To describe the thyroid function test among children with abdominal distention and to follow up the treatment received by children with abnormal thyroid function.
Cross-sectional study.
A total of 1089 children (median age:30 days (IQR=21-60 days) with abdominal distension were included in this single centre study in Nanjing, China.
Thyroid dysfunction was found in 43 of 148 Hirschsprung\'s disease (HSCR) cases, with 3 (2.03%) having hypothyroidism, 3 (2.03%) having subclinical hypothyroidism and 3 (2.03%) having subclinical hyperthyroidism. Thyroid dysfunction was found in 206 of 941 functional abdominal distension cases, with 4 (0.43%) having hypothyroidism, 23 (2.4%) having subclinical hypothyroidism, 28 (2.9%) having subclinical hyperthyroidism and 1 (0.11%) having hyperthyroidism. Among total 65 cases (9 from HSCR, 56 from functional abdominal distension) diagnosed with thyroid diseases, 12 were treated with levothyroxine (LT-4), of which 9 were discontinued treatment at about 2 years old, and 3 were still receiving LT-4. Thirty-two cases received no treatment and thyroid function returned to normal in about 1 month. Twenty-one cases were lost during the follow-up.
The paediatrician should be vigilant for hypothyroidism when dealing with children with abdominal distension. Thyroid function should be followed up rather than simply administering a short-term levothyroxine treatment.

This study aimed to investigate the seasonality of paediatric intussusception and the associations between meteorological factors and paediatric intussusception in Hangzhou, as well as aimed to compare the variance in sex and disease type.
An 8-year retrospective study was conducted from January 2014 to December 2021 in the Children\'s Hospital of Zhejiang University, Hangzhou, China.
This was a single-centre retrospective study review of intussusception cases in a large Children\'s Hospital in Hangzhou.
There were 17 674 patients with intussusception in this study.
A Spearman correlation analysis and Poisson regression analysis were used to determine the association between weekly intussusception cases and meteorological factors. The seasonality of paediatric intussusception was demonstrated via the t-test and visualised.
In January, May and December, there were relatively more intussusception patients. In February, there was a trough in the number of intussusception patients. Both the Spearman correlation analysis and Poisson regression analysis proved that weekly intussusception cases had significant associations with temperature (λ=-0.205, p<0.01; β=-0.080, p<0.01), feels-like temperature (λ=-0.214, p<0.01; β=-0.012, p<0.01), dew (λ=-0.249, p<0.01; β=0.095, p<0.01), humidity (λ=-0.230, p<0.01; β=-0.037, p<0.01), precipitation (λ=-0.148, p<0.01; β=-0.001, p<0.01), windspeed (λ=-0.135, p<0.01; β=0.005, p<0.01), visibility (λ=-0.206, p<0.01; β=-0.066, p<0.01), sea level pressure (λ=0.171, p<0.01; β=-0.004, p<0.01) and a total of 20 of 25 dynamic meteorological factors (p<0.05). These associations reflected gender differences but showed stronger associations in groups that were prone to recurrence.
Paediatric intussusception in Hangzhou showed a seasonal tendency. Additionally, intussusception was significantly associated with certain meteorological factors in all of the cases. These findings suggest that parents and paediatricians should be more vigilant about the occurrence of intussusception in children regarding seasonal change times and climate change times.

The MOSAIC study aimed to evaluate if the Cow\'s Milk-related Symptom Score (CoMiSS) can be used as a stand-alone diagnostic tool for cow\'s milk protein allergy (CMPA).
Single-blinded, prospective, multicentre diagnostic accuracy study.
10 paediatric centres in China.
300 non-breastfed infants (median age 16.1 weeks) with suspected CMPA.
After performing the baseline CoMiSS, infants commenced a cow\'s milk protein elimination diet with amino acid-based formula for 14 days. CoMiSS was repeated at the end of the elimination trial. Infants then underwent an open oral food challenge (OFC) with cow\'s milk-based formula (CMF) in hospital. Infants who did not react during the OFC also completed a 14-day home challenge with CMF. A diagnosis of CMPA was made if acute or delayed reactions were reported.
A logistic regression model for CoMiSS to predict CMPA was fitted and a receiver-operator characteristic (ROC) curve generated. An area under the curve (AUC) of ≥0.75 was deemed adequate to validate CoMiSS as a diagnostic tool (target sensitivity 80%-90% and specificity 60%-70%).
Of 254 infants who commenced the OFC, 250 completed both challenges, and a diagnosis of CMPA made in 217 (85.4%). The median baseline CoMiSS in this group fell from 8 (IQR 5-10) to 5 (IQR 3-7) at visit 2 (p<0.000000001), with a median change of -3 (IQR -6 to -1). A baseline CoMiSS of ≥12 had a low sensitivity (20.3%), but high specificity (87.9%) and high positive predictive value (91.7%) for CMPA. The ROC analysis with an AUC of 0.67 fell short of the predefined primary endpoint.
The present study did not support the use of CoMiSS as a stand-alone diagnostic tool for CMPA. Nevertheless, CoMiSS remains a clinically useful awareness tool to help identify infants with cow\'s milk-related symptoms.
NCT03004729; Pre-results.

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