Progress on detection of exhaled nitric oxide in diagnosis and treatment of asthma in children / 国际儿科学杂志

Asthma is a common chronic airway inflammatory disease in children.In recent decades, the global prevalence of asthma in children has been increasing significantly.As a heterogeneous disease, asthma presents multiple phenotypes, with the type 2(eosinophilic)airway inflammation predominating in children.Currently, fractional exhaled nitric oxide(FeNO)is an internationally recognized marker of eosinophilic airway inflammation, and its value in the diagnosis and treatment of asthma in children has been gradually recognized.This article reviews the sources, detection methods, possible influencing factors of FeNO and its role in the diagnosis and treatment of asthma in children.

Value and clinical significance of NLR, PLR, LMR in auxiliary diagnosis of children with bronchial asthma / 国际检验医学杂志

Objective To investigate the diagnostic value and clinical significance of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) in children with bronchial asthma.Methods A total of 182cases newly diagnosed with asthma were divided into mild persistent group (68cases), moderate persistent group (63cases) and of severe persistent group (51cases), and 100ageand sex-matched pediatric healthy children at the same period were chosen as healthy control group.WBC, NEU, LYM, MON, EOS, PLT, IgE, NLR, PLR and LMR of all subjects enrolled in this research were retrospectively reviewed.Results There was no significant difference in age and sexuality between children with asthma and control group (P＞0.05), but WBC, EOS, NEU, MON, PLT and IgE were all significantly up-regulated, and LYM was down.NLR and PLR were significantly up-regulated in children with asthma, while LMR decreased significantly.The area under the curve (AUC) of ROC curve was 0.88and the cutoff value were 2.619for NLR in diagnosing asthmatic children.The diagnostic value of PLR was similar to that of NLR, the AUC of ROC value was 0.87, and the cutoff value was 111.1.The diagnostic value of LMR was only0.79, and the cutoff value was 5.093.In addition, there was a significant correlation between NLR and IgE or lung function indexes.PLR was also correlated with IgE, but only negatively correlated with lung function indexes such as FVC, FEV1and FEV1/FVC％.There was no significant correlation between LMR and all indexes.NLR and PLR were significantly decreased in children with severe asthma after treatment with budesonide, while LMR was significantly up-regulated.Conclusion There are abnormal changes in NLR, PLR and LMR in children with bronchial asthma, which can be used as an index for auxiliary diagnosis, disease assessment and therapeutic effect monitoring in children with bronchial asthma.

Efficacy and psychological intervention of budesonide combined with terbutaline inhalation in the treatment of children with asthma / 中国生化药物杂志

Objective To study the efficacy and psychological intervention of budesonide combined with terbutaline inhalation in the treatment of children with asthma. Methods 100 children with asthma in our hospital from March 2015 to October 2016 were selected as the subjects. They were randomly divided into two groups: the control group and the experimental group, with 50 cases in each group. The control group received routine treatment of bronchial asthma, and the experimental group received budesonide combined terbutaline aerosol inhalation treatment, and psychological intervention, pay attention to the patient's psychological state. The clinical efficacy, relative clinical symptoms, improvement time and length of hospital stay were compared between the 2 groups. Results The effective rate of the treatment group was 94%, which was significantly higher than that of the control group (72%), and the difference was statistically significant (P<0.05). The improvement time of dyspnea, wheezing and cough in control group was significantly higher than that in experimental group, while the control group was significantly longer than the experimental group, the difference was statistically significant (P<0.05). Conclusion Compared with conventional treatment,budesonide combined with terbutaline aerosol inhalation and psychological intervention in the treatment of children with asthma has better clinical efficacy and shorter clinical symptoms. It has the significance of further popularization and application.

Clinical Study of Acupoint Application Combined with Daqinglong Decoction for Treatment of Children Asthma with Syndrome of Exterior Cold and Interior Heat / 广州中医药大学学报

Objective To investigate the therapeutic effect of acupoint application combined with Daqinglong Decoction (DD) for children asthma with the syndrome of exterior cold and interior heat. Methods One hundred and five children with mild and moderate persistent asthma were evenly randomized into combination group, DD group and Montelukast group. The three groups were separately given acupoint application combined with oral use of DD, oral use of DD, oral use of Montelukast, respectively. The treatment for the three groups lasted for 12 weeks. The scores of traditional Chinese medical syndromes in the three groups were recorded before and after treatment. The control of asthmatic symptoms, acute asthmatic attack frequency, and the course of disease were evaluated at the end of follow-up week 12. Results (1) At the end of treatment week 4 and 16, the syndrome scores were obviously decreased in the three groups (P0.05) . At the end of follow-up week 12, the decrease of syndrome scores in the combination group was superior to that in DD group and Montelukast group (P<0.05). (2) The effect of the combination group on controlling the asthmatic symptoms was superior to that of the other two groups ( P<0.01). ( 3) The combination group had lower acute asthmatic attack frequency and shorter disease course than DD group and Montelukast group ( P<0.01). Conclusion Acupoint application combined with oral use of Daqinglong Decoction is effective for children asthma with the syndrome of exterior cold and interior heat by relieving symptoms, enhancing the control of asthma, reducing acute asthmatic attack frequency and shortening disease course.

Therapeutic Effect of Heat-clearing and Dampness-removing Therapy Combined with Bifico for Ulcerative Colitis and Its Influence on Tumor Necrosis Factor Alpha and Interleukin-10 in Rats / 广州中医药大学学报

Objective To observe the therapeutic effect of heat-clearing and dampness-removing therapy combined with Bifico for ulcerative colitis ( UC) induced by trinitrobenzene sulfonic acid ( TNBS), and to explore its influence on tumor necrosis factor alpha ( TNF-α) and interleukin-10 ( IL-10) in rats. Methods Forty female adult Sprague-Dawley rats were evenly randomized into five groups, namely normal control group, model group, Bifico (175 mg/kg) group, Chinese medicine group(enema with Changdiqing 3.6/kg and oral use of Changyanling Recipe l) , and Chinese medicine plus Bifico group. After treatment, the damage of colonic mucous membrane was evaluated, and expression levels of IL-10 and TNF-α in colonic mucosa were observed through immunohistochemical assay. Results The degree of colonic mucosal injury was severer and the inflammation was more obvious in the model group than those in the normal control groups ( P<0.01) , and the above changes were relieved to various degrees in the medication group ( P<0.01 compared with those in the model group) . Chinese medicine plus Bifico group had better effect on reducing colonic mucosa damage index ( CMDI) and inflammation, and on promoting the healing of colonic mucosa than Bifico group and Chinese medicine group (P<0.05 ) . The expression level of TNF-α in the colonic mucosa was markedly increased while that of IL-10 was markedly decreased in the model group ( P<0.01 compared with those in the normal control group) . The medication groups could counteract the above changes in the colonic mucosa ( P<0.01 compared with those in the model group) . The combination group and Chinese medicine group had better effect on decreasing TNF-α expression level and on increasing IL-10 expression level than Bifico group ( P<0.05) . Conclusion IL-10 and TNF-α play an important role in the pathogenesis and development of ulcerative colitis. Chinese medicine combined with Bifico has satisfactory therapeutic effect on UC rats, and its mechanism may be related with the increase of IL-10 expression level and with the decrease of TNF-α expression level.

Effectiveness of magnesium sulfate as initial treatment of acute severe asthma in children, conducted in a tertiary-level university hospital: A randomized, controlled trial / Eficacia del sulfato de magnesio como tratamiento inicial del asma aguda grave pediátrica: Estudio aleatorizado y controlado

Introduction. Magnesium sulfate is a calcium antagonist that inhibits bronchial smooth muscle contraction promoting bronchodilation. It is used for the management of acute severe asthma in children; however most of the studies have been performed in adults. Objective. To evaluate the effectiveness of intravenous magnesium sulfate for the treatment of pediatric patients with acute severe asthma exacerbations. Population and Methods. A clinical, randomized, controlled trial was conducted between March 2006 and March 2011 at Hospital Universitario Austral. Children with acute severe asthma admitted to the emergency department were randomized into two groups. Group A (control group): standard protocol for the initial treatment of acute asthma exacerbation. Group B: treatment protocol with magnesium sulphate for acute severe asthma exacerbation. The primary outcome was the requirement of invasive or non invasive mechanical ventilation support. Results. One hundred and forty three patients randomized into 2 groups were analyzed. The treatment group included 76 patients receiving magnesium sulfate within the first hour of the initiation of rescue treatment at the hospital, and the control group included 67 patients not treated with magnesium sulphate. Among the patients in the control group, 33% (n= 22) required mechanical ventilation support, compared to only 5% (n= 4) of the patients in the treatment group (p = 0.001). Conclusions. Intravenous infusion of magnesium sulfate during the first hour of hospitalization in patients with acute severe asthma significantly reduced the percentage of children who required mechanical ventilation support.

Introducción. El sulfato de magnesio es un antagonista del calcio que inhibe la contracción del músculo liso bronquial y favorece la broncodilatación. Se utiliza en el manejo del asma aguda grave en pediatría no obstante haber sido la mayoría de los estudios desarrollados en adultos. Objetivo. Evaluar la eficacia del sulfato de magnesio endovenoso para exacerbaciones graves de pacientes asmáticos pediátricos. Población y métodos. Se realizó un estudio clínico, controlado y aleatorizado, entre marzo de 2006 y marzo de 2011 en el Hospital Universitario Austral. Los pacientes con asma aguda grave admitidos en Emergencias se aleatorizaron en dos grupos. Grupo A: protocolo inicial estándar de exacerbación asmática aguda grave. Grupo B: protocolo de intervención con sulfato de magnesio de exacerbación asmática aguda grave. La variable principal de resultado fue la necesidad de soporte invasivo o no invasivo ventilatorio mecánico. Resultados. Se analizaron 143 pacientes aleatorizados en 2 grupos. El grupo de intervención de 76 pacientes que recibieron tratamiento con sulfato de magnesio dentro de la primera hora de iniciado el tratamiento de rescate en el hospital, y el grupo control testigo de 67 pacientes que no recibieron tratamiento con sulfato de magnesio. El 33% (n= 22) de los pacientes del grupo control requirió asistencia ventilatoria mecánica, en comparación con solo 4 (5%) de los pacientes del grupo intervención (p= 0,001). Conclusiones. El uso de sulfato de magnesio en infusión endovenosa en la primera hora de ingreso del paciente con asma aguda grave redujo significativamente el porcentaje de niños que requirieron asistencia ventilatoria mecánica.

External application of Chinese medicine on acupoints in prevention and cure of bronchial asthma in children / 国际中医中药杂志

Objective To observe the therapeutic of Xiaochuanling ointment applied on acupoints combined with internal use of Yupingfeng pellets in the prevention and cure of bronchial asthma in children.Methods 80 children diagnosed of bronchial asthma were randomly recruited into a control group and a treatment group, 40 patients in each group. Patients in treatment group were treated with Xiaochuanling ointment applied on acupoints combined with internal use of Yupingfeng pellets. No treatment was used in the control group in relieving period, except observation and follow-up visit were performed. Observe the frequency,degree of asthma before and after treatment in both groups, along with the level variation of IgA, IgG, IgE and Eosnophils (EOS). Results After treatment, the average disease grade in treatment group was 1.82S with serum IgA (1.32±0.56) g/L, IgG (12.48± 1.85) g/L, IgE (257.06± 194.04) g/L, EOS (128.56±76.86) ×106/L and frequency of asthma (7.22 ±2.01). Compared with the control group and the treatment group before the treatment, there were statistical differences (P<0.01, P<0.05). Conclusion The effect of external application of Chinese medicine on acupoints in prevention and cure of bronchial asthma in children is especially remarkable.

Conhecimento sobre asma das mães de crianças acometidas pela patologia, em área coberta pelo Programa Saúde da Família / Mothers of children with asthma's knowledge on the condition, in area covered by the Family Health Program

OBJETIVO: Avaliar o conhecimento sobre asma das mães de crianças com esta patologia e os fatores associados a este conhecimento. MÉTODO: Realizou-se um estudo censitário para identificar as crianças com asma utilizando-se o questionário do ISAAC (International Study of Asthma and Alergies in Childhood). As mães das crianças identificadas responderam a outro questionário que levantou dados demográficos, socioeconômicos, ambientais, biológicos, comportamentais, aspectos relacionados ao manejo da doença e utilização de serviços de saúde. Foi considerado como conhecimento o preenchimento de três critérios: manejo inicial adequado das exacerbações, reconhecimento do agravamento dos episódios de sibilância e dos fatores desencadeantes. RESULTADOS: Das 258 mães entrevistadas, 67 (26,0 por cento) foram consideradas como tendo conhecimento adequado. Na análise dos fatores associados ao conhecimento materno, permaneceu associado ao desfecho, após ajuste: o sexo da criança, a prematuridade, a criança ter outras doenças atópicas e possuir medicação em casa para o manejo das exacerbações. CONCLUSÕES: O estudo mostrou que, apesar de relatarem ter recebido orientações, apenas um terço das mães efetuou mudanças ambientais e comportamentais. Além disso, quando se estabeleceu que o conhecimento adequado devesse ser o preenchimento dos três critérios, o número de mães classificadas foi ainda menor entre as respondentes. Estes achados reforçam a necessidade de intervenções educativas focadas nas deficiências do conhecimento, como meio de possibilitar às crianças asmáticas o desenvolvimento de atitudes de automanejo bem sucedidas.

Clinical study of salmeterol/fluticasone propionate combination in therapy of moderate to severe asthma in children / 重庆医科大学学报

Objective:To investigate the efficacy and safety of 6 months inhalation of(SM/FP) among children.with moderate to severe asthma.Methods:145 children with moderate-severe asthma,aged between 4 and 14 years,were given SM/FP at the dose of 50/100?g twice daily in moderate group and 50/100?g 3 times every day in severe group for 6 months.The PEFam,symptom scores and the as-needed beta2 agonists were recorded at the beginning,2 weeks,1 month,2 months,4 months and 6 months after treatment.And the side effects were recorded also during the therapy.Results:Outcomes of clinical symptoms, PEFam and as-needed beta2 agomsts in all 145 cases improved significantly since 2 week ( P