Background: To explore the profile and clinical significance of proinflammatory cytokines in serum and bronchoalveolar lavage fluid (BALF) of children with Mycoplasma pneumoniae pneumonia(MPP) and to elucidate the etiology and pathogenesis of severe MPP (SMPP). Methods: A cohort of 108 children with MPP was divided into SMPP (n=56) and non-severe MPP (NSMPP) (n=52). A total of 40 cases of hospitalized children, who underwent elective surgery, were selected as control group. The levels of proinflammatory cytokines in the serum and BALF were measured by ELISA(Enzyme-linked immunosorbent assay). Results: Compared to the control group, the MPP children showed that the levels of peripheral blood (PB) TNF-a, IFN-g, GM-CSF, IL-17, IL-18, IL-36a, sB7-H1, and sB7-H3 were much higher at the acute phase (P<0.05). Also, they were significantly higher in the SMPP group than that in the NSMPP group (P<0.05). Furthermore, in the SMPP group, the levels of TNF-a, IFN-g, GM-CSF, IL-1b, IL-2, IL-8, IL-36, MPO, MMP-9, NE, sB7-H3 in BALF were significantly higher at acute phase as compared to the control group (P<0.05). sB7-H3 was positively correlated with major proinflammatory cytokines in both PB and BALF specimens. The level of sB7-H3 in PB was >8000 pg/mL was an independent risk factor for SMPP. Conclusions: Excessive inflammation plays a critical role in the occurrence and development of MPP, especially SMPP, and sB7-H3 is an independent risk factor of SMPP.

Objective: To summarize the pathogens and clinical presentation of children with airway malacia complicated by pneumonia. Methods: Children hospitalized with airway malacia complicated by pneumonia were eligible for enrollment from January 1, 2013 to December 31, 2019. Medical records of patients were reviewed for etiology, clinical characteristics, and laboratory examination results.Results: A total of 164 pneumonia patients with airway malacia were admitted. The male-to-female ratio was 3:1. The age of patients ranged from 1 month to 4 years old. The median age was 6 (3–10) months. The most commonly detected pathogen were Mycoplasma pneumoniae (25/164, 15.24%), Streptococcus pneumoniae (18/164, 10.98%), and respiratory syncytial virus (16/164, 9.76%). Common signs among the 164 patients with confirmed airway malacia included cough (98.78%), wheezing (67.07%), fever (35.37%), intercostal retractions (23.17%), dyspnea (10.98%), cyanosis (11.11%), and crackles (50%). Compared with those without airway malacia, the incidence of premature delivery and mechanical ventilation was higher, and the duration of symptoms before admission (median, 13.5 d) and hospital stay (median 10.0 d) were longer. Of the children with pneumonia, 11.59% of those with airway malacia required supplemental oxygen compared with 4.88% of those without airway malacia (p<0.05).Conclusion: The median age of children with airway malacia was 6 months. The most common pathogen in patients with airway malacia complicated by pneumonia was Mycoplasma pneumoniae. Patients with airway malacia complicated by pneumonia often presented with a longer disease course, more severe symptoms, and had delayed recovery.

Objective To summarize the pathogens and clinical presentation of children with airway malacia complicated by pneumonia. Methods Children hospitalized with airway malacia complicated by pneumonia were eligible for enrollment from January 1, 2013 to December 31, 2019. Medical records of patients were reviewed for etiology, clinical characteristics, and laboratory examination results. Results A total of 164 pneumonia patients with airway malacia were admitted. The male-to-female ratio was 3:1. The age of patients ranged from 1 month to 4 years old. The median age was 6 (3–10) months. The most commonly detected pathogen were Mycoplasma pneumoniae (25/164, 15.24%), Streptococcus pneumoniae (18/164, 10.98%), and respiratory syncytial virus (16/164, 9.76%). Common signs among the 164 patients with confirmed airway malacia included cough (98.78%), wheezing (67.07%), fever (35.37%), intercostal retractions (23.17%), dyspnea (10.98%), cyanosis (11.11%), and crackles (50%). Compared with those without airway malacia, the incidence of premature delivery and mechanical ventilation was higher, and the duration of symptoms before admission (median, 13.5 d) and hospital stay (median 10.0 d) were longer. Of the children with pneumonia, 11.59% of those with airway malacia required supplemental oxygen compared with 4.88% of those without airway malacia (p < 0.05). Conclusion The median age of children with airway malacia was 6 months. The most common pathogen in patients with airway malacia complicated by pneumonia was Mycoplasma pneumoniae. Patients with airway malacia complicated by pneumonia often presented with a longer disease course, more severe symptoms, and had delayed recovery.

Background Symptomatic pulmonary involvement in systemic lupus erythematosus (SLE) is commonly reported in children. However, few studies have assessed risk factors that predict pulmonary involvement in SLE.Methods This was a seven-year retrospective study involving 111 SLE patients. The demographic, clinical and laboratory data of the patients were collected. Logistic regression analysis was performed to identify different clinical characteristics and laboratory parameters associated with presence of high resolution computerized tomography(HRCT) chest abnormalities.Results Of the 111 patients with SLE, we identified 18 patients (16.2%) with pulmonary involvement. The most common HRCT findings were ground glass opacity, interlobular septal thickening, bilateral diffuse infiltrates and pleurisy/pleural effusion (55.6%, 50%, 50%, and 44.4%, respectively). The variables independently associated with pulmonary involvement were anti- ribonucleoprotein (RNP) antibody (OR:7.9; 95% CI: 1.1–54.6) and anti-neutrophil cytoplasmic antibodies (ANCA, OR: 73.6; 95% CI: 2.9-1894.7).Conclusions Lung involvement was frequent in SLE patients from Southeast China. Anti-RNP antibody and ANCA were significantly associated with abnormal HRCT findings.