Mycoplasma pneumoniae pneumonia complicated with Legioneila pneumophila infection in 29 children / 中华实用儿科临床杂志

Objective To summarize the clinical features of mycoplasma pneumoniae pneumonia(MPP) complicated with legionella pneumophila(LP) infection in children.Methods Sixty-two cases of MPP were admitted in the Department of Pediatrics,the Sixth People's Hospital of Shanghai Affiliated to Shanghai Jiaotong University from Aug.2011 to Feb.2012 were enrolled.Serum antibodies of MP(IgM,IgG) were determined by passive agglutination method and serum antibody(IgM) of LP serogroup-1 was detected by indirect immunofluorescence method.The patients were divided into 2 groups(29 patients in MPP group complicated with LP infection and 33 patients in MPP group).Gender,age,clinical symptoms,duration of hospitalization,extra pulmonary complications and chest iconography were compared between the 2 groups.The SAS 6.12 software was used to analyze the data.Results Of the children in MPP complicated with LP infection group and MPP group,29 cases and 33 cases(100.0％,100.0％) had cough and fever,23 cases and 21 cases(79.3％,63.6％) had pulmonary crackles and(or) wheezing,6 cases and 12 cases(20.7％,36.4％) had no pulmonary signs,21 cases and 16 cases (72.4％,48.5％)had extra pulmonary complications.Chest X-ray (or/and chest CT)revealed bronchopneumonia in 18 cases and 22 cases (62.1％,66.7％),lobar pneumonia in 8 cases and 8 cases (27.6％,24.2％),interstitial pneumonia in 0 case and 2 cases (0.0,6.1％),atelectasis in 2 cases and 0 case(6.9％,0.0),and pleural effusion in 1 case and 1 case(3.4％,3.0％).Compared with MPP group,the significant differences were found in febrile days,cough days,pulmonary rales duration and length of stay in MPP with LP infection group(all P ＜ 0.05).The number of elevated CRP cases and granulocytopenia in the MPP group with LP was higher than that in the MPP group(P ＜ 0.05).But no significant difference was found in gender,age,the cases of pulmonary rales or the chest iconography type(all P ＞ 0.05).Conclusions Compared with MPP children,MPP with LP children had longer febrile and cough days,severe pulmonary rales and duration of hospitalization.The clinical symptoms and signs were much severe in MPP patients with LP infection patients.

Effects of andrographolide on the expression of eosinophil granulocytes and possible mechanisms / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Andrographolide, the active component in andrographis paniculata, has potent anti-inflammatory actions. This study aimed to evaluate the effects of andrographolide on eosinophil granulocytes (EOS) and the expression of eotaxin and IL-5 in mice with asthma.</p><p><b>METHODS</b>BALB/c mice were randomly assigned into normal control, asthma, budesonide treatment and andrographolide treatment groups (n=8 each). Mice in the latter three groups were sensitized and challenged with ovalbumin (OVA) to induce asthma. ELISA was used to detect the concentrations of eotaxin and IL-5 in bronchoalveolar lavage fluid (BALF) and peripheral blood. The expression of eotaxin mRNA and IL-5 mRNA in lung tissues was detected by real-time quantitative PCR.</p><p><b>RESULTS</b>Andrographolide treatment significantly decreased EOS count in BALF (P<0.05) and the effect of andrographolide was better than the effect of budesonide. Andrographolide treatment significantly down-regulated the expression of eotaxin and IL-5 in BALF, lung eotaxin mRNA expression and blood IL-5 expression (P<0.05), but the effects of andrographolide were poorer than the effects of budesonide. Andrographolide treatment resulted in a decrease in blood eotaxin expression and lung IL-5 mRNA expression and the effects of andrographolide were similar to budesonide.</p><p><b>CONCLUSIONS</b>Andrographolide can down-regulate the expression of IL-5 and eotaxin and thus suppress the inflitration of EOS in a mouse model of asthma.</p>

Pulmonary functions in children with segmental Mycoplasma pneumoniae pneumonia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the changes of pulmonary functions in children with segmental Mycoplasma pneumoniae pneumonia (SMPP).</p><p><b>METHODS</b>A total of 55 children with SMPP were recruited into this study. Pulmonary functions were measured at both acute and recovery phases, including FVC, FEV1, FEV1/FVC, PEF, FEF25%, FEF50%, FEF75% and FEF25%-75%.</p><p><b>RESULTS</b>FVC, FEV1, FEV1 /FVC, PEF, FEF25%, FEF50%, FEF75%, and FEF25%-75% were reduced in all of the 55 cases at the acute phase. FEF25%, FEF50%, FEF75% and FEF25%-75% decreased more significantly. The indexes above mentioned were improved significantly at the recovery phase compared with the acute phase (P<0.05). During the acute phase FVC and FEV1 decreased more significantly in the group with multiple area lesions than in the group with single area lesions (P<0.05).</p><p><b>CONCLUSIONS</b>Both large and small airway functions are damaged in different degrees in children with SMPP during the acute phase. More cases show restrictive ventilatory disorders and the injury of small airway function is more severe. The pulmonary function is markedly improved at the recovery phase, suggesting that the pulmonary function impairments are reversible. The pulmonary function impairments are more severe in children with multiple area lesions.</p>

Expressions of Chemokine Receptor CXCR3 and Its Ligand Interferon-?-Inducible Protein-10 in Lung Tissue of Asthmatic Model Mice and Their Significances / 实用儿科临床杂志

Objective To observe the expressions of the chemokine receptor CXCR3 and its ligand IFN-?-inducible protein-10(IP-10) in lung tissue of asthmatic model mice and to explore further the effect of dexamethasone(DEX)and bacillus Calmette-Guerin vaccine(BCG)on the expressions of CXCR3 and IP-10.Methods Forty Kunming mice were randomly divided into 4 groups:asthmatic group,DEX group,BCG group and control group,10 in each group.Mice were sensitized and challenged with ovalbumin (OVA) to establish asthmatic models.Ten mice in DEX group were administrated DEX (2 mg/kg) by abdomen injection 30 min before challenge (DEX group).Ten mice in BCG group were injected BCG(0.025 mg) intradermally 7,3,and 1 days before sensitization.The mice in control group mice were treated with 9 g/L saline instead of OVA.Mice of each group were executed 24 hours after the final challenge.Their lung tissue were paraffin embedded,sliced and stained by HE.The expressions of CXCR3 and IP-10 protein in lung tissue of mice were detected by immunohistochemistry.Results Distinct differences were discovered in the expressions of CXCR3(F=4.602 P=0.008) and IP-10(F=4.207 P=0.012) among the 4 groups.The expressions of CXCR3 and IP-10 in lung tissue of mice in asthmatic group were significantly higher than those in control group (Pa=0.002),while that in DEX group were significantly lower than that in asthmatic group (P=0.029,0.019).There were no significant difference between the BCG group and asthmatic group.Conclusions The chemokine receptor CXCR3 and its ligand IP-10 play an important roles in mechanisms in the pathogenesis of asthma.DEX and BCG can interfere the expressions of CXCR3 and IP-10 in varying degress.

Effects of Family Allergic History and Dermatophagoides Farina on Expression of Th1/Th2 Cytokine of Cord Blood and Allergic Disorders in Infancy / 实用儿科临床杂志

Objective To investigate the effects of family allergic history and dermatophagoides farina on the expressions of Th1/Th2 cytokine of cord blood and allergic disorders in infancy.Methods Ten mil cord blood were obtained from 34 neonates which 17 cases had family allergic history and 17 cases didn′t have.Cord blood mononuclear cells(CBMC) were isolated by gradient centrifugation with Ficoll and were cultured with phytohemagglutinin(PHA) or dermatophagoides farina for 48 hours in vitro.The expressions of interleukin(IL-4) and interferon(IFN-?) of the culture supernatant were detected by enzyme-linked immunosorbent assay(ELISA).Two groups were visited with telephone or clinical service every 1 or 2 months in 1 year follow-up survey.Results In no stimulation,the expressions of IL-4 of family allergic history and no family allergic history were(11.35?1.80) ng/L and(11.0?1.50) ng/L,respectively,there was no significant difference.The expressions of IFN-? were(9.55?1.47) ng/L and(10.19?1.37) ng/L,respectively,there was no significant difference also.In PHA stimulation,the expressions of IL-4 were(43.45?4.57) ng/L and(37.58?3.41) ng/L,respectively,there was significant difference.The expressions of IFN-? were(72.61?25.40) ng/L and(65.84?29.96) ng/L,respectively,there was no significant diffe-rence.In low density dermatophagoides farina stimulation,the expressions of IL-4 were(40.54?3.64) ng/L and(37.17?2.60) ng/L,respectively,which had significant difference.The expressions of IFN-? were(35.30?2.73) ng/L and(40.55?1.85) ng/L,respectively,which had significant difference.In high density dermatophagoides farina stimulation,the expressions of IL-4 were(43.50?3.19) ng/L and(39.55?4.13) ng/L,respectively,which had significant difference.The expressions of IFN-? were(39.40 ?5.21) ng/L and(40.94?2.96) ng/L respectively,which had no significant difference.Allergic diseases were happened in 7 cases of 13 cases with family allergic history and in 2 cases of 15 cases without family allergic history in 1 year follow-up except lost follow-up cases.There were significant difference in 2 groups.Conclusions Th2 cells of cord blood are relative dominant in neonates having family allergic history.Th2 cells relative dominant are more obvious in dermatophagoides farina stimulation.The neonates having family allergic history have a tendency to get allergic diseases in childhood.

Drug Sensitive Analysis of 207 Strains of Staphylococcus Aureus in Children / 实用儿科临床杂志

Objective To analyze the changes of the frequency of staphylococcus aureus (SAU) and methicillin resistant staphylococcus aureus (MRSA) isolated from hospitalized children from 2003 to 2006,and investigate the 21 antimicrobial susceptibility against SAU strains for providing reference for clinical rational use of drug.Methods The SAU strains were isolated from 207 children who were hospitalized in department of pediatrics of the sixth people′s hospital affiliated to Shanghai jiaotong university from Jan.2003 to Dec.2006 during the first 48 h of hospital stay.Strains were isolated from cotton-tipped swab of throat culture 75 strains,sputum culture 57 strains,secretion of bellybutton culture 25 strains,liquor puris culture 23 strains,hemoculture 20 strains,tube thoracostomy culture 3 strains,middle piece urnary culture 3 strains,cerebrospinal fluid culture 1 strain.The strains were identified by latex agglutination test,the in vitro activities of the 21 antimicrobial agents against 207 SAU isolates was tested by disc diffusion test (K-B method) according to the guidelines of the clinical and laboratory standards institute.MRSA was screened by oxacillin disc diffusion test.The data were analyzed by WHONET 5 software,Cochran-Mantel-Haenszel was used to analyze the tendency of SAU isolating rate and MRSA detectable rate.Results Of these SAU,30 strains(14.5 %) isolates were MRSA and 177 strains(85.5 %) were methicillin sensitive staphylococcus aureus.The sensitive rates of SAU to Penicilin,Oxacillin,Cefuroxime Sodium,Cefotaxime,Ceftriaxone,Erythromycin,Clindamycin,Trimethoprim/Sulfamethoxazole,Ciprofloxacin,Fosfomycin and Rifampin were 4.8%,85.5%,84.9%,90.0%,88.3%,37.5%,46.3%,92.7%,74.2%,97.2%,94.0%,respectively.All the strains were sensitive to peptide antibiotic(for instance,vacomycin and teicoplanin) and Levofloxacin.The SAU isolated rate and MRSA detectable rate were 9.6%,19.8%,25.0%,39.5% and 5.0%,5.9%,12.7%,24.7% in 2003-2006,respectively.Conclusions SAU has strong resis-tance to Penicilin and Erythromycin,but relative sensitive to Oxacillin and Cephalosporin.The SAU isolatating rate and MRSA resistant rate is increased in our area,pediatrics should to strengthen the monitoring of SAU is important in pediatrics.