1.Clinical application of next-generation sequencing in early screening of neonatal diseases.
Li-Hong JIANG ; Ben-Qing WU ; Zheng-Yan ZHAO
Chinese Journal of Contemporary Pediatrics 2025;27(4):432-437
OBJECTIVES:
To evaluate the clinical value of next-generation sequencing (NGS) in neonatal disease screening, particularly its advantages when combined with tandem mass spectrometry (MS/MS).
METHODS:
A prospective study was conducted involving blood samples from 1 999 neonates born at the Shenzhen Guangming District People's Hospital, between May and August 2021. All samples were initially screened using MS/MS and fluorescence immunoassay, followed by NGS to detect high-frequency variation sites in 135 related pathogenic genes. Suspected positive variants were validated using Sanger sequencing or multiplex ligation-dependent probe amplification in family studies.
RESULTS:
No confirmed positive cases were found in the MS/MS analysis of the 1 999 neonates. Genetic screening identified 58 positive cases (2.90%), 732 carriers of pathogenic genes (36.62%), and 1 209 negative cases (60.48%). One case of neonatal intrahepatic cholestasis was diagnosed (0.05%, 1/1 999). Fluorescence immunoassay identified 39 cases of glucose-6-phosphate dehydrogenase (G6PD) deficiency (1.95%, 39/1 999), while genetic screening identified 43 cases of G6PD deficiency (2.15%, 43/1 999). The fluorescence immunoassay also detected 6 cases of hyperthyrotropinemia (0.30%, 6/1 999), all of whom carried DUOX2 gene variants. The top ten pathogenic gene carrier rates were G6PD (12.8%), DUOX2 (8.7%), HBB (8.2%), ATP7B (6.6%), GJB2 (5.7%), SLC26A4 (5.6%), PAH (5.6%), ACADSB (4.6%), SLC25A13 (4.2%), and SLC22A5 (4.1%).
CONCLUSIONS
NGS can serve as an effective complement to MS/MS, significantly improving the detection rate of inherited metabolic disorders in neonates. When combined with family validation, it enables precise diagnosis, particularly demonstrating complementary advantages in screening for monogenic diseases such as G6PD deficiency.
Humans
;
Infant, Newborn
;
High-Throughput Nucleotide Sequencing/methods*
;
Neonatal Screening/methods*
;
Tandem Mass Spectrometry
;
Prospective Studies
;
Female
;
Male
;
Infant, Newborn, Diseases/diagnosis*
;
Genetic Testing
2.Guideline for the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal seizures (2025).
Chinese Journal of Contemporary Pediatrics 2025;27(6):638-647
Seizures are common clinical emergencies in neonatology, potentially leading to severe complications and directly impacting the neurodevelopmental prognosis of the infants with this condition. For primary healthcare providers, key clinical challenges include standardized emergency management, precise clinical diagnosis and treatment, and accurate assessment of referral indications. To assist primary healthcare providers in the prompt identification and standardized management of neonatal seizures, the Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association organized a panel of experts to develop the "Guideline for the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal seizures (2025)", based on the latest clinical evidence and expert consensus. This guideline provides primary healthcare providers with 17 recommendations addressing nine common clinical questions in neonatal seizures.
Humans
;
Infant, Newborn
;
Seizures/therapy*
;
Primary Health Care
;
Infant, Newborn, Diseases/diagnosis*
3.Guideline for the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal transport (2025).
Chinese Journal of Contemporary Pediatrics 2025;27(7):759-769
Neonatal transport is a crucial aspect of clinical work in neonatology, aimed at timely and safely transferring high-risk neonates from birth facilities or primary healthcare institutions to neonatal centers equipped for critical care. This ensures timely diagnosis and treatment, thereby reducing mortality and complications and improving outcomes. Currently, there is significant regional variation in neonatal transport practices across China. In response, the Subspecialty Group of Neonatology of Society of Pediatrics of Chinese Medical Association and the Editorial Board of Chinese Journal of Contemporary Pediatrics have jointly developed the "Guideline for the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal transport (2025)". This guideline addresses 10 clinical issues related to neonatal transport and formulates 18 recommendations based on the best available evidence and expert consensus. It aims to provide a systematic approach to neonatal transport in primary care settings, tailored to the national context of China, offering guidance and decision-making support for primary healthcare providers.
Humans
;
Infant, Newborn
;
Primary Health Care
;
Infant, Newborn, Diseases/diagnosis*
;
Transportation of Patients/standards*
4.Expert consensus on the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal vomiting (2025).
Chinese Journal of Contemporary Pediatrics 2025;27(7):770-777
To assist primary healthcare personnel in promptly and accurately identifying neonatal vomiting, providing precise diagnosis, standardized treatment, or timely referral for rescue, thereby reducing the occurrence of complications and ensuring the health of infants, the Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association has organized experts to formulate this consensus based on the latest clinical research advancements and thorough discussions. This consensus addresses eight common clinical issues faced by primary healthcare personnel and forms 21 recommendations.
Humans
;
Infant, Newborn
;
Vomiting/etiology*
;
Primary Health Care
;
Consensus
;
Infant, Newborn, Diseases/diagnosis*
5.Guideline for the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal resuscitation (2025).
Chinese Journal of Contemporary Pediatrics 2025;27(8):887-896
In order to further enhance the capacity of primary healthcare providers to perform neonatal resuscitation, and to reduce the incidence and mortality of asphyxia-related complications, the Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association, in collaboration with the Editorial Board of the Chinese Journal of Contemporary Pediatrics, organized experts to integrate the latest clinical research advances in neonatal resuscitation. Considering the realities of primary healthcare institutions, this guideline was developed after thorough expert discussion. The guideline addresses nine common issues concerning neonatal resuscitation faced by primary healthcare providers and provides 22 recommendations.
Humans
;
Infant, Newborn
;
Resuscitation/standards*
;
Primary Health Care
;
Infant, Newborn, Diseases/diagnosis*
6.Development of a quality control indicator system for neonatal screening of inherited metabolic diseases in obstetric settings.
Hui LI ; Jin ZHANG ; Dan-Feng CAO
Chinese Journal of Contemporary Pediatrics 2025;27(8):994-1001
OBJECTIVES:
To develop a quality control indicator system for neonatal screening of inherited metabolic diseases in obstetric settings, so as to provide a standardized tool for quality control in clinical neonatal screening of inherited metabolic diseases.
METHODS:
From March to May 2024, a literature review combined with expert clinical experience was conducted to develop a preliminary questionnaire on quality control indicators for neonatal screening of inherited metabolic diseases. The final indicator system was established after two rounds of the Delphi method, and the Analytic Hierarchy Process was used to determine indicator weights.
RESULTS:
Sixteen questionnaires were distributed in each of the two consultation rounds, with a valid response rate of 100% for both. The expert authority coefficients were 0.863 and 0.876, respectively. Kendall's coefficient of concordance for the importance and feasibility of the indicators ranged from 0.091 to 0.125. The final indicator system comprised 3 primary indicators, 8 secondary indicators, and 28 tertiary indicators for neonatal screening of inherited metabolic diseases in obstetric settings.
CONCLUSIONS
The quality control indicator system developed using the Delphi method demonstrates a strong systematic structure, high clinical adaptability, and strong operability, and can be effectively applied to quality control in neonatal screening of inherited metabolic diseases in obstetric settings.
Humans
;
Infant, Newborn
;
Neonatal Screening/standards*
;
Quality Control
;
Metabolism, Inborn Errors/diagnosis*
;
Metabolic Diseases/diagnosis*
;
Delphi Technique
;
Female
;
Quality Indicators, Health Care
;
Pregnancy
7.Expert consensus on the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal hypoglycemia (2025).
Chinese Journal of Contemporary Pediatrics 2025;27(11):1301-1309
To help primary healthcare providers promptly identify and effectively treat neonatal hypoglycemia, thereby reducing the risk of hypoglycemic encephalopathy, the Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association led the development of this expert consensus. Through thorough discussion, experts integrated recent clinical advances to formulate the "Expert consensus on the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal hypoglycemia (2025)". This consensus addresses 9 common clinical questions and provides 14 recommendations.
Humans
;
Hypoglycemia/therapy*
;
Infant, Newborn
;
Primary Health Care
;
Infant, Newborn, Diseases/diagnosis*
;
Consensus
8.Analysis of blood carnitine profile and SLC22A5 gene variants in 17 neonates with Primary carnitine deficiency.
Weiting SONG ; Sheng YE ; Lizhu ZHENG
Chinese Journal of Medical Genetics 2023;40(2):161-165
OBJECTIVE:
To analyze the blood free carnitine (C0) level and SLC22A5 gene variants in 17 neonates with Primary carnitine deficiency (PCD) and to determine its incidence in local area and explore the correlation between C0 level and genotype.
METHODS:
148 043 newborns born in 9 counties (cities and districts) of Ningde city from September 2016 to June 2021 were selected as study subjects. Blood free carnitine and acyl carnitine of 148 043 neonates were analyzed. Variants of the SLC22A5 gene were screened in those with blood C0 < 10 µmol/L, or C0 between 10 ∼ 15 µmol/L. Correlation between the free carnitine level and genetic variants was analyzed.
RESULTS:
In total 17 neonates were diagnosed with PCD, which yielded a prevalence of 1/8 707 in the region. Twelve variants of the SLC22A5 gene were identified, with the common ones including c.760C>T, c.1400C>G and c.51C>G. Compared with those carrying other variants of the gene, children carrying the c.760C>T variant had significantly lower C0 values (P < 0.01).
CONCLUSION
The prevalence of PCD is relatively high in Ningde area, and intervention measures should be taken to prevent and control the disease. The c. 760C>T variant is associated with lower level of C0, which can provide a clue for the diagnosis.
Humans
;
Infant, Newborn
;
Cardiomyopathies/diagnosis*
;
Carnitine
;
Hyperammonemia/diagnosis*
;
Muscular Diseases/genetics*
;
Solute Carrier Family 22 Member 5/genetics*
9.Recent research on machine learning in the diagnosis and treatment of necrotizing enterocolitis in neonates.
Cheng CUI ; Fei-Long CHEN ; Lu-Quan LI
Chinese Journal of Contemporary Pediatrics 2023;25(7):767-773
Necrotizing enterocolitis (NEC), with the main manifestations of bloody stool, abdominal distension, and vomiting, is one of the leading causes of death in neonates, and early identification and diagnosis are crucial for the prognosis of NEC. The emergence and development of machine learning has provided the potential for early, rapid, and accurate identification of this disease. This article summarizes the algorithms of machine learning recently used in NEC, analyzes the high-risk predictive factors revealed by these algorithms, evaluates the ability and characteristics of machine learning in the etiology, definition, and diagnosis of NEC, and discusses the challenges and prospects for the future application of machine learning in NEC.
Infant, Newborn
;
Humans
;
Enterocolitis, Necrotizing/therapy*
;
Infant, Newborn, Diseases
;
Prognosis
;
Gastrointestinal Hemorrhage/diagnosis*
;
Machine Learning
10.Retrospective Analysis of Pathological Diagnosis of Central Nervous System Diseases in Tibet.
Han-Huan LUO ; Qian WANG ; Bula DUO ; Zhen HUO
Acta Academiae Medicinae Sinicae 2022;44(1):24-29
Objective To analyze the disease spectrum and clinicopathological characteristics of central nervous system(CNS)diseases diagnosed based on pathological findings in Tibet. Methods We collected the data of all the cases with CNS lesions in Tibet Autonomous Region People's Hospital from January 2013 to December 2020.The clinicopathological features were analyzed via light microscopy,immunohistochemical staining,and special staining. Results A total of 383 CNS cases confirmed by pathological diagnosis were enrolled in this study,with a male-to-female ratio of 188∶195 and an average age of(40.03±17.39)years(0-74 years).Among them,127(33.2%)cases had non-neoplastic diseases,with a male-to-female ratio of 82∶45 and an average age of(31.99±19.29)years;256(66.8%)cases had neoplastic diseases,with a male-to-female ratio of 106∶150 and an average age of(44.01±14.87)years.The main non-neoplastic diseases were nervous system infectious diseases,cerebral vascular diseases,meningocele,cerebral cyst,and brain trauma.Among the infectious diseases,brain abscess,granulomatous inflammation,cysticercosis,and hydatidosis were common.The main neoplastic diseases included meningioma,pituitary adenoma,neuroepithelial tumor,schwannoma,metastatic tumor,and hemangioblastoma.The meningioma cases consisted of 95.4%(103/108)cases of grade Ⅰ,3.7%(4/108)cases of grade Ⅱ,and only 1(1/108,0.9%)case of grade Ⅲ.Among the neuroepithelial tumor cases,the top three were glioblastoma,grade Ⅲ diffuse glioma,and ependymoma. Conclusions There are diverse CNS diseases confirmed by pathological diagnosis in Tibet,among which non-neoplastic diseases account for 1/3 of all the cases.Infectious and vascular diseases are the most common non-neoplastic diseases in Tibet,and tuberculosis and parasitic infections are relatively common.The types and proportion of brain tumors in Tibet are different from those in other regions of China,and meningioma is the most common in Tibet,with higher proportion than neuroepithelial tumor.
Adolescent
;
Adult
;
Aged
;
Brain Neoplasms/diagnosis*
;
Central Nervous System Diseases/pathology*
;
Child
;
Child, Preschool
;
Ependymoma
;
Female
;
Humans
;
Infant
;
Infant, Newborn
;
Male
;
Meningeal Neoplasms
;
Middle Aged
;
Retrospective Studies
;
Tibet/epidemiology*
;
Young Adult

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