Episodic syndromes that may be associated with migraine / 中风与神经疾病杂志

Episodic syndromes that may be associated with migraine@#Episodic syndromes that may be associated with migraine are commonly seen in children and are likely to evolve into migraine in the subsequent course of the disease， including several subtypes such as benign paroxysmal torticollis， benign paroxysmal vertigo， and recurrent gastrointestinal disturbance. Understanding the above syndromes has an important clinical significance in the diagnosis of migraine in children.

Relationship between airway epithelial barrier dysfunction and allergic asthma / 国际儿科学杂志

Airway epithelial barrier dysfunction has been observed in allergic asthma patients.Inhaled allergens have shown a disruptive effect on the airway epithelial barrier.Airway barrier related genetic variation and epigenetics are also involved in the airway epithelial barrier dysfunction.A lot of studies believe that airway epithelial barrier dysfunction underlie the development of asthma.The study of the relationship between allergic asthma and airway epithelial barrier function will be helpful to understand the pathogenesis of allergic asthma and provide new ideas for the treatment of allergic asthma.

Imaging features of plastic bronchitis in children / 中华实用儿科临床杂志

Plastic bronchitis is a rare condition characterized by bronchial casts, that may result in respiratory failure, suffocation and even death.Therefore, early diagnosis and treatment are of great significance.This article summarizes the imaging characteristics of plastic bronchitis, in order to further improve the understanding of the disease among pediatricians, radiologists, and emergency physicians.

Progress of Wnt/β-catenin signaling pathway in the remodeling of asthma airway / 国际儿科学杂志

Asthma is a chronic airway inflammatory disease, and airway remodeling is one of its typical pathological features.Airway remodeling can result in hyperactivity, irreversible airflow limitation, and even decreased lung function.Studies have shown that the Wnt/β-catenin signaling pathway plays an important role in post-injury repair of the lung.Abnormal activation of the Wnt/β-catenin signaling pathway leads to airway remodeling in asthma.This article will review the progress of Wnt/β-catenin signaling pathway and asthma-related airway remodeling, and explore its possible therapeutic targets in asthma.

Advance in research on sleep disorder in children with bronchial asthma / 国际儿科学杂志

Bronchial asthma in children attacks or exacerbates at night and/or in the early morning.Sleep disorders are common concomitant symptoms of nocturnal asthma, including prolonged sleep onset latency, frequent wake-ups at night, daytime sleepiness, and sleep-disordered breathing, especially in children with poor asthma control.Asthma and sleep apnea share similar risk factors, and the interaction of potential causes promotes the disease progression.When it comes to treating children with asthma, it is necessary to clear whether sleep apnea exists or not.Sleep hygiene management and the treatment of obstructive sleep apnea play an important role in the standardized treatment of childhood asthma, which could improve asthma control and the sleep quality, thereby enhancing the quality of life in children with asthma.

Isolation, identification and cultivation of primary rat hepatic stellate cells / 局解手术学杂志

Objeetive To improve the method for the isolation and purification of rat hepatic stellate(HSC) cells and to provide a stable cell source for the research on liver-related diseases.Methods Rat liver was digested in situ by a two-step infusion assay under a strict control of the infusion temperature,flow rate and time with a combined utilization of Pronase E and Collagenase Ⅳ.And then,the HSC cells were separated by Percoll density gradient centrifugation.The cell growth curve and survival rate were measured by CCK-8 and trypan blue staining,respectively.The HSC cells were identified by flow cytometry and immunofluorescence cytochemistry.Results With the improved methods,there were (2.1 ± 0.2) × 107 HSC cells isolated from one rat and the survival rate was (96.2 ± 0.8) ％.The percentage of HSC cells with a spontaneous fluorescent characteristic from the isolated cells was 96.3％.The immunofluorescence cytochemistry was used to detect the expressions of the surface antigens α-SMA and Desmin in the isolated HSC cells.Conclusion By strict control of infusion temperature,flow rate and perfusion time as well as the combined application of Pronase E and Collagenase Ⅳ,there is an increased harvest of HSC cells with improved cell viability and purity,which is helpful for further research on HSC cells.

Value of combining PCT, BNP, D-dimer and PCIS score in predicting the prognosis of severe pediatric pneu-monia / 临床儿科杂志

Objective To evaluate the value of combining PCT, BNP, D-Dimer and PCIS score in predicting the prognosis of pediatric severe pneumonia in the early stage. Methods 80 cases of children with severe pneumonia were selected, 49 cases were boys , 31 cases were girls, with a median age of 7.5 months (1 month to 156 months). According to the final outcome, the cases are divided into treatment group and poor prognosis group. The score of PCIS, PCT, BNP and D-dimer within 24 hours after admission were recorded. According to the indicators, ROC curve was drawn independently and integrated with the four indicators,and the corresponding areas under ROC curve (AUC) were calculated to compare the accuracy of the assessment. Results The AUC of PCIS, PCT, BNP and D-dimer were between 0.7 and 0.9. The ROC curve integrated the four indicators showed the AUC were 0.932, which improved sensitivity and specificity. Conclusions The integration of PCIS, PCT, BNP and D-Dimer could improve the accuracy of prediction in the prognosis of severe pediatric pneumonia.

Clinical Analysis of 12 cases of Systemic Lupus Erythematosus Associated with Thrombotic Thrombocytopenic Purpura / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical manifestations, treatment strategies and outcomes of 12 patients with systemic lupus erythematosus (SLE) associated with thrombotic thrombocytopenic purpura(TTP).</p><p><b>METHODS</b>The clinical data from 12 cases of SLE associated with TTP admitted in the Second Hospital of Hebei Medical University from January 2002 to August 2015 were retrospectively analyzed.</p><p><b>RESULTS</b>12 cases of SLE associated with TTP included 11 females and 1 male, their median age was 34.5 years old, among them 5 cases of TTP were diagnosed during the treatment of SLE, 7 cases of TTP were comfirmed together with SLE on admission. The hemolytic anemia, thrombocytopenia and neurological deficits appeared in all the patients, the renal impairment was observed in 10 cases, the schistocytes of peripheral blood smears (>1%) were present in 9 cases, a severely reduction of ADAMTS 13 activity (<5%) with inhibitor-positive had been demonstrated in 5 cases, all of the 12 patients were treated with glucocorticoid, and 11 cases were treated in combination with other drug(10 cases combined with cytotoxics, 1 case with intravenous gamma globulin, 1 case with rituximab), plasma exchange were used in 10 cases, and 2 cases died, 2 cases without receiving plasma exchange all died, renal damage was observed in all the dead patients.</p><p><b>CONCLUSION</b>Clinical manifestation and repeated examinations of peripheral blood smears are helpful for early diagnosis of SLE associated with TTP, the plasma exchange combined with glucocortcoids is an effective treatment method, the renal impairment may be a risk factor related with poor prognosis.</p>

Bronchoscopy in the diagnosis and treatment of children with bronchiectasis / 中华实用儿科临床杂志

Objective To analyze the clinical features and the application of bronchoscopy in diagnosis and treatment of children with bronchiectasis.Methods All cases with bronchiectasis were collected from in-patient department of the Children's Hospital Affiliated to Nanjing Medical University from December 2011 to November 2015.Clinical manifestations,results of bronchoscopy examination were retrospectively analyzed.Results Of the 33 children,32 cases (97.0％) had chronic cough and sputum.Lung infection was the main cause (50％,16/33 cases).High resolution CT showed signet ring sign and/or double-track sign in lungs,and bronchiectatic lesions were most commonly found in the lower lobes (60.6％).Eighteen cases underwent bronchoscope ciliary biopsy,and the number of cilia decrease was found in 2 cases,and cilia ultrastructure abnormalities were found in 6 cases,with 2 cases diagnosed as Kartagener syndrome.The treatment included the following:treatment of the underlying disease,aggressive treatment of infections,promotion of mucociliary clearance,and bronchoscopy.The symptoms of the most patients were relieved through the symptomatic treatment.Follow-ups after discharge,showed that 15 cases had a slight cough without obvious sputum,11 cases with recurrent lung infections,regular bronchoscope lavage treatment;4 cases underwent surgical lung resection and recovered well postoperative,and 2 cases died.Conclusion The bronchoscopy should be performed early in the children with bronchiectasis,which can clearly detect pathogens and causes,so as to undertake lavage treatment to improve clinical symptoms.

Clinical analysis of 9 children with vertical infection of tuberculosis / 中华实用儿科临床杂志

Objective To explore the risk,diagnosis,treatment and prognosis of newborns suffering from congenital latent tuberculosis infection (CLTBI) by vertical transfer of mycobacterium tuberculosis(VTRTB) from mothers with active tuberculosis (TB) mothers during pregnancy.Methods The clinical data of 7 children with CLTBI follow-up of 1-6 years in Children's Hospital of Nanjing Medical University and 2 cases from literatures were reviewed,and they were divided into simple CLTBI group (n =5) and active TB group (n =4).Combined with the maternal history,the epidemiology,clinical features,treatment,prognosis and relative factors of the children were analyzed.Results Eight mothers had active TB during pregnancy,and premature delivery rate and low birth weight rate were 55.56％ (5/9 cases) respectively.The positive conversion rates of purified protein derivative tests (PPD),acid-fast bacilli (AFB) and TB culture were 6/9 cases,0/9 cases and 1/9 cases,respectively.Positive results of T cell enzyme-linked immunospot tuberculous test (T-SPOT.TB) and TB-DNA by fluorescent quantitative polymerase chain reaction (FQ-TB-DNA) were detected in 4 cases respectively,1 of 3 patients with T-SPOT.TB and 1 of 3 patients with FQ-TB-DNA were positive.There were 5 cases with chemoprophylaxis of anti-TB drugs for 1-6 years with isonicid or rifampicin;3 cases with pulmonary hilar or mediastinal lymph nodes enlargement,and 3 cases with pulmonary diffuse punctate,nodular or patchy high density shadow in 3 cases;the rate of VTRTB in 9 cases was 8/9 (88.89％) based on laboratory examination of etiology and immunology,and the risk of active TB in infants and early childhood was close to 50％ in neonates with CLTBI;the incidence of active TB was reduced from 100％ (4/4 cases) of non-intervention down to 0 (0/5 case) of intervention.Conclusions Etiology,immunology,imaging examination of TB and clinical efficacy,can prompt active TB and retrospective diagnosis of CLTBI,and application of T-SPOT.TB and FQ-TB-DNA for early diagnosis of CLTBI has a higher applied value;prophylactic and treatment of anti-tuberculosis drugs can reduce the progression of CLTBI to active TB and improve outcomes.

Effects of Gushen Antai pills combined with progestin on serum β-HCG, P, E2 and CA125 in patients with threatened abortion / 中国中药杂志

To investigate the clinical effect of Gushen Antai pills and progesterone in the treatment of threatened abortion, in order to provide references for early clinical intervention with threatened abortion. The 112 cases of patients with threatened abortion were randomly divided into the control group and the observation group. 56 cases in each group. Patients in the control group was injected with progesterone, the observation group was treated with Gushen Antai pills in addition to the therapy of the control group. Both groups were treated by drugs for two weeks. Their venous bloods (5 mL) were collected before treatment and in 1, 2 weeks after treatment to determine serum levels of β-HCG, P, E2 and CA125. The differences between the two groups after treatment were compared. The total effective rate of the control group and the observation group were 79% and 91.9% respectively, with a statistically significant difference between the two groups (P＜0.05). Two weeks after the treatment, the serum levels of P and E2 in the observation group were significantly higher than before treatment, but the serum CA125 levels decreased significantly after treatment (P<0.05). These indicators showed statistically significant difference compared with that of the control group (P<0.05). After treatment, the serum β-HCG levels of the two groups were significantly higher than before treatment (P<0.05), but there was no statistically significant difference between the two groups. Gushen Antai pills and progesterone had a better clinical curative effect in treatment threatened abortion, which could significantly raise serum β-HCG, P and E2, reduce serum CA125 and increase the tocolysis efficiency, and so it was worth promoted in clinic.

MSCT imaging research on atlanto-axial joint in rotary functional position / 中国骨伤

<p><b>OBJECTIVE</b>To provide quantitative foundation for the diagnosis of atlanto-axial rotatory subluxation by analyzing the various imaging features of normal atlanto-axial joints in neutral position and rotary functional position on the MSCT images.</p><p><b>METHODS</b>Forty-one normal volunteers were examined by CT on the atlanto-axial joint in neutral position and rotary functional position. By the observation and measurement of atlanto-dental interval (ADI), lateral atlanta-dental space (LADS), VBLADS and rotating angle of atlas on dentate (RAAD), the imaging manifestations and anatomical characteristics were analyzed and compared. In order to compare VBLADS and RAAD and make a correlation analysis between different age groups, 51 normal volunteers were divided into two groups: age younger than 45 years old group and age older than or equal to 45 years old group.</p><p><b>RESULTS</b>The dens in neutral position deviated in an angle range of (3.22±0.89)°. The articular facets of lateral atlantoaxial joint in rotary functional position had rotatory displacement and the range of the relative rotation angle was (33.85± 2.79)°. Through the correlation analysis of matching data, it could be concluded that there was no correlation between atlantoaxial relative rotation angle and VBLADS within a certain range. There were statistically differences of atlantoaxial relative rotation angle in rotary functional position between two groups.</p><p><b>CONCLUSION</b>MSCT imaging in rotary functional position can clearly show the anatomical structure and rotation function of a normal atlanto-axial joint, so as to provide a theoretical basis for the diagnosis of atlanto axial rotatory subluxation.</p>

Clinical study of electro-acupuncture treatment with different intensities for functional constipation patients / 华中科技大学学报（医学）（英德文版）

Functional constipation (FC) is a common functional bowel disorder disease that affects life quality of a large number of people. This study aimed to explore the impact of different intensities of electro-acupuncture (EA) treatment for FC patients. Totally, 111 patients with FC meeting the Rome III criteria were randomly assigned to different intensities of EA groups (low and high intensity of EA groups) and medicine-controlled (MC) group. In EA groups, patients were treated with EA at quchi (LI11) and shangjuxu (ST37) bilaterally for 4 weeks, 5 times/week in the first 2 weeks, and 3 times/week in the last 2 weeks. In MC group, 5 mg mosapride citrate was administered orally 3 times/day for 4 weeks. Spontaneous bowel movement frequency each day was recorded using a constipation diary. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the patients' psychological state. Cortisol (CORT), substance P (SP), and vasoactive intestinal polypeptide (VIP) were evaluated at baseline and at the end of 4 weeks after treatment. As compared with the baseline, there was statistically significant increase in stool frequency every week (P<0.01), but there was no statistically significant difference among the three groups. As compared with the baseline, after 4 weeks of EA therapy, the scores of SDS and serum levels of CORT were decreased significantly in low intensity of EA group (P<0.01), and the serum levels of SP and VIP were increased significantly (P<0.05); the scores of SAS and SDS and serum levels of CORT were decreased significantly in high intensity of EA group (P<0.05), and the serum levels of SP and VIP were increased significantly (P<0.05); the serum levels of CORT and VIP were increased significantly in MC group (P<0.05). As compared with MC group, after 4 weeks of treatment, the serum levels of SP were signifcicantly increased in low intensity of EA group (P<0.01). Low and high intensities of EA could increase the stool frequency, improve the FC patient's anxiety and depression, reduce the serum levels of CORT, and increase the serum levels of SP and VIP effectively. It is concluded that both low and high intensities of EA are effective for FC patients, but there is no significant difference between the low and high intensities of EA.

Clinical study of electro-acupuncture treatment with different intensities for functional constipation patients / 华中科技大学学报（医学）（英德文版）

Functional constipation (FC) is a common functional bowel disorder disease that affects life quality of a large number of people. This study aimed to explore the impact of different intensities of electro-acupuncture (EA) treatment for FC patients. Totally, 111 patients with FC meeting the Rome III criteria were randomly assigned to different intensities of EA groups (low and high intensity of EA groups) and medicine-controlled (MC) group. In EA groups, patients were treated with EA at quchi (LI11) and shangjuxu (ST37) bilaterally for 4 weeks, 5 times/week in the first 2 weeks, and 3 times/week in the last 2 weeks. In MC group, 5 mg mosapride citrate was administered orally 3 times/day for 4 weeks. Spontaneous bowel movement frequency each day was recorded using a constipation diary. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the patients' psychological state. Cortisol (CORT), substance P (SP), and vasoactive intestinal polypeptide (VIP) were evaluated at baseline and at the end of 4 weeks after treatment. As compared with the baseline, there was statistically significant increase in stool frequency every week (P<0.01), but there was no statistically significant difference among the three groups. As compared with the baseline, after 4 weeks of EA therapy, the scores of SDS and serum levels of CORT were decreased significantly in low intensity of EA group (P<0.01), and the serum levels of SP and VIP were increased significantly (P<0.05); the scores of SAS and SDS and serum levels of CORT were decreased significantly in high intensity of EA group (P<0.05), and the serum levels of SP and VIP were increased significantly (P<0.05); the serum levels of CORT and VIP were increased significantly in MC group (P<0.05). As compared with MC group, after 4 weeks of treatment, the serum levels of SP were signifcicantly increased in low intensity of EA group (P<0.01). Low and high intensities of EA could increase the stool frequency, improve the FC patient's anxiety and depression, reduce the serum levels of CORT, and increase the serum levels of SP and VIP effectively. It is concluded that both low and high intensities of EA are effective for FC patients, but there is no significant difference between the low and high intensities of EA.

Significance of fiberoptic bronchoscopy in diagnosis of congenital airway dysplasia in children / 中华实用儿科临床杂志

Objective To investigate the role and significance of fiberoptic bronchoscopy in diagnosis of congenital airway dysplasia.Methods The clinical data of 606 children with bronchoscopy who were admitted to Department of Respiratory Medicine,Nanjing Children's Hospital Affiliated to Nanjing Medical University from Mar.2008 to Mar.2012 were retrospectively analyzed.Results Among the 606 children,airway dysplasia were found in 120 cases,duded tracheobronchomalacia in 47 cases,racheobronchial stenosis in 31 cases,tracheal bronchus in 27 cases,laryngomalacia in 9 cases,abnormalities or variations at the bronchi opening in 16 cases,airway diverticulum in 8 cases,tracheal esophageal fistula in 5 cases,and 23 children in the 120 cases had 2 or more deformity.Conclusions The fiberoptic bronchoscopy plays a decisive role in diagnosis of congenital airway dysplasia.Fiberoptic bronchoscopy should be performed in suspicious children as soon as possible to determine the cause.

Long-term efficacy of sublingual immunotherapy with Dermatophagoides Farianae Drops in children with allergic asthma sensitized to dust mites / 中华儿科杂志

<p><b>OBJECTIVE</b>To observe the efficacy of sublingual immunotherapy (SLIT) in children with allergic asthma during the treatment and 1 year after the treatment.</p><p><b>METHOD</b>This is an open and retrospective study; 80 children with mild-moderate allergic asthma between 4 and 14 years of age were chosen from the Department of Respiratory Medicine, Nanjing Children's Hospital Affiliated to Nanjing Medical University from May to August, 2009. All children were sensitized to Dermatophagoides Farianae and/or Dermatophagoides Pteronyssinus and have received anti-asthma drug therapy for 3 months (baseline). Thirty-nine children in SLIT group underwent 2-year SLIT and combined with anti-asthma drug, these children were then followed up for 1 year. Forty-one children in drug group only received anti-asthma drug and were followed up for 3 years. The scores of asthma symptom, scores of asthma medication and the number of discontinuation of anti-asthma drug were compared between the SLIT group and drug group for the baseline, end of the 2nd year and 3rd year treatment. The frequency of acute attack of asthma was also compared between the two groups for 1 year before the treatment and the 3rd year treatment.</p><p><b>RESULT</b>(1) At baseline, the asthma symptom scores, the medication scores and the frequency of acute attack of asthma in 1 year before the treatment of the two groups showed no significant difference. (2) After 2-year SLIT, the daytime asthma symptom scores of SLIT group were lower than the drug group (0.18 ± 0.06,0.93 ± 0.12,Z = -4.873, P < 0.05), the night asthma symptom scores of the two groups showed no significant difference. One year after SLIT, the daytime and night asthma symptom scores of SLIT group were both lower than those of the drug group (daytime SLIT group vs. Drug group: 0.18 ± 0.06 vs. 1.46 ± 0.72,Z = -5.082, P < 0.05;night SLIT group vs. Drug group: 0.05 ± 0.04 vs. 0.66 ± 0.14,Z = -4.019, P < 0.05). (3) At the end of SLIT and 1 year after SLIT, the medication scores of SLIT group were both lower than those of the drug group (End of SLIT SLIT group vs. Drug group: 0.31 ± 0.07 vs. 0.75 ± 0.12,Z = -2.813, P < 0.05;1 year after SLIT SLIT group vs. Drug group: 0.17 ± 0.06 vs. 0.87 ± 0.17,Z = -4.106, P < 0.05), the number of discontinuation of anti-asthma drug of SLIT group were both more than the drug group (End of SLIT SLIT group vs. Drug group: 20 vs. 10,χ(2) = 6.167, P < 0.05;1 year after SLIT SLIT group vs. Drug group: 29 vs.13,χ(2) = 14.581, P < 0.05).(4) In the 3rd year, the frequency of acute attack of asthma in SLIT group was significantly lower than that of drug group (0.69 ± 1.20, 1.20 ± 1.44,Z = -1.968, P < 0.05) .</p><p><b>CONCLUSION</b>SLIT can significantly improve the symptoms of asthma, reduce the use of anti-asthma drug and reduce the frequency of the acute attack of asthma. Meanwhile, the efficacy could still maintain 1 year after the SLIT treatment.</p>

The difference of anti-pneumococcal capsular polysaccharide IgG levels in plasma of asthmatic and non-asthmatic children / 临床儿科杂志

Objectives To explore the humoral immunologic mechanisms of the susceptibility to invasive pneumococcal diseases (IPD) in asthmatic children. Methods Plasma samples were collected from 43 asthmatic and 20 non-asthmatic chil-dren. Anit-pneumococcal capsular polysaccharide (PPS)-IgG concentrations were measured by enzyme-linked immunosorbent assays. Results The mean concentrations of anti-PPS 14, 19A and 23F-IgG were signiifcantly higher in asthmatic children than in non-asthmatic children (P<0.05). The ratios of the asthmatic children who had anti-PPS 14, 19A and 23F-IgG concentrations higher than the protective antibody level (≥0.2 μg/ml ) were 100%for all the serotypes. Conclusions The immune responses of producing anti-PPS IgG to defense IPD were normal in asthmatic children. Asthmatic children may be more susceptive to pneumococcal infection or colonization than non-asthmatic children.

Studies on the core functional region of antimicrobial peptide LL-37 for inhibition of RSV replication / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the core functional region of antimicrobial peptide LL-37, which inhibites RSV replication and could be developed for theraputic aplication.</p><p><b>METHODS</b>A panel of 6 partial LL-37 peptides (referred to as P1 to P6) was synthesized according to LL-37 amino acide sequence. Hep-2 cells were infected with RSV, treated with LL-37 or partial peptides respectively. Cells were collected after 24 hours incubation at 37 degrees C, CO2 5%. Total RNA was obtained from the cells. Expression level of RSV N gene was quantified by real-time PCR. Meanwhile enzyme-linked immunosorbent assay (ELISA) was used to quantify the chemokines RANTES, IL-8, MCP1 in the supernatants of Hep-2 cultures after 24 h incubation with or without LL-37 and partial peptide P6.</p><p><b>RESULTS</b>N-terminal partial LL-37 peptide (corresponding to residues 1-12 of LL-37) had no significant effects on RSV replication (P > 0.05). In contrast, C-terminal (corresponding to residues 13-37) and a panel of 4 overlapping 22-mer partial peptides (from the peptide incorporating aa 13-34 through that spanning aa 16-37) showed significant inhibitory effect on RSV replication to some extent (P < 0.05 or P < 0.01). LL-37 induced significant expression of chemokine RANTES, IL-8 and MCP-1 in Hep-2 cells. In contrast, partial peptide P6 had no significant effect on expression of the chemokines in Hep-2 cells.</p><p><b>CONCLUSION</b>The LL-37 C-terminal 22-mer partial peptide P6 was putative core functional region for inhibition of RSV replication. The partial peptide didn't induce significant expression of chemokine RANTES, IL-8 and MCP-1.</p>

Application of flexible bronchoscopy in diagnosis and treatment of 104 children with pulmonary atelectasis / 中华儿科杂志

<p><b>OBJECTIVE</b>To evaluate the value of flexible fiberoptic bronchoscopy in diagnosis and treatment of pulmonary atelectasis in children.</p><p><b>METHOD</b>Totally 104 patients with pulmonary atelectasis, who were admitted to this department, received flexible fiberoptic bronchoscopy from January 2006 to May 2010, were enrolled in a retrospective analysis.</p><p><b>RESULT</b>The analysis on causes of pulmonary atelectasis showed that 76 cases (73%) of the 104 patients had sputum obstructions, which was the main cause of atelectasis. Thirteen cases (13%) had bronchopulmonary dysplasia, 9 cases among these were infants. Twelve cases (12%) had foreign body aspiration, 8 cases among these were under the age of 3-year. After flexible fiberoptic bronchoscopy, 100 cases got expansion of pulmonary atelectasis. Sixty-five of the sputum obstruction cases got atelectasis reexpansion after one time of flexible fiberoptic bronchoscopy. Eight of the sputum obstruction cases got atelectasis reexpansion after two times of flexible fiberoptic bronchoscopy. Two of the sputum obstruction cases got atelectasis reexpansion after three times of flexible fiberoptic bronchoscopy. The rate of atelectasis reexpansion after one time of alveolus lavement was higher in the cases whose courses of disease were under 3 weeks, than in the cases whose courses of disease were beyond 3 weeks.</p><p><b>CONCLUSION</b>Etiology of pulmonary atelectasis varied at different age. The morbidity of bronchopulmonary dysplasia was high in infants. Foreign body aspiration was the common cause of pulmonary atelectasis in children from 1 to 3-year of age. Sputum obstruction was the main cause of pulmonary atelectasis in over 3-year-old children. Most cases got atelectasis reexpansion after alveolar lavage. The patients who had shorter course of disease might have higher rate of atelectasis reexpansion after alveolar lavage once. Flexible fiberoptic bronchoscopy plays an important role in diagnosis and treatment of pulmonary atelectasis.</p>

Analysis of viral pathogen in children with acute lower respiratory tract infections / 临床儿科杂志

Objective To elucidate the etiology feature of viral infection in hospitalized children with acute lower respiratory infection. Methods A total of 5 480 children with acute lower respiratory tract infection, hospitalized from September 2007 to September 2009, were studied. Nasopharyngeal aspirates were screened for 8 types of viruses by direct immunofluorescence (DIF) assay. Results At least one type of viral pathogen was detected in 2 710 out of 5 480 patients and the overall positive rate was 49.5%. The most common virus was RSV (51.1%), followed by hMPV (18.9%), PIVⅢ (12.5%), ADV (7.1%), IFA (4.7%), IFB (2.9%), PIV Ⅰ (1.5%) and PIV Ⅱ (1.2%). The positive rate was highest in children under 6 months (43.5%). The seasonal change of RSV, hMPV was more obvious. The peak of RSV, hMPV appeared in the winter and the spring. The prevalence of viral infection in children with pneumonia, bronchitis, asthmatic bronchitis, non asthmatic bronchitis and asthma were 47.4%、63.6%、 50.5%、 30.1% and 43.5% respectively. Conclusions Viruses are the main cause of lower respiratory tract infections in children, especially in infants and young children. RSV and hMPV were the most common viruses in these years.