Objective:To analyze the clinical features and inflammatory factors of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children,and to explore the early prediction methods of RMPP.Methods:Children with Mycoplasma pneumoniae who were hospitalized in the Respiratory Department of Qingdao Women and Children's Hospital from January 2022 to December 2023 and underwent electronic bronchoscopic lavage were selected as the study objects.They were divided into RMPP group and GMPP group according to the severity of illness.Clinical features and inflammatory factors between the two groups were compared,and the risk factors of RMPP were analyzed by multivariate Logistic regression model.Receiver operating characteristic (ROC) curve was plotted to evaluate the predictive values.Results:A total of 232 children were included,including 114 cases in RMPP group and 118 cases in GMPP group.Compared with GMPP group,children in RMPP group were younger,had longer fever time and hospitalization time,and had higher levels of blood C-reactive protein,D-dimer,and lactate dehydrogenase(LDH),as well as higher proportion of pleural effusion observed in imaging.The cytokine levels of interferon(IFN)-α,IFN-γ,interleukin(IL)-2,IL-5,IL-6,IL-1β,IL-10 and IL-17 in bronchoalveolar lavage fluid (BALF) were higher in RMPP group.The differences were statistically significant (all P<0.05).Multivariate Logistic analysis showed that longer hospitalization time and fever time，increased levels of D-dimer and LDH in plasma,increased IL-5,IL-6,IL-17,IL-1β and IFN-α in BALF were independent risk factors for RMPP (all P<0.05).The area under ROC curve of hospitalization time,fever time,D-dimer,LDH,IL-5,IL-6,IL-17 and IL-1β were 0.669,0.857,0.606,0.811,0.686,0.890,0.647 and 0.691，respectively(all P<0.05).Among these,the diagnostic value of fever time,LDH and IL-6 was higher.The optimum critical value of fever time was 6.5 days,with a sensitivity of 97.40% and a specificity of 64.90%.The optimum critical value of LDH was 420.77U/L,with a sensitivity of 64.90% and a specificity of 89.50%.The optimal critical value of IL-6 was 293.04pg/mL,with a sensitivity of 91.2% and a specificity of 82.5%. Conclusion:Children with RMPP have long fever time and high inflammatory index.When children with Mycoplasma pneumoniae pneumonia have fever time >6.5 days,blood LDH>420.77 U/L and IL-6>293.04 pg/mL in BALF,it is helpful to identify RMPP at an early stage.

Objective:To analyze the clinical features and inflammatory factors of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children,and to explore the early prediction methods of RMPP.Methods:Children with Mycoplasma pneumoniae who were hospitalized in the Respiratory Department of Qingdao Women and Children's Hospital from January 2022 to December 2023 and underwent electronic bronchoscopic lavage were selected as the study objects.They were divided into RMPP group and GMPP group according to the severity of illness.Clinical features and inflammatory factors between the two groups were compared,and the risk factors of RMPP were analyzed by multivariate Logistic regression model.Receiver operating characteristic (ROC) curve was plotted to evaluate the predictive values.Results:A total of 232 children were included,including 114 cases in RMPP group and 118 cases in GMPP group.Compared with GMPP group,children in RMPP group were younger,had longer fever time and hospitalization time,and had higher levels of blood C-reactive protein,D-dimer,and lactate dehydrogenase(LDH),as well as higher proportion of pleural effusion observed in imaging.The cytokine levels of interferon(IFN)-α,IFN-γ,interleukin(IL)-2,IL-5,IL-6,IL-1β,IL-10 and IL-17 in bronchoalveolar lavage fluid (BALF) were higher in RMPP group.The differences were statistically significant (all P<0.05).Multivariate Logistic analysis showed that longer hospitalization time and fever time，increased levels of D-dimer and LDH in plasma,increased IL-5,IL-6,IL-17,IL-1β and IFN-α in BALF were independent risk factors for RMPP (all P<0.05).The area under ROC curve of hospitalization time,fever time,D-dimer,LDH,IL-5,IL-6,IL-17 and IL-1β were 0.669,0.857,0.606,0.811,0.686,0.890,0.647 and 0.691，respectively(all P<0.05).Among these,the diagnostic value of fever time,LDH and IL-6 was higher.The optimum critical value of fever time was 6.5 days,with a sensitivity of 97.40% and a specificity of 64.90%.The optimum critical value of LDH was 420.77U/L,with a sensitivity of 64.90% and a specificity of 89.50%.The optimal critical value of IL-6 was 293.04pg/mL,with a sensitivity of 91.2% and a specificity of 82.5%. Conclusion:Children with RMPP have long fever time and high inflammatory index.When children with Mycoplasma pneumoniae pneumonia have fever time >6.5 days,blood LDH>420.77 U/L and IL-6>293.04 pg/mL in BALF,it is helpful to identify RMPP at an early stage.

To analyze the positivity rate and titer of antinuclear antibody (ANA), as well as nuclear pattern and target antigen of ANA in healthy pregnant women during early pregnancy in Qingdao area. A prospective cohort study design was used to include a total of 9 528 healthy pregnant women registered at the Women and Children′s Hospital Affiliated to Qingdao University from March 2023 to June 2024.Indirect immunofluorescence assay (IIF) was used to detect ANA, its titer and cell staining pattern. Fifteen specific antibodies were tested using the magnetic bar code immunofluorescent luminescence method. Logistic regression model was used to analyze the risk factors of pregnancy with autoimmune disease(AID). The results showed that among 9 528 pregnant women in early pregnancy, 1 346 cases (14.1%) were positive of ANA, including 1 011 cases with a titer of 1∶100 (10.6%), 236 cases (2.5%) with a titer of 1∶320, and 99 cases (1.0%) were detected at a titer >1∶320. Among the 1 346 ANA-positive pregnant women, nuclear granular type accounted for the highest proportion (483 cases, 35.9%), followed by speckled type (347 cases, 25.8%) and cytoplasmic type (176 cases, 13.1%).Then, pregnant women with ANA titers ≥1∶100 were detected 15 specific antibodies.Anti-SSA was tested in 121 cases accounted for the majority, followed by 110 cases with anti-Ro-52, 56 cases with anti-SSB, 51 cases with anti-mitochondrial M2 subtype antibodies and 37 cases with anti-centromere B. In conclusion,in healthy pregnant women in Qingdao area, ANA positivity rate was 14.1%, and the titer of ANA was mainly at 1∶100.The predominant nuclear patterns were nuclear granular and speckled types.The specific autoantibodies were mainly anti-SSA antibodies and anti-Ro-52 antibodies.The detection of ANA and specific autoantibodies is of great significance for early prediction, diagnosis, and intervention of autoimmune diseases during pregnancy.

To analyze the positivity rate and titer of antinuclear antibody (ANA), as well as nuclear pattern and target antigen of ANA in healthy pregnant women during early pregnancy in Qingdao area. A prospective cohort study design was used to include a total of 9 528 healthy pregnant women registered at the Women and Children′s Hospital Affiliated to Qingdao University from March 2023 to June 2024.Indirect immunofluorescence assay (IIF) was used to detect ANA, its titer and cell staining pattern. Fifteen specific antibodies were tested using the magnetic bar code immunofluorescent luminescence method. Logistic regression model was used to analyze the risk factors of pregnancy with autoimmune disease(AID). The results showed that among 9 528 pregnant women in early pregnancy, 1 346 cases (14.1%) were positive of ANA, including 1 011 cases with a titer of 1∶100 (10.6%), 236 cases (2.5%) with a titer of 1∶320, and 99 cases (1.0%) were detected at a titer >1∶320. Among the 1 346 ANA-positive pregnant women, nuclear granular type accounted for the highest proportion (483 cases, 35.9%), followed by speckled type (347 cases, 25.8%) and cytoplasmic type (176 cases, 13.1%).Then, pregnant women with ANA titers ≥1∶100 were detected 15 specific antibodies.Anti-SSA was tested in 121 cases accounted for the majority, followed by 110 cases with anti-Ro-52, 56 cases with anti-SSB, 51 cases with anti-mitochondrial M2 subtype antibodies and 37 cases with anti-centromere B. In conclusion,in healthy pregnant women in Qingdao area, ANA positivity rate was 14.1%, and the titer of ANA was mainly at 1∶100.The predominant nuclear patterns were nuclear granular and speckled types.The specific autoantibodies were mainly anti-SSA antibodies and anti-Ro-52 antibodies.The detection of ANA and specific autoantibodies is of great significance for early prediction, diagnosis, and intervention of autoimmune diseases during pregnancy.

Objective:To analyze food intolerance status in children in Qingdao by detecting the serum levels of food-specific IgG (sIgG).Methods:In this cross-sectional study, a total of 4 249 children aged 0 to 14 years (all were permanent residents of Qingdao City) admitted to Women and Children′s Hospital Affiliated to Qingdao University from May 2017 to December 2020 for suspected food intolerance were selected as the study objects with the whole sampling method. According to the age, the objects were divided into 4 groups: 0-<1 year group (440 cases), 1-<3 years group (1 761 cases), 3-<6 years group (1 193 cases), and ≥6 years group (855 cases). Positive condition of serum sIgG antibodies of 14 kinds of food in the children were detected by enzyme-linked immunosorbent assay. Chi-square test was used to compare the positive rate of the antibodies among different foods, gender and age groups.Results:The total positive rate of food sIgG antibody in 4 249 children was 95.32% (4 050/4 249), the highest positive rate was found in eggs (81.50%) and the lowest positive rate was found in pork (1.15%). The positive rates of sIgG antibody in milk (54.98% vs 49.69%, χ2=11.627), crab (5.59% vs 3.71%, χ2=8.049) and shrimp (4.62% vs 2.75%, χ2=9.784) in boys were significantly higher than those in girls, and the positive rates of sIgG antibody in tomato (49.19% vs 45.54%, χ2=5.510), cod (8.53% vs 5.96%, χ2=10.512) and beef (2.58% vs 1.70%, χ2=3.959) in girls were significantly higher than those in boys (all P<0.05). The total positive rate of sIgG antibody in 14 foods was the lowest in 0-<1 year group (89.09%), and it was the highest in 3-<6 years group (96.98%) ( χ2=63.950, P<0.001). The highest positive rate in 0-<1 year group was found in tomato (56.36%), and it was eggs (85.29%, 88.94%, 85.50%) in all the other 3 groups. The positive rates of corn and beef decreased with age ( χ2=44.098, 20.106, P<0.001), while those of cod and mushroom increased with age ( χ2=32.315, 40.338, P<0.001). The positive rate of wheat (57.13%, χ2=42.273), tomato (57.01%, χ2=209.862), soybean (24.99%, χ2=92.580), crab (6.81%, χ2=33.201), shrimp (6.25%, χ2=47.863) were all the highest in 1-<3 years group among the 4 groups (all P<0.001), and the positive rate of chicken was the highest in 3-<6 years group (7.88%, χ2=29.875; P<0.001). Conclusions:Children in Qingdao have a high level of food intolerance, and the highest positive rate is for eggs. Milk, crab and shrimp should be focused on for boys, while tomatoes, cod and beef shoud be paid more attention to for girls. Children of different ages have different kinds of food intolerance, and their diets should be adjusted reasonably according to the characteristics.