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06 October 2020, Volume 35 Issue 10 Previous Issue    Next Issue

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Experts’ consensus on medical thoracoscopy for children in China 2020, 35(10): 745-752.  DOI: 10.19538/j.ek2020100601 Abstract ( )

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Application progress of modern pediatric respiratory intervention techniques in laryngeal stridor WANG Li-na，MENG Fan-zheng 2020, 35(10): 753-757.  DOI: 10.19538/j.ek2020100602 Abstract ( )   Laryngeal stridor is caused by a variety of causes，often accompanied by a variety of clinical manifestations and clinical symptoms，and the causes include not only laryngopharyngeal diseases，but also subglottic and tracheal lesions. Therefore，the thin and soft flexible bronchoscopy can evaluate and diagnose the laryngeal stridor comprehensively. In this paper，laryngomalacia and other 13 diseases were diagnosed by the flexible bronchoscopy according to the anatomical sites. With the rapid development of interventional pulmonology，the bronchoscope interventional techniques such as ablation，balloon dilatation and stenting have provided minimally invasive therapy for laryngeal stridor. In the future，with more and more pediatric respiratory interventional doctors paying attention to the diagnosis and treatment of laryngopharyngeal lesions，the diagnosis and treatment level of laryngeal stridor will be greatly improved.

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Progress in the application of modern pediatric respiratory intervention techniques in wheezing disorders ZHU Chun-mei 2020, 35(10): 757-760.  DOI: 10.19538/j.ek2020100603 Abstract ( )   Wheezing is a common symptom in childhood with many potential causes including lesions of the tracheal wall，intracavity obstruction and extracavity compression in airways.The variety of causes leads to the difficulty in diagnosis and treatment，and the effect of routine treatment is not good. Bronchoscopy is considered as a valuable auxiliary method to determine the cause of recurrent or persistent wheezing. It shows visualization of local tracheobronchial lesions and clarifies the types，sites and severity of airway abnormalities，which can provide a direct evidence in the diagnosis of pediatric wheezing disorders and function as an effective method of treatment. Therefore，bronchoscopy deserves further clinical applications.

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Application of modern pediatric respiratory intervention techniques in hemoptysis HUANG Han，ZHONG Li-li 2020, 35(10): 761-765.  DOI: 10.19538/j.ek2020100604 Abstract ( )   Although hemoptysis is not common in children，it can cause asphyxia，respiratory failure，shock and even death.Therefore，it is one of the critical illnesses in children. The causes of hemoptysis in children are various，and it is the premise of reasonable treatment to clarify the cause of hemoptysis. Modern pediatric respiratory intervention technology has obvious advantages in clarifying the cause of hemoptysis，bleeding site，endoscopic hemostasis，removing thrombus and improving oxygenation. However，these operations also have the risk of inducing bleeding. Improper treatment will aggravate asphyxia and even lead to death. Therefore，it is very important to standardize the application of respiratory intervention technology in hemoptysis and select the right time of application to reduce the complications and the relapse.

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Application progress of modern pediatric respiratory intervention techniques in atelectasis DAI Ji-hong，FU Wen-long，ZHANG Yin 2020, 35(10): 765-768.  DOI: 10.19538/j.ek2020100605 Abstract ( )   Atelectasis is common in childhood respiratory diseases. The etiology is complex and the treatment varies. With the development of pediatric bronchoscopic interventional therapy，it has played an increasingly important role in the treatment of childhood atelectasis in recent years. The purpose of this study is to briefly introduce the application progress of pediatric bronchoscopic interventional therapy in childhood atelectasis，such as bronchoalveolar lavage，local drug administration，brush removal，balloon dilatation，ablation，stent placement and foreign body removal.

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Advances in the application of modern pediatric respiratory intervention techniques in tracheal development malformation SUN Yong-feng，CHEN Min，JIN Rong，et al 2020, 35(10): 768-771.  DOI: 10.19538/j.ek2020100606 Abstract ( )   Tracheal malformation is rare compared with other respiratory diseases，but it can affect the growth and development of children，and even endanger life，which is an important content of diagnosis and treatment in respiratory department of children. With the wide application of bronchoscopy and airway reconstruction in pediatrics，the diagnosis rate of airway malformation in children is gradually increasing. In recent years，with the development of minimally invasive medicine of respiratory endoscope，the new broncho scopic intervention techniques have been gradually used in clinic，so children can get timely and effective diagnosis and treatment，and great progress has been made in treatment. This article briefly reviews the existing techniques to help clinicians apply these minimally invasive techniques.

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Application progress of modern pediatric respiratory intervention techniques in interstitial lung disease CHEN De-hui 2020, 35(10): 772-776.  DOI: 10.19538/j.ek2020100607 Abstract ( )   The interstitial lung diseases（ILD） are  a group of heterogeneous diseases with various causes，also with the more etiological subtypes. The etiological diagnosis follows the procedure of clinic-radiology-pathology. The pediatric respiratory endoscopy via the interventional techniques has the direct diagnostic value for some etiological subtypes of ILD. The pathological results of the lung tissue by TBLB，TBCB or TBNA has greater diagnostic significance in DAH，PAP. The interventional bronchoscopy has the advantages of minimal invasion，quick recovery and fewer complications. Although the interventional bronchoscopy can’t directly distinguish the etiological subtype of ILD，it can eliminate special infection，and reduced the clinical diagnostic scope，which provides some clinical message for the future gene defection，having greater value of clinical application.

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Application progress of modern pediatric respiratory intervention techniques in respiratory system tumor JIAO An-xia 2020, 35(10): 776-778.  DOI: 10.19538/j.ek2020100608 Abstract ( )   The benign and malignant airway tumor are not rare in children. In malignant airway tumors the primary malignant tumors are the main types. Modern pediatric respiratory endoscopic interventional technique plays an important role in the whole-process management of benign and malignant airway tumor in children.

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Application progress of modern pediatric respiratory intervention techniques in tracheoesophageal fistula WANG Zhong-tao，SHI Yong-sheng， WANG Yong-jun， et al. 2020, 35(10): 779-783.  DOI: 10.19538/j.ek2020100609 Abstract ( )   Tracheoesophageal fistula（TEF） is an abnormal canal between trachea and esophagus. Most of children’s TEF is congenital and primary，often combined with esophageal atresia（EA），and a few TEF is acquired and secondary. TEF is one of pediatric complex and rare diseases，which is troublesome and tough in diagnosis and treatment. The development of modern pediatric bronchoscopy with respiratory intervention techniques has brought new lines of thinking and methods to the diagnosis and treatment of this disease.

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Progress in the application of modern pediatric respiratory intervention techniques to perioperative evaluation and management in cardiothoracic surgery TANG Yuan-ping*，SUN Shan-quan 2020, 35(10): 783-786.  DOI: 10.19538/j.ek2020100610 Abstract ( )   Modern pediatric respiratory intervention techniques are simple，safe and effective，so reasonable and comprehensive application in cardiothoracic surgery，can strongly support its airway diagnosis，evaluation and airway management，effectively reduce surgical complications，increase the success rate of surgery，and improve the prognosis.

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Application progress of modern pediatric respiratory intervention techniques in pathogenic detection methods of pulmonary infectious diseases WU Ya-bin，DENG Wen-hua 2020, 35(10): 786-791.  DOI: 10.19538/j.ek2020100611 Abstract ( )   Lung infection is the major cause of death in children under 5 years of age. The key to successful diagnosis and treatment of lung infections， especially severe lung infections， is to find the etiology and to treat with antimicrobial drugs for the targeted microorganism. The modern pediatric respiratory intervention techniques can obtain not only the liquid specimen of bronchial lung lesions，but also intratracheal tissue specimens and lung tissue specimens. The sampling through these microscopic respiratory intervention techniques combined with navigation technology will be more accurate and safe. With the advance of pathogenic microbiological detection technology，a clear diagnosis of pathogenic microorganisms in pediatric lung infection would be more likely to be obtained. Therefore，modern pediatric interventional pulmonologists must be familiar with and master these pediatric respiratory intervention techniques and their advantages and disadvantages in the detection of pediatric pulmonary infection etiology，and the correct choice can be made in the clinical decision-making.

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Application of percutaneous endoscopic transgastric jejunostomy（PEG-J） in enteral nutrition for children with recurrent aspiration pneumonia ZHAO Hong，LOU Jin-gan，YU Jin-dan，et al 2020, 35(10): 792-795.  DOI: 10.19538/j.ek2020100612 Abstract ( )   Objective　To evaluate the efficacy of PEG-J in enteral nutrition for children with recurrent aspiration pneumonia. Methods　Totally 12 cases who underwent PEG-J in our center from January 2013 to March 2018. The children were analyzed for surgical complications，enteral nutrition complications，postoperative nutritional status of the children，outcome of the primary disease，and extubation. Results　A total of 12 children underwent PEG-J，including 8 males and 4 females，with an average age of 1 year and 5 months（4 months-6 years and 1 month）. The mean duration of the disease before surgery was 7 months（2-24 months），and all the children had recurrent aspiration pneumonia，9 cases（75%） of which had feeding disorders after birth accompanied by recurrent aspiration pneumonia，4 cases（33.3%） with severe malnutrition，and 3 cases（25.0%） with moderate malnutrition. The PEG-J was successful in all the patients through one operation. Three（25%） of the children presented surgery-related recent complications. Nutritional tube-related complications occurred in 2 cases（16.7%）. After jejunal enteral nutrition with PEG-J，11 patients with aspiration pneumonia were improved significantly，and in 1 patient（ball palsy with gastroesophageal reflux disease） the number of aspiration pneumonia attacks was significantly reduced. The Z-score of age-body weight for age before and after enteral nutrition was significantly increased（P＜0.05），and the height for age Z score was significantly higher（P＜0.05）. Conclusion　PEG-J is safe and effective in enteral nutrition treatment for children with recurrent aspiration pneumonia. It can not only reduce the number of episodes of aspiration pneumonia，improve nutritional status，but also has fewer side effects and fewer complications. It can be used for long-term enteral nutrition support treatment.

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Clinical analysis of typhoid fever in 56 children and risk factors for its complications TANG Yan*，JIANG Hui，ZHAN Xue 2020, 35(10): 796-801.  DOI: 10.19538/j.ek2020100613 Abstract ( )   Objective　To investigate the clinical characteristics and the risk factors forcomplications of typhoid fever（TF） in children. Methods　The clinical data of 56 TF children diagnosed in our hospital from 2009 to 2018 were reviewed. The analysis of related factors of complications by logistic regression，estimating the relativity between age，platelet count at admission and number of complications by Spearman rank correlation. Results　The symptoms of typhoid fever（TF） in children were atypical. The time from onset to diagnosis of typhoid fever was （12.0±8.3） days. In most children with diarrhea，the diarrhea often occurred within 1-5 days after fever. The positive rates of bacterial culture were 63.8% in blood culture，41.7% in bone marrow culture and 39.0% in fecal culture，and the positive rate of different disease period was different. However，the positive rate of Widal’s test was only 8.8%. Eosinophil count decreased in 73.8% and disappeared in 40.5%of the children. Children with typhoid fever were prone to electrolyte disorders（hyponatremia，hypokalemia and hypocalcaemia），especially in children aged less than 3 years. About 12.2% of the positive cases showed multidrug resistance. The sensitivity of clinical isolates to ceftazidime，cefepime，ceftriaxone，cefotaxime，ciprofloxacin and levofloxacin showed no significant change compared with that in 1993-2008. Complications occurred in 78.9%（71.7%-86.1%） of children with TF. Thrombocytopenia and the age of the child were associated with TF complications，and the degree of thrombocytopenia and age were also related to the number of complications. Conclusion　Clinical manifestations of TF in children are not typical. The time from onset to diagnosis of typhoid fever was relatively long，so it’s likely to be misdiagnosed. In most children with diarrhea，the diarrhea often occurred within 1-5 days after fever. The positive rate of blood culture was the highest. For culture-negative individuals，Widal test and eosinophil counts may be useful in the diagnosis of TF. In the recent 20 years the clinical isolates are still sensitive to the third generation of cephalosporin and quinolones. Children with TF are prone to complications，and children with thrombocytopenia or older age are more prone to these complications and also more prone to multiple complications.

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Genotype phenotype analysis and clinical study of 5 patients with epilepsy GUO Ting-yi，TENG Zi-teng，LI Wen-bo，et al 2020, 35(10): 802-804.  DOI: 10.19538/j.ek2020100614 Abstract ( )

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Research progress in mitochondrial epilepsy in children HAN Xiao-di，FANG Fang 2020, 35(10): 805-811.  DOI: 10.19538/j.ek2020100615 Abstract ( )

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Imaging characteristics and diagnosis and treatment experience of acute necrotizing encephalopathy related to influenza A DUAN Li-fen，XIAO Shu-fang，ZHANG Lin，et al 2020, 35(10): 812-815.  DOI: 10.19538/j.ek2020100616 Abstract ( )

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One case report of obstructive sleep apnea syndrome combined with multiple organ failure of severe pulmonary hypertension CHEN Lan-qin，YIN Ju，WANG Hua，et al 2020, 35(10): 816-818.  DOI: 10.19538/j.ek2020100617 Abstract ( )

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One case of sitosterolemia misdiagnosed as familial hypercholesterolemia WEN Wen-hui，WU Yue，XU Li-yuan，et al 2020, 35(10): 819-821.  DOI: 10.19538/j.ek2020100618 Abstract ( )

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Early diagnosis of Lesch-Nyhan syndrome: a case report XIN Qing-gang，ZHAO Peng，SHU Jian-bo，et al 2020, 35(10): 822-824.  DOI: 10.19538/j.ek2020100619 Abstract ( )