Pediatric patients usually require intravenous infusion maintenance fluid. Currently, maintenance fluid with 1/5 tension, 1/2 tension, and isotonic contraction were commonly used and lfuid with 1/5 tension and even with no tension is still commonly used. In recent years, a large number of high quality randomized controlled trials and meta analyses showed that compared with the traditional low tension maintenance lfuid, 1/2 tension or isotonic maintenance lfuid can effectively reduce the incidence of acute hyponatremia and the adverse reactions such as hypernatremia while hypernatremia were not caused. A number of national guidelines also recommend the use of 1/2 tension or isotonic contraction as a standard for maintaining liquid. In this paper, the present status and recent progress in the use of intravenous maintenance lfuid in pediatric patients were reviewed.

Eosinophil disorders are a range of heterogeneous diseases, which manifest as persistent increase of eosinophile granulocyte in blood and tissue, and may cause microenvironment change and irreversible chronic organ damage. According to World Health Organization, eosinophil diseases were divided into hypereosinophilia (HE) and hypereosinophilia syndrome (HES) by whether the organ is involved. Besides familial HE, HE were also divided into secondary (reactive) HE, primary (clonal/neoplastic) HE, and idiopathic HE. Lymphocytic variant HE is a special kind of secondary HE. With the study of the molecular mechanism of lymphocytic variant HE, the diagnosis is gradually clear. Moreover, some targeted therapeutic drugs, such as anti IL-5 monoclonal antibody (Mepolizumab) and anti CD 52 monoclonal antibody (Alemtuzumab) were also appeared. In this paper, the current basic and clinical researches of lymphocytic variant HE are reviewed.

Objective To compare the effectiveness and safety of glucocorticoid versus intravenous injection of human immunoglobulin (IVIG) in treatment of with acute primary immune thrombocytopenia (ITP) in children. Methods PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, Chinese biomedical literature database (CBM), Chinese Journal Full Text Database (CNKI) and Wanfang database were searched. The bibliography was screened according to the inclusion and exclusion criteria,and the target literatures were selected. The data were extracted and the quality of included literatures was evaluated. Revman 5 . 3 software was used to make meta-analysis. Results In 1500 papers searched, 8 papers met the inclusion criteria. Meta-analysis showed that there was a statistical signiifcance in platelet count (PLT,>20 × 109/L) after being treated for 48 h between glucocorticoid group and IVIG group (RR=0 . 77 , 95%CI:0 . 67~0 . 89 ). In subgroup analysis, there were statistical signiifcance in methylprednisolone (MP) 30 mg/kg versus IVIG 1 g/(kg·d)× 2 d, and metacortandratin (PDN) 4 mg/kg versus IVIG 1 g/(kg·d)× 2 d (RR=0 . 66 , 95%CI:0 . 47-0 . 91;RR=0 . 79 , 95%CI:0 . 66-0 . 95 ). After treatment for 24 h and 72 h, the platelet count>20 × 109/L were signiifcantly different in glucocorticoid group and in IVIG group (RR=0 . 69 , 95%CI:0 . 53-0 . 91;RR=0 . 82 , 95%CI:0 . 74-0 . 90 ). Moreover, after treatment for 24 h, 48 h and 72 h, the platelet count>50 × 109/L were signiifcantly different between glucocorticoid group and IVIG group (RR=0 . 38 ,95%CI:0 . 21-0 . 69;RR=0 . 53 , 95%CI:0 . 41-0 . 69;RR=0 . 80 , 95%CI:0 . 70-0 . 93 ). There was no difference in the incidence of splenic resection between two groups (RR=5 . 41 , 95%CI:0 . 95-30 . 74 , P=0 . 06 ). Conclusion The probability of platelet count to reach>20 × 109/L in the initial treatment with glucocorticoid of acute ITP patients were 32%lower than that with IVIG. With the initial therapeutic target being platelet count>50 × 109/L in 3 days, the effect of IVIG was better.

Objective To summarize the clinical characteristics and drug sensitivity of Pseudomonas aeruginosa in children. Methods The data of children with diagnosed Pseudomonas aeruginosa from 2006 to 2016 were retrospectively analysis. Results There were 14 patients who had diagnosis of Pseudomonas aeruginosa, most of whom were infants and toddlers ( 78 . 6%). The common complications were disseminated intravascular coagulation (DIC) and pulmonary hemorrhage. In 14 patients, 7 patients were cured, 4 were died, and 3 were given up treatment by their family because of serious illness. The antimicrobial susceptibility test showed that isolated pseudomonas aeruginosa had good sensitivity to aminoglycosides and quinolones. Conclusion Pseudomonas aeruginosa sepsis is more common in infants and toddlers, with high mortality. For suspected patients, the antibiotic that covers the Pseudomonas aeruginosa should be used in early antibiotic therapy.

Objective To analyze the clinical feature and common etiology of diffuse alveolar hemorrhage (DAH) in children. Methods Clinical data from 138 children with initially diagnosed DAH were retrospectively analyzed. The etiology, diagnosis, treatment, and prognosis had been summarized. Results Among 138 children, 76 were male and 62 were female. The clinical features are pallor ( 130 cases, 94 . 2%), cough ( 86 cases, 62 . 3%), fever ( 74 cases, 53 . 6%), anhelation ( 67 cases, 48 . 6%), hemoptysis ( 59 cases, 42 . 8%) and dyspnea ( 43 cases, 31 . 2%). Chest imaging changes were mainly patch shadow and ground glass shadow. Moreover, the detection rate of hemosiderin cells in sputum, gastric juice and bronchoalveolar lavage lfuid was 90 . 8%( 79/87 ). The common underlying diseases that caused DAH were idiopathic pulmonary hemosiderosis ( 65 cases), hematological system disease ( 22 cases), vascular inlfammatory diseases ( 15 cases), infectious diseases ( 14 cases) and cardiovascular disease ( 5 cases). The mortality rate in acute phase of DHA was 23 . 2%( 32/138 ). Conclusions DHA is a life-threatening clinical emergency disease, its cause was complex and diverse, and the acute mortality rate is high. Glucocorticoid is the ifrst choice of treatment for majority of patients.

Objective To explore the clinical characteristics of neonatal dengue fever. Methods The clinical data from 4 neonates with dengue fever who were admitted and treated in 2014 were retrospectively analyzed and the related literatures had been reviewed. Results Four cases of neonatal dengue fever were all males. Three cases were mother to child transmission, the age at onset was 1 to 7 days after birth, and their mothers suffered with prenatal fever and were diagnozed of dengue fever during perinatal period. One case was community acquired, the age at onset was day 21 after birth and the neonate was bit by mosquito the day before. All four neonates had fever, two cases had rash, and one case had hemorrhagic spot. None of them had jaundice or cough. All of them had thrombocytopenia ( 30-125 )× 109/L, prolonged activated partial thromboplastin time ( 44 . 0-89 . 8 s), and increased aspartate aminotransferase (AST) ( 46-71 U/L). Three cases had declined ifbrinogen ( 1 . 36-2 . 53 g/L). Two cases had increased CK-MB ( 29-86 U/L). Two cases had increased CRP ( 3 . 00-46 . 05 mg/L). After the treatment of anti-infection and intravenous immunoglobulin, all of them were cured and discharged. The duration of hospital stay was 4-17 days. Conclusion The clinical manifestations of neonatal dengue fever were mainly fever and blood coagulation dysfunction, clinical symptoms are mild and lack of speciifcity, and prognosis are good. Mother to child transmission is one of the ways of dengue virus infection.

Objective To compare the effects of different doses of amino acids and fat emulsions in parenteral nutrition on the incidence of complications and prognosis in very low birth weight infants (VLBWI). Methods The clinical data of 328 VLBWI who received nutrition support therapy for at least 5 days starting in 72 h after birth during January 2005 to December 2014 , were retrospectively analyzed. According to the dosage in parenteral nutrition, patients were divided into low-dose group and high-dose group. The incidence of complications and prognosis between two groups were compared. Results There were 204 cases in low-dose group and 124 cases in high-dose group. Compared with the low-dose group, the incidence of complications was lower in high-dose group during hospitalization and the incidence of intracranial hemorrhage was reduced most;the incidence of developmental retardation was lower at discharge;the overall incidence of metabolic complications of parenteral nutrition was higher, among which the incidence of high blood glucose, electrolyte disturbance and cholestasis were increased and the incidence of hypoglycemia was lower, and the differences were all statistically signiifcant (P??0 . 05 ). Conclutsions VLBWI can tolerate early aggressive parenteral nutrition which can reduce the incidence of extrauterine growth retardation and premature complications.

Objective To investigate the changes of protein and energy intakes and the z-score of weight for age in appropriate for gestational age (AGA) and small for gestational age (SGA) preterm infants with gestational age less than 34 weeks. Methods The data from 314 hospitalized premature infants ( 268 cases of AGA and 46 cases of SGA) during January 2012 to December 2014 were retrospectively collected. The intakes of protein and energy and the changes of weight within 2 weeks after birth were compared. Results Compared with AGA group, the hospital stays, durations of parenteral and enteral nutrition and total enteral nutrition, and time to achieve full dose feeding were signiifcantly longer in SGA group (P?

Extrauterine growth restriction (EUGR) in premature infant is a common problem in the world. The reasons for high EUGR rate, such as declining gestational age and birth weight, getting more medical treatment and examination or interruption of nutritional support, had been profoundly studied. However, there are few reports about the limited ability of intakes of energy and various nutrients and the updating of the growth standard curve . Research suggested that the average time taken to reach the recommended fat intake in preterm infants is proximately day 6 after birth, protein day 4 after birth, carbohydrate one-week after birth. Vitamins and trace elements are usually not able to or take a long time to reach the recommended nutrient intake. Without enough intake of energy and nutrients to maintain the need of intrauterine growth rate and catch-up growth in preterm infants, EUGR cannot be improved. In this paper, the EUGR and the intake of important nutrients, such as energy, fat, protein, vitamins and minerals, etc., during hospitalization were reviewed in hope to achieve more rational and standardized management for preterm infant,and provide more reasonable advise to control EUGR.

Objective To report the clinical manifestation and gene mutation of congenital insensitivity to pain with anhidrosis (CIPA) in two patients from one family. Methods The data of clinical manifestation, laboratory examination, and family history of two patients were collected. The peripheral blood of patients and their parents were collected. Neurotrophic tyrosine kinase receptor type 1 (NTRK 1 ) gene was detected directly by Sanger method, the pathogenicity of the mutation in the gene was analyzed by bioinformatics. Results Both of patients were female and mainly suffered with reduplicated non-infectious fever, anhidrosis, insensitive to pain, and mental retardation. The proband had fracture many times after minor injury. The ninth exon of NTRK 1 genes in the proband and her younger sister were found to have heterozygous mutations, c. 851-33 T>A, as previously reported. Meanwhile, there was also found a new mutation, c. 1711 G>A (p.G 571 S), in thirteenth exon of NTRK 1 genes in these two patients. It was predicted to be a harmful mutation by bioinformatics and the mutation site is conservative. Their father and mother were found carrying the c. 851-33 T>A and c. 1711 G>A mutations respectively. Conclusion Both patients had typical clinical manifestations. And the newly discovered p.G 571 S mutation expands the mutation spectrum of NTRK 1 gene.