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All patients were occluded successfully without any thoracotomy conversion. Operation time was 56-120 (mean, 75±13) minutes. A 1.5-2.0-cm median sternum incision was performed in 6 ASD&PDAs, 2 ASD&PSs, and 1 dcsVSD&PS. In 11 other patients, a 1.5-2.0-cm incision in the inferior sternum was made and the chest closed with a drain. There were no serious complications before discharge and at follow-up.

Simultaneous transthoracic intervention for multiple cardiac defects in children is feasible with good short-term outcomes. For different lesions, the appropriate surgical incision and operational sequence can render the intervention minimally invasive and safer.

Simultaneous transthoracic intervention for multiple cardiac defects in children is feasible with good short-term outcomes. For different lesions, the appropriate surgical incision and operational sequence can render the intervention minimally invasive and safer.

Vitamin D has gone from being just one vitamin to being an important prohormone with multiple effects on different tissue types. The mechanism of action of the active form or calcitriol is mediated by the intracellular vitamin D receptor (VDR). The interaction of the VDR with calcitriol modulates the expression of target genes involved in cell proliferation and cytokine production. Several studies have explored the effects of vitamin D deficiency in inflammatory disorders. Furthermore, some mutations in the

can affect its functionality. The focus of this study was to explore associations between

single nucleotide polymorphisms (SNPs) and markers of inflammation and oxidative stress in vitamin D sufficient children.

This is a cross-sectional study of a Caucasian Spanish population including 155 healthy children (87 males, 68 females) aged 10 to 14 years.

,

and

SNPs of the

gene were genotyped. Routine biochemistry, serum levels of interleukin-6, tumor necrosis factor-α, interferon-γ, 8-isopprovide a better understanding of the relationships between vitamin D and these clinical parameters.

In response to the ongoing epidemic of coronavirus disease 2019 (COVID-19), China has carried out restrictive disease containment measures across the country.

In this cross-sectional study, we collected demographic and epidemiological data of 376 laboratory-confirmed cases of COVID-19 among children younger than 18 years of age. (L)Dehydroascorbic Using descriptive statistics and odds ratios, we described the odds of exposure outside the family after the implementation of control measures compared to before.

Children diagnosed on or after February 4, 2020, had a lower odds of exposure to COVID-19 outside of the family compared to those diagnosed before February 3, 2020 (OR =0.594, 95% CI 0.391 to 0.904). In the stratified analysis, children aged 0 to 5 years had the lowest odds of exposure outside of the family (OR =0.420, 95% CI 0.196 to 0.904) compared to the other age groups assessed.

Our study on the children infected with COVID-19 as well as their exposure within family provided evidence that the implementation of containment measures was effective in reducing the odds of exposure outside of the family, especially for preschool children. Continuation of these efforts, coupled with tailored prevention and health education messaging for younger aged children, may help to reduce the transmission of COVID-19 among children until other therapeutic interventions or vaccines are available.

Our study on the children infected with COVID-19 as well as their exposure within family provided evidence that the implementation of containment measures was effective in reducing the odds of exposure outside of the family, especially for preschool children. Continuation of these efforts, coupled with tailored prevention and health education messaging for younger aged children, may help to reduce the transmission of COVID-19 among children until other therapeutic interventions or vaccines are available.

This study aims to investigate the current use of pediatric flexible bronchoscopy (PFB) in western China.

A cross-sectional survey was conducted in western China between January 1, 2018 to December 30, 2018. Fifty-four centers were invited to answer a questionnaire for seeking information about performance of PFB. The data collected were analyzed to investigate the current status of western China, and hierarchical cluster analysis was conducted to identify developmental level of PFB of cities.

Forty-seven centers were included in analysis. A total of 22,585 flexible bronchoscopies were carried out in the participating centers from January 1, 2018 to December 30, 2018. Eight centers (17.0%) performed more than 1,000 pediatric flexible bronchoscopies for children, but 20 centers (42.6%) performed less than 100. The median proportion of systematic and professional trained physicians in a single team was 50%, and the pooled rate was 59% (95% CI, 47-70%). Only 10, 8 and 11 centers performed balloon dilatation, thermal ablation and cryoablation, respectively. Obvious cough was the most frequent complication after the PFB procedure, the pooled rate is 24% (95% CI, 18-29%). No one died during and after the PFB procedure. Hierarchical cluster analysis showed that the development of PBF in western China varies, and Chongqing might be the most developed area in PFB use in western China.

Flexible bronchoscopy in children is now a mature and safe procedure, while the development of PFB varies in western China, especially for the advanced bronchoscopic intervention.

Flexible bronchoscopy in children is now a mature and safe procedure, while the development of PFB varies in western China, especially for the advanced bronchoscopic intervention.

Echocardiography has poor accuracy in grading the severity of pulmonary hypertension (PH) compared to cardiac catheterization. However, the relationship between degree of PH and prognostic outcomes remains uncertain. Our primary objective was to determine whether echocardiogram-assessed PH severity is associated with mortality and hospital readmission in the first year of life.

A retrospective cohort study of infants born less than 32 weeks of gestational age with bronchopulmonary dysplasia (BPD) underwent echocardiography was performed. Echocardiograms were performed at 36-38 weeks postmenstrual age. Data during hospitalization and post-discharge collected at 1-year age were analyzed with cox regression models and logistic regression models to identify the association of PH severity with mortality and readmission. Area under curve (AUC) was calculated to examine the accuracy of these models to reflect the likelihood of outcomes.

Fifty-six of 237 (23.6%) infants were diagnosed as PH. Moderate and severemortality in the first year of life.

To refine the bacterial meningitis (BM) score by improving its predictability of neonatal BM.

A multicenter, ambispective cohort study was conducted in China, comprising 9 hospitals (retrospective cohort January 2001 to December 2017; prospective cohort January 2018 to August 2019). Of 3,504 eligible full-term neonates, 475 neonates with cerebrospinal fluid (CSF) pleocytosis were included. Based on the receiver operating characteristic (ROC) curve and logistic regression analyses, the BM score was refined by changing the thresholds of CSF protein level and the CSF absolute neutrophil count (ANC), and removing some variables (the peripheral blood ANC and a history of seizure before or at the time of presentation).

Of 475 neonates, 94 (19.8%) had BM. Based on the refined BM score, neonates with none of the following high-risk predictors were classified as being at very low risk for BM CSF protein level ≥1,650 mg/L, CSF ANC ≥84×10

cells/L, and positive CSF Gram stain result. The refined score showed 100% sensitivity in identifying BM and much higher specificity compared to that for the BM score (70.9%

. 19.4%).

The refined BM score effectively identifies neonatal BM, and further studies are required to confirm our findings in prospective studies.

The refined BM score effectively identifies neonatal BM, and further studies are required to confirm our findings in prospective studies.

Recently, four influenza viruses are circulating worldwide A(H1N1)pdm09, A(H3N2), B/Victoria, and B/Yamagata. However, information on the clinical differences among pediatric patients infected with four recently circulating influenza viruses is sparse.

Medical records of pediatric patients (<20 years of age) diagnosed with influenza between the 2014-2015 and 2018-2019 influenza seasons were retrospectively reviewed. Clinical features were compared between (I) patients infected with influenza A (FluA) and influenza B (FluB) viruses, (II) patients infected with FluA when A(H1N1)pdm09 and A(H3N2) circulated dominantly, and (III) patients infected with FluB when B/Victoria and B/Yamagata circulated dominantly.

A total of 1,588 patients infected with FluA and 964 patients infected with FluB were included in this study. Patients infected with FluB were older (P<0.001) and more likely to report sore throat (P=0.002) than those infected with FluA. Otherwise, there were no significant differences in the clinical symptoms, diagnoses, and outcomes between patients infected with FluA and FluB. Overall, clinical features of influenza patients were similar regardless of the dominantly circulated subtype and lineage of the virus. In children aged ≤2 years, patients infected with FluB were more like to experience lower respiratory tract infection (P=0.034) and hospitalization (P=0.001) than those infected with FluA.

There were no significant clinical differences among pediatric patients infected with four recently circulating influenza viruses, except that FluB infection tended to be more severe than FluA infection in children aged ≤2 years.

There were no significant clinical differences among pediatric patients infected with four recently circulating influenza viruses, except that FluB infection tended to be more severe than FluA infection in children aged ≤2 years.

To evaluate the effectiveness of training on knowledge and practice of infection prevention and control (IPC) among pediatric health care workers (HCW) in Shanghai, China, in the context of COVID-19 pandemic.

An online training program was designed by the Shanghai Pediatric Clinical Quality Control Center (SPQCC) during the early phase of COVID-19 pandemic on disease knowledge and practice of IPC. Training took place in the 81 partner hospitals affiliated with SPQCC. A multicenter, cross-sectional questionnaire survey was designed with a 25-item self-administered questionnaire to evaluate the knowledge gained from the training. Stratified-random sampling was used to select HCW according to three professionals (i.e., pediatricians, nurses and administrators) within each partner hospital. Awareness and knowledge of COVID-19 and its related infection control and practice were assessed by comparing survey results between different types of hospitals, professionals and professional ranks. A higher survey scorepractice in infection protection and control measures. The online training was able to achieve its aim to enhance knowledge and awareness and could have contributed to the zero infection rate among HCW caring for confirmed COVID-19 cases in Shanghai.