Clinic significance of fractional exhaled nitric oxide in childhood bronchial asthma / 中国医师进修杂志

Objective To investigate the clinical significance of fraction exhaled nitric oxide (FeNO) in the diagnosis and monitoring of childhood bronchial asthma (asthma). Methods The FeNO levels of 204 children with acute asthma attack, 148 children with asthma clinical remission, 107 children with cough variant asthma (CVA) and 250 children with pneumonia from March 2016 to March 2017 were retrospectively analyzed and compared. Results The FeNO levels of acute asthma attack, asthma clinical remission, CVA and pneumonia were 18 (10, 37), 16 (10, 38), 18 (9, 31) and 13 (8, 20) nmol/L, and there was statistical difference (P<0.05). The FeNO levels of acute asthma attack, asthma clinical remission and CVA were significantly higher those of pneumonia, and there were statistical differences (P<0.05). There was no statistical difference in the FeNO levels among acute asthma attack, asthma clinical remission and CVA (P>0.05). Conclusions FeNO has clinical significance in the diagnosis of asthma in children, and its clinical significance in monitoring asthma and the prediction of acute attack needs further observations.

Analysis of ultrasonographic features of pulmonary ultrasound in children′s community acquired pneu-monia / 中国小儿急救医学

Objective To investigate the lung ultrasonography characteristics of community acquired pneumonia ( CAP) in children and to compare the value of lung ultrasonography in the diagnosis of CAP in children. Methods A total of 173 patients with CAP ( CAP group) were diagnosed by chest radiograph in our hospital,and 64 healthy children were treated with lung ultrasonography as the control group. The sono-graphic features of two groups were compared,and the positive rates of diagnosis of lung ultrasonography and chest radiograph in CAP group were also compared. Results It showed A-line disappearance ( 100%) , B-line presence ( 88. 4%) , pleural line abnormalities ( 98. 3%) , pulmonary consolidation ( 46. 2%) , bronchial sign(42. 8%),pleural effusion(9. 2%),lung sliding signs(97. 7%) in CAP group (P<0. 001). In the con-trol group,except the A-line disappearance,scattered in the B-line (34. 4%),the others were not present. The difference of the two groups was statistically significant (P<0. 001). A-line disappearance,B-line (or even fusion) ,pleural line abnormalities were the main signs of ultrasound in children with CAP, sensitivity and specificity were both 100%. The sensitivity of chest X radiograph was 100% and the specificity was 78. 0%. Conclusion The lung ultrasonic imaging features of CAP in children include A-line disappearance, with varying numbers and lengths of B-line, pleural line abnormalities, consolidation, bronchial signs, pleural effusion and so on. LUS can diagnose CAP accurately and reliably,with high sensitivity and specificity. It is simple and noninvasive, and has the advantage of being detected at any time and avoiding the damage of X-ray. So it is worth clinical application for children with respiratory tract diseases.

Analysis of ultrasonographic features of pulmonary ultrasound in children′s community acquired pneu-monia / 中国小儿急救医学

Objective To investigate the lung ultrasonography characteristics of community acquired pneumonia ( CAP) in children and to compare the value of lung ultrasonography in the diagnosis of CAP in children. Methods A total of 173 patients with CAP ( CAP group) were diagnosed by chest radiograph in our hospital,and 64 healthy children were treated with lung ultrasonography as the control group. The sono-graphic features of two groups were compared,and the positive rates of diagnosis of lung ultrasonography and chest radiograph in CAP group were also compared. Results It showed A-line disappearance ( 100%) , B-line presence ( 88. 4%) , pleural line abnormalities ( 98. 3%) , pulmonary consolidation ( 46. 2%) , bronchial sign(42. 8%),pleural effusion(9. 2%),lung sliding signs(97. 7%) in CAP group (P<0. 001). In the con-trol group,except the A-line disappearance,scattered in the B-line (34. 4%),the others were not present. The difference of the two groups was statistically significant (P<0. 001). A-line disappearance,B-line (or even fusion) ,pleural line abnormalities were the main signs of ultrasound in children with CAP, sensitivity and specificity were both 100%. The sensitivity of chest X radiograph was 100% and the specificity was 78. 0%. Conclusion The lung ultrasonic imaging features of CAP in children include A-line disappearance, with varying numbers and lengths of B-line, pleural line abnormalities, consolidation, bronchial signs, pleural effusion and so on. LUS can diagnose CAP accurately and reliably,with high sensitivity and specificity. It is simple and noninvasive, and has the advantage of being detected at any time and avoiding the damage of X-ray. So it is worth clinical application for children with respiratory tract diseases.

Study on the relationship between fractional exhaled nitric oxide level and asthma predictive index in recurrent wheezing infants under 3 years of age / 中国医师进修杂志

Objective To investigate the relationship between fractional exhaled nitric oxide (FENO) and asthma predictive index (API) in infants under 3 years of age. Methods Totally 62 cases (under 3 years of age) who were hospitalized from June 2015 to June 2016 and had more than 3 times wheezing over the past year were enrolled in this study. They were divided into two groups according to API:API positive group with 37 cases and API negative group with 25 cases. FENO levels and peripheral blood eosinophil levels were detected and skin prick allergy test (inhalation and ingestion of allergens)was done in all selected children, did skin prick allergy test (inhalation and ingestion of allergens), simultaneous detected peripheral blood eosinophil levels. The parents of the children were investigated by questionnaire to know the children′ history about atopic dermatitis (such as urticaria, eczema, etc) and parents′ wheezing history. Above information was recorded and statistics analysis was made. Results There were no significant differences between two groups in atopic dermatitis inhalation and ingestion of allergens (P<0.01 or <0.05). The level of FENO in API positive group and API negative group was (16.70 ± 11.07), (13.52 ± 11.01) ppb(1 ppb=1 × 10- 9 mol/L), and there was significant difference (P<0.01). Conclusions There are associations between FENO and API, and they have good reference value in predicting the risk of asthma.

Analysis of electronic bronchoscopy results of 400 children with respiratory disease / 中国医师进修杂志

Objective To investigate the value of electronic bronchoscopy in the diagnosis of children respiratory diseases. Methods The electronic bronchoscopy results in 400 children with respiratory disease were retrospectively analyzed. Results In 400 children, there were 246 cases with simple endobronchial inflammation, 67 cases with bronchial malacia, 38 cases with bronchial stenosis, 23 cases with bronchial foreign , 4 cases with tracheal bronchus, 4 cases with epiglottic cyst, 3 cases with bronchiectasis, 3 cases with endobronchial granulation, 3 cases with laryngomalacia, 2 cases with vascular ring compression of the trachea, 2 cases with laryngeal web, 1 case with subglottic cyst, 1 case with subglottic neoplasm, 1 case with tracheoesophageal fistula, 1 case with bronchial atresia (left) and 1 case with trachea cyst. All the children had no serious complications. Conclusions Electronic bronchoscopy can effectively improve the level of diagnosis and treatment of children' s respiratory system disease, and it is worth of clinical promotion.

Clinical application of impulse oscillation system determining bronchodilator reversibility test in the children of different ages / 中国医师进修杂志

Objective To explotr clinical application of impulse oscillation system(IOS)determining bronchodilator reversibility test and the impact of age factor on positive values of bronchoddilator reversibility test in children.Methods Two hundred and fifteen patients during asthma attack were recruited randomly for this study.They were divided into three groups according to their age(4-7 year-old group,8-11 year-old group and 12-16 year-old group).Mensurated MEFV and IOS lung function.Carried on the bronchial dilation test with the results.Forced expiratory volume in first second(FEV1),the sensitivity and specificity of IOS parameters,total respiratory impedance(Zrs),respiratory resistance at 5 Hz(R5)and 20 Hz(R20),reactance at 5 Hz(X5)and resonant frequency(Fres)for diagnosing asthma at different improvement levels after inhalation of bronchedilator were calculated respectively through using FEV1 as a "sold standard"in the different age groups.Results After inhalation of bronchodilator,Fres,Zrs,R5,X5 and R20 of IOS were improved significantly.The improvement of X5 was the most obvious,however the decline of R20 was the lowest.The improving rate of Fres,Zrs,R5 had very significant difference in the three age groups(P＜0.01).It displayed that the age factor was very important impact factor on the improving rate of Fres,Zrs,R5,however the improving rate of X5 was on difference in the three age groups(P＞0.05).In the three age groups,there were significantly positive correlations between X5,R5,Zrs and FEV1(P＜0.01).there wash't correlations between R20 and FEV1 in the 4-7 year-old group and the 12-16 year-old group(P＞0.05).Furthermore,when an increase of FEV1 equaling to or greater than 15% was used as reference for positive bronchial reversibility,the improve rate of Fres,Zrs,R5,and X5 equaled to or greater than 13%,23%,17%,31%,respectively in 4-7 year-old group,18%,26%,25%,32%,respectively in 8-11 year-old group,25%,28%,28%,36%,respectively in 12-16 year-old group. Conclusions IOS can be used to assess bronchodilator reversibility test in children,and age factors should be paid attention.

Diagnosis of tracheobronchomalacia in childen with electron-bronchoscopy / 中华全科医师杂志

Twenty five children with recurrent wheezing,intractable cough and recurrent respiratory infection were examined and treated by electron-bronchoscopy.Among them 9 cases were diagnosed as tracheobronchomalacia.simple endobronchial inflammation was found in 7 cases,foreign body in bronchus were found in 6 cases,bronchostenosis in 2 cases and pulmonary hemorrhage in 1 case.Tracheobronehomalacia is one of the leading causes of recurrent wheezing and intractable cough in children.Electron-bronchoscopie examination is important in diagnosis of tracheobronchomalacia in children.