上海市综合医院儿童慢性咳嗽诊治及生活质量分析

目的调查分析上海市综合医院慢性咳嗽儿童诊治及生活质量现况。方法选取2019年1月—2019年12月,在上海市三家综合医院就诊的758例慢性咳嗽患儿进行病因诊断,定期随访并根据病情变化修正诊断。通过莱塞斯特咳嗽量表(LCQ)和自制问卷调查慢性咳嗽儿童生活质量现况。结果各病因不同年龄段患儿的诊断修正率不同,学龄前儿童呼吸道感染后咳嗽的诊断修正率最高(38.0%)。用药方面首诊以白三烯受体拮抗剂、抗组胺药、抗生素等3-4种药物联合治疗最多见,后期减少至1-2种药物;抗生素的使用,在四种病因中的分布不同,差异均有统计学意义(χ^(2)=42.486,P<0.05;χ2=34.315,P<0.05;χ^(2)=24.774,P<0.05;χ^(2)=8.722,P<0.05)。慢性咳嗽儿童的生活质量普遍下降,无论是LCQ量表还是自制问卷均显示,上气道咳嗽综合征合并咳嗽变异性哮喘对生活质量影响最大。结论定期随访、反复评估在慢性咳嗽的诊治过程中至关重要,注重和家长沟通解释病情,缓解焦虑情绪,避免过度用药。

音乐创意短视频宣教模式对基层儿童哮喘控制水平的影响

目的探讨音乐创意短视频宣教模式对基层儿童哮喘控制水平的影响。方法选择2019年3月到2020年2月上海市浦东新区周浦医院儿童哮喘专病门诊初次确诊为支气管哮喘患儿109例,随机分为观察组55例和对照组54例,对照组予以常规吸入糖皮质激素(ICS)吸入治疗;观察组在对照组治疗的基础上予以音乐创意短视频模式宣教,随访1年,比较2组患儿肺功能(第1秒用力呼气量占用力肺活量的比值,FEV 1%)、75%肺活量时的最大呼气流速(FEF75)、呼出气一氧化氮(FENO)、哮喘控制率、依从率和医疗费用。结果观察组FEV 1%、FEF75、哮喘控制率、依从率,均较对照组有明显提高,2组比较差异有统计学意义(P<0.01);观察组FENO、月均医疗费用较对照组下降,2组比较差异有统计学意义(P<0.01)。结论音乐创意短视频宣教模式能够改善基层哮喘患儿的治疗依从性,提高肺功能水平和哮喘控制率,降低FENO水平,减少医疗支出,值得在临床中推广应用。

Screening of long non-coding RNAs markers in plasma of children with chronic gastritis

Objective::The study aimed to detect and analyze long non-coding RNAs (lncRNAs) in plasma of children diagnosed with chronic gastritis, and to explore its biological functions and involved signaling pathways.Methods::The plasma samples were collected from six children that were diagnosed with chronic gastritis by physical examination, gastroscopy, and pathological examination and six healthy children. The plasma samples were assayed for determining the expression profiles of lncRNA based upon the gen chip detection. The specific expression of lcnRNA in plasma of children with chronic gastritis was analyzed and its biological functions were speculated.Results::Five lncRNAs ( RP11-697M17.1, RP11-388M20.9, AFAP1-AS1, BC062758, and XLOC001406) were significantly upregulated, and five lncRNAs ( UNQ697, BX571672.5, CYP4F35P, ANKRD20A5P, and AL832737) were observed to be significantly down-regulated. The lncRNAs RP11-697M17.1, and UNQ697 were detected with the highest up-regulation and down-regulation, respectively. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis showed that the up-regulated lncRNAs were significantly enriched in 20 signaling pathways such as phosphoinositide-3-kinase-protein kinase B (PI3K-Akt) pathway, and the down-regulated lncRNAs target genes were significantly enriched in 20 signaling pathways such as the metabolic pathway. Conclusion::The analysis of the lncRNA expression profiles in plasma of children with chronic gastritis revealed that the lncRNA RP11-697M17.1, and lncRNA UNQ697 may act as plasma markers for predicting chronic gastritis in children.