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Objective:To investigate the common bacteria in the oropharynx of children with Mycoplasma pneumoniae pneumonia (MPP) and its clinical significance.Methods:A total of 134 children with MPP who were hospitalized in the Department of Pediatric Respiratory, Shengjing Hospital of China Medical University from December 2016 to June 2017 were selected as the research subjects, and 42 healthy children in the same hospital were selected retrospectively as the healthy control group during the same period.Fluorescent quantitative polymerase chain reaction Taqman probe was used to detect common oropharyngeal bacteria[ Streptococcus pneumoniae(SP), Moraxella catarrhalis(CTA), Haemophilus influenza(HI)] for the enrolled children.Firstly, the bacterial detection rate of MPP children and healthy children was compared.Then, according to age(<1 years old, 1-<3 years old, 3-<6 years old and 6-14 years old), bacterial detection[Mycoplasma pneumoniae(MP), MP+ bacteria]and bacterial species(MP+ SP, MP+ CTA, MP+ HI), 134 children with MPP were divided into groups to compare.Moreover, the relevant clinical datas were retrospectively analyzed by rank sum test and chi- square test. Results:Among 134 children with MPP, 79 (58.96%) children were detected bacteria, and 17 (40.48%) children were detected bacteria among 42 healthy children, with statistically significant differences( χ2=4.404, P<0.05). Compared with the MP group, the level of white blood cell (WBC)[8.5(6.7, 12.0)×10 9/L vs.7.8(5.8, 9.3)×10 9/L, Z=-2.232], C reactive protein(CRP)[19.2(7.2, 35.0) mg/L vs.8.4(3.4, 24.6) mg/L, Z=-2.810], lactate dehydrogenase(LDH)[286(244, 365) U/L vs.250(210, 302) U/L, Z=-2.474] and the incidence of lobar pneumonia[40.51%(32/79 cases) vs.18.18%(10/55 cases), χ2=7.510], pleural effusion[13.92%(11/79 cases) vs.3.64%(2/55 cases), χ2=3.917], refractory Mycoplasma pneumoniae pneumonia (RMPP)[34.18%(27/79 cases) vs.18.18%(10/55 cases), χ2=4.151] in MP+ bacteria group were higher; the course of fever[10(7, 12) d vs.8(6, 10) d, Z=-2.706] and duration of antibiotic use[16(13, 19) d vs.12(9, 16) d, Z=-3.747] in MP+ bacteria group were longer (all P<0.05). The level of WBC in MP+ SP group[12.20(7.80, 17.30)×10 9/L] was higher than that in MP+ HI group [6.75(5.37, 9.44)×10 9/L], and the differences were statistically significant( Z=11.574, P<0.05), and the incidence of lobar pneumonia in MP+ SP group [56.67%(17/30 cases)]was higher than that in MP+ CTA group [0(0/3 cases)]and MP+ HI group[18.75%(3/16 cases)], and the differences were statistically significant( χ2=9.770, P<0.05). Conclusions:Bacterial colonization or infection is more likely to occur in the oropharynx of children with MPP.When WBC, CRP, and LDH are significantly increased and the image shows a large consolidation or pleural effusion, it may indicate mixed bacterial infection, longer course of fever and higher incidence of RMPP, and the common mixed bacteria is SP.
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Objective:To summarize the clinical characteristics of plastic bronchitis caused by severe mycoplasma pneumoniae pneumonia in children, to find the risk factors for plastic bronchitis, and to provide references for judging the prognosis and comprehensively formulating treatment plans.Methods:We retrospectively analyzed the clinical data(146 cases)of children with severe mycoplasma pneumoniae pneumonia who underwent bronchoscopy in the Department of Pediatric Respiratory Medicine of Shengjing Hospital of China Medical University from January 2017 to December 2019.According to whether it was plastic bronchitis, all patients were divided into plastic bronchitis group(68 cases) and non-plastic bronchitis group(78 cases), and the gender, age, laboratory examination indicators, imaging characteristics and treatment of children were collected under the circumstances.The single factor with clinical significance and statistical significance would be subjected to multivariate Logistic regression analysis.Results:There were no significant differences in gender, age, heat duration, white blood cell count, C-reactive protein value, and interleukin-6 value between the two groups(all P>0.05). The percentage of neutrophils, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, D-dimer, number of cases of pleural effusion, length of hospital stay, and number of endoscopy in the plastic bronchitis group were higher than those in non-plastic bronchitis group, the number of right upper lobe consolidation cases was less than that in the non-plastic bronchitis group, and the differences were statistically significant( P<0.05). Multiple Logistic regression analysis showed that pleural effusion( OR=4.898, 95% CI 2.195-10.926) and lactate dehydrogenase ( OR=1.051, 95% CI 1.003-1.101) were independent predictors of plastic bronchitis in children with severe mycoplasma pneumoniae pneumonia. Conclusion:For children with severe mycoplasma pneumoniae pneumonia, if lung CT shows that the upper lobe of the non-right lung is uniformly compacted and complicated with pleural effusion, lactate dehydrogenase is significantly increased, and attention should be paid to the possibility of plastic bronchitis.Timely improvement of fiberoptic bronchoscopy may shorten the course of the disease and reduce the occurrence of complications.
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Objective:To investigate the clinical characteristics and imagological changes of atopic children with ADV pneumonia.Methods:One hundred and twenty cases of children with ADV pneumonia selected from Shengjing Hospital of China Medical University Pediatric Respiratory Department from June 2018 to December 2019.According to whether had atopy and severity of pneumonia, the children were divided into atopic group 42 cases (mild pneumonia 30 cases, severe pneumonia 12 cases)and non-atopic group 78 cases(mild pneumonia 50 cases, severe pneumonia 28 cases). The children were treated according to the guidelines of ADV pneumonia diagnosis and treatment.Laboratory examination, clinical manifestations, clinical features during hospitalization, pulmonary imaging changes at admission, at discharge and follow-up 1 month after discharge were statistically analyzed.Results:There were statistically significant differences in the proportion of severe cough and wheezing between the atopic children and non-atopic children with mild pneumonia( P=0.041, P=0.004, respectively). There was no statistically significant difference between the two groups in the proportion of children with small airway changes indicated by lung CT at admission and 1 month after discharge( P>0.05). The risk of wheezing during hospitalization of atopic children was 2.32 times as much as that of non-atopic children with mild pneumonia.The risk of developing severe cough was 1.72 times as much as that of non-atopic children with mild pneumonia.There were statistically significant differences in the proportion of wheezing after admission and after discharge between the atopic children and non-atopic children with severe pneumonia( P=0.002, P=0.034, respectively). There were significant differences in the proportion of small airway changes at admission and at discharge between the two groups( P=0.001, P=0.009, respectively). The risk of wheezing during hospitalization of atopic children was 1.94 times as much as that of non-atopic children with severe pneumonia.The risk of wheezing after discharge was 1.98 times as much as that of the non-atopic children with severe pneumonia.The risk of small airway change on admission in atopic children group was 1.25 times as much as that of non-atopic children with severe pneumonia.The risk of having small airway changes 1 month after discharge in atopic children group was 2.31 times as much as that of non-atopic children with severe pneumonia. Conclusion:Atopic children with ADV pneumonia had severe cough and wheezing, and atopic children with severe pneumonia are prone to small airway changes, long imaging recovery time and regular follow-up, which should be paid attention by clinicians.
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Objective:To explore the clinical characteristics of children with atopic mycoplasma pneumoniae pneumonia and to provide evidence for the diagnosis and treatment of children with atopic mycoplasma pneumoniae pneumonia.Methods:One hundred and eighty cases of children diagnosed with mycoplasma pneumoniae pneumonia in Shengjing Hospital of China Medical University from January 2018 to December 2018 were selected. According to whether they had atopic constitution, they were divided into atopic mycoplasma pneumoniae pneumonia(AMPP)group(84 cases)and non-atopic mycoplasma pneumoniae pneumonia(NAMPP)group(96 cases). The clinical data of age, sex, fever time, hospital stay, application time of macrolides, white blood cells, CRP, LDH, and lung CT were collected from the two groups, and the differences in clinical manifestations, laboratory examinations and imaging manifestations of the two groups were analyzed retrospectively.Results:(1)Both the absolute value of eosinophils and total IgE values in the AMPP group were higher than those in the NAMPP group, and the difference was statistically significant( P<0.05). The incidence of severe mycoplasma pneumoniae pneumonia(SMPP)and/or refractory mycoplasma pneumoniae pneumonia(RMPP)and chest imaging manifestations of interstitial pneumonia in the AMPP group was higher, and the difference was statistically significant( P<0.05). (2)The incidence of wheezing in the AMPP group was 48.81%(41 cases/84 cases), which was significantly higher than that in the NAMPP group 22.92%(22 cases/96 cases). The duration of cough and wheezing in the AMPP group was longer than that in the NAMPP group( P<0.05), with statistically significant differences( P<0.05). (3)In the AMPP group, 36.90%(31 cases /84 cases)of the children received intravenous methylprednisolone treatment, which was significantly higher than the 20.83%(20cases /96 cases)of the NAMPP group. Lung rales absorption time in the AMPP group[(9.73±3.59)d] was significantly longer than that in the NAMPP group[(7.52±2.44)d], and the difference was statistically significant( P<0.05). Lung CT examination showed that the absorption of lung inflammation in the AMPP group was worse than that in the NAMPP group, with a statistically significant difference( P<0.05). The hospitalization time of children in the AMPP group[(10.88±4.17)d] was longer than that in the NAMPP group[(9.68±2.68)d], with a statistically significant difference( P<0.05). Conclusion:The condition of AMPP is more serious than that of NAMPP, and it is more likely to cause incomplete absorption of pulmonary inflammation.
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Objective To investigate the effects of atomized budesonide on neonatal bronchopulmonary dysplasia after discharge from hospital to 6 months of gestational age correction.Methods Analyse clinical data of fifty children with BPD,observe the effects of atomized budesonide (0.5mg inhaled q12h,at least 4weeks,course(15.4 ±6.16) weeks.When wheezing or dyspnea occurred:1mg of budesonide and 1.25ml of albuterol and ipratropium bromide inhaled q12h,2 ～ 4weeks.When respiratory frequency,heart rate and blood oxygen saturation reached normal,three concave improved obviously,lung rale disappeared,gradually reduce to no treatment)improving the clinical symptoms of children with BPD in 6 months after discharge,and observe the effects of atomized budesonide on reducing respiratory tract infection (including upper respiratory tract infection,pneumonia,wheezing and hospitalization).Results Through budesonide aerosol therapy,respiratory frequency and heart rate of children with BPD could be reduced,blood oxygen saturation could be elevated,and three concave could be improved at corrected gestational age of 3 months and 6 months.(P ＜ 0.05),and at 3 months of corrected gestational age,the mean therapy time in treatment group is(56.8 ±26.9) d,this shows that 4weeks'treatment of budesonide aerosol could improve clinical symptoms;Also with budesonide aerosol therapy,the time of oxygen inhalation after hospital could be shortened (P ＜0.05);but respiratory infection of children with BPD in 6 months after discharge could not reduced (P ＞ 0.05).Conclusion The treatment of budesonide atomization can improve the clinical symptoms of children with BPD after discharge from hospital to 6 months of gestational age correction,improve oxygen and shorten the time of oxygen inhalation after hospital,cannot reduce the incidence of respiratory infection.
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Objective To observe the efficacy of bacterial lysate(bronchovaxom) in the acute phase of respiratory tract infection and to prevent recurrent respiratory tract infections.Methods From April 2014 to A-pril 2015,in pediatric respiratory ward of Shengjing hospital of China Medical University,80 children with recur-rent respiratory tract infection were randomly divided into treatment group and control group,with 40 cases in each group.The control group patients were received routine anti-infection and symptomatic treatment,the treat-ment group patients were received oral bacterial lysis products for 3 months on basis of the conventional anti-in-fection and symptomatic treatment.To observe the duration of clinical symptoms of two groups of children with respiratory tract infection in the acute phase,antibiotic use and hospital stay changes;observed the number of re-spiratory infections occurred again within 1 year;measured the levels of serum immunoglobulin before and 6 months after treatment. Results Compared with the control group,the duration of symptoms such as fever, cough and other symptoms of respiratory tract infection,the duration of pulmonary rales,the use of antibiotics and the length of hospital stay were significantly shortened in the treatment group,and the number of respiratory infections was significantly reduced,the difference significant(P<0.05).After treatment,the levels of IgG and IgA in the treatment group were significantly higher than those before treatment,and the immunoglobulin IgG and IgA in the treatment group were significantly higher than those in the control group(P<0.05).Conclusion Oral bacterial lysis products to prevent respiratory infections,not only can reduce the duration of various clini-cal symptoms of respiratory tract infection,shorten the use of antibiotics and hospital stay,and can improve chil-dren's immunity,reduce the number of respiratory infections again.
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Objective To investigate the effect of the asthmatic mice's contents of NF-κB、IκB、p-IκB treated with curcumin.Methods Thirty Balb/c mice were divided into three groups randomly,the normal mice,the asthmatic mice and the curcumin mice.The bronchial hyperresponsiveness of the three groups were exanined by lung function.The NF-κB 、IκB 、p-IκB content of three teams were tested.Results The content of cytoplasm NF-κB in asthmatic mice was lower than the control (P ＜ 0.01).However,the content of cytoplasm NF-κB in curcumin team was more than the asthmatic mice (P ＜ 0.05).In the other hand,The content of nuclear NF-κB in asthmatic mice was more than the control(P ＜0.01).However,the content of nuclear NF-κB in curcumin mice was lower than the asthmatic mice (P ＜ 0.05).The content of cytoplasm p-hκB in asthmatic mice was more than the control and the content of IκB was lower than the control(P ＜ 0.01).Howerer,the content of IκB in curcumin team have much more than the asthmatic mice and the content of p-IκB have much lower than the control(P ＜ 0.01).Condusion Curcumin alleviates the airway hyperresponsiveness of the asthmatic mice through the suppression of NF-κB transcribe to the nuclear via alleviating the phosphorylation of I-κB.
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Objective To investigate the effect of the asthmatic mice's contents of nuclear factorerythroid-2-related factor 2,Nrf2 and HO-1 reated with curcumin in lung tissue.Methods All 45 mice were divided into three teams randomly,the normal mice,the asthmatic mice and the curcumin mice group.We tested the expression of Nrf2 and HO-1 of three mice teams in lung by immunolfluorescence technique.We tested the protein contents of Nrf2 and HO-1 of the three teams in the lung tissue by Western blot.We tested the binding activity of Nrff2 and ARE of the three teams in lung by EMSA.Results The expression of Nrf2 and HO-1 in curcumin group was significantly higher than that in asthma group and normal control group by immunolfluorescence technique.There was no sigrnificant difference in content of cytoplasm Nrf2 protein in lung tissue between three groups by western blot(P ＞ 0.05).The content of nuclear Nrf2 and HO-1 protein in the lung tissue of the curcumin group was significantly higher than that in the other two groups,the difference is statistically significant (Nrf2,P ＜0.05;HO-1,P ＜0.01).The binding activity of Nrf2-ARE in lung tissue of curcumin group was significantly higher than that of asthma group and control group,with statistical significance(P ＜ 0.05).Conclusion Curcumin can increase the protein contents of the Nrf2 and HO-1 of mice and enhance the expression of them.
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Objective To investigate the effect of the asthmatic mice's airway inflammation and bronchial hyperresponsiveness treated with curcumin.Methods The mice were divided into three teams randomly,the normal mice,the asthmatic mice and the curcumin mice.The mice of three teams were detected by lung function,Giemsa dying,HE and PAS dying,and ELISA.Results After the Mch concentration of 6.25 g/L,the value of Penh in asthmatic mice was higher than the control mice,which was sighifiantly different(P ＜ 0.01).However,the value of Penh in curcumin team was lower than asthmatic mice,which was sighifiantly different (P ＜0.01).The number of total white blood cells and eosinophils was higher in asthmatic mice than the contol,which was sighifiantly different(P ＜0.01).However,the number in curcumin team was lowered than asthmatic team(P ＜ 0.01).The IgE content of BALF in asthmatic mice was higher than the control,which was significantly different(P ＜ 0.01).However,the content in curcumin team was lowered than the asthmatic mice,which had a significant difference(P ＜0.01).Pathology of HE staining in asthmatic mice showed the thickening bronchial wall,narrow lumen,peribronchial and perivascular infiltration with a large number of eosinophil-based inflammatory cells,lumen with many inflammatory secretions.However,the curcumin team was alleviated than the asthmatic mice.There were more goblet cells and more mucus secretion in the asthmatic mice by PAS staining.However,the curcumin team was alleviated than the asthmatic mice.Conclusion Curcumin can alleviate the airway inflammation,mucus secretion,airway hyperresponsiveness and the IgE content of bronchoalveolar lavege fluid.
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Objective To understand the correlation of gene detection of Mycoplasma pneumoniae and clinical refractory Mycoplasma pneumoniae pneumonia.Methods (1) For children with Mycoplasma pneumoniae pneumonia in our hospital with serum Mycoplasma pneumoniae antibody positive,we collected the pharyngeal swab specimens over the same period,applied nested PCR to amplify 23SrRNA gene and undergoing electrophoresis and find out 97 cases of both positive,conducted DNA sequencing analysis of macrolide resistant gene to isolate the mutants,compared clinical manifestations of drug-resistance gene group with no drug-resistance gene mutation group.(2) Ninety-seven cases of mycoplasma pneumonia (MPP) patients were devided into the general MPP group (68 cases) and refractory MPP group (29 cases),retrospectively analyzed clinical manifestation,laboratory examination and differences of imaging performance.Multivariate logistic regression analysis for the performance of refractory Mycoplasma pneumoniae pneumonia was carried out to examine whether there is relevance between the mutant of drug-resisting gene and refractory Mycoplasma pneumonia.Results (1) Seventeen of 97 cases (17.5％) were found out without mutations,the other 80 cases (82.5％) exist drug-resistance gene mutations.(2) Mutation of drug-resistance gene group showed high CRP values,heating time,hospitalization time,macrolide drug application time,application of macrolides fever time and longer cough,by statistical analysis with statistical significance,higher incidence of lobar pneumonia.(3) Compared to general MPP group,refractory MPP group showed high peripheral blood neutrophil percentage percentage,CRP,calcitonin) and lactate dehydrogenase (LDH) values,heating time,hospitalization time,macrolide drug application time,application of macrolides fever time and longer cough.There was significant difference (P ＜ 0.05);macrocyclic lactones drug application time and resistance gene mutation and refractory Mycoplasma pneumonia were correlated.Conclusion MPP drug-resistant genes are widespread.Drug resistance gene mutations group shows long clinical symptoms duration,slow recovery rate,higher CRP value,higher rates of lobar pneumonia.Compared with ordinary MPP group,there are higher drug resistance mutation rate,inflammatory indexes and lactate dehydrogenase value,large ring lactone class drugs after a longer time of cough and fever in RMPP group.Drug application time and resistant gene mutations are associated with RMPP.
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Objective To investigate the detection and clinical features of primary immunodeficiency disorders (PID) in children for an earlier diagnosis of disease.Methods The clinical data of the 27 children with PID diagnosed in Shengjing Hospital Affiliated to China Medical University from Dec.2003 to Nov.2011 were reviewed,including illness history,birth history,family history,clinical feature,laboratory data,diagnosis,treatment and outcome,etc.Results In 27 children with PID,antibody deficiencies were the most frequent findings (48.15％,13/27 cases),followed by combined immunodeficiency (22.22％,6/27 cases),phagocytic disorders (14.81％,4/27 cases),and immunodeficiency with other major defects accounted for 14.81％ (4/27 cases).PID was characterized by recurrent,severe and prolonged infection,but all kinds of PID had their own clinical features.Recurrent infections occurred in 24 cases.Respiratory infections and otitis media were the most common clinical manifestation.Seven patients had a family history.The fatality rate was 37.04％ (10/27 cases).Conclusions There are vast varieties of PID in our area and antibody deficiencies are the most common type.All kinds of PID have their own clinical features,which may guide us to choose appropriate lab examination.There are nearly 25％ patients with PID who have family history.The fatality rate is high.Patients who suffer from recurrent infections,especially respiratory infections or otitis media,or those with a family history should have early immunology testing so as to be detected and diagnosed of PID earlier.
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Our work focuses on the quality control and structural identification of Photocyanine as a cancer therapeutic photosensitizer. Photocyanine is a mixture which contains four ZnPcS2P2 type substituted Phthalocyanine isomers. In order to obtain the single component from Photocyanine, the mixture of four isomers possessing the similar structures and chemical property had been isolated and purified. An HPLC method with a mixture of methanol-acetonitrile-ion-pair buffer as the mobile phase was applied to isolate the four isomers by means of a semi-preparative C18 column. To remove the salts which were mixed in the preparative product, a SPE C18 column was used to separate the salts by elution with water and then the marker component was eluted by methanol. Subsequently, a column of Sephadex LH-20 gel was applied to elute the crudes with methanol to desalination. The purity of the isolated compound was measured by TLC and four different isomers of phthalocyanine were obtained. The chemical structures of them were elucidated by 1H NMR spectra, gCOSY and NOE1D. An HPLC-DAD method was developed for simultaneously determination of four major isomers in Photocyanine with a C18 column (Grace Smart, 150 mm x 4.6 mm ID, 5 microm). The separation was carried out with a gradient program at a flow rate of 1.0 mL x min(-1). The mobile phase was a mixture of acetonitrile and ion-pair buffer (0.01 mol x L(-1) hexadecyl trimethyl ammonium bromide and 0.01 mol x L(-1) potassium dihydrogen phosphate, adjusted the pH value to 6.8 with potassium hydroxide solution). The resolution values of four isomers were 2.5, 1.20, 1.33, and 1.8. Linear regression analysis for four compounds was performed by the external standard method. Four constituents were linear in the concentration range of 0.005 to 10 microg. The values of relative standard deviation (RSD) of intra-day were 0.12%, 0.66%, 0.99%, and 1.21%, respectively. The limits of detection for four compounds were 15 ng, 20 ng, 12 ng, and 25 ng, respectively. This method was simple, accurate and reproducible. The developed method can be successfully applied to analyze isomers in Photocyanine.