The role of Huaiqihuang Granules in the long-term management of bronchial asthma in young children: a multicenter real-world study / 中华实用儿科临床杂志

Objective:To observe the role of Huaiqihuang Granules (HQ) in the long-term management of bronchial asthma in young children, and the effective effect on concomitant rhinitis.Methods:A prospective real-world multicenter study was conducted in children aged 2-5 years with asthma diagnosed in the outpatient department (from April 2016 to March 2019)who received either inhaled corticosteroid (ICS)/leukotriene receptor antagonist (LTRA)(control group); inhaled ICS/LTRA plus HQ(combination group), or HQ alone(HQ group). All patients were followed up at week 4, 8, 12 after treatment. The number of days with asthma symptoms, the frequency of severe asthma attacks, the level of asthma control, and the days with rhinitis symptoms in the last 4 weeks were recorded. Differences before and after treatment, and those among groups after treatment were compared using Kruskal- Wallis H test or Wilcoxon rank-sum test. Results:A total of 2 234 eligible patients were recruited, and 2 147 cases completed followed-up visits, including 477, 1 374 and 296 cases in the control group, combination group, and HQ group, respectively. After the treatment, all 3 groups showed significant declines in the days with asthma symptoms, frequency of severe asthma attack and the days with rhinitis symptoms (all P<0.01), and the rate of well-controlled asthma increased significantly ( P<0.01). It lasted until the end of follow-up. Among groups, patients in the combination group showed significantly less days of asthma symptoms than those of the other 2 group at week 8 and 12[0(0, 0.9) d vs.0(0, 0.3) d, P<0.05; 0(0, 0.1) d vs. 0(0, 1.0) d, P<0.01]. Patients in the combination group and HQ group showed a significantly lower rate of severe asthma attacks than that of the control group at week 12 [0(0, 1), 0(0, 1), 0(0, 2), all P<0.05]. The well-controlled rate of asthma in the combination group was significantly higher than that of the control group and HQ group at week 8 and 12 (89.6% vs. 85.9% vs.82.1%, H=15.28; 90.9% vs. 84.1% vs. 81.8%, χ2=29.32, all P<0.01). Conclusions:HQ can significantly alleviate symptoms of asthma and rhinitis, severe attack of asthma, and increase the control rate of asthma when used as an additional treatment or used alone.

Interpretation of the Japanese Guidelines for Food Allergy 2020 / 中华实用儿科临床杂志

The prevalence of food allergy among children has significantly increased, which seriously affects the quality of life of children and increases the burden of society and family.The understanding of food allergy in Chinese pediatric clinicians is lacked, and oral food challenge test and oral immunotherapy have not been widely carried out, which need to be further improved and standardized.In the present review, the author summarized the clinical classification, auxiliary examination, prevention and management of food allergy based on the current situation in China and the Japanese Guidelines for Food Allergy 2020, aiming to provide references for clinicians.

Long-term trajectories of lung function and risk factors in children with bronchial asthma / 中华实用儿科临床杂志

Objective:To establish the long-term trajectories of lung function in children with bronchial asthma (asthma) and explore the risk factors of persistent pulmonary dysfunction.Methods:A retrospective cohort study was conducted.Children with asthma aged above 14 years who had been followed up regularly and completed pulmonary function testing in Children′s Hospital of Capital Institute of Pediatrics were enrolled in the study from January to December 2019.Their lung function data and clinical information were collected.The latent class growth model (LCGM) was used to fit the change of lung function in children with asthma, and different trajectory groups were established.Comparison between groups was performed by t-test, ANOVA or Chi- square test.The risk factors for the lung function trajectory were analyzed by the multivariate Logistic regression method. Results:A total of 173 children with asthma, aged from 6 to 17, were enrolled, and 1 160 lung function tests were completed.Four forced expiratory volume in the first second/forced vital capacity (FEV 1/FVC) latent class trajectory groups were established, including persistent high level [27 cases (15.6%)], above average level [66 cases (38.1%)], below average level [66 cases (38.1%)], and persistent low level [14 cases (8.1%)]. In all the 4 different trajectory groups, the FEV 1/FVC values were significantly different among patients of different ages (all P<0.05). The FEV 1/FVC values of patients at all ages in the persistent high level group were above 90%.The FEV 1/FVC values of patients in other 3 level groups decreased as a whole as the age increased.FEV 1/FVC of patients in the persistent low level group decreased to below 80% when they entered the school age period and approached 70% in adolescence.The trajectory and fluctuation of maximal midexpiratory flow (MMEF), which represents the small airway function, were similar to those of FEV 1/FVC.Risk factor analysis showed that the risk of lung function decreasing below the average level in children with typical asthma was 11.940 times higher than that in children with cough variant asthma ( P=0.008). The risk of lung function deteriorating to below the average level in children with multiple allergen sensitivities was 7.462 times higher than that in children with single allergen sensitivity ( P=0.015). Children taking drugs irregularly were 6.337 times more likely to suffer persistent low lung function than children taking drugs regularly ( P=0.035). Boys were 6.186 times more likely to suffer a lung function reduction to below the average level than girls ( P=0.002). Conclusions:Four long-term trajectories of lung function in asthmatic children aged 6 to 17 years can be established: persistent high level, above average level, below average level and persistent low level.The long-term lung function of nearly a half of the asthmatic children is below the average level.Many children develop persistent airflow limitation in adolescence, and few at school age.Typical asthma, multiple allergen sensitivities, irregular medication and boy were the risk factors of long-term lung function reduction.

A follow-up study on the outcome of 2 to 5 years old children with asthma at school age / 国际儿科学杂志

Objective:To investigate the outcome of asthma in young children after 3 years and the factors associated with the outcome.Methods:A total of 494 children aged 2 to 5 years with asthma diagnosed in 5 hospitals in Beijing from 2016 to 2017 were followed up by telephone using questionnaire survey.Information on the asthma attack, the disease control level, and the comorbidities of allergic diseases in the past 3 years was collected and analyzed.Results:Questionnaires were conducted in 387 children, including 261 males(67.4%)and 126 females(32.6%). Two hundred and forty-six patients(63.6%)had no any asthma symptom(remission) within 3 years, while 141 patients(36.4%)were found with asthma symptom(without remission). The main symptoms were as follows: wheezing in 116 cases(82.3%), recurrent cough in 59 cases(41.8%), shortness of breath in 45 cases(31.9%), chest tightness or waking up at night due to wheezing in 22 cases(15.6%). The causes of asthma attack were respiratory tract infection in 80 cases(56.7%), allergen exposure in 46 cases(32.6%), climate change or cold air stimulation in 59 cases(41.8%), strenuous exercise in 36 cases(25.5%), and irritating odor in 3 cases(2.1%). One-way anova analysis showed that significant difference( P<0.05)was respectively observed in age at follow-up, postnatal tobacco smoke exposure history, repeated respiratory tract infection before asthma onset, personal allergy history, snoring, allergic rhinitis, allergic rhinitis within 1 year, allergic conjunctivitis within 1 year between the remission group and without remission group.Multivariate unconditional logistic regression analysis showed that tobacco exposure after birth, allergic rhinitis and allergic conjunctivitis within 1 year were independent risk factors for the continuation of asthma symptoms to school age( P<0.05). Conclusion:Till the school age, more than 1/3 children still had asthma symptom and the risk factors for the unalleviated symptom were postnatal tobacco exposure, allergic rhinitis within 1 year and allergic conjunctivitis within 1 year.

Clinical characteristics of 21 children with wheat allergy / 中华实用儿科临床杂志

Objective:To analyze and summarize the clinical features of wheat allergy in children, and to increase the awareness and diagnosis of food allergy in children.Methods:Children suspected with wheat allergy in the Department of Allergy, Children′s Hospital of Capital Institute of Pediatrics from December 2018 to November 2019 were included.Clinical data were collected, including the demographic profile, serum allergen specific immunoglobulin E(IgE) detection, peripheral eosinophil detection, and skin prick testing.Results:A total of 21 cases were included, consisting of 15 males and 6 females, aged (21.5±12.8) months.The children developed allergic symptoms after intake of wheat products or contact with wheat flour.The most common clinical manifestations were cutaneous (20/21 cases, 95.2%), followed by respiratory (7/21 cases, 33.3%), digestive (6/21 cases, 28.6%) and nervous (1/21 cases, 4.8%) symptoms.Eleven children had anaphylaxis.Laboratory allergy test showed that the detection level of serum wheat-specific IgE in 21 children was 1.46 to 100.00 kU/L, and when the specific IgE level was in grade Ⅴ or above, the risk of serious allergic reaction was increased in children ( P<0.05). Five of them tested positive in the wheat skin prick test.The peripheral eosinophil ratio in children was 0.04-0.12.All children had a history of other food allergies and family allergies. Conclusions:Wheat allergy in children has early onset and diversified clinical manifestations, mainly skin symptoms.Serum specific IgE detection shows an important role in the diagnosis and evaluation of wheat allergy.The highly sensitized individuals are prone to anaphylaxis.

Evaluation of safety and consistency of inhaled allergen extracts in the diagnosis of allergic diseases in children / 中华实用儿科临床杂志

Objective:To investigate the safety and consistency of domestic inhaled allergen extracts in the diagnosis of allergic diseases in children.Methods:Nine thousand five hundred and sixty-three children diagnosed with allergic diseases from September 2018 to June 2020 in Children′s Hospital Affiliated to Capital Institute of Pedia-trics were selected in this study, and all of them were subjected to skin prick test(SPT), and 415 of them were subjected to serum specific IgE (sIgE) test at the same time.The adverse events during SPT were recorded and the consistency of the results between SPT and sIgE test was analyzed.Results:There were 14 cases with adverse events in 9 563 patients, and the overall incidence was 0.15%.The incidence of adverse events was 0.07% (2/2 581 cases) in the 1-5 years old group, 0.19% (12/6 197 cases) in the 6-11 years old and 0 in the 12-17 years old group.The severity of all these events was grade Ⅰ.Out of the 14 cases with adverse events, only 1 case was considered to be related to allergen preparations, with the incidence being 0.01% (1/9 563 cases). The Kappa index showed that the results of dermatophagoides pteronyssinus, dermatophagoides farinae, alternaria and artemisia measured by SPT and sIgE were almost the same.There was high consistency between tree pollens and ragweed ( P<0.01), and moderate consistency between aspergillus fumigatus ( P<0.01). When the results of sIgE were used as the diagnostic criteria, the Youden index for the results of SPT ranged from 0.76 to 0.89, with aspergillus fumigatus (0.76) and tree pollens mixture (0.79) as the lowest.The positive likelihood ratio for most of the inhaled allergens was more than 10 except for tree pollens mixture (7.12) and dermatophagoides farinae (9.10). The negative likelihood ratio for most of the inhaled allergens was less than or equal to 0.1 except for aspergillus fumigatus (0.19). Conclusions:The domestic inhaled allergen extracts had high safety in the clinical application of SPT, and their results of SPT had good consistency with those of serum sIgE, which was conducive to the diagnosis and evaluation of allergic diseases in children.

Risk factors for developing into bronchial asthma in children with allergic rhinitis / 国际儿科学杂志

In recent years, the prevalence of allergic rhinitis in children had increased significantly.After a period of time, some children developed into bronchial asthma on the basis of allergic rhinitis, while others did not.To clarify the risk factors of bronchial asthma in children with allergic rhinitis and take early intervention measures are of great significance to the prevention and treatment of bronchial asthma.This article reviews the roles on asthma development of genetics, allergen exposure, types of rhinitis, passive smoking, respiratory infections, early use of antibiotics, and intervention treatment.

The cutoff value of FEV1/FVC as the criteria of airway obstruction in children / 中华儿科杂志

Objective@#To explore the cutoff value of FEV1/FVC for evaluating obstructive ventilation dysfunction in children.@*Methods@#Three hundred and eighty-three healthy children (190 boys and 193 girls) aged 6-14 years in primary and middle school in Beijing, who were enrolled from May 2010 to June 2011, had their spirometry done with the Jaeger lung function instrument, and the lower limit of normal (LLN) of FEV1/FVC was calculated. Two hundred and thirteen asthmatic children (151 boys and 62 girls) aged 6-14 years from the outpatient Department of Allergy, Capital Institute of Pediatrics were enrolled consecutively from June to July 2018, whose clinical history and pulmonary function parameters were collected. The expected value of spirometric parameters of asthmatic children was calculated according to Zapletal prediction equations. And the LLN of FEV1/FVC in healthy children was used as the gold standard to calculate the sensitivity, specificity, Youden index and Kappa value of FEV1/FVC<80% and FEV1/FVC< 92% predicted.@*Results@#In healthy children, the FEV1/FVC and the LLN were 91%±5% and 82% respectively, while 90%±6% and 81% in boys, and 92%±5% and 84% in girls. There were 27 (12.7%) asthmatic children whose FEV1/FVC<80% but FEV1/FVC≥92% predicted (χ2=123.7, P<0.01). The sensitivity, specificity, Youden index and Kappa value of FEV1/FVC<80% were 80.3%, 100%, 0.803 and 0.787 respectively when FEV1/FVC<80% was used as the criteria to assess lung function, while they were 57.3%, 100%, 0.573 and 0.547, respectively, when FEV1/FVC<92% predicted was used as criteria.@*Conclusions@#The 80% of FEV1/FVC has a better consistency with the LLN of FEV1/FVC than 92% of FEV1/FVC% predicted. It is more accarate to use FEV1/FVC<80% as the diagnostic criteria for airway obstruction.

Study on the level of fractional exhaled nitric oxide in healthy preschool children in Beijing / 中华实用儿科临床杂志

Objective:To explore the level of fractional exhaled nitric oxide (FeNO) in preschool children in Beijing and analyze the influencing factors.Methods:Preschool students aged 3-5 in Beijing were selected from May to July 2017.Healthy children were screened through questionnaire survey and on-site physical examination, and their FeNO levels were detected.Results:A total of 317 healthy children were enrolled, including 161 males and 156 females.There was no significant difference in FeNO levels between different genders ( P>0.05). The geometric mean value of FeNO was 8.2 ppb in male(95% CI: 7.0-9.3 ppb)and 8.7 ppb in female (95% CI: 7.4-10.1 ppb). There were statistical differences in FeNO levels among the 3 age groups ( F=4.63, P<0.05). The geometric mean value of FeNO was 7.2 ppb in 3-year-old children (95% CI: 5.5-8.9 ppb), 8.8 ppb in 4-year-old children (95% CI: 7.4-10.2 ppb), and 9.2 ppb in 5-year-old children (95% CI: 7.7-10.7 ppb). The geometric mean value of FeNO of healthy preschool children was 8.5 ppb (95% CI: 7.6-9.3 ppb). There was a positive correlation between FeNO and height ( r=0.135, P<0.05), but there was no significant correlation between FeNO and weight. Conclusions:The geometric mean value of FeNO in healthy preschool children in Beijing is 8.5 ppb (95% CI: 7.6-9.3 ppb)and the 95% reference value is 23.5 ppb.The level of FeNO changes slightly with the increase of age, and height also affects the FeNO.It is highly feasible to use on-line tidal breathing method to measure FeNO of preschool children.

Issues in clinical application of forced expiratory lung function in pediatrics / 中华实用儿科临床杂志

Forced expiratory lung function testing plays an important role in the diagnosis and management of respiratory diseases in children patients, but its quality control and report interpretation via spirometry in the field of pediatrics still need improvement.In this paper, the issues existing in technical testing and report interpretation of forced expiratory lung function by spirometry are discussed.

Progress in drug treatment for children with bronchial asthma / 国际儿科学杂志

Pharmacotherapy is the main part of management of bronchial asthma in children.However, due to the heterogeneity of bronchial asthma, some patients are poorly controlled despite regular medication.Thus new drug and technologies need to be explored.With deep understanding of the pathogenesis of bronchial asthma, a lot of new drugs were available to asthmatic patients, especially the targeted drugs dominated by monoclonal antibodies, which have become the hot spot of bronchial asthma treatment.

Long-term prognosis and impact factors of recurrent wheezing in young children / 中华实用儿科临床杂志

Wheezing is one of the common clinical symptoms in young children, recurrent wheezing in early childhood may develop into typical asthma, and lead to decreased lung function.There are many causes of wheezing in young children, many causes of repeated attacks, and the prognosis is different.There are few studies on the prognosis of recurrent wheezing attack in young children in China.Therefore, the prognosis and influencing factors of repeated whee-zing in young children were summarized, so as to provide references for clinicians to evaluate and treat the conditions of wheezing in young children.

Long﹣term prognosis and impact factors of recurrent wheezing in young children / 中华实用儿科临床杂志

Wheezing is one of the common clinical symptoms in young children,recurrent wheezing in early childhood may develop into typical asthma,and lead to decreased lung function. There are many causes of wheezing in young children,many causes of repeated attacks,and the prognosis is different. There are few studies on the prognosis of recurrent wheezing attack in young children in China. Therefore,the prognosis and influencing factors of repeated whee﹣zing in young children were summarized,so as to provide references for clinicians to evaluate and treat the conditions of wheezing in young children.

A field follow_up study of six years′outcome of children with asthma / 中华实用儿科临床杂志

Objective To investigate six yearsˊ outcome of children with asthma. Methods Children with asthma diagnosed in the epidemiological survey of childhood asthma in urban area of Beijing in 2010 were selected in this study. The field follow-up was conducted in 2016(6 years later)to obtain information about asthma attack,di-sease control,medication usage,and comorbidities of allergic diseases. The skin prick test,lung function and exhaled ni-tric oxide were performed during field follow - up stage. Results Sixty - four children,aged 7 - 19 years old [(13. 59 ± 3. 48)years old],completed the field follow-up survey. Among 35. 9%(23/64 cases)children,the asth-ma symptoms still persisted within 2 years(without remission),while 64. 1%(41/64 cases)children had no symp-toms within 2 years and above(remission). The course of children without remission(9. 0 years)was significantly lon-ger than that of children with remission(5. 5 years),and there was statistical significance(z＝ -3. 775,P<0. 001). Among the children without remission,the number of uncontrolled children in the last month accounted for 13. 0%(3/23 cases),partially controlled for 17. 4%(4/23 cases),and under controlled for 69. 6%(16/23 cases). The majority of unrelieved children were treated with intermittent control drug[43. 5%(10/23 cases)υs. 12. 2%(5/41 cases), χ2 ＝8. 036,P<0. 01]. A total of 47. 8%(11/23 cases)of children without remission were completely unaffected by physical activity,while 92. 7%(38/41 cases)of children with clinical remission were completely unaffected by physi-cal activity(χ2 ＝14. 117,P<0. 001). The proportion of children without remission with eczema and atopic dermatitis lasting longer than 6 years old was 56. 5%(13/23 cases),which was significantly higher than that of children with re-mission[29. 3%(12/41 cases),χ2 ＝4. 598,P<0. 05]. In 2010 and 2016,there were 46 children with allergen re-sults. Compared with 2010,the proportion of animal fur and pollen allergy increased in 2016[19. 6%(9/46 cases)υs. 52. 2%(24/46 cases),36. 9%(17/46 cases)υs. 67. 4%(31/46 cases)],and there were statistical significances (χ2 ＝10. 632,8. 538,all P<0. 01). In 2016,the number and degree of total allergens in the clinical unrelieved chil-dren were higher than that in the relieved children. Further analysis showed that the unrelieved children had higher cigarette allergy positivity(21. 7% υs. 2. 5%,χ2 ＝4. 239,P<0. 05). There was no significant difference in lung func-tion and exhaling nitric oxide between the clinical unrelieved children and the relieved children. Conclusions Six years later,the proportion of animal fur and pollen allergy increased in children with asthma. Compared with children with remission,the children without remission had more treatment with intermittent control drug,with higher proportion of eczema and atopic dermatitis over six years old,and higher percentage of cigarette allergy positivity.

Application of impulse oscillometry in the measurement for childhood bronchial hyperresponsiveness / 中华实用儿科临床杂志

Objective To explore the effectiveness of impulse oscillometry(IOS)in airway responsiveness measurement and to find out the positive threshold of IOS for asthma diagnosis. Methods Seventy-nine children aged 6-14 years who had suspicious asthma,were recruited into the study. The positive criteria of the methacholine bron-chial provocation test was a 20％ reduction in forced expiratory volume in the first second (FEV 1 )compared to base-line. Simultaneously measured changes in various parameters of IOS,including resonant frequency(Fres),impedance at 5 Hz(Zrs),resistances at 5 and 20 Hz(R5,R20),reactance at 5 Hz(X5),and area of reactance(AX). The results of the challenge test were divided into positive and negative groups according to the pulmonary ventilation function me-thod. The differences between the 2 groups of IOS parameters before and after the challenge test,and the correlation be-tween the change rate of FEV1 and the change rate of IOS parameters were compared,and the positive judgment criteria of IOS parameters in the determination of respiratory responsiveness were determined. Results The positive group of bronchial provocation test had 37 patients and negative group had 42 patients. There was no significant difference in the basic values of parameters between the positive group and the negative group (all P > 0. 05). Changes in Zrs,R5,X5 of IOS were correlated with changes in FEV1 (r = 0. 374,0. 310,0. 449,all P < 0. 05). By single factor analysis,the area under the receiver operating characteristic(ROC)carve (AUC)showed:basic value of Zrs increased by 45. 85％,R5 increased by 45. 72％,X5 increased by 80. 74％ respectively compared to the baseline showed the optimal combination of sensitivity and specificity. In multivariate Logistic regression models,when Zrs and R5 were combined to measure the airway responsiveness,the sensitivity and specificity were 73. 0％ and 81. 0％,respectively. Conclusions IOS and spirometry can be used to determine airway responsiveness in children during methacholine bronchial challenge. Zrs≥45. 85％,or R5≥45. 72％,or X5≥80. 74％,or Zrs and R5 of multiple regression formula can be used as the positive criteria for young children with airway heperresponsiveness,the combination of Zrs and R5 has higher sensitivity and specificity.

Comparison of food allergy prevalence of food allergy in children with or without bronchial asthma in cite of China / 中华实用儿科临床杂志

Objective To explore the prevalence and clinical characteristics of food allergy in bronchial asth-matic children less than 14 years old in China. Methods A case - controlled study was designed. The questionnaires were given to children,who were diagnosed to be asthmatic during the national epidemiological survey of asthma in chil-dren in 31 cities from September 2009 to August 2010. Non - asthmatic children,matched with the cases in age and gender,were selected during the same survey as control subjects if they were matched with the cases in age and sex. In-formation regarding the food allergen and symptom of food - induced anaphylaxis was analyzed. The difference in food allergy was compared between children with or without bronchial asthma. Results As a result,9235 asthmatic children and 11391 control subjects were enrolled in the case - control study. There were 14. 66％(1354 / 9235 cases)of the asthmatic children who had food allergy,compared to 3. 99％(455 / 11391 cases)of the non - asthmatics children, and the findings showed a significant difference (χ2 = 725. 25,P < 0. 001). The most common food allergens were fish and shrimp in both groups,and the difference was not significant [44. 09％ (597 / 1354 cases)vs. 42. 20％ (192 / 455 cases),χ2 = 0. 50,P > 0. 05]. The rate of peanut allergy was 4. 58％ (62 / 1354 cases)and 1. 54％ (7 / 455 cases) (χ2 = 8. 58,P < 0. 05),respectively. And the rates of fruit allergy in the asthmatic group and the non - asthmatic group were 14. 03％(190 / 1354 cases)and 27. 69％(126 / 455 cases)(χ2 = 44. 01,P < 0. 05),respectively. Cutaneous and nasal symptoms were common clinical manifestations. The rates of rash,pruritus,and swelling sympions were 47. 27％(640 / 1354 cases)and 61. 32％(279 / 455 cases)(χ2 = 26. 90,P < 0. 001),respectively for asthmatic group and non -asthmatic group. Rates of nasal symptoms were 17. 13％(232 / 1354 cases)and 10. 55％(48 / 455 cases)(χ2 = 11. 29, P = 0. 001),respectively in the asthmatic group and the non - asthmatic groups. Respiratory symptoms,such as cough and wheezing,were 25. 33％(343 / 1354 cases)and 5. 49％(25 / 455 cases)(χ2 = 80. 72,P < 0. 001)in 2 groups. Twenty cases of 1354 asthmatic children had severe food allergy,while such severe conditions occurred only 1 child without asthma (455 cases)occurred severe condition (1. 48％ vs. 0. 22％,χ2 = 4. 96,P < 0. 05). Conclusion The-rate of food allergen sensitization is highly prevalent in the children with asthma. Compared to those without asthma, and their types of food allergen and clinical symptoms are different from the latter.

Epidemiology of food allergy in children from 31 cities in China / 国际儿科学杂志

Objective To investigate the prevalence of food allergy among children living in metropoli-ses aged 0-14 years. Methods In this cross-sectional study a questionnaire was distributed to parents taking care of children aged 0-14 years from China′s 31 metropolises to get the parents reported prevalence. Results A total of 337560 children aged 0-14 years participated in the survey. There are 19676 children reported with food aller-gy(5. 83%). In different regions,the parents reported prevalence of food allergy had significant difference(χ2 =657. 01,P<0. 001). It was highest in the eastern (7. 38%,5259) and the northeastern (7. 03%,2916) part of China,and was lowest in the northwestern part of China,which was 4. 35%. Of all the 31 surveyed metropolises, the parents reported prevalence of food allergy was highest in Qingdao,and lowest in Lhasa,which was 9. 11%(917/10066),and 2. 33% (116/4984)respectively. The prevalence of food allergy in males and females was 5. 87% and 5. 79% respectively,with no significant difference (χ2 =1. 078,P=0. 299). The prevalence of food allergy in preschool children (3-5 years old,6. 65%) was higher than other ages (χ2 =46. 469,P<0. 001). Of children reported to have food allergy,38. 5% had a history of eczema,23. 0% had a history of allergic rhinitis, and 37. 7% had a family history of allergic diseases. Conclusion The parents reported prevalence of food aller-gy among children 0-14 years old from 31 metropolises in China was 5. 83%. In different regions cities and a-ges,there′s significant difference of the reported prevalence. There′s no significant difference of parents reported prevalence between males and females. The study would have great significance in reflecting and evaluating the prevalence of food allergy among children.

Epidemiology of food allergy in children from 31 cities in China / 国际儿科学杂志

Objective To investigate the prevalence of food allergy among children living in metropoli-ses aged 0-14 years. Methods In this cross-sectional study a questionnaire was distributed to parents taking care of children aged 0-14 years from China′s 31 metropolises to get the parents reported prevalence. Results A total of 337560 children aged 0-14 years participated in the survey. There are 19676 children reported with food aller-gy(5. 83%). In different regions,the parents reported prevalence of food allergy had significant difference(χ2 =657. 01,P<0. 001). It was highest in the eastern (7. 38%,5259) and the northeastern (7. 03%,2916) part of China,and was lowest in the northwestern part of China,which was 4. 35%. Of all the 31 surveyed metropolises, the parents reported prevalence of food allergy was highest in Qingdao,and lowest in Lhasa,which was 9. 11%(917/10066),and 2. 33% (116/4984)respectively. The prevalence of food allergy in males and females was 5. 87% and 5. 79% respectively,with no significant difference (χ2 =1. 078,P=0. 299). The prevalence of food allergy in preschool children (3-5 years old,6. 65%) was higher than other ages (χ2 =46. 469,P<0. 001). Of children reported to have food allergy,38. 5% had a history of eczema,23. 0% had a history of allergic rhinitis, and 37. 7% had a family history of allergic diseases. Conclusion The parents reported prevalence of food aller-gy among children 0-14 years old from 31 metropolises in China was 5. 83%. In different regions cities and a-ges,there′s significant difference of the reported prevalence. There′s no significant difference of parents reported prevalence between males and females. The study would have great significance in reflecting and evaluating the prevalence of food allergy among children.

The condition of small airway function and its related influence factors in controlled bronchial asthmatic children / 中华实用儿科临床杂志

Objective To investigate the condition and the related influence factors of small airway function in controlled bronchial asthmatic children.Methods Children diagnosed with bronchial asthma controlled,aged 5-14 years old without gender limitation were consecutively enrolled.Survey questionnaire including asthma symptoms in the past one month and medication usage were conducted.Physical condition and lung function were examined.Results A total of 255 patients were included in this study,and 224 patients had normal small airway function in which the level of forced expiratory flow at 50％ of forced vital capacity(FVC) exhaled (FEF50),forced expiratory flow at 75％ of FVC exhaled(FEF75),maximal mid-expiratory flow(MMEF) was 87.9％ (77.0％,97.2％),73.8％ (65.6％,93.5％),and 84.9％ (76.4％,97.5％) of the predicted value,respectively.Thirty-one patients had small airway dysfunction,accounting for 12.2％ (31/255 cases),and the level of FEF50,FEF75,MMEF were 62.8％ (59.9％,65.5％),51.9％ (46.6％,55.5％),and 62.7％ (57.2％,64.4％) of the predicted value,in which FEF75 had shown more decrease than others.In small airway dysfunction group,10 patients had conducted bronchodilation testing,and improvement rate of FEF50,FEF75 and MMEF were 41.1％,47.5％ and 41.3％,and all 10 cases (100.0％) returned to normal level.No significant difference was found in gender,body mass index,atopy,disease duration,drug usage between 2 groups (all P ＞ 0.05).Conclusion In 5-14 controlled asthmatic children,12.2％ have small airway dysfunction with a certain degree of reversibility.Gender,body mass index,atopy,disease duration,drug usage are not influencing factors.

Percentages of the measured value vs.the expected value of pulmonary function parameters in healthy children aged 5-14 years in Beijing / 中华实用儿科临床杂志

Objective To investigate the distribution of measured value and the expected value of spirometry parameters in healthy children aged 5-14 years old in Beijing,and to provide evidence for clinical interpretation precisely.Methods Four hundred healthy children (198 boys and 202 girls) aged 5 to 14 years from the kindergartens and the primary schools in Beijing were selected as subjects.All of the parameters were measured by using Jaeger Masterscreen spirometry machine(Germany).Pulmonary function parameters including forced vital capacity(FVC),forced expiatory volume in 1 second (FEV1),FEV1/FVC,peak expiratory flow(PEF),forced expiratory flow at 50% of vital capacity(FEF50),forced expiratory flow at 75% of vital capacity(FEF75),and the maximal midexpiratory flow(MMEF) were collected for analysis.The expected values of the 7 parameters above were calculated according to Zapletal prediction equations(4-18 years old).The measured value vs.the expected value was calculated.Results Children aged 5 to 12 years had similar height and weight between boys and girls,and the differences were not significant(all P>0.05);while boys were taller and heavier than girls in 13-<14 years old group and 14 years old group,and the diffe-rences were significant(t=3.35,2.05,5.99,2.67;all P<0.05).The mean measured value vs.the expected value of PEF,FVC,FEV1,FEV1/FVC of children in different gender and age groups ranged between 105.0%-114.7%,95.4%-106.8%,104.6%-115.4% and 105.8%-112.6%,respectively.The mean measured value vs.the expected value of small airway function parameters FEF50,FEF75,MMEF was as follows respectively:79.7%-103.7%,70.2%-110.5%,and 81.6%-114.7%.The low limit of normal(LLN) measured value vs.the expected value of the 7 pulmonary function parameters was as follows:PEF 85.0%,FVC 84.7%,FEV1 92.4%,FEV1/FVC 98.4%,FEF50 67.7%,FEF75 60.1%,and MMEF 71.0%.Conclusions The pulmonary function parameters of the healthy children in Beijing are higher than those of the Zapletal prediction.The measured value vs.the expected value of FEV1 92.4%,FEV1/FVC 98.4%,PEF 85.0%,FVC 84.7%,FEF50 67.7%,FEF75 60.1%,and MMEF 71.0% can be used as LLN in 5-14 years old children.