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Objective:To analyze the distribution and drug sensitivity of pathogens in bronchoalveolar lavage fluid(BALF)of children with severe community acquired pneumonia(CAP)in Qingdao from 2018 to 2020.Methods:The clinical data of 482 children with severe CAP in Qingdao admitted to Women and Children′s Hospital of Qingdao University were collected.BALF was collected by bronchoscopy for detection of bacteria and mycoplasma.Results:(1)Bacterial infection was detected in 139 cases(27.84%), mycoplasma infection in 119 cases(24.69%), and virus infection in 141 cases(29.25%). (2)The detection rates of bacteria and virus infection in the 1-12 months old group were higher.The detection rate of mycoplasma pneumoniae was the highest in the group over 5 years old.(3)A total of 139 strains were positive in bacterial culture of lavage fluid under bronchoscope: 55 strains(39.57%) of gram-negative bacilli and 84 strains(60.43%) of gram-positive cocci.Streptococcus pneumoniae was the most common gram-positive bacteria.Haemophilus influenzae was the most common gram-negative strain.(4)Streptococcus pneumoniae and Staphylococcus aureus were highly sensitive to amoxicillin clavulanate potassium, vancomycin and linezolid.The resistance rate to erythromycin was high(100%). (5)Haemophilus influenzae, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae were highly sensitive to meropenem and cefoperazone sulbactam.They were highly resistant to amoxicillin, ampicillin and cefuroxime(>80%).Conclusion:Severe CAP in Qingdao area is mainly caused by virus and bacteria within 1 year old.Mycoplasma pneumoniae infection is the main cause of children over 5 years old.Respiratory syncytial virus, adenovirus and parainfluenza virus are main causes of virus infection.Streptococcus pneumoniae and haemophilus influenzae are the main pathogens, which are more sensitive to vancomycin, linezolid, meropenem and cefoperazone sulbactam, but resistant to erythromycin and amoxicillin.
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Objective:To analyze the clinical features of bronchiectasis, in order to improve the diagnosis, treatment, and prognosis.Methods:The clinical data of 78 children with bronchiectasis at Qingdao Women and Children′s Hospital of Qingdao University from January 2010 to January 2020 were analyzed, including age, regional distribution, etiology, clinical manifestations, lung function characteristics, results of lung high-resolution CT, results of fiberbronchoscopy examination, treatment, and prognosis.Results:Among 78 children with bronchiectasis, there were 35 males(44.9%)and 43 females(55.1%), with a median age of 8.7(6.1, 9.0)years.There were 51 children in rural areas(65.4%)and 27 children in urban areas(34.6%). The incidence of children in rural areas was higher than that in urban areas.The top three causes of bronchiectasis were 40 (51.3%)cases after infection, nine cases(11.5%)of primary immunodeficiency and seven cases(9.0%)of inhalation.The main clinical manifestations were wet cough, expectoration, wheezing and repeated respiratory infection.High-resolution CT of the lungs showed 36(46.2%)cases with diffuse bronchiectasis and 37 (47.4%) cases with localized bronchiectasis.Forty-nine(62.8%) cases had abnormal pulmonary ventilation function.Sixty-one(78.2%)cases were treated with fiberoptic bronchoscopy, of which 49(80.3%)cases had "fishbone" changes.After anti-infection, fiberbronchoscopy examination, expectorant and physical therapy, 67 cases were discharged and followed up for more than one year.Among them, 55 cases had symptoms improved, 12 patients had recurrent respiratory tract infection, and three patients died.Conclusion:The clinical manifestations of bronchiectasis in children have no obvious specificity.Early diagnosis, identification of the cause and comprehensive management are critical to prognosis of bronchiectasis.
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Objective To calibrate the dose of 12MeV high-energy electron for Siemens MD7745 medical linear accelerator.Methods The international protocols,contents and technical standards were expatiated.Some existing problems in dose calibration of high-energy electron were analyzed.Results The working precision met the requirement of quality assurance in radiotherapy by WHO.Conclusion In order to improve the therapeutic effect,the dose must be calibrated,and the error in dose calibration of high-energy electron should be reduced to the lowest.