目的研究反复肺炎患儿的肠道菌群变化和D-乳酸变化及意义。方法收集30例反复肺炎(反复组)患儿、30例急性肺炎(急性组)患儿及15例外科手术儿童(外科组)的粪便标本和血标本,采用16S r RNA荧光定量PCR技术定量检测各组粪便标本的双歧杆菌...目的研究反复肺炎患儿的肠道菌群变化和D-乳酸变化及意义。方法收集30例反复肺炎(反复组)患儿、30例急性肺炎(急性组)患儿及15例外科手术儿童(外科组)的粪便标本和血标本,采用16S r RNA荧光定量PCR技术定量检测各组粪便标本的双歧杆菌和大肠杆菌的数量,并计算双歧杆菌和大肠杆菌数量对数值的比值(B/E值),同时测定血清D-乳酸含量,并进行肠道菌群与D-乳酸的相关性分析。结果反复组患儿的双歧杆菌数量以及B/E值均低于急性组及外科组(P<0.05),而大肠杆菌数量高于外科组(P<0.05),反复组患儿的大肠杆菌数量与急性组差异无统计学意义(P>0.05);反复组患儿D-乳酸较急性组及外科组均增高(P<0.05);反复组患儿的B/E值与血清D-乳酸呈直线负相关(r=-0.539,P<0.05)。结论反复肺炎患儿存在肠黏膜生物屏障及肠黏膜机械屏障受损。展开更多
目的评价24 h联合食管多通道腔内阻抗-pH监测(24 h MII-pH)在婴幼儿胃食管反流病中的诊断价值,分析伴有反复肺炎的胃食管反流婴幼儿的反流特点。方法疑诊胃食道反流的反复肺炎婴幼儿17例,行24 h MII-pH监测,分析反流物性质和特点。结果...目的评价24 h联合食管多通道腔内阻抗-pH监测(24 h MII-pH)在婴幼儿胃食管反流病中的诊断价值,分析伴有反复肺炎的胃食管反流婴幼儿的反流特点。方法疑诊胃食道反流的反复肺炎婴幼儿17例,行24 h MII-pH监测,分析反流物性质和特点。结果 17例患儿中阳性11例(65%),共监测到853次反流周期,其中65.3%为酸反流,以餐后2 h以内发生为主(69.5%);71.6%为混合反流;反流发生的体位从多至少依次为直立位、仰卧位、侧卧位和俯卧位;反流物的高度以远端反流为主。根据Biox-ochoa评分,重度反流的患儿占73%(8/11)。结论联合食管MII-pH监测可分析反流物性质,增加胃食道反流病的检出率。展开更多
We are reporting 3 cases of pediatric endobronchialtumors presented with recurrent pneumonia. The median age of patients, at time of presentation, was 10.6 years. All patients presented with recurrent pneumonia with a...We are reporting 3 cases of pediatric endobronchialtumors presented with recurrent pneumonia. The median age of patients, at time of presentation, was 10.6 years. All patients presented with recurrent pneumonia with a mean time to occurrence, after onset of symptoms, of 14 mo. Bronchoscopy was early performed as part of diagnostic work-up and it revealed an endobronchial mass in every case. Complete surgical resection was performed in all cases, with lung preservation in two of them. Neither post-operative chemotherapy nor radiotherapy was required. The mean duration of follow-up was 7 years and all patients are still alive and disease-free. Recurrent pneumonia, in pediatrics, should raise the suspicion of an obstructing lesion, congenital malformation or systemic disease. A systematic approach is useful for organize the clinicians initial workup. Prompt diagnosis allows parenchymal-sparing surgery, which offers the best chance of cure and reduces clinical and functional complications in these patients.展开更多
We present a 39-year-old female with HIV, medication non-compliance, and recurrences of bacterial pneumonia. She presented with a two-day bout of worsening shortness of breath, dyspnea and productive cough. A CT of th...We present a 39-year-old female with HIV, medication non-compliance, and recurrences of bacterial pneumonia. She presented with a two-day bout of worsening shortness of breath, dyspnea and productive cough. A CT of the chest was notable for multi-lobular pneumonia. She underwent flexible bronchoscopy and biopsy which revealed lymphocytic interstitial pneumonitis. Conclusion: Recurrent bacterial pneumonia is a rare complication of lymphoid interstitial pneumonia (LIP) in HIV positive patients, and should be considered in the differential as a possible precipitator of recurrent pneumonia inan HIV positive patient.展开更多
文摘目的研究反复肺炎患儿的肠道菌群变化和D-乳酸变化及意义。方法收集30例反复肺炎(反复组)患儿、30例急性肺炎(急性组)患儿及15例外科手术儿童(外科组)的粪便标本和血标本,采用16S r RNA荧光定量PCR技术定量检测各组粪便标本的双歧杆菌和大肠杆菌的数量,并计算双歧杆菌和大肠杆菌数量对数值的比值(B/E值),同时测定血清D-乳酸含量,并进行肠道菌群与D-乳酸的相关性分析。结果反复组患儿的双歧杆菌数量以及B/E值均低于急性组及外科组(P<0.05),而大肠杆菌数量高于外科组(P<0.05),反复组患儿的大肠杆菌数量与急性组差异无统计学意义(P>0.05);反复组患儿D-乳酸较急性组及外科组均增高(P<0.05);反复组患儿的B/E值与血清D-乳酸呈直线负相关(r=-0.539,P<0.05)。结论反复肺炎患儿存在肠黏膜生物屏障及肠黏膜机械屏障受损。
文摘目的评价24 h联合食管多通道腔内阻抗-pH监测(24 h MII-pH)在婴幼儿胃食管反流病中的诊断价值,分析伴有反复肺炎的胃食管反流婴幼儿的反流特点。方法疑诊胃食道反流的反复肺炎婴幼儿17例,行24 h MII-pH监测,分析反流物性质和特点。结果 17例患儿中阳性11例(65%),共监测到853次反流周期,其中65.3%为酸反流,以餐后2 h以内发生为主(69.5%);71.6%为混合反流;反流发生的体位从多至少依次为直立位、仰卧位、侧卧位和俯卧位;反流物的高度以远端反流为主。根据Biox-ochoa评分,重度反流的患儿占73%(8/11)。结论联合食管MII-pH监测可分析反流物性质,增加胃食道反流病的检出率。
文摘We are reporting 3 cases of pediatric endobronchialtumors presented with recurrent pneumonia. The median age of patients, at time of presentation, was 10.6 years. All patients presented with recurrent pneumonia with a mean time to occurrence, after onset of symptoms, of 14 mo. Bronchoscopy was early performed as part of diagnostic work-up and it revealed an endobronchial mass in every case. Complete surgical resection was performed in all cases, with lung preservation in two of them. Neither post-operative chemotherapy nor radiotherapy was required. The mean duration of follow-up was 7 years and all patients are still alive and disease-free. Recurrent pneumonia, in pediatrics, should raise the suspicion of an obstructing lesion, congenital malformation or systemic disease. A systematic approach is useful for organize the clinicians initial workup. Prompt diagnosis allows parenchymal-sparing surgery, which offers the best chance of cure and reduces clinical and functional complications in these patients.
文摘We present a 39-year-old female with HIV, medication non-compliance, and recurrences of bacterial pneumonia. She presented with a two-day bout of worsening shortness of breath, dyspnea and productive cough. A CT of the chest was notable for multi-lobular pneumonia. She underwent flexible bronchoscopy and biopsy which revealed lymphocytic interstitial pneumonitis. Conclusion: Recurrent bacterial pneumonia is a rare complication of lymphoid interstitial pneumonia (LIP) in HIV positive patients, and should be considered in the differential as a possible precipitator of recurrent pneumonia inan HIV positive patient.
