Advances in peripheral blood parameter ratios in common pediatric diseases / 国际儿科学杂志

In the non-specific immune system of human, neutrophils, lymphocytes, monocytes and platelets are important components that play a role in regulating and inducing tissue damage and can reflect the body′s level of immunity.These peripheral blood cells are functionally and quantitatively abnormal in the presence of serious infections or immune deficiencies, but these parameters are usually interpreted in isolation.Recent studies have found that comprehensive indicators derived from peripheral blood parameters, such as neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, monocyte to lymphocyte ratio or lymphocyte to monocyte ratio have predictive value for the occurrence and prognosis of diseases.This article reviews the role of these indicators in common childhood diseases and provides a reference for the diagnosis and treatment of some diseases.

Trajectory and impact factors of cycle threshold values of virus load in respiratory tract in children infected with severe acute respiratory syndrome coronavirus 2 Omicron variants / 中华传染病杂志

Objective:To investigate the clinical characteristics of children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variants, and the impact factors of duration of cycle threshold (Ct) values turning to ≥35 detected by nucleotide test.Methods:Children aged 0 to 14 years with clinical symptoms of Omicron variants infection who admitted to designated hospital in Shanghai City (Renji Hospital, South Branch, Shanghai Jiao Tong University School of Medicine) from April 7 to June 2, 2022 were enrolled. The daily nasopharyngeal swab specimens were used for SARS-CoV-2 nucleic acid detecting by polymerase chain reaction and the results were expressed as Ct values. The T Ct≥ x was defined as from the symptom onset or first positive nucleic acid test results (the earlier data) to Ct≥ x of the open reading frame 1ab ( ORF1 ab) gene, which was the time duration from the initial to a specific Ct value.Clinical data were collected, including age, sex, vaccination and comorbidities.Cox model was performed to analyzed the impact factors of T Ct≥35. Results:A total of 871 pediatric cases with a median age of two years (ranging from one month to 14 years old) were included. Among them, 474 cases (54.4%) were male, and 89 cases (10.2%) had underlying diseases including congenital heart disease, solid tumors and epilepsy. There were 572(65.7%) mild cases, 298(34.2%) common cases, one (0.1%) severe case and no critical cases or deaths. The T Ct≥35 was 12(10, 14) days. Cox model indicated that compared to children aged one to 12 months, children aged 37 to 84 months and 85 to 168 months had shorter T Ct≥35 (hazard ratio ( HR)=1.55 and 1.84, respectively, both P<0.001). After adjusted with age, comparing to unvaccinated patients, patients with one or two shots vaccine had shorter T Ct≥35 (adjected hazard ratio (a HR)=1.49, P=0.011), and common patients had longer T Ct≥35 than mild patients (a HR=0.78, P=0.002), and patients with comorbidities had longer T Ct≥35than patients without comorbidities (a HR=0.38, P<0.001).The duration of T Ct≥28, T Ct≥30, T Ct≥33 and T Ct≥35 in children without underlying diseases were 7(6, 9) d, 9(7, 10) d, 10(8, 11) d and 12(10, 14) d, respectively. Conclusions:Age, vaccination, disease severity and underlying diseases could affect the duration of SARS-CoV-2 nucleotide turning to negative (Ct value≥35) in children infected with Omicron variants.

Experts proposal and frequently asked questions of rapid screening and prevention of novel coronavirus pneumonia in children / 中华实用儿科临床杂志

The outbreak of novel coronavirus pneumonia (NCP) has become the most severe public health issue at the moment, threatening people′s lives.Pediatricians in Shanghai have recently launched a discussion on the focused questions of NCP, including the incidence situation, epidemiological features, essentials of early screening, treatment and nosocomial infection prevention of children′s novel coronavirus infection (2019-nCoV), and further put forward the experts proposal upon the patterns of disease occurrence, development, diagnosis and control, for the reference of frontline pediatricians.

Experts proposal and frequently asked questions of rapid screening and prevention of novel coronavirus pneumonia in children / 中华实用儿科临床杂志

The outbreak of novel coronavirus pneumonia (NCP) has become the most severe public health issue at the moment, threatening people′s lives. Pediatricians in Shanghai have recently launched a discussion on the focused questions of NCP, including the incidence situation, epidemiological features, essentials of early screening, treatment and nosocomial infection prevention of children′s novel coronavirus infection (2019-nCoV), and further put forward the experts proposal upon the patterns of disease occurrence, development, diagnosis and control, for the reference of frontline pediatricians.

Clinical features and factors associated with osteonecrosis in childhood-onset systemic lupus erythematosus / 中华实用儿科临床杂志

Objective@#To analyze the clinical features and factors associated with osteonecrosis in children with systemic lupus erythematosus (SLE).@*Methods@#A retrospective analysis of 15 SLE patients with osteonecrosis in Department of Pediatrics, Renji Hospital Affiliated to School of Medicine of Shanghai Jiaotong University from January 2013 to May 2017 was carried out.Forty-two SLE patients without osteonecrosis were selected as control group.The clinical, laboratory variables and the treatment were compared among SLE patients who were with and without osteonecrosis.@*Results@#(1) Fifteen patients developed osteonecrosis that constituted 8.6% of all the 175 hospitalized SLE patients during the same period.(2) Of 15 patients, 2 patients were male, 13 patients were female, who developed osteonecrosis with an average age of (13.9±2.7) years (range: 10-18 years old). The duration of SLE before the diagnosis of osteonecrosis ranged from 6 days to 141 months, the median was 10 months, and 80.0% (12/15 cases) was diagnosed with osteonecrosis within 2 years of SLE diagnosis.There were 36 joints involved in 15 patients, all of which were detected by magnetic resonance imaging(MRI). The knees were the most commonly involved joints(14/15 cases, 93.3%), followed by hip and ankle joints.(3) Univariate analysis revealed that the level of Triglyceride [(2.080±1.500) mmol/L vs.(1.350±0.945) mmol/L], maximum daily dose of glucocorticoid[(1.25±0.33) mg/kg vs.(1.07±0.22) mg/kg], positive rate of gene associated with glucocorticoid-induced osteonecrosis of femoral head(100.0% vs.54.8%)were significantly higher in SLE with osteonecrosis than those in controls(all P<0.05). While the level of 25(OH)D3[(21.37±11.29) μg/L vs.(31.45±17.73) μg/L] was significantly lower than that of controls(P<0.05). Multiple factor Logistic regression analysis showed that hypertriglyceridemia and daily maximum dose of glucocorticoid were the risk factors for osteonecrosis.@*Conclusions@#Osteonecrosis mostly occurred in children over 10 years old, knee joint involvement is the most common.The high-risk time of osteonecrosis is within 2 years of SLE diagnosis.Hypertriglyceridemia and daily ma-ximum dose of glucocorticoid are risk factors associated with osteonecrosis in children with SLE.

Progress of malignant ovarian germ cell tumor / 肿瘤研究与临床

Malignant ovarian germ cell tumor (MOGCT) is a kind of primordial germ cell tumors deriving from embryonic gonads. It mainly occurs in adolescent women and is characterized with the rapid growth and high degree of malignancy. The traditional treatment methods include whole uterus and bilateral accessory resection or tumor cytoreductive surgery, although the patients have recovered after surgery, they lose their reproductive function. With the progress of chemotherapy research, the treatment mode of MOGCT has undergone fundamental changes, which provides new possibility of maintaining the reproductive function of patients with MOGCT.

Clinical features and factors associated with osteonecrosis in childhood-onset systemic lupus erythematosus / 中华实用儿科临床杂志

Objective To analyze the clinical features and factors associated with osteonecrosis in children with systemic lupus erythematosus (SLE).Methods A retrospective analysis of 15 SLE patients with osteonecrosis in Department of Pediatrics,Renji Hospital Affiliated to School of Medicine of Shanghai Jiaotong University from January 2013 to May 2017 was carried out.Forty-two SLE patients without osteonecrosis were selected as control group.The clinical,laboratory variables and the treatment were compared among SLE patients who were with and without osteonecrosis.Results (1) Fifteen patients developed osteonecrosis that constituted 8.6％ of all the 175 hospitalized SLE patients during the same period.(2) Of 15 patients,2 patients were male,13 patients were female,who developed osteonecrosis with an average age of (13.9 ± 2.7) years (range:10-18 years old).The duration of SLE before the diagnosis of osteonecrosis ranged from 6 days to 141 months,the median was 10 months,and 80.0％ (12/15 cases) was diagnosed with osteonecrosis within 2 years of SLE diagnosis.There were 36 joints involved in 15 patients,all of which were detected by magnetic resonance imaging(MRI).The knees were the most commonly involved joints(14/15 cases,93.3％),followed by hip and ankle joints.(3) Univariate analysis revealed that the level of Triglyceride [(2.080 ± 1.500) mmol/L vs.(1.350 ± 0.945) mmol/L],maximum daily dose of glucocorticoid [(1.25 ± 0.33) mg/kg vs.(1.07 ± 0.22) mg/kg],positive rate of gene associated with glucocorticoid-induced osteonecrosis of femoral head (100.0％ vs.54.8％) were significantly higher in SLE with osteonecrosis than those in controls (all P ＜ 0.05).While the level of 25 (OH) D3 [(21.37 ± 11.29) μg/L vs.(31.45 ± 17.73) μg/L] was significantly lower than that of controls(P ＜ 0.05).Multiple factor Logistic regression analysis showed that hypertriglyceridemia and daily maximum dose of glucocorticoid were the risk factors for osteonecrosis.Conclusions Osteonecrosis mostly occurred in children over 10 years old,knee joint involvement is the most common.The high-risk time of osteonecrosis is within 2 years of SLE diagnosis.Hypertriglyceridemia and daily ma-ximum dose of glucocorticoid are risk factors associated with osteonecrosis in children with SLE.

Case-control study and Logistic analysis of the risk factors of infants with recurrent wheezing in Shanghai Pujiang area / 中华实用儿科临床杂志

Objective To analyze the relevant risk factors of recurrent wheezing(≥3 attacks) in the first 3 years of life in Shanghai Pujiang.Methods A case-control study was conducted.Two hundred and sixty-two research children were chosen for clinical visits (＜ 3 years old) with wheezing at the Pediatric Department of Shanghai Renji Hospital (South Campus),School of Medicine,Shanghai Jiaotong University,from January to December 2014.According to the frequency of wheezing,the subjects were divided into 75 cases of recurrent wheezing group (≥ 3 attacks),110 cases of occasional wheezing group(1-2 attacks) and 77 cases of no wheezing group.Probable risk factors were inquired by using face-to-face questionnaire.The passive agglutination method was used to detect the Mycoplasma pneumoniae antibody immunoglobulin M (IgM).The indirect immunofluorescence was used to detect the respiratory pathogens.The Western blot was used to detect 20 items of serum allergen.Chi-square test was firstly used for univariate analysis,and then the multivariate stepwise Logistic regression was used to analyze the independent risk factors associated with infant recurrent wheezing.Results A total of 20 factors were found relevant to infant recurrent wheezing by univariate analysis,which included boys (OR =4.030,95％ CI:1.937-8.388),personal atopy (OR =13.125,95％ CI:5.951-28.946),allergic dermatitis (OR =9.833,95％ CI:4.663-20.737),allergic rhinitis (OR =40.327,95％ CI:5.300-306.842),like rubbing eyes or nose(OR =6.487,95％ CI:3.190-13.191),food allergy (OR =6.689,95 ％ CI:1.860-24.051),premature birth (OR =3.795,95 ％ CI:1.001-14.385),low birth weight (OR =9.075,95％ CI:1.106-74.450),parental atopy (OR =10.667,95％ CI:4.824-23.587),parental allergic dermatitis (OR =8.072,95 ％ CI:2.634-24.734),parental allergic rhinitis (OR =6.524,95 ％ CI:2.920-14.577),parental allergic conjunctivitis (OR =1.087,95％ CI:1.017-1.162),parental asthma history (OR =1.119,95％ CI:1.035-1.210),colds ＞ 6 times (OR =9.111,95％ CI:3.970-20.909),history of bronchopneumonia(OR =7.554,95％ CI:3.588-15.903),age at first time use of antibiotics less than 6 months (OR =2.388,95％ CI:1.129-5.052),exposure to cigarette smoking (OR =1.922,95 ％ CI:1.004-3.681),maternal passive smoking during pregnancy (OR =2.508,95 ％ CI:1.298-4.848),living close to wood stove (OR =3.342,95 ％ CI:1.427-7.827) and positive results of inhaled allergens (OR =1.821,95 ％ CI:1.420-2.336).Keeping cats was the protective factor(OR =0.922,95％ CI:0.864-0.984).The forward Logistic regression analysis showed that personal atopy (OR =10.278,95 ％ CI:2.503-42.202),like rubbing eyes or nose (OR =1 0.316,95 ％ CI:2.722-39.101),food allergy (OR =10.370,95％ CI:1.248-86.145),parental atopy (OR =5.402,95％ CI:1.340-21.778),colds ＞ 6 times (OR =7.048,95 ％ CI:1.688-29.423),history of bronchopneumonia (OR =7.876,95 ％ CI:2.040-30.407) and maternaal passive smoking (OR =3.696,95 ％ CI:1.013-13.494) during pregnancy were the independent risk factors of infants recurrent wheezing.Conclusion Personal atopy,like rubbing eyes or nose,food allergy,parental atopy,colds ＞ 6 times,history of bronchopneumonia,maternal passive smoking are the independent risk factors of recurrent wheezing in infants less than 3 years old.

Meta analysis of the risk factors of recurrent wheezing in infants / 中华实用儿科临床杂志

Obgective To analyze the relevant risk factors of recurrent wheezing(≥3 attacks) in the first 3 years of life.Methods Wheezing,respiratory sounds,risk factor were used as key words to retrieve papers in Chinese literature databases including Sinomed,Wanfang and Weipu databases.The same strategy was used to retrieve English papers in English literature databases including PubMed,Cochrane library and Embase.Time range was from 31th May 2004 to 1 rd June 2014.The execution of quality evaluation of the included documents was in compliance with Newcastle-Ottawa Scale and cross-sectional study standard recommended by Agency for Healthcare Research and Quality.The evidence quality evaluation was conducted with GRADEpro and followed by the Meta analysis with RevMan 5.2.R~ults A total of 13 studies were included in this Meta-analysis.Several factors were related to recurrent wheezing episodes,including risk factors such as maternal smoking during pregnancy (OR =1.47,95％ CI:1.30-1.66),asthma in parents (OR =1.94,95 ％ CI:1.72-2.19),family history of atopy (OR =1.94,95％ CI:1.72-2.19),male (OR =1.42,95 ％ CI:1.19-1.69),history of eczema (OR =2.36,95 ％ CI:1.69-3.30),colds (＞ 6 times) (OR =2.02,95 ％ CI:1.54-2.64),history of bronchopneumonia (OR =1.85,95 ％ CI:1.46-2.34),exposure to cigarette smoking(OR =2.30,95％ CI:1.68-3.14),daycare attendance(OR =2.27,95％ CI:1.97-2.60);Education received by the mother ＞ 12 years (OR =0.80,95％ CI:0.70-0.92) was the protective factor.Conclusions The risk factors of recurrent wheezing(≥3 attacks) in the first 3 years of life are maternal smoking during pregnancy,asthma in parents,family history of atopy,male,history of eczema,colds (＞ 6 times),history of bronchopneumonia,exposure to cigarette smoking and daycare attendance.The protective factor is education received by the mother ≥ 12 years.The prerequisite in precaution of infants recurrent wheezing is to ensure the utmost avoidance of hazardous factors and reinforcement of protective factors.

Association of interferon-γ gene polymorphism and risk of cervical HPV infection / 中华妇产科杂志

Objective To investigate the association of interferon (IFN) γ gene polymorphisms and risk and prognosis of HPV cervical infection.Methods PCR-ASP was used for detectiug IFN-γ rs2430561 polymorphism in 179 HPV positive patients and 328 HPV negative normal controls.Results The frequency of A allele of 63.7％ (228/358) was significantly higher than the frequency of T allele of 36.3％ (130/358) in HPV positive group (P =0.045).The frequencies were 41.3％ (74/179) in AA genotype and 14.0％ (25/179) in TT genotype,women carrying AA genotype increased the risk of HPV infection compare with those with TT genotype (OR =1.784,95％ CI:1.031-3.088,P =0.039).During follow-up,the rate of HPV positive again in AA genotype was 83.8％ (62/74),while TT genotype was 20.0％ (5/25).In the analysis of Kaplan-Meier,the cumulative HPV negative rates of AA,TA and TT genotype exhibited significantly different (P =0.008).The cumulative HPV negative rate of AA genotype was the lowest (1.1％-5.9％).Conclusions IFN-γ rs2430561 polymorphisms confer the susceptibility to HPV infection.Women with AA genotype exhibited higher risk of infection and inclined to be continuous status and recurrence after HPV infection.