A preliminary study on the disappearance time of influenza virus antigen / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the antigen clearance time, time to symptom disappearance, and the association between them using immunofluorescence assay for dynamic monitoring of influenza virus antigen in children with influenza.</p><p><b>METHODS</b>A total of 1 063 children suspected of influenza who visited the Hunan People's Hospital from March to April, 2016 were enrolled. The influenza A/B virus antigen detection kit (immunofluorescence assay) was used for influenza virus antigen detection. The children with positive results were given oseltamivir as the antiviral therapy and were asked to re-examine influenza virus antigen at 5, 5-7, and 7 days after onset.</p><p><b>RESULTS</b>Of all children suspected of influenza, 560 (52.68%) had an influenza virus infection. A total of 215 children with influenza virus infection were followed up. The clearance rate of influenza virus antigen was 9.8% (21 cases) within 5 days after onset. The cumulative clearance rate of influenza virus antigen was 32.1% (69 cases) within 5-7 days, and 98.1% (211 cases) within 7-10 days after onset. Among these children, 6 children (2.8%) achieved the improvement in clinical symptoms within 3 days after onset. The cumulative rate of symptom improvement was 84.7% (182 cases) within 3-5 days after onset, and 100% achieved the improvement after 5 days of onset.</p><p><b>CONCLUSIONS</b>The time to improvement in symptoms after treatment is earlier than antigen clearance time. Almost all of the children achieve influenza virus antigen clearance 7-10 days after onset. Therefore, it is relatively safe for children to go back to school within 7-10 days after onset when symptoms disappear.</p>

Clinical value of fluorescence lateral flow immunoassay in diagnosis of influenza A in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical value of a new type of fluorescence lateral flow immunoassay in rapid detection of influenza A virus.</p><p><b>METHODS</b>A total of 378 samples of nasopharyngeal secretions were collected from 378 children with influenza-like symptoms to detect the influenza A virus by fluorescence lateral flow immunoassay, colloidal gold immunoassay, and RT-PCR between July 2015 and August 2015.</p><p><b>RESULTS</b>Of the 378 samples, 81 (21.4%) were positive for influenza A virus by RT-PCR. Compared with RT-PCR, the sensitivities of fluorescence lateral flow immunoassay and colloidal gold immunoassay were 90.1% (73/81) and 75.3% (61/81), respectively, and the specificities were 99.3% (295/297) and 98.3% (292/297), respectively. The average threshold cycle (Ct) value for the positive samples detected by the fluorescence lateral flow immunoassay (30.6) was higher than that for the positive samples detected by the colloidal gold immunoassay (28.7).</p><p><b>CONCLUSIONS</b>Compared with colloidal gold immunoassay, fluorescence lateral flow immunoassay has higher sensitivity, specificity, and concordance rate with RT-PCR, suggesting that it can be used for early screening and diagnosis of influenza A.</p>

Clinical significance of bronchial reversibility test in the treatment of childhood asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To observe changes in the lung function of asthmatic children with different symptoms during treatment, and to investigate the clinical significance of bronchial reversibility test in the treatment of asthma in children.</p><p><b>METHODS</b>A total of 417 asthmatic children were treated by salmeterol/fluticasone inhalation for more than 3 months. These patients were divided into asymptomatic, single cough, paroxysmal cough and wheeze (cough+wheeze or wheeze alone) groups based on the symptoms when they revisited the clinic. Thirty-four healthy children were used as a control group. All children underwent bronchial reversibility test using nebulized salbutamol. Lung function testing was performed before and after the test.</p><p><b>RESULTS</b>After nebulization of salbutamol, each asthma group showed significantly decreased rate of abnormal lung function and significantly increased forced expiratory volume in one second percent (FEV1%) predicted (P<0.05). Before salbutamol nebulization, the single cough, paroxysmal cough and wheeze groups had significantly higher rates of abnormal lung function and significantly lower FEV1% predicted than the control group (P<0.05). There were significant differences in the rate of abnormal lung function and FEV1% predicted among the asthma groups (P<0.05). After salbutamol nebulization, the paroxysmal cough and wheeze groups had significantly higher rates of abnormal lung function than the control group (P<0.05), but there were no significant differences between other asthma and control groups; the wheeze group had significantly lower FEV1% predicted than the control group, but no significant differences were found between other asthma and the control groups. The positive rate of bronchial reversibility test in each asthma group was significantly higher than in the control group (P<0.05). There were significant differences in the positive rate of the test between the asthma groups except between the asymptomatic and single cough groups (P<0.05).</p><p><b>CONCLUSIONS</b>Asthmatic children with different symptoms demonstrate different lung functions during treatment. Bronchial reversibility test combined with lung function test is useful in assessing asthma control and guiding treatment.</p>

Results of skin prick test in young children with wheezing or allergic diseases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the characteristics of allergic reactions to common aeroallergens in young children with wheezing or allergic diseases by examining the results of skin prick test in children under 5 years old.</p><p><b>METHODS</b>A total of 196 children under 5 years old, from a district of Changsha City sampled between September 1 to December 31, 2010, were assigned into two groups according to the presence of wheezing or allergic diseases: allergen screening (n=102) and control (n=94). Skin prick tests were performed on both groups.</p><p><b>RESULTS</b>The positive rate of skin prick test in the allergen screening group was 61.8% (63/102), and this was significantly higher than in the control group (9.6%, 9/94; P<0.05). In the allergen screening group, the positive rate of skin prick test in children with both recurrent wheezing and allergic rhinitis was significantly higher than in children with wheezing alone (P<0.05). The frequency of wheezing was positively correlated with a positive skin prick test (r=0.91; P<0.05). The positive rate of skin prick test for mites was significantly higher than for other aeroallergens (24.2% vs 3.5%; P<0.05) in the allergen screening group. Skin prick testing of the children for dermatophagoides farinae showed a higher positive rate than for dermatophagoides pteronyssinus (50.0% vs 14.7%; P<0.05).</p><p><b>CONCLUSIONS</b>Wheezing in early childhood may be associated with the occurrence of asthma. Skin prick testing contributes to the diagnosis of allergic diseases and assessment of allergic reactions to aeroallergens in children with wheezing.</p>

Effects of inhaled corticosteroids on bone age and growth in children with asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Long-term inhaled corticosteroids are the preferred treatment for asthma, but their safety still controversial. The aim of the present study was to explore the effects of inhaled corticosteroids on bone age and growth in children with asthma.</p><p><b>METHODS</b>Seventy-three children with asthma received inhaled fluticasone treatment at a starting dosage of 250 μg/d for 3 months, when the dosage was reduced by a third. Three months later, the patients were treated with fluticasone at a dosage of 125 μg/d for 6 months. Bone age, heights and weights were measured before and one year of treatment.</p><p><b>RESULTS</b>The increase in the heights, weights and RUS (radius, ulna and short finger bones) bone age of the children with asthma after one year of treatment was not significantly different from healthy children. There were no significant differences in body mass index (BMI) before and after one year of treatment, however the level of carpal bone age [-0.2(-0.6,0.8) years] was delayed after therapy compared to before treatment [-0.5(-1.0,0.6) years] (P<0.05).</p><p><b>CONCLUSIONS</b>Treatment with inhaled corticosteroids for 1 year may suppress the level of carpal bone age, but the level of RUS bone age, heights, weights and BMI are not affected. It is necessary to monitor the growth of children with asthma who receive long-term inhaled corticosteroid treatment.</p>

Comparison of clinical data of childhood asthma in different periods in Changsha / 中国当代儿科杂志

<p><b>OBJECTIVE</b>The incidence of childhood asthma is growing. This study aimed to find the changes of clinical features of childhood asthma over a 20-year period.</p><p><b>METHODS</b>The medical data of 200 children with asthma between May 1986 and February 1988 (group 1) and of another 200 asthmatic children between June 2005 and May 2006 (group 2) were studied retrospectively.</p><p><b>RESULTS</b>Sixty-seven patients (33.5%) in group 1 and 128 patients (64.0%) in group 2 had concomitant allergic rhinitis (P < 0.01). The incidence of exercise-induced asthma, drug allergy and irritating smell allergy was significantly higher in group 2 than in group 1 (P < 0.05). Twenty-nine patients (14.5%) in group 1 and 112 patients (56.0%) in group 2 re-visited to the clinic (P < 0.01). The patients in group 1 received nonspecific immune and desensitizing therapy but those in group 2 received inhaled glucocorticoid therapy during the remission stage. After 3 months treatment, asthma was in under control in 11 patients (37.9%, 11/29) in group 1 and in 93 patients in group 2 (83.0%, 93/112) (P < 0.01).</p><p><b>CONCLUSIONS</b>The incidence of concomitant anaphylaxis increased in asthmatic children over a 20-year period. The compliance of re-examination has increased in asthmatic children in recent years and this may be associated with a better efficacy of inhaled glucocorticosteroid therapy.</p>