Delayed endophthalmitis caused by Gordonia bronchialis after intraocular collamer lens implantation

Dear Editor,We report a case of bacterial endophthalmitis following implantation of a Staar intraocular collamer lens(ICL)caused by Gordonia bronchialis.ICL implantation is an effective method to correct myopia which generally offers excellent safety.There are a few reports of ocular infection caused by Gordonia bronchialis,but no ICL-related endophthalmitis has been reported to date.We present the first case of delayed-onset endophthalmitis after ICL implantation caused by Gordonia bronchialis,identified by metagenomic next-generation sequencing(mNGS).

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.

Cryoablation for intrapulmonary bronchial cyst:A case report

BACKGROUND Bronchial cysts are congenital malformations usually located in the mediastinum,and intrapulmonary localization is very rare.Cryoablation is a novel therapeutic approach that promotes tumor necrosis and stimulates anti-tumor immune responses.CASE SUMMARY This article reports a case of a 68-year-old male patient who was diagnosed with an intrapulmonary bronchogenic cyst by computed tomography examination and pathology,and the patient subsequently underwent cryoablation therapy and achieved complete response with after 3 months of follow-up.CONCLUSION Intrapulmonary bronchogenic cysts are very rare,cryoablation therapy is feasible,safe,and effective for intrapulmonary bronchial cysts.

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.

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.

Assessing the Impact of General Anesthesia and Bronchial Intubation in Conjunction with Thoracic Paravertebral Nerve Block on Cellular Immunity and Surgical Management in Tuberculous Pyothorax Patients

Objective:This study aims to investigate the impact of combining general anesthesia with bronchial intubation and thoracic paravertebral nerve block during surgery for patients with tuberculous pyothorax.Methods:Eighty patients diagnosed with tuberculous pyothorax,admitted to the hospital between January 2023 and September 2023,were randomly selected for this study.The patients were divided into control and study groups using a numerical table method.The control group underwent general anesthesia with bronchial intubation,while the study group received general anesthesia with bronchial intubation in conjunction with thoracic paravertebral nerve block.Subsequently,the patients were monitored to assess mean arterial pressure,heart rate variations,and adverse reactions to anesthesia.Results:The study group exhibited significantly lower mean arterial pressure and heart rate levels during the post-surgical incision,immediate end of surgery,and immediate extubation periods compared to the control group(P<0.05).Furthermore,the Ricker and Ramsay scores in the study group were significantly lower than those in the control group(P<0.05).Conclusion:The combined use of general anesthesia via bronchial intubation and thoracic paravertebral nerve block has been found to stabilize mean arterial pressure and heart rate while providing effective sedation for surgical treatment in patients with tuberculous septic thorax.

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.

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.

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.

Recurrent hemoptysis in pediatric bronchial Dieulafoy’s disease with inferior phrenic artery supply:A case report

BACKGROUND Bronchial Dieulafoy’s disease(BDD)is characterized by the erosion of an anomalous artery in the submucosa of the bronchus.The etiology of pediatric BDD is mainly congenital dysplasia of bronchus and pulmonary arteries,which is different from chronic inflammatory injury of the airway in adult patients.The internal thoracic artery,subclavian artery,and intercostal artery are known to be involved in the blood supply to the BDD lesion in children.CASE SUMMARY We report a case of BDD in a 4-year-old boy with recurrent hemoptysis for one year.Selective angiography showed a dilated right bronchial artery,and anastomosis of its branches with the right lower pulmonary vascular network.Bronchoscopy showed nodular protrusion of the bronchial mucosa with a local scar.Selective embolization of the bronchial artery was performed to stop bleeding.One month after the first intervention,the symptoms of hemoptysis recurred.A computed tomography angiogram(CTA)showed another tortuous and dilated feeding artery in the right lower lung,which was an abnormal ascending branch of the inferior phrenic artery(IPA).The results of angiography were consistent with the CTA findings.The IPA was found to be another main supplying artery,which was not considered during the first intervention.Finally,the IPA was also treated by microsphere embolization combined with coil interventional closure.During the one-year follow-up,the patient never experienced hemoptysis.CONCLUSION The supplying arteries of the bleeding lesion in children with BDD may originate from multiple different aortopulmonary collateral arteries,and the IPA should be considered to reduce missed diagnosis.CTA is a noninvasive radiological examination for the screening of suspected vessels,which shows a high coincidence with angiography,and can serve as the first choice for the diagnosis of BDD.

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.

基于METTL3介导的miR-29a-3p的m^(6)A修饰探讨平喘颗粒抑制气道上皮细胞泛凋亡治疗哮喘的机制研究

目的:观察平喘颗粒对METTL3介导的气道上皮细胞中miR-29a-3p的m^(6)A修饰的影响,明确其抑制哮喘气道炎症的分子机制。方法:16HBE采用LPS诱导(50 mg/L)构建细胞模型,并给予平喘颗粒含药血清和地塞米松进行干预。分别采用CCK8法检测细胞活性、ELISA法检测炎症因子(TNF-α、IL-6和IL-8)的含量和miR-29a-3p的m^(6)A修饰水平、Western blot检测METTL3与泛凋亡蛋白的表达和qRT-PCR检测METTL3与miR-29a-3p的表达。结果:与模型组相比,平喘颗粒能够显著增加16HBE的活力,抑制炎症因子TNF-α、IL-6和IL-8的含量,下调泛凋亡相关蛋白p-RIPK3、p-MLKL、cleaved Caspase-1、cleaved Caspase-3的表达和GSDMD-NT/FL-GSDMD与GSDME-NT/FL-GSDME的比值,差异均具有统计学意义(P<0.01)。此外,平喘颗粒能够显著上调细胞中miR-29a-3p和METTL3的表达水平,促进miR-29a-3p的m^(6)A修饰水平,与模型组相比差异均具有统计学意义(P<0.01)。结论:平喘颗粒主要通过METTL3增强miR-29a-3p的m^(6)A修饰水平,抑制气道上皮细胞泛凋亡,改善气道炎症。

薄层CT多征象联合多平面重组诊断气管支气管结核

目的 观察薄层CT多征象联合多平面重组(MPR)诊断气管支气管结核(TBTB)的价值。方法 回顾性分析234例接受胸部薄层CT扫描的TBTB患者并行MPR,观察病变直接与间接表现;比较轴位平扫CT(直接观察法)与其联合MPR(联合观察法)的诊断效能。结果 直接观察法诊断TBTB的敏感度、特异度、阳性预测值、阴性预测值及准确率分别为38.88%(201/517)、98.13%(1 789/1 823)、85.53%(201/235)、84.99%(1 789/2 105)及85.04%(1 990/2 340),联合观察法上述各项分别为91.10%(471/517)、98.85%(1 802/1 823)、95.54%(471/493)、97.51%(1 802/1 848)及97.14%(2 273/2 340);2种方法间敏感度、阳性预测值、阴性预测值及准确率差异均有统计学意义(P均<0.001),而特异度差异无统计学意义(P>0.05)。结论 根据薄层CT多征象联合MPR可有效诊断TBTB。

芪桂五物汤对支气管哮喘患者症状改善、气道重塑及免疫平衡的影响

目的:观察并探讨芪桂五物汤对支气管哮喘患者症状改善、气道重塑及免疫平衡的影响。方法:选取2021年10月—2023年3月太仓市中医医院收治的80例支气管哮喘患者,按照单双数抽签法将其平均分为两组,即对照组(40例)和观察组(40例)。入院后,对照组给予常规方法治疗,观察组除常规治疗外再给予芪桂五物汤治疗。比较两组治疗效果、气道重塑指标、血清免疫因子水平及肺通气功能指标。结果:观察组的治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组气道重塑指标比较,差异均无统计学意义(P>0.05);治疗后,两组的气道重塑指标水平均较治疗前有降低,相较于对照组,观察组降低更为显著(P<0.05)。治疗前,两组血清免疫因子水平比较,差异均无统计学意义(P>0.05);治疗后,两组γ干扰素(IFN-γ)、白介素-4(IL-4)均较治疗前有所改善,相较于对照组,观察组改善更为显著(P<0.05)。治疗前,两组肺通气功能指标比较,差异均无统计学意义(P>0.05);治疗后,两组肺通气功能指标水平均较治疗前有所提高,相较于对照组,观察组提高更为显著(P<0.05)。结论:芪桂五物汤不仅可以明显改善支气管哮喘患者的临床症状,还能改善患者的气道重塑、血清免疫因子水平及肺功能指标,对支气管哮喘患者的治疗效果显著。

咯血患者甲状颈干异位支气管动脉解剖分析和栓塞治疗

目的分析咯血患者中起源于甲状颈干的异位支气管动脉解剖特点和栓塞治疗。方法回顾性分析2020年1月至2023年7月在湖州市中心医院接受支气管动脉栓塞术(BAE)治疗的连续565例咯血患者临床资料。所有患者BAE前均接受多层螺旋CT血管造影(MDCTA)检查,其中519例BAE期间同时行锁骨下动脉及其分支DSA检查。对发现起源于甲状颈干支气管动脉的解剖、影像学表现及BAE情况进行初次描述。结果21例患者中有22支起源于甲状颈干的异位支气管动脉。根据开口位置及血管走行,22支甲状颈干异位支气管动脉中13支(59.1%)为Ⅰ型,4支(18.2%)为Ⅱ型,4支(18.2%)为Ⅲ型,1支(4.5%)为Ⅳ型。有5支(22.7%)异位支气管动脉与其他支气管动脉交通。所有异位支气管动脉均经BAE栓塞成功,术后均未发生严重并发症。结论MDCTA联合锁骨下动脉及其分支DSA可显示起源于甲状颈干异位支气管动脉的解剖学特征。超选择性BAE栓塞此类支气管动脉安全有效。

过敏性哮喘个案管理的临床应用实践

目的评估基于个案管理模式的慢性疾病管理在过敏性哮喘患者中的临床应用效果。方法回顾性分析2020年2月至2023年2月北京清华长庚医院呼吸与危重症医学科门诊收治的过敏性哮喘患者。通过跟踪观察个案管理后1个月、3个月、6个月及1年的哮喘症状控制(ACT评分)及肺功能,分析个案管理对哮喘症状控制及肺功能的改善作用。结果纳入175例患者,男70例(40%)、女105例(60%);年龄(45.58±13.78)岁;合并过敏性鼻炎139例(79.4%)。个案管理前后肺功能指标第一秒用力呼气容积占预计值百分比(FEV1%pred)、第一秒用力呼气容积(FEV1)、一秒率(FEV1/FVC)、最大呼气中段流量占预计值百分比(MMEF75/25%pred)和呼气峰流速(PEF)分别由87.09%±18.56%、(2.65±0.88)L、75.09%±11.93%、52.20%(34.70%,69.30%)、(6.65±1.94)L/s升至97.80%±13.81%、(2.96±0.76)L、84.72%±11.18%、69.20%(53.70%,86.90%)、(7.57±1.89)L/s(P均<0.001)。ACT评分显示,个案管理1年控制良好率100%,其中完全控制率达到69.7%。重复测量方差分析显示性别和过敏性鼻炎史对症状控制效果均无影响(F=0.575,P=0.681;F=2.317,P=0.059);年龄组与个案管理时间存在交互作用,≥60岁患者在个案管理时间6个月时,ACT评分低于≤44岁和45~59岁组患者(P均<0.05)。吸入药物使用率和使用药物装置正确率在个案管理1个月、3个月、6个月、1年时分别为98.8%、86.8%、68.0%、51.4%和98.8%、100%、100%、100%。结论个案管理模式可显著提高患者使用吸入药物的使用率和使用吸入药物装置正确率,提高症状控制率,促进患者肺功能恢复。

单孔胸腔镜支气管袖状切除术与开胸支气管袖状切除术治疗中央型肺癌的疗效对比研究

目的对比单孔胸腔镜支气管袖状切除术和开胸支气管袖状切除术治疗中央型肺癌的可行性和安全性。方法回顾性分析2020年5月-2024年3月新疆医科大学附属肿瘤医院胸外科开展支气管袖状切除术的68例中央型肺癌患者,按照手术方式分为观察组(进行单孔胸腔镜支气管袖状切除术)32例,对照组(实施传统开胸支气管袖状切除术)36例。比较两组一般资料,包括:淋巴结清扫数目、手术时间、术中出血量、术后引流量、术后疼痛评分、术后拔管时间、术后住院时间、术后并发症情况。结果所有患者手术均顺利结束,均无支气管断端残留和围术期死亡。与对照组比较,观察组患者术中出血量、术后引流量减少;术后拔管时间、术后并发症发生率及术后住院天数缩短、术后疼痛评分降低,两组之间比较有统计学意义(P<0.05)。两组之间手术时间和术中淋巴结清扫情况比较,差异无统计学意义(P>0.05)。结论与传统开胸支气管袖状切除术相比,单孔胸腔镜支气管袖状切除术治疗中央型肺癌具有术中创伤小,术后恢复快,近期疗效可靠等优点,具有临床推广意义。

支气管哮喘患儿持续性气流受限的影响因素分析

目的探讨支气管哮喘患儿持续性气流受限(persistent airflow limitation,PAL)的影响因素。方法选取2021年1—12月首都儿科研究所附属儿童医院就诊的5~17岁PAL哮喘患儿(病例组)和同期就诊的非PAL哮喘患儿(对照组),每组50例。采集两组患儿临床资料,比较个人史、哮喘发作、过敏状况、呼吸道感染、肺功能水平等,采用多因素logistic回归方程分析PAL的影响因素。结果100例患儿中,男78例、女22例;年龄(9.5±2.2)岁。多因素logistic回归分析结果显示,既往肺炎史(OR=5.863,95%CI:2.295~14.975,P<0.01)、哮喘最严重一年发作次数越高(OR=1.599,95%CI:1.079~18.436,P<0.01)的患儿越容易发生PAL。结论哮喘患儿发生PAL起病早,肺炎史、哮喘频繁发作是患儿发生PAL的危险因素。应重视预防感染、减少呼吸道感染次数,合理用药,控制支气管哮喘发作,以减少PAL的发生。

孟鲁司特钠片联合糠酸氟替卡松治疗支气管哮喘患儿的疗效及对miRNA-21、miRNA-26a水平的影响

目的探究孟鲁司特钠片联合糠酸氟替卡松治疗对支气管哮喘患儿血清微小RNA(miRNA)-21及miRNA-26a水平的影响。方法选择2020年3月至2022年3月陕西省人民医院儿童病院收治的支气管哮喘患儿120例,按照随机数字表法分为两组,每组60例。在常规方法的基础上,对照组使用布地奈德雾化吸入治疗,观察组使用孟鲁司特钠片联合糠酸氟替卡松治疗。比较两组治疗后临床疗效和不良反应。检测并比较两组患儿肺功能指标、血清炎症因子以及miRNA-21、miRNA-26a表达水平。结果治疗后两组第1秒用力呼气容积(FEV_(1))和最大呼气流量(PEF)均显著升高(P<0.05),且观察组FEV1和PEF均显著高于对照组(P<0.05)。治疗后两组超敏C感应蛋白(hs-CRP)和白细胞介素6(IL-6)水平均显著降低(P<0.05),且观察组hs-CPR和IL-6水平均显著低于对照组(P<0.05)。治疗后两组miRNA-21和miRNA-26a表达水平均显著降低(P<0.05),且观察组均显著低于对照组(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)。结论糠酸氟替卡松联合孟鲁斯特钠片对儿童支气管哮喘具有更好的临床疗效,可提高肺功能,并具有一定的安全性。并且联合治疗可能通过下调miRNA-21和miRNA-26a的表达水平抑制炎症因子。

布地奈德福莫特罗粉吸入联合孟鲁司特钠治疗支气管哮喘急性发作的效果及对免疫功能的影响

目的探讨布地奈德福莫特罗粉吸入联合孟鲁司特钠治疗支气管哮喘急性发作的效果及对免疫功能的影响。方法选取2020年1月至2023年1月收治的80例支气管哮喘急性发作患者为研究对象,随机将其分为对照组(布地奈德福莫特罗粉吸入治疗)和观察组(布地奈德福莫特罗粉吸入联合孟鲁司特钠治疗),各40例。比较两组的治疗效果。结果观察组的治疗总有效率高于对照组(P<0.05)。治疗后,观察组的第1秒用力呼气容积(FEV_(1))、呼气峰值流速(PEF)、第1秒用力呼气容积占用力肺活量的百分比(FEV_(1)/FVC)均高于对照组(P<0.05)。治疗后,观察组的调节性T细胞(Treg)高于对照组,辅助性T细胞17(Th17)、Th17/Treg低于对照组(P<0.05)。治疗后,观察组的嗜酸性粒细胞趋化因子-2(eotaxin-2)、白细胞介素-33(IL-33)水平低于对照组(P<0.05)。结论布地奈德福莫特罗粉吸入联合孟鲁司特钠可提高支气管哮喘急性发作患者的治疗效果,促进肺功能及免疫功能改善,也能下调eotaxin-2、IL-33表达。