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Plant Diversity 2024年第3期46卷 386-394页

作者： Yunzhen Li Liujie Jin Xinyu Liu Chao He Siteng Bi sulaiman saeed Wenhao Yan National Key Laboratory of Crop Genetic Improvement Hubei Hongshan LaboratoryHuazhong Agricultural UniversityWuhan 430070China

Vernalization is necessary for winter wheat to flower.However,it is unclear whether vernalization is also required for spring wheat,which is frequently sown in fall,and what molecular mechanisms underlie the vernalization response in wheat varieties.In this study,we examined the molecular mechanisms that regulate vernalization response in winter and spring wheat varieties.For this purpose,we determined how major vernalization genes(VRN1,VRN2,and VRN3)respond to vernalization in these varieties and whether modifications to histones play a role in changes in gene expression.We also identified genes that are differentially regulated in response to vernalization in winter and spring wheat varieties.We found that in winter wheat,but not in spring wheat,VRN1 expression decreases when returned to warm temperature following vernalization.This finding may be associated with differences between spring and winter wheat in the levels of tri-methylation of lysine 27 on histone H3(H3K27me3)and tri-methylation of lysine 4 on histone H3(H3K4me3)at the VRN1 gene.Analysis of winter wheat transcriptomes before and after vernalization revealed that vernalization influences the expression of several genes,including those involved in leucine catabolism,cysteine biosynthesis,and flavonoid biosynthesis.These findings provide new candidates for further study on the mechanism of vernalization regulation in wheat.

关键词： Wheat Vernalization VRN1 Histone modification Regulate network

Metabolomic changes in children with autism

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World Journal of Clinical Pediatrics 2024年第2期13卷 171-197页

作者： Mohammed Al-Beltagi Nermin Kamal saeed Adel Salah Bediwy Reem Elbeltagi Department of Pediatric Faculty of MedicineTanta UniversityTanta 31511AlghrabiaEgypt Department of Pediatric University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671Bahrain Department of Pediatric University Medical CenterDr.Sulaiman Al Habib Medical GroupManamaBahrainManama 26671Bahrain Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 12Bahrain Medical Microbiology Section Department of PathologyIrish Royal College of SurgeonBahrainBusaiteen 15503MuharraqBahrain Department of Pulmonology Faculty of MedicineTanta UniversityTanta 31527AlghrabiaEgypt Department of Chest Disease University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671Bahrain Department of Chest Disease University Medical CenterDr.Sulaiman Al Habib Medical GroupManamaManama 26671Bahrain Department of Medicine The Royal College of Surgeons in Ireland-BahrainBusiateen 15503MuharraqBahrain

BACKGROUND Autism spectrum disorder(ASD)is a neurodevelopmental condition characterized by deficits in social communication and repetitive behaviors.Metabolomic profiling has emerged as a valuable tool for understanding the underlying metabolic dysregulations associated with ASD.AIM To comprehensively explore metabolomic changes in children with ASD,integrating findings from various research articles,reviews,systematic reviews,meta-analyses,case reports,editorials,and a book chapter.METHODS A systematic search was conducted in electronic databases,including PubMed,PubMed Central,Cochrane Library,Embase,Web of Science,CINAHL,Scopus,LISA,and NLM catalog up until January 2024.Inclusion criteria encompassed research articles(83),review articles(145),meta-analyses(6),systematic reviews(6),case reports(2),editorials(2),and a book chapter(1)related to metabolomic changes in children with ASD.Exclusion criteria were applied to ensure the relevance and quality of included studies.RESULTS The systematic review identified specific metabolites and metabolic pathways showing consistent differences in children with ASD compared to typically developing individuals.These metabolic biomarkers may serve as objective measures to support clinical assessments,improve diagnostic accuracy,and inform personalized treatment approaches.Metabolomic profiling also offers insights into the metabolic alterations associated with comorbid conditions commonly observed in individuals with ASD.CONCLUSION Integration of metabolomic changes in children with ASD holds promise for enhancing diagnostic accuracy,guiding personalized treatment approaches,monitoring treatment response,and improving outcomes.Further research is needed to validate findings,establish standardized protocols,and overcome technical challenges in metabolomic analysis.By advancing our understanding of metabolic dysregulations in ASD,clinicians can improve the lives of affected individuals and their families.

关键词： Autism spectrum disorder Metabolic dysregulations Metabolomic changes Children Mitochondrial dysfunction Oxidative stress Amino acids

Fecal calprotectin in pediatric gastrointestinal diseases:Pros and cons

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World Journal of Clinical Pediatrics 2024年第2期13卷 198-220页

作者： Mohammed Al-Beltagi Nermin Kamal saeed Adel Salah Bediwy Reem Elbeltagi Department of Pediatric Faculty of MedicineTanta UniversityTanta 31511AlghrabiaEgypt Department of Pediatrics University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671ManamaBahrain Department of Pediatrics University Medical CenterDr.Sulaiman Al Habib Medical GroupBahrainManama 26671ManamaBahrain Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 12ManamaBahrain Medical Microbiology Section Department of PathologyIrish Royal College of SurgeonBahrainBusaiteen 15503MuharraqBahrain Department of Pulmonology Faculty of MedicineTanta UniversityTanta 31527AlghrabiaEgypt Department of Pulmonology University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671ManamaBahrain Department of Pulmonology University Medical CenterKing Abdulla Medical CityDr.Sulaiman Al Habib Medical GroupManama 26671ManamaBahrain Department of Medicine The Royal College of Surgeons in Ireland-BahrainBusiateen 15503MuharraqBahrain

BACKGROUND Fecal calprotectin is a valuable biomarker for assessing intestinal inflammation in pediatric gastrointestinal diseases.However,its role,pros,and cons in various conditions must be comprehensively elucidated.AIM To explore the role of fecal calprotectin in pediatric gastrointestinal diseases,including its advantages and limitations.METHODS A comprehensive search was conducted on PubMed,PubMed Central,Google Scholar,and other scientific research engines until February 24,2024.The review included 88 research articles,56 review articles,six metaanalyses,two systematic reviews,two consensus papers,and two letters to the editors.RESULTS Fecal calprotectin is a non-invasive marker for detecting intestinal inflammation and monitoring disease activity in pediatric conditions such as functional gastrointestinal disorders,inflammatory bowel disease,coeliac disease,coronavirus disease 2019-induced gastrointestinal disorders,gastroenteritis,and cystic fibrosis-associated intestinal pathology.However,its lack of specificity and susceptibility to various confounding factors pose challenges in interpretation.Despite these limitations,fecal calprotectin offers significant advantages in diagnosing,monitoring,and managing pediatric gastrointestinal diseases.CONCLUSION Fecal calprotectin holds promise as a valuable tool in pediatric gastroenterology,offering insights into disease activity,treatment response,and prognosis.Standardized protocols and guidelines are needed to optimize its clinical utility and mitigate interpretation challenges.Further research is warranted to address the identified limitations and enhance our understanding of fecal calprotectin in pediatric gastrointestinal diseases.

关键词： Fecal calprotectin Pediatric gastrointestinal diseases Functional gastrointestinal disorders Inflammatory bowel disease Coeliac disease COVID-19-induced gastrointestinal disorders Infectious gastroenteritis Cystic fibrosis

Microphallus early management in infancy saves adulthood sensual life:A comprehensive review

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World Journal of Clinical Pediatrics 2024年第2期13卷 16-37页

作者： Mohammed Al-Beltagi Nermin Kamal saeed Adel Salah Bediwy Majed A Shaikh Reem Elbeltagi Department of Pediatric Faculty of MedicineTanta UniversityTanta 31511Egypt Department of Pediatric University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671Bahrain Department of Pediatric University Medical CenterSulaiman Al Habib Medical GroupManama 26671Bahrain Department of Medical Microbiology Section and Pathology Salmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 12Bahrain Department of Medical Microbiology Section and Pathology Irish Royal College of SurgeonBusaiteen 15503Bahrain Department of Pulmonology Faculty of MedicineTanta UniversityTanta 31527Egypt Department of Pulmonology University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671Bahrain Department of Pulmonology University Medical CenterSulaiman Al Habib Medical GroupManama 26671Bahrain Department of Pediatrics Ibn Al Nafees HospitalManama 54533Bahrain Department of Medicine The Royal College of Surgeons in Ireland-BahrainBusiateen 15503Bahrain

Microphallus/Micropenis is a rare condition with significant physical and psychological implications for affected individuals.This article comprehensively reviews micropenis,its etiology,epidemiology,and various treatment options.We conducted a thorough literature review to collect relevant information on micropenis and microphallus,as well as related disorders.Our primary databases were PubMed,Medline,and Google Scholar.We searched for articles published in English between 2000 and 2023.Our analysis included 67 review articles,56 research studies,11 case reports,one guideline,and one editorial.Our search terms included"microphallus","micropenis","congenital hypogonadotropic hypogonadism","androgen insensitivity syndrome","pediatric management of micropenis","testosterone therapy",and"psychosocial implications of micropenis".We focused on diagnosing micropenis and related conditions,including hormonal assessments,medical and surgical treatment options,psychosocial and psychological well-being,sexual development of adolescents,and sociocultural influences on men's perceptions of penile size.Additionally,we explored parenting and family dynamics in cases of micropenis and disorders of sex development,implications of hormonal treatment in neonates,and studies related to penile augmentation procedures and their effectiveness.The article highlights the importance of early diagnosis and intervention in addressing the physical and psychological well-being of individuals with micropenis.Surgical procedures,such as penile lengthening and girth enhancement,and non-surgical approaches like hormonal therapy are explored.The significance of psychological support,education,and lifestyle modifications is emphasized.Early management and comprehensive care are crucial for individuals with micropenis,from infancy to adolescence and beyond.A multidisciplinary approach involving urologists,endocrinologists,and mental health professionals is recommended.Regular assessment of treatment effectiveness and the need for updated guidelines

关键词： Microphallus Micropenis Hypogonadism Children Adults Sensual life Testosterone therapy

Gastrointestinal tolerability of organic infant formula compared to traditional infant formula: A systematic review

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World Journal of Clinical Pediatrics 2024年第1期13卷 125-140页

作者： Mohammed Al-Beltagi Nermin Kamal saeed Adel Salah Bediwy Reem Elbeltagi Mohamed Basiony Hamza Department of Pediatric Faculty of MedicineTanta UniversityTanta 31511AlghrabiaEgypt Department of Pediatric University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671ManamaBahrain Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 12ManamaBahrain Medical Microbiology Section Department of PathologyIrish Royal College of SurgeonBusaiteen 15503MuharraqBahrain Department of Pulmonology Faculty of MedicineTanta UniversityTanta 31527AlghrabiaEgypt Department of Pulmonology University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671ManamaBahrain Department of Medicine The Royal College of Surgeons in Ireland-BahrainBusiateen 15503MuharraqBahrain Department of Pediatric Faculty of MedicineTanta UniversityTanta 31511AlgahrbiaEgypt

BACKGROUND Infants'nutrition significantly influences their growth,development,and overall well-being.With the increasing demand for organic infant formula driven by the perception of health benefits and growing awareness of natural feeding options,it is crucial to conduct a comparative analysis of the gastrointestinal tolerability between organic and traditional infant formulas.AIM To provide a concise and precise analysis of the gastrointestinal tolerability of organic infant formula compared to traditional infant formula.Due to limited direct comparisons,the review synthesizes available literature on each formula type,presenting insights into their potential effects on infants'digestive health.METHODS An extensive literature search was conducted,compiling studies on organic and traditional infant formulas,their compositions,and reported effects on gastrointestinal tolerability.We searched academic databases such as PubMed and Google Scholar and specialized nutrition,paediatrics,and infant health journals using relevant keywords till October 1,2023.RESULTS Although specific comparative studies are scarce and formula heterogeneity is a significant limitation,this systematic review provides an in-depth understanding of organic infant formulas'composition and potential benefits.While scientific evidence directly comparing gastrointestinal tolerability is limited,organic formulas strive to use carefully selected organic ingredients to imitate breast milk composition.Potential benefits include improved lipid profiles,higher methionine content,and decreased antibiotic-resistant bacteria levels.Understanding the gastrointestinal tolerability of organic and traditional infant formulas is crucial for parents and healthcare providers to make informed decisions.CONCLUSION Despite limitations in direct comparisons,this systematic review provides insights into the composition and potential benefits of organic infant formulas.It emphasizes the need for further research to elucidate their gastrointestinal effects comprehensiv

关键词： Organic infant formula Traditional infant formula Gastrointestinal tolerability Formula ingredients Digestive health Infant nutrition Organic farming

Text Extraction with Optimal Bi-LSTM

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Computers, Materials & Continua 2023年第9期76卷 3549-3567页

作者： Bahera H.Nayef Siti Norul Huda Sheikh Abdullah Rossilawati sulaiman Ashwaq Mukred saeed Computer Techniques Engineering Department Ibn Khaldun University CollegeBaghdad10011Iraq Faculty of Information Science and Technology Universiti Kebangsaan MalaysiaBangiSelangor43600Malaysia School of Electrical Engineering and Artificial Intelligence Xiamen University MalaysiaSepang43900Malaysia

Text extraction from images using the traditional techniques of image collecting,and pattern recognition using machine learning consume time due to the amount of extracted features from the images.Deep Neural Networks introduce effective solutions to extract text features from images using a few techniques and the ability to train large datasets of images with significant results.This study proposes using Dual Maxpooling and concatenating convolution Neural Networks(CNN)layers with the activation functions Relu and the Optimized Leaky Relu(OLRelu).The proposed method works by dividing the word image into slices that contain characters.Then pass them to deep learning layers to extract feature maps and reform the predicted words.Bidirectional Short Memory(BiLSTM)layers extractmore compelling features and link the time sequence fromforward and backward directions during the training phase.The Connectionist Temporal Classification(CTC)function calcifies the training and validation loss rates.In addition to decoding the extracted feature to reform characters again and linking them according to their time sequence.The proposed model performance is evaluated using training and validation loss errors on the Mjsynth and Integrated Argument Mining Tasks(IAM)datasets.The result of IAM was 2.09%for the average loss errors with the proposed dualMaxpooling and OLRelu.In the Mjsynth dataset,the best validation loss rate shrunk to 2.2%by applying concatenating CNN layers,and Relu.

关键词： Deep neural network text features dual max-pooling concatenating convolution neural networks bidirectional long short memory text connector characteristics

MicroRNAs and JAK/STAT3 signaling:A new promising therapeutic axis in blood cancers

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Genes & Diseases 2022年第4期9卷 849-867页

作者： Mehdi Sajjadi-Dokht Talar Ahmad Merza Mohamad Heshu sulaiman Rahman Marwah Suliman Maashi Svetlana Danshina Navid Shomali saeed Solali Faroogh Marofi Elham Zeinalzadeh Morteza Akbari Ali Adili Ramin Aslaminabad Majid Farshdousti Hagh Mostafa Jarahian Immunology Research Center Tabriz University of Medical SciencesTabriz ***Iran Department of Pharmacology College of PharmacyHawler Medical UniversityErbil 44001Iraq Department of Physiology College of MedicineUniversity of SulaymaniyahSulaymaniyah 46001Iraq Department of Medical Laboratory Sciences Komar University of Science and TechnologySulaymaniyah 46002Iraq Department of Propaedeutics of Dental Diseases I.M.Sechenov First Moscow State Medical UniversityMoscow 119991Russia Department of Immunology Faculty of MedicineTabriz University of Medical SciencesTabriz ***Iran Department of Oncology Tabriz University of Medical SciencesTabriz ***Iran German Cancer Research Center(DKFZ) Toxicology and Chemotherapy Unit(G401)Heidelberg 69120Germany Stem Cells and Regenerative Medicine Unit at King Fahad Medical Research Centre Jeddah 21589Saudi Arabia

Blood disorders include a wide spectrum of blood-associated malignancies resulting from inherited or acquired defects.The ineffectiveness of existing therapies against blood disorders arises from different reasons,one of which is drug resistance,so different types of leukemia may show different responses to treatment.Leukemia occurs for a variety of genetic and acquired reasons,leading to uncontrolled proliferation in one or more cell lines.Regarding the genetic defects,oncogene signal transducer and activator of transcription(STAT)family transcription factor,especially STAT3,play an essential role in hematological disorders onset and progress upon mutations,dysfunction,or hyperactivity.Besides,microRNAs,as biological molecules,has been shown to play a dual role in either tumorigenesis and tumor suppression in various cancers.Besides,a strong association between STAT3 and miRNA has been reported.For example,miRNAs can regulate STAT3 via targeting its upstream mediators such as IL6,IL9,and JAKs or directly binding to the STAT3 gene.On the other hand,STAT3 can regulate miRNAs.In this review study,we aimed to determine the role of either microRNAs and STAT3 along with their effect on one another's activity and function in hematological malignancies.

关键词： Interleukin JAKs Leukemia miRNAs STAT3

Insulin-resistance in paediatric age:Its magnitude and implications

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World Journal of Diabetes 2022年第4期13卷 282-307页

作者： Mohammed Al-Beltagi Adel Salah Bediwy Nermin Kamal saeed Department of Pediatrics Faculty of MedicineTanta UniversityTanta 31511Egypt Department of Pediatrics University Medical CenterArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671Bahrain Department of Chest Disease Faculty of MedicineTanta UniversityTanta 31527Egypt Department of Pulmonology University Medical CenterArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671Bahrain Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthManama 12Bahrain Microbiology Section Department of PathologyIrish Royal College of SurgeonBusaiteen 15503Bahrain

Insulin resistance(IR)is insulin failure in normal plasma levels to adequately stimulate glucose uptake by the peripheral tissues.IR is becoming more common in children and adolescents than before.There is a strong association between obesity in children and adolescents,IR,and the metabolic syndrome components.IR shows marked variation among different races,crucial to understanding the possible cardiovascular risk,specifically in high-risk races or ethnic groups.Genetic causes of IR include insulin receptor mutations,mutations that stimulate autoantibody production against insulin receptors,or mutations that induce the formation of abnormal glucose transporter 4 molecules or plasma cell membrane glycoprotein-1 molecules;all induce abnormal energy pathways and end with the development of IR.The parallel increase of IR syndrome with the dramatic increase in the rate of obesity among children in the last few decades indicates the importance of environmental factors in increasing the rate of IR.Most patients with IR do not develop diabetes mellitus(DM)type-II.However,IR is a crucial risk factor to develop DM type-II in children.Diagnostic standards for IR in children are not yet established due to various causes.Direct measures of insulin sensitivity include the hyperinsulinemia euglycemic glucose clamp and the insulin-suppression test.Minimal model analysis of frequently sampled intravenous glucose tolerance test and oral glucose tolerance test provide an indirect estimate of metabolic insulin sensitivity/resistance.The main aim of the treatment of IR in children is to prevent the progression of compensated IR to decompensated IR,enhance insulin sensitivity,and treat possible complications.There are three main lines for treatment:Lifestyle and behavior modification,pharmacotherapy,and surgery.This review will discuss the magnitude,implications,diagnosis,and treatment of IR in children。

关键词： Insulin resistance Children Diabetes mellitus Obesity Genetic Acquired

Gut microbiota in various childhood disorders:Implication and indications

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World Journal of Gastroenterology 2022年第18期28卷 1875-1901页

作者： Nermin Kamal saeed Mohammed Al-Beltagi Adel Salah Bediwy Yasser El-Sawaf Osama Toema Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthManama 12Bahrain Microbiology Section Department of PathologyIrish Royal College of SurgeonBusaiteen 15503Bahrain Department of Pediatrics University Medical CenterArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671Bahrain Department of Pediatrics Faculty of MedicineTanta UniversityTanta 31511Egypt Department of Chest Disease Faculty of MedicineTanta UniversityTanta 31527Egypt Department of Pulmonology University Medical CenterArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671Bahrain Department of Tropical Medicine Faculty of MedicineTanta UniversityTanta 31527Egypt Department of Gastroenterology University Medical CenterArabian Gulf UniversityDr.Sulaiman Al-Habib Medical GroupManama 26671Bahrain

Gut microbiota has a significant role in gut development,maturation,and immune system differentiation.It exerts considerable effects on the child's physical and mental development.The gut microbiota composition and structure depend on many host and microbial factors.The host factors include age,genetic pool,general health,dietary factors,medication use,the intestine's pH,peristalsis,and transit time,mucus secretions,mucous immunoglobulin,and tissue oxidation-reduction potentials.The microbial factors include nutrient availability,bacterial cooperation or antagonism,and bacterial adhesion.Each part of the gut has its microbiota due to its specific characteristics.The gut microbiota interacts with different body parts,affecting the pathogenesis of many local and systemic diseases.Dysbiosis is a common finding in many childhood disorders such as autism,failure to thrive,nutritional disorders,coeliac disease,Necrotizing Enterocolitis,helicobacter pylori infection,functional gastrointestinal disorders of childhood,inflammatory bowel diseases,and many other gastrointestinal disorders.Dysbiosis is also observed in allergic conditions like atopic dermatitis,allergic rhinitis,and asthma.Dysbiosis can also impact the development and the progression of immune disorders and cardiac disorders,including heart failure.Probiotic supplements could provide some help in managing these disorders.However,we are still in need of more studies.In this narrative review,we will shed some light on the role of microbiota in the development and management of common childhood disorders.

关键词： Gut microbiota Dysbiosis Children Gastrointestinal disorders Immune disorders Allergic disorders Cardiac disorders

May 2022 acute hepatitis outbreak,is there a role for COVID-19 and other viruses?

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World Journal of Hepatology 2023年第3期15卷 364-376页

作者： Reem Elbeltagi Mohammed Al-Beltagi Nermin Kamal saeed Adel Salah Bediwy Osama Toema Department of Medicine The Royal College of Surgeons in Ireland-BahrainBusiateen 15503MuharraqBahrain Department of Pediatrics Faculty of MedicineTanta UniversityTanta 31511Al GharbiaEgypt Department of Pediatrics University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671Bahrain Department of Pathology Microbiology SectionSalmaniya Medical ComplexManama 12Bahrain Department of Microbiology Royal College of Surgeons in Ireland-BahrainBusaiteen 15503MuharraqBahrain Department of Chest Diseases Faculty of MedicineTanta UniversityTanta 31527Al GharbiaEgypt Department of Chest Diseases University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671Bahrain

There has been an increasing number of reported cases of acute hepatitis of unknown origin in previously healthy children since first reported on March 31,2022.This clinical syndrome is identified by jaundice and markedly elevated liver enzymes with increased aspartate transaminase and/or alanine aminotransa-minase(greater than 500 IU/L).We conducted an inclusive literature review with respect to acute hepatitis outbreaks in children using the search terms acute hepatitis,outbreak,children,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),coronavirus disease 2019(COVID-19),and adenovirus.According to the cumulative data presented in four main studies,the median age is 4 years,with a male predominance(1.3:1).Jaundice was the most common clinical manifestation(69%),followed by vomiting(63%),anorexia(52.9%),diarrhea(47.2%),abdominal pain(39%),pyrexia(33.3%),pale stool(30%),and dark urine(30%).Coryza and lethargy were reported in 16.6%,while pruritus was reported in 2%of cases.Acute liver failure was observed in 25%of cases.The exact mechanism of this acute hepatitis outbreak is still not entirely clear.Adenoviruses and SARS-CoV-2 were detected in a significant number of patients.Coinfection with adenovirus and SARS-CoV-2 could be a possible underlying mechanism.However,other possible infections and mechanisms must be considered in the pathogenesis of this condition.Acute hepatitis of unknown origin in children has been a serious problem since the start of the COVID-19 pandemic but has not yet been sufficiently addressed.Many questions remain regarding the underlying mechanisms leading to acute liver failure in children,and it is likely that extensive future research is needed.

关键词： Acute hepatitis of unknown origin Children Adenovirus SARS-CoV-2 COVID-19 Hepatic failure