Objective To systematically evaluate the clinical characteristics of Streptococcus gallolyticus(SG)in-fection in children.Methods PubMed,Embase,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang,and VIP databases were systematically retrieved,retrieval time was from database establish-ment to March 15,2024.Case reports or case series reports of SG infection in children were included,while re-views,abstracts that couldn't obtain the full text,and literatures outside of Chinese and English language were ex-cluded.Two researchers independently evaluated the quality of the included literatures,extracted literature informa-tion,and summarized the clinical characteristics of SG infection by adopting Joanna Briggs Institute(JBI)quality evaluation tools.Results 35 literatures were included in analysis,involving 65 pediatric patients,including 40 males and 22 females,with 3 cases not reporting gender.The age of onset ranges from 20 hours to 3.5 years old.Bacteremia,bacterial meningitis,infective endocarditis,urinary tract infection,and liver abscess were 53,38,4,2 cases,and 1 case,respectively.SG had a high susceptibility rate to penicillin(96.1％).Bacteremia and meningitis were often treated with monotherapy of penicillin G,ampicillin,or cefotaxime,with a few cases using two antimi-crobial combination.Four cases of endocarditis were all treated with two antimicrobial combination,and one case of liver abscess was treated with three antimicrobial combination;60 cases survived,4 cases died,and 1 case had no reported clinical outcome.Seven children with meningitis developed neurological complications,and one child with endocarditis developed glomerulonephritis.Conclusion Low-age children is the main population of SG infection in children,especially neonate,with bacteremia and meningitis being the most common.Most children have good clini-cal outcomes,and minority of children with bacteremia may die from septic shock.

Objective To systematically evaluate the clinical characteristics of Streptococcus gallolyticus(SG)in-fection in children.Methods PubMed,Embase,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang,and VIP databases were systematically retrieved,retrieval time was from database establish-ment to March 15,2024.Case reports or case series reports of SG infection in children were included,while re-views,abstracts that couldn't obtain the full text,and literatures outside of Chinese and English language were ex-cluded.Two researchers independently evaluated the quality of the included literatures,extracted literature informa-tion,and summarized the clinical characteristics of SG infection by adopting Joanna Briggs Institute(JBI)quality evaluation tools.Results 35 literatures were included in analysis,involving 65 pediatric patients,including 40 males and 22 females,with 3 cases not reporting gender.The age of onset ranges from 20 hours to 3.5 years old.Bacteremia,bacterial meningitis,infective endocarditis,urinary tract infection,and liver abscess were 53,38,4,2 cases,and 1 case,respectively.SG had a high susceptibility rate to penicillin(96.1％).Bacteremia and meningitis were often treated with monotherapy of penicillin G,ampicillin,or cefotaxime,with a few cases using two antimi-crobial combination.Four cases of endocarditis were all treated with two antimicrobial combination,and one case of liver abscess was treated with three antimicrobial combination;60 cases survived,4 cases died,and 1 case had no reported clinical outcome.Seven children with meningitis developed neurological complications,and one child with endocarditis developed glomerulonephritis.Conclusion Low-age children is the main population of SG infection in children,especially neonate,with bacteremia and meningitis being the most common.Most children have good clini-cal outcomes,and minority of children with bacteremia may die from septic shock.

Objective:To analyze the clinical characteristics and molecular mechanisms of 5 cases of hypoparathyroidism caused by GATA3 gene mutation.Methods:A total of 5 childhood-onset hypoparathyroidism patients with GATA3 mutation were identified from 198 hypoparathyroidism (aged ≤18 years) from 1975 to 2021 in Peking Union Medical College Hospital. Clinical data and biochemical indices of the 5 patients were collected and analyzed retrospectively. Genetic screening was conducted by targeted next-generation sequencing (T-NGS), and bioinformatics analysis was performed to analyze the underline mechanisms.Results:The medium onset age of hypoparathyroidism of the 5 patients was 0.5 (0.1, 1.3) years old, and the time duration from onset to confirmed diagnosis of hypoparathyroidism and hypoparathyroidism- deafness-renal dysplasia syndrome was (7.0±5.2) years and (15.0±5.4) years, respectively. The clinical manifestations included carpopedal spasm accompanied by seizures (5 cases), basal ganglia calcification (5 cases), cataract (1 case), deafness (4 cases), and renal malformations or absence (2 cases). The blood calcium and blood parathormone(PTH) before treatment was (1.65±0.31) mmol/L and (4.64±2.63) ng/L, respectively. The 5 patients carried different heterozygous mutations in GATA3 gene, which caused nonsense mutations, frameshift mutations and splice site mutations, respectively. All the GATA3 gene mutations of the 5 patients are classified as pathogenic or likely pathogenic by the Clin Var database and American College of Medical Genetics and Genomics(ACMG).Conclusions:Attention should be paid to genetic diseases in patients with childhood-onset hypoparathyroidism. The possibility of hypoparathyroidism-deafness-renal dysplasia syndrome should be considered in hypoparathyroidism patients with hearing loss or renal dysplasia. GATA3 gene screening is highly recommended for the confirmation of the diagnosis.

Objective: To investigate the association of GNA11 gene polymorphisms with the risk of adult-onset non-surgical hypoparathyroidism (Ns-HypoPT). Methods: Genotyping of GNA11 single nucleotide polymorphisms (SNPs) (rs28685098, rs4806907, rs11084997 and rs78003011) was carried out in 203 patients and 209 healthy participants by sequenom MassArray iPLEX System. These SNPs are located in promoter and 3′untranslated region (3′UTR) of GNA11 gene, respectively. Results: Allele and genotype frequencies of rs11084997 in patients were significantly different from those of controls (genotype GG:60.5% vs. 49.8%, GC: 35.5% vs. 41.6%, CC: 4.0% vs. 8.6%, P=0.038; G allele 78.3% vs. 70.6%, C allele 21.7% vs. 29.4%, P=0.012), and the C allele of rs11084997 carriers had a lower risk to develops Ns-HypoPT in additive and dominant genetic models [OR=0.382 (0.160-0.915), 0.647 (0.437-0.957)]. CC-Haplotype formed by the minor alleles of rs4806907 and rs11084997 was associated with a decreased risk of Ns-HypoPT in additive, dominant and recessive genetic model [OR=0.317 (0.126-0.801), 0.640 (0.430-0.952), 0.367 (0.148-0.912)]. Conclusion The minor allele C of rs11084997 in GNA11 gene promoter was associated with decreased risk of Ns-HypoPT in Chinese population.

Objective To explore the quality of life ( QoL ) and muscle strength in patients with pseudohypoparathyroidism ( PHP ) under regular treatment. Methods Twenty-three patients with PHP regularly followed at Peking Union Medical College Hospital from June 2017 to June 2018 were included. Age- and gender-matched 23 patients with nonsurgical hypoparathyroidism ( nHPT) and 23 healthy controls were also included. Short Form 36 Health Survey questionnaire version 2 ( SF36v2) were used to evaluate the QoL. Grip strength and repeated chair stand ( RCS) were used to assess muscle strength for upper and lower limbs respectively. Results Except for physical functioning, patients of PHP group had reduced scores in all other subdomains of SF36v2 compared to healthy controls ( P<0.05) . Comparing to nHPT patients, PHP patients had a higher score in social functioning, while no difference was found in other subdomains of SF36v2. Grip strength and RCS tests were similar in PHP patients and healthy controls. Conclusions Comparing to healthy controls, patients with PHP still had impaired QoL despite regular management, no significant difference of upper and lower limb muscle strength was found between PHP group and healthy controls.

Objective: To investigate the effectiveness and safety of high-dose native vitamin D versus active vitamin D by retrospective analysis of clinical data in patients with non-surgical hypoparathyroidism (ns-HP) in our hospital. Methods: ns-HP patients with stable therapeutic schedule in recent three years were included. According to the vitamin D agents used, patients were divided into three groups: active vitamin D group, native vitamin D group, and mixed vitamin D group. The effectiveness was evaluated by analysis of markers including post-treatment serum calcium, incidence of hypocalcemia, hypocalcemic symptoms and signs. The safety was evaluated in various groups by analyzing incidences of hypercalcemia and hypercalciuria, glomerular filtration rate, percentage of thiazide diuretic use, nephrocalcinosis or renal stone. Results: Patients in active vitamin D group were more likely to experience episodes of hypocalcemia compared with those in native group (32.94%±21.46% vs 24.86%±10.1%, P<0.05). No significant differences in other indexes for assessing effectiveness and safety were found among three groups (P>0.05). Conclusions Under the circumstance of regular follow-up, both high-dose native vitamin D and active vitamin D could treat ns-HP effectively and safely. Native vitamin D may be better in maintaining eucalcemia and reducing incidence of hypocalcemia compared with active vitamin D.

Inquisition language,as the information carrier on observing and describing disease status,makes it possible for patients to communicate well with doctors to acknowledge disease information.In order to make inquisition language possess specific properties of medical conversation,doctors need to master language skills in procedural inquisition,proper listening and responding to inquisition,distinguishing inquisition,transitional inquisition and secret-involved inquisition.Upholding inquisition language with courtesy,comfort,being explanatory,encouraging,and protecting is the basic requirement of clinical ethics.