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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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Objective To investigate the clinical features of acute pancreatitis (AP) in children of differem age.Methods From January 2010 to December 2015,pediatric inpatients with AP were searched by pediatric inpatient medical records retrieval system.According to age,patients were divided into three groups:infant and toddler group (age 0 years to three years),preschool group (age ＞three years to six years) and school-aged group (age ＞ six years to 16 years).The clinical features,etiology and laboratory findings of differem age groups were retrospectively analyzed.One-way analysis of variation or rank sum test was performed for measurement data analysis.Chi-square test or Fisher exact probability test was used for the count data analysis.Results A total of 88 pediatric patients (male 38,female 50) were enrolled,and the mean age was (8.8±4.4) years.Infant and toddler group,preschool group and schoobaged group were 16,14,58 cases,respectively.The average days of hospitalization of infant and toddler group,preschool group and school-aged group were (8.4±1.9),(9.4±2.6) and (7.5± 2.5) days,respectively,and the difference was statistically significant (F=3.649,P=0.030).About 93.2％ (82/88) pediatric patients had abdominal pain.The incidence rate of epigastric distention of school-aged group (34.5％,20/58) was higher than those of infant and toddler group (2/16) and preschool-aged group (1/14).The rate of nausea/vomiting of infant and toddler group was significantly higher than those of preschool group and school-aged group (12/16,4/14 and 46.6 ％ (27/58),respectively),and the differences were both statistically significant (x2 =6.250 and 6.805,both P＜0.05).Biliary pancreatitis was the main etiology of infant and toddler group and preschool group,and the incidence was 6/16 and 6/14,respectively.Whereas,there was a variety of etiologies in school-aged group.There were 20 cases (22.7％) of severe AP.The severe cases were more in the infant and toddler group and preschool group (7/16 and 6/14,respectively),and less in school-aged group (12.1％,7/58).There was no statistically significant difference among the three age groups in blood amylase level,lipase level,white blood cells count,blood glucose level,blood calcium level and blood urea nitrogen (all P＞0.05).The percentage of obese children of school-aged group was significantly higher than those of infant and toddler group and preschool group (31.0％,18/58;1/16 and 1/14,respectively),and the difference was statistically significant (x2 =6.689,P=0.035).In addition,the level of serum total cholesterol of school aged group was higher than that of infant and toddler group and preschool group ((5.1±0.9),(3.9±0.6) and (4.8±0.8) mmol/L,respectively),and the difference was statistically significant (F =13.855,P＜ 0.01).The positive rates of abdominal ultrasound of infant and toddler group,preschool group and school-aged group were 5/16,4/14 and 21.1％ (12/57),respectively,and there was no statistically significant difference (x2 =0.889,P 0.706).The positive rates of magnetic resonance cholangiopancreatography (MRCP) of infant and toddler group and school-aged group were 4/4 and 5/6,respectively,and which were both higher than those of pancreases computed tomography (CT) examination (4/14 and 51.2％,22/43) and those of abdominal ultrasound (5/16 and 21.1％,12/57),and the differences were significant (x2 =6.655 and 15.207,both P＜0.05).Conclusions Obese children is more in school-aged children with AP.Children of this age should pay more attention to life style.Nausea or vomiting symptom is more obvious in the infant and toddler children with AP and the condition is more severe.If children of this age with unexplainable vomiting,AP should be considered.Biliary factors are more common in the infant and toddler children with AP.When children are suspected with abnormal structure of pancreatic and biliary ductal system,MRCP should be conducted.
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Objective To explore the clinical characteristics and the levels of interleukin-17 (IL-17) in Mycoplasma pneumoniae (MP) pneumonia patients with atopic sensitization.Methods One hundred and sixty-two patients with MP pneumonia were hospitalized at the Department of Pediatrics,Tianjin Nankai Hospital from October 2015 to December 2016.All children with MP pneumonia were evaluated and divided into 2 groups:the atopic group (atopic MP pneumonia children,n =50) and the non-atopic group (non-atopic MP pneumonia children,n =112).Furthermore,30 healthy children were also included in this study as healthy control group at the Department of Pediatrics,Tianjin Nankai Hospital at the same time.The clinical characteristics and laboratory data of MP pneumonia patients of 2 groups were recorded and analyzed.The levels of serum IL-17 of MP pneumonia patients were measured by using enzyme-linked immunosorbent assays.Results Children with atopic MP pneumonia had more severe pneumonia.At the same time,the number of cases of oxygen therapy and glucocorticoid treatment,the duration of glucocorticoid treatment and the history of previous asthma in the atopic group were higher than those in the non-atopic group,and there was statistical difference between 2 groups(all P ＜ 0.05).The level of serum total immunoglobulin E in the atopic group [230.5 (120.8,421.5) IU/mL] was higher than that in the non-atopic group [79.9 (46.1,125.3) IU/mL],and the level of serum lactate dehydrogenase(LDH) in the atopic group [(319.3 ± 118.9) IU/L] was higher than that in the non-atopic group [(255.5 ± 66.6) IU/L],and there were statistical differences between 2 groups (all P ＜0.01).The levels of serum IL-17 in the healthy control group,atopic group and non-atopic group were (60.2 ± 15.7) ng/L,(382.2 ± 181.7) ng/L and(532.3 ± 169.1) ng/L,respectively,and there were statistical differences among the 3 groups (F =105.668,P =0.000).Whereas,the level of serum IL-17 in the atopic group was lower than that in the non-atopic group,there was statistical difference between 2 groups (t =-3.861,P ＜ 0.01).Conclusion Atopy mav cause adverse effects on the childhood MP pneumonia.It was likely to be relevant to low levels of IL-17.
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Objective In order to raise the clinicians' recognition of biliary pancreatitis in children,the clinical features between children with biliary pancreatitis and those with non-biliary pancreatitis were compared.Methods In this retrospective study,a total of 88 children with acute pancreatitis(AP)were enrolled,who stayed at the Department of Pediatrics,Tianjin Nankai Hospital from January 2010 to December 2015.The clinical characteristics,biochemical index(amylase,lipase,glucose,calcium,hepatic and renal function)and imageology examination [pancreatic ultrasound,pancreatic computed tomography,magnetic resonance cholangiopancreatography(MRCP)] were analyzed and evaluated.The etiology of biliary pancreatitis was analyzed.In addition,the clinical features,laboratory examinations and imageology between the children with biliary pancreatitis and those with non-biliary pancreatitis were also compared.Then,multiple Logistic regression analysis was conducted to identify the factors which were significantly associated with biliary pancreatitis independently.Results Of the 88 cases,there were 68 cases of non-biliary pancreatitis,aged(9.5±4.2)years,and 20 cases of biliary pancreatitis,aged(6.7±4.5)years,who represented the plurality(22.7％),including 9 cases of anatomic abnormalities and 11 cases of choledocholithiasis,cholecystolithiasis and cholestasis.Compared with children of non-biliary pancreatitis,children with biliary pancreatitis had more severe condition,there was statistically significance between 2 groups(x2=23.313,P=0.000).However,there was no statistically significance between 2 groups related to the gender,course of disease,hospitalization time,body mass index(BMI)percentile and clinical symptoms(all P>0.05).Children with biliary pancreatitis showed higher levels of serum amylase,serum lipase and urine amylase than those with non-biliary pancreatitis,and there were statistically significances between 2 groups(Z=-3.535,-3.980,-2.952,P=0.000,0.000,0.003).In addition,children with biliary pancreatitis had higher levels of alanin aminotransferase(ALT),aspartate aminotransferase(AST)than those with non-biliary pancreatitis,and there were statistically significances between 2 groups(Z=-5.625,-2.341,P=0.000,0.019).However,total bilirubin did not differ significantly between 2 groups(Z=-0.453,P=0.650).There was no statistically significance between 2 groups in relation to white blood cell count,C-reactive protein(CRP),lactate dehydrogenase(LDH),blood urea nitrogen(BUN),creatinine(Cr),calcium and glucose(all P>0.05).Of the 88 cases,all children with AP were fasting,fluid and electrolyte supplementation,acid suppression of omeprazole,and octreotide by conservative treatment,which was an inhibitor of exocrine pancreatic secretion.In addition,children with AP should be given intravenous antibiotics covering gram-negative bacteria in the early stage.Children with non-biliary pancreatitis had better prognosis than those with biliary pancreatitis,and there was a statistical significance between 2 groups(P=0.000).Children with non-biliary pancreatitis had lower recurrence risk than those with biliary pancreatitis,and there was a statistical significance between 2 groups(x2=4.778,P=0.044).The positive rate was higher by abdominal ultrasound(45.0％)and computed tomography(CT)(81.2％)in biliary pancreatitis group than those with non-biliary pan-creatitis group(17.9％,35.2％),and there were statistical significances between 2 groups(x2=4.782,10.554,P=0.029,0.002).However,there was no statistical significance in relation to MRCP between the biliary pancreatitis group(83.3％)and the non-biliary pancreatitis group(85.7％)(P=1.000).In multiple Logistic regression analysis,ALT was an independent predictor of biliary pancreatitis(OR=0.896,P=0.001).Conclusions ALT is the significant risk factor for predicting biliary pancreatitis over other etiology.A biliary cause should be suspected in children with AP who are presented with high levels of ALT.These findings will spur prospective studies to determine the optimal evaluation and management of children with biliary pancreatitis.
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Abstact:Objective To explore the clinical characteristics of biliary pancreatitis in children.Methods The clinical data from 10 children with biliary pancreatitis from January 2011 to July 2015 were retrospectively analyzed.Result In 10 children (2 males and 8 females), the average age was 6.1?±?4.9 years old, and the average hospital stay was 8.4?±?3.8 d. There were 4 cases of gallstone, 4 cases of cholestasis, 2 cases of calculus of bile duct, 2 cases of choledochocyst and 1 case of pancreatic divisum. Abdominal pain was the main clinical manifestation in these 10 children. All of them had elevated serum amylase, with the maximum value of 106-922 U/L. Six cases had elevated lipase of 22-2000 U/L. Six cases had abnormal serum alanine aminotransferase. Two cases had hypokalemia. One case had hypoglycemia. Four cases had acid-base imbalance. Abdominal ultrasonography showed pancreatitis in 4 cases. CT showed pancreatitis in all children. All of the children were treated by fasting, lfuid infusion, maintaining water and electrolyte balance, inhibiting gastric acid by omeprazole and inhibiting pancreatic secretion by octreotide. Nine cases were improved by conservative treatment and discharged, and one case was transferred to surgery. Conclusion The incidence of biliary pancreatitis in children is low. The clinical manifestation is atypical. Pancreatic duct abnormalities are more common in young children, in whom the effect of conservative treatment is relatively good.
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Objective To observe the effect of dexamethasone on the levels of IL-12 and IL-13 in bronchoaveolar la-vage fluid (BALF) and serum in rats with Mycoplasma pneumoniae (MP) infection. To explore the mechanism of treatment MP pneumonia by dexamethasone. Methods A total of one hundred rats were randomly divided into four groups:azithromycin in-tervened group (n=25); dexamethasone intervened group (n=25); azithromycin and dexamethasone combination intervened group (n=25);control group (n=25). The rat model of MP pneumonia was established by dropping pneumonia bacterial liquid to its nasal cavity on day 0, 1, 2, and 3. Four groups received different interventions at the second day when the model was estab-lished successfully. Amounts of IL-12 and IL-13 in BALF and serum were measured by ELISA, the inflammatory infiltration of lung tissues was evaluated on day 3, 5 and 8. Results Compared with the control group, the expression of IL-12 and IL-13 in se-rum and BALF in azithromycin intervened group and combination intervened group had a significant difference (P<0.05) on day 3, 5 and 8. Amount of IL-12 in serum in combination intervened group was higher than azithromycin intervened group on day 3, whereas IL-13 was lower than that in azithromycin intervened group (P<0.05). Conclusions Dexamethasone can relieve inflammatory infiltration of lung tissues in rats.