目的 分析过敏性疾病儿童过敏原的种类和特点。方法 采用国产欧博克试剂盒(酶联免疫法)对174例过敏性疾病患儿进行食物及吸入性过敏原特异性IgE(SIgE)检测,比较≤3岁和＞3岁两组患儿SIgE阳性率。结果 过敏性疾病患儿SIgE检测阳性率达72.99%(127/174),排名前2位的是:屋尘螨/粉尘螨(39.66%,69/174)、屋尘(26.44%,46/174)。≤3岁组食物性过敏原阳性率33.93%(19/56),吸入性过敏原阳性率44.64%(25/56),＞3岁组食物性过敏原阳性率41.53%(49/118),吸入性过敏原阳性率61.02%(72/118);127例阳性病例中, 96例对≥2种过敏原呈阳性反应, 69例SIgE等级≥3,＞3岁组混合过敏率及高度过敏率高于≤3岁组。结论 广州地区过敏性疾病儿童以吸入性过敏为主,主要过敏原是屋尘螨/粉尘螨、屋尘,随着年龄增长,吸入性过敏原阳性率升高,混合过敏的机率增加。建议对过敏疾病患儿进行过敏原检测,以制定相应环境干预措施及特异性脱敏治疗方案。

Objective To inverstigate the types and characteristics of allergen in children in different age with allergic diseases. Methods The food and inhalant allergen-specifi IgE(SIgE) were detected by the domestic specific IgE Screening ELISA kit in 174 children with allergic diseases,and were compared among children aged ≤3 and ＞3 years. Results 72.99%(127/174) of children with allergic diseases were positive for SIgE,the common allergen were dermatophagoides pteronyssinus/dermatophagoides farina and dust. In the group of ≤3 years old,the positives rate of food allergens was 33.93%(19/56),and the positives rate of aeroallergens was 44.65%(25/56).In the group of >3 years old, the positives rate of food allergens was 41.53%(49/118), the positives rate of aeroallergens was 61.02%(72/118).96 of 127(75.59%) positive cases yielded positive result to more than 2 allergens.69 patients's SIgE levels greater were ≥ 3,the mixed allergic rate and highly allergic rate of the children aged ＞3 years were higher than the children aged ≤3 years. Conclusion The children with allergic diseases in Guangzhou area were allergic mainly to inhalant allergens,especially to dermatophagoides pteronyssinus/dermatophagoides farina and dust.Aeroallergens are becoming the allergens as children grow with ages, and probability of mixture allergy is increasing.

目的 通过测试获取脑瘫外翻足患儿的足底压力参数特征,为设定步态康复训练方案提供参考。方法 根据纳入和排除标准,选择脑瘫患儿和健康儿童各15人,通过足底压力测试仪测得足底各部位压力分布、区域压力峰值及步态时相百分比,将两组结果进行统计学比较。结果 比较发现在足底接触面积、足底压力值,以及步态时相所占时间长短三方面均有指标存在差异,均有统计学意义(P<0.05)。结论 足底压力测试技术可使临床步态分析更加量化、精确化,为设定更有针对性的康复训练提供依据。

Objective Through the assessment to get the plantar pressure features of cerebral palsy children with talipes valgus, in order to design suitable treatment plan. Methods According to the inclusion criteria and exclusion criteria, we chose 15 cerebral palsy children with talipes valgus in experimental group, and 15 healthy children in control group. Through the test to get the plantar contact area, pressure parameters and the percent of gait phase. the two groups were compared with statistics method. Results There were significant differences between two groups on the plantar contact area, pressure parameters and the percent of gait phase. Conclusion Plantar pressure measurement makes clinic gait analysis more quantized and accurate, it will provide the evidence to plan the suitable treatment plan.

目的 探讨用捏脊联合中药外洗治疗脾胃气虚型儿童功能性消化不良的效果。方法 随机选取脾胃气虚型功能性消化不良的儿童120例,分为联合组、捏脊组、外洗组、对照组4个组,每组30例,分别采用捏脊、中药外洗、捏脊联合中药外洗、吗丁啉进行治疗,两周后观察4组治疗效果及唾液淀粉酶活性比值、D-木糖排泄率的变化,进行分析。结果 联合组的有效率优于捏脊组、外洗组、对照组,差异有统计学意义(P<0.05)。治疗后联合组的唾液淀粉酶活性比值比捏脊组、外洗组、对照组提高,差异有统计学意义(P<0.05)。治疗后D-木糖排泄率均较治疗前有增加,两两比较,联合组与对照组比较差异有统计学意义(P<0.05)。结论 捏脊联合中药外洗可改善脾胃气虚型儿童功能性消化不良,疗效良好,其机理同改善唾液淀粉酶活性有关。

目的 探讨儿童登革热(DF)合并肝功能损害的临床特征。方法 对2014年8—12月我院感染科收治住院的78例儿童DF的临床资料进行回顾性分析。结果 并发肝功能损害36例(46.15%),其中血清丙氨酸转氨酶(ALT)升高24例(30.77%),血清天冬氨酸转氨酶(AST)升高33例(42.31%);27例(75%)ALT/AST病程2周内恢复正常,9例于1月复查恢复正常。仅有1例总胆红素(TBIL)升高80.8 μmol/L,直接胆红素升高为主,1周后恢复正常。肝功能损害组较无肝功能损害组在外周血白细胞水平、血小板水平差异有统计学意义(P<0.05)。结论 儿童DF并肝功能损害较普遍,以轻度损害为主。与年龄、性别、皮疹、外周血白细胞、血小板有相关性。

Objective To approach the clinical characteristics of children dengue fever combined liver function damage. Methods Clinical data of 78 cases of children dengue fever in our hospital were retrospectively analyzed from August to December in 2014. Results 36 cases (46.15%) complicated with liver function damage. Among them 24 cases (30.77%) of serum alanine aminotransferase (ALT) increased, 33 cases (42.31%) of serum aspartate aminotransferase (AST) increased; 27 cases (75%)ALT/AST returned to normal within 2 weeks, 9 cases were recovered to normal in 1 month. Only 1 cases of total bilirubin (TBIL) increased to 80.8 mol/L, recovered after 1 week. Liver injury group and non liver injury group of peripheral blood leukocytes, platelets level comparison was statistically significant (P<0.05). Conclusion Children dengue fever combined liver function damage was common, mainly mild. There was correlation with age, gender, skin rash, peripheral blood leukocytes and platelets.

目的 探讨超声定位技术在重度水肿患儿颈内静脉置管中的应用效果。方法 选择重度水肿患儿23例,年龄1岁4个月～6岁,在超声引导下行颈内静脉置管。结果 本组23例患者均置管成功,置管成功率为100％,一次性穿刺成功率为91.3％,无1例发生出血、血气胸、血肿、空气栓塞等并发症。结论 超声引导定位重度水肿患儿颈内静脉置管,能有效提高穿刺成功率,减少并发症的发生。

目的 比较肺炎支原体肺炎(MPP)、非MPP患儿和健康儿童的免疫球蛋白、补体水平,以探讨儿童MPP体液免疫指标的变化规律。方法 分别检测52例MPP、55例非MPP患儿和33例健康儿童的血清免疫球蛋白(IgG、IgA、IgM)、补体(C3、C4),并比较儿童MPP急性期和恢复早期体液免疫指标。结果 MPP组急性期血清IgM、C3、C4水平高于非MPP组急性期和健康儿童(P<0.05)。儿童MPP恢复早期IgM水平高于急性期,C4水平低于急性期(P<0.05)。结论 与非MPP和健康儿童比较,MPP患儿存在明显体液免疫功能紊乱,从急性期到恢复早期,血清IgM逐渐升高,补体C4先升高后降低,自身免疫反应可能参与了儿童MPP的发病过程。

Objective To investigate the changes of serum immunoglobulins and complement in children with mycoplasma pneumoniae pneumonia (MPP). Methods 52 children with MPP, 55 children with non-MPP and 33 healthy children were enrolled. The levels of serum immunoglobulins (IgG, IgA and IgM) and complements (C3, C4) were detected. Results Compared with the non-MPP group and healthy control, the levels of IgM, C3 and C4 in MPP group during their acute phase were significantly higher (P<0.05). And among the MPP group the levels of IgM were hisher and C4 were lower than that in the acute phase. Conclusion Immune function disturbance exists in children with MPP. From acute to recovery stage, the level of IgM increased while C4 increased firstly and then decreased. Immune injury may be involved in the pathophysiology of childhood MPP.

目的 探讨对注意缺陷多动障碍（ADHD）患儿联合应用维生素D与盐酸托莫西汀的效果及对其行为功能障碍和神经功能损伤的影响。方法 选择于我院接受治疗的105例ADHD患儿,纳入时间为2023年7月—2024年3月,按照计算机分组法分为对照组52例给予盐酸托莫西汀治疗,观察组53例给予维生素D联合盐酸托莫西汀治疗,比较两组临床疗效、神经与行为功能、不良反应。结果 观察组总有效率（96.23%）高于对照组（78.85%）（P<0.05）。治疗后,与对照组比较,观察组神经元特异性烯醇化酶水平与行为、学习、躯体、冲动多动、焦虑及多动指数评分更低（P<0.05）。两组不良反应发生率对比差异无统计学意义（P>0.05）。结论 对于ADHD患儿,使用维生素D联合盐酸托莫西汀显示出更为显著的疗效,能有效缓解行为功能障碍,减少神经功能损伤,且具有良好的安全性。

Objective To explore the effect of combined use of vitamin D and atomoxetine hydrochloride on children with attention deficit hyperactivity disorder（ADHD）and its impact on their behavioral dysfunction and neurological damage. Methods A total of 105 children with ADHD treated in the hospital were included from July 2023 to March 2024. They were divided into control group with 52 cases treated with atomoxetine hydrochloride, and observation group with 53 cases treated with vitamin D combined with atomoxetine hydrochloride using a computerized grouping method. The clinical efficacy, neurological function, behavioral function, and adverse reactions were observed in both groups. Results The total effective rate of the observation group（96. 23%）was higher than that of the control group（78. 85%）（P<0. 05）. After treatment, compared with the control group, the levels of neuron-specific enolase in the observation group were significantly lower in terms of behavior, learning, physical fitness, impulsivity hyperactivity, anxiety and hyperactivity index scores（P<0. 05）. The comparison of the incidence of adverse effects between the two groups was not significant（P>0. 05）. Conclusions The combined use of vitamin D and atomoxetine hydrochloride has a more significant therapeutic effect on children with ADHD, which can effectively alleviate behavioral dysfunction, reduce neurological damage, and has good safety.

目的 利用可视化软件CiteSpace分析近20年儿童注意缺陷多动障碍（ADHD）及其共患病的相关文献,得出该领域的研究现状和发展趋势,为儿童注意缺陷多动障碍及其共患病的研究和诊疗提供参考。方法 检索2004—2024年发表在中国知网、维普、万方数据库关于儿童注意缺陷多动障碍及其共患病的相关文献,运用CiteSpace软件对纳入文献进行可视化分析,对来源、机构、发文量、作者、关键词绘制科学知识图谱。结果 共纳入383个机构、500个作者、235种期刊、577篇有效文献。自2012年发文量总体上呈波动上升趋势;在发文来源中,《中国儿童保健杂志》以47篇居首;研究机构以北京大学精神卫生研究所为代表;王玉凤作者发文21篇为最多;ADHD患儿的主要共患病为抽动障碍、癫痫、对立违抗障碍、学习障碍;主要治疗药物为托莫西汀;主要影响患儿的执行功能。ADHD患儿共患病研究分为3个阶段,第一阶段为2004—2009年,研究对象主要为品行障碍、对立违抗障碍、学习障碍、焦虑障碍,主要研究内容为患儿的脑损伤与基因;第二阶段为2009—2017年,重视研究患儿的心理问题,如焦虑、抑郁,也重视患儿的生活及家庭环境;第三阶段为2017—2024年,重点研究托莫西汀、阿立哌唑等药物,并重视ADHD共患癫痫的研究。结论 目前对ADHD共患病的研究仍较为局限,主要集中研究共患抽动障碍、对立违抗障碍、癫痫,未来应重视研究其他共患病,进一步探索更好的诊治方法。

Objective To analyze the literature on attention deficit hyperactivity disorder（ADHD）and its comorbidities in children in the past 20 years by using the visualization software CiteSpace, and to obtain the research status and development trend of this field, so as to provide reference for the research, diagnosis and treatment of ADHD and its comorbidities in children. Methods The relevant literature on ADHD and its comorbidities in children published in CNKI, VIP and Wanfang data bases from 2004 to 2024 was searched, and the included literature was visually analyzed by CiteSpace 6. 2R6 software, and the scientific knowledge graph was drawn by the source, institution, number of publications, authors and keywords. Results A total of 383 institutions, 500 authors, 235 journals, and 577 valid articles were included. Since 2012, the number of published documents has fluctuated and increased. Among the sources of publication, the Chinese Journal of Child Health ranked first with 47 articles. The research institutions were represented by the Institute of Mental Health of Peking University. Wang Yufeng was the most prolific author with 21 articles. The main comorbidities of ADHD children were tic disorder, epilepsy, oppositional defiant disorder and learning disorder. The main treatment drug was tomoxetine. It mainly affects the executive function of the children. The study on comorbidity in children with ADHD was divided into three stages. The first stage was from 2004 to 2009. The research objects mainly included conduct disorder, oppositional defiant disorder, learning disorder and anxiety disorder, and the main research content was brain injury and genes in children. The second stage, from 2009 to 2017, focused on the psychological problems of children, such as anxiety and depression, and also paid attention to the life and family environment of children. The third stage was 2017-2024, focusing on tomoxetine, aripiprazole and other drugs, and paying attention to the study of ADHD co-induced epilepsy. Conclusions The current research on ADHD and its comorbidities is still limited, and its pathogenesis should be explored in the future, so as to quickly and accurately identify comorbidities and further study better treatments.

        儿童孤立性直肠溃疡综合征（SRUS）是一种较为罕见的慢性直肠疾病,儿童发病率低且缺乏明确统计学数据。该病主要表现为便血、排黏液便和排便不尽感,临床诊断较为困难,常易误诊为其他疾病。其发病机制尚不明确,可能与排便习惯异常、直肠黏膜异常、血管异常以及遗传易感性等多种因素有关,其中 CHEK2 基因的 p.H371Y 突变可能在发病机制中起关键作用。诊断需综合病史、体格检查以及排粪造影、超声内镜、肠镜检查与组织病理活检等多种辅助检查手段。治疗上目前尚无统一指南,主要包括改善饮食和排便习惯、生物反馈治疗、药物治疗、内镜下治疗和外科手术治疗等,但总体治疗难度较大且复发率较高。本文对儿童 SRUS 的流行病学、发病机制、临床表现、诊断和治疗等方面的研究进展进行综述,旨在提高临床医师对该病的诊疗水平,为未来进一步的研究提供参考依据。

       Solitary rectal ulcer syndrome（SRUS）in children is a chronic and benign disease of the rectum characterized by ulcers. The clinical incidence of SRUS in children is not high, but it is prone to misdiagnose and miss diagnosis,which can delay the optimal treatment opportunity. This article reviews the research progress on the epidemiology,pathogenesis, clinical manifestations, diagnosis and treatment of SRUS in children, aiming to improve the diagnostic and therapeutic level of clinicians.

       目的   分析原发性肾病综合征（PNS）患儿在糖皮质激素（激素）治疗后淋巴细胞亚群及免疫因子的水平变化，以探讨PNS耐药机制。方法   选取PNS患儿共71例，正常对照组108例，收集PNS患者在激素治疗前、后及正常对照组儿童的淋巴细胞亚群［CD4⁺ 、CD8⁺ 、CD4⁺ /CD8⁺ 、CD19⁺ 和自然杀伤（NK）细胞］及免疫因子水平，并分析激素治疗后激素敏感患儿和激素耐药患儿相关指标的差异。结果  PNS患儿淋巴细胞亚群及免疫因子水平异常，激素治疗后PNS患儿总免疫球蛋白E（IgE）水平［767.50（270.25，1 937.50）IU/mL vs 311.00（62.70，757.00）IU/mL］（P=0.008）下降，而CD4⁺ T细胞比例［（33.88±7.42）% vs（38.25±7.16）%］（P=0.004）升高，激素治疗敏感患儿NK细胞比例高于激素治疗耐药患儿［（8.39±4.60）% vs（4.72±1.99）%］（P=0.034），IgE水平低于耐药患儿［311.00（62.70，633.00）IU/mL vs783.00（88.05，1 290.00）IU/mL］（P＜0.001）。结论  PNS患儿淋巴细胞亚群分布及免疫球蛋白水平异常，激素治疗可影响患儿CD4⁺ T细胞比例及IgE水平，并且NK细胞比例和IgE水平与患儿激素耐药相关。

       Objective  To evaluate the changes of lymphocyte subsets and immune factors levels in children with primary nephrotic syndrome（PNS），and explore the pathogenesis of PNS．Methods  A total of 71 patients with PNS and 108 normal control cases were selected．Flow cytometry was used to detect the concentration of lymphocyte subsets（CD4⁺ ，CD8⁺ ，CD4⁺ /CD8⁺ ，CD19⁺  and natural killer［NK］ cells）and immune factors before and after treatment．The difference of  related factors between steroid-sensitive and steroid-resistant children after therapy were analyzed．Results  Lymphocyte subsets and immune molecule levels were abnormal in children with NPS．The level of IgE（767.50［270.25，1 937.50］IU/mL vs 311.00［62.70，757.00］IU/mL，P=0.008）was significantly decreased after therapy（P＜0.05），while CD4⁺  T cells（［33.88±7.42］% vs［38.25±7.16］%，P=0.004）were significantly increased．The level of NK cells in steroid-sensitive children was significantly higher than that in steroid-resistant children（［8.39±4.60］% vs［4.72±1.99］%，P=0.034），while the level of  IgE was significantly lower than that of steroid -resistant children（311.00［62.70，633.00］IU/mL vs 783.00［88.05，1 290.00］IU/mL，P＜0.001）．Conclusions  The distribution of lymphocyte subsets and the level of immune factors in PNS children were abnormal．Steroid therapy could affect the levels of CD4⁺  T cells and IgE，and the levels of NK cells and IgE were related to steroid-resistance in PNS children．