ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the significance of gastric acid reflux in children with reflux esophagitis (RE).</p><p><b>METHODS</b>Twenty-four-hour esophageal pH monitoring and gastroscopy were performed in 180 children suffered from vomiting. The relationship between RE, non-esophagitis (NE), non-erosive reflux disease (NERD) and gastroesophageal reflux (GER) was analyzed.</p><p><b>RESULTS</b>Sixty-five of the 180 patients were confirmed as having RE by endoscopy. Among them, the number of cases with grades I, II and III RE according to the diagnostic criteria by endoscopy was 37, 19 and 9 cases, respectively, while the other 115 cases were diagnosed as NE. The positive rate of acid reflux in RE group was 58.5% (38/65), while it was 42.6% (49/115) in NE group (chi(2) = 4.179, P < 0.05). All parameters of acid reflux in RE group except for the episode of reflux and the number of reflux longer than 5 min were significantly higher than those in NE group. None of the parameters of acid reflux except for Boix-Ochoa score in grade III RE patients was significantly higher than that in both grade II and grade I RE cases. However, the difference in acid reflux parameter between grade I and grade II RE patients had not reached statistical significance. The results also showed that the positive rate of pathological acid reflux was 48.3% (87/180). Among them, 38 cases were RE, while other 49 cases were NERD. The difference in acid reflux between these two groups was not significant.</p><p><b>CONCLUSIONS</b>Gastric acid reflux may play a major role in the development of RE in children, but may not be a sole pathogenic factor. The degree of acid reflux is not closely correspondent to the severity of RE. Acid reflux may not completely contribute to RE. Gastroscopy is very important for patients with reflux symptom.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , China , Esophageal pH Monitoring , Esophagitis, Peptic , Diagnosis , Pathology , Esophagoscopy , Gastric Acid , Bodily Secretions , Gastroesophageal Reflux , Hydrogen-Ion Concentration , Severity of Illness IndexABSTRACT
<p><b>OBJECTIVE</b>To evaluate the viral pathogen of pneumonia in children.</p><p><b>METHODS</b>A total of 13 642 cases of children pneumonia in 3 years were enrolled in this study. Antigens of viral pathogen in respiratory excretion, including respiratory syncytial virus (RSV), type 1, 2 and 3 parainfluenza virus, type A and B influenza virus, and adenovirus were detected by direct immunofluorescence method.</p><p><b>RESULTS</b>Viral pneumonia accounted for 34.3% of all cases, including 25.8% cases of RSV, 4.7% of parainfluenza virus, 2.4% of type A influenza virus, 0.2% of type B influenza virus and 1.3% of adenovirus. Coinfection was found in 20 cases, in which 17 cases (85%) were infected with RSV and another virus. Positive rates of RSV in children < or = 1 year, 1 to 3 years, and >3 years were 33.1%, 19.7% and 5.1% with a significant difference (chi(2)(trend)=763.4, P < 0.001). The positive rate of adenovirus in children < or =1 year (0.7%) was significantly lower than that in children aged 1 to 3 years and in children >3 years (2.3% and 2.5%) (all P<0.01). The positive rate of type A influenza virus in children aged 1 to 3 years was higher than that in children < or =1 year (chi(2)=18.2, P<0.01). Type 1 parainfluenza virus was found in 1.2% children aged 1 to 3 years with most prevalence (P<0.05). Infection rates of type 3 parainfluenza in children < or =1 year, 1 to 3 years, and >3 years were 4.7%, 3.2% and 1.4% respectively with a significant difference (chi(2)(trend)=52.4, P<0.01). Although there were some differences of infection rate of RSV in different years, it tended to increase from November to next April with a highest rate of 62.8%. Type 3 parainfluenza virus and Type A influenza virus were almost sporadic while type A influenza virus was epidemic in August 2003 with an infection rate of 15.7%.</p><p><b>CONCLUSION</b>The highest infection rate of viral pathogen of pneumonia in children is RSV and the follows are parainfluenza, influenza and adenovirus in turn.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Adenoviridae , Adenovirus Infections, Human , Virology , Orthomyxoviridae , Orthomyxoviridae Infections , Virology , Paramyxoviridae , Paramyxoviridae Infections , Virology , Pneumonia, Viral , Virology , Respiratory Syncytial Virus Infections , Virology , Respiratory Syncytial VirusesABSTRACT
<p><b>OBJECTIVE</b>To study the epidemiolgy of respiratory syncytial virus (RSV) infection in children and its relations to climate factors in Hangzhou.</p><p><b>METHODS</b>Monthly positive rate of RSV in pneumonia inpatients and climate factor including mean air temperature, mean relative humidity and rainy days per month were continuously observed for 3 years. Correlation analysis for RSV positive rate and these three climate factors were performed using partial correlation, and regression methods between the positive rate and significant factor was done.</p><p><b>RESULTS</b>13 642 cases were detected and 25.8% showed positive of RSV. The positive rate of RSV in children < or =1 years old, 1-3 years old, > 3 years old were 33.1%, 19.7% and 5.1% respectively with significant difference (chi2 = 763.7, P = 0.000). Rate of RSV infection was increased from December and kept in high level until May or April next year, but were varied at different years. Partial correlations between positive rate and rainy days, mean relative humidity, and mean air temperature per month were 0.32 (P= 0.066), -0.27 (P = 0.117) and -0.83 (P = 0.000) respectively. The regression equation of RSV positive rate and mean air temperature was: RSV positive rate (%) = 52.933 - 1.914 x mean air temperature (degrees C).</p><p><b>CONCLUSION</b>RSV was one of the main factors causing of pneumonia in children while the highest infectious rate was in children < or =1 year old and infectious rate reduced along with the increase of age. Low air temperature was the main factor affecting the epidemiology of RSV. RSV was prevalent both in spring and winter in Hangzhou area.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , China , Epidemiology , Climate , Humidity , Logistic Models , Respiratory Syncytial Virus Infections , Epidemiology , Seasons , TemperatureABSTRACT
OBJECTIVE: To study the role of Haemophilus influenzae(Hi) in pneumonia and that of PCR in the diagnosis of Hi pneumonia. METHODS: Hi genus-specific PCR, Hib type-specific PCR and selective Hi culture media were used to detect 83 samples of deep nasal pharyngeal aspiration (NPA), 51 sera from 83 children younger than 3 years with pneumonia and 37 samples of pharyngeal swabs from healthy children. RESULTS: Of 83 NPA samples, 20(24.1 %) were positive by culture, 36 (43.4 %) positive by Hi-PCR and 19 (22.9 %) positive by Hib-PCR.Six out of 51 sera were positive by Hi-PCR and Hib-PCR, but none positive by culture. Of 37 pharyngeal swabs from healthy children, 3 ( 8.1 %) were positive by culture, 6 ( 16.2 %) positive by Hi-PCR and none positive by Hib-PCR. CONCLUSION: Hib-PCR is more appropriate for detecting NPA samples from children with pneumonia because of the high rate of non-typeable Hi carriers in healthy children.