OBJECTIVETo investigate the diagnosis and treatment of invasive pulmonary aspergillosis (IPA) in children.

METHODThe clinical data of 16 cases of proven or probable IPA who had been in our Hospital from January 2006 to June 2014 were retrospectively analyzed.

RESULTAmong the 16 patients, 11 were males and 5 were females. One child had proven IPA and 15 children had probable IPA. Host risk included long duration use of multiple broad-spectrum antibiotics in 16 cases, neutropenia in 9 cases, invasive mechanical ventilation in 3 cases, primary immunodeficiency disease in 2 cases, long-term use of glucocorticoids in 2 cases, measles in 2 cases, and congenital pulmonary hypoplasia in 1 case. Fever, cough and expectoration were present in all the children with IPA. At the time of diagnosis, the halo sign and subpleural wedge consolidation shadows were more common in neutropenia group (5/9, 7/9) than those in non-neutropenia group(0/7, 1/7)(P<0.05). The cavities and"air-crescent sign"were more common after 15 days to 1 month when the children had been treated with anti-aspergillosis drugs than that at the onset of diagnosis of IPA (P<0.05). The positive rate of serum galactomannan (GM) test was higher than that of sputum culture and serum G test (P<0.05). Thirteen children received voriconazole, in 7 of the children the treatment was effective.

CONCLUSIONNeutropenia were the common host risk factors in children with IPA. Subpleural wedge consolidation shadows, the halo sign and the"air-crescent"sign were highly suggestive of the diagnosis of IPA in children. Subpleural wedge consolidation shadows and the halo sign were more common in neutropenia group than in non-neutropenia group in the early stage of the course. Serum GM test played an important role in the diagnosis of IPA in children. Voriconazole was effective in majority of the children with IPA.

Anti-Bacterial Agents ; Aspergillosis ; Child ; Cough ; Female ; Fever ; Glucocorticoids ; Humans ; Male ; Mannans ; Measles ; Neutropenia ; Retrospective Studies ; Risk Factors ; Sputum ; Voriconazole

Objective To study the effect of inhibiting the phosphorylation of signal transducer and activator of transcription-3 (STAT3) on Th2 cell-mediated airway inflammation and airway remodeling,and to explore the role of STAT3 in the pathophysiology of bronchial asthma.Methods Forty Balb/c mice were randomly divided into control group(n =10),asthma group(n =10),AG490 by intraperitoneal group (n =10),and AG490 by inhalation group (n =10).The mice were sensitized with ovalbumin to establish the asthmatic model.The histological changes were evaluated by means of HE staining,while total broalchial wall thickness(Wat) and smooth muscle thickness(Wam) were measured by using image analysis system.The percentages of collagen deposition were detected by way of Masson's trichrome staining; the bronchoalveolar lavage fluid (BALF) were collected,the total cell and the cell differentials were counted,the levels of IL-4,IL-5 in BALF were measured by enzyme-linked immunosorbent assay; the lung tissue extracts were analyzed for phosphorylation of STAT3 (p-STAT3) by Western blot.The SPSS 13.0 software was used to analyze the data.Results 1.The histological changes by HE staining showed that less inflammatory cells infiltration in airway and around the pulmonary vascular in AG490 administration groups compared with asthmatic group.Wat,Wam and the percentages of collagen deposition in AG490 administration groups was significantly lower than that in asthmatic group(F =49.5,41.7,58.2,all P ＜ 0.05).2.The level of p-STAT3 in the lung of AG490 administration groups were significantly lower than those in asthmatic group(F =34.17,P ＜ 0.05).3.The total cells and eosinophils amounts in BALF of AG490 administration groups were significantly lower than those in asthmatic group (F =42.5,64.7,all P ＜ 0.05).The levels of IL-4,IL-5 in BALF of AG490 administration groups were significantly lower than those in asthmatic group,respectively (F =39.2,75.1,all P ＜ 0.05).Conclusions STAT3 signaling pathway is pivotal in Th2 cell-mediated airway inflammation and airway remodeling in asthmatic models,and AG490 can ameliorate airway inflammation and airway remodeling efficiently by inhibiting the phosphorylation of STAT3,and targeting this signaling pathway may be a novel therapy for asthma.

Objective:To analyze the expression of meiotic recombination 11 homolog A（MRE11A）in T lymphocytes of children with sepsis，and to explore the effect of MRE11A on the function of T lymphocytes in sepsis.Methods:Twenty-four children with sepsis hospitalized in PICU at the First Affiliated Hospital of Guangxi Medical University from December 2021 to April 2022 were selected as sepsis group.During the same period,24 healthy children who underwent outpatient physical examination in our hospital were selected as control group.The gender and age of two groups were collected,and the duration of invasive mechanical ventilation,laboratory examination index and hospitalization time were collected in sepsis group.The peripheral blood samples of sepsis group were collected within 24 hours of admission to PICU,and peripheral blood samples of control group were collected during the study period.Flow cytometry was used to detect the cytoplasmic MRE11A of peripheral blood T lymphocytes in two groups,and the proportion as well as expression of MRE11A positive cells between two groups were compared (expressed by mean fluorescence intensity) .Results:There were 24 cases in sepsis group,including 11 males and 13 females,with a median age of 32.50 (19.00,132.75) months.There were 24 cases in control group,including 14 males and 10 females,with a median age of 57.50 (33.75,102.25) months.There were no significant differences in gender and age between two groups (all P>0.05).The proportion of MRE11A +CD4 +T lymphocytes in sepsis group was lower than that in control group[3.59（2.29，8.87）% vs.99.90（99.03，100.00）%， Z=-5.961， P<0.001 ].The expression of MRE11A in CD4 +T lymphocytes in sepsis group was lower than that in control group[1 663.00（1 557.00，1 777.00）vs.5 689.00（4 415.25，9 567.00）， Z=-5.939， P<0.001].The proportion of MRE11A +CD8 +T lymphocytes in sepsis group was lower than that in control group[3.85（1.87，9.58）% vs.92.15（76.70，96.40）%， Z=-5.856， P<0.001].The expression of MRE11A in CD8 + T lymphocytes in sepsis group was lower than that in control group[1 921.50（1 680.00，2 217.00）vs.4 165.00（2 894.00，9 122.00）， Z=-5.083， P<0.001]. Conclusion:The expression level of MRE11A in the cytoplasm of T lymphocytes in children with sepsis was decreased,which may affect the function of T lymphocytes.