人感染猴痘的诊断和治疗

我国国家卫生健康委发布的《猴痘诊疗指南（2022年版）》介绍了人感染猴痘（human monkeypox，HMPX）诊断和治疗的关键知识点，未系统介绍HMPX病原学检测的送检样本类型、采集方法和检测要求，以及诊断标准国内外差异等信息。而对实验室确诊HMPX所需检测标本的采样方法和要求等信息，皮肤科以外的其他学科的医生缺乏了解，且相关参考资料较少。该文收集了HMPX诊断和治疗方面的信息，供临床学习、理解和实践该诊疗指南时参考。 ［中国当代儿科杂志，2022，24（9）：960-966］     

关注猴痘在多国的流行北大核心CSCD

全球人口流动造成新的传染病威胁仍无处不在,近日欧洲、美洲国家和澳大利亚报道了前所未有的人类猴痘病例,足以引起人们的高度重视。本文从猴痘的流行病学特点、传播途径、临床表现、诊断、预防等方面进行概述,以提高对此病的认识,并尽早采取预防措施。     

美国疾病预防和控制中心发布的《儿童和青少年猴痘的临床注意事项》解读

为应对出现的儿童和青少年猴痘，美国疾病预防和控制中心发布了《儿童和青少年猴痘的临床注意事项》。该文件专为服务于18岁以下儿童和青少年的医护人员撰写，以帮助医护人员规范管理接触过猴痘（包括人感染猴痘和动物猴痘），或疑似或确诊猴痘的儿童和青少年。该文件突出了儿童和青少年的特点，针对儿科临床实践的特殊问题提出了很多实用性建议，值得正在准备应对猴痘可能疫情的国内儿科医护人员研究学习。     

警惕猴痘在儿童中的蔓延

近年来全球饱受病毒感染大流行的严重影响，2022年5月以来猴痘突然肆虐，流行中心转向亚洲地区，对人类健康构成威胁。随着中国对于新型冠状病毒感染管控措施的改变，需警惕猴痘病毒在儿童感染的蔓延，该文就儿童猴痘感染的潜在风险及预防措施加以阐述。     

人感染甲型H1N1流感病毒的研究进展

2009年4月以来,包括墨西哥、美国和加拿大在内的许多国家发生了人感染甲型H1N1流感病毒疫情,WHO已于2009年4月29日将此次流感流行的预警级别不断提升至5级。现已基本明确,引起此次流感疫情的甲型H1N1流感病毒是猪流感病毒（swine influenza virus,SIV）的一种新型变异株。     

猴脾转移因子与人脾转移因子治疗小儿复发性呼吸道感染的效果比较

本文报道了猴脾转移因子(TFⅢ)与人脾转移因子(TFⅠ)治疗小儿复发性呼吸道感染的效果比较,结果表明,TFⅡ的临床疗效与TFⅠ相同,最后讨论了TFⅢ的应用前景。     

儿童和青少年2019冠状病毒病的临床表现及流行病学意义北大核心CSCD

2019年底开始的2019冠状病毒病(coronavirus disease 2019,COVID-19)疫情在几个月内迅速蔓延全球,2020年3月世界卫生组织宣布为全球疫情。根据美国儿科学会的数据,自疫情暴发以来,已有近1300万儿童确诊为COVID-19。总的来说,儿童和青少年COVID-19的症状比成人轻,病死率也较低。了解儿童和青少年中COVID-19的症状、传染性和传播模式对及时识别可疑患者和采取完善的管控措施具有重要意义。考虑到将来相当一段时间内,总会有一部分儿童尚不能接种疫苗,提高对儿童和青少年COVID-19的临床及流行病学意义认识就显得更重要。该文总结了儿童和青少年COVID-19临床表现的当前认识,分析其流行病学意义,为临床诊治、管理,以及幼儿园和学校等儿童聚集机构制订疫情防控策略提供参考。[中国当代儿科杂志,2022,24(8):846-852]     

严重急性呼吸系统综合征冠状病毒2感染儿童预防20问

自2019年12月以来,在中国武汉出现的病毒性肺炎已经逐渐蔓延至全国,导致这个疫情的病原体已经被证实是一种新型冠状病毒,属于β冠状病毒群,国际病毒分类委员会将新型冠状病毒命名为严重急性呼吸系统综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2),世界卫生组织(WHO)将新型冠状病毒感染的肺炎命名为Corona Virus Disease 2019(COVID-19)[1,2,3,4]。2020年1月30日,WHO正式宣布本次疫情升级为"国际关注的突发公共卫生事件(Public Health Emergency of International Concern,PHEIC)"。     

迎接挑战,做好小儿病毒性疾病的防治工作

1加深对我国小儿病毒性疾病危害性的认识自2003年春至2005年秋,根据各国向联合国粮食与农业组织的报告,由甲型流感病毒H5N1引起的禽流感已在18个国家和地区发生过2794起暴发流行。截至2006-02-06,向WHO报告的各国人感染H5N1的病例共165例,其中死亡88例(我国大陆患病10例,其中死     

严重急性呼吸综合征相关冠状病毒的研究进展

自 2 0 0 2年 11月在中国广东发现第一例病例以来 ,非典型肺炎 (atypicalpneumonia)便在中国大陆 ,香港和加拿大等地迅速蔓延 ,截至 5月 2 0日已累及全球 31个国家和地区 ,累计患病人数 7919人 ,累计相关死亡人数 6 6 2人。2 0 0 3年 2月 14日 ,WHO在其网站的每周疫情报告(weeklyepidemiologicalrecord)中首次以急性呼吸综合征 (acuterespiratorysyndrome)的名称公布了广东省报告的“非典”的疫情[1] ,当时认为病原体可能为一种新型流感病毒。当月 19日 ,香港学者在一个 9岁儿童患者体内分离到鸟类A型流感病毒 (H5N1) ,但是随后对该病毒…     

Transmission of monkeypox among persons exposed to infected prairie dogs in Indiana in 2003

OBJECTIVE: To describe a cluster of human monkeypox cases associated with exposure to ill prairie dogs in a home child care. DESIGN, SETTING, PARTICIPANTS: We identified all persons exposed to 2 pet prairie dogs in County A, Indiana; performed active surveillance for symptomatic monkeypox infection; and evaluated the types of exposure that may have resulted in infection. For children who attended the child care where the animals were housed, we also measured the rate of seroconversion to monkeypox virus. MAIN OUTCOME MEASURES: Nine (13%) of 70 persons exposed to the prairie dogs reported signs and symptoms of monkeypox. Two (40%) of 5 symptomatic child care attendees reported direct contact with the prairie dogs. Two (13%) of 15 child care attendees evaluated tested positive for IgM antibodies against orthopoxvirus; both reported symptoms consistent with monkeypox. RESULTS: The risk of symptomatic infection correlated with the time and intensity of animal exposure, which was 100% (4/4) among family members with extensive direct contact, 19% (5/26) among the veterinarian and nonfamily child care attendees with moderate exposure, and 0% (0/40) among school children with limited exposure (P<.01). CONCLUSIONS: Monkeypox virus was transmitted from ill prairie dogs in a child care and veterinary facilities. The risk of symptomatic infection correlated with the amount of exposure to the prairie dogs. Although most cases of human monkeypox were associated with direct animal contact, other routes of transmission cannot be excluded.     

杭州市19例新型冠状病毒Omicron变异株感染儿童的临床特征

目的 探讨儿童新型冠状病毒Omicron变异株感染者的临床特征,为临床诊疗提供参考。 方法 回顾性分析杭州市19例2022年1月28日至3月3日确诊为新型冠状病毒Omicron变异株感染儿童的临床资料。 结果 19例患儿中,男性7例（37%）,女性12例（63%）;年龄0.5~16.0岁,中位年龄为2岁1个月,以婴幼儿（≤3岁）多见（53%）。未接种新型冠状病毒疫苗者11例（58%）,接种者8例（42%）。3例（16%）有基础疾病史。19例患儿均有明确的新型冠状病毒感染者的密切接触史,其中母婴看护机构聚集性发病10例（53%）。临床表现为轻型13例（68%）,普通型6例（32%）,无重型病例。最常见症状为咳嗽（100%）和发热（63%）。患儿外周血白细胞计数（84%）及淋巴细胞计数多正常（68%）。患儿的血小板计数、降钙素原、肝功能指标（丙氨酸氨基转移酶、天冬氨酸氨基转移酶）、肾功能指标（肌酐、尿素）无明显异常。6例（32%）胸部CT有明显肺炎征象。19例患儿均给予对症治疗,12例（63%）雾化吸入干扰素α。所有患儿治愈出院。 结论 儿童Omicron变异株感染病例以婴幼儿多见,症状轻,预后良好。患儿多有新型冠状病毒感染者的密切接触史,应重视母婴看护中心等婴幼儿集中场所的疫情防控。     

New knowledge of Zahorsky exanthema subitum (critical 3-day fever-exanthema, roseola infantum

A survey is given on the history, characteristic symptoms and recent data of the etiology of exanthem subitum (Zahorsky's disease, sixth disease, roseola infantum). Some cases are presented and modern diagnostic techniques for atypical cases are discussed. The disease is caused by an infection with the human herpesvirus-6 (HHV 6; syn.:, "human B-lymphotropic virus", HBLV). Most babies and small children have an asymptomatic infection usually leading to lifelong immunity. The typical "exanthem subitum" develops only in a minority of the infected and susceptible persons. We suggest that the novel human herpesvirus-6 also has the potential of lifelong persistence in humans and can then be shedd at any age in case of acquired immunodeficiencies. World-wide research in this field is carried out by several working groups and new data will be available in a few years.     

Monkeypox: a review of the history and emergence in the Western hemisphere

A mysterious disease was reported on May 24, 2003, when the Wisconsin Division of Public Health (DPH) received notice of a 3-year-old girl who had been hospitalized in central Wisconsin with cellulites and fever after being bitten by a prairie dog on May 13. The laboratory isolated a gram-negative bacillus, raising concerns that it might be tularemia or plague; ultimately, it was identified as an acinetobacter species and was considered to be a contaminant. Because no other such cases were reported at the time, the case was thought to be merely an isolated event. However, within two weeks, on June 2, 2003, evidence of a much wider scenario began to emerge. On that date, the Wisconsin DPH received notice from the Marshfield Laboratory that the mother of the first patient had become ill on May 26 and that electron-microscopic evidence of a poxvirus was found in a skin lesion. On that same day, another report, this time from the Milwaukee Health Department, of a strange illness was received at the DPH and described the case of a meat inspector who resided in southeastern Wisconsin and also was a distributor of exotic animals. By July 30, 2003, 72 confirmed or suspected cases of monkeypox had been reported in Wisconsin, Illinois, and Indiana and represented a large outbreak. The peak in the onset of illness occurred between May 29 and June 9, 2003, and no further cases of illness have been reported in humans since June 22, 2003. Traceback investigations from the child and other patients followed the route of introduction of monkeypox into Wisconsin to a distributor in Illinois, who had received a shipment of exotic animals imported into the United States through Texas from Ghana, West Africa.     

How neuropsychology informs our understanding of developmental disorders

This review includes 1) an explanation of what neuropsychology is, 2) a brief history of how developmental cognitive neuroscience emerged from earlier neuropsychological approaches to understanding atypical development, 3) three recent examples that illustrate the benefits of this approach, 4) issues and challenges this approach must face, and 5) a forecast for the future of this approach.     

新型冠状病毒肺炎疫情前后2年儿童重症监护病房疾病谱的变化

目的 对比新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）疫情暴发前后2年内儿童重症监护病房（pediatric intensive care units，PICU）住院患儿疾病谱的变化。 方法 收集济宁医学院附属医院PICU 2018年1月至2019年12月（COVID-19疫情前组）和2020年1月至2021年12月（COVID-19疫情后组）所有住院患儿的疾病诊断相关信息，对2组患儿的疾病谱进行统计学分析。 结果 COVID-19疫情前组纳入2 368例患儿，COVID-19疫情后组纳入1 653例患儿。COVID-19疫情后组住院人数较COVID-19疫情前组减少了30.19%。COVID-19疫情前后2组年龄构成差异有统计学意义（P<0.05）。COVID-19疫情前组病例数居前10位的疾病依次为：呼吸系统疾病、神经系统疾病、脓毒症、危重症、循环系统疾病、神经外科重症、消化系统疾病、意外伤害、内分泌系统疾病、肿瘤。COVID-19疫情后组病例数居前10位的疾病依次为：呼吸系统疾病、神经系统疾病、脓毒症、循环系统疾病、意外伤害、内分泌系统疾病、神经外科重症、急腹症、创伤外科疾病、消化系统疾病。COVID-19疫情后组呼吸系统疾病、危重症、神经外科重症占比低于COVID-19疫情前组（P<0.05），而意外伤害、急腹症、内分泌系统疾病、创伤外科疾病、脓毒症占比高于COVID-19疫情前组（P<0.05）。 结论 COVID-19疫情后PICU住院患儿数量明显减少，疫情前后2年疾病谱发生了显著的变化。COVID-19疫情期间采取的相关防控措施可减少儿童呼吸系统疾病、神经系统疾病及其他危重症等的发生，但需加强疫情期间意外伤害的预防和慢性病管理。