Pediatric cerebral palsy is a syndrome of central motor and postural developmental disorders caused by non-progressive brain injury in fetuses or infants, often complicated by intellectual disability, language disorders, epilepsy, and behavioral abnormalities. Its incidence rate is approximately 2‰–3‰, with spastic type accounting for 60%–70%, making it a key and challenging condition in pediatric rehabilitation [1]. In traditional Chinese medicine (TCM), this disease falls under the categories of "Five Types of Retardation," "Five Types of Flaccidity," "Atrophy Syndrome," and "Fetal Weakness." Its core pathogenesis is congenital deficiency and lack of nourishment to the brain marrow, combined with improper post-natal care and phlegm-stasis obstructing the meridians, leading to disturbed qi and blood flow and failure to nourish the sinews, bones, and muscles. Western medicine mainly uses modern rehabilitation training, physical agent therapy, and symptomatic medications. Although these approaches can improve symptoms to some extent, they have limitations such as slow onset of action, unsatisfactory long-term efficacy, and poor tolerance in some children. Acupuncture and tuina, as characteristic external TCM therapies, have been widely used in the rehabilitation of pediatric cerebral palsy due to their safety, environmental friendliness, non-invasiveness, and ease of operation. With the deepening of integrated Chinese and Western medicine research, their mechanisms have been continuously elucidated, clinical protocols have become increasingly standardized and precise, and their combination with modern rehabilitation has achieved synergistic efficacy. This article reviews recent domestic clinical research progress on acupuncture and tuina for pediatric cerebral palsy from the aspects of mechanisms, clinical treatment protocols, efficacy evaluation systems, and combined application models, aiming to provide a reference for developing individualized and comprehensive rehabilitation plans for children with this condition.

目的:分析川崎病患儿肠道菌群构成及分布与其冠状动脉病变的相关性.方法:选择我院自2020年1月至2023年2月接诊的86例川崎病患儿作为研究对象,根据是否出现冠状动脉病变,分为冠状动脉病变组(35例)和非冠状动脉病变组(51例).检测所有患儿的肠道菌群多样性[肠道菌群丰度(Ace指数)、肠道菌群多样性(Shannon指数)]、肠道菌群构成比例[门水平(变形菌门、厚壁菌门、拟杆菌门)、属水平(乳杆菌属、拟杆菌属、韦荣球菌属)],使用多因素Logistic回归分析肠道菌群构成及分布与冠状动脉病变的关系.结果:冠状动脉病变组Ace指数大于非冠状动脉病变组(P＜0.05);冠状动脉病变组与非冠状动脉病变组的Shannon指数比较无差异(P＞0.05);冠状动脉病变组肠道厚壁菌门占比低于非冠状动脉病变组,拟杆菌门占比高于非冠状动脉病变组(P＜0.05);冠状动脉病变组与非冠状动脉病变组的肠道变形菌门占比比较无差异(P＞0.05);冠状动脉病变组肠道乳杆菌属占比、韦荣球菌属占比均低于非冠状动脉病变组(P＜0.05);冠状动脉病变组与非冠状动脉病变组的肠道拟杆菌属占比比较无差异(P＞0.05);经多因素Logistic回归分析,肠道Ace指数、厚壁菌门、拟杆菌门、乳杆菌属、韦荣球菌属均是川崎病患儿发生冠状动脉病变的独立影响因素(P＜0.05).结论:川崎病患儿肠道菌群构成及分布与其冠状动脉病变密切相关,为改善肠道菌群失调、增加患儿的临床获益提供依据,应引起临床重视.

Background:The imbalance of immune response between helper Th1 and Th2 cells is the direct cause of asthma. It was closely related to abnormal expression of lncRNAs. However, whether lncRNAs can regulate Th1/Th2 balance in pediatric asthma remains to be investigated.Methods:Peripheral blood samples were collected from children with asthma and normal volunteers at the Children's Hospital of Shaanxi Provincial People's Hospital (Xi'an, China) in 2020. The qRT-PCR was used to detect the expression of lncRNA NEAT1, miR-217 and GATA3 in peripheral blood samples. The effects of lncRNA NEAT1, miR-217, and GATA3 on CD4+T cell population were detected in vitro. Meanwhile, the regulatory effect of lncRNA NEAT1/miR-217/GATA3 was evaluated through the dual luciferase report assay, functional assays and animal experiments.Results:We investigated that lncRNA NEAT1 and GATA3 was significantly up-regulated in CD4+T cells in peripheral blood of children with asthma (P<0.001). Knockdown of lncRNA NEAT1 or GATA3 significantly reduced Th2-related cytokines (P<0.05), but had no effect on Th1 cells. Importantly, the interactions of lncRNA NEAT1 with miR-217 and miR-217 with GATA3 were confirmed by dual luciferase report assay. Meanwhile, functional assays and animal experiments demonstrated that lncRNA NEAT1 regulated GATA3 expression through sponge miR-217, thereby regulating Th1/Th2 balance in CD4+T cells in pediatric asthma.Conclusion:lncRNA NEAT1/miR-217/GATA3 axis may reveal the immunological mechanism of pediatric asthma, which has potential clinical application value in the future.

In this paper, we report a case of autism in a child who was cured of Kawasaki disease and the condition of autism was significantly improved. Kawasaki disease (KD), also known as cutaneous mucosal lymph node syndrome, was first reported by Japanese doctor Tomaku Kawasaki in 1967. In recent years, domestic and foreign studies believe that the pathogenesis of KD is significantly related to infection, genetic susceptibility and immune response, and its pathogenesis and treatment still need to be further studied. The occurrence of autism may be based on genetic predisposition and triggered by environmental factors during the critical period of immune establishment at the age of 1-3 years, which causes immune-mediated inflammation, changes the permeability of gastrointestinal tract and blood-brain barrier, and leads to chronic inflammation in the central nervous system, thereby affecting neurogenesis, migration and synaptic construction.

COVID-19 has been known as the part of “epidemic disease” in TCM (Traditional Chinese Medicine). The reason is that the human body feels the external toxin and pathogen. The pathogenesis is mainly "wet, heat, poison, stasis, deficiency" and the lesions are the principal in the spleen, lungs, and stomach. There are 4 COVID-19 waves in South Africa including ancestral variants, Beta, Delta, and Omicron. Compared COVID-19 cases of the 4 waves and found the admission rate of Omicron was 4.9%, Delta was 13.7%, and Beta was 18.9% (P<0.001). It also found that 28.8% of inpatients of Omicron were critical patients, while critical inpatients of Beta, and Delta were 60.1% and 66.9% respectively (P<0.001). The infectivity of Omicron is ten times that of Delta. Day on Jan 17, 2022, there were about 125 million omicron infections were diagnosed in the world. The current COVID-19 epidemic situation is frustrating. Today there are still no effective vaccines and targeted therapies for the treatment of COVID-19. Fight against the epidemic diseases in China, 90% of confirmed cases have been treated with TCD. TCD can effectively relieve symptoms, shorten the course of the disease, improve the cure rate, reduce the mortality rate, and promote rehabilitation, the total effective rate is more than 90%. This unique system of TCM has opened a new avenue to fight the novel pandemic.

目的:探讨阿托伐他汀对小鼠川崎病的治疗作用及机制.方法:把小鼠随机分为模型组、对照组、实验组,每组各20只.模型组和实验组在实验时开始给予干酪乳杆菌细胞壁提取物(LCWE)腹腔注射,对照组给予0.9％氯化钠溶液0.5 ml腹腔注射.实验组于实验第5天口服阿托伐他汀10 mg/d,模型组和对照组均腹腔注射等量0.9％氯化钠溶液.在实验第14、28天,每组取8只小鼠行超声心动图检测,并留取心脏标本进行病理分析.通过蛋白质印迹和电泳迁移率实验方法(EMSA)检测心脏组织核因子(NF)-κB表达量及活性.通过蛋白质印迹法和明胶酶谱法检测心脏组织基质金属蛋白酶-9(MMP-9)表达量及活性.结果:LCWE注射后HE染色发现,模型组小鼠冠状动脉局部可见炎性细胞浸润,第14、28天超声心动图检查可见冠状动脉增宽,阿托伐他汀治疗后炎性细胞浸润程度降低,左冠状动脉主干内径减小.模型组第14、28天NF-κB表达量高于对照组和实验组(均P<0.01),实验组和对照组NF-κB表达量比较差异无统计学意义(P>0.05).模型组第14、28天NF-κB活性明显高于对照组和实验组(均P<0.01),且实验组NF-κB活性明显高于对照组(P<0.05).模型组第14、28天MMP-9表达量及活性高于对照组和实验组(均P<0.05),实验组和对照组MMP-9表达量及活性比较差异无统计学意义(均P>0.05).结论:阿托伐他汀对小鼠川崎病具有一定的治疗效果,其作用机制可能是抑制川崎病小鼠模型N F-κB和MMP-9过度表达与激活,从而减少血管炎的发生.

This article reports a case of incomplete Kawasaki disease with no response to intravenous immunoglobulin (IVIG). A girl, aged 1 year, had the symptoms of fever, rash, finger desquamation, and coronary artery ectasia. She still had fever at 36 hours after the first dose of IVIG treatment, and her temperature returned to normal after the second dose of IVIG treatment. The follow-up after 1 month showed that the coronary artery diameter returned to normal. This article summarizes the experience in the treatment of incomplete Kawasaki disease with no response to IVIG in order to reduce the incidence of coronary artery damage.

Kawasaki shock syndrome is a severe disease that seriously affects cardiac in children . We need for early identification, timely and correct processing. This review of reference to eighteen international important literature, for the onset of KDSS, diagnosis and treatment, improve the level of diagnosis and treatment technology for KDSS.

Omicron is a newly discovered new variant virus, which spreads rapidly around Russia and the world and has a great impact. It is designated as a variant of concern (VOC) by the World Health Organization. Its characteristic of epidemiology, distribution, pathogenic and clinical diagnosis, treatment, and prevention is still being observed and summarized, and Clinical manifestations of COVID-19 infection are nonspecific, especially in preterm infants. Since there are few reports on the diagnosis and treatment of children with this infection. This article studies the diagnosis, treatment, and prevention of omicron in Russian children, to improve the understanding and attention to the disease.

Kawasaki disease (KD) is an acute, febrile, erupting, self-limited autoimmune disease with systemic vasculitis as the main lesion. It is more common in children under 5 years old, and the main lesions associate the coronary arteries. With the increasing incidence, it has become the first cause of acquired heart disease in children. There are many basic and clinical studies on Kawasaki disease at home and abroad, but there are few animal experimental studies on the treatment of coronary artery injury with stem cells. Therefore, it is of great value to select scientific experimental animal models for Kawasaki disease research to simulate the human characteristics of Kawasaki disease. Through the establishment and in-depth study of animal models of Kawasaki disease, it is helpful to better understand the pathophysiology, cytokines and molecular pathways related to disease advancement of Kawasaki disease. At the same time, it will augment the way for the development of new and effective diagnosis and treatment of Kawasaki disease. Therefore, based on the study of coronary artery lesion animal model of Kawasaki disease with stem cells, this article mainly discusses the research and new progress of Kawasaki disease animal models, so as to provide a good theoretical basis for clinical and animal experimental research. And make a review on this issue.

目的 探讨CD209基因3′非翻译区(3′UTR)单核苷酸多态性(SNP)与川崎病(KD)及冠状动脉损伤(CAL)的关联性.方法 采用Long-PCR方法 ,对2017年9月至2019年9月在陕西省人民医院儿童病院住院的KD患儿40例(KD组)及同期健康体检儿童40例(对照组)的CD209基因进行全长测序,根据是否合并CAL,KD组又分为CAL组(14例)和非CAL(NCAL)组(26例),分析评价其3′UTR区TagSNPs与儿童KD易感性和CAL发生的遗传关联性.结果 KD组的CD209基因rs4804800位点G等位基因和rs11465421位点T等位基因分布频率显著高于对照组(χ2值分别为3.906、4.103,均P<0.05);rs4804800位点携带G等位基因的基因型较AA基因型发生KD的风险显著增加(OR=2.818,P<0.05),rs11465421位点携带T等位基因的基因型较GG基因型发生KD的风险显著增加(OR=2.714,P<0.05);CAL组各位点基因型及等位基因分布与非CAL组比较均无显著性差异(均P>0.05).结论 CD209基因3′UTR区多态性与儿童KD的易感性相关联,但与CAL的发生无显著关联.

目的 探究紫草素对肺炎链球菌引起的肺炎小鼠细胞外信号调节激酶/p38丝裂素活化蛋白激酶/核苷酸结合寡聚化结构域样蛋白3(ERK/p38/NLRP3)信号通路及肺血管通透性的影响.方法 采用肺炎链球菌悬液50 L滴加BALB/c小鼠破损鼻黏膜建立肺炎链球菌性肺炎模型,成模小鼠采用随机数字表法分为模型组、紫草素低、中、高浓度组及头孢呋辛酯组,另取鼻腔滴加50 L生理盐水BALB/c小鼠为对照组,每组10只,紫草素低、中、高浓度组分别给予紫草素12.5 mg/kg、25.0 mg/kg、50.0 mg/kg,头孢呋辛酯组给予头孢呋辛酯50.0 mg/kg,对照组、模型组给予等量生理盐水,每天1次,连续灌胃7 d.末次给药12 h后处死小鼠,检测各组小鼠左肺湿/干重比值(W/D),每组采用随机数字表法选取4只小鼠进行1％伊文氏蓝5 mL/kg尾静脉注射检测肺血管通透性,酶联免疫吸附试验(ELISA)检测肺组织白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)表达量,实时荧光定量聚合酶链式反应(RT-qPCR)及蛋白质印迹法(WB)分别检测肺组织ERK、p38、NLRP3 mRNA及蛋白表达.结果 与对照组比较,模型组小鼠肺组织W/D比值[(4.49±0.27)％比(3.02±0.15)％]、肺血管通透性[(0.091±0.009)g/mg比(0.034±0.004)g/mg]、IL-1β[(567.29±14.65)pg/mL比(102.46±6.73)pg/mL]、TNF-α[(417.16±12.89)pg/mL比(83.59±6.28)pg/mL]、ERK、p38、NLRP3 mRNA及蛋白表达水平均显著增加(P<0.05);与模型组比较,紫草素低、中、高浓度组小鼠肺组织W/D比值、肺血管通透性、IL-1β、TNF-α表达量、ERK、p38、NLRP3 mRNA及蛋白表达水平均依次降低(P<0.05),紫草素高剂量组均低于头孢呋辛酯组(P<0.05).结论 紫草素可减轻肺炎链球菌性肺炎小鼠肺组织损伤、炎症反应及肺血管通透性,可能与抑制ERK/p38/NL?RP3信号通路有关.

The cases of coronavirusdisease 2019 in children have been increasing with the ongoing pandemic.The finding suggests children have mild symptoms and a short course of the disease. Angiotensinconverting enzyme-2 mediates entry of the virus into the cell, the combination of virus and ACE2 leads to an increase in activity of angiotensin II, resulting in acute injury to lungs, myocardium and other organs. The infection causes down-regulation of ACE2 expression. The ACE2 plays an important role in the infection progression and clinical characteristics of COVID-19. Works on ACE2 and virus spike protein have future prospects of strategic information on prevention, management as well as vaccine development.

目的 探讨川崎病(Kawasaki disease,KD)患儿发生首剂静脉免疫球蛋白(intravenous immunoglobulin,IVIG)抵抗的潜在预测因素.方法 回顾性分析301例KD患儿临床资料,将其分为IVIG不敏感组和IVIG敏感组,比较2组的基线资料及实验室指标,利用二元Logistic回归分析确定IVIG抵抗的危险因素,并构建受试者工作特征(receiver operating characteristic,ROC)曲线以确定危险因素的最佳预测界值和对应的敏感度、特异度.结果 与IVIG敏感组相比,IVIG不敏感组的中性粒细胞比率(N％)、嗜碱性粒细胞比率(B％)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、降钙素原(PCT)水平更高(P<0.05);淋巴细胞比率(L％)、单核细胞比率(M％)、红细胞比积(HCT)、平均红细胞血红蛋白量(MCH)、肌酸激酶(CK)、钠离子浓度(Na+)水平更低(P<0.05).二元Logistic回归分析结果显示,AST和PCT是IVIG抵抗的独立危险因素.ROC曲线分析结果显示,当AST≥29.5 U/L时,预测KD患儿发生IVIG抵抗的敏感度和特异度分别为91.7％、64.4％,当PCT≥1.70 ng/mL时,预测KD患儿发生IVIG抵抗的敏感度、特异度分别为91.7％、62.3％.结论 AST及PCT可作为KD患儿发生IVIG抵抗的潜在预测因素.

Objective:To explore the role of regular BMI monitoring and bone density testing in children's growth and development.Methods:A total of 984 children aged 5-15 years old in our physical examination from Janu-ary 1,2015 to January 1,2016 were selected as study objects and randomly divided into observation group and con-trol group.Control group children were given routine health development knowledge guide,observation group chil-dren in addition to regular child development and health care knowledge guidance,and regular monitoring of BMI and bone mineral density measurement,according to monitoring results,children and parents were related to monitoring education.The height,weight,BMI index,obesity rate,and bone mineral density were compared between the two groups.Results:Compared with children in the control group,the children in the observation group and the control group had significant differences in height,weight,and BMI index (P＜0.05).The incidence of overweight and o-besity in the observation group was significantly lower than that in the control group.The difference was statistically significant.Significance (P＜0.05) ;BMD was higher in children in the observation group than in the control group, with a statistically significant difference (P＜0.05).Conclusions:Children's regular BMI and bone mineral density tests help children grow physically and promote more healthy growth.

Objective: Retrospective clinical analysis of adverse drug reactions in children. Methods: Clinical data analysis was performed on 844 cases of hospitalized children reported for adverse drug reactions. Results: Children under 3 y of age were more prone to the adverse drug reactions; adverse reactions were mainly caused by antibiotics and traditional Chinese medicine; intravenous rout was the most common mode of administration of drug causing adverse reaction; adverse drug reaction was mostly observed within 1 h of drug administration; most common clinical manifestation of adverse drug reactions was the skin damage. Conclusions: More attention should be paid towards rational use of drugs, to avoid multiple drug use as far as possible, and to focus on prevention of adverse drug reactions, timely detection if happened and immediate treatment. Establishment of drug reaction reporting system will definitely help the physicians across the globe to better understand the phenomenon.

目的 探讨盐酸哌甲酯联合行为矫正治疗儿童注意缺陷多动障碍的临床疗效.方法 选取陕西省人民医院儿科自2015年3月至2017年2月收治的150例注意缺陷多动障碍患者,按随机数字表分法分为A、B两组,每组各75例患儿.A组给予常规疗法和行为矫正联合治疗,B组采取盐酸哌甲酯辅助行为矫正治疗.比较两组患儿治疗前及治疗后的Conners父母用量表、综合反应控制力商数(FRCQ)和综合注意力商数(FAQ)及临床疗效.结果 治疗后,B组患儿品行问题、学习问题、身心障碍、冲动-多动、多动指数因子分显著低于A组,差异均有统计学意义(P<0.05);但两组焦虑因子分比较,差异无统计学意义(P>0.05).治疗后,B组的FRCQ、FAQ总分明显大于A组,差异均有统计学意义(P<0.05).B组临床治疗有效率为93.3％(70/75),明显大于A组的81.3％(61/75),差异有统计学意义(P<0.05).结论 盐酸哌甲酯辅助行为矫正能有效提高注意缺陷多动障碍患儿的注意力,减少患儿的行为冲动,从而提高其自我控制能力,促进临床疗效.

Objective To explore the clinical efficacy of Montelukast sodium combined with budesonide in the treatment of 89 children with asthma,and to provide data for treatment of asthma in children.Methods This study enrolled 89 children with asthma treated between December 2015 and December 2016 in Shanxi Provinciar Reople's Hospital.The clinical data was retrospectively analyzed to compare the curative effect.48 of these cases who received Montelukast sodium combined with budesonide treatment were assigned to the observation group,while 41 of these children who received budesonide treatment were selected as the control group.Clinical efficacy was compared after three consecutive months of treatment,so were cough and wheeze extinction time of the two groups.Preoperative and postoperative levels of serum procalcitonin (PCT) and C-reactive protein (CRP) of the two groups were detected through enzyme-linked immunosorbent assay (ELISA),and the immunoglobulin E (IgE) level was determined.At the same time,pulmonary function indexes before and after treatment were compared,and the recurrence and adverse reactions were recorded within the follow-up period.Results The total effective rate of the observation group was 95.83%,which was significantly higher than that of the control group (85.37%),so the difference was of statistical significance (P＜0.05).The cough and wheeze extinction time of the observation group was significantly shorter than that of the control group (P＜0.05).PCT,CRP,and IgE levels of the two groups were significantly decreased after treatment,especially in the observation group,and the difference was statistically significant (P＜0.05).FVC,FEV1 and FEV1/FVC levels of the two group were significantly increased after treatment,especially in the observation group,and the difference between the two groups was of statistical significance (P＜0.05).The incidence of adverse reactions of the two groups was not significantly different (P＞0.05),but the recurrence rate of the observation group was significantly lower than that of the control group (P＜0.05).Conclusion Compared with budesonide treatment alone,the combined treatment with Montelukast sodium can significantly improve clinical efficacy of asthma in children,reduce recurrence and inflammatory responses,and enhance lung function as well.

目的 探讨儿童重症肺炎合并呼吸衰竭患儿采用经鼻持续正压通气治疗的临床效果.方法 选取我院收治的84例儿童重症肺炎合并呼吸衰竭患儿,随机分为试验组(42例)与对照组(42例),对照组患儿应用常规治疗,试验组患儿在常规治疗基础上采用经鼻持续正压通气治疗,对两组患儿的治疗效果进行对比分析.结果 治疗后,两组患儿的血气指标明显优于治疗前,差异具有统计学意义(P<0.05);试验组血气指标优于对照组,差异具有统计学意义(P<0.05).试验组患儿治疗总有效率明显优于对照组,差异有统计学意义(P<0.05).结论 儿童重症肺炎合并呼吸衰竭采用经鼻持续正压通气治疗可以取得较显著的治疗效果,能够快速改善患儿的临床症状,减少不良反应,安全可靠,值得临床推广应用.