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1.
Article in Chinese | WPRIM | ID: wpr-930494

ABSTRACT

Objective:To observe the therapeutic timing and dosage of intravenous immunoglobulin (IVIG) in children with severe adenovirus pneumonia.Methods:Clinical data of children with severe adenovirus pneumonia treated with IVIG at the Department of Respiratory, Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from January 2019 to January 2020 were retrospectively analyzed.Participants were classified as early presenters (5-10 days of illness course) and later presenters (11-15 days of illness course) according to the timing of IVIG treatment.They were further subdivided into plan 1 group[1 g/(kg·d) IVIG for 2 days] and plan 2 group [0.4-0.5 g/(kg·d) IVIG for 3-5 days]. Continuous variables and categorical variables between groups were analyzed by the nonparametric Mann- Whitney U test and the Fisher′ s exact test, respectively. Results:A total of 202 patients with the median age of 12 (12, 36) months were recruited, involving 128 early presenters (63.37%) and 74 later presen-ters (36.63%). Later presenters had a longer duration of fever [18.00(14.00, 23.25) days vs.11.00(9.00, 14.00) days], more demands for mechanical ventilation (33.78% vs.20.31%), and higher incidence of bronchiectasis (9.46% vs.1.56%) than those of early presenters (all P<0.05). For early presenters, no significant differences were detected in the demand for advanced life support, outcomes and sequelae between plan 1 group and plan 2 group (all P>0.05). For later presenters, a shorter duration of fever [18.00(14.00, 21.00) days vs.21.00(15.50, 30.75) days] and lower usage of extracorporeal membrane oxygenation (ECMO, 2.13% vs.18.52%) were observed in the plan 1 group than that of plan 2 group (all P<0.05). The incidence of post-infectious bronchiolitis obliterans and bronchiectasis as pulmonary sequelae was comparable between plan 1 group and plan 2 group ( P>0.05). The incidence of adverse events was 5.77% during IVIG infusion, showing no significant difference between plan 1 group and plan 2 group ( P>0.05). Conclusions:Early treatment of IVIG are very important to improve the prognosis of children with severe adenovirus pneumonia.For later presenters, a high dosage of IVIG is effective in reducing the ECMO use and shortening the duration of fever, thus providing clinical benefits.

2.
Article in Chinese | WPRIM | ID: wpr-930491

ABSTRACT

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

3.
Article in Chinese | WPRIM | ID: wpr-930463

ABSTRACT

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection (LRTI) and hospitalizations in infants under 1 year of age, seriously jeopardizing infants′ health.Most hospitalizations (up to 80%) due to RSV-LRTI occur in otherwise healthy infants born at term.At present, no effective treatment and preventative measure against RSV is available domestically.Passive immunization with fully human long-acting monoclonal antibody Nirsevimab offers immediate protection for all infants experiencing their first RSV season with one shot, thus ushering in a new era of prevention of RSV infection among infants.

4.
Article in Chinese | WPRIM | ID: wpr-930461

ABSTRACT

Penicillium marneffei (PM) is the only thermally dimorphic species as a Penicillium that causes the transmitted penicilliosis marneffei (PSM). PM infection is more common in immunodeficient children.Due to the lack of specific clinical manifestations, PSM is easily misdiagnosed as pulmonary plasmacycosis, tuberculosis or pulmonary aspergillosis.Because of the rapid progress and multiple complications of transmitted PSM, its mortality remains high without timely and effective treatment.Therefore, early diagnosis and treatment are of great significance, and the diagnosis of PSM mainly relies on the immune function examination, measurement of serum markers, pathogen detection and imaging examinations.There is no standard antifungal regimen, and Amphoterus B and Itraconazole are used as the first-line treatment.This study aims to review the progress of diagnosis and treatment of PM infection in children.

5.
Article in Chinese | WPRIM | ID: wpr-930430

ABSTRACT

Acute respiratory tract infection is the most common infectious disease in children, which seriously threatens children′s health.Rapid and accurate etiological diagnosis is of great significance for the clinical treatment and control of these diseases.Pathogen nucleic acid test was applied and became the main method of respiratory tract infection diagnosis for its high sensitivity and specificity.To regulate the application of pathogen nucleic acid amplification test in respiratory tract infection in children, improve the diagnosis level, expert consensus on nucleic acid amplification test of respiratory pathogens in children was prepared to guide the application and promote pathogens diagnosis ability.

6.
Article in Chinese | WPRIM | ID: wpr-929841

ABSTRACT

Human adenovirus(HAdV)is a double-stranded DNA virus with multiple serotypes.Owing to their genetic heterogeneity, HAdVs display broad tissue tropism and can infect several organs or tissues.Besides the most common respiratory system, different types of HAdV can enter into multi-tissue and cells of the whole body through different receptors and mechanisms, directly destroy the host cells and also trigger immune response that course further damages.Then a variety of extrapulmonary manifestations would appear, such as gastroenteritis, encephalitis, myocarditis, hemorrhagic cystitis, hemophagocytosis and conjunctivitis, which seriously threaten the health of children.

7.
Article in Chinese | WPRIM | ID: wpr-929821

ABSTRACT

Bronchial asthma is one of the most common chronic respiratory diseases in children.One of the important reasons for its recurrent exacerbations is respiratory virus infection.Coronavirus disease 2019(COVID-19), caused by 2019 novel coronavirus(2019-nCoV), has induced a large global outbreak.However, the impact of COVID-19 pandemic on asthmatic children remain unclear.This article summarizes the susceptibility of children with asthma to 2019-nCoV, the severity of asthma combined with COVID-19, treatment and management recommendations, asthma control, and the changes of mental health conditions during the uptrend period of COVID-19 epidemic.It may provide helpful evidence for clinical practice.

8.
Article in Chinese | WPRIM | ID: wpr-912872

ABSTRACT

Objective: To observe the clinical efficacy of acupuncture plus MOTOmed intelligent motor training in treating children with spastic cerebral palsy, and analyze the effects on lower limb motor function, intelligence development level, immune function and cerebral hemodynamics.Methods: A total of 42 children with spastic cerebral palsy were selected as the observation objects, and enrolled into the observation group. Another 42 cases treated in the same period were selected as the control group. Both groups received MOTOmed intelligent motor training, and the observation group was given additional acupuncture therapy, and the control group was given additional conventional rehabilitation treatment. After 2 consecutive treatment courses, the psychomotor development index (PDI) and mental development index (MDI) of Children's Developmental Center of China (CDCC) scale, the scores of gross motor function measure (GMFM) scale and modified Ashworth scale (MAS), and the changes in CD3+, CD4+, CD8+ and CD4+/CD8+ were observed. The peak systolic velocity (PSV) and mean flow velocity (MFV) of the anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) were observed and measured. The clinical efficacy was evaluated. Results: Compared with the same group before treatment, the scores of GMFM, PDI and MDI, levels of CD3+, CD4+ and CD4+/CD8+, PSV and MFV levels of ACA, MCA and PCA in both groups were significantly increased after treatment (all P<0.05), while the CD8+ level had no significant change (both P>0.05). After treatment, the total effective rate of lower limb spasm in the observation group was 90.5%, significantly higher than 71.4% in the control group (P<0.05). The scores of GMFM, PDI and MDI, the levels of CD3+ and CD4+, PSV and MFV, and the levels of ACA, MCA and PCA in the observation group were all significantly higher than those in the control group (all P<0.05). There were no significant differences in the CD8+ level and CD4+/CD8+ between the groups (all P>0.05). Conclusion: Acupuncture plus MOTOmed intelligent motor training has a better clinical efficacy than conventional rehabilitation plus MOTOmed intelligent motor training in treating children with spastic cerebral palsy, and is also superior in improving lower limb motor function and the level of intellectual development. And the mechanism may be related to the improvement of cerebral hemodynamics.

9.
Article in Chinese | WPRIM | ID: wpr-912327

ABSTRACT

Objective:To monitor the blood pressure in pediatric patients with coarctation of the aorta (CoA) before and 8 years after surgery, and explore the mechanism of elevated blood pressure in pediatric patients with repaired CoA.Methods:A cohort of 23 pediatric patients who underwent CoA repair between January 2010 and October 2010 in Guangzhou Women and Children's Medical Center was studied. And 20 age-, sex-match patients with isolated ventricular septal defect (VSD) who underwent surgery at the same time, 20 age-, sex-match health patients with normal echocardiographic findings were included in the study. Systolic blood pressure (SBP), diastolic blood pressure (DBP), arm-leg SBP gradient, right carotid intima-media thickness (CIMT), serum transforming growth factor-β1 (TGF-β1) were monitored at baseline(1 day before surgery) and 8-year follow-up (8 years after surgery).Results:There were no differences in SBP and DBP among patients with CoA, patients with VSD and health children at baseline ( P>0.05). But at 8-year follow-up, 2 patients with CoA exhibited hypertension. Not only that, patients with CoA had higher SBP than patients with VSD and health children at 8-year follow-up ( P<0.05). Patients with CoA had higher arm-leg SBP gradient than patients with VSD and health children at baseline ( P<0.01). But there were no differences in arm-leg SBP among patients with CoA, patients with VSD and health children at 8-year follow-up ( P>0.05). Patients with CoA had increased CIMT and higher serum levels of TGF-β1 at baseline and 8-year follow-up ( P<0.05). The preoperative levels of CIMT and serum TGF-β1 in the patients with CoA were highly positively correlated with their levels at 8-year follow-up, respectively ( P<0.01). There was a strong correlation between the levels of CIMT and serum TGF-β1 in patients with CoA, both preoperatively and postoperatively ( P<0.01). The preoperative and postoperative levels of CIMT and serum TGF-β1 in the patients with CoA were highly positively correlated with SBP at 8-year follow-up, respectively( P<0.05). Conclusion:Although surgery can successfully cure the anatomical " stenosis" , patients with CoA have elevated systolic blood pressure than normal people and patients with simple congenital heart disease (such as VSD). And some of the patients with CoA suffer from hypertension at long-term follow-up, even they are normotensive preoperatively. It may be related to vascular remodeling, in which TGF-β signaling pathway may be involved. Monitoring CIMT and TGF-β1 in patients with CoA preoperatively may be significative for prediction for the levels of SBP postoperatively.

10.
Article in Chinese | WPRIM | ID: wpr-907971

ABSTRACT

Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still worldwide.As a vulnerable group, severe and dead pediatric cases are also reported.Under this severe epidemic situation, children should be well protected.With the widespread vaccination of SARS-CoV-2 vaccine in adults, the infection rate have decreased.Therefore, SARS-CoV-2 vaccine inoculation for children groups step by step is of great significance to the protection of children and the prevention and control of corona virus disease 2019(COVID-19) as a whole.But the safety of children vaccinated with SARS-CoV-2 vaccine is a main concern of parents.Therefore, in order to ensure the safety of vaccination and the implementation of vaccination work, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health and the Society of Pediatrics, Chinese Medical Association organized experts to interpret the main issue of parents about SARS-CoV-2 vaccine for children, in order to answer the doubts of parents.

11.
Article in Chinese | WPRIM | ID: wpr-907970

ABSTRACT

At present, severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still rampant worldwide.As of September 10, 2021, there were about 222 million confirmed cases of corona virus disease 2019(COVID-19)and more than 4.6 million deaths worldwide.With the development of COVID-19 vaccines and the gradual vaccination worldwide, the increasing number of cases in children and unvaccinated young people has drawn attention.According to World Health Organization surveillance data, the proportion of COVID-19 infection cases in children gradually increased, and the proportion of cases in the age groups of under 5 years and 5-14 years increased from 1.0% and 2.5% in January 2020 to 2.0% and 8.7% in July 2021, respectively.At present, billions of adults have been vaccinated with various COVID-19 vaccines worldwide, and their protective effects including reducing infection and transmission, reducing severe disease and hospitalization, and reducing death, as well as high safety have been confirmed.Canada, the United States, Europe and other countries have approved the emergency COVID-19 vaccination in children and adolescents aged 12 to 17 years, and China has also approved the phased vaccination of COVID-19 vaccination in children and adolescents aged 3 to 17 years. For smooth advancement and implementation of COVID-19 vaccination in children, academic institutions, including National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health, and The Society of Pediatrics, Chinese Medical Association organized relevant experts to reach this consensus on COVID-19 vaccination in children.

12.
Article in Chinese | WPRIM | ID: wpr-930346

ABSTRACT

Objective:To analyze the dominant genotypes and epidemic characteristics of human rhinovirus (HRV) in pediatric community-acquired pneumonia (CAP) in China.Methods:Between June 2017 to December 2019, throat swabs or nasopharyngeal aspirates were collected from pediatric CAP patients hospitalized in 6 medical institutions in Southern and Northern China (bounded by Qinling and Huaihe River), respectively.A total of 16 species of common respiratory viruses were screened using respiratory pathogen detection kits.Samples with positive HRV were genotyped for further epidemiological analysis.Results:The total detection rate of HRV in pediatric CAP (2 913 cases) was 12.2%(356 cases) in this study, which was 10.3%(145/1 410 cases) and 14.0%(211/1 503 cases) in Northern and Southern China, respectively.The detection rate of HRV in the Southern region was significantly higher than that in the Northern region, the difference was statistically significant( χ2=9.562, P=0.002). Epidemiological analysis showed that the distribution of HRV-positive cases in the Northern region was similar in all age groups, while 90.5% of positive cases in the Southern region were infants under 3 years.Classified by seasonal distribution, HRV-positive cases in the Northern region were mainly distributed in summer and autumn, while those in the Southern region were mainly distributed in spring and autumn.The coinfection rate of HRV and other pathogens was 40.7%, which was significantly higher in the Southern region than that of Northern region (49.0% vs.28.0%), the difference was statistically significant( χ2=15.801, P<0.001). The most common pathogens mixed with HRV were respiratory syncytial virus (RSV), human boca virus (HBOV) and parainfluenza virus type Ⅲ (PIV3) in the Northern region, with the mixed infection rate of 5.0%, 5.0% and 4.0%, respectively, which were RSV, PIV3 and human metapneumovirus (HMPV) in the Southern region, with the mixed infection rate of 9.0%, 7.0% and 6.0%, respectively.The genotyping results showed that all three HRV genotypes were detected.HRV-A (118/220 cases) was the dominant genotype, followed by HRV-C(82/220 cases). Conclusions:The detection rate of HRV in pediatric CAP cases is 12.2% in this study.There are significant differences in age and seasonal distribution of HRV-positive cases in the Southern and Northern regions.Coinfection of HRV and other pathogens is detected.The coinfection rate is significantly higher in the Southern region than that in the Northern region.HRV-A is the dominant genotype, followed by HRV-C.

13.
Article in Chinese | WPRIM | ID: wpr-930342

ABSTRACT

Respiratory syncytial virus (RSV) is the main pathogen of respiratory diseases in infants and young children worldwide, and the incidence of severe RSV infection remains highest in infants.Effective preventive measures are urgently needed to prevent RSV infection.Currently, no vaccine has been approved to prevent RSV infection.In June 2021, World Health Organization (WHO) proposed the Characteristics of Monoclonal Antibodies for Passive Immunization against Respiratory Syncytial Virus Infection which facilitates the development of high-quality, safe, affordable and effective monoclonal antibodies to prevent severe RSV infection and deaths in infants and young children worldwide.This study aims to interpret this document, thus guiding pediatricians understand the ideal characteristics and application of monoclonal antibodies for passive immunity to RSV infection.

14.
Acta Pharmaceutica Sinica B ; (6): 1965-1977, 2021.
Article in English | WPRIM | ID: wpr-888845

ABSTRACT

Adoptive cell therapy (ACT) is an emerging powerful cancer immunotherapy, which includes a complex process of genetic modification, stimulation and expansion. During these

15.
Article in Chinese | WPRIM | ID: wpr-882907

ABSTRACT

2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.

16.
Article in Chinese | WPRIM | ID: wpr-882849

ABSTRACT

In recent years, with the changes of human living environment, the morbidity of respiratory tiact allergic diseases such as allergic rhinitis, infant wheezing, allergic asthma, and other diseases increased rapidly, thereby affecting the quality of children′s life, and increasing heavy burdens to families and society.Microbial infection, including virus, bacteria, mycoplasma pneumoniae/chlamydia, fungi and parasites, can regulate the occurrence and development of respiratory tract allergic diseases through the immune mechanism.In order to deepen the understanding of the relationship between respiratory allergy and microbial infection and its related mechanism, the research progress on the relationship between respiratory allergy and microbial infection was reviewed in this paper.

17.
Article in Chinese | WPRIM | ID: wpr-882818

ABSTRACT

Human adenovirus is a DNA virus and a common pathogen of respiratory tract infection in children of China.Adenovirus can trigger a variety of mechanisms, thereby dissolving and killing lung cells.Consequently, it leads to such acute lung injury as acute respiratory distress and lung consolidation, and such pulmonary sequelae as bronchiolitis obliterates, unilateral transparent lung, bronchiectasis, and interstitial fibrosis.In this article, the mechanism underlying children lung injury caused by adenovirus was reviewed.

18.
Article in Chinese | WPRIM | ID: wpr-882803

ABSTRACT

Plastic bronchitis (PB) is a kind of respiratory emergency that causes severe respiratory distress in children.Bronchoscopy plays an important role in the diagnosis and treatment of PB in children.To enable more PB children to benefit from bronchoscopy examination and treatment, pediatric clinicians should improve their knowledge of bronchoscopy and be familiar with the timing of endoscopic treatment of PB, the choice of rigid bronchoscope or fiber bronchoscopy, the efficacy of bronchoscopy interventional therapy, and the safety of bronchoscopy treatment.

19.
Article in Chinese | WPRIM | ID: wpr-864202

ABSTRACT

Primary immunodeficiencies (PIDs) are caused by one or more defects of the immune system.Children with PIDs are more likely to experience recurrent and/or severe infections and tend to develop a wide range of complications.Respiratory diseases are the main and initial manifestation in most cases.Pulmonary complications have significant morbidity and mortality in children with PIDs.The spectrum of pathogens usually varies among different types of PID.Early diagnosis and appropriate therapy can prevent or at least slow down the development and course of respiratory complications of PIDs.In this study, the main respiratory manifestations of common PIDs in children are reviewed.

20.
Article in Chinese | WPRIM | ID: wpr-864029

ABSTRACT

Objective:To analyze the clinical features and follow-up results of children with acute exogenous lipoid pneumonia (ELP), and to investigate the diagnosis strategy, treatment and risk factors of ELP.Methods:The clinical features, imaging manifestations, results of bronchoalveolar lavage fluid (BALF), treatment methods and prognosis of 41 ELP inpatients in Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from May 2013 to May 2018, were summarized and analyzed, and the related literature was reviewed.Results:(1) Among 41 patients, 29 cases were male and 12 cases were female.The age of onset ranged from 4 to 53 months.Most of them (35/41 cases, 85.4%) were less than 3 years old, and the majority were aged 1 to 2 years (23/41 cases, 56.1%). (2) The grease taken by children by accident included perfume oil (11 cases), white electric oil (7 cases), electric mosquito oil (5 cases), lubricating oil (5 cases), paraffin oil (4 cases), gasoline/diesel oil (3 cases), kerosene (2 cases), cod-liver oil (2 cases), sewing machine oil (1 case), and unclear oil (1 case). (3) The main clinical manifestations were cough (26/41 cases, 63.4%), shortness of breath (23/41 cases, 56.1%), fever (17/41 cases, 41.5%), cyanosis with hypoxemia (15/41 cases, 36.6%), wheezing (9/41 cases, 22.1%), respiratory distress (9/41 cases, 22.1%), pulmonary hemorrhage (6/41 cases, 14.7%), feeding difficulties and transient vomiting (4/41 cases, 9.8%). Some cases showed no symptoms (3/41 cases, 7.3%). (4) Chest X-ray mainly showed bilateral pulmonary exudative changes or pulmonary consolidation.The most common sign of high-resolution computerized tomography (HRCT) was local or extensive exudation, often accompanied by pulmonary consolidation (18/41 cases, 43.9%). The most common affected sites were bilateral lower lobes (8/41 cases, 19.5%), followed by right lower lobes (3/41 cases, 7.3%), right middle lobes (2/41 cases, 4.8%) and left lower lobes (2/41 cases, 4.8%). Other signs included alveolar changes, hyperventilation, ground glass changes, and nodule formation.(5) Seven children needed mechanical ventilation due to respiratory failure, and all patients underwent bronchoalveolar lavage (BAL). All patients recovered without death, with (11.67±4.90) days of hospitalization, and the hospitalization time of ELP patients with adenovirus infection was (19.25±5.93) days.Nine of them were lost to follow-up (8 cases were mild and 1 case was severe). The symptoms of the remaining children disappeared within 1 week to 1 month.The lung images of 21 cases returned to normal within 1 month after discharge, 7 cases returned to normal within 3 months after discharge, and 4 cases returned to normal after 6 months.Conclusion:The clinical manifestations and lung imaging of children with acute ELP have no specificity.Pulmonary imaging of severe patients shows multiple lobes involved, and consolidation and vacuolar changes may occur.Most patients have a favorable prognosis.Co-infection, especially adenovirus infection, may be a risk factor for acute ELP in children.BAL can play a role in both diagnosis and treatment, and its combination with local/systemic glucocorticoid therapy is effective for severe acute ELP.

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