Humans ; Lung ; physiopathology ; Pneumonia, Mycoplasma ; complications ; diagnosis ; physiopathology ; therapy

OBJECTIVETo study the clinical efficacy of adjuvant therapy with glucocorticoids in children with lobar pneumonia caused by Mycoplasma pneumoniae.

METHODSOne hundred and eight children with lobar pneumonia caused by Mycoplasma pneumoniae were randomly divided into routine treatment and hormone treatment groups. Both groups were treated with azithromycin and other symptomatic therapies. In addition to the basic treatment, the hormone treatment group was given dexamethasone 0.25-0.3 mg/(kg·d) by intravenous drip until the body temperature was normal. Then given oral prednisone tablets 0.5-1 mg/(kg·d) (gradually reduced) for a total treatment course of 7-10 days. Before and after treatment pulmonary functions were examined, and serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-2 (IL-2) and interleukin-6 (IL-6) were measured.

RESULTSThe duration of fever, cough relief time and pulmonary shadow absorption time on chest X-ray were significantly shorter in the hormone treatment group than in the routine treatment group (P<0.05). After treatment, the two groups showed improvements in serum CRP, ESR, IL-2, and IL-6 (P<0.05), but the hormone treatment group showed significantly more improvement (P<0.05). Varying degrees of mixed ventilation dysfunction were seen in the two groups before treatment, and hormone therapy significantly improved pulmonary function, especially promoting the recovery of small airway function.

CONCLUSIONSAdjuvant therapy with glucocorticoids can effectively alleviate clinical symptoms, promote the absorption of pulmonary inflammation, and improve pulmonary function in children with lobar pneumonia caused by Mycoplasma pneumoniae.

Adolescent ; Child ; Child, Preschool ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Interleukin-6 ; blood ; Lung ; physiopathology ; Male ; Pneumonia ; drug therapy ; immunology ; physiopathology ; Pneumonia, Mycoplasma ; drug therapy ; immunology ; physiopathology

Female ; Humans ; Infant ; Lung ; physiopathology ; Male ; Pneumonia, Viral ; physiopathology ; Respiratory Function Tests ; Respiratory Syncytial Virus Infections ; physiopathology ; Respiratory Syncytial Viruses

OBJECTIVETo investigate the changes of pulmonary functions in children with segmental Mycoplasma pneumoniae pneumonia (SMPP).

METHODSA total of 55 children with SMPP were recruited into this study. Pulmonary functions were measured at both acute and recovery phases, including FVC, FEV1, FEV1/FVC, PEF, FEF25%, FEF50%, FEF75% and FEF25%-75%.

RESULTSFVC, FEV1, FEV1 /FVC, PEF, FEF25%, FEF50%, FEF75%, and FEF25%-75% were reduced in all of the 55 cases at the acute phase. FEF25%, FEF50%, FEF75% and FEF25%-75% decreased more significantly. The indexes above mentioned were improved significantly at the recovery phase compared with the acute phase (P<0.05). During the acute phase FVC and FEV1 decreased more significantly in the group with multiple area lesions than in the group with single area lesions (P<0.05).

CONCLUSIONSBoth large and small airway functions are damaged in different degrees in children with SMPP during the acute phase. More cases show restrictive ventilatory disorders and the injury of small airway function is more severe. The pulmonary function is markedly improved at the recovery phase, suggesting that the pulmonary function impairments are reversible. The pulmonary function impairments are more severe in children with multiple area lesions.

Adolescent ; Child ; Child, Preschool ; Female ; Forced Expiratory Flow Rates ; Forced Expiratory Volume ; Humans ; Lung ; physiopathology ; Male ; Pneumonia, Mycoplasma ; physiopathology

Adolescent ; Common Variable Immunodeficiency ; complications ; Female ; Humans ; Lung Diseases, Interstitial ; etiology ; pathology ; physiopathology ; Pneumonia ; etiology ; pathology ; physiopathology

Administration, Inhalation ; Ambroxol ; administration & dosage ; Female ; Humans ; Infant, Newborn ; Male ; Pneumonia ; drug therapy ; physiopathology

OBJECTIVETo study the clinical application of ultrasonic cardiac output monitor (USCOM) in evaluation of cardiac function in children with severe pneumonia.

METHODSTwenty-nine children with severe pneumonia were enrolled in the observation group and forty-three children with common pneumonia were enrolled in the control group. The USCOM was used to measure the cardiac function indices in the two groups. The results were compared between the two groups. The changes in cardiac function indices after treatment were evaluated in the observation group.

ESULTSThe observation group had a significantly higher heart rate and significantly lower cardiac output, systolic volume, and aortic peak velocity than the control group (P<0.05). There were no significant differences in cardiac index or systemic vascular resistance between the two groups (P>0.05). In the observation group, the heart rate, cardiac output, systolic volume, aortic peak velocity, cardiac index, and systemic vascular resistance were significantly improved after treatment (P<0.05).

CONCLUSIONSThe USCOM is a fast, convenient, and accurate approach for dynamic measurement of cardiac function and overall circulation state in children with severe pneumonia. The USCOM can provide a basis for diagnosis, treatment, and evaluation of the disease, which is quite useful in clinical practice.

Cardiac Output ; physiology ; Child ; Female ; Humans ; Infant ; Male ; Monitoring, Physiologic ; instrumentation ; Pneumonia ; physiopathology ; Ultrasonics

OBJECTIVESTo investigate the changes of liver function during the course of serious acute respiratory syndrome (SARS) and to explore its possible influence factors.

METHODSThere were 91 patients with common SARS, and 23 patients with severe SARS, and 61 common pneumonia patients served as the controls. The liver functions of all the patients were measured.

RESULTSThe rate of anomaly liver function in the common SARS patients group was 68.1%, which was higher than that in the common pneumonia patients group (24.6%), chi2=27.7, P<0.01. The changes mainly existed in the mild to moderate elevation of alanine aminotransferase and aspartate aminotransferase. The severe SARS patients were older and the changing rate of liver function was as high as 95.7%.

CONCLUSIONSThe damage possibility of liver function in SARS patients is higher than that in common pneumonia patients. The damage is light and related to SARS itself. The damage of liver function in the severe SARS patients may have close relationship with age.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Humans ; Liver ; physiopathology ; Male ; Middle Aged ; Pneumonia ; physiopathology ; Severe Acute Respiratory Syndrome ; physiopathology

OBJECTIVE: To systematically summarize the clinical features of coronavirus disease 2019 (COVID-19) in children. METHODS: PubMed, Embase, Web of Science, The Cochrane Library, CNKI, Weipu Database, and Wanfang Database were searched for clinical studies on COVID-19 in children published up to May 21, 2020. Two reviewers independently screened the articles, extracted data, and assessed the risk of bias of the studies included. A descriptive analysis was then performed for the studies. Related indices between children with COVID-19 and severe acute respiratory syndromes (SARS) or Middle East respiratory syndrome (MERS) were compared. RESULTS: A total of 75 studies were included, with a total of 806 children with COVID-19. The research results showed that the age of the children ranged from 36 hours after birth to 18 years, with a male-female ratio of 1.21 : 1. Similar to SARS and MERS, COVID-19 often occurred with familial aggregation, and such cases accounted for 74.6% (601/806). The children with COVID-19, SARS, and MERS had similar clinical symptoms, mainly fever and cough. Some children had gastrointestinal symptoms. The children with asymptomatic infection accounted for 17.9% (144/806) of COVID-19 cases, 2.5% (2/81) of SARS cases, and 57.1% (12/21) of MERS cases. The children with COVID-19 and MERS mainly had bilateral lesions on chest imaging examination, with a positive rate of lesions of 63.4% (421/664) and 26.3% (5/19) respectively, which were lower than the corresponding positive rates of viral nucleic acid detection, which were 99.8% and 100% respectively. The chest radiological examination of the children with SARS mainly showed unilateral lesion, with a positive rate of imaging of 88.9% (72/81), which was higher than the corresponding positive rate of viral nucleic acid detection (29.2%). Viral nucleic acid was detected in the feces of children with COVID-19 or SARS, with positive rates of 60.2% (56/93) and 71.4% (5/7) respectively. The children with COVID-19 had a rate of severe disease of 4.6% (31/686) and a mortality rate of 0.1% (1/806), the children with SARS had a rate of severe disease of 1.5% (1/68) and a mortality rate of 0%, and those with MERS had a rate of severe disease of 14.3% (3/21) and a mortality rate of 9.5% (2/21). CONCLUSIONS Children with COVID-19 have similar symptoms to those with SARS or MERS, mainly fever and cough. Asymptomatic infection is observed in all three diseases. Children with COVID-19 or SARS have milder disease conditions than those with MERS. COVID-19 in children often occurs with familial aggregation. Epidemiological contact history, imaging examination findings, and viral nucleic acid testing results are important bases for the diagnosis of COVID-19.
Betacoronavirus ; Child ; Coronavirus Infections ; physiopathology ; Cough ; virology ; Female ; Fever ; virology ; Humans ; Male ; Middle East Respiratory Syndrome Coronavirus ; Pandemics ; Pneumonia, Viral ; physiopathology ; Severe Acute Respiratory Syndrome ; physiopathology ; virology

OBJECTIVETo recognize the clinical features of the bronchiolitis obliterans.

METHODClinical manifestation, chest X-ray, computed tomography (CT) and pulmonary function of 4 cases with bronchiolitis obliterans were retrospectively analyzed.

RESULTTwo cases were after Stevens-Johnson syndrome (SJS), the other 2 were after severe pneumonia, including one suffered from adenovirus pneumonia. Cough, tachypnea and wheezing persisted in all the 4 patients. The symptoms lasted for at least 6 weeks, in one case for over one year. Crackles and wheezing were present in all the 4 cases. Hyperinflation was seen in chest radiographs in all cases. On pulmonary CT/high-resolution CT (HRCT), patchy opacity and bronchial wall thickening were seen in each patient. Areas of air trapping were seen in three cases. Bronchiectasis was seen in 2 cases, atelectasis and mosaic perfusion were seen respectively in one case. PO(2) was low in all the four cases. Wheezing was not responsive to beta(2) agonist and other bronchodilating therapy. Prednisone was used at a dose of 1 mg/(kg.d) in 3 cases. Two cases were followed up for 3 months. The clinical condition of one case was improved, whose wheezing and bronchiolar constriction disappeared, cough and dyspnea were also relieved. However, the condition of one patient was not improved, although the wheezing disappeared. The HRCT of these two cases showed no improvement.

CONCLUSIONClinical symptoms of BO were cough, tachypnea, and wheezing after acute lung injury. Crackles and wheezing were the most common signs in the BO. Chest radiographs showed hyperinflation. Pulmonary CT showed bronchial wall thickening, bronchiectasis, atelectasis, and mosaic perfusion. Pulmonary function tests suggested obstruction of small airway.

Bronchiolitis Obliterans ; etiology ; pathology ; physiopathology ; Child ; Child, Preschool ; Humans ; Infant ; Male ; Pneumonia ; complications ; Pneumonia, Viral ; complications ; Prognosis ; Respiratory Function Tests ; Stevens-Johnson Syndrome ; complications ; Tomography, X-Ray Computed