Pollution has been widely recognized as a serious public health problem,which has a negative effect on many aspects of asthma in childhood.This paper mainly expounds the impact of pollution on asthma in childhood,emphatically introduces the possible mechanisms of pollution on the susceptibility to asthma and disease control.

Food allergy and asthma may frequently coexist.Children with food allergy are more than 2 to 4 times as likely to have other atopic conditions such as asthma,eczema,or respiratory allergy compared to children without food allergies.One third of children with food allergy have asthma and 4％-8％ of children with asthma have food allergies.Double-blind place-controlled food challenge test is the best way to investigate the relationships of asthma and food allergy.Apart from allergen avoidance in patients with documented IgE-mediated food allergies,there are no recommendations to avoid any foods in the treatment of asthma.For patients with asthma and food allergy together,information should be delievered to parents in order to recognize and avoid to affending foods properly.

Wheezing is a common problem in early childhood and leads to a diagnostic dilemma.Respiratory endoscopy permits the examination of the morphology and the dynamics of the upper and lower airways.Moreover,it allows additional procedures to be performed.These include bronchoalveolar lavage (BAL) and endobronchial biopsy that help to complete the diagnostic evaluation and complement the findings with information from more peripheral airways.

Objective Published literatures on the relationship between IL-13 gene polymorphism and the susceptibility of children to bronchial asthma in China were comprehensively analyzed with the use of Meta-analysis to evaluate this relationship.Methods The data were collected from the Medline database,Ovid database,the Cochrane library,and Chinese Biomedical database,and the references of eligible studies were manually screened.Published data related to case-control studies reporting the link between IL-13 polymorphisms and asthma in Chinese children were retrieved through those database.Meta-analysis was conducted to determine whether the IL-13 gene polymorphisms were associated with asthma.Results Eighteen studies were finally accepted for analysis.There were three studies focusing on C-1 112T polymorphism,and six studies focusing on C + 1923T polymorphism,and fourteen studies focusing on G + 2044A polymorphism.There was no evidence to confirm that the genotypes in position IL-13-1112 C/T were associated with asthma in Chinese children [odds ratio(OR) =1.00,95％ CI 0.82-1.22,P =0.98].The OR of asthma for TT/CC genotypes was 1.15 (95 ％ CI 0.57-2.33,P =0.69) and for CT/CC was 1.01 (95 ％ CI 0.82-1.25,P =0.89).There was significant evidence to confirm that the genotypes in position + 1923 C/T were associated with asthma in Chinese children(OR =1.86,95％ CI 1.29-2.67,P =0.000 9).The OR of asthma for TT/CC genotypes was 2.12 (95 ％ CI 1.27-3.56,P =0.004) and for TC/CC was 1.67 (95％ CI 1.18-2.35,P =0.003).There was no correlation between IL-13 + 2044G/A polymorphism and the susceptibility (OR =1.33,95％ CI 0.94-1.88,P =0.11).The OR of asthma for AA/GG genotypes was 1.30 (95 ％ CI 0.76-2.20,P =0.34) and for AG/GG was 1.24(95％ CI 0.90-1.70,P =0.19).Conclusions IL-13 gene + 1923 TT and TC genotypes should be associated with susceptibility of asthma in Chinese children,and the T allele could increase the risk of asthma.No clear relationship was found between the genotype TT/TC at the IL-13-1112 site and the incidence of asthma of children in China,and so was the genotype AA/AG at the IL-13 +2044 site and the incidence.

Objective To investigate the dynamic changes in the serum inflammatory cytokines and their association with neurogenic pulmonary edema (NPE) in the patients with severe hand-foot-mouth disease (HFMD).Methods Eighty-nine patients with severe HFMD from March 2010 to December 2012 were recruited in the study.The patients were divided into NPE group and central nervous system diseases (CNSD) group according whether they had NPE.The cytokines,including interleukin (IL)-4,IL-6,IL-10,IL-17,tumor necrosis factor-α (TNF-α) and interferon-γ(IFN-γ)were evaluated by using enzyme-linked immunosorbent assay on day 1,3 and 5 after admission to hospital.Risk factors for NPE involvement during hospital stay were analyzed with multivariate Logistic regression analysis.Results (1) Compared with the CNSD group,the serum levels of IL-6 (Ftime =1.876,P =0.177,Ftime* group =2.192,P =0.145,Fgroup =7.855,P =0.007),TNF-α(Ftime =13.133,P =0.001,Ftime* group =0.291,P =0.592,Fgroup =3.644,P =0.042),IL-10 (Ftime =14.580,P =0.001,Ftime* group =2.612,P =0.078,Fgroup =16.823,P =0.000),INF-γ (Ftime =3.093,P =0.045,Ftime* group =0.513,P =0.600,Fgroup =20.141,P =0.000) were significantly higher than those in NPE group.(2)The serum levels of TNF-α,IL-10,INF-γ rose to the peak on the third day.(3) By using multivariate Logistic regression analysis,age (OR =3.383,95％ CI:1.173-4.759),days of fever (OR =4.925,95％ CI:1.758-3.794),hyperglycaemia (OR =3.465,95％ CI:1.303-5.220),leucocytosis (OR =7.579,95 ％ CI:2.530-12.704) and elevation of IL-10 (OR =1.228,95 ％ CI:1.007-1.523) were entered into equation.In the risk evaluation model,these variables remained independent predictors for NPE.Conclusions Abnormal cytokine productions appear to be responsible for the pathogenesis of NPE,and might be an effective tool for predicting NPE in infants with severe HFMD.

Acute kidney injury(AKI) is a common critical syndrome involving multidisciplinary among pediatric clinical disorders.Early identification and early intervention in severe cases with kidney damage,which can reduce mortality and improve prognosis.Renal replacement therapy(RRT) is an important means in the treatment of AKI,but there is still lacking of ideal and general modality and doses of RRT at present.Understanding the risks and benefits of each modality of RRT in the treatment of AKI is helpful to evaluate RRT's influence on the prognosis of children in AKI.Therefore the selection of modality of RRT should clinically be based on hospital conditions and specific patient characteristics,in order to assure that the choice of modality of RRT is the most suitable for the individual.

Objective To evaluate whether or not the 3.0T magnetic resonance (MR) scanner noise has adverse influence on neonatal hearing by using brainstem auditory evoked potentials(BAEP).Methods Forty-nine inpatients who received the MR examination were enrolled in this study from Aug.to Dec.2013,admitted to the Bayi Children's Hospital Affiliated to Beijing Military General Hospital.The Ⅰ,Ⅲ,Ⅴ wave latencies and the inter-peak intervals before and after the MR scan were compared by using SPSS 16.0 software.Results The BAEP results before and after MR examination respectively:(1) The latencies were:left ear Ⅰ wave (1.96 ± 0.22) ms vs (1.95 ± 0.30) ms,right ear Ⅰ wave (1.96 ± 0.22) ms vs (1.97 ± 0.27) ms,respectively; left ear Ⅲ wave (4.79 ± 0.23) ms vs (4.85 ± 0.28) ms,right earlllwave(4.78 ±0.24) ms vs (4.77 ±0.31) ms,respectively;left ear Ⅴ wave (7.10 ±0.24) ms vs (7.12 ±0.33) ms,right ear Ⅴ wave (6.76 ±0.32) ms vs (7.04 ±0.39) ms,respectively(allP ＞0.05).(2) The inter-peak intervals were:left ear Ⅰ-Ⅲ inter-peak interval (2.83 ± 0.23) ms vs (2.86 ± 0.27) ms,right ear Ⅰ-Ⅲ inter-peak interval (2.82 ± 0.24) ms vs (2.80 ± 0.17) ms,respectively ; left ear Ⅲ-Ⅴ inter-peak interval (2.31 ±0.28) ms vs (2.31 ±0.29) ms,right ear Ⅲ-Ⅴ inter-peak interval (2.26 ±0.27) ms vs (2.26 ±0.23) ms,respectively;left ear Ⅰ-Ⅴ inter-peak interval (5.11 ±0.40) ms vs (5.13 ±0.35) ms,right ear Ⅰ-Ⅴ inter-peak interval (5.07 ± 0.39) ms vs (5.07 ± 0.36) ms,respectively(all P ＞ 0.05).Conclusion The 3.0T MR may have no adverse influence on neonatal BAEP.

Objective To explore the relationships between the sleep/wake-up patterns and temperament in preterm infants.Methods The developmental characteristics of sleep/wake-up patterns and temperament in preterm infants aged 4 months at corrected gestational age in their own home environments were described.The 23 relatively low-risk preterm infants were enrolled in this study.The sleep/wake-up data was collected with actigraphy.The temperament was assessed by Chinese Infant Temperament Questionnaire.Results Among the 23 infants,there were 13 coordinated difficult(D) type and 10 coordinated easy(E) type.The number of night wake-up in the coordinated D-type preterm infants[(2.78 ±0.01) times] were significantly more than that of coordinated E-type ones[(2.60 ± 0.03) times] (t =3.285,P =0.001).The longest continuous sleep time of coordinated D-type preterm infants [(4.20 ± 1.21) h] was significantly less than that of coordinated E-type ones[(4.41 ± 1.14) h] (t =3.374,P =0.001).There were no significant differences in daytime sleep duration,the number of naps,bedtime,sleep latency,nighttime sleep duration,the 24 hour sleep duration and morning awaking time between the two groups (all P ＞ 0.05).After the sex factor was controlled,there was a positive correlation between emotional nature and sleep latency at night (r =0.599,P =0.032).There was also positive correlation between persistence and the number of naps in daytime (r =0.439,P =0.035).Conclusions Preterm infants with different temperament types have different number of night wake-ups and the longest continuous sleep time.The emotional nature and persistence are associated with sleep latency at night and number of naps in daytime respectively.The parents of preterm infants should change their child rearing behaviors to improve sleep quality of the preterm infants.

Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia,which is rare in children.The treatment of APL mainly includes anthracycline-based chemotherapy,all-trans retinoic acid,and arsenic trioxide,which allow for complete remission,improve the long time survival rate and reduce related toxicity as well.About the optimized treatment,quick breakthroughs have already reached,not only at home in the 80's at the end of the 90's,but also abroad,like National Comprehensive Cancer Network of the United States in 2006-2013.This review summarizes the progress in diagnosis and treatment of children with APL.

Anemia is one of the most common disease in premature infants,it not only affects growth and development,but also have long-term impact on the future movement,cognition,learning ability and behavioral development,and most of mental harms nor reversible even though after iron supplementation.So,supplementation with intravenous iron will be a good approach to prevent and treatment with anemia for oral iron supplementations invalid or intolerant infants.Currently,safety and start time for iron supplementation in preterm infants remains controversial.This review focuses on the efficacy and safety of intravenous iron for prevent and treatment of iron deficiency anemia in preterm infants.