OBJECTIVES: To study the clinical characteristics of plastic bronchitis (PB) in children and investigate the the risk factors for recurrence of PB. METHODS: This was a retrospective analysis of medical data of children with PB who were hospitalized in Children's Hospital of Chongqing Medical University from January 2012 to July 2022. The children were divided into a single occurrence of PB group and a recurrent PB group and the risk factors for recurrence of PB were analyzed. RESULTS: A total of 107 children with PB were included, including 61 males (57.0%) and 46 females (43.0%), with a median age of 5.0 years, and 78 cases (72.9%) were over 3 years old. All the children had cough, 96 children (89.7%) had fever, with high fever in 90 children. Seventy-three children (68.2%) had shortness of breath, and 64 children (59.8%) had respiratory failure. Sixty-six children (61.7%) had atelectasis and 52 children (48.6%) had pleural effusion. Forty-seven children (43.9%) had Mycoplasma pneumoniae infection, 28 children (26.2%) had adenovirus infection, and 17 children (15.9%) had influenza virus infection. Seventy-one children (66.4%) had a single occurrence of PB, and 36 cases (33.6%) had recurrent occurrence of PB (≥2 times). Multivariate logistic regression analysis showed that involvement of ≥2 lung lobes (OR=3.376) under bronchoscopy, continued need for invasive ventilation after initial removal of plastic casts (OR=3.275), and concomitant multi-organ dysfunction outside the lungs (OR=2.906) were independent risk factors for recurrent occurrence of PB (P<0.05). CONCLUSIONS Children with pneumonia accompanied by persistent high fever, shortness of breath, respiratory failure, atelectasis or pleural effusion should be highly suspected with PB. Involvement of ≥2 lung lobes under bronchoscopy, continued need for invasive ventilation after initial removal of plastic casts, and concomitant multi-organ dysfunction outside the lungs may be risk factors for recurrent occurrence of PB.
Female ; Male ; Child ; Humans ; Child, Preschool ; Multiple Organ Failure ; Retrospective Studies ; Bronchitis/etiology* ; Dyspnea ; Pleural Effusion ; Pulmonary Atelectasis ; Plastics ; Respiratory Insufficiency

OBJECTIVETo investigate the etiology and clinical manifestation of hemoptysis in children.

METHODA retrospective analysis was performed for 106 cases of hemoptysis who were admitted to The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University from January 2005 to December 2014.The clinical information including laboratory tests and image data were collected and analyzed.

RESULTA total of 106 patients (50 males and 56 females) were identified. The median age was 9.1 years (range 2 months to 18 years). Pneumonia (35, 31.1%) was the most common etiology of hemoptysis, which included bacterial pneumonia (27 cases), mycoplasmal pneumonia(4 cases), chlamydial pneumonia (3 cases), and influenza pneumonia(1 case). Other causes included bronchitis(15, 14.2%), pulmonary tuberculosis (11, 10.4%), bronchiectasis (11, 10.4%), diffuse alveolar hemorrhage (8, 7.5%), idiopathic pulmonary hemosiderosis(6, 5.7%), cardiovascular dysplasia(6, 5.7%), pulmonary contusion (4, 3.8%), foreign body in bronchus (2, 1.9%), allergic bronchopulmonary aspergillosis (2, 1.9%). Eighty-six patients manifested mild hemoptysis; moderate and massive hemoptysis were found in nine and eleven patients, respectively. Pneumonia accounted for 33.7% of mild hemoptysis and 45.5% of massive hemoptysis were due to bronchiectasis; 80.2% were treated with antibiotics and 41.5% were given hemostatic agents; 8.5% received lobectomy. Ninety-six patients (90.6%) were cured and parents gave up treatment in 4 cases (3.8%). Six patients (5.7%) suffered from recurrent hemoptysis.

CONCLUSIONHemoptysis mainly occurred in children who were older than 6 years, the most common cause of hemoptysis was respiratory tract infection. In most cases, the amount of hemoptysis was small and the overall prognosis was good.

Adolescent ; Bronchiectasis ; complications ; Bronchitis ; complications ; Child ; Child, Preschool ; Female ; Foreign Bodies ; complications ; Hemoptysis ; diagnosis ; etiology ; therapy ; Hemosiderosis ; complications ; Humans ; Infant ; Influenza, Human ; complications ; Lung Diseases ; complications ; Lung Injury ; complications ; Male ; Pneumonia, Bacterial ; complications ; Prognosis ; Retrospective Studies ; Tuberculosis, Pulmonary ; complications

OBJECTIVETo evaluate the effect of diisononyl phthalate (DINP) exposure during gestation and lacta- tion on allergic response in pups and to explore the role of phosphoinositide 3-kinase/Akt pathway on it.

METHODSFemale Wistar rats were treated with DINP at different dosages (0, 5, 50, and 500 mg/kg of body weight per day). The pups were sensitized and challenged by ovalbumin (OVA). The airway response was assessed; the airway histological studies were performed by hematoxylin and eosin (HE) staining; and the relative cytokines in phosphoinositide 3-kinase (PI3K)/Akt pathway were measured by enzyme-linked immunosorbent assay (ELISA) and western blot analysis.

RESULTSThere was no significant difference in DINP's effect on airway hyperresponsiveness (AHR) between male pups and female pups. In the 50 mg/(kg·d) DINP-treated group, airway response to OVA significantly increased and pups showed dramatically enhanced pulmonary resistance (RI) compared with those from controls (P<0.05). Enhanced Akt phosphorylation and NF-κB translocation, and Th2 cytokines expression were observed in pups of 50 mg/(kg·d) DINP-treated group. However, in the 5 and 500 mg/(kg·d) DINP-treated pups, no significant effects were observed.

CONCLUSIONThere was an adjuvant effect of DINP on allergic airway inflammation in pups. Maternal DINP exposure could promote OVA-induced allergic airway response in pups in part by upregulation of PI3K/Akt pathway.

Animals ; Blotting, Western ; Bronchitis ; chemically induced ; Bronchoalveolar Lavage Fluid ; Dose-Response Relationship, Drug ; Enzyme-Linked Immunosorbent Assay ; Female ; Hypersensitivity ; etiology ; Male ; Maternal Exposure ; Phosphatidylinositol 3-Kinases ; metabolism ; Phosphorylation ; Phthalic Acids ; toxicity ; Pregnancy ; Proto-Oncogene Proteins c-akt ; metabolism ; Rats ; Rats, Wistar

OBJECTIVETo study the clinical features and pathogens of plastic bronchitis in children.

METHODSA retrospective analysis was performed on the clinical data of 9 children who were diagnosed with plastic bronchitis between January 2011 and December 2012.

RESULTSPlastic bronchitis began with a fever and cough in all cases, followed by progressive dyspnea on days 1-3 of onset; unilateral or bilateral decreased breath sounds and hepatosplenomegaly were found; complications included respiratory failure (6 cases), toxic encephalopathy (6 cases), toxic hepatitis (7 cases), shock (3 cases), heart failure (3 cases), and renal failure (2 cases). Chest X-ray or chest CT showed single and multiple lobar or segmental consolidation and atelectasis, as well as pleural effusion (4 cases). The bronchofibroscopy revealed some grey-white mucus plugs that blocked bronchial openings and aspirates of bronchial shape. Influenza viruses (IFVs) were detected in all cases, including IFV-A (6 cases, 67%) and IFV-B (3 cases, 33%). Mixed infection with IFV-A and Mycoplasma pneumoniae (MP)/bacteria was found in 50% of all cases. In the three cases of IFV-B infection, one was complicated by MP infection. Nine patients were given treatment of antibiotics, hormones, gamma globulin and necessary respiratory support, and also were given removal of endogenous foreign body by bronchoscopy. Five patients were given antiviral therapy of oseltamivir. Seven cases cured, and 2 died.

CONCLUSIONSPlastic bronchitis and severe pneumonia are similar in clinical manifestations. IFVs are the main pathogen. In addition to anti-infection treatment, hormone, gamma globulin, respiratory support, and other conventional treatments, endogenous foreign body removal by bronchofibroscopy and early antiviral therapy with oseltamivir have good efficacy.

Bronchitis ; diagnosis ; drug therapy ; etiology ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Orthomyxoviridae ; isolation & purification

This study is to investigate the protective effect of mangiferin on NF-kappaB (P65) and IkappaBalpha expression in peripheral blood mononuclear cell (PBMC) in rats with cigarette smoke induced chronic bronchitis. The rat model with chronic bronchitis was established by cigarette smoke. Real-time fluorescence RT-PCR was executed for evaluating the NF-kappaB (P65) and IKkappaBalpha gene expression in mononuclear cell, and flow cytometry for their protein expression. The serum hs-CRP (high-sensitivity C-reactive proteins) and TNF-alpha (tumor necrosis factor-alpha) were detected by enzyme-linked immunosorbent assay. The histopathological score was obtained from lung tissue HE staining slides of lung tissue. The results showed that mangiferin could markedly suppress the NF-kappaB (P65) mRNA and protein expression in mononuclear cell, while promote the IkappaBalpha mRNA and protein expression. Furthermore, mangiferin could lower serum hs-CRP and TNF-alpha level, and reduce the chronic inflammatory damage of bronchiole. These results suggested that mangiferin could notably ameliorate chronic bronchiole inflammation induced by cigarette smoke, and this protective effect might be linked to the regulation of NF-kappaB (P65) and IkappaBalpha expression in mononuclear cell.
Animals ; Bronchi ; pathology ; Bronchitis, Chronic ; blood ; etiology ; metabolism ; pathology ; C-Reactive Protein ; metabolism ; I-kappa B Kinase ; genetics ; metabolism ; Leukocytes, Mononuclear ; metabolism ; pathology ; Male ; Mangifera ; chemistry ; Plants, Medicinal ; chemistry ; RNA, Messenger ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tobacco Smoke Pollution ; Transcription Factor RelA ; genetics ; metabolism ; Tumor Necrosis Factor-alpha ; blood ; Xanthones ; isolation & purification ; pharmacology

Bronchitis ; diagnostic imaging ; etiology ; pathology ; Child, Preschool ; Humans ; Male ; Tomography, X-Ray Computed

Plastic bronchitis is an uncommon disorder characterized by the formation of bronchial casts. It is associated with congenital heart disease or pulmonary disease. In children with underlying conditions such as allergy or asthma, influenza can cause severe plastic bronchitis resulting in respiratory failure. A review of the literature showed nine cases of plastic bronchitis with H1N1 including this case. We report a case of a child with recurrent plastic bronchitis with eosinophilic cast associated with influenza B infection, who had recovered from plastic bronchitis associated with an influenza A (H1N1) virus infection 5 months previously. To the best of our knowledge, this is the first case of recurrent plastic bronchitis related to influenza viral infection. If patients with influenza virus infection manifest acute respiratory distress with total lung atelectasis, clinicians should consider plastic bronchitis and early bronchoscopy should be intervened. In addition, management for underlying disease may prevent from recurrence of plastic bronchitis.
Administration, Inhalation ; Adrenal Cortex Hormones/therapeutic use ; Antiviral Agents/therapeutic use ; Bronchitis/complications/*diagnosis/drug therapy ; Bronchoscopy ; Child ; DNA, Viral/analysis ; Dyspnea/etiology ; Humans ; Hypersensitivity/pathology ; Influenza A Virus, H1N1 Subtype/*genetics/isolation & purification ; Influenza B virus/genetics/isolation & purification ; Influenza, Human/complications/*diagnosis/drug therapy ; Male ; Oseltamivir/therapeutic use ; Pulmonary Atelectasis/drug therapy/radiography ; Real-Time Polymerase Chain Reaction ; Tachypnea/etiology ; Tomography, X-Ray Computed

Airway Remodeling ; Asthma ; physiopathology ; Bronchial Hyperreactivity ; etiology ; Bronchitis ; physiopathology ; Humans

BACKGROUND AND OBJECTIVEAlthough there are many randomized clinical trials of late course accelerated hyperfractionated radiotherapy (LCAHFR) combined with FP chemotherapy for esophageal cancer, the efficacy and toxicity are controversial. This study was to evaluate the efficacy and toxicity of LCAHFR combined with FP chemotherapy in treating esophageal cancer.

METHODSReports of randomized clinical trials on LCAHFR combined with FP chemotherapy for esophageal cancer published between January 1999 and January 2009 were researched through Wanfang, CNKI, and PubMed databases. RevMan4.2 software was used for Meta-analysis.

RESULTSTwenty-one reports, including 2030 patients, were included in the meta-analysis. Of the 2030 patients, 1006 underwent LCAHFR (LCAHFR group), and 1024 underwent LCAHFR combined with FP chemotherapy (combination group). Compared with those of the LCAHFR group, the 1-, 2-, 3-, 5-years survival rates and 1-, 2-, 3-year local control rates of the combination group were significant increased, and the acute toxicity was also increased, but chronic toxicity showed no significant difference.

CONCLUSIONSLCAHFR combined with FP chemotherapy can improve the survival rate and the local control rate of the patients with esophageal cancer. The increased acute toxicity need to be concerned, whereas the chronic toxicity needs a long-term observation.

Adenocarcinoma ; drug therapy ; radiotherapy ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bronchitis ; etiology ; Carcinoma, Squamous Cell ; drug therapy ; radiotherapy ; Cisplatin ; therapeutic use ; Combined Modality Therapy ; Dose Fractionation ; Esophageal Neoplasms ; drug therapy ; radiotherapy ; Esophageal Stenosis ; etiology ; Esophagitis ; etiology ; Humans ; Leukopenia ; etiology ; Nausea ; etiology ; Pulmonary Fibrosis ; etiology ; Randomized Controlled Trials as Topic ; Survival Rate ; Tegafur ; therapeutic use ; Uracil ; therapeutic use

Ambroxol ; administration & dosage ; therapeutic use ; Bronchitis, Chronic ; etiology ; therapy ; Bronchoalveolar Lavage ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; therapy ; Treatment Outcome