A multicenter clinical study of the impact of COVID-19 pandemic on hospitalization of children with bronchiolitis / 国际儿科学杂志

Objective:In order to explore the impact of corona virus disease 2019(COVID-19)on the hospitalization of children with bronchiolitis and to improve clinicians′ understanding of the characteristics of bronchiolitis during the COVID-19 epidemic.Methods:This was a multicenter clinical study, and the data have been collected from 23 children′s medical centers in China.All the clinical data were retrospectively collected from children with bronchiolitis who were hospitalized at each study center from January 1, 2019 to December 31, 2021.The results included gender, age at hospitalization, length of stay, respiratory syncytial virus(RSV) test results, severity rating, ICU treatment, and the total number of children hospitalized with respiratory tract infection during the same period.The clinical data of children with bronchiolitis in 2019 before COVID-19 epidemic and in 2020、2021 during COVID-19 epidemic were statistically analyzed and compared.Results:According to a summary of data provided by 23 children′s medical centers, there were 4 909 cases of bronchiolitis in 2019, 2 654 cases in 2020, and 3 500 cases in 2021.Compared with 2019, the number of bronchiolitis cases decreased by 45.94% in 2020 and 28.70% in 2021.In 2019, 2020 and 2021, there were no significant differences in gender ratio, age, and duration of hospitalization.Compared with 2019, the ratio of bronchiolitis to the total number of hospitalizations for respiratory tract infection decreased significantly in 2020 and 2021( χ2=12.762, P<0.05; χ2=84.845, P<0.05).The proportion of moderate to severe bronchiolitis cases in both 2020 and 2021 was lower than that in 2019, and the difference was statistically significant ( χ2=4.054, P<0.05; χ2=8.109, P<0.05).There was no statistically significant difference in the proportion of bronchiolitis cases requiring ICU treatment between 2019, 2020, and 2021 ( χ2=1.914, P>0.05).In 2019, a total of 52.60%(2 582/4 909) of children with bronchiolitis underwent RSV pathogen testing, and among them, there were 708 cases with RSV positive, accounting for 28.00%.In 2020, 54.14%(1 437/2 654) of children with bronchiolitis underwent RSV pathogen testing, and there were 403 cases with RSV positive, accounting for 28.04%.In 2021, 66.80%(2 238/3 500) of children with bronchiolitis underwent RSV pathogen testing, and there were 935 cases with RSV positive, accounting for 41.78%.Compared with 2019 and 2020, the RSV positive rate in 2021 showed a significant increase( χ2=99.673, P<0.05; χ2=71.292, P<0.05). Conclusion:During the COVID-19 epidemic, the implementation of epidemic prevention and control measures reduced the hospitalization rate and severity of bronchiolitis, but did not reduce the positive rate of RSV detection.

Progress in detection of serum antibodies related to myasthenia gravis in children / 国际儿科学杂志

Myasthenia gravis(MG)is an autoimmune disease, and local or systemic muscle weakness is the main symptom.The main auxiliary tests are serological, pharmacological and electrophysiological tests.Autoantibodies are the most important biomarkers to guide the diagnosis of myasthenia gravis.The clinical features and autoantibodies of myasthenia gravis in children were different from those in adults.Therefore, this paper summarizes the clinical significance of the main autoantibodies acetylcholine receptor(AChR)antibody, muscle specific kinase(MuSK)antibody, low density lipoprotein receptor associated protein 4(LRP-4)antibody and other related antibodies in children with myasthenia gravis, which has certain guiding significance for the diagnosis and individualized treatment of myasthenia gravis.

Comparison between modified Chinese Version of Test for Respiratory and Asthma Control in Kids and Global Initiative for Asthma guideline / 中华实用儿科临床杂志

Objective@#To explore the value of modified Chinese Version of Test for Respiratory and Asthma Control in Kids(TRACK) in the management of asthmatic children aged 0-5 years old by comparing with Global Ini-tiative for Asthma(GINA) guideline.@*Methods@#A total of 157 children aged 0-5 years old were enrolled at the Pedia-tric Asthma Outpatient Department of the Affiliated Hospital of Qingdao University from March to August 2018.All children were treated with individualized anti-asthma treatment for 3 months.After treatment, asthma experts assessed the level of asthma symptom control based on the GINA guideline, while caregivers of all children completed TRACK questionnaire.The optimal threshold of the TRACK questionnaire for asthma control was determined by analyzing receiver operating characteristic curve(ROC curve), and consistency of the 2 evaluation methods was compared.@*Results@#All enrolled children were divided into 3 groups based on GINA guideline: 59 children for the well controlled group, 52 children for the partly controlled group and 46 children for the uncontrolled group.There was a significant difference statistically in TRACK scores among the well controlled group [90(85, 95) scores], the partly controlled group [80(70, 85) scores] and the uncontrolled group [60(55, 65) scores] after treatment (H=101.740, P<0.001). Area under the ROC curve was 0.909 for diagnosing asthma control by the modified Chinese version of TRACK, with 80 scores for optimal threshold, 87.3% for sensitivity and 73.5% for specificity.The Kappa value of the consistency test between the TRACK questionnaire and the GINA guideline was 0.553, and consistency rate of these 2 evaluation methods was 77.1%.@*Conclusions@#The modified Chinese version of TRACK can be used as an effective assessment tool to monitor and manage asthmatic children aged 0-5 years.

Influence of five-in-one management mode on disease prevention and control of school children with asthma / 中华儿科杂志

Objective@#To investigate the influence of five-in-one management mode(standardized asthma treatment, asthma diary, peak expiratory flow (PEF) monitoring, reasonable diet and physical exercise) on disease prevention and control of school children with asthma.@*Methods@#From April to October 2018, 70 children with asthma in clinical remission were selected from Affiliated Hospital of Qingdao University using randomized controlled study design. These children were randomly divided into study group and control group, with 35 cases in each group. In the study group, 5 cases were lost to follow-up, and 30 cases were actually enrolled. In the control group, 6 cases were lost to follow-up, and 29 cases were actually enrolled. Children in the control group received routine medication and regular outpatient consultation, and children in the study group received the five-in-one asthma management model. In the first time of seeing a doctor, after 3 months and 6 months of follow-up, asthma control test score, medication compliance index score and lung function index (forced expiratory volume in 1 second (FEV1), PEF were evaluated respectively.Parental satisfaction, asthma acute episodes, weight, height and biochemical index were recorded during the 6 months of follow-up. Pulmonary function index, asthma control score and body mass index of overweight children with asthma were compared with t-test, medication compliance was compared with chi-square test, and the rank sum test was used for the comparison of the number of emergency visits of asthma attacks and parents′ satisfaction.@*Results@#A total of 59 children with asthma were included, among them 30 were in the study group (8.1±1.5) years old and 29 in the control group (9.2±1.1) years old. After 3 months of follow-up, FEV1, PEF, asthma control score in the study group were (86.3±1.5)%, (83.3±2.4)%, (24.7±2.6) points respectively; and in the control group, FEV1, PEF, asthma control score were (84.4±2.5)%, (82.2±1.9)%, (21.1±1.3) points respectively. The indicators in the study group were higher than those in the control group (t=3.62, 1.97, 6.64, P<0.05). After 6 months of follow-up, FEV1, PEF, asthma control score in the study group were (88.4±2.3)%, (85.4±2.2)%, (26.8±1.8) points respectively; and in the control group, FEV1, PEF, asthma control score were (85.5±1.9)%, (83.2±1.7)%, (22.5±1.4) points respectively. The indicators in the study group were significantly higher than those in the control group (t=5.34, 4.24, 10.41, P<0.05). During the 6-month follow up, the number of emergency visits of asthma attacks in the study group and in the control group were 0.42(0.36, 0.51) and 0.92(0.72, 1.27) respectively. The indicator in the study group was significantly lower than that in the control group (Z=3.21, P<0.05). After 3 months of follow-up, the proportions of children with good compliance in the study group and control group were 67% (20/30) and 62% (18/29), the proportions of poor compliance were 27% (8/30) and 34% (10/29), the proportions of non-compliance were 7% (2/30) and 7% (2/29). There were no statistically significant differences (χ2=0.14, 0.43, 0.00, P=0.71, 0.51, 0.97). After 6 months of follow-up, the proportions of children with good compliance in the study group and control group were 87% (26/30) and 69% (20/29), the proportion of poor compliance were 10% (3/30) and 28% (8/29), the proportion of non-compliance were 3% (1/30) and 7% (2/29), There were no statistically significant differences (χ2=2.70, 3.00, 0.39, P=0.10, 0.08, 0.53). After 6 months of follow-up, the number of great satisfaction, satisfaction and dissatisfaction in the study group were 20, 10 and 0 respectively, the satisfaction rate was 100%, meanwhile those indicators in the control group were 4, 15 and 10 respectively, the satisfaction rate was 66%, The indicator in the study group was significantly higher than that in the control group (Z=4.60, P<0.05).@*Conclusions@#The application of "five-in-one" asthma management model (standardized asthma treatment, asthma diary, PEF monitoring, reasonable diet and physical exercise) for school-age children with asthma can significantly improve lung function, as well as reduce the number of acute asthma attacks. It has a high parent satisfaction, therefore it should be recommended for clinical implementation.

Efficacy of sublingual immunotherapy in children with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the efficacy of sublingual immunotherapy with dermatophagoides farina drops on children with allergic rhinitis.@*METHOD@#This was retrospective study analyzing the efficacy of dermatophaguides farinae drops SLIT in 110 patients (aged 4-14 years old) with house dust mites induced allergic rhinitis (without asthma). All the patients were divided into the SLIT group (n = 60) and drug group (n = 50). Patients in SLIT group received sublingual immunotherapy combined with symptomatic medication, and patients in drug group only received symptomatic medication. We recorded and evaluated the total nasal symptom scores (TNSS), total medication scores (TMS) and visual analogue scale (VAS) of the 2 groups at three time points, before the treatment, and the treatment for 1-year and 2-year.@*RESULT@#After 1-year and 2-year treatment, compared with drug group, TMS, TNSS and VAS in SLIT group decreased significantly (P < 0.01). When compared with baseline, we got the similar result as compared with drug group. Besides, the TMS of drug group increased significantly after treatment (P < 0.01). And no significant difference was observed in TNSS and VAS. In addition, there was significant difference in the Proportion of patients withdrawing symptomatic medication in SLIT group and drug group (68.33%,16.00%, respectively; P < 0.01). There were 4 local adverse reactions occurred during the treatment and no serious adverse events occurred.@*CONCLUSION@#Sublingual immunotherapy with Dermatophagoides farinae drops showed significant clinical efficacy in children with allergic rhinitis comparing with pharmacotherapy.

Effect of 1,25-dihydroxyvitamin D3 on interleukin 17 expression in mice with asthma / 中华实用儿科临床杂志

Objective To explore the effects of interleukin 17 (IL-17) and 1,25-dihydroxyvitamin D3 [1,25-(OH)2VD3] on the pathogenesis of asthma.Methods Thirty-two Kunming mice were randomly divided into 4 groups:the control group (group A),the asthma group (group B),the 1,25-(OH)2VD3-treated group (group C) and the Dexamethasone-treated group (group D).The allergic mouse models were established by using ovalbumin (OVA).The behavioral changes of mice were observed and the number of leukocytes in the bronchoalveolar lavage fluid (BALF) were counted.HE staining was used to measure the histological changes of lung tissue.The levels of IL-17 and IgE in the BALF were detected by enzyme-linked immunosorbent assay (ELISA).Results The asthmatic symptoms were more severe in group A than those in the other groups,while they were relieved significantly in group C and group D when treated with 1,25-(OH)2VD3 or Dexamethasone.The number of leukocyte in groups B,C and D [(1.97 ± 0.23) × 108/L,(1.02 ±0.17) × 108/L,(0.95 ±0.14) × 108/L]were higher than those in group A[(0.56 ±0.16) × 108/L] (F =85.58,P ＜ 0.01),and lower in group C and group D than those in group B (all P ＜ 0.01),but there were no significant differences between group C and group D(P ＞0.05).The levels of IgE and IL-17 in group B were significantly higher than those in group A(all P ＜ 0.01).The levels of IgE and IL-17 in group B were significantly lower than those in group C and group D,but higher than those in group A(all P ＜0.01).No significant results were observed between group C and group D (all P ＞ 0.05).Conclusions IL-17 involves in the inflammation process of asthma,which promotes the respiratory inflammation.1,25-(OH)2VD3 may suppress IL-17 expression to relieve the respiratory inflammation in acute asthmatic mice,the effect of which is similar to that of Dexamethasone on asthma.

A Three-Month Non-Interventional Study of Asthma Treatment with Budesonide/Formoterol / 中国呼吸与危重监护杂志

Objective To evaluate the efficacy of Budesonide/formoterol to control asthma under real-life conditions.Methods A muhi-center, open label, non-interventional study was conducted.Asthma control after 12 week therapy with Budesonide/formoterol was assessed by Asthma Control Questionnaire (ACQ) and modified Asthma Control Questionnaire (ACQ5).Results A total of 360 asthma patients were recruited,including 228 adult patients and 132 child patients.After 12 weeks' therapy,all the patients' medium value of ACQ was decreased significantly from 2.03 (adults 2.20, children 1.74) at baseline to 0.60 (adults 0.78, children 0.29) (P < 0.0001), and the medium value of ACQ5 was also decreased significantly from 2.4 (adults 2.24, children 1.76) at baseline to 0.47 (adults 0.62, children 0.20) (P < 0.0001).Conclusion Budesonide/formoterol is effective in asthma treatment, by which most asthma patients obtain and maintain clineal control.

Relations between meteorological factors and asthma in children from Qingdao city / 中国组织工程研究

BACKGROUND: Bronchial asthma is one of those diseases that are significantly affected by meteorological factors. There is close relationship between asthma attack and meteorological factor. There have been some studies on the relationship between asthma and meteorological factors at home and abroad, but the results are various due to different area conditions.OBJECTIVE: To analyze the relationship between asthmatic attack and meteorological factors in children in Qingdao city.DESIGN: Observational experiment.SETTING: The Affiliated Hospital of Qingdao University Medical College.PARTICIPANTS: Altogether 445 inpatient children, 307 males, 138 females, aged ＜ 14 years, who were diagnosed of asthma attack definitely, of the Affiliated Hospital of Qingdao University Medical University, Qingdao Haici Hospital,Qingdao Children Hospital between January 1st 2000 and December 31st 2004 were retrieved.METHODS: The asthmatic attack time of 445 children patients with asthmatic attack of Qingdao city and concurrent month mean temperature, air pressure, relative humidity, wind speed and other meteorologic al data were collected.Seasonal rhythm of asthmatic attack in children and the relationship between asthmatic attack and meteorological factors were analyzed with circular distribution analysis and linear regression analysis, respectively.MAIN OUTCOME MEASURES: ①Month attack information of 445 asthma patients. ② Circular distribution analysis results of asthmatic attack time. ③ Linear regression analysis results about the relationship between asthma attack and meteorological factors.RESULTS: ① Data revealed that asthmatic attack in Qingdao city focused on November, December, January and February, which took up 47.9% of total amount in that year. There were 307 male patients (incidence 3.12%)in a year,female patients only 138 cases (incidence 1.51%), which revealed that boys have a higher incidence of asthma attack than girls. ②The peak season of incidence of asthmatic attack was found in winter and peak season for male and female patients was in January and December, respectively (P ＜ 0.05). ③ Higher incidence of asthmatic attack of children was related with higher air pressure, lower temperature, lower relative humidity(r =0.435, -0.320, -0.296, all P ＜ 0.05).CONCLUSION: The incidence of asthma attack presents seasonal rhythm in Qingdao city and it is influenced by climate conditions. Therefore, enough consideration of meteorological factors should be paid on preventive works for asthma.

Analysis of Economic Factors on Prevention and Cure of Childhood Asthma in Qingdao Area / 中国慢性病预防与控制

Objective To probe into the medical cost and economic losses of childhood asthma. Methods Total 200 of asthmatic children aged 2~16 yrs were diagnosed according to asthma OPD and enrolled in this study from the Affiliated Hospital of Medical College of Qingdao University during 2005—2006. All of them were taken the epidemiologic and economic survey. Results Among them, 184 were from kindergartens, primary or middle schools. There were totally 7 629 days for the asthmatic children absent from class per year because of illness. The overall direct economic loss was RMB 798 467.00 and indirect loss was RMB 210 997.80 yearly. Conclusion Asthma not only brings about great impact on children physical and mental health, but also exerts massive economic loss on the society and families. The whole society and medical workers should pay more attention to it and try to reduce its harm to a relatively low level.

Influence of tripterygium polyglycosid (雷公藤) on airway inflammation and remodeling in rats with allergic asthma / 中国中西医结合急救杂志

Objective: To observe the effect of tripterygium polyglycosid(TP,雷公藤) on airway inflammation and remodeling in rats with asthma.Methods: Forty rats were randomly divided evenly into negative control group,positive control group,normal dose TP group(TPⅠ group) and small dose TP group(TPⅡgroup).The experimental model was induced by ovalbumin sensitization.Number of cells in bronchoalveolar lavage fluid(BALF) was observed by immunocytochemical staining.The expressions of nuclear factor-?B(NF-?B),matrix metalloproteinases-9(MMP-9) and tissue of inhibitor of metalloproteinases-1(TIMP-1) were detected by immunohistochemistry method.Results: Compared with the negative control group,the counts of lymphocyte,neutrophilic leukocyte,macrophage and eosinocyte in BALF were elevated significantly,positive cell percentages of NF-?B, MMP-9 and TIMP-1 in lung tissues increased greatly in positive control group,the differences being significant(all P

Therapeutic effects of Okam on asthmatic mice / 中国海洋药物

Objective To investigate the therapeutic effects and mechanism of Okam on asthmatic mice.Methods The mice model of asthma was established with the egg albumen sensitization, and were treated with low and large doses of Okam for four weeks.The pathological changes of lung tissues were observed.Immunohistochemistry was used to determine the contents of matrix metalloproteinases-9(MMP-9) and tissue inhibitor Metalloproteinase-1 (TIMP-1) in the lung tissues.Results Gasp and inflammation in the lung tissues were significantly relieved in the test groups than that in the model group.MMP-9,TIMP-1 and MMP- 9/TIMP-1 ratios were significantly lowered in the test group than that in the model group. Conclusion The marine drug of Okam shows therapeutic effects on mice with asthma,which may be the result of reduced contents of MMP-9 and TIMP-1 in the lung tissues and the correction of the imbalanced MMP-9/TIMP-1 ratio.Okam is likely to be a new choice for the treatment of asthma.