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OBJECTIVE: Our aim was to describe the patient characteristics, clinical–epidemiological profile, and treatment outcome of childhood tuberculosis (TB). METHODS: A retrospective, descriptive study was undertaken of 1212 children aged 0 to 18 years admitted to Beijing Children’s Hospital for the treatment of TB from January 2002 to December 2010. Statistical significance of category variables was evaluated by using Fisher’s exact test. RESULTS: Fifty-four percent of patients had extrapulmonary tuberculosis (EPTB), 38.8% had tuberculous meningitis, and 31.3% had disseminated TB. The last 2 types were defined as severe TB. Most patients with TB (81.6%) were cured or completed treatment. There were more patients aged <5 years and from rural areas with EPTB than with pulmonary tuberculosis. More severe cases of TB were found in patients aged <1 year than other less severe types of TB. Patients with no bacille Calmette-Guérin vaccination and a contact history at home had a significantly risk of contracting severe TB. Children aged <1 year and those with severe TB were more likely to have poor treatment outcomes (failed to improve or died). Among those with EPTB, only 61.3% and 61.1% had positive results on the purified protein derivative tuberculin skin test and chest radiograph, respectively. CONCLUSIONS: In this referral hospital setting, more pediatric EPTB and severe TB patients were found among children aged <1 year. Age <1 year and having severe TB were risk factors for treatment failure. Thus, prevention and health care in pediatric TB should focus on both EPTB and severe TB.

Background We sought to investigate epidemiologic features of Kawasaki disease (KD) in Shanghai from 2013 through 2017 and identify risk factors for coronary artery lesions (CAL). Methods As in our previous three surveys, a set of questionnaires and diagnostic guidelines for KD were sent to 50 hospitals providing pediatric medical care in Shanghai. Medical records of KD patients diagnosed from January 2013 through December 2017 were retrospectively analyzed. Multivariate logistic regression analysis was performed to identify risk factors for CAL. Results A total of 4,452 cases were enrolled. Male-to-female ratio was 1.7:1. The incidence of KD was 68.8 to 107.3 per 100,000 children aged <5 years from 2013 to 2017. Age at onset ranged from 15 days to 14.0 years (median: 1.8 years). KD occurred more frequently in spring and summer. Of 4,325 patients (97.0%) receiving intravenous immunoglobulin (IVIG), 362 (8.4%) were resistant to initial IVIG. CAL occurred in 406 (9.1%) patients, including 118 (2.7%) with medium aneurysms and 31 (0.7%) with giant aneurysms. Recurrent cases were 60 (1.3%). No death was found in this survey. Higher platelet levels, lower albumin levels, male sex, incomplete KD, IVIG resistance, and receiving initial IVIG ≤4 days or >10 days, were independently associated with CAL. Conclusions The incidence of KD in Shanghai had substantially increased while the proportion of CAL had substantially decreased as compared with our previous surveys. Higher platelet levels, lower albumin levels, male sex, incomplete KD, IVIG resistance, and receiving initial IVIG ≤4 days or >10 days, were risk factors for CAL.

BackgroundHypertension is an important health problem in China and raised blood pressure in children may lead to future hypertension. Accordingly we aimed to provide a reference blood pressure table for age, gender and height in Chinese children.MethodsA reference sample of subjects was drawn from the Chinese Health and National Survey 1999–2009 aged 7–17 years after excluding overweight and obese children, the 50th, 90th and 95th percentiles of systolic and diastolic blood pressure (SBP and DBP)are presented corrected for height and age by gender. These values are compared with existing Chinese and US recommendations.ResultsResults for the 50th, 90th and 95th percentile of SBP and DBP for 6245 boys and 5707 girls were presented by age and height percentiles. These observations were lower than existing Chinese recommendations before 13 years of age at median heightbut went higher in those >13 years old. At same age and height, SBP levels of American children were overall higher than Chinese counterparts from this study by average 9–10 mm Hg, but DBP did not show overall or significant difference.ConclusionsThe first height-specific blood pressure reference values are proposed for Chinese children and adolescents aged 7–17 years. These are lower than existing US reference values and current Chinese cutoffs.

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Research project evaluation and selection is mainly concerned with evaluating a number of research projects and then choosing some of them for implementation. It involves a complex multiple-experts multiple-criteria decision making process. Thus this paper presents an effective method for evaluating and selecting research projects by using the recently-developed evidential reasoning (ER) rule. The proposed ER rule based evaluation and selection method mainly includes (1) using belief structures to represent peer review information provided by multiple experts, (2) employing a confusion matrix for generating experts' reliabilities, (3) implementing utility based information transformation to handle qualitative evaluation criteria with different evaluation grades, and (4) aggregating multiple experts' evaluation information on multiple criteria using the ER rule. An experimental study on the evaluation and selection of research proposals submitted to the National Science Foundation of China demonstrates the applicability and effectiveness of the proposed method. The results show that (1) the ER rule based method can provide consistent and informative support to make informed decisions, and (2) the reliabilities of the review information provided by different experts should be taken into account in a rational research project evaluation and selection process, as they have a significant influence to the selection of eligible projects for panel review.

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