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Objective:To assess the clinical effectiveness and safety of Omalizumab for treating pediatric allergic asthma in real world in China.Methods:The clinical data of children aged 6 to 11 years with allergic asthma who received Omalizumab treatment in 17 hospitals in China between July 6, 2018 and September 30, 2020 were retrospectively analyzed.Such information as the demographic characteristics, allergic history, family history, total immunoglobulin E (IgE) levels, specific IgE levels, skin prick test, exhaled nitric oxide (FeNO) levels, eosinophil (EOS) counts, and comorbidities at baseline were collected.Descriptive analysis of the Omalizumab treatment mode was made, and the difference in the first dose, injection frequency and course of treatment between the Omalizumab treatment mode and the mode recommended in the instruction was investigated.Global Evaluation of Treatment Effectiveness (GETE) analysis was made after Omalizumab treatment.The moderate-to-severe asthma exacerbation rate, inhaled corticosteroid (ICS) dose, lung functions were compared before and after Omalizumab treatment.Changes in the Childhood Asthma Control Test (C-ACT) and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) results from baseline to 4, 8, 12, 16, 24, and 52 weeks after Omalizumab treatment were studied.The commodity improvement was assessed.The adverse event (AE) and serious adverse event (SAE) were analyzed for the evaluation of Omalizumab treatment safety.The difference in the annual rate of moderate-to-severe asthma exacerbation and ICS reduction was investigated by using t test.The significance level was set to 0.05.Other parameters were all subject to descriptive analysis.A total of 200 allergic asthma patients were enrolled, including 75.5% ( n=151) males and 24.5% ( n=49) females.The patients aged (8.20±1.81) years. Results:The median total IgE level of the 200 patients was 513.5 (24.4-11 600.0) IU/mL.Their median treatment time with Omalizumab was 112 (1-666) days.Their first dose of Omalizumab was 300 (150-600) mg.Of the 200 cases, 114 cases (57.0%) followed the first Omalizumab dosage recommended in the instruction.After 4-6 months of Omalizumab treatment, 88.5% of the patients enrolled ( n=117) responded to Omalizumab.After 4 weeks of treatment with Omalizumab, asthma was well-controlled, with an increased C-ACT score [from (22.70±3.70) points to (18.90±3.74) points at baseline]. Four-six months after Omalizumab administration, the annual rate of moderate-to-severe asthma exacerbation had a reduction of (2.00±5.68) per patient year( t=4.702 5, P<0.001), the median ICS daily dose was lowered [0 (0-240) μg vs. 160 (50-4 000) μg at baseline] ( P<0.001), the PAQLQ score was improved [(154.90±8.57) points vs. (122.80±27.15) points at baseline], and the forced expiratory volume in one second % predicted (FEV 1%pred) was increased [(92.80±10.50)% vs. (89.70±18.17)% at baseline]. In patients with available evaluations for comorbidities, including allergic rhinitis, atopic dermatitis or eczema, urticaria, allergic conjunctivitis and sinusitis, 92.8%-100.0% showed improved symptoms.A total of 124 AE were reported in 58 (29.0%) of the 200 patients, and the annual incidence was 0(0-15.1) per patient year.In 53 patients who suffered AE, 44 patients (83.0%) and 9 patients (17.0%) reported mild and moderate AE, respectively.No severe AE were observed in patients.The annual incidence of SAE was 0(0-1.9) per patient year.Most common drug-related AE were abdominal pain (2 patients, 1.0%) and fever (2 patients, 1.0%). No patient withdrew Omalizumab due to AE. Conclusions:Omalizumab shows good effectiveness and safety for the treatment of asthma in children.It can reduce the moderate-to-severe asthma exacerbation rate, reduce the ICS dose, improve asthma control levels, and improve lung functions and quality of life of patients.
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The clinical practice teaching reform of pediatrics based on TBL combined with medical simulation teaching model was carried out. TBL teaching plan writing under the model of medical simulation teaching was researched. The principles, requirements, contents and procedures of compiling teaching plans were formed. Emphasis should be placed on medical simulation teaching, team cooperation, humanistic quality education and humanistic skills training. The purposes of the reform were to achieve standardized operation skills, improve clinical ability, ensure medical safety, and improve the quality of medical purposes, but still the reform need further improvement in the teaching practice.
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Objective To explore and analyze the influencing factors of family caregiving behavior and protective strategies in children with recurrent lower respiratory tract infection. Methods By reviewing the literature, a self-designed questionnaire for family caregiving behavior related to recurrent lower respiratory tract infection were adopted, including feeding behavior, hand hygiene, environmental factors, time of outdoor activities and family health-seeking behavior. Totally 206 cases with recurrent lower respiratory tract infection (the study group) and 206 cases with acute lower respiratory tract infection (the control group) were included and all cases were investigated by family caregiving behavior questionnaire. The influencing factors of family caregiving behavior of two groups were analyzed and compared. Results The feeding behavior in the study group was worse than that in the control group(χ2=5.14-14.76, P0.05). Conclusions We should guide parents to establish the right and reasonable family care behavior to effectively enhance children's physical fitness and disease resistance and to avoid exposure to infectious agents and harmful substances, reduce the occurrence of Recurrent Lower Respiratory Tract Infections.
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Objective To summarize the cystic fibrosis transmembrane conductance regulator (CFTR) gene mutation spectrum in Chinese children with cystic fibrosis(CF).Methods The data of Chinese children with CF reported in China national knowledge infrastructure,wanfang database,VIP journal database,PubMed were collected.The CFTR gene mutations of the patients retrieved and summarized,1 case diagnosed in the First Affiliated Hospital,Guangzhou Medical University were summarized.Inclusion criteria included:data from published literature,the cases reported were Chinese children with CF and with CFTR gene mutations.Exclusive criteria included:repetitive reports,undiagnosed patients,or patients without CFTR gene mutations.Results There were 58 Chinese children with CF,and 61 CFTR gene mutations were found.The CFTR gene mutations were ranked in order from more to less as the following:c.2909G→A (p.G970D) (9 times);1898 ±5G→T,which was not found in Caucasians,and c.263T→G(6 times respectively);c.3196 C--→T,c.1766 ± 5 G→T,c.3068 T→ G (5 times respectively);2215 insG,c.1666A→ G (4 times respectively);G2816A,c.293A→G,c.595C→T,c.326A→G (3 times respectively);c.3635delT,c.2907A→C,c.648 G→A (W216X),c.960_961insA (1092insA),c.1075C→T,c.1699G→T,c.2491-126T→C,c.3307delA and c.110 C→G were novel observation.△F508 was not found.Conclusions The most common CFTR gene mutation is c.2909G→A (p.G970D) in Chinese children with CF.△ F508 which is the most common mutation in Caucasian not found in Chinese children with CF.The gene mutation spectrum of CFTR in Chinese children with CF is significantly different from those in European and American countries.
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Objective Parainfluenza virus is an important pathogen of lower respiratory tract infections in infants and young children.This study was to search for a method for rapid culture and identification of human parainfluenza viruses from nasal swabs. Methods Nasal swab specimens were collected from 0-5 years old children with acute respiratory tract infection.The specimens were inoculated onto 96 plates with prefabricated LLC-MK2 cells and then centrifuged for 1 hour at 3000 r/min and also inoculated using the traditional culture method, followed by addition of virus mainte-nance medium containing 4 μg/mL TPCK trypsin.The cytopathic effect was observed daily, and hemagglutination and blood absorption tests were done at 2, 5, and 8 days after inoculation.In case of posi-tive result of either test, the specimen was subjected to immunofluo-rescence staining. Results Six strains of parainfluenza virus were isolated from the 83 nasal swab specimens, with a positive rate of 7.2%.There was a significant difference in the rate of separation be-tween the rapid and traditional culture methods after 2 days of culturing (7.2%vs 0%, P<0.05).The infected cells produced a cy-topathic effect that characterized by syncytium and crush formation.Hemagglutination and blood adsorption tests were positive at 4℃and negative at the room temperature.Immunofluorescence staining exhibited specific apple green fluorescence. Conclusion The method for rapid culture and identification of human parainfluenza viruses in nasal swab specimens was successfully established, which can be used to obtain and identify parainfluenza viruses with virulence and biological activity in 2 days.
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Objective To explore the correlation of infants with asthma and food allergens,to povide the basis for early prevent the development of asthma.Methods The U-niCAP-100 automatic detection system was used to check the common food allergens in serum of 79 infants with asthma and 68 healthy children of the same age.Results The positive rate of serum total IgE in the group of asthma was 64.6％,significantly higher than the healthy group (45.6％)(P＜0.01).The positive rate of serum SIgE was showed that:the mainly food allergens of the asthma group was milk(63.2％)and whole egg(26.3％)which were,significantly higher than the healthy group(36.8％,14.7％)(P ＜ 0.01 and P ＜ 0.05).Conclusion Asthma of infant had close relation with the food allergens.Early avoid food allergens had an important role in preventing the development in low-age children with asthma.
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Objective To evaluate the efficacy of Leukotriene receptor antagonists in treatment of patients with asthma and allergic rhinitis(AR).Methods This study was a 24-week,randomized,control open trial in which 100 children,who were diagnosed as mild to severe persistent coexisting asthma and AR,were enrolled.All cases were collected from pediatric out-patient department of the First Affiliated Hospital of Guangzhou Medical College from October 1st,2005 to April 30th,2006 and were divided into three groups.Montelukast group(1 group):inhated budesonide turbuhaler and oral singulair(5mg/Qn);Intranasal corticosteroids group(2 group):inhaled budesonide turbuhaler and intranasal budesonide nasal spray(64?g/Qd);Control group(Control group):only inhaled budesonide turbuhaler.Efficacy was assessed by recording daytime and nighttime symptom scores,nasal symptom scores,the times of acute episode,the symptomfree days,the requirement for the weekly beta 2-receptor agonist and the medication scores,using a daily diary card and the recording work were repeated per fo ur weeks in totally six months.Lung function(forced expiratory volume at 1 s inpredicted normal,FEV1%) and nasal eosinophil count had been tested three times:before treatment,after treatment of 8th and 24th week.Results 1 group and 2 group,compared with the prior treatment(P0.05);1 group was more statistically significant than 2 group in improving FEV1(P
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A monoclonal antibody 1C34-5 raised against human peripheral mononuclear cells was produced. This antibody, a monoclonal IgG1. showed positive reaction with about 90% of T and B lymphocytes, monocytes. granulocytes and bone marrow cells, but negative reaction with red blood cells and platelets by indirect immunoflurorescent technique. 1C34-5 also reacted with leucocytic cell lines except a non-T non-B lymphoid line Reh but not with erythroid line K562, HeLa cells and fibroblast cells so far tested.This antibody was also assayed histologically by an indirect immunoperoxidase technique against a variety of human normal tissue frozen sections. It was found that 1C34-5 bound to all lymphoid tissues including lymph nodes, tonsil, thymus. Peyer's patches and leucocytes scattered in other tissues, but not to all non-hematopoietic tissues as well as erythropoietic foci in fetal liver. Thus. 1C34-5 appears to recognize a human leucocyte antigen specifically.
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With light and electron microscope, we studied the morphology of the thymus of the neonatal mouse. The results showed: 1.the lobules of the thymus had not well developed and there was no distinct demarcation between the cortex and medulla; 2.a cyst composed of epithelial cells with microvilli or cilia might be frequently seen in the medulla; 3.occasionally small lymphocytes with some glycogen particles in their cytoplasm were observed; 4.only a few small-sized thymic corpusles existed in the medulla, The article also described the ultrastructure of the lymphocytes, epithelial reticular cells, macrophage, interdigitating cell and blood-thymus barrier in the thymus of the neonatal mouse.
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The ultrastructure of dissociated brain nerve cells from embryonic chicken cult ivated in vitro was studied both under SEM and TEM. Primitive synaptic junctions among the bipolar and multipolar neuronal cell bodies and its processes forming networks of fibers appeared after 4 days of culture. The presynaptic bags and desmosome-like cell junctions were observed simutaneously. Axo-dendritic, axo-somatic and axo-axonal synapses increased in number after 7 days of incubation onwards. Neuronal degeneration and proliferation of fibrous glial cells were evident in10 and 14 days cultures.