The nerve growth factor(NGF) belongs to the neurotrophin family, comes from many immune cells and lung resident cells, and regulates the functions of many immune cells. Recent studies suggest that NGF may play an important role in the pathogenesis of bronchial asthma. In this review, we will provide information about NGF in the airways, describe its expression and regulation, and point out its potential role in inflammation,hyperresponsiveness, and remodelling process observed in asthma.

Objective To explore the therapeutic value of bronchoscopy in pediatric status asthmaticus.Methods A total of 16 children with status asthmaticus received standard medical therapies (therapy group) from January 2008 to August 2010 in pediatric intensive care unit (PICU) at First Hospital,Xiamen University.However,l0 of them underwent fiberoptic bronchoscopy and bronchoalveolar lavage (BAL) (bronchoscopy group) along with standard medical therapies from September 2010 to July 2012.The values of oxygenation index (PaO2/FiO2),arterial partial pressure of carbon dioxide (PaCO2),blood oxygen saturation (SaO2),heart rate (HR),respiratory rate (RR) within 1 hour before bronchoscopy procedure,within 6 hour post procedure and within 24 hour post procedure were observed.The extinction time of wheezing sound,PICU length of stay and admission length of stay were observed between therapy and bronchoscopy groups.Results Bronchoscopies revealed a lot of thick mucus plugs and secretions.Large airways were lavaged for clearance of obstructive secretions with normal saline.Within BAL fluid counts of the bronchoscopy group,there were neutrophilia (n =8),eosinophilia (n =4) and neutrophilia/ eosinophilia (n =3).Within BAL fluid cultivation of the bronchoscopy group,4 patients had positive results for Streptococcus pneumoniae (n =2),Pseudomonas aeruginosa (n =1) and Staphylococcus aureus (n =1).In bronchoscopy group,the values of PaO/FiO2,PaCO2,SaO2,HR and RR were 319 ± 19,(40 ±4) mm Hg(1 mm Hg =0.133 kPa),(92.6 ± 1.5) ％,(128 ± 12) rates/min and (35 ± 4) breaths/min within 6 hour post procedure versus 255 ± 24,(54 ± 5) mm Hg,(89.2 ± 2.6) ％,(148 ± 10) rates/min and(50 ± 6)breaths/min within I hour before procedure (P ＜ 0.01).At 24 hour post procedure,the values of PaO2/FiO2,PaCO2,SaO2,HR,RR for bronchoscopy group were 354 ± 21,(40 ± 3) mm Hg,(93.4 ±1.1)％,(125±9)rates/min and(34 ±3)breaths/min versus 317 ±21,(46 ±4)mm Hg,(90.1±2.5) ％,(138 ± 8) rates/min and (43 ± 3) breaths/min respectively for therapy group (P ＜ 0.01).The extinction time of wheezing sound was (67 ± 22) hours for bronchoscopy group vs.(98 ± 23) hours for therapy group(P ＜ 0.01).The mean PICU length of stay was (1.6 ± 0.7) days for bronchoscopy group vs.(2.6 ± 0.7) days for therapy group (P ＜ 0.01).The mean admission length of stay was (5.0 ± 0.7) days for bronchoscopy group vs.(6.6 ± 1.2) days for therapy group(P ＜ 0.01).All patients for bronchoscopy group tolerated the procedure without any complications.Conclusion As a safe adjunctive therapy in pediatric status asthmaticus,flexible bronchoscopy with bronchial lavage may reduce the admission and PICU length of stay and alleviate clinical symptoms.

Objective:To observe the effect and its mechanism of hemoperfusion on injured myocardium under acute toxication of methomyl in rabbits. Methods:Twenty-four rabbits were randomly divided into three groups:control group ( N group) , acute metho-myl intoxication group ( P group) , hemoperfusion group ( HP group) . P group and HP group was treated by methomyl intoxication, and with 2-hour sham-hemoperfusion and hempoperfusion respectively. Then the pathological changes of myocardium were observed under optical microscope. The activity of SOD and content of MDA in myocardium were measured by colorimetry. The experimental data were analyzed by SPSS 16. 0 package. Results:There were congestion, edema and other pathological changes in group P, while no obvious changes in N group and HP group. The activity of SOD decreased while MDA content increased in P group versus N and HP group ( P< 0. 05). Conclusion:Hemoperfusion can alleviate the myocardial injury induced by methomyl poisoning through the mechanism of the resistance to oxidative damage.

Objective:To explore the feasibility and safety of long-term home mechanical ventilation(HMV) in children with chronic respiratory failure.Methods:Clinical data of 11 children with chronic respiratory failure, who underwent HMV with the care of the First Affiliated Hospital of Xiamen University from January 2013 to December 2019, were retrospectively reviewed. The clinical manifestation, growth and development, quality of life, adverse events and prognosis of HMV children were analyzed.Results:There were 8 boys and 3 girls with the onset age of 26 days to 13 years old; and the age at starting HMV was 3 months to 13 years old. Eight children were diagnosed as neuromuscular diseases, and 3 children were diagnosed as respiratory diseases. The duration of institutional mechanical ventilation was 2 weeks to 8 months. Six patients underwent invasive HMV via a tracheostomy, and 5 received non-invasive ventilation via nasal and face masks. Bi-level positive airway pressure ventilation mode was applied in all the patients. The duration of HMV was 3 months to 27 months. During follow-up, no HMV related adverse events were observed. Both the quality of life and nutritional status were improved in all cases. One patient lost follow-up 9 months later and 1 patient died of severe adenovirus pneumonia during hospitalization for examination, the remaining 9 cases survived. Liberation from HMV was obtained in 4 patients. The frequency of readmission was 1 to 2 times.Conclusion:It is suggested that long-term HMV is safe and feasible for children with chronic respiratory failure.

Objective:To evaluate the efficacy and safety of dl-3-butylphthalide ( NBP) injection and soft capsules in the treat-ment of acute middle cerebral artery infarction. Methods:Sixty-one patients with acute cerebral infarction in the left middle cerebral artery in 72 hours of onset of ischemic stroke with score of 5-25 according to the national institutes of health stroke scale ( NIHSS) were randomly divided into the observation group (n=31) and the control group (n=30). The control group was treated with the routine treatment, while the observation group was sequentially treated with NBP injection and soft capsules additionally. The treatment course was 90 days. Before the treatment, the NIHSS score was evaluated in both groups to compare the neurologic impairment degree. After the treatment, the daily living skills assessment was performed by Barthel index ( BI) and modified Rankin score ( mRS) , and the ad-verse reactions were recorded. Results:Before the treatment, the NIHSS score in the two groups had no statistical significance ( P>0. 05). After the treatment, the BI in the observation group and the control group was (88. 55 ± 16. 74) and (70. 67 ± 26. 18), and mRS was (1. 87 ± 1. 02) and (2. 53 ± 1. 40), respectively, suggesting the observation group had more favorable outcome than the con-trol group (P≤0. 05). The incidence of adverse reactions had no significant difference between the groups. Conclusion: dl-3-Bu-tylphthalide sequential therapy should be regarded as an effective and safe method for acute cerebral infarction, which can improve the daily living skills and 90-day outcome of patients.

Severe pneumonia is a common respiratory disease in pediatric intensive care unit(PICU). Airway lesions can be observed and specimens can be obtained by bronchoscopy to help to diagnose the cause and pathogen of severe pneumonia.For severe pneumonia, bronchoscopy interventional therapy is mainly used to relieve airway obstruction, remove necrosis material in the airway, and administer locally.In addition, bronchoscopy can guide tracheal intubation in the rescue of severe pneumonia.In conclusion, bronchoscopy is used in children with severe pneumonia in PICU, which can improve the diagnosis rate, improve the function of ventilation, and shorten the hospitalization time.It is worthy of clinical promotion and application.

Objective: To review children′s primary ciliary dyskinesia (PCD) in the pathogenesis, clinical manifestation, diagnosis and treatment. Method: To summarize and analyze the clinical data of a patient who was admitted to the first affiliated hospital of Xiamen University with primary ciliary dyskinesia in April 2014 while referring to related literature. Result: An 11 years old boy, weighting about 22 kg, had a course of more than 10 years with repeated cough, stuffy and runny nose shortly after the birth. Examinations after admission to hospital showed that he presented with visible clubbing, bilateral paranasal sinus area tenderness, pharynx posterior wall with visible yellow pussy stuff drip and bilateral lung had scattered wet rales. Auxiliary examination revealed bilateral maxillary sinus, ethmoid sinus inflammation and bronchitis with left lower lung bronchiectasis. Fiberoptic bronchoscopy discovered congestion and a lot of sputum; ciliary biopsy pathology displayed that cilia were sparse and partial cilia 9+ 2 microtubules structural abnormalities. Full sequence of exon gene sequencing revealed two mutations located at chromosome 16 chr16: 71061369 (non-coding regions) and chr16: 70993591 (coding). Two novel mutations m. 3362A>G(E20) and c. 6101G>A(E39) in exon 16 of the HYDIN gene were identified. With the" ciliary motility disorder, gene" as keywords , the CNKI, Wanfang digital knowledge service platform and PubMed were searched for relevant articles from the establishment to July 2016. The studies retrieved included 9 cases and these cases were summarized. Comprehensive analysis showed that HYDIN gene mutations related PCD patients had the typical PCD performance such as repeatedly wet cough, sinusitis, bronchiectasis, and otitis media. The majority of patients have a history of acute respiratory distress syndrome in infancy and no visceral dislocation was not found. Most of the patients had no obvious structural abnormalities in cilia electron microscopic examination. Conclusion The PCD patients with HYDIN genes mutations have clinical manifestations such as sinusitis, otitis media, bronchiectasis but without transposition of viscera. Cilia structure can be normal under the electron microscopic examination in some of patients.

OBJECTIVETo analyze the clinical manifestations of refractory Mycoplasma pneumoniae pneumonia (RMPP) which unresponded to methylprednisolone in the dosage of 2 mg/(kg·d) for 3 days.

METHODRetrospective analysis was performed on the clinical data of 110 children (64 boys and 46 girls) with RMPP. The patients were divided into "effective group" and "ineffective group" according to initial effect of 2 mg/(kg·d) methylprednisolone. The clinical manifestations, laboratory examination, radiological features and bronchofibroscopic findings of the children were compared. In order to seek the reference indexes which indicate nonresponsive to 2 mg/(kg·d) methylprednisolone, an ROC curve was made, of which the diagnostic cut-off was five independent correlation factors while grouping was made according to patients' different response to glucocorticosteroid.

RESULTThe effective group had 86 (86/110, 78.2%) children while ineffective group had 24 (24/110, 21.8%). The ineffective group children had the following performance: 16 children (16/24, 66.7%) in ineffective group had ultrahyperpyrexia (T ≥ 40 °C), which was significantly more severe compared to those in effective group (32/86, 37.3%, P < 0.01); the levels of white blood cell (WBC) count, percentage of neutrophils count (N), C-reactive protein (CRP), serum ferritin (SF), alanine transaminase (ALT), lactic dehydrogenase (LDH), creatine kinase isoenzyme (CK-MB) and fibrinogen (Fib) in ineffective group were significantly higher than those in effective group(P < 0.01); while percentage of lymphocyte count (L) was lower than that in effective group(P < 0.01). Proportion of mixed infection in ineffective group was higher than that in effective group (33.3% vs. 4.7%). Radiological manifestations: It was more frequently seen in ineffective group that chest CT scan indicated high density consolidation in no less than a whole pulmonary lobe and pulmonary necrosis (41.7% vs. 0%). Abundant secretions blockage (45.0% vs. 16.9%) and mucosal necrosis (37.5% vs. 8.1%) on bronchofibroscopy were more frequently seen in ineffective group. The critical values of the five independent correlation factors were CRP 110 mg/L, SF 328 mg/L, LDH 478 IU/L, N 0.78, L 0.13.

CONCLUSIONTreatment with 2 mg/(kg·d) methylprednisolone can improve clinical symptoms and radiological manifestations of most children with RMPP quickly, but it may be ineffective in some situations such as lasting high fever or ultrahyperpyrexia for more than 7 days, CRP ≥ 110 mg/L, N ≥ 0.78, L ≤ 0.13, serum LDH ≥ 478 IU/L, SF ≥ 328 µg/L, chest CT scan indicating high density consolidation in more than a whole pulmonary lobe involved and moderate-abundant pleural effusion.

Adrenal Cortex Hormones ; administration & dosage ; therapeutic use ; Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Bacterial Infections ; drug therapy ; epidemiology ; C-Reactive Protein ; analysis ; Child ; Child, Preschool ; Coinfection ; Female ; Ferritins ; blood ; Fever ; diagnosis ; drug therapy ; Humans ; Infusions, Intravenous ; Leukocyte Count ; Lung ; diagnostic imaging ; pathology ; Male ; Methylprednisolone ; administration & dosage ; therapeutic use ; Mycoplasma pneumoniae ; Pneumonia, Mycoplasma ; blood ; diagnosis ; drug therapy ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome

Objective:To compare the clinical characteristics of Mycoplasma pneumoniae pneumonia and adenoviral pneumonia in children. Methods:Clinical data of 151 children with pneumonia admitted to our hospital from January 2019 to June 2019 were retrospectively analyzed, including 106 cases of Mycoplasma pneumoniae pneumonia (MP group) and 45 cases of adenoviral pneumonia (ADV group). The general conditions, clinical manifestations, laboratory results, pulmonary imaging, proportion of severe cases, respiratory support style and length of hospital stay were compared between two groups. Results:The MP group had shorter fever time compared to the ADV group ( t=15.910, P<0.01); and the maximum temperature in the MP group was lower than the ADV group ( Z=3.561, P<0.01). In the comparison of shortness of breath, wet rales in the lungs, tri-concave sign, hypoxemia, the differences were all significant between two groups (χ 2=11.203, 6.807, 36.746, 21.177, all P<0.01). The WBC in the MP group was lower than that in the ADV group ( t=33.960, P<0.01); the PCT, IL-6, LDH and 25-(OH) D 3 levels in the MP group were lower than those in the ADV group ( Z=5.986, 3.146, 4.203, 2.094, all P<0.05); while there was no significant difference in CRP levels between two groups ( Z=1.360, P>0.05). Pulmonary imaging in the MP group mainly involved unilateral lung, and the ADV group mainly involved bilateral lungs (χ 2=27.055, P<0.01). There was no significant difference in pulmonary patchy exudation between two groups(χ 2=0.298, P>0.05). There were 30 patients (28.3%) with severe pneumonia in MP group and 33 patients (73.3%) in the ADV group ( t=26.345, P<0.01). Twelve patients (11.3%) in the MP group were given non-invasive respiratory support, 1 patient (0.9%) was given invasive respiratory support; while 31 patients (68.9%) were given non-invasive respiratory support in the ADV group, and 5 patients (11.1%) were given invasive respiratory support (χ 2=66.439, P<0.01). The MP group had shorter hospital stays than ADV group ( t=31.014, P<0.01). Conclusion:The conditions of disease are more severe, and length of hospital stay is longer in children with adenoviral pneumonia than those with Mycoplasma pneumoniae pneumonia.

Objective We designed a computer-based respiratory sound analysis system to identify pediatric normal lung sound.To verify the validity of the computer-based respiratory sound analysis system.Method First we downloaded the standard lung sounds from the network database (website:http://www.easyauscultation.corn/lung-sounds-reference-guide) and recorded 3 samples of abnormal loud sound (rhonchi,wheeze and crackles) from three patients of The Department of Pediatrics,the First Affiliated Hospital of Xiamen University.We regarded such lung sounds as "reference lung sounds".The " test lung sounds" were recorded from 29 children form Kindergarten of Xiamen University.we recorded lung sound by portable electronic stethoscope and valid lung sounds were selected by manual identification.We introduced Mel-frequency cepstral coefficient (MFCC) to extract lung sound features and dynamic time warping (DTW) for signal classification.Result We had 39 standard lung sounds,recorded 58 test lung sounds.This computer-based respiratory sound analysis system was carried out in 58 lung sound recognition,correct identification of 52 times,error identification 6 times.Accuracy was 89.7％.Conclusion Based on MFCC and DTW,our computer-based respiratory sound analysis system can effectively identify healthy lung sounds of children (accuracy can reach 89.7％),fully embodies the reliability of the lung sounds analysis system.