Clinical features of sleep-disordered breathing in children with neuromuscular disease / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of sleep-disordered breathing (SDB) in children with neuromuscular disease (NMD).@*METHODS@#A retrospective analysis was performed on the medical data of 18 children who were diagnosed with NMD and underwent polysomnography (PSG) (NMD group). Eleven children without NMD who had abnormal sleeping habit and normal sleep structure on PSG were enrolled as the control group. The two groups were compared in terms of the daily and nocturnal symptoms of SDB, incidence rate of obstructive sleep apnea (OSA), pulmonary function, end-tidal partial pressure of carbon dioxide (PetCO@*RESULTS@#In the NMD group, 16 children (89%) had related daily and nocturnal symptoms of SDB, and the youngest age was 1 year at the onset of such symptoms. Compared with the control group, the NMD group had significant reductions in total sleep time and sleep efficiency (@*CONCLUSIONS@#There is a high proportion of children with SDB among the children with NMD, and SDB can be observed in the early stage of NMD, which results in the damage of sleep structure and the reduction in sleep efficiency. Respiratory events are mainly obstructive events, and oxygen reduction events are mainly observed during REM sleep.

Clinical features of influenza with plastic bronchitis in children / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of influenza with plastic bronchitis (PB) in children, and to improve the awareness of the diagnosis and treatment of PB caused by influenza virus.@*METHODS@#A retrospective analysis was performed for the clinical data of 70 children with lower respiratory influenza virus infection from October 2018 to October 2019. According to the presence or absence of PB, they were divided into an influenza+PB group with 12 children and a non-PB influenza group with 58 children. Related clinical data were collected for the retrospective analysis, including general information, clinical manifestations, laboratory examination, imaging findings, treatment, and prognosis.@*RESULTS@#In the influenza+PB group, most children experienced disease onset at the age of 1-5 years, with the peak months of January, February, July, and September. Major clinical manifestations in the influenza+PB group included fever, cough, and shortness of breath. The influenza+PB group had significantly higher incidence rates of shortness of breath and allergic diseases such as asthma than the non-PB influenza group (P<0.05). Of the 12 children in the influenza+PB group, 7(58%) had influenza A virus infection and 5 (42%) had influenza B virus infection, among whom 1 had nephrotic syndrome. For the children in the influenza+PB group, major imaging findings included pulmonary consolidation with atelectasis, high-density infiltration, pleural effusion, and mediastinal emphysema. Compared with the non-PB influenza group, the influenza+PB group had a significantly higher proportion of children who were admitted to the pediatric intensive care unit (P<0.05). Bronchoscopic lavage was performed within 1 week after admission, and all children were improved and discharged after anti-infective therapy and symptomatic/supportive treatment.@*CONCLUSIONS@#Influenza with PB tends to have acute onset and rapid progression, and it is important to perform bronchoscopy as early as possible. The possibility of PB should be considered when the presence of shortness of breath, allergic diseases such as asthma or nephrotic syndrome in children with influenza.

Clinical value of continuous monitoring of fraction of exhaled nitric oxide in childhood asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate changes in the fraction of exhaled nitric oxide (FeNO) in childhood asthma, and to evaluate the clinical value of continuous monitoring of FeNO.</p><p><b>METHODS</b>Twenty children with mild to moderate asthma were enrolled from the special outpatient clinic for asthma. Follow-up was performed at 8, 16, 24, 32 and 40 weeks after treatment. At each follow-up, asthmatic symptoms were recorded, pulmonary function was evaluated and FeNO was measured.</p><p><b>RESULTS</b>The mean FeNO decreased rapidly 8 weeks after treatment and slowly afterwards. It decreased significantly 8,16,24 and 40 weeks after treatment (P<0.01). It increased significantly during acute attacks of asthma and decreased rapidly during periods of remission. There was significant negative correlation between FeNO and forced expiratory volume in one second (r =-0.193 P<0.05). The receiver operating characteristic curve of FeNO showed that FeNO had a sensitivity of 87.9% and a specificity of 80% for uncontrolled asthma when FeNO was 35.5 ppb, and that it had a sensitivity of 97% and a specificity of 27.1% when FeNO was 20.5 ppb.</p><p><b>CONCLUSIONS</b>monitoring of FeNO can be used to evaluate the control level of airway inflammation in childhood asthma. When FeNO is less than 20.5 ppb, airway inflammation may be well controlled. When FeNO is more than 35.5 ppb, airway inflammation may be out of control. A sharp increase in FeNO suggests the possibility of acute asthma attack in children.</p>

Pulmonary function of healthy children at ages of 1-48 months in Shenzhen area / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the development of pulmonary function of healthy children between 1-48 months.</p><p><b>METHODS</b>A total of 295 healthy children at ages of 1-48 months were classified into 7 groups according to their age, i.e., 1-2 months, 3-4 months, 5-7 months, 8-12 months, 13-24 months, 25-36 months, and 37- 48 months. Pediatric pulmonary function laboratory type 2600 (Sensor Medics Corporation USA) was used to detect tidal flow volume curve, which can partially replace the maximum expiratory flow volume curve and reflect airway ventilation function. Passive expiratory flow volume technique was used to examine respiratory system static compliance and total airway resistance. Open nitrogen washout method was used to measure functional residual capacity.</p><p><b>RESULTS</b>The values of tidal, peak tidal expiratory flow, and respiratory system static compliance functional residual capacity increased with the increasing age and were significantly different among the 7 groups. However, respiratory rate and total airway resistance decreased with the increased age. The value of each parameter of tidal flow volume curve was stable during 1-48 months.</p><p><b>CONCLUSIONS</b>This study displayed the developmental characteristics of pulmonary function of healthy children at ages of 1-48 months, which is useful to observe the changes of pulmonary function in respiratory diseases.</p>