Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fifth Edition)updated for the Omicron variant / 中华实用儿科临床杂志

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

Interpretation of outpatient respiratory management of infants, children, and adolescents with post-prematurity respiratory disease: an official American Thoracic Society clinical practice guideline / 中华实用儿科临床杂志

In recent years, the management of respiratory diseases related to preterm birth has received extensive attention.In 2021, the American Thoracic Society brought together multidisciplinary experts in respiratory, neonato-logy, otolaryngology, sleep medicine, radiology and nursing specialties to develop Guidelines for outpatient respiratory management in infants, children, and adolescents with post-preterm respiratory disease (hereinafter referred to as the " Guideline" ), aiming to provide evidence-based medical evidence for standardized outpatient management of respiratory diseases associated with preterm birth at different ages.The Guideline was interpreted and summarized so that pediatric clinicians could correctly diagnose and treat these diseases, and understand and implement standardized outpatient management on the basis of evidence.

Research progress of interleukin-17 in offspring autism spectrum disorder / 中华实用儿科临床杂志

Interleukin-17 (IL-17) plays an important role in the body′s immune response and inflammatory response.High levels of IL-17 are associated with a variety of autoimmune diseases, acute and chronic neurodegenerative diseases, and psychiatric disorders.Autism spectrum disorder (ASD) is a group of common neurodevelopmental disorders in childhood.Recent clinical and experimental studies have linked maternal immune activation (MIA) during pregnancy to the risk of ASD in offspring.Significantly increased IL-17 level is found in MIA-induced progeny ASD, which is the key factor leading to neurodevelopmental abnormalities in progeny mice.This article reviews the latest research progress on the relationship between IL-17 and progeny ASD, and provides new ideas for the prevention and treatment of ASD.

Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fourth Edition) / 中华实用儿科临床杂志

Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.

Research progress on the role of NLRP3 in the immune inflammation of the " lung-brain axis" of bronchial asthma / 中华实用儿科临床杂志

Bronchial asthma is the most common chronic disease in childhood.In clinical diagnosis and treatment, it is found that some children with asthma often have neuropsychiatric disorders of different severity, such as autism spectrum disorders, attention deficit-hyperactivity disorders, panic disorders and anxiety, which render the prognosis and treatment of asthma difficult.Some reports suggest that the " lung-brain axis" of bronchial asthma is related to the outbreak of inflammation-related mechanisms.A new idea to improve bronchial asthma with neuropsychiatric diseases may be inhibiting the release of inflammatory factors and blocking lung-brain inflammation communication.As one of the more thoroughly studied inflammasome family members, NOD-like receptor pyrin domain-containing protein 3 (NLRP3) is widely involved in the mechanisms of neuroinflammation and bronchial asthma attacks.In this article, the role of NLRP3 in the " lung-brain axis" immune inflammation mechanism of bronchial asthma is reported, which may provide new ideas for the diagnosis, treatment and research of bronchial asthma and neuropsychiatric comorbidities.

Expert consensus on the diagnosis, treatment and prevention of monkeypox in children / 中华实用儿科临床杂志

Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.

Twenty key issues on severe acute respiratory syndrome coronavirus-2 vaccination in children / 中华实用儿科临床杂志

Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still worldwide.As a vulnerable group, severe and dead pediatric cases are also reported.Under this severe epidemic situation, children should be well protected.With the widespread vaccination of SARS-CoV-2 vaccine in adults, the infection rate have decreased.Therefore, SARS-CoV-2 vaccine inoculation for children groups step by step is of great significance to the protection of children and the prevention and control of corona virus disease 2019(COVID-19) as a whole.But the safety of children vaccinated with SARS-CoV-2 vaccine is a main concern of parents.Therefore, in order to ensure the safety of vaccination and the implementation of vaccination work, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health and the Society of Pediatrics, Chinese Medical Association organized experts to interpret the main issue of parents about SARS-CoV-2 vaccine for children, in order to answer the doubts of parents.

Experts′ consensus on severe acute respiratory syndrome coronavirus-2 vaccination of children / 中华实用儿科临床杂志

At present, severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still rampant worldwide.As of September 10, 2021, there were about 222 million confirmed cases of corona virus disease 2019(COVID-19)and more than 4.6 million deaths worldwide.With the development of COVID-19 vaccines and the gradual vaccination worldwide, the increasing number of cases in children and unvaccinated young people has drawn attention.According to World Health Organization surveillance data, the proportion of COVID-19 infection cases in children gradually increased, and the proportion of cases in the age groups of under 5 years and 5-14 years increased from 1.0% and 2.5% in January 2020 to 2.0% and 8.7% in July 2021, respectively.At present, billions of adults have been vaccinated with various COVID-19 vaccines worldwide, and their protective effects including reducing infection and transmission, reducing severe disease and hospitalization, and reducing death, as well as high safety have been confirmed.Canada, the United States, Europe and other countries have approved the emergency COVID-19 vaccination in children and adolescents aged 12 to 17 years, and China has also approved the phased vaccination of COVID-19 vaccination in children and adolescents aged 3 to 17 years. For smooth advancement and implementation of COVID-19 vaccination in children, academic institutions, including National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health, and The Society of Pediatrics, Chinese Medical Association organized relevant experts to reach this consensus on COVID-19 vaccination in children.

Diagnosis, treatment and prevention of 2019 novel coronavirus infection in children: experts′ consensus statement (Third Edition) / 中华实用儿科临床杂志

2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.

Interpretation of consensus guidelines for diagnosis and treatment of aromatic L-amino acid decarboxylase deficiency / 中华实用儿科临床杂志

Aromatic L-amino acid decarboxylase deficiency(AADCD) is a rare early-onset autosomal recessive genetic neurometabolic disease which can be treated with target therapy.To find, diagnose and treat at its early stage is important to improving the prognosis.The international neurotransmitter-related diseases working group (iNTD) developed the consensus guidelines for the diagnosis and treatment of AADCD in 2017, which provided reco-mmendations based on the consensus to facilitate the diagnosis, treatment and long-term management of patients.This article interpreted and summarized the clinical symptoms and treatment of AADCD according to the consensus, in order to raise pediatric clinicians′ awareness and treatment level of the disease.

Relationship between asthma and attention deficit hyperactivity disorder in children and their risk factors / 中华实用儿科临床杂志

In recent years, the relationship between children′s chronic diseases and neuropsychiatric diseases and their pathogenesis have become a hot and difficult issue in pediatric research.Bronchial asthma (asthma) is a co-mmon chronic airway inflammatory disease in children.The latest large-scale population-based reports confirmed the close relationship between asthma and attention deficit hyperactivity disorder (ADHD), the most common neurodevelopmental disorder in children.Therefore, the specific relationship between asthma and ADHD, and the latest research progress of their risk factors were reviewed in this article in order to understand the specific relationship between them and its risk factors, so as to facilitate the long-term clinical management of asthmatic children.

Maternal dietary and environmental risk factors in children with asthma comorbid neuropsychiatric disorders / 中华实用儿科临床杂志

Objective To explore the prenatal dietary and environmental risk factors in children aged 6-16 years with asthma (CWA) comorbid neuropsychiatric disorders.Methods This cross-sectional study was conducted from March 2016 to March 2017.CWA aged 6 to 16 years were recruited as the study participants at the Outpatient Asthma Unit of Guizhou Provincial People's Hospital,China.Informed consent was obtained from their parents,and their parents were invited to participate in the Mini International Neuropsychiatric Interview of children and adolescents (MINI Kid) to assess the current neuropsychiatric disorders.Meanwhile,the questionnaires information about prenatal diet and environment were collected from their mothers as well.Patients were divided into 2 groups,one group with asthma comorbid neuropsychiatric disorders and the other with asthma only.Single factor analysis and multivariate non-conditional Logistic regression analysis were used to determine the risk factors associated with neuropsychiatric comorbidity.Results The study consisted of 261 patients (male:163 cases,female:98 cases) with asthma,with the age of (11.25 _± 3.12) years,the rate of asthma comorbid neuropsychiatric disorders was 26.4％ (69/261 cases).Single factor analysis showed that prenatal tobacco smoke exposure,winter coal combustion,food additives had statistically significant differences between the 2 group (x2 =7.385,3.993,4.529,all P ＜ 0.05),the other factors were not significantly different between two groups (all P ＞ 0.05);multivariate analysis indicated that prenatal tobacco smoke exposure was the independent risk factor for neuropsychiatric comorbidity in CWA (OR =5.098,95％ CI:1.089-23.871,P =0.039).Conclusions The result revealed that the prenatal tobacco smoke exposure is the independent risk factor for neuropsychiatric comorbidity in CWA,need to enhance the propaganda and education of negative effects for parents should be enhanced during pregnancy to diminish the prevalence.

Maternal dietary and environmental risk factors in children with asthma comorbid neuropsychiatric disorders / 中华实用儿科临床杂志

Objective@#To explore the prenatal dietary and environmental risk factors in children aged 6-16 years with asthma (CWA) comorbid neuropsychiatric disorders.@*Methods@#This cross-sectional study was conducted from March 2016 to March 2017.CWA aged 6 to 16 years were recruited as the study participants at the Outpatient Asthma Unit of Guizhou Provincial People′s Hospital, China.Informed consent was obtained from their parents, and their parents were invited to participate in the Mini International Neuropsychiatric Interview of children and adolescents (MINI Kid) to assess the current neuropsychiatric disorders.Meanwhile, the questionnaires information about prenatal diet and environment were collected from their mothers as well.Patients were divided into 2 groups, one group with asthma comorbid neuropsychiatric disorders and the other with asthma only.Single factor analysis and multivariate non-conditional Logistic regression analysis were used to determine the risk factors associated with neuropsychiatric comorbidity.@*Results@#The study consisted of 261 patients (male: 163 cases, female: 98 cases) with asthma, with the age of (11.25±3.12) years, the rate of asthma comorbid neuropsychiatric disorders was 26.4% (69/261 cases). Single factor analysis showed that prenatal tobacco smoke exposure, winter coal combustion, food additives had statistically significant differences between the 2 group (χ2=7.385, 3.993, 4.529, all P<0.05), the other factors were not significantly different between two groups (all P>0.05); multivariate analysis indicated that prenatal tobacco smoke exposure was the independent risk factor for neuropsychiatric comorbidity in CWA (OR=5.098, 95%CI: 1.089-23.871, P=0.039).@*Conclusions@#The result revealed that the prenatal tobacco smoke exposure is the independent risk factor for neuropsychiatric comorbidity in CWA, need to enhance the propaganda and education of negative effects for parents should be enhanced during pregnancy to diminish the prevalence.

Effect of arsenic exposure on learning and memory in rat models and its underlying mechanisms / 中华实用儿科临床杂志

Objective To explore the effects of arsenic exposure on learning and memory and its potential mechanism in rats.Methods Water-based arsenic-exposed rat models were established on 4-l0 postnatal days.The experimental animals were divided into 4 groups (10-12 cases in each group):the control group,the 15 μg/L As2O3 water group,the 30 μg/L As2O3 water group,and the 45 μg/L As2O3 water group.Cognitive functions were examined with the Morris water maze,exploratory behavior was detected by the exploratory behavior test.The hippocampus of pups from each experimental group was sectioned at various time points after arsenic exposure.The morphologies and neurogenesis of the neurons in the hippocampus CA1-CA3 region and dentate gyrus (DG) were observed by hematoxylin-eosin staining,Nissl staining,and doublecortin (DCX) immunostaining at different time points after arsenic exposure.Results Compared with the normal control group,the escape latency of the rats in the arsenic-exposed group was prolonged.The average escape latency of the rats in the normal control group,15 μg/L As2O3 group,30 μg/L As2O3 group and45 μg/L As2O3 group were (17.00±9.53) s,(35.89 ±19.81) s,(26.60 ±18.84) s,and (33.79 ±18.08) s,respectively,and the difference among 4 groups was statistically significant (F =3.591,P ＜ 0.05),and the residence time in the original target quadrant was shortened,respectively,(38.93 ± 8.33) s,(36.03 ± 16.25) s,(29.85 ± 9.27) s,and (29.84 ± 10.16) s,respectively,and there was no significant difference among 4 groups (F =1.681,P =0.187).HE staining and Nissl staining showed that pathological changes such as edema,degeneration and necrosis were observed in the hippocampal CA1 area and CA2 area as well as dentate gyrus cells in rats exposed to arsenic in the acute phase.The higher the concentration of arsenic exposure,the more obvious the cell structure disorder was.However,5 weeks after exposure,the pathological changes in hippocampal neurons in the arsenic-exposed group gradually returned to normal.Immunohistochemistry showed that the expressions of DCX in the CA1,CA2 and dentate gyrus of rats exposed to arsenic decreased significantly 24 h after arsenic exposure,especially in the 45 μg/L group.Five weeks after arsenic exposure,there was no expression in the hippocampal CA1-CA3 area,and there was still a small amount of expression in the dentate gyrus.Conclusions Postnatal low-concentration arsenic exposure may impair learning and abnormal germination of neurons in the hippocampal dentate gyrus may be the underlying mechanism.

3M syndrome: a case report and literature review / 临床儿科杂志

Objective To investigate the clinical features and gene mutations of 3M syndrome. Method The clinical data of a child with 3M syndrome was retrospectively analyzed. The DNA was extracted from the peripheral blood of the child and parents, and the sequence analyses were performed by Agilent SureSelect exon capture and Illumina HiSeq sequencing platform. And the mutant gene was validated by Sanger sequencing. Results The six-month-old girl presented special face and growth retardation.The girl had a missense mutation c.4898C>T,p.T1633M in the CUL7 gene(NM_014780.4),and both her parents had heterozygous mutations.The girl was diagnosed with 3M syndrome.Conclusions The CUL7 mutation is the major causative gene of 3M syndrome in this girl. Early gene testing should be performed to confirm the diagnosis in suspected clinical phenotype.

Effect of arsenic trioxide on cortical neuronal migration of rats and its potential mechanism / 中华实用儿科临床杂志

Objective To explore the effect of arsenic trioxide (As2O3) on the migration of neurons and the potential mechanism through the establishment of primary neuron culture from the brains of neonatal rats.Methods Brain tissues were selected from SD neonatal rats for primary neuron calture.The cells were divided into 4 groups based on the addition of As2 O3:normal control group,1 μmol/L As2O3 group,10 μmol/L As2O3 group and 20 μmol/L As2O3 group.The primary neurons were treated with different concentrations of As2O3 and cultured for 24 hours.Boyden chamber assay was used to detect the effect of As2O3 on neuronal migration.Immunofluorescence laser confocal microscope was used to observe the structure of actin.Results In the control group,the cultured neurons showed a regular pattern of distribution.In the 3 groups treated with As2O3,the distribution of neurons was loose and disordered,which was most obvious in the 20 μmol/L As2O3 group.The results showed that the higher concentration of As2O3,more difficult it was for the neurons to survive.The number of neuronal migration was 64.6 ± 4.3 for normal control group,63.0 ± 7.0 for 1 μmol/L As2O3 group,54.8 ± 3.6 for 10 μmol/L As2O3 group,and 21.6 ± 3.9 for 20 μmol/L As2O3 group.The results showed that As2O3 might inhibit the migration of primary neurons in a dose-dependent manner (F =49.31,P ＜0.001).The normal actin skeleton was destroyed under the laser confocal microscope in 10 μmol/L As2O3 group and 20 μmol/L As2O3 group,while they remained unaffected in normal control group and 1 μmol/L As2O2 group.Conclusion As2 O3 exposure can reduce the neuron migration in a dose-independent manner probably through disrupting the organization of acting cytoskeleton.

Radiofrequency ablation can reverse the abnormal circulating microRNA expression changes in patients with atrial fibrillation / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the change of circulating microRNAs(miRNAs), regulatory mechanism in patients with atrial fibrillation (AF) before and after radiofrequency ablation (RFA).</p><p><b>METHODS</b>From January 2011 to December 2013, peripheral blood samples were taken from 30 AF patients (10 paroxysmal, 10 persistent and 10 permanent AF) before and 3 months after RFA. The total RNA was extracted and hybridized with the miRNA chips, and the differential expression of miRNA and clustering analysis in whole genome were made with Volcano Plot and tMEV software respectively, and validated by real-time PCR. The target gene analysis of miRNAs was predicted through the Mirbase, Miranda and Targetscan databases. Results were compared with those from 10 healthy subjects (control group).</p><p><b>RESULTS</b>Compared with control group, the expressions of 25 miRNAs were down-regulated before RFA and up-regulated after RFA in AF group, while other 40 miRNAs expression changed in the opposite way; among them, the expressions of 7 miRNAs including miR-199a-3p/miR-199b-3p were down- regulated >1.5-fold before RFA and up-regulated>100-fold after RFA; oppositely, 6 miRNAs including miR-BART8-3p were up-regulated>1.5-fold before RFA and down-regulated>10-fold after RFA. Interestingly, 6 miRNAs including miR-30b-5p, which were involved in AF-related electrical and structural remodeling, were down-regulated>5-fold before RFA, but up-regulated>50-fold after RFA. Four miRNAs including miR-377-5p, which were involved in the regulation of CACNA1C ICaL channel protein, were different before and after RFA.</p><p><b>CONCLUSION</b>miRNAs regulate the occurrence and development of AF. RFA can change the expression of miRNAs in AF patients, which may be important for reversing the electrical and structural remodeling and maintaining sinus rhythm after RFA. miRNAs, such as miR-30b-5p, miR-377-5p and miR-199a-3p/miR-199b-3p etc., might become the target markers for early diagnosis and intervention of AF in future.</p>

Observations on pathogenicity between A and B subtype of hMPV in mice / 中华微生物学和免疫学杂志

ObjectiveTo investigate the difference of pathogenicity between the two genotypes of human metapneumovirus(hMPV) for the further research.MethodsAt various time after hMPV infection in BALB/c mice,viral titers of lung tissue were measured by real-time RT-PCR,pathology was assessed by a histopathological scoring system,airway responsiveness was assayed by animal lung function monitoring equipment.Pathogenicity was then measured by detailed evaluation through the results above.Results There is no significant difference in weight of mice between control group and experimental group through dynamic monitoring ; though the difference was exists in airway responsiveness and pathological changes of mice between control group and experimental group,the differences were not statistically in airway reaction,pathological changes and virus drops among the three groups of experimental group.ConclusionThere is no difference in pathogenicity between the two subtypes of hMPV in infection of BALB/c mice,viral genotype do not appear to be associated with pathogenicity.

siRNA targeting RSV-M2 gene improved the level of IFN-γ, IL-12 and IL-10 in BALF in mice infected with respiratory syncytial virus / 中华微生物学和免疫学杂志

Objective To elucidate the airway inflammation status in mice infected with respiratory syncytial virus (RSV), and whether the inflammation could be alleviated by small interference RNA (siRNA) targeting specific RSV gene. MethodsBALB/c mice were infected with RSV via intranasal instillation of RSV suspension, and were then treated with specific siRNA targeting RSV-M2 gene. ELISA assay was used to detect the levels of IFN-γ, IL-12 and IL-10 and Microscope was used to count white blood cells in bronchoalveolar lavage fluid(BALF). ResultsAfter RSV infection, a significant increase in leukocytes count was observed in BALF. Differential count showed a rise in the percentage of neutrophils, eosinophil, especially lymphocytes and a reduction of the percentage of monocytes and macrophages( P＜0.05 ).The levels of IFN-γ, IL-12 and IL-10 were also increased(P＜0.05). Furthermore, the leukocytes count,the percentage of lymphocytes, neutrophils and eosinophil, and the levels of IFN-γ, IL-12 and IL-10in BALF were decreased accordingly while the mice were given higher concentrations of siRNA ( P＜0.05 ).Conclusion RSV caused airway inflammation in BALB/c mice, which may be alleviated by RNAi technology.

Construction and significance of the short hairpin RNA recombinant plasmid targeting M2 gene of respiratory syncystial virus / 重庆医科大学学报

Objective: To construct the recombinant plasmid targeting M2 gene of respiratory syncystial virus(RSV) for further study of RNA interference(RNAi) technology in inhibiting RSV infection.Methods: According to the designing principles of shRNA,The M2 gene of RSV was selected as the target gene.A 19bp reverse repeated sequences with 9bp spacer were designed and synthesized.The complement strain were obtained by annealing and inserted into the vector pgenesil-1 containing green fluorescenet protein(GFP) sequence and U6 promotor.Finally the recombinant plasmid were identified by enzyme digesion and DNA sequencing,then transfected into HEP2 cells and observed by fluorescence microscope.Results: The recombinante plasmid targeting the mRNA of RSV M2 gene was successfully constructed and the good efficents of transfection were found by fluorescence microscope.Conclusion: The successful construction of the pshRNA recombinant plasmid targeting the M2 gene of RSV will help futher study on application of the RNAi technology to anti-RSV infection.