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Objective To study clinical manifestations,laboratory variables,imaging features and therapies of refractory Mycoplasma pneumoniae pneumonia (RMPP).Methods The retrospective analysis of clinical data was conducted in 45 children with RMPP and 74 children with Mycoplasma pneumoniae pneumonia (MPP)admitted to department of pediatrics.The general data,clinical manifestations,laboratory variables,imaging features and therapies were compared between two groups.Results As compared to MPP,the age(6.14 ±3.35)y,febrile days(9.49 ± 5.28)d,the hospitalized days(11.45 ±3.42)d were significantly higher than that of MPP group (P <0.001);RMPP had higher rations of unilateral pulmonary infiltration[41(91.11%)],large consolidation shadows[35(77.78%)], pulmonary[21(46.67%)]and extrapulmonary complications[24(51.33%)](P <0.05);CRP,ESR,LDH and IgM were increased,the difference was statistically significant (P <0.01);Thirty -seven cases(82%)of RMPP had to add ceftriaxone sodium,thirty -two cases(71.7%)of RMPP had to add glucocorticoid,,Bronchofiberoscope lavages were used in six cases of RMPP.Only one case of RMPP occured sequela.Conclusion The older children,the per-sistent high fever,large consolidation shadows of pulmonary,pulmonary and extrapulmonary complications,high level of serum CRP,ESR,LDH and IgM are the clinical related factors of RMPP.The combination of cephalosporins and (or)glucocorticoid might consider for the cases who have no effect with macrolides.The effect is sure for RMPP with Bronchofiberoscope lavages.
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Objective To investigate the distribution of etiological agents in children with asthma exacerbation in Chongqing during 2013 .Methods Four hundred and forty seven cases of hospitalized children with asthma exacerbation in 2013 in Children′s Hospital of Chongqing Medical University were retrospectively analyzed in SPSS19 .0 software .Results Among the 447 children with asthma exacerbation ,the percentage of bacteria was 43 .8% ,streptococcus pneumonia(SP)(25 .5% ) was the most common bacteria .Among the 25 cases with bacteria culture of bronchoalveolar lavage ,the positive rate was 44 .0% ,and the difference to sputum culture was not significant (P>0 .05) .The positive rate of 7 common respiratory viruses was 27 .3% ,RSV accounted for 18 .8% ,and it was the most common virus .The virus infection rate was higher in the groups below one years old ,and compared each groups′virus detection rates ,the difference was significant (P< 0 .05) .The positive rate of mycoplasma pneumoniae was 23 .5% ,chlamydia pneumonia was not detected .Conclusion Asthma exacerbation in children is closely related to respiratory infec‐tion .Bacteria detection rate was high in all ages ,which suggests that bacterial infection is an important factor in asthma exacerbation that can′t be ignored .
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Objective To study the relationship between mycoplasma pneumoniae(MP) infection and children asthma,and to observe the treatment effects of macrolide antibiotics (azithromycin) on mycoplasma pneumoniae infection.Methods 250 children of respiratory disease were investigated with olimpus electron gastroscope,200 children asthma;the serum specific antibodies were determined by Diagnostic Kit for measurement of antibodies to mycoplasma pneumoniae (Passive Particle Agglutination) ;and the eosinophilic grannlocytes were serologically analyzed in children with recent asthma.Random selection 42 MP infection positive to macrolides antibiotics (azithromycin) treatment.Results 44 MP infection positive,200 children asthma cases had MP infection with 21％ (42/200) MP positive,the specific antibody titers to MP showed significant difference in children with recent asthma compared with those in the contol group ( x2 =6.14,P ＜ 0.05 ),and correlated with the count of eosinophilic granulocy positively ( r =0.603,P ＜ 0.05) ;The positive rates of specific antibody,infection with MP were significantly higher than those in the control group( t =4.38,P ＜ 0.05 ).MP infection positive group with azithromycin treatment effect is significantly higher than that of cefuroxime group ( x2 =16.18,P ＜ 0.05 ).Conclusion MP infection is closely associated with the pathogenesis of children asthma;and early routine testing for MP antibodies.Macrolides antibiotics can eliminate MP infection,a new generation of macrolides antibiotics(azithromycin) is more advantageous to the control of acute attack of asthma.
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Objective To investigate the expression and significance of interkeulin 10 (IL-10)in children patients with mycoplasma pneumoniae pneumonia(MP). Methods Twenty-six children patients with MP( MP group)and20 health control( contrl group)were sequentially enrolled in this study. The production of IL-10 mRNA was measured by fluorescent quantitative polymerase chain reaction. Results Expression of IL-10 mRNA in MP group (33 893.22±5 207.60) copy/μg was significantly lower than that in control group(59 341.92 ±6 712.98) copy/μg(t = - 14. 49, P ＜ 0. 01 ). Expression of IL-10 mRNA in heavy degree MP group was significantly lower than that of mild degree MP group ( t= - 2. 20, P ＜ 0. 05 ). Conclusion The expression of IL-10 was low, and played an important role in the development of patients with MP.
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Objective To investigate the association of Mycoplasma pneumoniae(MP) infection with disease activity of ankylosing spondylitis. Methods A total of 158 subjects in our hospital were enrolled in this study, including patients with ankylosing spondylitis(AS, n=66), rheumatoid arthritis (RA, n=31),osteoarthritis(OA, n=25) and normal controls(NC, n=36). MP infection was defined as anti-MP IgM antibody positive. Anti-MP IgM antibodies were determined by a mycoplasma pneumoniae(Mac strain)membrane-based agglutination test. AS patients were divided into two groups: MP infection group and non-MP infection group. T-test was used for statistical analysis of age, blood white cells, ESR, CRP, immunoglobulin, BASDAI index, global assessment on VAS scale, Schober test and chest expansion reflecting spinal mobility.χ2-test was used to compare the positive rate of MP infection in different groups. Gender difference and prevalence of clinical infection in past four weeks between MP infection and MP-free group in AS patients was also compared. Ridit analysis was used to analyze the association of MP infection with degree of sacroiliac damage on CT. Results The prevalence of MP infection in AS (52%, 34/66) was much higher than that in rheumatoid arthritis (RA, 6%, P＜0.01 ), osteoarthritis(OA, 4%, P＜0.01 ) and normal controls (NC, 11%, P＜0.01) . Compared with the non-MP infection group, the MP infection group had more active disease in term of BASDAI(4.0±1.1 vs 3.0±1.9, P=0.017), ESR[(44±32) mm/1h vs (28±23) mm/1h, P=0.029], CRP [(40±38) mg/L vs (22±21) mg/L, P=0.025] serum total IgG level [(18±3) g/L vs (16±5) g/L, P=0.027],but not in serum total IgA and IgM. Regarding to the sacroiliac joint and spinal mobility, MP infection group did not exhibit any association with the sacroiliac grading on CT, Schober test and expansion. In AS patients with MP infection, only 44.1%(15/34) was complicated by clinical manifestations of upper respiratory tract in the past 4 weeks. However, a higher prevalence of MP infection was found in AS patients with clinical manifestation of upper respiratory tract, compared with those with negative clinical manifestation(71% vs 42%,P=0.027). Conclusion Mycoplasma pneumoniae is the most common reported pathogen in ankylosing spondylitis and relates to the disease activity of AS. MP infection is probably a principal triggering factor in the pathogenesis of AS.
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Objective To investigate the significance of IL-18R? expression on CD4+ T cells in peripheral blood (PB) of children with Mycoplasma pneumoniae pneumonia (MPP).Methods T cell subtype CD3/CD4/CD8 and expression of IL-18R? on CD4+ T cells in PB from 35 children with MPP and 15 age- and sex-matched control subjects was determined by flow cytometry.Results Compared with that of healthy control, CD3+ and CD4+ positive cells in MPP children were decreased (P0.05).Conclusion There exists cell-mediated immune function disorders and Th1/Th2 imbalance in children with MPP. Th1 immune response is dominant in acute-stage MPP.
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Objective To study the conventional CT and HRCT manifestations of adult mycoplasma pneumoniae pneumonia. Methods Conventional CT and HRCT were performed in 16 adult patients with mycoplasma pneumoniae pneumonia proven by serology. The CT images were retrospectively analyzed. Results Areas of ground glass opacity(GGO)were found in 12 cases. GGO showed lobular or patchy distribution in 9 cases. Air space consolidation was observed in 8 cases,"tree in bud" sign in 9,thickening of the interlobular septa in 3,and thickening of bronchovascular bundle in 1. 15 cases had two or more findings simultaneously. Conclusion Mycoplasma pneumoniae pneumonia has some characteristic CT findings, which can help to distinguish it from bacterial pneumonia.