-
[show abstract]
[hide abstract]
ABSTRACT: To analyze the clinical and radiological features of paragonimiasis in children and raise the awareness of this disease.
A total of 58 paragonimiasis patients were reviewed. They were 42 boys and 16 girls aged 2.0 to 15.3 years.
Among these patients, 20 were diagnosed in the recent 5 years, 46 with a history of raw water or food ingestion. Except 2 patients without any complaint, the most common features involved the systemic (41, 70.7%) and respiratory systems (43, 74.1%), followed by abdominal, cardiac and nervous systems, with rash and mass. Eosinophilia was noted in 46 (79.3%) patients, granulocytosis in 45 (77.6%), anemia in 14 (24.1%), and thrombocytopenia in 3. Imageology showed pneumonia in 26 (44.8%) patients, pleurisy in 28 (48.3%), hydropericardium in 17 (29.3%), ascites in 16 (27.6%), and celiac lymphadenitis in 13 (22.4%). Besides hepatomegaly and splenomegaly, calcification and multiple lamellar low echogenic areas in the liver were noted, each in one patient. Abnormal brain imaging was noted in 4 of 10 patients. Karyocyte hyperplasia with eosinophilia was noted in all the 19 patients who received bone marrow puncture.
Paragonimiasis should be considered in the differential diagnosis of patients with multiple organs or system lesions, especially those with eosinophilia, serous cavity effusion, respiratory, cardiac, digestive system, nervous system abnormality, and/or mass. Healthy eating habit is helpful for paragonimiasis prevention.
Iranian Journal of Pediatrics 12/2012; 22(4):505-11. · 0.29 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To investigate the clinical features of systemic lupus erythematosus (SLE) with pulmonary pleural lesion in children.
One hundred and thirty three child patients with SLE admitted from 2001 to 2010 were enrolled in the study. The clinical data, chest X-ray findings and laboratory examination were retrospectively reviewed. Cases with infectious pulmonary pleural lesion were excluded.
According to chest X-ray findings pleural pulmonary lesions were involved in 45 out of 133 cases with SLE (33.83 %); however, only 30 cases (66.67 %) had positive respiratory manifestations. Respiratory features included cough and/or sputum (55.56 %), dyspnea and chest pain (15.56 % and 11.11 %), and only 28.89 % case with pleural pulmonary lesions had rales. Chest X-ray findings included pleural effusion/pleurisy (32 cases, 71.11%), bronchial pneumonia (21 cases, 46.67%) or interstitial pulmonary disease (13 cases, 28.89%). Compared to children without pulmonary pleural lesion, children with pulmonary pleural lesion had higher incidence of leukopenia, lower C₃ or antibody dsDNA (+) (all P<0.05). There was no difference in abnormality of erythrocyte sedimentation rate (ESR), CRP, IgG,IgA,IgM, thrombocytopenia, antibody ANA(+), anti-SSA(+), anti-SSB(+) or anti-Sm(+) between children with or without pulmonary pleural lesion (P>0.05).
High incidence of pulmonary pleura lesions are present in children with SLE, however, clinical manifestations are lack of specificity or even no respiratory manifestation. Chest X-ray or HRCT scan are necessary in all cases with SLE. Children with leukopenia, lower C₃ or antibody dsDNA (+) are more likely to have pulmonary pleural lesion.
Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences 05/2012; 41(3):327-31.
-
[show abstract]
[hide abstract]
ABSTRACT: To investigate the incidence and clinical features of mixed infections in children with Mycoplasma pneumoniae (MP) pneumonia.
A total of 201 cases diagnosed as MP pneumonia were investigated for mixed infections by sputum bacterial culture, respiratory virus antigen detection and serum Chlamydia pneumoniae antibody test. For those with the indications for bronchoscopy, we also did bronchoalveolar lavage and lavage bacterial culture.
A high incidence (103/201, 51.2%) of mixed infections in children with MP pneumonia was revealed. The most frequent co-infected pathogen was Chlamydia pneumoniae (52, 25.9%), followed by viruses (29, 14.4%), and bacteria (22, 10.9%). Among viruses, respiratory syncytial virus was the most common (17, 8.5%), followed by adenovirus (6, 3.0%), parainfluenza virus type III (4, 2.0%) and influenza virus type B (2, 1.0%). Sputum bacterial culture was positive in 14/201 (7.0%) cases, Streptococcus pneumonia being most common (6, 3.0%). BALF culture yielded positive results in 11.6% (8/69), Streptococcus pneumonia was also common (5, 7.3%). Among 29 cases with MP and virus coinfection, 26 were younger than 3 years (89.7%), while for MP and Chlamydia pneumoniae coinfection, most of them were older than 3 years (40/52, 76.9%). Compared with non-mixed infections, those with mixed infections had longer fever duration (24.5% and 40.8% longer than 10 d), more frequently developed pleural effusion (11.2%, 23.3%) and large area of shadow in chest imaging (35.7%, 51.5%). White blood cell [(14.28 ± 4.99) × 10(9)/L], C-reactive protein (CRP) [69(32.5 - 99.5) mg/L] and neutrophil ratio in BALF [0.86 (0.63 - 0.91)] were much higher in children with mixed bacterial infections than that in non-mixed infections [(9.06 ± 3.47) × 10(9)/L, 3 (0 - 31.0) mg/L, 0.44 (0.03 - 0.88)]. But no significant difference was found in peripheral blood neutrophil proportion between mixed bacterial infections (0.38 ± 0.25) and non-mixed infections (0.51 ± 0.19).
More than half of cases with MP pneumonia had mixed infections, most commonly caused by Chlamydia pneumonia followed by viruses. The incidence of mixed infections with bacteria was low. Mixed infections with virus were more common in young children, while mixed infection with Chlamydia pneumoniae was more common in older ones. Bacterial infections should be paid more attention, especially those caused by Streptococcus pneumoniae, for those with high peripheral white blood cell counts, high CRP levels and high proportion of neutrophils in BALF.
Zhonghua er ke za zhi. Chinese journal of pediatrics 03/2012; 50(3):211-5.
-
[show abstract]
[hide abstract]
ABSTRACT: The P1 protein of Mycoplasma pneumoniae (MP) plays an important role in the pathogenesis of MP pneumonia. It mediates the attachment of the pathogen to host cells and elicits a strong humoral immune response during infection. In early studies, only two types of MP P1 genes were assumed to exist. Later, eight subtypes of MP P1 genes and some variations of P1 gene were reported. However, there are no related reports in China until now. This study aimed to understand epidemiology of MP subtype in Zhejiang province, China, as well as the relationship between MP subtype and clinical severity of MP pneumonia.
Clinical samples were collected by nasopharyngeal aspiration from children with MP pneumonia hospitalized in the Children's Hospital of Zhejiang University School of Medicine from February to December in 2009. P1 gene fragment was amplified by using PCR method (with primers of ADH1/ADH2 and ADH3/ADH4, respectively). Then ADH1/ADH2-generated fragments were digested with HaeIII, HpaII, Sau3A, and the ADH3/ADH4-generated fragments digested with HaeIII, Sau3A, HhaI, RsaI. The MP P1 subtypes were determined based on resulting fragments. Part of samples were selected for sequencing. The clinical data of different MP subtype pneumonia were compared.
A total of 300 hospitalized children with MP pneumonia were enrolled in this study. All the samples produced specific bands for MP P1 gene after PCR with primers of ADH1/ADH2 and ADH3/ADH4 respectively. By restrictive fragment length polymorphism analysis, 297 clinical specimens showed the characteristic band patterns for P1 type 1 identical to Mp129, and only 3 clinical specimens showed the characteristic band pattern for P1 type 2 identical to MP-FH. All P1 type 1 and P1 type 2 showed the same subtype bands respectively, as subtype 1b and 2a. After sequencing, one synonymous point mutation in P1 type 1 was identified relative to the MP129 P1 sequence at nucleotide position (nt) 208(G→A). Three cases with P1 type 2 MP pneumonia were found to have liver damage, and longer hospital stay and fever duration than P1 type 1, but no statistically significant difference was found.
Clinical samples can be used directly for genotyping of MP. The dominating type of MP in Zhejiang Province was P1 type 1 subtype 1b. But whether there was any relationship between MP subtype and clinical severity remains to be clarified.
Zhonghua er ke za zhi. Chinese journal of pediatrics 10/2011; 49(10):750-4.
-
[show abstract]
[hide abstract]
ABSTRACT: Mycoplasma pneumoniae (M. pneumoniae) is an important pathogen of pediatric respiratory infections and the relation of M. pneumoniae pneumonia (MPP) with meteorological factors remains obscure. This study aims to investigate the epidemiological characteristics of childhood MPP and observe if there is a relationship between epidemiological characteristics and meteorological factors in Hangzhou.
M. pneumoniae DNA in nasopharyngeal aspirates of hospitalized pneumonia children were detected by polymerase chain reaction from January 1, 2007 to December 31, 2009. The positive rates of MPP (MPP rates) in different years, seasons and ages were compared. The relationship between MPP rates and meteorological data, including mean air temperature (°C), mean relative humidity (%), monthly precipitation (mm) and raining days were analyzed.
In 14 799 pneumonia cases found from 2007 to 2009, the MPP rate was 18.5%. Altogether 1610 boys (16.9%) and 1134 girls (21.4%) suffered from MPP with a significant difference between both genders (χ(2)=45.68, P<0.001). In children younger than 1 year, 1-2 years, 3-6 years, and older than 7 years, the MPP rates were 9.8%, 21.1%, 44.4% and 61.6%, respectively. The MPP rates were significantly higher in older children than in younger ones (trends test χ(2)=46.72, P<0.001). In a descending order, the MPP rates in summer, autumn, spring, and winter were 27.8%, 23.9%, 18.0% and 11.6%, respectively (χ(2)=372.75, P<0.001). The MPP rates in 2007 to 2009 were 12.9%, 19.3% and 23.6%, respectively (trends test χ(2)=13.72, P<0.001). Of the four meteorological factors, only monthly mean air temperature was included in the multiple linear regression model (P<0.001).
This study showed that the MPP rate was higher in older children than in younger ones. Girls had a higher positive rate of MPP than boys. In Hangzhou, MPP was more prevalent in summer and autumn. Air temperature was the only meteorological factor affecting the prevalence of MPP.
World Journal of Pediatrics 08/2011; 7(3):240-4. · 1.22 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To reveal changes in clinical manifestations of Mycoplasma pneumoniae (Mp) pneumonia in children older than 3 years of age during 2000 - 2006.
Totally 288 older children with Mp pneumonia hospitalized in the hospital between 2000 and 2006 were enrolled. Clinical manifestation, chest X-ray and clinical outcomes among three time periods (2000 - 2002, 2003 - 2004, 2005 - 2006) were compared.
(1) Fever and its duration; 281 cases (97.6%) had fever of different duration (median = 7.2 d, 8.5 d, and 11.2 d, respectively) among the time periods, showing statistically significant difference (P < 0.01). (2) Respiratory symptoms: different incidence of wheezing/dyspnea (6.1%, 9.9%, 16.3%), thrilling (6.9%, 11.3%, 19.8%) and chest pain (12.2%, 15.5%, 22.1%) among different time periods had significant difference (χ(2) = 5.87, 11.46, 5.21, P < 0.05). (3) The incidence of extrapulmonary damages (13.0%, 38.0%, 48.8%) among different time periods also had significant difference (χ(2) = 21.27, P < 0.01). (4) Chest X-ray examination showed large area of lesions in most cases; 30.2% of cases seen during 2005 - 2006 were found having pulmonary complications such as pleural effusion or atelectasis. The incidences of pulmonary complications among different time periods had significant difference (P < 0.01). (5) Treatment and outcome: after comparing the efficacy of erythromycin or azithromycin, decline of clinical effectiveness was revealed among different time periods (P < 0.05). The duration of fever after macrolide administration (median = 3.2 d, 4.5 d, 6.2 d, respectively) and hospital stay (median = 7.0 d, 8.7 d, and 11.4 d, respectively) among different time periods showed significant differences (P < 0.05).
More refractory and severe Mp pneumonia cases appeared during 2000 - 2006 in children older than 3 years of age in Hangzhou, with prolonged fever duration, aggravated respiratory symptoms and more complications and extrapulmonary damages.
Zhonghua er ke za zhi. Chinese journal of pediatrics 07/2010; 48(7):531-4.
-
[show abstract]
[hide abstract]
ABSTRACT: To investigate the epidemic characteristics of etiological agents in children with hand, foot and mouth disease (HFMD) and analyze the differences between the severe and mild cases with HFMD seen from 2008 to 2009 in the Children's Hospital.
A total of 154 patients with HFMD were enrolled from May 2008 to September 2008 and from May 2009 to September 2009, including 28 severe HFMD patients. Data from 80 cases with suspected herpangina were collected as control. Enterovirus universal type, enterovirus type 71 (EV71) and coxsackie virus group A 16 (CA16) were detected by real-time RT-PCR respectively.
The positive rate of enterovirus universal type in the 154 patients with HFMD was 81.82%(126/154). EV71 positive rate in these 126 patients with enterovirus universal type infection was 57.14%(72/126). The positive rate of enterovirus universal type in the 80 cases with suspected herpangina was 68.75%(55/80). There was no EV71 infection in these 80 cases with suspected herpangina. EV71 infection was mainly popular in 2008. Both EV71 and CA16 were prevalent in 2009. The epidemic characteristics of enterovirus infection with HFMD between 2008 and 2009 had significant differences (χ(2) = 23.50, P = 0.000) (P < 0.01). The epidemic characteristics of enterovirus infection between severe and mild HFMD patients also had significant differences (χ(2) = 29.85, P < 0.01). There were 28 cases with severe HFMD, in whom the EV71 positive rate was 92.86% (26/28). EV71 positive rate in the mild HFMD was 36.51% (46/126) (χ(2) = 29.22, P < 0.01). There was no significant difference in the gender (χ(2) = 0.135, P = 0.714) and virus load (t = 0.141, P = 0.889) between the mild and severe HFMD cases. But the age of mild and severe HFMD showed a significant difference (t = 2.926, P = 0.009). Patients who were less than 2 years of age had a proportion of 88.89% (8/9) with severe HFMD. The mean age of mild HFMD patients was 3.19 years.
HFMD showed different epidemic characteristics at different times of enterovirus infection. There was no significant difference in the gender and virus load between the mild and severe cases with HFMD. Children under 3 years of age with EV71 infection were at high risk for severe HFMD.
Zhonghua er ke za zhi. Chinese journal of pediatrics 07/2010; 48(7):535-9.
-
The Indian Journal of Pediatrics 02/2010; 77(5):581-2. · 0.52 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Pleuropulmonary blastomas (PPB) are rare and highly aggressive tumors. Herein, we report an infantile case of type III PPB. A 9-mth-old boy presented to our unit with a history of cough and tachypnea for 2 days. Chest computed tomography revealed a mass in the left upper lobe, emphysema in the left upper lung, and mediastinum and heart shifted towards the right. The mass was removed completely by left upper lobectomy and histology confirmed diagnosis of type III PPB. The immature blastematous tissue was positive for vimentin while benign epithelium was positive for epithelial membrane antigen and cytokeratin. No lymph nodule metastasis was found in the 7 lymph nodules obtained from the hilum of the lung near the tumor. Currently, the patient is under close follow-up and is doing well.
The Indian Journal of Pediatrics 09/2009; 76(9):948-9. · 0.52 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Foreign body aspiration (FBA) into the tracheobronchial tree is a common problem in children necessitating prompt recognition and management. This study aimed to report our experience in airway foreign body removal by flexible bronchoscopy in children.
A total of 1027 patients with FBA were reviewed retrospectively. They were 626 boys and 401 girls aged from 5 months to 14 years with a median age of 17 months. The clinical manifestations, radiological findings, bronchoscopic findings and complications of the procedure were analyzed.
Among the patients, only 53.4% had a definite history of FBA. The most frequent symptom was paroxysmal cough (84.3%), followed by stridor or wheezing, fever and dyspnea. Chest X-ray showed emphysema in 68.8% of the patients, atelectasis in 13.3% and bronchopneumonia in 56.3%. A bronchoscope was inserted intranasally in most children, but through mouth and endotracheal tube in 17 and 3 children, respectively. Foreign bodies were removed successfully by flexible bronchoscopy with disposable grasping forceps or biopsy forceps in 938 (91.3%) of the patients. The other 89 patients turned to rigid bronchoscopy. During the procedures, 132 (12.9%) of the patients showed transient hypoxia, which was alleviated by oxygen supplement and/or temporary cessation of the procedure. A small amount of bleeding was found in 17 patients and bradycardia in 3. Air leak and laryngeal edema were noted in 2 patients and relieved within 24 hours.
Flexible bronchoscopy is useful and safe in retrieving airway foreign bodies in children. With skilled personnel and perfect equipments, flexible bronchoscopy could be considered as the first choice for the removal of airway foreign body.
World Journal of Pediatrics 09/2009; 5(3):191-5. · 1.22 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Mycoplasma pneumoniae (M. pneumoniae), an atypical pathogen, is increasingly recognized as a common and important pathogen. Previous studies showed that M. pneumoniae infection may play a role in asthmatic mechanisms based on evidence collected from peripheral blood or sputum of patients or animal models. However, evidence reported from the airways of patients has been rare.
To estimate the role of M. pneumoniae infection in asthma by measuring the immunological parameters from peripheral blood and bronchoalveolar lavage fluid (BALF) in pediatric patients with mycoplasma pneumonia.
A total of 30 patients with mycoplasma pneumonia and 37 patients without M. pneumoniae infection undergoing fiberoptic bronchoscopy were reviewed. The peripheral blood cell count, immunoglobulins (Ig), BALF cell count, and other clinical and laboratory data were reviewed and analyzed.
There were significantly more patients with raised basophil counts in the M. pneumoniae group than that in the control group (p = 0.033). Serum immunoglobulin (Ig) A, IgM, and IgG levels in the M. pneumoniae group were significantly higher than those in the control group (p = 0.008, p = 0.011, and p = 0.019, respectively). The percentage of eosinophils in BALF cells was in the range 0 to 10% in M. pneumoniae patients, while it ranged between 0 and 4% in the control group with a significant difference (p = 0.043). In the M. pneumoniae group, we found that the percentage of eosinophils in the BALF cells was positively correlated with age, the percentage of peripheral eosinophils, and BALF lymphocytes (r = 0.298, p = 0.030; r = 0.341, p = 0.014; r = 0.387, p = 0.006; respectively) and negatively correlated with total peripheral white blood cell (r = -0.387, p = 0.005).
These results suggest that M. pneumonia infection is associated with the asthma mechanism, especially in older children.
Journal of Asthma 05/2009; 46(3):265-9. · 1.52 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To better understand the neutrophil activation and protease imbalance in respiratory syncytial virus (RSV) bronchiolitis.
Pediatric patients with RSV bronchiolitis were collected, 11 with the Lowell scores > or = 10 (severe group), and 19 with the Lowell scores < 10 (mild group). 20 RSV bronchiolitis patients in convalescent group, 24 patients with bacterial pneumonia, and 15 patients as control group. The percentages of neutrophils were detected. ELISA was used to detect the concentration of neutrophil elastase (NE) and interleukin (IL)-8, and the elastase inhibition capacity (EIC)/free neutrophil elastase activity were detected by colorimetry. Immunohistochemistry was used to examine the expression of alpha(1) antitrypsin (alpha(1)AT).
The neutrophil percentage, the NE and IL-8 concentration of the RSV bronchiolitis group (0.528, 6.39 x 10(7) kg/L and 13.62 x 10(9) kg/L)were all significantly higher than those of the control (0.074, 2.53 x 10(7) kg/L and 2.64 x 10(9) kg/L) and convalescent groups (0.306, 1.23 x 10(7) kg/L and 5.95 x 10(9) kg/L, all P < 0.05). The neutrophil percentage and IL-8 concentration of the convalescent group were both significantly higher than those of the control group (both P < 0.05). Increased expression of alpha(1)AT in RSV bronchiolitis was found when compared with convalescent infants (0.49 vs 0.09, P < 0.05). The free elastase activity level of the bronchiolitis group was 6/30, not different with 7/24 of pneumonia group, and it was only one in convalescent infants.
Mass of neutrophil aggregation and activation exist in RSV bronchiolitis, as well as protease system imbalance, and may play an important role in the inflammatory response and pathogenesis of RSV bronchiolitis.
Zhonghua yi xue za zhi 03/2009; 89(6):397-9.
-
[show abstract]
[hide abstract]
ABSTRACT: To determine the value and safety of fiberoptic bronchoscopy in neonatal and pediatric intensive care units (NICUs, PICUs).
A total of 53 fiberoptic bronchoscopy procedures on 47 patients were reviewed. Bronchoalveolar lavage (BAL) was performed in 23 patients.
The primary diseases were pneumonia (n = 16), foreign body aspiration (n = 14), congenital airway abnormality (n = 12), trauma and/or following operations (n = 4) and Guillain-Barré syndrome (n = 1). The major bronchoscopic findings included inflammation in 26 patients, foreign body in 14, congenital airway abnormality in 12 and blood clotting in 3. Microbiology on BAL fluid was positive in 19 of 23 patients. In 23 patients with atelectasis, full and partial re-expansion was obtained in 14 and 6 patients, respectively, at 24 h after the procedures. The clinical features of 9 patients with sputum retention or blood clotting improved significantly after BAL. Positive or negative microbiologic BAL fluid results changed treatment in 11 patients, leading to marked clinical improvement in 9 patients. Moreover, 13 patients were extubated within 24 h of bronchoscopy.
These data show that fiberoptic bronchoscopy is safe and effective in the diagnosis and therapy of pulmonary disorders in NICUs and PICUs.
Medical Principles and Practice 02/2009; 18(4):305-9. · 0.89 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To document the viral etiology of acute lower respiratory tract infection (ALRIs) in Chinese children.
Children Hospital, Zhejiang University, China.
Cross-sectional.
34885 children with ALRI between January 2001 to December 2006.
Nasopharyngeal aspirates were collected from all subjects. Respiratory syncytial virus (RSV), adenovirus (ADV), type 1 to 3 parainfluenza viruses (PIV), and type A and B influenza virus (Flu) were detected by direct immunofluorescence.
Viruses were identified in 32.3% cases, including RSV (23.6%), PIV 3 (4.3%), Flu A (2.0%), ADV (1.7%), PIV I (0.6%), Flu B (0.2%) and PIV 2 (0.1%). RSV and PIV 3 predominated in younger children while Flu A and Flu B predominated in older children (P<0.001, respectively). PIV 1 was more prevalent in children aged 1 to 3 years. The peak frequency of RSV, PIV 3 and Flu A were in early spring, June to August, and August and September, respectively. Flu B had a peak in the winter and spring. Adenovirus infections occurred in all seasons with a relatively constant frequency.
Viruses are an important cause of ALRIs in Chinese children constituting 1/3 of total cases. RSV is the most common pathogen.
Indian pediatrics 12/2008; 45(12):971-5. · 1.05 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of the study was to report on 3 cases of childhood undifferentiated embryonal liver sarcoma (UELS) and to highlight the clinical features, laboratory findings, diagnosis, and management of this rare disease.
The patients' age, sex, clinical features, laboratory findings, pathologic results, and therapy were reviewed. Immunohistochemistry analysis was performed on the resected mass sections.
In this study, 2 cases were female (aged 8 and 12 years) and 1 was male (aged 9 years). The causes of hospitalization were mainly abdominal pain, mass, or fever. An elevated erythrocyte sedimentation rate was noted in 2 available cases, and alpha fetoprotein (AFP) was within the normal range. Imaging findings indicated a well-defined heterogeneous large mass in the right lobe. Histopathologic evaluation of the mass confirmed the diagnosis of UELS. Immunohistochemical staining showed that vimentin and CD68 antigen were positive in all samples, whereas desmin was positive in one sample. Surgery with chemotherapy was performed in 2 cases.
The diagnosis of UELS depends mainly on the pathologic findings. Undifferentiated embryonal liver sarcoma should be included in the differential diagnosis of mass in the liver, especially with well-defined heterogeneous imaging findings and normal AFP. Diagnosis and management should be made early as UELS is a potentially treatable tumor.
Journal of Pediatric Surgery 11/2008; 43(10):1912-9. · 1.45 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To study the value of bronchofibroscopy in the etiologic identification of chronic cough in children.
Under local anesthesia of lidocaine, bronchofibroscopy was performed in 118 children with chronic cough of unknown origin (73 males and 45 females). Their ages ranged from 3 months to 13 years.
The cause of chronic cough was identified in 115 cases. The most common cause was respiratory infection (n=39),followed by bronchial foreign bodies (n=19), upper airway cough syndrome (n=17), bronchial asthma or cough variant asthma (n=17), bronchomalacia (n=7), bronchial congenital malformation (n=5), primary ciliary dyskinesia (n=3), gastro-esophageal reflux (n=3), bronchial tumor (n=2), bronchial tuberculosis (n=1), pulmonary fibrosis (n=1) and idiopathic pulmonary hemosiderosis (n=1).
Bronchofibroscopy is useful in the etiologic identification of chronic cough in children.
Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 07/2008; 10(3):319-21.
-
[show abstract]
[hide abstract]
ABSTRACT: To investigate the distribution characteristics of the single nucleotide polymorphisms (SNPs) of the human CD14 gene in Chinese Han ethnic group children in Wenzhou, and their association with atopic diseases.
Totally 113 cases were recruited in atopic disease group who met the following criteria: 2 - 12 years old, clinically diagnosed as asthma or allergic rhinitis or atopic dermatitis, elevation of serum total IgE levels and serum specific IgE. Sixty-seven healthy children were enrolled in control group. The related regions of CD14 gene were sequenced to identify and characterize the SNPs, and plasma TIgE and SIgE were detected by immunoassay system and uniCAP system, respectively. The frequency of genotypes and alleles between two groups, as well as the levels of IgE in different genotypes, were compared.
CD14/-159 SNP was present in Han ethnic group population of Wenzhou. The frequency of each genotype was 57.0% (TT), 28.0% (TC), 15.0% (CC) in normal children, and 46.9% (TT), 35.4% (TC), 17.7% (CC) in atopic children. No significant difference was found in the distribution of CD14/-159 polymorphism between atopic children and healthy control (chi(2) = 1.918, P > 0.05) according to Hardy-Weinberg principle statistics. There were no significant difference in frequency of each genotype between boys and girls. No significant difference was found in the total plasma IgE levels among groups of TT genotypes [(2520 +/- 460) IU/L], TC genotypes [(2400 +/- 460) IU/L] and CC genotype [(2500 +/- 460) IU/L] (F = 0.807, P > 0.05).
CD14/-159 SNP is present in Han ethnic group children in Wenzhou, and other SNP in CD14 gene was not found. TT genotype was the primary genotype in CD14/-159 SNP in the children studied. No relationship between CD14/-159 SNP and atopic disease or serum total IgE level was found.
Zhonghua er ke za zhi. Chinese journal of pediatrics 02/2007; 45(2):105-8.
-
[show abstract]
[hide abstract]
ABSTRACT: To study the pathogenic bacteria of lower respiratory tract infection (LRTI), and age and gender distribution and drug resistance of the pathogenic bacteria in children.
Sputum specimens for bacterial cultures were collected in sterile tubes from all of the children with LRTI who had been admitted to the Children's Hospital of Zhejiang University between August 2001 and July 2002. Antibiotic susceptibility tests were performed using the Vitek system, the Kirby-Bauer diffuse method and the Etest method after bacteria were identified.
Among the 4,238 patients with LRTI during the study period, 1,181 patients were bacteria-positive, with a positive rate of 27.9%. Streptococcus pneumoniae (S. pneumoniae) was the most common (222 strains), followed by Haemophilus influenzae (H. influenzae) (216 strains), Klebsiella pneumoniae (K. pneumoniae) (216 strains), Escherichia coil (E. coli) (169 strains) and Staphylococcus aureus (S. aureus) (89 strains). The isolation rate of S. pneumoniae in females was significantly higher than in males (6.2% vs 4.7%; P < 0.05). However, the isolation rates of K. pneumoniae and S. aureus in males were higher than in females (5.1% vs 4.1% and 2.5% vs 1.5%, respectively; P < 0.05). A higher incidence of LRTI due to S. pneumoniae and H. influenzae was found in the 1-3 years group, while the incidence of LRTI due to K. pneumoniae, E. coli, S. aureus and E. cloacae was higher in patients under 1 year of age. Antibiotic susceptibility tests showed that rates of penicillin non-susceptible S. pneumoniae, ampicillin resistant H. influenzae, oxacillin-resistant S. aureus and ESBL-positive K. pneumoniae and E. coli were 55.0%, 16.5%, 41.2%, 42.6% and 4.5%, respectively.
S. pneumoniae, H. influenzae, K. pneumoniae, E. coli and S. aureus were common pathogens of LRTI in children. The infection rate varied with age and gender. Antibiotics for treating LRTI should be selected based on the drug susceptibility test.
Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 11/2006; 8(5):365-8.
-
Zhonghua er ke za zhi. Chinese journal of pediatrics 07/2006; 44(6):472-3.
-
[show abstract]
[hide abstract]
ABSTRACT: A 9-year-old girl was admitted because of recurrent cough, dyspnea, and tachypnea for over 3 months, which had become worse for the preceding week. A chest X-ray revealed a mass in the lumen of the trachea. Fiberoptic bronchoscopy confirmed a polypoid mass in the upper trachea 3 cm under the vocal cords, with a 1.5-cm diameter that occluded approximately 70% of the lumen. Endoscopic excision of the neoplasm was performed with rigid bronchoscopy. Results of immunolabeling, which was positive for S-100 protein and vimentin, demonstrated a benign neurilemmoma. Clinical symptoms and signs improved after the tumor was removed. Intratracheal neurilemmoma is an extremely rare neoplasm, and only 34 cases were previously reported worldwide. The most common presentation is airway obstruction. Preoperative diagnosis is difficult, and radiographic techniques are helpful for diagnosis. Bronchoscopy is recommended for diagnosis, biopsy, and resection of the tumor. Long-term follow-up after simple enucleation is required.
Pediatric Pulmonology 01/2006; 40(6):550-3. · 2.53 Impact Factor
