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As a biomarker of airway inflammation, alveolar exhaled nitric oxide(CaNO), which represents small airway inflammation, is increasingly used in respiratory diseases.CaNO not only can be applied to children bronchial asthma severity evaluation, the selection of treatment and treatment effect of the dynamic monitoring, can also be applied to the early diagnosis of interstitial lung disease and assessment of the severity of lung damage for other diseases such as tuberculosis, pulmonary hypertension diagnosis.This paper reviews the diagnostic and therapeutic value of CaNO in pediatric respiratory diseases, and discusses the role of CaNO in the diagnosis and therapeutic evaluation in pediatric lung diseases.
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BACKGROUND:Current basic and clinical research have showed that increases in bone resorption and bone loss accur earlier after spinal cord injury (SCI) than disuse atrophy, revealing that other mechanisms are involved in the pathogenesis of the SCI-induced osteoporosis (SIO). OBJECTIVE:To introduce the current lab and clinical research progress in SIO focusing on the functional changes of two major neurotransmitters in the spinal cord, including dopamine (DA), 5-hydroxytryptamine (5-HT) and their receptors, as well as their regulatory functions on bone metabolism, aiming at finding a new treatment strategy for SIO. METHODS:A computer-based online search in PubMed and Embase databases was conducted for clinical and basic research related to SIO published from January 1967 to August 2016, using the keywords of“spinal cord injury;osteoporosis;dopamine;serotonin;5-hydroxytryptamine”in English. Irrelevant, poorly related and repetitive studies were excluded, and finally 41 eligible articles were included. RESULTS AND CONCLUSION:DA and 5-HT are major neurotransmitters in the central nervous system, both involving in the regulation of bone remodeling. After SCI, loss of innervation and descending neurotransmitters especially DA, 5-HT and subsequent deregulation of their receptors are responsible for the onset of post-traumatic bone loss. The above research progress, in combination with the emerging clinical and lab investigations targeting 5-HT, DA and their receptors for improving neural functions after SCI, provides possible therapeutic pathways for SIO.
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BACKGROUND:Articular injections of opioids are widely adopted for pain management of total knee arthroplasty, with both peri-articular and intra-articular administration routes. Recent studies have indicated that commonly used anesthetics, steroids and non-steroidal anti-inflammatory drugs are associated with potential adverse effects. Peripheral opioids are relatively safe with lower complication rates, but great controversy exits regarding the analgesic effects. OBJECTIVE:To introduce the current clinical application status and basic research progress in peri-articular and intra-articular opioid injections for postoperative analgesia of knee arthroplasties. METHODS:A computer-based search in PubMed and Embase databases was conducted for clinical and basic research articles related to pain management of knee arthroplasties using peri-articular and intra-articular injections of opioids published from January 1967 to May 2015, using the keywords of“opioids;peri-articular injection;intra-articular injection;analgesia;knee arthroplasty”in English. Irrelevant, poorly related and repetitive studies were excluded. RESULTS AND CONCLUSION:Peri-articular and intra-articular opioids injection plans vary greatly between different institutions, which does not support reliable quantitative data synthesis for a meta-analysis. Controversy exists regarding its efficacy, but there are studies supporting the usage of opioids for providing effective analgesia in a dose-dependent manner. The peri-articular administration route is associated with lower complication rates including nausea and vomiting compared to systematic injections. Applications of opioids help to avoid potential chondrocyte and stem cel cytotoxicity caused by other anesthetics, steroids and non-steroidal anti-inflammatory drugs, which is important for pain management of total knee arthroplasties. Future investigations are required to promote articular analgesic effects and time duration by exploring more advanced drug combinations and dosage forms.