Respiratory syncytial virus (RSV) is the most common respiratory pathogen in infants and young children, which can lead to severe pneumonia and even death. Early diagnosis and intervention are crucial for reducing complications and sequelae and improving prognosis. This study presents the complete diagonsis and treatment process of a typical severe RSV pneumonia patient. For high-risk children, the condition can progress rapidly after RSV infection, and may present with respiratory failure and multiple extrapulmonary complications, such as heart failure, liver and kidney function impairment, coagulation dysfunction. After active symptomatic and supportive treatment, the prognosis is generally good. RSV infection will not lead to long-lasting immunity, but as the child grows older and their immune function gradually improves, the condition of a secondary infection is generally relatively mild. Currently, there are no specific antiviral drugs or safe and effective vaccines for RSV. Long-acting monoclonal antibodies are one of the effective means to prevent RSV infection in infants and young children and have been approved for use in China.

Objective:To explore the effect of Simo decoction improving the low duodenal inflammation and protecting the du-odenal mucosal barrier in rats with functional dyspepsia(FD).Methods:Sixty SD rats were randomly divided into control group(10 rats)and model group(50 rats),and the modeling rats were prepared by multivariate intervention method.After successful modeling,the modeling rats were randomly divided into model group,Simo decoction high-dose,medium-dose,low-dose group and mosapride group,with 10 rats in each group.The high-dose,medium-dose,and low-dose groups of Simo decoction were ga-vage given 5.62 g/kg,2.81 g/kg,and 1.40 g/kg,respectively,and the mosapride group was gavage given 0.305 mg/kg of mosapride,and the control group and model group were gavage given the same amount of distilled water for 14 days.The body weight of rats was observed;gastric emptying rate and small bowel propulsion rate were measured;transmission electron microscopy was used to observe the morphology of duodenal epithelial cells;ELISA detected serum levels of IL-17A and IL-22;Western blot and immunohistochemis-try were used to detect the expressions of protease-activated receptor 2(PAR-2)and tight junction protein(ZO-1,claudin-1)in the duodenum.Results:Compared with the control group,the body weight,gastric emptying rate and small intestinal propulsion rate of the model group were significantly reduced(P<0.01),transmission electron microscopy showed widening of the duodenal epithelial cell space,serum IL-17A and IL-22 levels were significantly increased(P<0.01),the expression of PAR-2 in duodenal tissue was in-creased,and the expressions of ZO-1 and claudin-1 were downregulated(P<0.01).Compared with model group,the gastric emptying rate and small intestinal propulsion rate in Simo decoction high-dose,medium-dose and mosapride group were increased(P<0.05,P<0.01),the contents of IL-17A and IL-22 in serum decreased(P<0.05,P<0.01),and the expression of PAR-2 in duodenal tissues was down-regulated,the expressions of ZO-1 and claudin-1 was significantly increased(P<0.01).The low-dose group of Simo soup could improve weight loss(P<0.01),reduce IL-17A content and PAR-2 expression,and increase ZO-1 and claudin-1 expression(P<0.05,P<0.01),while the effect on other indexes was not obvious.Conclusion:Simo decoction may reduce low-grade duodenal in-flammation to repair the mucosal barrier by down-regulating the levels of IL-17A and IL-22 and the expression of PAR-2,and up-regu-lating the expression of ZO-1 and claudin-1,so as to exert the effect of FD treatment.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.

Objective To investigate the application of targeted next-generation sequencing test(tNGS)in detecting patho-gens and drug resistance genes in the diagnosis and treatment of Mycoplasma pneumoniae pneumonia(MPP)in chil-dren.Methods The clinical data of children diagnosed with MPP and hospitalized in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from July 2022 to December 2023 were analyzed.The differences of MP se-quence detected by tNGS in children of different gender,age,course,and clinical features were compared.The performance of tNGS in detecting macrolides resistance genes was assessed.The optimal prediction cut-off value of MP resistance gene was ex-plored by ROC.Results A total of 497 cases were included,including 257(51.7％)male and 240(48.3％)female.The age dis-tribution was from 3 months to 13 years old[(6.08±2.68)years old in average],and the average durations of fever and cough were(6.04±3.42)and(7.46±5.54)days,respectively.MP was detected in all patients by tNGS method.There was no signifi-cant difference in different gender or age groups.The MP sequence count in patients with positive nucleic acid was significantly higher than that in patients with negative nucleic acid.The MP sequence count in lower respiratory specimens was significantly higher than that in upper respiratory specimens.MP sequence count in severe cases was significantly higher than that in non-se-vere cases,but there was no significant difference between patients with or without pulmonary complications and refractory or non-refractory cases.The overall diagnostic sensitivity of tNGS for detecting MP drug-resistant genes was 92.8％,specificity was 27.8％,PPV was 48.3％,NPV was 84.2％,and the mutation site was 23S rRNA:A2063G.The ratio of MP pathogenic se-quence to drug-resistant gene sequence was 6.83,which was the best cut-off value for predicting drug resistance.The negative predictive value was higher when the MP pathogenic sequence ratio was greater than 6.83.Conclusion tNGS has the value in early diagnosis of MPP.The MP sequence counts may have a guiding value in predicting disease severity.The negative predictive value is higher in drug-resistant gene detection.

Objective:To explore the effect of Simo decoction improving the low duodenal inflammation and protecting the du-odenal mucosal barrier in rats with functional dyspepsia(FD).Methods:Sixty SD rats were randomly divided into control group(10 rats)and model group(50 rats),and the modeling rats were prepared by multivariate intervention method.After successful modeling,the modeling rats were randomly divided into model group,Simo decoction high-dose,medium-dose,low-dose group and mosapride group,with 10 rats in each group.The high-dose,medium-dose,and low-dose groups of Simo decoction were ga-vage given 5.62 g/kg,2.81 g/kg,and 1.40 g/kg,respectively,and the mosapride group was gavage given 0.305 mg/kg of mosapride,and the control group and model group were gavage given the same amount of distilled water for 14 days.The body weight of rats was observed;gastric emptying rate and small bowel propulsion rate were measured;transmission electron microscopy was used to observe the morphology of duodenal epithelial cells;ELISA detected serum levels of IL-17A and IL-22;Western blot and immunohistochemis-try were used to detect the expressions of protease-activated receptor 2(PAR-2)and tight junction protein(ZO-1,claudin-1)in the duodenum.Results:Compared with the control group,the body weight,gastric emptying rate and small intestinal propulsion rate of the model group were significantly reduced(P<0.01),transmission electron microscopy showed widening of the duodenal epithelial cell space,serum IL-17A and IL-22 levels were significantly increased(P<0.01),the expression of PAR-2 in duodenal tissue was in-creased,and the expressions of ZO-1 and claudin-1 were downregulated(P<0.01).Compared with model group,the gastric emptying rate and small intestinal propulsion rate in Simo decoction high-dose,medium-dose and mosapride group were increased(P<0.05,P<0.01),the contents of IL-17A and IL-22 in serum decreased(P<0.05,P<0.01),and the expression of PAR-2 in duodenal tissues was down-regulated,the expressions of ZO-1 and claudin-1 was significantly increased(P<0.01).The low-dose group of Simo soup could improve weight loss(P<0.01),reduce IL-17A content and PAR-2 expression,and increase ZO-1 and claudin-1 expression(P<0.05,P<0.01),while the effect on other indexes was not obvious.Conclusion:Simo decoction may reduce low-grade duodenal in-flammation to repair the mucosal barrier by down-regulating the levels of IL-17A and IL-22 and the expression of PAR-2,and up-regu-lating the expression of ZO-1 and claudin-1,so as to exert the effect of FD treatment.

Respiratory syncytial virus (RSV) is the most common respiratory pathogen in infants and young children, which can lead to severe pneumonia and even death. Early diagnosis and intervention are crucial for reducing complications and sequelae and improving prognosis. This study presents the complete diagonsis and treatment process of a typical severe RSV pneumonia patient. For high-risk children, the condition can progress rapidly after RSV infection, and may present with respiratory failure and multiple extrapulmonary complications, such as heart failure, liver and kidney function impairment, coagulation dysfunction. After active symptomatic and supportive treatment, the prognosis is generally good. RSV infection will not lead to long-lasting immunity, but as the child grows older and their immune function gradually improves, the condition of a secondary infection is generally relatively mild. Currently, there are no specific antiviral drugs or safe and effective vaccines for RSV. Long-acting monoclonal antibodies are one of the effective means to prevent RSV infection in infants and young children and have been approved for use in China.

Objective To investigate the application of targeted next-generation sequencing test(tNGS)in detecting patho-gens and drug resistance genes in the diagnosis and treatment of Mycoplasma pneumoniae pneumonia(MPP)in chil-dren.Methods The clinical data of children diagnosed with MPP and hospitalized in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from July 2022 to December 2023 were analyzed.The differences of MP se-quence detected by tNGS in children of different gender,age,course,and clinical features were compared.The performance of tNGS in detecting macrolides resistance genes was assessed.The optimal prediction cut-off value of MP resistance gene was ex-plored by ROC.Results A total of 497 cases were included,including 257(51.7％)male and 240(48.3％)female.The age dis-tribution was from 3 months to 13 years old[(6.08±2.68)years old in average],and the average durations of fever and cough were(6.04±3.42)and(7.46±5.54)days,respectively.MP was detected in all patients by tNGS method.There was no signifi-cant difference in different gender or age groups.The MP sequence count in patients with positive nucleic acid was significantly higher than that in patients with negative nucleic acid.The MP sequence count in lower respiratory specimens was significantly higher than that in upper respiratory specimens.MP sequence count in severe cases was significantly higher than that in non-se-vere cases,but there was no significant difference between patients with or without pulmonary complications and refractory or non-refractory cases.The overall diagnostic sensitivity of tNGS for detecting MP drug-resistant genes was 92.8％,specificity was 27.8％,PPV was 48.3％,NPV was 84.2％,and the mutation site was 23S rRNA:A2063G.The ratio of MP pathogenic se-quence to drug-resistant gene sequence was 6.83,which was the best cut-off value for predicting drug resistance.The negative predictive value was higher when the MP pathogenic sequence ratio was greater than 6.83.Conclusion tNGS has the value in early diagnosis of MPP.The MP sequence counts may have a guiding value in predicting disease severity.The negative predictive value is higher in drug-resistant gene detection.

Inflammatory bowel disease (IBD) is a chronic, nonspecific inflammatory disease of the digestive tract with unknown etiology, complicated pathogenesis and diverse clinical manifestations.Biologic therapies, particularly anti-tumor necrosis factor-α antibodies, have fundamentally changed the treatment and course of IBD in children.In recent years, more biologics have been applied to pediatric IBD.This review summarizes the application of different biologics in pediatric IBD and elaborates on the latest research progress in their mechanism of action, efficacy, safety, clinical conversion and combined application, so as to improve the optimal treatment of IBD by pediatricians.