1.Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fifth Edition)updated for the Omicron variant
Rongmeng JIANG ; Zhengde XIE ; Yi JIANG ; Xiaoxia LU ; Runming JIN ; Yuejie ZHENG ; Yunxiao SHANG ; Baoping XU ; Zhisheng LIU ; Gen LU ; Jikui DENG ; Guanghua LIU ; Xiaochuan WANG ; Jianshe WANG ; Luzhao FENG ; Wei LIU ; Yi ZHENG ; Sainan SHU ; Min LU ; Wanjun LUO ; Miao LIU ; Yuxia CUI ; Leping YE ; Adong SHEN ; Gang LIU ; Liwei GAO ; Lijuan XIONG ; Yan BAI ; Likai LIN ; Zhuang WEI ; Fengxia XUE ; Tianyou WANG ; Dongchi ZHAO ; Zhengyan ZHAO ; Jianbo SHAO ; Wong Wing-kin GARY ; Yanxia HE ; Xingwang LI ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2023;38(1):20-30
China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.
2.Expert consensus on the diagnosis, treatment and prevention of monkeypox in children
Rongmeng JIANG ; Yuejie ZHENG ; Lei ZHOU ; Luzhao FENG ; Lin MA ; Baoping XU ; Hongmei XU ; Wei LIU ; Zhengde XIE ; Jikui DENG ; Lijuan XIONG ; Wanjun LUO ; Zhisheng LIU ; Sainan SHU ; Jianshe WANG ; Yi JIANG ; Yunxiao SHANG ; Miao LIU ; Liwei GAO ; Zhuang WEI ; Guanghua LIU ; Gang LIU ; Wei XIANG ; Yuxia CUI ; Gen LU ; Min LU ; Xiaoxia LU ; Runming JIN ; Yan BAI ; Leping YE ; Dongchi ZHAO ; Adong SHEN ; Xiang MA ; Qinghua LU ; Fengxia XUE ; Jianbo SHAO ; Tianyou WANG ; Zhengyan ZHAO ; Xingwang LI ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2022;37(13):964-973
Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.
3.Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fourth Edition)
Rongmeng JIANG ; Zhengde XIE ; Yi JIANG ; Xiaoxia LU ; Runming JIN ; Yuejie ZHENG ; Yunxiao SHANG ; Baoping XU ; Zhisheng LIU ; Gen LU ; Jikui DENG ; Guanghua LIU ; Xiaochuan WANG ; Jianshe WANG ; Luzhao FENG ; Wei LIU ; Yi ZHENG ; Sainan SHU ; Min LU ; Wanjun LUO ; Miao LIU ; Yuxia CUI ; Leping YE ; Adong SHEN ; Gang LIU ; Liwei GAO ; Lijuan XIONG ; Yan BAI ; Likai LIN ; Zhuang WEI ; Fengxia XUE ; Tianyou WANG ; Dongchi ZHAO ; Zhengyan ZHAO ; Jianbo SHAO ; Kwok-keung Daniel NG ; Wing-kin Gary WONG ; Xingwang LI ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2022;37(14):1053-1065
Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.
4.Diagnosis, treatment and prevention of 2019 novel coronavirus infection in children: experts′ consensus statement (Third Edition)
Rongmeng JIANG ; Zhengde XIE ; Yi JIANG ; Xiaoxia LU ; Runming JIN ; Yuejie ZHENG ; Baoping XU ; Zhisheng LIU ; Likai LIN ; Yunxiao SHANG ; Sainan SHU ; Yan BAI ; Min LU ; Gen LU ; Jikui DENG ; Wanjun LUO ; Lijuan XIONG ; Miao LIU ; Yuxia CUI ; Leping YE ; Liwei GAO ; Yongyan WANG ; Xuefeng WANG ; Jiafu LI ; Tianyou WANG ; Dongchi ZHAO ; Jianbo SHAO ; Xingwang LI ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2021;36(10):721-732
2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.
5.Experts′ consensus on severe acute respiratory syndrome coronavirus-2 vaccination of children
Yuejie ZHENG ; Xiaochuan WANG ; Luzhao FENG ; Zhengde XIE ; Yi JIANG ; Gen LU ; Xingwang LI ; Rongmeng JIANG ; Jikui DENG ; Miao LIU ; Baoping XU ; Zhuang WEI ; Gang LIU ; Xiaoxia LU ; Runming JIN ; Zhisheng LIU ; Yunxiao SHANG ; Sainan SHU ; Yan BAI ; Min LU ; Guanghua LIU ; Wanjun LUO ; Yuxia CUI ; Leping YE ; Likai LIN ; Dongchi ZHAO ; Adong SHEN ; Jianbo SHAO ; Lijuan XIONG ; Liwei GAO ; Tianyou WANG ; Zhengyan ZHAO ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2021;36(18):1361-1367
At present, severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still rampant worldwide.As of September 10, 2021, there were about 222 million confirmed cases of corona virus disease 2019(COVID-19)and more than 4.6 million deaths worldwide.With the development of COVID-19 vaccines and the gradual vaccination worldwide, the increasing number of cases in children and unvaccinated young people has drawn attention.According to World Health Organization surveillance data, the proportion of COVID-19 infection cases in children gradually increased, and the proportion of cases in the age groups of under 5 years and 5-14 years increased from 1.0% and 2.5% in January 2020 to 2.0% and 8.7% in July 2021, respectively.At present, billions of adults have been vaccinated with various COVID-19 vaccines worldwide, and their protective effects including reducing infection and transmission, reducing severe disease and hospitalization, and reducing death, as well as high safety have been confirmed.Canada, the United States, Europe and other countries have approved the emergency COVID-19 vaccination in children and adolescents aged 12 to 17 years, and China has also approved the phased vaccination of COVID-19 vaccination in children and adolescents aged 3 to 17 years. For smooth advancement and implementation of COVID-19 vaccination in children, academic institutions, including National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health, and The Society of Pediatrics, Chinese Medical Association organized relevant experts to reach this consensus on COVID-19 vaccination in children.
6.Twenty key issues on severe acute respiratory syndrome coronavirus-2 vaccination in children
Baoping XU ; Zhuang WEI ; Gen LU ; Yuejie ZHENG ; Xiaochuan WANG ; Luzhao FENG ; Zhengde XIE ; Gang LIU ; Yi JIANG ; Xingwang LI ; Rongmeng JIANG ; Jikui DENG ; Miao LIU ; Xiaoxia LU ; Runming JIN ; Zhisheng LIU ; Yunxiao SHANG ; Sainan SHU ; Yan BAI ; Min LU ; Guanghua LIU ; Wanjun LUO ; Yuxia CUI ; Leping YE ; Likai LIN ; Dongchi ZHAO ; Adong SHEN ; Jianbo SHAO ; Lijuan XIONG ; Liwei GAO ; Tianyou WANG ; Zhengyan ZHAO ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2021;36(18):1368-1372
Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still worldwide.As a vulnerable group, severe and dead pediatric cases are also reported.Under this severe epidemic situation, children should be well protected.With the widespread vaccination of SARS-CoV-2 vaccine in adults, the infection rate have decreased.Therefore, SARS-CoV-2 vaccine inoculation for children groups step by step is of great significance to the protection of children and the prevention and control of corona virus disease 2019(COVID-19) as a whole.But the safety of children vaccinated with SARS-CoV-2 vaccine is a main concern of parents.Therefore, in order to ensure the safety of vaccination and the implementation of vaccination work, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health and the Society of Pediatrics, Chinese Medical Association organized experts to interpret the main issue of parents about SARS-CoV-2 vaccine for children, in order to answer the doubts of parents.
7.Construction of evaluation index system for full-time scientific researchers in Level-three general hospital
Zhisheng CUI ; Jianyi NIU ; Limin TANG ; Jing LI ; Sheng GUO ; Xiaoyan XU
Chinese Journal of Medical Science Research Management 2020;33(6):410-414
Objective:To establish a set of comprehensive appraisal indicator system for the full-time scientific research personnel in Level-three general hospitals, improve the management of full-time scientific research personnel at hospital.Methods:Firstly, an initial indicator system was established by literature review and in-depth interviews with experts. Secondly, Delphi method was used to screen the indicators to confirm the indicator system. Finally, Analytic Hierarchy Process (AHP) was used to determine the weights of indicators at all levels, consistency tests were also conducted.Results:A set of comprehensive appraisal index system for full-time scientific research personnel in Level-three general hospitals was established, including four first-level indicators, which covered the comprehensive quality, scientific research capacity, scientific research performance and academic impact, as well as other 17 secondary indicators and 53 third-level indicators. Among these indicators, the scientific research performance has the largest weight value (0.5224), and according to the consistency test results, CR was less than 0.1. Besides, through the consistency test, the weight assignment is reasonable.Conclusions:The appraisal index system of full-time scientific research personnel in Level-three general hospitals is reliable. It can be used as a tool for evaluation of full-time scientific research personnel, which also provide reference for other hospitals to improve the management of full-time scientific research personnel.
8.Investigation on the status of monotherapy for newly diagnosed tic disorders and its comorbidity in children
Qing LU ; Yonghua CUI ; Zhisheng LIU ; Dan SUN ; Fang FANG ; Jing PENG ; Shuizhen ZHOU ; Jiaqin WANG ; Rong LUO ; Li JIANG ; Jiong QIN ; Yuwu JIANG ; Yi ZHENG
Chinese Journal of Pediatrics 2020;58(11):887-892
Objective:To investigate the status of monotherapy for newly diagnosed tic disorders and its comorbidity in children, so as to provide a reference for clinical medication.Methods:A questionnaire survey was conducted to collect the application experience of monotherapy for newly diagnosed tic disorders and comorbidities in 110 pediatric neurologists and psychiatrists from Chinese Tic Disorders Study Consortium from February to August in 2019. Doctors were asked to rate treatment options based on a rank 5-point scale with "1" least appropriate and "5" most appropriate. The drug evaluation index was based on the comparison of the median score of a single drug with the overall scores of all drugs in this disease ( M( Q1, Q3)), single drug M≥ overall Q3 was recommended as preferred drugs; overall Q1≤ single drug M< overall Q3 was considered as secondary drugs; single drug M< overall Q1 was considered as unsuitable drugs. Results:Among 110 electronic questionnaires, 94 (86%) were availably responded, responding doctors included 37 (39%) males and 57 (61%) females, the age of responding doctors was (48±10) years, and their working year was (17±10) years. In the investigation of the first and second monotherapy for newly diagnosed tic disorders in children without comorbidities, there were no preferred drugs for mild transient tic disorders. The scores of clonidine, aripiprazole and tiapride were 4 (3, 4), 4 (3, 4), 4 (4, 5) scores respectively, and were greater than overall scores (3 (2, 4) scores), so they could be recommended as the preferred drugs for moderate chronic tic disorders, the recommendation for initial mild Tourette syndrome (TS) treatment was the same as preferred drugs for moderate chronic tic disorders. Similarly, clonidine, aripiprazole, tiapride and haloperidol could be recommended as the preferred drugs for other kinds of tic disorders. As for the second monotherapy, the preferred drugs for moderate transient tic disorders, mild chronic tic disorders and severe TS were all aripiprazole, tiapride, haloperidol, sulpiride, clonidine and topiramate. While clonidine, aripiprazole, tiapride could be considered as preferred drugs for severe transient tic disorders, moderate to severe chronic tic disorders and mild to moderate tic disorders. In the investigation of monotherapy for newly diagnosed tic disorders in children with comorbidities, for moderate chronic tic disorders and TS comorbid with obsessive-compulsive disorder, aripiprazole (4 (3, 5) scores) and sertraline (4 (3, 4) scores) were preferred drugs,the median scores of which were all greater than overall scores (3 (3, 4) scores), they were also the preferred treatment for severe transient tic disorders and mild chronic tic disorders. For mild and moderate transient tic disorders, severe chronic tic disorders and TS comorbid with obsessive-compulsive disorder, aripiprazole, fluvoxamine, fluoxetine, haloperidol and sertraline were preferred drugs. When comorbid with attention deficit hyperactivity disorder (ADHD), severe transient tic disorders, moderate chronic tic disorders and TS, tomoxetine and clonidine were recommended as preferred drugs (both 4 (4, 5) scores), and tomoxetine and clonidine were also the preferred treatment for severe TS. For severe chronic tic disorders comorbid with ADHD, clonidine (5(4, 5) scores) was preferred drug, greater than overall scores (4 (3, 5) scores), while for mild and moderate transient tic disorders clonidine, tomoxetine, guanidine and methylphenidate were recommended as preferred drugs. For mild chronic tic disorders and TS comorbid with ADHD tomoxetine was preferred drug. When comorbid with sleep disorders, there were no preferred drugs for mild transient tic disorders; estazolam (3 (2, 3) scores) was the preferred drug for mild chronic tic disorders and TS comorbid with sleep disorders. For othe kind of tic disorders comorbid with sleep disorders, estazolam, melatonin and clonazepam were preferred drugs. When comorbid with anxiety and depressive disorders, for all kinds of tic disorders sertraline was recommended as preferred drugs, the median scores of sertraline were all (4 (3, 5) scores) in severe transient tic disorders, moderate to severe chronic tic disorders and moderate TS, and greater than overall scores (3 (3, 4) scores). While severe chronic tic disorders comorbid with anxiety and depressive disorders, fluvoxamine could also be chosen as preferred drugs.Conclusions:Drug therapy is not recommended for mild transient tic disorders, while tiapride, aripiprazole, clonidine, and haloperidol are mainly preferred drugs for the other kinds of tic disorders. Corresponding drugs should be selected when tic disorders are combined with obsessive-compulsive disorder, ADHD, sleep disorders, anxiety, depression, etc.
9.The construction and use of primary and secondary school clinics in China
LIU Meicen, CUI Zhisheng, LI Yicheng, HU Dan
Chinese Journal of School Health 2019;40(6):903-906
Objective:
To analyse the construction and use of primary and secondary school clinics in China, and to provide the reference for the construction and management of infrastructure of the clinics of primary and secondary schools.
Methods:
By using stratified cluster random sampling method, 873 primary and secondary schools were selected in east, middle and west of China as research objects to describe the construction and management of the clinics of primary and secondary schools. Regional differences were analyzed by statistical method.
Results:
Among the 873 schools investigated, 294 (33.7%) schools had clinics, 177 (20.3%) schools had healthcare rooms, and 402 (46.0%) schools had no clinics or healthcare rooms. Among the 294 clinics, only 56 (19.0%) schools had medical institution licenses; 73 (24.8%) schools had a construction area of ≥40 square meters; 135 (45.9%) schools had legal clinics, and 38 (12.9%) schools was a disinfection supply room, 2 (<0.01%) schools had a laboratory, 165 (56.1%) schools was not independent between the departments; the overall standard school clinics construction rate was less than 5%. There were differences in the construction of clinics and healthcare rooms in the east, middle and west parts of China (χ2=237.33, P<0.01). Equipment allocation of the country's primary and secondary schools’ clinics were uneven among regions. The normal allocation rates of thermometer, visual acuity chart and lever weight scale were 96.6%, 83.0% and 75.9%, respectively, and the allocation rate of ultraviolet lamp was 66.7%. Less than 50% syringes and high-pressure sterilizers could be used normally. The reasons for the failure to provide health services in clinics was the absence of equipment and space, which account for 43%.
Conclusion
The construction of school clinics and healthcare rooms in China is insufficient, and regional differences are obvious, especially in the west. It is necessary to strengthen regional construction, allocate and use the equipment reasonably.
10. A wave is a marker in demyelination subtype in children′s Guillain-Barré syndrome and it correlates with short-term prognosis
Ruidi SUN ; Xiaoli YU ; Lin CUI ; Xiaoqing LUO ; Hongmin ZHU ; Jun JIANG ; Zhisheng LIU
Chinese Journal of Applied Clinical Pediatrics 2019;34(24):1867-1870
Objective:
To explore the A wave value in neuroelectrophysiological subtype of Guillain-Barré syndrome(GBS)and the clinical severity and short-term prognosis of acute inflammatory demyelinating polyradiculoneuropathy(AIDP).
Methods:
From March 2014 to March 2017, a total of 56 children with GBS at Department of Neurology of Wuhan Children′s Hospital Affiliated to Tongji Medical College, Huazhong University of Science & Technology were enrolled.The patients were divided into AIDP subtype(40 cases) and axonal GBS subtype(16 cases) according to the results of electrophysiological examination.According to whether there was existence of A wave or not, the GBS children were divided into 2 groups.The first group was the A wave in GBS group(18 cases), and the second group was non-A wave in GBS group(38 cases). In order to explore classification value for GBS with A wave, clinical data including age, gender, history of prodromal infection, cranial nerve dysfunction, autonomic nerve involvement and conduction blocks were analyzed.To explore A wave value in clinical severity and short-term prognosis of AIDP, the age, gender, clinical severity, conduction blocks, short-term prognosis of the 2 groups were analyzed in A wave with AIDP (18 cases) and non-A wave with AIDP(22 cases).
Results:
Compared with non-A wave GBS patients, A wave GBS patients had more conduction blocks(10 cases


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