Occasionally，previously healthy children develop severe hyperinflammatory syndrome shortly after infection with severe acute respiratory syndrome coronavirus 2（SARS-CoV-2），which is mainly manifested as digestive tract symptoms，skin mucosal damage and cardiovascular system involvement.This disease is known as multisystem inflammatory syndrome in children（MIS-C），which is confused with other diseases manifested as systemic acute inflammation.The pathogenesis of MIS-C is not clear yet，and it may be related to immune disorders secondary to the SARS-CoV-2 infection.At present，its diagnostic criteria are not established.This article reviews the characteristics of MIS-C and the research progress，in order to improve the pediatricians' skill in recognition，diagnosis and treatment of MIS-C.

Objective To explore the value of biparametric magnetic resonance imaging(bp-MRI)radiomics models in noninvasive prediction of high-risk prostate cancer.Methods A total of 320 patients with pathologically confirmed prostate cancer were retro-spectively selected,and all patients underwent bp-MRI before pathology,including T2WI and diffusion weighted imaging(DWI).Appar-ent diffusion coefficient(ADC)maps were extracted from DWI.All patients were divided into high-risk(Gleason score≥8)and medium-low risk(Gleason score ≤7)groups based on the Gleason score.Using 3D Slicer software,the entire prostate gland was outlined.Python software was used to calculate parameters,and the minimum redundancy maximum correlation and sequence back-ward elimination algorithms were used to extract and select radiomics features and to build a model.Three radiomics(T2 WI,DWI,ADC)models were constructed and verified by logistic regression(LR).The performance of the model was evaluated by area under the curve(AUC)of receiver operating characteristic(ROC)curve,specificity(SP),sensitivity(SE),and accuracy(ACC).An indi-vidual prediction model was established via the clinical data of 224 patients and bp-MRI features,and validated via the data of 96 patients.Results A total of 1 165 radiomics features were extracted.After feature screening,2,4 and 6 radiomics features were screened out to construct T2WI model,DWI model and ADC model for predicting high-risk prostate cancer.All radiomics models had significant predictive performance in identifying medium-low risk and high-risk groups(P＜0.05).The DWI model had the highest predictive value,and the AUC,ACC,SE,and SP in the training group were 0.814,0.756,0.838,and 0.744,respectively.The AUC,ACC,SE,and SP in the verification group were 0.840,0.756,0.848,and 0.784,respectively.Conclusion Radiomics based on bp-MRI can better identify medium-low risk and high-risk prostate cancer before surgery.

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

Objective To explore the virulence of enterovirus 71 from infected children in neonatal mice. Methods Three strains of EV71 were isolated from the mild, severe and dead patients. Symptoms, weight and death of mice were recorded throughout 14 days. The mice were sacrificed on the first, third, fifth, seventh and ninth days post infection to gain the tissue virus load including the liver, spleen, lung, intestine, brain and muscle tissue which were used to detect the virus tilter by real-time RT-QPCR, and pathological lesions using HE staining. Results As to the severity of symptoms, no significant difference was found between the severe and mild groups (P＝0. 693), which were more serious than that of the fatal group. (P＝0. 000 ＜ 0. 05/6, P＝0. 000 ＜ 0. 05/6). The survival rate of the mice with mild, severe and fatal virus infection was 77. 2%, 81. 7% and 97. 8%, respectively, and there was a significant difference among the three groups (P＝0. 0010 ＜ 0. 05, P＝0. 001 ＜ 0. 05, P＝0. 0004 ＜ 0. 05). Lung hemorrhage of the mild group was the most serious, and there were no significant differences in pathological lesions of the brain, muscle, spleen and intestine. Virus titer in the liver and muscle was higher than the other tissues and that in mild group of different tissues tended to be higher than the other two groups. Conclusions Neonatal mice infected with the mild strain of enterovirus 71 presents heaviest symptoms, which are not consistent with the outcomes of humans. It is considered to be related to the virus gene, host and other factors.

Objective: To explore the clinical characteristics of drug-resistant tuberculosis (TB) in children and to study the effectiveness of second-line anti-TB therapy for children and to examine the incidence of adverse drug reactions. Method: Retrospective research was conducted. The clinical records of children in West China Second Hospital diagnosed as drug-resistant TB from January 2010 to June 2014 were investigated.The clinical characteristics and risk factors were analyzed retrospectively. Treatment effect at discharge was examined as a short-term outcome indicator to evaluate the effectiveness of second-line anti-TB therapy and the incidence of adverse drug reactions. χ² test was used. Result: Forty-six patients were diagnosed as drug-resistant TB in 443 children infected with TB, with a 10.4% resistance rate. The 46 children included 26 male and 20 female patients, aged from one month and 28 days to 17 years and 5 months, with the average age (8.4±4.5) years, >7 to 14 years old patients as the biggest part(25 patients, 54.3%). Among the 46 children, 20 patients(43.5%)had close contact with TB patients, of whom 12 patients (60.0%) contacted with family members (including parents, brothers and sisters and grandparents living together) and 8 patients(40.0%) contacted with patients from outside family (such as relatives or neighbors). Moreover, 11 cases (23.9%) were under initial treatment and 35 cases (76.1%) were retreated.From 2010 to 2014, the number of cases of initial and retreated patients had no significant difference(0 and 1, 1 and 13, 4 and 7, 4 and 11, 2 and 3 cases, χ²=3.255, P=0.196). Among retreated patients, 31.4% (11/35) had irregular treatment before.Until discharge, the effective rate was 87.0% (40/46), while the incidence rate of adverse drug reaction was 10.9%(5/46). Conclusion The therapy for drug-resistant TB is effective and the incidence of adverse drug reaction is relatively low.

Objective To explore the clinical characteristics of drug-resistant tuberculosis ( TB) in children and to study the effectiveness of second-line anti-TB therapy for children and to examine the incidence of adverse drug reactions .Method Retrospective research was conducted .The clinical records of children in West China Second Hospital diagnosed as drug-resistant TB from January 2010 to June 2014 were investigated.The clinical characteristics and risk factors were analyzed retrospectively .Treatment effect at discharge was examined as a short-term outcome indicator to evaluate the effectiveness of second-line anti-TB therapy and the incidence of adverse drug reactions .χ2 test was used.Result Forty-six patients were diagnosed as drug-resistant TB in 443 children infected with TB, with a 10.4% resistance rate.The 46 children included 26 male and 20 female patients , aged from one month and 28 days to 17 years and 5 months,with the average age ( 8.4 ±4.5 ) years, >7 to 14 years old patients as the biggest part (25 patients, 54.3%).Among the 46 children, 20 patients(43.5%)had close contact with TB patients, of whom 12 patients (60.0%) contacted with family members (including parents, brothers and sisters and grandparents living together) and 8 patients(40.0%) contacted with patients from outside family (such as relatives or neighbors).Moreover, 11 cases (23.9%) were under initial treatment and 35 cases (76.1%) were retreated.From 2010 to 2014, the number of cases of initial and retreated patients had no significant difference(0 and 1, 1 and 13, 4 and 7, 4 and 11, 2 and 3 cases,χ2 =3.255,P=0.196).Among retreated patients, 31.4% (11/35) had irregular treatment before.Until discharge, the effective rate was 87.0%(40/46), while the incidence rate of adverse drug reaction was 10.9%(5/46).Conclusion The therapy for drug-resistant TB is effective and the incidence of adverse drug reaction is relatively low .

Objective To investigate the clinical characteristics of tuberculous pleurisy(TP) in children in order to provide a good solution to the diagnosis and treatment of this disease.Methods Retrospective analysis was performed on the clinical data of 113 cases confirmed with TP who were admitted to Children's Hospital of Chongqing Medical University from January 2009 to December 2014.Results Among the 113 pediatric inpatients with TP,85 cases (75.2％) were sick for less than 1 month;92.9％ (105/113 cases) age ≥≥5 years old by onset;and 21.2％ (24/113 cases) patients demonstrated the contact with tuberculosis ,among whom 70.8％ (17/24 cases) attributed to linear relatives.The primary clinical manifestations included fever[96.5％ (109/113 cases)], cough [76.1％ (86/113 cases)] and chest pain[38.9％ (44/113 cases)] ,with as high as 89.0％ (87/109 cases) of the patients experiencing moderate or ardent fever.The positive rates of acid-fast bacilli smear and mycobacterium tuberculosis culture were 12.2％ (17/139 cases) and 22.7％ (15/66 cases), respectively;among the 41 patients who received pleural biopsy,40 cases (97.6％) were identified with the typical pathological changes in tuberculosis;and all 11 patients who received acid fast stain test on pleural tissues were positive to the test.Pulmonary parenchymatous lesions were revealed on CT examination in 89.1％ patients(98/113 cases),82.4％ (90/109 cases) of the patients had normal body temperature within a short period,and reduced effusion was revealed in 86 out of 98 patients who received repeated chest imaging examinations.Conclusions TP in children has acute onset typically, and the diagnosis of TP in children is more difficult than in adults,requiring considering multiple factors.Contact history with tubercular patients, etiological examination, pleural biopsy and chest CT are essential for the diagnosis of this disease.

Objective To investigate the prevalence of PLA2R1 in renal biopsy specimens of patients with idiopathic membranous nephropathy (IMN) and explore the relationship between PLA2R1 and IMN. Methods A total of 108 adult patients with biopsy-proved glomerular diseases were enrolled in this study, including 41 with IMN, 2 with hepatitis B-associated membranous nephropathy, 8 with V lupus nephritis, 27 with IgA nephropathy, 19 with minimal change nephropathy, 5 with mild mesangial proliferative glomerulonephritis, and 6 with focal segmental glomeruloselerosis (FSGS). Indirect immunofluorescence assay was used to detect PLA2R1 in the biopsy specimens and the clinical variables of the IMN patients were analyzed. Results In 35 of the 41 (85.37%) patients with IMN, PLA2R1 was detected with a fine granular pattern in the subepithelial deposits along the glomerular capillary loops. PLA2R1 antigen was not detected in patients with other glomerulopathies. No significant differences were found in age, serum creatinine, serum albumin, or 24-h urinary protein level between PLA2R1-positive and negative patients with IMN (P>0.05). Conclusion According to our results, 85.37% of adult patients with biopsy-proven IMN are positive for PLA2R1 antigen, which, however, does not contribute to variations of the patients' clinical manifestations.

Objective To investigate the prevalence of PLA2R1 in renal biopsy specimens of patients with idiopathic membranous nephropathy (IMN) and explore the relationship between PLA2R1 and IMN. Methods A total of 108 adult patients with biopsy-proved glomerular diseases were enrolled in this study, including 41 with IMN, 2 with hepatitis B-associated membranous nephropathy, 8 with V lupus nephritis, 27 with IgA nephropathy, 19 with minimal change nephropathy, 5 with mild mesangial proliferative glomerulonephritis, and 6 with focal segmental glomeruloselerosis (FSGS). Indirect immunofluorescence assay was used to detect PLA2R1 in the biopsy specimens and the clinical variables of the IMN patients were analyzed. Results In 35 of the 41 (85.37%) patients with IMN, PLA2R1 was detected with a fine granular pattern in the subepithelial deposits along the glomerular capillary loops. PLA2R1 antigen was not detected in patients with other glomerulopathies. No significant differences were found in age, serum creatinine, serum albumin, or 24-h urinary protein level between PLA2R1-positive and negative patients with IMN (P>0.05). Conclusion According to our results, 85.37% of adult patients with biopsy-proven IMN are positive for PLA2R1 antigen, which, however, does not contribute to variations of the patients' clinical manifestations.

Objectives To summarize the clinical features and relevant factors of 203 cases with infantile pulmonary tuberculosis. Methods Clinical data of 203 infantile with pulmonary tuberculosis were retrospectively reviewed. Results Among 203 infants, 127 (62.6%) were from country, 76 (37.4%) from city;64.5%of city infants have received BCG vaccination, which is higher than 46.5%in country infants;78 cases (38.4%) have clear evidence for active tuberculosis exposure, 26 cases (12.8%) have suspicious tuberculosis exposure;175 cases (86.2%) have fever, 165 cases (81.3%) have respiratory symptoms, 107 cases (52.7%) have pulmonary signs, 80 cases (39.4%) have hepatosplenomegaly;Etiology was conifrmed in 91 cases (44.8%);54.7%of patients were found with concurrent extrapulmonary tuberculosis, and the most commonly seen was formis tuberculous meningitis. In this study, the misdiagnosis rate is 39.9%, and 84.0%patients were often misdiagnosed as bronchial pneumonia;Vaccinated BCG rate is lower in infants with severe tuberculosis (44.83%) than that of infants with mild tuberculosis (74.14%). Conclusions Infantile pulmonary tuberculosis is featured with acute onset, severe clinical performance and easily complicated with extrapulmonary tuberculosis, atypical clinical performance, and high misdiagnosed rate which needs early detection and diagnosis. Unvaccinated BCG and active tuberculosis exposure were important clues for the diagnosis of infantile pulmonary tuberculosis.