Objective To investigate the common allergens and the relationship between the common allergens and the age of children with bronchial asthma in Jiading area of Shanghai. Methods Skin prick test (SPT) of 15 common allergens with standard prick liquid were performed in 351 asthmatic children, the children were divided into ≤3 years group, 3 ～6 years group and ＞6 years group, and we observed the positive rates and allergens in different age groups. Results (1) The positive rate of SPT for inhalant allergens in children with bronchial asthma is 71. 2%, specifically are: dust mite (49. 6%), house dust mite (49. 0%), fungi Ⅰ (36. 8%), mold Ⅱ (34. 8%), tree Ⅰ (32. 5%), dog epithelium (31.9%), cat epithelium (31.3%), pollen (29. 1%), tree Ⅱ (28. 8%), and feather (27.4%). (2)The positive rate of SPT for food allergens in children with bronchial asthma is 39. 6%, specifically are: shrimp(24.2%), eggs(15.7%), milk(14.8%), peanuts (13. 7%), and curries(12.5%). (3) The positive rate of inhalant allergens was significantly higher than food allergens. The positive rate of inhalant allergens had no significant differences among different ages, while the positive rate of food allergens was increased with age. Conclusions Most children with bronchial asthma and allergens are related, and allergens are related to age.

Objective To evaluate the influence of atopy on exhaled nitric oxide in chronic persistent asthmatic children. Methods A total of 52 chronic persistent asthmatic children who completed FeNO measurements and skin prick testing were enrolled. Patients were divided into non-atopic group and atopic group by skin prick testing results, and subdivided into non-allergic rhinitis and rhinitis group according to whether combined with allergic rhinitis. At the same time 78 healthy children were chosen as control group. Moreover, 32 chronic persistent asthmatic children who completed FeNO measurements twice interval of three months were enrolled. Results The FeNO level was signiifcantly different among the atopic group (n=40), the non-atopic group (n=12) and the control group (H=33.29, P=0.000);The FeNO level was signiifcantly higher in the atopic group than that in the non-atopic group (P<0.05). And the FeNO level were signiifcantly different among the rhinitis group (n=41), the non-rhinitis group (n=11) and the control group (H=30.63, P=0.000). The FeNO level was signiifcantly higher in the rhinitis group than that in the control group (P<0.05), however there were no difference between the rhinitis group and the non-rhinitis group(P>0.05).There were no correlations between FeNO levels of chronic persistent asthmatic children and the wheal diameter of house dust mites or dust mites (r=2.05, P=0.135;r=1.58, P=0.312). Moreover, the FeNO level was signiifcantly lower after 3 months ICS treatment (z=-2.05, P=0.041). Conclusions Atopy had major inlfuence on the FeNO level of chronic persistent asthmatic children, and the FeNO level declined with the theatment of ICS.

Objective To assess the effects of inhaled corticosteroids on growth velocity in children with asthma .Methods We searched the Cochrane Airways Group Specialised Register of trials (CAGR) ,which was derived from systematic searches of bibliographic databases including CENTRAL ,MEDLINE ,EMBASE ,CINAHL ,AMED and PsycINFO .We also searched Wan Fang Chinese periodical Database and VIP Chinese periodical Database from the establishment of the database to October 2014 .Articles which were parallel‐group randomised controlled trials comparing daily used of ICS ,delivered by any type of inhalation device ,ver‐sus placebo or non‐steroidal drugs in children up to 18 years of age with persistent asthma are selected .The data analysis was used by RevMan 5 .2 software .Results A total of 18 randomized control trials were included .Meta analysis showed that inhaled cortico‐steroids for 6-8 months ,1 year significantly slowing down growth velocity in children with asthma (MD= -0 .77 ,-0 .55 ,respec‐tively ,P<0 .01) .Inhaled corticosteroids for 2 years had no significant inhibition on growth velocity in children with asthma (MD=-0 .30 ,P>0 .05) .Conclusion This systematic review showed that ICS therapy had temporarily inhibition on growth velocity in children with asthma ,the peak inhibition happen within half a year ,its inhibitory effect decrease with time .

Objective To explore the factors influencing serum trough concentration of vancomycin in pediatric patients with severe gram-positive cocci pneumonia. Methods The general information, the biochemical test results, and plasma concentration of vancomycin were collected from 93 pediatric patients with severe gram-positive cocci pneumonia. The relative factors influencing trough concentration of vancomycin were analyzed retrospectively. Results With the dosage of 40-60 mg/(kg·d), serum trough concentration of vancomycin were between 10-20 mg/L in 26 patients, <10 mg/L in 54 cases, ≥20 mg/L in 13 cases. The ALT, AST, GFR, and γ-GT were significantly different among three groups (P<0.05); the 10-20 mg/L group had the highest levels of AST and γ-GT, the ≥20 mg/L group had the highest level of ALT and the lowest level of GFR. Multiple linear regression analysis showed that GFR was negatively linearly correlated with the serum trough concentration of vancomycin (R2=0.039, P<0.05). The median serum trough concentration of vancomycin in pediatric patients with GFR≥90, 60–90, 30–60 mL/(min·1.73m2) were 8.66, 18.21, 8.45 mg/L respectively, and the difference is statistically significant (P<0.05). Conclusions The serum trough concentration of vancomycin is negatively linearly correlated with GFR in pediatric patients with severe gram-positive cocci pneumonia. The patients with impaired renal function are easier to reach the target serum trough concentration of vancomycin. Clinical use of vancomycin should follow the low doses in the range the guideline recommended, and the serum trough concentration should be closely monitored.

Problem-based learning (PBL) teaching method combined with formative evalua-tion was used in the teaching practice of pediatrics education. This method was implemented by four phases: courses designing, group-preparing, problems-organizing and teaching practice. The method was evaluated by students' feedback and survey results of patients, teachers and teaching councilors. It was showed that the teaching effects of PBL combined with formative evaluation was better than tra-ditional teaching method in pediatrics teaching.

Objective:To investigate the clinical characteristics of children with invasive pneumococcal di-sease (IPD) and the sensitivity of Streptococcus pneumoniae (SP) isolates to antibacterial drugs, so as to provide the reference for diagnosis and treatment of IPD. Methods:The clinical data of IPD patients in the Children′s Hospital of Chongqing Medical University from January 2014 to December 2018 as well as the drug sensitivity results of SP isolates were retrospectively analyzed.Results:The male to female ratio of 139 patients enrolled was 1.5∶1.0.One hundred and sixteen (83.5%) patients were under 5 years old.Of the 31 patients (22.3%) with underlying diseases, 7 patients (5.1%) had hematological malignancy, 6 patients (4.3%) had congenital heart diseases, and 18 patients (12.9%) were immunosuppressed.The common sources of infection were the respiratory system (59.0%, 82/139 cases) and the central nervous system (28.8%, 40/139 cases). The in-hospital mortality rate among them was 15.8% (22/139 cases). More than 90.0% of the SP isolates were insusceptible to Erythromycin, Tetracycline and Clindamycin, and 74.8% (104/139 cases) of the isolates were insusceptible to Meropenem.The susceptibility rate of SP isolates to Amoxicillin was 69.1% (96/139 cases). The SP isolates were completely susceptible to Vancomycin, Linezolid, Moxifloxacin and Ofloxacin.Meningitis isolates had lower susceptibility rates to Penicillin (10.0% vs. 54.5%, P<0.001) and Cefotaxime (32.5% vs. 74.7%, P<0.001) than those in nonmeningitis isolates. Conclusions:Children under 5 years old with underlying diseases are susceptible to IPD and have a high mortality rate.The SP isolates in children with IPD are highly insusceptible to Erythromycin, Tetracycline, Clindamycin and Meropenem, and completely susceptible to Vancomycin, Linezolid, Moxifloxacin and Ofloxacin.Meningitis isolates are less susceptible to Penicillin and Cefotaxime than non-meningitis isolates.