Detection of viral pathogens and allergens in infants and young children at high risk of asthma during a wheezing episode / 中国当代儿科杂志

OBJECTIVE@#To investigate the viral etiology and allergen distribution in infants and young children at high risk of asthma during a wheezing episode.@*METHODS@#A total of 135 infants and young children at high risk of asthma were enrolled who were admitted due to asthmatic bronchitis or asthmatic bronchopneumonia between April 2016 and August 2017. Fluorescent probe PCR was used to measure influenza A (Flu A), respiratory syncytium virus (RSV), adenovirus (ADV), parainfluenza virus (PinF), human rhinovirus (HRV), human partial lung virus (hMPV) and human bocavirus (HBoV) in nasopharyngeal aspirates. ImmunoCAP was used to measure inhaled allergens, food allergens, and total IgE concentration.@*RESULTS@#Among the 135 patients, the overall virus detection rate of nasopharyngeal aspirates was 49.6%, and HRV had the highest detection rate of 25.2%, followed by HBoV (9.6%), RSV (8.1%), PinF (5.9%), Flu-A (3.7%), ADV (1.5%) and hMPV (0.7%). The 1-3 years group had a significantly higher detection rate of HRV than the <1 year group (P<0.05). The positive rate of allergen screening was 59.3%, with 44% for inhaled allergens and 89% for food allergens. Among the inhaled allergens, dust mites had the highest positive rate of 77%, followed by mould (37%), pollen (26%) and animal dander (9%). Among the food allergens, egg white had a positive rate of 73% and milk had a positive rate of 68%. The <1 year group had a significantly higher positive rate of inhaled allergens than the 1-3 years group (P<0.05). The 1-3 years age group had a significantly higher level of T-IgE than the <1 year group (P<0.05). The positive virus group had a significantly higher positive rate of inhaled allergens than the non-virus group (P<0.05). The children with the second wheezing episode had significantly higher positive rates of inhaled allergens and food allergens and level of T-IgE than those with the first wheezing episode (P<0.05). The children with the second wheezing episode also had significantly higher positive rates of dust mites and mould than those with the first wheezing episode (P<0.05).@*CONCLUSIONS@#Early HRV infection and inhaled allergen sensitization are closely associated with the development of wheezing in infants and young children at high risk of asthma.

Analysis of skin prick test results in children with bronchial asthma and allergic rhinitis in Children's Hospital of Soochow University / 中国实用儿科杂志

OBJECTIVE: To use skin prick test to understand the main allergens in patients with bronchial asthma and allergic rhinitis,and to provide important evidence for its prevention,diagnosis and treatment. METHODS: A total of 2252 patients diagnosed with bronchial asthma or allergic rhinitis between August 2015 and July 2017 in the outpatient department of Children's Hospital Affiliated to Suzhou University were tested for allergens by skin prick test,and sex and disease types were analyzed by SPSS 21.0. RESULTS: The skin prick test was performed in 2252 patients,1390 cases were positive,and the positive rate was 61.7%;the ratio of male to female was 1.75∶1;the positive rate in boys was(925/1433,64.5%)higher than that of girls(465/819,56.8%)(P<0.05). The positive rate in children with bronchial asthma was 65.3%(607/929),the positive rate in allergic rhinitis was 58.8%(664/1129),and the positive rate in bronchial asthma combined with allergic rhinitis was 61.3%(119/194). The positive rate of bronchial asthma group was higher than that of allergic rhinitis group(P<0.05). Dust mites(60.3%)and house dust mites(43.4%)were most common,followed by grass pollen and cat hair. CONCLUSION: The most common allergens in children with bronchial asthma and allergic rhinitis in Suzhou Children's Hospital are mites;skin prick test provides a basis for the diagnosis of allergic diseases.

Epidemiological analysis of 440 cases of respiratory adenovirus infections in children from the Suzhou area between 2006 and 2015 / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the epidemiological characteristics of respiratory adenovirus (ADV) infections in children from the Suzhou area, China.</p><p><b>METHODS</b>The clinical data of ADV-positive children out of 35 529 children with respiratory tract infections who were hospitalized in the Children's Hospital of Soochow University between January 2006 and December 2015 were retrospectively studied.</p><p><b>RESULTS</b>Of the 35 529 children with respiratory tract infections, 440 (1.24%) were ADV-positive. There was no significant difference in the rate of ADV infections between boys and girls (1.18% vs 1.34%). The ADV infection rates of children at the age of <1 year old, 1-3 years old, 3-7 years old and 7-14 years old were 0.39% (71/18 002), 1.12% (103/9 191), 3.14% (201/6 398), and 3.35%( 65/1 938) respectively and the rate increased with age (P<0.01). The ADV infection rates in spring [1.85%(60/8 658)] and summer [2.20%(189/8 606)] were significantly higher than in autumn [0.30%(27/8 952)] and winter [0.69%(64/9 313)] (P<0.01).</p><p><b>CONCLUSIONS</b>The ADV infection rate is increased with age in the children from the Suzhou area, but it is not associated with gender. ADV infections are more common in spring and summer.</p>

Clinical significance of MP-DNA from endotracheal aspirates in diagnosis of Mycoplasma pneumoniae pneumonia in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To compare the detection rates of Mycoplasma pneumoniae (MP) from nasopharyngeal aspirates (NPA) and bronchoalveolar lavage fluid (BALF) in children with pneumonia.</p><p><b>METHODS</b>A total of 164 hospitalized children with pneumonia were enrolled. NPA and BALF of these children were collected within 24 hours of admission, and MP-DNA was detected by fluorescence quantitative PCR. Venous blood samples of all these children were collected within 24 hours of admission and on days 7-10 of treatment, and serum MP-IgM was detected using ELISA.</p><p><b>RESULTS</b>The positive rate of MP-DNA in NAP of the 164 cases was 51.8% , which was lower than 63.4% as the detection rate of MP-IgM in serum (P=0.044), and the two detection rates were moderately consistent with each other (Kappa=0.618, P<0.01). The positive rate of MP in BALF was 71.3%, which was not significantly different with that of MP-IgM in serum (P>0.05), and the detection rates were well consistent (Kappa=0.793, P<0.01). The detection rate of MP in NPA was lower than that in BALF (P<0.01), with moderate consistency between two of them (Kappa=0.529, P<0.01). The median MP copy number in BALF was significantly higher than that in NPA (P<0.01). The MP detection rates in NPA and BALF were significantly different among different courses of disease (P<0.05). As the course of disease extended, the MP detection rates in both NPA and BALF showed a declining trend; children with MP pneumonia of 1-2 weeks' duration and 2-4 weeks' duration had a higher MP-DNA detection rate in BALF than in NPA (P<0.05).</p><p><b>CONCLUSIONS</b>MP-DNA in BALF has a high sensitivity, with a great significance for early diagnosis of MP pneumonia, while NPA MP-DNA tests may lead to a missed diagnosis.</p>

Risk factors of asthma among children aged 0 - 14 in Suzhou city / 中华预防医学杂志

<p><b>OBJECTIVE</b>This study aimed to investigate risk influencing factors of asthma for children in Suzhou City, China.</p><p><b>METHODS</b>A survey of asthma was conducted on children aged 0 - 14 with or without asthma from September 2010 to April 2011 in Pingjiang district of Suzhou city. A total of 271 children diagnosed with asthma were considered as a case group, and 271 non-asthmatic children with the same age, sex and living region formed the control group. Risk factors were analyzed with χ(2) test and logistic regression analysis.</p><p><b>RESULTS</b>All children were Han. The case group was composed of 165 boys and 106 girls, so was the case group. The average age was (7.5 ± 2.3) years for the case group and (7.8 ± 2.9) years for the control group, which did not showed any significant difference (P > 0.05). Family history of allergy (OR = 10.624, 95%CI: 6.294 - 18.623), history of children's eczema (OR = 4.403, 95%CI: 8.627 - 29.632), history of allergic rhinitis (OR = 6.871, 95%CI: 7.658 - 31.871), passive smoking when baby was born (OR = 3.323, 95%CI: 3.541 - 11.634), mold contamination (OR = 1.837, 95%CI: 1.531 - 4.926) were the risk factors, and breast-feeding (OR = 0.513, 95%CI: 0.418 - 0.914) was the protective factor.</p><p><b>CONCLUSION</b>Family history of allergy, history of children's eczema, history of allergic rhinitis, passive smoking, and old contamination are the risk factors, and breast-feeding is the protective factor.</p>

SOX40L: an important inflammatory mediator in adult bronchial asthma

<p><b>INTRODUCTION</b>The role of soluble OX40 ligand (sOX40L) in adult bronchial asthma is unclear. This study aims to determine the serum concentrations of sOX40L in adult patients with bronchial asthma, and discussed its relationship with pulmonary function.</p><p><b>MATERIALS AND METHODS</b>We measured the pulmonary function using the spirometer and detected the serum concentrations of sOX40L by enzyme linked immunosorbent assay (ELISA) in 19 healthy persons in the control group, 58 acute asthmatic adult patients who were grouped according to their disease severity: 18 mild grade, 24 moderate grade, 16 severe grade, and 24 persons in a stable asthmatic group.</p><p><b>RESULTS</b>The serum concentrations of sOX40L in asthmatic adult patients (6.80 ± 4.95 ng/L) were distinctly higher than those in the control group (3.98 ± 2.83 ng/L, P <0.05), and they were negatively correlated with pulmonary function indexes (FEV1%, FVC%, FEV1/FVC) (r = -0.754, P <0.01, r = -0.557, P <0.01, r = -0.457, P <0.01, respectively). Moreover, the serum concentrations of sOX40L showed obvious differences among control, mild, moderate, and severe groups (3.98 ± 2.83, 4.87 ± 1.89, 6.97 ± 5.91, 8.71 ± 5.18 ng/L, respectively; P <0.01). The concentrations of sOX40L decreased to the same extent as the control group after therapeutic treatments were provided to the asthmatic adult patients.</p><p><b>CONCLUSION</b>The concentrations of sOX40L were found to be high in adult asthmatic patients and were associated with the severity of the disease. Therefore, sOX40L could be a potential inflammatory mediator in the pathogenesis of asthma.</p>

Influence of Inhaled Corticosteroids on Airway Transforming Growth Factor - ?1 Expression of Asthmatic Remodeling Model / 实用儿科临床杂志

Objective To investigate the role of inhaled corticosteroids (ICS) on transforming growth factor - ?1 (TGF - ?1 )of asthmatic remodeling model Methods One hundred and eight guinea pigs were divided into 3 groups randomly and equally: asthmatic group( A), therapeutic group(B), control group(C) Three groups were treated by ovalbumin, budesonide, normal saline respectively The lung tissue specimens were collected after the guinea pigs were killed; the expression of TGF- ?1 was determined Results The expressions of TGF-?1 in A, K and C groups were(41 83 ? 10. 45) %, (27. 22 ? 8. 09)% , (15. 36 ? 2. 64)% respectively at 12 weeks. It was statistically significant( P