Objective：To determine the reliability and validity of Fudan Chinese version of Motor Function Measure for young children with neuromuscular diseases(NMD). Methods：Inclusion criteria: Children diagnosed as all kinds of NMD aged above 2 years old by detecting genes or muscle biopsy in Department of Neurology of Children's Hospital of Fudan University and accepted Fudan Chinese version of Motor Function Measure in Rehabilitation Department from June 2013 to July 2017. Exclusion criteria: Children who had accepted surgical operation within 1 year; children with severe cognition impairments; children who had taken part in activities severely affecting physical strength before the measurement. To determine the reliability of interraters, 2 physical therapists conducted MFM20 and MFM32 at the same time. To determine the retest reliability, the same rater evaluated the test for a second time at the interval of 3 to 7 d after the first evaluation. The 6 minute walk distance Test (6 MWT) and 4 timed function test were the validity index. By analyzing the correlation between the MFM score and 6 MWT or 4 timed function test, the correlation validity was determined. By analyzing the correlation between the MFM score and North Star Ambulatory Assessment (NSAA) score of children with Duchenne muscular dystrophy (DMD) including objects,the correlation validity was determined. Results：A total of 372 cases were included in this study, with average age of (6.5±2.7) years. Among them, 222 cases were <7 years, 338 were males, and 263 were diagnosed with DMD. Sixteen cases aged 2 to 7 years were tested for the retest validity, while 16 cases aged 2 to 7 years and 29 cases aged above 7 years were tested for the interraters validity. The results indicated that of the total scores of MFM32, MFM20 and the subscore of each domain, ICC was 0.89 to 0.97. There were moderate and strong correlation between the total scores of MFM32, MFM20 and D1 domain subscore , the result of 6 MWT and timed function test of all the children (r=0.48 to 0.73), with D2 and D3 domains subscores, the correlation was moderate and weak. For children with DMD, the correlation of the total scores of MFM32 and MFM20 and the subscore of D1 domain and NSAA was strong and great. Conclusion：Fudan Chinese version of Motor Function Measure indicates satisfactory reliability and validity for young children with NMD , and thus it could be used to test the status of motor function in children with NMD reliably and effectively.
Objective：Body temperature (T), white blood cell count, plasma C-reactive protein and interleukin-6 of non-infectious surgical patients in pediatric intensive care unit were monitored dynamically, to explore their value in predicting nosocomial infection. Methods：Patients were admitted to the study in Children's Hospital of Fudan University from June 23th, 2016 to March 15th, 2017, according to inclusion and exclusion criteria. They were categorized into two groups, nosocomial infection group and non-nosocomoal infection group, according to the diagnostic criteria of nosocomial infection. The values of T, WBC, CPR and IL-6 at 4 h (P1), (48±1)h (P2), (120±1)h (P3) and (192±1)h (P4) after admission were recorded and their value in predicting nosocomial infection was analyzed. Receiver-operating characteristic (ROC) curves were determined for them, and the areas under the curve (AUC), sensitivity and specificity were calculated. Results：A total of 42 patients were registered in the study, and 11 of them had nosocomial infection. There were no statistical difference for sex, age, weight, body temperature, WBC count, CRP, IL-6, primary disease distribution and invasive operation distribution between nosocomial infection group and non-nosocomoal infection group (P>0.05), but were statistical differences for central venous catheterization between the two groups (P=0.03), when patients were just admitted to PICU. The statistical differences of T, WBC, CRP and IL-6 were significant between nosocomial infection group and non-nosocomoal infection group (P<0.05), and the AUC of them was 0.778, 0.765, 0.767 and 0.704, respectively. The best cut-off values of them were 37.3 ℃, 10.3×109·L-1, 27.0 mg·L-1and 55.0 pg·mL-1, respectively.The sensitivity ranged from 63.6% to 90.9%, while the specificity ranged from 64.5% to 83.9%. Sex, age, CRP at admission, 4 kinds of invasive procedures, primary disease, endotracheal intubation, central venous catheterization and indwelling urethral catheter were not independent risk factors for nosocomial infection (P>0.05). The 4 indicators could be made up into 11 combinations, and the AUC ranged from 0.754 to 0.842, the sensitivity ranged from 72.7% to 90.9%, and the specificity ranged from 71.0% to 96.8%. Conclusion：The combination of T, WBC and IL-6 can be taken as an indicator for monitoring nosocomial infection with relatively high sensitivity and specificity.
Objective：To investigate the composition and characteristics of oropharyngeal and pulmonary bacterial microbiota of infants with pneumonia less than 6 months old. Methods：Patients who were diagnosed as pneumonia and aged less than 6 months old were recruited from the respiratory ward of Children's Hospital of Fudan University. The oropharyngeal swabs and bronchoalveolar lavage fluid (BALF) was collected to extract DNA. The V3V4 region of the bacteria's 16S rDNA gene was amplified by PCR. Sequencing of the purified amplicons was performed and analyzed. Results：Overall, 24 infants with pneumonia were recruited and further analyzed. The top 5 abundant bacteria in the oropharyngeal were Streptococcus, Pseudomonas, Prevotella_7, Veillonella and EscherichiaShigella. The top 5 abundant bacteria in the lung were Pseudomonas, Streptococcus, Prevotela_7, Klebsiella and Rothia. The pulmonary microbiota had much more particular bacteria. The oropharyngeal microbiota richness was significantly lower in the 24 patients as compared with the microbiota of the pulmonary (P＜0.05). The diversity was significantly lower in pulmonary microbiota (P＜0.05). At the genus level, the oropharyngeal microbiota was dominated by Streptococcus (53.55%) and Pseudomonas (13.39%); the pulmonary microbiota was also dominated by Pseudomonas (73.06%) and Streptococcus (16.91%). The relative abundance of streptococcus and pseudomonas was significantly different between the oropharyngeal and pulmonary microbiota (P＜0.05). Conclusion：There are significant changes in the oropharyngeal and pulmonary microbiota of infant with pneumonia. The composition of oropharyngeal and pulmonary microbiota is similar and the proportion of each bacteria is different.
