[Changes in pulmonary function in infants and young children with Mycoplasma pneumoniae pneumonia].

OBJECTIVE: To study the changes in pulmonary function in infants and young children with Mycoplasma pneumoniae pneumonia (MPP). METHODS: A total of 196 hospitalized children (at age of 0-36 months) who were diagnosed with MPP from January 2014 to June 2018 were enrolled as study subjects. A total of 208 children (at age of 0-36 months) with pneumonia not caused by Mycoplasma pneumoniae infection during the same period of time were enrolled as controls (non-MPP group). A retrospective analysis was performed for their clinical data. The two groups were compared in the pulmonary function on the next day after admission and on the day of discharge. The children with MPP were followed up to observe pulmonary function at weeks 2 and 4 after discharge. RESULTS: Compared with the non-MPP group, the MPP group had significant reductions in the ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/TE), ratio of volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE), inspiratory-to-expiratory time ratio, and tidal expiratory flow at 25% remaining expiration on the next day after admission and on the day of discharge (P<0.05). In addition there were significant increases in the ratio of peak tidal expiratory flow to tidal expiratory flow at 25% remaining expiration, respiratory rate, effective airway resistance, and plethysmographic functional residual capacity per kilogram (P<0.05). Compared with the normal reference values of pulmonary function parameters, both groups had reductions in VPTEF/VE and TPTEF/TE on the next day after admission; on the day of discharge, the MPP group still had reductions in VPTEF/VE and TPTEF/TE, while the non-MPP group had normal values. The MPP group had increases in VPTEF/VE and TPTEF/TE from the day of discharge to weeks 2 and 4 after discharge (P<0.05), but TPTEF/TE still did not reach the normal value at week 4 after discharge. CONCLUSIONS: Airway obstruction is observed in infants and young children with acute MPP or non-MPP, and the children with MPP have a higher severity of airway obstruction and a longer time for improvement, with a certain degree of airway limitation in the recovery stage.

[Readmission of children with bronchopulmonary dysplasia in the first 2 years of life: a clinical analysis of 121 cases].

OBJECTIVE: To investigate the clinical features of readmitted children with bronchopulmonary dysplasia (BPD) in the first 2 years of life. METHODS: A retrospective analysis was performed for the clinical data of 242 children with BPD who were readmitted due to recurrent lower respiratory tract infection (LRTI) in the first 2 years of life. RESULTS: Among all the 242 children with BPD, 115(47.5%) had wheezing, and the children aged 1-2 years had a significantly higher incidence rate of wheezing than those aged less than 1 year (P<0.05). Chest imaging was performed for 193 children, among whom 31 (16.1%) had hyperlucent areas. Pulmonary function examination showed that the BPD children had significantly lower TV/kg, TPEF/TE, VPEF/VE, TEF50 and TEF75, and significantly higher respiratory rate than the controls without respiratory disease (P<0.05). Bronchoscopy was performed for 28 children, among whom 21 (75%) had airway dysplasia. All the 242 children used inhaled corticosteroids (ICS) and experienced no treatment-related adverse reactions. Six children were given intravenous infusion of human umbilical cord blood mesenchymal stem cells (hUCB-MSCs) and experienced no infusion-related events or adverse reactions, among whom one child successfully stopped oxygen therapy. CONCLUSIONS: The incidence rate of wheezing increases with the increase in age in children with BPD who are readmitted due to LRTI. Pulmonary function examination shows small airway obstruction, reduced expiratory flow rate in case of low lung capacity, and increased respiratory rate, and most children have airway dysplasia. ICS can be used to inhibit inflammatory response in the acute stage. Infusion of hUCB-MSCs is safe and feasible and may bring some benefits to the recovery from BPD.

[Significance of exhaled nitric oxide measurement in remitting childhood asthma with concurrent remitting rhinitis].

OBJECTIVE: To evaluate the value of exhaled nitric oxide in the severity evaluation of asthmatic children with remitting rhinitis. METHODS: A total of 214 asthmatic children were randomly allocated to a untreated control and a conventional treatment group. Patients in each of the two subclasses were classified as asthma with concurrent rhinitis and asthma without concurrent rhinitis. Values of the 20% fall in forced expiratory volume in 1 second (PC20FEV1) and fractional exhaled nitric oxide (FeNO) were measured. RESULTS: The PC20FEV1 level was significantly higher in untreated asthma patients without rhinitis than in those with concurrent rhinitis (P<0.05), while FeNO was not significantly different between these two groups (P>0.05). There were no significant differences in both FeNO and PC20FEV1 between treated asthma patients with and without concurrent rhinitis (P>0.05). PC20FEV1 was significantly increased (P<0.05) but FeNO was significantly decreased (P<0.05) in asthma patients with concurrent rhinitis after conventional treatment. In asthmatic children without concurrent rhinitis, treatment significantly decreased the level of FeNO (P<0.05) but had not effect on PC20FEV1 (P>0.05). CONCLUSIONS: Exhaled nitric oxide measurement may be useful in the severity evaluation of asthmatic children with remitting rhinitis.

[Association of FEV1 and PEF with small airway function in asthmatic children: cross-sectional analysis of 619 cases].

OBJECTIVE: To investigate the association of forced expiratory volume in 1 second (FEV1) and the maximum peak expiratory flow (PEF) with small airway function in asthmatic children of different ages and genders. METHODS: This cross-sectional study was conducted among 619 asthmatic children with disease remission aged 3 to 13 years. The children were divided into 3 age groups, namely 3 to 5 years group (314 cases), 6 to 9 years group (207 cases) and 10 to 13 years group (98 cases), and their respiratory physiological parameters such as FEV1 and PEF were measured. RESULTS: Of the airway function parameters, PEF showed the highest abnormality rate (>85%) in these asthmatic children. In male and female asthmatic children aged 6 to 9 years, abnormalities in forced expiratory flow rate 25% (MEF25) showed the highest frequency (56% and 63%, respectively). In 3-5 years and 10-13 years groups, MEF25 abnormalities were the most frequent in male children (43% and 71%, respectively), whereas abnormalities in MEF50 were the most common in female children (33% and 69%, respectively). FEV1 and PEF were positively correlated to all the parameters of small airway functions in these asthmatic children (r>0.5, P<0.01) except for MEF25 in female asthmatic children aged 3 to 5 years (r=0.19, P=0.168; r=0.086, P=0.535). CONCLUSION: In asthmatic children, FEV1 and PEF are positively correlated to the parameters of small airway function with only the exception of MEF25 in female children aged 3 to 5 years, suggesting the value of FEV1 in the diagnosis of asthma in children.

[Case-control study of the relationship between children's moderate-severe asthma and development indicators].

OBJECTIVE: To investigate the relationship between moderate-severe asthma and development in children. METHODS: A total of 389 children in the state of moderate-severe persistent asthma were enrolled, which were divided into moderate (226 cases) and severe group (163 cases). According to age, each group was divided into three groups: 3-year-old (85 cases and 63 cases), 5-year-old (76 cases and 52 cases) and 7 to 10 year-old (65 cases and 48 cases). Meanwhile, 298 healthy children in the same age group were enrolled as control, of which 3-year-old were 96 cases, 5-year-old were 92 cases and 7 to 10 year-old were 110 cases. Height, weight and lung function were measured respectively. RESULTS: 3-year-old of severe group, the value of height, the value of weight, the percentage of height, the percentage of weight, the SDS of height, the SDS of weight [(98.54 ± 7.75) cm, (14.87 ± 2.46) kg, 50.30% ± 16.31%, 50.27% ± 18.29%, 0.11 ± 0.66, 0.06 ± 0.49, respectively] were lower than the moderate group of the same age group ((103.58 ± 5.48) cm, (16.60 ± 2.21) kg, 65.80% ± 18.54%, 65.10% ± 18.92%, 0.46 ± 0.53, 0.45 ± 0.54, respectively) and the control group ((105.60 ± 6.29) cm, (17.82 ± 2.82) kg, 72.37% ± 11.37%, 71.92% ± 2.82%, 0.66 ± 0.62, 0.66 ± 0.52), the difference was significant (F values were 7.295, 8.034, 15.246, 10.745, 8.026, 10.864, respectively, P < 0.05).5-years of severe group, the value of height, the value of weight, the percentage of height, the percentage of weight, the SDS of height, the SDS of weight ((110.10 ± 7.36) cm, (18.76 ± 3.20) kg, 45.86% ± 18.92%, 41.69% ± 12.50%, -0.95 ± 0.42, -0.23 ± 0.34, respectively) were lower than the moderate group of the same age group ((117.76 ± 6.35) cm, (21.63 ± 2.75) kg, 61.81% ± 20.75%, 61.79% ± 18.92%, 0.36 ± 0.62, 0.38 ± 0.56) and the control group ((119.90 ± 5.78) cm, (22.80 ± 3.07) kg, 68.97% ± 18.59%, 66.27% ± 18.35%, 0.57 ± 0.65, 0.48 ± 0.63), the difference was significant (F values were 8.351, 7.864, 15.037, 13.921, 12.116, 11.725, respectively, P < 0.05).7 to 10 years-old of severe group, the value of height, the value of weight, the percentage of height, the percentage of weight, the SDS of height, the SDS of weight ((123.50 ± 9.52) cm, (23.82 ± 5.72) kg, 45.81% ± 15.51%, 42.63% ± 14.91%, -0.06 ± 0.48, -0.02 ± 0.61, respectively) were lower than the moderate group of the same age group ((129.1 ± 8.41) cm, (26.70 ± 5.72) kg, 66.84% ± 16.09%, 64.07% ± 18.58%, 0.48 ± 0.46, 0.42 ± 0.49) and the control group ((131.87 ± 7.71) cm, (28.06 ± 6.01) kg, 71.44% ± 12.70%, 69.64% ± 16.20%, 0.60 ± 0.43, 0.60 ± 0.51), the difference was significant(F values were 6.136, 6.678, 57.316, 37.893, 37.210, 34.152, respectively, P < 0.05). 3-, 5-, 7 to 10 year-old of moderate group, the value of height, the value of weight, the percentage of height, the percentage of weight, the SDS of height, the SDS of weight dropped compared to the control group of the same age, but no significant difference was found (t values were -2.008, -1.988, -1.810, -1.879, -1.713, -1.844, -1.904, -2.019, -1.605, -1.017, -1.411, -0.713, -1.881, -1.896, -1.746, -1.906, -1.523, -1.864, respectively, P > 0.05). CONCLUSION: The height and weight of children with severe asthma were lower than those of normal children or with moderate asthma.