Value of sTREM-1 in serum and bronchoalveolar lavage fluid, APACHE II score, and SOFA score in evaluating the conditions and prognosis of children with severe pneumonia / 中国当代儿科杂志

OBJECTIVE@#To study the significance of the level of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in serum and bronchoalveolar lavage fluid (BALF), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score in evaluating the conditions and prognosis of children with severe pneumonia.@*METHODS@#A total of 76 children with severe pneumonia who were admitted from August 2017 to October 2019 were enrolled as the severe pneumonia group. According to the treatment outcome, they were divided into a non-response group with 34 children and a response group with 42 children. Ninety-four children with common pneumonia who were admitted during the same period of time were enrolled as the common pneumonia group. One hundred healthy children who underwent physical examination in the outpatient service during the same period of time were enrolled as the control group. The serum level of sTREM-1, APACHE II score, and SOFA score were measured for each group, and the level of sTREM-1 in BALF was measured for children with severe pneumonia. The correlation of the above indices with the severity and prognosis of severe pneumonia in children was analyzed.@*RESULTS@#The severe pneumonia group had significantly higher serum sTREM-1 level, APACHEII score, and SOFA score than the common pneumonia group and the control group (P0.05).@*CONCLUSIONS@#The level of sTREM-1 in serum and BALF and SOFA score can be used to evaluate the severity and prognosis of severe pneumonia in children.

Intervention measures for maintenance of clinical control in the remission stage of childhood asthma / 中国当代儿科杂志

OBJECTIVE@#To explore the intervention measures to maintain clinical control in children with asthma in the remission stage when concomitant with acute upper respiratory infection (AURI).@*METHODS@#A total of 100 asthmatic children who had achieved clinical control were randomly divided into observation group and control group. The two groups were both treated with a combination of inhaled corticosteroids and long-acting β2 receptor agonist (ICS/LABA) at the lowest dose every night. Conventional therapies were used for the two groups when suffering from AURI. In addition to conventional therapies, the observation group was given early short-term upgrade therapy, i.e., on the basis of maintenance therapy, the same amount of ICS/LABA complex preparation was inhaled every morning, which lasted for 7-10 days. Both groups were treated following asthma guidelines according to the severity of the disease at the time of acute attacks. The control rate of asthma, severity of acute attacks, changes in pulmonary function indices, and occurrence of adverse events were evaluated after 3, 6, 9, and 12 months of treatment.@*RESULTS@#At each time point of follow-up, the rate of asthma control in the observation group was significantly higher than that in the control group (90% vs 80%; P<0.05). The severity of acute attacks in the observation group was significantly lower than that in the control group at all follow-up time points (P<0.05). Compared with the control group, the observation group had significantly improved pulmonary function indices of large and small airways (P<0.05) and significantly reduced mean amount of inhaled glucocorticoids and impact on family life (P<0.01).@*CONCLUSIONS@#Early short-term upgrade therapy for children with asthma in the remission stage when concomitant with AURI can prevent acute attacks of asthma, raise the rate of asthma control and improve pulmonary function.

Causes of chronic cough in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the causes of chronic cough in children.</p><p><b>METHODS</b>Retrospective analysis was carried out on the clinical data of 132 children with chronic cough from August 2010 to September 2011.</p><p><b>RESULTS</b>Several conditions were found to contribute to chronic cough in children, including cough variant asthma (CVA, n=56), upper airway cough syndrome (UACS, n=44), infections/postinfectious cough (IC/PIC, n=22), allergic cough (AC, n=8), gastroesophageal reflux cough (GERC, n=5), and others (n=3). There was significant difference in the distribution of IC/IPC among an infant group (<1 year), a group of young children (>1 year), a group of preschool aged children (>3 years) and a group of school-age children (6-14 years) (χ2=11.638, P=0.001), and the infant group showed a significantly higher prevalence of IC/PIC than the other three age groups (P<0.05). IC/PIC was the main cause of chronic cough in the infant group, while CVA and UACS were the main causes in each of the other groups. A relatively large proportion of AC, CVA and UACS cases had a personal history of allergy, a family history of allergy/asthma and a history of exposure to harmful environments.</p><p><b>CONCLUSIONS</b>CVA, UACS, and IC/PIC are main causes of chronic cough in children, varying among different age groups. Children with a personal history of allergy, family history of allergy/asthma and a history of exposure to harmful environment are more vulnerable to AC, CVA and UACS.</p>

Inoculation of bacille calmette guerin combined with intraperitoneal adenosine injection enhances antibacterial effect of macrophage against Mycobacterium tuberculosis in mice / 中华儿科杂志

<p><b>OBJECTIVE</b>The protection rate of inoculation with BCG vaccine is only 50 percent, and most of patients with tuberculosis had a history of BCG vaccine inoculation. Adenosine (ADO) has an immunomodulating effect; it promotes immune reaction by increasing number of macrophage and enhancing phagocytosis. The present study was designed to investigate if combined use of adenosine with BCG enhances the anti-Mycobacterium tuberculosis effect of macrophage in mice.</p><p><b>METHODS</b>Fifty BALB/C mice were divided randomly into 3 groups: BCG group (n = 21), BCG plus ADO group (n = 21) and control group (n = 8). The mice in BCG and BCG plus ADO groups were inoculated with 0.1 ml BCG intradermally and the mice in BCG plus ADO group were injected intraperitoneally with ADO 30 mg/(kg.d) for 5 days. The mice in BCG group and control group were injected with NS 0.1 ml/d for 5 days. Six weeks after the last injection, all mice were challenged with intravenous 1 x 10(6) CFU human Mycobacterium tuberculosis virulent strain. After challenging, lung and spleen specimens were taken at the 10th, 20th and 30th days from the mice of BCG and BCG plus ADO groups and at the 30th day from mice in control group. The pathological examinations of lung and spleen sections were performed after HE staining and acid-fast staining, and detection of cell apoptosis was also performed.</p><p><b>RESULTS</b>Consolidation with neutrophil infiltration was found in most of the lung tissue taken at the day 30; there were a lot of tuberculous granulomas and Mycobacterium tuberculosis in the lungs of control group. The alveolar septum in BCG gradually became wide and in interstitium lymphocyte infiltration dominated, and there were less tuberculous granulomas but there were large number of Mycobacterium tuberculosis in the lungs from 10th to 30th days after challenging. The widening of alveolar septum and consolidation of lung tissue in BCG plus ADO group became milder with monocytes infiltration, and there were few tuberculosis granulomas and Mycobacterium tuberculosis in the lungs from 10th to 30th days after challenging.</p><p><b>CONCLUSION</b>ADO could increase the number of monocyte-macrophages and promoted anti-bacterial effects of these cells.</p>