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Monkeypox and the perinatal period:what does maternal-fetal medicine need to know?

World Journal of Pediatrics 2023年第3期19卷 213-223页

作者： Kai Yan Lu-Kun Tang Fei-Fan Xiao Peng Zhang Chun-Mei Lu Li-Yuan Hu lai-shuan wang Guo-Qiang Cheng Wen-Hao Zhou Department of Neonatology Children Hospital of Fudan UniversityNational Children's Medical CenterShanghai 201102China Kunming Medical University Kunming 678400China Department of Neonatology Dehong People's HospitalKunming 650000China Department of Nursing Children's Hospital of Fudan UniversityNational Children's Medical CenterShanghai 201102China Key Laboratory of Neonatal Diseases of National Health Ministry Shanghai 201102China

Background After the global elimination of smallpox,monkeypox has become the most threatening orthopoxvirus to human health.Very few studies have been reported on pregnant women and newborns.In the case of monkeypox infection,the virus can cause serious adverse pregnancy events in women,which can lead to fetal or neonatal death.Data sources We made a comprehensive review after an extensive literature search in the PubMed/Medline database and websites concerning smallpox and monkeypox.Results Two case reports reported a total of nine pregnant women,six of whom had fetal deaths.In the autopsy of a stillbirth,researchers found that the placenta was infected with monkeypox virus,but the mechanism of infection remains unclear.Smallpox vaccine should be administered to acutely exposed pregnant women and newborns.Several novel recombinant vac-cinia immunogloblin(rVIG)and human-specific monoclonal antibodies are being developed for the prevention and treatment of monkeypox virus infection.After the fetus was delivered,the newborn should take a bath as soon as possible to remove the amniotic fluid and dirt from the body.The appropriate isolation protocol for the newborn should be selected according to the infection status of the mother.It is not known whether monkeypox virus is present in breast milk,and pasteurized breast milk can be given to newborns when breastfeeding is considered.Conclusion This review presents an overview of monkeypox in the perinatal period and guides the future research direction.

关键词： Fetal Maternal Monkeypox Newborn

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What can we learn from neonates with COVID-19?

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World Journal of Pediatrics 2020年第3期16卷 280-283页

作者： Tian-Tian Xiao Kai Yan lai-shuan wang Wen-Hao Zhou National Clinical Research Center for Children's Hospital of Fudan University ShanghaiChina Department of Neonatology Children's Hospital of Fudan University399 Wanyuan RoadShanghai 201102China

The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic.Studies on epidemiological and clinical characteristics of patients with COVID-19 have indicated that children are susceptible to SARS-CoV-2 [1-3].To date,the largest study in China reported that over 90% of 2143 children with COVID-19 were asymptomatic,or had mild or moderate illness,and that 5.8% presented critical illness [3].Although the data of neonates are limited and only six neonates with COVID-19 have been reported thus far,several important points should be addressed from these neonatal cases.

关键词： acute respiratory nates

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Risk stratification of hemodynamically significant patent ductus arteriosus by clinical and genetic factors

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World Journal of Pediatrics 2023年第12期19卷 1192-1202页

作者： Yu-Xi Chen Tian-Tian Xiao Hui-Yao Chen Xiang Chen Ya-Qiong wang Qi Ni Bing-Bing Wu Hui-Jun wang Yu-Lan Lu Li-Yuan Hu Yun Cao Guo-Qiang Cheng lai-shuan wang Fei-Fan Xiao Lin Yang Xin-Ran Dong Wen-Hao Zhou Center for Molecular Medicine of Children’s Hospital of Fudan University Institutes of Biomedical SciencesFudan University138 Yi Xue Yuan RoadShanghaiChina Department of Neonatology Children’s Hospital of Fudan UniversityNational Children’s Medical CenterShanghaiChina Center for Molecular Medicine Children’s Hospital of Fudan University399 Wanyuan RoadShanghai201102China

Background Hemodynamically significant patent ductus arteriosus(hsPDA)is associated with increased comorbidities in neonates.Early evaluation of hsPDA risk is critical to implement individualized intervention.The aim of the study was to provide a powerful reference for the early identification of high-risk hsPDA population and early treatment decisions.Methods We enrolled infants who were diagnosed with PDA and performed exome sequencing.The collapsing analyses were used to find the risk gene set(RGS)of hsPDA for model construction.The credibility of RGS was proven by RNA sequencing.Multivariate logistic regression was performed to establish models combining clinical and genetic features.The models were evaluated by area under the receiver operating curve(AUC)and decision curve analysis(DCA).Results In this retrospective cohort study of 2199 PDA patients,549(25.0%)infants were diagnosed with hsPDA.The model[all clinical characteristics selected by least absolute shrinkage and selection operator regression(all CCs)]based on six clinical variables was acquired within three days of life,including gestational age(GA),respiratory distress syndrome(RDS),the lowest platelet count,invasive mechanical ventilation,and positive inotropic and vasoactive drugs.It has an AUC of 0.790[95%confidence interval(CI)=0.749–0.832],while the simplified model(basic clinical characteristic model)including GA and RDS has an AUC of 0.753(95%CI=0.706–0.799).There was a certain consistency between RGS and differentially expressed genes of the ductus arteriosus in mice.The AUC of the models was improved by RGS,and the improvement was significant(all CCs vs.all CCs+RGS:0.790 vs.0.817,P<0.001).DCA demonstrated that all models were clinically useful.Conclusions Models based on clinical factors were developed to accurately stratify the risk of hsPDA in the first three days of life.Genetic features might further improve the model performance.

关键词： Exome sequencing-Hemodynamically significant patent ductus arteriosus Multivariate logistic regression Neonates Risk stratification

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Genetic etiologies associated with infantile hydrocephalus in a Chinese infantile cohort

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World Journal of Pediatrics 2021年第3期17卷 305-316页

作者： Hong-Fang Mei Xin-Ran Dong Hui-Yao Chen Yu-Lan Lu Bing-Bing Wu Hui-Jun wang Guo-Qiang Cheng lai-shuan wang Yun Cao Lin Yang Wen-Hao Zhou Department of Neonatology Children's Hospital of Fudan UniversityNational Children's Medical CenterShanghaiChina Key Laboratory of Birth Defects Children’s Hospital of Fudan UniversityNational Children’s Medical CenterShanghaiChina Center for Molecular Medicine of Children’s Hospital of Fudan University Institutes of Biomedical SciencesFudan UniversityShanghaiChina Clinical Genetic Center Children’s Hospital of Fudan UniversityNational Children's Medical Center399 Wan Yuan RoadShanghai 201102China

Background Infantile hydrocephalus(IHC)is commonly related to other central nervous system diseases,which may have adverse effects on prognosis.The causes of IHC are heterogeneous,and the genetic etiologies are not fully understood.This study aimed to analyze the genetic etiologies of an IHC cohort.Methods The data for 110 IHC patients who had received exome sequencing at the Clinical Genetic Center of the Children's Hospital of Fudan University between 2016 and 2019 were reviewed and analyzed retrospectively.An exome-wide association analysis(EWAS)was performed within this cohort using IHC as the study phenotype.Results Of the 110 IHC patients,a pathogenic or likely pathogenic variant was identified in 16(15%)patients,spanning 13 genes.The genes were mainly associated with metabolic disorders,brain abnormalities,and genetic syndromes.IHC patients who had unclear clinical etiology were more likely to possess a genetic etiology.Based on previous studies and on our EWAS results,ZEB1,SBF2,and GNAI2 were over-represented among IHC patients and might alfect the signaling pathways involved in IHC formation.Conclusions Our study showed heterogeneous genetic etiologies in an IHC cohort.It is essential to perform genetic testing on IHC patients who have unclear clinical etiology,and genes associated with metabolic disorders,brain abnormalities,and genetic syndromes should he noted.In addition,when aiming to discover IHC susceptibility genes,genes that might influence the signaling pathways involved in IHC formation should be prioritized.

关键词： Etiology Genetic Hydrocephalus Infantile

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Short-term developmental outcomes in neonates born to mothers with COVID-19 from Wuhan, China

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World Journal of Pediatrics 2021年第3期17卷 253-262页

作者： Ling-Kong Zeng Hua-Ping Zhu Tian-Tian Xiao Si-Cong Peng Wen-Hao Yuan Jian-Bo Shao lai-shuan wang Fei-Fan Xiao Shi-Wen Xia Shoo K.Lee Kai Yan Wen-Hao Zhou Department of Neonatology Wuhan Children's Hospital(Wuhan Maternal and Child Healthcare Hospital)Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Department of Neonatology Maternal and Child Health Hospital of Hubei ProvinceWuhanChina National Children’s Medical Center Children’s Hospital of Fudan UniversityShanghaiChina Department of Neonatology Chengdu Women's and Children's Central HospitalSchool of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina Department of Neonatology Children's Hospital of Fudan UniversityNational Children's Medical CenterShanghaiChina Maternal-Infant Care Research Center(MiCARE)and Department of Pediatrics Mount Sinai HospitalTorontoONCanada Department of Pediatrics Department of Obstetrics and Gynecology and Dal la Lana School of Public HealthUniversity of TorontoTorontoONCanada

Background Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is an emerging disease.The consequences of SARS-CoV-2 exposure in infants remain unknown.Therefore,this study aims to investigate whether neonates born to mothers with COVID-19 have adverse brain development.Methods This multicenter observational study was conducted at two designated maternal and children's hospitals in Hubei Province,China's Mainland from February 1,2020 to May 15,2020.Neonates born to mothers with COVID-19 were enrolled.Brain magnetic resonance imaging(MRI)findings,and volumes of grey and white matters,and physical growth parameters were observed at 44 weeks corrected gestational age.Results Of 72 neonates born to mothers with COVID-19,8(11%)were diagnosed with COVID-19,8(11%)were critically ill,and no deaths were reported.Among the eight neonates that underwent brain MRI at corrected gestational age of 44 weeks,five neonates were diagnosed with COVID-19.Among these five neonates,three presented abnormal MRI findings including abnormal signal in white matter and delayed myelination in newborn 2,delayed myelination and brain dysplasia in newborn 3,and abnormal signal in the bilateral periventricular in newborn 5.The other three neonates without COVID-19 presented no significantly changes of brain MRI findings and the volumes of grey matter and white matter compared to those of healthy newborns at the equivalent age(P>0.05).Physical growth parameters for weight,length,and head circumference at gestational age of 44 weeks were all above the 3rd percentile for all neonates.Conclusions Some of the neonates born to mothers with COVID-19 had abnormal brain MRI findings but these neonates did not appear to have poor physical growth.These findings may provide the information on the follow-up schedule on the neonates exposed to SARS-CoV-2,but further study is required to evaluate the association between the abnormal MRI findings and the exposure to SARS-CoV-2.

关键词： Coronavirus disease 2019 Follow-up Neonate Severe acute respiratory syndrome coronavirus 2

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2017-2021年某儿科医院耐碳青霉烯类革兰阴性菌综合干预感控措施效果及其耐药基因

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中华医院感染学杂志 2024年第3期34卷 410-415页

作者：殷丽军武娜娜缪瑾杨韦菁何磊燕陆国平曹云王来栓翟晓文王传清复旦大学附属儿科医院院内感染控制与防保科上海201102 复旦大学附属儿科医院临床检验中心细菌室上海201102 复旦大学附属儿科医院儿科重症监护室上海201102 复旦大学附属儿科医院新生儿重症监护室上海201102 复旦大学附属儿科医院新生儿科上海201102 复旦大学附属儿科医院血液科上海201102

目的评估儿科医院感染高风险部门(新生儿科、新生儿重症监护室、儿科重症监护病房、血液科)耐碳青霉烯类革兰阴性菌(CR-GNB)综合干预措施效果及其耐药基因.方法选取2017-2021年复旦大学附属儿科医院感染高风险部门患儿为研究对象,2017... 详细信息

目的评估儿科医院感染高风险部门(新生儿科、新生儿重症监护室、儿科重症监护病房、血液科)耐碳青霉烯类革兰阴性菌(CR-GNB)综合干预措施效果及其耐药基因.方法选取2017-2021年复旦大学附属儿科医院感染高风险部门患儿为研究对象,2017年开始对上述患儿入院后48 h以内以及住院期间每周一次在上呼吸道和肠道进行主动筛查,2018年1月开始对主动筛查及临床送检标本检出CR-GNB阳性患儿实施集中安置,比较CR-GNB主动筛查率、定植率、集中安置率以及医院感染率的变化;同时通过聚合酶链式反应(PCR)检测耐碳青霉烯酶基因,对其耐药机制进行研究.结果2017-2021年肛咽拭子CR-GNB主动筛查率均逐年增加(P7 d的患儿CR-GNB定植率呈现下降趋势(P<0.001),同时医院感染率从2017年的1.16%(153/13190)下降到2021年的0.29%(28/9774)(P<0.001);耐碳青霉烯类肺炎克雷伯菌主要耐药基因是blaNDM-i(52.00%,26/50)、blaKPC-2(42.00%,21/50)和blaDHA-i(26.00%,13/50),耐碳青霉烯类鲍氏不动杆菌均检出blaOXA-23耐药基因,仅有3株耐碳青霉烯铜绿假单胞菌检出耐药基因,1株为blaBIC,2株为blaVIM-2.结论对感染高风险部门进行CR-GNB主动筛查及A/B等级的隔离安置措施能降低CR-GNB定植及医院感染率.

关键词：主动筛查病人安置耐碳青霉烯类革兰阴性菌定植 KPC NDM OXA-23 综合干预感控措施感染监测

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新型冠状病毒肺炎儿童合并急性脑炎的临床特点及研究进展

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中国当代儿科杂志 2022年第12期24卷 1301-1306页

作者：许普(综述) 王来栓周文浩(审校) 国家儿童医学中心/复旦大学附属儿科医院新生儿科上海201102

2019年底以来,新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)在世界范围内大流行,该病出现神经系统症状的报道不断增加。其中,脑炎被认为是COVID-19严重的神经系统并发症,但国内报道缺乏。合并急性脑炎患儿症状重,如未能早期识... 详细信息

2019年底以来,新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)在世界范围内大流行,该病出现神经系统症状的报道不断增加。其中,脑炎被认为是COVID-19严重的神经系统并发症,但国内报道缺乏。合并急性脑炎患儿症状重,如未能早期识别、及时治疗,病死率高,预后差。目前全球疫情仍在流行期间,有必要对COVID-19儿童神经系统重症表现予以关注。因此该综述通过文献检索及详细病案分析,探讨COVID-19合并急性脑炎的临床特点,旨在为临床医生应对可能出现的COVID-19合并急性脑炎病例提供参考。

关键词：新型冠状病毒肺炎脑炎儿童

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A novel S1P1 modulator IMMH002 ameliorates psoriasis in multiple animal models

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Acta Pharmaceutica Sinica B 2020年第2期10卷 276-288页

作者： Jing Jin Nina Xue Yuan Liu Rong Fu Mingjin wang Ming Ji Fangfang lai Jinping Hu Xiaojian wang Qiong Xiao Xiaoying Zhang Dali Yin Liping Bai Xiaoguang Chen shuan Rao State Key Laboratory of Bioactive Substances and Functions of Natural Medicines Institute of Materia MedicaChinese Academy of Medical SciencesPeking Union Medical CollegeBeijing 100050China Department of Thoracic Surgery Nanfang HospitalSouthern Medical UniversityGuangzhou 510515China State Key Laboratory of Quality Research in Chinese Medicine Macao Institutefor Applied Research in Medicine and HealthMacao University of Science and TechnologyTaipaMacao SAR 999078China

Psoriasis is characterized by abnormal proliferation of keratinocytes,as well as infiltration of immune cells into the dermis and epidermis,causing itchy,scaly and erythematous plaques of skin.The understanding of this chronic inflammatory skin disease remains unclear and all available treatments have their limitations currently.Here,we showed that IMMH002,a novel orally active S1 P1 modulator,desensitized peripheral pathogenic lymphocytes to egress signal from secondary lymphoid organs and thymus.Using different psoriasis animal models,we demonstrated that IMMH002 could significantly relieve skin damage as revealed by PAS I score and pathological injure evaluation.Mechanistically,IMMH002 regulated CD3+T lymphocytes re-distribution by inducing lymphocytes’homing,thus decreased T lymphocytes allocation in the peripheral blood and skin but increased in the thymus.Our results suggest that the novel SIP1 agonist,IMMH002,exert extraordinary capacity to rapidly modulate T lymphocytes distribution,representing a promising drug candidate for psoriasis treatment.

关键词： S1P1 S1P1 agonist IMMH002 Lymphocyte Psoriasis

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新生儿重症救护单元到新生儿神经重症救护单元的演变和发展

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中国实用儿科杂志 2023年第5期38卷 364-367,385页

作者：王来栓周文浩国家儿童医学中心国家卫健委新生儿疾病重点实验室复旦大学附属儿科医院新生儿科上海201102

脑损伤仍然是新生儿医学中尚未解决的主要问题之一,幸存者终生神经残疾的风险很高。新生儿脑损伤后的病理生理过程与正常脑发育轨迹、遗传易感性和住院环境之间相互作用都对患儿的远期神经结局产生重要影响。协调一致的、多学科联合的... 详细信息

脑损伤仍然是新生儿医学中尚未解决的主要问题之一,幸存者终生神经残疾的风险很高。新生儿脑损伤后的病理生理过程与正常脑发育轨迹、遗传易感性和住院环境之间相互作用都对患儿的远期神经结局产生重要影响。协调一致的、多学科联合的方法及早发现脑损伤的根本原因,通过加强临床护理提供最佳干预机会可以改善结果并促进新的神经保护治疗的研发。“神经重症监护单元”是从新生儿重症监护单元进化而来,以多学科团队提供持续一致的护理为基础,也为新生儿神经学、神经监测、神经影像和护理等专业教育和培训提供了重要机会。

关键词：新生儿脑损伤神经重症监护室神经监测神经成像

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Application of droplet digital PCR in detection of seed-transmitted pathogen Acidovorax citrulli

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Journal of Integrative Agriculture 2020年第2期19卷 561-569页

作者： LU Yu ZHANG Hai-jun ZHAO Zi-jing WEN Chang-long WU Ping SONG Shun-hua YU shuan-cang Luo lai-xin XU Xiu-lan Beijing Key Laboratory of Vegetable Germplasms Improvement Beijing Vegetable Research CenterBeijing Academy of Agriculture and Forestry SciencesBeijing 100097P.R.China Supervision Inspection and Test Center of Vegetable Seed Quality of Ministry of Agriculture and Rural AffairsBeijing 100097P.R.China Beijing Key Laboratory of Seed Disease Testing and Control College of Plant PathologyChina Agricultural UniversityBeijing 100093P.R.China

Bacterial fruit blotch caused by Acidovorax citrulli is a serious threat to cucurbit industry worldwide.The pathogen is seedtransmitted,so seed detection to prevent distribution of contaminated seed is crucial in disease management.In this study,we adapted a quantitative real-time PCR(qPCR)assay to droplet digital PCR(ddPCR)format for A.citrulli detection by optimizing reaction conditions.The performance of ddPCR in detecting A.citrulli pure culture,DNA,infested watermelon/melon seed and commercial seed samples were compared with multiplex PCR,qPCR,and dilution plating method.The lowest concentrations detected(LCD)by ddPCR reached up to 2 fg DNA,and 102 CFU mL–1 bacterial cells,which were ten times more sensitive than those of the qPCR.When testing artificially infested watermelon and melon seed,0.1%infestation level was detectable using ddPCR and dilution plating method.The 26 positive samples were identified in 201 commercial seed samples through ddPCR,which was the highest positive number among all the methods.High detection sensitivity achieved by ddPCR demonstrated a promising technique for improving seed-transmitted pathogen detection threshold in the future.

关键词： bacterial fruit blotch Acidovorax citrulli droplet digital PCR seed detection quantitative real-time PCR

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