Monitoring is a major component of asthma management in children. Regular monitoring allows for diagnosis confirmation, treatment optimization and natural history review. Numerous factors that may affect disease activity and patient wellbeing need to be monitored: response and adherence to treatment, disease control, disease progression, comorbidities, quality of life, medication side-effects, allergen and irritant exposures, diet and more. However, the prioritization of such factors and the selection of relevant assessment tools is an unmet need. Furthermore, rapidly developing technologies promise new opportunities for closer, or even ‘real-time’, monitoring between visits. Following an approach that included needs assessment, evidence appraisal and Delphi consensus, the PeARL Think Tank, in collaboration with major international professional and patient organizations, has developed a set of 24 recommendations on pediatric asthma monitoring, to support healthcare professionals in decision-making and care pathway design.

The Alveolar soft-part sarcoma (ASPS) involving the lung is mostly metastatic, while the primary ASPS involving the lung occurs more rarely. Herein, we reported on another case of primary ASPS, which might be with the earliest onset reported thus far. In this report, surgery was used to excise the lesion as much as possible, and its combination with chemoradiotherapy and anti-angiogenic agent may provide an important reference for the development of standard treatment or first-line treatment for these children patients. This case may provide an important reference for the development of standard treatment or first-line treatment for these children patients.

Background: This study aimed to explore the clinical characteristics and management of mycoplasma pneumoniae pneumonia (MPP) combined with pulmonary embolism (PE) in children and gain a better understanding of the diagnosis treatment and prognosis of the disease. Methods: We retrospectively reviewed the medical records of 16 children who were diag-nosed with MPP associated with PE and NP between Janunary 2016 and Janunary 2023 at Children’s Hospital, Zhejiang University School of Medicine. Results: All of the cases were diagnosed with refractory mycoplasma pneumoniae pneum-onia (RMPP) and complicated with necrotizing pneumonia(NP). The ages of the patients ranged from 5.3 to 11.5 years old. The main manifestations were cough and fever（n=16, 100%）,chest pain (n=8, 50%) , shortness of breath(n=8,50%), hemoptysis (n=4, 25%). Among them, the pulmonary artery was involved in 12 patients, including 6 cases on the right, 4 cases on the left, and 2 cases on both sides. Besides, the pulmonary vein was suffered in 3 patients. Furthermore, Pulmonary artery and pulmonary vein were involved in 1 patient. The mean D-dimer level was 8.50±4.76mg/L. All patients underwent anticoa-gulant therapy. After treatment, all patients ’s symptoms were improved, and the lung lesions were significantly improved. Conclusion: For children with RMPP, PE and NP should be considered when chest pain, hemoptysis or high level of d-dimer are present. Chest enhanced CT scan should be perf-ormed as soon as possible, and anticoagulation should be treated once the diagnosis of PEis confirmed. The long-term prognosis of PE was favorable after the timely administrationof anticoagulant therapy.

Background: This study aimed to explore the clinical characteristics and management of mycoplasma pneumoniae pneumonia (MPP) combined with pulmonary embolism (PE) in children and gain a better understanding of the diagnosis treatment and prognosis of the disease. Methods: We retrospectively reviewed the medical records of 16 children who were diag-nosed with MPP associated with PE and NP between Janunary 2016 and Janunary 2023 at Children’s Hospital, Zhejiang University School of Medicine. Results: All of the cases were diagnosed with refractory mycoplasma pneumoniae pneum-onia (RMPP) and complicated with necrotizing pneumonia(NP). The ages of the patients ranged from 5.3 to 11.5 years old. The main manifestations were cough and fever（n=16, 100%）,chest pain (n=8, 50%) , shortness of breath(n=8,50%), hemoptysis (n=4, 25%). Among them, the pulmonary artery was involved in 12 patients, including 6 cases on the right, 4 cases on the left, and 2 cases on both sides. Besides, the pulmonary vein was suffered in 3 patients. Furthermore, Pulmonary artery and pulmonary vein were involved in 1 patient. The mean D-dimer level was 8.50±4.76mg/L. All patients underwent anticoagulant therapy. After treatment, all patients ’s symptoms were improved, and the lung lesions were significantly improved. Conclusion: For children with RMPP, PE and NP should be considered when chest pain, hemoptysis or high level of d-dimer are present. Chest enhanced CT scan should be perf-ormed as soon as possible, and anticoagulation should be treated once the diagnosis of PEis confirmed. The long-term prognosis of PE was favorable after the timely administrationof anticoagulant therapy.

Brucellosis is the most common zoonotic infection over the world, caused by bacterial genus brucella. The disease is transmitted rarely via human-to-human transmission. Limited data support vertical transmission of human brucellosis. Herein, we reported a case of congenital brucellosis case. Brucella meliteusis DNA was detected by next-generation sequencing and bacterial identifying under microscope in mother’s placental specimen, which also proved chorioamnionitis. After the first course of rifampicin for 6 weeks and meropenem for 2 weeks, the disease relapsed within 3 weeks. The second course were rifampicin and SMZ/TMP for 8 weeks. The baby was still in following-up.

Changes in sensitization rates in patients with asthma and/or rhinitis in China between 2008 and 2018: a national cross-sectional studyWanjun Wang1*, Jianhong Wang2*, Guihua Song3*, Hua Xie4*, Xiaoping Lin4*, Ruonan Chai4*, Rongfei Zhu5*, Yong He6*, Jun Tang7*, Junge Wang8*, Jinghua Yang9*, Lili Zhi10*, Lin Wu11*, Yan Jiang12*, Xiaoqin Zhou13*, Dongming Huang14*, Ning Wang15*, Rui Xu16*, Yuan Gao17*, Zhimin Chen18*, Jinling Liu18*, Xiaoli Han19*, Guolin Tan20*, Jinzhun Wu21*, Deyu Zhao22*, Jianjun Chen23*, Xiwei Zhang24*, Mengrong Li24*, Yuemei Sun25*, Yi Jiang26*, Weitian Zhang27*, Qianhui Qiu28*, Chuanhe Liu29*, Jie Yin30*, Guodong Hao31*, Huabin Li32*, Yongsheng Xu33*, Shaohua Chen34*, Hua Zhang35, Shi Chen36, Juan Meng37, Dan Zeng38, Wei Tang39, Chuangli Hao40, Jing Li1†, Nanshan Zhong1†, for the China Alliance of Research on Respiratory Allergic Disease*Contributed equally†Joint corresponding authors1 National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University;2 The First People’s Hospital of Yibin, Sichuan;3 The First Affiliated Hospital of Henan University of Traditional Chinese Medicine;4 General Hospital of Northern Theater Command;5 Tongji Hospital, Tongji Medical College, Huazhong University of Science&Technology;6 The Affiliated Hospital of Medical School, Ningbo University;7 Foshan First people’s hospital;8 Beijing Hospital of Traditional Chinese Medicine;9 GuangDong Provincial Hospital of Chinese Medicine;10 The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases;11 Hangzhou Hospital of Traditional Chinese;12 The Affiliated Hospital of Qingdao University;13 Hubei Province Maternal and Child Health Hospital;14 Boai Hospital of Zhongshan City;15 Xi’an Children’s Hospital;16 The First Affiliated Hospital of Sun-Yat University;17 The First Affiliated Hospital of Zhengzhou University;18 Children’s Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health;19 Hebei General Hospital;20 Third Xiangya Hospital of Central South University;21 The Women and Children’s Hospital affiliated to Xiamen University;22 Children’s Hospital of Nanjing Medical University;23 Union hospital of Tongji medical college;24 The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University;25 Yu Huang Ding Hospital;26 The First Hospital of Shanxi Medical University;27 Shanghai Jiao Tong University Affiliated Sixth People’s Hospital;28 Zhujiang Hospital of Southern Medical University;29 Children’s Hospital Capital Institute of Pediatrics;30 Chengdu First People’s Hospital;31 Tangshan Gongren Hospital;32 ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University;33 Children’s Hospital of Tianjin University;34 Guangdong Provincial People’s Hospital;35 The First Affiliated Hospital of Xinjiang Medical University;36 Hainan provincial people’s Hospital;37 West China Hospital of Sichuan University;38 Chongqing General Hospital, University of Chinese Academy of Sciences;39 Ruijin Hospital of Shanghai Jiaotong University;40 Children’s Hospital of Soochow University.

Background: The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 on childhood asthma outcomes. Methods: The PeARL multinational cohort included 1,054 children with asthma and 505 non-asthmatic children aged between 4-18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID-19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control. Results: During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks and hospitalizations due to asthma, in comparison to the preceding year. Sixty-six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimal clinically important difference. Pre-bronchodilatation FEV1 and peak expiratory flow rate were improved during the pandemic. When compared to non-asthmatic controls, children with asthma were not at increased risk of LRTIs, episodes of pyrexia, emergency visits or hospitalizations during the pandemic. However, an increased risk of URTIs emerged. Conclusion: Childhood asthma outcomes, including control, were improved during the first wave of the COVID-19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID-19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent.

Primary intratracheal neurilemmoma is rare in children. Here, we reported a case of tracheal neurilemmoma in a 10-year-old girl. She had recurrent cough, dyspnea, and tachypnea. Magnetic resonance imaging revealed a soft-tissue mass was located on the right lateral posterior wall of the trachea. A multidisciplinary operation was performed. Immunohistochemical analysis demonstrated a benign neurilemmoma. Her clinical symptoms and signs improved. We reviewed the clinical features and surgical procedures of ten children with intratracheal neurilemmoma reported in literature. Radiographic techniques and bronchoscopy are helpful for diagnosis of the disease. Long-time follow-up is required.

Background Community-acquired pneumonia (CAP) is one of the leading causes of morbidity and mortality in the children worldwide. In this study, we aim to describe the aetiology of viral infection of pediatric community-acquired pneumonia in mainland China. Methods During Nov. 2014 and Jun. 2016, the prospective study was conducted at thirteen hospitals. The hospitalized children under 18 years old who met the criteria for CAP were enrolled. The throat swabs or nasopharyngeal aspirates were collected from cases and screened the eighteen respiratory viruses using multiplex PCR assay. Results Viral pathogens were present in 56.6% (1539/2721) of enrolled cases, with the detection rate of single virus in 39.8% cases and multiple viruses in 16.8% cases. The most frequently detected virus was RSV (15.2%, 413/2721). The highest detection rate of virus was in < 6 m age group (70.7%). RSV, HMPV, HPIVs and Flu B showed the similar prevalence pattern both in northern and south China, but HPIVs, Flu A, HBoV, HAdV and HCoVs showed the distinct circulating patterns in northern and south China. HEV/HRV (27.6%, 27/98), HBoV (18.4%, 18/98), RSV (16.3%, 16/98) and HMPV (14.3%, 14/98) were the most commonly detected virus in severe pneumonia children with signal virus infection. Conclusions In conclusion, viral pathogens are frequently detected in pediatric CAP cases and may therefore play a vital role in the aetiology of CAP. RSV was the most important virus in hospitalized children with CAP in mainland China.