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OBJECTIVE One of the aims of this study is to know the morbidity of LPR in children with chronic cough. And also to explore the relationship among the morbidity of LPR,the pH value in the laryngopharynx, the frequency of ref lux events,the duration of ref lux with age, sex, position, allergy and so on. METHODS A retrospective analysis was conducted on 185 children with pH monitoring in Shanghai Children's Hospital from February 1, 2015 to August 31, 2018. The pH monitoring was taken in those patients for the reasons of chronic cough, and can't be remitted by regular treatment. The sex, diagnosis, allergy and the results of 24h pH monitoring were recorded. RESULTS A total of 185 cases were reviewed. 60％(111/185) were boys and 40％(74/185) were girls. LPR was present in 36.8％ of all the children(68/185). Compared with older patients, children younger than 12m had significant higher morbidity of LPR. Higher morbidity of LPR was also found in patients with food allergy. CONCLUSION LPR has high morbidity in children. In our study, 36.8％ of the chronic cough children combined with LPR. Children younger than 12m had higher morbidity of LPR. There may be a correlation between LPR and food allergy in children.
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Objective To determine the vitamin D status in children with sepsis/severe sepsis in pediatric intensive care unit (PICU) in order to explor the association between vitamin D status and clinical outcomes,in turn to provide evidence for optimizing nutrition support.Methods It was a prospective,observational,multi-center study,carried out in patients with sepsis/severe sepsis from March 1,2013,to March 30,2014,in the PICUs of three tertiary-care children's hospitals.Total serum 25-hydroxy vitamin D [25 (OH) D] was measured by using an enzyme-linked immunosorbent assay at admission.The association of vitamin D status at admission with length of PICU length of stay,total hospital stay,in-hospital mortality,28-days mortality and costs were analyzed.Results A total of 194 patients includng 117 boys (60.3％)and 77 girls (39.7％) were enrolled.There were 96 patients with sepsis and 98 with severe sepsis.The mortality on discharge and 28 days were 6.7％ and 24.2％ respectively.The median vitamin D level was 9.79 ng/mL (5.32,18.46) at admission.Of them 77.8％ (151/194) had vitamin D deficiency and 50.5％ (98/194) had severe vitamin D deficiency.Patients with severe vitamin D deficiency,had higher mortality on discharge (P =0.011).Vitamin D status had no significant correlations with 28 days mortality,length of PICU stay,total hospital stay and costs.Conclusions More than three-quarters (77.8％) of children with sepsis/severe sepsis in PICUs had Vitamin D deficiency.Patients with severe vitamin D deficiency at admission had higher risk of mortality at discharge.
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Sepsis is a common condition in the intensive care unit and is associated with high mortality.Vitamin D deficiency in septic patients is more common than in their healthy peers,indicating that it may be identified as a predictor of sepsis in the critically ill and that Vitamin D deficiency may also be associated with adverse prognosis in septic patients.The immunomodulatory role of Vitamin D,the interaction between Vitamin D and infectious diseases,the status of Vitamin D deficiency in sepsis cases and the relationship between Vitamin D levels and prognosis of septic patients are reviewed in this article.