Dexmededomidine in pediatric unilateral internal inguinal ring ligation

BACKGROUND Safe and effective analgesia strategy remains one of the priorities for pediatric inguinal hernia treatment.AIM To explore safety and efficacy of dexmededomidine monotherapy for postoperative analgesia in children who received laparoscopic unilateral internal inguinal ring ligation.METHODS This randomized single-center controlled trial included 390 children(aged 1-3 years,ASA grade I-II),randomly divided into a dexmededomidine group(D group),a dexmededomidine+sufentanil group(DS group),and a sufentanil group(S group).The primary endpoint was percentage of children with the Face,Legs,Activity,Cry,and Consolability(FLACC)score≤3 points 2 h after surgery.RESULTS The comparisons of the FLACC scores at 2,4,6,8,12,and 24 h were not significantly different among the three groups(P>0.05).The sedative effects in the D group were significantly better than those in the S group(P>0.05),but not significantly different from those in the DS group.The incidence of nausea and vomiting was significantly lower in the D group than in the S group and DS group(P>0.05).CONCLUSION Analgesic effects of dexmededomidine monotherapy are comparable to those of sufentanil alone or in combination with dexmededomidine for children who underwent laparoscopic unilateral internal inguinal ring ligation,with better sedative effects and a lower incidence of adverse events.

A Multicenter Study of Viral Aetiology of Community-Acquired Pneumonia in Hospitalized Children in Chinese Mainland

Community-acquired pneumonia(CAP) is one of the leading causes of morbidity and mortality in children worldwide.In this study,we aimed to describe the aetiology of viral infection of pediatric CAP in Chinese mainland.During November2014 to June 2016,the prospective study was conducted in 13 hospitals.The hospitalized children under 18 years old who met the criteria for CAP were enrolled.The throat swabs or nasopharyngeal aspirates(NPAs) were collected which were then screened 18 respiratory viruses using multiplex PCR assay.Viral pathogens were present in 56.6%(1539/2721) of the enrolled cases,with the detection rate of single virus in 39.8% of the cases and multiple viruses in 16.8% of the cases.The most frequently detected virus was respiratory syncytial virus(RSV)(15.2%,414/2721).The highest detection rate of virus was in <6-month-age group(70.7%,292/413).RSV,human metapneumovirus(HMPV),human parainfluenza viruses(HPIVs) and influenza B virus(Flu B) showed the similar prevalence patterns both in north and south China,but HPIVs,Flu A,human bocavirus(HBoV),human adenovirus(HAdV) and human coronaviruses(HCoVs) showed the distinct circulating patterns in north and south China.Human enterovirus/human rhinovirus(HEV/HRV)(27.6%,27/98),HBoV(18.4%,18/98),RSV(16.3%,16/98) and HMPV(14.3%,14/98) were the most commonly detected viruses in severe pneumonia cases with single virus infection.In conclusion,viral pathogens are frequently detected in pediatric CAP cases and may therefore play a vital role in the aetiology of CAP.RSV was the most important virus in hospitalized children with CAP in Chinese mainland.