Humans ; Mycoplasma pneumoniae ; Pneumonia, Mycoplasma ; diagnosis

Asthma and chronic obstructive pulmonary disease (COPD) are main chronic respiratory diseases in adulthood,which bring a heavy burden to society and economy.The adulthood asthma and COPD originate from childhood.Atopy and certain respiratory viral infection are the risk factors of asthma.Some factors in childhood including premature,childhood asthma,serious lung infection,air pollution,active smoking will damage pulmonary function in adulthood,which contribute to COPD onset.Strategies such as preventing premature birth and controlling asthma will reduce the burden of chrouic respiratory diseases in adults.

Objective To investigate and summarize the clinical and high-resolution computed tomography(HRCT) characteristics of invasive pulmonary fungal infections(IPFIs)in children.Methods Clinical and HRCT data of 35 cases with IPFIs admitted in our hospital between March 2007 and July 2015 were retrospectively analyzed.The clinical and HRCT characteristics were summarized.Results Thirty-five patients consisted of 23 boys and 12 girls with mean age of(3.2±1.9) years.Host factors included acute leukemia (n=12),primary immunodeficiency disease (n=4),congenital heart disease (n=2),cerebral palsy (n=2),severe influenza A infection (H1N1) (n=2),ichthyosis (n=1),acquired immunodeficiency syndrome(n=1),systemic lupus erythematous (n=1),tubercular meningitis(n=1),mechanical ventilation(n=2).All patients were treated with broad-spectrum antibiotic,ranking by descending order:third-generation cephalosporins (28 cases),carbapenems(19 cases)and vancomycin (18 cases).Seventeen cases were treated with corticosteroids systemically and 12 cases with acute leukemia took antineoplastic medicine.The symptoms of IPFIs were intermittent or persistent fever,cough and rales.HRCT results:nodules (n=25,71.4％),subpleural patchy opacities (n=24,68.6％),mass (＞3cm) (n=4,11.4％),halo sign (n=27,77.1％),cavities (n=8,22.9％),air crescent sign (n=4,11.4％),miliary nodules (n=2,5.7％),pleural effusion (n=14,40％).Conclusion There are certain specific characteristics of IPFIs in children in clinical and HRCT aspects.The possible diagnosis of IPFIs can be made based on clinical and HRCT features.

Objective To explore the relationship between the amount of bleeding and the histopathologic grade of cerebral glioma with susceptibility weighted imaging (SWI), so that to assess the diagnostic value of SWI in grading cerebral glioma. Methods Totally 30 patients with cerebral glioma underwent SWI. The area of hemorrhage of every slice displayed in SWI was measured with software. The rate and amount of bleeding were compared between high and low grade tumors. Results There was no statistical significance in the incidence of detected bleeding on SWI (P=0.064), though it was higher in highly malignant group (80.00%) than that in low grade group (46.67%), while there was statistical significance in the amount of bleeding detected on SWI (Z=-2.275, P=0.026) between highly malignant group and low grade group. Conclusion The amount of tumor hemorrhage displayed in SWI is valuable for the preoperative grading of cerebral glioma.

ATP-Binding Cassette Transporters ; genetics ; DNA Mutational Analysis ; Humans ; Infant ; Lung ; pathology ; physiopathology ; Lung Diseases, Interstitial ; diagnosis ; genetics ; pathology ; Mutation ; genetics ; Pulmonary Alveoli ; pathology ; Pulmonary Surfactant-Associated Proteins ; deficiency ; genetics

OBJECTIVE To investigate the disinfectant-sulfanilamide resistance gene(qacE△1-sul1)and integrase gene(IntⅠ1)of Acinetobacter baumannii(ABA)isolated in pediatric clinic and analyze the relationship between these genes and multidrug resistance.METHODS Twenty eight strains of A.baumannii were collected and isolated from the sputum culture in the deep trachea of children with pneumonia during 2006.Identification of bacteria and susceptibility test by VITEK-32 automicroscan using GNI and GNS cards,were undertaken,qacE△1-sul1 gene and IntⅠ1 gene were analyzed by polymerase chain reaction(PCR).RESULTS Three of 28 strains of A.baumannii showed multidrug resistance,the positive rate was 10.71%.A.baumannii 4 strains were resistant to sulfamethoxazole/trimethoprim(SXT)with the positive rate 14.29%.Eleven strains that carrying qacE△1-sul1 genes and 4 strains carrying IntⅠ1 genes were detected,the positive rate was 39.29% and 14.29%,and qacE△1-sul1 and IntⅠ1 genes positive strains of A.baumannii were resistant to SXT,the other 7 qacE△1-sul1 positive strains were sensitive to SXT.CONCLUSIONS The main drug resistance in ABA resistant to SXT is to obtain qacE△1-sul1 gene.It should be paid attention to qacE△1-suⅠ1 positive but sensitive to SXT strains.It indicates that the strain carrying integron Ⅰ may show multidrug resistance.

Objective To study the diagnosis and treatment of protracted bacterial bronchitis (PBB) in children. Methods Children with PBB conifrmed by bronchoscopy were recruited from May 2013 to April 2015 . The clinical data were retrospectively analyzed. Results All 31 cases include 18 boys and 13 girls were recruited. 28/31 were younger than 6 years old. They all complained of wet cough, some of them were reported with wheeze ( 17/31 ) and with ruttle in the lungs ( 16/31 ). White blood cell were in normal range ( 18/31 ) or slightly elevated ( 13/31 ). The C-reactin protein was in normal range ( 28/31 ). Chest X-ray test of 16 cases were normal. Twenty-four cases taken chest computerized tomograph scan, 5 had a sign of tracheobronchial stenosis. The purulent bronchitis without tracheobronchial stenosis were conifrmed by bronchoscopy. Four cases had tracheomalacia. The medians of proportion of neutrophil were 80% in bronchoalveolar lavage lfuid (BALF). The pathogens were identiifed in BALF in 17 cases, 6 with Streptococcus pneumoniae, 6 with Haemophilus parainfluenzae, 3 with Moraxella catarrhalis, 2 with Staphylococcus aureus and 1 with Haemophilus influenzae. The symptoms were improved in all cases and co-amoxiclav was prescribed to most cases when discharged. The course of antibiotics therapy was 2-4 weeks in 23 cases, and more than 4 weeks in 8 cases. Twenty-three ( 23 ) cases were cured but 8 of them relapsed. Another 8 cases were improved but not completely remitted, 7/8 were cured by further treatment for concomitant diseases such as nasosinusitis and allergic rhinitis. Conclusions Children with PBB are typically younger than six years old, and presented with prolonged wet cough and parent-reported wheeze, normal or with ruttle in the lungs. A conifrmed diagnosis was reached by bronchoscopy. The antibiotics therapy were effective, the course should be more than 2-4 weeks, however, relapse were common. When antibiotics therapy does not lead to complete remission, concomitant diseases should be considered.

Objective To observe the expression of chemokine (MCP-1) and chemokine receptor (CCR2) in bone marrow cells,bone marrow stromal cells of multiple myeloma (MM) patients.Methods 15 cases were diagnosed by domestic uniform standard for MM patients,7 cases of male,8 cases of female,age range from 38 to 67 years,mean age 53.7 years old.According to the Durie-Salmon staging system,patients were divided into Ⅰ (2 cases),Ⅱ (5 cases) and Ⅲ period(8 cases).Control group were from 10 cases of non-malignant blood disease patients.MCP-1,CCR2 expression were measured by flow cytometry.Results Almost 14 cases of bone marrow cells expressed MCP-1and CCR2 in MM patients,while in the control group,bone marrow cells almost did not express MCP-1and CCR2.Stromal cells had similar MCP-1and CCR2 expression profile (68.17 ％ vs 4.27 ％. P＜0.05).Tumor cells of MCP-1/CCR2 expression rates were 3.25 ％ and 32.76 ％. Compared MCP-1/ CCR2 expression of stromal cells and tumor cells with different stages of disease, the activated stage and the stable stage had similar level (68.71％ and 32.76 ％ vs 70.12 ％ and 53.39 ％. P＞0.05). Conclusion Most patients with MM bone marrow were expressed MCP-1and CCR2.MCP-1and CCR2 are the major MM cell surface expression of chemokine/receptor, which play important roles in the progress of.

Objective To retrospectively analyze the clinical characteristics of 5 cases with recurrence of congenital tracheoesophageal fistula (rTEF) and to further understand the diagnosis and treatment of this disease.Methods We totally diagnosed 5 cases of rTEF from September 2015 to July 2016 in the department of respiration of Shenzhen Children′s Hospital.The clinical materials,characteristics,risk factors of recurrence and diagnostic methods were analyzed.Results Two cases were diagnosed of rTEF at 8 years after the first repair,one case was at one year after the initial repair and two cases were at 1 to 2 months after their operations.Three cases manifested mainly in bucking after feeding,recurrent pneumonia and growth retardation.One case was admitted for vomiting and abdominal distension.One case was asymptomatic.Esophageal anastomotic leaks occurred in three cases and esophageal trictures occurred in four cases after their repairs.Three cases accompanied with gastroesophageal reflux and five cases with tracheomalacia.Four cases were performed esophagography,but only two cases were suspected of recurrence.All of five cases were performed bronchoscopy.One case was diagnosed of rTEF directly.Two cases were found suspected fistulas.And another two cases were only found surgical scars.But these four cases were confirmed by Methylene blue test observed by bronchoscopy.Conclusion Although the leading clinical manifestations of rTEF are respiratory symptoms and feeding difficulties,sometimes rTEF is asymptomatic.Because rTEF is usually complicated with the other diseases with similar symptoms,it is possible to miss the diagnosis.Esophageal anastomotic leaks and trictures are the risk factors of recurrence.Bronchoscopy is the first choice for the diagnosis of rTEF,and Methylene blue test is golden standard.Thoracotomy is recommended for the treatment of rTEF.

Objective:To investigate the etiology, clinical characteristics and outcome of severe pneumonia-associated hemophagocytic lymphohistiocytosis, and to analyze the risk factors for mortality.Methods:Clinical data of patients with severe pneumonia-associated hemophagocytic lymphohistiocytosis admitted to Shenzhen Children′s Hospital from February 2009 to February 2019 were retrospectively analyzed.The data included clinical characteristics, etiology, clinical manifestations, laboratory data, treatment and outcomes of the patients.The clinical characteristics and laboratory data of the survival group and the death group were compared by independent sample t-test. Results:(1) Clinical characteristics: the patients were aged from 3 months to 8 years and 7 months, including 15 males and 15 females.Severe pneumonia-associated hemophagocytic lymphohistiocytosis accounted for 2.74% (30/1 096 cases) of severe pneumonia in the same period.(2) Etiology: Mycoplasma pneumoniae infection was found in 8 cases (8/30 cases, 26.67%), virus infection in 7 cases (7/30 cases, 23.33%, including 5 cases with adenovirus infection, 1 case with EB virus infection, and 1 case with cytomegalovirus infection), Mycoplasma pneumoniae complicated with adenovirus infection in 4 cases (4/30 cases, 13.33%), bacterial infection in 3 cases (3/30 cases, 10%), and fungal infection in 2 cases, Mycobacterium tuberculosis infection in 1 case.The pathogens were not identified in 5 patients.(3) Clinical manifestations: fever and hepatomegaly were present in all patients.Besides, 86.67% (26/30)patients had fever duration more than 10 days, 83.33% (25/30 cases) patients had cough, 76.66% (23/30 cases) patients had splenomegaly, and 33.33% (10/30 cases) patients had nervous system symptoms.Laboratory data showed varying degrees of reduction of binary and ternary systems in 80.00%(24/30 cases) of the patients.Liver function impairment was found in half of the patients, and serum ferritin and lactate dehydrogenase levels were elevated in all patients.(4) The mortality rate was 30.00% (9/30 cases). The differences in age, hypertriglyceridemia and high serum ferritin levels between the survival and death groups were significant (all P<0.05). Conclusions:Severe pneumonia-associated hemophagocytic lymphohistiocytosis is a disease with a high mortality rate.Patients with Mycoplasma pneumoniae and adenovirus pneumonia are more likely to suffer from secondary hemophagocytic lymphohistiocytosis.Younger age, hypertriglyceridemia and high serum ferritin levels are indicative of poor prognosis.