Objective:To explore the etiology and characteristics of chronic wet cough in children in Qingdao.Methods:Patients with chronic wet cough treated at respiratory clinic of the Women and Children′s Hospital Affiliated to Qingdao University from July 2018 to June 2019 were included in this study.After three-month follow-up, the etiological data was analyzed.Results:(1)A total of 213 children were included, ranging in age from 1 month to 14 years old, including 38 cases of 1 month~1 year old, 47 cases of 1~3 years old, 87 cases of 3~6 years old, and 41 cases of 6~14 years old.The median age was 4.7 years.The top four causes of chronic wet cough in children were upper airway cough syndrome(33.8%), protracted bacterial bronchitis(20.7%), asthma with upper airway cough syndrome(15.5%), and asthma with infection(10.8%). Other causes were postinfection cough, pertussis syndrome, bronchiectasis, gastroesophageal reflux, bronchial foreign body, abnormal airway development, cystic fibrosis and so on.(2)The first cause of chronic wet cough in different age groups: 1 month to 3 years old group was protracted bacterial bronchitis; 3 to 14 years old group was upper airway cough syndrome.(3)The causes of chronic wet cough showed seasonal differences.Upper airway cough syndrome and cough after infection had a more balanced incidence throughout the year; protracted bacterial bronchitis and pertussis syndrome were common in winter; asthma with upper airway cough syndrome and asthma with infection were common in spring and autumn.Conclusion:Upper airway cough syndrome, protracted bacterial bronchitis, asthma with upper airway cough syndrome, and asthma with infection are the 4 leading causes for children with chronic wet cough in Qingdao.The causes of chronic wet cough have age and seasonal differences.

Objective To study the adenovirus infection and popular features in hospitalized respira-tory infection children of Qingdao area. Methods A total of 6 820 cases of respiratory infection from March 2011 to February 2014 in our hospital were enrolled,the average age was 5 years and 2 months old. Their ve-nous serums were collected on the first day of hospitalization,adenovirus IgM was monitored by indirect im-munofluorescence application. The adenovirus-positive rates of cases between different age groups, seasons and diseases were observed. Results Adenovirus were positive in 1 043 children,the rate was 15. 29%. The positive rate of young children group(1-3 years old) was 16. 92%,which was highest,there was statistic difference between young children group and other age groups(χ2 =12. 50,P<0. 05). Adenovirus infection rates were upward in recent years,the infection rates of winter and spring were higher than those of summer and fall,and there were significant differences between them(χ2 =28. 89,P <0. 05). The positive rate of AdV-IgM in children with severe respiratory tract infection was higher[19. 90%(877/4 408)]than that of the children with mild infection[12. 27%(296/2 412)](χ2 =64. 25,P<0. 05). Conclusion In recent years, adenovirus infection rate in Qingdao hospitalized respiratory infection children was rising,the infection rates in winter and spring were high,young children were the most vulnerable populations. The positive rate of ade-novirus infection in children with severe respiratory tract infection is higher than that of the children with mild respiratory tract infection.

Objective To study the serum levels of brain natriuretic peptide (BNP) and the correlation with the heart function in children with Kawasaki disease(KD), and to explore its clinical value for diagnosis of KD. Method A total of 43 children aged from 5 months to 8 years with mean age of (2.3 + 0.6) years with KD admitted from February 2007 to April 2009 were enrolled into this study as KD group, and patients with myocarditis, myocardiopathy, congenital heart disease and other primary heart disease were ruled out. Another 30 healthy children were taken as control health group. There were no significant differences in age and gender between two groups (P >0.05) .The serum levels of BNP were measured both in acute and recovery stages of KD by using ELISA. The serum levels of BNP in healthy children were measured randomly once. The left ventricular ejection fraction (LVEF), left ventricular shorten fraction ( LVSF), cardiac index (CI) and left ventricular inflow velocity through the mitral annulus (including E-velocity and A-velocity) were measured by using two-dimensional echocardiography in acute and recovery stages of KD. Data were analyzed with t -test and the linear regression analysis test. Results The serum level of BNP in acute stage was (517.26 + 213.40) ng/mL and was significantly higher than that in recovery stage (91.56 + 47.97) ng/mL, and higher than that in control group (91.56 + 47.97) ng/mL (P < 0.01). The levels of LVEF, LVSF and CI in the acute stage were significantly lower than those in the recoverystage ( P < 0.0%), but there was no significant difference in E/A between acute stage and recovery stage (P > 0.05). The BNP level had negative correlation with the levels of LVEF, LVSF and CI(r = -0.63, -0.52, and - 0.53, respectively, P < 0.05), but had no significant correlation with E/A (r = - 0.18, P > 0.05). Conclusions The serum levels of BNP increase significantly in the KD patients, and have negative correlation with the levels of LVEF, LVSF and CI. The detection of serum levels of BNP has an important significance for diagnosis of KD.

Objective To investigate the effects of edaravone (EDA) on cell apoptosis induced by endoplasmic reticu?lum stress (ESR) after spinal cord injury (SCI) in rats. Methods Thirty-six healthy adult SD rats were randomly divided in?to three groups (12 rats for each group):Sham group, SCI group and EDA group. The rat model of SCI was made by Allen’s method and the sham group was only received laminectomy and kept the spinal cord intact. Rats in sham group and SCI group accepted the same volume and frequency of saline injection as EDA group. The EDA group was given 10 mg/kg EDA once every 12 h intraperitoneally. Three days after injuring, the spinal cords were harvested, and the protein levels of C/EBP homologous protein (CHOP), Cleaved caspase-12 and Cleaved caspase-3 were detected by Western blot assay. Immunofluo?rescence staining was used to analyze the positive ratio of caspase-12 and CHOP in spinal cord of three groups. Meanwhile, TUNEL staining was used to identify cell apoptosis of spinal cord. Results Compared with sham group, the protein levels of CHOP, Cleaved caspase-12 and Cleaved caspase-3 were obviously higher in SCI group (P<0.01);the proportion of Cas?pase-12 and CHOP positive cells was significantly increased (P<0.01), and the apoptotic rates were also significantly in?creased in spinal cord (P<0.01). However, compared with SCI group, the protein levels of CHOP , Cleaved caspase-12 and Cleaved caspase-3 were significantly decreased in EDA group (P<0.01);the proportion of Caspase-12 and CHOP positive cells was significantly reduced (P<0.01), and the apoptotic rates were also significantly decreased in spinal cord (P<0.01). Conclusion EDA has neuroprotective potential to spinal cord injury. The mechanism of its neuroprotective effect may asso?ciate with its inhibitory effect to the cell apoptosis induced by endoplasmic reticulum stress after SCI.

Objective To investigate the effects of hydrogen sulfide on autophagy and the apoptosis after acute spinal cord injury in rats. Methods Thirty-six adult male SD rats (250-300 g) were randomly divided into three groups (n=12 for each group):sham operation group (Sham group), spinal cord injury group (Model group) and hydrogen sulfide pre-treatment group (H2S group). Allen’s method was used to establish the rat model of spinal cord injury. Rats of sham operation group re?ceived only laminectomy. Rats of H2S group received sodium hydrosulphide injection intraperitoneally (50μmol/kg) 1h after spinal cord injury, and Model group was given the same amount of saline solution. Rats in the three groups were sacrificed 24 h after spinal cord injury, then the spinal cord was removed. The expressions of LC3, p70S6K and Cleaved caspase-3 were detected by Western blot assay. The expression of LC3 was also detected by immunofluorescence. The cell apoptosis was as?sessed by TUNEL stain. Results Compared with Sham group, the expression levels of LC3Ⅱ/LC3Ⅰand Cleaved caspase-3 were increased in Model group, but the expression of p70S6K decreased and cell apoptosis increased in Model group (P<0.01). Compared with Model group, the expression levels of LC3Ⅱ/LC3Ⅰand Cleaved caspase-3 were decreased significant?ly, while the expression of p70S6K increased and cell apoptosis decreased significantly in H2S group (P < 0.01). Conclu?sion Hydrogen sulfide can inhibit autophagy and reduce cell apoptosis after acute spinal cord injury in rats.

Objective:To summarize the clinical characteristics of 102 children with protracted bacterial bronchitis in Qingdao area.Methods:One hundred and two children with protracted bacterial bronchitis treated at respiratory clinic of Women and Children′s Hospital affiliated to Qingdao University from January 2016 to March 2021 were included in this study.The clinical data, age and seasonal distribution, etiology, clinical manifestations, high-resolution CT of the lungs, characteristics of lung function, bronchoscopy and treatment prognosis were retrospectively analized.Results:The top three pathogens of protracted bacterial bronchitis in 102 children (55 boys, 47 girls, median age: 1.7 (0.8, 4.2)years were Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, with frequency of 12.75%, 10.78%, and 6.86%, respectively.The onset season was mainly autumn and winter, with a total of 73 (71.57%) cases.The main clinical manifestations were wet cough and (or) wheezing, and the cough was not divided between day and night.CT of the lungs showed thickening of the bronchial wall in 16(15.69%) cases and uneven ventilation in 5(4.90%) cases.Twenty-three (22.55%) cases had abnormal lung function.Fifty-two (50.98%) cases underwent bronchoscopy, of which 33(32.35%) cases had multiple lung segmental purulent changes under the microscope.After standard anti-infection, bronchoscopy and alveolar lavage, expectorant and physical therapy, the prognosis was mostly good.Conclusion:The clinical manifestations of protracted bacterial bronchitis in children have no obvious specificity.Early diagnosis, identification of the cause and comprehensive management are critical to its prognosis.

Objective To study the pulmonary artery shrink pressure(PASP) and pulmonary function in children with asthmatic diseases,and screen pulmonary arterial hypertension (PAH).To probe the correlation between PASP and pulmonary function.Methods Ninety children with asthmatic diseases from November 2014 to April 2015 at the Department of Respiratory,Women and Children's Hospital of Qingdao City were chosed as asthmatic group,and 90healthy children in the same period were selected as healthy control group.PASP and pulmonary function were detected by Doppler ultrasound and tidal flow-volume loop respectively within 24 hours of admission,the respite degrees were assessed by clinical and tidal flow-volume loop.SPSS 13.0 statistical software was used for statistical analysis.Results PASP of the asthmatic group and the healthy control group was (3.24 ±0.66) kPa and (3.15 ±0.49) kPa,and the difference was statistically significant (F =7.50,P ＜ 0.05).There were 10 cases of PAH in the asthmatic group,which had statistically difference with the healthy control group (x2 =10.59,P ＜ 0.05).The tidal volume per kilogram,the ratio of time to peak tidal expiratory flow to total expiratory time,the ratio of volume to peak expiratory flow to total expiratory volume of the asthmatic group were (6.62 ± 1.63) mL/kg,(26.76 ± 6.48) ％ and (26.66 ± 6.54) ％,and these three indicators of the healthy control group were (8.38 ± 0.80) mL/kg,(34.35 ± 2.84) ％ and (34.23 ±3.02) ％,but that of the former group were less than that of the lower respectively (F =86.28,138.08,113.27,all P ＜0.05).PASP had negative correlation with the ratio of time to peak tidal expiratory fow to total expiratory time in the asthmatic group (r =-9.45,P ＜ 0.05).PASP was increased with the aggravation of respite,and it had statistical difference between the mild or moderate asthmatic group [(3.43 ± 0.50) kPa,(3.66 ± 0.59) kPa] and the severe group [(4.20 ± 0.75) kPa] (x2 =24.81,12.55,all P ＜ 0.05),and the cases of PAH had significant differences among these 3 groups (0,2,8 cases in mild,mode rate and severe group,respectively) (x2 =54.92,P ＜ 0.05).Conclusions For children with more severe airway obstruction and wheezing,the risk of PASP and PAH will be higher.It is helpful to reduce right ventricular function damage for children with asthmatic diseases by measuring PASP and screening PAH in the early stage according to the clinical condition and lung function.

Objective:To summarize the characteristics of chest CT imaging and prognosis of children with necrotizing pneumonia (NP) after flexible bronchoscopy, in order to improve the clinician′s diagnosis and treatment of this disease.Methods:The clinical information, imaging features of the sixty-six patients suffering from NP, who were diagnosed and treated in Qingdao Women and Children′s Hospital from September 2015 to April 2019, were retrospectively analyzed. Fourty-six cases who were treated with flexible bronchoscopy alveolar lavage(treatment group) were comparative analyzed with the left 20 cases who were not treated with flexible bronchoscopy alveolar lavage(control group).Results:In treatment group, all patients appered lung consolidation at early stages, and multiple balloon chambers emerged in consolidation shadows in late period. There was no statistic difference in basic information, clinical manifestations, laboratory examinations and etiology between the control group and treatment group( P>0.05). The treatment group had a lower incidence of pulmonary complications and a higher lung shadow full absorption rate, which showed the statistical difference( P<0.05). Conclusion:The flexible bronchoscopy alveolar lavage plays an important role in the process of treating the children with NP, and chest CT provides reliable imaging evidence in the early diagnosis and prognosis of the NP children.

Objective:To analyze the clinical features of bronchiectasis, in order to improve the diagnosis, treatment, and prognosis.Methods:The clinical data of 78 children with bronchiectasis at Qingdao Women and Children′s Hospital of Qingdao University from January 2010 to January 2020 were analyzed, including age, regional distribution, etiology, clinical manifestations, lung function characteristics, results of lung high-resolution CT, results of fiberbronchoscopy examination, treatment, and prognosis.Results:Among 78 children with bronchiectasis, there were 35 males(44.9%)and 43 females(55.1%), with a median age of 8.7(6.1, 9.0)years.There were 51 children in rural areas(65.4%)and 27 children in urban areas(34.6%). The incidence of children in rural areas was higher than that in urban areas.The top three causes of bronchiectasis were 40 (51.3%)cases after infection, nine cases(11.5%)of primary immunodeficiency and seven cases(9.0%)of inhalation.The main clinical manifestations were wet cough, expectoration, wheezing and repeated respiratory infection.High-resolution CT of the lungs showed 36(46.2%)cases with diffuse bronchiectasis and 37 (47.4%) cases with localized bronchiectasis.Forty-nine(62.8%) cases had abnormal pulmonary ventilation function.Sixty-one(78.2%)cases were treated with fiberoptic bronchoscopy, of which 49(80.3%)cases had "fishbone" changes.After anti-infection, fiberbronchoscopy examination, expectorant and physical therapy, 67 cases were discharged and followed up for more than one year.Among them, 55 cases had symptoms improved, 12 patients had recurrent respiratory tract infection, and three patients died.Conclusion:The clinical manifestations of bronchiectasis in children have no obvious specificity.Early diagnosis, identification of the cause and comprehensive management are critical to prognosis of bronchiectasis.

Objective:To analyze the molecular characteristics of antibiotic resistance in Helicobacter pylori(HP)and provide a molecular bio-logical basis for clinical eradication of HP by means of rational antibiotic use.Methods:From February 2019 to November 2023,1,144 pa-tients at the Gansu Wuwei Cancer Hospital who tested positive for HP using the 14C-urea breath test were enrolled in the study.Antibiotic resistance and related molecular characteristics of HP,and CYP2C19 polymorphisms in the patients were detected by diffusion drug suscept-ibility testing,drug resistance gene testing,and next-generation sequencing,respectively.Results:Among the six antibiotics assessed,the resistance rate and the prevalence of resistance genes(rdxA)were highest for metronidazole(92.00%and 86.12%,respectively),and lowest for amoxicillin(Pbp1)(11.78%and 37.11%,respectively).The prevalence of CYP2C19 alleles showed that 46.77%,44.58%,and 8.65%of par-ticipants were fast,medium,and slow metabolizers,respectively.Of the participants,148(18.55%)had immunohistochemical sphericity.The eradication rate of HP lower using conventional treatment regimens than that using personalized treatment regimens(χ2=8.627,P=0.003).The HP eradication rate was higher among patients with a first diagnosis of drug resistancebased on molecular testing,than that in patients undergoing retreatment(χ2=6.242,P=0.012).Conclusions:The prevalence of amoxicillin-resistant HP is low in Wuwei City,which has a high incidence of gastric cancer.Molecular diagnosis of antimicrobial resistance could improve the HP eradication rate and provide a refer-ence for rational use of antibiotics in clinical practice.