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Background: Sepsis leads to the high mortality in critically ill infants and children. It is still controversial whether vitamin D deficiency was associated with the incidence of sepsis. Thus we designed the systematic review and meta-analysis. Methods: The Ovid Medline, Embase, PubMed, and Cochrane library were systematically searched until April 5, 2020. The 25 hydroxyvitamin D (25-OHD) level was recorded and set 20 ng/mL as cut-off in cohort study to divide the lower and higher 25-OHD group. The odds ratio (OR) and 95% confidence intervals (CIs) were calculated for comparing the impact of vitamin D deficiency on the incidence of sepsis in critically ill children. Results: A total of 27 studies were included with 17 case-control studies and 10 cohort studies. In those case-control studies, the maternal 25-OHD level and neonatal 25-OHD level in sepsis group was significant lower than non-sepsis group (P < .001). The percentage of severe vitamin D deficiency was significant higher in sepsis group comparing to non-sepsis group (odds ratio [OR] = 2.66, 95% CI = 1.13–6.25, P < .001). In those cohort studies, the incidence of sepsis in lower 25-OHD group was 30.4% comparing with 18.2% in higher 25-OHD level group. However, no statistical significant difference in terms of mechanical ventilation rate and 30-day mortality. Conclusion: We demonstrated that critically ill infants and children with sepsis could have a lower 25-OHD level and severe vitamin D deficiency comparing to those without sepsis. Future studies should focus on the association of vitamin D supplement and the occurrence of sepsis in critically ill children.

Review question / Objective: Pediatric acute respiratory distress syndrome (PARDS) is a life-threatening condition that may impact the quality of life in survivors and cause serious socio-economic and psychological consequences on their families. Today, there are few data to guide the early adjuvant treatment of PARDS. In this meta-analysis, we aimed to evaluate the role of prone position ventilation (PPV) in the treatment for PARDS patients more comprehensively. INPLASY 1International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY PROTOCOLThe efficacy of prone position ventilation in treating pediatric acute respiratory distress syndrome: a systematic review and meta-analysis Yu, WJ 1 ; Hou, QY 2 ; Zhu, W 3 ; Ying, QL 4 .To cite: Yu et al. The efficacy of prone position ventilation in treating pediatric acute respiratory distress syndrome: a systematic review and metaanalysis. Inplasy protocol 2022120070.

Background: In this article, we present the case of a newborn with respiratory insufficiency caused by SFTPC gene mutation. We summarized and analyzed the clinical, chest imaging and gene test data of the case, and reviewed related literature. Case presentation: Case data: female infant, 6 hours with dyspnea. Physical examination on admission showed three concave signs, no rales or dryness in both lungs. Multiple chest radiographs indicated that the brightness of the two lungs gradually decreased, and chest CT indicated diffuse lung lesions. Sp-related gene detection indicated that SFTPC was newly mutated due to c.563t > c (p.l188p). Literature reported six similar cases: 1) SFTPC gene c.68G > G/A, p.r23q heterozygosity missense mutation, 2) SFTPC gene c.115G > G/T, p.v39l heterozygosity missense mutation, 3) c.203T >a, p. Val68asp mutation, 4) c.435G> c mutation, 5) Cys121Phe/C121F mutation, and 6) p. Cp121gly /C121G mutation. All these cases developed severe neonatal respiratory distress syndrome shortly after birth, and there are no reports consistent with the gene loci and manifestations of this case. Conclusion: The mutation of SFTPC gene can cause early respiratory insufficiency and lead to progressive exacerbation of respiratory failure. We report a newly mutated SFTPC gene due to c.563t > c (p.l188p).