Correlation study of cough variant asthma and mycoplasma pneumonia infection in children

Cough variant asthma [CVA], as one of bronchitis diseases, features with repeated cough. In clinics, CAV does not show significant abnormal signs, therefore antibiotic therapy can hardly achieve satisfactory treatment effect. With the development of scientific technologies, the correlation between mycoplasma pneumoniae infection and CVA has become a hot research topic in clinics. In clinics, mycoplasma pneumoniae is extensively regarded as major cause for CVA, with complex pathogenic mechanism. The symptoms of CVA is characterized by chronic non abnormal inflammation, normally accompanied with bronchospasm and intestinal infection. Clinical practices show that about 6% of CVA children mainly show continuous cough till midnight during onset period, which is easily to misdiagnosed as bronchitis. Mycoplasma pneumoniae infection is a common disease threatening Children's health in China. With the annual increase of incidence of infantile pneumonia in China, mycoplasma pneumoniae infection has become a major reason leading to the death of child in China. More such mycoplasma pneumoniae infection is a sporadic disease spreading in a small range, and can onset in four seasons, making great impact on living quality and health of children. On this basis, this paper analyzes the correlation between Children's CVA and mycoplasma pneumoniae infection, in the hope of providing valuable reference for clinical treatment

Prognosis and weaning of elderly multiple organ dysfunction syndrome patients with invasive mechanical ventilation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Elderly multiple organ dysfunction syndrome (MODS) patients receiving invasive mechanical ventilation have poor prognosis in intensive care units (ICUs). We studied the usefulness of four commonly used severity scores and extrapulmonary factors that affected weaning to predict outcome of such patients.</p><p><b>METHODS</b>Clinical data of 197 patients on admission to ICUs (from January 2009 to June 2012) were used retrospectively. The Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE III, Sample Acute Physiological Score (SAPS) II and MODS scores were calculated. All the patients were grouped into survivors and nonsurvivors according to the prognosis. Patients, who weaned from ventilator (n = 154), were subdivided into a successful weaning group and a failed weaning group. The receiver operating characteristic (ROC) curves and Logistic regression was used for prognostic and weaning assessment.</p><p><b>RESULTS</b>Based on the outcomes, the areas under the ROC of APACHE II, APACHE III, SAPS II, and MODS were 0.837, 0.833, 0.824, and 0.837, respectively. The Logistic regression analysis revealed that the odds ratio (OR) of underlying lung diseases, serum albumin and creatinine, and the number of organ failures was 2.374, 0.920, 1.003, and 1.547. APACHE II scores on admission performed excellent (ROC: 0.921) on the weaning assessments.</p><p><b>CONCLUSIONS</b>APACHE II and MODS systems were marginally better for evaluating the prognosis of elderly MODS patients who received invasive mechanical ventilation. Underlying lung diseases, serum albumin, serum creatinine and the number of organ failures were independent prognostic factors. Using the APACHE II scores on admission before weaning may increase the likelihood of successful weaning. (ClinicalTrial.gov identifier NCT01802983).</p>

Heliox as a driving gas to atomize inhaled drugs on acute exacerbation of chronic obstructive pulmonary disease: a prospective clinical study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common condition, which affects not only the quality of life of patients but also their prognosis. The purpose of this study was to explore the effects of an inhaled salbutamol sulfate solution and an inhalation suspension of the glucocorticoid budesonide that were atomized with heliox to treat patients with AECOPD.</p><p><b>METHODS</b>Twenty-three patients with AECOPD were divided into a treatment group (He/O2 = 70%/30%) and a control group (N2/O2 = 70%/30%). The salbutamol sulfate and budesonide were administered by inhalation twice a day for 7 days. Vital signs, arterial blood gas levels, pulmonary function and the levels of serum myostatin (sMSTN) were measured and lung vibration imaging was performed.</p><p><b>RESULTS</b>We found that the PaO2 and PaCO2 values were not significantly different between the two groups at the various time points (P > 0.05). There were also no significant differences in any of the parameters of pulmonary function between the two groups. However, after baseline correction, the increase rate of the forced expiratory volume in one second (FEV1), the forced vital capacity (FVC), and the maximum minute ventilation (MVV) appeared to be significantly increased at some time points compared with the baseline (before treatment) in both groups (P < 0.05). Although the values of quantitative lung distribution (QLD) for different regions and the levels of sMSTN were slightly different between the two groups, the repeated measures analysis of variance (ANOVA) revealed that there were no significant differences between the two groups or within any group (P > 0.05).</p><p><b>CONCLUSION</b>Although the use of heliox as a driving gas can improve symptoms and benefit patients with AECOPD, the heliox treatment group did not have significant differences in arterial blood gases, lung function, lung vibration response imaging or the levels of sMSTN compared with the control group. (Chinese Clinical Trial Register Center ChiCTRTRC-00000273).</p>