Chronic cough in children is closely related to gastroesophageal reflux (GER). However, this association has not been adequately studied due to a lack of diagnostic tools. Combined esophageal multichannel intraluminal impedance and pH (MII-pH) monitoring is considered the most accurate method for evaluating the association between symptoms and reflux, but data on its use in children with chronic cough are still lacking. We aimed to assess the association between chronic cough and GER in children through MII-pH monitoring. Children with chronic cough (> 4 weeks) who were suspected gastroesophageal reflux disease(GERD) were selected to undergo 24 h MII-pH monitoring at our hospital. Patients were divided into groups according to their age, body position, reflux index (RI) or total reflux events, and the differences between the groups were analyzed. Then the significance and value of 24 h pH and impedance monitoring in chronic cough and the relationship between chronic cough and reflux were discussed. Overall, 426 patients were included. The median age was 12 months (interquartile range: 6–39.5 months), 129 (30.3%) patients had RI > 7% detected by pH-metry, and 290 (68.1%) patients had positive diagnosis based on the impedance data. GER predominantly occurred in the upright position and mostly involved weakly acidic reflux and mixed gas–liquid reflux. There were 14.1% of children in non-acid GER group were SAP positive showing no difference in acid GER group 13.2% (P = 0.88), whereas patients with SAP > 95% in MII positive group (47[16.2%]) is higher than in MII negative group (P < 0.05). Twenty four hour MII-pH monitoring is safe, well tolerated in children, but also has a higher detection rate of gastroesophageal reflux. It can find identify weakly acidic reflux, weakly alkaline reflux and reflux events with different physical properties, which can explain the relationship between GER and chronic cough more comprehensively. It provides new approach for exploring the etiology, diagnosis and treatment of children with chronic cough.

Kawasaki disease (KD) has replaced rheumatic fever as the main cause of acquired heart disease in Japanese, American, and Chinese children. Polymorphisms in angiotensin-converting enzyme may be associated with susceptibility to KD, but the association of angiotensin-converting enzyme 2 (ACE2) with vascular endothelial injury in KD and the possibility for prognosis of vascular injury in KD by evaluating changes in serum ACE2 have not yet been assessed. Thus, this study aimed to investigate ACE2 levels in patients with KD to further explore the relationship between ACE2 and vascular injury in KD. Blood samples were collected from 49 children with KD before intravenous immunoglobulin treatment and 28 healthy children in the same period as the control group. Clinical data were collected from the patients and serum ACE2 levels of all participants were measured using an enzyme-linked immunosorbent assay. Serum ACE2 levels were significantly higher in the KD group than in the control group, and were negatively correlated with platelet levels in patients with KD. Serum ACE2 levels are related to the pathogenesis of KD and may be used as a potential serum marker for KD diagnosis.

Objective: To investigate the correlation between fractional exhaled nitric oxide (FeNO) measurement and pediatric gastroesophageal reflux disease (GERD), explore potential non-invasive screening indicators for pediatric GERD. Methods: A retrospective cohort of 159 children with suspected GERD was enrolled from the Department of Pediatrics, Maternal and Child Health Hospital of Hubei Province between April 2017 and August 2025. Data on 24 h ph and multiple intraluminal impedance monitoring and FeNO were systematically collected and analyzed. Results: Among 159 children, 32 (20.1%) were diagnosed with GERD. In the 101 children under 5 years, 23 (22.8%) were GERD-positive. The median FeNO in the GERD-positive group was significantly higher than that in the GERD-negative group (18.00 vs. 10.00 ppb, P < 0.001). Spearman analysis revealed that FeNO was significantly correlated with the number of reflux cycles ( P = 0.012) and pH reflux cycles ( P = 0.010). ROC analysis for FeNO predicting GERD yielded an AUC of 0.751 ( P = 0.000), with an optimal cutoff of 17.5 ppb, a sensitivity of 52.2%, and a specificity of 87.2%. Multivariate logistic regression further confirmed FeNO as an independent risk factor for GERD in children under 5 years. However, in the 58 children aged ≥5 years, no significant difference in GERD-positive rate was observed between the FeNO ₅₀ -positive and FeNO ₅₀ -negative groups ( P = 1.00). Conclusions: Elevated FeNO is independently associated with GERD in children under 5 years, showing moderate diagnostic value as a potential non-invasive screening tool, but not in those aged ≥5 years.

Background Chronic cough in children is closely related to gastroesophageal reflux. However, this association has not been adequately studied owing to a lack of diagnostic tools. Combined multichannel intraluminal impedance and pH (MII-pH) monitoring is considered the most accurate method for evaluating the association between symptoms and reflux, but data on its use in children with chronic cough are lacking. We aimed to assess the association between chronic cough and gastroesophageal reflux in children through MII-pH monitoring. Methods Children with chronic cough were selected to undergo 24-h MII-pH monitoring at our hospital. Patients were divided into two groups according to their age and reflux index (RI), and the differences between the groups were analyzed. Results Overall, 426 patients were included. The median age was 12 months (interquartile range: 6–39.5 months), and 129 patients (30.3%) had RI＞7%. Gastroesophageal reflux predominantly occurred in the upright position andmostly involved weakly acidic reflux and mixed gas-liquid reflux. Impedance reflux events did not show any difference between groups (p＜0.01). Conclusion The presence of acid and non-acid reflux in children can be detected through 24 h MII-pH monitoring, which is valuable for diagnosing gastroesophageal reflux disease and reflux-related cough.

Objective: To analyze the distribution characteristics of pathogens in the bronchoalveolar lavage fluid of children with community‐acquired pneumonia. Methods: We retrospectively analyzed the etiological data of 1526 children diagnosed and treated at the Maternal and Child Health Hospital of Hubei Province from January 1, 2023, to December 31, 2023. Results: Pathogens were detected in 1524 of the 1526 children (99.9%). The five most frequently identified pathogens were Mycoplasma pneumoniae , rhinovirus, Epstein‒Barr virus, Streptococcus pneumoniae , and human bocavirus. The overall mixed infection rate was 62%. Epstein‒Barr virus, rhinovirus, Streptococcus pneumoniae , human bocavirus, and Haemophilus influenzae were the most common co‐infections of Mycoplasma pneumoniae . Staphylococcus aureus and Pneumocystis jirovecii infections were more common in males than in females. Human bocavirus, parainfluenza virus, respiratory syncytial virus, Cytomegalovirus , Pneumocystis jirovecii , and WU polyomavirus were more prevalent in infants and young children, and Epstein‒Barr virus was more common in preschool‐aged and school‐aged children. More than half (51.6%) of the Mycoplasma pneumoniae infections occurred in autumn. Mycobacterium tuberculosis complex , human parainfluenza virus, and Cytomegalovirus were more common in spring and summer, and influenza B virus and adenovirus were more common in autumn and winter. Respiratory syncytial virus, influenza A virus, and Fusobacterium nucleatum were more common in winter and spring. Enteroviruses were more prevalent in summer and autumn. Conclusion: The positive rate of pathogen detection in bronchoalveolar lavage fluid was extremely high. Most patients presented with mixed infections, and the distribution of some pathogens varied by sex, age, and season.