Objective:To investigate the mechanism of Fuyang Jiebiao granule(FYJBKL)in the treatment of viral pneumonia.Methods:Firstly,a network model was constructed using network pharmacology to study the target expression sit...Objective:To investigate the mechanism of Fuyang Jiebiao granule(FYJBKL)in the treatment of viral pneumonia.Methods:Firstly,a network model was constructed using network pharmacology to study the target expression sites of FYJBKL viral pneumonia,so as to determine the main targets and important signal transduction pathways for the treatment of viral pneumonia.Secondly,the main components of the drug and the main target are docked.Then,the fever,sweating and inflammation rat models were established to explore the antipyretic,sweating and anti-inflammatory mechanisms of FYJBKL.Finally,the contents of IL-17,IL-1β,TNF-αand IL-6 in blood samples of rats were analyzed by ELISA method,and the morphological changes of lung tissue were observed by HE staining.Results:Quercetin,luteolin,kaempferol,etc.,and the main mechanism targets are IL-17,IL-1β,TNF-α,IL-6 and so on.Thirty signal pathways were identified by KEGG enrichment analysis,including interleukin-17 signaling pathway(IL-17 signaling pathway),human cytomegalovirus infection pathway(human cytomegalovirus infection),Kaposi's sarcoma associated herpesvirus infection pathway(Kaposi's sarcoma-as-sociated herpesvirus infection)and so on.After the study of molecular docking,we found that the contact efficiency between active substances and possible key targets is good.The high and middle concentration groups of FYJBKL significantly decreased the expression of IL-17,IL-1β,TNF-αand IL-6 in the blood of rats with inflammation(P<0.05).FYJBKL significantly reduced the foot swelling induced by egg white and inhibited the increase of body temperature induced by yeast in rats(P<0.05).HE staining showed that FYJBKL improved pulmonary fibrosis and inflammatory exudation to varying degrees.Conclusion:The effects of FuyangJiebiao granules on the related signal pathways of anti-virus,anti-immune and anti-inflammation as well as biological and cellular processes may be caused by the binding of quercetin,luteolin,kaempferol and other active ingredients to their shared targets.Fuyang Jiebiao granules can improve the related symptoms caused by viral pneumonia,and its mechanism may be related to the activities of TNF,IL-17,IL-6 and other related channels,which are multiple targets of inflammation regulation.展开更多
Background:In this investigation,we sought to evaluate the benefits of Xiaochaihu decoction(XCHD)on polyinosinic:polycytidylic acid-induced viral pneumonia in mice and elucidate its mechanisms of action.Method:A viral...Background:In this investigation,we sought to evaluate the benefits of Xiaochaihu decoction(XCHD)on polyinosinic:polycytidylic acid-induced viral pneumonia in mice and elucidate its mechanisms of action.Method:A viral pneumonia model was established in mice using polyinosinic:polycytidylic acid,with mice being intragastrically administered different doses of XCHD.The benefits of XCHD therapy for mice with viral pneumonia were assessed by determining the weight ratio of lung tissue,wet-to-dry,overall protein concentrations,and total cell counts in bronchoalveolar lavage fluid,and hematoxylin and eosin staining of lung tissues.By determining the interleukin-1βlevels,interleukin-6,tumor necrosis factor-alpha,nitric oxide,interleukin-10,and interleukin-4,and the mRNA and protein expression of nitric oxide synthase 2,arginase-1,and macrophage mannose receptor 1 in bronchoalveolar lavage fluid,we assessed consequences of XCHD on macrophage polarization with mice suffering from viral pneumonia.Results:XCHD was found to significantly reduce lung tissue wet-to-dry and the total protein content and total number of cells of bronchoalveolar lavage fluid,while ameliorating pathological modifications to the lung tissues of rodents suffering from viral pneumonia,thereby indicating that this medicinal preparation has a healing impact on model mice with viral pneumonia.In addition,XCHD was found to reduce the magnitudes of interleukin-1β,interleukin-6,tumor necrosis factor-alpha,and nitric oxide and the mRNA and protein manifestation of nitric oxide synthase 2,and promote an increase in the levels of interleukin-10 and interleukin-4 and the mRNA and protein expression of arginase-1 and macrophage mannose receptor 1,thereby indicating that XCHD can favorably mediate polarization of macrophages in mice with viral pneumonia.Conclusion:XCHD has notable therapeutic effects on viral pneumonia in mice,the fundamental workings of action of which may be connected to regulation of macrophage polarization.展开更多
Objective A meta-analysis was used to evaluate the efficacy and safety of traditional Chinese medicine(TCM)for dispelling dampness in the treatment of viral pneumonia.Methods The databases of CNKI,CBM,WanFang data,VIP...Objective A meta-analysis was used to evaluate the efficacy and safety of traditional Chinese medicine(TCM)for dispelling dampness in the treatment of viral pneumonia.Methods The databases of CNKI,CBM,WanFang data,VIP,EMBASE,PubMed,and Cochrane library were searched,and the clinical trials of dispelling dampness TCM in the treatment of viral pneumonia were selected.The retrieval period is from the establishment of the database to December 2022.Stata 17.0 software was used to perform meta-analysis,and review manager 5.3 software was used to assess the risk of bias.Overall efficacy was evaluated by OR,and improvement in major clinical symptoms were evaluated by RR.Results A total of 20 randomized controlled trials were included,with a total of 2136 patients,including 1180 patients in the experimental group and 956 patients in the control group.Meta-analysis showed that TCM for dispelling dampness could significantly improve the efficacy of viral pneumonia patients[OR=2.652,95%CI=(2.187,3.217),Z=9.908,P<0.05];The child with abnormal lung X-rays returned to normal after treatment[RR=4.23,95%CI=(2.42,7.42),Z=5.04,P<0.05];In addition,patients had fewer adverse reactions to dispelling dampness TCM,and the safety of the trial was good.Conclusion This Meta-analysis further clarified the efficacy of TCM for dispelling dampness in the treatment of viral pneumonia by combining clinical data and has suggestive significance for the treatment of novel coronavirus pneumonia.展开更多
Influenza viruses were responsible for most adult viral pneumonia.Presently,coronavirus disease 2019(COVID-19)has evolved into serious global pandemic.COVID-19 outbreak is expected to persist in months to come that wi...Influenza viruses were responsible for most adult viral pneumonia.Presently,coronavirus disease 2019(COVID-19)has evolved into serious global pandemic.COVID-19 outbreak is expected to persist in months to come that will be synchronous with the influenza season.The management,prognosis,and protection for these two viral pneumonias differ considerably and differentiating between them has a high impact on the patient outcome.Reverse transcriptase polymerase chain reaction is highly specific but has suboptimal sensitivity.Chest computed tomography(CT)has a high sensitivity for detection of pulmonary disease manifestations and can play a key-role in diagnosing COVID-19.We reviewed 47 studies and delineated CT findings of COVID-19 and influenza pneumonia.The differences observed in the chest CT scan can be helpful in differentiation.For instance,ground glass opacities(GGOs),as the most frequent imaging finding in both diseases,can differ in the pattern of distribution.Peripheral and posterior distribution,multilobular distribution,pure or clear margin GGOs were more commonly reported in COVID-19,whereas central or peri-bronchovascular GGOs and pure consolidations were more seen in influenza A(H1N1).In review of other imaging findings,further differences were noticed.Subpleural curvilinear lines,sugar melted sign,intra-lesional vascular enlargement,reverse halo sign,and fibrotic bands were more reported in COVID-19 than H1N1,while air space nodule,tree-in-bud,bronchiectasia,pleural effusion,and cavitation were more seen in H1N1.This delineation,when combined with clinical manifestations and laboratory results may help to differentiate these two viral infections.展开更多
Objective:To objectively evaluate the clinical effect of traditional Chinese medicine in treating children's respiratory syncytial viral pneumonia(RSVP) of phlegm-heat blocking Fei(肺) syndrome(PHBFS). Methods:A s...Objective:To objectively evaluate the clinical effect of traditional Chinese medicine in treating children's respiratory syncytial viral pneumonia(RSVP) of phlegm-heat blocking Fei(肺) syndrome(PHBFS). Methods:A single-blinded multi-center,blocked,randomized and parallel-controlled method was adopted.The clinical study was carried out on 206 children with RSVP-PHBFS who were assigned to two groups,108 in the test group treated through intravenous dripping of Qingkailing Injection(清开灵注射液) in combination of...展开更多
Objective To evaluate the efficacy and safety of Xiyanping Injection in the treatment of viral pneumonia in children. Methods We searched several databases, including Pub Med, CNKI, VIP and Wanfang Data(January— June...Objective To evaluate the efficacy and safety of Xiyanping Injection in the treatment of viral pneumonia in children. Methods We searched several databases, including Pub Med, CNKI, VIP and Wanfang Data(January— June, 2014). The references of all selected studies were also retrieved to collect the relevantly randomized controlled trials(RCTs) on Xiyanping Injection for viral pneumonia in children. Two authors screened the literatures in accordance with the inclusive criteria, extracted the data and assessed the methodological quality of the included studies. We used Rev Man 5.2 software for meta-analysis. Results Meta-analysis on the 10 included RCTs showed that the effective rates of defervescing and vanishing of the rashes and cough in the Xiyanping Injection group were better than those in the Ribavirin Injection group. There was no significant difference between the two groups in the incidence of adverse drug reaction. Conclusion The existing research indicated that Xiyanping Injection is a secure and efficient scheme for viral pneumonia in children. Because of the poor quality of present researches, these results should be verified by strictly-designed and large-scale sample RCTs.展开更多
Background:Until January 18,2021,coronavirus disease-2019(COVID-19)has infected more than 93 million individuals and has caused a certain degree of panic.Viral pneumonia caused by common viruses such as respiratory sy...Background:Until January 18,2021,coronavirus disease-2019(COVID-19)has infected more than 93 million individuals and has caused a certain degree of panic.Viral pneumonia caused by common viruses such as respiratory syncytial virus,rhinovirus,human metapneumovirus,human bocavirus,and parainfluenza viruses have been more common in children.However,the incidence of COVID-19 in children was significantly lower than that in adults.The purpose of this study was to describe the clinical manifestations,treatment and outcomes of COVID-19 in children compared with those of other sources of viral pneumonia diagnosed during the COVID-19 outbreak.Methods:Children with COVID-19 and viral pneumonia admitted to 20 hospitals were enrolled in this retrospective multi-center cohort study.A total of 64 children with COVID-19 were defined as the COVID-19 cohort,of which 40 children who developed pneumonia were defined as the COVID-19 pneumonia cohort.Another 284 children with pneumonia caused by other viruses were defined as the viral pneumonia cohort.The epidemiologic,clinical,and laboratory findings were compared by Kolmogorov-Smirnov test,t-test,Mann-Whitney U test and Contingency table method.Drug usage,immunotherapy,blood transfusion,and need for oxygen support were collected as the treatment indexes.Mortality,intensive care needs and symptomatic duration were collected as the outcome indicators.Results:Compared with the viral pneumonia cohort,children in the COVID-19 cohort were mostly exposed to family members confirmed to have COVID-19(53/64 vs.23/284),were of older median age(6.3 years vs.3.2 years),and had a higher proportion of ground-glass opacity(GGO)on computed tomography(18/40 vs.0/38,P<0.001).Children in the COVID-19 pneumonia cohort had a lower proportion of severe cases(1/40 vs.38/284,P=0.048),and lower cases with high fever(3/40 vs.167/284,P<0.001),requiring intensive care(1/40 vs.32/284,P<0.047)and with shorter symptomatic duration(median 5d vs.8d,P<0.001).The proportion of cases with evaluated inflammatory indicators,biochemical indicators related to organ or tissue damage,D-dimer and secondary bacterial infection were lower in the COVID-19 pneumonia cohort than those in the viral pneumonia cohort(P<0.05).No statistical differences were found in the duration of positive PCR results from pharyngeal swabs in 25 children with COVID-19 who received antiviral drugs(lopinavir-ritonavir,ribavirin,and arbidol)as compared with duration in 39 children without antiviral therapy(median 10d vs.9d,P=0.885).Conclusions:The symptoms and severity of COVID-19 pneumonia in children were no more severe than those in children with other viral pneumonia.Lopinavir-ritonavir,ribavirin and arbidol do not shorten the duration of positive PCR results from pharyngeal swabs in children with COVID-19.During the COVID-19 outbreak,attention also must be given to children with infection by other pathogens infection.展开更多
目的探讨鼻氧管、氧气面罩和氧袋面罩三种吸氧方法治疗重型病毒性肺炎患者的临床效果。方法113例重型病毒性肺炎患者为研究对象,其中,32例接受鼻氧管吸氧氧疗(鼻氧管组),40例接受氧气面罩吸氧氧疗(氧气面罩组),41例接受氧袋面罩吸氧氧疗...目的探讨鼻氧管、氧气面罩和氧袋面罩三种吸氧方法治疗重型病毒性肺炎患者的临床效果。方法113例重型病毒性肺炎患者为研究对象,其中,32例接受鼻氧管吸氧氧疗(鼻氧管组),40例接受氧气面罩吸氧氧疗(氧气面罩组),41例接受氧袋面罩吸氧氧疗(氧袋面罩组)。对比三组患者吸氧治疗前后的血气分析监测结果[pH值、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(OI)、血氧饱和度(SpO_(2))],OI<300 mm Hg(1 mm Hg=0.133 kPa)持续时间、治疗有效率及气管插管率。结果治疗前,三组患者的pH值、PaO_(2)、PaCO_(2)、OI、SpO_(2)对比,差异无统计学意义(P>0.05)。氧袋面罩组治疗48 h后的pH值高于本组治疗前,差异具有统计学意义(P<0.05);氧袋面罩组治疗24、48 h后的PaO_(2)高于本组治疗前,且高于氧气面罩组及鼻氧管组同时点,差异具有统计学意义(P<0.05);氧袋面罩组治疗24、48 h后的OI高于氧气面罩组及鼻氧管组同时点,差异具有统计学意义(P<0.05);三组患者治疗24、48 h后的SpO_(2)均高于本组治疗前,差异具有统计学意义(P<0.05)。氧袋面罩组患者的OI<300 mm Hg持续时间为(8.32±3.82)d、治疗有效率为70.7%、气管插管率为19.5%;氧气面罩组患者的OI<300 mm Hg持续时间为(9.34±4.36)d、治疗有效率为67.5%、气管插管率为22.5%;鼻氧管组患者的OI<300 mm Hg持续时间为(12.35±4.64)d、治疗有效率为56.3%、气管插管率为31.3%。氧袋面罩组及氧气面罩组患者的OI<300 mm Hg持续时间均短于鼻氧管组,差异具有统计学意义(P<0.05);氧袋面罩组及氧气面罩组患者的OI<300 mm Hg持续时间对比,差异无统计学意义(P>0.05);三组患者的治疗有效率及气管插管率两两对比,差异无统计学意义(P>0.05)。结论氧气面罩、氧袋面罩吸氧氧疗应用于重型病毒性肺炎患者较鼻氧管吸氧氧疗可更明显改善患者的血气指标,具有较高的安全性。展开更多
基金Emergency Research Project for Novel Coronavirus(2019-nCoV)Prevention and Control in Shanxi Province(No.202003D31012/GZ)Jingfang Fuyang Key Laboratory of Shanxi Province(No.202104010910011)Shanxi Provincial Health Commission Key Laboratory Construction Project。
文摘Objective:To investigate the mechanism of Fuyang Jiebiao granule(FYJBKL)in the treatment of viral pneumonia.Methods:Firstly,a network model was constructed using network pharmacology to study the target expression sites of FYJBKL viral pneumonia,so as to determine the main targets and important signal transduction pathways for the treatment of viral pneumonia.Secondly,the main components of the drug and the main target are docked.Then,the fever,sweating and inflammation rat models were established to explore the antipyretic,sweating and anti-inflammatory mechanisms of FYJBKL.Finally,the contents of IL-17,IL-1β,TNF-αand IL-6 in blood samples of rats were analyzed by ELISA method,and the morphological changes of lung tissue were observed by HE staining.Results:Quercetin,luteolin,kaempferol,etc.,and the main mechanism targets are IL-17,IL-1β,TNF-α,IL-6 and so on.Thirty signal pathways were identified by KEGG enrichment analysis,including interleukin-17 signaling pathway(IL-17 signaling pathway),human cytomegalovirus infection pathway(human cytomegalovirus infection),Kaposi's sarcoma associated herpesvirus infection pathway(Kaposi's sarcoma-as-sociated herpesvirus infection)and so on.After the study of molecular docking,we found that the contact efficiency between active substances and possible key targets is good.The high and middle concentration groups of FYJBKL significantly decreased the expression of IL-17,IL-1β,TNF-αand IL-6 in the blood of rats with inflammation(P<0.05).FYJBKL significantly reduced the foot swelling induced by egg white and inhibited the increase of body temperature induced by yeast in rats(P<0.05).HE staining showed that FYJBKL improved pulmonary fibrosis and inflammatory exudation to varying degrees.Conclusion:The effects of FuyangJiebiao granules on the related signal pathways of anti-virus,anti-immune and anti-inflammation as well as biological and cellular processes may be caused by the binding of quercetin,luteolin,kaempferol and other active ingredients to their shared targets.Fuyang Jiebiao granules can improve the related symptoms caused by viral pneumonia,and its mechanism may be related to the activities of TNF,IL-17,IL-6 and other related channels,which are multiple targets of inflammation regulation.
基金supported by Jiaxing Science and Technology Bureau,applied basic research(no.2023AD11044)Zhejiang Chinese Medicine University joint project(no.2022FSYYZZ23).
文摘Background:In this investigation,we sought to evaluate the benefits of Xiaochaihu decoction(XCHD)on polyinosinic:polycytidylic acid-induced viral pneumonia in mice and elucidate its mechanisms of action.Method:A viral pneumonia model was established in mice using polyinosinic:polycytidylic acid,with mice being intragastrically administered different doses of XCHD.The benefits of XCHD therapy for mice with viral pneumonia were assessed by determining the weight ratio of lung tissue,wet-to-dry,overall protein concentrations,and total cell counts in bronchoalveolar lavage fluid,and hematoxylin and eosin staining of lung tissues.By determining the interleukin-1βlevels,interleukin-6,tumor necrosis factor-alpha,nitric oxide,interleukin-10,and interleukin-4,and the mRNA and protein expression of nitric oxide synthase 2,arginase-1,and macrophage mannose receptor 1 in bronchoalveolar lavage fluid,we assessed consequences of XCHD on macrophage polarization with mice suffering from viral pneumonia.Results:XCHD was found to significantly reduce lung tissue wet-to-dry and the total protein content and total number of cells of bronchoalveolar lavage fluid,while ameliorating pathological modifications to the lung tissues of rodents suffering from viral pneumonia,thereby indicating that this medicinal preparation has a healing impact on model mice with viral pneumonia.In addition,XCHD was found to reduce the magnitudes of interleukin-1β,interleukin-6,tumor necrosis factor-alpha,and nitric oxide and the mRNA and protein manifestation of nitric oxide synthase 2,and promote an increase in the levels of interleukin-10 and interleukin-4 and the mRNA and protein expression of arginase-1 and macrophage mannose receptor 1,thereby indicating that XCHD can favorably mediate polarization of macrophages in mice with viral pneumonia.Conclusion:XCHD has notable therapeutic effects on viral pneumonia in mice,the fundamental workings of action of which may be connected to regulation of macrophage polarization.
文摘Objective A meta-analysis was used to evaluate the efficacy and safety of traditional Chinese medicine(TCM)for dispelling dampness in the treatment of viral pneumonia.Methods The databases of CNKI,CBM,WanFang data,VIP,EMBASE,PubMed,and Cochrane library were searched,and the clinical trials of dispelling dampness TCM in the treatment of viral pneumonia were selected.The retrieval period is from the establishment of the database to December 2022.Stata 17.0 software was used to perform meta-analysis,and review manager 5.3 software was used to assess the risk of bias.Overall efficacy was evaluated by OR,and improvement in major clinical symptoms were evaluated by RR.Results A total of 20 randomized controlled trials were included,with a total of 2136 patients,including 1180 patients in the experimental group and 956 patients in the control group.Meta-analysis showed that TCM for dispelling dampness could significantly improve the efficacy of viral pneumonia patients[OR=2.652,95%CI=(2.187,3.217),Z=9.908,P<0.05];The child with abnormal lung X-rays returned to normal after treatment[RR=4.23,95%CI=(2.42,7.42),Z=5.04,P<0.05];In addition,patients had fewer adverse reactions to dispelling dampness TCM,and the safety of the trial was good.Conclusion This Meta-analysis further clarified the efficacy of TCM for dispelling dampness in the treatment of viral pneumonia by combining clinical data and has suggestive significance for the treatment of novel coronavirus pneumonia.
文摘Influenza viruses were responsible for most adult viral pneumonia.Presently,coronavirus disease 2019(COVID-19)has evolved into serious global pandemic.COVID-19 outbreak is expected to persist in months to come that will be synchronous with the influenza season.The management,prognosis,and protection for these two viral pneumonias differ considerably and differentiating between them has a high impact on the patient outcome.Reverse transcriptase polymerase chain reaction is highly specific but has suboptimal sensitivity.Chest computed tomography(CT)has a high sensitivity for detection of pulmonary disease manifestations and can play a key-role in diagnosing COVID-19.We reviewed 47 studies and delineated CT findings of COVID-19 and influenza pneumonia.The differences observed in the chest CT scan can be helpful in differentiation.For instance,ground glass opacities(GGOs),as the most frequent imaging finding in both diseases,can differ in the pattern of distribution.Peripheral and posterior distribution,multilobular distribution,pure or clear margin GGOs were more commonly reported in COVID-19,whereas central or peri-bronchovascular GGOs and pure consolidations were more seen in influenza A(H1N1).In review of other imaging findings,further differences were noticed.Subpleural curvilinear lines,sugar melted sign,intra-lesional vascular enlargement,reverse halo sign,and fibrotic bands were more reported in COVID-19 than H1N1,while air space nodule,tree-in-bud,bronchiectasia,pleural effusion,and cavitation were more seen in H1N1.This delineation,when combined with clinical manifestations and laboratory results may help to differentiate these two viral infections.
基金Supported by the National Key Technologies Research and Development Program of China during the 10th Five-Year PlanPeriod(No.2004BA716B03)
文摘Objective:To objectively evaluate the clinical effect of traditional Chinese medicine in treating children's respiratory syncytial viral pneumonia(RSVP) of phlegm-heat blocking Fei(肺) syndrome(PHBFS). Methods:A single-blinded multi-center,blocked,randomized and parallel-controlled method was adopted.The clinical study was carried out on 206 children with RSVP-PHBFS who were assigned to two groups,108 in the test group treated through intravenous dripping of Qingkailing Injection(清开灵注射液) in combination of...
基金Public Health Cultivation Program of the capital of China(No.z131100004013007)
文摘Objective To evaluate the efficacy and safety of Xiyanping Injection in the treatment of viral pneumonia in children. Methods We searched several databases, including Pub Med, CNKI, VIP and Wanfang Data(January— June, 2014). The references of all selected studies were also retrieved to collect the relevantly randomized controlled trials(RCTs) on Xiyanping Injection for viral pneumonia in children. Two authors screened the literatures in accordance with the inclusive criteria, extracted the data and assessed the methodological quality of the included studies. We used Rev Man 5.2 software for meta-analysis. Results Meta-analysis on the 10 included RCTs showed that the effective rates of defervescing and vanishing of the rashes and cough in the Xiyanping Injection group were better than those in the Ribavirin Injection group. There was no significant difference between the two groups in the incidence of adverse drug reaction. Conclusion The existing research indicated that Xiyanping Injection is a secure and efficient scheme for viral pneumonia in children. Because of the poor quality of present researches, these results should be verified by strictly-designed and large-scale sample RCTs.
基金Scientific Research Project of Military Logistics Department,Grant Award Number:CLB20J032。
文摘Background:Until January 18,2021,coronavirus disease-2019(COVID-19)has infected more than 93 million individuals and has caused a certain degree of panic.Viral pneumonia caused by common viruses such as respiratory syncytial virus,rhinovirus,human metapneumovirus,human bocavirus,and parainfluenza viruses have been more common in children.However,the incidence of COVID-19 in children was significantly lower than that in adults.The purpose of this study was to describe the clinical manifestations,treatment and outcomes of COVID-19 in children compared with those of other sources of viral pneumonia diagnosed during the COVID-19 outbreak.Methods:Children with COVID-19 and viral pneumonia admitted to 20 hospitals were enrolled in this retrospective multi-center cohort study.A total of 64 children with COVID-19 were defined as the COVID-19 cohort,of which 40 children who developed pneumonia were defined as the COVID-19 pneumonia cohort.Another 284 children with pneumonia caused by other viruses were defined as the viral pneumonia cohort.The epidemiologic,clinical,and laboratory findings were compared by Kolmogorov-Smirnov test,t-test,Mann-Whitney U test and Contingency table method.Drug usage,immunotherapy,blood transfusion,and need for oxygen support were collected as the treatment indexes.Mortality,intensive care needs and symptomatic duration were collected as the outcome indicators.Results:Compared with the viral pneumonia cohort,children in the COVID-19 cohort were mostly exposed to family members confirmed to have COVID-19(53/64 vs.23/284),were of older median age(6.3 years vs.3.2 years),and had a higher proportion of ground-glass opacity(GGO)on computed tomography(18/40 vs.0/38,P<0.001).Children in the COVID-19 pneumonia cohort had a lower proportion of severe cases(1/40 vs.38/284,P=0.048),and lower cases with high fever(3/40 vs.167/284,P<0.001),requiring intensive care(1/40 vs.32/284,P<0.047)and with shorter symptomatic duration(median 5d vs.8d,P<0.001).The proportion of cases with evaluated inflammatory indicators,biochemical indicators related to organ or tissue damage,D-dimer and secondary bacterial infection were lower in the COVID-19 pneumonia cohort than those in the viral pneumonia cohort(P<0.05).No statistical differences were found in the duration of positive PCR results from pharyngeal swabs in 25 children with COVID-19 who received antiviral drugs(lopinavir-ritonavir,ribavirin,and arbidol)as compared with duration in 39 children without antiviral therapy(median 10d vs.9d,P=0.885).Conclusions:The symptoms and severity of COVID-19 pneumonia in children were no more severe than those in children with other viral pneumonia.Lopinavir-ritonavir,ribavirin and arbidol do not shorten the duration of positive PCR results from pharyngeal swabs in children with COVID-19.During the COVID-19 outbreak,attention also must be given to children with infection by other pathogens infection.
文摘目的探讨鼻氧管、氧气面罩和氧袋面罩三种吸氧方法治疗重型病毒性肺炎患者的临床效果。方法113例重型病毒性肺炎患者为研究对象,其中,32例接受鼻氧管吸氧氧疗(鼻氧管组),40例接受氧气面罩吸氧氧疗(氧气面罩组),41例接受氧袋面罩吸氧氧疗(氧袋面罩组)。对比三组患者吸氧治疗前后的血气分析监测结果[pH值、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(OI)、血氧饱和度(SpO_(2))],OI<300 mm Hg(1 mm Hg=0.133 kPa)持续时间、治疗有效率及气管插管率。结果治疗前,三组患者的pH值、PaO_(2)、PaCO_(2)、OI、SpO_(2)对比,差异无统计学意义(P>0.05)。氧袋面罩组治疗48 h后的pH值高于本组治疗前,差异具有统计学意义(P<0.05);氧袋面罩组治疗24、48 h后的PaO_(2)高于本组治疗前,且高于氧气面罩组及鼻氧管组同时点,差异具有统计学意义(P<0.05);氧袋面罩组治疗24、48 h后的OI高于氧气面罩组及鼻氧管组同时点,差异具有统计学意义(P<0.05);三组患者治疗24、48 h后的SpO_(2)均高于本组治疗前,差异具有统计学意义(P<0.05)。氧袋面罩组患者的OI<300 mm Hg持续时间为(8.32±3.82)d、治疗有效率为70.7%、气管插管率为19.5%;氧气面罩组患者的OI<300 mm Hg持续时间为(9.34±4.36)d、治疗有效率为67.5%、气管插管率为22.5%;鼻氧管组患者的OI<300 mm Hg持续时间为(12.35±4.64)d、治疗有效率为56.3%、气管插管率为31.3%。氧袋面罩组及氧气面罩组患者的OI<300 mm Hg持续时间均短于鼻氧管组,差异具有统计学意义(P<0.05);氧袋面罩组及氧气面罩组患者的OI<300 mm Hg持续时间对比,差异无统计学意义(P>0.05);三组患者的治疗有效率及气管插管率两两对比,差异无统计学意义(P>0.05)。结论氧气面罩、氧袋面罩吸氧氧疗应用于重型病毒性肺炎患者较鼻氧管吸氧氧疗可更明显改善患者的血气指标,具有较高的安全性。
