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Objective To understand the clinical features and the differences of age on children with asthma exacerbation.Methods Totally 395 inpatients with asthma exacerbation of our hospital were enrolled from January 2013 to December 2015.All the inpatients were divided into 2 groups:＜ 5 years of age group and ≥5 years of age group.The general data,epidemiology,predisposing factors,respiratory tract infection and pathogenic spectrum of these children were compared and analyzed.Results Average age of all inpatients was 4.25 ±2.51 years old,the proportion of male and female was 2.06:1,and autumn was the epidemical season.367 inpatients(92.91％)were complicated with respiratory tract infection.113 inpatients (28.61％) had been diagnosed with asthma before hospitalization.31 inpatients(7.89％) were followed up with long term standardized treatment.Compared with ≥ 5 years of age group,inpatients of ＜ 5 years of age group were more easily to be complicated with respiratory tract infection (x2 =9.856,P =0.007),especially with pneumonia (x2 =9.846,P =0.002).The detection rate of respiratory syncytial virus in ＜ 5 years of age group were higher than ≥ 5 years of age group (x2 =10.870,P =0.001).But there were no significant difference between the two groups in the detection rate of mycoplasma.(x2 =3.090,P =0.079).The diagnostic rate of asthma before hospitalization and rate of long term standardized follow-up treatment in ＜ 5 years of age group were lower than ≥5 years of age group (x2 =16.742,P =0.000;x2 =12.948,P =0.000).Conclusion Respiratory tract infection,non-timely diagnosis and standard treatment were major predisposing factors for asthma exacerbation of children.＜ 5years of age group were easily to be complicated with respiratory tract infection,especially with pneumonia and respiratory syncytial virus infection.The diagnostic rate of asthma before hospitalization and rate of long term standardized follow-up treatment were lower.
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Objective To explore the morphological change of upper airway in obese patients with multislice spiral CT (MSCT) scan and post-processing techniques and to reveal the relationship between structural abnormalities and the severity of obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Adults with obesity were enrolled and divided into OSAHS group (n =25) and non-OSAHS group (n =25) based on polysomnography (PSG).MSCT covering upper airway was performed and measurements of soft tissue,bone structure and spatial structure of the upper airway were obtained from a 3-dimensional segmentation using image analysis.And their relationship between body mass index(BMI),neck circumference,apnea hyponea index(AHI) were analyzed.Results Compared with non-OSAHS control group,the area of the soft palate was significantly increased (P ＜ 0.05).The volume of the soft palate was further significantly increased (P ＜0.01);The cross-sectional area,anteroposterior diameter and volumes of the oropharynx in OSAHS group were decreased (P ＜ 0.05).The volume of the soft palate had significant positive correlation with BMI and AHI (P ＜ 0.01).Conclusion MSCT can evaluate obese patients from 2 days and 3 days structure on airway obstruction and surrounding soft tissues,and these results suggest the soft palate volume may be associated with severity of OSAHS.
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AIM: To investigate the mechanism of renal damage in chronic intermittent hypoxia (CIH) rat model.METHODS:The Sprague-Dawley rats were randomly divided into 2-week CIH group (2IH), 2-week simulated air control group (2C), 4-week CIH group (4IH) and 4-week simulated air control group (4C).HE staining, PAS staining and Masson staining were used for histological evaluation .Blood was collected for the measurement of superoxide dismutase (SOD).The mRNA expression of hypoxia-inducible factor-1α(HIF-1α), manganese superoxide dismutase (MnSOD), copper/zinc superoxide dismutase ( Cu/ZnSOD ) was detected by real-time PCR.RESULTS: ( 1 ) No significance difference of renal weight , body weight , and the ratio of renal weight to body weight was observed , while IH caused mor-phologic kidney damage , especially in 4IH group.Hypertrophy of epithelial cells in the kidney tubles and dilation in the glomeruli were observed under light microscope with HE and PAS staining , especially in 4IH group.Masson staining showed no significant fibrotic response in the kidney of the rats exposed to IH .(2) The SOD levels in the serum and kid-ney were decreased after CIH .Compared with the corresponding control groups , the levels of serum SOD were significantly lower in CIH groups, especially in 4IH group.The mRNA expression of Cu/ZnSOD and MnSOD in CIH groups decreased significantly as compared with control groups .The mRNA levels of HIF-1αwere significantly higher in CIH groups than those in the corresponding control groups .CONCLUSION: CIH induces abnormalities of glomeruli and convoluted tu-bules, while 4-week IH exposure has not led to fibrotic response .CIH participates in the process of renal oxidative stress damage by upregulating HIF-1αtranscription and downregulating Cu/ZnSOD and MnSOD transcription .
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<p><b>OBJECTIVE</b>To determine the clinical value of portable sleep testing by Watch-PAT (PAT) in children with obstructive sleep apnea syndrome (OSAS).</p><p><b>METHOD</b>Fifty cases of snoring children aged 3-11 years were randomly selected to undergo the polysomnography (PSG) and PAT simultaneously at the same night. The consistency of sleep parameters in OSAS and non - OSAS children were compared with PSG as reference standard, and ROC curve analysis was performed to assess the sensitivity and specificity in the diagnosis of OSAS with PAT portable sleep monitor.</p><p><b>RESULT</b>Fourteen cases were diagnosed as OSAS in 6-11 years group by PAT and PSG. But in 3-5 years group, only six children were diagnosed as OSAS, there was significant difference between PAT and PSG (P < 0.05). Among those 6-11 years old children, compared with non-OSAS, PAT study showed that III+IV stage sleep ((30.5 ± 2.4)% vs. (38.2 ± 2.3)%, χ(2)=4.31, P<0.05), REM sleep duration ((8.9 ± 2.5)% vs. (18.3 ± 2.1)%, χ² =4.31, P<0.05), TST ((458 ± 78) min vs. (522 ± 56) min, t=4.85, P<0.05) and sleep efficiency ((83.5 ± 3.1)% vs. (93.5 ± 3.5)%, t=3.75, P<0.05) decreased, I+II stage sleep ((61.5 ± 4.4)% vs. (44.1 ± 3.5)%, χ² =6.07, P<0.05), arousal index ((29.5 ± 8.2)/h vs. (10.6 ± 5.6)/h, t=3.70, P<0.05), AHI ((7.6 ± 5.3)/h vs. (2.1 ± 2.0)/h, t=2.40, P<0.05), RDI((18.2 ± 5.1)/h vs. (6.5 ± 3.9)/h, t=3.85, P<0.05) increased in OSAS children. Furthermore, the total sleep time (TST) ((458 ± 78) min vs. (430 ± 76) min, t=2.90, P<0.05) and sleep efficiency ((83.5 ± 3.1) % vs. (81.9 ± 4.3) %, t=2.45, P<0.05) were higher by PAT than scored by PSG. ROC curve analysis showed the best threshold selection of AHI 5.0, the sensitivity was 0.952, the specificity was 0.858. AHI 7.0, the sensitivity was 0.968, the specificity was 0.985. AHI 10, the sensitivity was 0.985 and the specificity was 0.99, but AHI 1.0, the sensitivity was 0.852 and the specificity was 0.785.</p><p><b>CONCLUSION</b>PAT can be used at home in school age children due to the high consistency with PSG and the high compliance.</p>
Subject(s)
Child , Child, Preschool , Humans , Polysomnography , Methods , ROC Curve , Sensitivity and Specificity , Sleep , Sleep Apnea, Obstructive , Diagnosis , Sleep Stages , SnoringABSTRACT
Childhood obstructive sleep apnea and hypopnea syndrom (OSAHS) has complex causes,which can lead to cardiovascular diseases,neurological complications such as cognitive impairment,and metabolic syndrome.It has affected children's physical and mental health.Childhood OSAHS should emphasize the early identification of the risk factors,it's necessary to undergo polysomnography and intervene timely.The diagnosis and treatment of OSAHS should be combined with clinical characteristics,and should not only rely on undergo polysomnography report results.Tonsil and adenoidectomy is still the first line treatment,nasal inhaled hormone and leukotriene receptor antagonist are effective for mild OSAHS children.
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Obesity and sleep disorders are both familial clustering. Childhood obesity can cause sleep disordered breathing and sleep deprivation. The expression of energy metabolism related genes can also be inlfuenced by obesity, which may lead to overweight or obesity, even metabolic syndrome. In this review, the recent progress on obesity related gene polymorphism and its relationship to childhood sleep disorders is summerized.