Case report of allergic bronchopulmonary aspergillosis with hemoptysis in a child with cystic fibrosis / 中华实用儿科临床杂志

The clinical data of a cystic fibrosis (CF) child with allergic bronchopulmonary aspergillosis (ABPA) and hemoptysis in the Department of Respiratory Disease Ⅰ, Beijing Children′s Hospital, Capital Medical University in May 2021 were retrospectively analyzed.Meanwhile, relevant literature was reviewed to analyze the clinical characteristics, diagnosis and treatment of CF patients with ABPA.This patient was a 15 years and 4 months old boy and complained of recurrent cough with sputum.The test showed increased blood eosinophils, total serum IgE higher than 500 IU/mL, positive aspergillus fumigatus specific IgE and IgG antibodies.Chest CT revealed central bronchiectasis and high-density mucus thrombus, and the patient was initially diagnosed with ABPA.Further examinations suggested the sweat chloride concentration was 89 mmol/L, and the genetic results showed a compound heterozygous mutation of CFTR (c.2909G>A from his father, c.3310G>T from his mother). Then, he was diagnosed with CF complicated with ABPA and treated with glucocorticoid and antifungal therapy.The disease was repeated after drug withdrawal.Due to hemoptysis, the right upper lobe lobectomy was performed.Unfortunately, ABPA occurred again 2 years later.The child is being followed up at present.CF is a rare monogenetic disease with poor prognosis.It is difficult to treat CF patients with ABPA and the disease repeats easily.Early identification and treatment will improve the prognosis.

Diagnosis and treatment of tracheobronchial tuberculosis in children / 中华实用儿科临床杂志

Tracheobronchial tuberculosis (TBTB) is a common type of pulmonary tuberculosis in children.Due to its insidious onset and non-specific presentation, the diagnosis is often delayed.Its pathogenesis is not completely clear.Bronchoscopy is a necessary tool for diagnosis and interventional treatment of TBTB.Tracheobronchial stenosis is one of the most common long-term sequela.In this article, the pathogenesis, diagnosis, bronchoscopy classification, drug and interventional therapy of TBTB in children are discussed, and current unresolved issues and future research directions are proposed.

Clinical study of tracheal stent in the treatment of congenital heart disease with airway obstruction in children / 中华胸心血管外科杂志

Objective To study the clinical effect of endotracheal stent implantation for treatment of congenital tracheal obstruction due to preoperative airway stenosis and postoperative dislocation difficulty .Methods 23 children with congenital heart disease complicated with severe tracheal stenosis were treated in our hospital from March 2015 to December 2017.The op-eration of congenital heart disease and airway stenting were performed .The preoperative diagnosis of the children was based on the bronchoscopy and CT airway reconstruction, and the patients were followed up for 1 to 24 months after the hospital was dis-charged.And every 1 to 3 month, the hospital was assessed by FFB.Results 20 children had good growth and development, and 21 of the 23 cases were removed by tracheal intubation to NCPAP within 1 weeks after the stent implantation , and they were transferred to the general ward within 2 weeks after the operation, and the hospital was discharged within 4 weeks after the oper-ation.1 children were discharged from hospital in 4 month after the operation ,because of severe lung infection.In 1 cases, the airway was blocked by recurrent granulation tissue and necrotic epithelium, the treatment was abandoned.22 cases of children were followed up by FFB.The stent was well epithelialization.13 out of 23 cases were successfully removed.Conclusion Tracheal intubation can not be performed in children with congenital heart disease due to airway stenosis before operation .After operation,with uncontrolled pulmonary infection and atelectasis, the children often failed to removing intubation.By FFB, the airway stent of implantation and removal are one of the effective treatment methods .However, there are still many complications and need to be strictly controlled .

Characteristics of airway lesions under bronchoscopy in children with protracted bacterial bronchitis / 中华实用儿科临床杂志

Protracted bacterial bronchitis (PBB) in children is associated with protracted bacterial infection of the respiratory airways.The lesions of airway mucosa and/or airway lumen that is helpful for the diagnosis and differential diagnosis of PBB can be observed directly via the bronchoscope.