Clinical characteristics of plastic bronchitis and risk factors for recurrence in children / 中国当代儿科杂志

OBJECTIVES@#To study the clinical characteristics of plastic bronchitis (PB) in children and investigate the the risk factors for recurrence of PB.@*METHODS@#This was a retrospective analysis of medical data of children with PB who were hospitalized in Children's Hospital of Chongqing Medical University from January 2012 to July 2022. The children were divided into a single occurrence of PB group and a recurrent PB group and the risk factors for recurrence of PB were analyzed.@*RESULTS@#A total of 107 children with PB were included, including 61 males (57.0%) and 46 females (43.0%), with a median age of 5.0 years, and 78 cases (72.9%) were over 3 years old. All the children had cough, 96 children (89.7%) had fever, with high fever in 90 children. Seventy-three children (68.2%) had shortness of breath, and 64 children (59.8%) had respiratory failure. Sixty-six children (61.7%) had atelectasis and 52 children (48.6%) had pleural effusion. Forty-seven children (43.9%) had Mycoplasma pneumoniae infection, 28 children (26.2%) had adenovirus infection, and 17 children (15.9%) had influenza virus infection. Seventy-one children (66.4%) had a single occurrence of PB, and 36 cases (33.6%) had recurrent occurrence of PB (≥2 times). Multivariate logistic regression analysis showed that involvement of ≥2 lung lobes (OR=3.376) under bronchoscopy, continued need for invasive ventilation after initial removal of plastic casts (OR=3.275), and concomitant multi-organ dysfunction outside the lungs (OR=2.906) were independent risk factors for recurrent occurrence of PB (P<0.05).@*CONCLUSIONS@#Children with pneumonia accompanied by persistent high fever, shortness of breath, respiratory failure, atelectasis or pleural effusion should be highly suspected with PB. Involvement of ≥2 lung lobes under bronchoscopy, continued need for invasive ventilation after initial removal of plastic casts, and concomitant multi-organ dysfunction outside the lungs may be risk factors for recurrent occurrence of PB.

Angiotensin converting enzyme 2 alleviates infectious bronchitis virus-induced cellular inflammation by suppressing IL-6/JAK2/STAT3 signaling pathway / 生物工程学报

The goal of this study was to investigate the regulatory effect of angiotensin converting enzyme 2 (ACE2) on cellular inflammation caused by avian infectious bronchitis virus (IBV) and the underlying mechanism of such effect. Vero and DF-1 cells were used as test target to be exposed to recombinant IBV virus (IBV-3ab-Luc). Four different groups were tested: the control group, the infection group[IBV-3ab-Luc, MOI (multiplicity of infection)=1], the ACE2 overexpression group[IBV-3ab Luc+pcDNA3.1(+)-ACE2], and the ACE2-depleted group (IBV-3ab-Luc+siRNA-ACE2). After the cells in the infection group started to show cytopathic indicators, the overall protein and RNA in cell of each group were extracted. real-time quantitative polymerase chain reaction (RT-qPCR) was used to determine the mRNA expression level of the IBV nucleoprotein (IBV-N), glycoprotein 130 (gp130) and cellular interleukin-6 (IL-6). Enzyme linked immunosorbent assay (ELISA) was used to determine the level of IL-6 in cell supernatant. Western blotting was performed to determine the level of ACE2 phosphorylation of janus kinase 2 (JAK2) and signal transducer and activator of transcription 3 (STAT3). We found that ACE2 was successfully overexpressed and depleted in both Vero and DF-1 cells. Secondly, cytopathic indicators were observed in infected Vero cells including rounding, detaching, clumping, and formation of syncytia. These indicators were alleviated in ACE2 overexpression group but exacerbated when ACE2 was depleted. Thirdly, in the infection group, capering with the control group, the expression level of IBV-N, gp130, IL-6 mRNA and increased significantly (P < 0.05), the IL-6 level was significant or extremely significant elevated in cell supernatant (P < 0.05 or P < 0.01); the expression of ACE2 decreased significantly (P < 0.05); protein phosphorylation level of JAK2 and STAT3 increased significantly (P < 0.05). Fourthly, comparing with the infected group, the level of IBV-N mRNA expression in the ACE2 overexpression group had no notable change (P > 0.05), but the expression of gp130 mRNA, IL-6 level and expression of mRNA were elevated (P < 0.05) and the protein phosphorylation level of JAK2 and STAT3 decreased significantly (P < 0.05). In the ACE2-depleted group, there was no notable change in IBV-N (P > 0.05), but the IL-6 level and expression of mRNA increased significantly (P < 0.05) and the phosphorylation level of JAK2 and STAT3 protein decreased slightly (P > 0.05). The results demonstrated for the first time that ACE2 did not affect the replication of IBV in DF-1 cell, but it did contribute to the prevention of the activation of the IL-6/JAK2/STAT3 signaling pathway, resulting in an alleviation of IBV-induced cellular inflammation in Vero and DF-1 cells.

A Comparative Study of Nebulized 3% Hypertonic Saline Versus Nebulized Adrenaline in The Treatment of Acute Bronchiolitis

Background: Acute bronchiolitis is the most common lower respiratory tract infection in young infants and young children. The respiratory syncytial virus is the commonest cause of bronchiolitis. Recently the role of nebulized 3% saline has come into focus. Nebulized adrenaline has also been suggested as another treatment option, its primary role being the reduction of mucosal edema, which is an important part of the disease pathology in bronchiolitis. Objective: To see the effects of nebulized adrenaline in comparison to nebulized 3% hypertonic saline in the treatment of acute bronchiolitis. Material & Methods:This was a randomized controlled trial, carried out in the Department of Pediatrics, Bangladesh Shishu Hospital and Institute from October 2017 to March 2020. A total of 90 children from 1 month to 2 years of age of either sex who were diagnosed and admitted with acute bronchiolitis were enrolled. After enrollment, they were randomly assigned to either 3% nebulized hypertonic saline (group A=45) or to the nebulized adrenaline-1:1000 group (group B=45). Monitoring was done by respiratory distress assessment instrument (RDAI) score at 12 hours interval for 1st 24 hours and then 24 hourly till the patient was ready for discharge. The efficacy was determined by assessing clinical severity score/RDAI score and length of hospital stay. Data were analyzed using SPSS version-23.Results:The mean age was found 6.34±3.89 months in group A and 6.06±3.55 months in group B. The majority of patients were males in both groups. All patients had a cough, breathing difficulty, Ronchi, and chest indrawing in both groups. Changes in heart rate were 5.68±6.61/min in group A and 2.86±5.87/min in group B, which was significantly decreasing in group A than in group B. Mean clinical severity scores at 12 hours and at 24 hours were statistically significant (p<0.05). However, mean clinical severity scores at baseline, at 48 hours, at 72 hours, and at 96 hours were not statistically significant. The mean duration of oxygen therapy was found 15.00±5.36 hours in group A and 24.63±11.64 hours in group B. Which indicates that the duration of oxygen therapy was significantly higher in group B than in group A. Majority of the patients of group A and group B were discharged within 72 hours 39(86.7%) and 28(62.2%) respectively, which was statistically significant.Conclusions:Nebulization with 3% hypertonic saline significantly reduced clinical severity score and length of hospital stay in case of acute bronchiolitis in comparison to nebulized adrenaline.

Uso de solución salina hipertónica al 3 por ciento en niños con bronquiolitis aguda / Usage of 3 percent Hypertonic Saline Solution in Children with Acute Bronchitis

Introducción: La bronquiolitis aguda es la infección del tracto respiratorio inferior más frecuente en el lactante. Tiene una incidencia anual del 10 por ciento en los lactantes y una tasa de ingreso de entre el 2 y el 5 por ciento con un incremento importante en los últimos años. Objetivo: Determinar la efectividad del uso de solución salina hipertónica al 3 por ciento nebulizada en pacientes con bronquiolitis aguda. Métodos: Se realizó un estudio analítico longitudinal prospectivo de tipo casos y controles. El universo estuvo constituido por 132 pacientes distribuidos en 66 casos y 66 controles. Resultados: La edad media fue de 3,6 ± 2,5 meses. Los sibilantes se hallaron en 129 pacientes, lo que representó el 97,7 por ciento. Se encontró una estadía hospitalaria media de 3,19 ± 1,41 días en los casos, mientras que en los controles se encontró una media de 4,97 ± 1,77 días, diferencia que resultó altamente significativa (p < 0,001). Conclusiones: Aunque los pacientes tratados con solución salina hipertónica al 3 por ciento necesitaron más días con oxigenoterapia, el tratamiento resultó ser efectivo al mostrar una menor estadía hospitalaria y un menor número de complicaciones en pacientes con bronquiolitis aguda(AU)

Introduction: Acute bronchiolitis is the most frequent lower respiratory tract infection in the infant. It has a yearly incidence of 10 percent in infants and an admission rate of 2 percent to 5 percent, with a significant increase in recent years. Objective: To determine the effectiveness of nebulized 3 percent hypertonic saline solution treatment in patients with acute bronchiolitis. Methods: A prospective, longitudinal and analytical study of case-control design was carried out. The universe consisted of 132 patients distributed into 66 cases and 66 controls. Results: The mean age was 3.6±2.5 months. Wheezing was found in 129 patients, accounting for 97.7 percent. A mean hospital stays of 3.19±1.41 days was found in cases, while a mean of 4.97±1.77 days was found in controls, a difference that was highly significant (P<0.001). Conclusions: Although patients treated with 3 percent hypertonic saline solution required more days with oxygen therapy, the treatment proved to be effective by showing a shorter hospital stay and a lower number of complications in patients with acute bronchiolitis(AU)

A Conceptual Study on the Role of Vasa Bhavit Haridra Churnam in Vataja Kasa (Dry Cough) w.s.r. to Allergic Bronchitis: A Review

In the present era of COVID -19, management of respiratory disorders is becoming a challenge to the world. Ayurveda, the science of life, provides a lot of hope in the present condition by assuring better results in the field of prevention and management of respiratory diseases. Cough carries out an essential protective function for the respiratory tract and lungs. Kasa (cough) is one of the commonest complaints in day-to-day life and it is also a symptom of various diseases of the respiratory system. In Ayurveda, Acharyas have explained Kasa in detail. They have described five types of Kasa. Among the various respiratory diseases, Vataja Kasa (dry cough) has been selected here. In the contemporary science, it can be correlated to Allergic Bronchitis, which is one of the common problems throughout the world. In the present study Vasa Bhavit Haridra Churnam (VBHC) has been selected from Siddh Bhaisajya Manimala and further details regarding the ingredients were collected from various text books, PubMed, research articles, previous works done etc. As per the data collected, Allergic Bronchitis when treated with Vasa Bhavit Haridra Churnam will be effective in relieving the symptoms. Ayurveda has a vital role to play in the field of respiratory ailments.

Indicaciones de rehabilitación respiratoria en niños y adolescentes con enfermedades respiratorias crónicas / Indications for respiratory rehabilitation in children and adolescents with chronic respiratory diseases

Resumen El aumento de la expectativa de vida de niños y adolescentes con enfermedades respiratorias crónicas ha llevado a implementar estrategias como la rehabilitación respiratoria (RR). El presente artículo profundiza en las distintas indicaciones de la RR en distintos niveles de atención médica, distinto grado de dependencias tecnológicas y diversas patologías como: Fibrosis Quística, Bronquiolitis Obliterante, Enfermedades Neuromusculares, anomalías de caja torácica y escoliosis.

The increase in the life expectancy of children and adolescents with chronic respiratory diseases has led to implement strategies such as respiratory rehabilitation (RR). This article delves into the different indications of RR at different levels of medical care, different level of technological dependencies and different pathologies such as: Cystic Fibrosis, Bronchiolitis Obliterans, Neuromuscular Diseases, Rib cage abnormalities and Scoliosis.

The potential inhibitory impact of curcumin, epigallocatechin gallate and their combinations on infectious bronchitis virus in vivo

Aims@#Infectious bronchitis virus (IBV) is a highly contagious, acute viral respiratory disease that mostly affects chickens. The poultry sector has suffered enormous losses as a result of IBV. Currently, live attenuated vaccines are routinely used to prevent and control IBV. However, due to the enormous genetic variety, vaccinations are becoming ineffective, with low cross-protection effects among vaccine serotypes. The present study aimed at investigating the possible antiviral effects of curcumin, epigallocatechin gallate (EGCG) and their mixtures against IBV in vivo.@*Methodology and results@#Curcumin, EGCG and their combinations were administered to infected and uninfected chicken groups and viral load titers were determined by real-time PCR. The clinical symptoms of both the negative and positive control groups were also compared. Finally, the trachea tissues of each group were examined histopathologically. According to our findings, the viral titer and the clinical signs dropped significantly during the pretreatment infection procedure. Curcumin, EGCG and their combinations also show significant antiviral activities.@*Conclusion, significance and impact of study@#This study clearly shown that natural compounds and their combinations, such as curcumin or/and ECGC can reduce viral pathogenicity in vivo, suggesting that they might have therapeutic implications in the poultry sector.

Effects of Huaiqihuang Granules on airway inflammation in bronchiolitis / 中国基层医药

Objective:To investigate the effects of Huaiqihuang Granule on airway inflammation and wheezing reattack in bronchiolitis. Methods:A total of 120 patients with bronchiolitis presenting airway inflammation and wheezing reattack who received treatment in Zaozhuang Municipal Hospital and Yicheng Hospital of Traditional Chinese Medicine between January 2018 and October 2019 were included in this study. These patients randomly underwent either conventional treatment (control group, n = 60) or conventional treatment + Huaiqihuang Granule treatment (experimental group, n = 60). They received pulmonary function examinations and laboratory tests for evaluating serum and urinary inflammatory factors at admission and 2 months after discharge. They were followed up by telephone 3 months and 1 year after onset. Results:The ratio of time to reach the peak tidal expiratory flow over total expiratory time (TPTEF/TE) and the volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE) were significantly higher in the experimental group compared with those in the control group ( t = 3.13, 3.60, all P < 0.01). The ratio of tidal peak flow to tidal expiratory flow when 25% of tidal volume remains in the lungs (PF/TEF25) and functional residual capacity/kg (FRCp/kg) significantly decreased in the experimental group compared with those in the control group ( t = 3.88, 3.74, all P < 0.01). Interleukin-4 level and the ratio of interleukin-4/γ-interferon levels were significantly lower in the experimental group than in the control group ( t = 5.70, 8.93, all P < 0.01). Gamma-interferon level was significantly higher in the experimental group than in the control group ( t = 3.85, P < 0.01). There was no significant difference in urinary leukotriene E4 level post-treatment between the two groups ( t = 1.18, P > 0.05). The number of patients who had a wheezing attack again within 3 months post-treatment and the number of patients who had ≥3 wheezing attacks were significantly lower in the experimental group compared with those in the control group ( χ2 = 5.18, 6.98, P < 0.01 or 0.05). Conclusion:Huaiqihuang granule can effectively regulate the balance of the Th 1/Th 2 ratio, inhibit airway inflammation in bronchiolitis, improve pulmonary function, and reduce the number of wheezing reattacks.

Etiological characteristics and changes of plastic bronchitis in children in single center / 中国小儿急救医学

Objective:To investigate the etiological characteristics and changes of plastic bronchitis(PB)in children from 2010 to 2019 at Shenzhen Children′s Hospital, and provide reference basis for improving the understanding of PB etiology.Methods:The clinical data of children diagnosed with infectious-associated PB at Shenzhen Children′s Hospital from Jan 2010 to Dec 2019 were retrospectively analyzed, and the etiological characteristics and changes were summarized.Results:There were 94 cases of mycoplasma pneumoniae, 38 cases of influenza virus, 41 cases of adenovirus, 16 cases of mixed infection, 11 cases of bacteria, and 57 cases of unclear etiology in 266 infectious-associated PB children.The distribution of PB in each age group: 15 cases were infants, 63 cases were toddlers, 112 cases were preschoolers, and 76 cases were school-age children.Adenovirus was the main pathogen of PB in infants and toddlers(60.0%, 28.6%), and mycoplasma pneumoniae(34.8%, 60.5%) as well as influenza virus(13.4%, 22.4%) were the main pathogen in preschool and school-age children, with statistically significant difference( P<0.001). From 2010 to 2019, the annual positive rates of pathogens were 62.5%, 60.0%, 66.7%, 74.1%, 64.0%, 50.0%, 93.3%, 57.1%, 75.0%, and 84.7%, respectively.PB was caused by mycoplasma pneumoniae infection every year.From 2016 to 2019, PB caused by mycoplasma pneumoniae infection increased year by year, while PB caused by adenovirus infection increased every other year. Conclusion:Mycoplasma pneumoniae was the most common pathogen of PB, followed by adenoviruses and influenza viruses, while bacteria, fungi and other viruses were relatively rare.In the infant group, adenovirus infection was predominant, while in preschool and school-age children group, mycoplasma pneumoniae and influenza virus infection were predominant.

Treatments used by chronic obstructive pulmonary disease patients in Brazil: National Survey of Health, 2013 / Tratamentos utilizados por portadores de DPOC no Brasil: Pesquisa Nacional de Saúde, 2013

ABSTRACT OBJECTIVE To estimate the prevalence of treatments used for the management of chronic obstructive pulmonary disease (COPD) in the Brazilian adult population. METHODS A population-based cross-sectional study with data from the 2013 Brazilian National Survey of Health, including individuals aged 40 years or older, with a self-reported medical diagnosis of COPD, chronic bronchitis and/or emphysema, who were asked about treatments used for disease management. RESULTS A total of 60,202 adults were interviewed, of which 636 were 40 years of age or older and had reported a medical diagnosis of COPD, emphysema, or chronic bronchitis. Less than half (49.4%) of the diagnosed population reported using some type of treatment, with differences regarding the macro-region of the country (South 53.8% - Northeast 41.2%, p = 0.007). Pharmacological treatment was the most reported, and emphysema patients had the highest proportion of those undergoing more than one type of treatment. Among the individuals who reported having only chronic bronchitis, 55.1% (95%CI: 48.7-61.4) used medication, 4.7% (95%CI: 2.6-8.3) underwent physical therapy, and 6.0% (95%CI: 3.6-9.9) oxygen therapy. On the other hand, among the emphysema patients, 44.1% (95%CI: 36.8-51.7) underwent drug treatment, 8.8% (95%CI: 5.4-14.2) physical therapy, and 10.0% (95%CI: 6.3-15.6) oxygen therapy. CONCLUSION The prevalence of treatments for COPD management was below ideal in 2013. The pharmacological treatment was the main type of treatment, followed by oxygen therapy and physical therapy.

RESUMO OBJETIVO Estimar a prevalência dos tratamentos utilizados para o manejo da doença pulmonar obstrutiva crônica (DPOC) na população adulta brasileira. MÉTODOS Estudo transversal de base populacional com dados oriundos da Pesquisa Nacional de Saúde de 2013, incluindo indivíduos com 40 anos ou mais, com diagnóstico médico autorreferido de DPOC, bronquite crônica e/ou enfisema, os quais foram questionados sobre tratamentos utilizados para o manejo da doença. RESULTADOS Foram entrevistados 60.202 adultos, dos quais 636 tinham 40 ou mais anos de idade e haviam referido diagnóstico médico de DPOC, enfisema ou bronquite crônica. Menos da metade (49,4%) da população diagnosticada relatou utilizar algum tipo de tratamento, havendo diferenças quanto à macrorregião do país (Sul 53,8% - Nordeste 41,2%, p = 0,007). O tratamento medicamentoso foi o mais referido e portadores de enfisema apresentaram a maior proporção de mais de um tipo de tratamento utilizado. Entre os indivíduos que declararam ter apenas bronquite crônica, 55,1% (IC95% 48,7-61,4) usavam medicamento, 4,7% (IC95% 2,6-8,3) realizavam fisioterapia e 6,0% (IC95% 3,6-9,9) oxigenoterapia. Por outro lado, entre os enfisematosos, 44,1% (IC95% 36,8-51,7) realizavam tratamento medicamentoso, 8,8% (IC95% 5,4-14,2) fisioterapia e 10,0% (IC95% 6,3-15,6) oxigenoterapia. CONCLUSÕES As prevalências de tratamentos para o manejo da DPOC estavam aquém do ideal em 2013. O medicamentoso foi o principal tipo de tratamento, seguido de oxigenoterapia e fisioterapia.

Characteristics of severe adenovirus pneumonia complicated with plastic bronchitis in children / 中国小儿急救医学

Objective:To summarize the clinical characteristics and investigate risk factors associated with the development of plastic bronchitis(PB)in pediatric patients who have severe pneumonia caused by adenovirus(HAdVs)infections.Methods:We retrospectively reviewed the clinical manifestations, laboratory results, radiological examinations, and treatment courses of 258 children who were diagnosed as HAdVs associated severe pneumonia between 1st January, 2015 and 31st October, 2019 at Shenzhen Children′s Hospital.According to the presence of PB, patients were divided into PB group( n=45)and non-PB group( n=213). Results:In PB group, the male to female ratio was 1.65∶1(including 28 boys and 17 girls)and the median age was 41.0(18.5, 65.5)months.Patients younger than 6 years of age accounted for 80.0%(36/45)and older patients accounted for 20.0%(9/45). The major clinical symptoms of patients in PB group were high fever(95.6%, 43/45), cough(100.0%, 45/45)and conjunctivitis(33.3%, 15/45). Physical examinations revealed that most patients had tachypnea(80.0%, 36/45)and crackles(80.0%, 36/45). Compared to patients in non-PB group, the duration of fever in PB group was significant longer( Z=-13.519, P<0.001). Compared to non-PB group, there was a significant decrease of the lymphocyte count[2.24(1.44, 3.84)×10 9/L vs.1.75(1.21, 3.03)×10 9/L] and a significantly increase of the procalcitonin level[0.46(0.19, 1.73)ng/mL vs.1.54(0.37, 2.96)ng/mL] in PB group( P<0.05). Chest radiological examinations revealed that patients in PB group had higher rates to develop pleural effusion(62.2% vs.42.3%) and atelectasis(57.8% vs.22.1%) of the lungs compared to non-PB group( P<0.05). The majority of patients improved after resolution of symptoms(97.8%, 44/45) in PB group.Only one patient(2.2%, 1/45) died due to discontinuation of treatment.Conjunctivitis( P<0.001, OR=108.514, 95% CI 17.476-673.791), tachypnea( P<0.001, OR=18.788, 95% CI 5.172-68.246), pleural effusion( P=0.007, OR=3.363, 95% CI 1.389-8.139) were independent risk factors associated with the development of PB in children with HAdVs associated severe pneumonia. Conclusion:Pre-school age children are at higher risk to develop HAdVs related severe pneumonia that complicated with PB.Fever and cough remain the main clinical symptoms.The presence of PB is associated with longer period of fever and higher risks to have pleural effusion and atelectasis.Conjunctivitis, tachypnea orpleural effusion are higher risk to develop PB in those with HAdVs associated severe pneumonia.

Early warning analysis of plastic bronchitis in children and clinical study of flexible bronchoscopy / 中华实用儿科临床杂志

Objective:To study the clinical characteristics and etiological distribution characteristics of plastic bronchitis in children, analyze its early warning indicators, and evaluate the clinical diagnosis and treatment effect of flexible bronchoscopy.Methods:The clinical data of 232 children with severe pneumonia admitted to Guiyang Maternal and Child Health Hospital from January 2019 to February 2021 were retrospectively analyzed.The children were divided into the plastic bronchitis group and non-plastic bronchitis group according to bronchoscopic results.The gender, age, clinical manifestations, auxiliary examinations, imaging features, bronchoscopy findings and treatment of the children were collected, compared and analyzed, comparison between two groups by t test and χ2 test. Results:A total of 232 children were included in this study, including 98 cases in the plastic bronchitis group and 134 cases in the non-plastic bronchitis group.The main symptoms of both groups were fever, cough and shortness of breath.The age of onset in the plastic bronchitis group was (54.640±37.085) months, and the age of onset in the non-plastic bronchitis group was (14.870±19.813) months.The difference in the age of onset between the two groups was statistically significant ( t=9.656, P<0.001). The average hospitalization days of the plastic and non-plastic bronchitis groups were (16.133±6.227) d and (12.690±4.287) d, respectively.Significant difference was found in the average hospitalization days between the two groups ( t=4.721, P<0.001). The average fever days of the plastic bronchitis group were (10.090±3.473) d, and the average fever days of the non-plastic bronchitis group were (6.030±4.850) d. There was significant difference in the average fever days between the two groups ( t=5.654, P<0.001). The age of onset, hospitalization days, and fever days of the plastic bronchitis group were larger than those of the non-plastic bronchitis group (all P<0.001). The physical examination suggested that 40% (39/98) of patients in the plastic bronchitis group had reduced the breath sounds, and this percentage was significantly higher than that in the non-plastic bronchitis group[6%(8/134)]. The plastic bronchitis group had lower partial pressure of blood oxygen (PO 2) and oxygen saturation (SO 2) levels than the non-plastic bronchitis group (all P<0.01). The plastic bronchitis group had a higher percentage of neutrophils (N), C-reactive protein (CRP) level, procalcitonin (PCT) level, lactate dehydrogenase (LDH) level and D-dimer level than the non-plastic bronchitis group (all P<0.01). According to the imaging results, in the plastic bronchitis group, lung consolidation was found in 72 cases (73%, 72/98), atelectasis in 32 cases (33%, 32/98), and pleural effusion in 33 cases (34%, 33/98). In the non-plastic bronchitis group, 65%(87/134) cases had lung consolidation, 5%(7/134) cases had atelectasis, 3.7% (5/134) cases had pleural effusion.The first pathogen detected in 46.9% of the patients in the plastic bronchitis group was Mycoplasma pneumoniae (MP), and the percentage was significantly higher that in the non-plastic bronchitis group (11.1%). Flexible bronchoscopy was performed on both groups at their admission.The plastic bronchitis group received the flexible bronchoscopy check for (2.960±1.157) times on average, and the non-plastic bronchitis group was tested for (1.140±0.371) times on average.Of 98 children in the plastic bronchitis group, 95 cases were improved and discharged, 2 cases were transferred, and 1 case died.All 134 children in the non-plastic bronchitis group were improved and discharged. Conclusions:Preschool and school-age children, fever ≥10 d, PCT, CRP, LDH, D-dimer levels are early warning signs of plastic bronchitis clinically.MP is still the primary pathogen causing plastic bronchitis.Flexible bronchoscopy technique is a key measure for timely diagnosis and effective treatment of plastic bronchitis.

Diferencias entre el SARS-CoV-2 y el coronavirus de la Bronquitis Infecciosa Aviar (IBV) / Differences between SARS-CoV-2 and Avian Infectious Bronchitis (IBV) coronavirus / Diferenças entre o coronavírus SARS-CoV-2 e Bronquite Infecciosa Aviária (IBV)

Resumen La enfermedad por el nuevo coronavirus 2019 (COVID-19) es causada por el virus denominado SARS-CoV-2, no obstante, en los pollos de corral los coronavirus causan Bronquitis Infecciosa Aviar. En la actualidad, se ha logrado analizar la secuencia genómica del virus SARS-CoV-2, el cual indica que éste emergió de un reservorio animal, incluso se ha considerado que un virus aislado de un murciélago, idéntico a SARS-CoV, sea el progenitor del nuevo coronavirus. En otros estudios, se ha evidenciado que la glicoproteína de la espícula viral tiene un alto grado de emparentamiento entre virus que infectan mamíferos y aves, que es la que permite el contacto con el huésped. Mientras que en el caso del IBV, al inhalarse, el virus se ligará a los receptores de glucoproteína que contienen ácido siálico en las células epiteliales ciliadas del tejido respiratorio, entonces la replicación viral dará como resultado la pérdida de la función ciliar, acopiamiento de moco, necrosis y descamación, provocando dificultad para respirar y asfixia. El IBV afecta tráquea, riñones y tracto reproductivo de muchas aves. En el caso de las gallinas, el IBV virémico causa lesiones en el magnum y en el útero. Esta revisión dilucida algunos puntos clave en las diferencias en el nuevo coronavirus y el virus de la bronquitis infecciosa. Es muy poco probable que SARS-CoV-2 infecte o cause enfermedades en las aves de corral.

Abstract The new coronavirus 2019 disease (COVID-19) is caused by the virus called SARS-CoV-2, however, in free-range chicken's coronaviruses cause Avian Infectious Bronchitis. Currently, it has been possible to analyze the genomic sequence of the SARS-CoV-2 virus, which indicates that it emerged from an animal reservoir, it has even been considered that a virus isolated from a bat, identical to SARS-CoV, is the parent of the new coronavirus. In other studies, it has been shown that the glycoprotein of the viral spicule has a high degree of relationship between viruses that infect mammals and birds, which is the one that allows contact with the host. Whereas in the case of IBV, when inhaled, the virus will bind to sialic acid-containing glycoprotein receptors in hair epithelial cells of respiratory tissue, then viral replication will result in loss of ciliary function, mucus clearance, necrosis, and peeling, causing shortness of breath and suffocation. IBV affects the trachea, kidneys, and reproductive tract of many birds. In chickens, viremic IBV causes lesions in the magnum and the uterus. This review elucidates some key points in the differences between the novel coronavirus and the infectious bronchitis virus. SARS-CoV-2 is highly unlikely to infect or cause disease in poultry.

Resumo A nova doença coronavírus 2019 (COVID-19) é causada pelo vírus denominado SARS-CoV-2, no entanto, em galinhas caipiras, os coronavírus causam bronquite infecciosa aviária. Atualmente, foi possível analisar a sequência genômica do vírus SARS-CoV-2, o que indica que ele emergiu de um reservatório animal, inclusive se considerou que um vírus isolado de um morcego, idêntico ao SARS-CoV, é o progenitor do novo coronavírus. Em outros estudos, foi demonstrado que a glicoproteína da espícula viral possui alto grau de parentesco entre os vírus que infectam mamíferos e aves, o que permite o contato com o hospedeiro. Enquanto no caso do IBV, quando inalado, o vírus se liga aos receptores de glicoproteína contendo ácido siálico nas células epiteliais ciliadas do tecido respiratório, a replicação viral resultará em perda da função ciliar, acúmulo de muco , necrose e descamação, causando falta de ar e sufocação. O IBV afeta a traqueia, os rins e o trato reprodutivo de muitas aves. No caso das galinhas, o IBV virêmico causa lesões no magno e no útero. Esta revisão elucida alguns pontos-chave nas diferenças entre o novo coronavírus e o vírus da bronquite infecciosa. É altamente improvável que o SARS-CoV-2 infecte ou cause doenças em aves.

A clinical analysis of protracted bacterial bronchitis in 102 children in Qingdao Area / 中国小儿急救医学

Objective:To summarize the clinical characteristics of 102 children with protracted bacterial bronchitis in Qingdao area.Methods:One hundred and two children with protracted bacterial bronchitis treated at respiratory clinic of Women and Children′s Hospital affiliated to Qingdao University from January 2016 to March 2021 were included in this study.The clinical data, age and seasonal distribution, etiology, clinical manifestations, high-resolution CT of the lungs, characteristics of lung function, bronchoscopy and treatment prognosis were retrospectively analized.Results:The top three pathogens of protracted bacterial bronchitis in 102 children (55 boys, 47 girls, median age: 1.7 (0.8, 4.2)years were Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, with frequency of 12.75%, 10.78%, and 6.86%, respectively.The onset season was mainly autumn and winter, with a total of 73 (71.57%) cases.The main clinical manifestations were wet cough and (or) wheezing, and the cough was not divided between day and night.CT of the lungs showed thickening of the bronchial wall in 16(15.69%) cases and uneven ventilation in 5(4.90%) cases.Twenty-three (22.55%) cases had abnormal lung function.Fifty-two (50.98%) cases underwent bronchoscopy, of which 33(32.35%) cases had multiple lung segmental purulent changes under the microscope.After standard anti-infection, bronchoscopy and alveolar lavage, expectorant and physical therapy, the prognosis was mostly good.Conclusion:The clinical manifestations of protracted bacterial bronchitis in children have no obvious specificity.Early diagnosis, identification of the cause and comprehensive management are critical to its prognosis.

Clinical characteristics and risk factors for plastic bronchitis caused by severe mycoplasma pneumonia in children / 中国小儿急救医学

Objective:To summarize the clinical characteristics of plastic bronchitis caused by severe mycoplasma pneumoniae pneumonia in children, to find the risk factors for plastic bronchitis, and to provide references for judging the prognosis and comprehensively formulating treatment plans.Methods:We retrospectively analyzed the clinical data(146 cases)of children with severe mycoplasma pneumoniae pneumonia who underwent bronchoscopy in the Department of Pediatric Respiratory Medicine of Shengjing Hospital of China Medical University from January 2017 to December 2019.According to whether it was plastic bronchitis, all patients were divided into plastic bronchitis group(68 cases) and non-plastic bronchitis group(78 cases), and the gender, age, laboratory examination indicators, imaging characteristics and treatment of children were collected under the circumstances.The single factor with clinical significance and statistical significance would be subjected to multivariate Logistic regression analysis.Results:There were no significant differences in gender, age, heat duration, white blood cell count, C-reactive protein value, and interleukin-6 value between the two groups(all P>0.05). The percentage of neutrophils, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, D-dimer, number of cases of pleural effusion, length of hospital stay, and number of endoscopy in the plastic bronchitis group were higher than those in non-plastic bronchitis group, the number of right upper lobe consolidation cases was less than that in the non-plastic bronchitis group, and the differences were statistically significant( P<0.05). Multiple Logistic regression analysis showed that pleural effusion( OR=4.898, 95% CI 2.195-10.926) and lactate dehydrogenase ( OR=1.051, 95% CI 1.003-1.101) were independent predictors of plastic bronchitis in children with severe mycoplasma pneumoniae pneumonia. Conclusion:For children with severe mycoplasma pneumoniae pneumonia, if lung CT shows that the upper lobe of the non-right lung is uniformly compacted and complicated with pleural effusion, lactate dehydrogenase is significantly increased, and attention should be paid to the possibility of plastic bronchitis.Timely improvement of fiberoptic bronchoscopy may shorten the course of the disease and reduce the occurrence of complications.

Analysis of clinical characteristics and risk factors of plastic bronchitis caused by Mycoplasma pneumoniae infection / 中华实用儿科临床杂志

Objective:To analyze the clinical characteristics of patients suffering from plastic bronchitis (PB) caused by Mycoplasma pneumoniae (MP) and explore its risk factors as well. Methods:A retrospective analysis on clinical and laboratory data of PB children caused by MP and treated in Department of Respiratory in Children′s Hospital of Soochow University from January 2011 to December 2017, compared with MP pneumonia(MPP) children without PB in the same period.Meanwhile, Logistic regression analysis was performed. Results:Among the 306 MPP children, there were 50 cases in the PB group and 256 cases in the non-PB group.Compared with children in the non-PB group, children in PB group were higher in terms of age [(82.74±35.17)months vs.(66.63±35.67) months], percentage of neutrophils (0.705 8±0.139 1 vs.0.605 7±0.162 6), C reactive protein(CRP) [17.4(10.21, 42.86) mg/L vs.11.43(4.55, 23.66) mg/L], D-dimer(DD) [1 071 (279.5, 2 386.5) μg/L vs.523 (233, 1 099.5) μg/L], lactate dehydrogenase(LDH) [491.1 (342.3, 607.4) U/L vs.394.9 (319.1, 512.8) U/L], erythrocyte sedimentation rate(ESR)[25.0 (17.0, 36.0) mm/1 h vs.15.5(9.0, 28.0) mm/1 h], aspartate aminotranferase(AST) [33.5(26.1, 49.3) U/L vs.29.2(24.0, 37.2) U/L], alanine aminotransferase (ALT) [19.1(11.45, 31.50) U/L vs.13.6 (10.3, 23.15) U/L], IgA [1.46(0.98, 2.12) mg/L vs.1.15 (0.64, 1.60) mg/L], CD3 -CD (16+56)+ (0.155 0±0.088 6 vs.0.120 2±0.071 5), allergy history [44.0%(22/50 cases) vs.25.8%(65/256 cases)], mixed infection [38.0% (19/50 cases) vs.24.6%(63/256 cases)], and microscopic mucosal erosion [10.0%(5/50 cases) vs.2.3%(6/256 cases)] (all P<0.05). Logistic regression analysis displayed that allergy history ( OR= 5.604, 95% CI: 1.937-16.216), age ( OR = 3.142, 95% CI: 1.425-6.929), percentage of neutrophils ( OR=2.387, 95% CI: 1.088-5.238), CRP ( OR=3.959, 95% CI: 1.072-14.662), and DD ( OR=7.824, 95% CI: 2.824-21.673) were independent risk factors for PB caused by MP infection (all P<0.05). The cut-off values of age, percentage of neutrophils, CRP, and DD were 64 months, 0.70, 35 mg/L, and 2 000 μg/L. Conclusions:Children with PB caused by MP often develop in older and allergic children who have stronger inflammatory reactions, immune disorders, and hyperfibrinolysis.

Advance in the diagnosis and treatment of plastic bronchitis in children / 国际儿科学杂志

As a clinical syndrome involving multiple systems, plastic bronchitis(PB)raises a widely interest among researchers due to its complex etiology and unclear pathogenesis.It is currently believed that PB is related to bronchial asthma, cystic fibrosis, sickle cell disease and respiratory tract infection.The main characteristic of PB is the formation of dendritic casts in the bronchus, causing local or extensive obstruction, acute dyspnea, even respiratory failure, and death.Besides, the lack of effective management may result in recurrent respiratory infection, seriously affecting children′s quality of life.The disease is rare in pediatrics, and its clinical and imaging manifestations have no specificity, which can easily lead to misdiagnosis and missed diagnosis.Hence, it is extremely important for early diagnosis and timely removal of plastic substances blocking the airway.

Meta-analysis on Clinical Effect and Safety of Tanreqing Injection in Treatment of Elderly Chronic Bronchitis / 中国实验方剂学杂志

Objective:To systematically evaluate the clinical efficacy of Tanreqing injection in the treatment of elderly chronic bronchitis. Method:CBM，CNKI，WanFang Data，VIP，PubMed，The Cochrane Library，Embase and other databases were retrieved by computer to screen out randomized controlled trials of Tanreqing injection in the treatment of elderly chronic bronchitis. The retrieval time was from the establishment to December 2019. After two researchers independently screened out the literatures according to the inclusion and exclusion criteria，extracted data and evaluated the literature quality，made meta-analysis using RevMan 5.3 software，and performed Egger test by Stata 14.0 software to evaluate publication bias. In case of any publication bias，clipping and supplementation method was further used to evaluate the effect of bias on the results. Result:A total of 48 studies were included，including 4 356 patients with diabetic nephropathy. The results of Meta-analysis showed that compared with conventional antibiotic therapy，the group of combination with Tanreqing injection was better than the control group in effective rate and lowering serum c-reactive protein （CRP） level，with statistically significant differences. The results of the publication bias test showed that a developmental bias in the effective rate. Further analysis based on the non-parametric clipping and supplementation method showed stable results of meta-analysis and no impact from potential publication bias. The adverse reactions had no statistically significance. Conclusion:This study shows that Tanreqing injection has a significant effect in treating chronic bronchitis in the elderly，and can reduce the serum CRP level of the patients. Compared with the conventional therapy group，the incidence of adverse reactions is not significantly increased，and the results need further clinical tests.

Complex Network Analysis of Xiyanping Injection in Treatment of Bronchitis Based on Real World / 中国实验方剂学杂志

Objective:To explore the group modules of Chinese medicine and western medicine for the treatment of bronchitis patients with Xiyanping injection based on the real world to provide references for the clinical treatment of bronchitis with Chinese medicine and western medicine. Method:Medical records of 13 874 patients with bronchitis treated by Xiyanping injection were extracted from 29 hospital information systems （HISs） in China，and complex network analysis was carried out using Tabu Search algorithm to obtain the substructure and associated information of core drug combination of Xiyanping injection for the treatment of bronchitis and to analyze clinical medication protocols. Result:Medication protocols for the pathogens of bronchitis are listed below： Xiyanping injection + cefuroxime for bacterial infection. Xiyanping injection + interferon for viral infection. Xiyanping injection + azithromycin for mycoplasma infection. According to the clinical symptoms and complications of bronchitis， the appropriate medication protocols were as follows： Xiyanping injection + ambroxol + Feilike mixture + ibuprofen for uncomplicated bronchitis. Xiyanping injection + ipratropium bromide + budesonide + salbutamol for asthmatic bronchitis. Xiyanping injection + mannitol + furosemide + phenobarbital + gangliosides + immunoglobulin for bronchitis complicated with viral encephalitis. Xiyanping injection + creatine phosphate sodium + vitamin C for bronchitis complicated with viral myocarditis. The combined medication of Chinese medicine for the treatment of bronchitis was adopted based on its characteristics of traditional Chinese medicine. Conclusion:The data of this study were derived from the real world. The combined medications protocols of Xiyanping injection targeting the clinical symptoms and complications of bronchitis were extracted and summarized. However， it is necessary to formulate an individualized medication protocol according to the specific condition.

Mechanism of Qingke Pingchuan Granule in Treatment of Acute and Chronic Bronchitis Complicated with Chronic Obstructive Pulmonary Disease： An Exploration Based on Network Pharmacology / 中国实验方剂学杂志

Objective:To explore the potential mechanism of Qingke Pingchuan granule in treating acute and chronic bronchitis complicated with chronic obstructive pulmonary disease （COPD） by network pharmacology. Method:The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） was retrieved to collect the active components of Qingke Pingchuan granule and predict the action targets， followed by the construction of component-target network using Cytoscape 3.8. GeneCards， Online Mendelian Inheritance in Man（OMIM）， and DrugBank were used to harvest disease targets， whose names were put into UniProt for standardization. The treatment targets of Qingke Pingchuan Granule against the two diseases were obtained based on Venn diagram， which were then imported into the STRING platform for constructing the protein-protein interaction （PPI） network. Following the gene ontology（GO） and Kyoto encyclopedia of genes and genomes（KEGG） pathway enrichment analysis based on MetaScape， the active component-common target-signaling pathway network of Qingke Pingchuan granule against acute and chronic bronchitis complicated with COPD was finally constructed. The accuracy of the target was confirmed by literature. Result:A total of 165 active components， 374 related targets， 512 disease-related targets， and 130 common targets were obtained. Among them， the 14 core therapeutic targets were further subjected to GO enrichment analysis， which yielded 390 biological processes， nine cell components， and 23 molecular functions. The KEGG pathway analysis revealed 22 signaling pathways. Conclusion:Qingke Pingchuan granule alleviates the diseases possibly by regulating such targets as vascular endothelial growth factor receptor 2（KDR）， transforming growth factor beta-1 （TGF-<italic>β</italic>₁）， caveolin 1（CAV1）， hypoxia-inducible factor-1alpha（HIF-1<italic>α</italic>）， and interleukin-2（IL-2）， affecting the synthesis and transport of regulatory factors in cytoplasm， and controlling the cell proliferation and apoptosis.