Clarifying the relationship and analyzing the influential factors of bronchial asthma in children with attention-deficit hyperactivity disorder

BACKGROUND Bronchial asthma is closely related to the occurrence of attention-deficit hyperactivity disorder(ADHD)in children,which can easily have adverse effects on children’s learning and social interactions.Studies have shown that childhood asthma can increase the risk of ADHD and the core symptoms of ADHD.Compared with children with ADHD alone,children with asthma and ADHD are more likely to show high levels of hyperactivity,hyperactive-impulsive and other externalizing behaviors and anxiety in clinical practice and have more symptoms of somatization and emotional internalization.AIM To explore the relationship between ADHD in children and bronchial asthma and to analyze its influencing factors.METHODS This retrospective cohort study was conducted at Dongying People's Hospital from September 2018 to August 2023.Children diagnosed with ADHD at this hospital were selected as the ADHD group,while healthy children without ADHD who underwent physical examinations during the same period served as the control group.Clinical and parental data were collected for all participating children,and multivariate logistic regression analysis was employed to identify risk factors for comorbid asthma in children with ADHD.RESULTSSignificant differences were detected between the ADHD group and the control group in terms of family history ofasthma and allergic diseases, maternal complications during pregnancy, maternal use of asthma and allergymedications during pregnancy, maternal anxiety and depression during pregnancy, and parental relationshipstatus (P < 0.05). Out of the 183 children in the ADHD group, 25 had comorbid asthma, resulting in a comorbidityrate of 13.66% (25/183), compared to the comorbidity rate of 2.91% (16/549) among the 549 children in the controlgroup. The difference in the asthma comorbidity rate between the two groups was statistically significant (P <0.05). The results of the multivariate logistic regression analysis indicated that family history of asthma and allergicdiseases, maternal complications during pregnancy, maternal use of asthma and allergy medications duringpregnancy, maternal anxiety and depression during pregnancy, and parental relationship status are independentrisk factors increasing the risk of comorbid asthma in children with ADHD (P < 0.05).CONCLUSIONChildren with ADHD were more likely to have comorbid asthma than healthy control children were. A familyhistory of asthma, adverse maternal factors during pregnancy, and parental relationship status were identified asrisk factors influencing the comorbidity of asthma in children with ADHD. Clinically, targeted interventions basedon these factors can be implemented to reduce the risk of comorbid asthma. This information is relevant for resultssections of abstracts in scientific articles.

Research Progress on Pulmonary Rehabilitation in Children with Bronchial Asthma

Bronchial asthma is a chronic respiratory disease that poses a significant threat to the physical and mental health of children globally.Currently,pulmonary rehabilitation is a non-pharmacological intervention that has shown promise in treating chronic respiratory diseases.However,most studies related to pulmonary rehabilitation only focus on chronic conditions such as chronic obstructive pulmonary disease(COPD),lung cancer,and bronchiectasis.Research on bronchial asthma in children is still in the preliminary stages.This article reviews the concept,basic content,and application mode of pulmonary rehabilitation,to provide reference for the clinical research of pulmonary rehabilitation in children with bronchial asthma,and to carry out multimodal pulmonary rehabilitation to improve the disease control level and quality of life of asthma in children.

Comparison of Allergic Rhinitis and Bronchial Asthma Impacts on Tympanometric Parameters in Children at Kano, Nigeria

Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction that affects sino-nasal mucosa and is characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness and eyes itching. Bronchial asthma (BA) is one of the common childhood diseases that affects the respiratory system characterized by recurrent cough, wheezing, chest tightness and difficulty with breathing. The two conditions are different manifestations of allergic disease of the airway;the composition of the inflammatory substrate in the mucosa of allergic patients is similar to the late-phase allergic response seen elsewhere in the respiratory tract, such as in bronchial asthma. Aim: The aim was to compare the impacts of allergic rhinitis and bronchial asthma on tympanometric parameters in children. Patients & Methods: This is a hospital based comparative cross-sectional study. Two groups of participants aged 4 - 12 years, one group with documented clinical diagnosis of allergic rhinitis and the other group with documented clinical diagnosis of bronchial asthma were consecutively selected from ear, nose and throat (ENT) and pediatrics cardiopulmonary outpatient clinics of Aminu Kano Teaching Hospital Kano respectively. Equal number of children aged 4 - 12 years with no history of ENT diseases or bronchial asthma that were selected from elementary schools within the same community served as a control group. An interviewer-administered questionnaire was filled out for all the participants, complete ENT and chest examinations were carried out and subsequently all the selected participants had tympanometry done, findings were recorded and analyzed. Results: The mean age of participants with bronchial asthma was found to be 7.5 ± 2.6 years while participants with allergic rhinitis had the mean age of 6.8 ± 2.1 years. The mean middle ear pressure (MEP) of participants with bronchial asthma was found to be -15.22 dapa and -40.32 dapa in those with allergic rhinitis. Acoustic reflex was found to be absent in 15.4% of the participants with bronchial asthma and 29.6% of allergic rhinitis participants. Type B tympanogram was found in 2.8% of bronchial asthma participants and 7.3% in participants with allergic rhinitis. Type C tympanogram was found in 4.6% of participants with bronchial asthma and 15.5% of participants with allergic rhinitis. Type A tympanogram was found in 90% of participants with bronchial asthma and 75% of participants with allergic rhinitis. The difference between type A, B and C tympanograms of participants with bronchial asthma and those with allergic rhinitis was found to be statistically significant (Type A χ2 = 14.62, df = 4, p value = 0.01, Type B χ2 = 14.06, df = 4, p value = 0.01, Type C χ2 = 17.01, df = 6, p value = 0.01). Conclusion: Participants with allergic rhinitis were found to have more abnormalities of tympanometric parameters compared to participants with bronchial asthma which signifies allergic rhinitis conferred an increased risk of having middle ear diseases and otitis media with effusion compared to bronchial asthma.

Analysis of montelukast in combined with extended care applied in children with bronchial asthma

Objective:To explore the application effect of montelukast in combined with extended care in children with bronchial asthma.Methods:A total of 80 children with bronchial asthma who were admitted in our hospital from May, 2014 to May, 2015 were included in the study and randomized into the observation group and the control group with 40 cases in each group. The patients in the two groups were given routine treatments and pidotimod granules. On this basis, the patients in the observation group were given additional montelukast and extended care after discharge. The fasting peripheral venous blood before treatment and 3 months after treatment in the two groups was collected. The immunoturbidimetry was used to detect the serum IgA, IgG, and IgM. The pulmonary function detector was used to detect FEV1, FVC, and PEF. Follow-up visits were paid to record the asthma attack times, readmission rate, re-first aid rate, and first aid times after discharge within 1 year.Results:IgA and IgG after treatment in the two groups were significantly elevated (P<0.05), while IgM had no significant change (P>0.05). The elevated degree of IgA and IgG in the observation group was significantly greater than that in the control group (P<0.05). FEV1 (L), FVC (L), and PEF (L/min) after treatment in the two groups were significantly elevated when compared with before treatment (P<0.05). The elevated degree of FEV1, FVC, and PEF in the observation group was significantly greater than that in the control group (P<0.05). The asthma attack times, readmission rate, re-first aid rate, and first aid times after discharge within 1 year in the observation group were significantly lower than those in the control group (P<0.05).Conclusions:The routine treatment in combined with montelukast can better effectively control the symptoms in children with asthma, and improve the pulmonary function. After discharge, the extended care can be more beneficial to control the asthma attack, and enhance the living quality.

Clinical effect of terbutaline injection aerosol inhalation combined with conventional drug therapy for acute attack of bronchial asthma in children

Objective: To study the clinical effect of terbutaline injection aerosol inhalation combined with conventional drug therapy for acute attack of bronchial asthma in children. Methods:Children with acute attack of bronchial asthma who were treated in Wusheng Hospital of Traditional Chinese Medicine and Qiandongnan Prefecture People's Hospital between January 2014 and July 2017 were selected as the study cases for prospective study and randomly divided into the experimental group who received terbutaline + budesonide aerosol inhalation and the control group who received budesonide aerosol inhalation. The expression levels of immune cell transcription factors in peripheral blood as well as the contents of adhesion factors, chemokines, proteases and their inhibitory molecules in serum were determined before treatment and 3 days after treatment. Results: Foxp3 and T-bet expression in peripheral blood as well as TIMP1 and TIMP2 contents in serum of both groups after treatment were higher than those before treatment whereas RORγt and GATA-3 expression in peripheral blood as well as TARC, Eotaxin, ICAM-1, VCAM-1, L-selectin, ADAM8, NE and MMP9 contents in serum were lower than those before treatment, and Foxp3 and T-bet expression in peripheral blood as well as TIMP1 and TIMP2 contents in serum of experimental group after treatment were higher than those of control group whereas RORγt and GATA-3 expression in peripheral blood as well as TARC, Eotaxin, ICAM-1, VCAM-1, L-selectin, ADAM8, NE and MMP9 contents in serum were lower than those of control group. Conclusion: Terbutaline injection aerosol inhalation combined with conventional drug therapy can effectively regulate the immune response and inflammatory response and inhibit the airway remodeling mediated by protease in children with acute attack of bronchial asthma.

Expression and detection significance of immune markers and inflammatory factors in peripheral blood of children with bronchial asthma

Objective: To explore the expression and detection significance of immune markers and inflammatory factors in peripheral blood of children with bronchial asthma. Method: A total of 86 cases of children with bronchial asthma admitted in our hospital from March 2015 to January 2017 were selected as observation group, and 86 cases of healthy children were selected as control group. The level of peripheral blood immunity included CD3+, CD4+, CD8+, CD4+ /CD8+, Th1, Th2, Th1/Th2, Th9, Th17, and the level of inflammatory factors included interferon-γ (IFN-γ), tumor necrosis factor-ɑ (TNF-ɑ), interleukin-17(IL-17) and interleukin-9 (IL-9) were compared in the two groups. Result: The expression levels of CD3+and CD8+ in the observation group were significantly lower than those in the control group, and the levels of CD4+ and CD4+/CD8+ were significantly higher than those in the control group. The expression levels of Th2, Th9 and Th17 in the observation group were significantly higher than those in the control group, while the expression levels of Th1 and Th1/Th2 were significantly lower than those in the control group. The expression levels of TNF-ɑ, IL-17 and IL-9 in the observation group were significantly higher than those in the control group, while the expression level of IFN-γ was significantly lower than that in the control group. Conclusion: The expression level of peripheral blood immunity and inflammatory factors in children with bronchial asthma plays an important role in the occurrence of bronchial asthma, and it is of great significance in clinical practice.

Clinical effect of Maxing Shigan decoction combined with point application in children with bronchial asthma

Objective:To observe the clinical efficacy of Maxingshigan tang combined with point application in children with bronchial asthma, and detect the pulmonary function, inflammatory factor, and immunologic function, and record the adverse reaction. Method:Selecting the 120 children with bronchial asthma according to the require of our research, then the 120 children were divided into control group (n=60) and observation group (n=60). The children in the control group were given conventional therapy (oxygen uptake and aerosol inhalation)+ Maxingshigan tang, observation group were given point application on this basic, treatment for 3 months, then assessed the clinical efficacy and the pulmonary function and the immunidy index, inflammatory factor, and record the adverse reaction. Results:Before the treatment, the pulmonary function, immunidy index, and inflammatory factor in the children with bronchial asthma between the two groups had no statistical difference (p>0.05). After treatment, the pulmonary function was higher than before treatment in both groups (p<0.05). Before the treatment, CD4^+, CD8^+, CD4^+/ CD8^+, IL-6, TNF-α, and TGF-β1 were similar between the two groups, and had no statistical difference (p>0.05), after treatment, the IL-6, TNF-α, and CD8^+ were lower than before treatment (p<0.05) in the two groups, and the IL-6, TNF-α, and CD8+ in the observation group were lower than control group (p<0.05);after treatment, CD4^+, CD4^+/ CD8^+, and TGF-β1 were higher than before treatment (p<0.05) in the two groups, and the CD4^+, CD4^+/ CD8^+, and TGF-β1 in the observation group were higher than control group (p<0.05), the clinical efficacy in the observation group were higher than control group (p<0.05). Conclusions:Maxingshigan tang combined with point application in children with bronchial asthma can improve the pulmonary function, inflammatory factor, and immunologic function, having less AEs.

Efficacy and Impact on Inflammatory Factors and Lung Function in Pediatric Bronchial Asthma Treated with Modified Dingchuan Decoction

Objective:To study the efficacy of treating pediatric bronchial asthma with a modified Dingchuan Decoction and its effect on inflammatory factors and lung function levels.Methods:Sixty cases of bronchial asthma admitted to the hospital between January and December 2023 were divided into two groups using a computerized randomization method.One group of 30 cases received basic treatment with a salmeterol ticarcoson powder inhaler(control group),while the observation group received the same treatment plus a modified Dingchuan Decoction.The disappearance time of symptoms,levels of inflammatory factors,lung function indexes,and clinical efficacy were compared between the two groups.Results:The disappearance time of symptoms in the observation group was shorter than that in the control group.The levels of inflammatory factors after treatment were lower,and lung function indexes were higher in the observation group compared to the control group.Additionally,the total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).Conclusion:In the clinical treatment of pediatric bronchial asthma,supplementing conventional Western medicine with a modified Dingchuan Decoction is effective,as it actively reduces inflammatory factor levels and improves lung function.

Analysis of the Effect of Non-Invasive Positive Pressure Ventilation in Emergency Treatment of Severe Bronchial Asthma with Respiratory Failure

Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with severe bronchial asthma combined with respiratory failure between September 2022 and December 2023 were selected for the study and randomly divided into the experimental group(NIPPV-assisted treatment)and the control group.The differences between the two groups were compared in terms of total effective rate of treatment,days of clinical symptom disappearance,days of hospitalization,lung function indexes,incidence of adverse reactions,and quality of life.Results:Patients in the experimental group had a significantly higher total effective rate of treatment(97.78%)than the control group(75.56%).In terms of pulmonary function indexes,patients in the experimental group showed significant improvement after treatment,especially the increase in forced expiratory volume and forced vital capacity,while these improvements were not as obvious in the control group.In addition,the incidence of adverse reactions was significantly lower in the experimental group than in the control group,suggesting that the application of NIPPV is relatively safe.Quality of life assessment also showed that patients in the experimental group had significantly better quality of life than the control group after treatment.Conclusion:This study demonstrated the effectiveness of NIPPV as an adjunctive treatment for severe bronchial asthma combined with respiratory failure.NIPPV can improve lung function,reduce the incidence of adverse effects,increase the overall effectiveness of the treatment,and contribute to the improvement of patients'quality of life.Therefore,NIPPV should be regarded as an effective and safe treatment in clinical management,especially in patients with severe bronchial asthma combined with respiratory failure,where its application has potential clinical significance.

Research Progress in Integrated Chinese and Western Medicine Health Management for School-Age Children with Asthma

Objective:The purpose of this study is to investigate the application of Chinese and Western medicine in the health management of school-age children with asthma and its research progress,with a view to providing a more comprehensive and effective management strategy for the clinic.Methods:Using the method of literature review,this study systematically searched and analyzed the relevant studies on the combination of Chinese and Western medicine in the health management of school-aged children with asthma in recent years,focusing on Chinese medicine treatment,Western medicine treatment,and the combined health management of Chinese and Western medicine.Results:Chinese medicine treatment,Western medicine treatment,and the health management mode of combining Chinese and Western medicine showed unique advantages in school-age asthmatic children.Through the comprehensive use of Chinese medicine’s diagnosis and treatment,Chinese medicine conditioning,Chinese medicine characteristic therapy,and Western medicine’s modern medical methods,it not only effectively relieved asthma symptoms but also significantly improved the quality of life of the children.At the same time,this management mode also focuses on the psychological guidance and family care of the children,forming an all-round and multi-level health management system.Conclusion:The health management strategy of combining Chinese and Western medicine has a broad application prospect in school-age asthmatic children,and its specific interventions and mechanisms of action should be further studied to provide more scientific and systematic guidance for clinical practice.

The Effects of Omega-3 Fatty Acids Supplementation in Bronchial Asthma

Bronchial asthma is a chronic inflammatory disease. Allergies are intensely related to bronchial asthma and to other respiratory diseases such as chronic sinusitis, middle ear infections, and nasal polyps. Treatment can vary from inhalers to oral medications to drugs delivered in a nebulizer or breathing machine. Besides, dietary involvement was a significant tool to reduce the severity of many chronic inflammatory diseases including asthma. Randomly assigned, double blind, and placebo controlled 290 adults with mild to moderately persistent bronchial asthma concluded in this study, were subjected to alternating phases of supplementation with omega-3 fatty acids, vitamin C and Zn either singly or in combination. Subjective symptom improvement, pulmonary function, and biochemical tests were carried out at the beginning of the study and at the end of each therapeutic phase. The study findings showed that nearly half of the cases were in age between 18 years to 40 years followed by 29.6 of the cases that fall in age range between 40 years and 60 years. It was clear that all the four supplements (ogema-3 fatty acids, vitamin C and Zn, and combination) contributed more than placebo in reducing the severity of bronchial asthma. However, omega 3 fatty acids and combined supplement significantly contributed in symptomatic improvement (p < 0.05). There was a significant improvement of pulmonary function and sputum inflammatory markers with diet supplementation (p < 0.05). So, the subjects with mild and moderately persistent bronchial asthma may get benefit from their dietary supplementation with omega 3 fatty acids, Zinc and vitamin C. It is evident from this study that omega 3 fatty acids and combined supplementation significantly improved the severity of bronchial asthma.

COVID-19 frequency and clinical course in children with asthma

BACKGROUND The epidemic of severe acute respiratory syndrome coronavirus 2 infection,known as the coronavirus disease 2019(COVID-19),has caused a global health concern.Since its emergence,numerous studies have focused on various clinical manifestations and outcomes in different populations.However,studies are ongoing as the consequences and impact of COVID-19 in children with chronic diseases such as asthma are controversial.AIM To fill this research gap by retrospectively evaluating the course,laboratory,and clinical findings of COVID-19 among 414 asthmatic children followed up from the pediatric allergy outpatient clinic and known to have had COVID-19.METHODS The data of 5510 patients over the age of 5 diagnosed with asthma in our hospital's data were retrospectively scanned with specific parameters using protocol numbers from the hospital filing system.The data included retrospective evaluation of pulmonary function test results before and after COVID-19,routine hematological and biochemical parameters,sensitization states(total IgE,specific IgE,and skin prick test results),and radiological(computed tomography)findings.To inquire about the course and symptoms of COVID-19,asthma patients or their parents were then called and evaluated with a questionnaire.RESULTS As a result of retrospectively scanning the data of 5510 asthma patients over the age of 5,it was determined that 414(7.5%)patients had COVID-19.The mean age of 414 patients was 17.18±4.08(min:6;max:28)years.Two hundred and three of our 414 patients are male,and 211 are female.When their vaccination status was questioned,21.5% were vaccinated.When the symptoms of our 290 patients were questioned,it was stated that 59.0% had fever symptoms.The rate of using regular prophylactic asthma medications was 19%.The rate of using salbutamol in asthma was found to be 22%.The rate of patients using methylprednisolone was 1%.Emergency service admission was 17.2%,and hospitalization was found to be 4.8%.Leukopenia(<4000)was found in 14.1%of patients,and 8.08% of our patients had neutropenia(<1500).Lymphopenia(<1500)was detected in 44.4% of patients,and lymphocytosis(>4000)was found in 5.05% of patients.In 65% of our patients,the C-reactive protein value was elevated.A high aspartate aminotransferase and alanine aminotransferase value was detected in 3.2% and 5.4% of patients were found,respectively.31%of patients had an elevated lactate dehydrogenase value.Typical radiological findings for COVID-19 were detected in 3/309 of patients.CONCLUSION According to our study,there is a correlation between the severity of COVID-19 and asthma symptoms and the course of the disease.However,it is worth noting that the retrospective nature of the study and the differences in sample size,age,and demographic characteristics between the two groups do not allow for an optimal comparison.Therefore,further investigation is needed to explore the relationship between COVID-19 and asthma,and it can be suggested that COVID-19 may trigger asthma attacks and asthma may impact the course of COVID-19.

Systematic Evaluation and Meta-analysis of Efficacy and Safety of Zhichuanling Oral Liquid (止喘灵口服液) in the Treatment of Bronchial Asthma

Objective:To systematically evaluate the effectiveness and safety of Zhichuanling Oral Liquid(止喘灵口服液)in the treatment of bronchitis asthma.Methods:A systematic search of CNKI,Wanfang Data,VIP,CBM,Cochrane Library,PubMed,Embase and Web of Science was conducted to screen out randomized controlled trials of Zhichuanling Oral Liquid in the treatment of bronchial asthma.Meta-analysis and systematic evaluation of the included studies were conducted to finally included researches using the Cochrane Handbook 5.1 evaluation standard tool and RevMan 5.3 software.Results:Five studies were included,with a total sample size of 354 cases,176 in experimental group and 178 in control group.Meta-analysis showed that the total effective rate of Zhichuanling Oral Liquid combined with conventional treatment was better than that of conventional treatment alone(RR=1.27,95%CI[1.13-1.42],P<0.0001).Conclusion:Based on the existing data and methods,Zhichuanling Oral Liquid combined with conventional Western medicine in the treatment of bronchial asthma can improve the total effective rate.However,the quality of the included studies is not high and the number is small,so it is necessary to adopt clinical trial protocols with large samples,rigorous design and in line with international standards to improve the quality of evidence in the future.

Comparison of treatment guidance based on bronchial responsiveness to mannitol, spirometry or exhaled nitric oxide in stable asthmatic children

Aim: The goal of this study was to compare asthma treatment guidance based on bronchial hyper-responsiveness to mannitol, spirometry or exhaled nitric oxide (FeNO) in stable asthmatic children. Methods: 60 stable allergic asthmatic children aged 7 to 16 years on a low to medium dose treatment with inhaled corticosteroids (ICS) were recruited to a double blind randomised controlled trial. At study entry (visit 1), the following was assessed: FeNO, spirometry, bronchial hyper-responsiveness to mannitol (MDP-?test), quality of life (paediatric asthma quality-of-life questionnaire;PAQLQ) and asthma control (asthma control test;ACT). Subjects were randomly assigned to one of three groups and treatment was modified by a blinded respiratory physician according to the test results of visit 1: ICS dose was doubled when FeNO was >22 ppb (group 1), in case of a positive MDP-test (group 2) or when FEV1 was <80% of a predicted one (group 3), respectively, or remained unchanged for the remaining subjects. After 3 months (visit 2), the subjects were reassessed and all tests were repeated. Results: 48 children successfully completed the study. At the first visit, 8 out of 16 (50%) children in group 1 showed a FeNO > 22 ppb, 8 children out of 16 (50%) in group 2 showed a positive MDP-test and 3 children out of 16 (18.7%) in group 3 had a FEV1 < 80% of that predicted and had their ICS-dose doubled. In group 1, FeNO decreased significantly after the intervention (p = 0.005), whereas the self-administered and the interviewer-administered PAQLQ (p = 0.02 resp. p = 0.033) as well as the ACT (p = 0.031) increased. Neither the number of children with a positive mannitol challenge nor spirometric results changed significantly. In group 2 and group 3, there were no significant changes in none of the assessed parameters. Conclusion: In this small pragmatic double blind randomised controlled study, we showed that ICS dose modification based on FeNO led to increased quality of life and enhanced asthma control, and to a reduction in airway inflammation and was superior to treatment modifications based on bronchial hyper-responsiveness to mannitol or on FEV1.

Regulating effect of glycyrrhetinic acid on bronchial asthma smooth muscle proliferation and apoptosis as well as inflammatory factor expression through ERK1/2 signaling pathway

Objective: To study the influence of glycyrrhetinic acid(GA) on bronchial asthma(BA)smooth muscle proliferation and apoptosis as well as inflammatory factor expression and its molecular mechanism.Methods: Male SD guinea pigs were selected and made into asthma models, bronchial asthma smooth muscle cells were cultured and divided into BA group, GA group and GA + LM group that were treated with serum-free RPMI1640 culture medium, serumfree RPMI1640 culture medium containing 50 ng/mL glycyrrhetinic acid, serum-free RPMI1640 culture medium containing 50 ng/mL glycyrrhetinic acid and 100 ng/mL LM22B-10 respectively; normal guinea pigs were collected and bronchial smooth muscle cells were cultured as control group. The cell proliferation activity as well as the expression of proliferation and apoptosis genes, inflammatory factors and p-ERK1/2 was determined.Results: Proliferation activity value and m RNA expression of Bcl-2, TNF-α, IL-4, IL-6,YKL-40, protein expression of p-ERK1/2 of airway smooth muscle cell in BA group were significantly higher than those of control group while m RNA expression levels of Bax,caspase-9 as well as caspase-3 were significantly lower than that of control group(P < 0.05); proliferation activity value and m RNA expression of Bcl-2, TNF-α, IL-4, IL-6, YKL-40, protein expression of p-ERK1/2 of airway smooth muscle cell in GA group were significantly lower than those of BA group(P < 0.05) while the m RNA expression levels of Bax, caspase-9 as well as caspase-3 were significantly higher than those of BA group(P < 0.05); proliferation activity value and m RNA expression of Bcl-2, TNF-α, IL-4, IL-6, YKL-40 of airway smooth muscle cell in GA + LM group were significantly higher than those of GA group(P < 0.05) while m RNA expression levels of Bax, caspase-9 as well as caspase-3 were significantly lower that of GA group(P < 0.05).Conclusion: GA can inhibit the proliferation of bronchial smooth muscle cells and reduce the expression of inflammatory factors by inhibiting the phosphorylation of ERK1/2.

The cross-talk between family and pediatrician: The case of bronchial asthma

Today the most important challenge facing the pediatrician is the increasing prevalence of chronic diseases. With this regard, pediatricians play a key role in the management of these conditions. The closeness with the family, the knowledge of the clinical case and the care continuity allow the pediatrician to acquire a position of director of every case. When pathological events have a chronic feature, suddenly the quality of life of the whole family changes. For this reason the first communication of chronic disease is very important and the task of the pediatrician should be to provide a positive message to help the family in facing the difficulty of this new challenge. The bronchial asthma is the most common chronic disease worldwide. The incidence, the prevalence, and the mortality of the disease have increased in children over the past decades. These trends are particularly marked above all in preschool children. The success reached by Pediatricians is closely related to the compliance and the implementation of the therapy followed by the little patient and his family. With this regard authors, in this review, focus on the illustration of several strategies, based on the pediatrician’ skills and medicine documents, that can be used for the improvement of communication among pedia- trician-family and child, never forgetting the hu- man aspect of the same doctor, that should con- ciliate with the scientific knowledge in the taking care of a specific chronic disease.

Chinese and Uighur medicine diagnostic criteria of the evaluation of the Modern drug treatment side-effects in bronchial asthma patients

We studied Chinese and Uighur medicines and create an automated computer diagnostics system according to principals of Uighur medicine for evaluation of bronchial asthma patient′s state.498 patients with bronchial asthma were enrolled the automated computer diagnostic program.304 patients were evaluated in the process of drug and non-drug treatment.Savda asthma type of Uighur medicine do not corresponds with any of the defined clinico-pathogenetic variants of the disease.Thus,prevailing of atopic bronchial asthma with probability of 0.7 is defined with Savda categories with such as 'Lungs energy deficiency','Spleen energy deficiency' and 'Kidneys Yin deficiency'(P<0.01) variants in Chinese Medicine.The combination of infectious-dependent variant of bronchial asthma Abnormal Savda syndrome with atopy with a probability of 0.8 is accompanied by the categories of 'Hot and Full' asthma with such variants as 'Lungs energy deficiency' 'Spleen energy deficiency','Kidneys Yin deficiency'(P<0.01).Patients with an easier case of Abnormal Savda syndrome bronchial asthma in 71% of cases have prevailing diagnostic categories of 'External,Full and Cold' asthma.Patients with a harder case of Abnormal Savda in 74% of cases belongs to the categories of 'Internal,Empty and Hot' asthma.So,hormone dependency of the disease in 69% of cases is accompanied by the 'Kidneys Yin deficiency' variant and,if there is an aspirin component in the pathogenesis of mixed asthma,in 83% of cases 'Kidneys Yin deficiency' and 'Kidneys Yang deficiency' variants are defined.

Exploring Action Mechanism of Sanzi Yangqin Decoction in Treating Bronchial Asthma Based on Network Pharmacology and Molecular Docking

[Objectives]To explore the molecular mechanism of Sanzi Yangqin Decoction in the treatment of bronchial asthma based on network pharmacology and molecular docking.[Methods]The components of Fructus Perillae,Semen Raphani and Semen Sinapis three traditional Chinese medicine-related components and targets of Feiduqing Sanzi Yangqin Decoction were obtained using Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),and the targets of bronchial asthma were obtained using Genecards and OMIM databases.Sanzi Yangqin Decoction"drug-active ingredient-target-disease"network was established with the aid of Cytoscape 3.7.2 software and network topology analysis was carried out.The gene ontology(GO)function enrichment analysis and the KEGG pathway enrichment analysis were performed by DAVID.The top 3 components and targets in the network topology analysis were respectively molecularly docked.[Results]Through network analysis,4 key active components were obtained,mainly luteolin,arachidonic acid,β-carotene,etc.;5 key targets,mainly NCOA2,PGR,PTGS2,etc.Through GO analysis,523 items(P<0.05)were obtained,including 396 items in biological process(BP),53 items in cell composition(CC),and 74 items in molecular function(MF).KEGG analysis generated 144 signal pathways(P<0.05),involving PI3K-Akt signal pathway,human cytomegalovirus infection,Kaposi's sarcoma-associated herpes virus infection,proteoglycans in cancer,prostate cancer,etc.The results of molecular docking showed that core active compounds such as luteolin andβ-carotene in Sanzi Yangqin Decoction had good affinity with NCOA2,PGR,PTGS2 and other target genes,which were similar to clinically recommended chemical drugs.[Conclusions]The active compounds luteolin and carotene in Sanzi Yangqin Decoction may mainly bind to targets such as NCOA2,PGR,PTGS2,and regulate multiple signaling pathways such as PI3K-Akt to play a role in treating bronchial asthma.It is intended to provide new ideas for the clinical application and research of Sanzi Yangqin Decoction.

Pattern of Acute Asthma Seen in Children Emergency Department of the River State University Teaching Hospital Portharcourt Nigeria

Acute exacerbations of asthma are one of the leading causes of emergency room visits and hospitalizations in children. Asthma exacerbations also demonstrate a seasonal pattern in which high rates can be seen at a particular season and knowledge of the seasonal pattern of asthma exacerbation in any locality can improve asthma management. Objective: To determine the prevalence, management outcome and seasonal pattern of emergency department visits for acute exacerbation of asthma. Methods: This was a retrospective review of the emergency department register of all asthma admissions in the Rivers State University Teaching Hospital, Portharcourt, Nigeria over a five year period from January 2014 to December 2018. Results: A total of 205 (2.9%) asthma-related visits were recorded out of 7046 emergency room visits. The mean age of the patients was 6.1 (±4.2) yrs, with an M:F ratio of 1.97:1. The median length of hospital stay was 24 hrs. Children older than 11 yrs were more likely to be admitted for >48 hrs (OR 4.18, 95% CI;1.67, 10.39, P;0.003). Emergency department visits for asthma were more in the rainy season April-September 129 (63.9%) with a peak in May. There is a significant variation in the seasonal pattern of emergency room asthma admission with age (P = 0.018). Children >3 yrs have their highest admission rates in May while younger children experience two peaks in February and November. Conclusion: Asthma exacerbation is more in rainy season among children in Portharcourt although there is a variation in seasonal pattern of asthma exacerbation with age.

Clinical Analysis of Dispelling Wind,Eliminating Lung and Relieving Cough Combined with Western Medicine in the Treatment of Cough Variant Asthma in Children

Objective:This study mainly explores the clinical effect of dispelling wind,eliminating lung and relieving cough combined with western medicine in the treatment of cough variant asthma.Methods:80 children with cough variant asthma accepted by our hospital from January 2018 to December 2020 were randomly selected for the study and divided into two groups.One group was the reference group(40 cases)treated with procaterol hydrochloride tablets and montelukast sodium,and the other group was the research group(40 cases)・The method of eliminating wind,eliminating lung and relieving cough was combined with procaterol hydrochloride tablets and montelukast sodium to observe and compare the curative effects of the two groups.Results:There was no significant difference in TCM symptom score and eosinophil(EOS)count between the two groups before treatment(P>0.05);After treatment,the TCM symptom scores of coughs,pharyngeal itching,expectoration,nasal congestion and nasal itching in the research group were lower than those in the reference group,and the EOS count was lower than that in the reference group(P<0.05);The effective rate of research group was higher than that of reference group(P<0.05).Conclusions:For children with cough variant asthma,Qufeng Sufei cough relieving method combined with procaterol hydrochloride and montelukast sodium can improve children's symptoms and reduce eosinophil count.