A Meta-Analysis of the Effectiveness of Vitamin C in the Prevention and Treatment of Childhood Upper Respiratory Tract Infections

Background:The effectiveness of vitamin C in the prevention and treatment of pediatric upper respiratory tract infections was evaluated in a meta-analysis.Methods:A total 2,573 children with upper respiratory tract infections were included in the meta-analysis,1,280 of whom received vitamin C and 1,293 who received control medication.The analysis of findings related to the studies included was done through random or fixed effects model to determine whether vitamin C supplementation could stop and control upper respiratory tract infections in children using mean difference(MD)with 95%confidence intervals(CIs).Results:On average,vitamin C-treated children had fewer upper respiratory tract infection bouts,their illness lasted shorter(MD-0.84;95%CI-1.47 to-0.20,P=0.009),and they were less contagious than the control.Conclusions:The number of episodes and illness duration of upper respiratory tract-infected pediatric subjects were considerably reduced in the intervention group(vitamin C)compared to the control.Due to the small sample size in four of 11 studies and the limited number of studies included for comparison,the outcomes should be carefully examined.

Antibiotic prescribing patterns for upper respiratory tract infections in rural Western China

Objective To explore the prescribing patterns of outpatients receiving antibiotics for upper respiratory tract infections(URTIs)in rural Western China and to identify the correlation in terms of doctors and patients characteristics.Methods Totally 7 678 prescriptions for URTIs were collected from 680 primary health village clinics of 40 counties across 10 provinces of Western China.Two outcome variables were used in the analysis:the occurrence of prescribing at least one antibiotic drug for an URTI and the occurrence of prescribing two or more antibiotics for an URTI.GEE logistic regression models were used to examine the socioeconomic and demographic determinants of the above two outcome variables.Results The percentage of prescribing at least one antibiotic for URTIs was 48.6% while the percentage of prescribing antibiotic combination(two or more antibiotics)was 4.6%.The two measurements of antibiotic utilization differed remarkably among the 10 provinces.Patients diagnosed with tonsillitis and faucitis had higher odds(OR=8.86 for tonsillitis and OR=4.64 for faucitis)of antibiotic prescription than patients with other diagnosis of URTIs.Patients with tonsillitis and faucitis also had higher odds(OR=3.82 for tonsillitis and OR=2.71 for faucitis)of multiple antibiotic prescription than those with other diagnosis of URTIs.The number of drugs per prescription and injection in prescriptions were also significant predictors of antibiotic and multiple antibiotic utilization for URTIs.Conclusion It is concluded that the percentage of antibiotic prescription for URTIs is higher in rural Western China than in most of other countries with available data and that prescriptions of antibiotics for URTIs are associated with residence regions of patients,URTI diagnosis and background information on drug prescription.

Detection of Streptococci in the Throat Swabs from Upper Respiratory Tract Infections in Kurdistan Region

The study was conducted for the detection of streptococcus bacteria of two groups of people with pharyngitis and tonsillitis. All the plates with α-haemolytic and β-haemolytic colonies were identified by conventional methods. β-haemolytic colonies was further identified by observing its sensitivity towards bacitracin disc tested on sheep blood agar plate. Alpha-hemolytic colonies on blood agar plate were identified with optchin disc. Different bacteria which included Streptococcus pyogenes, S. agalactiae, S. pnenmoniae and S. celis that had proportions 48.57%, 51.43%, 59.1% and 40.9% respectively isolated by the sensitivity test （depends on agents bacitracin and optchin）. Isolates of beta-Streptococcal which included S. pyogenes at child group （A） and the isolates alpha- Streptococcal which included S. pnenmoniae at adults group （B） showed marked rise.

Plasma Metabonomics of Human Adenovirus-infected Patients with Pneumonia and Upper Respiratory Tract Infection

Objective Human adenovirus(HAdV)infection is common and can develop to serious conditions with high mortality,yet the mechanism of HAdV infection remains unclear.In the present study,the serum metabolite profiles of HAdV-7-infected patients with pneumonia or upper respiratory tract infection(URTI)were explored.Methods In total,35 patients were enrolled in the study following an outbreak of HAdV-7 in the army,of whom 14 had pneumonia and 21 had URTI.Blood samples were collected at the acute stage and at the recovery stage and were analyzed by untargeted metabolomics.Results Over 90% of the differential metabolites identified between the pneumonia patients and URTI patients were lipids and lipid-like molecules,including glycerophospholipids,fatty acyls,and sphingolipids.The metabolic pathways that were significantly enriched were primarily the lipid metabolism pathways,including sphingolipid metabolism,glycerophospholipid metabolism,and linoleic acid metabolism.The sphingolipid metabolism was identified as a significantly differential pathway between the pneumonia patients and URTI patients and between the acute and recovery stages for the pneumonia patients,but not between the acute and recovery stages for the URTI patients.Ceramide and lactosylceramide,involved in sphingolipid metabolism,were significantly higher in the pneumonia patients than in the URTI patients with good discrimination abilities[area under curve(AUC)0.742 and 0.716,respectively;combination AUC 0.801].Conclusion Our results suggested that HAdV modulated lipid metabolism for both the patients with URTI and pneumonia,especially the sphingolipid metabolism involving ceramide and lactosylceramide,which might thus be a potential intervention target in the treatment of HAdV infection.

The Effect of Comfort Nursing on the Compliance and Efficacy of Treatment for Children with Acute Otitis Media Caused by Upper Respiratory Tract Infection

Objective:To explore and analyze the clinical effect of comfort nursing on children with acute otitis media.Methods:62 children with acute otitis media caused by upper respiratory tract infection who visited the outpatient clinic of our hospital from June 2022 to June 2023 were selected for this study.They were divided into a study group(n=31)and a control group(n=31).Children in the control group received basic care,while children in the study group received comfort nursing along with basic care.The hearing thresholds,body temperature,treatment compliance,and nursing satisfaction of the two groups of children were compared.Results:After the nursing intervention,the hearing threshold and average body temperature of the children in the study group were lower than those in the control group(P<0.05);the treatment compliance of the children in the study group was higher than that in the control group(P<0.05);the nursing satisfaction of the study group was higher than that of the control group(P<0.05).Conclusion:Comfort nursing can improve the treatment effect,treatment compliance,and nursing satisfaction of children with children with acute otitis media caused by upper respiratory tract infection.

Effect of Jiuwei Zhuhuang Powder on Cough Resolution in Children with Upper Respiratory Tract Infections:A Multicenter Randomized Controlled Trial

Objective:To assess the effectiveness of Jiuwei Zhuhuang Powder(JWZH),a Tibetan patent medicine in treating upper respiratory tract infection(URTI)associated cough in children.Methods:The study was a multicenter,randomized,open-label,controlled trial.A total of 142 children aged 2 to 14 years old,with URTIassociated cough within 48 h of onset,were randomly assigned to two groups at a 1:1 ratio by computer-generated randomization sequence.Children were treated with JWZH(1 to 1.5 g,twice to thrice daily)in the treatment group or conventional treatment(Pediatric Paracetamol,Artificial Cow-bezoar and Chlorphenamine Maleate Granules,0.25 to 1 g,thrice daily)in the control group for 5 days.The primary endpoints were the time to cough resolution and 4-day cough resolution rate.The secondary endpoints were the daily improvement in symptom scores and cough resolution rate during the study period.Results:A total of 138 children were included in the intention-to-treat analysis,with 71 cases in the treatment group and 67 cases in the control group.Compared with the conventional treatment,the children receiving JWZH had a shorter time to cough resolution[hazard ratio,2.10;95%confidence interval(CI),1.29-3.40;P=0.003].The median time to cough resolution for children receiving JWZH was shorter than that of the conventional treatment(2 days vs.3 days;P<0.001).The 4-day cough resolution rate in the JWZH group was higher than that of the control group(94.4%vs.74.6%;risk difference:19.8%,95%CI:8.1%-31.5%;relative risk:1.265,95%CI:1.088-1.470;P=0.001).There were no statistically significant differences in the improvement of other symptoms caused by URTI(P>0.05).Adverse events was reported in 5.6%(4/71)and 4.5%(3/67)in participants of JWZH and PPACCM groups(P>0.05),respectively,which were all mild and resolved without treatment.Conclusion:JWZH seemed to be a safe and effective therapy for URTI-associated cough in children.(Trial registration No.Chi CTR2000039421)

Effectiveness and Safety of Jinye Baidu Granules(金叶败毒颗粒)for Acute Upper Respiratory Tract Infection:A Systematic Review and Meta-analysis

To evaluate the effectiveness and safety of Jinye Baidu Granules(金叶败毒颗粒)for acute upper respiratory tract infection(AURTI).Database such as CNKI,Wan-fang,VIP,Sino Med,Web of science,Clinical Trials gov,Medline、EMBASE,CENTRAL,Cochrane Library were retrieved to collect randomized controlled trials(RCTs)on Jinye Baidu Granules(金叶败毒颗粒)in treating AURTI from the estabslishment of the database to March 2019.A total of 2 reviewers independently screened the literature according to the inclusion and exclusion criteria,and extracted material and the quality evaluation of the included studies.Quality evaluation adopted Cochrane Handbook 5.1 evaluation standards and tools.Rev Man5.3 was used to perform Meta-analysis for the adopted study.Finally a total of 4 RCTs involving 636 patients were included.Meta-analysis results showed that:compared with conventional Western medicine alone,Jinye Baidu Granules(金叶败毒颗粒)combined with Western medicine in the treatment of acute upper respiratory tract infection can improve the total effective rate of clinical efficacy[RR=0.13,95%CI(0.06,0.29),P<0.00001],shorten the time of antipyretic time for acute upper respiratory tract infection[MD=–1.22,95%CI(–1.43,–1.00),P<0.00001],shorten the time of pharyngeal pain[MD=–1.97,95%CI(–2.97,–0.96),P<0.0001]and shorten the cough disappear time[MD=–1.97,95%CI(–2.97,–0.96),P<0.0001].There were 2 papers reporting adverse reactions during the study period,and one of them specifically reported diarrhea,nausea,vomiting and stomachache in the experimental group.In the control group:diarrhea,nausea and adverse reactions disappeared after drug withdrawal;the incidence of adverse reactions was 3.92%in the control group and 5.88%in the observation group.There was no significant difference between the 2 groups(P>0.05).Based on existing data and methods,the systematic evaluation showed that,compared with Western medicine alone,Jinye Baidu Granules(金叶败毒颗粒)combined with Western medicine alone could improve the total effective rate of clinical efficacy,reduce the time of fever,sore throat,and the disappearance of cough with less adverse reactions.However,due to the low quality of the included study,large samples,multicenter,randomized,double-blind trials and trials are still needed to randomized controlled trials with reference to the CONSORT standard and the STRICTA statement.

Analysis of the Real-world Efficacy of Lianhua Qingwen Capsule(莲花清瘟胶囊)in the Treatment of Upper Respiratory Tract Infection

Objective:To explore the efficacy of Lianhua Qingwen Capsule(莲花清瘟胶囊)on upper respiratory tract infection,to understand the impact of Lianhua Qingwen Capsule(莲花清瘟胶囊)on the treatment outcome of upper respiratory tract infection,and provide reference for rational clinical drug use.Methods:The HIS database based on 18 large third-grade class-A hospitals was selected to match 1:1 for upper respiratory tract infection patients using and without Lianhua Qingwen Capsule(莲花清瘟胶囊)according to certain standards.The recombination of treatment outcome as"recovery"and"improvement"in the database was defined as effective treatment,"ineffectiveness","death"and"other"as ineffectivetreatment populations,and the effectiveness of treatment outcomes in the remerged 2 groups was compared by propensity score method.Results:After matching,454 cases were in both the patients treated by(experimental group)and without(control group)Lianhua Qingwen Capsule(莲花清瘟胶囊).Analysis was performed by three Logistic regression methods,all showing regression coefficients greater than 0 and statistically significant differences(P<0.05).Conclusion:Patients with upper respiratory tract infection treated by Lianhua Qingwen Capsule(莲花清瘟胶囊)are more effective than that without Lianhua Qingwen Capsule(莲花清瘟胶囊),it can improve the clinical efficacy of patients with upper respiratory tract infection。

Effect of gastrointestinal heat retention syndrome on gut microbiota in children with upper respiratory tract infection and lung-heat syndrome

Objective:Gastrointestinal heat retention syndrome(GHRS)is associated with lung-heat syndrome and is related to recurrent respiratory infection.Upper respiratory tract infection(URTI)lung heat syndrome is common in children.The study will explore the effect of GHRS on the structure and function of gut microbiota in children with URTI lung-heat syndrome.Methods:Participants were divided into both groups using the self-developed URTI scale and the“GHRS Diagnostic Scale$Pediatric Part”:GHRS-positive children(LS group)and GHRS-negative children(L group).General information,clinical symptoms,and stool were collected.We used 16S rRNA amplicon sequencing technology to determine the gene sequence of the V3eV4 region in feces and measure the gut microbiota of the both groups at the genus level.Results:A total of 23 children were included in the both groups.There were 12 cases in the LS group and 11 cases in the L group.There was no statistical difference between the both groups in age,gender,height,weight,and body mass index.The effective sequences shared by the both groups accounted for 85.66%of the total.In the gut microbiota,there was no difference in the a diversity and the b diversity between the both groups.Compared with the L group,the LS group had a significant increase in the relative abundance of the Ruminococcus gnavus group,Prevotella-9,Staphylococcus,and Actinomyces(P<.05).The functions of the both groups of microbiota primarily concentrate on metabolism,genetic information processing,and environmental information processing.The relative abundance of signaling molecules and interactions in the LS group were higher than that in the L group(P<.05).The redundancy analysis(RDA)showed that the URTI score had the greatest impact on the distribution of microbiota.Conclusion:GHRS may affect the development of URTI lung-heat syndrome by changing the relative abundances of gut microbiota.

Meta-analysis of the comparison between reduning injection and ribavirin injection for acute upper respiratory tract infection in children

Objective:To systematically evaluate the effectiveness and safety of reduning injection in acute upper respiratory tract infection of children.Methods:Use computer to search PubMed,the Cochrane Library,EMBASE,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang Database,Weipu database(VIP)and China Biomedical studies Service System(CBM)for randomized controlled trials(RCT)of acute upper respiratory tract infection in children,and the retrieval time is from their establishment to May,2022.After two researchers independently screened the studies,extracted data and evaluated the risk bias of studies,RevMan5.3 software was used to perform meta-analysis.Results:10 studies in total were included,involving 1466 patients.Results of the meta-analysis:total effective rate[RR=1.12,95%CI(1.07,1.16),P<0.00001],cure time[MD=-1.51,95%CI(-1.71,-1.32),P<0.00001],antipyretic time[MD=-1.32,95%CI(-1.72,-0.92),P<0.00001],disappearing time of nasal obstruction and nose running[MD=-1.04,95%CI(-1.45,-0.62),P<0.00001],disappearing time of cough[MD=-1.35,95%CI(-1.58,-1.13),P<0.00001],disappearing time of throat congestion[MD=-1.36,95%CI(-1.68,-1.03),P<0.00001],disappearing time of sore throat[MD=-1.55,95%CI(-1.74,-1.35),P<0.00001],the incidence of adverse reactions[RR=0.34,95%CI(0.20,0.57),P<0.0001].The differences between two groups in total effective rate,cure time,antipyretic time,disappearing time of nasal obstruction and nose running,disappearing time of cough,disappearing time of throat congestion,disappearing time of sore throat and the incidence of adverse reactions are all statistically significant(P<0.05).The sensitivity analysis demonstrates that three outcomes(total effective rate,cure time and disappearing time of sore throat)have unstable results,while others having stable results.Conclusion:Reduning injection is more effective than ribavirin injection in clinical,and it is better than ribavirin injection at relieving fever,nasal obstruction and nose running,cough and throat congestion.In addition,it’s safer in clinical than ribavirin injection.

ACUPUNCTURE TREATMENT OF 42 CASES OF ACUTE UPPER RESPIRATORY TRACT INFECTION

We made clinical observations on the therapeutic effect of acupuncture on acute upper respiratory tract infection and compared with the effect of paracetamol and Antondine, The result showed that acupuncture therapy could allay fever more rapidly than drugs, so long as the differentiation of syndromes is correct and the acupoint is selected properly.

Clinical practices s of Traditional Chinese Medicine for acute upper respiratory tract infection in children

OBJECTIVE:To develop Clinical practice s of Traditional Chinese Medicine(TCM) for acute upper respiratory tract infection(AURI) in children;TCM is usedalone or administered together with antibiotics.METHODS:Under the guidance of evidence-based medicine concept,in strict accordance with the rules of international s development,as well as on the basis of evidence of clinical research of TCM,the s solicited opinions from clinical experts and methodologists in TCM and Western Medicine.GRADE standard was applied to form experts' consensus.RESULTS:The s standardized classification of TCM patterns and TCM treatments in children with AURI,including prescription,Chinese patent medicine,non-drug treatment and prevention.CONCLUSION:Follows the principle of "evidence based,consensus supplemented,and experience referred",these s were formulated,but the quality of evidence of included studies were relatively low.Further refinement of the s should be needed as deeper clinical studies as available in future.

Clinical and Experimental Study on Shuanghua Aerosol (双花喷雾剂) in Treating Infantile Upper Respiratory Tract Infection

Objective: To study the effect and mechanism of Shuanghua aerosol (SHA) in treating infantile upper respiratory tract infection. Methods: In the clinical study, 276 patients were randomly divided into two groups. The treated group was treated with SHA and the control group was treated with Shuanghuanglian aerosol (SHLA, 双黄连气雾剂). In the experimental study, the effects of SHA on anti-inflammation and anti-virus were observed. Results: The clinical total effective rate of SHA was 99.03% and its cure rate 65.38%, while those of the SHLA were 94.11% and 44.12% respectively, significant difference was shown between the two groups (P<0.01). Experimental study showed that SHA could inhibit the xylol induced ear swelling and the egg white induced paw swelling in mice obviously, and inhibit the proliferation of influenza virus in rat's lung. Conclusion: SHA has obvious anti-inflammatory and anti-viral effect, and has good curative effect in treating infantile upper respiratory tract infection.

Clinical implications of exercise immunology

Maintaining leanness and a physically active lifestyle during adulthood reduces systemic inflammation,an underlying factor in multiple chronic diseases.The anti-inflammatory influence of near-daily physical activity in lowering C-reactive protein,total blood leukocytes,interleukin-6,and other inflammatory cytokines may play a key role in lowering risk of cardiovascular disease,certain types of cancer,type 2 diabetes,sarcopenia,and dementia.Moderate exercise training causes favorable perturbations in immunity and a reduction in incidence of upper respiratory tract infection(URTI).During each bout of moderate exercise,an enhanced recirculation of immunoglobulins,neutrophils,and natural killer cells occurs that persists for up to 3-h post-exercise.This exercise-induced surge in immune cells from the innate immune system is transient but improves overall surveillance against pathogens.As moderate exercise continues on a near-daily basis for 12-15 weeks,the number of symptoms days with URTI is decreased 25％-50％ compared to randomized sedentary controls.Epidemiologic and animal studies support this inverse relationship between URTI risk and increased physical activity.Copyright(c)2012,Shanghai University of Sport.Production and hosting by Elsevier B.V.All rights reserved.

Observational Study of a Multi-Active Ingredient Over-the-Counter Cold Remedy Following Active Pharmacist Recommendation

Real-world user satisfaction with a fixed dose combination over-the-counter cold remedy (Vicks Symptomed Complete Cytrynowy hot drink;VSCC) was evaluated in a prospective, non-comparative, observational study involving 176 pharmacies in Poland from February to April 2015. 1391 participants completed a questionnaire in the pharmacy and several paper questionnaires at home following use of the product at their own discretion. Participants returned their completed questionnaires to the pharmacy. 1356 participants were included in the intent-to-treat analysis. Participants highly valued the advice from their pharmacist (97%, P < 0.0001, important vs. not important) and thought the quality of that advice was good (93%, P < 0.0001, good/very good vs. very bad-fair). 96% of participants found VSCC to be effective in some way against their cold symptoms (P < 0.0001, effective vs. not effective) and 68% of them stated that it was better than any other cold therapy they had used before (P < 0.0001, better/best vs. same/worse). Adverse event reporting was very low.