中华儿科杂志最新文献

{"title":"[Clinical characteristics of severe human metapneumovirus infection in children and analysis of risk factors for critical illness].","authors":"L J Liu, J Wang, J Wang, W Q Jiang, Y Z Guo, A N Cheng, L J Meng, Y J Huang","doi":"10.3760/cma.j.cn112140-20250228-00160","DOIUrl":"10.3760/cma.j.cn112140-20250228-00160","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the clinical characteristics of children with severe human metapneumovirus (HMPV) infection and identify the risk factors associated with critical illness. <b>Methods:</b> A retrospective cohort study was conducted, enrolling 157 hospitalized children with severe HMPV infection, who tested positive for HMPV nucleic acid via PCR-capillary electrophoresis fragment analysis of nasopharyngeal secretions at Shanghai Children's Hospital from January 2021 to December 2023.Clinical features, co-infections, treatment, and outcomes were collected. Based on the diagnostic criteria for severe HMPV infection, the patients were categorized into a critical illness group and a non-critical illness group. Intergroup comparisons were performed using the <i>χ</i><sup>2</sup> test or the Mann-Whitney <i>U</i> test. Multivariate Logistic regression analysis was employed to identify risk factors for critical HMPV infection and to establish a predictive model.The performance of the model was evaluated using receiver operating characteristic (ROC) curve analysis and calibration curves. <b>Results:</b> Among the 157 cases of severe HMPV infection, there were 67 males and 90 females, with an onset age of 39.0 (20.0, 55.5) months. Single-pathogen infection was observed in 125 cases (79.6%), while mixed infections accounted for 32 cases (20.4%).Severe pneumonia was diagnosed in 136 cases (86.6%).The predominant manifestations of severe HMPV infection included fever 152 cases (96.8%), cough 151 cases (96.2%), and wheezing 94 cases (59.9%).Sixty-eight patients (43.3%) required non-invasive respiratory support, 58 cases (36.9%) were admitted to the intensive care unit, and 22 cases (14.0%) underwent mechanical ventilation. Of the total, 149 cases (94.9%) were discharged with improvement, 8 cases (5.1%) were discharged against medical advice, and there were no fatal cases. The cohort was further stratified into a critical illness group 31 cases and a non-critical illness group 126 cases. Compared to the non-critical illness group, the critical illness group exhibited significantly higher rates of respiratory distress, lethargy, and intercostal retractions, along with a higher proportion of underlying comorbidities, and elevated levels of C-reactive protein and procalcitonin (all <i>P</i><0.05).Conversely, albumin and hemoglobin levels were significantly lower in the critical illness group (both <i>P</i><0.05). ROC curve analysis revealed that the optimal cutoff value for the duration of fever in predicting severe HMPV infection was 4.5 days.The multivariate binary Logistic regression analysis revealed that prolonged fever duration (>4.5 days) (<i>OR</i>=28.00, 95%<i>CI</i> 5.09-153.93, <i>P</i><0.001), anorexia (<i>OR</i>=11.72, 95%<i>CI</i> 1.26-108.75, <i>P</i>=0.030), and immune dysfunction (<i>OR</i>=36.71, 95%<i>CI</i> 1.55-867.31, <i>P</i>=0.026) were independent risk factors for severe HMPV infection. A predictive model for critical","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"63 8","pages":"864-869"},"PeriodicalIF":0.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683681","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":"[Modified Atkins diet in the treatment of a glycogen storage disease type Ⅲ patient].","authors":"X Y Zhang, Z Y Lu, J S Wang","doi":"10.3760/cma.j.cn112140-20241209-00898","DOIUrl":"10.3760/cma.j.cn112140-20241209-00898","url":null,"abstract":"","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"63 8","pages":"914-916"},"PeriodicalIF":0.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683695","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":"[The clinical and epidemiological characteristics of pertussis and antimicrobial resistance patterns of <i>Bordetella pertussis</i> in children in Anhui region in 2024].","authors":"X Y Zeng, B Q Chen, H Ma, L Wang, X M Xu, H Wang, M Zeng","doi":"10.3760/cma.j.cn112140-20250326-00256","DOIUrl":"10.3760/cma.j.cn112140-20250326-00256","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the epidemiological and clinical characteristics of pertussis in children and the antimicrobial resistance pattern of <i>Bordetella pertussis</i> isolates in Anhui province in 2024. <b>Methods:</b> Prospective observational study. The demographic information of 4 233 cases of pertussis confirmed by nucleic acid testing in Anhui Provincial Children's Hospital in 2024 and the clinical data of hospitalized cases were collected. The annual epidemic trend of pertussis in children, the clinical characteristics of hospitalized cases, and the vaccination status were analyzed. <i>Bordetella pertussis</i> isolates were recovered from nasopharyngeal swabs obtained from hospitalized children and their family caregivers during the outbreak period and antimicrobial susceptibility was tested. <b>Results:</b> Among the 4 233 children, 2 330 were male and 1 903 were female. A total of 4 059 cases (95.9%) occurred from March to September, with the peak of the disease from April to July (3 364 cases (79.5%)).There were 4 075 cases (96.3%) aged 9 years and under, among which 718 cases (17.0%) were under 1 year old and 2 494 cases (58.9%) were aged 4 to 7 years. During the outbreak period, there were a total of 301 hospitalized children (7.1%), with an average age of 4.4 (2.8, 16.5) months. Among them, 61 cases (20.3%) received the full course of vaccination (4 doses), 64 cases (21.3%) received partial doses of the vaccine, and 176 cases (58.5%) were unvaccinated. Among the unvaccinated children, 79.6% (172/216) were under 1 year old, 8.7% (2/23) were between 1 and 3 years old, and 3.2% (2/62) were 3 years old or older. None of the 20 cases (6.6%) of severe pertussis received pertussis vaccine.Among the 301 hospitalized children, 298 cases (99.0%) presented with typical paroxysmal spasmodic cough, 94 cases (31.2%) had vomiting after coughing, 82 cases (27.2%) had whooping sounds, and 54 cases (17.9%) had cyanotic attacks. There were 228 cases (75.7%) complicated with pneumonia and 5 cases (1.7%) with pertussis encephalopathy. The infection rate among the accompanying family members who underwent screening was 77.1% (371/481). Based on the minimum inhibitory concentration testing of 186 <i>Bordetella pertussis</i> isolates, the minimum inhibitory concentration 90 of azithromycin and trimethoprim-sulfamethoxazole were >256.000 and 0.050 mg/L, respectively. <b>Conclusions:</b> The peak of pertussis cases in Anhui region in 2024 occurred from April to July. Children aged ≤9 years were the major affected population. Infants and preschool children were most susceptible to pertussis. The intrafamily transmission rate of pertussis is high. Empirical use of macrolides for the treatment of pertussis is not recommended. Trimethoprim-sulfamethoxazole can be used as the preferred antibiotic for pertussis in children aged 2 months and above.</p>","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"63 8","pages":"852-857"},"PeriodicalIF":0.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683699","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":"[Research progress on calcineurin inhibitors in the treatment of monogenic steroid resistant nephrotic syndrome].","authors":"X Y Yu, W Y Huang","doi":"10.3760/cma.j.cn112140-20250226-00152","DOIUrl":"10.3760/cma.j.cn112140-20250226-00152","url":null,"abstract":"","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"63 8","pages":"929-932"},"PeriodicalIF":0.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683697","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":"[Epidemiological characteristics of human metapneumovirus infection among children with acute respiratory infections in Beijing from 2023 to 2024].","authors":"X Y Li, R N Zhu, Y Sun, Y C Sun, Y T Zhou, Y Yao, Q Guo, G Q Zhang, C M Zhu, L Q Zhao","doi":"10.3760/cma.j.cn112140-20250529-00457","DOIUrl":"10.3760/cma.j.cn112140-20250529-00457","url":null,"abstract":"<p><p><b>Objective:</b> To explore the molecular epidemiological characteristics of human metapneumovirus (HMPV) in children with acute respiratory infection (ARI) in Beijing from 2023 to 2024. <b>Methods:</b> In the longitudinal study, 9 834 children with ARI were enrolled from August 2023 to December 2024, including the influenza-like illness (ILI) group from emergency and outpatient department receiving influenza virus (Flu) and HMPV test and the ARI inpatient group for 13 common respiratory pathogen screening test including HMPV, Flu, respiratory syncytial virus, and so on. All respiratory samples positive with HMPV were genotyped by amplifying and sequencing of G gene and further phylogenetic analysis. The <i>χ</i>² test and Wilcoxon rank-sum test were used to compare the positive rate and basic clinical data of the 2 groups. <b>Results:</b> Among 9 834 enrolled patient, there were 5 276 male and 4 558 female children, with age 5.4 (1.9, 8.2) years. In ILI group of 1 460 patients, there were 83 cases (5.7%) positive for HMPV, with the age 4.9 (3.6, 6.6) years and children under 6.0 years old 59 cases (71.1%). Among 8 374 ARI inpatients, there were 256 cases (3.1%) positive for HMPV, with age 3.5 (1.3, 6.4) years and children under 6.0 years old 188 cases (73.4%). The HMPV positive rate and the age of children positive for HMPV in ARI inpatient group were significantly lower than that in ILI group (both <i>P</i><0.001). In December, 2024, the HMPV positive rates of ILI and ARI inpatient group (21.3% (17/80), 15.0% (47/314)) were significantly higher than the total positive rates of each group (both <i>P</i><0.001). Among 279 subtyped specimens, there were 155 cases (55.6%) belonging to genotype A and 124 cases (44.4%) belonging to genotype B. Sub-lineage A2.2.2 containing 111nt-insertions was predominate one in 2023 with positive ratio 89.2% (91/102), and B2 was predominate in 2024 with positive ratio 64.4% (114/177). <b>Conclusions:</b> From 2023 to 2024, the positive rate of HMPV in the ILI group was higher than that in the ARI inpatient group, suggesting a common epidemic of HMPV infection. Children positive for HMPV in the ARI inpatient group were younger than that in the ILI group. A severe epidemic of HMPV was observed in the winter of 2024, which requires attention. Sub-lineage A2.2.2 with 111nt-duplicate insertions and B2 were the predominant epidemic strains in 2023 and 2024, respectively.</p>","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"63 8","pages":"858-863"},"PeriodicalIF":0.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683688","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 extremely premature infant with type Ⅱ Bartter syndrome characterized by hyperkalemia].","authors":"J L Sun, Y Y Chen, L Y Hu, L Yang, F S Xu, Y Cao, C Chen, J Wang","doi":"10.3760/cma.j.cn112140-20250222-00143","DOIUrl":"10.3760/cma.j.cn112140-20250222-00143","url":null,"abstract":"","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"63 8","pages":"912-914"},"PeriodicalIF":0.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683667","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 future prospects of transitional management for children with congenital heart disease].","authors":"M Zhang, T L Liu","doi":"10.3760/cma.j.cn112140-20250401-00288","DOIUrl":"10.3760/cma.j.cn112140-20250401-00288","url":null,"abstract":"","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"63 8","pages":"926-929"},"PeriodicalIF":0.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683685","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":"[Expert consensus on the diagnosis and management of non transfusion dependent thalassemia in children (2025)].","authors":"","doi":"10.3760/cma.j.cn112140-20250421-00358","DOIUrl":"10.3760/cma.j.cn112140-20250421-00358","url":null,"abstract":"","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"63 8","pages":"839-846"},"PeriodicalIF":0.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683690","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":"[CT angiography and perfusion imaging diagnosed a child of brain death].","authors":"J Wu, S Y Qian, T Yu, Y Li, Z Li, Q Wang","doi":"10.3760/cma.j.cn112140-20250210-00102","DOIUrl":"10.3760/cma.j.cn112140-20250210-00102","url":null,"abstract":"","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"63 8","pages":"916-918"},"PeriodicalIF":0.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683684","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 8 children with TCF3:: HLF fusion gene positive acute lymphoblastic leukemia].","authors":"W Lin, Y Y Zhang, J J Yu, Y Wu, P J Qi, J Fan, P L Huang, J X Xu, Y J Guan, W Liu, H Y Zheng, T Y Wang, R D Zhang","doi":"10.3760/cma.j.cn112140-20250616-00521","DOIUrl":"10.3760/cma.j.cn112140-20250616-00521","url":null,"abstract":"<p><p><b>Objective:</b> To summarize the clinical characteristics and key points of diagnosis and treatment in children with TCF3::HLF fusion gene-positive acute lymphoblastic leukemia (ALL). <b>Methods:</b> A case series study was conducted. Clinical data of 8 children diagnosed with TCF3::HLF positive ALL at the Hematology Center of Beijing Children's Hospital, Capital Medical University and the Hematology Oncology Department of Henan Children's Hospital between January 2019 and January 2024 were collected. Descriptive analysis was performed on their clinical features, laboratory findings, treatment regimens and prognosis. <b>Results:</b> The cohort included 8 children (3 males and 5 females) with the age of 5.5 (3.5, 7.0) years. Bone pain was the primary clinical manifestation in 4 cases, with multi-site skeletal involvement in 4 cases, hypercalcemia in 5 cases, and coagulation abnormalities in 6 cases. Immunophenotyping revealed common B-cell lineage with myeloid markers in 7 cases and common B-cell phenotype in 1 case. All 8 children were positive for the TCF3::HLF fusion gene. Regarding treatment, 1 case abandoned therapy after diagnosis, while the remaining 7 cases received chemotherapy following the Chinese Children's Leukemia Group-ALL2018 high-risk protocol. Only 1 case achieved minimal residual disease (MRD) negativity by day 33 of induction therapy. Among the 3 cases with MRD negativity before consolidation therapy, 1 case achieved it via conventional chemotherapy, while 2 cases required additional agents (venetoclax or blinatumomab). One case failed to achieve MRD negativity after consolidation therapy and later discontinued treatment (survival periods: 7months).Of the 4 cases who achieved MRD negativity after consolidation, 2 cases received conventional chemotherapy and 2 cases achieved negativity following chimeric antigen receptor T-cell therapy (CART). All 4 cases underwent hematopoietic stem cell transplantation (HSCT). Two cases in the CART combined with HSCT group survived as of the last follow-up (survival periods: 22 and 13 months). In the conventional chemotherapy combined HSCT group, 1 case relapsed and died (survival: 38 months), and 1 case died from transplant complications (survival: 11 months). The other 2 cases achieved MRD negativity before consolidation therapy but did not receive regular subsequent chemotherapy. After MRD recurrence, they underwent CART therapy without HSCT and remained alive at the last follow-up (survival periods: 49 and 12 months). <b>Conclusions:</b> Children with TCF3::HLF positive ALL often present with bone destruction accompanied by hypercalcemia and coagulopathy at initial diagnosis. This subtype of ALL shows poor response to conventional chemotherapy regimens, characterized by low early remission rates and high relapse risk even after HSCT. Better therapeutic outcomes have been observed with small molecule targeted drugs, immunotherapy and CART therapy.</p>","PeriodicalId":60813,"journal":{"name":"中华儿科杂志","volume":"63 8","pages":"896-900"},"PeriodicalIF":0.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683669","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}