Background Recent decades have shown a rapid increase in the prevalence of overweight and obesity among Chinese children based on several national surveys.Restrictions due to the coronavirus disease 2019 outbreak have...Background Recent decades have shown a rapid increase in the prevalence of overweight and obesity among Chinese children based on several national surveys.Restrictions due to the coronavirus disease 2019 outbreak have worsened its epidemiol-ogy.This review updates the trends in the prevalence of overweight and obesity among Chinese children and adolescents and analyzes the underlying reasons to provide evidence for better policy making.Methods Studies published in English and Chinese were retrieved from PubMed,Google Scholar,China National Knowl-edge Infrastructure andWanfang.Results The prevalence of overweight and obesity has been increasing for decades and varies with age,sex and geography but is more pronounced in primary school students.The increase in obesity in boys appeared to be slower,whereas that in girls showed a declining trend.The northern areas of China have persistently maintained the highest levels of obesity with a stable trend in recent years.Meanwhile,the prevalence in eastern regions has dramatically increased.Notably,the overall prevalence of obesity in children has shown a stabilizing trend in recent years.However,the occurrence of obesity-related metabolic diseases increased.The effect of migrants floating into east-coast cities should not be neglected.Conclusions The high prevalence of overweight and obesity among Chinese children and adolescents persists but with vary-ing patterns.Obesity-related metabolic diseases occur more frequently despite a stable trend of obesity.Multiple factors are responsible for the changing prevalence.Thus,comprehensive and flexible policies are needed to effectively manage and prevent the burden of obesity and its related complications.展开更多
A 13-year-old boy presented with a 1-week history of hair loss on the scalp.Physical examination revealed linear alopecia with the normal scalp(Fig.1a).Trichoscopy examination revealed irregular black dots,flame hair,...A 13-year-old boy presented with a 1-week history of hair loss on the scalp.Physical examination revealed linear alopecia with the normal scalp(Fig.1a).Trichoscopy examination revealed irregular black dots,flame hair,and V sign(Fig.1b).After a detailed inquiry,the patient finally admitted that he had pulled his hair down every night.The boy was then referred to the Psychology Clinic of the hospital.In the psychiatry visit,psychological scales(Children's Yale-Brown Obsessive–Compulsive Scale,Screen for Child Anxiety Related Emotional Disorders,Depression Self-Rating Scale for Children and Child Behavior Checklist)indicated a high level of anxiety due to isolation during the COVID-19 epidemic.A diagnosis of trichotillomania was made.Trichotillomania is a compulsive desire or habit to pluck the hair,which is frequently associated with anxiety or depression[1].Pathulos et al.reported that the COVID-19 pandemic led to hair-pulling symptoms increased in the patients with the body-focused repetitive behaviors that include trichotillomania,nail biting,and skin picking[2].In additional,three cases of trichotillomania in children were reported which might be induced by bored mental,because the schools closed in the COVID-19 outbreak[3].In our case,long-time separation from parents and lack of outdoor activity during the COVID-19 pandemic could be the cause.After 4 weeks of behavior modification therapy in the Psychology Clinic,the patient’s alopecia achieved full remission(Fig.1c).We also summarize detailed psychological assessment scores before and after interventions in Table 1.This case reminded us that more attention should be paid to the mental health of children affected by the COVID-19 pandemic.展开更多
Down syndrome,Turner syndrome,and Klinefelter syndrome are the most common chromosomal disorders world-wide.Down syndrome is caused by an extra copy of the 21st chromosome and has an incidence of 1 in 800 to 1000 live...Down syndrome,Turner syndrome,and Klinefelter syndrome are the most common chromosomal disorders world-wide.Down syndrome is caused by an extra copy of the 21st chromosome and has an incidence of 1 in 800 to 1000 live births.Turner syndrome results from X-chromosome monosomy and has an incidence of 1 in 2000 of live-born female infants.展开更多
Childhood obesity has emerged as an important public health problem not only in developed countries but in many developing countries [1,2].As we know, the increasing prevalenceof childhood obesity is associated with t...Childhood obesity has emerged as an important public health problem not only in developed countries but in many developing countries [1,2].As we know, the increasing prevalenceof childhood obesity is associated with the grooving increaseof the incidence of adult diseases including type 2 diabetes mellitus, nonalcoholic fatty liver disease and other disease,which dramatically threaten public health.展开更多
Background In China,as the social transformation and economic development from 1985 to 2015,children's feeding pattern has undergone some changes.So we aimed to analyze the secular trend on feeding patterns of cit...Background In China,as the social transformation and economic development from 1985 to 2015,children's feeding pattern has undergone some changes.So we aimed to analyze the secular trend on feeding patterns of city children in China.Methods All data were from a series of national survey which implemented once every 10 years in China from 1985 to 2015.We use same indexes to evaluate the feeding pattern of children in these four surveys.Results From 1985 to 2005,the exclusive breastfeeding rates in infants under 6 months of age decreased,especially in suburban areas decreased by 17.7%;the continuous breastfeeding rate of 1-year-old children in suburban area decreased from 60.1 to 27.6%.However,from 2005 to 2015,the exclusive breastfeeding rates under 6 months of age increased by 16.0% in urban areas and 5.9% in suburban areas;the continuous breastfeeding rate of 1-year-old children in urban increased from 17.0 to 36.0%.The overall feeding rate of complementary food in infants under 6 months of age declined from 1985 to 2015;the average age at introduction of all complementary foods was around 6 months of age in 2015.Conclusions There is an obvious trend on feeding pattern of Chinese children.From 1985 to 2005,the breastfeeding rate decreased,the duration time of breastfeeding was shortened and the age at introduction of complementary food was advanced.From 2005 to 2015,the breastfeeding rate increased,the duration time of breastfeeding was prolonged,and the age at introduction of complementary food was postponed.展开更多
Both attention-deficit/hyperactivity disorder (ADHD) and juvenile bipolar mood disorder (BP) share many clinical symptoms in common. Differentiating between both condi-tions is crucial, both for course and prognosis a...Both attention-deficit/hyperactivity disorder (ADHD) and juvenile bipolar mood disorder (BP) share many clinical symptoms in common. Differentiating between both condi-tions is crucial, both for course and prognosis and to inform functional and therapeutic outcomes which differ consider-ably.展开更多
In the current medical environment,efforts to improve detection rates and subsequent.management for infants with neonatal abstinence syndrome (NAS),a condition typically associated with opiates,are being renewed and s...In the current medical environment,efforts to improve detection rates and subsequent.management for infants with neonatal abstinence syndrome (NAS),a condition typically associated with opiates,are being renewed and strengthened.[1] We laud recent legislation such as the Protecting Our Infants Act of 2015,as it is well established that alignment between research,policv and practice resuhs in better population health.展开更多
Background:The prevalence of Mycoplasma pneumoniae pneumonia has increased considerably in recent years.To evaluate the efficacy of combined treatment of azithromycin with intravenous immunoglo-bulin (IVIG) or methylp...Background:The prevalence of Mycoplasma pneumoniae pneumonia has increased considerably in recent years.To evaluate the efficacy of combined treatment of azithromycin with intravenous immunoglo-bulin (IVIG) or methylprednisolone in children with refractory Mycoplasma pneumoniae pneumonia (RMPP).Methods:Children with RMPP were randomly allocated to group A [intravenous azithromycin (IA)+ methylprednisolone],group B (IA+IVIG) or group C (IA alone).Following a 7-day treatment,group C patients were randomly separated into two sub-groups:group C1 (IA+methylprednisolone) and group C2 (IA+IVIG).Temperature,respiratory symptoms and signs were examined.The average febrile period after treatment (F2),average total febrile period (F3),infiltration absorption,atelectasis resolution,pleural effusion disappearance were determined.The levels of C-reactive protein (CRP),D-dimer,and lactate dehydrogenase (LDH) were measured.Results:Seven days after enrollment,the average F2 after treatment of group A was the shortest.Compared with the control group C,the combined treatment group A and B showed higher rates of infiltration absorption,atelectasis resolution and pleural effusion disappearance,while lower levels of serum CRP,D-dimer and LDH.Fourteen days after enrollment,all children with combined therapy clinically improved,and presented better laboratory results.Group C1 showed shorter F3 and lower levels of CRP and LDH than those of group C2.Overall,group A showed the shortest F3,also has the lowest CRP and LDH.Conclusions:Azithromycin with IVIG or methylprednisolone was better treatment for children with RMPP than azithromycin alone.IVIG treatment may be beneficial,especially when the efficacy of corticosteroids is insecure,thus could be considered as an alternative of primary therapeutic approaches.展开更多
Background:Cyclosporine A and tacrolimus(TAC)are often used as a second-line treatment for children with refractory nephrotic syndrome(NS).This study was undertaken to investigate the efficacy and safety of Tacrobell&...Background:Cyclosporine A and tacrolimus(TAC)are often used as a second-line treatment for children with refractory nephrotic syndrome(NS).This study was undertaken to investigate the efficacy and safety of Tacrobell®,a locally produced generic form of TAC.Methods:This study was a one-year prospective,open-label,single-arm,multicenter trial.Fourty-four children with steroid-dependent NS(SDNS)and 33 children with steroid-resistant NS(SRNS)were enrolled.The primary endpoints were defined as the remission rates,whereas the secondary endpoints were recognized as the duration of remission and adverse effects of TAC.Results:After one-year treatment,34(77.3%)of the 44 patients with SDNS were in complete remission,and 6(13.6%)were in partial remission.Nineteen(43.2%)patients did not relapse during the study;for those who did relapse,the mean duration of remission was 4.6±2.9 months.The number of relapse episodes during the study period(0.90 per patient-year)was significantly lower than that in the preceding year(2.8 per patientyear).After treatment for 3 and 6 months,12(36.4%)of the 33 patients with SRNS were in remission,and after treatment for 12 months,the number of patients had increased to 13(39.4%).The mean time to achieve remission was 4.0±3.2 months.After remission(duration,3.7±2.7 months),12(54.5%)of 22 patients relapsed.The fasting blood glucose and blood pressure levels during the therapy were similar to those at the time of study entry.Conclusions:Treatment with Tacrobell®was effective and safe for children with refractory NS.The efficacy of this generic form of TAC was better than that of the original TAC formula.展开更多
Background:Pancreatic neuroendocrine tumor is rarely seen,particularly in children.One of the symptoms of this tumor is jaundice that may be misdiagnosed as the sign of hepatitis A,especially in countries with a high ...Background:Pancreatic neuroendocrine tumor is rarely seen,particularly in children.One of the symptoms of this tumor is jaundice that may be misdiagnosed as the sign of hepatitis A,especially in countries with a high prevalence of this infectious disease.Methods:We present a 3.5-year-old girl with four weeks of icterus,who was misdiagnosed with hepatitis A.Results:The patient wasfi nally diagnosed as having a low grade pancreatic neuroendocrine carcinoma.Conclusion:Pediatricians should be aware of or consider a tumor in differential diagnosis of jaundice,especially prolonged one in children.展开更多
Background:Systemic treatment with propranolol is proven to be effective for patients with hemangiomas with less side-effect.We used a propranolol gel for topical use on hemangiomas.Methods:In this retrospective study...Background:Systemic treatment with propranolol is proven to be effective for patients with hemangiomas with less side-effect.We used a propranolol gel for topical use on hemangiomas.Methods:In this retrospective study,we analyzed 148 patients who had been treated topically with propranolol gel for 12 weeks.We analyzed the data of patients and clinically gave each hemangioma a"hemangioma score"to determine the treatment success.Results:In 147 of the 148 patients,strong signs of resolution under treatment included lightening,paling,and less vascularization.The hemangioma score showed a signifi cant decrease during the treatment.Relevant serum levels of propranolol were not found.Adverse effects were rare and not related to propranolol.Conclusion:Topical treatment with propranolol gel is suitable for specific hemangiomas in addition to cryotherapy and systemic treatment with propranolol.展开更多
Background Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents,more adequate studies are needed to predict the trends of alcohol and substance use during ...Background Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents,more adequate studies are needed to predict the trends of alcohol and substance use during recent periods,including the mid-pandemic period.This study investigated the changes in alcohol and substance use,except tobacco use,throughout the pre-,early-,and mid-pandemic periods in adolescents using a nationwide serial cross-sectional survey from South Korea.Methods Data on 1,109,776 Korean adolescents aged 13–18 years from 2005 to 2021 were obtained in a survey operated by the Korea Disease Control and Prevention Agency.We evaluated adolescents’alcohol and substance consumption prevalence and compared the slope of alcohol and substance prevalence before and during the COVID-19 pandemic to see the trend changes.We define the pre-COVID-19 period as consisting of four groups of consecutive years(2005–2008,2009–2012,2013–2015,and 2016–2019).The COVID-19 pandemic period is composed of 2020(early-pandemic era)and 2021(midpandemic era).Results More than a million adolescents successfully met the inclusion criteria.The weighted prevalence of current alcohol use was 26.8%[95%confidence interval(CI)26.4–27.1]from 2005 to 2008 and 10.5%(95%CI 10.1–11.0)in 2020 and 2021.The weighted prevalence of substance use was 1.1%(95%CI 1.1–1.2)from 2005 to 2008 and 0.7%(95%CI 0.6–0.7)between 2020 and 2021.From 2005 to 2021,the overall trend of use of both alcohol and drugs was found to decrease,but the decline has slowed since COVID-19 epidemic(current alcohol use:βdiff 0.167;95%CI 0.150–0.184;substance use:βdiff 0.152;95%CI 0.110–0.194).The changes in the slope of current alcohol and substance use showed a consistent slowdown with regard to sex,grade,residence area,and smoking status from 2005 to 2021.Conclusion The overall prevalence of alcohol consumption and substance use among over one million Korean adolescents from the early and mid-stage(2020–2021)of the COVID-19 pandemic showed a slower decline than expected given the increase during the prepandemic period(2005–2019).展开更多
World Journal of Pediatrics is a peer-reviewed journal published by Children's Hospital,Zhejiang University School of Medicine,Hangzhou,China.The journal gives priority to reports of outstanding clinical and exper...World Journal of Pediatrics is a peer-reviewed journal published by Children's Hospital,Zhejiang University School of Medicine,Hangzhou,China.The journal gives priority to reports of outstanding clinical and experimental works as well as important contributions related to common problems of infants,children and adolescents worldwide.展开更多
Background Antibiotics,a common strategy used for neonatal infection,show consistent effect on the gut microbiota of neonates.Supplementation with probiotics has become increasingly popular in mitigating the loss of t...Background Antibiotics,a common strategy used for neonatal infection,show consistent effect on the gut microbiota of neonates.Supplementation with probiotics has become increasingly popular in mitigating the loss of the gut microbiota.However,no clear consensus recommending the use of probiotics in the infection of neonates currently exists.This study examined the effects of probiotics on the gut microbiota of infectious neonates when used concurrently with or during the recovery period following antibiotic therapy.Methods Fifty-five full-term neonates diagnosed with neonatal infections were divided into the following groups:NI(no intervention,antibiotic therapy only),PCA(probiotics used concurrently with antibiotics),and PAA(probiotics used after antibiotics).The NI group received antibiotic treatment(piperacillin–tazobactam)for 1 week and the PCA group received antibiotic treatment together with probiotics(Bifidobacterium longum,Lactobacillus acidophilus,and Enterococcus faecalis)for 1 week.The PAA group received antibiotic treatment for 1 week followed by probiotics for 1 week.Fecal samples were collected at four time nodes:newborn,1 week,2 weeks,and 42 days after birth.The composition of the gut microbiota was determined by the high-throughput sequencing of 16S rRNA amplicons.Results Antibiotic exposure was found to dramatically alter gut microbiota,with a significant decrease of Bifidobacterium and Lactobacillus.The use of probiotics did not restore the overall diversity of the gut microbiota.However,using probiotics simultaneously with the antibiotics was found to be beneficial for the gut microbiota as compared to delaying the use of probiotics to follow treatment with antibiotics,particularly in promoting the abundance of Bifidobacterium.Conclusions These results suggest that the early use of probiotics may have a potential ability to remodel the gut microbiota during recovery from antibiotic treatment.However,further study is required to fully understand the long-term effects including the clinical benefits.展开更多
Background Asthma has been a global problem,especially in children.We aim to evaluate the contemporary prevalence and influencing factors of asthma among children aged 3–7 years in Shanghai,China.Methods A random sam...Background Asthma has been a global problem,especially in children.We aim to evaluate the contemporary prevalence and influencing factors of asthma among children aged 3–7 years in Shanghai,China.Methods A random sample of preschool children was included in this study.The International Study of Asthma and Allergies in Childhood questionnaire was adopted to assess the childhood asthma.Multivariable logistic regression models were used to evaluate the associations between independent variables and childhood asthma.Results Of 6389 preschool children who were invited to take part in this study,6163(response rate:96.5%)completed the questionnaire and were included in the analysis.The overall prevalence of asthma was 14.6%which increased more than six folds from 2.1%in 1990.Being male,younger age,preterm delivery,being born in spring or autumn,being delivered by elective cesarean section without indication,miscarriage,high socioeconomic status,having allergy history,and exposure to passive smoking,latex paint,and dust were potential risk factors for childhood asthma.Spending more time outdoors(>30 min/day),having indoor plants,and cleaning rooms more frequently were potential protective factors.Conclusions The prevalence of childhood asthma in Shanghai has increased dramatically during the past three decades.The findings about risk and protective factors of childhood asthma could be used to develop appropriate strategies to prevent and control childhood asthma in Shanghai and in other similar metropolitan cities.展开更多
Background Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has spread around the world and reports of children during early epidemic period showed features of fam...Background Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has spread around the world and reports of children during early epidemic period showed features of family clusters.The aim of this study is to assess clinical profiles of COVID-19 in family clusters with children.Methods We performed a systematic literature review of English database(PubMed,Web of Science)and Chinese database(“www.cnki.net”,“www.cqvip.com”and“www.Wanfangdata.com.cn”)to identify papers on family clusters of COVID-19 with children and their family members.Results Eighteen studies involving 34 children and 98 adults from 28 families were included.Fever,cough and ground-grass opacity change of chest computed tomography(CT)were the dominant features,whereas proportion of asymptomatic infections for children was higher than adults with statistical significance(32.4%and 13.3%,respectively,P<0.05).Median time of longer incubation period(10 days)and shorter duration of pharyngeal swab nucleic acid test positive period(11 days)were seen in children than adults(7 and 17 days,respectively)with statistical significance(P<0.05).There were statistically significant differences in lymphopenia,increased C-reactive protein and abnormal chest CT between children and adult patients(P<0.05).Twenty-seven families reported adults as first case of COVID-19 in family clusters.Conclusions The same virus strain can cause milder disease in children compared with their caregivers.Children of COVID-19 were infected by adults in family during the early epidemic period.Asymptomatic patients can transmit the virus.展开更多
Background Although Kawasaki disease(KD)is known to cause anemia,the relationship between its prognosis and hemoglobin level is less well known.Methods We herein performed a secondary analysis of data from a previous ...Background Although Kawasaki disease(KD)is known to cause anemia,the relationship between its prognosis and hemoglobin level is less well known.Methods We herein performed a secondary analysis of data from a previous study(Post-RAISE).Children aged 6 months to 2 years at the time of KD diagnosis were enrolled.Decreased hemoglobin was defined as a decrease>10%on post-treatment day 2 compared with the level prior to the initial therapy.Results Of 1253 KD cases,treatment resistance was observed in 209(17%)and was significantly more frequent in the decreased hemoglobin group(37/167 vs.172/1086,P=0.041).Multivariable logistic regression analysis revealed that decreased hemoglobin was associated with resistance to the initial treatment(odds ratio 1.53;95%confidence interval 1.00-2.33;P=0.048).Conclusions Decreased hemoglobin was significantly associated with resistance to initial treatment in patients with KD.展开更多
Background Women who had delivered a macrosomic newborn will have a higher risk to deliver another macrosomia.We aimed to examine the recurrence risk of macrosomia in the subsequent pregnancy and the implications in l...Background Women who had delivered a macrosomic newborn will have a higher risk to deliver another macrosomia.We aimed to examine the recurrence risk of macrosomia in the subsequent pregnancy and the implications in long-term child health.Methods Data from the Collaborative Perinatal Project,a longitudinal birth cohort with 54,371 singleton births,were used.401 recurrent macrosomic infants (macro-macro) and 1327 normal weight babies with a macrosomia in the last pregnancy (macro-normal) were selected to explore risk factors for recurrent macrosomia.Furthermore,768 newly onset macrosomia with normal birthweight infant in previous pregnancies (normal-macro) were identified to examine long-term health effects of recurrent macrosomia.Results The recurrent rate of macrosomia was 23.2% [95% confidence interval (CI) 21.2%,25.2%].White race,higher pre-pregnant body mass index (BMI),more gestational weight gain,male infant and more prior macrosomic infants were significant risk factors for recurrent macrosomia.At 4 years of age,recurrent macrosomic infants had a higher BMI (16.7 vs.16.1 kg/m2,adjusted fβ:0.36,95% CI:0.12,0.60) and a higher risk of overweight and obesity (adjusted OR:1.56,95% CI:1.10,2.23) than infants with normal birthweight after a previous macrosomic sibling.There was no significant difference between recurrent macrosomia and newly onset macrosomia in child outcomes after adjustment for covariates.Conclusions Fetal macrosomia has a high recurrence rate in the following pregnancy.Higher maternal pre-pregnant BMI and gestational weight gain are still important risk factors for recurrence of macrosomia,which in turn increases the risk for childhood obesity.展开更多
Background Vitamin D(25-OHD)has a role in bone health after treatment for cancer.25-OHD deficiency has been associated with risk factors for cardiovascular disease,but no data focusing on this topic in childhood cance...Background Vitamin D(25-OHD)has a role in bone health after treatment for cancer.25-OHD deficiency has been associated with risk factors for cardiovascular disease,but no data focusing on this topic in childhood cancer survivors have been published.We investigated the 25-OHD status in children treated for acute lymphoblastic leukemia(ALL),and evaluated its influence on vascular function.Methods 25-OHD levels were evaluated in 52 ALL survivors and 40 matched healthy controls.Patients were grouped according to 25-OHD level(<20 ng/m or≥20 ng/ml).Auxological parameters,biochemical and hemostatic markers of endothelial function(AD,HMW-AD,ET-1,vWFAg,TAT,D-dimers,Fbg,and hs-CRP),ultrasound markers of vascular endothelial function(flow-mediated dilatation,FMD,common carotid intima-media thickness,C-IMT,and antero-posterior diameter of infra-renal abdominal aorta,APAO)were evaluated in the patients.Results Cases showed higher prevalence of 25-OHD deficiency than controls(p=0.002).In univariate analysis via mean comparisons,25-OHD deficient(<20 ng/ml)patients showed higher C-IMT values compared to the 25-OHD non-deficient(≥20 ng/ml)group(P=0.023).Significant differences were also found for ET-1(P=0.035)and AD-HMW(P=0.015).In the multiple regression models controlling for some confounders,25-OHD still was associated with C-IMT(P=0.0163),ET-1(P=0.0077),and AD-HMW(P=0.0008).Conclusions Childhood ALL survivors show higher prevalence of 25-OHD deficiency as compared to controls.The 25-OHD levels appear to be linked to indicators of endothelial and vascular dysfunction.Careful monitoring of 25-OHD balance may help to prevent cardiovascular diseases in childhood ALL survivors,characterized by high cardiovascular risk.展开更多
Background:To describe the sleep patterns of children below 36 months in Hong Kong,and evaluate the associations between parental behaviors and childhood sleep/wake patterns.Methods:Parents of 1049 infants and toddler...Background:To describe the sleep patterns of children below 36 months in Hong Kong,and evaluate the associations between parental behaviors and childhood sleep/wake patterns.Methods:Parents of 1049 infants and toddlers completed an internet-based expanded version of the Brief Infant Sleep Questionnaire.Results:Total sleep duration (P<0.001),frequency (P<0.001) and duration (P<0.001) of nocturnal awakenings decreased with age,whereas the longest sleep duration (P<0.001) and nocturnal sleep duration (P<0.001) increased with age.Children who room-or bed-shared with parents had later bedtimes (P<0.001),but similar sleep duration compared with those who had a separate sleep location.Falling asleep independently was associated with longer nocturnal sleep duration (P<0.001) and less sleep awakenings (P<0.001).Full-time employment of parents was associated with shorter total sleep duration of children (P<0.001).Although breastfeeding was associated with more nocturnal awakenings (P<0.001),no association was detected between breastfeeding and shorter sleep duration in children.Conclusions:As infants and toddlers develop,their sleep consolidates.Falling asleep independently was associated with longer nocturnal sleep duration and fewer sleep awakenings,whereas sleep location was not.This is an important finding,especially for families with limited living space where parent/ child room-or bed-sharing cannot be avoided.展开更多
基金supported by the National Key Research and Development Program of China(Nos.2021YFC2701901 and 2016YFC1305301)National Natural Science Foundation of China(Nos.81570759 and 81270938)Zhejiang Provincial Key Disciplines of Medicine(Innovation Discipline,No.11-CX24).
文摘Background Recent decades have shown a rapid increase in the prevalence of overweight and obesity among Chinese children based on several national surveys.Restrictions due to the coronavirus disease 2019 outbreak have worsened its epidemiol-ogy.This review updates the trends in the prevalence of overweight and obesity among Chinese children and adolescents and analyzes the underlying reasons to provide evidence for better policy making.Methods Studies published in English and Chinese were retrieved from PubMed,Google Scholar,China National Knowl-edge Infrastructure andWanfang.Results The prevalence of overweight and obesity has been increasing for decades and varies with age,sex and geography but is more pronounced in primary school students.The increase in obesity in boys appeared to be slower,whereas that in girls showed a declining trend.The northern areas of China have persistently maintained the highest levels of obesity with a stable trend in recent years.Meanwhile,the prevalence in eastern regions has dramatically increased.Notably,the overall prevalence of obesity in children has shown a stabilizing trend in recent years.However,the occurrence of obesity-related metabolic diseases increased.The effect of migrants floating into east-coast cities should not be neglected.Conclusions The high prevalence of overweight and obesity among Chinese children and adolescents persists but with vary-ing patterns.Obesity-related metabolic diseases occur more frequently despite a stable trend of obesity.Multiple factors are responsible for the changing prevalence.Thus,comprehensive and flexible policies are needed to effectively manage and prevent the burden of obesity and its related complications.
基金The Special Fund of the Pediatric Medical Coordinated Development Center of Beijing Hospitals Authority(XTZD20180502)Beijing Natural Science Foundation(7222058).
文摘A 13-year-old boy presented with a 1-week history of hair loss on the scalp.Physical examination revealed linear alopecia with the normal scalp(Fig.1a).Trichoscopy examination revealed irregular black dots,flame hair,and V sign(Fig.1b).After a detailed inquiry,the patient finally admitted that he had pulled his hair down every night.The boy was then referred to the Psychology Clinic of the hospital.In the psychiatry visit,psychological scales(Children's Yale-Brown Obsessive–Compulsive Scale,Screen for Child Anxiety Related Emotional Disorders,Depression Self-Rating Scale for Children and Child Behavior Checklist)indicated a high level of anxiety due to isolation during the COVID-19 epidemic.A diagnosis of trichotillomania was made.Trichotillomania is a compulsive desire or habit to pluck the hair,which is frequently associated with anxiety or depression[1].Pathulos et al.reported that the COVID-19 pandemic led to hair-pulling symptoms increased in the patients with the body-focused repetitive behaviors that include trichotillomania,nail biting,and skin picking[2].In additional,three cases of trichotillomania in children were reported which might be induced by bored mental,because the schools closed in the COVID-19 outbreak[3].In our case,long-time separation from parents and lack of outdoor activity during the COVID-19 pandemic could be the cause.After 4 weeks of behavior modification therapy in the Psychology Clinic,the patient’s alopecia achieved full remission(Fig.1c).We also summarize detailed psychological assessment scores before and after interventions in Table 1.This case reminded us that more attention should be paid to the mental health of children affected by the COVID-19 pandemic.
文摘Down syndrome,Turner syndrome,and Klinefelter syndrome are the most common chromosomal disorders world-wide.Down syndrome is caused by an extra copy of the 21st chromosome and has an incidence of 1 in 800 to 1000 live births.Turner syndrome results from X-chromosome monosomy and has an incidence of 1 in 2000 of live-born female infants.
文摘Childhood obesity has emerged as an important public health problem not only in developed countries but in many developing countries [1,2].As we know, the increasing prevalenceof childhood obesity is associated with the grooving increaseof the incidence of adult diseases including type 2 diabetes mellitus, nonalcoholic fatty liver disease and other disease,which dramatically threaten public health.
文摘Background In China,as the social transformation and economic development from 1985 to 2015,children's feeding pattern has undergone some changes.So we aimed to analyze the secular trend on feeding patterns of city children in China.Methods All data were from a series of national survey which implemented once every 10 years in China from 1985 to 2015.We use same indexes to evaluate the feeding pattern of children in these four surveys.Results From 1985 to 2005,the exclusive breastfeeding rates in infants under 6 months of age decreased,especially in suburban areas decreased by 17.7%;the continuous breastfeeding rate of 1-year-old children in suburban area decreased from 60.1 to 27.6%.However,from 2005 to 2015,the exclusive breastfeeding rates under 6 months of age increased by 16.0% in urban areas and 5.9% in suburban areas;the continuous breastfeeding rate of 1-year-old children in urban increased from 17.0 to 36.0%.The overall feeding rate of complementary food in infants under 6 months of age declined from 1985 to 2015;the average age at introduction of all complementary foods was around 6 months of age in 2015.Conclusions There is an obvious trend on feeding pattern of Chinese children.From 1985 to 2005,the breastfeeding rate decreased,the duration time of breastfeeding was shortened and the age at introduction of complementary food was advanced.From 2005 to 2015,the breastfeeding rate increased,the duration time of breastfeeding was prolonged,and the age at introduction of complementary food was postponed.
文摘Both attention-deficit/hyperactivity disorder (ADHD) and juvenile bipolar mood disorder (BP) share many clinical symptoms in common. Differentiating between both condi-tions is crucial, both for course and prognosis and to inform functional and therapeutic outcomes which differ consider-ably.
文摘In the current medical environment,efforts to improve detection rates and subsequent.management for infants with neonatal abstinence syndrome (NAS),a condition typically associated with opiates,are being renewed and strengthened.[1] We laud recent legislation such as the Protecting Our Infants Act of 2015,as it is well established that alignment between research,policv and practice resuhs in better population health.
基金This study was funded by Natural Science Foundation of Liaoning Province of China(2013021017).
文摘Background:The prevalence of Mycoplasma pneumoniae pneumonia has increased considerably in recent years.To evaluate the efficacy of combined treatment of azithromycin with intravenous immunoglo-bulin (IVIG) or methylprednisolone in children with refractory Mycoplasma pneumoniae pneumonia (RMPP).Methods:Children with RMPP were randomly allocated to group A [intravenous azithromycin (IA)+ methylprednisolone],group B (IA+IVIG) or group C (IA alone).Following a 7-day treatment,group C patients were randomly separated into two sub-groups:group C1 (IA+methylprednisolone) and group C2 (IA+IVIG).Temperature,respiratory symptoms and signs were examined.The average febrile period after treatment (F2),average total febrile period (F3),infiltration absorption,atelectasis resolution,pleural effusion disappearance were determined.The levels of C-reactive protein (CRP),D-dimer,and lactate dehydrogenase (LDH) were measured.Results:Seven days after enrollment,the average F2 after treatment of group A was the shortest.Compared with the control group C,the combined treatment group A and B showed higher rates of infiltration absorption,atelectasis resolution and pleural effusion disappearance,while lower levels of serum CRP,D-dimer and LDH.Fourteen days after enrollment,all children with combined therapy clinically improved,and presented better laboratory results.Group C1 showed shorter F3 and lower levels of CRP and LDH than those of group C2.Overall,group A showed the shortest F3,also has the lowest CRP and LDH.Conclusions:Azithromycin with IVIG or methylprednisolone was better treatment for children with RMPP than azithromycin alone.IVIG treatment may be beneficial,especially when the efficacy of corticosteroids is insecure,thus could be considered as an alternative of primary therapeutic approaches.
基金supported by a grant from the Korean Health Technology R&D Project,Ministry of Health&Welfare,Republic of Korea(HI12C0014)Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education(NRF-2012R1A1A2006858)+1 种基金Chong Kun Dang Pharmaceutical Corp.,Seoul,Koreaapproved by the Institutional Review Board of Seoul National University Hospital(No.0911-027-300).
文摘Background:Cyclosporine A and tacrolimus(TAC)are often used as a second-line treatment for children with refractory nephrotic syndrome(NS).This study was undertaken to investigate the efficacy and safety of Tacrobell®,a locally produced generic form of TAC.Methods:This study was a one-year prospective,open-label,single-arm,multicenter trial.Fourty-four children with steroid-dependent NS(SDNS)and 33 children with steroid-resistant NS(SRNS)were enrolled.The primary endpoints were defined as the remission rates,whereas the secondary endpoints were recognized as the duration of remission and adverse effects of TAC.Results:After one-year treatment,34(77.3%)of the 44 patients with SDNS were in complete remission,and 6(13.6%)were in partial remission.Nineteen(43.2%)patients did not relapse during the study;for those who did relapse,the mean duration of remission was 4.6±2.9 months.The number of relapse episodes during the study period(0.90 per patient-year)was significantly lower than that in the preceding year(2.8 per patientyear).After treatment for 3 and 6 months,12(36.4%)of the 33 patients with SRNS were in remission,and after treatment for 12 months,the number of patients had increased to 13(39.4%).The mean time to achieve remission was 4.0±3.2 months.After remission(duration,3.7±2.7 months),12(54.5%)of 22 patients relapsed.The fasting blood glucose and blood pressure levels during the therapy were similar to those at the time of study entry.Conclusions:Treatment with Tacrobell®was effective and safe for children with refractory NS.The efficacy of this generic form of TAC was better than that of the original TAC formula.
文摘Background:Pancreatic neuroendocrine tumor is rarely seen,particularly in children.One of the symptoms of this tumor is jaundice that may be misdiagnosed as the sign of hepatitis A,especially in countries with a high prevalence of this infectious disease.Methods:We present a 3.5-year-old girl with four weeks of icterus,who was misdiagnosed with hepatitis A.Results:The patient wasfi nally diagnosed as having a low grade pancreatic neuroendocrine carcinoma.Conclusion:Pediatricians should be aware of or consider a tumor in differential diagnosis of jaundice,especially prolonged one in children.
文摘Background:Systemic treatment with propranolol is proven to be effective for patients with hemangiomas with less side-effect.We used a propranolol gel for topical use on hemangiomas.Methods:In this retrospective study,we analyzed 148 patients who had been treated topically with propranolol gel for 12 weeks.We analyzed the data of patients and clinically gave each hemangioma a"hemangioma score"to determine the treatment success.Results:In 147 of the 148 patients,strong signs of resolution under treatment included lightening,paling,and less vascularization.The hemangioma score showed a signifi cant decrease during the treatment.Relevant serum levels of propranolol were not found.Adverse effects were rare and not related to propranolol.Conclusion:Topical treatment with propranolol gel is suitable for specific hemangiomas in addition to cryotherapy and systemic treatment with propranolol.
基金supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI)funded by the Ministry of Health&Welfare,Republic of Korea(grant number:HV22C0233 and grant number:HI22C1976)The funders had no role in study design,data collection,data analysis,data interpretation,or writing of the report.
文摘Background Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents,more adequate studies are needed to predict the trends of alcohol and substance use during recent periods,including the mid-pandemic period.This study investigated the changes in alcohol and substance use,except tobacco use,throughout the pre-,early-,and mid-pandemic periods in adolescents using a nationwide serial cross-sectional survey from South Korea.Methods Data on 1,109,776 Korean adolescents aged 13–18 years from 2005 to 2021 were obtained in a survey operated by the Korea Disease Control and Prevention Agency.We evaluated adolescents’alcohol and substance consumption prevalence and compared the slope of alcohol and substance prevalence before and during the COVID-19 pandemic to see the trend changes.We define the pre-COVID-19 period as consisting of four groups of consecutive years(2005–2008,2009–2012,2013–2015,and 2016–2019).The COVID-19 pandemic period is composed of 2020(early-pandemic era)and 2021(midpandemic era).Results More than a million adolescents successfully met the inclusion criteria.The weighted prevalence of current alcohol use was 26.8%[95%confidence interval(CI)26.4–27.1]from 2005 to 2008 and 10.5%(95%CI 10.1–11.0)in 2020 and 2021.The weighted prevalence of substance use was 1.1%(95%CI 1.1–1.2)from 2005 to 2008 and 0.7%(95%CI 0.6–0.7)between 2020 and 2021.From 2005 to 2021,the overall trend of use of both alcohol and drugs was found to decrease,but the decline has slowed since COVID-19 epidemic(current alcohol use:βdiff 0.167;95%CI 0.150–0.184;substance use:βdiff 0.152;95%CI 0.110–0.194).The changes in the slope of current alcohol and substance use showed a consistent slowdown with regard to sex,grade,residence area,and smoking status from 2005 to 2021.Conclusion The overall prevalence of alcohol consumption and substance use among over one million Korean adolescents from the early and mid-stage(2020–2021)of the COVID-19 pandemic showed a slower decline than expected given the increase during the prepandemic period(2005–2019).
文摘World Journal of Pediatrics is a peer-reviewed journal published by Children's Hospital,Zhejiang University School of Medicine,Hangzhou,China.The journal gives priority to reports of outstanding clinical and experimental works as well as important contributions related to common problems of infants,children and adolescents worldwide.
基金This work was supported by grants from the National Natural Science Foundation of China(Nos.81230057,81200264,81372615,and 81472262)the Emerging Cutting-Edge Technology Joint Research Projects of Shanghai(No.SHDC12012106)the Tongji University Subject Pilot Program(No.162385).
文摘Background Antibiotics,a common strategy used for neonatal infection,show consistent effect on the gut microbiota of neonates.Supplementation with probiotics has become increasingly popular in mitigating the loss of the gut microbiota.However,no clear consensus recommending the use of probiotics in the infection of neonates currently exists.This study examined the effects of probiotics on the gut microbiota of infectious neonates when used concurrently with or during the recovery period following antibiotic therapy.Methods Fifty-five full-term neonates diagnosed with neonatal infections were divided into the following groups:NI(no intervention,antibiotic therapy only),PCA(probiotics used concurrently with antibiotics),and PAA(probiotics used after antibiotics).The NI group received antibiotic treatment(piperacillin–tazobactam)for 1 week and the PCA group received antibiotic treatment together with probiotics(Bifidobacterium longum,Lactobacillus acidophilus,and Enterococcus faecalis)for 1 week.The PAA group received antibiotic treatment for 1 week followed by probiotics for 1 week.Fecal samples were collected at four time nodes:newborn,1 week,2 weeks,and 42 days after birth.The composition of the gut microbiota was determined by the high-throughput sequencing of 16S rRNA amplicons.Results Antibiotic exposure was found to dramatically alter gut microbiota,with a significant decrease of Bifidobacterium and Lactobacillus.The use of probiotics did not restore the overall diversity of the gut microbiota.However,using probiotics simultaneously with the antibiotics was found to be beneficial for the gut microbiota as compared to delaying the use of probiotics to follow treatment with antibiotics,particularly in promoting the abundance of Bifidobacterium.Conclusions These results suggest that the early use of probiotics may have a potential ability to remodel the gut microbiota during recovery from antibiotic treatment.However,further study is required to fully understand the long-term effects including the clinical benefits.
基金The study was funded by special grant for Preschool Children’s Health Management from Shanghai Municipal Education Commission,grants from National Natural Science Foundation of China(81874266,81673183)key project from Shanghai Municipal Science and Technology Commission(18411951600).
文摘Background Asthma has been a global problem,especially in children.We aim to evaluate the contemporary prevalence and influencing factors of asthma among children aged 3–7 years in Shanghai,China.Methods A random sample of preschool children was included in this study.The International Study of Asthma and Allergies in Childhood questionnaire was adopted to assess the childhood asthma.Multivariable logistic regression models were used to evaluate the associations between independent variables and childhood asthma.Results Of 6389 preschool children who were invited to take part in this study,6163(response rate:96.5%)completed the questionnaire and were included in the analysis.The overall prevalence of asthma was 14.6%which increased more than six folds from 2.1%in 1990.Being male,younger age,preterm delivery,being born in spring or autumn,being delivered by elective cesarean section without indication,miscarriage,high socioeconomic status,having allergy history,and exposure to passive smoking,latex paint,and dust were potential risk factors for childhood asthma.Spending more time outdoors(>30 min/day),having indoor plants,and cleaning rooms more frequently were potential protective factors.Conclusions The prevalence of childhood asthma in Shanghai has increased dramatically during the past three decades.The findings about risk and protective factors of childhood asthma could be used to develop appropriate strategies to prevent and control childhood asthma in Shanghai and in other similar metropolitan cities.
基金This research was funded by the National Natural Science Foundation of China(No.81771621)the Natural Science Foundation of Liaoning Province(No.2019JH8/10300023).
文摘Background Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has spread around the world and reports of children during early epidemic period showed features of family clusters.The aim of this study is to assess clinical profiles of COVID-19 in family clusters with children.Methods We performed a systematic literature review of English database(PubMed,Web of Science)and Chinese database(“www.cnki.net”,“www.cqvip.com”and“www.Wanfangdata.com.cn”)to identify papers on family clusters of COVID-19 with children and their family members.Results Eighteen studies involving 34 children and 98 adults from 28 families were included.Fever,cough and ground-grass opacity change of chest computed tomography(CT)were the dominant features,whereas proportion of asymptomatic infections for children was higher than adults with statistical significance(32.4%and 13.3%,respectively,P<0.05).Median time of longer incubation period(10 days)and shorter duration of pharyngeal swab nucleic acid test positive period(11 days)were seen in children than adults(7 and 17 days,respectively)with statistical significance(P<0.05).There were statistically significant differences in lymphopenia,increased C-reactive protein and abnormal chest CT between children and adult patients(P<0.05).Twenty-seven families reported adults as first case of COVID-19 in family clusters.Conclusions The same virus strain can cause milder disease in children compared with their caregivers.Children of COVID-19 were infected by adults in family during the early epidemic period.Asymptomatic patients can transmit the virus.
文摘Background Although Kawasaki disease(KD)is known to cause anemia,the relationship between its prognosis and hemoglobin level is less well known.Methods We herein performed a secondary analysis of data from a previous study(Post-RAISE).Children aged 6 months to 2 years at the time of KD diagnosis were enrolled.Decreased hemoglobin was defined as a decrease>10%on post-treatment day 2 compared with the level prior to the initial therapy.Results Of 1253 KD cases,treatment resistance was observed in 209(17%)and was significantly more frequent in the decreased hemoglobin group(37/167 vs.172/1086,P=0.041).Multivariable logistic regression analysis revealed that decreased hemoglobin was associated with resistance to the initial treatment(odds ratio 1.53;95%confidence interval 1.00-2.33;P=0.048).Conclusions Decreased hemoglobin was significantly associated with resistance to initial treatment in patients with KD.
文摘Background Women who had delivered a macrosomic newborn will have a higher risk to deliver another macrosomia.We aimed to examine the recurrence risk of macrosomia in the subsequent pregnancy and the implications in long-term child health.Methods Data from the Collaborative Perinatal Project,a longitudinal birth cohort with 54,371 singleton births,were used.401 recurrent macrosomic infants (macro-macro) and 1327 normal weight babies with a macrosomia in the last pregnancy (macro-normal) were selected to explore risk factors for recurrent macrosomia.Furthermore,768 newly onset macrosomia with normal birthweight infant in previous pregnancies (normal-macro) were identified to examine long-term health effects of recurrent macrosomia.Results The recurrent rate of macrosomia was 23.2% [95% confidence interval (CI) 21.2%,25.2%].White race,higher pre-pregnant body mass index (BMI),more gestational weight gain,male infant and more prior macrosomic infants were significant risk factors for recurrent macrosomia.At 4 years of age,recurrent macrosomic infants had a higher BMI (16.7 vs.16.1 kg/m2,adjusted fβ:0.36,95% CI:0.12,0.60) and a higher risk of overweight and obesity (adjusted OR:1.56,95% CI:1.10,2.23) than infants with normal birthweight after a previous macrosomic sibling.There was no significant difference between recurrent macrosomia and newly onset macrosomia in child outcomes after adjustment for covariates.Conclusions Fetal macrosomia has a high recurrence rate in the following pregnancy.Higher maternal pre-pregnant BMI and gestational weight gain are still important risk factors for recurrence of macrosomia,which in turn increases the risk for childhood obesity.
文摘Background Vitamin D(25-OHD)has a role in bone health after treatment for cancer.25-OHD deficiency has been associated with risk factors for cardiovascular disease,but no data focusing on this topic in childhood cancer survivors have been published.We investigated the 25-OHD status in children treated for acute lymphoblastic leukemia(ALL),and evaluated its influence on vascular function.Methods 25-OHD levels were evaluated in 52 ALL survivors and 40 matched healthy controls.Patients were grouped according to 25-OHD level(<20 ng/m or≥20 ng/ml).Auxological parameters,biochemical and hemostatic markers of endothelial function(AD,HMW-AD,ET-1,vWFAg,TAT,D-dimers,Fbg,and hs-CRP),ultrasound markers of vascular endothelial function(flow-mediated dilatation,FMD,common carotid intima-media thickness,C-IMT,and antero-posterior diameter of infra-renal abdominal aorta,APAO)were evaluated in the patients.Results Cases showed higher prevalence of 25-OHD deficiency than controls(p=0.002).In univariate analysis via mean comparisons,25-OHD deficient(<20 ng/ml)patients showed higher C-IMT values compared to the 25-OHD non-deficient(≥20 ng/ml)group(P=0.023).Significant differences were also found for ET-1(P=0.035)and AD-HMW(P=0.015).In the multiple regression models controlling for some confounders,25-OHD still was associated with C-IMT(P=0.0163),ET-1(P=0.0077),and AD-HMW(P=0.0008).Conclusions Childhood ALL survivors show higher prevalence of 25-OHD deficiency as compared to controls.The 25-OHD levels appear to be linked to indicators of endothelial and vascular dysfunction.Careful monitoring of 25-OHD balance may help to prevent cardiovascular diseases in childhood ALL survivors,characterized by high cardiovascular risk.
文摘Background:To describe the sleep patterns of children below 36 months in Hong Kong,and evaluate the associations between parental behaviors and childhood sleep/wake patterns.Methods:Parents of 1049 infants and toddlers completed an internet-based expanded version of the Brief Infant Sleep Questionnaire.Results:Total sleep duration (P<0.001),frequency (P<0.001) and duration (P<0.001) of nocturnal awakenings decreased with age,whereas the longest sleep duration (P<0.001) and nocturnal sleep duration (P<0.001) increased with age.Children who room-or bed-shared with parents had later bedtimes (P<0.001),but similar sleep duration compared with those who had a separate sleep location.Falling asleep independently was associated with longer nocturnal sleep duration (P<0.001) and less sleep awakenings (P<0.001).Full-time employment of parents was associated with shorter total sleep duration of children (P<0.001).Although breastfeeding was associated with more nocturnal awakenings (P<0.001),no association was detected between breastfeeding and shorter sleep duration in children.Conclusions:As infants and toddlers develop,their sleep consolidates.Falling asleep independently was associated with longer nocturnal sleep duration and fewer sleep awakenings,whereas sleep location was not.This is an important finding,especially for families with limited living space where parent/ child room-or bed-sharing cannot be avoided.
