[Clinical characteristics and prognosis in 12 children with SARS-CoV-2 Omicron variant infection-associated acute necrotizing encephalopathy]. / 12ä¾‹æ–°åž‹å† çŠ¶ç— æ¯’Omicronå˜å¼‚æ ªæ„ŸæŸ“ç›¸å ³æ€¥æ€§åæ­»æ€§è„‘ç— å„¿ç«¥çš„ä¸´åºŠç‰¹ç‚¹åŠé¢„åŽåˆ†æž.

OBJECTIVES: To study the clinical characteristics and prognosis of SARS-CoV-2 Omicron variant infection-associated acute necrotizing encephalopathy (ANE) in children. METHODS: A retrospective analysis was conducted on the medical data of 12 children with SARS-CoV-2 Omicron variant infection-associated ANE who were admitted to the Pediatric Intensive Care Unit, Qingdao Women and Children's Hospital from December 18 to 29, 2022. The children were divided into two groups based on outcomes: death group (7 cases) and survival group (5 cases). The clinical manifestations and auxiliary examination results were compared between the two groups. RESULTS: The median age of the 12 patients was 30 months, with a male-to-female ratio of 1:1. All patients presented with persistent high fever, with a median highest body temperature of 41℃. The median time from fever onset to seizure or consciousness disturbance was 18 hours. The death group had a higher proportion of neurogenic shock, coagulation dysfunction, as well as elevated lactate, D-dimer, interleukin-6, interleukin--8, and interleukin-10 levels compared to the survival group (P<0.05). CONCLUSIONS: Children with SARS-CoV-2 Omicron variant infection-associated with ANE commonly present with persistent high fever, rapidly progressing disease, and have a high likelihood of developing consciousness disorders and multiorgan dysfunction within a short period. The occurrence of neurogenic shock, coagulation dysfunction, and significantly elevated cytokine levels suggests an increased risk of mortality.

Alterations of intestinal flora and the effects of probiotics in children with recurrent respiratory tract infection.

BACKGROUND: Recurrent respiratory tract infection (RRTI) is a disease occurred frequently in preschool children. METHODS: A total of 120 RRTI children were randomly divided into active group, remission group, intervention group and control group, meanwhile 30 healthy children were selected as the healthy group. Children in the intervention group were given oral Bifidobaeterium tetravaccine tablets (Live) for 2 months, while the control group received routine treatment. Stool sample were detected to analyze the bacterial strains. The occurrence of respiratory tract infection (RTI) was compared between different groups during 1 year follow-up. RESULTS: Compared with the healthy group, the number of Bifidobacteria and Lactobacilli in the active group, remission group, intervention group and control group was significantly decreased (P < 0.05). The number of Bifidobacteria and Lactobacilli in the intervention group was significantly higher compared to other RRTI groups (P < 0.05). During the follow-up period, the average annual frequency of different acute RTI and use of antibiotics were significantly reduced (P < 0.05), the average duration of cough, fever and use of antibiotics at each episode were also significantly shortened (P < 0.05) in the intervention group compared to the control group. CONCLUSIONS: Children with RRTI are susceptible to intestinal flora imbalance. Oral probiotics can effectively improve the RRTI intestinal microecological balance in children and reduce the frequency of RTI.

[Clinical features of children with Epstein-Barr virus-related acute liver failure: an analysis of four cases].

A retrospective analysis was performed for the clinical data of four children with Epstein-Barr virus (EBV)-related acute liver failure. There were two boys and two girls with a median age of 10 months (range 8.5-44 months). Of the four children, three were diagnosed with infectious mononucleosis (IM), among whom two met the diagnostic criteria of hemophagocytic lymphohistiocytosis (HLH), and one was diagnosed with past EBV infection. All the children had positive EBV DNA in blood and all had pyrexia, hepatomegaly, and jaundice on admission. Three children had the symptom of splenomegaly, ascites, or vomiting. Two children had enlargement of cervical lymph nodes, skin rash, or pleural effusion. One child had gastrointestinal bleeding or stage 2 hepatic encephalopathy. All the children had an abnormal lymphocyte count of <10%, and only one child had leukocytosis and thrombocytopenia. Among the four children, alanine aminotransferase level increased by 10-100 times; total bilirubin level increased by 3-5 times; lactate dehydrogenase level increased by many 10 times; prothrombin time prolonged significantly. All the children were given antiviral therapy with intravenously injected acyclovir or ganciclovir, as well as hepatocyte growth factor to promote hepatocyte growth and hormone to alleviate inflammatory response. Two children were given plasma exchange in addition, among whom one was given the combination of continuous venovenous hemodiafiltration. Two children with HLH were given chemotherapy according to the HLH-2004 regimen. Three children survived, and one child with HLH died of multiple organ failure. It is concluded that EBV infection can cause acute liver failure and that early use of multimodality therapy including blood purification may be beneficial for prognosis in these children.

[Association between S100B gene polymorphisms and hand, foot and mouth disease caused by enterovirus 71 infection].

OBJECTIVE: To investigate the association between rs9722 polymorphisms in the S100B gene and hand, foot and mouth disease (HFMD) caused by enterovirus 71. METHODS: A total of 124 HFMD children with enterovirus 71 infection were enrolled as subjects, and 56 healthy children were enrolled as control group. The rs9722 polymorphisms in the S100B gene were detected for both groups, and the serum level of S100B protein was measured for 74 HFMD children. RESULTS: The rs9722 locus of the S100B gene had three genotypes, CC, CT, and TT, and the genotype frequencies were in accordance with Hardy-Weinberg equilibrium. Compared with the control group, the HFMD group had significant increases in the frequencies of TT genotype and T allele (P<0.01). Children with severe HFMD caused by enterovirus 71 infection had significantly higher frequencies of TT genotype and T allele than those with moderate or mild HFMD (P<0.05). Compared with the cured patients, the patients with poor prognosis had significant increases in the frequencies of TT genotype and T allele in the rs9722 locus of the S100B gene (P<0.05). Among the 74 children with HFMD, the children with TT genotype had the highest serum level of S100B protein, and those with CC genotype had the lowest level (P<0.01). CONCLUSIONS: T allele in the rs9722 locus of the S100B gene might be a risk factor for severe HFMD caused by enterovirus 71 infection.

[Effect of milkvetch injection on immune function of children with tetralogy of Fallot after radical operation].

OBJECTIVE: To evaluate the effect of milkvetch injection (MI) on immune function of children with tetralogy of Fallot (TOF) after radical operation. METHODS: Forty-children with TOF were divided into two groups, the 20 in the control group treated with conventional treatment alone and the 20 in the treated group treated with conventional treatment plus 15 ml of MI every 12 hrs for 14 days. Changes of immunoglobulin, complements, lymphocyte phenotypes and cytokines were observed. RESULTS: In the treated group, the abnormally increased levels of IgG, IgM, C3, C4, CD8+ and CD19+ began to lower at lst-2nd week after treatment, and basically restored to the levels of normal at 3rd-4th week; while the decreased levels of IgA, CD3+, CD4+, CD4+/CD8+ ratio, CD3+/HLA-DR+ and CD3+/CD16+ -CD56+ raised gradually from the 1st week and restored to normal range at 2nd-3rd week. The IL-6 and tumor necrosis factor-alpha (TNF-alpha) levels in the plasma and supernatant, produced in vitro by peripheral blood mononuclear cells (PBMC) decreased gradually at 1st week and restored to the normal level at 3rd-4th weeks. The different value before and after treatment of the above-mentioned indexes in the treated group were superior to those in the control group (P<0.05 or P<0.01). CONCLUSION: MI could significantly improve the immune function of children with TOF after radical operation.

[Effect of Milkvetch Injection on cardiac function and hemodynamics in children with tetralogy of Fallot after radical operation].

OBJECTIVE: To evaluate the effect of Milkvetch Injection (MI) on cardiac function and hemodynamics in children with tetralogy of Fallot after radical operation. METHODS: Thirty-two children with tetralogy of Fallot were divided into two groups, the 20 patients in the control group treated with conventional treatment and the 12 patients in the treated group treated with 15 ml of MI every 12 hrs for 7 days. The cardiac function and hemodynamic parameters were determined by echocardiography and thermodilution catheter inserted in pulmonary artery. RESULTS: Patients' cardiac function and hemodynamic parameters were improved significantly 1 hr after administering 15 ml of MI Injection, but restored to the level before medication in 2-4 hrs. Administering MI injection for successive 7 days could gradually improve patients' cardiac function and hemodynamic parameters after operation, and the improvement became more evident with the prolonging time of medication. The intubation time, intensive care unit duration and the time of intravenously administration of inotropic drugs in the treated group were significantly shorter than those in the control group (P < 0.01). CONCLUSION: MI could significantly improve the hemodynamics and cardiac function, and shorten the recovery time in children with tetralogy of Fallot after radical operation.

Effects of astragaloside IV on myocardial calcium transport and cardiac function in ischemic rats.

AIM: To explore the effects of astragaloside IV (XGA) on myocardial calcium transport and cardiac function in ischemic rats. METHODS: Eighty-four Wistar rats were divided into three groups: control group (n=12); ischemic group (n=12) was given isoprenaline injection sc at a dose of 30 mg/kg; and XGA group (n=60) was given XGA after isoprenaline administration. The changes of the parameters of hemodynamics, cardiac function, and intra- and extracellular calcium concentration of the myocardial cells were determined. The dose- and time-effect relationship of XGA on myocardial calcium transport and cardiac function were observed. RESULTS: After XGA administration, there was significant improvement in cardiac function and hemodynamics in ischemic rats. The cardiac output, heart rate, stroke volume, mean aortic pressure, systolic aortic pressure, the stroke work of left ventricule, the right and left ventricle systolic pressure, and +dp/dt of the right ventricle of ischemic rats gradually recovered to the level of the control group with increasing the dose of XGA and prolongation of the action of XGA. The ionized calcium of the myocardium and the total amount of calcium of the myocardial tissue decreased markedly compared to those in ischemic group, and the activity of calcium pump of erythrocyte membrane increased significantly in comparison to that of ischemic group, but their changes had no trend of increase with increasing dose of the XGA. However, there was a gradual decrease of the ionized calcium of the myocardium with the prolongation of acting time of XGA. CONCLUSION: XGA improves the cardiac function in ischemic rats, and the reduction of excessive accumulation of intracellular calcium within myocardial cells plays an important role.