Objective To explore the correlation between erythrocyte sedimentation rate(ESR)and cellular immunity in children with Mycoplasma pneumoniae pneumonia(MPP)of different ages.Methods 195 children diagnosed with Mycoplasma pneumoniae pneumonia admitted to our hospital from January 2020 to December 2023 were selected as the study subjects.All patients were divided into three groups based on age:74 infants and young children(≤3 years old),63 young children(3-6 years old),and 58 older children(≥6 years old).Compare clinical data,imaging information,and cellular immune levels of children of different age groups,and analyze the correlation between ESR levels and cellular immune levels through EmpowerStats stratified interaction test.MMP patients were divided into RRTI group(n=63)and non RRTI group(n=132)based on whether they had recurrent respiratory tract infection(RRTI).Clinical data of the two groups were compared,and the Cox proportional hazards model was used to analyze the correlation between ESR levels and the occurrence of RRTI in MPP patients at different age groups.ESR levels were divided into a quintile array from low to high,and a subgroup analysis was conducted on the correlation between ESR levels and the occurrence of RRTI in MPP patients.The restricted cubic spline model was used to analyze the dose-response relationship between ESR levels and the occurrence of RRTI in MPP patients.Results Children of different ages had fever peaks,fever duration,persistent high fever>7 days,difficulty breathing,asthma,wet rales,wheezing,extrapulmonary complications,neutrophil count(ESR),Eosinophil count,C-reactive protein(CRP),lactate dehydrogenase(LDH),D-dimer,and whether RRTI were present were statistically significant(P<0.05).Compared with MPP patients in the infant and toddler group,the incidence of lobular parenchymal infiltration,interstitial infiltration,and CD8+levels in the younger and older infant groups were significantly reduced(P<0.05),while the incidence of pulmonary parenchymal infiltration,pleural effusion,CD3+,CD4+levels,and CD4+/CD8+ratio levels were significantly increased(P<0.05).EmpowerStats stratified interaction test analysis showed that after adjusting for other factors such as heat peak,heat duration,and dyspnea,the relationship between ESR levels and cellular immune indicators still exists in MPP patients of different ages.There were significant differences in age,age group,heat peak,ESR,CRP,Fibrinogen(Fib),D-dimer,lobular parenchymal infiltration,segmental parenchymal infiltration,atelectasis,pleural effusion,CD3+,CD4+,CD8+,and CD4+/CD8+ratio between the RRTI and non RRTI groups(P<0.05).The Cox proportional risk model results showed that after adjusting for variables such as CRP and pleural effusion,ESR levels remained a protective factor for RTTI in MPP patients,and there was interaction between subgroups.The results of the restricted cubic spline model show that there is no non-linear dose-response relationship between ESR levels and RRTI occurrence in MPP patients of different ages.Conclusion There is a correlation between ESR levels and cellular immunity in children with MPP of different ages,and the relationship is stable.ESR level is a protective factor for MPP patients with RRTI.

Objective To explore the correlation between erythrocyte sedimentation rate(ESR)and cellular immunity in children with Mycoplasma pneumoniae pneumonia(MPP)of different ages.Methods 195 children diagnosed with Mycoplasma pneumoniae pneumonia admitted to our hospital from January 2020 to December 2023 were selected as the study subjects.All patients were divided into three groups based on age:74 infants and young children(≤3 years old),63 young children(3-6 years old),and 58 older children(≥6 years old).Compare clinical data,imaging information,and cellular immune levels of children of different age groups,and analyze the correlation between ESR levels and cellular immune levels through EmpowerStats stratified interaction test.MMP patients were divided into RRTI group(n=63)and non RRTI group(n=132)based on whether they had recurrent respiratory tract infection(RRTI).Clinical data of the two groups were compared,and the Cox proportional hazards model was used to analyze the correlation between ESR levels and the occurrence of RRTI in MPP patients at different age groups.ESR levels were divided into a quintile array from low to high,and a subgroup analysis was conducted on the correlation between ESR levels and the occurrence of RRTI in MPP patients.The restricted cubic spline model was used to analyze the dose-response relationship between ESR levels and the occurrence of RRTI in MPP patients.Results Children of different ages had fever peaks,fever duration,persistent high fever>7 days,difficulty breathing,asthma,wet rales,wheezing,extrapulmonary complications,neutrophil count(ESR),Eosinophil count,C-reactive protein(CRP),lactate dehydrogenase(LDH),D-dimer,and whether RRTI were present were statistically significant(P<0.05).Compared with MPP patients in the infant and toddler group,the incidence of lobular parenchymal infiltration,interstitial infiltration,and CD8+levels in the younger and older infant groups were significantly reduced(P<0.05),while the incidence of pulmonary parenchymal infiltration,pleural effusion,CD3+,CD4+levels,and CD4+/CD8+ratio levels were significantly increased(P<0.05).EmpowerStats stratified interaction test analysis showed that after adjusting for other factors such as heat peak,heat duration,and dyspnea,the relationship between ESR levels and cellular immune indicators still exists in MPP patients of different ages.There were significant differences in age,age group,heat peak,ESR,CRP,Fibrinogen(Fib),D-dimer,lobular parenchymal infiltration,segmental parenchymal infiltration,atelectasis,pleural effusion,CD3+,CD4+,CD8+,and CD4+/CD8+ratio between the RRTI and non RRTI groups(P<0.05).The Cox proportional risk model results showed that after adjusting for variables such as CRP and pleural effusion,ESR levels remained a protective factor for RTTI in MPP patients,and there was interaction between subgroups.The results of the restricted cubic spline model show that there is no non-linear dose-response relationship between ESR levels and RRTI occurrence in MPP patients of different ages.Conclusion There is a correlation between ESR levels and cellular immunity in children with MPP of different ages,and the relationship is stable.ESR level is a protective factor for MPP patients with RRTI.

Objective:To explore the detection of potentially pathogenic bacteria (PPB) in the nasopharynx of children with respiratory syncytial virus (RSV) bronchiolitis and the influence of PPB types on disease severity.Methods:In this retrospective cohort study, clinical data of patients hospitalized for RSV bronchiolitis at Department of Respiratory Medicine, Children′s Hospital of Soochow University between January 1, 2017 and December 31, 2019 were retrospectively analyzed.The virus, Mycoplasma pneumoniae and bacteria in nasopharyngeal secretion of children were detected.They were classified into <3 months group, 3-<6 months group, 6 months-<1 year group and 1-2 years group based on the age.In addition, they were further classified into RSV infection group, RSV+ G + group, RSV+ G - group and RSV+ G + + G - group based on detected PPB in the nasopharynx.Comparison of RSV + PPB frequency between groups was performed by Chi- squared test, clinical characteristics were compared by using Mann- Whitney U test. Results:A total of 280 patients with RSV bronchiolitis were included in the study, involving 113 cases (40.4%) with PPB in the nasopharynx.The most-common detection bacterium was Streptococcus pneumoniae.The detection rate of Streptococcus pneumoniae increased with age ( χ2=12.609, P=0.005), while that of Staphylococcus aureus decreased with age ( χ2=8.387, P=0.034). Compared with RSV group, patients in RSV+ G - group had a longer length of stay, higher rate of fever and shortness of breath, higher oxygen supplement and higher C-reactive protein (CRP) (all P<0.05). Compared with RSV group, patients in RSV+ G + group were older, and they had higher rate of fever, higher percentage of neutrophil, lower percentage of lymphocyte and higher CRP (all P<0.05). Conclusions:PPB in nasopharynx can be detected in about 40% of children hospitalized with RSV bronchiolitis, and nasopharynx complicated with PPB infection may affect the severity of RSV bronchiolitis.

Objective To explore the effects of pneumoperitioneal on respiratory function and haemodynamic and liver function in laparoscopic hcpatectomy under general anesthesia. Methods changes of pneumoperitioneal on respiratory function and haemodynamic were analyzed retrospectively in 15 LH.Results SBP、DBP、HR were higher significant after C02 insufflation(P＜0.05).SpO2 were lower significant after CO2 insufflation(P＜0.05),there was significant difference between after 30 min after deflation and before CO2 insufflation(P＞0.05);VT were lower significant after CO2 insumation(P＜0.05),there was no significant difference between after 30 min after deflation and before CO2 insufflation (P＞0.05);Ppeak were higher significant after CO2 insufflation(P＜0.05),there was no significant difference between after 30 min afterdefiation anal before CO2 insufflation (P＞0.05). Conclusion there were significant effects of pneumoperitioneal on respiratory function and haemodynamic in laparoscopic hepatectomy under general anesthesia,there weren,t significant effects of liver function.