Effectiveness of polyvalent bacterial lysate for pediatric asthma control: a retrospective propensity score-matched cohort study.

Background: Previous studies showed bacterial lysates were effective for pediatric asthma. However, evidence of polyvalent bacterial lysate Qipian is lacking. Methods: In this real-world retrospective cohort study, data of children with asthma, aged six months to 14 years old, attending to Jiangxi Provincial Children's Hospital from January 2021 to April 2022, prescribed routine treatment for asthma plus Qipian (Qipian group) or not (control group) were extracted. To minimize the impact of confounders on the outcomes, baseline characteristics were utilized to perform propensity score matching through a multivariable logistic regression model. After matching, asthma control, exacerbation, etc. were compared. Results: Totally, 795 patients were included (337 in the Qipian group and 458 in the control group), with 278 pairs (556 patients) matched. Most baseline characteristics were well-balanced. The proportion of males were 68.3% and 70.1% in the two groups. The Qipian group favored better asthma control, with more "controlled" [3-month: 257 (92.4%) vs. 240 (86.3%); 6-month: 246 (88.5%) vs. 235 (84.5%)], and fewer "poorly/very poorly controlled" patients, compared with the control group (P=0.004 and 0.025, respectively). Patients in the Qipian group had lower risks of exacerbation. Incidence rate ratios (IRR) for any exacerbation were 0.56 [95% confidence interval (CI): 0.33 to 0.93] in the 3-month period and 0.83 (95% CI: 0.55 to 1.26) in the 6-month period. IRR for severe exacerbations were 0.09 (95% CI: 0.01 to 0.71) in the 3-month period and 0.20 (95% CI: 0.06 to 0.70) in the 6-month period (compared to the control group). Qipian significantly reduced the cumulative dose of short-acting beta-agonist (3-month: 3.22±10.37 vs. 8.08±16.71 mg; P<0.001; 6-month: 6.56±16.23 vs. 11.81±24.41 mg; P=0.002). There was no difference in incidences of respiratory tract infection or fever due to respiratory tract infection between the two groups. Numbers of antibacterial agent prescription were fewer in the Qipian group compared to the control group (3-month: 0.67±1.16 vs. 1.04±1.45; P=0.001; 6-month: 1.14±1.69 vs. 1.51±2.12; P=0.023). Conclusions: According to this retrospective study, Qipian may be effective for improved pediatric asthma control. Safety profile and mechanisms of action of Qipian need further investigation. Further randomized controlled trials are warranted to confirm our results.

[Characteristics of tidal breathing pulmonary function in children with tracheobronchomalacia].

OBJECTIVE: To investigate the characteristics of tidal breathing pulmonary function in children with tracheobronchomalacia (TBM). METHODS: In this study, 30 children who were diagnosed with TBM using electronic bronchoscopy were enrolled in the observation group; 30 healthy children were recruited in the normal control group. For individuals in each group, the assessment of tidal breath pulmonary function was performed at diagnosis and 3, 6, 9, and 12 months after diagnosis. RESULTS: There were no significant differences in tidal volume, inspiratory time, expiratory time, and inspiratory to expiratory ratio between the two groups (P>0.05). Compared with the control group, the observation group had a significantly higher respiratory rate and significantly lower ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/TE) and ratio of volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE). There was a time-dependent increase in TPTEF/TE and VPTEF/VE for TBM children from the time of initial diagnosis to 12 months after diagnosis. CONCLUSIONS: Tidal breathing pulmonary function has characteristic changes in children with TBM. Tidal breathing pulmonary function tends to be recovered with increased age in children with TBM.

[Clinical analysis of immune function changes in children with bronchial pneumonia].

OBJECTIVE: To investigate changes in serum complement, immunoglobulins and lymphocyte subsets in children with common and severe bronchial pneumonia, and the role of immune function testing in bronchial pneumonia. METHODS: Twenty children with common bronchial pneumonia, 20 with severe bronchial pneumonia and 20 healthy children (as controls) were enrolled in this study. Immunization rate scattering turbidimetry and six-color flow cytometry were used to detect changes in serum levels of IgA, IgG and IgM, complement C3 and C4 and CD3(+), CD4(+), CD8(+), CD16(+), CD56(+) and CD19(+) cells. RESULTS: The IgA levels of children with common and severe pneumonia were significantly lower than in the control group (P<0.05). The IgG level of children with severe pneumonia was significantly lower than in the control group (P<0.05). There were no significant differences in the levels of IgM and complement C3 and C4 between the two pneumonia groups and the control group (P>0.05). Compared with the controls, the children with severe pneumonia showed significantly lower CD4(+) and CD3(+) counts (P<0.05) and a significantly higher CD19(+) count (P<0.05), and the CD16(+) and CD56(+) counts of children with severe pneumonia were significantly lower than in the controls and in children with common pneumonia (P<0.05). There were no differences in CD8(+) count and CD4(+)/CD8(+) ratio between the two pneumonia groups and the control group (P>0.05). CONCLUSIONS: Immune dysfunction exists in children with bronchial pneumonia, especially those with severe pneumonia. Changes in immune function are correlated with the severity of pneumonia. Immune function testing in children with pneumonia has important clinical significance.

[Application of bacterial cultures of bronchoalveolar lavage fluids in children with pulmonary infection].

OBJECTIVE: To study the value of bacterial cultures of bronchoalveolar lavage fluids (BALF) in children with pulmonary infection. METHODS: Bacterial cultures sampled from both sputum and BALF were performed on 80 hospitalized children with pulmonary infection between June 2008 and February 2011.Culture results between the two samples were compared. RESULTS: In the 80 children with pulmonary infection, bacterial cultures of BALF showed that Viridans Streptococci were found in 72 cases (90%), Neisseria in 41 cases (51%), Streptococcus pneumoniae in 11 cases (14%), Staphylococcus Aureus in 3 cases (4%) and Escherichia coli in 3 cases (4%). The positive rates of Viridans Streptococci in the bacterial cultures of BALF was not significantly different from the bacterial cultures of sputum, but the positive rate of Streptococcus pneumoniae in the bacterial cultures of BALF was significantly higher than in the bacterial cultures of sputum (4%). Moreover, Escherichia coli were found only by bacterial cultures of BALF. CONCLUSIONS: Bacterial cultures of BALF are useful in the identification of pathogenic bacteria for pulmonary infection in children. Due to the samples taken from the lesion regions in bacterial cultures of BALF, the results of may be more reliable.