Background Recent studies have reported associations between, human bocavirus (HBoV), and respiratory tract diseases in children. However, there is limited information on the epidemiology of HBoV in infants. This prospective study investigated the prevalence and clinical characteristics of HBoV infection in infants with acute lower respiratory tract infection (ALRTI) in eastern China. Methods Nasopharyngeal aspirates and throat swab samples were collected from infants with ALRTI and age-matched healthy infants between January 2016 and December 2019. HBoV was identified by polymerase chain reaction. Laboratory data and clinical characteristics were analyzed. Results Of 2510 infants, 145 tested positive for HBoV. The highest prevalence of HBoV was detected during the winter. Co-infection was frequently observed during this period of high viral transmission. There were no HBoV-positive infants in the control group. Clinical signs and symptoms included cough, wheezing, fever, nasal discharge, vomiting, diarrhea, hypoxemia, and tachypnea. Co-infections included: Streptococcus pneumoniae, Staphylococcus aureus, Mycoplasma pneumoniae, Chlamydophila pneumoniae, respiratory syncytial virus, and adenovirus. Conclusions HBoV was frequently detected in infants with ALRTI in China. The prevalence of HBoV was highest in winter. Co-infection was common, especially in infants requiring intensive care unit admission. Comprehensive clinical evaluation may facilitate optimal treatment.

Aims To explore the contagiousness and new SARS-CoV-2 mutations in pediatric COVID-19. Methods This cohort study enrolled all pediatric patients admitted to 8 hospitals in Zhejiang Province of China between 21 January and 29 February 2020, their family members and close-contact classmates. Epidemiological, demographic, clinical and laboratory data were collected. Bioinformatics was used to analyze the features of SARS-CoV-2. Individuals were divided into 3 groups by the first-generation case: Groups 1 (unclear), 2 (adult), and 3 (child). The secondary attack rate (SAR) and R 0 were compared among the groups. Results The infection rate among 211 individuals was 64%(135/211). The SAR in Groups 2 and 3 was 71%(73/103) and 3%(1/30), respectively; the median R 0 in Groups 2 and 3 was 2 (range: 1-8) and 0 (range: 0-1), respectively. Compared with adult cases, the SAR and R 0 of pediatric cases were significantly lower (p<0.05). We obtained SARS-CoV-2 sequences from the same infant's throat and fecal samples at a two-month interval and found that the new spike protein A958D mutation detected in the stool improved thermostability theoretically. Conclusions Children have lower ability to spread SARS-CoV-2. The new A958D mutation is a potential reason for its long residence in the intestine.

Background:The GJB2 gene is reported to be the main hereditary factor responsible for non-syndromic hearing impairment in infants. Several kinds of hearing loss have been linked to elevated inflammatory markers. This study aimed to evaluate serum levels of IL-2, IL-4, IL-6, IL-10, IL-17, a-TNF, and g-IFN and the severity of hearing loss. Material/Methods:Ninety newborns were divided into 3 groups: severe hearing impairment (31 infants), moderate hearing impairment (30 infants), and normal hearing (29 infants). Hearing screening was performed using otoacoustic emissions test. Mutations of the GJB2 gene were detected with Sanger sequencing. The patients had DNFB1 mutation. Seven blood inflammatory markers were tested using Cytometric Bead Array. We performed the t test to examine differences in expression of 7 inflammatory markers between sexes in the groups. The correlation between indicators within groups was studied using the Pearson correlation test. Correlation of different indicators among groups was studied using the Spearman correlation test. Results:When compared among the 3 groups (severe, moderate hearing impairment, and normal hearing group), we found that IL-10 had a positive correlation with the severity of GJB2-associated hearing loss, which was statistically significant (P<0.05). Conclusions:This research aimed to assess the relationship of 7 serum inflammatory markers with GJB2-associated hearing loss in infants. Inflammatory marker IL-10 had a positive correlation with the severity of GJB2-associated infant hearing loss, and it might have the potential to become a future therapeutic target.

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Ubiquitin-like with plant homeodomain and ring finger domains 1 (UHRF1) promotes the maintenance of established patterns of DNA methylation in mammalian cells. Extensive methylation of connexin26 (COX26) during hearing impairment has been demonstrated. The present study aims to determine whether UHRF1 can induce the methylation of COX26 in cochlea damaged by intermittent hypoxia (IH). After the establishment of the cochlear injury model through IH treatment or isolation of the cochlea containing Corti’s organ, pathological changes were observed via HE staining. Expressions of COX26 and UHRF1 were detected by quantitative reverse-transcription polymerase chain reaction and Western blot. The effect of COX26 methylation levels was analyzed by methylation-specific PCR (MSP). Phalloidin/immunofluorescence staining was used to observe structural changes. The binding relationship between UHRF1 and COX26 was verified by chromatin immunoprecipitation. IH caused cochlear damage, accompanied by increased methylation of COX26 and expression of UHRF1 in the cochlea of neonatal rats. CoCl2 treatment caused the loss of cochlear hair cells, downregulation and hypermethylation of COX26, abnormal upregulation of UHRF1, and disordered expressions of apoptosis-related proteins. UHRF1 in cochlear hair cells binds to COX26, and its knockdown upregulated COX26 level. Overexpressed COX26 partially alleviated the CoCl2-caused cell damage. UHRF1 induces COX26 methylation and aggravates the cochlear damage caused by IH.

Objective: To explore potential predictors of RMPP in early stage.Study design: The prospective study, multicenter study was conducted in Zhejiang, China from May 1st, 2019 to January 31st, 2020. Children aged 29 days to 14 years old, with fever time during 48 to 120 hours were included. A total of 1428 children completed the study. A questionnaire was designed to collect patients’ information. Pharyngeal swab samples were collected. M. pneumoniae DNA in pharyngeal swab specimens were detected. Whether the patients develop to RMPP were assessed. Logistic regression analyses were used to examine associations between clinical data and RMPP.Results: The ages of the patients ranged from 34 days to 13.9 years with a median 4.3 years. The positive rate of M. pneumoniae -DNA was 37.4% (534/1428), and 446 cases were Mycoplasma pneumoniae pneumonia (MPP). In MPP patients, 55 cases were RMPP (12.3%), others were general MPP (GMPP) patients (n=391, 87.7%). Only the peak body temperature before the first visit and LDH level in RMPP patients were higher than that in GMPP [39.6 (39.1-40.0) °C vs. 39.2 (38.9-39.7) °C, p=0.003, and 332.5 (278.8-392.1) U/L vs. 310.5 (259.0-358.8) U/L, p=0.024]. Logistic regression also only included the above two parameters in the prediction probability. The area under ROC curve of the prediction probability π of RMPP was 0.682 (95% CI, 0.593-0.771), P<0.01. The cut-off value was 0.12. Sensitivity and specificity of the prediction probability π in cut-off value was 0.64 and 0.70, respectively.Conclusions: AND RELEVANCE A prediction probability, calculating from the peak body temperature before the first visit and LDH level for early identifying RMPP from other MPP within 2-5 days of fever duration, with a cut-off value of 0.12 may be helpful in clinical practice.

IntroductionAsthma and bronchiolitis in children are considered common clinical problems associated with gut microbiota. However, the exact relationship between gut microbiota and the above‐mentioned diseases remains unclear. Here, we discussed recent advances in understanding the potential mechanism underlying immune regulation of gut microbiota on asthma and bronchiolitis in children as well as the role of the gut–lung axis.MethodsWe retrieved and assessed all relevant original articles related to gut microbiota, airway inflammation‐induced wheezing in children, and gut–lung axis studies from databases that have been published so far, including PubMed/MEDLINE, Scopus, Google Scholar, China National Knowledge Infrastructure (CNKI) and the Wanfang Database.ResultsThe infant period is critical for the development of gut microbiota, which can be influenced by gestational age, delivery mode, antibiotic exposure and feeding mode. The gut microbiota in children with asthma and bronchiolitis is significantly distinct from those in healthy subjects. Gut microbiota dysbiosis is implicated in asthma and bronchiolitis in children. The presence of intestinal disturbances in lung diseases highlights the importance of the gut–lung axis.ConclusionGut microbiota dysbiosis potentially increases the risk of asthma and bronchiolitis in children. Moreover, a deeper understanding of the gut–lung axis with regard to the gut microbiota of children with respiratory diseases could contribute to clinical practice for pulmonary diseases.