Airway microbiota and acute respiratory infection in children

Acute respiratory infections (ARIs), such as bronchiolitis and pneumonia, are the leading cause of hospitalization of infants in the US. While the incidence and severity of ARI can vary widely among children, the reasons for these differences are not fully explained by traditional risk factors (e.g., prematurity, viral pathogens). The recent advent of molecular diagnostic techniques has revealed the presence of highly functional communities of microbes inhabiting the human body (i.e., microbiota) that appear to influence development of local and systemic immune response. We propose a ‘risk and resilience’ model in which airway microbiota are associated with an increased (risk microbiota) or decreased (resilience microbiota) incidence and severity of ARI in children. We also propose that modulating airway microbiota (e.g., from risk to resilience microbiota) during early childhood will optimize airway immunity and, thereby, decrease ARI incidence and severity in children.     

温肺健脾化痰法配合雾化吸入治疗急性毛细支气管炎120例

目的观察温肺健脾化痰法配合雾化吸入治疗急性毛细支气管炎的临床疗效。方法将240例确诊患儿随机分为治疗组和对照组,各120例,对照组以雾化吸入和对症治疗为主,治疗组在对照组治疗的基础上配合温肺健脾化痰法治疗,治疗3月后统计临床疗效及1年后的症情变化情况。结果治疗3月后,治疗组疗效优于对照组（经Radit检验,u=2.2064,P〈0.05）,且治疗组1年复发率明显低于对照组。追踪1年观察发现患儿咳嗽、喘憋、痰鸣等临床症状改善,且睡眠、饮食和生长发育指标均优于对照组（P〈0.05）。结论温肺健脾化痰法配合短期雾化吸入治疗急性毛细支气管炎疗效确切,且能有效防止并减少喘息的反复发作。     

沙丁胺醇氧喷治疗毛细支气管炎临床疗效观察

目的:比较沙丁胺醇(万托林)氧喷与超声雾化吸入治疗毛细支气管炎临床疗效.方法:106例毛细支气管炎患儿在接受综合治疗的基础上随机分为治疗组70例,对照组36例.对照组加用病毒唑、地塞米松、糜蛋白酶超声雾化吸入,治疗组加用沙丁胺醇氧气驱动雾化吸入.结果:治疗组喘憋、哮鸣音、肺部湿啰音消失时间及平均住院日明显短于对照组(P＜0.01).结论:沙丁胺醇以氧气为动力雾化吸人辅助治疗毛细支气管炎临床疗效明显优于对照组.     

氧气驱动雾化吸入双黄连治疗毛细支气管炎临床研究

目的:观察氧气驱动雾化吸入双黄连治疗毛细支气管炎临床疗效.方法:设治疗组63例,对照组33例.治疗组常规治疗加用双黄连注射液,对照组采用常规治疗.结果:治疗组有效率为95.24%,对照组有效率为84.89%,两组差别显著(P＜0.05).结论:氧化驱动雾化吸入双黄连治疗毛细支气管炎疗效显著.     

VIRAL INFECTIONS OF THE RESPIRATORY TRACT IN HOSPITALIZED CHILDREN A Study from Oslo during a 90 Months'Period

ABSTRACT. A diagnosis of 979 respiratory viral infections was made in hospitalized children. Respiratory syncytial virus greatly outnumbered the other viruses: it caused 58% of the total virus infections and occurred in winter epidemics. Influenza A and B virus occurred during late winter and spring, rhinovirus had a seasonal distribution towards spring and autumn, whereas adenovirus types 1, 2 and 5 had no distinct seasonal distribution. Whereas respiratory syncytial virus were mainly associated with bronchiolitis and adenovirus type 7 with pneumonia, rhinovirus infections were most often found in children with episodes of acute bronchial asthma. The influenza A and B and adenovirus types 1, 2 and 5 infections often occurred with extrarespiratory symptoms, especially febrile convulsions.     

High-resolution CT features of severe asthma and bronchiolitis obliterans

AIM: To evaluate the high-resolution CT findings of severe asthma (SA) and bronchiolitis obliterans (BO) and determine whether any reliable discriminating HRCT features exist. MATERIALS AND METHODS: HRCT examinations of the chest of 30 patients with SA and 14 patients with BO were analysed. Images were scored for the presence and extent of 21 CT findings. RESULTS: The most consistent HRCT features in SA were bronchial wall thickening in 30 (100%), expiratory air trapping in 19 of 22 examinations with expiratory images (87%), inspiratory decreased attenuation in 18 (60%), and bronchial luminal narrowing in 12 (40%). The most consistent HRCT features in BO were expiratory air trapping in 10 of 10 examinations with expiratory images (100%), bronchial wall thickening in 13 (93%), inspiratory decreased attenuation in 11 (79%), ground glass opacity in seven (50%), and mosaic pattern of attenuation in seven (50%). Decreased attenuation was more extensive in BO than in SA on both inspiratory and expiratory images. The mosaic pattern of attenuation was present in seven (50%) BO patients but in only one (3%) SA patients (P=0.0006). CONCLUSIONS: Mosaic pattern of attenuation, when present, is highly suggestive of BO, but SA and BO may be indistinguishable.