ABSTRACT
Objective:To explore the clinical features and risk factors of severe mycoplasma pneumoniae pneumonia(SMPP) in children, and to provide guidance for early identification of SMPP.Methods:The clinical data of 263 children with mycoplasma pneumoniae pneumonia admitted to the Respiratory Department at Anhui Children′s Hospital from January 2019 to December 2021 were analyzed retrospectively.According to the severity of the disease, the patients were divided into severe group( n=88) and mild group( n=175). The general conditions, clinical manifestations, laboratory examination, imaging features and bronchoscopic findings between two groups were compared and statistically analyzed. Results:There was no significant difference in sex and onset season between two groups( P>0.05). The age of severe group was older than that of mild group( P<0.05). According to the age group, the incidence of SMPP in the infant group(14.10%) was lower than that in the preschool group (45.00%) and the school age group (37.65%) ( P<0.05), but there was no significant difference between preschool group and school age group ( P>0.05). The degree of fever and the proportion of extrapulmonary complications in severe group were higher than those in mild group, and the duration of fever, length of hospital stay and use of macrolides in severe group were longer than those in mild group ( P<0.05). There were significant differences in white blood cell count/lymphocyte count, C-reactive protein (CRP), prealbumin, glutamic pyruvic transaminase, lactate dehydrogenase (LDH), immunoglobulin G, immunoglobulin A, procalcitonin, erythrocyte sedimentation rate (ESR) and D-dimer between two groups(all P<0.05). There was significant difference in the copies of mycoplasma pneumoniae DNA in bronchoalveolar lavage fluid between two groups ( P<0.05). The proportion of large shadow, pleural thickening, atelectasis, pleural effusion, bronchoalveolar lavage and airway mucus thrombus blockage in severe group were higher than those in mild group ( P<0.05). Multivariate Logistic regression analysis showed that hot course ( OR=1.294, 95% CI: 1.127-1.485), CRP level( OR=1.027, 95% CI: 1.003-1.052), LDH level( OR=1.006, 95% CI: 1.002~1.011), D-dimer level( OR=1.406, 95% CI: 1.065~1.875), ESR( OR=1.042, 95% CI: 1.008-1.077), large shadow( OR=21.811, 95% CI: 6.205~76.664) and pleural effusion( OR=5.495, 95% CI: 1.604-18.826) were independent risk factors for SMPP.ROC curve analysis showed that thermal path, CRP level, LDH level, D-dimer level and ESR had high predictive value in the diagnosis of SMPP, and the best thresholds were 8.50 d, 25.625 mg/L, 412.50 IU/L, 0.98 mg/L and 36.5 mm/h, respectively. Conclusion:Children with SMPP had high degree of fever, long duration of fever, length of hospital stay, long use of macrolides, significantly increased inflammatory indexes, and severe changes in pulmonary imaging and bronchoscopy.Hot course, CRP level, LDH level, D-dimer level, ESR, large shadow and pleural effusion are risk factors for SMPP.It is helpful for early identification of SMPP when the hot course is >8.50 d, CRP>25.625 mg/L, LDH > 412.50 IU/L, D-dimer > 0.98 mg/L, ESR > 36.5 mm/h.
ABSTRACT
AIM: To investigate the effect of Qiteng Xiaozhuo granule on inflammation indexes in rats with chronic glomerulonephritis (CGN) through miR-339-5p. METHODS: CGN model was established by adriamycin (ADR) injection into tail vein of rats. Qiteng Xiaozhu granules (21.6, 10.8, 5.4 g/kg) of different doses were intragastric-fed for 30 days. Pathological changes in kidney tissues of CGN rats were observed by HE staining and electron microscopy. The contents of IL-1β, IL-6, IL-10 and TNF-α in serum and kidney tissue of CGN rats were detected by qRT-PCR, ELISA and Western blot. Relative expressions of miR-339-5p, Syk and p-Syk proteins were detected by Western blot, the relative expressions of miR-339-5p mRNA and Syk mRNA were detected by qRT-PCR. RESULTS: There were thickening of basement membrane and glomerular atrophy in the model group. Compared with the normal group, the expression of miR-339-5p and IL-10 in the model group was significantly down-regulated, while the expression of IL-1β, IL-6, TNF-α and Syk was significantly up-regulated. Qiteng Xiaozhuo granule group could significantly reduce the protein and mRNA expression levels of IL-1β, IL-6, TNF-α, Syk in kidney tissue.CONCLUSION: Qiteng Xiaozhuo granule may down-regulate the expression of inflammatory factors through miR-339-5p in the treatment of inflammatory symptoms in CGN rats.