Child ; Child Behavior Disorders ; etiology ; Cognition Disorders ; physiopathology ; Humans ; Sleep Apnea Syndromes ; psychology

Objective The purpose of this study was to evaluate the feasibility of expiratory flow limitation(EFL) detected by negative(NEP) and the correlation between EFL and routine lung function measurements(Forced expiratory volume in first second,FEV1),EFL and MRC dyspnea scale,in patients with stable and acute asthma,to find a simple,reliable and objective method for the diagnosis,differential diagnosis,the severity of disease and evaluation of severity and efficacy of treatment for asthma,and a objective method reflecting the severity of dyspnea.Methods Sixty-four children enrolled in No.306 Hospital of PLA from Jun.to Dec.in 2012 were included in this study.The severity of dyspnea was rated according to the dyspnea scale proposed by the Medical Research Council(MRC).Then routine pulmonary ventilation function tests and NEP technique were performed respectively.Result (1) All asthmatic patients tolerated NEP well.(2) Pulmonary ventilation function tests:The mean FEV1 in 64 was 71.33 ± 13.92％ pred.(3) MRC dyspnea scale:MRC dyspnea scale was 2 in 10,1 in 54 of 64 children with stable asthma.The Spearman' s correlation coefficient of MRC dyspnea scale with FEV1 was-0.635(P ＜0.05).(4)EFL detected by NEP:There were no EFL in 46 children with asthma both in seated and supine positions.There were EFL in 8 children both in seated and supine positions and in 10 only in supine position..The Spearman's correlation coefficient of three-point EFL score with FEV1 and MRC dyspnea scale was-0.607 and 0.964(P ＜ 0.05) respectively.The Spearman's correlation coefficient of five-point EFL score with FEV1 and MRC dyspnea scale was-0.626 and 0.966 (P ＜ 0.05)respectively.Conclusion (1) NEP technique can be used in children with asthma.(2) There was a significant correlation between EFL detected by NEP technique and FEV1.(3) There is a stronger correlation between EFL and MRC dyspnea scale than that between FEV1 and MRC dyspnea scale.

Objective To explore the nursing care of patients with Marfan syndrome accompanied with lens subluxation, and the clinical efficacy of phacoemusification combined with the implantation of modified capsular tension ring and foldable posterior chamber intraocular lens. Methods 11 patients (11 eyes) were performed the surgery. Uncorrected visual acuity preoperatively was (0.13±0.09). Best corrected visual acuity preoperatively was (0.20±0.17). Preoperative preparation, intraoperative observation and postoperative guidance were executed. The prognosis of these patients were observed. Results The operations were performed successfully. No intraoperative complications were founded. Mean uncorrected visual acuity at 2 year postoperatively was (0.60±0.28), and mean best corrected visual acuity was (0.70±0.28). Conclusions Careful preparation before surgery, close cooperation during surgery and the correct management after surgery were the important measures for the success of surgery.

Objective:To understand the present situation of the construction of standardized asthma clinic for children in China, to explore the problems existing in the process of construction, and to promote the healthy development of standardized clinic construction.Methods:The process and current situation of the construction of standar-dized asthma clinics for children in China were reviewed and investigated, and the practical significance of the China Children′s Asthma Action Plan (CCAAP) in the construction of standardized asthma clinics for children was explored.Results:(1)By December 2020, 1 289 standardized asthma clinics for children and 135 regional demonstration centers had been built; 56 training sessions had been held, with a total of 2 560 doctors and 650 nurses trained, covering 2 560 hospitals across the country; and 4 518 patient education sessions were held.Online publicity covers a total of 1 million person-times, with an annual average of 1.33 million patients.(2)CCAAP improved the quality control level of standardized asthma clinic and promoted the standardized management of children.Conclusions:Through process optimization, professional evaluation, individual health education and real-time disease monitoring, standardized asthma clinic for children with asthma can effectively enhance asthma management awareness of children and their parents, improve disease awareness, and promote better control of asthma.It is an effective management model of asthma in children at present, and it is worthy of clinical promotion.CCAAP plays a good role in the construction of standardized outpatient clinic for asthma in children.The construction of standardized asthma clinic for children in China has achieved remarkable results, and the development trend is good in the future.

Objective:To explore the nursing cooperation of gonioscope assisted transluminal trabeculectomy (GATT).Methods:From February 2019 to August 2020, preoperative visits, preoperative equipment debugging and surgical instrument preparation were conducted for 30 patients (30 eyes) undergoing GATT for open-angle glaucoma in Zhongshan Ophthalmic Center of Sun Yat-sen University. Nurses closely attended the patients and expertly cooperated with doctors in the intraoperative management of patients. The incidence of complications was observed. The intraocular pressure (IOP) and medication were compared before and after operation.Results:Totally 30 cases (30 eyes) completed the operation successfully without serious complications and nursing adverse events. Twenty-six patients (86.7%) completed 360° total incision, and four patients (13.3%) completed 270° total incision. The mean preoperative IOP was (27.43±6.46) mmHg (1 mmHg= 0.133 kPa), the mean postoperative IOP was (13.67±3.01)mmHg. The difference between preoperative and postoperative IOP and the use of anti-glaucoma drugs were of statistical significance ( t value was 10.67, Z value was 4.18, P<0.05). Conclusions:The implementation of fine nursing for patients with GATT can ensure the smooth operation, reduce the incidence of complications and improve the postoperative rehabilitation effect.

OBJECTIVETo analyze the epidemiological characteristics and the bacterial pathogen composition of pneumonia among children under 5 years old in Ningbo.

METHODSIn 2013 February-April, we selected pediatric ward in three hospitals according to stratified cluster random sampling, and from which we collected all 57 556 hospitalized cases in January 2009-December 2012 period of children under 5 years old. A total of 16 740 medical records and bacterial spectrum records of pneumonia or bronchial pneumonia cases among children under 5 years old were described to calculate the proportions of children pneumonia or bronchial pneumonia hospitalized cases accounted for hospitalized children over the same period(referred to as proportions of pneumonia incidence), the detection rate of bacterial pathogens, proportions of bacterial spectrum, and to analyze the characteristics and bacterial pathogen composition of pneumonia among children under 5 years.

RESULTSThe proportions of children pneumonia in 2009-2012 were 26.16% (2 882/11 017), 31.23% (4 004/12 819), 29.35% (4 898/16 689) and 29.10% (4 956/17 031)(Z = 3.13, P < 0.01), and were in a downward trend by the increasing of age(Z = -113.74, P < 0.01). The proportions of children pneumonia of 0-5 age group were 50.71% (6 756/13 318), 26.60% (3 159/11 877), 24.17% (2 574 /10 648), 22.36% (2 509 /11 223) and 16.63% (1 745 /10 490). The proportions of children pneumonia with different season were 26.90% (3 725/13 850), 26.51% (3 788/14 287), 29.59% (4 442/15 011) and 33.21% (4 785 /14 408) (χ² = 198.77, P < 0.01). The proportions of severe children pneumonia of 0-5 age group were 1.10% (74/6 753), 0.47% (15/3 159), 0.19% (5 /2 574),0.08% (2 /2 509) and 0.06% (1 /1 745), with a downward trend by the age(F = 57.62, P < 0.01). The detection rate of Klebsiella pneumoniae, Haemophilus influenzae,Acinetobacter baumannii, Escherichia coli, Staphylococcus aureus, and Streptococcus pneumoniae was 19.3% (540/2 805), 16.4% (460/2 805), 13.6% (381/2 805), 11.9% (335/2 805), 11.5% (323/2 805) and 6.8% (192/2 805).

CONCLUSIONIn 2009-2012, the proportions of children pneumonia under 5 year old constituted a relatively high proportion in Ningbo city. Children under 1 year old were the major suffering group of pneumonia and severe pneumonia, which should be the key prevention group. The major bacterial pathogens of children's pneumonia in Ningbo are gram-negative bacteria.

Acinetobacter baumannii ; Child ; Epidemics ; Escherichia coli ; Gram-Negative Bacteria ; Haemophilus influenzae ; Humans ; Incidence ; Infant ; Klebsiella pneumoniae ; Pneumonia ; Staphylococcus aureus ; Streptococcus pneumoniae

Objective To analyze the epidemiological characteristics and the bacterial pathogen composition of pneumonia among children under 5 years old in Ningbo.Methods In 2013 February-April, we selected pediatric ward in three hospitals according to stratified cluster random sampling,and from which we collected all 57 556 hospitalized cases in January 2009-December 2012 period of children under 5 years old.A total of 16 740 medical records and bacterial spectrum records of pneumonia or bronchial pneumonia cases among children under 5 years old were described to calculate the proportions of children pneumonia or bronchial pneumonia hospitalized cases accounted for hospitalized children over the same period( referred to as proportions of pneumonia incidence), the detection rate of bacterial pathogens, proportions of bacterial spectrum, and to analyze the characteristics and bacterial pathogen composition of pneumonia among children under 5 years.Results The proportions of children pneumonia in 2009-2012 were 26.16%( 2 882/11 017),31.23%(4 004/12 819),29.35%(4 898/16 689) and 29.10%(4 956/17 031)(Z=3.13,P<0.01),and were in a downward trend by the increasing of age(Z=-113.74,P<0.01).The proportions of children pneumonia of 0-5 age group were 50.71%(6 756/13 318),26.60%(3 159/11 877),24.17%(2 574 /10 648),22.36%(2 509 /11 223) and 16.63%(1 745 /10 490).The proportions of children pneumonia with different season were 26.90%(3 725/13 850),26.51%(3 788/14 287),29.59%(4 442/15 011) and 33.21%( 4 785 /14 408 ) (χ2 =198.77, P <0.01 ) .The proportions of severe children pneumonia of 0-5 age group were 1.10%(74/6 753),0.47%(15/3 159),0.19%(5 /2 574),0.08%(2 /2 509) and 0.06%(1 /1 745),with a downward trend by the age(F=57.62,P<0.01).The detection rate of Klebsiella pneumoniae, Haemophilus influenzae, Acinetobacter baumannii, Escherichia coli, Staphylococcus aureus,and Streptococcus pneumoniae was 19.3%(540/2 805),16.4%(460/2 805),13.6%(381/2 805), 11.9%(335/2 805),11.5%(323/2 805) and 6.8%(192/2 805).Conclusion In 2009-2012,the proportions of children pneumonia under 5 year old constituted a relatively high proportion in Ningbo city.Children under 1 year old were the major suffering group of pneumonia and severe pneumonia, which should be the key prevention group.The major bacterial pathogens of children′s pneumonia in Ningbo are gram-negative bacteria.

Objective To analyze the epidemiological characteristics and the bacterial pathogen composition of pneumonia among children under 5 years old in Ningbo.Methods In 2013 February-April, we selected pediatric ward in three hospitals according to stratified cluster random sampling,and from which we collected all 57 556 hospitalized cases in January 2009-December 2012 period of children under 5 years old.A total of 16 740 medical records and bacterial spectrum records of pneumonia or bronchial pneumonia cases among children under 5 years old were described to calculate the proportions of children pneumonia or bronchial pneumonia hospitalized cases accounted for hospitalized children over the same period( referred to as proportions of pneumonia incidence), the detection rate of bacterial pathogens, proportions of bacterial spectrum, and to analyze the characteristics and bacterial pathogen composition of pneumonia among children under 5 years.Results The proportions of children pneumonia in 2009-2012 were 26.16%( 2 882/11 017),31.23%(4 004/12 819),29.35%(4 898/16 689) and 29.10%(4 956/17 031)(Z=3.13,P<0.01),and were in a downward trend by the increasing of age(Z=-113.74,P<0.01).The proportions of children pneumonia of 0-5 age group were 50.71%(6 756/13 318),26.60%(3 159/11 877),24.17%(2 574 /10 648),22.36%(2 509 /11 223) and 16.63%(1 745 /10 490).The proportions of children pneumonia with different season were 26.90%(3 725/13 850),26.51%(3 788/14 287),29.59%(4 442/15 011) and 33.21%( 4 785 /14 408 ) (χ2 =198.77, P <0.01 ) .The proportions of severe children pneumonia of 0-5 age group were 1.10%(74/6 753),0.47%(15/3 159),0.19%(5 /2 574),0.08%(2 /2 509) and 0.06%(1 /1 745),with a downward trend by the age(F=57.62,P<0.01).The detection rate of Klebsiella pneumoniae, Haemophilus influenzae, Acinetobacter baumannii, Escherichia coli, Staphylococcus aureus,and Streptococcus pneumoniae was 19.3%(540/2 805),16.4%(460/2 805),13.6%(381/2 805), 11.9%(335/2 805),11.5%(323/2 805) and 6.8%(192/2 805).Conclusion In 2009-2012,the proportions of children pneumonia under 5 year old constituted a relatively high proportion in Ningbo city.Children under 1 year old were the major suffering group of pneumonia and severe pneumonia, which should be the key prevention group.The major bacterial pathogens of children′s pneumonia in Ningbo are gram-negative bacteria.

OBJECTIVETo evaluate the sleep architecture and hypoxia and clinical features of habitual snoring children with an obstructive sleep apnea-hypopnea index (OAHI) 1 to 5.

METHODThe polysomnographic data of 267 children aged from 2 to 16 years with habitual snoring were analyzed retrospectively, and the clinical features were analyzed in 108 of the children. The recruited children were divided into primary snoring group (PS group, OAHI≤1), obstructive sleep apnea hypopnea syndrome (OSAHS) group (15 or dostructive apnea index>1, LSpO2<0.92).

RESULTThe oxygen desaturation index of the intermediate OSAHS group (3.8±0.4) was significantly higher than that of PS group (1.6±0.1) (χ2=34.5, P<0.01). The LSpO2 of intermediate OSAHS group was significantly lower than that of PS group (89(87,91) vs. 93(91,94), χ2=40.2, P<0.01). Comparing to the PS group, the non-rapid eye movement 1 ratio (N1%) was significantly higher (19.0±1.2 vs. 14.2±0.1, χ2=14.1, P<0.01), and the non-rapid eye movement 3 ratio (N3%) was significantly lower (24.4±1.0 vs. 29.0±1.1, P<0.01) in the intermediate OSAHS group. The pediatric questionnaire score intermediate OSAHS group was higher than PS (0.41±0.19 vs. 0.28±0.14, χ2=8.52, P=0.01). The adenoids-nasopharynx ratio was higher than that of PS group (0.70±0.07 vs. 0.62±0.10, χ2=8.96, P=0.01). The hypertrophy of tonsil was higher than PS group (2(1,2) vs. 1(1,2), χ2=7.95, P<0.05).

CONCLUSIONHypoxia and abnormal sleep structure are present in HS children with an OAHI of 1 to 5, and they also have the clinical features of OSAHS.

Adenoids ; pathology ; Adolescent ; Child ; Child, Preschool ; Humans ; Hypertrophy ; Hypoxia ; Oxygen ; blood ; Palatine Tonsil ; pathology ; Polysomnography ; Retrospective Studies ; Sleep ; Sleep Apnea, Obstructive ; diagnosis ; Snoring ; Surveys and Questionnaires

Objective To investigate the predominant genotypes and epidemiological characteristics of human adenovirus (HAdV) in pediatric community-acquired pneumonia (CAP) in China.Methods This was a repeated cross sectional study.Between November 2014 and November 2016,nasopharyngeal aspirates (NPAs) or throat swabs from each hospitalized pediatric patients diagnosed as CAP in 12 hospitals in Northern and Southern China were collected.Respiratory specimens were screened for 18 respiratory viruses including HAdV by using Luminex xTAG RVP Fast V2 multiplex Assay.Typing of HAdV and analysis for the epidemiological characteristic of HAdV were performed.Results (1) A total of 2 723 hospitalized pediatric patients with CAP were enrolled in this study and 156 (5.7％,156/2 723) respiratory specimens were positive for HAdV,and 74 (6.6％,74/1 128) and 82 (5.1％,82/1 595) were in Northern and Southern China,respectively.There was no significant difference in the positive detection rate between the Northern and Southern China.(2) In Northern China,the HAdV positive rate of children at the age of ＜6 months,6 months-＜1 years,1-＜3 years,3-＜5 years and ≥5 years was 5.9％(6/101),6.7％(7/104),10.3％(34/331),4.1％(11/266) and 4.9％(16/326),respectively,and the incidence of HAdV infection peaked in children aged 1-3 years (x2=11.511,P=0.021).While in Southern China the HAdV positive rate of children at the age of ＜6 months,6 months-＜1 years,1-＜3 years,3-＜5 years and ≥5 years was 2.2％ (7/312),4.6％ (12/259),6.3％ (31/494),7.3％ (18/245) and 4.9％(14/285),respectively.There was no significant difference in the positive detection rate among age groups.(3) In 2015,the highest detection rate of HAdV in northern China was 12.5％ (25/200) in winter,and in Southern China was 6.7％ (35/525) in spring and 5.3％ (19/357) in summer.(4) In 108 cases of HAdV positive specimens typing was done and 80 in cases classification was successfully performed.Totally 7 genotypes of HAdV,including HAdV-3 (n=32),HAdV-7 (n=9),HAdV-1 (n=12),HAdV-2 (n=15),HAdV-5 (n=10),HAdV-6 (n=1) and HAdV-4 (n=1),were detected.The predominant HAdV genotypes were HAdV-3 (30.8％,8/26) and HAdV-7 (26.9％,7/26) in Northern China,while HAdV-3 (44.4％,24/54) and HAdV-2 (22.2％,12/54) were the most prevalent genotypes in Southern China.Conclusions HAdV is an important viral pathogen in pediatric CAP.The predominant HAdV genotypes and peak seasons of HAdV infections were different between Northern and Southern China.The predominant HAdV genotypes were HAdV-3 and HAdV-7 in Northern China,while HAdV-3 and HAdV-2 in Southern China.The peak season of HAdV infections was winter in Northern China.However,HAdV infections are more common in spring and summer in Southern China.