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.

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.

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.

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.

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。

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。

支气管封堵器在左侧肺叶切除术后行右侧肺部分切除术患者肺隔离中的临床应用

目的:探讨左侧肺叶切除术后行右侧肺部分切除术患者的临床特征及肺隔离方法效果。方法:选取2022年5月至2023年11月首都医科大学附属北京友谊医院胸外科收治的5例行左侧肺叶切除术后再行右侧肺部分切除术的患者。术前评估患者胸部CT除外下呼吸道解剖异常,全麻诱导后使用单腔气管插管联合支气管封堵器行肺隔离,采用短暂停通气结合术侧肺阻塞技术行单肺通气。术中均采用保护性肺通气策略,观察肺隔离成功、单肺通气时高气道峰压、低氧血症发生情况及处理方法。结果:5例患者均无右肺上叶开口解剖变异,使用支气管封堵器行肺隔离完成手术治疗,其中2例患者行右肺隔离,2例患者行选择性右肺上叶隔离,1例患者行选择性右肺中下叶隔离。2例行选择性右肺上叶隔离患者中,1例患者需降低单肺通气时潮气量以利于右肺上叶的显露。另1例单肺通气后出现高气道峰压,调整呼吸模式后未见好转且脉搏血氧饱和度进行性下降,在窒息氧合下完成肿物切除。5例患者单肺通气时均未发生低氧血症,术后随访均无麻醉并发症。结论:支气管封堵器可安全用于左侧肺叶切除术后再次行右肺部分切除手术患者的肺隔离,但术前应仔细评估右肺上叶开口位置是否存在变异,选择合理的肺隔离方案,并有相应处理预案。

预先单肺通气联合呼吸暂停对支气管封堵器用于胸腔镜手术单肺通气时肺萎陷的影响

目的 探讨预先单肺通气(OLV)联合呼吸暂停对支气管封堵器(BB)用于胸腔镜手术行OLV时肺萎陷的影响。方法 选择择期行胸腔镜下左肺段或肺叶切除术的患者75例,随机分为预先OLV组(A组)、呼吸暂停组(B组)和预先OLV联合呼吸暂停组(C组),每组25例。记录3组打开胸膜到肺完全萎陷的时间、外科医生满意度、进胸前准备时间、OLV时间、手术时间和OLV开始至胸膜打开后20 min内低氧血症[经皮动脉血氧饱和度(SpO_(2))<90%]的发生情况;记录3组胸膜腔开放即刻(T_0)、胸膜腔开放后1 min (T_1)、5 min (T_2)、10 min (T_3)和20 min (T_4)的肺萎陷评分(LCS)。结果 与A组和B组比较,C组肺完全萎陷时间明显缩短,外科医生满意度明显提高,差异均有统计学意义(P <0.05),A组和B组肺完全萎陷时间和外科医生满意度比较,差异均无统计学意义(P> 0.05);与A组比较,B组T0时点LCS低于A组,而在T_1时点,则明显高于A组,C组T_(1)、T_(2)、T_(3)和T_(4)时点LCS明显高于A组和B组,差异均有统计学意义(P <0.05);C组T2时点SpO_(2)明显低于A组和B组,差异有统计学意义(P <0.05)。结论 对于用BB行OLV的胸腔镜手术患者,预先使用OLV联合呼吸暂停,可以改善非通气侧肺的肺萎陷效果,缩短了肺完全萎陷时间,提高了外科医生满意度,且OLV的早期LCS更高,但仍需监测OLV期间的SpO_(2)。

小儿肺咳颗粒联合硫酸沙丁胺醇治疗支气管哮喘患儿急性发作期的临床研究

目的探讨小儿肺咳颗粒联合硫酸沙丁胺醇治疗支气管哮喘患儿急性发作期的效果。方法选取2021年10月至2022年11月在江西省儿童医院接受治疗的支气管哮喘患儿84例,按随机数字表法将患儿分为对照组和观察组,各42例。对照组在常规治疗基础上采用硫酸沙丁胺醇雾化吸入溶液治疗;观察组在对照组基础上联合小儿肺咳颗粒口服治疗;2组均治疗7 d。比较2组的临床疗效以及治疗前后呼气峰值流速占预计值百分比(PEF%)、第1秒用力呼气容积占预计值百分比(FEV_(1)%)、白细胞介素1β(IL-1β)、白三烯B4、C反应蛋白(CRP)、CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)水平和不良反应发生情况。结果观察组总有效率高于对照组[90.5%(38/42)比73.8%(31/42)](P=0.046)。治疗后,2组PEF%、FEV_(1)%均高于治疗前,且观察组均高于对照组[(90±10)%比(85±10)%、(92±8)%比(88±8)%](均P<0.05);2组血清IL-1β、白三烯B4、CRP水平均低于治疗前,且观察组均低于对照组(均P<0.05);2组CD_(3)^(+)、CD_(4)^(+)水平均高于治疗前,且观察组均高于对照组,2组CD_(8)^(+)水平均低于治疗前,且观察组低于对照组(均P<0.05)。治疗期间,2组不良反应发生率比较差异无统计学意义(P>0.05)。结论小儿肺咳颗粒联合硫酸沙丁胺醇治疗支气管哮喘患儿急性发作期的效果较好,可有效改善患儿的肺功能及细胞免疫功能,降低炎症反应。

肺癌病理应用支气管冲洗细胞块免疫组化链霉菌亲生物素蛋白-过氧化物酶连接法染色的诊断效果及检出率评价

目的探讨肺癌病理应用支气管冲洗细胞块免疫组化链霉菌亲生物素蛋白-过氧化物酶连接法(SP)染色的诊断效果及检出率。方法选取2017年2月至2021年12月广东省开平市中心医院收治的70例经支气管冲洗液检查阳性患者作为研究对象。采用液基薄层细胞学(TCT)技术制备细胞块,分别采用免疫组化SP法、苏木精伊红染色(HE)进行常规细胞学检查,比较两种检测方法诊断效能及不同肺癌类型免疫组化SP法检查后不同抗体阳性表达率比较。结果免疫组化SP法对恶性肿瘤诊断的灵敏度为96.15%、准确度为95.71%,均高于HE染色的69.23%、70.00%(P<0.05),特异度为94.44%,高于HE染色的72.22%,但差异无统计学意义。免疫组化SP法对肺癌病理类型总检出率高于HE染色,差异有统计学意义(P<0.05)。免疫组化SP法对肌上皮(p63)、细胞角蛋白5/6抗体(CK5/6)、细胞角蛋白7(CK7);甲状腺转录因子-1(TTF-1)、突触素(Syn)、人表皮生长因子受体-5(CD56),增殖细胞的核抗原(Ki67),天冬氨酸蛋白酶(Napsin-A)表达阳性率均高于HE染色,差异统计学意义(P<0.05)。不同类型肺癌患者p63、CK5/6、CK7、TTF-1、Syn、CD56、Ki67、Napsin-A阳性表达率比较差异有统计学意义(P<0.05)。结论支气管冲洗液细胞块免疫组化SP法染色对肺癌有较高的诊断价值,对不同类型肺癌有较高的检出率及鉴别率,具有重要的临床意义。

布地奈德联合阿奇霉素治疗支气管哮喘的效果研究

目的探究支气管哮喘患者联合使用阿奇霉素与布地奈德的治疗效果。方法110例支气管哮喘患者,随机分为研究组与对照组,各55例。对照组使用阿奇霉素治疗,研究组使用布地奈德联合阿奇霉素治疗。对比两组患者症状改善时间、治疗效果、肺功能及炎症指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、C反应蛋白]、不良事件发生情况及生活质量。结果研究组患者气喘、呼吸困难、肺部杂音以及咳嗽改善时间分别为(3.37±1.26)、(2.04±0.21)、(5.02±0.44)、(4.03±0.57)d,均短于对照组的(6.37±2.12)、(3.56±1.22)、(8.17±1.26)、(5.21±0.43)d,比较可知有统计学价值(P<0.05)。研究组治疗总有效率96.36%显著高于对照组的78.18%,比较可知有统计学价值(P<0.05)。研究组不良事件发生率较对照组更低,比较可知有统计学价值(P<0.05)。研究组患者FEV1(2.75±0.68)L与FVC(3.65±0.84)L显著高于对照组的(2.22±0.37)、(2.71±0.76)L,C反应蛋白(2.66±0.56)mg/L低于对照组的(5.07±0.88)mg/L,比较可知有统计学价值(P<0.05)。研究组患者躯体疼痛、生命活力、生理功能以及情感功能评分分别为(83.57±7.21)、(84.66±9.18)、(85.36±9.07)、(83.21±9.54)分,均高于对照组的(76.44±8.34)、(80.30±8.09)、(80.49±8.36)、(75.64±8.56)分,比较可知有统计学价值(P<0.05)。结论联合使用阿奇霉素与布地奈德可有效改善支气管哮喘患者的肺功能及炎症指标,提升治疗效果,预防不良事件,从而改善患者生活质量。

支气管哮喘患儿血清LCN2、SDC⁃1水平及临床意义

目的分析支气管哮喘患儿血清脂质运载蛋白2(LCN2)和多配体蛋白聚糖1(SDC⁃1)水平,并探讨两者与病情严重程度、哮喘控制水平的关系,以及对儿童支气管哮喘的诊断价值。方法纳入112例支气管哮喘患儿作为哮喘组,104例健康儿童作为正常组。根据病情严重程度再将哮喘组患儿分为轻度间歇组(36例)、轻度持续组(25例)、中度持续组(32例)和重度持续组(19例)。比较哮喘组与正常组之间,以及哮喘组不同病情严重程度患儿之间血清LCN2、SDC⁃1水平。分析哮喘组患儿血清LCN2和SDC⁃1的相关性,以及二者与第1秒用力呼气量(FEV_(1))、FEV_(1)/用力肺活量(FVC)值、儿童哮喘控制测试(C⁃ACT)评分的相关性。绘制受试者工作特征(ROC)曲线分析血清LCN2、SDC⁃1水平对儿童支气管哮喘的诊断价值。结果与正常组相比,哮喘组血清LCN2、SDC⁃1水平升高(P<0.05)。轻度间歇组、轻度持续组、中度持续组、重度持续组支气管哮喘患儿血清LCN2、SDC⁃1水平依次升高(P<0.05)。支气管哮喘患儿血清LCN2水平与血清SDC⁃1水平呈正相关,血清LCN2和SDC⁃1水平分别与FEV_(1)、FEV_(1)/FVC值、C⁃ACT评分呈负相关(P<0.05)。血清LCN2、SDC⁃1水平联合诊断儿童支气管哮喘的曲线下面积(AUC)为0.881,大于血清LCN2、SDC⁃1水平单独诊断的AUC(分别为0.778和0.768,P<0.05)。结论支气管哮喘患儿血清LCN2、SDC⁃1水平升高,且与病情严重程度和哮喘控制水平有关。血清LCN2、SDC⁃1水平可作为辅助诊断儿童支气管哮喘的生物标志物,且两者联合诊断的效能更高。