Constipation in children is one of the most common clinical symptoms in pediatric outpatient clinic.With a high incidence rate,it can be caused by a variety of causes,and mainly include functional constipation.Children's functional constipation is different from adult at many aspects such as clinical manifestation,diagnostic criteria,treatment,etc.It is because children are in a special condition with growth and development.In the course of the treatment,there are many problems such as children do not coordinate the treatment,symptoms can be difficult to control,recurrence after treatment,and so on,which have adverse effects on the physical and mental health of children.So in recent years,children's functional constipation reports continue to emerge.This review will elaborate the current status and progresses of children's functional constipation treatment.

Objective:To investigate the age of onset of functional constipation in children and to explore its relationship with possible factors.Methods:Four hundred and sixteen children with functional constipation who were admitted to the Digestive Specialist Clinic of Nanjing Children′s Hospital from January 2017 to December 2018 were divided into 4 groups (Q1-Q4) according to the quartiles of the onset age.The gender, duration of symptoms and constipation of their parents of the 4 groups were analyzed.Results:Age of onset of 416 children was (1.58±1.64) years, the age of onset in the Q1 group was (0.27±0.19) years, the age of onset in the Q2 group was (0.82±0.17) years, the age of onset in the Q3 group was (1.64±0.32) years, and the age of onset in the Q4 group was (3.91±1.83) years.The constipation duration in 416 patients was (1.50±1.62) years; the constipation duration of Q1, Q2 and Q4 groups was (2.20±1.95) years, (1.33±1.48) years, (1.11±1.05) years and (1.35±1.66) years, respectively, and the group with the youngest age of onset (Q1) had the longest duration of constipation, which was statistically significant compared with the other three groups ( F=9.644, P<0.05). Of the 416 children, 190 cases (45.7%) were boys, 226 cases (54.3%) were girls; 54 boys (50.9%) and 52 girls (49.1%) in the Q1 group, 47 boys (39.8%) and 71 girls (60.2%) in the Q2 group, 39 boys (40.6%) and 57 girls (59.4%) in the Q3 group; 53 boys (55.2%) and 43 girls (44.8%) in the Q4 group; there were no significant differences in gender ( χ2=7.210, P>0.05). Among 416 children with FC, 196 cases (47.1%) had at least one of their parents with constipation symptoms, including 61 cases (57.5%) in Q1 group, and 66 cases (55.9%) in Q2 group, 34 cases(35.4%) in Q3 group, 35 cases (36.5%) in Q4 group.The 2 groups (Q1-Q2) with younger onset compared with the older onset children (Q3-Q4), their parents were more likely to have constipation symptoms, and the difference was statistically significant ( χ2=17.96, P<0.05). Conclusions:The age of onset of functional constipation in children is young, and younger functional constipation children are less likely to receive formal guidance treatment at an early stage; gender has no significant relationship with the age of onset; children with a younger onset, genetic factors are more meaningful to them.

Objective To observe the value of quality control system based on artificial intelligence(AI)for improving imaging quality of chest CT.Methods Totally 1 726 CT images obtained from 415 patients were retrospectively collected,among which 1 414 images were used for convolutional neural network(CNN)training and the rest 312 images were used for validation.Precision,Recall,F1-Score,mean average precision(mAP)and intersection over union(IOU)of quality control system based on AI for chest CT scanning were calculated.Meanwhile,21 patients with unsatisfactory chest CT who would undergo re-examination were prospectively enrolled,and chest CT scanning with quality control system based on AI were performed.The results of 2 examinations were compared.Results Precision,Recall,F1-Score,mAP and IOU of quality control system based on AI for chest CT were all good.All 21 cases were diagnosed correctly with re-examination CT based on quality control system.Among 21 cases,the first CT misdiagnosed 19 cases,the displaying of the area,volume and display quality of pulmonary nodules were not significantly different,but the morphology,boundaries,spiny protrusions,vacuolar signs,inflatable bronchial signs of nodules as well as the thickened and twisted blood vessels were obviously different between 2 times examination.The first CT missed 1 case while correctly diagnosed 1 case.Conclusion The quality control system based on AI was helpful for improving imaging quality of chest CT and increasing diagnostic efficacy.

Objective: To investigate the clinical and epidemiological characteristics of Coronavirus HKU1 (Human CoV-HKU1) and NL63 (Human CoV-NL63) in children with acute respiratory tract infection in Nanjing. Methods: From August 2009 to July 2011, 1 286 respiratory samples were collected from the outpatient and hospitalized children in the Children′s Hospital of Nanjing Medical University. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect HCoV-HKU1 and NL63 genes, besides, positive samples were used for common respiratory virus screening. The positive amplification products were cloned, sequenced, homologous and phylogenetic analysis was conducted by molecular biological method . Results: The detection rate of HCoV-HKU1 was 1.1% (14/1 286), the positive sequences shared a 98.2%-100% nucleotide identity with the HCoV-HKU1 strains and mixed infection rate was 92.9%. The main clinical diagnoses were bronchitis, bronchopneumonia and bronchiolitis. The clinical manifestations were cough, fever, wheezing. The detection rate of HCoV-NL63 was 1.5% (19/1 286), the positive sequences shared a 95.6%-100% nucleotide identity with the HCoV-NL63 strains and mixed infection rate were 63.2%. The main clinical diagnosis were acute upper respiratory tract infection, bronchitis, bronchopneumonia. The clinical manifestations were fever, cough, expectoration. No deaths were found in both HCoV-HKU1 and NL63 infections. Conclusions From August 2009 to July 2011, HCoV-HKU1 and NL63 were detected in children with respiratory tract infection in Nanjing area. HCoV-HKU1 infected cases were lower respiratory tract infection, epidemic in winter and spring, infected cases were mainly under 1 years of age, HCoV-NL63 infected cases including upper respiratory and lower respiratory tract infection, epidemic in the season of summer and autumn. The infected cases were mainly at the age rank from 1 year to 3 years. The clinical manifestations of children infected with coronavirus HKU1 and NL63 are not specificity.