Objective To explore the association between antibiotic exposure before 1 year of age and development of childhood asthma. Methods This study was based on tne epidemiological investigation of asthms among children aged0~14 years in Soochow,from whom we selected 7500 children aged at 3~14 years. Antibiotic exposure was determined for the first year of life. The data was analyzed by using chi-square test and Logistic regression analysis,calculating OR and 95%CI. Results Antibiotic exposure in the first year of life was associated with a significant but small risk of development of asthma in childhood after adjusting for gestational age,birth weight,house condition,parental allergy and so on(OR*1.230,95% CI:1.026,1.474);the risk increased especially in parents without allergy(OR*1.313,95% CI:1.023,1.685). As the number of courses of antibiotics increased,this was associated with increased asthma risk,with the highest risk being in children who received 3 courses and more(OR*2.468,95%CI:1.593,3.824). Conclusion The use of antibiotics in the first year of life is associated with a small risk of developing asthma,and this risk increases with the number of courses of antibiotics.

Objective To investigate if there is an association between caesarean section and allergic rhinitis as well as asthma in Suzhou children and whether the association is affected by family history of allergies.MethodsThis study was based on the epidemiological investigation of asthma among children aged 0-14 years from Pingjiang area of Suzhou city in2010. From 540 asthmatic children we selected 427 children aged 5 to 14 years,290 males and 137 females,the average age being(8.46±2.3)years. Another 427 non-asthmatic children were chosen by 1:1 matching by the same sex and age with the asthma children,A total of 854 cases were chosen as the study population.Then analyze the survey data by using Chi-square test and Logistic regression analysis.ResultsOf the 854 children,388 were delivered by cesarean section(allergic rhinitis 158 cases,asthma 191 cases)and 466 by vaginal(allergic rhinitis 146 cases,asthma 236 cases).After adjusting for potential confounders,caesarean section was associated with an increased risk of allergic rhinitis(OR=1.66,95%CI 1.21,2.29).Specifically,while approximately 2.6-fold higher odds of allergic rhinitis was observed in children with a family history of allergies(OR=2.58,95%CI 1.46,4.56),no association was observed in children without a family history of allergies(OR=1.42,95%CI 0.95,2.13).Children born by cesarean section had no higher risk of asthma than those delivered vaginally(OR=0.91,95%CI 0.68,1.22).ConclusionThe association of caesarean section and allergic rhinitis appears more remarkable in children with family history of allergies.However,caesarean section is not associated with asthma in childhood.

<正>过敏性疾病主要包括:湿疹、过敏性皮炎、过敏性结膜炎、过敏性肠炎、过敏性鼻炎、过敏性哮喘(简称哮喘)等。这些过敏性疾病可单独存在,也可相互并存导致多系统过敏。许多流行病学调查研究证实,近年来,过敏性疾病的发病率在全球范围内不断攀升,尤其是儿童哮喘的发病率[1]。随着现代医疗技术的发展,通过正规的吸入治疗,哮喘可以达到有效的控制,但哮喘的治疗和长期维持治疗所

目的 分析哮喘儿童缓解期肺功能的相关影响因素.方法 在哮喘缓解期检测肺功能提示为限制性通气功能不足的儿童中,选择5~13岁儿童30例作为研究对象(研究组);同时选择30例正常同龄儿童的肺功能检测结果 作为对照(正常组),对2组儿童肺功能有关指标进行分析.结果 经肺功能图文解读,研究组中21例(70.00%)患儿在检测过程中呼气时间短,未达到呼气平台,其中5~10岁儿童18例(85.71%),明显高于3例11~13岁的儿童(14.29%),并有显著性差异(确切概率法,P=0.0083).呼气时间不足的儿童中,肺功能肺活量、用力肺活量明显低于呼气时间足够长的儿童(t值分别为4.54、2.48,均P<0.05).结论 呼气时间不足是导致限制性通气功能不足的主要原因,哮喘缓解期儿童小气道功能可存在不同程度损害.

Objective:To discuss the diagnosis value of detection releases IFN-gamma specific-T cells in children with tuberculosis .Method: By cytokine flow cytometry(CFC)for 41cases tuberculosis,75cases latent tuberculosis infection and 20cases healthy control were tested releases IFN-gamma specific-T cells in peripheral blood meanwhile checkupTST and tuberculosis-antibody.Result:(1)By CFC,the positivity was 90.24%, negativity is 9.76%in tuberculosis cases;Healthy controls in 1 positive,explain the specificity of 95%(19/20).(2)In tuberculosis group,the positivity was 90.24% by CFC,the positivity was 70.73% by TSTand the positivity 56.10% of tuberculosis antibody test ,which compared with CFC’s positivity had statistical difference( P <0.05).(3)The positivity was 85.33% of CFC in groupLTBI,had a good concordance withTST. While the positivity was only 28% of tuberculosis antibody test in this group compared with CFC had significantly statistical difference( P <0.01).Conclusion:(1)The method of antigen-specific-T cells IFN-gamma measured by CFC has higher sensitivityand specificity than TST and tuberculosis antibody test for diagnosis of tuberculosis.(2)In the diagnosis of LTBI,CFC and TST effect is similar,but over tuberculosis antibody test.

OBJECTIVE This study aimed to investigate risk influencing factors of asthma for children in Suzhou City, China. METHODS A survey of asthma was conducted on children aged 0 - 14 with or without asthma from September 2010 to April 2011 in Pingjiang district of Suzhou city. A total of 271 children diagnosed with asthma were considered as a case group, and 271 non-asthmatic children with the same age, sex and living region formed the control group. Risk factors were analyzed with χ(2) test and logistic regression analysis. RESULTS All children were Han. The case group was composed of 165 boys and 106 girls, so was the case group. The average age was (7.5 ± 2.3) years for the case group and (7.8 ± 2.9) years for the control group, which did not showed any significant difference (P > 0.05). Family history of allergy (OR = 10.624, 95%CI: 6.294 - 18.623), history of children's eczema (OR = 4.403, 95%CI: 8.627 - 29.632), history of allergic rhinitis (OR = 6.871, 95%CI: 7.658 - 31.871), passive smoking when baby was born (OR = 3.323, 95%CI: 3.541 - 11.634), mold contamination (OR = 1.837, 95%CI: 1.531 - 4.926) were the risk factors, and breast-feeding (OR = 0.513, 95%CI: 0.418 - 0.914) was the protective factor. CONCLUSION Family history of allergy, history of children's eczema, history of allergic rhinitis, passive smoking, and old contamination are the risk factors, and breast-feeding is the protective factor.

目的了解支气管哮喘对苏州市儿童及家庭的影响。方法采用全国统一制定的儿童哮喘与过敏性疾病初筛表、0～14岁儿童哮喘调查表,在苏州市平江区筛查出540例哮喘患儿,同时调查的有关内容包括:一年最多医疗花费、患病以来总花费、对家庭的影响、对学龄儿童学习的影响、对学龄儿童体育活动的影响、家庭成员工作的影响。结果一年最多医疗费用平均为4 138元,患病以来总医疗费用平均为12 033元,有5.74%家庭认为经济不能承受,平均每例患儿每年缺课6.85 d,92.63%的患儿体育活动不受影响,缺勤天数为每户家庭每年8 d。结论急性发作对患儿和家庭带来沉重负担,控制哮喘发作,可以将其影响降到较低水平。

【Objective】 To understand the morbidity and onset of asthma in children age,inductive factors,treatment status,in order to provide better scientific basis for management of childhood asthma.【Methods】 A sample survey methods,had two steps:the first step suspected children with asthma were screened to get information,the second step:screening children with suspected had made clinical diagnosis of asthma,and the inductive factors and the treatment situation were understood in asthma children.【Results】 By 10 805 screening questionnaires 622 cases were related to wheezing,540 cases of children were clinically diagnosed with asthma,5 cases cough variant asthma and 77 cases of suspected asthma in children.Cumulative prevalence of asthma was 5%,of which male and female prevalence rates were 6.22%,3.51% respectively.1 130 cases of allergic rhinitis,the prevalence rate was 10.46%,male and female prevalence rates were 12.37%,8.13% respectively.884 cases of eczema,prevalence was 8.18%,male and female prevalence rates were 8.85%,7.35% respectively.77.17% asthma age of onset was at 3 years of age.98.23% children with asthma had application of antibiotics in acute exacerbation of asthma,59.97%with inhalation therapy in acute exacerbation of asthma inhaled therapy to maintain remission of only 8.89%.【Conclusions】 1)2010,Suzhou cumulative prevalence of asthma in children aged 0~14 is more than ten years ago.2)Onset of asthma in children over the age of 3 years of age.therefore,prevent asthma in the early.3)The majority of asthma treatment is not standardized,new knowledge,new drug must education in correct treatment for asthms.

Objective To explore the relationship between Natural killer cells and Mycoplasma pneumoniae pneumonia(MPP) by detecting the Natural killer cells in children with MPP,to learn the main clinical features of MPP and to discuss the effects of transfer factors on Natural killer cells.Methods Collecting sixty cases of MPP children′s symptoms and chest X-ray performance by consulting history and doing retrospectively analyze.Adopting flow cytometry analysis technology to detect peripheral Natural killer cell percentage of sixty MPP cases,thirty cases of healthy children as control.Sixty MPP children were divided into two groups,MPP treatment group took azithromycin and transfer factors,and the control group only took azithromycin,and dose and duration were the same.Results The percentage of Natural killer cells in Mycoplasma pneumoniae pneumonia group was lower than that of the control group(P0.01).The percentage of Natural killer cells in MPP treatment group after the intervention increased more significantly(P0.01).Conclusion Cough and fever are the major clinical traits of Mycoplasma pneumoniae pneumonia and the chest X-ray changes is mainly for the lobar pneumonia.The Natural killer cell′s function in children with Mycoplasma pneumoniae pneumonia is lower than that in the healthy children,and transfer factors can improve Natural killer cell′s quantity,enhance cellular immune function.

<正>呼吸道合胞病毒(RSV)是引起婴幼儿冬季下呼吸道感染的最重要和常见病原,可表现为咳嗽、喘息、气促,临床上6个月以内婴儿的毛细支气管炎以及年幼儿RSV肺炎可威胁生命。除年龄外,其他高危因素如先天性心脏病伴有肺动脉高压或慢性肺疾患、早产、早产伴支气管肺发育不良均可增加RSV感染的严重度和死亡率[1]。另外,RSV感染引起的毛

Objective To analyze the changes of T lymphocyte subsets,B lymphocyte and NK cells in pneumonia children infected by parainfluenza virus types 3(PIV3).Methods Multi-pathogen detection using direct fluorescence antibody test(DFA),clear etiology diagnosis.T lymphocyte subsets,B lymphocyte and NK cells in peripheral blood in part of patients were examined by flow cytometry.Results In,There was no significant difference in CD3+T,CD4+T,CD8+T cells and CD19+B cells between the patients with PIV3 pneumonia and the controls.But the ratio of NK cells were lower in group PIV3 than those in the controls(P0.05).In contrast,the ratio of CD4+/CD8+ increase in group PIV3 than those in the controls(P0.05).Conclusion Parainfluenza virus types 3(PIV3)cases of pneumonia children cellular immune disorders.

目的探讨婴儿支气管肺炎与胃扭转的关系。方法回顾性分析婴儿肺炎合并胃扭转23例病例资料,总结诊断及治疗要点。结果肺炎合并胃扭转者予以体位疗法,可缓解抗生素治疗效果不佳的肺炎患儿症状。结论肺炎患儿病程较长且抗感染等治疗效果不理想、平素吐奶较频繁者应及时行上消化道钡餐检查,以明确是否合并胃扭转,予以相应体位疗法可缓解临床症状。

Objective To explore the effect of azithromycin on the airway inflammation in children with bronchiolitis by detecting the se-rum concentration change of the eosinophile cationic protein(ECP),interleukin-8(IL-8) and nitrogen oxide(NO) in children.Methods One hundred and eighty-five cases of primary asthmatic attack with atopy subject were collected,and they were divided into 4 groups after asthmatic symptoms relived,group A oraled azithromycin,group B inhaled budesonide,group C oraled montelukast,and blank control was group D.The vein bloods were sampled on the first day in hospital,before and after medication,respectively when treatment of 3 months was completed.Serum concentration of ECP,IL-8 and NO were measured.They were followed up through clinic service and telephone analysis for 1 year.Analysis of all data was conduced with SPSS 15.0 sofware.Results The cases of asthma recurrence within 3 months and asthmatic recurrence within 1 year were no statistical difference between group A and group B,group C and group D,respectively.After 3 months intervention,there was significant difference of the serum concentration of ECP,IL-8 and NO at the 3 treatment groups compared with group D.There was no significant difference in decrease of ECP and NO in group A and group B,but decrease of ECP and NO in group C were significant compared with those in group A(Pa0.01).The serum concentration of IL-8 in each group was obviously decreased especially in group A.Statistical difference was obvious between group A and group B,group C(Pa0.01).Conclusions The medication of azithromycin may result to decrease the serum concentration of ECP and NO,especially for IL-8 in bronchiolitis.There is some valid contribution of azithromycin actting on the airway inflammation in bronchiolitis in our investigation.

Objective To discuss the effect of azithromycin on the airway inflammation in children at high risk for asthma by detecting the serum concentration change of eosinophil cationic protein(ECP), intedeukin-8(IL-8) and nitrogen oxide(NO), and also to explore the effect of azithromycin on secondary prevention of asthma. Methods Two hundred and twenty three cases of primary asthmatic attack with atopy (eczema, family asthmatic history) were collected and divided into four groups(group A, B,C,D) after asthmatic symptoms relief, group A was taken orally with azithromycin(5mg/kg Biw), group B was inhaled budesonide(0.5mg Bid), group C was taken orally with singulair (4mg qN),and group D was only given with symptomatic treatment. The vein blood was sampled on the first day in hospital, before and after medication respectively when treatment of three months was completed. Serum concentration of ECP and IL-8 was obtained by ELISA methods, and NO was measured by nitric acid enzyme reduction method. Clinic service and telephone follow-up was taken for one year. Results After three monthes intervention, there was significant difference in the serum concentration of ECP, IL-8 and NO at group A, B, C compared with group D( P<0.01 ). There was no significant difference in decrease of ECP and NO between group A and B( P > 0.05), but decrease of ECP and NO in group C was significant difference compared with group A( P<0.01). The serum concentration of IL-8 in each group was obviously decreased especially in group A, and difference was obvious between group A and group B,C( P<0.01). There was no significant difference in the cases of asthma recurrence within three months and asthmatic recurrence within one year between group A and group B, group C and group D respectively. Conchlsions (1)The medication of azithromycin might result to decrease the serum concentration of ECP and NO, especially for IL-8 in children at high risk for asthma. (2)The effects of azithromycin on change of ECP and NO in children at high risk for asthma were similar to budesonide, but different with montelukast, while the inhabitant effects of IL-8 were different with inhaled steroid hormone and leukotriene receptor obviously. (3)There was some valid contribution of azithromycin actting on the secondary prevention of asthma in our investigation.

Objective To explore the effect of montelukast on the treatment of airway inflammation in bronchiolitis after respiratory syncytial virus (RSV) infection by studying the clinical manifestations and changes of serum concentration of inflammatory cellular factors including eosinophil cationic protein (ECP), interleukin-8 (IL-8), and nitrogen monoxide (NO). Methods 142 infants with bronchiolitis caused by primary infection of RSV associated with atopy (eczema, family asthmatic history) were recruited in the study and they were randomly divided into three groups after alleviation of asthmatic symptoms (group A was designated as oral intake of montelukast, group B as inhaled budesonide, and group C as blank control) . Blood samples were collected on the first day on admission, before treatment, 3 months after medication. Serum concentration of ECP, IL-8, and NO were measured. Follow up was done for one year. Statistical analysis was conducted with SPSS15.0 software package. Results The differences in patients with recurrence of asthma within 3 months and recurrence within one year between groups A and group C were significant, while the differences between group B and group C were not significant. The reduction of ECP and NO in group A were significant in comparison with group B. There was no statistical difference in serum level of IL-8 between group A and group B. Conclusions Montelukast might decrease the serum concentrations of ECP, NO, and IL-8 and it may play a role in the prevention of asthma.

Objective To explore the value of electronic bronchoscopy for children with atelectasis and emphysema. Methods 31 cases with atelectasis and 35 with emphysema were examined and treated by electronic bronchoscopy and bronchoalveolar lavage. Results In 31 cases with atelectasis, 24 cases were caused by inflammation (77.4%), which was the most common cause, followed by tracheobronchomalacia and bronch deformity n=5;(16.2%). 1 case had granuloma and 1 had tumour. In 35 cases with emphysema, 22 cases were caused by inflammation (62.9%), which was the most common cause, followed by foreign body n=7;(20%), tracheobronchomalacia n=5;(14.3%). Foreign body was most commonly seen in children during 1～3 years. 1 case had tumour. 19 of 24 cases had infection-associated atelectasis, showing re-expansion and were treated by bronchoalveolar lavage. Conclusion Inflammation is the most common cause of atelectasis and emphysema in children, followed by foreign body, tracheobronchomalacia and bronch deformity. Electronic bronchoscopy is effective in the diagnosis and treatment of atelectasis and emphysema in children.

Objective To explore the causes of misdiagnosis and missed diagnosis of mediastinal tumor in children.Methods The clinical data of 25 children with mediastinal tumor in the Children's Hospital affiliated to Soochow University was analyzed retrospectively.Results These illnesses which led to mediastinal tumor included teratoma(10),lymphoma(7),neuroblastoma(4),thymoma(3),and neurofibroma(1).Most cases were misdiagnosed as pneumonia because of repeated coughing,wheezing,and fever.Conclusion The causes of their misdiagnosis and missed diagnosis were that their manifestations were not typical or were covered by pneumonia,as well as inadequate understanding by clinicians where their chest X-ray film,and CT do not attract enough attention.Therefore clinicians should be on high alert to do the corresponding inspection as early as possible to confirm the diagnosis.

目的探讨咳嗽变异性哮喘(CVA)和过敏因素之间的相互关系。方法对116例CVA患儿、68名健康儿童选择常见的17种过敏原进行皮肤点刺实验。结果一种以上过敏原阳性率,CVA组为80.17%,健康儿童组为35.29%,两组相比,差异有高度统计学意义(P<0.01);而其中12种过敏原的阳性检出率两组之间的差异均有统计学意义(P<0.05或<0.01)。结论CVA与过敏因素关系密切;可用过敏原点刺方法作为病因辅助诊断,并有效避免过敏原的刺激。

目的通过检测炎性因子嗜酸性粒细胞阳离子蛋白(ECP)、白介素-8(IL-8)、一氧化氮(NO)的变化探讨顺尔宁对哮喘高危儿气道炎症的影响。探讨顺尔宁对哮喘二级预防的作用。方法选择初次喘息发作具有特应性体质的毛细支气管炎患儿共166例,常规治疗症状控制后随机分成4组:A组顺尔宁口服,B组普米克氧喷,C组空白对照,分别在住院当日、干预前、干预后3个月抽取静脉血,检测血清中ECP、IL-8、NO的浓度,临床门诊及电话随访1年。SPSS15.0软件包统计分析。结果3个月内喘息再次发作人数及1年后哮喘发生情况,顺尔宁组与空白对照组比较有统计学差异。用药后ECP及NO下降水平,顺尔宁组幅度较大与普米克组比较有统计学差异;IL-8下降水平,二者比较无统计学差异。结论顺尔宁对哮喘二级预防具有一定临床意义。

Objective To analyse the virus pathogens that caused children hospitalized with acute respiratory infection in Suzhou from Dec,2005 to Nov,2006.Methods Patients,suffering from acute respiratory tract infec-tion who were admitted to the Children’s Hospital,Affliated to Suzhou University from december 2005 to november 2006 were chosen.The 7 common respiratory viruses,including respiratory syncitial virus(RSV),adenovirus,influnenza A and B,and Parainfluenza 1,2,3,were detected by using direct immunofluenscene viral antigen rapid diagnosis in nasopharygeal aspirate(NPS) of these children.Result Among the all 1,456 samples,546(37.5%) was shown to be viral positive. Of the 1,456 samples ,RSV accounted for 457(83.7%),ADV 32(5.9%),InfA 31(5.7%),InfB 14 (2.6%),PinfⅠ 10(1.8%),PinfⅡ3(0.5%),PinfⅢ 1(0.2%).The peak season of RSV infection was between No-vember and February.Most of infection cases were less than 2 years old.The ratio of male of female was 1.70:1. Conclusion RSV infection is dominant in ARI in Suzhou.