Clinical analysis of 16 cases of invasive pulmonary aspergillosis in children / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the diagnosis and treatment of invasive pulmonary aspergillosis (IPA) in children.</p><p><b>METHOD</b>The clinical data of 16 cases of proven or probable IPA who had been in our Hospital from January 2006 to June 2014 were retrospectively analyzed.</p><p><b>RESULT</b>Among the 16 patients, 11 were males and 5 were females. One child had proven IPA and 15 children had probable IPA. Host risk included long duration use of multiple broad-spectrum antibiotics in 16 cases, neutropenia in 9 cases, invasive mechanical ventilation in 3 cases, primary immunodeficiency disease in 2 cases, long-term use of glucocorticoids in 2 cases, measles in 2 cases, and congenital pulmonary hypoplasia in 1 case. Fever, cough and expectoration were present in all the children with IPA. At the time of diagnosis, the halo sign and subpleural wedge consolidation shadows were more common in neutropenia group (5/9, 7/9) than those in non-neutropenia group(0/7, 1/7)(P<0.05). The cavities and"air-crescent sign"were more common after 15 days to 1 month when the children had been treated with anti-aspergillosis drugs than that at the onset of diagnosis of IPA (P<0.05). The positive rate of serum galactomannan (GM) test was higher than that of sputum culture and serum G test (P<0.05). Thirteen children received voriconazole, in 7 of the children the treatment was effective.</p><p><b>CONCLUSION</b>Neutropenia were the common host risk factors in children with IPA. Subpleural wedge consolidation shadows, the halo sign and the"air-crescent"sign were highly suggestive of the diagnosis of IPA in children. Subpleural wedge consolidation shadows and the halo sign were more common in neutropenia group than in non-neutropenia group in the early stage of the course. Serum GM test played an important role in the diagnosis of IPA in children. Voriconazole was effective in majority of the children with IPA.</p>

Effect of inhibiting the phosphorylation of signal transducer and activator of transcription-3 on Th2 cell-mediated airway inflammation and airway remodeling in a mouse model of asthma / 中华实用儿科临床杂志

Objective To study the effect of inhibiting the phosphorylation of signal transducer and activator of transcription-3 (STAT3) on Th2 cell-mediated airway inflammation and airway remodeling,and to explore the role of STAT3 in the pathophysiology of bronchial asthma.Methods Forty Balb/c mice were randomly divided into control group(n =10),asthma group(n =10),AG490 by intraperitoneal group (n =10),and AG490 by inhalation group (n =10).The mice were sensitized with ovalbumin to establish the asthmatic model.The histological changes were evaluated by means of HE staining,while total broalchial wall thickness(Wat) and smooth muscle thickness(Wam) were measured by using image analysis system.The percentages of collagen deposition were detected by way of Masson's trichrome staining; the bronchoalveolar lavage fluid (BALF) were collected,the total cell and the cell differentials were counted,the levels of IL-4,IL-5 in BALF were measured by enzyme-linked immunosorbent assay; the lung tissue extracts were analyzed for phosphorylation of STAT3 (p-STAT3) by Western blot.The SPSS 13.0 software was used to analyze the data.Results 1.The histological changes by HE staining showed that less inflammatory cells infiltration in airway and around the pulmonary vascular in AG490 administration groups compared with asthmatic group.Wat,Wam and the percentages of collagen deposition in AG490 administration groups was significantly lower than that in asthmatic group(F =49.5,41.7,58.2,all P ＜ 0.05).2.The level of p-STAT3 in the lung of AG490 administration groups were significantly lower than those in asthmatic group(F =34.17,P ＜ 0.05).3.The total cells and eosinophils amounts in BALF of AG490 administration groups were significantly lower than those in asthmatic group (F =42.5,64.7,all P ＜ 0.05).The levels of IL-4,IL-5 in BALF of AG490 administration groups were significantly lower than those in asthmatic group,respectively (F =39.2,75.1,all P ＜ 0.05).Conclusions STAT3 signaling pathway is pivotal in Th2 cell-mediated airway inflammation and airway remodeling in asthmatic models,and AG490 can ameliorate airway inflammation and airway remodeling efficiently by inhibiting the phosphorylation of STAT3,and targeting this signaling pathway may be a novel therapy for asthma.