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<p><b>OBJECTIVE</b>To explore the effects of inhaled corticosteroids (ICS) on the distribution of throat flora in children with bronchial asthma.</p><p><b>METHODS</b>Sixty healthy children were included in the study as the control group and 160 children with asthma in acute period before ICS therapy were chosen as the experimental group. The experimental group were treated with ICS therapy. In this group, 89 children were followed up for 3 months, 68 for 6 months and 60 for 12 months. The ICS in the study was budesonide with the trade name as Pulmicort. Swab from the pharynx was used, then inoculated in agar plate. The bacteria were isolated, the distribution and variation of the microbial population in pharyngeal portion were evaluated. The data collected were analyzed using SPSS12.0 software.</p><p><b>RESULTS</b>Bacteria could be detected in all samples collected from children with asthma in acute, untreated period, which were mainly non-β-hemolytic streptococcus and gram negative cocci bacteria. Gram negative bacilli, streptococcus pneumoniae and mycetes were less. There were no significant differences (χ(2) value were 4.7441, 7.8582 and 1.5583 respectively, Fisher exact value were 0.0699, 0.6398, 0.2433, 0.8580, 0.6616, 0.6339, and 0.8479 respectively, P > 0.05) among children with asthma in acute period, children with asthma treated with ICS after 3, 6 and 12 months and control group. Three strains of mycetes were detected in the experimental group, and one strain in children with asthma treated with ICS for 6 months group.</p><p><b>CONCLUSIONS</b>There were no significant changes in the distribution of throat flora between the control group and the experimental group. The throat microbiology did not show significant change. Inhaled corticosteroids had no obvious effect in throat flora in children with asthma after being used for a short term and for 12 months, which suggested that inhaled corticosteroids was safe in bronchial asthma treatment. Dynamic monitoring of throat flora while the inhaled corticosteroids are used is of clinical significance.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Administration, Inhalation , Adrenal Cortex Hormones , Therapeutic Uses , Asthma , Drug Therapy , Microbiology , Bacteria , Case-Control Studies , Fungi , Pharynx , MicrobiologyABSTRACT
<p><b>OBJECTIVE</b>Impulse oscillometry (IOS) is a novel technique for the evaluation of pulmonary function. Soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) are definitive indicators for the severity of asthma. This study aimed to explore the relationship of IOS pulmonary function with sICAM-1 and sVCAM-1, and their values in childhood asthma.</p><p><b>METHODS</b>IOS via Master Screen System for pulmonary function was performed in 40 children with acute asthma and 25 healthy children. Twenty-three of 40 children with acute asthma were re-tested for IOS pulmonary function at remission. sICAM-1 and sVCAM-1 levels were measured in 23 children with acute asthma, 20 asthmatic children at remission and 16 healthy children.</p><p><b>RESULTS</b>The parameters of IOS pulmonary function, R5, R20, R5-R20, X5, Fres and Zrs in children with acute asthma were significantly higher than in asthmatic children at remission and in normal controls (q= 2.91-15.61, P < 0.01 or 0.05). There were significant differences in R5, R5-R20, Fres and Zrs between the asthmatic children at remission and normal controls (q= 3.08- 9.19, P < 0.01 or 0.05). sICAM-1 and sVCAM-1 levels in children with acute asthma were significantly higher than in asthmatic children at remission and in normal controls (q= 6.23-26.15, P < 0.01). The asthmatic children at remission had higher levels of sICAM-1 and sVCAM-1 than the normal controls (q=16.86, 12.46, P < 0.01). R5-R20 positively correlated with sICAM-1 and sVCAM-1 in children with acute asthma (r=0.45, 0.57, P <0.05).</p><p><b>CONCLUSIONS</b>IOS for pulmonary function and sICAM-1 and sVCAM-1 may be used to evaluate the severity and therapeutic effects of childhood asthma. A correlation exists between IOS pulmonary function and sICAM-1 and sVCAM-1.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Asthma , Intercellular Adhesion Molecule-1 , Blood , Lung , Oscillometry , Methods , Respiratory Function Tests , Methods , Vascular Cell Adhesion Molecule-1 , BloodABSTRACT
Objective To explore the risk factors for asthma in children.Methods A 1:1 matched and hospital-based case-control study was conducted to analyses risk factors for asthma in 300 pairs of children by logistic regression analysis. Results The result of univariate Logistic regression analysis showed that there were 17 related factors for children asthma, including disease history of parents in respiratory system,family income,atopie character,history of acute respiratory infections, eating habit,the amount of sea foods intakes,foam plastics,family decoration,the way of exhaust fume in kitchen,the exhaust effectiveness,raising pet in house,family history of asthma,family history of allergic rhinitis,family history of food allergy,dust allergy of parents,systemic therapy after the first attack.With multivariate Logistic regression analysis,7 factors were entered the model,6 risk factors including father's history of respiratory diseases(OR 3.771,95%CI 1.533～9.278),low family income(OR 1.503, 95%CI 1.258～1.795),atopy(OR 3.788,95%CI 2.368～6.058),meat-eating habit(OR 2.042,95%CI 1.481～2.815),asthma history of family members(OR 1.710,95%CI 0.988～2.958),the family history of allergic rhinitis(OR 1.991,95%CI 1.234～3.211), and 1 protective factor of raising pet in house(OR 0.443,95%CI 0.265～0.739).The coefficients of these factors in multivariate logistic regression model were 1.327、0.407、1.322、0.714、0.536、0.689、and-0.814 respectively.Conclusion Children asthma was a multi-factorial complex disease,and the interaction of environmental and genetic risk factors played an important role in the onset of this disease.
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Objective To explore the therapeutic effects of Montelukast for bronchial asthma combined with allergic rhinitis(AR) in children.Methods Ninety asthmatic children with AR rhinitis were randomly divided into group A,group B and control group.The children in control group were treated only with Symbicort Turbuhaler.In addition to inhalation of Symbicort Turbuhaler,the children in group A were given Montelukast 5 mg/d orally,while the children in group B were given Budesonide Nasal Spray 64 ?g/d.All the children were observed for 6 months.Daytime and night asthma symptom scores,rhinitis symptom scores,the number of days with or without acute asthma symptoms were recorded every 4 weeks.FEV1%,as one of the lung function parameters,was also recorded in the pre-treatment and 8th week,24th week after the treatment.Results After the treatment,the daytime and night asthma symptom scores and rhinitis symptom scores of group A and group B were significantly reduced(group A:F=3.45,3.35 Pa0.05).However,there was better improvement of FEV1%,more days without symptoms and fewer acute asthma attacks in group A than those in group B (t=3.83,3.76,4.26 Pa
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Objective To investigate clinical significance of computed tomography (CT) scan in diagnosis of bronchial foreign body in children.Methods Twenty-one suspected children with bronchial foreign body were studied with spiral CT cross-section scan and coronal reconstruction and diagnosis was confirmed with bronchoscopy.Results The foreign body was displayed in all of 21 cases. CT scan showed foreign body was located in right main bronchial 12 cases, right middle bronchial 1 case, right inferior lobar bronchial 2 cases and left main bronchial 6 cases. Foreign bodies were extracted with bronchoscopy.Conclusion CT scan can display and locate accurately foreign body in bronchial of children,and has very important diagnostic value in patients having atypical histories, clinical and radiological findings.
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Objective To explore influence of long-term inhaled glucocoticoids(IGS) on soluble intercellular adhesion molecule-1(sICAM-1)) in children with bronchial asthma.Methods Enzyme-linked immunosorbent assay(ELISA) method was used to detect the serum sICAM-1 level in 36 healthy children and 29 children with bronchial asthma(untreated and post-treated for 3,6 and 12 months).Results 1.Serum sICAM-1 level was significantly elevated in children with asthma and significantly higher than that in normal control group(P
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0.05).Conclusion Long-term inhaled glucocorticosteroids has no obvious effect on GH and height growth of asthmatic children.
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Objective To study the effects of different glucocorticasteroid(GCS) inhalation regimens for remissive children with asthma. Methods Three hundred and twenty - three patients with moderate asthma were enrolled on a 12 - week randomized parallel group remissive treatment after a 4 - week baseline treatment. During the baseline treatment terbutaline sulfate 250 ?g tid a day and bud esonide 200 ?g twice a day were given, and oral bronchodilators were used if necessary. The remissive treatment were composed of budesomde inhabit ion 100 ?g once a day (group A), 100 ?g twice a day(group B) and 200 ?g once a day(group 0). Patients subsequently returned to the clinic for 3 additional clinic visits (4,8 and 12 weeks) or telephone visits . On every clinic visit, the daytime and nocturnal time seventy score were recorded and spirometry was conducted in patients who were capable of performing the maneuver. Results Ultimately, 323 children were enrolled on the baseline treatment and 281 (87%) children achieved clinical remission. The rate of compliance decreased gradually during the remissive treatment, but in group B(P
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Objective To explore the effect of Okam on airway inflammation in asthmatic mouse.Methods Thirty-two SPF grade Kunming Strain mice were randomly divided into positive control group,glucocorticoid inhalation group,Okam group and negative control group with 8 mice in each group.The mice were sensitized and repeatedly challenged with ovalbumin(OVA) to establish the models of chronic asthma.The glucocorticoid group were given Budesonide(200 ?g) and saline everyday by inhalation,the Okam group were given 50 mg/kg Okam by gavage,and the positive group had saline at the same time,the negative control group received saline at all stages.The inflammation of the lung tissue were scored underwent HE staining.Bronchoalveolar lavage fluid(BALF) cell count and differential were studied,and interferon-?(IFN-?),interleukin-4(IL-4) in BALF were determined by enzyme-linked immunosorbent assay(ELISA).Results There were no inflammatory cell infiltrate of bronchiole in the negative control group.Inflammatory infiltration of lung tissue were obvious in the positive control group.Inflammatory infiltration of lung tissue lightened obviously in the Budesonide and Okam groups.The total cell number,Eosinophils(EOS) and IL-4 level in BALF,and the score of the lung tissue in Okam group were all markedly lower than those in positive control group(t=5.942,7.089,7.078 Pa0.05),IFN-? lower(t=4.275 P
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Objective To explore the influence of Azithromycin on helper T lymphocyte cell(Th)1/Th2 in peripheral blood of children with bronchitic asthma.Methods Twenty-four asthmatic children and 20 healthy children were selected.Peripheral blood mononuclear cells (PBMC) were isolated from venous blood and made into cells suspension in aseptic condition.0.2 mg/L,0.1 mg/L,0.05 mg/L and 0 mg/L Azithromycin were added into the cultures in asthmatic group.The control group was not interfered with Azithromycin.The supernatant was collected after 48 h.The levels of IFN-?,IL-4 and IL-10 in the supernatant were determined by enzyme-linked immunosobent assay(ELISA).SPSS 11.5 software was used to analyze data.Results 1.The level of IL-4 produced from PBMC of asthmatic group was significantly higher than that of control group(P0.05).2.Azithromycin 0.1 mg/L more promoted the secretion of IL-4 than the other 3 concentrations(Pa0.05).3.Azithromycin 0.2 mg/L and 0.1 mg/L more increased the level of IL-10 than the control group(P0.05).Conclusions The routine drug level of Azithromycin(0.1 mg/L) had no effects on the imbalance of Th1/Th2 of asthmatic children,but could modulate the immunological function by up-regulating the level of IL-10.
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0.05).Conclusions The serum concentrations of cortisol,GH,IGF-Ⅰ and IGFBP3 in children suffered from asthma have no obvious change before and after 24 months long-term inhaled corticosteroids.The height changes before and after therapy have no significant difference between observation group and control group with same age and gender.