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Treatment of multisystem inflammatory syndrome in children

World Journal of Pediatrics 2024年第4期20卷 325-339页

作者： Tong Tong Yi-Hua Jin Min Wang Fang-Qi Gong Department of Cardiology Children's HospitalZhejiang University School of MedicineNational Clinical Research Center for Child HealthNo.3333 Binsheng RoadHangzhou 310052China

Background Multisystem inflammatory syndrome in children(MIS-C),a relatively uncommon but severe pediatric complication,is associated with coronavirus disease 2019(COVID-19).A variety of treatment approaches,including intravenous immunoglobulins(IVIGs),glucocorticoids(GCs)and biologic agents,such as anakinra and infliximab,have been described for the management of COVID-19-related *** therapy is also ***,a well-developed treatment system has not been established,and many issues remain *** recently published articles related to the treatment of MIS-C have been ***,in this review,we identified relevant articles published recently and summarized the treatment of MIS-C more comprehensively and *** sources We reviewed the literature on the treatment of MIS-C through 20 September *** PubMed/Medline,Web of Science,EMBASE,and Cochrane Library databases were searched with the combination of the terms"multisystem inflammatory syndrome","MIS-C","PIMS-TS","therapy","treatment","drug","IVIG","GCs","intravenous immunoglobulin","corticosteroids","biological agent",and"aspirin".Results The severity of MIS-C varies,and different treatment schemes should be used according to the specific *** research and data collection are vital to better understand the pathophysiology and optimal management of *** MIS-Cis a disease involving multiple systems and has great *** the accumulation of additional experience,we have garnered fresh insights into its treatment ***,there remains a critical need for greater standardization in treatment protocols,alongside the pressing necessity for more robust and meticulously conducted studies to deepen our understanding of these protocols.

关键词： Coronavirus disease 2019-Corticosteroids Intravenous immunoglobulin Multisystem inflammatory syndrome in children-Treatment

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Early diagnosis and management of neonatal sepsis:a perspective

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World Journal of Pediatrics 2024年第4期20卷 303-306页

作者： Li‑Zhong Du Neonatal Intensive Care Unit Children’s Hospital Zhejiang University School of MedicineNational Clinical Research Center for Child Health3333 Binsheng RoadHangzhou 310052China

Neonatal sepsis is an illness caused by bloodstream bacteria or fungal infections that affect newborn infants under 28 days of *** stands as a significant contributor to morbidity and mortality in neonatal intensive care units(NICUs).With the improved survival rates of very low-birth-weight or extremely premature infants,a growing number of these vulnerable infants are receiving intensive care and undergoing invasive procedures,making nosocomial infections a persistent challenge in *** mortality rate associated with neonatal sepsis varies depending on factors such as birth weight,gestational age,and other *** can also lead to a range of long-term health consequences,including neurodevelopmental disabilities like cerebral palsy,visual or hearing impairments,and cognitive ***,neonatal sepsis is linked to various adverse outcomes,including respiratory complications,bronchopulmonary dysplasia,nutritional and growth issues,and immunological dysfunction[1].Due to its atypical clinical presentation and the low rate of specific diagnostic indicators,such as a positive blood culture,accurately diagnosing neonatal sepsis is ***,the appropriateness of antibiotic treatment is often a matter of controversy.

关键词： neonatal mortality diagnosis

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Perioperative complication incidence and risk factors for retroperitoneal neuroblastoma in children:analysis of 571 patients

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World Journal of Pediatrics 2024年第3期20卷 250-258页

作者： Min He Jia-Bin Cai Xuan Wu Yin-Bing Tang Jin-Yan Wang Jun-Qin Mao Ji-Jun Chen Li-Feng Zhang Zhong-Hai Guan Jie-Ni Xiong Wan-Xin Peng Jin-Hu Wang Ting Tao Pediatric Cancer Research Center National Clinical Research Center for Child HealthHangzhouChina Department of Surgical Oncology Children's HospitalZhejiang University School of MedicineHangzhouChina Cancer Center Zhejiang UniversityNo.3333 Binsheng RodeHangzhouChina

Background Surgery plays an important role in the treatment of *** complications may impact the course of neuroblastoma *** date,comprehensive analyses of complications and risk factors have been *** Patients with retroperitoneal neuroblastoma undergoing tumor resection were retrospectively analyzed between 2014 and *** data collected included clinical characteristics,operative details,operative complications and postopera-tive *** factors for perioperative complications of retroperitoneal neuroblastoma were *** A total of 571 patients were enrolled in this *** complications were observed in 255(44.7%)*** leakage(28.4%),diarrhea(13.5%),and injury(vascular,nerve and organ;7.5%)were the most frequent *** were three operation-related deaths(0.53%):massive hemorrhage(n=1),biliary tract perforation(n=1)and intestinal necrosis(n=1).The presence of image-defined risk factors(IDRFs)[odds ratio(OR)=2.09,P<0.01],high stage of the International Neuroblastoma Risk Group staging system(INRGSS)(OR=0.454,P=0.04),retroperitoneal lymph node metastasis(OR=2.433,P=0.026),superior mesenteric artery encasement(OR=3.346,P=0.003),and inferior mesenteric artery encasement(OR=2.218,P=0.019)were identified as independent risk factors for perioperative *** Despite the high incidence of perioperative complications,the associated mortality rate was quite ***-perative complications of retroperitoneal neuroblastoma were associated with IDRFs,INRGSS,retroperitoneal lymph node metastasis and vascular *** with high-risk factors should receive more serious attention during surgery but should not discourage the determination to pursue total resection of neuroblastoma.

关键词： Complication Neuroblastoma Risk factors Surgery

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Expert consensus on the diagnosis, treatment, and prevention of respiratory syncytial virus infections in children

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World Journal of Pediatrics 2024年第1期20卷 11-25页

作者： Xian-Li Zhang Xi Zhang Wang Hua Zheng-De Xie Han-Min Liu Hai-Lin Zhang Bi-Quan Chen Yuan Chen Xin Sun Yi Xu Sai-Nan Shu Shun-Ying Zhao Yun-Xiao Shang Ling Cao Yan-Hui Jia Luo-Na Lin Jiong Li Chuang-Li Hao Xiao-Yan Dong Dao-Jiong Lin Hong-Mei Xu De-Yu Zhao Mei Zeng Zhi-Min Chen Li-Su Huang Department of Infectious Disease Children's HospitalZhejiang University School of Medicine3333 Binsheng RoadBinjiang DistrictHangzhou 310052China Clinical Research Unit Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina Beijing Pediatric Research Institute Beijing Children's HospitalCapital Medical UniversityBeijingChina Department of Pediatric Pulmonology West China Second University HospitalSichuan UniversityChengduChina Department of Pediatric Pulmonology the Second Affiliated Hospital&Yuying Children's HospitalWenzhou Medical UniversityWenzhouChina Department of Infectious Disease Anhui Provincial Children's HospitalHefeiChina Department of Pediatrics the Second Hospital of Hebei Medical UniversityShijiazhuangChina Department of Pediatrics Xijing Hospitalthe Fourth Military Medical UniversityXi'anChina Department of Infectious Disease Guangzhou Women and Children's Medicine CenterGuangzhou Medicine UniversityGuangzhouChina Department of Pediatrics Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Department of Respiratory Disease Beijing Children's HospitalCapital Medical UniversityBeijingChina Department of Pediatric Respiratory Shengjing Hospital of China Medical UniversityShenyangChina Respiratory Department Children's Hospital Affiliated to Capital Institute of PediatricsBeijingChina Department of Clinical Epidemiology Aarhus UniversityAarhusDenmark Department of Respirology Children's Hospital of Soochow UniversitySuzhouChina Department of Respiratory Children's Hospital of ShanghaiChildren's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina Department of Infectious Disease Hainan Women and Children's Medical CenterHaikouChina Department of Infectious Disease Children's Hospital of Chongqing Medical UniversityChongqingChina Department of Respiratory Children's Hospital of Nanjing Medical UniversityNanjingChina Department of Infectious Di

Background Respiratory syncytial virus(RSV)is the leading global cause of respiratory infections and is responsible for about 3 million hospitalizations and more than 100,000 deaths annually in children younger than 5 years,representing a major global healthcare *** is a great unmet need for new agents and universal strategies to prevent RSV infections in early life.A multidisciplinary consensus development group comprising experts in epidemiology,infectious diseases,respiratory medicine,and methodology aims to develop the current consensus to address clinical issues of RSV infections in *** sources The evidence searches and reviews were conducted using electronic databases,including PubMed,Embase,Web of Science,and the Cochrane Library,using variations in terms for"respiratory syncytial virus","RSV","lower respiratory tract infection","bronchiolitis","acute","viral pneumonia","neonatal","infant""children",and"pediatric".Results Evidence-based recommendations regarding diagnosis,treatment,and prevention were proposed with a high degree of *** supportive care remains the cornerstone for the management of RSV infections,new monoclonal antibodies,vaccines,drug therapies,and viral surveillance techniques are being rolled *** This consensus,based on international and national scientific evidence,reinforces the current recommendations and integrates the recent advances for optimal care and prevention of RSV *** improvements in the management of RSV infections will require generating the highest quality of evidence through rigorously designed studies that possess little bias and sufficient capacity to identify clinically meaningful end points.

关键词： Consensus prevention Respiratory syncytial virus Treatment

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Flow structure over a wavy bed with vegetation cover

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International Journal of Sediment Research 2017年第2期32卷 186-194页

作者： Fazeleh Kabiri Hossein Afzalimehr Jueyi Sui Department of Water Engineering Isfahan University of Technology Environmental Engineering Program University of Northern British Columbia 3333 University Way

On the basis of experiments carried out in flume with a wavy bed with vegetation cover,flow velocity,turbulence intensities and Reynolds stress distributions are *** wavy bed was similar to dune in this *** fixed artificial dunes were constructed over the bed and artificial vegetation put over them in a laboratory *** Acoustic Doppler Velocimeter and spatially-averaged method were applied to determine turbulent flow components and shear *** were compared with a gravel *** was observed that vegetation cover influences considerably the flow structure and displays clearly the flow separation and reattachment *** law of the wall was not valid within the vegetation cover,but it was fitted well to the zone above the vegetation cover within the inner *** a wavy bed having the same dimensions,shear velocity and friction factor over vegetation cover are 1.7 and 2.6 times of those for the gravel bedform,*** results of laboratory study were compared with those of river study.

关键词： Wavy bed Vegetation cover Turbulence Flow separation Gravel

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Corrosion Behavior of AZ31 Magnesium Alloy in Highly Alkaline Environment

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Acta Metallurgica Sinica(English Letters) 2017年第4期30卷 367-375页

作者： Somi Doja Lukas Bichler Simon Fan School of Engineering University of British ColumbiaOkanagan 3333 University Way Kelowna BC V1V 1VTCanada ZincNyx Energy Solutions Vancouver BC V6P 6T3 Canada

Industrial components made with a magnesium-aluminum alloy AZ31 are often used in diverse engineering applications where component weight, strength, and durability are critical. Similarly as other Mg alloys, however, the AZ31 is susceptible to corrosion in alkaline environments. In this work, corrosion of commercial grade AZ31 alloy plate was examined in potassium hydroxide （KOH） using immersion and potentiodynamic studies. The results suggest that the concentration of A1 and Mn in the alloy may govern the kinetics of micro-galvanic corrosion and the initiation of corrosion pits. Further, trace amounts of Ni in the AZ31 alloy were seen to enable formation of Ni（OH）2 surface layer, which may have further accelerated alloy corrosion due to its cracking and void coalescence. The effect of pH on the corrosion behavior of AZ31 was studied with reference to Pourbaix diagrams.

关键词： Magnesium alloy AZ31 KOH

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Can plasticity make spatial structure irrelevant in individual-tree models?

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Forestry Studies in China 2014年第3期16卷 134-146页

作者： Oscar Garcia university of Northern British Columbia 3333 University WayV2N 4Z9 Prince GeorgeBCCanada

Background： Distance-dependent individual-tree models have commonly been found to add little predictive power to that of distance-independent ones. One possible reason is plasticity, the ability of trees to lean and to alter crown and root development to better occupy available growing space. Being able to redeploy foliage （and roots） into canopy gaps and less contested areas can diminish the importance of stem ground locations. Methods： Plasticity was simulated for 3 intensively measured forest stands, to see to what extent and under what conditions the allocation of resources （e.g., light） to the individual trees depended on their ground coordinates. The data came from 50 x 60 m stem-mapped plots in natural monospecific stands of jack pine, trembling aspen and black spruce from central Canada. Explicit perfect-plasticity equations were derived for tessellation-type models. Results： Qualitatively similar simulation results were obtained under a variety of modelling assumptions. The effects of plasticity varied somewhat with stand uniformity and with assumed plasticity limits and other factors. Stand-level implications for canopy depth, distribution modelling and total productivity were examined. Conclusions： Generally, under what seem like conservative maximum plasticity constraints, spatial structure accounted for less than 10% of the variance in resource allocation. The perfect-plasticity equations approximated well the simulation results from tessellation models, but not those from models with less extreme competition asymmetry Whole-stand perfect plasticity approximations seem an attractive alternative to individual-tree models.

关键词： Growth and yield Competition Perfect plasticity approximation (PPA) siplab

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FTO gene polymorphisms and obesity risk in Chinese population: a meta-analysis

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World Journal of Pediatrics 2019年第4期15卷 382-389页

作者： Ning-Ning Zhao Guan-Ping Dong Wei WU Jin-Ling Wang Rahim Ullah Jun-Fen Fu Department of Endocrinology Children's HospitalZhejiang University School of Medicine3333Binsheng RoadHangzhou 310052China

Background There is tremendous increase in obesity *** factors including diet,life style,genetic,and epigenetic changes contribute to *** fat mass and obesity-associated (FTO) gene polymorphisms are strongly associated with *** has been reported that FTO single-nucleotide polymorphisms (SNPs) are associated with obesity in European populations;however,it was controversial in Chinese *** present meta-analysis study was designed to investigate the association between FTO polymorphisms and obesity risk in Chinese *** The investigators searched studies using the following databases:PubMed,web of science,and Cochrane Central Register of Controlled Trials.A random-effects model was used to calculate the pooled odds ratios (ORs).The heterogeneity among the studies was measured by I2 *** analysis was used to find out the potential factors influencing the *** A total of 18 articles including 26 studies were included in the present ***,the FTO SNPs were significantly associated with obesity in Chinese population (OR 1.30;95% CI 1.19-1.42;P < 0.001) under per-allele *** subgroup analysis also showed strong association between four FTO SNPs (rs9939609,rs6499640,rs8050136,and rs 1558902) and obesity ***,subgroup analysis stratified by children/adolescent and adult groups showed same *** The present meta-analysis indicated that FTO SNPs are associated with obesity risk in both children/adolescents and adults in Chinese population.

关键词： FTO SNPs Obesity Chinese population

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The role of statins in both cognitive impairment and protection against dementia:a tale of two mechanisms

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Translational Neurodegeneration 2018年第1期7卷 43-53页

作者： Bob G.Schultz Denise K.Patten Daniel J.Berlau Regis university School of Pharmacy 3333 Regis Boulevard H-28DenverCO 80221USA

Nearly 30% of adults 40 years and older in the United States are on a *** widespread use heightens the importance of careful consideration of their varied effects on the *** randomized controlled trials have not confirmed cognitive impairing effects with statins,continuing evidence suggests statins have the ability to cause reversible cognitive impairment in some ***,statins have also been shown to decrease the risk of dementia,Alzheimer’s disease,and improve cognitive impairment in some ***,randomized controlled trials have similarly failed to find the beneficial *** evidence for both claims is compelling whereas known limitations of the clinical trials may explain the lack of *** narrative review aims to explain why there is still controversy and how both effects can,and may,be *** mechanisms that have been hypothesized for each effect are seemingly independent from one another and may explain the contradicting *** mindful of the complex effects of statins,health care providers need to be able to identify patients who are at risk for or already experiencing cognitive impairment from statin use while also identifying those who could potentially decrease their risk of dementia with statins.

关键词： Statin Cognition Dementia Memory Cholesterol Alzheimer’s disease Vascular dementia Neuroprotection

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Biomarkers of intravenous immunoglobulin resistance and coronary artery lesions in Kawasaki disease

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World Journal of Pediatrics 2019年第2期15卷 168-175页

作者： Wei-Xing Kong Fei-Yue Ma Song-Ling Fu Wei Wang Chun-Hong Xie Yi-Ying Zhang Fang-Qi Gong Department of Cardiovascular Diseases Children's HospitalZhejiang University School of Medicine3333 Binsheng RoadHangzhou 310052China

Background Currently,there are no reliable indicators for predicting intravenous immunoglobulin resistance and coronary artery lesions in the early stage of Kawasaki *** A total of 300 patients with Kawasaki disease were studied *** data were compared between the intravenous immunoglobulin resistant (29 patients) and responsive groups,and between the groups with coronary artery lesions (48 patients) and without coronary artery *** The intravenous immunoglobulin resistant group had significantly higher D-dimer,globulin,interleukin-6 and serum ferritin levels in comparison to the intravenous immunoglobulin responder group.D-dimer level had a sensitivity of 87.0% and a specificity of 56.3% for predicting intravenous immunoglobulin resistance at a cutoff point of 1.09 mg/*** had a sensitivity of 62.1% and a specificity of 82.3% for predicting intravenous immunoglobulin resistance at a cutoff point of 34.7 g/*** ferritin level had a sensitivity of 42.9% and a specificity of 88.8% for predicting intravenous immunoglobulin resistance at a cutoff point of 269.7 ng/*** patients with coronary artery lesions had higher D-dimer and tumor necrosis factor-α level.D-dimer level had a sensitivity of 50% and a specificity of 78.6% for predicting coronary artery lesions at a cutoff point of 1.84 mg/*** on analysis by multivariate logistic regression,serum ferritin and globulin were independent risks for intravenous immunoglobulin resistance,D-dimer was independent risk for coronary artery *** Elevated serum ferritin,globulin and D-dimer levels are significantly associated with intravenous immunoglobulin resistance in Kawasaki ***,serum D-dimer is significantly increased in Kawasaki disease with coronary artery lesions.

关键词： Biomarkers Coronary artery lesions Intravenous immunoglobulin resistance Kawasaki disease

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