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世界儿科杂志(英文版)

世界儿科杂志(英文版)

  • 发文量：343
  • 被引量：108
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  • 开始收录时间：2017(1)
  • CNKI综合因子：0.0
  • 维普期刊影响因子： 0.431
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  • 创刊时间：2005
  • 国内刊号/CN：33-1390/R
    国际刊号/ISSN：1708-8569
  • 发行周期：双月刊
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  • 主管单位：浙江省卫生厅
    主办单位：浙江省医学学术交流管理中心;浙江大学医学院附属儿童医院;浙江大学出版社有限责任公司
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  • 摘要：Background Tacrolimus,a calcineurin inhibitor,is recommended by the recent guidelines from the Kidney Disease Improving Global Outcomes Group as the first-line treatment for steroid-resistant nephrotic syndrome(SRNS),but its clinical application in China is still limited.We investigated the efficacy and safety of tacrolimus combined with low-dose corticosteroids in a population of Chinese children with SRNS.Methods In this prospective non-randomized,non-controlled study,Chinese children with SRNS who failed the previous full-dose prednisone treatment were given tacrolimus(0.1 mg/kg/day)and low-dose prednisone(0.25-0.50 mg/kg/day).We compared the overall remission rate(ORR)and adverse events in the follow-up period with this therapeutic regimen.Results A total of 76 children were enrolled into the study with an average follow-up period of 18±6 months(maximum 36 months).ORR achieved by the first,third,and sixth months was 94.7%,94.7%,and 96.0%,respectively.All patients who attained an initial tacrolimus trough concentration(FK506C0)>6 ng/mL(60.3%)achieved remission.The relative risk of relapse at FK506C0<3 ng/mL compared to 3-6 ng/mL,6-9 ng/mL,and 9-12 ng/mL was 2.3,3.2,and 16.9,respectively.During the follow-up period,adverse effects that had been previously reported were rare.Conclusions Combination of tacrolimus and low-dose prednisone was safe and effective for the treatment of children with SRNS,with high remission rates observed as early as the first month.Relapses were infrequent,but tended to increase significantly with decreases in FK506C0.
  • 摘要：The coronavirus disease 2019 (COVID-19) global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major public health event.As a special population,children have special respiratory tract structure characteristics,immature immune system,and susceptibility to respiratory virus infections.Therefore,it is highly important for clinicians to treat the infected children cautiously despite most pediatric patients have milder symptoms and better prognosis compared with the adult patients.
  • 摘要：The viral pneumonia in Wuhan City,China has spread around China.The virus has been proven to be a novel coronavirus (named as "2019-nCoV") by World Health Organization (WHO).2019-nCoV belongs to beta-coronavirus genera.On January 30,2020,WHO re-evaluated the potential effects of 2019-nCoV infection in global public health,and declared this epidemic as a "Public Health Emergency of International Concern (PHEIC)".
  • 摘要：The 2019-nCoV epidemic has become a major challenging public health problem in China.For standardizing the diagnosis and treatment strategies of 2019-nCoV pneumonia,National Health Commission of the People''s Republic of China has released the Diagnosis and Treatment Standards of 2019-nCoVpneumonia,and updated the standards to the 4th edition based on the status of epidemic and accumulated experiences in clinical practice now [1].
  • 摘要：Since the outbreak of 2019 novel coronavirus infection (2019-nCoV) in Wuhan City,China,by January 30,2020,a total of 9692 confirmed cases and 15,238 suspected cases have been reported around 31 provinces or cities in China.Among the confirmed cases,1527 were severe cases,171 had recovered and been discharged at home,and 213 died.And among these cases,a total of 28 children aged from 1 month to 17 years have been reported in China.For standardizing prevention and management of 2019-nCoV infections in children,we called up an experts'' committee to formulate this experts'' consensus statement.This statement is based on the Novel Coronavirus Infection Pneumonia Diagnosis and Treatment Standards (the fourth edition) (National Health Committee) and other previous diagnosis and treatment strategies for pediatric virus infections.The present consensus statement summarizes current strategies on diagnosis,treatment,and prevention of 2019-nCoV infection in children.
  • 摘要：In the early February,2020,we called up an experts'' committee with more than 30 Chinese experts from 11 national medical academic organizations to formulate the first edition of consensus statement on diagnosis,treatment and prevention of coronavirus disease 2019 (COVID-19) in children,which has been published in this journal.With accumulated experiences in the diagnosis and treatment of COVID-19 in children,we have updated the consensus statement and released the second edition recently.The current version in English is a condensed version of the second edition of consensus statement on diagnosis,treatment and prevention of COVID-19 in children.In the current version,diagnosis and treatement criteria have been optimized,and early identification of severe and critical cases is highlighted.The early warning indicators for severe pediatric cases have been summarized which is utmost important for clinical practice.This version of experts consensus will be valuable for better prevention,diagnosis and treatment of COVID-19 in children worldwide.
  • 摘要：Since December 2019,an epidemic caused by novel coronavirus (2019-nCoV) infection has occurred unexpectedly in China.As of 8 pm,31 January 2020,more than 20 pediatric cases have been reported in China.Of these cases,ten patients were identified in Zhejiang Province,with an age of onset ranging from 112 days to 17 years.Following the latest National recommendations for diagnosis and treatment of pneumonia caused by 2019-nCo V (the 4th edition) and current status of clinical practice in Zhejiang Province,recommendations for the diagnosis and treatment of respiratory infection caused by 2019-nCoV for children were drafted by the National Clinical Research Center for Child Health,the National Children''s Regional Medical Center,Children''s Hospital,Zhejiang University School of Medicine to further standardize the protocol for diagnosis and treatment of respiratory infection in children caused by 2019-nCoV.
  • 摘要：The outbreak of coronavirus disease 2019 (COVID-19;formally known as 2019-nCoV) has become a most challenging health emergency.Owing to rigorous quarantine and control measures taken in China,routine neonatal health surveillance and follow-up have become challenging.Without follow-up surveillance,some rapid and progressive newborn diseases,such as bilirubin encephalopathy,may be ignored.The characteristics of onset age of kernicterus suggest that monitoring of bilirubin level at home provides a useful way to alert hospital visits and to prevent the development of extremely hyperbilirubinemia.Therefore,we developed an online follow-up program for convenient monitoring of bilirubin level of newborns that is based on our practical experiences.The aim is to make our management strategies of neonatal jaundice tailored to the infection prevention and control during the COVID-19 epidemic.
  • 摘要：Background An outbreak of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 was first detected in Wuhan,Hubei,China.People of all ages are susceptible to SARS-CoV-2 infection.No information on severe pediatric patients with COVID-19 has been reported.We aimed to describe the clinical features of severe pediatric patients with COVID-19.Methods We included eight severe or critically ill patients with COVID-19 who were treated at the Intensive Care Unit (ICU),Wuhan Children''s Hospital from January 24 to February 24.We collected information including demographic data,symptoms,imaging data,laboratory findings,treatments and clinical outcomes of the patients with severe COVID-19.Results The onset age of the eight patients ranged from 2 months to 15 years;six were boys.The most common symptoms were polypnea (8/8),followed by fever (6/8) and cough (6/8).Chest imaging showed multiple patch-like shadows in seven patients and ground-glass opacity in six.Laboratory findings revealed normal or increased whole blood counts (7/8),increased C-reactive protein,procalcitonin and lactate dehydrogenase (6/8),and abnormal liver function (4/8).Other findings included decreased CD16 + CD56 (4/8) and Th/Ts*(1/8),increased CD3 (2/8),CD4 (4/8) and CD8 (1/8),IL-6 (2/8),IL-10 (5/8) and IFN-γ (2/8).Treatment modalities were focused on symptomatic and respiratory support.Two critically ill patients underwent invasive mechanical ventilation.Up to February 24,2020,three patients remained under treatment in ICU,the other five recovered and were discharged home.Conclusions In this series of severe pediatric patients in Wuhan,polypnea was the most common symptom,followed by fever and cough.Common imaging changes included multiple patch-like shadows and ground-glass opacity;and a cytokine storm was found in these patients,which appeared more serious in critically ill patients.
  • 摘要：Background The clinical characteristics and outcome of COVID-19 in children are different from those in adults.We aimed to describe the characteristics of infants under 1 year of age (excluding newborns) with COVID-19.Methods We retrospectively retrieved data of 36 infants with SARS-CoV-2 infection in Wuhan Children''s Hospital from January 26 to March 22,2020.Clinical features,chest imaging findings,laboratory tests results,treatments and clinical outcomes were analyzed.Results The mean age of the infected infants was 6.43 months,with a range of 2-12 months.61.11% of the patients were males and 38.89% females.86.11% of the infants were infected due to family clustering.Cough (77.78%) and fever (47.22%) were the most common clinical manifestations.Chest CT scan revealed 61.11% bilateral pneumonia and 36.11% unilateral pneumonia.47.22% of the infants developed complications.Increased leucocytes,neutrophils,lymphocytes,and thrombocytes were observed in 11.11,8.33,36.11 and 44.44% of infants,respectively.Decreased leucocytes,neutrophils,thrombocyte and hemoglobin were observed in 8.33,19.44,2.78 and 36.11% of infants,respectively.Increased C-reactive protein,procalcitonin,lactate dehydrogenase,alanine aminotransferase,creatine kinase and D-dimer were observed in 19.44,67.74,47.22,19.44,22.22 and 20.69% of infants,respectively.Only one infant had a high level of creatinine.Co-infections with other respiratory pathogens were observed in 62.86% of infants.CD3 (20.69%),CD4 (68.97%),CD19 (31.03%) and Th/Ts (44.83%) were elevated;CD8 (6.9%) and CD16+CD56 (48.28%) was reduced.IL-4 (7.69%),IL-6 (19.23%),IL-10 (50%),TNF-α (11.54%) and IFN-γ (19.23%) were elevated.Up to March 22,97.22% of infants recovered,while a critical ill infant died.When the infant''s condition deteriorates rapidly,lymphocytopenia was discovered.Meanwhile,C-reactive protein,D-dimer,alanine aminotransferase,creatine kinase,creatinine,IL-6 and IL-10 increased significantly.Conclusions In the cohort,we discovered that lymphocytosis,elevated CD4 and IL-10,and co-infections were common in infants with COVID-19,which were different from adults with COVID-19.Most infants with COVID-19 have mild clinical symptoms and good prognosis.
  • 摘要：Background Coronovirus disease 2019 (COVID-19) has spread rapidly across the globe.People of all ages are susceptible to COVID-19.However,literature reports on pediatric patients are limited.Methods To improve the recognition of COVID-19 infection in children,we retrospectively reviewed two confirmed pediatric cases from two family clusters.Both clinical features and laboratory examination results of the children and their family members were described.Results The two confirmed children only presented with mild respiratory or gastrointestinal symptoms.Both of them had normal chest CT images.After general and symptomatic treatments,both children recovered quickly.Both families had travel histories to Hubei Province.Conclusions Pediatric patients with COVID-19 are mostly owing to family cluster or with a close contact history.Infected children have relatively milder clinical symptoms than infected adults.We should attach importance to early recognition,early diagnosis,and early treatment of infected children.
  • 摘要：Up to now,no antiviral therapeutic regimens with exact efficacy are recommended to be used in children with coronavirus disease 2019 (COVID-19).Interim Guidance for Diagnosis and Treatment (the sixth edition) of COVID-19 [1] only provided potential antiviral treatments in adults.According to the current guidelines for management in adults and children and available resources in antiviral drugs,we herein discussed the pharmaceutical care of the five antiviral treatments (IFN-α,lopinavir/ritonavir,ribavirin,chloroquine diphosphate and arbidol) in children with COVID-19 (Table 1).
  • 摘要：An epidemic of coronavirus disease 2019 (COVID-19) has spread rapidly throughout China and the world since 2019.As of March 3rd 2020,China had reported a total of 80,304 cases of COVID-19,including 2,946 deaths.Outside China,there are now 10,566 cases in 72 countries and 166 deaths.Of the deaths reported so far,most of them have been elderly men [1-4].Adults are more likely to be infected with novel coronavirus (SARS-CoV-2) than children;and symptoms are relatively milder in pediatric patients than in adult patients.The same conditions occurred during the SARS and MERS outbreaks.It is still not clear why children seem to be escaping the worst effects of the coronavirus infection [5-7].
  • 摘要：School closure and stay-at-home,as a part of non-pharmaceutical interventions (NPI),have been implemented in China since February as an effective way to mitigate the spread of the virus during the COVID-19 outbreak.As concerns rose over the potential impacts of such NPI measures on children''s health,such as longer exposure to digital screens,irregular sleep pattern,weight gain,and loss of cardiorespiratory fitness [1],the Chinese Government,experts on public health,educators on school health,and teachers have been making joint and massive efforts to provide distance learning with well-organized online courses to help.
  • 摘要：The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic.Studies on epidemiological and clinical characteristics of patients with COVID-19 have indicated that children are susceptible to SARS-CoV-2 [1-3].To date,the largest study in China reported that over 90% of 2143 children with COVID-19 were asymptomatic,or had mild or moderate illness,and that 5.8% presented critical illness [3].Although the data of neonates are limited and only six neonates with COVID-19 have been reported thus far,several important points should be addressed from these neonatal cases.
  • 摘要：Background The molecular characteristics and antimicrobial susceptibility of Staphylococcus aureus (S.aureus) in general pediatric wards and county-level hospitals were rarely reported in China.Methods Staphylococcus aureus was isolated from children hospitalized with respiratory tract infection (RTI) in Zhongjiang and Youyang counties in 2015.All isolates were typed by multilocus sequence,staphylococcal protein A,accessory gene regulator (agr),and staphylococcal cassette chromosome mec [SCCmec,for methicillin-resistant S.aureus (MRSA) only].Polymerase chain reaction was used to screen 21 super-antigen (SAg) genes and panton-valentine leukocidin (pvl).Antimicrobial susceptibility testing was performed by E test.Results A total of 2136 children were enrolled.Overall,125 (5.9%) children carried S.aureus,among which MRSA accounted for 42.4%.ST59-SCCmec type Ⅳ-t437-agr group Ⅰ (58.5%) was the most prevalent genotype in MRSA,and ST188-t189-agr group Ⅰ (22.2%) was the top genotype in methicillin-sensitive S.aureus (MSSA).The pvl carriage rate in MRSA and MSSA was 15.1% and 9.7%,respectively (P =0.4112).About 96.8% of S.aureus isolates were positive for at least one SAg gene.The most common SAg gene profile in the dominant ST59 clone was seb-sek-seq (42.8%).All S.aureus isolates were resistant to penicillin and erythromycin (minimum inhibitory concentration 90 was > 32 and 256 mg/L to penicillin and erythromycin,respectively),but usually susceptible to other tested non-β-lactam antimicrobials.Conclusions Staphylococcus aureus and MRSA were detected with a high frequency in children with RTI in county-level hospitals of China.ST59-SCCmec type Ⅳ-t437-agr group Ⅰ was the dominant MRSA clone.The S.aureus isolates exhibited high resistance to penicillin and erythromycin.
  • 摘要：Background The role of human bocavirus (HBoV) as a respiratory pathogen has not been fulfilled yet.We aimed to describe clinical and serological characteristics of children with HBoV hospitalized for acute respiratory tract infection and to evaluate whether differences occur between HBoV alone and in co-infection.Methods We retrospectively reviewed data from 60 children (median age of 6.2 months,range 0.6-70.9) hospitalized for acute respiratory symptoms,with HBoV detected from a respiratory sample,using a reverse transcriptase-PCR for 14 respiratory viruses (including respiratory syncytial virus (RSV),influenza virus A and B,human coronavirus OC43,229E,NL-63 and HUK1,adenovirus,rhinovirus,parainfluenza virus 1-3,and human metapneumovirus).Results HBoV was detected alone in 29 (48.3%) patients,while in co-infection with other viruses in 31 patients (51.7%),with a peak between December and January.Among the 60 patients,34 were bronchiolitis,19 wheezing,3 pneumonia,2 upper respiratory tract infection,and 2 whooping cough.Seven children (11.6%) required admission to the paediatric intensive care unit (PICU) for respiratory failure.No differences was observed in age,family history for atopy and/or asthma,clinical presentations,chest X-ray,or laboratory findings in children with HBoV alone vs.multiple viral detection.RSV was the most frequently co-detected virus (61.3%).When compared with HBoV detection alone,the co-detection of RSV and HBoV was associated with male sex (P=0.013),younger age (P=0.01),and lower blood neutrophil count (P=0.032).Conclusions HBoV can be detected alone and in co-infection respiratory samples of children with an acute respiratory tract infection.A cause-effect relationship between HBoV and respiratory infection is not clear,so further studies are needed to clarify this point.
  • 摘要：Background Pulmonary hemorrhage (PH) is a life-threatening respiratory complication of extremely low-birth-weight infants (ELBWIs).However,the risk factors for PH are controversial.Therefore,the purpose of this study was to analyze the perinatal risk factors and short-term outcomes of PH in ELBWIs.Methods This was a retrospective cohort study of live born infants who had birth weights that were less than 1000 g,lived for at least 12 hours,and did not have major congenital anomalies.A logistic regression model was established to analyze the risk factors associated with PH.Results There were 168 ELBWIs born during this period.A total of 160 infants were included,and 30 infants were diagnosed with PH.Risk factors including gestational age,small for gestational age,intubation in the delivery room,surfactant in the delivery room,repeated use of surfactant,higher FiO2 during the first day,invasive ventilation during the first day and early onset sepsis (EOS) were associated with the occurrence of PH by univariate analysis.In the logistic regression model,EOS was found to be an independent risk factor for PH.The mortality and intraventricular hemorrhage rate of the group of ELBWIs with PH were significantly higher than those of the group of ELBWIs without PH.The rates of periventricular leukomalacia,moderate-to-severe bronchopulmonary dysplasia and severe retinopathy of prematurity,and the duration of the hospital stay were not significantly different between the PH and no-PH groups.Conclusions Although PH did not extend hospital stay or increase the risk of bronchopulmonary dysplasia,it increased the mortality and intraventricular hemorrhage rate in ELBWIs.EOS was the independent risk factor for PH in ELBWIs.
  • 摘要：Background Hearing impairment is one of the most common birth defects in children.Universal newborn hearing screenings have been performed for 19 years in Guangdong province,China.A screening/diagnosis/intervention system has gradually been put in place.Over the past 10 years,a relatively complete data management system had been established.In the present study,an etiological analysis of newborn cases that failed the initial and follow-up screenings was performed.Methods The nature and degree of hearing impairment in newborns were confirmed by a set of procedures performed at the time of initial hearing screening,rescreening and final hearing diagnosis.Then,multiple examinations were performed to explore the associated etiology.Results Over a period of 10 years,720 children were diagnosed with newborn hearing loss.Among these children,445 (61.81%) children had a clearly identified cause,which included genetic factor(s) (30.56%),secretory otitis media (13.30%),maternal rubella virus infection during pregnancy (5.83%),inner ear malformations (4.86%),maternal human cytomegalovirus infection during pregnancy (2.92%),malformation of the middle ear ossicular chain (2.50%) and auditory neuropathy (1.81%).In addition,275 cases of sensorineural hearing loss of unknown etiology accounted for 38.19% of the children surveyed.Conclusions Long-term follow-up is needed to detect delayed hearing impairment and auditory development in children.The need for long-term follow-up should be taken into account when designing an intervention strategy.Furthermore,the use of the deafness gene chip should further elucidate the etiology of neonatal hearing impairment.
  • 摘要：Background This study aims at characterizing the extent of correlation of treatment response (TR) obtained in various observation settings (home,school,clinic) by different observers (parents,teachers,clinicians).Methods Children with attention deficit hyperactivity disorder (ADHD) underwent a 2-week double-blind,randomized,cross-over clinical trial with methylphenidate and placebo,and various measures were obtained during the 2 weeks.Interrelationships of TR were examined using Pearson''s correlation coefficients.Results The study included 526 children (420 male,106 female) with ADHD.TR between different observers shows a variable correlation between parents and teachers.No correlation is seen between parents/teacher evaluation of TR and laboratory-based measures (Continuous Performance Task;Restricted Academic Situation Scale).Conclusion The results firmly support the need to synthesize information from many sources in evaluating TR in ADHD.
  • 摘要：World Journal of Pediatrics is a peer-reviewed journal published by Children’s Hospital, Zhejiang University School of Medicine,Hangzhou,China.The journal gives priority to reports of outstanding clinical and experimental works as well as important contributions related to common problems of infants,children and adolescents worldwide.
  • 摘要：World Journal of Pediatrics is a peer-reviewed journal published by Children''s Hospital,Zhejiang University School of Medicine,Hangzhou,China.The journal gives priority to reports of outstanding clinical and experimental works as well as important contributions related to common problems of infants,children and adolescents worldwide.
  • 摘要：Acute poisoning remains a major public health problem in childhood worldwide[1,2].The profile of these incidents differs between countries[1-3].In general,unintentional poisonings occur in children younger than 5 years,while intentional poisonings,usually suicide attempts,involve teenagers[1-3].
  • 摘要：Yu and colleagues[1]presented an online survey in World Journal of Pediatrics.The results indicated that parents have highly conflicting decision-making on attention deficit hyperactivity disorder(ADHD)treatment,and internet information affects their health decisions.
  • 摘要：Background This study assessed the necessity of postoperative nasogastric tube(NGT)use in acute pediatric cases of per-forated appendicitis.Methods All cases of acute pediatric perforated appendicitis managed with transumbilical laparoscopic-assisted appendec-tomy at our hospital from 2011 to 2017 were retrospectively reviewed.Sixty-two cases were selected and divided into two groups based on NGT placement.Results There were no significant differences between the two groups in most parameters of patient demographics,or surgi-cal data.Notably,the mean time to first oral intake and to regular diet was significantly shorter in no-NGT group(1 day vs 3 days,P<0.0001;and 4 days vs 7 days,P=0.003,respectively).Postoperative length of stay was significantly shorter in no-NGT group(7 days vs 9 days,P<0.0001).Conclusion Considering the results of our analysis,we believe that routine NGT placement is not always necessary in these situations.
  • 摘要：Background To optimize and apply an approach suitable for large-scale neonatal thalassemia genetic screening in China,thalassemia genotypes were determined by polymerase chain reaction-reverse dot blot using DNA extracted from dried blood spots(DBS)obtained from newborn screening programs.Methods Firstly,the most suitable commercial DNA extraction kit for DBS was screened.Then,the appropriate amount of DBS required for the automated high-throughput DNA extraction system was evaluated.Finally,the thalassemia prevalence and genotype spectrum in Shenzhen were investigated in 2028 newborns using the optimized screening procedure.Results The Magentec extraction kit was best suited for the automated DBS DNA extraction system using eight 3-mm DBS discs.The neonatal thalassemia prevalence in Shenzhen was 9.12%;6.31%α-thalassemia,2.37%β-thalassemia,and 0.44%α-/β-thalassemia.Conclusions Genetic screening based on DBS can precisely identify the thalassemia genotypes.Bothα-andβ-thalassemia are widely distributed in Shenzhen newborns.Newborn genetic screening is important for establishing a comprehensive thalassemia prevention program and for public education.
  • 摘要：Background There is much concern about declining rates of exclusive breastfeeding(EBF)all over the world including Saudi Arabia which deprives infants from many immunological,nutritional,and psychosocial benefits.This study was per-formed to determine EBF prevalence and factors influencing EBF in relation to knowledge,attitude and practice(KAP)of breastfeeding mothers(BFM)in Rabigh,Western Saudi Arabia.Methods Data about factors that could be associated with EBF and KAP of BFM were collected by cross-sectional ques-tionnaire-based study from 420 BFM.Results Prevalence of EBF for 6 months was 27.6%which is far below World Health Organization recommendations.Demographic,socioeconomic,biomedical as well as most studied variables of KAP of 50%to over 90%of participating mothers were adequate to account for low EBF rate.Proper knowledge about benefits of colostrum and continuation of breastfeeding for 2 years was given by only 86.2%and 36.7%of BFM,respectively.The most significant independent factors associated with EBF were perception of sufficient human milk[adjusted odds ratio(AOR)2.89;95%confidence interval(CI)1.72-4.89],absence of nipple pain(AOR 2.77;95%CI 1.72-4.45)and mothers without university education(AOR 1.86;95%CI 1.15-3.01).Early introduction of formula in hospital after birth was the main inappropriate feeding practice in 76.2%of infants of BFM.Conclusion Findings of this study should be utilized by Rabigh community and other national or worldwide communities with similar characters to promote EBF by targeted educational programs after identification of significant factors inltuenc-ing EBF and gaps in KAP of BFM.
  • 摘要：Background Interferon alpha(IFN-α)is a preferred therapy for antiviral treatment of children with chronic hepatitis B(CHB)aged>1 year currently.Peginterferon alpha-2a(Peg-IFNα-2a)is a recommended international guideline for treatment of CHB children,which is limited to children aged>3 years.But the exact efficacy and safety of IFN-αand Peg-IFNα-2a for treating CHB are not sufficient.Methods Clinical manifestations,baseline characteristics,related laboratory tests and adverse events were retrospectively analyzed in children with CHB,who visited Children''s Hospital of Fudan University and were treated with IFNα-2b or Peg-IFNα-2a monotherapy and followed up from January 2003 to October 2018.Results A total of 36 immune-active patients without advanced fibrosis were enrolled to be treated with IFNα-2b(group A,n=18)or Peg-IFNα-2a(group B,n=18).IFNα-2b or Peg-IFNα-2a was administered for a median of 48 weeks subcu-taneously by body surface area(BSA)category at a dose of 3 MU/m2 or 104μg/m2,respectively.HBV e antigen(HBeAg)seroconversion rates at 48 weeks post-treatment were higher in group A than group B(92.9%vs.87.5%),so as the rates of HBsAg clearance(22.2%vs.11.1%),and hepatitis B virus(HBV)-DNA<1000 IU/mL(88.9%vs.83.3%).Only mild flu-like symptoms and transient neutropenia appeared in some children at the early stage of treatment.No severe abnormal results was observed in other laboratory assessments.Conclusion The antiviral monotherapy of 48-week IFNα-2b or Peg-IFNα-2a in children with CHB is well tolerated and effective,which is associated with higher rates of HBeAg seroconversion and HBsAg clearance than in adults and previ-ously pediatric patients.
  • 摘要：Background Pediatric patients with croup are frequently admitted if they require two doses of racemic epinephrine(RE)in the emergency department(ED).We aimed to identify factors associated with the need for additional therapy(>2 RE doses)among pediatric patients with croup.Methods We performed a single-center retrospective study of consecutive patients admitted from the ED with a diagnosis of croup between January 1,2011 and December 31,2015.Primary outcome was need for>2 doses of RE.Secondary out-comes included time to third RE and 72-hour return visits.We performed logistic regression to identify factors associated with use of>2 RE doses during hospitalization,and survival analysis to identify time to dosing of 3rd RE from 2nd RE.Results Of 353 included admissions[250(70.8%)males,median age 1.48,interquartile range 0.97-2.51 years],106/353(30.0%)required>2 RE.In univariate logistic regression,only recent use of steroids within 1 day prior to presentation(4.18,1.48-11.83;P=0.007)was associated with need for>2 RE.Survival from third RE was 0.74(95%CI 0.69-0.78),which was similar to the survival at 12 hours(0.70,95%CI 0.65-0.75).Return visits occurred in 19(5.4%)patients,of whom 12/19(63.2%)were given RE.Conclusions Patients hospitalized for croup with recent use of steroids prior to ED presentation have a greater need for>2 RE during hospitalization.The majority who require inpatient RE will do so within 8-12 hours.These data provide informa-tion for risk stratification and duration of monitoring for patients hospitalized with croup.
  • 摘要：Background Infants in the first 90 days of life are more prone to develop serious bacterial infections(SBIs).Multi-drug-resistant organisms(MDROs)are emerging as important pathogens causing SBIs.We reviewed the epidemiology of SBIs in infants 0-90 days old and compared the clinical features,laboratory values and final outcome for SBIs due to MDROs vs.non-MDROs.Methods Episodes of culture-proven SBIs(bacteremia,urinary tract infections,or meningitis)with age at onset of 0-90 days during a 7-year period were retrospectively reviewed.Health care-associated infections were excluded.We collected demo-graphics,clinical features,and laboratory and microbiology data.We compared clinical characteristics,laboratory data,microbiologic results and final outcome for SBIs due to MDROs vs.non-MDROs.Results Ninety-four episodes(88 patients)including bacteremia(42.6%),urinary tract infections(54.3%)and meningi-tis(3.1%)were caused by Gram-negative bacteria(67%),and Gram-positive bacteria(33%).Escherichia coli,Klebsiella pneumoniae and GBS were the most common causes.MDROs caused SBIs in 39 patients(44.3%).SBIs due to MDROs were associated with more delay in providing targeted antimicrobial therapy compared to non-MDROs(74.4%vs.0%,P≤0.001,but no difference in case-fatality rate(12.8%vs.12.2%,P=1.0).Clinical features or basic laboratory values were not statistically different between the two groups.Conclusions The bacteriology of SBIs in the first 90 days of life is changing to include more MDROs,which causes more delay in providing targeted antimicrobial therapy.Awareness of the local epidemiology is crucial to ensure appropriate antibiotics are provided in a timely manner.

    世界儿科杂志(英文版)的期刊信息

    • 曾用名：
    • 创刊时间：2005
    • 地区：CHINA MAINLAND
    • 语言：中文
    • 热门主题：CHILDREN PEDIATRIC JOURNAL INSTRUCTIONS AUTHORS NEWBORN TREATMENT DIAGNOSIS NEONATAL INFANTS
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      2

      PEDIATRICS:Q3;

      Medicine:Pediatrics, Perinatology and Child Health;

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