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Continuous positive airway pressure in children with severe pneumonia: a meta-analysis

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World Journal of Pediatrics 2020年第6期16卷 637-641页

作者： Zhi-Li Wang Yu He Zheng-Xiu Luo Chongqing Key Laboratory of Pediatrics Department of RespiratoryMinistry of Education Key Laboratory of Child Development and DisordersNational Clinical Research Center for Child Health and Disorders(Chongqing)China International Science and Technology Cooperation Base of Child Development and Critical DisordersChildren's Hospital of Chongqing Medical UniversityChongqing 400014China

pneumonia is the leading cause of death among children aged 1-59 months worldwide[1].WHO recommends providing low flow oxygen by nasal cannula in pediatric patients with oxygen saturationpneumonia[6,7],but its effect and safety are uncertain.Therefore,we performed a meta-analysis that compared CPAP with standard therapy or low-flow oxygen to figure out the effects and safety of CPAP.

关键词： airway pneumonia distress

Systemic air embolism in a fungal pneumonia patient with lung cavities formation and review of literature

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Chinese Journal of Traumatology 2019年第5期22卷 308-310页

作者： Hai-Jun Huang Shu Lei Lin Yang Li-Ming Jin First Affiliated Hospital Zhejiang University of Traditional Chinese MedicineHangzhou 310006China Zhejiang Provincial People's Hospital Hangzhou 310014China Affiliated People's Hospital of Hangzhou Medical College Hangzhou 310014China

Systemic air embolism is a rare but potentially fatal complication related to many factors.The purpose of this article is to alert clinicians once patients occurs an abnormal neurological and cardiovascular status,following minor traumatic treatment,air embolism should be considered.A 20-year-old man who presented with fungal pneumonia with lung cavities formation was adm让ted to an intensive care unit(ICU)and received positive airway pressure ventilation.Four days later,the fun gal pneumonia was improved,but the patient's blood pressure and arterial oxygen saturation deteriorated,so computed tomography(CT)scans were preformed to reevaluate him.The scans detected air embolism in the left atrium and ventricle,ascending aorta,aortic arch and its branches(right brachiocephalic,bilateral common carotid and right subclavian arteries),descending aorta and right coronary artery.A CT scan of the abdomen revealed air in the spleen,cauda pancreatic,superior mesenteric artery and right external iliac artery.The patient died two days later from multiple organ dysfunction.We suggest that vascular air embolism should be considered under mechanical ventilation when patients'neurologic and cardiovascular status deteriorates,and hyperbaric oxygen therapy should be conducted immediately.

关键词： Air embolism Fungal pneumonia Positive end-expiratory pressure

Validation of risk scoring models for predicting stroke-associated pneumonia in patients with ischaemic stroke

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Stroke & Vascular Neurology 2016年第3期1卷 122-126页

作者： Siyin Gong Zhiwei Zhou Muke Zhou Zhao Lei Jian Guo Ning Chen Li He Neurology Department West China Hospital of Sichuan UniversityChengduChina

Objective:Various risk scoring models have been developed to predict stroke-associated pneumonia(SAP).We aim to determine whether these risk models could effectively predict SAP in Chinese patients with ischaemic stroke(IS).Methods:Consecutive patients with IS in West China hospital between January 2011 and September 2013 were included to assess the predictive performance of risk scoring models,including Chumbler’s score,A^(2)DS^(2) and AISAPS.The area under the receiver operating characteristic curve(AUROC)was used to evaluate the performance of each risk model in predicting pneumonia.Results:A total of 1569 consecutive patients with IS within 30 days of onset in West China hospital were included.The incidence of pneumonia is 15.3%.The AUROC of Chumbler’s score,A^(2)DS^(2) and AISAPS was 0.659,0.728 and 0.758,respectively,and AISAPS had the highest AUROC.Conclusions:A^(2)DS^(2) and AISAPS had acceptable discriminatory abilities to predict SAP in Chinese patients with IS within 30 days of onset.

关键词： pneumonia patients predicting

Clinical efficacy and safety of moxifloxacin versus levofloxacin plus metronidazole for community-acquired pneumonia with aspiration factors

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Chinese Medical Journal 2014年第7期127卷 1201-1205页

作者： Sun Tieying Sun Li Wang Rongmei Ren Xiaoping Sui Dong-jiang Pu Chun Ren Yajuan Liu Ying Yang Zhuo Li Fengzhi Department of Respiratory and Critical Care Medicine Beijing Hospital of the Ministry of Health Beijing 100730 China Department of Respiratory Diseases Shaanxi Provincial People's Hospital Xi'an Shaanxi 710068China Department of Respiratory Diseases Air Force General HospitalPeople's Liberation Army Beijing 100142 China

Background Community-acquired pneumonia （CAP） is a common infectious disease throughout the world and the incidence continues to grow as the population ages.Aspiration is an important pathogenic mechanism for pneumonia in the elderly and the management of patients with community-acquired pneumonia with aspiration factors is a major medical problem.Our study aimed to assess whether moxifloxacin in comparison to levofloxacin plus metronidazole are effective and safe in the treatment of community-acquired pneumonia with aspiration factors.Methods In this prospective,multicenter,open-label,randomized controlled trial,77 patients with mild-to-moderate community-acquired pneumonia with aspiration factors were enrolled and randomly assigned to receive moxifloxacin or levofloxacin plus metronidazole.The primary efficacy variables were clinical outcomes in evaluable patients at a follow-up visit 7 to 14 days after the end of therapy.Results Seven days after the end of therapy a clinical cure was achieved for 76.7％（23 of 37） of efficacy-evaluable patients in the moxifloxacin group and 51.7％（15 of 40） of patients in the levofloxacin plus metronidazole group.There was a significant difference between the two groups （x2=4.002,P ＜0.05）.Bacteriological success rates were similar in the moxifloxacin group （93.3％） and levofloxacin plus metronidazole group （96.4％）,there was no significant difference between the two groups （P ＞0.05）.The overall adverse event rate was 10.8％（4/37） in the moxifloxacin group versus 17.5％（7/40） in the levofloxacin plus metronidazole group,there was no significant difference between the two groups （P＞0.05）.No serious adverse events were observed.Conclusions Moxifloxacin is effective and safe for treatment of community-acquired pneumonia with aspiration factors.And the regimen of moxifloxacin monotherapy is more convenient compared with levofloxacin plus metronidazole.

关键词： pneumonia community-acquired infection moxifloxacin levofloxacin metronidazole

Severe bacteremia community-acquired methicillinresistant Staphylococcus aureus pneumonia in a young adult

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World Journal of Emergency Medicine 2020年第4期11卷 263-266页

作者： Dan-li Cai Xia-qing Zhou Ye-song Wang Ling-cong Wang Department of ICU the First Affi liated Hospital of Zhejiang Chinese Medical UniversityHangzhouChina Department of Critical Care Medicine the Second Affi liated Hospital of Zhejiang University School of MedicineHangzhouChina

Dear editor,Adults with community-acquired methicillin-resistant Staphylococcus aureus(CA-MRSA)are prone to necrotizing pneumonia,bacteremia,and high mortality.Several studies have reported the disease worldwide,but only a few cases of CA-MRSA pneumonia in children and adolescents have been reported in China.[1]No CA-MRSA was detected in the pathogens of community-acquired respiratory tract infections in Chinese adults from 2009 to 2010.During the influenza epidemic,such as COVID-19,viral infections are followed by repeated bacterial infections,and methicillin-sensitive Staphylococcus aureus(MSSA)and MRSA pneumonia are known complications.[2]Thus,identifying and treating these infections is a tricky clinical issue.A case of CA-MRSA pneumonia with bloodstream infection and pneumothorax was successfully treated in our hospital in January 2018.Herein,we presented a case report based on previous studies.

关键词： pneumonia methicillin mortality

Experience of Clinical Management for Pregnant Women and Newborns with Novel Coronavirus pneumonia in Tongji Hospital,China

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Current Medical Science 2020年第2期40卷 285-289页

作者： Shao-shuai WANG Xuan ZHOU Xing-guang LIN Yan-yan LIU Jian-li WU Lali Mwamaka Shariful Xiao-lin HU Zhi-bui RONG Wei LIU Xiao-ping LUO Zhuo CHEN Wan-jiang ZENG Su-hua CHEN Ding MA Ling CHEN Ling FENG Department of Obstetrics and Gynecology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Pediatrics Tongji HospitalTongji Medical CollegeHuazhong Universiry 0f Science and TechnologyWuhan 430030 China Deparment of Traditional Chinese Medicine Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

Based on the New Diagnosis and Treatment Scheme for Novel Coronavirus Infected pneumonia(Trial Edition 5),combined with our current clinical treatment experience,we recently proposed a revision of the first edition of“Guidance for maternal and fctal management during pneumonia epidemics of novel coronavirus infection in the Wuhan Tongji Hospital".This article focused on the issues of greatest concern of pregnant women including severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection diagnostic criteria,inspection precautions,drug treatment options,indications and methods of termination of pregnancy,postpartum fever,breastfeeding considerations,mode of mother-to-child transmission,neonatal isolation and advice on nconatal nursing,to provide valuable experience for better management of SARS-CoV-2 infection in pregnant women and newborns.

关键词： COVID-19 pneumonia pregnant women newborn disease management

Personal knowledge on novel coronavirus pneumonia

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Chinese Medical Journal 2020年第9期133卷 1121-1122页

作者： Han-Yu-Jie Kang Yi-Shan Wang Zhao-Hui Tong Department of Respiratory and Critical Care Medicine Beijing Institute of Respiratory MedicineBeijing Chao-Yang HospitalCapital Medical UniversityBeijing 100020China

The epidemiological history of some patients infected with novel coronavirus(2019-nCoV)is unclear,and the incubation period of the virus can last for 2 weeks,even longer.During the period of latent infection or the period of incubation following infection,the disease may be infectious.As in cases of influenza,some patients develop only upper respiratory tract infection,whereas others with a severe form of the disease develop pneumonia.Patients may not have fever,mild cough,or apparent respiratory symptoms,and headache or gastrointestinal symptoms may be present.Some patients show insidious onset and slow progression,and do not appear to be sick.Thus,they may not receive attention or be identified.Some patients with severe disease or critical illness may present with moderate-to-low-grade fever,but apparent fever may also be absent.

关键词： pneumonia respiratory infection

Effect of zinc supplementation on infants with severe pneumonia

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世界儿科杂志:英文版 2016年第2期12卷 166-169页

作者： Xiao Yuan Su-Yun Qian Zheng Li Zhe-Zhe Zhang Pediatric Department of Beijing Friendship Hospital Capital Medical UniversityBeijingChina PICU Beijing Children's HospitalCapital Medical UniversityBeijingChina

Background:pneumonia is a common respiratory infectious disease in infancy.Previous work shows controversial results on the benefit of zinc supplementation in patients with pneumonia.We conducted this study to investigate serum zinc status amongst infants with severe pneumonia and the clinical impact that zinc supplementation has on those patients with low serum zinc levels.Methods:This study design was a non-blinded prospective randomized controlled trial.The study is approved by the Ethics Committees of Beijing Children's Hospital.A total of 96 infants diagnosed with severe pneumonia and hospitalized in the pediatric intensive care unit between November 2011 and January 2012 were enrolled.Enrolled patients were divided into low serum zinc and normal serum zinc group.The low serum zinc group was randomized into treatment and control groups.Only the treatment group received zinc supplementation within 48-72 hours after hospitalization.Results:The prevalence of zinc defi ciency on admission was 76.0%.The low zinc level was most apparent in infants between 1 and 3 months of age.The serum zinc level increased in the zinc treatment group and returned to a normal level(median,53.20μmol/L)on day 12±2.There was no statistical difference in the pediatric critic illness score,lung injury score,length of hospital stay,and duration of mechanical ventilation between the zinc treatment group and control group.Conclusions:Zinc deficiency is common in infants with severe pneumonia.Normalization of zinc levels with zinc supplementation did not improve clinical outcomes of infants with pneumonia.

关键词： infant pneumonia supplementation zinc

Coronavirus MHV-A59 infects the lung and causes severe pneumonia in C57BL/6 mice

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Virologica Sinica 2014年第6期29卷 393-402页

作者： Zhangsheng Yang Jun Du Gang Chen Jie Zhao Xuanming Yang Lishan Su Genhong Cheng Hong Tang Key Laboratory of Infection and Immunity (CASKLII) Institute of BiophysicsChinese Academy of Sciences Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education Institute of BiotechnologyShanxi University Department of Microbiology and Immunology and Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill School of MedicineNC 27599-7295USA Department of Microbiology Immunology and Molecular GeneticsUniversity of CaliforniaLos AngelesCA 90095USA

It remains challenging to develop animal models of lung infection and severe pneumonia by severe acute respiratory syndrome coronavirus(SARS-CoV) and Middle East respiratory syndrome cornavirus(MERS-Co V) without high level of containment. This inevitably hinders understanding of virushost interaction and development of appropriate countermeasures. Here we report that intranasal inoculation of sublethal doses of murine coronavirus mouse hepatitis virus A-59(MHV-A59), a hepatic and neuronal tropic coronavirus, can induce acute pneumonia and severe lung injuries in C57BL/6 mice. Inflammatory leukocyte infiltrations, hemorrhages and fibrosis of alveolar walls can be observed 2-11 days after MHV-A59 infection. This pathological manifestation is associated with dramatical elevation of tissue IP-10 and IFN-γ and moderate increase of TNF-α and IL-1β, but inability of anti-viral type I interferon response. These results suggest that intranasal infection of MHV-A59 would serve as a surrogate mouse model of acute respiratory distress syndrome by SARS-CoV and MERS-CoV infections.

关键词： coronavirus MHV-A59 pneumonia inflammation cytokine