Pneumomediastinum Secondary to Foreign Body Aspiration： Clinical Features and Treatment Explorement in 39 Pediatric Patients

Background：Pneumomediastinum （PM） secondary to foreign body aspiration （FBA） is rare in children.Although it is mainly benign,some cases may be fatal.Due to the rare nature of this clinical entity,proper assessment and management have been poorly studied so far.Here,we characterized the presentation and management of this clinical entity and provided an evaluation system for the management.Methods：We retrospectively reviewed children with PM secondary to FBA,who were treated in Beijing Children＇s Hospital from January 2010 to December 2015.All patients were stratified according to the degree of dyspnea on admission,and interventions were given accordingly.Bronchoscopic removals of airway foreign bodies （FBs） were performed on all patients.For patients in acute respiratory distress,emergent air evacuation and/or resuscitations were performed first.Admission data,interventions,and clinical outcomes were recorded.Results：A total of 39 patients were included in this study.The clinical severity was divided into three grades （Grades Ⅰ,Ⅱ,and Ⅲ） according to the degree of dyspnea.Thirty-one patients were in Grade Ⅰ dyspnea,and they simply underwent bronchoscopic FBs removals.PM resolved spontaneously and all patients recovered uneventfully.Six patients were in Grade Ⅱ dyspnea,and emergent drainage preceded rigid bronchoscopy.They all recovered uneventfully under close observation.Two exhausted patients were in Grade Ⅲ dyspnea.They died from large PM and bilateral pneumothorax,respectively,despite of aggressive interventions in our hospital.Conclusions：PM secondary to FBA could be life-threatening in some patients.The degree of dyspnea should be evaluated immediately,and patients in different dyspnea should be treated accordingly.For patients in Grade Ⅰ dyspnea,simple bronchoscopic FBs removals could promise a good outcome.For patients in Grade Ⅱ dyspnea,emergent air evacuation and/or resuscitation should precede a bronchoscopy before the children become exhausted.

Change of Accessory Genital Glands Markers in the Patients with Oligoasthenospermia

Objective To evaluate the effect of the accessory gential gland on the male fertility. Methods The relevant seminal parameters of 32 normal donors and 35 patients with olioasthenospermia were measured by seminal routine analysis, sperm morphology and accessory, gentital glands markers.Results The percentage of normal spermatozoa, the function of sperm penetration through cervical mucus and the enzyme activity of neutral α-1,4-glucosidase significantly declined as compared with the control. There was a significant negative relationship between the semen volume and the sperm motility for the oligoasthenospermia （r= -0.415, P〈0.05）, and a significant positive relationship between the sperm count and the percentage of normal sperm （r=0.393, P〈0.05）.Conclusion The abnormal function of epididymis exists in patients with oligoasthenospermia. Sperm function,for the oligoasthenospermia declines with an increase of the percentage of the abnormal sperm. The poorer the spermatogenises function of the testis is, the higher the percentage of the abnormal sperm appears.