BACKGROUND:Asthma is a chronic inflammatory disease of the airways, characterized by immune cell infiltration and airway hyperresponsiveness. Recent studies have identified lncRNAs as key regulators in asthma pathogenesis, but the underlying mechanisms remain unclear. LINC00458, a lncRNA, has been implicated in various diseases, yet its role in asthma has not been thoroughly investigated. AIM:This study aims to explore the role of LINC00458 in asthma and its potential mechanism in regulating inflammation and ferroptosis. METHODS:The expression of LINC00458 in asthma cells and tissues was measured using qPCR. The effects of LINC00458 knockdown were evaluated in primary human bronchial epithelial (NHBE) cells treated with house dust mite (HDM) extract. The interaction between LINC00458 and ELAVL1 was assessed using RNA pulldown and RIP-qPCR. HMOX1 mRNA stability and its impact on ferroptosis were also analyzed. Finally, the m6A modification of LINC00458 was examined using MeRIP-qPCR and RNA pulldown assays. RESULTS:LINC00458 was upregulated in asthma cells and tissues. Knockdown of LINC00458 suppressed ferroptosis and inflammatory cytokine release. LINC00458 stabilized HMOX1 mRNA by interacting with the RNA-binding protein ELAVL1. Furthermore, METTL3-mediated m6A modification promoted the stability of LINC00458, enhancing its inflammatory response regulation. CONCLUSION:LINC00458 plays a significant role in asthma by modulating inflammation and ferroptosis. Its interaction with ELAVL1 and m6A modification pathway suggests potential therapeutic targets for asthma treatment.

Background:Respiratory syncytial virus (RSV) is one of the most common virus causing community-acquired pneumonia (CAP) in children. To guide the prevention, diagnosis and treatment of RSV, we aimed to analyze the epidemiology of RSV in hospitalized children with CAP.Methods:A total of 9,837 hospitalized children (≤14 years old) with CAP from January 2010 to December 2019 were reviewed. Using the real-time polymerase chain reaction (RT-PCR), the oropharyngeal swab specimens were collected and tested for RSV, influenza virus A (INFA), influenza virus B (INFB), parainfluenza virus (PIV), enterovirus (EV), coronavirus (CoV), human metapneumovirus (HMPV), human bocavirus (HBoV), human rhinovirus (HRV), and adenovirus (ADV) for each patient.Results:The detection rate of RSV was 15.3% (1,507/9,837). From 2010 to 2019, the RSV detection rate showed a wavy change (χ2=166.982, P<0.001), with the highest detection rate in 2011 (158/636, 24.8%). RSV can be detected throughout the year, with the highest detection rate in February (123/482, 25.5%). Children younger than 0.5 years old had the highest detection rate (410/1,671, 24.5%). The detection rate of RSV in male children (1,024/6,226, 16.4%) was higher than that in female children (483/3,611, 13.4%) (P<0.001). A proportion of 17.7% (266/1,507) of RSV positive cases were also co-infected with other viruses, and INFA (41/266, 15.4%) was the most common coinfection virus. After adjusting for potential confounders, the RSV-positive children were associated with increased risk of severe pneumonia [odds ratio (OR) 1.26, 95% confidence interval (CI): 1.04 to 1.53, P=0.019]. Moreover, children with severe pneumonia had significantly lower cycle threshold (CT) values of RSV than those without severe pneumonia (28.88±3.89 vs. 30.42±3.33, P<0.01). Patients with coinfection (38/266, 14.3%) had a higher risk of severe pneumonia than those without coinfection (142/1,241, 11.4%), but the difference was not statistically significant (OR 1.39, 95% CI: 0.94 to 2.05, P=0.101).Conclusions:The detection rate of RSV in CAP hospitalized children changed by years, months, ages, and sexes. CAP hospitalized children with RSV are more likely to develop severe pneumonia than those without RSV. Policy makers and doctors should make timely adjustments to prevention measures, medical resources and treatment options based on these epidemiological characteristics.

目的:总结因DNAAF3突变引发原发性纤毛运动障碍(primary ciliary dyskinesia,PCD)患儿临床表现、诊治要点及治疗转归.方法:回顾性分析广州医科大学附属第一医院儿科2022年7月9日收治的1例男性PCD患儿(4个月10天)的临床资料及诊治经过,并以"原发纤毛运动障碍DNAAF3基因"检索万方、中国知网、中国生物医学文献数据库,以"primary ciliary dyskinesia DNAAF3"检索PubMed数据库进行文献复习,检索时间截止至2022年8月.结果:患儿出生后(2022年3月1日)因反复"新生儿肺炎/重症肺炎、内脏反位、病理性黄疸、新生儿贫血、新生儿败血症"予以化痰、平喘、抗感染、无创呼吸机辅助通气治疗,疗效不佳.于2022年7月因"反复咳嗽4个月余,加重伴喘息2 d"就诊于广州医科大学附属第一医院.经完善血常规、炎症指标、呼吸道病原学检测、胸部CT扫描、心脏及肝胆脾胰彩色多普勒超声检查后,提示肺部感染(肺炎链球菌、呼吸道合胞病毒、2型副流感病毒感染)、多部位内脏转位;纤维支气管镜检查见左、右支气管镜像倒置;纤毛活检电镜检出纤毛外动力臂缺失明显;全外显子组测序检测证实患儿存在DNAAF3基因突变(c.748_752dupGACGC和c.326G＞C),诊断为PCD0予化痰、抗感染、纤维支气管镜灌洗治疗10d后好转出院.结合检索到的4例由DNAAF3基因突变导致的PCD患者,发现4例患儿确诊年龄均＜1岁,另1例也仅10岁.5例患儿均为足月顺产,除本例患儿外,其余均有新生儿呼吸窘迫和鼻窦炎表现.胸部CT扫描提示5例均有内脏左右异位.呼吸道纤毛电镜示1例动力臂稀少、3例内外动力臂缺失、1例外动力臂缺失.5例基因突变染色体位置不同,可见于2、3、4、5、6、12、19号染色体.诊断明确后予抗感染或对症治疗后均转归良好.结论:DNAAF3基因突变可导致儿童原发性纤毛运动障碍,临床表型与基因型相关.临床工作中,对儿童出现内脏转位且反复出现咳嗽、咳痰和鼻窦炎者应提高警惕,可借助鼻呼气一氧化氮检测、呼吸道纤毛电镜检查和基因检测来提高PCD确诊率.

混合式教学充分利用现代信息技术、线上与线下结合进行翻转课堂教学,有助于提升教学效果.本文分享混合式教学在儿科学理论教学和实践技能教学中的应用体会.

新生儿窒息是围产期新生儿死亡和致残的主要原因之一[1].新生儿复苏是针对刚娩出的患儿无法建立自主呼吸的抢救措施,能有效减少新生儿窒息引起的低氧血症、高碳酸血症及全身脏器损害,是一种迅速、便捷、高效地减少伤残率的手段[2].因此,熟练掌握新生儿复苏是医务人员必备的基本素质,但现阶段我国基层医务人员对新生儿复苏技术的掌握情况较差,尤其是初级职称人员[3].目前在本科阶段已开展新生儿复苏的教育,但师生反映教学比较难.本文统计了207名广州医科大学2014级临床医学本科班学生新生儿复苏考核的失分点,总结新生儿复苏的医学本科教育的学习难点,并提出解决对策.

BACKGROUND Refractory mycoplasma pneumonia (RMPP) is one of the important pathogens of community-acquired pneumonia (CAP) in children. Its treatment is difficult. The aims of this study were to analyze the clinical manifestations, diagnosis, and treatment of 20 cases of RMPP in children in order to provide a reference for the diagnosis and treatment of RMPP. METHODS The clinical data of 20 patients with RMPP admitted to the Pediatrics Department of the First Affiliated Hospital of Guangzhou Medical University in the recent three years were retrospectively analyzed. The clinical data of 36 patients with common mycoplasma pneumonia in the same period were compared. The clinical manifestations, laboratory examinations, and imaging characteristics of RMPP were discussed. Intrapulmonary and extrapulmonary complications and treatment were also analyzed in order to provide assistance in the diagnosis and treatment of RMPP. RESULTS There were significant differences between the refractory group and the general group in terms of heat duration, hospitalization time, hypoxemia, lung rales, CRP, ESR, PCT, LDH, ALT, PLT, WBC, D dimer and other laboratory examinations, intrapulmonary and extrapulmonary complications, and treatment (all P<0.05). There was no significant difference in the age, sex, and wheezing between the two groups (P>0.05). CONCLUSIONS Long duration of fever, tachycardia, and lung rale protrusion may be the clinical characteristics of RMPP. Unilateral pulmonary shadow and atelectasis should be paid more attention, which may be a high-risk factor for the development of RMPP. The inflammation index of RMPP cases increased and there were many complications inside and outside the patients' lungs. It was necessary to give enough macrolides to fight the infection by using Glucocorticoid and Intravenous immunoglobulin reasonably while liver, heart, and fiberoptic bronchoscopy was completed to improve the effectiveness of the diagnosis and treatment.

在我国开放二孩政策后,儿科医生极度短缺,加快儿科医生的培养乃当务之急.然而目前高校医学教学儿科学课时短,常规课堂教学存在难点解析不够透彻的问题,学生难以在短短的课堂学习中完全掌握难点内容.现阶段儿科学教学迫切需要一种主题鲜明、高效、灵活、便于学生自习的教学方法进行弥补.微课这一新型教学模式将学习中遇到的重点和难点转换成"碎片化"视频,具有篇幅短但主题明确、网络交流便利,使学生有自主性学习选择从而提升学习效率的优势.微课这一新型教学模式也成为高校教育教学改革的热点,受到国内外教育领域的广泛关注.儿科学难点解析微课能有效解析教学难点,弥补课堂教学的不足.

目的 探讨品管圈活动降低早产儿肺部感染发生率的应用效果。 方法 成立品管圈，确立降低早产儿肺部感染发生率为活动主题，进行现况调查，要因分析，遵循PDCA流程，依据5W1H原则制定对策并实施。 结果 早产儿肺部感染发生率由活动前的15.69%下降到活动后的1.85%（P<0.05）；圈员在解决问题能力、团队精神、沟通协调能力、责任心、工作积极性等方面取得进步。 结论 品管圈活动可有效降低早产儿肺部感染发生率，从而降低新生儿医院感染的发生，增加了团队凝聚力，提升了新生儿医护人员解决问题的能力。

患儿,女,2月龄,因低热1月余,咳嗽1周入院.1月余前无明显诱因出现反复低热,体温波动在37℃～ 38℃,无时间规律性,能自行退热,曾在外院门诊予口服抗生素治疗后仍发热.近1周出现干咳,非连续性刺激性咳嗽,病程中无气促,无喘息,无发绀,无咯血.精神好,多汗,胃纳欠佳,大小便正常. 患儿足月顺产,出生体重3 kg,无窒息抢救史,出生后常规接种卡介苗,生后1个月内左上臂接种部位曾出现红肿、化脓、破溃,持续约1个月愈合.与患儿接触的家人均否认结核病史,胸片检查均无异常,患儿父亲PPD试验阳性(++),母亲PPD试验阴性. 入院体查:T 36.8℃,P 150次/分,R40次/分,体重5 kg.神志清,反应好,营养中等,皮肤弹性良好.左上臂三角肌外缘处皮肤一红色硬结,直径约1 cm×1 cm,周围皮肤无红肿,无破溃,无渗液,全身浅表淋巴结未触及.咽无充血,口腔黏膜光滑.胸廓无畸形,呼吸平顺,未见三凹征,双肺叩诊清音,两侧呼吸音对称,增粗,未闻及罗音.心率150次/分,心律齐,心音有力,未闻及杂音.腹部平软,按压无哭闹,肝脾未及,肠鸣音正常.

OBJECTIVE:To analyze the clinical characteristics, image findings, laboratory examination, the therapeutic methods and clinical outcomes of bronchiolitis obliterans (BO) in pediatric patients.METHOD:Twenty-six pediatric patients with BO were reported. All data were collected from cases who were hospitalized in the Department of Pediatrics, First Affiliated Hospital of Guangzhou Medical College from June 1(st), 2009 to the April 30(th), 2011, and infectious agents, clinical manifestations, risk factors, changes in imageology, laboratory examination, therapeutic methods and treatment responses were analyzed.RESULT:The ranges of age at onset was 4.5 months-8 years in 26 cases (18 boys and 8 girls). The course of disease was (6.2 ± 3.5) months. The period of followed-up ranged from 2 to 24 months. The common clinical characteristics were persistent wheezing of different severity (26 cases, 100%), cough (24 cases, 92%), intolerance to exercise (22 cases, 85%), short of breath (21 cases, 81%), retraction (20 cases, 77%), wheezy phlegm (16 cases, 62%), keeping with crackles (10 cases, 38%), cyanosis around the mouth (3 cases, 12%) and no clubbed fingers (toes). In 18 cases the etiology was detected, mycoplasma (11 cases, 42%), respiratory syncytial virus (4 cases, 15%), parainfluenza virus (2 cases, 8%), influenza virus A (2 cases, 8%) and influenza virus B (2 cases, 8%), human bocavirus (HBoV) (1 case, 4%). There were 8 cases (31%) with combined infection. Chest X-ray in 10 cases indicated changes suggestive of bronchopneumonia (38%), in only 1 case there was an image of interstitial pneumonia disease (4%). All the patients were diagnosed by high-resolution computerized tomography (HRCT). All cases were demonstrated to have air retention, poor blood perfusion in lung, just like "Westemark sign" with HRCT. In 19 cases antineutrophil cytoplasmic antibody (ANCA) was determined and 10 patients (53%) were positive for P-ANCA, and 8 cases (42%) were positive for C-ANCA. All patients received oral corticosteroid and low doses azithromycin. In 13 cases (50%) the treatment effectively reduced the severity of disease and the frequency of cough and wheezing. The average number of days for symptom improvement was (7.1 ± 4.8) days.CONCLUSION:Respiratory infection plays an important role in BO in children. The chronic and persistent wheezing, cough, intolerance to exercises, short breath, retraction were the main clinical manifestations. But these symptoms are non-specific. Chest X-ray can not provide enough information for diagnosis. Classical "Westemark sign" with HRCT is an important sign. ANCA with a high positive rate (approximately 50%) suppose immuno-lesion in BO. Oral corticosteroid and methotrexate may relieve clinical symptoms.

BACKGROUND:Little data have been available concerning the mechanism of drag resistance and anti-apoptosis in leukemic cells of leukemia children.The majority of studies focus on normal bone marrow mesenchymal stem cells (MSCs) and established stroma cells,but not interaction of MSCs and leukemic cells in leukemia children.OBJECTIVE:To explore the effect of MSCs in leukemia children on the proliferation and apoptosis of leukemic cell strain K562/AO_2.DESIGN,TIME AND SETTING:In vitro cytology experiment was performed at the laboratory of Department of Pediatrics,First Affiliated Hospital of Guangzhou Medical College from December 2007 to August 2008.MATERIALS:MSCs were provided by 30 leukemia children admitted to First Affiliated Hospital of Guangzhou Medical College,including 22 acute lymphoblastic leukemia and 8 acute myeloblastic leukemia.Written informed content was obtained from all families.K562/AO_2 was provided by Tianjin Institute of Hematopathy.METHODS:MSCs were isolated and cultured by Ficoll density gradient method.They were cultured in two conditions:the co-culture of MSCs and K562/AO_2 and K562/AO_2 suspension alone.In co-culture group,1×10~8 /L K562/AO_2 cells at log phase were added to confluent MSCs,and free floating K562/AO_2 cells were discarded after 24 hours.MAIN OUTCOME MEASURES:Effect of MSCs on the growth of K562/AO_2 cells was observed;effect of addamycln on K562/AO_2 cell apoptosis was detected by AnnexinV-FITC method.Cell cycle was determined by flow cytomtry,mdrl gene of K562/AO_2 cell was detected by Taqman-MGB probe real-time PCR.RESULTS:Compared with K562/AO_2 alone,the K562/AO_2 cell co-cultured with MSCs grew slower and the log phase of growth was not significant;the rate of apoptosis in earlier period was significantly decreased (P ＜ 0.05);co-cultured K562/AO_2 G_0-G_1 phase increased,but S phase decreased.No changes in mdr1 gene in cells were found between two culture conditions (P ＞ 0.05).CONCLUSION:In vitro cytology has demonstrated that leukemia children MSCs induce drug resistance of K562/AO_2 cells by changing K562/AO2 cell cycle through adhesion to avoid pro-apoptotic effect of drugs but not related with mdr1 gene.