RESUMO
Objective:To investigate the normal range of exhaled nitric oxide (FeNO) in 6-18-year-old children in China, so as to provide a data base for the establishment of FeNO standards for Chinese children.Methods:A multi-center study was conducted on 5 949 children aged 6-18 (3 101 males and 2 848 females) in 16 pro-vinces of 7 administrative districts in China.According to the technical standard recommended by American Thoracic Society/European Respiratory Association, FeNO was measured, and the relationship of FeNO with the sex, age, height, weight, body mass index and region was discussed.Results:The geometric mean FeNO value of Chinese children aged 6-18 was 14.1 ppb, and its 95% confidence interval (skewness distribution) was 1.0-38.2 ppb.The geometric mean FeNO values of children aged 6-11 and 12-18 were 13.1 ppb and 15.7 ppb, respectively, and their 95% confidence intervals (skewness distribution) were 1.0-38.1 ppb and 2.0-38.2 ppb.For children at and under 11 years old, FeNO decreased with age, with a mean decline of 1 ppb per year.The multiple linear regression results suggested that there was a significant correlation between FeNO and age for children aged 6-11, and FeNO of children aged 12-18 was significantly correlated with the gender, height, and region(all P<0.01). Conclusions:FeNO values of Chinese children and adolescents in this study are higher than those obtained by the previous study conducted from 2010 to 2012.For children aged 12-18, 16 ppb is recommended as the clinical cut-off point.For children at or under 11 years old, the influence of age on FeNO should be considered, and the cut-off point of FeNO decreases by 1 ppb as the age is reduced by one year.
RESUMO
Objective:To investigate the normal range of exhaled nitric oxide in healthy children aged 6-18 in Jinan.Methods:The healthy school children aged 6-18 in Jinan from October 11 to 26, 2017 were selected for questionnaire survey, physical examination and exhaled nitric oxide test.The levels of mouth exhaled nitric oxide at the flow rate of 50 mL/s (FeNO 50) and mouth exhaled nitric oxide at the flow rate of 200 mL/s(FeNO 200), alveolar nitric oxide (CaNO), and nasal exhaled nitric oxide at the flow rate of 10 mL/s(FnNO 10) were measured by the electroche-mical method.The distributions of FeNO 50, FeNO 200, CaNO and FnNO 10 were analyzed, and their correlations with gender, age, height and body mass index (BMI) were discussed by the multiple linear regression model. Results:A total of 772 healthy children were enrolled in this study, including 364 males and 408 females, with a median age of 12.1(11.8-12.3) years old, a median height of 154.8(153.6-156.0) cm, and a median BMI of 20.3 (20.0-20.6) kg/m 2. The measured values of FeNO 50, FeNO 200, CaNO and FnNO 10 fluctuated in the range of 3.0-168.0 ppb, 2.0-44.0 ppb, 0.5-44.2 ppb and 0-1 253.0 ppb, respectively.FeNO 50, FeNO 200 and CaNO values showed skewed a distribution, and their 95% upper limits were 35.0 ppb, 13.3 ppb and 8.5 ppb, respectively.The geometric mean(95% CI) of FeNO 50 in males (95% CI)[14.6 (13.7-15.5) ppb] was significantly higher than that in females [13.3(12.7-14.0) ppb], and the difference was statistically significant ( Z=1.470, P=0.027). The multiple linear regression results suggested that, FeNO 50 was positively correlated with age and height ( β=0.023, 0.007, respectively, all P<0.05), and negatively correlated with BMI ( β=-0.016, P<0.05). The geometric mean (95% CI) of FeNO 200in males[7.1 (6.8-7.4) ppb] was significantly higher than that in females[6.4 (6.1-6.6) ppb], and the difference was statistically significant( Z=1.747, P=0.004). The multiple linear regression results suggested that, FeNO 200 was positively correlated with height ( β=0.005) and negatively correlated with gender(female β=-1.126) (all P<0.05). There was no significant difference between male and female in CaNO, which had no correlation with gender, age, height and BMI (all P>0.05). FnNO 10 showed a normal distribution, with a mean value of 456.2 ppb, 95% CI of 29.3-863.4 ppb.The geometric mean (95% CI) of FnNO 10 in males [408.7 (377.1-443.0) ppb] was significantly higher than that in females [368.8 (339.0-401.3) ppb], and the difference was statistically significant ( Z=1.722, P=0.005). The multiple linear regression results indicated that FnNO 10 was related to gender ( β=-36.098, P<0.05), and not correlated with age, height and BMI (all P>0.05). Conclusions:The normal ranges of FeNO 50, FeNO 200, CaNO and FnNO 10 in healthy children aged 6-18 in Jinan are 3.0-35.0 ppb, 2.0-13.3 ppb, 0.5~8.5 ppb and 29.3-863.4 ppb, respectively.FeNO 50 is correlated with age, height and BMI.FeNO 200 is correlated with gender and height.CaNO and FnNO 10 are not correlated with age, height or BMI.
RESUMO
Objective To assess the level and trend of community acquired respiratory distress syndrome (CARDS) toxin after the infection of Mycoplasma pneumonia(MP),and evaluate the clinical characteristics,the level of immunoglobulin E (IgE) and interleukin-4 (IL-4) so as to find the association among these factors.Methods According to whether the child had wheezing symptoms,all the 63 children were divided into wheezing group (26 ca-ses) and non-wheezing group (3 cases).The levels of CARDS toxin were respectively detected in the acute stage of MP infection,3 and 6 months later after MP infection in different groups,moreover,IgE and IL-4 levels were monitored at the same time.Results (1) The mean level of IgE were (384.96 ± 316.62) × 103 IU/L and (87.32 ± 66.32) × 103 IU/L in wheezing group and non-wheezing group,respectively,and there was statistically significant difference (P ＜ 0.05).(2) The load of CARDS toxin in wheezing group and non-wheezing group were (1.87 ± 0.62) Delta Rn and (1.15 ± 0.48) Delta Rn in the stage of acute infection,respectively,and there was statistically significant difference (P ＜ 0.05).Nevertheless,differences between 2 groups after 3 months and 6 months were not significant.(3) In the acute stage,the level of CARDS toxin in the severe cases were higher than the mild cases [(2.37 ± 0.37) Delta Rn vs (1.21 ± 0.45) Delta Rn],and there was statistically significant difference (P ＜ 0.05).(4) IL-4 showed significant difference in the acute stage and 3 months later after acute infection between 2 groups,however,there were no difference between 2 groups after 6 months later.(5)The load of CARDS toxin showed no significant difference between 2 groups at 3 months [(0.96 ± 0.35) vs.(0.99 ± 0.40) Delta Rn,P =0.757] and 6 months [(0.67 ± 0.20) vs.(0.69 ±0.32) Delta Rn,P =0.641] later after MP infection.(6)The children in wheezing group coughed for (24.89 ±7.04) days after acute infection and the last time for non-wheezing group was (16.46 ± 4.79) days,and there was statistically significant difference(P =0.000).Conclusions The load of CARDS toxin decreased after acute MP infection and it was still detectable six months after onset in the blood.The level of CARDS toxin was associated with the cough and wheezing symptom and the severity of disease.
RESUMO
Objective To analyze the effects of Hual qi huang granules on children with mycoplasma pneumoniae pneumonia.Methods A randomized,multicenter parallel controlled clinical trial was carried out.A total of 3 000 cases of hospitalized children with mycoplasma pneumoniae pneumonia were selected.All of them were given treatment for mycoplasma pneumoniae pneumonia with macrolide antibiotics and symptomatic treatment.They were randomly divided into 2 groups:research group and control group.The children of research group were give oral Huai qi huang granules for three months.According to the classification of pneumonia,these two groups were divided into:lobar pneumonia research group,lobar pneumonia control group,lobular pneumonia research group,lobular pneumonia control group.The hospitalization duration of fever,length of hospital stay,the absorption area of lung inflammation and pneumonia severity sores were observed.The frequency of upper respiratory infections,bronchitis,pneumonia were observed in 3 months after discharge.Results 2 378 cases were investigated.The hospitalization duration of fever,length of hospital stay of research group were significantly shorter than that of in control group (P ＜ 0.001).The children with lobar pneumonia,2 weeks after treatment,the absorption of consolidation of the lobar pneumonia research group is significantly better than lobar pneumonia control group (P ＜0.001).After two weeks treatment,the pneumonia scores of lobar pneumonia research group is lower than lobar pneumonia control group (P ＜ 0.05).Followup of 3 months after hospital discharge,frequency of upper respiratory infection and bronchitis of research group,were significantly lower than that of control.In addition,appetite increased significantly in research group than control (P ＜ 0.001).There are 21 cases with drug associated adverse reactions (mild diarrhea),including 12 cases of research group,9 cases of control group,and there was no statistical significance (P ＞0.05).Conclusion Standard treatment combined with oral Huai qi huang granules in the treatment of mycoplasma pneumoniae pneumonia,can significantly shorten hospitalization duration of fever,length of hospital stay and reduce the severity score of pneumonia.Three months oral Huai qi huang granules can significant reduce the frequency of respiratory infections and bronchitis,also can increase patients appetite,and be safe.
RESUMO
Objective To summmrize the clinical characteristics complications,antimicrobial resistance and prognosis in 15 children with streptococcus pneumoniae meningitis so as to improve the diagnosis and treatment of this disease.Methods A systematic retrospective analysis was carried out in the Qilu Children's Hospital of Shandong University from Jan.2010 to Jan.2013,and clinical data from 15 children with streptococcus pneumococcal meningitis were retrospectively analyzed and followed up for 6 months in order to observe the prognosis.Results Eleven cases of streptococcus pneumoniae meningitis occuned in the winter and spring.And it often occuned in children less than 2 years of age who lived in rural areas (13 cases).The clinical manifestations showed diverse characteristics,severe symptoms,obvious changes in symptoms and cerebrospinal fluid were observed.Severe or death cases had low temperature,low leukopenia or low blood platelet.Common complications of streptococcus pneumoniae meningitis included anemia (10 cases),hypoalbuminemia (9 cases),sepsis (8 cases).Multi-drug resistance and complications in streptococcus pneumoniae meningitis led to the therapeutic difficulties.In this study,3 cases were cured,9 cases had varying degrees of sequences,such as left languages,sports,hydrocephalus and cognitive dysfunction,and 3 cases died,and the main cause of death was multiple organ dysfunction syndrome.Conclusions Streptococcus pneumoniae meningitis mainly occurred in the winter and spring.And the children under 2 years of age who lives in rural areas were often attacked.Clinical characteristics and cerebrospinal fluid changes obviously; severe cases are common with low temperature,low leukopenia or blood platelet.And there aye often diverse complications and multi-sequelae; the problem of multi-drug resistant and complications can lead to great difficulties in the clinical treatment.
RESUMO
OBJECTIVE@#To determine the role of fragile histidine triad (FHIT) and MDM2 in carcinogenesis of oral submucous fibrosis (OSF).@*METHODS@#The expression of FHIT and MDM2 was examined by immunohistochemical S-P method in 44 OSF cases, 15 canceration tissues of OSF, and 10 normal oral mucosa tissues.@*RESULTS@#The expression of FHIT was positive in the normal oral mucosa epithelium. The positive expression of FHIT decreased in the OSF and canceration tissues of the OSF.The rate of FHIT positive expression was significantly lower in canceration tissues of OSF than that of the OSF (P < 0.05). The expression of MDM2 was negative in normal oral mucosa epithelium. The positive expression of MDM2 increased in the OSF and canceration tissues of the OSF, and the rate of MDM2 positive expression was significantly higher in the canceration tissues of OSF than that of the OSF (P < 0.05).@*CONCLUSION@#The loss of FHIT and over-expression of MDM2 may play an important role in the carcinogenesis of OSF.