Respiratory Tract In Children Research Articles

Rational use of antibiotics for the management of children's respiratory tract infections in the ambulatory setting: an evidence-based consensus by the Italian Society of Preventive and Social Pediatrics

Several guidelines for the management of respiratory tract infections in children are available in Italy, as well as in other European countries and the United States of America. However, poor adherence to guidelines and the sustained inappropriate use of antibiotics have been reported. In the outpatient setting, almost half of antibiotics are prescribed for the treatment of common respiratory tract infections. In Italy the antibiotic prescription rate is significantly higher than in other European countries, such as Denmark or the Netherlands, and also the levels of antibiotic resistance for a large variety of bacteria are higher. Therefore, the Italian Society of Preventive and Social Paediatrics organised a consensus conference for the treatment of respiratory tract infections in children to produce a brief, easily readable, evidence-based document. The conference method was used, according to the National Institute of Health and the National Plan Guidelines. A literature search was performed focusing on the current guidelines for the treatment of airway infections in children aged 1 month-18 years in the ambulatory setting. Recommendations for the treatment of acute pharyngitis, acute otitis media, sinusitis, and pneumonia have been summarized. Conditions for which antibiotic treatment should not be routinely prescribed have been highlighted. This evidence-based document is intended to accessible to primary care pediatricians and general practice physicians in order to make clinical practice uniform, in accordance with the recommendations of the current guidelines.

CARBOCYSTEINE LYSINE SALT MONOHYDRATE IN TREATMENT OF DISEASES OF LOWER RESPIRATORY TRACT IN CHILDREN

Inflammatory diseases of the respiratory tract are characterized by changes in rheological properties of the phlegm and lower of the mucociliary clearance. Adjustment of mucoregulatory agents is of a special significance in treatment of diseases of the lower respiratory tract in children. Aim: to assess efficacy of carbocysteine lysine salt monohydrate as a mucokinetic agent in children with respiratory tract diseases. Patients and methods : 65 children (31 girls and 34 boys) aged from 5 to 16 years old with acute respiratory tract diseases received treatment in Belgorod pediatric out-patient clinic № 4 were included into the study. The results of the clinical follow-up of these children are shown in the article. Results : carbocysteine lysine salt monohydrate was found to be effective and safe in treatment of acute and chronic inflammatory diseases of the respiratory tract in children. The authors observed quicker convalescence of the patients and possibility of combination of this drug with other medicines used in pediatric practice. Conclusions : the above-mentioned drug when used in combination with antibacterial agents intensifies penetration of the latter into the bronchial secretion and bronchial mucous membrane thereby increasing their efficacy. The drug does not have toxicity, is well-tolerated even when prolonged using and can be recommended for treatment of cough in children both under out- and in-patients conditions. Keywords : children, respiratory tract diseases, carbocysteine.

Theoretical deposition of nanotubes in the respiratory tract of children and adults.

Nanotubes are assumed to contribute to a significant exacerbation of asthma and to enhance the risk of profibrotic effects in lungs being affected by this injury. Therefore, deposition of nanotubes in the lungs of subjects with different ages was subject to a detailed theoretical investigation. Nanoparticle deposition was computed by application of well validated stochastic deposition model, including four main deposition forces (Brownian diffusion, inertial impaction, interception, gravitational settling). Nonspherical particle geometry was considered with the help of the aerodynamic diameter concept. Deposition was calculated for particles with diameters adopting values of 1, 10, and 100 nm as well as aspect ratios of 10, 50, and 100. Lungs of subjects with different ages were generated with the help of scaling factors and allometric functions. Inhalation was uniformly supposed to take place under non-strain conditions (sitting breathing conditions). Total deposition of nanotubes is significantly increased with proceeding age, with deposition probability being negatively correlated with particle size (diameter and aspect ratio). Whilst extrathoracic deposition is subject to a slight decrease from infants to adults, bronchial/bronchiolar and alveolar depositions are exponentially increased. Due to an increase of nanotube deposition with proceeding age infants and children enjoy a certain protection from excessive particle exposure. This circumstance mostly reprieves their lungs from injuries induced by this sort of particles.

Internalization and Trafficking of Nontypeable Haemophilus influenzae in Human Respiratory Epithelial Cells and Roles of IgA1 Proteases for Optimal Invasion and Persistence

Nontypeable Haemophilus influenzae (NTHI) is a leading cause of opportunistic infections of the respiratory tract in children and adults. Although considered an extracellular pathogen, NTHI has been observed repeatedly within and between cells of the human respiratory tract, and these observations have been correlated to symptomatic infection. These findings are intriguing in light of the knowledge that NTHI persists in the respiratory tract despite antibiotic therapy and the development of bactericidal antibodies. We hypothesized that intracellular NTHI avoids, escapes, or neutralizes the endolysosomal pathway and persists within human respiratory epithelial cells and that human IgA1 proteases are required for optimal internalization and persistence of NTHI. Virtually all strains encode a human IgA1 protease gene, igaA, and we previously characterized a novel human IgA1 protease gene, igaB, that is associated with disease-causing strains and is homologous to the IgA1 protease that is unique to pathogenic Neisseria spp. Here, we show that NTHI invades human bronchial epithelial cells in vitro in a lipid raft-independent manner, is subsequently trafficked via the endolysosomal pathway, and is killed in lysosomes after variable durations of persistence. IgaA is required for optimal invasion. IgaB appears to play little or no role in adherence or invasion but is required for optimal intracellular persistence of NTHI. IgaB cleaves lysosome-associated membrane protein 1 (LAMP1) at pHs characteristic of the plasma membrane, early endosome, late endosome, and lysosome. However, neither IgA1 protease inhibits acidification of intracellular vesicles containing NTHI. NTHI IgA1 proteases play important but different roles in NTHI invasion and trafficking in respiratory epithelial cells.

Bronchial foreign body misdiagnosed as pulmonary tuberculosis

Retained and neglected foreign bodies in the respiratory tract in children are a common occurrence. Undiagnosed foreign bodies can cause mechanical effects or chemical reactions and may present as chronic pulmonary infection, bronchiectasis, asthma, and lung collapse or lung abscess. Delay in diagnosis, appears to result from a failure to give serious consideration to the diagnosis, normal chest roentgenographic findings, and negative bronchoscopic findings. A case of left bronchial foreign body aspiration is herein reported to illustrate the causes and complications of the delayed diagnosis. It is hoped that this will help sensitize the medical practitioner of the need for a high index of suspicion in children presenting with symptoms suggestive of foreign body aspiration. This study will also serve as advocacy for the provision of adequate bronchoscopic equipments for paediatric practice in our health facilities.

INFANT ASTHMA: KEY PRINCIPLES OF CONTROL ATTAINMENT IN THE MODERN STAGE

The article is dedicated to the issue of bronchial asthma in children. Immaturity of respiratory and immune systems, peculiarities of the disease course, difficulty in establishing diagnosis and selecting delivery devices for drugs and a limited amount of evidence-based recommendations determine the current situation: only few guides touch upon the subject of infant asthma management. Although asthma is the most widespread disease of lower respiratory tract in children, a significant number of patients do not receive adequate treatment, which is why they cannot control asthma. The authors of this article analyzed the most up-to-date documents (ICON, GINA, PRACTALL, NAEPP, SIGN) that touch upon this subject and briefly stated the key principles of attaining control over this nosology in order to increase availability, spread and introduction of standard therapy of infant asthma.

Affinity-Purified Respiratory Syncytial Virus Antibodies from Intravenous Immunoglobulin Exert Potent Antibody-Dependent Cellular Cytotoxicity

Mixed infections are one of the major therapeutic challenges, as the current strategies have had limited success. One of the most common and widespread conditions of mixed infection is respiratory syncytial virus-mediated pathology of the respiratory tract in children. There is a dire need for the development of novel therapeutic approaches during mixed infections. Therapeutic intravenous immunoglobulin preparations, obtained from plasma pools of healthy donors have been used in immune deficiencies. This study was thus designed to characterize the functional efficacy of RSV-specific antibodies in IVIg. To explore the functional ability of these affinity-purified RSV-specific antibodies, the antibody-dependent and complement dependent cytotoxicity was determined using peripheral cells of healthy donors. This study demonstrates the existence of highly potent RSV-specific antibodies in IVIg preparations and provides the basis for the use of IVIg as broad-spectrum protective shield to RSV-infected children during mixed infections.

Współwystępowanie objawów z układu pokarmowego i oddechowego u dzieci z chorobą refluksową przełyku na podstawie obserwacji własnych

IntroductionGastroesophageal reflux disease (GERD) often occurs in children and characterizes with diverse clinical symptomatology. In small children symptoms mostly occur in digestive tract, but they can also occur as different symptoms in respiratory tract. AimThe evaluation of frequency and types of clinical symptoms from digestive and respiratory tract in children up to 3 years of age with suspicion of GERD. Material and methodsThe study included 285 children (age: 6–36 months) with suspicion of GERD. In every child medical investigation was carried out according to a designed questionnaire, which included the symptoms from digestive and respiratory tract. All children underwent 24-hour esophageal pH monitoring. The results were statistically elaborated. ResultsThe that pathological gastroesophageal reflux was detected in 90 patients (31.6%). Among these children, isolated symptoms from respiratory tract were observed in 21.1% while from digestive tract in 30.0% of patients. Symptoms from both systems were more often observed in children with reflux disease (48.9%). The reflux index value in children with GERD showed its highest intensity in patients presenting symptoms from both systems. Conclusions1. Diagnose of GERD in about 1/3 of patients shows the need for its confirmation with pH monitoring before application of anti-reflux therapy. 2. The conducted study showed common coexistence of symptoms from digestive and respiratory tract in children with GERD. 3. The occurrence of symptoms from both systems in children with GERD indicates significantly higher intensity of reflux in pH monitoring record.

The peculiarities of food allergies in accordance with the level of injury of respiratory tract in children of Eastern Siberia

AimTo determine the course of food allergy in accordance with the level of respiratory tract injury in children of Eastern Siberia.Design of the researchWe have examined 70 children aged 2–16, who have food sensibilization. We divided them into 2 groups: group I (n=32) with diseases of the upper and middle respiratory tract; and group II (n=38) with diseases of the lower respiratory tract.MethodsAllergological medical history, clinical laboratory examination and immunological examination, including the determination of IgA, IgM, IgG and IgE in blood serum. In cases where causal allergens were found, elimination diets were recommended.ResultsOnset of upper respiratory tract injury in group I was more often registered in children aged 0–1; in group II, it was in the 3–7 age group. Isolated food sensibilization was more often marked in group I as compared to group II. Atopic mechanisms of respiratory tract injuries were more often registered in group II children. In the course of the elimination diet, we marked positive dynamics in 100% of group I and in 75% of group II.ConclusionThe most frequent allergens that cause respiratory forms of food allergy are hen eggs, cow milk, nutritive cereals, vegetables and fruit. Indices of a humoral link of immunity in the examined patients were more often registered as normal or their level is increased. Timely etiotropic therapy in the majority of cases allows for a stabilization of allergic inflammation.

Clinical and radiological characteristics of unrecognized foreign body aspiration into respiratory tract in children

Diagnosing of foreign body aspiration in children is often postponed. The aim of this study was to evaluate complications, clinical signs and radiological presentation of respiratory illness arising from unrecognized foreign body aspiration in pediatric population. The study sample consisted of 33 patients aged from one to 18 years who had undergone bronchoscopy for foreign body removal over the 10 years' period (from 2000 to 2010). Neither their parents nor the pediatricians who had treated these patients before admission to hospital recognized the acute aspiration event. All the children were treated unsuccessfully for a period exceeding 10 days. The retrospective analysis included the history of foreign body aspiration, patients' age, kind of aspirated foreign body, clinical manifestations that led to hospitalization, radiographic findings and the time lapse from the first symptoms to diagnosis proven by endoscopic intervention. The majority of the foreign bodies were organic (93.93%). Broncho-obstructive syndrome, which was the most frequent clinical presentation, was found in 18 (54.55%) patients; pneumonia was diagnosed in 10 (30.30%) patients, four children were referred to hospital due to infiltrative changes with acute broncho-obstructive syndrome and only one child (3.03%) had persistent productive cough. Radiological findings (chest X-rays) were pathological in all patients. Rigid bronchoscopy was performed in 16 (48.49%) patients 10 days after presenting the first symptoms of respiratory illness, in 6 (18.18%) patients within 10-21 days' period and in 11 (33.33%) patients 3 weeks after the first respiratory symptom. Unrecognized foreign body aspiration results in various clinical manifestations and non-responsiveness to the standard therapy applied.

Clinical-immunological assessment of therapy effect of the neuro-sensory-motor integration program of reflex patterns in airway chronic inflammatory diseases

Event Abstract Back to Event Clinical-immunological assessment of therapy effect of the neuro-sensory-motor integration program of reflex patterns in airway chronic inflammatory diseases Svetlana K. Masgutova1, Nelly K. Akhmatova2 and Olga V. Lebedinskaya3* 1 Educational Institute for Neuro-Sensory-Motor and Reflex Integration, United States 2 I.I. Mechnikov Research Institute for Vaccines and Sera,, Russia 3 Acad. E.A. Wagner Perm State Medical Academy, Russia Airway chronic inflammatory diseases and recurrent exacerbations are mainly caused by damage of immune regulation mechanisms. Treatment of chronic inflammatory diseases of respiratory tract in children and adults was carried out by combining complimentary therapy using the method of neuro-sensory-motor reflex patterns integration (NRI), which works with primary motor system activation and conventional treatment; the parameters of the immune status and the cortisol level in children suffering from of a recurrent obstructive bronchitis are studied, as well as the assessment of therapy efficiency based on NRI method is done. It is established that combining the therapy using primary motor system/reflex integration with the conventional treatment allows correcting the immune system mechanisms’ damage to a certain extent mainly to normalize the amount of Т lymphocytes (CD3, CD4, CD8) and NK-cells, metabolic function of leukocytes, the level of regulatory and anti-inflammatory cytokines. The therapy based on neuro-sensory-motor reflex patterns integration (NRI) improves the effect of standard therapy on immune system cells and strengthens the polarization of immune response to Th-1 type. It decreases the frequency of airway viral inflammatory diseases, leads to positive dynamics of chronic respiratory diseases and prolongs their remission. Keywords: Airway chronic inflammatory diseases, damage of immune regulation, neuro-sensory-motor reflex patterns integration, chronic respiratory diseases, remission Conference: 15th International Congress of Immunology (ICI), Milan, Italy, 22 Aug - 27 Aug, 2013. Presentation Type: Abstract Topic: Immune-mediated disease pathogenesis Citation: Masgutova SK, Akhmatova NK and Lebedinskaya OV (2013). Clinical-immunological assessment of therapy effect of the neuro-sensory-motor integration program of reflex patterns in airway chronic inflammatory diseases. Front. Immunol. Conference Abstract: 15th International Congress of Immunology (ICI). doi: 10.3389/conf.fimmu.2013.02.00865 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 20 Jun 2013; Published Online: 22 Aug 2013. * Correspondence: Ms. Olga V Lebedinskaya, Acad. E.A. Wagner Perm State Medical Academy, Perm, Russia, lebedinska@mail.ru Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Svetlana K Masgutova Nelly K Akhmatova Olga V Lebedinskaya Google Svetlana K Masgutova Nelly K Akhmatova Olga V Lebedinskaya Google Scholar Svetlana K Masgutova Nelly K Akhmatova Olga V Lebedinskaya PubMed Svetlana K Masgutova Nelly K Akhmatova Olga V Lebedinskaya Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Detecting human adenoviruses in respiratory samples collected from children with acute respiratory infections by loop-mediated isothermal amplification

To establish a rapid and reliable loop-mediated isothermal amplification (LAMP) method for detecting adenoviruses (ADV)in respiratory samples collected from children with acute respiratory infections. According to the sequences of hexon genes of common adenovirus serotypes (Ad3, Ad7, and Ad14) downloaded from GenBank, primers were designed and LAMP method for detecting adenovirus DNA was developed. Sensitivity of the LAMP method was evaluated by using constructed recombinant plasmid DNA with gene fragment from hexon of ADV3, and specificity was tested through cross-reaction with other viruses. Then 11 ADV strains isolated from clinical specimens using tissue cultures were tested by LAMP method. A total of 108 nasopharyngeal aspirates from hospitalized patients with acute respiratory infections which had been tested by direct immunofluorescence assay (DFA), including 36 for ADV positive and 72 for ADV negative, were tested by both LAMP method and multiplex nested PCR. Analysis for sensitivity indicated that this LAMP method can detect 1.9×10(2)copies/ml of DNA, and no amplification was shown in DNA or cDNA of other viruses, which revealed that the specificity of the LAMP method is high. For 108 specimens which had been tested by DFA, 34 out of the 36 ADV positive specimens showed positive signal within 90 minutes using LAMP. Five out of 72 negative specimens by DFA were positive using LAMP; 39 out of the 41 ADV positive specimens by multiplex nested PCR showed positive signal using LAMP, including 19 for Ad3 and 20 for Ad7; 67 negative specimens confirmed by multiplex nested PCR showed negative signal using LAMP. The total consistency rate of DFA and LAMP method for detecting ADV was 93.5%, and the total coincidence rate of multiplex nested PCR and LAMP method for detecting ADV was 98.1%. A new, sensitive, accurate and rapid method for detecting human adenovirus from nasopharyngeal aspirates by LAMP was developed, which should be a potential method for rapid detection of ADV from respiratory tract of children in clinical diagnosis of ADV infection.

Can the Pelargonium sidoides root extract EPs® 7630 prevent asthma attacks during viral infections of the upper respiratory tract in children?

IntroductionAsthma is a chronic disease characterized by airway inflammation. Viral infection initiates an immune inflammatory response that may produce asthma attacks. There is no effective preventing therapy for asthma attack during upper respiratory tract viral infections. ObjectiveTo investigate the efficacy of 5 days of Pelargonium sidoides therapy for preventing asthma attack during upper respiratory tract viral infections. MethodsSixty one asthmatic children with upper respiratory tract viral infection were enrolled in the study. The patients were randomized to receive Pelargonium sidoides daily for 5 days (n=30) or not (n=31). Before and after treatment, they all were examined and symptom scores were determined. Following five days treatment, children were evaluated whether or not they had an asthma attack. ResultsTreatment with Pelargonium sidoides was not associated with a statistically significant differences in fever and muscle aches (p>0.05, Chi-square test). There were significant differences in cough frequency and nasal congestion between the groups (p<0.05, Chi-square test). There were statistically significant differences in having asthma attack between the groups (p<0.05, Chi-square). Pelargonium sidoides group had less frequency of asthma attack. DiscussionOur study shows that Pelargonium sidoides may prevent asthma attacks during upper respiratory tract viral infections.

Zapalenia górnych dróg oddechowych u dzieci – leczenie immunostymulujące

This paper is a review of publications about viral infections of the upper respiratory tract in children with regard to recurring infections which can be consequence of a lack of treatment, inappropriate therapy or accompanying diseases. Perhaps an impaired condition of immunity may lead to recurring infections. In this review a great deal of attention has been given to the mechanisms and the varies stages of viral infection and the onset of an organism's defence mechanisms against viruses. The below function of the immunomodulatory and immunostimulatory medicinal product, namely inosine pranobex has been described in in vitro and in vivo studies. A review has been presented of the antiviral activity of inosine pranobex and the onset of cellular and humoral immunity.

PREVALENCE OF RESPIRATORY CHLAMYDIOSIS IN CHILDREN,ATTENDING KINDERGARTENS

The article represents the data on the prevalence of Chlamydia contamination of upper respiratory tract inchildren, who attend kindergartens. The authors show species composition of identified Chlamydiae structuredby gender and their predominance in children with respiratory chlamydiosis in acute and chronic pathology ascompared to non-contaminated children. The obtained results are based on examination of 121 children. Chla-mydiae diagnosis was carried out by implementing direct immune fluorescence.

Psychogenic and functional disorders of the respiratory tract in children and adolescents – a pilot study

Psychogenic and functional disorders of the respiratory tract in children and adolescents – a pilot study

Host range of Canine minute virus in cell culture

Canine minute virus (CnMV) is a member of the Bocavirus genus, together with Bovine parvovirus (BPV), which emerged as a new pathogen of dogs in 1967. The genus Bocavirus gained more recognition after the recent identification of Human bocavirus in pooled specimens from the respiratory tract of children. The cell culture host range of CnMV appears to be restricted to the Walter Reed canine cell (WRCC) line, although there is a report that indicates susceptibility of the Madin-Darby canine kidney (MDCK) cell line. In order to study the susceptibility of different cell lines to CnMV, the replication in cell cultures of canine, bovine, and human origin and the interaction of the virus with freshly isolated canine peripheral blood mononuclear cells were evaluated. The in vitro host range was unexpectedly wide. As shown by indirect fluorescent antibody and polymerase chain reaction assays, CnMV replicates efficiently in the A72 and MDCK canine cell lines. Bovine and human cell lines support the replication of CnMV less efficiently. In contrast, canine mononuclear blood cells are permissive to replication of CnMV in vitro. The present study revealed the ability of CnMV to replicate in continuous cell lines of different origin and, partially, in canine mononuclear cells.

Streptococcus pyogenes upper respiratory infection and atopic conditions other than asthma: a retrospective cohort study.

Patients with asthma have an increased risk of Streptococcus pyogenes infection compared with those without asthma. It is unknown whether this is true for children with other atopic conditions such as atopic dermatitis or allergic rhinitis. To determine the risk of developing S. pyogenes infections of the upper respiratory tract in children and adolescents with atopic dermatitis and/or allergic rhinitis. We conducted a retrospective cohort study that followed a convenience sample of 340 healthy children. Atopic dermatitis or eczema and allergic rhinitis or hay fever were determined based on a physician diagnosis documented in medical records. All laboratory test results of cultures, rapid antigen detection, and polymerase chain reaction tests for S. pyogenes infections during the first 18 years of life were collected to compare the incidence of S. pyogenes infections between children with and without a physician diagnosis of atopic conditions. A Poisson regression was fit to determine the association between asthma and S. pyogenes infections, controlling for other covariates including asthma. Of the 340 subjects, 327 were eligible for the study. Of these 327 subjects, 143 (44%) had atopic conditions other than asthma. The incidence of S. pyogenes infections in children with atopic conditions other than asthma and those without atopic conditions was 0.24 per person-year and 0.18 per person-year, respectively. The adjusted risk ratios for allergic rhinitis and atopic dermatitis were 1.36 (95% CI 1.07 to 1.66, p=0.011) and 1.30 (95% CI 0.98 to 1.71, p=0.06), respectively, controlling for asthma and other covariates. In addition to asthma, allergic rhinitis but not atopic dermatitis is associated with an increased risk of S. pyogenes upper respiratory tract infections.

Antiviral Effect of Cimicifugin from Cimicifuga foetida Against Human Respiratory Syncytial Virus

Human respiratory syncytial virus (RSV) causes serious infection of the lower respiratory tract in children and an effective antiviral therapy against the viral pathogen remains unavailable. We previously demonstrated that the oriental medicinal plant, Cimicifuga foetida L. (C. foetida), possessed inhibitory activity against RSV. Since cimicifugin is a major constituent of C. foetida, we sought to examine in this study its anti-RSV effect on both the human upper (HEp-2) and lower (A549) respiratory tract cell lines. Results revealed that cimicifugin dose-dependently inhibited RSV-induced plaque formation in both HEp-2 and A549 cells (p < 0.0001), with a superior effect in the latter cell type (p < 0.0001). The antiviral activity of cimicifugin was time-dependent (p < 0.0001) and was most effective when cells were treated with the compound before viral inoculation. Additional experiments demonstrated that cimicifugin could inhibit viral attachment (p < 0.0001) and viral internalization (p < 0.0001). Furthermore, the drug could potentiate heparin's effect against attachment of RSV, particularly in A549 cells. Enzyme-linked immunosorbent assay (ELISA) analysis of antiviral cytokines induction revealed that cimicifugin could also stimulate epithelial cells to secrete IFN-β to counteract viral infection. Taken together, these results indicate that cimicifugin is an efficient antiviral agent against RSV infection. We suggest that cimicifugin might be useful for the management of RSV pathogenesis.

Clinical Investigation of Application of Sevoflurane and Muscle Relaxant to Foreign Body Extraction in Respiratory Tract of Children

Objective: To compare the advantages and disadvantages of anesthesia by Cisatracurium, small dose Cisatracurium, sevoflurane and smaller dose Cisatracurium in the anesthesia of tracheobronchial foreign body extraction in children.Methods: Sixty children aged from 5 months to 7 years who were performed tracheobronchial foreign body extraction were randomly allocated to three groups: group C1 (Cisatracurium 0.1mg/kg), group C2 (Cisatracurium 0.08mg/kg), group C3 (sevoflurane + Cisatracurium 0.06 mg/kg). The time of operation and recovery, the number of body movement or breathe action 3 min after administration, the adverse reaction of airway (such as bucking, breath holding, laryngismus) were recorded.Results: There is no significant difference of the operation time between the three groups, the time of recovery : C1>C2>C3, the patients of group C1,group C2 were well relaxant after administration, but there are 30% patients still had body movement or breathe action after administration. There is no adverse reaction in the three groups.Conclusions: The application of sevoflurane and Cisatracurium in tracheobronchial foreign body extraction in children is safe.