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Additional file 1: Table S1. PRISMA Checklist.

Additional file 5: Figure S3. Funnel plot for studies included in this meta-analysis. (a) FBG, (b) Insulin, (c) HbAc1, and (d) HOMA-IR.

Additional file 4: Figure S2. Sensitivity analysis for studies included in this meta-analysis. (a) FBG, (b) Insulin, (c) HbAc1, and (d) HOMA-IR.

Additional file 2: Table S2. MeSH and non-MeSH terms used in the systematic search.

Rationale: Kawasaki disease (KD) is an acute febrile systemic vasculitis of unknown etiology and often occurs in children under 5 years old. During the acute phase, approximately 5% of children with KD develop hypotension and shock, a severe condition termed KD shock syndrome (KDSS). Macrophage activation syndrome (MAS), another life-threatening complication, has been reported to be associated with KD, although rarely. KDSS complicated with MAS is extremely rare. In this article, we present our experience in the diagnosis and treatment of KDSS complicated with MAS. Patient concerns: A 5-month boy with fever for 5 days was diagnosed with KD. After 2 doses of intravenous immunoglobulin and regular antiinflammatory treatment at a local hospital, the fever did not subdue. He was admitted to our department on the 10th day of illness. The boy developed KDSS on the 11th day of illness. In the mean time, the boy had hepatosplenomegaly, and laboratory tests showed hypertriglyceridemia, hypofibrinogenemia, decreased blood red cells and platelets, increased ferritin and soluble sIL2Rα, and reduced natural killer cell activity. Diagnosis: The patient had KDSS complicated with MAS. Interventions: Emergency antishock therapy along with high-dose steroid with a longer tapering course was carried out. Following these treatments, fever subsided and other symptoms and signs relieved, but progressive coronary dilatation occurred, warfarin was thereby administered. Outcomes: The patient was discharged 30 days after hospitalization. Echocardiography at the 2 month follow-up showed regression of coronary aneurysm. Lessons: Laboratory testing is critical for the diagnosis of MAS and we recommend that 2009 HLH diagnostic criteria be used for the diagnosis of MAS in KD. Emergency treatment of shock and a longer course of high-dose steroid anti-inflammatory therapy are vital for the management of KDSS complicated with MAS.

The experiment used agar as a coating agent to manufacture dysprosium-neodymium modified water-based magnetic fluid coated by agar with the method of chemical co-precipitation when the two rare-earth element dysprosium and neodymium were precipitated with Fe3+ and Fe2+ together, which has high stability and a strong magnetic field. After the experimental research on all aspects of factors influencing the magnetic fluid, the best conditions were summarized as follows: Under the premises those the mol ratio between Fe and (Nd3++Dy3+) is 29:1 and it between Fe3+ and Fe2+ is 1.70 to 1.75, the mol ratio between Nd3+ and Dy3+ should be 1:1; 25%NH3·H2O is the precipitation reagent and the pH value regulator, which is used to control the pH value between 9 and 11; Under the above-mentioned conditions, dysprosium-neodymium modified water-based magnetic fluid is manufactured at the reaction temperature 35°C. And then the agar with a high degree of biological affinity is used as a coating agent to coat the above product, under the conditions of the temperature 55°C and the pH value 2.5, whose best dosage is 0.0100g each 55mL liquid. The dysprosium-neodymium ferrite water-based magnetic fluid manufactured under the best conditions has black color, and its stability and magnetic properties are better than those of the ordinary one. It will appear a bright magnetic halo under the combined effect of the visible light irradiation and the role of magnetic fields. In addition, its characterization was tested in this experiment, such as the situation of surface coating, the stability, the viscosity, the magnetization intensity, etc.