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Group A Streptococcus (GAS) is a very important pathogen, especially for children.On a global scale, GAS is an important cause of morbidity and mortality.But the burden of disease caused by GAS is still unknown in China and also has not obtained enough attention.For this purpose, the expert consensus is comprehensively described in diagnosis, treatment and prevention of GAS diseases in children, covering related aspects of pneumology, infectiology, immunology, microbiology, cardiology, nephrology, critical care medicine and preventive medicine.Accordingly, the consensus document was intended to improve management strategies of GAS disease in Chinese children.
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Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.
ABSTRACT
Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases.Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic.Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection.This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities.The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.
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Recombinant human interferonα1b (IFN-α1b) is the first internationally unique novel ge-netic engineering medicine in China. As a major interferon subtype with natural antiviral activity, IFN-α1b has high safety and broad-spectrum antiviral effect, so it has broad application prospects in the treatment of viral diseases. Chinese pediatric doctors have taken the lead globally in conducting clinical research of IFN-α1b in the treatment of respiratory syncytial virus ( RSV) pneumonia、 bronchiolitis、 hand-foot-mouth disease, her-petic angina、 viral diarrhea, etc. A series of clinical guidance and expert consensus have been published which are in line with China's national conditions. This article summarizes the innovative research of IFN-α1b and proposes common issues and potential application in pediatric clinical applications.
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Recombinant human interferon αl b (rhIFN-1 b) is the first internationally unique novel genetic engineering medicine in China.In the previous article,it has been summarized that it is a major interferon subtype that is naturally antiviral in human body,and has high safety and broad-spectrum antiviral effect.A number of pediatric consensus and guidelines of clinical experts have formed in China's national conditions.This article summarizes its innovative research and achievements in the clinical treatment of pediatric diseases,and further discusses the problems that need to be solved in the clinical application of rhIFN-α1b in pediatrics.
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Cefpodoxime proxetil(CPDX-PR) is the third generation cephalosporin with high oral efficiency.It has strong anti-gram negative bacteria and-gram positive bacteria effects, with wide tissue distribution, long plasma half-time(T1/2), stable to lactamase, good tolerance, small therapeutic dose, few times of administration, definite cli-nical efficacy and other advantages.It is recommended for application in the treatment guidelines of foreign children with various infectious diseases.It is of great clinical significance to discuss the rational application of CPDX-PR oral preparation under the condition of severe bacterial drug resistance.This article reviews the pharmacological characteristics of CPDX-PR and the research progress in the treatment of common infectious diseases in pediatrics, so as to promote the research on the rational clinical application of CPDX-PR in China.
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As the first class Ⅰ novel genetic engineering medical product in China,recombinant human interferon alpha 1b (IFNα1b) shows unique biological significance and clinical value.Especially in the field of pediatrics,IFNα1 b has been used in the treatment of viral pneumonia,viral hepatitis,bronchiolitis,herpetic angina,hand-footmouth disease and some tumors in children and shown definite efficacy and good safety.It is also used in the prevention and treatment of virus-related wheezing and major infectious diseases,such as influenza.With a greater application prospect,IFNα1b plays an important role in promoting children's health in China.Now,IFNα1b's gene and molecular characteristics,new delivery methods,and the frontier clinical research will be discussed.
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Objective To analyze the epidemiological features of leprosy in China from 2011 to 2015,and to provide scientific evidences for prevention and treatment strategies.Methods An epidemiological analysis and a trend analysis were conducted based on the national leprosy surveillance data from 2011 to 2015.Results The leprosy detection rate in China decreased from 0.085 per 100 000 in 2011 to 0.049 per 100 000 in 2015,with an average annual decline rate being 12.9％.A total of 4 775 leprosy cases were newly detected during 2011-2015,including 106 (2.2％) children,1 499 (31.4％) females,518 (10.8％) floating people,4 041 (84.6％) multibacillary cases and 1 134 (23.7％) cases with grade 2 disabilities.From 2011 to 2015,328 relapsed cases were reported,including 153 (46.6％) cases recurring after combined chemotherapy.The prevalence rate of leprosy in China decreased from 0.407 per 100 000 in 2011 to 0.235 per 100 000 in 2015,with an average annual decline rate being 12.9％.By the end of 2015,there had been 3 230 registered leprosy cases and 124 counties with a prevalence rate above 1 per 100 000.Conclusions The detection rate and prevalence rate of leprosy in China were both decreasing continuously from 2011 to 2015.The high-epidemic provinces were Yunnan,Guizhou,Sichuan and Guangdong.However,leprosy control in middle-and low-epidemic provinces can not be ignored.
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Objective To systematically assess the safety of recombinant human interferon α1b(rhIFNα1b) as therapy for viral diseases in children,so as to provide on evidence-based medicine for the clinical treatment.Methods Randomized controlled trails (RCTs) of rhIFNα1b for viral diseases in children were investigated through PubMed literature retrieval service system,Science Citation Index,China National Knowledge Infrastructure,WanFang Database;RCTs were selected according to the inclusion and exclusion criteria.Related data were extracted and the Meta-analysis was performed.Results Nineteen RCTs were involved,including 2 731 patients.In the overall,59/1 437 cases (4.1％) in the rhIFNα1b treatment group and 79/1 294 cases (6.1％) in the control group had adverse reactions.The Meta-analysis revealed that in the overall and in atomization inhalation subgroup,the incidence of adverse reactions was significantly lower in the rhIFNα1b treatment group than that in the control group [Z =2.18 (P =0.03),RR =0.71(95％ CI:0.52-0.97);Z =2.44(P =0.01),RR =0.53 (95％ CI:0.32-0.88)].But,there was no significant difference in the incidence of adverse reactions between the rhIFNα1b treatment group and the control group in intramuscular injection subgroup,and the test for overall effect was Z =0.78 (P =0.43),RR =0.86 (95 ％ CI:0.58-1.26).The incidence of adverse reactions of the control group was significantly higher than that of the rhIFNα1b treatment group in gastrointestinal adverse reaction [Z =2.20 (P =0.03),RR =0.60 (95 ％ CI:0.39-0.95)],and the incidence of adverse reactions of the rhIFNα1b treatment group was significantly higher than that of the control group in nervous system symptoms [Z=2.09(P=0.04),RR =4.28(95％ CI:1.10-16.72)].Conclusion Compared with other antiviral drugs,the treatment of pediatric common viral diseases with rhIFNα1 b has good safety,low incidence of adverse reactions,and the incidence of adverse reactions through atomization inhalation can be lower than that of intramuscular injection.
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Obgective To investigate the impact of different ways and doses of recombinant human interferon o1b(rhIFN-α1b) on antiviral effect on respiratory syncytial virus(RSV)-effected mice and signal pathway of JAK/ STAT.Methods Forty-eight mice were divided randomly into 6 groups,negative control group,RSV-infection model group,12.5,25.0,50.0 μg rhIFN-α1 b atomization inhalation of intervention group,and 12.5 μg rhIFN-α 1 b injection of intervention group.After continuous drug therapy for 5 days,the left lung tissues of mice were aseptically dissected in the sixth day.Then it were observed lung tissue pathology changes by optical microscope,and expression of STAT1 and STAT2 protein with laser scanning confocal microscopy.Results It was observed that RSV-infection model mice's lungs had significant inflammatory injury under light microscope.After treatments of rhIFN-α 1b,it showed that the mice lung tissue had recovery of inflammation on different degrees.The group of inhaled rhIFN-o1b 50.0 μg was damaged on lightest degree.There were statistically significant differences between each group (all P ＜ 0.05).The expression of STAT1 and STAT2 protein in RSV-infection model mice's lungs decreased remarkably under fluorescene microscopy.Treatments of rhIFN-α 1b increased the expression of STAT1 and STAT2 inhibited by RSV-infection.The expression of STAT1 and STAT2 protein of the inhaled rhIFN-α1b 50.0 μg group increased significantly.The differences between groups were statistically significant(all P ＜ 0.05).Conclusions rhIFN-α 1 b played an important role in anti-RSV effects,simultaneously,it could improve the activity of JAK/STAT signal pathway inhibited by RSV-infection.The treatment effect of rhIFN-α 1b deliveried by atomization inhalation was better than that of intraperitoneal injection.And curative effect is proportional to the atomization inhalation dose within a certain range.