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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.
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Objective:To explore the value of early pulmonary function tests in children with community acquired pneumonia(CAP)by analyzing the clinical and imaging manifestations and pulmonary function tests of children with CAP.Methods:The clinical data of children diagnosed with CAP and undergoing routine pulmonary ventilation tests within 24 hours of admission were retrospectively collected from January 2016 to June 2018 in the Department of Pediatric Respiratory Medicine of Shengjing Hospital Affiliated to China Medical University.The children′s pulmonary ventilation function test data were statistically analyzed with clinical manifestations, laboratory tests and imaging data.Results:A total of 154 children were included in the study, of which 54(35.06%)had normal pulmonary ventilation function, and the remaining 100 children(64.94%)had different degrees of pulmonary ventilation impairment, which were manifested as restrictive ventilation disorder in 54 cases(35.06%), obstructive ventilation disorder in 8 cases(5.19%), mixed ventilation disorder in 30 cases(19.48%), and small airway ventilation dysfunction in 8 cases(5.19%). According to the results of pulmonary ventilation function, the mixed ventilation dysfunction group had a greater probability of pulmonary imaging changes to consolidation than the normal group( χ2=7.83, P=0.007). Mycoplasma pneumoniae infection was negatively correlated with forced expiratory volume in the first second, 75% forced expiratory flow, one second rate and maximal mid-expiratory flow level( r=-0.23, r=-0.22, r=-0.25, r=-0.23, all P<0.05), and there was no significant correlation with the level of forced vital capacity. Conclusion:Early pulmonary ventilation test has important clinical significance in the diagnosis and treatment of CAP in children.
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Objective To explore the effect of grape seed proanthocyanidin extract(GSPE) on the proliferation of airway smooth muscle cells( ASMCs) induced by platelet-derived growth factor( PDGF) and the underlying molecular mechanism. Methods ASMCs of primary rat were cultured. MTT and flow cytom-etry were used to detect the cell proliferation activity and cell cycle distribution of ASMCs which were treated with PDGF and GSPE respectively. The expression levels of cyclin D1,extracellular regulated protein kinases ( ERK)1/2,p-ERK1/2 and β-actin protein in each group ASMCs were analyzed using western blotting assay after ERK1/2 inhibitor PD98059 intervention. Results Compared with control group,cell proliferative activ-ity,S phase fraction and the expression of cyclin D1 and p-ERK1/2 protein increased in PDGF induced group (P<0. 05). These effects induced by PDGF could be reversed by GSPE. PD98059 also could block PDGF induced higher expression of p-ERK1/2 and cyclin D1 proteins in rat ASMCs. Conclusion GSPE can inhib-it PDGF induced cell proliferation and via ERK1/2 signaling pathway in rat ASMCs,which provide a new way for treatment of bronchial asthma.
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Wheezing is one of the characteristic symptoms of asthma.But non-asthmatic preschool children may also experience repeated wheezing.Asthma diagnosis is difficult.Preschool children are not cooperative enough to participate in spiromet~ and invasive tests.Thus,searching for biological markers that can help diagnose and evaluate asthma in preschool children has been a hot research topic.We reviewed studies on biomarkers for diagnosis and assessment of asthma in preschool children.
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Objective: To investigate the regulatory effect of epigallocatechin-3-gallate (EGCG) on the immune imbalance of regulatory T lymphocytes/helper T lymphocytes 17 (Treg/Th17) in the mice with obese asthma, and to provide the basis for the treatment of obese asthma by EGCG. Methods: A total of 40 C57BL/6J mice were randomly divided into normal control group (fed with chow diet), obese group (fed with high fat diet), obese asthma group [fed with high fat diet and sensitized and challenged with ovalbumin (ova)], EGCG intervention group (20 mg middot; kg-1 EGCG was administered intraperitoneally 1 h before challenge of OVA) and dexamethasone intervention group (2 mg middot; kg-1 dexamethasone was administered intraperitoneally 1 h before challenge of OVA), and there were 8 mice in each group. The edhanced pause (Penh) values of the mice in various groups were measured with non-invasive lung function instrument; the pathomorphology of lung tissue of the mice in various groups were observed by HE staining, and the inflammation scores were evaluated by semi-quantitative method for HE staining section; the levels of interleukin-10 (IL-10) and interleukin-17A (IL-17A) in bronchoalveolar lavage fluid (BALF) and adiponectin and leptin in serum of the mice in various groups were detected by ELISA method, and the percentages of Treg and Th17 in spleen tissue of the mice in various groups were detected by flow cytometery. Results: Compared with normal control group, the body weight of the mice in obese group was increased (P<0. 05); it was 1. 67 times the average weight of the mice in normal control group. Compared with normal control group, the Penh value and inflammation score of the mice in obese asthma group were increased (P< 0. 05); the leptin level in serum of the mice in obese asthma group was increased (P<0. 05); the IL-17 level in BALF of the mice in obese asthma group was increased (P<0. 05) and IL-10 level in BALF of the mice in obese asthma group was decreased (P<0. 05); the percentage of Th17 in spleen tissue of the mice in obese asthma group was increased (P<0.05) and the percentage of Treg in spleen tissue of the mice in obese asthma group was decreased (P<0. 05). Compared with obese asthma group, the Penh value and inflammation score of the mice in EGCG intervention group were decreased (P<0. 05); the leptin level in serum of the mice in EGCG intervention group was decreased (P<0. 05); the IL-17 level in BALF of the mice in EGCG intervention group was decreased (P<0. 05) and IL-10 level in BALF of the mice in EGCG intervention group was increased (P<0. 05); the percentage of Th17 in spleen tissue of the mice in EGCG intervention group was decreased (P<0. 05) and the percentage of Treg in spleen tissue of the mice in EGCG intervention group was increased (P < 0. 05). Conclusion: Treg/Th17 immune imbalance exists in the mice with obese asthma. EGCG could inhibit the airway inflammation and hyperresponsiveness in the mice with obese asthma and improve the Treg/Th17 immune imbalance.
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Objective: To investigate the expressions of phosphorylated extracellular signal-regulated kinase (pERK) in the hippocampus of the mice of embryonic (E) 18 d and postnatal (P) 1, 3, 7, 14, 21 and 28 d, and to discuss its possible role during the hippocampus development of the mice. Methods: The hippocampus tissues of the mice of E 18 d, P 1 d, P 3 d, P 7 d, P 14 d, P 21 d and P 28 d were obtained. Each time point was used as observation group. Immunohistochemistry, Western blotting and image analysis technique were used to analyze the expression levels of pERK protein in hippocampus tissue at each time point. Results: The immunohistochemistry results revealed that pERK protein mainly expressed in the nucleus of the nerve cells in the granular layer of dentate gyrus and pyramidal layer of Ammon' s horn in hippocampus. In the mice of E 18 d, the expression of pERK in DG and CA regions of hippocampus were slightly stained and arranged sparsely, and the expression level was low; and the pERK was deeply stained and the expression levels of pERK were increased gradually with the development of the hippocampus from E 18d to P 7 d; compared with other six time points, the expression level of pERK of the mice of P 7 d was the highest (F=34. 537, P0.05). The Western blotting results showed that pERK expressed at each time point, from E18 d to P7 d, the expression levels of pERK were increased gradually; compared with other six time points, the expression level of pERK on P 7 d was the highest (F = 33.856, P0.05). Conclusion: The hippocampus development is increased significantly at the early stage of the mice (E18 - P 7 d), and the expression levels of pERK are increased gradually in the meanwhile; the expression level peaks on P 7 d, and then it is gradually decreased until a stable level. pERK may take part in the cell proliferation in the development of hippocampus of the mice.
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Objective Allergic asthma is a chronic inflammatory disease of the airways.T lymphocytes play important roles in the pathogenesis of asthma.The voltage-gated Kvl.3 potassium channel may be a key factor in the activation of T lymphocytes.This research aims to detect the function of Kvl.3 channel in the neutrophlial asthma(NA) model and eosinophilic asthma(EA) model.Methods A total of 24 mice were randomly assigned into three groups:control,neutrophilic asthma model and eosinophilic asthma group.Neutrophilic asthma model was established with ovalbumin (OVA)and lipopolysaccharide(LPS);eosinophilic asthma was established with OVA and Al(OH)3;airway responsiveness of mice in each group was measured with a noninvasive pulmonary function instrument;lung inflammation changes were observed by pathological HE staining;IL-17A and IL-4 cytokines levels in bronchoalveolar lavage fluid were evaluated by ELISA;Kvl.3 channel protein level in lung was evaluated by western blot;the change of current density in CD4 +.T lymphocytes were tested by whole-cell patch clamp technique.Results Levels of IL-17A and IL-4 in bronchoalveolar lavage fluid increased in both NA and EA model (P ＜ 0.05).Compare with EA model,the IL-17A level was significantly higer in NA model,while the IL-4 level was significantly lower.In NA and EA model,kv1.3 protein expression in lung tissue was significantly higher than that in the control group(P ＜ 0.05),and kv1.3 protein expression in NA model was significantly higer than that in the EA model (P ＜ 0.05).Current intensity and current density of kv1.3 channel increased in both NA and EA model.While the current intensity and current density of kv1.3 channel were significantly higher in NA model than that in EA model.Conclusion Kv1.3 protein level,Kv1.3 channel current intensity and kv1.3 channel current density increased in both NA and EA model,especially in NA group,providing a new way for treatment of bronchial asthma.
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Flavonoids are polyphenolic plant secondary metabolites, which ubiquitously present in our daily diet.Flavonoids have been found to have several biological effects, that is, antioxidant, anti-inflammatory,anti-allergic and immune-modulating properties.Because of the safety and strong biological effects of flavonoids,it has been widely concemed about the prevention and treatment of asthma.This review focuses on the effects and mechanism of flavonoids in the prevention and treatment of asthma.
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Objective To explore effect of grape seed proanthocyanidin extract (GSPE)on airway inflammation and hyperresponsiveness of ovalbumin-induced murine asthma model and the associated regulatory effect on Treg/Th17 imbalance.Methods A total of 40 mice were randomly assigned to four experimental groups:control,asthma model,low dose GSPE (40 mg/kg),and high dose GSPE (80 mg/kg).Acute asthma model was established with OVA;airway responsiveness of mice in each group was measured with a noninvasive pulmonary function instrument;lung inflammation changes were observed by pathological HE staining;Treg/Th17 cytokines levels in bronchoalveolar lavage fluid were evaluated by ELISA;the expressions of forkhead/winged helix transcription factor(Foxp3) mRNA and retinoid-related orphan receptor gammat (RORγt) mRNA in lung tissue of each group were gained by Real-time PCR method.Results GSPE inhibited ovalbumin-induced increases in airway responsiveness(P ＜ 0.05).Histological studies demonstrated that GSPE substantially inhibited OVA-induced airway inflammation in lung tissue.GSPE decreased IL-17A levels and increased IL-10 levels in bronchoalveolar lavage fluid (P ＜ 0.05).In the asthma model group,RORγt mRNA expression in lung tissue was significantly higher than that in the control group(P ＜ 0.05)and Foxp3 mRNA expression was significantly lower than that in the control group (P ＜ 0.05).In the GSPE group,RORγt mRNA expression was lower than that in asthma model group (P ＜ 0.05),however the Foxp3 mRNA expression was higher than that in asthma model group(P ＜ 0.05).Conclusion GSPE could alleviate airway hyperresponsiveness and airway inflammation of in asthmatic mice.It can modify the asthmatic mice Treg/Th17 imbalance by decreasing IL-17A and increasing IL-10 concentration at the level of cytokines;and also by increasing Foxp3 mRNA expression and inhibiting the expression of RORγt mRNA at the transcriptional level,which provide a new way for treatment of bronchial asthma.
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Objective To investigate the advantages of pediatric electronic fiber bronchoscope ( FBO) in the infant bronchial foreign body,discuss the clinical features of infant bronchial foreign body,lung imaging characteristics and the kinds of microscopically position,the change of airway mucosa after stimulation by for-eign body under local anesthesia in 30 cases of infant bronchial foreign body. Methods Thirty cases,aged 0 to 3 years,were collected from September to December,2014. All of them were with foreign bodies examined by FBO in pediatric bronchoscopy room in Shengjing Hospital of China Medical University. Results In all infants, 6 cases (20. 0%) without history of inhaled foreign bodies and 24 cases (80. 0%) with a record history of in-haled. In the aspects of signs:normal breath sounds with a history of no choking cough in children were 2 cases (6. 7%) ,wheezing sounds were 3 patients (10. 0%) and weakened side breath sound was 1 case (3. 3%);with a history of choking cough in children,6 cases(20. 0%) with normal breath sounds,12 cases(40. 0%) with wheez-ing,6 cases(20. 0%) with lateral breath sounds less. Lung imaging characteristics was lack of specific perform-ance:only a case of all(n=30)show foreign body directly. Otherwise,other 29 cases had no specificity. Lung em-physema in 13 cases (43. 3%) is the main characteristic,while normal imaging findings in 2 cases (6. 7%). For-eign bodies in 19 cases were in the left lung (63. 4%) and 21 cases(70. 0%) of foreign body stimulated granula-tion inside airway,necrosis sputum bolt in distal obstruction of airway occured in 5 cases (16. 7%). Inhalled time of foreign body in airway was 4. 5 [2. 8,12. 5] day and inhalled time of foreign body in airway correlation coefficient with granulation hyperplasia(r=0. 688,P=0. 000),there was a significant correlation. Main adverse reaction was low oxygen in 6 cases (16. 7%). Conclusion The diagnostic accuracy of FBO under local anesthesia on children is high-er than other methods,and the FBO bronchial foreign bodies under local anesthesia is a safe and effective method.
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<p><b>OBJECTIVE</b>To investigate the changes in whole brain gray matter volume in patients with trigeminal neuralgia using voxel-based morphometry (VBM).</p><p><b>METHODS</b>Twenty-eight patients with trigeminal neuralgia and 28 healthy controls underwent magnetic resonance imaging with a Philips 1.5T MRI scanner. VBM was used to compare the structural differences in the whole brain gray matter between the two groups based on the DARTEL after data preprocessing with SPM8 software package.</p><p><b>RESULTS</b>Compared with the healthy controls, the patients with trigeminal neuralgia presented with decreased gray matter volume in several brain regions including the bilateral middle temporal gyrus, bilateral superior/middle frontal gyrus, left pre-/post-central gyrus, right fusiform and anterior cingulate gyrus.</p><p><b>CONCLUSIONS</b>Patients with trigeminal neuralgia had abnormal gray matter volume in some brain regions associated with perception and processing of pain sensation. These changes may provide clues for further exploration of the neuropathogenic basis of trigeminal neuralgia.</p>
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Humans , Brain Mapping , Case-Control Studies , Frontal Lobe , Pathology , Gray Matter , Pathology , Magnetic Resonance Imaging , Temporal Lobe , Pathology , Trigeminal Neuralgia , PathologyABSTRACT
Passive smoking causes significant adverse effects on the origins and progress of childhood asthma. Passive smoking may lead to an increased risk for the development of new cases of asthma in child. For the children who have already established asthma, passive smoking has great impact on asthma control, including increasing asthma symptoms, inducing exacerbations, decreasing quality of life and responsiveness to therapy drugs. The related mechanisms by which passive smoking makes induction of asthma and worsening of established asthma are still in exploration. The presented mechanisms have been postulated are impaired immune responses,impaired lung development, bronchial hyperreactivity, and genetic predisposition.