中国当代儿科杂志最新文献

Objectives: To investigate the efficacy and safety of prolonged azithromycin (PAZM) versus switching to doxycycline (SDXC) in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) in children.

Methods: A total of 173 children with MUMPP who were hospitalized in Baoji Central Hospital, from January to December 2023 were selected as subjects. According to the choice of secondary antibiotic after 72 hours of initial macrolide therapy, they were divided into two groups: PAZM and SDXC. The efficacy and adverse drug reactions were compared between the two groups, and the risk factors for refractory Mycoplasma pneumoniae pneumonia (RMPP) were analyzed.

Results: Compared with the PAZM group, the SDXC group had significantly shorter time to defervescence and time to cough relief, a significantly lower proportion of patients using glucocorticoids, and a significantly higher proportion of patients with lung lesion absorption (P<0.05). No adverse reactions such as liver and kidney function impairment and tooth discoloration were observed in either group. RMPP occurred in 47 cases in the PAZM group. The univariate analysis showed that lactate dehydrogenase levels and age were risk factors for RMPP (P<0.05).

Conclusions: The efficacy of SDXC is superior to that of PAZM in children with MUMPP, and short-term use of doxycycline is relatively safe.

In order to guide clinical blood transfusion practices for pediatric patients, the National Health Commission has released the health standard "Guideline for pediatric transfusion" (WS/T 795-2022). Considering the physiological particularities of the neonatal period, blood transfusion practices for neonates are more complex than those for other children, the guidelines include a separate chapter dedicated to neonatal blood transfusion. This paper interprets the background and evidence for the compilation of the neonatal blood transfusion provisions, hoping to aid in the understanding and implementation of the neonatal blood transfusion section of the guidelines.

Objectives: To investigate the interaction between catechol-O-methyltransferase (COMT) gene polymorphisms and childhood trauma in adolescents with non-suicidal self-injury (NSSI), and to provide a basis for the prevention and intervention of NSSI among adolescents.

Methods: A total of 84 adolescents with NSSI and 87 healthy controls were enrolled in this study. Oral saliva samples were collected for genotyping of the COMT gene at rs4680 and rs165599. Childhood Trauma Questionnaire, Behavioral Function Assessment Scale of Non-suicidal Self-injury in Adolescents, and Patient Health Questionnaire-9 Items were used for mental health assessment. A hierarchical linear regression analysis was used to examine the main effect and interactive effect of COMT gene polymorphisms at rs4680 and rs165599 and childhood trauma on NSSI. The Johnson-Neyman technique was used to identify the regions where the moderating variables had a significant impact.

Results: The interaction between COMT gene polymorphisms at rs165599 and the subtype of emotional neglect in childhood trauma could predict NSSI in adolescents (β=0.251, t=2.329, P=0.022). As for the adolescents carrying the G/G genotype at rs165599, the high emotional neglect group had a significantly higher NSSI score than the low emotional neglect group (F=4.579, P=0.049).

Conclusions: Adolescents carrying the G/G genotype at rs165599 of the COMT gene may have an increase in susceptibility to NSSI in case of high emotional neglect in childhood.

With advancements in clinical medicine, pediatric blood transfusion has evolved from traditional empirical practices to evidence-based approaches grounded in clinical research data. To better guide pediatric blood transfusion practices and improve clinical outcomes for pediatric patients, the National Health Commission has developed and issued "Guideline for pediatric transfusion". This article summarizes the unique aspects of pediatric blood transfusion, the application of blood component therapy in treating pediatric patients, the significance of interpreting the "Guideline for pediatric transfusion", and anticipates future developments in pediatric blood transfusion medicine.

The patient is a 10-month and 21-day-old girl who began to show developmental delays at 3 months of age, with severe language developmental disorders, stereotyped movements, and easily provoked laughter. Physical examination revealed fair skin and a flattened occiput. At 10 months of age, a video electroencephalogram suggested atypical absence seizures, with migrating slow-wave activity observed during the interictal period. Whole exome sequencing of three family members indicated a novel mutation in the AP2M1 gene, c.508C>T (p.R170W), in the patient. A total of six cases of autosomal dominant intellectual developmental disorder 60 with seizures associated with mutations in the AP2M1 gene have been reported both domestically and internationally (including this study). The main clinical features included developmental delays (6 cases), language developmental disorders (5 cases), stereotyped movements (3 cases), a tendency to smile (1 case), and atypical absence seizures (4 cases). Interictal electroencephalograms showed widespread spike waves and spike-slow wave discharges (5 cases), and migrating slow-wave activity (1 case). The c.508C>T (p.R170W) mutation may be a hotspot for mutations in the AP2M1 gene, and its clinical features are similar to those of Angelman syndrome.

Objectives: To study the treatment outcomes of extremely preterm infants.

Methods: A retrospective analysis was performed for the clinical data of extremely preterm infants who were admitted to the neonatal intensive care unit of the Third Affiliated Hospital of Zhengzhou University from January 2016 to December 2022. The infants were divided into a non-in-hospital death group and a survival group. SPSS 29.0 was used for data analysis.

Results: A total of 422 extremely preterm infants were included, of which 155 were in the non-in-hospital death group and 267 in the survival group. The gestational age, birth weight, cesarean section rate, and proportion of mothers with premature rupture of membranes >18 hours in the non-in-hospital death group were all lower than those in the survival group (P<0.05). In contrast, the proportions of Apgar score ≤3 at 1 minute, intubation, neonatal respiratory distress syndrome, early-onset sepsis, periventricular-intraventricular hemorrhage (grades III-IV), and pneumorrhagia were higher in the non-in-hospital death group compared to the survival group (P<0.05).

Conclusions: Low gestational age, low birth weight, the history of birth asphyxia, severe intracranial hemorrhage, and pneumorrhagia may be the main causes of non-in-hospital death in extremely preterm infants, and therefore, perinatal health care should be enhanced to reduce the onset of asphyxia and severe diseases.

Objectives: To investigate the changing trends and influencing factors for growth retardation-related obesity in Chinese children aged 7-12 years in 2010-2020, providing a basis for formulating physical health interventions for children.

Methods: The data of body height and body mass index were collected from 16 289 children aged 7-12 years in the China Family Panel Studies (CFPS) in 2010-2020, and the trends of growth retardation, obesity, and growth retardation-related obesity in 2010-2020 were analyzed and compared between different sexes and between urban and rural areas.

Results: From 2010 to 2020, the overall rates of growth retardation and growth retardation-related obesity among children aged 7-12 years in China showed a declining trend (P<0.05). By gender and urban-rural classification, the overall obesity rate from 2010 to 2020 showed an increasing trend in all groups except for the rural male and female children groups, the rural children group, and the female children group (P<0.05). The prevalence rates of growth retardation, obesity, and growth retardation-related obesity in male children were significantly higher than those in female children, and similarly, these indicators were also significantly higher in rural children compared to urban children (P<0.05). Urban/rural residence, age, sex, and year were influencing factors for growth retardation and growth retardation-related obesity in children aged 7-12 years (P<0.05).

Conclusions: The prevalence of growth retardation, obesity, and growth retardation-related obesity among Chinese children aged 7-12 years shows gender and urban-rural disparities, which highlights the needs for targeted interventions for boys and children in rural areas.

Objectives: To investigate the factors influencing the levels of fear regarding psychotherapy in adolescents with depression.

Methods: A prospective study was conducted among 258 adolescents with depression who were treated in the outpatient service and inpatient department of the First Affiliated Hospital of Nanchang University from September 2023 to March 2024. A questionnaire survey was performed. The questionnaires used included General Information Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Self-Compassion Scale, Self-Concealment Scale, Depression Self-Stigma Scale, and Thoughts About Psychotherapy Survey. The factors influencing the levels of fear regarding psychotherapy were analyzed among the adolescents with depression.

Results: The levels of fear regarding psychotherapy in the adolescents with depression were positively associated with the scores on the Patient Health Questionnaire-9, Self-Concealment Scale, and Depression Self-Stigma Scale (P<0.05), and were negatively associated with the score on the Self-Compassion Scale (P<0.05). Concerns about therapist responsiveness were negatively associated with the score on the Self-Compassion Scale (P<0.05), and were positively associated with the scores on the Generalized Anxiety Disorder-7 and Depression Self-Stigma Scale (P<0.05). The adolescents from one-child families had significantly higher levels of concerns about therapist responsiveness than those from non-one-child families (P<0.05). The levels of image concerns were positively associated with the scores on Patient Health Questionnaire-9, Self-Concealment Scale, and Depression Self-Stigma Scale (P<0.05); the levels of coercion concerns were positively associated with the scores of the Patient Health Questionnaire-9 and Self-Concealment Scale (P<0.05) and were negatively associated with the score on the Self-Compassion Scale (P<0.05). Middle school students had a significantly higher risk of coercion concerns than university students (P<0.05).

Conclusions: In adolescents with depression, the levels of fear regarding psychotherapy are associated with educational levels, only-child status, depression symptoms, anxiety symptoms, self-compassion, self-concealment, and depression self-stigma.

Objectives: To explore the epidemiological characteristics of respiratory syncytial virus (RSV) infection in children in Nanchang and its correlation with climate environmental factors.

Methods: The clinical data were collected from children with acute respiratory infection in Nanchang who were tested for RSV at Jiangxi Provincial Children's Hospital from January 2019 to December 2023, along with climate environmental data for the same period. The epidemiological characteristics of RSV and their correlation with climate environmental factors were investigated.

Results: A total of 178 127 children underwent RSV testing from January 2019 to December 2023, with a positive detection rate of 8.35% (14 873/178 127). The positive detection rate in males was 8.92% (10 137/113 660), which was higher than that in females (7.35%, 4 736/64 467). The differences in RSV positive detection rates among different age groups were statistically significant (P<0.001), with the highest rate observed in the 0 to <3 months age group (14.38%, 3 328/23 142). Peaks in RSV positive detection occurred during winter and spring periods in 2019, 2020, and 2022, while in 2023, it occurred in spring and summer periods, with no seasonality noted in 2021. The RSV positive detection rate showed a positive correlation with average humidity, average atmospheric pressure, monthly PM_2.5, and monthly carbon monoxide levels (P<0.05), while it showed a negative correlation with average wind speed, average temperature, and maximum 8-hour ozone levels (P<0.05).

Conclusions: In Nanchang, the RSV positive detection rate in children with acute respiratory infection is higher in males than in females. Among children of all age groups, the infants aged 0 to <3 months have the highest detection rate of RSV. RSV infection predominantly occurs in winter and spring periods. Lower temperatures, lower wind speeds, higher humidity, and elevated levels of PM_2.5 and carbon monoxide may increase the risk of RSV infection in children.