Viewpoint on chest tightness variant asthma in children / 中华实用儿科临床杂志

Chest tightness variant asthma(CTVA) is a newly recognized and special type of bronchial asthma, with the only main clinical manifestation of chest tightness or sighing respiration, but without wheezing and other typical symptoms of bronchial asthma.At the same time, the patients with CTVA are likely to be misdiagnosed in clinic practices.There are few studies on CTVA in children.This article focuses on hot issues about the clinical features, pathoge-nesis, diagnosis and treatment of CTVA, which hopes to enhance the diagnosis and treatment level of CTVA in children.

Clinical features of protracted bacterial bronchitis in children / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the clinical characteristics of protracted bacterial bronchitis (PBB) in children.</p><p><b>METHOD</b>The clinical data of patients seen from October, 2010 to March, 2014 in Department of Respiratory Diseases of our hospital were retrospectively analyzed. Inclusion criteria were over 4 weeks cough, receiving fiberoptic bronchoscopy, positive bacterial culture and (or) the increased percentage of neutral granulocytes in bronchoalveolar lavage fluid (BALF).</p><p><b>RESULT</b>Twenty eight patients were involved, 26 were male (93%) and two were female (7%). The median age of patients was 8.5 months. The median duration of cough was four weeks. The average length of hospital stay was (8.3 ± 3.9)days. The main clinical feature was wet cough in 28 cases, wet cough with wheezing was seen in 21 cases. The wet cough phase distribution was irregular in 21 cases. The crackles with wheeze (in 21 cases) was main signs of PBB. The percentage of CD3⁻ CD16⁺ 56⁺ cells increased in peripheral blood. The fiberoptic bronchoscopic manifestations of PBB were luminal mucosal edema. Eleven patients also had airway malacia. The neutrophil median in BALF was 0.2. The positive rate of bacterial culture of BALF was 36%. The main bacteria were Streptococcus pneumoniae (50%) and Haemophilus influenzae (30%). The main treatment for PBB patients included amoxycillin/clavulanate potassium and second-generation cephalosporins. The average duration of treatment was (17.3 ± 3.2)days, the prognosis was good.</p><p><b>CONCLUSION</b>PBB is common in male infants. Persistent wet cough with wheezing was the main characteristic of PBB. PBB is commonly accompanied by immune dysfunction and airway malacia, and the pathogens were Streptococcus pneumoniae and Haemophilus influenzae.</p>