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Group A Streptococcus (GAS) is a very important pathogen, especially for children.On a global scale, GAS is an important cause of morbidity and mortality.But the burden of disease caused by GAS is still unknown in China and also has not obtained enough attention.For this purpose, the expert consensus is comprehensively described in diagnosis, treatment and prevention of GAS diseases in children, covering related aspects of pneumology, infectiology, immunology, microbiology, cardiology, nephrology, critical care medicine and preventive medicine.Accordingly, the consensus document was intended to improve management strategies of GAS disease in Chinese children.
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Objective:To study the value and advantage of color Doppler and cervical multi-slice spiral CT (MSCT) in the diagnosis of cervical lymphadenopathy.Methods:A total of 130 patients with cervical lymphadenopathy diagnosed and treated in the Chenzhou First People′s Hospital from January 2019 to December 2020 were selected and received color Doppler ultrasound examination and MSCT examination. The results of pathological examination were used as the gold standard to compare the efficacy of the two methods in the differential diagnosis of benign and malignant cervical lymphadenopathy.Results:Ultrasound examination of malignant lymph nodes showed irregular boundaries, uneven internal hypoecho, and abundant blood flow signals in lymph nodes; ultrasound examination of benign lymph nodes showed uniform fine dot echo, uniform growth of endothelial medulla, clear and smooth boundary, no blood flow signal or scattered dot blood flow signal. The MSCT images of malignant lymph node showed irregular shape, blurred edge, obvious and uneven enhancement and higher rate of calcification. The aspect ratio of lymph nodes in benign lymph node was significantly higher than that in malignant lymph node (2.14 ± 0.48 vs. 1.92 ± 0.43), and the maximum blood flow velocity (V max), resistance index (RI) and blood flow (BF) in systolic period were significantly lower than those in lymph node [(21.38 ± 3.61) cm/s vs. (23.17 ± 2.55) cm/s, 0.62 ± 0.14 vs. 0.71 ± 0.17, (48.82 ± 13.51) ml/(min·100 g) vs. (65.61 ± 14.64) ml/(min·100 g)], there were statistical differences ( P<0.05). The most common blood flow types was lymphatic hilum type in benign lymph node, the proportion was 51.79% (29/56), while the most common type in malignant lymph node was marginal type and central type, the proportion was 44.59% (33/74) and 25.68% (19/74). The sensitivity, specificity, accuracy and Kappa value of ultrasound combined with MSCT in diagnosis were 92.86%, 95.95%, 94.62% and 0.890. Conclusions:Both color Doppler ultrasonography and MSCT can differentiate the benign and malignant of cervical lymph node lesions with better parameters such as lymph node imaging characteristics and blood flow distribution pattern, but the combined diagnosis has higher sensitivity, specificity and accuracy.
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Acute respiratory tract infection is the most common infectious disease in children, which seriously threatens children′s health.Rapid and accurate etiological diagnosis is of great significance for the clinical treatment and control of these diseases.Pathogen nucleic acid test was applied and became the main method of respiratory tract infection diagnosis for its high sensitivity and specificity.To regulate the application of pathogen nucleic acid amplification test in respiratory tract infection in children, improve the diagnosis level, expert consensus on nucleic acid amplification test of respiratory pathogens in children was prepared to guide the application and promote pathogens diagnosis ability.
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BACKGROUND@#Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease.@*OBJECTIVE@#This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m@*MAIN OUTCOME MEASURES@#The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment.@*RESULTS@#A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group.@*CONCLUSION@#SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone.@*TRIAL REGISTRATION NUMBER@#NCT02063100 on ClinicalTrials.gov.
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Antibiotic-associated diarrhea(AAD) is a frequent adverse effect of antibiotic in children.AAD is associated with longer hospitalization, higher healthcare cost and even lead to death.Pediatricians usually do not pay enough attention to AAD.Domestic experts from pulmonary medicine, infection and gastroenterology are organized to develop the consensus, to improve the diagnosis, treatment and prevention of AAD, and contribute the children health in future.
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Objective:To explore the value of tidal lung function in distinguishing central and small intrathoracic airway obstructive lesions.Methods:A total of 124 infants with intrathoracic obstructive diseases, including bronchiolitis obliterans (BO), bronchiolitis, airway foreign body, and airway stenosis, were confirmed in Children′s Hospital of Chongqing Medical University from April 2014 to June 2019 and selected as subjects, and 111 normal infants were enrolled as healthy control group.According to the location of lesions, these subjects suffering from intrathoracic obstructive diseases were divided into small airway lesion group(BO, bronchiolitis) and central airway lesion group(airway foreign body, airway stenosis). Lung function was assessed by plethysmography.Results:As for the ratio of time to reach peak tidal expiratory flow to total expiratory time (TPTEF/TE) and the ratio of volume to reach peak tidal expiratory flow to total expiratory volume (VPTEF/VE), all disease groups were lower than that in healthy control group TEF/TE: BO 13.2(10.3, 16.3)%, bronchiolitis 15.9 (13.2, 19.7)%, airway foreign body 24.5 (16.7, 30.7)%, airway stenosis 20.7 (16.1, 29.3)%, healthy control group 30.2(25.6, 36.5)%; VPTEF/VE: BO 18.2(17.8, 22.3)%, bronchiolitis 20.3(17.0, 21.6)%, airway foreign body 26.0(20.5, 30.7)%, airway stenosis 22.9(20.2, 29.1)%, healthy control group 31.5(28.1, 37.0)%]( P<0.05) and the lesion in the small airway lesion group was significantly lower than that in central airway lesion group.Compared with the healthy control group, the functional residual capacity (FRC)was higher in each disease group[BO (501.6±166.5) mL, bronchiolitis (334.6±149.6) mL, airway foreign body (392.2±130.1) mL, airway stenosis (350.1±127.9) mL, healthy control group (191.6±73.8) mL]( P<0.05). The ratio of peak expiratory flow to tidal expiratory flow at 25% remaining expiration(PF/TEF 25) was obviously higher in small airway lesion group than that in central airway lesion and healthy control group [BO 232.7(183.2, 261.2)%, bronchiolitis 186.4 (153.3, 247.7)%, airway foreign body 143.1(126.8, 168.9)%, airway stenosis 140.3(122.9, 186.0)%, healthy control group 132.3 (123.1, 147.8)%] ( P<0.05), while no significant differences were found between central airway lesion group and healthy control group ( P>0.05). There were no significant differences in effective airway resistance among all groups ( P>0.05). The tidal breathing flow volume (TBFV) curve shape of small airway lesion group showed the depression of expiratory phase to the transverse axis, while the slope of descending branch of expiratory phase had no significant increase in central airway lesion group. Conclusions:Combined with the increase in PF/TEF 25, the decrease in TPTEF/TE and VPTEF/VE is the characteristic of small airway obstruction.PF/TEF 25 is a sensitive index reflecting small airway obstruction.Combined with the value of lung function parameters, the shape of TBFV is helpful to distinguish central and small airway obstructive lesions.
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OBJECTIVE@#To study the detection rate, epidemic pattern, and clinical features of respiratory syncytial virus (RSV) in hospitalized children with acute lower respiratory infection (ALRI).@*METHODS@#Nasopharyngeal aspirates were collected from children with ALRI, aged < 2 years, who were hospitalized in Children's Hospital of Chongqing Medical University from June 2013 to May 2018. Multiplex PCR was used to detect 16 common respiratory viruses. The epidemiological characteristics of RSV were analyzed.@*RESULTS@#A total of 2 066 hospitalized children with ALRI were enrolled. Among the children, 1 595 (77.20%) tested positive for virus and 826 (39.98%) tested positive for RSV [410(49.6%) positive for RSV-A, 414 (50.1%) positive for RSV-B, and 2 (0.2%) positive for both RSV-A and RSV-B]. RSV-B was the main subtype detected in 2013-2014 and 2016-2017, while RSV-A was the main subtype in 2014-2015 and 2017-2018, and these two subtypes were prevalent in 2015-2016. The highest detection rate of RSV was noted in winter. RSV + human rhinovirus was the most common combination of viruses and was detected in 123 children. These children were more likely to develop wheezing than those with single RSV detected (@*CONCLUSIONS@#In Chongqing in 2013-2018, RSV-A and RSV-B not only can predominate alternately, but also can co-circulate during a season. RSV is the major viral pathogen of hospitalized children with ALRI and can cause severe lower respiratory tract infection. There are no differences in clinical manifestations between children with RSV-A infection and those with RSV-B infection, but boys are more susceptible to RSV-A infection.
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Enfant , Enfant d'âge préscolaire , Femelle , Humains , Nourrisson , Mâle , Enfant hospitalisé , Chine/épidémiologie , Infections à virus respiratoire syncytial/épidémiologie , Virus respiratoire syncytial humain , Infections de l'appareil respiratoire/épidémiologieRésumé
At present, effective antibiotics and comprehensive symptomatic/supportive treatment as early as possible are mainly used for the treatment of severe pertussis in clinical practice. However, some children with severe pertussis have unsatisfactory response to commonly used drugs and treatment measures in the intensive care unit and thus have a high risk of death. Studies have shown that certain treatment measures given in the early stage, such as exchange transfusion, may help reduce deaths, but there is still a lack of uniform implementation norms. How to determine the treatment regimen for severe pertussis and improve treatment ability remains a difficult issue in clinical practice. This article reviews the advances in the treatment of severe pertussis, in order to provide a reference for clinical treatment and research.
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Enfant , Humains , Antibactériens , Exsanguinotransfusion , Coqueluche/traitement médicamenteuxRésumé
OBJECTIVE@#To explore the value of leukotriene D4 (LTD4) bronchial provocation test (BPT) in detection of airway hyper-responsiveness (AHR) in children.@*METHODS@#A total of 151 children aged 6 to 14 years, including 86 in remission of asthma and 65 with acute bronchitis, who were followed up in our respiratory clinic between November, 2017 and August, 2018. The children were randomly divided into LTD4 group (78 cases) and methacholine (MCH) group (73 cases). In LTD4 group, the 78 children underwent LTD4-BPT, including 46 with asthma and 32 children having re-examination for previous episodes of acute bronchitis; in MCH group, the 73 children underwent MCH-BPT, including 40 with asthma and 33 with acute bronchitis. MCH-BPT was also performed in the asthmatic children in the LTD4 group who had negative responses to LTD4 after an elution period. The major adverse reactions of the children to the two BPT were recorded. The diagnostic values of the two BPT were evaluated using receiver-operating characteristic (ROC) curve.@*RESULTS@#There was no significant difference in the results of basic lung function tests between LTD4 group and MCH group (>0.05). The positive rate of BPT in asthmatic children in the LTD4 group was significantly lower than that in the MCH group (26.1% 72.5%; < 0.05). The positive rate of BPT in children with previous acute bronchitis in the LTD4 group was lower than that in the MCH group (3.1% 15.2%). The positive rate of MCH-BPT in asthmatic children had negative BPT results in LTD4 group was 58.8%, and their asthma was mostly mild. The sensitivity was lower in LTD4 group than in MCH group (0.2609 0.725), but the specificity was slightly higher in LTD4 group (0.9688 vs 0.8485).The area under ROC curvein LTD4 group was lower than that in MCH group (0.635 0.787). In children with asthma in the LTD4 group, the main adverse reactions in BPT included cough (34.8%), shortness of breath (19.6%), chest tightness (15.2%), and wheezing (10.9%). The incidence of these adverse reactions was significantly lower in LTD4 group than in MCH group ( < 0.05). Serious adverse reactions occurred in neither of the two groups.@*CONCLUSIONS@#LTD4-BPT had high safety in clinical application of children and was similar to the specificity of MCH-BPT. However, it had low sensitivity, low diagnostic value, and limited application value in children's AHR detection.
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Adolescent , Enfant , Humains , Asthme , Tests de provocation bronchique , Leucotriène D4 , Chlorure de méthacholine , Hypersensibilité respiratoireRésumé
Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.
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Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases.Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic.Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection.This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities.The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.
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Refractory pulmonary disease is a respiratory disease that seriously threatens the health of patients, and can lead to impaired pulmonary function and even respiratory failure.Currently, conventional drug therapy does not work well, so it is particularly important to find more effective treatments.Mesenchymal stem cells(MSCs) are a kind of multifunctional stem cells, which can promote the repair of damaged cells by regulating inflammatory and immune reactions and boost the regeneration of damaged tissues through paracrine.Therefore, MSCs are expected to provide a possibility for the treatment of refractory lung pulmonary diseases.
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Objective:To evaluate the enrollment rate, mutation rate and causes of variability the clinical pathway of bronchopneumonia.Methods:The enrollment rate, completion rate, variation and reasons of the clinical pathway in Beijing Children′s Hospital, Capital Medical University from January 2012 to December 2016 were retrospectively collected.Data of patients after the clinical pathway of bronchopneumonia in other tertiary class A hospitals were gathered by questionnaires, and the enrollment rate, completion rate, variation rate and reasons were analyzed.Results:(1)At the end of 2016, 11 of the 13 hospitals included in this study had implemented the clinical pathway for 5 years, 1 hospital for 3 years, and 1 hospital for 2 years.(2) Eleven hospitals provided their enrollment rates.The enrollement rate of 2 hospitals was<50%, and that of 9 hospitals was>80%.The annual completion rate of Beijing Children′s Hospital was ≥75%, and the completion rates offered by 8 hospitals were basically >70%.(3) Since the implementation of the clinical pathway for 5 years in Beijing Children′s Hospital, a total of 427 cases were enrolled of which 93 cases were mutated (variability 21.78%). The variability of 5 hospitals was maintained at <15%.The variability of 3 hospitals decreased with the implementation years, and became qualified.The variability of 1 hospital first rebounded and then controlled; 1 hospital increased by 27.65%; 1 hospital was first controlled and rebounded; 1 hospital was always >15%.The main cause of the mutation was coexisting diseases, complications, progression of the disease, or correction of the first diagnosis, etc.Conclusions:The completion rate of tertiary class A hospitals meets the requirements of national policy.However, the enrollment rate needs to be improved, and the variation rate among different hospitals differs a lot.Further implementation of the clinical pathway should be strengthened and monitored.
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Objective:To explore the value of airway responsiveness measurement by the tidal lung function test combined with the bronchial provocation test (BPT) in the diagnosis of infant cough variant asthma (CVA), and to provide evidence for clinical diagnosis of CVA.Methods:The tidal lung function test and BPT test results of 131 cases of chronic cough (including 70 CVA cases and 61 non-CVA cases) treated in the Asthma Specialist Clinic of Children′s Hospital Affiliated to Chongqing Medical University from January 2018 to September 2018 were retrospectively analyzed.The results between CVA group and non-CVA group were compared.Results:There was no significant difference in the basal tidal lung function detection results between the CVA group and non-CVA group ( P>0.05). The positive rate of BPT in the CVA group was significantly higher than that in the non-CVA group (98.6% vs. 27.9%, χ2=30.757, P<0.01). Among the patients with positive BPT, the proportion of patients with moderate and severe positive reactions in the CVA group was significantly higher than that in the non-CVA group (40.0% vs. 3.3%, 15.7% vs. 0, χ2=24.894, 20.464, all P<0.01). During BPT test process, a significantly greater number of patients showed wheezing and a significant decrease in oxygen saturation(SpO 2) in the CVA group than in the non-CVA group (50.0% vs.0, 91.4% vs.45.9%, χ2=32.169, 36.544, all P<0.01), while the number of patients with severe cough and shortness of breath was similar in both groups (all P>0.05). After the application of bronchodilator or oxygen inhalation, the symptoms of polypnea and wheezing disappeared in all children.The values of the ratio of the time to reach peak tidal expiratory flow to total expiratory time[(TPTEF/TE)%] and the ratio of the volume required to reach peak tidal expiratory flow to total expiratory volume[(VPTEF/VE)%] recovered to more than 80% of the basic values and SpO 2 up to 95%. Conclusions:The tidal lung function test combined with the BPT test is of certain significance for the diagnosis and differential diagnosis of CVA infants.CVA can be better diagnosed based on the degree of BPT and the clinical manifestations during the course of the test.
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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.
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Cefpodoxime proxetil(CPDX-PR) is the third generation cephalosporin with high oral efficiency.It has strong anti-gram negative bacteria and-gram positive bacteria effects, with wide tissue distribution, long plasma half-time(T1/2), stable to lactamase, good tolerance, small therapeutic dose, few times of administration, definite cli-nical efficacy and other advantages.It is recommended for application in the treatment guidelines of foreign children with various infectious diseases.It is of great clinical significance to discuss the rational application of CPDX-PR oral preparation under the condition of severe bacterial drug resistance.This article reviews the pharmacological characteristics of CPDX-PR and the research progress in the treatment of common infectious diseases in pediatrics, so as to promote the research on the rational clinical application of CPDX-PR in China.
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OBJECTIVE@#To investigate the constitution of causes of chronic cough in children.@*METHODS@#The clinical data of 202 children with chronic cough who were hospitalized in the Affiliated Children's Hospital of Chongqing Medical University from May 2015 to November 2017 were retrospectively analyzed.@*RESULTS@#As for the causes of chronic cough in the 202 children, 81 (40.1%) had post-infection cough (PIC), 71 (35.1%) had cough variant asthma (CVA), 43 (21.3%) had upper airway cough syndrome (UACS), 3 (1.5%) had foreign body aspiration, 1 (0.5%) had gastroesophageal reflux cough, 2 (1.0%) had Tourette syndrome, and 1 (0.5%) had congenital respiratory disorders. Of the 202 children, 119 (58.9%) had chronic cough caused by a single factor and 83 (41.1%) had chronic cough caused by multiple factors. There was a significant difference in the constitution of causes of chronic cough among the children with different ages (<1 year, ≥1 year, ≥3 years and 6-14 years) or natures of cough (wet cough and dry cough) (P<0.01).@*CONCLUSIONS@#The top three causes of chronic cough in children are PIC, CVA and UACS. There are significant differences in the main causes of chronic cough between children with different ages and between those with different natures of cough.
Sujets)
Enfant , Humains , Asthme , Chine , Maladie chronique , Toux , Études rétrospectivesRésumé
OBJECTIVE@#To study the clinical features of children with bronchial asthma complicated by pulmonary fungal infection and the risk factors for pulmonary fungal infection.@*METHODS@#A retrospective analysis was performed for the clinical data of 150 children with bronchial asthma who were admitted from January 2015 to June 2018. Among these children, 75 had pulmonary fungal infection (fungal infection group) and 75 did not have such infection (control group). The distribution of pathogenic fungi, clinical symptoms/signs and treatment outcome were recorded for the fungal infection group. The multivariate logistic regression analysis was used to investigate the risk factors for pulmonary fungal infection.@*RESULTS@#A total of 69 pathogenic fungi were detected in 75 children in the fungal infection group, among which Candida albicans had the highest detection rate of 61%. Major clinical symptoms were cough (93%), persistent high fever (56%), wheezing (49%) and dyspnea (48%). Major signs were dry and moist rales (43%) and moist rales (29%). Parts of children had hepatosplenomegaly. Among the 75 children in the fungal infection group, 39 were markedly improved, 26 were improved, 7 had no response, and 3 experienced aggravation and then died. Age 3 times during hospitalization, intravenous administration of glucocorticoids, non-rational use of antibiotics, mechanical ventilation and prolonged hospital stay were independent risk factors for pulmonary fungal infection in children with asthma (OR=4.865, 3.241, 2.255, 3.725, 3.568, 1.549, 3.808; P3 times during hospitalization, intravenous administration of glucocorticoids, non-rational use of antibiotics, mechanical ventilation or prolonged hospital stay have a higher risk for secondary pulmonary fungal infection.
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Enfant , Humains , Asthme , Mycoses pulmonaires , Études rétrospectives , Rhinite allergique , Facteurs de risqueRésumé
Objective To preliminarily validate the clinical usability of the ameliorated Kawashima Itch Scale(Xie-Kawashima Itch Scale) among adult pruritic patients on maintenance hemodialysis. Methods Xie-Kawashima Itch Scale was developed on the basis of Kawashima Itch Scale. Patients were asked to record their pruritus condition according to Xie-Kawashima Itch Scale or visual analogue scale(VAS) during daytime and night for two weeks. The record at the second week was used for analyzing the correlation between Xie-Kawashima Itch Scale and VAS. Results Totally 134 patients were enrolled in this study,among whom 128 entered the final analysis. Xie-Kawashima Itch Scale was positively correlated with VAS(r=0.832,95% CI=0.810-0.851,P<0.01 for daytime record;and r=0.848,95% CI=0.828-0.865,P<0.01 for night record). Subgroup analysis also showed similar correlations between different age groups and among different gender groups. Conclusion Xie-Kawashima Itch Scale has good correlation with VAS in patients on hemodialysis,without being affected by age or gender. Thus,it can be a useful tool for the assessment of pruritus in clinical practice and research.
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Bronchopulmonary dysplasia(BPD)is the most common chronic respiratory disease in premature in-fants,there is a lack of effective treatment now. In recent years,animal studies showed that treatment of mesenchymal stem cells (MSCs)can ameliorate hyperoxia-induced lung injury by promoting the restoration of alveolar epithelium and reducing the inflammation of lung through regeneration,paracrine and immunomodulatory,moreover,there has been a clinical trial shows that MSCs in the treatment of BPD is safe and feasible. Which may benefit the recovery of BPD and bring a hope for radical treatment of BPD. Now,focusing on the biological characteristics of MSCs,the mechanism and application of MSCs in the treatment of BPD in animal models and clinical trials as well as the existing problems in the latest research were reviewed.