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ObjectiveTo evaluate the efficacy and safety of An'erning granules in the treatment of community-acquired pneumonia in children. MethodA randomized， double-blind， single-simulation， placebo-controlled trial was designed in this study. The children were randomly assigned into an observation group （An'erning granules combined with ceftriaxone sodium） and a control group （An'erning granules placebo combined with ceftriaxone sodium） according to the ratio of 2∶1. The disease cure rate was taken as the main indicator of efficacy， and the safety of An'erning granules was observed. ResultA total of 206 children （137 in the observation group and 69 in the control group） were included in this study. Before treatment， the age， sex， body height， body weight， diagnosis time of pneumonia， and symptom and sign scores had no significant differences between the two groups. After 8 days of continuous medication， the observation group［70.80%（97/137）］ had higher cure rate than the control group［56.52%（39/69）］（χ2=4.17，P<0.05） and total effective rate of chest X-ray ［97.98%（97/99）］ than the control group［86.27%（44/51）］ （χ2=12.98，P<0.01）. The observation group was superior to the control group in the alleviation of TCM syndrome under the condition of 0-3 g dose stratification on day 3 of medication （P<0.01）. The recovery time， time to complete fever abatement， time to fever abatement and expectoration alleviation， rate of conversion to severe case， and reduction in the frequency of antibiotic use showed no significant differences between the two groups. In terms of safety， 13 and 7 adverse events occurred in the observation group and control group， respectively， which were relieved or disappeared after drug withdrawal or symptomatic treatment and showed no significant difference between the two groups. ConclusionIntravenous drip of ceftriaxone sodium combined with An'erning granules is effective in the treatment of community-acquired pneumonia in children. It can accelerate the absorption of pulmonary inflammation， alleviate the clinical symptoms in a short time for young children or the children with mild symptoms， and is safe in clinical application.
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ObjectiveTo evaluate the efficacy and safety of An'erning granules in the treatment of community-acquired pneumonia in children. MethodA randomized， double-blind， single-simulation， placebo-controlled trial was designed in this study. The children were randomly assigned into an observation group （An'erning granules combined with ceftriaxone sodium） and a control group （An'erning granules placebo combined with ceftriaxone sodium） according to the ratio of 2∶1. The disease cure rate was taken as the main indicator of efficacy， and the safety of An'erning granules was observed. ResultA total of 206 children （137 in the observation group and 69 in the control group） were included in this study. Before treatment， the age， sex， body height， body weight， diagnosis time of pneumonia， and symptom and sign scores had no significant differences between the two groups. After 8 days of continuous medication， the observation group［70.80%（97/137）］ had higher cure rate than the control group［56.52%（39/69）］（χ2=4.17，P<0.05） and total effective rate of chest X-ray ［97.98%（97/99）］ than the control group［86.27%（44/51）］ （χ2=12.98，P<0.01）. The observation group was superior to the control group in the alleviation of TCM syndrome under the condition of 0-3 g dose stratification on day 3 of medication （P<0.01）. The recovery time， time to complete fever abatement， time to fever abatement and expectoration alleviation， rate of conversion to severe case， and reduction in the frequency of antibiotic use showed no significant differences between the two groups. In terms of safety， 13 and 7 adverse events occurred in the observation group and control group， respectively， which were relieved or disappeared after drug withdrawal or symptomatic treatment and showed no significant difference between the two groups. ConclusionIntravenous drip of ceftriaxone sodium combined with An'erning granules is effective in the treatment of community-acquired pneumonia in children. It can accelerate the absorption of pulmonary inflammation， alleviate the clinical symptoms in a short time for young children or the children with mild symptoms， and is safe in clinical application.
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Objective To analyze the clinical characteristics and risk factors of myocardial damage in children with mycoplasma pneumonia in Qinghai area, and to provide evidence for clinical diagnosis and treatment. Methods A total of 328 children diagnosed with mycoplasma pneumonia in Qinghai region from June 2016 to June 2020 were selected as the research subjects. According to whether they were complicated with myocardial damage, they were divided into the control group (no myocardial damage, n=185) and the experimental group (complicated with myocardial damage, n=143). The data of the children were collected by using a questionnaire made by our hospital. These included gender, age, fever duration, initiation time of macrocyclic esters and fever degree, etc., and the levels of CK-MB, CK, CTNNI, NT-proBNP, CRP, LDH and RDW were determined. RESULTS: There were no significant differences in age, gender and complications between the two groups (P>0.05). There were statistically significant differences in the use time, fever duration and fever degree between the two groups (P<0.05). In terms of laboratory indicators, there were statistically significant differences in the levels of CK-MB, CK, cTNnI, NT-probNP, CRP, LDH and RDW between the two groups (P<0.05).Logistic regression analysis showed that the duration of fever (OR=3.105), the start time of macrolides (OR=1.457), the degree of fever (OR=2.495), CRP(OR=1.853) and RDW(OR=1.358) were the risk factors for myocardial damage in children with mycoplasma pneumonia in Qinghai area (P<0.05). Conclusion The duration of fever, the initiation time of macrolide drugs, the degree of fever, CRP and RDW are independent risk factors for myocardial damage in children with mycoplasma pneumonia in Qinghai area. The early use of macrolide drugs can prevent myocardial damage, improve the treatment effect and improve the prognosis of children.
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Introducción: La neumonía adquirida en la comunidad continúa siendo un problema de salud global. Objetivo: Caracterizar desde la óptica clínico-epidemiológica la neumonía adquirida en la comunidad en la edad pediátrica. Métodos: Estudio descriptivo de corte transversal y prospectivo de pacientes entre 1 mes-18 años, no vacunados con antineumocócica, ingresados en el Hospital Pediátrico Centro Habana, enero 2018-julio 2019 con diagnóstico confirmado por radiología de neumonía adquirida en la comunidad. Los pacientes no presentaban enfermedades crónicas, exceptuando el asma. Los padres o tutores dieron su consentimiento. Se evaluaron variables demográficas y clínicas, factores de riesgo, evolución y complicaciones según grupo de edad. Resultados: Se estudiaron 277 enfermos, predominaron los niños entre 1 a 4 años de edad (39,4 por ciento), superioridad del sexo masculino (55,2 por ciento). Los síntomas más frecuentes fueron: fiebre (98,9 por ciento), disnea (99,3 por ciento), tos (98,9 por ciento) y disminución del murmullo vesicular (96,4 por ciento). Como factores de riesgo predominaron la asistencia a círculos infantiles (31,8 por ciento), lactancia materna inadecuada (23,8 por ciento) y el tabaquismo pasivo (16,6 por ciento). Hubo complicaciones en 110 niños (39,7 por ciento) con predominio de derrame pleural, sobre todo en prescolares y asociación significativa entre complicaciones y edad. No hubo fallecimientos. Conclusiones: Es importante la vigilancia de las neumonías y su desarrollo clínico epidemiológico, para la prevención y diagnóstico en esa etapa previa a la introducción de la vacuna antineumoccócica. En población no vacunada contra el neumococo, es estrategia significativa reducir los factores de riesgo modificables como la insuficiente lactancia materna, el tabaquismo pasivo y la malnutrición(AU)
Introduction: Community-acquired pneumonia continues to be a global health problem. Objective: Characterize from the clinical-epidemiological perspective community-acquired pneumonia in the pediatric ages. Methods: Descriptive cross-sectional and prospective study of patients from 1 month to 18 years old not vaccinated with pneumococcal vaccine, admitted in Centro Habana Pediatric Hospital from January 2018 to July 2019 with diagnosis confirmed by radiology of pneumonia acquired in the community. Patients did not have chronic diseases, except for asthma. Parents or guardians consented. Demographic and clinical variables, risk factors, evolution and complications were assessed according to the age group. Results: 277 patients were studied, children from 1 to 4 years old predominated (39.4 percent); there was male superiority (55.2 percent). The most common symptoms were fever (98.9 percent), dyspnea (99.3 percent), cough (98.9 percent) and decreased vesicular murmur (96.4 percent). As risk factors, attendance to nurseries (31.8 percent), inadequate breastfeeding (23.8 percent) and passive smoking (16.6 percent) predominated. There were complications in 110 children (39.7 percent) with prevalence of pleural effusion, especially in pre-schoolers and significant association among complications and age. There were no deaths. Conclusions: Monitoring of pneumonia and its epidemiological clinical development is important for prevention and diagnosis at this stage prior to the introduction of the pneumococcal vaccine. In populations not vaccinated against pneumococcus, it is a significant strategy to reduce modifiable risk factors such as insufficient breastfeeding, passive smoking and malnutrition(AU)
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Humans , Pleural Effusion , Asthma , Tobacco Smoke Pollution , Dyspnea , MalnutritionABSTRACT
Objective To compare the efficacy and safety of β - lactams alone and the combination of β - lactams with macrolides in the treatment of community-acquired pneumonia(CAP) in children. Methods PubMed, CNKI and VIP databases were searched by computer. RCT on children with CAP treated by β-lactams and macrolides were collected. The retrieval time was from the establishment of the database to July 2020. Literatures were selected and data was extracted according to inclusion and exclusion criteria. The risk of bias was evaluated, RevMan 5.3 software was used for Meta-analysis. Results Thirteen articles with 1788 patients were included in the study. The results showed that the clinical efficacy of the combination therapy in the experimental group was better than that in the control group [RR = 1.11, CI = 1.07–1.15, P < 0.000 01]. The time for fever returning to normal was shorter in the experimental group than that in the control group [MD = −1.31, CI =−1.58– −1.05, P < 0.000 01]. The disappearance time of pulmonary rales was shorter in the experimental group than that in the control group [MD = −1.75, CI = −2.13– −1.37, P < 0.000 01], There was no statistically significant difference in adverse reactions between the two groups (P > 0.05). Conclusion The combination therapy of β - lactams and macrolides is better than β-lactams alone in children with CAP with no significant difference in adverse reactions. Limited by the quantity and quality of the included studies, the conclusions from this study need to be further verified by large samples of high-quality RCT.
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Pneumonia is the highest mortality rate of children under 5 years old,and vitamin A deficiency is one of the four major nutritional deficiencies.Recent studies have shown that vitamin A plays an important role in maintaining epithelial cell integrity and regulating immune function.Vitamin E has antioxidant effect and regulates the release of immune system and inflammatory factors.Vitamin A and vitamin E deficiency are related to pneumonia.This article reviews the research progress of the relationship between vitamin A and vitamin E deficiency and pneumonia in children.
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Objective::To observe the clinical efficacy of modified Weijingtang and Maxing Shigan Tang combined with half-dose hormones in the treatment of mycoplcasma pneumoniae pneumonia in children caused by toxic heat closing lung. Method::Totally 120 cases were randomly divided into control group and observation group, with 60 cases in each group. In addition to the basic therapy, control group was given Lianhua Qingwen granules + methanilone (10 mg·kg-1, 2 times/day), while observation group was given modified Weijingtang and Maxing Shigan Tang + methanilone (10 mg·kg-1, 1 time/day) for 14 days. Lung function indicators [maximal voluntary ventilation (MVV), time of peak tidal expiratory flow (TPTEF), forced expiratory volume in one second (FEV1), volume peak time expiratory flow (VPTEF)], plasma myocardial enzyme profile [creatine kinase (CK), creatine kinase isoenzyme (CKMB), lactate dehydrogenase (LDH), hydroxybutyric acid dehydrogenase (HBDH)], immune function [immunoglobulin G (IgG), immunoglobulin M (IgM), erythrocyte immune complex (RBC-ICR), erythrocyte C3b receptor (RBC-C3bR)], inflammatory factors [tumor necrosis factor-alpha (TNF-α), gamma-interferon (IFN-γ), interleukin-13 (IL-13), interleukin-17A (IL-17A)], clinical efficacy and adverse reactions were observed before and after treatment. Result::Four cases fell off during the study period. The total effective rate in observation group was 96.6%(57/59), which was higher than that in control group 84.2%(48/57, P<0.05). Compared with control group after treatment, lung function, RBC-C3bR and IL-13 were increased in observation group (P<0.05), while myocardial enzyme spectrum, IgG, IgM, RBC-ICR, TNF-α, IFN-γ and IL-17A were decreased in observation group (P<0.05). The incidence of adverse reactions in observation group was, lower than that in control group(P<0.05). Conclusion::Modified Weijingtang and Maxing Shigan Tang combined with half-dose hormones can improve lung function, myocardial enzyme profile, immune function and inflammatory factor levels of refractory mycoplasma pneumoniae in children caused by toxic heat closing lung, with a incidence of adverse reactions.
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Objective:To investigate the clinical efficacy of Loulu Shengma Tang combined with azithromycin in the treatment of pediatric mycoplasma pneumoniae pneumonia（MPP） with obstruction of lung by pathogenic heat， and its effect on inflammatory factors， treg and Foxp3 mRNA. Method:Totally 274 children with MPP were divided into observation group （137 cases） and control group （137 cases）. Observation group was treated with Loulu Shengma Tang combined with azithromycin dry suspension， while control group was treated with azithromycin dry suspension alone. The changes of traditional Chinese medicine（TCM） syndrome score of pathogenic-heat obstruction in the lung， serum inflammatory cytokines ［interleukin-6 （IL-6），interleukin-10 （IL-10），tumor necrosis factor-α （TNF-α），C-reactive protein （CRP）］， CD4+CD25+Treg， CD4+Foxp3+Treg and Foxp3 mRNA expressions were observed after treatment. The clinical efficacy and the incidence of adverse reactions were compared between two groups. Result:The total effective rate of observation group was 94.16%（129/137） after treatment， which was significantly higher than 77.37% （106/137）of observation group （P<0.05）. The disappearance times of cough， lung rale， fever and lung shadow in observation group were shorter than that in control group （P<0.05）. After treatment， TCM syndrome score of pathogenic-heat obstruction in lung was significantly higher than those in control group （P<0.05）， serum IL-6， IL-10， TNF-α and CRP levels in observation group were significantly lower than those in control group （P<0.05， P<0.01）， while CD4+CD25+Treg， CD4+Foxp3+Treg and Foxp3 mRNA expressions were significantly higher than those in control group （P<0.05）. The incidence of adverse reactions in observation group was 7/137 （5.11%）， which was significantly lower than 16/137 （11.68%） in control group. Conclusion:The clinical efficacy of Loulu Shengma Tang combined with azithromycin dry suspension in the treatment of pediatric MPP and its effect on serum inflammatory factors （IL-6， IL-10， TNF-α， CRP）， regulatory T cells and Foxp3 mRNA expressions were better than those of azithromycin dry suspension alone. The incidence of adverse reactions of Loulu Shengma Tang was lower than that of azithromycin dry suspension alone.
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Background: Acute respiratory illness is responsible for 19% of all deaths in children in below five years of age and 8.2% of all disability as measured by DALY. Recent studies have added other risk factors to the list including large family size, poor socioeconomic status, family history of bronchitis, advanced birth order, crowding, young age, air pollution, and the use of non-allopathic treatment in early stages of illness. Also, indoor air pollution is one of the major risk factors for acute lower respiratory tract infection in children in developing countries. The objectives of this study were to identify and compare the risk factors associated with severe and very severe pneumonia.Methods: A prospective observational study. Children between 2 months to 5 years with clinical features of severe pneumonia were included in the study. Socioeconomic history like the type of house, family size, sanitary facilities and fuel-based cooking was recorded. Detailed history about immunization, feeding practice and degree of malnutrition was recorded. Chi Square test was used to determine significant differences between two groups.Results: Total 150 patients could be included in the study. Immunization status shows that 74% were completely immunized, 9% were unimmunized and 17% were partially immunized. Most of the children were breast fed 95.33% and only 4.67% were bottle fed. 30% of the cases were grade 3 and 4 PEM and anemic. The socioeconomic status showed 84% were belonged to grade 3,4 and 5 and 16% belonged to grade 1 and 2. 96.67% were living in ill ventilated kutcha house with poor sanitation facilities and nearly 94% were living in house with fuel other than LPG.Conclusions: Factors like previous history of similar illness, inappropriate immunization for age, anemia, PEM grade 3 and 4, poor housing condition, and indoor air pollution were significantly associated with severity of pneumonia. While severity of illness, PEM grade 3 and 4 and associated illness were the important risk factors for mortality.
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Objective To study the application value of neutrophil elastase (NE), fibrinogen (Fib) combined with tumor necrosis factor-α (TNF-α) in the prognosis prediction of severe pneumonia in children. Methods Eighty-two children with severe pneumonia who were admitted into the Yuhang District Maternal and Child Health Hospital of Hangzhou in Zhejiang Province from July 2016 to September 2018 were treated as a severe group, and the children with severe pneumonia were subdivided into a survival group (70 cases) and a death group (12 cases) according to the prognosis; another 90 children with common pneumonia who were treated in our hospital at the same time were selected as a general group; and 85 normal children who received physical examinations at the same time as a healthy control group. The levels of serum NE, Fib and TNF-α in the three groups were measured by enzyme-linked immunosorbent assay (ELISA), and the pneumonia severity index (PSI) was calculated in the severe group and the general group; Spearman correlation analysis was used to analyze the correlation between NE, Fib, TNF-α and PSI;the NE, Fib and TNF-α levels were evaluated to predict the prognosis of children with severe pulmonary disease;the receive operating characteristic (ROC) curve was drawn to evaluate the prognostic value of NE, Fib, TNF-α in children with severe pulmonary disease. Results The expression levels of serum NE, Fib and TNF-α in the severe group were higher than those in the general group and the healthy control group [NE (μg/L): 127.5±12.3 vs. 75.1±6.6, 24.3±5.9, Fib (g/L): 6.9±1.2 vs. 5.1±0.7, 2.8±0.8, TNF-α (μg/L): 98.3±6.9 vs. 63.1±6.8, 30.2±2.1, all P <0.05]. Serum levels of NE, Fib and TNF-α in the death group were higher than those in the survival group [NE (μg/L):141.2±14.9 vs. 80.3±7.4, Fib (g/L): 7.6±1.5 vs. 5.7±1.0, TNF-α (μg/L): 105.4±7.8 vs. 68.2±4.6, all P < 0.05]. It was shown by ROC curve analysis that NE, Fib, TNF-α have some value in predicting the prognosis of children with severe pneumonia, the area under the ROC curve (AUC) were 0.889, 0.809, 0.803, 0.961, 95% confidence internal (95%CI) were 0.817-0.968、0.706-0.909、0.702-0.891、0.908-1.000, the sensitivity were 71.2%, 62.7%, 64.9%, 92.3%, the specificity were 73.5%, 68.3%, 74.5%, 90.9%, all P = 0.000. The PSI of severe pneumonia group was significantly higher than that of the general group (97.4±12.1 vs. 76.4±9.6), the PSI of the death group was obviously higher than that of the survival group (100.8±13.1 vs. 87.3±10.5), and the differences were statistically significant (both P < 0.01). Spearman correlation analyses showed that serum NE, Fib, TNF-α and PSI were significantly positively correlated in children with severe pneumonia respectively (r = 0.767, 0.734, 0.673, all P < 0.05), and there were positive correlations between NE and Fib (r = 0.655,P = 0.000), NE and TNF-α (r = 0.530,P = 0.000), Fib and TNF-α (r = 0.522,P = 0.000). Conclusion The combined detections of NE, Fib, and TNF-α levels can help clinicians determine the changes in the condition of children with severe pneumonia and evaluate their prognoses, combined detection has high sensitivity and specificity.
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Objective To analyse the clinical significance of (IL-5),interleukin-6 (IL-6),interleukin-8 (IL-8),eosinophil cationic protein (ECP),eosinophil (EOS),immunoglobulin E (IgE),vascular endothelial growth factor (VEGF) and its receptor in serum of children with infectious pneumonia.Methods 80 children with infectious pneumonia were enrolled in Lianyungang Maternal and Child Health Hospital from March 2016 to March 2017,and were included in the observation group.According to the pathogen type,these children in the observation group were divided into virus group,mycoplasma infection group and bacterial infection group.At the same time,30 healthy children were selected as the control group.The levels of TNF-α,IL-5,IL-6,IL-8,ECP,VEGF,VEGF-R1 and VEGF-R2 in serum were measured by enzyme-linked immunosorbent assay (ELISA).The levels of EOS in blood were measured by automatic blood cell analyzer and the level of lgE in serum was detected by immunoturbidimetric turbidimetric assay.Results The levels of TNF-α,IL-5,IL-6,IL-8,ECP,VEGF,VEGF-R1,VEGF-R2,EOS and IgE in the blood of the observation group were significantly higher than those in the control group (t=2.325 ～ 3.593,all P＜0.05).The levels of TNF-α,IL-5,IL-6 and IL-8 in the serum of the bacterial infection group were significantly higher than those in the virus group and mycoplasma group (all P＜0.05).The levels of VEGF,VEGF-1 and VEGF-R2 in serum of patients with mycoplasma infection were significantly higher than those in the group of bacterial infection and virus infection (all P＜0.05).Serum IgE levels and the number of peripheral blood EOS in the bacterial infection group,viral infection group and mycoplasma infection group had no significant difference (P＞0.05).Conclusion The serum levels of TNF-α,IL-5,IL-6 and IL-8 can be used as markers for bacterial infectious pneumonia and viral infectious pneumonia and mycoplasma infectious pneumonia.
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This study was aimed to evaluate the clinical effect and safety of Qing-Fei Tong-Luo (QFTL) ointment for treating children with pneumonia.Randomized controlled trial (RCT) was conducted among 460 cases of children with pneumonia.The observation group was given QFTL ointment combined with basic treatment.And the control group was only treated by basic treatment.Evaluation was given on the total clinical efficacy,disappeared time of fever,cough,expectoration,shortness of breath,and medication safety.The incidence of respiratory diseases was followed up on the 30th days after drug withdrawal.The results showed that in the aspect of clinical efficacy between two groups,the cure rate of the observation group was 98.26％,and that of the control group was 93.89％,with statistic significance (P ＜ 0.05).The cure rate of the observation group was better than that of the control group.There was statistical difference on expectoration disappeared time (P ＜ 0.05).There was no statistical difference on disappeared time of fever,cough and shortness of breath (P ＞ 0.05).There was statistical difference on the incidence of respiratory diseases on the 30th days followed-up after drug withdrawal (P ＜ 0.05).There was no statistical difference on the incidence of upper respiratory tract infection,pneumonia and asthma (P ＞ 0.05).No adverse reactions occurred in the observation group.It was concluded that QFTL ointment combined with basic therapy on the treatment of pneumonia in children was significantly better than the control group in the aspect of clinical efficacy,expectoration disappeared time and the incidence of bronchitis.It is safe and effective.The prognosis is good and worthy of promotion in the clinical practice.
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Objective To investigate the effect of serum high sensitive C reactive protein (hs-CRP) level on the curative effect of azithromycin in treatment of mycoplasma pneumonia in children.Methods The 68 cases of children with mycoplasma pneumonia in Maternal and Child Health Care Hospital of Chongzhou were selected as the research objects from June 2013 to June 2016.All the children were treated with 10mg/kg azithromycin daily.The clinical symptoms,chest X-ray changes and adverse reactions of children during treatment were observed and the level of hs-CRP was determined by latex immunoassay.Results The mean value of serum hs-CRP was (19.06 ± 3.01),and the median of serum hs-CRP was 12.92mg/L,which were higher than the normal upper limit value of 10mg/L.Children were divided into high hs-CRP group and low hs-CRP group by the median value of hs-CRP.There were no significant differences in the age,sex,course of disease and body temperature between the two groups (P ＞ 0.05).The overall effective rate of low hs-C RP group was 94.12％,which was significantly higher than that of high hs-C RP group at 76.47％ (x2 =4.221,P =0.040).The duration of cough,wheezing and lesion absorption time in high hs-CRP group were longer than those in the low hs-CRP group (P ＜0.05).But no significant difference was observed in time of fever,hospitalization time,the incidence of adverse reactions between two groups (P ＞0.05).Conclusion hs-CRP plays an important role in children's mycoplasma pneumonia,and the clinical effect of azithromycin is much better on the patients with low level of hs-CRP.
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Objective To investigate the effect of serum high sensitive C reactive protein (hs-CRP) level on the curative effect of azithromycin in treatment of mycoplasma pneumonia in children.Methods The 68 cases of children with mycoplasma pneumonia in Maternal and Child Health Care Hospital of Chongzhou were selected as the research objects from June 2013 to June 2016.All the children were treated with 10mg/kg azithromycin daily.The clinical symptoms,chest X-ray changes and adverse reactions of children during treatment were observed and the level of hs-CRP was determined by latex immunoassay.Results The mean value of serum hs-CRP was (19.06 ± 3.01),and the median of serum hs-CRP was 12.92mg/L,which were higher than the normal upper limit value of 10mg/L.Children were divided into high hs-CRP group and low hs-CRP group by the median value of hs-CRP.There were no significant differences in the age,sex,course of disease and body temperature between the two groups (P ＞ 0.05).The overall effective rate of low hs-C RP group was 94.12％,which was significantly higher than that of high hs-C RP group at 76.47％ (x2 =4.221,P =0.040).The duration of cough,wheezing and lesion absorption time in high hs-CRP group were longer than those in the low hs-CRP group (P ＜0.05).But no significant difference was observed in time of fever,hospitalization time,the incidence of adverse reactions between two groups (P ＞0.05).Conclusion hs-CRP plays an important role in children's mycoplasma pneumonia,and the clinical effect of azithromycin is much better on the patients with low level of hs-CRP.
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Objective To investigate the effect of gamma globulin combined with glucocorticoid pulse therapy in the treatment of children with refractory mycoplasma pneumonia in CRP and safety.Methods 46 cases of children with refractory mycoplasma pneumonia from February 2012 to February 2016 were selected and randomly divided into the control group and experimental group,23 cases in each group.On the basis of the regular treatment,the control group was given azithromycin,10mg/kg,qd,intravenous drip,on the basis of the control group treatment,the experimental group was treated with methylprednisolone 2mg/kg+human immunoglobulin 400mg/kg,qd,intravenous drip.The levels of serum C-reactive protein(CRP),white blood cell count(WBC),lymphocyte count(LC),therapeutic efficiency and safety were measured before and after treatment.Results After treatment,compared with the control group,the serum levels of CRP、WBC、LC were lower in the experimental group,the difference was statistically significant(P<0.05).The treatment efficiency of the experimental group(91.31％)was significantly higher than that of the control group(65.22％),the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The gamma globulin combined with glucocorticoid pulse therapy can significantly reduce the serum levels of CRP,WBC and LC in children with refractory mycoplasma pneumonia,improve clinical efficacy and the safety were good.
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Objective: To evaluate the effects of Xiaoer Feire Kechuan Granule for treating children with bronchial pneumonia. Methods: A randomly controlled trial was used. One hundred and twenty children with bronchial pneumonia were studied. The children in the experimental group were given Xiaoer Feire Kechuan Granule combined with basic treatment, and in the control group only treated by basic treatment, then the children with the disease in these two groups were observed to evaluate the general curative effect, traditional Chinese medicine (TCM) syndrome efficacy, symptoms of fever, and cough disappeared time before and after treatment of TCM primary symptom integra. Results: The overall efficacies in disease, syndromes curative effect, cough effect disappeared time, primary symptom score after therapy and hospital days for children in the two groups had statistical significance (P<0.05). Conclusion: Xiaoer Feire Kechuan Granule is applicable to the treatment of infantile pneumonia by antipyretic and antitussive function, promoting the pulmonary rales absorption, and shortening the course of treatment.
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Background@#Serum procalcitonin is a useful biomarker in establishing the presence of bacterial infections and has been used in algorithms to guide antibiotic treatment among adults. It role in pediatric infections, however, remains unclear. @*Objectives@#This research aims to evaluate the impact of serum procalcitonin in guiding antibiotic therapy among pediatric patients with suspected local or systemic infections. @*Methodology@#Randomized controlled trials comparing procalcitonin-guided antibiotic therapy to clinically guided therapy in pediatric patients with local or systemic infections were searched through MEDLINE, Cochrane, EMBASE, HERDIN and ClinicalTrials.gov. Hand search in various search engines was also done. Outcomes included antibiotic usage, morbidity and mortality. Two reviewers independently assessed potentially relevant studies. Statistical analysis was conducted using RevMan 5.3 using inverse variance weighting and random effects model. @*Results@#Five randomized controlled trials were included. Overall, there was a reduction in antibiotic prescription rate in the procalcitonin group compared to controls for all groups (RD -0.13, 95% CI [-021,0.06]; p <0.00001), however, pooled studies were heterogenous. Subgroup analysis showed that for children with pneumonia, procalcitonin guidance significantly reduced antibiotic prescription rate (RD – 012,95% CI [-021,0.04]; p <0.005 ), and may have potential in reducing the duration of therapy (95% CI [-6.8,2,54], p <0.0001) and antibiotic-related adverse effects (RD- 0.17, 95% CI[-0.24,-0.10], p<0.00001) compared to controls. In one study on neonates with early onset sepsis, procalcitonin guidance reduced antibiotic prescription rate by 27% (p=0.0009) and duration of therapy by 22.4 hours (p=0.0009). Procalcitonin guidance has no significant impact on antibiotic prescription rate in children with fever without a source (RD -0.11, 95% CI[0.28,0.05], p=0.190). @*Conclusion@#Procalcitonin guidance significantly reduces antibiotic prescription rate among children with pneumonia and neonates with early onset sepsis. It has the potential in reducing the duration of antibiotic therapy and antibiotic-related side effects in these populations. ON the other hand, it had no impact among children with fever without a source. These results highlight the need for algorithm-based approaches using procalcitonin cut-off values to guide antibiotic therapy in children.
Subject(s)
Procalcitonin , Neonatal SepsisABSTRACT
Objective To evaluate the clinical efficacy of Tanreqing injection combined with ganciclovir in the treatment of pediatric respiratory syncytial virus pneumonia.Methods Ninety cases of children with respiratory tract virus pneumonia were selected in our hospital from August 2014 to December 2015,and were randomly divided into observation group and control group,and 45 cases in each group.The control group was given conventional anti infection,expectorant and antiasthmatic,antipyretic,atomization inhalation symptomatic and supportive treatment,on this basis the ganciclovir injection;the observation group was additionally given Tanreqing treatment on the basis of the control group.Then we compared the effects of two groups,pulmonary rales,wheezing,cough disappeared time,hospitalization time and the incidence of adverse reactions.Results After the treatment,the total efficiency of the observation group (93.3％) was significantly higher than that of control group (75.6％),the difference was statistically significant (P ＜ 0.05).The pulmonary rales (5.58 + 1.41),cough (5.78 + 1.61),wheezing (3.45 + 0.87) disappear time and hospital stay time (5.34 ± + 0.61) of patients in the observation group was significantly shorter than that of the control group (6.93 + 1.61,7.73 + 1.65,479 + 1.02,736,0.52),and the difference was statistically significant (P ＜ 0.05).The adverse reaction incidence in the observation group (20.0％) and the control group (22.2％) had no statistically significant difference (P ＞ 0.05) Conclusion Tanreqing injection combined with ganciclovir in the treatment of children with respiratory syncytial virus pneumonia has good efficacy and less adverse reactions,it is worthy of further research and application in clinic.
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Objective To investigate the effect of complication and treatment compliance on PDCA nursing pathway in children with bronchial pneumonia. Methods 126 children with bronchial pneumonia were divided into two groups by random number table. There were 67 children in observation group with PDCA nursing pathway and 59 children in control group with normal nursing pathway. The effects of nursing in two groups were observed, including complications, length of hospital stay, cost, nursing compliance and satisfaction of nursing. Results The total occurrence rate of complication in observation group was 4.5%(3/67), while in control group was 18.6%(11/59). There was significant difference between the two groups (χ2=6.375, P<0.05). Compliance rate of children in observation group was 62.7%(42/67) which was significantly higher than 44.1% (26/59) of control group (χ2=4.738, P < 0.05). Hospitalization time in observation group was (5.9±2.1) d and cost was (1 703±390) yuan, while those in control group were (6.9 ± 2.8) d and (2 012 ± 501) yuan respectively. Both in observation group were obviously lower than in control group, and the difference was significant (χ2=2.161, 3.668, P<0.05). The satisfaction of nursery in observation group was significantly higher than the control group, which were 82.1% (55/67) and 61.0% (36/59) respectively. The difference was significantly different (χ2=6.944,P <0.05). Conclusions PDCA nursing pathway could decrease complication and improve treatment compliance as well as satisfaction of patients, it′s worth popularizing.
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Objective To evaluate the effectiveness and safety of TCM treatment to children with mycoplasma pneumonia. Methods RCTs of trational Chinese medicine in treating children with mycoplasma pneumonia were retrieved. CNKI, Wanfang Database and CBMdisc were searched for Chinese literature, and PubMed, EMbase and Cochrane Library were searched for foreign literature. All searching time was up to May 25, 2012. Data were picked up by two system reviewers individually and evaluation standard of Cochrane was used to evaluate the quality of selected literature. Results A total of 64 RCTs including 6289 cases of children with mycoplasma pneumonia were analyzed. In the improvement of clinical symptoms, among comparison between traditional Chinese medicine and western medicine (RR=1.10, 95%CI:-1.0--1.18) and comparison between traditional Chinese medicine plus western medicine and western medicine (RR=1.14, 95%CI:1.10-1.18), curative effects of treatment group were superior to the control group, P<0.00;For the fever clearance time, among comparison between traditional Chinese medicine and western medicine (RR=-4.26, 95%CI:-8.15--0.37), comparison between traditional Chinese medicine plus western medicine and western medicine (RR=-0.97, 95%CI:-1.27--0.66), curative effects of treatment group were superior to the western medicine group. For the time of the disappearance of cough and pulmonary rales, and the basic X-ray absorption time, curative effects of treatment group were also superior to the control group. Untoward effects in western medicine group were obvious than that of traditional Chinese medicine group. Conclusion TCM could improve and shorten the duration of symptoms of children with mycoplasma pneumonia. However, it is still necessary to be verified with more multi-center, double-blind, large sample randomized controlled trials, since the literature which have been brought into related researches were with low quality.