目的 总结哮喘患儿的临床特点,发现诊治过程中新的问题,不断提高临床诊治水平.方法 回顾性分析2017年4月至2021年4月于我院儿童哮喘门诊确诊为哮喘的101例患儿,对其性别、年龄、初次喘息年龄、平均每年喘息次数、既往治疗情况、个人及家族过敏史、过敏原、临床表现、肺功能结果进行描述性分析.结果 101例患儿中,男76例(75.2％),女25例(24.8％);初次喘息年龄≤3岁患儿43例(42.6％);初次就诊6～14岁60例(59.4％);哮喘患儿每年喘息发作次数1～3次40例(39.6％).101例患儿中,有过敏性疾病家族史83例(82.2％),合并过敏性鼻炎81例(80.2％),有慢性咳嗽史70例(69.3％).72例过敏原检测提示,主要以吸入性过敏原为主,其中粉尘螨过敏居首27例(37.5％);肺功能检测结果第一秒用力呼气量(FEV1):(80.9±16.9)％,1秒率(FEV1/FVC):(96.6±10.9)％,用力呼出75％肺活量的呼气流量(FEF75):(56.3±22.6)％,用力呼出50％肺活量的呼气流量(FEF50):(61.2±18.8)％,最大呼气中段流量(MMEF):(61.1±19.5)％.对异常肺功能结果分析能够提示小气道功能异常的主要指标:MMEF、FEF50、FEF75.结论 要重视婴幼儿哮喘,确诊后要尽早治疗,以减少学龄期哮喘发作;反映小气道功能的指标如MMEF、FEF50、FEF75在儿童哮喘的早期诊断中有非常重要的作用,也可作为辅助诊断儿童非典型哮喘的敏感指标.

目的 总结13例侵袭性真菌感染(IFI)患儿的临床特点、感染菌种及有效治疗方法.方法 对13例IFI新生儿的临床资料进行回顾性分析,总结其临床特点、感染菌种及有效治疗方法.结果 13例患儿均为早产儿,以极低出生体重儿(VLBW)为主10例,存在广谱抗生素应用史13例,侵袭性检查治疗操作气管插管5例、中心静脉置管7例,发生真菌败血症时间(16.6±6.1)天,临床表现为刺激反应弱12例、呼吸暂停9例、心率增快6例、肤色发花7例,8例患儿发病时间为夏季.真菌培养结果13例中感染热带假丝酵母菌6例、白假丝酵母菌5例、近平滑假丝酵母菌1例、光滑假丝酵母菌1例.氟康唑治疗后13例患儿症状均减轻,后均好转出院.结论 VLBW容易发生IFI,存在抗生素应用、侵袭性检查治疗操作的新生儿好发IFI,IFI好发于夏季,缺乏典型临床表现.真菌培养是确诊IFI的主要方法,IFI主要为热带假丝酵母菌、白假丝酵母菌感染.氟康唑治疗新生儿IFI效果较好.

Objective To investigate the contribution of IL-8,IL-10 and IFN-to the immunology pathogenesis and to find the significant cytokines to direct the clinical management.Methods The serum levels of IL-8,IL-10 and IFN-in 34 patients at acute stage and in 30 patients at convalescence stage and in 20 age-and sex-matched control subjects were determined by the method of ELISA.Results The serum levels of IL-8 in patients at acute stage and at convalescence stage were significantly higher than that of control group(P<0.05,P<0.01),and the level at convalescence stage was significantly higher than those at acute stage(P<0.01).The serum level of IFN-at acute stage was significantly higher than those at convalescence stage and than that of the control group(P<0.01).The serum level of IL-10 at acute stage was Lower than those at convalescence stage and that of control group(P<0.05,P<0.01).The serum level of IFN-in severe cases at acute stage was higher than those in mild cases(P<0.05),and the level of IL-10 was lower than those in mild cases(P<0.05).Conclusion IL-8 and IFN-participate in the onset of MPP.The serum level of IL-10 declines temporarily at acute stage.The serum levels of IFN-and IL-10 at acute stage play a significant role in indicating the patient's conditions.

Objectives To identify the risk factors for the sequelae in children with Mycoplasma pneumoniae pneumonia(MPP)and thus provide instructions for the clinical therapy to minimize risk of the sequelae. Methods The clinical data of 1705 children with MPP were retrospectively reviewed from Jan. 2002 to Oct. 2006 in Beijing Children's Hospital. Based on the findings of X-ray and/or the CT scan,the subjects were divided into two groups,the sequelae group(144 cases)and the control group(190 cases). The comparison was made between two groups in age,gender,fever,wheeze,pleural effusion,complication diseases,the manifestation of pneumonia on X-ran and/or CT scan,white blood cell count(WBC),erythrocyte sedimentation rate(ESR),and C reaction protein(CRP). If the results of single factor regression showed P 0.2,the indicators were analyzed by the multifactor logistic regression. Results The results of logistic regression indicated that the independent risk factors included fever lasting more than 10 days(P 0.05,OR = 1.987),pleural effusion(P 0.01,OR = 7.724),location of the pneumonia at the right upper lung(P 0.01,OR = 3.547),the large patchy shadow(P 0.01,OR = 2.009),and complication diseases(P 0.05,OR = 2.232). Pleural effusion was the most important factor. Conclusions Fever,pleural effusion,complication diseases,location of the pneumonia,and the pattern of radiography are factors associated with the sequelae.

By understanding the connotation of ecological city,we extract the concept of ecological region.This article makes the county-territory as the epitome of the region and uses the master plan of Xiangshan County-territory as a example,to find a ecological plan method fits for all regions.