ABSTRACT
Objective:To observe the role of Huaiqihuang Granules (HQ) in the long-term management of bronchial asthma in young children, and the effective effect on concomitant rhinitis.Methods:A prospective real-world multicenter study was conducted in children aged 2-5 years with asthma diagnosed in the outpatient department (from April 2016 to March 2019)who received either inhaled corticosteroid (ICS)/leukotriene receptor antagonist (LTRA)(control group); inhaled ICS/LTRA plus HQ(combination group), or HQ alone(HQ group). All patients were followed up at week 4, 8, 12 after treatment. The number of days with asthma symptoms, the frequency of severe asthma attacks, the level of asthma control, and the days with rhinitis symptoms in the last 4 weeks were recorded. Differences before and after treatment, and those among groups after treatment were compared using Kruskal- Wallis H test or Wilcoxon rank-sum test. Results:A total of 2 234 eligible patients were recruited, and 2 147 cases completed followed-up visits, including 477, 1 374 and 296 cases in the control group, combination group, and HQ group, respectively. After the treatment, all 3 groups showed significant declines in the days with asthma symptoms, frequency of severe asthma attack and the days with rhinitis symptoms (all P<0.01), and the rate of well-controlled asthma increased significantly ( P<0.01). It lasted until the end of follow-up. Among groups, patients in the combination group showed significantly less days of asthma symptoms than those of the other 2 group at week 8 and 12[0(0, 0.9) d vs.0(0, 0.3) d, P<0.05; 0(0, 0.1) d vs. 0(0, 1.0) d, P<0.01]. Patients in the combination group and HQ group showed a significantly lower rate of severe asthma attacks than that of the control group at week 12 [0(0, 1), 0(0, 1), 0(0, 2), all P<0.05]. The well-controlled rate of asthma in the combination group was significantly higher than that of the control group and HQ group at week 8 and 12 (89.6% vs. 85.9% vs.82.1%, H=15.28; 90.9% vs. 84.1% vs. 81.8%, χ2=29.32, all P<0.01). Conclusions:HQ can significantly alleviate symptoms of asthma and rhinitis, severe attack of asthma, and increase the control rate of asthma when used as an additional treatment or used alone.
ABSTRACT
Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.
ABSTRACT
Hypoxemia is a common complication of pneumonia, asthma, and bronchopulmonary dysplasia in children.Rapid identification of hypoxemia is of great significance for the disposal and management of critical children.Pulse oximetry is recognized by the World Health Organization as the best way to monitor hypoxemia in children, and it can monitor pulse oxygen saturation noninvasively and continuously.Based on the related literature at home and abroad, combined with the clinical needs of pediatrics, the " Expert consensus on clinical application of pulse oximetry in children" is formulated to improve the understanding of pediatricians and nurses on the application in pediatric clinical practice, principle, operation techniques, and limitations of pulse oximetry.
ABSTRACT
Objective@#To investigate the clinical manifestations of surfactant protein C gene (SFTPC) exon-2 c. 115G>G/T (p.V39L).@*Method@#Patients were screened for the entire coding sequence of SFTPC. Three cases from three children′s hospital with mutation in p. V39L were reported.@*Result@#All the three cases were females. The age of onset ranged from 2 months to 7 years. Two cases had recurrent lower respiratory tract infection and failed to thrive. One had chronic anoxia and clubbing fingers. Chest computed tomography (CT) showed diffused ground glass pattern, localized emphysema and intralobular septal thickening. In one case, early sign of cyst formation was also shown on CT. Two were lost to follow-up after alleviation of acute respiratory infection. One was treated with oral low-dose azithromycin and nebulized budesonide and terbutaline. She had recurrent lower respiratory tract infection in more than one year of follow-up.@*Conclusion@#Mutations in SFTPC p. V39L cause interstitial lung diseases. Clinical manifestations included recurrent respiratory tract infections, chronic lung disease. Chest CT showing diffused ground glass pattern, localized emphysema, intralobular septal thickening and early sign of cyst formation. The treatment and prognosis need further study.
ABSTRACT
Objective To investigate the related risk factors of complicated parapneumonic effusion (CPPE) in children. Method The clinical data of 88 children with parapneumonic effusion (PPE) were retrospectively analyzed from January 2013 to April 2015. According to the treatment effect of antibiotics, CPPE group and uncomplicated parapneumonic effusion (UPPE) group were divided. The univariate analysis of clinical and laboratory parameters was performed between two groups. Then the multifactor logistic regression was performed further. The receiver operator characteristic (ROC) curve was draw. Results The univariate analysis indicated that the risk factors were the formation of loculation and serum CD3+ and CD19+ levels (Z=2.030~7.457, P30%and the formation of loculation.
ABSTRACT
Objective To explore the clinical characteristics of pleural effusion caused byMycoplasma pneumoniae in children.MethodsThe clinical data from children with pleural effusion caused byMycoplasma pneumoniae were retrospectively analyzed. Differences of clinical characteristics in children with pleural effusion caused byMycoplasma pneumoniae infection and non-Mycoplasma pneumoniae infection were compared. Moreover, multiple logistic regression analysis was performed on the factors that were identified to have statistical differences in single factor analysis. Receiver operating characteristic (ROC) curve was performed and the diagnostic boundary value of each factor and the diagnostic accuracy of the regression model were calculated.ResultsThere were statistical differences between children with pleural effusion caused byMycoplasma pneumoniae infection and by non-Mycoplasma pneumoniae infection in age, white blood cell count, lactic dehydrogenase (LDH), levels of IgA and IgM, and the proportion of multiple nuclei, glucose and lactic acid (LAC) in pleural effusion, pleural thickening, and formation of ifbrous separation (allP??3.92 years, serum IgM?>?1.29 g/L, LDH?>?367 U/L and pleural effusion LAC?
ABSTRACT
Objective To identify the relevant factors for the loculation clinically in children with parapneumonic pleural effusion (PPE).Methods The clinical data of 172 children with PPE were retrospectively reviewed from January 2012 to March 2015 in Children's Hospital of Hebei Province.Based on the findings of chest ultrasound, the subjects were divided into 2 groups, the loculation group (78 cases) and the control group (94 cases).The comparison was made between the 2 groups in gender, age, course of disease and fever before admitting into hospital, the location of the effusion, white blood cells (WBC) and the percentage of neutrophils (N), blood platelet (PLT) ,lactate dehydrogenase (LDH),C-reactive protein (CRP), mycoplasma (MP), the routine and biochemical examination of pleural fluid, including white cell count (WBCp), the percentage of polymorphonuclear cell (PMN), lactate dehydrogenase (LDHp) ,glucose (GLU) ,adenosine deaminase (ADA) ,lactic acid (LAC) and C-reactive protein (CRPp).If the result of single factor regression showed P ＜ 0.01, the indicators were analyzed by the multifactor Logistic regression.The receiver operator characteristic (ROC) curve was drawn to evaluate the prediction ability of Logistic regression models.Results (1) The result of single factor regression indicated that the risk factors included age, WBC, PLT, LDH, MP, WBCp, PMN, GLU and LAC (all P ＜ 0.05).(2) The result of multifactor Logistic regression showed that the factors included PLT (OR =3.437,P =0.007), LDH (OR =0.306, P =0.006), GLU (OR =0.324, P =0.037), MP (OR =0.375 ,P =0.022) and LAC (OR =3.656, P =0.003).(3) The area under the ROC curve was 0.876, P =0.000,which indicated that the regression models had over medium diagnostic accuracy.Conclusions When PLT ＞ 434.5 × 109/L,LDH ＜400 U/L,non MP infection,GLU ＜6.11 mmol/L and LAC ＞3.83 mmol/L,it may indicate that the formation of loculation for the PPE children.
ABSTRACT
Objective To analyze the risk factors of mucous plug caused byMycoplasma pneumoniae pneumonia (MPP) in children and guide clinical therapy to decrease the incidence of sequela caused by airway inlfammatory obstruc-tion.Methods We conducted a retrospective study of the clinical data of 116 children with MPP who received ifber broncho-scope from January 2012 to January 2014 admitted to the respiratory department of the Children's Hospital of Hebei provience. Based on the airway mucosal lesions seen through the bronchoscope, the subjects were divided into the mucous plug group (n=67) and the control group (n=49). Gender, age of onset, febrile course, pleural effusion, white blood cell counts, neutrophil ratio, C reactive protein (CRP), serum lactate dehydrogenase level (LDH), initial time of received macrolides and ifber bronchoscope were compared between the two groups. If the Results of single factor analysis showedP<0.05, the indicators were analyzed by the logistic regression analysis. The receiver operator characteristic (ROC) curve was drawn to evaluate the predictability of logistic regression model.Results The Results of single factor analysis showed that age of onset, febrile course, CRP, serum LDH, pleural effusion cases in the mucous plug group were higher than those in control group (P<0.05). The Results of the logis-tic regression analysis showed that older than three years (OR=7.45), febrile course more than 10 days (OR=4.01), the level of CRP and LDH higher than 40 mg/L (OR=5.41) and 350 U/L (OR=3.63) were respectively the risk factors of mucous plug caused by MPP in children. The area under the ROC curve is 0.846 (95%CI: 0.773-0.919,P=0.000).Conclusions MPP children with age older than three years, or with febrile course more than 10 days, or with the level of CRP and LDH higher than 40 mg/L and 350 U/L has the possibility of forming a mucous plug.
ABSTRACT
Objective To investigate the allergens of asthmatic children of the local area, and provide a reliable objective basis for the prevention, treatment and care of children with asthma. Methods Allergen skin prick test was performed on 217 asthmatic children in our hospital out-patient clinic and hospital from February,2008 to September,2009. All children were divided into three groups by age, there were 48 cases with asthma in the five-months to three-year-old group, 57 cases with asthma in the 3 year-old group, and 112 cases with asthma in the 5 to14 year-old group. The production of allergens developed 10 kinds of inhaled,7 kinds of food allergen with Beijing Union Medical College Hospital Research Center. Results The total positive rate of allergen skin prick test of asthmatic children was up to 89.4%. Conclusions Among the allergic factors, the inhaling allergens are the main factors at wheezing episodes in the local area, and dust mites, indoor dust are the main allergens in the inhaling allergens, in the allergic factors of food, sea shrimp is the important factor that could not be ignored to the wheezing episodes. Therefore, helping parents and children to avoid or reduce dust mites, room dust and sea shrimp exposure is the most basic measures for the prevention, treatment and care of children with asthma.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the expression of mdr1 gene in hematopoietic cells of a murine bone marrow transplantation model and to explore the feasibility of transferring mdr1 gene into hematopoietic cells to pro-vent myelosuppression from chemotherapy.</p><p><b>METHODS</b>mdr1 gene was transferred into hematopoietic cells of murine bone marrow by retrovirus vector. The expression and function of mdr1 gene in vivo was tested in a murine bone marrow transplantation model.</p><p><b>RESULTS</b>(1) mdr1 gene was successfully transferred into murine MNC, the transduction rate was 35%. (2) mdr1 gene transferred murine bone marrow transplantation model was established successfully by scheduled-bone marrow transplantation method. (3) In 1 approximately 5 months period, stable and effective expression of mdr1 gene could be detected in hematopoietic cells of the recipient mouse, the percentage of mdr1 gene expression cells in recipient's hematopoietic cells decreased monthly to 8.0%, 8.0%, 7.5%, 4.0% and 3.0%. (4) mdr1 expression hematopoietic cells had efficient resistance to chemotherapy.</p><p><b>CONCLUSION</b>It is an effective approach to transfer mdr1 gene into hematopoietic cells for preventing myelosuppression in chemotherapy.</p>