托珠单抗治疗难治性全身型幼年特发性关节炎疗效及安全性分析

目的：了解重庆地区经鼻气道正压通气（nCPAP）治疗的重症肺炎住院患儿的病原学特点。方法：回顾性分析2015年3月至2019年4月在我院呼吸科住院接受nCPAP治疗的354例重症肺炎患儿的病原学资料。结果：354例患儿nCPAP使用时间（72.45±43.04）h。痰病原阳性288例（81.36%），其中病毒202例（70.14%），细菌167例（57.99%），混合病原109例（37.85%）。共检出病原体435株，包括病毒220株（50.57%），以呼吸道合包病毒（RSV）检出率最高（115株）；细菌181株（41.61%），以流感嗜血杆菌为主（77株）。不同季节、年龄组病原检出率比较差异有统计学意义（P<0.05）。抗生素使用率为94.92%，高于细菌检出率（52.54%）。结论：使用nCPAP的住院重症肺炎患儿病原主要是病毒，以RSV为主，其次为细菌，以流感嗜血杆菌为主。痰标本病原检出率较灌洗液高，抗生素使用率偏高。

Efficacy and Safety of Tocilizumab in the Treatment of Refractory Systemic Onset Juvenile Idiopathic Arthritis

Objective: To investigate the etiological characteristics of hospitalized children with severe pneumonia treated by nasal continuous positive airway pressure (nCPAP) in Chongqing. Methods: Etiological data of 354 children with severe pneumonia who received nCPAP treatment in the respiratory department of our hospital from Mar. 2015 to Apr. 2019 were retrospectively analyzed. Results: The duration of application of nCPAP in 354 children was (72.45±43.04) h. There were 288 cases (81.36%) with positive sputum pathogen, including 202 cases (70.13%) of virus infection, 167 cases (57. 99%) of bacterial infection, and 109 cases (37.85%) of mixed infection. A total of 435 strains of pathogens were detected, including 220 strains (50.57%) of virus, with the highest detection rate of respiratory syncytial virus (RSV, 115 strains). There were 181 strains of bacteria (41.61%), the main strains were Haemophilus influenzae (77 strains). There was statistically significant difference in pathogen detection rate in different seasons and age groups (P<0.05). The application rate of antibiotics was 94.92%, higher than the detection rate of bacteria (52.54%). Conclusion: The pathogens of hospitalized children with severe pneumonia treated by nCPAP are mainly viruses, RSV is the commonest, followed by bacteria infection, with H. influenzae as the main pathogen. The detection rate of pathogens in sputum specimens is higher than that of lavage fluid, and the application rate of antibiotics is higher.