Objective:To analyze the characteristics of obstructive sleep apnea（OSA）in children with Prader-Willi syndrome (PWS),and to improve the understanding of OSA during rapid eye movement sleep.Methods:The clinical data of 13 children with PWS aged 2-14 years admitted to Shenzhen Children's Hospital from June 2017 to June 2024 were retrospectively collected as the PWS group,and 12 children with snoring caused by adenoids,tonsil hypertrophy and/or obesity were selected as the control group.The gender,age,body mass index (BMI),obstructive apnea index (OAI),oxygen desaturation index (ODI),obstructive sleep apnea hypopnea index (OAHI),rapid eye movement period OAHI(OAHIrem),non-rapid eye movement period OAHI(OAHInrem) and OAHIrem/total sleep period OAHI ratio were compared between the two groups.Multivariate linear regression was used to assess the association between PWS and OAHIrem.Results:Among the 13 children in PWS group,there were 7 males and 6 females,with an average age of (7.63±4.05) years and an average BMI of (23.06±6.12) kg/m2.Among the 12 children in control group,there were 10 males and 2 females,with an average age of (7.28±3.92) years and an average BMI of (22.41±5.68) kg/m2.There were no statistically significant differences in age,gender,and BMI between the two groups ( P>0.05).All 13 children (100%) with PWS had OSA,with 8 cases (61.53%) of mild OSA and 5 cases (38.46%) of moderate to severe OSA.OAI and ODI in PWS group were significantly higher than those in control group ( P<0.05).OAHI and OAHInrem in PWS group were higher than those in control group,but the difference was not statistically significant ( P>0.05).OAHIrem and OAHIrem/ total sleep OAHI ratio were significantly higher than those in the control group,with statistical significance ( P<0.05).Multivariate linear regression analysis showed that PWS was significantly correlated with OAHIrem/ total sleep OAH ratio (square root) ( P=0.008). Conclusion:Children with PWS have a high incidence of OSA,with a high proportion of moderate to severe OSA.They are prone to OSA with hypoxemia during rapid eye movement sleep.It is recommended that respiratory monitoring of children with PWS during rapid eye movement sleep should be strengthened,and individualized treatment plan should be formulated according to the type and severity of OSA.

Objective:To analyze the characteristics of obstructive sleep apnea（OSA）in children with Prader-Willi syndrome (PWS),and to improve the understanding of OSA during rapid eye movement sleep.Methods:The clinical data of 13 children with PWS aged 2-14 years admitted to Shenzhen Children's Hospital from June 2017 to June 2024 were retrospectively collected as the PWS group,and 12 children with snoring caused by adenoids,tonsil hypertrophy and/or obesity were selected as the control group.The gender,age,body mass index (BMI),obstructive apnea index (OAI),oxygen desaturation index (ODI),obstructive sleep apnea hypopnea index (OAHI),rapid eye movement period OAHI(OAHIrem),non-rapid eye movement period OAHI(OAHInrem) and OAHIrem/total sleep period OAHI ratio were compared between the two groups.Multivariate linear regression was used to assess the association between PWS and OAHIrem.Results:Among the 13 children in PWS group,there were 7 males and 6 females,with an average age of (7.63±4.05) years and an average BMI of (23.06±6.12) kg/m2.Among the 12 children in control group,there were 10 males and 2 females,with an average age of (7.28±3.92) years and an average BMI of (22.41±5.68) kg/m2.There were no statistically significant differences in age,gender,and BMI between the two groups ( P>0.05).All 13 children (100%) with PWS had OSA,with 8 cases (61.53%) of mild OSA and 5 cases (38.46%) of moderate to severe OSA.OAI and ODI in PWS group were significantly higher than those in control group ( P<0.05).OAHI and OAHInrem in PWS group were higher than those in control group,but the difference was not statistically significant ( P>0.05).OAHIrem and OAHIrem/ total sleep OAHI ratio were significantly higher than those in the control group,with statistical significance ( P<0.05).Multivariate linear regression analysis showed that PWS was significantly correlated with OAHIrem/ total sleep OAH ratio (square root) ( P=0.008). Conclusion:Children with PWS have a high incidence of OSA,with a high proportion of moderate to severe OSA.They are prone to OSA with hypoxemia during rapid eye movement sleep.It is recommended that respiratory monitoring of children with PWS during rapid eye movement sleep should be strengthened,and individualized treatment plan should be formulated according to the type and severity of OSA.

Epilepsy is often comorbid with other neuropsychiatric conditions,which are known as epilepsy comor-bidities.Among these conditions,the comorbidity of epilepsy and migraine is very common.Although they are two differ-ent diseases,they overlap in terms of pathophysiological features and clinical symptoms,and several anti-seizure medica-tions(ASMs)have been proved to be effective in migraine.However,there are still controversies over the concept of epi-lepsy comorbid with migraine,and there is often a lack of effective treatment for migraine due to missed diagnosis or misdi-agnosis.In order to improve the ability for identification and precise treatment of epilepsy comorbid with migraine among clinicians,this article elaborates on the possible mechanism of epilepsy comorbid with migraine and discusses the con-cept,identification,and diagnosis and treatment regimens for epilepsy comorbid with migraine by considering the tempo-ral association between headache symptoms and epileptic seizures,with reference to the classification of epilepsy comorbid with migraine and related diagnostic criteria in Chinese expert consensus(2019)and the ICHD-3-2018 guidelines issued by the International Headache Society.

Objective:To investigate the clinical characteristics and serotyping characteristics of respiratory syncytial virus(RSV)infection in children prevalent during summer of 2020 in Shenzhen City, and provide basis for the diagnosis, monitoring and prevention of RSV infection in this area.Methods:The clinical data of 509 cases of RSV infection were analyzed in the Respiratory Department at Shenzhen Children′s Hospital from July 1, 2020 to August 31, 2020.The children diagnosed with pneumonia were divided into mild RSV pneumonia group and severe RSV pneumonia group according to the severity.The age, sex, clinical manifestations, basic diseases, mixed infection, clinical diagnosis of the patients were analyzed.Results:In 509 children with RSV infection, the male to female ratio was 1.84∶1, and the mean thermal range was (3.98±3.25) d. The detection rate of RSV was 51.4% (126/245) in children aged < 6 months, 45.6% (247/542) in children aged from 6 months to 2 years, 41.8% (123/294) in children aged from 2 to 5 years, and 8.5% (13/153) in children aged > 5 years.Common clinical manifestations were cough (96.2%), fever (72.5%), runny nose (61.9%), and nasal congestion (54.6%). Of the 509 cases, 123 (24.2%) had underlying diseases and 49 (9.6%) had mixed infections.A total of 371 cases had RSV pneumonia, including 280 mild cases (55.0%) and 91 severe cases (17.8%). Compared with the mild RSV pneumonia group, the severe RSV pneumonia group was significantly higher in male, age < 1 years, proportion of wheezing, underlying disease, mixed infection, and hospitalization time and fever time (all P<0.05). Multivariate analysis showed that age less than 1 year, mixed infection and underlying diseases were the high risk factors of severe RSV pneumonia( OR=10.1, 14.3 and 3.4, respectively, all P<0.05). Of the 198 serotyping cases, 18 were type A and 180 were type B. Conclusion:During the summer of 2020, the epidemic of RSV infection in children in Shenzhen is dominated by type B. In addition to children aged from 6 months to 2 years, children aged 2-5 years are also susceptible groups.Age<1 year, underlying diseases and mixed infection are independent risk factors of severe RSV pneumonia in children.

Objective:To analyze the characteristics of sleep disordered breathing (SDB) in children with allergic rhinitis (AR), and improve the diagnosis and treatment at AR combined with obstructive sleep apnea (OSA).Methods:The clinical data of 120 patients with AR and OSA (AR and OSA group) admitted to the respiratory department at Shenzhen Children′s Hospital from May 2019 to December 2020 were retrospectively analyzed.A total of 120 children diagnosed with OSA and excluded AR during the same period were selected as control group.The SDB day and night symptoms, sleep structure characteristics and sleep breathing events were compared between two groups.Results:The average course of disease in children with AR and OSA was significantly longer than that in control group ( P=0.030). The main manifestations of children in AR and OSA group were mouth breathing (100.0%), snoring (99.2%), nasal obstruction (88.5%), and restless sleep (68.0%). There was no significant difference in sleep structure between two groups ( P>0.05), but the sleep efficiency of AR and OSA group was significantly lower than that of control group ( P=0.028). The respiratory events apnea hypopnea index, obstructive apnea index, obstructive apnea hypopnea index, hypopnea index and oxygen desaturation index of each sleep period in AR and OSA group were significantly higher than those in control group ( P<0.05). Among the children in AR and OSA group, moderate and severe OSA were the main manifestations, and the difference between two groups was statistically significant ( P<0.001). Conclusion:The combination of AR delayed the course of OSA in children.The main characteristics of sleep disordered breathing in children with AR are mouth opening, restless sleep, snoring and nasal obstruction.The sleep efficiency is decreased.Obstructive hypopnea and apnea are the most common respiratory events, and oxygen deficiency often occurs in rapid eye movement phase.Children with AR are more likely to have moderate or severe obstructive sleep apnea.

Since December 2019, the novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) infection has broken out worldwide, causing enormous social and economic burdens.Sudden exacerbations in SARS-CoV-2 infected people may be caused by infection-related cytokine storms.The basic state of the body and the strength of the immune response determine the prognosis of SARS-CoV-2.The interaction between proinflammatory factors and anti-inflammatory factors, and continued proinflammatory response cause lung edema, exudation, progression to acute respiratory distress syndrome involving the lung tissues and organs, multi-organ failure, and even death.The efficacy of antiviral therapy alone for immune complications like cytokine storm during viral infection is not ideal, and the targeted therapy of cytokines has become a potentially popular therapeutic strategy.Early identification and appropriate treatment of immune complications contribute to reduce the morbidity and mortality of severe viral infections.

Objective To explore the life quality of postoperative patients after a hypertensive cerebral hem-orrhage in the basal ganglia and the factors influencing it, so as to provide evidence for improving the life quality of such patients. Methods A total of 128 patients were studied retrospectively. Their gender, age, occupation, mari-tal status, education level, place of residence and family size were tabulated, as well as whether or not they were liv-ing with their children, smoking or drinking alcohol. Their household income was recorded along with their clinical condition during surgery ( midline shift, blood loss, operative time, whether a hernia occurred, consciousness, and whether bleeding broke into the ventricles. The SF-36 health measurement scale was used to evaluate the patients′life quality, and the factors influencing it were analyzed. Results Univariate analysis showed that: ( 1) Their physio-logical functioning ( PF) and global health ( GH) were mainly affected by age, marital status, family size, midline shift, quantity of cerebral hemorrhage, occurrence of herniation, consciousness and whether the hemorrhage broke in-to the ventricles. (2) Their physiological role (RP) was influenced by marital status, education background, household monthly income, midline shift, consciousness and whether the hemorrhage broke into the ventricles. (3) Pain (BP) was mainly affected by marital status and family size. (4) Social functioning (SF) was closely related to marital status, family size, consciousness and whether hemorrhage broke into the ventricles. (5) Their mental health (MH) was main-ly affected by the amount of bleeding, whether they were living with their children, the operation′s duration and whether the hemorrhage broke into the ventricles. (6) Their emotions (RE) were influenced by their consciousness and whether bleeding broke into the ventricles. (7) Their vitality (VT) was affected by their marital status, smoking, consciousness and whether the bleeding broke into the ventricles. Multivariate analysis showed that whether the hemorrhage broke into the ventricles was the most influential factor. Family size was also influential. Conclusions Age, number of family members, whether they are living with their children, and whether hemorrhage broke into the ventricles are all influen-tial in predicting the life quality of survivors of hypertensive cerebral hemorrhage in the basal ganglia.

Objectives To summarize the clinical feature of severe adenovirus pneumonia (SAP) in children and further to improve prognosis and clinical diagnosis of SAP. Methods The clinical data of 213 children with SAP from June 2009 to June 2011 were retrospectively analyzed. Results Among 213 patients, 155 (72.8%) children were aged 6 months to 2 years, with a males to females ratio of 2.7∶1. The onset of 158 patients (74.2%) was in winter and spring. All patients had fever, 172 (80.8%) with high temperature of 39.1℃-41℃, 161 (75.6%) with a fever lasting more than 2 weeks. Two hundred and ifve (96.2%) patients had cough in the early stage, 120 (56.3%) with wheeze, 139 (65.3%) with moist rales and wheezing in the lung. Imaging ifndings in the preliminary stage of SAP showed that 63 patients (92.6%) had pulmonary interstitial changes;in critical stage, 80 patients (54.4%) had segmental consolidation and 33 (22.4%) with pleural effusion, 25 (17.0%) with pleuritis;in recovery phase, 50 patients (68.5%) showed absorption in segmental area of consolidation. All cases had complications, 175 (82.2%) with respiratory failure, including 10 (4.7%) with ARDS;among extrapulmonary complications, diseases of cardiovascular system (64.3%) and alimen-tary system (44.1%) were the most common ones, and the occurrence of myocarditis and diarrheal disease were the highest. Age, ARDS and more than two kinds of complications had adverse impact on the outcomes, and the difference was signiifcant (P<0.05). Conclusions SAP is a severe pneumonia with long duration of high fever, severe clinical manifestations with more complications. When SAP is suspected, it is recommended to complete etiological and chest radiographic examination for early diagnosis and treatment.