Association between dietary habits and recurrent respiratory infection in children: A case-control study

Objective:To explore the association between dietary habits and recurrent respiratory infection(RRI)in children aged 0e14 years.Methods:This caseecontrol study compared dietary data of children with(cases)and without RRI(controls)collected via structured questionnaire.Participants were recruited from Chinese medicine clinics,hospitals,and children’s learning institutions in Beijing.A logistic regression analysis and odds ratio(OR)calculations were conducted using SPSS 17.0 software.Results:A total of 241 questionnaires were collected(case:control ratio:approximately 2:1).Frequent consumption of processed foods(OR Z 2.988,95%confidence intervals 1.375e6.491)and high-sugar foods(OR Z 2.268,95%confidence intervals 1.163e4.424),frequent picky eating(OR Z 2.614,95%confidence intervals 1.363e5.014),and a meat-heavy diet with fewer vegetables(OR Z 1.830,95%confidence intervals 1.358e2.467)correlated positively correlated with RRI.Additionally,57.80%of the children with RRI were addicted to high-sugar foods,compared with 41.57%of the children without RRI(P Z.015).Furthermore,63.16%of the children with RRI were picky eaters,compared with 48.31%of the children without RRI(P Z.024).Finally,30.92%of the children with RRI frequently consumed processed foods,compared with only 17.98%of the children without RRI(P Z.027Conclusion:Although RRI correlates positively with several dietary habits,in the future,prospective cohort studies with larger samples are needed to generalize these findings.

Treatment of Recurrent Respiratory Infection with Chinese Drug Therapy of Tonifying-Shen(肾) and Solidifying Superficiality—A Clinical Case Report

Children recurrent respiratory infection （CRRI） indicates that children suffer from frequent infections along the upper or lower respiratory tract for a certain number of times. It is not an independent disease but a clinical syndrome mostly brought about by some basic diseases such as nonspecific immunity, specific immune suppression or deficiency disease, congenital bronchopulmonary dysplasia, vitamin or microelement deficiency, or is induced by some factors such as smoking, cross infection, and nursing errors.（2） Clinically, CRRI is commonly treated by anti-infective agents, symptomatic and supportive treatment, and immune-regulatory therapy. However, the therapeutic effectiveness is always imperfect, which could even lead to a premium on asthma, or nephritis, etc.

Three pediatric massage schools in treating recurrent respiratory tract Infection

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

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

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

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

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

Clinical manifestations of respiratory syncytial virus infection and the risk of wheezing and recurrent wheezing illness:a systematic review and meta‑analysis

Background Respiratory syncytial virus(RSV)infection in infants is a global health priority.We aimed to investigate the common manifestations of RSV infection by age group and human development index(HDI)level and to assess its association with the development of wheezing and recurrent wheezing illness.Methods We searched the literature published between January 1,2010 and June 2,2022 in seven databases.Outcomes included common manifestations and long-term respiratory outcomes of RSV infection in children.Random-and fixed-effect models were used to estimate the effect size and their 95%confidence intervals.Subgroup analysis was conducted by age and HDI levels.This review was registered in PROSPERO(CRD42022379401).Results The meta-analysis included 47 studies.The top five manifestations were cough(92%),nasal congestion(58%),rhinorrhea(53%),shortness of breath(50%),and dyspnea(47%).The clinical symptoms were most severe in infants.In our analysis,compared to very high and high HDI countries,fewer studies in medium HDI countries reported related manifestations,and no study in low HDI countries reported that.The RSV-infected infants were more likely to develop wheezing than the non-infected infants[odds ratio(OR),3.12;95%CI,2.59–3.76]and had a higher risk of developing wheezing illnesses after recovery(OR,2.60;95%CI,2.51–2.70).Conclusions Cough and shortness of breath are common manifestations of RSV infection.More attention should be given to infants and areas with low HDI levels.The current findings confirm an association between RSV infection and wheezing or recurrent wheezing illness.

From infections to autoimmunity:Diagnostic challenges in common variable immunodeficiency

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

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

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

Unilateral Diaphragmatic Agenesis with Lung Cyst Herniating into the Abdomen Precluding Diaphragmatic Hernia in an Adult

Background: Diaphragmatic agenesis or complete absence of a hemidiaphragm in adulthood is rare. The significance of presence of a lung cyst occupying the common thoracoabdominal space lies in the absence of associated diaphragmatic hernia which has not been documented previously. Case Presentation: We report a case of previously undiagnosed complete absence of a hemidiaphragm in a 62-year-old male who presented with recurrent respiratory infection, episodes of nausea and postprandial fullness. Computed Tomography scan showed a large cyst in relation to the lower lobe of left lung. During surgery, he was found to have complete absence of a left hemidiaphragm and a large cyst arising from the lower lobe of left lung occupied the common thoracoabdominal space. Abdominal viscera were found displaced downwards and fixed in a thick fibrous membrane. There was no herniation of abdominal organs into the thoracic cavity after excision of the cyst. The left lung could be fully expanded and chest was closed after putting a chest drain. Diaphragmatic agenesis did not require any additional procedure. The cyst was excised with closure of bronchocystic opening. The patient had an uneventful recovery. Conclusions: The association of lung cyst with diaphragmatic agenesis (presented in the adulthood) is rare. It has precluded a diaphragmatic hernia and survived the patient acting as a protective barrier. The significance of lung cyst in presence of diaphragmatic agenesis lies in the absence of associated diaphragmatic hernia which has not been documented previously.