Purpose To investigate the diagnostic significance of modified lung ultrasound score(MPUS)for pediatric bacterial and viral pneumonia.Materials and Methods A total of 93 eligible children with suspected community-acquired pneumonia in Quanzhou Maternal and Child Care Hospital(Quanzhou Children’s Hospital)from December 2022 to June 2023 were elected as the study subjects.All these children received lung ultrasound and the MLUS was recorded according to the ultrasound manifestations of A line,B line and lung consolidation.According to the etiological results,the children were divided into a bacterial pneumonia group and a viral pneumonia group.According to disease severity,the children were divided into the mild group and the severe group.The MLUS was used to analyze the diagnostic significance of pediatric bacterial and viral pneumonia.Results The MLUS in the mild pneumonia group was 7(4,13)points and the MLUS in the severe pneumonia group was 20(14,30)points,and MLUS scores of pneumonia in the two groups were different(Z=-5.205,P<0.05).By drawing receiver operating characteristic curve,MLUS score of 14.5 was used as the cut-off point,the sensitivity for diagnosing severe pneumonia was 75.9%,the specificity was 82.8%.Area under the curve was 0.838.There was no significant differences in MLUS of 8.00(4.00,16.00)between the bacterial pneumonia group and 13.00(7.00,21.75)between the viral pneumonia group(Z=-1.981,P>0.05).The MLUS of 10.00(5.25,17.75)in the mild bacterial pneumonia group and 5.00(4.00,9.50)in the mild viral pneumonia group were significantly different(Z=-3.403,P<0.05).There was no significant differences in MLUS between the severe bacterial pneumonia group and the severe viral pneumonia group(t=0.017,P>0.05).In mild pneumonia,the cut-off value for the modified lung ultrasound score of 10.5 predicted moderate diagnostic efficacy of mild bacterial pneumonia,the area under the curve was 0.747,sensitivity was 50%and specificity was 87.5%.Large-area lung consolidation was more common in the bacterial pneumonia group than in the viral pneumonia group(χ2=8.360,P<0.05).Conclusion The modified lung ultrasound score can effectively evaluate the severity of pediatric bacterial pneumonia and viral pneumonia.For the identification of the two,MLUS may be a certain guiding significance.

Purpose To investigate the diagnostic significance of modified lung ultrasound score(MPUS)for pediatric bacterial and viral pneumonia.Materials and Methods A total of 93 eligible children with suspected community-acquired pneumonia in Quanzhou Maternal and Child Care Hospital(Quanzhou Children’s Hospital)from December 2022 to June 2023 were elected as the study subjects.All these children received lung ultrasound and the MLUS was recorded according to the ultrasound manifestations of A line,B line and lung consolidation.According to the etiological results,the children were divided into a bacterial pneumonia group and a viral pneumonia group.According to disease severity,the children were divided into the mild group and the severe group.The MLUS was used to analyze the diagnostic significance of pediatric bacterial and viral pneumonia.Results The MLUS in the mild pneumonia group was 7(4,13)points and the MLUS in the severe pneumonia group was 20(14,30)points,and MLUS scores of pneumonia in the two groups were different(Z=-5.205,P<0.05).By drawing receiver operating characteristic curve,MLUS score of 14.5 was used as the cut-off point,the sensitivity for diagnosing severe pneumonia was 75.9%,the specificity was 82.8%.Area under the curve was 0.838.There was no significant differences in MLUS of 8.00(4.00,16.00)between the bacterial pneumonia group and 13.00(7.00,21.75)between the viral pneumonia group(Z=-1.981,P>0.05).The MLUS of 10.00(5.25,17.75)in the mild bacterial pneumonia group and 5.00(4.00,9.50)in the mild viral pneumonia group were significantly different(Z=-3.403,P<0.05).There was no significant differences in MLUS between the severe bacterial pneumonia group and the severe viral pneumonia group(t=0.017,P>0.05).In mild pneumonia,the cut-off value for the modified lung ultrasound score of 10.5 predicted moderate diagnostic efficacy of mild bacterial pneumonia,the area under the curve was 0.747,sensitivity was 50%and specificity was 87.5%.Large-area lung consolidation was more common in the bacterial pneumonia group than in the viral pneumonia group(χ2=8.360,P<0.05).Conclusion The modified lung ultrasound score can effectively evaluate the severity of pediatric bacterial pneumonia and viral pneumonia.For the identification of the two,MLUS may be a certain guiding significance.

Objective:This study examines the application of echocardiography in the prenatal diagnosis of copy number variation (CNV) associated with fetal congenital heart disease (CHD).Methods:A retrospective analysis was conducted on 447 singleton pregnancies from Quanzhou Maternal and Child Care Hospital (Quanzhou Children's Hospital) from January 2019 to August 2022. These individuals underwent echocardiographic assessments suggestive of fetal CHD and subsequently received invasive prenatal diagnoses. Comprehensive karyotype analysis and chromosome microarray analysis (CMA) were performed for each case. The discrepancies in the chromosomal abnormality detection were analyzed between the results produced by CMA and karyotype analysis. Furthermore, differences in the detection of pathogenic copy number variation (pCNV) between the two methods in CHD cases with diverse cardiac phenotypes, including the presence or absence of extracardiac structural malformations, the type, and quantity of cardiac structural anomalies, were explored. Statistical analysis was conducted using the Chi-square test. Results:Compared with conventional karyotype analysis, CMA demonstrated a higher detection rate of fetal chromosomal abnormalities [10.5% (47/447) vs. 20.6% (92/447), χ 2=161.56, P<0.001]. In terms of distinct cardiac phenotypes, CHD cases with extracardiac structural anomalies displayed an escalated pCNV detection rate in comparison to isolated CHD cases [11.4% (45/394) vs. 32.1% (17/53), χ 2=16.68, P<0.001]. Within the cardiac structural anomaly subgroups, increased pCNV detection rates were observed in the septal defect subgroup, conotruncal malformation subgroup, and left ventricular malformation subgroup [18.4%(29/158), 25.9%(7/27), and 25.0%(7/28) vs. 7.6%(16/210); χ 2=9.15, 9.68, and 8.55, respectively, all P<0.05]. The CMA-identified pCNV correlated with CHD included 22q11.2 deletions/duplications in eight cases, 4p16.3 deletions in two cases, 11q23.3 microduplications in two cases, 1q21.1 microdeletions/microduplications in two cases, 4q28.3 microduplications in one case, and 10p15.3 microdeletions in one case. Conclusions:CMA technology exhibited an enhanced ability to detect pCNV in fetuses with CHD. Echocardiography can guide targeted CMA screening, thereby facilitating prenatal genetic assessment of CHD.

OBJECTIVE: To explore the diagnosis, treatment and genetic characteristics of a neonate with severe pulmonary hypertension and respiratory failure. METHODS: Perinatal history, clinical manifestations, laboratory finding and diagnosis and treatment data of the child were collected. Whole exome sequencing was carried out for the child, and Sanger sequencing was used to verify the candidate variants. RESULTS: The female neonate has developed progressive respiratory failure and refractory pulmonary hypertension shortly after birth. Conventional treatment such as mechanical ventilation, vasoactive drugs, and inhaled nitric oxide were ineffective. She has developed sustained pulmonary hypertension after weaning from extracorporeal membrane oxygenation therapy, and had died after the treatment had ceased. Whole exome sequencing revealed that she has harbored a heterozygous de novo variant of c.682_683insGCGGCGGC (p.G234Rfs*148) of the FOXF1 gene, which was predicted as pathogenic based on guidelines from the American College of Medical Genetics and Genomics (ACMG), with evidence items of PVS1_Strong+PM2_Supporting+PS2. Based on her clinical manifestations and result of genetic testing, the child was diagnosed with alveolar capillary dysplasia with misalignment of the pulmonary veins (ACD/MPV). CONCLUSION Discovery of the c.682_683insGCGGCGGC (p.G234 Rfs*148) variant of the FOXF1 gene has expanded the mutational spectrum of the FOXF1 gene, which has facilitated implementation of specific treatment and provided a basis for clinical diagnosis and genetic counseling.
Female ; Humans ; Child ; Infant, Newborn ; Pregnancy ; Persistent Fetal Circulation Syndrome/therapy* ; Hypertension, Pulmonary ; Pulmonary Veins ; Forkhead Transcription Factors/genetics*

Objective To investigate the correlation between neutrophil-lymphocyte ratio (NLR) and disease activity of systemic lupus erythematosus (SLE),and the changes of NLR in different organ involvement of SLE patients.Methods A total of 155 SLE patients and 135 healthy controls from the Rheumatology Department of Xiangya Hospital were enrolled in this study from 2010 to 2018.Patients with SLE were divided into lupus nephritis group (LN group) and non-lupus nephritis group (non-LN group),serositis group and non-serositis group,according to whether they had kidney involvement or serositis.According to the SLE disease activity index 2000(SLEDAI-2000),the patients were divided into mild to moderate disease activity group (SLEDAI score ＜ 15) and severe disease activity group (SLEDAI score≥ 15).The NLR values of the above groups were compared.Spearman's correlation analysis was used to analyze the correlation between NLR and SLE patients' laboratory indexes.Multiple linear regression model was used to analyze the relationship between NLR and SLE disease activity.Receiver operating characteristic curve (ROC) was used to evaluate the value of NLR in SLE diagnosis and activity assessment.Results (1)The NLR value of SLE patients was significantly higher than that of healthy control group,and the difference was statistically significant (P ＜ 0.01).(2)The NLR value of SLE patients in the LN group was higher than that in the non-LN group,and the NLR value of SLE patients with serositis was higher than that in the group without serositis,with statistically significant differences (both P ＜ 0.05).(3)The NLR value of SLE patients in the severe disease activity group was higher than that in the mild and moderate disease activity group,and the difference was statistically significant (P ＜ 0.01).(4)NLR of SLE patients was positively correlated with CRP (rs=0.188,P=0.019),SLEDAI score (rs=0.264,P=0.001),and negatively correlated with total serum protein (rs=-0.250,P=0.002) and serum albumin (rs=-0.329,P ＜ 0.001),respectively.(5) Multiple linear regression showed that NLR was independently associated with SLE disease activity (B=0.351,95％CI 0.012-0.690,t=2.047,P=0.042).(6) According to ROC curve,the optimal cut-off value of NLR for SLE diagnosis was 2.17 (sensitivity 60.0％,specificity 83.1％,AUC=0.744),and the best cut-off value for predicting the activity of severe disease activity in SLE patients was 3.28 (sensitivity 58.5％,specificity 78.1％,AUC=0.700).Conclusion NLR is closely related to renal involvement,serositis and disease activity in SLE patients,which indicates that NLR,as a new inflammatory indicator,is of great significance for the assessment of SLE disease activity and organ involvement.

Objective To explore the pulmonary ventilation characters of performing HP and L 1 anti-G maneuvers,to determine the flow requirement for oxygen system design,and to provide references to the pilot anti-G straining maneuver training and physiological requirements for oxygen system development.Methods Ten male subjects were trained on ground by HP and L-1 maneuvers and the pulmonary ventilation parameters were recorded as follows:respiratory frequency,expiratory volume,inspiratory volume,peak expiratory flow rate (PEFR),peak inspiratory flow rate (PIFR),and maximal voluntary ventilation (MVV).Results The respiratory frequency,expiratory volume,PEFR and MVV of performing HP maneuver were higher than those of performing L-1 maneuvers (P＜0.01).The differences of inspiratory volume and PIFR between performing L-1 and HP maneuver were not significantly (P ＞ 0.05).Without the oxygen-mask wearing,the PIFR of performing HP and L-1 maneuvers was (300.31 ± 72.08) L/min and (281.00 ± 86.56) L/min respectively.Conclusions The demands of performing HP and L-1 maneuvers to the peak flow of oxygen system are almost same because of the similar characters in inspiration period.The faster respiratory rate of performing HP maneuver indicates that the pilots should be guided to keep the right frequency during +Gz exposure.In order to completely meet the needs of respiratory demands of performing HP and L-1 maneuvers,the peak flow of oxygen system should be more than 300 L/min.The variation of pulmonary ventilation parameters when performing the maneuvers together with mask oxygen supply needs further investigation.

Objective To explore the pulmonary ventilation characters of performing HP and L 1 anti-G maneuvers,to determine the flow requirement for oxygen system design,and to provide references to the pilot anti-G straining maneuver training and physiological requirements for oxygen system development.Methods Ten male subjects were trained on ground by HP and L-1 maneuvers and the pulmonary ventilation parameters were recorded as follows:respiratory frequency,expiratory volume,inspiratory volume,peak expiratory flow rate (PEFR),peak inspiratory flow rate (PIFR),and maximal voluntary ventilation (MVV).Results The respiratory frequency,expiratory volume,PEFR and MVV of performing HP maneuver were higher than those of performing L-1 maneuvers (P＜0.01).The differences of inspiratory volume and PIFR between performing L-1 and HP maneuver were not significantly (P ＞ 0.05).Without the oxygen-mask wearing,the PIFR of performing HP and L-1 maneuvers was (300.31 ± 72.08) L/min and (281.00 ± 86.56) L/min respectively.Conclusions The demands of performing HP and L-1 maneuvers to the peak flow of oxygen system are almost same because of the similar characters in inspiration period.The faster respiratory rate of performing HP maneuver indicates that the pilots should be guided to keep the right frequency during +Gz exposure.In order to completely meet the needs of respiratory demands of performing HP and L-1 maneuvers,the peak flow of oxygen system should be more than 300 L/min.The variation of pulmonary ventilation parameters when performing the maneuvers together with mask oxygen supply needs further investigation.