A cross-sectional study of the clinical characteristics of hospitalized children with community-acquired pneumonia in eight eastern cities in China.

BACKGROUND: Community-acquired pneumonia in children is common in China. To understand current clinical characteristics and practice, we conducted a cross-sectional study to analyze quality of care on childhood pneumonia in eight eastern cities in China. METHODS: Consecutive hospital records between January 1, 2010 and December 31, 2010 were collected from 13 traditional Chinese medicine (TCM) and western medicine (WM) hospitals in February, May, August, and November (25 cases per season, 100 cases over the year), respectively. A predesigned case report form was used to extract data from the hospital medical records. RESULTS: A total of 1298 cases were collected and analyzed. Symptoms and signs upon admission at TCM and WM hospitals were cough (99.3% vs. 98.6%), rales (84.8% vs. 75.0%), phlegm (83.3% vs. 49.1%), and fever (74.9% vs. 84.0%) in frequency. Patients admitted to WM hospitals had symptoms and signs for a longer period prior to admission than patients admitted to TCM hospitals. Testing to identify etiologic agents was performed in 1140 cases (88.4%). Intravenous antibiotics were administered in 99.3% (595/598) of cases in TCM hospitals and in 98.6% (699/700) of cases in WM hospitals. Besides, Chinese herbal extract injection was used more frequently in TCM hospitals (491 cases, 82.1%) than in WM hospitals (212 cases, 30.3%) (p < 0.01). At discharge, 818 cases (63.0%) were clinically cured, with a significant difference between the cure rates in TCM (87.6%) and WM hospitals (42.0%) (OR = 9.8, 95% confidence interval (CI): 7.3 ~ 12.9, p < 0.01). Pathogen and previous medical history were more likely associated with the disappearance of rales (OR = 7.2, 95% CI: 4.8 ~ 10.9). Adverse effects were not reported from the medical records. CONCLUSIONS: Intravenous use of antibiotics is highly prevalent in children with community-acquired pneumonia regardless of aetiology. There was difference between TCM and WM hospitals with regard to symptom profile and the use of antibiotics. Intravenous use of herbal injection was higher in TCM hospitals than in WM hospitals. Most of the cases were diagnosed based on clinical signs and symptoms without sufficient confirmation of aetiology. Audit of current practice is urgently needed to improve care.

[Treadmill exercise test in patients with coronary artery myocardial bridging].

OBJECTIVE: To observe treadmill exercise test (TET) characteristics in patients with myocardial bridging (MB). METHODS: TET results from January 2003 to December 2010 were retrospectively analyzed in 156 patients with confirmed MB diagnosis. MB patients were divided into smoking group (68 cases) and non-smoking group (88 cases). Coronary angiography results were used to analyze the relations between MB length, myocardial ischemia and exercising duration. RESULTS: (1) MB was documented on two coronary arteries in 2 patients (1%), MB was detected in single artery in 154 patients (99%), of whom 146 cases were located at left anterior descending artery, 8 cases were located at right coronary artery. The degree of narrowing of MB was graded 1 (less than 50%) in 16 patients (10%), grade 2 (50% to 75%) in 108 patients (69%) and grade 3 (greater than 75%) in 32 patients (21%). The length of MB ranged between 4 to 40 mm, MB length was less than 10 mm in 40 patients (26%), between 11 to 20 mm in 48 patients (31%), between 21 to 30 mm in 44 patients (28%), greater than 31 mm in 24 patients (15%). (2) TET positive rate was 41% (64/156) and the TET positive rate was significantly higher in smoking group than in non-smoking group [57% (39/68) vs. 28% (25/88, P < 0.01)]. (3) The length of MB was positively related to the ST-segment depression (r = 0.723, P < 0.01) and negatively related to exercising duration (r = -0.828, P < 0.01). Heart rate was positively related to the ST-segment depression (r = 0.368, P < 0.01). CONCLUSIONS: TET may serve as a good test to assess myocardial ischemia in patients with MB. The length of MB is positively related with myocardial ischemia and negatively related with exercising duration. Smoking might increase myocardial ischemic incidence in MB patients, MB patients should be advised to stop smoking.

Sap Flow Velocity in Fraxinus pennsylvanica in Response to Water Stress and Microclimatic Variables.

In arid and semiarid regions with water shortage, forestry development is limited by water availability. Understanding how tree sap flow responds to water stress and microclimatic variables is essential for the management of trees and the understanding of the eco-physiological properties of trees in arid areas. In the city of Tianjin in northern China, we measured the sap flow of Fraxinus pennsylvanica, a widely distributed urban greening tree species in semiarid regions of China. We measured the sap flow in four F. pennsylvanica trees over 6 months (April-September 2021), using a thermal diffusion probe method, and simultaneously monitored microclimatic variables and soil moisture. Results indicated that high nighttime sap flow velocity might be produced under the water stress condition. In addition, the nighttime sap flow velocity under the water stress condition was more susceptible to the combined effects of meteorological factors at night. The daytime sap flow velocity exerted a highly significant positive effect on the nighttime sap flow velocity during the whole research period, and the model fit was higher in the early growing season than that in the late growing season (early growing season: R 2 = 0.51, P < 0.01; late growing season: R 2 = 0.36, P < 0.01). Vapor pressure deficit had a positive effect on daytime sap flow. However, net vapor pressure deficit restrained daytime sap flow velocity when the intercorrelation between the microclimatic variables was removed. Our study highlights that drought areas perhaps have higher nighttime sap flow and that more emphasis should be placed on nighttime sap flow and the response of nighttime sap flow to microclimatic variables. In addition, the influence of other microclimatic variables on vapor pressure deficit needs to be considered when analyzing the relationship between daytime sap flow and vapor pressure deficit. An increase in net VPD can suppress the daytime sap flow.

Effects of astragaloside IV on IFN-gamma level and prolonged airway dysfunction in a murine model of chronic asthma.

Astragaloside IV (AST) is the main active constituent of Radix Astragali, a Chinese herb traditionally used to prevent asthma attack from chronic asthma patients. Its efficacy and action mechanisms in asthma attack prevention remain nonetheless to be further explored. In this study, chronic asthma was induced exposing ovalbumin (OVA) sensitized mice to repeated OVA challenges twice every two weeks for 12 weeks. Mice were treated with AST for 4 weeks just after the final challenge. In this murine model of chronic asthma, the airway dysfunction and remodeling remained severe and was accompanied with suppression of the IFN-gamma level in the bronchoalveolar lavage fluid (BALF) even four weeks after the final challenge, indicating that the airway structural changes continued to develop even after interruption of OVA challenges. However, after AST treatment, the airway hyperresponsiveness was sharply relieved, accompanied by the reduction of collagen deposition and mucus production, meanwhile the inflammatory cells were decreased but the IFN-gamma level increased in BALF. In conclusion, AST could prevent the development of chronic asthma, thus reducing asthma attacks. Our results indicated that it should be used as a supplementary therapy on preventing asthma attacks from chronic asthma patients.

[Effect of danshao granule on serum superoxide dismutase activity and malonyldialdehyde content in children with Henoch-Schonlein purpura nephritis].

OBJECTIVE: To explore the effect and mechanism of Danshao Granule (DSG) in treating Henoch-Schonlein purpura nephritis (HSPN) in children. METHODS: The 63 patients with HSPN were randomly divided into two groups. The 32 patients in the treated group were treated with DSG and the 31 patients in the control group were treated with Tripterygium polyglycosides tablet and composite Salviae tablet. The therapeutic course for both groups was one month. The skin purpura, macroscopic hematuria, hypertension and edema subsidence time, 24 hrs urinary protein content, serum levels of immunoglobulins (IgA, IgG, IgM), superoxide dismutase (SOD) activity and malonyldialdehyde (MDA) content were observed before and after treatment. RESULTS: Therapeutic effect in the treated group was better than that in the control group in curing skin purpura and macroscopic hematuria (P < 0.05). The 24 hrs urinary protein content and serum levels of IgA, SOD and MDA were improved after treatment in both groups significantly (P < 0.01). However, the improvement of 24 hrs urinary protein, serum SOD and MDA in the treated group was more significant than that in the control group respectively (P < 0.05). CONCLUSION: DSG can alleviate the injury of free radicals in organism, so it is an ideal remedy for treatment of HSPN.