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Zhonghua er ke za zhi = Chinese journal of pediatrics最新文献

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[Clinical advance on parent training for attention-deficit hyperactivity disorder]. [注意力缺陷多动症家长培训临床进展]。
Pub Date : 2024-04-16 DOI: 10.3760/cma.j.cn112140-20231225-00458
J. Y. Lu, J. Ma
注意缺陷多动障碍(ADHD)的临床干预方法主要为药物治疗与行为治疗。父母培训包含了心理教育、行为治疗等内容,通常作为ADHD患儿进入治疗的第一步,并且贯穿全治疗过程。父母培训在不同的治疗阶段起到相应辅助作用,对于药物干预的具体实施也有着一定的积极意义。本文将对父母培训的目的、具体内容及实证性研究进行综述,并总结相关培训计划的实践进展。.
注意缺陷多动障碍(ADHD)的临床干预方法主要为药物治疗与行为治疗。父母培训包含了心理教育、行为治疗等内容,通常作为ADHD患儿进入治疗的第一步,并且贯穿全治疗过程。父母培训在不同的治疗阶段起到相应辅助作用,对于药物干预的具体实施也有着一定的积极意义。本文将对父母培训的目的、具体内容及实证性研究进行综述,并总结相关培训计划的实践进展。.
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引用次数: 0
[L-DEP regimen salvage therapy for refractory primary hemophagocytic lymphohistiocytosis triggered by Epstein-Barr virus infection in 4 children]. [4名儿童因感染 Epstein-Barr 病毒而引发的难治性原发性嗜血细胞淋巴组织细胞增多症的 L-DEP 方案挽救疗法]。
Pub Date : 2024-04-16 DOI: 10.3760/cma.j.cn112140-20240319-00188
Y. Z. Zhao, H. H. Ma, H. Lian, D. Wang, T. Y. Wang, R. Zhang
Objective: To analyze the efficacy and safety of the L-DEP regimen (asparaginase, liposome doxorubicin, etoposide and methylprednisolone) as a salvage therapy for the refractory primary hemophagocytic lymphohistocytosis triggered by Epstein-Barr virus infection (EBV-pHLH) in children. Methods: In this retrospective case study, clinical and laboratory data before and after L-DEP regimen of 4 children diagnosed with EBV-pHLH in Beijing Children's hospital between January 2016 and June 2022 were collected, and the efficacy and safety of L-DEP regimen for the treatment of EBV-pHLH were analyzed. Results: Among 4 patients, there were 3 females and 1 male with the age ranged from 0.8 to 7.0 years. Two of them showed compound heterozygous mutations of PRF1, one with a heterozygous mutation of UNC13D, one homozygous mutation of ITK. Before the L-DEP therapy, all of them had anemia and a soaring level of soluble CD25, 3 patients had neutropenia and thrombopenia, 3 patients had a high level of ferritin, 3 patients had hypofibrinogenemia and 1 patient had hypertriglyceridemia. After receiving 1 or 2 cycles of L-DEP treatment, three achieved remission, including complete remission (1 case) and partial remission (2 cases), and the other one had no remission. The levels of blood cell counts, soluble CD25, triglyceride, fibrinogen and albumin were recovered gradually in 3 patients who got remission. All four patients underwent hematopoietic stem cell transplantation (HSCT) after L-DEP regimen, and three survived. All patients had no severe chemotherapy related complications. The main side effects were bone marrow suppression, infection and pancreatitis, which recovered after appropriate treatments, apart from one who died from severe infection after urgent HSCT. Conclusion: L-DEP regimen could be served as an effective and safe salvage treatment for refractory pediatric EBV-pHLH, and also provide an opportunity for patients to receive HSCT.
目的分析L-DEP方案(天冬酰胺酶、脂质体多柔比星、依托泊苷和甲基强的松龙)作为一种挽救疗法治疗由爱泼斯坦-巴氏病毒感染引发的难治性原发性嗜血细胞淋巴组织细胞增多症(EBV-pHLH)的有效性和安全性。研究方法在这项回顾性病例研究中,收集了2016年1月至2022年6月期间在北京儿童医院确诊的4例EBV-pHLH患儿接受L-DEP方案治疗前后的临床和实验室数据,分析了L-DEP方案治疗EBV-pHLH的疗效和安全性。结果4例患者中,女性3例,男性1例,年龄在0.8岁至7.0岁之间。其中2例为PRF1复合杂合突变,1例为UNC13D杂合突变,1例为ITK同源突变。在接受 L-DEP 治疗前,所有患者均有贫血和可溶性 CD25 水平飙升,3 名患者有中性粒细胞减少和血栓性血小板减少,3 名患者铁蛋白水平较高,3 名患者有低纤维蛋白原血症,1 名患者有高甘油三酯血症。在接受 1 或 2 个周期的 L-DEP 治疗后,3 名患者的病情得到缓解,包括完全缓解(1 例)和部分缓解(2 例),另一名患者的病情没有缓解。3 名获得缓解的患者的血细胞计数、可溶性 CD25、甘油三酯、纤维蛋白原和白蛋白水平逐渐恢复。四名患者在接受 L-DEP 治疗后都进行了造血干细胞移植(HSCT),其中三人存活。所有患者均未出现严重的化疗相关并发症。主要的副作用是骨髓抑制、感染和胰腺炎,这些副作用在经过适当治疗后都已恢复,只有一名患者在紧急造血干细胞移植后死于严重感染。结论L-DEP方案可作为难治性小儿EBV-pHLH有效、安全的挽救治疗方案,同时也为患者提供了接受造血干细胞移植的机会。
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引用次数: 0
[Analysis of language and influencing factors of children with speech disorder in Beijing]. [北京语言障碍儿童的语言及影响因素分析]。
Pub Date : 2024-04-16 DOI: 10.3760/cma.j.cn112140-20240105-00015
J. Wang, Q. Xu, H. F. Duan, L. Wang, B. Zhou, L. Zhang, X. Wang, L. J. Zhou, X. M. Liu
Objective: To investigate the features and influencing factors of language in children with various types of speech disorders. Methods: A case-control study was carried out, 262 children with speech disorder had been diagnosed at the language-speech clinic of the Center of Children's Healthcare, Children's Hospital, Capital Institute of Pediatrics from January 2021 to November 2023, the children with speech sound disorder as the speech sound disorder group, the children with developmental stuttering as the stuttering group. There were 100 typically-developed children who underwent physical checkups at the Center of Healthcare during the same period as the healthy group. All children experienced a standardized evaluation of language with diagnostic receptive and expressive assessment of mandarin-comprehensive(DREAM-C) and questionnaire, One-way ANOVA and LSD test were conducted to compare the differences in overall language, receptive language, expressive language, semantics, and syntax scores among 3 groups of children. According to the results of DREAM-C, the children with speech disorder were divided into language normal group and language delay group. Chi-square test and multivariate Logistic regression were implemented to analyze the association between the linguistic development of children with speech disorder and potential influential factors. Results: There were 145 children in the speech sound disorder group, including 110 males and 35 females respectively, with an age of (5.9±1.0) years; 117 children in the stuttering group, including 91 males and 26 females, with an age of (5.8±1.0) years; 100 children in the healthy group, including 75 males and 25 females, with an age of (5.7±1.2) years. The variations in overall language, expressive language, and syntax scores among 3 groups of children were statistically significant (92±18 vs.96±11 vs. 98±11, 81±18 vs. 84±14 vs. 88±13, 87±16 vs. 89±11 vs. 91±10, F=5.46, 4.69, 3.68, all P<0.05). Pairwise comparison revealed that the speech sound disorder group had lower scores in overall language, expressive language, and syntactic compared to the healthy group, and the differences were statistically significant (all P<0.01) and the overall language score was lower than that of children with stuttering (P<0.05). In terms of overall language and expressive language, there was a statistically significant difference in the incidence of language delay among the three groups of children (15.9% (23/145) vs. 20.5% (24/117) vs. 7.0% (7/100), 46.2% (67/145) vs. 39.3% (46/117) vs. 26.0% (26/100); χ2=7.93, 10.28; both P<0.05). In terms of overall language, the stuttering group took up the highest proportion. In terms of expressive language, the speech sound disorder group accounted for the highest amount. The incidence of language delay in children with speech disorder was 44.3% (116/262). Non-parent-child reading, daily screen time ≥1 hour and screen exposure before 1.5 years of age are risk factors for the d
目的研究各类语言障碍儿童的语言特点和影响因素。方法:进行病例对照研究:对2021年1月至2023年11月在首都儿科研究所附属儿童医院儿童保健中心语言-言语门诊确诊的262名言语障碍儿童进行病例对照研究,将言语发音障碍儿童作为言语发音障碍组,将发育性口吃儿童作为口吃组。同期在保健中心进行体检的100名发育正常儿童为健康组。所有儿童都接受了普通话接受和表达能力综合诊断评估(DREAM-C)和问卷调查的标准化语言评估,并进行了单因素方差分析和LSD检验,以比较三组儿童在总体语言、接受语言、表达语言、语义和句法得分方面的差异。根据 DREAM-C 的结果,将语言障碍儿童分为语言正常组和语言延迟组。采用卡方检验和多元 Logistic 回归分析言语障碍儿童的语言发展与潜在影响因素之间的关联。结果语音障碍组145名儿童,其中男110名,女35名,年龄(5.9±1.0)岁;口吃组117名儿童,其中男91名,女26名,年龄(5.8±1.0)岁;健康组100名儿童,其中男75名,女25名,年龄(5.7±1.2)岁。3组儿童的语言总分、语言表达能力和句法得分差异有统计学意义(92±18 vs.96±11 vs.98±11, 81±18 vs.84±14 vs.88±13, 87±16 vs.89±11 vs.91±10, F=5.46, 4.69, 3.68, 均P<0.05)。配对比较显示,与健康组相比,言语发声障碍组在语言总分、语言表达能力和句法方面得分较低,差异有统计学意义(均P<0.01),且语言总分低于口吃儿童(P<0.05)。在总体语言和表达性语言方面,三组儿童的语言延迟发生率差异有统计学意义(15.9%(23/145)vs 20.5%(24/117)vs 7.0%(7/100),46.2%(67/145)vs 39.3%(46/117)vs 26.0%(26/100);χ2=7.93,10.28;均P<0.05)。就总体语言而言,口吃组所占比例最高。在语言表达方面,语音障碍组所占比例最高。语言障碍儿童的语言延迟发生率为 44.3%(116/262)。非亲子阅读、每天屏幕时间≥1小时和1.5岁前接触屏幕是言语障碍儿童语言发展的风险因素(OR=1.87、2.18、2.01;95%CI 1.07-3.27、1.23-3.86、1.17-3.45;均P<0.01)。阴性家族史是语言能力进步的保护因素(OR=0.37,95%CI 0.17-0.81,P<0.05)。结论有语言障碍的儿童往往容易出现语言发育迟缓,尤其是在语言表达和句法方面。语言障碍儿童语言发育迟缓的发生与家庭病史、亲子阅读、屏幕时间等因素密切相关。应关注语言障碍儿童的语言发展。
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引用次数: 0
[Clinical characteristics of children with severe SARS-CoV-2 infection in Yunnan]. [云南重症 SARS-CoV-2 感染儿童的临床特征]。
Pub Date : 2024-04-16 DOI: 10.3760/cma.j.cn112140-20231201-00406
Y. Li, X. Z. Hu, C. Y. Liu, X. Tao, R. Wang, R. Lu, Y. Pu, C. R. Mu, J. H. Xu, H. Fu
Objective: To investigate the clinical characteristics of 130 children with severe SARS-CoV-2 infection in Yunnan province after the relaxation of non-pharmaceutical interventions, and analyze the risk factors for mortality. Methods: This study is a retrospective case summary that analyzed the demographic data, underlying diseases, clinical diagnoses, disease outcomes, and laboratory results of 130 children with severe COVID-19 infections admitted to nine top-tier hospitals in Yunnan Province from December 2022 to March 2023. According to the prognosis, the patients were divided into survival group and death group. The clinical and laboratory data between the two groups were compared, and the risk factors of death were evaluated. The χ2 test and Mann-Whitney U test were employed to compare between groups, while Spearman correlation test and multiple Logistic regression were used to analyze the risk factors for death. The predictive value of independent risk factors was evaluated by receiver operating characteristic curve. Results: The 130 severe patients included 80 males and 50 females with an onset age of 28.0 (4.5, 79.5) months. There were 97 cases in the survival group and 33 cases in the death group with no significant differences in gender and age between the two groups (P>0.05). Twenty-five cases (19.2%) out of the 130 patients had underlying diseases, and the number with underlying diseases was significantly higher in death group than in survival group (36.4% (12/33) vs. 13.4%(13/97), χ2=8.36, P=0.004). The vaccination rate in the survival group was significantly higher than that in the death group (86.1% (31/36) vs. 7/17, χ2=9.38, P=0.002). A total of 42 cases (32.3%) of the 130 patients were detected to be infected with other pathogens, but there was no significant difference in the incidence of co-infection between the death group and the survival group (39.3%(13/33) vs. 29% (29/97), χ2=1.02, P>0.05). Among the 130 cases, severe respiratory cases were the most common 66 cases (50.8%), followed by neurological severe illnesses 34 cases (26.2%) and circulatory severe cases 13 cases (10%). Compared to the survival group, patients in the death group had a significantly higher levels of neutrophil, ferritin, procalcitonin, alanine aminotransferase, lactate dehydrogenase, creatine kinase isoenzyme, B-type natriuretic peptide, interleukin-6 and 10 (6.7 (4.0, 14.0) vs. 3.0 (1.6, 7.0)×109/L, 479 (298, 594) vs. 268 (124, 424) μg/L, 4.8 (1.7, 10.6) vs. 2.0 (1.1, 3.1) μg/L, 66 (20, 258) vs. 23 (15, 49) U/L, 464 (311, 815) vs. 304 (252, 388) g/L, 71(52, 110) vs. 24(15, 48) U/L, 484 (160, 804) vs. 154 (26, 440) ng/L, 43 (23, 102) vs. 19 (13, 27) ng/L, 216 (114, 318) vs. 86 (45, 128) ng/L, Z=-4.21, -3.67, -3.76, -3.31, -3.75, -5.74, -3.55, -4.65, -5.86, all P<0.05). The correlated indexes were performed by multivariate Logistic regression and the results showed that vaccination was a protective factor from death in severe cases (OR=0.01, 95%CI 0-0.97
目的调查云南省 130 名重症 SARS-CoV-2 感染儿童在放宽非药物干预后的临床特征,并分析死亡的危险因素。研究方法本研究为回顾性病例总结,分析了2022年12月至2023年3月云南省9家三甲医院收治的130例重症COVID-19感染患儿的人口学资料、基础疾病、临床诊断、疾病结局和实验室结果。根据预后将患者分为生存组和死亡组。比较两组患者的临床和实验室数据,并评估死亡的危险因素。组间比较采用χ2检验和Mann-Whitney U检验,死亡危险因素分析采用Spearman相关检验和多元Logistic回归。通过接收者操作特征曲线评估独立风险因素的预测价值。结果130 例重症患者中,男性 80 例,女性 50 例,发病年龄为 28.0(4.5,79.5)个月。存活组 97 例,死亡组 33 例,两组在性别和年龄上无明显差异(P>0.05)。130 例患者中有 25 例(19.2%)患有基础疾病,死亡组患有基础疾病的人数明显高于存活组(36.4% (12/33) vs. 13.4%(13/97), χ2=8.36, P=0.004)。存活组的疫苗接种率明显高于死亡组(86.1% (31/36) vs. 7/17,χ2=9.38,P=0.002)。130 例患者中共有 42 例(32.3%)被检测出感染了其他病原体,但死亡组与存活组的合并感染率无明显差异(39.3%(13/33) vs. 29%(29/97),χ2=1.02,P>0.05)。在 130 例重症病例中,呼吸系统重症病例最多,为 66 例(50.8%),其次是神经系统重症病例 34 例(26.2%)和循环系统重症病例 13 例(10%)。与存活组相比,死亡组患者的中性粒细胞、铁蛋白、降钙素原、丙氨酸氨基转移酶、乳酸脱氢酶、肌酸激酶同工酶、B 型钠尿肽、白细胞介素-6 和白细胞介素-10 的水平明显更高(6.7 (4.0, 14.0) vs. 3.0 (1.6, 7.0)×109/L, 479 (298, 594) vs. 268 (124, 424) μg/L, 4.8 (1.7, 10.6) vs. 2.0 (1.1, 3.1) μg/L,66 (20, 258) vs. 23 (15, 49) U/L, 464 (311, 815) vs. 304 (252, 388) g/L,71(52, 110) vs. 24(15, 48) U/L, 484 (160, 804) vs. 154 (26, 440) μg/L。154(26,440)纳克/升,43(23,102)纳克/升 vs. 19(13,27)纳克/升,216(114,318)纳克/升 vs. 86(45,128)纳克/升,Z=-4.21,-3.67,-3.76,-3.31,-3.75,-5.74,-3.55,-4.65,-5.86,所有P<0.05)。通过多变量 Logistic 回归对相关指标进行分析,结果显示接种疫苗是重症病例死亡的保护因素(OR=0.01,95%CI 0-0.97,P=0.049),而小儿序贯器官衰竭评估(PSOFA)(OR=3.31,95%CI 1.47-7.47,P=0.004)、中性粒细胞与淋巴细胞比值(NLR)(OR=1.56,95%CI 1.05-2.32,P=0.029)和D二聚体(OR=1.49,95%CI 1.00-1.02,P=0.033)是死亡的独立危险因素(均P<0.05)。预测死亡的三个独立风险因素的曲线下面积分别为 0.86(95%CI 0.79-0.94)、0.89(95%CI 0.84-0.95)和 0.87(95%CI 0.80-0.94),均 P<0.001,临界值分别为 4.50、3.66 和 4.69 mg/L。结论严重的 SARS-CoV-2 感染可发生在所有年龄段的儿童中,主要影响呼吸系统,但也可感染神经系统、循环系统或其他系统。死亡儿童的炎症、组织损伤和凝血功能障碍更为严重。PSOFA、NLR和D二聚体的升高是导致重症儿童死亡的独立风险因素。
{"title":"[Clinical characteristics of children with severe SARS-CoV-2 infection in Yunnan].","authors":"Y. Li, X. Z. Hu, C. Y. Liu, X. Tao, R. Wang, R. Lu, Y. Pu, C. R. Mu, J. H. Xu, H. Fu","doi":"10.3760/cma.j.cn112140-20231201-00406","DOIUrl":"https://doi.org/10.3760/cma.j.cn112140-20231201-00406","url":null,"abstract":"Objective: To investigate the clinical characteristics of 130 children with severe SARS-CoV-2 infection in Yunnan province after the relaxation of non-pharmaceutical interventions, and analyze the risk factors for mortality. Methods: This study is a retrospective case summary that analyzed the demographic data, underlying diseases, clinical diagnoses, disease outcomes, and laboratory results of 130 children with severe COVID-19 infections admitted to nine top-tier hospitals in Yunnan Province from December 2022 to March 2023. According to the prognosis, the patients were divided into survival group and death group. The clinical and laboratory data between the two groups were compared, and the risk factors of death were evaluated. The χ2 test and Mann-Whitney U test were employed to compare between groups, while Spearman correlation test and multiple Logistic regression were used to analyze the risk factors for death. The predictive value of independent risk factors was evaluated by receiver operating characteristic curve. Results: The 130 severe patients included 80 males and 50 females with an onset age of 28.0 (4.5, 79.5) months. There were 97 cases in the survival group and 33 cases in the death group with no significant differences in gender and age between the two groups (P>0.05). Twenty-five cases (19.2%) out of the 130 patients had underlying diseases, and the number with underlying diseases was significantly higher in death group than in survival group (36.4% (12/33) vs. 13.4%(13/97), χ2=8.36, P=0.004). The vaccination rate in the survival group was significantly higher than that in the death group (86.1% (31/36) vs. 7/17, χ2=9.38, P=0.002). A total of 42 cases (32.3%) of the 130 patients were detected to be infected with other pathogens, but there was no significant difference in the incidence of co-infection between the death group and the survival group (39.3%(13/33) vs. 29% (29/97), χ2=1.02, P>0.05). Among the 130 cases, severe respiratory cases were the most common 66 cases (50.8%), followed by neurological severe illnesses 34 cases (26.2%) and circulatory severe cases 13 cases (10%). Compared to the survival group, patients in the death group had a significantly higher levels of neutrophil, ferritin, procalcitonin, alanine aminotransferase, lactate dehydrogenase, creatine kinase isoenzyme, B-type natriuretic peptide, interleukin-6 and 10 (6.7 (4.0, 14.0) vs. 3.0 (1.6, 7.0)×109/L, 479 (298, 594) vs. 268 (124, 424) μg/L, 4.8 (1.7, 10.6) vs. 2.0 (1.1, 3.1) μg/L, 66 (20, 258) vs. 23 (15, 49) U/L, 464 (311, 815) vs. 304 (252, 388) g/L, 71(52, 110) vs. 24(15, 48) U/L, 484 (160, 804) vs. 154 (26, 440) ng/L, 43 (23, 102) vs. 19 (13, 27) ng/L, 216 (114, 318) vs. 86 (45, 128) ng/L, Z=-4.21, -3.67, -3.76, -3.31, -3.75, -5.74, -3.55, -4.65, -5.86, all P<0.05). The correlated indexes were performed by multivariate Logistic regression and the results showed that vaccination was a protective factor from death in severe cases (OR=0.01, 95%CI 0-0.97","PeriodicalId":23998,"journal":{"name":"Zhonghua er ke za zhi = Chinese journal of pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140697780","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}
引用次数: 0
[Current status of pubertal sexual characteristics development of 2 704 girls aged 6-18 years in Tongzhou District of Beijing]. [北京市通州区 2 704 名 6-18 岁女孩青春期性征发育现状]。
Pub Date : 2024-04-16 DOI: 10.3760/cma.j.cn112140-20240104-00014
Y. Zhang, H. H. Wu, W. Shu, Y. Li, C. D. Yu, T. Li, G. M. Huang, D. Hou, F. F. Chen, J. T. Liu, S. L. Li, X. Zong
Objective: To understand the current status of pubertal sexual characteristics development of girls aged 6-18 years in Tongzhou District of Beijing and to compare the differences in sexual characteristics development among girls characterized as thin, normal, overweight, and obese. Methods: A cross-sectional survey was conducted among 2 844 girls aged 6-18 years in Tongzhou District of Beijing from September 2022 to July 2023. The developmental stages of breast and pubic hair were assessed on site, and menarche status was inquired. Weight and height were measured. The girls were subsequently characterized into thin, normal, overweight and obese groups. Basic information (including family and personal history) was obtained through questionnaires. Probit probability unit regression was applied to calculate the age of each Tanner stage of sexual characteristics development and the age of menarche. The χ2 test was applied to compare the counting data between two or multiple groups. Results: A total of 2 844 girls were surveyed and 2 704 girls met the inclusion criteria, resulting in a valid response rate of 95.1%. Among these girls, 1 105 (40.9%) were aged 6-9 years, 1 053 (38.9%) were aged 10-13 years, and 546 (20.2%) were aged 14-18 years. The of height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and body mass index-for-age Z-score (BAZ) were 0.46(-0.23,1.16), 0.69(-0.16,1.67), and 0.67(-0.27,1.73) respectively. The prevalences of thin, overweight, and obesity were respectively 1.7% (45/2 704), 17.3% (467/2 704), and 19.9% (538/2 704), respectively. There were 45 girls in the thin group, 1 654 girls in the normal weight group, 1 005 girls in the overweight and obesity group. The age of Tanner stage breast 2 (B2), Tanner stage pubic hair 2 (P2), and menarche was 9.0 (95%CI 8.9-9.1), 10.5 (95%CI 10.4-10.6), and 11.4 (95%CI 11.3-1.5) years, respectively. The current status of breast and pubic hair maturity in girls with pubertal development shows that 64.6% (1 211/1 874) of these girls had breast development preceding pubic hair development, 32.4% (607/1 874) had concurrent breast and pubic hair development, and 3.0% (56/1 874) had pubic hairs development preceding breast development. The interval age between B2 and B5 was 4.7 (95%CI 4.6-4.8) years, between P2 and P5 was 4.5 (95%CI 4.4-4.6) years, and between B2 and menarche was 2.4 (95%CI 2.3-2.5) years. The ages of sexual characteristics development in overweight and obese groups were earlier than that in normal and thin groups. The ages of B2 in thin, normal, overweight, and obese groups were 10.0 (95%CI 9.5-10.6), 9.3 (95%CI 9.2-9.4), and 8.6 (95%CI 8.4-8.7) years, respectively. The age of menarche in thin, normal, overweight, and obese groups were 13.1 (95%CI 12.4-13.7), 11.6 (95%CI 11.4-11.7), and 11.1 (95%CI 11.0-11.2) years, respectively. The interval ages between B2 and B5 and between P2 and P5 was 4.5 and 4.1 years, respectively in the overweight and obese groups, and those in norma
目的:了解北京市通州区 6-18 岁女孩青春期性征发育的现状,并比较瘦小、正常、超重和肥胖女孩性征发育的差异:了解北京市通州区 6-18 岁女孩青春期性征发育的现状,比较瘦弱、正常、超重和肥胖女孩性征发育的差异。研究方法2022 年 9 月至 2023 年 7 月,对北京市通州区 2 844 名 6-18 岁女童进行了横断面调查。现场评估了乳房和阴毛的发育阶段,并询问了初潮状况。测量了体重和身高。随后将女孩分为瘦弱组、正常组、超重组和肥胖组。通过问卷调查获得了基本信息(包括家族史和个人史)。采用 Probit 概率单位回归法计算性征发育各坦纳阶段的年龄和初潮年龄。采用χ2检验比较两组或多组之间的计数数据。结果共调查了 2 844 名女孩,2 704 名女孩符合纳入标准,有效回复率为 95.1%。在这些女孩中,6-9 岁的有 1 105 人(40.9%),10-13 岁的有 1 053 人(38.9%),14-18 岁的有 546 人(20.2%)。年龄身高 Z 值(HAZ)、年龄体重 Z 值(WAZ)和年龄体重指数 Z 值(BAZ)分别为 0.46(-0.23,1.16)、0.69(-0.16,1.67)和 0.67(-0.27,1.73)。瘦弱、超重和肥胖的发生率分别为 1.7%(45/2 704)、17.3%(467/2 704)和 19.9%(538/2 704)。瘦弱组有 45 名女孩,正常体重组有 1 654 名女孩,超重和肥胖组有 1 005 名女孩。坦纳期乳房 2 期(B2)、坦纳期阴毛 2 期(P2)和初潮年龄分别为 9.0(95%CI 8.9-9.1)岁、10.5(95%CI 10.4-10.6)岁和 11.4(95%CI 11.3-1.5)岁。青春期发育女孩的乳房和阴毛成熟现状显示,64.6%(1 211/1 874)的女孩乳房发育早于阴毛发育,32.4%(607/1 874)的女孩乳房和阴毛同时发育,3.0%(56/1 874)的女孩阴毛发育早于乳房发育。B2 和 B5 之间的间隔年龄为 4.7(95%CI 4.6-4.8)岁,P2 和 P5 之间的间隔年龄为 4.5(95%CI 4.4-4.6)岁,B2 和初潮之间的间隔年龄为 2.4(95%CI 2.3-2.5)岁。超重组和肥胖组的性征发育年龄早于正常组和瘦弱组。瘦弱组、正常组、超重组和肥胖组的 B2 年龄分别为 10.0(95%CI 9.5-10.6)岁、9.3(95%CI 9.2-9.4)岁和 8.6(95%CI 8.4-8.7)岁。瘦弱组、正常组、超重组和肥胖组的初潮年龄分别为 13.1(95%CI 12.4-13.7)岁、11.6(95%CI 11.4-11.7)岁和 11.1(95%CI 11.0-11.2)岁。超重组和肥胖组 B2 和 B5 之间以及 P2 和 P5 之间的间隔年龄分别为 4.5 岁和 4.1 岁,正常组和消瘦组的间隔年龄分别为 4.7 岁和 4.5 岁、4.6 岁和 4.7 岁。结论北京市通州区女孩性征发育和月经初潮的年龄往往早于 20 年前北京市的调查报告。超重和肥胖女孩的青春期开始年龄不仅早于体重正常的女孩,而且发育过程也较短。
{"title":"[Current status of pubertal sexual characteristics development of 2 704 girls aged 6-18 years in Tongzhou District of Beijing].","authors":"Y. Zhang, H. H. Wu, W. Shu, Y. Li, C. D. Yu, T. Li, G. M. Huang, D. Hou, F. F. Chen, J. T. Liu, S. L. Li, X. Zong","doi":"10.3760/cma.j.cn112140-20240104-00014","DOIUrl":"https://doi.org/10.3760/cma.j.cn112140-20240104-00014","url":null,"abstract":"Objective: To understand the current status of pubertal sexual characteristics development of girls aged 6-18 years in Tongzhou District of Beijing and to compare the differences in sexual characteristics development among girls characterized as thin, normal, overweight, and obese. Methods: A cross-sectional survey was conducted among 2 844 girls aged 6-18 years in Tongzhou District of Beijing from September 2022 to July 2023. The developmental stages of breast and pubic hair were assessed on site, and menarche status was inquired. Weight and height were measured. The girls were subsequently characterized into thin, normal, overweight and obese groups. Basic information (including family and personal history) was obtained through questionnaires. Probit probability unit regression was applied to calculate the age of each Tanner stage of sexual characteristics development and the age of menarche. The χ2 test was applied to compare the counting data between two or multiple groups. Results: A total of 2 844 girls were surveyed and 2 704 girls met the inclusion criteria, resulting in a valid response rate of 95.1%. Among these girls, 1 105 (40.9%) were aged 6-9 years, 1 053 (38.9%) were aged 10-13 years, and 546 (20.2%) were aged 14-18 years. The of height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and body mass index-for-age Z-score (BAZ) were 0.46(-0.23,1.16), 0.69(-0.16,1.67), and 0.67(-0.27,1.73) respectively. The prevalences of thin, overweight, and obesity were respectively 1.7% (45/2 704), 17.3% (467/2 704), and 19.9% (538/2 704), respectively. There were 45 girls in the thin group, 1 654 girls in the normal weight group, 1 005 girls in the overweight and obesity group. The age of Tanner stage breast 2 (B2), Tanner stage pubic hair 2 (P2), and menarche was 9.0 (95%CI 8.9-9.1), 10.5 (95%CI 10.4-10.6), and 11.4 (95%CI 11.3-1.5) years, respectively. The current status of breast and pubic hair maturity in girls with pubertal development shows that 64.6% (1 211/1 874) of these girls had breast development preceding pubic hair development, 32.4% (607/1 874) had concurrent breast and pubic hair development, and 3.0% (56/1 874) had pubic hairs development preceding breast development. The interval age between B2 and B5 was 4.7 (95%CI 4.6-4.8) years, between P2 and P5 was 4.5 (95%CI 4.4-4.6) years, and between B2 and menarche was 2.4 (95%CI 2.3-2.5) years. The ages of sexual characteristics development in overweight and obese groups were earlier than that in normal and thin groups. The ages of B2 in thin, normal, overweight, and obese groups were 10.0 (95%CI 9.5-10.6), 9.3 (95%CI 9.2-9.4), and 8.6 (95%CI 8.4-8.7) years, respectively. The age of menarche in thin, normal, overweight, and obese groups were 13.1 (95%CI 12.4-13.7), 11.6 (95%CI 11.4-11.7), and 11.1 (95%CI 11.0-11.2) years, respectively. The interval ages between B2 and B5 and between P2 and P5 was 4.5 and 4.1 years, respectively in the overweight and obese groups, and those in norma","PeriodicalId":23998,"journal":{"name":"Zhonghua er ke za zhi = Chinese journal of pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140697808","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}
引用次数: 0
[Standardized diagnosis and assessment of overweight or obesity in children]. [儿童超重或肥胖的标准化诊断和评估]。
Pub Date : 2024-04-16 DOI: 10.3760/cma.j.cn112140-20240130-00084
J. J. Chen, Y. R. Jiang
超重、肥胖已成为危害我国儿童健康的重要公共卫生问题之一,但在临床实践中针对儿童超重或肥胖的诊断及评估方法亟待规范。为保证医疗服务的科学性、同质性,现基于儿童肥胖相关专家共识及临床实用性,对儿童超重或肥胖的诊断、评估方法进行介绍。.
超重、肥胖已成为危害我国儿童健康的重要公共卫生问题之一,但在临床实践中针对儿童超重或肥胖的诊断及评估方法亟待规范。为保证医疗服务的科学性、同质性,现基于儿童肥胖相关专家共识及临床实用性,对儿童超重或肥胖的诊断、评估方法进行介绍。.
{"title":"[Standardized diagnosis and assessment of overweight or obesity in children].","authors":"J. J. Chen, Y. R. Jiang","doi":"10.3760/cma.j.cn112140-20240130-00084","DOIUrl":"https://doi.org/10.3760/cma.j.cn112140-20240130-00084","url":null,"abstract":"\u0000 超重、肥胖已成为危害我国儿童健康的重要公共卫生问题之一,但在临床实践中针对儿童超重或肥胖的诊断及评估方法亟待规范。为保证医疗服务的科学性、同质性,现基于儿童肥胖相关专家共识及临床实用性,对儿童超重或肥胖的诊断、评估方法进行介绍。.\u0000","PeriodicalId":23998,"journal":{"name":"Zhonghua er ke za zhi = Chinese journal of pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140694756","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}
引用次数: 0
[Two cases of rituximab induced serum sickness in children with nephrotic syndrome]. [两例肾病综合征患儿因利妥昔单抗引起的血清病]。
Pub Date : 2024-04-16 DOI: 10.3760/cma.j.cn112140-20231019-00304
Y. Yang, H. Bai
2例原发性肾病综合征患儿使用利妥昔单抗(RTX)诱发血清病,诊断为利妥昔单抗诱导血清病(RISS)。例1,男,8岁,确诊原发性肾病综合征5年余,病理为局灶节段性肾小球硬化,应用第2剂RTX治疗6 d后,出现急性皮疹、关节肿痛、高热及休克等血清病表现,经激素等治疗5 d逐渐好转。例2,女,9岁,确诊原发性单纯型肾病综合征3年2个月,病理诊断微小病变,应用第2剂RTX治疗11 d后,出现急性皮疹、关节肿痛表现,2 d后自行好转。2例儿童肾病综合征RISS均发生在学龄期患儿重复使用RTX时,症状出现在再次应用1~2周内,主要表现为皮疹、关节痛、发热。严重者出现休克。激素为RISS的主要治疗方法,轻者自行缓解。.
2例原发性肾病综合征患儿使用利妥昔单抗(RTX)诱发血清病,诊断为利妥昔单抗诱导血清病(RISS)。例1,男,8岁,确诊原发性肾病综合征5年余,病理为局灶节段性肾小球硬化,应用第2剂RTX治疗6 d后,出现急性皮疹、关节肿痛、高热及休克等血清病表现,经激素等治疗5 d逐渐好转。例2,女,9岁,确诊原发性单纯型肾病综合征3年2个月,病理诊断微小病变,应用第2剂RTX治疗11 d后,出现急性皮疹、关节肿痛表现,2 d后自行好转。2例儿童肾病综合征RISS均发生在学龄期患儿重复使用RTX时,症状出现在再次应用1~2周内,主要表现为皮疹、关节痛、发热。严重者出现休克。激素为RISS的主要治疗方法,轻者自行缓解。.
{"title":"[Two cases of rituximab induced serum sickness in children with nephrotic syndrome].","authors":"Y. Yang, H. Bai","doi":"10.3760/cma.j.cn112140-20231019-00304","DOIUrl":"https://doi.org/10.3760/cma.j.cn112140-20231019-00304","url":null,"abstract":"\u0000 2例原发性肾病综合征患儿使用利妥昔单抗(RTX)诱发血清病,诊断为利妥昔单抗诱导血清病(RISS)。例1,男,8岁,确诊原发性肾病综合征5年余,病理为局灶节段性肾小球硬化,应用第2剂RTX治疗6 d后,出现急性皮疹、关节肿痛、高热及休克等血清病表现,经激素等治疗5 d逐渐好转。例2,女,9岁,确诊原发性单纯型肾病综合征3年2个月,病理诊断微小病变,应用第2剂RTX治疗11 d后,出现急性皮疹、关节肿痛表现,2 d后自行好转。2例儿童肾病综合征RISS均发生在学龄期患儿重复使用RTX时,症状出现在再次应用1~2周内,主要表现为皮疹、关节痛、发热。严重者出现休克。激素为RISS的主要治疗方法,轻者自行缓解。.\u0000","PeriodicalId":23998,"journal":{"name":"Zhonghua er ke za zhi = Chinese journal of pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140694733","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}
引用次数: 0
[Interpretation of treatment of seizures in the neonate: guidelines and consensus-based recommendations-special report from the ILAE Task Force on Neonatal Seizures(2023)]. [新生儿癫痫发作治疗的解释:指南和基于共识的建议--来自 ILAE 新生儿癫痫发作工作组的特别报告(2023 年)]。
Pub Date : 2024-04-16 DOI: 10.3760/cma.j.cn112140-20231210-00421
J. Yang, P. Zhang, L. Li, G. Cheng
癫痫发作是新生儿常见危重症,治疗方法存在很大差异。2023年9月,国际抗癫痫联盟(ILAE)新生儿癫痫发作工作组发布了“新生儿癫痫发作的治疗:指南和基于共识的建议——ILAE新生儿癫痫发作工作组特别报告”,本文通过与世界卫生组织(WHO)及ILAE等2011年制订的新生儿癫痫发作指南、我国新生儿惊厥临床管理专家共识(2022)比较,对该建议进行解读,以帮助国内医务人员更好地理解和遵循建议,优化新生儿癫痫发作的治疗。.
癫痫发作是新生儿常见危重症,治疗方法存在很大差异。2023年9月,国际抗癫痫联盟(ILAE)新生儿癫痫发作工作组发布了“新生儿癫痫发作的治疗:指南和基于共识的建议——ILAE新生儿癫痫发作工作组特别报告”,本文通过与世界卫生组织(WHO)及ILAE等2011年制订的新生儿癫痫发作指南、我国新生儿惊厥临床管理专家共识(2022)比较,对该建议进行解读,以帮助国内医务人员更好地理解和遵循建议,优化新生儿癫痫发作的治疗。.
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引用次数: 0
[Diagnosis and treatment of acute focal bacterial nephritis in children]. [儿童急性局灶性细菌性肾炎的诊断和治疗]。
Pub Date : 2024-04-16 DOI: 10.3760/cma.j.cn112140-20231121-00384
Y. Chen, Z. H. Yu
急性局灶性细菌性肾炎(AFBN)是一种局限于肾实质的细菌性感染。AFBN临床表现缺乏特异性;其影像学特征是肾脏超声显示肾实质内局灶性病变、皮髓质分界不清,增强CT示肾实质内楔形低密度灶,病变在增强MRI的T2W呈低信号、增强后T1W呈低强化。当急性肾盂肾炎患儿经抗菌药物治疗后发热持续时间≥48 h、白细胞尿持续时间超过4 d、血清白细胞介素6、干扰素γ显著增高时要疑诊AFBN;若发现AFBN影像学特征性改变,则可诊断为AFBN。AFBN的抗菌药物疗程至少为3周。.
急性局灶性细菌性肾炎(AFBN)是一种局限于肾实质的细菌性感染。AFBN临床表现缺乏特异性;其影像学特征是肾脏超声显示肾实质内局灶性病变、皮髓质分界不清,增强CT示肾实质内楔形低密度灶,病变在增强MRI的T2W呈低信号、增强后T1W呈低强化。当急性肾盂肾炎患儿经抗菌药物治疗后发热持续时间≥48 h、白细胞尿持续时间超过4 d、血清白细胞介素6、干扰素γ显著增高时要疑诊AFBN;若发现AFBN影像学特征性改变,则可诊断为AFBN。AFBN的抗菌药物疗程至少为3周。.
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引用次数: 0
[Analysis of clinical characteristic of pediatric with progressive familial intrahepatic cholestasis type 3]. [小儿进行性家族性肝内胆汁淤积症 3 型临床特点分析]。
Pub Date : 2024-04-16 DOI: 10.3760/cma.j.cn112140-20231010-00270
L. L. Cao, J. G. Yan, D. Feng, Y. Dong, Z. Q. Xu, F. Wang, Y. J. Gao, S. Zhu, M. Zhang
Objective: To analyze the clinical manifestations, pathology, and gene variant characteristics in children with progressive familial intrahepatic cholestasis type 3 (PFIC3). Methods: This retrospective study assessed the clinical manifestations, pathological features, gene variants, and prognosis data of 11 children with PFIC3 hospitalized in the Department of Hepatology, Fifth Medical Center, PLA General Hospital, from January 2015 to December 2022. Panel or whole exome sequencing was performed on the probands, followed by Sanger sequencing for verification within the family. Detected pathogenic variants were compared with known disease databases. Additionally, the new variants were predicted the deleteriousness and protein structure using relevant software to evaluate their pathogenicity. Results: Among the 11 PFIC3 children, 8 were boys and 3 were girls. The age of onset was 3.1 (0.2, 15.6) years. The main complaint of onset was different in the 11 patients;5 of them were abnormal liver function, 3 of them were liver and spleen enlargement, 2 of them were abdominal distension, and 1 of them was jaundice. alanine aminotransferase, asparate aminotransferase and r-glutamyltransferase increased in all the patients, which were(113±40), (150±44) and (270±156) U/L respectively. Moreover, direct bilirubin increased in 9 patients, and cholestasis was showed in 8 patients. All patients showed liver fibrosis on imaging, and 8 patients had cirrhosis. The pathological features of 8 cases by liver biopsy were as follows: 8 cases of fibrosis in the portal area, 7 cases of small bile duct hyperplasia, 4 cases of positive copper staining, and 5 cases of cirrhosis. A total of 17 ABCB4 gene variants were detected, including 9 new variants: c.589C>T(p.Q197X), c.1230+1G>A(Splicing), c.2914G>A(P.D972N), c.1058G>A(p.C353Y), c.956G>T(p.G319V), c.473T>A(p.L158Q), c.164T>C(p.L55S), c.2493G>C(p.R831S), and c.1150G>C(p.G384R). All 11 patients were treated with ursodeoxycholic acid and followed up for 5.1(0.6, 7.4) years. Among them, 4 cases of cirrhosis progressed continuously, 3 cases had liver transplantations, and the remaining 4 cases were stable after medical treatment. Conclusions: Children with PFIC3 have early onset, diverse clinical manifestations, rapid progression of fibrotic and cholestasis, as well as poor prognosis. Genetic testing helps to confirm the diagnosis.
目的分析进行性家族性肝内胆汁淤积症3型(PFIC3)患儿的临床表现、病理和基因变异特征。方法:回顾性研究这项回顾性研究评估了2015年1月至2022年12月期间在解放军总医院第五医学中心肝病科住院的11名PFIC3患儿的临床表现、病理特征、基因变异和预后数据。研究人员对疑似患者进行了基因组测序或全外显子组测序,随后在家族内部进行了桑格测序验证。检测到的致病变异与已知疾病数据库进行比较。此外,还使用相关软件预测了新变异的缺失性和蛋白质结构,以评估其致病性。结果:11 名 PFIC3 患儿中,8 名男孩,3 名女孩。发病年龄为 3.1(0.2,15.6)岁。所有患者的丙氨酸氨基转移酶、天门冬氨酸氨基转移酶和谷氨酰转移酶均升高,分别为(113±40)、(150±44)和(270±156)U/L。此外,9 名患者的直接胆红素升高,8 名患者出现胆汁淤积。所有患者的影像学检查均显示肝纤维化,8 例患者为肝硬化。8 例患者的肝活检病理特征如下:8 例肝门区纤维化,7 例小胆管增生,4 例铜染色阳性,5 例肝硬化。共检测到 17 个 ABCB4 基因变异,包括 9 个新变异:c.589C>T(p.Q197X)、c.1230+1G>A(剪接)、c.2914G>A(P.D972N)、c.1058G>A(p.C353Y)、c.956G>T(p.G319V)、c.473T>A(p.L158Q)、c.164T>C(p.L55S)、c.2493G>C(p.R831S)和c.1150G>C(p.G384R)。所有 11 例患者都接受了熊去氧胆酸治疗,并随访了 5.1(0.6,7.4)年。其中,4 例肝硬化持续进展,3 例进行了肝移植,其余 4 例经药物治疗后病情稳定。结论PFIC3儿童发病早,临床表现多样,肝纤维化和胆汁淤积进展迅速,预后不良。基因检测有助于确诊。
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引用次数: 0
期刊
Zhonghua er ke za zhi = Chinese journal of pediatrics
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