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Objective To study the difference in clinical characteristics between respiratory syncytial virus(RSV) bronchiolitis and non-RSV bronchiolitis.Methods A retrospective review of the medical records of 541 children with bronchiolitis in Children's Hospital of Soochow University between January 2012 and December 2013 was conducted.The secretions of the lower respiratory tract were collected to detect RSV and other pathogens,the clinical characteristics between the 2 teams were analyzed by using PASW 21.0 software.Results (1)There were 194 patients(36％) hospitalized for bronchiolitis,who were assigned as RSV group,and 347 patients (64％) were assigned as non-RSV group.(2) Bronchiolitis due to RSV was more common from December to February,and bronchiolitis due to non-RSV was more common from May to October.(3) Compared with non-RSV group,RSV bronchiolitis started from a younger age(Z =5.62,P ＜0.001),pron to cyanosis(x2 =9.02,P =0.003),longer hospital stays,more expensive cost,more oxygen use,longer days of oxygen,ICU and mechanical ventilation,higher risk of ICU admission,higher the percentage of lymphocyte and platelet,the differences between 2 types were statistically significant(all P ＜ 0.05).White blood cell(WBC) count,neutrophils proportion and C-reactive protein(CRP) was higher in non-RSV than RSV bronchiolitis,the levels of lymphocyte,blood platelet and alanine aminotransferase (ALT) were higher in RSV than non-RSV bronchiolitis,the differences were statistically significant(all P ＜ 0.05).Conclusions Compared with non-RSV group,so RSV bronchiolitis is much more severe,and the patients need longer hospital stays and more expensive cost.Clinicians should pay close attention to RSV bronchiolitis.
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Objective To evaluate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for CT-positive mediastinal lymph nodes. Methods From September 2009 to December 2009, 28 patients with confirmed or suspected non-small-cell lung cancer with CT scan demonstrating enlarged ( ≥ 1 cm) mediastinal lymph nodes underwent EBUS-TBNA. The diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were evaluated. Results 28 patients with 40 lymph nodes were studied. 27 patients had been performed successfully with enough specimens. No complications happened in the group. Mediastinal metastases were confirmed by EBUS-TBNA in 20 patients. 8 patients with benign mediastinal nodes as detected by EBUS-TBNA underwent surgery and mediastinal lymph node dissection, which confirmed N2 disease in 2 patients. Overall diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of EBUS-TBNA in the detection of mediastinal metastasis were 92.9%, 90.9%,100%, 100%, 75% respectively. Conclusion EBUS-TBNA is a safe and effective technique for CT-positive mediastinal lymph nodes on CT scan.
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Objective To discuss the effect of azithromycin on the airway inflammation in children at high risk for asthma by detecting the serum concentration change of eosinophil cationic protein(ECP), intedeukin-8(IL-8) and nitrogen oxide(NO), and also to explore the effect of azithromycin on secondary prevention of asthma. Methods Two hundred and twenty three cases of primary asthmatic attack with atopy (eczema, family asthmatic history) were collected and divided into four groups(group A, B,C,D) after asthmatic symptoms relief, group A was taken orally with azithromycin(5mg/kg Biw), group B was inhaled budesonide(0.5mg Bid), group C was taken orally with singulair (4mg qN),and group D was only given with symptomatic treatment. The vein blood was sampled on the first day in hospital, before and after medication respectively when treatment of three months was completed. Serum concentration of ECP and IL-8 was obtained by ELISA methods, and NO was measured by nitric acid enzyme reduction method. Clinic service and telephone follow-up was taken for one year. Results After three monthes intervention, there was significant difference in the serum concentration of ECP, IL-8 and NO at group A, B, C compared with group D( P<0.01 ). There was no significant difference in decrease of ECP and NO between group A and B( P > 0.05), but decrease of ECP and NO in group C was significant difference compared with group A( P<0.01). The serum concentration of IL-8 in each group was obviously decreased especially in group A, and difference was obvious between group A and group B,C( P<0.01). There was no significant difference in the cases of asthma recurrence within three months and asthmatic recurrence within one year between group A and group B, group C and group D respectively. Conchlsions (1)The medication of azithromycin might result to decrease the serum concentration of ECP and NO, especially for IL-8 in children at high risk for asthma. (2)The effects of azithromycin on change of ECP and NO in children at high risk for asthma were similar to budesonide, but different with montelukast, while the inhabitant effects of IL-8 were different with inhaled steroid hormone and leukotriene receptor obviously. (3)There was some valid contribution of azithromycin actting on the secondary prevention of asthma in our investigation.
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Objective To evaluate the efficacy and safety of Guominjian to infants with eczema. Methods Fifty-seven infants with eczema were randomly divided into the treated group and the control group, who received treatment of Guominjian and usual treatment respectively. Eczema symptoms and change of serum IgE, IL-2, IL-4 was observed before and after treatment. Results After treatment, significant difference was shown between the two groups, significant improvement was shown in the treated group. Conclusion Guominjian is helpful in improving clinical symptoms, reducing corticosteroids use.
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Objective To compare the efficacy between bronchial sleeve resection and bronchial wedge resection in the treatment of lung cancers.Methods The clinic datas of bronchial sleeve resection in 38 cases and bronchial wedge resection in 24 cases were analyzed,comparing the incindence of the fistulas on the anastomotic sites,early death,carcinoma cells on the bronchial edges,cancer recurrence on the anastomotic sites and survival rates between two groups.Results In the group of the bronchial sleeve resection,2 cases underwent the fistulas on the anastomotic sites,3 cases suffered death in the early period,2 cases residued carcinoma cells on the bronchial edges,1 case had scar hyperplasia on the anastomotic sites,1 case had cancers recurrence on the anastomotic sites.1 year,3 years,5 years survival rates were respectively 87.5%(28/32),60%(15/25),40%(4/10).In the group of the bronchial wedge resection,no cases underwent the fistulas on the anastomotic sites,2 cases suffered death in the early period,5 cases residued carcinoma cell on the bronchial edges,4 cases found scar hyperplasia on the anastomotic sites,3 cases having cancer recurrence on the anastomotic sites.1 year,3 years,5 years survival rates were respectively 85.7%(18/21),53.3%(8/15),42.9%(3/7).Conclusion Compared with bronchial sleeve resection in the treatment of lung cancers,the bronchial wedge resection increases the incindence of carcinoma cell on the bronchial edges and cancer recurrence on the anastomotic sites,but there is no difference in survival rate between them.
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Objective To study the protective effects of bcl-2 gene against lung ischemia-reperfusion injury in vitro. Methods The lungs of rabbits were harvested respectively and preserved according to the way of lung transplantation. Then the lungs were reperfused using an ex vivo model. The rabbits were divided into 3 groups: control group, 0.9%NaCl was given; group2, Ad/Lac Z and group 3, receiving Ad/s-bcl-2. Agents were given to the rabbits by continuous intravenous infusion 48 hours before operations. Results Ad/s-bcl-2 increased the contents of bcl-2 mRNA in lung tissue, increased lung tissue SOD contents, decreased lung tissue MDA contents, decreased PAP, improved lung edema, reduced incidence of apoptosis and improved lung histological manifestation. These indexes in the Ad/s-bcl-2 group were better than in the groups of 0.9%NaCl and Ad/LacZ. Conclusion The bcl-2 gene amy provide significant protective effects on ischemia-reperfusion injury of the lung.