Serum level of vitamin A in children with pneumonia aged less than 3 years / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the association of the serum level of vitamin A (VA) with the severity of pneumonia and recurrent respiratory infection (RRI) within one year after treatment in children with pneumonia, and to provide a basis for serum VA level used as an index for judgment of the condition of pneumonia and prediction of the risk of recurrent respiratory infection.</p><p><b>METHODS</b>A total of 88 children with pneumonia aged less than 3 years were enrolled as study subjects. Serum VA level was measured on admission, and the development of RRI was followed up by telephone within 1 year after discharge.</p><p><b>RESULTS</b>The children with pneumonia showed a reduction in the serum level of VA (0.8±0.3 μmol/L). The severe pneumonia group had a significantly lower serum level of VA than the mild pneumonia group (0.7±0.3 μmol/L vs 0.9±0.3 μmol/L; P<0.05), as well as a significantly higher detection rate of vitamin A deficiency (VAD) than the mild pneumonia group (63% vs 28%; P<0.05). The children were followed up for 1 year. The VAD-pneumonia group showed a significantly higher incidence of RRI than the normal VA-pneumonia group (49% vs 18%; P<0.05), while there were no significant differences in the incidence of RRI between the suspected subclinical vitamin A deficiency (SSVAD)-pneumonia group and the normal VA-pneumonia group, as well as between the VAD-pneumonia group and the SSVAD-pneumonia group (P>0.05).</p><p><b>CONCLUSIONS</b>Children with pneumonia often have a low level of VA, and the level of VA is associated with the severity of pneumonia and the development of RRI afterwards.</p>

Efficacy of regular or intermittent inhalation of corticosteroids in treatment of asthma and its effects on growth and development in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To observe the efficacy of regular or intermittent inhalation of salmeterol/fluticasone propionate (SM/FP) in the treatment of bronchial asthma and its effects on growth and development in children.</p><p><b>METHODS</b>A total of 112 children diagnosed with bronchial asthma between September 2012 and October 2013 were assigned to standardized treatment (standard group, n=56) and non-standardized treatment (intermittent group, n=56). Comparisons of clinical symptom scores and main pulmonary function indicators between the two groups were carried out before treatment and at 6 and 12 months after treatment. The growth velocity and changes in body mass index (BMI) were observed in the two groups.</p><p><b>RESULTS</b>At 6 and 12 months after the treatment, the standard group had significantly reduced clinical symptom scores and significantly increased pulmonary function indicators (percentage of predicted peak expiratory flow, PEF%; percentage of forced expiratory volume in 1 second, FEV1%) (P<0.05); the intermittent group had significantly reduced clinical symptom scores and significantly increased FEV1% (P<0.05), but PEF% was significantly increased only at 6 months after treatment (P<0.05). At 12 months after treatment, the standard group had significantly lower clinical symptom scores and significantly higher PEF% and FEV1% when compared with the intermittent group (P<0.05). The growth velocity and BMI showed no significant differences between the two groups at 6 and 12 months after treatment (P>0.05).</p><p><b>CONCLUSIONS</b>Compared with intermittent inhalation, long-term regular inhalation of SM/FP performs better in controlling clinical symptoms and enhancing pulmonary function in children with asthma. Inhalation of SM/FP for one year reveals no apparent effect on the growth and development of these children.</p>

Effect of clinical pathway management on pediatric pneumonia / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate effect of clinical pathway management on pediatric pneumonia.</p><p><b>METHOD</b>Data were colleted from children hospitalizated with bronchial pneumonia, bronchiolitis, mycoplasma pneumonia in Center of Respiratory Disorders in Children's Hospital of Chongqing Medical University from January 2011 to December 2012. According to implement of clinical pathway management, all patients were divided into pathway management group (n = 405) and non-pathway management group (n = 503). Length of stay, costs of hospitalization, clinical effect and use of antibiotics were compared in these two groups.</p><p><b>RESULT</b>In pathway management group, average length of stay of children with bronchial pneumonia and bronchiolitis was (6.1 ± 1.6) d and (6.2 ± 1.5) d respectively. While in non-pathway management group, length of stay was (7.2 ± 1.9) d and (7.3 ± 1.5) d (P = 0.000). There was no significant difference in length of stay between these two groups of children with mycoplasma pneumonia [ (6.9 ± 1.8) d vs.(7.7 ± 2.5) d] (P = 0.198). Costs of auxiliary tests in pathway management group was slightly higher than that in non-pathway management group. While other costs in pathway management group were significantly lower than those in non-pathway management group. Total costs of hospitalization of patients with these three diseases in pathway management group and non-pathway management group were ¥(4609 ± 1225) vs ¥ (5629 ± 1813) , ¥ (5006 ± 1250) vs. ¥ (5686 ± 1337), ¥ (4946 ± 1259) vs. ¥ (6488 ± 3032) respectively. There was a significant difference (P < 0.05). Percentages of antibiotics use in two groups were 70.9% vs.99.4%, 45.7% vs.93.4% and 96.2% vs.100.0%. Antibiotics related indicators such as mean number of day of use, ratio of combination and grade of antibiotics were significantly higher in pathway management group compared to non-pathway management group (P < 0.01). There was no significant difference in other indicators like clinical effect and unscheduled readmission in 30 days between two groups (P > 0.05).</p><p><b>CONCLUSION</b>Clinical pathway management can regulate medical behaviors through reduction of medical costs, avoidance of excessive laboratory tests and therapy, and regulation of antibiotic use.</p>

Surveillance for Respiratory Viruses in Children with Acute Lower Respiratory Infections in Chongqing between 2003 and 2007 / 实用儿科临床杂志

Objective To investigate the clinical spectrum of respiratory viruses in infants and young children with acute lower respiratory infection(ALRI) in Chongqing area from 2003-2007.And to assess the clinical diagnostic value of virus detection in nasopharyngeal secretions(NPS) and serum viral antibody detection for ALRI.Methods Cases of 2 529 specimens of NPS in hospitalized children with ALRI from Apr.2003 to Oct.2007 were taken for detecting 7 common respiratory virus antigens by immunofluorescence assay including respiratory syncytial virus (RSV),adenovirus(ADV),influenza A(IA),influenza B (IB),parainfluenza virus1-3 (PIV1,PIV2,PIV3).Fifty-five thousand eight hundred and eighty-seven samples were tested for ADV-IgM by ELISA.Among those,45 159 cases were further tested for RSV-IgM by ELISA.Results Respiratory virus pathogens were detected in 778 samples out of 2 529(30.76%) including RSV positive in 668 samples (85.86%),PIV3 positive in 75 samples (9.64%),IA positive in 22 samples (2.57%),ADV positive in 15 samples ( 1.93%),only 1 sample ( 0.13%) positive for both PIV1 and RSV. And the positive rate of RSV-IgM was 0.9%-15.2%,and the positive rate for ADV-IgM was about 0.6%-10.6%.RSV infection occured mainly in winter and spring.Conclusions Respiratory virus is the most common pathogen in children with ALRI during the survey period in Chongqing area,especially for RSV infection.The pattern of RSV circulation varied every year with seasonality.It is suggest that this year is peak one for RSV infection from the monthly positive results,especially in Feburary(50%) in 2007.But the infection rate of PIV3,IA,ADV and PIV1 are lower,particularly IB and PIV2 infection have not been seen for the last 5 years.It is fast and accurate to detect RSV antigen and suit to clinical diagnosis by using immunofluorescence assay than other antibody detection.

Effect of Budesonide Inhalation Suspension Treatment on Mild to Moderate Wheezing Diseases in Infants / 实用儿科临床杂志

Objective To explore the effect of atomization inhaled Budesonide on mild to moderate wheezing diseases in infants.Me-thods One hundred and twenty infants in the ward of center of respiratory were divided into 2 groups randomly during Jan. to Dec.2006.They suffered from bronchiolitis(56 cases)or wheezing bronchitis(11 cases) or asthzma of infants and young children(53 cases),aged 1 month to 3 years old.On the basis of the routine treatment, Budesonide inhalation suspension was administered on the therapeutic group, the dosage of Budesonide was 0.5 mg/time(1 month to 1 year old),1.0 mg/time(1 to 3 years old),2 times/d;Dexamethasone was given in the control group,the dosage of Dexamethasone was 5.0 mg/time(1 month to 1 year old),7.5 mg/time(1 to 3 years old),2 times/d. The persistence time of clinical symptoms,signs and staying in hospital were compared after the treatment, and the pulmonary function of two groups were also compared before and after treatment.Software of SPSS 12.0 was used to analyze data.Results There were significant differences in clinical symptoms (wheeze, cough), signs(wheezing rale) and time of staying in hospital between the treatment group and control group (t=3.98,5.44,4.61,2.96 Pa