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Objective:To analyze the difference of clinical characteristics and outcomes of infants with moderate and severe pediatric acute respiratory distress syndrome(PARDS)diagnosed according to baseline oxygenation index(OI) in pediatric intensive care unit(PICU).Methods:Second analysis of the data collected from the "Efficacy of pulmonary surfactant (PS) in the treatment of children with moderate and severe ARDS" program.Retrospectively compare of the differences in clinical data such as general condition, underlying diseases, OI, mechanical ventilation, PS administration and outcomes among infants with moderate and severe PARDS divided by baseline OI who admitted to PICUs at 14 participating tertiary hospitals from 2016 to December 2021.Results:Among the 101 cases, 55 cases (54.5%) were moderate and 46 cases (45.5%) were severe PARDS.The proportion of male in the severe group (50.0% vs.72.7%, P=0.019) and the pediatric critical illness score(PCIS)[72 (68, 78) vs.76 (70, 80), P=0.019] were significantly lower than those in the moderate group, while there was no significant difference regarding age, body weight, etiology of PARDS and underlying diseases.The utilization rate of high-frequency ventilator in the severe group was significantly higher than that in the moderate group (34.8% vs.10.9%, P=0.004), but there was no significant difference in PS use, fluid load and pulmonary complications.The 24 h OI improvement (0.26±0.33 vs.0.04±0.34, P=0.001) and the 72 h OI improvement[0.34 (-0.04, 0.62) vs.0.15 (-0.14, 0.42), P=0.029)]in the severe group were significantly better than those in the moderate group, but there was no significant difference regarding mortality, length of hospital stay and intubation duration after diagnosis of PARDS between the two groups. Conclusion:In moderate and severe(divided by baseline OI) PARDS infants with invasive mechanical ventilation, children in severe group have better oxygenation improvement in the early stage after PARDS identified and are more likely to receive high frequency ventilation compared to those in moderate group.Baseline OI can not sensitively distinguish the outcomes and is not an ideal index for PARDS grading of this kind of patient.
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Objective@#To detect the single nucleotide polymorphism (SNP) at locus 1 165 of β1-adrenoceptor (β1-AR) and to investigate the association between the SNP and the infection by enterovirus A71(EV-A71).@*Methods@#Polymerase chain reaction (PCR) amplification technique was used to detect the SNP at locus 1 165 of β1-AR between hand, foot and mouth disease (HFMD) and healthy controls by sanger sequencing method .@*Results@#There was a G1165C SNP and three kinds of genotypes (GG, GC, CC) in β1-AR gene in the 77 cases of EV-A71 HFMD patients and 66 cases of healthy controls. For HFMD patients, frequencies of GG, GC and CC genotypes of the G1165C locus were 10%, 47% and 43%, respectively, and alleles frequency of G and C were 34% and 66%, respectively. But in healthy children, GG, GC, CC genotype frequencies were 7%, 41% and 52%, respectively, and G and C allele frequencies were 28% and 72% respectively. Chi-square analysis showed that there were no significant differences in distribution of genotypes (χ2=1.154, df=2, P=0.562) and alleles frequency (χ2=1.091, df=2, P=0.296) between the EV-A71-infected group and the healthy control group. Between mild and severe EV-A71-infected group, there were no significant differences in distribution of genotypes (χ2=3.945, df=2, P=0.139) and alleles frequency (χ2=3.763, df=2, P=0.052).@*Conclusions@#The 1 165 SNP in the coding region of β1-AR was not associated with EV-A71 infection and its severity.
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Objective To analyze the epidemiological characteristics of Mycoplasma pneumoniae(MP)infection in children with acute respiratory tract infection in Haikou area and surrounding area to provide a scientific evidence for the prevention and treatment of MP infection in children.Methods A total of 1 699 children inpatients with acute respiratory tract infection in our hospital from 1 January to 1 December,2014 were collected.The serum MP antibody was detected.The MP infection status of different sites,genders,ages and months was retrospectively analyzed.Results Among 1 699 children patients with acute respiratory tract infection,the total positive rate of MP infection was 17.60％,in which male was 15.73％ and female was 21.59％,the positive rate of female was higher than that of male with statistical difference(P＜0.01).The lower respiratory infection rate was 18.75％ and upper respiratory tract infection was 13.70％,the difference was statistically significant(P＜0.05).The MP infection rates was common in children aged >1-4 years old,in which children aged >3-4 years old had the highest infection rate.MP infection was sporadic in the whole year and was highly epidemic in March and April.Conclusion MP was an important pathogen of acute respiratory tract infection for children in Haikou during 2014,and its epidemic characteristics were manifested by higher incidence in female than that in male.Children aged within 4 years old are a high onset group and MP infection occurs all year round,March and April are the relatively high onset period of MP infecting.