目的 分析住院腺病毒肺炎患儿选择纤维支气管镜检查和治疗的影响因素.方法 回顾性分析114例住院腺病毒感染肺炎患儿临床资料.其中,23例实施了纤维支气管镜检查和治疗(气管镜组),91例未行支气管镜检查(非气管镜组).分析影响实施纤维支气管镜检查和治疗的因素.结果 两组患儿性别构成比、年龄、发热、咳嗽及喘息的发生率比较均无统计学意义(P＞0.05).Logistic回归分析显示,入院诊断为重症肺炎、住院时间长、CD19+比例高为住院腺病毒肺炎患儿实施纤维支气管镜检查和治疗的影响因素(P＜0.05).结论 住院腺病毒感染肺炎患儿诊治中,对重症肺炎和CD19+比例异常增高者需要考虑实施纤维支气管镜检查和治疗.

Background Chronic cough is a common symptom in children. We wished to explore the value of fractional exhaled nitric oxide (FeNO) for cough-variant asthma (CVA) in children with chronic cough. Methods This prospective cohort study was conducted in the Children's Hospital of Soochow University from January 2012 to December 2014. Children aged 6-14 years with a cough of duration >4 weeks were enrolled. They underwent FeNO measurement, sputum cytology and pulmonary function tests. Results A total of 115 patients and 25 healthy controls were evaluated. For the diagnosis of CVA, the optimal FeNO cutoff value was 25 ppb with a sensitivity of 84.0%, specificity of 97.1%, positive predictive value of 97.5%, and negative predictive of being 81.4%. The FeNO level had a significant correlation with eosinophil count in sputum (P<0.05). FeNO level in CVA was decreased significantly after treatment (P=0.001). Conclusions In children, FeNO measurement might be an excellent method for diagnosing CVA with high sensitivity and specificity.

Objective To investigate the clinical features of human parainfluenza virus type 3 ( HPIV3 ) in-fection in Suzhou area. Methods From January 2013 to December 2013, the respiratory sputum was collected from 2298 patients with acute infections. Direct immunofluorescence was applied to test parainfluenza virus (1~3), influ-enza virus A and B, respiratory syncytial virus ( RSV) and adenovirus. DNA of HBoV was tested by real-time PCR, and RNA of human metapneumovirus and human rhinovirus was tested by reverse-transcription. The epidemiology and clinical features of patients with HPIV3 infection were analyzed and compared with those RSV infection. Results The positive rate of virus was 42. 78% (983 cases), the positive rate of HPIV3 was 4. 26% (98 cases), and 10. 14% of postive ferior RSV (233 cases). HPIV3 infection could occur all the year around but most seen in spring and summer, with the highest incidence of 45. 92% in summer. The highest detection rate (60. 20%) occurred in pa-tients aged from 1 to 12 months, almost younger than 6 years old. 61 cases were the only pathogen of HPIV3. Cough (96. 72%), wheezing (44. 26%) and fever (47. 54%) were more common in patients with HPIV3. The percentage of bronchopneumonia caused by HPIV3 infection was 80. 33%. Compared with RSV infection, HPIV3 had a less in-cidence of wheezing (P<0. 05). Conclusion HPIV3 is one of the most importment viral pathogens in children with respiratory infection in Suzhou area. Infection can be caused by HPIV3 only. The occurrences of season and clinical feature of HPIV3 infection are difference with RSV infection.

The role of Toll-like receptor (TLR) 2 in modulating allergy-induced asthma is contradictory. We investigated the effect of TLR2 gene deletion in a murine model of ovalbumin (OVA)-challenged asthma. TLR2 wild-type (TLR2(+/+)) and TLR2-deficient (TLR2(-/-)) mice were sensitized to soluble OVA antigens and challenged with OVA, and the extent of allergic airways disease was analyzed in both groups of mice at day 8 after being challenged with OVA aerosol. At day 8 post-OVA, TLR2(-/-) mice exhibited significantly lower airway hyperresponsiveness, airway inflammation, and whole lung T-helper type 2 (Th2) cytokine levels compared with the TLR2(+/+) group. TLR2 deletion also significantly reduced mucus cell metaplasia and peribronchial fibrosis in mice at day 8 after challenged by OVA. The p38/AKT/nuclear factor kappaB (NF-kappaB) p65 and phosphate extracellular signal-regulated kinase (ERK)/p38/AKT was decreased in TLR2(-/-) mouse lungs. Thus, during OVA asthma in mice, TLR2 is a major contributor to the maintenance of the adaptive Th2-cytokine-driven inflammatory disorder and ERK/p38 as well as AKT/NF-κB playing a role in it.

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.

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.

Objective To approach variance of cellular immunological function of hand-foot-mouth disease(HFMD)with enterovirus 71(EV71)in children.Methods A total of 90 confirmed cases with EV71 infection,from January 2011 to June 2011,were divided into two groups,severe group and common group.They were diagnosed according to the criteria of the Center for Disease Control and Prevention of China.Indirect inguinal hernia was selected as control group.Their cellular immunity functions were tested with flow cytometry.Results Percentage of CD3+,CD3+CD4+ and CD3-CD16+CD56+ subsets decreased obviously in severe group and common group,concurrently,severe group lower than common group(P 0.05).Percentage of CD3-CD19+,CD19+CD23+ subsets significantly increased in severe and common groups,compared with control group(P 0.05).Conclusions EV71 infection has obvious disorder in their cellular immunity function.CD3+,CD3+CD4+,CD3-CD16+CD56+ can be selected as index of severe HFMD.

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.

目的:探讨EV71、COXA16手足口病发病的临床特征、并发症、免疫功能,为临床治疗手足口病提供参考。方法:回顾性分析2010年7月至2011年6月苏州大学附属儿童医院139例EV71、COXA16手足口病患儿的临床特点、生化指标、免疫功能、WBC、CRP。结果:两组病例发病年龄、呼吸道症状、血糖、WBC、肝功能、心酶谱、IgA、IgG、CD3+CD8+、CD4+/CD8+T细胞百分比、NK差异无统计学意义(P>0.05);口腔损害、并发脑炎、皮疹数量、CRP、IgM、CD3+、CD3+CD4+、CD3-CD19+、CD19+CD23+、CD4+CD25+T细胞百分比差异有统计学意义(P<0.05)。结论:EV71手足口病重症率较高,细胞免疫功能紊乱更明显。

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.