Archive

06 June 2019, Volume 34 Issue 6 Previous Issue    Next Issue

---

For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

Select

Expert consensus on the interventional diagnosis and treatment with respiratory endoscope in children with refractory pneumonia in China 2019, 34(6): 449-457.  DOI: 10.19538/j.ek2019060601 Abstract ( )

Select

Expert guidance for the interventional treatment of fetal structural heart disease（2019） 2019, 34(6): 458-460.  DOI: 10.19538/j.ek2019060602 Abstract ( )

Select

Interpretation of European Consensus Guidelines on the Management of Respiratory Distress Syndrome-2019 Update SHI Yong-yan，FU Jian-hua 2019, 34(6): 461-465.  DOI: 10.19538/j.ek2019060603 Abstract ( )   The 2019 European Guideline on Respiratory Distress Syndrome（RDS） updated and supplemented the 2016 version according to newly-published evidence and literature，in order to optimize the management of RDS. The updates includes risk factors of preterm births，the standardized use of prenatal glucocorticoids protocol，the evidence-based delivery room management and the early application of protective pulmonary ventilation after birth；pulmonary surfactant administration as the crucial treatment for RDS；the incidence chronic lung disease can be reduced by non-invasive respiratory support. Prenatal glucocorticoids use and caffeine administration can significantly shorten the duration of mechanical ventilation. In addition，good temperature control，precise fluid and nutrition management，perfusion maintenance and cautious antibiotic use can help improve the outcome of preterm births.

Select

History, present situation and  prospect of interventional respiratory diseases in pediatrics LIU Xi-cheng 2019, 34(6): 466-469.  DOI: 10.19538/j.ek2019060604 Abstract ( )   The development of respiratory endoscopy in pediatrics in China is more than 10 years later than that in adults. In 1985，fiberoptic bronchoscopy was used in pediatrics hospitals in China. In the 1990s，Beijing Children’s Hospital established the first paediatric bronchoscopy room in China. Pediatric tracheoscopy method which is of great significance to respiratory specialty has since been established in China. Up to now，bronchoscopy has become a safe and reliable means of diagnosis and treatment in many hospitals. The demand for bronchoscopy in diagnosis is even as popular as CT. Interventional methods play an important role in the diagnosis and treatment of severe and difficult respiratory diseases. In the future，children’s interventional respiratory disease should be developed into a comprehensive multi-disciplinary clinical application.

Select

Application of rapid on-site evaluation in contemporary pediatric interventional respiratory diseases WANG Zhong-tao，SHI Yong-sheng 2019, 34(6): 470-475.  DOI: 10.19538/j.ek2019060605 Abstract ( )   Rapid on-site evaluation（ROSE） is a cytopathological technique acquiring microsamples through biopsy. ROSE is applied to the quality control of specimens，diagnostic consideration，and further examinations of samples in contemporary paediatric interventional pulmonology. ROSE is still on the initial stage in modern pediatrics，which is divided into cytological ROSE（C-ROSE） and microbiological ROSE（M-ROSE），the latter being more practical. Although it isn’t a definite diagnosis，ROSE can guide therapeutic decisions when performing peadiatric bronchoscopy and other inverventional pulmonary operations.

Select

Diagnosis and treatment of pleural cavity disease in children with thoracoscope ZHANG Li，WANG Li-jun，LIU Na，et al 2019, 34(6): 475-479.  DOI: 10.19538/j.ek2019060606 Abstract ( )   Thoracoscopy has a high diagnostic and therapeutic value in adult pleural cavity diseases and it is safe and effective. However，in our country  thoracoscopy  is applied in children later and the experience is less than in the adult. Thoracoscopy is mainly used for the diagnosis and treatment of the children’s pleural cavity diseases，such as  pyothorax，tuberculous pleurisy，pneumothorax, hemothorax，chylothorax，pleural cavity mass，and pleural cavity foreign body，et al. This paper introduces the classification and development history of thoracoscopy and its clinical application in children with pleural cavity diseases.

Select

Application of electromagnetic navigation technology in modern pediatric interventional respiratory diseases HUANG Yan 2019, 34(6): 479-482.  DOI: 10.19538/j.ek2019060607 Abstract ( )   With the advantages of real-time navigation and accurate positioning，electromagnetic navigation bronchoscopy has high clinical application value in biopsy of peripheral pulmonary diseases，biopsy of mediastinum and hilar lymph node lesions，and respiratory interventions requiring precise positioning of lung, airway and mediastinum. After more than ten years of clinical practice，this technique is considered to be safe，reliable，minimally invasive and highly efficient. The introduction and popularization of this technology in the field of pediatric respiratory diseases will promote the further development of interventional diagnosis and treatment of pediatric respiratory diseases.

Select

Bronchoscopic ablative therapy in modern pediatric interventional respiratory diseases JIAO An-xia 2019, 34(6): 482-485.  DOI: 10.19538/j.ek2019060608 Abstract ( )   Bronchoscopic ablative therapy, which is mainly used in airway obstructive diseases, includes laser，thermo-coagulation（electrocautery，and argon plasma coagulation） and cryotherapy. The thermal ablation and frozen cut can quickly destroy the obstructions in the airway，such as the granulation tissue，scar tissue and tumors. In the meanwhile，the freezing and thawing technique can effectively inhibit the granulation tissue and scar tissue regeneration. Timely，standardized and integrated application of bronchoscopic ablation is the key to gaining the safe and effective treatment in children with severe airway obstructive diseases.

Select

Application of airway stenting in modern pediatric interventional respiratory diseases MENG Chen， LIU Shuai-shuai， WANG Shao-chao 2019, 34(6): 485-490.  DOI: 10.19538/j.ek2019060609 Abstract ( )   With the popularization and development of lung CT scanning and technology of bronchoscopy in pediatrics，central airway obstruction has been diagnosed more and more. Central airway obstruction can affect airway ventilation and secretion discharge，such children are often hospitalized for repeated pneumonia，and sometimes need mechanical ventilation but may be difficult weaning from it. Malnutrition，hypoxic brain injury and backward growth and development are often associated. In the past，central airway obstruction has been mainly treated by surgery. However，with the development of minimally invasive technology of bronchoscopy in children，airway stent implantation has become an effective and alternative treatment recently. This article reviews the types of pediatric central airway obstruction，indications and contraindication of airway stent implantation，types and selection of stent，and the procedures of stent implantation.

Select

Application of TBNA in modern pediatric interventional respiratory diseases CHEN Min，ZHONG Li-li 2019, 34(6): 490-493.  DOI: 10.19538/j.ek2019060610 Abstract ( )   Transbronchial needle aspiration（TBNA） is an important technique of endoscopic interventional diagnosis and treatment of lung disease. It plays an important role in the diagnosis of the nature of mediastinal, hilar and peripheral nodule lesions，as well as in the classification and staging of lung cancer. Compared with mediastinoscopy and thoracotomy，TBNA has the advantages of simple operation，less trauma，low cost and fewer complications. It has been widely used in adult respiratory diseases. However，because of their own characteristics，children have higher requirements on TBNA technology，equipment，anesthesia and so on，and the application of TBNA faces more challenges. With the continuous improvement of technology and the continuous exploration of pediatric respiratory interventional physicians，TBNA has been used more and more often in children，filling in the blank of routine diagnosis and treatment and bringing new diagnostic ideas and methods for children with mediastinal or hilar lesions.

Select

Application of transbronchial lung biopsy in modern pediatric interventional respiratory diseases WU Shang-zhi，CHEN De-hui 2019, 34(6): 494-497.  DOI: 10.19538/j.ek2019060611 Abstract ( )   Transbronchial lung biopsy（TBLB） has been widely used and has successfully helped in the diagnosis of lung diseases in adults. However，TBLB is less used in children with lung diseases. In order to recognize the skills of TBLB，the authors introduced the applications of TBLB in interventional respiratory diseases in children.

Select

Application of balloon dilatation in modern pediatric interventional respiratory diseases ZHU Chun-mei， ZHANG Yi 2019, 34(6): 497-500.  DOI: 10.19538/j.ek2019060612 Abstract ( )   Balloon dilatation under bronchoscope is mainly used in the treatment of benign airway stenosis in children. It is a safe，simple and minimally invasive treatment. It also plays an important role in the removal of some special foreign bodies and the treatment for massive hemoptysis. Interventional therapy under bronchoscope is a comprehensive treatment technique，and balloon dilatation needs to be combined with other methods.

Select

Application of rigid bronchoscopy in modern pediatric interventional respiratory diseases SUN Yong-feng，JIN Rong，CHEN Min，et al 2019, 34(6): 500-503.  DOI: 10.19538/j.ek2019060613 Abstract ( )   Rigid bronchoscopy is an effective technique in the diagnosis and treatment of airway diseases，but it has a high operational risk and many complications. In recent years，with the improvement of equipment and technological advancement，the safety of rigid bronchoscopy operation has been improved, and clinical applications have begun to increase. However，in the clinical practice of rigid bronchoscopy, clinicians should judge according to clinical experience，master the insertion technology，and understand the application indications，in order to ensure the safe and effective application.

Select

Value of fiberoptic bronchoscopy in the diagnosis and treatment of refractory mycoplasma pneumoniae pneumonia in children ZHANG Han，SHANG Yun-xiao 2019, 34(6): 504-507.  DOI: 10.19538/j.ek2019060614 Abstract ( )   Mycoplasma pneumoniae is one of the main pathogens of common community-acquired pneumonia in children. The incidence of refractory mycoplasma pneumoniae pneumonia has been increasing in recent years，and the drugs are limited in children. Fiberoptic bronchoscopy plays an important role in the diagnosis and treatment of refractory mycoplasma pneumoniae pneumonia in children. In this paper，the diagnostic and therapeutic value of fiberoptic bronchoscopy in the treatment of refractory mycoplasma pneumoniae pneumonia in children was expounded from the aspects of endobronchial lesions，pathogen and cytokine analysis in bronchoalveolar lavage fluid，bronchoalveolar lavage，airway cleaning and local drug injection under bronchoscopy.

Select

Clinical research of nosocomial invasive fungal bloodstream infections in PICU children：A clinical analysis of 21 cases LIU Bo，WANG Li-jie 2019, 34(6): 508-512.  DOI: 10.19538/j.ek2019060615 Abstract ( )   Objective　To improve the understanding of the IFI，and to help the early diagnosis and treatment and positive improvement of prognosis. Methods　A total of 21 children were chosen as the research subjects，who were diagnosed with the IFI bloodstream infection and were hospitalized in Shengjing Hospital affiliated to China Medical University from January 2012 to January 2018，and the clinical characteristics，high risk factors and prognosis of them were retrospectively analyzed. Results　There was no significant correlation between the incidence of fungal infection and age or sex in 21 children with IFI bloodstream infection. Candida albicans and Candida parapsilosis were the leading pathogen，and the mortality rate of Candida parapsilosis was high（80%）.For the 21 children with IFI bloodstream infection，the mortality rate was as high as 61.9%（13 cases） with 28 days’ following research. The protopathy was mainly respiratory system disease（14.29%） and digestive system disease（23.81%）. Among them，there were 4 cases of severe pneumonia and 4 cases of gastrointestinal perforation. The high risk factors were mainly the combined use of broad-spectrum antibiotics，invasive operation（tracheal intubation，central venous catheterization，catheterization and indwelling stomach tube，etc.），long-term hospitalization in ICU and so on，all above 85%. Fungal infection was characterized by atypical fever（80.95%），abnormal increase or decrease of white blood cells（47.62%） and CRP increase（80.95%）；the positive rate of G test could reach 42.86%. In the survival group including 8 cases of children，75% were treated with antifungal treatment before diagnosed with fungal infection；the rate of preventive drug use was 53.85% for the death group. Conclusion　Long-term hospitalization in ICU，long-term and combined use of a large amount of broad-spectrum antibiotics，invasive operation，autoimmune deficiency and other factors increase the risk of fungal infection. If there is atypical refractory infection after clinical primary diseases，fungal infection should be paid attention to and the related microbiological examination should be performed.

Select

Application of alveolar lavage fluid mNGS in the etiological diagnosis of children with severe pneumonia LI Xue-qing，WANG Li-na，ZHANG Li，et al 2019, 34(6): 513-516.  DOI: 10.19538/j.ek2019060616 Abstract ( )   Objective　To explore the application of alveolar lavage fluid NGS in etiological diagnosis of children with severe pneumonia. Methods　The clinical data of 34 children with severe pneumonia hospitalized in Pediatric Respiratory Department from September 2018 to March 2019 were retrospectively analyzed. The collected alveolar lavage fluid was analyzed by metagenomics NGS. Results　Totally 34 cases were diagnosed as severe pneumonia. The results of mNGS：32 cases（94.1%） were detected in 34 samples，19 cases（55.9%） of Mycoplasma pneumoniae，6 cases（17.6%） of human adenovirus type 7，1 case（2.9%） of Forsystanella，1 case of Staphylococcus aureus（2.9%）；1 cases（2.9%） was not detected，and the positive rate of Mycoplasma pneumoniae was the highest. The mixed infection showed human adenovirus type 7+ Mycoplasma pneumoniae in 2 cases（5.9%），human adenovirus type 7+ Haemophilus influenzae in 1 case（2.9%） and human adenovirus type 7+ Aspergillus fumigatus in 3 cases（8.8%）. After anti-infection and symptomatic support treatment，33 cases were improved and discharged，and 1 case died. Conclusion　The metagenomics NGS can improve the diagnostic accuracy of the pathogen in severe pneumonia，and early and accurate identification of the pathogen plays an important role in guiding the rational use of antibiotics in clinical practice.

Select

Research progress in the etiology and pathogenesis of inflammatory bowel disease in children YAO Jia-wei，LI Xiao-lu，SHAO Pei，et al 2019, 34(6): 517-522.  DOI: 10.19538/j.ek2019060617 Abstract ( )

Select

Research progress in gene detection of diabetes mellitus in children WANG Xiao-yan，CHEN Lin-qi，SUN Hui，et al 2019, 34(6): 523-526.  DOI: 10.19538/j.ek2019060618 Abstract ( )

Select

Registered clinical research and real-world research of recombinant human growth hormone Norditropin® WU Wei，LUO Xiao-ping 2019, 34(6): 527-531.  DOI: 10.19538/j.ek2019060619 Abstract ( )

Select

Diabetic ketoacidosis complicated with acute severe pancreatitis in one case of Prader-Willi syndrome GONG Ming，XIN Ying 2019, 34(6): 532-533.  DOI: 10.19538/j.ek2019060620 Abstract ( )

Select

Application of standardized patient combined with formative assessment in pediatric teaching FAN Hui-feng，ZHENG Rui-dan，GONG Si-tang 2019, 34(6): 534-536.  DOI: 10.19538/j.ek2019060621 Abstract ( )   Due to pediatric patients，there are the absence of clinical cases and the conflict between physicians and patients during teaching. Formative assessment（FA） is a teaching method to provide feedback and correctives at each stage in the teaching-learning process，which has been applied in clinical training for medical students and resident standardizing training recent years. Standardized patient（SP） is a simulated teaching tool，and when SPs are introduced in formative assessment by applied to history taking，patient education and counseling and communication skills. The combination not only solves the scarcity of clinical cases，but avoids doctor-patient contradiction. Therefore，SPs provide a broader application prospect for formative assessment. In fact，the combination offers new ideas for pediatric teaching.