AIM:To compare the consistency of two autorefractors(Tianle RM-9000 and Topcon KR-800)for school-age myopia children,and to provide a basis for largescale data analysis and comparison.METHODS:The refractive error in 9...AIM:To compare the consistency of two autorefractors(Tianle RM-9000 and Topcon KR-800)for school-age myopia children,and to provide a basis for largescale data analysis and comparison.METHODS:The refractive error in 909 subjects(age 4–18y)were measured using both autorefractors without cycloplegia.The data were analyzed using Fourier decomposition and the correlation coefficients,intraclass correlation coefficients(ICC),and Bland-Altman limits of agreement(LoA)for each parameter were calculated.RESULTS:There was a strong correlation between the spherical equivalent(SE),sphere diopter(DS),and cylinder diopter(DC)readings of the Tianle RM-9000 and those of the Topcon KR-800,with correlation coefficient values of 0.98,0.98 and 0.83 and ICC values of 0.99,0.99 and 0.93,respectively.However,the correlation coefficients and ICC values of J0 and J45 were unreliable(R=-0.004,-0.034;both ICC<0.10).Bland-Altman analysis revealed that SE,DS,and DC measured by the Tianle RM-9000 were significantly biased toward myopia compared with the Topcon KR-800,and the mean differences were-0.072,-0.026,-0.091 D,respectively(all P<0.01).The minimum absolute value of the difference within the 95%LoA for SE,DS,and DC was 0.63 D,0.50 D,0.62 D,respectively;all these values were in the clinically acceptable range.For J0 and J45,the mean differences were close to zero(P=0.43,0.84);however,the 95%LoA were relatively wide(J0 SD:0.53;95%CI:-1.00,1.10;J45 SD:0.52;95%CI:-1.00,1.00).CONCLUSION:The two autorefractors are consistent with each other,as the differences in SE,DS,and DC were within the clinically acceptable range.Readers can compare the data measured by either device in different studies and use the two devices in the same study to generate a dataset that can be analyzed together.However,the J0 and J45 vectors are unreliable and should not be used to assess astigmatism.展开更多
BACKGROUND The detection rate of peptic ulcer in children is improving,with development of diagnostic procedures.Gastroscopy is the gold standard for the diagnosis of peptic ulcer,but it is an invasive procedure.Gastr...BACKGROUND The detection rate of peptic ulcer in children is improving,with development of diagnostic procedures.Gastroscopy is the gold standard for the diagnosis of peptic ulcer,but it is an invasive procedure.Gastrointestinal contrast-enhanced ultrasonography(CEUS)has the advantages of being painless,noninvasive,nonradioactive,easy to use,and safe.AIM To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children.METHODS We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022.All children were examined by routine ultrasound,gastrointestinal CEUS,and gastroscopy.The pathological results of gastroscopy were taken as the gold standard.Routine ultrasonography was performed before gastrointestinal CEUS.Conventional ultrasound showed the thickness of the gastroduodenal wall,gastric peristalsis,and the adjacent organs and tissues around the abdominal cavity.Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall;the size,location and shape of the ulcer;gastric peristalsis;and adjacent organs and tissues around the abdominal cavity.The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS.All children received informed consent from their guardians for CEUS.This study was reviewed and approved by the hospital medical ethics committee.RESULTS Among the 43 children,17(15 male,2 female)were diagnosed with peptic ulcer by gastroscopy.There were 26 children with nonpeptic ulcer.There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound.The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1%(34/43),which was significantly different from that of gastroscopy(P=0.033).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low.Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS.The diagnostic coincidence rate of peptic ulcer in children was 95.3%(41/43).There was no significant difference between CEUS and gastroscopy(P=0.655).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high.CONCLUSION Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children,and can be used as a preliminary examination method.展开更多
Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Metho...Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.展开更多
Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target ...Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target population, which are school-age children. The objective was to determine the prevalence and the risk factors associated with geo-helminthiasis in children aged 0 to 3 years in a rural health district. Method: From December 2020 to May 2021, a descriptive and analytical cross-sectional study of 376 children between 6 and 36 months was carried out in the Akonolinga health district. This was a cluster sampling in 4 health areas. Stool samples were collected and analysed using the mini-FLOTAC method. The results expressed as the number of eggs per gram of stool. A questionnaire on socio-demographic and lifestyle data was administered to the parents. The Chi-squared test was used to measure the association between geo-helminth infection and the data collected. A multivariate analysis using logistic regression was performed (p 0.05). Results: The prevalence of STH was 19.4% (Ascaris lumbricoides: 16% and Trichuris trichiura: 8%). Risk factors were: consumption of contaminated water (AOR = 1.93 [1.03 - 3.6];p = 0.040), early contact of the child with the ground (before age of 4 months) (AOR = 4.9 [2.1 - 11.37];p .001), habit of walking barefoot (AOR = 2.91 [1.1 - 7.97];p = 0.038), and living in a habitat with unpaved ground (AOR = 7.4 [1.55 - 35.7];p = 0.012). Conclusion: The prevalence of STHs in infants was high. Preventive chemotherapy should be extended to this age-group, and other measures intensified.展开更多
Objective Hypertriglyceridemic waist(HW),hypertriglyceridemic waist-to-height ratio(HWHtR),and waist-to-hip ratio(WHR)have been shown to be indicators of cardiometabolic risk factors.However,it is not clear which indi...Objective Hypertriglyceridemic waist(HW),hypertriglyceridemic waist-to-height ratio(HWHtR),and waist-to-hip ratio(WHR)have been shown to be indicators of cardiometabolic risk factors.However,it is not clear which indicator is more suitable for children and adolescents.We aimed to investigate the relationship between HW,HWHtR,WHR,and cardiovascular risk factors clustering to determine the best screening tools for cardiometabolic risk in children and adolescents.Methods This was a national cross-sectional study.Anthropometric and biochemical variables were assessed in approximately 70,000 participants aged 6–18 years from seven provinces in China.Demographics,physical activity,dietary intake,and family history of chronic diseases were obtained through questionnaires.ANOVA,χ2 and logistic regression analysis was conducted.Results A significant sex difference was observed for HWHtR and WHR,but not for HW phenotype.The risk of cardiometabolic health risk factor clustering with HW phenotype or the HWHtR phenotype was significantly higher than that with the non-HW or non-HWHtR phenotypes among children and adolescents(HW:OR=12.22,95%CI:9.54-15.67;HWHtR:OR=9.70,95%CI:6.93-13.58).Compared with the HW and HWHtR phenotypes,the association between risk of cardiometabolic health risk factors(CHRF)clustering and high WHR was much weaker and not significant(WHR:OR=1.14,95%CI:0.97-1.34).Conclusion Compared with HWHtR and WHR,the HW phenotype is a more convenient indicator with higher applicability to screen children and adolescents for cardiovascular risk factors.展开更多
BACKGROUND Meckel’s diverticulum is a common congenital malformation of the small intestine,with the three most common complications being obstruction,per-foration,and inflammation.To date,only a few cases have been ...BACKGROUND Meckel’s diverticulum is a common congenital malformation of the small intestine,with the three most common complications being obstruction,per-foration,and inflammation.To date,only a few cases have been reported world-wide.In children,the clinical symptoms are similar to appendicitis.As most of the imaging features are nonspecific,the preoperative diagnosis is not precise.In addition,the clinical characteristics are highly similar to pediatric acute appendicitis,thus special attention is necessary to distinguish Meckel’s diver-ticulum from pediatric appendicitis.Patients with poor disease control should undergo laparoscopic exploration to avoid serious complications,including intestinal necrosis,intestinal perforation and gastrointestinal bleeding.CASE SUMMARY This report presents three cases of appendicitis in children combined with intestinal obstruction,which was caused by fibrous bands(ligaments)arising from the top part of Meckel's diverticulum,diverticular perforation,and diver-ticular inflammation.All three patients,aged 11-12 years,had acute appendicitis as their initial clinical presentation.All were treated by laparoscopic surgery with a favorable outcome.A complete dataset including clinical presentation,dia-gnostic imaging,surgical information,and histopathologic findings was also provided.CONCLUSION Preoperative diagnosis of Meckel’s diverticulum and its complications is challenging because its clinical signs and complications are similar to those of appendicitis in children.Laparoscopy combined with laparotomy is useful for diagnosis and treatment.展开更多
Background: This study investigated serum Glucose transporter (GLUT) 4 levels and examined the relationship between serum GLUT4 levels and sepsis in critically ill children. Methods: This was a retrospective study of ...Background: This study investigated serum Glucose transporter (GLUT) 4 levels and examined the relationship between serum GLUT4 levels and sepsis in critically ill children. Methods: This was a retrospective study of 77 critically ill children and 33 non-diabetic healthy children (controls) who were admitted between 07/2015 and 05/2016. Patient data, clinical information, and blood samples were collected on admission, alongside a large number of laboratory parameters that were routinely assessed. Critically ill patients were divided into sepsis and non-sepsis/systemic inflammatory response syndrome (SIRS). Serum GLUT4 was measured using western blotting and enzyme-linked immunosorbent assays. Insulin resistance indexes, clinical data, laboratory parameters, and inflammatory cytokines were assessed. Results: GLUT4 serum levels were higher in critically ill children than in healthy children (90.5 vs. 30.3 μg/L, P 0.05). Compared to healthy children, hyperglycemic patients (n = 48) had elevated GLUT4 serum levels (30.3 vs. 103.7 g/L, P Conclusions: GLUT4 serum levels might be significantly increased in critically ill children compared with healthy children, particularly those in septic shock. Serum GLUT4 could predict disease severity.展开更多
Background: Guangzhou Women and Children’s Medical Center was chosen as the designated facility for screening, diagnosing, and treating children in Guangzhou with SARS-CoV-2 infection after the COVID-19 outbreak in C...Background: Guangzhou Women and Children’s Medical Center was chosen as the designated facility for screening, diagnosing, and treating children in Guangzhou with SARS-CoV-2 infection after the COVID-19 outbreak in China. From January 23 to March 20, 2020, the center opened new wards for screening and treatment, taking measures to prevent and control nosocomial infections. This article summarizes and evaluates measures for preventing and controlling nosocomial infections to provide reference information during the pandemic. Methods: The COVID-19 nosocomial infection prevention and control strategies were summarized and analyzed, including the formulation of the hospital partition, the improvement of the hospitalization process, environmental cleaning and disinfection, graded protection based on risk assessment, enhanced training on-site quality control inspection, data monitoring and evaluation, among others, and evaluating the effects by comparing before and after the intervention. Results: There were 159 patients admitted to the screening wards, including 98 males and 61 females, with a median age of 34 years (interquartile range (IQR): 15, 60) months. There were no abnormal findings in these patients and their families during follow-up. During the screening ward opening period, hand hygiene compliance was significantly improved. Fifty staff members in close contact with the contaminated area had tested for SARS-CoV-2 nucleic acid by polymerase chain reaction (PCR), which showed zero infections and no nosocomial infections occurred. Conclusions: For SARS-CoV-2 nosocomial infections, taking the “standard prevention & contact isolation & droplet isolation & air isolation” strategies can prevent patients and staff effectively.展开更多
1 Scope This standard specifies the evaluation indicators and methods for the growth level and nutritional status of children under 7 years of age.This standard is applicable to the group and individual evaluation of ...1 Scope This standard specifies the evaluation indicators and methods for the growth level and nutritional status of children under 7 years of age.This standard is applicable to the group and individual evaluation of the growth level and nutritional status of children under 7 years of age.展开更多
This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demogra...This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demographic and Health Surveys(DHS).Results from both fixed effects(FE)and instrumental variable(IV)estimates show that using non-solid cooking fuel significantly improves the nutrition outcomes of under-five children.Compared with their peers from households mainly using solid fuel,children from households mainly using non-solid fuel exhibit a lower probability of experiencing stunting(by 5.9 percentage points)and being underweight(by 1.2 percentage points).Our further investigation provides evidence for several underlying mechanisms,such as improved indoor air quality,induced reduction in children’s respiratory symptoms,benefits on maternal health,and reduction in maternal time spent on fuel collection or cooking.Heterogenous analyses suggest that the nutrition benefits of using non-solid cooking fuel are more prominent among boys,children above three years old,and those from households of lower socioeconomic status,rural areas,and Southeast Asia.展开更多
BACKGROUND Parents of children with disabilities often have difficulty understanding their child’s behavior and are unable to do it appropriately because they do not know what to do.The more we properly understand ch...BACKGROUND Parents of children with disabilities often have difficulty understanding their child’s behavior and are unable to do it appropriately because they do not know what to do.The more we properly understand children with disabilities,the more positive the importance of parent education becomes in various aspects.AIM To demonstrate the effectiveness of parent education for children with disabilities in various aspects and present it as evidence that can be used clinically.METHODS For a meta-analysis on the effectiveness of parent education for children with disabilities,literature was collected from 2002 to 2022 using PubMed,Embase,Web of Science,Directory of Open Access Journals,and Europe PMC.Search terms were“disabled children,”“disabled children,”“parent education,”“parent training,”and“parent coaching.”The final searched literature included a total of 11 articles.To calculate the effect size,the mean,standard deviation,and sample size of the experimental and control groups were analyzed,and a meta-analysis was performed using RevMan version 5.4.1.To analyze statistical heterogeneity,a chi-square test was performed to evaluate the significance of Q statistics to indicate statistical heterogeneity.RESULTS The final literature totaled 11 articles,and a total of 4 items were analyzed.There were 5 studies on parental depression,the heterogeneity was 98%,and the effect size for parental depression was 0.35[confidence interval(CI:0.30-0.40)],indicating a small but statistically significant effect size.There were 4 studies on parenting attitude,the heterogeneity was 100%,the effect size on parenting attitude was 0.41(CI:0.37-0.46),which was a medium effect size,and the P value showed a statistically significant score.Additionally,face-to-face parent education was found to have a larger effect size than non-face-to-face education.Regarding parent education methods,face-to-face parent education had a medium effect size[0.57(CI:0.52-0.61)],while non-face-to-face parent education had a small effect size[0.23(CI:0.18-0.28)].CONCLUSION Parental education has shown high effectiveness in child development,and it has proven to be even more effective when face-to-face parenting education is conducted.Accordingly,more effective and objective data was presented.Based on this study,it is believed that parent education research applying various diagnostic groups should continue to be conducted.展开更多
Diarrhea is among the leading causes of morbidity and mortality in children aged Escherichia coli (DEC) accounts for 30% - 40% of childhood diarrhea cases. To identify the pathotypes involved in diarrheal outbreaks in...Diarrhea is among the leading causes of morbidity and mortality in children aged Escherichia coli (DEC) accounts for 30% - 40% of childhood diarrhea cases. To identify the pathotypes involved in diarrheal outbreaks in Kenya, we analyzed archived E. coli isolates from children E. coli confirmation and antimicrobial susceptibility testing were done using the VITEK<sup>®</sup>2 instrument. Pathotype identification was performed via conventional polymerase chain reaction. Of 175 E. coli isolates, 48 (27%) were DEC pathotypes, with enteroaggregative E. coli (EAEC) predominating (71%, 34/48). Enterohemorrhagic (EHEC) and enteropathogenic E. coli (EPEC) represented 19% and 10% of isolates, respectively. Enteroinvasive and enterotoxigenic pathotypes were not identified. All DEC isolates were susceptible to amikacin, ertapenem, imipenem, meropenem and tigecycline. Conversely, most (>80%) isolates were resistant to ampicillin, ampicillin-sulbactam and sulfamethoxazole-trimethoprim. Half of all EAEC and EPEC strains were resistant to cefazolin while half of EHEC isolates were resistant to ciprofloxacin and moxifloxacin. In total, 18 resistance phenotypes were identified with “ampicillin-cefazolin-ampicillin/ sulbactam-sulfamethoxazole/trimethoprim” predominating (33%, 16/48). The majority (81%) of DEC isolates were multidrug-resistant, with extended-spectrum beta-lactamase production identified in 8% of these isolates. This study highlights the predominance of Enteroaggregative E. coli and multidrug resistance of DEC pathotypes. Studying the epidemiology of diarrheal disease and antimicrobial resistance surveillance, will aid in identifying dominant etiological agents of diarrhea and newly emerging resistant strains in informal settlements.展开更多
The test floor effects seen in standardised tests lead to a standardised score of 1 or less with a flat profile that hides a child’s individual strengths and needs. The Griffiths III community of practitioners reques...The test floor effects seen in standardised tests lead to a standardised score of 1 or less with a flat profile that hides a child’s individual strengths and needs. The Griffiths III community of practitioners requested advice on the reporting of children’s development below the floor of the test, so that individual strengths and needs can be described. This paper reports the third phase of research following an earlier Scoping Review and a wider literature review. To confirm quality control, Phase 3 was conducted in a retrospective manner using the same methodology as the earlier phases but in a reverse direction. Peer reviewer comments and key elements from the Scoping Review and keywords from the publications were tabulated. Data analysis included a change of perspective to that of the child and their individual rights with respect to the literature themes already described in Phase 2. These confirmed that there is little specific guidance in the literature, but that computational advances for homogeneous populations and especially disaggregated data offer some solutions. A greater balance between broad biopsychosocial models and standardised models of assessment should be sought by practitioners together with the use of disaggregated data to highlight issues that pertain to individual subsets of results. This will ensure that the child’s right for their individual strengths and needs to be described together with a plan for management, may be met.展开更多
Objective: The aim is to study the trends in ventricular septal defect (VSD) mortality in children in Kazakhstan.Methods: The retrospective study was done for the period 2011–2020. Descriptive and analytical methods ...Objective: The aim is to study the trends in ventricular septal defect (VSD) mortality in children in Kazakhstan.Methods: The retrospective study was done for the period 2011–2020. Descriptive and analytical methods of epidemiologywere applied. The universally acknowledged methodology used in sanitary statistics is used to calculatethe extensive, crude, and age-specific mortality rates. Results: Kazakhstan is thought to be seeing an increase inmortality from VSDs in children. As a result, this study for the years 2011 to 2020 was conducted to retrospectivelyassess data from the central registration of the Bureau of National Statistics that was available throughoutthe nation. Age-standardized mortality data were obtained and compared between age categories. It was shownthat 507 children died from this condition throughout the time period under study. The average annual standardizedmortality rate was 1.88 per 100,000 population and tended to decrease over time. The peak of mortality wasnoted at the age of up to 1 year, namely the neonatal period. Cartogram mortality rates were calculated usingstandardized indicators. Additionally, age-sex variations were taken into account when performing all calculations.Conclusion: In recent years, the death rate from VSD has declined from 1.5 to 0.6 per 100,000 people, withthe trend remaining constant (T = 1.4%, R^(2) = 0.5825). The analysis of mortality trends related to VSD is crucial inboth theoretical and practical aspects, as it enables early detection and treatment of VSDs. The findings of thisstudy will be valuable to public health authorities in developing a strategy to treat VSDs effectively.展开更多
Education is a great cause to achieve national prosperity, national rejuvenation and people’s happiness, and an important way to block the intergenerational transmission of poverty. Rural revitalization, education fi...Education is a great cause to achieve national prosperity, national rejuvenation and people’s happiness, and an important way to block the intergenerational transmission of poverty. Rural revitalization, education first. Rural children’s education is an important issue of rural revitalization. This paper takes rural children, especially left behind children and children in distress as the help objects, and uses the advantages of “Internet plus” to improve the system, strengthen family education guidance, integrate social love resources, etc., to solve the problems faced by rural children, such as no guidance in learning, lack of guidance in behavior, lack of care in life, promote the overall healthy development of rural children, and solve the problem of rural education backwardness.展开更多
Background: Meningitis remains a leading cause of death among children below 5 years of age in the Democratic Republic of the Congo (DR Congo). Distinguishing children with bacterial meningitis from those with viral m...Background: Meningitis remains a leading cause of death among children below 5 years of age in the Democratic Republic of the Congo (DR Congo). Distinguishing children with bacterial meningitis from those with viral meningitis in the emergency department is sometimes difficult. Here we identified bacteria and virus in the cerebral spinal fluid (CSF) of children with meningitis. Material and Methods: This is a prospective, analytical study carried out in the Pediatrics department of Panzi Hospital in the South-Kivu province of DR Congo. Between April 2021 and March 2022, 150 of 251 collected CSF from children aged from 1 to 59 months hospitalised due to clinical meningitis at Panzi referral university hospital, Bukavu, Eastern DR Congo were sent to the Lancet laboratory for bacteria identification by a multiplex real-time PCR assay for detection of the most different viruses and bacterial species causing meningitis. Result: The used multiplex real-time PCR assay allowed us to identify germs in 24.7% of cases (37/150). We isolated bacteria in 25/37 (67.5%) cases, and viruses in 9/37 (24.3%) while virus and bacteria co-infection was detected in 3/37 (8.1%). The most frequently identified bacteria were Streptococcus pneumoniae 14/37 (37.8%) followed by Haemophilus influenzae 6/37 (16.2%). The main virus was cytomegalovirus 5/37 (3.5%). Despite the age, the most found bacterial are common in children from rural areas and unvaccinated children. Bacterial and virus co-infection were identified in 66.7% of children aged between 25 - 60 months, mainly among male children, and in all children from rural areas (100%). The overall case fatality rate was 30% and was very high among cases with co-infection CMV-Pneumococcal (66.7%), followed by Streptococcus pneumoniae (50%). Conclusion: Meningitis remains frequent among children aged from one to 59 months among Bukavu Infants. We noticed that, Children with co-infection with bacteria and viruses might need higher attention when having meningitis symptoms, as this could lead to fatal outcomes. The introduction of molecular techniques, such as multiplex real-time PCR, has the potential to improve diagnosis and patient outcomes.展开更多
Objective:To rapidly assess the effectiveness,safety,economy,and applicability of Shaoma Zhijing granule(SZG)for the treatment of children with tic disorders(TD),and provide currently available best evidence for decis...Objective:To rapidly assess the effectiveness,safety,economy,and applicability of Shaoma Zhijing granule(SZG)for the treatment of children with tic disorders(TD),and provide currently available best evidence for decision-makers of health policies.Methods:We conducted a rapid health technology assessment(RHTA)to explore the value of SZG.A systematic literature search in eight literature databases and on three clinical trial registration platforms was performed.The literature was screened according to eligibility criteria.The screening process and data extraction were conducted by two reviewers,and the quality of the literature was also assessed.The results were summarized,analyzed,and presented in tables or figures.Results:A total of five randomized controlled trials(RCTs)were included in this study,of which one was published in English(in the Journal of Child Psychology and Psychiatry)and four in Chinese journals.The overall risk of bias for the five RCTs was evaluated as“some concerns.”SZG monotherapy or in combi-nation with tiapride was better than tiapride alone in improving traditional Chinese medicine(TCM)syndromes and tic symptoms,with a daily cost of¥67.50e107.22.Adverse events were mainly related to the digestive,respiratory,and neurological systems,but all were mild.Conclusion:Overall,the current RHTA of published,peer-reviewed literature has located a small body of evidence evaluating the use of SZG for the treatment of TD in children.SZG has effects on improving TCM syndromes and tic symptoms;the daily cost is¥67.50e107.22;and all adverse events are mild.High-quality studies with long-term follow-up should be conducted,so as to provide local evidence and consistently guide and improve scientific decision-making.展开更多
Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assess...Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assessment needs to be performed whenever an indication for reoperation is suspected.The aim was to illuminate the experiences of parents of children diagnosed with RVOT anomalies,in particular,how they experience their child’s heart disease and everyday life during the assessment and after the decision on whether to perform a reoperation.Method:Individual interviews(n=27)were conducted with nine parents on three occasions between 2014 and 2016 and analyzed using reflexive thematic analysis.Results:The analysis resulted in the following five main coexisting themes:The heart surgery keeps my child alive illuminates parents’experiences during and after the assessment and emphasizes that heart surgery,although dreaded,is central for their child’s survival;Everyday struggles illuminates the different struggles parents had to face to ensure that their child would be in the best possible condition;the remaining three themes,Unconditional love,Trust in life,and Togetherness,illuminate the ways in which the parents gained inner strength and confidence in their everyday lives.Conclusion:Although the parents were grateful for the assessment and had learned to navigate among the fears it aroused,they experienced several distressing situations during the assessment process that should be addressed.By inviting both the parents and their child to participate in the child’s care,individualized support can take into account the needs of both parents and child.展开更多
Speech disorders are a common type of childhood disease.Through experimental intervention,this study aims to improve the vocabulary comprehension levels and language ability of children with speech disorders through t...Speech disorders are a common type of childhood disease.Through experimental intervention,this study aims to improve the vocabulary comprehension levels and language ability of children with speech disorders through the language cognition and emotional speech community method.We also conduct a statistical analysis of the inter-ventional effect.Among children with speech disorders in Dongguan City,224 were selected and grouped accord-ing to their receptive language ability and IQ.The 112 children in the experimental group(EG)received speech therapy with language cognitive and emotional speech community,while the 112 children in the control group(CG)only received conventional treatment.After six months of experimental intervention,the Peabody Picture Vocabulary Test-Revised(PPVT-R)was used to test the language ability of the two groups.Overall,we employed a quantitative approach to obtain numerical values,examine the variables identified,and test hypotheses.Further-more,we used descriptive statistics to explore the research questions related to the study and statistically describe the overall distribution of the demographic variables.The statistical t-test was used to analyze the data.The data shows that after intervention through language cognition and emotional speech community therapy,the PPVT-R score of the EG was significantly higher than that of the CG.Therefore,we conclude that there is a significant difference in language ability between the EG and CG after the therapy.Although both groups improved,the post-therapy language level of EG is significantly higher than that of CG.The total effective rate in EG is higher than CG,and the difference is statistically significant(p<0.05).Therefore,we conclude that the language cogni-tion and emotional speech community method is effective as an interventional treatment of children’s speech dis-orders and that it is more effective than traditional treatment methods.展开更多
基金Supported by the National Natural Science Foundation of China(No.81873683).
文摘AIM:To compare the consistency of two autorefractors(Tianle RM-9000 and Topcon KR-800)for school-age myopia children,and to provide a basis for largescale data analysis and comparison.METHODS:The refractive error in 909 subjects(age 4–18y)were measured using both autorefractors without cycloplegia.The data were analyzed using Fourier decomposition and the correlation coefficients,intraclass correlation coefficients(ICC),and Bland-Altman limits of agreement(LoA)for each parameter were calculated.RESULTS:There was a strong correlation between the spherical equivalent(SE),sphere diopter(DS),and cylinder diopter(DC)readings of the Tianle RM-9000 and those of the Topcon KR-800,with correlation coefficient values of 0.98,0.98 and 0.83 and ICC values of 0.99,0.99 and 0.93,respectively.However,the correlation coefficients and ICC values of J0 and J45 were unreliable(R=-0.004,-0.034;both ICC<0.10).Bland-Altman analysis revealed that SE,DS,and DC measured by the Tianle RM-9000 were significantly biased toward myopia compared with the Topcon KR-800,and the mean differences were-0.072,-0.026,-0.091 D,respectively(all P<0.01).The minimum absolute value of the difference within the 95%LoA for SE,DS,and DC was 0.63 D,0.50 D,0.62 D,respectively;all these values were in the clinically acceptable range.For J0 and J45,the mean differences were close to zero(P=0.43,0.84);however,the 95%LoA were relatively wide(J0 SD:0.53;95%CI:-1.00,1.10;J45 SD:0.52;95%CI:-1.00,1.00).CONCLUSION:The two autorefractors are consistent with each other,as the differences in SE,DS,and DC were within the clinically acceptable range.Readers can compare the data measured by either device in different studies and use the two devices in the same study to generate a dataset that can be analyzed together.However,the J0 and J45 vectors are unreliable and should not be used to assess astigmatism.
基金Supported by Scientific Research Fund of the Wenzhou Science and Technology Division,No.Y2020798 and No.Y2020805.
文摘BACKGROUND The detection rate of peptic ulcer in children is improving,with development of diagnostic procedures.Gastroscopy is the gold standard for the diagnosis of peptic ulcer,but it is an invasive procedure.Gastrointestinal contrast-enhanced ultrasonography(CEUS)has the advantages of being painless,noninvasive,nonradioactive,easy to use,and safe.AIM To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children.METHODS We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022.All children were examined by routine ultrasound,gastrointestinal CEUS,and gastroscopy.The pathological results of gastroscopy were taken as the gold standard.Routine ultrasonography was performed before gastrointestinal CEUS.Conventional ultrasound showed the thickness of the gastroduodenal wall,gastric peristalsis,and the adjacent organs and tissues around the abdominal cavity.Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall;the size,location and shape of the ulcer;gastric peristalsis;and adjacent organs and tissues around the abdominal cavity.The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS.All children received informed consent from their guardians for CEUS.This study was reviewed and approved by the hospital medical ethics committee.RESULTS Among the 43 children,17(15 male,2 female)were diagnosed with peptic ulcer by gastroscopy.There were 26 children with nonpeptic ulcer.There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound.The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1%(34/43),which was significantly different from that of gastroscopy(P=0.033).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low.Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS.The diagnostic coincidence rate of peptic ulcer in children was 95.3%(41/43).There was no significant difference between CEUS and gastroscopy(P=0.655).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high.CONCLUSION Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children,and can be used as a preliminary examination method.
基金supported by the Evidence-based Capacity Building Project of Traditional Chinese medicine of the National Administration of Traditional Chinese Medicine(60102)the Fundamental Research Funds for the Central Public Welfare Research Institutes(49425).
文摘Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.
文摘Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target population, which are school-age children. The objective was to determine the prevalence and the risk factors associated with geo-helminthiasis in children aged 0 to 3 years in a rural health district. Method: From December 2020 to May 2021, a descriptive and analytical cross-sectional study of 376 children between 6 and 36 months was carried out in the Akonolinga health district. This was a cluster sampling in 4 health areas. Stool samples were collected and analysed using the mini-FLOTAC method. The results expressed as the number of eggs per gram of stool. A questionnaire on socio-demographic and lifestyle data was administered to the parents. The Chi-squared test was used to measure the association between geo-helminth infection and the data collected. A multivariate analysis using logistic regression was performed (p 0.05). Results: The prevalence of STH was 19.4% (Ascaris lumbricoides: 16% and Trichuris trichiura: 8%). Risk factors were: consumption of contaminated water (AOR = 1.93 [1.03 - 3.6];p = 0.040), early contact of the child with the ground (before age of 4 months) (AOR = 4.9 [2.1 - 11.37];p .001), habit of walking barefoot (AOR = 2.91 [1.1 - 7.97];p = 0.038), and living in a habitat with unpaved ground (AOR = 7.4 [1.55 - 35.7];p = 0.012). Conclusion: The prevalence of STHs in infants was high. Preventive chemotherapy should be extended to this age-group, and other measures intensified.
基金supported by the National Natural Science Foundation of China[no.81903336,Yi-de Yang]the Health Research Project of Hunan Provincial Health Commission[no.202112031516,Yi-de Yang]+3 种基金Scientific Research Fund of Hunan Provincial Education Department[no.22B0038,Yi-de Yang]the Research Team for Reproduction Health and Translational Medicine of Hunan Normal University[2023JC101]Key Project of Developmental Biology and Breeding from Hunan Province[no.2022XKQ0205]Open Project for Postgraduates of Hunan Normal University[no.KF2022019,Tianli Xiao].
文摘Objective Hypertriglyceridemic waist(HW),hypertriglyceridemic waist-to-height ratio(HWHtR),and waist-to-hip ratio(WHR)have been shown to be indicators of cardiometabolic risk factors.However,it is not clear which indicator is more suitable for children and adolescents.We aimed to investigate the relationship between HW,HWHtR,WHR,and cardiovascular risk factors clustering to determine the best screening tools for cardiometabolic risk in children and adolescents.Methods This was a national cross-sectional study.Anthropometric and biochemical variables were assessed in approximately 70,000 participants aged 6–18 years from seven provinces in China.Demographics,physical activity,dietary intake,and family history of chronic diseases were obtained through questionnaires.ANOVA,χ2 and logistic regression analysis was conducted.Results A significant sex difference was observed for HWHtR and WHR,but not for HW phenotype.The risk of cardiometabolic health risk factor clustering with HW phenotype or the HWHtR phenotype was significantly higher than that with the non-HW or non-HWHtR phenotypes among children and adolescents(HW:OR=12.22,95%CI:9.54-15.67;HWHtR:OR=9.70,95%CI:6.93-13.58).Compared with the HW and HWHtR phenotypes,the association between risk of cardiometabolic health risk factors(CHRF)clustering and high WHR was much weaker and not significant(WHR:OR=1.14,95%CI:0.97-1.34).Conclusion Compared with HWHtR and WHR,the HW phenotype is a more convenient indicator with higher applicability to screen children and adolescents for cardiovascular risk factors.
文摘BACKGROUND Meckel’s diverticulum is a common congenital malformation of the small intestine,with the three most common complications being obstruction,per-foration,and inflammation.To date,only a few cases have been reported world-wide.In children,the clinical symptoms are similar to appendicitis.As most of the imaging features are nonspecific,the preoperative diagnosis is not precise.In addition,the clinical characteristics are highly similar to pediatric acute appendicitis,thus special attention is necessary to distinguish Meckel’s diver-ticulum from pediatric appendicitis.Patients with poor disease control should undergo laparoscopic exploration to avoid serious complications,including intestinal necrosis,intestinal perforation and gastrointestinal bleeding.CASE SUMMARY This report presents three cases of appendicitis in children combined with intestinal obstruction,which was caused by fibrous bands(ligaments)arising from the top part of Meckel's diverticulum,diverticular perforation,and diver-ticular inflammation.All three patients,aged 11-12 years,had acute appendicitis as their initial clinical presentation.All were treated by laparoscopic surgery with a favorable outcome.A complete dataset including clinical presentation,dia-gnostic imaging,surgical information,and histopathologic findings was also provided.CONCLUSION Preoperative diagnosis of Meckel’s diverticulum and its complications is challenging because its clinical signs and complications are similar to those of appendicitis in children.Laparoscopy combined with laparotomy is useful for diagnosis and treatment.
文摘Background: This study investigated serum Glucose transporter (GLUT) 4 levels and examined the relationship between serum GLUT4 levels and sepsis in critically ill children. Methods: This was a retrospective study of 77 critically ill children and 33 non-diabetic healthy children (controls) who were admitted between 07/2015 and 05/2016. Patient data, clinical information, and blood samples were collected on admission, alongside a large number of laboratory parameters that were routinely assessed. Critically ill patients were divided into sepsis and non-sepsis/systemic inflammatory response syndrome (SIRS). Serum GLUT4 was measured using western blotting and enzyme-linked immunosorbent assays. Insulin resistance indexes, clinical data, laboratory parameters, and inflammatory cytokines were assessed. Results: GLUT4 serum levels were higher in critically ill children than in healthy children (90.5 vs. 30.3 μg/L, P 0.05). Compared to healthy children, hyperglycemic patients (n = 48) had elevated GLUT4 serum levels (30.3 vs. 103.7 g/L, P Conclusions: GLUT4 serum levels might be significantly increased in critically ill children compared with healthy children, particularly those in septic shock. Serum GLUT4 could predict disease severity.
文摘Background: Guangzhou Women and Children’s Medical Center was chosen as the designated facility for screening, diagnosing, and treating children in Guangzhou with SARS-CoV-2 infection after the COVID-19 outbreak in China. From January 23 to March 20, 2020, the center opened new wards for screening and treatment, taking measures to prevent and control nosocomial infections. This article summarizes and evaluates measures for preventing and controlling nosocomial infections to provide reference information during the pandemic. Methods: The COVID-19 nosocomial infection prevention and control strategies were summarized and analyzed, including the formulation of the hospital partition, the improvement of the hospitalization process, environmental cleaning and disinfection, graded protection based on risk assessment, enhanced training on-site quality control inspection, data monitoring and evaluation, among others, and evaluating the effects by comparing before and after the intervention. Results: There were 159 patients admitted to the screening wards, including 98 males and 61 females, with a median age of 34 years (interquartile range (IQR): 15, 60) months. There were no abnormal findings in these patients and their families during follow-up. During the screening ward opening period, hand hygiene compliance was significantly improved. Fifty staff members in close contact with the contaminated area had tested for SARS-CoV-2 nucleic acid by polymerase chain reaction (PCR), which showed zero infections and no nosocomial infections occurred. Conclusions: For SARS-CoV-2 nosocomial infections, taking the “standard prevention & contact isolation & droplet isolation & air isolation” strategies can prevent patients and staff effectively.
文摘1 Scope This standard specifies the evaluation indicators and methods for the growth level and nutritional status of children under 7 years of age.This standard is applicable to the group and individual evaluation of the growth level and nutritional status of children under 7 years of age.
基金This work was supported by the National Natural Science Foundation of China(71861147003 and 71925009).
文摘This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demographic and Health Surveys(DHS).Results from both fixed effects(FE)and instrumental variable(IV)estimates show that using non-solid cooking fuel significantly improves the nutrition outcomes of under-five children.Compared with their peers from households mainly using solid fuel,children from households mainly using non-solid fuel exhibit a lower probability of experiencing stunting(by 5.9 percentage points)and being underweight(by 1.2 percentage points).Our further investigation provides evidence for several underlying mechanisms,such as improved indoor air quality,induced reduction in children’s respiratory symptoms,benefits on maternal health,and reduction in maternal time spent on fuel collection or cooking.Heterogenous analyses suggest that the nutrition benefits of using non-solid cooking fuel are more prominent among boys,children above three years old,and those from households of lower socioeconomic status,rural areas,and Southeast Asia.
文摘BACKGROUND Parents of children with disabilities often have difficulty understanding their child’s behavior and are unable to do it appropriately because they do not know what to do.The more we properly understand children with disabilities,the more positive the importance of parent education becomes in various aspects.AIM To demonstrate the effectiveness of parent education for children with disabilities in various aspects and present it as evidence that can be used clinically.METHODS For a meta-analysis on the effectiveness of parent education for children with disabilities,literature was collected from 2002 to 2022 using PubMed,Embase,Web of Science,Directory of Open Access Journals,and Europe PMC.Search terms were“disabled children,”“disabled children,”“parent education,”“parent training,”and“parent coaching.”The final searched literature included a total of 11 articles.To calculate the effect size,the mean,standard deviation,and sample size of the experimental and control groups were analyzed,and a meta-analysis was performed using RevMan version 5.4.1.To analyze statistical heterogeneity,a chi-square test was performed to evaluate the significance of Q statistics to indicate statistical heterogeneity.RESULTS The final literature totaled 11 articles,and a total of 4 items were analyzed.There were 5 studies on parental depression,the heterogeneity was 98%,and the effect size for parental depression was 0.35[confidence interval(CI:0.30-0.40)],indicating a small but statistically significant effect size.There were 4 studies on parenting attitude,the heterogeneity was 100%,the effect size on parenting attitude was 0.41(CI:0.37-0.46),which was a medium effect size,and the P value showed a statistically significant score.Additionally,face-to-face parent education was found to have a larger effect size than non-face-to-face education.Regarding parent education methods,face-to-face parent education had a medium effect size[0.57(CI:0.52-0.61)],while non-face-to-face parent education had a small effect size[0.23(CI:0.18-0.28)].CONCLUSION Parental education has shown high effectiveness in child development,and it has proven to be even more effective when face-to-face parenting education is conducted.Accordingly,more effective and objective data was presented.Based on this study,it is believed that parent education research applying various diagnostic groups should continue to be conducted.
文摘Diarrhea is among the leading causes of morbidity and mortality in children aged Escherichia coli (DEC) accounts for 30% - 40% of childhood diarrhea cases. To identify the pathotypes involved in diarrheal outbreaks in Kenya, we analyzed archived E. coli isolates from children E. coli confirmation and antimicrobial susceptibility testing were done using the VITEK<sup>®</sup>2 instrument. Pathotype identification was performed via conventional polymerase chain reaction. Of 175 E. coli isolates, 48 (27%) were DEC pathotypes, with enteroaggregative E. coli (EAEC) predominating (71%, 34/48). Enterohemorrhagic (EHEC) and enteropathogenic E. coli (EPEC) represented 19% and 10% of isolates, respectively. Enteroinvasive and enterotoxigenic pathotypes were not identified. All DEC isolates were susceptible to amikacin, ertapenem, imipenem, meropenem and tigecycline. Conversely, most (>80%) isolates were resistant to ampicillin, ampicillin-sulbactam and sulfamethoxazole-trimethoprim. Half of all EAEC and EPEC strains were resistant to cefazolin while half of EHEC isolates were resistant to ciprofloxacin and moxifloxacin. In total, 18 resistance phenotypes were identified with “ampicillin-cefazolin-ampicillin/ sulbactam-sulfamethoxazole/trimethoprim” predominating (33%, 16/48). The majority (81%) of DEC isolates were multidrug-resistant, with extended-spectrum beta-lactamase production identified in 8% of these isolates. This study highlights the predominance of Enteroaggregative E. coli and multidrug resistance of DEC pathotypes. Studying the epidemiology of diarrheal disease and antimicrobial resistance surveillance, will aid in identifying dominant etiological agents of diarrhea and newly emerging resistant strains in informal settlements.
文摘The test floor effects seen in standardised tests lead to a standardised score of 1 or less with a flat profile that hides a child’s individual strengths and needs. The Griffiths III community of practitioners requested advice on the reporting of children’s development below the floor of the test, so that individual strengths and needs can be described. This paper reports the third phase of research following an earlier Scoping Review and a wider literature review. To confirm quality control, Phase 3 was conducted in a retrospective manner using the same methodology as the earlier phases but in a reverse direction. Peer reviewer comments and key elements from the Scoping Review and keywords from the publications were tabulated. Data analysis included a change of perspective to that of the child and their individual rights with respect to the literature themes already described in Phase 2. These confirmed that there is little specific guidance in the literature, but that computational advances for homogeneous populations and especially disaggregated data offer some solutions. A greater balance between broad biopsychosocial models and standardised models of assessment should be sought by practitioners together with the use of disaggregated data to highlight issues that pertain to individual subsets of results. This will ensure that the child’s right for their individual strengths and needs to be described together with a plan for management, may be met.
文摘Objective: The aim is to study the trends in ventricular septal defect (VSD) mortality in children in Kazakhstan.Methods: The retrospective study was done for the period 2011–2020. Descriptive and analytical methods of epidemiologywere applied. The universally acknowledged methodology used in sanitary statistics is used to calculatethe extensive, crude, and age-specific mortality rates. Results: Kazakhstan is thought to be seeing an increase inmortality from VSDs in children. As a result, this study for the years 2011 to 2020 was conducted to retrospectivelyassess data from the central registration of the Bureau of National Statistics that was available throughoutthe nation. Age-standardized mortality data were obtained and compared between age categories. It was shownthat 507 children died from this condition throughout the time period under study. The average annual standardizedmortality rate was 1.88 per 100,000 population and tended to decrease over time. The peak of mortality wasnoted at the age of up to 1 year, namely the neonatal period. Cartogram mortality rates were calculated usingstandardized indicators. Additionally, age-sex variations were taken into account when performing all calculations.Conclusion: In recent years, the death rate from VSD has declined from 1.5 to 0.6 per 100,000 people, withthe trend remaining constant (T = 1.4%, R^(2) = 0.5825). The analysis of mortality trends related to VSD is crucial inboth theoretical and practical aspects, as it enables early detection and treatment of VSDs. The findings of thisstudy will be valuable to public health authorities in developing a strategy to treat VSDs effectively.
文摘Education is a great cause to achieve national prosperity, national rejuvenation and people’s happiness, and an important way to block the intergenerational transmission of poverty. Rural revitalization, education first. Rural children’s education is an important issue of rural revitalization. This paper takes rural children, especially left behind children and children in distress as the help objects, and uses the advantages of “Internet plus” to improve the system, strengthen family education guidance, integrate social love resources, etc., to solve the problems faced by rural children, such as no guidance in learning, lack of guidance in behavior, lack of care in life, promote the overall healthy development of rural children, and solve the problem of rural education backwardness.
文摘Background: Meningitis remains a leading cause of death among children below 5 years of age in the Democratic Republic of the Congo (DR Congo). Distinguishing children with bacterial meningitis from those with viral meningitis in the emergency department is sometimes difficult. Here we identified bacteria and virus in the cerebral spinal fluid (CSF) of children with meningitis. Material and Methods: This is a prospective, analytical study carried out in the Pediatrics department of Panzi Hospital in the South-Kivu province of DR Congo. Between April 2021 and March 2022, 150 of 251 collected CSF from children aged from 1 to 59 months hospitalised due to clinical meningitis at Panzi referral university hospital, Bukavu, Eastern DR Congo were sent to the Lancet laboratory for bacteria identification by a multiplex real-time PCR assay for detection of the most different viruses and bacterial species causing meningitis. Result: The used multiplex real-time PCR assay allowed us to identify germs in 24.7% of cases (37/150). We isolated bacteria in 25/37 (67.5%) cases, and viruses in 9/37 (24.3%) while virus and bacteria co-infection was detected in 3/37 (8.1%). The most frequently identified bacteria were Streptococcus pneumoniae 14/37 (37.8%) followed by Haemophilus influenzae 6/37 (16.2%). The main virus was cytomegalovirus 5/37 (3.5%). Despite the age, the most found bacterial are common in children from rural areas and unvaccinated children. Bacterial and virus co-infection were identified in 66.7% of children aged between 25 - 60 months, mainly among male children, and in all children from rural areas (100%). The overall case fatality rate was 30% and was very high among cases with co-infection CMV-Pneumococcal (66.7%), followed by Streptococcus pneumoniae (50%). Conclusion: Meningitis remains frequent among children aged from one to 59 months among Bukavu Infants. We noticed that, Children with co-infection with bacteria and viruses might need higher attention when having meningitis symptoms, as this could lead to fatal outcomes. The introduction of molecular techniques, such as multiplex real-time PCR, has the potential to improve diagnosis and patient outcomes.
基金This study was supported by the National Natural Science Foundation of China(82174239)China Academy of Chinese Med-ical Sciences Innovation Fund(CI2021A00701-3 and CI2021A05503)China Center for Evidence Based Traditional Chinese Medicine(2020YJSZX-2).
文摘Objective:To rapidly assess the effectiveness,safety,economy,and applicability of Shaoma Zhijing granule(SZG)for the treatment of children with tic disorders(TD),and provide currently available best evidence for decision-makers of health policies.Methods:We conducted a rapid health technology assessment(RHTA)to explore the value of SZG.A systematic literature search in eight literature databases and on three clinical trial registration platforms was performed.The literature was screened according to eligibility criteria.The screening process and data extraction were conducted by two reviewers,and the quality of the literature was also assessed.The results were summarized,analyzed,and presented in tables or figures.Results:A total of five randomized controlled trials(RCTs)were included in this study,of which one was published in English(in the Journal of Child Psychology and Psychiatry)and four in Chinese journals.The overall risk of bias for the five RCTs was evaluated as“some concerns.”SZG monotherapy or in combi-nation with tiapride was better than tiapride alone in improving traditional Chinese medicine(TCM)syndromes and tic symptoms,with a daily cost of¥67.50e107.22.Adverse events were mainly related to the digestive,respiratory,and neurological systems,but all were mild.Conclusion:Overall,the current RHTA of published,peer-reviewed literature has located a small body of evidence evaluating the use of SZG for the treatment of TD in children.SZG has effects on improving TCM syndromes and tic symptoms;the daily cost is¥67.50e107.22;and all adverse events are mild.High-quality studies with long-term follow-up should be conducted,so as to provide local evidence and consistently guide and improve scientific decision-making.
基金This study was supported by the Pediatric Heart Center at Skåne University Hospital Lund and Lund University,and by the Swedish Children’s Heart Association.
文摘Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assessment needs to be performed whenever an indication for reoperation is suspected.The aim was to illuminate the experiences of parents of children diagnosed with RVOT anomalies,in particular,how they experience their child’s heart disease and everyday life during the assessment and after the decision on whether to perform a reoperation.Method:Individual interviews(n=27)were conducted with nine parents on three occasions between 2014 and 2016 and analyzed using reflexive thematic analysis.Results:The analysis resulted in the following five main coexisting themes:The heart surgery keeps my child alive illuminates parents’experiences during and after the assessment and emphasizes that heart surgery,although dreaded,is central for their child’s survival;Everyday struggles illuminates the different struggles parents had to face to ensure that their child would be in the best possible condition;the remaining three themes,Unconditional love,Trust in life,and Togetherness,illuminate the ways in which the parents gained inner strength and confidence in their everyday lives.Conclusion:Although the parents were grateful for the assessment and had learned to navigate among the fears it aroused,they experienced several distressing situations during the assessment process that should be addressed.By inviting both the parents and their child to participate in the child’s care,individualized support can take into account the needs of both parents and child.
文摘Speech disorders are a common type of childhood disease.Through experimental intervention,this study aims to improve the vocabulary comprehension levels and language ability of children with speech disorders through the language cognition and emotional speech community method.We also conduct a statistical analysis of the inter-ventional effect.Among children with speech disorders in Dongguan City,224 were selected and grouped accord-ing to their receptive language ability and IQ.The 112 children in the experimental group(EG)received speech therapy with language cognitive and emotional speech community,while the 112 children in the control group(CG)only received conventional treatment.After six months of experimental intervention,the Peabody Picture Vocabulary Test-Revised(PPVT-R)was used to test the language ability of the two groups.Overall,we employed a quantitative approach to obtain numerical values,examine the variables identified,and test hypotheses.Further-more,we used descriptive statistics to explore the research questions related to the study and statistically describe the overall distribution of the demographic variables.The statistical t-test was used to analyze the data.The data shows that after intervention through language cognition and emotional speech community therapy,the PPVT-R score of the EG was significantly higher than that of the CG.Therefore,we conclude that there is a significant difference in language ability between the EG and CG after the therapy.Although both groups improved,the post-therapy language level of EG is significantly higher than that of CG.The total effective rate in EG is higher than CG,and the difference is statistically significant(p<0.05).Therefore,we conclude that the language cogni-tion and emotional speech community method is effective as an interventional treatment of children’s speech dis-orders and that it is more effective than traditional treatment methods.
