中国当代儿科杂志最新文献

{"title":"[A multicenter study on the risk factors for in-hospital mortality in neonates with severe asphyxia at tertiary hospitals in Henan Province].","authors":"Wan-Jun Pei, Yan-Hua Zhang, Shu-Jin Li, Bian-Sheng Zhou, Ya-Qin Cao, Bao-Feng Wang, Qian Liu, Zhan-Sheng Wang, Hong-Xiang Guo, Jian-Wei Sun, Li Li, Min Feng, Xiao-Bing Wang, Ping Zhu, Cheng-He Tang, Le Kang, Shi-Chang Zhang, Xiao-Yan Guo, Lei Shi, Feng-Lin Yan, Wei-Ling Meng, Shu-Ping Chen, Fa-Lin Xu, Hui-Fang Dong","doi":"10.7499/j.issn.1008-8830.2606073","DOIUrl":"10.7499/j.issn.1008-8830.2606073","url":null,"abstract":"<p><strong>Objectives: </strong>To construct a risk prediction model for in-hospital mortality in neonates with severe asphyxia.</p><p><strong>Methods: </strong>A total of 836 neonates with severe asphyxia admitted to 20 tertiary hospitals in Henan Province between January 2022 and December 2025 were retrospectively enrolled and divided into a death group (<i>n</i>=267) and a survival group (<i>n</i>=569) according to outcome. Birth characteristics, resuscitation measures, and early complications were analyzed. Multivariable logistic regression was used to identify risk factors, and a nomogram prediction model was developed. Receiver operating characteristic curves, calibration curves, and decision curve analysis were used to evaluate the model's discrimination, calibration accuracy, and clinical applicability.</p><p><strong>Results: </strong>Multivariable logistic regression showed that high lactate level, low birth weight, a 5-minute Apgar score of ≤5, use of epinephrine, volume expansion during resuscitation, persistent pulmonary hypertension of the newborn, pulmonary hemorrhage, shock, and grade III/IV intraventricular hemorrhage were independent risk factors for in-hospital mortality in neonates with severe asphyxia (<i>P</i><0.05). The nomogram based on these risk factors yielded an area under the curve of 0.795 (95%<i>CI</i>: 0.762-0.827). Calibration and decision curve analyses indicated that the model had high accuracy and good clinical applicability.</p><p><strong>Conclusions: </strong>In-hospital mortality among severely asphyxiated neonates is closely associated with birth weight, resuscitation modalities, and early complications such as pulmonary hemorrhage and shock. The risk model constructed based on these factors shows good predictive value.</p>","PeriodicalId":39792,"journal":{"name":"中国当代儿科杂志","volume":"28 10","pages":"1209-1217"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Guideline for intervention and rehabilitation in children with autism spectrum disorder (2026 edition)].","authors":"","doi":"10.7499/j.issn.1008-8830.2609207","DOIUrl":"10.7499/j.issn.1008-8830.2609207","url":null,"abstract":"<p><p>On September 22, 2026, the National Health Commission released the \"Guideline for intervention and rehabilitation in children with autism spectrum disorder (2026 edition)\". The guideline applies to intervention and rehabilitation services for children with autism spectrum disorder (ASD) under 18 years of age. It establishes eight basic principles, namely early intervention, individualized intervention, comprehensive intervention, evidence-based practice, long-term and high-intensity intervention, primary-level care as the mainstay, family participation, and social inclusion and support, and specifies that the optimal treatment window is before 6 years of age and that intervention should be provided for at least 20 hours per week. It covers health education, intervention for developmental deficits, intervention for challenging behaviors, family intervention, digital and intelligent intervention and rehabilitation, and follow-up.</p>","PeriodicalId":39792,"journal":{"name":"中国当代儿科杂志","volume":"28 10","pages":"1175-1183"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Establishing reference ranges for right ventricular functional parameters on neonatal echocardiography: a multicenter, prospective observational study].","authors":"Wen-Hui Dong, Lie Huang, Yan-Bin An, Bo-Yin Deng, Ying Fan, Jian-Hui Wang, Yuan Shi","doi":"10.7499/j.issn.1008-8830.2601165","DOIUrl":"10.7499/j.issn.1008-8830.2601165","url":null,"abstract":"<p><strong>Objectives: </strong>To establish reference ranges for right ventricular functional parameters at defined postnatal time points in neonates, thereby providing a basis for precise hemodynamic assessment and clinical management of critically ill neonates.</p><p><strong>Methods: </strong>In a prospective multicenter observational study, clinical and echocardiographic data were collected from 406 term neonates who were admitted to neonatal departments or seen in outpatient clinics of three centers (Children's Hospital of Chongqing Medical University, Yinchuan First People's Hospital, and Inner Mongolia Maternal and Child Health Care Hospital) between June 2023 and May 2024. Bedside echocardiography was used to measure right ventricular functional parameters. Spearman rank correlation was applied to assess associations between each parameter and sex, birth weight, gestational age, and postnatal age. Reference ranges were constructed using the 95% confidence interval approach for postnatal days 1, 3, 7, 14, and 28, with stratification by gestational age and birth weight.</p><p><strong>Results: </strong>Among the right ventricular functional parameters, right ventricular fractional area change (RV-FAC), tricuspid annular plane systolic excursion (TAPSE), and tricuspid annular peak systolic velocity were positively correlated with gestational age and birth weight (all <i>P</i><0.05). RV-FAC, TAPSE, right ventricular outflow tract velocity-time integral, tricuspid annular peak systolic velocity, tricuspid inflow E-wave peak velocity, tricuspid inflow E/A ratio, and peak early diastolic velocity of the lateral tricuspid annulus (e') were positively correlated with postnatal age (all <i>P</i><0.05). None of the right ventricular parameters was correlated with sex (all <i>P</i>>0.05). Reference ranges for postnatal days 1, 3, 7, 14, and 28 were established with stratification by gestational age and birth weight.</p><p><strong>Conclusions: </strong>Multiple parameters of neonatal right ventricular systolic and diastolic function are associated with postnatal age, gestational age, and birth weight. The comprehensive, stratified reference ranges for right ventricular functional parameters established in this study may serve as an important reference for refined hemodynamic assessment and management in critically ill neonates.</p>","PeriodicalId":39792,"journal":{"name":"中国当代儿科杂志","volume":"28 10","pages":"1242-1249"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expression patterns of fecal iron metabolism-related proteins in infants with food allergy].","authors":"Zi-Bei Zhou, Juan Zhang, Zai-Ling Li","doi":"10.7499/j.issn.1008-8830.2601154","DOIUrl":"10.7499/j.issn.1008-8830.2601154","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the expression patterns of fecal iron metabolism-related proteins at the early stage of food allergy (FA) onset in infants, and to explore the association between imbalance of local intestinal iron homeostasis and infant FA.</p><p><strong>Methods: </strong>A nested case-control design within a prospective clinical cohort was used. From October 2024 to June 2025, 162 infants with suspected FA were recruited from outpatient clinics, the child health department, and community settings, and classified into an FA group (<i>n</i>=88) and a non-FA group (<i>n</i>=74) according to standardized oral food challenge results. Baseline fecal samples collected prior to diagnosis were tested by enzyme-linked immunosorbent assay for iron metabolism-related proteins, and fecal non-heme iron content was measured. Group differences were compared.</p><p><strong>Results: </strong>FA onset peaked at 4-6 months of age, coinciding with the period of physiological depletion of fetal iron stores. Gastrointestinal symptoms predominated. Compared with the non-FA group, the FA group had significantly higher fecal transferrin receptor 1 concentrations (<i>P</i><0.001) and significantly lower ferritin heavy chain, ferritin light chain, and non-heme iron content (all <i>P</i><0.05). No significant between-group differences were observed in lactoferrin or hephaestin concentrations (<i>P</i>>0.05).</p><p><strong>Conclusions: </strong>Infants with FA exhibit an imbalance of local intestinal iron homeostasis at the early stage of disease onset, characterized by enhanced iron uptake signaling alongside reduced iron storage, indicative of a functional iron deficiency state. This imbalance appears associated with the early occurrence of infant FA.</p>","PeriodicalId":39792,"journal":{"name":"中国当代儿科杂志","volume":"28 10","pages":"1226-1233"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Assessment of myocardial injury following anthracycline chemotherapy in children with leukemia by echocardiography].","authors":"Ya-Lin Xia, Wen Jiang, Jie-Fan Sun, Xu-Fang Zhou, Ling-Jun Kong, Pei Wang","doi":"10.7499/j.issn.1008-8830.2601134","DOIUrl":"10.7499/j.issn.1008-8830.2601134","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical value of echocardiography in assessing myocardial injury following anthracycline chemotherapy in children with leukemia.</p><p><strong>Methods: </strong>A total of 267 children with leukemia who received anthracycline-based chemotherapy at Suzhou Wujiang District Children's Hospital from June 2020 to May 2025 were enrolled. Based on cardiac troponin I levels, the children were divided into a myocardial injury group (<i>n</i>=81) and a non-myocardial injury group (<i>n</i>=186). Clinical data, myocardial injury markers, and echocardiographic parameters were compared between groups. A random forest algorithm was used to screen for influencing factors, and multivariable logistic regression was employed to identify independent predictors. Receiver operating characteristic curve analysis was used to evaluate the predictive performance of individual and combined factors, and the DeLong test was employed to compare combined diagnostic performance across sex- and age-stratified subgroups.</p><p><strong>Results: </strong>Random forest analysis indicated the lowest out-of-bag error rate when the model included left ventricular ejection fraction (LVEF), cumulative anthracycline dose, left ventricular end-diastolic volume index, left ventricular end-systolic volume index, E-wave velocity, A-wave velocity, and E-wave velocity/A-wave velocity (E/A) ratio. Multivariable logistic regression showed that cumulative anthracycline dose (<i>OR</i>=8.998, 95%<i>CI</i>: 4.759-15.013), and pre-chemotherapy LVEF (<i>OR</i>=7.714, 95%<i>CI</i>: 3.985-14.932), E/A ratio (<i>OR</i>=12.207, 95%<i>CI</i>: 6.269-23.769), E-wave velocity (<i>OR</i>=5.842, 95%<i>CI</i>: 2.959-11.532), and A-wave velocity (<i>OR</i>=7.114, 95%<i>CI</i>: 3.913-12.933) were independent predictors of myocardial injury following chemotherapy (<i>P</i><0.05). Receiver operating characteristic curve analysis showed that the combined diagnostic model achieved superior predictive performance compared with any single indicator, with an area under the curve of 0.936, sensitivity of 0.820, and specificity of 0.917; predictive efficacy was maintained in both sex- and age-stratified subgroups.</p><p><strong>Conclusions: </strong>A combined model integrating echocardiographic parameters (LVEF, E-wave velocity, A-wave velocity, and E/A ratio) with cumulative anthracycline dose demonstrates high predictive efficacy for post-chemotherapy myocardial injury in children with leukemia and is applicable across sexes and age groups.</p>","PeriodicalId":39792,"journal":{"name":"中国当代儿科杂志","volume":"28 10","pages":"1250-1259"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A multicenter study on vibrating mesh nebulization of pulmonary surfactant for treating respiratory distress syndrome in preterm infants].","authors":"Yu-Meng Wu, Xin Chen, Ru-Na Li, Si-Ying Sun, Rui Rao, Lu-Ling Yang, Xiao-Hong Jiang, Xue-Tao Xu, Hui Wang, Han-Qing Wang, Yin-Long Zhang, Mei Liu, Ya-Li Zhang, Qian Guo, Jin-Hong Li, De-Xin Li, Bo Wang, Hou-Jiang Luo, Jun Yang, Min Feng, Shi-Di Xie, Hong Xu, Qiao-Qiao Zou, Dan Sun, Lei Shi, Hong Wan, Zi-Ang Wang","doi":"10.7499/j.issn.1008-8830.2601004","DOIUrl":"10.7499/j.issn.1008-8830.2601004","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the efficacy of noninvasive ventilation combined with vibrating mesh nebulization of pulmonary surfactant (PS) in preterm infants with respiratory distress syndrome (RDS) and to identify predictors of treatment failure.</p><p><strong>Methods: </strong>Preterm infants with RDS (gestational age >28 weeks, birth weight >1 000 g) admitted to neonatal intensive care units at 12 hospitals between June 2023 and November 2024 were prospectively enrolled. All infants initially received nasal continuous positive airway pressure and were treated with PS administered via vibrating mesh nebulization. Infants were categorized into a success group or a failure group according to whether escalation to invasive mechanical ventilation via endotracheal intubation was required. Multivariable logistic regression was used to identify predictors of failure of vibrating mesh nebulized PS treatment. A prediction model was constructed, and its performance was assessed using receiver operating characteristic (ROC) curves and the area under the curve (AUC).</p><p><strong>Results: </strong>A total of 126 preterm infants with RDS were included, with 107 (84.9%) in the success group and 19 (15.1%) in the failure group. Multivariable logistic regression analysis showed that nonstandard antenatal glucocorticoid use, a lower 1-minute Apgar score, chest radiograph showing RDS grade ≥III, and a lower ratio of partial pressure of arterial oxygen (PaO₂) to fraction of inspired oxygen (FiO₂) (PaO₂/FiO₂) at 30 minutes after treatment were independent predictors of treatment failure (<i>P</i><0.05). The prediction model for treatment failure based on these four factors yielded an AUC of 0.857 (95%<i>CI</i>: 0.789-0.943), with a sensitivity of 84.21% and a specificity of 74.53%. The cutoff values for the 1-minute Apgar score and PaO₂/FiO₂ at 30 minutes after treatment were <8 and <220 mmHg, respectively.</p><p><strong>Conclusions: </strong>Noninvasive ventilation combined with vibrating mesh nebulization of PS achieves a high success rate in preterm infants with RDS who had a gestational age >28 weeks and a birth weight >1 000 g. Nonstandard antenatal glucocorticoid use, a 1-minute Apgar score <8, chest radiograph showing RDS grade ≥III, and PaO₂/FiO₂ <220 mmHg at 30 minutes after treatment are independent predictors of treatment failure.</p>","PeriodicalId":39792,"journal":{"name":"中国当代儿科杂志","volume":"28 10","pages":"1201-1208"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of the number of sensitizing allergens on the efficacy of subcutaneous immunotherapy and quality of life in children with asthma].","authors":"Mo-Yu Xu, Yu-Die Wang, Jia-Yi Liu, Han Jiang, Yu-Qin Li, Hong-Yan Lu, Ming Chang","doi":"10.7499/j.issn.1008-8830.2603092","DOIUrl":"10.7499/j.issn.1008-8830.2603092","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the efficacy of subcutaneous immunotherapy (SCIT) and its impact on quality of life between children with dust mite-allergic asthma who are monosensitized and those who are polysensitized.</p><p><strong>Methods: </strong>This prospective longitudinal cohort study enrolled 80 children with dust mite-allergic asthma, who were divided into a monosensitization group (<i>n</i>=40) and a polysensitization group (<i>n</i>=40). All children completed 3 years of standardized dust mite SCIT. Indicators compared between the two groups before and after treatment included peripheral blood eosinophil percentage, fractional exhaled nitric oxide, pulmonary function parameters, visual analog scale score, Asthma Control Test score, quality of life score, and Children's Sleep Habits Questionnaire score.</p><p><strong>Results: </strong>After 3 years of treatment, both groups showed significant improvements in all indicators from baseline (all <i>P</i><0.05). The monosensitization group demonstrated greater improvements than the polysensitization group in peripheral blood eosinophil percentage, fractional exhaled nitric oxide, maximum mid-expiratory flow as a percentage of predicted value, Asthma Control Test scores, and quality of life scores (all <i>P</i><0.05). The incidence of adverse reactions did not differ significantly between the two groups (<i>P</i>>0.05).</p><p><strong>Conclusions: </strong>SCIT is effective in children with dust mite-allergic asthma, and monosensitized children show greater improvements in small airway function, asthma control, and quality of life.</p>","PeriodicalId":39792,"journal":{"name":"中国当代儿科杂志","volume":"28 10","pages":"1234-1241"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Mechanisms by which interleukin-18 binding protein regulates the NLRP3 inflammasome in Kawasaki disease-related coronary artery lesions].","authors":"Wen Xu, Shi Wang, Tian-Hua Li","doi":"10.7499/j.issn.1008-8830.2605032","DOIUrl":"10.7499/j.issn.1008-8830.2605032","url":null,"abstract":"<p><p>Kawasaki disease (KD) is an acute febrile illness characterized by systemic vasculitis, with coronary artery lesion (CAL) representing its most serious complication. The NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome plays a pivotal role in KD-associated CAL. Upon activation, it cleaves and releases mature interleukin-18 (IL-18) and other proinflammatory cytokines, which propagates downstream inflammatory cascades. IL‑18 binding protein (IL‑18BP) is an endogenous high-affinity antagonist. Studies have shown that dysregulation of the IL‑18/IL‑18BP axis, together with aberrant NLRP3 inflammasome activation, contributes to the initiation and progression of coronary artery injury in KD. This review aims to elucidate the positive feedback amplification between IL-18 and the NLRP3 inflammasome in KD-CAL, and the pathways through which IL-18BP regulates the NLRP3 inflammasome by blocking this positive feedback loop, thereby providing a new theoretical basis and potential interventional targets for the treatment of KD.</p>","PeriodicalId":39792,"journal":{"name":"中国当代儿科杂志","volume":"28 10","pages":"1312-1317"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effects of miR‑17‑5p regulation of the HIF‑1α/BNIP3 pathway on cognitive function and hippocampal synaptic plasticity in epileptic mice].","authors":"Jin-Lai Zhang, Pei-Pei Gao, Yu Ren","doi":"10.7499/j.issn.1008-8830.2605091","DOIUrl":"10.7499/j.issn.1008-8830.2605091","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effects of microRNA (miR)-17-5p regulation of the hypoxia-inducible factor-1α (HIF-1α)/Bcl-2/adenovirus E1B 19 kDa interacting protein 3 (BNIP3) pathway on cognitive function and hippocampal synaptic plasticity in epileptic mice.</p><p><strong>Methods: </strong>A mouse epilepsy model was established by intraperitoneal injection of pentylenetetrazol (PTZ). Specific pathogen-free BALB/c mice were randomly assigned to seven groups (<i>n</i>=12 each): normal control, PTZ, miR‑17‑5p agomir control (PTZ + agomir negative control), miR‑17‑5p agomir (PTZ + miR‑17‑5p agomir), miR‑17‑5p agomir + pcDNA (PTZ + miR‑17‑5p agomir + empty vector), miR‑17‑5p agomir + pc-HIF‑1α (PTZ + miR‑17‑5p agomir + HIF‑1α overexpression plasmid), and miR‑17‑5p agomir + pc-BNIP3 (PTZ + miR‑17‑5p agomir + BNIP3 overexpression plasmid). Cognitive function was evaluated by the Morris water maze test. Field potential recording was used to measure field excitatory postsynaptic potentials (fEPSPs) in the hippocampal CA1 region. Transmission electron microscopy was used to observe synaptic ultrastructure. Quantitative real-time reverse transcription polymerase chain reaction and Western blot were employed to detect miR‑17‑5p, HIF‑1α, BNIP3, and synapse-related proteins [postsynaptic density protein 95 (PSD95), synaptotagmin-1 (Syt1), synaptosome-associated protein 25 (SNAP25), and gephyrin] in the hippocampus. A dual-luciferase reporter assay was used to verify whether miR-17-5p directly targets HIF-1α.</p><p><strong>Results: </strong>Compared with the normal control group, the PTZ group showed significant cognitive impairment (prolonged escape latency, reduced time in the target quadrant, and fewer platform crossings), damage to hippocampal synaptic structure (widened synaptic cleft and thinner postsynaptic density), reduced synaptic plasticity (a decreased maximum amplitude of fEPSPs and a reduced increase in the fEPSP slope 1 hour after high-frequency stimulation), downregulation of miR‑17‑5p and synapse-related proteins (PSD95, Syt1, SNAP25, and gephyrin), and upregulation of HIF‑1α and BNIP3 (<i>P</i><0.05). In the miR-17-5p agomir group, these pathological changes were significantly reversed compared with the PTZ group (<i>P</i><0.05). Overexpression of HIF‑1α or BNIP3 antagonized the protective effects of miR‑17‑5p, restoring all indicators except miR-17-5p to levels close to those of the PTZ group (<i>P</i><0.05). The dual-luciferase assay confirmed that miR‑17‑5p could directly bind to the 3'-UTR of HIF‑1α.</p><p><strong>Conclusions: </strong>miR‑17‑5p can directly target and inhibit the HIF‑1α/BNIP3 pathway, upregulate the expression of synapse-related proteins, repair hippocampal synaptic ultrastructure, enhance synaptic plasticity, and thereby improve cognitive function in epileptic mice, providing a potential therapeutic target for epilepsy-related cognitive impairment.</p>","PeriodicalId":39792,"journal":{"name":"中国当代儿科杂志","volume":"28 10","pages":"1274-1283"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical and genetic characteristics and follow-up of 12 children with hypophosphatasia].","authors":"Shuo Wu, Yi-Rou Wang, Jia-Yue Hu, Guo-Ying Chang, Xin Li, Qun Li, Yu Ding, Ting-Ting Yu, Xiu-Min Wang","doi":"10.7499/j.issn.1008-8830.2606161","DOIUrl":"10.7499/j.issn.1008-8830.2606161","url":null,"abstract":"<p><strong>Objectives: </strong>To summarize the clinical and genetic characteristics and follow-up data of children with hypophosphatasia (HPP).</p><p><strong>Methods: </strong>A retrospective analysis was conducted of 12 children with HPP who were treated at Shanghai Children's Medical Center between January 2018 and August 2025, including clinical features, genetic testing results, and follow-up data.</p><p><strong>Results: </strong>Of the 12 children, 1 had infantile HPP, 8 had childhood HPP, and 3 had odonto-HPP. Common manifestations included non-traumatic premature loss of primary teeth (<i>n</i>=11), skeletal deformities (<i>n</i>=6), and short stature (<i>n</i>=5). The median age at symptom onset was 23.50 months, and the median age at clinical diagnosis was 38.50 months. The serum alkaline phosphatase standard deviation score was lower in children with childhood HPP than in those with odonto-HPP (<i>P</i><0.05). A total of 19 <i>ALPL</i> variants were identified, six of which had not been previously reported: c.191T>A (p.Val64Asp), c.1407C>A (p.His469Gln), c.351C>G (p.Tyr117Ter), c.1007T>C (p.Ile336Thr), c.1280delins14 (p.Glu427Glyfs*), and c.181+5G>C. Seven children carried compound heterozygous variants, and five carried a single heterozygous variant. All three children with odonto-HPP carried only a single heterozygous variant.</p><p><strong>Conclusions: </strong>HPP in children shows clinical and genetic heterogeneity, and clinical diagnosis may be delayed. Non-traumatic premature loss of primary teeth and <i>ALPL</i> variants are important features of HPP. There are significant differences in the levels of serum alkaline phosphatase among different subtypes. For suspected cases, serum ALP testing and <i>ALPL</i> genetic testing should be completed promptly.</p>","PeriodicalId":39792,"journal":{"name":"中国当代儿科杂志","volume":"28 10","pages":"1266-1273"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}