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06 June 2020, Volume 35 Issue 6 Previous Issue    Next Issue

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3rd of the recommendations series of experts on clinical practical hot issues of children’s immune related diseases——Advice on the application of cyclosporine in the immune diseases in children Pediatric Allergy Immunology Rheumatology Branch of Asia-Pacific Association of Medicine and Bio-Immunology，Editorial Committee of Chinese Journal of Practical Pediatrics 2020, 35(6): 417-423.  DOI: 10.19538/j.ek2020060601 Abstract ( )

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4th of the recommendations series of experts on clinical practical hot issues of children’s immune related diseases——Advice on the application of leflunomide in the immune diseases in children Pediatric Allergy Immunology Rheumatology Branch of Asia-Pacific Association of Medicine and Bio-Immunology，Editorial Committee of Chinese Journal of Practical Pediatrics 2020, 35(6): 424-430.  DOI: 10.19538/j.ek2020060602 Abstract ( )

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5th of the recommendations series of experts on clinical practical hot issues of children’s immune related diseases——Advice on the application of thalidomide in the immune diseases in children Pediatric Allergy Immunology Rheumatology Branch of Asia-Pacific Association of Medicine and Bio-Immunology，Editorial Committee of Chinese Journal of Practical Pediatrics 2020, 35(6): 431-434.  DOI: 10.19538/j.ek2020060603 Abstract ( )

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Expert consensus on quality control management of pediatric rehabilitation in China Subspecialty Group of Rehabilitation of the Society of Pediatrics of Chinese Medical Association 2020, 35(6): 435-438.  DOI: 10.19538/j.ek2020060604 Abstract ( )

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Interpretation of State of the evidence traffic lights 2019：Systematic review of interventions for preventing and treating children with cerebral palsy published by Current Neurology and Neuroscience Reports in 2020 Subspecialty Group of Rehabilitation of the Society of Pediatrics of Chinese Medical Association 2020, 35(6): 439-445.  DOI: 10.19538/j.ek2020060605 Abstract ( )   Cerebral palsy is the most common physical disability in children. In recent years，there are more and more intervention methods for the prevention and treatment of cerebral palsy，and the evidence base has continued to expand rapidly，which expands the information needed by clinicians in clinical decision-making. A systematic review of cerebral palsy interventions of recent years was published on Current Neurology and Neuroscience Reports in 2020，which pooled their systematic reviews on intervention evidence of cerebral palsy in 2013. They rated the whole cerebral palsy intervention evidence base，with the aim of providing families，clinicians，managers，and policy-makers with the best available intervention evidence. This paper will interpret this systematic review according to the actual situation of intervention methods of cerebral palsy in China，in order to standardize the current situation of prevention and treatment of cerebral palsy in China，help the clinicians to learn about the latest research progress in intervention measures，and provide information for clinical decision-making.

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Endocrine assessment and hormone replacement therapy in children with craniopharyngioma after operation MIAO Yu-qi，WU Di 2020, 35(6): 446-450.  DOI: 10.19538/j.ek2020060606 Abstract ( )   Craniopharyngioma is a benign tumor of sellar region originating from the remnants cells of Rathke’s cleft cyst，which commonly occurs in childhood. Primary clinical manifestations are headache and nausea due to increased intracranial pressure，visual impairment and hypothalamic-pituitary dysfunction. The main treatment for craniopharyngioma is surgical resection. The 10-year survival rate of craniopharyngioma children is as high as 80%. However，due to the specific location of craniopharyngioma，post-surgery patients are prone to hypopituitarism，which strongly affects their long-term quality of life. Understanding the occurrence of postoperative hypopituitarism in children with craniopharyngioma，monitoring the hypothalamic-pituitary axis function  at regular intervals，and conducting regular，precise and individualized alternative therapy is very important for children with craniopharyngioma. It will improve their prognosis and long-term quality of life，as well as their adaptability to the society.

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Treatment for 21-hydroxylase deficiency of congenital adrenal hyperplasia and the growth balance in children WANG Jin-ling，DONG Guan-ping，HUANG Ke，et al 2020, 35(6): 450-455.  DOI: 10.19538/j.ek2020060607 Abstract ( )   21 hydroxylase deficiency（21-OHD） is the most common type of congenital adrenal hyperplasia（CAH）. 21-OHD has many effects on childhood growth and development，including reduced final adult height，early onset of puberty，and metabolic complications. It is an important goal for 21-OHD patients to obtain as normal adult height as possible. Through scientific diagnosis and hydrocortisone treatment，combined with regular monitoring and growth-promoting drugs such as growth hormone，gonadotropin-releasing hormone analogue，aromatase inhibitor，height loss can be effectively relieved and growth balance achieved.

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Epiphyseal developmental disorders and growth ZHU Min，XIONG Feng 2020, 35(6): 455-460.  DOI: 10.19538/j.ek2020060608 Abstract ( )   Normal bone is very important in maintaining normal body shape and healthy activities，and any bone disease will endanger human health. Bone growth and development is a complex process，which is influenced by many pathways and factors. The growth plate carried by epiphyseal cartilage is an important part of bone growth，and its developmental disorder directly affects bone growth. This paper describes the representative osteopathy caused by the normal growth and development of epiphyseal and its disorders：spinal epiphyseal dysplasia and cartilage dysplasia syndrome.

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Advances in the study of drugs to improve growth of children with short stature WANG Chun-lin*，FU Jun-fen，LIANG Li 2020, 35(6): 460-464.  DOI: 10.19538/j.ek2020060609 Abstract ( )   Children’s height has been more and more concerned about by the society，parents and pediatricians. We discussed the research progress of drugs to improve growth of pediatric patients with short stature. Growth and final height are related to heredity，intrauterine development，postnatal nutrition，environment and endocrine hormones. New data confirm the known-efficacy of recombinant human growth hormone（rhGH） in growth hormone deficiency（GHD） and idiopathic short stature，and long-acting recombinant human growth hormone（LA-rhGH） in GHD. In future，the research and development of LA-rhGH and its clinical trials to expand the indications will be mainly carried out. Recombinant human insulin growth factor-1（rhIGF-1） is the main drug in the treatment of IGF-1 deficiency，and hypoglycemia and neoplasm should be monitored. GnRHa and the third generation of nonsteroidal aromatase inhibitors（AIs）can effectively delay epiphyseal fusion，and when combined with rhGH treatment it is beneficial to improve height. However，its efficacy is related to the etiology，age，heredity，treatment course and other factors. Long-term safety，efficacy and economy of the GnRHa or AIs should be considered comprehensively to make careful evaluation and selection. The modified recombinant C-type natriuretic peptide has completed the phase Ⅲ clinical trial, which has certain benefits to improve the height of children with achondroplasia. Some safe，effective，high-quality and stable new drugs were expected to be developed in order to enhance growth and promote their physical and mental health.

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Predictive modeling of reference equations for pulmonary ventilation function parameters of children aged 3-12 years in Chongqing LIU Sha，FU Zhou，GONG Cai-hui，et al 2020, 35(6): 465-470.  DOI: 10.19538/j.ek2020060610 Abstract ( )   Objective　To establish predictive modeling of reference equations for pulmonary ventilation function parameters of pre-school children and primary school-age children. Methods　The pulmonary function test（PFT） of 458 children aged 3-12 years from Chongqing were measured using JAEGER MasterScreen Pead system with standardized protocols. All statistical analyses were performed using SAS Statistics version 9.4. Univariate linear regression was used to analyze the influence of the known or potential influencing factors on each PFT parameters，then reference equations adjusted for gender，age，length and weight were built using multiple linear regression model. Comparison between our estimates and those published reference equations was done，the mean of relative prediction error（RPE%） the applicatility was used to evaluate of the equations. Results　Age，height and weight were correlated with each PFT parameters（excepted MEF25） in pre-school children，and gender was correlated with FVC、FEV0.5、FEV1、PEF、MEF50、MEF75 and MVV. In school-age children，age，height and weight were correlated with each PFT parameters excepted MMEF，gender was correlated with FVC，FEV1，FEV0.5/FVC，MEF50 and MVV. Comparisons between various predictive equations showed that the current equations derived from our raw data were applicable to our population. Conclusion　Age，height and weight are the main variables affecting most parameters of PFT for preschool and school-age children. The influence of gender on pre-school children is greater than on school age children. Establishment of predicted reference equations of PFT parameters should be based on different age groups. The current equations are applicable in children aged 3-12 years for the prediction of pulmonary ventilation function parameters.

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Relationship between glycaemic variability and outcomes in critically ill children at different age DU Yu-hui*，LI Jing，LIU Cheng-jun 2020, 35(6): 471-477.  DOI: 10.19538/j.ek2020060611 Abstract ( )   Objective　To compare the ability of different indices of glycemic variability（GV） in the prognostic evaluation of critically ill children and investigate the effect of age in GV and mortality. Methods　A retrospective study of 410 patients was conducted admitted to the medical-surgical PICU of a teaching hospital from January 2016 to December 2016. The patients were divided into survivors or non-survivors according to the 28 days physical condition after PICU admission. Physiological parameters and outcome data were recorded for 72 h after PICU admission，a variety of statistical methods were used for statistical analysis, including the univariate, spearman correlation，receiver operating characteristic（ROC） curve and logistic regression analysis and so on. Results　（1）Survivors and non-survivors showed significant differences in terms of the SD，CV，MAGE，and GLI（ P＜0.05，for all）. However，GLI was superior to the other indices（GLI：r＝0.404， P＜0.001；AUC＝0.626，95%CI＝0.558～0.693），and showed an independent association with ICU mortality（OR＝1.069，95%CI＝1.018～1.122，P＜0.01. （2）Different from adult  studies, there is a heterogeneous effect of GV in children, sub-group analysis disaggregated by quartiles of MGL and GV revealed that younger subjects（age ≤36 months） in the lowest quartile of the MGL and in the highest quartile of GV had significantly higher mortality（71.4%）；the older children（age＞36 months）  in the highest quartiles of MGL and GV experienced higher mortality（69.2%）. Conclusion　GV increased the risk of mortality in critically ill children，and among all glucose parameters evaluated，GLI was found to be the strongest predictor of outcomes. This study is the first report showing that there is a heterogeneous effect of GV in different age groups in children.

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Two types of lung ultrasonography examinations in children with dyspnea：Comparison and analysis of the diagnostic value CHEN Shui-wen，ZHOU Gang，XIE Hong-bo，et al 2020, 35(6): 478-481.  DOI: 10.19538/j.ek2020060612 Abstract ( )   Objective　To assess the diagnostic value of the routine lung ultrasound and bedside lung ultrasound in emergency（BLUE） protocol  in children with dyspnea. Methods　Totally 217 children with dyspnea hospitalized from Sep 1，2017 to May 31，2019，in Shenzhen Bao’an Maternal and Child Health Hospital，were included in this study. All the children were examined by LUS and BLUE protocol of LUS. Results　There were 186 patients（85.7%） with lung diseases and 31（14.3%） without lung diseases. The cases with lung diseases were as follows：89 cases（47.8%） of severe pneumonia，43 cases（23.1%） of  capillary bronchitis，34 cases（18.3%） of bronchial asthma，12 cases（6.5%） of laryngitis and 8 cases（4.3%） of acute respiratory distress syndrome（ARDS）. The 32 cases among 217 children in which abnormal signs couldn’t be found by X-ray were found with lung consolidation and/or interstitial syndrome by LUS. There were 37 cases among 217 children which were  misdiagnosed  by the BLUE protocol of LUS，the difference between the results of regular LUS and BLUE protocol was statistically significant （P＜0.001）. Conclusion　The diagnosis by LUS  is feasible in children with dyspnea in PICU. However，the use of the BLUE protocol should be with care in order to avoid errors.

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Relationship between hepatitis B vaccination and transient surface antigenemia ZENG Qian，GAO De-qiang，LI Yu-rong，et al 2020, 35(6): 482-484.  DOI: 10.19538/j.ek2020060613 Abstract ( )

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Research progress in the pathogenesis of bronchiolitis obliterans WANG Xia，LI Qu-bei 2020, 35(6): 485-489.  DOI: 10.19538/j.ek2020060614 Abstract ( )

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One case report on recurrent pneumonia due to DNA ligase Ⅳ deficiency XUE Ren-jie，TIAN Man，ZHAO De-yu，et al 2020, 35(6): 490-492.  DOI: 10.19538/j.ek2020060615 Abstract ( )

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One case report on mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase deficiency SHEN Ling-hua，WU Sheng-nan，WANG Hui-zhen，et al 2020, 35(6): 493-496.  DOI: 10.19538/j.ek2020060616 Abstract ( )