Journal of Clinical Pediatrics

Effect of head circumference growth rate on neurodevelopmental outcome at 1 year old in very low birth weight infants in neonatal intensive care unit

ZHANG Xiaoting, ZHAO Xiangqun, LI Mingying, et al

Journal of Clinical Pediatrics. 2020, 38(4): 241. doi:10.3969/j.issn.1000-3606.2020.04.001

Abstract ( 425 )

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Objective　To predict the neuromotor development outcome at the corrected age of 1 year by the head circumference growth rate of very low birth weight (VLBW) infants in the neonatal intensive care unit (NICU). Methods The VLBW preterm infants (birth weight < 1500 g) admitted to NICU from June 2016 to December 2017 were prospectively collected. The growth rate of head circumference during hospitalization was monitored dynamically. According to the percentiles of different growth rates of head circumference, they were divided into slow growth group, moderate growth group and rapid growth group. The follow-up was continued until the corrected age of 1 year. The neuromotor development was assessed by the Bayley scales of infant development. According to the score results, the children were divided into the developmental retardation group (≤69 points), marginal group (70-79 points) and normal group (≥80 points), and the anthropometrics and complications among three group were compared. Results　The mean gestational age of the 131 subjects was (30.29±2.06) weeks, the mean birth weight was (1280±184) g, and the average growth rate of head circumference during hospitalization was (0.49±0.19) cm/ week. The head circumference growth rates of slow growth, moderate growth group and rapid growth group were (0.12±0.05) cm/week, (0.49±0.13) cm/week and (0.81±0.03) cm/week respectively. The corrected 1-year-old mental development index (MDI) and physical development index (PDI) in moderate growth group and rapid growth group were higher than those in slow growth group, and the difference was statistically significant (P<0.05). The growth rate of head circumference in both the MDI marginal group and the normal group was greater than that in the development retardation group, and the growth rate of head circumference in the PDI normal group was greater than that in the development retardation group, and differences statistically significant (P<0.05). Conclusions The growth rate of head circumference of VLBW infants during hospitalization was correlated with the neuromotor development outcome at the corrected age of 1 year.

Risk factors in the prognosis of neonatal capillary leak syndrome

WEI Huan, ZHANG Zhongyao, LI Luquan

Journal of Clinical Pediatrics. 2020, 38(4): 246. doi:10.3969/j.issn.1000-3606.2020.04.002

Abstract ( 517 )

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Objective　To explore the risk factors in the prognosis of neonatal capillary leak syndrome (CLS). Methods From October 2010 to July 2019, newborns who were clearly diagnosed with CLS and whose admission age was <28 days were selected as the study subjects. The clinical data of newborns in the survival group and the death group were retrospectively analyzed and the risk factors in the prognosis of CLS were analyzed. Results　In a total of 66 CLS newborns included, 46 (69.7%) survived and 20 (30.3%) died. Compared with the death group, the birth weight of the survival group was higher and the proportion of children with low birth weight was lower, and the differences were statistically significant (P<0.05). The prevalence of pulmonary hemorrhage, gastrointestinal hemorrhage, hyperglycemia and hyperkalemia in the survival group was lower than those in the death group, and the differences were statistically significant (all P<0.05). Logistic regression analysis showed that pulmonary hemorrhage (OR=8.20, 95%CI: 2.29~29.40, P=0.001) significantly increased the mortality of children with CLS. Conclusion　Pulmonary hemorrhage is an independent risk factor for the prognosis of CLS.

The value of serum miR-200c-3p expression in determining the severity and prognosis of neonatal respiratory distress syndrome

GU Yuniao, HUO Kaiming, ZHUANG Xiujuan, et al

Journal of Clinical Pediatrics. 2020, 38(4): 250. doi:10.3969/j.issn.1000-3606.2020.04.003

Abstract ( 315 )

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Objective　To explore the value of serum mir-200c-3p expression in determining the severity and prognosis of neonatal respiratory distress syndrome (NRDS). Methods　A total of 102 NRDS newborns admitted to the Second Affiliated Hospital of Hainan Medical College from June 2016 to June 2019 were selected and the Score for Neonatal Acute Physiology with Perinatal Extension-II (SNAPPE II) was calculated. According to the survival of the children, they were divided into the survival group (n=73) and the death group (n=29). According to the X-ray results and the severity of the disease, the children were divided into the mild group (grade Ⅰ and Ⅱ, 67 cases) and the severe group (grade Ⅲ and Ⅳ, 35 cases). The expression level of miR-200c-3p was detected by real-time fluorescent quantitative PCR. ROC curve was used to analyze the miR-200c-3p levels and SNAPPE-II score in predicting death in children with NRDS. Results　The serum miR-200c-3p expression level and SNAPPE-II score in the death group were significantly higher than those in the survival group, the expression level of miR-200c3p, SNAPPE-II score and mortality rate in the severe group were significantly higher than those in the mild group, and differences were statistically significant (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of serum miR-200c-3p expression combined with SNAPPE-II was 0.93 (95%CI: 0.87~0.98) in predicting NRDS death, significantly higher than that of miR-200c-3p alone (0.84, 95%CI: 0.78~0.90) or SNAPPE-II alone (0.80, 95%CI: 0.75~0.86), and differences were statistically significant (P<0.05). Its sensitivity and specificity were 94.0% and 88.5% respectively. There was a significant positive correlation between the expression of miR-200c-3p and SNAPPE-II in NRDS (r= 0.84, P< 0.01). Conclusions　The increased expression of miR-200c-3p in serum is related to the severity and prognosis of NRDS. The combination of miR-200c-3p and SNAPPE-II is of high value in the prognosis of NRDS.

Study on gastrointestinal microbiota of late preterm infants with feeding intolerance

REN Jiandong, LI Jun, YAN Jie, et al

Journal of Clinical Pediatrics. 2020, 38(4): 255. doi:10.3969/j.issn.1000-3606.2020.04.004

Abstract ( 293 )

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Objective　To explore the changes of gastrointestinal microbiota in late preterm infants with feeding intolerance. Methods　Premature infants admitted within 24 hours of birth to the neonatal intensive care unit from January to December 2018 were selected as the study subjects. Their gestational age was 34~36+6 weeks and their mothers had no history of prenatal infection or premature rupture of membranes. Fecal samples were collected from 30 patients with feeding intolerance (intolerance group), from 30 patients without feeding intolerance (control group), and from 30 remission patients in intolerance group (remission group). The differences of fecal microbiota were compared. Results　The relative abundances of bacteroidetes and actinobacteria in the intolerance group and the remission group were lower than those in the control group, and the relative abundances of proteobacteria in the intolerance group were higher than those in the control group and the remission group, and the differences were statistically significant (all P<0.05). The relative abundance of enterococcus and bacteroides in the intolerance group was significantly lower than those in the control group and the remission group (P<0.05). The relative abundance of streptococcus and staphylococcus in the intolerance group was significantly higher than those in the control group and the remission group (P<0.05). The relative abundance of clostridium in the intolerant group and the control group was significantly lower than that in the remission group (P<0.05). The relative abundance of bifidobacterium in the intolerance group and the remission group was significantly lower than that in the control group (P<0.05). The Observed_otus number, Chao1 index and Shannon index of the intolerance group were lower than those in the control group and the remission group, and the differences were statistically significant (all P<0.05). Conclusions　The relative abundance and diversity of intestinal microbiota decreased in feeding intolerant preterm infants. With the remission of feeding intolerance, the relative abundance and diversity of intestinal microbiota was gradually recovered.

Risk factors of multiple bacterial infections in NICU neonates with severe pneumonia

XIE Chaoyun, MENG Guiluan, XIONG Yun, et al

Journal of Clinical Pediatrics. 2020, 38(4): 260. doi:10.3969/j.issn.1000-3606.2020.04.005

Abstract ( 384 )

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　Objective　To analyze the risk factors of multiple bacterial infection in neonates with severe pneumonia in neonatal intensive care unit (NICU). Methods　The clinical data of 1057 newborns with severe bacterial pneumonia admitted to the NICU from January 2014 to May 2019 were retrospectively analyzed, and the risk factors for multiple bacterial infections were analyzed. Results　Univariate analysis showed that 12 factors including gestational age (<37 weeks), birth weight (<2500 g), onset age (<7 days), infection type (nosocomial infection), hospital stays (≥14 days), mechanical ventilation, Apagar score (<7 points), premature rupture of membranes, days of antibiotics use (≥10 days), changes of antibiotics (≥3) and combined use of antibiotics (≥3) were risk factors for the multiple bacterial infections in neonates with severe pneumonia in NICU, and differences were statistically significant (P<0.05). Multivariate analysis showed that changes of antibiotics (≥3), Apagar score (< 7 points), type of infection (nosocomial infection), mechanical ventilation and amniotic fluid contamination (degree II and III) were independent risk factors for the multiple bacterial infections in neonates with severe pneumonia in NICU (P<0.05). Conclusions　Comprehensive prevention and control measures should be taken in the clinic for the main risk factors to reduce multiple bacterial infections of neonates with severe pneumonia in NICU.

Characteristics of gut microbiota in children with attention deficit hyperactivity disorder

ZHANG Shan, WAN Lin, SUN Yulin, et al

Journal of Clinical Pediatrics. 2020, 38(4): 264. doi:10.3969/j.issn.1000-3606.2020.04.006

Abstract ( 730 )

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Objective　To explore the distribution characteristics of gut microbiota in children with attention deficit hyperactivity disorder (ADHD) and its possible role and mechanism in the pathogenesis of ADHD. Methods　Case-control study was used in this study. From January 2019 to June 2019, 17 ADHD children aged 6-12 years were selected, and 17 healthy children of the same age were recruited as controls. Metagenomic sequencing and analysis of fecal microflora were carried out to compare the Alpha diversity of microflora and the relative abundance of species classification (genus and species) between groups. Results　There was no significant difference in Alpha diversity of gut microbiota between ADHD and control groups (P>0.05). At the level of bacteria genus, compared with healthy children, the abundance of Facelibacterium and Veillonellaceae was reduced while the abundance of Odoribacter was increased in ADHD children, and differences were statistically significant (P<0.05). Furthermore, Enterococcus were significantly increased (LDA>2). At the level of bacteria species, the abundance of Faecalibacterium prausnitzii, Lachnospiraceae bacterium and Ruminococcus gnavus was decreased, while the abundance of Bacteroides caccae, Odoribacter splanchnicus, Paraprevotella xylaniphila and Veillonella parvula was increased in ADHD children, and there were significantly differences (P<0.05). Conclusion　The composition of gut microbiota in ADHD children was abnormal.

Clinical characteristics and prognosis of severe Mycoplasma pneumoniae pneumonia with pleural effusion in 46 cases

WANG Chongjie, LUO Xueqin, LUO Jian, et al

Journal of Clinical Pediatrics. 2020, 38(4): 269. doi:10.3969/j.issn.1000-3606.2020.04.007

Abstract ( 458 )

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　Objective　To explore the clinical characteristics and prognosis of severe Mycoplasma pneumoniae pneumonia (SMPP) with pleural effusion. Methods　The clinical data of SMPP with pleural effusion in 46 children and SMPP without pleural effusion in 53 children were retrospectively analyzed and compared. Results　Compared with SMPP without pleural effusion group, male to female sex ratio and the proportions of pulmonary atelectasis, extrapulmonary system damage and systemic glucocorticoid use were significantly increased. The days of hospitalization, days of fever, the effective time of azithromycin and the absorption time of pulmonary lesions after discharge were all significantly prolonged. The levels of C-reactive protein, PCT, D-dimer and lactate dehydrogenase were significantly increased. The level of albumin was significantly decreased in SMPP with pleural effusion group. The differences were statistically significant (P<0.05). Compared with the low-medium volume of pleural effusion group, the children in the high volume of pleural effusion group were older and had significantly longer duration of fever and hospitalization, and differences were statistically significant (P<0.05). The age of children with MP positive hydrothorax was significantly higher than that of children with MP negative hydrothorax (P<0.05). The levels of D-dimer and LDH in children having intrinsic airway secretory status rating > 4 were higher than those in children having intrinsic airway secretory status rating ≤ 4 (P<0.05) in SMPP children with pleural effusion. Conclusions　Children with SMPP combined with pleural effusion have a longer duration of fever, a higher incidence of extrapulmonary and intrapulmonary complications, significantly abnormal serum inflammatory indicators and blood biochemical indicators, and later start time of effectiveness of azithromycin alone and a longer absorption time of pulmonary lesions. The possibility of systemic glucocorticoid application should be predicted as early as possible in the acute phase and regular follow-up of chest imaging is required after discharge.

Intervention therapy of patent ductus arteriosus in children: a single-center observation and medium-long term follow-up

ZHOU Jiwei, YI Qijian, WANG Xianmin

Journal of Clinical Pediatrics. 2020, 38(4): 275. doi:10.3969/j.issn.1000-3606.2020.04.008

Abstract ( 317 )

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Objective　To explore the complications and causes of interventional therapy for patent ductus arteriosus (PDA) in children. Methods　The clinical data of children with PDA who underwent interventional occlusion from January 1, 2004 to January 1, 2019 were collected and the changes before and after occlusion and at the 1-year follow-up were compared. Results　A total of 1408 children (482 boys and 926 girls) were included and a median age was 27.0 (2.0~215.0) months, and 1404 (99.72%) children were successfully closured by intervention. PDA was 3.3 (0.1~18) mm measured by echocardiography, and was 2.2 (0.1~18) mm measured by angiocardiography. The size of implanted device was (8.47±2.52) mm. Twenty-four hours after operation, there were 125 cases of residual shunt, 21 cases of thrombocytopenia, 31 cases of arrhythmia, 2 cases of hemolysis, 3 cases of arterial thrombosis, 4 cases of pseudoaneurysm, 1 case of right common iliac artery rupture, 1 case of right renal contusion, 4 cases of device shift, 1 case of aorta coarctation, 1 case of pulmonary artery stenosis and 1 case of anterior tricuspid valve chordae tendineae rupture. Multivariate logistic regression analysis showed that the female, the increasing severity of pulmonary hypertension and the increasing diameter of the occlusive device were independent risk factors for residual shunt after surgery (P<0.05). Conclusions　The interventional therapy for PDA in children is safe and effective. Patients with PDA having large diameter and moderate to severe pulmonary hypertension had a higher incidence of postoperative complications.

Hyperthyroid crisis with multiple organ failure: a case report

XIONG Daoxue, LUO Yulin, JIANG Jianyu, et al

Journal of Clinical Pediatrics. 2020, 38(4): 281. doi:10.3969/j.issn.1000-3606.2020.04.009

Abstract ( 592 )

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　Objective　To explore the clinical characteristics of hyperthyroidism crisis in children. Method　The clinical data of hyperthyroid crisis complicated with multiple organ failure in a child was analyzed retrospectively. Results A 13-year-old girl had no history of thyroid disease. The initial symptoms included nausea, vomiting and lethargy, and the main manifestations at admission included arrhythmia, cardiogenic shock, and heart failure, so it was considered as fulminant myocarditis. Physical examination at admission revealed mild exophthalmos, and thyroid function test revealed significantly increased free T3 (FT3) and free T4 (FT4) and significantly decreased thyroid stimulating hormone (TSH). After admission, the patient successively developed respiratory failure, renal failure, and hepatic failure. The thyroid storm score was 120 points and accordingly the diagnosis of thyroid storm was confirmed. After treated with active antiarrhythmic treatment, vasoactive agents, respiratory support, propylthiouracil, iodine, glucocorticoids, and blood purification, etc., the patient was eventually discharged with improved condition. Conclusions　Thyroid storm is a rare condition in children. It can have thyroid diseases as its initial presentation in children. Early identification and management are the keys to successful treatment.

Systemic lupus erythematosus with thrombotic thrombocytopenic purpura: a case report

HUA Ran, DENG Fang

Journal of Clinical Pediatrics. 2020, 38(4): 285. doi:10.3969/j.issn.1000-3606.2020.04.010

Abstract ( 342 )

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Objective　To explore the clinical characteristics, diagnosis and treatment of systemic lupus erythematosus (SLE) with thrombotic thrombocytopenic purpura (TTP). Method　The clinical data of SLE combined with TTP in a child were analyzed retrospectively, and the related literature was reviewed. Results　A 13-year-old girl who was presented with onset of nephrotic syndrome was diagnosed with severe SLE and lupus nephritis. Headache, thrombocytopenia, anemia, acute kidney injury and fever reappeared after initial treatment and improvement. The ratio of broken red blood cells in the blood smear was 2%, and TTP was diagnosed. After comprehensive treatment such as high dose of hormones, plasma exchange, and application of immunosuppressive agents, her condition was relieved. Conclusion　SLE with TTP is relatively rare and has a high mortality. Early recognition and appropriate treatment can improve the prognosis.

Clinical and genetic analysis of hypophosphatasia in 5 children

SU Na, ZHU Min, XU Ke, et al

Journal of Clinical Pediatrics. 2020, 38(4): 289. doi:10.3969/j.issn.1000-3606.2020.04.011

Abstract ( 514 )

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e　To summarize the clinical and genetic characteristics of hypophosphatasia (HPP). Methods　The clinical data and results of peripheral blood high-throughput sequencing in 5 children with HPP as well as Sanger verification of the children and their relatives were retrospectively analyzed. Results　All 5 patients had poor bone mineralization and decreased serum alkaline phosphatase, and 3 patients had nervous system symptoms such as convulsion. Six mutation sites were identified in these 5 children by high-throughput sequencing, including c.346G>A (p.A116T), c.1097 to c.1099del CCT complex heterozygous mutation (p.T366_S367deli), c.1014 to c.1015ins G (p.H338fs), c.1446C>A (p.482H>Q) compound heterozygous mutations, c.920C>T (p.P307L) and c.883A>G (p.M295V). Among them, c.1014-c.1015ins g, c.1097-c.1099del CCT and c.1446c> A were reported for the first time. Protein structure was predicted to be potentially harmful, and ACMG rates them as possibly pathogenic. Conclusions　Five children were diagnosed with HPP and three new mutations were found, which enriched the human ALPL gene mutation database.

Shwachman-Diamond syndrome: a case report and literature review

WANG Lu, YU Hui, WU Xia

Journal of Clinical Pediatrics. 2020, 38(4): 294. doi:10.3969/j.issn.1000-3606.2020.04.012

Abstract ( 652 )

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　Objective　To explore the clinical and genetic characteristics of Shwachman-Diamond syndrome (SDS). Methods　The clinical data of SDS in a child diagnosed by gene detection were analyzed retrospectively, and the clinical manifestations, gene characteristics and treatment of SDS were summarized based on the related literature. Results　 The 14-month-old boy presented with recurrent abnormal liver function as the first clinical manifestation, accompanied by developmental retardation. The absolute peripheral neutrophil count was less than 1.5×109/L. There was no typical pancreatic exocrine dysfunction in the children, the X-ray of the long bones of the limbs showed bone age lag with abnormal bone density, and the abdominal CT showed no pancreatic fatty infiltration. Gene sequencing suggested the c.258+2T>C homozygous variation of SBDS gene. Conclusions　SDS is typically characterized by pancreatic fat infiltration and exocrine dysfunction, hematological abnormalities (especially neutropenia), and skeletal abnormalities. Timely genetic testing of suspected children helps early diagnosis and treatment.

Clinical and genetic analysis of malformations of cortical development caused by mutation of TUBA1A gene in 2 cases

ZHANG Chao, LI Zhenmei, ZHAO Hongling, et al

Journal of Clinical Pediatrics. 2020, 38(4): 298. doi:10.3969/j.issn.1000-3606.2020.04.013

Abstract ( 618 )

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Objective　To explore the clinical and genetic characteristics of malformations of cortical development (MCD) caused by TUBA1A gene mutation. Methods　The clinical data of MCD in 2 children diagnosed by molecular detection were analyzed retrospectively, and the relative literature was reviewed to summarize the clinical characteristics of patients with the same genotype. Results　Both patients visited for intermittent convulsions. Patient 1 was a 1-year- 3-month-old boy. His manifestations were eyes staring, cyanosis of lips and face and extremities rigidity, and the symptoms could spontaneously remitted in 1-2 minutes. Abnormal epileptic wave was shown in electroencephalogram (EEG), and neuronal migration disorder (smooth brain and megagyrus) was shown in magnetic resonance imaging (MRI). Heterozygous mutation of c.387C>A (p.C129X) was found in TUBA1A gene by gene detection, and the fluorescence quantitative PCR showed that the mutation affected RNA level. Patient 2 was a 6-month-old girl. She had no obvious inducement of convulsion, which was characterized by sudden nodding of head, adduction of upper limbs and a series of attacks. There was no obvious shaking and stiffness in the limbs, and no obvious abnormality in lip color and complexion. Long-term EEG showed high degree of arrhythmia and isolated or serial spastic seizures. MRI showed bilateral fronto-parietal giant gyrus malformation. A heterozygous mutation (c.848A>G) in TUBA1A gene were found in this patient. Conclusion　MCD is caused by TUBA1A gene abnormality and genetic testing can help clinical diagnosis.

Clinical characteristics analysis of a child with West syndrome caused by SLC35A2 gene mutation in a Marfan syndrome family and literature review

TIAN Yang, HOU Chi, WANG Xiuying, et al

Journal of Clinical Pediatrics. 2020, 38(4): 302. doi:10.3969/j.issn.1000-3606.2020.04.014

Abstract ( 631 )

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Objective　To explore the pathogenic gene mutation of a child with West syndrome in a Marfan syndrome family, and to provide the basis for genetic consultation. Methods　The clinical data of the child and her family members were collected and analyzed. Peripheral blood DNA of the child and her parents, maternal grandmother and uncle were extracted. The whole exome next genetic sequencing was employed and copy number variation was detected, and then the result was verified by Sanger sequencing. The relevant literature was reviewed. Results　A 10-month-old girl had recurrent convulsions for 7 months, presenting as infantile spasm. There were signs of Marfan syndrome in the child, her mother and grandmother. There was nonsense mutation of c.7240C>T (p.R2414*) in FBN1 gene in the proband, her mother and the maternal grandmother. Furthermore, a frameshift mutation of c.601delG (p.A201Qfs*148) in SLC35A2 gene was also found in the proband, but no such mutation was found in SLC35A2 gene of the parents. This gene mutation has not been reported before. The thoracic ventricular septal defect repair was performed for the child. After the treatment with topiramate and galactose supplementation, the epilepsy and development of the child were improved. A total of 16 articles on SLC35A2 gene mutation with complete clinical data were retrieved, involving a total of 74 patients and 58 mutation loci, among which missense mutation was the most common. Patients could have different clinical phenotypes, and early infant epileptic encephalopathy was the most common. Conclusions　The SLC35A2 gene c.601delG (p.A201Qfs*148) is a pathogenic variant of West syndrome in Marfan syndrome family. This study expanded the gene mutation spectrum and provided the basis for genetic counseling of the family. Galactose combined with topiramate treatment is helpful to control seizures and improve development.

A case of tricho-rhino-phalanseal syndrome with new nonsense mutation and literature review

LI Li, MAO Guoshun, ZHAO Xiaofeng, et al

Journal of Clinical Pediatrics. 2020, 38(4): 306. doi:10.3969/j.issn.1000-3606.2020.04.015

Abstract ( 784 )

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　Objective　To explore the genetic etiology of tricho-rhino-phalanseal syndrome (TRPS). Methods　The clinical and genetic testing data from a child were retrospectively analyzed. Results　The 4 years and 9 months old boy presented with short stature and difficult to feed，He has suffered from hand-foot-mouth disease（HFMD） many times and has sparse eyebrows and hair and pear-shaped nose. X-ray examination showed that his phalanx bones were tapered, and some bones were merged advance. The GH peak value of clonidine excitation test is 28.17 ng/mL，The genomic DNA of the child and his parents were extracted，The sequencing method was constructed by Agilent SureSelect method, and high-throughput sequencing was performed on the Illumina platform and verified by Sanger sequencing. The child's TRPS1 gene (NM_014112.4) was found to have "nonsense mutation c.1338C>A, P.Tyr446X (heterozygous)" as a new mutation, which has not been reported at home and abroad. It is determined as a pathogenic mutation according to the interpretation criteria and guidelines of ACMG sequence variation. Conclusion　Short stature is a common feature of TRPS, This mutation site of the TRPS1 gene in this case is the first report.

Recommendations on practice of pediatric interventional cardiac catheteriazation during COVID-19 　pneumonia epidemic

Journal of Clinical Pediatrics. 2020, 38(4): 310. doi:10.3969/j.issn.1000-3606.2020.04.016

Abstract ( 282 )

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Strategy for prevention and control of COVID-19 pneumonia in children's hospital

LYU Zhe, LI Anmao, ZHANG Ningxin, et al

Journal of Clinical Pediatrics. 2020, 38(4): 313. doi:10.3969/j.issn.1000-3606.2020.04.017

Abstract ( 217 )

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Research progress on high risk factors and prevention of early-onset sepsis in neonates

TIAN Yueyue, WU Mingyuan

Journal of Clinical Pediatrics. 2020, 38(4): 317. doi:10.3969/j.issn.1000-3606.2020.04.018

Abstract ( 279 )

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