Three pediatric massage schools in treating recurrent respiratory tract Infection

This paper describes the similarities and differences between three-character scripture school from Shandong, Shanghai pediatric massage and Hunan Liu Kaiyun pediatric massage in the treatment of Recurrent respiratory tract in order to standardize operation, collect references and provide the basis for local infantile massage school.

A Study on Isolation and Antibiotic Sensitivity Testing of Pseudomonas aeruginosa Isolated from Patients with Respiratory Tract Infection with Special Reference to Phenotypic and Genotypic Characterization of Extended Spectrum Beta Lactamases (ESBL)

Backgrounds: Pseudomonas aeruginosa is a classic opportunistic pathogen with innate resistance to many antibiotics and disinfectants. The lung is a main target for colonization and infection by the bacteria either in the context of a chronic, progressively deteriorating infectious and inflammatory pulmonary disease such as cystic fibrosis (CF) or in a more acute setting such as severe pneumonia in immunocompromised patients [1]. Aim and Objectives: To study the prevalence, virulence and the resistance pattern, phenotypic and genotypic characterization of P. aeruginosa from sputum samples. Materials and Methods: The present study was carried out with a total of 500 clinical sputum samples, which were received from patients, admitted to the various departments of Rajah Muthiah Medical College & Hospital, Annamalai University, Chidambaram. Result: Of the 500 samples subjected for isolation and identification of P. aeruginosa, 116 (23.20%) were positive. The isolated strains were tested for antibiotic sensitivity patterns. 93.10% of P. aeruginosa showed a maximum sensitivity to Ofloxacin, Norfloxacin and 86.20% of strains were highly resistant to Cefotaxime. The same isolates were also tested for phenotypic characterization of Extended Spectrum of Beta Lactamases by double disc synergy method against Cefotaxime and Clavulanic acid, according to the criteria of Hi-Media [2]. Of the resistant strains of P. aeruginosa isolated from sputum, 59% were positive for ESBL. The genotype characterization of ESBL P. aeruginosa showed 40% of CTX-M and 46.66% SHV gene. Conclusion: The present study strongly recommends for further checking of the antibiotic resistant strains of P. aeruginosa for phenotypic characterization of ESBL for effective treatment.

Exploration of Therapeutic Measures and Clinical Efficacy for Recurrent Respiratory Infections in Children

Objective:To explore the treatment strategies and clinical effects for recurrent respiratory infections in children.Methods:From May 2022 to May 2024,100 pediatric patients with recurrent respiratory infections were selected in this study and evenly divided into two groups.The control group(50 patients)was treated with conventional therapy supplemented with budesonide,while the observation group(50 patients)received pidotimod treatment in addition to the control group’s treatment.Subsequently,the duration of clinical symptom improvement,respiratory function enhancement,serological index changes,reinfection status,and parental satisfaction were compared between the two groups.Results:In terms of clinical symptoms,the observation group showed significantly shorter durations of fever reduction,cough relief,tonsil swelling reduction,and disappearance of fine wet rales compared to the control group(average reduction times were 1.6 days,2.3 days,2.1 days,and 1.9 days,respectively,P<0.05).Regarding respiratory function,the observation group experienced a 12%increase in peak expiratory flow rate variability,a 0.6-liter increase in lung capacity,a 0.7-liter increase in forced lung capacity,and a 0.5-liter increase in forced expiratory volume in the first second after treatment,all significantly higher than the control group(P<0.05).Serological testing revealed that interferon-γand interleukin-2 levels increased by 15%and 18%,respectively,while interferon-α,interleukin-5,and interleukin-4 levels decreased by 10%,12%,and 9%,respectively,in the observation group,showing significant differences compared to the control group(P<0.05).Additionally,the reinfection rate in the observation group(10%)was significantly lower than that in the control group(30%),with an average reduction of two reinfections within one year and a 3.2-day shorter infection control time(P<0.05).In terms of parental satisfaction,the observation group achieved 95%,significantly higher than the 70%in the control group(P<0.05).Conclusion:The addition of pidotimod to conventional therapy for pediatric patients with recurrent respiratory infections can significantly alleviate clinical symptoms,promote the recovery of respiratory function,regulate serological indicators,effectively reduce the risk of reinfection,and improve parental satisfaction.This method deserves widespread clinical application.

The Expression of Exogenous ADA Gene in T－lymphocytes of Children with Recurrent Respiratory Tract infectious Diseases

The adenosine deaminase(ADA) activities in blood lymphocytes of 41normal children and 17 with recurrent respiratory tract infections were examined,and the T-lymphocytes of two children whose ADA activities were obviously lower than those of others were cultared in vilro. Then the exogenous human ADA gene was transfected into these cells by means of lipofectin mediated gene transfer. The results showed that the ADA activities in cultured T-lymphocytes were raised and the immunological were also improved.

Clinical Observation on 46 Cases of Infantile Repeated Respiratory Tract Infection Treated by Mild-Moxibustion over Acupoints on Back

Repeated respiratory tract infection is a frequently-occurring disease during childhood. At present, western medicine doctors generally adopt anti-infectives and immunomodulators to treat the disease, while traditional Chinese medicine doctors mainly administer decoction of Chinese herbs. The authors treated 46 cases of repeated respiratory tract infection from March 1990 to April 1996 by applying mild-moxibustion over points on the back with satisfactory therapeutic results. A report follows.Clinical Data All the 86 cases were outpatients in our hospital with duration of common cold for over 10 days and characterized by relapse of respiratory tract infection. There were over 7-time relapse of respiratory tract infection on each case within a year. Eighty-six cases were randomly divided into treatment group (46 cases) and control group (40 cases). Of the 46 cases in the treatment group, 22 were boys and 24 girls. 17 cases (36.9%) were 6 months to 4 years old, 18 (39.1%) 4 to 6 years, and 11 (23.9%) 6 to 12 years. Among the 40 cases in the control group, 19 cases were boys and 21 girls.

Association between gastrointestinal heat retention syndrome and respiratory tract infections in children:A prospective cohort study

Objective:To explore the relationship between gastrointestinal heat retention syndrome and the incidence of pneumonia and recurrent respiratory tract infections(RRTIs)in children.Methods:A prospective cohort study was conducted in the pediatric outpatient department of Beijing Dongfang Hospital.Children without respiratory tract infections(RTIs)were consecutively recruited according to the selection criteria.A semi-structured questionnaire was used to record traditional Chinese medicine(TCM)symptoms and demographic and physiological characteristics.Gastrointestinal heat retention syndrome was considered to be a predisposing factor and was diagnosed according to a scale with reliability and validity.The participants were followed up for 12 months.Participants and their parents or guardians were contacted via clinical interviews and telephone every 6 months.Episodes of pneumonia and RTIs were recorded in detail.Results:A total of 420 children were included.Of participants,370(88.10%)were followed up for 12 months.The mean number of RTI episodes per participant was 5.37(95%CI:5.14 to 5.60).In total,186 participants in the gastrointestinal heat retention syndrome group and 184 participants in the nongastrointestinal heat retention syndrome group completed the 12-month follow-up period.The baseline of both groups was comparable.The incidence of RRTIs in children with gastrointestinal heat retention syndrome was 1.27(95%CI:1.01 to 1.59)times that in children without gastrointestinal heat retention syndrome.Logistic regression analysis revealed that abnormally increased appetite with frequent hunger,foul breath,dry stools,and dark red or purple fingerprints were positively correlated with the incidence of pneumonia.Irascibility and feverish feelings in the palms and soles were positively correlated with the occurrence of RRTI.Conclusions:Gastrointestinal heat retention syndrome is a risk factor for RRTIs in children.Studies with larger sample sizes and longer follow-up time are warranted to confirm the degree of causal risk associated with RTIs.

Effect of pediatric Tuina on children's recurrent acute respiratory tract infections: a retrospective cohort study in Southern China

OBJECTIVE: To determine the effectiveness of pediatric Tuina(PT) in preventing recurrent acute respiratory tract infections(ARTIs) in children. METHODS: This is a retrospective cohort study based on the electronic medical records of children with recurrent ARTIs in 2016. Children were divided into a PT group or a non-PT group, according to whether they had received PT or not in 2016. The primary outcome was the number of ARTI episodes in 2017 and 2018. The secondary outcomes were the number of ARTIs leading to outpatient department visits and outpatient antibiotic prescriptions due to ARTIs in the same time period. Negative binomial regressions were used to detect the association between PT and the outcomes. RESULTS: A total of 2303 children were included in the analysis, including 94 in the PT group and 2209 in the non-PT group. Children who received PT six or more times in 2016 had fewer episodes of ARTIs in 2017 [incidence rate ratio(IRR): 0.59, 95% confidence interval(CI)(0.42-0.84)] and 2018 [IRR: 0.58, 95% CI(0.36-0.94)] and fewer outpatient department visits due to ARTIs in 2017 [IRR: 0.56, 95% CI(0.38-0.83)] than children who had not received PT in 2016. There was no significant difference in the number of outpatient antibiotic prescriptions between the two groups. CONCLUSIONS: Receiving PT six or more times within one year is associated with a decrease in recurrent ARTIs in children in the following two years. Randomized controlled trials are needed for effect evaluation prior to establishing PT as a method for preventing recurrent ARTIs among children.

Clinical observation on spleen-invigorating and qi-benefiting pediatric massage for treating recurrent respiratory tract infection in children with cerebral palsy due to qi deficiency of spleen and lung

Objective:To observe the clinical efficacy of spleen-invigorating and qi-benefiting pediatric massage(tuina)for treating recurrent respiratory tract infection in children with cerebral palsy due to qi deficiency of spleen and lung.Methods:A total of 70 children with cerebral palsy who suffered from recurrent respiratory tract infection due to qi deficiency of spleen and lung were randomized into an observation group and a control group by the random number table method,with 35 cases in each group.Both groups were treated with conventional rehabilitation training,while the observation group was given additional spleen-invigorating and qi-benefiting pediatric massage,and the control group additionally took oral Yu Ping Feng granule.The clinical efficacy was evaluated by the total effective rate,traditional Chinese medicine(TCM)symptom score,and serum levels of immunoglobulin(Ig)A,IgM and IgG.Results:The difference in total effective rate between the two groups after treatment was statistically significant(P<0.05).After treatment,the TCM symptom scores in both groups decreased to varying degrees than those before treatment,and the intra-group differences were statistically significant(all P<0.01);the differences in the scores of various TCM symptoms between the two groups were statistically significant(all P<0.05).After treatment,the levels of IgA,IgM and IgG of the children in both groups increased to varying degrees,and the intra-group differences were statistically significant(all P<0.05).The between-group differences in the IgA,IgM and IgG levels after treatment were statistically significant(all P<0.05).Conclusion:Spleen-invigorating and qi-benefiting pediatric massage can effectively treat recurrent respiratory tract infection due to qi deficiency of spleen and lung in children with cerebral palsy,relieve the clinical symptoms and improve immune function,and thus is worthy of clinical promotion and application.

Safety and efficacy of Yupingfeng granules in children with recurrent respiratory tract infection:A randomized clinical trial

Importance:Recurrent respiratory tract infection(RRTI)is common in children.Inappropriate RRTI treatment will lead to asthma and other diseases,thereby seriously affecting the growth and physical health of children.Immune function modulation can prevent and alleviate childhood RRTI.Yupingfeng(YPF),a patented traditional Chinese medicine(TCM),has immunomodulatory effects and is widely used in China to treat children with RRTI.Objective:To evaluate the safety and efficacy of YPF monotherapy in treating children with RRTI.Methods:This multicenter,randomized,double-blind,double-simulation,noninferiority clinical trial was conducted from January 2015 to August 2017,with an 8-week treatment period and 52-week follow-up after the drug withdrawal.Children aged 2–6 years with RRTI meeting the inclusion and exclusion criteria were enrolled in 13 hospitals in China and divided randomly into three groups(2:2:1 ratio)to receive YPF,pidotimod,or placebo.The primary outcome was the proportion of RRTI returning to normal standard level during the follow-up.The secondary outcomes were reduction in the number of RRTI recurrences,effect on clinical symptoms(in accord with TCM practice),effect per symptom,and safety.The trial was registered at the Chinese Clinical Trials Registry(www.chictr.org.cn)under the unique identifier ChiCTR-IPR-15006847.Results:Three hundred and fifty-one children were enrolled and randomly assigned to 3 groups;124,125,and 61 children in the YPF,pidotimod,and placebo groups,respectively,had completed the trial.During the follow-up,the proportion of RRTI returning to normal standard level was 73.13%,67.15%,and 38.81%with YPF,pidotimod,and placebo,respectively(P<0.0001).The proportion of cases who returned to normal standard level in the YPF group was 34.32%higher than that in the placebo group.The safety profile did not significantly differ among the groups.Interpretation:YPF granules were noninferior to the active control drug pidotimod oral solution for the treatment of RRTI in children,and were superior to placebo,with a high safety profile.

Clinical observation on moxibustion therapy plus tuina in treating children with recurrent respiratory tract infections due to qi deficiency of spleen and lung

Objective:To observe the clinical efficacy of moxibustion therapy plus Liu's pediatric massage(tuina)for children with recurrent respiratory tract infections due to qi deficiency of spleen and lung.Methods:A total of 60 children who met the inclusion criteria were divided into an observation group and a control group according to the visiting sequence,with 30 cases in each group.Children in the observation group were treated with moxibustion therapy plus Liu's pediatric massage,and those in the control group were treated with Liu's pediatric massage alone.The incidence of respiratory tract infections and traditional Chinese medicine(TCM)symptoms score were observed and recorded in both groups before and after treatment.And the clinical efficacy was compared between the two groups・Results:The total effective rate of the observation group was 93.3%,and that of the control group was 83.3%.The differenee between the two groups was statistically significant(P<0.05).After treatment,the TCM symptoms score and total times of infections in both groups were all statistically different from those before treatment(all P<0.05).The differences in TCM symptoms score and infection frequency before and after treatment in the observation group were statistically different from those in the control group(both P<0.05).Conclusion:Moxibustion therapy plus Liu's pediatric massage has a better effect in improving the clinical symptoms and reducing the frequency of respiratory tract infections for children with recurrent respiratory tract infections due to qi deficiency of spleen and lung than the pediatric massage alone.

Middle East respiratory syndrome coronavirus disease is rare in children: An update from Saudi Arabia

AIM To summarize the reported Middle East respiratory syndrome-coronavirus(MERS-Co V) cases, the associated clinical presentations and the outcomes. METHODS We searched the Saudi Ministry of Health website, the World Health Organization website, and the Flutracker website. We also searched MEDLINE and Pub Med for the keywords: Middle East respiratory syndromecoronavirus, MERS-Co V in combination with pediatric, children, childhood, infancy and pregnancy from the initial discovery of the virus in 2012 to 2016. The retrieved articles were also read to further find other articles. Relevant data were placed into an excel sheet and analyzed accordingly. Descriptive analytic statistics were used in the final analysis as deemed necessary.RESULTS From June 2012 to April 19, 2016, there were a total of 31 pediatric MERS-Co V cases. Of these cases 13(42%) were asymptomatic and the male to female ratio was 1.7:1. The mean age of patients was 9.8 ± 5.4 years. Twenty-five(80.6%) of the cases were reported from the Kingdom of Saudi Arabia. The most common source of infection was household contact(10 of 15 with reported source) and 5 patients acquired infection within a health care facility. Using real time reverse transcriptase polymerase chain reaction of pediatric patients revealed that 9 out of 552(1.6%) was positive in the Kingdom of Saudi Arabia. CONCLUSION Utilizing serology for MERS-CoV infection in Jordan andSaudi Arabia did not reveal any positive patients. Thus, the number of the pediatric MERS-CoV is low; the exact reason for the low prevalence of the disease in children is not known.

From infections to autoimmunity:Diagnostic challenges in common variable immunodeficiency

Common variable immunodeficiency(CVID)is the most common clinically significant primary antibody deficiency diagnosed in adults.The early symptoms are not specific.They include common infections,mainly of the respiratory tract,caused by typical microorganisms,so cases can be missed in primary care.In the majority of patients increased susceptibility to infections coexists with signs or symptoms of autoimmunity,inflammation or polyclonal lymphoproliferation,which can divert diagnosis from immune deficiency.The overall incidence of malignancy is increased in CVID and certain cancers are significantly more common.Lymphomas and gastric carcinoma are the most frequently reported malignancies in CVID,so a high index of suspicion is recommended.Diagnostic delay in CVID is seen worldwide.The main goal of this paper is to increase the awareness about CVID among health care professionals.We aim to present features which can be helpful in CVID diagnosis in order to shorten the“latency”of proper management of CVID patients.We review clinical symptoms,complications and laboratory abnormalities of CVID.Immunoglobulin replacement therapy is regarded as the cornerstone of pharmacological intervention.New modes of Ig application,mainly subcutaneously and via the hyaluronidase-facilitated subcutaneous route,help to adjust therapy to patients’needs and preferences.Still there remain unmet needs.It remains to be seen whether CVID complications can be avoided by earlier diagnosis,treatment and thorough monitoring in the context of increased risk of malignancy.Development of patient tailored protocols depending on the clinical phenotype and risk factors might be more appropriate.The most important consideration is to diagnose suspected cases and stratify patients in a precise and timely way.Work is needed to define features predictive of unfavorable prognosis.

宣肺运脾方辅助西药治疗儿童哮喘并发反复呼吸道感染临床研究

目的:探究宣肺运脾方辅助西药治疗哮喘并反复呼吸道感染儿童的临床价值。方法:将110例哮喘并发反复呼吸道感染患儿按抽签法分为西医组55例,使用西药治疗;中西医结合组55例,使用宣肺运脾方加西药治疗。比较两组疗效指标、炎症因子、免疫功能及药物不良反应发生情况。结果:两组疗效指标、炎症因子、免疫功能比较差异均有统计学意义(P<0.05),中西医结合组治疗总有效率更高,呼吸道感染及哮喘发作次数、发热及咳嗽持续时间均更少(P<0.05),干扰素γ(IFN-γ)、辅助性T细胞CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)更高(P<0.05),白细胞介素13(IL-13)、基质金属蛋白酶9(MMP-9)、CD8^(+)更低(P<0.05);两组药物不良反应发生情况差异无统计学意义(P>0.05)。结论:西药联合宣肺运脾方治疗哮喘并反复呼吸道感染儿童可提高疗效,抑制炎症反应,改善免疫功能。

反复呼吸道感染患儿外周血单个核细胞中TLR2、TLR4表达情况与Th1/Th2免疫应答的关系

目的探讨反复呼吸道感染(RRTI)患儿外周血单个核细胞(PBMC)Toll样受体2(TLR2)、Toll样受体4(TLR4)表达情况与辅助性T细胞1(Th1)/辅助性T细胞2(Th2)免疫应答的关系。方法将2020年12月至2022年12月该院收治的65例确诊为RRTI的患儿纳入研究作为RRTI组。另选取同期于该院体检的健康儿童45例作为对照组。采用实时荧光定量PCR(qPCR)检测PBMC中TLR2和TLR4的信使核糖核酸(mRNA)相对表达水平。采用流式细胞仪检测PBMC中TLR2和TLR4蛋白表达率。采用酶联免疫吸附法(ELISA)检测血浆中Th1细胞因子干扰素-γ(IFN-γ)、Th2细胞因子白细胞介素-4(IL-4)水平及二者比值(IFN-γ/IL-4)。采用Pearson相关分析TLR2、TLR4蛋白表达率与血浆IFN-γ、IL-4水平的相关性。结果RRTI组血浆Th2细胞因子IL-4水平高于对照组,血浆Th1细胞因子IFN-γ水平低于对照组,IFN-γ/IL-4低于对照组,差异均有统计学意义(P<0.05)。RRTI组PBMC中TLR2和TLR4 mRNA相对表达水平及蛋白表达率均高于对照组,差异均有统计学意义(P<0.05)。Pearson相关分析显示,RRTI患儿PBMC中TLR2和TLR4蛋白表达率与血浆IFN-γ水平及IFN-γ/IL-4均呈负相关(P<0.05),与血浆IL-4水平均呈正相关(P<0.05)。结论RRTI患儿PBMC中TLR2、TLR4的表达及血浆Th1/Th2细胞因子均可能参与疾病的发生、发展的过程。过度活化的TLR2和TLR4可能会使Th1功能减弱、Th2功能增强。

以早期肺功能监测为指导的干预在反复下呼吸道感染患儿中的应用

目的:探究以早期肺功能监测为指导的干预对反复下呼吸道感染患儿的影响。方法:选择2022年9月—2023年12月晋江市医院收治的80例反复下呼吸道感染患儿,根据随机数字表法分为两组,各40例。对照组进行常规下呼吸道感染干预治疗,观察组则以早期肺功能监测为指导进行针对性干预。比较两组疾病控制总有效率、干预前后肺功能指标[呼气峰值流速(PEF)、第1秒用力呼气容积占预计值的百分比(FEV_(1)%pred)及?第1秒用力呼气容积占用力肺活量的比值(FEV_(1)/FVC)]及免疫状态指标[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、补体C3、CD8^(+)、CD19^(+)、CD3^(+)及CD4^(+)]。结果:观察组疾病控制总有效率显著高于对照组,差异有统计学意义(P<0.05)。干预前,两组肺功能指标及免疫状态指标比较,差异均无统计学意义(P>0.05);干预后,观察组PEF、FEV_(1)%pred、FEV_(1)/FVC均显著高于对照组,CD8^(+)、CD19^(+)均显著低于对照组,IgA、IgG、IgM、补体C3、CD3^(+)、CD4^(+)均显著高于对照组,差异均有统计学意义(P<0.05)。结论:以早期肺功能监测为指导的干预有助于反复下呼吸道感染患儿的疾病控制,调控其免疫状态,有助于患儿肺功能状态的改善。

TLR4基因多态性与小儿反复呼吸道感染的关系

目的探究Toll样受体4(TLR4)基因多态性与小儿反复呼吸道感染(RRTI)的关系。方法选择107例RRTI病儿作为观察组,另选103例体检健康儿童作为对照组(近1年未出现RRTI),采用限制性片段长度多态性聚合酶链反应(PCR-RFLP)技术分析两组TLR4基因rs2737190位点多态性,比较不同病情严重程度病儿TLR4基因多态性的差异,并分析不同TLR4基因多态性病儿临床特征的差异。结果观察组TLR4基因rs2737190位点AG基因型、G等位基因频率均明显高于对照组,AA基因型频率明显低于对照组(χ^(2)=4.129~8.564,P<0.05);中重度RRTI病儿GG基因型、G等位基因频率明显高于轻度病儿,AA基因型频率显著低于轻度病儿(χ^(2)=9.233~13.357,P<0.05);AA基因型病儿年发作次数、合并呼吸困难比例,以及C反应蛋白、白细胞介素-6、γ-干扰素和丙二醛等指标均显著低于AG和GG基因型病儿,超氧化物歧化酶则显著高于AG和GG基因型病儿(χ^(2)=7.573,F=4.668~24.317,P<0.05)。结论TLR4基因rs2737190位点AG基因型、G等位基因频率会增加小儿RRTI易感性,并促进其炎症反应升高和病情进展。

陈华教授从“阴虚瘀热”论治小儿反复呼吸道感染经验总结

[目的]总结陈华教授从“阴虚瘀热”论治小儿反复呼吸道感染的经验。[方法]通过随师临证,总结整理病案资料,阐释陈师治疗小儿反复呼吸道感染的临床经验及方药特色,并通过临床验案加以佐证。[结果]陈师认为,小儿反复呼吸道感染病因为风、痰、瘀、虚,病机为肺脾两虚,痰瘀阻络,迁延不愈,瘀热互结,创新性地提出从“阴虚瘀热”辨治小儿反复呼吸道感染,总结出重视风邪,祛风解表;三因制宜,滋阴清瘀;详辨虚实,巧用和法;顾护中焦,健运脾胃的诊治经验。验案为反复呼吸道感染患儿,辨为阴虚感冒,兼痰瘀阻滞证,陈师分期论治,滋阴清瘀治法贯穿疾病治疗的中后期,迁延期养阴退热、化痰祛瘀,恢复期养阴退热、健脾益气,疗效显著。[结论]陈师继承浙派中医儿科特色,从“阴虚瘀热”辨治小儿反复呼吸道感染,疗效显著,对指导临床有较高实用价值。

保儿宁口服液联合耳穴贴压治疗小儿反复呼吸道感染肺脾气虚证的临床研究

目的 研究保儿宁口服液联合耳穴贴压治疗小儿反复呼吸道感染肺脾气虚证的临床效果。方法 选择2022年2月至2023年2月江苏省江阴市中医院收治的106例反复呼吸道感染患儿为研究对象,按照随机数字表法将其分为对照组与研究组,各53例。对照组接受保儿宁口服液治疗,研究组在对照组的基础上联合耳穴贴压治疗。两组均治疗8个疗程(6 d为1个疗程)。比较两组临床疗效;比较两组治疗前后中医证候评分、炎症因子、血清学指标、免疫功能;比较两组不良反应发生率。结果 研究组临床疗效优于对照组(P<0.05)。治疗后,两组中医症候评分、肿瘤坏死因子-α、人类β-防御素2低于治疗前,且研究组低于对照组(P<0.05);白细胞介素-2、分泌型免疫球蛋白A、CD3^(+)、免疫球蛋白G高于治疗前,且研究组高于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 保儿宁口服液联合耳穴贴压治疗小儿反复呼吸道感染肺脾气虚证效果确切,可改善患儿临床症状、免疫功能,减轻炎症反应,调节血清sIgA、人类β-防御素2表达,且安全可靠。

山东省聊城市某医院老年患者下呼吸道鲍曼不动杆菌感染菌株的药敏特点及预后危险因素分析

目的:分析山东省聊城市某医院老年患者下呼吸道鲍曼不动杆菌感染菌株的药敏特征,探讨预后影响因素,为临床早期干预及合理用药提供理论依据。方法:回顾性分析2020年7月-2022年12月聊城某医院182例鲍曼不动杆菌下呼吸道感染老年患者的临床资料,药敏试验采用自动化仪器检测法及纸片扩散法(Kirby-Bauer,K-B)检测,根据临床和实验室标准协会,(Clinical&Laboratory Standards Institute,CLSD)标准判读结果,采用WHONET5.6和SPSS23.0统计软件进行数据分析。结果:药敏试验结果显示鲍曼不动杆菌对常用抗生素耐药率高于40%,其中对喹诺酮类、三代头孢菌素、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、碳青霉烯类(美罗培南、亚胺培南)呈高度耐药,耐药率在67%~77%之间;对庆大霉素、复方磺胺甲唑的耐药率>60%;对头孢吡耐药率46.7%。未见对粘菌素耐药菌株。对四环素类耐药率低,其中对替加环素耐药率0.6%,对米诺环素耐药率29.1%。多重耐药菌占比73.6%。共有54名患者死亡(29.7%),单因素分析显示,住院时间≥15天、昏迷、气管插管≥5d、多重耐药菌感染及使用广谱抗生素有统计学意义(P<0.05)。多因素Logistic回归分析显示,气管插管≥5d、住院时间≥15天、使用广谱抗生素是患者死亡的独立危险因素(P<0.05)。结论:老年患者下呼吸道鲍曼不动杆菌感染菌株对喹诺酮类、三代头孢菌素、酶抑制剂、碳青霉烯等抗生素耐药率较高,临床需加强细菌耐药监测,合理使用抗生素,及时评估并早期干预,可改善预后,降低死亡率。

重组人干扰素α1b雾化吸入联合布地奈德对反复上呼吸道感染患儿的治疗效果

目的分析重组人干扰素α1b雾化吸入联合布地奈德对反复上呼吸道感染(RURTI)患儿的治疗效果。方法选取2022年6月至2023年6月我院收治的90例RURTI患儿,随机分为联合组(n=45)和单一组(n=45),单一组予以匹多莫德治疗,联合组予以重组人干扰素α1b雾化吸入联合布地奈德治疗。对比两组的临床疗效、症状消失时间及不良反应。结果联合组总有效率为93.33%,高于单一组的75.56%(P<0.05)。联合组发热、咽喉肿痛、咳嗽、肺啰音消失时间短于单一组(P<0.05)。两组的不良反应发生率比较无统计学差异(P>0.05)。结论重组人干扰素α1b雾化吸入联合布地奈德治疗RURTI患儿可提高临床疗效,缩短发热、咽喉肿痛、咳嗽、肺啰音消失时间,安全性良好。