Efficacy and safety of Omalizumab for the treatment of pediatric allergic asthma: a retrospective multicenter real-world study in China / 中华实用儿科临床杂志

Objective:To assess the clinical effectiveness and safety of Omalizumab for treating pediatric allergic asthma in real world in China.Methods:The clinical data of children aged 6 to 11 years with allergic asthma who received Omalizumab treatment in 17 hospitals in China between July 6, 2018 and September 30, 2020 were retrospectively analyzed.Such information as the demographic characteristics, allergic history, family history, total immunoglobulin E (IgE) levels, specific IgE levels, skin prick test, exhaled nitric oxide (FeNO) levels, eosinophil (EOS) counts, and comorbidities at baseline were collected.Descriptive analysis of the Omalizumab treatment mode was made, and the difference in the first dose, injection frequency and course of treatment between the Omalizumab treatment mode and the mode recommended in the instruction was investigated.Global Evaluation of Treatment Effectiveness (GETE) analysis was made after Omalizumab treatment.The moderate-to-severe asthma exacerbation rate, inhaled corticosteroid (ICS) dose, lung functions were compared before and after Omalizumab treatment.Changes in the Childhood Asthma Control Test (C-ACT) and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) results from baseline to 4, 8, 12, 16, 24, and 52 weeks after Omalizumab treatment were studied.The commodity improvement was assessed.The adverse event (AE) and serious adverse event (SAE) were analyzed for the evaluation of Omalizumab treatment safety.The difference in the annual rate of moderate-to-severe asthma exacerbation and ICS reduction was investigated by using t test.The significance level was set to 0.05.Other parameters were all subject to descriptive analysis.A total of 200 allergic asthma patients were enrolled, including 75.5% ( n=151) males and 24.5% ( n=49) females.The patients aged (8.20±1.81) years. Results:The median total IgE level of the 200 patients was 513.5 (24.4-11 600.0) IU/mL.Their median treatment time with Omalizumab was 112 (1-666) days.Their first dose of Omalizumab was 300 (150-600) mg.Of the 200 cases, 114 cases (57.0%) followed the first Omalizumab dosage recommended in the instruction.After 4-6 months of Omalizumab treatment, 88.5% of the patients enrolled ( n=117) responded to Omalizumab.After 4 weeks of treatment with Omalizumab, asthma was well-controlled, with an increased C-ACT score [from (22.70±3.70) points to (18.90±3.74) points at baseline]. Four-six months after Omalizumab administration, the annual rate of moderate-to-severe asthma exacerbation had a reduction of (2.00±5.68) per patient year( t=4.702 5, P<0.001), the median ICS daily dose was lowered [0 (0-240) μg vs. 160 (50-4 000) μg at baseline] ( P<0.001), the PAQLQ score was improved [(154.90±8.57) points vs. (122.80±27.15) points at baseline], and the forced expiratory volume in one second % predicted (FEV 1%pred) was increased [(92.80±10.50)% vs. (89.70±18.17)% at baseline]. In patients with available evaluations for comorbidities, including allergic rhinitis, atopic dermatitis or eczema, urticaria, allergic conjunctivitis and sinusitis, 92.8%-100.0% showed improved symptoms.A total of 124 AE were reported in 58 (29.0%) of the 200 patients, and the annual incidence was 0(0-15.1) per patient year.In 53 patients who suffered AE, 44 patients (83.0%) and 9 patients (17.0%) reported mild and moderate AE, respectively.No severe AE were observed in patients.The annual incidence of SAE was 0(0-1.9) per patient year.Most common drug-related AE were abdominal pain (2 patients, 1.0%) and fever (2 patients, 1.0%). No patient withdrew Omalizumab due to AE. Conclusions:Omalizumab shows good effectiveness and safety for the treatment of asthma in children.It can reduce the moderate-to-severe asthma exacerbation rate, reduce the ICS dose, improve asthma control levels, and improve lung functions and quality of life of patients.

Analysis of the pedigree of a child with interstitial lung disease caused by a novel mutation of p. K114N in SFTPC gene / 中国小儿急救医学

Objective:To analyze the clinical and chest CT features in a family with interstitial lung disease(ILD), and assess the probable causative gene mutations for the family.Methods:In order to identify the etiology of the proband′s ILD, the pedigree was investigated.The clinical data of five proband′s pedigree members were collected, and the chest HRCT examination was performed on four proband′s pedigree members with respiratory symptoms.The human whole exon sequencing was performed on the proband′s blood samples, then its deleterious effects were assessed.Subsequently, the strong pathogenic mutation was validated by Sanger sequencing.Results:According to the family survey, there were five patients with ILD in the family, including three males and two females.One of them died.The surfactant protein C(SFTPC)gene(exon4, c.342G>T, p.K114N)was found in all four surviving patients.The mutation was considered to be originated from the father of the proband, and the pathogenic mutation was considered, which was not included in the databases and was a noval mutation.In addition, the clinical manifestations of different patients in the family were significantly different.Conclusion:The novel mutation of p. k114n in SFTPC gene can lead to ILD in children, and the mutation has incomplete exons in family members.Chest CT and whole exon sequencing play an important role in the diagnosis of ILD in children.

Influencing factors on chest CT characteristic changes in children with invasive pulmonary fungal infections / 中国小儿急救医学

Objective To analyze the characteristics of chest CT in children with invasive pulmonary fungal infections(IPFIs),and to explore the influencing factors on chest CT manifestations in children with IPFIs.Methods A retrospective case-control study was conducted to select 97 children with IPFIs from October 2010 to October 2016 in the department of respiratory medicine,PICU and hematology.The children were divided into CT characteristic change group(39 cases) and CT non-characteristic change group(58 cases) according to the chest CT manifestations. Non-conditional multivariate Logistic regression analysis was used to identify the independent influencing factors of CT characteristic changes in children with IPFIs. Results The ratios of less than 3-year-old infants, Candida, the proportion of ICU admission in the CT characteristic change group were lower than those in the CT non-characteristic change group(P<0.05). The proportions of more than 3-year-old, neutropenia,Aspergillus,central venous catheter,hematological malig-nancies were higher than those in the CT non-characteristic change group(P<0.05).Multivariate Logistic regression analysis showed that the hematological malignancies was an independent influencing factor for the characteristic changes of CT in children with IPFIs.Conclusion When children with blood system malignant tumors manifest as fever,cough and other symptoms of infection,chest CT manifestations show characteristic changes,Aspergillus infection should be considered,and empirical antifungal treatment should be focused.

Expression and Significance of Discoidin Domain Receptor 1 in Tumors of Digestive System / 胃肠病学

Discoidin domain receptor 1(DDR1)is a kind of receptor tyrosine kinases(RTKs),which is expressed abnormally in many tumors. It is involved in the development,invasion and metastasis process of tumors and may become a potential target of tumor therapy. This article reviewed the expression and significance of DDR1 in tumors of digestive system.

Application of fiberoptic bronchoscopy in neonates with weaning failure / 中国小儿急救医学

Objective To evaluate the safety and efficacy of fiberoptic bronchoscopy in the diagno-sis of 41 neonates with weaning failure.Methods A retrospective study on the results of fiberoptic broncho-scopy was performed in 41 neonates with weaning failure.Results A total of 41 neonates of throat abnor-malities were examined by fiberoptic bronchoscopy,including 38 cases with laryngomalacia,8 cases with seri-ous hyperemia and swelling of the vocal cords,2 cases with scar stenosis of subglottic,and one case in each of congenital laryngeal web,glottic insufficiency and congenital epiglottis cyst;trachea-bronchial abnormali-ties,including 31 cases with tracheomalacia,2 cases with tracheal stenosis,4 cases with partial bronchial ste-nosis,1 cases with bridging bronchus and 1 cases with tracheoesophageal fistula.Thirty-eight neonates under-went fiberoptic bronchoscopy to obtain bronchoalveolar lavage fluid and culture,bacterial culture positive in 15 cases(39.4%),of which 5 cases of Klebsiella pneumoniae,3 cases in each of Pseudomonas aeruginosa and Acinetobacter baumannii,2 cases of Staphylococcus aureus,1 case in each of Escherichia coli and Strep-tococcus mitis;fungal culture positive for 6 cases(15.7%),of which 3 cases of Aspergillus fumigatus,1 case in each of Candida glabrata,Candida albicans and Candida parapsilosis.The most common complications of fiberoptic bronchoscopy were hypoxia and heart rate transient decline(26 cases,63.4%),3 cases fever af-ter operation.Conclusion Fiberoptic bronchoscopy can not only find congenital tracheal deformity and tra-cheal mucosa lesions,but also complete the etiology from deep discharge.Fiberbronchoscopy is safe and relia-ble given adequate preparation and if it is performed by skilled personnel.

Diagnostic value of fiberobronchoscopy in endobronchial tuberculosis / 临床儿科杂志

Objective To assess the value of fiberobronchoscopy in the diagnosis of endobronchial tuberculosis. Methods A total of 67 children suspected of endobronchial tuberculosis in our ward from March 2010 to December 2012 had been tested by chest CT and ifberobronchoscopy, mycobacteria culture, liquid-based interlayer vessel technique and FQ-PCR from bronchoalveolar lavage fluid and biopsy. Results 50 patients were clinically diagnosed as endobronchial tuberculosis. The positive rate of FQ-PCR (60%) and liquid-based interlayer vessel technique (42%) are higher than that of mycobacteria culture (20%), which showed no signiifcant difference with biopsy. The positive rate of the combined detection (FQ-PCR and liquid-based interlayer vessel technique) is significantly higher than that of mycobacteria culture and biopsy. Conclusions Fiberobronchoscopy is effective for the diagnosis of endobronchial tuberculosis.

An experimental study of the impacts of magnetic fields on superoxide dismutase and malondialdehyde in rat pancreatic islet cells / 中华物理医学与康复杂志

Objective To explore the impacts of magnetic fields of different intensities on the superoxide dismutase (SOD) activity and malondialdchvde (MDA) levels in rat pancreatic islet cells under normal and hypoxic conditions.Methods Rat pancreatic islet cells were culured,and after 3 days were subjected to a magnetic field of either 44.8 mT,90.6 mT or 182.1 mT under either normal or hypoxic conditions.Control cells received no magnetic field exposure,SOD activity and MDA level were measured after 72 hr.Results The cultured cells grew linearly with optical density (OD) of 0.067 ± 0.021 after 2 days and 0.449 ± 0.113 afier 5 days.SOD activity was significantly lower in the three magnetic field intervention groups than in the control group.Under hypoxic culture conditions,in all the magnetic field intervention groups SOD activity increased at first and then deereased.Under normal culture conditions,MDA content was significantly higher in the 182.1 mT group than in the control group.In the other two groups it was significantly lower.Conclusion Magnetic field exposure can cause oxidative damage to pancreatic islet cells,at least rat cells in culture.Under hypoxic culture conditions a magnetic field can inhibit such damage.

Testing and analysis of the magnetic sources of permanent magnet wafers for magnetotherapy / 中华物理医学与康复杂志

Objective To explore the magnetic properties of permanent magnet wafers commonly used in magnetotherapy to provide a basis for the scientific and rational use of sources of magnetism.Methods A magnetometer was used to measure the magnetic induction intensities of the N and S polar centers of eight groups of magnet wafers (axial magnetization) with nominal magnetic induction intensities of 6 mT, 10 mT, 20 mT, 30 mT, 60 mT,100 mT, 200 mT and 350 mT.Results There were some differences between the nominal values and the measured mean magnetic induction intensities. In a few groups the differences were close to 20％. There were also differences within the same group. The magnetic induction intensities of the two polar surfaces were not always equal for the same magnet, and there were large differences among individual magnets.Conclusions The intensities of magnetic sources must be measured before use to ensure the consistency of magnetic induction intensities in therapeutic applications.

Present research on magnetostatic biological effects / 国际中医中药杂志

With the rise of magnetic therapy, biological effects of magnetic field have gotten more and more attention in recent years. Based on literatures both at home and abroad, this article summarized research status of biological effects of static magnetic field on whole level, tissue-organ level, cellular level and molecular level of living organisms. We found that conclusions and results of researches varied with different purposes and experiment methods, demonstrating that researches on dose-response relationship and safety of static magnetic field were necessary.