Objective To study the effect of obesity and overweight on the hospital stays and total course of common pneumonia in children and the possible reasons.Methods A total of 455 children with common pneumonia aged from 2 to 7 years were enrolled in this study,including 147 obese children,141 overweight children and 167 normal weight children.Then all the children were divided into 2 groups based on age:≥ 2-4 years group and ≥ 4-7 years group.The information of the patients was collected from the medical records management system of our hospital,and including gender,age,weight,height,hospital stays,total course,peripheral blood cell counts (white blood cell,neutrophil,monocyte and lymphocyte),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),IgG,IgA,CD4 + T,CD8 +T and the history of recurrent pneumonia.Results In ≥ 2-4 years group,the average length of the hospital stays of common pneumonia in obese and overweight children was longer than that in the normal weight children(P =0.037,0.009),and the total course of common pneumonia in obese children was longer than that in the normal weight children (P =0.014).In ≥ 4-7 years group,the average length of the hospital stays and total course of common pneumonia in obese and overweight children were longer than those in the normal weight children (the hospital stay:P =0.002,0.000,the total course:P =0.004,0.001).In ≥2-4 years group,the peripheral blood cell counts(white blood cell,neutrophil,monocyte and lymphocyte),CRP,ESR,IgG,IgA,CD4 + T,CD8 + T,CD4 + T/CD8 + T and the history of recurrent pneumonia were of no significant difference among obese,overweight and normal weight children (all P ＞0.05).In ≥4-7 years group,the peripheral blood cell counts(white blood cell,neutrophil,monocyte and lymphocyte),and ESR were of no significant difference among obese,overweight and normal weight children (all P ＞ 0.05),but the levels of IgG,CD4 + T and CD4 + T/CD8 + T in obese and overweight children were lower than those in the normal weight children,and the obese children were more notable in this aspect (P ＜ 0.05).And obese and overweight children were more likely to suffer from recurrent pneumonia.Conclusions Obese and overweight children with common pneumonia aged from 2 to 7 years may need longer hospital stay and total course than normal weight children.Impaired immunity may be the main reason for the ≥4-7 years group,but in the ≥2-4 years old group,it may be attribute to some non-immune factors.

Objective To investigate the changes of immune function,serum procalcitonin (PCT) and C-reactive protein (CRP) in children with mycoplasma pneumoniae pneumonia (MPP),and to provide clinical evidence for immunotherapy in children with MPP.Methods A total of 126 children with MPP during their hospitalization were enrolled into lobar pneumonia group (n =42) and bronchopneumonia group (n =84),and 28 healthy children were enrolled into normal control group.The immunoglobulin(Ig),CD4+T,CD8+T,PCT and CRP of all children were determined.Results The levels of IgG,IgM and IgE of children in lobar pneumonia group and bronchopneumonia group were significantly higher than that of the normal control group (P ＜0.05),but there were no significant differences in the level of IgA between three groups (P ＞ 0.05).The levels of IgG in lobar pneumonia group were significantly higher than that of bronchopneumonia group (P ＜ 0.05),but there were no significant differences in the levels of IgM,IgE,IgA between the two groups(P ＞0.05).The ratios of CD4+T and CD4+T/CD8+T in lobar pneumonia group and bronchopneumonia group were significantly lower than that of the normal control group(P ＜ 0.05).The levels of PCT and CRP in lobar pneumonia group and bronchopneumonia group were significantly higher than that of the normal control group (P ＜ 0.05).Conclusion Humoral immunity and cellular immune dysfunction plays an important role in pathogenesis of MPP.They are important for PCT and CRP in evaluating clinical condition and immunotherapy.

A 1-year-old boy developed multiple skin-colored nodules on the forehead and extremities when he was 4 months old.Physical examination revealed that his general condition was well with no hepatomegaly,splenomegaly,lymphadenectasis,testicle abnormality or gingival hypertrophy.Pathologically,the epidermis was normal,while the dermis and subcutaneous tissue were diffusely infiltrated with medium-to large-sized deformed cells,which had a small amount of cytoplasm,oval nucleus,irregular shape and fine chromatin.Some infiltrating cells had nuclear groove and nucleoli.Immunohistochemical studies showed that the tumor cells were positive for S-100 protein,CD56,CD123,CD163,CD68,Ki-67 (40％),weakly positive for CD4 (some),but negative for myeloperoxidase,CD1,CD21.Bone marrow smears showed a 24.5％ infltration by monoblasts and promonocytes.A diagnosis of monoblastic sarcoma cutis preceding acute monoblastic leukemia was made.