OBJECTIVEInfection-associated atelectasis is rather common during childhood and the effects of drug therapy are often unsatisfactory. The present study aimed to evaluate the effectiveness of flexible bronchoscopy in the treatment of infection-associated atelectasis in children.

METHODSOne hundred and twenty-five patients (68 male and 57 female; age ranged from 10 d to 14 years and their courses of disease were from 3 d to 2.5 years) with infection-associated atelectasis confirmed by chest X-ray or CT were enrolled in the study. The following conditions were excluded by bronchoscopy: airway foreign body, airway anomalies, tumor, tuberculosis. The patients were divided into two groups: flexible bronchoscopy group and medication group. In the flexible bronchoscopy group, 65 patients were treated mainly with flexible bronchoscopy whereas in medication 60 group patients only received medication. Chest X-ray or CT was regularly reviewed for every patient, meanwhile the effect of flexible bronchoscopy at different courses of disease was observed.

RESULTSFlexible bronchoscopy group and medication group had no significant differences in age, sex and course of disease (P > 0.05). In flexible bronchoscopy group 39 patients were cured, 20 were improved and 6 cases had no change; in medication group 17 patients were cured, 25 were improved and 18 had no change. The two groups had significant differences (P < 0.01); in bronchoscopy group there were significant differences among patients with the courses of disease less than 3 months, 3 to 6 months and more than 6 months.

CONCLUSIONSThe authors concluded that flexible bronchoscopy was an effective method for treatment of infection-associated atelectasis. Flexible bronchoscopy can reach pathological part and clear pus and granulation. It can remove obstruction and relieve symptoms. When course of disease was short, bronchoscopic therapy was advantageous to recovery of atelectasis. Bronchial washing may overcome the shortcomings of bronchoalveolar lavage, therefore the former seemed to be more suitable for treatment of infection-associated atelectasis.

Adolescent ; Bronchoscopy ; methods ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Pulmonary Atelectasis ; drug therapy ; etiology ; therapy ; Respiratory Tract Infections ; complications ; drug therapy ; therapy ; Treatment Outcome

OBJECTIVETo observe the effect of Qingfei Peiyuan Micro-pill (QPM) on HIV/AIDS patients with pulmonary infection of phlegm heat obstructing lung syndrome (PHOLS).

METHODSTotally 141 HIV/AIDS patients with pulmonary infection of PHOLS were randomly assigned to the treatment group (94 cases) and the control group (47cases). On the basis of Western medicine, patients in the treatment group took QPM. The therapeutic course for all was 28 days. The improvement of symptoms and signs was observed. The body temperature (BT), chest X ray, and white blood cells (WBCs) were detected.

RESULTSThe Chinese medical syndrome score was lower in the treatment group than in the control group at the 7th, 21st, and 28th day of treatment, showing statistical difference (P < 0.05). The efficacy was better in the treatment group than in the control group at the 7th, 21st, and 28th day of treatment, showing statistical difference (P < 0.05). The BT was lower in the treatment group than in the control group on the 7th day. There was no statistical difference in the patient number with normal WBCs on the 7th day (P > 0.05). But there was statistical difference in the patient number with normal WBCs on the 14th, 21st, and 28th day of treatment (P < 0.05). There was no statistical difference in the patient number with normal chest X ray on the 7th and 28th day of treatment (P > 0.05). But there was statistical difference in the patient number with normal chest X ray on the 14th and 21 st day of treatment (P < 0.05).

CONCLUSIONQPM had certain complementary effect on HIV/AIDS patients with pulmonary infection of PHOLS.

Acquired Immunodeficiency Syndrome ; complications ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Respiratory Tract Infections ; complications ; drug therapy ; Treatment Outcome

OBJECTIVETo investigate the clinical effect of mild warming moxibustion (MWM) on acupoints Shenque (RN8) and Guanyuan (RN4) for treatment of recurrent respiratory tract infection (RRTI) in children with cerebral palsy (CP).

METHODSSixty-four CP patients with RRTI were randomly and equally assigned to two groups, all received conventional rehabilitation treatment, but in acute infection stage, MWM was applied on the treated group, and intravenous dripping of immunoglobulin was given to the control group, all for 3 months. The frequency of RRTI attacking (Fre), the mean cough alleviating time (T-CA) and rale disappearing time (T-RA) during infection, as well as the serum levels of immune globulins during the post-treatment 1-year follow-up period were observed.

RESULTSThe effectiveness in the treated group was better than that in the control group, showing in aspects of Fre (2.38 +/- 0.64 times vs. 6.50 +/- 0.84 times), T-CA (3.92 +/- 1.32 days vs. 6.48 +/- 2.18 days) and T-RA (4.66 +/- 1.82 days vs. 7.64 +/- 1.44 days), significant difference was shown between groups (P < 0.01). The serum levels of IgG, IgM and IgA all raised in both two groups (P < 0.05), comparison of immunoglobulin levels between groups showed that they were lower immediately after treatment, but higher at the end of the 1-year follow-up in the treated group than those in the control group.

CONCLUSIONMWM on acupoints Shengue and Guanyuan has a better and long-term clinical effect for treatment of RRTI in children with CP.

Acupuncture Points ; Cerebral Palsy ; complications ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Moxibustion ; methods ; Respiratory Tract Infections ; complications ; drug therapy ; prevention & control ; Secondary Prevention

OBJECTIVETo investigate the clinical efficacy of Jianpi Yiqi Huoxue Decoction (JYHD) on children bronchial asthma complicated with recurrent respiratory infection (RRI) that could not be effectively controlled by regular inhalation of corticosteroid (ICS).

METHODSFifty-eight patients were divided into 2 groups: both were treated with anti-infective and symptomatic therapy, but JYHD was given additionally to patients in the treated group. Changes in clinical symptoms of RRI and asthma as well as the serum contents of IgA, IgG and IgM were observed.

RESULTSCompared with the control group, the frequency of respiratory infection occurred, duration of fever, cough and asthma sustained and time of antibiotics used were all lower significantly in the treated group (P < 0.05). The serum contents of IgA and IgG increased in the treated group after treatment, as compared with those before treatment and in the control group, all showed significant difference (P < 0.05).

CONCLUSIONFor children suffered from intractable bronchial asthma complicated RRI, application of JYHD in addition with the conventional treatment could prevent RRI effectively, so as th reduce the frequency of asthma attack and alleviate the severity of the disease.

Anti-Bacterial Agents ; therapeutic use ; Asthma ; complications ; drug therapy ; Child ; Child, Preschool ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Phytotherapy ; Recurrence ; Respiratory Tract Infections ; complications ; drug therapy ; pathology ; Treatment Outcome

OBJECTIVETo study the prognosis of childhood asthma and the factors influencing asthmatic attacks and prognosis.

METHODSThe medical data of 212 children with asthma who were followed up for more than 5 years were retrospectively studied.

RESULTSDuring the 5-year follow up, asthmatic attacks termination was found in 121 cases (57.1%) and asthma persistence was observed in 91 cases. Respiratory tract infections were found as the major factors inducing asthmatic attacks (71.7%), followed by inhaled allergens (17.0%).The children with asthma induced by respiratory tract infections had a higher remission rate of asthmatic attacks (61.2%) than those induced by allergens (41.7%) or exercises (26.3%). Three risk factors for asthma persistence were identified: concurrent allergic rhinitis and eczema, parental asthma and allergy-induced wheezing.

CONCLUSIONSThe 5-year follow-up study demonstrated that asthmatic attacks stopped in the majority of children with asthma. Respiratory tract infections may be the major factors inducing acute asthma attacks. The children with asthma induced by respiratory infections may experience a better outcome. Atopic children or children with the genetic background of atopy are at high risks for the development of persistent asthma.

Asthma ; drug therapy ; etiology ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Prognosis ; Respiratory Tract Infections ; complications ; Retrospective Studies ; Risk Factors

An 8-year-old girl who had experienced intermittent cough and fever over a 3 year period, was admitted after experiencing a recurrence for one month. One year ago the patient experienced a recurrent oral mucosal ulcer. Physical examination showed vitiligo in the skin of the upper right back. Routine blood tests and immune function tests performed in other hospitals had shown normal results. Multiple lung CT scans showed pulmonary infection. The patient had recurrent fever and cough and persistent presence of some lesions after anti-infective therapy. The antitubercular therapy was ineffective. Routine blood tests after admission showed agranulocytosis. Gene detection was performed and she was diagnosed with dyskeratosis congenita caused by homozygous mutation in RTEL1. Patients with dyskeratosis congenita with RTEL1 gene mutation tend to develop pulmonary complications. Since RTEL1 gene sequence is highly variable with many mutation sites and patterns and can be inherited via autosomal dominant or recessive inheritance, this disease often has various clinical manifestations, which may lead to missed diagnosis or misdiagnosis. For children with unexplained recurrent pulmonary infection, examinations of the oral cavity, skin, and nails and toes should be taken and routine blood tests should be performed to exclude dyskeratosis congenita. There are no specific therapies for dyskeratosis congenita at present, and when bone marrow failure and pulmonary failure occur, hematopoietic stem cell transplantation and lung transplantation are the only therapies. Androgen and its derivatives are effective in some patients. Drugs targeting the telomere may be promising for patients with dyskeratosis congenita.
Child ; Dyskeratosis Congenita ; complications ; therapy ; Female ; Humans ; Mouth Diseases ; etiology ; Mouth Mucosa ; pathology ; Recurrence ; Respiratory Tract Infections ; etiology ; Telomere ; drug effects ; Ulcer ; etiology

BACKGROUND/AIMS: Drug-induced liver injury (DILI) is a frequent cause of pediatric liver disease; however, the data on DILI are remarkably limited. METHODS: All 69 children hospitalized with DILI between January 2009 and December 2011 were retrospectively studied. RESULTS: A total of 37.7% of the children had medical histories of respiratory infection. The clinical injury patterns were as follows: hepatocellular 89.9%, cholestatic 2.9%, and mixed 7.2%. Liver biopsies from 55 children most frequently demonstrated chronic (47.3%) and acute (27.3%) hepatitis. Hypersensitivity features, namely, fever (31.9%), rash (21.7%), and eosinophilia (1.4%), were found. Twenty-four children (34.8%) developed chronic DILI. Antibiotics (26.1%) were the most common Western medicines (WMs) causing DILI, and the major implicated herbs were Ephedra sinica and Polygonum multiflorum. Compared with WM, the children whose injuries were caused by Chinese herbal medicine (CHM) showed a higher level of total bilirubin (1.4 mg/dL vs 16.6 mg/dL, p=0.004) and a longer prothrombin time (11.8 seconds vs 17.3 seconds, p=0.012), but they exhibited less chronic DILI (2/15 vs 18/39, p=0.031). CONCLUSIONS: Most cases of DILI in children are caused by antibiotics or CHM used to treat respiratory infection and present with hepatocellular injury. Compared with WM, CHM is more likely to cause severe liver injury, but liver injury caused by CHM is curable.
Anti-Bacterial Agents/*adverse effects ; Bilirubin/blood ; Child ; Child, Preschool ; China ; Drug-Induced Liver Injury/blood/*etiology/pathology ; Drugs, Chinese Herbal/*adverse effects ; Female ; Humans ; Liver/pathology ; Male ; Prothrombin Time ; Respiratory Tract Infections/*complications/drug therapy ; Retrospective Studies

OBJECTIVETo examine the clinical features of children with acute lymphoblastic leukemia (ALL) complicated by pulmonary infection after chemotherapy.

METHODSThe clinical data of 108 ALL children (115 case-times) with post-chemotherapy pulmonary infection were retrospectively reviewed. The risk factors for pulmonary infection and the relationship between pathogens and chest CT findings were evaluated.

RESULTSThe highest incidence (77.4% ) of pulmonary infection occurred during remission induction, peaking at 31-60 days after chemotherapy. Patients with neutropenia had the highest incidence rate of pulmonary infection (67.0%). Bacteria (36%) and fungi (41%) were the two most common pathogens in the 41 patients who were etiologically suspected of or diagnosed with pulmonary infection. There was no significant difference in chest CT findings between patients with bacterial and fungal infections.

CONCLUSIONSThe children with ALL are most susceptible to pulmonary infection during remission induction, especially when they are neutropenic. Bacteria and fungi are the main pathogens of pulmonary infections in these patients. However, the changes in chest CT images are poor indicators of the nature of pulmonary infection.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; drug therapy ; Respiratory Tract Infections ; diagnostic imaging ; epidemiology ; etiology ; microbiology ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVETo observe the effect and the possible mechanism of Jiexiao Oral Liquid (JXOL) in preventing and curing virus induced asthma in children.

METHODSOne hundred and sixty patients of acute upper respiratory tract infection (AURTI) with asthma history were randomly divided into 2 groups. JXOL was given to the treated group within 24 hrs after occurrence of AURTI symptoms, and virazole of 10-15 mg.kg-1.d-1 was given to the control group, the therapeutic course for both groups was 7 days. Changes of clinical symptoms, signs, therapeutic effect, pulmonary function and immuno-globulin in patients were observed.

RESULTSThe total effective rate of the treated group was 83.8%, the clinical control rate was 48.8%, while those in the control group were 62.5% and 23.8% respectively, showing significant difference between them (P < 0.01). JXOL could obviously improve the indexes of forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF), reduce the level of IgE, as compared with those before treatment, the difference was significant (P < 0.01 or P < 0.05); it also showed significant difference as compared with those in the control group after treatment. The changes of IgA, IgG and IgM after treatment showed insignificant difference.

CONCLUSIONJXOL was effective in preventing and curing virus induced asthma in children, it also shows pulmonary function improving and immune regulating effects.

Adolescent ; Asthma ; drug therapy ; prevention & control ; virology ; Child ; Child, Preschool ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin E ; blood ; Immunoglobulin G ; blood ; Male ; Phytotherapy ; Respiratory Tract Infections ; complications ; virology

We report a very rare case of a bronchogenic cyst combined with nontuberculous mycobacterial pulmonary disease in an immunocompetent patient. A 21-year-old male was referred to our institution because of a cough, fever, and worsening of abnormalities on his chest radiograph, despite anti-tuberculosis treatment. Computed tomography of the chest showed a large multi-cystic mass over the right-upper lobe. Pathological examination of the excised lobe showed a bronchogenic cyst combined with a destructive cavitary lesion with granulomatous inflammation. Microbiological culture of sputum and lung tissue yielded Mycobacterium avium. The patient was administered anti-mycobacterial treatment that included clarithromycin.
Anti-Bacterial Agents/therapeutic use ; Biopsy ; Bronchogenic Cyst/*complications/diagnosis/immunology/surgery ; Humans ; *Immunocompetence ; Male ; Mycobacterium avium Complex/*isolation & purification ; Mycobacterium avium-intracellulare Infection/*complications/diagnosis/drug therapy/immunology/microbiology ; Pneumonectomy ; Respiratory Tract Infections/*complications/diagnosis/drug therapy/immunology/microbiology ; Sputum/microbiology ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult