Timolol has been demonstrated to be efficacious in the topical treatment of superficial infantile hemangiomas (IHs). We conducted a prospective study to evaluate the short-term efficacy and safety of timolol in the treatment of superficial IH in Chinese infants. From March to November 2012, 124 patients with superficial IHs were included in the prospective study. The patients were divided into two groups: treatment (101 patients, the timolol drops were administered on the surface of the lesions three times daily, and erythromycin ointment was applied around the lesions) and observation (23 patients, without treatment). The results were categorized into three grades: class 1 (ineffective), class 2 (controlled growth) and class 3 (promoted regression). Within one week of the initiation of timolol treatment, a number of the lesions became softer and lighter in color. Four months following the initiation of timolol treatment, the overall response was class 1 in eight patients (7.9%), class 2 in 36 patients (35.6%) and class 3 in 57 patients (56.4%). Complete tumor regression was observed in 12 patients. No adverse effects were recorded during the treatment period. Among the patients in the observation group, there were 15 class 1 patients (65.2%), seven class 2 patients (30.4%) and only one class 3 patient (4.3%). In conclusion, timolol is an effective and safe treatment for superficial IH. In addition, it may be used in the treatment of proliferative superficial IH, particularly in infants within 6 months of age.

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Laparoscopic percutaneous extraperitoneal closure of inguinal hernia with variable devices as an effective technique in minimal-access surgery for pediatric inguinal hernias in children was investigated in the present study. A Veress needle was inserted into the abdomen. Trocars, laparoscope and needle holder were placed through the umbilical incision. Under laparoscopic monitoring, a round needle was introduced into the peritoneal cavity through the anterior abdominal wall. The end of the suture inside the peritoneal cavity was left outside the peritoneal cavity in favor of ligation. The needle was passed through the peritoneum to place an extraperitoneal purse-string suture around the internal inguinal ring, counterclockwise on the left and clockwise on the right. The needle was then passed back into the peritoneal cavity and out through the abdominal wall, and the needle ends of the stitch were cut. The ends of the suture were tied. We described a technique used for transumbilical endoscopic closure of pediatric inguinal hernias in girls. This technique is simple and can be performed quickly. The cosmetic result is excellent because the two umbilical incisions are only 5-mm long, which make it possible to perform surgery without a visible scar. We performed this procedure in over 96 patients and have had no recurrences. Thus, this method may become the laparoscopic repair of choice for females with inguinal hernias.

Background: Ilioinguinal/iliohypogastric nerve block (IINB) is a common operation in pediatric surgery. Nerve block under contrast-enhanced ultrasound (CEUS) has the advantages of visualization and noninvasiveness, which creates conditions for its application in nerve block. It can significantly improve the success rate of nerve block and reduce the complications of nerve block. At present, few studies in China have analyzed the effect of nerve block guided by ultrasound technology compared with ordinary treatment.Methods: With "ilioinguinal/iliohypogastric nerve block", "ultrasonic examination of the children", and "ultrasonography for ilioinguinal/iliohypogastric" as the keywords, the related literature published before 2022 was searched. RevMan 5.3 and Stata provided by the Cochrane Collaboration were employed for analysis and evaluation. Begg's risk of bias was utilized to assess the risk bias of the included references.Heterogeneity among studies was evaluated using the Q test and heterogeneity (I 2 ).Results: Six studies were included, with a total of 391 cases. The overall risk (OR) of ilioinguinal/ iliosubabdominal complications in children treated with nerve block after ultrasound examination was 0.49, and the complications of ilioventral/iliosubabdominal complications in children treated with nerve block after ultrasound examination were reduced. The OR of inhibiting pain events was 0.35, and the ilioinguinal/ iliosubabdominal pain events were reduced after nerve block treatment by ultrasound examination. The OR of inhibiting adverse reactions was 0.45. After ultrasound examination, the adverse reactions of ilioinguinal/ iliosubabdominal nerve block treatment were reduced, and there was no heterogeneity among the study groups (I 2 =0.00%). Conclusions:The results of the meta-analysis confirmed that the complications of nerve block treatment after ultrasound examination were less than those of ordinary treatment. The incidence of pain events and adverse reactions in nerve block treatment were reduced after ultrasonography. Moreover, in terms of pain events, the effect of ultrasound guidance was significant. In short, in clinical studies, CEUS can be used to accurately evaluate complex situations and provide a more accurate reference for subsequent treatment.