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Antibiotic-associated diarrhea(AAD) is a frequent adverse effect of antibiotic in children.AAD is associated with longer hospitalization, higher healthcare cost and even lead to death.Pediatricians usually do not pay enough attention to AAD.Domestic experts from pulmonary medicine, infection and gastroenterology are organized to develop the consensus, to improve the diagnosis, treatment and prevention of AAD, and contribute the children health in future.
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Objective To analyze the effects of Hual qi huang granules on children with mycoplasma pneumoniae pneumonia.Methods A randomized,multicenter parallel controlled clinical trial was carried out.A total of 3 000 cases of hospitalized children with mycoplasma pneumoniae pneumonia were selected.All of them were given treatment for mycoplasma pneumoniae pneumonia with macrolide antibiotics and symptomatic treatment.They were randomly divided into 2 groups:research group and control group.The children of research group were give oral Huai qi huang granules for three months.According to the classification of pneumonia,these two groups were divided into:lobar pneumonia research group,lobar pneumonia control group,lobular pneumonia research group,lobular pneumonia control group.The hospitalization duration of fever,length of hospital stay,the absorption area of lung inflammation and pneumonia severity sores were observed.The frequency of upper respiratory infections,bronchitis,pneumonia were observed in 3 months after discharge.Results 2 378 cases were investigated.The hospitalization duration of fever,length of hospital stay of research group were significantly shorter than that of in control group (P ＜ 0.001).The children with lobar pneumonia,2 weeks after treatment,the absorption of consolidation of the lobar pneumonia research group is significantly better than lobar pneumonia control group (P ＜0.001).After two weeks treatment,the pneumonia scores of lobar pneumonia research group is lower than lobar pneumonia control group (P ＜ 0.05).Followup of 3 months after hospital discharge,frequency of upper respiratory infection and bronchitis of research group,were significantly lower than that of control.In addition,appetite increased significantly in research group than control (P ＜ 0.001).There are 21 cases with drug associated adverse reactions (mild diarrhea),including 12 cases of research group,9 cases of control group,and there was no statistical significance (P ＞0.05).Conclusion Standard treatment combined with oral Huai qi huang granules in the treatment of mycoplasma pneumoniae pneumonia,can significantly shorten hospitalization duration of fever,length of hospital stay and reduce the severity score of pneumonia.Three months oral Huai qi huang granules can significant reduce the frequency of respiratory infections and bronchitis,also can increase patients appetite,and be safe.
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The incidence of obstructive sleep disordered breathing (SDB) in children increases gradually, while good sleep is the premise to ensure the healthy growth of children. Reasonable and effective treatment can reduce or completely alleviate the symptoms of children, reduce complications and improve children's quality of life. Trauma and complications caused by simple surgical treatment make parents and clinical workers expect more safe and effective treatment plan. Positive airway pressure,drugs and other non-surgical treatment methods become more mature,and the research progress is reviewed in this paper.
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MicroRNA is small,noncoding,single-stranded RNA,which represses gene expression by mRNA destabilization and translational inhibition.With the further study of microRNA,it is found to be related to allergic disease in children, including allergic rhinitis, atopic dermatitis, eosinophilic esophagitis,asthma,milk protein allergy,etc.In recent years,with the change of the living environment and diet structure,the incidence of children allergic disease is increasing.The emergence of microRNA provides a new diagnosis method for children allergic disease.This article summarizes the research progress of microRNA in allergic disease in children.
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Objective To explore the relationship between the polymorphism of integrin-metalloproteinase-33 (ADAM33) gene and bronchial asthma. Methods Subjects were selected from the Department of Respiratory Medicine in our department from June 2015 to December 2016 in the treatment of 120 cases of asthma patients as the observation group, the same period into our hospital physical examination of 120 healthy children as the control group. The patients were enrolled in the upper extremity elbow vein and extracted DNA, followed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and sequencing. The frequency of T2 genotype distribution and the frequency distribution of T2 locus and the relative risk of asthma were compared according to Hardy-Weinberg equilibrium law. Results The frequency of A gene in the T2 allele of the subject was significantly higher than that of the control group. The frequency of A gene in the T2 allele was significantly higher than that in the control group (P<0.05) There was significant difference between the two groups (χ2=8.09, P=0.00), and the increase of A allele was the risk factor of asthma (OR=2.32); the observation group T2 gene AG (χ2=4.21, P=0.04), and the increase of AG allele was the risk factor of asthma. The frequency of asthma was significantly higher than that of control group (OR=1.89). Conclusion ADAM33 gene T2 locus polymorphism is significantly associated with bronchial asthma, which can significantly increase the risk of bronchial asthma.
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Allergic bronchial pulmonary aspergillosis is a kind of lung disease that is a body of the parasitic in the bronchial aspergillus caused by allergic reactions.This disease usually occurs in patients with asthma and cystic fibrosis.Due to China's high incidence of asthma,to improve the awareness of asthma in patients with allergic bronchopulmonary aspergillosis and timely treatment are particularly important.Glucocorticoid inhibition of immune inflammatory response combined with antifungal agents to reduce fungal load is the main treatment.There are also anti-IgE treatment and other treatment.
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Childhood functional constipation(FC)as a common digestive system disease,has been valued by clinicians.Because of its high incidence,the adverse effects of physical health and mental health of the children formed a greater social burden.In the course of treatment,symptoms can be difficult to control,easy to relapse,so in recent years for childhood FC reports continue to emerge.In this paper,childhood FC diagnosis,etiology,treatment,problems and follow-up are reviewed.
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Objective To observe the clinical efficacy and safety of GINA regimen and GINA regimen combined with oral Huaiqihuang granule in the treatment of children with bronchial asthma.Methods A ran-domized,single blind,multicenter,parallel controlled clinical trial wascarried out.A total of 1 128 patients with bronchial asthma in children were randomized into two groups.The observation group were treated with GINA regimen combined with oral Huaiqihuang granule.The GINA regimen treatment group was treated by GINA reg-imen.Clinical assessment and C-ACT scores was observed in first month,third month,sixth month after treat-ment.Clinical assessment included the times of upper respiratory tract infection occurrence,bronchitis and pneu-monia,asthmatic attacks,application of emergency medicine,hospitalizations due to asthmatic.Drug adverse effect in the two groups was compared.Results The times of upper respiratory tract infection,bronchitis and pneumonia,asthmatic was significantly decreased(P 0.05).Conclusion The treatment of bronchial asthma in children with GINA regimen combined with oral Huaiqihuang granule can significantly reduce the incidence of respiratory infections and the number of asthmatic attacks dramatically and safely improve clinical curative effect,asthma control.
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Objective To explore the characteristics and clinical significance of lung function in children with mycoplasma pneumoniae pneumonia. Methods The pulmonary ventilation function of 60 cases of mycoplasma pneumoniae pneumonia was tested in the acute stage and 2 weeks after treatment by the pneumatometer made by JAEGER company in Germany. FVC, FEV1, PEF, FEF25,FEF50、FEF75 and MMEF75/25 was detected. Results In acute phase, lung function indexs (FVC, FEV1, PEF, FEF25, FEF50, FEF75, MMEF75/25) of 60 children with MPP were less than expected:(1.56 ± 0.53) L vs.(1.99 ± 0.69) L, (1.37 ± 0.47) L vs. (1.68 ± 0.57) L, (2.90 ± 0.86) L/s vs. (3.95 ± 1.08) L/s, (2.48 ± 0.67) L/s vs. (3.56 ± 0.89) L/s, (1.42 ± 0.41) L/s vs. (2.51 ± 0.64) L/s, (0.65 ± 0.20) L/s vs. (1.28 ± 0.33) L/s, (1.22 ± 0.77) L/s vs.(2.18 ± 0.61) L/s], and there were significant difference (P<0.01). In recovery period, the level of FVC, FEV1, PEF, FEF25, FEF50, FEF75, MMEF75/25 was significantly better than that in acute phase: (98.80 ± 9.34)% vs.(79.14 ± 6.28)%, (98.67 ± 8.28)% vs. (81.63 ± 6.56)%, (86.23 ± 6.86)% vs.(73.17 ± 6.21)%, (85.17 ± 7.86)% vs. (69.79 ± 8.16)%, (79.08 ± 7.99)% vs. (56.57 ± 8.77)%, (70.85 ± 7.48)% vs. (50.66 ± 9.86)%, (77.35 ± 6.81)% vs. (56.19 ± 9.61)%, P<0.01. Conclusions In the acute stage, the pulmonary function of children with MPP shows hybrid ventilation dysfunction. In the recovery period, pulmonary function index improves significantly, but there are still abnormal small airway indicators.
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Mycoplasma pneumonia (MP) is one of common pathogens of community-acquired pneumonia in children. In recent years, the incidence of MP pneumonia (MPP) shows a trend of increasing. The report of severe refractory MPP was more and more. Glucocorticoids has anti-inlfammatory, anti-allergic and restraining immune response pharmacological effects and is the most effective anti-inlfammatory drug currently. In this paper, pathogenesis of the lower respiratory infection by MP and the therapeutic effects of glucocorticoid were reviewed.
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Objective To investigate the change of lung function in children with atypical asthma and different lung function index to evaluate the difference of bronchial dilation test positive rate.Methods Seventy-one cases of atypical asthma children routine monitoring lung function,underwent bronchial dilation test,the airway index changes were observed.Results Seventy-one cases of atypical asthma children with big airways function index of forced expiratory volume in first second FEV1,percentage of FEV1 to forced vital capacity (FVC) were basic normal,and the reaction of small airways function index of forced expiratory flow at 25％ of FVC,forced expiratory flow at 50％ of FVC,forced expiratory flow at 75％ of FVC,forced expiratory flow at 25％-75％ of FVC were decreased in different degrees,and mainly for medium and severe damage.FEV1 as evaluation index,the positive rate of bronchial dilation test diastolic was 47.9％ (34/71),and forced expiratory flow rate at 25％-75％ in FVC as evaluation index,the positive rate of bronchial dilation test was 69.0％ (49/71),there was significant difference (x2 =8.086,P =0.004).Conclusions Lung function changes in atypical asthma children are mainly on small airways,and mainly for medium and severe damage,the bronchial dilation test positive rate in such children using the evaluation,forced expiratory flow rate at 25％-75％ in FVC can assist FEV1,decrease the rate of misdiagnosis and missed diagnosis.
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Objective To discuss the characteristics of pulmonary function in children patients with positive bronchodilating response using impulse oscillation system(IOS) and provide the evidence for clinical diagnosis and performing IOS.Methods Seventy children patients with bronchodilating response using IOS were recruited randomly for this study.Forty children patients with positive bronchodilating response were regarded as positive group and the other thirty children patients with negative bronchodilating response were regarded as negative group.The IOS parameters,for example,total respiratory impedance (Z5),respiratory resistance at 5 Hz(R5),reactance at 5 Hz(X5),peripheral respiratory resistance(Rp) in the two groups were analyzed.Results Z5,R5,X5 of the positive group [(123.45 ± 24.75)％,(120.09 ± 25.40)％,(138.62 ± 33.48)％] were higher than those of the negative group [(103.89 ± 16.30)％,(102.67 ± 18.16)％,(111.85 ± 14.93)％].There were significantly different between the two groups (P ＜ 0.05).Moreover,Rp ≥ 19.89 cmH2O/ (L·s)(1 cmH2O =0.098 kPa) in the positive group was 50.00％(20/40),which was higher than that in the negative group[23.33％(7/30)].There was significant difference between the two groups(P＜ 0.05).Conclusions The impedance of children patients with positive bronchodilating response using IOS is significantly increased,especially X5.When IOS parameters ≥ 100％,especially X5 ≥ 100％,which suggest that perform the bronchodilation test in order to decrease the rate of missed diagnosis of asthma.