Mycoplasma pneumoniae (MP) is an important etiological agent in childhood community acquired pneumonia. Pediatricians are concerned about the clinical problems of MP infection. In this review,MP infection-related clinical issues, such as epidemiology, pathogenesis, clinical features, imaging, and relationship of bronchial asthma, laboratory diagnosis and treatment, were discussed to improve pediatricians' awareness and knowledge of clinical diagnosis and treatment of MP infection.

Particular difficulties were presented when diagnosis of asthma in children under 5 was made. Diagnosis of asthma in early childhood is a big challenge and has been based largely on clinical justification and assessment of symptoms and physical signs. The PRACTALL consensus report focus exclusively on pediatric asthma, such as natural history and pathophysiology of pediatric asthma, different patterns of recurrent wheeze in pediatric patients, different phenotypes of asthma in children, and provides recommendations for diagnosis, practical management and monitoring. More factors should be considered for diagnosis of asthma in children under 5, including the patterns of recurrent wheeze, history of atopy, risk factor of asthma, long-term follow-up, extensive differential diagnoses, response to bronchodilator and/or anti-inflammatory treatment and so on.

Objective To investigate the relationship between mine environment and hypertension in miners. Methods 1736 male miners who worked under the ground and 825 on the ground were recruited in this study. Prevalence of hypertension under the ground and on the ground miners was compared. Results Prevalence of hypertension of miners under the ground was 23.91% and on the ground was 15.52% (χ2 = 23.56,P <0.001 ). Compared to miners on the ground, the relative risk of hypertension under the ground workers was 1.71 (95% CI 1.38 - 2.13 ). Prevalence of hypertension was correlated to the years of ground working (χ2 = 37.00, P < 0.001 ). The binary logistic regression showed significant relationship between mine environment and hypertension under the ground miners ( OR = 1.05,95% CI 1.02 - 1.08 ).Conclusion The underground environment is an important risk factor hypertension to the miners.

Objective To investigate the effect of budesonide on NK-1 receptor expression in airway smooth muscle cell (ASMC). Methods According to the random method,45 wistar rats were divided into three groups: asthmatic group, budesonide treatment group and control group. Aerosolize ovalbumin was used to make asthmatic rat model. Budesonide treatment group were given budesonide after inhaled ovalbumin. On day 21 .primary rat ASMC culture was conducted. The fourth cell passage and purified ASMC was collected for RT-PCR. The content of NK-1R was determined by real-time quantitative PCR. Data were expressed as mean±standard error (SE). The ANOVE Tukey test was carried out by using SPSS17.0 software and P＜0. 05 was considered significant. Results As compared with that of asthmatic group(1.1687±0.1356),NK-1R mRNA in therapy group( 1.0820 ±0. 1146) decreased significantly (P ＜0.05) ,but remained still higher than that of control group(1.034 7±0.2503) (P＜0. 05). Conclusion NK-1R may be involved in the pathogenesis of asthma. Budesonide may down-regulate the expression of the NK-1R mRNA in the airway smooth muscle cell, which may inhibit inflammation in asthmatic attacks.

With the wide applications of flexible bronchoscopy in pediatric clinical affairs,the rate of adverse reactions and complications have been increased synchronously.In order to safely make correct diagnosis and improve the therapeutic effects,lower the incidence of complications,it is very important to be familiar with various complications and the ways of management about them as well as indications,contraindications and operating procedures.It's also necessary to negotiate with children's parents on health and fortune including anaesthesia so as to decrease the risks of unexpected affairs and adverse effects.

Bronchiolitis is the main cause of wheezing episodes in infants under 2 years old.Most of them are caused by virus infection.Most of the children with bronchiolitis can recover after clinical treatment, but some of them may have recurrent wheezing or even asthma.There are many risk factors and complicated pathogenesis of recurrent wheezing after bronchiolitis.Risk factors mainly include: susceptible gene, virus type infected in the first wheezing, atopy, exposure to school-age siblings, tobacco exposure, family history of asthma, increased specific IgE, high blood eosinophils count, etc.In this paper, the risk factors of recurrent wheezing after bronchiolitis are introduced as follows.

Sleep apnea includes obstructive sleep apnea,central sleep apnea and mixed sleep apnea.Ob-structive sleep apnoea syndrome(OSAS)is affecting up to 5.7% of children,which hss adverse impact on growth,development cognitive and behavioral outcomes,and untreated OSAS increases cardiovascular risk,so paying closer attention to childhood OSAS early diagnosis and treatment seems more important.First-line treat-ment in OSAS children is adenotonsillectomy,although other treatment options available include continuous posi-tive airways pressure,anti-inflammatory therapies,airway adjuncts and orthodontic appliances.Central sleep ap-nea may be related to respiratory regulation center immaturity or dysplasia.Central sleep apnea may be hereditary or acquired.Therefore,the treatment of central sleep apnea should be focused on primariy etiology.

Objective To investigate the effect of neuropeptide substance P on airway smooth muscle cell contraction amplitude.Methods According to random method, 10 Wistar rats were divided into normal group and asthmatic group.By inhaled OVA to make asthmatic rat model;primary culture ASMC;confocal microscopy were used to observe the morphological changes and measure the length before and after different intervention.The percent of contraction length come from different group ASMC were used for statistical analysis.Results The ASMCs volume in acetylcholine intervented group and substance P intervented group decreased significantly,cell diameters shorten, cytoplasm reduction and cell arranged densely.The ASMCs volume in substance P receptor antagonist intervented group and nimodipine intervented group are about the same size as the ones in normal control group, were spindle-shaped, abundant cytoplasm and arrangement regularly.The contraction length percent of Ach intervened group is the biggest(19.60 ± 3.47) ％, contraction length percent of nimodiping intervented group is the shortest(3.25 ± 1.14)％ ,the contraction length percent in substance Precepter antagonist intervented group is bigger than the one in control group (3.54 ± 1.26) ％, but less than the one in Ach intervented group, asthmatic (14.36 ± 2.37) ％ and substance P intervened group (17.79 ± 3.19) ％.Conclusion Substance P can increase the amplitude of airway smooth muscle cell contraction, but the effect less than Ach;substance P receptor antagonists can inhibit smooth muscle cell contractility, but the effect less than nimodipine.Substance P participates in acute attack of asthma, increases airway reactivity by increasing airway smooth muscle contraction intensity.

Necrotizing pneumonia is a severe complication of community-acquired pneumonia in children, with no clear deif-nition currently, characterized by parenchymal injury, necrosis and cavity formation. Streptococcus pneumonia is the most common pathogen;however a positive microbiology is not always obtainable. The clinical manifestation of necrotizing pneumonia is more seri-ous than ordinary pneumonia, and complications are common. Chest CT scan is helpful to early detection and diagnosis. Antibio-tics remain the mainstay of treatment, and the prognosis is relatively well.

Objective To explore the influence of Lactobacillus salivarius on IgE,eosinophil cationic protein(ECP)and transforming growth factor(TGF)-βof serum and lung tissue homogenates of asthmic Balb/c mouse.Methods Thirty female Balb/c mice weighing 16-18 g(4 weeks old),SPF grade,were ran-domly divided into three groups:normal control group(group A),asthma group(group B),asthma combined Lactobacillus salivarius group(group C).Acute asthma model was established applying ovalbumin,behavioral changes were observed in mice,the changes in airway inflammation and the number changes of tracheal cilia were observed by pathological HE staining and the electron microscope respectively.The levels of IgE,ECP and TGF-βin the serum and lung tissue homogenate were measured by ELISA method.Results (1 )The mice in group B presented obvious restlessness,head and facial itching,scratching,shortness of breath,peri-oral cyanosis with abdominal breathing,sneezing,stooping,forelimbs shrinkage,urine and feces incontinence and other asthma acute phase performances in 5-1 0 minuts after 4% ovalbumin saline solution atomization excitation,the above reaction alleviated in group C compared to group B.(2)Pathology of HE staining in group B showed the thickening bronchial wall,narrow lumen,peribronchial and perivascular infiltration with a large number of eosinophil-based inflammatory cells,lumen with many inflammatory secretions,pathological changes in lung tissue of mice in group C significantly alleviated compared with group B.Under the electron microscope,the number of cilia in group B significantly decreased compared with group A,while group C significantly increased compared with group B.(3)Expression levels of serum IgE and ECP in group C were sig-nificantly lower than those in group B[(0.86 ±0.14)μg/ml vs.(1.30 ±0.12)μg/ml;(2.30 ±0.15)ng/ml vs.(3.41 ±0.15)ng/ml,P <0.05,respectively].The contents of lung tissue homogenate IgE[(0.97 ± 0.06)μg/ml]and ECP[(5.88 ±0.13)ng/ml]in group C significantly decreased,respectively,compared with the IgE[(1.13 ±0.05)μg/ml]and ECP[(8.08 ±0.15)ng/ml]in group B(P<0.05).The levels of serum TGF-β[(0.17 ±0.01 )μg/ml]and lung tissue homogenates TGF-β[(0.18 ±0.01 )μg/ml]in group C were higher than the serum TGF-β[(0.13 ±0.01 )μg/ml]and lung tissue homogenates TGF-β[(0.15 ±0.01 )μg/ml]in group B,respectively,the differences were statistically significant(P<0.05 ). Conclusion Lavage with Lactobacillus salivarius before sensitization could alleviate clinical symptoms of asthmatic mice,as well as reduce airway inflammation in some degree,TGF-βmay be involved in the mecha-nism of Lactobacillus salivarius playing a protective role.