Safety and efficacy of dexmedetomidine hydrochloride combined with midazolam in fiberoptic bronchoscopy in children: a prospective randomized controlled study / 中国当代儿科杂志

OBJECTIVES@#To study the safety and efficacy of dexmedetomidine hydrochloride combined with midazolam in fiberoptic bronchoscopy in children.@*METHODS@#A total of 118 children who planned to undergo fiberoptic bronchoscopy from September 2018 to February 2021 were enrolled. They were divided into a control group (@*RESULTS@#Compared with the control group, the observation group had significantly decreased MAP at T@*CONCLUSIONS@#Dexmedetomidine hydrochloride combined with midazolam is a safe and effective way to administer general anesthesia for fiberoptic bronchoscopy in children, which can ensure stable vital signs during examination, reduce intraoperative adverse reactions and postoperative agitation, shorten examination time, and increase amnesic effect.

Expression profiles of PI3K, NF-κB, and STAT1 in peripheral blood mononuclear cells in children with bronchial asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the expression profiles of PI3K, NF-κB, and STAT1 in peripheral blood mononuclear cells (PBMCs) in children with bronchial asthma, as well as their roles in the pathogenesis of asthma.</p><p><b>METHODS</b>Thirty children with acute exacerbation of bronchial asthma were enrolled as the asthma group, and 20 healthy children were enrolled as the control group. RT-PCR and Western blot were used to measure the mRNA and protein expression levels of PI3K, NF-κB, and STAT1 in PBMCs. A spirometer was used to compare the pulmonary function between the two groups. The correlations between the mRNA expression of PI3K, NF-κB, and STAT1 and pulmonary function in children with bronchial asthma were analyzed.</p><p><b>RESULTS</b>The asthma group had significantly higher mRNA and protein expression levels of PI3K, NF-κB, and STAT1 than the control group (P<0.05). Compared with the control group, the asthma group showed significant reductions in pulmonary function indices such as FEV1%, FEV1/FVC, and PEF% (P<0.05). In children with bronchial asthma, the mRNA expression levels of PI3K, NF-κB, and STAT1 were negatively correlated with FEV1%, FEV1/FVC, and PEF% (P<0.05).</p><p><b>CONCLUSIONS</b>The expression levels of PI3K, NF-κB, and STAT1 increase in children with asthma, and are negatively correlated with pulmonary function indices, suggesting that PI3K, NF-κB and STAT1 are involved in the development and progression of bronchial asthma in children.</p>

Role of cerebral computed tomography in the evaluation of brain injury following hypoxia in neonates / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the role of cerebral computed tomography (CT) in the evaluation of the severity of brain injury following hypoxia in neonates.</p><p><b>METHODS</b>A total of 114 full-term newborns who had perinatal hypoxia, including 25 cases of hypoxic-ischemic encephalopathy (HIE), 36 cases of neonatal asphyxia and 53 cases of simple intrauterine fetal distress, were enrolled in this study. Twenty normal newborns served as the Control group. All had cerebral CT scan at 2-7 days of age. Neonatal behavior neurological assessment (NBNA) was performed at 5 days of age.</p><p><b>RESULTS</b>The average NBNA scores were significantly lower and the abnormality rate of NBNA was significantly higher in the HIE group than in the other three groups (P < 0.05). The Asphyxia and the Distress groups had also lower NBNA scores and higher abnormality rate of NBNA than the Control group (P < 0.05). Twenty-two patients were found to have cerebral CT abnormality in the HIE group, but there was only 1 case in the Control group (P < 0.01). The abnormality rate of cerebral CT in the Asphyxia and the Distress groups was not statistically different from that of the Control group. Twenty-five cases of HIE were divided into mild (n=15), medium (n=6) and severe (n=4) by clinical grading but were divided into normal (n=3), mild (n=10), medium (n=7) and severe (n=5) by CT grading. CT and clinical grading on HIE was not consistent. The sensitivity of CT in the diagnosis of mild, moderate and severe HIE was 47%, 33% and 50% respectively, the specificity was 70%, 74% and 86% respectively and the accuracy was 48%, 64% and 80% respectively.</p><p><b>CONCLUSIONS</b>CT evaluation on mild brain injury induced by asphyxia or intrauterine fetal distress is not of any value and the role of CT evaluation on the HIE grade is uncertain and doubtful.</p>