Archive

06 August 2023, Volume 38 Issue 8 Previous Issue   

---

For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

Select

Expert consensus on the evaluation and management of feeding disorders in clinical rehabilitation of children The Subspecialty Group of Rehabilitation, the Society of Pediatrics, Chinese Medical Association 2023, 38(8): 561-566.  DOI: 10.19538/j.ek2023080601 Abstract ( )   Feeding disorders are common in clinical rehabilitation of children and the etiology is heterogeneous；failure to identify and standardize management in time will aggravate the adverse consequences，even threaten life. However，there is still a lack of comprehensive evaluation and rehabilitation management standards for pediatric feeding disorders. Based on research evidence at home and abroad and combined with clinical experience，the Subspecialty Group of Rehabilitation，the society of Pediatrics，  Chinese Medical Association discussed and put forward the expert consensus on the evaluation and management of pediatric feeding disorders，in order to scientifically standardize management and guide clinical practice.

Select

Standardized diagnosis and treatment of attention-deficit hyperactivity disorder ZHENG Yi 2023, 38(8): 567-570.  DOI: 10.19538/j.ek2023080602 Abstract ( )   The article introduces the research and new progress in diagnosis and treatment of attention deficit hyperactivity disorder（ADHD），focusing on the differences in diagnosis and treatment between domestic and foreign countries，and proposes the theory and practice of standardized diagnosis and treatment of ADHD in China，in order to provide scientific reference for clarifying the current non-standard state in the diagnosis and treatment of ADHD.

Select

Alert to the spread of mpox in children LU Qing-hua, ZHENG Yue-jie, YANG Yong-hong 2023, 38(8): 571-574.  DOI: 10.19538/j.ek2023080603 Abstract ( )   In recent years，the world has been seriously affected by the viral infectionpandemic，the sudden outbreak of monkeypox has emerged and is currently exhibiting an epidemic trend in Asia，thereby posing a grave threat to human health.Given the alterations in the control measures for novel coronavirus infection in China，it is imperative to exercise caution regarding the spread of monkeypox virus infection among children. This article aims to explicate the potential hazards and preventive measures of monkeypox infection in children.

Select

Research progress on brain magnetic resonance in pediatric attention deficit hyperactivity disorder ZHANG Kang-fu-xi, CAO Qing-jiu 2023, 38(8): 575-579.  DOI: 10.19538/j.ek2023080604 Abstract ( )   Attention deficit hyperactivity disorder （ADHD） is one of the most common neurodevelopmental disorders. In recent years，the advancement of magnetic resonance imaging （MRI） technology has provided a non-invasive means to investigate the structural and functional abnormalities of brain in ADHD. This article reviewed the research conducted in recent years on ADHD using various MRI techniques，including structural MRI （sMRI），diffusion tensor imaging （DTI），functional MRI （fMRI），and arterial spin labeling（ASL）. These studies have revealed abnormalities in brain structure，white matter microstructure，resting-state brain function，task-related brain function （such as attention，impulse control，and inhibition），as well as cerebral blood flow in ADHD children. Considering the gender differences in ADHD prevalence，it is speculated that there are differences in brain structure and function between males and females. This review specifically focuses on the gender differences observed in brain MRI findings. The findings from MRI studies on ADHD have significant implications for a better understanding of the underlying pathological mechanisms of ADHD.

Select

Research progress in genetics of attention deficit hyperactivity disorder in children ZHANG Ling, LIU Huan-zhong 2023, 38(8): 580-584.  DOI: 10.19538/j.ek2023080605 Abstract ( )   Attention deficit hyperactivity disorder （ADHD） is one of the most common neurodevelopmental disorders in children with a complex etiology，and genetic factors play a pivotal role in the development of ADHD in children，with a heritability rate as high as 75%. This paper now summarizes the progress of genetic research on childhood ADHD，starting from candidate genes，genome-wide association studies （GWAS），epigenetics，and gene copy number variants （CNVs），in order to understand the progress of genetic research on childhood ADHD and further help medical practitioners to increase their understanding of the disease from genetic aspects.

Select

Evaluation and diagnosis of attention deficit hyperactivity disorder in children ZHANG Xiao-hua, CUI Yong-hua, YAN Jun-juan, et al 2023, 38(8): 584-587.  DOI: 10.19538/j.ek2023080606 Abstract ( )   Attention deficit hyperactivity disorder（ADHD） is the most common neurodevelopmental disorder，but the hospital-visit rate is low. Early detection，early evaluation and diagnosis are the prerequisite for early treatment. The assessment of children's ADHD involves all data collection before diagnosis，including diagnostic clues，medical history collection，clinical examination，and laboratory and auxiliary examination. DSM-5 diagnostic standard has been widely used in the diagnosis of ADHD，and ICD-11 will be the official diagnostic standard in China after its promulgation. The contents of both are basically the same. It's best is to avoid underdiagnosis and over-diagnosis as much as possible in the diagnosis，and pay attention to the diagnosis of comorbidity. Accurate diagnosis can lead to accurate treatment.

Select

Common psychiatric comorbidities and treatment of atten-tion deficit hyperactivity disorder in children HUANG Huan-huan, HE Fan 2023, 38(8): 588-592.  DOI: 10.19538/j.ek2023080607 Abstract ( )   Attention deficit hyperactivity disorder （ADHD） is a common neurodevelopmental disorder in children. The comorbidity rate of ADHD is high，and there are many types of comorbidities. The existence of comorbidities often leads to serious damage to patients' social function and affects prognosis. This article introduces the common psychiatric comorbidities for ADHD in children，and discusses the treatment for common comorbidities of ADHD，further helping medical workers to have a deeper understanding of the disease and provide more targeted treatment.

Select

Common neurological comorbidity and treatments of ADHD in children WANG Hua 2023, 38(8): 592-596.  DOI: 10.19538/j.ek2023080608 Abstract ( )   Attention deficit hyperactivity disorder（ADHD） is a common neurodevelopmental disorder in childhood. Although there are many causes of ADHD，much attention should be paid to ADHD secondary to neurological diseases in children，especially for the treatments. From the perspective of abnormal brain structure pediatric neurological diseases and ADHD，the relationship between epilepsy，headache，sleep disorder，encephalitis and ADHD have been discussed in this paper. Although early diagnosis，treatment and intervention are important，etiological diagnosis and differential diagnosis cannot be ignored，and it is very important o treat the synupt-oms and causes at the same time.

Select

Traditional Chinese medicine treatment for children with attention deficit hyperactivity disorder WANG Su-mei, CHEN Zi-jia 2023, 38(8): 597-600.  DOI: 10.19538/j.ek2023080609 Abstract ( )   Attention deficit hyperactivity disorder （ADHD） is a common behavioral disorder in children. With the change of lifestyle，environment and diet structure，the incidence rate increases year by year. According to traditional Chinese medicine，ADHD is a state of excess of yang and deficiency of yin on the whole. It starts from the spleen，develops in the liver，reverses in the lung，becomes deficient in the kidney and loses heart. It is a disease with dysfunction of five internal organs and mutual influence，and is mixture of deficiency and excess. It is related to the mind，wind and phlegm. Traditional Chinese medicine treatment for ADHD has the advantages of individualization，definite curative effect and mild side effects，and is one of the effective clinical treatment methods. This article discusses the progress of traditional Chinese medicine treatment for ADHD from the aspects of TCM's understanding of the etiology and pathogenesis of ADHD，the treatment based on syndrome differentiation and traditional Chinese medicine preparations.

Select

Randomized controlled，multi-center clinical study of Huanglong Zhike Granules combined with montelukast sodium chewable tablets for treatment of cough variant asthma in children MA Rong, HU Si-yuan, LI Xin-min, et al 2023, 38(8): 601-607.  DOI: 10.19538/j.ek2023080610 Abstract ( )   Objective    To evaluate the clinical efficacy and safety of Huanglong Zhike Granules combined with montelukast sodium chewable tablets for the treatment of cough variant asthma （CVA） in children with lung-kidney qi deficiency and phlegm-heat lung-stagnation syndrome. Methods    From March 2018 to September 2019，160 cases in 8 research centers were included for research by stratified，randomied，paralleled controlled method（First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine，Qianfoshan Hospital of Shandong Province，Dongfang Hospital of Beijing University of Traditional Chinese Medicine，Shengjing Hospital of China Medical University，The First Affiliated Hospital of Henan University of Chinese Medicine，Tianjin Children's Hospital，Shanghai Municipal Hospital of Traditional Chinese Medicine，Shenzhen Children 's Hospital ），including 80 cases in the experimental group and 80 cases in the control group. The experimental group were treated with Huanglong Zhike Granules and montelukast sodium chewable tablets；the control group was given montelukast sodium chewable tablets and Huanglong Zhike Granule simulant，and the usage and dosage were the same as those in the experimental group. Both groups were treated continuously for 4 weeks. The disease control and TCM efficacy of the two groups were observed. The cough symptom severity score，TCM syndrome score，lung function and safety index were compared between the two groups. Results    All the 160 cases entered the full analysis set （FAS），safety data set （SS），and 152 cases entered the compliance scheme data set （PPS）. In the experimental group，73 cases were controlled，3 cases were partially controlled，and 1 case was not controlled after 4 weeks of treatment. In the control group，63 cases were controlled，11 cases were partially controlled，and 1 case was not controlled. The disease control in the experimental group was better than that in the control group. The difference between the two groups was statistically significant （P<0.05）. The conclusion of PPS and FAS analysis was consistent with this. After 4 weeks of treatment，the efficacy of TCM syndromes in the experimental group was better than that in the control group. The scores of daytime cough symptom severity，nighttime cough symptom severity，and TCM syndrome scores were lower than those in the control group. The difference between the two groups was statistically significant （P<0.05）. The results of PPS and FAS analysis were consistent  with this. There was no significant difference in FEV1，FVC and FEV1/FVC between the two groups （P>0.05）. There were 2 cases of adverse events，and 1 case was judged as adverse reaction. There was no significant difference in the incidence of adverse events or rate of adverse reactions between the two groups （P>0.05）. Conclusion    Huanglong Zhike Granules combined with montelukast sodium chewable tablets is superior to montelukast sodium chewable tablets alone in the treatment of children with CVA of lung and kidney qi deficiency and phlegm-heat stagnation regarding lung syndrome disease control and TCM syndrome. It can reduce the severity of cough symptoms in children，improve related symptoms，and has good safety.

Select

Correlation between the clinical characteristics of human metapneumovirus infection in preschool children and the level of cellular immunity YAN Shi-wei, QIN Min, WU Qiu-pin, et al 2023, 38(8): 608-612.  DOI: 10.19538/j.ek2023080611 Abstract ( )   Objective    To investigate the correlation between clinical features and cellular immunity level in preschool children infected with human metapneumovirus （hMPV）. Methods    A total of 1275 nasopharyngeal swabs were collected for retrospective analysis from  preschool children with respiratory tract infection admitted to our hospital from May 2021 to May 2022. PCR amplification was used to screen hMPV and other common respiratory viruses and bacteria. The epidemiological characteristics，clinical manifestations，laboratory tests and imaging tests and their correlation with the level of T-lymphocyte subsets were analyzed. Results Among 1275 samples，105 samples were positive for hMPV （8.2%），among which 20 cases were hMPV combined with other viruses，and 77 cases were hMPV combined with bacterial infection.The positive rate of hMPV peaked in late spring and early summer. There were 42 females （40.0%） and 63 males （60.0%）. The main clinical features included fever in 86 cases （81.9%），cough in 103 cases （98.1%），wheezing in 47 cases （44.8%），shortness of breath in 27 cases （25.7%），oxygen therapy in 27 cases （25.7%），moist rale in lung in 91 cases （86.7%）；imaging pneumonia： there were 82 cases （78.1%），28 cases （26.7%） with lung consolidation，82 cases （78.1%） with elevated lactate dehydrogenase，CD3+CD4+（38.42±9.17），CD3+CD8+（23.52±6.26），CD3-CD19+（24.54±8.15），CD56+CD16+（7.72±4.74）.In the hMPV group，children receiving oxygen were negatively correlated with CD3+CD4+ （P=0.007）. Conclusion    The main clinical manifestations of preschool children infected with hMPV are cough，fever，and moist rales in the lungs. Some children have wheezing attacks，a small number of children can have cause severe infection，and most children have increased lactate dehydrogenase. The levels of T-lymphocytes subsets show that the proportion of CD3+CD8+，CD56+CD16+ decreases，while proportion of B-lymphocytes increases. In the hMPV group，the level of CD3+，CD3+CD4+，CD3+CD8+，and CD56+CD16+ are negatively correlated with severe infecion in children.

Select

Diagnostic value of flexible bronchoscope combined with rapid on site evaluation technique in children with refractory pneumonia LIU Xiang-teng, WANG Gui-lan, CHEN Ang, et al 2023, 38(8): 613-618.  DOI: 10.19538/j.ek2023080612 Abstract ( )   Objective    To explore the diagnostic value of flexible bronchoscopy combined with rapid on-site evaluation（ROSE） in children with refractory pneumonia，and provide reference for rapid clinical diagnosis. Methods    Retros-pective analysis was performed in children with refractory pneumonia receiving flexible bronchoscopy，who were admitted to Boai Hospital of Zhongshan from November 2017 to February 2022. According to whether ROSE   examination was performed，they were divided into the simple bronchoscopy group and the bronchoscopy +ROSE group. The relevant examination results in the two groups were compared，and the confirmed diagnosis results at discharge were compared with the on-site examination results in the two groups. Kappa values were calculated and the working characteristics curve of subjects （ROC） was drawn to evaluate the diagnostic effect. Results    A total of 351 patients were included，including 172 cases in the bronchoscope + ROSE group and 179 cases in the simple bronchoscope group. There was no significant difference in the first bronchoscopy time between the two groups（t=-0.672，P>0.05），but the proportion of patients requiring multiple examinations in the bronchoscope + ROSE group was significantly lower than that in the simple bronchoscope group，and the difference was statistically significant（χ2 =4.407，P<0.05）；the sensitivity and specificity of the on-site examination results in the bronchoscopy +ROSE group were 91.4% and 78.6%，respectively，and the sensitivity and specificity of the on-site examination results in the bronchoscopy alone group were 63.6% and 68.8%，respectively. Compared with the bronchoscopy alone group，the bronchoscopy +ROSE group had higher diagnostic efficency (coincidence rate：90.3% vs. 64.1%；Kappa：0.511 vs. 0.133；AUC：0.846 vs. 0.662）. Conclusion    Flexible bronchoscope combined with ROSE technology can significantly improve the diagnostic efficiency of refractory pneumonia in children and effectively reduce the number of bronchoscopy examinations，which is worthy of clinical promotion.

Select

Risk factors of brain imaging abnormalities  in pediatric patients supported by extracorporeal membrane oxygenation with cervical vessels cannulation FENG Qiu-shuang, LIU Chang-e, ZHAO Zhe, et al 2023, 38(8): 619-624.  DOI: 10.19538/j.ek2023080613 Abstract ( )   Objective    To explore the risk factors of brain imaging abnormalities in children with ECMO who are intubated through the right neck. Methods    A retrospective analysis was performed on the data of children who underwent VA-ECMO support and survived by cannulation of the right internal jugular vein and common carotid artery from January 2016 to December 2021. According to the head CT/MRI information，they were divided into an abnormal group and a normal group. The demographic data，ECMO-related laboratory tests，and treatment were analyzed. The variables with statistical significance in the univariate analysis were included in the multivariate logistic regression to analyze the independent risk factors for ECMO-related acute brain imagng abnormalities. Results    A total of 108 children were included. There were 47 cases in the normal group and 61 cases in the abnormal group，with a brain CT/MRI abnormality rate of 56.48%. After ECMO，the right common carotid artery ligation rate was 37.04% （n=40）in the 108 cases，and the repair rate was 62.96% （n=68）. The rate of brain imaging abnormalities in carotid artery ligation was 62.50% （n=25），and that of repairers was 52.94% （n=36）， but there was no significant difference between the two （P>0.05）. There was no significant difference in the basic data such as type （neonatal/child），gender，weight，or pre-ECMO diagnosis （P>0.05）.  The pH value， base excess and lactate value before ECMO  were significantly different from those in the normal group（P<0.05）. The lactate value before ECMO in the abnormal group was significantly higher than that in the normal group （P = 0.003），which a significant positive correlation with brain imaging abnormalities （OR=1.107）. Conclusion    Lactic acid accumulation before ECMO is an independent risk factor for brain imaging abnormalities，and right common carotid artery ligation after ECMO withdrawal is not significantly associated with brain imaging abnormalities.

Select

Multidisciplinary management of osteogenesis imperfecta DONG Zhong-xin, YIN Shi-jie, DONG Li-na, et al 2023, 38(8): 625-630.  DOI: 10.19538/j.ek2023080614 Abstract ( )   Osteogenesis imperfecta is a group of rare skeletal diseases with clinical heterogeneity and different clinical severity. Due to the distribution of type I collagen，osteogenesis imperfecta often involves multiple systems as well requiring multidisciplinary treatments. Understanding the common clinical manifestations of osteogenesis imperfecta，mastering the principles of treatment，and carrying out multidisciplinary management are essential to improving the quality of life of patients with osteogenesis imperfecta.

Select

Research progress of serum amyloid A protein in neonatal necrotizing enterocolitis ZHANG Xiao-xia, ZHAO Xiu-zhi, ZHANG Xiao-mei 2023, 38(8): 631-633.  DOI: 10.19538/j.ek2023080615 Abstract ( )   Necrotizing enterocolitis （NEC） is a serious intestinal inflammatory disease in the neonatal period，which can lead to the death of newborns，premature infants especially. Serum amyloid A protein （SAA） is an acute phase reactive protein secreted by liver. The content of SAA increases sharply when the body has an acute phase response. As a pro-inflammatory factor，it accelerates the body's inflammatory reaction，and has important value for the early recognition，diagnosis and assessment of NEC.

Select

PARS2 gene-related developmental and epileptic encephalopathy： A case report and literature review HUANG Xiu-li, WEI Cui-jie, YANG Zhi-xian, et al 2023, 38(8): 634-639.  DOI: 10.19538/j.ek2023080616 Abstract ( )   Analyze the clinical and molecular genetic characteristics of PARS2-related developmental and epileptic encephalopathy. Clinical，imaging and genetic data of one patient with PARS2-related developmental and epileptic encephalopathy were retrospectively analyzed. Summarize clinical and genetic characteristics of this disorder based on literature review. The 9-month old boy was admitted to the Department of Pediatrics of Peking University First Hospital in January 2022 for "repeated convulsions for 3 months". They were followed up for eight months and global developmental delay，hypotonia and microcephaly were observed.  A total of 20 patients were analyzed. The main clinical manifestations included onset during the first six months of age，global developmental delay，spasm，hypotonia，microcephaly，cortical atrophy with obvious frontal involvement and abnormal hyperintensities around the cerebellar dentate nuclei and cardiac involvement. A total of 11 pathogenic variants were reported，and the most common variants were c. 283G > A （ 42.3 % ） and c. 1091C > G （ 19.2 % ）. For children with global developmental delay and spasm during the first six months of age，when they had hypotonia，microcephaly，cortical atrophy with obvious frontal involvement and  abnormal hyperintensities around the cerebellar dentate nuclei and cardiac involvement，PARS2-related developmental and epileptic encephalopathy should be considered. The c. 283G > A （ 42.3 % ） and c. 1091C > G （ 19.2 % ） were two high frequency pathogenic variants.