Objective:To observe the efficacy and safety of combined lienal polypeptide injection therapy in the treatment of Mycoplasma pneumoniae pneumonia（MPP）in children aged 3 to 14 years old in multiple clinical centers.Methods:A randomized，controlled，multi-center clinical study design was adopted.A total of 240 hospitalized children aged 3 to 14 years old with MPP from 7 hospitals from September 1，2023 to January 31，2024 were included.According to the severity of pneumonia，they were divided into the mild MPP group with 80 cases and the severe MPP/refractory MPP（SMPP/RMPP）group with 160 cases，and then randomly divided into the control group and the experimental group at a ratio of 1 ∶1，using the random number table method.After screening，subjects entered a treatment period of 5 to 7 days.The control group was treated with azithromycin，while the experimental group was treated with azithromycin plus lienal polypeptide injection .The recovery of lung CT，length of hospital stay，duration of fever，cough score，whether mild cases developed into severe or refractory cases，duration of hormone use，use of intravenous immunoglobulin（IVIG），bronchoscopy treatment，and immune function were observed between the two groups to evaluate the efficacy of lienal polypeptide injection.Adverse events after medication，vital signs，blood routine，urine routine，liver function，myocardial enzymes，renal function，and electrocardiogram were observed to evaluate the safety. Results:A total of 231 subjects have completed the trial in the 7 hospitals，including 118 cases in the experimental group and 113 cases in the control group.Main observation index：the rate of lung CT aggravation in the experimental group was lower than that in the control group（2.6% vs 15.3%， P<0.01），and the difference was statistically significant.Secondary indexes：there were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and immunoglobulin between the two groups（all P>0.05）.However，the rate of cases of plastic bronchitis（PB）found under bronchoscopy in the experimental group was lower than that in the control group（0 vs 18.8%， P=0.03），and the difference was statistically significant.Among the mild MPP（72 cases），there were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and the improvement rate of lung CT between the two groups（all P>0.05）.However，compared with the control group，the rate of cases developing into SMPP/RMPP in the experimental group was less（24.3% vs 48.6%， P=0.03），and the difference in IgG before and after treatment was small［0.53（-0.04，1.18）g/L vs 1.33（0.48，2.25）g/L， P=0.01］.Among the SMPP/RMPP cases（159 cases），the rate of cases of PB found under bronchoscopy in the experimental group was less than that in the control group（0 vs 20%， P=0.04），and the rate of cases with aggravated lung CT in the experimental group was less than that in the control group（1.3% vs 19.5%， P<0.01），and the improvement rate of lung CT in the experimental group was higher than that in the control group（88.8% vs 75.3%， P=0.03），with statistically significant differences.There were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and immunoglobulin between the two groups（all P>0.05）.Two cases in the experimental group developed rashes，which improved after the drug was discontinued.There were no serious adverse reactions such as abnormal vital signs like dyspnea and cyanosis due to the use of lienal polypeptide injection.There were no obvious changes in blood routine，liver function，myocardial enzymes，renal function，electrocardiogram，and urine routine values before and after medication compared with the baseline. Conclusion:The combined use of lienal polypeptide injection in the treatment of MPP in children can reduce the probability of the transformation from mild cases to SMPP/RMPP，reduce the rate of aggravation of the image findings，promote the absorption of lung inflammation，reduce the rate of PB found under bronchoscopy，and has good safety.

Respiratory syncytial virus（RSV）is the leading cause of severe lower respiratory tract infections in young children，with a high rate of hospitalization and mortality.Specific anti-RSV therapies have not been reported.The structure of RSV is such that it is mainly F and G proteins in the surface that act as adhesion and invade the host cells.Therefore，monoclonal antibodies against F and G proteins with neutralization sites are currently being developed. This review summarized the mechanism, prevention and treatment of RSV based on neutralizing antibody.

Objective:To investigate the prognostic value of molecular subtypes in patients with resected invasive breast cancer.Methods:Between 2015 and 2018 7 869 patients with invasive breast cancer after undergoing surgery were included in this analysis. Breast cancer was classified into four subtypes according to the status of hormone receptor (HR) and HER2: HR+/HER2-, HR+/HER2+, HR-/HER2+, and HR-/HER2-. Kaplan-Meier curves and COX regression were used to compare disease-free survival (DFS) and overall survival (OS) among different subtypes.Results:The 5-year DFS and OS were 86.30% and 94.29%, respectively. Proportions of HR+/HER2-、HR+/HER2+、HR-/HER2+ and HR-/HER2- were 52.9%、17.5%、14.1%和15.5%, respectively. The 5-year DFS of HR+/HER2- subtype (88.12%) was higher than HR+/HER2+ (84.67%, P=0.026), HR-/HER2+ (84.19%, P<0.001) and HR-/HER2- (83.70%, P<0.001). The 5-year OS of HR+/HER2- (95.38%) was not different from HR+/HER2+ (95.17%, P=0.187), while it was higher than that of HR-/HER2+ (92.26%, P<0.001) and HR-/HER2- (91.69%, P<0.001). Subtype was still a significant factor regarding DFS and OS in multivariable analyses adjusting for age, sex, stage, Ki67, types and time of surgery. The DFS ( P=0.257) and OS ( P=0.511) was not different between HR-/HER2+与HR+/HER2- subtypes, while HR-/HER2+ and HR-/HER2- patients had worse DFS ( P<0.05) and OS ( P<0.05) than that with HR+/HER2-. Conclusions:Molecular subtype is a significant independent prognostic factor for DFS and OS in operable invasive breast cancer. HR+ subtypes have better prognosis compared with HR- subtypes. The DFS and OS were not different between HR+/HER2- and HR+/HER2+, or between HR-/HER2+ and HR-/HER2-.

Pediatric acute lung injury(ALI)is a common disease in pediatric intensive care unit with a high fatality rate.Because the etiology of ALI is complex, the exact pathogenesis of ALI is not clear.At present, it is known that the important factors leading to the incidence of ALI in children are oxidative stress and dysregulation of inflammatory response.Progressive hypoxemia and respiratory distress are the main clinical manifestations of ALI.Respiratory support and drug control are the common treatment measures.In recent years, stem cell and molecular targeted therapy as new treatment pathways of ALI, have achieved certain achievements in the research, and are expected to become new treatment methods of ALI in chidren.

The patients with trauma have a high mortality and disability rate, and the incidence of trauma is increasing year by year.Rapid and accurate diagnosis is the key to improve the prognosis of patients with trauma.The traditional diagnostic imaging techniques are X-ray and CT examination.Although X-ray examination can be completed at the bedside, its sensitivity is not high.The diagnostic sensitivity of CT examination is high, but it can not be completed by bedside.Moreover, the process of repeated transportation of patients will delay the best treatment time, even cause secondary injury.Bedside ultrasound has the advantages of fast, real-time, noninvasive and repeatable operation.With the continuous development of bedside ultrasound technology, it has been widely used in the diagnosis of trauma.This review summarized the clinical applications of bedside ultrasound in trauma patients.

Severe viral pneumonia in children has become an urgent public health problem in view of its high morbidity and mortality.Neutralizing antibodies, as passive immune agents, can be injected into the body so that the body can quickly obtain immunity against specific viruses and have the potential to prevent and treat severe viral pneumonia in children.This review analyzed the possible mechanisms by which neutralizing antibodies play roles in severe viral pneumonia in children, discussed the shortcomings of existing research and possible challenges, and attempted to point out the direction worthy of future research.

Children′s unique physiological, developmental and psychological attributes make them one of the most vulnerable groups in large-scale flood disasters.Formulating a reasonable and feasible emergency preparedness plan for flood disasters can improve their ability to cope with flood disasters and optimize the outcomes of children suffering from flood disasters.The emergency preparedness plan for children′s flood disaster should cover the allocation and utilization of various resources during disasters, regional cooperative rescue and evacuation of children, ethical problems in treatment under special circumstances, psychological counseling of children, family members and medical personnel.Relevant staff of pediatric emergency rescue need to consider all aspects and make reasonable plans so that the rescue work of children affected by disasters can be carried out in an orderly manner.

Objective: To investigate the variability of the time and frequency of Moderate to Vigorous Physical Activity (MVPA) during the school days and weekends of junior high school students, and to explore the correlation between MVPA and physical fitness. Methods: A cluster sampling method was used to investigate 79 students of grade 1 and grade 2 in Beijing Huilongguan Middle School. Adapted one day physical activity recording tool was implemented to investigate students’ physical activity from 8:00 to 23:00 a week, activity records were classified into daily MVPA parts and non MVPA parts based on MET values. Physical activity time series for 5 consecutive days and 2 weekends, as well as MVPA total time and the lempel ziv complexity of the sequence was calculated. Investigated the correlation between the MVPA situation and the results of national students’ physical fitness standard test. Results: There was no statistical difference in MVPA time between males and females during school days( t =-0.90, P >0.05). Females had greater variability in MVPA than males(58.9%, 53.5%). There was also no statistical difference in MVPA complexity between genders( t =-0.55, P >0.05). During weekends, there was no significant difference in the total MVPA time between men and women( t =-0.13, P >0.05). The CV of male MVPA time was lower than that of female(141.5%, 152.8%). There was also no significant difference( t =-0.63, P >0.05), and male MVPA complex CV was slightly higher than that of female ( 55.1% , 48.1%). The MVPA time CV of adolescents during weekdays was slightly lower for males (weekdays vs weekends: 53.5%, 141.5%) than females(58.9%, 152.8%). The MVPA complexity in weekdays among males was moderately correlated with BMI( r =0.41), and the MVPA time and weight of females ( r =-0.30) and BMI ( r =-0.31) were low. The complexity was related to body weight ( r =-0.31) and BMI ( r =-0.33) to a low degree( P <0.05). Conclusion Junior middle school students are more active on school days than weekend, but the MVPA time series are limited. Schools can effectively improve physical fitness by spreading out the activity period of MVPA in one day. MVPA complexity, as a more comprehensive indicator, may be more sensitive to BMI of junior middle school students.

Vitamin D is a necessary fat-soluble vitamin in the body.It is found that not only does vitamin D deficiency associate with infant nutritional rickets, but it can also affect the functions of nervous, respiratory, immune, cardiovascular, endocrine, skin, kidney, and other function of systems.This paper made an overview of factors influencing infant vitamin D levels, including season of birth, sunshine time, eating habits, feeding patterns and prenatal vitamin D supplement dose.Among the above, as the vitamin D deficiency of infants and young children in plateau areas is quite special, thus it is emphasized in this review, in order for prevention and treatment of vitamin D deficiency.

Thrombotic microangiopathy(TMA) is a group of clinical and pathological syndromes, characterized mainly by hemolytic anemia, thrombocytopenia, and multiple organ dysfunctions caused by a variety of factors.Classic types of TMA include hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura(TTP). HUS is a critically ill glomerular disease.Depending on the pathogenesis, HUS is currently divided into 2 categories, namely typical and atypical HUS.Atypical HUS is at a rapid onset and is a type of dangerous disease, which tends to recur easily, and has high mortality in its acute phase.TTP is a rare but fatal entity of TMA.The pathophysiology of the disease is based on a severe functional deficiency of a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13(ADAMTS-13), the specific von Willebrand factor(VWF)-cleavage protease.This deficiency may be either acquired or congenital.The activity of plasma ADAMTS-13<10%is the only definitive method for diagnosing TTP.This article reports the recent advances on the diagnosis and treatment of severe TMA in children.