Advances on animal experimental study of mesenchymal stem cell extracellular vesicles in the treatment of bronchopulmonary dysplasia / 中华实用儿科临床杂志

Bronchopulmonary dysplasia (BPD) is a chronic lung disease that commonly occurs in preterm infants requiring mechanical ventilation and oxygen therapy.BPD usually has a poor long-term prognosis due to the lack of effective prevention and treatment method currently, which is one of the medical problems to be solved urgently.Many animal experiments indicated that mesenchymal stem cell extracellular vesicles (MSC-EVs) can replace mesenchymal stem cells as an effective treatment strategy for BPD, which has great application prospect.At present, the use of MSC-EVs has gradually deepened into the molecular mechanism and made new progress.In order to explore the value of MSC-EVs in the treatment of BPD, the recent advances on the mechanism of MSC-EVs in the treatment of BPD are investigated.

Clinical analysis of 176 children with congenital tracheobronchial malformation / 中华实用儿科临床杂志

Objective:To investigate the clinical characteristics of congenital tracheobronchial malformation in children.Methods:Retrospective analysis was performed on the data of 176 children with congenital tracheobronchial malformation who were diagnosed by bronchoscopy at Children′s Hospital of Chongqing Medical University from January 2016 to October 2016, and were followed up by telephone for the presence of dyspnea, operation and death within 3 years after discharge.Results:(1) Among the 176 cases, there were 156 cases less than 3 years old, accounting for 88.64%.(2) Among the 176 cases, there were 54 cases with congenital tracheobronchial stenosis, 42 cases with congenital tracheomalacia, 26 cases with abnormal bronchial openings, 3 cases with airway diverticulum, 1 case with tracheoesophageal fistula, 1 case with bridging bronchus, and 49 cases with mixed type (2 or more malformations). (3) The most common clinical manifestations included recurrent or persistent dyspnea (86 cases), chronic cough (61 cases), and recurrent respiratory infection (34 cases) with the most frequent occurrence.Other manifestations included laryngeal stridor (14 cases), pulmonary atelectasis (29 cases), localized emphysema (6 cases), and difficulty extubation after endotracheal intubation (6 cases). (4) Among the 139 patients who underwent chest CT examination and airway reconstruction, only 44 cases were diagnosed correctly.(5) All 176 patients received routine medical treatment and bronchoscopy during hospitalization, among which 17 cases received surgical treatment.One hundred and seventy cases were improved in their condition and discharged, and 6 cases did not respond well.A total of 47 patients were followed up by telephone for 3 years.The proportion of children with dyspnea after 1 year, 2 years and 3 years were 59.57%, 51.06% and 38.30%, respectively.Among the follow-up patients, 4 patients received surgical treatment and 2 patients died.Conclusions:Congenital tracheobronchial malformation in children often occurs in infants, and their clinical manifestations are not typical.Therefore, suspected patients should receive chest CT and airway reconstruction as early as possible, and bronchoscopy can be employed in time if the diagnosis is unclear.The majority of children can obtain a favorable prognosis, with few death cases.Partial patients would present with a risk of recurrent or persistent dyspnea, and some critically ill children shall receive the airway stent implantation or surgical intervention.

Progress on the pathogenesis of protracted bacterial bronchitis / 国际儿科学杂志

Protracted bacterial bronchitis(PBB)is one of the main causes of chronic cough in children.At present, the pathogenesis of PBB is mainly related to airway persistent bacterial infection, airway inflammatory response, immune dysfunction, airway deformity and airway microbial population disorder, especially airway persistent bacterial infection and airway inflammatory response.This reviwe summarizes the progress on the pathogenesis of PBB, in order to improve the understanding of clinical workers on PBB.

Progress of the etiology of bronchiectasis in children / 国际儿科学杂志

Bronchiectasis is a chronic lung disease involving a "vicious circle" of complex interactions between host, respiratory pathogens, and environmental factors.With the wide application of high-resolution CT, the diagnostic rate of bronchiectasis has been improved and the etiology and pathology of bronchiectasis have been promoted.After infection, cystic fibrosis, primary immunodeficiency disease, bronchial foreign body and primary ciliary dyskinesia are the main causes of bronchiectasis, and the clinical manifestations of bronchiectasis in children are not specific.HRCT examination should be conducted as early as possible for children suspected of bronchiectasis, and the potential etiology should be actively sought for children.This paper summarizes the recent progress of the etiology of bronchiectasis in children, and provides the clinical data for the correct understanding of the etiology of bronchiectasis.

Clinical features and follow-up of 35 children with post-infectious bronchiolitis obliterans / 临床儿科杂志

Objective To analyze the clinical characteristics, treatment, and prognosis of post-infectious bronchiolitis obliterans (PIBO) in children. Methods Clinical data from 35 children diagnosed with PIBO were retrospectively analyzed from April 2010 to June 2015 . The children were divided into different groups according to the length of glucocorticoid use, and the prognosis were compared. Results Thirty-ifve children all presented cough and wheezing. There were 12 cases in the group of less than one year of glucocorticoid treatment, 8 cases in the group of 1-2 years of glucocorticoid treatment, and 6 cases in the group of great than or equal to 2 years of glucocorticoid treatment. There was no signiifcant difference in the prognosis among the groups (P>?0 . 05 ). Conclusions The overall prognosis is poor in children with PIBO, even if the symptoms are improved. Glucocorticoid is helpful to remiss the symptoms of cough and wheezing, but prolonged use have no signiifcant effect on the prognosis.

Analysis of etiological agents in children with asthma exacerbation in 2013 / 重庆医学

Objective To investigate the distribution of etiological agents in children with asthma exacerbation in Chongqing during 2013 .Methods Four hundred and forty seven cases of hospitalized children with asthma exacerbation in 2013 in Children′s Hospital of Chongqing Medical University were retrospectively analyzed in SPSS19 .0 software .Results Among the 447 children with asthma exacerbation ,the percentage of bacteria was 43 .8% ,streptococcus pneumonia(SP)(25 .5% ) was the most common bacteria .Among the 25 cases with bacteria culture of bronchoalveolar lavage ,the positive rate was 44 .0% ,and the difference to sputum culture was not significant (P>0 .05) .The positive rate of 7 common respiratory viruses was 27 .3% ,RSV accounted for 18 .8% ,and it was the most common virus .The virus infection rate was higher in the groups below one years old ,and compared each groups′virus detection rates ,the difference was significant (P< 0 .05) .The positive rate of mycoplasma pneumoniae was 23 .5% ,chlamydia pneumonia was not detected .Conclusion Asthma exacerbation in children is closely related to respiratory infec‐tion .Bacteria detection rate was high in all ages ,which suggests that bacterial infection is an important factor in asthma exacerbation that can′t be ignored .

Diagnosis of children with occult bronchial foreign body / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinical manifestation of children with occult bronchial foreign body, to analyze the reasons of misdiagnosis, to summarize the way of diagnosis and to emphasize the value of bronchoscopy in diagnosis and treatment of children with such disease.</p><p><b>METHOD</b>A retrospective analysis of 22 cases of occult bronchial foreign body diagnosed and treated with bronchoscopy in Children's Hospital of Chongqing Medical University during the period from March 1, 2009 to February 28, 2014.</p><p><b>RESULT</b>Of the 22 cases, 15 were male and 7 female. Their age ranged from nine months and eight days to fourteen years and six months. The course of disease ranged in length from six days to one year. It took us one to thirty-three days in diagnosing the problem. They or their parents all denied aspirating foreign body and the patients did not have irritating chokes. They did not have tracheal displacement or flapping sound. There were no direct signs of bronchial foreign body in their imaging examination. Twenty-one patients were diagnosed as pneumonia before bronchoscopy, and the remaining one was diagnosed as tuberculosis. All of the patients were complicated with infection; atelectasis was found in 15 cases/times, lung consolidation in 10 cases/times, emphysema in 4, pleural effusion in 5, bronchiectasis in 4, one case had respiratory failure, one case had septicemia. The clinical symptoms were relieved in the patients after bronchoscopy, 3 cases were cured, 19 cases were improved.</p><p><b>CONCLUSION</b>Occult bronchial foreign body with certain complications and great harm is hard to diagnose. We should pay more attention to the important clues, such as a child with repeated pulmonary infection, indirect signs of airway obstruction and difficult to treat. Early bronchoscopy will be useful to improve diagnostics once the vital clue is found.</p>

Clinical features of 213 cases of severe adenovirus pneumonia in children / 临床儿科杂志

Objectives To summarize the clinical feature of severe adenovirus pneumonia (SAP) in children and further to improve prognosis and clinical diagnosis of SAP. Methods The clinical data of 213 children with SAP from June 2009 to June 2011 were retrospectively analyzed. Results Among 213 patients, 155 (72.8%) children were aged 6 months to 2 years, with a males to females ratio of 2.7∶1. The onset of 158 patients (74.2%) was in winter and spring. All patients had fever, 172 (80.8%) with high temperature of 39.1℃-41℃, 161 (75.6%) with a fever lasting more than 2 weeks. Two hundred and ifve (96.2%) patients had cough in the early stage, 120 (56.3%) with wheeze, 139 (65.3%) with moist rales and wheezing in the lung. Imaging ifndings in the preliminary stage of SAP showed that 63 patients (92.6%) had pulmonary interstitial changes;in critical stage, 80 patients (54.4%) had segmental consolidation and 33 (22.4%) with pleural effusion, 25 (17.0%) with pleuritis;in recovery phase, 50 patients (68.5%) showed absorption in segmental area of consolidation. All cases had complications, 175 (82.2%) with respiratory failure, including 10 (4.7%) with ARDS;among extrapulmonary complications, diseases of cardiovascular system (64.3%) and alimen-tary system (44.1%) were the most common ones, and the occurrence of myocarditis and diarrheal disease were the highest. Age, ARDS and more than two kinds of complications had adverse impact on the outcomes, and the difference was signiifcant (P<0.05). Conclusions SAP is a severe pneumonia with long duration of high fever, severe clinical manifestations with more complications. When SAP is suspected, it is recommended to complete etiological and chest radiographic examination for early diagnosis and treatment.