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| 1 | Treatment and outcomes of 1041 pediatric patients with neuroblastoma who received multidisciplinary care in China显示文摘Importance:Neuroblastoma is the most common extracranial malignant solid tumor in children.Multidisciplinary care is critical to improving the survival of pediatric patients with neuroblastoma.Objective:To systematically summarize the clinical characteristics of children with neuroblastoma and evaluate their prognosis with multidisciplinary care provided in a single center.Methods:This retrospective study analyzed the clinical data of 1041 patients with neuroblastoma who were diagnosed,treated,and followed-up in the Hematology-Oncology Center of Beijing Children’s Hospital from 2007 to 2019.Results:The median age at diagnosis was 34 months;80.8%of the patients were younger than 5 years of age.Notably,243 patients(23.3%)were classified as low-risk,249 patients(23.9%)were classified as intermediate-risk,and 549(52.7%)were classified as high-risk.Furthermore,956 patients underwent surgical resections;986(94.7%)patients received chemotherapy;and 176 patients with high-risk neuroblastoma received hematopoietic stem cell transplantation.The 5-year event-free survival(EFS)rate was 91.3%and 5-year overall survival(OS)rate was 97.5%in low-risk group;in the intermediate-risk group,these rates were 85.1%and 96.7%,respectively,while they were 37.7%and 48.9%in the high-risk group(P<0.001 for both).The 5-year EFS and OS rates were significantly higher in patients diagnosed between 2015 and 2019 than in patients diagnosed between 2007 and 2014(P<0.001).In total,278 patients(26.7%)exhibited tumor relapse or progression;the median interval until relapse or progression was 14 months.Of the 233 patients who died,83%died of relapse or progression of neuroblastoma and 4.3%died of therapy-related complications.Interpretation:The 5-year OS rate was low in high-risk patients,compared with low-and intermediate-risk patients.Multidisciplinary care is critical for improvement of survival in pediatric patients with neuroblastoma.Additional treatment strategies should be sought to improve the prognosis of patients with high-risk neuroblastoma. | Yan Su Hong Qin Chenghao Chen Shengcai Wang Shihan Zhang Dawei Zhang Mei Jin Yun Peng Lejian He Xiaoman Wang Suyun Qian Maoquan Qin Ming Ge Fuquan Zhang Qi Zeng Huanmin Wang Xiaoli Ma Xin Ni | 2020 | Pediatric Investigation2020，4，3： | 16 |
| 2 | Clinical characteristics and effectiveness of antiviral agents in hospitalized children with infectious mononucleosis in China:A multicenter retrospective study显示文摘Importance:The clinical characteristics of infectious mononucleosis(IM)in Chinese children have not been evaluated in multicenter studies,and the effectiveness of antiviral treatment are controversial.Objective:To investigate the clinical characteristics of Chinese children with IM and current status of antiviral therapy for affected patients.Methods:Hospitalized patients with IM were enrolled between 2018 and 2020 in five children’s hospitals in China.The clinical characteristics were compared among four age groups:<3 years,3-<6 years,6-<10 years,and≥10 years.The clinical characteristics of IM and effectiveness of antiviral therapy were compared among patients receiving acyclovir(ACV),ganciclovir(GCV),and no antiviral therapy(i.e.,non-antiviral group).Results:In total,499 patients were analyzed;most patients were 3-<6 years of age.The most common symptoms and signs included fever(100%),lymphadenopathy(98.6%),pharyngitis(86.4%),eyelid edema(76.8%),and snoring(72.9%).There were significant differences in rash,hepatomegaly,and liver dysfunction among the four age groups.Patients aged<3 years had a lower incidence of liver dysfunction and a higher incidence of rash.Among the 499 patients,50.1%were treated with GCV,26.3%were treated with ACV,and 23.6%received no antiviral therapy.Compared with the non-antiviral group,patients in the ACV and GCV groups had longer durations of fever(P<0.001).There were no significant differences in the incidences of complications among the three treatment groups.Interpretation:The incidence of IM in Chinese children peaked at 3-<6 years of age.Clinical features of IM varied according to age.Patients receiving antiviral therapy exhibited more serious clinical manifestations than did patients without antiviral therapy.The effectiveness of antiviral therapy for IM requires further analysis. | Huili Hu Huiling Deng Jing Bi Yi Xu Shuangjie Li Yue Xie Xinrong Sun Dongmeng Wang Xufang Li Wenxian Ouyang Bing Hu Yufeng Zhang He Tang Chunxiao Fang Hui Zhang Lingyun Guo Chen Wang Tianyi Wang Fengxia Yang Tao Jiang Zhengde Xie Gang Liu | 2021 | Pediatric Investigation2021，5，3： | 12 |
| 3 | effective treatment of post-intubation subglottic stenosis in children with holmium laser therapy and cryotherapy via flexible bronchoscopy显示文摘Importance:Post-intubation subglottic stenosis(SGS)in children can be life threatening.Definitive treatment varies and lacks a universally accepted approach.Objective:We performed a prospective study to assess the safety and feasibility of holmium laser combined with cryotherapy delivered via flexible bronchoscopy for the treatment of post-intubation SGS in children.Methods:This study involved all patients with post-intubation SGS seen at the Interventional Pulmonology Department of Beijing Children's Hospital between July 2014 and December 2016.Holmium laser treatment and cryotherapy was then performed under flexible bronchoscopy,whose parents refused to accept the alternative standard treatment of tracheotomy and balloon dilation under direct laryngoscopy.results:Sixteen patients with post-intubation SGS were included in this study.Ages ranged from 2 months to 12.25 years old.According to the Cotton-Myer grading system,three cases were Grade II,12 cases were Grade III,and one case was Grade IV.According to the McCaffrey system,eight cases were Stage 1,two cases were Stage 2,and six cases were Stage 3.The average number of procedures was 4.88.Fifteen of the 16 patients achieved clinical cure.One patient achieved clinical improvement.The average treatment course duration was 55.31 days.No severe complications were seen.Post-treatment clinical symptoms,endoscopic findings and quality of life showed marked improvement.Interpretation:Our study supports the conclusion that holmium laser treatment combined with cryotherapy via flexible bronchoscopy appears to be a safe and feasible treatment for post-intubation SGS in children. | Anxia Jiao Fang Liu Andrew D.Lerner Xiaochun Rao Yan Guo Chenfang Meng Yuena Pan Gan Li Zheng Li Fang Wang Jing Zhao Yuyan Ma Xicheng Liu Xin Ni Kunling Shen | 2019 | Pediatric Investigation2019，3，1： | 10 |
| 4 | Epidemiology and treatment of beta thalassemia major in China显示文摘Thalassemia, classified as the main types α- and β-thalassemia, is a single gene disorder resulting from globin chain synthesis impairment through the mutation or deletion of globin genes. The incidence of thalassemia is high worldwide, with high associated mortality. Therefore, treatment is important to improve patient outcomes. This paper reviews the current status of β-thalassemia major in China, including its epidemiology and treatment. | Xiaoxiao Xu Xuedong Wu | 2020 | Pediatric Investigation2020，4，1： | 9 |
| 5 | Family integrated care:Supporting parents as primary caregivers in the neonatal intensive care unit显示文摘Family integrated care (FICare) is a collaborative model of neonatal care which aims to address the negative impacts of the neonatal intensive care unit (NICU) environment by involving parents as equal partners, minimizing separation, and supporting parent-infant closeness. FICare incorporates psychological, educational, communication, and environmental strategies to support parents to cope with the NICU environment and to prepare them to be able to emotionally, cognitively, and physically care for their infant. FICare has been associated with improved infant feeding, growth, and parent wellbeing and self-efficacy;important mediators for long-term improved infant neurodevelopmental and behavioural outcomes. FICare implementation requires multi-disciplinary commitment, staff motivation, and sufficient time for preparation and readiness for change as professionals relinquish power and control to instead develop collaborative partnerships with parents. Successful FICare implementation and culture change have been applied by neonatal teams internationally, using practical approaches suited to their local environments. Strategies such as parent and staff meetings and relational communication help to break down barriers to change by providing space for the co-creation of knowledge, the negotiation of caregiving roles and the development of trusting relationships. The COVID-19 pandemic highlighted the vulnerability within programs supporting parental presence in neonatal units and the profound impacts of parent-infant separation. New technologies and digital innovations can help to mitigate these challenges, and support renewed efforts to embed FICare philosophy and practice in neonatal care during the COVID-19 recovery and beyond. | Chandra Waddington Nicole Rvan Veenendaal Karel O’Brien Neil Patel for the International Steering Committee for Family Integrated Care | 2021 | Pediatric Investigation2021，5，2： | 9 |
| 6 | Central precocious puberty as a prelude of gonad dysplasia显示文摘There is increasing evidence that patients with gonad dysplasia,as characterized by absent or incomplete puberty,can also exhibit central precocious puberty(CPP).Herein,we review the reported cases that manifest with both gonad dysplasia and CPP.Further,we examine the hypothesis that these patients exhibit a normal hypothalamic-pituitarygonadal axis,hypogonadism,and the presence of residual gonadal function,and that the onset of disease is related to early initiation of the hypothalamic-pituitary-gonadal axis.Thus,we suggest that CPP is a prelude of some partial hypogonadism. | Lele Li Chunxiu Gong | 2019 | Pediatric Investigation2019，3，1： | 6 |
| 7 | A brief introduction to the FUTang Updating medical REcords(FUTURE)database显示文摘Introduction Futang Research Center of Pediatric Development(FRCPD),the first nonprofit social service organization engaging in pediatric research in China,was founded in May 2013.Until August 2021,FRCPD has 40 tertiary children’s hospitals,accounting for about 65.6%of all national public children’s hospitals,which was reported to be 61 in China Health Statistical Yearbook(2020).The hospitals are distributed in 30 provinces,autonomous regions,and municipalities(except for Tibet autonomous region),and most of them are in the capital of the province,forming a broad frontline representing the best quality of health care for the diagnosis and treatment of children’s disease in China.Based on the idea of sharing,FRCPD realized the exchange of experts,medical resources,research findings,educational events,preventive strategies,and management experiences among members.In the long run,FRCPD aims to continuously promote the quality of healthcare and medical service capability for children in China. | Xinyu Wang Yueping Zeng Jian Tian Hui Xu Fei Song Yongli Guo Xin Xu Guoshuang Feng Xin Ni | 2021 | Pediatric Investigation2021，5，3： | 6 |
| 8 | Advances in understanding Kawasaki disease-related immuno-inflammatory response and vascular endothelial dysfunction显示文摘Kawasaki disease(KD)is a systemic vasculitis of unknown etiology,which tends to involve coronary arteries and can lead to acquired heart disease in children.The immuno-inflammatory response and vascular endothelial dysfunction are important causes of coronary artery disease in patients with KD.Multisystem inflammatory syndrome in children(MIS-C)is a rare inflammatory disease in children identified in recent years,which is caused by severe acute respiratory syndrome coronavirus 2 infection;this disease overlaps with KD.This review examines research progress concerning the immuno-inflammatory response and vascular endothelial dysfunction associated with KD,as well as differences between KD and MIS-C. | Yuchen Wang Tao Li | 2022 | Pediatric Investigation2022，6，4： | 6 |
| 9 | Effects of dexmedetomidine on the expression of inflammatory factors in children with congenital heart disease undergoing intraoperative cardiopulmonary bypass:A randomized controlled trial显示文摘Importance:Dexmedetomidine inhibits the inflammatory response associated with cardiopulmonary bypass(CPB)and protects neural function.However,the mechanism of dexmedetomidine’s anti-inflammatory pathway is unclear.Objective:To investigate the effect of dexmedetomidine on the cognitive level and expression of inflammatory factors in children with congenital heart disease undergoing intraoperative CPB.Methods:Ninety children with congenital heart disease were recruited and randomly divided into 3 groups of 30 children in each.In Group 1,a 1.0μg·kg-1·h-1 intravenous bolus of dexmedetomidine was administered 10 minutes after induction of anesthesia,followed by a 0.2μg·kg-1·h-1 infusion until the surgical incision.In Group 2,a 0.5μg/kg intravenous bolus of dexmedetomidine was administered 10 minutes after induction of anesthesia,followed by a 0.1μg·kg-1·h-1 infusion until the surgical incision.The control group was given physiological saline using the same method as in Groups 1 and 2.The serum levels of nuclear factor-kappa B(NF-κB),S-100βprotein,neuron-specific enolase(NSE),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)were measured before the surgery(T1),at the end of CPB(T2),2 hours after CPB(T3),6 hours after CPB(T4),and 24 hours after CPB(T5).The Wechsler Intelligence Scale for children(WISC)was measured before the operation and at 3,6,and 12 months after the operation to evaluate the neurodevelopmental state of the children.Results:The levels of the NF-κB,S-100βprotein,NSE,TNF-α,IL-6 were significantly higher at T2,T3,or T4 than before the surgery(T1)in the control group or the dexmedetomidine groups.However,the increases of NF-κB,TNF-α,IL-6,S-100βand NSE levels were significantly smaller in the dexmedetomidine groups than those in the control group(P<0.017).The WISC scores were similar among the three groups before or after the operation.Interpretation:The increases in NF-κB,TNF-α,and IL-6 levels indicated aggravation of the inflammatory reaction and the increase S-100βprotein and NSE levels indicated that the nervous system was damaged.Administration of dexmedetomidine to children with congenital heart disease undergoing intraoperative CPB can inhibit the inflammatory response and may ameliorate the neurodevelopmental damage caused by CPB. | Yongsheng Qiu Chan Li Xiaoqin Li Yingping Jia | 2020 | Pediatric Investigation2020，4，1： | 6 |
| 10 | Type I interferon:From innate response to treatment for COVID-19显示文摘Effective prophylactic and therapeutic interventions are urgentlyneeded to address the coronavirus disease 2019(COVID-19)pandemic.Various antiviral drugs have recently been tested.Type I interferon(IFN)is a regulatory protein involved in the innate immune response,with broad-spectrum antiviral activities and the ability to directly block viral replication and support the immune response to eliminate virus infection.Insufficient virus-induced type I IFN production is characteristic of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection,because SARS-CoV-2 suppresses the IFN response by interacting with essential IFN signaling pathways.Exogenous type I IFN is recommended for treating COVID-19.Unexpectedly however,angiotensin converting enzyme-2(ACE2)receptor,which acts as a SARS-CoV-2 receptor,was shown to be stimulated by IFN,raising doubts about the suitability of IFN use.However,further studies have excluded concerns regarding IFN administration.Type I IFNs,including IFN-α1b,have been used clinically as antiviral drugs for many years and have shown strong antiviral activity against SARS-CoV-2in vitro.Preliminary clinical studies of type I IFNs,especially when delivered via aerosol inhalation,have demonstrated efficacy for the treatment and prevention of COVID-19.Randomized controlled trials of IFN for COVID-19 treatment are ongoing. | Fuyu Lin Kunling Shen | 2020 | Pediatric Investigation2020，4，4： | 5 |
| 11 | Short fixation with a 3‐rod technique for posterior hemivertebra resection in children younger than 5 years old显示文摘Importance Congenital hemivertebra is commonly treated with posterior hemivertebra resection with bilateral transpedicular fixation.However,implant‐related complications are common in children younger than 5 years old who undergo this surgical procedure.Objective To present the preliminary clinical and radiological outcomes of children younger than 5 years old treated by posterior hemivertebra resection and 3‐rod fixation technique.Methods From January 2016 to December 2017,14 consecutive patients of congenital scoliosis with 16 hemivertebrae were retrospectively reviewed,including 5 girls and 9 boys,aged between 25 and 55 months old(average,37.6 months).All patients underwent posterior hemivertebra resection with short fixation with bilateral pedicle screws and a convex lamina hook.Surgical complications and corrective outcomes were assessed based on the clinical charts and spinal radiographs with a minimum 24‐month follow‐up.Results The mean Cobb angle of the main curve was 38.4°before surgery,8.5°after surgery,and 8.7°at final follow‐up.In the compensatory cranial curve,the preoperative Cobb angle of 16.8°was corrected to 8.1°postoperatively and was 10.3°at final follow‐up.In the compensatory caudal curve,the preoperative Cobb angle of 15.9°improved to 5.3°postoperatively and was 7.8°at final follow‐up.The segmental kyphosis was corrected from 13.5°to 0.5°and was 1.1°at final follow‐up.There were no crankshaft phenomena,no proximal kyphosis,and no complications related to the instrumentation.Interpretation Posterior hemivertebra resection with instrumentation with bilateral pedicle screws and a convex lamina hook can achieve rigid fixation and deformity correction. | Dong Guo Ziming Yao Xinyu Qi Chengxin Li Xuejun Zhang | 2020 | Pediatric Investigation2020，4，2： | 4 |
| 12 | Prevention strategies of mother‐to‐child transmission of hepatitis B virus(HBV)infection显示文摘Chronic hepatitis B virus(HBV)infection caused by mother‐to‐child transmission(MTCT,also known as vertical transmission)during the perinatal period is a major public health problem worldwide.Despite the availability of the combined active‐passive immunization with a hepatitis B vaccine and hepatitis B immunoglobulin after birth,about 9%of newborns are still infected with HBV,especially those born to hepatitis B e antigen(HBeAg)‐positive mothers.Currently,the management of HBV infection during pregnancy remains controversial.This article briefly reviews the recent advances in the epidemiology of HBV,immunization against it,and management strategies in the third trimester. | Yao Hu Hui Yu | 2020 | Pediatric Investigation2020，4，2： | 4 |
| 13 | Clinical characteristics and post-discharge follow-up analyses of 10 infants with congenital tuberculosis:A retrospective observational study显示文摘Importance Congenital tuberculosis(TB)is a rare,potentially fatal disease.There is currently a lack of detailed clinical information available regarding this disease.Objective This retrospective study investigated the clinical manifestations,treatment,and long-term prognosis of congenital TB.Methods Patients were treated in Beijing Children’s Hospital,Capital Medical University(Beijing,China)between 2009 and 2018.Their demographic data,maternal and family histories,symptoms and signs,treatment information,and follow-up data were retrospectively collected using the hospital’s electronic information system.Results Ten infants with congenital TB were enrolled.The mean gestational age was 36.6±2.2 weeks and mean birth weight was 2517±487 g.All 10 patients exhibited fever,nine patients(90%)had anemia,and six patients(60%)had extrauterine growth retardation.On chest computed tomography scans,all 10 patients presented multiple pulmonary nodules and four patients(40%)had mediastinal adenopathy.Nine out of ten(90%)completed the T-spot test,and eight of them(8/9,89%)were positive.Anti-TB treatment was initiated upon diagnostic confirmation.All patients(100%)received combined treatment with isoniazid(INH)and rifampicin(RIF).Eight of 10 patients(80%)received combined treatment with INH,RIF,and pyrazinamide.The survival rate was 100%.One patient was lost to follow-up and four patients are currently continuing treatment.Three of nine patients(33%)achieved normal developmental milestones at 6 months of age.Interpretation Early diagnosis based on maternal history,typical imaging results,and timely treatment can improve outcomes in infants with congenital TB. | Juan Du Shixiao Dong Shengnan Jia Qiaoru Zhang Mingyan Hei | 2021 | Pediatric Investigation2021，5，2： | 4 |
| 14 | Pay attention to SARS-CoV-2 infection in children显示文摘The novel coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS・CoV-2)has been prevalent for nearly two months.The first case of COVID-19 was reported in Wuhan,Hubei Province,China in mid-December,2019.On January 9,2020,Chinese scientists isolated and obtained the genome sequence of the new virus;they shared the genome information on releva nt international websites one day later. | Zhengde Xie | 2020 | Pediatric Investigation2020，4，1： | 3 |
| 15 | Implications of hepatic dysfunction in Kawasaki disease:Time-related changes in aspartate aminotransferase, alanine aminotransferase,total bilirubin,and C-reactive protein levels显示文摘Importance:The cause of the hepatic dysfunction that commonly accompanies Kawasaki disease(KD)remains unclear.Objective:We tried to clarify the cause of the hepatic dysfunction.Methods:A total of 381 consecutive patients with acute KD,who had undergone inpatient treatment with intravenous immunoglobulin until the 7th day of illness,were divided into a group of 199 patients with an alanine aminotransferase(ALT)level≥40 IU/L on admission(group I),a group of 52 patients with an ALT level≥40 IU/L at some point after admission(group II),and a group of 130 patients with ALT levels consistently<40 IU/L throughout hospitalization(group III).Aspartate aminotransferase(AST),ALT,total bilirubin(T-Bil),and C-reactive protein(CRP)levels were analyzed over time,and time-courses were compared.results:In the initial stage of illness,in group I,AST,ALT,T-Bil peaked on days 1-3,and AST tended to improve significantly on the 4th day(P<0.001).T-Bil improved on day 5(P<0.01),and ALT improved significantly on day 6(P<0.001).CRP increased every day up to day 6(P<0.001).In group II,AST and ALT increased after admission,and thereafter CRP increased,then decreased.The frequency of use of aspirin and aspirin doses did not differ significantly in the three groups.Interpretation:Recovery from liver dysfunction occurred in the initial stage of illness in group I-within the period of CRP exacerbation,which is an indicator of systemic inflammation. | Yasuhiko Tomita Takashi Fukaya Yasuko Yamaura Rie Tsujiguchi Haruko Muratani Maki Shimaya | 2019 | Pediatric Investigation2019，3，1： | 3 |
| 16 | Safety and efficacy of Yupingfeng granules in children with recurrent respiratory tract infection:A randomized clinical trial显示文摘Importance:Recurrent respiratory tract infection(RRTI)is common in children.Inappropriate RRTI treatment will lead to asthma and other diseases,thereby seriously affecting the growth and physical health of children.Immune function modulation can prevent and alleviate childhood RRTI.Yupingfeng(YPF),a patented traditional Chinese medicine(TCM),has immunomodulatory effects and is widely used in China to treat children with RRTI.Objective:To evaluate the safety and efficacy of YPF monotherapy in treating children with RRTI.Methods:This multicenter,randomized,double-blind,double-simulation,noninferiority clinical trial was conducted from January 2015 to August 2017,with an 8-week treatment period and 52-week follow-up after the drug withdrawal.Children aged 2–6 years with RRTI meeting the inclusion and exclusion criteria were enrolled in 13 hospitals in China and divided randomly into three groups(2:2:1 ratio)to receive YPF,pidotimod,or placebo.The primary outcome was the proportion of RRTI returning to normal standard level during the follow-up.The secondary outcomes were reduction in the number of RRTI recurrences,effect on clinical symptoms(in accord with TCM practice),effect per symptom,and safety.The trial was registered at the Chinese Clinical Trials Registry(www.chictr.org.cn)under the unique identifier ChiCTR-IPR-15006847.Results:Three hundred and fifty-one children were enrolled and randomly assigned to 3 groups;124,125,and 61 children in the YPF,pidotimod,and placebo groups,respectively,had completed the trial.During the follow-up,the proportion of RRTI returning to normal standard level was 73.13%,67.15%,and 38.81%with YPF,pidotimod,and placebo,respectively(P<0.0001).The proportion of cases who returned to normal standard level in the YPF group was 34.32%higher than that in the placebo group.The safety profile did not significantly differ among the groups.Interpretation:YPF granules were noninferior to the active control drug pidotimod oral solution for the treatment of RRTI in children,and were superior to placebo,with a high safety profile. | Baoping Xu Xinmin Li Siyuan Hu Yixiao Bao Fengmei Chen Zhimin Chen Yonggang Du Enmei Liu Yufeng Liu Qinghui Mou Baoling Su Bo Wang Jianwen Xu Guiping Xu Qiaozhi Yang Liwei Gao Xiaohui Liu Lei Li Rong Ma Kunling Shen | 2022 | Pediatric Investigation2022，6，2： | 3 |
| 17 | Epidemiological and clinical characteristics of 35 children with COVID-19 in Beijing,China显示文摘Importance:Within the coronavirus disease 2019(COVID-19)global pandemic,more attention is warranted for whether this new infectious disease has unique manifestations in children.Objective:To retrospectively determine the epidemiological and clinical characteristics of 35 children with COVID-19 in Beijing,China.Methods:We collected data for 35 children diagnosed with COVID-19 who were admitted to Beijing Ditan Hospital from January 2020 to June 2020,and analyzed their epidemiological characteristics,clinical manifestations,laboratory examinations,chest imaging findings,treatments,and outcomes.Results:The children comprised 18 boys(51.4%)and 17 girls(48.6%)aged 6 months to 15 years.All patients had clear epidemiological history,with family clusters accounting for 28 cases(80.0%)and clear tracing of exposure to high epidemic areas in the remaining 7 cases(20.0%).Four(11.4%)patients were classified as asymptomatic,17(48.6%)as acute upper respiratory infection,and 14(40.0%)as mild pneumonia,with no severe or critical cases.Clinical manifestations were mild,including fever in 18(51.4%),cough in 14(40.0%),and nausea and diarrhea in 7(20.0%)patients.White blood cell count was mostly normal(26 cases,74.3%)or decreased(7 cases,20.0%);lymphocyte percentage was increased in 24(68.7%);neutrophil percentage was decreased in 25(71.4%);alanine aminotransferase was increased in 3(8.6%);and serum potassium was decreased in 4(11.4%).Time to negative viral nucleic acid testing was 2-42 days(mean:14.0±9.4 days).Chest imaging examination revealed that 20 patients(57.1%)had different forms of lung inflammation.Treatment was mainly isolation and nutritional support.Eleven patients were treated with interferon atomization inhalation.No patients required oxygen therapy.All 35 children were cured and discharged.Length of hospital stay was 9-54 days(mean:25.4±13.8 days).During regular follow-up after discharge,5 children showed positivity again in the viral nucleic acid test and were re-hospitalized for observation and treatment.The mean length of re-hospitalization stay was 10.8 days.Interpretation:Children with COVID-19 mainly become infected within their family,and children of all ages are generally susceptible.The disease in children is mostly mild and the prognosis is good.Nucleic acid tests in some patients become positive again after discharge,suggesting that it is of great significance to carry out centralized isolation medical observations and active nucleic acid tests in close contacts for early detection of patients and routine epidemic prevention and control. | Ming He Caiying Wang Lin Xu Huimin Zhang Yuhuan Liu Yang Zhao Shuxin He Yanlan Zhang Hongling Yang Yang Liu Min Miao Zhihai Chen Lin Pang | 2020 | Pediatric Investigation2020，4，4： | 3 |
| 18 | Diagnosis and treatment of infantile malignant solid tumors in Beijing,China:A multicenter 10-year retrospective study显示文摘Importance:Cancer is the main cause of death by disease in children.Children experience the highest incidence of cancer in the first year of life.However,there is no comprehensive registration system for children with tumors in China.Objective:To summarize the diagnosis and treatment of infant cancer and analyze the status of standardized diagnosis and management among several treatment centers in Beijing,China,thereby providing evidence to guide further clinical research.Methods:From January 1,2010 to December 31,2019,patients with newly diagnosed infantile malignant solid tumors were admitted to six large tertiary pediatric solid tumor diagnosis and treatment centers in Beijing.The epidemiology,clinical features,and therapeutic effects of tumors in these patients were analyzed retrospectively.All patients were followed up until March 31,2020.Results:In total,938 patients were enrolled in this study.There were 530 boys(56.5%)and 408 girls(43.5%);the median age was 6.0 months(range,0-12.0 months).The three most common tumors were retinoblastoma in 366 patients(39.0%),neuroblastoma in 266 patients(28.4%),hepatoblastoma in 133 patients(14.2%),and central nervous system tumors in 52 patients(5.5%).The estimated 5-year overall survival rate was 81.3%±1.8%,and the 5-year event-free survival rate was 71.8%±2.9%.The 5-year overall survival rates of non-rhabdomyosarcoma soft tissue sarcoma,neuroblastoma,and retinoblastoma were 100%,88%±2.2%,and 86.9%±2.1%,respectively.The 5-year event-free survival rates were 81.1%±2.7%for neuroblastoma,81.6%±9.8%for non-rhabdomyosarcoma soft tissue sarcoma,and 72.7%±14.1%for extracranial malignant germ cell tumors.Interpretation:The three most common infantile malignant solid tumors were retinoblastoma,neuroblastoma,and hepatoblastoma.Multidisciplinary combined diagnosis and treatment is needed for infantile tumors. | Mei Jin Zhi Tian Yao Xie Zhaoxia Zhang Miao Li YaxiongYu Weiling Zhang Junyang Zhao Huanmin Wang Qi Zeng Long Li Ming Ge Ning Sun Xiaolun Zhang Jian Gong Wanshui Wu Rong Liu Weihong Zhao Dongsheng Huang Xiaoli Ma | 2020 | Pediatric Investigation2020，4，3： | 3 |
| 19 | Computed tomography for guidance in the diagnosis and surgical correction of recurrent pediatric acute dacryocystitis显示文摘Importance:This is the first retrospective study of the effect of computed tomography(CT)in diagnosis and surgical correction of recurrent pediatric acute dacryocystitis(PAD).Objective:To explore the pathogenesis of recurrent PAD and the impact of CT in guidance of surgical planning.Methods:Medical histories,clinical manifestations,and CT results of 10 patients with recurrent PAD were reviewed.Etiologies and treatment effectiveness were recorded for all patients.results:CT revealed that three patients had congenital dacryocystocele with lacrimal sac cyst,enlargement of the nasolacrimal canal,and intranasal cyst of affected sides.After regression of local inflammation,marsupialization was performed.CT showed that four patients had PAD secondary to congenital nasolacrimal canal dysplasia;these patients exhibited normal upper portions of the nasolacrimal canals,but had stenotic or atretic middle and terminal segments.After improvement of local inflammation,endonasal dacryocystorhinostomy was performed.Three patients had PAD secondary to congenital lacrimal sac diverticulum;after contrast injection,CT showed that the cysts at the lacrimal sac area were filled with contrast,and were connected to the normal lacrimal sac.After the topical infection was controlled,transcutaneous dacryocystorhinostomy was performed in combination with excision of the lacrimal sac diverticulum.No recurrence of PAD was detected at 6-month follow-up.Interpretation:Causes of PAD include congenital dacryocystocele,congenital lacrimal sac diverticulum,or congenital nasolacrimal canal dysplasia.Marsupialization with endoscope,endonasal dacryocystorhinostomy,and transcutaneous dacryocystorhinostomy constitute distinct surgeries for PAD treatment.CT provides an important diagnostic function and facilitates selection of specific surgical approaches for recurrent PAD. | Chengyue Zhang Yanhui Cui Qian Wu Li Li | 2019 | Pediatric Investigation2019，3，1： | 3 |
| 20 | Efficacy and brain mechanism of transcutaneous auricular vagus nerve stimulation for adolescents with mild to moderate depression:Study protocol for a randomized controlled trial显示文摘Background Depression is a common mental illness in childhood and adolescence,with an incidence of 4%–5%;it can lead to impairments in learning and social functioning.Transcutaneous auricular vagus nerve stimulation(taVNS)is a commonly used method of auricular acupuncture point stimulation,which is regarded as an effective treatment for adults with depression.The aim of this study was to investigate the efficacy and mechanism of taVNS for adolescents with mild to moderate depression.Methods This randomized controlled clinical trial will include 120 patients aged 12–16 years,all of whom are diagnosed with mild to moderate depression.Patients will be randomly assigned to a taVNS group and a drug control group(sertraline hydrochloride)at a ratio of 1:1.Patients will be evaluated using the 17‐item Hamilton Depression Scale,Hamilton Anxiety Rating Scale,Self‐Rating Depression Scale,Self‐Rating Anxiety Scale,and Pittsburgh Sleep Quality Index scores at baseline,as well as at the 2nd,4th,6th,8th,and 12th weeks.To investigate the underlying neural mechanisms of taVNS treatment from the perspective of the default mode network,multimodal magnetic resonance imaging(MRI;i.e.,structural MRI[sMRI],resting state MRI[rsMRI],and pseudocontinuous arterial spin‐labeled[pcASL]MRI)will be used to compare cerebral images among groups.MRI data will also be collected from 40 healthy volunteers to assess whether the participants exhibit normal development of structural and functional components.Discussion Depression is the most common mental disorder in adolescence.Drug treatment can improve depression symptoms;however,the side effects of drug treatments are often severe.This study proposes a simple physiotherapy that aims to treat adolescents with mild to moderate depression.The mechanism of taVNS in the treatment of depression will also be investigated.The results of this study will provide evidence to guide the application of taVNS in adolescents with depression. | Xue Xiao Xiaobing Hou Zhangjing Zhang Ying Li Xue Yu Yanhui Wang Jing Tian Ke Xu | 2020 | Pediatric Investigation2020，4，2： | 3 |
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