The role of bronchoscopy in slide tracheoplasty in children / 中国当代儿科杂志

OBJECTIVES@#To study the role of bronchoscopy in slide tracheoplasty.@*METHODS@#A retrospective analysis was conducted on the diagnosis and treatment of four children with tracheal stenosis admitted to Hunan Provincial People's Hospital from 2017 to 2020. The role of bronchoscopy was summarized in the preoperative evaluation, intraoperative positioning and measurement, and postoperative wound evaluation and treatment during slide tracheoplasty.@*RESULTS@#Bronchoscopy evaluation before slide tracheoplasty showed that 3 of the 4 children had complete trachea rings, 2 had pulmonary artery sling, and 2 had multiple stenosis. Slide tracheoplasty was performed in the hospital on 3 children, and the midpoint of the stenosis segment was judged under bronchoscopy, and the length of the stenosis segment was measured, which assisted in the resection of the stenosis segment of the trachea. The pathogens were identified by lavage after the surgery. One child who developed scar traction 9 months after slide tracheoplasty in another hospital was improved by interventional treatment under bronchoscopy. Mucosal changes were found under bronchoscopy in 2 children 4 days after surgery, and the treatment plan was adjusted. One month after surgery, 2 children had granulation hyperplasia, which was improved by cryotherapy under bronchoscopy. One child abandoned treatment due to anastomotic necrosis and died. Three survivors were followed up for over 6 months with good prognosis, but all had tracheobronchial malacia.@*CONCLUSIONS@#Bronchoscopy can be used for the management of slide tracheoplasty in children with tracheal stenosis, which is helpful to postoperative rehabilitation and follow-up.

"Massive hemoptysis" and shock after fever and cough / 中国当代儿科杂志

A boy, aged 11 years, was admitted due to intermittent fever for 15 days, cough for 10 days, and "hemoptysis" for 7 days. The boy had fever and cough with left neck pain 15 days ago, and antibiotic treatment was effective. During the course of disease, the boy developed massive "hemoptysis" which caused shock. Fiberoptic bronchoscopy revealed a left pyriform sinus fistula with continuous bleeding. In combination with neck and vascular imaging examination results, the boy was diagnosed with internal jugular vein injury and thrombosis due to congenital pyriform sinus fistula infection and neck abscess. The boy was improved after treatment with temperature-controlled radiofrequency ablation for the closure of pyriform sinus fistula, and no recurrence was observed during the follow-up for one year and six months. No reports of massive hemorrhage and shock due to pyriform sinus fistula infection were found in the searched literature, and this article summarizes the clinical features, diagnosis, and treatment of this boy, so as to provide a reference for the early diagnosis of such disease and the prevention and treatment of its complications.

Clinical features of children with / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of children with @*METHODS@#A total of 310 MPP children who were hospitalized and underwent bronchoalveolar lavage from June 2018 to June 2019 were enrolled and divided into two groups: simple MPP group with 241 children (without peripheral lymphocytopenia) and MPP + peripheral lymphocytopenia group with 69 children. The two groups were compared in terms of clinical data and treatment outcome.@*RESULTS@#Compared with the simple MPP group, the MPP + peripheral lymphocytopenia group had significantly longer duration of fever and length of hospital stay and significant increases in C-reactive protein, lactate dehydrogenase, and @*CONCLUSIONS@#Children with MPP and peripheral lymphocytopenia tend to have more severe immunologic injury. Peripheral blood lymphocyte count may be used to evaluate the severity of MPP.

Clinical features of / 中国当代儿科杂志

OBJECTIVES@#To study the clinical features of @*METHODS@#A retrospective analysis was performed on the medical data of 228 children with MPP alone and 28 children with MPP and ADV infection. The two groups were compared in terms of clinical features, laboratory results, and treatment outcome.@*RESULTS@#Compared with the MPP group, the MPP+ADV group had significantly longer duration of fever and length of hospital stay, a significantly higher proportion of patients with severe lesions (erosion and exfoliation) of the airway mucosa under bronchoscopy, a significantly higher clinical pulmonary infection score, and a significantly higher proportion of patients requiring oxygen therapy (@*CONCLUSIONS@#Compared with children with MPP alone, children with MPP and ADV infection tend to have more severe clinical manifestations and airway mucosal lesions and are more likely to require oxygen therapy, but most of the laboratory markers lack specificity.

Clinical effect of propranolol in the treatment of respiratory hemangioma in infants and young children / 中国当代儿科杂志

OBJECTIVE@#To study the clinical effect of oral propranolol in the treatment of respiratory hemangioma in infants and young children.@*METHODS@#A retrospective analysis was performed from the chart review data of children with respiratory hemangioma treated by oral propranolol and diagnosed by bronchoscopy and laryngeal plain enhanced CT/MRI from November 2012 to December 2019.@*RESULTS@#A total of 20 children were enrolled. All children had improvement in the symptoms of laryngeal stridor and dyspnea after oral administration of propranolol for 1-2 days. The median treatment time was 10 months (range 6-12 months). The median follow-up time was 10 months (range 3-15 months). Of the 20 children, 19 (95%) achieved regression of tumor, and 1 (5%) experienced an increase in tumor size during reexamination at 6 months after drug withdrawal and had no recurrence after the treatment with an increased dose of propranolol for 6 months. Only 1 child (5%) had adverse reactions, and 1 child (5%) was still under treatment.@*CONCLUSIONS@#Oral propranolol can quickly relieve the symptoms such as dyspnea and achieve tumor regression, with few adverse events, and it is therefore an effective method for the treatment of respiratory hemangioma in infants and young children.

Detection of respiratory pathogens and clinical features in 225 children with acute exacerbation of bronchial asthma / 中国当代儿科杂志

OBJECTIVE@#To investigate the respiratory pathogens and clinical features in children with acute exacerbation of bronchial asthma.@*METHODS@#Nasopharyngeal swabs were collected from 225 children with acute exacerbation of bronchial asthma, aged <14 years, who attended the outpatient service or were hospitalized from August 2017 to August 2019. Quantitative real-time PCR was used to detect 12 pathogens, i.e., respiratory syncytial virus (RSV), human rhinovirus (HRV), influenza virus A (IFVA), influenza virus B (IFVB), parainfluenza virus types 1-3 (PIV1-3), human metapneumovirus (HMPV), adenovirus (ADV), Bordetella pertussis (BP), Chlamydia pneumoniae (CP), and Mycoplasma pneumoniae (MP).@*RESULTS@#The overall detection rate of virus was 46.2% (104/225), and 7 kinds of viruses were detected, i.e., HRV (19.6%, 44/225), ADV (16.0%, 36/225), IFVB (5.8%, 13/225), RSV (4.9%, 11/225), IFVA (3.6%, 8/225), PIV3 (1.8%, 4/225), and HMPV (0.4%, 1/225). Of all pathogens, BP had the highest detection rate of 28.4% (64/225), and the detection rates of MP and CP were 16.4% (37/225) and 0.4% (1/225), respectively. The mild exacerbation group had a higher detection rate of BP than the severe exacerbation group (P<0.05), while the severe exacerbation group had significantly higher detection rates of RSV and MP than the mild exacerbation group (P<0.05). There were significant differences in the proportion of children with paroxysmal cough, spasmodic cough, fever, lung rales and abnormal lung imaging findings among the simple BP infection, simple virus infection and simple MP infection groups (P<0.05).@*CONCLUSIONS@#BP, HRV, and MP are common respiratory pathogens detected in children with acute exacerbation of bronchial asthma, and respiratory virus infection is an important pathogen of acute exacerbation of asthma in children. Acute exacerbation of asthma caused by different pathogens has different clinical features and severities.

Application of TBNA in modern pediatric interventional respiratory diseases / 中国实用儿科杂志

()portant technique of endoscopic interventional diagnosis and treatment of lung disease. It plays an important role in the diagnosis of the nature of mediastinal, hilar and peripheral nodule lesions,as well as in the classification and staging of lung cancer. Compared with mediastinoscopy and thoracotomy,TBNA has the advantages of simple operation,less trauma,low cost and fewer complications. It has been widely used in adult respiratory diseases. However,because of their own characteristics,children have higher requirements on TBNA technology,equipment,anesthesia and so on,and the application of TBNA faces more challenges. With the continuous improvement of technology and the continuous exploration of pediatric respiratory interventional physicians,TBNA has been used more and more often in children,filling in the blank of routine diagnosis and treatment and bringing new diagnostic ideas and methods for children with mediastinal or hilar lesions.

Expression of interferon-λ1 in respiratory epithelial cells in children with human rhinovirus infection / 中国当代儿科杂志

OBJECTIVE@#To study the expression of interferon-λ1 (IFN-λ1) in respiratory epithelial cells in children with human rhinovirus (HRV) infection.@*METHODS@#Sputum samples and nasopharyngeal swabs were collected from the children who were hospitalized due to acute respiratory infection from February to October, 2017. Bacterial culture was performed, and nucleic acid test was performed for 11 respiratory pathogens. A total of 90 children with positive HRV alone were enrolled as the HRV infection group, and 95 children with positive respiratory syncytial virus (RSV) alone were enrolled as the RSV infection group. A total of 50 healthy children who underwent outpatient physical examination during the same period of time and had negative results for all pathogen tests were enrolled as the healthy control group. Nasopharyngeal swabs were collected from all groups, and quantitative real-time PCR was used to measure viral load and the mRNA expression of IFN-λ1.@*RESULTS@#In the HRV infection group, there was no significant difference in the mRNA expression of IFN-λ1 between boys and girls and across all age groups (P>0.05). In the HRV infection group, there was no correlation between the mRNA expression of IFN-λ1 and HRV load (P>0.05). The mRNA expression of IFN-λ1 in the HRV infection group was significantly higher than that in the healthy control group (P<0.05), but significantly lower than that in the RSV infection group (P<0.05).@*CONCLUSIONS@#HRV can induce the expression of IFN-λ1 in respiratory epithelial cells, suggesting that IFN-λ1 may play an important role in anti-HRV infection in children.

Burkholderia cepacia infection in children: a clinical analysis of 16 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the distribution characteristics and clinical features of Burkholderia cepacia infection in children.</p><p><b>METHODS</b>A retrospective analysis was performed for the clinical data of 16 children with Burkholderia cepacia infection who were hospitalized between June 2012 and September 2017.</p><p><b>RESULTS</b>All 16 children with Burkholderia cepacia infection were sporadic cases. A total of 16 strains of Burkholderia cepacia were isolated, among which 8 were detected by sputum culture, 5 were detected by blood culture, 2 were detected by tracheal intubation tip culture, and 1 was detected by lung biopsy culture. Of the 16 children, there were 11 boys and 5 girls, with an age of 5 days to 6 years, and the children aged <1 year accounted for 69%. As for department distribution, 10 children were in the PICU/NICU and 6 were in the general wards. As for clinical manifestations, one child had disseminated intravascular coagulation, and the other 15 children had pulmonary infection, among who 11 had severe pneumonia (8 of them underwent mechanical ventilation during treatment). As for underlying diseases, 2 had severe congenital heart disease, 4 had primary immunodeficiency, 3 were highly suspected of immunodeficiency or inherited metabolic diseases, 1 had tracheal stenosis, 1 had Kawasaki disease, 1 was a preterm infant with bronchopulmonary dysplasia, 1 had severe cleft lip and palate, and 3 had no definite underlying diseases. Of all the children, 7 also had infections with adenovirus and Mycoplasma. The average length of hospital stay was 20.3 days for all children, and 12 were improved and 4 died after treatment. All 16 strains of Burkholderia cepacia had a drug resistance rate of 100% to amikacin and gentamicin and ≥80% to ampicillin/sulbactam and ticarcillin/clavulanic acid, as well as the lowest drug resistance rate to levofloxacin.</p><p><b>CONCLUSIONS</b>Burkholderia cepacia is an opportunistic pathogen often found in immunocompromised children and can produce drug resistance. The presence or absence of underlying diseases should be considered during anti-infective therapy. The children with Burkholderia cepacia infection often have a poor prognosis, and an understanding of the disease spectrum of Burkholderia cepacia infection helps with clinical diagnosis and treatment.</p>

Relationship between viral load of human bocavirus and clinical characteristics in children with acute lower respiratory tract infection / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the prevalence of human bocavirus (HBoV) in children with acute lower respiratory tract infection and to explore the relationship between the viral load of HBoV and the clinical characteristics of acute lower respiratory tract infection in children.</p><p><b>METHODS</b>A total of 1 554 nasopharyngeal aspirates from children who were hospitalized due to acute lower respiratory tract infection between March 2011 and March 2014 were collected. Quantitative real-time PCR was used to detect 12 RNA and 2 DNA viruses, adenovirus (ADV) and HBoV, and to measure the viral load of HBoV in HBoV-positive children. A comprehensive analysis was performed with reference to clinical symptoms and indicators.</p><p><b>RESULTS</b>In the 1 554 specimens, 1 212 (77.99%) were positive for viruses, and 275 (17.70%) were HBoV-positive. In HBoV-positive cases, 94.9% were aged <3 years, and there were more males than females. In the 275 HBoV-positive cases, 45 (16.36%) had single infection, and 230 (83.64%) had mixed infection. There was no significant difference in viral load between children with single infection and mixed infection (P>0.05). The patients with fever had a significantly higher viral load than those without fever (P<0.05). The children with wheezing had a significantly higher viral load than those without wheezing (P<0.05). There was no significant difference in viral load between children with mild, moderate, and severe acute lower respiratory tract infection (P>0.05).</p><p><b>CONCLUSIONS</b>HBoV is one of the important pathogens of acute lower respiratory tract infection in children. Children with a higher viral load of HBoV are more likely to experience symptoms such as fever and wheezing. However, the severity of disease and mixed infection are not significantly related to viral load.</p>

Expression of interferon-λ1 in respiratory epithelial cells of children with RSV infection and its relationship with RSV load / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the expression of IFN-λ1 in respiratory epithelial cells of children with respiratory syncytial virus (RSV) infection and its relationship with RSV load.</p><p><b>METHODS</b>The nasopharyngeal swabs were collected from the children who were hospitalized with respiratory tract infection from June 2015 to June 2016. A direct immunofluorescence assay was used to detect the antigens of seven common respiratory viruses (including RSV) in the nasopharyngeal swabs. A total of 120 children who were only RSV positive were selected as the RSV infection group. A total of 50 children who had negative results in the detection of all viral antigens were selected as the healthy control group. Fluorescence quantitative real-time PCR was used to determine the RSV load and the expression of IFN-λ1 mRNA in the nasopharyngeal swabs of children in the two groups.</p><p><b>RESULTS</b>The expression of IFN-λ1 in the RSV infection group was significantly higher than that in the healthy control group (P<0.05). The expression of IFN-λ1 was positively correlated with RSV load (r=0.56, P<0.05).</p><p><b>CONCLUSIONS</b>RSV can induce the expression of IFN-λ1 in respiratory epithelial cells, suggesting that IFN-λ1 may play an important role in anti-RSV infection.</p>

Recurrent fever, hepatosplenomegaly and eosinophilia in a boy / 中国当代儿科杂志

A 2-year-old boy was admitted into the hospital because of cough and fever. Lymph node tuberculosis was noted when he was 2 months old and he was subsequently hospitalized several times because of cough and fever. After hospitalization the laboratory examination showed an increased eosinophia level in blood. The immune function tests shows decreased levels of IgG, IgA, and IgM. The patient had no response to anti-tuberculosis, anti-bacterial, and anti-fungal treatment, resulting in recurrent fever and progressive enlargement of the liver and spleen. Jam-like stools were noted 35 days after admission. B ultrasonography showed suspected intussusception. Laparotomy, reduction of intussusception and ileocecum angioplasty, biopsies of intestinal wall nodules and lymphoglandulae mesentericae, and hepatic biopsy were then performed under general anesthesia. The patient eventually died because of postoperative severe liver damage, disseminated intravascular coagulation and electrolyte disorder. Both the blood culture and hepatic biopsy tests showed Penicillium marneffei infecton. Immunodeficiency gene test was performed on the patient, his bother and their parents. T→G base substitution mutation (IVS1-3 T→G) in the CD40L gene was found in the patient. X-linked hyper-IgM syndrome was thus diagnosed in the patient. His mother was a carrier of the mutated CD40L gene, but his father was normal in the gene test. Hemizygous mutation in the CD40L gene was found in both the patient and his bother.

Clinical value of fluorescence lateral flow immunoassay in diagnosis of influenza A in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical value of a new type of fluorescence lateral flow immunoassay in rapid detection of influenza A virus.</p><p><b>METHODS</b>A total of 378 samples of nasopharyngeal secretions were collected from 378 children with influenza-like symptoms to detect the influenza A virus by fluorescence lateral flow immunoassay, colloidal gold immunoassay, and RT-PCR between July 2015 and August 2015.</p><p><b>RESULTS</b>Of the 378 samples, 81 (21.4%) were positive for influenza A virus by RT-PCR. Compared with RT-PCR, the sensitivities of fluorescence lateral flow immunoassay and colloidal gold immunoassay were 90.1% (73/81) and 75.3% (61/81), respectively, and the specificities were 99.3% (295/297) and 98.3% (292/297), respectively. The average threshold cycle (Ct) value for the positive samples detected by the fluorescence lateral flow immunoassay (30.6) was higher than that for the positive samples detected by the colloidal gold immunoassay (28.7).</p><p><b>CONCLUSIONS</b>Compared with colloidal gold immunoassay, fluorescence lateral flow immunoassay has higher sensitivity, specificity, and concordance rate with RT-PCR, suggesting that it can be used for early screening and diagnosis of influenza A.</p>

Clinical features and pathogens of plastic bronchitis in children: an analysis of 9 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical features and pathogens of plastic bronchitis in children.</p><p><b>METHODS</b>A retrospective analysis was performed on the clinical data of 9 children who were diagnosed with plastic bronchitis between January 2011 and December 2012.</p><p><b>RESULTS</b>Plastic bronchitis began with a fever and cough in all cases, followed by progressive dyspnea on days 1-3 of onset; unilateral or bilateral decreased breath sounds and hepatosplenomegaly were found; complications included respiratory failure (6 cases), toxic encephalopathy (6 cases), toxic hepatitis (7 cases), shock (3 cases), heart failure (3 cases), and renal failure (2 cases). Chest X-ray or chest CT showed single and multiple lobar or segmental consolidation and atelectasis, as well as pleural effusion (4 cases). The bronchofibroscopy revealed some grey-white mucus plugs that blocked bronchial openings and aspirates of bronchial shape. Influenza viruses (IFVs) were detected in all cases, including IFV-A (6 cases, 67%) and IFV-B (3 cases, 33%). Mixed infection with IFV-A and Mycoplasma pneumoniae (MP)/bacteria was found in 50% of all cases. In the three cases of IFV-B infection, one was complicated by MP infection. Nine patients were given treatment of antibiotics, hormones, gamma globulin and necessary respiratory support, and also were given removal of endogenous foreign body by bronchoscopy. Five patients were given antiviral therapy of oseltamivir. Seven cases cured, and 2 died.</p><p><b>CONCLUSIONS</b>Plastic bronchitis and severe pneumonia are similar in clinical manifestations. IFVs are the main pathogen. In addition to anti-infection treatment, hormone, gamma globulin, respiratory support, and other conventional treatments, endogenous foreign body removal by bronchofibroscopy and early antiviral therapy with oseltamivir have good efficacy.</p>

Effects of suplatast tosilate on airway inflammation and interleukin-5 in asthmatic rats / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effects of suplatast tosilate (IPD) on the airway inflammation and expression of interleukin-5 in asthmatic rats.</p><p><b>METHODS</b>Fifty adult male Sprague-Dawley rats (4-week- old) were randomly assigned to five groups: placebo control, untreated asthma, budesonide(BUD)-treated asthma , early or late IPD intervention group (n=10 rats each). Asthmatic mode was prepared by ovalbumin sensitizion and challenge. Inflammatory cells and the percentage of EOS were detected in bronchoalveolar lavage fluid (BALF). The lung tissues were removed to detect the lung histomorphology. Gene expression of IL-5 was measured by reverse transcription-polymerase chain reaction (RT-PCR). Levels of interleukin 5 (IL-5) in BALF were measured using ELISA.</p><p><b>RESULTS</b>The inflammatory cells and the percentage of EOS in BALF, IL-5 levels in BALF and IL-5 mRNA expression in the lung tissues were obviously higher in the untreated asthma group than the control group (P<0.05), while the parameters in the IPD or BUD-treated asthma groups were significantly lower than the untreated asthma group (P<0.05).</p><p><b>CONCLUSIONS</b>IPD treatment can alleviate airway inflammation in asthmatic rats, possibly through inhibiting IL-5 mRNA transcripts.</p>

Virus detection in bronchoalveolar lavage fluid of 122 children with severe pneumonia / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the prevalence of viral pathogen in children with severe pneumonia in Hunan.</p><p><b>METHOD</b>Bronchoalveolar lavage fluid [BALF] were collected from 122 hospitalized children with severe pneumonia in People's Hospital of Hunan province from January 2011 to December 2011. Nested- or reverse transcription Polymerase chain reaction (PCR or RT-PCR) was used to screen Adenovirus (ADV), Human Bocavirus (HBoV), Parainfluenzaviruses1-4 (PIV1-4), Human Respiratory Syneytial virus (RSV), Influenza virus A (IFVA), Influenza virus B (IFVB), Human Rhinovirus(HRV), Human Metapneumovirus (HMPV), human coronaviruses NL63 and HKU1 (HCoV-NL63, HCoV- HKU1).</p><p><b>RESULTS</b>Among the 122 bronchoalveolar lavage fluid, viral agents were detected in 60 samples(49.1%), among which ADV (40.98%) was the most common virus, followed by RSV (7.37%) and HBoV (7.37%). Two viruses were detected in 21 individual (35%) samples, of which 20 were dual positive for ADV (40%).</p><p><b>CONCLUSION</b>ADV is the most frequently detected viral etiology of severe pneumonia in children in Hunan during this year. And its Coinfection with other respiratory viruses was common.</p>

Levels of interleukin-4 and interferon-gamma in the bronchoalveolar lavage fluid of children with refractory Mycoplasma pneumoniae pneumonia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To measure levels of interleukin-4 (IL-4) and interferon-gamma (INF-γ) in the bronchoalveolar lavage fluid (BALF) of children with refractory Mycoplasma pneumoniae pneumonia (RMPP), and to investigate changes in local Th1-Th2-type cytokine levels in children with RMPP and their significance.</p><p><b>METHODS</b>A total of 42 children with RMPP were divided into atopic (n=11) and non-atopic groups (n=31) according to whether they had eczema, allergic rhinitis, urticaria, and family history of allergic disease. The study also included a control group of 12 children with bronchial foreign bodies who underwent foreign body removal and were re-examined by fiberoptic bronchoscopy four weeks later. The different cells in BALF from all children were analyzed, and the levels of IL-4 and INF-γ in BALF were measured using enzyme-linked immunosorbent assay.</p><p><b>RESULTS</b>Compared with the control group, the total number of cells in BALF from children with RMPP increased significantly (P<0.05), the increase mainly accounted for by neutrophils (P<0.01), and levels of IL-4 and INF-γ in BALF from children with RMPP increased significantly (P<0.05). Compared with the control group, levels of IL-4 and INF-γ in BALF in the atopic group increased significantly (P<0.05). The level of INF-γ in BALF in the non-atopic group also increased significantly (P<0.05). There were no significant differences in INF-γ/IL-4 ratio among all groups (P>0.05).</p><p><b>CONCLUSIONS</b>Significant increase in cell numbers, especially neutrophils, as well as IL-4 and INF-γ levels, can be seen in BALF from children with RMPP, but there is no change to the INF-γ/IL-4 ratio. This indicates a significant local inflammatory response in children with RMPP, but there is no evidence of Th2-dominated inflammatory response.</p>

Viral etiology of 1165 hospitalized children with acute lower respiratory tract infection / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To explore the viral etiology of acute low respiratory tract infection (ALRTI) among hospitalized children in Changsha of Hunan Province of China.</p><p><b>METHODS</b>Nasopharyngeal aspirates were collected from 1165 hospitalized children with ALRTI in Changsha from September 2007 to August 2008. Respiratory syncytin virus (RSV), human rhinovirus (HRV), influenza virus A (IFVA), influenza virus B (IFVB), parainfluenza 1-3 (PIV 1-3), human metapneumovirus (hMPV), human coronaviruses NL63 (HCoV-NL63), and human coronaviruses HKU1 (HCoV-HKU1) were detected by reverse transcription polymerase chain reaction (RT-PCR). Adenovirus (ADV) and human bocavirus (HBoV) were detected by standard polymerase chain reaction (PCR). WU polyomaviruses (WUPyV) and KI polyomaviruses(KIPyV) were detected by nested PCR. The positive samples further underwent genetic sequencing.</p><p><b>RESULTS</b>Among the 1165 nasopharyngeal aspirates, viruses were detected in 871 samples (74.76%), among which RSV (27.03%) was the most common virus, followed by HRV (17.33%), PIV3 (13.73%), HBoV (8.67%) and hMPV (6.52%). The overall positive rate of viral detection showed no significant differences between males and females (X2=2.241, P=0.134), whereas the positive rates of PIV3, hMPV, and HBoV in males were higher than in females. The positive rate of viral detection showed significant differences among different age groups (X2=10.934, P=0.027), and the highest positive rate was noted in the age group of 6 months to 1 year. Furthermore, the overall positive rate of viral detection showed a significant difference in term of seasonal distribution, with a peak prevalence in winter.</p><p><b>CONCLUSIONS</b>Virues predominate in the etiology of pediatric ALRTI in Changsha, and RSV, HRV and PIV3 are the main viruses for ALRTI. HBoV and hMPV have become increasingly important. Viral infection-associated ALRTI shows a prevail in the age group of 6 months to 1 year as well as in winter.</p>

Results of skin prick test in young children with wheezing or allergic diseases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the characteristics of allergic reactions to common aeroallergens in young children with wheezing or allergic diseases by examining the results of skin prick test in children under 5 years old.</p><p><b>METHODS</b>A total of 196 children under 5 years old, from a district of Changsha City sampled between September 1 to December 31, 2010, were assigned into two groups according to the presence of wheezing or allergic diseases: allergen screening (n=102) and control (n=94). Skin prick tests were performed on both groups.</p><p><b>RESULTS</b>The positive rate of skin prick test in the allergen screening group was 61.8% (63/102), and this was significantly higher than in the control group (9.6%, 9/94; P<0.05). In the allergen screening group, the positive rate of skin prick test in children with both recurrent wheezing and allergic rhinitis was significantly higher than in children with wheezing alone (P<0.05). The frequency of wheezing was positively correlated with a positive skin prick test (r=0.91; P<0.05). The positive rate of skin prick test for mites was significantly higher than for other aeroallergens (24.2% vs 3.5%; P<0.05) in the allergen screening group. Skin prick testing of the children for dermatophagoides farinae showed a higher positive rate than for dermatophagoides pteronyssinus (50.0% vs 14.7%; P<0.05).</p><p><b>CONCLUSIONS</b>Wheezing in early childhood may be associated with the occurrence of asthma. Skin prick testing contributes to the diagnosis of allergic diseases and assessment of allergic reactions to aeroallergens in children with wheezing.</p>

Viral etiology and risk factors for severe community-acquired pneumonia in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the virus spectrum of severe community-acquired pneumonia (CAP) and risk factors for the disease in children.</p><p><b>METHODS</b>Respiratory secretion specimens were collected from 1096 children hospitalized with CAP from June 2007 to November 2008, including 100 cases of severe CAP. Respiratory viruses were detected by PCR, nest-PCR or RT-PCR. Clinical data on the children were analyzed by univariate and multivariate logistic regression analysis for examining risk factors for severe CAP.</p><p><b>RESULTS</b>Viral pathogens were isolated from 82 (82%) of the 100 cases with severe CAP. RSV was the most common (37%), followed by HBoV (25%) and HRV (18%). Mixed infection was noted in 32 cases (32%). The presence of underlying diseases (OR=6.623, P<0.01) and RSV infection (OR=1.672, P<0.05) were risk factors for severe CAP in children, while age was a protective factor (OR=0.475, P<0.01).</p><p><b>CONCLUSIONS</b>RSV is the most frequent viral pathogen in children with severe CAP. The presence of underlying diseases and RSV infection may be risk factors for severe CAP, while age is a protective factor.</p>