. It is mainly characterized by chronic synovitis and accompanied by various tissues and organs. As a highly disabling childhood disease, juvenile idiopathic arthritis arthropathy mainly occurs in the early stage of the disease, especially within 2 years of the disease. Early drug treatment and intervention can control the disease to a certain extent and reduce joints. Damage is of great significance for improving the prognosis of the disease. If we can understand the early symptoms of JIA. Early detection of disease symptoms and regular treatment for children will help reduce joint damage and avoid serious complications. So, what are the early symptoms of juvenile idiopathic arthritis? The early symptoms of juvenile idiopathic arthritis are joint swelling and pain, morning stiffness, and generally the joints will develop bilaterally symmetrically. Systemic juvenile idiopathic arthritis is The most serious type is mainly systemic manifestations. There may be no joint symptoms at the beginning of the illness. The clinical symptoms are not specific. The most common symptoms are fever, arthritis and skin rashes, and 31% of children show it There are lymphadenopathy. Polyarticular juvenile idiopathic arthritis, which often manifests as small joint pain in the early stage, such as ankle joints, wrist joints, foot and plantar joints, and finger joints. Few articular juvenile idiopathic arthritis, often involving large joints Joints, such as hip joints and knee joints. The above are the typical early symptoms of juvenile idiopathic arthritis. Due to the diversified clinical manifestations of juvenile idiopathic arthritis disease itself, some symptoms are similar to general inflammation and fever. In addition, juvenile idiopathic arthritis is more common in young children. They do not express the symptoms of the disease in a proper way and are easily affected by parents. Neglect, it is also easy to be misdiagnosed and missed during treatment. Therefore, please remind parents that if your child has the above symptoms or minor illnesses (such as a cold) have not been cured, please do not ignore it, and take your child to a regular hospital to seek professional help in time.

Children are also susceptible to colon polyps

 Patient Li, male, 8 years old, student. The main reason was that he had blood in the stool for 1 week. One week ago, the child had bloody stools with no obvious cause, which was bright red, 2-3 times a day, about 100 ml each time, without dizziness, palpitations, abdominal pain and other symptoms, and no recent weight loss. There are no similar patients in the family.   Seen under colonoscopy: A 1.5×1.5 cm polyp can be seen at the sigmoid colon 25 cm from the anus, protruding into the intestinal cavity, with a slightly narrow base and sub-pedicle. The surface was hyperemia, edema, and erosion, with a small amount of mucus covered, soft in texture, and ulcers and masses at the end of the colon. The biopsy pathology report was a hamartoma. Colonoscopy diagnosis: single polyp of sigmoid colon.   Disease analysis and treatment plan: This case has the characteristics of being more common in male children, having a history of painless blood in the stool, a single polyp of the sigmoid colon found under colonoscopy, and a hamartoma confirmed by pathology. It can be diagnosed as a juvenile polyp. 90% of this polyp occurs in children under 10 years old, mostly boys. Its appearance is round or oval, dark red, smooth or with fine particles, superficial ulcers, obvious hyperemia, erosion and bleeding. 90% grow within 25 cm from the anus, most of them are less than 1 cm in diameter, 70% are single, and most have pedicles, sessile and less than 0.5 cm, accounting for only 6%. Histologically, the glands are well differentiated and irregular in size, some of which form cystic expansion and store mucus, so they are also known as resident polyps. There are stromal hyperplasia and more inflammatory cell infiltration, and sometimes ulcers are formed on the surface. According to ultrastructure and tissue culture studies, juvenile polyps are hamartomas. This polyp generally does not become cancerous, only occasional reports of canceration. This child’s colonic polyp erosion and lower gastrointestinal bleeding can cause anemia, hemorrhagic shock, and even life-threatening in severe cases. Therefore, early diagnosis and timely treatment should be given. For treatment, a snare can be used for electrocautery resection from the root of the polyp pedicle. The excised polyps should be re-examined by pathological biopsy to confirm the diagnosis.   Prognosis: It suggests that the prognosis of juvenile polyps is good after removal.   It is generally believed that when blood in the stool is repeatedly accompanied by severe anemia or malnutrition and other serious complications, or polyps with severe dysplasia or even cancerous changes and polyps cannot be removed by endoscopy, surgical treatment should be considered. The principle of surgery is to remove all the diseased intestines, but as much as possible to preserve the function of the anal sphincter. All polyps resected under colonoscopy and surgical specimens should be pathologically examined. Patients with juvenile polyps and their first-degree relatives should undergo regular endoscopy, and it is recommended that they be checked every 3-5 years. It has been reported that all first-degree relatives of juvenile polyps patients (even without any clinical symptoms) are prone to gastrointestinal cancer.

What medicine to take for anemia

 1. Vitamin B12 injection. It has a certain effect on bone marrow hematopoietic function and liver function. It is mainly used for various megaloblastic anemia, or pernicious anemia, with better curative effect. This medicine may cause allergic reactions and even anaphylactic shock, so it should not be abused. Coenzyme vitamin B12 tablets are a new type of vitamin B12. It is also used for megaloblastic anemia and malnutrition anemia. Keep tightly closed and protected from light. The folic acid tablets are especially suitable for pregnancy and infantile megaloblastic anemia.  2, ferrous sulfate tablets. It is divalent iron, easy to absorb, and good effect.   3. Ferrous salt. Used for iron deficiency anemia caused by chronic blood loss, malnutrition, pregnancy, and child growth. Commonly used drugs include ferrous sulfate, vitamin iron tablets (also known as Fonaide), ferrous fumarate, ferrous gluconate, ferrous succinate tablets, and ferrous lactate.   4. Heche Daizo Maru.   5. Liver essence tablets. Contain vitamin B12, folic acid and other ingredients, used for pernicious anemia.   6, ferrous fumarate tablets. For the treatment of various iron deficiency anemia. It is easier to absorb after oral administration, its iron content is higher, it works quickly, and has fewer side effects. But people who are allergic to iron should not take it.   7. Ferric ammonium citrate solution. It is trivalent iron, not as easy to absorb as ferrous sulfate tablets and blood iron tablets, but it is non-irritating and suitable for children and patients who cannot swallow tablets.

Diagnostic criteria for anemia in children

Diagnostic criteria for pediatric anemia: neonatal hemoglobin (HB) &lt.145g/l within ten days after birth. Infant (HB) from ten days to three months old (HB) &lt.100g/l. Three months to less than six years old HB&lt.110g/l. Six to fourteen years old HB&lt.120g/l. is anemia. In terms of sea level, HB increases by about 4% for every 1000 meters of altitude increase.  Causal diagnosis of anemia:   Anemia is not a disease, but a syndrome. The cause must be found out and the cause diagnosis must be made. In order to correctly treat and judge the future.   1. Onset, development and characteristic manifestations of anemia, acute leukemia. Acute aplastic anemia is more rapid onset, anemia is a progressive development. Chronic aplastic anemia. Chronic hemolytic anemia, slow onset and long course.  2. Family history: with or without genetic factors, there are more anemias in childhood and inheritance. Such as hemoglobinopathy&nbsp., thalassemia, and congenital red blood cell enzyme deficiency. Fanconi anemia and other diseases. There are often the same patients in the family (or close relatives).  3. The patient’s living area is in schistosomiasis, hookworm, and malaria endemic areas. Due to consideration of anemia caused by parasitic infections, corresponding examinations should be performed to confirm the diagnosis.  4. Age and nutritional history: jaundice that occurs within one to two days of the birth of a newborn, and anemia is likely to cause hemolysis in the newborn. Infants and adolescents from 6 to 3 years old and adolescents are the peak age of onset of iron deficiency anemia. Long-term pure breastfeeding&nbsp., nutritional megaloblastic anemia is highly likely. Iron deficiency or long-term diarrhea in artificially fed foods may lead to iron deficiency anemia. Older children have a history of peptic ulcer, so pay attention to hemorrhagic anemia.   5. Seasons, drug history. And whether there are pathogenic factors: Broad bean disease often occurs during the harvest season of broad beans, and there is a history of eating broad beans, and drug-induced hemolysis often has a history of medication. The onset of aplastic anemia is related to chloramphenicol cytotoxic drugs.  6. ​​The degree and speed of anemia: Anemia that occurs within a few hours or days and worsens rapidly is mostly related to acute hemolysis and blood loss. Severe anemia is due to consideration of hemolysis, hookworm disease, blood loss and aplastic anemia. Nutritional iron deficiency anemia is often mild.   7. Anemia with fever. Hepatosplenic lymph nodes enlarged, bleeding tendency, and cachexia may have leukemia. There are anemia, fever, bleeding, but the liver and spleen lymph nodes are not swollen, while white blood cells and thrombocytopenia may be aplastic anemia. One or several groups of lymph nodes are enlarged, suggesting malignant lymphoma.   8. Anemia with mental retardation. And tremor of the limbs is the possibility of megaloblastic anemia, anemia, hepatosplenomegaly, and idiopathic pulmonary hemosiderosis in patients with repeated respiratory infections. Anemia, jaundice, splenomegaly and hemoglobinuria are mostly acute hemolytic anemia.  9. Are there chronic diseases that cause anemia: chronic infections (tuberculosis, parasites, bacteria), malignant tumors, kidney and liver endocrine diseases, autoimmune diseases, gastrointestinal malformations, polyps, and rheumatism can all cause anemia.  10. Responses to commonly used anti-anemia drugs. Iron, vitamin B12, and folic acid are good for nutritional iron deficiency anemia and megaloblastic anemia. It is ineffective for malignant tumors, aplastic anemia, and thalassemia.

To prevent rheumatoid arthritis, only adults and children? Children’s rheumatism is even more terrible!

The children at home are our babies. Usually there is a cold and fever. Everyone will be in a hurry. Especially when the child has a long fever for unknown reasons. When I have found some doctors and changed hospitals, I am worried. Get angry. And when the child has the following situations, parents should be careful, it is likely that juvenile rheumatoid is at work! The clinical manifestations of juvenile rheumatoid fever mostly occur slowly, and a few appear suddenly, which can be irregular hypothermia, persistent high fever or intermittent high fever. Fever can relieve itself after a few weeks to several months, but it is easy to occur repeatedly. About 1/5 of children with rash have rashes during fever. The rashes vary in shape, most of them are small maculopapular rashes, and a few have erythema with nodular erythema in the center of the ring, which can spread throughout the body and occasionally itching. Rashes often disappear quickly, but can reappear with fever. Joint swelling and pain often occur weeks or months after the fever, and often invade the knee and wrist joints first, and then develop into elbow, ankle, shoulder, and cervical joints. Mostly bilateral symmetry, and some children are wandering. Other parts of the child may also be accompanied by anemia, pericarditis, myocarditis, pleurisy, pneumonia, and splenomegaly, with less involvement of the kidneys. Some parents may be wondering if rheumatoid arthritis is not a disease that only adults can get. How can children get it? In fact, there is a kind of juvenile rheumatoid arthritis in rheumatoid arthritis, which occurs in children under 16 years old. Infants are very rare within 6 months, and the high incidence age is 1-3 years old. The incidence rate of juvenile rheumatoid arthritis is 16-150 / 100000. Although the incidence rate does not seem to be high, it is easy to cause misdiagnosis and missed diagnosis because it is not well known, and it is more likely to cause harm to children. Therefore, when the child has the above symptoms, the children must take the child to the rheumatology and immunology department of the regular hospital in time to see if they are suffering from juvenile rheumatoid arthritis. The main causes of juvenile rheumatoid arthritis 1. Autoimmune factors. It is now believed that the occurrence of juvenile rheumatoid arthritis is caused by certain microorganisms such as bacteria, viruses, mycoplasma, etc. stimulating the body, so that the normal immunoglobulin IgG in the body becomes denatured IgG, which acts as an antigen to stimulate the body to produce anti-denatured IgG Antibody, which is what we often say about rheumatoid factor. Rheumatoid factor and its antigen (ie denatured IgG) combine to become an immune complex. Granulocytes engulf immune complexes to form rheumatoid cells. The proteolytic enzymes and collagenases released by rheumatoid cells decompose and destroy joint synovium and cartilage. Some intermediate substances and inflammatory factors produced during the decomposition process lead to inflammation of synovium, forming rheumatoid arthritis. 2. Infectious factors. Some scholars believe that the occurrence of juvenile rheumatoid arthritis is related to infection. For example, there is peptidoglycan on the cell wall of hemolytic streptococcus, which may be a continuous stimulus for the onset of this disease. Some people think that the infection of rubella virus and mycoplasma is also related to the occurrence of juvenile rheumatoid arthritis, but they are not sure. 3. Genetic factors. Juvenile rheumatoid arthritis also has a family genetic tendency, which is related to the presence of susceptibility genes in the body. 4. Other factors. The onset of juvenile rheumatoid arthritis is also related to environmental, mental factors such as cold, humidity, fatigue, etc. They can be used as inducements to cause the occurrence of this disease. How to prevent juvenile rheumatoid in life? 1. Always pay attention to the weather changes, especially when changing seasons, according to the weather conditions to increase or decrease clothing, do a good job of keeping children warm, to prevent cold and cold. The room where the child sleeps should be ventilated and sunny, pay attention to moisture and cold, and reduce the stimulation of environmental induced factors. 2. When the child suffers from colds, stuffy nose, fever, rash, joint pain and other symptoms, it is necessary to go to the hospital for treatment and treatment in time to prevent the occurrence of rheumatoid arthritis. 3. Let children develop good eating habits, not picky eaters, not partial eaters, eat less sweets and cold and greasy foods, and ensure a balanced diet. Summer is here, especially to keep children from drinking cold drinks. 4. Many children now stay at home watching TV and playing games for a long time. Parents should allow their children to correct these bad habits. They should exercise more at home during the epidemic. Quality, enhance resistance, but pay attention not to overwork. The doctor’s suggestion that if children’s rheumatoid arthritis is not effectively treated in time, it will not only cause great pain to the child, but even bring lifelong health damage. Early detection and early treatment are very important. Finally, again

A case of plastic surgery for concealed penis

A 30-year-old male patient has a penis-shaped penis appearance, which can reveal normal tissues with a hand push. It is a typical hidden penis. Fortunately, the patient had not undergone foreskin surgery in his childhood. Otherwise, once the correction was performed, there is a high possibility that the foreskin margin is insufficient, and it is very likely that skin graft surgery will be performed. Admitted to the operation to remove the abnormally stretched periosteal tissue, loosen and prolong the skin, so that Tintin “sees the sky”, in accordance with the principle of refined plastic surgery, for the use of foreskin circular micro-slit incision design, and performed a wound-type cosmetic suture In this way, the surgical traces are even more concealed than ordinary circumcision surgery. Parents are reminded here that if they find that their child has abnormal development, they must go to the hospital for examination as soon as possible so that the problem can be solved. As in the case of this article, if the operation is performed at an early age, the difficulty and trauma of the operation will be much smaller than that of the adult, and it will also have many benefits for development.