Child ; Humans ; Pediatrics ; methods ; Sleep Apnea, Obstructive ; therapy

Objective To establish z-score model for fetal aorta (Ao) and pulmonary artery (PA) dimensions base on fetal femur length (FL),then to evaluate them in prenatal diagnosis of tetralogy of Fallot (TOF).Methods Three hundred twenty-nine normal fetuses and 43 fetuses with TOF were involved,Ao and PA dimensions were measured for all cases offline after cardio-spatiotemporal image correlation (STIC) volume acquisition,and PA to Ao ratio (PA/Ao) was calculated.Normal Ao and PA dimensions z-score models were constructed by using first standard regression analysis using FL as independent variable.Subsequently,the three parameters between normal and TOF fetuses were compared.Results The models use to calculate z-score for Ao and PA dimensions were constructed,FL had close correlation with fetal Ao and PA dimensions.Compared with normal fetuses,the mean z-scores of Ao,PA and PA/Ao ratio were statistical different in TOF fetuses.All Ao z-scores were ＞ + 2 z-scores and all the PA/Ao ratio were ＜ the 95％ CI in TOF group,however,only 48.84％ (21/43) PA z-scores of TOF cases were ＜-2 z-scores.Conclusions The Ao and PA dimensions z-score can provide quantitative evidence in prenatal diagnosis of TOF.Aortic dilatation and abnormal PA/Ao ratio are the main performances in fetal TOF and would be markers for prenatal diagnosis of TOF.

Objective The study is to investigate the role of miR-328 in endothelial mesenchymal transition (EMT)induced by high glucose in human umbilical vein endothelial cells (HUVECs)and its signaling mechanism.Methods HUVECs were cultured in high glucose environment to induce EMT;The recombinant lentiviruses were created by miR-328 and antagomiR- 328 transfection of HUVECs.The experiment was divided into seven groups: normal glucose;mannitol group;high glucose;miR-328;miR-328 virus negative control;high glucose + U0126;miR-328 + U0126.Double immunofluorescent staining was used to determine expression of EMT markers;Changes in miR-328 expression is examined by RT-qPCR;The expressions of type Ⅰ/Ⅲ collagen,p-MEK1/2 and p-ERK1/2 are examined by Western blot.Results 1)HUVECs showed positive staining for CD31 and α-SMA in high glucose group.2)The expression of miR-328 was up-regulated(P<0.05)in HUVECs treated by high glucose or miR-328.Compared with high glucose group or miR-328 group,miR-328 expression was less pronounced aftertreatment with U0126.3)The expressions of type Ⅰ/Ⅲ collagen increased in HUVECs treated by high glucose or miR-328(P<0.05) Compared with high glucose group or miR-328 group,typeⅠ/Ⅲ collagen expressions were less pronounced after treatment with U0126.4)The expressions of p-MEK1/2 and p-ERK1/2 were increased in HUVECs treated by high glucose or miR-328 in comparison to the control group (P<0.05);a lower expression of p-MEK1/2 and p-ERK1/2 were observed in U0126 group than in high glucose group or miR-328 group.Conclusions The phenomenon of EMT in HUVECs is induced by high glucose with increased expression of miR-328;overexpression of miR-328 induced EMT in HUVECs;miR-328 induced EMT is related with MEK1/2-ERK1/2 signaling pathway.

Objective Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are common and life-threatening disease in children with mortality as high as 40%-70%. Alveolar type Ⅱ cells (ATII cells),characterized by the presence of lamellar bodies (LBs),synthesize and secret surfactant proteins (SPs),which contribute significantly to surfactant homeostasis and pulmonary immunity.The functions of ATⅡ cells including pulmonary surfactant production are autocratically dominated by the structural integrity of ATII cells.Our study is focused on the ultrastructural alterations of AT Ⅱ cells in rats with lipopolysaccharide(LPS)-induced ALI.Methods Rat ALI models were established by intraperitoneal injection of LPS (4 mg/kg).0.9 % NS with same amount was given in the normal control group.The rats were randomly chosen and sacrificed at 24, 48 and 72 hrs after LPS injection (8 rats at each time point).Lung samples (1 mm3 of the size) were obtained from the lower parts of left lungs and fixed with 2.5% glutaraldehyde for the transmission electron microscope examination.Results The microvilli around ATII cells disappeared and the number of LBs increased at 24 hrs after LPS administration.LBs rearranged like a ring around the nuclei.It was commonly seen that two nuclei were present in one AT Ⅱ cell.Vacuole-like deformity prominently occurred in cytoplasm at 48 hrs.Giant LBs presented at the same time.The shapes of nuclei were irregular and some of the borders were unclear at 48 and 72 hrs.The remnant of ruptured LBs scattered in cytoplasm at 72 hrs.The number of LBs reduced obviously.Karyolysis occurred in some of the nuclei.Conclusions The ALI-related alterations of ATII cells characterized by the changes of LBs,nuclei,and nucleoli were time-dependent. ATII cell injury was serious at 48 and 72 hrs.This may lead to the insufficiency of pulmonary surfactant synthesis and unstability of pulmonary homeostasis,which contributed to to the pathogenesis of acute lung injury.

OBJECTIVE To illuminate the adenoid bacteria distribution in children with adenoid hypertrophy. METHODS PubMed, Embash, Medline, CNKI, VIP Information and Wanfang data were searched for studies on the adenoid bacteria distribution and adenoid hypertrophy. Random effects meta-analysis was used to pool data. RESULTS Nine studies were included in this meta analysis. The pooled detection rates of haemophilus influenza, staphylococcus aureus and streptococcus pneumonia were 0.21 (95%CI, 0.09-0.32), 0.14 (95%CI, 0.09-0.20) and 0.15 (95%CI , 0.08-0.22) respectively. CONCLUSION Haemophilus influenzae, staphylococcus aureus, and streptococcus pneumoniae are three main kinds of pathogenic bacteria of adenoid hypertrophy in children.

Antibiotic-associated diarrhea(AAD) is a frequent adverse effect of antibiotic in children.AAD is associated with longer hospitalization, higher healthcare cost and even lead to death.Pediatricians usually do not pay enough attention to AAD.Domestic experts from pulmonary medicine, infection and gastroenterology are organized to develop the consensus, to improve the diagnosis, treatment and prevention of AAD, and contribute the children health in future.

Objective To determine the appropriate criteria of obstructive sleep apnea syndrome (OSAS) in children.Method Children with snoring and healthy children were recruited from October 2014 to September 2015.Subjects were divided into four groups based on polysomnography (PSG).Group 1:children with obstructive apnea hypopnea index (OAHI) ≥ 1 (the OSAS criteria of the International Classification of Sleep Disorders,ICSD) but their AHI≤5 or OAI ≤1 (under the OSAS criteria of AHI ＞ 5 or OAI ＞ 1 by the American Thoracic Society,ATS);Group 2:children with OAHI ＜ 1 (the primary snoring criteria of the ICSD);Group 3:children with AHI ＞5 or OAI ＞ 1;and Group 4:normal children as controls.Sleep disorder scales and polysomnography parameters were compared among the four groups.Results A total of 1 115 children were included.There were 143,345,529 and 98 children in each group.After adjust for age,gender and body mass index(BMI),children in group 1 had higher total sleep disorder scale score (P＜0.01),as well as sub-scores for severe snoring (P ＜ 0.01),daytime behavior problem (P ＜0.01) and sleep related nighttime abnormality (P ＜0.05) compared with normal controls,and they had longer mean and longest duration of obstructive apnea and hypopnea and lower minimum oxygen saturation compared with children with obstructive AHI ＜ 1 (all P ＜ 0.05 or ＜ 0.01).Conclusion OA-H＞ 1 should be defined as the criteria of OSAS in children.

Objective To investigate the population distribution of intermediate host snails and crabs of Paragonimus along the Jiulongjiang River, Zhangjiang River, and Dongxi River basins in Bopingling Mountain, southern Fujian Province, so as to provide baseline data for researches on parasitic disease prevention and control and enlargement of samples in the parasitic resource bank. Methods A total of 23 villages in 8 counties (districts) along the Jiulong River, Zhangjiang River, and Dongxi River basins in Zhangzhou City, Fujian Province were selected as survey sites during the period from November 2020 through March 2023, and snail and freshwater crabs were sampled from 1 to 3 streams and ditches neighboring residential areas in each village. Morphological identification of snails was performed according to the external morphological characteristics of collected snail shells, and the unidentified snail species sampled from the natural foci of paragonimiasis in Yunxiao County were subjected to se-quence analysis of the mitochondrial cytochrome oxidase 1 (CO1) gene. The crab species was identified by observing the morphological characteristics of the terminal segment of the first pleopod of male crabs, and Paragonimus cercariae and metacercariae were detected in collected snails. Results The shells of the unidentified snails sampled from the natural foci of paragonimiasis in Yunxiao County were approximately 50 mm in height and 18 mm in width, thick and solid, long tower cone-shaped, and had 8 to 10 whorls. CO1 gene sequence analysis identified the snail species as Sulcospira hainanensis. A total of 6 freshwater snail species belonging to 5 genera within 3 families, identified 23 survey sites, including Semisulcospira libertina, Paludomus zhangchouensis and S. hainanensis that belonged to the Family Pleurceridae, Tricula fujianensis and T. huaanensis that belonged to the subfamily Triculinae, Family Pomatiopsidae, and Melanoides tuberculata (Family Thiaridae), and 11 species of freshwater crabs belonging to 5 genera within 2 families were identified, including Sinopotamon genus of S. jianglense, S. pinheense, and S. zhangzhouense, Huananpotamon genus of H. planopodum and H. zhangzhouense, Nanhaipotamon genus of N. huaanense and N. longhaiense, and Minpotamon genus of M. nasicum and M. auritum that belonged to the Family Potamidae, and Somanniathelphusa genus of S. huaanensis and S. zhangpuensis (Family Parathelphusidae). In addition, the prevalence of P. westermani cercariae infections was 0.08% (2/2 317) in P. zhangchouensis from Danyan Village in Changtai District and 0.09% (1/1 039) in S. hainanensis from Jinkeng Village in Yunxiao County, and the prevalence of P. westermani metacercariae infections was 25.81% (8/31) in S. jianglense from Danyan Village in Changtai District, and 26.31% (5/19) in S. zhangzhouense from Jinkeng Village in Yunxiao County, respectively. Conclusions There is a population diversity in the intermediate host snails and crabs along the Jiulongjiang River, Zhangjiang River, and Dongxi River basins in Bopingling Mountain, southern Fujian Province, and P. zhangzhouensis and S. hainanensis are, for the first time, confirmed as the first intermediate hosts of P. westermani.

Objective:To explore the brain electrical activity and its correlation with polysomnography monitoring parameters in children with obstructive sleep apnea syndrome (OSAS) and primary snoring.Methods:It was a prospective observational study involving children aged 6-12 years who presented to the Sleep Center of Beijing Children′s Hospital, Capital Medical University for polysomnography monitoring due to snoring at sleep from July 1 to December 31, 2019.Clinical data, polysomnography monitoring and 6-min measurement of brain electrical activity were collected from all the subjects.According to the results of polysomnography monitoring, the subjects were divided into the primary snoring group and the OSAS group at varying degrees.Based on the electroencephalogram (EEG) wavelet analysis, the brain injury index obtained by EEG synchronization and complexity analysis was used to reflect the changes of brain electrical activity in children in the resting state.Rank sum test was used to test the differences in brain injury index and the percentage of each frequency band of brainwave.Multivariate linear regression method was used to analyze risk factors for EEG activity.Results:A total of 149 children were recruited, including 110 males and 39 females.There was no significant difference in the proportions of α, θ, β and δ waves among OSAS children at varying degrees(all P>0.05). The brain injury index of the primary snoring group, mild OSAS group, moderate OSAS group and severe OSAS group was 0 (0, 3), 14 (9, 16), 26 (24, 28), and 34(30, 44), respectively.There were statistically significant differences in the brain injury index among groups ( H=129.70, P<0.01). The brain injury index gradually increased from the primary snoring group to the severe OSAS group.Multivariate linear regression analysis showed that the obstructive apnea hypopnea index (OAHI), mean oxygen saturation and minimum oxygen saturation were independently correlated with the brain injury index (all P<0.05). Conclusions:There were no significant differences in the ratios of α, θ, β and δ waves among OSAS children at varying degrees, while the EEG complexity and synchronicity varied a lot.With the increase of OAHI, the brain injury index gradually increased.The brain injury index was independently correlated with OAHI, mean oxygen saturation and minimum oxygen saturation.

Objective:To explore the clinical characteristics and disease composition of pediatric patients with central apnea (CA) (classification by respiratory event type) and enhance the understanding of pediatric sleep-disordered breathing diseases.Methods:A cross section study was conducted.From March 2019 to March 2022, a total of 5 708 children underwent overnight polysomnography (PSG) at the Sleep Monitoring Center of Beijing Children′s Hospital, Capital Medical University.Among them, 56 patients (1.0%) had the central apnea index (CAI)≥5 times/h and the number of CA and/or central hypopneas>50% of the number of apneas and hypopneas.A retrospective analysis was conducted on the PSG and clinical data of the 56 pediatric patients with CA as the main manifestation.The disease composition and respiratory characteristics were summarized and analyzed.The factors related to central respiratory events were analyzed by multiple linear regression analysis.Results:Among the 56 children, 37 had concurrent obstructive sleep apnea (OSA), including 16 boys and 21 girls.CAI was positively correlated with the obstructive apnea-hypopnea index in central sleep apnea(CSA) patients with OSA ( r=0.673, P<0.001) and had no significant correlation with the body mass index or age.Among the 56 CSA patients, 4 had a CAI>20 times/h, including 1 case of Chiari malformation, 2 cases of brainstem tumors, and 1 case of inherited metabolic disease. Conclusions:The incidence of CA is lower compared to obstructive apnea.CSA patients often have concurrent OSA, and the severity of obstruction is the main factor affecting CAI.If CAI>20 times/h, it should be given high attention, and a comprehensive assessment of medical history and relevant imaging examinations are necessary to exclude underlying medical conditions causing CSA.