中华儿科杂志最新文献

{"title":"[Metagenomic sequencing-based pathogen analysis in pediatric severe acute non-A-E hepatitis].","authors":"N L Wang, L F Xu, X G Liu, X X Wei, X P Chen, L X Wang, K Zhou, Y Q Lin, Y P Gong, Z D Xie, J S Wang","doi":"10.3760/cma.j.cn112140-20260608-00446","DOIUrl":"https://doi.org/10.3760/cma.j.cn112140-20260608-00446","url":null,"abstract":"<p><p><b>Objective:</b> Metagenomic sequencing was employed to analyze the pathogen detection profile in pediatric severe acute non-A-E hepatitis. <b>Methods:</b> Based on the platform of the China Childhood Severe Acute Hepatitis Collaborative Group, a case series study was conducted. This study enrolled 36 children with severe acute non-A-E hepatitis, who were admitted to 17 hospitals between April and July 2022. Clinical data, including etiological test results and liver function tests, were collected, and peripheral blood and nasopharyngeal swab specimens were obtained. Metagenomic next-generation sequencing (mNGS) was performed to detect potential infectious pathogens. <b>Results:</b> Among 36 children, there were 24 males and 12 females, with an onset age of 3.5 (1.1, 9.0) years. Common clinical symptoms were fever in 22 cases (61%), jaundice in 13 cases (36%), vomiting in 12 cases (33%), abdominal pain in 10 cases (28%), rash in 10 cases (28%), and diarrhea in 3 cases (8%). Serum alanine aminotransferase and aspartate aminotransferase levels were 950 (826, 1 404) and 811 (498, 1 295) U/L, respectively. Using PCR, plasma Epstein-Barr virus (EBV)-DNA was tested in 31 cases (86%) and plasma cytomegalovirus (CMV)-DNA in 25 cases (69%), and all results were below 5×10⁵ copies/L. Plasma mNGS was performed on all 36 patients, detecting 11 viruses. These included EBV in 14 cases, CMV in 12 cases, human adenovirus in 2 cases, herpes simplex virus type 1 in 2 cases, adeno-associated virus type 2 (AAV2) in 1 case, and 6 other viruses. No patient tested positive for both human adenovirus and AAV2 simultaneously. Plasma mNGS results showed a viral read count of 4 (2, 10) per 1×10⁸ reads. Nasopharyngeal swab mNGS was performed on 8 cases (22%), detecting 7 viruses. These included human herpesvirus 7 in 4 cases, EBV in 3 cases, and CMV in 3 cases, as well as 4 other viruses. Human adenovirus and AAV2 were not detected. Among the 4 children with human herpesvirus 7, 2 cases were also positive for human herpesvirus 6B, but neither virus was detected in their plasma mNGS. <b>Conclusions:</b> The detection rates of human adenovirus and AAV2 are both low among children with severe acute non-A-E hepatitis, and there are no cases of co-infection with both viruses.</p>","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"64 9","pages":"1041-1047"},"PeriodicalIF":0.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of influencing factors for the emotional and behavioral problems in school-age children with lower urinary tract dysfunction].","authors":"Z M Yue, B Wang, L J Zhao","doi":"10.3760/cma.j.cn112140-20260608-00448","DOIUrl":"https://doi.org/10.3760/cma.j.cn112140-20260608-00448","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the clinical characteristics of lower urinary tract dysfunction (LUTD) in school-age children, examine their correlation with emotional-behavioral problems, and explore the potential influencing factors for such problems in this population. <b>Methods:</b> This case-control study enrolled 130 LUTD patients aged 6-12 years who were admitted to Shanxi Children's Hospital from June 2024 to October 2025, comprising the LUTD group. A control group of 125 age- and gender-matched children undergoing routine health check-ups at the hospital's outpatient department during the same period was also established. All participants were assessed by using a general information questionnaire, the dysfunctional voiding and incontinence scoring system (DVISS) and the Achenbach Child Behavior Checklist (CBCL) to evaluate lower urinary tract symptoms and emotional-behavioral problems. Independent sample <i>t</i> test, Mann Whitney <i>U</i> or <i>χ</i>² test were used for comparison between groups. Multiple linear regression was applied to analyze the risk factors for emotional and behavioral problems in the LUTD group. Spearman rank correlation analysis was used to examine the correlation between emotional and behavioral problems and DVISS scores in the LUTD group. <b>Results:</b> The LUTD group consisted of 72 males and 58 females, with age of (8.5±1.7) years, while the control group included 66 males and 59 females, with age of (8.9±1.7) years. The scores of the total CBCL score, depression, hyperactivity, aggression, boy social problems and schizoid traits were all higher in the LUTD group than in the control group (<i>t</i>=4.78, <i>Z</i>=2.71, 4.76, 3.60, 2.17, 2.10, all <i>P</i><0.05). Multiple linear regression analysis revealed that low educational level of caregivers, poor academic performance, family conflict and abnormal DVISS score were associated with emotional and behavioral problems in children with LUTD (<i>β</i>=4.99, 5.85, 2.87, 5.75, all <i>P</i><0.05). In the LUTD group, DVISS scores were all positively correlated with the scores of social withdrawal, hyperactivity, aggression, social problems, obsessive-compulsive symptoms and the total CBCL score (<i>r</i>=0.24, 0.22, 0.21, 0.27, 0.29, 0.51, all <i>P</i><0.05). <b>Conclusions:</b> School-aged children with LUTD are more likely to develop emotional-behavioral problems than healthy children. These problems are associated with the educational level of caregivers, severity of lower urinary tract symptoms, academic performance, and family relationships.</p>","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"64 9","pages":"1003-1008"},"PeriodicalIF":0.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical features, diagnosis, and treatment advances in RAS-associated autoimmune lymphoproliferative disorders].","authors":"Y C Li, H Gu, R X Wang, Z Shu, H W Mao","doi":"10.3760/cma.j.cn112140-20260228-00164","DOIUrl":"https://doi.org/10.3760/cma.j.cn112140-20260228-00164","url":null,"abstract":"","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"64 9","pages":"1080-1083"},"PeriodicalIF":0.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Upholding righteousness to keep original aspiration, protecting children for a shared mission].","authors":"Z Q Wei, M Zeng","doi":"10.3760/cma.j.cn112140-20260512-00380","DOIUrl":"10.3760/cma.j.cn112140-20260512-00380","url":null,"abstract":"","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"64 8","pages":"969-970"},"PeriodicalIF":0.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A case report of infantile autoimmune diabetes caused by RNU4ATAC variation].","authors":"H Yin, Y Song, S Y Huang, T Q Wang, Z Q Liu, B Y Cao","doi":"10.3760/cma.j.cn112140-20260424-00347","DOIUrl":"10.3760/cma.j.cn112140-20260424-00347","url":null,"abstract":"","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"64 8","pages":"951-953"},"PeriodicalIF":0.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Homozygous TMPRSS15 gene variant cause enterokinase deficiency in a child].","authors":"P Y Chen, L L Geng, S T Gong, L Y Xiong, W H Lin, H W Li, L Ren","doi":"10.3760/cma.j.cn112140-20260127-00084","DOIUrl":"10.3760/cma.j.cn112140-20260127-00084","url":null,"abstract":"","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"64 8","pages":"947-948"},"PeriodicalIF":0.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A case of developmental delay with gastrointestinal, cardiovascular, genitourinary, and skeletal abnormalities caused by ZNF699 variation].","authors":"X N Zhu, L L Wang, Z X Qi, J Yang, T Y He","doi":"10.3760/cma.j.cn112140-20260520-00401","DOIUrl":"10.3760/cma.j.cn112140-20260520-00401","url":null,"abstract":"","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"64 8","pages":"949-951"},"PeriodicalIF":0.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Current status and challenges of artificial intelligence application in pediatric intensive care unit].","authors":"S Fu, F Xu, F Li, S Y Qian","doi":"10.3760/cma.j.cn112140-20260309-00195","DOIUrl":"10.3760/cma.j.cn112140-20260309-00195","url":null,"abstract":"","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"64 8","pages":"848-852"},"PeriodicalIF":0.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pathogen distribution and antimicrobial resistance in severe community-acquired bacterial pneumonia in the pediatric intensive care unit].","authors":"M Y Xin, Y J Shan, J Y Dou, Y C Zhang, H Li, Y Cui","doi":"10.3760/cma.j.cn112140-20260130-00096","DOIUrl":"10.3760/cma.j.cn112140-20260130-00096","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the pathogen distribution and antimicrobial resistance profiles of severe community-acquired bacterial pneumonia (SCABP) in children admitted to the pediatric intensive care unit (PICU). <b>Methods:</b> This retrospective cohort study included 308 children with SCABP treated at the PICU of Children's Hospital of Shanghai Jiao Tong University between January 2018 and December 2024. A total of 426 non-duplicate pathogenic bacteria were isolated from bronchoalveolar lavage fluid and sputum specimens. Antimicrobial susceptibility testing was performed for all isolates. Patients were stratified by admission year and the trends in isolation rates were tested using the Cochran-Armitage trend test. <b>Results:</b> A total of 426 non-duplicate pathogens were isolated from the 308 pediatric patients (178 males, 130 females), comprising 330 strains (77.5%) Gram-negative and 96 strains (22.5%) Gram-positive bacteria. The 5 most common organisms were: <i>Acinetobacter baumannii</i> (AB, 84 strains, 19.7%), <i>Haemophilus influenzae</i> (HI, 76 strains, 17.8%), <i>Streptococcus pneumoniae</i> (SP, 49 strains, 11.5%), <i>Staphylococcus aureus</i> (SA, 47 strains, 11.0%), and <i>Pseudomonas aeruginosa</i> (PA, 39 strains, 9.2%). Over the study period, HI emerged as the leading pathogen in 2024, with its isolation rate rising significantly from 8.3% (6/72) in 2018 to 36.1% (22/61) in 2024. In contrast, the isolation rates of AB and SP declined significantly from 33.3% (24/72) and 16.7% (12/72) in 2018 to 4.9% (3/61) and 1.6% (1/61) in 2024, respectively (<i>χ</i>² for trend=18.75, 27.50, 9.50, all <i>P</i><0.05). The overall resistance rates of HI to ampicillin, trimethoprim-sulfamethoxazole (TMP-SMZ), azithromycin, and cefuroxime were 72.4% (55/76), 71.1% (54/76), 63.2% (48/76), and 60.5% (46/76), respectively, while it remained fully susceptible to ceftriaxone. No PA isolates exhibited resistance to amikacin or piperacillin-tazobactam throughout the study. SP was universally resistant to erythromycin and clindamycin, with 71.4% (35/49) resistance to TMP-SMZ, while remaining fully susceptible to amoxicillin-clavulanate. SA had an 85.1% (40/47) resistance rate to penicillin, but retained complete susceptibility to vancomycin, linezolid, minocycline, tigecycline, TMP-SMZ, and rifampicin. <b>Conclusions:</b> Gram-negative bacteria predominate in SCABP among PICU patients. The pathogen spectrum has shifted significantly over time, with HI emerging as the predominant causative agent and exhibiting high resistance to multiple antibiotics. Ongoing surveillance and susceptibility-guided antibiotics selection are essential in clinical management.</p>","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"64 8","pages":"911-916"},"PeriodicalIF":0.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of clinical and muscle pathological features of juvenile idiopathic inflammatory myopathy].","authors":"G Ge, X Z Chang, T Y Ji, H Xiong, Y Wu, X H Bao, Y H Zhang, Y Zhang, J Zhang, Y Wu, H Dong, C J Wei","doi":"10.3760/cma.j.cn112140-20260217-00146","DOIUrl":"10.3760/cma.j.cn112140-20260217-00146","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the clinical manifestations, muscle imaging features, and muscle pathological characteristics of juvenile idiopathic inflammatory myopathies (IIM). &lt;b&gt;Methods:&lt;/b&gt; A retrospective cohort study was conducted including 76 children with IIM admitted to Children's Medical Center, Peking University First Hospital from January 2012 to January 2024. Clinical manifestations, laboratory findings, muscle imaging features, and muscle pathological characteristics were compared between the major subtypes of dermatomyositis and immune-mediated necrotizing myopathy (IMNM). Independent sample &lt;i&gt;t&lt;/i&gt;-test or Mann-Whitney &lt;i&gt;U&lt;/i&gt; test, and &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; test or Fisher's exact test were used to compare differences in characteristics between groups. &lt;b&gt;Results:&lt;/b&gt; Among 76 children with IIM, 30 were males and 46 were females, with the age of onset at 5.0 (3.0, 8.0) years. Of these 76 children, 57 children were diagnosed with dermatomyositis, 15 children with immune-mediated necrotizing myopathy (IMNM) and 4 children with overlap myositis. The proportion of heliotrope rash, Gottron's sign, and antinuclear antibody positivity were all higher in the dermatomyositis group than those in the IMNM group (63% (36/57) &lt;i&gt;vs.&lt;/i&gt;1/15, 47% (27/57) &lt;i&gt;vs.&lt;/i&gt; 0/15, and 68% (32/47) &lt;i&gt;vs.&lt;/i&gt; 5/14, respectively, all &lt;i&gt;P&lt;/i&gt;&lt;0.05), whereas serum creatine kinase (CK), alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase levels were all lower (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). The proportion of myositis specific autoantibody positivity was also lower in the dermatomyositis group than in the IMNM group (52% (24/46) &lt;i&gt;vs.&lt;/i&gt; 13/14, &lt;i&gt;P&lt;/i&gt;=0.006). Muscle MRI showed that subcutaneous soft tissue edema was more frequently observed in the dermatomyositis group than in the IMNM group (28% (14/50) &lt;i&gt;vs.&lt;/i&gt; 0/14, &lt;i&gt;P&lt;/i&gt;=0.005), whereas muscle fatty infiltration was less common in the dermatomyositis group (16% (8/50) &lt;i&gt;vs.&lt;/i&gt; 9/14, &lt;i&gt;P&lt;/i&gt;&lt;0.001). On muscle pathology, perifascicular muscle fiber atrophy and perivascular inflammatory cell infiltration, as well as sarcoplasmic myxovirus resistance protein A expression on perifascicular myofibers, were more common in the dermatomyositis group (78% (28/36) &lt;i&gt;vs.&lt;/i&gt; 1/7, 89% (32/36) &lt;i&gt;vs.&lt;/i&gt;1/7 and 10/14 &lt;i&gt;vs.&lt;/i&gt; 0/4, respectively, all &lt;i&gt;P&lt;/i&gt;&lt;0.05), while muscle fiber necrosis, perimysial hyperplasia, and endomysial hyperplasia were more common in the IMNM group (7/7 &lt;i&gt;vs.&lt;/i&gt; 33% (12/36), 2/7 &lt;i&gt;vs.&lt;/i&gt; 0/36 and 4/7 &lt;i&gt;vs.&lt;/i&gt; 3% (1/36), respectively, all &lt;i&gt;P&lt;/i&gt;&lt;0.05). &lt;b&gt;Conclusions:&lt;/b&gt; There are differences between the 2 major juvenile IIM subtypes in terms of clinical manifestations, muscle MRI findings, and muscle pathological features. Dermatomyositis is more likely to present with characteristic skin rashes and perifascicular muscle fiber pathological changes, whereas IMNM is characterized by markedly elevated serum CK levels and prominent muscle fiber necr","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"64 8","pages":"917-923"},"PeriodicalIF":0.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}