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In recent years, the discovery of Group 2 innate lymphoid cells(ILC2) has expanded the understanding of type 2 immunity and promoted the birth of the concept of type 2 inflammation.Type 2 inflammation is an inflammatory reaction mediated by both innate and adaptive immunity.It is mainly involved by ILC2 cells and T helper 2 cells and is characterized by upregulation of type 2 cytokines and IgE-mediated release of inflammatory mediators and barrier dysfunction.Due to the common intrinsic mechanism, several kinds of type 2 inflammatory diseases always coexist in the same person, and their prevalence rate and severity continue to rise among children and adolescents, placing a heavy burden on them and their families.This review summarizes the recent development in understanding the mechanism of type 2 immune response and the pathophysiological mechanism of type 2 inflammatory diseases, emphasize the importance of ILC2 and summarize some targeted biologics used in the treatment of related diseases, so as to have a more systematic, comprehensive and in-depth understanding of type 2 inflammation.
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Objective:To observe the role of Huaiqihuang Granules (HQ) in the long-term management of bronchial asthma in young children, and the effective effect on concomitant rhinitis.Methods:A prospective real-world multicenter study was conducted in children aged 2-5 years with asthma diagnosed in the outpatient department (from April 2016 to March 2019)who received either inhaled corticosteroid (ICS)/leukotriene receptor antagonist (LTRA)(control group); inhaled ICS/LTRA plus HQ(combination group), or HQ alone(HQ group). All patients were followed up at week 4, 8, 12 after treatment. The number of days with asthma symptoms, the frequency of severe asthma attacks, the level of asthma control, and the days with rhinitis symptoms in the last 4 weeks were recorded. Differences before and after treatment, and those among groups after treatment were compared using Kruskal- Wallis H test or Wilcoxon rank-sum test. Results:A total of 2 234 eligible patients were recruited, and 2 147 cases completed followed-up visits, including 477, 1 374 and 296 cases in the control group, combination group, and HQ group, respectively. After the treatment, all 3 groups showed significant declines in the days with asthma symptoms, frequency of severe asthma attack and the days with rhinitis symptoms (all P<0.01), and the rate of well-controlled asthma increased significantly ( P<0.01). It lasted until the end of follow-up. Among groups, patients in the combination group showed significantly less days of asthma symptoms than those of the other 2 group at week 8 and 12[0(0, 0.9) d vs.0(0, 0.3) d, P<0.05; 0(0, 0.1) d vs. 0(0, 1.0) d, P<0.01]. Patients in the combination group and HQ group showed a significantly lower rate of severe asthma attacks than that of the control group at week 12 [0(0, 1), 0(0, 1), 0(0, 2), all P<0.05]. The well-controlled rate of asthma in the combination group was significantly higher than that of the control group and HQ group at week 8 and 12 (89.6% vs. 85.9% vs.82.1%, H=15.28; 90.9% vs. 84.1% vs. 81.8%, χ2=29.32, all P<0.01). Conclusions:HQ can significantly alleviate symptoms of asthma and rhinitis, severe attack of asthma, and increase the control rate of asthma when used as an additional treatment or used alone.
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Objective @# To investigate the protective effect of caffeine on oxidative stress injury induced by hyperoxia in neonatal SD rats with bronchopulmonary dysplasia ( BPD) and its related mechanism．@*Methods @#Neonatal SD rats were randomly divided into air control group ( N group) ，caffeine air control group ( NC group) ，model group (H group) and caffeine intervention group ( HC group) ．The high oxygen induction method was used to establish the BPD model．Blood and lung tissue of six samples were collected from each group on day 3，7，14 and 21．Each group was divided into four subgroups according to four days of age．The 21-day panel of four groups measured their body weights．The upper lobe of the right lung was used to measure wet-dry weight ratio (W / D) of lung tissue in each group ; the lower lobe of the right lung was sliced after paraffin embedding and stained with hematoxylin-eosin ( HE) to observe morphological changes and calculate radial alveolar count (RAC) values ; the levels of malondialdehyde (MDA) and superoxide dismutase (SOD) in blood and lung tissues were determined to evaluate the imbalance of oxidative and antioxidant homeostasis in neonatal rats ; real-time fluorescence quantitative reverse transcrip- tion polymerase chain reaction ( RT-qPCR) was used to detect the relative expression level of nuclear factor-ery- throid 2-related factor 2 (Nrf2) mRNA in lung tissues. @*Results @#① H group showed a gradual decline in activity after 3 days and an increasing trend in body weight after 14 days. ② W / D value of H group reached its peak at day 14，and the trend of HC group was similar to that of H group. ③ The lung tissue structure of H group was irregular， RAC value of which decreased significantly after 7 days of peak，and the difference between H group and HC group was statistically significant (P＜0. 01) . ④ The MDA value of H group increased on day 7 and gradually decreased on day 14，while the SOD activity decreased obviously on day 7，and there were significant differences in MDA and SOD activity between H group and HC group at 14 days and 21 days (P＜0. 05) . ⑤ The expression of Nrf2 mRNA in H group was significantly enhanced at day 7 and stabilized at day 14，and there were statistically significant differences between H and HC groups at day 3，day 7 and day 14 (P ＜0. 05) . ⑥ The relative expression level of Nrf2 mRNA was positively correlated with MDA and negatively correlated with SOD． @*Conclusion @# Caffeine can regulate oxidative stress response through Nrf2 pathway and alleviate lung oxidative stress injury induced by hyperoxia in neonatal rats with BPD.
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Hypoxemia is a common complication of pneumonia, asthma, and bronchopulmonary dysplasia in children.Rapid identification of hypoxemia is of great significance for the disposal and management of critical children.Pulse oximetry is recognized by the World Health Organization as the best way to monitor hypoxemia in children, and it can monitor pulse oxygen saturation noninvasively and continuously.Based on the related literature at home and abroad, combined with the clinical needs of pediatrics, the " Expert consensus on clinical application of pulse oximetry in children" is formulated to improve the understanding of pediatricians and nurses on the application in pediatric clinical practice, principle, operation techniques, and limitations of pulse oximetry.
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Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.
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Protracted bacterial bronchitis is Chronic lower respiratory infection,defined as chronic moist cough for more than 4 weeks and resolution of symptoms in the majority when antibiotic therapy is given for at least 2 to 3 weeks.After airway epithelial cells impaired by various factors,bacteria such as haemophilus influenzae and streptococcus pneumoniae colonizes on bronchial mucous membranes and leads to neutrophil infiltration.The diagnosis of protracted bacterial bronchitis is mainly based on chronic moist cough persisting for more than 4 weeks,sometimes accompanied by wheezing,with normal chest x-ray and bronchial wall thickened on high-resolution computed tomography,revealed redness and edema of the bronchial mucous membranes sometimes accompanied by tracheobronchomalacia as the main characteristic of bronchoscopy.The definite diagnosis can be made if the culture of bronchoalveolar lavage fluid is positive.If the majority of symptoms cannot be removed after 4-week therapy,the underline pathogenesis should be searched.Curing of of acute bacterial infection can prevent protracted bacterial bronchitis.New vaccines offering all serotype protection are needed to prevent protracted bacterial bronchitis caused by haemophilus infiuenzae and streptococcus pneumoniae.