1.Clinical features of 213 cases of severe adenovirus pneumonia in children
Ailiang LIU ; Ying HUANG ; Yang YANG ; Chang SHU ; Jihong DAI ; Qubei LI
Journal of Clinical Pediatrics 2013;(8):726-729
Objectives To summarize the clinical feature of severe adenovirus pneumonia (SAP) in children and further to improve prognosis and clinical diagnosis of SAP. Methods The clinical data of 213 children with SAP from June 2009 to June 2011 were retrospectively analyzed. Results Among 213 patients, 155 (72.8%) children were aged 6 months to 2 years, with a males to females ratio of 2.7∶1. The onset of 158 patients (74.2%) was in winter and spring. All patients had fever, 172 (80.8%) with high temperature of 39.1℃-41℃, 161 (75.6%) with a fever lasting more than 2 weeks. Two hundred and ifve (96.2%) patients had cough in the early stage, 120 (56.3%) with wheeze, 139 (65.3%) with moist rales and wheezing in the lung. Imaging ifndings in the preliminary stage of SAP showed that 63 patients (92.6%) had pulmonary interstitial changes;in critical stage, 80 patients (54.4%) had segmental consolidation and 33 (22.4%) with pleural effusion, 25 (17.0%) with pleuritis;in recovery phase, 50 patients (68.5%) showed absorption in segmental area of consolidation. All cases had complications, 175 (82.2%) with respiratory failure, including 10 (4.7%) with ARDS;among extrapulmonary complications, diseases of cardiovascular system (64.3%) and alimen-tary system (44.1%) were the most common ones, and the occurrence of myocarditis and diarrheal disease were the highest. Age, ARDS and more than two kinds of complications had adverse impact on the outcomes, and the difference was signiifcant (P<0.05). Conclusions SAP is a severe pneumonia with long duration of high fever, severe clinical manifestations with more complications. When SAP is suspected, it is recommended to complete etiological and chest radiographic examination for early diagnosis and treatment.
2.Postoperative quality of life for patients with hypertensive cerebral hemorrhage in the basal ganglia
Qiang GUO ; Ailiang ZHANG ; Zhibing SONG ; Jianwei GAO ; Xuguang LI ; Qingguo LIU ; Long WANG
Chinese Journal of Physical Medicine and Rehabilitation 2016;38(7):514-523
Objective To explore the life quality of postoperative patients after a hypertensive cerebral hem-orrhage in the basal ganglia and the factors influencing it, so as to provide evidence for improving the life quality of such patients. Methods A total of 128 patients were studied retrospectively. Their gender, age, occupation, mari-tal status, education level, place of residence and family size were tabulated, as well as whether or not they were liv-ing with their children, smoking or drinking alcohol. Their household income was recorded along with their clinical condition during surgery ( midline shift, blood loss, operative time, whether a hernia occurred, consciousness, and whether bleeding broke into the ventricles. The SF-36 health measurement scale was used to evaluate the patients′life quality, and the factors influencing it were analyzed. Results Univariate analysis showed that: ( 1) Their physio-logical functioning ( PF) and global health ( GH) were mainly affected by age, marital status, family size, midline shift, quantity of cerebral hemorrhage, occurrence of herniation, consciousness and whether the hemorrhage broke in-to the ventricles. (2) Their physiological role (RP) was influenced by marital status, education background, household monthly income, midline shift, consciousness and whether the hemorrhage broke into the ventricles. (3) Pain (BP) was mainly affected by marital status and family size. (4) Social functioning (SF) was closely related to marital status, family size, consciousness and whether hemorrhage broke into the ventricles. (5) Their mental health (MH) was main-ly affected by the amount of bleeding, whether they were living with their children, the operation′s duration and whether the hemorrhage broke into the ventricles. (6) Their emotions (RE) were influenced by their consciousness and whether bleeding broke into the ventricles. (7) Their vitality (VT) was affected by their marital status, smoking, consciousness and whether the bleeding broke into the ventricles. Multivariate analysis showed that whether the hemorrhage broke into the ventricles was the most influential factor. Family size was also influential. Conclusions Age, number of family members, whether they are living with their children, and whether hemorrhage broke into the ventricles are all influen-tial in predicting the life quality of survivors of hypertensive cerebral hemorrhage in the basal ganglia.
3.Epidemiological characteristics of respiratory syncytial virus infection in children in Shenzhen Area during summer of 2020
Ailiang LIU ; Yanmin BAO ; Li LI ; Heping WANG
Chinese Pediatric Emergency Medicine 2022;29(2):123-127
Objective:To investigate the clinical characteristics and serotyping characteristics of respiratory syncytial virus(RSV)infection in children prevalent during summer of 2020 in Shenzhen City, and provide basis for the diagnosis, monitoring and prevention of RSV infection in this area.Methods:The clinical data of 509 cases of RSV infection were analyzed in the Respiratory Department at Shenzhen Children′s Hospital from July 1, 2020 to August 31, 2020.The children diagnosed with pneumonia were divided into mild RSV pneumonia group and severe RSV pneumonia group according to the severity.The age, sex, clinical manifestations, basic diseases, mixed infection, clinical diagnosis of the patients were analyzed.Results:In 509 children with RSV infection, the male to female ratio was 1.84∶1, and the mean thermal range was (3.98±3.25) d. The detection rate of RSV was 51.4% (126/245) in children aged < 6 months, 45.6% (247/542) in children aged from 6 months to 2 years, 41.8% (123/294) in children aged from 2 to 5 years, and 8.5% (13/153) in children aged > 5 years.Common clinical manifestations were cough (96.2%), fever (72.5%), runny nose (61.9%), and nasal congestion (54.6%). Of the 509 cases, 123 (24.2%) had underlying diseases and 49 (9.6%) had mixed infections.A total of 371 cases had RSV pneumonia, including 280 mild cases (55.0%) and 91 severe cases (17.8%). Compared with the mild RSV pneumonia group, the severe RSV pneumonia group was significantly higher in male, age < 1 years, proportion of wheezing, underlying disease, mixed infection, and hospitalization time and fever time (all P<0.05). Multivariate analysis showed that age less than 1 year, mixed infection and underlying diseases were the high risk factors of severe RSV pneumonia( OR=10.1, 14.3 and 3.4, respectively, all P<0.05). Of the 198 serotyping cases, 18 were type A and 180 were type B. Conclusion:During the summer of 2020, the epidemic of RSV infection in children in Shenzhen is dominated by type B. In addition to children aged from 6 months to 2 years, children aged 2-5 years are also susceptible groups.Age<1 year, underlying diseases and mixed infection are independent risk factors of severe RSV pneumonia in children.
4.Cytokine storms associated with respiratory virus infection and targeted therapy strategies
Ailiang LIU ; Yanmin BAO ; Yuejie ZHENG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2021;36(24):1913-1917
Since December 2019, the novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) infection has broken out worldwide, causing enormous social and economic burdens.Sudden exacerbations in SARS-CoV-2 infected people may be caused by infection-related cytokine storms.The basic state of the body and the strength of the immune response determine the prognosis of SARS-CoV-2.The interaction between proinflammatory factors and anti-inflammatory factors, and continued proinflammatory response cause lung edema, exudation, progression to acute respiratory distress syndrome involving the lung tissues and organs, multi-organ failure, and even death.The efficacy of antiviral therapy alone for immune complications like cytokine storm during viral infection is not ideal, and the targeted therapy of cytokines has become a potentially popular therapeutic strategy.Early identification and appropriate treatment of immune complications contribute to reduce the morbidity and mortality of severe viral infections.
5.Comorbidity of epilepsy and headache
Xiaoshan WANG ; Ailiang MIAO ; Hongxing LIU
Journal of Apoplexy and Nervous Diseases 2024;41(6):493-498
Epilepsy is often comorbid with other neuropsychiatric conditions,which are known as epilepsy comor-bidities.Among these conditions,the comorbidity of epilepsy and migraine is very common.Although they are two differ-ent diseases,they overlap in terms of pathophysiological features and clinical symptoms,and several anti-seizure medica-tions(ASMs)have been proved to be effective in migraine.However,there are still controversies over the concept of epi-lepsy comorbid with migraine,and there is often a lack of effective treatment for migraine due to missed diagnosis or misdi-agnosis.In order to improve the ability for identification and precise treatment of epilepsy comorbid with migraine among clinicians,this article elaborates on the possible mechanism of epilepsy comorbid with migraine and discusses the con-cept,identification,and diagnosis and treatment regimens for epilepsy comorbid with migraine by considering the tempo-ral association between headache symptoms and epileptic seizures,with reference to the classification of epilepsy comorbid with migraine and related diagnostic criteria in Chinese expert consensus(2019)and the ICHD-3-2018 guidelines issued by the International Headache Society.
6.Characteristics of obstructive sleep apnea in children with allergic rhinitis
Xiao HUANG ; Qin YANG ; Ailiang LIU ; Congcong WANG ; Jiahui LI ; Yanmin BAO ; Wenjian WANG ; Yuejie ZHENG ; Hongguang PAN
Chinese Pediatric Emergency Medicine 2022;29(8):622-625
Objective:To analyze the characteristics of sleep disordered breathing (SDB) in children with allergic rhinitis (AR), and improve the diagnosis and treatment at AR combined with obstructive sleep apnea (OSA).Methods:The clinical data of 120 patients with AR and OSA (AR and OSA group) admitted to the respiratory department at Shenzhen Children′s Hospital from May 2019 to December 2020 were retrospectively analyzed.A total of 120 children diagnosed with OSA and excluded AR during the same period were selected as control group.The SDB day and night symptoms, sleep structure characteristics and sleep breathing events were compared between two groups.Results:The average course of disease in children with AR and OSA was significantly longer than that in control group ( P=0.030). The main manifestations of children in AR and OSA group were mouth breathing (100.0%), snoring (99.2%), nasal obstruction (88.5%), and restless sleep (68.0%). There was no significant difference in sleep structure between two groups ( P>0.05), but the sleep efficiency of AR and OSA group was significantly lower than that of control group ( P=0.028). The respiratory events apnea hypopnea index, obstructive apnea index, obstructive apnea hypopnea index, hypopnea index and oxygen desaturation index of each sleep period in AR and OSA group were significantly higher than those in control group ( P<0.05). Among the children in AR and OSA group, moderate and severe OSA were the main manifestations, and the difference between two groups was statistically significant ( P<0.001). Conclusion:The combination of AR delayed the course of OSA in children.The main characteristics of sleep disordered breathing in children with AR are mouth opening, restless sleep, snoring and nasal obstruction.The sleep efficiency is decreased.Obstructive hypopnea and apnea are the most common respiratory events, and oxygen deficiency often occurs in rapid eye movement phase.Children with AR are more likely to have moderate or severe obstructive sleep apnea.