Objective To investigate the clinical characteristics of lower respiratory tract infections oc-currence and respiratory system prognosis in infantile stage of children patients with bronchopulmonary dys-plasia(BPD).Methods Fifty premature infants with lower respiratory tract infection and BPD treated in this hospital from March 2017 to December 2020 were selected as the BPD group and 50 preterm infants with low-er respiratory tract infection without BPD during the same period were selected as the non-BPD group.The clinical data and occurrence situation of respiratory system diseases within 3 years after birth in the two groups were collected and analyzed.Results Compared with the non-BPD group,the incidence rates of tachy-pnoea(48.0%vs.12.0%),wheeze(44.0%vs.10.0%),wheezing rale(44.0%vs.10.0%),three concave sign(28.0%vs.8.0%),cyanosis(20.0%vs.4.0%),severe pneumonia(48.0%vs.12.0%)and respirato-ry failure(20.0%vs.4.0%)in the BPD group were higher,the hospitalization duration[7.5(7.0,10.0)d vs.7.0(6.0,7.0)d]was longer,the reaching peak time ratio[18.20%(14.65%,22.25%)vs.24.85%(19.55%,32.78%)],the reaching peak volume ratio[22.15%(19.43%,23.83%)vs.25.65%(22.40%,34.90%)]and the inspiratory/expiratory ratio(0.70±0.12 vs.0.76±0.11)were lower,the 3-year total lower respiratory tract infection times[5.0(4.0,10.0)times vs.3.0(2.0,5.0)times],wheeze times[2.0(1.0,4.0)times vs.0.5(0,1.0)times],the hospitalization times[3.00(2.00,5.00)times vs.2.00(1.00,2.00)times],severe pneumonia times[2.0(1.0,2.0)times vs.1.0(0,1.0)times]and wheeze times in differ-ent ages were more,total hospitalization duration[29.50(19.50,38.25)d vs.13.00(7.00,17.75)d]was lon-ger,the differences were statistically significant(P<0.05).Conclusion The children patients with BPD are prone to lower respiratory tract infections,especially 0-<1 years old,the proportion of severe pneumonia af-ter infection is higher and wheezing is easily to develop.

The research of damp-heat syndrome in modern TCM mainly focuses on inflammatory response, water metabolism, lipid metabolism, hemorheology, intestinal flora and so on. Modern omics techniques such as metabolomics and genomics provide a new perspective for the exploration of the micro-mechanism of damp-heat syndrome. The study found that the abnormal expression of aquaporin is closely related to the formation of "dampness" in damp-heat syndrome, and the release of inflammatory factors reflects the pathological characteristics of "heat". Damp-heat syndrome is often accompanied by dyslipidemia, hemorheological changes and intestinal flora imbalance, showing characteristic changes in urine, blood and saliva metabolomics, and there are differences in gene expression between damp-heat constitution and gentleness constitution. In the future, the pertinence and systematicness of research should be strengthened, the relationship between indicators should be deeply explored, build a biomarker system should be built, the immune-metabolic regulation mechanism should be explored, the multi-target mechanism of heat-clearing and dampness-removing Chinese materia medica should be clarified to further improve the damp-heat syndrome system, and provide theoretical support for clinical treatment.

Objective:To explore the effects of inhaled budesonide (i-BUD) on the growth rate and height of asthmatic children.Methods:Databases of PubMed, Embase, Cochrane Library, CNKI, and Wanfang were searched (up to April 30, 2022), and randomized controlled trials (RCTs) and high-quality cohort studies on the effects of i-BUD on growth rate and height in asthmatic children were collected. Patients in the observation group were treated with i-BUD, and those in the control group were treated with placebo or no drug. The outcome index was the height and growth rate of the children in short- and long-term treatment with i-BUD. The Cochrane Collaboration risk of bias assessment tool was used for methodological quality assessment of RCT studies, and the Newcastle Ottawa scale (NOS) was used for quality assessment of cohort studies. Stata 11.0 software was used for the meta-analysis, and the effect sizes were expressed as mean difference ( MD) with its 95% confidence interval ( CI). Results:A total of 16 studies were included in the meta-analysis (15 RCTs and 1 cohort study), including 2 578 patients in the observation group and 2 422 in the control group. Risk of bias was low in 9 of the 15 RCTs, high in 2 RCTs, and unclear in 4 RCTs. The NOS score of the only prospective cohort study was 8 (high quality). The short-term effects of i-BUD on the growth rate of the lower limbs in children were examined in 6 studies. The exposure time to i-BUD in children in the observation group ranged from 2 to 8 weeks and the meta-analysis showed that the growth rate of lower limbs of children was significantly slower than that of children in the control group ( MD=-0.18 mm/week, 95% CI: -0.24--0.13 mm/week, P<0.01). Subgroup analysis by dose showed that the growth rate of children′s lower limbs was similar in the 2 groups at 200 μg/d of inhaled i-BUD ( MD=-0.10 mm/week, 95% CI: -0.25-0.05 mm/week, P=0.209); the growth rate of children′s lower limbs was significantly lower in the observation group at 400 μg/d and 800 μg/d of inhaled i-BUD than that in the control group ( MD=-0.17 mm/week, 95% CI: -0.23--0.10 mm/week, P<0.01; MD=-0.34 mm/week, 95% CI: -0.48--0.20 mm/week, P<0.01). The effect of long-term (≥1 year) exposure to i-BUN on children′s height was observed in 10 studies. The meta-analysis showed that the height of children under long-time exposure to i-BUD was significantly lower than that of children in the control group ( MD=-0.72 cm, 95% CI: -0.86--0.58 cm, P<0.01). The subgroup analysis according to the i-BUD exposure time showed that the height of children with 1-year, 2-years, and 4-6 years of i-BUD exposure was significantly lower than that in the corresponding control group ( MD=-0.60 cm, 95% CI: -0.75--0.44 cm, P<0.01; MD=-1.30 cm, 95% CI: -1.70--0.90 cm, P<0.01; MD=-1.15 cm, 95% CI: -1.67--0.64 cm, P<0.01), but the impact of i-BUD on height of children was not significant when the average exposure time was 9.2 years ( MD=-0.60 cm, 95% CI: -2.15-0.95 cm, P=0.448). Conclusion:Short-term and long-term application of i-BUN both may affect the growth rate and height of asthmatic children.

Objective:To explore the effects of inhaled budesonide (i-BUD) on the growth rate and height of asthmatic children.Methods:Databases of PubMed, Embase, Cochrane Library, CNKI, and Wanfang were searched (up to April 30, 2022), and randomized controlled trials (RCTs) and high-quality cohort studies on the effects of i-BUD on growth rate and height in asthmatic children were collected. Patients in the observation group were treated with i-BUD, and those in the control group were treated with placebo or no drug. The outcome index was the height and growth rate of the children in short- and long-term treatment with i-BUD. The Cochrane Collaboration risk of bias assessment tool was used for methodological quality assessment of RCT studies, and the Newcastle Ottawa scale (NOS) was used for quality assessment of cohort studies. Stata 11.0 software was used for the meta-analysis, and the effect sizes were expressed as mean difference ( MD) with its 95% confidence interval ( CI). Results:A total of 16 studies were included in the meta-analysis (15 RCTs and 1 cohort study), including 2 578 patients in the observation group and 2 422 in the control group. Risk of bias was low in 9 of the 15 RCTs, high in 2 RCTs, and unclear in 4 RCTs. The NOS score of the only prospective cohort study was 8 (high quality). The short-term effects of i-BUD on the growth rate of the lower limbs in children were examined in 6 studies. The exposure time to i-BUD in children in the observation group ranged from 2 to 8 weeks and the meta-analysis showed that the growth rate of lower limbs of children was significantly slower than that of children in the control group ( MD=-0.18 mm/week, 95% CI: -0.24--0.13 mm/week, P<0.01). Subgroup analysis by dose showed that the growth rate of children′s lower limbs was similar in the 2 groups at 200 μg/d of inhaled i-BUD ( MD=-0.10 mm/week, 95% CI: -0.25-0.05 mm/week, P=0.209); the growth rate of children′s lower limbs was significantly lower in the observation group at 400 μg/d and 800 μg/d of inhaled i-BUD than that in the control group ( MD=-0.17 mm/week, 95% CI: -0.23--0.10 mm/week, P<0.01; MD=-0.34 mm/week, 95% CI: -0.48--0.20 mm/week, P<0.01). The effect of long-term (≥1 year) exposure to i-BUN on children′s height was observed in 10 studies. The meta-analysis showed that the height of children under long-time exposure to i-BUD was significantly lower than that of children in the control group ( MD=-0.72 cm, 95% CI: -0.86--0.58 cm, P<0.01). The subgroup analysis according to the i-BUD exposure time showed that the height of children with 1-year, 2-years, and 4-6 years of i-BUD exposure was significantly lower than that in the corresponding control group ( MD=-0.60 cm, 95% CI: -0.75--0.44 cm, P<0.01; MD=-1.30 cm, 95% CI: -1.70--0.90 cm, P<0.01; MD=-1.15 cm, 95% CI: -1.67--0.64 cm, P<0.01), but the impact of i-BUD on height of children was not significant when the average exposure time was 9.2 years ( MD=-0.60 cm, 95% CI: -2.15-0.95 cm, P=0.448). Conclusion:Short-term and long-term application of i-BUN both may affect the growth rate and height of asthmatic children.

Objective:To analyze the epidemiological and clinical characteristics of patients with imported corona virus disease 2019 (COVID-19) in Beijing City.Methods:A case-control study was performed to retrospectively analyze 69 cases of imported COVID-19 from abroad and 147 cases of domestic confirmed COVID-19 from China as a control group from January 20 to March 20, 2020 admitted to Beijing Ditan Hospital, Capital Medical University.The epidemiological and clinical characteristics were compared.Statistical analysis were performed by t test, Mann-Whitney U test, chi-square test and Fisher exact test. Results:The main sources of the cases in the import group were from the United Kingdom, Italy, Spain and other European countries, with 44.9%(31/69) of the overseas students entering the country by air. The age of the imported group (27(21, 40) years) was lower than the domestic group (43 (32, 59)years), the difference between the two groups was statistically significant ( U=2 828.500, P<0.01). Compared with the domestic group, the proportion of cases with contact history of confirmed cases in the imported group was lower (30.4%(21/69) vs 68.0%(100/147)), the interval between onset and admission ≤seven days was higher (81.2%(56/69) vs 66.0%(97/147)), the proportion of cases with underlying diseases was lower (21.7%(15/69) vs 44.2%(65/147)). The differences between the two groups were all statistically significant ( χ2=26.935, 5.233 and 10.175, respectively, all P<0.05). The proportion of mild cases in the imported group was higher than that in the domestic group (42.0%(29/69) vs 10.9%(16/147)). Seventeen cases with olfactory abnormality and 12 cases with taste abnormality were found in the imported group, while no olfactory and taste abnormality was found in the domestic group. The proportions of fever, weakness, muscle soreness and dyspnea were all lower than those of the domestic group, the differences between the two groups were all statistically significant ( χ2=13.851, 8.118, 9.730 and 16.255, respectively, all P<0.01). The proportions of cases with decreased lymphocyte absolute numbers (37.7%(26/69) vs 67.3%(99/147)) and increased C reactive protein level (15.9%(11/69) vs 51.8%(72/139)) were both lower than the domestic group, and the differences between the two groups were both statistically significant ( χ2=18.015 and 24.722, respectively, both P<0.01). The proportions of cases with ground glass shadow and consolidation of chest computed tomography were lower than those of the domestic group and the differences between the two groups were all statistically significant ( χ2=11.961 and 5.099, respectively, all P<0.05). In terms of complications, the proportions of cases with acute respiratory distress syndrome and acute myocardial injury were lower (2.9%(2/69) vs 10.9%(16/147) and 4.3%(3/69) vs 14.0%(16/114), respectively), and there were statistically significant differences between the two groups ( χ2=4.017 and 4.335, respectively, both P<0.05). There were no cases received mechanical ventilation and extracorporeal membrane oxygenation in the imported group, and the proportions of patients received oxygen therapy and antibiotic treatment were significantly lower than those in the domestic group (13.0%(9/69) vs 26.5%(39/147) and 13.0%(9/69) vs 39.5%(58/147), respectively) and the differences between the two groups were statistically significant ( χ2=4.942 and 15.797, respectively, both P<0.05). Conclusions:The majority of imported COVID-19 cases are mainly from European countries, mostly young and middle-aged, and mostly mild and ordinary types.The symptoms of olfactory and taste abnormality are found for the first time.

This is a case report of the diagnosis and treatment of atrial flutter with atrial septal aneurysm in a preterm infant. A male neonate born at 35 +2 weeks was delivered by emergent cesarean section due to fetal tachycardia (230-240 bpm) observed during electronic fetal monitoring. The baby was admitted due to tachycardia, tachypnea, and grunting for 15 min after birth. The electrocardiogram demonstrated atrial flutter with the atrial rate of 440 bpm and the ventricular rate of 220 bpm, and 2∶1 atrioventricular conduction. The echocardiography revealed atrial septal aneurysm, patent ductus arteriosus, and patent foramen ovale. Cedilanid and amiodarone were administered firstly. The sinus rhythm was restored after synchronized electrical cardioversion with 4 J (1.8 J/kg). There was no recurrence of atrial flutter during follow-ups till December 18, 2019, with a corrected gestational age of 41 +4 weeks.

Objective To summarize the clinical data of atypical hemolytic uremic syndrome (aHUS) and analyze the treatment and prognosis.Methods A prospective cohort study was conducted on 66 cases in Beijing Children's Hospital affiliated to Capital Medical University from January 2011 to December 2017.The children were divided into positive and negative auto-antibody groups according to the results of anti-factor H autoantibody test.The clinical characteristics,treatment plan and prognosis of the two groups were compared.Results Among the 66 children who met the inclusion criteria,there were 43 cases (65.2％) in the positive group,with an average onset age of (8.0±2.9) years.There were 23 eases (34.8％) in the negative group,with an average onset age of (3.0± 2.6) years.On the basis of plasma treatment,in the positive group,the usage rate of hormone was 83.3％ (35/42) and the usage rate of immunosuppressive agents was 42.9％(18/42),while in the negative group,the rates were 63.6％(14/22) and 13.6％(3/22) respectively.The average follow-up time was 19.3 months.One child in each group was lost to follow-up.In the positive group,8 cases recurred (19.0％)and the average recurrence interval time was 16.1 months.In the negative group,7 cases recurred (31.8％) and the average recurrence interval time was 9.3 months.And the recurrent interval time in the positive group was more longer than the negative group (P ＜ 0.05).A total of 85.9％(55/64) children had complete hemolysis control and complete recovery of renal function,in which the positive group was 85.7％(36/42) and negative group was 86.4％(19/22).However,7.8％(5/64) children had abnormal renal function,in which the positive group was 9.5％(4/42) and the negative group was 4.5％(1/22).And 4.7％(3/64) children died,in which the positive group was 2.4％(1/42) and the negative group was 9.1％ (2/22).The one left (1.6％) showed dialysis dependence,which was positive for the auto-antibody.Multifactor Cox regression analysis showed that the age of less than 3 years old was the risk factor of poor prognosis (HR=4.651,95％CI 0.988-21.898,P=0.047).Conclusions The positive proportion of anti-factor H autoantibody in children with aHUS is high.The age of these children is older.Individualized therapy based on anti-factor H autoantibody and immunosuppressive therapy is of great significance for disease remission,preventing recurrence and improving the prognosis.Age less than 3 years old is the risk factor for poor prognosis.

Objective To evaluate the impact of Montessori-based intervention on eating ability of the elderly with dementia.Methods Sixty-four patients with dementia were randomly divided into intervention group(n=32) and control group(n=32).Patients in intervention group were given Montessori-based intervention,and patients in control group received regular care.The effect of Montessori-based intervention on eating ability,eating difficulty and self-eating time were assessed by the simplified Chinese version of EBS (C-EBS),simplified Chinese version of Edinburgh feeding evaluation in dementia scale (C-EdFED) and stopwatch respectively at pre-intervention,post-intervention,1-month and 3-month follow-up.Results Compared with the control group (EBS:(12.42± 3.59);EdFED:(10.48± 3.83);self-eating time:(15.28±6.04) min)),the average scores of EBS(14.31±2.63) increased and the self-eating time ((21.44±7.17)min) increased after 8 weeks intervention in intervention group,while the average scores of EdFED (7.86±4.16) increased.The C-EBS scores and self-eating time in intervention group were significantly higher than that of control group while the C-EdFED scores were lower than that of control at all time points(P＜0.01).The difference in time effect between the two groups was statistically significant (P ＜ 0.05)Conclusion The Montessori-based intervention can improve the eating ability of elderly people with dementia,reduce eating difficulty and increase self-eating time.

Objective To develop the Dementia Caregivers' Nursing Ability Scale and test its reliability and validity. Methods Based on the model of Caregiver Skill Building/Effectiveness, the item pool was formulated through literature review and semi-structured interview, the items were selected by experts consultation and the pilot survey of 30 dementia caregivers. Totally 293 dementia caregivers in the hospital and the elderly homes were selected for investigation to test the reliability and validity. Results The Dementia Caregivers' Nursing Ability Scale consisted 5 subscales and 36 items, the exploratory factor analysis identified five principal factors which explained 79.44% of the total variance. The item content validity index ranged from 0.857 to 1, the scale content validity index was 0.985. The Cronbach's α coefficient of the scale was 0.936, the split reliabilit was 0.970, and the test-retest reliability was 0.980. Conclusion Dementia Caregivers' Nursing Ability Scale has good reliability and validity, which can be used as a tool to measure the dementia caregivers' nursing ability.

Objective To study the patients' clinical characteristics and prognosis when only C3 deposition exists in endocapillary proliferative glomerulonephritis and try to understand deeply the role of C3 in kidney damage deeply. Methods The patients who were diagnosed with endocapillary proliferative glomerulonephritis but only had C3 deposited in immunofluorescence(to avoid false positive,C3≥2 ﹢ was included)were selected from Beijing Children's Hospital Affiliated to Capital Medical University during November 2010 to October 2014. Their clinical manifestations,la-boratory examinations,treatments,prognosis,and pathological changes were analyzed,and literature review was performed. Their clinical characteristics and prognosis were summarized. Results There were 11 patients diagnosed with endocapil-lary proliferative glomerulonephritis which had only C3 deposition(≥2 ﹢ ). Nine of them had onset with acute nephritis syndrome(81. 8% ),and 2 cases presented recurrent paroxysmal gross hematuria(18. 2% ). Seven cases were diagnosed with acute post streptococcal glomerulonephritis(63. 6% ). Eleven cases' clinical manifestations were relatively severe, and the complement C3 was significantly lower than the normal(100. 0% ). Their light microscope showed capillary proli-ferative glomerulonephritis,and the electron microscope showed the immune complexes were deposited in the endothelium,the epithelium or the mesangial area. The patients received corresponding treatment respectively,and all the patients had good prognosis during following up of 7 months up to 39 months. Conclusions Streptococcus infection is a common cause in endocapillary proliferative glomerulonephritis with only C3 deposition. The clinical manifestations of some children are similar to post streptococcal glomerulonephritis but relatively severe. Only deposition of C3 without IgG may be involved in another complement activation mechanism.