Chinese herbal medicine combined with Western medicine for Mycoplasma pneumoniae pneumonia in children:An overview of systematic reviews

Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.

Serum inflammatory markers in children with Mycoplasma pneumoniae pneumonia and their predictive value for mycoplasma severity

BACKGROUND Mycoplasma pneumoniae pneumonia(MPP)significantly impacts pediatric health,necessitating markers for early severe disease identification.AIM To investigate the correlation between serum inflammatory marker and the severity of MPP in children.METHODS A prospective study was carried out from January 2023 to November 2023.A total of 160 children with MPP who underwent treatment were selected:80 had severe MPP and 80 had mild MPP.Clinical and laboratory data were collected at the time of hospital admission and during hospitalization.Receiver operating characteristic curves were utilized to assess the diagnostic and prognostic for severe MPP.RESULTS Fever duration and length of hospitalization in pediatric patients with severe MPP exceeded those with mild MPP.The incidence of pleural effusion,lung consolidation,and bronchopneumonia on imaging was markedly elevated in the severe MPP cohort compared to the mild MPP cohort.In contrast to the mild cohort,there was a notable increase in C-reactive protein(CRP),procalcitonin(PCT),erythrocyte sedimentation rate,lactic dehydrogenase,D-dimer,and inflammatory cytokines[interleukin(IL)-6,IL-8,IL-10 and tumor necrosis factor(TNF)-α]in the severe MPP group were significantly higher.CONCLUSION Serum inflammatory markers(CRP,PCT,IL-6,D-dimer,IL-10 and TNF-α)were considered as predictors in children with severe MPP.

Research Progress on Combined Chinese and Western Medicine Treatment of Mycoplasma pneumoniae Pneumonia in Children

With the continuous development of medical technology,combined treatment of Chinese and Western medicine has gradually become a research hotspot.As a common disease in pediatrics,the treatment of Mycoplasma pneumoniae pneumonia(MPP)in children is also being explored and improved.This article summarizes the research progress of combined Chinese and Western medicine treatment of MPP in children in recent years,aiming to provide a useful reference for the combined treatment of MPP in children.The article firstly introduces the etiology and pathogenesis of MPP in children,thereafter briefly introduces the Western anti-infective treatment and traditional Chinese medicine(TCM)diagnosis and treatment of MPP in children,and lastly introduces the methods of combined treatment of TCM and Western medicine in detail.The article points out that the combination of Chinese and Western medicine can give full play to the overall regulation of Chinese medicine and the precise treatment advantages of Western medicine,improve the therapeutic effect,reduce the use of antibiotics,and lower the recurrence rate of the disease,which is worthy of further research and promotion.

Clinical characteristics of community-acquired pneumonia in children caused by mycoplasma pneumoniae with or without myocardial damage:A single-center retrospective study

BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneumonia(CAP)in children who presented with mild or severe mycoplasma pneumoniae pneumonia(MPP);to identify the incidence of myocardial damage between the two groups.METHODS This work is a retrospective study.We identified children between 2 mo and 16 years of age with clinical and radiological findings consistent with CAP.We admitted patients to the inpatient department of the Second Hospital of Jilin University,Changchun,China,from January 2019 to December 2019.RESULTS A total of 409 hospitalized patients were diagnosed with MPP.Among them were 214(52.3%)males and 195(47.7%)females.The duration of fever and cough was the longest in severe MPP cases.Similarly,plasma levels of highly sensitive Creactive protein(t=-2.834,P<0.05),alanine transaminase(t=-2.511,P<0.05),aspartate aminotransferase(t=-2.939,P<0.05),and lactate dehydrogenase(LDH)(t=-2.939,P<0.05)were all elevated in severe MPP cases compared with mild MPP cases,and these elevations were statistically significant(P<0.05).Conversely,the neutrophil percentage was significantly lower in severe MPP cases than in mild MPP cases.The incidence of myocardial damage was significantly higher in severe MPP cases than in mild MPP cases(χ^(2)=157.078,P<0.05).CONCLUSION Mycoplasma pneumoniae is the main cause of CAP.The incidence of myocardial damage was higher and statistically significant in severe MPP cases than in mild MPP cases.

Evaluating the role of interleukin-2 and interleukin-12 in pediatric patients with concurrent Mycoplasma pneumoniae and Epstein-Barr virus infections

BACKGROUND Mycoplasma pneumoniae(MP)frequently causes respiratory infections in children,whereas Epstein-Barr virus(EBV)typically presents subclinical manifestations in immunocompetent pediatric populations.The incidence of MP and EBV coinfections is often overlooked clinically,with the contributory role of EBV in pulmonary infections alongside MP remaining unclear.AIM To evaluate the serum concentrations of interleukin-2(IL-2)and interleukin-12(IL-12)in pediatric patients with MP pneumonia co-infected with EBV and assess their prognostic implications.METHODS We retrospectively analyzed clinical data from patients diagnosed with MP and EBV co-infection,isolated MP infection,and a control group of healthy children,spanning from January 1,2018 to December 31,2021.Serum IL-2 and IL-12 levels were quantified using enzyme-linked immunosorbent assay.Logistic regression was employed to identify factors influencing poor prognosis,while receiver operating characteristic(ROC)curves evaluated the prognostic utility of serum IL-2 and IL-12 levels in co-infected patients.RESULTS The co-infection group exhibited elevated serum IL-2 and C-reactive protein(CRP)levels compared to both the MP-only and control groups,with a reverse trend observed for IL-12(P<0.05).In the poor prognosis cohort,elevated CRP and IL-2 levels,alongside prolonged fever duration,contrasted with reduced IL-12 levels(P<0.05).Logistic regression identified elevated IL-2 as an independent risk factor and high IL-12 as a protective factor for adverse outcomes(P<0.05).ROC analysis indicated that the area under the curves for IL-2,IL-12,and their combination in predicting poor prognosis were 0.815,0.895,and 0.915,respectively.CONCLUSION Elevated serum IL-2 and diminished IL-12 levels in pediatric patients with MP and EBV co-infection correlate with poorer prognosis,with combined IL-2 and IL-12 levels offering enhanced predictive accuracy.

Understanding serum inflammatory markers in pediatric Mycoplasma pneumoniae pneumonia

This editorial reflects on the research,which investigates the potential of serum markers to predict the severity of Mycoplasma pneumoniae infections.Mycoplasma pneumoniae pneumonia(MPP)is a prevalent cause of respiratory infections in children,often leading to significant morbidity.Predicting the severity of MPP can significantly enhance patient management and outcomes.This editorial reviews the role of specific laboratory markers:(1)Lactate dehydrogenase;(2)Interleukin(IL)-6;(3)IL-10;(4)Tumor necrosis factor-α;and(5)D-dimer in predicting the severity of MPP in pediatric patients.Elevated levels of these markers are strongly associated with severe cases of MPP,providing clinicians with valuable tools for early diagnosis and targeted intervention.

The Predictive Value of NLR, IL-6, CRP, and PCT in Mycoplasmal Pneumonia with Complicated Myocardial Injury

Objective:To evaluate the dynamic changes in neutrophil-to-lymphocyte ratio(NLR),interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)levels in children with Mycoplasma pneumoniae pneumonia(MPP)complicated by myocardial injury and to determine their predictive value both individually and in combination.Methods:150 children diagnosed with MPP at Jiujiang Maternal and Child Health Hospital between June 2023 and June 2024 were selected.Patients were divided into the myocardial damage group(MD group,n=65)and the non-myocardial damage group(non-MD group,n=85),based on the presence of myocardial injury.Ninety hospitalized children without MPP served as the control group(Con group).Myocardial enzyme profile indicators,including lactate dehydrogenase(LDH),α-hydroxybutyrate dehydrogenase(α-HBDH),aspartate aminotransferase(AST),high-sensitivity cardiac troponin I(hs-cTnI),creatine kinase(CK),and creatine kinase-MB(CK-MB),were measured using a chemiluminescent immunoassay analyzer.Serum NLR,IL-6,CRP,and PCT levels were determined using appropriate analyzers.The correlation between these markers and myocardial enzyme indicators was analyzed using Spearman correlation analysis.Multivariate logistic regression was applied to identify risk factors for myocardial injury in MPP patients.Results:Serum levels of NLR,IL-6,CRP,and PCT in the MD and non-MD groups were significantly higher than in the Con group(P<0.05),with the MD group showing higher levels than the non-MD group(P<0.05).These markers were positively correlated with myocardial enzyme indicators.Logistic regression identified elevated NLR,IL-6,CRP,PCT,LDH,α-HBDH,AST,hs-cTnI,CK,and CK-MB as risk factors for myocardial injury in MPP patients(P<0.05).Conclusion:Elevated levels of NLR,IL-6,CRP,PCT,and myocardial enzymes are significant risk factors for myocardial injury in children with MPP,offering valuable insights for prevention and prognosis.

Analysis of the Role of D-Dimer,Interleukin-6,and Interleukin-18 in Differential Diagnosis of Pediatric Refractory Mycoplasma pneumoniae Pneumonia

Objective:To analyze the value of D-dimer(D-D),interleukin-6(IL-6),and IL-18 in the differential diagnosis of children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods:The medical records of 92 children with Mycoplasma pneumoniae pneumonia(MPP)treated in the hospital were selected for retrospective analysis from January 2023 to January 2024.After comprehensive examinations such as computed tomography examination of the chest,48 children with general Mycoplasma pneumoniae pneumonia(GMPP)were put in the GMPP group and 44 children with RMPP were grouped in the RMPP group.The IL-6,IL-18,and D-D levels were compared between the two groups,and the receiver operating characteristic(ROC)curves were plotted to analyze their value for differential diagnosis of RMPP.Results:The levels of IL-6,IL-18,and D-D in the RMPP group were higher than those in the GMPP group(P<0.05);the ROC curves showed that the specificity of the differential diagnosis of IL-6,IL-18,and D-D was higher,and their diagnostic value was significant.Conclusion:Determination of IL-6,IL-18,and D-D levels in children with MPP can further diagnose the children’s condition,which can help physicians formulate targeted treatment plans,and is of great significance to the improvement of the children’s condition,which is worthy of attention.

Intestinal Microecology in Children with Pneumonia: The Relationship Between Digestive Health and Disease Recovery

This paper explores the association between intestinal microecology and digestive health and disease recovery in children with pneumonia.Intestinal microecological imbalance is common in children with pneumonia,which is closely associated with digestive health and disease recovery.Intestinal microecological imbalance may affect digestive enzyme activity,intestinal mucosal barrier function,and nutrient absorption,which in turn affects digestive health.In addition,intestinal microecological imbalances may be associated with immune regulation,inflammatory responses,and pathogen suppression,affecting disease recovery.Strategies to regulate intestinal microecology include probiotic supplementation,dietary modification,and pharmacological treatment.Currently,the study of intestinal microecology in children with pneumonia faces challenges,and there is a need for improved research methods,individualized treatment strategies,and the development of novel probiotics.In conclusion,the intestinal microecology of children with pneumonia is closely related to digestive health and disease recovery,and the regulation of intestinal microecology is of great significance to the treatment of children with pneumonia.Furthermore,future research should further explore the application of the microecology of the intestinal microecology in the treatment of children with pneumonia.

The Effect of Azithromycin in Treating Mycoplasma Pneumonia in Children

Objective:To discuss and analyze the effect of azithromycin in the treatment of mycoplasma pneumonia in children.Methods:A total of 120 children with mycoplasma pneumonia who were admitted to the Department of Pediatrics of our hospital from January 2022 to December 2022 were selected as the research subjects.They were divided into an azithromycin group and a reference group according to the random number drawing method,with 60 cases in each group.The azithromycin group was treated with azithromycin,and the reference group was treated with conventional treatment.The efficacy of treatment,laboratory indicators,platelet count and D-dimer,and adverse reactions of both groups were compared.Results:The efficacy of the azithromycin group was significantly higher than that of the reference group(P<0.05).Before treatment,there were no significant differences in the laboratory indicators like ferritin,procalcitonin(PCT),and erythrocyte sedimentation rate(ESR)between the two groups(P>0.05);after treatment,the laboratory indicators of the azithromycin group were significantly better than those of the reference group(P<0.05).Before treatment,there was no statistically significant difference in platelet count and D-dimer between the groups(P>0.05);after medication,the platelet count,and D-dimer in the azithromycin group were significantly better than those in the reference group(P<0.05).The total incidence of adverse reactions in the azithromycin group was significantly lower than that in the reference group(P<0.05).Conclusion:Azithromycin is more effective in treating mycoplasma pneumonia in children,and has certain clinical value.

Children with infectious pneumonia caused by Ralstonia insidiosa:A case report

BACKGROUND Ralstonia is a Gram-negative non-fermentative bacterium widespread in nature,and includes four species,Ralstonia pickettii,Ralstonia solanacearum,Ralstonia mannitolilytica,and Ralstonia insidiosa,which were proposed in 2003.Ralstonia is mainly found in the external water environment,including municipal and medical water purification systems.This bacterium has low toxicity and is a conditional pathogen.It has been reported in recent years that infections due to Ralstonia are increasing.Previous studies have shown that most cases of infection are caused by Ralstonia pickettii,a few by Ralstonia mannitolilytica,and infections caused by Ralstonia insidiosa are rare.CASE SUMMARY A 2-year-old Chinese child suffered from intermittent fever and cough for 20 d and was admitted to hospital with bronchial pneumonia.Bronchoscopy and alveolar lavage fluid culture confirmed Ralstonia insidiosa pneumonia.The infection was well controlled after treatment with meropenem and azithromycin.CONCLUSION Ralstonia infections are increasing,and we report a rare case of Ralstonia insidiosa infection in a child.Clinicians should be vigilant about Ralstonia infections.

Mycoplasma pneumoniae Macrolide Resistance and MLVA Typing in Children in Beijing,China,in 2016:Is It Relevant?

Objective The aim of this study is to investigate the macrolide resistance rate and molecular type with multiple-locus variable-number tandem-repeat analysis(MLVA)of Mycoplasma pneumoniae of Beijing in 2016 in pediatric patients.Methods Real-time quantitative polymerase chain reaction(PCR)was used to identify M.pneumoniae,and MLVA was performed.The domain V of the 23 S rRNA was sequenced to detect macrolide-resistant point mutations.We also investigated the activities of antibiotics against M.pneumoniae isolates in vitro.Results The PCR detection rate of M.pneumoniae in children in Beijing was 40%,and the macrolide resistance rate was 66%.The A2063 G mutation in the 23 S rRNA V region is the dominant mutation(137/146,93.84%),whereas the A2064 G mutation is rare(9/146,6.16%).Seventy-three samples were typed successfully by MLVA typing,including 86.3%(63/73)were MLVA type 4-5-7-2,and 13.7%(10/73)were MLVA type 3-5-6-2.No other types were found.No strains were resistant to levofloxacin or tetracycline.Conclusion In 2016,a specific decrease in the macrolide resistance rate occurred in Beijing.The detection rate and macrolide resistance rate of outpatients are lower than those of inpatients.The A2063 G mutants M.pneumoniae have high levels of resistance to erythromycin and azithromycin.The primary MLVA type is 4-5-7-2,followed by 3-5-6-2.No other MLVA types were detected.No strains resistant to tetracycline or levofloxacin were found in vitro.

Correlation Between the Clinical Severity, Bacterial Load, and Inflammatory Reaction in Children with Mycoplasma Pneumoniae Pneumonia

Given the lack of defining features in the clinical manifestations and radiographic findings for children with mycoplasma pneumoniae pneumonia(MPP),quantitative polymerase chain reaction(qPCR)has become a useful diagnostic method.This study was performed to explore the relationship between the qPCR findings,clinical symptoms,and inflammatory markers in children with MPP.Four hundred children with MPP have been enrolled in this retrospective analysis.All clinical and analytical information,including mycoplasma pneumoniae(MP)PCR results,has been collected.Based on the PCR results,the patients were divided into groups with load values(copy number)<105(54 cases),2105 and<106(71 cases),2106 and<107(112 cases),>107 and<108(114 cases),and>108(49 cases).The clinical features(including symptoms and signs)and inflammatory indicators were compared among the groups.The incidence of high fever(above 39℃),thermal peak during the entire hospitalization period,fever duration,days of hospitalization,and plasma lactate dehydrogenase(LDH)levels were statistically correlated with the MP PCR load value in children with MPP.The analysis of relevance degree showed the correlative order as a thermal peak of hospitalization>duration of fever>period of hospitalization>LDH value>C-reactive protein value.The host immune response was significantly greater in the complication group than in the non-complication group.

Using 16S rDNA Sequencing Technology to Preliminarily Analyze Intestinal Flora in Children with Mycoplasma pneumoniae Pneumonia

Objective We investigated changes in the intestinal flora of children with Mycoplasma pneumoniae pneumonia(MPP).Methods Between September 2019 and November 2019,stool samples from 14 children with MPP from The Fourth Hospital of Baotou city,Inner Mongolia Autonomous Region,were collected and divided into general treatment(AF)and probiotic(AFY)groups,according to the treatment of“combined Bifidobacterium,Lactobacillus,Enterococcus,and Bacillus cereus tablets live”.Highthroughput 16S rDNA sequencing was used to identify intestinal flora.Results Intestinal flora abundance and diversity in children with MPP were decreased.Both Shannon and Simpson indices were lower in the AF group when compared with healthy controls(P<.05).When compared with healthy controls,the proportion of Enterorhabdus was lower in the AF group,while the proportion of Lachnoclostridium was higher(P<0.05).The proportion of Bifidobacteria and Akkermansia was lower in the AFY group but Enterococcus,Lachnoclostridium,Roseburia,and Erysipelatoclostridium proportions were higher.The proportion of Escherichia coli-Shigella in the AFY group after treatment was decreased(P<0.05).Conclusions The intestinal flora of children with MPP is disturbed,manifested as decreased abundance and diversity,and decreased Bifidobacteria.Our probiotic mixture partly improved intestinal flora disorders.

Effect of Yanhuning in combined with azithromycin on the inflammatory cytokines and immunological function in children with mycoplasma pneumonia

Objective: To explore the effect of Yanhuning in combined with azithromycin on the inflammatory cytokines and immunological function in children with mycoplasma pneumonia. Methods: A total of 130 children with mycoplasma pneumonia were included in the study and randomized into the treatment group (n=65) and the control group (n=65). The patients in the control group were given azithromycin. On the above basis, the patients in the treatment group were given Yanhuning. The patients in the two groups were continuously treated for 7 d. The levels of serum inflammatory cytokines and immunological function indicators before and after treatment in the two groups were detected and compared. Results: When compared with before treatment, the serum IL-2 level after treatment in the two groups was significantly elevated, while IL-4, IL-10, IL-13, IL-6, TNF-α, and IFN-γ levels were significantly reduced;moreover, the improvement in the treatment group was significantly superior to that in the control group. When compared with before treatment, CD3+, CD4+, and CD4+/CD8+ after treatment in the two groups were significantly elevated, and those in the treatment group were significantly higher than those in the control group, while CD8+ was significantly reduced, but the comparison between the two groups was not statistically significant. When compared with before treatment, RBC-C3bR after treatment in the two groups was significantly elevated, while RBC-ICR was significantly reduced;moreover, the improvement in the treatment group was significantly superior to that in the control group. Conclusions: Yanhuning in combined with azithromycin in the treatment of mycoplasma pneumonia in children can significantly enhance the immunological function, and reduce the inflammatory reaction, with an effect significantly superior to that by single application of azithromycin.

The study on the mechanism of Tanreqing and ambroxol combined with Azithromycin for the treatment of mycoplasma pneumonia in children

Objective:To observe the mechanism of Tanreqing and ambroxol combined with Azithromy for the treatment of mycoplasma pneumonia in children and offer help to mycoplasma pneumonia treatment.Methods:86 cases of mycoplasma pneumonia patients in our hospital were selected and randomly divided into observation group and control group, each group were 43 cases. Control group was treated with conventional therapy, and observation group was treated with Tanreqing and ambroxol combined with Azithromy based on conventional therapy, the changes of lung function [V-T (Tidal volume)/kg, t-PTEF/t-E (time ratio of peak to peak), TEF25/PTEF (Instantaneous velocity of exhaling tidal volume 75% and Peak tidal expiratory flow ratio) and MTIF/MTEF (medium-term inspiratory flow rate and medium-term expiratory flow rate ratio)], cytokines (IL-2, IL-10, IL-6 and TNF-α) and the myocardial enzymes [LDH (lactate dehydrogenase), CK-MB (creatine kinase isoenzyme), CK (creatine kinase) and AST (glutamic-oxaloacetic transaminase)] were detected before and after treatment.Results: The comparison of lung function, cytokines and themyocardial enzymes in the two groups before treatment was not statistically significant (P>0.05). MTIF/MTEF, themyocardial enzymes (LDH, CK-MB, CK and AST) and cytokines (IL-10, IL-6 and TNF-α) in both groups after treatment significantly decreased compared with that before treatment (P<0.05);lung function (V-T/kg, t-PTEF/t-E, TEF25/PTEF), and IL-2 in both groups after treatment significantly increased compared with that before treatment (P<0.05). Lung function (V-T/kg, t-PTEF/t-E, TEF25/PTEF), and IL-2 in observation group after treatment increased more significantly than that in control group (P<0.05), and MTIF/MTEF, themyocardial enzymes (LDH, CK-MB, CK and AST) and cytokines (IL-10, IL-6 and TNF-α) decreased more significantly than that in control group (P<0.05).Conclusions:Tanreqing and ambroxol combined with Azithromy could improve lung function, cytokines and the myocardial enzymes in children with mycoplasma pneumonia, which has a very important clinical significance of the treatment to mycoplasma pneumonia.

Acute coalescent mastoiditis in a 16-month-old child due to Streptococcus pneumoniae infection

Rationale:Acute otitis media is a common disease in early childhood,and is usually caused by Streptococcus pneumoniae(S.pneumoniae).Acute mastoiditis is a complication of acute otitis media and can involve not only the mucoperiosteum of the middle ear but can also spread to the periosteum by destroying the mastoid bone(acute coalescent mastoiditis).In addition,the infection can extend through the surrounding bones or the emissary veins beyond the mastoid’s air cells,leading to subperiosteal abscesses.Patient’s Concern:A 16-month-old female patient was hospitalized due to the purulent discharge of the left ear and the symptoms of right mastoiditis(swelling and redness of the skin).Diagnosis:Bilateral acute coalescent mastoiditis caused by S.pneumoniae infection.The computer tomography revealed bilateral bone destruction of the mastoid and abscesses found behind the auricle on both sides.Interventions:The patient underwent intravenous antibiotic therapy and surgical treatment.Outcomes:The patient was discharged 14 days after hospitalization with an improved condition.Lessons:Improperly treated acute coalescent mastoiditis can lead to extracranial and intracranial complications,sometimes serious and even life-threatening.Complications are prevalent in children under 2 years,in whom the disease progresses more rapidly and severely.The vaccination with a 13-valent vaccine may not result in sufficient immunity against S.pneumoniae,a predominant pathogen in children affected by acute coalescent mastoiditis.

Correlation of serum complement and immunoglobulin contents with inflammatory stress response in children with Mycoplasma pneumoniae pneumonia

Objective:To study the correlation of serum complements C3 and C4 as well as immunoglobulins IgM, IgA and IgG contents with inflammatory stress response in children with mycoplasma pneumoniae pneumonia.Methods: The children who were diagnosed with Mycoplasma pneumoniae pneumonia in Xiangyang No. 1 People's Hospital, Hubei University of Medicine between February 2015 and January 2018 were selected as the MPP group, and healthy children who received physical examination during the same period were selected as the control group. The contents of complements, immunoglobulins and inflammatory stress mediators in serum as well as the expression of inflammatory stress molecules in peripheral blood were measured.Results: Serum C3, C4, IgM, sICAM-1, CD40L, HMGB1, Cor and MDA levels as well as peripheral blood TLR2, TLR4, CD11b, CD18, MPO and NOX2 expression intensity of MPP group were significantly higher than those of control group, IgA level was significantly lower than that of control group, and IgG level was not different from that of control group;serum C3, C4 and IgM levels of MPP group were positively correlated with serum sICAM-1, CD40L, HMGB1, Cor and MDA levels as well as peripheral blood TLR2, TLR4, CD11b, CD18, MPO and NOX2 expression intensity, and serum IgA level was negatively correlated with serum sICAM-1, CD40L, HMGB1, Cor and MDA levels as well as peripheral blood TLR2, TLR4, CD11b, CD18, MPO and NOX2 expression intensity. Conclusion: The changes of serum complements and immunoglobulins in children with Mycoplasma pneumoniae pneumonia are related to the excessive activation of inflammatory stress response in the course of disease.

Effect of adjuvant therapy of transfer factor oral solution on the infection process of children with Mycoplasma pneumonia

Objective:To explore the effect of adjuvant transfer factor oral solution therapy on the infection process of children with mycoplasma pneumonia.Methods:A total of 164 children with mycoplasma pneumonia who were treated in our hospital between January 2017 and January 2018 were selected as the research subjects and divided into control group (n=82) and transfer factor oral solution group (n=82) by random number table method. Control group received clinical routine therapy for children with mycoplasma pneumonia, transfer factor oral solution group received both routine therapy and transfer factor oral solution therapy, and both groups were treated for consecutive 1 week. The differences in infection-related index levels were compared between the two groups before and after treatment.Results:Before treatment, the differences in serum levels of inflammatory factors, coagulation indexes and immunoglobulins were not statistically significant between the two groups. After 1 week of treatment, serum inflammatory factors IL-2, IL-13 and IL-18 contents of transfer factor oral solution group were lower than those of control group;serum coagulation index FIB level was lower than that of control group whereas PT and APTT levels were higher than those of control group;serum immunoglobulins IgG, IgA and IgM contents were lower than those of control group.Conclusion: Adjuvant transfer factor oral solution therapy can effectively relieve the systemic inflammatory response and reduce the coagulation system and humoral immune system function damage in children with mycoplasma pneumonia.

The value of IgM and IgG contents for the diagnosis and judgment of mycoplasma pneumonia in children

Objective: To explore the value of IgM and IgG contents for the diagnosis and judgment of mycoplasma pneumonia in children. Methods: 560 children with mycoplasma pneumonia who received inpatient treatment in our hospital between October 2016 and October 2017 were selected as mycoplasma pneumonia group, and 200 healthy children who received vaccination in our hospital during the same period were selected as normal control group. The differences in peripheral blood IgM and IgG contents as well as serum inflammatory factor and pulmonary surfactant protein contents were compared between the two groups, and Pearson test was used to evaluate the inner link of peripheral blood IgM and IgG contents with inflammatory factors and pulmonary surfactant proteins in children with mycoplasma pneumonia. Results: Peripheral blood IgM and IgG contents of mycoplasma pneumonia group were higher than those of normal control group;serum inflammatory factors MCP-4, IL-5, IL-13, IL-17, IL-18 and IL-23 contents were higher than those of normal control group;serum pulmonary surfactant proteins SP-A, SP-B, SP-C and SP-D contents were higher than those of normal control group. Correlation analysis showed that peripheral blood IgM and IgG contents in children with mycoplasma pneumonia were positively correlated with the contents of inflammatory factors and pulmonary surfactant proteins. Conclusion: Peripheral blood IgM and IgG contents are abnormally high in children with mycoplasma pneumonia, and they are closely related to the inflammatory response and lung injury degree.