Objective:To investigate the risk factors of acute respiratory distress syndrome（ARDS）in children with sepsis，and to establish a risk prediction model based on least absolute shrinkage and selection operator(LASSO) regression analysis for early identification of sepsis patients who may develop ARDS.Methods:The children with sepsis treated in the Pediatric Center of the First Affiliated Hospital of Xinjiang Medical University from January 2021 to December 2023 were selected，and divided into ARDS group and non-ARDS group according to whether ARDS occurred.The basic data and related laboratory indexes of the two groups were compared,and the characteristic variables were screened by LASSO regression.The independent risk factors of ARDS in septic children were analyzed by multivariate Logistic regression,and a Nomogram prediction model was constructed.The predictive power of the model was verified by using receiver operating characteristic(ROC) curve,calibration curve and clinical decision curve.Results:A total of 197 children with sepsis were included,including 113 males and 84 females,51 cases (25.9%) in ARDS group and 146 cases (74.1%) in non-ARDS group.There were no statistically significant differences in gender,ethnicity,age and body mass index between the two groups( P>0.05).The pediatric critical illness score,pH value,alkaline residue,and platelets in ARDS group were significantly lower than those in non-ARDS group.The ratio of pulmonary infection and septic shock,mortality,lactic acid,interleukin-6,urea,creatinine,uric acid,N-terminal B-type natriuretic peptide precursor and so on were significantly higher than those in non-ARDS group( P<0.05).According to LASSO regression and multivariate Logistic analysis,high lactate ( OR 1.715,95% CI 1.409-2.088, P<0.001),pulmonary infection ( OR 3.679,95% CI 1.653-8.187, P<0.001),and septic shock ( OR 11.474,95% CI 5.396-24.398, P<0.001) were independent risk factors for ARDS in children with sepsis.The prediction model constructed based on these three independent risk factors had an area under the ROC curve of 0.795,a sensitivity of 0.686,and a specificity of 0.870.The calibration curve showed that the predicted probability of the model was basically consistent with the actual probability.The clinical decision curve showed that the prediction model had good clinical effectiveness. Conclusion:High lactate，pulmonary infection，and septic shock are independent risk factors for ARDS in children with sepsis.The clinical prediction model based on these three independent risk factors has good diagnostic efficacy and clinical application value.

Objective:To investigate the risk factors of acute respiratory distress syndrome（ARDS）in children with sepsis，and to establish a risk prediction model based on least absolute shrinkage and selection operator(LASSO) regression analysis for early identification of sepsis patients who may develop ARDS.Methods:The children with sepsis treated in the Pediatric Center of the First Affiliated Hospital of Xinjiang Medical University from January 2021 to December 2023 were selected，and divided into ARDS group and non-ARDS group according to whether ARDS occurred.The basic data and related laboratory indexes of the two groups were compared,and the characteristic variables were screened by LASSO regression.The independent risk factors of ARDS in septic children were analyzed by multivariate Logistic regression,and a Nomogram prediction model was constructed.The predictive power of the model was verified by using receiver operating characteristic(ROC) curve,calibration curve and clinical decision curve.Results:A total of 197 children with sepsis were included,including 113 males and 84 females,51 cases (25.9%) in ARDS group and 146 cases (74.1%) in non-ARDS group.There were no statistically significant differences in gender,ethnicity,age and body mass index between the two groups( P>0.05).The pediatric critical illness score,pH value,alkaline residue,and platelets in ARDS group were significantly lower than those in non-ARDS group.The ratio of pulmonary infection and septic shock,mortality,lactic acid,interleukin-6,urea,creatinine,uric acid,N-terminal B-type natriuretic peptide precursor and so on were significantly higher than those in non-ARDS group( P<0.05).According to LASSO regression and multivariate Logistic analysis,high lactate ( OR 1.715,95% CI 1.409-2.088, P<0.001),pulmonary infection ( OR 3.679,95% CI 1.653-8.187, P<0.001),and septic shock ( OR 11.474,95% CI 5.396-24.398, P<0.001) were independent risk factors for ARDS in children with sepsis.The prediction model constructed based on these three independent risk factors had an area under the ROC curve of 0.795,a sensitivity of 0.686,and a specificity of 0.870.The calibration curve showed that the predicted probability of the model was basically consistent with the actual probability.The clinical decision curve showed that the prediction model had good clinical effectiveness. Conclusion:High lactate，pulmonary infection，and septic shock are independent risk factors for ARDS in children with sepsis.The clinical prediction model based on these three independent risk factors has good diagnostic efficacy and clinical application value.

OBJECTIVES: To explore the effect of glucocorticoid therapy on the growth and development of children with bronchiolitis. METHODS: A total of 143 children with bronchiolitis who were treated with glucocorticoids from February 2017 to March 2018 were enrolled. The medical data were retrospectively collected, including height, weight, course of the disease, and diagnosis and treatment plan at initial admission. After three years of treatment, physical development indices were measured, growth and development were evaluated by Z-score, and related hematological parameters were measured, including osteocalcin, serum phosphorus, and insulin-like growth factor-1. RESULTS: As for the children with bronchiolitis, the incidence rates of growth retardation and obesity increased significantly after three years of glucocorticoid therapy (P<0.05). The children treated with glucocorticoids for ≥29 days showed a significantly higher incidence rate of obesity than those treated with glucocorticoids for <29 days (P<0.05), while nebulized glucocorticoid treatment had no effect on the growth and development (P>0.05). Compared with the children with growth retardation, the children with normal development had significantly higher levels of serum phosphorus and insulin-like growth factor-1 (P<0.05). CONCLUSIONS Glucocorticoid therapy can adversely affect long-term growth and development in children with bronchiolitis.
Body Height ; Bronchiolitis/drug therapy* ; Child ; Glucocorticoids/adverse effects* ; Hospitalization ; Humans ; Retrospective Studies

Objective To discuss the variation in serum factor IL-6,anti-inflammatory cytokine IL-10,and vascular cell adhesion molecule-1 (ICAM-1) level of children with obstructive sleep apnea-hypopnea syndrome (OSAHS) and their clinical significances.Methods One hundred and forty-two hospitalized children were divided into 2 groups:OSAHS group (47 cases) and the control group (95 cases),according to test result of polysomnography (the golden standard).The differences of IL-6,IL-10,high-sensitivity C-reactive protein (hsCRP) and ICAM-1 level between the two groups were measured and compared by using enzyme linked immunosorbent assay,and correlation analysis between IL-6,IL-10,ICAM-1 and each sleep-breathing parameter of OSAHS group was performed.The children of OSAHS group were divided into 3 groups:mild,moderate and severe group,according to the level of apnea hypopnea index(AHI).Statistical analysis was performed on the above indexes among the 3 groups.Reassessment of the children diagnosed with OSAHS was performed after 12 weeks of treatment.Results The serum levels of IL-6,ICAM-1 and hsCRP [(2.98 ± 0.27) ng/L,(391.7 ± 115.6) μg/L,(15.4 ± 4.9) mg/L] of OSAHS group were significantly higher than those of the control group[(1.67 ± 0.07) rng/L,(189.8 ± 106.4) μg/L,(2.5 ± 2.1) mg/L],while its serum IL-10 level was lower than that of the control group[(195.2 ± 33.6) ng/L vs (458.5 ± 102.2)ng/L],and there were significant differences between the 2 groups (t =33.26,32.45,10.94,-53.72,all P ＜0.01) ; there were significant differences in terms of IL-6,IL-10 and ICAM-1 level among the mild,the moderate and the severe groups (F =128.90,102.60,8.25,all P ＜0.05).Of which the serum levels of IL-6,ICAM-1 and hsCRP of the severe group[(3.22 0.27) ng/L,(427.7 ± 95.4) μg/L,(21.0 ± 3.9) mg/L] were higher than those of the mild group [(1.92 ± 0.24) ng/L,(236.5 ± 115.6) μg/L,(11.0 ± 3.8) mg/L] and the moderate group [(2.02 ± 0.31) ng/L,(401.5 ± 105.6) μg/L,(17.0 ± 2.8)mg/L],and serum levels of IL-6,ICAM-1 as well as hsCRP were increased accompanied with the raise of AHI.While the serum level of IL-10[(115.2 ±30.6) ng/L] in the severe group was lower than that of the mild and the moderate groups [(400.2 ± 55.6) ng/L,(203.2 ± 27.6) ng/L] ; serum levels of IL-6 and ICAM-1 of OSAHS children were positively correlated with AHI and micro-arousal index (r =0.341,0.427,all P ＜0.05),negatively correlated with lowest oxygen saturation (LSaO2) at night (r =-0.190,P ＜ 0.01),and without correlation with body mass index (BMI) (r =-0.121,P ＞ 0.05).Serum level of IL-10 was negatively correlated with AHI (r =-0.266,P ＜ 0.05),positively correlated with LSaO2 (r =0.240,P ＜ 0.01),and without correlation with BMI or micro-arousal index (r =-0.183,-0.159,all P ＞ 0.05) ; After 12-week treatment,the IL-6 and ICAM-1 levels of OSAHS group [(2.02 ± 0.13)ng/L,(269.9 ± 107.2) μg/L] were decreased,while IL-10 [(476.3 ± 86.t2) ng/L] were increased compared with pre-treatment[(3.08 ± 0.30) ng/L,(187.2 ± 29.63) ng/L,(379.9 ± 105.2) μg/L] (t =24.22,22.32,66.96,all P ＜ 0.05).Conclusions OSAHS children have systemic inflammatory response,which may increase the risk of cardiovascular disease; this inflammatory response is reversible,so early identification and treatment of OSAHS is beneficial.

OBJECTIVETo understand the prevalence of sleep disorders and their influencing factors in primary school children from Urumqi.

METHODSA total of 2034 children at the ages of 6-14 years were randomly sampled in 3 districts of Urumqi. The children's sleep states and their family and social environments were investigated through questionnaires.

RESULTSThe prevalence of sleep disorders in the subjects was 55%. The prevalence of sleep inquietude was the highest (14.7%), followed by sleep talking (4.8%), sleep walking (1.5%), nocturnal enuresis (1.5%), sleep teeth grinding (5.7%), habitual snoring (12.9%), sleep apnea (0.5%), and waking up by choke (1.9%). Taking drugs to stimulate or inhibit the central nervous system, frequent colds, confined housing area, family history, and sleeping with parents were risk factors for the development of sleep disorders.

CONCLUSIONSThe prevalence of sleep disorders within primary school children in Urumqi is higher than the reported data. The development of sleep disorders is multifactorial.

Adolescent ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Prevalence ; Sex Characteristics ; Sleep Wake Disorders ; epidemiology ; etiology