Archive

06 March 2017, Volume 32 Issue 3 Previous Issue    Next Issue

---

For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

Select

Diagnosis and treatment in children with acute tonsillitis：clinical practice guideline（2016） Ear-nose-throat Expert Committee，Pediatrician Branch，Chinese Medical Doctor Association 2017, 32(3): 161-164.  DOI: 10.19538/j.ek2017030601 Abstract ( )

Select

Paying attention to standardized diagnosis and treatment of pleural effusion ZHAO Shun-ying*，LU Quan 2017, 32(3): 165-167.  DOI: 10.19538/j.ek2017030602 Abstract ( )   Pleural effusion has high morbidity among hospitalized children. The mainstays of treatment are to establish an early diagnosis. Because the causes of pleural effusion are complex，the management of pleural effusion is very challenging and varies with causes. The review presents the approach to pleural effusion，including etiology，fluid analysis and managment. Pediatricians should be aware that pleural effusion is only the starting point of diagnosis and differential diagnosis，it is more important to find the cause，and clear etiology will result in effective and precise treatment.

Select

Recognition and treatment of empyema in children ZHAO De-yu，GU Li-na 2017, 32(3): 168-171.  DOI: 10.19538/j.ek2017030603 Abstract ( )   Empyema is a kind of common infectious disease， more common in infants and young children. Because of the different etiology，pathogenic bacteria and parts，pediatric empyema has more characteristics compared with adults, such as rapid progress and dangerous course. If not handled properly, empyema in children will lead to more complications. Therefore, clinicians need to identify the characteristics of empyeme earlier, make accurate diagnosis according to the pathological stage and perform timely and effective treatment.

Select

Diagnosis and treatment of pleural effusion caused by mycoplasma pneumoniae in children ZHENG Bao-ying, CAO Ling 2017, 32(3): 171-174.  DOI: 10.19538/j.ek2017030604 Abstract ( )   Mycoplasma pneumoniae is one of the most important pathogens causing community-acquired pneumonia in children. About 4%-20% of the M.pneumoniae -associated pneumonia are complicated by pleural effusion. The M.pneumoniae infection can lead to inflamation of pleura through direct damage and indirect injury. The pleural effusion caused by M.pneumoniae can disappear after the treatment with antibiotics and glucocorticoids；thoracentesis can be carried out to deal with large amount of pleural effusion，for which use of chest tube drainage and surgical intervention are rarely used.

Select

Diagnosis and treatment of tuberculous pleural effusion in children LI Hui-min，ZHAO Shun-ying 2017, 32(3): 174-177.  DOI: 10.19538/j.ek2017030605 Abstract ( )   The pathogenesis of tuberculous pleural effusion（TPE） is mainly due to pleural delayed hypersensitivity to mycobacterial protein. The diagnosis of TPE  is largely based on age，clinical manifestations，chest imaging features，a history of contact with tuberculosis，tuberculin skin test，pleural fluid analysis and microbiology. The treatment of TPE is mainly through the use of antituberculous drugs. Therapeutic thoracentesis should be used and corticosteroids can be added for massive tuberculous pleural effusion.

Select

Diagnosis and treatment of malignant pleural effusion ZHANG Bing-yu，JIN Run-ming 2017, 32(3): 178-181.  DOI: 10.19538/j.ek2017030606 Abstract ( )   Pleural effusions usually arise as underlying disease processes，including heart failure，infection, malignancy，etc. Malignant pleural effusions（MPEs）are caused by malignant tumors. Our understanding of MPEs，including diagnosis and treatment，has made tremendous progress. Specific molecular marker detection，risk stratification，and thoracic catheterization may develop progressively and may become the standard of care in the future. Progress in the diagnosis and treatment of malignant pleural effusion has brought new hope to the clinical work.

Select

Parasitic infections involving the pleura ZOU Ying-xue 2017, 32(3): 181-186.  DOI: 10.19538/j.ek2017030607 Abstract ( )   Parasitic infections are prevalent in the world and may cause pleural involvement，which often goes unrecognized. With the rapid development of transportation，some regional epidemic parasitic infections have broken through the geographical restrictions，becoming very common and a serious threat to human health. Common parasites involving the pleura include Entamoeba histolytica，Echinococcus granulosus and Paragonimus westermani. Parasitic infection can cause reactive pleural effusions，empyema，bronchopleural fistula，and pleural thickening and pneumothorax. This article provides a comprehensive review of parasitic diseases of the pleura. A high index of suspicion in the appropriate clinical setting is required to facilitate prompt diagnosis and treatment of these diseases.

Select

Diagnosis and treatment of chylous hydrothorax LIU Jin-rong*，ZHAO Shun-ying，SHEN Wen-bin 2017, 32(3): 186-190.  DOI: 10.19538/j.ek2017030608 Abstract ( )   Chylous hydrothorax is a relatively rare cause of pleural effusion in children. The common reason is primary lymphatic diseases such as congenital chylothorax and lymphangiomatosis，which have a high death rate. Conservative treatment is important including alimentary control，such as a fat-free diet with the addition of medium-chain triglycerides and total parenteral nutrition，somatostatin and octreotide，which reduce lymphatic fluid production and lymphatic flow. Surgical treatment is recommended，such as ligation of thoracic duct and pleurodes，when conservative treatment fails.

Select

Value of thoracoscopy in the diagnosis of pleural effusion MENG Chen 2017, 32(3): 190-193.  DOI: 10.19538/j.ek2017030609 Abstract ( )   Pleural effusion is common in pediatric respiratory disease. In most of the patients etiology could be identified by routine examinations，however，thoracoscopy is necessary in a few patients. Thoracoscopy makes it possible to observe lesions in pulmonary parenchyma and pleura directly and also get better biopsy，thus a majority of unexplained pleural could be diagnosed clearly. Pediatric thoracoscopy has been developing very fast in the past few years. Here we report our experience by referring to literature.

Select

Clinical significance of indicators detection in pleural effusions DAI Bing，CAI Xu-xu 2017, 32(3): 193-198.  DOI: 10.19538/j.ek2017030610 Abstract ( )   Pleural effusion is one of the most common complications during the progression of some diseases，and its mobidity has been increasing for the past few years. Etiology of pleural effusion is diverse. Laboratory examinations of pleural fluid include routine，cytology,biochemistry，immunology and microbiology examination. Infecton is the major cause of pleural effusion in children. As a result，there are many molecular microbiological detection techniques for infectious pleural effusion in recent years，e.g，polymerase chain reaction，nucleic acid amplification technique. Novel biomarkers have also emerged，including procalcitonin，C reactive protein，pentraxin-3 and aromatic amino acid，et al，which can be used to distinguish parapneumonic effusion，tuberculous pleural effusion or malignant pleural effusion. Routine laboratory examinations and these novel technologies or biomarkers need to be appropriately evaluated and compared，hoping that with those indicators clinicians could  benefit in the early etiological diagnosis，and the appropriate therapeutic approaches to prevent deterioration and improve prognosis.

Select

Comparing the measurements of exhaled nitric oxide of the children from 3 to 5 years old during tidal breathing LI Xiao-dan，DENG Li，CHEN Fang，et al 2017, 32(3): 199-203.  DOI: 10.19538/j.ek2017030611 Abstract ( )   Objective　To compare the FeNO（Fractional exhaled nitric oxide，FeNO）of the children 3-5 years old by facemask with that by mouthpieces during tidal breathing，and to analyze the applicative value of the measurement for the children 3 to 5 years old. Methods　From Junuary 2016 to August 2016，the children who came to Guangzhou Women’s and Children’s Medical Center to take the FeNO experiment were selected as the research subjects. During tidal breathing，children used the facemask to cover their nose and mouth to breath，or word the nose clip and used the mouthpieces to breath during the FeNO test. After the test，the clinical data were summarized and analyzed. Results　The cases，which have no coughing and wheezing symptoms，whether with rhinitis or not，currently using the mouthpieces to measure the FeNO，were fewer than which using the facemask. The result of using mouthpieces and facemask to test in children with rhinitis was （7.8±10.6） ×10-9 vs. （15.8±9.9） ×10-9  and，without rhinitis it was （5.0±4.5） ×10-9 vs. （14.0±10.0） ×10-9 respectively，P＜0.05. The children having coughing or wheezing symptoms，whether with rhinitis or not，using the mouthpieces to measure the FeNO， was fewer than those using the facemask. The result of using mouthpieces and facemask to test in children with rhinitis was 6.1×10-9［（2.1～16.3） ×10-9 vs. 11.6×10-9［（4.1～26.5） ×10-9］  and in those without rhinitis it was 4.6×10-9［（1.9～9.9） ×10-9］ vs. 11.5×10-9［（6.5～25.8） ×10-9］ respectively，P＜0.05. All of them were statistically different. Conclusion　When we measure the FeNO in children from 3 to 5 years old during tidal breathing，breathing through the mouthpieces can reflect the airway inflammation better.

Select

Application of 24-hour oropharyngeal pH monitoring in children with suspected laryngopharyngeal re?ux WANG Wen-jian，HUANG Lu，ZHENG Yue-jie 2017, 32(3): 204-208.  DOI: 10.19538/j.ek2017030612 Abstract ( )   Objective　To explore the application of oropharyngeal pH-monitoring in diagnosis for children with suspected LPR-related respiratory symptoms. Methods　Children suffering from airway-related problems with suspected LPR between October 2015 and February 2016 were included in this descriptive qualitative study. All subjects underwent oropharyngeal 24-hour pH-monitoring. The positive rate of RYAN index，demographic data，distribution of clinical presentation and initial diagnosis among the positive LPR patients were analyzed. Results　The study included 76 subjects with the age range between 1 month and 12 years old with a mean age of 4.9 years old. All patients successfully completed 24-hour of pH recording and the positive rate of RYAN index was 39.5%（30/76），LPR in younger group was higher than that in the older group. Some LPR patients treated with omeprazole reported RYAN index negtive after 8 weeks of follow-ups. LPR-related presentation included chronic cough，wheezing，snore，hoarseness，throat clearing，choking sucking， foaming at the mouth，stridor，shortness of breath， facial cyanosis and nasal obstruction. Meanwhile， those patients were mostly diagnosed with airway diseases，such as pneumonia，sinusitis and rhinitis，laryngomalacia，pharyngitis，asthmatic bronchitis，adenoid hypertrophy，etc. Conclusion　Clinical manifestations of LPR are nonspecific and  may lead to misdiagnosis. Being minimally invasive and easy for operation，oropharyngeal 24-Hour pH-monitoring can be conducted for children at all ages，and may be considered as the standards for diagnosis of pediatric laryngopharyngeal reflux.

Select

Diagnostic roles of methylene blue test observed by bronchoscopy in congenital tracheoesophageal fistulas in children BAO Yan-min，LI Jing，ZHAO Hai-xia，et al 2017, 32(3): 209-214.  DOI: 10.19538/j.ek2017030613 Abstract ( )   Objective    To assess retrospectively the diagnostic roles of methylene blue test observed by bronchoscopy in congenital tracheoesophageal fistulas（TEFs） in children. Methods    We collected the clinical data of 5 patients，two of whom were diagnosed with congenital H-TEF and three of whom were diagnosed with recurrent TEF（rTEF） over the past 8 months in Shenzhen Children’s Hospital. We respectively analysed and compared the results of contrast esophagography，regular bronchoscopy，methylene blue test observed by bronchoscopy and chest MDCT，all of which were performed on the above 5 patients. Results    Each of these five cases was observed by bronschoscopy that methylene blue came out from the fistula of the trachea when methylene blue was injected into esophagus. Although all cases were examined by regular bronchoscopy，two recurrent TEFs cases weren’t found the fistulas. Four cases were examined by contrast esophagography，but only one rTEF case was diagnosed. None of these 4 cases could be diagnosed by the results of chest MDCT，but air trapping in the lower esophagus could be seen in chest MDCT in these cases. Conclusion    Methylene blue test observed by bronchoscopy is reliable in the diagnosis of congenital TEFs in children，which is the first recommendation. Both of esophagography and regular bronchoscopy can miss the diagnosis in congenital TEFs in children. The diagnostic value of MDCT is limited for this disease，but air trapping in the lower esophagus in MDCT implicates the possibility of congenital TEFs.

Select

Clinical analysis of 46 cases of Prader-Willi syndrome LI Jie-ling，CAO Jie 2017, 32(3): 215-219.  DOI: 10.19538/j.ek2017030614 Abstract ( )   Objective　To study clinical features and diagnostic means of children with Prader-Willi syndrome（PWS） from neonatal period to adolescence. Methods　Conduct retrospective analysis of clinical characteristics and genetic testing results of children with PWS in Children’s Hospital of Chongqing Medical University from January 2010 to January 2016. Results　Totally 46 children with PWS were chosen，28 male，18 female，the ratio of male to female being 3∶2；the age of children receiving medication for the first time ranges from birth to 9 years old；the age of diagnosed children ranges from 14 days to 14 years，and the longest course of PWS had lasted for 9 years. The main clinical manifestations included hypotonia（28 cases，60%），feeding difficulties（20 cases，44%），low crying（18 cases，40%），disturbance of intelligence（42 cases，92%），obesity（25 cases，55%） and microsomia（26 cases，57%），etc. Different ages showed different performances：newborns（0-28 days） mainly had hypotonia，weak crying，poor suck；infants（29 days-1 year） mainly showed backward motor development，hypotonia，weak crying，poor suck，special facial features and skin hypopigmentation etc.；babies（1-3 years） mainly showed backward motor and intelligent development，hypotonia and skin hypopigmentation etc. Children（＞3 years） mainly showed backward intelligent development，bulimia，obesity，microsomia and agenosomia（incomplete sextual development）. Among the samples，44 cases were 15q11-13 region deletion of paternal origin of the genetic material（96%），whilst 2 cases were uniparental disomy of maternal origin of the genetic material（4%）. Conclusion　As different children with PWS show different clinical manifestations，earlier genetic testing is  beneficial to the early diagnosis.

Select

Analysis of the health-related quality of life in children with short stature QIAO Jian-min，ZHANG Mei，SUN Hai-ling，et al 2017, 32(3): 220-222.  DOI: 10.19538/j.ek20170306015 Abstract ( )

Select

Clinical analysis of five cases of tuberculous pleurisy in children YU Mei，ZOU Ying-xue，MA Cui-an，et al 2017, 32(3): 223-226.  DOI: 10.19538/j.ek20170306016 Abstract ( )

Select

Analysis of the causes and clinical features of pleural effusion in 177 children ZHANG Yi，CAO Ling，ZHU Chun-mei，et al 2017, 32(3): 227-229.  DOI: 10.19538/j.ek2017030617 Abstract ( )

Select

Fever，cough，chest pain XU Hui，ZHAO Shun-ying 2017, 32(3): 230-233.  DOI: 10.19538/j.ek2017030618 Abstract ( )

Select

Research progress in the pathogenesis of mycoplasma pneumoniae pneumonia YU Li-li, ZHAO De-yu 2017, 32(3): 234-238.  DOI: 10.19538/j.ek2017030619 Abstract ( )

Select

Report of 2 cases of pleural effusion in children of rare causes LI Jiao, ZOU Ying-xue, GUO Yong-sheng, et al 2017, 32(3): 239-240.  DOI: 10.19538/j.ek2017030620 Abstract ( )