[Investigation on cognition, diagnosis and treatment status of chest tightness variant asthma among Chinese pediatricians].

Objective: To evaluate the awareness, diagnosis and treatment of chest tightness variant asthma (CTVA) among pediatricians in China. Methods: The survey was conducted by convenient sampling method. Pediatricians with professional title of attending physician and above from different grades hospitals in 30 provinces were invited to conduct online questionnaire surveys through WeChat, pediatricians scan QR codes to complete electronic questionnaires in the mini program from January 16th to February 4th, 2021. The contents of questionnaire included the awareness, diagnosis and treatment of CTVA, and comparing the differences between pediatricians in secondary hospitals and tertiary hospitals. Results: A total of 1 529 pediatricians participated in the survey, and 1 484 (97.06%) pediatricians completed the questionnaire and included in the analysis, including 420 males (28.30%). The awareness rate of CTVA among pediatricians was 77.83 % (1 155/1 484). Pediatricians in tertiary hospitals had higher rates of awareness of CTVA than pediatricians in secondary hospitals [81.86% (898/1 097) vs 66.41% (257/387), P<0.001] and had better execution of the guidelines [89.15% (978/1 097) vs 79.59% (308/387), P<0.001]. A total of 93.06 % (1 381/1 484) of pediatricians' first-line treatment included inhaled corticosteroids (ICS) for CTVA. Among them, a higher proportion of pediatricians in tertiary hospitals used ICS included regimens for first-line treatment of CTVA compared with pediatricians in secondary hospitals [94.90% (1 041/1 097) vs 87.86% (340/387), P<0.001]. The reported well control rate of CTVA was 32.08% (476/1 484), which was significantly lower in secondary hospitals than that in tertiary hospitals [17.31% (67/387) vs 37.28% (409/1 097), P<0.001]. Conclusion: Most pediatricians are well aware of CTVA, among which there is a certain gap in clinical practice between pediatricians in secondary hospitals and tertiary hospitals in terms of understanding, diagnosis, and treatment of CTVA.

[Analysis of respiratory syncytial virus infection in hospitalized children with acute lower respiratory tract infection in China from 2017 to 2020].

Objective: To understand the detection rate, epidemic pattern of respiratory syncytial virus (RSV) in hospitalized children with acute lower respiratory tract infection (ALRTI) in China. Methods: From June 2017 to March 2020, a prospective multi-center study on the viral aetiology among hospitalized children with ALRTI was conducted in six pediatrics hospital of North China, Northeast, Northwest, South China, Southeast, and Southwest China. A total of 2 839 hospitalized children with ALRTI were enrolled, and the respiratory specimens were collected from these cases. A multiplex real-time RT-PCR assay were employed to screen the respiratory viruses, and the molecular epidemiological and clinical characteristics of children infected with RSV were analyzed. Results: The positve rate of RSV was 18.6% (528/2 839), and the positive rate of RSV in different regions ranged from 5.5% to 44.3%. The positive rate of RSV in male was higher than that in female (20.2% vs 16.3%), and there was a significant statistically difference between two groups (χ2=6.74, P=0.009). The positive rate of RSV among children under 5 years old was higher than that among children older than 5 years old (22.3% vs 4.5%), and there was a significant statistically difference between two groups (χ2=97.98,P<0.001). The positive rate of RSV among the <6 months age group was higher than that of other age groups (all P<0.05). During January 2018 and December 2019, RSV was detected in almost all through the year, and showed peaks in winter and spring. RSV-positive cases accounted for 17.0% (46/270) among children with severe pneumonia, including 36 cases infected with RSV alone. Conclusion: RSV is an important viral pathogen in children under 5 years old with ALRTI in China. The virus can be detected almost all through the year and reached the peak in winter and spring. RSV could lead to severe pneumonia in children and caused huge threaten to children's health.

DXA-measured visceral fat mass and lean body mass reflect abnormal metabolic phenotypes among some obese and nonobese Chinese children and adolescents.

BACKGROUND AND AIM: The exact constellation of body composition characteristics among metabolically unhealthy obese (MUO) and nonobese (MUNO) children and adolescents remains unclear. The purpose of this study was to identify the major body composition determinants of metabolically unhealthy phenotypes among Chinese children and adolescents. METHODS AND RESULTS: We used data from a cross-sectional survey in 2015 that included 1983 children and adolescents aged 6-18 years. Subjects were classified into two phenotypes based on a combination of body mass index (BMI) and metabolic syndrome components. Body composition was measured by dual-energy X-ray absorptiometry (DXA). Among all boys and among adolescent boys, those with MUNO phenotypes displayed significantly higher indices of body composition except for fat mass (FM) percentage and trunk-to-legs FM ratio compared with the metabolically healthy nonobese phenotype (all P < 0.05). MUO individuals had higher arm FM, lean body mass (LBM), and trunk lean mass compared to metabolically healthy obese individuals (all P < 0.05). Visceral fat mass (VFM) and BMI were the major independent determinants of MUNO (VFM, 6- to 9-year-old boys, OR = 1.02, 95% CI = 1.00-1.03, P = 0.021; BMI, 6- to 9-year-old girls, OR = 1.90, 95% CI = 1.31-2.84, P = 0.001; and adolescent boys, OR = 1.34, 95% CI = 1.23-1.44, P < 0.001). LBM was the major independent predictor of MUO among adolescent boys (OR = 1.90, 95% CI = 1.03-1.17, P = 0.003). CONCLUSIONS: Among children and adolescents, the metabolically unhealthy phenotype was associated with excess of body composition, but with significant differences observed based on age and sex. VFM and LBM derived by DXA can predict the metabolically unhealthy phenotype effectively in specific sex and age groups.

[Study on the correlation between depression and emotion regulation strategies in the elderly residents].

Objective: To explore the cross-sectional study of depressive and emotional regulation strategies of elderly residents in Yinchuan and their relationship. Methods: A total number of 1 043 elderly cases, including 505 from 5 nursing institutions and 538 from 5 communities in Yinchuan city were chosen, from March to May, 2016. Depression survey using the Geriatric Depression Scale (GDS), emotional adjustment strategies were conducted using the Gross Emotional Regulatory Questionnaire and the Rumination Scale. Results: The overall incidence rate of depression among the elderly residents appeared as 32.0%, with 35.5% in the communities and 28.3% in the nursing homes and the difference was statistically significant (χ(2)=6.187, P<0.05). There was no significant difference in the incidence of depression among the elderly and the aged in the community (χ(2)=0.066, P=0.798) by the trend analysis method. The score of GDS for the 1 043 elderly was (9.1±5.7) points. The scores on cognitive reappraisal in emotional adjustment strategies and on expression inhibition were (26.7±8.0) and (16.3±6.6) points respectively. The score of the rumination was (34.5±11.7) points. There were significant differences in cognitive reappraisal scores on different sex, hobbies and physical exercise (all Ps<0.05) among the elderly. There were significant differences in rumination scores among the elderly with different age, marital status, cultural level, interest (all Ps<0.05) and in the scores of expression inhibition among the elderly with different levels of education and income (all Ps<0.05). There appeared a negative correlation between the depression scores and cognitive reappraisal (r=-0.400, P<0.01) but a positive correlation between the scores of depression and rumination (r=0.652, P<0.01). Conclusion: The incidence of depression identified in the elderly residents appeared high and was associated with emotional adjustment strategies, in Yinchuan city.

Effects of Mycoplasma pneumoniae infection on airway neurokinin-1 receptor expression in BALB/c mice.

The aim of this study was to establish a BALB/c mouse model of Mycoplasma pneumoniae (MP) infection and to explore the expression of neurokinin-1 receptor (NK1-R) in the trachea and lung tissue and changes in its relative content at different time points (on the 3rd, 7th, 14th, 21st, and 30th days after infection) in MP-infected BALB/c mice. Immunohistochemistry and Western blot analysis were performed to determine NK1-R expression in the trachea and lung tissue and changes in relative content in MP-infected BALB/c mice. After MP infection, the expression of NK1-R on the surfaces of upper tracheal and bronchial epithelial cells, submucosa, and alveolar epithelial cells, as well as around the smooth muscle, was upregulated more significantly in the infection group than in the control group (P < 0.05); NK1-R protein expression was enhanced on the 3rd, 7th, 14th, 21st, and 30th days after infection compared with that of the control group (P < 0.05). NK1-R expression in the trachea, bronchus, and lung tissue increased in MP-infected BALB/c mice, which may explain why wheezing occurs after MP infection.

Role of 1,25-dihydroxyvitamin D3 in the treatment of asthma.

OBJECTIVE: This study aims to observe the influence of 1,25-(OH)2D3 on airway inflammation and chemokine expression in asthmatic rats and to explore its significance in the treatment of asthma. MATERIALS AND METHODS: Wistar rats were randomly divided into a normal control group (N), an asthma group (A), a 1,25-(OH)2D3 group (VD), a budesonide group (P) and a 1,25-(OH)2D3 + budesonide treatment group (L). The acute asthma models were established through ovalbumin sensitisation and challenge. Lung tissues were stained with haematoxylin and eosin to observe pathologic changes, whereas an enzyme-linked immunosorbent assay was used to examine serum IgE, as well as the eosinophil chemoattractant protein (eotaxin) and interleukin-8 (IL-8) expression levels in bronchoalveolar lavage fluid and the serum. RESULTS: VD treatment partially reversed the characteristic pathological changes of airway inflammation. The IgE, eotaxin, and IL-8 expression levels in the VD group were significantly lower than those in the A group (p < 0.05) but remained higher than those in the control group (p < 0.05). CONCLUSIONS: 1,25-(OH)2D3 reduces airway inflammation, airway hyperresponsiveness and airway remodeling by partially inhibiting chemokine production during airway inflammation, and 1,25-(OH)2D3 synergises with hormone therapy.

Cytoskeleton changes of airway smooth muscle cells in juvenile rats with airway remodeling in asthma and the RhoA/ROCK signaling pathway mechanism.

This article aimed to investigate changes in the cytoskeleton of airway smooth muscle cells (ASMCs) in juvenile rats with airway remodeling in asthma. We further investigated the involvement of the RhoA/ROCK signaling pathway mechanism. Rat models of airway remodeling in asthma were established by antigen sensitization with ovalbumin for 2, 4, 6, and 8 weeks. The control group was treated with normal saline instead of ovalbumin. In the intervention group, after 8 weeks of culture, ASMCs were treated with the ROCK-specific inhibitor Y-27632. Immunofluorescence, real-time polymerase chain reaction, and Western blot analyses were used to observe changes in the cytoskeleton (F-actin and α-tubulin) of ASMCs and expressions of RhoA and ROCK. The asthmatic groups had significantly higher average gray values of F-actin in ASMCs compared to the control group (P < 0.01), and these values for the intervention group were significantly lower than those of the 8-week asthmatic group (P < 0.05). Expression levels of the α-tubulin protein in the asthmatic groups were all significantly higher than those of the control group (P < 0.01), and the levels in the intervention group were significantly reduced (P < 0.05). Expressions of RhoA and ROCK mRNA and proteins in all asthmatic groups were significantly higher than those of the control group (P < 0.01). Together, these results demonstrate substantial changes of the ASMC cytoskeleton and abnormal expressions of RhoA and ROCK mRNA and proteins in juvenile rats with airway remodeling in asthma.

Prevention and treatment of diarrhoea with Saccharomyces boulardii in children with acute lower respiratory tract infections.

The aim of this study was to determine whether Saccharomyces boulardii prevents and treats diarrhoea and antibiotic-associated diarrhoea (AAD) in children. A total of 333 hospitalised children with acute lower respiratory tract infection were enrolled in a 2-phase open randomised controlled trial. During the 1st phase, all children received intravenous antibiotics (AB). They were randomly allocated to group A (S. boulardii 500 mg/day + AB, n=167) or group B (AB alone, n=166) and followed for 2 weeks. Diarrhoea was defined as ≥3 loose/watery stools/day during at least 2 days, occurring during treatment and/or up to 2 weeks after AB therapy had stopped. AAD was considered when diarrhoea was caused by Clostridium difficile or when stool cultures remained negative. In the 2nd phase of the study, group B patients who developed diarrhoea were randomly allocated to two sub-groups: group B1 (S. boulardii + oral rehydration solution (ORS)) and group B2 (ORS alone). Data from 283 patients were available for analysis. Diarrhoea prevalence was lower in group A than in group B (11/139 (7.9%) vs. 42/144 (29.2%); relative risk (RR): 0.27, 95% confidence interval (CI): 0.1-0.5). S. boulardii reduced the risk of AAD (6/139 (4.3%) vs. 28/144 (19.4%); RR: 0.22; 95% CI: 0.1-0.5). When group B patients developed diarrhoea (n=42), S. boulardii treatment during 5 days (group B1) resulted in lower stool frequency (P<0.05) and higher recovery rate (91.3% in group B1 vs. 21.1% in B2; P<0.001). The mean duration of diarrhoea in group B1 was shorter (2.31±0.95 vs. 8.97±1.07 days; P<0.001). No adverse effects related to S. boulardii were observed. S. boulardii appeared to be effective in the prevention and treatment of diarrhoea and AAD in children treated with intravenous antibiotics.