BACKGROUND:Studies have found that activation of nuclear factor-erythroid 2-related factor 2/heme oxidase-1(Nrf2/HO-1)pathway can alleviate oxidative stress caused by cerebral ischemia-reperfusion injury,but whether human bone marrow mesenchymal stem cells(hBMSC)can activate Nrf2/HO-1 pathway to alleviate cerebral ischemia-reperfusion injury is still lacking relevant studies. OBJECTIVE:To investigate whether intracranial transplantation of hBMSC alleviates oxidative stress injury in cerebral ischemia-reperfusion animal models by activating Nrf2/HO-1 pathway. METHODS:Totally 40 male SPF SD rats were randomly divided into sham operation group,model group,hBMSC transplantation group,hBMSC+solvent group and hBMSC+Nrf2 inhibitor group.Each group consisted of eight animals.In the model group and the hBMSC transplantation group,middle cerebral artery occlusion model was prepared by thread embolization method.The thread embolization was removed 1 hour later,and 30 μL PBS or hBMSC cultured to at least passage 5 was injected into the right cortex and striatum of rats.In the hBMSC+Nrf2 inhibitor group and hBMSC+solvent group,the left ventricle was injected with Nrf2 inhibitor Brusatol and its solvent dimethyl sulfoxide respectively 24 hours before model establishment,then the middle cerebral artery occlusion model was prepared,and hBMSC was injected.Relevant indexes were detected 3 days after transplantation. RESULTS AND CONCLUSION:(1)CT and TTC staining showed the same area and volume of cerebral infarction:model group>hBMSC+Nrf2 inhibitor group>hBMSC+solvent group>hBMSC transplantation group>sham operation group.(2)Hematoxylin-eosin staining and Nissl's staining showed that the ischemic brain tissue was intact and the neurons were normal in the sham operation group.Compared with the model group,the pathological morphology and neuronal injury of the hBMSC transplantation group and the hBMSC+solvent group were significantly improved.Compared with the hBMSC+solvent group,the hBMSC+Nrf2 inhibitor group had more serious pathological morphology and neuronal damage.(3)Western blot assay and oxidative stress index detection results showed that compared with the sham operation group,Nrf2 and HO-1 proteins were decreased(all P<0.05),malondialdehyde was increased and superoxide dismutase was decreased(all P<0.05)in the model group.Compared with the model group,the expression levels of Nrf2 and HO-1 proteins were increased(all P<0.05),malondialdehyde was decreased and superoxide dismutase was increased(all P<0.05)in the hBMSC transplantation group and the hBMSC+solvent group.Compared with the hBMSC+solvent group,the expression levels of Nrf2 and HO-1 proteins were simultaneously decreased(all P<0.05),and malondialdehyde was increased and superoxide dismutase was decreased(all P<0.05)in the hBMSC+Nrf2 inhibitor group.(4)These results indicate that hBMSC can alleviate cerebral ischemia-reperfusion injury possibly by activating Nrf2/HO-1 pathway.

BACKGROUND:Rotator cuff muscle degeneration(muscle atrophy,fibrosis and fatty infiltration)is a common condition after rotator cuff tears,which seriously affects shoulder function and surgical outcomes.Ginsenoside Rg1 has biological effects such as anti-oxidation,anti-apoptosis and lipid-lowering.However,the effect of ginsenoside Rg1 on muscle degeneration after rotator cuff tear has not been reported. OBJECTIVE:To investigate the effect of ginsenoside Rg1 on muscle degeneration after massive rotator cuff tear in mice. METHODS:Sixty C57BL/6J mice were randomly divided into sham group,model group,ginsenoside Rg1 low dose group and ginsenoside Rg1 high dose group,with 15 mice in each group.The skin of the right shoulder of mice in the sham group was cut and sutured.Massive rotator cuff tear mouse models of the right shoulder were established in the other three groups.Supraspinatus tendon and suprascapular nerve compression were administrated.Mice in the sham and model groups were intraperitoneally injected with 0.5 mL of saline after operation,while those in the ginsenoside Rg1 low and high dose groups were intraperitoneally injected with ginsenoside Rg1 30 and 60 mg/kg respectively,once a day,for 6 weeks.Mice were assessed for limb function by gait analysis the day after the last injection.After euthanasia,the supraspinatus muscle on the operated side was taken to measure the muscle atrophy rate and muscle contractility.Muscle tissue was stained with oil red O and Masson.RT-PCR was used to detect the expression of atrophy,fibrosis,and fatty infiltration related genes. RESULTS AND CONCLUSION:Compared with the model group,low-and high-dose ginsenoside Rg1 significantly increased paw print area and step length(P<0.05).Compared with the model group,low-and high-dose ginsenoside Rg1 significantly increased myofiber cross-sectional area and supraspinatus contractility(P<0.05),and significantly decreased wet muscle mass reduction ratio,fatty infiltration area ratio,and collagen fiber area ratio(P<0.05).Compared with the model group,low-and high-dose ginsenoside Rg1 significantly decreased the expression of atrophy,fibrosis,and fatty infiltration related genes(P<0.05).There was no significant difference in paw print area,supraspinatus muscle contractility,and myofiber cross-sectional area between ginsenoside Rg1 low and high dose groups(P>0.05),and all other indexes were better in the ginsenoside Rg1 high dose group than in the ginsenoside Rg1 low dose group(P<0.05).To conclude,ginsenoside Rg1 could significantly reduce muscle atrophy,fibrosis and fatty infiltration following massive rotator cuff tear in mice,which is beneficial to improve muscle strength and limb function.

Objective:To compare the therapeutic effects of percutaneous transhepatic choledochoscopic lithotripsy (PTCSL) and traditional open hepatectomy (OH) on regional hepatolithiasis with biliary cirrhosis.Methods:From January 2020 to August 2022, 110 cases of regional hepatolithiasis complicated with biliary cirrhosis treated in the hepatology department of Hunan Provincial People′s Hospital were retrospectively collected. According to the surgical methods of treating hepatolithiasis, the patients were divided into minimally invasive group and laparotomy group. The minimally invasive group received PTCSL, and the laparotomy group received OH. The clinical data of the two groups were compared and analyzed, and the postoperative exhaust time, gastrointestinal function recovery time, operation time and intraoperative bleeding volume were observed. The levels of alanine aminotransferase (ALT), γ-glutamyltransferase(GGT) and aspartate aminotransferase (AST) before and after operation were compared between the two groups. The incidence of complications and stone removal rate of the two groups were recorded.Results:The postoperative exhaust time (11.12±2.09)h, gastrointestinal function recovery time (25.76±4.28)h, operation time (108.51±16.19)h, intraoperative blood loss (20.16±3.59)ml and postoperative exhaust time (29.35±4.83)h and gastrointestinal function recovery time in the minimally invasive group were less than those in the laparotomy group (36.91±6.35)h, operation time (116.27±21.54)h and intraoperative blood loss (38.03±6.22)ml (all P<0.05). The levels of ALT (77.82±16.25)U/L, GGT (248.16±24.83)U/L and AST (65.42±16.82)U/L in the minimally invasive group after operation were lower than those in the laparotomy group [ALT (102.37±25.64)U/L, GGT (345.45±32.60)U/L and AST (96.30±22.17)U/L] (all P<0.05). The incidence of postoperative complications was 7.27%(4/55) in the minimally invasive group and that in the laparotomy group was 29.09%(16/55), with statistically significant difference ( P<0.05). The stone removal rate was 61.82%(34/55) in the minimally invasive group and 92.73%(51/55) in the laparotomy group, with statistically significant difference ( P<0.05). Conclusions:PTCSL and OH are effective in the treatment of regional hepatolithiasis complicated with biliary cirrhosis. The traditional OH has a high stone removal rate, and PTCSL has little influence on liver function, small complication rate and fast postoperative recovery.

BACKGROUND: Microsatellite instability (MSI) is a key biomarker for cancer immunotherapy and prognosis. Integration of MSI testing into a next-generation-sequencing (NGS) panel could save tissue sample, reduce turn-around time and cost, and provide MSI status and comprehensive genomic profiling in single test. We aimed to develop an MSI calling model to detect MSI status along with the NGS panel-based profiling test using tumor-only samples. METHODS: From January 2019 to December 2020, a total of 174 colorectal cancer (CRC) patients were enrolled, including 31 MSI-high (MSI-H) and 143 microsatellite stability (MSS) cases. Among them, 56 paired tumor and normal samples (10 MSI-H and 46 MSS) were used for modeling, and another 118 tumor-only samples were used for validation. MSI polymerase chain reaction (MSI-PCR) was performed as the gold standard. A baseline was built for the selected microsatellite loci using the NGS data of 56 normal blood samples. An MSI detection model was constructed by analyzing the NGS data of tissue samples. The performance of the model was compared with the results of MSI-PCR. RESULTS: We first intersected the target genomic regions of the NGS panels used in this study to select common microsatellite loci. A total of 42 loci including 23 mononucleotide repeat sites and 19 longer repeat sites were candidates for modeling. As mononucleotide repeat sites are more sensitive and specific for detecting MSI status than sites with longer length motif and the mononucleotide repeat sites performed even better than the total sites, a model containing 23 mononucleotide repeat sites was constructed and named Colorectal Cancer Microsatellite Instability test (CRC-MSI). The model achieved 100% sensitivity and 100% specificity when compared with MSI-PCR in both training and validation sets. Furthermore, the CRC-MSI model was robust with the tumor content as low as 6%. In addition, 8 out of 10 MSI-H samples showed alternations in the four mismatch repair genes ( MLH1 , MSH2 , MSH6 , and PMS2 ). CONCLUSION MSI status can be accurately determined along the targeted NGS panels using only tumor samples. The performance of mononucleotide repeat sites surpasses loci with longer repeat motif in MSI calling.
Humans ; Microsatellite Instability ; Colorectal Neoplasms/diagnosis* ; Microsatellite Repeats/genetics* ; DNA Mismatch Repair

Objective:To investigate the correlation between state-trait anxiety levels and quality of life before and after orthognathic surgery in patients with dentofacial deformities, and explore the feasibility of using the state-trait anxiety inventory(STAI) to screen postoperative patients with low quality of life.Methods:Patients with dentofacial deformities who underwent orthognathic surgery in Peking University Stomatological Hospital from September 2019 to March 2021 were selected as the research objects. STAI [including state anxiety inventory(SAI) and trait anxiety inventory(TAI)] and orthognathic quality of life questionnaire(OQLQ) were used to investigate patients before surgery, 2 weeks after surgery, 3 months after surgery and 6 months after surgery. The total scores of SAI and TAI ranged from 20 to 80 points, with higher scores implying a higher level of state-trait anxiety. The OQLQ includes four dimensions: social function, facial aesthetics, oral function and aesthetic perception, with total scores ranging from 22 to 88, higher scores representing a lower life quality level. SPSS 26.0 software used for statistical analysis, the measurement data was expressed as Mean±SD. Repeated measures ANOVA and the Bonferroni method were used to compare the SAI, TAI and OQLQ scores in different periods. Pearson correlation analysis was used to explore the correlation between patients’ demographic characteristics (gender, age, diagnostic classification, education, number of social contacts) and state-trait anxiety level, and life quality level at different periods, as well as the correlation between the state-trait anxiety level and the life quality level over time. Receiver operator characteristic(ROC) curve analysis was used to explore the feasibility of using the preoperative STAI scale to screen postoperative patients with low quality of life.Results:A total of 96 patients were included in this study, including 26 males and 70 females, aged (26.0±5.8) years. The SAI, TAI, and OQLQ total scores decreased during three postoperative periods compared to preoperative period ( P<0.01), indicating that the patients’ postoperative state-trait anxiety level decreased and their life quality level improved after surgery. Pearson correlation analysis showed a negative correlation between the patient’s social contact number and their SAI and TAI scores at postoperative 2 weeks (SAI: r=-0.30, P=0.003; TAI: r=-0.35, P<0.001). SAI and TAI scores were positively correlated in different periods ( r=0.48-0.84, P<0.01). Preoperative SAI scores and TAI scores were correlated with preoperative social function, aesthetic perception, facial aesthetic scores and total OQLQ scores (SAI: r=0.39-0.52, P<0.01; TAI: r=0.32-0.51, P<0.01). Preoperative SAI scores were positively correlated with social function and aesthetic perception scores and total OQLQ scores at 2 weeks postoperatively and with aesthetic perception, social function at 6 months postoperatively ( r=0.20-0.52, P<0.05 or <0.01). Postoperative SAI scores were positively correlated with OQLQ scores in all dimensions and total scores except for oral function scores at 3 months postoperatively, which were not correlated with the same period ( r= 0.24-0.55, P<0.05 or <0.01). Preoperative TAI scores were positively correlated with social function scores at 2 weeks( r=0.36, P<0.001) and 3 months( r=0.21, P=0.041) postoperatively. Postoperative TAI scores were positively correlated with OQLQ scores in all dimensions and total scores except for oral function scores at 2 weeks postoperatively, which were not correlated with oral function scores at the same period ( r=0.21-0.58, P<0.05 or <0.01). ROC curve analysis showed that preoperative SAI scores >34.5 and >33.5 screened people with low life quality level at postoperative 3 months and 6 months, with an area under the curve (AUC) of 0.75 (95% CI: 0.62-0.87, P=0.001) and 0.71 (95% CI: 0.59-0.84, P=0.003), respectively. Preoperative TAI scores >43.5, >42.5 and >33.5 can screen patients with low quality of life at 2 weeks, 3 months and 6 months after surgery, with AUC of 0.64(95% CI: 0.52-0.75, P=0.046), 0.73(95% CI: 0.60-0.85, P=0.001)and 0.67(95% CI: 0.55-0.80, P=0.016)respectively. Conclusion:The preoperative and postoperative state-trait anxiety level of patients with dentofacial deformity is correlated with the overall level of quality of life, social function, aesthetic perception and facial aesthetics. The preoperative application of STAI scale can screen patients with low quality of life after orthognathic surgery.

Objective:To investigate the correlation between state-trait anxiety levels and quality of life before and after orthognathic surgery in patients with dentofacial deformities, and explore the feasibility of using the state-trait anxiety inventory(STAI) to screen postoperative patients with low quality of life.Methods:Patients with dentofacial deformities who underwent orthognathic surgery in Peking University Stomatological Hospital from September 2019 to March 2021 were selected as the research objects. STAI [including state anxiety inventory(SAI) and trait anxiety inventory(TAI)] and orthognathic quality of life questionnaire(OQLQ) were used to investigate patients before surgery, 2 weeks after surgery, 3 months after surgery and 6 months after surgery. The total scores of SAI and TAI ranged from 20 to 80 points, with higher scores implying a higher level of state-trait anxiety. The OQLQ includes four dimensions: social function, facial aesthetics, oral function and aesthetic perception, with total scores ranging from 22 to 88, higher scores representing a lower life quality level. SPSS 26.0 software used for statistical analysis, the measurement data was expressed as Mean±SD. Repeated measures ANOVA and the Bonferroni method were used to compare the SAI, TAI and OQLQ scores in different periods. Pearson correlation analysis was used to explore the correlation between patients’ demographic characteristics (gender, age, diagnostic classification, education, number of social contacts) and state-trait anxiety level, and life quality level at different periods, as well as the correlation between the state-trait anxiety level and the life quality level over time. Receiver operator characteristic(ROC) curve analysis was used to explore the feasibility of using the preoperative STAI scale to screen postoperative patients with low quality of life.Results:A total of 96 patients were included in this study, including 26 males and 70 females, aged (26.0±5.8) years. The SAI, TAI, and OQLQ total scores decreased during three postoperative periods compared to preoperative period ( P<0.01), indicating that the patients’ postoperative state-trait anxiety level decreased and their life quality level improved after surgery. Pearson correlation analysis showed a negative correlation between the patient’s social contact number and their SAI and TAI scores at postoperative 2 weeks (SAI: r=-0.30, P=0.003; TAI: r=-0.35, P<0.001). SAI and TAI scores were positively correlated in different periods ( r=0.48-0.84, P<0.01). Preoperative SAI scores and TAI scores were correlated with preoperative social function, aesthetic perception, facial aesthetic scores and total OQLQ scores (SAI: r=0.39-0.52, P<0.01; TAI: r=0.32-0.51, P<0.01). Preoperative SAI scores were positively correlated with social function and aesthetic perception scores and total OQLQ scores at 2 weeks postoperatively and with aesthetic perception, social function at 6 months postoperatively ( r=0.20-0.52, P<0.05 or <0.01). Postoperative SAI scores were positively correlated with OQLQ scores in all dimensions and total scores except for oral function scores at 3 months postoperatively, which were not correlated with the same period ( r= 0.24-0.55, P<0.05 or <0.01). Preoperative TAI scores were positively correlated with social function scores at 2 weeks( r=0.36, P<0.001) and 3 months( r=0.21, P=0.041) postoperatively. Postoperative TAI scores were positively correlated with OQLQ scores in all dimensions and total scores except for oral function scores at 2 weeks postoperatively, which were not correlated with oral function scores at the same period ( r=0.21-0.58, P<0.05 or <0.01). ROC curve analysis showed that preoperative SAI scores >34.5 and >33.5 screened people with low life quality level at postoperative 3 months and 6 months, with an area under the curve (AUC) of 0.75 (95% CI: 0.62-0.87, P=0.001) and 0.71 (95% CI: 0.59-0.84, P=0.003), respectively. Preoperative TAI scores >43.5, >42.5 and >33.5 can screen patients with low quality of life at 2 weeks, 3 months and 6 months after surgery, with AUC of 0.64(95% CI: 0.52-0.75, P=0.046), 0.73(95% CI: 0.60-0.85, P=0.001)and 0.67(95% CI: 0.55-0.80, P=0.016)respectively. Conclusion:The preoperative and postoperative state-trait anxiety level of patients with dentofacial deformity is correlated with the overall level of quality of life, social function, aesthetic perception and facial aesthetics. The preoperative application of STAI scale can screen patients with low quality of life after orthognathic surgery.

Objective:To discuss the clinical value and significance of real-time ultrasound-guided anatomical segmental hepatectomy in patients with primary liver cancer.Methods:43 patients with primary liver cancer treated in Hunan Provincial People′s Hospital from January 2015 to October 2017 were retrospectively selected as the control group, and 43 patients with primary liver cancer treated from November 2017 to December 2019 were selected as the observation group. The control group was treated with irregular hepatectomy, and the observation group was treated with anatomical segmental hepatectomy under real-time ultrasound navigation. The operation, postoperative complication rate and quality of life score were compared between the two groups after different treatment.Results:The portal occlusion rate and blood transfusion rate of the observation group (13.9%, 9.3%) were significantly lower than those of the control group (30.2%, 25.5%; all P<0.05); the operation time of the observation group [(153.4±14.20)min] was significantly longer than that of the control group [(127.3±12.10)min, P<0.05]; one year after operation, the recurrence rate of the observation group (9.3%) was significantly lower than that of the control group (30.2%, P<0.05), and the survival rate (81.4%) was significantly higher than that of the control group (51.2%, P<0.05). Conclusions:The application of real-time ultrasound-guided anatomical segmental hepatectomy in patients with primary liver cancer can significantly reduce the porta hepatis block rate and blood transfusion rate. It is of positive and important significance to promote the recovery of postoperative liver function, improve the quality of life and reduce the probability of disease recurrence.

Infectious diseases of spine (IDS) refer to a series of infectious diseases in different parts of the spine (vertebral body, intervertebral disc, appendix of vertebra, spinal canal, and adjacent paravertebral tissues) caused by various pathogenic microorganisms, accounting for about 2%~7% of systemic musculoskeletal system infections. According to the classic classification IDS can be divided into two types: specific infection and non-specific infection. IDS often has an insidious onset, atypical clinical manifestations, and less-specific imaging and laboratory tests, which causes great difficulties for the accurate diagnosis and treatment, often leading to missed diagnosis, misdiagnosis, and even mistreatment. Problems such as disordered clinical diagnosis and treatment procedures, diverse treatment methods, and non-standard medication and course of treatment still affect the prognosis of IDS. This article reviews the current research progress of the diagnosis and treatment process of IDS, in order to further standardize the diagnosis and treatment process of IDS.

Objective:To investigate the efficacy and safety of dexmedetomidine in noninvasive continuous positive airway pressure(NCPAP)for acute respiratory failure in children.Methods:Clinical data of children with acute respiratory failure who underwent NCPAP from January 2018 to March 2020 in PICU of Hunan Children′s Hospital were prospectively collected.They were randomly divided into dexmedetomidine group(group D)and midazolam group(group M), with a total of 100 children.We compared the sedation depth of the two groups at 7 time points after sedation at 0.5 h(t1), 1 h(t2), 2 h(t3), 6 h(t4), 12 h(t5), 24 h(t6), and 48 h(t7), time to reach proper sedation, NCPAP time, NCPAP failure rate, oxygenation index(P/F value)before sedation(T0)and 1h(T1), 24h(T2), and 48h(T3)after sedation, and the main vital signs and adverse reactions before sedation(T0)and 1h(T1), 24h(T2), 48h(T3)after sedation.Results:(1)The proportion of proper sedation at T4, T5, T6 and T7 after sedation in group D was higher than that in group M[98%(49/50)vs.84%(42/50), 94%(47/50)vs.90%(45/50), 96%(48/50)vs.88%(44/50), 90%(45/50)vs.88%(44/50), χ2=6.538, 8.043, 8.174, 7.678, all P<0.05]. Time to reach proper sedation in group D was shorter[(58.6±7.9)s vs.(66.7±9.3)s, t=4.682, P<0.01]. (2)The treatment time and failure rate of NCPAP in group D were lower than those in group M[(134.9±25.5)h vs.(147.8±24.3)h, 10%(5/50)vs.28%(14/50), all P<0.05]. P/F after NCPAP treatment in the two groups was improved as compared with that before treatment(all P<0.01), and the improvement was more significant in group D than in group M at T2 and T3 after sedation[(199.3±26.1)vs.(188.5±24.2)mmHg, (212.2±25.4)mmHg vs.(200.8±24.8)mmHg, t=2.132, 2.278, all P<0.05]. (3)There were no significant differences in heart rate(HR), mean arterial pressure(MAP), and respiratory rate(RR)before sedation between the two groups(all P>0.05). HR and RR after sedation in both groups decreased as compared with those before sedation( P<0.01). HR at T1, T2, and T3 after sedation in group D decreased more significantly than that in group M[(116.3±17.6)bpm vs.(124.8±14.1)bpm, (110.2±18.4)bpm vs.(121.9±15.2)bpm, (108.5±18.7)bpm vs.(117.6±12.8)bpm, t=0.479, -3.474, -2.840, all P<0.05]. There was no significant difference in RR after sedation between the two groups( t=1.872, 1.632, 1.675, all P>0.05). MAP at T1 in group D decreased as compared with T0( P<0.01). MAP at T1 in group D was lower than that in group M[(65.5±5.1)mmHg vs.(68.0±5.7)mmHg, t=-2.297, P=0.024]. (4)There was no significant difference in the incidence of total adverse reactions between the two groups[20%(10/50)vs.14%(7/50), P=0.595]. The incidence of bradycardia was higher in group D than in group M[16%(8/50)vs.2%(1/50), P=0.031]. Conclusion:The incidence of adverse reactions of dexmedetomidine and midazolam in the sedation of NCPAP in children with acute respiratory failure is similar, but the sedative effect of dexmedetomidine is better than that of midazolam in the improvement of pulmonary oxygenation.

Objective:To investigate the efficacy and safety of bronchoscopic lavage in children with severe adenoviral pneumonia.Methods:Patients with severe adenovirus pneumonia who were admitted to ICU department of Hunan Children′s Hospital for bronchoscopy were collected from February to June 2019 and divided into lavage group( n=36) and non-lavage group( n=15) in line with whether lavage was performed.Their results, namely, bronchoscopic diagnosis, blood gas analysis before and 2 hours, 24 hours and 48 hours after bronchoscopy, improvement time of clinical symptoms(fever and pulmonary moist rales), the positive rate of pathogen detection and mortality rate, main vital signs such as heart rate, respiratory rate, mean arterial pressure and bronchoscopy-related complications were recorded before and 1 hour, 2 hours and 24 hours after bronchoscopy. Results:A total of 51 children were collected, all of whom suffered from endobronchitis.More secretions were observed in the airways of 36 patients in the lavage group, and only a little or no secretions were observed in 15 patients in the non-lavage group.P/F value and PCO 2 at 2 hours, 24 hours and 48 hours after treatment in the lavage group were improved comparing to those before treatment and were superior to those in the non-lavage group( P<0.05). P/F values at 24 hours and 48 hours after treatment in the non-lavage group increased and PCO 2 decreased at 48 hours after treatment( P<0.05). The thermal duration, time to resolution of moist rales in the lungs in the lavage group were shorter than those in the non-lavage group( P<0.05). The mortality rate in the lavage group was lower than that in the non-lavage group[2.8%(1/36) vs.26.7%(4/15), P<0.05]. The positive rate of pathogen detection in lavage group was higher than that in non-lavage group[55.6%(20/36) vs. 20.0%(3/15), P<0.05]. There was no significant difference in heart rate, respiratory rate, and mean arterial pressure at each time point before and after bronchoscopic treatment( P>0.05). Associated complications were 11 cases of intraoperative transient hypoxemia, four cases of bronchial mucosal bleeding, and one case each of postoperative hypoxemia, intraoperative hypertension and hypotension.There was no significant difference in the incidence of complications between the two groups( P>0.05). Conclusion:Bronchoscopic lavage, in treating children with severe adenovirus pneumonia, may improve clinical symptoms, respiratory function, and rate of pathogen detection, reduce mortality, and is effective and safe.