Translational pediatrics最新文献

{"title":"Trends in short-term outcomes of very low birth weight infants from a single center in Shanghai from 2013 to 2023.","authors":"Ling Zhao, Wan Tang, Pu Xu, Ziming Wang, Jiayu Zhou, Yingying Jiang, Zhuoyu Zhao, Rong Zhang, Jin Wang, Laishuan Wang","doi":"10.21037/tp-2025-16","DOIUrl":"10.21037/tp-2025-16","url":null,"abstract":"<p><strong>Background: </strong>Very low birth weight infants (VLBWI) are vulnerable to serious complications. We aim to describe the short-term outcomes of VLBWI in a single center during 2013-2023, providing the basis for clinical disease management.</p><p><strong>Methods: </strong>A retrospective study of VLBWI admitted to a tertiary neonatal intensive care unit (NICU) between 1 January 2013 and 31 December 2023 was conducted to analyze trends of mortality and major morbidities over the 11-year period. Infants were divided into two subgroups according to birth weight (BW): <1,000 and 1,000-1,500 g. Major morbidities were defined as bronchopulmonary dysplasia (BPD), late onset sepsis (LOS), intraventricular hemorrhage (IVH) ≥ grade 3, necrotizing enterocolitis (NEC) ≥ stage 2, retinopathy of prematurity (ROP) ≥ stage 3 or needed treatment, and periventricular leukomalacia (PVL).</p><p><strong>Results: </strong>A total of 2,475 VLBWI were enrolled from 2013 to 2023. Analysis showed that the overall trend of mortality, LOS, NEC, IVH and PVL decreased, but BPD and ROP increased during the 11 years. Except for ROP, which exhibited a consistent increasing trend, other outcomes have a significant inflection point. Mortality, LOS, NEC, IVH and PVL kept steady initially, but decreased quickly around 2017. BPD was stable from 2013 to 2016, after which it increased dramatically. Most trends in the two subgroups by BW were similar to the patterns in the overall infants.</p><p><strong>Conclusions: </strong>Mortality and most morbidities in VLBWI decreased from 2013 to 2023, with the exception of BPD and ROP. Continuous research and quality improvement (QI) efforts should be made to further improve the outcomes of VLBWI, especially for BPD and ROP.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 5","pages":"788-798"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global T-cell functionality evaluated by whole blood interferon-gamma release assay as a valuable indicator for immune reconstitution monitoring in pediatric allo-HSCT.","authors":"Min Wang, Liang Ma, Chengjuan Luo, Changying Luo, Xia Qin, Xiaohang Huang, Yan Miao, Qing Cao, Aurore Fleurie, Franck Berthier, Ji Liang, Jing Chen","doi":"10.21037/tp-2025-80","DOIUrl":"10.21037/tp-2025-80","url":null,"abstract":"<p><strong>Background: </strong>Adequate T-cell immune reconstitution (IR) following allogeneic hematopoietic stem cell transplantation (allo-HSCT) is pivotal for the recovery and optimal outcomes of pediatric HSCT recipients. A thorough assessment of global T-cell functionality is a crucial component in monitoring T-cell IR during the post-transplant period. The purpose of this study is to provide a novel tool and strategy for assessing and monitoring T-cell IR after pediatric allo-HSCT.</p><p><strong>Methods: </strong>This study enrolled 126 pediatric patients receiving allo-HSCT at a single institution. A standardized whole blood interferon-gamma release assay (WB-IGRA) was introduced to evaluate global T-cell functionality in different periods after HSCT.</p><p><strong>Results: </strong>The study revealed that T-cell functionality, assessed via the WB-IGRA assay, progressively enhanced over the post-transplant period, effectively distinguishing between patients with and without immunosuppression, thereby highlighting the assay's viability in assessment of T-cell IR in children after allo-HSCT. Further analysis stratified by age revealed a more significant enhancement in T-cell functionality among children >10 years old compared to those ≤10. Conversely, when evaluating immune cell subsets, increases in CD3⁺, CD4⁺, and CD8⁺ subsets well reflected immune reconstructive progress in children ≤10 years old, whereas only increases in CD4⁺ cell subsets exhibited statistical significance in older children. Additionally, all three T cell subset counts were significantly correlated with T-cell functionality in older children, whereas no such correlation was observed in younger ones.</p><p><strong>Conclusions: </strong>This study demonstrated the potential application of the WB-IGRA approach in evaluating and monitoring T-cell IR in pediatric allo-HSCT recipients. Combining the assessment of T-cell immune functionality with cellular phenotypes could enhance the understanding of T-cell IR in HSCT children of different ages.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 5","pages":"834-843"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal osteomyelitis: a case series and literature review.","authors":"Huanhuan Wang, Xiaoyan Ni, Guoqiang Cheng, Laishuan Wang, Jin Wang","doi":"10.21037/tp-2025-45","DOIUrl":"10.21037/tp-2025-45","url":null,"abstract":"<p><strong>Background: </strong>Neonates have a number of risk factors that make them susceptible to bone and joint infections. Pathogens can access the bone through the bloodstream (hematogenous spread), direct inoculation (traumatic or procedural), or by contiguous spreading from nearby infected soft tissues or synovial fluid. Studies focused on neonatal osteomyelitis are very rare and most of them only involved a small number of cases. This study aimed to describe the cases of neonatal osteomyelitis in one of the largest neonatal intensive care units in China across a 6-year time period and to compare the results with those reported in the latest literature.</p><p><strong>Methods: </strong>This study retrospectively reviewed the data of clinical characteristics, etiologies and outcomes in neonates with osteomyelitis from 2016 to 2021 in Children's Hospital of Fudan University and compared our results with six large case series (>10 cases) of neonatal osteomyelitis reported in the past 30 years.</p><p><strong>Results: </strong>Fifteen neonates were identified, accounting for 0.05% of the total neonatal admissions. The median [interquartile range (IQR)] gestational age was 37.9 (IQR, 36.6-39.9) weeks, and one-third were preterm infants. The median (IQR) birth weight (BW) was 3,000 (IQR, 2,400-4,000) grams and 26.7% were of BW <2,500 g. The median (IQR) age at onset was 7 (IQR, 6-16) days after birth, and the median (IQR) time from symptom onset to confirmed diagnosis was 5 (IQR, 1-10) days. The most common presenting signs were fever, local swelling and reduced mobility of the affected segment. Femur was the most frequently affected site (66.7%) and 73.3% neonates had ≥2 bones involved. <i>Staphylococcus aureus</i> was the most common organism identified (40.0%), but there were 40.0% patients with negative cultures. The median (IQR) duration of intravenous antibiotic therapy and length of hospital stay was 29 (IQR, 25-42) and 30 (IQR, 29-42) days, respectively. The patients were followed up for a median (IQR) time of 9 (IQR, 2-19) months. All patients survived, but 40.0% presented with joint deformity during follow-up. The data from the latest literature showed a wide variability, in which about 1/4 had negative cultures, over 1/2 required surgical intervention, and 13.4% had sequelae during follow-up.</p><p><strong>Conclusions: </strong>Neonates with osteomyelitis required a long duration of antibiotics and had a high rate of sequelae. The treatment of neonatal osteomyelitis remains challenging, especially for those with negative culture. Further research is needed to investigate the proper duration of antibiotics administration and the indicators for switching antibiotics from intravenous to oral therapy for this population.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 5","pages":"871-880"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central line-associated bloodstream infections in children: a systematic review and meta-analysis.","authors":"Lixiang Li, Yingshan Zheng, Weiying Deng, Xiuyun Chen, Sihuan Lin","doi":"10.21037/tp-2024-597","DOIUrl":"10.21037/tp-2024-597","url":null,"abstract":"<p><strong>Background: </strong>Central line-associated bloodstream infection (CLABSI) in pediatric patients poses significant clinical challenges, with prevention strategies heavily reliant on identifying modifiable risk factors. Despite numerous studies investigating these risk factors, heterogeneity in study designs, populations, and regional settings necessitates a systematic synthesis of evidence to guide clinical practice. This meta-analysis aims to consolidate existing data and quantify key risk factors for pediatric CLABSI.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science was conducted for observational studies (cohort and case-control) published up to April 1, 2024. Two independent reviewers screened studies, extracted data, and assessed quality using the MOOSE checklist for observational meta-analyses. Meta-analyses were performed using Stata 15.0 software, with pooled odds ratios (ORs) and 95% confidence intervals (CIs) calculated via random-effects models. Heterogeneity was evaluated with I² statistics.</p><p><strong>Results: </strong>Seventeen studies (17 cohort studies) involving 15,221 pediatric patients were included. Significant risk factors for CLABSI were: blood transfusions (OR =5.69; 95% CI: 2.93-11.05), congenital diseases (OR =2.58; 95% CI: 1.14-5.83), central nervous system (CNS) diseases (OR =4.13; 95% CI: 1.17-9.98), total parenteral nutrition (OR =4.37; 95% CI: 1.14-16.82), multiple catheters (OR =4.16; 95% CI: 2.36-7.31), prolonged catheterization time (OR =1.19; 95% CI: 1.08-1.30). Subgroup analyses confirmed consistency across regions and study types (I²<50% for most factors).</p><p><strong>Conclusions: </strong>This meta-analysis identifies blood transfusions, congenital/CNS comorbidities, parenteral nutrition, and catheter-related practices as critical modifiable risk factors for pediatric CLABSI. Clinicians should prioritize early catheter removal, judicious blood product use, and intensified monitoring for high-risk patients. These findings align with existing guidelines but provide stronger evidence for pediatric-specific protocols.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 5","pages":"799-811"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>MASP1</i> as a favorable prognostic biomarker in pediatric osteosarcoma: an integrated analysis of machine learning, bioinformatics, and validation experiments.","authors":"Chun-Xian Lu, Zhen-Xue Long, Ji-Li Lu, Cheng-Kua Huang, Tomoki Nakamura, Shou-Wen Tao, Shu-Liang Hua, Da-Lang Fang","doi":"10.21037/tp-2025-262","DOIUrl":"10.21037/tp-2025-262","url":null,"abstract":"<p><strong>Background: </strong>Osteosarcoma (OS), the most common pediatric bone tumor, faces challenges with frequent relapse despite treatment advances. Identifying early diagnostic biomarkers and therapeutic targets is critical. The purpose of this study was to investigate the novel biomarkers for OS, and we also aimed to explore whether these biomarkers could potentially serve as the therapy targets.</p><p><strong>Methods: </strong>Integrated analysis combined three Gene Expression Omnibus (GEO) datasets (GSE42352, GSE126209, GSE12865) and TARGET-OS clinical-transcriptomic data (n=88). Immune-related genes from ImmPort (1,793 genes) were analyzed alongside differentially expressed genes (DEGs) identified via sva batch correction. Functional enrichment used clusterProfiler, while machine learning [eXtreme Gradient Boosting (XGB), random forest (RF), generalized linear model (GLM), support vector machine (SVM)] models were built with caret, xgboost, and kernlab. Prognostic genes were screened via univariate Cox regression (P<0.05). Key genes intersecting SVM and Cox results were validated via package for receiver operating characteristic (pROC), survival analysis, competing endogenous RNA (ceRNA) network (Cytoscape), immune infiltration (CIBERSORT), drug sensitivity (GDSC), and quantitative polymerase chain reaction (qPCR).</p><p><strong>Results: </strong>Differential analysis identified 1,370 DEGs (748 upregulated, 622 downregulated), intersecting with immune-related genes to yield 174 OS-linked immune-DEGs. Enrichment highlighted cytokine-PI3K-Akt pathways. Machine learning prioritized 10 genes, with <i>MASP1</i> showing highest diagnostic accuracy [area under the curve (AUC) =0.903, 95% confidence interval (CI): 0.769-0.993]. Univariate Cox linked <i>NRP3</i>, <i>STC2</i>, <i>ANGPT1</i>, <i>MASP1</i>, <i>SDC4</i>, <i>NEDD4</i>, <i>TYROBP</i> to prognosis (P<0.05). Intersection identified MASP1 as the core gene, significantly downregulated in OS tissue. Survival analysis across GEO/TARGET confirmed higher <i>MASP1</i> expression correlated with better outcomes (P<0.05). <i>MASP1</i> inversely correlated with resting CD4+ T-cell infiltration (r=-0.14, P=0.04), a poor prognostic marker. Drug sensitivity analysis associated <i>MASP1</i> with enhanced response to doxorubicin, vinblastine, gemcitabine, and sorafenib. qPCR validated <i>MASP1</i> downregulation in OS samples.</p><p><strong>Conclusions: </strong><i>MASP1</i> is a promising diagnostic biomarker and therapeutic target for OS. These findings could help to improve patient prognosis and the treatment response. Further studies should be conducted explore <i>MASP1</i> clinical applications.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 5","pages":"1003-1018"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kearns-Sayre syndrome presenting with fanconi syndrome: a case report.","authors":"Yixiu Lu, Shan Jian, Min Qian, Zhengqing Qiu, Min Wei, Juan Xiao, Hongmei Song, Zhenjie Zhang","doi":"10.21037/tp-2025-138","DOIUrl":"10.21037/tp-2025-138","url":null,"abstract":"<p><strong>Background: </strong>Kearns-Sayre syndrome (KSS) is a mitochondrial genetic disorder characterized by progressive external ophthalmoplegia, short stature, atrioventricular block, and proximal renal tubular dysfunction. While Fanconi syndrome is a recognized renal manifestation of KSS, it is rare as the initial presenting feature. This report describes the clinical and genetic features of a child with KSS who initially presented with Fanconi syndrome.</p><p><strong>Case description: </strong>A 10-year-old girl, initially diagnosed with Fanconi syndrome at 3 years of age, exhibited growth retardation by age 5 years and bilateral ptosis by age 8 years. In July 2022, her age of 10 years, she developed diabetes mellitus and third-degree atrioventricular block. The patient presented for medical evaluation. Upon examination, she was found to have sensorineural hearing loss, hyperlactatemia, elevated cerebrospinal fluid protein, decreased folate levels, and renal insufficiency. Muscle biopsy revealed ragged red fibers, and mitochondrial gene analysis confirmed the diagnosis of KSS. Whole-exome sequencing identified a heterozygous mutation in the <i>DNA2</i> gene (c.865C>T, p.R286X) along with a 7,521-base pair mitochondrial DNA deletion. Symptoms improved with nutritional mitochondrial therapy.</p><p><strong>Conclusions: </strong>Mitochondrial mutations may contribute to the development of Fanconi syndrome. Fanconi syndrome may present as the initial manifestation of KSS. KSS should be considered in pediatric patients presenting with Fanconi syndrome and extrarenal manifestations, such as ptosis.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 5","pages":"1059-1064"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory management of pediatric patient with bronchiolitis obliterans syndrome during general anesthesia surgery: a case report.","authors":"Ziyu Huang, Bailin Jiang, Hong Zhao, Yi Feng","doi":"10.21037/tp-2024-607","DOIUrl":"10.21037/tp-2024-607","url":null,"abstract":"<p><strong>Background: </strong>Bronchiolitis obliterans syndrome (BOS) is a rare but severe noninfectious pulmonary complication that typically arises in the context of chronic graft-versus-host disease (cGVHD) following allogeneic hematopoietic stem cell transplantation (HSCT). Characterized by progressive small airflow obstruction and irreversible airflow limitation, it poses significant challenges in managing general anesthesia, especially in pediatric patients. There is currently no established consensus or clinical research on the optimal anesthetic approach for such cases, making this report noteworthy.</p><p><strong>Case description: </strong>We report the case of a 6-year-old boy with BOS and steroid-induced obesity who had undergone HSCT for acute lymphoblastic leukemia and required general anesthesia for cataract surgery. He had severely reduced lung function and hypercapnia. Anesthesia was induced with propofol, rocuronium, and remifentanil, and mechanical ventilation was managed using pressure-controlled ventilation-volume guaranteed (PCV-VG) mode to minimize airway pressures and prevent barotrauma. The surgery was completed without complications, and the patient was safely extubated and discharged the next day.</p><p><strong>Conclusions: </strong>This case demonstrates that the PCV-VG ventilation mode can be a viable option for managing pediatric patients with severe BOS undergoing general anesthesia. This approach can help achieve sufficient ventilation while minimizing airway pressures and the risk of ventilator-induced lung injury. This approach offers a viable anesthetic management option for similar cases in the future.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 5","pages":"1033-1038"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluid management during pediatric lung transplantation: a single-center experience.","authors":"Lifang Zhang, Xinchen Tao, Ge Luo, Yuanyuan Yao, Ping Gao, Man Huang, Yantian Lv, Shui Yu, Yejun Zhao, Lan Liu, Peng Cen, Ming Gong, Congcong Chen, Jingcheng Zou, Jie Xiao, Jingyu Chen, Min Yan","doi":"10.21037/tp-2024-619","DOIUrl":"10.21037/tp-2024-619","url":null,"abstract":"<p><strong>Background: </strong>The impact of intraoperative fluid balance on postoperative outcomes in pediatric lung transplantation (LTx) has not been conclusively established. This study aimed to investigate the effect of fluid balance on postoperative outcomes in pediatric LTx, while also sharing insights from our clinical experiences in fluid management.</p><p><strong>Methods: </strong>We reviewed the medical records of children who underwent LTx from July 2019 to August 2023. Intraoperative data, fluid management strategies, and postoperative outcomes were recorded. Fluid overload (FO) was defined as an intraoperative fluid balance ≥10%. The patients were categorized into two groups: FO and non-FO. Differences in the incidence of primary graft dysfunction (PGD) and other outcomes were compared between these groups.</p><p><strong>Results: </strong>A total of 20 children were included in the study, with 12 in the FO group and 8 in the non-FO group. The analysis revealed no significant differences between the two groups regarding postoperative grade 3 PGD (P=0.35), acute kidney injury (AKI) within 48 hours after surgery (P=0.67), duration of postoperative mechanical ventilation (P=0.05), and duration of ICU stay (P=0.73). Although red blood cell (RBC) (P=0.13), fresh frozen plasma (FFP) (P=0.16), crystalloid (P=0.61) and total intake (P=0.23) were higher in the PGD group compared to the non-PGD group, these differences were not statistically significant.</p><p><strong>Conclusions: </strong>The current evidence is insufficient to support the hypothesis that a non-FO approach within a restrictive fluid strategy can reduce the risk of adverse outcomes following pediatric LTx. However, this does not imply that an FO strategy should be advocated. Further high-quality clinical studies are necessary to validate these findings.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 5","pages":"881-892"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations of gut microbiota and metabolites in children with Crohn's disease and their correlation with disease activity.","authors":"Yan Kong, Tianzhuo Zhang, Xiaolin Ye, Jie Wu","doi":"10.21037/tp-2025-36","DOIUrl":"10.21037/tp-2025-36","url":null,"abstract":"<p><strong>Background: </strong>The disruption of the gut microbiota is a prominent feature seen in children with Crohn's disease (CD), impacting metabolic processes. These factors collectively contribute significantly to the onset and progression of CD. The aim of this study was to assess the variations in gut microbiota and metabolites in children with newly diagnosed CD and those in remission, and to investigate their potential correlation with clinical indexes.</p><p><strong>Methods: </strong>This was a retrospective study. From June 2018 and March 2024, 57 children with CD admitted to Beijing Children's Hospital were included, and 22 healthy children during the same period were selected as the control group. Their peripheral blood and fecal samples were obtained, and clinical data were collected. Analysis of the fecal microbiota and serum metabolites was conducted using metagenomic sequencing and non-targeted mass spectrometry, respectively, to compare the alteration in children with CD and healthy controls (HCs), and their correlation with clinical indexes.</p><p><strong>Results: </strong>Analysis of fecal metagenomic sequencing data revealed that the alpha diversity was significantly lower in the newly diagnosed CD group compared to the HC group, whereas it was ameliorated in the CD remission group. The beta diversity showed that the microbial structures of the three groups were obviously separated. <i>Firmicutes</i> was identified as the primary altered bacteria in the microbiota. Specifically, the abundance of <i>Ruminococcus</i>, <i>Faecalimonas</i>, <i>Blautia</i>, and <i>Faecalibacterium</i> were correlated with clinical indexes such as pediatric Crohn's disease activity index (PCDAI). Metabolomic analysis highlighted differences in lipid metabolism, bile acid (BA) metabolism, amino acid metabolism and energy homeostasis between the CD remission and newly diagnosed CD groups. Notably, the levels of citric acid were correlated with clinical indexes such as PCDAI, which was also potential indicator for identifying clinical activity of pediatric CD patients [area under the curve (AUC) =0.77, specificity =0.64, sensitivity =0.83].</p><p><strong>Conclusions: </strong>The microbial diversity of children with newly diagnosed CD decreased, but then ameliorated in the remission stage. Some short-chain fatty acids (SCFAs)-producing bacteria, lipid metabolites, and energy homeostasis products were associated with clinical indexes. In particular, citric acid demonstrated specific effectiveness in identify clinical activity of pediatric CD patients, which was a potential biomarker. Further exploring the mechanism of energy homeostasis in CD is beneficial to find new therapeutic targets.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 5","pages":"960-971"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of fiberoptic bronchoscopy on systemic inflammatory markers and outcomes in neonatal patients with respiratory conditions.","authors":"Qing Qing, Yujuan Wang, Lili Wang, Ping Zha, Liying Dai","doi":"10.21037/tp-2025-81","DOIUrl":"10.21037/tp-2025-81","url":null,"abstract":"<p><strong>Background: </strong>Fiberoptic bronchoscopy is an essential tool in neonatal respiratory medicine, facilitating both diagnosis and management of complex respiratory disorders. Despite its widespread use, the procedure's impact on systemic health parameters, including inflammation, remains under-evaluated. This study investigates the effects of fiberoptic bronchoscopy on respiratory function and systemic inflammatory markers, such as the systemic immune-inflammation index (SII), in neonatal patients.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 38 neonatal patients at Anhui Provincial Children's Hospital who underwent fiberoptic bronchoscopy between January 2019 and December 2022. Clinical characteristics, respiratory outcomes, including partial pressure of oxygen (PO₂) and oxygen saturation (SO₂), and systemic inflammatory responses were assessed. Key parameters like blood gas values, SII, and other inflammatory markers were evaluated pre- and post-bronchoscopy. Multivariate linear regression and receiver operating characteristic (ROC) curve analysis were deployed to explore the relationships between inflammatory markers and neonatal hyperbilirubinemia risk.</p><p><strong>Results: </strong>Significant improvements were noted in blood gas parameters post-treatment, with increased PO₂ and SO₂ levels indicative of enhanced respiratory function. Inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), and notably SII, showed significant reductions post-bronchoscopy, suggesting decreased systemic inflammation. SII emerged as a strong predictor for neonatal hyperbilirubinemia with an area under the curve (AUC) of 0.9091, highlighting its potential clinical utility. The study also identified correlations between bilirubin levels and SII, underscoring a novel link between systemic inflammation and bilirubin metabolism in neonates.</p><p><strong>Conclusions: </strong>Fiberoptic bronchoscopy offers significant therapeutic benefits in neonatal respiratory care beyond airway management. The identified reduction in systemic inflammation and the novel association between SII and neonatal hyperbilirubinemia offer important insights for optimizing clinical practices and patient outcomes in neonatal respiratory medicine. Further research is warranted to validate these findings and explore their implications for individualized patient care.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 5","pages":"972-983"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}