Objective:To observe the efficacy of LIU’s infantile Tuina(Chinese therapeutic massage)combined with Bi Yan Gao in treating allergic rhinitis(AR)in kids and the impact on serum inflammatory factors.Methods:A total of...Objective:To observe the efficacy of LIU’s infantile Tuina(Chinese therapeutic massage)combined with Bi Yan Gao in treating allergic rhinitis(AR)in kids and the impact on serum inflammatory factors.Methods:A total of 120 kids with AR were recruited and divided into a Tuina group,a Bi Yan Gao group,and a combined group using the random number table method,with 40 cases in each group.The three groups all received oral desloratadine syrup as the basic intervention.In addition,the Tuina group was treated with LIU’s infantile Tuina therapy once daily;the BI Yan Gao group received external application of Bi Yan Gao,once every morning and night;the combined group was intervened by LIU’s infantile Tuina plus Bi Yan Gao external application.The intervention lasted for 8 weeks.Before and after the intervention,the total nasal symptom score(TNSS)was compared,and the serum levels of interleukin(IL)-4,IL-6,IL-8,and immunoglobulin E(IgE)were detected.The total effective rate was also compared among the three groups.Results:After 8 weeks of treatment,the total effective rate was 87.2%in the combined group,60.5%in the Tuina group,and 57.5%in the Bi Yan Gao group,showing significant between-group differences(P<0.05).The contents of serum IL-6,IL-8,and IgE were lower in the combined group compared to the Tuina and Bi Yan Gao groups,presenting statistical significance(P<0.05).The level of IL-4 was statistically parallel across the three groups(P>0.05).Conclusion:The combined use of LIU’s infantile Tuina and Bi Yan Gao can improve nasal symptoms and lower the levels of serum inflammatory factors and IgE in kids with AR,producing a higher total effective rate compared to the separate use of the two approaches.展开更多
Background:Continuous care for children with enterostomy and their families has been gaining popularity in China.Objective:To evaluate the feasibility of continuous care for children with enterostomy and their familie...Background:Continuous care for children with enterostomy and their families has been gaining popularity in China.Objective:To evaluate the feasibility of continuous care for children with enterostomy and their families in China.Methods:The PubMed,Web of Science,Embase,Cochrane Library,EBSCO,CNKI,CBM,VIP,and WanFang were searched for clinical trials until December 30,2025.Two reviewers independently searched articles,evaluated quality and extracted data.This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA).Results:33 studies involving 2774 participants were included.The meta-analysis showed that continuous care strategy can significantly reduce the incidence of complications in children with enterostomy(OR=0.20,95%CI=0.16-0.26,p<0.001,I2=0%),effectively improve the family caregiver ability for enterostomy(MD=-10.34,95%CI=-13.82 to-6.85,p<0.001,I2=99%),shorten the time for family members to replace stoma bags(MD=-13.57,95%CI=-19.66 to-7.49,p<0.001,I2=100%),and alleviate negative emotions such as anxiety(SMD=-1.80,95%CI=-2.36 to-1.23,p<0.001,I2=92%)and depression(SMD=-1.54,95%CI=-2.04 to-1.04,p<0.001,I2=89%)in the families of the affected children.Conclusions:Continuous care can reduce complications of enterostomy in children,improve the family caregiver ability for enterostomy and alleviate negative emotions of family members such as anxiety and depression.展开更多
Hepatoblastoma(HB)is the most common primary malignant liver tumor in children,representing approximately 50%to 60%of pediatric liver cancers.It predominantly affects children under the age of 3 years,with a slightly ...Hepatoblastoma(HB)is the most common primary malignant liver tumor in children,representing approximately 50%to 60%of pediatric liver cancers.It predominantly affects children under the age of 3 years,with a slightly higher incidence in boys compared to girls.The main pathological subtypes of HB are epithelial and mixed types.The etiology and pathogenesis are unclear and may be related to factors such as genetics and gene mutations.The diagnosis primarily relies on imaging examinations(including abdominal ultrasound,computed tomography,and magnetic resonance imaging)and serum alpha-fetoprotein testing.Treatment approaches include surgical resection,chemotherapy,and liver transplantation.Surgical resection is currently the only curative option,especially effective for early-stage localized tumors;chemotherapy can be used to shrink tumors before surgery or to manage their progression;liver transplantation is recommended for cases that cannot be surgically removed or for instances where the disease recurs after surgery.Recent advancements have encouraged a mul-tidisciplinary approach to treatment,with ongoing research into new chemothera-peutic and targeted agents.Despite these developments,challenges remain,such as the need for more precise and individualized therapies,chemotherapy resistance that can lead to poor outcomes in some patients,and a shortage of organ donors,along with the risk of immune rejection after transplantation.A thorough synthesis of current therapeutic strategies will establish an evidence-based foundation to enhance the management of HB in children,ultimately improving prognosis and quality of life.展开更多
BACKGROUND In multisystem inflammatory syndrome in children(MIS-C)with coronavirus disease 2019,there was paucity of data from low-income and middle-income countries on cardiovascular involvement and its longitudinal ...BACKGROUND In multisystem inflammatory syndrome in children(MIS-C)with coronavirus disease 2019,there was paucity of data from low-income and middle-income countries on cardiovascular involvement and its longitudinal outcomes.We planned to estimate the pattern of cardiovascular involvement among children with MIS-C and its mid-term outcomes.AIM To determine association between cardiovascular abnormalities and clinical and laboratory parameters.To study the time-line for resolution of various abnormalities.METHODS In this prospective study done in a tertiary care hospital,270 were recruited from June 2020 to January 2022.Baseline demographic data and clinical presentation were recorded.Laboratory parameters and echocardiography were done at admission.Follow-up was done at 2 weeks,3 months,6 months and 1 year after diagnosis.Descriptive statistics were used for parametric and non-parametric data.Risk factors were identified by multivariate regression analysis.RESULTS The 211(78.2%)had cardiac involvement and 102 needed intensive care unit(ICU)admission.Cardiovascular abnormalities observed were shock 123(45.6%),coronary dilatation 28(10.4%),coronary aneurysm 77(28.5%),left ventricular(LV)dysfunction 78(29.3%),mitral regurgitation(MR)77(28.5%)and pericardial effusion 98(36.3%).Coronary artery aneurysm/dilatation during follow-up at 2 weeks and 1 year were 25.7%and 0.9%respectively.Multivariate regression analysis revealed breathlessness[odds ratio(OR)=3.91,95%CI:1.25-12.21,P=0.019]and hi-flow nasal cannula(HFNC)support(OR=8.5,95%CI:1.06-68.38,P=0.044)as predictors of cardiovascular involvement.Higher mean age(OR=1.16,95%CI:1.02-1.32,P=0.026),breathlessness(OR=4.99,95%CI:2.05-12.20,P<0.001),gallop(OR=4.45,95%CI:0.41-2.52,P=0.016),MR(OR=3.61,95%CI:1.53-8.53,P=0.004)and invasive ventilation(OR=4.01,95%CI:1.28-12.58,P=0.017)were predictive of LV dysfunction.Altered sensorium(OR=4.96,95%CI:2.23-11.02,P<0.001),headache(OR=6.61,95%CI:1.46-29.92,P=0.014),HFNC(OR=7.03,95%CI:2.04-24.29,P=0.002),non-rebreathing mask usage(OR=21.13,95%CI:9.00-49.61,P<0.001)and invasive ventilation(OR=5.64,95%CI:1.42-22.45,P=0.014)were risk factors for shock.Anemia was a risk factor for coronary involvement(OR=3.09,95%CI:1.79-5.34,P<0.001).CONCLUSION Significant number of children with MIS-C had cardiovascular involvement contributing to higher ICU management.Although shock resolved quickly,resolution of ventricular function and coronary abnormalities were slower,and hence warrants a structured long-term follow-up protocol.展开更多
AIM:To compare the efficacy of different administration regimens of compound tropicamide eyedrops(CTE)for pupil dilation for children with dark iris.METHODS:A prospective,comparative,randomized interventional study wa...AIM:To compare the efficacy of different administration regimens of compound tropicamide eyedrops(CTE)for pupil dilation for children with dark iris.METHODS:A prospective,comparative,randomized interventional study was conducted.Children in Group 1 received CTE 3 times with a 3min interval between each application.Children in Group 2 received CTE 4 times with a 5min interval between each application.We measured their pupil diameters at baseline(pre-drug instillation)and 30min and 60min post-drug instillation and assessed the pupillary light reflex at 60min post-drug instillation.RESULTS:In total,194 eyes of 101 children were enrolled.The changes of pupil diameter at 30min and 60min post-drug instillation were 1.2±0.6 mm and 2.3±1.0 mm in Group 1,and 2.3±0.9 mm and 3.7±1.0 mm in Group 2,respectively.Group 2 showed a larger change in pupil size than Group 1 at 30min(P<0.01)and 60min(P<0.01).The effect of pupil dilation in Group 2 was 1.25 times that in Group 1.The change in pupil size was positively associated with age.A higher proportion of children in Group 1 had smaller pupil diameter and reactive pupils at the final time point,with only 33 children(33.7%)had final pupil size≥6.5 mm,and only 9 children(9.2%)had non-reactive pupils.Children in Group 2 achieved larger pupil diameter and more nonreactive pupils at the final time point,with 84 children(87.5%)had final pupil size≥6.5 mm,and only 22 children(22.9%)had reactive pupils.CONCLUSION:Increasing the frequency of compound tropicamide and lengthening the interval between eye drop applications can produce stronger mydriatic effects.展开更多
BACKGROUND Gastric adenomyoma(GA)in children is a relatively rare condition,and currently,there is limited knowledge regarding its optimal diagnostic methods and treatment strategies.To improve our understanding GA pa...BACKGROUND Gastric adenomyoma(GA)in children is a relatively rare condition,and currently,there is limited knowledge regarding its optimal diagnostic methods and treatment strategies.To improve our understanding GA particularly in children,one case of a 4-month-old boy was reported and existing literature was comprehensively reviewed.CASE SUMMARY A 4-month-old boy was admitted to the hospital with a 2-month history of recurrent vomiting of gastric contents.Ultrasound examination demonstrated that the pyloric canal muscle was 3.2 mm in thickness,14.6 mm in diameter,and 17.6 mm in length.Pathological finding showed that a mass approximately 2.8 cm×2 cm×1.5 cm in size and grayish-white in color was detected.The cystic wall was composed of smooth muscles lined with the gastric mucosal epithelium and a small amount of intestinal epithelium.Scattered glandular epithelium and a small amount of pancreatic tissue were observed in smooth muscle.Immunohistochemistry revealed positivity for gastrin,insulin,and smooth muscle actin,confirming the diagnosis of GA.In addition,the Ki-67 proliferation index was low.CONCLUSION We report a case of GA in children,successfully treated with laparoscopic surgery.Ultrasound and computed tomography may be helpful in differential diagnosis when detecting low-density septal lesions biased toward one side.We also review the existing literature data regarding GA in children.展开更多
Objective Previous studies have yielded contradictory conclusions on the relationship between intermittent exotropia(IXT)and the magnitude of myopia,especially in children.The aim of this study was to determine the cl...Objective Previous studies have yielded contradictory conclusions on the relationship between intermittent exotropia(IXT)and the magnitude of myopia,especially in children.The aim of this study was to determine the clinical characteristics of IXT in children with myopia and myopic anisometropia.Methods We retrospectively evaluated the clinical data of patients(4–15 years of age)with convergence insufficiency(CI)-IXT and basic IXT who underwent surgery between 2022 and 2023.All patients underwent cycloplegia before the examinations and surgery.The degree of strabismus was measured when the patient viewed from the center of the glasses.Ocular dominance was routinely tested in children with IXT via the“hole-in-card test”after best-corrected visual acuity was obtained.Children were subsequently grouped into 2 groups(anisometropia and nonanisometropia)according to the difference in binocular spherical equivalent(SE)values(≥1.0 diopters[D]).Results A total of 197 patients were included in the study.The preoperative deviation at near was significantly lower in the basic IXT group than in the CI-IXT group,whereas the distance exodeviation was significantly greater in the basic IXT group than in the CI-IXT group(P<0.05).Patients with anisometropia were older than those without anisometropia(P<0.001).The dominant eyes had significantly less myopia than the nondominant eyes did in the CI-IXT and anisometropia groups(P=0.049 and P=0.003,respectively).High myopia was more prevalent in middle school students with IXT(16.67%)than in preschool students(4.55%)and primary schoolchildren(3.18%).The percentage of individuals with anisometropia(≥3.0 D)varied in the low(1.68%),moderate(8.7%),and high myopia groups(22.22%).Binomial logistic regression analysis revealed that age and SE of the dominant eye were independent factors related to anisometropia in children with IXT(P<0.001 and P<0.001,respectively).Conclusion Patients with IXT,especially those with anisometropia and CI-IXT,were shown to have less myopia in the dominant eye.Age and SE of the dominant eye were found to be independent factors related to anisometropia in children with IXT.展开更多
Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention a...Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention and management of mental disorders.Methods In this hospital-based retrospective study,we utilized child and adolescent medical records data from the Wuhan Mental Health Center from January 2014 to December 2022 and examined the top 5 mental disorders(schizophrenia,depressive episode,bipolar disorder,pervasive developmental disorder,and unspecified mood disorder)that accounted for the overall proportion of patients admitted.The rank and proportion of these mental disorders,demographic characteristics and disease indicators were analysed.Results There was a significant upwards trend in the number of children and adolescents diagnosed with mental disorders over the past 9 years,with a sharp decline in 2020 due to the COVID-19 pandemic,followed by a rebound in 2021 and a sustained level above prepandemic figures by 2022.The average age of hospitalization decreased significantly from 20.7 to 16.2 years,with a marked increase in the 12-17-year-old age group.The proportion of female hospitalizations increased from 39.2%to 55.2%,with a corresponding decrease in male hospitalizations.There was a notable decrease in the proportion of schizophrenia cases and an ascent of depressive episode to the most prevalent position.Conclusion This study emphasizes the critical need for targeted interventions and resources for severe mental disorders in children and adolescents and the importance of early detection and management of mental disorders to mitigate long-term effects on well-being and development.展开更多
The aim of this study was to investigate the trend in testicular volume changes after orchiopexy in children with cryptorchidism.The clinical data of 854 children with cryptorchidism who underwent orchiopexy between J...The aim of this study was to investigate the trend in testicular volume changes after orchiopexy in children with cryptorchidism.The clinical data of 854 children with cryptorchidism who underwent orchiopexy between January 2013 and December 2016 in Shenzhen Children’s Hospital(Shenzhen,China)were retrospectively analyzed.The mean(standard deviation)age of the patients was 2.8(2.5)years,and the duration of follow-up ranged from 1 year to 5 years.Ultrasonography was conducted preoperatively and postoperatively.The variables analyzed included age at the time of surgery,type of surgical procedure,laterality,preoperative testicular position,preoperative and postoperative testicular volumes,and the testicular volume ratio of them.The average testicular volumes preoperatively and at 1 year,2 years,3 years,and 5 years postoperatively were 0.27 ml,0.38 ml,0.53 ml,0.87 ml,and 1.00 ml,respectively(P<0.001).The corresponding testicular volume ratios were 0.67,0.76,0.80,0.83,and 0.84(P<0.001).The mean volume of the undescended testes was significantly smaller than the mean normative value(P<0.001,lower than the 10th percentile).The postoperative testicular volumes in children with cryptorchidism were generally lower than those in healthy boys but were still greater than the 10th percentile and exhibited an increasing trend.The older the child is at the time of surgery,the larger the gap in volume between the affected and normal testes.Although testicular volume tends to gradually increase after orchiopexy for cryptorchidism,it could not normalizes.Earlier surgery results in affected testicular volumes closer to those of healthy boys.展开更多
BACKGROUND Childhood intestinal lymphoma is characterized by its insidious onset and the absence of specific clinical symptoms.The thinner abdominal wall in children significantly aids in the ultrasound visualization ...BACKGROUND Childhood intestinal lymphoma is characterized by its insidious onset and the absence of specific clinical symptoms.The thinner abdominal wall in children significantly aids in the ultrasound visualization of the abdominal cavity and intestines.Although many typical cases of intestinal lymphoma can be diagnosed through ultrasound,physicians often either overlook these values or assume that ultrasound has limited diagnostic value for intestinal lymphoma.AIM To clarify the diagnosis of intestinal lymphoma and classify its severity using ultrasound,as well as to correlate this with prognosis.METHODS The correlation between ultrasound diagnostic outcomes,laboratory indicators,and clinical prognosis was analyzed to demonstrate the effectiveness of ultrasound in assessing the severity of intestinal lymphoma and to provide new evidence for the diagnosis and treatment of the disease in children.A retro-spective analysis was conducted on the sonographic images and case data of 28 children diagnosed with intestinal lymphoma and confirmed by surgical pathology.Additionally,we sought to determine the correlation between ultrasonic classification of lymphoma,lactate dehydrogenase(LDH)values,pathological classification,and prognosis.RESULTS Ultrasound was utilized to categorize 28 cases of intestinal lymphoma into focal segmental(15 cases)and extensive(13 cases)types.Ultrasound classification and LDH levels were significantly correlated with prognosis(P<0.05),while pathological type,age,gender,and treatment modality showed no significant correlation(P>0.05).Among ultrasound manifestations,there was a significant difference in LDH levels between the segmental and extensive groups(P<0.05).The prognosis for children with extensive intestinal lymphoma was poorer than that for children with localized segmental intestinal lymphoma(P<0.05).CONCLUSION Ultrasound can be used in the diagnosis and classification of intestinal lymphoma in children.Extensive intestinal lymphoma is associated with significantly elevated LDH and poor prognosis.展开更多
This study analyzed case and prescription data of children aged 12 to 18 years diagnosed with influenza A from the outpatient and emergency departments at the Women and Children’s Hospital of Ningbo University during...This study analyzed case and prescription data of children aged 12 to 18 years diagnosed with influenza A from the outpatient and emergency departments at the Women and Children’s Hospital of Ningbo University during the influenza epidemic period between February and April 2023.Patients were categorized into two groups based on their medication:the Baloxavir Marboxil group(196 cases)and the Oseltamivir group(126 cases).SPSS Statistics 24.0 software was utilized to compare variables between the two groups,including age,sex,weight,first visit department,number of visits,average prescription cost per patient,drug varieties used,hospitalization rate,and the combined medication usage,to evaluate the relative advantages and disadvantages of the two treatments.The results indicated that the number of visits in the Baloxavir Marboxil group was significantly lower than in the Oseltamivir group,whereas the average prescription cost per patient was higher(P<0.05).There were no significant differences between the two groups regarding age,sex,weight,first visit department,number of drug types used,hospitalization rate,or combined medication usage(P>0.05).When comparing the use of single-class combined drugs,only the quantity of antiviral drugs differed significantly(P<0.05).The Oseltamivir group required more adjuvant treatment with both Chinese and Western antiviral medications.The distribution of the number of combined drug types was concentrated around three and two types in both groups(Baloxavir Marboxil group:41.34%and 39.66%;Oseltamivir group:44.54%and 36.97%).This study highlighted that the new drug,Baloxavir Marboxil,offered certain therapeutic benefits over Oseltamivir in treating influenza among children aged 12 to 18 years,including advantages in single-dose administration,oral compliance,and specific treatment outcomes.The higher unit cost associated with Baloxavir Marboxil might be a factor for further consideration.These findings provided a new reference point for the clinical selection of anti-influenza medications.展开更多
[Objectives]This study was conducted to explore the curative effect of Qingfei Ditan decoction combined with targeted drug penetration therapy of traditional Chinese medicine on severe mycoplasma pneumonia in children...[Objectives]This study was conducted to explore the curative effect of Qingfei Ditan decoction combined with targeted drug penetration therapy of traditional Chinese medicine on severe mycoplasma pneumonia in children.[Methods]Based on the retrospective study method,children with severe mycoplasma pneumonia admitted to the Children s Hospital of Soochow University from April 2023 to October 2023 were selected,and divided into a treatment group including 56 cases and a control group including 145 cases.The curative effect and adverse reactions of the two groups were compared.[Results]The total effective rate of the treatment group was higher than that of the control group,and the disappearance time of cough and lung rales was shorter than that of the control group,and the incidence of adverse reactions was lower,showing statistical significance(P<0.05).However,defervescence time and bronchoscope flushing rate showed no significant difference(P>0.05).[Conclusions]Qingfei Ditan Decoction combined with targeted drug penetration therapy of traditional Chinese medicine has a significant effect on severe mycoplasma pneumonia in children,and can reduce the side effects of drugs.It is a safe and efficient combination treatment scheme of traditional Chinese medicine.展开更多
Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus(HAdV),particularly in children with acute respiratory tract infections(ARIs).Therefore,continual monitoring ...Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus(HAdV),particularly in children with acute respiratory tract infections(ARIs).Therefore,continual monitoring of these events is essential for effective viral surveillance and control.Methods Respiratory specimens were collected from children with ARIs between January 2022 and December 2023.The penton base,hexon,and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type.In cases with inconsistent typing results,genes were cloned into the pGEM-T vector to detect recombination events.Metagenomic next-generation sequencing(mNGS)was performed to characterize the recombinant HAdV genomes.Results Among 6,771 specimens,277(4.09%,277/6,771)were positvie for HAdV,of which 157(56.68%,157/277)were successfully typed,with HAdV-B3 being the dominant type(91.08%,143/157),and 14(5.05%,14/277)exhibited inconsistent typing results,six of which belonged to species B.The penton base genes of these six specimens were classified as HAdV-B7,whereas their hexon and fiber genes were classified as HAdV-B3,resulting in a recombinant genotype designated P7H3F3,which closely resembled HAdV-B114.Additionally,a partial gene encoding L152/55 kD was identified,which originated from HAdV-B16.Conclusion A novel recombinant,P7H3F3,was identified,containing sequences derived from HAdV-B3 and HAdV-B7,which is similar to HAdV-B114,along with additional sequences from HAdV-B16.展开更多
Introduction Choledochal cysts(CCs)are cystic dilatations of the intrahepatic and/or extrahepatic biliary ducts that affect primarily female infants[1-3].CCs vary markedly in incidence worldwide:the incidence is appro...Introduction Choledochal cysts(CCs)are cystic dilatations of the intrahepatic and/or extrahepatic biliary ducts that affect primarily female infants[1-3].CCs vary markedly in incidence worldwide:the incidence is approximately 1 in 100,000 to 1 in 150,000 live births in Western countries and 1 in 1,000 people in Asian countries[4].展开更多
Background:Even though various research has demonstrated the connection between consanguinity and health issues,consanguineous marriage still common in Egypt with high prevalence rate 35.3%,23.5%in semi-urban and 17.7...Background:Even though various research has demonstrated the connection between consanguinity and health issues,consanguineous marriage still common in Egypt with high prevalence rate 35.3%,23.5%in semi-urban and 17.7%in urban areas.Methods:This study was conducted on 434native Arabic-speaking Egyptians children(3-10 years)who visited Special Needs Clinic at National Research Centre,among one year presenting with a hearing or/and language problem.They were subjected to psychometric assessment,Conners'Parent Rating Scales-Revised,Autism Diagnostic Interview Revised,Childhood Autism Rating Scale,audiological assessment,and Arabic Preschool Language Scale-4.Participants were classified into 6 subgroups according to the cause of language delay.We estimated the frequency and degree of consanguinity in each group and the association between consanguinity and hearing and language problems.Results:The prevalence of the consanguineous marriage in all participants(n=434)was31.6%with the mean inbreeding coefficient of 0.01208.First cousins'marriages were the most common type of consanguineous marriages(50.3%of consanguineous marriages).Among all participants in the 6 subgroups(n=434),language delay secondary to cognitive delay showed the highest percentage of consanguineous marriages(35%)followed by autism spectrum disorder(32.8%).No significant association between consanguinity and language problems.Among the 78 participants with sensorineural hearing loss,35.9%of consanguineous couples(no.=28 cases)were reported versus 64.1%of non-consanguineous couples(no.=50 cases).Conclusions:The Frequency of consanguineous marriages in our participants was 31.6%which was close to that reported in Egyptian population.Absence of significant association between consanguinity and language problems warrants further investigation and point to the role of genetic-environment interplay in cases of language delay.展开更多
BACKGROUND Mycoplasma pneumoniae(M.pneumoniae)is considered to be one of the causative agents of community acquired pneumonia in children with general or severe course of disease.Severe M.pneumoniae pneumonia(SMPP)has...BACKGROUND Mycoplasma pneumoniae(M.pneumoniae)is considered to be one of the causative agents of community acquired pneumonia in children with general or severe course of disease.Severe M.pneumoniae pneumonia(SMPP)has emerged as a crucial global health concern due to high mortality rate in children under 5 years,potentially life-threatening complications,and growing challenges in pediatric treatment associated with rising macrolide resistance.Additionally,MPP can be complicated by other bacterial and/or viral pathogens,which may exacerbate disease severity.After the lifting of strict non-pharmaceutical interventions(NPIs)worldwide,the dramatic rise of incidence of MPP in Asia and Europe was observed.AIM To perform the comprehensive study of community acquired MPP cases registered in 2023 in Baoding Hospital,China.METHODS A total of 1160 children from 1 month to 15 years old with confirmed MPP diagnosis were enrolled in the study.The blood and respiratory samples were collected within the 24 hours after admission.The hematological parameters,biochemical markers,cytokine profiles were assessed.The respiratory samples were tested for the presence of M.pneumoniae and other 23 bacterial/viral pathogens by multiplex polymerase chain reaction(PCR).The macrolide resistance mutations(A2063G,A2064G in the 23S rRNA gene of M.pneumoniae)were determined by PCR.RESULTS Number of MPP cases has dramatically increased starting August with peak in November.SMPP and general MPP(GMPP)were identified in 264 and 896 of 1160 hospitalized children.The binary logistic regression analysis identified six[C-reactive protein(CRP),lactate dehydrogenase,procalcitonin,erythrocyte sedimentation rate,fibrin and fibrinogen degradation products(FDPs),D-dimer]and four(neutrophils,CRP,FDPs,prothrombin time)predictors of SMPP in age groups 2-5 years and 6-15 years,respectively.Children with SMPP showed significantly higher levels of cytokine interleukin(IL)-17F(2-5 years),and cytokines interferon-gamma,tumor necrosis factoralpha,IL-10(6-13 years).Concomitant viral/bacterial pathogens were determined in 24.3%and 28.0%cases of SMPP and GMPP.Among them,Streptococcus pneumoniae(S.pneumoniae)and Haemophilus influenzae(H.influenzae)were predominant.93.2%cases of MPP were associated with macrolide resistant M.pneumoniae.CONCLUSION Specific MPP epidemiological pattern associated with lifting NPIs was revealed:Increase of hospitalized cases,prevalence of S.pneumoniae and H.influenzae among concomitant pathogens,93.2%of macrolide resistant M.pneumonia.展开更多
Testicular torsion is a urological emergency that requires prompt diagnosis and treatment,accounting for 10%-15%of cases of acute scrotum.[1]It occurs most frequently during the perinatal period and adolescence and ca...Testicular torsion is a urological emergency that requires prompt diagnosis and treatment,accounting for 10%-15%of cases of acute scrotum.[1]It occurs most frequently during the perinatal period and adolescence and can occur at any age.[2]The incidence of testicular torsion is 1/4,000 in males under 25 years of age and 1/160 in males over 25 years of age.[3]Unilateral torsion is relatively common,with a higher incidence on the left side.Testicular torsion is typically managed through surgical exploration.Necrotic testes,identified by a black appearance,require orchiectomy.[4]展开更多
BACKGROUND Cryptococcus is a systemic opportunistic pathogenic fungus that can cause infections in both immunocompromised and immunocompetent hosts,with diverse clinical manifestations,ranging from asymptomatic pulmon...BACKGROUND Cryptococcus is a systemic opportunistic pathogenic fungus that can cause infections in both immunocompromised and immunocompetent hosts,with diverse clinical manifestations,ranging from asymptomatic pulmonary lesions to disseminated central nervous system infections.The incidence of pulmonary cryptococcosis(PC)has rapidly increased in recent years,with an increasing proportion of non-human immunodeficiency virus-infected and immunocompetent patients making its diagnosis challenging.If not properly recognized,PC can lead to systemic dissemination and high mortality rates.Early diagnosis and treatment can improve the prognosis.This study summarizes the clinical features of three immunocompetent children with PC who presented with chest pain to raise clinicians'awareness of the disease and reduce mortality.CASE SUMMARY Three male pediatric patients in good health were hospitalized because of chest pain without cough or fever.Chest computed tomography(CT)revealed pleuralbased nodules and consolidation with cavitation.A lung biopsy was performed in one case,and Cryptococcus was cultured from the pathological tissues.Cryptococcus was detected in the alveolar lavage fluid,and serum Cryptococcus capsular(C.capsular)polysaccharide antigen was positive in one case,and the other case was positive for serum C.capsular polysaccharide.All patients received oral fluconazole treatment.Follow-up chest CT scans after six months showed significant resolution of the lesions.CONCLUSION PC can also occur in immunocompetent children.When encountering children with chest pain only in the clinic,one should be vigilant about PC,promptly complete the relevant examinations,and avoid misdiagnosis.展开更多
Background Pulmonary arterial hypertension (PAH) is a progressive condition with a poorprognosis in children. Lung transplantation (Ltx) remains the ultimate option when patients are refractory toPAH-speciffc therapy....Background Pulmonary arterial hypertension (PAH) is a progressive condition with a poorprognosis in children. Lung transplantation (Ltx) remains the ultimate option when patients are refractory toPAH-speciffc therapy. Reverse Potts shunt (RPS) has been introduced to treat suprasystemic PAH. This studyaims to investigate the clinical outcomes of suprasystemic PAH in children. Methods Embase, Pubmed,and the Cochrane Library databases were searched for related studies that reported the clinical outcomes ofsuprasystemic PAH following RPS in children. To investigate the clinical outcomes of RPS, meta-analyses ofthe early and overall mortalities were performed. Results Nine studies were included in this study. Theestimated early mortality was 14.4% (95% CI, 7.1% to 23.1%), and the overall mortality/Ltx was 23.2% (95%CI, 14.4% to 32.9%). The estimated 1-year survival was 86.3% (95% CI, 75.9% to 88.7%). A qualitative reviewshowed that the median value of 5-year survival free from Ltx of patients undergoing RPS was 68.6% (range:65% to 92.3%). Compared to Ltx, RPS did not signiffcantly increase the early mortality (OR, 2.48, 95% CI0.75 to 8.24, p = 0.14). RPS also signiffcantly improved the New York Heart Association/World HealthOrganization functional class, reduced the BNP/NT-pro BNP levels, decreased the PAH-speciffc therapy,and increased the six-minute-walking distance. Conclusions RPS may serve as an alternative treatmentfor suprasystemic drug-refractory PAH. Further large-scale and prospective cohort studies are needed tovalidate these ffndings.展开更多
BACKGROUND Spigelian hernia(SH),a protrusion of intra-abdominal contents through a defect in the semilunar line(Spigelian fascia)of the abdominal wall,is extremely rare in the pediatric population.Fewer than 100 cases...BACKGROUND Spigelian hernia(SH),a protrusion of intra-abdominal contents through a defect in the semilunar line(Spigelian fascia)of the abdominal wall,is extremely rare in the pediatric population.Fewer than 100 cases of pediatric SH have been reported in the literature since the first description in 1939.Pediatric SH is often congenital and may present with non-specific symptoms,making diagnosis challenging.Notably,about one-quarter to one-third of reported pediatric cases are associated with ipsilateral undescended testis,an association sometimes termed the"Spigelian-cryptorchidism syndrome".AIM To systematically review all reported cases of Spigelian hernia in children and identify its diagnostic and surgical features.METHODS A comprehensive literature search was performed(1939 through 2023)using PubMed and other databases for all publications on Spigelian(semilunar line)hernias in children.Both English and non-English articles were included.Case reports,case series,and relevant reviews were analyzed.Data extracted included patient demographics,hernia side/location,clinical features,imaging and intraoperative findings,coexisting conditions(particularly cryptorchidism),management(open vs laparoscopic repair),and outcomes.RESULTS A total of approximately 90 pediatric SH cases from 44 publications were identified.The median age at presentation was around 3-4 years(range:Neonate to 17 years).Slight male predominance was observed,although SH also occurs in females.About 30%of cases involved an ipsilateral undescended testis within the hernia sac or in the Spigelian region.Rare associations with other anomalies were noted,including concurrent inguinal hernias,umbilical hernia,and even complex syndromic presentations(for example,limb defects,neuroblastoma)in a few cases.Clinical presentation often included a reducible lump or intermittent bulge along the lateral aspect of the lower abdomen,sometimes misdiagnosed as an inguinal hernia.Recurrent localized abdominal pain was a frequent symptom,and some infants presented with acute intestinal obstruction from incarcerated SH.Diagnosis was most commonly established by ultrasound,which is considered the gold standard imaging modality for SH in children due to its ability to detect fascial defects and herniated tissue dynamically.A subset of cases(approximately 10%)were attributed to blunt abdominal trauma(for example,bicycle handlebar injury),causing an acquired SH.Management:All reported pediatric SHs were treated surgically,given the high risk of incarceration.Open hernia repair through a small transverse incision over the defect was the traditional approach,and no recurrences have been reported after adequate fascial closure.Over the last decade,laparoscopic repair has become the method of choice,especially for cases combined with an undescended testis,allowing simultaneous orchiopexy.Laparoscopic techniques have been successful in safely reducing the hernia and closing the defect,with excellent outcomes and minimal morbidity.CONCLUSION Spigelian hernia in children is a rare but clinically important entity that should be considered in cases of unexplained recurrent abdominal pain,lateral abdominal wall swelling,or cryptorchidism.Early recognition using high-resolution ultrasound and prompt surgical intervention are critical to prevent life-threatening incarceration.Congenital defect of the Spigelian fascia underlies most pediatric cases,and the frequent association with ipsilateral undescended testis suggests a developmental interplay.Surgical repair has excellent outcomes.Increased awareness of pediatric SH among clinicians is necessary to ensure timely diagnosis and treatment,thereby avoiding complications and improving patient outcomes.展开更多
基金supported by the Foshan City’s Selffunded Science and Technology Innovation Project in 2022(2022年佛山市自筹经费类科技创新项目,No.2220001005034).
文摘Objective:To observe the efficacy of LIU’s infantile Tuina(Chinese therapeutic massage)combined with Bi Yan Gao in treating allergic rhinitis(AR)in kids and the impact on serum inflammatory factors.Methods:A total of 120 kids with AR were recruited and divided into a Tuina group,a Bi Yan Gao group,and a combined group using the random number table method,with 40 cases in each group.The three groups all received oral desloratadine syrup as the basic intervention.In addition,the Tuina group was treated with LIU’s infantile Tuina therapy once daily;the BI Yan Gao group received external application of Bi Yan Gao,once every morning and night;the combined group was intervened by LIU’s infantile Tuina plus Bi Yan Gao external application.The intervention lasted for 8 weeks.Before and after the intervention,the total nasal symptom score(TNSS)was compared,and the serum levels of interleukin(IL)-4,IL-6,IL-8,and immunoglobulin E(IgE)were detected.The total effective rate was also compared among the three groups.Results:After 8 weeks of treatment,the total effective rate was 87.2%in the combined group,60.5%in the Tuina group,and 57.5%in the Bi Yan Gao group,showing significant between-group differences(P<0.05).The contents of serum IL-6,IL-8,and IgE were lower in the combined group compared to the Tuina and Bi Yan Gao groups,presenting statistical significance(P<0.05).The level of IL-4 was statistically parallel across the three groups(P>0.05).Conclusion:The combined use of LIU’s infantile Tuina and Bi Yan Gao can improve nasal symptoms and lower the levels of serum inflammatory factors and IgE in kids with AR,producing a higher total effective rate compared to the separate use of the two approaches.
文摘Background:Continuous care for children with enterostomy and their families has been gaining popularity in China.Objective:To evaluate the feasibility of continuous care for children with enterostomy and their families in China.Methods:The PubMed,Web of Science,Embase,Cochrane Library,EBSCO,CNKI,CBM,VIP,and WanFang were searched for clinical trials until December 30,2025.Two reviewers independently searched articles,evaluated quality and extracted data.This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA).Results:33 studies involving 2774 participants were included.The meta-analysis showed that continuous care strategy can significantly reduce the incidence of complications in children with enterostomy(OR=0.20,95%CI=0.16-0.26,p<0.001,I2=0%),effectively improve the family caregiver ability for enterostomy(MD=-10.34,95%CI=-13.82 to-6.85,p<0.001,I2=99%),shorten the time for family members to replace stoma bags(MD=-13.57,95%CI=-19.66 to-7.49,p<0.001,I2=100%),and alleviate negative emotions such as anxiety(SMD=-1.80,95%CI=-2.36 to-1.23,p<0.001,I2=92%)and depression(SMD=-1.54,95%CI=-2.04 to-1.04,p<0.001,I2=89%)in the families of the affected children.Conclusions:Continuous care can reduce complications of enterostomy in children,improve the family caregiver ability for enterostomy and alleviate negative emotions of family members such as anxiety and depression.
文摘Hepatoblastoma(HB)is the most common primary malignant liver tumor in children,representing approximately 50%to 60%of pediatric liver cancers.It predominantly affects children under the age of 3 years,with a slightly higher incidence in boys compared to girls.The main pathological subtypes of HB are epithelial and mixed types.The etiology and pathogenesis are unclear and may be related to factors such as genetics and gene mutations.The diagnosis primarily relies on imaging examinations(including abdominal ultrasound,computed tomography,and magnetic resonance imaging)and serum alpha-fetoprotein testing.Treatment approaches include surgical resection,chemotherapy,and liver transplantation.Surgical resection is currently the only curative option,especially effective for early-stage localized tumors;chemotherapy can be used to shrink tumors before surgery or to manage their progression;liver transplantation is recommended for cases that cannot be surgically removed or for instances where the disease recurs after surgery.Recent advancements have encouraged a mul-tidisciplinary approach to treatment,with ongoing research into new chemothera-peutic and targeted agents.Despite these developments,challenges remain,such as the need for more precise and individualized therapies,chemotherapy resistance that can lead to poor outcomes in some patients,and a shortage of organ donors,along with the risk of immune rejection after transplantation.A thorough synthesis of current therapeutic strategies will establish an evidence-based foundation to enhance the management of HB in children,ultimately improving prognosis and quality of life.
文摘BACKGROUND In multisystem inflammatory syndrome in children(MIS-C)with coronavirus disease 2019,there was paucity of data from low-income and middle-income countries on cardiovascular involvement and its longitudinal outcomes.We planned to estimate the pattern of cardiovascular involvement among children with MIS-C and its mid-term outcomes.AIM To determine association between cardiovascular abnormalities and clinical and laboratory parameters.To study the time-line for resolution of various abnormalities.METHODS In this prospective study done in a tertiary care hospital,270 were recruited from June 2020 to January 2022.Baseline demographic data and clinical presentation were recorded.Laboratory parameters and echocardiography were done at admission.Follow-up was done at 2 weeks,3 months,6 months and 1 year after diagnosis.Descriptive statistics were used for parametric and non-parametric data.Risk factors were identified by multivariate regression analysis.RESULTS The 211(78.2%)had cardiac involvement and 102 needed intensive care unit(ICU)admission.Cardiovascular abnormalities observed were shock 123(45.6%),coronary dilatation 28(10.4%),coronary aneurysm 77(28.5%),left ventricular(LV)dysfunction 78(29.3%),mitral regurgitation(MR)77(28.5%)and pericardial effusion 98(36.3%).Coronary artery aneurysm/dilatation during follow-up at 2 weeks and 1 year were 25.7%and 0.9%respectively.Multivariate regression analysis revealed breathlessness[odds ratio(OR)=3.91,95%CI:1.25-12.21,P=0.019]and hi-flow nasal cannula(HFNC)support(OR=8.5,95%CI:1.06-68.38,P=0.044)as predictors of cardiovascular involvement.Higher mean age(OR=1.16,95%CI:1.02-1.32,P=0.026),breathlessness(OR=4.99,95%CI:2.05-12.20,P<0.001),gallop(OR=4.45,95%CI:0.41-2.52,P=0.016),MR(OR=3.61,95%CI:1.53-8.53,P=0.004)and invasive ventilation(OR=4.01,95%CI:1.28-12.58,P=0.017)were predictive of LV dysfunction.Altered sensorium(OR=4.96,95%CI:2.23-11.02,P<0.001),headache(OR=6.61,95%CI:1.46-29.92,P=0.014),HFNC(OR=7.03,95%CI:2.04-24.29,P=0.002),non-rebreathing mask usage(OR=21.13,95%CI:9.00-49.61,P<0.001)and invasive ventilation(OR=5.64,95%CI:1.42-22.45,P=0.014)were risk factors for shock.Anemia was a risk factor for coronary involvement(OR=3.09,95%CI:1.79-5.34,P<0.001).CONCLUSION Significant number of children with MIS-C had cardiovascular involvement contributing to higher ICU management.Although shock resolved quickly,resolution of ventricular function and coronary abnormalities were slower,and hence warrants a structured long-term follow-up protocol.
基金Supported by the National Natural Science Foundation of China(No.82371093,No.72342015)R&D Program of Beijing Municipal Education Commission(No.KZ202110025039).
文摘AIM:To compare the efficacy of different administration regimens of compound tropicamide eyedrops(CTE)for pupil dilation for children with dark iris.METHODS:A prospective,comparative,randomized interventional study was conducted.Children in Group 1 received CTE 3 times with a 3min interval between each application.Children in Group 2 received CTE 4 times with a 5min interval between each application.We measured their pupil diameters at baseline(pre-drug instillation)and 30min and 60min post-drug instillation and assessed the pupillary light reflex at 60min post-drug instillation.RESULTS:In total,194 eyes of 101 children were enrolled.The changes of pupil diameter at 30min and 60min post-drug instillation were 1.2±0.6 mm and 2.3±1.0 mm in Group 1,and 2.3±0.9 mm and 3.7±1.0 mm in Group 2,respectively.Group 2 showed a larger change in pupil size than Group 1 at 30min(P<0.01)and 60min(P<0.01).The effect of pupil dilation in Group 2 was 1.25 times that in Group 1.The change in pupil size was positively associated with age.A higher proportion of children in Group 1 had smaller pupil diameter and reactive pupils at the final time point,with only 33 children(33.7%)had final pupil size≥6.5 mm,and only 9 children(9.2%)had non-reactive pupils.Children in Group 2 achieved larger pupil diameter and more nonreactive pupils at the final time point,with 84 children(87.5%)had final pupil size≥6.5 mm,and only 22 children(22.9%)had reactive pupils.CONCLUSION:Increasing the frequency of compound tropicamide and lengthening the interval between eye drop applications can produce stronger mydriatic effects.
文摘BACKGROUND Gastric adenomyoma(GA)in children is a relatively rare condition,and currently,there is limited knowledge regarding its optimal diagnostic methods and treatment strategies.To improve our understanding GA particularly in children,one case of a 4-month-old boy was reported and existing literature was comprehensively reviewed.CASE SUMMARY A 4-month-old boy was admitted to the hospital with a 2-month history of recurrent vomiting of gastric contents.Ultrasound examination demonstrated that the pyloric canal muscle was 3.2 mm in thickness,14.6 mm in diameter,and 17.6 mm in length.Pathological finding showed that a mass approximately 2.8 cm×2 cm×1.5 cm in size and grayish-white in color was detected.The cystic wall was composed of smooth muscles lined with the gastric mucosal epithelium and a small amount of intestinal epithelium.Scattered glandular epithelium and a small amount of pancreatic tissue were observed in smooth muscle.Immunohistochemistry revealed positivity for gastrin,insulin,and smooth muscle actin,confirming the diagnosis of GA.In addition,the Ki-67 proliferation index was low.CONCLUSION We report a case of GA in children,successfully treated with laparoscopic surgery.Ultrasound and computed tomography may be helpful in differential diagnosis when detecting low-density septal lesions biased toward one side.We also review the existing literature data regarding GA in children.
基金supported by the National Natural Science Foundation of China(No.82371093 and No.81970844).
文摘Objective Previous studies have yielded contradictory conclusions on the relationship between intermittent exotropia(IXT)and the magnitude of myopia,especially in children.The aim of this study was to determine the clinical characteristics of IXT in children with myopia and myopic anisometropia.Methods We retrospectively evaluated the clinical data of patients(4–15 years of age)with convergence insufficiency(CI)-IXT and basic IXT who underwent surgery between 2022 and 2023.All patients underwent cycloplegia before the examinations and surgery.The degree of strabismus was measured when the patient viewed from the center of the glasses.Ocular dominance was routinely tested in children with IXT via the“hole-in-card test”after best-corrected visual acuity was obtained.Children were subsequently grouped into 2 groups(anisometropia and nonanisometropia)according to the difference in binocular spherical equivalent(SE)values(≥1.0 diopters[D]).Results A total of 197 patients were included in the study.The preoperative deviation at near was significantly lower in the basic IXT group than in the CI-IXT group,whereas the distance exodeviation was significantly greater in the basic IXT group than in the CI-IXT group(P<0.05).Patients with anisometropia were older than those without anisometropia(P<0.001).The dominant eyes had significantly less myopia than the nondominant eyes did in the CI-IXT and anisometropia groups(P=0.049 and P=0.003,respectively).High myopia was more prevalent in middle school students with IXT(16.67%)than in preschool students(4.55%)and primary schoolchildren(3.18%).The percentage of individuals with anisometropia(≥3.0 D)varied in the low(1.68%),moderate(8.7%),and high myopia groups(22.22%).Binomial logistic regression analysis revealed that age and SE of the dominant eye were independent factors related to anisometropia in children with IXT(P<0.001 and P<0.001,respectively).Conclusion Patients with IXT,especially those with anisometropia and CI-IXT,were shown to have less myopia in the dominant eye.Age and SE of the dominant eye were found to be independent factors related to anisometropia in children with IXT.
文摘Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention and management of mental disorders.Methods In this hospital-based retrospective study,we utilized child and adolescent medical records data from the Wuhan Mental Health Center from January 2014 to December 2022 and examined the top 5 mental disorders(schizophrenia,depressive episode,bipolar disorder,pervasive developmental disorder,and unspecified mood disorder)that accounted for the overall proportion of patients admitted.The rank and proportion of these mental disorders,demographic characteristics and disease indicators were analysed.Results There was a significant upwards trend in the number of children and adolescents diagnosed with mental disorders over the past 9 years,with a sharp decline in 2020 due to the COVID-19 pandemic,followed by a rebound in 2021 and a sustained level above prepandemic figures by 2022.The average age of hospitalization decreased significantly from 20.7 to 16.2 years,with a marked increase in the 12-17-year-old age group.The proportion of female hospitalizations increased from 39.2%to 55.2%,with a corresponding decrease in male hospitalizations.There was a notable decrease in the proportion of schizophrenia cases and an ascent of depressive episode to the most prevalent position.Conclusion This study emphasizes the critical need for targeted interventions and resources for severe mental disorders in children and adolescents and the importance of early detection and management of mental disorders to mitigate long-term effects on well-being and development.
基金This study was funded by the Guangdong High-level Hospital Construction Fund and Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties(SZXK035).
文摘The aim of this study was to investigate the trend in testicular volume changes after orchiopexy in children with cryptorchidism.The clinical data of 854 children with cryptorchidism who underwent orchiopexy between January 2013 and December 2016 in Shenzhen Children’s Hospital(Shenzhen,China)were retrospectively analyzed.The mean(standard deviation)age of the patients was 2.8(2.5)years,and the duration of follow-up ranged from 1 year to 5 years.Ultrasonography was conducted preoperatively and postoperatively.The variables analyzed included age at the time of surgery,type of surgical procedure,laterality,preoperative testicular position,preoperative and postoperative testicular volumes,and the testicular volume ratio of them.The average testicular volumes preoperatively and at 1 year,2 years,3 years,and 5 years postoperatively were 0.27 ml,0.38 ml,0.53 ml,0.87 ml,and 1.00 ml,respectively(P<0.001).The corresponding testicular volume ratios were 0.67,0.76,0.80,0.83,and 0.84(P<0.001).The mean volume of the undescended testes was significantly smaller than the mean normative value(P<0.001,lower than the 10th percentile).The postoperative testicular volumes in children with cryptorchidism were generally lower than those in healthy boys but were still greater than the 10th percentile and exhibited an increasing trend.The older the child is at the time of surgery,the larger the gap in volume between the affected and normal testes.Although testicular volume tends to gradually increase after orchiopexy for cryptorchidism,it could not normalizes.Earlier surgery results in affected testicular volumes closer to those of healthy boys.
基金Supported by the Fujian Province Science and Technology Innovation Joint Fund Project,No.2021Y9188。
文摘BACKGROUND Childhood intestinal lymphoma is characterized by its insidious onset and the absence of specific clinical symptoms.The thinner abdominal wall in children significantly aids in the ultrasound visualization of the abdominal cavity and intestines.Although many typical cases of intestinal lymphoma can be diagnosed through ultrasound,physicians often either overlook these values or assume that ultrasound has limited diagnostic value for intestinal lymphoma.AIM To clarify the diagnosis of intestinal lymphoma and classify its severity using ultrasound,as well as to correlate this with prognosis.METHODS The correlation between ultrasound diagnostic outcomes,laboratory indicators,and clinical prognosis was analyzed to demonstrate the effectiveness of ultrasound in assessing the severity of intestinal lymphoma and to provide new evidence for the diagnosis and treatment of the disease in children.A retro-spective analysis was conducted on the sonographic images and case data of 28 children diagnosed with intestinal lymphoma and confirmed by surgical pathology.Additionally,we sought to determine the correlation between ultrasonic classification of lymphoma,lactate dehydrogenase(LDH)values,pathological classification,and prognosis.RESULTS Ultrasound was utilized to categorize 28 cases of intestinal lymphoma into focal segmental(15 cases)and extensive(13 cases)types.Ultrasound classification and LDH levels were significantly correlated with prognosis(P<0.05),while pathological type,age,gender,and treatment modality showed no significant correlation(P>0.05).Among ultrasound manifestations,there was a significant difference in LDH levels between the segmental and extensive groups(P<0.05).The prognosis for children with extensive intestinal lymphoma was poorer than that for children with localized segmental intestinal lymphoma(P<0.05).CONCLUSION Ultrasound can be used in the diagnosis and classification of intestinal lymphoma in children.Extensive intestinal lymphoma is associated with significantly elevated LDH and poor prognosis.
基金Ningbo Top Medical and Health Research Program(Grant No.2022020405)Wu Jieping Medical Foundation(Grant No.320.6750.2023-25-3).
文摘This study analyzed case and prescription data of children aged 12 to 18 years diagnosed with influenza A from the outpatient and emergency departments at the Women and Children’s Hospital of Ningbo University during the influenza epidemic period between February and April 2023.Patients were categorized into two groups based on their medication:the Baloxavir Marboxil group(196 cases)and the Oseltamivir group(126 cases).SPSS Statistics 24.0 software was utilized to compare variables between the two groups,including age,sex,weight,first visit department,number of visits,average prescription cost per patient,drug varieties used,hospitalization rate,and the combined medication usage,to evaluate the relative advantages and disadvantages of the two treatments.The results indicated that the number of visits in the Baloxavir Marboxil group was significantly lower than in the Oseltamivir group,whereas the average prescription cost per patient was higher(P<0.05).There were no significant differences between the two groups regarding age,sex,weight,first visit department,number of drug types used,hospitalization rate,or combined medication usage(P>0.05).When comparing the use of single-class combined drugs,only the quantity of antiviral drugs differed significantly(P<0.05).The Oseltamivir group required more adjuvant treatment with both Chinese and Western antiviral medications.The distribution of the number of combined drug types was concentrated around three and two types in both groups(Baloxavir Marboxil group:41.34%and 39.66%;Oseltamivir group:44.54%and 36.97%).This study highlighted that the new drug,Baloxavir Marboxil,offered certain therapeutic benefits over Oseltamivir in treating influenza among children aged 12 to 18 years,including advantages in single-dose administration,oral compliance,and specific treatment outcomes.The higher unit cost associated with Baloxavir Marboxil might be a factor for further consideration.These findings provided a new reference point for the clinical selection of anti-influenza medications.
基金Supported by Key project of National Key R&D Program of China in 2022(2022YFC2502700).
文摘[Objectives]This study was conducted to explore the curative effect of Qingfei Ditan decoction combined with targeted drug penetration therapy of traditional Chinese medicine on severe mycoplasma pneumonia in children.[Methods]Based on the retrospective study method,children with severe mycoplasma pneumonia admitted to the Children s Hospital of Soochow University from April 2023 to October 2023 were selected,and divided into a treatment group including 56 cases and a control group including 145 cases.The curative effect and adverse reactions of the two groups were compared.[Results]The total effective rate of the treatment group was higher than that of the control group,and the disappearance time of cough and lung rales was shorter than that of the control group,and the incidence of adverse reactions was lower,showing statistical significance(P<0.05).However,defervescence time and bronchoscope flushing rate showed no significant difference(P>0.05).[Conclusions]Qingfei Ditan Decoction combined with targeted drug penetration therapy of traditional Chinese medicine has a significant effect on severe mycoplasma pneumonia in children,and can reduce the side effects of drugs.It is a safe and efficient combination treatment scheme of traditional Chinese medicine.
基金supported by the Capital’s Funds for Health Improvement and Research(CFH,shoufa-2022-1G-1131 and shoufa 2022-4G-1133)the High Level Technical Talent Construction Project of Beijing Municipal Health Commission(Discipline Leader-02-20)+1 种基金Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(JYY2023-10)the Pathogen Spectrum and Host Marker Analysis in Children with Respiratory Tract Infections of Children(Grant 2024-0040).
文摘Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus(HAdV),particularly in children with acute respiratory tract infections(ARIs).Therefore,continual monitoring of these events is essential for effective viral surveillance and control.Methods Respiratory specimens were collected from children with ARIs between January 2022 and December 2023.The penton base,hexon,and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type.In cases with inconsistent typing results,genes were cloned into the pGEM-T vector to detect recombination events.Metagenomic next-generation sequencing(mNGS)was performed to characterize the recombinant HAdV genomes.Results Among 6,771 specimens,277(4.09%,277/6,771)were positvie for HAdV,of which 157(56.68%,157/277)were successfully typed,with HAdV-B3 being the dominant type(91.08%,143/157),and 14(5.05%,14/277)exhibited inconsistent typing results,six of which belonged to species B.The penton base genes of these six specimens were classified as HAdV-B7,whereas their hexon and fiber genes were classified as HAdV-B3,resulting in a recombinant genotype designated P7H3F3,which closely resembled HAdV-B114.Additionally,a partial gene encoding L152/55 kD was identified,which originated from HAdV-B16.Conclusion A novel recombinant,P7H3F3,was identified,containing sequences derived from HAdV-B3 and HAdV-B7,which is similar to HAdV-B114,along with additional sequences from HAdV-B16.
基金Funding support for this article was provided by the Key R&D Program of Zhejiang(2023C03029).
文摘Introduction Choledochal cysts(CCs)are cystic dilatations of the intrahepatic and/or extrahepatic biliary ducts that affect primarily female infants[1-3].CCs vary markedly in incidence worldwide:the incidence is approximately 1 in 100,000 to 1 in 150,000 live births in Western countries and 1 in 1,000 people in Asian countries[4].
文摘Background:Even though various research has demonstrated the connection between consanguinity and health issues,consanguineous marriage still common in Egypt with high prevalence rate 35.3%,23.5%in semi-urban and 17.7%in urban areas.Methods:This study was conducted on 434native Arabic-speaking Egyptians children(3-10 years)who visited Special Needs Clinic at National Research Centre,among one year presenting with a hearing or/and language problem.They were subjected to psychometric assessment,Conners'Parent Rating Scales-Revised,Autism Diagnostic Interview Revised,Childhood Autism Rating Scale,audiological assessment,and Arabic Preschool Language Scale-4.Participants were classified into 6 subgroups according to the cause of language delay.We estimated the frequency and degree of consanguinity in each group and the association between consanguinity and hearing and language problems.Results:The prevalence of the consanguineous marriage in all participants(n=434)was31.6%with the mean inbreeding coefficient of 0.01208.First cousins'marriages were the most common type of consanguineous marriages(50.3%of consanguineous marriages).Among all participants in the 6 subgroups(n=434),language delay secondary to cognitive delay showed the highest percentage of consanguineous marriages(35%)followed by autism spectrum disorder(32.8%).No significant association between consanguinity and language problems.Among the 78 participants with sensorineural hearing loss,35.9%of consanguineous couples(no.=28 cases)were reported versus 64.1%of non-consanguineous couples(no.=50 cases).Conclusions:The Frequency of consanguineous marriages in our participants was 31.6%which was close to that reported in Egyptian population.Absence of significant association between consanguinity and language problems warrants further investigation and point to the role of genetic-environment interplay in cases of language delay.
基金Supported by Baoding Science and Technology Plan Project,No.2272P011Hebei Province Scientific Research Project,No.20241734Hebei Natural Science Foundation Project,No.H2024104011.
文摘BACKGROUND Mycoplasma pneumoniae(M.pneumoniae)is considered to be one of the causative agents of community acquired pneumonia in children with general or severe course of disease.Severe M.pneumoniae pneumonia(SMPP)has emerged as a crucial global health concern due to high mortality rate in children under 5 years,potentially life-threatening complications,and growing challenges in pediatric treatment associated with rising macrolide resistance.Additionally,MPP can be complicated by other bacterial and/or viral pathogens,which may exacerbate disease severity.After the lifting of strict non-pharmaceutical interventions(NPIs)worldwide,the dramatic rise of incidence of MPP in Asia and Europe was observed.AIM To perform the comprehensive study of community acquired MPP cases registered in 2023 in Baoding Hospital,China.METHODS A total of 1160 children from 1 month to 15 years old with confirmed MPP diagnosis were enrolled in the study.The blood and respiratory samples were collected within the 24 hours after admission.The hematological parameters,biochemical markers,cytokine profiles were assessed.The respiratory samples were tested for the presence of M.pneumoniae and other 23 bacterial/viral pathogens by multiplex polymerase chain reaction(PCR).The macrolide resistance mutations(A2063G,A2064G in the 23S rRNA gene of M.pneumoniae)were determined by PCR.RESULTS Number of MPP cases has dramatically increased starting August with peak in November.SMPP and general MPP(GMPP)were identified in 264 and 896 of 1160 hospitalized children.The binary logistic regression analysis identified six[C-reactive protein(CRP),lactate dehydrogenase,procalcitonin,erythrocyte sedimentation rate,fibrin and fibrinogen degradation products(FDPs),D-dimer]and four(neutrophils,CRP,FDPs,prothrombin time)predictors of SMPP in age groups 2-5 years and 6-15 years,respectively.Children with SMPP showed significantly higher levels of cytokine interleukin(IL)-17F(2-5 years),and cytokines interferon-gamma,tumor necrosis factoralpha,IL-10(6-13 years).Concomitant viral/bacterial pathogens were determined in 24.3%and 28.0%cases of SMPP and GMPP.Among them,Streptococcus pneumoniae(S.pneumoniae)and Haemophilus influenzae(H.influenzae)were predominant.93.2%cases of MPP were associated with macrolide resistant M.pneumoniae.CONCLUSION Specific MPP epidemiological pattern associated with lifting NPIs was revealed:Increase of hospitalized cases,prevalence of S.pneumoniae and H.influenzae among concomitant pathogens,93.2%of macrolide resistant M.pneumonia.
基金supported by the National Natural Science Foundation of China(82371709).
文摘Testicular torsion is a urological emergency that requires prompt diagnosis and treatment,accounting for 10%-15%of cases of acute scrotum.[1]It occurs most frequently during the perinatal period and adolescence and can occur at any age.[2]The incidence of testicular torsion is 1/4,000 in males under 25 years of age and 1/160 in males over 25 years of age.[3]Unilateral torsion is relatively common,with a higher incidence on the left side.Testicular torsion is typically managed through surgical exploration.Necrotic testes,identified by a black appearance,require orchiectomy.[4]
基金Supported by Shenzhen Fund for Guangdong Provincial High-Level Clinical Key Specialties,No.SZGSP012Shenzhen Key Medical Discipline Construction Fund,No.SZXK032。
文摘BACKGROUND Cryptococcus is a systemic opportunistic pathogenic fungus that can cause infections in both immunocompromised and immunocompetent hosts,with diverse clinical manifestations,ranging from asymptomatic pulmonary lesions to disseminated central nervous system infections.The incidence of pulmonary cryptococcosis(PC)has rapidly increased in recent years,with an increasing proportion of non-human immunodeficiency virus-infected and immunocompetent patients making its diagnosis challenging.If not properly recognized,PC can lead to systemic dissemination and high mortality rates.Early diagnosis and treatment can improve the prognosis.This study summarizes the clinical features of three immunocompetent children with PC who presented with chest pain to raise clinicians'awareness of the disease and reduce mortality.CASE SUMMARY Three male pediatric patients in good health were hospitalized because of chest pain without cough or fever.Chest computed tomography(CT)revealed pleuralbased nodules and consolidation with cavitation.A lung biopsy was performed in one case,and Cryptococcus was cultured from the pathological tissues.Cryptococcus was detected in the alveolar lavage fluid,and serum Cryptococcus capsular(C.capsular)polysaccharide antigen was positive in one case,and the other case was positive for serum C.capsular polysaccharide.All patients received oral fluconazole treatment.Follow-up chest CT scans after six months showed significant resolution of the lesions.CONCLUSION PC can also occur in immunocompetent children.When encountering children with chest pain only in the clinic,one should be vigilant about PC,promptly complete the relevant examinations,and avoid misdiagnosis.
基金Chongqing Medical University Program for Youth Innovation in Future Medicine(W0204)Natural Science Foundation Project of Chongqing,Chongqing Science and Technology Commission(CSTB2023NSCQ-BHX0010)+1 种基金Chongqing Postdoctoral Research Project Special Support(2023CQBSHTB3074)Science and Technology Research Program of Chongqing Municipal Education Commission(KJQN202400421).
文摘Background Pulmonary arterial hypertension (PAH) is a progressive condition with a poorprognosis in children. Lung transplantation (Ltx) remains the ultimate option when patients are refractory toPAH-speciffc therapy. Reverse Potts shunt (RPS) has been introduced to treat suprasystemic PAH. This studyaims to investigate the clinical outcomes of suprasystemic PAH in children. Methods Embase, Pubmed,and the Cochrane Library databases were searched for related studies that reported the clinical outcomes ofsuprasystemic PAH following RPS in children. To investigate the clinical outcomes of RPS, meta-analyses ofthe early and overall mortalities were performed. Results Nine studies were included in this study. Theestimated early mortality was 14.4% (95% CI, 7.1% to 23.1%), and the overall mortality/Ltx was 23.2% (95%CI, 14.4% to 32.9%). The estimated 1-year survival was 86.3% (95% CI, 75.9% to 88.7%). A qualitative reviewshowed that the median value of 5-year survival free from Ltx of patients undergoing RPS was 68.6% (range:65% to 92.3%). Compared to Ltx, RPS did not signiffcantly increase the early mortality (OR, 2.48, 95% CI0.75 to 8.24, p = 0.14). RPS also signiffcantly improved the New York Heart Association/World HealthOrganization functional class, reduced the BNP/NT-pro BNP levels, decreased the PAH-speciffc therapy,and increased the six-minute-walking distance. Conclusions RPS may serve as an alternative treatmentfor suprasystemic drug-refractory PAH. Further large-scale and prospective cohort studies are needed tovalidate these ffndings.
文摘BACKGROUND Spigelian hernia(SH),a protrusion of intra-abdominal contents through a defect in the semilunar line(Spigelian fascia)of the abdominal wall,is extremely rare in the pediatric population.Fewer than 100 cases of pediatric SH have been reported in the literature since the first description in 1939.Pediatric SH is often congenital and may present with non-specific symptoms,making diagnosis challenging.Notably,about one-quarter to one-third of reported pediatric cases are associated with ipsilateral undescended testis,an association sometimes termed the"Spigelian-cryptorchidism syndrome".AIM To systematically review all reported cases of Spigelian hernia in children and identify its diagnostic and surgical features.METHODS A comprehensive literature search was performed(1939 through 2023)using PubMed and other databases for all publications on Spigelian(semilunar line)hernias in children.Both English and non-English articles were included.Case reports,case series,and relevant reviews were analyzed.Data extracted included patient demographics,hernia side/location,clinical features,imaging and intraoperative findings,coexisting conditions(particularly cryptorchidism),management(open vs laparoscopic repair),and outcomes.RESULTS A total of approximately 90 pediatric SH cases from 44 publications were identified.The median age at presentation was around 3-4 years(range:Neonate to 17 years).Slight male predominance was observed,although SH also occurs in females.About 30%of cases involved an ipsilateral undescended testis within the hernia sac or in the Spigelian region.Rare associations with other anomalies were noted,including concurrent inguinal hernias,umbilical hernia,and even complex syndromic presentations(for example,limb defects,neuroblastoma)in a few cases.Clinical presentation often included a reducible lump or intermittent bulge along the lateral aspect of the lower abdomen,sometimes misdiagnosed as an inguinal hernia.Recurrent localized abdominal pain was a frequent symptom,and some infants presented with acute intestinal obstruction from incarcerated SH.Diagnosis was most commonly established by ultrasound,which is considered the gold standard imaging modality for SH in children due to its ability to detect fascial defects and herniated tissue dynamically.A subset of cases(approximately 10%)were attributed to blunt abdominal trauma(for example,bicycle handlebar injury),causing an acquired SH.Management:All reported pediatric SHs were treated surgically,given the high risk of incarceration.Open hernia repair through a small transverse incision over the defect was the traditional approach,and no recurrences have been reported after adequate fascial closure.Over the last decade,laparoscopic repair has become the method of choice,especially for cases combined with an undescended testis,allowing simultaneous orchiopexy.Laparoscopic techniques have been successful in safely reducing the hernia and closing the defect,with excellent outcomes and minimal morbidity.CONCLUSION Spigelian hernia in children is a rare but clinically important entity that should be considered in cases of unexplained recurrent abdominal pain,lateral abdominal wall swelling,or cryptorchidism.Early recognition using high-resolution ultrasound and prompt surgical intervention are critical to prevent life-threatening incarceration.Congenital defect of the Spigelian fascia underlies most pediatric cases,and the frequent association with ipsilateral undescended testis suggests a developmental interplay.Surgical repair has excellent outcomes.Increased awareness of pediatric SH among clinicians is necessary to ensure timely diagnosis and treatment,thereby avoiding complications and improving patient outcomes.
