Effects of combined supplementation of 2 '-fucosyllactose and bifidobacterium bivalent strains on infective diseases and intestinal microecology in infants

开始日期2024-09-01

申办/合作机构-

ITMCTR2024000112 / RecruitingIIT

Clinical study of Kaifei mixture in the treatment of children with community-acquired pneumonia

开始日期2024-03-15

申办/合作机构-

ChiCTR2400081421 / Suspended早期临床1期IIT

An exploration of clinical predictors of failure of respiratory support with high-flow nasal cannula oxygen therapy in children

开始日期2024-03-01

申办/合作机构-

100 项与儿童肺炎相关的临床结果

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100 项与儿童肺炎相关的转化医学

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0 项与儿童肺炎相关的专利（医药）

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项与儿童肺炎相关的文献（医药）

2020-04-01·Computer Methods and Programs in Biomedicine2区 · 工程技术

A transfer learning method with deep residual network for pediatric pneumonia diagnosis

2区 · 工程技术

Article

作者: Liang, Gaobo ; Zheng, Lixin

BACKGROUND AND OBJECTIVEComputer aided diagnosis systems based on deep learning and medical imaging is increasingly becoming research hotspots. At the moment, the classical convolutional neural network generates classification results by hierarchically abstracting the original image. These abstract features are less sensitive to the position and orientation of the object, and this lack of spatial information limits the further improvement of image classification accuracy. Therefore, how to develop a suitable neural network framework and training strategy in practical clinical applications to avoid this problem is a topic that researchers need to continue to explore.METHODSWe propose a deep learning framework that combines residual thought and dilated convolution to diagnose and detect childhood pneumonia. Specifically, based on an understanding of the nature of the child pneumonia image classification task, the proposed method uses the residual structure to overcome the over-fitting and the degradation problems of the depth model, and utilizes dilated convolution to overcome the problem of loss of feature space information caused by the increment in depth of the model. Furthermore, in order to overcome the problem of difficulty in training model due to insufficient data and the negative impact of the introduction of structured noise on the performance of the model, we use the model parameters learned on large-scale datasets in the same field to initialize our model through transfer learning.RESULTSOur proposed method has been evaluated for extracting texture features associated with pneumonia and for accurately identifying the performance of areas of the image that best indicate pneumonia. The experimental results of the test dataset show that the recall rate of the method on children pneumonia classification task is 96.7%, and the f1-score is 92.7%. Compared with the prior art methods, this approach can effectively solve the problem of low image resolution and partial occlusion of the inflammatory area in children chest X-ray images.CONCLUSIONSThe novel framework focuses on the application of advanced classification that directly performs lesion characterization, and has high reliability in the classification task of children pneumonia.

2019-12-01·BMC Microbiology3区 · 生物学

Antimicrobial resistance pattern, virulence determinants and molecular analysis of Enterococcus faecium isolated from children infections in Iran

3区 · 生物学

ArticleOA

作者: Sattari-Maraji, Azin ; Beigverdi, Reza ; Node Farahani, Narges ; Emaneini, Mohammad ; Jabalameli, Fereshteh

BACKGROUNDEnterococcus species continues to be an important cause of hospital-acquired infection worldwide. This study was designed to determine the antibiotic resistance profiles, virulence genes and molecular characteristics of Enterococcus faecium strains isolated from an Iranian children hospital in a four-years period.RESULTSA total 189 Enterococcus strains, comprising 108 (57%) E. faecium, 67 (35%) E. faecalis and 14 (7%) isolates of other spp. were isolated during the collection period. More than 92% of E. faecium isolates were resistant to ampicillin (92.5%), ciprofloxacin (96%), erythromycin (100%) and clindamycin (96%). A high frequency of resistance to clindamycin (100%), erythromycin (98.5%) and ciprofloxacin (80.5%) was observed among E. faecalis isolates, while resistance to ampicillin (7%) was less frequent. The prevalence of vanA gene among vancomycin resistant E. faecium and vancomycin resistant E. faecalis was 95 and 50%, respectively. The analysis of 108 E. faecium isolates revealed 34 variable number tandem repeat (VNTR) patterns and 27 Multi Locus VNTR Analysis (MLVA) types (MTs).CONCLUSIONSThe results show a shift from E. faecalis to E. faecium as the dominant enterococcal species among patients at the children Hospital. Our data revealed that the majority of E. faecium isolates (66%) belonged to three common MTs and these types were isolated from different wards in children hospital.

2005-06-01·Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine

[Evaluation on clinical efficacy of treatment of children pneumonia by combined internal-external therapy of TCM].

Article

作者: Wang, Xue-feng ; Dong, Dan ; Liu, Fang

OBJECTIVETo evaluate the clinical efficacy of combined internal-external therapy of TCM on children pneumonia. Adopting multi-center, randomized, controlled, double blinded principle, children with pneumonia were divided into 2 groups. Besides the basic treatment of western medicine, to the 406 children in the treated group internal administering of Chinese recipe prescribed according to syndrome differentiation and external applying of Fuxiong plaster were given additionally, while to the 411 children in the control group simulative placeboes were given for instead. The clinical efficacy of treatment on disease and syndrome, improvement of TCM syndrome and physical signs of lung between the two groups were compared after treatment.RESULTSThe cured-markedly effective rate of treatment on disease and syndrome was 97.3%, 95.1% in the treated group and 89.8%, 86.6% in the control group, respectively, the differences of the two indexes between the two groups were significant (P < 0.05). The improvements on physical signs of lung, symptoms as cough, dyspnea and sputum expectorating in the treated group were significantly better than those in the control group (P < 0.05).CONCLUSIONIt was showed that the combined internal-external TCM treatment, which could significantly enhance the clinical efficacy, is an effective therapy for children pneumonia.

项与儿童肺炎相关的新闻（医药）

2024-04-01

·CPHI制药在线

肺炎支原体肺炎的发病机制及其临床诊断研究进展

关注并星标CPHI制药在线肺炎支原体肺炎（Mycoplasmal pneumonia pneumonia, MPP）又称原发性非典型肺炎或冷凝集阳性肺炎，是因感染肺炎支原体（Mycoplasmal pneumoniae, MP）引起的儿童常见的呼吸系统疾病，多发于学龄期儿童。大部分早期肺炎支原体肺炎患儿常被忽略，延误病情。小儿肺炎“发病容易、传遍迅速”，大部分肺炎支原体肺炎患儿常快速发展为难治性肺炎支原体肺炎（RMPP），甚至引起多器官功能障碍，严重影响患儿生活质量，尤其不利于儿童健康发育。支原体肺炎在临床上前期无特异性症状，多表现为周身酸痛、疲乏无力等轻症，往往被忽视，但随着病情的进展，多表现为持续性强烈干咳、高热，并伴有胸部疼痛、咽喉痛、咳嗽浓痰、头疼等症状，严重者可累及多器官，造成相应较为严重的病症，如呼吸困难、心肌炎、脑膜炎等，危及患者的生命安全。目前肺炎支原体肺炎的发病机制尚未完全明确，比较主流的学说有肺炎支原体对宿主细胞的直接接触损害和免疫损伤。 1、肺炎支原体对宿主细胞的直接接触损害肺炎支原体是感染呼吸系统的病原体，动物模型、体外细胞培养等研究显示，肺炎支原体在进入呼吸道后，会附着于呼吸道上皮细胞，其吸附作用可破坏呼吸道黏膜上皮的完整性，是支原体致病的前提条件。肺炎支原体细胞膜表面的黏附蛋白种类较多，不仅具有抗原性，还可变异，以保证其与宿主细胞的紧密联系，且不会被黏液纤毛系统清除。肺炎支原体与上皮细胞相结合可在附着处释放多种细胞毒素，破坏气道黏膜的完整性。并且通过黏附作用还能消耗上皮细胞的营养物质，影响细胞的新陈代谢。同时肺炎支原体合成的过氧化氢、超氧化物基团堆积于宿主细胞内，将成为重要的致病因素，可抑制呼吸道上皮的纤毛运动，使上皮细胞线粒体肿胀，最终致宿主细胞溶解死亡。 2、肺炎支原体感染引起的免疫损伤 ①体液免疫损伤肺炎支原体感染后，机体会产生免疫球蛋白 M（IgM）、免疫球蛋白 G（IgG）等特异抗体，这是机体清除支原体的重要方式之一。IgM 出现在机体感染肺炎支原体1周后，3周左右到达最高浓度后逐渐降低，可持续出现2~4 个月。IgG 出现在机体感染肺炎支原体20天后，其滴度在1:16以上认为有临床意义，且病情越重，IgG 阳性率越高。先天性低丙种球蛋白血症者较健康者更易感染肺炎支原体，并引发肾炎、关节疼痛等，表明完整体液免疫对预防肺炎支原体感染的重要性。肺炎支原体感染后会诱导呼吸道黏膜表面产生特异性MP-IgE，诱导5-羟色胺、组胺等炎性介质产生，进而激活B淋巴细胞活化增殖，产生抗体，以促进康复，但B淋巴细胞与特异性抗体的清除能力有限，一旦机体正常体液免疫反应出现异常增强，也会引起反复感染造成相应组织的病理损害，导致疾病发生。动物试验发现，较正常小鼠，缺乏B淋巴细胞的小鼠在感染肺炎支原体后上皮细胞、血管增值更明显的减少，表明B淋巴细胞及B1淋巴细胞介导的体液免疫与肺炎支原体感染密切相关。另有研究显示，将肺炎支原体免疫血清注射在B淋巴细胞缺乏的小鼠体内，也会导致小鼠出现病理性气道内壁血管增生。表明气道表面的免疫复合物也是导致肺炎支原体慢性炎症的原因之一。人体在感染肺炎支原体后，会刺激B 淋巴细胞释放 IgM、IgG，但宿主细胞膜与肺炎支原体的细胞膜糖抗原具有共同的抗原成分，进而可出现交叉反应与自身抗体，形成免疫复合物，引起靶器官病变，导致组织或器官出现各种病变，并出现相应的临床症状。肺炎支原体感染后导致大量补体消耗，研究发现，支原体肺炎患者的 IgM、IgG 水平明显高于健康患者。所以体液免疫是导致肺炎支原体致病的重要原因。 ②细胞免疫损伤细胞免疫主要与T细胞有关，在机体感染肺炎支原体后，T细胞将起到重要作用，动物试验发现，切除胸腺后的细胞免疫抑制动物在感染肺炎支原体后肺组织损伤程度更小，感染初期病理研究发现，其机体中动脉、细支气管周围出现 CD4+T 淋巴细胞浸润现象，表明在感染肺炎支原体后会出现类似自身免疫反应的以淋巴细胞为优势的免疫反应。T淋巴细胞可分为CD8+T 淋巴细胞、CD4+T 淋巴细胞等多个亚群。CD8+T 淋巴细胞可直接杀伤靶抗原，而 CD4+T淋巴细胞可调节免疫网络中其他细胞的生物学活性，以控制免疫反应的启动、强弱等，两者均是重要的 T 淋巴细胞。机体健康的情况下，其水平保持动态平衡，共同调节免疫应答与自稳。在病理因素的作用下可导致 CD4+/CD8+失衡，进而致病。研究显示较健康患者，肺炎支原体肺炎患者 CD4+明显上升，CD8+明显下降，并且病情越严重，其失衡情况越严重。肺炎支原体肺炎患儿可损害细胞免疫功能，导致其出现紊乱，表明肺炎支原体的蛋白抗体可能是细胞免疫启动因素，而T淋巴细胞又在肺炎支原体肺炎中起着重要作用。 ③细胞因子肺炎支原体侵入下呼吸道后刺激呼吸道黏膜上皮细胞，巨噬细胞等产生并释放多种细胞因子如 IL-1β、IL-4、IL-6、IL-8、IL-18、IFN-γ，进一步趋化，活化特异性及非特异性免疫细胞，引起炎症反应，参与肺炎支原体肺炎的发病过程，加剧肺炎支原体肺炎病情，甚至破坏机体组织，导致嗜血细胞综合症。IL-2 也可以在机体的免疫应答中起着非常重要的作用，并参与广泛的调节作用。IL-6 是由 IL-1 与 TNF-α 诱导产生的促炎细胞因子，促进 Th2 细胞分化，同时抑制 Th1 细胞分化，而 TNF-a 是另一种参与急性和慢性炎症反应的重要促炎细胞因子。IL-10 是一种 TH2 细胞分泌的抗炎细胞因子，能够靶向抑制巨噬细胞细胞因子的产生。研究者认为，用糖皮质激素联合阿奇霉素治疗小儿肺炎支原体大叶性肺炎的临床症状消失的时间较短，肺部 X线吸收较快，IL-6 等炎性因子恢复较快。IL-17 主要通过 NF-kB-DNA 途径和 MAP 激酶两个途径促进基质细胞产生可以增强细胞间粘附分子分泌功能的细胞因子，促进支气管上皮细胞及巨噬细胞等多种细胞分泌大量细胞因子介导免疫炎症反应。 3、肺炎支原体肺炎的诊断目前，对于肺炎支原体呼吸道感染不论是从病原学、生化还是放射学上均没有比较特异的诊断方法。因此诊断支原体肺炎的呼吸道感染必须通过微生物学，得到微生物学结果的支持。尽管肺炎支原体的培养经过优化，但仍然不是检测临床标本中的敏感工具，而且费用比较昂贵，因此肺炎细菌培养很少作为临床诊断方法。临床上常用的诊断方法是血清学诊断方法，包括有冷凝集试验、被动颗粒凝集法、金标免疫斑点法、酶联免疫吸附试验（ELISA）等，其操作方便简单，但是血清学诊断需要对急性期和恢复期 2-4 周内的样本比较才能提供可靠地诊断依据，这样对于急性期的患儿不利于确定抗生素的选择。分子诊断方法 (PCR) 的应用在一定程度上可以在感染的急性期提供快速、敏感和特异的结果。但也有研究表明实时聚合酶链式反应并不是诊断症状性肺炎支原体感染的一种明确的方法，当聚合酶链式反应结果与血清学数据结合起来时，诊断的准确性并没有提高。在影像学检查中，肺炎支原体肺炎感染初期缺乏特异性的影像学诊断，单靠胸部X 线很难将肺炎支原体肺炎与其他病原菌肺炎相鉴别，然而胸部CT 检查与较普通胸片相比较可以提供更多有利于诊断的信息。研究表明，CT 值可以用来肺炎支原体肺炎是否并发了坏死性肺炎。但需要严格掌握肺 CT 的适应症以及禁忌症。参考资料 [1]孙美婷.肺炎支原体发病机制及诊治研究进展[J].现代诊断与治疗,2021,32(09):1370-1372. [2]郑肖肖,陈静.肺炎支原体肺炎的发病机制、诊疗的研究进展[J].世界最新医学信息文摘,2021,(第67期). [3]吴雪,陈晓.儿童难治性支原体肺炎发病机制及诊治进展[J].世界最新医学信息文摘(连续型电子期刊),2022,(第0期). 作者简介：小米虫，药品质量研究工作者，长期致力于药品质量研究及药品分析方法验证工作，现就职于国内某大型药物研发公司，从事药品检验分析及分析方法验证。【智药研习社近期课程预告】来源：CPHI制药在线声明：本文仅代表作者观点，并不代表制药在线立场。本网站内容仅出于传递更多信息之目的。如需转载，请务必注明文章来源和作者。投稿邮箱：Kelly.Xiao@imsinoexpo.com▼更多制药资讯，请关注CPHI制药在线▼点击阅读原文，进入智药研习社~

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