Objective:This study aims to explore the experiences of social alienation among adolescents with depression,providing practical This study aims to explore the experiences of social alienation among adolescents with de...Objective:This study aims to explore the experiences of social alienation among adolescents with depression,providing practical This study aims to explore the experiences of social alienation among adolescents with depression,providing practical guidance for improving their interpersonal relationships and facilitating their reintegration into society.Methods:This qualitative research was conducted following the conventional content analysis method.20 adolescents with depression were employed to select from June to August 2024 for face-to-face semi-structured interviews.The collected data were analyzed using Colaizzi's seven-step method.Results:Three themes and eight sub-themes were analyzed and identified:individual level(feelings of helplessness and powerlessness,cognitive distortion,avoidance and withdrawal),family level(lack of family awareness,family conflict),social level(limitations of academic stress and social circle,lack and degradation of skills,generalization of virtual reality,social“stigma”).Conclusion:Adolescents with depression experience complex social alienation.Healthcare providers should enhance their self-awareness and social adaptation skills,improve family dynamics,and provide a comprehensive range of services and services to help them to cope with the challenges of depression.Healthcare providers should enhance their self-awareness and social adaptation skills,improve family dynamics,strengthen communication,bolster family support systems,and collaborate to develop comprehensive social networks and psychological services.This will create a supportive social atmosphere to help adolescents gradually alleviate their feelings of social alienation.展开更多
<b>Objective:</b> <i>Angiostrongylus cantonensis</i> (<i>A. cantonensis</i>) is an important parasite, which causes neurological infection in children, and is generally difficult to...<b>Objective:</b> <i>Angiostrongylus cantonensis</i> (<i>A. cantonensis</i>) is an important parasite, which causes neurological infection in children, and is generally difficult to diagnose. We analyzed the significance of metagenomic next-generation sequencing in diagnosing <i>A. cantonensis</i> encephalitis/meningitis in children to provide a reference for clinical diagnosis. <b>Methods:</b> The case collection of <i>A. cantonensis</i> encephalitis/meningitis was from July 2018 to August 2020. The patients’ clinical characteristics and pathogen were described, and diagnostic sensitivity methods for <i>A. cantonensis</i> encephalitis/meningitis were compared and analyzed, including parasite antibody detection and metagenomic next-generation sequencing (mNGS) detection in different samples. <b>Results:</b> Eleven cases were diagnosed with <i>A. cantonensis</i> encephalitis/meningitis, including six males (54.5%) and five females (45.5%), and the age ranged from 1 to 13 years with a median of 21 months (IQR: 15.6, 96). All patients were undiagnosed upon admission, of which ten cases had neurological symptoms or signs, six cases (54.5%) had a history of definite or suspicious exposure to parasites, and eight cases (72.7%) had abnormal changes in cranial MRI. The results of <i>A. cantonensis</i> antibodies in the peripheral blood and cerebrospinal fluid (CSF) were compared with CSF’s metagenomic next-generation sequencing (mNGS). The antibody-positive rate of peripheral blood was 54.5%, CSF antibody-positive rate was 27.2%, and mNGS-positive rate of CSF was 81.8%, and the positive diagnostic rate of the latter was significantly higher than the former two (<i>p</i> = 0.035 < 0.05 and <i>p</i> = 0.030 < 0.05, respectively). <b>Conclusion:</b> Metagenomic next-generation sequencing has a higher positive rate for diagnosing infection and plays an important role in clarifying diagnosis and reducing misdiagnosis.展开更多
Objective: Febrile convulsion in children is age-dependent and genetic predisposition. However, mild electrolyte disturbances are not uncommon in such children. This study was to investigate the effect of electrolyte ...Objective: Febrile convulsion in children is age-dependent and genetic predisposition. However, mild electrolyte disturbances are not uncommon in such children. This study was to investigate the effect of electrolyte disturbance on febrile convulsion and to screen for febrile convulsion-related genes. Methods: This retrospective cohort study included children who admitted to the Pediatric Emergency Department of Guangzhou Women and Children’s Medical Center due to fever and febrile convulsion between May to December 2020. Clinical manifestations and serum electrolyte levels were recorded and analyzed by binary logistic regression on risk factors of convulsion, and children with family histories were screened for febrile convulsion-related genes. Results: This study included 322 children with fever: 161 in the febrile convulsion group (FC Group) including 71 in the single convulsion group (SC Group) and 90 in the multiple convulsion group (MC Group), and the control group consisted of 161 children with fever without convulsion and nervous system disease. Serum sodium, potassium and calcium in FC Group were lower than those in the control group (p Conclusion: Hyponatremia may be a relative risk factor in febrile convulsion, and for children with a family history of febrile convulsion and serum sodium lower than 133 mmol/L, related gene analysis can be performed.展开更多
Background: To explore the early clinical features and laboratory findings of influenza-associated acute necrotizing encephalopathy (IANE). Methods: The demographics data, clinical manifestations, and laboratory indic...Background: To explore the early clinical features and laboratory findings of influenza-associated acute necrotizing encephalopathy (IANE). Methods: The demographics data, clinical manifestations, and laboratory indicators of cases diagnosed with IANE and influenza with febrile convulsions (FS), respectively, admitted to Guangzhou Women and Children’s Medical Center from January 2016 to January 2020 were retrospectively analyzed. Results: Among the 25 cases of IANE, there were 9 males and 16 females, aged 3 to 6 years. The mortality rate was 40.00% (10/25). Influenza virus type A in 9 cases (36.00%) and influenza virus type B in 10 cases (40.00%). The main clinical manifestations of children with IANE were acute disorders of consciousness (64.00%, 16/25) and convulsions (72.00%, 18/25), which were statistically significant when compared with the FS group (P < 0.05). Typical changes on cranial MRI of IANE were cerebral edema, typically with symmetric necrosis of the thalamus and other brain structures. Significant differences (P < 0.05) existed between the IANE and FS groups in laboratory indicators for ALT, AST, CK-MB, LDH, cerebrospinal fluid (CSF) microprotein, CSF LDH, which were above the normal reference range. In addition, logistic regression analysis showed that LDH ≥ 348.5 U/L predicted a significantly higher risk of IANE. Conclusions: Children with influenza present early with acute impairment of consciousness or convulsive seizures, or with elevated AST, ALT, CK-MB, LDH, and CSF protein and CSF LDH, especially if blood LDH is ≥348.5 U/L, should be closely evaluated and alerted to the possibility of IANE.展开更多
Objectives: To summarize the characteristics and research progress of influenza-associated brain complications in children and provide references for early diagnosis and brain protection treatment. Methods: Studied pu...Objectives: To summarize the characteristics and research progress of influenza-associated brain complications in children and provide references for early diagnosis and brain protection treatment. Methods: Studied published articles of influenza-associated neurocomplications in children from PubMed and summarizes them from epidemiology, clinical manifestations, diagnosis and treatment, and basic research progress. Results: Common brain complications in flu-children include febrile seizures, influenza-associated encephalopathy (IAE), acute or post-influenza encephalitis, and the most severe condition is acute necrotizing encephalopathy (ANE). However, the mechanism and relevant factors of influenza-associated brain damage have not been elucidated. Conclusion: Influenza could be accompanied by various brain lesion complications in dif ferent stages of the disease, some of which are life-threatening or leave severe neurological sequelae, such as ANE. Due to different brain injury mechanisms, specific early diagnosis and brain protection treatment for different complications are unclear or unanimous. Therefore, further classification and basic research are needed.展开更多
Background: The COVID-19 pandemic has led to a shortage of blood supplies for children, resulting in prolonged waiting times for transfusions. This study aims to explore the effect of timely blood transfusion on the e...Background: The COVID-19 pandemic has led to a shortage of blood supplies for children, resulting in prolonged waiting times for transfusions. This study aims to explore the effect of timely blood transfusion on the effect and prognosis of blood transfusion in children during the COVID-19 pandemic. Methods: This retrospective cohort study included children who were indicated for blood transfusion in the Pediatric Emergency Department of Guangzhou Women and Children’s Medical Center between January 2020 and December 2020. The outcomes were the effect and the final clinical outcomes of blood transfusion. Results: This study included 260 children with non-traumatic non-surgical low Hb: 209 with timely transfusion, 40 with delayed transfusion, and 11 without transfusion;80% of children were below 60 g/L (min 17 g/L), and the waiting time for transfusion within 100.5 hours (P Conclusions: During the 100-h waiting time, there were no significant differences in outcomes among the timely, delayed, and no transfusion groups. A timely blood transfusion may not affect the clinical outcomes of children.展开更多
Background:During Enterovirus type 71(EV71)infection,the structural viral protein 1(VP1)activates endoplasmic reticulum(ER)stress associated with peripheral myelin protein 22(PMP22)accumulation and induces autophagy.H...Background:During Enterovirus type 71(EV71)infection,the structural viral protein 1(VP1)activates endoplasmic reticulum(ER)stress associated with peripheral myelin protein 22(PMP22)accumulation and induces autophagy.However,the specific mechanism behind this process remains elusive.Methods:In this research,we used the VP1-overexpressing mouse Schwann cells(SCs)models co-transfected with a PMP22 silencing or Autocrine motility factor receptor(AMFR/gp78)overexpressing vector to explore the regulation of gp78 on PMP22 and its relationship with autophagy and apoptosis.Results:The activity of gp78 could be influenced by EV71-VP1,leading to a decrease in the ubiquitination and degradation of PMP22,resulting in PMP22 accumulation in ER.In VP1-overexpressing mouse SCs,all three ER stress sensors,including pancreatic endoplasmic reticulum kinase(PERK),activating transcription factor 6(ATF6)and inositol-requiring enzyme 1(IRE1)and the related downstream signals(C/EBP-homologous protein(CHOP)and Caspase 12)were activated,as well as the ER-resident chaperone Glucose-regulated protein 78(GRP78).In addition,VP1 upregulated the autophagy marker Microtubule-associated protein 1 light chain 3 beta(LC3B),while PMP22 silencing or gp78 overexpression reversed the phenomenon.Meanwhile,PMP22 silencing or gp78 overexpression increased proliferation of EV71-VP1-transfected mouse SCs.Conclusion:Gp78 could regulate PMP22 accumulation through ubiquitination degradation and cause ER stress and autophagy in EV71-VP1-overexpressing mouse SCs.Therefore,the gp78/PMP22/ER stress axis might emerge as a promising therapeutic target for myelin and neuronal damage induced by EV71 infection.展开更多
Background: Bloodstream infection is a serious infectious disease. In recent years, the drug resistance of pathogenic bacteria to commonly used anti-infective drugs has been widely concerned, which also makes the trea...Background: Bloodstream infection is a serious infectious disease. In recent years, the drug resistance of pathogenic bacteria to commonly used anti-infective drugs has been widely concerned, which also makes the treatment of bloodstream infection face severe challenges. Objective: To explore the distribution characteristics of blood culture-positive pathogens and the resistance to antibacterial drugs, so as to provide clinicians with accurate laboratory evidence, so as to guide clinicians to rationally apply antibiotics, improve clinical treatment effects, and reduce the emergence of drug-resistant strains. Methods: From January 2019 to June 2022, 2287 positive blood culture specimens of patients in Guangzhou Women and Children’s Medical Center were retrospectively analyzed, and the proportion of different pathogenic bacteria, the distribution of pathogenic bacteria in different departments, and the multi-drug resistance of different pathogenic bacteria were counted. Results: Among the 2287 blood culture positive samples, 1560 strains (68.20%) of gram-positive bacteria and 727 strains (31.80%) of gram-negative bacteria were strained. The top three departments in the distribution of pathogenic bacteria were pediatric intensive care unit (600 strains), pediatric internal medicine (514 strains), and pediatric emergency comprehensive ward (400 strains). The pathogens with high detection rates were: Staphylococcus epidermidis (24.09%), Staphylococcus humans (23.74%), Escherichia coli (13.21%) and Klebsiella pneumoniae (8.71%). The pathogens with high multi-drug resistance rates were: Streptococcus pneumoniae (93%), Staphylococcus epidermidis (83.76%), Enterobacter cloacae (75.61%) and Staphylococcus humans (62.43%). Conclusion: In our hospital, gram-positive bacteria were the main pathogenic bacteria in the blood culture of children patients. The children’s intensive care unit was the department with the largest distribution of pathogenic bacteria, and the multiple drug resistance rate of Streptococcus pneumoniae was the highest.展开更多
Background: Guangzhou Women and Children’s Medical Center was chosen as the designated facility for screening, diagnosing, and treating children in Guangzhou with SARS-CoV-2 infection after the COVID-19 outbreak in C...Background: Guangzhou Women and Children’s Medical Center was chosen as the designated facility for screening, diagnosing, and treating children in Guangzhou with SARS-CoV-2 infection after the COVID-19 outbreak in China. From January 23 to March 20, 2020, the center opened new wards for screening and treatment, taking measures to prevent and control nosocomial infections. This article summarizes and evaluates measures for preventing and controlling nosocomial infections to provide reference information during the pandemic. Methods: The COVID-19 nosocomial infection prevention and control strategies were summarized and analyzed, including the formulation of the hospital partition, the improvement of the hospitalization process, environmental cleaning and disinfection, graded protection based on risk assessment, enhanced training on-site quality control inspection, data monitoring and evaluation, among others, and evaluating the effects by comparing before and after the intervention. Results: There were 159 patients admitted to the screening wards, including 98 males and 61 females, with a median age of 34 years (interquartile range (IQR): 15, 60) months. There were no abnormal findings in these patients and their families during follow-up. During the screening ward opening period, hand hygiene compliance was significantly improved. Fifty staff members in close contact with the contaminated area had tested for SARS-CoV-2 nucleic acid by polymerase chain reaction (PCR), which showed zero infections and no nosocomial infections occurred. Conclusions: For SARS-CoV-2 nosocomial infections, taking the “standard prevention & contact isolation & droplet isolation & air isolation” strategies can prevent patients and staff effectively.展开更多
Influenza-associated encephalopathy (IAE) can perform as varying patterns of neuroimaging. Central brain herniation (CBH) secondary to IAE is rare;it may be a bad prognosis. Here, we presented a 4-year-old girl with i...Influenza-associated encephalopathy (IAE) can perform as varying patterns of neuroimaging. Central brain herniation (CBH) secondary to IAE is rare;it may be a bad prognosis. Here, we presented a 4-year-old girl with influenza who had a pontocerebellar hypoplasia (PCH) history;she performed the second Magnetic Resonance Imaging (MRI) on Day 6 from onset, showed the diffuse edema and the occurrence of central herniation;the medulla was “Z-like” folded and the basal cisterns were obliterated completely. Finally she was declared dead. The imbalance between supratentorial and infratentorial pressure can lead to the occurrence of CBH. Severe edema relates to IAE and unstable structure of the posterior fossa might be the main reason for the herniation. MRI is helpful in early diagnosis. Early treatment of cerebral edema in patients with congenital abnormalities of the posterior fossa is vital for their management.展开更多
Objective: The related factors of no improvement of hypoxia and ineffective infusion were analyzed to provide new ideas, clinical observation and evaluation pathway for RBC transfusion in clinical children. Methods: R...Objective: The related factors of no improvement of hypoxia and ineffective infusion were analyzed to provide new ideas, clinical observation and evaluation pathway for RBC transfusion in clinical children. Methods: Retrospective analysis from January 2020 to December 2020, Guangzhou women and children’s medical center hospital in the emergency observation room of 249 children under 1 month to 18 years of blood cell suspension infusion, analyze the clinical effect of red blood cell infusion and children gender, age, fever after transfusion, disease type, delay transfusion. The possible influencing factors were analyzed by logistic regression. Results: Invalid transfusion was associated with the type of transfusion product (P = 0.032), logistic regression analysis showed that patients infused with washed RBC suspension were 3.231 times more likely to not achieve the expected effect than those infused with RBC suspension (P = 0.025). Failure transfusion was associated with the type of transfusion products. In ineffective transfusion was closely related to post-transfusion fever (P P P = 0.031). Logistic regression analysis showed that fever after transfusion was a risk factor for no improvement of hypoxia (OR = 5.809, P = 0.001), and the improvement of hypoxia in adolescent children was 10.744 times higher than that of infants (0 - 3 years old). Late transfusion hypoxia improvement was 4.212 times more likely to achieve no effect than timely transfusion. If ineffective infusion of red blood cells is considered and hypoxia after transfusion is not improved, univariate suggests a close correlation with fever after transfusion (P = 0.002), logistic regression analysis showed that fever after transfusion was an independent risk factor (OR = 7.258, P = 0.002). Conclusion: There was no correlation between the ineffective transfusion of red blood cells and the type of disease affected in the child. Infusion of red cell suspension has an advantage over the wash red cell infusion. Ineffective RBC transfusion and no improvement in hypoxia after transfusion were closely related to post-transfusion fever, with no difference between children in all age groups. Red blood cell infusion in pediatric clinical treatment activities should pay attention to adolescent children, especially female children to give more attention, and give timely red blood cell infusion as much as possible.展开更多
<b>Objective:</b> A case-control study of Influenza-Associated Necrotizing Encephalopathy (IANE) in children was conducted to explore the risk factors for the diagnosis of IANE, and to provide a predictive...<b>Objective:</b> A case-control study of Influenza-Associated Necrotizing Encephalopathy (IANE) in children was conducted to explore the risk factors for the diagnosis of IANE, and to provide a predictive reference for the diagnosis of IANE. <b>Methods:</b> The children with IANE who received treatment in our hospital from January 2016 to December 2020 were selected as the study group, and the children with Influenza-Associated Encephalopathy (IAE) group who received treatment in the same period were selected as the control group. The blood biochemical, coagulation function and cerebrospinal fluid test results of the two groups were analyzed by univariate analysis. Receiver Operating Characteristic curve (ROC) analysis was used to determine the optimal threshold point of each index for the indicators with statistically significant differences in univariate analysis results, and multivariate Logistic stepwise regression analysis was performed according to the optimal threshold points. <b>Results:</b> In the IANE group, there were 32 children, including 20 males and 12 females, aged 60 (35, 84) months. There were 40 children in IAE group, including 26 males and 14 females, aged 58 (23, 97) months. Univariate results showed that serum Lactate Dehydrogenase (LDH), Cerebrospinal Fluid Lactate Dehydrogenase (CSF LDH) and Cerebrospinal Fluid Protein (CSF PRO) in the IANE group were significantly higher than those in the IAE group, and the difference between the two groups was statistically significant (P < 0.001). The optimal threshold points of blood LDH, CSF LDH and CSF PRO by ROC curve analysis were 535 U/L, 67 U/L and 0.49 g/L, respectively. Further Multivariate Logistic stepwise regression analysis showed that LDH > 535 U/L (OR = 31.264, 95% CI: 5.892 - 165.878, P < 0.001) and CSF PRO > 0.49 g/L (OR = 7.695, 95% CI: 1.052 - 56.305, P = 0.044) were independent risk factors for IANE. <b>Conclusion:</b> For children with influenza whose neurological symptoms appear rapidly and persist in the early stages of the disease, blood LDH > 535 U/L and CSF PRO > 0.49 g/L are independent risk factors for IANE.展开更多
Dear Editor,The on-going coronavirus disease 2019(COVID-19)pandemic caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has resulted in u叩rece-dented medical and socioeconomic disruption globally.As ...Dear Editor,The on-going coronavirus disease 2019(COVID-19)pandemic caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has resulted in u叩rece-dented medical and socioeconomic disruption globally.As of late September 2021,over 231 million confirmed cases have been reported worldwide.Although the viral pathogenesis remains largely unclear,impairment of interferon(IFN)responses likely contributes to disease progression and severity(Blanco-Melo et al.,2020;Meffre and Iwasaki,2020;Min et al.,2021).Indeed,several viral proteins are potential regulators of the IFN system(Min et al.,2021).However,the underlying mechanisms employed by SARS-CoV-2 IFN antagonist candidates,such as nonstructural protein 13(NSP13),still need to be determined.展开更多
基金2024 Annual project of National Social Science Foundation“Research on Problem Identification and Governance Countermeasures of Minor Mental Health Network Support”(Project No.:24BXW044).
文摘Objective:This study aims to explore the experiences of social alienation among adolescents with depression,providing practical This study aims to explore the experiences of social alienation among adolescents with depression,providing practical guidance for improving their interpersonal relationships and facilitating their reintegration into society.Methods:This qualitative research was conducted following the conventional content analysis method.20 adolescents with depression were employed to select from June to August 2024 for face-to-face semi-structured interviews.The collected data were analyzed using Colaizzi's seven-step method.Results:Three themes and eight sub-themes were analyzed and identified:individual level(feelings of helplessness and powerlessness,cognitive distortion,avoidance and withdrawal),family level(lack of family awareness,family conflict),social level(limitations of academic stress and social circle,lack and degradation of skills,generalization of virtual reality,social“stigma”).Conclusion:Adolescents with depression experience complex social alienation.Healthcare providers should enhance their self-awareness and social adaptation skills,improve family dynamics,and provide a comprehensive range of services and services to help them to cope with the challenges of depression.Healthcare providers should enhance their self-awareness and social adaptation skills,improve family dynamics,strengthen communication,bolster family support systems,and collaborate to develop comprehensive social networks and psychological services.This will create a supportive social atmosphere to help adolescents gradually alleviate their feelings of social alienation.
文摘<b>Objective:</b> <i>Angiostrongylus cantonensis</i> (<i>A. cantonensis</i>) is an important parasite, which causes neurological infection in children, and is generally difficult to diagnose. We analyzed the significance of metagenomic next-generation sequencing in diagnosing <i>A. cantonensis</i> encephalitis/meningitis in children to provide a reference for clinical diagnosis. <b>Methods:</b> The case collection of <i>A. cantonensis</i> encephalitis/meningitis was from July 2018 to August 2020. The patients’ clinical characteristics and pathogen were described, and diagnostic sensitivity methods for <i>A. cantonensis</i> encephalitis/meningitis were compared and analyzed, including parasite antibody detection and metagenomic next-generation sequencing (mNGS) detection in different samples. <b>Results:</b> Eleven cases were diagnosed with <i>A. cantonensis</i> encephalitis/meningitis, including six males (54.5%) and five females (45.5%), and the age ranged from 1 to 13 years with a median of 21 months (IQR: 15.6, 96). All patients were undiagnosed upon admission, of which ten cases had neurological symptoms or signs, six cases (54.5%) had a history of definite or suspicious exposure to parasites, and eight cases (72.7%) had abnormal changes in cranial MRI. The results of <i>A. cantonensis</i> antibodies in the peripheral blood and cerebrospinal fluid (CSF) were compared with CSF’s metagenomic next-generation sequencing (mNGS). The antibody-positive rate of peripheral blood was 54.5%, CSF antibody-positive rate was 27.2%, and mNGS-positive rate of CSF was 81.8%, and the positive diagnostic rate of the latter was significantly higher than the former two (<i>p</i> = 0.035 < 0.05 and <i>p</i> = 0.030 < 0.05, respectively). <b>Conclusion:</b> Metagenomic next-generation sequencing has a higher positive rate for diagnosing infection and plays an important role in clarifying diagnosis and reducing misdiagnosis.
文摘Objective: Febrile convulsion in children is age-dependent and genetic predisposition. However, mild electrolyte disturbances are not uncommon in such children. This study was to investigate the effect of electrolyte disturbance on febrile convulsion and to screen for febrile convulsion-related genes. Methods: This retrospective cohort study included children who admitted to the Pediatric Emergency Department of Guangzhou Women and Children’s Medical Center due to fever and febrile convulsion between May to December 2020. Clinical manifestations and serum electrolyte levels were recorded and analyzed by binary logistic regression on risk factors of convulsion, and children with family histories were screened for febrile convulsion-related genes. Results: This study included 322 children with fever: 161 in the febrile convulsion group (FC Group) including 71 in the single convulsion group (SC Group) and 90 in the multiple convulsion group (MC Group), and the control group consisted of 161 children with fever without convulsion and nervous system disease. Serum sodium, potassium and calcium in FC Group were lower than those in the control group (p Conclusion: Hyponatremia may be a relative risk factor in febrile convulsion, and for children with a family history of febrile convulsion and serum sodium lower than 133 mmol/L, related gene analysis can be performed.
文摘Background: To explore the early clinical features and laboratory findings of influenza-associated acute necrotizing encephalopathy (IANE). Methods: The demographics data, clinical manifestations, and laboratory indicators of cases diagnosed with IANE and influenza with febrile convulsions (FS), respectively, admitted to Guangzhou Women and Children’s Medical Center from January 2016 to January 2020 were retrospectively analyzed. Results: Among the 25 cases of IANE, there were 9 males and 16 females, aged 3 to 6 years. The mortality rate was 40.00% (10/25). Influenza virus type A in 9 cases (36.00%) and influenza virus type B in 10 cases (40.00%). The main clinical manifestations of children with IANE were acute disorders of consciousness (64.00%, 16/25) and convulsions (72.00%, 18/25), which were statistically significant when compared with the FS group (P < 0.05). Typical changes on cranial MRI of IANE were cerebral edema, typically with symmetric necrosis of the thalamus and other brain structures. Significant differences (P < 0.05) existed between the IANE and FS groups in laboratory indicators for ALT, AST, CK-MB, LDH, cerebrospinal fluid (CSF) microprotein, CSF LDH, which were above the normal reference range. In addition, logistic regression analysis showed that LDH ≥ 348.5 U/L predicted a significantly higher risk of IANE. Conclusions: Children with influenza present early with acute impairment of consciousness or convulsive seizures, or with elevated AST, ALT, CK-MB, LDH, and CSF protein and CSF LDH, especially if blood LDH is ≥348.5 U/L, should be closely evaluated and alerted to the possibility of IANE.
文摘Objectives: To summarize the characteristics and research progress of influenza-associated brain complications in children and provide references for early diagnosis and brain protection treatment. Methods: Studied published articles of influenza-associated neurocomplications in children from PubMed and summarizes them from epidemiology, clinical manifestations, diagnosis and treatment, and basic research progress. Results: Common brain complications in flu-children include febrile seizures, influenza-associated encephalopathy (IAE), acute or post-influenza encephalitis, and the most severe condition is acute necrotizing encephalopathy (ANE). However, the mechanism and relevant factors of influenza-associated brain damage have not been elucidated. Conclusion: Influenza could be accompanied by various brain lesion complications in dif ferent stages of the disease, some of which are life-threatening or leave severe neurological sequelae, such as ANE. Due to different brain injury mechanisms, specific early diagnosis and brain protection treatment for different complications are unclear or unanimous. Therefore, further classification and basic research are needed.
文摘Background: The COVID-19 pandemic has led to a shortage of blood supplies for children, resulting in prolonged waiting times for transfusions. This study aims to explore the effect of timely blood transfusion on the effect and prognosis of blood transfusion in children during the COVID-19 pandemic. Methods: This retrospective cohort study included children who were indicated for blood transfusion in the Pediatric Emergency Department of Guangzhou Women and Children’s Medical Center between January 2020 and December 2020. The outcomes were the effect and the final clinical outcomes of blood transfusion. Results: This study included 260 children with non-traumatic non-surgical low Hb: 209 with timely transfusion, 40 with delayed transfusion, and 11 without transfusion;80% of children were below 60 g/L (min 17 g/L), and the waiting time for transfusion within 100.5 hours (P Conclusions: During the 100-h waiting time, there were no significant differences in outcomes among the timely, delayed, and no transfusion groups. A timely blood transfusion may not affect the clinical outcomes of children.
基金The study was supported by Guangdong Natural Science Foundation(Grant Numbers 2020A1515010014,2022A1515012411)Science and Technology Key Project for People’s Livelihood of Guangzhou,China(Grant Number 202206010060)+1 种基金Guangzhou Science and Technology Bureau Basic Research Project(SL2024A03J01288)Innovative Project of Children’s Research Institute,Guangzhou Women and Children’s Medical Center,China(Grant Numbers Pre-NSFC-2019-002,NKE PRE-2019-015).
文摘Background:During Enterovirus type 71(EV71)infection,the structural viral protein 1(VP1)activates endoplasmic reticulum(ER)stress associated with peripheral myelin protein 22(PMP22)accumulation and induces autophagy.However,the specific mechanism behind this process remains elusive.Methods:In this research,we used the VP1-overexpressing mouse Schwann cells(SCs)models co-transfected with a PMP22 silencing or Autocrine motility factor receptor(AMFR/gp78)overexpressing vector to explore the regulation of gp78 on PMP22 and its relationship with autophagy and apoptosis.Results:The activity of gp78 could be influenced by EV71-VP1,leading to a decrease in the ubiquitination and degradation of PMP22,resulting in PMP22 accumulation in ER.In VP1-overexpressing mouse SCs,all three ER stress sensors,including pancreatic endoplasmic reticulum kinase(PERK),activating transcription factor 6(ATF6)and inositol-requiring enzyme 1(IRE1)and the related downstream signals(C/EBP-homologous protein(CHOP)and Caspase 12)were activated,as well as the ER-resident chaperone Glucose-regulated protein 78(GRP78).In addition,VP1 upregulated the autophagy marker Microtubule-associated protein 1 light chain 3 beta(LC3B),while PMP22 silencing or gp78 overexpression reversed the phenomenon.Meanwhile,PMP22 silencing or gp78 overexpression increased proliferation of EV71-VP1-transfected mouse SCs.Conclusion:Gp78 could regulate PMP22 accumulation through ubiquitination degradation and cause ER stress and autophagy in EV71-VP1-overexpressing mouse SCs.Therefore,the gp78/PMP22/ER stress axis might emerge as a promising therapeutic target for myelin and neuronal damage induced by EV71 infection.
文摘Background: Bloodstream infection is a serious infectious disease. In recent years, the drug resistance of pathogenic bacteria to commonly used anti-infective drugs has been widely concerned, which also makes the treatment of bloodstream infection face severe challenges. Objective: To explore the distribution characteristics of blood culture-positive pathogens and the resistance to antibacterial drugs, so as to provide clinicians with accurate laboratory evidence, so as to guide clinicians to rationally apply antibiotics, improve clinical treatment effects, and reduce the emergence of drug-resistant strains. Methods: From January 2019 to June 2022, 2287 positive blood culture specimens of patients in Guangzhou Women and Children’s Medical Center were retrospectively analyzed, and the proportion of different pathogenic bacteria, the distribution of pathogenic bacteria in different departments, and the multi-drug resistance of different pathogenic bacteria were counted. Results: Among the 2287 blood culture positive samples, 1560 strains (68.20%) of gram-positive bacteria and 727 strains (31.80%) of gram-negative bacteria were strained. The top three departments in the distribution of pathogenic bacteria were pediatric intensive care unit (600 strains), pediatric internal medicine (514 strains), and pediatric emergency comprehensive ward (400 strains). The pathogens with high detection rates were: Staphylococcus epidermidis (24.09%), Staphylococcus humans (23.74%), Escherichia coli (13.21%) and Klebsiella pneumoniae (8.71%). The pathogens with high multi-drug resistance rates were: Streptococcus pneumoniae (93%), Staphylococcus epidermidis (83.76%), Enterobacter cloacae (75.61%) and Staphylococcus humans (62.43%). Conclusion: In our hospital, gram-positive bacteria were the main pathogenic bacteria in the blood culture of children patients. The children’s intensive care unit was the department with the largest distribution of pathogenic bacteria, and the multiple drug resistance rate of Streptococcus pneumoniae was the highest.
文摘Background: Guangzhou Women and Children’s Medical Center was chosen as the designated facility for screening, diagnosing, and treating children in Guangzhou with SARS-CoV-2 infection after the COVID-19 outbreak in China. From January 23 to March 20, 2020, the center opened new wards for screening and treatment, taking measures to prevent and control nosocomial infections. This article summarizes and evaluates measures for preventing and controlling nosocomial infections to provide reference information during the pandemic. Methods: The COVID-19 nosocomial infection prevention and control strategies were summarized and analyzed, including the formulation of the hospital partition, the improvement of the hospitalization process, environmental cleaning and disinfection, graded protection based on risk assessment, enhanced training on-site quality control inspection, data monitoring and evaluation, among others, and evaluating the effects by comparing before and after the intervention. Results: There were 159 patients admitted to the screening wards, including 98 males and 61 females, with a median age of 34 years (interquartile range (IQR): 15, 60) months. There were no abnormal findings in these patients and their families during follow-up. During the screening ward opening period, hand hygiene compliance was significantly improved. Fifty staff members in close contact with the contaminated area had tested for SARS-CoV-2 nucleic acid by polymerase chain reaction (PCR), which showed zero infections and no nosocomial infections occurred. Conclusions: For SARS-CoV-2 nosocomial infections, taking the “standard prevention & contact isolation & droplet isolation & air isolation” strategies can prevent patients and staff effectively.
文摘Influenza-associated encephalopathy (IAE) can perform as varying patterns of neuroimaging. Central brain herniation (CBH) secondary to IAE is rare;it may be a bad prognosis. Here, we presented a 4-year-old girl with influenza who had a pontocerebellar hypoplasia (PCH) history;she performed the second Magnetic Resonance Imaging (MRI) on Day 6 from onset, showed the diffuse edema and the occurrence of central herniation;the medulla was “Z-like” folded and the basal cisterns were obliterated completely. Finally she was declared dead. The imbalance between supratentorial and infratentorial pressure can lead to the occurrence of CBH. Severe edema relates to IAE and unstable structure of the posterior fossa might be the main reason for the herniation. MRI is helpful in early diagnosis. Early treatment of cerebral edema in patients with congenital abnormalities of the posterior fossa is vital for their management.
文摘Objective: The related factors of no improvement of hypoxia and ineffective infusion were analyzed to provide new ideas, clinical observation and evaluation pathway for RBC transfusion in clinical children. Methods: Retrospective analysis from January 2020 to December 2020, Guangzhou women and children’s medical center hospital in the emergency observation room of 249 children under 1 month to 18 years of blood cell suspension infusion, analyze the clinical effect of red blood cell infusion and children gender, age, fever after transfusion, disease type, delay transfusion. The possible influencing factors were analyzed by logistic regression. Results: Invalid transfusion was associated with the type of transfusion product (P = 0.032), logistic regression analysis showed that patients infused with washed RBC suspension were 3.231 times more likely to not achieve the expected effect than those infused with RBC suspension (P = 0.025). Failure transfusion was associated with the type of transfusion products. In ineffective transfusion was closely related to post-transfusion fever (P P P = 0.031). Logistic regression analysis showed that fever after transfusion was a risk factor for no improvement of hypoxia (OR = 5.809, P = 0.001), and the improvement of hypoxia in adolescent children was 10.744 times higher than that of infants (0 - 3 years old). Late transfusion hypoxia improvement was 4.212 times more likely to achieve no effect than timely transfusion. If ineffective infusion of red blood cells is considered and hypoxia after transfusion is not improved, univariate suggests a close correlation with fever after transfusion (P = 0.002), logistic regression analysis showed that fever after transfusion was an independent risk factor (OR = 7.258, P = 0.002). Conclusion: There was no correlation between the ineffective transfusion of red blood cells and the type of disease affected in the child. Infusion of red cell suspension has an advantage over the wash red cell infusion. Ineffective RBC transfusion and no improvement in hypoxia after transfusion were closely related to post-transfusion fever, with no difference between children in all age groups. Red blood cell infusion in pediatric clinical treatment activities should pay attention to adolescent children, especially female children to give more attention, and give timely red blood cell infusion as much as possible.
文摘<b>Objective:</b> A case-control study of Influenza-Associated Necrotizing Encephalopathy (IANE) in children was conducted to explore the risk factors for the diagnosis of IANE, and to provide a predictive reference for the diagnosis of IANE. <b>Methods:</b> The children with IANE who received treatment in our hospital from January 2016 to December 2020 were selected as the study group, and the children with Influenza-Associated Encephalopathy (IAE) group who received treatment in the same period were selected as the control group. The blood biochemical, coagulation function and cerebrospinal fluid test results of the two groups were analyzed by univariate analysis. Receiver Operating Characteristic curve (ROC) analysis was used to determine the optimal threshold point of each index for the indicators with statistically significant differences in univariate analysis results, and multivariate Logistic stepwise regression analysis was performed according to the optimal threshold points. <b>Results:</b> In the IANE group, there were 32 children, including 20 males and 12 females, aged 60 (35, 84) months. There were 40 children in IAE group, including 26 males and 14 females, aged 58 (23, 97) months. Univariate results showed that serum Lactate Dehydrogenase (LDH), Cerebrospinal Fluid Lactate Dehydrogenase (CSF LDH) and Cerebrospinal Fluid Protein (CSF PRO) in the IANE group were significantly higher than those in the IAE group, and the difference between the two groups was statistically significant (P < 0.001). The optimal threshold points of blood LDH, CSF LDH and CSF PRO by ROC curve analysis were 535 U/L, 67 U/L and 0.49 g/L, respectively. Further Multivariate Logistic stepwise regression analysis showed that LDH > 535 U/L (OR = 31.264, 95% CI: 5.892 - 165.878, P < 0.001) and CSF PRO > 0.49 g/L (OR = 7.695, 95% CI: 1.052 - 56.305, P = 0.044) were independent risk factors for IANE. <b>Conclusion:</b> For children with influenza whose neurological symptoms appear rapidly and persist in the early stages of the disease, blood LDH > 535 U/L and CSF PRO > 0.49 g/L are independent risk factors for IANE.
基金supported by grants from the National Natural Science Foundation of China(31870162 and 82161138003)the National Key Research and Development Program of China(2018YFA0507202)the Youth Innovation Promotion Association of Chinese Academy of Sciences.
文摘Dear Editor,The on-going coronavirus disease 2019(COVID-19)pandemic caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has resulted in u叩rece-dented medical and socioeconomic disruption globally.As of late September 2021,over 231 million confirmed cases have been reported worldwide.Although the viral pathogenesis remains largely unclear,impairment of interferon(IFN)responses likely contributes to disease progression and severity(Blanco-Melo et al.,2020;Meffre and Iwasaki,2020;Min et al.,2021).Indeed,several viral proteins are potential regulators of the IFN system(Min et al.,2021).However,the underlying mechanisms employed by SARS-CoV-2 IFN antagonist candidates,such as nonstructural protein 13(NSP13),still need to be determined.
